Combining markers of nephrotoxicity and hepatotoxicity for improved monitoring and detection of chronic alcohol abuse.
BACKGROUND
Most of the commonly used markers of chronic alcohol abuse reflect alcohol hepatotoxicity; however, such abuse is deleterious to the kidneys as well. Combined use of serum markers of liver origin and urinary markers of kidney origin may be of diagnostic advantage.


METHODS
The study was performed in 73 male alcoholics undergoing detoxification and 36 male alcoholics who had maintained abstinence for > or =6 weeks. Factor analysis, discriminant analysis and receiver operating characteristic (ROC) analysis were used to assess the discriminative power of two urinary markers of alcohol nephrotoxicity, namely beta-N-acetylhexosaminidase (Hex, EC 3.2.1.52) and alanine aminopeptidase (EC 3.4.11.2), and of three serum markers of alcohol hepatotoxicity, namely aspartate aminotransferase (EC 2.6.1.1), alanine aminotransferase (EC 2.6.1.2) and gamma-glutamyltransferase (GGT, EC 2.3.2.2), and of their quantitative combinations.


RESULTS
The discriminative power of the urinary markers matched that of the serum markers. Hex and GGT appeared to be the best for discriminating the study groups. Their combination given by the equation G&H=0.62 x ln(GGT)+0.72 x ln(Hex) showed excellent discriminative ability (ROC area under the curve 0.92) that was significantly higher than that of any single marker in this report, indicating superior diagnostic accuracy of the compound marker.


CONCLUSIONS
Kidney-derived urinary markers, particularly Hex, can complement or replace, if necessary, serum markers of chronic alcohol abuse that relate to alcohol hepatotoxicity. The compound marker proposed seems a promising tool for the monitoring and perhaps detection of chronic alcohol abuse and warrants further studies.
Taracha
Ewa
E
Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland. taracha@ipin.edu.pl
Habrat
Bogusław
B
Chrapusta
Stanisław J
SJ
Lehner
Małgorzata
M
Wisłowska
Aleksandra
A
Woronowicz
Bohdan T
BT
Bogulas
Marta
M
Charewicz
Jolanta
J
Markuszewski
Cezary
C
Płaźnik
Adam
A
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000437:Alcoholism / Q000150:complications / Q000175:diagnosis*; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000032:analysis* / Q000097:blood / Q000652:urine; D018826:CD13 Antigens / Q000652:urine; D016002:Discriminant Analysis; D005163:Factor Analysis, Statistical; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D007677:Kidney Function Tests; D016014:Linear Models; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D001619:beta-N-Acetylhexosaminidases / Q000652:urine; D005723:gamma-Glutamyltransferase / Q000097:blood
D015415:Biomarkers; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001619:beta-N-Acetylhexosaminidases; D018826:CD13 Antigens