Carbohydrate-Deficient Transferrin Determination in a Clinical Setting: Consistency Between Capillary Electrophoresis Assays and Utility of HPLC as a Confirmatory Test.
BACKGROUND
Carbohydrate-deficient transferrin (CDT) is used to assess chronic alcohol consumption in administrative and forensic context. The aim of the present study was the optimization of the diagnostic strategy for CDT determination in a clinical laboratory setting.


METHODS
Two capillary zone electrophoresis (CZE) assays, the CEofix CDT (Analis, Suarlée, Belgium) run on single capillary MDQ instrument and the muticapillary (Sebia, Lisses, France), were compared as screening methods and a commercial high-performance liquid chromatography (HPLC) assay (Recipe, Munich, Germany) was used for confirmation.


RESULTS
In total, 367 serum samples were analyzed by both CZE assays with concordant classification in 92% of cases. All discordant samples were classified as negative by HPLC, as did 2/3 of those that could not be classified by either CZE assay. Classification of samples with CDT values close to cut-off by CZE was confirmed by HPLC in 95-100% of negative samples but only in 28.6-33.3% of positive samples.


CONCLUSIONS
Both CZE assays proved suitable for CDT screening. HPLC was useful for discriminating CDT value in most of samples that could not be interpreted by CZE due to analytical interferences. Considering the implication of CDT testing, HPLC assay may also be helpful for the confirmation of positive results close to the cut-off value of CZE assays.
Laboratory of Toxicology, Department of Laboratory Medicine, Ospedale S. Agostino-Estense, Modena, Italy. ag.veronesi@ausl.mo.it.
Agnese
A
Veronesi
Laboratory of Toxicology, Department of Laboratory Medicine, Ospedale S. Agostino-Estense, Modena, Italy.
Cristina
C
Rota
Laboratory of Toxicology, Department of Laboratory Medicine, Ospedale S. Agostino-Estense, Modena, Italy.
Tommaso
T
Trenti
Laboratory of Toxicology, Department of Laboratory Medicine, Ospedale S. Agostino-Estense, Modena, Italy.
Elisabetta
E
Cariani
D002851:Chromatography, High Pressure Liquid / Q000379:methods*; D019075:Electrophoresis, Capillary / Q000379:methods*; D006801:Humans; D044967:Serum / Q000737:chemistry*; D018709:Statistics, Nonparametric; D014168:Transferrin / Q000031:analogs & derivatives* / Q000032:analysis / Q000378:metabolism
D014168:Transferrin; C056759:carbohydrate-deficient transferrin
HPLC; alcohol; capillary zone electrophoresis; carbohydrate deficient transferrin (CDT); clinical chemistry; cut-off value