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Clinical Chemistry 47: 681-685, 2001;
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(Clinical Chemistry. 2001;47:681-685.)
© 2001 American Association for Clinical Chemistry, Inc.

Articles

Improved Diagnostic Classification of Alcohol Abusers by Combining Carbohydrate-deficient Transferrin and {gamma}-Glutamyltransferase

Pekka Sillanaukee1,2,3,a and Ulf Olsson4

1 Pharmacia & Upjohn Diagnostics AB, Alcohol Related Diseases, 751 82 Uppsala, Sweden.

2 University of Tampere, Medical School and Tampere University Hospital, Department of Clinical Chemistry, 33014 Tampere, Finland.

3 Karolinska Institute, Medical School, 171 77 Stockholm, Sweden.

4 Swedish University of Agricultural Sciences, Department of Biometry and Informatics, 750 07 Uppsala, Sweden.
a Address correspondence to this author at: Oy Finnish Immunotechnology Ltd., Lenkkeilijänkatu 8, 33 520 Tampere, Finland. Fax 358-3-31387050; e-mail Pekka.Sillanaukee{at}finnish-immunotech.com.

Background: Biochemical markers can provide objective evidence of high alcohol consumption. However, currently available markers have limitations in their diagnostic performance.

Methods: The diagnostic values of the most frequently used markers [carbohydrate-deficient transferrin (CDT), {gamma}-glutamyltransferase (GGT), aspartate aminotransferase, alanine aminotransferase, and mean corpuscular volume] were studied in an analysis of six different clinical studies (n = 1412) on alcohol abusers and social drinkers. The purpose of the analyses was to determine whether a combination of markers would improve the diagnosis of subjects.

Results: Discrimination between alcohol abusers and social drinkers, as measured by the areas under nonparametric ROC plots, was significantly better (P <0.001) for the new combined marker [{gamma}-CDT = 0.8 · ln(GGT) + 1.3 · ln(CDT)] than for any of the separate markers or combination of CDT or GGT with other markers. The cutoff values for {gamma}-CDT (6.5) can be taken to be the same among males and females.

Conclusions: The combined variable {gamma}-CDT is a powerful tool to discriminate alcohol abusers from social drinkers and is recommended for clinical use.




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