Why Gender And Race Are Factors In Determining Blood and Breath Alcohol Levels:

High Blood Alcohol Levels in Women: The Role of Decreased Gastric Alcohol Dehydrogenase Activity and First-Pass Metabolism, Frezza & Lieber,

322 (2) New England Journal of Medicine 95 (1990)

David Rosenbloom explains proven drawbacks with Utah Law Enforcement Intoxilizer testing.

Dave's Plain Language Analysis/Synopsis: Women almost always demonstrate higher blood and breath alcohol concentrations than men because of increased bioavailability, decreased first pass (gut-liver) metabolism), and higher percentage fat content v. men. This normally results in a 10-20% increase in breath testing, and about a 10% increase in blood alcohol level; the differential likely being due to physiological differences between airways and mouth alcohol contamination.

After consuming comparable amounts of ethanol, women have higher blood ethanol concentrations than men, even with allowance for differences in size, and are more susceptible to alcoholic liver disease. Recently, we documented significant "first-pass metabolism" of ethanol due to its oxidation by gastric tissue. We report a study of the possible contribution of this metabolism to the sex-related difference in blood alcohol concentrations in 20 men and 23 women. Six in each group were alcoholics. The first-pass metabolism was determined on the basis of the difference in areas under the curves of blood alcohol concentrations after intravenous and oral administration of ethanol (0.3 g per kilogram of body weight). Alcohol dehydrogenase activity was also measured in endoscopic gastric biopsies. In nonalcoholic subjects, the first-pass metabolism and gastric alcohol dehydrogenase activity of the women were 23 and 59 percent, respectively, of those in the men, and there was a significant correlation (rs = 0.659) between first-pass metabolism and gastric mucosal alcohol dehydrogenase activity. In the alcoholic men, the first-pass metabolism and gastric alcohol dehydrogenase activity were about half those in the nonalcoholic men; in the alcoholic women, the gastric mucosal alcohol dehydrogenase activity was even lower than in the alcoholic men, and first-pass metabolism was virtually abolished. We conclude that the increased bioavailability of ethanol resulting from decreased gastric oxidation of ethanol may contribute to the enhanced vulnerability of women to acute and chronic complications of alcoholism.

Abstract courtesy of www.pubmed.org - A service of the National Library of Medicine and the National Institutes of Health

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Milne, Canfield, Gallagher, Hunt, Klevay, Ethanol Metabolism in Postmenopausal Women Fed a Diet Marginal in Zinc, 46 American Journal of Clinical Nutrition 688 (1987)

Article Summary: Zinc Deficiency = High Blood Alcohol Content

Five postmenopausal women aged 50-63 y were fed a diet of mixed Western foods that supplied an average of 2.6 mg zinc/d for 6 mo. Plasma zinc did not change significantly during Zn depletion but increased slightly when Zn was fed. Zn content of blood cellular components and activities of Zn-containing enzymes were not affected by Zn intake. Ethanol tolerance tests performed at the end of control, middle of depletion, end of depletion, and end of repletion showed a change in ethanol metabolism at the end of the low-Zn intake period that was corrected within 1 mo with Zn supplementation. These data suggest that there are homeostatic mechanisms that maintain circulating levels of Zn. Zn and activity of Zn enzymes in tissues may be decreased before changes in circulating Zn levels are seen. Functional indices of Zn biochemistry, such as ethanol metabolism, may be more sensitive indicators of Zn stores and nutriture than circulating Zn.

Abstract courtesy of www.pubmed.org - A service of the National Library of Medicine and the National Institutes of Health

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Yoshida, et al., Molecular Genetics of Alcohol-Metabolizing Enzymes, 16 Biochemical Society Transactions 230 (1988)

Article Summary: 50% of Japanese lack one of the two types of ALDHArticle Summary: 84% of the Asian subjects responded to measure al. with flush face ;Japanese, Taiwanese, and Koreans, after drinking amounts of alcohol that have no detectable effect on Caucasoids, respond with a marked facial flushing and mild to moderate symptoms of intoxication. Group differences are present at birth, and are probably related to variations in autonomic reactivity.

Remarkable racial differences is isoenzyme components of the ethanol metabolizing enzymes, i.e. the class I alcohol dehydrogenase [alcohol: NAD oxidoreductase (ADH), EC 1.1.1.1] and the aldehyde dehydrogenase [aldehyde: NAD oxidoreductase (ALDH), EC 1.2.1.3], in conjunction with the differences in alcohol sensitivity between Caucasians and Orientals, have been the subject of interest of biochemical and genetic studies in recent years. Liver ADH activity of about 90% of Orientals is several fold higher than that of most Caucasians (Stamatoyannopoulos et al., 1975), while approximately 50% of Orientals lack the activity of mitochondrial ALDH (ALDH2) in their livers and other issues (Harada et al., 1978). The enzyme differences, mainly the absence of the active ALDH2 component, and the consequent accumulation of acetaldehyde in the body, have been attributed to the high frequency of alcohol flushing in Orientals.

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