Alkol yoksunluğunda hipotalamik-hipofizer-gonadal eksen hormonları ve saldırganlık ile ilişkisi

Amaç: Alkolün hipotalamik-hipofizer-gonadal (HPG) eksen üzerine etkilerinin olduğu bilinmektedir. Alkol bağımlısı hastalarda, HPG eksen hormonlarındaki değişikliklerin bazıları saldırganlıkla ilişkili olabilir. Çalışmanın amacı, alkol bağımlısı hastalarda erken ve geç alkol yoksunluk döneminde HPG eksen değişiklikleri ile saldırganlık düzeyi arasındaki ilişkiyi araştırmaktı.Yöntem: Depresyonu olmayan alkol bağımlısı erkek hastalar (n=28) ve kontrol grubu olarak alınan sağlıklı erkekler (n=19), anlık ve yaşam boyu saldırganlık düzeyini ölçen nöropsikolojik testlerle değerlendirildi. Hastalar Brown-Goodwin saldırganlık skoruna (yüksek ve düşük) göre iki gruba ayrıldı. Serum total testosteron, luteinize edici hormon (LH) ve follikül uyarıcı hormon (FSH) düzeyleri alkol bağımlısı hastalarda yoksunluğun 1. ve 28. günlerinde ve kontrollerde bir kez ölçüldü.Bulgular: Çalışma, alkol bağımlısı hastalarda erken yoksunluk döneminde total testosteron düzeyinin yükseldiğini, erken ve geç yoksunluk dönemi boyunca da LH düzeyinin yüksek olduğunu gösterdi. Hastalar saldırganlık düzeyi yüksek ve düşük olanlar şeklinde iki gruba ayrılarak değerlendirildiğinde her iki grupta da LH düzeyinin erken ve geç yoksunluk döneminde kontrollere kıyasla yüksek olduğu bulundu. Testosteron düzeyi, saldırganlık düzeyi düşük olan grupta sadece erken yoksunluk döneminde yüksek iken, saldırganlık düzeyi yüksek olan grupta hem erken hem geç yoksunluk döneminde yükselmişti.Sonuç: Alkol yoksunluğunda olan testosteron düzeyi değişiklikleri, sürekli alkol kullanımının bir sonucu olabileceği gibi, alkol bağımlısı hastaların bir kısmında görülen saldırganlık eğilimi ile de ilişkili olabilir.

Hormones of hypothalamic-pituitary-gonadal axis in alcohol withdwal and their relationships with aggression

Objective: Alcohol is known to have some influences on hypothalamic-pituitary-gonadal (HPG) axis activity. Some changes in HPG axis hormones may be related to aggression in alcoholic patients. The study aims to investigate the relationship between HPG axis alterations and aggression level in alcoholic patients during early and late alcohol withdrawal.Method: Alcohol dependent males without depression (n=28) and healthy control male subjects (n=19) were rated with neuropsychological tests measuring immediate and life-long aggression. The patients were divided into two subgroups according to their (high or low) level of aggression in Brown-Goodwin Aggression scale. Serum levels of total testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured on the first and 28th days of withdrawal periods in alcohol dependents and once in healthy controls.Results: The study revealed increased total testosterone level in early withdrawal and increased LH level during both early and late withdrawal periods in all alcoholic patients. When the patients were assessed in two separate groups as high- and low-aggressives, it was found that LH level was high during early and late withdrawal in both groups compared to controls. While testosterone level was high in low-aggression group only in early withdrawal, it was increased in high-aggression group during both early and late withdrawal periods.Conclusion: Alterations of testosterone level during alcohol withdrawal may be associated not only with chronic alcohol use per se but also with aggressivity that is present in some of alcoholic patients.

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