Alcoholic liver disease

Liver toxicity due to acetaldehyde accumulation which leads to liver damage and dysfunction • Altered liver metabolism due to decrease in NAD+/NADH ratio and increased availability of acetyl CoA Consequences include: • Escape of liver enzymes (e.g. ALT, AST and gamma glutamyl transpeptidase) to blood • Reduced taking up and conjugation of bilirubin leading to hyperbilirubinaemia • Reduced production of urea leading to hyperammonaemia • Reduced synthesis of proteins (albumin, clotting factors and lipoproteins)