phosphatidylethanol and Liver-Diseases

Phosphatidylethanol (PEth) is a direct nonoxidative metabolite of ethanol that may be measured in clinical samples as a marker for monitoring alcohol consumption. It has been used in a wide variety of clinical and nonclinical settings; however, its investigation in relation to liver disease has been limited. This study aims at providing a short review on the applications and challenges for the incorporation of PEth testing in identifying alcohol intake in this patient population.

Topics: Alcohol Drinking; Biomarkers; Glycerophospholipids; Humans; Liver Diseases

Phosphatidylethanol (PEth) is a direct alcohol biomarker. Aim of the study was to evaluate the performance of six homologues of PEth in comparison to other alcohol markers in patients with liver diseases.. The study included 234 patients with liver disease, who gave statements about alcohol consumption during the three months prior to the doctor's appointment. Ethylglucuronide in urine (uEtG) and in hair (hEtG) and carbohydrate-deficient transferrin (CDT) were analyzed in addition to PEth.. Of all patients 47% stated to have drunk alcohol during the past three months. UEtG, hEtG and CDT showed a sensitivity of 29% and a specificity of 92% together for ingestion of at least two standard drinks (24 g) per week. With PEth 16:0/18:1 in addition, sensitivity increased to 59%. For consumption in the last week uEtG's sensitivity and specificity was 28% and 100%, respectively. PEth's was 75% and 93%. When looking at patients who consumed at least two standard drinks per week during the past three months and of which a hair sample could be obtained, hEtG's sensitivity was 37% and specificity 90%. PEth had a sensitivity of 53% and specificity of 100%. Quotients of PEth 16:0/18:1 with 16:0/18:2, 16:0/20:4 and 18:0/18:2 were smaller when alcohol had been consumed more recently.. Despite the rather poor overall sensitivity of alcohol biomarkers in this study, PEth showed best sensitivity for all time periods of alcohol consumption.

Topics: Alcohol Drinking; Biomarkers; Glycerophospholipids; Humans; Liver Diseases

Blood phosphatidylethanol (PEth) is a promising biomarker of alcohol consumption. This study was conducted to evaluate its performance in patients with liver disease.. This study included 222 patients with liver disease. Patient-reported alcohol use was obtained as a reference standard, and PEth was measured by tandem mass spectrometry. Receiver operating characteristic (ROC) and contingency table analyses were used to assess the performance of PEth in detecting any drinking and averaging 4 or more drinks daily in the past 30 days.. At the limit of quantitation (20 ng/ml), PEth was 73% sensitive (95% confidence interval [CI] 65 to 80) and 96% specific (95% CI 92 to 100) for any drinking in the past month. Subjects who drank but had a negative PEth result were mainly light drinkers. Subjects who reported 30-day abstinence but with quantifiable PEth either reported heavy drinking within the past 6 weeks or had data that suggested underreported drinking. At the optimal cutoff concentration of 80 ng/ml, PEth was 91% sensitive (95% CI 82 to 100) and 77% specific (95% CI 70 to 83) for averaging at least 4 drinks daily.. PEth is a useful test for detecting alcohol use in patients with liver disease, but cutoff concentrations for heavy drinking will result in misclassification of some moderate to heavy drinkers.

Topics: Adult; Age Factors; Alcohol Drinking; Biomarkers; Case-Control Studies; Chronic Disease; Female; Glycerophospholipids; Humans; Liver Cirrhosis; Liver Diseases; Male; Middle Aged; Reproducibility of Results; Sensitivity and Specificity; Severity of Illness Index; Sex Factors