Comparing the Diagnostic Accuracy of Carbohydrate-Deficient Transferrin, gamma-Glutamyltransferase, and Mean Cell Volume in a General Practice Population

Abstract

In certain populations, the biological alcohol marker carbohydrate-deficient transferrin (CDT) is known to have a high diagnostic accuracy. The aim of this study was to compare the diagnostic accuracy of CDT, gamma-glutamyltransferase (gamma-GT), and mean cell volume (MCV) in a general practice population; more specifically, to ascertain whether CDT is a better tool than gamma-GT and MCV for (early) recognition of excessive alcohol use. To represent the general practice situation as realistically as possible, three different drinking patterns are defined: irregular excessive, regular excessive, and very excessive. From a sample of 524 men from seven general practices, sensitivity, specificity, and predictive values of the three markers for the three drinking patterns were compared, and receiver-operating characteristic analysis was used to compare differences between the markers. The results indicate that drinking patterns do influence the (difference in) diagnostic accuracy. CDT has a higher diagnostic accuracy for all three drinking patterns than gamma-GT and higher predictive values for hazardous [(ir)regular excessive] drinking patterns than MCV. However, receiver-operating characteristic analyses failed to demonstrate a significant difference between these patterns. It is concluded that the performance of all tests is too low to be useful for screening procedures in a general population; however, some tests may be useful for case finding. CDT seems to be the best alcohol marker available, although the difference between CDT and MCV is small.

Carbohydrate-Deficient Transferrin: Validity of a New Alcohol Biomarker in a Sample of Patients with Diabetes and Hypertension

“…There are also factors besides alcohol use that may affect CDT levels, including age, 22 genetic variants, 14 medication, female hormones, 24 iron stores, 25 tobacco use, 26 and other factors. 27,28 The %CDT TIA is the test used for this study. Of the 12 tests that measure CDT levels, this is the only CDT test currently approved by the FDA in the US.…”

Opportunistic screening for alcohol use disorders in primary care: comparative study

“…Several studies have questioned the value of measuring traditional biochemical markers of excessive alcohol consumption for screening in primary care, such as γ-glutamyltransferase, aspartate aminotransferase, erythrocyte mean cell volume, and per cent carbohydrate deficient transferrin 12 13. The alcohol use disorders identification test (AUDIT) is a 10 item questionnaire specifically developed for use as a short screening instrument for the identification of hazardous, harmful, or dependent alcohol users 14 15.…”

Improved HPLC Method for Carbohydrate-deficient Transferrin in Serum

“…The main asset of CDT compared with the conventional biochemical indicators of chronic alcohol abuse, such as the liver enzyme ␥-glutamyltransferase and the mean corpuscular volume of erythrocytes, is its high specificity for alcohol abuse with a resulting low rate of false-positive identifications (10,11 ). However, drawbacks include the lack of standardization regarding the procedures applied for determination and in the definition of CDT.…”