Biochemical and haematological indicators of excessive alcohol consumption.

Abstract

SUMMARY Discriminant function analysis was used to determine the optimum combination of haematological and biochemical tests which gave the best discrimination between hospital patients with high and low alcohol intakes. We studied 265 patients with alcohol-related disease, 133 gastroenterology outpatients drinking less than 20 g of alcohol per day, and 104 patients with a variety of non-alcoholic liver disease. Values of mean cell volume (MCV), serum bilirubin, aspartate transaminase, serum alkaline phosphatase (AP) and y glutamyl transferase (yGT), serum albumin, serum globulin, and uric acid were determined in each patient. The best discrimination between the three groups of patients was provided by a combination of mean corpuscular volume, log1o yGT, and log1o serum alkaline phosphatase. In women, 92% of the high alcohol group, 100% of the low alcohol group, and 87% of the non-alcoholic liver disease were correctly allocated by the discriminant analysis. The corresponding figures for the men were 80%, 100%, and 71%. Thus, over 80% ofpatients with excessive alcohol intake were correctly allocated by the use of three simple laboratory tests.Alcohol consumption in the United Kingdom has been increasing rapidly with an accompanying rise in the prevalence of alcohol-related diseases. As recognition of these patients is often difficult, there is a need for simple laboratory investigations to help identify those patients whose illness is associated with excessive alchol intake.The most widely used tests for this purpose are standard liver function tests, Vy glutamyl transferase (yGT), and mean cell volume (MCV) as measured using an electronic cell counter. Although yGT is a sensitive indicator of excessive alcohol intake, it is also raised in a variety of non-alcoholic liver diseases.' We have found mean cell volume to be raised in approximately 80% of hospital patients with excessive alcohol consumption

Biochemical and Haematological Response to Alcohol Intake

“…aspartate transaminase, alkaline phosphatase) should be considered as additional markers of heavy alcohol consumption. ": 9 The data in this study indicate that these tests provide relatively little extra information once GGT is known.…”

Biochemical markers for alcohol consumption

“…Plasma urate have been shown to correlate with recent alcohol intake. The heavy drinkers tend to have a slightly raised serum alkaline phosphatase (21). Urea concentrations are often reduced because alcohol inhibits enzymes in the urea cycle (22).…”

Serum Enzymes and Enzyme Profiles in the Diagnosis of Liver and Biliary Tract Disease

“…Specificity can be increased by linking it with a second test, e.g. high-density lipoprotein cholesterol [32] or mean corpuscular volume (MC'V) and AP [33,34] to detect alcoholic liver disease, or with lipoprotein-X and AP isoenzymes to diagnose cholestasis [34,35], It has been included with other tests in profiles to detect liver secondaries, and specific GGT isoen zymes have been described in hepatocellular carcinoma [36], GGT is at least as sensitive as serum bile acids in detecting patients with hepatobiliary disease, and although it is a less specific test [37,38], normal values help to exclude such disease [39]. An exception is in the early diag nosis of cholestasis in pregnancy where the sensitivities of serum bile acids and GGT were 71 an 35%, respectively [40],…”