Use of biomarkers for alcohol use disorders in clinical practice.
BACKGROUND
Biomedical markers may provide additive objective information in screening and confirmation of acute or recent consumption, intoxication, relapse, heavy drinking, hazardous/harmful use/abuse and dependence and alcohol use related organ dysfunction (alcohol use-related disorders: AUDs).


OBJECTIVE
To review the use of biomarkers in clinical practice to detect AUDs.


RESULTS
About one-fifth of the patients seen in clinical practice have AUDs, which offer a variety of treatment options if diagnosed. The diagnosis of AUDs relies on clinical and alcohol-related history, physical examination, questionnaires and laboratory values. No clinical available laboratory test [e.g. for acute abuse: alcohol in blood or breath; for chronic alcohol abuse: gamma-glutamyl transferase (GGT), mean corpuscular volume (MCV), carbohydrate-deficient transferrin (CDT)] is reliable enough on its own to support a diagnosis of alcohol dependence, harmful use or abuse. Sensitivities, specificities and the predictive values may vary considerably according to patient and control group characteristics (e.g. gender, age or related comorbidity). In patient groups with limited cooperation markers may be helpful when considering treatment options.


CONCLUSIONS
More research is needed to determine the value of markers (single or combined, with questionnaires) in the context of clinical decision-making algorithms in defined settings and with defined dichotomous outcome variables.
Department of Anesthesiology and Intensive Care Medicine, Universitaetsmedizin-Berlin Charité, Charité Campus Mitte Berlin, Germany.
Tim
T
Neumann
Claudia
C
Spies
D000367:Age Factors; D019973:Alcohol-Related Disorders / Q000150:complications / Q000175:diagnosis*; D015415:Biomarkers / Q000032:analysis*; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis; D012737:Sex Factors; D014947:Wounds and Injuries / Q000209:etiology
D015415:Biomarkers