Search

Alcoholism and alcohol-associated organ injury is one of the major health problems worldwide. Alcohol may lead to an alteration in intermediary metabolism and the relation between alcohol intake and body weight is a paradox. The effect of alcohol intake on resting metabolic rate, assessed by indirect calorimetry, and lipid oxidation, is still controversial. Small quantities of ethanol seem to have no effect on body weight. Ingestion of moderate amounts may lead to an increase in body weight, via a lipid-oxidizing suppressive effect. Chronic intake of excessive amounts in alcoholics leads to a decrease in body weight, probably via increased lipid oxidation and energy expenditure. Chronic ethanol abuse alters lipid-soluble (vitamins A, D and E) and water-soluble (B-complex vitamins, vitamin C) vitamins status, and some trace elements status such as magnesium, selenium or zinc.

The effects of alcohol withdrawal on fibrinolysis were studied in 10 middle-aged male chronic alcoholics institutionalized for withdrawal therapy. All patients were sampled on admission [day 1 (D1)] and 21 days after alcohol withdrawal [day 22 (D22)]. The overall plasma fibrinolytic capacity (OFC) was assayed by measuring the ability of patient plasma to generate D-dimers from a standardized fibrin clot, and tissue-type plasminogen activator (t-PA) and t-PA inhibitor (PAI-1) levels were assayed together with serum cholesterol, triglyceride and cholesterol fractions. At D22, the OFC significantly increased in seven patients [D1 = 10 +/- 0.7 microg/h (mean +/- SD), D22 = 17 +/- 7.4 microg/h; P < 0.01], while t-PA and PAI-1 levels decreased in all patients but two (t-PA: D1 = 16.6 +/- 5 ng/ml, D22 = 10.2 +/- 3.8 ng/ml; P < 0.001; and PAI-1: D1 = 46 +/- 39 ng/ml, D22 = 21 +/- 28 ng/ml; P < 0.01). This study clearly demonstrates an increase in overall fibrinolytic activity after alcohol withdrawal, which is mainly due to a decrease in PAI-1 levels. These changes induced by alcohol abstinence might provide clear benefit by reducing the risk of thromboembolic events and particularly of stroke associated with elevated PAI-1 levels described in heavy drinkers.

This study examines the effect of alcohol withdrawal on lipoprotein(a) [Lp(a)] in 24 male, middle-aged chronic alcohol abusers admitted for withdrawal therapy. Serum concentration of Lp(a) was determined before and during the first 3 weeks of abstinence. The changes in three sialylated proteins [Lp(a), alpha 1-antitrypsin (alpha 1-AT), and haptoglobin (Hp)] and in desialylated transferrin (CDT) were also determined in 14 patients. After the 3 weeks of withdrawal therapy, the mean and median Lp(a) concentrations increased (p = 0.0001). The changes in Lp(a) levels were not related to the changes in dietary intake nor to the decrease in total HDL, HDL3, HDL2 cholesterol, Apo A-I, and Apo B. In the subgroup of 14 chronic alcohol abusers, Lp(a) levels increased parallel with Hp and alpha 1-AT, whereas CDT decreased. It is concluded that the impact of alcohol on sialylated proteins may be one of the mechanisms responsible for the increase in plasma Lp(a) after alcohol withdrawal.

This study examines the effect of alcohol withdrawal on plasma lipids and particularly on HDL-cholesterol subfractions, in 18 middle-aged, clinically healthy but chronically drinking men, institutionalized for withdrawal therapy. Plasma lipids, total HDL and HDL3-cholesterol, Apo A-I and Apo B were assayed before and after 30-86 days of abstinence. A 38% decrease in mean total HDL-cholesterol levels was observed after withdrawal therapy (P = 0.0002), and this was due mainly to a drop in HDL3-cholesterol concentrations (-43%, P = 0.0002). The decrease in HDL2-cholesterol concentrations was also significant (-21%, P < 0.005) but less marked. These results were not dependent on quantities of alcohol ingested before therapy, on duration of hospitalization and on changes in dietary fat intake or smoking habits. Apo A-I levels decreased (-39%, P = 0.0002) and the magnitude of the decrease after alcohol withdrawal was positively related to the duration of hospitalization. Apo B levels increased (+24%, P < 0.005). Among the anthropometric parameters, arm muscle area was significantly higher after alcohol withdrawal. The energy and macronutrient intakes did not significantly change during hospitalization. It is concluded that the modifications of HDL-cholesterol, HDL3-cholesterol, HDL2-cholesterol Apo A-I and Apo B values were induced by alcohol withdrawal in this population of chronic french alcoholics.