title: Hair ethyl glucuronide as a biomarker of alcohol consumption in alcohol-dependent patients: role of gender differences.
abstract: BACKGROUND
  Ethyl glucuronide (EtG) is a minor alcohol metabolite that accumulates in hair and is proposed as a stable marker for the detection of chronic and excessive alcohol consumption above a cut-off level of 30pg/mg hair. A correlation between drinking behavior and EtG hair concentrations is observed, but large variability exists.
  
  
  OBJECTIVE
  To investigate the correlation between alcohol consumption and hair EtG concentrations in alcohol dependent patients, and the effect of gender differences as a factor for the variability on this correlation.
  
  
  METHODS
  EtG was measured by gas chromatography coupled to mass spectrometry in the hairs (first 3cm) of 36 alcohol dependent patients (25 males/11 females) starting and alcohol detoxification program. Factors that possibly influence EtG content in hair (except age and gender) were excluded. Detailed retrospective alcohol consumption was obtained over the last 3 months using the Timeline Follow Back interview.
  
  
  RESULTS
  Median total alcohol consumption over 3 months was 13,050g pure alcohol (range 60-650g/day). Hair EtG concentrations varied between 32 and 662pg/mg. There was a statistically significant linear and positive correlation between hair EtG and amounts of alcohol consumed (Pearson r=0.83; p<0.001), in both males (Pearson r=0.83; p<0.001) and females (Pearson r=0.76; p=0.007).
  
  
  CONCLUSIONS
  There is a linear correlation, with no significant effect of gender, between hair EtG concentrations and amounts of alcohol consumed in alcohol-dependent individuals. Analysis of EtG in hair can be applied to estimate retrospective alcohol consumption in both male and female alcohol dependent subjects using the same cut-off.
authors.affiliation: Toxicological Center, University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium. Electronic address: cleo.crunelle@gmail.com.
authors.forename: Cleo L
authors.initials: CL
authors.lastname: Crunelle
authors.affiliation: Toxicological Center, University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium. Electronic address: delphine.cappelle@gmail.com.
authors.forename: Delphine
authors.initials: D
authors.lastname: Cappelle
authors.affiliation: Toxicological Center, University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium. Electronic address: adrian.covaci@uantwerpen.be.
authors.forename: Adrian
authors.initials: A
authors.lastname: Covaci
authors.affiliation: Toxicological Center, University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium. Electronic address: alexander.vannuijs@uantwerpen.be.
authors.forename: Alexander L N
authors.initials: AL
authors.lastname: van Nuijs
authors.affiliation: Toxicological Center, University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium. Electronic address: kristof.maudens@uantwerpen.be.
authors.forename: Kristof E
authors.initials: KE
authors.lastname: Maudens
authors.affiliation: Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium. Electronic address: bernard.sabbe@uantwerpen.be.
authors.forename: Bernard
authors.initials: B
authors.lastname: Sabbe
authors.affiliation: Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium. Electronic address: geert.dom@fracarita.org.
authors.forename: Geert
authors.initials: G
authors.lastname: Dom
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Antwerp, Wilrijkstraat 10, B2650 Antwerp, Belgium. Electronic address: peter.michielsen@uza.be.
authors.forename: Peter
authors.initials: P
authors.lastname: Michielsen
authors.affiliation: Laboratoire National de Santé, Service de Toxicologie, L3555 Dudelange, Luxembourg. Electronic address: michel.yegles@lns.etat.lu.
authors.forename: Michel
authors.initials: M
authors.lastname: Yegles
authors.affiliation: Toxicological Center, University of Antwerp, Universiteitsplein 1, B2610 Antwerp, Belgium; Toxicology Laboratory, ZNA Stuivenberg, Lange Beeldekenstraat 267, B2060 Antwerp, Belgium. Electronic address: Hugo.Neels@zna.be.
authors.forename: Hugo
authors.initials: H
authors.lastname: Neels
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D000437:Alcoholism / Q000175:diagnosis*; D015415:Biomarkers / Q000032:analysis; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D005965:Glucuronates / Q000032:analysis*; D006197:Hair / Q000737:chemistry*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D015415:Biomarkers; D005965:Glucuronates; C093924:ethyl glucuronide
keywords: Alcohol biomarker; Alcohol dependence; Ethyl glucuronide; Gender; Hair