Morini Luca, Groppi Angelo, Marchei Emilia, Vagnarelli Federica, Algar Oscar Garcia, Zuccari Piergiorgio, Pichini Simona
Department of Legal Medicine, Forensic and Pharmaco-Toxicological Science, University of Pavia, Pavia.
Ther Drug Monit. 2010 Jun;32(3):359-63. doi: 10.1097/FTD.0b013e3181d5f14a.
The detection of ethyl glucuronide (EtG) and ethyl sulfate (EtS) in meconium has been investigated recently as an alternative to meconium fatty acid ethyl esters (FAEEs) measurement as an objective estimate of prenatal alcohol exposure, independent of maternal self-reporting. We report the results of the first study conducted to investigate the concentrations of EtG and EtS in meconium from newborns with and without intrauterine exposure to ethanol, defined by questionnaire and meconium FAEEs concentration. FAEEs, EtG, and EtS were quantified by liquid chromatography tandem mass spectrometry in meconium samples obtained from the Arcispedale Santa Maria Nuova, Reggio Emilia, Italy (n = 80) and from the Hospital del Mar in Barcelona, Spain (n = 105). Median EtG and EtS values in meconium from newborns without intrauterine exposure to ethanol varied between 0.100 and 0.140 nmol/g and 0.010 and 0.020 nmol/g in Reggio Emilia and Barcelona samples, respectively. In meconium from newborns with uncertain prenatal ethanol exposure, the EtG median value was 0.160 nmol/g in the Italian cohort and 0.250 nmol/g in the Spanish one. The median EtS concentration was 0.020 in both cohorts. EtG and EtS median values in 5 meconium samples from newborns of heavily drinking mothers were 7.240 nmol/g and 0.033 nmol/g, respectively. A positive cutoff of 2.0 nmol/g for EtG yielded the best sensitivity and specificity (100%) to discriminate for true prenatal exposure to ethanol. It was not possible to establish a proper cutoff for EtS because of the low number of positive samples. Based on our results, meconium EtG can be proposed as an alternate biomarker for intrauterine alcohol exposure. In contrast to the 7 FAEEs, EtG is just one molecule that could be screened in meconium samples from all newborns by a simple, low-cost, easy-to-perform immunoassay, which can be routinely applied in neonatology wards for the early diagnosis of prenatal exposure to ethanol.
近期，人们对胎粪中葡萄糖醛酸乙酯（EtG）和硫酸乙酯（EtS）的检测进行了研究，以此作为胎粪脂肪酸乙酯（FAEEs）测量的替代方法，用于客观评估产前酒精暴露情况，且不依赖于母亲的自我报告。我们报告了第一项研究的结果，该研究旨在调查有或无宫内乙醇暴露的新生儿胎粪中EtG和EtS的浓度，宫内乙醇暴露情况通过问卷调查和胎粪FAEEs浓度来定义。通过液相色谱串联质谱法对从意大利雷焦艾米利亚的圣玛丽亚诺瓦医院（n = 80）和西班牙巴塞罗那的德尔马医院（n = 105）获取的胎粪样本中的FAEEs、EtG和EtS进行定量。在雷焦艾米利亚和巴塞罗那的样本中，无宫内乙醇暴露的新生儿胎粪中EtG和EtS的中位数分别在0.100至0.140 nmol/g和0.010至0.020 nmol/g之间。在产前乙醇暴露情况不确定的新生儿胎粪中，意大利队列中EtG的中位数为0.160 nmol/g，西班牙队列为0.250 nmol/g。两个队列中EtS的中位数浓度均为0.020。来自大量饮酒母亲的新生儿的5份胎粪样本中EtG和EtS的中位数分别为7.240 nmol/g和0.033 nmol/g。EtG的阳性临界值为2.0 nmol/g时，对区分真正的产前乙醇暴露具有最佳的敏感性和特异性（100%）。由于阳性样本数量较少，无法确定EtS的合适临界值。根据我们的结果，胎粪EtG可作为宫内酒精暴露的替代生物标志物。与7种FAEEs不同，EtG只是一个分子，可通过简单、低成本、易于操作的免疫测定法在所有新生儿的胎粪样本中进行筛查，该方法可常规应用于新生儿病房，用于产前乙醇暴露的早期诊断。
