Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers

BMC Gastroenterology

Elizabeth E Powell¹  Jacobus PJ Ungerer⁵  Carel J Pretorius⁵  Ian Scott²  Jennifer Martin²  Peter O’Rourke³  Lambro Johnson⁵  Leigh U Horsfall¹  Linda M Fletcher⁴  Brett C McWhinney⁵  Katharine M Irvine¹  Kevin J Fagan¹ 

[1] Centre for Liver Disease Research, School of Medicine, The University of Queensland, Brisbane, Australia;Division of Medicine, Princess Alexandra Hospital, Brisbane, Australia;Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia;School of Medicine, The University of Queensland, Brisbane, Australia;Pathology Queensland, Royal Brisbane and Women’s Hospital, Brisbane, Australia

关键词: Obesity;    Biomarker;    Cirrhosis;    High performance liquid chromatography;    Alcohol;   

Others  :  855199
DOI  :  10.1186/1471-230X-14-97

 received in 2014-01-17, accepted in 2014-05-14,  发布年份 2014

【 摘 要 】

Background and Aim

Carbohydrate deficient transferrin (CDT) is the most specific serum biomarker of heavy alcohol consumption, defined as ≥ 350–420 g alcohol/week. Despite introduction of a standardized reference measurement technique, widespread use of CDT remains limited due to low sensitivity. The aim of this study was to determine the factors that affect diagnostic sensitivity in patients with sustained heavy alcohol intake.

Methods

Patients with a self-reported history of sustained heavy alcohol consumption were recruited from the hepatology outpatient department or medical wards. Each patient was interviewed with a validated structured questionnaire of alcohol consumption and CDT analysis using the standardized reference measurement technique with high performance liquid chromatography was performed on serum collected at time of interview.

Results

52 patients were recruited: 19 from the hepatology outpatient department and 33 from general medical wards. Median alcohol intake was 1013 (range 366–5880) g/week over the preceding two week period. 26 patients had a diagnostic CDT based on a threshold value of %CDT > 1.7 indicating heavy alcohol consumption, yielding a sensitivity of 50%. Overweight/obesity (defined as body mass index (BMI) ≥ 25 kg/m² in Caucasians and ≥ 23.0 kg/m² in Asians), female gender and presence of cirrhosis were independently associated with non-diagnostic %CDT (≤ 1.7).

Conclusions

CDT has limited sensitivity as a biomarker of heavy alcohol consumption. Caution should be applied when ordering and interpreting %CDT results, particularly in women, patients with cirrhosis and those with an elevated BMI.

【 授权许可】

   
2014 Fagan et al.; licensee BioMed Central Ltd.

【 图 表 】

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