CARBOHYDRATE-DEFICIENT TRANSFERRIN AS AN INDICATOR OF DRINKING STATUSDURING A TREATMENT OUTCOME STUDY

Biological markers of alcohol consumption have been used in both clini cal and research settings to aid in the identification of relapse drin king. Although carbohydrate-deficient transferrin (CDT) has been shown to be a sensitive and specific marker for the identification of heavy drinkers, little data are available as to its utility as a marker for relapse drinking during treatment, particularly in comparison with th e more widely used serum gamma-glutamyltransferase (GGT). CDT and GGT were measured in 35 male alcoholics before entering, and every 4 weeks during, a 12-week outpatient treatment trial combining pharmacotherap y and cognitive behavioral therapy. CDT and GGT were again measured 14 weeks after completion of treatment. During the 12-week treatment per iod, CDT showed a significant difference in those individuals who abst ained from drinking (30% decrease), compared with those who relapsed ( 10% increase). GGT decreased on average in all individuals, and the ch ange from treatment entry did not differ significantly across the drin king outcome groups. The change in CDT, but not GGT, from study entry to termination, significantly correlated with total alcohol consumptio n during the trial. At the 14-week posttreatment, follow-up evaluation CDT showed about a 60% elevation and GGT showed a 30% elevation, on a verage, from study entry values in those individuals who had relapse d rinking by self and/or collateral report. The change in both markers d iffered between those individuals who remained abstinent or relapsed d uring the poststudy period. In general, the change in CDT from pretrea tment levels seemed more sensitive to drinking status during treatment and follow-up than GGT. This indicates that CDT may be a more sensiti ve marker for evaluating drinking status during both clinical and rese arch treatment trials.