Alcohol and Alcoholism, Vol 34, 71-77, Copyright © 1999 by Medical Council on Alcoholism
F Wurst, C Kempter, S Seidl and A Alt
Ethyl glucuronide (EtG) is a non-volatile, water-soluble, direct metabolite
of ethanol that can be detected in body fluids and hair. We investigated
urine and serum samples from three patient groups: (1) 33 in-patients in
acute alcohol withdrawal; (2) 30 detoxified in-patients (treated for at
least 4 weeks) from a 'motivation station'; and (3) 43 neuro-rehabilitation
patients (non-alcoholics; most of them suffering from stroke, traumatic
brain injury, Parkinson's disease etc.) using gas chromatography/mass
spectrometry (GC/MS) with deuterium-labelled EtG as the internal standard
and additionally in the second group of patients using liquid
chromatography (LC/MS-MS). We found no correlation between the
concentration of EtG in urine at hospitalization and the blood-ethanol
concentration (r 0.17), the time frame of detection
(r 0.5) or the total amount of clomethiazole required
for the treatment of withdrawal symptoms (r 0.28). In
four out of 30 in-patients from the 'motivation station' - where neither
clinical impression nor routine laboratory findings gave indications of
relapse - concentrations of EtG in urine ranged between 4.2 and 196.6 mg/l.
EtG concentrations in urine of between 2.89 and 23.49 mg/l were found in
seven out of 43 neuro-rehabilitation patients using GC/MS. The GC/MS and
the LC/MS-MS results showed a correlation of 0.98 with Pearson's
correlation test and 1.0 with Spearman's correlation test. We suggest that
EtG is a marker of alcohol consumption that can be detected for an extended
time period after the complete elimination of alcohol from the body. When
used as a relapse marker with a specific time frame of detection
intermediate between short- and long-term markers. EtG fills a clinically
as well as forensically important gap. Its specificity and sensitivity
exceed those of all other known ethanol markers.
ARTICLES
Ethyl glucuronide - a marker of alcohol consumption and a relapse marker with clinical and forensic implications
Department of Psychiatry II, Department of Forensic Medicine, University of Ulm, Gunzburg, Germany; Department of Hydrochemistry and Hydrobiology, University of Stuttgart, Stuttgart, Germany; Corresponding author address: Department of Psychiatry II, University of Ulm, Ludwig-Heilmeyer-Str. 2, 89312 Gunzburg, Germany
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