title: Hair ethyl glucuronide is highly sensitive and specific for detecting moderate-to-heavy drinking in patients with liver disease.
abstract: OBJECTIVE
  Hair ethyl glucuronide (EtG) is a promising biomarker of moderate-to-heavy alcohol consumption and may have utility in detecting and monitoring alcohol use in clinical populations where alcohol use is of particular importance. This study evaluated the relationship between hair EtG and drinking in patients with liver disease.
  
  
  METHODS
  The subjects (n = 200) were patients with liver disease who presented for care at a university medical center. Alcohol use during the 3 months preceding participation in the study was assessed, and a sample of hair was obtained for EtG testing. Classification of drinking status (any drinking or averaging at least 28 g per day) by hair EtG was evaluated, as well as the effects of liver disease severity and demographic and hair care factors.
  
  
  RESULTS
  The area under the receiver operating characteristic curve for detecting an average of 28 g or more per day during the prior 90 days was 0.93. The corresponding sensitivity and specificity of hair EtG ≥8 pg/mg for averaging at least 28 g of ethanol per day were 92 and 87%, respectively. Cirrhosis and gender may have a modest influence on the relationship between drinking and hair EtG.
  
  
  CONCLUSIONS
  Hair EtG was highly accurate in differentiating subjects with liver disease averaging at least 28 g of ethanol per day from abstainers and lighter drinkers.
authors.affiliation: Division of General Internal Medicine, University at Buffalo, Buffalo, NY, USA. ss243@buffalo.edu
authors.forename: Scott H
authors.initials: SH
authors.lastname: Stewart
authors.forename: David G
authors.initials: DG
authors.lastname: Koch
authors.forename: Ira R
authors.initials: IR
authors.lastname: Willner
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Randall
authors.forename: Adrian
authors.initials: A
authors.lastname: Reuben
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D005965:Glucuronates / Q000032:analysis* / Q000378:metabolism*; D006197:Hair / Q000737:chemistry* / Q000378:metabolism*; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015813:Substance Abuse Detection / Q000592:standards
chemical_list: D005965:Glucuronates; C093924:ethyl glucuronide