Abstract Objective: Alcohol use and alcohol use disorders (AUDs) are an increasing concern among veterans, particularly those from recent conflicts in Iraq and Afghanistan. The study of biomarkers in alcohol use and AUD has moved to enhancing the understanding of the development and maintenance of AUDs, as well as investigating its association with clinical severity and potential predictors of treatment response. Cortisol, a glucocorticoid known as a stress hormone, has been linked with both stress and trauma, as well as increased alcohol suppression effects. Method/Results: The present review summarizes existing literature and presents suggestions for future research to evaluate whether cortisol may be a possible biomarker of alcohol use disorder risk in combat veterans. Specifically, aspects of combat deployments and high levels of PTSD, coupled with the stress of reintegration may dysregulate cortisol and increase risk to AUD. There may also be bidirectional impacts, such that alcohol is used as a coping mechanism and can dysregulate hypothalamic pituitary adrenal (HPA) axis functioning and cortisol. Conclusions: In the context of this framework, cortisol may serve as a biomarker for the development of AUD, as well as a biomarker of risk or relapse. This review ends with both theoretical and clinical implications, as well as directions for future research.

中文翻译：

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皮质醇作为退伍军人饮酒的生物标志物：文献综述和未来研究框架

摘要目标：酒精使用和酒精使用障碍 (AUDs) 越来越受到退伍军人的关注，尤其是那些来自伊拉克和阿富汗最近冲突的退伍军人。对酒精使用和 AUD 中生物标志物的研究已经转向增强对 AUD 的发展和维持的理解，以及调查其与临床严重程度和治疗反应的潜在预测因子的关联。皮质醇是一种被称为压力激素的糖皮质激素，与压力和创伤以及增加的酒精抑制作用有关。方法/结果：本综述总结了现有文献并提出了对未来研究的建议，以评估皮质醇是否可能是退伍军人酒精使用障碍风险的可能生物标志物。具体来说，作战部署和高水平的 PTSD 方面，再加上重新融入社会的压力，可能会使皮质醇失调并增加患澳元的风险。也可能存在双向影响，例如酒精被用作应对机制，并可能使下丘脑垂体肾上腺 (HPA) 轴功能和皮质醇失调。结论：在该框架的背景下，皮质醇可作为 AUD 发展的生物标志物，以及风险或复发的生物标志物。这篇综述以理论和临床意义以及未来研究的方向结束。皮质醇可作为 AUD 发展的生物标志物，以及风险或复发的生物标志物。这篇综述以理论和临床意义以及未来研究的方向结束。皮质醇可作为 AUD 发展的生物标志物，以及风险或复发的生物标志物。这篇综述以理论和临床意义以及未来研究的方向结束。