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Wielders JPM, Porpiglia NM, Schellenberg F, Deenmamode J, Delanghe J, Anton RF, Bortolotti F, Siebelder C, Tagliaro F, Weykamp C, Helander A. Recommendations on the measurement and use of the alcohol consumption biomarker CDT. A position paper from the IFCC Working Group on CDT standardisation. Clin Chim Acta 2024; 555:117800. [PMID: 38309557 DOI: 10.1016/j.cca.2024.117800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/10/2024] [Accepted: 01/22/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Carbohydrate deficient transferrin (CDT) is a biomarker for excessive alcohol consumption utilized in clinical and forensic medicine and workplace testing. Previously, many different analytical methods for CDT were used and the measurand varied considerably, making direct comparison of test results difficult. To end this confusion, the IFCC established a working group on CDT standardisation (WG-CDT) which completed its tasks in 2017. METHODS This IFCC position paper by the WG-CDT summarizes state of the art information about the measurand and the analytical methods and gives concise recommendations for its utilization. RESULTS The results achieved by the CDT standardisation process led to accuracy improvements in national external quality assessment schemes over the years. A brief review of ROC based comparison studies with the traditional biomarkers (GGT, MCV, ALT and AST) discusses the bias resulting from inadequate study populations. In large groups of the general population the superior diagnostic performance of CDT is confirmed. CONCLUSION The relationship between alcohol intake versus resulting CDT is discussed as well as the cutoff and measurement uncertainty. Concerning the application in practice, potential pitfalls are considered and recommendations handling both analytical and preanalytical caveats are given. Finally, some examples of serious misunderstandings in publications about CDT are addressed.
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Affiliation(s)
- J P M Wielders
- Joseph Peter Marie Wielders, Amersfoort, the Netherlands.
| | - N M Porpiglia
- Nadia Maria Porpiglia, Department of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Verona, Italy.
| | | | | | - J Delanghe
- Joris Delanghe, Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - R F Anton
- Raymond Francis Anton, Medical University of South Carolina, Charleston, SC, USA
| | - F Bortolotti
- Federica Bortolotti, Department of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Verona, Italy
| | - C Siebelder
- Carla Siebelder, MCA Laboratory, Queen Beatrix Hospital, Winterswijk, the Netherlands
| | - F Tagliaro
- Franco Tagliaro, Department of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Verona, Italy
| | - C Weykamp
- Cas Weykamp, MCA Laboratory, Queen Beatrix Hospital, Winterswijk, the Netherlands
| | - A Helander
- Anders Helander, Karolinska Institutet, Karolinska University Laboratory, Stockholm, Sweden
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Bernstein SL, Li F, Abujarad F, Grant DR, D'Onofrio G, Dziura J. Modeling human health behavior with a new index that measures connectivity. Prev Med Rep 2023; 33:102172. [PMID: 37223571 PMCID: PMC10201843 DOI: 10.1016/j.pmedr.2023.102172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 01/31/2023] [Accepted: 03/05/2023] [Indexed: 03/17/2023] Open
Abstract
Objective Health behavior is an important determinant of health. Adherence to medication and abstinence from harmful substances are two critical health behaviors. Although conceptually related, both are assessed using disparate measures. The goal of this study was to develop and test a new index, gamma, which models health behavior by quantifying the connectedness of discrete incidents of health behavior. Study design and setting We derive gamma from first principles and use it to reanalyze data from a published trial of treatment for alcohol use disorders. We model a primary endpoint, changes in binge drinking, using gamma and a traditional measure: change in number of monthly binges. The original trial was conducted in an urban hospital emergency department in the U.S. Results Incorporating gamma into the model provided additional insights into the relationship between the intervention and long-term changes in drinking. Conclusion Gamma provides an additional tool to model the effects of interventions on outcomes in trials of substance use interventions or medication adherence. Gamma measures the pattern of behavior and may increase the explanatory power of models assessing differences between various treatments. The gamma index offers the possibility of novel real-time interventions to promote healthy behaviors.
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Affiliation(s)
- Steven L. Bernstein
- Department of Emergency Medicine, Yale School of Medicine, United States
- Yale Cancer Center, Yale School of Medicine, United States
| | - Fangyong Li
- Yale Center of Analytical Science, Yale School of Medicine, United States
| | - Fuad Abujarad
- Department of Emergency Medicine, Yale School of Medicine, United States
| | - David R. Grant
- Department of Mathematics, University of Colorado, Boulder, CO, United States
| | - Gail D'Onofrio
- Department of Emergency Medicine, Yale School of Medicine, United States
- Yale School of Public Health, Yale School of Medicine, United States
| | - James Dziura
- Department of Emergency Medicine, Yale School of Medicine, United States
- Yale Center of Analytical Science, Yale School of Medicine, United States
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Trbojević-Akmačić I, Vučković F, Pribić T, Vilaj M, Černigoj U, Vidič J, Šimunović J, Kępka A, Kolčić I, Klarić L, Novokmet M, Pučić-Baković M, Rapp E, Štrancar A, Polašek O, Wilson JF, Lauc G. Comparative analysis of transferrin and IgG N-glycosylation in two human populations. Commun Biol 2023; 6:312. [PMID: 36959410 PMCID: PMC10036557 DOI: 10.1038/s42003-023-04685-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/09/2023] [Indexed: 03/25/2023] Open
Abstract
Human plasma transferrin (Tf) N-glycosylation has been mostly studied as a marker for congenital disorders of glycosylation, alcohol abuse, and hepatocellular carcinoma. However, inter-individual variability of Tf N-glycosylation is not known, mainly due to technical limitations of Tf isolation in large-scale studies. Here, we present a highly specific robust high-throughput approach for Tf purification from human blood plasma and detailed characterization of Tf N-glycosylation on the level of released glycans by ultra-high-performance liquid chromatography based on hydrophilic interactions and fluorescence detection (HILIC-UHPLC-FLD), exoglycosidase sequencing, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). We perform a large-scale comparative study of Tf and immunoglobulin G (IgG) N-glycosylation analysis in two human populations and demonstrate that Tf N-glycosylation is associated with age and sex, along with multiple biochemical and physiological traits. Observed association patterns differ compared to the IgG N-glycome corroborating tissue-specific N-glycosylation and specific N-glycans' role in their distinct physiological functions.
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Affiliation(s)
| | | | - Tea Pribić
- Genos Glycoscience Research Laboratory, Zagreb, Croatia
| | - Marija Vilaj
- Genos Glycoscience Research Laboratory, Zagreb, Croatia
| | - Urh Černigoj
- BIA Separations d.o.o., a Sartorius company, Ajdovščina, Slovenia
| | - Jana Vidič
- BIA Separations d.o.o., a Sartorius company, Ajdovščina, Slovenia
| | | | - Agnieszka Kępka
- Genos Glycoscience Research Laboratory, Zagreb, Croatia
- Department of Immunology, Faculty of Biology, Institute of Zoology, University of Warsaw, Warsaw, Poland
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, Split, Croatia
- Algebra University College, Zagreb, Croatia
| | - Lucija Klarić
- MRC Human Genetics Unit, Institute for Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | | | | | - Erdmann Rapp
- Max Planck Institute for Dynamics of Complex Technical Systems, Magdeburg, Germany
- glyXera GmbH, Magdeburg, Germany
| | - Aleš Štrancar
- BIA Separations d.o.o., a Sartorius company, Ajdovščina, Slovenia
| | - Ozren Polašek
- Department of Public Health, University of Split School of Medicine, Split, Croatia
- Algebra University College, Zagreb, Croatia
| | - James F Wilson
- MRC Human Genetics Unit, Institute for Genetics and Cancer, University of Edinburgh, Edinburgh, UK
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Gordan Lauc
- Genos Glycoscience Research Laboratory, Zagreb, Croatia.
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia.
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Suzuki T, Eguchi A, Shigefuku R, Nagao S, Morikawa M, Sugimoto K, Iwasa M, Takei Y. Accuracy of carbohydrate-deficient transferrin as a biomarker of chronic alcohol abuse during treatment for alcoholism. Hepatol Res 2022; 52:120-127. [PMID: 33797850 DOI: 10.1111/hepr.13642] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/26/2021] [Accepted: 03/21/2021] [Indexed: 12/12/2022]
Abstract
AIM Clinical evaluations are generally used to verify the effectiveness of detoxification treatments for alcohol dependence, but new objective biomarkers are essential for accurate diagnosis. We aim to assess the accuracy of carbohydrate-deficient transferrin (%CDT) in a cohort of Japanese patients admitted to a psychiatric hospital specializing in alcohol dependence. In addition, we investigated the kinetics of %CDT during alcohol moderation or cessation. METHODS The study cohort consisted of 126 alcohol-dependent patients. The levels of serum %CDT were assessed by the N Latex CDT direct immunonephelometric assay. RESULTS Alcohol consumption was significantly correlated with %CDT. The only independent predictive factor of alcohol consumption was %CDT, with glutamyltranspeptidase (GGT) and albumin-bilirubin score proving insufficient. The cut-off value of %CDT was 1.9% with high sensitivity and specificity in detecting alcohol abstinence beyond 30 days (68.6% sensitivity, 91.8% specificity) and excessive alcohol drinking (77.9% sensitivity, 77.1% specificity). The %CDT levels were significantly decreased at 30 days of abstinence when compared with baseline. Notably, %CDT values were significantly changed even in the light alcohol drinking cohort (p = 0.0009), whereas GGT levels were not significantly changed. CONCLUSIONS Our results indicate that %CDT is an accurate and specific biomarker of alcohol consumption and is useful in detecting alcohol abstinence even in a low alcohol intake patient cohort. These results suggest that %CDT could be a useful objective biomarker of chronic alcohol abuse during clinical treatment for alcoholism.
