The usefulness of direct ethanol metabolites in assessing alcohol intake in nonintoxicated male patients in an emergency room setting
The usefulness of direct ethanol metabolites in assessing alcohol intake in nonintoxicated male patients in an emergency room setting
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DOI：
10.1111/j.1530-0277.2008.00696.x
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发表时间：
2008-07-01
影响因子：
3.2
通讯作者：
Wurst, Friedrich Martin
中科院分区：
文献类型：
--
作者：
Kip, Miriam Julia;Spies, Claudia Doris;Wurst, Friedrich Martin
背景：内科病理学的主要部分与慢性酒精中毒有关。本研究的目的是调查酒精使用障碍（AUD）的筛查是否可以通过与传统的生物状态标志物、酒精使用障碍识别测试（AUDIT）和超出阳性血液酒精浓度（BAC）检测时间段的额外自我报告相比，直接乙醇代谢物的测定来改善。方法：共纳入74例血液酒精阴性男性患者，他们在急诊室出现胸部或胃肠道疾病。测定全血中的磷脂酰乙醇（PEth）以及血清和尿液样本中的乙基葡糖苷酸（EtG）。测定传统的生物学状态标志物[碳水化合物缺乏转铁蛋白（%CDT），γ谷氨酰转肽酶（GGT），平均红细胞体积（MCV）]。获得了AUDIT，此外，所有患者都完成了额外的饮酒自我报告。将患者分为两（2）组：AUDIT评分< 8 and AUDIT scores >= 8。结果：在评估AUDIT后，将患者分配到以下组之一：AUDIT评分< 8（n = 52）和AUDIT评分>= 8（n = 22）的患者。25%的AUDIT评分低于临界值的患者（n = 13/52）的PEth和UEtG检测结果均为阳性。在过去12个月内宣称清醒的患者中，38.5%的患者PEth和UEtG检测呈阳性。对于AUDIT评分>= 8，PEth与%CDT的区别相似（AUC：0.672; 95%CI 0.524至0.821）。酒精消费的自我报告是不可靠的。结论：直接乙醇代谢产物，如PEth和UEtG的测定提供了额外的证据筛选AUD在ER设置。PEth的测定可以被认为是对%CDT的补充或替代。
Background: A major part of medical pathology in internal medicine is associated with chronic alcoholism. The aim of the current study was to investigate whether screening for Alcohol Use Disorders (AUD) can be improved through determination of direct ethanol metabolites compared to traditional biological state markers, the Alcohol Use Disorders Identification Test (AUDIT) and additional self-reports beyond the detection time period of a positive blood alcohol concentration (BAC).Methods: A total of 74 blood alcohol negative male patients who presented at the emergency room with either thoracic or gastrointestinal complaints were included. Phosphatidylethanol (PEth) was determined in whole blood, and ethyl glucuronide (EtG) in serum and urine samples. Traditional biological state markers [carbohydrate deficient transferrin (%CDT), gamma glutamyl transpeptidase (GGT), mean corpuscular volume (MCV)] were determined. The AUDIT was obtained and furthermore, all patients completed an additional self-report of alcohol consumption. Patients were divided into two (2) groups: AUDIT scores < 8 and AUDIT scores >= 8.Results: After assessment of the AUDIT, patients were allocated to one of the following groups: patients with AUDIT scores < 8 (n = 52) and with AUDIT scores >= 8 (n = 22). Twenty-five percent of the patients with AUDIT scores below the cut-off (n = 13/52) were tested positive for both PEth and UEtG. Of the patients who declared to be sober during the past 12 months, 38.5% were tested positive for PEth and UEtG. PEth discriminated similarly as %CDT for AUDIT scores >= 8 (AUC: 0.672; 95%CI 0.524 to 0.821). Self-reports of alcohol consumption were unreliable.Conclusion: Determination of direct ethanol metabolites such as PEth and UEtG provides additional evidence in screening for AUD in an ER setting. Determination of PEth might be considered complementary with or alternatively to %CDT.