title: Detection times for urinary ethyl glucuronide and ethyl sulfate in heavy drinkers during alcohol detoxification.
abstract: OBJECTIVE
  Ethyl glucuronide (EtG) and ethyl sulfate (EtS) are conjugated ethanol metabolites formed in low amounts after alcohol consumption. Compared with ethanol, EtG and EtS are excreted in urine for a prolonged time, making them useful as sensitive alcohol biomarkers. This study determined the detection times for EtG and EtS in alcoholic patients undergoing alcohol detoxification.
  
  
  METHODS
  Alcohol-dependent patients (n = 32) with an initial alcohol concentration >or=1 g/L based on breath testing were followed during detoxification. Urine samples for determination of EtG, EtS, ethanol and creatinine were collected on admission to the hospital and thereafter once daily for several days. EtG and EtS measurements were performed by liquid chromatography-mass spectrometry (LC-MS) and EtG also using an immunochemical assay (DRI-EtG EIA, ThermoFisher/Microgenics).
  
  
  RESULTS
  The detection time for urinary EtG was weakly correlated (r = 0.434, P = 0.013) with the initial alcohol concentration (range 1.0-3.4 g/L). For EtG, the individual time range until return to below the applied cut-off limit (<0.5 mg/L) was approximately 40-130 h (median 78) with a similar time course observed for EtS. After correction for urine dilution, the time until an EtG/creatinine ratio <0.5 mg/g was approximately 40- 90 h (median 65). The detection times after an estimated zero ethanol concentration were approximately 30-110 h (median 66) for EtG and approximately 30- 70 h (median 56) for EtG/creatinine. The EtG results by LC-MS and the immunoassay were in good agreement.
  
  
  CONCLUSIONS
  During alcohol detoxification, EtG and EtS remained detectable in urine for several days. The detection times showed wide inter-individual variations, also after adjusting values for urine dilution and to the estimated times for a completed ethanol elimination.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. anders.helander@ki.se
authors.forename: Anders
authors.initials: A
authors.lastname: Helander
authors.forename: Michael
authors.initials: M
authors.lastname: Böttcher
authors.forename: Christoph
authors.initials: C
authors.lastname: Fehr
authors.forename: Norbert
authors.initials: N
authors.lastname: Dahmen
authors.forename: Olof
authors.initials: O
authors.lastname: Beck
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000523:psychology / Q000652:urine*; D001944:Breath Tests; D002492:Central Nervous System Depressants / Q000097:blood / Q000378:metabolism; D002851:Chromatography, High Pressure Liquid; D003404:Creatinine / Q000652:urine; D000431:Ethanol / Q000097:blood / Q000378:metabolism; D005260:Female; D005965:Glucuronates / Q000652:urine*; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013463:Sulfuric Acid Esters / Q000652:urine*; D013695:Temperance
chemical_list: D002492:Central Nervous System Depressants; D005965:Glucuronates; D013463:Sulfuric Acid Esters; C093924:ethyl glucuronide; D000431:Ethanol; D003404:Creatinine; C011612:diethyl sulfate