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PROJECT TOPIC – EFFECTS OF ALCOHOL ON SOME BIOCHEMICAL PARAMETERS OF ALCOHOLICS IN NSUKKA, ENUGU STATE, NIGERIA

EFFECTS OF ALCOHOL ON SOME BIOCHEMICAL PARAMETERS OF ALCOHOLICS IN NSUKKA, ENUGU STATE, NIGERIA

 

ABSTRACT

This work was aimed at finding the effects of alcohol on some biochemical parameters. A total of one hundred and eighty (180) apparently healthy, nonhypertensive male alcoholics were used for the study. Forty (40) non-consumers of alcohol were used as control. The activity of alanine aminotransferase (ALT) in the control was 10.50±2.00 IU/L while it was 16.50±1.50 IU/L; 17.50±2.00 IU/L and 18.31±2.00 IU/L in alcoholics who showed preference for palmwine, beer and distilled spirit respectively. Also, the activity of aspartate aminotransferase (AST) in the control was 9.51±0.35 IU/L while it was 18.44±0.40 IU/L, 19.21±0.19 IU/L, 20.32±0.64 IU/L in alcoholics who showed preference for palmwine, beer and distilled spirit respectively. The ALT and AST activities of alcoholic subjects who showed preference for distilled spirit was significantly higher (p < 0.05) than those who showed preference for palmwine and beer.

The activities of alcoholics who showed preference for palmwine was the lowest. Furthermore, the serum total bilirubin concentration of the alcoholics was significantly higher (p < 0.05) compared with the control. The serum total bilirubin concentrations were 18.65±2.10 μmol/l, 19.40±1.50 μmol/l and 22.75±1.60 μmol/l for alcoholics who showed preference for palmwine, beer and distilled spirit respectively. The serum total bilirubin of the control was 8.30 ± 2.00 μmol/l. The alkaline phosphatase (ALP) activity of the alcoholic subjects was significantly higher (p<0.05) compared with the control. The ALP activity of the control was 61.50 ± 30.00 IU/L while the ALP activity was 174.20±2.50 IU/L, 175.10±1.50 IU/L and 177.40±1.00 IU/L in the three categories of alcoholics who showed preference for palmwine, beer and distilled spirit respectively.

Moreover, the urine total protein concentration of the alcoholics was significantly higher (p<0.05) compared with the control. Alcoholics who showed preference for distilled spirit had urine total protein of 153.96±0.43 mg/dl followed by alcoholics who showed preference for beer and palmwine who had urine total protein of 152.74±0.42 mg/dl and 151.34±0.60 mg/dl respectively. The urine total protein of the control was 56.40±0.40 mg/dl. Furthermore, the urine specific gravity, serum urea and creatinine of the alcoholics were significantly higher (p < 0.05) compared with the control. However, the plasma sodium, potassium and creatinine clearance of the alcoholics were significantly lower (p < 0.05) compared with the control. The body mass index (BMI) of the three groups of alcoholics fell within the range of 18.50 to 24.90. The blood pressure of both the alcoholic and control subjects were normal
(below 140/90 mmHg). This work therefore shows that chronic alcohol use could induce both hepatic and renal dysfunctions in the alcoholics which manifested in form of adverse variations in some biochemical parameters of prognostic and diagnostic utility.

 

CHAPTER ONE

INTRODUCTION

Generally, alcohol designates a class of compounds that are hydroxyl derivatives of aliphatic hydrocarbons. However, in this study, the term alcohol used
without additional qualifications refers specifically to ethanol. A variety of alcoholic beverages have been consumed by man in the continuing search for euphoria producing stimuli. Among some people, alcohol enjoys a high status as a social lubricant that relieves tension, gives self confidence to the inadequate, blurs the appreciation of uncomfortable realities and serves as an escape from environmental and emotional stress. Alcohol has been loved and hated at different times by different people. Alcohol has been celebrated as healthful especially to the heart (red wine) and most pleasant to the taste buds; and then dismissed as “demon’s rum” and “devil in solution” depending on the prevalent view. In spite of the apparent divergent and sometimes conflicting opinions about alcohol, the consensus shared by drinkers and non drinkers alike is that excessive and chronic consumption of alcohol is a disorder.

