Relationship of ghrelin with alcohol withdrawal and craving: A prospective, case–control study

ABSTRACT Background: Ghrelin, an endogenous ligand of the growth hormone secretagogue receptor 1A, is expressed in the hypothalamus and has a role in hunger and meal initiation. Ghrelin also alters the function of areas involved in reward and incentive motivation and in learning and memory. At present, the role of ghrelin in the neurobiology of alcohol dependence and craving is unclear. Aim: The aim of this study was to examine the relation of ghrelin as a biological marker with alcohol craving and withdrawal. Methods: Twenty-five patients admitted with the diagnosis of alcohol dependence were included in the study along with 15 healthy individuals in the control group. Ghrelin levels were assessed on days 1, 7, and 21. Withdrawal scores were assessed using the Clinical Institute Withdrawal Assessment of Alcohol Scale–Revised (CIWA-Ar) and craving using Penn’s Alcohol Craving Scale (PACS). Results: Ghrelin levels of cases and controls were significantly different on day 1 ( P = 0.015) and day 7 ( P = 0.07). There was a significant fall of ghrelin levels from day 1 to 7 and from day 7 to day 21. There was a significant fall in mean scores of CIWA-Ar from day 1 to 7 and also scores of PACS from day 7 to 21. A positive correlation was seen between ghrelin levels and craving scores. No correlation was seen between ghrelin levels and CIWA-Ar scores. Conclusion: It was found that ghrelin had no significant correlation with alcohol withdrawal scores; however, it had a positive correlation with craving scores after abstinence. This study hints toward a bigger role of ghrelin in the clinical state of craving rather than withdrawal.