Bell H, Tallaksen C, Sjåheim T, Weberg R, Raknerud N, Orjasaeter H, Try K, Haug E
Medical Department, Aker University Hospital, Oslo, Norway.
Alcohol Clin Exp Res. 1993 Apr;17(2):246-52. doi: 10.1111/j.1530-0277.1993.tb00757.x.
We measured serum levels of carbohydrate deficient transferrin (CDT) in 420 subjects: 100 healthy blood donors, 82 healthy employees, 70 abstaining patients with different chronic nonalcoholic liver disease, 16 abstaining patients with alcoholic fatty liver, 50 abstaining patients with alcoholic liver cirrhosis, 25 abusing patients with alcoholic fatty liver, 41 abusing patients with alcoholic liver cirrhosis, and 36 patients with alcohol dependence syndrome with a daily ethanol consumption of 173 +/- 120 g the last 4 weeks before blood was drawn. In controls the serum level of CDT was significantly higher in females compared with males (17.7 +/- 5.1 and 13.7 +/- 3.8 units/liter, respectively), and the upper normal limit was defined as 27 and 20 units/liter. Sixty-two of 102 (60.8%) abusing patients with alcoholic liver disease had increased levels of CDT compared with 1 of 66 abstaining (1.5%) patients with alcoholic liver disease, and 10 of 70 (14.3%) abstaining patients with nonalcoholic liver disease among them 3 with primary biliary cirrhosis and 2 with chronic autoimmune hepatitis. No correlation was found between serum CDT and gamma-glutamyltranspeptidase (GGT), AST, ALT, and mean red cell volume (MCV). The sensitivity and specificity for serum CDT was 61 and 92%, respectively, compared with 85 and 18% for GGT and 70 and 66% for MCV. No advantage was gained by using the CDT/transferrin ratio. Our study confirms that CDT is a specific marker for chronic alcohol abuse, except in few patients with other chronic liver diseases. Serum CDT seems to be a better indicator of abstention than GGT; AST and MCV in patients with alcoholic liver disease. However, in our hands CDT is not so sensitive for alcohol abuse in patients with liver disease as reported earlier in unselected alcoholics.
我们检测了420名受试者的血清中缺糖转铁蛋白（CDT）水平：100名健康献血者、82名健康员工、70名戒酒的不同慢性非酒精性肝病患者、16名戒酒的酒精性脂肪肝患者、50名戒酒的酒精性肝硬化患者、25名酗酒的酒精性脂肪肝患者、41名酗酒的酒精性肝硬化患者，以及36名酒精依赖综合征患者，这些患者在采血前的最后4周内每日乙醇摄入量为173±120克。在对照组中，女性血清CDT水平显著高于男性（分别为17.7±5.1和13.7±3.8单位/升），正常上限分别定义为27和20单位/升。102名酗酒的酒精性肝病患者中有62名（60.8%）CDT水平升高，而66名戒酒的酒精性肝病患者中只有1名（1.5%）升高；70名戒酒的非酒精性肝病患者中有10名（14.3%）升高，其中3名原发性胆汁性肝硬化患者和2名慢性自身免疫性肝炎患者。血清CDT与γ-谷氨酰转肽酶（GGT）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）和平均红细胞体积（MCV）之间未发现相关性。血清CDT的敏感性和特异性分别为61%和92%，而GGT分别为85%和18%，MCV分别为70%和66%。使用CDT/转铁蛋白比值并无优势。我们的研究证实，CDT是慢性酒精滥用的特异性标志物，但少数其他慢性肝病患者除外。血清CDT似乎比GGT、AST和MCV更能准确反映酒精性肝病患者是否戒酒。然而，在我们的研究中，CDT对肝病患者酒精滥用的敏感性不如之前报道的未经过筛选的酗酒者高。
