Excretion profiles of ethyl glucuronide in human urine after internal dilution

Ethyl glucuronide (EG) is a useful marker of alcohol consumption because its presence in urine can be detected up to five days. We investigated the impact of diuresis on the urinary excretion of EG, a minor ethanol metabolite. Seven healthy volunteers drank 250 mL of wine (25 g ethanol) in 15 min and, 240 min later, ingested 1 L of water within 15 min. Urine was voided before the drinking started and every 30-60 min for 400-550 min thereafter. Urinary ethyl glucuronide (UEG), creatinine, and ethanol were determined using liquid chromatography-tandem mass spectrometry, Jaffé's method, and the enzymatic ADH method, respectively. The maximum diuresis coincided with the lowest values of the UEG concentrations of 2 mg/L and the lowest creatinine values of 10 mg/dL 250-400 min after drinking. After drinking the wine, the urinary creatinine decreased slowly. After a short period of increasing, it decreased to minimum values caused by the water intake. After the intake of 1 L water, the diuresis increased within 60 min to its maximum. The amount of ethyl glucuronide excreted in urine was 10 mg (SD 5 mg) corresponding to 0.04% (SD 0.02%) of the dose administered. In successive voids during the elimination phase, the UEG and the diuresis were influenced after the subjects drank 1 L of water. Minimum UEG values of 0.5 mg/L could still be measured. Measuring UEG provides a reliable way to monitor recent drinking of alcohol. However, urinary creatinine needs to be measured additionally. Establishing a cutoff value of 25 mg/dL for urinary creatinine in diluted samples, like for the analysis of illicit drugs, is recommended. If the creatinine value is too low, the analyst has to decide about the further procedure.