Should We Use Carbohydrate-deficient Transferrin instead of γ-Glutamyltransferase for Detecting Problem Drinkers? A Systematic Review and Metaanalysis

Abstract Background: Carbohydrate-deficient transferrin (CDT) has been used as a test for excessive alcohol consumption in research, clinical, and medico-legal settings, but there remain conflicting data on its accuracy, with sensitivities ranging from <20% to 100%. We examined evidence of its benefit over a conventional and less expensive test, γ-glutamyltransferase (GGT), and compared the accuracy of different CDT assay methods. Methods: We performed a systematic review using summary ROC analysis of 110 studies prior to June 1998 on the use of CDT in the detection of alcohol dependence or hazardous/harmful alcohol use. Results: We identified several potential sources of bias in studies. In studies examining CDT and GGT in the same subjects, subject characteristics were less likely to influence the comparison. In such paired studies, the original Pharmacia CDT assay was significantly more accurate than GGT, but the modified CDTect assay did not perform as well as the original and was not significantly better than GGT. The accuracy of the AXIS %CDT assay was statistically indistinguishable from modified CDTect. Several CDT assay methods appeared promising, in particular, liquid chromatography (chromatofocusing, HPLC, fast protein liquid chromatography) and isoelectric focusing, but there were insufficient paired studies from which to draw firm conclusions. Conclusions: In studies published before June 1998, the results obtained with commercially available CDT assays were not significantly better than GGT as markers of excessive alcohol use in paired studies. Further high-quality studies comparing CDTect (modified) and other CDT assays with GGT in the same subjects are needed.

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ACCURACY OF CARBOHYDRATE-DEFICIENT TRANSFERRIN IN THE DETECTION OF EXCESSIVE ALCOHOL CONSUMPTION: A SYSTEMATIC REVIEW

Alcohol and Alcoholism ◽

10.1093/alcalc/agh031 ◽

2004 ◽

Vol 39 (2) ◽

pp. 75-85 ◽

Cited By ~ 48

Author(s):

H. Koch

Keyword(s):

Systematic Review ◽

Alcohol Consumption ◽

Excessive Alcohol Consumption ◽

Carbohydrate Deficient Transferrin ◽

Excessive Alcohol

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Clinical Significance of Gamma-Glutamyltranspeptidase Combined with Carbohydrate-Deficient Transferrin for the Assessment of Excessive Alcohol Consumption in Patients with Alcoholic Cirrhosis

Medicines ◽

10.3390/medicines8070039 ◽

2021 ◽

Vol 8 (7) ◽

pp. 39

Author(s):

Akihiko Shibamoto ◽

Tadashi Namisaki ◽

Junya Suzuki ◽

Takahiro Kubo ◽

Satoshi Iwai ◽

...

Keyword(s):

Alcohol Consumption ◽

Biological Markers ◽

Prediction Accuracy ◽

Total Bilirubin ◽

Alcoholic Cirrhosis ◽

Serum Total Bilirubin ◽

Excessive Alcohol Consumption ◽

Significant Difference ◽

Carbohydrate Deficient Transferrin ◽

Excessive Alcohol

: Background: This study aimed to compare the diagnostic performance of carbohydrate-deficient transferrin (CDT) and gamma-glutamyltranspeptidase (γ-GTP) to assess the single and combined benefits of these biological markers for the detection of chronic excessive alcohol consumption in patients with alcoholic cirrhosis. Methods: Biological markers were determined in blood samples from patients with alcoholic cirrhosis (drinking group, n = 35; nondrinking group, n = 81). The prediction accuracy of %CDT alone, γ-GTP alone, and their combination for the detection of excessive alcohol consumption was determined in patients with alcoholic cirrhosis. Results: Serum total bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-GTP, and alkaline phosphatase levels and %CDT were significantly higher and serum albumin levels were significantly lower in the drinking group than in the nondrinking group. The combination of %CDT and γ-GTP compared with %CDT or γ-GTP alone showed a higher prediction accuracy. The combination of %CDT and γ-GTP exhibited a higher specificity than γ-GTP alone. However, in terms of sensitivity, no significant difference was found between single or combined markers. Conclusions: The combination of %CDT and γ-GTP is considered a useful biomarker of chronic excessive alcohol consumption in patients with alcoholic cirrhosis.