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Affiliation(s)
- Tatsuya Suzuki
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan.,Department of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Akiko Eguchi
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Ryuta Shigefuku
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | | | | | - Kazushi Sugimoto
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Motoh Iwasa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshiyuki Takei
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
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5
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Shibamoto A, Namisaki T, Suzuki J, Kubo T, Iwai S, Tomooka F, Takeda S, Fujimoto Y, Enomoto M, Murata K, Inoue T, Ishida K, Ogawa H, Takagi H, Kaya D, Tsuji Y, Ozutsumi T, Fujinaga Y, Furukawa M, Nishimura N, Sawada Y, Kitagawa K, Sato S, Takaya H, Kaji K, Shimozato N, Kawaratani H, Moriya K, Akahane T, Mitoro A, Yoshiji H. Clinical Significance of Gamma-Glutamyltranspeptidase Combined with Carbohydrate-Deficient Transferrin for the Assessment of Excessive Alcohol Consumption in Patients with Alcoholic Cirrhosis. MEDICINES 2021; 8:medicines8070039. [PMID: 34357155 PMCID: PMC8307258 DOI: 10.3390/medicines8070039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 11/16/2022]
Abstract
Background: This study aimed to compare the diagnostic performance of carbohydrate-deficient transferrin (CDT) and gamma-glutamyltranspeptidase (γ-GTP) to assess the single and combined benefits of these biological markers for the detection of chronic excessive alcohol consumption in patients with alcoholic cirrhosis. Methods: Biological markers were determined in blood samples from patients with alcoholic cirrhosis (drinking group, n = 35; nondrinking group, n = 81). The prediction accuracy of %CDT alone, γ-GTP alone, and their combination for the detection of excessive alcohol consumption was determined in patients with alcoholic cirrhosis. Results: Serum total bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-GTP, and alkaline phosphatase levels and %CDT were significantly higher and serum albumin levels were significantly lower in the drinking group than in the nondrinking group. The combination of %CDT and γ-GTP compared with %CDT or γ-GTP alone showed a higher prediction accuracy. The combination of %CDT and γ-GTP exhibited a higher specificity than γ-GTP alone. However, in terms of sensitivity, no significant difference was found between single or combined markers. Conclusions: The combination of %CDT and γ-GTP is considered a useful biomarker of chronic excessive alcohol consumption in patients with alcoholic cirrhosis.
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Affiliation(s)
- Akihiko Shibamoto
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Tadashi Namisaki
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
- Correspondence: ; Tel.: +81-744-22-3015
| | - Junya Suzuki
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Takahiro Kubo
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Satoshi Iwai
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Fumimasa Tomooka
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Soichi Takeda
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Yuki Fujimoto
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Masahide Enomoto
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Koji Murata
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Takashi Inoue
- Institute for Clinical and Translational Science, Nara Medical University Hospital, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan;
| | - Koji Ishida
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Hiroyuki Ogawa
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Hirotetsu Takagi
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Daisuke Kaya
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Yuki Tsuji
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Takahiro Ozutsumi
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Yukihisa Fujinaga
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Masanori Furukawa
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Norihisa Nishimura
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Yasuhiko Sawada
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Koh Kitagawa
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Shinya Sato
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Hiroaki Takaya
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Kosuke Kaji
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Naotaka Shimozato
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Hideto Kawaratani
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Kei Moriya
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Takemi Akahane
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Akira Mitoro
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
| | - Hitoshi Yoshiji
- Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan; (A.S.); (J.S.); (T.K.); (S.I.); (F.T.); (S.T.); (Y.F.); (M.E.); (K.M.); (K.I.); (H.O.); (H.T.); (D.K.); (Y.T.); (T.O.); (Y.F.); (M.F.); (N.N.); (Y.S.); (K.K.); (S.S.); (H.T.); (K.K.); (N.S.); (H.K.); (K.M.); (T.A.); (A.M.); (H.Y.)
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Transferrin Isoforms, Old but New Biomarkers in Hereditary Fructose Intolerance. J Clin Med 2021; 10:jcm10132932. [PMID: 34208868 PMCID: PMC8267838 DOI: 10.3390/jcm10132932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/17/2021] [Accepted: 06/28/2021] [Indexed: 12/11/2022] Open
Abstract
Hereditary Fructose Intolerance (HFI) is an autosomal recessive inborn error of metabolism characterised by the deficiency of the hepatic enzyme aldolase B. Its treatment consists in adopting a fructose-, sucrose-, and sorbitol (FSS)-restrictive diet for life. Untreated HFI patients present an abnormal transferrin (Tf) glycosylation pattern due to the inhibition of mannose-6-phosphate isomerase by fructose-1-phosphate. Hence, elevated serum carbohydrate-deficient Tf (CDT) may allow the prompt detection of HFI. The CDT values improve when an FSS-restrictive diet is followed; however, previous data on CDT and fructose intake correlation are inconsistent. Therefore, we examined the complete serum sialoTf profile and correlated it with FSS dietary intake and with hepatic parameters in a cohort of paediatric and adult fructosemic patients. To do so, the profiles of serum sialoTf from genetically diagnosed HFI patients on an FSS-restricted diet (n = 37) and their age-, sex- and body mass index-paired controls (n = 32) were analysed by capillary zone electrophoresis. We found that in HFI patients, asialoTf correlated with dietary intake of sucrose (R = 0.575, p < 0.001) and FSS (R = 0.475, p = 0.008), and that pentasialoTf+hexasialoTf negatively correlated with dietary intake of fructose (R = -0.386, p = 0.024) and FSS (R = -0.400, p = 0.019). In addition, the tetrasialoTf/disialoTf ratio truthfully differentiated treated HFI patients from healthy controls, with an area under the ROC curve (AUROC) of 0.97, 92% sensitivity, 94% specificity and 93% accuracy.
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Abstract
Human lifespan has increased significantly in the last 200 years, emphasizing our need to age healthily. Insights into molecular mechanisms of aging might allow us to slow down its rate or even revert it. Similar to aging, glycosylation is regulated by an intricate interplay of genetic and environmental factors. The dynamics of glycopattern variation during aging has been mostly explored for plasma/serum and immunoglobulin G (IgG) N-glycome, as we describe thoroughly in this chapter. In addition, we discuss the potential functional role of agalactosylated IgG glycans in aging, through modulation of inflammation level, as proposed by the concept of inflammaging. We also comment on the potential to use the plasma/serum and IgG N-glycome as a biomarker of healthy aging and on the interventions that modulate the IgG glycopattern. Finally, we discuss the current knowledge about animal models for human plasma/serum and IgG glycosylation and mention other, less explored, instances of glycopattern changes during organismal aging and cellular senescence.
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Årving A, Høiseth G, Hilberg T, Trydal T, Husa A, Djordjevic A, Kabashi S, Vindenes V, Bogstrand ST. Comparison of the Diagnostic Value of Phosphatidylethanol and Carbohydrate‐Deficient Transferrin as Biomarkers of Alcohol Consumption. Alcohol Clin Exp Res 2020; 45:153-162. [DOI: 10.1111/acer.14503] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Alexander Årving
- From the Department of Forensic Sciences (AÅ, GH, SK, VV, STB) Oslo University Hospital Oslo Norway
| | - Gudrun Høiseth
- From the Department of Forensic Sciences (AÅ, GH, SK, VV, STB) Oslo University Hospital Oslo Norway
- Faculty of Medicine (GH, SK, VV) Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Thor Hilberg
- Fürst Medisinsk Laboratorium (TH, TT, AH, AD) Oslo Norway
| | - Torleif Trydal
- Fürst Medisinsk Laboratorium (TH, TT, AH, AD) Oslo Norway
| | - Asgeir Husa
- Fürst Medisinsk Laboratorium (TH, TT, AH, AD) Oslo Norway
| | | | - Saranda Kabashi
- From the Department of Forensic Sciences (AÅ, GH, SK, VV, STB) Oslo University Hospital Oslo Norway
- Faculty of Medicine (GH, SK, VV) Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Vigdis Vindenes
- From the Department of Forensic Sciences (AÅ, GH, SK, VV, STB) Oslo University Hospital Oslo Norway
- Faculty of Medicine (GH, SK, VV) Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Stig Tore Bogstrand
- From the Department of Forensic Sciences (AÅ, GH, SK, VV, STB) Oslo University Hospital Oslo Norway
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9
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Miller S, A Mills J, Long J, Philibert R. A Comparison of the Predictive Power of DNA Methylation with Carbohydrate Deficient Transferrin for Heavy Alcohol Consumption. Epigenetics 2020; 16:969-979. [PMID: 33100127 DOI: 10.1080/15592294.2020.1834918] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Currently, the most commonly used biomarker of alcohol consumption patterns is carbohydrate-deficient transferrin (CDT). However, the CDT has limited sensitivity and requires the use of blood. Recently, we have shown that digital DNA methylation techniques can both sensitively and specifically detect heavy alcohol consumption (HAC) using DNA from blood or saliva. In order to better understand the relative performance characteristics of these two tests, we compared an Alcohol T-Score (ATS) derived from our prior study and serum CDT levels in 313 (182 controls and 131 HAC cases) subjects discordant for HAC. Overall, the Receiver Operating Characteristic (ROC) area under the curve (AUC) analyses showed that DNA methylation predicted HAC status better than CDT with AUCs of 0.96 and 0.87, respectively (p < 0.0001). The performance of the CDT was affected by gender while the ATS was not, while both were affected by age. We conclude that DNA methylation is a promising method for quantifying HAC and that further studies to better refine its strengths and limitations are in order.
