Improved Diagnostic Classification of Alcohol Abusers by Combining Carbohydrate-deficient Transferrin and g-Glutamyltransferase (original) (raw)
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Clinical chemistry, 2001
Biochemical markers can provide objective evidence of high alcohol consumption. However, currently available markers have limitations in their diagnostic performance. The diagnostic values of the most frequently used markers [carbohydrate-deficient transferrin (CDT), gamma-glutamyltransferase (GGT), aspartate aminotransferase, alanine aminotransferase, and mean corpuscular volume] were studied in an analysis of six different clinical studies (n = 1412) on alcohol abusers and social drinkers. The purpose of the analyses was to determine whether a combination of markers would improve the diagnosis of subjects. Discrimination between alcohol abusers and social drinkers, as measured by the areas under nonparametric ROC plots, was significantly better (P<0.001) for the new combined marker [gamma-CDT = 0.8. ln(GGT) + 1.3. ln(CDT)] than for any of the separate markers or combination of CDT or GGT with other markers. The cutoff values for gamma-CDT (6.5) can be taken to be the same among...
Alcoholism: Clinical and Experimental Research, 1994
Carbohydrate-deficient transferrin (CDT) has been described as a more specific and sensitive marker of recent heavy alcohol consumption as compared with the current tests now available, such as 7-glutamyltransferase (GGT). Most of the data generated from European populations have not compared the utility of CDT and GGT in the detection of heavy alcohol consumption as a function of gender. We examined the ability of both CDT and GGT to discriminate between 42 men and 18 women with heavy alcohol consumption (>60 g/day) admitted to an alcohol detoxification center and a group of controls matched for age, race, and gender. CDT was higher, but GGT lower, in control females compared with males. Both CDT and GGT were higher in patients of both genders. At specificities >gooh, the sensitivity of CDT for detecting male alcohol abusers was 79% and for female alcohol abusers 44%. For GGT, the sensitivities were 65% and 44%, respectively. When both tests were used simuttaneously, the sensitivity for the detection of alcohol abusers increased to 95% for males and 72% for females. Receiver Operator Characteristic analysis tended to confirm the superiority of CDT over GGT in the detection of heavy alcohol consumption in males, but not in females. A positive relationship was found between serum iron levels and CDT in control females but in no other group. The concordant findings of this American study with those in similar French and Finnish clinical populations, utilizing similar assay techniques, suggest that the measurement of CDT is clinically more useful than GGT in detecting recent heavy alcohol consumption in males. Because sewm CDT and GGT levels appear to be independently associated with heavy alcohol consumption, their combined measurement should increase the sensitivity of detection of this condition.
Serum Carbohydrate Deficient Transferrin: A Sensitive Marker in Diagnosing Alcohol Abuse
MED PHOENIX, 2023
Introduction: Alcohol is a psychoactive substance with dependence producing properties and the burden of disease and death related to alcohol consumption remains significant in most countries. Early detection and proper medication with counselling can restore the alcoholics to normalcy. There is a need for a specific assay procedure to detect alcoholics early, so that proper therapy can be instituted. The traditional biomarkers in liver function test (LFT) are more frequently used for diagnosing alcohol abuse but they have variable and limited sensitivity and specificity. Carbohydrate Deficient Transferrin (CDT) can be considered as a more sensitive and specific marker for diagnosing alcohol abuse. The aim of this study is to determine % CDT in alcoholics and compare it with other alcohol markers in respect with sensitivity and specificity. The results of the study will be helpful in assessment of the alcohol dependence patients and therefore in their early detection and management. Materials and Methods: This is a hospital based comparative cross-sectional study carried out in Dharan. A total of 40 cases of alcohol abuse with ≥2 score in CAGE questionnaire and matched 40 subjects with no history of alcohol intake were enrolled in the study. Informed written consent and ethical approval were taken. Result: Serum %CDT has the highest diagnostic efficacy followed by serum gamma glutamyl transferase (GGT), Aspartate Transaminase (AST), Alanine Transaminase (ALT), AST/AL, and ALP as a biomarker for diagnosing alcohol abuse. Serum %CDT has the highest sensitivity with 97.5% and specificity of 73% at a cut off value of 3.5% compared to serum GGT with the sensitivity and specificity of 87% and 73%, respectively at a cut off value of 33.5 U/L. Conclusion: Serum %CDT is a better marker both in terms of sensitivity and specificity compared to other conventional markers and thus can be used as a tool to early diagnose the alcoholic cases and monitor the therapy and for early identification of the relapses in alcoholics during treatment.
