Usefulness of carbohydrate-deficient transferrin in alcoholic patients with normal gamma-glutamyltranspeptidase.
The biological diagnosis of alcoholism is conducted routinely by assay of gamma-glutamyltranspeptidase (GGT) and mean corpuscular volume (MCV). However, their low specificity and sensitivity have prompted research to find other more reliable parameters. Stibler showed an increase in desialylated transferrin [carbohydrate-deficient transferrin (CDT)] in alcoholic patients. The normal value of the serum CDT concentration is under 60 mg/liter; a value between 60 and 100 mg/liter indicates probable alcoholism, and a value > 100 mg/liter indicates a very high probability of alcoholism (specificity: 99%). Its sensitivity ranges from 60 to 91%, and its specificity ranges from 92 to 100%. Its half-life is 17 +/- 4 days. CDT is thus a useful laboratory marker, but its assay is costlier and more complex than that of GGT. This study concerns 31 alcohol-dependent patients as defined by DSM-IV, with GGT levels in the normal range. It evaluates CDT at day 0 and its time course after 15 days withdrawal. GGT and MCV were assayed concomitantly. Remarkably, the results show a sensitivity of 83.9 (26 positives of 31) in this particular population and a specificity of 92.2. The fall in CDT after 15 days withdrawal was 36%. CDT is thus a particularly useful marker for the diagnosis and follow-up of alcoholics with normal GGT levels.
Reynaud
M
M
Department of Medical Psychology Center B, Faculty of Medicine, Teaching Hospital, Clermont-Ferrand, France.
Hourcade
F
F
Planche
F
F
Albuisson
E
E
Meunier
M N
MN
Planche
R
R
D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000201:enzymology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011237:Predictive Value of Tests; D014168:Transferrin / Q000031:analogs & derivatives* / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000097:blood*
D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D005723:gamma-Glutamyltransferase