George D T, Lindquist T, Alim T, Flood M, Eckardt M J, Linnoila M
Laboratory of Clinical Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892.
Alcohol Clin Exp Res. 1994 Jun;18(3):685-91. doi: 10.1111/j.1530-0277.1994.tb00931.x.
Chronic excessive alcohol consumption can significantly disturb the hypothalamic control of glucose metabolism; however, the mechanism and clinical significance of this disturbance are poorly understood. We used 2-deoxy-D-glucose (2-DG), which produces intracellular glucoprivation, to compare neurochemical, physiological, and behavioral responses to glucoprivic stress between alcoholics abstinent for 3 weeks and healthy volunteers. Twenty-six male alcoholics and 15 male healthy volunteers received intravenous infusions of placebo, 12.5 mg/kg, and 25.0 mg/kg of body weight of 2-DG over 30 min on three separate days, following a random-ordered, double-blind procedure. Minimal effects were observed following administration of the 12.5 mg/kg of body weight dose of 2-DG. Following 25.0 mg/kg, alcoholics showed both exaggerated ACTH and cortisol responses and greater increases in caloric intake when compared with controls. Although anxiety, desire to consume alcohol, plasma progesterone, and sympathetic and adrenal medullary activity all increased following 2-DG, these responses did not differ between alcoholics and controls. The present findings suggest certain specificity for the exaggerated hypothalamic and adrenocortical responses to mild glucoprivic stress in 3-week-abstinent alcoholics.
长期过量饮酒会严重扰乱下丘脑对葡萄糖代谢的控制；然而，这种紊乱的机制和临床意义却鲜为人知。我们使用能引起细胞内葡萄糖缺乏的2-脱氧-D-葡萄糖（2-DG），来比较戒酒3周的酗酒者和健康志愿者对葡萄糖缺乏应激的神经化学、生理及行为反应。26名男性酗酒者和15名男性健康志愿者在三天内按照随机顺序、双盲程序，在30分钟内静脉输注安慰剂、12.5毫克/千克体重和25.0毫克/千克体重的2-DG。静脉输注12.5毫克/千克体重剂量的2-DG后观察到的影响极小。静脉输注25.0毫克/千克体重剂量的2-DG后，与对照组相比，酗酒者促肾上腺皮质激素（ACTH）和皮质醇反应均过度，热量摄入增加更多。虽然静脉输注2-DG后焦虑、饮酒欲望、血浆孕酮以及交感神经和肾上腺髓质活动均增加，但这些反应在酗酒者和对照组之间并无差异。目前的研究结果表明，戒酒3周的酗酒者对轻度葡萄糖缺乏应激的下丘脑和肾上腺皮质反应过度具有一定的特异性。
