EFFECTS OF ABSTINENCE ON SEX-HORMONE PROFILE IN ALCOHOLIC PATIENTS WITHOUT LIVER-FAILURE

Excessive ethanol ingestion induces hypoandrogenism in male subjects. To confirm its presence and to study its relationship with the degree of liver damage and alcohol abstinence, plasma, sex hormones were meas ured in alcoholic patients without liver failure, after two different abstinence periods. Patients were 30 male chronic alcoholics admitted to the Alcoholism Ward for treatment of their addiction. On admission, we measured: testosterone (T), estradiol (E), follicle stimulating ho rmone (FSH), luteinizing hormone (LH) and sex-hormone binding globulin (SHBG). A liver biopsy was also performed. These measurements were re peated at discharge and were also done in 15 normal volunteers. On adm ission (mean abstinence 1.9 +/- 1.7 days) total T was similar to contr ols, FSH was lower (p< 0.02) and high levels of SHBG were found (3.5 f old increase, as compared to controls). Histologically, 9 patients had normal liver; 14 had moderate alterations and 7 showed marked alterat ions. Hormonal values were not different in these 3 groups. At dischar ge, 11.1 +/- 4.7 days after admission, T, E and FSH did not show signi ficant changes but LH decreased (8.2 +/- 5.2 mIU/ml vs 12.9 +/- 4.1, p < 0.001); SHBG also decreased (65.4 +/- 21.6 nmol/l vs 117.2 +/- 33.3, p< 0.001) to values that still were twice those of controls. It is co ncluded that alcoholic patients without clinical signs of liver failur e have normal plasma testosterone levels, irrespective of their histol ogic liver alterations and high plasma SHBG levels that decreased sign ificantly after a short abstinence. The concomitant LH decrease sugges ts that hypoandrogenism is likely in these patients. Fast changes in S HBG levels rise the possibility that this protein is candidate marker of alcoholism.