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Abstract
The last decade saw the emergence of carbohydrate-deficient transferrin (CDT) as the most promising marker for the diagnosis of alcohol abuse. Daily alcohol consumption of four beers, four glasses of wine or three standard drinks causes increased concentrations of CDT in serum. CDT is serum transferrin with a reduced content of oligosaccharides due to the detrimental effects of alcohol metabolism on the glycosylation pathway of hepatocytes and/or the increased activity of circulating glycosidases in serum. Most current CD procedures entail separation of normal transferrin from CDT in a charged matrix-like isoelectric focusing and ion exchange chromatography, followed by detection/quantitation of CDT by a myriad of immunoassays: immunoblotting, radioimmunoassay, enzyme immunoassay and nephelometry. New CDT procedures present the advantages of improved performance, inexpensive automation and CDT results expressed as a percentage of total serum transferrin. CDT's major asset is its high specificity in well-defined populations i. e. individuals ingesting 60 g alcohol daily for at least a week. The sensitivity rates, which vary between 22% and 81 %, depend on the amount of alcohol ingested, time of sample collection after the cessation of drinking, age, gender and the cut-off point chosen for analysis of tests' results. Regarding clinical applications, best outcome is achieved when the test is used to confirm a suspicion of alcohol abuse and when monitoring abstinence and relapses. The low prevalence of alcohol abuse in the general population challenges its use as a screening test. With the advent of inexpensive automation and the constant emergence of innovative, improved tests, we are seeing the rise of a new era in alcohol abuse diagnosis as affordability and education allows widespread use of CDT in a variety of settings.
Introduction
The last decade saw the emergence of carbohydrate-deficient transferrin (CDT) as the most promising marker for diagnosis of alcohol abuse and monitoring alcohol abstinence."'2 More than 100 scientific studies published since the first appearance of CDT in the late 1970s have aimed to elucidate its diagnostic performance and clinical utility as a biochemical marker.3,4 This document describes the different CDT procedures currently available in the market and their diagnostic performance and clinical utility in different medical fields. With the advent of inexpensive automation, we are seeing the rise of a new era...