Factors affecting %CDT status at entry into a multisite clinical treatment trial: Experience from the COMBINE study
Factors affecting %CDT status at entry into a multisite clinical treatment trial: Experience from the COMBINE study
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DOI：
10.1111/j.1530-0277.2006.00225.x
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发表时间：
2006-11-01
影响因子：
3.2
通讯作者：
Youngblood, Marston
中科院分区：
文献类型：
--
作者：
Anton, Raymond F.;Youngblood, Marston
背景：在大量饮酒者中，碳水化合物缺乏型转铁蛋白（CDT）占正常转铁蛋白（%CDT）的比例较高。%CDT在临床和治疗试验中用作酒精使用障碍严重程度和治疗结果的标志物。然而，很少有人知道的参数，预测哪些患者是%CDT阳性治疗进入。这些参数可能包括饮酒水平，测试前的禁欲天数，和酒精依赖的严重程度evaluation.Methods：%CDT水平收集前随机组合研究，一个大型的联邦资助的多地点临床试验，评估药物和行为疗法的酒精依赖门诊患者的参与者。1，193名受试者的%CDT（在中心实验室测定）在测试前30天内有饮酒史，并记录了酒精中毒严重程度的测量结果。饮酒史和酒精严重程度的影响进行了评估，预测%CDT阳性的测试status.Results：更少的百分比天禁欲（PDA）和更多的饮料每饮酒日（DDD）预测率较高的%CDT阳性患者（最高67%）。测试前长达14天的连续禁欲似乎对%CDT状态没有显著影响。%CDT阳性率保持相当稳定，高达约40% PDA。多年的依赖性饮酒水平有一个意想不到的负面影响%的CDT阳性率，而以前的治疗有一个小的，但积极的影响%的CDT阳性率。ADS和DrInC分数没有预测价值超过和以上最近的饮酒量%CDT status.Conclusions：%CDT是更有可能是积极的，在那些谁喝了更多的天喝酒，并在较小的程度上，在那些谁喝了更多的每饮酒日。即使在测试前许多天停止饮酒的酒精受试者中，它也可以保持阳性。有更多治疗经验的酒精中毒受试者的%CDT阳性率似乎略高。
Background: Carbohydrate-deficient transferrin (CDT) occurs as a higher percentage of normal transferrin (%CDT) in heavy drinkers. %CDT is used as a marker of both alcohol use disorder severity and treatment outcome both clinically and in treatment trials. Nevertheless, little is known about the parameters that predict which patients are %CDT positives at treatment entry. These parameters might include level of drinking, days of abstinence before testing, and severity of alcohol dependence before evaluation.Methods: %CDT levels were collected before randomization from participants of the COMBINE Study, a large federally sponsored multisite clinical trial evaluating medications and behavioral therapies in alcohol-dependent outpatients. %CDT (assayed in a central laboratory) was available in 1,193 individuals for whom drinking history in the 30 days before testing and measures of alcoholism severity were documented. The effects of drinking history and alcohol severity were evaluated for prediction of a %CDT-positive test status.Results: Less percent days abstinent (PDA) and more drinks per drinking day (DDD) were predictive of higher rates of %CDT-positive patients (maximum 67%). Up to 14 days of continuous abstinence before testing did not appear to significantly affect %CDT status. Rates of %CDT positives remained reasonably steady up to about 40% PDA. Years of drinking at dependence levels had an unexpected negative impact on %CDT-positive rates while previous treatment had a small but positive impact of %CDT-positive rates. ADS and DrInC scores had no predictive value over and above recent drinking amounts on %CDT status.Conclusions: %CDT is more likely to be positive in those who have more days of drinking and to a lesser degree in those who drink more per drinking day. It can remain positive even in those alcoholic subjects who stop drinking many days before testing. Alcoholic subjects with more treatment experiences appear to have a marginally higher %CDT-positive rate.