Marker Of Alcohol Intake Research Articles

The gut-immune-liver axis in patients with alcohol use disorder and clinically low serum zinc levels.

Alcohol use disorder (AUD) with chronic and heavy alcohol consumption causes alcohol-associated liver disease (ALD). Early-stage ALD exhibits dyshomeostasis of zinc. We investigated the role of zinc deficiency in gut-barrier dysfunction, proinflammatory response, hepatocyte injury, and death, as well as potential sex differences in AUD patients. Thirty-nine male and female AUD patients were grouped by normal [≥71 μg/dL (Group 1, number (n) = 26)] and low [<71 μg/dL (Group 2, n = 13)] serum zinc levels. Demographics, alcohol intake markers [Lifetime Drinking History (LTDH), heavy drinking days in the past 90-days (HDD90), total drinks in the past 90-days (TD90), number of drinking days in the past 90-days (NDD90), average drinks per day in the past 90 days (AvgDPD90)] were collected. Blood samples were tested for complete blood count (CBC), comprehensive metabolic panel (CMP), coagulation markers, gut-barrier dysfunction markers, cytokines, and hepatocyte death markers. Group 2 females exhibited lower LTDH than Group 2 males (p = 0.028), but higher recent drinking. Aspartate transaminase: alanine transaminase (AST:ALT) ratio was higher (p = 0.049) in Group 2 males compared to Group 1 males. Overall, Group 2 showed threefold higher interleukin 8 (IL-8) levels than Group 1 (p = 0.92); these were sevenfold higher in Group 2 females than Group 1 females. Group 2 females also had higher K18M65, but lower K18M30 than Group 1 females. Necrotic type of cell death (K18M65) was well-described only in Group 2 by the arrangement of lipopolysaccharide (LPS), soluble cluster of differentiation 14 (sCD14), and tumor necrosis factor alpha (TNF-α) (R2 = 0.633, p = 0.037). Our findings demonstrated the role of the gut-immune-liver axis in describing hepatocyte injury and death in zinc-deficient AUD patients. These patients represented an arrangement of gut-barrier dysfunction and an exacerbated immune response. Shift in the cell-death mechanism from apoptosis in zinc-replete females to necrosis in zinc-deficient females suggests a subclinical to clinical transition of ALD associated with zinc status.

Serum gamma-glutamyl transferase, a marker of alcohol intake, is associated with telomere length and cardiometabolic risk in young adulthood

Studies based on self-reported alcohol consumption and telomere length show inconsistent results. Therefore, we studied the association between gamma-glutamyl transferase (GGT), a widely used biomarker of alcohol intake, and telomere length. The possible health relevance in young adulthood was explored by investigating cardiometabolic risk factors. Mixed modelling was performed to examine GGT and alcohol consumption in association with telomere length in buccal cells of 211 adults between 18 and 30 years old of the East Flanders Prospective Twin Survey. In addition, we investigated the association between GGT and cardiometabolic risk factors; waist circumference, systolic blood pressure, fasting glucose, HDL cholesterol, and triglycerides. Although we did not observe an association between self-reported alcohol consumption and telomere length, our results show that a doubling in serum GGT is associated with 7.80% (95% CI − 13.9 to − 1.2%; p = 0.02) shorter buccal telomeres, independently from sex, chronological age, educational level, zygosity and chorionicity, waist-to-hip ratio and smoking. The association between GGT was significant for all five cardiometabolic risk factors, while adjusting for age. We show that GGT, a widely used biomarker of alcohol consumption, is associated with telomere length and with risk factors of cardiometabolic syndrome, despite the young age of this study population.

