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Date Posted: 04:36:23 11/27/07 Tue
Author: Vancomycin
Subject: Re: Alcoholic ketoacidosis
In reply to: ªA³¡¥bÂà 's message, "Alcoholic ketoacidosis" on 20:55:39 11/21/07 Wed

Sorry about this late reply... I need to check my biochem notes...

First, we need to understand this,

C2H5OH--A-->C2H4O---A--->CH3COOH

A: NAD+-->NADH

There are other enzymes for alcohol-->acetaldehyde-->acetate (among them alcohol dehydrogenase if you remember)... the reason I want to point out NAD+-->NADH is that NADH-->NAD+ (its reverse) is crucial to the [lactate-->pyruvate] step in gluconeogenesis, without which impaired gluconeogenesis took place and, if there is a decreased carbohydrate(CHO) intake, the PREFERRED way of energy production in your body would become lipolysis leading to ketone (and subsequently ketosis, very much the same pathway in diabetic ketoacidosis)

The dehydration part is quite easily explained... in binge drinking people vomit-->decreased body fluid volume--> decreased renal perfusion--> concentration of ketone in body--> increases propensity to ketoacidosis.

If you have more questions feel free to drop me a line... it's time to review my biochem too~! Exams are coming!

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