Effect of ethanol on metabolism of purine bases (hypoxanthine, xanthine, and uric acid).
There are many factors that contribute to hyperuricemia, including obesity, insulin resistance, alcohol consumption, diuretic use, hypertension, renal insufficiency, genetic makeup, etc. Of these, alcohol (ethanol) is the most important. Ethanol enhances adenine nucleotide degradation and increases lactic acid level in blood, leading to hyperuricemia. In beer, purines also contribute to an increase in plasma uric acid. Although rare, dehydration and ketoacidosis (due to ethanol ingestion) are associated with the ethanol-induced increase in serum uric acid levels. Ethanol also increases the plasma concentrations and urinary excretion of hypoxanthine and xanthine via the acceleration of adenine nucleotide degradation and a possible weak inhibition of xanthine dehydrogenase activity. Since many factors such as the ALDH2*1 gene and ADH2*2 gene, daily drinking habits, exercise, and dehydration enhance the increase in plasma concentration of uric acid induced by ethanol, it is important to pay attention to these factors, as well as ingested ethanol volume, type of alcoholic beverage, and the administration of anti-hyperuricemic agents, to prevent and treat ethanol-induced hyperuricemia.
Yamamoto
Tetsuya
T
Division of Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1. Nishinomiya, Hyogo 663-8501, Japan. tetsuya@hyo-med.ac.jp
Moriwaki
Yuji
Y
Takahashi
Sumio
S
D000105:Acetyl Coenzyme A / Q000096:biosynthesis; D000426:Alcohol Dehydrogenase / Q000235:genetics; D000444:Aldehyde Dehydrogenase / Q000235:genetics; D000071396:Aldehyde Dehydrogenase, Mitochondrial; D000431:Ethanol / Q000097:blood / Q000494:pharmacology*; D006801:Humans; D033461:Hyperuricemia / Q000517:prevention & control / Q000628:therapy; D019271:Hypoxanthine / Q000378:metabolism*; D019344:Lactic Acid / Q000097:blood; D009243:NAD / Q000378:metabolism; D010084:Oxidation-Reduction; D014527:Uric Acid / Q000378:metabolism*; D019820:Xanthine / Q000378:metabolism*; D014968:Xanthine Dehydrogenase / Q000037:antagonists & inhibitors
D009243:NAD; D019820:Xanthine; D014527:Uric Acid; D019271:Hypoxanthine; D019344:Lactic Acid; D000431:Ethanol; D000105:Acetyl Coenzyme A; C489332:ADH1B protein, human; D000426:Alcohol Dehydrogenase; D014968:Xanthine Dehydrogenase; C096127:ALDH2 protein, human; D000444:Aldehyde Dehydrogenase; D000071396:Aldehyde Dehydrogenase, Mitochondrial