Carbohydrate-deficient transferrin

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. 

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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. 

A. Fleming MF, Anton RF, Spies CD. A review of genetic, biological, pharmacological, and clinical factors that affect carbohydrate-deficient transferrin levels. Alcohol Clin Exp Res 2004 28 1347-55,... 

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

A. Wuyts B, Delanghe IR. The analysis of carbohydrate-deficient transferrin, marker of chronic alcoholism, using capillary electrophoresis. Clin Chem Lab Med 2003 41 739-46. 

A. Yersin B, Nicolet JF, Dercrey H, Burnier M, van MeUe G, Pecoud A. Screening for excessive alcohol drinking Comparative value of carbohydrate-deficient transferrin, gamma-glutamyltransferase and mean corpuscular volume. Arch Intern Med 1995 155 1907-11. 

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... 

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)...

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C.S. Lieber, Carbohydrate deficient transferrin in alcoholic liver disease mechanisms and clinical implications, Alcohol, 19, 249-254 (1999). 

P. SiUanaukee, N. Strid, J.P. Allen and R.Z. Litten, Possible reasons why heavy drinking increases carbohydrate-deficient transferrin. Alcohol. Clin. Exp. Res., 25, 34 40 (2001). 

J.O. Jeppsson, H. Kristensson and C. Fimiani, Carbohydrate-deficient transferrin quantified by HPLC to determine heavy consumption of alcohol, Clin. Chem., 39, 2115-2120 (1993). 

J. Peter, C. Unverzagt, W.D. Engel, D. Renauer, C. Seidel and W. Hdsel, Identification of carbohydrate deficient transferrin forms by MALDI-TOF mass spectrometry and lectin ELISA, Biochim. Biophys. Acta, 1380, 93-101 (1998). 

H. Stibler, S. Borg and M. Joustra, Micro anion exchange chromatography of carbohydrate-deficient transferrin in serum in relation to alcohol consumption (Swedish Patent 8400587-5), Alcohol. Clin. Exp. Res., 10, 535-544 (1986). 

A. Helander, Absolute or relative measurement of carbohydrate-deficient transferrin in serum Experiences with three immunological assays, Clin. Chem., 45, 131-135 (1999). 

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). 

J. Keating, C. Cheung, T.J. Peters and R.A. Sherwood, Carbohydrate deficient transferrin in the assessment of alcohol misuse absolute or relative measurements A comparison of two methods with regard to total transferrin concentration, Clin. Chim. Acta, 272, 159-169 (1998). 

L. Dibbelt, Does trisialo-transferrin provide valuable information for the laboratory diagnosis of chronically increased alcohol consumption by determination of carbohydrate-deficient transferrin , Clin. Chem., 46, 1203-1205 (2000). 

C. Colome, I. Ferrer, R. Artuch, M.A. Vilaseca, M. Pineda and P. Briones, Personal experience with the application of carbohydrate-deficient transferrin (CDT) assays to the detection of congenital disorders of glycosylation, Clin. Chem. Lab. Med., 38, 965-969 (2000). 

A. Helander, M. Fors and B. Zakrisson, Study of Axis-Shield new %CDT immunoassay for quantification of carbohydrate-deficient transferrin (CDT) in serum, Alcohol Alcohol., 36, 406 412 (2001). 

P. Simonsson, S. Lindberg and C. Alling, Carbohydrate-deficient transferrin measured by high-performance liquid chromatography and CDTect immunoassay, Alcohol Alcohol., 31, 397 402 (1996). 

F. Renner, K. Stratmann, R.D. Kanitz and T. Wetterling, Determination of carbohydrate-deficient transferrin and total transferrin by HPLC diagnostic evaluation, Clin. Lab., 43, 955-964 (1997). 

F. Renner and R.D. Kanitz, Quantification of carbohydrate-deficient transferrin by ion-exchange chromatography with an enzymatically prepared calibrator, Clin. Chem., 43, 485 90 (1997). 

E. Werle, G.E. Seitz, B. Kohl, W. Fiehn and H.K. Seitz, High-performance liquid chromatography improves diagnostic efficiency of carbohydrate-deficient transferrin. Alcohol Alcohol., 32, 71-77 (1997). 

A. Helander, J.P. Bergstrom, Determination of carbohydrate-deficient transferrin in human serum using the Bio-Rad% CDT by HPLC test, Clin Chim. Acta, 187-190 (2006). 

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). 

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