Relationship Between Ghrelin Levels, Alcohol Craving, and Nutritional Status in Current Alcoholic Patients

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Abstract
Background: Ghrelin is a peptide produced mainly by the gut and hypothalamus. Ghrelin is able to stimulate food-seeking behavior. Alcohol-craving and food-seeking behavior could share common neural circuits. Ghrelin is related to nutritional status, but few data are available in alcoholic patients on the relationship between ghrelin and nutritional disorders. Methods: Plasma ghrelin was evaluated in 15 current alcoholic male patients compared with 15 healthy male volunteers. Craving was evaluated by the Obsessive–Compulsive Drinking Scale. Body composition was assessed by dual-energy X-ray absorptiometry. Energy substrate utilization was evaluated by indirect calorimetry. Results: Ghrelin was significantly reduced in alcohol-dependent patients with respect to healthy subjects (p=0.0278). A significant positive correlation was found between ghrelin and craving (r=0.55; p=0.034). A preferential utilization of lipids as an energy substrate with a reduction of the fat mass (p=0.01) and an increase of the free fat mass (p=0.0091) was found in alcoholic patients. Conclusions: Within our sample showing low ghrelin levels probably related to the impaired nutritional status; patients with higher levels of ghrelin showed higher levels of alcohol craving. These preliminary data indicate that ghrelin could be implicated in the neurobiological mechanisms of alcohol craving, other than a hormone influenced by the nutritional status.