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Al-Asmari AI, Altowairgi MM, Al-Amoudi DH. Effects of postmortem interval, putrefaction, diabetes, and location of death on the analysis of ethyl glucuronide and ethyl sulfate as ethanol biomarkers of antemortem alcohol consumption. Forensic Sci Int 2022; 335:111280. [PMID: 35364550 DOI: 10.1016/j.forsciint.2022.111280] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 01/16/2023]
Abstract
This study evaluated the forensic value of ethanol biomarkers ethyl glucuronide (EtG) and ethyl sulfate (EtS) under different conditions, including diabetes mellitus, drug abuse, and advanced decomposition. In addition, we explored whether ethanol, EtG, or EtS formation occurred in patients who died as a result of diabetes mellitus. Fifty-two routine postmortem cases were divided into three groups. Group 1 included only the post-mortem cases in which at least blood samples were available (n=47). Group 2 included all cases with positive BAC (n=28). Group 3 included the cases with negative BAC while information surrounding the cases suspected antemortem alcohol consumption and cases that tested negative for ethanol but positive for EtG and EtS. We analyzed multiple bodily fluid specimens, including the vitreous humor, for ethanol biomarker analysis and accurately identified antemortem ethanol consumption or postmortem ethanol synthesis. We also determined the utility of urine samples for analyzing ethanol and its metabolites in putrefaction cases. If no urine sample was available at autopsy due to urination before death or diabetes-associated glucosuria, vitreous humor samples were an appropriate alternative for ethanol biomarker testing. We observed postmortem ethanol synthesis in diabetic individuals even with a short postmortem interval (PMI), however, glucose did not increase postmortem ethanol production in individuals with diabetes under appropriate preservation. The shorter the PMI, the better the ethanol source can be determined. Postmortem ethanol production occurred in all body fluid specimens analyzed herein, including the vitreous humor. EtG and EtS levels were stable and provided accurate insight into ethanol sources, even in cases of postmortem ethanol production. While the present study focused on the use of vitreous humor for the analysis, it is expected such samples may not be available in cases of advanced decay. In cases where no other bodily fluid specimens are available, solid tissue specimens are highly preferred.
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Affiliation(s)
- Ahmed I Al-Asmari
- King Abdulaziz Hospital, Laboratory Department,، Jeddah, Saudi Arabia, P.O. Box 6470, Jeddah 21442, Saudi Arabia.
| | | | - Danih H Al-Amoudi
- Al-Thagar Hospital, Department of Laboratory, Ministry of Health, Jeddah, Saudi Arabia.
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Ethyl glucuronide and ethyl sulfate: a review of their roles in forensic toxicology analysis of alcohol postmortem. Forensic Toxicol 2021; 40:19-48. [DOI: 10.1007/s11419-021-00588-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 07/07/2021] [Indexed: 12/12/2022]
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Dip A, Mozayani A. Evaluation of the Compatibility of Ethyl Glucuronide and Ethyl Sulphate Levels to Assess Alcohol Consumption in Decomposed and Diabetic Postmortem Cases. J Anal Toxicol 2021; 45:878-884. [PMID: 34086901 DOI: 10.1093/jat/bkab061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/22/2021] [Accepted: 06/03/2021] [Indexed: 11/14/2022] Open
Abstract
The aim of the study is to evaluate the contribution of ethanol metabolite detection in postmortem cases by showing the connection between the presence of ethanol metabolites, which are indicators of alcohol consumption, and the detection of potential postmortem ethanol formation in decomposed and diabetic cases. Determination of ethanol consumption before death is often one of the most important questions in death investigations. Postmortem ethanol formation or degradation products in the blood make it difficult to distinguish antemortem consumption or postmortem formation of ethanol and eventually may lead to misinterpretation. Decomposed bodies and diabetic cases are vulnerable to postmortem ethanol formation due to putrefaction, fermentation or other degradations. Ethyl glucuronide (EtG) and ethyl sulphate (EtS) are two metabolites of ethanol produced only in the antemortem time interval. In this study, EtG and EtS levels in urine and vitreous humor samples of 27 postmortem cases, including diabetic and degraded bodies were compared to ethanol results of their blood, urine, and vitreous humor samples. EtG and EtS in urine and vitreous humor were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS-MS) and ethanol was assayed by routine headspace gas chromatography-flame ionization detector (GC-FID). These cases were devoid of other influences from forensically relevant drugs, so ethanol and/or glucose were among the only positive findings in these cases. The results of this pilot study indicate the postmortem ethanol concentrations do not correlate with the measured EtG and EtS values but are beneficial in rulings of accidental or natural deaths. This preliminary study gives additional data to help distinguish between antemortem ethanol intake and postmortem formation. EtG and EtS were well correlated positively with antemortem ethanol use instead of forming spontaneously in samples from decedents who are decomposing or have a history of diabetic hyperglycemia.
