Smoking, obesity, and hypertension alter the dose-response curve and test sensitivity of carbohydrate-deficient transferrin as a marker of alcohol intake

Serum carbohydrate-deficient transferrin (CDT) is a specific and comparativ ely sensitive marker of excessive alcohol use; however, reports of its sens itivity vary according to the population or patient groups studied and thei r average alcohol intake. We have characterized the dose-response curve bet ween alcohol intake and CDT concentrations in a study of 1400 men and women from a community-based twin registry. Our results show that mean CDT incre ases with increasing reported alcohol consumption even within the range of alcohol use considered to be nonhazardous. We found significant effects of sex, age, smoking, previous alcohol dependence, body mass index, and diasto lic hypertension on the alcohol-CDT dose-response curve. These variables ei ther affect test sensitivity or require adjustment of reference intervals. The results also provide insight into the physiological and biochemical fac tors that affect CDT concentration.