© 1997 Medical Council on Alcohol
research-article
HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY IMPROVES DIAGNOSTIC EFFICIENCY OF CARBOHYDRATE-DEFICIENT TRANSFERRIN
Central Laboratory, Medical Clinic and Policlinic, University of Heidelberg Bergheimerstr. 58, 69115 Heidelberg, Germany
1Laboratory of Alcohol Research, Liver Disease and Nutrition and Dept. of Medicine, Salem Medical Center Zeppelinstr, 11-33, 69121 Heidelberg, Germany
*Author to whom correspondence should be addressed
Received 29 March 1996; accepted 21 August 1996
Carbohydrate-deficient transferrin (CDT) is considered a useful biochemical marker of regular high alcohol intake. CDT was measured in the sera of 51 alcohol abusers, 20 patients with nonalcoholic liver disease and 30 healthy controls with an alcohol intake of <30g/day. The mean CDT levels of these three groups respectively were determined with high-performance liquid chromatography (HPLC; 4.6 ± 5.2%; 0.7 ± 0.2%; 0.7 ± 0.2%) and with a radioimmunoassay after microcolumn anion-exchange chromatography (MAEC/RIA; 34.2 ± 26.9 U/1; 16.9 ± 3.8 U/1; 18.0 ± 5.7 U/1). CDT levels in patients with severe alcohol abuse (161.6 ± 96.4g/day) were significantly higher than in the two other groups under investigation (P < 0.0001). In heavily drinking subjects, the mean daily alcohol intake correlated with aspartate aminotransferase levels (ASAT) but not with the CDT levels determined either with HPLC or MAEC/RIA. With both methods, the CDT levels were slightly higher in patients with an ASAT concentration >30 U/1, which may indicate an advanced liver damage (P < 0.05). Analysis of receiver-operating characteristic (ROC) plots demonstrated that the diagnostic accuracy of the HPLC method, which determines the relative amount of CDT, was significantly higher than the established MAEC/RIA method, which measures the absolute amount of CDT (area under the ROC curve: 0.95 ± 0.02 vs 0.73 ± 0.05; P < 0.0001). At a specificity of >95%, the sensitivity of CDT determined with HPLC and MAEC/RIA was 80 and 47%, respectively. In addition, HPLC may be a useful and reliable method for the determination of this important biochemical marker, since the HPLC chromatogram is a visible document of the successful isotransferrin separation and measurement.
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