Comparison of new methods for measuring carbohydrate-deficient transferrin (CDT): application to a public health approach for the prevention of alcoholic cirrhosis.
Recently, Xin et al. (1991) developed an isoelectric focusing/Western blot (IEF/WB) procedure for serum CDT measurement which compares favorably with the micro anion-exchange chromatography/radioimmunoassay technique of Stibler et al. (1986). The latter is now marketed in a modified version (Stibler et al., 1991), gives values that correlate with those of IEF/WB but are nearly 5-fold lower, with significantly lesser sensitivity for detecting recent drinkers; these are also less well discriminated from non-drinking patients with liver disease. We are now able to screen for heavy drinking using IEF/WB. Some of the complications of liver disease are then detected with standard liver function tests. Next we need to detect precirrhotic lesions (perivenular and/or perisinusoidal fibrosis) which, at present, requires a liver biopsy. These patients--at high risk to rapidly develop cirrhosis upon continuation of drinking--should be subjected to intensive treatment, instituted prior to their medical or social disintegration, with the goal to prevent progression to cirrhosis.
Lieber
C S
CS
Alcohol Research and Treatment Center, Bronx VA Medical Center, New York, NY, USA.
Xin
Y
Y
Lasker
J M
JM
Rosman
A S
AS
D000428:Alcohol Drinking / Q000097:blood; D000818:Animals; D015415:Biomarkers / Q000097:blood; D015153:Blotting, Western; D002852:Chromatography, Ion Exchange; D006801:Humans; D007525:Isoelectric Focusing; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood* / Q000188:drug therapy / Q000517:prevention & control*; D010713:Phosphatidylcholines / Q000627:therapeutic use; D011863:Radioimmunoassay; D012436:S-Adenosylmethionine / Q000627:therapeutic use; D014168:Transferrin / Q000031:analogs & derivatives* / Q000032:analysis
D015415:Biomarkers; D010713:Phosphatidylcholines; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D012436:S-Adenosylmethionine