Assessment of erythrocyte delta-aminolaevulinate dehydratase for outpatient detection of alcoholic liver disease: comparison with gamma-glutamyltransferase and casual blood ethanol.
An enzyme temporarily depressed by alcohol ingestion, erythrocyte delta-aminolaevulinate dehydratase (delta-ALAD), was compared with afternoon casual blood ethanol and plasma gamma-glutamyltransferase (gamma-glutamyltransferase (gamma-GT) simultaneously measured in outpatients. These comprised 37 individuals with chronic alcoholism, of whom 14 had severe liver disease, 22 patients with non-alcoholic liver disease and 24 healthy control subjects. All tests distinguished poorly between those alcoholics with, and those without histological liver damage. The highest specificity for alcoholism was achieved by gamma-ALAD; the best overall performance, with highest sensitivity and specificity was, however, gamma-GT. Although there was no correlation between the results of tests in individuals, 32/37 (87%) of alcoholics had at least one of the three tests abnormal compared with 8% of controls and 64% of non-alcoholic liver disease patients. The tests are therefore complementary and may form a battery of tests for problem drinking and its physical consequences.
D004796:Clinical Enzyme Tests; D004912:Erythrocytes / Q000201:enzymology*; D000431:Ethanol / Q000097:blood*; D005260:Female; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000097:blood / Q000175:diagnosis*; D008297:Male; D000623:Porphobilinogen Synthase / Q000097:blood*; D005723:gamma-Glutamyltransferase / Q000097:blood*
D000431:Ethanol; D005723:gamma-Glutamyltransferase; D000623:Porphobilinogen Synthase