Non-oxidative Metabolism of Ethanol and Its Influence on the Metabolic Pathway of Serotonin and Transferrin

About 95% of ethanol is metabolised via the oxidative pathway. Trace amounts of ethanol are a substrate of non-oxidative metabolism, which generates such products as fatty acid ethyl esters, phosphatidylethanol and ethyl glucuronide. Ethanol also changes the metabolic pathway of serotonin (5-hydroxytryptophol) and transferrin. Multiorgan toxicity of these metabolites increases our understanding of many clinical symptoms of alcoholic disease, which up to now have erroneously been ascribed solely to acetoaldehyde (a metabolite of the oxidative pathway). Due to a long biological half-life and tissue accumulation, non-oxidative metabolites of ethanol and serotonin (5-hydroxytryptophol) and carbohydrate deficient transferrin are used increasingly in clinical and forensic medicine in the detection of alcohol consumption.