The flushing response to alcohol use among Koreans and Taiwanese

Validation of Alcohol Flushing Questionnaires in Determining Inactive Aldehyde Dehydrogenase-2 and Its Clinical Implication in Alcohol-Related Diseases

BACKGROUND

Our aim was to validate alcohol flushing questionnaires in detecting inactive ALDH2 (ALDH2*1/*2 or ALDH2*2/*2).

METHODS

Two study sets were established; in study set 1, 210 healthy male subjects (age 22 to 59 years) were enrolled; in study set 2, 756 subjects were enrolled who received esophagogastroduodenoscopy to evaluate their dyspeptic symptoms or as part of a gastric cancer screening program. Subjects in study sets 1 and 2 completed the modified alcohol flushing questionnaires of Yokoyama and colleagues (, ). Polymerase chain reaction-restriction fragment length polymorphism method was used to determine ALDH2 genotype.

RESULTS

In study set 1, 29.0% (61 of 210) had inactive ALDH2. The sensitivity and specificity of the modified alcohol flushing questionnaire for detecting inactive ALDH2 were 95.1 and 76.5%, respectively. Drinking problems negatively correlated with positive alcohol flushing response and inactive ALDH2 (all p-values < 0.05). In study set 2, the sensitivity and specificity of the alcohol flushing questionnaire for detecting inactive ALDH2 were 78.9 and 82.1%, respectively. Interestingly, drinking ≥7 units/wk in men or ≥3.5 units/wk in women significantly increased the risk of benign gastric ulcer (BGU) among positive alcohol flushers (odds ratio, 8.97; 95% confidence interval, 1.38 to 58.30), but not among negative alcohol flushers.

CONCLUSIONS

Simple flushing questionnaires may be administered to the Korean population as a screening tool in detecting individuals who carry inactive ALDH2. Alcohol flushing response negatively correlates with drinking problems and can modify the risk for BGU by alcohol intake.

The educational potential of alcohol-related flushing among Chinese young people

Aim: This paper describes Chinese university students' understanding of the meaning of the alcohol-related flushing response and how they reacted to their own and someone else's flushing in a group drinking situation. Method: The researcher surveyed 530 Chinese university students about their understanding of flushing and their perception of how people respond to a person who visibly flushes while drinking alcohol. Findings: Most students did not know about the physiological cause of flushing. There were significant gender differences in both reactions to and perception of responses to a person who flushes. There was no direct relationship between flushing and drinking behaviour.

CONCLUSIONS

This description of flushing behaviour and responses to a flushing person is discussed in terms of educational opportunities to change behaviours that could reduce the cancer related risks of this visibly at-risk group.

Differential effects of acculturation on drinking behavior in Chinese- and Korean-American college students

OBJECTIVE

Recent evidence suggests increasing rates of alcohol use and related disorders among Asian-American young adults. Relatively little research has focused on this group, and few studies have examined heterogeneity in drinking prevalence and correlates across Asian subgroups. This study examined interactive effects of ethnicity, acculturation, and gender on drinking behavior among Asian-American undergraduates.

METHOD

Participants were 112 Chinese Americans and 108 Korean Americans (mean age = 19.2 years, 61% female) who completed measures of alcohol use, acculturation, and demographic factors. Multivariate analyses examined drinking behavior (defined as quantity, frequency, and duration) as a function of ethnicity, gender, and acculturation.

RESULTS

Overall, Korean ethnicity predicted increased drinking, and acculturation predicted decreased drinking. However, acculturation interacted with ethnicity such that its influence was protective for Korean Americans and negligible for Chinese Americans.

CONCLUSIONS

Previous research implicates acculturation as a risk factor for drinking among Asian Americans, but the current findings suggest that protective effects may also exist. Results also indicate that Korean ethnicity is a risk factor particularly in the context of low acculturation. These findings illustrate the need to consider ethnic subgroup differences in drinking rates and in risk and protective factors for alcohol use among Asian Americans.

