%CDT, measured with the HPLC candidate reference method, is independently associated with gestational week. Differently from what has been previously reported or expected, the relationship between pregnancy and CDT could be more complex. The diagnostic accuracy of CDT for detecting alcohol abuse in a legal context may be limited in pregnant women and the effect of gestational age should be considered.

A relevant proportion of drivers with high BAC are chronic abusers. GGT-CDT, previously validated with CDT immunoassays, should not be applied to traffic medicine in its current form and its performances re-evaluated with CDT measured by HPLC.

Large variability exists between CDT and EtG in detecting chronic alcohol consumption. We suggest to use CDT, or a combination of different biomarkers, to identify alcohol abuse in a forensic context. EtG results close to the cutoff (30-50 pg/mg) should be cautiously considered before any sanction is assigned.

Alcohol-related problems are typically associated with medical, economic and social issues. The reduction of the problem can only occur if effective strategies to prevent, diagnose and treat alcohol abuse are developed. Real help could come from laboratory tests that represent objective evidence of alcohol problems. Authors present new biomarkers as Carbohydrate-deficient transferrin (CDT), Ethyl Glucuronide and Ethyl Sulfate (EtG and EtS)), Fatty Acids Ethyl Esters (FAEE) anf Phosphatidy ethanol (PEth) in differents biological samples.

Age-specific Disialo-Tf cut-offs are not necessary. In children 1.3% and 6.4% may be suggested as upper limits of normal range to detect increases of Disialo- and Trisialo-Tf. The presence of Asialo- and Monosialo-Tf should be considered an abnormal finding and prompt further investigations.