High Blood Acetaldehyde Levels after Ethanol Administration

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Abstract
Blood acetaldehyde and ethanol levels were measured in 11 subjects, six with chronic alcoholism and five nonalcoholic controls, after alcohol had been given intravenously. Despite a progressive fall in blood ethanol over a range of 54 to 33 mM, acetaldehyde did not decrease in any of the 11 subjects. The mean acetaldehyde plateau level was significantly (p < 0.001) higher in alcoholic (42.7 ± 1.2 μM) than in nonalcoholic (26.5 ± 1.5 μM) subjects. When the mean blood ethanol concentration reached 24 mM, the acetaldehyde plateau ended abruptly in each subject. The ethanol concentration at which this fall of blood acetaldehyde occurred suggests desaturation of an ethanol oxidizing system other than alcohol dehydrogenase and indicates that at high ethanol blood levels, such a system contributes to ethanol oxidation. The higher acetaldehyde levels in alcoholism may result from both greater activity of this system and mitochondrial damage, and could contribute to the neurologic, hepatic and cardiac complications of alcoholism. (N Engl J Med 292:386–389, 1975)