ALDH2 Status and Conduct Disorder Mediate the Relationship Between Ethnicity and Alcohol Dependence in Chinese, Korean, and White American College Students

This study examined aldehyde dehydrogense (ALDH2) gene status, alcohol dehydrogense (ADH2) gene status, conduct disorder, and alcohol dependence in Chinese, Korean, and White American college students. Chinese had a lower rate of alcohol dependence (5%) than Koreans (13%) and Whites (17%). Koreans had a higher rate of conduct disorder (15%) than Whites (9%) and Chinese (6%). The relationship of ethnicity to alcohol dependence was mediated by ALDH2 status and conduct disorder, although Chinese ethnicity remained significant. ADH2 status was not related to alcohol dependence with ALDH2 included, and no interactions were significant. Results suggest that different rates of risk (e.g., conduct disorder) and protective (e.g., ALDH2 status) factors partially account for ethnic differences in rates of alcohol dependence.

Aldehyde dehydrogenase 2 genotypes, alcohol flushing symptoms and drinking patterns in Thai men

The drinking behavior, alcohol-induced facial flushing and ALDH2 genotypes were determined in 283 Thai men comprising 85 who were alcohol-dependent, 62 hazardous/harmful drinkers and 136 non-drinkers or infrequent drinkers. A structured interview questionnaire, containing the 'tri-level' method and the Alcohol-Use Disorders and Associated Disabilities Schedule, was used to determine the quantity of drinking and the number of alcohol-related adverse experiences. The study revealed the mutant ALDH2*2 allele in 44 (15.5%) subjects. The risks of being alcohol-dependent and of having hazardous/harmful drinking were lower in individuals with heterozygous ALDH2*1/*2, compared with homozygous ALDH2*1/*1 [relative probability ratios (95% CI) 0.14 (0.05-0.41) and 0.23 (0.08-0.61), respectively]. Eighty percent of those who were heterozygous and 28% of those who were homozygous ALDH2*1 reported flush symptoms after drinking alcohol. Twenty-nine percent of homozygous ALDH2*1 individuals, but only 9% of heterozygous subjects, drank almost everyday (24-30 days/month). Similarly, higher percentages of people drinking beyond the safety limit (>60 g/day) and having alcohol-related problems were observed in homozygous ALDH2*1 compared with heterozygous individuals: 32% vs. 5% and 27% vs. 12%, respectively. Overall, the study supports the role of the mutant ALDH2*2 allele in preventing high alcohol consumption and the development of alcohol dependence in a Thai population.

Race/ethnicity and other sociocultural influences on alcoholism treatment for women

This chapter discusses sociocultural influences on the availability, access, diagnosis, and treatment of alcoholism for women, particularly those in minority groups. Race/ethnicity and other sociocultural influences are presented in terms of the societal context and the counselor-client relationship. The latest data on heavy drinking, alcohol-induced mortality, and alcoholism treatment utilization are presented on African-American, Hispanic, and white women. Data also are presented on the ability to pay for treatment through insurance or earnings. Information on Native Americans and Asian/Pacific Islanders is included whenever possible.

Binge drinking in Chinese, Korean, and White college students: genetic and ethnic group differences

Studies of Asian college students have found that rates of binge drinking are associated with variation in the aldehyde dehydrogenase (ALDH2) gene. Chinese and Koreans have different prevalence rates of the ALDH2*2 allele, alcohol use, and alcoholism. The association of ALDH2 status and ethnic group with binge drinking was examined in 328 Chinese, Korean, and White college students. Ethnic group differences were found, with Whites having the highest rate of binge drinking, followed by Koreans and then Chinese. Among Asian participants, ALDH2 status and ethnicity related to binge drinking in an additive manner. Possessing an ALDH2*2 allele and being Chinese were protective factors, and being White and being Korean without an ALDH2*2 allele were risk factors for binge drinking. These results suggest that ALDH2 status, as well as other factors that differ in Koreans and Chinese, but do not interact with ALDH2, are associated with binge drinking among Asians.

The role of acetaldehyde in the actions of alcohol (update 2000)

BACKGROUND

Recent advances in the field of acetaldehyde (AcH) research have raised the need for a comprehensive review on the role of AcH in the actions of alcohol. This update is an attempt to summarize the available AcH research.

METHODS

The descriptive part of this article covers not only recent research but also the development of the field. Special emphasis is placed on mechanistic analyses, new hypotheses, and conclusions.

