CARBOHYDRATE-DEFICIENT TRANSFERRIN AS A MARKER OF ALCOHOL-CONSUMPTIONIN MALE-PATIENTS WITH LIVER-DISEASE

Carbohydrate-deficient transferrin (CDT) has been proposed as a marker of alcohol abuse, However, its value in patients with associated live r disease is still controversial, The aim of the study was to investig ate the usefulness of CDT as a marker of alcohol consumption in patien ts with liver disease. We measured serum levels of CDT and those of co mmonly used hematological and biochemical markers, mean corpuscular vo lume (MCV), transaminases (AST and ALT), and gamma-glutamyltransferase in 179 male subjects divided into four groups: 45 active drinkers (13 with normal liver, 21 with fibrosteatosis, and 11 with liver cirrhosi s), 45 abstinent chronic alcoholics (18 with and 27 without liver dise ase), 58 patients with nonalcoholic liver disease, and 31 healthy cont rols. Serum CDT in active alcoholics was 37.5 +/- 3.6 units/liter, bei ng significantly higher than that of abstinent alcoholics (20.3 +/- 1. 5 units/liter), patients with nonalcoholic liver disease (18.1 +/- 1.1 units/liter), and controls (13.1 +/- 0.8 units/liter). Contrary to th e other markers, no significant differences were observed in CDT value s in relation with the presence and severity of liver disease in eithe r the active drinkers or in the abstinent alcoholics. The sensitivity and specificity of CDT as a marker of alcoholism in the series as a wh ole was 64% and 82%, respectively, similar to the best conventional ma rker, MCV (64 and 82%). In patients with liver disease, CDT maintained good sensitivity (72%) and specificity (83%). Receiver operating char acteristic analysis confirmed that CDT had a similar diagnostic value to that of MCV, but better than gamma-glutamyltransferase and transami nases for the detection of alcohol abusers, The good diagnostic effica cy of CDT remained unchanged when analyzing only patients with liver d isease, We conclude that serum CDT is a good marker of alcoholism and is less influenced than the currently used biochemical markers for ass ociated liver disease, Thus, CDT is an effective laboratory test to de tect alcohol abuse regardless of the presence of alcoholic liver disea se.