LIPOPROTEIN(a) IN ALCOHOL-DEPENDENT MALE PATIENTS DURING A SIX-MONTH ABSTINENCE PERIOD

— Aims: The best known and probably most important mechanism of health-protective moderate alcohol drinking is beneficial changes in plasma lipid levels. We determined changes in main plasma lipid levels in alcohol-dependent patients over a 6-month abstinence period. Methods: Fifty-four alcohol-dependent male patients, who were abstinent for less than 14 days, and 20 non-alcoholic males, who had not drunk alcohol for the last month, were studied. In all patients at the study start and after 4 weeks and 6 months observation, lipoprotein(a) [Lp(a)], total cholesterol (TC), HDL cholesterol (HDL), LDL cholesterol (LDL) and triglyceride concentrations, both fasting and 5 h after a fatty meal, were determined. Results: Alcohol-dependent patients had similar mean fasting and post-prandial plasma lipid levels as the control group, both at the study start and after 4 weeks of abstinence. Whereas, in alcohol-dependent patients after 4 weeks of abstinence, a significant decrease in Lp(a) and fasting HDL levels, as well as a significant increase in fasting LDL level and pro-atherogenic indices of plasma lipids [TC/HDL, (TC–HDL)/HDL, LDL/HDL, Lp(a)/HDL] were observed. Post-prandial levels of studied plasma lipids, except HDL, did not change over the 6-month observation period. In patients who did not remain abstinent for the whole observation period (n = 9), in comparison to abstinent patients, significantly higher HDL levels and a tendency to higher values of LDL, LDL/HDL, Lp(a) and Lp(a)/HDL were found. Conclusions: (1) Higher Lp(a) levels soon after alcohol withdrawal may be a factor potentially responsible for the increase of acute cardiac syndromes prevalent in the drinking and early abstinence period, in spite of high HDL concentration; (2) in alcohol-dependent male patients, after a 6-month abstinence period, pro-atherogenic plasma cholesterol fraction changes occurred, expressed by a decrease in HDL level and an increase in LDL concentration.