Carbohydrate-deficient transferrin and alcohol use in medical examiner cases

Carbohydrate-deficient transferrin (CDT) has been studied as an index of heavy alcohol use. The present study evaluates the utility of CDT as a marker for chronic alcohol use in medical examiner cases. Over a 5-month period, serum specimens were collected in consecutive deaths that were referred to the medical examiner's office (N = 25). Manner of death was accidental in nine cases, homicide/suicide for eight cases, and natural causes for seven cases. Fifteen of the 17 cases having alcohol abuse had positive CDT levels above threshold, indicating chronic use (sensitivity 88%). Eight cases had no evidence of alcohol abuse but three of these cases had CDT levels also above threshold (specificity 63%). There was no correlation between serum CDT levels and the time of death to blood collection for the total sample, indicating that CDT is stable postmortem for at least 36 h. CDT appears to have value as a marker of ante-mortem alcohol use prior to time of death in medical examiner cases.