Serum Carbohydrate‐Deficient Transferrin as a Marker of Alcohol Consumption in Patients with Chronic Liver Diseases

Abstract

We measured serum levels of carbohydrate deficient transferrin (CDT) in 420 subjects: 100 healthy blood donors, 82 healthy employees, 70 abstaining patients with different chronic nonalcoholic liver disease, 16 abstaining patients with alcoholic fatty liver, 50 abstaining patients with alcoholic liver cirrhosis, 25 abusing patients with alcoholic fatty liver, 41 abusing patients with alcoholic liver cirrhosis, and 36 patients with alcohol dependence syndrome with a daily ethanol consumption of 173 +/- 120 g the last 4 weeks before blood was drawn. In controls the serum level of CDT was significantly higher in females compared with males (17.7 +/- 5.1 and 13.7 +/- 3.8 units/liter, respectively), and the upper normal limit was defined as 27 and 20 units/liter. Sixty-two of 102 (60.8%) abusing patients with alcoholic liver disease had increased levels of CDT compared with 1 of 66 abstaining (1.5%) patients with alcoholic liver disease, and 10 of 70 (14.3%) abstaining patients with nonalcoholic liver disease among them 3 with primary biliary cirrhosis and 2 with chronic autoimmune hepatitis. No correlation was found between serum CDT and gamma-glutamyltranspeptidase (GGT), AST, ALT, and mean red cell volume (MCV). The sensitivity and specificity for serum CDT was 61 and 92%, respectively, compared with 85 and 18% for GGT and 70 and 66% for MCV. No advantage was gained by using the CDT/transferrin ratio. Our study confirms that CDT is a specific marker for chronic alcohol abuse, except in few patients with other chronic liver diseases. Serum CDT seems to be a better indicator of abstention than GGT; AST and MCV in patients with alcoholic liver disease. However, in our hands CDT is not so sensitive for alcohol abuse in patients with liver disease as reported earlier in unselected alcoholics.

Treatment Outcome in Alcoholism – A Comparison of Self-Report and the Biological Markers Carbohydrate-Deficient Transferrin and γ-Glutamyl Transferase

“…CDT seems to have a higher specificity; however, severe liver diseases or genetic D variants can influence CDT test results. Even though for this study patients with chronic liver diseases or using medications influencing liver enzymes were excluded, elevation of CDT or GGT levels might not be solely due to alcohol consumption [39][40][41][42][43][44].…”

Carbohydrate Deficient Transferrin in Abstaining Patients With End-Stage Liver Disease

“…However, while the degree of liver fibrosis did not correlate with elevated CDT levels, in that study few patients had advanced liver disease (cirrhosis) and only 10% were clinically affected by their liver disease (Stibler, 1987). In contrast, investigations of other specific populations have reported a high degree of variability in CDT depending on body iron (DeFeo, 1999), gender and exogenous estrogens (Stauber, 1996), and specific types of liver diseases (Murawaki, 1997;Bell, 1993, Stauber, 1995. For example, Heinemann found an unacceptable specificity rate (as low as 20 -50%) resulting in a high rate of false positives in patients with severe liver disease awaiting liver transplantation (Heinemann, 1998).…”

Pretransplant screening of sobriety with carbohydrate-deficient transferrin in patients suffering from alcoholic cirrhosis

“…Pretransplant abstinence does not reliably pre- Table 1 Efficacy of pretransplant CDT in comparison with posttransplant diagnosis of alcohol relapse. Sensitivity % = (2/ 2+2)x100=50%; sensitivity % = (7/7+33)~100=50% Compared with other biological markers the most important advantage of CDT was the independence from the severity of the liver disease [18]. According to this observation, CDT was identified as a very useful marker for the monitoring of an alcohol relapse in patients following OLT for alcoholic cirrhosis, as has been previously indicated [ 191.…”