Aoun Elie G, Lee Mary R, Haass-Koffler Carolina L, Swift Robert M, Addolorato Giovanni, Kenna George A, Leggio Lorenzo
Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, USA.
Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
Alcohol Alcohol. 2015 Jan;50(1):24-9. doi: 10.1093/alcalc/agu085. Epub 2014 Nov 28.
A few studies have suggested a relationship between thyroid hormones and alcohol dependence (AD) such as a blunted increase of thyroid stimulating hormone (TSH) in response to thyrotropin-releasing hormone (TRH), lower levels of circulating free triiodothyronine (fT3) and free thyroxine (fT4) levels and down regulation of the TRH receptors. The current study aimed to explore the relationship between the hormones of the thyroid axis and alcohol-seeking behaviors in a sample of alcohol-dependent patients.
Forty-two treatment-seeking alcohol-dependent individuals enrolled in a 12-week treatment study were considered. The Timeline Follow Back (TLFB) was used to assess the number of drinks consumed during the 12-week period. Blood levels of thyroid hormones (TSH, fT3 and fT4) were measured prior to and at the end of treatment. Questionnaires were administered to evaluate craving for alcohol [Penn Alcohol Craving Scale (PACS) and the Obsessive Compulsive Drinking Scale (OCDS) and its two subscales ODS for obsessions and CDS for compulsions] as well as anxiety [State and Trait Inventory (STAI)], depression [the Zung Self-Rating Depression Scale (Zung)] and aggression [the Aggressive Questionnaire (AQ)].
At baseline, we found significant positive correlations between fT3 and OCDS (r = 0.358, P = 0.029) and CDS (r = 0.405, P = 0.013) and negative correlations between TSH levels and STAI (r = -0.342, P = 0.031), and AQ (r = -0.35, P = 0.027). At the end of the 12-week study period, abstinent patients had a greater change in TSH than those who relapsed (-0.4 vs. -0.25, F(1,24) = 5.4, P = 0.029).
If confirmed in larger samples, these findings could suggest that the thyroid axis might represent a biomarker of alcohol craving and drinking.
一些研究表明甲状腺激素与酒精依赖(AD)之间存在关联,比如促甲状腺激素(TSH)对促甲状腺激素释放激素(TRH)反应的增加不明显、循环游离三碘甲状腺原氨酸(fT3)和游离甲状腺素(fT4)水平较低以及TRH受体下调。本研究旨在探讨甲状腺轴激素与酒精依赖患者样本中觅酒行为之间的关系。
纳入42名寻求治疗的酒精依赖个体参与一项为期12周的治疗研究。采用时间线追溯法(TLFB)评估12周期间的饮酒量。在治疗前和治疗结束时测量甲状腺激素(TSH、fT3和fT4)的血液水平。使用问卷评估对酒精的渴望程度[宾夕法尼亚酒精渴望量表(PACS)、强迫性饮酒量表(OCDS)及其两个子量表,即用于强迫观念的ODS和用于强迫行为的CDS]以及焦虑[状态特质焦虑量表(STAI)]、抑郁[zung自评抑郁量表(zung)]和攻击性[攻击性问卷(AQ)]。
在基线时,我们发现fT3与OCDS(r = 0.358,P = 0.029)和CDS(r = 0.405,P = 0.013)之间存在显著正相关,TSH水平与STAI(r = -0.342,P = 0.031)和AQ(r = -0.35,P = 0.027)之间存在负相关。在为期12周的研究期结束时,戒酒患者的TSH变化大于复发患者(-0.4对-0.25,F(1,24) = 5.4,P = 0.029)。
如果在更大样本中得到证实,这些发现可能表明甲状腺轴可能是酒精渴望和饮酒的生物标志物。