Turkey Ministry of Justice, Council of Forensic Medicine, Chemistry Department, Adana 01120, Turkey.
Department of Administration of Justice, Texas Southern University, 3100 Cleburne Street, Houston, TX 77004, USA.
J Anal Toxicol. 2021 Sep 17;45(8):878-884. doi: 10.1093/jat/bkab061.
The aim of the study is to evaluate the contribution of ethanol metabolite detection in postmortem cases by showing the connection between the presence of ethanol metabolites, which are indicators of alcohol consumption, and the detection of potential postmortem ethanol formation in decomposed and diabetic cases. Determination of ethanol consumption before death is often one of the most important questions in death investigations. Postmortem ethanol formation or degradation products in the blood make it difficult to distinguish antemortem consumption or postmortem formation of ethanol and eventually may lead to misinterpretation. Decomposed bodies and diabetic cases are vulnerable to postmortem ethanol formation due to putrefaction, fermentation or other degradations. Ethyl glucuronide (EtG) and ethyl sulfate (EtS) are two metabolites of ethanol produced only in the antemortem time interval. In this study, EtG and EtS levels in urine and vitreous humor samples of 27 postmortem cases, including diabetic and degraded bodies were compared to ethanol results of their blood, urine and vitreous humor samples. EtG and EtS in urine and vitreous humor were analyzed by liquid chromatography-tandem mass spectrometry, and ethanol was assayed by routine headspace gas chromatography-flame ionization detector. These cases were devoid of other influences from forensically relevant drugs, so ethanol and/or glucose were among the only positive findings in these cases. The results of this pilot study indicate the postmortem ethanol concentrations do not correlate with the measured EtG and EtS values but are beneficial in rulings of accidental or natural deaths. This preliminary study gives additional data to help distinguish between antemortem ethanol intake and postmortem formation. EtG and EtS were well correlated positively with antemortem ethanol use instead of forming spontaneously in samples from decedents who are decomposing or have a history of diabetic hyperglycemia.
本研究旨在通过显示乙醇代谢物的存在与分解和糖尿病案例中潜在的死后乙醇形成之间的联系，评估死后案例中乙醇代谢物检测的贡献。在死亡调查中，确定死亡前的乙醇摄入量通常是最重要的问题之一。死后血液中乙醇的形成或降解产物使得区分生前消耗或死后形成的乙醇变得困难，并最终可能导致误解。由于腐败、发酵或其他降解，分解的尸体和糖尿病案例容易发生死后乙醇形成。乙基葡萄糖醛酸苷（EtG）和乙基硫酸盐（EtS）是仅在生前时间间隔内产生的两种乙醇代谢物。在这项研究中，比较了 27 例死后案例（包括糖尿病和分解的尸体）的尿液和玻璃体液样本中的 EtG 和 EtS 水平与其血液、尿液和玻璃体液样本中的乙醇结果。通过液相色谱-串联质谱法分析尿液和玻璃体液中的 EtG 和 EtS，并用常规顶空气相色谱-火焰离子化检测器测定乙醇。这些案例没有受到其他与法医学相关药物的影响，因此在这些案例中，乙醇和/或葡萄糖是唯一的阳性发现。这项初步研究的结果表明，死后乙醇浓度与测量的 EtG 和 EtS 值不相关，但有助于判断意外或自然死亡。这项初步研究提供了额外的数据，有助于区分生前摄入的乙醇和死后形成的乙醇。EtG 和 EtS 与生前乙醇使用呈正相关，而不是在分解或有糖尿病高血糖病史的死者样本中自发形成。