International Journal of Advanced Biochemistry Research
Alcohol abuse is very common all over the world. The biological, clinical and social effects of alcohol abuse have long made evident the need for objective and specific markers for alcohol-related diseases and for early detection of alcohol consumers at risk. Alcohol abusers may exhibit several biochemical alterations, some of which have been used as markers of alcoholism i.e. Alanine Aminotransferase (ALT), Gamma Glutamyl Transferase (GGT) and Carbohydrate Deficient Transferrin (CDT). The present study was taken up to estimate serum biochemical parameters i.e. ALT, GGT and CDT in chronic alcoholics. The study subjects were divided into 2 group's i.e. Group-I was cases and Group-II was controls. Group-I includes (n=30) male chronic alcoholics with a history of alcohol abuse (since 1year to 11+ years) and aged 25-65 years. Group-II includes (n=30) age-matched, non alcoholics were taken as controls in the study. Biomarkers i.e. ALT, GGT and CDT were assayed in the serum of all study subjects. The present study shown increased serum levels of ALT, GGT and CDT in Group-I as compared to Group-II. There is a significant increase of enzyme activities seen in CDT, when compared to serum GGT, ALT levels of case group. CDT sensitive bio markers which can be used to diagnose alcohol abuse and is superior to GGT, ALT in terms of sensitivity as well as specificity.
Alcoholism: Clinical and Experimental Research, 1994
Carbohydrate-deficient transferrin (CDT) has previously been reported to be an excellent marker of male alcoholics. Less is known of its efficiency among women and especially of early-phase alcohol abuse in nonselected populations. The present population-based study examined the diagnostic value of CDT among consecutive women, including 13 teetotallers, 135 social drinkers (mean alcohol consumption 45 f 34 g/week), and 57 nonalcoholic heavy drinkers (197 +, 97 glweek). Sixty-two women with a well-documented history of chronic alcoholism (942 f 191 glweek) were also studied, as well as 36 pregnant women used as a reference group. Two weeks of abstinence among 11 alcoholics was followed. The CDT (containing part of isotransferrin with pl = 5.7, 5.8, and 5.9) was separated by anion exchange chromatography and assayed by radioimmunoassay. In the whole material, CDT correlated significantly with alcohol consumption (r = 0.43, p c 0.001) but not with conventional markers (7-glutarnyltransferase, AST, ALT, and mean corpuscular volume).
Clinical …, 2000
Background: Carbohydrate-deficient transferrin (CDT) has been used as a test for excessive alcohol consumption in research, clinical, and medico-legal settings, but there remain conflicting data on its accuracy, with sensitivities ranging from <20% to 100%. We examined evidence of its benefit over a conventional and less expensive test, ␥-glutamyltransferase (GGT), and compared the accuracy of different CDT assay methods. Methods: We performed a systematic review using summary ROC analysis of 110 studies prior to June 1998 on the use of CDT in the detection of alcohol dependence or hazardous/harmful alcohol use. Results: We identified several potential sources of bias in studies. In studies examining CDT and GGT in the same subjects, subject characteristics were less likely to influence the comparison. In such paired studies, the original Pharmacia CDT assay was significantly more accurate than GGT, but the modified CDTect assay did not perform as well as the original and was not significantly better than GGT. The accuracy of the AXIS %CDT assay was statistically indistinguishable from modified CDTect. Several CDT assay methods appeared promising, in particular, liquid chromatography (chromatofocusing, HPLC, fast protein liquid chromatography) and isoelectric focusing, but there were insufficient paired studies from which to draw firm conclusions. Conclusions: In studies published before June 1998, the results obtained with commercially available CDT assays were not significantly better than GGT as markers of excessive alcohol use in paired studies. Further highquality studies comparing CDTect (modified) and other CDT assays with GGT in the same subjects are needed.
