CDT, GGT, and AST As Markers of Alcohol Use: The WHO/ISBRA Collaborative Project

Conigrave, Katherine M.; Degenhardt, Louisa; Whitfield, John B.; Saunders, John B.; Helander, Anders; Tabakoff, Boris

doi:10.1111/j.1530-0277.2002.tb02542.x

Cited by 254 publications

(101 citation statements)

References 27 publications

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“…This gender variation has been recently demonstrated for %CDT (5,39 ) and agrees with the most recent WHO/ISBRA assessment that CDT is a slightly but significantly better marker of high-risk consumption in men (40 ). Turpeinen et al (27 ) recently reported a 1.8% cutoff for HPLC analysis of disialo-Tf.…”

Section: Discussionsupporting

confidence: 61%

Use of Capillary Zone Electrophoresis for Differentiating Excessive from Moderate Alcohol Consumption

Legros¹,

Nuyens²,

Baudoux

et al. 2003

Clinical Chemistry

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Background:The poorly sialylated transferrin isoforms in serum were analyzed by capillary zone electrophoresis (CZE) to differentiate moderate from heavy alcohol consumption. Methods: We enrolled 614 volunteers, classified after interviews, self-reported drinking habits, and AUDIT scores as alcohol abusers (consuming >50 g/day ethanol for the previous 3 months or longer; n ‫؍‬ 413) or moderate drinkers (<30 g/day ethanol; n ‫؍‬ 201). Serum transferrin isoforms were separated at 28 kV and monitored at 214 nm on a P/ACE 5500 CZE with use of fused-silica capillaries and the related CEofix CDT reagent set. Immunosubtraction by anti-human transferrin and electrophoretic migration times identified the isoforms. Previous markers of alcohol abuse and an assay combining anion-exchange minicolumn chromatography with immunoturbidimetry (%CDT) were included in the study. Sensitivities and specificities were compared by ROC analysis. Results: The asialylated isoform was missing in 95% of moderate drinkers but present in 92% of alcohol misusers. Disialotransferrin had a specificity and sensitivity of 0.75 at a cutoff of 0.7% of total transferrin, whereas the sum (asialo-؉ disialotransferrin) at a threshold of 1.2% had a sensitivity of 0.73 and a specificity of 0.92. Trisialotransferrin values did not distinguish between the two populations. Sensitivities and specificities of %CDT averaged 0.77 and 0.74, respectively, at a 2.6%

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Section: Discussionsupporting

confidence: 61%

Use of Capillary Zone Electrophoresis for Differentiating Excessive from Moderate Alcohol Consumption

Legros¹,

Nuyens²,

Baudoux

et al. 2003

Clinical Chemistry

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“…A couple of markers such as -glutamyltransferase (GGT) or carbohydrate deficient transferrin (CDT) may be the most appropriate for the early detection of nondependent hazardous or harmful drinking (Sillanaukee et al 2000;Conigrave et al 2002), inasmuch as the elevated GGT or CDT is not always indicative of a clinically diagnosed disease. Aspartate aminotransferase (AST) seems to be a primary marker for hepatocellular injury (Stewart 2002), because it is more specific than other liver enzymes for detecting alcohol-induced hepatocyte necrosis (Cohen and Kaplan 1979).…”

mentioning

confidence: 99%

Effects of Alcohol Consumption on Hepatocellular Injury in Japanese Men

Dakeishi

Iwata

Ishii

et al. 2004

Tohoku J. Exp. Med.

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To clarify the effects of alcohol consumption on hepatocellular injury, we examined aspartate and alanine aminotransferases (AST and ALT), and -glutamyltransferase (GGT), together with weekly alcohol consumption calculated from a self-rating questionnaire, in 1113 Japanese salesmen. The thresholds of associations between alcohol consumption and liver markers were estimated by the benchmark dose (BMD) method. The AST, ALT and GGT were positively correlated with alcohol intake (p<0.001), as well as age and body mass index (BMI); the relations to alcohol were statistically significant even when controlling for age, BMI and smoking habit. Although the AST and GGT were associated with four types of alcoholic beverage (p<0.01), it was only whisky that had close relation to the ALT (p<0.05). The thresholds of alcohol consumption (ethanol g/week), i.e., 95% lower confidence limits of the BMD, were 362 for AST, 660 for ALT, and 252 for GGT. The thresholds for GGT and AST in Japanese men seem to be somewhat higher than those reported in Western countries. It is suggested that hepatocellular injury (i.e., AST elevation) in Japanese men may emerge at the ethanol level of more than 50 g/day. alcohol consumption; hepatocellular injury; aspartate aminotransferase (AST); benchmark dose method; critical dose

