These authors share the position of the first/last author; Institute of Legal Medicine, Department of Toxicology and Alcohology, Faculty of Medicine, University of Cologne, Germany; Institute of Legal Medicine, Department of Toxicology and Alcohology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany; Forensisch Toxikologisches Centrum München GmbH, Munich, Germany; Hepatobiliary Surgery and Transplantation Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Dtsch Arztebl Int. 2018 May 4;115(18):309-315. doi: 10.3238/arztebl.2018.0309.
Biomarkers of alcohol consumption are important not only in forensic contexts, e.g., in child custody proceedings or as documentation of alcohol abstinence after temporary confiscation of a driver's license. They are increasingly being used in clinical medicine as well for verification of abstinence or to rule out the harmful use of alcohol.
This review is based on pertinent publications that were retrieved by a selective literature search in PubMed concerning the direct and indirect alcohol markers discussed here, as well as on the authors' experience in laboratory analysis and clinical medicine.
Alongside the direct demonstration of ethanol, the available markers of alcohol consumption include the classic indirect markers carbohydrate-deficient transferrin (CDT), gamma-glutamyltransferase (GGT), and mean corpuscular volume (MCV) as well as direct alcohol markers such as ethyl glucuronide (EtG) and ethyl sulfate (EtS) in serum and urine and EtG and fatty acid ethyl esters (FAEE) in hair. Phosphatidylethanol (PEth) is a promising parameter that com - plements the existing spectrum of tests with high specificity (48-89%) and sensi - tivity (88-100%). In routine clinical practice, the demonstration of positive alcohol markers often leads patients to admit previously denied alcohol use. This makes it possible to motivate the patient to undergo treatment for alcoholism.
The available alcohol biomarkers vary in sensitivity and specificity with respect to the time period over which they indicate alcohol use and the minimum extent of alcohol use that they can detect. The appropriate marker or combination of markers should be chosen in each case according to the particular question that is to be answered by laboratory analysis.
生物标志物对于酒精摄入的检测不仅在法医领域非常重要，例如在儿童监护权诉讼中，或作为吊销驾驶执照后暂时禁酒的证明，在临床医学中也越来越多地被用于验证是否戒酒或排除酒精的滥用。
本文是基于在 PubMed 中进行了选择性文献检索后，检索到的有关本文讨论的直接和间接酒精标志物的相关文献，并结合作者在实验室分析和临床医学方面的经验而撰写的。
除了直接检测乙醇外，目前可用的酒精摄入标志物包括经典的间接标志物，如转铁蛋白缺乏（CDT）、γ-谷氨酰转移酶（GGT）和平均红细胞体积（MCV），以及血清和尿液中的直接酒精标志物，如乙基葡萄糖醛酸苷（EtG）和乙基硫酸盐（EtS），以及头发中的 EtG 和脂肪酸乙酯（FAEE）。磷脂酰乙醇（PEth）是一种很有前途的参数，它与现有的测试谱相结合，具有很高的特异性（48-89%）和灵敏度（88-100%）。在常规临床实践中，阳性酒精标志物的检测结果往往促使患者承认以前否认的饮酒行为，这使得患者有可能接受酒精中毒的治疗。
目前可用的酒精生物标志物在指示酒精使用的时间范围和检测到的最低酒精使用量方面的灵敏度和特异性存在差异。在每种情况下，都应根据实验室分析要回答的特定问题选择适当的标志物或标志物组合。
