c-peptide and Substance-Withdrawal-Syndrome

Alcohol abusers often present with deteriorated glucose metabolism and insulin resistance. Changes in other glucoregulators, such as insulin-like growth factor-I (IGF-I) and IGF-binding protein-1 (IGFBP-1) may also be related to alcohol abuse. We studied the effects of alcohol withdrawal on blood glucose, serum insulin and C-peptide, and plasma IGF-I and IGFBP-1 levels in 27 noncirrhotic male alcoholics aged 43 +/- 9.0 (mean +/- SD) years on four consecutive days immediately after withdrawal. A 4-day monitoring period was conducted in four healthy nonalcoholic control men. The groups were similar in age and body mass index. Glucose, insulin, IGF-I, and IGFBP-1 did not differ significantly between the groups at the baseline, but C-peptide was higher in alcoholics (p < 0.01). After alcohol withdrawal, serum insulin and C-peptide levels increased in close correlation with each other (r = 0.82, p < 0.001). During the 4-day observation period in alcoholics, IGFBP-1 levels declined by 59%, whereas IGF-I increased by 41% (p < 0.001 for both comparisons). The change in insulin correlated inversely with the change in IGFBP-1 levels (r = -0.39, p < 0.05). In the control group, glucose, insulin, IGF-I, and IGFBP-1 remained unchanged during the 4-day monitoring period, whereas some reduction was observed in C-peptide. In conclusion, alcohol withdrawal enhances insulin production, as seen in increased C-peptide levels. An inverse correlation between the changes in insulin and that in IGFBP-1 might suggest that inhibition of IGFBP-1 by insulin remains largely unchanged during the acute phase of alcohol withdrawal.

Topics: Adult; Blood Glucose; Body Mass Index; C-Peptide; Ethanol; Humans; Insulin; Insulin-Like Growth Factor Binding Protein 1; Insulin-Like Growth Factor I; Male; Middle Aged; Substance Withdrawal Syndrome

A decreased tolerance to carbohydrates has been reported in several studies of liver diseases, whereas only a few investigations have been performed in chronic noncirrhotic alcoholic patients with and without alcohol abstinence. The aim of this study was to evaluate in detail the metabolic portrait of six noncirrhotic alcoholics during the early phase of alcohol withdrawal by quantifying the main processes involved in glucose disappearance. Data from frequently sampled intravenous glucose tolerance tests (FSIGTs) were analyzed by means of the minimal model (MINMOD) approach, which provided measurements of the (prehepatic) beta-cell secretion and of insulin degradation in the liver, along with indexes of insulin sensitivity and glucose effectiveness. Plasma insulin levels were lower in the patients (basal, 3.5 +/- 0.2 v 8.0 +/- 1.8 in matching controls, P < .05; area under the curve, 1.41 +/- 0.07 mU/mL in 240 minutes v 4.06 +/- 0.37, P < .001), and C-peptide concentrations were higher (basal, 107 +/- 3.5 v 36 +/- 9 ng/dL in controls, P < .05; area under the curve, 492 +/- 118 ng/mL in 240 minutes v 245 +/- 66, P = .05). The model analysis confirmed the absence of a decrease beta-cell release; in fact, in the alcoholics there was a basal secretion of 19 +/- 5 versus 9 +/- 2 pmol/L/min in controls (P < .05) and a total release of 9.5 +/- 1.8 nmol/L in 240 minutes versus 6.5 +/- 1.4.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Alcoholism; Biopsy; Blood Glucose; C-Peptide; Ethanol; Female; Glucose Tolerance Test; Humans; Insulin; Islets of Langerhans; Liver; Male; Mathematics; Middle Aged; Models, Biological; Substance Withdrawal Syndrome; Time Factors

Insulin secretion was studied after stimulation with oral glucose and intravenous glucagon in 23 chronic alcoholics in a withdrawal state. Each subject was studied twice at one week's interval between the examinations. The insulin and C-peptide responses to glucagon were lower in the early withdrawal state. Moreover, the insulin and C-peptide increments were, when related to the magnitude of the glycemic stimulus, lower in the early than in the late withdrawal state. The fasting values of blood glucose, insulin and C-peptide and the blood glucose and C-peptide levels after oral glucose were higher in the early withdrawal state. These findings indicate that glucose metabolism in alcoholics in a withdrawal state can be disturbed by impaired insulin secretion and insulin resistance.

Topics: Adult; Aged; Alcoholism; Blood Glucose; C-Peptide; Ethanol; Female; Glucagon; Glucose; Humans; Insulin; Insulin Secretion; Islets of Langerhans; Male; Middle Aged; Substance Withdrawal Syndrome; Time Factors

Insulin effect was investigated in 20 chronic alcoholics by use of an insulin and glucose infusion which suppressed endogenous insulin secretion. It was found that the effect of insulin was lower during the first week than the second week of alcohol withdrawal.

Topics: 3-Hydroxybutyric Acid; Adult; Aged; Alcoholism; Blood Glucose; C-Peptide; Growth Hormone; Humans; Hydroxybutyrates; Insulin; Male; Middle Aged; Substance Withdrawal Syndrome; Time Factors