THE PARADOXICAL EFFECT OF ALCOHOL ON CARBOHYDRATE METABOLISM IN FOUR PATIENTS WITH LIVER GLYCOGEN DISEASE

Oxidation of ethanol to acetaldehyde, the first step in alcohol metabolism, is catalyzed by the enzyme alcohol dehydrogenase and resuits in the reduction of DPN to DPNH. In a coupled reaction, pyruvate is converted to lactate with regeneration to DPN. There are a number of consequences of these reactions when alcohol is consumed. Lactate levels in blood rise; DPNH produced by the reaction inhibits the enzymatic steps involved in the conversion of UDP galactose to UDP glucose and glutamate to alpha keto glutarate. As a result of these inhibitions, galactose removal from blood is markedly delayed and gluconeogenesis from amino acids is inhibited.