[Mechanisms of high hemoglobin A1 in alcohol drinkers]

Hemoglobin A1 (HbA1) levels were significantly higher in healthy alcohol drinkers (HbA1 = 7.50%, n = 11) than in normal non-drinkers (HbA1 = 6.62%, n = 13). Ethanol was not able to change HbA1 level when ethanol was added to human whole blood in vitro. Acetaldehyde (AcCHO), although, markedly increased it. Glucose utilization in erythrocytes was stimulated by AcCHO. While it was completely blocked by sodium fluoride in the presence of AcCHO in the incubation medium, but sodium fluoride did not affect the formation of HbA1. AcCHO formed HbA1 with human purified hemoglobin in vitro. The level of HbA1 formed by AcCHO was significantly low when purified human hemoglobin used as a substrate in comparison with the use of whole blood. AcCHO and dihydroxyacetone phosphate reacted in the presence of aldolase. The reacted product, 5-deoxy-D-xylulose-1-phosphate, increased HhA1 level of human purified hemoglobin. It is suggested, the high level of HbA1 in healthy drinkers was caused by AcCHO, the first metabolite of ethanol. AcCHO formed addicts with human hemoglobin directly, and there might be other mechanisms of HbA1 formation due to AcCHO, such as 5-deoxy-D-xylulose-1-phosphate, which is the reacted product of AcCHO.