Heavy alcohol use, rather than alcohol dependence, is associated with dysregulation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system

Lynn Boschloo, Nicole Vogelzangs, Carmilla M M Licht, Sophie A Vreeburg, Johannes H Smit, Wim van den Brink, Dick J Veltman, Eco J C de Geus, Aartjan T F Beekman, Brenda W J H Penninx

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND: Heavy alcohol use as well as alcohol dependence (AD) have been associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA)-axis and the autonomic nervous system (ANS). However, the relative contribution of alcohol use and AD is unclear.

METHODS: Baseline data were derived from 2947 persons of the Netherlands Study of Depression and Anxiety (NESDA), including non-drinkers (n=498), moderate drinkers (n=2112) and heavy drinkers (n=337). We also distinguished between persons with no lifetime DSM-IV AD (n=2496), remitted AD (> 1 year; n = 243), and current AD (≤ 1 year; n=208). ANS measures included ECG-based heart rate (HR), respiratory sinus arrhythmia (RSA, high RSA reflecting high cardiac parasympathetic control) and pre-ejection period (PEP, high PEP reflecting low cardiac sympathetic control). HPA-axis measures included the cortisol awakening response (area under the curve with respect to the ground [AUCg] and increase [AUCi]), evening cortisol and a 0.5mg dexamethasone suppression test, all measured in saliva.

RESULTS: Heavy drinkers showed higher basal cortisol levels (AUCg: p=.02; evening cortisol: p=.006) and increased cardiac sympathetic control (higher HR: p=.04; lower PEP: p=.04) compared to moderate drinkers. Persons with current or remitted AD did not differ from persons without lifetime AD on any of the HPA-axis or ANS indicators (all p>.33). Similar patterns of HPA-axis and ANS activity across alcohol use groups were found in persons with and without lifetime AD.

CONCLUSIONS: Our findings suggest that current heavy alcohol use, rather than current or remitted AD, is associated with hyperactivity of the HPA-axis and increased cardiac sympathetic control.

Original languageEnglish
Pages (from-to)170-176
Number of pages7
JournalDrug and Alcohol Dependence
Volume116
Issue number1-3
Early online date16 Feb 2011
DOIs
Publication statusPublished - 1 Jul 2011

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Autonomic Nervous System
Neurology
Alcoholism
Alcohols
Hydrocortisone
Heart Rate
Saliva
Diagnostic and Statistical Manual of Mental Disorders
Netherlands
Dexamethasone
Area Under Curve
Electrocardiography
Anxiety
Depression

Keywords

  • Adult
  • Alcohol Drinking/epidemiology
  • Alcoholism/epidemiology
  • Autonomic Nervous System/physiopathology
  • Databases, Factual
  • Electrocardiography/drug effects
  • Ethanol/pharmacology
  • Female
  • Heart Rate/drug effects
  • Humans
  • Hydrocortisone/metabolism
  • Hypothalamo-Hypophyseal System/physiopathology
  • Male
  • Middle Aged
  • Netherlands
  • Pituitary-Adrenal System/physiopathology
  • Saliva
  • Surveys and Questionnaires
  • Time Factors

Cite this

Boschloo, Lynn ; Vogelzangs, Nicole ; Licht, Carmilla M M ; Vreeburg, Sophie A ; Smit, Johannes H ; van den Brink, Wim ; Veltman, Dick J ; de Geus, Eco J C ; Beekman, Aartjan T F ; Penninx, Brenda W J H. / Heavy alcohol use, rather than alcohol dependence, is associated with dysregulation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. In: Drug and Alcohol Dependence. 2011 ; Vol. 116, No. 1-3. pp. 170-176.
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abstract = "BACKGROUND: Heavy alcohol use as well as alcohol dependence (AD) have been associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA)-axis and the autonomic nervous system (ANS). However, the relative contribution of alcohol use and AD is unclear.METHODS: Baseline data were derived from 2947 persons of the Netherlands Study of Depression and Anxiety (NESDA), including non-drinkers (n=498), moderate drinkers (n=2112) and heavy drinkers (n=337). We also distinguished between persons with no lifetime DSM-IV AD (n=2496), remitted AD (> 1 year; n = 243), and current AD (≤ 1 year; n=208). ANS measures included ECG-based heart rate (HR), respiratory sinus arrhythmia (RSA, high RSA reflecting high cardiac parasympathetic control) and pre-ejection period (PEP, high PEP reflecting low cardiac sympathetic control). HPA-axis measures included the cortisol awakening response (area under the curve with respect to the ground [AUCg] and increase [AUCi]), evening cortisol and a 0.5mg dexamethasone suppression test, all measured in saliva.RESULTS: Heavy drinkers showed higher basal cortisol levels (AUCg: p=.02; evening cortisol: p=.006) and increased cardiac sympathetic control (higher HR: p=.04; lower PEP: p=.04) compared to moderate drinkers. Persons with current or remitted AD did not differ from persons without lifetime AD on any of the HPA-axis or ANS indicators (all p>.33). Similar patterns of HPA-axis and ANS activity across alcohol use groups were found in persons with and without lifetime AD.CONCLUSIONS: Our findings suggest that current heavy alcohol use, rather than current or remitted AD, is associated with hyperactivity of the HPA-axis and increased cardiac sympathetic control.",
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author = "Lynn Boschloo and Nicole Vogelzangs and Licht, {Carmilla M M} and Vreeburg, {Sophie A} and Smit, {Johannes H} and {van den Brink}, Wim and Veltman, {Dick J} and {de Geus}, {Eco J C} and Beekman, {Aartjan T F} and Penninx, {Brenda W J H}",
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Heavy alcohol use, rather than alcohol dependence, is associated with dysregulation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. / Boschloo, Lynn; Vogelzangs, Nicole; Licht, Carmilla M M; Vreeburg, Sophie A; Smit, Johannes H; van den Brink, Wim; Veltman, Dick J; de Geus, Eco J C; Beekman, Aartjan T F; Penninx, Brenda W J H.

