Validity of 5-aminolevulinate dehydratase activity (5-ALAD) for the discrimination of alcoholics and nonalcoholics with chronic liver disease.

Alcohol consumption decreases erythrocyte 5-ALAD activity. Our aim was to assess the diagnostic value of 5-ALAD in discriminating alcoholics from nonalcoholics among patients with chronic liver disease and to find the combination of 5-ALAD and other clinical chemical tests that best differentiates these two groups. Measurements of erythrocyte 5-ALAD activity by fluorometry and 10 other biochemical tests were performed in 205 subjects with biopsy-verified liver damage (88 alcoholics, 117 nonalcoholics). The highest six Chi-square (chi 2) test values out of the 11 tests performed were diagnostically evaluated individually and in combinations of two to five tests, according to the number of positive findings. Our results show that 5-ALAD provides the highest efficiency as an individual test, while combinations of three tests where 5-ALAD is involved, especially the combination of 5-ALAD, gamma-glutamyltransferase and mean corpuscular volume of erythrocytes, seem to be the best test combinations for discriminating alcoholics from nonalcoholics among patients with chronic liver diseases.