RESULTS

Elevated AcH during alcohol intoxication causes alcohol sensitivity, which involves vasodilation associated with increased skin temperature, subjective feelings of hotness and facial flushing, increased heart and respiration rate, lowered blood pressure, sensation of dry mouth or throat associated with bronchoconstriction and allergy reactions, nausea and headache, and also reinforcing reactions like euphoria. These effects seem to involve catecholamine, opiate peptide, prostaglandin, histamine, and/or kinin mechanisms. The contribution of AcH to the pathological consequences of chronic alcohol intake is well established for different forms of cancer in the digestive tract and the upper airways. AcH seems to play a role in the etiology of liver cirrhosis. AcH may have a role in other pathological developments, which include brain damage, cardiomyopathy, pancreatitis, and fetal alcohol syndrome. AcH creates both unpleasant aversive reactions that protect against excessive alcohol drinking and euphoric sensations that may reinforce alcohol drinking. The protective effect of AcH may be used in future treatments that involve gene therapy with or without liver transplantation.

CONCLUSIONS

AcH plays a role in most of the actions of alcohol. The individual variability in these AcH-mediated actions will depend on the genetic polymorphism, not only for the alcohol and AcH-metabolizing enzymes but also for the target sites for AcH actions. The subtle balance between aversive and reinforcing, protecting and promoting factors will determine the overall behavioral and pathological developments.

The role of acetaldehyde in the actions of alcohol (update 2000)

BACKGROUND

Recent advances in the field of acetaldehyde (AcH) research have raised the need for a comprehensive review on the role of AcH in the actions of alcohol. This update is an attempt to summarize the available AcH research.

METHODS

The descriptive part of this article covers not only recent research but also the development of the field. Special emphasis is placed on mechanistic analyses, new hypotheses, and conclusions.

RESULTS

Elevated AcH during alcohol intoxication causes alcohol sensitivity, which involves vasodilation associated with increased skin temperature, subjective feelings of hotness and facial flushing, increased heart and respiration rate, lowered blood pressure, sensation of dry mouth or throat associated with bronchoconstriction and allergy reactions, nausea and headache, and also reinforcing reactions like euphoria. These effects seem to involve catecholamine, opiate peptide, prostaglandin, histamine, and/or kinin mechanisms. The contribution of AcH to the pathological consequences of chronic alcohol intake is well established for different forms of cancer in the digestive tract and the upper airways. AcH seems to play a role in the etiology of liver cirrhosis. AcH may have a role in other pathological developments, which include brain damage, cardiomyopathy, pancreatitis, and fetal alcohol syndrome. AcH creates both unpleasant aversive reactions that protect against excessive alcohol drinking and euphoric sensations that may reinforce alcohol drinking. The protective effect of AcH may be used in future treatments that involve gene therapy with or without liver transplantation.

CONCLUSIONS

AcH plays a role in most of the actions of alcohol. The individual variability in these AcH-mediated actions will depend on the genetic polymorphism, not only for the alcohol and AcH-metabolizing enzymes but also for the target sites for AcH actions. The subtle balance between aversive and reinforcing, protecting and promoting factors will determine the overall behavioral and pathological developments.

A family study of homeland Korean alcohol use

Survey data were obtained from 199 homeland Korean families consisting of 199 sets of parents, and 300 college-age sons (162) and daughters (138). Data were obtained regarding quantity and frequency of alcohol consumption by users and of judgments of what constituted "normal" and "problem" alcohol use, flushing status, symptoms experienced following alcohol use, reasons for drinking given by users, and reasons for abstaining given by abstainers. Fathers and sons differed little in use status, but daughters were abstainers far less often than their mothers. Female users drank a good deal less than males, fathers and sons differed slightly, while daughters drank considerably more than their mothers. Own use was substantially correlated with judgments of the nature of normal use and far less related judgements of problem use. There was a significant difference in fast versus slow skin flushing. with a higher proportion of females being fast flushers. Fast flushers drank less than slow flushers and also judged lower amounts of consumption as being "normal." Fast flushers experienced more physical symptoms than slow flushers; persons who drank more experienced fewer symptoms. Males more than females, slow flushers more than fast flushers, and heavy more than light users of alcohol are more likely to endorse a variety of reasons for drinking. Reasons for not drinking differ little across family membership groups. Contemporary homeland Koreans drink less than would have been expected on the basis of prior research, even though there is a substantial generational difference among females, with daughters being less frequently abstainers and drinking more, and more often than their mothers.

