SERUM CARBOHYDRATE-DEFICIENT TRANSFERRIN AS A MARKER OF ALCOHOL-CONSUMPTION IN PATIENTS WITH CHRONIC LIVER-DISEASES

We measured serum levels of carbohydrate deficient transferrin (CDT) i n 420 subjects: 100 healthy blood donors, 82 healthy employees, 70 abs taining patients with different chronic nonalcoholic liver disease, 16 abstaining patients with alcoholic fatty liver, 50 abstaining patient s with alcoholic liver cirrhosis, 25 abusing patients with alcoholic f atty liver, 41 abusing patients with alcoholic liver cirrhosis, and 36 patients with alcohol dependence syndrome with a daily ethanol consum ption of 173 +/- 120 g the last 4 weeks before blood was drawn. In con trols the serum level of CDT was significantly higher in females compa red with males (17.7 +/- 5.1 and 13.7 +/- 3.8 units/liter, respectivel y), and the upper normal limit was defined as 27 and 20 units/liter. S ixty-two of 102 (60.8%) abusing patients with alcoholic liver disease had increased levels of CDT compared with 1 of 66 abstaining (1.5%) pa tients with alcoholic liver disease, and 10 of 70 (14.3%) abstaining p atients with nonalcoholic liver disease among them 3 with primary bili ary cirrhosis and 2 with chronic autoimmune hepatitis. No correlation was found between serum CDT and gamma-glutamyltranspeptidase (GGT), AS T, ALT, and mean red cell volume (MCV). The sensitivity and specificit y for serum CDT was 61 and 92%, respectively, compared with 85 and 18% for GGT and 70 and 66% for MCV. No advantage was gained by using the CDT/transferrin ratio. Our study confirms that CDT is a specific marke r for chronic alcohol abuse, except in few patients with other chronic liver diseases. Serum CDT seems to be a better indicator of abstentio n than GGT; AST and MCV in patients with alcoholic liver disease. Howe ver, in our hands CDT is not so sensitive for alcohol abuse in patient s with liver disease as reported earlier in unselected alcoholics.