Stomach Enzyme Deficit May Place Women At More Risk From Drinking Alcohol.

2001 APR 26 -- (NewsRx Network) -- In most cultures, including the United States, alcohol is the most frequently used drug. Although American men with alcohol-related problems continue to outnumber American women at a ratio of roughly three to one, women appear to have a greater vulnerability to alcohol-related diseases. This may be due to the fact that, when both genders drink the same amount of alcohol, women develop higher blood alcohol levels than men do.

A study in the April 2001 issue of Alcoholism: Clinical & Experimental Research addressed the mechanisms that may cause this effect, concentrating on the stomach's role in metabolizing alcohol.

"It has been known for a long time," said Steven Schenker, professor of medicine and pharmacology at The University of Texas, Health Science Center at San Antonio, "that, in general, both women and female animals are more susceptible to the negative or toxic effects of alcohol. This is true for the liver, heart muscle, skeletal muscle, and it may be true for the pancreas and the brain. In other words, there is something about the female gender that makes them more susceptible to toxic amounts of alcohol."

Charles S. Lieber, professor of medicine and pathology at Mount Sinai School of Medicine, chief of the Alcohol Research and Treatment Center at the Bronx VA Medical Center, New York, and the study's lead author, agrees. "For example," he said, "women have a higher propensity to develop liver disease than men. In fact, some studies have shown that the minimal amount necessary to produce cirrhosis in the liver in women is two to three times less than in men. Additionally, because of the higher blood level of alcohol in their blood, women are more vulnerable to the alcohol's central nervous system effects. Accordingly, the brain is more affected in women than in men."

This phenomenon -- where women need to drink a lesser amount of alcohol than men, or for a shorter amount of time, to produce the same degree of damage -- is referred to as "telescoping."

Women achieve higher blood alcohol levels than men do after drinking a similar amount of alcohol for several different reasons. One reason is their body size. In general, women's weights are lower, while drink sizes are standard. Another reason is that women tend to have more fatty tissue as a percentage of their body weight than men do. Fat is inversely related to body water. Because alcohol is more soluble in water than in fat, the alcohol is distributed throughout a lower water volume in women, resulting in less alcohol dilution. Third, it is believed that women younger than the age of 50 have a greater bioavailability (blood circulation) of alcohol, or less first-pass metabolism, than men do.

When people drink alcohol, a portion of it is metabolized in the stomach before it enters the blood stream. This metabolism of alcohol is due to the activity of gastric alcohol dehydrogenase (ADH) isozymes. The stomach's metabolism of alcohol decreases the amount of alcohol that reaches the blood stream, essentially functioning as a kind of protective barrier against excessive rise of blood alcohol. This process is referred to as "first-pass metabolism," because some of the alcohol is removed by metabolism on its first-pass through the stomach. As a result of first-pass metabolism, the blood level achieved for any given dose of alcohol is less when given orally than if it were to be given intravenously.