여성 과음의 선별을 위한 생물학적 표지자의 임상적 유용성
Usefulness of Biomarkers to Screen Heavy Drinking in Korean Females
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연구배경: 본 연구는 여성에서 과음을 선별하는 검사로서 생물학적 표지자의 임상적 유용성을 평가하고자 하였다. 방법: 2006년 1월부터 12월까지 충남대학교 병원 가정의학과 외래에 내원한 음주 여성 55명을 대상으로 삼았다. 최근 1개월간의 주당 평균음주량을 조사하여 7잔 이하의 적절 음주군(40명)과 7잔을 초과하는 과음군(15명)으로 나누었다. Carbohydrate-deficient transferrin (%CDT), mean corpuscular volume (MCV), gamma glutamyl transferase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT)의 음주량에 대한 상관성, 과음에 대한 민감도, 특이도, 양성 예측도, 음성 예측도, ROC 곡선(receiver operating characteristic curve)을 조사하였다. 결과: 주당 평균음주량에 대해 %CDT (r=0.583, P＜0.01), MCV (r=0.290, P＜0.05), AST (r=0.423, P＜0.01)가 유의한 양의 상관관계를 보였다. 과음에 대한 %CDT, MCV, GGT, AST, ALT의 민감도는 각각 66.7%, 13.3%, 40.0%, 26.7%, 26.7%, 특이도는 각각 80.0%, 97.4%, 71.1%, 90.0%, 85.0%, 양성 예측도는 각각 55.6%, 66.6%, 35.3%, 50.0%, 40.0%, 음성 예측도는 각각 86.5%, 74.5%, 75.0%, 76.6%, 75.6%이었다. %CDT, MCV, GGT, AST, ALT의 ROC curve 아래 면적(95% 신뢰구간)은 각각 0.873 (0.780∼0.966), 0.806 (0.668∼0.944), 0.549 (0.372∼0.725), 0.519 (0.328∼0.710), 0.479 (0.293∼0.666)로 %CDT가 가장 높았고 ROC curve에 의한 %CDT의 절단치는 2.53이었다. 결론: 여성과음의 선별을 위해서 %CDT가 민감도와 특이도가 높아 유용할 것으로 생각된다.
Abstract
Background: The present study purposed to evaluate the clinical usefulness of biological indicators in identifying Korean female heavy drinkers. Methods: Fifty five drinking women were selected among those who visited the Department of Family Medicine of Chungnam National University Hospital during the period from January to December 2006. We surveyed the alcohol intake during the recent one month. The correlation of alcohol intake with %CDT (carbohydrate- deficient transferrin), mean corpuscular volume (MCV), gamma glutamyl transferase (γGT), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was examined. The sensitivity, specificity, positive predictive value, negative predictive value and ROC (receiver operating characteristic) curve of the biomarkers for heavy drinking (more than 7 drinks per week, one drink= 14 g of alcohol) were also investigated. Results: The mean weekly alcohol intake showed a significant positive correlation with %CDT (r=0.583, P＜ 0.01), MCV (r=0.290, P＜0.05) and AST (r=0.423, P＜0.01). The sensitivity of %CDT, MCV, γGT, AST and ALT to heavy drinking were 66.7%, 13.3%, 40.0%, 26.7% and 26.7%, respectively, and the specificity 80.0%, 97.4%, 71.1%, 90.0% and 85.0%, respectively, and positive predictive values 55.6%, 66.6%, 35.3%, 50.0% and 40.0%, respectively, and negative predictive values 86.5%, 74.5%, 75.0%, 76.6% and 75.6%, respectively. The areas under the ROC curve (95% confidence interval) of %CDT, MCV, γGT, AST and ALT were 0.873 (0.780∼0.966), 0.806 (0.668∼0.944), 0.549 (0.372∼0.725), 0.519 (0.328∼0.710) and 0.479 (0.293∼0.666), respectively. Conclusion: %CDT is considered as the most useful marker for identifying Korean female heavy drinkers.(J Korean Acad Fam Med 2008;29:412-417)
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