Detection of Phosphatidylethanol (PEth) in the Blood of Drivers in an Alcohol Ignition Interlock Program

Marques, Paul R.; Hansson, Therése; Isaksson, Anders; Walther, Lisa; Jones, Joseph; Lewis, Douglas; Jones, Megan

doi:10.1080/15389588.2010.544048

Cited by 33 publications

(33 citation statements)

References 17 publications

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“…PEth homologues are a group of phospholipids formed primarily in the red blood cell membrane from phosphatidylcholine in the presence of alcohol by the enzyme phospholipase D. They have a half-life of approximately 4 to 10 days with detection windows up to 3 weeks in active drinkers with alcohol use disorders (AUD) (Winkler et al, 2013). PEth has been validated to identify harmful consumption patterns in a variety of settings including forensic pathology, treatment programs, motor vehicle assessment programs, and prenatal screening (Bakhireva et al, 2014, Helander et al, 2012, Marques et al, 2011, Schrock et al, 2016). Recently, clinical laboratories in Sweden have instituted a cut-point level at 210 ng/mL for excessive alcohol consumption (Helander and Hansson, 2013).…”

Section: Introductionmentioning

confidence: 99%

Cut-Point Levels of Phosphatidylethanol to Identify Alcohol Misuse in a Mixed Cohort Including Critically Ill Patients

Afshar

Burnham

Joyce

et al. 2017

Alcohol Clin Exp Res

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Background Although alcohol misuse is associated with deleterious outcomes in critically ill patients, its detection by either self-report or examination of biomarkers is difficult to obtain consistently. Phosphatidylethanol (PEth) is a direct alcohol biomarker that can characterize alcohol consumption patterns; however, its diagnostic accuracy in identifying misuse in critically ill patients is unknown. Methods PEth values were obtained in a mixed cohort comprised of 122 individuals from medical and burn intensive care units (n=33), alcohol detoxification unit (n=51), and healthy volunteers (n=38). Any alcohol misuse and severe misuse were referenced by AUDIT and AUDIT-C scores separately. Mixed effects logistic regression analysis was performed and the discrimination of PEth was evaluated using the area under the receiver operating characteristic (ROC) curve. Results The area under the ROC curve for PEth was 0.927 (95% CI: 0.877, 0.977) for any misuse and 0.906 (95% CI: 0.850, 0.962) for severe misuse defined by AUDIT. By AUDIT-C, the area under the ROC curves were 0.948 (95% CI: 0.910, 0.956) for any misuse and 0.913 (95% CI: 0.856, 0.971) for severe misuse. The PEth cut-points of ≥ 250 ng/mL and ≥ 400 ng/mL provided optimal discrimination for any misuse and severe misuse, respectively. The positive predictive value for ≥ 250 ng/mL was 88.7% (95% CI: 77.5%, 95.0%) and negative predictive value was 86.7% (95% CI: 74.9%, 93.7%). PEth ≥ 400 ng/mL achieved similar values and similar results were shown for AUDIT-C. In a subgroup analysis of critically ill patients only, test characteristics were similar to the mixed cohort. Conclusions PEth is a strong predictor and has good discrimination for any and severe alcohol misuse in a mixed cohort that includes critically ill patients. Cut-points at 250 ng/mL for any, and 400 ng/mL for severe, are favorable. External validation will be required to establish these cut-points in critically ill patients.

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Section: Introductionmentioning

confidence: 99%

Cut-Point Levels of Phosphatidylethanol to Identify Alcohol Misuse in a Mixed Cohort Including Critically Ill Patients

Afshar

Burnham

Joyce

et al. 2017

Alcohol Clin Exp Res

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“…Several reports highlight the value of PEth for identification of harmful drinking (Aradottir et al, 2006, Hahn et al, 2010, Hansson et al, 1997, Miller et al, 2005, Stewart et al, 2010, Hahn et al, 2012), monitoring consumption during treatment (Kip et al, 2008), and various forensic applications (Marques et al, 2011, Marques et al, 2010). Yet a more complete characterization of the synthesis and elimination of PEth would provide more accurate estimations of the amount and time frame of ethanol consumption.…”

Section: Introductionmentioning

confidence: 99%

Characterization of the Pharmacokinetics of Phosphatidylethanol 16:0/18:1 and 16:0/18:2 in Human Whole Blood After Alcohol Consumption in a Clinical Laboratory Study

