Alcohol and Alcoholism Advance Access published online on January 14, 2009
Alcohol and Alcoholism, doi:10.1093/alcalc/agn116
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Is Cortisol Involved in the Alcohol-Related Fat Mass Impairment? A Longitudinal Clinical Study
1 Institute of Internal Medicine, Catholic University of Rome, Rome, Italy,
2 Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, USA,
3 Metabolic Unit, Institute of Internal Medicine, Catholic University of Rome, Rome, Italy,
4 Department of Cardiac Surgery, St Andrea Hospital, University of Rome "La Sapienza", Rome, Italy
* Corresponding author: Institute of Internal Medicine, Catholic University of Rome, L. go A. Gemelli 8, I-00168, Rome, Italy. Tel: +39-06-30154334; Fax: +39-06-35502775; E-mail: g.addolorato{at}rm.unicatt.it
Received 13 August 2008; first review notified 1 October 2008; in revised form 14 November 2008; accepted 11 December 2008
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Abstract |
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Aims: Subjects with chronic alcohol abuse can present several metabolic and nutritional alterations. The hypothalamic-pituitary-adrenal (HPA) axis may play a role in these nutritional and metabolic disorders. The goal of this study was to investigate if there is any relationship between HP-hormones and metabolic and nutritional parameters in alcoholic subjects. Methods: Sixteen alcoholics were considered before and after 3 months of total alcohol abstinence. HP-related hormones were determined. Nutritional and metabolic parameters were assessed by dual-energy X-ray absorptiometry (DXA) and indirect calorimetry. Results: At baseline, a significant negative correlation was found between fat mass (FM) and cortisol (r = –0.54, P = 0.03). During abstinence, a significant increase of both body mass index (BMI) (P < 0.0001) and FM (P < 0.0001) was found at 12 weeks compared to baseline. A significant decrease of both plasma cortisol (P = 0.044) and aldosterone (P = 0.023) was found at 12 weeks compared to baseline. At 12 weeks, the significant correlation between cortisol and FM disappeared. Conclusions: A higher HPA-axis activation—reflected by higher cortisol levels—was associated with a lower FM in alcoholics. Conversely, during total abstinence a reduced HPA-axis activity can play a role in the parallel nutritional recovery. The present results suggest a role of the HPA axis throughout cortisol both in the etiology of the alcohol-related nutritional alterations and in their recovery after a period of total alcohol abstinence.
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