碳水化合物缺乏转铁蛋白 (CDT) 与酒精相关道路交通碰撞高度关联的新证据。对 929 名受伤驾驶员的回顾性研究。
New evidence of high association between carbohydrate deficient transferrin (CDT) and alcohol-related road traffic accidents. A retrospective study on 929 injured drivers.
机构信息
Unit of Forensic Medicine, Department of Diagnostics and Public Health, University of Verona, Piazzale L. A. Scuro 10, 37134 Verona, VR, Italy.
Unit of Forensic Medicine, Department of Diagnostics and Public Health, University of Verona, Piazzale L. A. Scuro 10, 37134 Verona, VR, Italy; Institute Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, 2-4 Bolshaya Pirogovskaya Street, 119991 Moscow, Russia.
出版信息
Forensic Sci Int. 2022 Nov;340:111438. doi: 10.1016/j.forsciint.2022.111438. Epub 2022 Aug 20.
BACKGROUND
It is well known that traffic injuries still represent one of the main causes of death and that high blood alcohol concentrations while driving significantly increase the occurrence of accidents. However, only limited literature on the correlation between chronic alcohol abuse and accident risk is available. The aim of the present study was to investigate the hypothesis of an association between elevated concentrations of carbohydrate deficient transferrin (CDT) and the occurrence of alcohol-related traffic accidents.
METHODS
The analytical determinations of BAC and CDT were performed following certified methods in HS-GC-FID and HPLC, respectively. For BAC, 0.50 g/L was used as cut-off, whereas 2.0% was used for CDT, according to the standardisation proposed by IFCC. A total of 929 drivers, tested for BAC at the time of hospital admission after a traffic accident, were classified into two groups: InjDr 1 (BAC ≤ 0.50 g/L) and InjDr 2 (BAC>0.50 g/L); all drivers were also tested for CDT.
RESULTS
InjDr 1 included 674 individuals, only 2.5% showing a CDT above the cutoff, whereas InjDr 2 group consisted of 255 subjects, 28.6% testing positive for CDT (Odds Ratio 15.5). When subdividing the InjDr group into increasing classes of CDT, a steady increase in the percentage of BAC-positive drivers was appreciated. Moreover, average BAC was found to parallel each class of CDT.
CONCLUSIONS
The reported data strongly support the use of CDT as a biomarker of increased risk of alcohol-related traffic accidents in the procedures of re-granting of the driving license upon confiscation for "drink driving".
背景
众所周知，交通伤害仍然是主要死亡原因之一，而血液中酒精浓度高时驾车会显著增加事故发生的可能性。然而，仅有有限的文献研究慢性酒精滥用与事故风险之间的相关性。本研究旨在检验血液中糖缺失转铁蛋白（CDT）浓度升高与酒精相关的交通事故发生之间存在关联的假设。
方法
采用经认证的方法，分别通过 HS-GC-FID 和 HPLC 进行 BAC 和 CDT 的分析测定。根据 IFCC 的标准化建议，对于 BAC，使用 0.50 g/L 作为截止值，而对于 CDT，使用 2.0%。对 929 名因交通事故在医院入院时进行 BAC 检测的驾驶员进行分类：受伤驾驶员 1（BAC ≤ 0.50 g/L）和受伤驾驶员 2（BAC>0.50 g/L）；所有驾驶员还进行了 CDT 检测。
结果
受伤驾驶员 1 组包括 674 人，仅有 2.5%的人 CDT 超过截止值，而受伤驾驶员 2 组包括 255 人，28.6%的人 CDT 阳性（比值比 15.5）。当将受伤驾驶员组细分为 CDT 递增组时，BAC 阳性驾驶员的百分比呈稳步上升。此外，平均 BAC 与每类 CDT 呈平行关系。
结论
报告的数据有力支持在吊销酒后驾车的驾驶执照后重新发放驾照的程序中，将 CDT 作为酒精相关交通事故风险增加的生物标志物的使用。
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