Sex- and ALDH2-dependent differences in alcohol metabolism and psychomotor performance: a study in Han Chinese adults after binge drinking

Ann Med. 2025 Dec;57(1):2496798. doi: 10.1080/07853890.2025.2496798. Epub 2025 Apr 28.

ABSTRACT

BACKGROUND: Psychomotor impairments due to alcohol consumption may lead to a series of negative consequences. However, the influence of sex and ALDH2 polymorphism on psychomotor dysfunction has not yet been investigated.

METHODS: One-hundred and three participants, genotyped for ALDH2 rs671, were administered a dose of 1.0 g/kg of white spirits. The blood ethanol concentration (BEC) and acetaldehyde concentration (BAAC) were measured at specific time intervals before and after alcohol consumption. Additionally, auditory simple reaction time (ASRT), visual choice reaction time (VCRT), pursuit tracking task (PTT) and digit-symbol substitution test (DSST) were used to evaluate psychomotor function. Linear mixed-effects model was used to analyze the effects of sex and the ALDH2 genotype on alcohol metabolism and psychomotor function..

RESULTS: Acetaldehyde metabolism depended on both ALDH2 genotype and sex. Women with ALDH2*1/*1 genotype exhibited 2.21 to 18.27 µmol/L higher BAAC levels than men with the same genotype. Conversely, among participants with ALDH2*1/*2 genotype, BAAC levels of women were 0.25 to 31.32 µmol/L lower than men. The impact of ALDH2 genotype on psychomotor function varied across the four tests. VCRT increased significantly in men with ALDH2*1/*2 genotype compared to those with ALDH2*1/*1 at 2-4 h post-consumption. In the PTT test, the percentage of time on target decreased by 3.83% and 3.11% in women relative to men at 1 and 2 h post-consumption, respectively. Notably, ASRT performance was significantly correlated with BAAC levels. No effects of ALDH2 genotype and sex were observed on DSST performance.

CONCLUSIONS: ALDH2 genotype and sex independently or interactively contribute to alcohol-related psychomotor impairment.

PMID:40289679 | DOI:10.1080/07853890.2025.2496798