Wurst Friedrich Martin, Thon Natasha, Weinmann Wolfgang, Yegles Michel, Preuss Ulrich
Universitätsklinik für Psychiatrie und Psychotherapie II, Christian-Doppler-Klinik, Salzburger Landeskliniken, Paracelsus Medical University (PMU), Ignaz-Harrer-Straße 79, 5020, Salzburg, Österreich,
Wien Med Wochenschr. 2014 Jan;164(1-2):25-33. doi: 10.1007/s10354-013-0254-9. Epub 2013 Dec 10.
Alcohol and tobacco related disorders are the two leading and most expensive causes of illness in central Europe. In addition to self reports and questionnaires, biomarkers are of relevance in diagnosis and therapy of alcohol use disorders. Traditional biomarkers such as gamma glutamyl transpeptidase or mean corpuscular volume are indirect biomarkers and are subject to influence of age, gender and non alcohol related diseases, among others.Direct ethanol metabolites such as ethyl glucuronide (EtG), ethyl sulphate (EtS) and phosphatidylethanol (PEth) are direct metabolites of ethanol, that are positive after intake of ethyl alcohol. They represent useful diagnostic tools for identifying alcohol use even more accurately than traditional biomarkers. Each of these drinking indicators remains positive in serum and urine for a characteristic time spectrum after the cessation of ethanol intake--EtG and EtS in urine up to 7 days, EtG in hair for months after ethanol has left the body. Applications include clinical routine use, emergency room settings, proof of abstinence in alcohol rehabilitation programs, driving under influence offenders, workplace testing, assessment of alcohol intake in the context of liver transplantation and fetal alcohol syndrome.
酒精和烟草相关疾病是中欧地区两大主要且成本最高的致病因素。除自我报告和问卷调查外，生物标志物在酒精使用障碍的诊断和治疗中也具有重要意义。传统生物标志物，如γ-谷氨酰转肽酶或平均红细胞体积，是间接生物标志物，会受到年龄、性别以及非酒精相关疾病等因素的影响。直接乙醇代谢产物，如葡萄糖醛酸乙酯（EtG）、硫酸乙酯（EtS）和磷脂酰乙醇（PEth），是乙醇的直接代谢产物，在摄入乙醇后呈阳性。它们是比传统生物标志物更准确识别酒精使用情况的有用诊断工具。在停止摄入乙醇后的特定时间范围内，这些饮酒指标在血清和尿液中均保持阳性——尿液中的EtG和EtS可达7天，乙醇离开人体数月后，毛发中的EtG仍为阳性。其应用包括临床常规使用、急诊室环境、酒精康复项目中的戒酒证明、酒后驾车违法者、工作场所检测、肝移植和胎儿酒精综合征背景下的酒精摄入量评估。