Acute reactions to alcohol

Where the experience of alcohol is unpleasant because of adverse reactions to small amounts, alcohol consumption is likely to be low and alcohol dependence rare. This is shown by many studies of Asian subjects who experience the alcohol flush reaction (AFR) due to inherited aldehyde dehydrogenase (ALDH) deficiency. Alcohol reactions are less common and on average less severe in non-Asian subjects, but they do occur and can affect alcohol consumption. Information about alcohol reactions and their consequences in Europeans is reviewed, and such reactions are compared with those caused by mitochondrial ALDH deficiency in Asians.

Is alcohol-related flushing a protective factor for alcoholism in Caucasians?

Although alcohol-related flushing seems to be a genetically influenced protective factor for alcoholism in some Asian groups, little is known about whether this is true for Caucasians. The evidence for alcohol-related flushing as a protective factor for the development of alcoholism was examined in a sample of 5831 Australian twins (2041 men, 3790 women) who were administered a structured psychiatric interview. Twin correlations for self-reported adverse alcohol reactions (e.g., "flushing or blushing" and "feeling very sleepy" after drinking 1 or 2 drinks) were modest, suggesting minimal contribution of genetic factors, but when corrected for reliability of measurement, were consistent with moderate heritabilities. In accord with studies examining Asian samples, we found that individuals who experienced adverse reactions after drinking small amounts of alcohol drank less often and slightly less per drinking occasion than those who did not experience adverse reactions. However, those who experienced adverse reactions were more likely to have symptoms of alcoholism and to report a parental history of alcohol problems. We conclude that self-reported alcohol-related flushing is not a protective factor for alcoholism in Caucasians and may be a risk factor.

Molecular biological aspects of alcohol-induced liver disease

Molecular biological investigations have become a predominant methodology applied to the study of alcohol-induced liver disease. The enzymatic pathways responsible for ethanol metabolism, and their genetic as well as environmental control, have become the focus of detailed investigation. More recently, the significance of cytokines in the pathogenesis of alcohol-induced liver disease has also become a major area of speculation. This review focuses on the advances made in studies of two important enzymes responsible for alcohol metabolism, alcohol dehydrogenase and aldehyde dehydrogenase, as well as the investigation of the proinflammatory and profibrogenic cytokines involved in the process of hepatic fibrogenesis. The quality and quantity of new discoveries made in the field of alcohol-induced liver disease is impressive, especially when one realizes that molecular biological approaches have been employed in this area for only 15 years. However, in most cases the studies have been predominantly descriptive, with little direct relevance to the therapeutics of alcoholism and alcohol-induced organ injury. Because the groundwork has been laid, one hopes that the next 15 years will rectify this failure.

Alcohol consumption by orientals in North America is predicted largely by a single gene

Orientals consume significantly less alcohol, and show a lower prevalence of alcohol abuse and dependence, than Caucasians. Sociological theories propose that this difference is due mainly to cultural factors. Physiological theories have suggested that the flushing reaction experienced by some Orientals serves as a deterrent to ethanol consumption. The flushing reaction is observed mainly in individuals who possess a mutation in the high-affinity aldehyde dehydrogenase (ALDH2) which renders the enzyme inactive. However, the tendency to flush correlates poorly with alcohol consumption, thus casting doubt on the physiological interpretations. The present study investigates the influence of the ALDH2 allele and of acculturation in North America on alcohol consumption by Orientals born in Canada or the United States. Oriental males carrying the inactive ALDH2(-) allele drink two-thirds less alcohol (6.1 +/- 1.5 vs. 18.2 +/- 2.8 drinks/4 weeks; p < 0.001), show one-third the prevalence of binge drinking (15.2 vs. 42.2%; p < 0.01), and are three times more likely to be abstainers (39.4 vs. 13.3%; p < 0.01) than Oriental ALDH2(+) males carrying the gene for the active enzyme. There were no significant differences in binge drinking or abstinence rates between ALDH2(+) Orientals and Caucasian males. Acculturation in North American society accounted for only 7-11% of the variance in overall consumption (p < 0.02). It is concluded that a single mutation in the high-affinity aldehyde dehydrogenase (ALDH2) gene predicts two-thirds of the alcohol consumption and excessive alcohol use by Oriental males born in North America.

