Mean corpuscular volume of erythrocytes (MCV)

The SCRE is a measure of the size of a red blood cell.

Deviations from the norm indicate changes in the maturity of erythrocytes and deformation of erythropoiesis (S.L. Rapaport, 1971).

Repetitive, chronic alcohol abuse can affect the maturity, number, and size of red blood cells, leading to an increase in SCRE.

deficit folic acid and vitamin B12 contributes to changes in erythrocytes, while alcohol has a direct toxic effect, and increased values ​​of SCOE do not disappear when vitamins are replenished until the patient with alcoholism stops drinking alcohol (J. Lindenbaum, C. S. Leiber, 1969).

Elevated values ​​of the ESC correlate with the frequency and amount of alcohol consumed - with correlation coefficients of 0.34 and 0.44, respectively (M.Irwin, S.Baird, T.Smith et al., 1988; T.P.Whitehead, C.A.Clarke, A.G.W. Whitfield, 1978 ), which possibly reflects the 120-day half-life of an erythrocyte (S.LRapaport, 1971).

Deviations from the normal size do not occur after a recent (within the last month) alcohol excess. Prolonged alcohol abuse at a dose of at least 60 g of pure alcohol per day is required, so that as a result the SCRE rises above the normal level from 80 to 90 r.

SCOE values ​​above 98 m3 in men and 100 m3 in women are considered abnormal and indicate alcohol abuse both in alcoholics and heavy drinkers. 45% sensitivity of the SCSE test was reported when examining heterogeneous groups: but the sensitivity of the test increased to 90% when compared inpatients with alcoholism with a control group composed of representatives of the general population (P.Cushman, G.Jacobson, J.J.Barboriaketal., 1984; H.A. Skinner, S. Holt, R. Schulleretal., 1984).

If any groups of subjects are taken into account, then the sensitivity of the test will be at least 50%.

Specificity elevated values The ESV is also quite high, as non-drinkers or socially acceptable drinkers rarely show high ESV values. 90% specificity was reported in identifying alcoholics compared to drinkers in socially acceptable norms (H.A.Skinner, S.Holt, R.Schuller et al., 1984).

Thus, the combination of high sensitivity and high specificity of the SCOE test makes it possible to identify patients with alcoholism with a 96% probability. This means that in 96 cases out of 100 people with elevated SCOE will be alcoholics.

Additional Liver Function Tests

To identify people who abuse alcohol, but do not yet have obvious signs of alcohol damage to internal organs, including the liver, a number of laboratory tests have been proposed, among which an important place is occupied by the study of enzymatic indicators of blood serum.

Aspartate aminotransferase (ACT)

The content of this enzyme is often found to be elevated in the plasma of individuals who have relatively mild and often reversible liver damage, such as alcoholic fatty liver disease. An increase in the content of ACT can be observed in a number of somatic diseases of non-alcoholic origin - hepatitis, heart disease, recent skeletal muscle injury.

However, clinical studies have shown that the ACT can be a moderately sensitive and specific test of alcohol abuse. According to T.V. Chernobrovkina (1992), the ACT value at a rate of 40 U/l in the group of persons with clinically established domestic drunkenness averaged 62.3 ± 15.29 U/l, in patients with stage 1 alcoholism - 46, 3±2.18 U/l, in patients with stage 2 alcoholism - 68.1±9.08 U/l and in patients with stage 3 alcoholism - 92.6±14.54 U/l.

An increase in ACT above the norm was also noted by foreign authors. In outpatients with alcoholism, an increase in ACT was detected only in 28% of the studied 543 patients with alcoholism (P.Cushman, G.Jacobson, J.J.Barboriak et al., 1984).

In patients with chronic alcoholism, the proportion of people with elevated levels of ACT reached 56% (E. Nemesansky, S. B. Rosalki, A. Y. Foo, 1981).

In general, the specificity of elevated ACT levels is estimated to be approximately 80%.

Table 1. Laboratory tests useful for identifying alcohol abusers

	Norm	Sensitivity (%)	Specificity(%)	Notes
				When used at 5 conventional doses or more, is often the only elevated test
				Not applicable for withdrawal monitoring
3. Additional liver function tests: Aspartate transaminase Alkapine phosphatase	10-40 units/ml			The increase reflects liver damage and does not necessarily correlate with alcohol consumption.
				Rise after 2 weeks of abuse and decline at the same rate
5. Uric acid				Many factors can affect uric acid levels, and the test is useful in combination with other tests.

