Development of a Column-Switching HPLC-MS/MS Method and Clinical Application for Determination of Ethyl Glucuronide in Hair in Conjunction with AUDIT for Detecting High-Risk Alcohol Consumption

Abstract

It is critical to assess the severity of alcohol consumption in certain diseases such as alcohol liver disease and alcohol addiction. Ethyl glucuronide (EtG) is a highly stable metabolite of ethanol in hair; thus, it was proposed as a long-term monitoring marker for alcohol consumption. Therefore, an HPLC-MS/MS method for EtG in hair was developed and applied to a clinical setting to assess the relevance of the EtG concentration and/or the Alcohol Use Disorders Identification Test (AUDIT) score to high-risk alcohol consumption. EtG was extracted from 10 mg of hair using water and analyzed using on-line sample purification coupled to HPLC-MS/MS. The diagnostic performances of the EtG concentration and/or the AUDIT score for detecting high-risk alcohol consumption were statistically evaluated between alcohol addicts (n = 44) and average alcohol users (n = 19). The on-line sample purification resulted in labor-saving with smaller sample amount. Both the EtG concentrations (4.0–587.4 pg/mg vs. 12.9–74.9 pg/mg) and the AUDIT scores (4–40 vs. 5–28) obtained from the alcohol addicts were significantly higher than those from the average alcohol users. The performance evaluation demonstrated that the integration score of the EtG concentration and the AUDIT score increased diagnostic performance for high-risk alcohol consumption.

Identification of Potential Biomarkers for Diagnosis of Patients with Methamphetamine Use Disorder

“…However, the reliability and validity of these instruments have not been fully established, and they are often used in conjunction with quantitative analysis of drugs and/or metabolites in peripheral biospecimens. Although combining drug use disorder screening test scores with analytical results has been shown to improve diagnostic performance in some cases [38,39], their efficacy has not been fully demonstrated, particularly in the diagnosis of MUD. Our previous studies have shown that there is no correlation between MA concentration in hair and drug use disorder screening test scores in current and former patients [28], indicating that hair analysis cannot monitor the recovery status of MUD patients.…”

Hair Metabolomics in Animal Studies and Clinical Settings

“…Segmental analysis of scalp hair provides information on the history of drug or toxicant exposure or toxicological changes over time [19,50,51]. The knowledge that scalp hair grows approximately 1 cm/month allows one to predict the period during which the drug was ingested, which has been often applied to test hair samples from drug-facilitated crimes [52,53,54,55] and post-mortem drug poisoning cases [36,38,56,57] for forensic purposes.…”

Detection of Fluorescently Labeled Carbohydrate-Deficient Transferrin, a Marker of Alcohol Dependence, in Dried Blood Spots

“…For short-term occasional drinking or excessive drinking behavior, it can be detected by some alcohol metabolism-related indexes or organ damage-related indexes [2], such as blood-blood (and/or breath) ethanol content [3], acetaldehyde dehydrogenase (ALDH) [4], ethyl glucuronide (EtG) [5], ethyl sulfate (EtS), liver function indexes (GGT, ALT and AST) [6], fatty acid ethyl ester ( FAEE) [7], mean corpuscular volume (MCV) [8], and phosphatidylethanol (PEth).…”