BIOMARKER

Phosphatidylethanol as a sensitive and specific biomarker—comparison with gamma-glutamyl transpeptidase, mean corpuscular volume and carbohydrate-deficient transferrin

Addiction Biology 12 (1), 81–84.

• Susanne Hartmann¹
• ¹Psychiatric University Clinic, Basel, Switzerland, ,
• Steina Aradottir²
• ²Department of Medical Neurochemistry, Lund, Sweden, ,
• Marc Graf¹
• ¹Psychiatric University Clinic, Basel, Switzerland, ,
• Gerhard Wiesbeck¹
• ¹Psychiatric University Clinic, Basel, Switzerland, ,
• Otto Lesch³
• ³Psychiatric University Clinic, Vienna, Austria and ,
• Katrin Ramskogler³
• ³Psychiatric University Clinic, Vienna, Austria and ,
• Manfred Wolfersdorf⁴
• ⁴State Mental Hospital Bayreuth, Germany ,
• Christer Alling²
• ²Department of Medical Neurochemistry, Lund, Sweden, &
• Friedrich Martin Wurst¹
• ¹Psychiatric University Clinic, Basel, Switzerland, Friedrich Martin Wurst, Psychiatric University Hospital, Wilhelm Klein Strasse 27, 4025 Basel, Switzerland. E-mail: friedrich.wurst@upkbs.ch

• ¹Psychiatric University Clinic, Basel, Switzerland, ²Department of Medical Neurochemistry, Lund, Sweden, ³Psychiatric University Clinic, Vienna, Austria and ⁴State Mental Hospital Bayreuth, Germany

Friedrich Martin Wurst, Psychiatric University Hospital, Wilhelm Klein Strasse 27, 4025 Basel, Switzerland. E-mail: friedrich.wurst@upkbs.ch

ABSTRACT

Phosphatidylethanol (PEth), a direct ethanol metabolite, is detectable in blood for more than 2 weeks after sustained ethanol intake.

Our aim was to assess the usefulness of PEth [comparing sensitivity, specificity and the area under the curve (AUC)] as compared with carbohydrate-deficient transferrin (CDT), gamma-glutamyl transpeptidase (GGT) and mean corpuscular volume (MCV), calculating the results from sober patients against those from alcohol-dependent patients during withdrawal.

Fifty-six alcohol-dependent patients (ICD-10 F 10.25) in detoxification, age 43 years, GGT 81 U/l, MCV 96.4 fl, %CDT 4.2, 1400 g ethanol intake in the last 7 days (median), were included in the study.

Over the time of 1 year, 52 samples from 35 sober forensic psychiatric addicted in-patients [age 34 years, GGT 16 U/l, MCV 91 fl, CDT 0.5 (median)] in a closed ward were drawn and used for comparison . PEth was measured in heparinized whole blood with a high-performance liquid chromatography method. GGT, MCV and %CDT were measured using routine methods.

A receiver operating characteristic curve analysis was carried out, with ‘current drinking status’ (sober/drinking) as the state variable and PEth, MCV, GGT and CDT as test variables. The resulting AUC was 0.974 (P < 0.0001, confidence interval 0.932–1.016) for PEth. At a cut-off of 0.36 µmol/l, the sensitivity was 94.5% and specificity 100%. The AUC for CDT, GGT and MCV were 0.931, 0.894 and 0.883, respectively.

A significant Spearman’s rank correlation was found between PEth and GGT (r = 0.739), CDT (r = 0.643), MVC (r = 0.639) and grams of ethanol consumed in the last 7 days (r = 0.802).

Our data suggest that PEth has potential to be a sensitive and specific biomarker, having been found in previous studies to indicate longer lasting intake of higher amounts of alcohol.