Phosphatidylethanol Levels in a Group of Life Insurance Applicants Tested for Carbohydrate-Deficient Transferrin

Area of Science:

• Biomarkers and Diagnostics
• Clinical Chemistry
• Toxicology

Background:

• Carbohydrate-deficient transferrin (CDT) is a traditional biomarker for chronic alcohol consumption.
• Phosphatidylethanol (PEth) offers a more direct measure of recent alcohol intake.
• Comparing PEth and CDT is crucial for optimizing alcohol use detection.

Purpose of the Study:

• To compare the efficacy of PEth and CDT as alcohol biomarkers.
• To evaluate their performance in a population of life insurance applicants.

Main Methods:

• A cohort of 619 life insurance applicants was tested for both PEth and CDT.
• Linear regression models assessed marker relationships with other lab values.
• Classification and Regression Tree (CART) models identified predictors of high marker levels.

Main Results:

• PEth demonstrated a moderate correlation (0.52) with CDT.
• PEth positivity was 23% (threshold 200 ng/ml), compared to 11% for CDT (threshold 1.5%).
• Gamma-glutamyl transferase (GGT) and aspartate aminotransferase (AST) predicted PEth levels, while HDL and AST predicted CDT levels.

Conclusions:

• PEth appears to be a more sensitive biomarker for alcohol consumption than CDT.
• PEth can serve as a useful reflex test based on other laboratory results.
• These findings support PEth's utility in both clinical practice and life insurance evaluations.