Carbohydrate deficient transferrin in alcoholic liver disease: mechanisms and clinical implications

Carbohydrate-deficient transferrin (CDT) is now considered to be the most sensitive and specific biological marker of alcohol abuse. The mechanism by which chronic alcohol consumption causes an elevation of CDT levels in serum is discussed. The sensitivity and specificity of various test procedures are compared, with special emphasis on the impact of liver disease. Clinical applications are reviewed, including the utility of CDT as a marker of relapse in alcoholic patients, and the use of CDT for the systematic screening of drinking in vulnerable populations as part of a public health approach to alcoholism.