Like any other chronic disorder, it  develops insidiously but follows a predictable course. The first or pre-alcoholic symptomatic phase begins with the use of alcohol to relieve tensions. The second (or prodromal) phase is marked by a range of behaviours including preoccupation with alcohol, surreptitious drinking and loss of memory (Hock et al., 1992). In the third (or crucial) phase, the individual loses control over his drinking. This loss of control is the beginning of the disease process of addiction. The individual starts drinking early in the morning and stays up drinking till late in the night. Impairment in biochemical
activities becomes manifest as the organs of the alcoholic begin to deteriorate. Other medical problems develop by the time the alcoholic gets into the final (chronic phase). Prolonged intoxications become the rule. Alcoholic psychosis develops, thinking is impaired, and fear and tremors become persistent (Klemin and Sherry, 1981).

A previously responsible individual may be transformed into an inebriate – stereotype alcoholic. Fear-instilling but thought- provoking terms such as the “coming epidemic”, a “miserable trap”, have been used to show concern for the potential hazard of widespread alcoholism. In its 1978 revision of the international classification of diseases, the World Health Organization defined alcoholism as “a state, psychic and usually also physical, resulting from taking alcohol, characterised by behavioural and other responses that always include a compulsion to take alcohol on a continuous or periodic basis in order
to experience its psychic effects and sometimes to avoid the discomfort of its absence; tolerance may or may not be present. This definition emphasized the compulsive nature of drinking, the psychological and physical effects, and dependence (“discomfort of its absence”) (WHO, 1978). The kidney and liver could be particularly vulnerable to the chemical assault resulting from alcohol abuse because they receive high percentage of the total cardiac output. Also, the liver is pivotal in intermediary metabolism; so ingested alcohol must come in contact with the liver and kidney. Alcohol could produce many of its damaging effects by the formation of dangerous, highly reactive intermediates such as acetaldehyde which may lead to glutathione depletion, free radical generation, oxidative stress and cell dysfunction.

Alcohol dehydrogenase in the presence of a hydrogen acceptor nicotinamide adenine dinucleotide (NAD) oxidizes ethanol to acetaldehyde. This is the initial
obligatory biochemical event in alcohol induced hepatotoxic and nephrotoxic effects. Thus, it is important to find out in quantitative terms the effects of different types of alcohol drinks on some principal biochemical parameters of diagnostic utility.

1.1 Alcohol

1.1.1 Chemistry of Alcohol

The term ‘alcohol’ refers to a class of compounds that are hydroxy (-OH) derivatives of aliphatic hydrocarbons. There are many common alcohols – methanol or wood alcohol, isopropyl alcohol, the antifreeze diethylene glycol, and glycerine. In this study however, when the term alcohol is used without additional qualification, ethyl alcohol, a liquid also known as ethanol, is referred to. Alcohol can be considered as being derived from the corresponding alkanes by replacing the hydrogen atoms with hydroxyl groups. The hydroxyl group is the functional group of alcohols as it is responsible for their characteristic chemical properties. Monohydric alcohols contain only one hydroxyl group in each molecule. Monohydric alcohols form a homologues
series with the general molecular formular CnH2n+1OH. All alcoholic beverages arise from the process of fermentation. Indeed, ethanol, the alcohol in beverages, is the quantitative end product of yeast glycolysis. In the presence of water, yeasts are able to convert the sugar (glucose) of plants into
alcohol, as depicted by the following chemical reaction: C6H12O6 2C2H5OH + 2CO2 Glucose lAcohol Carbon dioxide

A wide variety of plants have proved to be useful substrates for the action of yeast, and this is reflected by the different types of beverages used throughout the world.

