Phosphatidylethanol, ethyl glucuronide and ethanol in blood as complementary biomarkers for alcohol consumption

Background:Ethyl alcohol is the most popular legal drug, but its excessive consumption causes social problems. Despite many public campaigns against alcohol use, car accidents, instances of aggressive behaviour, sexual assaults and deterioration in labor productivity caused by inebriated people is still commonplace. Fast and easy diagnosis of alcohol consumption is required in order to introduce proper and effective therapy, and is crucial in forensic toxicology analysis. The easiest method to prove alcohol intake is determination of ethanol in body fluids or in breath. However, since ethanol is rapidly metabolized in the human organism, only recent consumption can be detected using this method. Because of that, the determination of alcohol biomarkers was introduced for monitoring alcohol consumption over a wider range of time.Objective:The objective of this study was to review published studies focusing on the sample preparation methods and chromatographic or biochemical techniques for the determination of alcohol biomarkers in whole blood, plasma, serum and urine.Methods:An electronic literature search was performed to discuss possibilities and limitations of application of alcohol biomarkers in toxicological analysis.Results:Authors described the markers of alcohol consumption such as: ethanol, its nonoxidative metabolites (ethyl glucuronide, ethyl sulfate, phosphatidylethanol, ethyl phosphate, fatty acid ethyl esters) and oxidative metabolites (acetaldehyde and acetaldehyde adducts). We also discussed issues concerning the detection window of these biomarkers, and possibilities and limitations of their use in routine analytical toxicology for monitoring alcohol consumption or sobriety during alcohol therapy.

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Development and validation of a method for the simultaneous analysis of fatty acid ethyl esters, ethyl sulfate and ethyl glucuronide in neonatal meconium: application in two cases of alcohol consumption during pregnancy

Analytical and Bioanalytical Chemistry ◽

10.1007/s00216-021-03248-0 ◽

2021 ◽

Vol 413 (11) ◽

pp. 3093-3105

Author(s):

Mateusz Kacper Woźniak ◽

Laura Banaszkiewicz ◽

Justyna Aszyk ◽

Marek Wiergowski ◽

Iwona Jańczewska ◽

...

Keyword(s):

Mass Spectrometry ◽

Fatty Acid ◽

Alcohol Consumption ◽

Solid Phase ◽

Fatty Acid Ethyl Esters ◽

Ethyl Esters ◽

Ethyl Glucuronide ◽

Published Data ◽

Ethyl Sulfate ◽

Analytical Approaches

AbstractAlcohol consumption during pregnancy constitutes one of the leading preventable causes of birth defects and neurodevelopmental disorders in the exposed children. Fatty acid ethyl esters (FAEEs), ethyl glucuronide (EtG) and ethyl sulfate (EtS) have been studied as potential biomarkers of alcohol consumption. However, most analytical approaches proposed for their analysis in meconium samples consist of separated extraction procedures requiring the use of two meconium aliquots, which is costly in terms of both time and materials. Therefore, the aim of this study was to develop and validate a method for the simultaneous extraction of 9 FAEEs, EtG and EtS from one meconium aliquot. The sample was homogenized using methanol, and then FAEEs were extracted with hexane while EtG and EtS were isolated using acetonitrile. Then, extracts were applied to solid-phase extraction columns and analysed by gas chromatography mass spectrometry (FAEEs) and liquid chromatography tandem mass spectrometry (EtG and EtS). Calibration curves were linear with r values greater than 0.99. The LODs ranged from 0.8 to 7.5 ng/g for FAEEs and were 0.2 ng/g and 0.8 ng/g for EtS and EtG, respectively. LOQs ranged from 5 to 25 ng/g for FAEEs and were 1 ng/g and 2.5 ng/g for EtS and EtG, respectively. Accuracies and precisions were between 93.8 and 107% and between 3.5 and 9.7%, respectively. The recovery values ranged from 89.1 to 109%. The method proved to be sensitive, specific, simple and fast and allowed for the reduction of the amount of organic solvent used for extraction compared to other published data while higher recoveries were obtained. The method was used for analysis of meconium samples in two cases of mothers who were consuming alcohol during pregnancy.

