Ethyl glucuronide: on the time course of excretion in urine during detoxification

Abstract

Ethyl glucuronide (EtG) is a promising new biological state marker of recent alcohol consumption that detects alcohol use reliably over a definite time period. Other currently available markers lack acceptable sensitivity and specificity. Our aim is to elucidate under naturalistic conditions the time course of EtG excretion in urine following alcohol consumption and to show how this can be utilized for monitoring and prognosis in patients. There are no other existing data on this issue to date. One hundred and thirty-eight urine samples from 28 male alcohol withdrawal patients were drawn every 3-24 hours for up to 94 hours after hospitalization. Breath ethanol concentration (mean) at hospitalization was 900 mg/L. Patient age in years was 40.3 (mean). Determination of urine EtG was performed by gas chromatography/mass spectrometry (GC/MS) with deuterium-labelled EtG as an internal standard. The strongest correlations (p<0.01) were found between EtG determinations in the different patient when breath ethanol concentrations (BEC) were 0 and 48 hours after BEC=0 (r=0.747), EtG 24 and 48 hours after BEC=0 (r=0.872), and in the time frame of detection (hours) of EtG and EtG 48 hours after BEC=0 (r=0.762). No significant correlation was found (Mann-Whitney test) between EtG concentrations in urine at different time points between the groups of patients with (a) 1 or less-2, (b) 3-4 or more previous hospitalizations, (c) a history of seizures (yes/no) or (d) an age above or below the median (40.5). EtG excretion in urine is not random, but seems rather to follow a kinetic profile. Furthermore our preliminary data indicate, that there is no significant difference for EtG concentration in urine when correlated to group variables such as age, seizures and hospitalizations.

A study of ethyl glucuronide in post-mortem blood as a marker of ante-mortem ingestion of alcohol

“…There was no explanation for this, but error in the analysis could not be excluded. EtG are however quite short in blood, ~10 h, according to our results (paper I and IV) and others (134) and the problem would be more pronounced if EtG and EtS were only analyzed in urine, in which this difference might be up to several days (45,61). This shows how the analysis in blood and urine complement each other; the risk of false negatives caused by instability is highest in blood and the risk of false positives from previous ethanol ingestions is highest in urine.…”

Microwave assisted extraction for the determination of ethyl glucuronide in urine by gas chromatography‐mass spectrometry

“…Selected ions for this study were the same as those used by Janda and Alt (2001) and Wurst et al (2002b;1999) to analyse EtG in urine, but in contrast to these good selectivity of the proposed method. Figure 3 shows a chromatogram for a urine sample spiked with EtG.…”

Detection of the ethanol consumption markers ethyl glucuronide and ethyl sulfate in urine samples from inmates of two German prisons

“…Depending on the individual formation of EtG and the ingested amount of ethanol, the performed tests mirror a time frame for the detectability of ethanol consumption of up to 4 days after excessive alcohol consumption [23][24][25][26][27]. For several reasons, an excessive ingestion of ethanol is not conjecturable in jail, though.…”

“…Detection times were up to about 100 h after drinking for EtG and about 40 h for EtS [23][24][25][26][27]. The detectability and kinetics of EtG are better suitable for abstinence control [28], whereas EtS proved to be more stable [25,29,30].…”