Figlie N B, Benedito-Silva A A, Monteiro M G, Souza-Formigoni M L O
Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.
Alcohol Clin Exp Res. 2002 Jul;26(7):1062-9.
The purpose of this study was to compare the sensitivity and specificity of some new and traditional biological markers and indicators of health among Brazilian nondrinkers, drinkers, and alcohol-dependent patients.
We evaluated 130 nondrinkers, 167 drinkers, and 183 alcohol-dependent drinkers from Brazil who participated in the WHO/ISBRA Study on State and Trait Markers of Alcohol Use and Dependence. A standardized WHO/ISBRA Interview Schedule provided background information on the subjects' characteristics including reported health problems and alcohol consumption. Blood samples were analyzed for aspartate aminotransferase (AST), carbohydrate deficient transferrin (CDT), gamma-glutamyltransferase (GGT), blood alcohol levels (BAL), and platelet adenylate cyclase activity (basal levels [AC] and levels after stimulation with Gpp(NH)p, cesium fluoride, and forskolin).
The alcohol-dependent drinkers presented higher levels of AST, GGT, AC, CDT, and BAL than the nondrinkers and drinkers, whose levels were similar. Sex differences in the sensitivity of CDT and AC were found. The alcohol-dependent women presented a lower prevalence of abnormal values of CDT and Gpp(NH)p-stimulated AC than the alcohol-dependent men, despite the fact that they presented similar alcohol consumption levels. The alcohol-dependent drinkers presented a higher prevalence of clinical disorders than the nondrinkers and drinkers. The drinkers and alcohol-dependent patients presented significantly higher rates of gastritis than the nondrinkers.
Sex differences in the sensitivity of CDT and AC suggest that these markers are not as sensitive at detecting excessive alcohol use in women as they are in men. If data from this Brazilian sample are compared with those reported for international samples, relevant differences are detected, which suggests that genetic and cultural differences should be considered in the selection of biological markers of heavy alcohol consumption.
本研究旨在比较巴西非饮酒者、饮酒者和酒精依赖患者中一些新的和传统的生物标志物及健康指标的敏感性和特异性。
我们评估了来自巴西的130名非饮酒者、167名饮酒者和183名酒精依赖饮酒者,他们参与了世界卫生组织/国际酒精研究协会关于酒精使用和依赖的状态及特质标志物的研究。一份标准化的世界卫生组织/国际酒精研究协会访谈问卷提供了关于受试者特征的背景信息,包括报告的健康问题和酒精消费情况。对血液样本进行了天冬氨酸转氨酶(AST)、缺糖转铁蛋白(CDT)、γ-谷氨酰转移酶(GGT)、血液酒精水平(BAL)以及血小板腺苷酸环化酶活性(基础水平[AC]以及用Gpp(NH)p、氟化铯和福斯高林刺激后的水平)的分析。
酒精依赖饮酒者的AST、GGT、AC、CDT和BAL水平高于非饮酒者和饮酒者,而后两者的水平相似。发现了CDT和AC敏感性方面的性别差异。尽管酒精依赖女性的饮酒量与男性相似,但她们CDT和Gpp(NH)p刺激后AC异常值的患病率低于酒精依赖男性。酒精依赖饮酒者临床疾病的患病率高于非饮酒者和饮酒者。饮酒者和酒精依赖患者胃炎的发生率显著高于非饮酒者。
CDT和AC敏感性方面的性别差异表明,这些标志物在检测女性过度饮酒方面不如在男性中敏感。如果将这个巴西样本的数据与国际样本报告的数据进行比较,会发现相关差异,这表明在选择重度酒精消费的生物标志物时应考虑遗传和文化差异。