Acetaldehyde-hemoglobin adducts: an unreliable marker of alcohol abuse.

Acetaldehyde reacts with hemoglobin in vitro to produce acetaldehyde-hemoglobin adducts, but we could not detect these in the blood of 20 alcoholics, either by cation-exchange chromatography or agar gel electrophoresis. Thus, contrary to previous reports, this test is not a reliable marker of alcohol abuse. Nuclear magnetic resonance and gas chromatographic-mass spectroscopic analysis of acetaldehyde revealed the presence of aldehydic impurities. Formation of adducts in vitro may thus result from the reaction of hemoglobin with these impurities or with acetaldehyde condensation products (aldol) or from acetaldehyde condensation/dehydration products (crotonaldehyde).