Ethanol, as a small-molecule organic compound exhibiting both hydrophilic and lipophilic properties, quickly pass through the biological barriers. Over 95% of absorbed ethanol undergoes biotransformation, the remaining amount is excreted unchanged, mainly with urine and exhaled air.

The main route of ethyl alcohol metabolism is its oxidation to acetaldehyde, which is converted into acetic acid with the participation of cytosolic NAD⁺ - dependent alcohol (ADH) and aldehyde (ALDH) dehydrogenases. Oxidative biotransformation pathways of ethanol also include reactions catalyzed by the microsomal ethanol oxidizing system (MEOS), peroxisomal catalase and aldehyde (AOX) and xanthine (XOR) oxidases. The resulting acetic acid can be activated to acetyl-CoA by the acetyl-CoA synthetase (ACS).

It is also possible, to a much smaller extent, non-oxidative routes of ethanol biotransformation including its esterification with fatty acids by ethyl fatty acid synthase (FAEES), re-esterification of phospholipids, especially phosphatidylcholines, with phospholipase D (PLD), coupling with sulfuric acid by alcohol sulfotransferase (SULT) and with glucuronic acid using UDP-glucuronyl transferase (UGT, syn. UDPGT).

The intestinal microbiome plays a significant role in the ethanol biotransformation and in the initiation and progression of liver diseases stimulated by ethanol and its metabolite - acetaldehyde, or by lipopolysaccharide and ROS.

乙醇是一种既具有亲水性又具有亲脂性的小分子有机化合物，可迅速通过生物屏障。吸收的乙醇中超过95％经历了生物转化，剩余的量不变地排泄，主要是尿液和呼出的空气。

乙醇代谢的主要途径是将其氧化为乙醛，并在胞质NAD ⁺依赖性酒精（ADH）和醛（ALDH）脱氢酶的参与下将其转化为乙酸。乙醇的氧化生物转化途径还包括由微粒体乙醇氧化系统（MEOS），过氧化物酶体过氧化氢酶和醛（AOX）和黄嘌呤（XOR）氧化酶催化的反应。可以通过乙酰辅酶A合成酶（ACS）将所得乙酸活化为乙酰辅酶A。

在较小程度上，乙醇生物转化的非氧化途径也是可能的，包括乙醇经乙基脂肪酸合酶（FAEES）与脂肪酸的酯化，磷脂，特别是磷脂酰胆碱与磷脂酶D（PLD）的再酯化，偶联通过乙醇磺基转移酶（SULT）与硫酸反应，并通过UDP-葡萄糖醛酸基转移酶（UGT，合成UDPGT）与葡萄糖醛酸反应。

肠道微生物组在乙醇的生物转化以及由乙醇及其代谢产物（乙醛）或脂多糖和ROS刺激的肝脏疾病的发生和发展中起着重要作用。