Relationship between serum cortisol, liver function, and depression in detoxified alcoholics.
Relationship between serum cortisol, liver function, and depression in detoxified alcoholics.
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戒毒酗酒者血清皮质醇、肝功能和抑郁之间的关系。
DOI：
10.1111/j.1530-0277.1986.tb05097.x
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Gasparini,F
中科院分区：
文献类型：
--
作者：
Zern,MA;Halbreich,U;Bacon,K;Galanter,M;Kang,BJ;Gasparini,F
血清皮质醇水平升高或地塞米松抑制试验异常可能有助于诊断重度抑郁障碍。然而，与酒精滥用相关的肝功能异常是否会否定地塞米松抑制试验在酗酒者中的诊断价值，仍存在争议。我们通过分析酒精戒毒治疗中心住院患者的KVER功能、皮质醇水平和精神状态，探讨地塞米松抑制试验在酒精患者中的价值。受试者符合DSM III酒精依赖标准，但没有长期服用药物，并进行了药物滥用的阴性筛查。他们进行了常规的血液筛查以评估肝功能，下午的皮质醇试验和地塞米松抑制试验以研究糖皮质激素的活性，并进行了结构化评估以确定精神诊断。血液化学结果显示，尽管43%的受试者肝酶有一定程度的升高，但在这组患者中没有明显的五种合成功能障碍。我们没有发现皮质醇水平正常和异常的患者之间的肝功能差异。然而，患有内源性抑郁症的受试者下午的皮质醇水平确实显著升高，他们的肝脏检查往往更正常。这些结果表明，轻度肝功能障碍不会影响血浆皮质醇测试或地塞米松抑制测试作为评估这组戒酒患者抑郁的诊断工具的有效性。此外，他们还证明了抑郁症与血浆皮质醇水平之间的关系，并表明在寻求戒毒的酒鬼中，抑郁症与肝功能改善之间存在相关性。
High levels of serum Cortisol or abnormal dexamethasone suppression tests may be helpful in diagnosing major depressive disorder. However, a controversy exists as to whether abnormal Hver function associated with alcohol abuse may negate the diagnostic value of the dexamethasone suppression test in alcoholics. We investigated the value of the dexamethasone suppression test in alcoholics by analyzing the Kver function, Cortisol levels, and psychiatric status of inpatients from an alcohol detoxification treatment center. The subjects met the DSM III criteria for alcohol dependence but took no chronic medication and had negative screening for substance abuse. They had routine blood screening to evaluate liver function, the afternoon Cortisol test and dexamethasone suppression test to study glucocorticoid activity, and a structured evaluation to determine psychiatric diagnoses. The blood chemistry findings demonstrated a lack of significant fiver synthetic dysfunction in this group, although 43% of the subjects had some elevation of their liver enzymes. We did not find differences in the liver function between patients with normal and abnormal Cortisol levels. However, subjects with endogenous depression did have significantly elevated afternoon Cortisol levels, and they tended to have more normal liver tests. These results indicate that modest liver dysfunction does not contaminate the validity of the plasma Cortisol tests or the dexamethasone suppression test as diagnostic tools for assessing depression in this group of detoxified alcoholics. In addition, they demonstrate an association between depression and plasma Cortisol levels and suggest a correlation between depression and better liver function in alcoholics who seek detoxification.
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