EVALUATION OF ACETALDEHYDE-MODIFIED HEMOGLOBIN AND OTHER MARKERS OF CHRONIC HEAVY ALCOHOL-USE - EFFECTS OF GENDER AND HEMOGLOBIN CONCENTRATION

The present study examined whether measurement of hemoglobin-acetaldeh yde (HbA1-AcH) using an improved methodology may be useful as a biolog ical marker of alcohol abuse. Red blood cell hemolysates of 182 patien ts consecutively admitted to the drug and alcohol treatment unit of ou r institution were analyzed for HbA1-AcH concentration using cation ex change HPLC. Mean HbA1-AcH of those who claimed to drink greater than or equal to 6 drinks/day [mean = 0.055 (% total hemoglobin), SD = 0.05 1] was significantly higher than the mean of those who drank <6 drinks /day (mean = 0.026, SD = 0.0174). The greatest sum of sensitivity (67% ) and specificity (77%) came with a cut-score of 0.030 area% of total hemoglobin. A cut-score of 0.080 produced a 100% specificity, but lowe red the sensitivity to 20%. The Pearson product moment correlation (r) between HbA1-AcH and reported drinks per day was r = 0.30 (p < 0.001) . There was no significant difference in the association of HbA1-AcH e nd reported drinking between males and females, and the small differen ce observed was shown to be entirely associated with differences in he moglobin levels between the sexes. Cocaine use did not significantly a lter the correlation between reported drinking and HbA1-AcH levels. He moglobin levels were shown to have a significant correlation with HbA1 -AcH independent of drinking. HbA1-AcH was shown to have a better sens itivity and specificity than gamma-glutamyltransferase, ALT, AST, or m ean corpuscular volume in this population. The results suggest that Hb A1-AcH may be a useful marker to help detect alcohol abuse, especially in populations where other markers have been shown to fail.