만성적 문제 음주 평가에 %탄수화물결핍트랜스페린(Carbohydrate-deficient transferrin: CDT) 검사의 임상적 유용성
Clinical Validity of %CDT test in detecting of chronic problematic alcohol consumption
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Objectives Carbohydrate-deficient transferring (CDT) has recently been interested as a promising objective laboratory markers for evaluation of chronic alcohol consumption. The objective of this study is to evaluate the validity of CDT among other markers and propose the reasonable cut-off level to detect problematic drinking. Methods Total 162 subjects (130 male, 32 female) were enrolled among social drinkers or alcohol dependence patients. Mean amount of weekly alcohol consumption was collected and %CDT, mean corpuscular volume(MCV), gamma-glutamyl transferase(GGT), aspartate transaminase(AST) and alanine transaminase (ALT) were measured. Severity of hepatic illness was evaluated by abdominal USG. Correlation analysis was performed among markers and alcohol consumption. Linear regression analysis was done between %CDT and alcohol consumption. To find the cut-off value of chronic alcohol drinking, the Receiver operating characteristic (ROC) curve was conducted. Results %CDT, GGT, AST, and ALT showed the significant correlation with the amount of alcohol consumption. After correction of bias such as sex, age and severity of hepatic illness, GGT lost the significant correlation. %CDT was the only factor (28.2%) which could explain the correlation with alcohol drinking by the regression analysis. Measuring the area under ROC curves, %CDT was the significantly better than other markers. 1.15% of %CDT was proposed as a suitable cut-off value to detect problematic drinking. Conclusions %CDT was the most sensitive and specific marker to detect problematic recent alcohol drinking especially with hepatic illness. %CDT could be a reliable and useful marker when clinicians monitored patients with alcohol related health problems.
Abstract
Objectives Carbohydrate-deficient transferring (CDT) has recently been interested as a promising objective laboratory markers for evaluation of chronic alcohol consumption. The objective of this study is to evaluate the validity of CDT among other markers and propose the reasonable cut-off level to detect problematic drinking. Methods Total 162 subjects (130 male, 32 female) were enrolled among social drinkers or alcohol dependence patients. Mean amount of weekly alcohol consumption was collected and %CDT, mean corpuscular volume(MCV), gamma-glutamyl transferase(GGT), aspartate transaminase(AST) and alanine transaminase (ALT) were measured. Severity of hepatic illness was evaluated by abdominal USG. Correlation analysis was performed among markers and alcohol consumption. Linear regression analysis was done between %CDT and alcohol consumption. To find the cut-off value of chronic alcohol drinking, the Receiver operating characteristic (ROC) curve was conducted. Results %CDT, GGT, AST, and ALT showed the significant correlation with the amount of alcohol consumption. After correction of bias such as sex, age and severity of hepatic illness, GGT lost the significant correlation. %CDT was the only factor (28.2%) which could explain the correlation with alcohol drinking by the regression analysis. Measuring the area under ROC curves, %CDT was the significantly better than other markers. 1.15% of %CDT was proposed as a suitable cut-off value to detect problematic drinking. Conclusions %CDT was the most sensitive and specific marker to detect problematic recent alcohol drinking especially with hepatic illness. %CDT could be a reliable and useful marker when clinicians monitored patients with alcohol related health problems.
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