Fonzi S, Murialdo G, Bo P, Filippi U, Costelli P, Parodi C, Maurelli M, Polleri A, Savoldi F
Dipartimento di Scienze Endocrinologiche e Metaboliche, Università degli Studi di Genova.
Ann Ital Med Int. 1992 Apr-Jun;7(2):87-94.
Neuroendocrine dysfunctions, in part similar to those found in depression, are present in chronic alcoholism. The aim of this investigation was to evaluate the effects of chronic alcohol intake on cortisol secretion in basal conditions, after dexamethasone (DXT) suppression or corticotropin (ACTH) stimulation in 10 alcoholic men, during active drinking and after two weeks of alcohol withdrawal. The 24-hour, day- and night-time urinary cortisol and melatonin levels, and the effects of thyrotropin releasing hormone (TRH) on thyrotropin (TSH) and prolactin (PRL) secretions were studied in the same subjects. The data were correlated to the scores obtained by the Hamilton Rating Scale for depression and compared to those found in healthy subjects. Increased cortisol levels and the lack of DXT suppression of cortisol secretion are considered to be alcohol-dependent inasmuch as they disappear in most patients after alcohol withdrawal. The cortisol response to ACTH 1-24 infusion measured before and after alcohol withdrawal was similar in the patients we studied; moreover no significant difference was found between patients and controls. The increment of urine free cortisol levels in active alcoholics was not statistically significant. Urine cortisol levels became similar to those of the control subjects after alcohol withdrawal. The increased diurnal values of urine melatonin and the inversion of the physiological ratio between nocturnal and diurnal levels observed during alcohol intake became normal upon alcohol withdrawal. The TSH and PRL responses after the administration of 50 or 200 micrograms TRH were higher in alcoholics than in controls, while a blunted response is known to occur in depression.
神经内分泌功能障碍在慢性酒精中毒中存在，部分与抑郁症中发现的功能障碍相似。本研究的目的是评估10名男性酒精依赖者在饮酒期及戒酒两周后，长期饮酒对基础状态下、地塞米松（DXT）抑制或促肾上腺皮质激素（ACTH）刺激后皮质醇分泌的影响。在同一批受试者中研究了24小时、白天和夜间尿皮质醇和褪黑素水平，以及促甲状腺激素释放激素（TRH）对促甲状腺激素（TSH）和催乳素（PRL）分泌的影响。将这些数据与汉密尔顿抑郁量表评分进行关联，并与健康受试者的数据进行比较。皮质醇水平升高以及皮质醇分泌缺乏DXT抑制被认为与酒精依赖有关，因为在大多数患者戒酒之后这些情况会消失。我们研究的患者在戒酒前后测量的ACTH 1-24输注后皮质醇反应相似；此外，患者与对照组之间未发现显著差异。活跃期酒精依赖者尿游离皮质醇水平的升高无统计学意义。戒酒之后尿皮质醇水平与对照组相似。饮酒期间观察到的尿褪黑素日间值升高以及夜间与日间水平的生理比例倒置在戒酒时恢复正常。给予50或200微克TRH后，酒精依赖者的TSH和PRL反应高于对照组，而抑郁症患者会出现反应迟钝。
