Keiding S, Christensen N J, Damgaard S E, Dejgård A, Iversen H L, Jacobsen A, Johansen S, Lundquist F, Rubinstein E, Winkler K
Biochem Pharmacol. 1983 Oct 15;32(20):3097-102. doi: 10.1016/0006-2952(83)90255-1.
Some alcoholics have a regular daily alcohol consumption of more than 100 g. In preliminary observations we had the impression that the claimed alcohol intake in such 'heavy drinkers' was higher than could be accounted for by the ethanol elimination rate as measured routinely at 10 mmol/l (0.5 g/l). We therefore measured the ethanol elimination rate at very high blood ethanol concentrations of 40-80 mmol/l (2-4 g/l) found in eight alcoholics following heavy alcohol intake by measuring the falling blood ethanol concentrations until being less than 1 mmol/l. The elimination rate, on average 83 mumol/min per 1 blood, was about 49% higher than the elimination rate measured at 10 mmol/l in the same subject, being on average 58 mumol/min per 1/blood (paired t-test, P less than 0.05). The elimination rate following the high initial ethanol concentrations remained high until the concentration was below 5 mmol/l. Calculations of elimination rates are based on a number of assumptions concerning the physiologic and metabolic conditions. We examined specifically if the concentration-time curves could be adequately described by assuming metabolism according to a Michaelis-Menten pathway with a low Km value (simulating alcoholdehydrogenase with Km 0.2 mmol/l) or by assuming metabolism by two pathways with an alternative high-Km pathway with Km about 10 mmol/l. It was not necessary, in the statistical analysis, to include an alternative high-Km pathway. On the other hand, the data does give room for up to 50% elimination via such alternative pathways. The elimination rate at the high concentrations corresponded roughly to the claimed daily alcohol intake; furthermore the measured elimination rate at the lower concentrations were similar to values in non-alcoholics.
一些酗酒者每天的酒精摄入量超过100克。在初步观察中，我们感觉这类“重度饮酒者”声称的酒精摄入量高于通过常规测量的10毫摩尔/升（0.5克/升）乙醇消除率所能解释的量。因此，我们测量了8名酗酒者在大量饮酒后血液乙醇浓度非常高（40 - 80毫摩尔/升，即2 - 4克/升）时的乙醇消除率，通过测量血液乙醇浓度下降直至低于1毫摩尔/升来进行。消除率平均每升血液为83微摩尔/分钟，比同一受试者在10毫摩尔/升时测量的消除率高出约49%，后者平均每升血液为58微摩尔/分钟（配对t检验，P < 0.05）。在初始乙醇浓度较高时，消除率一直保持较高水平，直到浓度低于5毫摩尔/升。消除率的计算基于一些关于生理和代谢状况的假设。我们专门研究了浓度 - 时间曲线是否可以通过假设按照米氏途径代谢且米氏常数较低（模拟米氏常数为0.2毫摩尔/升的乙醇脱氢酶）来充分描述，或者通过假设由两条途径代谢，其中一条替代途径的米氏常数约为10毫摩尔/升来描述。在统计分析中，没有必要纳入替代的高米氏常数途径。另一方面，数据确实为通过此类替代途径进行高达50%的消除留出了空间。高浓度时的消除率大致与声称的每日酒精摄入量相对应；此外，在较低浓度下测量的消除率与非酗酒者的值相似。