Beyond liver and culture: a review of theories and research in drinking among Chinese in North America

Low levels of alcohol consumption and drinking problems have been consistently found among the Chinese in North America and in other Chinese societies. Two theories of Chinese drinking have been popular in the literature. First, the physiological explanation attributes the light alcohol use among the Chinese to their high propensity to flush, which protects them from heavy drinking. Second, the cultural explanation suggests that Chinese cultural values emphasizing moderation and self-restraint discourage drinking to the point of drunkenness. A review of existing research shows that both explanations are not supported by adequate empirical research findings and are plagued with conceptual and methodological shortcomings. It is also noted that both theories cannot explain why some Chinese do become heavy or problem drinkers. It is suggested that we should look beyond physiological and cultural factors for a better understanding of contemporary Chinese drinking patterns.

Ethanol sensitivity

Ethanol sensitivity is a syndrome of flushing, tachycardia, weakness, fatigue, and other dysphoric symptoms in response to relatively small doses of ethanol. We describe a case of extreme ethanol sensitivity presenting with coma and review the pathophysiology of the syndrome.

Cutaneous vasomotor sensitivity to ethanol and acetaldehyde: subtypes of alcohol-flushing response among Chinese

A cutaneous test has been applied in examination of the flushing response to ethanol and acetaldehyde in 402 Chinese of Han ethnicity. Using this noninvasive method, five response subtypes have been observed: (A) fast flushing to both ethanol and acetaldehyde; (B) fast flushing only to ethanol but not to acetaldehyde; (C) slow flushing to ethanol only; (D) no response either to ethanol or to acetaldehyde; (E) vasoconstriction to ethanol, or to both ethanol and acetaldehyde. A total of 94% in subtype (A) are reported to be flushers, while only 25% was reported in subtype (D). Other physiological responses, such as tachycardia, dizziness, headache, drowsiness, and nausea are less frequent after alcohol ingestion. The recent history of consumption of alcohol of the subjects in different subtypes was also obtained. Although alcohol-induced flushing is thought to be a deterrent factor to heavy consumption of alcohol, the frequency of drinking of alcoholic beverages was not found to be different between flushers and nonflushers.

Familial transmission of alcohol use norms and expectancies and reported alcohol use

Members of 183 families (biological parents and one adult offspring) completed questionnaires on their quantity and frequency of alcohol use, what they would consider a "normal" quantity-frequency of alcohol use, "problem" quantity-frequency of use, flushing after alcohol use, and other expected physiological and subjective responses to alcohol. Within individuals, own quantity-frequency of alcohol use was moderately negatively correlated with flushing after one drink or less ("fast flushing"), but more highly positively correlated with judged normal alcohol use and with expected subjective effects. Spouse resemblances were low for quantity-frequency of alcohol use and flushing, but high for alcohol use norms and expected physiological and subjective responses. Parent-offspring resemblances were low to moderate for own alcohol use and flushing, but moderate to high for expected physiological and subjective effects. These results were discussed in terms of the effects of genetically transmitted flushing after alcohol use and culturally transmitted alcohol norms and expectations on alcohol use.

Genetic or cultural determinants of drinking: a study of embarrassment at facial flushing among Japanese and Japanese-Americans

Facial flushing after the ingestion of alcohol is common among Asians. Flushers are genetically less able to tolerate alcohol than nonflushers and are less likely to become alcoholics. This study examined whether lower consumption of alcohol among flushers was correlated with cultural factors such as embarrassment over flushing as well as with biological factors among Japanese in Japan and Japanese-Americans using data from a joint Japan-U.S. collaborative survey. Eight hundred forty-six Japanese and 737 Japanese-American current drinkers with known flushing status were studied. The mean alcohol intake differed significantly between groups: (1) habitat--Japanese versus Japanese-Americans, (2) flushing status--flushers versus nonflushers, and (3) embarrassment about flushing. Among men, ethnicity was the major determinant of alcohol consumption, followed by flushing status and embarrassment about flushing. Among women, differences were not significant. Lower alcohol consumption by flushers than by nonflushers has been attributed to differences in physiological reactions to alcohol. However, this study demonstrated that cultural factors such as embarrassment also contribute to lower alcohol consumption by flushers. The lack of interaction between habitat and flushing status and between habitat and embarrassment status suggests that flushing status and embarrassment status associated with drinking levels are independent of habitat.

