Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers.
Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers.
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DOI：
10.1186/1471-230x-14-97
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发表时间：
2014-05-22
影响因子：
2.4
通讯作者：
Powell EE
中科院分区：
文献类型：
--
作者：
Fagan KJ;Irvine KM;McWhinney BC;Fletcher LM;Horsfall LU;Johnson L;O'Rourke P;Martin J;Scott I;Pretorius CJ;Ungerer JP;Powell EE
碳水化合物缺乏性转铁蛋白（CDT）是重度饮酒最特异性的血清生物标志物，定义为≥350-420 g酒精/周。尽管引入了标准化的参考测量技术，但由于灵敏度低，CDT的广泛使用仍然受到限制。本研究的目的是确定影响持续大量饮酒患者诊断敏感性的因素。自我报告有持续重度饮酒史的患者从肝病门诊部或病房招募。每位患者接受了一份经过验证的结构化酒精消耗问卷，并对访谈时收集的血清使用高效液相色谱标准化参考测量技术进行CDT分析。52例患者被招募：19例来自肝病门诊部，33例来自普通病房。在前两周期间，酒精摄入量中位数为1013克/周（范围366-5880）。26例患者诊断CDT的阈值为%CDT bb1.7，表明重度饮酒，敏感性为50%。超重/肥胖(定义为高加索人体重指数（BMI)≥25kg /m2，亚洲人体重指数(BMI)≥23.0 kg/m2）、女性和肝硬化的存在与非诊断性CDT %（≤1.7）独立相关。CDT作为重度饮酒的生物标志物敏感性有限。在订购和解释%CDT结果时应谨慎，特别是在女性、肝硬化患者和BMI升高的患者中。
Carbohydrate deficient transferrin (CDT) is the most specific serum biomarker of heavy alcohol consumption, defined as ≥ 350–420 g alcohol/week. Despite introduction of a standardized reference measurement technique, widespread use of CDT remains limited due to low sensitivity. The aim of this study was to determine the factors that affect diagnostic sensitivity in patients with sustained heavy alcohol intake. Patients with a self-reported history of sustained heavy alcohol consumption were recruited from the hepatology outpatient department or medical wards. Each patient was interviewed with a validated structured questionnaire of alcohol consumption and CDT analysis using the standardized reference measurement technique with high performance liquid chromatography was performed on serum collected at time of interview. 52 patients were recruited: 19 from the hepatology outpatient department and 33 from general medical wards. Median alcohol intake was 1013 (range 366–5880) g/week over the preceding two week period. 26 patients had a diagnostic CDT based on a threshold value of %CDT > 1.7 indicating heavy alcohol consumption, yielding a sensitivity of 50%. Overweight/obesity (defined as body mass index (BMI) ≥ 25 kg/m2 in Caucasians and ≥ 23.0 kg/m2 in Asians), female gender and presence of cirrhosis were independently associated with non-diagnostic %CDT (≤ 1.7). CDT has limited sensitivity as a biomarker of heavy alcohol consumption. Caution should be applied when ordering and interpreting %CDT results, particularly in women, patients with cirrhosis and those with an elevated BMI.