Abbreviations: GGT, gamma-glugamyl transferase; SCOE - average corpuscular volume of erythrocytes; HDL - high density lipoprotein cholesterol; and / 1 - units / liter

A number of other serum tests point to probable liver damage under the influence of alcohol abuse. The selective hepatotropic effect of alcohol in the body of an abuser can be thought of when comparing ACT hyperenzymemia with the activity of other serum enzymes of the “liver profile”: alkaline phosphatase (AP), leucineamino-peptidase (LAP), cholinesterase (ChE) and lactate dehydrogenase (LDH).

A friendly reaction of these blood serum enzymes confirms the presence of alcoholic liver damage and indicates its severity (T.V. Chernobrovkina, 1992). However, the use of these tests as the only markers of alcohol abuse does not provide high sensitivity and specificity of the study.

At least 35 laboratory blood tests are known to identify individuals with suspected alcoholism. If you need to limit yourself to the smallest number of tests, then you can recommend a combination of two of them - GGT and SCOE.

These two tests correctly identified 91% of alcoholics in the general population of people seeking medical help (V.Chick, N.Kreitman, M.Plant, 1981). The combination of GGT and ACT tests is able to correctly identify 100% of alcohol abusers and 90% of completely abstinent individuals (M.A. Schuckit, M. Irwin, 1988).

Carbohydrate-deficient transferrin

Relatively recently, a test has been proposed - determination of the level of carbohydrate-deficient transferrin (UDT) in blood serum. An increase in UDT levels may indicate alcohol abuse. Human transferrin is present in high concentrations in the blood serum and in small amounts in the cerebrospinal and amniotic fluids. It is mainly synthesized in the liver. The biological half-life of serum transferrin is 6-12 days.

Regular intake of large doses of alcohol leads to the appearance of transferrin isoforms that are deficient in the carbohydrate component and differ in their characteristics from normal serum transferrin.

Daily intake of alcohol in excess of 60 g of ethanol for at least 1 week is accompanied by a marked increase in serum UBT levels. According to various authors, the sensitivity of the UDT test ranges from 80 to 90%, and the specificity - from 90 to 100% (N.N. Ivanets, L.F. Panchenko, I.R. Andersen et al., 1994).

It was shown that the average level of serum UBT in the group of healthy male volunteers was 17.4±1.3 U/l, in the group healthy women- 22.2±0.8 U/l, and the average in the group of patients with alcoholism upon admission to inpatient treatment was 38.6±3.8 U/l.

These data indicate a significant increase in the level of UDT in patients with alcoholism. When re-examined 9-12 days after admission to the hospital, patients with alcoholism showed a significant decrease in blood UBT, which, however, did not reach the control values ​​in 80% of patients and averaged 28.7±2.1 U/l (N. N. Ivanets, L.F. Panchenko, I.R. Andersen et al., 1994).

Based on the results of determining the UDT obtained in Russia and in a number of other countries, the authors recommend using the UDT test to determine the presence of alcohol abuse, to diagnose alcohol withdrawal syndrome, to monitor patients with alcoholism during treatment and to control the quality of remission. The UDT method is claimed to have greater sensitivity and specificity than the until recently considered best test for determining gamma-glutamyl transpeptidase activity.

However, this method has less sensitivity in women (at the level of generally accepted methods) and in persons who have recently begun to abuse alcohol.