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Affiliation(s)
| | - James A Mills
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Jeffrey Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA.,Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Robert Philibert
- Behavioral Diagnostics LLC, Coralville, IA, USA.,Department of Psychiatry, University of Iowa, Iowa City, IA, USA
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10
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CDG biochemical screening: Where do we stand? Biochim Biophys Acta Gen Subj 2020; 1864:129652. [DOI: 10.1016/j.bbagen.2020.129652] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/18/2020] [Accepted: 05/28/2020] [Indexed: 12/22/2022]
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Azurmendi-Funes ML, Martínez-Villanueva M, Delgado-Marín JL, Ramis R, Sánchez-Sauco MF, López-Hernández FA, Sánchez-Solís M, Monteagudo-Piqueras O, Noguera-Velasco JA, Claudio L, Ortega-García JA. An Integrative Screening Tool of Alcohol Exposure During Early Pregnancy: Combining of the CDT Biomarker with Green Page Questionnaire. Alcohol Alcohol 2020; 54:599-608. [PMID: 31612211 DOI: 10.1093/alcalc/agz073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/01/2019] [Accepted: 08/08/2019] [Indexed: 11/14/2022] Open
Abstract
AIMS In current clinical practice, prenatal alcohol exposure is usually assessed by interviewing the pregnant woman by applying questionnaires. An alternative method for detecting alcohol use is to measure the biomarker carbohydrate-deficient transferrin (CDT). However, few studies measure CDT during pregnancy. This study examines the utility of CDT biomarker in the screening of alcohol exposure during early pregnancy. METHODS A cohort of 91, first-trimester pregnant women assigned to a public reference maternity hospital, was screened using the Green Page (GP) questionnaire, an environmental exposure tool. CDT levels and other biomarkers of alcohol use were measured and compared with questionnaire data. RESULTS About 70% of the mothers in the study consumed alcohol during early pregnancy and 22% met high-risk criteria for prenatal exposure to alcohol. CDT measurement showed a statistically significant area under the receiver operating characteristic curve with a value of 0.70. For a value of 0.95% of CDT, a specificity of 93% was observed. The most significant predictors of CDT were the number of binge drinking episodes, women's body mass index and European white race. CONCLUSION Pregnant women with a CDT value >0.95% would be good candidates for the performance of the GP questionnaire during early pregnancy in order to detect potential high-risk pregnancy due to alcohol exposure.
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Affiliation(s)
- María Luisa Azurmendi-Funes
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environmental and Human Health (A5) Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain
| | - Miriam Martínez-Villanueva
- Clinical Laboratory, University Clinical Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain
| | - Juan Luís Delgado-Marín
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Virgen de la Arrixaca University Hospital, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain
| | - Rebecca Ramis
- Cancer and Environmental Epidemiology Unit, National Epidemiology Centre, Carlos III Health Institute and Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Avda. Monforte de Lemos 5, 28029 Madrid, Spain
| | - Miguel Felipe Sánchez-Sauco
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environmental and Human Health (A5) Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain
| | - Fernando Antonio López-Hernández
- Departamento de Métodos Cuantitativos e Informáticos, Universidad Politécnica de Cartagena, C/ Real, 3; 30201 Cartagena, Murcia, Spain
| | - Manuel Sánchez-Solís
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environmental and Human Health (A5) Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain
| | | | - José Antonio Noguera-Velasco
- Clinical Laboratory, University Clinical Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain
| | - Luz Claudio
- Department of Environmental Medicine and Public Health, Mount Sinai School of Medicine, One Gustave L. Levy Place, #1057, New York, NY, 10029-6574, USA
| | - Juan Antonio Ortega-García
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environmental and Human Health (A5) Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain
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Helander A, Böttcher M, Dahmen N, Beck O. Elimination Characteristics of the Alcohol Biomarker Phosphatidylethanol (PEth) in Blood during Alcohol Detoxification. Alcohol Alcohol 2019; 54:251-257. [PMID: 30968936 PMCID: PMC7011165 DOI: 10.1093/alcalc/agz027] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 03/07/2019] [Accepted: 03/15/2019] [Indexed: 11/17/2022] Open
Abstract
Aims The study documented elimination characteristics of three phosphatidylethanol (PEth) homologs in serially collected blood samples from 47 heavy drinkers during ~2 weeks of alcohol detoxification at hospital. Methods Venous whole blood and urine samples were collected every 1–2 days during treatment. Concentrations of PEth, and of urinary ethyl glucuronide (EtG) and ethyl sulfate (EtS) to detect relapse drinking, were measured using liquid chromatography-tandem mass spectrometry. Results When included in the study, negative or decreasing breath ethanol concentrations demonstrated that the patients were in the elimination phase. The EtG and EtS measurements further confirmed alcohol abstinence during the study, with three exceptions. On admission, all patients tested positive for PEth, the total concentration ranging 0.82–11.7 (mean 6.35, median 5.88) μmol/l. PEth 16:0/18:1, 16:0/18:2 and 16:0/20:4 accounted for on average ~42%, ~26% and ~9%, respectively, of total PEth in these samples. There were good correlations between total PEth and individual homologs (P < 0.0001). There was no significant difference in PEth values between male and female subjects. During abstinence, the elimination half-life values ranged 3.5–9.8 days for total PEth, 3.7–10.4 days for PEth 16:0/18:1, 2.7–8.5 days for PEth 16:0/18:2 and 2.3–8.4 days for PEth 16:0/20:4. Conclusions The results demonstrated a very high sensitivity (100%) of PEth as alcohol biomarker for recent heavy drinking, but considerable differences in the elimination rates between individuals and between different PEth forms. This indicates that it is possible to make only approximate estimates of the quantity and recency of alcohol intake based on a single PEth value.
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Affiliation(s)
- Anders Helander
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Pharmacology and Clinical Chemistry, Karolinska University Laboratory, Stockholm, Sweden
- Corresponding author: C1:74, Clinical Chemistry, Karolinska University Laboratory Huddinge, SE-141 86 Stockholm, Sweden. Tel.: +46-8-58581293; E-mail:
| | | | - Norbert Dahmen
- Universitätsmedizin Mainz, Klinik für Psychiatrie und Psychotherapie, Mainz, Germany
| | - Olof Beck
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Pharmacology and Clinical Chemistry, Karolinska University Laboratory, Stockholm, Sweden
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Porpiglia NM, Savchuk SA, Appolonova SA, Bortolotti F, Tagliaro F. Capillary Electrophoresis (CE) vs. HPLC in the determination of asialo-Tf, a crucial marker for the reliable interpretation of questioned CDT increases. Clin Chim Acta 2018; 486:49-53. [DOI: 10.1016/j.cca.2018.07.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/17/2018] [Accepted: 07/17/2018] [Indexed: 11/17/2022]
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14
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Yoo G, Kim J, Yoon KJ, Lee JH. The characteristics of transferrin variants by carbohydrate-deficient transferrin tests using capillary zone electrophoresis. J Clin Lab Anal 2018; 32:e22451. [DOI: 10.1002/jcla.22451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 03/23/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Gilsung Yoo
- Departments of Laboratory Medicine; Yonsei University Wonju College of Medicine; Wonju Korea
| | - Juwon Kim
- Departments of Laboratory Medicine; Yonsei University Wonju College of Medicine; Wonju Korea
| | - Kap Joon Yoon
- Departments of Laboratory Medicine; Yonsei University Wonju College of Medicine; Wonju Korea
| | - Jong-Han Lee
- Departments of Laboratory Medicine; Yonsei University Wonju College of Medicine; Wonju Korea
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15
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Bortolotti F, Sorio D, Bertaso A, Tagliaro F. Analytical and diagnostic aspects of carbohydrate deficient transferrin (CDT): A critical review over years 2007-2017. J Pharm Biomed Anal 2017; 147:2-12. [PMID: 28912047 DOI: 10.1016/j.jpba.2017.09.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 08/30/2017] [Accepted: 09/01/2017] [Indexed: 02/07/2023]
Abstract
The need for investigating alcohol abuse by means of objective tools is worldwide accepted. Among the currently available biomarkers of chronic alcohol abuse, carbohydrate-deficient transferrin (CDT) is one of the most used indicator, mainly because of its high specificity. However, some CDT analytical and interpretation aspects are still under discussion, as witnessed by numerous research papers and reviews. The present article presents a critical review of the literature on CDT appeared in the period from 2007 to 2017 (included). The article is organized in the following sections: (1) introduction, (2) pre-analytical aspects (3) analytical aspects (4) diagnostic aspects (5) concluding remarks. As many as 139 papers appeared in the international literature and retrieved by the search engines PubMed, Web of Science and Scopus are quoted.
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Affiliation(s)
- F Bortolotti
- Dept of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Italy.
| | - D Sorio
- Dept of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Italy
| | - A Bertaso
- Dept of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Italy
| | - F Tagliaro
- Dept of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Italy; Institute of Pharmacy and Translational Medicine, Sechenov First Medical University, Moskow, Russia
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Kilpatrick LE, Kilpatrick EL. Optimizing High-Resolution Mass Spectrometry for the Identification of Low-Abundance Post-Translational Modifications of Intact Proteins. J Proteome Res 2017; 16:3255-3265. [PMID: 28738681 DOI: 10.1021/acs.jproteome.7b00244] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Intact protein analysis by liquid chromatography-mass spectrometry (LC-MS) is now possible due to the improved capabilities of mass spectrometers yielding greater resolution, mass accuracy, and extended mass ranges. Concurrent measurement of post-translational modifications (PTMs) during LC-MS of intact proteins is advantageous while monitoring critical proteoform status, such as for clinical samples or during production of reference materials. However, difficulties exist for PTM identification when the protein is large or contains multiple modification sites. In this work, analyses of low-abundance proteoforms of proteins of clinical or therapeutic interest, including C-reactive protein, vitamin D-binding protein, transferrin, and immunoglobulin G (NISTmAb), were performed on an Orbitrap Elite mass spectrometer. This work investigated the effect of various instrument parameters including source temperatures, in-source CID, microscan type and quantity, resolution, and automatic gain control on spectral quality. The signal-to-noise ratio was found to be a suitable spectral attribute which facilitated identification of low abundance PTMs. Source temperature and CID voltage were found to require specific optimization for each protein. This study identifies key instrumental parameters requiring optimization for improved detection of a variety of PTMs by LC-MS and establishes a methodological framework to ensure robust proteoform identifications, the first step in their ultimate quantification.
