Measurement of carbohydrate-deficient transferrin by isoelectric focusing/western blotting and by micro anion-exchange chromatography/radioimmunoassay: comparison of diagnostic accuracy.
At present, the most reliable marker of recent and heavy alcohol intake is carbohydrate-deficient transferrin (CDT). While most CDT quantitation methods (including immunofixation and micro anion-exchange chromatography [MAEC] combined with radioimmunoassay [RIA]) either lack the precision required for diagnostic usage or are not commercially available, we recently described an isoelectric focusing/Western blotting (IEF/WB) procedure that provides sensitive and specific assessment of serum CDT content. However, a modified MAEC/RIA kit, supposedly more reliable than the original, is also being advanced as suitable for widespread clinical application. Therefore, we compared this modified MAEC/RIA procedure to the IEF/WB method of CDT quantitation in the following 108 subjects; 53 alcoholics undergoing detoxification without clinical or histological evidence of liver disease, 24 recently drinking alcoholics with biopsy-proven liver disease, eight alcoholics abstinent for more than 30 days with biopsy-proven liver disease, seven non-drinking patients with non-alcoholic liver disease, and 16 healthy controls. Although CDT measurements by the two methods were correlated (r = 0.60, P < 0.01), serum CDT values obtained with IEF/WB were nearly five-fold higher than those obtained with MAEC/RIA (e.g. 140.0 +/- 58 versus 28.5 +/- 16 mg/l among the active drinkers). Of the two methods, IEF/WB exhibited significantly greater sensitivity than MAEC/RIA for detecting recent, heavy drinking (75% versus 61%, P < 0.05) and generated no false positives whereas MAEC/RIA gave falsely elevated CDT levels in 37% of the abstinent alcoholics.(ABSTRACT TRUNCATED AT 250 WORDS)
Xin
Y
Y
Alcohol Research & Treatment Center, Bronx Veterans Affairs Medical Center, NY.
Rosman
A S
AS
Lasker
J M
JM
Lieber
C S
CS
D000328:Adult; D000437:Alcoholism / Q000097:blood / Q000175:diagnosis / Q000534:rehabilitation; D001706:Biopsy; D015153:Blotting, Western; D002852:Chromatography, Ion Exchange; D006801:Humans; D007525:Isoelectric Focusing; D008099:Liver / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000097:blood / Q000175:diagnosis / Q000534:rehabilitation; D011863:Radioimmunoassay; D014168:Transferrin / Q000031:analogs & derivatives* / Q000032:analysis
D014168:Transferrin; C056759:carbohydrate-deficient transferrin