Srovnání diagnostické validity karbohydrátdeficientního transferinu a dalších laboratorníchmarkerů chronického abúzu etanolu

Comparison of the Diagnostic Validity of Carbohydrate-deficientTransferrin with other Laboratory Markers of the Chronic Ethanol Abuse

Background.
Carbohydrate-deficient transferrin (CDT) has been reported to be the best laboratory marker of thechronic alcohol abuse, but there are conflicting data on its accuracy and sensitivity ranging from 19 % to 96 % invarious studies. The aim of this study was to compare the diagnostic efficiency of CDT with the other markers ofalcohol abuse used in clinical practice with respect to possible sex differences.Methods and Results. The serum CDT (using the method of anion-exchange chromatography and TIA), meancorpuscular volume (MCV), gamma-glutamyl-transferase (GMT) values and platelet count were evaluated in 50alcohol-dependent patients admitted to the Center of Detoxification and in the reference group of 85 healthyteetotallers. The cut-off values for %CDT where established in the level of 2,2 % and 2,5 % for men and womenrespectively. In men we proved a comparatively high diagnostic efficiency of CDT (AUC 0,94, senzitivity 82,6 %,specificity 96,7 %) and GMT, MCV seem to be less accurate marker of chronic alcohol abuse. In contrast there wasa lower diagnostic validity of CDT in women in comparison with common markers (AUC 0,83, senzitivity 60 %,specificity 88 %).Conclusions. The laboratory diagnosis of chronic alcohol consumption can be improved by using a combination ofseveral markers. The specificity and also the cumulative sensitivity of such a battery of laboratory markers can beelevated by CDT evaluation. In a part of patients, CDT can be the only detectable abnormity.

Key words:
carbohydrate deficient transferrin, mean corpuscular volume, gamma-glutamyl transferasis, chronicalcohol consumption, ROC curve.