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Affiliation(s)
- Lisa E Kilpatrick
- National Institute of Standards and Technology , Material Measurement Laboratory, Biomolecular Measurement Division, 100 Bureau Drive, Stop 8314, Gaithersburg, Maryland 20899, United States
| | - Eric L Kilpatrick
- National Institute of Standards and Technology , Material Measurement Laboratory, Biomolecular Measurement Division, 100 Bureau Drive, Stop 8314, Gaithersburg, Maryland 20899, United States
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17
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Reprint of Standardisation and use of the alcohol biomarker carbohydrate-deficient transferrin (CDT). Clin Chim Acta 2017; 467:15-20. [DOI: 10.1016/j.cca.2017.03.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 05/02/2016] [Accepted: 05/20/2016] [Indexed: 11/22/2022]
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18
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IFCC approved HPLC reference measurement procedure for the alcohol consumption biomarker carbohydrate-deficient transferrin (CDT): Its validation and use. Clin Chim Acta 2017; 465:91-100. [DOI: 10.1016/j.cca.2016.12.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 12/21/2016] [Indexed: 11/21/2022]
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Fluorescent adduct formation with terbium: a novel strategy for transferrin glycoform identification in human body fluids and carbohydrate-deficient transferrin HPLC method validation. Anal Bioanal Chem 2016; 409:1369-1378. [DOI: 10.1007/s00216-016-0069-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 10/26/2016] [Indexed: 11/26/2022]
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Aakerøy R, Skråstad RB, Helland A, Hilberg T, Aamo T, Dyrkorn R, Spigset O. [New biomarkers for assesing alcohol consumption]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2016; 136:1643-1647. [PMID: 27790892 DOI: 10.4045/tidsskr.16.0056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Alcohol abuse has significant medical, social and socioeconomic consequences. Alcohol biomarkers may serve as a useful tool in identifying individuals with excessive alcohol consumption in medical as well as medico-legal contexts.
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Affiliation(s)
| | - Ragnhild Bergene Skråstad
- Avdeling for klinisk farmakologi St. Olavs hospital og Institutt for laboratoriemedisin, barne- og kvinnesykdommer Norges teknisk-naturvitenskapelige universitet
| | - Arne Helland
- Avdeling for klinisk farmakologi St. Olavs hospital og Institutt for laboratoriemedisin, barne- og kvinnesykdommer Norges teknisk-naturvitenskapelige universitet
| | | | - Trond Aamo
- Avdeling for klinisk farmakologi St. Olavs hospital
| | - Roar Dyrkorn
- Avdeling for klinisk farmakologi St. Olavs hospital
| | - Olav Spigset
- Avdeling for klinisk farmakologi St. Olavs hospital og Institutt for laboratoriemedisin, barne- og kvinnesykdommer Norges teknisk-naturvitenskapelige universitet
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Wrześniak M, Kepinska M, Królik M, Milnerowicz H. Influence of tobacco smoking on transferrin sialylation during pregnancy in smoking and non-smoking women with iron deficiency. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2016; 46:95-102. [PMID: 27448041 DOI: 10.1016/j.etap.2016.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Tobacco smoking influence on proteins is leading to despaired foetal nourishment. Transferrin, is an essential metal-binding protein responsible for iron transport and proper foetal development. This study examines influence of tobacco smoking on transferrin sialic acid residues and its connection to foetal nourishment at women with iron deficiency. METHODS The study involved 190 samples from pregnant women in 1st, 2nd and 3rd trimester. Women were divided in terms of tobacco smoking and iron deficiency. RESULTS During pregnancy, the levels of 2-, 5- and 6-sialo transferrin were increasing while 3- and 4-sialo transferrin were decreasing in all groups. Transferrin isoforms showed positive correlation with lowered iron stores in the blood of non-smoking women. CONCLUSION Tobacco smoking has an influence on number of sialic acids residues in the transferrin and seems to change conversion of Tf isoforms, and this may disturb iron transport and in consequence influence on foetal development and nourishment.
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Affiliation(s)
- Marta Wrześniak
- Department of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland.
| | - Marta Kepinska
- Department of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland
| | - Małgorzata Królik
- Early Pregnancy Pathology Clinic, Centre of Gynecology, Obstetrics and Neonatology, Reymonta 8, 45-066 Opole, Poland
| | - Halina Milnerowicz
- Department of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland.
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Helander A, Wielders J, Anton R, Arndt T, Bianchi V, Deenmamode J, Jeppsson JO, Whitfield JB, Weykamp C, Schellenberg F. Standardisation and use of the alcohol biomarker carbohydrate-deficient transferrin (CDT). Clin Chim Acta 2016; 459:19-24. [DOI: 10.1016/j.cca.2016.05.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 05/02/2016] [Accepted: 05/20/2016] [Indexed: 10/21/2022]
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Wrześniak M, Kepinska M, Bizoń A, Milnerowicz-Nabzdyk E, Milnerowicz H. Transferrin Sialylation in Smoking and Non-Smoking Pregnant Women with Intrauterine Growth Restriction. Fetal Pediatr Pathol 2015; 34:391-9. [PMID: 26470653 DOI: 10.3109/15513815.2015.1095260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Transferrin (Tf) is a glycosylated protein responsible for transporting iron. Various sialylation levels of Tf are observed during physiological and pathological processes. We studied if the changes in iron stores as well as tobacco smoke may have an impact on foetal development and in consequence lead to intrauterine growth restriction (IUGR). In the third trimester of pregnancy, lower levels of 4-sialoTf isoform and higher levels of 5-sialoTf were observed in the serum of non-smoking women with IUGR in comparison to the control group. On the day of labour, level of 2-sialoTf was significantly lower and level of 3-sialo was Tf higher in the serum of non-smoking women. Level of 4-sialo was found lower in the serum of smoking women with IUGR than in the control group. The observed changes may suggest a connection between iron stores, transport of iron to the foetus and foetal development.
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Affiliation(s)
- Marta Wrześniak
- a Department of Biomedical and Environmental Analysis , Wrocław Medical University , Wrocław , Poland
| | - Marta Kepinska
- a Department of Biomedical and Environmental Analysis , Wrocław Medical University , Wrocław , Poland
| | - Anna Bizoń
- a Department of Biomedical and Environmental Analysis , Wrocław Medical University , Wrocław , Poland
| | - Ewa Milnerowicz-Nabzdyk
- b 2nd Department and Clinic of Gynaecology and Obstetrics , Wrocław Medical University , Wrocław , Poland
| | - Halina Milnerowicz
- a Department of Biomedical and Environmental Analysis , Wrocław Medical University , Wrocław , Poland
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Stokbroekx MAL, Houterman S, Coolen SAJ, van der Lely N, Pelleboer RAA. Are Carbohydrate-Deficient Transferrin Assays Useful for the Detection of Recurrent 'Binge Drinking' in Children with an Alcohol Intoxication in the Emergency Department? Alcohol Alcohol 2014; 49:635-8. [PMID: 25227633 DOI: 10.1093/alcalc/agu050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 07/07/2014] [Indexed: 11/12/2022] Open
Abstract
AIMS The aim of this study was to evaluate different carbohydrate-deficient transferrin (CDT) assays for the detection of recurrent excessive alcohol abuse in adolescents prior to acute alcohol intoxication. METHODS Data on drinking behaviour and CDT levels of adolescents (13-18 years) registered at the outpatient clinic for youth and alcohol at three major district general hospitals in the Netherlands were retrospectively collected. CDT and disialotransferrin (DST) levels of binge-drinking teenagers were compared with non-binge-drinking teenagers. RESULTS In total 198 samples were collected for the N Latex CDT method (N = 83), no differences were found in mean CDT levels for binge versus non-binge drinkers (P = 0.8). The Helander HPLC (N = 78) showed significantly higher values for binge drinkers than for non-binge drinkers (mean 1.20%DST, SD 0.28 and mean 1.01%DST, SD 0.31, respectively (P = 0.01)). The Recipe ClinRep method (N = 37) also showed significantly higher values for binge drinkers (mean 1.17%DST, SD 0.36 and mean 0.89%DST, SD 0.34, respectively (P = 0.03)). CONCLUSION With the Helander HPLC method and the Recipe ClinRep assay higher levels are measured in binge drinkers than in non-binge drinkers.
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Affiliation(s)
| | - Saskia Houterman
- Department of Education and Research, Catharina Hospital, Eindhoven, the Netherlands
| | - Stefan A J Coolen
- Medical Laboratories, Department of Clinical Chemistry, Reinier de Graaf Hospital, Delft, the Netherlands
| | - Nico van der Lely
- Department of Paediatrics, Reinier de Graaf Hospital, Delft, the Netherlands
| | - Rolf A A Pelleboer
- Department of Paediatrics, Catharina Hospital, Eindhoven, the Netherlands
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Weykamp C, Wielders J, Helander A, Anton RF, Bianchi V, Jeppsson JO, Siebelder C, Whitfield JB, Schellenberg F. Harmonization of Measurement Results of the Alcohol Biomarker Carbohydrate-Deficient Transferrin by Use of the Toolbox of Technical Procedures of the International Consortium for Harmonization of Clinical Laboratory Results. Clin Chem 2014; 60:945-53. [DOI: 10.1373/clinchem.2014.221531] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
BACKGROUND
The need for equivalent results of routine measurement procedures for the alcohol biomarker carbohydrate-deficient transferrin (CDT) has been recognized by the IFCC. This article describes a project to harmonize CDT as conducted by an IFCC working group initiated for this purpose.
