Relative versus absolute carbohydrate-deficient transferrin as a marker ofalcohol consumption in patients with acute alcoholic hepatitis

Background: Carbohydrate-deficient transferrin has been described as a sens itive and specific marker for alcohol consumption. This study investigated the usefulness of carbohydrate-deficient transferrin as a marker of alcohol consumption in acute alcoholic hepatitis. Methods: Absolute concentrations (U/l) and relative values (%) of carbohydr ate-deficient transferrin determined in serum with commercial assays, as we ll as conventional markers for alcohol consumption, were compared with the alcohol consumption (as estimated by a questionnaire) in patients with acut e alcoholic hepatitis (n = 19), alcoholic liver cirrhosis (n = 37), and non alcoholic liver diseases (n = 16). Results: The concentration of carbohydrate-deficient transferrin was increa sed (p < 0.001) in nonabstaining patients (median intake 80 g alcohol/day) with alcoholic liver cirrhosis (45.7 +/- 30 U/l), but not in patients with acute alcoholic hepatitis (20.0 +/- 7.5 U/l) despite higher alcohol consump tion (median 130 g/d), nor in abstainers with alcoholic liver cirrhosis (19 .4 +/- 6.0 U/l) or nonalcoholic liver disease (18.5 +/- 6.7 U/l). However, the relative values of carbohydrate-deficient transferrin were increased bo th in acute alcoholic hepatitis (7.9 +/- 2.1%) and nonabstainers with alcoh olic liver cirrhosis (7.4 +/- 2.8%), but not in abstainers with alcoholic l iver cirrhosis (4.6 +/- 3.5%) or nonalcoholic liver disease (3.8 +/- 0.9%) (p < 0.001). In acute alcoholic hepatitis, the sensitivity and specificity were only 32% and 87% for absolute concentrations, respectively, but 79% an d 97% for relative values of carbohydrate-deficient transferrin. The concen trations of carbohydrate-deficient and total transferrin in serum were stro ngly correlated (r = 0.60; p = 0.008). Conclusions: The relative value (% of total), but not the absolute concentr ation, of carbohydrate deficient transferrin in serum is a useful marker of alcohol consumption in acute alcoholic hepatitis.