ALCOHOL METABOLISM
ALCOHOL METABOLISM
Walker has rightly said
'alcohol can be a food,
a drug or a poison
depending on the
dose.
ALCOHOL METABOLISM
Sources
(a) Endogenous Small amounts of alcohol in the blood
may be produced by intestinal flora.
(b) Exogenous Alcohol consumed by pleasure seekers
is absorbed easily all along gastro intestinal tract
and reaches liver.
Site
Liver is the major site of alcohol metabolism.
There are two pathways for alcohol degradation.
1. Major pathway
Alcohol is converted to acetate
by the action of two enzymes.
Cytosolic alcohol dehydrogenase
Mitochondrial aldehyde dehydrogenase
Acetyl-CoA may be formed from acetate which
enters TCA cycle or fatty acid biosynthesis.
2. Minor pathway
1. Major pathway
2. Minor pathway
Alcohol is converted to acetaldehyde
by
Microsomal cytP450-dependent
ethanol oxidizing system.
It is an induceble pathway and become
prominent in chronic alcoholics.
Biochemical changes in alcoholism
The metabolism of alcohol (by both dehydrogenases)
involves the consumption of NAD+, and consequently a
high NADH/NAD+ ratio.
This is mostly responsible for the metabolic alterations
observed in alcoholism.
1. High concentration of NADH favours the conversion of
pyruvate to lactate which may lead to lactic acidosis.
2. Hypoglycemia due to reduced gluconeogenesis is
observed. This happens as a result of decreased
availability of pyruvate and oxaloacetate (the latter gets
converted to malate by high NADH).
3. Citric acid cycle is impaired since the
availabilitv of oxaloacetate and NAD+ is
reduced.
As a result, acetyl CoA accumulates which gets
diverted towards ketogenesis,
cholesterologenesis, and fatty acid synthesis.
Accumulation of fats leads to fatty liver and
hyperlipidemia.
4. Increased concentration of serum uric acid due to
its reduced excretion is observed in alcoholism.
This is due to lactic acidosis
5. Acetaldehyde interferes with the functioning of
neurotransmitters, with an overall effect of
neurological depression.
6. Acetaldehyde causes headache, nausea/
tachycardia, reduced blood pressure etc.
Effects of Chronic alcoholism
Cirrhosis of Liver,
Neurodegenerative Changes,
Cardiomyopathy,
Diuresis,
Impotence etc.
How much alcohol one
can drink?
Alcohol consumption should not exceed
moderate drinking.
Moderation is defined as no more than one drink per
day for women and no more than two drinks per day
for men.
A drink is defined as 1 regular beer,
5 ounces of wine (a little over 1⁄2 cup), or
1.5 ounces of an 80-proof liquor, such as whiskey.
Pregnant women should drink no alcohol.
Fetal alcohol syndrome (FAS)
The ingestion of alcohol by
pregnant women can result in
Fetal alcohol syndrome (FAS) is marked by
prenatal and postnatal growth
deficiency,
developmental delay, and
craniofacial, limb, and
cardiovascular defects.
