From the Research
Dicarboxylic acids appear in the urine of chronic alcoholics due to metabolic adaptations that occur with prolonged alcohol consumption, specifically the shift to omega-oxidation to process fatty acids, as evidenced by the production of dicarboxylic acids such as adipic, suberic, and sebacic acids 1. When someone drinks alcohol chronically, their liver shifts to an alternative metabolic pathway called omega-oxidation to process fatty acids. This happens because the primary pathway (beta-oxidation) becomes overwhelmed by the constant processing of alcohol. Some key points to consider include:
- Omega-oxidation produces dicarboxylic acids such as adipic, suberic, and sebacic acids, which are then excreted in urine.
- This metabolic shift is particularly pronounced during periods of alcohol withdrawal or when alcoholics are fasting, as the body mobilizes fat stores for energy.
- The presence of these dicarboxylic acids in urine can actually serve as a biochemical marker of chronic alcoholism.
- Additionally, alcohol-induced damage to mitochondria (the cell's energy producers) further impairs normal fatty acid metabolism, contributing to this alternative pathway usage, although this is not directly supported by the provided evidence 2, 3, 4, 5. It is worth noting that the evidence provided does not directly address the question of why dicarboxylic acid is in the urine of chronic alcoholics, but rather provides information on the differential diagnosis of dicarboxylic aciduria and the use of dicarboxylic acids as an alternate fuel substrate in parenteral nutrition 2, 1, 5.