Division of Gastroenterology and Hepatology, Department of Medicine, and Clarian Digestive Disease Center, Indiana University School of Medicine, and Roudebush Veterans Administration Medical Center, Indianapolis, Indiana 46202-5124, USA.
J Stud Alcohol Drugs. 2010 Mar;71(2):249-52. doi: 10.15288/jsad.2010.71.249.
The misuse of alcohol, even at levels just above two drinks per day, is a public health problem, but identifying patients with this potentially unhealthy drinking is hindered by the lack of tests. Several blood tests, such as those testing for gamma-glutamyl transpeptidase (GGT) or mean corpuscular volume (MCV), are among the commonly used markers to identify very heavy drinking, but combinations of these markers have rarely been tested in lighter drinkers. We examined the relationship between alcohol drinking and the levels of these markers in a national population-based study composed primarily of lighter drinkers.
Data were analyzed from 8,708 adult participants in the third U.S. National Health and Nutrition Examination Survey after excluding subjects with iron overload; with hepatitis B and C; who were pregnant; and who were taking prescription drugs such as phenytoin (Dilantin), barbiturates, and hydroxyurea (Droxia and Hydrea). The relationship between the amount of alcohol drinking and GGT, aspartate aminotransferase:alanine aminotransferase ratio, MCV of erythrocytes, and apolipoprotein A1 and B were analyzed and adjusted for potential liver injury risk factors.
The prevalence of unhealthy alcohol drinking (defined as consumption of more than two standard drinks per day) was 6.7%. Heavier drinkers tended to be younger and reported an average of 4.2 drinks per day. When tested alone or in combination, the sensitivity and positive predictive values for these blood tests were too low to be clinically useful in identifying the subjects in the heavier drinking category.
In this large, national, population-based study, the markers of heavy drinking studied here, either alone or in combination, did not appear to be useful in identifying unhealthy drinking. More work is needed to find the novel marker(s) associated with risky alcohol drinking.
即使饮酒水平仅略高于每天两杯，酒精滥用也是一个公共卫生问题，但由于缺乏检测手段，识别有这种潜在不健康饮酒习惯的患者受到了阻碍。几种血液检测，如检测γ-谷氨酰转肽酶（GGT）或平均红细胞体积（MCV）的检测，是用于识别重度饮酒的常用标志物之一，但这些标志物的组合在轻度饮酒者中很少进行过测试。我们在一项主要由轻度饮酒者组成的全国性人群研究中，研究了饮酒与这些标志物水平之间的关系。
在排除铁过载、乙型和丙型肝炎、妊娠以及服用苯妥英钠（Dilantin）、巴比妥酸盐和羟基脲（Droxia 和 Hydrea）等处方药的患者后，我们对美国第三次国家健康和营养调查的 8708 名成年参与者的数据进行了分析。我们分析了饮酒量与 GGT、天门冬氨酸氨基转移酶：丙氨酸氨基转移酶比值、红细胞 MCV 和载脂蛋白 A1 和 B 之间的关系，并对潜在的肝损伤危险因素进行了调整。
不健康饮酒（定义为每天饮用超过两杯标准饮品）的患病率为 6.7%。饮酒量较大的人往往更年轻，平均每天饮用 4.2 杯酒。当单独或组合使用时，这些血液检测的敏感性和阳性预测值太低，无法在临床上用于识别重度饮酒者。
在这项大型的全国性人群研究中，这里研究的重度饮酒标志物，无论是单独使用还是组合使用，似乎都不能用于识别不健康的饮酒行为。需要进一步的研究来寻找与危险饮酒相关的新型标志物。
