title: Combinations of carbohydrate-deficient transferrin, mean corpuscular erythrocyte volume, gamma-glutamyltransferase, homocysteine and folate increase the significance of biological markers in alcohol dependent patients.
abstract: OBJECTIVE
  The traditionally used biological markers for alcoholism include a wide range of sensitivity and specificity as single tests. This study focuses on the combination of established laboratory parameters with new meaningful biomarkers to advance the significance regarding alcohol dependence.
  
  
  METHODS
  We analyzed blood samples from alcohol-dependent patients (n=177) compared with a control group (n=181). In the statistical calculation we included carbohydrate-deficient transferrin (CDT), mean corpuscular erythrocyte volume (MCV), gamma-glutamyltransferase (GGT), total plasma homocysteine, and folate.
  
  
  RESULTS
  None of the examined biomarkers reached sensitivity above 90% while all markers showed a good specificity. Combinations of different markers led to a significant elevation in sensitivity. Best values for men were achieved by using a combination of MCV, CDT, GGT, homocysteine and folate in different weightings (sensitivity: 98.6%, specificity: 86.4%). For women, similar results were yielded by combining MCV and CDT (sensitivity: 94.1%, specificity: 96%). The addition of homocysteine and folate in different weightings did not result in further enhancement.
  
  
  CONCLUSIONS
  Gender-specific clusters including MCV, CDT, GGT, homocysteine and folate led to an increase in sensitivity compared to single laboratory markers. This is a reliable help to identify patients with regular heavy drinking in clinical practice which might prevent further complications.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Germany. daniela.rinck@uk-erlangen.de
authors.forename: Daniela
authors.initials: D
authors.lastname: Rinck
authors.forename: Helge
authors.initials: H
authors.lastname: Frieling
authors.forename: Anne
authors.initials: A
authors.lastname: Freitag
authors.forename: Thomas
authors.initials: T
authors.lastname: Hillemacher
authors.forename: Kristina
authors.initials: K
authors.lastname: Bayerlein
authors.forename: Johannes
authors.initials: J
authors.lastname: Kornhuber
authors.forename: Stefan
authors.initials: S
authors.lastname: Bleich
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis* / Q000201:enzymology; D015415:Biomarkers / Q000097:blood; D004909:Erythrocyte Indices; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012016:Reference Values; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014168:Transferrin / Q000031:analogs & derivatives* / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D015415:Biomarkers; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D006710:Homocysteine; D005492:Folic Acid; D005723:gamma-Glutamyltransferase