title: Carbohydrate-deficient transferrin: validity of a new alcohol biomarker in a sample of patients with diabetes and hypertension.
abstract: OBJECTIVE
  To test the reliability and validity of a new alcohol biomarker.
  
  
  METHODS
  Cross-sectional with matched control. Alcohol use, symptoms of alcohol dependence, health status, current medications, carbohydrate-deficient transferrin (CDT) levels, and gamma-glutamyl transferase levels were assessed. Validity of the %CDT test was estimated using a drinking cutoff of 90 or more drinks in the previous 30 days.
  
  
  METHODS
  Sample (n = 799) included 89 patients with type 2 diabetes, 299 patients with hypertension, 209 patients with hypertension and type 2 diabetes, and 202 matched control subjects with neither diabetes nor hypertension.
  
  
  RESULTS
  Three hundred ninety-six women and 403 men ages 30 to 60 participated in the study. Six percent (45 of 799) reported drinking more than 14 drinks per week, 2% (n = 17) met criteria for alcohol abuse, and 3% (n = 23) met DSM-IV criteria for dependence. The overall sensitivity of the %CDT test was 61% with a specificity of 85%. A receiver operating characteristic curve was used to determine that the best fit was for persons who reported >90 drinks per month and a CDT level >2.5% with an area under the curve of 0.83. Test-retest reliability (R) was 0.94.
  
  
  CONCLUSIONS
  %CDT levels are useful in detecting and/or confirming high-risk drinking in patients being treated for type 2 diabetes and hypertension.
authors.affiliation: Department of Family Medicine, University of Wisconsin Medical School, Madison, 53715, USA. mfleming@fammed.wisc.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Fleming
authors.forename: Marlon
authors.initials: M
authors.lastname: Mundt
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014168:Transferrin / Q000031:analogs & derivatives* / Q000032:analysis*
chemical_list: D015415:Biomarkers; D014168:Transferrin; C056759:carbohydrate-deficient transferrin