DIAGNOSTIC-TESTS FOR ALCOHOL-CONSUMPTION

A variety of laboratory tests are available to assist in the diagnosis of hazardous alcohol consumption and related disorders. Standard test s, such as serum gamma glutamyltransferase activity and erythrocyte me an cell volume, have limited sensitivity, particularly in detecting no n-dependent hazardous consumption. Most also have poor specificity in that results are affected by common diseases and medications. Over the past 10 years a number of new laboratory tests have emerged. One of t hese, carbohydrate deficient transferrin, has high sensitivity in dete cting persons with alcohol dependence, and shows promise for identific ation of non-dependent hazardous drinking: it is also highly specific. Others such as measurement of bound acetaldehyde, serum beta-hexosami nidase and the ratio of urinary serotonin metabolites offer promise in detecting recent heavy drinking. However, many issues remain unresolv ed. The newer markers have often been judged by contrasting their valu es in patients who are clearly alcohol dependent and abstainers or ver y light drinkers. It is now apparent that some are relatively insensit ive markers of hazardous consumption. Future research needs to examine the performance of these markers among subjects with a range of alcoh ol intakes to fully determine their value in assessing drinking histor y. In addition, assays which are capable of some degree of automation need to be developed for analysing large numbers of samples.