Carbohydrate deficient transferrin for the assessment of recent alcohol intake in excessive drinkers

Background: There are not reliable markers to detect heavy drinking or as a tool to control abstinence compliance in alcoholic treatments. The Mean Co rpuscular Volume (MCV) and the gammaglutamyl transpeptidase (GGT), are wide ly used although their predictive value is somewhat limited due to their lo w specificity. On the other hand, the Carbohydrate-deficient transferrin (C DT) described in the eighties is highly specific and would be of value in e arly detection of problem drinking. Aim: To compare the sensitivity and spe cificity of CDT, GGT, and MCV in order to evaluate their single and combine d use as markers for detection of heavy drinking behaviour. Patients and me thods: CDT, GGT, and MCV values were determined in blood samples from (a) a lcoholics (drinking more than 100 9 alcohol/day); n=47) and (b) healthy vol unteers, teetotalers from the Church of Saints of Later Days (n=34). At the time of sampling alcoholics were presently drinking or had been abstinents for no more than six weeks. ROC curves were used to determine the best cut -off point for each marker. Results: Sensitivity was found to be similar fo r all three markers. Specificity was found higher for GGT (90.9%) and CDT ( 91.0%). The combined use of MCV, GGT and CDT, that is, when at least one of the markers is altered, was shown to detect 83% of the patients. No correl ation was observed between the markers and the level of alcohol intake. Con clusions: CDT could be of value as a marker to detect heavy drinking when u sed with GGT and MCV values combined. CDT is particularly higher in drinkin g alcoholics and remains significantly high for at least six weeks after th ey stop drinking.