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“…CDT is more specific than GGT. [48][49][50] Ethyl glucuronide is a direct metabolite of alcohol and it can be measured in tissues, blood, hair, and urine. 42 Urinary ethyl glucuronide offers several advantages over other biomarkers of alcohol relapse.…”

Section: How To Assess Relapse After Liver Transplantmentioning

confidence: 99%

Liver Transplantation for Alcohol-Related Liver Disease

Choudhary

Kumar

Saigal

et al. 2016

Journal of Clinical and Experimental Hepatology

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Alcoholic liver disease (ALD) is a common indication for liver transplantation. It is a much debated indication for deceased donor liver transplantation due to organ shortage and potential of alcohol relapse after liver transplantation. A six-month abstinence before liver transplantation is required at most centers to decrease chances of alcohol relapse after liver transplantation. However, this rule is not relevant for patients with severe alcoholic hepatitis or severely decompensated patients who are unlikely to survive till 6 months. Long-term care of these patients after liver transplantation includes assessment of relapse, smoking, and surveillance of de novo malignancies. Current review discusses role of abstinence, factors affecting alcohol relapse, liver transplantation for alcoholic hepatitis, role of living donor liver transplantation, and long-term care of ALD patients who undergo liver transplantation. ( J CLIN EXP HEPATOL 2016;6:47-53) A lcoholic liver disease (ALD) is common indication for liver transplantation worldwide, 1,2 and is a common cause of decompensated cirrhosis and acute-on-chronic liver failure in India as well. 3,4 ALD has good outcome after liver transplantation that is comparable or better than other etiologies of liver transplantation. Recent European liver transplant registry data showed 73% 5-year and a 59% 10-year survival rate for ALD. 2 However, survival is lower in recipients who relapse to harmful pattern of drinking as noted in a systemic review of 13 studies by Rustad et al. 5 Liver transplantation for ALD leads to improvement in quality of life and employment rates. 6,7 During selection of these patients for liver transplantation, it is important to identify other alcohol-related problems like cardiomyopathy, chronic pancreatitis, skeletal muscle wasting, and neurotoxicities that may preclude or impair outcome of liver transplantation. 8 Patients who have lack of social support, are active smokers, and have psychiatric disorders or alcohol dependence should be listed only with reservations. 9 Smoking worsens the outcome of alcohol-related liver disease 10 and active smoking at the time of liver transplantation has been shown to be associated with post-transplant recidivism also. 11 PREDICTORS OF RELAPSEWhile liver transplantation improves functions of liver and cures complications of portal hypertension, it does not affect alcoholism and recipients may relapse again, sometimes to harmful levels of drinking, and pretransplant sobriety does not confirm sobriety after liver transplant. [12][13][14] Relapse may be in the form of occasional slips or harmful drinking pattern for a prolonged period; the later affects graft and patient survival. 5,11 Initially, 6-month abstinence was considered as a requirement before allocating organ to patients with ALD; however, it was based on poor quality small data. 15 The 6-month rule serves 2 purposes; it provides patient time to demonstrate a certain period of abstinence and patient may recover on medical management, and thus preempt...

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CDT, GGT, and AST As Markers of Alcohol Use: The WHO/ISBRA Collaborative Project

Cited by 254 publications

References 27 publications

Use of Capillary Zone Electrophoresis for Differentiating Excessive from Moderate Alcohol Consumption

Use of Capillary Zone Electrophoresis for Differentiating Excessive from Moderate Alcohol Consumption

Effects of Alcohol Consumption on Hepatocellular Injury in Japanese Men

Liver Transplantation for Alcohol-Related Liver Disease

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