USE OF BIOCHEMICAL MARKERS IN EARLY PREDICTION OF DELIRIUM TREMENS IN GERIATRIC PATIENTS WITH ALCOHOL USE DISORDERS

Introduction Delirium Tremens (DT) may be an underrecognized entity in the elderly, leading to both morbidity and mortality in patients with alcohol use disorders (AUDs). The clinical institute of withdrawal assessment for alcohol- revised (CIWA-Ar) protocol has been established and widely used in hospital systems for management and prevention of further complications in geriatric patients with AUDs. The CIWA- Ar score is also often used in disposition decision making with patients being discharged from the emergency room for outpatient detoxification if score is Methods The authors conducted a literature review regarding identification and management of delirium tremens in geriatric patients with a history of alcohol use disorder.We searched PubMed using keywords and phrases including: delirium tremens, alcohol withdrawal, chronic alcoholism, CIWA, alcohol effect on CNS, treatment of delirium tremens, treatment of alcohol withdrawal. Results If early identification of delirium tremens and appropriate disposition is the goal that small rural healthcare settings should aim for then it is critical that early predictors of alcohol withdrawal seizures and delirium tremens are clearly established. The overdependence on physical markers such as pulse and blood pressure may be counterproductive in psychiatric units, which lack adequate nursing staff to constantly monitor these vitals. The CIWA-Ar protocol, although validated and useful in many patients with alcohol withdrawal in the general hospital setting, does have drawbacks. Its efficacy and use has not been as successful in patients with complex medical illnesses as well as post-surgical patients. Conclusions Established laboratory tests such as γ-glutamyltransferase (GGT) activity, aspartate aminotransferase (AST) activity, high-density lipoprotein cholesterol (HDL-C) content of serum, and erythrocyte mean corpuscular volume (MCV) are established markers of alcohol intake and provide valuable measures of recent alcohol intake and abstinence. In the same light, homocysteine, potassium levels and platelet counts should be integral part of the assessment of persons with hazardous alcohol consumption. The employment of biochemical markers, electrolyte assessment and BP monitoring along with basic history taking and examination skills in decision making regarding disposition and treatment should form the basis of alcohol use disorder management protocols especially in low resource settings with limited nursing support. This research was funded by: No funding was received for this poster presentation

Lessons and Challenges from a 6-Month Randomized Pilot Study of Daily Ethanol Consumption

BackgroundObservational studies and crossover feeding studies suggest that moderate alcohol use may benefit cardiovascular risk, but we know of no long-term randomized trials that have tested this hypothesis. ObjectiveWe evaluated the feasibility of an efficacy study of daily ethanol use in a 6-mo randomized pilot study in adults at higher cardiovascular risk. MethodsIn a double-blind, randomized, controlled parallel-design trial, we screened 67 adults aged ≥55 y and randomly assigned 45 participants to consume 150 mL of an artificially sweetened beverage with or without 10% grain alcohol daily for 6 mo. Participants were asked to consume no other alcohol and returned monthly to receive the beverage and undergo measurement of HDL cholesterol, liver function tests, and complete blood counts. ResultsOf the 45 randomly assigned participants, 39 completed the trial; the primary reason cited for attrition was inconvenience. None of the participants reported problem drinking or developed any serious adverse events or abnormal biochemical findings. However, we observed no differences in concentrations of HDL cholesterol, HDL lipoprotein subclasses, aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, mean corpuscular volume, or adiponectin between the alcohol and control arms, suggesting that adherence was poor. Every participant accurately identified their assigned beverage, most with great certainty. ConclusionsIn this parallel-design pilot study of daily alcohol use, we observed none of the expected changes in markers of alcohol intake, which suggests poor adherence to this pure alcohol intervention. Our results suggest that long-term trials of alcohol consumption, if they are conducted in light drinkers similar to these, must use pragmatic designs for maximal feasibility. This study was registered at clinicaltrials.gov as NCT01377727.

Status of Serum Gamma GlutamylTranspeptidase and Serum Homocysteine in Young Adults with Essential Hypertension

