Ethanol metabolites: their role in the assessment of alcohol intake.
BACKGROUND
Alcohol-related disorders are common, expensive in their course, and often underdiagnosed. To facilitate early diagnosis and therapy of alcohol-related disorders and to prevent later complications, questionnaires and biomarkers are useful.


METHODS
Indirect state markers like gamma-glutamyl-transpeptidase, mean corpuscular volume, and carbohydrate deficient transferrin are influenced by age, gender, various substances, and nonalcohol-related illnesses, and do not cover the entire timeline for alcohol consumption. Ethanol (EtOH) metabolites, such as ethyl glucuronide, ethyl sulfate, phosphatidylethanol, and fatty acid ethyl esters have gained enormous interest in the last decades as they are detectable after EtOH intake.


RESULTS
For each biomarker, pharmacological characteristics, detection methods in different body tissues, sensitivity/specificity values, cutoff values, time frames of detection, and general limitations are presented. Another focus of the review is the use of the markers in special clinical and forensic samples.


CONCLUSIONS
Depending on the biological material used for analysis, ethanol metabolites can be applied in different settings such as assessment of alcohol intake, screening, prevention, diagnosis, and therapy of alcohol use disorders.
Paracelsus Medical University, Salzburg, Austria.|Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany.
Friedrich M
FM
Wurst
Paracelsus Medical University, Salzburg, Austria.
Natasha
N
Thon
Service de Toxicologie, Laboratoire National de Sante, Luxembourg, Luxembourg.
Michel
M
Yegles
Institute of Forensic Medicine, University of Bern, Bern, Switzerland.
Alexandra
A
Schrück
Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University of Halle, Halle, Germany.
Ulrich W
UW
Preuss
Institute of Forensic Medicine, University of Bern, Bern, Switzerland.
Wolfgang
W
Weinmann
D000428:Alcohol Drinking / Q000378:metabolism*; D000437:Alcoholism / Q000175:diagnosis* / Q000378:metabolism*; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D005965:Glucuronates / Q000378:metabolism; D006801:Humans; D015813:Substance Abuse Detection / Q000379:methods; D014018:Tissue Distribution / Q000502:physiology; D014168:Transferrin / Q000031:analogs & derivatives / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000378:metabolism
D015415:Biomarkers; D005965:Glucuronates; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C093924:ethyl glucuronide; D005723:gamma-Glutamyltransferase
Alcohol Intake; Ethanol Metabolites; Ethyl Glucuronide; Ethyl Sulfate; Fatty Acid Ethyl Esters; Phosphatidylethanol