Value of ethyl glucuronide in plasma as a biomarker for recent alcohol consumption in the emergency room.
OBJECTIVE
This emergency department (ED) study compared the value of plasma ethyl glucuronide (EtG) testing with the information about alcohol consumption obtained using the standard alcohol biomarkers gamma-glutamyltransferase (GGT) and carbohydrate-deficient transferring (CDT) and the AUDIT questionnaire.


METHODS
Minimally injured and clinically non-intoxicated male patients (n = 81) admitted to an ED were screened regarding their alcohol consumption, using the computerized AUDIT questionnaire and a paper-and-pencil assessment including the type, amount and time of alcohol intake. Blood samples were collected for determination of ethanol, EtG (LC-MS) and GGT in plasma and %CDT in serum (Axis-Shield %CDT immunoassay).


RESULTS
Out of the 81 patients, 23 (28%) were positive (>/=8 points) on the AUDIT questionnaire. Only 3 (4%) showed a detectable ethanol concentration (range 0.01-0.07 g/L) but 31 (38%) showed a detectable EtG (0.16-39.5 mg/L). In four patients, EtG was detectable in plasma for >48 h after estimated completed elimination of ethanol. EtG was not correlated with the long-term biomarkers %CDT or GGT, or the AUDIT results, but with the time since estimated completed ethanol elimination.


CONCLUSIONS
EtG testing in blood was found useful in the ED as a way to detect recent drinking, even in cases of a negative ethanol test, and to confirm abstinence from alcohol. This sensitive and specific short-term biomarker provides valuable additional information about individual drinking habits and might also be helpful to identify an alcohol hangover.
Neumann
Tim
T
Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Germany. tim.neumann@charite.de
Helander
Anders
A
Dahl
Helen
H
Holzmann
Tilly
T
Neuner
Bruno
B
Weiss-Gerlach
Edith
E
Müller
Christian
C
Spies
Claudia
C
D000328:Adult; D000437:Alcoholism / Q000097:blood* / Q000453:epidemiology / Q000534:rehabilitation*; D015415:Biomarkers; D015992:Body Mass Index; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D000431:Ethanol / Q000097:blood; D005965:Glucuronates / Q000097:blood*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D012372:ROC Curve; D011795:Surveys and Questionnaires; D013997:Time Factors; D014168:Transferrin / Q000031:analogs & derivatives* / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000097:blood*
D015415:Biomarkers; D005965:Glucuronates; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C093924:ethyl glucuronide; D000431:Ethanol; D005723:gamma-Glutamyltransferase