A regression model applied to gender-specific ethanol elimination rates from blood and breath measurements in non-alcoholics

Abstract

As elimination rates for alcohol are suggested to be gender specific, a novel regression model has been applied to estimate these rates for both men and women using experimentally measured data from 81 female and 96 male volunteers described in previous papers. Breath alcohol measurements were done with the Alcotest 7110 Evidential device and were coupled with concomitant sampling of venous blood. Statistical analyses involved use of a mixed linear model for blood alcohol concentration (BAC) and breath alcohol concentration (BrAC), respectively. The model takes regression lines for each test subject into account with an individual starting value (2 h after the end of drinking) and with an individual alcohol elimination rate per hour (coincidental effects). Further, the data was modeled so that an average alcohol elimination rate per hour could be estimated separately for both genders (constant effects). This enables us to methodically correctly estimate the back calculation. The elimination rates beta (60), which can be used for minimum and maximum back calculations for the BAC, were 0.115 g/kg/h and 0.260 g/kg/h, respectively, for women and 0.096 g/kg/h and 0.241 g/kg/h, respectively, for men. These figures widely deviate from gender-unspecific values commonly used in Germany (0.1 and 0.2 g/kg/h, respectively). The corresponding values for the BrAC were 0.061 mg/l/h and 0.124 mg/l/h for women and 0.049 mg/l/h and 0.112 mg/l/h for men. The probability of an over- or underestimation of the abovementioned extreme values is 0.3% in each case.

Evidence-based survey of the elimination rates of ethanol from blood with applications in forensic casework

“…Likewise, after binge drinking for days or weeks before an arrested a drunken driver might have a faster elimination rate of alcohol, such as 25-30 mg/ 100 mL/h. Elimination rates of alcohol from blood are slightly faster in women compared with men (see Table 8) but not to such an extent that warrants the use of gender-specific values in back calculations as suggested elsewhere [206]. By contrast, gender differences in the distribution volume of ethanol needs to be considered when the amount of alcohol absorbed and distributed in the body is calculated from the measured BAC.…”

“…In women, the minimum and maximum elimination rates were 12 and 27 mg/100 mL/h compared with 10 and 25 mg/100 mL/h in the men. Also reported in the article were rates of alcohol elimination from breath using a quantitative breath-alcohol analyzer to follow the fate of alcohol in the body [206].…”

“…When making a back calculation, the minimum elimination rate is assumed to be 10 mg/100 mL/h. The use of gender-specific rates of alcohol elimination from blood was recommended for legal purposes [206]. In a well-designed human dosing study involving 81 women and 96 men, the rates of elimination of alcohol from blood were determined by methods described by Widmark.…”

Alcohol, its absorption, distribution, metabolism, and excretion in the body and pharmacokinetic calculations

“…One study showed that the V d of ethanol derived from analysis of breath alcohol curves in male and female subjects, assuming a 2,100:1 blood‐breath ratio, agreed well with values expected from analysis of blood samples (Cowan Jr., Weathermon, McCutcheon, & Oliver, ). However, more studies are needed in which ADME of ethanol was characterized from BrAC profiles and pharmacokinetic parameters derived and compared with conventional BAC analysis (Dettling, Witte, Skopp, Graw, & Haffner, ).…”

Sex-dependent alterations in erythrocyte trace element levels and antioxidant status after a month of moderate daily red wine consumption

“…In women the chronic consumption of even 20 g of alcohol per day is associated with significant morbidity and mortality owing to hepatotoxicity, whereas men are more resistant up to 30 g of alcohol per day. The possible explanations for this sex-dependent difference include a number of factors such as different pharmacokinetics of alcohol [2], elimination rate of alcohol [3], high endogenous oestrogen levels [4], different metabolic enzyme activities [5,6], alcohol distribution volume in the body [7,8] and enhanced sensitivity of liver cells to inflammatory stimuli [4].…”