Is cortisol involved in the alcohol-related fat mass impairment? A longitudinal clinical study.
OBJECTIVE
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.
Leggio
Lorenzo
L
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy.
Malandrino
Noemi
N
Ferrulli
Anna
A
Cardone
Silvia
S
Miceli
Antonio
A
Gasbarrini
Giovanni
G
Capristo
Esmeralda
E
Addolorato
Giovanni
G
D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000473:pathology; D050154:Adiposity / Q000187:drug effects* / Q000502:physiology*; D000328:Adult; D000437:Alcoholism / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D000450:Aldosterone / Q000097:blood; D015415:Biomarkers; D001823:Body Composition / Q000187:drug effects; D001835:Body Weight / Q000502:physiology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000502:physiology*; D008111:Liver Function Tests; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status
D015415:Biomarkers; D000450:Aldosterone; D006854:Hydrocortisone