Changes of Serum Trace Elements during Three Weeks of Abstinence from Alcoholic Beverages in Patients with Alcohol Dependence

INTRODUCTIONTwo basic goals are achieved by nourishment: providing the source of energy and maintaining the organism structure and function. Alcohol-dependent persons are often undernourished, either due to the fact that they do not eat enough and consequently do not have sufficient essential ingredients or due to the direct effect of alcohol on digestion, i.e. obstruction of deposition, use and discharge of nutrients.1 Alcohol slows down the metabolism of nutrients into useful molecules by reducing the discharge of digestive enzymes from pancreas.2 It also obstructs the absorption of nutrients, as it hurts stomach and intestines lining, thus interfering with absorption of digestive tract substances into blood.3 Insufficient introduction of nutrients can also lead to nutritional disorders. In case when the nutrients have been absorbed, alcohol may prevent their use by changing their deposition, transport and discharge.4Minerals are chemical elements which are necessary for completion of various physiological processes, such as regulation of bodily fluids, muscle contractions and nervous impulses. Presence of calcium, phosphorus and magnesium in the body is necessary in greater quantities as opposed to chrome, copper, flour, iodine, iron, selenium and zinc which are represented in smaller quantities.5'6 Sodium, chlorine and potassium are three electrolytes (transporting electric impulses through bodily fluids), which are also minerals.In alcoholism, the insufficiency of calcium, iron, zinc and magnesium is frequent, although the researches up to now indicate that that alcohol has no direct influence on their absorption.7 Their insufficiency is a consequence of secondary processes appearing after drinking of alcohol. Consequently, the reduced absorption of calcium occurs due to the reduced absorption of fats, insufficiency of magnesium occurs due to its reduced consumption, increased discharge by urine, vomiting and diarrhoea.8 Also, the insufficiency of magnesium occurs in withdrawal syndrome.9Chronic bleeding from digestive tract is often the cause of iron insufficiency. Here the direct toxic effect of alcohol on eritrocytopoesis should be mentioned, causing damage to mitochondria and forming of annular sideroblasts.10'11 Poor nutrition along with the influence of alcohol on the metabolism of nutritive ingredients leads to folie acid insufficiency.12'13 Poor absorption of zinc or loss of zinc is connected with the lack of other nutrients. 14 It is very often followed by insufficiency of magnesium, thiamine, folacin and vitamins D and E, particularly in case of serious liver damage.15 Minerals insufficiency can cause the whole range of health problems, such as bone diseases due to the lack of calcium or night blindness and skin lesions due to the lack of zinc.The researches indicate that only a small number of more seriously damaged alcoholics have nutritional deficiencies accessible to detection, although many hospitalised alcoholics feel some consequences of serious malnutrition. 16'17 Alcoholics do not eat enough and consequently do not introduce a sufficient quantity of nutrients into their bodies, including carbohydrates, fats, proteins, vitamins A, C and B group and minerals such as calcium and iron.18'19 Considering all mentioned above, the effects of alcohol on digestive system should be closely monitored as they can lead to a serious malnutrition.SUBJECTS AND METHODSSubjectsThe study group consisted of 30 male patients with chronic alcohol dependence, aged between 19 and 59 years, mean+SD; 44.5+ 12.2 years. The duration of their alcohol dependence ranged from 1 to 25 years, mean+SD; 12.6+12.2 years. Subjects with alcohol dependence were undergoing the hospital treatment. During their hospitalization, they undertook an intensive schedule of 30 hours of individual and group therapy per week, as well as other socio-therapeutic activities. Treatment program was based on principles of the therapeutic community. …