Background: Hypertension is recognized as the most common cause of cardiovascular disorder and a leading cause of morbidity and mortality in both developed and developing countries. Gamma-glutamyl transpeptidase is serum transferase enzyme synthesised by liver. It is commonly used in clinical practice to monitor liver function, hepato-biliary disorders and as a marker of alcohol intake. It has been proposed that gamma glutamyl transpeptidase is a potent preclinical marker of atherosclerosis. Hyperhomocysteinemia (HHcy) has been regarded as a new risk factor related to hypertension. Our study was aimed to find out the status of serum gamma glutamyl transpeptidase and homocysteine in hypertensive and normotensive subjects & Correlation of serum GGT with serum homocysteine in hypertensive subjects. Materials and methods: The present study was conducted on 100 patients with essential hypertension who attended the medical OPD of Jawahar Lal Nehru Medical College and Associated Group of Hospital, Ajmer. The results of patients were compared with 50 normotensive subjects. Anthropometric parameters and biochemical estimation were performed after taking approval from Ethical Committee. The Serum GGT was measured by colorimetric kinetic assay and Serum Homocysteine was measured by ELISA technique. Results: The mean serum level of GGT was elevated in hypertensive subjects as compared to normotensive subjects (controls) and was statistically significant (P<0.001). The mean serum level of Homocysteine was elevated in hypertensive subjects as compared to normotensive subjects and was highly significant (P<0.0001).The present study has also shown a positive correlation (r=0.74) between serum GGT & serum homocysteine in hypertensive subjects. Conclusion: The present study shows that the level of both, serum GGT and serum homocysteine is raised in young adult patients with essential hypertension and has also shown a positive correlation between serum GGT & serum homocysteine in these subjects. Thus the elevated GGT and Homocysteine in young adults may contribute to their susceptibility to hypertension and provide an additional evidence of novel role of GGT and Homocysteine in cardiovascular risk evaluation. This study was limited and needs to be further worked upon.

O15: Determination of EtG in body hair samples for monitoring of teetotalism: A suitable alternative to scalp hair locks?

Introduction The quantitative determination of ethyl glucuronide (EtG) in scalp hair has become established in both clinical and forensic toxicology as a direct marker for alcohol intake. It is a useful tool in the retrospective assessment of alcohol consumption, providing a specific window of detection that depends on the length of the hair sample. However, scalp hair is not always available, e.g. due to cosmetic reasons or bodily changes like alopecia. The main focus of this study was on statistical evaluation of our routine cases and the practicability of non-head hair in the context of the recommended interpretation threshold of 7 pg/mg EtG in hair. Additionally, a comparison of hair from different alternative anatomical sites (chest, axilla, arm, leg, and beard) was made. Pubic hair samples were not investigated. Methods Two different analytical methods to analyze EtG in hair samples were used. One was a GC-NCI-MS/MS method with SPE clean up (OASIS Max) and PFPA-derivatisation and the other one a LC-MS/MS method; both were validated. Our routine work, e.g. during the assessment for re-granting the driver's license, includes several 1,000 cases per annum . Thereof, 9% were body hair samples, mainly chest and leg hair, and could be analyzed. In a recent paper, an intra-individual comparison of EtG quantified in scalp and nonhead hair was presented (A. Pianta, B Liniger, M. R. Baumgartner, Alcohol and Alcoholism, 48 ( 2013 ). 295 – 302). Additionally, we compared hair samples of one type (e.g. leg hair) collected from different regions (e.g. left and right leg, front and back side). Results and Discussion EtG concentration could be determined in arm hair samples (in 0.5% of all routine cases), in leg hair samples (4.4%), in chest hair samples (3.9%), and in beard hair samples (0.1%), respectively. The gender distribution of our overall case work is 87% men and 13% women. As far as body hair samples are concerned, only four arm hair samples from women (less than 0.1%) were tested during the last few years. From all the subjects that were tested for long term teetotalism (no alcohol intake during more than 6 months), the percentage of negative cases for head hair was 83%, for leg and chest hair 75%, for arm and beard hair 67% and 64%, respectively. Repeated analysis of body hair revealed no larger inhomogeneity than for head hair. Conclusion Chest, arm, leg, and beard hair samples may represent a suitable alternative to monitor alcohol intake, especially for assessment of long term teetotalism. Admittedly, due to today's beau ideal, body hair can usually be collected only from men.

