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酒精依赖患者下丘脑-垂体-甲状腺轴与酒精渴望之间的关系:一项纵向研究。

Relationship between the hypothalamic-pituitary-thyroid axis and alcohol craving in alcohol-dependent patients: a longitudinal study.

作者信息

Leggio Lorenzo, Ferrulli Anna, Cardone Silvia, Malandrino Noemi, Mirijello Antonio, D'Angelo Cristina, Vonghia Luisa, Miceli Antonio, Capristo Esmeralda, Kenna George A, Gasbarrini Giovanni, Swift Robert M, Addolorato Giovanni

机构信息

Institute of Internal Medicine, Catholic University of Rome, Rome, Italy.

出版信息

Alcohol Clin Exp Res. 2008 Dec;32(12):2047-53. doi: 10.1111/j.1530-0277.2008.00792.x. Epub 2008 Sep 25.

Abstract

BACKGROUND

A relationship between some hypothalamic-pituitary-related hormones and craving for alcohol has been suggested, leading to hypothesize a role of some hormones in the neurobiology of alcohol dependence. Investigating this association in alcohol-dependent (AD) patients was the aim of this preliminary and exploratory study.

METHODS

Cortisol, adrenocorticotropic hormone, prolactin, thyroid-stimulating hormone (TSH), free T3, free T4, growth hormone, follicle-stimulating hormone, luteinizing hormone as well as administering the Obsessive-Compulsive Drinking Scale (OCDS) and Penn Alcohol Craving Scale (PACS) were assessed at baseline and after 12 weeks in 25 current AD patients. Patients were treated with baclofen (10 mg t.i.d.) for these 12 weeks. Sixteen patients remained totally abstinent for 12 weeks.

RESULTS

At baseline, a significant inverse correlation was found between TSH and PACS (r = -0.46; p = 0.022) and OCDS scores (r = -0.53; p = 0.007). A significant direct correlation was found between free T3 and OCDS score (r = 0.44; p = 0.026). In the 16 abstinent patients, craving scores were significantly decreased at 12 weeks (p < 0.01). At 12 weeks, no significant correlation was found between TSH and craving, but free T3 remained directly correlated with OCDS score (r = 0.60; p = 0.013).

CONCLUSIONS

A relationship between alcohol craving and free T3 and TSH was demonstrated in AD patients, suggesting the potential involvement of the hypothalamic-pituitary-thyroid axis in the neurobiology of alcohol craving.

摘要

背景

已有研究表明某些下丘脑 - 垂体相关激素与酒精渴望之间存在关联,这促使人们推测某些激素在酒精依赖神经生物学中发挥作用。本初步探索性研究旨在调查酒精依赖(AD)患者中的这种关联。

方法

对25例现患AD患者在基线时及12周后评估皮质醇、促肾上腺皮质激素、催乳素、促甲状腺激素(TSH)、游离T3、游离T4、生长激素、促卵泡激素、黄体生成素,并使用强迫性饮酒量表(OCDS)和宾夕法尼亚酒精渴望量表(PACS)进行评估。患者在这12周内接受巴氯芬(10毫克,每日三次)治疗。16例患者在12周内完全戒酒。

结果

在基线时,发现TSH与PACS(r = -0.46;p = 0.022)及OCDS评分(r = -0.53;p = 0.007)之间存在显著负相关。发现游离T3与OCDS评分之间存在显著正相关(r = 0.44;p = 0.026)。在16例戒酒患者中,12周时渴望评分显著降低(p < 0.01)。在12周时,未发现TSH与渴望之间存在显著相关性,但游离T3仍与OCDS评分直接相关(r = 0.60;p = 0.013)。

结论

在AD患者中证实了酒精渴望与游离T3和TSH之间的关系,提示下丘脑 - 垂体 - 甲状腺轴可能参与酒精渴望的神经生物学过程。

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