The Role of the Clinical Laboratory in Nutritional Assessment
Aruna Bakhru in Nutrition and Integrative Medicine, 2018
The two primary biomarkers of alcoholism are gamma glutamyl transferase (GGT) and carbohydrate-deficient transferrin (CDT).32 Phosphatidylethanol is another biomarker of regular alcohol consumption. In a 1989 study, 19 of 22 (86%) self-reported alcoholics had elevated CDT levels, versus none of 47 patients with non-alcoholic liver disease.33 In a more current study, of the various biomarkers for alcoholism, CDT had the highest area under the curve (0.77), followed by GGT (0.68).34 The percentage of excessive drinkers with aspartate aminotransferase:alanine aminotransferase ratio (AST:ALT) >2 was only 2%, a very low sensitivity. CDT typically normalizes within weeks of abstinence. Importantly, there are other causes of elevated CDT levels, including congenital disorders of glycosylation (e.g., hereditary fructosamine and galactosemia) and other genetic and nongenetic causes of liver disease.
Challenges in the Statistical Analysis of Biomarker Data
Anthony P. DeCaprio in Toxicologic Biomarkers, 2006
In their study, Salmi et al. (52) determined the “significance” of their correlation coefficients by testing the null hypothesis that the population correlation coefficient is equal to zero. However, there are several problems with this approach, the primary one being that correlations of no practical significance may be declared to be “significant” simply because the p-value is less than 0.05 (57). We have found the classification scheme presented by Morton et al. (58) to be useful in interpreting the magnitude of correlation coefficients in terms of their practical significance. They classify correlations between 0.0 and 0.2 as “negligible,” between 0.2 and 0.5 as “weak,” between 0.5 and 0.8 as “moderate,” and between 0.8 and 1.0 as “strong.” In their sample of 411 Finnish men, Salmi et al. (52) found a significant correlation of 0.108 between sVAP-1 and carbohydrate-deficient transferrin, a measure of liver dysfunction. While this correlation is statistically significant (p = 0.029), it would be considered negligible according to the Morton et al. criteria mentioned earlier, raising doubt about the practical, biological significance of the result.
Fundamentals of Receiver Operating Characteristic Curve Analyses
Albert Vexler, Alan D. Hutson, Xiwei Chen in Statistical Testing Strategies in the Health Sciences, 2017
In order to examine methods for combining quantitative results for serum carbohydrate-deficient transferrin (CDT), gamma-glutamyltransferase (GGT), and aspartate aminotransferase (AST), and refining these by inclusion of patient characteristics, Chen et al. (2003b) developed clinical rules for combining the results based on the data from 1684 subjects, recruited from the general population, abstainer groups, and alcohol treatment centers (participants in the five-nation WHO/ISBRA study of biological markers of alcohol use). It was concluded that combining biochemical markers enhances detection of problem drinking in men but not in women. Information on clinical variables increases the ability to correctly detect problem drinking.
Mean platelet volume and mean platelet volume/platelet count ratio in patients with chronic alcohol consumption
Published in Platelets, 2015
Sun Young Cho, Hee Joo Lee, Jong Woo Kim, Tae Sung Park
Mean platelet volume (MPV) is a parameter generated by fully automated blood count analyzers as a part of routine complete blood count (CBC), and a useful laboratory index for estimating platelet function and activation [1–3]. In the aspect of alcohol effects on MPV, MPV has been investigated in alcohol-associated liver disease such as alcoholic fatty liver disease and alcoholic liver cirrhosis and in vivo condition, respectively [4, 5]. However, data which directly analyzed MPV and laboratory marker for alcohol consumption were very rare, although increased mean corpuscular erythrocyte volume (MCV) is a commonly used CBC index in patients with chronic alcoholics. Therefore, we planned to study this platelet index in patients with chronic alcohol abuse to investigate whether chronic alcohol consumption can influence to MPV. We used carbohydrate-deficient transferrin (CDT) test, the sum of a- and disialotransferrin, to identify patients with chronic alcohol consumption, which is considered the most efficient routine biological marker of alcohol abuse [6, 7].
Role of activation of lipid peroxidation in the mechanisms of acute methanol poisoning*
Published in Clinical Toxicology, 2018
Jiri Hlusicka, Tomas Loster, Lucie Lischkova, Manuela Vaneckova, Zdenek Seidl, Pavel Diblik, Pavel Kuthan, Pavel Urban, Tomas Navratil, Petr Kacer, Sergey Zakharov
Upon being released from hospital, patients were re-examined 3–8 months and 2 years after discharge. The examination protocol included a complete assessment of visual function, including a complete eye examination, routine ophthalmic tests and optical coherence tomography (OCT) of the retinal nervous fibers layer (RNFL). Further, MRI brain examinations, neurological and psychological examinations, Neuroprotection and Natural History in Parkinson’s Plus Syndromes scale (NNIPPS), and neurological examinations of motor and sensory functions, reflexes, cerebellar function and cranial nerves, were performed. Biochemical tests were also performed: glucose, glycohemoglobin, albumin, prealbumin, liver and renal function, lipids, thyroid stimulating hormone, vitamins B1 and B12, ethyl glucuronide screening in urine and carbohydrate-deficient transferrin.
Consumption outcomes in clinical trials of alcohol use disorder treatment: Consideration of standard drink misestimation
Published in The American Journal of Drug and Alcohol Abuse, 2019
Megan Kirouac, Eric Kruger, Adam D. Wilson, Kevin A. Hallgren, Katie Witkiewitz
The COMBINE study used a rigorous methodology for accurately collecting drinking data. Trained research assistants administered the Form 90, a calendar-based method that asks participants about their drinking in the 90 days preceding the assessment (18). Memory cues were used to facilitate accurate recollection and visual aids of drink containers were provided with active probing about drink sizes in effort to obtain accurate drink size estimates. Research assistants collected data on brands and types of beverages and computed the number of standard drinks rather than relying on participant calculations. The COMBINE study also used biochemical verification for participant drinking using % Carbohydrate Deficient Transferrin (%CDT; 16). For the purposes of our simulation, we considered the methodology used in the COMBINE study to be the gold standard method for accurately assessing drinking quantities in alcohol clinical trials. We therefore used a simulation design with the COMBINE data reflecting the “true” amount of alcohol consumption, which we then degraded by incorporating increasing levels of drink size misestimation.
Related Knowledge Centers
- Alanine Transaminase
- Aspartate Transaminase
- Ethanol
- Monosaccharide
- Peptide
- Polysaccharide
- Sialic Acid
- Carbohydrate
- Transferrin
- Gamma-Glutamyltransferase