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Biochemical markers for alcoholism: sensitivity problems.

P Cushman, G Jacobson, J J Barboriak

    Alcoholism, Clinical and Experimental Research
    |May 1, 1984
    PubMed
    Summary
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    Blood tests for alcohol abuse show low sensitivity individually, but combined markers can identify abuse. Clinical history remains crucial for diagnosing alcoholism, especially with intermittent drinking or recent abstinence.

    Area of Science:

    • Clinical Biochemistry
    • Addiction Medicine
    • Diagnostic Markers

    Background:

    • Biochemical markers are often used to detect alcohol abuse.
    • The sensitivity of these markers in clinical populations requires further investigation.

    Purpose of the Study:

    • To evaluate the sensitivity of individual and combined blood tests for detecting alcohol abuse in alcoholics undergoing rehabilitation.
    • To assess the utility of these markers in different patient subgroups.

    Main Methods:

    • Analysis of blood samples from 543 alcoholics entering ambulatory rehabilitation.
    • Assessment of individual markers: gamma-glutamyl transpeptidase, mean corpuscular volume, high density lipoprotein cholesterol (HDLC), serum glutamic oxaloacetic transaminase (SGOT), and blood alcohol.
    • Evaluation of pooled sensitivity of seven combined markers.

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    Main Results:

    • Individual markers showed low sensitivity (e.g., gamma-glutamyl transpeptidase 49%, HDLC 25%).
    • Combined markers identified abnormalities in 82% of males and 71% of females.
    • High sensitivity was associated with heavy recent drinking, positive blood alcohol levels, and liver disease.

    Conclusions:

    • Biochemical markers can suggest alcohol abuse, particularly in specific populations like drivers.
    • Reliance on these markers is limited in alcoholics with intermittent drinking or recent abstinence due to low sensitivity.
    • Clinical history remains the cornerstone for diagnosing alcoholism, encompassing a wide range of alcohol-related problems.