title: Improved detection of alcohol consumption using the novel marker phosphatidylethanol in the transplant setting: results of a prospective study.
abstract: Phosphatidylethanol (PEth) is a new, highly specific alcohol marker. The aim of this study was to assess its diagnostic value in the liver transplant setting. In 51 pre- and 61 post-transplant patients with underlying alcoholic liver disease PEth, ethanol, methanol, carbohydrate-deficient transferrin (CDT), and ethyl glucuronide in urine (uEtG) and hair (hEtG) were tested and compared with patients' questionnaire reports. Twenty-eight (25%) patients tested positive for at least one alcohol marker. PEth alone revealed alcohol consumption in 18% of patients. With respect to detection of alcohol intake in the preceding week, PEth showed a 100% sensitivity. PEth testing was more sensitive than the determination of ethanol, methanol, CDT or uEtG alone [sensitivity 25% (confidence interval (CI) 95%, 7-52%), 25% (7-52%), 21% (6-45%) and 71% (41-91%), respectively], or ethanol, methanol and uEtG taken in combination with 73% (45-92%). Specificity of all markers was 92% or higher. Additional testing of hEtG revealed alcohol consumption in seven patients, not being positive for any other marker. Phosphatidylethanol was a highly specific and sensitive marker for detection of recent alcohol consumption in pre- and post-transplant patients. The additional determination of hEtG was useful in disclosing alcohol consumption 3-6 months retrospectively.
authors.affiliation: Department of Legal Medicine, University Medical Center Hamburg - Eppendorf, Hamburg, Germany.
authors.forename: Hilke
authors.identifier: http://orcid.org/0000-0002-8779-8902
authors.initials: H
authors.lastname: Andresen-Streichert
authors.affiliation: Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg - Eppendorf, Hamburg, Germany.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Beres
authors.affiliation: Institute of Forensic Medicine, University of Bern, Bern, Switzerland.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Weinmann
authors.affiliation: Institute of Forensic Medicine, University of Bern, Bern, Switzerland.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Schröck
authors.affiliation: Department of Legal Medicine, University Medical Center Hamburg - Eppendorf, Hamburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Müller
authors.affiliation: Department of Legal Medicine, University Medical Center Heidelberg, Heidelberg, Germany.
authors.forename: Gisela
authors.initials: G
authors.lastname: Skopp
authors.affiliation: Department of Medicine (Med Klinik I), University Medical Center Hamburg - Eppendorf, Hamburg, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Pischke
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg - Eppendorf, Hamburg, Germany.
authors.forename: Eik
authors.initials: E
authors.lastname: Vettorazzi
authors.affiliation: Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg - Eppendorf, Hamburg, Germany.
authors.forename: Ansgar
authors.initials: A
authors.lastname: Lohse
authors.affiliation: Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg - Eppendorf, Hamburg, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Nashan
authors.affiliation: Department of Medicine (Med Klinik I), University Medical Center Hamburg - Eppendorf, Hamburg, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Sterneck
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000378:metabolism / Q000652:urine*; D015415:Biomarkers / Q000032:analysis / Q000652:urine; D000431:Ethanol / Q000652:urine; D005189:False Positive Reactions; D005260:Female; D005965:Glucuronates / Q000652:urine; D020404:Glycerophospholipids / Q000032:analysis / Q000652:urine; D006197:Hair / Q000737:chemistry; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000378:metabolism / Q000601:surgery* / Q000652:urine*; D016031:Liver Transplantation; D008297:Male; D000432:Methanol / Q000652:urine; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014168:Transferrin / Q000031:analogs & derivatives / Q000652:urine
chemical_list: D015415:Biomarkers; D005965:Glucuronates; D020404:Glycerophospholipids; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C051521:phosphatidylethanol; C093924:ethyl glucuronide; D000431:Ethanol; D000432:Methanol
keywords: alcoholic liver disease; carbohydrate-deficient transferrin; cirrhosis; ethyl glucuronide; methanol; phosphatidylethanol