Urinary ethyl glucuronide as a novel screening tool in patients pre- and post-liver transplantation improves detection of alcohol consumption

Hepatology

Volumn 54, Issue 5, 2011, Pages 1640-1649

  Staufer, Katharina ^a   Andresen, Hilke ^a   Vettorazzi, Eik ^a   Tobias, Niels ^b   Nashan, Bjoern ^a   Sterneck, Martina ^a  

^a UNIVERSITY MEDICAL CENTER HAMBURG EPPENDORF   (Germany)

^b Department of Clinical Pharmacology   (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

ALANINE AMINOTRANSFERASE; ALCOHOL; ASPARTATE AMINOTRANSFERASE; CARBOHYDRATE DEFICIENT TRANSFERRIN; ETHYL GLUCURONIDE; GAMMA GLUTAMYLTRANSFERASE; METHANOL;

ADULT; AGED; ALANINE AMINOTRANSFERASE BLOOD LEVEL; ALCOHOL BLOOD LEVEL; ALCOHOL CONSUMPTION; ARTICLE; ASPARTATE AMINOTRANSFERASE BLOOD LEVEL; CONTROLLED STUDY; FEMALE; GAMMA GLUTAMYL TRANSFERASE BLOOD LEVEL; HUMAN; LIVER TRANSPLANTATION; MAJOR CLINICAL STUDY; MALE; MEAN CORPUSCULAR VOLUME; OUTPATIENT DEPARTMENT; PRIORITY JOURNAL; PROSPECTIVE STUDY; SCREENING; SENSITIVITY AND SPECIFICITY; URINE LEVEL;

ADULT; AGED; ALCOHOL DRINKING; FEMALE; GLUCURONATES; HUMANS; LIVER DISEASES, ALCOHOLIC; LIVER TRANSPLANTATION; MALE; MASS SCREENING; MIDDLE AGED; POSTOPERATIVE CARE; PREDICTIVE VALUE OF TESTS; PREOPERATIVE CARE; PROSPECTIVE STUDIES; RECURRENCE; SENSITIVITY AND SPECIFICITY; TEMPERANCE; WAITING LISTS; YOUNG ADULT;

EID: 80055035872     PISSN: 02709139     EISSN: 15273350     Source Type: Journal    
DOI: 10.1002/hep.24596     Document Type: Article

References (40)