Rom. J. …, 2008
Carbohydrate-deficient transferrin (CDT) represents an important instrument for the evaluation process of alcohol consumption. But there is not a consensus on its use in the routine practice. The objective of this study was to compare carbohydrate-deficient transferrin and gammaglutamyl transpeptidase (GGT) assays for the evaluation of alcohol consumption. 165 patients (100 males and 65 females) were included in this study. Patients were divided into five categories according to alcohol consumption: category 1 included non-weaned patients drinking more than 30 g/day for women and more than 50 g/day for men, category 2 included relapse patients, category 3 included moderate drinkers, category 4 included patients weaned less than one month, and category 5 included patients weaned more than one month. A specifically standardized questionnaire was used. Blood samples were drawn at the alcohol-cure outpatient centre. Samples were drawn at the first consultation and later as prescribed depending on the clinical situation. Sensitivity of CDT varied, depending on patient category, from 36% to 96% versus 45% to 70% for GGT. Specificity of CDT varied from 72% to 90% versus 21% to 61% for GGT. This study shows that carbohydrate-deficient transferrin is more accurate in predicting alcohol consumption compared with gamma-glutamyl transpeptidase in alcoholic patients evaluation.
Alcoholism: Clinical and Experimental Research, 1994
An isoform of transferrin, carbohydrate-deficient transferrin (CDT) is increased in a high percentage of abusing alcoholics and has been found superior in its specificity compared with other biological markers. We used serum CDT as a screening parameter in 502 patients consecutively admitted to our medical department during a 4-week period. The intake of ethanol during the last 4 weeks was registrated by personal interviews and the mean daily consumption calculated. Serum CDT was measured at admission (CDTect) and compared with r-glutamyltranspeptidase (GGT), AST, ALT, and mean corpuscular volume (MCV). Serum CDT detected 18 of 26 (69%) patients who consumed >50 g ethanol daily. The clinical sensitivity of CDT of detection ethanol consumption >50 g daily was 69%, compared with 73%, 50%, 35%, and 52K for increased values of GGT, AST, ALT, and MCV, respectively. Altogether, 38 of 476 patients (8%) with a daily ethanol consumption c50 g also had increased serum CDT levels. The specificity of CDT was 92%, compared with 75%, 82%, 86%, and 85% for GGT, AST, ALT, and MCV, respectively. In the 60 patients who consumed >10 g ethanol daily, we found a significantly positive correlation between CDT and ethanol consumption (r = 0.52, p c 0.001). A positive correlation was also found between serum transferrin and CDT (f = 0.51,~ c 0.001). In conclusion, the specificity of CDT is much higher compared with GGT in detecting alcohol abuse. Some acute and chronic illnesses may increase the serum level of CDT. False-positive CDT levels may be caused by changes in serum transferrin concentration.
Evaluation of Two Biological Markers Combined as a Parameter of Alcohol Dependency
Alcohol and Alcoholism, 1997
A test was constructed by combining carbohydrate-deficient transferrin (%CDT) and yglutamyltransferase (GT) and was evaluated in detecting alcohol-dependent patients in a surgical ward. The performance of the combined test was significantly better than that of either %CDT alone or GT alone, as evaluated by calculating sensitivity and likelihood ratio at a specificity of 0.85 and by comparing areas under receiver-operating characteristic curves statistically. Improved performance was found for the whole group of patients, for men, for patients older than 35 years of age, and for those patients consuming more than 60 g alcohol per day. The performance of %CDT alone was similar to that of GT, %CDT being better in the age group 35-50 years, whereas GT was better for those drinking less than 60 g per day and for the oldest patients (>50 years). Neither of the two tests or their combination performed well for patients younger than 36 years of age.