Leggio Lorenzo, Ferrulli Anna, Malandrino Noemi, Miceli Antonio, Capristo Esmeralda, Gasbarrini Giovanni, Addolorato Giovanni
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy.
Alcohol Clin Exp Res. 2008 Mar;32(3):450-8. doi: 10.1111/j.1530-0277.2007.00589.x. Epub 2008 Jan 22.
Preclinical data suggest that brain insulin and insulin growth factor-1 (IGF-1) may contribute to the development of addiction. The aim of this clinical study was to evaluate the relationships between insulin and IGF-1 plasma concentrations and alcohol craving.
The correlations between insulin and craving in actively drinking alcoholics were evaluated in the experiment 1 retrospectively and in the experiment 2 in a case-control study. Experiment 3 evaluated the correlations between insulin and craving in 12-weeks abstinent alcoholics in a longitudinal study. C-peptide and IGF-1 were also investigated in experiments 2-3. Alcohol craving was evaluated by the Obsessive-Compulsive Drinking Scale (OCDS).
Significant positive correlations between insulin concentrations and craving scores were found in actively drinkers (p < 0.05). Specifically, in the first experiment insulin significantly correlated with the compulsive scores. In the second experiment and in an analysis of experiments 1-2 together, insulin plasma concentration correlated with total OCDS craving (p < 0.05) and compulsive craving (p < 0.05) and showed a trend of correlation with the obsessive craving. At 12 weeks no correlation was found between insulin and craving scores. In all the experiments the correlations between C-peptide and craving were close to the ones between insulin and craving while IGF-1 never correlated with craving.
This study suggests that insulin could be involved in the neurobiology of alcohol craving and addiction. This characteristic seems specific of insulin since similar data were found on C-peptide but not on IGF-1. Future confirming studies on larger samples are needed, also to investigate possible therapeutic implications.
临床前数据表明,脑胰岛素和胰岛素样生长因子-1(IGF-1)可能与成瘾的发展有关。本临床研究的目的是评估胰岛素和IGF-1血浆浓度与酒精渴望之间的关系。
在实验1中对正在饮酒的酗酒者胰岛素与渴望之间的相关性进行回顾性评估,在实验2中进行病例对照研究。实验3在一项纵向研究中评估了戒酒12周的酗酒者胰岛素与渴望之间的相关性。在实验2至3中还对C肽和IGF-1进行了研究。通过强迫性饮酒量表(OCDS)评估酒精渴望。
在正在饮酒者中发现胰岛素浓度与渴望得分之间存在显著正相关(p < 0.05)。具体而言,在第一个实验中,胰岛素与强迫得分显著相关。在第二个实验以及对实验1和2的综合分析中,胰岛素血浆浓度与OCDS总渴望得分(p < 0.05)和强迫性渴望得分(p < 0.05)相关,并与强迫性渴望呈相关趋势。在12周时,未发现胰岛素与渴望得分之间存在相关性。在所有实验中,C肽与渴望之间的相关性与胰岛素和渴望之间的相关性相近,而IGF-1与渴望从未相关。
本研究表明,胰岛素可能参与了酒精渴望和成瘾的神经生物学过程。这一特征似乎是胰岛素所特有的,因为在C肽上发现了类似的数据,但在IGF-1上未发现。未来需要对更大样本进行进一步的验证研究,以探讨可能的治疗意义。