Kinetics in serum and urinary excretion of ethyl sulfate and ethyl glucuronide after medium dose ethanol intake

Institute of Forensic Medicine, University Hospital Freiburg, Albertstrasse 9, 79104 Freiburg, Germany.
Deutsche Zeitschrift für die Gesamte Gerichtliche Medizin (Impact Factor: 2.71). 03/2008; 122(2):123-8. DOI: 10.1007/s00414-007-0180-8
Source: PubMed


The direct ethanol metabolites, ethyl glucuronide (EtG) and ethyl sulfate (EtS), are of increasing importance for clinical and forensic applications, but there are only few studies on the kinetics of EtG in serum and none on EtS. In this study, 13 volunteers (social drinkers) drank ethanol in the form of white wine to reach a blood alcohol concentration of 0.51 +/- 0.17 g/kg, and blood and urine samples were analyzed for EtG and EtS simultaneously by chromatography-tandem mass spectrometry (LC-MS/MS). Mean peak serum EtG and EtS concentrations were 2.9 +/- 1.3 and 2.8 +/- 1.6 micromol/l, respectively, and were reached between 4.0 +/- 0.9 h after the start of drinking (3.0 +/- 0.5 h for EtS). The mean time differences between reaching maximum blood ethanol levels and serum metabolite levels were 2.3 +/- 0.9 h for EtG and 1.2 +/- 0.5 h for EtS. In the last blood samples collected (10-11 h after the start of drinking), 11 (of 13) volunteers were still positive for EtG in serum, whereas only 2 were positive for EtS. In the serum of one female person, no EtS was detectable at any time; however, it was excreted in the urine in (low) concentrations. Ethanol was detectable in the serum for up to 8.6 h after the start of drinking, whereas EtG and EtS were detectable up to more than 5.8 h (EtG) and 4.0 h (EtS), respectively. Mean peak urinary concentrations were 401 +/- 232 micromol/l for EtG and 266 +/- 153 micromol/l for EtS, and mean peak levels were reached 6.2 +/- 0.9 h (EtG) and 5.3 +/- 1.2 h (EtS) after the start of drinking. Maximum concentrations of EtG and EtS in serum showed a wide interindividual variation and could not be correlated to the maximum blood ethanol concentrations. Correlations (p < 0.001, Kendall's Tau b) were found when comparing pairs of parameters, but mostly involved areas under the curve (AUC) of metabolites or of ethanol; one correlation linked the peak concentrations of EtG and EtS in urine.

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    • "Although combined tests, like early detection of alcohol consumption (EDAC) and an analysis of a panel of 10–56 routine laboratory tests, are considered useful in detection of heavy drinking (Harasymiw and Bean, 2001, 2007; Helander, 2003; Harasymiw et al., 2004, 2005; Bean and Harasymiw, 2011), more specific tests seem to be much more convenient. Determination of the ethanol derivatives of extended excretion time, like ethyl glucuronides and sulfates, fatty acid ethyl esters and phosphatidylethanol , is considered as they are sensitive and specific indicators of recent alcohol ingestion (Dahl et al., 2002; Helander and Beck, 2004, 2005; Erim et al., 2007; Halter et al., 2008; Helander and Zheng, 2009; Helander et al., 2009a,b; Palmer, 2009; Waszkiewicz et al., 2010b; Hastedt et al., 2012; Lees et al., 2012). Although useful, such tests also generate false-positive as well as false-negative results. "
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