Ethanol + NAD - acetaldehyde + NADH + H So there is increase ratio of NADH / NAD due to increase NADH (1) Beat oxidation will not occur (2) Fatty acid synthesis will increase in liver and lead to fatty liver (3) Oxaloacetate + NADH + H - MALATE (4) Pyruvate +NADH + H - MALATE Due to excess NADH, oxaloacetate is unavailable for TCA CYCLE and acetyl COA will increase and forms fats in body Pyruvate and oxaloacetate, the predominant substrates for gluconeogenesis, are made unavailable by alcohol intoxication and that lead to hypoglycemia in body