Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Forensic Sci Int. 2020 Dec;317:110518. doi: 10.1016/j.forsciint.2020.110518. Epub 2020 Sep 19.
The impact of renal impairment and hemodialysis on ethyl glucuronide concentrations in hair (hEtG) is not well known. Here, hEtG levels were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in patients presenting to the transplant outpatient clinic and compared with the self-reported alcohol consumption in an anonymous validated questionnaire. Estimated daily alcohol intake (EDI) was calculated. A total of 94 patients with varying renal function (Glomerular filtration rate (GFR) > 60 mL/min: group 1 (n = 47); GFR 30-60 ml/min: group 2 (n = 29); GFR < 30 mL/min: group 3 (n = 18)) were included in the study. Fifteen of 18 (83.3%) patients in group 3 were on dialysis. Altogether, hEtG tested positive (> 5 pg/mg) in 25.5% (n = 24) of patients, while 36.2% (n = 34) and 14.9% (n = 14) of patients reported any or regular (> 10 g/d) alcohol consumption, respectively. The median hEtG concentration of positive samples was much higher in patients in group 3 with advanced renal dysfunction or on dialysis than in patients in group 1 or 2 (group 1, 2, 3 dialysis patients: 74, 52, 145 and 155 pg/mg, respectively), although they consumed on average much less alcohol per day (median EDI group 1, 2, 3, dialysis patients: 16, 17, 3 and 3 g/d, respectively). Also, there was a significant correlation between the hEtG concentration and EDI for patients in group 1 (ρ = 0.84; p = 0.01), but not for patients in group 2 (ρ = -0.35, p = 0.39) or 3 (ρ = 0.02, p = 0.96). Furthermore, the ability of hEtG to correctly identify abstainers as such was lower for patients with advanced renal dysfunction than for the remaining patients (specificity for group 1, 2, 3: 92%, 87%, 82%, respectively). So, monitoring hEtG concentration was less reliable in patients with advanced renal dysfunction or on hemodialysis and by far overestimated the amount of alcohol consumed.
肾功能不全和血液透析对毛发中乙基葡萄糖醛酸苷浓度（hEtG）的影响尚不清楚。在这里，通过液相色谱-串联质谱（LC-MS/MS）在移植门诊就诊的患者中测定 hEtG 水平，并与匿名验证问卷中自我报告的饮酒量进行比较。计算了估计的每日酒精摄入量（EDI）。共有 94 名肾功能不同的患者（肾小球滤过率（GFR）> 60ml/min：第 1 组（n = 47）；GFR 30-60ml/min：第 2 组（n = 29）；GFR < 30ml/min：第 3 组（n = 18））被纳入研究。第 3 组中有 18 名患者中的 15 名（83.3%）正在接受透析。总共，25.5%（n = 24）的患者 hEtG 检测呈阳性（> 5pg/mg），而 36.2%（n = 34）和 14.9%（n = 14）的患者报告有任何或定期（> 10g/d）饮酒。第 3 组肾功能严重障碍或透析患者的阳性样本中位 hEtG 浓度明显高于第 1 组或第 2 组（第 1 组、第 2 组、第 3 组透析患者：74、52、145 和 155pg/mg），尽管他们每天的平均饮酒量要少得多（第 1 组、第 2 组、第 3 组、透析患者的平均 EDI：16、17、3 和 3g/d）。此外，第 1 组患者的 hEtG 浓度与 EDI 之间存在显著相关性（ρ=0.84；p=0.01），但第 2 组（ρ=-0.35，p=0.39）或第 3 组（ρ=0.02，p=0.96）患者则没有。此外，对于肾功能不全患者，hEtG 正确识别禁欲者的能力低于其余患者（第 1 组、第 2 组、第 3 组的特异性分别为 92%、87%、82%）。因此，对于肾功能不全或血液透析的患者，hEtG 浓度监测的可靠性较差，并且远远高估了饮酒量。