In: Drug and Alcohol Dependence, Vol. 116, No. 1-3, 01.07.2011, p. 170-176.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Heavy alcohol use, rather than alcohol dependence, is associated with dysregulation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system

AU - Boschloo, Lynn

AU - Vogelzangs, Nicole

AU - Licht, Carmilla M M

AU - Vreeburg, Sophie A

AU - Smit, Johannes H

AU - van den Brink, Wim

AU - Veltman, Dick J

AU - de Geus, Eco J C

AU - Beekman, Aartjan T F

AU - Penninx, Brenda W J H

N1 - Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

PY - 2011/7/1

Y1 - 2011/7/1

N2 - BACKGROUND: Heavy alcohol use as well as alcohol dependence (AD) have been associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA)-axis and the autonomic nervous system (ANS). However, the relative contribution of alcohol use and AD is unclear.METHODS: Baseline data were derived from 2947 persons of the Netherlands Study of Depression and Anxiety (NESDA), including non-drinkers (n=498), moderate drinkers (n=2112) and heavy drinkers (n=337). We also distinguished between persons with no lifetime DSM-IV AD (n=2496), remitted AD (> 1 year; n = 243), and current AD (≤ 1 year; n=208). ANS measures included ECG-based heart rate (HR), respiratory sinus arrhythmia (RSA, high RSA reflecting high cardiac parasympathetic control) and pre-ejection period (PEP, high PEP reflecting low cardiac sympathetic control). HPA-axis measures included the cortisol awakening response (area under the curve with respect to the ground [AUCg] and increase [AUCi]), evening cortisol and a 0.5mg dexamethasone suppression test, all measured in saliva.RESULTS: Heavy drinkers showed higher basal cortisol levels (AUCg: p=.02; evening cortisol: p=.006) and increased cardiac sympathetic control (higher HR: p=.04; lower PEP: p=.04) compared to moderate drinkers. Persons with current or remitted AD did not differ from persons without lifetime AD on any of the HPA-axis or ANS indicators (all p>.33). Similar patterns of HPA-axis and ANS activity across alcohol use groups were found in persons with and without lifetime AD.CONCLUSIONS: Our findings suggest that current heavy alcohol use, rather than current or remitted AD, is associated with hyperactivity of the HPA-axis and increased cardiac sympathetic control.

AB - BACKGROUND: Heavy alcohol use as well as alcohol dependence (AD) have been associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA)-axis and the autonomic nervous system (ANS). However, the relative contribution of alcohol use and AD is unclear.METHODS: Baseline data were derived from 2947 persons of the Netherlands Study of Depression and Anxiety (NESDA), including non-drinkers (n=498), moderate drinkers (n=2112) and heavy drinkers (n=337). We also distinguished between persons with no lifetime DSM-IV AD (n=2496), remitted AD (> 1 year; n = 243), and current AD (≤ 1 year; n=208). ANS measures included ECG-based heart rate (HR), respiratory sinus arrhythmia (RSA, high RSA reflecting high cardiac parasympathetic control) and pre-ejection period (PEP, high PEP reflecting low cardiac sympathetic control). HPA-axis measures included the cortisol awakening response (area under the curve with respect to the ground [AUCg] and increase [AUCi]), evening cortisol and a 0.5mg dexamethasone suppression test, all measured in saliva.RESULTS: Heavy drinkers showed higher basal cortisol levels (AUCg: p=.02; evening cortisol: p=.006) and increased cardiac sympathetic control (higher HR: p=.04; lower PEP: p=.04) compared to moderate drinkers. Persons with current or remitted AD did not differ from persons without lifetime AD on any of the HPA-axis or ANS indicators (all p>.33). Similar patterns of HPA-axis and ANS activity across alcohol use groups were found in persons with and without lifetime AD.CONCLUSIONS: Our findings suggest that current heavy alcohol use, rather than current or remitted AD, is associated with hyperactivity of the HPA-axis and increased cardiac sympathetic control.

KW - Adult

KW - Alcohol Drinking/epidemiology

KW - Alcoholism/epidemiology

KW - Autonomic Nervous System/physiopathology

KW - Databases, Factual

KW - Electrocardiography/drug effects

KW - Ethanol/pharmacology

KW - Female

KW - Heart Rate/drug effects

KW - Humans

KW - Hydrocortisone/metabolism

KW - Hypothalamo-Hypophyseal System/physiopathology

KW - Male

KW - Middle Aged

KW - Netherlands

KW - Pituitary-Adrenal System/physiopathology

KW - Saliva

KW - Surveys and Questionnaires

KW - Time Factors

U2 - 10.1016/j.drugalcdep.2010.12.006

DO - 10.1016/j.drugalcdep.2010.12.006

M3 - Article

VL - 116

SP - 170

EP - 176

JO - Drug and Alcohol Dependence

JF - Drug and Alcohol Dependence

SN - 0376-8716

IS - 1-3

ER -