SUPERIORITY OF CARBOHYDRATE-DEFICIENT TRANSFERRIN TO GAMMA-GLUTAMYL-TRANSFERASE IN DETECTING RELAPSE IN ALCOHOLISM

Objective: The usefulness of carbohydrate-deficient transferrin is wid ely accepted in screening (male) population samples for heavy alcohol consumption, but its role in relapse detection is not convincingly est ablished. The authors therefore compared the diagnostic value of carbo hydrate-deficient transferrin with the commonly used gamma-glutamyltra nsferase in identifying relapsed alcoholics during outpatient aftercar e. Method: The patients were 101 male alcoholics who entered a 6-month rehabilitation program after hospital detoxification. Drinking status was assessed by means of self- and collateral reports obtained during regular contacts with the rehabilitation team; relapse was defined as consumption of any alcohol. Visits occurred weekly during month 1, bi weekly during month 2, and every 4 weeks during months 3-6. At every v isit a blood sample was taken for measurement of carbohydrate-deficien t transferrin and gamma-glutamyltransferase. Results: The proportion o f men who reported relapse was 25.6% per scheduled contact on average. Positive predictive values indicated that relapse was identified with a 76.2% probability by carbohydrate-deficient transferrin values abov e the upper normal limit, in contrast to a 32.9% chance with gamma-glu tamyltransferase. Carbohydrate-deficient transferrin was especially us eful in detecting early relapses during the initial rehabilitation pha se, when gamma-glutamyltransferase values had not normalized. Because of the longer half-life of gamma-glutamyltransferase, it had some valu e with a 4-week monitoring schedule in detecting new drinking episodes in alcoholic whose previous results had been normal. Conclusions: Car bohydrate-deficient transferrin proved to be superior to gamma-glutamy ltransferase in relapse detection in an outpatient care setting for al coholics.