Alcohol dependence is linked to hormones and proteins which are different in men and women, suggests research recently presented in Milan, Italy.
Scientists found that alcoholism, depressive symptoms and relapse were associated with levels of various sex hormones and reproduction-related proteins, that were different in men and women.
This implied that men and women should receive different treatments for alcoholism, concluded lead researcher Dr. Victor Karpyak, professor of Psychiatry at Mayo Clinic in Minnesota.
Excessive alcohol use is responsible for approximately 178,000 deaths every year in the U.S., shortening the lives of those who died by an average of 24 years, according to statistics from the Centers for Disease Control and Prevention.
"There are numerous sex (biological) and gender (psychosocial) differences in alcohol use and its consequences, including alcohol use disorders," Karpyak told Newsweek. "I see those differences in my daily clinical practice.
"Our research is advantage efforts to personalize treatment approaches for patients suffering from alcohol use disorders.
"Sex and gender related differences are known to impact the patterns of drinking and risk of developing negative consequences."
In this study, 268 men and 132 women with alcoholism answered questionnaires about their moods, cravings and alcohol use during three months of treatment.
They were also tested to measure the levels of a variety of sex hormones, such as testosterone, estrogen and progesterone.
And they measured the presence of proteins known to affect reproduction, including follicle stimulating hormone (FSH) and luteinizing hormone (LH)—which have key roles in the female menstrual cycle—as well as albumin and sex hormone binding-globulin (SHBG), which carry hormones in the blood.
"These hormones and proteins are known to have an influence on behavior, and indeed we see an association between different levels of these compounds and different behavioral aspects of alcohol use disorder, although we can't for sure say that one directly causes another," said Karpyak in a statement.
"What it does mean is that, if you are treating a man and a woman for alcoholism, you are dealing with different biochemical and psychological starting points. This implies that what works for a man may not work for a woman, and vice versa."
Specifically, the researchers found that male alcoholics with more symptoms of depression and alcohol cravings at the beginning of the study had lower levels of testosterone, estrogen and SHBG than other male alcoholics. The same was not true for women.
Instead, women who drank more alcoholic drinks per day at the beginning of the study had, on average, lower estrogen and higher FSH and LH than other female alcoholics in the study. This wasn't true for men.
There were also links between these hormones and proteins, and whether participants were likely to relapse during the first three months of the study, while they were receiving treatment.
Men with lower levels of progesterone and albumin—and women with higher levels of testosterone, SHBG and albumin—were more likely to relapse during this period, than the other alcoholics in the study.
Women with higher levels of testosterone, SHBG and albumin were also more likely to have a history of depression or anxiety than women in the study with lower levels of these biomarkers.
"This is the first study large enough to be able to confirm that particular combinations of sex hormones and related proteins may be part of the biological differences in how alcoholism manifests itself in men and women," said Karpyak in a statement.
"We need more research to understand what this means for disease progression and its treatment."
Karpyak said he was particularly interested to see how the menstrual cycle, and menopause, affected "the biochemistry of alcoholism" and the efficacy of certain treatments.
"Our study is the first to show that alcoholism-related phenotypes are indeed associated with specific combinations of these hormones and proteins, and the associated signatures are specific to men and women affected by this illness," he told Newsweek.
He added that his team has previously shown that, while biological differences in alcoholism seem to remain stable over time, gender-related differences seem to be going away, which could be an important avenue of inquiry in future.
This study was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and its findings are being presented at the European College of Neuropsychopharmacology Congress, September 21-24.
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Reference
Karpyak, V., Song, Y., Ho, A.M.C., Geske, J., Pazdernik, V., Waller, C., Winham, S. (2024). Exploring the relationship between plasma sex-related hormone and protein levels with clinical characteristics and treatment outcomes in alcohol dependent patients, ECNP Congress 37: abstract P2001.
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