V.D. Moskalenko, T.V. Agibalova

DETERMINATION OF THE TRANSFERRIN FRACTION (CDT) (DIAGNOSIS OF ALCOHOL ABUSE) Carbohydrate-deficient transferrin is a biomarker of chronic alcohol consumption (more than 60 grams of ethanol per day). What is this analysis used for? To diagnose alcohol abuse. When is an analysis scheduled? For suspected alcohol abuse and monitoring for withdrawal. Synonyms Russian Carbohydrate-deficient transferrin (UDT), carbohydrate-deficient transferrin. Synonyms English Carbohydrate-deficient transferrin (CDT),% CDT. Research method High performance liquid chromatography. Units of measurement % (percentage). What biomaterial can be used for research? Venous blood. How to properly prepare for research? Eliminate alcohol from your diet for 24 hours prior to testing. Do not eat for 8 hours before the analysis, you can drink pure non-carbonated water. Completely exclude the use of drugs within 24 hours before the analysis (as agreed with the doctor). Eliminate physical and emotional overstrain 30 minutes before the analysis. Do not smoke for 30 minutes prior to analysis. General information about the study Transferrin is a whey protein whose main function is iron transport. In the blood, it is present in the form of isoforms with a different number of attached sialic acid residues (there can be up to 8 of them in a transferrin molecule). In the blood, the main form of transferrin is tetrasialotransferrin. When alcohol is consumed in large quantities, transferrin glycosylation is disturbed and the concentration of its other isoforms with fewer sialic acid residues (asialo-, mono-, disialotransferrins) increases in the blood. They are evaluated as total carbohydrate-deficient transferrin (CDT). The level of carbohydrate-deficient transferrin increases significantly with daily consumption of more than 60 grams of ethanol (4-5 alcoholic beverages or 0.75 liters of wine per day) for at least two weeks. With a single intake of high doses of alcoholic beverages, the concentration of carbohydrate-deficient transferrin in the blood does not change. The half-life of transferrin is 2 weeks, therefore, after the cessation of alcohol consumption, the indicator normalizes within the above period. The specificity of CDT for the diagnosis of chronic alcohol abuse is 80-90%, the sensitivity is 60-70%. A high performance liquid chromatography (HPLC) study has a significant advantage over the immunological method in terms of specificity and sensitivity. CDT is measured in relative units (% of total transferrin), so the presence of anemia does not affect the result of the analysis. Carbohydrate-deficient transferrin is more specific for the diagnosis of alcoholism than gamma-glutamyl transpeptidase (GGTP) and mean cell volume (MCV). However, a separate appointment of CDT (without additional tests) as a screening is not recommended due to its lack of sensitivity. It should also be taken into account that the level of carbohydrate-deficient transferrin increases with congenital disorders of glycosylation, galactosemia, pregnancy and the use of hormonal drugs. What is research used for? To diagnose chronic high-dose alcohol use; to evaluate the effectiveness of alcoholism treatment; for monitoring abstinence in order to detect relapses of alcoholism; for differential diagnosis of the causes of changes in liver function, changes in behavior. When is the study scheduled? If alcohol abuse is suspected; in the presence of clinical data and changes in laboratory tests that may be associated with alcohol consumption (increase in GGTP, change in the ALT / AST ratio, impaired liver function, pancreas, neuropsychiatric changes); when monitoring patients at risk of relapse of alcoholism. What do the results mean? Reference values< 1,2 % от общего трансферрина – нормальные значения; >2.5% of total transferrin - pathological values. Causes of increased CDT: alcohol abuse at a dose of more than 60 grams of ethanol per day for at least two weeks; congenital disorders of glycosylation. What can influence the result? The results of the study may be distorted by pregnancy, hormone replacement therapy, congenital glycosylation disorders (for example, carbohydrate-deficient glycoprotein syndrome type Ia), galactosemia, congenital fructose intolerance. The study is more specific for men than for women. Taking medications (antidepressants, disulfirams) does not cause significant changes in the result of this analysis. Important Notes CDT levels return to normal 2 weeks after drinking has stopped. Single doses of high doses of alcohol do not cause an increase in this indicator.

1

The spread of chronic alcohol abuse and alcoholism in Russia actualizes the task of developing a set of measures aimed at implementing a new state anti-alcohol policy. Modern examination methods make it possible to identify with a high degree of certainty persons prone to chronic alcohol abuse, unable to perform their duties in stressful situations, as well as their consequences associated with the specific conditions of professional activity. Among them, an important place is occupied by methods of diagnostic examination of the population of various social and age groups, allowing timely, at an early stage to identify individuals with a chronic alcohol load.

alcoholism

testing markers

alcohol addiction diagnosis

carbon-deficient transferrin

1. A. V. Nemtsov and A. T. Terekhin. DIMENSIONS AND DIAGNOSTIC COMPOSITION OF ALCOHOLIC MORTALITY IN RUSSIA // NARCOLOGY. - 2007. - No. 12. - P. 72–80.

