Liver and adipose tissue fatty acid ethyl esters obtained at autopsy are postmortem markers for premortem ethanol intake.
BACKGROUND
Fatty acid ethyl esters (FAEEs) are nonoxidative ethanol metabolites that have been implicated as mediators of alcohol-induced organ damage. FAEEs are detectable in the blood after ethanol ingestion, and on that basis have been proposed as markers of ethanol intake. Because blood is not always available at autopsy, in this study we quantified FAEEs in human liver and adipose tissue as potential postmortem markers of premortem ethanol intake.


METHODS
Twenty-four sets of samples were collected at the Massachusetts State Medical Examiner's Office, and 7 sets of samples were obtained from the Pathology Department of Massachusetts General Hospital. Samples of liver and adipose tissue were collected at autopsy, and FAEEs were isolated and quantified from these organs as mass per gram of wet weight. Postmortem analysis of blood involved assessment for ethanol and other drugs.


RESULTS
The study shows a substantial difference in FAEE concentrations in liver and adipose tissue of patients with detectable blood ethanol at the time of autopsy vs those with no detectable blood ethanol, who were either chronic alcoholics or social drinkers. In addition, a specific FAEE, ethyl arachidonate, was found at concentrations >200 pmol/g almost exclusively in the liver and adipose tissue of individuals with detectable blood ethanol at the time of death, providing an additional FAEE-related marker for prior ethanol intake.


CONCLUSIONS
The mass of FAEEs in liver and adipose tissue and the presence of ethyl arachidonate can serve as postmortem markers of premortem ethanol intake when no blood sample can be obtained.
Refaai
Majed A
MA
Division of Laboratory Medicine, Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Nguyen
Phan N
PN
Steffensen
Thora S
TS
Evans
Richard J
RJ
Cluette-Brown
Joanne E
JE
Laposata
Michael
M
D000273:Adipose Tissue / Q000737:chemistry*; D000328:Adult; D000428:Alcohol Drinking / Q000097:blood; D000437:Alcoholism / Q000175:diagnosis*; D001095:Arachidonic Acids / Q000032:analysis; D001344:Autopsy; D015415:Biomarkers / Q000032:analysis; D000431:Ethanol / Q000032:analysis* / Q000097:blood; D005227:Fatty Acids / Q000032:analysis*; D005260:Female; D006801:Humans; D008099:Liver / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D015813:Substance Abuse Detection / Q000379:methods*
D001095:Arachidonic Acids; D015415:Biomarkers; D005227:Fatty Acids; D000431:Ethanol; C035723:ethyl arachidonate