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LONGITUDINAL COMPARISON OF CARBOHYDRATE-DEFICIENT TRANSFERRIN AND GAMMA-GLUTAMYL TRANSFERASE: COMPLEMENTARY MARKERS OF EXCESSIVE ALCOHOL CONSUMPTION

Alcohol and Alcoholism ◽

10.1093/oxfordjournals.alcalc.a008106 ◽

1996 ◽

Vol 31 (1) ◽

pp. 101-107 ◽

Cited By ~ 65

Author(s):

A. HELANDER ◽

A. V. CARLSSON ◽

S. BORG

Keyword(s):

Alcohol Consumption ◽

Gamma Glutamyl Transferase ◽

Excessive Alcohol Consumption ◽

Gamma Glutamyl ◽

Carbohydrate Deficient Transferrin ◽

Excessive Alcohol ◽

Longitudinal Comparison ◽

Glutamyl Transferase

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Alcohol Use Disorders Identification Test-consumption Predicts the Risk of Excessive Alcohol Consumption After Liver Transplantation

Transplantation Proceedings ◽

10.1016/j.transproceed.2019.02.031 ◽

2019 ◽

Vol 51 (6) ◽

pp. 1934-1938

Author(s):

Takuya Yano ◽

Masahiro Ohira ◽

Ryoko Sakamoto ◽

Aiko Narisada ◽

Seiichi Shimizu ◽

...

Keyword(s):

Liver Transplantation ◽

Alcohol Consumption ◽

Alcohol Use ◽

Alcohol Use Disorders ◽

Excessive Alcohol Consumption ◽

Identification Test ◽

Excessive Alcohol

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Increased serum concentration of carbohydrate-deficient transferrin in patients with combined pancreas and kidney transplantation

Clinical Chemistry ◽

10.1093/clinchem/43.2.344 ◽

1997 ◽

Vol 43 (2) ◽

pp. 344-351 ◽

Cited By ~ 39

Author(s):

Torsten Arndt ◽

Rolf Hackler ◽

Thomas Müller ◽

Tilman O Kleine ◽

Axel M Gressner

Keyword(s):

Kidney Transplantation ◽

Alcohol Abuse ◽

Serum Concentration ◽

Normal Values ◽

Laboratory Diagnosis ◽

Kidney Transplants ◽

Excessive Alcohol Consumption ◽

Chronic Alcohol Abuse ◽

Carbohydrate Deficient Transferrin ◽

Excessive Alcohol

Abstract 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.

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Is carbohydrate-deficient transferrin in serum useful for detecting excessive alcohol consumption in hypertensive patients?

Clinical Chemistry ◽

10.1093/clinchem/40.11.2057 ◽

1994 ◽

Vol 40 (11) ◽

pp. 2057-2063 ◽

Cited By ~ 26

Author(s):

B Fagerberg ◽

S Agewall ◽

A Berglund ◽

M Wysocki ◽

P A Lundberg ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Intake ◽

High Alcohol ◽

Clinical Value ◽

Excessive Alcohol Consumption ◽

Cross Sectional ◽

Hypertensive Patients ◽

Carbohydrate Deficient Transferrin ◽

Excessive Alcohol ◽

High Alcohol Intake

Abstract The aim of this study was to examine the diagnostic usefulness of carbohydrate-deficient transferrin (CDT) in serum in a cross-sectional study of 439 treated hypertensive men. We related the results to alcohol intake by questionnaire and to biochemical and hemodynamic measurements known to reflect excessive alcohol consumption. The diagnostic sensitivity and the specificity for high alcohol intake (> or = 24 g/day of ethanol) were 44% and 87%, respectively. The group with reported high alcohol intake (n = 32) was characterized by hemodynamic and biochemical changes typical of alcohol abuse. The corresponding profile for the patients with increased serum CDT concentrations (n = 70) was different in several respects, indicating a considerable number of false-positive tests. We conclude that serum CDT determination had low sensitivity and specificity for excessive alcohol consumption in this group of hypertensive patients. The results illustrate the importance of evaluating new laboratory methods in unselected patient populations before drawing any conclusions about their clinical value.

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Cultural Differences in Tweeting about Drinking Across the US

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17041125 ◽

2020 ◽

Vol 17 (4) ◽

pp. 1125 ◽

Cited By ~ 3

Author(s):

Salvatore Giorgi ◽

David B. Yaden ◽

Johannes C. Eichstaedt ◽

Robert D. Ashford ◽

Anneke E.K. Buffone ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Drunk Driving ◽