2. P. P. OGURTSOV, A. B. POKROVSKY, and A. E. Uspenskii, Acoust. ALCOHOL AND THE HEALTH OF THE RUSSIAN POPULATION 1900–2000 // MATERIALS OF THE VSEROS. FORUM. - M., 1998. - S. 167-73.

3. JENKINS M.A. CLINICAL APPLICATIONS OF CAPILLARY ELECTROPHORESIS // MOLECULAR BIOTECHNOLOGY. 2000. - No. 15. - R.201-209.

4. RAO R. ENDOTOXEMIA AND GUT BARRIER DYSFUNCTION IN ALCOHOLIC LIVER DISEASE// HEPATOLOGY. 2009. - Vol. 50, No. 2. - R.638-44.

5. ROGAEV E.I. SMALL RNAS IN HUMAN BRAIN DEVELOPMENT AND DISORDERS // BIOCHEMISTRY (MOSC). 2005. - Vol. 70, No. 12. - R. 1404-7.

6. PETROV D.V. DIAGNOSIS, TREATMENT AND PREVENTION OF DISORDERS CAUSED BY ALCOHOL USE - YAROSLAVL: YAGMA, 2003. - S. 86–87.

7. JUNG M.H., PARK B.L., LEE B.C., ASSOCIATION OF CHRM2 POLYMORPHISMS WITH SEVERITY OF ALCOHOL DEPENDENCE // GENES BRAIN BEHAV. - 2011. - Vol. 10, No. 2. - R. 253-6.

8. Landers J.P. CLINICAL CAPILLARY ELECTROPHORESIS // CLIN.CHEM. - 1995. - No. 41. - P. 495-509.

9. HACK L.M., KALSI G., ALIEV F. LIMITED ASSOCIATIONS OF DOPAMINE SYSTEM GENES WITH ALCOHOL DEPENDENCE AND RELATED TRAITS IN THE IRISH AFFECTED SIB PAIR STUDY OF ALCOHOL DEPENDENCE (IASPSAD) // ALCOHOL CLIN. EXP. RES. 2011. - Vol. 35, No. 2. - R. 376-85.

Alcohol abuse is one of the main causes of low life expectancy in Russia. Between one third and more than half of the deaths of men of working age are direct and indirect alcohol losses. In addition to the analysis of socio-economic and psychological factors, the study of alcoholism is of great importance, which makes it possible to identify the molecular mechanisms of the development of the disease and disorders associated with alcohol abuse. A worldwide study of diagnostic markers of alcohol consumption is currently underway. They are used in professional medical examinations, when returning a driver's license withdrawn due to driving under the influence of alcohol, when monitoring the course of treatment of patients with alcoholism, and in preparation for surgery. The most specific and promising of these markers for clinical practice is carbon-deficient transferrin (CDT). Among the existing methods for identifying citizens suffering from chronic alcoholism, the most common are methods that allow conducting a survey. These include tests: CAGE, AUDIT, LeGo Grid. They are easy to fill in by patients, are easily and quickly assessed by a doctor, and take into account national characteristics to the greatest extent " Russian mentality» and attitude to alcohol.

World experience shows that a brief questionnaire and an elementary medical examination are high-quality diagnostic tools. Additional use of tests that increase the likelihood of recognizing chronic alcohol intoxication (CHAI) is necessary. First of all, these include biochemical analyzes that determine an increase in the activity of gamma-glutamyl transpeptidase (GGT), an aminotransferase. In recent years, qualitative and quantitative determination of the marker of carbohydrate-deficient transferrin (CDT) in the patient's blood serum has been used for objective laboratory diagnosis of chronic alcohol intoxication.

Among the markers of alcohol consumption, the most specific is carbon-deficient transferrin. Transferrin is a protein that carries iron ions to the cells of all tissues of the body when they are absorbed in the intestine or released from red blood cells. The difference in isoforms of transferrin is determined by glycosylation. The main fraction of transferrin is isoform with 4 sialic acid residues. With the consumption of significant amounts of alcohol (40-60 g per day for several days, or large single doses), the proportion of carbonhydrate-deficient transferrin (CDT) isoforms with two, one residue or completely desialyzed transferrin (0-form) increases. Normally, the CDT fraction does not exceed 1.3% - 1.7%, while when consuming the indicated amounts of alcohol, the CDT level exceeds these limits and can increase up to 10-15 times. The choice of this marker is based on its diagnostic ability to reflect both early and latent alcohol abuse, and to monitor the effectiveness of ongoing therapy by objectively reflecting remission or relapse.

