CARBOHYDRATE-DEFICIENT TRANSFERRIN IN DETECTING RELAPSE IN ALCOHOL DEPENDENCE

Patients' reports together with findings at clinical examination and i nformation from an informant such as a relative were used to categoris e patients as relapsed or not relapsed during a 6 month period of out- patient treatment at an alcohol problems clinic. At each fortnightly v isit, blood was taken for measurement of serum gamma-glutamyl transfer ase and carbohydrate deficient transferrin (Pharmacia method). A total of 53 patients attended for at least one follow-up visit. Mean CDT di fferentiated relapsers from non-relapsers at seven of the 11 visits (P < 0.05), but at no visit did mean GGT differentiate. CDT tended to be come elevated after a relapse more quickly than GGT. However, whether using upper limit of normal (ULN), or defining a 'positive test' as > last test and either > 20% above lowest previous test or > ULN, specif icity (averaged over the 11 visits) was greater for GGT than CDT. Some of the false positive results for CDT were in patients who, shortly a fter having a positive test, relapsed, suggesting that a rising CDT ca n herald a relapse admitted by the patient. This could not be shown fo r false positive GGT results. Inspection of individual trajectories of alcohol consumption and blood test results shows that for some patien ts GGT is the more effective marker of relapse, whilst for others CDT operates better. (C) 1997 Elsevier Science Ireland Ltd.