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Urinary ethyl glucuronide testing detects alcohol consumption in alcoholic liver disease patients awaiting liver transplantation

Liver Transplantation ◽

10.1002/lt.21163 ◽

2007 ◽

Vol 13 (5) ◽

pp. 757-761 ◽

Cited By ~ 53

Author(s):

Yesim Erim ◽

Michael Böttcher ◽

Uta Dahmen ◽

Olof Beck ◽

Christoph E. Broelsch ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Disease ◽

Alcohol Consumption ◽

Alcoholic Liver Disease ◽

Ethyl Glucuronide

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AWARE: A Wearable Awareness with Real-time Exposure, for monitoring alcohol consumption impact through ethyl glucuronide detection

Alcohol ◽

10.1016/j.alcohol.2018.10.006 ◽

2019 ◽

Vol 81 ◽

pp. 93-99 ◽

Cited By ~ 1

Author(s):

Kai-Chun Lin ◽

David Kinnamon ◽

Devangsingh Sankhala ◽

Sriram Muthukumar ◽

Shalini Prasad

Keyword(s):

Alcohol Consumption ◽

Real Time ◽

Ethyl Glucuronide ◽

Time Exposure

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Urinary Ethyl Glucuronide as Measure of Alcohol Consumption and Risk of Cardiovascular Disease: A Population‐Based Cohort Study

Journal of the American Heart Association ◽

10.1161/jaha.119.014324 ◽

2020 ◽

Vol 9 (7) ◽

Cited By ~ 1

Author(s):

Inge A. T. van de Luitgaarden ◽

Ilse C. Schrieks ◽

Lyanne M. Kieneker ◽

Daan J. Touw ◽

Adriana J. van Ballegooijen ◽

...

Keyword(s):

Cardiovascular Disease ◽

Alcohol Consumption ◽

Cox Proportional Hazards ◽

Hazard Ratio ◽

Self Report ◽

Ethyl Glucuronide ◽

Categorical Variables ◽

Study Cohort ◽

Cvd Risk ◽

All Cause Mortality

Background Moderate alcohol consumption has been associated with a lower risk of cardiovascular disease (CVD) and all‐cause mortality compared with heavy drinkers and abstainers. To date, studies have relied on self‐reported consumption, which may be prone to misclassification. Urinary ethyl glucuronide (EtG) is an alcohol metabolite and validated biomarker for recent alcohol consumption. We aimed to examine and compare the associations of self‐reported alcohol consumption and EtG with CVD and all‐cause mortality. Methods and Results In 5676 participants of the PREVEND (Prevention of Renal and Vascular End‐Stage Disease) study cohort, EtG was measured in 24‐hour urine samples and alcohol consumption questionnaires were administered. Participants were followed up for occurrence of first CVD and all‐cause mortality. Cox proportional hazards regression models, adjusted for age, sex, and CVD risk factors, were fitted for self‐reported consumption, divided into 5 categories: abstention, 1 to 4 units/month (reference), 2 to 7 units/week, 1 to 3 units/day, and ≥4 units/day. Similar models were fitted for EtG, analyzed as both continuous and categorical variables. Follow‐up times differed for CVD (8 years; 385 CVD events) and all‐cause mortality (14 years; 724 deaths). For both self‐reported alcohol consumption and EtG, nonsignificant trends were found toward J‐shaped associations between alcohol consumption and CVD, with higher risk in the lowest (hazard ratio for abstention versus 1–4 units/month, 1.42; 95% CI, 1.02–1.98) and highest drinking categories (hazard ratio for ≥4 units/day versus 1–4 units/month, 1.11; 95% CI, 0.68–1.84). Neither self‐report nor EtG was associated with all‐cause mortality. Conclusions Comparable associations with CVD events and all‐cause mortality were found for self‐report and EtG. This argues for the validity of self‐reported alcohol consumption in epidemiologic research.

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