Biological markers of problem drinking in homeless patients.
OBJECTIVE
In the search for optimal biomarkers of excessive drinking, a central limitation has been the lack of sensitivity of measures. Many patients have apparently normal values of liver markers despite a considerable alcohol intake. This study aimed to test a novel combined indicator of alcohol drinking.


METHODS
Concentrations of carbohydrate-deficient transferrin (%CDT), gamma glutamyl transferase (gammaGT), aspartate aminotransferase (ASAT), and mean corpuscular volume (MCV), together with a combined index of the %CDT and gammaGT, the Antilla Index (AI), were studied in 104 homeless patients with (n = 87) or without (n = 24) problem drinking according to the Fast Alcohol Screening Test.


RESULTS
Concentrations of all markers were significantly higher in the alcoholic patients than in other homeless patients. The best agreement between liver markers and self-reported status was found between the combined %CDT and gammaGT index (kappa = 0.61, p < 0.001, sensitivity = 63%, specificity = 94%).


CONCLUSIONS
The combined AI is a relatively efficient measure of current drinking in homeless populations.
Thiesen
Henrik
H
City of Copenhagen HealthTeam, 2300 Copenhagen S, Denmark. alkodoktor@dadlnet.dk
Hesse
Morten
M
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000097:blood*; D000437:Alcoholism / Q000097:blood / Q000175:diagnosis; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003718:Denmark; D004909:Erythrocyte Indices; D005260:Female; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014168:Transferrin / Q000031:analogs & derivatives / Q000737:chemistry; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
D015415:Biomarkers; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases