title: Detecting alcohol abuse: traditional blood alcohol markers compared to ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs) measurement in hair.
abstract: Alcohol abuse is a common problem in society; however, the technical capabilities of evaluating individual alcohol consumption using objective biomarkers are rather limited at present. In recent years research has focused on alcohol markers using hair analysis but data on performance and reliable cut-off values are still lacking. In this study 169 candidates were tested to compare traditional biomarkers, such as carbohydrate-deficient-transferrin (CDT), gamma glutamyl transferase (GGT), aspartate amino transferase, alanine amino transferase and the mean corpuscular volume of the erythrocytes, with alcohol markers detectable in hair such as ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs). This study revealed that EtG, GGT and CDT showed the best results, demonstrating areas under the curve calculated from receiver operating characteristics of 0.941, 0.943 and 0.899 respectively. The lowest false-negative and false-positive rates were obtained by using a combined interpretation system for hair EtG and FAEEs. All markers demonstrated only low to moderate correlations. Optimum cut-off values for differentiation between social and chronic excessive drinking calculated for hair EtG and FAEEs were 28 pg/mg and 0.675 ng/mg, respectively. The critical values published in the "Consensus on Alcohol Markers 2012" by the Society of Hair Testing were confirmed.
authors.affiliation: Institute of Legal Medicine and Forensic Sciences, Charité, Medical University Berlin, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Hastedt
authors.forename: Mara
authors.initials: M
authors.lastname: Büchner
authors.forename: Michael
authors.initials: M
authors.lastname: Rothe
authors.forename: René
authors.initials: R
authors.lastname: Gapert
authors.forename: Sieglinde
authors.initials: S
authors.lastname: Herre
authors.forename: Franziska
authors.initials: F
authors.lastname: Krumbiegel
authors.forename: Michael
authors.initials: M
authors.lastname: Tsokos
authors.forename: Thorsten
authors.initials: T
authors.lastname: Kienast
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.forename: Sven
authors.initials: S
authors.lastname: Hartwig
mesh_terms: D000437:Alcoholism / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D004952:Esters / Q000032:analysis*; D000431:Ethanol / Q000378:metabolism*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005227:Fatty Acids / Q000032:analysis*; D005965:Glucuronates / Q000032:analysis*; D006197:Hair / Q000737:chemistry*; D006801:Humans; D011237:Predictive Value of Tests; D012372:ROC Curve; D015813:Substance Abuse Detection / Q000379:methods*; D014168:Transferrin / Q000031:analogs & derivatives / Q000032:analysis; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015415:Biomarkers; D004952:Esters; D005227:Fatty Acids; D005965:Glucuronates; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C093924:ethyl glucuronide; D000431:Ethanol; D005723:gamma-Glutamyltransferase