Arndt T, Hackler R, Müller T, Kleine T O, Gressner A M
Abteilung Klinische Chemie und Zentrallaboratorium, Marburg, Germany.
Clin Chem. 1997 Feb;43(2):344-51.
Serum concentration of carbohydrate-deficient transferrin (cCDT) is used for laboratory diagnosis and follow-up of chronic alcohol abuse. In analyzing by CDTect-RIA (Pharmacia) sera from outpatients with combined pancreas and kidney transplantation and no excessive alcohol consumption, we found above-normal values for cCDT and CDT/transferrin ratios (CDT/Tf) in more than half of the samples. Isoelectric focusing of these samples showed distinct bands of carbohydrate-deficient isotransferrins, supporting the abnormal findings from the CDTect assay. In contrast, diabetics and outpatients who had received only kidney transplants showed normal values for cCDT, CDT/Tf, and isotransferrin patterns. Increased serum Tf, sialidase-producing microorganisms, and immunosuppressive medication were eliminated as causes of these abnormal cCDT and CDT/Tf results. Successful pancreas transplantation leads to hyperinsulinemia and normoglycemia, in contrast to hypoinsulinemia and hyperglycemia in the patients who receive kidney transplants alone. These factors may have pathogenic importance for CDT increase, yielding results falsely interpreted as positive with respect to alcohol abuse in patients with combined pancreas and kidney transplantation.
血清缺糖转铁蛋白（cCDT）浓度用于慢性酒精滥用的实验室诊断及随访。在使用CDTect - RIA（Pharmacia公司）分析胰腺和肾脏联合移植的门诊患者且无过量饮酒情况的血清时，我们发现超过半数样本的cCDT及CDT/转铁蛋白比值（CDT/Tf）高于正常水平。对这些样本进行等电聚焦显示出缺糖异转铁蛋白的清晰条带，支持了CDTect检测的异常结果。相比之下，糖尿病患者及仅接受肾脏移植的门诊患者的cCDT、CDT/Tf及异转铁蛋白模式均显示正常。血清转铁蛋白升高、产唾液酸酶的微生物及免疫抑制药物被排除为这些异常cCDT和CDT/Tf结果的原因。与仅接受肾脏移植患者的低胰岛素血症和高血糖症相反，成功的胰腺移植导致高胰岛素血症和血糖正常。这些因素可能对CDT升高具有致病重要性，导致在胰腺和肾脏联合移植患者中，其结果被错误地解释为酒精滥用阳性。
