Abstract
AimsValid measures to identify harmful alcohol use are important. Alcohol Use Disorders Identification Test (AUDIT) is a validated questionnaire used to self-report harmful drinking in several cultures and settings. Phosphatidylethanol 16:0/18:1 (PEth) is a direct alcohol biomarker measuring alcohol consumption levels. The aim of this study was to investigate how PEth levels correlate with AUDIT-QF and weekly grams of alcohol consumed among patients in two urban hospitals. In addition, we wanted to investigate the predictive value of PEth in identifying harmful alcohol use as defined by AUDIT-QF and weekly grams of alcohol cutoffs.MethodsA cross-sectional study comprising acute medically ill patients with measurable PEth levels (≥0.030 μM) admitted to two urban hospitals in Oslo, Norway (N = 931) and Moscow, Russia (N = 953) was conducted using PEth concentrations in whole blood, sociodemographic data and AUDIT-QF questionnaires.ResultsPEth levels from patients with measurable PEth were found to be positively correlated with AUDIT-QF scores, with PEth cutpoints of 0.128 μM (Oslo) and 0.270 μM (Moscow) providing optimal discrimination for harmful alcohol use defined by AUDIT-QF (the difference between cities probably reflecting different national drinking patterns in QF). When converting AUDIT-QF into weekly grams of alcohol consumed, the predictive value of PEth improved, with optimal PEth cutpoints of 0.327 (Oslo) and 0.396 (Moscow) μM discriminating between harmful and non-harmful alcohol use as defined in grams (≥350 grams/week).ConclusionsBy using PEth levels and converting AUDIT-QF into weekly grams of alcohol it was possible to get an improved rapid and sensitive determination of harmful alcohol use among hospitalized patients.
Highlights
Alcohol use might be a risk factor for more than 30 diseases (World Health Organization, 2007), and is associated with intentional and unintentional injuries (Room et al, 2005) and premature death (Griswold et al, 2018)
There were totally 2874 Norwegian patients included in this study, with a total of 931 Norwegian patients with complete Alcohol Use Disorders Identification Test (AUDIT)-QF data and Phosphatidylethanol 16:0/18:1 (PEth) concentrations ≥0.030 μM
The median PEth concentrations (50% percentile) in the data from Oslo and Moscow were somewhat similar across patients with the same AUDIT-QF scores, with slightly higher concentrations among the Russian patients with lower scores compared to the Norwegian patients with similar scores
Summary
Alcohol use might be a risk factor for more than 30 diseases (defined by ICD-10) (World Health Organization, 2007), and is associated with intentional and unintentional injuries (Room et al, 2005) and premature death (Griswold et al, 2018). Several studies have investigated the relationship between AUDIT and PEth, and found significant correlations (Francis et al, 2015; Piano et al, 2015; Schrock et al, 2017) Both quantity and frequency of alcohol will affect PEth concentration, and it is possible to calculate the weekly grams of alcohol consumed from the first two questions of the AUDIT. Harmful alcohol use is a commonly known risk factor for several diseases, but alcohol screening is rarely done in clinical settings, and few studies have investigated the association between self-reported alcohol intake and the biomarker PEth in hospital populations. The aim of this study was to investigate if levels of the alcohol biomarker PEth in blood correlate with self-reported alcohol consumption among acute medically ill patients in Moscow and Oslo, and the performance of PEth in identifying harmful alcohol use
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