Markers for detecting alcoholism and monitoring for continued abuse

Several biochemical and haematological abnormalities are associated with excessive alcohol intake and some are used in the recognition and management of alcoholics. The ideal biological marker for detecting and monitoring alcoholics should be sensitive and highly specific for alcohol abuse; its value should be affected by changes in alcohol intake over relatively short periods of time and it should be quick, simple, convenient and inexpensive to estimate. At the present time no simple reliable marker is available which fulfills these criteria. Measurements of serum aspartate transaminase, serum gamma-glutamyl-transpeptidase and mean corpuscular volume are of proven value however and the majority of alcoholics can be detected and monitored by combining the measurements of these three tests. Blood/breath alcohol measurements are of limited value for detection but are useful for follow up. Measurement of the plasma alpha-amino-n-butyric acid/leucine ratio is of disputed value and not likely to be of great practical use. Measurement of serum alpha-lipoproteins, erythrocyte delta-aminolaevulinic acid dehydrase activity and qualitative estimation of serum transferrin have all been proposed as markers for alcohol abuse and are currently under evaluation.