Department of Epidemiology, University of Florida, Gainesville, Florida.
School of Medicine, University of California, San Francisco, San Francisco, California.
Alcohol Clin Exp Res. 2018 Jan;42(1):128-134. doi: 10.1111/acer.13540. Epub 2017 Dec 5.
Biomarkers can play a key role in supplementing self-report information in alcohol research. In this study, we examined phosphatidylethanol (PEth) in comparison with self-reported alcohol use over time in a randomized controlled trial.
Participants were women living with HIV enrolled in a randomized placebo-controlled trial of naltrexone for reducing hazardous drinking. Drinking behavior was measured using Timeline Followback (TLFB), and PEth as a biomarker using dried blood spots. Data collected at baseline, and months 2 and 7 were analyzed. In addition to calculated Spearman's correlations, mixed-effects modeling was used to evaluate the changes in self-reported drinking and PEth, respectively, adjusting for body mass index (BMI).
A total of 194 participants (83% black, mean age 48) were included in the analysis. PEth levels were significantly correlated with self-reported drinking via TLFB, Spearman's r = 0.21 at baseline, r = 0.29 at 2 months, and r = 0.28 at 7 months, respectively. No demographic or health factors, except for BMI, was associated with whether self-report was consistent with PEth. Mixed-effects model indicated that self-reported drinking showed significantly greater reductions in the naltrexone treatment group than the placebo group at the 2- and 7-month visits, whereas PEth measure only showed this difference at the 7-month follow-up.
The magnitude of the correlation between PEth and self-reported alcohol consumption was small. Caution is needed when using either self-report or PEth as a sole outcome measure for alcohol behavior changes in clinical trials.
生物标志物在补充酒精研究中的自我报告信息方面可以发挥关键作用。在这项研究中，我们在一项随机对照试验中比较了磷酰乙醇（PEth）与随时间推移的自我报告饮酒情况。
参与者为参加纳曲酮减少危险饮酒随机安慰剂对照试验的艾滋病毒感染者。使用时间线回溯（TLFB）测量饮酒行为，使用干血斑测量 PEth 作为生物标志物。分析了基线、第 2 个月和第 7 个月收集的数据。除了计算 Spearman 相关系数外，还使用混合效应模型分别评估自我报告饮酒和 PEth 的变化，同时调整体重指数（BMI）。
共有 194 名参与者（83%为黑人，平均年龄 48 岁）纳入分析。PEth 水平与通过 TLFB 报告的饮酒量呈显著相关，基线时 Spearman r 为 0.21，第 2 个月时 r 为 0.29，第 7 个月时 r 为 0.28。除 BMI 外，没有任何人口统计学或健康因素与自我报告与 PEth 是否一致有关。混合效应模型表明，在第 2 个月和第 7 个月的随访中，纳曲酮治疗组的自我报告饮酒量显著减少，而安慰剂组则没有，而 PEth 测量仅在第 7 个月的随访中显示出这种差异。
PEth 与自我报告的酒精摄入量之间的相关程度很小。在临床试验中，无论是使用自我报告还是 PEth 作为酒精行为变化的单一结果测量，都需要谨慎。
