[Biological markers of alcoholism]

Since most patients with an alcohol problem downplay their alcohol consumption, reliable tests for detection of alcohol abuse would be of value in clinical practice. Single determinations of common laboratory tests such as gamma-glutamyl transpeptidase, transaminases or mean corpuscular volume are only of limited reliability in detecting alcohol abuse. Most newer parameters, including the serum ASAT/ALAT ratio, the ratio of mitochondrial to total ASAT in serum, and serum levels of acetaldehyde-hemoglobin adducts or of antibodies against acetaldehyde adducts, still do not allow us to discriminate reliably enough between alcoholic and nonalcoholic liver diseases. beta-hexosaminidase activity and desialylated transferrin levels in serum appear to be the most promising tests for detecting alcohol abuse in the future. They require, however, additional validation and technical simplification respectively before they are suitable for daily clinical use. Thus, it remains valid that no single test can replace a careful history, clinical examination and laboratory results in detecting patients with alcohol problems.