Figure 5 summarizes the epigenetic effects of alcohol metabolism, which include the following: Global hypomethylation resulting from a reduction in SAM levels. SAM levels are reduced as a result of alcohol-induced reduction in folate and the inhibition of methionine synthase. At the same time, SAH levels increase, which inhibits DNMT.Histone modification that is associated with an increase in NADH levels caused by alcohol metabolism. The increase in NADH affects SIRT1 activity, leading to gene expression and/or silencing.Production of ROS, which affect the expression of inflammatory genes, and acetate, which is used in extrahepatic tissues to produce acetyl-CoA. The latter then is used in histone acetylation by HATs.
