title: Pregnancy and variations of carbohydrate-deficient transferrin levels measured by the candidate reference HPLC method.
abstract: OBJECTIVE
  Contrasting data are available on the diagnostic accuracy of carbohydrate-deficient transferrin (CDT) during pregnancy. These differences may depend in part on how CDT was evaluated and expressed. Here, we report on variations of CDT levels in pregnant women using the high performance liquid chromatography (HPLC) candidate reference method.
  
  
  METHODS
  Alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, mean corpuscular volume, serum transferrin, urine and serum ethyl glucuronide and CDT were measured in 64 women, self-reporting as non-alcohol abusers (age: median 34, IQR: 28-38), at different stages of normal pregnancy (gestational weeks: median 28, IQR: 8-33). CDT was expressed as percentage of disialotransferrin to total transferrin (%CDT).
  
  
  RESULTS
  Transferrin was associated with both %CDT (r = 0.66; P < 0.001) and gestational week (r = 0.68; P < 0.001). Interestingly, %CDT was highly correlated with gestational week (r = 0.77; P < 0.001), even after controlling for the effect of transferrin. Moreover, statistically significant differences in %CDT were also evident between women grouped for pregnancy trimester (first trimester: mean 1.01% (SD 0.19); second trimester: 1.30% (SD 0.14); third trimester: 1.53% (SD 0.22); ANOVA P < 0.001). Trend analysis confirmed a proportional increase of %CDT along with pregnancy trimesters (P < 0.001).
  
  
  CONCLUSIONS
  %CDT, measured with the HPLC candidate reference method, is independently associated with gestational week. Differently from what has been previously reported or expected, the relationship between pregnancy and CDT could be more complex. The diagnostic accuracy of CDT for detecting alcohol abuse in a legal context may be limited in pregnant women and the effect of gestational age should be considered.
authors.affiliation: Toxicology Laboratory, Department of Clinical Pathology, SS. Antonio e Biagio e C. Arrigo Hospital, Alessandria, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Bianchi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ivaldi
authors.forename: Alessia
authors.initials: A
authors.lastname: Raspagni
authors.forename: Carlo
authors.initials: C
authors.lastname: Arfini
authors.forename: Matteo
authors.initials: M
authors.lastname: Vidali
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002851:Chromatography, High Pressure Liquid / Q000379:methods*; D004909:Erythrocyte Indices / Q000187:drug effects; D005260:Female; D005865:Gestational Age; D005965:Glucuronates / Q000097:blood / Q000652:urine; D006801:Humans; D008111:Liver Function Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D011264:Pregnancy Trimesters; D012795:Sialoglycoproteins / Q000097:blood*; D014168:Transferrin / Q000031:analogs & derivatives* / Q000032:analysis*
chemical_list: D015415:Biomarkers; D005965:Glucuronates; D012795:Sialoglycoproteins; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C519691:disialotransferrin; C093924:ethyl glucuronide