Fonzi S, Solinas G P, Costelli P, Parodi C, Murialdo G, Bo P, Albergati A, Montalbetti L, Savoldi F, Polleri A
Dipartimento di Scienze Endocrinologiche e Metaboliche, Università di Genova, Italy.
Chronobiologia. 1994 Jan-Jun;21(1-2):109-12.
Changes in central neurotransmission and in hypothalamo-pituitary function occur in both ethanol (ETOH) intake and withdrawal. Melatonin (MLT) secretion is regulated by the noradrenergic system, which is activated upon ETOH withdrawal. Experimental evidence exist that pineal gland may have a role in ETOH intake and preference in rats. Twenty-four hour urinary excretion of MLT was found to be increased during ETOH intake in chronic alcoholics. In this study we have determined 24h plasma levels of MLT and cortisol in 8 chronic alcoholic males hospitalized for a detoxication program and in 8 healthy controls. The study was performed just after admission, on the first day of ETOH withdrawal and after 14 days of controlled abstinence. Circadian periodicity has been evaluated by the cosinor method. The initial determinations corresponded to the acute withdrawal phase. Twenty-four hour plasma MLT mean levels on acute withdrawal were higher than after 14 days abstinence and than those found in controls. Large interindividual differences prevented the detection of statistical significance. The cosinor analysis disclosed the loss of circadian periodicity in the acute withdrawal. Significant 24h periodicity was restored after 14 days abstinence. Cortisol levels were significantly higher than those found on day 14 and in healthy controls. Twenty-four hour periodicity was maintained in both alcoholics series. A delay in cortisol acrophase occurred in acute withdrawal. The effects of Corticotropin Releasing Hormone infusion on cortisol secretion were significantly enhanced in the acute withdrawal phase in comparison with those occurring when patients were retested and with healthy controls.
乙醇（ETOH）摄入和戒断时，中枢神经传递及下丘脑 - 垂体功能都会发生变化。褪黑素（MLT）的分泌受去甲肾上腺素能系统调节，该系统在ETOH戒断时被激活。有实验证据表明松果体可能在大鼠ETOH摄入及偏好方面发挥作用。研究发现，慢性酗酒者在ETOH摄入期间，24小时尿中MLT排泄量会增加。在本研究中，我们测定了8名因戒酒计划住院的慢性酗酒男性和8名健康对照者的24小时血浆MLT和皮质醇水平。研究在入院后、ETOH戒断第一天以及控制戒酒14天后进行。采用余弦分析方法评估昼夜节律。初始测定对应急性戒断期。急性戒断时24小时血浆MLT平均水平高于戒酒14天后及对照组。个体差异较大，未能检测到统计学显著性。余弦分析显示急性戒断时昼夜节律消失。戒酒14天后恢复了显著的24小时周期性。皮质醇水平显著高于第14天及健康对照组。两个酗酒者系列均维持24小时周期性。急性戒断时皮质醇峰值相位出现延迟。与再次检测患者及健康对照时相比，促肾上腺皮质激素释放激素输注对皮质醇分泌的影响在急性戒断期显著增强。
