Envíe este artículo por correo electrónico Efectos del alcohol en la fisiología humana
Resumen
El alcohol etílico es tóxico para el organismo, pero consumido de forma esporádica y a dosis bajas, sus efectos son rápidamente reversibles. Dosis elevadas sobre el tubo digestivo dan lugar a trastornos de la motilidad esofágica, aparición de reflujo gastroesofágico con todas sus posibles consecuencias, gastritis, trastornos del vaciado gástrico y diarreas. A nivel cardiovascular el consumo agudo da lugar a una reducción aguda de la función contráctil del corazón y a la aparición de arritmias cardíacas. Las alteraciones agudas de la función contráctil del corazón se deben a un efecto inotrópico negativo del etanol sobre el músculo cardíaco, pero este efecto suele quedar enmascarado por un efecto indirecto cronotrópico e inotrópico positivo secundario a la liberación de catecolaminas. Más importancia tiene la relación entre consumo de alcohol y arritmias cardíacas, conocido bajo el término de “corazón del fin de semana” (holiday heart), que debe considerarse como una forma preclínica de miocardiopatía alcohólica. Además de la embriaguez deben destacarse otros efectos sobre el sistema nervioso central como sus efectos sobre la electrofisiología cerebral (potenciales evocados visuales y auditivos), el metabolismo cerebral y la circulación cerebral. Existen posibles efectos beneficiosos del consumo de cantidades moderadas como antiséptico gástrico e intestinal, sobre el sistema cardiovascular (reducción de la mortalidad global y de la mortalidad coronaria) y sobre la enfermedad de Alzheimer.
Palabras clave
Texto completo:
PDFReferencias
(1) Burbige EJ, Lewis DR, Halsted CH. Alcohol and gastrointestinal tract. Med Clin North Am 1984; 68: 77 - 89 (**).
(2) Keshavarzian A, Polepalle C, Iber FL, Durkin M. Esophageal motor disorder in alcoholics: result of alcoholism or withdrawal?. Alcohol Clin Exp
Res 1990; 14: 561 - 567.
(3) Grande L, Monforte R, Ros E, Toledo-Pimentel V, Estruch R, Lacima G, Urbano-Márquez A, Pera C. High amplitude contractions in the middle third
of the oesophagus: a manometric marker of chronic alcoholism. Gut 1996; 38: 655 - 662 (*).
(4) Kaufman SE, Kaye MD. Induction of gastrooesophageal reflux by alcohol. Gut 1978; 19:336 - 338.
(5) Altura BM, Altura BT. Peripheral and cerebrovascular action of ethanol, acetaldehyde and acetate: relationship to divalent cations. Alcohol
Clin Exp Res 1987; 11: 99 - 111.
(6) Intorre L, Bertini S, Luchetti E, Mengozzi G, Crema F. Soldari G. The effect of ethanol, beer and wine on histamine release from dog stomach.
Alcohol 1996; 13: 547 - 551.
(7) Brenner H, Bode G, Adler G, Hoffmeister A, Koenig W, Rothenbacher D. Alcohol as a gastric desinfectant?. The complex relationship between
alcohol consumption and current Helicobacter pylori infection. Epidemiology 2001; 12: 209 - 214.
(8) Gottfried EB, Korstein MA, Lieber CS. Alcoholinduced gastric and duodenal lesions in man. Am J Gastroenterol 1978; 70: 587 - 592.
(9) Oneta, C M; Simanowski, U A; Martinez, M; Allali-Hassani, A; Pares, X; Homann, N; Conradt, C; Waldherr, R; Fiehn, W; Coutelle, C; Seitz, H K. First pass metabolism of ethanol is strikingly influenced by the speed of gastric emptying. Gut 1998; 43: 612 - 619.
(10) Caballeria J, Frezza M, Hernández-Muñoz R, DiPalova E, Korstein MA, Baraona E, Lieber CS. Gastric origin of the first-pass metabolism of
ethanol in humans: Effect of gastrectomy. Gastroenterology 1989; 97: 1205 - 1209.
(11) Pfeiffer A, Hoge B, Kaess H. Effect of ethanol and commonly ingested alcoholic beverages on gastric emptying and gastrointestinal transit.
Clin Investig 1992; 70: 487 - 491.
(12) Estruch R, Nicolas JM, Villegas E, Junqué A, Urbano-Márquez A. Relationship between ethanol-related diseases and nutritional status
in chronically alcoholic men. Alcohol Alcohol 1993; 28: 543 - 550.