METHODS
We used procedures for achieving harmonization as developed by the Consortium for Harmonization of Clinical Laboratory Results to assess the suitability of a candidate reference measurement procedure (cRMP), candidate reference materials (cRMs), and the success of efforts to achieve harmonization.
RESULTS
CDT measurement procedures in routine use showed good reproducibility (CV 1.1%–2.8%) and linearity (r > 0.990) with variable slopes (0.766–1.065) and intercepts (−0.34 to 0.92) compared to the cRMP. Heterogeneity after simulated harmonization was 4.7%. cRMs of frozen human native sera demonstrated commutability and 3-year stability for routine measurement procedures. The cRMP provided reproducible value assignment to cRMs with an expanded uncertainty (k = 2) of 0.03% at the 1.2% CDT level and 0.06% at the 4.4% CDT level. Harmonization efforts reduced the intermeasurement CV from 8.8% to 3.4%, allowed 99% recovery of the values assigned with the cRMP, and demonstrated 99% of results within the desirable allowable total error. Harmonization was less successful in samples with low CDT and high trisialotransferrin concentrations.
CONCLUSIONS
Harmonization of CDT is possible with frozen human native sera as cRMs with values assigned by use of the cRMP. We propose the cRMP as a candidate international conventional reference measurement procedure and cRMs as candidate international calibrators.
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Affiliation(s)
- Cas Weykamp
- Department of Clinical Chemistry, Queen Beatrix Hospital, Winterswijk, the Netherlands
| | - Jos Wielders
- Department of Clinical Chemistry, Meander Medical Center, Amersfoort, the Netherlands
| | - Anders Helander
- Department of Laboratory Medicine, Karolinska Institutet, and Karolinska University Laboratory, Clinical Chemistry, Stockholm, Sweden
| | - Raymond F Anton
- The Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston, SC
| | - Vincenza Bianchi
- Toxicology Reference Laboratory, SS. Antonio e Biagio Hospital, Alessandria, Italy
| | - Jan-Olof Jeppsson
- Department of Laboratory Medicine, Malmö University Hospital, Malmö, Sweden
| | - Carla Siebelder
- Department of Clinical Chemistry, Queen Beatrix Hospital, Winterswijk, the Netherlands
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Fagan KJ, Irvine KM, McWhinney BC, Fletcher LM, Horsfall LU, Johnson L, O'Rourke P, Martin J, Scott I, Pretorius CJ, Ungerer JPJ, Powell EE. Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers. BMC Gastroenterol 2014; 14:97. [PMID: 24885510 PMCID: PMC4042141 DOI: 10.1186/1471-230x-14-97] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 05/14/2014] [Indexed: 12/27/2022] Open
Abstract
Background and Aim Carbohydrate deficient transferrin (CDT) is the most specific serum biomarker of heavy alcohol consumption, defined as ≥ 350–420 g alcohol/week. Despite introduction of a standardized reference measurement technique, widespread use of CDT remains limited due to low sensitivity. The aim of this study was to determine the factors that affect diagnostic sensitivity in patients with sustained heavy alcohol intake. Methods Patients with a self-reported history of sustained heavy alcohol consumption were recruited from the hepatology outpatient department or medical wards. Each patient was interviewed with a validated structured questionnaire of alcohol consumption and CDT analysis using the standardized reference measurement technique with high performance liquid chromatography was performed on serum collected at time of interview. Results 52 patients were recruited: 19 from the hepatology outpatient department and 33 from general medical wards. Median alcohol intake was 1013 (range 366–5880) g/week over the preceding two week period. 26 patients had a diagnostic CDT based on a threshold value of %CDT > 1.7 indicating heavy alcohol consumption, yielding a sensitivity of 50%. Overweight/obesity (defined as body mass index (BMI) ≥ 25 kg/m2 in Caucasians and ≥ 23.0 kg/m2 in Asians), female gender and presence of cirrhosis were independently associated with non-diagnostic %CDT (≤ 1.7). Conclusions CDT has limited sensitivity as a biomarker of heavy alcohol consumption. Caution should be applied when ordering and interpreting %CDT results, particularly in women, patients with cirrhosis and those with an elevated BMI.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Elizabeth E Powell
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Woolloongabba 4102, Brisbane, Queensland, Australia.
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Song B, Zhu J, Wu J, Zhang C, Wang B, Pan B, Guo W. Determination of carbohydrate-deficient transferrin in a Han Chinese population. BMC BIOCHEMISTRY 2014; 15:5. [PMID: 24571498 PMCID: PMC3945810 DOI: 10.1186/1471-2091-15-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Accepted: 02/17/2014] [Indexed: 11/21/2022]
Abstract
Background Carbohydrate-deficient transferrin (CDT) is a widely used alcohol biomarker. Because of the high prevalence of chronic alcohol abuse in many countries, CDT plays an important role in the areas of traffic, clinical, and forensic medicine. However, CDT levels have not been determined in the Han Chinese population. Therefore, we investigated the frequency of genetic transferrin variants and the relationship between CDT levels and alcohol consumption in this population. From this data, we established a CDT cut-off for Han Chinese and evaluated the analytical performance of the CDT capillary zone electrophoresis system. Results The prevalence of transferrin variants was 4.14%. The mean CDT level of the reference group was 0.73%. We recommended CDT level >1.5% as cut off standard of alcohol intake to ensuring the specificity was best. The CDT test total precision for 0.5%, 0.7%, and 1.55% was 14.4%, 11.5%, and 7.2%, respectively. The data showed good linearity in the studied range of 0.6% to 8.2%. Conclusions These results demonstrate that CDT is a useful marker to detect heavy daily alcohol consumption. We proposed and evaluated the first CDT cut-off for the Han Chinese population, and we showed that the CDT capillary zone electrophoresis system is a reliable analytic method.
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Affiliation(s)
| | | | | | | | | | | | - Wei Guo
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
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Vidali M, Bianchi V, Bagnati M, Atzeni N, Bianchi AM, Bellomo G. False negativity to carbohydrate-deficient transferrin and drugs: a clinical case. Biochem Med (Zagreb) 2014; 24:175-9. [PMID: 24627727 PMCID: PMC3936976 DOI: 10.11613/bm.2014.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 01/15/2014] [Indexed: 11/18/2022] Open
Abstract
Introduction: In this work we report on the possible effect of the medical therapy on CDT concentration in a chronic alcohol abuser, with known medical history (July 2007 – April 2012) and alcohol abuse confirmed by relatives. Case history: At the end of 2007, patient displayed the following laboratory results: AST 137 U/L, ALT 120 U/L, GGT 434 U/L, MCV 101 fL and CDT 3.3%. On December 2007, after double coronary artery bypass surgery, he began a pharmacological treatment with amlodipine, perindopril, atorvastatin, isosorbide mononitrate, carvedilol, ticlopidine and pantoprazole. In the next months, until may 2011, the patient resumed alcohol abuse, as confirmed by relatives; however, CDT values were repeatedly found negative (0.8% and 1.1%) despite elevated transaminases and GGT, concurrent elevated ethyl glucuronide concentration (> 50 mg/L) and blood alcohol concentration (> 1 g/L). Alcohol consumption still continued despite increasing disulfiram doses ordered by an Alcohol Rehab Center. On May 2011, the patient was transferred to a private medical center where he currently lives. Conclusions: This study suggests the possibility that a medical therapy including different drugs may hamper the identification of chronic alcohol abusers by CDT.
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Affiliation(s)
- Matteo Vidali
- Department of Health Sciences, University "Amedeo Avogadro" of East Piedmont, and Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Vincenza Bianchi
- Toxicology Laboratory, Deaprtment of Clinical Pathology, SS. Antonio e Biagio e C. Arrigo Hospital, Alessandria, Italy
| | - Marco Bagnati
- Department of Health Sciences, University "Amedeo Avogadro" of East Piedmont, and Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Nadia Atzeni
- Department of Health Sciences, University "Amedeo Avogadro" of East Piedmont, and Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Andrea Marco Bianchi
- Department of Health Sciences, University "Amedeo Avogadro" of East Piedmont, and Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Giorgio Bellomo
- Department of Health Sciences, University "Amedeo Avogadro" of East Piedmont, and Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy
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Helander A, Kenan Modén N. Effect of transferrin glycation on the use of carbohydrate-deficient transferrin as an alcohol biomarker. Alcohol Alcohol 2013; 48:478-82. [PMID: 23690231 DOI: 10.1093/alcalc/agt045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Measurement of an alcohol-induced shift in the serum transferrin glycosylation pattern, termed carbohydrate-deficient transferrin (CDT), is used as a biomarker for sustained high alcohol consumption. The present work examined whether non-enzymatic reaction of transferrin with glucose (glycation) might interfere with the use of CDT as an alcohol biomarker. METHODS The blood specimens were leftover volumes from the routine sample pool. Plasma and serum were collected among samples submitted for hemoglobin A1c (HbA1c) and CDT testing. Quantification of individual transferrin glycoforms in percentage of total transferrin was performed by an HPLC candidate CDT reference method. RESULTS Incubating serum spiked with 20 or 200 mmol/l glucose caused time- and dose-dependent changes in the chromatographic profile of transferrin glycoforms, resulting in gradually wider peaks and reduced relative amounts of disialo- and trisialotransferrin. No similar chromatographic effects were seen in samples collected from diabetic patients with elevated HbA1c (>68 mmol/mol) values. These samples instead showed slightly higher mean %disialotransferrin levels (1.21%) compared with low HbA1c (<44 mmol/mol) samples (mean 1.06%; P = 0.023), pointing at a higher alcohol consumption level in the former group. Altogether ∼5% of the CDT values exceeded the cutoff. There was no significant difference in phosphatidylethanol (PEth) levels between the high and low HbA1c samples, but several (∼14%) showed elevated PEth concentrations. CONCLUSION Glycation of serum transferrin in vivo was indicated to differ from that in vitro, and suggested not to interfere with %CDT testing by the HPLC method. The results indicated that CDT and PEth are useful as objective, complementary alcohol biomarkers to identify risky drinking also in diabetic subjects.
