Mechanisms for Hypoglycemia during Alcohol Binges in Pregnancy
Maternal alcohol abuse is detrimental to the developing fetal brain and metabolic derangements may be one potential mechanism of injury. We have previously shown that in pregnant ewes, alcohol intoxication causes acute hypoglycemia. We explored one possible mechanism for alcohol- induced hypoglycemia: ethanol affects the binding mechanism of the Corticosteroid Binding Globulin (CBG), and prevents the detachment of cortisol from the protein, and consequently lowers blood glucose levels.
Acute ethanol administration proved to decrease both the CBG-bound and free cortisol levels of the pregnant ewes tested. The ethanol infused sheep experienced an 85.66% average decrease in free cortisol concentration, and a 75.97% decrease in CBG-bound cortisol concentration. On the other hand, the control (saline) animals experienced a 68.42% and 100% average increase in free and CBG-bound cortisol concentrations respectively.
In second trimester pregnant ewes, binge alcohol intoxication leads to a pronounced decrease in the levels of free and CBG-bound cortisol levels. Glucocorticoids are essential for gluconeogenesis and the lower cortisol concentrations could be a factor in promoting hypoglycemia which may be detrimental to the fetal brain.
Due to the fact that these are preliminary results, more animals need to be included in the study. Statistical analysis should also be added to fully demonstrate the discrepancies between the ethanol infused sheep and the control (saline) sheep. Methods involving less intrusive mechanisms to obtain blood and saliva samples could be implemented, since cortisol is also a stress hormone. Furthermore, samples could be collected after the 3.5 hour time point to try to establish a correlation with the ethanol elimination rate and the rate at which cortisol levels return to baseline. Cortisol is secreted in response to adrenocorticotropic hormone (ACTH) from the anterior pituitary, so future studies might focus on the effects of ethanol on the adrenal glands.
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