Serum Lipids and Lipoproteins Changes during Three Weeks of Abstinence in Patients with Alcohol Dependence

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Summary - The goal of this research was to observe changes in serum lipids and lipoproteins in long-time alcoholics at the beginning of treatment and after three weeks of abstinence from alcoholic beverages.

For the purposes of this research we have examined the previously mentioned changes in the patients already undergoing in the alcohol dependency treatment. The research included 31 male patients with diagnosed alcohol dependency in accordance with ICD-10 criteria. Serum concentrations of cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, HDL2-cholesterol, HDL3-cholesterol, ApoA^sub 1^, ApoB, ApoA1/ApoB, and Lp(a) were analysed at the beginning of treatment and after three weeks of abstinence from alcoholic beverages. There were no statistically significant differences in serum levels of cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, ApoB, HDL^sub 2^-cholesterol in alcohol dependent patients between the time of admission to treatment and after three weeks of abstinence from alcoholic beverages. On the other hand there was a statistically significant difference of serum levels of ApoA^sub 1^, ApoA^sub 1^/ApoB, Lp(a), and HDL^sub 3^-cholesterol in alcohol dependent patients between the time of admission to treatment and after three weeks of abstinence from alcoholic beverages.

Key words: alcohol dependency, serum lipids, serum lipoproteins, abstinence

INTRODUCTION

Lipoproteins are hydrophilic macromolecular complexes of lipids and proteins of spherical form and represent a transport form of lipids in the circulation. Proteins in lipids are called apoproteins. Using the ultra-centrifuge six fractions of lipoproteins can be separated, namely hilomicrons, lipoproteins of very low (VLDL), medium (IDL), low (LDL and high (HDL) density and Lp(a) lipoproteins. Among the conditions connected with the lipoproteins metabolism disorders, the most significant are arteriosclerosis, myocardial infarction and cerebral stroke as the most frequent complications.1,2 Along with the other risk factors (overweight, physical inactivity, male sex, cigarette smoking, positive familiar heredity for coronary disease, social and economic factors), high concentration of serum LDL-cholesterol along with low concentration of HDL-cholesterol and high concentration of glucose is of a particular importance.

Lp(a) lipoproteins show structural similarity with LDL unit. The thing that separates them from other lipoproteins is apo(a) glycoprotein, which is structurally similar and competing with plasminogene, the consequence of which is fibrinolisis inhibition. Lp(a) represents the main congenital risk factor for the development of arteriosclerosis. The value of 30mg/dl increases twice the risk of cardiovascular disease, independently from the level of other lipids and five times if, along with that, level of LDL-cholesterol is increased.3 It is not possible to influence concentration of Lp(a) by exogenous factors, although it has been observed that reduced values are found in liver disease and alcoholism.4

The genetic risk factors for development of arteriosclerosis should also be mentioned. In order for arteriosclerosis to be developed, the presence of surrounding factors is necessary along with the existing genetic factors. One of the most frequently mentioned risk genes for the development of arteriosclerosis is the gene for apolipoprotein (apo) E. Clinical expression of E2 izoform is dependent on surrounding factors, primarily excessive drinking of alcohol, excessive bodily mass and fatty food. There are only few studies published, which observed interaction between those two factors: gene for apolipoprotein E, as hereditary risk factor and excessive drinking as surrounding factor.5,6 Gueguen and al. also report about how alcohol dependency directly changes the effects of apo E polymorphism on apo B plane.7

Frohlich states that normal drinking of alcohol also leads to changes of lipoproteins metabolism. …