1. Pageaux GP, Bismuth M, Perney P, Costes V, Jaber S, Possoz P, et al. Alcohol relapse after liver transplantation for alcoholic liver disease: does it matter? J Hepatol 2003; 38: 629-634.
2. Berlakovich GA, Soliman T, Freundorfer E, Windhager T, Bodingbauer M, Wamser P, et al. Pretransplant screening of sobriety with carbohydrate-deficient transferrin in patients suffering from alcoholic cirrhosis. Transpl Int 2004; 17: 617-621.
3. Burra P, Mioni D, Cillo U, Fagiuoli S, Senzolo M, Naccarato R, et al. Long-term medical and psycho-social evaluation of patients undergoing orthotopic liver transplantation for alcoholic liver disease. Transpl Int 2000; 13(Suppl 1): S174-S178.
4. Cuadrado A, Fabrega E, Casafont F, Pons-Romero F Alcohol recidivism impairs long-term patient survival after orthotopic liver transplantation for alcoholic liver disease. Liver Transpl 2005; 11: 420-426.
5. Dew MA, DiMartini AF, Steel J, De Vito Dabbs A, Myaskovsky L, Unruh M, et al. Meta-analysis of risk for relapse to substance use after transplantation of the liver or other solid organs. Liver Transpl 2008; 14: 159-172.
6. Gish RG, Lee A, Brooks L, Leung J, Lau JY, Moore DH, 2nd Long-term follow-up of patients diagnosed with alcohol dependence or alcohol abuse who were evaluated for liver transplantation. Liver Transpl 2001; 7: 581-587.
7. Anttila P, Jarvi K, Latvala J, Blake JE, Niemela O Diagnostic characteristics of different carbohydrate-deficient transferrin methods in the detection of problem drinking: effects of liver disease and alcohol consumption. Alcohol Alcohol 2003; 38: 415-420.
8. Heinemann A, Sterneck M, Kuhlencordt R, Rogiers X, Schulz KH, Queen B, et al. Carbohydrate-deficient transferrin: diagnostic efficiency among patients with end-stage liver disease before and after liver transplantation. Alcohol Clin Exp Res 1998; 22: 1806-1812.
9. Helander A, Eriksson G, Stibler H, Jeppsson JO Interference of transferrin isoform types with carbohydrate-deficient transferrin quantification in the identification of alcohol abuse. Clin Chem 2001; 47: 1225-1233.
10. Helander A, Husa A, Jeppsson JO Improved HPLC method for carbohydrate-deficient transferrin in serum. Clin Chem 2003; 49: 1881-1890.
11. Mundle G, Ackermann K, Munkes J, Steinle D, Mann K Influence of age, alcohol consumption, and abstinence on the sensitivity of carbohydrate-deficient transferrin, gamma-glutamyltransferase, and mean corpuscular volume. Alcohol Alcohol 1999; 34: 760-766.
12. Hock, BS, chwarz, M, Domke, I, Grunert, VP, Wuertemberger, M, Schiemann, U, et al. Validity of carbohydrate-deficient transferrin (%CDT), gamma-glutamyltransferase (gamma-GT), and mean corpuscular erythrocyte volume (MCV) as biomarkers for chronic alcohol abuse: a study in patients with alcohol dependence and liver disorders of non-alcoholic and alcoholic origin. Addiction 2005; 100: 1477-1486.
13. Stibler H Carbohydrate-deficient transferrin in serum: a new marker of potentially harmful alcohol consumption reviewed. Clin Chem 1991; 37: 2029-2037.
14. Helander A, Carlsson S Carbohydrate-deficient transferrin and gamma-glutamyl transferase levels during disulfiram therapy. Alcohol Clin Exp Res 1996; 20: 1202-1205.
15. DiMartini A, Day N, Lane T, Beisler AT, Dew MA, Anton R Carbohydrate deficient transferrin in abstaining patients with end-stage liver disease. Alcohol Clin Exp Res 2001; 25: 1729-1733.
16. Nalpas B, Hispard E, Thepot V, Pot S, Dally S, Berthelot P A comparative study between carbohydrate-deficient transferrin and gamma-glutamyltransferase for the diagnosis of excessive drinking in a liver unit. J Hepatol 1997; 27: 1003-1008.
17. Salaspuro M Carbohydrate-deficient transferrin as compared to other markers of alcoholism: a systematic review. Alcohol 1999 Nov; 19(3): 261-71.
18. National Institutes of Health. Helping patients who drink too much: a clinician's guide. Updated 2005 edition. NIH publication no. 07-3769 (p. 32). National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health. Available at
19. Helander A, Eriksson CJ Laboratory tests for acute alcohol consumption: results of the WHO/ISBRA Study on State and Trait Markers of Alcohol Use and Dependence. Alcohol Clin Exp Res 2002; 26: 1070-1077.
