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Dinis-Oliveira RJ. "Not everything that can be counted counts" in ethanol toxicological results: an antemortem and postmortem technical interpretation focusing on driving under the influence. Forensic Sci Res 2024; 9:owae023. [PMID: 39006154 PMCID: PMC11240237 DOI: 10.1093/fsr/owae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/29/2024] [Indexed: 07/16/2024] Open
Abstract
Ethanol blood analysis is the most common request in forensic toxicology, and some studies point to positive results in approximately one-third of all unnatural deaths. However, distinguishing sober deaths from drunk deaths is not as simple as it may seem. This technical, clinical, and forensic interpretation is proposed to interpret the ethanol toxicological results, discussing several artefacts and pitfalls that must be considered, namely focusing on driving under the influence. This work is presented with a practical and objective approach, aiming to alleviate the complexities associated with clinical, physiological, pathophysiological, and toxicological aspects to enhance comprehension, practicality, and applicability of its content, especially to courts. Particularly the physical integrity of the body, the postmortem interval, putrefactive signs, anatomic place of blood collection, alternative samples such as vitreous humour and urine, the possibility of postmortem redistribution, the inclusion of preservatives in containers, and optimal temperature conditions of shipment are among some of the aspects to pay attention. Although several biomarkers related to postmortem microbial ethanol production have been proposed, their translation into forensic routine is slow to be implemented due to the uncertainties of their application and analytical difficulties. Specifically, in the interpretation of ethanol toxicological results, "not everything that can be counted counts and not everything that counts can be counted" (attributed to Albert Einstein).
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Affiliation(s)
- Ricardo Jorge Dinis-Oliveira
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences - CESPU, Gandra, Portugal
- UCIBIO - Research Unit on Applied Molecular Biosciences, Translational Toxicology Research Laboratory, University Institute of Health Sciences 1H-TOXRUN, IUCS-CESPU, Gandra, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
- FOREN - Forensic Science Experts, Lisbon, Portugal
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Sarpe (Paduraru) AM, Dodul C, Vlase EA, Onișor C, Niculet E, Ciobotaru OC, Drima EP. Mental Manifestations and Biomarkers of Alcohol Consumption. Life (Basel) 2024; 14:873. [PMID: 39063626 PMCID: PMC11277869 DOI: 10.3390/life14070873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/06/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
The purpose of this study is to examine healthcare usage, morbidities, and alcohol consumption monitoring in patients before a diagnosis of mental manifestations to assist in the early identification of individuals at risk. Biological markers of alcoholism are separated into two groups: those biological variables that highlight with great confidence and validate the presence of a predisposition to alcoholism, also called trait markers, or those that highlight alcohol consumption, called markers of alcoholism ("status markers"). Biomarkers are the true "gold standard" for the diagnosis of alcoholism. They are valuable for tracking evolution and progress during biological and psychological therapy and for highlighting relapse. This review compiles the existing data from research on healthcare utilization, comorbidities, and alcohol consumption monitoring in patients before a diagnosis of mental manifestations to aid in the early identification of individuals at risk. This documentary study took place over three to four months by searching for terms on the Science Direct platform, PubMed, Web of Science, and Google Scholar such as alcoholism, alcohol use disorders, alcohol abuse, and biomarkers. Studies reporting on the development, characteristics, and utilization of blood biomarkers for alcohol consumption were included in the search. The initial search included a number of 11.019 articles that contained the keywords biomarkers and alcohol. Finally, a total of 50 research articles were considered. I am involved in clinical studies, meta-analyses, reviews, and case studies regarding alcohol consumption detection, as well as potential alcohol markers.
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Affiliation(s)
- Ana-Maria Sarpe (Paduraru)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 Al. I. Cuza Street, 800008 Galati, Romania; (C.D.); (C.O.); (E.N.); (O.C.C.)
- “Sf. Apostol Andrei” Emergency County Clinical Hospital Galati, 177 Brailei Street, 800578 Galati, Romania;
| | - Cristina Dodul
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 Al. I. Cuza Street, 800008 Galati, Romania; (C.D.); (C.O.); (E.N.); (O.C.C.)
- “Sf. Apostol Andrei” Emergency County Clinical Hospital Galati, 177 Brailei Street, 800578 Galati, Romania;
| | - Emil-Andrei Vlase
- “Sf. Apostol Andrei” Emergency County Clinical Hospital Galati, 177 Brailei Street, 800578 Galati, Romania;
| | - Cristian Onișor
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 Al. I. Cuza Street, 800008 Galati, Romania; (C.D.); (C.O.); (E.N.); (O.C.C.)
- “Sf. Apostol Andrei” Emergency County Clinical Hospital Galati, 177 Brailei Street, 800578 Galati, Romania;
| | - Elena Niculet
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 Al. I. Cuza Street, 800008 Galati, Romania; (C.D.); (C.O.); (E.N.); (O.C.C.)
- “Sf. Apostol Andrei” Emergency County Clinical Hospital Galati, 177 Brailei Street, 800578 Galati, Romania;
| | - Octavian Catalin Ciobotaru
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 Al. I. Cuza Street, 800008 Galati, Romania; (C.D.); (C.O.); (E.N.); (O.C.C.)
- Railway General Hospital–Galati, 5-7 Alexandru Moruzzi Street, 800223 Galati, Romania
| | - Eduard Polea Drima
- “Elisabeta Doamna” Clinical Hospital of Psychiatry Galati, 290 Traian Street, 800179 Galati, Romania;
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Barry CV, Chrysanthopoulou SA, Tallo V, Jarilla B, Vargas Z, McDonald E, Gundogan F, Friedman JF. The Impact of Prenatal Alcohol Exposure on Longitudinal Growth, Nutritional Status, and Insulin-Like Growth Factor 1 in Early Childhood in Leyte, the Philippines. J Pediatr 2024; 269:113977. [PMID: 38401788 PMCID: PMC11096041 DOI: 10.1016/j.jpeds.2024.113977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/24/2024] [Accepted: 02/16/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE To assess the impact and potential mechanistic pathways of prenatal alcohol exposure (PAE) on longitudinal growth and nutritional status in early childhood. STUDY DESIGN A cohort of 296 mother-infant dyads (32% with PAE vs 68% unexposed) were recruited in Leyte, the Philippines, and followed from early gestation through 24 months of age. PAE was assessed using serum phosphatidylethanol (PEth) captured twice prenatally and in cord blood and supplemented with self-reported alcohol consumption. Linear mixed models were used to examine longitudinal effects of PAE on growth from birth through 2 years including key potential mediating factors (placental histopathology, and infant serum leptin and Insulin-like Growth Factor 1 [IGF-1]). RESULTS After adjusting for potential confounders, we found that PAE was significantly associated with a delayed blunting of linear growth trajectories (height-for-age z-score, body length) and weight (weight-for-age z-score, body weight) that manifested between 4 and 6 months and continued through 12-24 months. PAE was also associated with a decreased rate of mid-upper-arm circumference growth from birth to 12 months, and a lower mean IGF-1 levels at birth and 6 months. CONCLUSION This study demonstrates a delayed impact of PAE on growth that manifested around 6 months of age, underscoring the importance of routine clinical monitoring in early childhood. Furthermore, the findings supported prior animal model findings that suggest a mechanistic role for IGF-1 in PAE-induced growth delay.
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Affiliation(s)
- Christopher V Barry
- Warren Alpert Medical School of Brown University, Providence, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | | | - Veronica Tallo
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Blanca Jarilla
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Zorimel Vargas
- Center for International Health Research, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI
| | - Emily McDonald
- Center for International Health Research, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI
| | - Fusun Gundogan
- Department of Pathology, Warren Alpert Medical School of Brown University, Providence, RI; Women and Infants' Hospital, Care New England, Providence, RI
| | - Jennifer F Friedman
- Warren Alpert Medical School of Brown University, Providence, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI; Center for International Health Research, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI
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4
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de Bejczy A. Phosphatidylethanol (B-PEth) and other direct and indirect biomarkers of alcohol consumption. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2024; 175:313-344. [PMID: 38555120 DOI: 10.1016/bs.irn.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
When identifying, preventing and treating alcohol use disorder, a correct estimation of alcohol intake is essential. An objective marker is preferred as self-reported alcohol intake suffers from bias, and the use of alcohol biomarkers is increasing globally. An easy-to-use blood biomarker to correctly assess alcohol consumption is an invaluable asset in alcohol treatment strategies, as well as in alcohol research studies. The specific, cumulative, biomarker phosphatidylethanol, mirroring the past two weeks of consumption, has shown superiority over traditional biomarkers and is an attractive choice of proxy for alcohol intake.
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Affiliation(s)
- Andrea de Bejczy
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden.
