尿乙基葡糖苷酸可作为普通人群习惯性饮酒的生物标志物。
Urinary Ethyl Glucuronide Can Be Used as a Biomarker of Habitual Alcohol Consumption in the General Population.
机构信息
Julius Center for Health Sciences and Primary Care of the University Medical Center Utrecht, Utrecht, Netherlands.
Julius Clinical, Zeist, Netherlands.
出版信息
J Nutr. 2019 Dec 1;149(12):2199-2205. doi: 10.1093/jn/nxz146.
BACKGROUND
Alcohol consumption is a frequently studied risk factor for chronic diseases, but many studies are hampered by self-report of alcohol consumption. The urinary metabolite ethyl glucuronide (EtG), reflecting alcohol consumption during the past 72 h, is a promising objective marker, but population data are lacking.
OBJECTIVE
The objective of this study was to assess the reliability of EtG as a marker for habitual alcohol consumption compared with self-report and other biomarkers in the general population.
METHODS
Among 6211 participants in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) cohort, EtG concentrations were measured in 24-h urine samples. EtG was considered positive when concentrations were ≥100 ng/mL. Habitual alcohol consumption was self-reported by questionnaire (categories: no/almost never, 1-4 units per month, 2-7 units per week, 1-3 units per day or ≥4 units per day). Plasma HDL cholesterol concentration, erythrocyte mean corpuscular volume (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltransferase (GGT) were determined as indirect biomarkers of alcohol consumption. Sensitivity, specificity, positive and negative predictive value, and proportions of agreement between reported consumption and EtG were calculated. To test the agreement of EtG concentration and alcohol consumption in categories, linear regression analysis was performed. In addition, the association between EtG concentrations and indirect biomarkers was analyzed.
RESULTS
Mean age was 53.7 y, and 52.9% of participants men. Of the self-reported abstainers, 92.3% had an EtG concentration <100 ng/mL. Sensitivity was 66.3%, positive predictive value was 96.3%, and negative predictive value was 47.4%. The proportion of positive agreement was 78.5%, and the proportion of negative agreement was 62.7%. EtG concentrations were linearly associated with higher categories of alcohol consumption (P-trend < 0.001), adjusted for age, sex, and renal function. EtG was positively related to MCV, HDL cholesterol, and GGT but not to AST and ALT concentrations.
CONCLUSIONS
This study shows that urinary EtG is in reasonable agreement with self-reported alcohol consumption and therefore can be used as an objective marker of habitual alcohol consumption in the general population.
背景
饮酒是慢性疾病的一个常见研究风险因素，但许多研究受到饮酒自我报告的阻碍。尿液代谢物乙基葡萄糖醛酸（EtG）反映过去 72 小时内的饮酒情况，是一种有前途的客观标志物，但缺乏人群数据。
目的
本研究旨在评估 EtG 作为习惯性饮酒标志物的可靠性，将其与一般人群中的自我报告和其他生物标志物进行比较。
方法
在预防肾脏和血管终末期疾病（PREVEND）队列的 6211 名参与者中，测量了 24 小时尿液样本中的 EtG 浓度。当浓度≥100ng/mL 时，认为 EtG 呈阳性。习惯性饮酒通过问卷（类别：从不/几乎从不、每月 1-4 单位、每周 2-7 单位、每天 1-3 单位或每天≥4 单位）进行自我报告。血浆高密度脂蛋白胆固醇浓度、红细胞平均体积（MCV）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）和γ-谷氨酰转移酶（GGT）被确定为饮酒的间接生物标志物。计算报告的消耗量与 EtG 之间的灵敏度、特异性、阳性和阴性预测值以及一致性比例。为了测试 EtG 浓度和酒精消耗类别的一致性，进行了线性回归分析。此外，还分析了 EtG 浓度与间接生物标志物之间的关联。
结果
平均年龄为 53.7 岁，参与者中 52.9%为男性。在自我报告的不饮酒者中，92.3%的 EtG 浓度<100ng/mL。灵敏度为 66.3%，阳性预测值为 96.3%，阴性预测值为 47.4%。阳性一致性比例为 78.5%，阴性一致性比例为 62.7%。EtG 浓度与较高的饮酒类别呈线性相关（趋势 P<0.001），调整了年龄、性别和肾功能。EtG 与 MCV、高密度脂蛋白胆固醇和 GGT 呈正相关，但与 AST 和 ALT 浓度无关。
结论
本研究表明，尿液 EtG 与自我报告的饮酒量具有合理的一致性，因此可作为一般人群习惯性饮酒的客观标志物。
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