Sex hormone-binding globulin in non-cirrhotic alcoholic patients during early withdrawal and after longer abstinence

In recently intoxicated non-cirrhotic male alcohol-misusing and -dependent patients, we studied, during early withdrawal and more prolonged abstinence . the rate of changes of sex hormones and their binding globulin (SHBG), th e prevalence of hypo-androgenism and possible determinant factors of SHBG i ncrease. Twenty-one alcoholics and 21 controls were studied. SHBG plasma le vels, sex hormones (SH), cortisol, insulin and thyroid hormones were measur ed at admission and discharge. SHBG and SH were also determined on days 2, 4 and 7 after admission and on weeks 2, 6 and 12 after discharge. SHBG show ed a 3-fold increase, decreasing slowly during the first 10 days, but remai ning above control values. Luteinizing hormone was also increased. Free tes tosterone (Tf) was low at admission and correlated negatively with SHBG dur ing the first 10 days. By day 10, Tf reached normal values, despite SHBG re maining elevated. The other sex hormones were normal. Neither insulin nor t hyroid hormones correlated with SHBG. Cortisol was high at admission and th en normalized. Clinical hypo-androgenism was found in 33-50% of patients, b ut did not correlate with SHBG or SH. During follow-up, nine patients relap sed. In those remaining abstinent, SHBG continued decreasing, reaching norm al levels in the 12th week. In those who relapsed, SHBG remained high or ev en increased further. Gamma-glutamyltransferase showed similar but faster c hanges. We conclude that excessive alcohol ingestion is associated with mar ked increases of SHBG which slowly revert during abstinence. High SHBG does not fully explain the low Tf values or the presence of clinical hypo-andro genism in alcoholics. This SHBG response to ethanol makes it a potential ma rker of excessive alcohol intake.