Reversibility of increased formation of catecholamines in patients with alcoholic liver disease.
BACKGROUND
While chronic alcohol abuse has been shown to be associated with increased production of catecholamines, little is known about the reversibility of this increased sympathetic activity and the influence of severity of alcoholic liver disease (ALD). The aim of the present study was to investigate whether the increase in urinary excretion rates and plasma levels of catecholamines in alcohol-abusing patients are reversible during prolonged abstinence, especially with respect to the severity of ALD.


METHODS
Urinary excretion rates and plasma levels of noradrenaline (NA), adrenaline (A) and dopamine (DA) were determined in 15 subjects with mild to moderate ALD (ALD1) and in 7 alcoholic cirrhotics (ALD2) on admission and after 2 and 12 weeks of abstinence. Eight healthy males, age-matched to ALD1, served as controls (HC).


RESULTS
Urinary excretion rates (24 h) and resting plasma concentrations of NA and A were increased in ALD1 and ALD2 about 2-fold, while those of DA were elevated only moderately compared to HC. During exercise under a load of 100 watts, the increases in plasma levels of NA and A with reference to the resting values were nearly identical in all three groups. Already after 2 weeks of abstinence, the urinary excretion rate of NA had nearly normalized in ALD1 but remained unchanged in ALD2.


CONCLUSIONS
The marked enhancement of catecholamine production, especially that of NA, observed in actively drinking alcoholics is reversible under abstinence within a few weeks in subjects with mild to moderate ALD but only partially reversible in alcoholic cirrhosis.
Parlesak
A
A
Dept. of Physiology of Nutrition, Hohenheim University, Stuttgart, Germany. parlesak@uni-hohenheim.de
Reisenauer
C
C
Biermann
J
J
Ratge
D
D
Bode
J C
JC
Bode
C
C
D000328:Adult; D000437:Alcoholism / Q000097:blood* / Q000652:urine*; D001794:Blood Pressure; D016022:Case-Control Studies; D002395:Catecholamines / Q000097:blood* / Q000652:urine*; D005080:Exercise Test; D006339:Heart Rate; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000097:blood* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors
D002395:Catecholamines