Quantification of Phosphatidylethanols in Whole Blood as a Proxy for Chronic Alcohol Consumption, Using Ultra Performance Convergence Chromatography Tandem Mass Spectrometry

Long-term impacts of prenatal alcohol exposure (PAE) may include cognitive, physical, and/or behavioral disabilities, collectively called fetal alcohol spectrum disorders (FASD) (Memo et al., 2013). Accurate measurement of PAE in any population is central to the estimation of current and predicted FASD prevalence, helping ensure that commensurate programs and facilities are in place to promote preconception health, educate individuals on the risks of PAE, and refer to substance abuse counseling if necessary (Popova et al., 2017). Rates of PAE can be ascertained by self-report, which is often under-reported for a variety of reasons (e.g., fear of punitive measure, embarrassment, and/or recall bias) or by biomarker quantification (Lange et al., 2014).

Section: Methods Validationsupporting

confidence: 83%

Quantitation of phosphatidylethanols in dried blood spots to determine rates of prenatal alcohol exposure in Ontario

DiBattista

Ogrel

MacKenzie

et al. 2022

“…The procedure has proven to be reliable and robust. The UPC2-MS/MS method has been reported as a reliable, flexible, and suitable method for PEth measurements (van der Nagel et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Diagnostic Value of Phosphatidylethanol and Carbohydrate‐Deficient Transferrin as Biomarkers of Alcohol Consumption

Årving

Høiseth

Hilberg³

et al. 2020

Background The aim of this study was to compare the results of Phosphatidylethanol (PEth) and carbohydrate‐deficient transferrin (CDT) in blood as biomarkers of alcohol consumption in a large clinical cohort and to evaluate concentrations in relation to age and sex. Methods Results of PEth 16:0/18:1 in blood and CDT in serum were included, together with information of age and sex, which were extracted from a clinical chemistry database containing samples mostly from patients of primary care physicians and social care institutions. PEth concentrations were determined using Ultra Performance Convergence chromatography mass spectrometer. CDT was quantified by electrophoretic Capillary System. CDT values ≥ 1.7 %‐units and PEth values ≥ 0.31 µmol/L were considered to indicate heavy alcohol consumption. Results Samples from 6705 patients were included. The median age was 54.5 years, and 34 % were females. Only 47 % of the patients with PEth ≥ 0.31 µmol/L had increased CDT ≥ 1.7 %‐units examined in the same specimen (Cohen’s kappa was 0.43, p < 0.001). Patients above 50 years had significantly higher concentrations for both CDT (1.0 %‐units vs. 0.9 %‐units, p < 0.001) and PEth (0.340 µmol/L vs. 0.200 µmol/L, p < 0.001) compared with younger patients. Concentrations of CDT were significantly higher in males compared with females (p = 0.002), while no significant sex differences were seen for PEth (p = 0.465). Conclusions A high fraction of the patients had PEth values above the suggested cutoff for heavy drinking and normal CDT values, verifying the superior sensitivity of PEth compared with CDT. The effect of age seems to be minor for both markers. Higher concentrations of CDT, but not PEth, were seen in males, indicating that PEth, as opposed to CDT, might be formed equally in men and women. Therefore, the bias due to sex is possibly present only for CDT, not for PEth.

“…To minimalize the possibility of impurity, different batch numbers were used. The analysis is validated according to FDA/EMA validation guidelines (van der Nagel et al, 2018 ) and the assay is performed in the ISO15189 accredited Erasmus MC pharmacy laboratory. Based on PEth, three categories of drinking are identified; (1) light drinking/abstinence, (2) moderate alcohol consumption, and (3) excessive drinking.…”

Section: Methodsmentioning

confidence: 99%

Screening for hazardous alcohol use in the Emergency Department: Comparison of phosphatidylethanol with the Alcohol Use Disorders Identification Test and the Timeline Follow‐back

Verheij

Haagsma

Koch

et al. 2022

Self Cite

Background Up to 15% of all visits to the Emergency Department (ED) are alcohol related. Identification of problematic alcohol use is important in this setting because it allows for intervention and prevention efforts. This study investigated the correlation between the objective phosphatidylethanol (PEth) marker and the subjective Alcohol Use Disorders Identification Test (AUDIT) and Timeline Followback Questionnaire (TLFB) as screening methods for hazardous alcohol use in the general ED population. Methods This prospective cohort study included 301 ED patients (57% male) who were seen in the ED and required to give a blood sample. The correlation between the values of PEth (PEth 16:0/18:1 and PEth 16:0/18:2) and the scores on the AUDIT and TLFB were analyzed using Spearman's rank correlation coefficient. Differences between risk categories of PEth and AUDIT were also examined. Results The Spearman correlation coefficients between PEth 16:0/18:1|PEth 16:0/18:2 values and the AUDIT scores were moderate (PEth 16:0/18:1: 0.67, p < 0.001; PEth 16:0/18:2: 0.67, p < 0.001). Of the patients who scored ‘low risk drinking/abstinence’ according to the AUDIT questionnaire, respectively 1% and 4% had PEth 16:0/18:1|PEth 16:0/18:2 values indicating excessive alcohol use, and another 10% and 12% had PEth 16:0/18:1|PEth 16:0/18:2 values indicating moderate alcohol consumption. Of the 12 (PEth 16:0/18:1) and 25 (PEth 16:0/18:2) patients with high‐risk values, respectively 25% and 40% scored in the lowest risk category on the AUDIT questionnaire. Spearman correlation coefficients between PEth 16:0/18:1|PEth 16:0/18:2 values and TLFB two‐week scores were high (PEth 16:0/18:1: 0.74, p < 0.001; PEth 16:0/18:2: 0.82, p < 0.001). Conclusions AUDIT scores were moderately correlated with PEth values in the general ED population. In almost all cases where there was not a good correlation, patients had high PEth values with low AUDIT scores. We conclude that PEth identifies patients with problematic alcohol use who are missed by the AUDIT questionnaire and therefore PEth could be used as an additional screening method for hazardous alcohol use in this population.