To assess the performance of a range of biomarkers of alcohol consumption in a heavy-drinking population of working-aged Russian men.
Cross-sectional study of men originally sampled at random from a population register.
Izhevsk, a Russian city with a population of 650,000 people
1,023 men aged 27–59 years living in Izhevsk who took part in a health check examination in 2008–2009.
Self-reported alcohol consumption, hazardous drinking behaviours, socio-economic position, anthropometric measurements plus blood levels of alcohol biomarkers (CDT, GGT, ALT, AST and MCV) and hepatitis B and C status.
In the year before interview there was a high prevalence of high-risk alcohol consumption indicated by consumption of non-beverage alcohols (5.0%), problem drinking behaviours (4.4%), and alcohol consumption exceeding an average 40 g per day (12.6%). All biomarkers were strongly associated with total beverage alcohol consumption even after adjustment for confounders. CDT performed best as an alcohol biomarker, with a sensitivity of 67% and specificity of 71% for detecting an average consumption of over 40 g per day vs. less. For all biomarkers sensitivity was considerably lower than specificity. Hazardous drinking patterns per se were not well detected by any of the biomarkers, all with sensitivity below 60%.
In a Russian population with high levels of alcohol consumption, carbohydrate deficient transferrin (CDT) may be the most sensitive and specific biomarker for detecting ethanol consumption above 40g/day. A biomarker reflecting hazardous drinking patterns has yet to be established.
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