Phosphatidylethanol testing: patterns, demographic and clinical correlates, and outcomes.

Area of Science:

• Clinical Chemistry
• Biomarker Analysis
• Public Health

Background:

• Phosphatidylethanol (PEth) is a key biomarker for monitoring alcohol consumption.
• Interpretation of PEth levels can be influenced by demographic factors, and clinical relevance of existing cutoffs requires further investigation.
• Understanding PEth distribution and associations is crucial for accurate clinical interpretation.

Purpose of the Study:

• To examine the distribution of PEth values in a large healthcare network.
• To investigate associations between PEth levels and demographic characteristics, laboratory markers, and clinical outcomes.
• To assess the clinical relevance of PEth as a biomarker for alcohol use.

Main Methods:

• Retrospective cohort study of 4892 adults with PEth 16:0/18:1 results from January 2022 to August 2024.
• Linear regression analysis to assess associations between PEth and demographics, AST, LDL, A1c, hospital encounters, length of stay, and self-reported alcohol use.

Main Results:

• 60% of patients had negative PEth (<20 ng/mL); among positives, median was 251 ng/mL.
• PEth was associated with AST, age, BMI, income, and A1c. Black patients had higher PEth than White patients.
• Higher PEth correlated with more hospital encounters but shorter stays; poor correlation with self-reported alcohol use was observed, with 31% of positive PEth patients reporting no alcohol use.

Conclusions:

• PEth values in this broad clinical population were higher than previously reported.
• Observed demographic disparities and limited agreement with self-reported alcohol use suggest PEth's potential to detect unhealthy alcohol use and unmet care needs.
• Further research is warranted to refine PEth interpretation and its clinical utility.