Relative versus absolute carbohydrate-deficient transferrin as a marker of alcohol consumption in patients with acute alcoholic hepatitis.
BACKGROUND
Carbohydrate-deficient transferrin has been described as a sensitive and specific marker for alcohol consumption. This study investigated the usefulness of carbohydrate-deficient transferrin as a marker of alcohol consumption in acute alcoholic hepatitis.


METHODS
Absolute concentrations (U/I) and relative values (%) of carbohydrate-deficient transferrin determined in serum with commercial assays, as well as conventional markers for alcohol consumption, were compared with the alcohol consumption (as estimated by a questionnaire) in patients with acute alcoholic hepatitis (n = 19), alcoholic liver cirrhosis (n = 37), and nonalcoholic liver diseases (n = 16).


RESULTS
The concentration of carbohydrate-deficient transferrin was increased (p < 0.001) in nonabstaining patients (median intake 80 g alcohol/day) with alcoholic liver cirrhosis (45.7 +/- 30 U/l), but not in patients with acute alcoholic hepatitis (20.0 +/- 7.8 U/l) despite higher alcohol consumption (median 130 g/d), nor in abstainers with alcoholic liver cirrhosis (19.4 +/- 6.0 U/l) or nonalcoholic liver disease (18.5 +/- 6.7 U/l). However, the relative values of carbohydrate-deficient transferrin were increased both in acute alcoholic hepatitis (7.9 +/- 2.1%) and nonabstainers with alcoholic liver cirrhosis (7.4 +/- 2.8%), but not in abstainers with alcoholic liver cirrhosis (4.6 +/- 3.5%) or nonalcoholic liver disease (3.8 +/- 0.9%) (p < 0.001). In acute alcoholic hepatitis, the sensitivity and specificity were only 32% and 87% for absolute concentrations, respectively, but 79% and 97% for relative values of carbohydrate-deficient transferrin. The concentrations of carbohydrate-deficient and total transferrin in serum were strongly correlated (r = 0.60; p = 0.008).


CONCLUSIONS
The relative value (% of total), but not the absolute concentration, of carbohydrate-deficient transferrin in serum is a useful marker of alcohol consumption in acute alcoholic hepatitis.
Halm
U
U
Department of Medicine II, University of Leipzig, Germany. halmu@medizin.uni-leipzig.de
Tannapfel
A
A
Mössner
J
J
Berr
F
F
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000428:Alcohol Drinking / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004909:Erythrocyte Indices / Q000502:physiology; D005260:Female; D006519:Hepatitis, Alcoholic / Q000097:blood*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood*; D008297:Male; D008875:Middle Aged; D014168:Transferrin / Q000031:analogs & derivatives* / Q000032:analysis
D015415:Biomarkers; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase