37 38Background: Alcohol-related disorders are common, expensive in their course and 39 often underdiagnosed. To facilitate early diagnosis and therapy of alcohol-related 40 disorders and to prevent later complications, questionnaires and biomarkers are 41
useful. 42Methods: Indirect state markers like gamma-glutamyl-transpeptidase (GGT), mean 43 corpuscular volume (MCV) and carbohydrate deficient transferrin (CDT) are 44 influenced by age, gender, various substances and non-alcohol-related illnesses, and 45 do not cover the entire timeline for alcohol consumption. Ethanol metabolites, such 46 as ethyl glucuronide (EtG), ethyl sulphate (EtS), phosphatidylethanol (PEth) and fatty 47 acid ethyl esters (FAEEs) have gained enormous interest in the last decades as they 48 are detectable after ethanol intake. influenced by a number of factors like age, gender, and non-alcohol-related 83 illnesses, and do not cover the entire time frame (acute, short-term, long-term) of 84 alcohol use (Conigrave et al., 2002; Laposata, 1999; Helander, 2003; Hannuksela et 85 al., 2007; Niemelä, 2007). Generally, ethanol metabolites are detectable in serum or whole blood for hours 102 (EtG, EtS), in urine for up to seven days (EtG, EtS), in whole blood over two weeks 103 (PEth) and in hair over months (EtG, FAEEs) (review by Thon et al 2014). 104 105