Biomarkers in alcoholism

Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, FIN-60220 Seinäjoki, Finland.
Clinica Chimica Acta (Impact Factor: 2.82). 03/2007; 377(1-2):39-49. DOI: 10.1016/j.cca.2006.08.035
Source: PubMed


Alcoholism ranks as one of the main current threats to the health and safety of people in most Western countries. Therefore, a high priority should be given to aims at reducing its prevalence through more effective diagnosis and early intervention. The need for objective methods for revealing alcohol abuse in its early phase has also been widely acknowledged. It is postulated here that the diagnosis of alcohol use disorders could be markedly improved by a more systematic use of specific questionnaires and laboratory tests, including blood ethanol, serum gamma-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT), and mean corpuscular volume of erythrocytes (MCV). Recent research has provided new insights into the relationships between ethanol intake, biomarkers, and factors affecting their diagnostic validation, including gender, age, and the effects of moderate drinking and obesity. It appears that the concept of reference intervals for several ethanol-sensitive parameters in laboratory medicine needs to be revisited. CDT is currently the most specific marker of alcohol abuse, and when combined with GGT using a mathematically formulated equation a high sensitivity is reached without loss of assay specificity. Possible new biomarkers include minor ethanol metabolites (protein-acetaldehyde condensates and associated autoimmune responses, ethylglucuronide, and phosphatidylethanolamine), 5-hydroxytryptophol, and genetic markers although so far their routine applications have been limited.

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    • "Considering that serum -GTP enzyme activity is a generally known biomarker of excessive alcohol consumption and liver dysfunction (Niemelä, 2007), our results raise the possibility that excessive consumption of alcohol influences blood heavy metal status through the impairment of liver function. Moreover, subjects with high scores for the alcohol and noodle dietary pattern showed higher levels of blood glucose, total cholesterol and triglyceride before and after adjustment. "
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    ABSTRACT: The aim of the present study was to evaluate the associations between dietary patterns and blood levels of lead and mercury in Korean adults. A total of 858 Korean adults (⩾20 years) who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) V-1 2010 were included in this study. Data of biochemical measurements including blood lead and mercury levels, nutrients intakes and anthropometric measurements were acquired. 'Balanced diet', 'Grain and kimchi', and 'Alcohol and noodle' dietary patterns were derived from a factor analysis, and the subjects were divided into tertiles by each dietary pattern score. A logistic multiple regression analysis showed that the balanced diet pattern was negatively associated with blood levels of lead before and after adjustment. On the other hand, the alcohol and noodle pattern was positively associated with blood lead and mercury levels. These results indicate that the alcohol and noodle dietary pattern characterized by high alcohol consumption and lack of various foods, and the balanced dietary pattern, including vegetable, fish, meat and milk intake, was associated with the blood concentrations of heavy metals in Korean adults.
    Full-text · Article · Oct 2013 · Food and chemical toxicology: an international journal published for the British Industrial Biological Research Association
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    • "It plays a pivotal role in the extracellular metabolism of glutathione and thereby regulates oxidant stress status in vivo (Lee et al., 2004; Zhang and Forman, 2009; Mistry and Stockley, 2010). While serum GGT activities have long been used as a biomarker of excessive alcohol consumption and liver dysfunction (Niemelä, 2007), several lines of recent evidence have shown that it is also predictive of mortality associated with liver disease, cardiovascular diseases, type 2 diabetes and metabolic syndrome (Ruttmann et al., 2005; Lee et al., 2006b; Mason et al., 2010; Ryu et al., 2010; Targher, 2010). Consequently, there has been growing interest in the significance of alterations in serum GGT levels as a general indicator of health and disease. "
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    ABSTRACT: While serum gamma-glutamyltransferase (GGT) enzyme activity is a well established biomarker of excessive alcohol consumption and liver dysfunction, recent studies have also implicated it as a predictor of morbidity due to extrahepatic causes. Therefore, further information on the associations between ethanol intake and GGT activities in apparently healthy individuals appears warranted. Data on alcohol consumption and serum GGT activities were collected from 18,899 individuals (8807 men, 10,092 women), mean age 48 years and range 25-74 years, who participated in a national cross-sectional health survey. Alcohol use was assessed by detailed questionnaires and the study population was subsequently divided into subgroups according to age and gender. Body mass index and smoking were used as covariates in all analyses. In men over 40 years, a reported regular consumption of 8 standard ethanol doses ('dose' = 12 g ethanol) or more per week was found to lead to a significant elevation in serum GGT activities, whereas those below 40 showed first significant changes not until the reported ethanol intake exceeded 14 doses per week. For women, the corresponding threshold levels were four and seven standard ethanol doses, respectively. The data pertaining to the present population sample indicate that rather low levels of reported regular ethanol consumption lead to elevated levels of GGT and that age over 40 markedly enhances the impact of alcohol consumption on GGT activity. The present findings should form the basis for defining safe levels of ethanol consumption and in recalibrating goals for normal limits in the clinical use of GGT measurements.
    Full-text · Article · Jun 2012 · Alcohol and Alcoholism
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    • "While sex differences in %CDT appear to exist, more sophisticated newer and standardized assays and methods (Bergstrom and Helander, 2008, Helander et al., 2010) have overcome this issue with the current test for the percent disialo isoform of CDT (%dCDT). The sensitivity of %CDT and %dCDT is frequently low (Niemela, 2007) but may be increased in combination with GGT (Hietala et al., 2006). However, GGT may be elevated and therefore not valid for use in those infected with HIV and/or HBV. "
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    ABSTRACT: Alcohol is heavily consumed in sub-Saharan Africa and affects HIV transmission and treatment and is difficult to measure. Our goal was to examine the test characteristics of a direct metabolite of alcohol consumption, phosphatidylethanol (PEth). Persons infected with HIV were recruited from a large HIV clinic in southwestern Uganda. We conducted surveys and breath alcohol concentration (BRAC) testing at 21 daily home or drinking establishment visits, and blood was collected on day 21 (n = 77). PEth in whole blood was compared with prior 7-, 14-, and 21-day alcohol consumption. (i) The receiver operator characteristic area under the curve (ROC-AUC) was highest for PEth versus any consumption over the prior 21 days (0.92; 95% confidence interval [CI]: 0.86 to 0.97). The sensitivity for any detectable PEth was 88.0% (95% CI: 76.0 to 95.6) and the specificity was 88.5% (95% CI: 69.8 to 97.6). (ii) The ROC-AUC of PEth versus any 21-day alcohol consumption did not vary with age, body mass index, CD4 cell count, hepatitis B virus infection, and antiretroviral therapy status, but was higher for men compared with women (p = 0.03). (iii) PEth measurements were correlated with several measures of alcohol consumption, including number of drinking days in the prior 21 days (Spearman r = 0.74, p < 0.001) and BRAC (r = 0.75, p < 0.001). The data add support to the body of evidence for PEth as a useful marker of alcohol consumption with high ROC-AUC, sensitivity, and specificity. Future studies should further address the period and level of alcohol consumption for which PEth is detectable.
    Full-text · Article · Dec 2011 · Alcoholism Clinical and Experimental Research
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