Clinical and diagnostic value of alcohol biomarkers

Abstract

Alcohol abuse is a socially significant problem that makes a significant negative contribution to the world health statistics. Alcohol is one of the main factors of mortality in Russia. Despite the current situation, the existing diagnostic approaches to patients with possible alcohol abuse and alcohol-associated diseases do not always allow us to determine the direct contribution of alcohol to the severity and prognosis of the course of these diseases. Objective diagnostic tools for identifying and monitoring the fact of alcohol consumption and its pattern in clinical practice can be useful from the point of view of managing the patient’s disease. In addition, informing the patients about the possibilities of such a diagnosis can motivate them to refuse to take alcohol during further treatment, thereby improving the prognosis of the disease. Currently, various approaches have been developed to assess the fact and nature of alcohol consumption, including the direct determination of ethanol in the blood, but not all of them have found their wide application in clinical practice. In this review, we presented information about the main alcohol biomarkers currently developed: alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltranspeptidase, mean corpuscular volume, carbohydrate-deficient transferrin, ethylglucuronide and ethylsulfate, phosphatidylethanol, ethyl esters of fatty acids, described their disadvantages and advantages in terms of application in clinical practice. Despite the high sensitivity and specificity of some alcohol biomarkers, for example, phosphatidylethanol, the results of laboratory assessment of the content of alcohol biomarkers should be interpreted only in the context of all relevant factors, including the clinical presentation, medical history, mental and physical health of the patient