Determination of ethyl glucuronide in human hair by hydrophilic interaction liquid chromatography–tandem mass spectrometry

Ethyl glucuronide (EtG) is a direct metabolite of ethanol and has been utilized as a marker for alcohol intake. This study presents development, validation and application of a new hydrophilic interaction liquid chromatography–tandem mass spectrometry (HILIC–MS/MS) method for the analysis of EtG in human hair samples. The linearity was assessed in the range of 5–2000 pg/mg hair, with a correlation coefficient of >0.99. The method was selective and sensitive, with a limit of detection (LOD) and limit of quantitation (LOQ) of 0.05 pg/mg and 0.18 pg/mg in hair, respectively. Differently from the extraction procedures in the literature, a fast and simple liquid–liquid method was used and highest recoveries and cleanest extracts were obtained.The method was successfully applied to 30 human hair samples which were taken from those who state they consume alcohol. EtG concentrations in the hair samples of alcohol users participated in this study, ranged between 1.34 and 82.73 pg/mg. From the concentration of EtG in hair strands 20 of the 30 subjects can be considered regular moderate drinkers.

Urine Creatinine as a marker for Alcohol intake

Urine Creatinine as a marker for Alcohol intake

Measuring Carbohydrate-Deficient Transferrin by Direct Immunoassay: Factors Affecting Diagnostic Sensitivity for Excessive Alcohol Intake

carbohydrate-deficient transferrin (CDT) is a marker of alcohol intake that is used for detecting or monitoring alcohol-use disorders. The introduction of a new direct immunoassay for CDT justifies reevaluation of test performance and reexamination of factors affecting test diagnostic sensitivity and specificity. individuals enrolled in twin/family studies of alcohol use and dependence provided blood samples and information on recent alcohol use. Serum CDT concentration was measured in 2 088 people with the N Latex CDT (Dade Behring) method, and CDT percentage (CDT%) was calculated as the proportion of the total transferrin concentration measured with Roche reagents. diagnostic sensitivity was low, both for comparisons of men who reported an alcohol intake of >28 drinks/week vs those who consumed < or = 28 drinks/week (28% sensitivity) and for women who consumed >14 drinks/week vs those who consumed < or = 14 drinks/week (18% sensitivity), at cutoff values that yielded a 95% specificity. Body mass index, variables associated with metabolic syndrome, and smoking had notable effects on the probability of an abnormal CDT result with excessive alcohol use. Diagnostic sensitivity was greater in men of normal weight (43%) than in obese men (10%) and greater in male smokers (38%) than in male nonsmokers (21%). In women, diagnostic sensitivities were < or = 20%, even for those of normal weight and for smokers. CDT is a poor marker of excessive alcohol intake in both women and men who are overweight or obese. It is also less useful in nonsmokers than in smokers. The diagnostic performance of the direct immunoassay and the effects of obesity and smoking are similar to those reported with previous anion-exchange immunoassay methods.

Gamma-Glutamyltransferase Is Associated With Incident Vascular Events Independently of Alcohol Intake

To investigate the association of gamma-glutamyltransferase (GGT) with incident CHD and stroke [corrected] GGT [corrected] is a marker of alcohol intake but may also reflect oxidative stress and nonalcoholic fatty liver disease. Alanine aminotransferase (ALT) is the enzyme most closely associated with liver fat content. Associations of GGT and ALT with incident CHD, stroke, and a combined outcome of CHD or stroke were examined in the British Women's Heart and Health study (n=2961), and a meta-analysis of population based studies examining these associations was performed. In pooled analyses of fully adjusted results of 10 prospective studies, a change of 1 U/L of GGT was associated with a HR=1.20 (95% CI: 1.02, 1.40) for CHD; a HR=1.54 (95% CI: 1.20, 2.00) for stroke; and HR=1.34 (95% CI: 1.22, 1.48) for CHD or stroke. Heterogeneity was substantially decreased when 2 studies in Asian populations were excluded. In a subgroup of nondrinkers results were similar to the main analysis. Meta analyses of the only 2 studies that examined the association of ALT with incident cardiovascular events found a HR=1.18, 95% CI: 0.99, 1.41) for CHD and a HR=1.10 (95% CI: 0.89, 1.36) for CHD or stroke (combined). GGT is associated with incident vascular events independently of alcohol intake. The mechanisms underlying this association remain unclear and require future study.

