Alcohol and Alcoholism Advance Access originally published online on October 29, 2008
Alcohol and Alcoholism 2009 44(1):55-61; doi:10.1093/alcalc/agn084
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Detection Times for Urinary Ethyl Glucuronide and Ethyl Sulfate in Heavy Drinkers during Alcohol Detoxification
1 Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden,
2 Arztpraxis für Medizinische Mikrobiologie und Labordiagnostik, Dessau, Germany,
3 Klinik fur Psychiatrie und Psychotherapie, Universitatsklinikum Mainz, Mainz, Germany and
4 Department of Medicine, Karolinska Institute, and Division of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
* Corresponding author: Alcohol Laboratory, L7:03, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden. Tel: +46-8-51771530; Fax: +46-8-51771532; E-mail: anders.helander{at}ki.se
Received 30 June 2008; first review notified 21 August 2008; in revised form 27 August 2008, 18 September 2008; accepted 23 September 2008; advance access publication 29 October 2008
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Abstract |
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Aims: Ethyl glucuronide (EtG) and ethyl sulfate (EtS) are conjugated ethanol metabolites formed in low amounts after alcohol consumption. Compared with ethanol, EtG and EtS are excreted in urine for a prolonged time, making them useful as sensitive alcohol biomarkers. This study determined the detection times for EtG and EtS in alcoholic patients undergoing alcohol detoxification. Methods: Alcohol-dependent patients (n = 32) with an initial alcohol concentration 
1 g/L based on breath testing were followed during detoxification. Urine samples for determination of EtG, EtS, ethanol and creatinine were collected on admission to the hospital and thereafter once daily for several days. EtG and EtS measurements were performed by liquid chromatography-mass spectrometry (LC-MS) and EtG also using an immunochemical assay (DRI-EtG EIA, ThermoFisher/Microgenics). Results: The detection time for urinary EtG was weakly correlated (r = 0.434, P = 0.013) with the initial alcohol concentration (range 1.0–3.4 g/L). For EtG, the individual time range until return to below the applied cut-off limit (<0.5 mg/L) was 
40–130 h (median 78) with a similar time course observed for EtS. After correction for urine dilution, the time until an EtG/creatinine ratio <0.5 mg/g was 40– 90 h (median 65). The detection times after an estimated zero ethanol concentration were 30–110 h (median 66) for EtG and 30– 70 h (median 56) for EtG/creatinine. The EtG results by LC-MS and the immunoassay were in good agreement. Conclusions: During alcohol detoxification, EtG and EtS remained detectable in urine for several days. The detection times showed wide inter-individual variations, also after adjusting values for urine dilution and to the estimated times for a completed ethanol elimination.
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