Sensitive determination of ethyl glucuronide in serum and whole blood: detection time after alcohol exposure compared with urine

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_labmed-2019-0203_s_999_w2aab3b7b1b1b6b1aab1c14b1Aa"><jats:title>Objectives</jats:title><jats:p>Ethyl glucuronide (EtG) is a conjugated, minor ethanol metabolite used as a biomarker for recent alcohol intake. EtG is commonly measured in urine as part of a drug testing service but has also attracted attention for measurement in blood. However, due to lower EtG concentrations in blood, the detection time is expected to be shorter. The present work aimed to improve the analytical sensitivity of EtG in blood, to prolong the detection time.</jats:p></jats:sec><jats:sec id="j_labmed-2019-0203_s_998_w2aab3b7b1b1b6b1aab1c14b2Aa"><jats:title>Methods</jats:title><jats:p>A liquid chromatography-tandem mass spectrometry method was developed for EtG in whole blood and serum, using protein precipitation with methanol, a deuterated internal standard, and selected reaction monitoring mode with negative electrospray ionization. No significant matrix effect was observed. The method generated linear results in the measuring range 1.0–50 μg/L, the accuracy was within ±10% and the imprecision &lt;15%.</jats:p></jats:sec><jats:sec id="j_labmed-2019-0203_s_997_w2aab3b7b1b1b6b1aab1c14b3Aa"><jats:title>Results</jats:title><jats:p>In 46 patients followed with daily blood and urine sampling during alcohol detoxification, the mean (median) time to first negative serum EtG sample was 112 (111) h. This was slightly longer than for EtG in urine, using 100 μg/L as cutoff. The detection rate was 76% for serum EtG and 68% for urine EtG. In cases where serum EtG was positive but urine EtG negative, the urine samples tended to be more dilute as indicated by lower creatinine concentrations. On admission to hospital, the whole-blood and serum EtG concentrations correlated with the breath ethanol concentration (p = 0.012 and p = 0.027, respectively). In 100 patients sampled at admission to hospital for other reasons than substance abuse and with no ethanol detected in breath, 40% tested positive for EtG in serum and 43% in urine. In 79 paired urine and serum EtG measurements, the median urine/serum concentration ratio was 155.</jats:p></jats:sec><jats:sec id="j_labmed-2019-0203_s_996_w2aab3b7b1b1b6b1aab1c14b4Aa"><jats:title>Conclusions</jats:title><jats:p>A sensitive method was developed for EtG measurement in whole-blood and serum specimens, offering similar detection time for recent alcohol exposure compared with routine EtG measurement in urine.</jats:p></jats:sec>

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

“…EtG analysis was made by an in-house DIN EN ISO 17025 accredited UPLC-MS/MS method, which will be reported in detail separately ( Neumann et al ., 2020 ). In brief, a 20-μl aliquot of serum was mixed with 200-μl methanol containing 20-pg EtG-d5 (Cerrilliant, Merck KGaA, Darmstadt, Germany).…”

Death-causing cardiac injuries after chronic alcohol intake identified by forensic medicine

“…The detection of the level of EtG in the blood, in parallel with the investigation data and the diagnosis following the necropsy, can lead to the diagnosis of chronic intoxication with Ethanol and the elucidation of inconclusive situations [ 46 ].…”

Development and validation of an analytical method for the simultaneous determination of the alcohol biomarkers ethyl glucuronide, ethyl sulfate, N‐acetyltaurine, and 16:0/18:1‐phosphatidylethanol in human blood

“…2,12 Several methods are described for the single or combined detection of alcohol biomarkers in blood. 10,11,[14][15][16][17][18][19] Until now, the development of an analytical method for the simultaneous detection of all four alcohol biomarkers (EtG, EtS, NAcT, and PEth) in blood was not pursued.…”