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Affiliation(s)
- Aybike Dip
- Council of Forensic Medicine, Chemistry Department, Turkey Ministry of Justice, 01120 Adana, Turkey
| | - Ashraf Mozayani
- Department of Administration of Justice, Texas Southern University, 3100 Cleburne Street, Houston, Texas 77004, USA
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Neumann J, Keller T, Monticelli F, Beck O, Böttcher M. Ethyl glucuronide and ethanol concentrations in femoral blood, urine and vitreous humor from 117 autopsy cases. Forensic Sci Int 2020; 318:110567. [PMID: 33234349 DOI: 10.1016/j.forsciint.2020.110567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/11/2020] [Accepted: 10/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Vitreous humor (VH) is a specimen of great value in forensic investigations and is being used for evaluating possible post-mortem formation of ethanol. Ethyl glucuronide (EtG) is an ethanol metabolite that has found interest for the same purpose. Both compounds can be measured in VH and because of differences in rate of distribution and elimination they may offer complementary information. METHODS VH, femoral blood (FB) and urine were collected from 117 autopsy cases for forensic investigation. Ethanol was measured with headspace gas chromatography, while EtG was measured with liquid chromatography - tandem mass spectrometry. RESULTS AND CONCLUSION Ethanol was detected in all matrices in 39 cases, while EtG was present in 62 cases. The VH-FB and the VH-urine ethanol concentrations in the 39 cases were statistically correlated (p < 0.00001). In one case with an ethanol concentration of 0.11 g/L in FB, no ethanol was detected in VH and urine, and no EtG in any specimen, indicating a possible post-mortem formation. EtG was present in VH in more cases than in FB and urine. The correlation between the EtG concentrations in VH and FB was statistically significant (p < 0.0003) as was the case also for VH and urine (p < 0.001). The combined information on ethanol and EtG concentrations in the three matrices can be used to interpret alcohol drinking habit before death. This study confirms the value of using VH as a specimen in forensic investigations regarding recent exposure to ethanol. EtG can be used not only for investigating post-mortem ethanol formation but also for estimating recent alcohol drinking.
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Affiliation(s)
| | - Thomas Keller
- Institute of Forensic Medicine, University of Salzburg, Austria
| | | | - Olof Beck
- MVZ Labor Dessau GmbH, Dessau, Germany
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Arora B, Velpandian T, Lalwani S, Saxena R, Ghose S. Ocular disposition of diazepam in rabbits: understanding its level in vitreous humour for forensic applications. AUST J FORENSIC SCI 2016. [DOI: 10.1080/00450618.2016.1205661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Beauty Arora
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
- Department of Forensic Science, Institute of Forensic Science, Mumbai, India
| | - Thirumurthy Velpandian
- Department of Ocular Pharmacology and Pharmacy, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Lalwani
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Saxena
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Supriyo Ghose
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Pélissier-Alicot AL. La redistribution post mortem : état des lieux en 2016. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2016. [DOI: 10.1016/j.toxac.2015.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cabarcos P, Álvarez I, Tabernero MJ, Bermejo AM. Determination of direct alcohol markers: a review. Anal Bioanal Chem 2015; 407:4907-25. [DOI: 10.1007/s00216-015-8701-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/26/2015] [Accepted: 04/13/2015] [Indexed: 12/15/2022]
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Rainio J, Ahola S, Kangastupa P, Kultti J, Tuomi H, Karhunen PJ, Helander A, Niemelä O. Comparison of ethyl glucuronide and carbohydrate-deficient transferrin in different body fluids for post-mortem identification of alcohol use. Alcohol Alcohol 2013; 49:55-9. [PMID: 24154730 DOI: 10.1093/alcalc/agt159] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Alcohol abuse is a major risk factor for premature death. Confirming the role of alcohol consumption in cause-of-death investigations has, however, remained difficult, due to lack of reliable biomarkers. METHODS We compared ethyl glucuronide (EtG) and carbohydrate-deficient transferrin (CDT) assays from serum, urine, cerebrospinal fluid and vitreous humor in a forensic autopsy population with either a positive (n = 38) or negative (n = 22) history of alcohol abuse based on detailed medical and police records and forensic toxicological investigations. RESULTS A positive blood alcohol concentration (median 1.15‰, range 0-3.3‰) was found in 26/38 (68%) of the cases with a documented history of alcohol abuse. EtG concentrations (mean ± SD) in urine (339 ± 389 mg/l, P < 0.001), vitreous humor (4.2 ± 4.8 mg/l, P < 0.001), serum (6.9 ± 8.9 mg/l, P < 0.01) and cerebrospinal fluid (1.7 ± 2.7 mg/l, P < 0.01) were significantly higher among the cases with a positive history of alcohol use than those in the alcohol-history negative group, whereas in corresponding comparisons CDT was significantly different only in cerebrospinal fluid (4.3 ± 2.1 vs. 2.3 ± 0.6%, P < 0.05). The highest sensitivities (92%) in detecting ante-mortem alcohol use were obtained for urine and vitreous humor EtG assays. CONCLUSION Our data indicate that measurements of EtG in urine or vitreous humor show the highest diagnostic accuracies in post-mortem investigations of excessive alcohol consumption and can be recommended for routine applications.
