Elimination Characteristics of the Alcohol Biomarker Phosphatidylethanol (PEth) in Blood during Alcohol Detoxification

Abstract

Aims The study documented elimination characteristics of three phosphatidylethanol (PEth) homologs in serially collected blood samples from 47 heavy drinkers during ~2 weeks of alcohol detoxification at hospital. Methods Venous whole blood and urine samples were collected every 1–2 days during treatment. Concentrations of PEth, and of urinary ethyl glucuronide (EtG) and ethyl sulfate (EtS) to detect relapse drinking, were measured using liquid chromatography-tandem mass spectrometry. Results When included in the study, negative or decreasing breath ethanol concentrations demonstrated that the patients were in the elimination phase. The EtG and EtS measurements further confirmed alcohol abstinence during the study, with three exceptions. On admission, all patients tested positive for PEth, the total concentration ranging 0.82–11.7 (mean 6.35, median 5.88) μmol/l. PEth 16:0/18:1, 16:0/18:2 and 16:0/20:4 accounted for on average ~42%, ~26% and ~9%, respectively, of total PEth in these samples. There were good correlations between total PEth and individual homologs (P < 0.0001). There was no significant difference in PEth values between male and female subjects. During abstinence, the elimination half-life values ranged 3.5–9.8 days for total PEth, 3.7–10.4 days for PEth 16:0/18:1, 2.7–8.5 days for PEth 16:0/18:2 and 2.3–8.4 days for PEth 16:0/20:4. Conclusions The results demonstrated a very high sensitivity (100%) of PEth as alcohol biomarker for recent heavy drinking, but considerable differences in the elimination rates between individuals and between different PEth forms. This indicates that it is possible to make only approximate estimates of the quantity and recency of alcohol intake based on a single PEth value.

High-Throughput LC-MS/MS Method for Determination of the Alcohol Use Biomarker Phosphatidylethanol in Clinical Samples by Use of a Simple Automated Extraction Procedure—Preanalytical and Analytical Conditions

“…As of 2017, all Swedish laboratories utilize mass spectrometric methods to determine PEth 16:0/ 18:1. A special external quality assessment program for PEth was started within the EQUALIS organization (External Quality Assessment in Laboratory Medicine in Sweden) in 2013, and since then, there is a preliminary consensus agreement between all laboratories in Sweden on how to report and interpret a result for PEth (12). The number of clinical samples sent to our laboratory has shown an approximately logarithmic increase since the start in 2006 with >54000 requests during 2016.…”

“…LOQ is defined as the level at which the method has a CV <20%. A PEth value <0.05 μmol/L (<35 ng/mL) is interpreted as corresponding to low or no ethanol consumption, and there is an agreement between Swedish laboratories not to report results below this limit (12). At this level, the method shows a total CV of <10%, which means that LOQ is <0.05 μmol/L.…”

“…Like carbohydratedeficient transferrin and in contrast to ethanol measurements (serum, urine, or breath) and urine ethyl glucuronide/sulfate, which reflect recent intake, PEth is an alcohol marker with a long window of detection. PEth values <0.05 μmol/L (35 ng/mL) are interpreted as corresponding to no or low consumption, whereas values of 0.05 to 0.30 μmol/L (35-211 ng/mL) and >0.30 μmol/L (>211 ng/mL) are interpreted as moderate and excessive consumption (12), respectively. In the presence of ethanol, PEth is formed in the erythrocyte cell membrane from phosphatidylcholine through a transphosphatidylation reaction catalyzed by phospholipase D (13,14).…”

Performance of PEth Compared With Other Alcohol Biomarkers in Subjects Presenting For Occupational and Pre-Employment Medical Examination

“…, 2017 ). During abstinence, the half-life of PEth differs between individuals in the range 4–10 (median 6) days ( Helander et al. , 2019a ).…”

No blue-yellow color vision impairment after acute ethanol ingestion

“…Phosphatidylethanol (PEth) is a direct marker for an alcohol misuse. PEth homologues 16:0/18:1 levels >210 ng/mL indicates an alcohol misuse and thus subjects with a PEth concentration above this limit were excluded from the study (Helander & Hansson, 2013). PEth homologues 16:0/18:1 was determined by a validated LC-MS/MS method (limit of quantification 100 ng/mL) (Schröck, Hernandez Redondo, Martin Fabritius, Konig, & Weinmann, 2016;Schröck, Thierauf-Emberger, Schurch, & Weinmann, 2016).…”