First-pass metabolism of alcohol

Abstract

To determine whether the first-pass metabolism (FPM) of orally consumed alcohol varies with the time of day, 12 healthy male subjects were tested with both oral and intravenous alcohol (0.3 g/kg), in the morning and evening, always 1 hr after the same standard meal. The results revealed no significant differences in FPM (81.6 +/- 11.6 vs 92.8 +/- 10.6 mg/kg) or in any other index of alcohol absorption and metabolism. Eleven subjects were also tested in the evening after treatment with cimetidine, an H2-antagonist that inhibits gastric alcohol dehydrogenase activity in vitro. Compared to baseline, cimetidine (1 g/day for eight days) significantly decreased FPM (from 100.1 +/- 8.0 to 52.6 +/- 11.4 mg/kg, P < 0.01) and increased the systemic bioavailability of alcohol (from 66 +/- 3 to 82 +/- 4%, P < 0.01), as well as peak blood alcohol concentrations (from 4.3 +/- 0.4 to 5.9 +/- 0.5 mM, P < 0.05) and areas under the curve (from 5.1 +/- 0.5 to 7.0 +/- 0.5 mM/hr, P < 0.01). The results indicate the absence of diurnal variation in FPM and suggest that patients given cimetidine should be warned of its possible interaction with alcohol regardless of the time of day.

Lower survival and higher rates of cirrhosis in patients with ROUX-EN-Y gastric bypass hospitalised with alcohol-associated hepatitis

“…We found that patients with RYGB and AH had higher rates of cirrhosis after discharge from hospital when compared with controls. First-pass alcohol metabolism by gastric alcohol dehydrogenase is significantly reduced in patients with RYGB, while faster gastric emptying results in uncontrolled exposure to and absorption of alcohol through the small bowel 34 35. As a result, patients with RYGB who ingest alcohol may have higher peak blood alcohol concentrations compared with patients with normal stomach anatomy, which may be more directly toxic to the liver and accelerate the development of cirrhosis 36.…”

The Effects of Salty and Nonsalty Food on Peak Breath Alcohol Concentration and Divided Attention Task Performance in Women

“…Regardless of the inconsistencies in the gender difference data, the presence of ADH in the stomach provides the first opportunity for the oxidation of ingested alcohol. Therefore, the presence of food in the stomach should slow gastric emptying and reduce BACs (2,9,10). Meals of greater energy density, of greater volume, and of solid food will slow gastric emptying more than meals of lower density, of lesser volume, and of liquid food (11)(12)(13).…”