Evaluation of Carbohydrate‐deficient Transferrin Compared with Tf Index and Other Markers of Alcohol Abuse

Abstract

It has been known for some years that a partial deglycosylation of transferrin occurs in the sera of alcohol abusers. Different methods have been proposed in order to evaluate this carbohydrate-deficient fraction of serum transferrin. Chromatofocusing or isoelectric focusing followed by direct immunofixation have been used until now. Recently, a new method called the carbohydrate-deficient transferrin (CDT) test based on ion-exchange chromatography has been developed by Stibler et al. (Alcohol Clin Exp Res 10:535-544, 1986). Here we compare this new method with results obtained using our Tf index determination method. The upper limit of normal values was set to the 90th percentile of the values observed in a reference population. The population under investigation consisted of 50 healthy volunteers and 160 alcohol abusers whose ethanol consumption was evaluated through a questionnaire. Sensitivity and specificity of the CDT test have been found higher than 0.76 and 0.90, respectively. The correlation between both methods was 0.794, a satisfactory result considering that the CDT test and the Tf index do not exactly measure the same part of the carbohydrate-deficient transferrin. In a population of 23 patients with liver diseases not related to alcohol abuse, no abnormal CDT value was observed. We can conclude from these results that the CDT test now seems to be the best test to detect alcohol abusers.

Objective Diagnosis of Alcohol Abuse: Compared Values of Carbohydrate‐Deficient Transferrin (CDT), γ‐Glutamyl Transferase (GGT), and Mean Corpuscular Volume (MCV)

“…These results are similar to those of Lesch et al (1996), obtained during experimental consumption of large amounts of alcohol by healthy subjects, and they reflect better sensitivity in the population of abusers than for the heavy drinkers reported by Sillanaukee (1996). This is readily understandable, because the inclusion threshold for the latter study was consumption of 40 g/day for men and 25 g/day for women, which is rather low to produce a positive effect on CDT (Allen et al, 1992;Mihas and Tavassoli, 1992;Schellenberg et al, 1989Schellenberg et al, , 1996Stibler, 1991). These results must be compared with those of Yersin et al (1995) (sensitivity of 58%, specificity of 82%), in which the recruitment included abusers and dependents.…”

“…The first relates to the inclusion characteristics (Gjerde et al, 1988;La Grange et al, 1994;Schellenberg et al, 1989;Stibler et al, 1988): depending on the study, the alcohol consumption threshold for subjects classified as drinkers ranges from 25 to 100 g/day. Logically, studies based on higher thresholds , assuming comparable specificity, will produce higher levels of sensitivity than studies for which a lower threshold was chosen (Fagerberg et al, 1994;Nystrom et al, 1992).…”

Reliability of Carbohydrate-Deficient Transferrin to Detect Chronic Alcohol Misuse in Carcinoma Patients

“…Serum levels of the conventional investigated laboratory markers have been used as biological markers of excessive alcohol consump tion. Compared with CDT, the sensitivities reported for the MCV and yGT are comparable to the low sensitivities and specifities observed in our patients [12][13][14][15][16][17], The data for the ASAT and ALAT in our study revealed a higher specificity, but a lower sensitivity [12,13,15,16]. This may be due to the fact that the investigated surgical patients were moderate alcohol misusers and had no seri ous alcohol-related liver disease.…”

“…Therefore, laboratory tests with sufficient sensitivity and specificity are required. Conventional lab oratory markers such as the mean corpuscular volume (MCV), the y-glutamyltransferasc (yGT), the aspartate aminotransferase (ASAT) and the alanine aminotransfer ase (ALAT) are not sensitive and specific enough to detect chronic alcohol misuse [10][11][12][13][14][15][16][17], New biological markers such as carbohydrate-deficient transferrin (CDT) for de tecting alcohol misuse could assist in making a preopera tive diagnosis [18]. After more than a week a chronic daily intake of more than 60 g alcohol leads to increased levels of transferrin isoforms which are deficient in their carbo hydrate moieties [10].…”

Changes of Carbohydrate-Deficient Transferrin in Chronic Alcoholism

“…Until now, changes in the hepatic enzyme system [GOT (ASAT), GPT (ALAT), GGT and LDH] were the only biochemical parameters serving to quantify chronic alcoholism and as a supplementary method, the increase in mean cellular volume of red blood cells is recognised. All these parameters have the disadvantage of low speci ficity [9,10] in that they do not differentiate between short-term and chronic consumption of ethanol alcohol and may in addition be affected by (infectious) liver dis eases. Moreover, enzyme levels decrease in parallel with the progression of hepatic cirrhosis [11] and increase in case of neurological diseases like epilepsy, neuropathy, dementia, cerebral atrophy and cerebellopathy [12], thus possibly causing a continuation of the patient's chronic alcoholism.…”