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Affiliation(s)
- Juha Rainio
- Corresponding author: Seinäjoki Central Hospital, 60220 Seinäjoki, Finland.
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Yaldiz F, Daglioglu N, Hilal A, Keten A, Gülmen MK. Determination of ethyl glucuronide in human hair by hydrophilic interaction liquid chromatography–tandem mass spectrometry. J Forensic Leg Med 2013; 20:799-802. [DOI: 10.1016/j.jflm.2013.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 06/10/2013] [Accepted: 06/27/2013] [Indexed: 10/26/2022]
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Zeren C, Keten A, Çelik S, Damlar I, Daglıoglu N, Çeliker A, Karaarslan B. Demonstration of ethyl glucuronide in dental tissue samples by liquid chromatography/electro-spray tandem mass spectrometry. J Forensic Leg Med 2013; 20:706-10. [PMID: 23910866 DOI: 10.1016/j.jflm.2013.03.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 03/04/2013] [Accepted: 03/19/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Ethyl glucuronide (EtG) has been studied in various tissues and body fluid for determination of alcohol intake. However, no study, dealing with EtG analysis in dental tissue, was performed so far. In this study, we aimed to demonstrate EtG levels in dental tissue. MATERIALS AND METHODS Michigan Alcohol Screening Test (MAST) was performed to 29 participants. Following the test, cases were divided into three groups as non-hazardous alcohol users, alcohol abusers and 6 controls who verbally declared that they were abstainers. A total of 29 tooth specimens, obtained from participants, was included in the study. These specimens were analyzed using LC/MS/MS. RESULTS All of the participants included in the study were male. According to the MAST outcomes 14 of the participants were non-hazardous alcohol users, and 9 were alcohol abusers, while 6 patients verbally declared that they were abstainers. Dental tissue analyses revealed EtG levels ranging between EtG<LOD and 23.39 pg/mg. EtG levels were observed to be <LOD in dental specimens of 6 abstainer cases. A significant correlation was found between EtG levels measured in the dental tissues and MAST outcomes on the statistical analyses (r=0.914). CONCLUSION The findings of the present study demonstrated that dental tissue can be used for detection of alcohol intake, using LC/MS/MS.
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Affiliation(s)
- Cem Zeren
- Mustafa Kemal University, Medical Faculty, Department of Forensic Medicine, Hatay, Turkey
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Immunoassay for ethyl glucuronide in vitreous humor: A new tool for postmortem diagnostics of alcohol use. Forensic Sci Int 2013; 226:261-5. [DOI: 10.1016/j.forsciint.2013.01.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/22/2013] [Accepted: 01/26/2013] [Indexed: 11/19/2022]
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Thierauf A, Kempf J, Perdekamp MG, Auwärter V, Gnann H, Wohlfarth A, Weinmann W. Ethyl sulphate and ethyl glucuronide in vitreous humor as postmortem evidence marker for ethanol consumption prior to death. Forensic Sci Int 2011; 210:63-8. [DOI: 10.1016/j.forsciint.2011.01.036] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 01/20/2011] [Accepted: 01/30/2011] [Indexed: 10/18/2022]
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Affiliation(s)
- T. A. Brettell
- Department of Chemical and Physical Sciences, Cedar Crest College, 100 College Drive, Allentown, Pennsylvania 18104-6196, United States
| | - J. M. Butler
- Biochemical Science Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899-8312, United States
| | - J. R. Almirall
- Department of Chemistry and Biochemistry and International Forensic Research Institute, Florida International University, University Park, Miami, Florida 33199, United States
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Current Awareness in Drug Testing and Analysis. Drug Test Anal 2010. [DOI: 10.1002/dta.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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