Urinary ethyl glucuronide testing detects alcohol consumption in alcoholic liver disease patients awaiting liver transplantation
Urinary ethyl glucuronide testing detects alcohol consumption in alcoholic liver disease patients awaiting liver transplantation
复制标题
DOI：
10.1002/lt.21163
复制
发表时间：
2007-05-01
影响因子：
4.6
通讯作者：
Helander, Anders
中科院分区：
文献类型：
--
作者：
Erim, Yesim;Boettcher, Michael;Helander, Anders
这项研究将尿乙基葡萄糖醛酸(EtG)的测量与呼气酒精测试和自我报告作为披露18名被诊断为酒精性肝病并接受成瘾小组治疗计划的肝移植患者最近饮酒情况的方法进行了比较。EtG是一种结合的次要乙醇代谢物，检测窗口比乙醇本身更长。在每个治疗过程中，患者被问及在这段时间内是否饮酒，他们还进行了强制性的呼气酒精测试，同时自愿提供用于测量EtG的观察尿样。这些患者中没有人承认摄入过酒精，127例呼气酒精测试中只有1例呈阳性。然而，49份尿样中有24份(49%)EtG检测结果为阳性，其中9例阳性。尿样EtG阳性的个体频率为22%~100%，平均值为57%。由于6名患者总共18次拒绝提供尿液，酒精使用可能更普遍。这些结果强调了自我报告数据的不确定性和呼气酒精测试作为披露最近饮酒情况的低敏感性，并强调了在移植环境中引入敏感和具体的最近酒精消费的客观指标的必要性，例如EtG。
This study compared measurement of urinary ethyl glucuronide (EtG), a conjugated minor ethanol metabolite with a longer detection window than ethanol itself, with breath alcohol testing and self-report as ways to disclose recent drinking by 18 liver transplant candidates with an alcoholic liver disease diagnosis that underwent an addiction group therapy program. At each therapy session, patients were questioned about any alcohol consumption in the intervening time, and they also performed a mandatory breath alcohol test, while observed urine samples for measurement of EtG were delivered on a voluntary basis. None of the patients ever admitted to intake of alcohol, and only 1 of 127 breath alcohol tests turned out positive. However, 9 patients showed positive EtG results in 24 (49%) of 49 urine samples. The individual frequency of urine samples being positive for EtG ranged from 22% to 100% with a mean value of 57%. Because 6 patients refused to provide urine on a total of 18 occasions, alcohol use might have been even more common. These results underscore the uncertainty of self-report data and the low sensitivity of breath alcohol testing as ways to disclose recent drinking, and underline the necessity of introducing sensitive and specific objective measures of recent alcohol consumption, such as EtG, in the transplantation setting.