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Affiliation(s)
- Anders Helander
- Alcohol Laboratory, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
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Pilowsky DJ, Wu LT. Screening instruments for substance use and brief interventions targeting adolescents in primary care: a literature review. Addict Behav 2013; 38:2146-53. [PMID: 23454877 DOI: 10.1016/j.addbeh.2013.01.015] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 12/03/2012] [Accepted: 01/24/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND A review of the literature was conducted to examine substance use screening instruments commonly used with adolescents in medical settings, their comparative usefulness, and SBIRT (Screening, Brief Intervention, and Referral to Treatment). METHODS We screened two databases (Ovid MEDLINE and PsycINFO) targeting journal articles dealing with screening for alcohol and drug use in adolescence as well as adolescent SBIRT. RESULTS Adolescents preferred paper forms and computerized questionnaires over interviews with physicians or nurses. The CRAFFT was the best studied instrument for screening for alcohol/drug use and related problems, and is the only tool with data to support its use in medical settings. Other screening instruments require more testing/evaluation in more representative samples of adolescents in primary care settings. Long term follow-up data to establish the efficacy of SBIRT in adolescence are not available. Innovative computerized approaches to screening for substance use in this population have recently been proposed. Although promising, they require further evaluation. CONCLUSIONS The CRAFFT has the most consistent data to support its use in primary care settings. The effects of SBIRT in adolescence have not been adequately evaluated. Adolescents' opinions and preferences for SBIRT should be studied to improve their acceptance.
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Bakhireva LN, Cano S, Rayburn WF, Savich RD, Leeman L, Anton RF, Savage DD. Advanced gestational age increases serum carbohydrate-deficient transferrin levels in abstinent pregnant women. Alcohol Alcohol 2012; 47:683-7. [PMID: 22878591 DOI: 10.1093/alcalc/ags087] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Carbohydrate-deficient transferrin (%CDT) is a well-established and highly specific biomarker for sustained heavy consumption of alcohol. However, in pregnant women, the specificity of this biomarker might be affected by advanced gestational age, even after accounting for increased transferrin concentrations in pregnancy. The goal of this prospective study was to assess the variability in %CDT during pregnancy among alcohol-abstaining patients. METHODS Patients were recruited during one of the first prenatal care visits and followed-up to term. Abstinence was confirmed by maternal self-report and by alcohol biomarkers. Biomarkers assessed in the mother included serum gamma-glutamyltranspeptidase, urine ethyl glucuronide and ethyl sulfate, and whole blood phosphatidylethanol (PEth). In addition, PEth was measured in a dry blood spot card obtained from a newborn. For %CDT analysis, serum samples were collected at baseline and at term and analyzed by an internationally validated high-performance liquid chromatography and spectrophotometric detection method. RESULTS At recruitment (mean gestational age 22.6 ± 7.3 weeks), the mean %CDT concentration was 1.49 ± 0.30%, while at term, it increased to 1.67 ± 0.28% (P = 0.001). Using a conventional cutoff concentration %CDT >1.7%, 22.9 and 45.7% of the sample would be classified as 'positive' for this biomarker at recruitment and at term, respectively (P = 0.011 ). CONCLUSION These results suggest that a conventional cutoff of 1.7% might be too low for pregnant women and would generate false-positive results. We propose that %CDT >2.0% be used as a cutoff concentration indicative of alcohol exposure in pregnant women. The sensitivity of %CDT at this cutoff for heavy drinking during pregnancy needs to be assessed further.
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Affiliation(s)
- Ludmila N Bakhireva
- Department of Pharmacy Practice and Administrative Sciences, University of New Mexico Health Sciences Center, MSC09 5360, Albuquerque, NM 87131, USA.
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Helander A, Péter O, Zheng Y. Monitoring of the alcohol biomarkers PEth, CDT and EtG/EtS in an outpatient treatment setting. Alcohol Alcohol 2012; 47:552-7. [PMID: 22691387 DOI: 10.1093/alcalc/ags065] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIMS To compare the sensitivity of whole blood phosphatidylethanol (PEth) with serum carbohydrate-deficient transferrin (CDT) as biomarkers of current regular alcohol consumption, during outpatient treatment for alcohol-related problems. Urinary ethyl glucuronide (EtG) and ethyl sulfate (EtS), and clinical assessment, were used as complementary estimates of relapse to drinking. METHODS Biomarker results for 29 men and 11 women (aged 20-73 years) undergoing voluntary outpatient treatment for harmful alcohol use or dependence were utilized for this evaluation. In connection with visits to the unit, blood and/or urine were sampled for measurement of PEth, EtG and EtS (by liquid chromatography-mass spectrometry), and CDT (%disialotransferrin, by high-pressure liquid chromatography). RESULTS The comparison included 326 whole blood, 319 serum (1-82 samples/patient) and 654 urine samples (1-178 samples/patient) collected over ~2 years. At the initial assessment, the total PEth value ranged between 0 and 16.5 µmol/l (mean 2.6) with 70% being above the quantification limit (0.1 µmol/l) and 55% above the reference interval (0.7 µmol/l). Initial CDT values were 0.87-6.9% (mean 2.1) with 35% above the applied reference interval (1.7%). At the final sampling (treatment period up to 21 months), the total PEth value had decreased to 0-5.9 µmol/l (mean 0.6; P = 0.0004) and CDT to 0.87-3.3% (mean 1.3; P = 0.0030). Relapses were detected by PEth alone (43% of cases), by PEth and CDT (38%) and the remainder by EtG/EtS. CONCLUSION PEth was the most sensitive biomarker of current regular alcohol consumption. PEth-16:0/18:1, usually being the major subform, was as sensitive as total PEth. PEth, CDT and EtG/EtS are useful complementary tools for objective identification of current drinking and relapse detection.
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Affiliation(s)
- Anders Helander
- Alcohol Laboratory, Department of Laboratory Medicine, Karolinska Institutet, C1:74, Clinical Chemistry, Karolinska University Laboratory Huddinge, SE-141 86 Stockholm, Sweden.
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Hahn JA, Dobkin LM, Mayanja B, Emenyonu NI, Kigozi IM, Shiboski S, Bangsberg DR, Gnann H, Weinmann W, Wurst FM. Phosphatidylethanol (PEth) as a biomarker of alcohol consumption in HIV-positive patients in sub-Saharan Africa. Alcohol Clin Exp Res 2012; 36:854-62. [PMID: 22150449 PMCID: PMC3310261 DOI: 10.1111/j.1530-0277.2011.01669.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Alcohol is heavily consumed in sub-Saharan Africa and affects HIV transmission and treatment and is difficult to measure. Our goal was to examine the test characteristics of a direct metabolite of alcohol consumption, phosphatidylethanol (PEth). METHODS Persons infected with HIV were recruited from a large HIV clinic in southwestern Uganda. We conducted surveys and breath alcohol concentration (BRAC) testing at 21 daily home or drinking establishment visits, and blood was collected on day 21 (n = 77). PEth in whole blood was compared with prior 7-, 14-, and 21-day alcohol consumption. RESULTS (i) The receiver operator characteristic area under the curve (ROC-AUC) was highest for PEth versus any consumption over the prior 21 days (0.92; 95% confidence interval [CI]: 0.86 to 0.97). The sensitivity for any detectable PEth was 88.0% (95% CI: 76.0 to 95.6) and the specificity was 88.5% (95% CI: 69.8 to 97.6). (ii) The ROC-AUC of PEth versus any 21-day alcohol consumption did not vary with age, body mass index, CD4 cell count, hepatitis B virus infection, and antiretroviral therapy status, but was higher for men compared with women (p = 0.03). (iii) PEth measurements were correlated with several measures of alcohol consumption, including number of drinking days in the prior 21 days (Spearman r = 0.74, p < 0.001) and BRAC (r = 0.75, p < 0.001). CONCLUSIONS The data add support to the body of evidence for PEth as a useful marker of alcohol consumption with high ROC-AUC, sensitivity, and specificity. Future studies should further address the period and level of alcohol consumption for which PEth is detectable.
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Affiliation(s)
- Judith A Hahn
- Department of Medicine, University of California, San Francisco, 94143-0886, USA.