EFFECTS OF ALCOHOL ON SOME BIOCHEMICAL PARAMETERS OF ALCOHOLICS IN NSUKKA, ENUGU STATE, NIGERIA

 

1.1.2 Alcohol Production

1.1.2.1 Beer Production

Beer is generally considered to be of two types, the ale types, brewed with Saccharomyces cerevisiae and the lager type, brewed with Saccharomyces
carlsbergensis. The main ingredients of beer are malted barley, the source of fermentable carbohydrates, proteins, polypeptides, minerals, and hops the primary purpose of which is to impart bitterness and the hop characteristic, but which also have anti-microbial properties, yeast and water. The basic processes for the brewing of beer include:

(a) Malting

Malting involves the mobilization and development of the enzymes formed during germination of the barley grain. The grain is permitted to germinate under
controlled conditions of moisture and temperature, the starch/enzyme balance then being fixed by kilning at drying temperatures as high as 104oC

(b) Mashing

During mashing, ground malt is mixed (mashed) with hot water. This serves both to extract existing soluble compounds from the malt and to reactivate malt
enzymes which complete the breakdown of starch and proteins.

(c) Wort boiling

  • Yeast Wort is drained from the mash tun into a copper and boiled to inactivate malt enzymes. In traditional brewing, hops are added at this stage, the humulones (-acids) being extracted and chemically isomerized. The resulting iso-humulones have a greater solubility and contribute the characteristic bitter flavour to beer, while the ‘hop character’ is derived from essential oils. In recent years, there has been a tendency to replace hop cones with various types of hop pellets, powders or extracts including pre-isomerized hop products which may be added after fermentation. Boiling serves two other functions: reducing the potential for microbiological problems by effectively sterilizing the wort and coagulation of proteins followed by their removal as ‘trub’. Inadequate coagulation may adversely affect the subsequent fermentation due to interference with yeast:substrate exchange processes (membrane blocking) and
    lead to poor quality beer.

(d) Fermentation

Fermentations are considered to be of two distinct types: the top fermentation used in production of ales, in which CO2 carries flocculated Sacch. cerevisiae to the surface of the fermenting vessel, and the bottom fermentation used in production of lagers, in which Sacch. carlsbergensis sediments to the bottom of the vessel. Differentiation on the basis of the behaviour of the yeast is, however, becoming less distinct with the increasing use of cylindro-conical fermenters and centrifuges. (e) Maturation (Conditioning; Secondary fermentation) Maturation may be considered to include all transformations between the end of primary fermentation and the final filtration of the beer. These include carbonation by fermentation of residual sugars, removal of excess yeast, adsorption of various non-volatiles onto the surface of the yeast and progressive change in aroma and flavour. During maturation, priming sugar may be added or amyloglucosidase used to hydrolyse dextrins.

 

1.1.2.2 The Production of Palm Wine

There are two main sources of palmwine namely: raphia palm particularly Raphia vinifera and Raphia hookeri; and the oil palm: Elaeis guineensis. Palmwine is an alcoholic beverage produced from the fermenting palm sap. The part tapped is the male inflorescence of a standing oil palm tree. The fermentable sugars present in palm wine are glucose, sucrose, fructose, maltose, and raffinose. The yeast species – Saccharomyces spp are responsible mainly for the conversion of the sugars in palm sap into alcohol as well as oxidative fermentation of alcohol to acetic acid. In the fermentation of natural palm wine, lactic acid bacteria, Lactobacillus plantarium, Leuconostoc mentseriodes and Pediococcus cerevisiae are also involved. All of them utilize meyerhof parnas pathway which results in the formation of alcohol as well as organic acids. The leuconostoc mesenteriode is a hetero-fermenter and ferments sugar to produce acetic acid., lactic acid, ethanol and carbondioxide.

Lactobacillus plantarium is a homofermenter and ferments sugars to produce mainly lactic acid and small amount of alcohol and carbondioxide. Pediococcus cerevisiae is also a homo fermenter and produces the same metabolites as Lactobacillus plantarium. Thus, the bacterial flora of palm wine contribute significantly to the fermentation of sugars to alcohol and the alcoholic constituent of palm wine varies with the species of palm tree from which the wine was tapped.

 

EFFECTS OF ALCOHOL ON SOME BIOCHEMICAL PARAMETERS OF ALCOHOLICS IN NSUKKA, ENUGU STATE, NIGERIA

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