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5
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Fiorelli D, Romani L, Treglia M, Pallocci M, Passalacqua P, Coppeta L, Marsella LT, Tittarelli R. Carbohydrate-Deficient Transferrin (CDT) as a Biomarker of Alcohol Abuse: A Retrospective Study of the Italian Drinking Trend among Drivers from 2016 to 2022. TOXICS 2023; 11:914. [PMID: 37999566 PMCID: PMC10675514 DOI: 10.3390/toxics11110914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/30/2023] [Accepted: 11/04/2023] [Indexed: 11/25/2023]
Abstract
Alcohol abuse is still one of the leading causes of death worldwide. Early diagnosis of alcohol abuse enables preventive intervention on the effects and risks associated with its consumption. Carbohydrate-deficient transferrin (CDT) is one of the most reliable biomarkers of chronic alcohol misuse. We retrospectively studied a population of 12,624 subjects who had their driving license suspended for driving under the influence of alcohol or drugs from 2016 to 2022. The analytical determination of CDT was performed following a certified high-performance liquid chromatography (HPLC) method. Data were split by year, age and gender. The majority of subjects with positive %CDT were male, although the trend of positivity was similar between males and females. A steady increase in both the number of tests performed and the number of positives was observed over the years. Patients aged 41-50 years had the highest prevalence, followed by 51-60, 31-40 and 18-30 years. CDT continues to be a steady marker for diagnosis of alcohol abuse in the majority of cases. Data emerging from our study are in line with the increasing national trends on traffic accidents, injuries and deaths related to alcohol and drug DUI (driving under the influence), requiring the implementation of preventive measures to limit this ever-growing phenomenon.
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Affiliation(s)
- Denise Fiorelli
- Laboratory of Forensic Toxicology, Section of Legal and Forensic Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (D.F.); (R.T.)
| | - Leonardo Romani
- Laboratory of Forensic Toxicology, Section of Legal and Forensic Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (D.F.); (R.T.)
- PhD School in Medical-Surgical Applied Sciences, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy
| | - Michele Treglia
- Laboratory of Forensic Toxicology, Section of Legal and Forensic Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (D.F.); (R.T.)
| | - Margherita Pallocci
- Laboratory of Forensic Toxicology, Section of Legal and Forensic Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (D.F.); (R.T.)
| | - Pierluigi Passalacqua
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Luca Coppeta
- Laboratory of Forensic Toxicology, Section of Legal and Forensic Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (D.F.); (R.T.)
| | - Luigi Tonino Marsella
- Laboratory of Forensic Toxicology, Section of Legal and Forensic Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (D.F.); (R.T.)
| | - Roberta Tittarelli
- Laboratory of Forensic Toxicology, Section of Legal and Forensic Medicine, Social Security and Forensic Toxicology, Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (D.F.); (R.T.)
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Fakhari S, Waszkiewicz N. Old and New Biomarkers of Alcohol Abuse: Narrative Review. J Clin Med 2023; 12:jcm12062124. [PMID: 36983134 PMCID: PMC10054673 DOI: 10.3390/jcm12062124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
The harmful use of alcohol is responsible for 5.1% of the global burden of disease, and the early detection of alcohol problems may prevent its development and progression. Therefore, the aim of the study is to review traditional and new biomarkers associated with alcohol use. The nature and practical application and limitations of alcohol biomarkers in the diagnosis and monitoring of drinking are reviewed. Despite the limited specificity and sensitivity in alcohol drinking detection, traditional biomarkers are useful in clinical practice, and new generations of biomarkers, e.g., proteomic markers, are in need of further investigation. Traditional biomarkers are broadly available and cost-efficient, providing valuable data on the complications of drinking and prognosis, as well as on concurrent conditions affected by drinking. The most important challenge in the future will be to translate methodically advanced methods of detecting alcohol markers into simpler and cheaper methods. Larger population studies are also needed to test the usefulness of these potential markers of alcohol use.
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Affiliation(s)
- Sara Fakhari
- Department of Psychiatry, Mazowieckie Specjalistyczne Centrum Zdrowia w Pruszkowie, 05-800 Pruszków, Poland
- Correspondence: ; Tel.: +48-69-6963901
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Bialystok, 15-089 Bialystok, Poland
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Yi S, Zhang G, Liu M, Yu W, Cheng G, Luo L, Ning F. Citrus Honey Ameliorates Liver Disease and Restores Gut Microbiota in Alcohol-Feeding Mice. Nutrients 2023; 15:nu15051078. [PMID: 36904078 PMCID: PMC10005585 DOI: 10.3390/nu15051078] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023] Open
Abstract
Citrus honey (CH) is rich in nutrients that have a wide variety of biological functions, such as antibacterial, anti-inflammatory, and antioxidant activities, and which demonstrate therapeutic properties, such as anti-cancer and wound-healing abilities. However, the effects of CH on alcohol-related liver disease (ALD) and the intestinal microbiota remain unknown. This study aimed to determine the alleviating effects of CH on ALD and its regulatory effects on the gut microbiota in mice. In total, 26 metabolites were identified and quantified in CH, and the results suggested that the primary metabolites were abscisic acid, 3,4-dimethoxycinnamic acid, rutin, and two markers of CH, hesperetin and hesperidin. CH lowered the levels of aspartate aminotransferase, glutamate aminotransferase, and alcohol-induced hepatic edema. CH could promote the proliferation of Bacteroidetes while reducing the abundance of Firmicutes. Additionally, CH also showed some inhibitory effects on the growth of Campylobacterota and Turicibacter. CH enhanced the secretion of short-chain fatty acids (SCFAs), such as acetic acid, propionic acid, butyric acid, and valeric acid. Given its alleviating functions in liver tissue damage and its regulatory effects on the gut microbiota and SCFAs, CH could be a promising candidate for the therapeutic treatment of ALD.
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Affiliation(s)
- Shengxiang Yi
- School of Life Sciences, Nanchang University, Nanchang 330031, China
| | - Gaowei Zhang
- School of Life Sciences, Nanchang University, Nanchang 330031, China
| | - Mingyan Liu
- School of Life Sciences, Nanchang University, Nanchang 330031, China
| | - Wenjie Yu
- School of Life Sciences, Nanchang University, Nanchang 330031, China
- College of Food and Health, Beijing Technology and Business University (BTBU), Beijing 100048, China
| | - Guohua Cheng
- Agriculture and Rural Affairs Bureau of Nanfeng County, Fuzhou 344500, China
| | - Liping Luo
- School of Life Sciences, Nanchang University, Nanchang 330031, China
- College of Food and Health, Beijing Technology and Business University (BTBU), Beijing 100048, China
- Correspondence: (L.L.); (F.N.); Tel./Fax: +86-0791-83969519 (L.L.)
| | - Fangjian Ning
- School of Life Sciences, Nanchang University, Nanchang 330031, China
- College of Food and Health, Beijing Technology and Business University (BTBU), Beijing 100048, China
- Correspondence: (L.L.); (F.N.); Tel./Fax: +86-0791-83969519 (L.L.)
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Ghosh S, Jain R, Rao R, Mishra AK, Jhanjee S. Does ethyl glucuronide in hair correlate with alcohol consumption? A comparative study with other traditional biomarkers among individuals with alcohol dependence syndrome. Alcohol 2023; 106:55-60. [PMID: 36395967 DOI: 10.1016/j.alcohol.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
AIM Ethyl glucuronide (EtG) in hair is a direct biomarker proven to be useful for the detection of chronic excessive alcohol use. This study investigated the association of self-reported alcohol consumption with traditional biomarkers: GGT, AST, ALT, CDT, and MCV in blood and a direct biomarker, hair EtG, in a total of 122 patients with alcohol dependence syndrome. The diagnostic accuracy of the biomarkers to differentiate heavy from non-heavy drinkers was also evaluated. METHOD GGT, AST, and ALT in serum were measured by Automated Chemistry Analyzer, MCV in blood was measured by Haematology Analyzer, serum CDT was analyzed by ELISA, and EtG in hair was evaluated by gas chromatography-mass spectrometry. The association between the biomarkers and the amount of alcohol consumed (self-reported) was determined using Spearman's rank correlation. RESULTS All participants showed EtG level above the cut-off (0.03 ng/mg). Hair EtG showed a statistically significant linear and positive correlation with the amounts (in grams) of alcohol consumed (r = 0.60; p < 0.001). No correlation was observed among the traditional biomarkers and the quantity of alcohol consumed. Also, EtG showed an excellent receiver operating characteristic (ROC) curve (98%) with good sensitivity (85%) and specificity (60%) to classify heavy drinkers among individuals with alcohol dependence syndrome. CONCLUSION Hair EtG can be helpful to estimate retrospective alcohol consumption in long-term chronic alcohol consumption cases. Hair EtG also provides a reliable diagnostic test to detect heavy drinkers among individuals with alcohol dependence syndrome.
