title: Hair ethyl glucuronide and serum carbohydrate deficient transferrin for the assessment of relapse in alcohol-dependent patients.
abstract: OBJECTIVE
  Ethyl glucuronide in hair (hEtG) and serum carbohydrate deficient transferrin (%CDT) are valuable markers for alcohol abuse, but their diagnostic accuracy to monitor abstinence and relapse is unclear. Here, we investigate to what extent repeated measurements of hEtG and %CDT can be used to monitor relapse in alcohol-dependent patients during abstinence treatment.
  
  
  METHODS
  HEtG and %CDT were measured in individuals starting treatment for alcohol dependence both at treatment entry and 3months later. Alcohol consumption and relapse episodes were recorded using the Time Line Follow Back and by alcohol breath and urine tests, and correlated with hEtG and %CDT measurements.
  
  
  RESULTS
  Fifteen patients completed the study, of which nine had one or more relapses. Hair EtG and serum %CDT identified whether a relapse occurred in 78% and 57% of cases, respectively. Only hEtG correlated with the amount of alcohol consumed before treatment entry (Pearson r=0.92; p<0.001). The specificity of %CDT to assess abstinence during treatment was 100%. HEtG had a specificity of only 17%; however, in all patients who remained abstinent, hEtG decreased with >85% from initial values. Mean hEtG, but not %CDT, differed significantly between patients who relapsed and patients who remained abstinent (p=0.034).
  
  
  CONCLUSIONS
  HEtG was more sensitive than serum %CDT to assess relapse in alcohol-dependent patients and was positively correlated with the amounts of alcohol consumed. In contrast, serum %CDT was more specific for assessing abstinence. We highlight the benefit of repeated measurements of hEtG and serum %CDT for monitoring abstinence during treatment.
authors: Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium. Electronic address: cleo.crunelle@gmail.com.
authors: Cleo L
authors: CL
authors: Crunelle
authors: Department of Hepatology, University Hospital KU Leuven, Leuven, Belgium.
authors: Jef
authors: J
authors: Verbeek
authors: Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium.
authors: Geert
authors: G
authors: Dom
authors: Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium.
authors: Adrian
authors: A
authors: Covaci
authors: Laboratoire National de Santé, Service de Toxicologie, Dudelange, Luxembourg.
authors: Michel
authors: M
authors: Yegles
authors: Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium.
authors: Peter
authors: P
authors: Michielsen
authors: Toxicology and TDM Laboratory, ZNA Stuivenberg Hospital, Antwerp, Belgium.
authors: Mireille
authors: M
authors: De Doncker
authors: Department of Hepatology, University Hospital KU Leuven, Leuven, Belgium.
authors: Frederik
authors: F
authors: Nevens
authors: Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium.
authors: Delphine
authors: D
authors: Cappelle
authors: Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium.
authors: Alexander L N
authors: AL
authors: van Nuijs
authors: Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium; Toxicology and TDM Laboratory, ZNA Stuivenberg Hospital, Antwerp, Belgium.
authors: Hugo
authors: H
authors: Neels
mesh_terms: D000437:Alcoholism / Q000150:complications* / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism*; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005965:Glucuronates / Q000032:analysis*; D006197:Hair / Q000737:chemistry* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D015813:Substance Abuse Detection / Q000379:methods*; D014168:Transferrin / Q000031:analogs & derivatives* / Q000032:analysis; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005965:Glucuronates; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C093924:ethyl glucuronide; D000431:Ethanol
keywords: Abstinence assessment; Alcohol; Carbohydrate deficient transferrin; Ethyl glucuronide; Hair; Relapse