Should we use carbohydrate deficient transferrin as a marker for alcohol abusers?

Abstract

Carbohydrate deficient transferrin (CDT) is one of the conventional markers for chronic alcohol consumption, is used by researchers and clinicians. A number of enzymes are affected by ethanol intake. The induction or inhibition of sialyl transferase and plasma sialidase may be involved in the CDT level elevation. An alteration of protein transport during post-translational modification could be a primary mechanism in the impairment of protein metabolism associated with chronic alcohol abuse. Transferrin being a steroid responsive protein, sex-based hormonal variations might contribute to the lower sensitivity of CDT. Varying hormonal statuses such as pregnancy, use of contraceptives, menopause/ menstrual cycle can alter iron homeostasis in women. CDT levels are markedly affected by iron homeostasis. Several CDT assay methods appeared promising, but it is not readily apparent which technique is the most accurate. Moreover, false-positive results of CDT have been reported in non-alcohol related hepatic failure and in rare conditions. Therefore clinical interpretation of CDT needs careful assessment in patients with alcohol-related or non-alcohol-related health disorders. KEY WORDSCarbohydrate deficient transferdn (CDT), Transferrin, Alcohol, Marker, Iron homeostasis.

Self-reported alcohol consumption, carbohydrate deficient transferrin and risk of cardiovascular disease: The PREVEND prospective cohort study

“…Carbohydrate deficient transferrin has been used for long term monitoring of early detection of relapse drinking during rehabilitation and in the assessment for reinstating driver licenses [13]. Given that CDT is known to vary with sex and age and to compensate for variations in the total transferrin concentration in various conditions (e.g., iron deficiency, iron overload) [14], the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Working Group has proposed percent CDT (%CDT) (i. e., CDT as a percentage of total transferrin) as the preferred method of reporting, as it is superior to absolute CDT as an alcohol biomarker [15,16]. Data on the prospective association between CDT and CVD are lacking.…”