不同缺糖转铁蛋白检测方法在筛查问题饮酒中的诊断特征：肝脏疾病和酒精摄入的影响

Diagnostic characteristics of different carbohydrate-deficient transferrin methods in the detection of problem drinking: effects of liver disease and alcohol consumption.

作者信息

Anttila Petra, Järvi Kimmo, Latvala Jaana, Blake Joan E, Niemelä Onni

机构信息

Department of Clinical Chemistry, EP Central Hospital, FIN-60220 Seinäjoki, Finland.

出版信息

Alcohol Alcohol. 2003 Sep-Oct;38(5):415-20. doi: 10.1093/alcalc/agg102.

DOI:10.1093/alcalc/agg102

PMID:12915516

Abstract

AIMS

Due to methodological heterogeneity, conflicting views have been expressed on the validity of CDT measurements in the detection of alcohol misuse.

METHODS

We compared the characteristics of the conventional CDTect method and the Axis turbidimetric CDT assays in the assessment of 62 alcoholics, who were either with (n = 33) or without (n = 29) liver disease, as analysed by combined clinical, laboratory, and morphological indices. Controls were 45 healthy volunteers who were either social drinkers or abstainers.

RESULTS

In the total sample of alcoholics, the sensitivity of the %CDT method, which excludes the trisialotransferrin isoform from the measurement, was 63% for men and 46% for women, as compared to 65% and 36% of CDTect, respectively. Both of these methods showed higher sensitivities than the %CDT-TIA method, which reacts with trisialotransferrin (32% and 25%, respectively). The assay specificities were 100% for men and 91% for women with %CDT, and 96% and 87% with the CDTect, respectively. The correlation between the CDTect and %CDT method was higher in men (r = 0.86) than in women (r = 0.57). The presence of liver disease was found to influence the results of the CDTect method, such that the highest CDT concentrations were observed in patients with mild to moderate liver disease, especially among women, whereas the %CDT method was less sensitive to the effect of liver pathology. The self-reported alcohol consumption from the 4 weeks prior to sampling showed a higher correlation between the %CDT results (r = 0.64, P < 0.0001) than with the CDTect results (r = 0.40; P < 0.01).

CONCLUSIONS

The data indicate that the new %CDT method offers advantages over the previous versions of the CDT methods. The improved characteristics may be most useful in assays for excessive alcohol consumption in female alcoholics, patients with liver disease, and in patients with abnormal serum transferrin concentrations.

摘要

目的

由于方法学的异质性，对于检测酒精滥用时CDT测量的有效性存在相互矛盾的观点。

方法

我们通过综合临床、实验室和形态学指标，比较了传统的CDTect方法和Axis比浊法CDT检测在评估62名酗酒者（其中33名患有肝病，29名未患肝病）时的特征。对照组为45名健康志愿者，他们或是社交饮酒者或是戒酒者。

结果

在酗酒者的总样本中，排除测量中的三唾液酸转铁蛋白异构体的%CDT方法，男性的敏感性为63%，女性为46%，而CDTect方法分别为65%和36%。这两种方法的敏感性均高于与三唾液酸转铁蛋白反应的%CDT - TIA方法（分别为32%和25%）。%CDT方法男性的检测特异性为100%，女性为91%；CDTect方法分别为96%和87%。CDTect方法与%CDT方法之间的相关性男性（r = 0.86）高于女性（r = 0.57）。发现肝病的存在会影响CDTect方法的结果，在轻度至中度肝病患者中观察到最高的CDT浓度，尤其是女性，而%CDT方法对肝脏病理的影响较不敏感。采样前4周的自我报告饮酒量与%CDT结果之间的相关性更高（r = 0.64，P < 0.0001），高于与CDTect结果的相关性（r = 0.40；P < 0.01）。