Summary: Timely identification of excessive alcohol use and its potential complications is a prerequisite for successful treatment. Several routine tests have been used in laboratories that may help in diagnosing alcoholism, such as determination of MCV, AST, ALT, GGT, but it has been shown that they lack specificity and sensitivity. Contemporary biomarkers are increasingly being used today that may due to their unique characteristics help in disco vering the onset of chronic alcohol abuse, as well as in abstinence and relapse monitoring. The term carbohydrate-deficient transferrin (CDT) stands for a small group of human transferrin isoforms (asialo, monosialo, and disialotran sferrin) with a lower degree of glycosylation in comparison to the dominant transferrin isoform (tetrasialotransferrin). Persons consuming large quantities of alcohol (≥50 -80 g daily) over a period of at least two weeks have increased concentrations of transferrin isoforms lacking one (disialo transferrin) or both (asialotransferrin) carbohydrate chains. In this paper the traditional markers of chronic alcohol abuse (GGT, AST, ALT, and MCV) were determined, as well as the new biomarker CDT, after which diagnostic evaluation was performed and their usability and clinical value in routine laboratory practice were estimated. These markers were also determined in heavy alcoholics on admission into hospital and after two weeks of therapy, with the aim of estimating their diagnostic value for abstinence and relapse monitoring.
Keywords: alcoholism, biomarkers, CDT, transferrinKratak sadr`aj: Pravovremeno prepoznavanje preko merne upotrebe alkohola i potencijalnih komplika cija pred uslov je za uspe{no le~enje. U laboratorijama se koristi neko liko rutinskih testova koji mogu da pomognu u dijagnostici alkoholizma, kao npr. odre|ivanje MCV, AST, ALT, GGT, ali su se pokazali kao nedovoljno specifi~ni i osetljivi. Danas su sve vi{e u upotrebi savremeni biomarkeri koji zahvaljuju}i svojim jedin stvenim osobinama mogu da pomognu kod otkrivanja po ja ve hroni~nog alkoholizma, kao i pri pra}enju apstinencije i relapsa. Naziv transferin deficijentan ugljenim hidratima (CDT) podrazumeva manju grupu izoformi humanog trans ferina (asialo-, monosialo-i disialo-transferin), koje imaju ni`i stepen glikozilacije u pore|enju sa do minantnom izo for mom transferina (tetrasialotran sfe rin). Osobe koje unose velike koli~ine alkohola (≥50-80 g dnevno) u periodu od najmanje 2 nedelje imaju povi{ene koncentracije izoformi transferina kojima nedostaje jedan (disialotransferin) ili oba (asialotransferin) ugljeno hidratna lanca. U ovom radu oba vlje no je odre|ivanje tradicionalnih marke ra hroni~ne alko ho lne potro{nje (GGT, AST, ALT i MCV), kao i novog bio markera CDT, a zatim je izvr{ena dijagno sti~ka evaluacija i procena njihove upotrebljivosti i klini~ke vrednosti u rutin skoj laboratorijskoj praksi. Tako|e je izvr{eno odre|ivanje navedenih markera kod te{kih alkoholi~ara pri prijemu na bolni~ko odeljenje i nakon 2 nedelje terapije u cilju proce ne njihove dijag...