Comparative evaluation of the clinical utility of three markers of ethanol intake: the effect of gender.
We evaluated three markers of ethanol intake [whole blood associated acetaldehyde (WBAA), serum beta-hexosaminidase, and gamma-glutamyl transpeptidase (GGT)] in four groups of subjects: teetotalers (n = 104), random insurance applicants or "normals" (n = 1,010), subjects enrolling in an alcohol treatment program or "alcoholics" (n = 31), and subjects attending outpatient drug/alcohol treatment follow-up clinics (n = 128). Significant differences (p < 0.004 for each assay and each comparison) were found in the mean values between teetotalers and normals and normals and alcoholics. Male teetotalers and normals had significantly (p < 0.002) higher levels of WBAA than females of the same group. Male normals had significantly higher levels of GGT than females (p < 0.001). GGT increased with age in the normal population into the fifth decade and decreased thereafter. WBAA was the most sensitive assay with 97% of alcoholics having values above the 99th percentile for the teetotaler population (vs. 66% for serum beta-hexosaminidase and 70% for GGT). None of the alcoholic subjects had values for all three assays below the 99th percentile for teetotalers compared with 21% of those in follow-up and 72% of normals. We conclude that WBAA appears to be the best of the three markers studied and that measurement of multiple markers for ethanol use appears clinically useful and incremental.
Halvorson
M R
MR
Home Office Reference Laboratory, Shawnee Mission, Kansas.
Campbell
J L
JL
Sprague
G
G
Slater
K
K
Noffsinger
J K
JK
Peterson
C M
CM
D000079:Acetaldehyde / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000201:enzymology / Q000534:rehabilitation; D000431:Ethanol / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012737:Sex Factors; D013695:Temperance; D001619:beta-N-Acetylhexosaminidases / Q000097:blood*; D005723:gamma-Glutamyltransferase / Q000097:blood*
D000431:Ethanol; D005723:gamma-Glutamyltransferase; D001619:beta-N-Acetylhexosaminidases; D000079:Acetaldehyde