The online version of this article (doi:10.1186/1471-230X-14-97) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
KF conceived and coordinated the study, collected patient data and blood samples, contributed to analysis of data and wrote the manuscript. KI contributed to analysis of data and writing the manuscript. LH collected patient data and blood samples and contributed to the manuscript. BM, LJ, JU, CP performed the CDT analysis and contributed to data analysis and writing the manuscript. PO performed the statistical analysis and contributed to the manuscript. LF, JM and IS contributed to data analysis and writing the manuscript. EP conceived the study and contributed to analysis of data and writing the manuscript. All authors read and approved the final manuscript.
Carbohydrate deficient transferrin (CDT) is the most specific serum biomarker of heavy alcohol consumption, defined as ≥ 350–420 g alcohol/week. Despite introduction of a standardized reference measurement technique, widespread use of CDT remains limited due to low sensitivity. The aim of this study was to determine the factors that affect diagnostic sensitivity in patients with sustained heavy alcohol intake.
Patients with a self-reported history of sustained heavy alcohol consumption were recruited from the hepatology outpatient department or medical wards. Each patient was interviewed with a validated structured questionnaire of alcohol consumption and CDT analysis using the standardized reference measurement technique with high performance liquid chromatography was performed on serum collected at time of interview.
52 patients were recruited: 19 from the hepatology outpatient department and 33 from general medical wards. Median alcohol intake was 1013 (range 366–5880) g/week over the preceding two week period. 26 patients had a diagnostic CDT based on a threshold value of %CDT > 1.7 indicating heavy alcohol consumption, yielding a sensitivity of 50%. Overweight/obesity (defined as body mass index (BMI) ≥ 25 kg/m2 in Caucasians and ≥ 23.0 kg/m2 in Asians), female gender and presence of cirrhosis were independently associated with non-diagnostic %CDT (≤ 1.7).
CDT has limited sensitivity as a biomarker of heavy alcohol consumption. Caution should be applied when ordering and interpreting %CDT results, particularly in women, patients with cirrhosis and those with an elevated BMI.
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- Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers
Kevin J Fagan
Katharine M Irvine
Brett C McWhinney
Linda M Fletcher
Leigh U Horsfall
Carel J Pretorius
Jacobus PJ Ungerer
Elizabeth E Powell
- BioMed Central
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