ERYTHROCYTE ALDEHYDE DEHYDROGENASE ACTIVITY: LACK OF ASSOCIATION WITH ALCOHOL USE AND DEPENDENCE OR ALCOHOL REACTIONS IN AUSTRALIAN TWINS

Aldehyde dehydrogenase 1 (ALDH1) has been advocated as a marker of alcohol intake. The absence or low levels of ALDH1 may be associated with alcohol-induced flushing or other reactions to alcohol in Europeans and therefore, with reduced alcohol use. This study tested whether variation in erythrocyte ALDH1 activity was associated with alcohol use, alcohol dependence or reactions to alcohol in unselected subjects of European descent, and whether variation in ALDH1 activity was subject to genetic influences. ALDH activity was measured in erythrocytes from 677 men and women who had participated in a twin study of alcohol use and dependence. There were no significant effects of sex, alcohol consumption or alcohol dependence on ALDH activity. Subjects who reported reactions to alcohol did not have low activity. Women aged below 45 years had lower ALDH activity than men or older women. The heritability of ALDH activity was 56% (95% confidence interval = 42-67%). Previous reports that erythrocyte ALDH activity is low in alcoholics were not substantiated in this community-based sample. Associations with alcohol reactions were not found. ALDH activity varies widely between subjects, largely because of genetic factors.

Platelet Counts Vary by Ethnicity, Sex, and Age: Analysis of NHANES III Data.

Background: The possibility of variation in platelet count by age and genetic background has not been examined. Identification of subpopulations with elevated platelet counts, within what is traditionally considered a normal range, may identify a group with excessive morbidity or mortality. Furthermore, platelet count differences may suggest populations in which genetic polymorphisms in regulatory proteins such as the thrombopoietin receptor influence platelet production. We hypothesized that there were differences in platelet count by ethnicity, sex and age not explained by environmental factors. Objective: To demonstrate differences in mean platelet counts by ethnicity, sex, and age while controlling for variables known to influence platelet count.Methods and Design: We used data from the National Health, Nutrition and Examination Survey III (NHANES III), which is a multistage probability sample of the United States population with data collected between 1988 and 1994. Using appropriate weighting for the complex sampling design, the geometric mean platelet count was calculated for the total population and the population stratified by ethnicity, sex, and age, while controlling for C-reactive protein, white blood cell count, iron-deficiency, serum folate, markers of alcohol intake, presence of hepatitis B or C antibodies, and diabetes mellitus. Other potential influences, such as medications, were found not to affect the predicted counts and not included in the models.Results: The lowest mean platelet counts were among whites (259 K/ml [95% C.I. 255–264 K/ml]) and the highest were in non-Hispanic blacks (275 K/ml [95% C.I. 270–280 K/ml]) with Mexican-Americans having intermediate values (266 K/ml [95% C.I. 261–272 K/ml]), when controlled for age and sex. Older men and women of each ethnicity consistently had lower mean platelet counts, with 60–69 years olds having mean counts approximately 7 K/ml lower than young adults (p=0.015) and 70–90 year olds having mean counts 19 K/ml lower than young adults (p<0.001). Even with controlling for iron deficiency, women had significantly higher platelet counts than men (273 K/ml [95% C.I. 269 – 278]) versus 251 K/ml [95% C.I. 245 – 256])Conclusion: Mean platelet counts differ by ethnicity, sex, and age and these differences are not explained by covariates known to influence platelet count. This suggests that genetic influences on the platelet count are operative. These data also suggest that there may be a hormonal regulation of platelet count. The decline with age may reflect decreased stem cell function with age; alternatively, there may be a survival advantage to having a lower platelet count. Longitudinal studies of platelet count with aging are indicated.

This month in J Lab Clin Med: Issue highlights for August 2002

This month in J Lab Clin Med: Issue highlights for August 2002

Sex differences in gamma-glutamyltransferase in people aged 40–42 years in two Norwegian counties

Gamma-glutamyltransferase (GGT) is widely used as a marker of alcohol intake, although it is documented that other factors are also associated with serum levels of GGT. The total population of men and women aged 40–42 years in two Norwegian counties was invited to participate in a health survey program. GGT was measured in 8116 men and 8689 women—67 % of the eligible population. In sex-specific multiple regression analyses, GGT showed a positive association with body mass index (BMI), cholesterol, ln triglycerides, systolic blood pressure, and number of drinks per 2 weeks for both men and women. Glucose and ‘years of smoking’ were significant in women only. Cups of boiled coffee per day and physical activity in spare time were inversely associated with GGT level for both men and women. A significant positive interaction between alcohol intake and BMI was observed for men but not for women. The use of GGT as a marker of alcohol consumption in middle-aged persons should take into account sex, BMI and drinking of boiled coffee.

