Lieber C S
JAMA. 1975 Sep 8;233(10):1077-80.
Malnutrition is common among alcoholics because alcohol displaces protein-, vitamin-, and mineral-containing foods in the diet, and chronic alcohol consumption results in maldigestion and malabsorption of essential nutrients. In addition, alcohol exerts direct toxic effects on both the liver and gut, resulting in structural alterations in the intestine and the development of fatty liver, alcoholic hepatitis, and cirrhosis. Liver injury is preceded by an adaptive phase characterized by accelerated metabolism of drugs (including ethanol), and hyperlipemia, secondary to hypertrophy and hyperactivity of the smooth endoplasmic reticulum. Side effects include enhanced hepatotoxicity of CCI4 and possibly energy wastage. Alcoholics should not be led to beleive that correction or prevention of nutritional deficiency will prevent liver damage in the face of continued alcohol abuse.
营养不良在酗酒者中很常见，因为酒精会取代饮食中含蛋白质、维生素和矿物质的食物，长期饮酒会导致必需营养素的消化和吸收不良。此外，酒精对肝脏和肠道有直接毒性作用，导致肠道结构改变以及脂肪肝、酒精性肝炎和肝硬化的发生。肝损伤之前有一个适应阶段，其特征是药物（包括乙醇）代谢加速以及高脂血症，这是由于滑面内质网肥大和活性增强所致。副作用包括四氯化碳肝毒性增强以及可能的能量浪费。面对持续的酒精滥用，不应让酗酒者认为纠正或预防营养缺乏就能防止肝损伤。