[Genetically-induced variability of alcohol metabolism and its effect on drinking behavior and predisposition to alcoholism]

Alcoholism is one of the most challenging current health problems in the Western countries with far-reaching medical, social, and economic consequences. There are a series of factors that interact in predisposing or protecting an individual against alcoholism and alcohol-related disorders. This article surveys the state of our knowledge concerning the biochemical and genetic variations in alcohol metabolism and their implications in alcohol sensitivity, alcohol drinking habits, and alcoholism in different racial/ethnic groups. The major pathway for the degradation of ethanol is its oxidation to hydrogen and acetaldehyde--to which many of the toxic effects of ethanol can be attributed. Variations in alcohol and acetaldehyde metabolism via genetically determined polymorphisms in alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) seem to play an important role in individual and racial differences in acute and chronic reactions to alcohol, alcohol drinking habits, as well as vulnerability to organ damage after chronic alcohol abuse. Alcohol sensitivity and associated discomfort symptoms accompanying alcohol ingestion may be determinental for the significantly low incidence of alcoholism among the Japanese, Chinese and other Orientals of Mongoloid origin. An abnormal ALDH isozyme has been found to be widely prevalent among individuals of the Mongoloid race and is mainly responsible for the acute sensitivity to alcohol commonly observed in this race. Persons sensitive to alcohol by virtue of their genetically controlled ALDH isozyme deficiency may be discouraged from drinking large amounts of alcohol in their daily life due to the initial adverse reaction experienced after drinking alcohol. Indeed, a significantly low incidence of the mitochondrial ALDH isozyme deficiency has been observed in alcoholics as compared to psychiatric patients, drug dependents and healthy controls in Japan. How far any variation in ADH and/or ALDH activity among individuals of Caucasian origin will have similar effects has yet to be studied.

Asians, Asian-Americans and alcohol

The association of flushing (vasodilation, reddening of the skin) with the alcohol use of Asians and Asian-Americans is examined. Historical changes in alcohol use, recent secular changes in alcohol use, and marked differences in consumption among Asian populations and among Asian-Americans of the same national origins, as well as the lack of reduction of sex differences among flushers, indicate that flushing has little influence on alcohol consumption. Social, psychological, and cultural influences seem to be more adequate explanatory devices with regard to Oriental alcohol use.

Ethanol patch test--a simple and sensitive method for identifying ALDH phenotype

The ethanol patch test, which is considered to be a cutaneous model of flushing, was performed on 311 healthy Japanese (237 adults and 74 children). By comparing the results with aldehyde dehydrogenase (ALDH) phenotype determined by isoelectric focusing from hair roots samples, it was demonstrated that the ethanol patch test is a good indicator of the ALDH phenotype. The usefulness of this test in future studies was discussed.

Judgments of "normal" and "problem" alcohol use as related to reported alcohol consumption

We obtained alcohol use data and judgments of individual ("What do you think?") and cultural ("What do people in general think?") norms for normal and problem quantity and frequency of alcohol use, as well as ratings of whether particular alcohol-related behaviors indicated a drinking problem, from 928 adult respondents who were members of Hawaii's five major racial/ethnic groups [Chinese, European (Caucasian), Filipino, Hawaiian/Part-Hawaiian, and Japanese ancestry]. As compared with older survey data (but consonant with recent survey data), Hawaiians have substantially increased in alcohol use, as have Filipinos (if they drink at all; a high proportion are abstainers), and to a lesser extent, Japanese. Chinese remain very low in alcohol use, while Caucasians have relatively decreased in use. Alcohol use norms (especially of own judged normal use) vary across sexes and ethnic groups and are predictors of consumption both within and across groups. Family resemblances are substantial with regard to alcohol use category (present users, former drinkers, abstainers). Among present users, family resemblances are often significant with regard to amount used; resemblances are more substantial between mothers and offspring than between spouses or between fathers and offspring. There were small but significant ethnic group differences in the number of specific behaviors judged to be indicative of a drinking problem, with the groups reporting the highest mean alcohol consumption (Caucasians and Hawaiians/Part Hawaiians) also indicating more behaviors, particularly pathological as opposed to celebratory behaviors, as being problematic.(ABSTRACT TRUNCATED AT 250 WORDS)

International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 15/4. Genetic aspects of the relation between alcohol metabolism and consumption in humans

Alcohol consumption is believed to involve genetic factors. In this paper genetically determined metabolic factors influencing the alcohol metabolism, such as different types of alcohol dehydrogenase and aldehyde dehydrogenase are discussed.