[Ethanol and lipid metabolism (author's transl)]

Abstract

Fatty liver and hyperlipoproteinemia are the main clinical manifestations of interrelationships between ethanol and fat metabolism. Elevation of VLDL is observed more, hyperchylomicronemia less frequently. In metabolic healthy volunteers reversible hypertriglyceridemia can be provoked as well. The pathogenesis of ethanol-induced hyperlipoproteinemia is based on metabolic alterations directly dependent on the oxidation of ethanol in the liver as well as on indirect effects: Besides decreased oxidation and increased de-novo-synthesis by the liver, the sources of fatty acids for the enhanced production of VLDL are the adipose tissue and alimentary fat. VLDL concentrations have been shown to correlate with risk of atherogenesis in the middle-aged. Enhancement of alpha/beta (HDL/LDL)-cholesterol which would indicate an antiatherogenetic effect have been observed in relation to ethanol intake. At the moment it is premature to conclude that ethanol-induced changes in plasma lipoproteins may favour or delay atherogenesis.