Faster absorption of ethanol and higher peak concentration in women after gastric bypass surgery
Faster absorption of ethanol and higher peak concentration in women after gastric bypass surgery
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DOI：
10.1046/j.1365-2125.2002.01698.x
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发表时间：
2002-12-01
影响因子：
3.4
通讯作者：
Jones, AW
中科院分区：
文献类型：
--
作者：
Klockhoff, H;Näslund, I;Jones, AW
目的探讨胃分流术后肠道异常妇女对乙醇的吸收、分布和消除情况。因病态肥胖而接受胃分流术的患者抱怨术后对酒精的敏感性增加。方法选取12例既往手术治疗3年以上病态肥胖的健康女性。另外12名年龄和身体质量指数（BMI）相近的女性作为对照组。禁食一夜后，每个受试者服用95% v/v乙醇（0.30 g kg（-1）体重）作为大剂量。乙醇用橙汁稀释至20% v/v， 5 min完成。在开始饮用前和给药后3.5小时内每10分钟从留置导管中取静脉血标本。采用顶空气相色谱法测定血液酒精浓度。结果手术组最大血乙醇浓度（C (max)）为0.741 +/- 0.211 g l(-1) (+/- s.d)，对照组为0.577 +/- 0.112 g l(-1)(平均差值0.164 g l（-1)， 95%可信区间（CI） 0.021, 0.307）。旁路患者达到峰值（t (max)）的中位时间为10分钟，而对照组为30分钟(中位差为-15分钟（95% CI为-10，-20分钟）。在给药后10和20分钟，旁路患者的BAC较高（P < 0.05），但在30分钟和以后的所有时间都没有升高（P < 0.05）。乙醇的其他药动学参数在两组女性间差异无统计学意义（P < 0.05）。结论胃分流术后对乙醇的高敏感性可能反映了乙醇吸收更快，导致C-max升高，t（max）提前。如果消耗相同绝对数量的乙醇，手术后体重的显著减少也可能是一个考虑因素。
Aims To investigate the absorption, distribution and elimination of ethanol in women with abnormal gut as a result of gastric bypass surgery. Patients who undergo gastric bypass for morbid obesity complain of increased sensitivity to the effects of alcohol after the operation.Methods Twelve healthy women operated for morbid obesity at least 3 years earlier were recruited. Twelve other women closely matched in terms of age and body mass index (BMI) served as the control group. After an overnight fast each subject drank 95% v/v ethanol (0.30 g kg(-1) body weight) as a bolus dose. The ethanol was diluted with orange juice to 20% v/v and finished in 5 min. Specimens of venous blood were taken from an indwelling catheter before drinking started and every 10 min for up to 3.5 h post-dosing. The blood alcohol concentration (BAC) was determined by headspace gas chromatography.Results The maximum blood-ethanol concentration (C (max) ) was 0.741 +/- 0.211 g l(-1) (+/- s.d.) in the operated group compared with 0.577 +/- 0.112 g l(-1) in the controls (mean difference 0.164 g l(-1) , 95% confidence interval (CI) 0.021, 0.307). The median time to peak (t (max) ) was 10 min in the bypass patients compared with 30 min in controls (median difference -15 min (95% CI -10, -20 min). At 10 and 20 min post-dosing the BAC was higher in the bypass patients (P < 0.05) but not at 30 min and all later times (P > 0.05). Other pharmacokinetic parameters of ethanol were not significantly different between the two groups of women (P > 0.05).Conclusions The higher sensitivity to ethanol after gastric bypass surgery probably reflects the more rapid absorption of ethanol leading to higher C-max and earlier t(max) . The marked reduction in body weight after the operation might also be a factor to consider if the same absolute quantity of ethanol is consumed.