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Affiliation(s)
- Shayani Ghosh
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi-11002, India
| | - Raka Jain
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi-11002, India.
| | - Ravindra Rao
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi-11002, India
| | - Ashwani Kumar Mishra
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi-11002, India
| | - Sonali Jhanjee
- National Drug Dependence Treatment Centre, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi-11002, India
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Transferrin analysis in wistar rats plasma: Towards an electrochemical point-of-care approach for the screening of alcohol abuse. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gamma-Glutamyltransferase Activity (GGT) Is a Long-Sought Biomarker of Redox Status in Blood Circulation: A Retrospective Clinical Study of 44 Types of Human Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8494076. [PMID: 35707277 PMCID: PMC9192220 DOI: 10.1155/2022/8494076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/05/2022] [Indexed: 12/09/2022]
Abstract
Background and Aim. Redox equilibria are critical for life, but the biomarkers of redox status are currently unavailable. Gamma-glutamyltransferase (GGT) is an essential factor for modulating redox equilibrium through glutathione. In clinical practice, increased circulating GGT activity is used as a hepatobiliary disease biomarker. However, increased circulating GGT activities have also been observed in cancers, heart disease, diabetes, hyperuricemia, inflammation, renal insufficiency, and other diseases, explained by its role in maintaining redox equilibrium inside and outside cells. Previous studies on GGT were mainly limited to one type of disease at one time. In the current study, we systematically compared the GGT levels in 44 different human diseases to test if it could serve as a redox status biomarker in blood circulation. Methods. The clinical GGT data from 168,858 patients with 44 diseases and 132,357 healthy control in the clinical laboratory of our hospital over the past five years were retrieved. All data were analyzed with SPSS, RStudio V.1.3.1073, and python libraries 3.8. Results. Thirty-eight out of 44 diseases had significantly increased (
) circulating GGT activities, whereas gastric cancer, anemia, renal cyst, cervical cancer, preeclampsia, and knee-joint degenerative diseases had significantly decreased (
) GGT activities compared to the healthy control. ROC analyses showed that GGT was an excellent biomarker for liver cancer (
), pancreatitis (
), or hepatic encephalopathy (
). All pancreas-related diseases had more than 8-fold increases in GGT activity span than the healthy control, while pancreatic cancer had a 12-fold increase (1021 U/L vs. 82 U/L). The knee-joint degenerative disease had the lowest median and narrowest GGT activity range (63 U/L). Furthermore, most diseases’ lowest to highest GGT activities were beyond the healthy control in both directions. Conclusions. Thirty-eight out of 44 diseases were in overall oxidative states defined by the increased GGT median values. In contrast, knee-joint degenerative disease, gastric cancer, anemia, renal cyst, cervical cancer, and preeclampsia were in overall antioxidative states. Moreover, most diseases swing between oxidative and antioxidative states, evidenced by the increased lowest to highest GGT activity ranges than the healthy control. Liver- and pancreas-related abnormalities were responsible for significantly increased GGT activities. Our overall results suggested that circulating GGT was a redox status biomarker.
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Wang Y, Xu F, Zhang X, Mi F, Qian Y, Hong R, Zou W, Bai H, He L, Wang S, Yin J. Cross-sectional association between gamma-glutamyl transferase and hyperuricaemia: the China Multi-Ethinic Cohort (CMEC) study. BMJ Open 2022; 12:e058793. [PMID: 35636797 PMCID: PMC9152940 DOI: 10.1136/bmjopen-2021-058793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Several studies have demonstrated the association between gamma-glutamyl transferase (GGT) and hyperuricaemia, but little is known about such relation in less-developed ethnic minority regions. DESIGN We cross-sectionally analysed data from the China Multi-Ethnic Cohort (Yunnan region). SETTING Cross-sectional study. PARTICIPANTS 22 020 participants aged 30-79 years from Han ethnicity, Yi ethnicity and Bai ethnicity. OUTCOMES The serum level of uric acid, GGT and other metabolic parameters were tested. Weight, height and blood pressure were measured. Smoking, drinking, ethnicity, education and medical history were obtained from questionnaires. RESULTS In the crude model, compared with the lowest quintile, the second, third, fourth and fifth quintiles of serum GGT exhibited a positive association with hyperuricaemia risk (OR=1.69, 2.90, 4.34 and 7.70, 95% CI=1.42 to 2.01, 2.47 to 3.42, 3.71 to 5.09 and 6.60 to 8.98, respectively, p-trend<0.0001). In fully adjusted model, compared with the lowest quintile, the second, third, fourth and fifth quintiles of serum GGT also exhibited a positive association with hyperuricaemia risk (OR=1.26, 1.68, 2.02 and 3.02, 95% CI=1.04 to 1.51, 1.40 to 2.00, 1.69 to 2.42 and 2.51 to 3.64, respectively, p-trend<0.0001). Logistic regression model was conducted separately in ethnic groups. Compared with first quintile, the highest GGT level were related to higher risk of hyperuricaemia in three ethnic groups (OR (95% CI): 2.89 (2.26 to 3.68), 2.81 (1.93 to 4.11) and 3.04 (1.91 to 4.84) for Han, Yi and Bai ethnicity, respectively, p-trend <0.0001). The relationship between GGT and hyperuricaemia was also observed in different age groups or gender groups. CONCLUSIONS High serum GGT level was related to a higher risk of hyperuricaemia in less-developed ethnic minority regions in China.
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Affiliation(s)
- Yanjiao Wang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Fang Xu
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Xuehui Zhang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Fei Mi
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Ying Qian
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Rudan Hong
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Wei Zou
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Hua Bai
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Likun He
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Songmei Wang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Jianzhong Yin
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
- Baoshan College of Traditional Chinese Medicine, Baoshan, China
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A Review on Flexible Electrochemical Biosensors to Monitor Alcohol in Sweat. BIOSENSORS 2022; 12:bios12040252. [PMID: 35448313 PMCID: PMC9026542 DOI: 10.3390/bios12040252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/17/2022]
Abstract
The continued focus on improving the quality of human life has encouraged the development of increasingly efficient, durable, and cost-effective products in healthcare. Over the last decade, there has been substantial development in the field of technical and interactive textiles that combine expertise in electronics, biology, chemistry, and physics. Most recently, the creation of textile biosensors capable of quantifying biometric data in biological fluids is being studied, to detect a specific disease or the physical condition of an individual. The ultimate goal is to provide access to medical diagnosis anytime and anywhere. Presently, alcohol is considered the most commonly used addictive substance worldwide, being one of the main causes of death in road accidents. Thus, it is important to think of solutions capable of minimizing this public health problem. Alcohol biosensors constitute an excellent tool to aid at improving road safety. Hence, this review explores concepts about alcohol biomarkers, the composition of human sweat and the correlation between alcohol and blood. Different components and requirements of a biosensor are reviewed, along with the electrochemical techniques to evaluate its performance, in addition to construction techniques of textile-based biosensors. Special attention is given to the determination of biomarkers that must be low cost and fast, so the use of biomimetic materials to recognize and detect the target analyte is turning into an attractive option to improve electrochemical behavior.
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Changes in Serum N-Glycome for Risk Drinkers: A Comparison with Standard Markers for Alcohol Abuse in Men and Women. Biomolecules 2022; 12:biom12020241. [PMID: 35204742 PMCID: PMC8961540 DOI: 10.3390/biom12020241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 01/11/2023] Open
Abstract
Background and aim: Glycomic alterations serve as biomarker tools for different diseases. The present study aims to evaluate the diagnostic capability of serum N-glycosylation to identify alcohol risk drinking in comparison with standard markers. Methods: We included 1516 adult individuals (age range 18–91 years; 55.3% women), randomly selected from a general population. A total of 143 (21.0%) men and 50 (5.9%) women were classified as risk drinkers after quantification of daily alcohol consumption and the Alcohol Use Disorders Identification Test (AUDIT). Hydrophilic interaction ultra-performance liquid chromatography (HILIC-UPLC) was used for the quantification of 46 serum N-glycan peaks. Serum gamma-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT), and red blood cell mean corpuscular volume (MCV) were measured by standard clinical laboratory methods. Results: Variations in serum N-glycome associated risk drinking were more prominent in men compared to women. A unique combination of N-glycan peaks selected by the selbal algorithm shows good discrimination between risk-drinkers and non-risk drinkers for men and women. Receiver operating characteristics (ROC) curves show accuracy for the diagnosis of risk drinking, which is comparable to that of the golden standards, GGT, MCV and CDT markers for men and women. Additionally, the inclusion of N-glycan peaks improves the diagnostic accuracy of the standard markers, although it remains relatively low, due to low sensitivity. For men, the area under the ROC curve using N-glycome data is 0.75, 0.76, and 0.77 when combined with GGT, MCV, and CDT, respectively. In women, the areas were 0.76, 0.73, and 0.73, respectively. Conclusion: Risk drinking is associated with significant variations in the serum N-glycome, which highlights its potential diagnostic utility.
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Høiseth G, Hilberg T, Trydal T, Husa A, Vindenes V, Bogstrand ST. The alcohol marker phosphatidylethanol is closely related to AST, GGT, ferritin and HDL-C. Basic Clin Pharmacol Toxicol 2021; 130:182-190. [PMID: 34591374 DOI: 10.1111/bcpt.13662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the quantitative relation between common clinical chemical analyses and ethanol use, measured by a combination of the two alcohol markers phosphatidylethanol (PEth) and carbohydrate-deficient transferrin (CDT). METHODS Results of PEth and CDT in whole blood and serum, respectively, were included, together with information on 10 different commonly measured clinical chemical analytes, as well as age and sex. PEth was analysed by UPC2 -MS/MS and CDT was measured by capillary electrophoresis. RESULTS Samples from 4873 patients were included. The strongest relation to alcohol consumption as measured by PEth, when correcting for age and sex, was found for HDL-C (standardized β = 0.472, p < 0.001), AST (standardized β = 0.372, p < 0.001), ferritin (standardized β = 0.332, p < 0.001) and GGT (standardized β = 0.325, p < 0.001). The relation to PEth was weak for total cholesterol, TG and ALP. No relation was found for Hb and LDL-C. CONCLUSIONS When using PEth as a marker for alcohol consumption, this study demonstrated the quantitative relation to commonly used test as AST or GGT, but also an important relation to ferritin or HDL-C. In clinical practice, elevated levels of these clinical chemical analytes should initiate further work-up on possibly harmful alcohol use.
