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Increased NADH/NAD ratio leads to lactic acidemia, ketoacidosis, hyperuricemia, hypoglycemia, hypomagnesemia, hypophosphatemia. Also mitochondrial dysfunction, induction of microsomal enzymes resulting in altered drug metabolism, lipid peroxidation leading to membrane damage, hypermetabolic state; many features of alcoholic hepatitis are attributable to toxic effects of acetaldehyde and cytokines (interleukins 1 and 6, and TNF, released because of impaired detoxification of endotoxin).

Outline

Section 11. Gastroenterology