Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are the major enzymes responsible for the metabolism of ethanol in the body. Both exhibit genetic polymorphism in racial populations. To determine hepatic ethanol metabolizing activities in relation to genetic polymorphism, a total of 23 surgical specimens were investigated. The expression patterns of ADH and ALDH isoenzymes were identified by means of agarose isoelectric focusing, and the activities were assayed spectrophotometrically. At 33 mM ethanol, pH 7.5, the activities in the liver with the homozygous phenotype ADH2 1-1 and ADH2 2-2 and the heterozygous phenotype ADH2 1-2 were determined to be 2.9 +/- 0.7, 16.0 +/- 2.5, and 13.6 +/- 1.0 U/g tissue, respectively. The activities of the ALDH2-active and ALDH2-inactive phenotypes at 200 microM acetaldehyde were determined to be 1.06 +/- 0.13 and 0.71 +/- 0.07 U/g tissue, respectively. These findings indicate that human hepatic ethanol-metabolizing activities differ significantly with respect to polymorphism at both the ADH2 and ALDH2 loci. The results suggest that this genetically determined differential hepatic activity may influence drinking behavior and the development of alcoholism among Orientals.