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Affiliation(s)
- Gudrun Høiseth
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.,Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | | | | - Vigdis Vindenes
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Stig Tore Bogstrand
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Cirillo M, Cavallo P, Palladino R, Terradura-Vagnarelli O, Zulli E, Villa R, Veneziano R, Laurenzi M. Relationship of the Intake of Water and Other Beverages With Renal Endpoints: Cross-Sectional and Longitudinal Data-Observational, Population-Based Study. J Ren Nutr 2021; 32:68-77. [PMID: 34452813 DOI: 10.1053/j.jrn.2021.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/28/2021] [Accepted: 06/27/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The relationship of water intake with kidney function in the population is uncertain. This study investigated cross-sectionally and longitudinally the relationship of the intake of water and other beverages with kidney function within an adult Italian population sample. METHODS In 4,554 Gubbio Study examinees (54.4% women, age 18-95 years), data collection at baseline included demographics, anthropometry, questionnaires on habitual intakes of water and other beverages (non-water fluids), a timed overnight urine collection, estimated glomerular filtration rate (eGFR), decreased eGFR (<60 mL/minute/1.73 m2), and other variables including urinary markers of diet. At 15-year follow-up, the incidence of renal/kidney replacement therapy, the eGFR change from baseline, and the incidence of decreased eGFR were used as indices of kidney function change over time. RESULTS In multivariable analyses, higher water intake is independently related to higher urine flow (beta = 0.163, P < .001), lower urine osmolality (beta = 0.184, P < .001), lower eGFR (beta = 0.030, P = .002), and higher prevalence of decreased eGFR (logistic coefficient ± standard error = 1.13 ± 0.32, P < .001). Water intake did not relate to kidney function change over time. Intake of non-water fluids did not independently relate to urinary indices nor to kidney function. CONCLUSIONS In the general population, water intake relates cross-sectionally to urine flow, urine concentration, and kidney function but it does not relate to kidney function change over time. The intake of other beverages does not relate to urinary indices or kidney function. Results do not support a role of water intake in kidney function decline over time in the population.
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Affiliation(s)
- Massimo Cirillo
- Department of Public Health, University of Naples "Federico II", Naples, Italy.
| | | | - Raffaele Palladino
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | | | - Enrico Zulli
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Rachele Villa
- Department "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Rosangela Veneziano
- Department "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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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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Lehikoinen A, Voutilainen R, Romppanen J, Heinonen S. The effect of maternal alcohol and drug abuse on first trimester screening analytes: a retrospective cohort study. BMC Pregnancy Childbirth 2020; 20:562. [PMID: 32977750 PMCID: PMC7517691 DOI: 10.1186/s12884-020-03171-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 08/11/2020] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to determine whether first trimester trisomy screening (FTS) parameters are affected by alcohol and drug use. Methods A routine combined FTS including measurements of maternal serum levels of free β-human chorionic gonadotropin subunit (free β-hCG) and pregnancy-associated plasma protein A (PAPP-A) were measured at 9–11 weeks of gestation, and fetal nuchal translucency thickness (NTT) at 11–13 weeks of gestation. In total 544 women with singleton pregnancies [71 alcohol and drug abusers, 88 smokers, 168 non-smokers delivering a small for gestational age (SGA) child, and 217 unexposed control women] were assessed. Results Free β-hCG levels were higher in alcohol and drug abusing than in unexposed pregnant women [mean 1.5 vs. 1.2 multiples of medians (MoM); P = 0.013]. However, stepwise multiple linear regression analyses suggested that smoking could explain increased free β-hCG. Additionally, we observed lower PAPP-A levels in the smoking mothers (0.9 vs. 1.2 MoM; P = 0.045) and in those giving birth to an SGA child compared to the controls (1.1 vs.. 1.2 MoM; P < 0.001). Fetal NTT did not differ significantly between any of the groups. Conclusions The present study shows increased free β-hCG levels in alcohol and drug abusers, but maternal smoking may explain the result. Maternal serum PAPP-A levels were lower in smoking than non-smoking mothers, and in mothers delivering an SGA child. However, FTS parameters (PAPP-A, free β-hCG and NTT) seem not to be applicable for the use as alcohol biomarkers because of their clear overlap between alcohol abusers and healthy controls.
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Affiliation(s)
- Anni Lehikoinen
- Department of Pediatrics, Kuopio University Hospital, P.O. Box 100, 70029, Kuopio, Finland. .,Department of Pediatrics, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland.
| | - Raimo Voutilainen
- Department of Pediatrics, Kuopio University Hospital, P.O. Box 100, 70029, Kuopio, Finland.,Department of Pediatrics, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Jarkko Romppanen
- Eastern Finland Laboratory Centre Joint Authority Enterprise (ISLAB), P.O. Box 1700, 70211, Kuopio, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, P.O. Box 140, 00029, Helsinki, Finland.,Department of Obsteterics and Gynecology, University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland.,Department of Obsteterics and Gynecology, Kuopio University Hospital, P.O. Box 100, 70029, Kuopio, Finland
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Quantitation of phosphatidylethanol in dried blood after volumetric absorptive microsampling. Talanta 2020; 223:121694. [PMID: 33303146 DOI: 10.1016/j.talanta.2020.121694] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Stimulated by the increased recognition of phosphatidylethanol (PEth) as sensitive direct marker of alcohol intake, the Ghent University's Laboratory of Toxicology and the National Institute of Criminalistics and Criminology combined their efforts to develop a quantitative method. To facilitate implementation the focus was on the use of a sampling technique which allows quick and easy blood collection, without the need of dedicated personnel at any place/any time. In the meantime the cooperation of the two labs should also allow to initiate a Belgian network of laboratories capable of quantifying PEth. METHODS Dried blood microsamples were collected via volumetric absorptive microsampling (VAMS). PEth 16:0/18:1 was quantified after liquid-liquid extraction using two independent isotope dilution - liquid chromatography - tandem mass spectrometry methods. A systematic review of the entire process at both sites was performed before the final method comparison using samples from 59 routine toxicology cases collected within a one-year time interval. RESULTS Initial differences between both laboratories were solved by focusing on important methodological aspects: (i) trueness verification of the calibration protocol focusing on the primary material, preparation of the stock solutions and adequate equilibration of calibrators and QCs, and (ii) verification of comparability of results obtained with different m/z transitions. Several of these aspects could only be verified by critically assessing spiked and native samples. After a final validation good average comparability of the two methods was observed. The average bias was -0.4%, with 85% of the differences within 20%. Moreover, the methods proved to be reproducible and robust within a one-year time interval. CONCLUSION This study is the first to develop a quantitative volumetric absorptive microsampling based method for PEth measurements, in addition it is the first to perform a systematic comparison of PEth measurements between two laboratories. From the discussion on the encountered pitfalls it is clear that also on a global scale, more efforts are needed to improve interlaboratory agreement.
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Kruckenberg KM, DiMartini AF, Rymer JA, Pasculle AW, Tamama K. Urinary Auto-brewery Syndrome: A Case Report. Ann Intern Med 2020; 172:702-704. [PMID: 32092761 DOI: 10.7326/l19-0661] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Andrea F DiMartini
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (K.M.K., A.F.D.)
| | - Jacqueline A Rymer
- Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, Pennsylvania (J.A.R.)
| | - A William Pasculle
- Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (A.W.P.)
| | - Kenichi Tamama
- Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, University of Pittsburgh School of Medicine, McGowan Institute for Regenerative Medicine, University of Pittsburgh, and Clinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania (K.T.)
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20
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Uljas E, Jalkanen V, Kuitunen A, Hynninen M, Hästbacka J. Prevalence of risk-drinking in critically ill patients, screened with carbohydrate-deficient transferrin and AUDIT-C score: A retrospective study. Acta Anaesthesiol Scand 2020; 64:216-223. [PMID: 31541613 DOI: 10.1111/aas.13484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/19/2019] [Accepted: 09/11/2019] [Indexed: 12/13/2022]
Abstract
Background Studies demonstrate that up to one-third of intensive care unit (ICU) admissions are directly or indirectly related to alcohol. Screening for alcohol use is not routine. This study examined the prevalence of elevated %CDT (carbohydrate-deficient transferrin) and above risk-level AUDIT-C (Alcohol Use Disorders Identification Test, Consumption) in patients admitted to ICU. Methods We conducted a retrospective analysis of clinical and laboratory data from a single ICU where %CDT and AUDIT-C were included in routine assessment. After excluding readmissions, 2532 adult patients from a 21-month period were included. Admission values of %CDT were available for 2049 patients, and AUDIT-C was available for 1617 patients. The association of %CDT and AUDIT-C with short- and long-term outcome was studied by using univariate and multivariate logistic regression analysis. Results %CDT was above the reference value in 23.7% (486/2048) of patients with available %CDT. Of patients with available AUDIT-C, 33% (544/1617) had a risk-level AUDIT-C score. Patients with a risk-level AUDIT-C score were significantly younger than those with a lower score (51 vs 64 years, P < .0001). Increased %CDT was associated with higher severity of illness. AUDIT-C was associated independently with increased risk of long-term mortality in multivariate analysis (P = .007). Conclusion One in three of ICU patients are risk-level alcohol users as measured with AUDIT-C score, and one in four are analysed with %CDT. The prevalence varies according to the method used and any method alone may be insufficient to detect risk-level consumption reliably. Editorial Comment Alcohol overconsumption is associated with need for ICU admission and with less favorable outcomes. Diagnosis of alcohol overconsumption though is problematic due to low sensitivity in screening. In a pilot study, a biomarker and a screening tool are compared. The finding is that multiple tools are needed to achieve an adequate sensitivity for detection.
