Helander A, Carlsson A V, Borg S
Karolinska Institute, Department of Clinical Neuroscience, Psychiatry Section at St Görans Hospital, Stockholm, Sweden.
Alcohol Alcohol. 1996 Jan;31(1):101-7. doi: 10.1093/oxfordjournals.alcalc.a008106.
The utility of carbohydrate-deficient transferrin (CDT) and gamma-glutamyl transferase (GGT) as biochemical markers of excessive alcohol consumption was studied in alcohol-dependent subjects. Serum samples were collected once weekly from 10 male out-patients undergoing a 6-month alcohol treatment programme. Frequency of relapse into drinking (defined as any intake of alcoholic beverage) was assessed by self-reports during patient interviews three times per week and by daily determination of the 5-hydroxytryptophol level in urine. A marked decrease in mean CDT and GGT values was observed during the initial month. Only one patient remained totally abstinent throughout the observation period, while four had sporadic relapses (2-5 days with alcohol consumption). Both CDT and GGT remained below the respective reference limits in those patients. The other five patients drank more frequently (range 22-57 days) and increased their mean levels of CDT and GGT after the initial decrease. As determined from the values at admission and during the course of the study, CDT appeared to be the most sensitive marker in six out of the 10 patients. In one patient, both markers were affected in a parallel way, whereas two of those with frequent relapses responded to alcohol consumption with a marked increase in GGT, but with no or only a slight increase in CDT. One patient did not show any abnormal CDT or GGT values. In 54 female and 60 male serum samples collected at random from patients during admission at an alcohol detoxification unit, 35% and 58% of the CDT values exceeded the reference limits for females and males, respectively. For GGT, 59% of the female and 67% of the male values were above cut-off. Carbohydrate-deficient transferrin and GGT were not significantly correlated. Taken together, the present results indicate that measurement of both CDT and GGT will increase the possibility of identifying excessive alcohol consumption. By following changes in CDT and GGT values during a period of alcohol withdrawal, the most sensitive individual marker can be determined. This in turn allows for improved detection of relapse into heavy drinking during long-term monitoring of out-patients.
在酒精依赖患者中，研究了缺糖转铁蛋白（CDT）和γ-谷氨酰转移酶（GGT）作为过度饮酒生化标志物的效用。从10名正在接受为期6个月酒精治疗项目的男性门诊患者中，每周采集一次血清样本。通过患者每周三次访谈中的自我报告以及每日测定尿中5-羟色醇水平，评估复发饮酒的频率（定义为任何酒精饮料摄入量）。在最初的一个月内，观察到平均CDT和GGT值显著下降。在整个观察期内，只有一名患者完全戒酒，而四名患者有零星复发（饮酒2 - 5天）。在这些患者中，CDT和GGT均保持在各自的参考限值以下。另外五名患者饮酒更频繁（范围为22 - 57天），在最初下降后，他们的CDT和GGT平均水平有所上升。根据入院时和研究过程中的值确定，在10名患者中的6名中，CDT似乎是最敏感的标志物。在一名患者中，两种标志物以平行方式受到影响，而在那些频繁复发的患者中，有两名患者饮酒后GGT显著升高，但CDT没有升高或仅略有升高。一名患者未显示任何异常的CDT或GGT值。在一家酒精解毒单位入院时随机采集的54份女性和60份男性血清样本中，CDT值分别有35%和58%超过了女性和男性的参考限值。对于GGT，59%的女性值和67%的男性值高于临界值。缺糖转铁蛋白和GGT无显著相关性。综上所述，目前的结果表明，同时测量CDT和GGT将增加识别过度饮酒的可能性。通过跟踪戒酒期间CDT和GGT值的变化，可以确定最敏感的个体标志物。这反过来又有助于在门诊患者的长期监测中更好地检测出重度饮酒的复发情况。
