Suzuki Tatsuya, Eguchi Akiko, Shigefuku Ryuta, Nagao Saeko, Morikawa Masayuki, Sugimoto Kazushi, Iwasa Motoh, Takei Yoshiyuki
Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan.
Department of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki, Japan.
Hepatol Res. 2022 Jan;52(1):120-127. doi: 10.1111/hepr.13642. Epub 2021 Apr 13.
Clinical evaluations are generally used to verify the effectiveness of detoxification treatments for alcohol dependence, but new objective biomarkers are essential for accurate diagnosis. We aim to assess the accuracy of carbohydrate-deficient transferrin (%CDT) in a cohort of Japanese patients admitted to a psychiatric hospital specializing in alcohol dependence. In addition, we investigated the kinetics of %CDT during alcohol moderation or cessation.
The study cohort consisted of 126 alcohol-dependent patients. The levels of serum %CDT were assessed by the N Latex CDT direct immunonephelometric assay.
Alcohol consumption was significantly correlated with %CDT. The only independent predictive factor of alcohol consumption was %CDT, with glutamyltranspeptidase (GGT) and albumin-bilirubin score proving insufficient. The cut-off value of %CDT was 1.9% with high sensitivity and specificity in detecting alcohol abstinence beyond 30 days (68.6% sensitivity, 91.8% specificity) and excessive alcohol drinking (77.9% sensitivity, 77.1% specificity). The %CDT levels were significantly decreased at 30 days of abstinence when compared with baseline. Notably, %CDT values were significantly changed even in the light alcohol drinking cohort (p = 0.0009), whereas GGT levels were not significantly changed.
Our results indicate that %CDT is an accurate and specific biomarker of alcohol consumption and is useful in detecting alcohol abstinence even in a low alcohol intake patient cohort. These results suggest that %CDT could be a useful objective biomarker of chronic alcohol abuse during clinical treatment for alcoholism.
临床评估通常用于验证酒精依赖解毒治疗的有效性,但新的客观生物标志物对于准确诊断至关重要。我们旨在评估在一家专门治疗酒精依赖的精神病医院住院的日本患者队列中,缺糖转铁蛋白(%CDT)的准确性。此外,我们研究了在适度饮酒或戒酒期间%CDT的动力学变化。
研究队列由126名酒精依赖患者组成。血清%CDT水平通过N Latex CDT直接免疫比浊法进行评估。
饮酒量与%CDT显著相关。饮酒量的唯一独立预测因素是%CDT,而谷氨酰转肽酶(GGT)和白蛋白-胆红素评分被证明不够充分。%CDT的临界值为1.9%,在检测超过30天的戒酒情况(敏感性68.6%,特异性91.8%)和过度饮酒情况(敏感性77.9%,特异性77.1%)时具有高敏感性和特异性。与基线相比,戒酒30天时%CDT水平显著下降。值得注意的是,即使在轻度饮酒队列中,%CDT值也有显著变化(p = 0.0009),而GGT水平没有显著变化。
我们的结果表明,%CDT是饮酒量的一种准确且特异的生物标志物,即使在低酒精摄入量患者队列中也有助于检测戒酒情况。这些结果表明,%CDT可能是酒精中毒临床治疗期间慢性酒精滥用的一种有用的客观生物标志物。