Alcohol abuse carbohydrate-deficient transferrin

Figure 6.1 Structural illustration of the major normal glycoforms of human serum transferrin and those being influenced by chronic alcohol abuse (carbohydrate-deficient transferrin CDT) and in congenital disorders of glycosylation (CDG)...

Alcohol consumption is very difficult to assess. There is widespread belief that individuals underreport their intake and there are no reliable laboratory tests available for definitive diagnosis of alcohol abuse. A combination of abnormalities in the plasma activity of gamma-glutamyl transferase (GGT or yGT), AST and reduction in erythrocyte mean cell volume (MCV) maybe useful and all are routine lab. tests. A potential marker of interest is carbohydrate-deficient transferrin (CDT) which is an abnormal isoform of serum transferrin arising due to defects in the attachment of carbohydrate chains to the protein core. Unfortunately, CDT is a somewhat specialized test, not performed by most laboratories. Other markers which have attracted some research interest are ethyl sulphate and ethyl glucuronide. Excretion in the urine of these metabolites occurs for up to 50 hours after binge drinking so they offer a useful index of recent heavy alcohol intake. 

De Feo, T.M., Fargion, S., Duca, L., Mattioli, M., Cappellini, M.D., Sampietro, M., Cesana, B.M., Fiorelli, G. Carbohydrate-deficient transferrin, a sensitive marker of chronic alcohol abuse, is highly influenced by body iron. Hepatology 1999 29 658-663... 

A. Arndt T. Carbohydrate-deficient transferrin as a marker of chronic alcohol abuse A critical review of preanalysis, analysis, and interpretation. Clin Chem 2001 47 13-27. 

B. Niemela O, Sorvajarvi K, Blake JE, Israel Y. Carbohydrate-deficient transferrin AS. A marker of alcohol abuse. Relationship to alcohol consumption, severity of liver disease and fibrinogenesis. Alcohol Clin Esp Res 1995 19 1205-8. 

B. SiUanaukee P, Olsson U. Improved Diagnostic Classification of Alcohol Abusers by Combining Carbohydrate-deficient Transferrin and-Glutamyltransferase. Clin Chem 2001 47 681-5. 

Qualitative modifications in the glycosylation of this protein occur after prolonged heavy alcohol consumption and also in patients with rare congenital disorders of glycosylation (CDG). Therefore, measurement of transferrin microheterogeneity has been used both as a biomarker for detection and follow-up of alcohol abuse [known as carbohydrate-deficient transferrin (CDT)]" and for diagnosis of CDG. This chapter will review the microheterogeneity of human transferrin and the methods used for the measurement of transferrin... 

A. Helander, G. Eriksson, H. Stibler and J.-O. Jeppsson, Interference of transferrin isoform types with carbohydrate-deficient transferrin quantification in the identification of alcohol abuse, Clin. Chem., 47, 1225-1233 (2001). 

K. Sorvajarvi, J.E. Blake, Y. Israel and O. Niemela, Sensitivity and specificity of carbohydrate-deficient transferrin as a marker of alcohol abuse are significantly influenced by alterations in serum transferrin comparison of two methods. Alcohol. Clin. Exp. Res., 20, 449 54 (1996). 

F.J. Legros, V. Nuyens, E. Minet, P. Emonts, K.Z. Boudjeltia, A. Courbe, J.L. Ruelle, J. Colicis, F. de L Escaille and J.P. Henry, Carbohydrate-deficient transferrin isoforms measured by capillary zone electrophoresis for detection of alcohol abuse, Clin. Chem., 48, 2177-2186 (2002). 

H. Henty and collaborators also showed alterations of the glycosylation of transferrin in patients with chronic alcohol abuse, producing the carbohydrate-deficient transferrin isoforms (Henry et al, 1999). These alterations were veiy similar to those present in patients with carbohydrate-deficient glycoprotein syndrome type 1 (CDGl) (Henty et al, 1997 Heyne... 

Legros, F.J. et al.. Carbohydrate-deficient transferrin isoforms measured by capillary zone electrophoresis for detection of alcohol abuse, Clin. Chem., 48, 2177, 2002. 

Tagliaro, F. et al.. Carbohydrate-deficient transferrin determination revisited with capillary electrophoresis A new biochemical marker of chronic alcohol abuse, J. Cap. Electrophor. Microchip Tech., 5, 137, 1999. 

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