Phosphatidylethanol in Blood as a Marker of Chronic Alcohol Use: A Systematic Review and Meta-Analysis

Abstract

The present paper aims at a systematic review of the current knowledge on phosphatidylethanol (PEth) in blood as a direct marker of chronic alcohol use and abuse. In March 2012, the search through “MeSH” and “free-text” protocols in the databases Medline/PubMed, SCOPUS, Web of Science, and Ovid/Embase, combining the terms phosphatidylethanol and alcohol, provided 444 records, 58 of which fulfilled the inclusion criteria and were used to summarize the current evidence on the formation, distribution and degradation of PEth in human blood: (1), the presence and distribution of different PEth molecular species (2), the most diffused analytical methods devoted to PEth identification and quantization (3), the clinical efficiency of total PEth quantification as a marker of chronic excessive drinking (4), and the potential utility of this marker for identifying binge drinking behaviors (5). Twelve papers were included in the meta-analysis and the mean (M) and 95% confidence interval (CI) of total PEth concentrations in social drinkers (DAI ≤ 60 g/die; M = 0.288 μM; CI 0.208–0.367 μM) and heavy drinkers (DAI > 60 g/die; M = 3.897 μM; CI 2.404–5.391 μM) were calculated. The present analysis demonstrates a good clinical efficiency of PEth for detecting chronic heavy drinking.

Quantification of phosphatidylethanol 16:0/18:1, 18:1/18:1, and 16:0/16:0 in venous blood and venous and capillary dried blood spots from patients in alcohol withdrawal and control volunteers

“…One study showed good agreement, with a mean difference of 95.8 ng/mL (RSD=3.0%) and -4. In literature, HPLC-ELSD methods analysing total PEths in blood generally used cut-off values between 0.2 and 1 µmol/L [7,10,11,17,19] to detect alcohol consumption. In Sweden, 0.7 µmol/L of total PEths is used as the clinical threshold [7].…”

“…The half-life of PEths in whole blood was calculated to be 4.0 ± 0.7 days [3]. In case of chronic/excessive alcohol consumption, PEths are detectable in blood up to 28 days after sobriety [10]. Moreover, quantification of PEths can be used to detect the degree of alcohol consumption as a significant correlation between the PEths concentrations in blood and the amount of consumed ethanol has been demonstrated [11].…”

“…Numerous studies have been published on the quantification of PEths in blood and these have been reviewed in 2012 [10]. The most used extraction technique is a liquid-liquid extraction (LLE) with hexane [5][6][7][11][12][13][14][15][16][17] (or heptane [8]) after stepwise addition of blood to isopropanol and the internal standard (IS) solution.…”

Application of phosphatidylethanol (PEth) in whole blood in comparison to ethyl glucuronide in hair (hEtG) in driving aptitude assessment (DAA)

“…Due to an elimination half-life of about four days [17], accumulation of PEth is observed after repeated drinking. Therefore, PEth has been discussed as marker for detection of prolonged excessive alcohol consumption in several studies [16,[19][20][21][22][23].…”

Direct biomarkers to determine alcohol consumption during pregnancy, which one to use?

“…However the 100 to 1000 fold higher affinity of PLD for alcohol promotes the transphosphatidylation of alcohol and PC, therefore PEth is always formed when alcohol is present [12,13]. Due to the half-life of 4 to 5 days, PEth however can be detected up to at least two weeks on average in blood [14]. This relatively long half-life compared to for instance EtG makes PEth a promising retrospective marker for alcohol consumption detectable in blood.…”