Javors

Hill‐Kapturczak

Roache

et al. 2016

Alcoholism Clin & Exp Res

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Background The purpose of this study was to characterize the pharmacokinetics of two homologues of phosphatidylethanol (PEth) and their combined total in uncoagulated, whole blood samples taken from participants in a human clinical lab study after consumption of low doses of ethanol. Methods As part of a larger study, 14 male and 13 female participants received either 0.25 or 0.50 g/kg oral doses of ethanol during a 15 min period. Blood samples were collected before and throughout 6 h after each ethanol dose on the day of consumption, and then every 3 days during the next 14 days. PEth 16:0/18:1 and PEth 16:0/18:2 levels were quantified in blood samples by HPLC/MS/MS and reported separately or as their combined total (combined PEth). Breath alcohol concentrations (BrAC) were measured concurrently with each blood collection. Transdermal alcohol concentrations (TAC) were measured every 30 min during the entire 22 day study to confirm the absence of drinking during a 7 day period before and the 14 day period after ethanol consumption. Results (1) Single doses of 0.25 and 0.50 g ethanol/kg produced proportional increases in BrAC and combined PEth levels of all participants; (2) the areas under the curve (AUC) for each participant’s BrAC levels during the 6 h period after ethanol administration were correlated with AUCs of cPEth (calculated as the AUC of the increase above baseline for combined PEth); (3) the mean half-life of combined PEth, determined during the 14 day period after ethanol consumption, was 4.6 ± 3.5 (SD) days (range: 1.0 to 13.1 days). Conclusions Combined PEth is a sensitive biomarker for the identification of relatively low levels of ethanol consumption. The measurement of these two homologues may provide additional sensitivity to identify low levels of drinking.

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“…Numerous studies indicate the PEth is a valid marker of recent alcohol consumption (33; see 34 for a review and meta-analysis), with evidence that the most common molecular species of PEth (1-palmitoyl-2-oleoyl- sn -glycero-3-phosphatidylethanol; PEth 16:0/18:1; 35) has higher sensitivity to detect recent alcohol consumption compared to other alcohol biomarkers (36, 37). Studies indicate PEth can be used as an alcohol biomarker for several purposes, including neonatal screening for prenatal alcohol exposure (38, 39), to assess alcohol intake in emergency rooms (40), to measure alcohol consumption in patients with liver disease and hypertension (41–43), to estimate driver risk among those previously convicted of driving while intoxicated (35), and to assess alcohol consumption among individuals who are HIV-infected (44, 45).…”

Section: Introductionmentioning

confidence: 99%

Phosphatidylethanol (PEth) as a Biomarker of Alcohol Consumption in HIV-Infected Young Russian Women: Comparison to Self-Report Assessments of Alcohol Use

et al. 2017

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Background Alcohol use is particularly deleterious for HIV-infected individuals and thus accurate assessment of alcohol consumption is crucial in this population. Phosphatidylethanol (PEth) provides an objective assessment of drinking and can be compared to self-reported alcohol assessments to detect underreporting. The purpose of this study was to identify underreporting and its potential predictors in an HIV-infected sample of young Russian women. Methods The current study examined the concordance between a quantitative measure of PEth and self-reported recent alcohol consumption in a prospective sample of HIV-infected young women (N = 204) receiving medical care in Saint Petersburg, Russia. Results At baseline, 53% of participants who denied drinking in the prior 30 days tested positive for PEth (i.e., underreporters), although this rate decreased significantly at a three-month follow-up assessment. Further exploration did not identify consistent predictors of underreporting status. Quantitative PEth levels showed, at best, modest overlap to self-reported alcohol consumption among those reporting alcohol use (e.g., Spearman’s r = .27 between PEth and total drinks past-30 days at baseline). Conclusions Objective measures of alcohol consumption demonstrate modest overlap with self-report measures of use in HIV-infected young Russian women. Incorporating objective and quantifiable biological markers are essential for valid assessments of alcohol use.

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Detection of Phosphatidylethanol (PEth) in the Blood of Drivers in an Alcohol Ignition Interlock Program

Cited by 33 publications

References 17 publications

Cut-Point Levels of Phosphatidylethanol to Identify Alcohol Misuse in a Mixed Cohort Including Critically Ill Patients

Cut-Point Levels of Phosphatidylethanol to Identify Alcohol Misuse in a Mixed Cohort Including Critically Ill Patients

Characterization of the Pharmacokinetics of Phosphatidylethanol 16:0/18:1 and 16:0/18:2 in Human Whole Blood After Alcohol Consumption in a Clinical Laboratory Study

Phosphatidylethanol (PEth) as a Biomarker of Alcohol Consumption in HIV-Infected Young Russian Women: Comparison to Self-Report Assessments of Alcohol Use

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