Alcoholism also will trigger presence of the acute attack, especially excessive
alcohol consumption (Doss, 2000). It accelerates the secretion of
oxygenate gene which lead to deterioration of AIP (Jadil, Grady, Lee, & Anderson,
2010). According to Sezgin (2016) study, patients suffered from AIP
with heavy alcohol assumption obviously reported more severe in the disease, as
alcoholism would induce the synthase of aminolevulinic acid synthase (ALAS).
Smoking,
includes second smokers, also served as one of the factors that contributed to
presence of high AIP attack (Anderson, et al., 2005). Smoking acted as an enzyme inducer,
influence the drug metabolic rate as well as steroid hormone metabolism. It had
triggered an anti-oestrogenic effects and related to the increase of hepatic
mono-oxygenases which bring an effect on triggering the attack (Lip, Mccoll, Goldberg, & Moore,
1991). A conclusion can be drawn that cigarette smoking is
associated with the inducing of acute attack.
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