CARBOHYDRATE-DEFICIENT TRANSFERRIN AS AN ALCOHOL MARKER AMONG FEMALE HEAVY DRINKERS - A POPULATION-BASED STUDY

Carbohydrate-deficient transferrin (CDT) has previously been reported to be an excellent marker of male alcoholics. Less is known of its eff iciency among women and especially of early-phase alcohol abuse in non selected populations. The present population-based study examined the diagnostic value of CDT among consecutive women, including 13 teetotal lers, 135 social drinkers (mean alcohol consumption 45 +/- 34 g/week), and 57 nonalcoholic heavy drinkers (197 +/- 97 g/week). Sixty-two wom en with a well-documented history of chronic alcoholism (942 +/- 191 g /week) were also studied, as well as 36 pregnant women used as a refer ence group. Two weeks of abstinence among 11 alcoholics was followed. The CDT (containing part of isotransferrin with pl = 5.7, 5.8, and 5.9 ) was separated by anion exchange chromatography and assayed by radioi mmunoassay. In the whole material, CDT correlated significantly with a lcohol consumption (r = 0.43, p < 0.001) but not with conventional mar kers (gamma-glutamyltransferase, AST, ALT, and mean corpuscular volume ). The CDT values of alcoholics (34 +/- 20 units/liter) were significa ntly (p < 0.001) higher than those of teetotallers (19 +/- 6 units/lit er), social drinkers (20 +/- 6 units/liter), or pregnant women (16 +/- 3 units/liter). Heavy drinkers also had higher values (25 +/- 13 unit s/liter), but the difference did not reach statistic significance. The specificity of CDT was on the level of conventional markers when the cut-off value was increased from 26 to 29 units/liter. At a specificit y of 95%, CDT found 19% of the heavy drinkers and 52% of the alcoholic s; the best traditional marker, AST, with a specificity of 97%, found 7% and 56%, respectively. CDT was useful for follow-up of alcohol with drawal when its initial value was elevated. In general, CDT (as well a s conventional laboratory markers) does not seem to be sensitive enoug h in the detection of alcohol abuse in the female population. This is especially clear among nonalcoholic female heavy drinkers. CDT gives, however, additional information about alcohol abuse, and it may be rec ommended for parallel use with conventional markers in clinical use.