Pyridoxine Deficiency

Pyridoxine (vitamin B6) is required for transamination reactions, including the elimination of homo-cysteine. Pyridoxine deficiency in chronic alcoholism is caused by poor diet, whereas displacement of pyridoxal phosphate from circulating albumin by the alcohol metabolite acetaldehyde increases its urinary excretion. Low serum levels of pyridoxal phosphate are common in chronic alcoholics, and pyridoxine deficiency is manifest by peripheral neuropathy and sideroblastic anemia. In alcoholic hepatitis, the serum level of alanine transaminase (ALT) is disproportionately low compared to aspartate transaminase (AST), due to the requirement of pyr-idoxine for ALT activity.

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