title: A comparison between serum carbohydrate-deficient transferrin and hair ethyl glucuronide in detecting chronic alcohol consumption in routine.
abstract: OBJECTIVE
  In heavy alcohol consumption laboratory tests represent an objective evidence. In this study we compared older and newer biomarkers in blood and in hair.
  
  
  METHODS
  Carbohydrate-deficient transferrin (CDT), ethyl glucuronide (EtG), AST, ALT, GGT, MCV were measured in a large sample (n = 562). All people declared no alcohol consumption within the last 3 months. Serum CDT was measured by the candidate HPLC reference method and expressed as relative amount of disialotransferrin (%DST: cutoff 1.7%). EtG was measured in hair by a validated in-house method by LC-MS/MS (cutoff 30 pg/mg).
  
  
  RESULTS
  Respectively, 42 (7.5%) and 76 (13.5%) subjects were positive to CDT and EtG. In particular, 30 (5.3%) subjects were positive to both tests, 12 (2.1%) only to CDT, while 46 (8.2%) only to EtG. The agreement (positive and negative pairs) between CDT and EtG was 89.7%. Interestingly, 6 out of 12 (50%) CDT-positive subjects had EtG < 15 pg/mg, whereas 27 out of 46 (59%) EtG-positive subjects had CDT < 1.1%. Forty-one out of 76 (54%) EtG-positive subjects display EtG values within 30-50 pg/mg.
  
  
  CONCLUSIONS
  Large variability exists between CDT and EtG in detecting chronic alcohol consumption. We suggest to use CDT, or a combination of different biomarkers, to identify alcohol abuse in a forensic context. EtG results close to the cutoff (30-50 pg/mg) should be cautiously considered before any sanction is assigned.
authors.affiliation: Toxicology Laboratory, SS. Antonio e Biagio e C. Arrigo Hospital, Alessandria, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Bianchi
authors.affiliation: Toxicology Laboratory, SS. Antonio e Biagio e C. Arrigo Hospital, Alessandria, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Premaschi
authors.affiliation: School of Medicine, Insubria University, Varese, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Raspagni
authors.affiliation: Toxicology Laboratory, SS. Antonio e Biagio e C. Arrigo Hospital, Alessandria, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Secco
authors.affiliation: Department of Medical Sciences, University 'Amedeo Avogadro' of Eastern Piedmont, Novara, Italy Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy vidali@med.unipmn.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Vidali
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism; D000428:Alcohol Drinking / Q000378:metabolism*; D000437:Alcoholism / Q000175:diagnosis* / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015415:Biomarkers; D002851:Chromatography, High Pressure Liquid; D002853:Chromatography, Liquid; D002908:Chronic Disease; D004909:Erythrocyte Indices; D005260:Female; D005965:Glucuronates / Q000378:metabolism*; D006197:Hair / Q000737:chemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012795:Sialoglycoproteins / Q000378:metabolism; D015813:Substance Abuse Detection / Q000379:methods*; D053719:Tandem Mass Spectrometry; D014168:Transferrin / Q000031:analogs & derivatives* / Q000378:metabolism; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000378:metabolism
chemical_list: D015415:Biomarkers; D005965:Glucuronates; D012795:Sialoglycoproteins; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C519691:disialotransferrin; C093924:ethyl glucuronide; D005723:gamma-Glutamyltransferase; C554782:gamma-glutamyltransferase, human; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase