Phosphatidylethanol (PEth) detected in blood for 3 to 12 days after single consumption of alcohol—a drinking study with 16 volunteers

Abstract

In most studies, the alcohol marker phosphatidylethanol (PEth) was used to differentiate social drinking from alcohol abuse. This study investigates PEth's potential in abstinence monitoring by performing a drinking study to assess the detection window of PEth after ingesting a defined amount of alcohol. After 2 weeks of abstinence, 16 volunteers ingested a single dose of alcohol, leading to an estimated blood alcohol concentration (BAC) of 1 g/kg. In the week after drinking, blood and urine samples were taken daily; in the second week, samples were taken every other day. PEth 16:0/18:1 and 16:0/18:2 were analyzed in blood by online-SPE-LC-MS/MS. Ethyl glucuronide and ethyl sulfate were determined in urine for abstinence monitoring. Prior to start of drinking, PEth 16:0/18:1 exceeded 30 ng/mL in blood samples of five volunteers despite the requested abstinence period. Positive PEth values resulted from drinking events prior to this abstinence period. After the start of drinking, maximum BACs were reached after 2 h with a mean of 0.80 ± 0.13 g/kg (range: 0.61-1.11 g/kg). PEth 16:0/18:1 increased within 8 h to maximum concentrations (mean: 88.8 ± 47.0 ng/mL, range: 37.2-208 ng/mL). After this event, PEth was detectable for 3 to 12 days with a mean half-life time of approximately 3 days. PEth has a potential in abstinence monitoring, since PEth could be detected for up to 12 days after a single drinking event. Further investigations are necessary, to establish cut-off levels for PEth as diagnostic marker for the determination of drinking habits like abstinence, social drinking, or risky alcohol consumption.

The PEth Blood Test in the Security Environment: What it is; Why it is Important; and Interpretative Guidelines

“…Studies have found no gender differences in the formation of PEth . As women generally have a higher percentage of body fat (in which alcohol is insoluble) and a correspondingly lower percentage of body water, the number of drinks needed to attain a BAC high enough to register a positive PEth will usually be lower than for men of the same weight.…”

“… The length of time prior to PEth testing that the subject had been alcohol abstinent. Some studies have used only a 2‐week period of abstinence as their baseline, although PEth can be detected for up to 28‐days . It is especially common for studies performed within clinical settings not to have a prior period of abstinence . Whether the amount of alcohol consumed was identified by quantity alone (e.g., three to five drinks per day) or dosed according to body weight (e.g., 1 g of alcohol/kg of body weight), or to attain a particular calculated BAC. Whether the data were based on patient self‐report or carefully administered and monitored alcohol dosages. The comparison of nominally similar groupings that are in fact quite different (e.g., “moderate” drinking may be 1–2 drinks/day or 1–5 drinks/per day).…”

Recent alcohol use prolongs hospital length of stay following lung transplant

“…EtG can detect recent alcohol use in the urine for approximately 2‐4 days after imbibing alcohol . PEth is detectable in the blood 3‐12 days after a single ingestion of an alcoholic drink, with a reported detection window of 2‐3 weeks with larger quantities of alcohol …”

“…Traditional alcohol biomarkers, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ‐glutamyltranspeptidase (GGT), and mean corpuscular volume (MCV), lack the sensitivity and specificity to identify and quantify alcohol use unless that use is extreme. Direct alcohol biomarkers, including that of phosphatidylethanol (PEth) and ethylglucuronide (EtG), are much more accurate in identifying alcohol use and are utilized by alcohol abstinence programs to monitor compliance …”

Commentary on the Paper of Walther L. et al.: Phosphatidylethanol Is Superior to CDT and GGT as an Alcohol Marker and Is a Reliable Estimate of Alcohol Consumption Level

“…a single dose of ethanol, 35 -66 g, yielding a blood alcohol concentration (BAC) of 1 ‰ there is only minor accumulation of PEth, resulting in detection of low PEth values with a detection window of only 3 up to 12 days (Schröck 2014; manuscript in preparation).…”