Effects of Alcohol Consumption on Indices of Iron Stores and of Iron Stores on Alcohol Intake Markers

Alcohol increases body iron stores. Alcohol and iron may increase oxidative stress and the risk of alcohol-related liver disease. The relationship between low or "safe" levels of alcohol use and indices of body iron stores, and the factors that affect the alcohol-iron relationship, have not been fully characterized. Other aspects of the biological response to alcohol use have been reported to depend on iron status. We have measured serum iron, transferrin, and ferritin as indices of iron stores in 3375 adult twin subjects recruited through the Australian Twin Registry. Information on alcohol use and dependence and smoking was obtained from questionnaires and interviews. Serum iron and ferritin increased progressively across classes of alcohol intake. The effects of beer consumption were greater than those of wine or spirits. Ferritin concentration was significantly higher in subjects who had ever been alcohol dependent. There was no evidence of interactions between HFE genotype or body mass index and alcohol. Alcohol intake-adjusted carbohydrate-deficient transferrin was increased in women in the lowest quartile of ferritin results, whereas adjusted gamma-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase values were increased in subjects with high ferritin. Alcohol intake at low level increases ferritin and, by inference, body iron stores. This may be either beneficial or harmful, depending on circumstances. The response of biological markers of alcohol intake can be affected by body iron stores; this has implications for test sensitivity and specificity and for variation in biological responses to alcohol use.

Effects of Alcohol Consumption on Indices of Iron Stores and of Iron Stores on Alcohol Intake Markers

Effects of Alcohol Consumption on Indices of Iron Stores and of Iron Stores on Alcohol Intake Markers

Gamma Glutamyl Transferase

Referee: R. Rej, New York State Dept. of Health, Albany, NY Serum gamma-glutamyl transferase (GGT) has been widely used as an index of liver dysfunction and marker of alcohol intake. The last few years have seen improvements in these areas and advances in understanding of its physiological role in counteracting oxidative stress by breaking down extracellular glutathione and making its component amino acids available to the cells. Conditions that increase serum GGT, such as obstructive liver disease, high alcohol consumption, and use of enzyme-inducing drugs, lead to increased free radical production and the threat of glutathione depletion. However, the products of the GGT reaction may themselves lead to increased free radical production, particularly in the presence of iron. There have also been important advances in the definition of the associations between serum GGT and risk of coronary heart disease, Type 2 diabetes, and stroke. People with high serum GGT have higher mortality, partly because of the association between GGT and other risk factors and partly because GGT is an independent predictor of risk. This review aims to summarize the knowledge about GGT's clinical applications, to present information on its physiological roles, consider the results of epidemiological studies, and assess how far these separate areas can be combined into an integrated view.

Carbohydrate-Deficient Transferrin as a Marker of Change in Alcohol Intake in Men Drinking 20 to 60 g of Alcohol Per Day