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Affiliation(s)
- Eliisa Uljas
- Division of Intensive Care Department of Anaesthesiology, Intensive Care and Pain Medicine University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Ville Jalkanen
- Department of Intensive Care University of Tampere Tampere University Hospital Tampere Finland
| | - Anne Kuitunen
- Department of Intensive Care University of Tampere Tampere University Hospital Tampere Finland
| | - Marja Hynninen
- Division of Intensive Care Department of Anaesthesiology, Intensive Care and Pain Medicine University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Johanna Hästbacka
- Division of Intensive Care Department of Anaesthesiology, Intensive Care and Pain Medicine University of Helsinki and Helsinki University Hospital Helsinki Finland
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Paulke A, Söhling N, Held H, Wurglics M, Skopp G, Toennes SW. Chronic alcohol abuse may lead to high skin iron content, but not to hepatic siderosis. Forensic Sci Int 2019; 304:109851. [DOI: 10.1016/j.forsciint.2019.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 06/06/2019] [Accepted: 06/07/2019] [Indexed: 10/26/2022]
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Ramenskaia GV, Melnik EV, Petukhov AE. [Phospholipase D: its role in metabolism processes and disease development]. BIOMEDIT︠S︡INSKAI︠A︡ KHIMII︠A︡ 2019; 64:84-93. [PMID: 29460838 DOI: 10.18097/pbmc20186401084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Phospholipase D (PLD) is one of the key enzymes that catalyzes the hydrolysis of cell membrane phospholipids. In this review current knowledge about six human PLD isoforms, their structure and role in physiological and pathological processes is summarized. Comparative analysis of PLD isoforms structure is presented. The mechanism of the hydrolysis and transphosphatidylation performed by PLD is described. The PLD1 and PLD2 role in the pathogenesis of some cancer, infectious, thrombotic and neurodegenerative diseases is analyzed. The prospects of PLD isoform-selective inhibitors development are shown in the context of the clinical usage and the already-existing inhibitors are characterized. Moreover, the formation of phosphatidylethanol (PEth), the alcohol abuse biomarker, as the result of PLD-catalyzed phospholipid transphosphatidylation is considered.
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Affiliation(s)
- G V Ramenskaia
- Sechenov First Moscow State Medical University (Sechenovskiy University), Moscow, Russia
| | - E V Melnik
- Sechenov First Moscow State Medical University (Sechenovskiy University), Moscow, Russia
| | - A E Petukhov
- Sechenov First Moscow State Medical University (Sechenovskiy University), Moscow, Russia; Moscow Research and Practical Centre for Narcology, Moscow, Russia
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Palmieri A, Petrini M. Tryptophol and derivatives: natural occurrence and applications to the synthesis of bioactive compounds. Nat Prod Rep 2019; 36:490-530. [DOI: 10.1039/c8np00032h] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This report presents some fundamental aspects related to the natural occurrence and bioactivity of tryptophol as well as the synthesis of tryptophols and their utilization for the preparation of naturally occurring alkaloid metabolites embedding the indole system.
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Affiliation(s)
- Alessandro Palmieri
- School of Science and Technology
- Chemistry Division
- University of Camerino
- Italy
| | - Marino Petrini
- School of Science and Technology
- Chemistry Division
- University of Camerino
- Italy
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24
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Jannetto PJ. Selecting and Interpreting Alcohol Biomarker Tests: Enough to Drive You to Drink. J Appl Lab Med 2018; 2:827-829. [DOI: 10.1373/jalm.2017.025593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 12/12/2017] [Indexed: 11/06/2022]
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25
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Lehikoinen AI, Kärkkäinen OK, Lehtonen MA, Auriola SO, Hanhineva KJ, Heinonen ST. Alcohol and substance use are associated with altered metabolome in the first trimester serum samples of pregnant mothers. Eur J Obstet Gynecol Reprod Biol 2018; 223:79-84. [DOI: 10.1016/j.ejogrb.2018.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 02/05/2018] [Accepted: 02/05/2018] [Indexed: 11/16/2022]
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Batra A, Müller CA, Mann K, Heinz A. Alcohol Dependence and Harmful Use of Alcohol. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 113:301-10. [PMID: 27173413 DOI: 10.3238/arztebl.2016.0301] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 03/09/2016] [Accepted: 03/09/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND In Germany today, there are more than 1.8 million persons who are dependent on alcohol, and 1.6 million persons whose use of alcohol is harmful. The many complications of alcohol use are both mental and physical-in particular, gastrointestinal and neurological. Yet more than 80% of persons whose alcohol use is problematic still receive no treatment for their harmful use or dependence, despite contact with the health-care system. METHODS This article is a selective review of the pertinent literature, including guidelines, meta-analyses, and Cochrane Reviews. RESULTS The treatment is divided into an early interventional and motivational phase, qualified withdrawal, long-term cessation therapy, and a stabilization phase. Pharmacotherapy with acamprosate or naltrexone increases the rate of abstinence (number needed to treat: 12 and 20, respectively). If a patient lacks the motivation to abstain from alcohol entirely, reduced consumption can be agreed upon as a goal of treatment. 85% of patients relapse if no further treatment is given after initial detoxification. CONCLUSION What is needed in routine medical practice is practical diagnostic evaluation followed by individually tailored treatment, based on the severity of the condition, the development of the patient's motivation to be treated, and the local treatment options (e.g., outpatient addiction clinics, counseling centers, or day clinics).
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Affiliation(s)
- Anil Batra
- Section for Addiction Medicine and Addiction Research, Department of Psychiatry and Psychotherapy, University Hospital and Faculty of Medicine, Tübingen, Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Department of Psychiatry and Psychotherapy, University Hospital; Charité - Universitätsmedizin Berlin; Campus Charité Mitte
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Alladio E, Giacomelli L, Biosa G, Corcia D, Gerace E, Salomone A, Vincenti M. Development and validation of a Partial Least Squares-Discriminant Analysis (PLS-DA) model based on the determination of ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs) in hair for the diagnosis of chronic alcohol abuse. Forensic Sci Int 2018; 282:221-230. [DOI: 10.1016/j.forsciint.2017.11.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/05/2017] [Accepted: 11/07/2017] [Indexed: 01/09/2023]
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Hatch E, Morrow D, Liu W, Cahill PA, Redmond EM. Differential effects of alcohol and its metabolite acetaldehyde on vascular smooth muscle cell Notch signaling and growth. Am J Physiol Heart Circ Physiol 2017; 314:H131-H137. [PMID: 29212792 DOI: 10.1152/ajpheart.00586.2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Alcohol (EtOH) consumption can variously affect cardiovascular disease. Our aim was to compare the effects of EtOH and its primary metabolite acetaldehyde (ACT) on vascular smooth muscle Notch signaling and cell growth, which are important for atherogenesis. Human coronary artery smooth muscle cells (HCASMCs) were treated with EtOH (25 mM) or ACT (10 or 25 μM). As previously reported, EtOH inhibited Notch signaling and growth of HCASMCs. In contrast, ACT treatment stimulated HCASMC proliferation (cell counts) and increased proliferating cell nuclear antigen expression, concomitant with stimulation of Notch signaling, as determined by increased Notch receptor (N1 and N3) and target gene (Hairy-related transcription factor 1-3) mRNA levels. Interaction of the ligand with the Notch receptor initiates proteolytic cleavage by α- and γ-secretase, resulting in the release of the active Notch intracellular domain. Neither EtOH nor ACT had any significant effect on α-secretase activity. A fluorogenic peptide cleavage assay demonstrated almost complete inhibition by EtOH of Delta-like ligand 4-stimulated γ-secretase activity in solubilized HCASMCs (similar to the effect of the control inhibitor DAPT) but no effect of ACT treatment. EtOH, but not ACT, affected the association and distribution of the γ-secretase catalytic subunit presenilin-1 with lipid rafts, as determined by dual fluorescent labeling and confocal microscopic visualization. In conclusion, ACT stimulates vascular smooth muscle cell Notch signaling and growth, effects opposite to those of EtOH. These differential actions on vascular smooth muscle cells of EtOH and its metabolite ACT may be important in mediating the ultimate effects of drinking on cardiovascular disease. NEW & NOTEWORTHY Acetaldehyde stimulates, in a Notch-dependent manner, the vascular smooth muscle cell growth that contributes to atherogenesis; effects opposite to those of ethanol. These data suggest that in addition to ethanol itself, its metabolite acetaldehyde may also mediate some of the effects of alcohol consumption on vascular cells and, thus, cardiovascular health.
