The measurement of D,L-2,3-butanediol in controls and patients with alcoholic cirrhosis.

Plasma D,L-2,3-butanediol was measured in 53 controls and 50 patients with alcoholic cirrhosis, none of whom had measurable amounts of blood ethanol. Thirteen of 50 samples from patients with alcoholic cirrhosis had measurable D,L-2,3-butanediol. (range less than 5-154 microM). In one patient with alcoholic cirrhosis who had been abstinent from ethanol for over 5 years plasma levels of D,L-2,3-butanediol ranged between 154 and 211 microM over a one-year period. Only one of the 53 control subjects had detectable levels of D,L-2,3-butanediol. Although it has previously been reported that 2,3-butanediol is present in alcoholics consuming distilled spirits (Rutstein et al. (1983) Lancet ii, 534), this is the first report of the persistent presence of these compounds in alcoholics in the absence of ethanol. Clearly in abstinent alcoholics the presence of 2,3-butanediol is not due to the ingestion of undistilled spirits nor is it likely to arise directly from the metabolic products of ethanol. The presence of D,L-2,3-butanediol in patients with alcoholic cirrhosis and its absence in control subjects suggests that this compound may be a marker of some forms for alcoholism.