Urinary Ethyl Glucuronide Can Be Used as a Biomarker of Habitual Alcohol Consumption in the General Population

Abstract

BackgroundAlcohol consumption is a frequently studied risk factor for chronic diseases, but many studies are hampered by self-report of alcohol consumption. The urinary metabolite ethyl glucuronide (EtG), reflecting alcohol consumption during the past 72 h, is a promising objective marker, but population data are lacking.ObjectiveThe objective of this study was to assess the reliability of EtG as a marker for habitual alcohol consumption compared with self-report and other biomarkers in the general population.MethodsAmong 6211 participants in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) cohort, EtG concentrations were measured in 24-h urine samples. EtG was considered positive when concentrations were ≥100 ng/mL. Habitual alcohol consumption was self-reported by questionnaire (categories: no/almost never, 1–4 units per month, 2–7 units per week, 1–3 units per day or ≥4 units per day). Plasma HDL cholesterol concentration, erythrocyte mean corpuscular volume (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltransferase (GGT) were determined as indirect biomarkers of alcohol consumption. Sensitivity, specificity, positive and negative predictive value, and proportions of agreement between reported consumption and EtG were calculated. To test the agreement of EtG concentration and alcohol consumption in categories, linear regression analysis was performed. In addition, the association between EtG concentrations and indirect biomarkers was analyzed.ResultsMean age was 53.7 y, and 52.9% of participants men. Of the self-reported abstainers, 92.3% had an EtG concentration <100 ng/mL. Sensitivity was 66.3%, positive predictive value was 96.3%, and negative predictive value was 47.4%. The proportion of positive agreement was 78.5%, and the proportion of negative agreement was 62.7%. EtG concentrations were linearly associated with higher categories of alcohol consumption (P-trend < 0.001), adjusted for age, sex, and renal function. EtG was positively related to MCV, HDL cholesterol, and GGT but not to AST and ALT concentrations.ConclusionsThis study shows that urinary EtG is in reasonable agreement with self-reported alcohol consumption and therefore can be used as an objective marker of habitual alcohol consumption in the general population.

A Pilot Study Comparing the Effects of Consuming 100% Orange Juice or Sucrose-Sweetened Beverage on Risk Factors for Cardiometabolic Disease in Women

“…As shown in Figure 7 ethyl-β-D-glucuronide, a metabolite of alcohol consumption [38] was elevated only in participants consuming OJ (+11.9 ± 3.3, p < 0.0001) but was undetected in those consuming sucrose-SB; (p = 0.001 between groups). This metabolite was undetected among38st all participants at baseline.…”

“…One interesting outcome of this study was the increase in ethyl-β-D-glucuronide, a well-known biomarker for monitoring ethanol intake [38,64], in the plasma of subjects consuming OJ. This metabolite was not observed at baseline and was not observed after intervention in participants consuming sucrose-SB.…”

“…Spectra were processed and a total of 46 metabolites were identified and quantified using Chenomx NMRSuite v8.1 (Chenomx Inc., Edmonton, AB, Canada). Out of these 46 metabolites, we focused on 2-hydroxybutyrate, a biomarker of insulin resistance [36,37] and ethyl-β-D-glucuronide, a metabolite of ethanol [38].…”

Benefits and Risks of Moderate Alcohol Consumption on Cardiovascular Disease: Current Findings and Controversies

“…As per evident ethical and logistical reasons, the main body of evidence relies on epidemiological studies of associative nature which carry several limitations such as the quantification of alcohol consumption. In the future, these studies should include reliable measurements of biological biomarkers of alcohol exposure such as urinary ethyl glucuronide [144] which may better reflect short-term and habitual alcohol consumption than self-reported intake and should also include repeated measures over time.…”

Alcohol-Related Liver Disease: Basic Mechanisms and Clinical Perspectives

“…CDT has been the most commonly used biomarker to confirm chronic alcohol consumption for years, although the sensitivity and specificity vary considerably between different studies, and numerous confounders could influence the results, including age, sex, and the stage of liver disease [ 155 , 156 ]. EtG can be detected in the urine or hair, has a much longer detection window, and a higher specificity than CDT, although biological variability (e.g., medications and foods) still exists and may complicate the interpretation of the results [ 157 , 158 ]. Several studies have compared the detection ability of these biomarkers and revealed conflicting results [ 154 , 157 , 159 , 160 ].…”