Hypothalamus-hypophysis-adrenal-cortical function in chronic alcoholism

Hypothalamic-pituitary-adrenocortical (HPA) function was assessed during normal daily work and family life in 15 male brewery workers with a daily alcohol intake of 100 g or more for at least 10 years. Free urinary cortisol was determined during 3 baseline days and for 3 days during administration of dexamethasone 0.5 mg 6-hourly. All subjects had normal basal urinary cortisol excretion and all, except one, suppressed normally upon dexamethasone. 4 subjects had cushingoid-like moon face and 2 of these also buffalo hump. There was no correlation between free urinary cortisol excretion of dexamethasone suppression and the cushingoid stigmata. It is concluded that chronic alcohol intake per se does not influence HPA-function. Previous reports of biochemical evidence of HPA hyperfunction together with cushingoid appearance in chronic alcoholics are probably explained by factors other than alcohol as such, leading to increased HPA function.