The Correlation of Concentration of Plasma Lactates and Blood Alcohol Concentration in Patients Acutely Intoxicated by Alcohol
Franceski, Tanja, Karlovic, Dalibor, Kovak-Mufic, Ana, Madzarac, Vedran, Torre, Robert, Alcoholism
Lactates are the final product of anaerobic glycolysis, especially in muscles, erythrocytes, intestines and brain. The formed lactate converts itself into glucose by gluconeogenesis in liver, and partly in the kidney cells.1 Ethanol inhibits the processes of gluconeogenesis in several points by decreasing the intake of glucose precursor from liver and kidneys. It directs the precursors towards other metabolic paths (it limits the entrance in the gluconeogenesis paths), directly limits gluconeogenesis enzymes, and by use of metabolic products decreases cofactors (NAD) and mitochondrion oxidative processes which help gluconeogenesis.2 Since lactate is one of the main gluconeogenesis substrates, an increase of plasma lactates with a possible occurrence of acidosis induced by lactic acid is expected to occur due to acute alcohol intoxication.
Alcohol intoxication occurs by a single intake of an alcoholic beverage, and in proportion to the quantity of the alcohol intake it leads to the consciousness level disorder, cognition disorder, perception disorder, mood disorder and other forms of behavior disorders. While a mild intoxication can cause the patient to become relaxed, talkative, and euphoric, a severe intoxication often leads to severe disorders, such as aggression, labile mood, erroneous judgment and social and working inability.3-5
The intoxicated persons show at least one of the following symptoms: irregular and incomprehensible speaking, coordination disturbances, nystagmus, memory disorder, somnolence, sopor, and coma.
Complications in acute drunkenness are head injuries (subdural, epidural and intracranial hematoma), fractures of other bone systems, inhaling the thrown up content, traffic accidents, crimogene behavior, homicides and suicides. Complications, especially changes of consciousness to which the development of lacteal acidosis can contribute, are a special problem.67
The aim of this paper was to examine the correlation of concentration of plasma lactates and blood alcohol concentration in patients acutely intoxicated with alcohol.
SUBJECTS AND METHODS
The study was structured as prospective-observational and it included all the patients acutely intoxicated with alcohol detoxicated at the Department of Psychiatry, University Hospital Sestre milosrdnice, in the first five months of 2006 (N = 73). All the patients with a somatic diagnosis (N = 50) were excluded from the study. The final sample consisted of 23 patients. There were 18 male and 5 female patients. The subjects' mean age was (mean ± SD; 45.9 ± 9.82) years (from a minimum of 32 to a maximum of 65 years of age). 10 patients had regular consciousness, while 13 were somnolent. The mean duration of excessive drinking was (mean ± SD; 3.7 ± 1.2) years (from a minimum of 1 to a maximum of 5 years of age).
The diagnosis of acute alcohol intoxication was made according to the International Classification of Diseases (ICD 10 criteria). Acute alcohol intoxication is a transitory condition which is the result of alcohol intake and it can cause the disturbance of consciousness level, cognition disorder, perception disorder, mood disorder, and other psychophysiological functions and responses.
Consciousness, plasma concentrations of glucose, urea, lactates, ethyl alcohol, AST, ALT and GGT were analyzed in all patients by enzyme methods and dry chemistry analyzer (Vitros, Johnson & Johnson, USA) (Table 1).
While doing the statistical analysis, we used the descriptive statistics; for each variable we showed the mean value, standard deviation, minimum and maximum. The correlation between the examined variables was calculated by Spearman's rank correlation coefficient since the Kolmogorov-Smirnov test showed an abnormal distribution of variables. We used the commercial statistical program SSPS to calculate the statistics.
The values of plasma concentrations of glucose, urea, lactates, ethyl alcohol, AST, ALT and GGT are shown in Table 1 . …