Persistent alterations of vasopressin and N-terminal proatrial natriuretic peptide plasma levels in long-term abstinent alcoholics.
BACKGROUND
During alcohol withdrawal and early abstinence, severe alterations of electrolyte and water homeostasis and their regulating hormones are well recognized. Almost nothing is known about regeneration of these functions with long-term abstinence. This cohort study was designed to monitor determinants of electrolyte and water balance over 280 days of abstinence in alcohol-dependent men compared with healthy controls.


METHODS
Vasopressin (AVP), N-terminal proatrial natriuretic peptide, aldosterone, angiotensin II, and electrolytes, together with major parameters of kidney and liver function, were monitored in 35 male alcoholics aged 44 +/- 8 years. Of these, 21 could be followed up to 280 days of strictly controlled abstinence due to their participation in the Outpatient Long-Term Intensive Therapy for Alcoholics. The control group comprised 20 healthy male volunteers aged 39 +/- 7 years.


RESULTS
Basal AVP levels were found to be suppressed over the whole study period. In contrast, N-terminal proatrial natriuretic peptide remained increased over all 280 days. No persistent alterations were found for aldosterone or angiotensin II. Sodium and potassium in plasma and urine returned to normal within a few weeks. Creatinine clearance, urea nitrogen in plasma and urine, urinary osmolality, hematocrit, and hemoglobin remained low as compared with controls over the entire study.


CONCLUSIONS
Chronic alcohol abuse causes severe and persistent alterations in the hormonal regulatory systems of electrolyte and water balance. The suppressed basal secretion of AVP may reflect a dysregulation in the brain that influences the hypothalamic-pituitary-adrenal axis function, mood, memory, addiction behavior, and craving during alcohol abstinence. These findings may provide a ground for future therapeutic approaches to stable abstinence.
Döring
Wolf K H
WK
Departments of Psychiatry and Neurology, Georg-August University, Göttingen, Germany.
Herzenstiel
Marie-Noelle
MN
Krampe
Henning
H
Jahn
Henriette
H
Pralle
Lars
L
Sieg
Sonja
S
Wegerle
Elisabeth
E
Poser
Wolfgang
W
Ehrenreich
Hannelore
H
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000437:Alcoholism / Q000097:blood* / Q000503:physiopathology / Q000628:therapy*; D000450:Aldosterone / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000097:blood*; D001769:Blood; D001806:Blood Urea Nitrogen; D004326:Drinking; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008099:Liver / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D011498:Protein Precursors / Q000097:blood*; D013375:Substance Withdrawal Syndrome / Q000097:blood*; D013997:Time Factors; D014508:Urea / Q000652:urine; D014556:Urine; D014667:Vasopressins / Q000097:blood*; D014882:Water-Electrolyte Balance; D005723:gamma-Glutamyltransferase / Q000097:blood
D011498:Protein Precursors; D014667:Vasopressins; D000804:Angiotensin II; D000450:Aldosterone; D009320:Atrial Natriuretic Factor; D014508:Urea; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase