Phosphatidylethanol Reliably and Objectively Quantifies Alcohol Consumption in Adolescents and Young Adults

Röhricht, Milan; Paschke, Kerstin; Sack, Peter‐Michael; Weinmann, Wolfgang; Thomasius, Rainer; Wurst, Friedrich Martin

doi:10.1111/acer.14464

Cited by 12 publications

(10 citation statements)

References 43 publications

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“…Due to a detection window of up to several weeks after alcohol consumption, its application potential is broader than for other ethanol biomarkers [13]. PEth has been validated as a biological marker of alcohol use in several populations and settings [14][15][16][17]. In patients admitted to somatic emergency units, PEth has identified a high incidence of alcohol use, and has also proven to be useful in identifying individuals that underreport alcohol intake [18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Identification of unhealthy alcohol use by self-report and phosphatidylethanol (PEth) blood concentrations in an acute psychiatric department

et al. 2022

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Background The use of standard screening methods could improve the detection rate of unhealthy alcohol use in patients admitted to psychiatric acute and emergency departments. The aim of the present study was to investigate the ability of the alcohol biomarker phosphatidylethanol (PEth) to identify patients with high levels of alcohol consumption prior to admission. Methods The data were prospectively collected at admittance to an acute psychiatric department in the period January 2016 to June 2017. A blood sample for the analysis of PEth was available from 177 patients. We compared the PEth concentrations with the Alcohol Use Disorders Identification Test (AUDIT) scores during the hospital stay, and psychiatric diagnoses at discharge. Results A total of 45.8% of the patients had a PEth concentration ≥ 0.03 μmol/L, indicating significant alcohol consumption. AUDIT scores consistent with unhealthy alcohol use were present in 51.7%. There was a significant positive correlation between PEth concentrations and AUDIT scores (r = 0.631, p < 0.001). PEth was above the detection limit of 0.03 μmol/L in 19% of those reporting an average daily intake of zero alcohol units per day during the last week before admission. PEth concentrations were significantly higher among those with an alcohol diagnosis than among those without such a diagnosis (0.82 μmol/L vs. 0.09 μmol/L, p = 0.001). Conclusion PEth provides supplementary information on recent alcohol consumption in a psychiatric population and would be particularly helpful in patients unable or unwilling to give such information at admission.

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Section: Introductionmentioning

confidence: 99%

Identification of unhealthy alcohol use by self-report and phosphatidylethanol (PEth) blood concentrations in an acute psychiatric department

et al. 2022

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“…for detecting prior month unhealthy drinking, defined as drinking above recommended limits (Bajunirwe et al, 2014;Edelman et al, 2019;Eyawo et al, 2018;Ghosh et al, 2019;Hahn et al, 2018;Magidson et al, 2019;Muyindike et al, 2017;Ulwelling & Smith, 2018;Walther et al, 2015;Wang et al, 2017), and good correlations with total self-reported volume of alcohol consumed ranging from 0.53 to 0.80 (Aradottir et al, 2006;Cherrier et al, 2020;Ferguson et al, 2020;Gerbase et al, 2020;Hahn et al, 2012;Hartmann et al, 2007;Helander et al, 2019b;Kechagias et al, 2015;Piano et al, 2015;Röhricht et al, 2020;Walther et al, 2015), although a few studies found correlations of 0.21 to 0.44 (Littlefield et al, 2017;Papas et al, 2016;Wang et al, 2017). These characteristics make PEth a preferred biomarker of medium-term (several weeks) unhealthy alcohol use (the spectrum from use of risky amounts through alcohol use disorder).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta‐analysis

Hahn

Murnane

Vittinghoff

et al. 2021

Alcoholism Clin & Exp Res

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Background Objective measurement of alcohol consumption is important for clinical care and research. Adjusting for self‐reported alcohol use, we conducted an individual participant data (IPD) meta‐analysis to examine factors associated with the sensitivity of phosphatidylethanol (PEth), an alcohol metabolite, among persons self‐reporting unhealthy alcohol consumption. Methods We identified 21 eligible studies and obtained 4073 observations from 3085 participants with Alcohol Use Disorders Identification Test—Consumption (AUDIT‐C) positive scores (≥3 for women and ≥4 for men) and PEth measurements. We conducted 1‐step IPD meta‐analysis using mixed effects models with random intercepts for study site. We examined the associations between demographic (sex, race/ethnicity, and age) and biologic (body mass index—BMI, hemoglobin, HIV status, liver fibrosis, and venous versus finger‐prick blood collection) variables with PEth sensitivity (PEth≥8 ng/ml), adjusting for the level of self‐reported alcohol use using the AUDIT‐C score. Results One third (31%) of participants were women, 32% were African, 28% African American, 28% White, and 12% other race/ethnicity. PEth sensitivity (i.e., ≥8 ng/ml) was 81.8%. After adjusting for AUDIT‐C, we found no associations of sex, age, race/ethnicity, or method of blood collection with PEth sensitivity. In models that additionally included biologic variables, those with higher hemoglobin and indeterminate and advanced liver fibrosis had significantly higher odds of PEth sensitivity; those with higher BMI and those living with HIV had significantly lower odds of PEth sensitivity. African Americans and Africans had higher odds of PEth sensitivity than whites in models that included biologic variables. Conclusions Among people reporting unhealthy alcohol use, several biological factors (hemoglobin, BMI, liver fibrosis, and HIV status) were associated with PEth sensitivity. Race/ethnicity was associated with PEth sensitivity in some models but age, sex, and method of blood collection were not. Clinicians should be aware of these factors, and researchers should consider adjusting analyses for these characteristics where possible.

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“…Some studies showed higher agreement; Francis et al ( 2015 ) showed that when compared to PEth, self‐reported heavy alcohol intake has a sensitivity of 92–100% and a specificity of 64–85% among young people. Other studies in various populations have shown these good correlations as well (Jain et al, 2014 ; Kuteesa et al, 2019 ; Röhricht et al, 2020 ).…”

Section: Discussionmentioning

confidence: 63%

Screening for hazardous alcohol use in the Emergency Department: Comparison of phosphatidylethanol with the Alcohol Use Disorders Identification Test and the Timeline Follow‐back

Verheij

Haagsma

Koch

et al. 2022

Alcoholism Clin & Exp Res

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Background Up to 15% of all visits to the Emergency Department (ED) are alcohol related. Identification of problematic alcohol use is important in this setting because it allows for intervention and prevention efforts. This study investigated the correlation between the objective phosphatidylethanol (PEth) marker and the subjective Alcohol Use Disorders Identification Test (AUDIT) and Timeline Followback Questionnaire (TLFB) as screening methods for hazardous alcohol use in the general ED population. Methods This prospective cohort study included 301 ED patients (57% male) who were seen in the ED and required to give a blood sample. The correlation between the values of PEth (PEth 16:0/18:1 and PEth 16:0/18:2) and the scores on the AUDIT and TLFB were analyzed using Spearman's rank correlation coefficient. Differences between risk categories of PEth and AUDIT were also examined. Results The Spearman correlation coefficients between PEth 16:0/18:1|PEth 16:0/18:2 values and the AUDIT scores were moderate (PEth 16:0/18:1: 0.67, p < 0.001; PEth 16:0/18:2: 0.67, p < 0.001). Of the patients who scored ‘low risk drinking/abstinence’ according to the AUDIT questionnaire, respectively 1% and 4% had PEth 16:0/18:1|PEth 16:0/18:2 values indicating excessive alcohol use, and another 10% and 12% had PEth 16:0/18:1|PEth 16:0/18:2 values indicating moderate alcohol consumption. Of the 12 (PEth 16:0/18:1) and 25 (PEth 16:0/18:2) patients with high‐risk values, respectively 25% and 40% scored in the lowest risk category on the AUDIT questionnaire. Spearman correlation coefficients between PEth 16:0/18:1|PEth 16:0/18:2 values and TLFB two‐week scores were high (PEth 16:0/18:1: 0.74, p < 0.001; PEth 16:0/18:2: 0.82, p < 0.001). Conclusions AUDIT scores were moderately correlated with PEth values in the general ED population. In almost all cases where there was not a good correlation, patients had high PEth values with low AUDIT scores. We conclude that PEth identifies patients with problematic alcohol use who are missed by the AUDIT questionnaire and therefore PEth could be used as an additional screening method for hazardous alcohol use in this population.

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Phosphatidylethanol Reliably and Objectively Quantifies Alcohol Consumption in Adolescents and Young Adults

Cited by 12 publications

References 43 publications

Identification of unhealthy alcohol use by self-report and phosphatidylethanol (PEth) blood concentrations in an acute psychiatric department

Identification of unhealthy alcohol use by self-report and phosphatidylethanol (PEth) blood concentrations in an acute psychiatric department

Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta‐analysis

Screening for hazardous alcohol use in the Emergency Department: Comparison of phosphatidylethanol with the Alcohol Use Disorders Identification Test and the Timeline Follow‐back

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