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Affiliation(s)
- Ekaterina Hatch
- Department of Surgery, University of Rochester Medical Center , Rochester, New York
| | - David Morrow
- Department of Surgery, University of Rochester Medical Center , Rochester, New York
| | - Weimin Liu
- Department of Surgery, University of Rochester Medical Center , Rochester, New York
| | - Paul A Cahill
- Vascular Biology and Therapeutics Laboratory, School of Biotechnology, Dublin City University , Dublin , Ireland
| | - Eileen M Redmond
- Department of Surgery, University of Rochester Medical Center , Rochester, New York
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Ya Z, Fei L, Yue Z, Dan L, Neng-Bo L, Yi L, Ying M, Qin W. Association between serum gamma-glutamyl transferase and serum uric acid levels in Chinese females: A cross-sectional study. Endocr Res 2017; 42:296-301. [PMID: 28332856 DOI: 10.1080/07435800.2017.1300809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To investigate the association between serum gamma-glutamyl transferase (GGT) levels and serum uric acid levels in middle-aged and elderly Chinese females. METHODS A cross-sectional population survey was performed in Luzhou, China (2014). Questionnaires, physical examinations and biochemical tests were conducted. Finally, we included 2486 females who were > 40 years old as participants. Multiple linear regression analysis was used to estimate the association of serum acid levels and other variables. Serum GGT levels were divided into four groups using the 25th, 50th and 75th percentiles as cut-off points. Finally, binary logistic regression analysis was used to investigate the association of different serum GGT quartiles with the risk of hyperuricemia. RESULTS The prevalence of hyperuricemia was 25.1% in the studied population and gradually increased across the serum GGT quartiles (P < 0.05). Binary logistic regression analysis showed that compared with subjects in the lowest quartile of serum GGT levels, the adjusted odds ratio (ORs) for uric acid in the highest quartile was 2.34 (95% confidence interval (CI), 1.68-3.28, P < 0.001),after corrections for TG, TC, HDL-C, LDL-C, creatinine (CR), GGT, AST, ALT, fasting plasma glucose (FPG), postprandial 2-h plasma glucose, hemoglobin A1c(HbA1c), age, BMI, SBP, DBP, waist-to-hip ratio and neck circumference (NC). CONCLUSIONS The serum GGT level is associated with hyperuricemia in middle-aged and elderly Chinese females.
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Affiliation(s)
- Zhao Ya
- a Department of Endocrinology , The Affiliated Hospital of Luzhou Medical College , Luzhou , China
- b Department of Endocrinology , Pixian Chinese Medicine Hospital , Chengdu , China
| | - Liu Fei
- a Department of Endocrinology , The Affiliated Hospital of Luzhou Medical College , Luzhou , China
| | - Zeng Yue
- a Department of Endocrinology , The Affiliated Hospital of Luzhou Medical College , Luzhou , China
| | - Liu Dan
- a Department of Endocrinology , The Affiliated Hospital of Luzhou Medical College , Luzhou , China
| | - Lin Neng-Bo
- a Department of Endocrinology , The Affiliated Hospital of Luzhou Medical College , Luzhou , China
| | - Luo Yi
- a Department of Endocrinology , The Affiliated Hospital of Luzhou Medical College , Luzhou , China
| | - Miao Ying
- a Department of Endocrinology , The Affiliated Hospital of Luzhou Medical College , Luzhou , China
| | - Wan Qin
- a Department of Endocrinology , The Affiliated Hospital of Luzhou Medical College , Luzhou , China
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Petukhov AE, Nadezhdin AV, Bogstrand ST, Bryun EA, Ramenskaya GV, Koshkina EA, Mel'nik EV, Smirnov AV, Tetenova EY. [The comparative analysis of the methods for the determination of phosphatidylethanol in blood as a biological marker of alcohol abuse]. Sud Med Ekspert 2017; 60:23-26. [PMID: 28980550 DOI: 10.17116/sudmed201760523-26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The confirmation of the fact of alcohol abuse is currently an important problem of both medical and social significance. Of all biological markers of alcohol consumption presently in use, blood phosphatidylethanol (PEth) is considered to be most sensitive and specific one. Therefore it has promising prospects for the further application. There is no universally accepted method for the calculation of the phosphatidylethanol concentration in human blood. For this reason, the present article places emphasis on the comparative characteristic of various methods for the determination of this substance.
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Affiliation(s)
- A E Petukhov
- Moscow Research and Practical Narcological Centre, Moscow Health Department, Moscow, Russia, 109390; A.P. Arzamastsev Department of Pharmaceutical and Toxicological Chemistry, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia, 119991
| | - A V Nadezhdin
- Moscow Research and Practical Narcological Centre, Moscow Health Department, Moscow, Russia, 109390
| | | | - E A Bryun
- Moscow Research and Practical Narcological Centre, Moscow Health Department, Moscow, Russia, 109390
| | - G V Ramenskaya
- A.P. Arzamastsev Department of Pharmaceutical and Toxicological Chemistry, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia, 119991
| | - E A Koshkina
- Moscow Research and Practical Narcological Centre, Moscow Health Department, Moscow, Russia, 109390
| | - E V Mel'nik
- A.P. Arzamastsev Department of Pharmaceutical and Toxicological Chemistry, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia, 119991
| | - A V Smirnov
- Moscow Research and Practical Narcological Centre, Moscow Health Department, Moscow, Russia, 109390
| | - E Yu Tetenova
- Moscow Research and Practical Narcological Centre, Moscow Health Department, Moscow, Russia, 109390
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Schröck A, Wurst FM, Thon N, Weinmann W. Assessing phosphatidylethanol (PEth) levels reflecting different drinking habits in comparison to the alcohol use disorders identification test - C (AUDIT-C). Drug Alcohol Depend 2017. [PMID: 28645063 DOI: 10.1016/j.drugalcdep.2017.04.026] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In addition to monitoring problematic or harmful alcohol consumption, drinking experiments indicated the potential of phosphatidylethanols (PEth) in abstinence monitoring. To date, no profound evaluation of thresholds for the differentiation of abstinence from moderate drinking and for detection of excessive consumption based on PEth homologues exists. Investigations with a large group of healthy volunteers (n=300) were performed to establish PEth reference values reflecting different drinking habits. Blood samples were analyzed for PEth 16:0/18:1 and 16:0/18:2 by online-SPE-LC-MS/MS method. Results were compared to AUDIT-C questionnaires, to the amounts of alcohol consumed during the two-weeks prior to blood sampling, and were statistically evaluated. PEth concentrations were significantly correlated with self-reported alcohol consumption (r>0.69) and with AUDIT-C scores (r>0.65). 4.0% of 300 volunteers reported abstinence (AUDIT-C score: 0), no PEth was detectable in their blood. PEth 16:0/18:1 concentrations below the limit of detection of 10.0ng/mL match with abstinence and light drinking habits (≤10g pure alcohol/day). However, some volunteers classified as "excessive alcohol consumers" had negative PEth results. In the group of volunteers classified as "moderate drinkers" (AUDIT-C score: 1-3 (women) and 1-4 (men)), 95% of the test persons had PEth 16:0/18:1 ranging from not detected to 112ng/mL, and PEth 16:0/18:2 ranging from not detected to 67.0ng/mL. Combination of self-reported alcohol consumption and AUDIT-C score showed that negative PEth results match with abstinence or light drinking. Moderate alcohol consumption resulted in PEth 16:0/18:1 from 0 to 112ng/mL and for PEth 16:0/18:2 ranged from 0 to 67.0ng/mL. Higher PEth concentrations indicated excessive alcohol consumption.
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Affiliation(s)
- Alexandra Schröck
- Institute of Forensic Medicine, Forensic Toxicology and Chemistry, University of Bern, Switzerland; Graduate School for Cellular and Biomedical Sciences, University of Bern, Switzerland
| | - Friedrich M Wurst
- Center for Interdisciplinary Addiction Research Hamburg, Germany; University of Basel, Basel, Switzerland
| | - Natasha Thon
- Paracelsus Medical University, Salzburg, Austria
| | - Wolfgang Weinmann
- Institute of Forensic Medicine, Forensic Toxicology and Chemistry, University of Bern, Switzerland.
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Park J, Lee J, Lee D, Lee Y. Serum γ-glutamyltransferase level and metabolic syndrome in children and adolescents: Korean National Health and Nutrition Examination Survey. J Diabetes Investig 2017; 9:522-528. [PMID: 28741806 PMCID: PMC5934261 DOI: 10.1111/jdi.12716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 06/26/2017] [Accepted: 07/18/2017] [Indexed: 12/11/2022] Open
Abstract
AIMS/INTRODUCTION Serum γ-glutamyltransferase (GGT) is positively related to cardiometabolic diseases, such as type 2 diabetes mellitus, hypertension and metabolic syndrome (MetS), in adult populations. Our aim was to investigate whether serum GGT is independently associated with MetS and its components in a nationally representative sample of Korean children and adolescents. MATERIALS AND METHODS The study included data from 1,618 participants (867 boys, 751 girls) aged 10-18 years from the 2010-2011 Korean National Health and Nutrition Examination Survey. MetS was diagnosed by the 2007 International Diabetes Federation criteria for children and adolescents. Participants were stratified using a cut-off value of the 75th percentile of serum GGT levels (19 IU/L for boys, 15 IU/L for girls). The odds ratios and 95% confidence intervals for MetS and its components were determined with multiple logistic regression analyses. RESULTS The mean values of most cardiometabolic variables were significantly higher in the upper stratum. Except for low high-density lipoprotein cholesterol in boys and elevated blood pressure in girls, participants in the upper GGT stratum had significantly higher odds of MetS and its components than those in the lower stratum. The multivariate-adjusted odds ratios for MetS for the upper stratum were 5.79 (95% confidence interval 1.21-27.02) in boys and 6.20 (95% confidence interval 1.71-22.47) in girls, after adjusting for age, household income and residential area. CONCLUSIONS Serum GGT was positively associated with MetS and its components in Korean children and adolescents. Serum GGT could be a useful measure for identifying children and adolescents with MetS.
