Use of Carbohydrate-Deficient Transferrin (CDT) and a Combination of GGT and CDT (GGT-CDT) to Assess Heavy Alcohol Consumption in Traffic Medicine

Bianchi, Vincenza; Ivaldi, A.; Raspagni, Alessia; Arfini, Carlo; Vidali, Matteo

doi:10.1093/alcalc/agq006

Cited by 30 publications

(19 citation statements)

References 36 publications

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“…Disialotransferrin is one of the minor glycoforms of human transferrin, and the percentage of total CDT that is disialotransferrin, as determined by high-performance liquid chromatography (HPLC), is the recommended method for measuring %CDT [9]. The percent of abstainers and moderate drinkers combined that tested %CDT positive (i.e., the percent false positive, or one minus the specificity of the test) using a cutoff of 1.8% was 0% in Italy [10] and Sweden [9] and 5.6% in a multi-national study [6]. In the latter study, the specificity was 100% when moderate drinkers were excluded, and the authors noted that errors in self-report were likely among the moderate drinkers [6].…”

Section: Methodsmentioning

confidence: 99%

Biomarker Testing to Estimate Under-Reported Heavy Alcohol Consumption by Persons with HIV Initiating ART in Uganda

et al. 2010

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Alcohol affects the transmission and treatment of HIV, yet may be under-reported in resource-limited settings. We compared self-reported alcohol consumption with levels of plasma carbohydrate-deficient transferrin (%CDT), a biomarker of heavy alcohol consumption, in persons initiating antiretroviral therapy in Uganda. Almost seven percent (6.7%) of persons reporting abstaining and 10% reporting consuming 1–40 drinks in the prior month tested positive for %CDT, and actual under-report may be higher due to low sensitivity of %CDT. These results suggest likely under-report in those reporting abstaining and current drinking. Improved identification of heavy alcohol consumption is needed for research and clinical purposes.

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Section: Methodsmentioning

confidence: 99%

Biomarker Testing to Estimate Under-Reported Heavy Alcohol Consumption by Persons with HIV Initiating ART in Uganda

et al. 2010

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“…A compound known as carbohydrate-deficient transferrin (CDT) is the most well known among those being studied as a biomarker for excessive alcohol use 63,64. Although liver enzymes are often elevated in individuals who drink excessively, their usefulness as a screening tool is limited by their lack of ethanol specificity.…”

Section: Recent Developmentsmentioning

confidence: 99%

Screening for alcohol and drug use disorders among adults in primary care: a review

Pilowsky

Wu²

2012

SAR

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BackgroundThe Patient Protection and Affordable Care Act of 2010 supports integration of substance abuse interventions and treatments into the mainstream health care system. Thus, effective screening and intervention for substance use disorders in health care settings is a priority.ObjectiveThis paper reviews the prevalence of alcohol and drug use disorders (abuse or dependence) in primary care settings and emergency departments, as well as current screening tools and brief interventions.MethodsMEDLINE was searched using the following keywords: alcohol use, alcohol use disorder, drug use, drug use disorder, screening, primary care, and emergency departments. Using the related-articles link, additional articles were screened for inclusion. This review focuses on alcohol and drug use and related disorders among adults in primary care settings.ConclusionScreening, brief intervention, and referral for treatment are feasible and effective in primary care settings, provided that funding for screening is available, along with brief interventions and treatment facilities to which patients can be referred and treated promptly.

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“…In the present study, the upper limit of GGT was obtained exactly in the same way as for CDT; the 95% confidence interval for GGT obtained in the apparently healthy nondrinkers was 61 U/l. It is well-known that a combination of CDT and GGT, namely GGT-CDT, can have higher sensitivity than single markers alone in detecting excessive drinkers [16]. Although MCV is often included in the current standards of biomarkers for excessive drinking, sensitivity of MCV in detection of habitual drinkers is lower than those of GGT as demonstrated in several reports [17,18].…”

Section: Discussionmentioning

confidence: 99%

Determination of Serum Carbohydrate-Deficient Transferrin (CDT) by the Nephelometric N Latex CDT Assay in Japanese Habitual Drinkers and Patients with Non-Alcoholic Liver Diseases

Seimiya¹

2013

J Alcoholism Drug Depend

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Background: Excessive alcohol consumption is a health risk that can lead to a variety of medical and social problems. Carbohydrate Deficient Transferrin (CDT) is now widely used for detection of chronic alcohol abuse and monitoring sobriety in alcoholics. We assessed the diagnostic performance of the direct immunoassay for %CDT (N Latex CDT) in Japanese habitual drinkers at their annual medical check-up. We also tested whether this direct assay is influenced by the presence of non-alcoholic liver disease including non-alcoholic steatohepatitis and HCVrelated hepatocellular carcinoma. Methods: We performed the N Latex CDT assay using a Siemens BN-II nephelometric analyzer to measure CDT concentration. The reference intervals of %CDT and gamma glutamyl transferase (GGT) activities were obtained based on their measurements in 160 apparently healthy nondrinkers. Habitual drinkers were divided into light drinkers (less than 40g ethanol/day) and heavy drinkers (more than 60g ethanol/day) Furthermore, %CDT levels in a total of 184 patients with non-alcoholic chronic liver diseases including Hepatitis C Virus (HCV) related liver cirrhosis, Non-Alcoholic Steatohepatitis (NASH) were determined. Results: In the heavy drinkers, the positive rates of %CDT and GGT were 58.3% and 41.7%, respectively. The combination assay of %CDT and GGT resulted in 75% sensitivity and 95% specificity. It was notable that 57% of GGT non-responders were detected by CDT measurements. The mean serum level of %CDT was not influenced by the presence of NASH, but was increased in patients with moderate-severe HCV-related liver cirrhosis. The %CDT levels were also high in patients with hepatocellular carcinoma with liver cirrhosis, but were not related to their tumor stages. Conclusions:The %CDT determined by automated N Latex CDT may be useful biomarker complementary to GGT to detect excessive habitual drinkers in Japan. However, caution should be taken to interpret the results in advanced non-alcoholic liver cirrhosis.

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Use of Carbohydrate-Deficient Transferrin (CDT) and a Combination of GGT and CDT (GGT-CDT) to Assess Heavy Alcohol Consumption in Traffic Medicine

Abstract: A relevant proportion of drivers with high BAC are chronic abusers. GGT-CDT, previously validated with CDT immunoassays, should not be applied to traffic medicine in its current form and its performances re-evaluated with CDT measured by HPLC.

Cited by 30 publications

References 36 publications

Biomarker Testing to Estimate Under-Reported Heavy Alcohol Consumption by Persons with HIV Initiating ART in Uganda

Biomarker Testing to Estimate Under-Reported Heavy Alcohol Consumption by Persons with HIV Initiating ART in Uganda

Screening for alcohol and drug use disorders among adults in primary care: a review

Determination of Serum Carbohydrate-Deficient Transferrin (CDT) by the Nephelometric N Latex CDT Assay in Japanese Habitual Drinkers and Patients with Non-Alcoholic Liver Diseases

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