[CDT (desialylated transferrin)--a new biochemical marker of alcohol abuse]

Serum concentration of carbohydrate-deficient transferrin (CDT) is used for laboratory diagnosis of chronic alcohol abuse. Several earlier studies reported sensitivities of 90% or above for CDT, with a specificity of 90-100%, although other investigators found lower sensitivities. In general, CDT has been reported to be highly specific (92%) and relatively sensitive (80%) for the detection and monitoring of alcoholism. There are no correlation between CDT concentration and gamma-GT activity. Any alteration in serum total transferrin concentration markedly decreases the CDT assay specificity. This should be considered when interpreting the assay results in patients with elevated serum transferrin. There are differences between the CDT isoforms (asialo-Tf and monosialo-Tf) in males and females relative to alcohol consumption. Alcohol consumption increases the levels of asialo-Tf and monosialo-Tf in women more strongly than in men. Sensitivity of CDT assay is also related to age of patients. There is a significantly higher sensitivity of CDT in patients above 40 years of age as compared to younger patients. The measurement of carbohydrate-deficient transferrin may be used as a marker of excessive alcohol abuse in patients with liver diseases (also in cirrhosis). The specificity of CDT in patients with non-alcoholic liver disease was consistently higher than that of gamma-GT (80% vs 60%). Disulfiram therapy during detoxification does not influence the serum level of CDT.