Markers for detecting alcoholism and for monitoring for continued abuse

4

B MARKERS FOR DETECTING FOR CONTINUED ABUSE MARSHA

ALCOHOLISM

AND FOR MONITORING

Y. MORGAN

Professorial Medical 2&G (Gt. Britain)

Unit, Royal Free Hospital,

Pond Street,

Hampstead,

London

NW3

Biochemical and haematological investigation can make a major contribution to the recognition and management of alcoholism. It can facilitate the identification of excessive drinking, can monitor the progress and treatment of the alcoholic and can identify hepatic and non-hepatic complications. No one marker, however, is of universal use; a combination of two or more markers will identify the majority of alcoholics and will assist in detecting continued abuse. Markers

of proven use (1) Serum aspartate transaminase (AST): elevated in 40 - 75% alcoholics (2) Serum gamma-glutamyl transpeptidase (y GPT): elevated in 54 88% alcoholics (3) Mean corpuscular volume (MCV): elevated in 60 - 90% alcoholics, females > males. A combination of these three markers will identify 95% alcoholics. The same combination may be used to monitor continued abuse, though changes in MCV generally occur much more slowly than changes in AST and y GPT.

Markers

(1) (2) (3) (4) (5) Marker

of limited value

Blood/breath ethanol OLamino-n-butyric acid and leucine plasma ratio Serum glutamate dehydrogenase Plasma cr-lipoprotein Erythrocyte S -aminolaevulinic acid dehydrase under evaluation

(1) Abnormal transferrin component. At the present time a combination of AST, y GPT and MCV estimations will serve for routine screening and monitoring of alcoholics.