Liver disease and HPLC quantification of disialotransferrin for heavy alcohol use: a case series.
BACKGROUND
It had previously been suggested that individuals with cirrhosis may have a pattern of transferrin glycosylation that interferes with the interpretation of carbohydrate-deficient transferrin (CDT) testing for heavy alcohol use. The goal of this case series was to evaluate the prevalence of liver disease among individuals with poor resolution of transferrin glycoforms by high performance liquid chromatography.


METHODS
We reviewed the electronic medical records of 35 consecutive patients with poor chromatographic resolution of disialotransferrin from trisialotransferrin and recorded information on diagnosed liver disease, liver function testing, and other factors.


RESULTS
Thirty of the 35 subjects with poor chromatographic resolution of the transferrin glycoforms had sufficient data in the medical record for some estimation of liver function. Of these 30 subjects, 25 had previously diagnosed liver pathology. Of the remaining 5 subjects, 2 had liver imaging results suggestive of benign tumor; the remaining 3 had mildly elevated bilirubin and aminotransferase activity, and low albumin.


CONCLUSIONS
Liver abnormalities, but not necessarily cirrhosis, are common in individuals with poor chromatographic separation of transferrin glycoforms, which might lead to false-positive results on CDT testing. However, the chromatographic-based assay can detect this issue, minimizing the reporting of false positives, but not necessarily assisting in valid detection of heavy drinking.
Stewart
Scott H
SH
Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston, South Carolina 29425, USA. stewarsh@musc.edu
Comte-Walters
Susana
S
Bowen
Emily
E
Anton
Raymond F
RF
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000437:Alcoholism / Q000378:metabolism*; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000378:metabolism; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006519:Hepatitis, Alcoholic / Q000378:metabolism*; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000378:metabolism / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000378:metabolism / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D012795:Sialoglycoproteins / Q000032:analysis / Q000378:metabolism*; D014168:Transferrin / Q000031:analogs & derivatives* / Q000032:analysis / Q000378:metabolism
D012709:Serum Albumin; D012795:Sialoglycoproteins; D014168:Transferrin; C519691:disialotransferrin; C520536:trisialotransferrin, human; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin