CARBOHYDRATE-DEFICIENT TRANSFERRIN (CDT) AS A MARKER OF ALCOHOLDEPENDENCY

BACKGROUND Excessive alcohol consumption starts to change the structure of transferrin into thecarbohydrate-deficient transferrin (CDT). CDT is the only specific laboratory marker foralcohol dependency. However no one at all is sensitive enough.Method In our study we wanted to confirm the alcohol dependency by means of questionnairesand laboratory markers, particularly CDT. RESULTS Investigated were 68 (92.6 % males, 7.4 % females) general practice healthy patientsand blood donors and 186 (89.2 % males, 10.8 % females) inpatient alcoholics. A bloodsample was taken once from every healthy subject and three times from every alcoholic: onadmission to hospital, after 12 days and again after 42 days.In alcoholics we found statistically significantly elevated CDT, glutamate dehidrogenaze(GLDH), aspartate-aminotransferaze (AST), alanine-aminotransferaze (ALT), gamaglutamyltransferaze (GGT) and mean corpuscular volume (MCV) and decreased ureavalues. CDT was the most reliable marker with high specificity (91.2 %) and sensitivity(81.4 %). The area under ROC-curve was exceptional with 99.9 %.The kinetics of CDT, AST, ALT, GGT, MCV and creatinine normalization after 14 dayswere also statistically significant as well as kinetics of CDT, AST, GGT, MCV and creatininenormalization after 42 days. We estimated the course of CDT value normalization as themost applicable.The most important diagnostic marker combination was composed by CDT, MCV and AST.GGT had lower importance as expected. CONCLUSIONS In our population CDT was the most specific marker of all, attaining high sensitivity. But itwas not reliable enough as the sole marker or as the screening one for alcohol dependency.Its main applicability is in diagnostics of alcoholism, control of alcohol abstention andforensic cases but solely in combination with other laboratory markers of alcoholism