We evaluated carbohydrate-deficient transferrin (CDT) and γ-glutarnyltranspeptidase (γ-GT) as markers of alcohol intake and change in alcohol intake in white Australian men aged 20 to 63 years who regularly drank 20 to 60 g of alcohol/day (2 to 6 standard drinks), either as weekend (n = 14) or daily drinkers (n = 41). After 4 weeks of familiarization on usual alcohol intake, men were provided with low alcohol beer (24 times 375 ml cans, 0.9%, v/v, two-weekly), and, for 4 weeks, consumed as much or as little as they wished with no additional alcohol permitted. In an alternate 4-week period, the same amount of full-strength beer (4.9%, v/v) was provided, whereas subjects continued their usual amount and pattern of alcohol consumption. The order of experimental conditions was randomized. Retrospective 7-day diaries documented weekly alcohol intake during 4 weeks of familiarization and 8 weeks of intervention. Mean alcohol intake was 345 g/week of alcohol (SD 97) during familiarization. During the last 4 weeks of intervention (study weeks 8 to 12), mean alcohol intake either increased by 360 g/week (SD 138) with the switch from low to high alcohol or decreased by 328 g/week (SD 120) with the reverse. During familiarization (study weeks 1 to 4), alcohol intake was significantly related independently (R2= 0.21) to mean corpuscular volume (ρ= 0.008) and uric acid (ρ= 0.003), but not to γ-GT (ρ= 0.22) nor CDT (p = 0.94). Change in alcohol intake was predicted independently (R2= 0.60) by change in CDT (ρ < 0.0001) and γ-GT (ρ= 0.0003), but not by change in uric acid or mean corpuscular volume. A 10% change in CDT gave 70% sensitivity and 80% specificity to detect a change of at least 2 standard drinks/day; respective values were 68% and 0 for 10% change in γ-GT. Results were not related to drinking pattern, smoking, age, or weight CDT, particularly when used as a continuous variable, may have a place in monitoring alcohol consumption, even in men whose alcohol intake is in the 20 to 60 g/day range.

Smoking, obesity, and hypertension alter the dose–response curve and test sensitivity of carbohydrate-deficient transferrin as a marker of alcohol intake

Serum carbohydrate-deficient transferrin (CDT) is a specific and comparatively sensitive marker of excessive alcohol use; however, reports of its sensitivity vary according to the population or patient groups studied and their average alcohol intake. We have characterized the dose-response curve between alcohol intake and CDT concentrations in a study of 1400 men and women from a community-based twin registry. Our results show that mean CDT increases with increasing reported alcohol consumption even within the range of alcohol use considered to be nonhazardous. We found significant effects of sex, age, smoking, previous alcohol dependence, body mass index, and diastolic hypertension on the alcohol-CDT dose-response curve. These variables either affect test sensitivity or require adjustment of reference intervals. The results also provide insight into the physiological and biochemical factors that affect CDT concentration.

Carbohydrate‐Deficient Transferrin as a Marker of Change in Alcohol Intake in Men Drinking 20 to 60 g of Alcohol Per Day

We evaluated carbohydrate-deficient transferrin (CDT) and gamma-glutamyltranspeptidase (gamma-GT) as markers of alcohol intake and change in alcohol intake in white Australian men aged 20 to 63 years who regularly drank 20 to 60 g of alcohol/day (2 to 6 standard drinks), either as weekend (n = 14) or daily drinkers (n = 41). After 4 weeks of familiarization on usual alcohol intake, men were provided with low alcohol beer (24 x 375 ml cans, 0.9%, v/v, two-weekly), and, for 4 weeks, consumed as much or as little as they wished with no additional alcohol permitted. In an alternate 4-week period, the same amount of full-strength beer (4.9%, v/v) was provided, whereas subjects continued their usual amount and pattern of alcohol consumption. The order of experimental conditions was randomized. Retrospective 7-day diaries documented weekly alcohol intake during 4 weeks of familiarization and 8 weeks of intervention. Mean alcohol intake was 345 g/week of alcohol (SD 97) during familiarization. During the last 4 weeks of intervention (study weeks 8 to 12), mean alcohol intake either increased by 360 g/week (SD 138) with the switch from low to high alcohol or decreased by 328 g/week (SD 120) with the reverse. During familiarization (study weeks 1 to 4), alcohol intake was significantly related independently (R2 = 0.21) to mean corpuscular volume (p = 0.008) and uric acid (p = 0.003), but not to gamma-GT (p = 0.22) nor CDT (p = 0.94). Change in alcohol intake was predicted independently (R2 = 0.60) by change in CDT (p < 0.0001) and gamma-GT (p = 0.0003), but not by change in uric acid or mean corpuscular volume. A 10% change in CDT gave 70% sensitivity and 80% specificity to detect a change of at least 2 standard drinks/day; respective values were 68% and 0 for 10% change in gamma-GT. Results were not related to drinking pattern, smoking, age, or weight. CDT, particularly when used as a continuous variable, may have a place in monitoring alcohol consumption, even in men whose alcohol intake is in the 20 to 60 g/day range.