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肾功能减退患者毛发中乙基葡萄糖醛酸苷水平:社会饮酒者误分类的可能性。

Levels of Hair Ethyl Glucuronide in Patients with Decreased Kidney Function: Possibility of Misclassification of Social Drinkers.

作者信息

Fosen Jan Toralf, Morini Luca, Sempio Cristina, Ganss Rudiger, Mørland Jørg, Høiseth Gudrun

机构信息

Division of Forensic Sciences, Norwegian Institute of Public Health, Oslo, Norway.

Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.

出版信息

Alcohol Clin Exp Res. 2016 Mar;40(3):451-6. doi: 10.1111/acer.12970. Epub 2016 Feb 8.

Abstract

BACKGROUND

The use of hair ethyl glucuronide (EtG) levels as a biomarker for chronic high intake of ethanol (EtOH) is increasing, and misclassification of alcohol consumption may have large implications for the patient. The aim of this study was to compare levels of hair EtG in patients with reduced kidney function to levels seen in a comparable control group and to investigate whether the hair EtG levels among kidney failure patients who are social drinkers may lead to a false-positive diagnosis of heavy drinking.

METHODS

A total of 41 patients with reduced kidney function and 42 healthy volunteers were included in the study. Both patients and the healthy volunteers reported moderate alcohol intake. The levels of EtG in hair (corrected for estimated daily intake of EtOH [EDI]) were compared between the 2 groups.

RESULTS

There was no significant difference between the groups regarding EDI. Despite this, there were significant higher levels of hair EtG (corrected for EDI) in the patient group compared to the control group (p < 0.001). Eight subjects (20%) in the patient group showed EtG levels in hair above 30 pg/mg, in contrast to no subjects among healthy volunteers (p = 0.002). In the patient group, there was significant correlation between levels of EtG in hair and both estimated glomerulus filtration rate and serum creatinine levels.

CONCLUSIONS

This study documents an increased risk of obtaining a false-positive diagnosis of heavy drinking among renal disease patients who are social drinkers. Interpretation of EtG levels in hair among patients with reduced kidney function must be performed with caution.

摘要

背景

使用毛发乙基葡萄糖醛酸苷(EtG)水平作为慢性高乙醇(EtOH)摄入量的生物标志物的情况日益增多,而饮酒情况的错误分类可能对患者产生重大影响。本研究的目的是比较肾功能减退患者的毛发EtG水平与可比对照组的水平,并调查社交饮酒的肾衰竭患者的毛发EtG水平是否可能导致酗酒的假阳性诊断。

方法

本研究共纳入41例肾功能减退患者和42名健康志愿者。患者和健康志愿者均报告有适度饮酒。比较两组毛发中EtG的水平(校正EtOH估计每日摄入量[EDI])。

结果

两组之间的EDI无显著差异。尽管如此,患者组毛发EtG(校正EDI)水平显著高于对照组(p < 0.001)。患者组中有8名受试者(20%)毛发中的EtG水平高于30 pg/mg,而健康志愿者中无此情况(p = 0.002)。在患者组中,毛发中EtG水平与估计肾小球滤过率和血清肌酐水平均存在显著相关性。

结论

本研究证明社交饮酒的肾病患者存在酗酒假阳性诊断风险增加的情况。对肾功能减退患者毛发中EtG水平的解读必须谨慎进行。

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