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Post mortem markers of chronic alcoholism
D W Sadler1, E Girela, D J Pounder
1Department of Forensic Medicine, University of Dundee, Royal Infirmary, UK.
Forensic Science International
|September 30, 1996
Summary
Carbohydrate-deficient transferrin (CDT) is the most promising postmortem marker for chronic alcoholism, outperforming gamma-glutamyltransferase (GGT) and alcoholic liver disease (ALD). Further research is needed to optimize its diagnostic accuracy.
Area of Science:
- Forensic Pathology
- Toxicology
- Biochemistry
Background:
- Establishing chronic alcoholism postmortem is challenging.
- Biomarkers like GGT, CDT, and ALD are used, but their postmortem diagnostic value requires validation.
- External markers such as bruises and hygiene are less specific.
Purpose of the Study:
- To compare the postmortem diagnostic utility of various markers for chronic alcoholism.
- To evaluate gamma-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT), alcoholic liver disease (ALD), blood alcohol concentration (BAC), bruises, and hygiene.
- To determine the most reliable marker for identifying heavy, continuous alcohol consumption in a forensic autopsy setting.
Main Methods:
- A case-control study involving 32 alcoholics and 32 matched controls from a forensic autopsy population.
- Analysis of femoral venous blood, urine, and vitreous humor for BAC using gas chromatography (GC).
- Measurement of serum GGT and CDT (using isoelectric focusing/laser densitometry and radioimmunoassay), and histological grading of ALD.
Main Results:
- CDT demonstrated the highest diagnostic accuracy among the tested biomarkers, followed by ALD and GGT.
- Quantification of CDT by IEF/laser densitometry showed slightly better performance than the CDTect radioimmunoassay kit.
- Normal cut-off values for GGT, CDT, and ALD yielded poor specificity, which improved with adjusted thresholds at the cost of sensitivity.
Conclusions:
- Carbohydrate-deficient transferrin (CDT) shows significant promise as a reliable postmortem marker for chronic alcoholism.
- CDT, particularly when quantified by IEF/laser densitometry, offers superior diagnostic value compared to GGT and ALD.
- Further optimization of CDT testing may enhance its utility in forensic investigations of heavy alcohol consumption.
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