EtOH treatment leads to osteogenic differentiation reduction and osteopenia. (a) Body weight of mice for 22 weeks. (b) The serum alcohol concentration of the mice in the EtOH-treated group was twice as much as the control group when sacrificed. (c) The level of BALP in serum was decreased. (d, e) DXA analysis of mouse bilateral femurs (e) showed that chronic alcohol consumption significantly reduced the BMD of mice (d). (f, g) Micro-CT analysis of trabecular revealed that BMD, BV/TV, Tb.Th, Tb.N, and Ct.Th were markedly decreased in EtOH-treated mouse distal femurs and with the increase of Tb.Sp. (h, i) Histomorphometric analysis revealed that the distal trabecular bone structure was disordered and loose, the numbers of trabecular bone (h, yellow rectangle area), the ratio of OS/BS (h, two yellow dotted lines), and Ob.S/BS were significantly decreased, and the ratio of ES/BS (h, two green dotted lines) was increased compared to untreated mice (i). Bar: 100 μm. (j–n) Both mRNA and protein levels of Runx2 in mouse bone tissue were significantly decreased that evaluated by immunofluorescent staining (j, k; bar: 100 μm), western bolt analysis (l, m), and RT-PCR (n). All experimental data were verified in at least three independent experiments. Error bars represent the SD from the mean values. ∗p < 0.05. EtOH: ethyl alcohol; BALP: bone alkaline phosphatase; DXA: dual-energy X-ray absorptiometry; micro-CT: micro-computed tomography assay; BMD: bone mineral density; BV/TV: bone volume/total volume; Tb.Th: trabecular thickness; Tb.N: trabecular number; Ct.Th: cortical thickness; Tb.Sp: trabecular separation; OS: osteoid surface; ES: eroded surface; OS/BS: osteoid surface to bone surface; Ob.S/BS: osteoblast surface to bone surface; ES/BS: eroded surface to bone surface; Runx2: runt-related transcription factor 2.