[Validity of carbohydrate-deficient transferrine (CDT) in assessing chronic abuse of ethyl alcohol in urban public transport workers].
OBJECTIVE
The aim of this study was to verify the ability of some chemical-clinical parameters, with particular emphasis on carbohydrate-deficient transferrin (CDT), in assessing chronic abuse of ethanol in a group of urban public transport workers.


METHODS
In the 512 subjects, public transport tram drivers, all males, who entered the study, information on the intake of alcoholic beverages was collected during the periodical health surveillance controls performed according to Italian legislation (DM88/99). In the study subjects the following clinical-chemical parameters were measured: CDT gamma-glutamyltransferase (GGT), mean corpuscular volume of erythrocytes (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT).


RESULTS
The subjects were divided into five groups according to different levels of alcohol intake: non-drinkers, occasional drinkers, moderate drinkers, habitual drinkers and heavy drinkers. The median values of CDT GGT and MCV were higher in drinkers than in non-drinkers, with an increasing trend in proportion to the amount of ethanol ingested. The validity of each parameter in determining chronic abuse of ethyl alcohol was calculated taking as true the statement on alcohol intake made spontaneously by the subject. CDT was confirmed as the parameter with the best sensitivity and specificity: 90% and 98%, respectively, the negative predictive value was 99%, while the positive predictive power was 45%. The combination of CDT with GGT or MCV led to small improvements in the positive predictive ability, which reached 50% for CDT and MCV and 60% for CDT and GGT.


CONCLUSIONS
Our results confirmed that, also in the workplace, CDT is the most important parameter for the diagnosis of chronic abuse of alcohol intake, but also showed that the positivity of this marker cannot be taken as certainty of abuse. The adoption of further diagnostic tools is therefore proposed, such as a specific questionnaire to collect information on alcohol intake, and in case of positive CDT a second-level test with a high specificity.
Fustinoni
Silvia
S
Unitá Operativa di Epidemiologia, Dipartimento di Medicina Preventiva, del Lavoro e dell'Ambiente "Clinica del Lavoro L. Devoto", Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena e Università degli Studi di Milano, Milano, Italy. silvia.fustinoni@unimi.it
De Vecchi
M
M
Bordini
L
L
Todaro
A
A
Riboldi
L
L
Bertazzi
P A
PA
D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000175:diagnosis*; D015415:Biomarkers; D002947:Cities; D003627:Data Interpretation, Statistical; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis*; D009790:Occupations; D012907:Smoking / Q000453:epidemiology; D014168:Transferrin / Q000031:analogs & derivatives* / Q000032:analysis; D014186:Transportation
D015415:Biomarkers; D014168:Transferrin; C056759:carbohydrate-deficient transferrin