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The aim of this study was to investigate the arterial hypoxemia in Japanese patients with alcoholic liver disease (ALD) with regard to alcohol consumption and/or disease severity. Hypoxemia was observed in 78% patients with ALD and in all 46 patients with alcoholic liver cirrhosis (ALC) and 33 (56%) of 59 patients with noncirrhotic alcoholic liver disease (NCALD) ( P a O 2 ) was 71.1 ± 5.2 mm Hg in ALC and 78.7 ± 6.3 mm Hg in NCALD ( P < 0.0001). The oxygen consumption in ALD was significantly higher than that in control subjects ( P < 0.0001), and a high oxygen consumption was seen in 88% of the patients with ALD, in all 46 ALC patients, and in 46 (78%) of 59 NCALD patients ( P < 0.01). Following abstinence from alcohol, the P a O 2 and oxygen consumption significantly recovered after day 2 ( P < 0.0001), whereas the prothrombin index did not change in either NCALD or ALC patients. Multivariate analysis showed that alcohol consumption and oxygen consumption were significant independent predictors of P a O 2 . In conclusion, the present findings suggest that increased oxygen consumption due to alcohol ingestion is principally responsible for the hypoxemia in ALD patients. [ABSTRACT FROM AUTHOR]