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Alcohol metabolism in man: Effect of intravenous fructose infusion on blood ethanol elimination rate following stimulation by phenobarbital treatment or chronic alcohol consumption

Untersuchungen zur Regulation des Alkoholabbaus beim Menschen: Effekt einer intravenösen Fruktose-Infusion auf die durch Phenobarbitalvorbehandlung oder chronischen Alkoholkonsum stimulierte Blutalkoholelimination

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Zusammenfassung

Es wurde der Einfluß einer Vorbehandlung mit Phenobarbital (PB) und eines chronischen Alkoholabusus auf die Geschwindigkeit der Blutalkoholelimination (BAE) beim Menschen untersucht. Es wurde die BAE vor und während einer intravenösen Fruktoseinfusion gemessen. Fruktosezufuhr erhöht die Kapazität der Leber zur NADH-Oxidation und kann hierdurch die Alkoholoxidation stimulieren.

Durch PB-Vorbehandlung (300 mg/Tag für 5–6 Tage,n=8) nahm die unstimulierte (U-) BAE im Mittel um 50% zu. Die durch Fruktose stimulierte (FS-) BAE wurde durch PB-Vorbehandlung jedoch nicht signifikant beeinflußt. Bei chronischen Alkoholikern (n=15) wurden U-BAE-Werte, die über dem Bereich der bei gesunden Kontrollen gefundenen Abbauraten lagen, nur dann beobachtet, wenn die Dauer des Alkoholentzugs weniger als eine Woche betrug (n=6). Bei den chronischen Alkoholikern mit erhöhter U-BAE lagen die Werte der FS-BAE im gleichen Bereich wie bei den gesunden Kontrollen. Bei 5 der 6 Alkoholiker mit erhöhten Werten der U-BAE konnte letztere 2–4 Wochen nach Beginn des Alkoholentzugs erneut bestimmt werden. Die Werte waren in allen Fällen im Vergleich zu den Ausgangsbefunden deutlich vermindert. Die FS-BAE blieb somit durch Phenobarbital-Behandlung und chronischen Alkoholkonsum nahezu unbeeinflußt. Gleiches gilt, wie in einer vorangehenden Mitteilung gezeigt wurde, für längeres Fasten. Hieraus wird geschlossen, daß die deutlichen Änderungen der U-BAE vermutlich unabhängig von Aktivitätsänderungen der am Alkoholabbau beteiligten Enzyme sind.

Summary

The effect of phenobarbital (PB) pretreatment and of chronic alcoholism on blood ethanol elimination rate (BEER) was investigated in man. In order to gain additional information concerning the mechanism of possible changes BEER was determined before and during intravenous infusion of fructose, a compound known to increase the NADH-oxidizing capacity of the liver and thereby stimulating alcohol oxidation rate. Following PB-treatment (300 mg/day for 5–6 days,n=8) a marked increase in unstimulated (U-) BEER was obtained. But the fructose stimulated (FS-) BEER was not significantly changed by PB-treatment. In chronic alcoholics (n=15) U-BEER values above the upper limit (x+2 S D) obtained in healthy controls, were observed only when the time of sobriety was less than one week (n=6). Values of FS-BEER in chronic alcoholics with increased basal alcohol oxidation rates were in the same range as those of healthy controls. In 5 out of the 6 alcoholics in whom the values were elevated on admission, BEER decreased significantly after withdrawal of alcohol for 2–4 weeks. Since FS-BEER was nearly identical in all conditions tested, the distinct changes in U-BEER are probably independent of changes in the activity of enzymes involved in alcohol oxidation. It is assumed that alcohol metabolism in man is mainly controlled by the rate of NADH reoxidation in the liver.

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  1. Medizinische Universitäts-Klinik, Mannkopffstraße 1, D-3550, Marburg a.d. Lahn, Germany

    J. Ch Bode, Ch. Bode & D. Thiele

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Supported by Deutsche Forschungsgemeinschaft (Grant Bo. 334/5–6)

Parts of the data were presented at the 9th Meeting of the European Association for the Study of the Liver (E.A.S.L.), Hemsedahl, Norway, Oct. 1974 (5), and at the 2nd International Symposium on “Alcohol and Aldehyde Metabolizing Systems”, Philadelphia, USA, Oct. 1976 (7a)

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Bode, J.C., Bode, C. & Thiele, D. Alcohol metabolism in man: Effect of intravenous fructose infusion on blood ethanol elimination rate following stimulation by phenobarbital treatment or chronic alcohol consumption. Klin Wochenschr 57, 125–130 (1979). https://doi.org/10.1007/BF01476052

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