Gender differences in alcohol metabolism: Relationship to liver volume andeffect of adjusting for body mass

Background & Aims: Alcoholic liver disease purportedly develops more readil y in women than in men. Some studies have demonstrated faster rates of alco hol elimination in women. This study examined whether gender differences in alcohol metabolism are related to differences in liver Volume and/or diffe rences in lean body mass. Methods: Ten men and 10 women had alcohol elimina tion rates determined by clamping of the breath alcohol concentration at 50 mg/dL by means of a constant rate of intravenous infusion of 6% ethanol. L iver volume was determined by computed tomography. Results: Mean alcohol el imination rate and mean computed liver volume were not significantly differ ent in men and women. Lean body mass was 42% greater in men than in women. Consequently, the calculated alcohol elimination rate and liver volume per kilogram of lean body mass were 33% and 38% higher in women than in men, re spectively. When the alcohol elimination rate was calculated per unit liver volume, no gender-related difference was found. Conclusions: Women have gr eater clearance of ethanol per unit lean body mass, confirming previous ora l alcohol administration studies. Women have approximately the same liver v olume as men, explaining the equivalent alcohol elimination rates seen when men and women are compared on the basis of liver size.