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Alcohol and Alcoholism Vol. 36, No. 3, pp. 231-234, 2001
© 2001 Medical Council on Alcoholism

Carbohydrate-deficient transferrin in vitreous humour: a marker of possible withdrawal-related death in alcoholics

Adam Berkowicz, Sven Wallerstedt1,, Kerstin Wall2, and Hans Denison1,*,

Department of Forensic Medicine, Göteborg University, Göteborg,
1 Department of Medicine, Sahlgrenska University Hospital/Östra, Göteborg University, Göteborg and
2 Pharmacia & Upjohn Diagnostics AB, Uppsala, Sweden

Received 17 November 1999; first review notified 16 November 2000; accepted 12 December 2000

The possibility of performing reliable post-mortem analysis of carbohydrate-deficient transferrin (CDT) concentration in vitreous humour (VH) by using a commercial assay designed for serum analysis (CDTectTM) as well as the usefulness of VH-CDT as a marker of alcohol misuse and possible withdrawal-related death were evaluated in a forensic sample. Detectable VH-CDT was found in 20 of 21 alcoholic subjects and in two of seven controls. By using the detection limit of the CDTectTM method (VH-CDT = 5 U/l) as cut-off level for a positive test, the alcoholic group was significantly separated from the control group (P = 0.0024, Fisher's exact test). The sensitivity and specificity of the test was 95% and 71%, giving a positive and a negative predictive value of 91% and 83%, respectively. Time-dependent changes of VH-CDT in the dead body could not unequivocally be excluded, which must be considered when selecting cases suitable for VH-CDT analysis. We conclude that adding VH-CDT analysis to ordinary alcohol tests may become useful in forensic medicine for establishing the so-called ‘alcoholic state’, which may provide a tool in research dealing with the relation between alcohol withdrawal and various causes of death in alcoholics.


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