Effect of an intravenous infusion of ethanol on serum enzymes and lipids in patients with alcoholic liver disease.

Administration of ethanol to healthy subjects as well as those with alcoholic fatty livers has been noted to cause mild elevation of serum enzyme activities and alcoholic hyperlipemia. To see whether this effect is also manifested in alcoholics with advanced liver damage, the serum enzyme activities and lipid content after administration of i.v. ethanol (1.2 g/kg of body wt) over 90 min were compared in 5 alcoholics with hepatic fibrosis and/or alcoholic fatty liver and in 9 patients with alcoholic hepatitis with or without cirrhosis. Disappearance rate of ethanol from the serum was nearly the same in both groups. Serum activities of asparate aminotransferase, mitochondrial isoenzyme of asparate aminotransferase, and ornithine carbamyl transferase, measured at 9 and 12 hr after termination of the i.v. ethanol, were significantly elevated in alcoholics with alcoholic hepatitis (P less than 0.05). They were not elevated in alcoholics with fatty liver. By contrast, hyperlipemic responses, measured as the serum content of triacylglycerol 3 hr after ethanol were significantly greater in alcoholics with fatty liver than in alcoholics with alcoholic hepatitis (P less than 0.05). The observed difference in responses of serum enzyme activities and lipid content after ethanol represents an enhanced susceptibility of patients with alcoholic hepatitis and cirrhosis towards alcohol-induced injury.