Objective consisted in establishing the diagnostic significance of the comparative determination of markers of chronic alcohol use, by capillary electrophoresis and biochemical analysis in the examination of various groups of patients with alcoholism.

Materials and methods of research

The study was conducted on the basis of the Moscow Scientific and Practical Center for Narcology DZ of the city of Moscow in a group of men, which excludes the influence of gender differences.

The clinical study was performed in a group of patients consisting of 250 patients aged 23 to 72 years with a diagnosis of chronic alcoholism. Analysis of blood serum for the content of the marker of carbohydrate-deficient transferrin was carried out in dynamics, by taking venous blood on the 1st, 7th, 14th and 21st days of treatment. The control group consisted of 1000 healthy donors. A comprehensive assessment of patients with chronic alcoholism included data on age, sex and duration of the disease. The analyzed groups of patients were homogeneous in all of the above characteristics.

To establish the diagnostic significance of markers of chronic alcohol consumption, the determination of isoforms of glycosylated transferrin (CDT) in the blood serum of patients and biochemical parameters of the content of hepatic enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamine aminotranspeptidase (GGT) were performed.

Blood in the amount of 5 ml was taken into monovets. Next, the tubes were centrifuged in an ELMI SM-6M centrifuge (Latvia) for 5 min at a speed of 3000 rpm. min. After that, the serum was divided into 1.5 ml aliquots into eppendorf tubes to determine the content of biochemical markers and transferrin. Determination of the CDT protein was carried out on a Minicap instrument (France). To determine biochemical markers, ALT, AST, and GGT blood readings, 1 ml of serum, were instilled into the cuvettes of a HORIBA ABX Pentra 400 biochemical analyzer (France). Statistical analysis was performed using standard methods using the WinSTAT 2003.1 package integrated into Excel. When assessing the odds ratio (OR) and the significance of differences in frequencies according to Fisher's exact test, the freely distributed WinPepi software package was used: http://www.brixtonhealth.com/pepi4windows.html

Research results and discussion

In chronic alcohol abuse, transferrin glycosylation is impaired, resulting in a change in the percentage of its isoforms towards an increase in the level of low-sialylated variants, also called carbohydrate-deficient, or CDT. The pathomechanism of increased CDT levels in response to chronic alcohol abuse is mainly that ethanol and/or its metabolite, acetaldehyde, affect the synthesis of N-glycan chains in the Golgi apparatus, inhibiting the activity of galactosyltransferase and N-acetylglucosaminyltransferase and simultaneously increasing sialidase activity in liver plasma membranes. Ethanol also causes destabilization and a decrease in the concentration of mRNA?-2,6-sialyltransferase and a decrease in the synthesis of?-2,6-sialyltransferase, due to a decrease in the activity of sialyltransferase, and, as a result, a decrease in the sialylation of transferrin molecules. We have carried out studies aimed at determining the diagnostic significance of the results obtained by two independent methods when examining a group of people with chronic alcohol dependence. Determination of the CDT marker was carried out in blood samples on the 1st, 7th, 14th and 21st days of treatment. For analysis of biochemical markers ALT, AST and GGT, samples of the 1st and 21st days were used. When analyzing the obtained averaged results, the dependences presented in Figs. 12.

As can be seen from fig. 1, the CDT concentration averaged 4.31% on admission, decreasing to 2.27% on day 7 of treatment. By day 14 it was 1.48%, by day 21 of treatment it was 1.14%. The data obtained indicate that with the complete rejection of alcohol, the patient's protein concentration decreases and the CDT value returns to normal in 2-3 weeks.

Rice. 1. Dependence of CDT values ​​on time

Rice. 2. Dependence of biochemical parameters on time

On fig. 2 shows the dynamics of changes in biochemical markers. The concentration of enzymes also decreases over time. However, even after 2-3 weeks, these values ​​do not normalize and remain high. The obtained data and their values ​​do not allow confirming the complete refusal of the patient from alcohol within these periods. Thus, comparing the dynamics of the decrease in the numerical series of CDT values ​​and biochemical parameters characterizing the content of enzymes, it can be seen that CDT data are more informative compared to such markers as ALT, AST and GGT. In contrast to the content of enzymes, an increase in glycosylated transferrin is least associated with organic damage to the liver or other organs (both alcoholic and non-alcoholic) or increased synthesis of microsomal enzymes. Unlike other glycoproteins, lack of sialylation of transferrin isoforms is in no way associated with liver or kidney clearance.

