title: Value of ethyl glucuronide in plasma as a biomarker for recent alcohol consumption in the emergency room.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Germany. tim.neumann@charite.de
authors.forename: Tim
authors.initials: T
authors.lastname: Neumann
authors.forename: Anders
authors.initials: A
authors.lastname: Helander
authors.forename: Helen
authors.initials: H
authors.lastname: Dahl
authors.forename: Tilly
authors.initials: T
authors.lastname: Holzmann
authors.forename: Bruno
authors.initials: B
authors.lastname: Neuner
authors.forename: Edith
authors.initials: E
authors.lastname: Weiss-Gerlach
authors.forename: Christian
authors.initials: C
authors.lastname: Müller
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
mesh_terms: 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*
chemical_list: D015415:Biomarkers; D005965:Glucuronates; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C093924:ethyl glucuronide; D000431:Ethanol; D005723:gamma-Glutamyltransferase