20. Haffner HT, Banger M, Graw M, Besserer K, Brink T The kinetics of methanol elimination in alcoholics and the influence of ethanol. Forensic Sci Int 1997; 89: 129-136.
21. Iffland R New ways to use biochemical indicators of alcohol abuse to regrant licences in a fairer manner after drunken driving in Germany. Alcohol Alcohol 1996; 31: 619-620.
22. Roine RP, Eriksson CJ, Ylikahri R, Penttila A, Salaspuro M Methanol as a marker of alcohol abuse. Alcohol Clin Exp Res 1989; 13: 172-175.
23. Brinkmann B, Madea B Handbuch gerichtliche medizin, band 2. Berlin/Heidelberg/New York: Springer; 2003: 526.
24. Wurst FM, Skipper GE, Weinmann W Ethyl glucuronide-the direct ethanol metabolite on the threshold from science to routine use. Addiction 2003; 98(Suppl 2): 51-61.
25. Wurst FM, Kempter C, Seidl S, Alt A Ethyl glucuronide-a marker of alcohol consumption and a relapse marker with clinical and forensic implications. Alcohol Alcohol 1999; 34: 71-77.
26. Thierauf A, Halter CC, Rana S, Auwaerter V, Wohlfarth A, Wurst FM, et al. Urine tested positive for ethyl glucuronide after trace amounts of ethanol. Addiction 2009; 104: 2007-2012.
27. Wurst FM, Wiesbeck GA, Metzger JW, Weinmann W On sensitivity, specificity, and the influence of various parameters on ethyl glucuronide levels in urine-results from the WHO/ISBRA study. Alcohol Clin Exp Res 2004; 28: 1220-1228.
28. Bottcher M, Beck O, Helander A Evaluation of a new immunoassay for urinary ethyl glucuronide testing. Alcohol Alcohol 2008; 43: 46-48.
29. Dahl H, Voltaire Carlsson A, Hillgren K, Helander A Urinary ethyl glucuronide and ethyl sulfate testing for detection of recent drinking in an outpatient treatment program for alcohol and drug dependence. Alcohol Alcohol 2011; 46: 278-282.
30. Stephanson N, Dahl H, Helander A, Beck O Direct quantification of ethyl glucuronide in clinical urine samples by liquid chromatography-mass spectrometry. Ther Drug Monit 2002; 24: 645-651.
31. Slot C Plasma creatinine determination. A new and specific Jaffe reaction method. Scand J Clin Lab Invest 1965; 17: 381-387.
32. Nyblom H, Berggren U, Balldin J, Olsson R High AST/ALT ratio may indicate advanced alcoholic liver disease rather than heavy drinking. Alcohol Alcohol 2004; 39: 336-339.
33. Pencina MJ, D'Agostino RB, Sr., D'Agostino RB, Jr., Vasan RS Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Stat Med 2008; 27: 157-172; discussion, 207-212.
34. Erim Y, Bottcher M, Dahmen U, Beck O, Broelsch CE, Helander A Urinary ethyl glucuronide testing detects alcohol consumption in alcoholic liver disease patients awaiting liver transplantation. Liver Transpl 2007; 13: 757-761.
35. Crews B, Latyshev S, Mikel C, Almazan P, West R, Pesce A, et al. Improved detection of ethyl glucuronide and ethyl sulfate in a pain management population using high-throughput LC-MS/MS. J Opioid Manag 2010; 6: 415-421.
36. Thierauf A, Wohlfarth A, Auwarter V, Perdekamp MG, Wurst FM, Weinmann W Urine tested positive for ethyl glucuronide and ethyl sulfate after the consumption of yeast and sugar. Forensic Sci Int 2010; 202: e45-e47.
37. Hoiseth G, Bernard JP, Stephanson N, Normann PT, Christophersen AS, Morland J, et al. Comparison between the urinary alcohol markers EtG, EtS, and GTOL/5-HIAA in a controlled drinking experiment. Alcohol Alcohol 2008; 43: 187-191.
38. Gruner O, Bilzer N, Liebmann J [Methanol formation in vitro and in vivo (methanol formation after pectin administration)]. Blutalkohol 1994; 31: 228-232.
39. Helander A Biological markers in alcoholism. J Neural Transm Suppl 2003: 15-32.
40. Enoch MA, Johnson K, George DT, Schumann G, Moss HB, Kranzler HR, et al. Ethical considerations for administering alcohol or alcohol cues to treatment-seeking alcoholics in a research setting: can the benefits to society outweigh the risks to the individual? A commentary in the context of the National Advisory Council on Alcohol Abuse and Alcoholism-recommended council guidelines on ethyl alcohol administration in human experimentation (2005). Alcoholism, clinical, and experimental research. [Guideline Research Support, NIH, Intramural Research Support, Non-U.S. Gov't]. 2009; 33: 1508-1512.