i i,I ELSEVIER 0741-8329(95)02112-4 Alcohol,Vol. 13, No. 3,309-314, 1996 Copyright© 1996 Elsevier Science Inc. Printedin the USA.All rightsreserved 0741-8329/96$15.00 + .00 Serum Lipoprotein(a) [Lp(a)] in Alcoholic Men: Effect of Withdrawal JACQUES DELARUE,* MARION HUSSON,t FRANt~OIS SCHELLENBERG,:~ JEAN TICHET,§ SYLVIANE VOL,§ CHARLES COUET* AND FERNAND LAMISSE *l *Clinique Mddicale A, H6pital Bretonneau, 37044 Tours Cedex, and Laboratoire de Nutrition, Universit~ Francois Rabelais, 37042 Tours Cedex, France tCentre de Cure Louis Sevestre (Dr J P Ferrant), 37390 La Membrolle sur Choisille, France ~Laboratoire de Biochimie (Pr J. Weill), H6pital Trousseau, 37044 Tours Cedex, France §Institut Rdgional de la Santd, 45 Rue de la Parmentibre, 37520 La Riche, France Received 3 August 1995; Accepted 7 December 1995 DELARUE, J., M. HUSSON, F. SCHELLENBERG, J. TICHET, S. VOL, C. COUET AND F. LAMISSE. Serum lipoprotein(a) [Lp(a)] in alcoholic men: Effect of withdrawal. ALCOHOL 13(3) 309-314, 1996.-This study examines the effect of alcohol withdrawal on lipoprotein(a) [Lp(a)] in 24 male, middle-aged chronic alcohol abusers admitted for with- drawal therapy. Serum concentration of Lp(a) was determined before and during the first 3 weeks of abstinence. The changes in three sialylated proteins [Lp(a), al-antitrypsin (ctl-AT), and haptoglobin (Hp)] and in desialylated transferrin (CDT) were also determined in 14 patients. After the 3 weeks of withdrawal therapy, the mean and median Lp(a) concentrations increased (p = 0.0001). The changes in Lp(a) levels were not related to the changes in dietary intake nor to the decrease in total HDL, HDL3, I-IDL2cholesterol, Apo A-I, and Apo B. In the subgroup of 14 chronic alcohol abusers, Lp(a) levels increased parallel with Hp and ,~I-AT, whereas CDT decreased. It is concluded that the impact of alcohol on sialylated proteins may be one of the mechanisms responsible for the increase in plasma Lp(a) after alcohol withdrawal. Lipoprotein(a) High-density lipoprotein Alcohol Withdrawal Human LIPOPROTEIN(a) [Lp(a)] is a low-density lipoprotein (LDL) in which apo B100 is linked to a protein, apolipoprotein(a) [Apo(a)] by a disulfide bridge (21,45). Apo(a) is a glycoprotein containing about 30070 carbohydrate by weight, and has a striking structural similarity to plasminogen. Another charac- teristic of Apo(a) is size polymorphism (300-800 kDa) under the control of several alleles at the Apo(a) gene locus located on the long arm of chromosome 6. High serum levels of Lp(a) (>0.30g/l) are considered to be a risk factor for coronary heart disease (6,22,28), peripheral vascular disease (46), and stroke (22,51). Lp(a) levels are genetically determined and are relatively stable with aging (2,27). The variation of interindi- vidual serum Lp(a) level is l to 100 and the distribution of Lp(a) concentrations in the caucasian population is not Gauss- ian (11). Lp(a) levels are relatively unaffected by changes in diet (3), and there are few studies of the effects of chronic alcoholism (20) and alcohol withdrawal (10,13) on serum con- centrations of Lp(a). The present study was designed to ex- plain the mechanisms that modify serum Lp(a) levels after alcohol withdrawal. METHOD Patients Twenty-four alcoholic men (28-49 years) admitted to a spe- cialist drying-out center volunteered for this prospective study. The clinical and biochemical features of the population studied are presented in Table 1. Each subject was still con- suming alcohol on admission (79-408 g ethanol/day). The source of alcohol was wine for nine subjects, beer for six subjects, and both wine and beer for the remaining nine sub- jects. Alcohol drinking history ranged from 5 to 33 years. None of the subjects had clinical signs of liver cirrhosis and plasma level of prothrombin factor was above 90% in all subjects. Serum aspartate aminotransferase (AST) level was elevated in 13 subjects (30-125 U/l; N < 30 U/l). Thirteen subjects had an increase in serum alanine aminotransferase (ALT) (31-148 U/l; N < 30 U/l). Gammaglutamyltransferase (GGT) was elevated in 16 pa- tients (48-457 U/l; N < 40 U/l). Twenty-one men were cur- rent smokers (10-80 cigarettes per day). Control values for Requests for reprints should be addressed to Fernand Lamisse, Clinique M6dicaleA, H6pital Bretonneau, 37044Tours Cedex, France. 309