(13) Hajnal F, Flores MC, Valenzuela JE. Pancreatic secretion in chronic alcoholics. Effects of acute alcohol or wine on response to a meal. Dig Dis
Sci 1993; 38: 12 - 17.
(14) Saluja AK, Lu L, Yamaguchi Y, Hofbauer B, Runzi M, Dawra R, Bhatia M, Steer ML. A cholecystokinin- releasing factor mediates ethanolinduced
stimulation of rat pancreatic secretion. J Clin Invest 1997; 99: 506 - 512.
(15) Urbano-Márquez A, Estruch R, Navarro-López F, Grau JM, Mont Ll, Rubin E. The effects of alcoholism on skeletal and cardiac muscle. N
Engl J Med 1989; 320: 409 - 415 (*).
(16) Aguilera MT, de la Sierra A, Coca A, Estruch R, Fernández-Solà J, Urbano-Márquez A. Effect of alcohol abstinence on blood pressure: assessment by 24-hour ambulatory blood pressure monitoring. Hypertension 1999;33: 653-7.
(17) Estruch R. Efectos cardiovasculares del alcohol. Med Clin (Barc) 1995; 105: 628 - 635 (**).
(18) Monforte R, Estruch R, Graus F, Nicolas JM, Urbano-Márquez A. High ethanol consumption as risk factor for intracerebral hemorrhage in
young and middle-aged people. Stroke. 1990; 21: 1529-32.
(19) Gronbaek M, Becker U, Johansen D, Gottshau A, Schnohr P, Hein HO, Jensen G, Sorensen TI. Type of alcohol consumed and mortality from
all causes, coronary heart disease and cancer. Ann Intern Med 2000; 191: 411 - 419 (**).
(20) Greenberg BH, Schutz R, Grunkemeir GL, Griswold H. Acute effects of alcohol in patients with congestive heart failure. Ann Intern Med
; 97: 171 - 175.
(21) Schulman SP, Lakatta EG, Weiss RG, Wolff MR, Hano O, Gerstenblith G. Contractile, metabolic and electrophysiologic effects of ethanol in the
isolated rat heart. J Mol Cell Cardiol 1991; 23: 417 - 426.
(22) Kelbaek H, Gjorup T, Hartling OJ, Marving J, Christensen NJ, Godtfredsen J. Left ventricular function during alcohol intoxication and
autonomic nervous blockade. Am J Cardiol 1987; 59: 685 - 688.
(23) Thomas AP, Rozanski DJ, Renard DC, Rubin E. Effects of ethanol on the contractile function of the heart: a review. Alcohol Clin Exp Res 1994;
: 121 - 131.
(24) Koskinen P. Kupari M, Leinonen H. Role of alcohol in recurrences of atrial fibrillation in persons < 65 years of age. Am J Cardiol 1990; 66:
- 958.
(25) Ettinger PO, Wu CF, De la Cruz C Jr, Weisse AB, Ahmed SS, Regan TJ. Arrhythmias and the “Holiday Heart”: Alcohol-associated cardiac
rhythm disorders. Am Heart J 1978; 95: 555 - 562 (*).
(26) Kupari M, Koskinen P. Alcohol, cardiac arrhythmias and sudden death. Novartis Found Symp 1998; 216: 68 - 79.
(27) Fernández-Solà J, Nicolás JM, Paré JC, Sacanella E, Fatjo F, Cofan M, Estruch R. Diastolic function impairment in alcoholics. Alcohol Clin
Exp Res 2000; 24: 1830 - 1835.
(28) Urbano-Márquez A, Estruch R, Fernández-Solà J, Nicolás JM, Paré JC, Rubin E. The greater risk of alcoholic cardiomyopathy and myopathy
in women compared to men. JAMA 1995; 274:149 - 154 (*).
(29) Gordon T, Kanel WB. Drinking and its relation to smoking, blood pressure and uric acid: The Fragmingham study. Arch Intern Med 1983;
: 1366 - 1374.
(30) DeFrank RS, Jenkins CD, Rose RM. A longitudinal investigation of the relationship among alcohol consumption, psychosocial factors and
blood pressure. Psychosomatic Med 1987; 49: 236 - 249.
(31) Potter JF, Watson RS, Skan W, Beevers DG. The pressor and metabolic effects of alcohol in normotensive subjects. Hypertension 1986; 8:625 - 631.