Conclusion

Comparative studies of markers of chronic alcohol abuse characterizing changes in the content of enzymes and glycosylated transferrin were carried out. In this case, the methods of biochemical analysis and capillary electrophoresis were used. It has been established that the most important data for the diagnosis of early states of alcoholism are CDT determination data.

Thus, the CDT marker is a universal diagnostic tool for the implementation of a preventive and medical rehabilitation strategy for diseases of dependence on alcohol-containing substances. The key component when using the CDT marker is the objectification of the fact of alcohol abuse by laboratory diagnostic methods. The presented CDT marker is currently the only marker for assessing chronic alcohol load that has experience in practical use.

The results obtained based on the analysis of data on patients with alcoholism will serve as the basis for the development of risk monitoring strategies, optimal therapeutic and preventive strategies, as well as the search for new pharmacological targets using new methods for diagnosing such a socially significant disease as alcoholism.

Bibliographic link

Myagkova M.A., Pushkina V.V., Petrochenko S.N., Myagkova M.A., Pushkina V.V., Petrochenko S.N., Morozova V.S. DETERMINATION OF MARKERS OF CHRONIC ALCOHOL ABUSE BY THE METHOD OF CAPILLARY ELECTROPHORESIS // International Journal of Applied and fundamental research. - 2015. - No. 12-9. - S. 1640-1643;
URL: https://applied-research.ru/ru/article/view?id=8210 (date of access: 11/29/2017). We bring to your attention the journals published by the publishing house "Academy of Natural History"

• Description
• Training
• Indications
• Interpretation of results

The test is used to detect chronic consumption of large doses of alcohol.

Transferrin - a glycoprotein involved in the transport of iron in the body, is present in the blood in the form of various isoforms. Depending on the composition of the carbohydrate chains of transferrin, the number of attached sialic acid residues in its molecule can reach eight. Of these, only 5-(penta-), 4-(tetra), 3-(tri-), and 2-(di-) sialotransferrins circulate in detectable amounts. Normally, transferrin is represented mainly by tetrasialotransferrin. Chronic use of large doses of alcohol leads to inhibition of transferrin glycosylation (and attachment of sialic acid residues), resulting in an increase in the content of isoforms with a reduced amount of sialic acid residues (asialo-, mono- and disialo-transferrins), which are estimated in total as carbohydrate-deficient transferrin (UDT). The main part of UDT is disialotransferrin. When alcohol is discontinued, the elevated UDT content persists for up to 2 weeks (transferrin half-life), after which the test results return to normal.

Currently, the study of carbohydrate-deficient transferrin is used as the most specific and reliable test for suspected chronic heavy drinking. This may be important in various social situations in case of suspected alcohol abuse, including professional examinations, as well as in the examination of patients with diseases that are often associated with excessive alcohol consumption (liver disease, pancreatitis, depression). Establishing the fact of chronic alcohol abuse is essential for the correct interpretation of laboratory test results and the correct diagnosis. Alcohol dependence is not always adequately diagnosed using questionnaires, although this factor can be corrected. Indirect laboratory signs of chronic alcohol abuse, commonly used for this purpose (increased levels of the GGT enzyme - gamma-glutamyl transferase, mean blood cell volume - MCV, increased levels and changes in the ratio of AST / ALT enzymes), are often not specific enough. In contrast, UBT does not change in other diseases (eg, non-alcoholic liver disease). The content of UDT is not affected by drugs - in particular, antidepressants or disulfiram (a drug used to treat alcoholism). The test for carbohydrate-deficient transferrin reliably detects long-term use of large doses of alcohol (more than 60 g / day for 2 weeks). An increase in the level of carbohydrate-deficient transferrin is not observed with a single use of a large dose of alcohol, or with the use of moderate doses of alcohol. In patients at high risk of alcohol misuse, UDT testing can be used in monitoring to detect relapses. The sensitivity of the UDT test varies somewhat individually. It is estimated that the sensitivity of UDT studies in detecting alcohol dependence reaches 60-70%, specificity - 80-90%. The highest specificity of the test is observed in examinations of men older than 40 years. The study is less specific for women, especially during pregnancy, as well as in the case of hormone replacement therapy or hormonal contraceptives. The test is not applicable in cases of suspected congenital disorders of glycosylation. The use of relative units (percentage of total transferrin) to evaluate the result reduces the likelihood of bias due to variation in total transferrin in anemia or during pregnancy.

