Iwasa Motoh, Eguchi Akiko, Suzuki Tatsuya, Shigefuku Ryuta, Nagao Saeko, Morikawa Masayuki, Sugimoto Kazushi, Nakagawa Hayato
Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Mie, Japan.
Department of Gastroenterology, Murase Hospital, Mie, Japan.
JMA J. 2025 Jul 15;8(3):885-892. doi: 10.31662/jmaj.2025-0109. Epub 2025 Jun 13.
Alcohol dependence is linked to various issues, including not only alcohol-associated/related liver disease (ALD) but also social isolation, making the assessment of alcohol consumption crucial for patient management. Meanwhile, a multisociety consensus group has introduced a new classification for steatotic liver disease (SLD), including ALD, based on alcohol consumption. The evaluation of alcohol intake uses tools such as the Alcohol Use Disorders Identification Test and Lifetime Drinking History; however, these tools may lack accuracy in clinical settings. Carbohydrate-deficient transferrin (%CDT) is a quantitative and objective biomarker for alcohol consumption. Therefore, we aimed to determine %CDT values that stratify alcohol consumption.
This cross-sectional analysis included 285 serum samples from patients receiving inpatient or outpatient treatment at two specialized alcohol dependency medical centers. Participants were alcohol-dependent patients who underwent detailed interviews regarding alcohol consumption, biochemical blood tests, and %CDT testing.
Among the 285 samples, 32.6%, 19.6%, and 47.7% corresponded to alcohol consumption levels of ≤30 g/day for men/≤20 g/day for women, 30-60 g/day for men/20-50 g/day for women, and ≥60 g/day for men/≥50 g/day for women, respectively. %CDT values increased with increasing alcohol consumption (p < 0.05-0.0001). The cutoff values reflecting alcohol consumption of 30 g/day for men/20 g/day for women and 60g/day for men/50g/day for women were 1.67% and 2.48%, respectively. Gamma-glutamyl transferase (GGT) and GGT-CDT were able to distinguish between alcohol consumption above and below 60 g/day for men and 50 g/day for women (p < 0.0001). However, they had difficulty distinguishing between alcohol consumption above and below 30 g/day for men and 20 g/day for women.
%CDT, in conjunction with detailed interviews, can be used to detect alcohol consumption, particularly to distinguish whether it exceeds 30 g/day in men and 20 g/day in women. Applying this to the clinical management of patients with alcohol dependence accompanied by ALD or SLD may contribute to improving the quality of care.
酒精依赖与多种问题相关，不仅包括酒精性肝病（ALD），还包括社会隔离，因此评估酒精摄入量对患者管理至关重要。同时，一个多学会共识小组引入了一种基于酒精摄入量的脂肪性肝病（SLD）新分类，其中包括ALD。酒精摄入量的评估使用诸如酒精使用障碍识别测试和终生饮酒史等工具；然而，这些工具在临床环境中可能缺乏准确性。缺糖转铁蛋白（%CDT）是酒精摄入量的一种定量且客观的生物标志物。因此，我们旨在确定能够对酒精摄入量进行分层的%CDT值。
这项横断面分析纳入了来自两个专门的酒精依赖医疗中心接受住院或门诊治疗的患者的285份血清样本。参与者为酒精依赖患者，他们接受了关于酒精摄入量的详细访谈、血液生化检测以及%CDT检测。
在这285份样本中，分别有32.6%、19.6%和47.7%对应男性酒精摄入量≤30克/天/女性≤20克/天、男性30 - 60克/天/女性20 - 50克/天以及男性≥60克/天/女性≥50克/天的水平。%CDT值随着酒精摄入量的增加而升高（p < 0.05 - 0.0001）。反映男性酒精摄入量30克/天/女性20克/天以及男性60克/天/女性50克/天的截断值分别为1.67%和2.48%。γ-谷氨酰转移酶（GGT）和GGT - CDT能够区分男性酒精摄入量高于和低于60克/天以及女性高于和低于50克/天的情况（p < 0.0001）。然而，它们难以区分男性酒精摄入量高于和低于30克/天以及女性高于和低于20克/天的情况。
%CDT结合详细访谈可用于检测酒精摄入量，特别是区分男性是否超过30克/天以及女性是否超过20克/天。将其应用于伴有ALD或SLD的酒精依赖患者的临床管理中可能有助于提高护理质量。
