title: Distribution and dose response of laboratory markers to alcohol consumption in a general population: results of the study of health in Pomerania (SHIP).
abstract: OBJECTIVE
  Biomarker distributions must be well known for use as screening tools for hazardous alcohol consumption in general populations. The aim of this study was to investigate characteristics of carbohydrate-deficient transferrin (CDT) and to compare it with gamma-glutamyltransferase (GGT) and erythrocyte mean corpuscular volume (MCV) in regard to distribution in the general population; the dose response relationship between alcohol consumption and biomarkers; and the effect of gender, age, body mass index (BMI) and smoking.
  
  
  METHODS
  In a cross-sectional health survey in northeast Germany (1997-2001), a sample of 7,008 men and women aged 20-79 years was drawn, following stratification by age and gender. Of this sample, 4,310 subjects (2,193 women) took part in the study. Alcohol consumption was evaluated by self-reports with a beverage specific quantity-frequency method.
  
  
  RESULTS
  Biomarker distributions differ across age and gender. The distribution of drinkers and nondrinking subjects showed considerable overlap. The association of alcohol consumption to laboratory markers is weak in the general population: strongest for GGT, followed by CDT and MCV For CDT and MCV it is weaker in women than in men. We found increasing risk of all three elevated marker values with increasing alcohol consumption and significant effects of age, gender, smoking and body mass index on the alcohol-biomarker dose response curve.
  
  
  CONCLUSIONS
  When biomarkers are used for screening, all confounding effects have to be taken into account and adjusted normal ranges must be used. CDT shows no overall advantage over GGT. Low correlation of biomarkers with alcohol consumption, their high variability and widely spread ranges in nondrinking subjects limit the usefulness of these markers in general population settings.
authors.affiliation: Institut für Epidemiologie und Sozialmedizin, Ernst-Moritz-Arndt-Universität Greifswald, Walther-Rathenau-Strasse 48, D-17487 Greifswald, Germany. alte@uni-greifswald.de
authors.forename: Dietrich
authors.initials: D
authors.lastname: Alte
authors.forename: Jan
authors.initials: J
authors.lastname: Lüdemann
authors.forename: Marion
authors.initials: M
authors.lastname: Piek
authors.forename: Christiane
authors.initials: C
authors.lastname: Adam
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Rose
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000097:blood* / Q000453:epidemiology*; D015415:Biomarkers; D002241:Carbohydrates / Q000172:deficiency; D002391:Catchment Area, Health; D003430:Cross-Sectional Studies; D004909:Erythrocyte Indices / Q000502:physiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D011795:Surveys and Questionnaires; D014168:Transferrin / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000378:metabolism
chemical_list: D015415:Biomarkers; D002241:Carbohydrates; D014168:Transferrin; D005723:gamma-Glutamyltransferase