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DOI: 10.1055/s-2001-17196
Age and bioavailability of alcohol
Bioverfügbarkeit des Alkohols im AlterPublication History
17.4.2001
29.5.2001
Publication Date:
14 September 2001 (online)
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Summary
It has been shown that advanced age results in a decreased first pass metabolism (FPM) of ethanol with elevated serum ethanol concentrations (SECs). It is still unknown if this is due to age by itself or to other factors like for example atrophic gastritis with decreased activity of alcohol dehydrogenase (ADH). To study the effect of age on SECs and on bioavailability of ethanol, 15 volunteers with a mean age of 71 ± 1 year (8males and 7 females) and 16 volunteers with a mean age of 37 ± 2 years (8males and 8 females) showing normal gastric histology received ethanol (0.225 g/kg b. w.) intravenously (iv.) and orally.
Results: The difference between the SEC time curves after iv. and oral ethanol administration (so called FPM of ethanol) was significantly increased in elderly subjects (54 ± 6 vs. 12 ± 9 %, p < 0.001). The SEC time curves after iv. ethanol application were significantly increased in the elderly (p < 0.001), whereas SECs following oral alcohol administration were significantly lower in elderly as compared to younger individuals (p < 0.02). Peak SECs following iv. application was also significantly elevated with age (52 ± 4 vs. 31 ± 1 mg/100 ml, p < 0.001) and occurrence of peak SECs following oral ethanol intake was significantly delayed (47 ± 4 vs. 28 ± 4 min, p < 0.001). No gender effect at all was observed.
Conclusion: FPM of ethanol is inexpectedly increased in elderly with normal gastric morphology compared to young people. The elevation of SECs after iv. ethanol administration in the elderly could be explained by the reduction of the water distribution space with age, whereas the increased FPM of ethanol in elderly subjects with normal gastric morphology is probably due to a deceleration of the speed of gastric emptying leading to an increased contact time of alcohol with gastric alcohol dehydrogenase (ADH). Our data do not confirm results from other research groups showing increased SECs in the elderly after alcohol consumption. Increased SECs are therefore not due to age by itself, but are probably caused by other factors as for example atrophic gastritis which is frequently found in the elderly people and which decreases FPM of ethanol.
Bioverfügbarkeit des Alkohols im Alter
Es ist gezeigt worden, dass höheres Alter mit einem verminderten First-Pass-Stoffwechsel (FPS) des Alkohols und erhöhten Serumalkoholkonzentrationen (SAK) einhergeht. Dabei ist unklar, ob dieser Effekt durch das Alter an sich zustande kommt oder vielmehr mit anderen Faktoren, wie zum Beispiel einer atrophischen Gastritis mit verminderter Aktivität der Alkoholdehydrogenase (ADH), im Zusammenhang steht. Um dies zu untersuchen, wurden 15 Probanden mit einem Durchschnittsalter von 71 ± 1 Jahr (8 Männer und 7 Frauen) und 16 Probanden mit einem Durchschnittsalter von 37 ± 2 Jahren (8 Männer und 8 Frauen), alle eine normale Magenhistologie aufweisend, mit Alkohol (0,225 g/kg KG) sowohl intravenös (i. v.) als auch peroral belastet.
Resultate: Der Unterschied zwischen den SAK-Zeit-Kurven nach i. v. und oraler Alkoholgabe (sog. FPS des Alkohols) war signifikant höher bei den älteren Probanden (54 ± 6 vs. 12 ± 9 %, p < 0,001). Die SAK-Zeit-Kurven nach i. v. Alkoholgabe waren bei den Alten ebenfalls signifikant höher (p < 0,001), wohingegen diejenigen nach oraler Alkoholgabe im Vergleich zu den Jungen niedriger ausfielen (p < 0,02). Die Spitzen-SAK waren bei den älteren Leuten nach i. v. Alkoholverabreichung signifikant erhöht (52 ± 4 vs. 31 ± 1 mg/100 ml, p < 0,001), während ihr Erreichen nach oraler Alkoholverabreichung bei diesen verzögert war (47 ± 4 vs. 28 ± 4 min, p < 0,001). Es wurden keinerlei Geschlechtsunterschiede beobachtet.
Schlussfolgerung: Der FPS des Alkohols ist bei älteren Leuten mit normaler Magenmukosahistologie im Vergleich zu jungen unerwarteterweise verstärkt. Die bei den Alten erhöhten SAK nach i. v. Alkoholgabe können mit der Reduktion des Wasserverteilungsvolumens erklärt werden, während der erhöhte FPS des Alkohols sehr wahrscheinlich auf die Verzögerung der Magenentleerung mit dadurch erhöhter Kontaktzeit des Alkohols mit der Magen-ADH zurückzuführen ist. Die Resultate anderer Arbeitsgruppen, dass oraler Alkoholkonsum bei alten Leuten mit erhöhten SAK einhergeht, können durch unsere Daten nicht bestätigt werden. Erhöhte SAK bei älteren Individuen sind deshalb nicht direkt mit dem Alter assoziiert, sondern vielmehr bedingt durch andere Faktoren, wie zum Beispiel einer atrophischen Gastritis, die häufig bei alten Leuten angetroffen wird und den FPS von Alkohol vermindert.
Key words
Alcohol - Age - First Pass Metabolism of Ethanol - Gastric Emptying - Gastritis - Alcohol Dehydrogenase
Schlüsselwörter
Alkohol - First-Pass-Metabolismus von Äthanol - Magenentleerung - Gastritis - Alkoholdehydrogenase
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Address for correspondence
Helmut K Seitz, MD
Laboratory of Alcohol Research
Liver Disease and Nutrition
Dept. of Internal Medicine
Salem Medical Center
Zeppelinstraße 11-33
69121 HeidelbergGermany
Phone: 00 49/62 21-48 32 01
Email: helmut_karl.seitz@urz.uni-heidelberg.de