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Alcohol and Alcoholism Advance Access published online on May 25, 2008
Alcohol and Alcoholism, doi:10.1093/alcalc/agn035
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© The Author 2008. Published by Oxford University Press on behalf of the Medical Council on Alcohol. All rights reserved

Value of ethyl glucuronide in plasma as a biomarker for recent alcohol consumption in the emergency room

Tim Neumann1,a,*, Anders Helander2,a, Helen Dahl2, Tilly Holzmann1, Bruno Neuner1, Edith Weiß-Gerlach1, Christian Müller3 and Claudia Spies1

1 Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Germany
2 Alcohol Laboratory, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden and
3 Institute for Laboratory Medicine and Pathobiochemistry, Charité-Universitätsmedizin Berlin, Germany

* Corresponding author: Tim Neumann, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Klinik für Anästhesiologie und Operative Intensivmedizin, Chariteplatz 1, D-10117 Berlin, Germany. Tel: +49-30-450-631-249; Fax: +49-30-450-531-911; E-mail: tim.neumann{at}charite.de

Received 27 September 2007; in revised form 17 December 2007; in revised form 6 February 2008; in revised form 17 March 2008; accepted 3 April 2008


  Abstract

Aim: This emergency department (ED) study compared the value of plasma ethyl glucuronide (EtG) testing with the information about alcohol consumption obtained using the standard alcohol biomarkers gamma-glutamyltransferase (GGT) and carbohydrate-deficient transferring (CDT) and the AUDIT questionnaire. Methods: Minimally injured and clinically non-intoxicated male patients (n = 81) admitted to an ED were screened regarding their alcohol consumption, using the computerized AUDIT questionnaire and a paper-and-pencil assessment including the type, amount and time of alcohol intake. Blood samples were collected for determination of ethanol, EtG (LC-MS) and GGT in plasma and %CDT in serum (Axis-Shield %CDT immunoassay). Results: Out of the 81 patients, 23 (28%) were positive (≥8 points) on the AUDIT questionnaire. Only 3 (4%) showed a detectable ethanol concentration (range 0.01–0.07 g/L) but 31 (38%) showed a detectable EtG (0.16–39.5 mg/L). In four patients, EtG was detectable in plasma for >48 h after estimated completed elimination of ethanol. EtG was not correlated with the long-term biomarkers %CDT or GGT, or the AUDIT results, but with the time since estimated completed ethanol elimination. Conclusion: EtG testing in blood was found useful in the ED as a way to detect recent drinking, even in cases of a negative ethanol test, and to confirm abstinence from alcohol. This sensitive and specific short-term biomarker provides valuable additional information about individual drinking habits and might also be helpful to identify an alcohol hangover.

a To equal parts.


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