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Affiliation(s)
- Jae‐Min Park
- Department of Family MedicineKonkuk University Medical CenterSeoulKorea
| | - Jee‐Yon Lee
- Department of Family MedicineCHA University College of MedicineChaum Life CenterCHA Bundang Medical CenterSeoulKorea
| | - Duk‐Chul Lee
- Department of Family MedicineYonsei University College of MedicineSeoulKorea
| | - Yong‐Jae Lee
- Department of Family MedicineYonsei University College of MedicineSeoulKorea
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Phosphatidylethanol (PEth) as a Biomarker of Alcohol Consumption in HIV-Infected Young Russian Women: Comparison to Self-Report Assessments of Alcohol Use. AIDS Behav 2017; 21:1938-1949. [PMID: 28421353 DOI: 10.1007/s10461-017-1769-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Alcohol use is particularly deleterious for HIV-infected individuals and thus accurate assessment of alcohol consumption is crucial in this population. Phosphatidylethanol (PEth) provides an objective assessment of drinking and can be compared to self-reported alcohol assessments to detect underreporting. The purpose of this study was to identify underreporting and its potential predictors in an HIV-infected sample of young Russian women. The current study examined the concordance between a quantitative measure of PEth and self-reported recent alcohol consumption in a prospective sample of HIV-infected young women (N = 204) receiving medical care in Saint Petersburg, Russia. At baseline, 53% of participants who denied drinking in the prior 30 days tested positive for PEth (i.e., underreporters), although this rate decreased significantly at a three-month follow-up assessment. Further exploration did not identify consistent predictors of underreporting status. Quantitative PEth levels showed, at best, modest overlap to self-reported alcohol consumption among those reporting alcohol use (e.g., Spearman's r = 0.27 between PEth and total drinks past-30 days at baseline). Objective measures of alcohol consumption demonstrate modest overlap with self-report measures of use in HIV-infected young Russian women. Incorporating objective and quantifiable biological markers are essential for valid assessments of alcohol use.
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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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Alladio E, Martyna A, Salomone A, Pirro V, Vincenti M, Zadora G. Evaluation of direct and indirect ethanol biomarkers using a likelihood ratio approach to identify chronic alcohol abusers for forensic purposes. Forensic Sci Int 2017; 271:13-22. [DOI: 10.1016/j.forsciint.2016.12.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/16/2016] [Accepted: 12/12/2016] [Indexed: 11/25/2022]
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Rascu A, Naghi E, Arghir OC, Moise L, Otelea M. Differential diagnosis between occupational chronic intoxication with organic solvents and ethanol abuse by biological markers. Case report and literature review. ARS MEDICA TOMITANA 2016. [DOI: 10.1515/arsm-2016-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Given the occupational exposure to substances contained in petroleum heated to high temperature, cholestatic liver disease, neurological signs and symptoms can occur. We present a case report of a male patient with no tobacco exposure or alcohol use, but with prolonged occupational exposure to petroleum vapours and natural gases like methane, propane butane who developed liver and neurologic disease, in the absence of protective equipment. Delayed diagnosis was established after 9 years of the first symptoms occurrence. Differential diagnosis with alcoholic etiology was considered and biological biomarkers were useful.
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Affiliation(s)
- Agripina Rascu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Eugenia Naghi
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Laura Moise
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Marina Otelea
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Mladenović B, Nagorni A, Bjelaković G, Radovanović-Dinić B, Mladenović N, Arsić N. ALCOHOLIC CIRRHOSIS OF THE LIVER AND DISARRANGEMENT OF PLASMA ATHEROGENIC FACTORS. ACTA MEDICA MEDIANAE 2016. [DOI: 10.5633/amm.2016.0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Phosphatidylethanol (PEth) detected in blood for 3 to 12 days after single consumption of alcohol—a drinking study with 16 volunteers. Int J Legal Med 2016; 131:153-160. [DOI: 10.1007/s00414-016-1445-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 08/26/2016] [Indexed: 10/21/2022]
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Walther L, de Bejczy A, Löf E, Hansson T, Andersson A, Guterstam J, Hammarberg A, Asanovska G, Franck J, Söderpalm B, Isaksson A. Phosphatidylethanol is superior to carbohydrate-deficient transferrin and γ-glutamyltransferase as an alcohol marker and is a reliable estimate of alcohol consumption level. Alcohol Clin Exp Res 2016; 39:2200-8. [PMID: 26503066 DOI: 10.1111/acer.12883] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 08/20/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND In clinical practice as well as research situations, it is of great importance to get reliable information about a patient's alcohol consumption. The aim of the study was to investigate the correlation of alcohol biomarkers (phosphatidylethanol [PEth], carbohydrate-deficient transferrin [CDT], γ-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase) to retrospective as well as diary-based alcohol self-reports and to examine whether it is possible to correlate a biomarker result to a more precise level of alcohol consumption. METHODS One hundred and sixty alcohol-dependent patients were included in a randomized, placebo-controlled clinical trial of pharmacotherapy for alcohol dependence, of which 115 (76 men and 39 women) completed the study. Retrospective alcohol consumption data were collected at baseline, and alcohol diaries were used during the study. Blood samples for determination of alcohol biomarkers were collected on 5 occasions during the study. RESULTS PEth and CDT showed a better correlation with alcohol consumption documented in the diary (PEth rs = 0.56 and CDT rs = 0.35) than with retrospective consumption data (PEth rs = 0.23 and CDT rs = 0.22). An even higher correlation (rs = 0.63) was seen between the 2 alcohol biomarkers PEth and CDT. At all consumption levels, PEth had the highest sensitivity of all biomarkers studied. CONCLUSIONS PEth was the biomarker with the best correlation to self-reported alcohol consumption. PEth was superior to CDT owing to its substantially higher sensitivity but also due to its closer correlation to self-report. PEth values can be translated into an approximate level of alcohol consumption and PEth appears to be a more reliable measure of alcohol consumption than self-reports.
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Affiliation(s)
- Lisa Walther
- Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, University Hospital, Lund University, Lund, Sweden
| | - Andrea de Bejczy
- Addiction Biology Unit, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Beroendekliniken, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elin Löf
- Addiction Biology Unit, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Beroendekliniken, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Therese Hansson
- Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, University Hospital, Lund University, Lund, Sweden
| | - Anders Andersson
- Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, University Hospital, Lund University, Lund, Sweden
| | - Joar Guterstam
- Department of Clinical Neuroscience , Karolinska Institutet, Stockholm, Sweden
| | - Anders Hammarberg
- Department of Clinical Neuroscience , Karolinska Institutet, Stockholm, Sweden
| | - Gulber Asanovska
- Department of Clinical Alcohol Research , Malmö University Hospital, Lund University, Lund, Sweden
| | - Johan Franck
- Department of Clinical Neuroscience , Karolinska Institutet, Stockholm, Sweden
| | - Bo Söderpalm
- Addiction Biology Unit, Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Beroendekliniken, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Isaksson
- Division of Clinical Chemistry and Pharmacology, Department of Laboratory Medicine, University Hospital, Lund University, Lund, Sweden
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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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Biomarkers of alcohol misuse: recent advances and future prospects. GASTROENTEROLOGY REVIEW 2016; 11:78-89. [PMID: 27350834 PMCID: PMC4916243 DOI: 10.5114/pg.2016.60252] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 12/24/2015] [Indexed: 12/21/2022]
Abstract
Alcohol abuse and dependence are highly prevalent in many cultures and contribute considerably to the global burden of health and social issues. The current inability to accurately characterise long-term drinking behaviours is a major obstacle to alcoholism diagnosis and treatment. Therefore, it is of great importance to develop objective diagnostic tools to discern subjects with excessive alcohol use and alcoholism or to confirm abstinence. Research over past years has revealed several biochemical compounds with considerable potential for accurate reflection of alcohol intake. This review will address the issue of alcohol biomarker definition, the types of molecules used as so-called traditional biomarkers, and the compounds that can serve as novel biomarker candidates or components of biomarker panels.
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Hahn JA, Emenyonu NI, Fatch R, Muyindike WR, Kekiibina A, Carrico AW, Woolf-King S, Shiboski S. Declining and rebounding unhealthy alcohol consumption during the first year of HIV care in rural Uganda, using phosphatidylethanol to augment self-report. Addiction 2016; 111:272-9. [PMID: 26381193 PMCID: PMC4715487 DOI: 10.1111/add.13173] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 07/20/2015] [Accepted: 09/16/2015] [Indexed: 12/13/2022]
Abstract
AIMS We examined whether unhealthy alcohol consumption, which negatively impacts HIV outcomes, changes after HIV care entry overall and by several factors. We also compared using phosphatidylethanol (PEth, an alcohol biomarker) to augment self-report to using self-report alone. DESIGN A prospective 1-year observational cohort study with quarterly visits. SETTING Large rural HIV clinic in Mbarara, Uganda. PARTICIPANTS A total of 208 adults (89 women and 119 men) entering HIV care, reporting any prior year alcohol consumption. MEASUREMENTS Unhealthy drinking was PEth+ (≥ 50 ng/ml) or Alcohol Use Disorders Identification Test-Consumption+ (AUDIT-C+, over 3 months, women ≥ 3; men ≥ 4). We calculated adjusted odds ratios (AOR) for unhealthy drinking per month since baseline, and interactions of month since baseline with perceived health, number of HIV symptoms, antiretroviral therapy (ART), gender and self-reported prior unhealthy alcohol use. FINDINGS The majority of participants (64%) were unhealthy drinkers (PEth+ or AUDIT-C+) at baseline. There was no significant trend in unhealthy drinking overall [per-month AOR: 1.01; 95% confidence interval (CI) = 0.94-1.07], while the per-month AORs were 0.91 (95% CI = 0.83-1.00) and 1.11 (95% CI = 1.01-1.22) when participants were not yet on ART and on ART, respectively (interaction P-value < 0.01). In contrast, 44% were AUDIT-C+; the per-month AORs for being AUDIT-C+ were 0.89 (95% CI = 0.85-0.95) overall, and 0.84 (95% CI = 0.78-0.91) and 0.97 (95% CI = 0.89-1.05) when participants were not on and were on ART, respectively. CONCLUSIONS Unhealthy alcohol use among Ugandan adults entering HIV care declines prior to the start of anti-retroviral therapy but rebounds with time. Augmenting self-reported alcohol use with biomarkers increases the ability of current alcohol use measurements to detect unhealthy alcohol use.
