Phosphatidylethanol is superior to carbohydrate-deficient transferrin and γ-glutamyltransferase as an alcohol marker and is a reliable estimate of alcohol consumption level.
BACKGROUND
In clinical practice as well as research situations, it is of great importance to get reliable information about a patient's alcohol consumption. The aim of the study was to investigate the correlation of alcohol biomarkers (phosphatidylethanol [PEth], carbohydrate-deficient transferrin [CDT], γ-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase) to retrospective as well as diary-based alcohol self-reports and to examine whether it is possible to correlate a biomarker result to a more precise level of alcohol consumption.


METHODS
One hundred and sixty alcohol-dependent patients were included in a randomized, placebo-controlled clinical trial of pharmacotherapy for alcohol dependence, of which 115 (76 men and 39 women) completed the study. Retrospective alcohol consumption data were collected at baseline, and alcohol diaries were used during the study. Blood samples for determination of alcohol biomarkers were collected on 5 occasions during the study.


RESULTS
PEth and CDT showed a better correlation with alcohol consumption documented in the diary (PEth rs = 0.56 and CDT rs = 0.35) than with retrospective consumption data (PEth rs = 0.23 and CDT rs = 0.22). An even higher correlation (rs = 0.63) was seen between the 2 alcohol biomarkers PEth and CDT. At all consumption levels, PEth had the highest sensitivity of all biomarkers studied.


CONCLUSIONS
PEth was the biomarker with the best correlation to self-reported alcohol consumption. PEth was superior to CDT owing to its substantially higher sensitivity but also due to its closer correlation to self-report. PEth values can be translated into an approximate level of alcohol consumption and PEth appears to be a more reliable measure of alcohol consumption than self-reports.
Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, University Hospital, Lund University, Lund, Sweden.
Lisa
L
Walther
Addiction Biology Unit, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Beroendekliniken, Sahlgrenska University Hospital, Gothenburg, Sweden.
Andrea
A
de Bejczy
Addiction Biology Unit, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Beroendekliniken, Sahlgrenska University Hospital, Gothenburg, Sweden.
Elin
E
Löf
Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, University Hospital, Lund University, Lund, Sweden.
Therese
T
Hansson
Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, University Hospital, Lund University, Lund, Sweden.
Anders
A
Andersson
Department of Clinical Neuroscience , Karolinska Institutet, Stockholm, Sweden.
Joar
J
Guterstam
Department of Clinical Neuroscience , Karolinska Institutet, Stockholm, Sweden.
Anders
A
Hammarberg
Department of Clinical Alcohol Research , Malmö University Hospital, Lund University, Lund, Sweden.
Gulber
G
Asanovska
Department of Clinical Neuroscience , Karolinska Institutet, Stockholm, Sweden.
Johan
J
Franck
Addiction Biology Unit, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Beroendekliniken, Sahlgrenska University Hospital, Gothenburg, Sweden.
Bo
B
Söderpalm
Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, University Hospital, Lund University, Lund, Sweden.
Anders
A
Isaksson
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000097:blood*; D000437:Alcoholism / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D005260:Female; D020404:Glycerophospholipids / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D057566:Self Report / Q000592:standards; D014168:Transferrin / Q000031:analogs & derivatives* / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000097:blood*
D015415:Biomarkers; D020404:Glycerophospholipids; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C051521:phosphatidylethanol; D005723:gamma-Glutamyltransferase
Alcohol Biomarker; Carbohydrate-Deficient Transferrin; Phosphatidylethanol; Reported Alcohol Consumption