Biomarkers in alcoholism

Area of Science:

• Clinical Biochemistry
• Addiction Medicine
• Laboratory Diagnostics

Background:

• Alcoholism is a major public health concern in Western countries, necessitating improved diagnostic and early intervention strategies.
• Objective methods for early detection of alcohol abuse are crucial for effective treatment and reducing health risks.

Purpose of the Study:

• To enhance the diagnosis of alcohol use disorders through systematic application of specific questionnaires and laboratory tests.
• To re-evaluate reference intervals for ethanol-sensitive laboratory parameters considering factors like gender, age, moderate drinking, and obesity.

Main Methods:

• Utilizing established biomarkers such as blood ethanol, serum gamma-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT), and mean corpuscular volume (MCV).
• Investigating novel biomarkers including minor ethanol metabolites (e.g., ethylglucuronide, phosphatidylethanolamine), 5-hydroxytryptophol, and genetic markers.
• Developing a mathematically formulated equation to combine CDT and GGT for improved diagnostic accuracy.

Main Results:

• Carbohydrate-deficient transferrin (CDT) is identified as a highly specific marker for alcohol abuse.
• Combining CDT with GGT in a specific equation significantly increases diagnostic sensitivity without compromising specificity.
• Factors such as gender, age, moderate alcohol consumption, and obesity influence the diagnostic validation of biomarkers.

Conclusions:

• A systematic approach combining validated biomarkers like CDT and GGT can markedly improve the early diagnosis of alcohol use disorders.
• Revisiting laboratory reference intervals for ethanol-sensitive markers is necessary to account for influencing factors.
• While promising, novel biomarkers require further research for routine clinical application in alcohol abuse detection.