BMI But Not Stage or Etiology of Nonalcoholic Liver Disease Affects the Diagnostic Utility of Carbohydrate-Deficient Transferrin

Fagan, Kevin J., Irvine, Katharine M., McWhinney, Brett C., Fletcher, Linda M., Horsfall, Leigh U., Johnson, Lambro A., Clouston, Andrew D., Jonsson, Julie R., O'Rourke, Peter, Martin, Jennifer, Pretorius, Carel J., Ungerer, Jacobus P. J. and Powell, Elizabeth E. (2013) BMI But Not Stage or Etiology of Nonalcoholic Liver Disease Affects the Diagnostic Utility of Carbohydrate-Deficient Transferrin. Alcoholism Clinical and Experimental Research, 37 10: 1771-1778. doi:10.1111/acer.12143


Author Fagan, Kevin J.
Irvine, Katharine M.
McWhinney, Brett C.
Fletcher, Linda M.
Horsfall, Leigh U.
Johnson, Lambro A.
Clouston, Andrew D.
Jonsson, Julie R.
O'Rourke, Peter
Martin, Jennifer
Pretorius, Carel J.
Ungerer, Jacobus P. J.
Powell, Elizabeth E.
Title BMI But Not Stage or Etiology of Nonalcoholic Liver Disease Affects the Diagnostic Utility of Carbohydrate-Deficient Transferrin
Journal name Alcoholism Clinical and Experimental Research   Check publisher's open access policy
ISSN 0145-6008
1530-0277
Publication date 2013-10-01
Year available 2013
Sub-type Article (original research)
DOI 10.1111/acer.12143
Volume 37
Issue 10
Start page 1771
End page 1778
Total pages 8
Place of publication Hoboken, NJ United States
Publisher Wiley-Blackwell Publishing, Inc.
Language eng
Formatted abstract
Background
A reliable biomarker is required in hepatology clinics for detection and follow-up of heavy alcohol consumption. Carbohydrate-deficient transferrin (CDT) increases with sustained heavy alcohol consumption and is the most specific biomarker of ethanol (EtOH) consumption. Recent introduction of a standardized method for measuring CDT has improved its clinical application. This study was designed to determine whether alcohol-independent factors influence CDT levels in patients with chronic liver disease (CLD).

Methods
The relationship between serum %CDT and self-reported history of alcohol consumption was examined in 254 patients referred for evaluation of liver disease. CDT analysis was performed on serum collected at time of liver biopsy.

Results
CDT levels were not affected by severity or etiology of nonalcoholic liver disease. Thirteen of 254 subjects had a %CDT >1.7, predictive of heavy alcohol intake, 6 of whom did not acknowledge heavy drinking. Twelve of these 13 subjects were suspected heavy drinkers on review of their medical records and clinical results. Conversely, not all acknowledged heavy drinkers had %CDT >1.7. Heavy drinkers with a body mass index (BMI) in the overweight or obese range had significantly lower %CDT than lean heavy drinkers. This persisted even when lean body weight was used as an approximation of the EtOH volume of distribution.

Conclusions
An elevated BMI reduces the diagnostic utility of CDT at higher alcohol intake in subjects with CLD using the standardized method. In a hepatology outpatient setting, this assay is likely to be useful to confirm suspicion of heavy drinking in subjects who are not overweight, but cannot reliably identify moderate drinkers or heavy drinkers who are overweight.

Keyword Alcohol
High Performance Liquid Chromatography
Cirrhosis
Biomarker
Chronic Hepatitis C
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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