Transferin z zmanjšanim deležem ogljikovih hidratov (CDT) kot označevalec sindroma odvisnosti od alkohola
Carbohydrate-deficient transferrin (CDT) as a marker of alcohol dependency

slovenian

2008

volume 77, issue 3

Alcohol, Ethyl   Alcoholism   Biological Markers   Diagnosis   diagnostika   Roc Curve   Temperance   Transferrin

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Background Excessive alcohol consumption starts to change the structure of transferrin into the carbohydrate-deficient transferrin (CDT). CDT is the onlyspecific laboratory marker for alcohol dependency. However no one at all is sensitive enough. Method In our study we wanted to confirm the alcohol dependency by means of questionnaires and laboratory markers, particularly CDT. Results Investigated were 68 (92.6% males, 7.4% females) general practicehealthy patients and blood donors and 186 (89.2% males, 10.8% females)inpatient alcoholics. A blood sample was taken once from every healthysubject and three times from every alcoholic: on admission to hospital,after 12 days and again after 42 days. In alcoholics we found statistically significantly elevated CDT, glutamate dehidrogenaze (GLDH), aspartate-aminotransferaze (AST), alanine-aminotransferaze (ALT), gamaglutamyltransferaze (GGT) and mean corpuscular volume (MCV) and decreased urea values. CDT was the most reliable marker with high specificity (91.2%) and sensitivity (81.4%). The area under ROC-curve was exceptional with 99.9%. The kinetics of CDT, AST, ALT, GGT, MCV and creatinine normalization after 14 days were also statistically significant as well as kinetics of CDT, AST, GGT,MCV and creatinine normalization after 42 days. We estimated the course ofCDT value normalization as the most applicable. The most important diagnostic marker combination was composed by CDT, MCV and AST. GGT had lower importance as expected. Conclusions In our population CDT was the most specific marker of all, attaining high sensitivity. But it was not reliable enough as the sole marker or as the screening one for alcohol dependency. Its main applicability is in diagnostics of alcoholism, control of alcohol abstention and forensic cases but solely in combination with other laboratory markers of alcoholism.

16.09.2009