Ethylglucuronide in Hair Is a Top Predictor of Impaired Driving Recidivism, Alcohol Dependence, and a Key Marker of the Highest BAC Interlock Tests
Ethylglucuronide in Hair Is a Top Predictor of Impaired Driving Recidivism, Alcohol Dependence, and a Key Marker of the Highest BAC Interlock Tests
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DOI：
10.1080/15389588.2013.824569
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发表时间：
2014-05-19
影响因子：
2
通讯作者：
Yegles, Michel
中科院分区：
文献类型：
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作者：
Marques, Paul R.;Tippetts, A. Scott;Yegles, Michel
目的：本研究重点探讨头发中乙基葡萄糖醛酸苷(HEtG)对评估酒后驾车违法者风险的预测性和比较性意义。早期的工作比较了不同的酒精生物标记物，以估计在8个月的连锁参与期间记录的血液酒精浓度(BAC)测试的失败率。这些分析评估了几种酒精标记物的比较性能，包括hEtG和其他标记物，过去的驾驶员记录，以及心理测量评估预测因子对4个标准的检测：新酒后驾车再犯(DUI)，酒精依赖，以及连锁记录变量包括失败率和最大连锁BAC记录。方法：加拿大艾伯塔省被控酒精损害(DUI)的司机(n=534；%的初犯，36%的多次犯罪者)安装了点火连锁装置，并同意参与评估血液、头发和尿液衍生的酒精生物标志物的研究；坐下来进行访谈；进行心理评估；允许分析驾驶记录和连锁记录文件。受试者变量包括人口统计数据、计划开始时的酒精依赖、计划前酒驾前定罪、登记后新的酒后驾车定罪、自我报告的饮酒评估、早晨和总体联锁BAC测试失败率以及最大联锁BAC读数。再犯、依赖、高BAC和综合失败率被设定为标准；其他变量被设定为预测因素。计算受试者工作特征(ROC)曲线下面积(A)估计灵敏度和特异度。对基线hEtG水平进行了额外的分析。根据标准的hEtG过量饮酒标准(30pg/mg)和更高的标准50pg/mg，评估了司机的表现和饮酒指标。用Mann-Whitney等级统计对HEtG分裂进行评估。结果：HEtG是区分联锁安装后发生的新的再犯事件、进入酒精依赖和记录的最高联锁BAC的最高总体预测因子。HEtG和磷脂酰乙醇(Peth)是所有标准指标的最高预测因子。相反，头发衍生的酒精生物标志物hEtG和hFAEE(脂肪酸乙酯)作为连锁BAC测试失败率的检测器比其他酒精生物标志物差。结论：这项研究表明，hEtG是一种客观的替代通常不可靠的自我报告的过去饮酒水平的代表，在连锁项目的早期对司机与酒精相关的风险有重要的洞察力，并且是新的累犯者事件的最高预测因子。与佩斯一起，这些标记物将成为检测饮酒情况的极佳支撑物。
Objectives: This study focuses on the predictive and comparative significance of ethyl glucuronide measured in head hair (hEtG) for estimating risks associated with alcohol-impaired driving offenders. Earlier work compared different alcohol biomarkers for estimating rates of failed blood alcohol concentration (BAC) tests logged during 8 months of interlock participation. These analyses evaluate the comparative performance of several alcohol markers including hEtG and other markers, past driver records, and psychometric assessment predictors for the detection of 4 criteria: new driving under the influence (DUI) recidivism, alcohol dependence, and interlock record variables including fail rates and maximal interlock BACs logged.Methods: Drivers charged with alcohol impairment (DUI) in Alberta, Canada (n = 534; 64% first offenders, 36% multiple offenders) installed ignition interlock devices and consented to participate in research to evaluate blood-, hair-, and urine-derived alcohol biomarkers; sit for interviews; take psychometric assessments; and permit analyses of driving records and interlock log files. Subject variables included demographics, alcohol dependence at program entry, preprogram prior DUI convictions, postenrollment new DUI convictions, self-reported drinking assessments, morning and overall rates of failed interlock BAC tests, and maximal interlock BAC readings. Recidivism, dependence, high BAC, and combined fail rates were set as criteria; other variables were set as predictors. Area under the receiver operating characteristics (ROC) curve (A) estimates of sensitivity and specificity were calculated. Additional analyses were conducted on baseline hEtG levels. Driver performance and drinking indicators were evaluated against the standard hEtG cutoff for excessive drinking at (30 pg/mg) and a higher criterion of 50 pg/mg. HEtG splits were evaluated with the Mann-Whitney rank statistic.Results: HEtG emerged as a top overall predictor for discriminating new recidivism events that occur after interlock installation, for entry alcohol dependence, and for the highest interlock BACs recorded. Together, hEtG and phosphatidylethanol (PEth) were the top predictors of all criterion measures. By contrast, the hair-derived alcohol biomarkers hEtG and hFAEE (fatty acid ethyl esters) were poorer than other alcohol biomarkers as detectors of interlock BAC test fail rates.Conclusions: This study showed that hEtG, an objective alternative to often unreliable self-reported past representation of drinking levels, yields crucial insight into driver alcohol-related risks early in an interlock program and is a top predictor of new recidivist events. Together with PEth, these markers would be excellent anchors in a panel for detecting alcohol consumption.