(32) Potter JF, Beevers DG. Pressor effects of alcohol in hypertension. Lancet 1984; 1: 119 - 122.
(33) Hart CL, Smith GD, Hole DJ, Hawthorne VM. Alcohol consumption and mortality from all causes, coronary heart disease and stroke: results from a prospective cohort study of Scottish men with 21 years of follow-up. BMJ
; 318: 1725 - 1729.
(34) Mukamed KJ, Maclure M, Mueller JE, Sherwood JB, Mittleman MA. Prior alcohol consumption and mortality following acute myocardial
infarction. JAMA 2001; 285: 1965 - 1970.
(35) Renaud SC, Gueguen R, Schenker J, d’Houtaud A. Alcohol and mortality in middle-aged men from eastern France. Epidemiology 1998;
: 184 - 188.
(36) Imhof A, Froehlich M, Brenner H, Boeing H, Pepys MB, Koenig W. Effect of alcohol consumption on systemic markers of inflammation.
Lancet 2001; 357 : 763 - 767.
(37) Hertog MG, Kromhout D, Aravanis C, Blackburn H, Buzina R, Fidanza F, Giampaoli S, Jansen A, Menotti A, Nedeljkovic S. Flavonoid intake
and long-term risk of coronary heart disease and cancer in the seven countries study. Arch Intern Med 1995; 155: 381 - 386.
(38) Quintyn JC, Massy J, Quillard M, Brasseur G. Effects of low alcohol consumption on visual evoked potentials, visual field and visual contrast
sensitivity. Acta Ophthamol Scand 1999; 77: 23 - 26.
(39) Nicolas JM, Estruch R, Salamero M, Orteu N, Fernández-Solà J, Sacanella E, Urbano-Márquez A. Brain impairment in well nourished
chronic alcoholics is related to ethanol intake. Ann Neurol 1997; 41: 590 - 598 (**).
(40) Cohen HL, Porjesz B, Stimus AT, Begleiter H. Effects of ethanol on temporary recovery of auditory-evoked potentials in individuals at risk
for alcoholism. Alcohol Clin Exp Res 1998; 22: 945 - 953 (*).
(41) Keenan JP, Freeman PR, Harrell R. The effects of family history, sobriety length and drinking history in younger alcoholics on P300 auditoryevoked potentials. Alcohol Alcohol 1997; 32:233 - 239.
(42) De Wit H, Metz J, Wagner N, Cooper N. Behavioral and subjective effects of ethanol-relationship to cerebral metabolism using PET.
Alcohol Clin Exp Res 1990; 14: 482 - 489.
(43) Wang GJ, Volkow ND, Franceschi D, Fowler JS, Thanos PK, Scherbaum N, Pappas N, Wong CT, Hitzemann RJ, Felder CA. Regional brain metabolism during alcohol intoxication. Alcohol Clin Exp Res 2000; 29: 822 - 829.
(44) Tishonen J, Kuikka J, Hakola P, Paanila J, Airaksinen J, Eronen M, Hallikainen T. Acute ethanolinduced changes in cerebral blood flow. Am J
Psychiatry 1995; 152: 1695 - 1696.
(45) Nicolas JM, Catafau AM, Estruch R, Lomeña FJ, Salamero M, Herranz R, Monforte R, Cardenal C, Urbano-Márquez A. Regional cerebral
blood flow - SPECT in chronic alcoholism: relation to neuropsychological testing. J Nucl Med 1993;34: 1452 - 1459 (*).
(46) Catafau AM, Etcheberrigaray A, Pérez de los Cobos V, Estorch M, Guardia J, Flotats A, Berna L, Mari C, Casas M, Carrio I. Regional cerebral
blood flow changes in chronic alcoholic patients induced by naltrexone challenge during detoxification. J Nucl Med 1999; 40: 19 - 24.
(47) Orgogozo JM, Dartigues JF, Lafont S, Letenneur L, Commenges D, Salomon R, Renaud S, Breteler MB. Wine consumption and dementia
in the elderly: a prospective community study in the Bordeaux area. Rev Neurol (Paris) 1997; 153. 185 - 192.
(48) Commenges D, Scotet V, Renaud S, Jacqmin- Gadda H, Barberger-Gateau P, Dartigues JF. Intake of flavonoids and risk of dementia. Eur J
Epidemiol 2000; 16: 357 - 363.
DOI: https://doi.org/10.20882/adicciones.519
Enlaces refback
- No hay ningún enlace refback.