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Maenhout TM, Baten G, De Buyzere ML, Delanghe JR. Carbohydrate Deficient Transferrin in a Driver's License Regranting Program. Alcohol Alcohol 2012; 47:253-60. [DOI: 10.1093/alcalc/ags013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bianchi V, Raspagni A, Arfini C, Vidali M. High performance liquid chromatography evaluation of serum carbohydrate-deficient transferrin and more sialylated transferrin glycoforms in children. Scandinavian Journal of Clinical and Laboratory Investigation 2012; 72:274-80. [PMID: 22339393 DOI: 10.3109/00365513.2012.660537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The evaluation of the age-specific distribution of transferrin glycoforms in paediatric patients may help in defining reference intervals which are critical for an improved and earlier diagnosis. DESIGN AND METHODS Serum samples from 224 children (age: 2 months-14 years) were analyzed by HPLC (Bio-Rad CDT/HPLC kit) and glycoforms expressed as percentage of the total area of transferrin (Tf). RESULTS Asialo- and Monosialo-Tf were not detectable in any patient. Medians (IQR) were respectively 0.92% (0.80-1.04%) for Disialo-Tf; 3.47% (2.69-4.18%) for Trisialo-Tf; 82.54% (81.32-83.53%) for Tetrasialo-Tf; 12.73% (11.91-14.09%) for Pentasialo-Tf. Statistically significant differences in Trisialo-Tf (p < 0.0005), Tetrasialo-Tf (p = 0.001), Pentasialo-Tf (p < 0.0005), but not in Disialo-Tf, were observed between the age groups. CONCLUSIONS Age-specific Disialo-Tf cut-offs are not necessary. In children 1.3% and 6.4% may be suggested as upper limits of normal range to detect increases of Disialo- and Trisialo-Tf. The presence of Asialo- and Monosialo-Tf should be considered an abnormal finding and prompt further investigations.
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Affiliation(s)
- Vincenza Bianchi
- Reference Toxicology Laboratory, Department of Clinical Pathology, SS. Antonio e Biagio e C. Arrigo Hospital, Alessandria, Italy
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Brown KJ, Vanderver A, Hoffman EP, Schiffmann R, Hathout Y. Characterization of Transferrin Glycopeptide Structures in Human Cerebrospinal Fluid. INTERNATIONAL JOURNAL OF MASS SPECTROMETRY 2012; 312:97-106. [PMID: 22408387 PMCID: PMC3293479 DOI: 10.1016/j.ijms.2011.06.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Transferrin in cerebrospinal fluid (CSF) exists as a mixture of silao and asialo glycoforms believed to originate from liver and brain respectively. We have previously shown that alteration in the asialo glycoform pattern could be an indication of certain anomalies in the central nervous system. Additionally, CSF asialo-transferrin has been shown to be a reliable marker to assess cerebrospinal leakage in head trauma. Therefore, the CSF transferrin glycoform pattern could be a useful diagnostic and prognostic tool. In this study we sought to characterize, in-depth, the transferrin glycovariants in cerebrospinal fluid using a combination of two-dimensional gel electrophoresis and high precision mass spectrometry analysis. Cerebrospinal fluid transferrin was detected as multiple spots (seven major spots) with different isoelectric points and slight shift in apparent molecular mass. High resolution (>60,000) and high accuracy (< 3 ppm error) mass spectrometry analysis revealed that each spot had a unique glycopeptide signature. MS(n) analysis enabled characterization of the glycan structure directly from the in-gel digested spots. The multiple spots detected for cerebrospinal fluid transferrin were mainly due to heterogeneity of di-antennary and tri-antennary glycans harboring a varying number of terminal N-acetylneuraminic acids and the existence of a high mannose and high N-acetylhexosamine glycosylated species.
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Affiliation(s)
| | | | | | - Raphael Schiffmann
- Hôpital de la Salpetriere, Paris, France
- Baylor Research Institute, Dallas, TX
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McAleer MA, Mason DL, Cunningham S, O'Shea SJ, McCormick PA, Stone C, Collins P, Rogers S, Kirby B. Alcohol misuse in patients with psoriasis: identification and relationship to disease severity and psychological distress. Br J Dermatol 2012; 164:1256-61. [PMID: 21457207 DOI: 10.1111/j.1365-2133.2011.10345.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Moderate to severe psoriasis is associated with increased alcohol intake and excessive mortality from alcohol-related causes. Alcohol biomarkers provide an objective measure of alcohol consumption. Carbohydrate-deficient transferrin (CDT) is the single most sensitive and specific alcohol biomarker. OBJECTIVES To assess alcohol consumption in a cohort of patients with moderate to severe psoriasis using standard alcohol screening questionnaires and biomarkers. We investigated whether there was an association between alcohol intake, anxiety, depression and disease severity. METHODS Consecutive patients with chronic plaque psoriasis were recruited and completed a range of anonymized assessments. Psoriasis severity, anxiety and depression, and the impact of psoriasis on quality of life were assessed. Alcohol screening questionnaires were administered. Blood specimens were taken and γ-glutamyltransferase (γGT) and CDT were measured. RESULTS A total of 135 patients completed the study. Using validated questionnaires, between 22% and 32% had difficulties with alcohol. Seven per cent had CDT > 1·6% indicating a heavy alcohol intake. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was superior to other validated questionnaires in detecting alcohol misuse. There were no significant associations between measures of excessive alcohol consumption and disease severity. Excessive alcohol intake as measured by the CAGE questionnaire was associated with increased depression (P = 0·001) but other measures of alcohol excess did not correlate with psychological distress. Men had significantly more difficulties with alcohol than women (P < 0·001). CONCLUSION Alcohol misuse is common in patients with moderate to severe psoriasis. Screening with the AUDIT questionnaire and CDT may allow the identification of patients who are misusing alcohol and allow appropriate intervention.
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Affiliation(s)
- M A McAleer
- Department of Dermatology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Luo LZ, Jin HW, Huang L, Huang HQ. Different binding affinities of Pb2+ and Cu2+ to glycosylation variants of human serum transferrin interfere with the detection of carbohydrate-deficient transferrin. Biol Trace Elem Res 2011; 144:487-95. [PMID: 21792595 DOI: 10.1007/s12011-011-9150-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Accepted: 07/11/2011] [Indexed: 10/18/2022]
Abstract
Carbohydrate-deficient transferrin (CDT) is a specific biomarker of alcohol abuse, and for diagnosis of chronic alcohol, abuse is often determined using isoelectric focusing (IEF) and chromatographic techniques. To allow this method to be used for the diagnosis of alcohol abuse, inferences of various physical and chemical factors with the detection of CDT have been investigated. However, few reports have focused thus far on whether different metal ions have different binding affinities to CDT and HTf variants or further interfere in the detection of CDT. Here, in order to figure out whether and how metal ions such as Pb(2+) and Cu(2+) bind to holo-human serum transferrin (holo-HTf) and further interfere in CDT detection, the binding characteristics and the binding parameters of holo-HTf with metal ions such as Pb(2+) and Cu(2+) were investigated using UV-visible spectroscopy, Fluorescence spectroscopy, and ICP-MS. Moreover, whether the metal ions such as Pb(2+) and Cu(2+) will reduce the diagnostic accuracy of CDT in clinic was investigated using IEF. The present study demonstrates that Pb(2+) and Cu(2+) have different binding affinities to holo-HTf variants and produce different changes in the relative amounts of each glycosylation isoforms of HTf. Accordingly, the glycosylation chains of HTf will affect the binding affinities of glycosylation isoforms with Pb(2+) and Cu(2+), causing further interferences in CDT detection.
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Affiliation(s)
- Lian-Zhong Luo
- Key Laboratory of MOE for Cell Biology and Tumor Cell Engineering, School of Life Sciences, Xiamen University, Xiamen, 361005, China
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Wurst FM, Thon N, Weinmann W, Tippetts S, Marques P, Hahn JA, Alling C, Aradottir S, Hartmann S, Lakshman R. Characterization of Sialic Acid Index of Plasma Apolipoprotein J and Phosphatidylethanol During Alcohol Detoxification-A Pilot Study. Alcohol Clin Exp Res 2011; 36:251-7. [DOI: 10.1111/j.1530-0277.2011.01618.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Luo LZ, Jin HW, Huang HQ. Application of capillary isoelectric focusing and peptide mass fingerprinting in carbohydrate-deficient transferrin detection. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2011; 25:1391-1398. [PMID: 21504004 DOI: 10.1002/rcm.4993] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Carbohydrate-deficient transferrin (CDT) is a specific biomarker of alcohol abuse and is widely used in clinical diagnosis to detect and follow up excessive alcohol consumption. However, false %CDT results still exist in CDT detection, because of interference from genetic variants and the lack of standardization in CDT analysis. Therefore, it is still very important to find a method with high sensitivity and high accuracy for CDT detection. Here, we compared the detection sensitivity and accuracy of pI values based methods [isoelectric focusing on polyacrylamide gel electrophoresis (IEF-PAGE) and capillary isoelectric focusing (CIEF)] with hydrophobic characteristic based methods [reversed-phase high-performance liquid chromatography (RP-HPLC)] on CDT detection. Moreover, we investigated the potential of peptide mass fingerprinting (PMF), a method based on the mass spectrometry to identify human transferrin (HTf) variants including CDT isoforms and genetic variants, based on their specific peptide masses. Results indicated that PMF can identify HTf variants including CDT isoforms and genetic variants based on their specific peptides, and CIEF showed higher sensitivity detection of HTf variants than RP-HPLC and IEF-PAGE did. Accordingly, we suggest that PMF is suitable for identifying CDT with high accuracy, and CIEF has potential for detection of CDT and genetic variants with high sensitivity; moreover, they are both worth further investigation in clinical diagnosis.