Driving Under The Influence ◽

Behavioral Risk ◽

Excessive Alcohol Consumption ◽

Linguistic Markers ◽

Community Project ◽

The Us ◽

Excessive Alcohol

Excessive alcohol use in the US contributes to over 88,000 deaths per year and costs over $250 billion annually. While previous studies have shown that excessive alcohol use can be detected from general patterns of social media engagement, we characterized how drinking-specific language varies across regions and cultures in the US. From a database of 38 billion public tweets, we selected those mentioning “drunk”, found the words and phrases distinctive of drinking posts, and then clustered these into topics and sets of semantically related words. We identified geolocated “drunk” tweets and correlated their language with the prevalence of self-reported excessive alcohol consumption (Behavioral Risk Factor Surveillance System; BRFSS). We then identified linguistic markers associated with excessive drinking in different regions and cultural communities as identified by the American Community Project. “Drunk” tweet frequency (of the 3.3 million geolocated “drunk” tweets) correlated with excessive alcohol consumption at both the county and state levels (r = 0.26 and 0.45, respectively, p < 0.01). Topic analyses revealed that excessive alcohol consumption was most correlated with references to drinking with friends (r = 0.20), family (r = 0.15), and driving under the influence (r = 0.14). Using the American Community Project classification, we found a number of cultural markers of drinking: religious communities had a high frequency of anti-drunk driving tweets, Hispanic centers discussed family members drinking, and college towns discussed sexual behavior. This study shows that Twitter can be used to explore the specific sociocultural contexts in which excessive alcohol use occurs within particular regions and communities. These findings can inform more targeted public health messaging and help to better understand cultural determinants of substance abuse.

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Association of PIP4K2A Polymorphisms with Alcohol Use Disorder

Genes ◽

10.3390/genes12101642 ◽

2021 ◽

Vol 12 (10) ◽

pp. 1642

Author(s):

Olga Yu. Fedorenko ◽

Ekaterina V. Mikhalitskaya ◽

Valentina A. Toshchakova ◽

Anton J.M. Loonen ◽

Nikolay A. Bokhan ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Social Impact ◽

National Level ◽

Control Group ◽

Excessive Alcohol Consumption ◽

Lateral Habenula ◽

Healthy Men ◽

Excessive Alcohol ◽

First Time

Background: Alcohol use disorder (AUD) not only influences individuals and families but also has a lasting social impact on communities at the national level. Dopaminergic neurotransmission is involved in excessive alcohol consumption. Phosphatidylinositol-5-phosphate-4-kinase type 2 α (PIP4K2A) plays an important role in the regulation of ascending dopamine pathways. In this study; we determined possible associations between nine polymorphisms in PIP4K2A and AUD in Russian men. Methods: 279 Russian men with AUD were investigated. The control group consisted of 222 healthy men from the general Russian population. Genotyping of DNA samples for nine polymorphic variants of PIP4K2A was carried out by the Applied Biosystems™ QuantStudio™ 5 Real-Time PCR System with use of the TaqMan1 Validated SNP Genotyping Assay (Applied Biosystems; CШA). Results: Carriage of the PIP4K2A rs2230469*TT/T genotype/allele was a relative risk factor for developing AUD in men (p = 0.026 and p = 0.0084 accordingly). Moreover; men with AUD had a higher frequency of PIP4K2A rs746203*T allele (p = 0.023) compared to healthy men. Conclusions: For the first time; we demonstrated different PIP4K2A polymorphisms to be associated with AUD presumably due to dopamine system modulation resulting from regulation of the lateral habenula.

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Clinical evaluation of carbohydrate deficient transferrin as an indicator of alcohol dependence

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700012349 ◽

1994 ◽

Vol 11 (2) ◽

pp. 64-66 ◽

Cited By ~ 1

Author(s):

Prakash C Naik ◽

Tim Webb ◽

Phillip C McLean

Keyword(s):

Alcohol Use ◽

Alcohol Dependence ◽

Mean Corpuscular Volume ◽

Blood Donors ◽

False Positive Rate ◽

Corpuscular Volume ◽

Blood Samples ◽

Positive Rate ◽

Carbohydrate Deficient Transferrin ◽

Excessive Alcohol

AbstractObjective:To evaluate the clinical usefulness of carbohydrate deficient transferrin (CDT) as an indicator of alcohol dependence (DSM 111R).Method:Subjects included 18 patients with alcohol dependence and 36 controls (15 recovering alcohol dependents and 21 blood donors). Blood samples from the subjects were analysed for CDT, mean corpuscular volume (MCV) and γ Glutamyltransferase (γGT). These indicators were compared for their sensitivities and specificities to detect excessive alcohol use.Results:Amongst patients with alcohol dependence, CDT was detected in all (100%), γGT was raised in 8 (44%) and MCV was raised in 4 (22%). CDT was detected in five of the 36 controls.Conclusion:CDT was the most sensitive indicator of alcohol dependence. However, CDT showed a much higher false positive rate compared to previous studies. More research is required to elicit at what level of alcohol consumption CDT becomes positive. CDT could prove to be a clinically useful indicator of excessive alcohol use in future.

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