Detection of Relapses in Alcohol‐Dependent Patients Using Carbohydrate‐Deficient Transferrin: Improvement with Individualized Reference Levels during Long‐Term Monitoring

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Abstract
The present study examined whether the sensitivity of carbohydrate‐deficient transferrin (CDT) in serum, a biochemical marker of recent excessive alcohol consumption, could be improved during long‐term monitoring by introducing individualized cut‐offs between normal and elevated CDT levels. Alcohol‐dependent male outpatients (n= 22), trying to abstain from alcohol for 6 months, were monitored by comparing weekly measurements of CDT with self‐reports of alcohol consumption three times/week and daily urinary levels of 5‐hydroxytryptophol (5‐HTOL), a new marker of recent alcohol intake. The method used to calculate cut‐offs was based on the intraindividual variation in CDT not dependent on excessive alcohol consumption or analytical variations. An increase in CDT exceeding the minimum level for each patient by 3 and 4 times the mean coefficient of variation for healthy social drinkers (i.e., by 30% and 40%) was compared as an indication of alcohol consumption, even if the value did not exceed the conventional cut‐off. By using individualized CDT cut‐off points, 68 and 41 episodes of drinking were detected in the patients with the cut‐offs of >30% and >40%, respectively, as compared with 25 with the conventional limit. Most episodes could be verified clinically and/or by elevated urinary 5‐HTOL levels during the 2‐week period preceding each serum sampling. The results suggest that the possibility to detect relapses by CDT can be improved during long‐term monitoring of alcohol‐dependent outpatients by introducing individualized cut‐off points between normal and elevated CDT levels.

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