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Affiliation(s)
- Lian-Zhong Luo
- Key Laboratory of MOE for Cell Biology and Tumor Cell Engineering, School of Life Sciences, Xiamen University, Xiamen 361005, China
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Evaluation of capillary electrophoresis assay for CDT on SEBIA's Capillarys System: Intra and inter laboratory precision, reference interval and cut-off. Clin Chim Acta 2010; 411:1888-93. [DOI: 10.1016/j.cca.2010.07.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 06/23/2010] [Accepted: 07/14/2010] [Indexed: 11/20/2022]
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Kenan N, Husand S, Helander A. Importance of HPLC confirmation of problematic carbohydrate-deficient transferrin (CDT) results from a multicapillary electrophoresis routine method. Clin Chim Acta 2010; 411:1945-50. [DOI: 10.1016/j.cca.2010.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 07/23/2010] [Accepted: 08/04/2010] [Indexed: 10/19/2022]
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Helander A, Wielders JPM, Jeppsson JO, Weykamp C, Siebelder C, Anton RF, Schellenberg F, Whitfield JB. Toward standardization of carbohydrate-deficient transferrin (CDT) measurements: II. Performance of a laboratory network running the HPLC candidate reference measurement procedure and evaluation of a candidate reference material. Clin Chem Lab Med 2010; 48:1585-92. [PMID: 21034250 DOI: 10.1515/cclm.2010.322] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Carbohydrate-deficient transferrin (CDT) is a descriptive term used for a temporary change in the transferrin glycosylation profile caused by alcohol, and used as a biomarker of chronic high alcohol consumption. The use of an array of methods for measurement of CDT in various absolute or relative amounts, and sometimes covering different transferrin glycoforms, has complicated the comparability of results and caused confusion among medical staff. This situation prompted initiation of an IFCC Working Group on CDT standardization. This second publication of the WG-CDT covers the establishment of a network of reference laboratories running a high-performance liquid chromatography (HPLC) candidate reference measurement procedure, and evaluation of candidate secondary reference materials. The network laboratories demonstrated good and reproducible performance and thus can be used to assign target values for calibrators and controls. A candidate secondary reference material based on native human serum lyophilized with a cryo-/lyoprotectant to prevent protein denaturation was found to be commutable and stable during storage. A proposed strategy for calibration of different CDT methods is also presented. In an external quality assurance study involving 66 laboratories and covering the current routine CDT assays (HPLC, capillary electrophoresis and immunoassay), recalculation of observed results based on the nominal values for the candidate calibrator reduced the overall coefficient of variation from 18.9% to 5.5%. The logistics for distribution of reference materials and review of results were found to be functional, indicating that a full reference system for CDT may soon be available.
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Affiliation(s)
- Anders Helander
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
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Changes in transferrin glycosylation during pregnancy may lead to false-positive carbohydrate-deficient transferrin (CDT) results in testing for riskful alcohol consumption. Clin Chim Acta 2010; 412:129-33. [PMID: 20869959 DOI: 10.1016/j.cca.2010.09.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 09/17/2010] [Accepted: 09/17/2010] [Indexed: 12/12/2022]
Abstract
BACKGROUND An alcohol-induced change in serum transferrin glycosylation, termed carbohydrate-deficient transferrin (CDT), is widely used as a biomarker of heavy long-term drinking. This study examined the transferrin glycosylation profile and the risk for false-positive CDT results during pregnancy. METHODS Serum samples were collected from 24 healthy pregnant women starting in gestation week 9-21, throughout pregnancy, and 8 or more weeks after delivery. Altogether 171 sera (5-9 samples/person) were analysed. Transferrin glycoforms were quantified as a percentage of total transferrin, using an HPLC candidate reference method for CDT. RESULTS During pregnancy, the relative disialo-, pentasialo- and hexasialotransferrin levels increased gradually, whereas trisialo- and tetrasialotransferrin were reduced. This effect was most pronounced in the third trimester. For disialotransferrin, the main target in CDT testing, initial values of 1.07 ± 0.17% (mean ± SD) increased to 1.61 ± 0.23% before delivery (~50% increase). Nine (38%) pregnant women reached %disialotransferrin values ≥ 1.7% (97.5th percentile for controls) but all results were < 2.0%. In the postpartum samples, all glycoform levels had returned towards the starting values. CONCLUSIONS These results suggest that the cutoff for %disialotransferrin and %CDT employed to indicate heavy long-term drinking need to be raised slightly in pregnant women, to minimize the risk for false-positive results on CDT testing.
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Moon HW, Yun YM, Kim S, Choe WH, Hur M, Kim JQ. Determination of Carbohydrate-deficient Transferrin Levels by Using Capillary Electrophoresis in a Korean Population. Ann Lab Med 2010; 30:477-84. [DOI: 10.3343/kjlm.2010.30.5.477] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hee-Won Moon
- Departments of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Yeo-Min Yun
- Departments of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Serim Kim
- Departments of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Won Hyeok Choe
- Departments of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Mina Hur
- Departments of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
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CHD risk in relation to alcohol intake from categorical and open-ended dietary instruments. Public Health Nutr 2010; 14:402-9. [PMID: 20707945 DOI: 10.1017/s1368980010002041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the risk of CHD in relation to alcohol intake from three different instruments. DESIGN In the European Prospective Investigation into Cancer in Norfolk study, weekly alcohol intake was estimated from a single question in a mail-in health and lifestyle questionnaire (HLQ), a semi-quantitative FFQ, and a 7 d diet diary (7DD). Information on smoking status, physical activity, disease history, social class and medication use was reported in the HLQ. Height, weight, blood pressure and blood lipids were measured at a health check-up. The average length of follow-up was 11 years. The association between alcohol intake and incident fatal and non-fatal CHD in a nested case-control sample was calculated using logistic regression. SETTING Norfolk, England. SUBJECTS A total of 2151 cases of incident fatal and non-fatal CHD and 5354 controls. RESULTS The Spearman correlation values between the 7DD, FFQ and HLQ alcohol estimates ranged from r = 0·70 to 0·82 (P < 0·0001 for all r values). Alcohol intake from all instruments was inversely associated with the risk of CHD in age- and multivariate-adjusted models. The relationships between the risk of CHD and alcohol intake from the 7DD, HLQ or FFQ were not significantly different from each other (P >0·10). A marginal difference between men and women was detected for the risk of CHD in relation to HLQ alcohol intake (P = 0·065). CONCLUSIONS In conclusion, while the instruments were not uniform in their assessment of alcohol intake levels, the 7DD, HLQ and FFQ yielded similar inverse associations between alcohol intake and risk of CHD.
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Marques-Vidal P, Bochud M, Paccaud F, Waterworth D, Bergmann S, Preisig M, Waeber G, Vollenweider P. No interaction between alcohol consumption and HDL-related genes on HDL cholesterol levels. Atherosclerosis 2010; 211:551-7. [PMID: 20430392 DOI: 10.1016/j.atherosclerosis.2010.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Revised: 03/12/2010] [Accepted: 04/02/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To assess the relationships and possible interactions between polymorphisms related to HDL levels and alcohol consumption. METHODS Cross-sectional population-based study including 2863 women and 2546 men aged 35-75 years (CoLaus study). Alcohol intake was assessed by the reported alcohol consumption of the last 7 days. Nineteen candidate genes known to influence HDL levels were studied. RESULTS Alcohol consumption increased HDL cholesterol levels in both genders. After multivariate adjustment for gender, age, body mass index, smoking, hypolipidaemic drug treatment, physical activity and alcohol consumption, APOA5, CETP, LIPC and LPL gene polymorphisms were significantly (10(-5) threshold) related with HDL cholesterol levels, while no genexalcohol intake interaction was found for all SNPs studied. ABCA1 polymorphisms were related to HDL cholesterol levels on bivariate analysis but the relationship was no longer significant after multivariate analysis. CONCLUSION Our data confirm the association of alcohol consumption and of APOA5, CETP, LIPC and LPL gene polymorphisms with HDL cholesterol levels. Conversely, no genexalcohol consumption interactions were found, suggesting that the effect of alcohol consumption on HDL cholesterol levels is not mediated via a modulation of HDL related genes.
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Carbohydrate-Deficient Transferrin - A Contemporary Biomarker in Comparison with Traditional Laboratory Markers of Chronic Alcohol Abuse. J Med Biochem 2010. [DOI: 10.2478/v10011-010-0011-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Carbohydrate-Deficient Transferrin - A Contemporary Biomarker in Comparison with Traditional Laboratory Markers of Chronic Alcohol AbuseTimely identification of excessive alcohol use and its potential complications is a prerequisite for successful treatment. Several routine tests have been used in laboratories that may help in diagnosing alcoholism, such as determination of MCV, AST, ALT, GGT, but it has been shown that they lack specificity and sensitivity. Contemporary bio-markers are increasingly being used today that may due to their unique characteristics help in discovering the onset of chronic alcohol abuse, as well as in abstinence and relapse monitoring. The term carbohydrate-deficient transferrin (CDT) stands for a small group of human transferrin isoforms (asialo, monosialo, and disialotran sferrin) with a lower degree of glycosylation in comparison to the dominant transferrin isoform (tetrasialotransferrin). Persons consuming large quantities of alcohol (≥50-80 g daily) over a period of at least two weeks have increased concentrations of transferrin isoforms lacking one (disialotransferrin) or both (asialotransferrin) carbohydrate chains. In this paper the traditional markers of chronic alcohol abuse (GGT, AST, ALT, and MCV) were determined, as well as the new biomarker CDT, after which diagnostic evaluation was performed and their usability and clinical value in routine laboratory practice were estimated. These markers were also determined in heavy alcoholics on admission into hospital and after two weeks of therapy, with the aim of estimating their diagnostic value for abstinence and relapse monitoring.
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Bianchi V, Ivaldi A, Raspagni A, Arfini C, Vidali M. Use of Carbohydrate-Deficient Transferrin (CDT) and a Combination of GGT and CDT (GGT-CDT) to Assess Heavy Alcohol Consumption in Traffic Medicine. Alcohol Alcohol 2010; 45:247-51. [DOI: 10.1093/alcalc/agq006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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