NMS Labs, 200 Welsh Road, Horsham, PA 19044, United States.
NMS Labs, 200 Welsh Road, Horsham, PA 19044, United States.
Clin Biochem. 2020 Aug;82:85-89. doi: 10.1016/j.clinbiochem.2020.03.002. Epub 2020 Mar 4.
Laboratory tests vary widely in their utility and each test has unique advantages and disadvantages. For the detection of ethanol use and abuse, a variety of direct and indirect markers are available. Alcohol biomarkers provide objective measures for numerous areas of testing including clinical trials, alcohol abuse, postmortem assessment, and drugs of abuse screening. Because the utility of alcohol biomarkers vary depending on the context in which the results will be used, knowing the analogous distribution of results is of value. Herein we report distributions of ethanol in blood, phosphatidylethanol in blood, ethyl glucuronide in urine, and ethyl sulfate in urine for results reported in the last twelve months by our laboratory. Positivity rates were higher for directed analyses when compared to broad screening or panel tests with the highest overall positivity for ethyl glucuronide and ethyl sulfate. The distribution of results for ethyl glucuronide and ethyl sulfate were higher in clinical testing scenarios compared to forensic and a significant correlation between ethyl glucuronide and ethyl sulfate was found consistent with previous reports. Phosphatidylethanol was rarely ordered for forensic use while distributions between routine clinical and clinical trial use were similar. Approximately 21% of all phosphatidylethanol results were in the moderate to chronic alcohol use category. These results provide a summary of four commonly used direct markers for alcohol use with positivity rates and overall quantitative distributions. These data supply insights broken out by various disciplines where applicable providing a concise comparison of results for these markers.
实验室检测在其用途上有很大的差异，每种检测都有其独特的优点和缺点。对于乙醇使用和滥用的检测，有多种直接和间接的标志物可供选择。酒精生物标志物为包括临床试验、酒精滥用、死后评估和滥用药物筛查在内的许多测试领域提供了客观的衡量标准。由于酒精生物标志物的用途取决于将使用结果的上下文，因此了解结果的类似分布是有价值的。在此，我们报告了过去十二个月我们实验室报告的血液中乙醇、血液中磷脂酰乙醇、尿液中乙基葡萄糖醛酸苷和尿液中乙基硫酸盐的分布情况。与广泛的筛选或面板测试相比，定向分析的阳性率更高，乙基葡萄糖醛酸苷和乙基硫酸盐的总体阳性率最高。与法医相比，乙基葡萄糖醛酸苷和乙基硫酸盐的结果在临床检测情况下的分布更高，并且发现乙基葡萄糖醛酸苷和乙基硫酸盐之间存在显著相关性，这与之前的报告一致。磷脂酰乙醇很少用于法医用途，而常规临床和临床试验使用之间的分布相似。大约 21%的磷脂酰乙醇结果属于中度至慢性酒精使用类别。这些结果提供了四种常用的直接酒精使用标志物的阳性率和总体定量分布的概述。这些数据按各个学科进行了细分，适用于这些标志物的结果进行简明比较。
