The final metabolism of acetate derived from etha-
nol remains unclear. However, some important principles have been elucidated:
1. The majority of absorbed ethanol is metabolized in the liver and released as acetate. Acetate release from the liver increases 2| times after ethanol consumption.
2. Acetyl-CoA synthetase catalyzes the conversion of acetate to acetyl-CoA via a reaction requiring adenosine triphosphate. The adenosine monophosphate produced is converted to adenosine in a reaction catalyzed by 5'-nucleosidase.
3. Acetyl-CoA may be converted to glycerol, glyco-gen, and lipid, particularly in the fed state. However, this only accounts for a small fraction of absorbed ethanol.
4. The acetyl-CoA generated from acetate may be used to generate adenosine triphosphate via the Kreb's cycle.
5. Acetate readily crosses the blood-brain barrier and is actively metabolized in the brain. The neurotransmitter acetylcholine is produced from acetyl-CoA in cholinergic neurons.
6. Both cardiac and skeletal muscle are very important in the metabolism of acetate.
Based on these observations, future studies on the effects of ethanol metabolism should focus on skeletal and cardiac muscle, adipose tissue, and the brain.
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