Twenty,five to 50 percent of Asians possess a gene, inactive aldehyde dehydrogenase 2 (ALDH2,2) (Cook and Gurling 2001; Lieber 2001), which causes them to metabolize alcohol differently from people who do not have this gene. ALDH2,2 is one of several variants of the gene that produces aldehyde dehydrogenase (ALDH), one of two enzymes involved in alcohol metabolism. When a person with this gene drinks alcohol, ALDH2,2 leads to the slower than normal oxidation of acetaldehyde, which results in elevated levels of acetaldehyde in the blood. After drinking, people with the ALDH2,2 gene experience a constellation of physical reactions: perspiration, headache, palpitations, nausea, tachycardia (rapid heartbeat), and facial flushing, which is caused by dilation of blood vessels in the face. These aversive effects are sometimes referred to collectively as the facial flushing response.
The flushing response may serve as a deterrent to drinking, and this deterrent effect may contribute to the associations observed between the ALDH2,2 gene and low rates of drinking, alcohol dependence, and alcohol,related problems (Cook and Gurling 2001). Although some variation exists in the specific alcohol consumption rates of Asian American groups, it has consistently been found that regardless of national origin, Asian American women have relatively low rates of alcohol use and problem drinking (Gilbert and Collins 1997). Thus, in prevalence studies of Asian drinking, more than half of the women of Chinese, Korean, Filipino, and Vietnamese backgrounds were abstainers (Chi et al. 1989; Padilla et al. 1993). These relatively high rates of abstention, which occur in most groups of Asian women, are likely related to facial flushing and associated reactions.
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