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Affiliation(s)
- Judith A Hahn
- University of California, Department of Medicine, San Francisco, CA, USA
- University of California, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
| | - Nneka I Emenyonu
- University of California, Department of Medicine, San Francisco, CA, USA
| | - Robin Fatch
- University of California, Department of Medicine, San Francisco, CA, USA
| | - Winnie R Muyindike
- Mbarara University of Sciences and Technology, Faculty of Medicine, Mbarara, Uganda
| | - Allen Kekiibina
- Mbarara University of Sciences and Technology, Faculty of Medicine, Mbarara, Uganda
| | - Adam W Carrico
- University of California, Department of Community Health Systems, San Francisco, CA, USA
| | - Sarah Woolf-King
- University of California, Department of Medicine, San Francisco, CA, USA
| | - Stephen Shiboski
- University of California, Department of Epidemiology and Biostatistics, San Francisco, CA, USA
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Abstract
This issue provides a clinical overview of alcohol use, focusing on health benefits, harms, prevention, screening, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.
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Schröck A, Hernández Redondo A, Martin Fabritius M, König S, Weinmann W. Phosphatidylethanol (PEth) in blood samples from “driving under the influence” cases as indicator for prolonged excessive alcohol consumption. Int J Legal Med 2015; 130:393-400. [DOI: 10.1007/s00414-015-1300-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/27/2015] [Indexed: 11/28/2022]
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Abstract
Alcoholic liver disease is the second most common indication for orthotopic liver transplantation in western countries. The majority of patients with alcoholic liver disease, however, are not referred for transplant evaluation. If evaluated, a 6 month period of sobriety is required before waitlisting for transplant. The consequences of relapse to alcohol use in patients on the waitlist are usually removal from the list. Therefore, identification and treatment of alcohol use disorder in patients with end-stage liver disease greatly impacts quality of life, treatment options and survival in patients’ course with this grave illness. Psychosocial and behavioral interventions prior to transplant appear to reduce drinking in the period before the surgery as well as reduce relapse rates post-transplant. Only one of the three medications approved by the Food and Drug Administration, acamprosate, seems feasible for use in patients with end-stage liver disease, while several other medications currently under investigation for the treatment of alcohol use disorder can be considered for use in this population. While only baclofen has been formally studied in alcoholic patients with end-stage liver disease with positive results for safety and efficacy, other medications also hold promise to treat alcohol use disorder in this population. Transplant programs with addictions specialists who function as an integral part of the treatment team may offer better outcomes to patients in terms of success of maintaining sobriety both pre- and post-transplant.
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Affiliation(s)
- Mary R. Lee
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD
| | - Lorenzo Leggio
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD,Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI,Contact information: Lorenzo Leggio, M.D., Ph.D., M.Sc., Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, NIAAA & NIDA, NIH, 10 Center Drive (10CRC/15330) MSC 1108; Room 1-5429, Bethesda, MD 20892-1108, Phone: +1 301 435 9398; Fax: + 1 301 402 0445,
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Bakhireva LN, Shrestha S, Gutierrez HL, Berry M, Schmitt C, Sarangarm D. Stability of Phosphatidylethanol in Dry Blood Spot Cards. Alcohol Alcohol 2015; 51:275-80. [PMID: 26519350 DOI: 10.1093/alcalc/agv120] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/05/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The analysis of phosphatidylethanol, a promising direct ethanol metabolite, in dry blood spots (PEth-DBS) is advantageous due to ease of storage, transportation and minimal invasiveness of capillary blood collection. One potential application of PEth-DBS is to confirm prenatal alcohol exposure in newborns suspected of FASD; however, stability of PEth-DBS is largely unknown. METHODS Phlebotomized samples from 31 adults with a history of alcoholism, admitted to the University of New Mexico Emergency Department, were analyzed for blood alcohol content and pipetted onto DBS cards (13 spots per patient). The first spot was analyzed within 2 weeks of collection for a baseline PEth; the remaining 12 spots were allocated into three temperature conditions (room temperature, 4°C, -80°C) for the repeated measures analysis. In addition, 5 newborn DBS samples with a baseline PEth>LOD were obtained from a prospective cohort at UNM and re-analyzed at 4 months after storage at -80°C. A mixed linear model was fitted to examine the effects of temperature, time and temperature-time interaction on PEth degradation over the first 9 months. RESULTS The baseline PEth levels were 592.8 ± 86.7 ng/ml and 18.3 ± 4.8 ng/ml in adult and newborn samples, respectively. All DBS samples remained positive in successive samples in all temperature conditions. Results of mixed linear model demonstrated a significant effect of temperature (P < 0.001) on PEth degradation over 9 months. CONCLUSIONS PEth-DBS appears to be relatively stable, especially when stored at lower temperatures. These initial results are encouraging and highlight the PEth-DBS potential in retrospective assessment of alcohol exposure.
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Affiliation(s)
- Ludmila N Bakhireva
- Department of Pharmacy Practice and Administrative Sciences, UNM, Albuquerque, NM, USA Department of Family and Community Medicine, UNM, Albuquerque, NM, USA
| | - Shikhar Shrestha
- Department of Pharmacy Practice and Administrative Sciences, UNM, Albuquerque, NM, USA
| | - Hilda L Gutierrez
- Department of Pharmacy Practice and Administrative Sciences, UNM, Albuquerque, NM, USA
| | - Mike Berry
- Department of Emergency Medicine, UNM, Albuquerque, NM, USA
| | - Cheryl Schmitt
- Department of Pharmacy Practice and Administrative Sciences, UNM, Albuquerque, NM, USA
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Wurst FM, Thon N, Yegles M, Schrück A, Preuss UW, Weinmann W. Ethanol Metabolites: Their Role in the Assessment of Alcohol Intake. Alcohol Clin Exp Res 2015; 39:2060-72. [DOI: 10.1111/acer.12851] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 07/22/2015] [Indexed: 01/12/2023]
Affiliation(s)
- Friedrich M. Wurst
- Paracelsus Medical University; Salzburg Austria
- Center for Interdisciplinary Addiction Research; University of Hamburg; Hamburg Germany
| | | | - Michel Yegles
- Service de Toxicologie; Laboratoire National de Sante; Luxembourg Luxembourg
| | - Alexandra Schrück
- Institute of Forensic Medicine; University of Bern; Bern Switzerland
| | - Ulrich W. Preuss
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine; University of Halle; Halle Germany
| | - Wolfgang Weinmann
- Institute of Forensic Medicine; University of Bern; Bern Switzerland
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Sogawa K, Iida F, Kawshima Y, Yamada M, Satoh M, Sanda A, Takizawa H, Maruyama K, Wada Y, Nomura F. Evaluation of serum carbohydrate-deficient transferrin by HPLC and MALDI-TOF MS. Clin Chim Acta 2015; 448:8-12. [DOI: 10.1016/j.cca.2015.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/02/2015] [Accepted: 06/02/2015] [Indexed: 02/07/2023]
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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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50
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Singh G. Reflex Testing for Carbohydrate-Deficient Transferrin (CDT) in Insurance Applicants with Elevated High Density Lipoprotein Cholesterol (HDL). J Insur Med 2015; 45:42-7. [PMID: 27584808 DOI: 10.17849/0743-6661-45.1.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectives .- Ascertain the utility of testing carbohydrate deficient transferrin (CDT) levels in insurance applicants with elevated high density lipoprotein cholesterol (HDL) levels. Background .- Chronic alcoholism is not uncommon and is a risk factor for health and longevity and thus of interest to providers of insurance. A number of tests serve as markers of alcohol use, eg, blood alcohol level, elevated liver enzymes, ethyl glucuronide in urine, whole blood associated aldehyde (WBAA), macrocytosis, elevated HDL, elevated CDT and others. WBAA and CDT are usually only done, if some other screening test suggests alcohol use. HDL testing is routinely done for assessing cardiac risk, however, chronic alcohol intake tends to raise HDL and some insurance providers reflex to CDT testing when HDL is elevated. Methods .- A number of the clients of Heritage Labs Inc. have rules in place to test for CDT levels in specimens showing elevated HDL levels. The commonest HDL level that serves as the trigger for reflex testing for CDT is 80mg/dL. The results of this practice were analyzed to assess the utility of reflex testing for CDT to identify chronic alcohol abusers among the applicants. Results .- In examining the results of CDT levels done as a reflex test due to elevated HDL levels, about 2% of the applicants, 0.7% of women and 3% of men, tested positive for elevated CDT levels. Conclusions .- The incidence of elevated CDT levels is high enough to warrant routinely testing for this analyte in applicants, especially men, with high HDL levels.
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