Abstract
It is critical to assess the severity of alcohol consumption in certain diseases such as alcohol liver disease and alcohol addiction. Ethyl glucuronide (EtG) is a highly stable metabolite of ethanol in hair; thus, it was proposed as a long-term monitoring marker for alcohol consumption. Therefore, an HPLC-MS/MS method for EtG in hair was developed and applied to a clinical setting to assess the relevance of the EtG concentration and/or the Alcohol Use Disorders Identification Test (AUDIT) score to high-risk alcohol consumption. EtG was extracted from 10 mg of hair using water and analyzed using on-line sample purification coupled to HPLC-MS/MS. The diagnostic performances of the EtG concentration and/or the AUDIT score for detecting high-risk alcohol consumption were statistically evaluated between alcohol addicts (n = 44) and average alcohol users (n = 19). The on-line sample purification resulted in labor-saving with smaller sample amount. Both the EtG concentrations (4.0–587.4 pg/mg vs. 12.9–74.9 pg/mg) and the AUDIT scores (4–40 vs. 5–28) obtained from the alcohol addicts were significantly higher than those from the average alcohol users. The performance evaluation demonstrated that the integration score of the EtG concentration and the AUDIT score increased diagnostic performance for high-risk alcohol consumption.
Highlights
Alcohol is one of the most consumed and accessible drugs globally
In Switzerland, Ethyl glucuronide (EtG) in hair was used as a direct marker for abstinence monitoring in driving aptitude assessment [20]
The EtG concentrations in hair from cadavers improved the diagnosis of alcoholism in the forensic domain [21]
Summary
Alcohol is one of the most consumed and accessible drugs globally. In particular, certain alcohol consumption patterns such as binge drinking tend to increase among young people around the world [1]. In 2004, the World Health Organization reported that around 276.3 million people showed alcohol use disorders [5] Ethanol rapidly undergoes both oxidative and non-oxidative metabolic processes and is converted to multiple metabolites. Since EtG in hair is significantly more stable than ethanol and other oxidative metabolites, it was proposed as a long-term monitoring marker to measure alcohol consumption [11,12]. We assessed the relevance of hair EtG concentration and/or the Alcohol Use Disorders Identification Test (AUDIT) score to high-risk alcohol consumption in well-characterized study participants of authentic alcohol addicts and average alcohol users. We proposed an improved diagnostic approach to detect high-risk alcohol consumption, by combining the hair EtG concentration with the AUDIT score
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