ATTENTION! This laboratory study is not an examination. The type of study is a preliminary screening laboratory study. The results obtained by the patient may be submitted to the judicial authorities and may be considered as evidence in legal proceedings only at the discretion of the court.

1. Suspicion of alcohol abuse.
2. In the complex examination of patients with diseases often associated with alcohol abuse (liver disease, pancreatitis, depression).
3. In order to confirm the cause of some shifts in laboratory tests that may be associated with alcohol abuse (increased GGT, increased MCV, increased HDL cholesterol, changes in the level and ratio of AST / ALT).
4. Monitor patients at high risk for alcohol abuse to detect relapses.

The interpretation of the results of the study contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. An accurate diagnosis is made by the doctor, using both the results of this examination and the necessary information from other sources: history, results of other examinations, etc.

Units: %

Reference values: < 1,3%

Result interpretation:

• CDT ≤ 1.3% result within normal limits
• CDT > 1.3% and ≤ 1.6% inconclusive, further follow-up needed
• CDT > 1.6% above normal

Literature

1. O.I. Tarasova, P.P. Ogurtsov, N.V. Mazurchik, V.S. Moiseev. Modern laboratory markers of alcohol consumption. Clinical pharmacology and therapy. 2007, 16, 1, pp. 1−5.
2. H.R. Tavakoli, M. Hull, Lt.M. Okasinski. Review of current clinical biomarkers for the detection of alcohol dependence. Innov.Clin.Neurosci. 2011, 8.3, 26−33. 3. Materials of the manufacturer of reagents.

To date, there is a test in narcology that allows you to determine chronic alcoholism at an early stage. At its core, this test is a blood test. With the help of laboratory tests in the blood, the level of carbohydrate-deficient transferry is determined, which is called CDT. If a person consumes ethanol in the range of 40-80 g for 7-10 days, this indicator in the blood begins to increase significantly, which indicates the presence of dependence. If a person consumes alcohol within reasonable rate, his CDT remains within acceptable limits.

Feedback from a resident who successfully completed a rehabilitation course at the center

For an accurate analysis, 2-4 ml of blood taken from a vein is sufficient. The analysis is carried out by the method of capillary electrophoresis, which makes it possible to identify chronic diseases of the liver, gastrointestinal tract, and kidneys. All these diseases can be exacerbated by excessive consumption of alcoholic beverages.

The norm of CDT readings ranges up to 1.3%, between 1.3% -1.6% there is a so-called gray zone, a dangerous indicator is 1.6% and higher. This indicates the development of alcoholism in its chronic form, which requires the immediate intervention of specialists who recommend starting an active alcoholism treatment.

How does chronic alcoholism develop?

The World Health Organization has long defined the limits of the permissible amount of alcohol per person and its dangerous doses. By their standards, 40 grams of ethanol for men and 20 grams for women is a dangerous dose and leads to pathological changes in the body and psyche. Tolerance and addiction are not formed in one day or even in a month. Some need a year or two for this, and others 5-10 years.

According to WHO, there are 4 types of unhealthy drinking

Unauthorized when teenagers drink alcohol, pregnant women and so on;

Harmful use is considered to be the form in which a person harms his or her body;

Dangerous use precedes harmful use and bears some of its premises;

Dysfunctional - harms a person's life (lost his job, due to alcohol abuse, and so on).

Alcohol addiction always combines physical abnormalities and mental illness. Its result is the complete degradation of the personality and the destruction of a person's life, where no small suffering falls on loved ones. How it takes to continue the life of an addict addiction treatment So the alcoholic should stop drinking alcohol.

Patients who have been rehabilitation center "Impulse" s, were able to find real freedom from their addictions, today we are ready to help you get on the path to recovery!