Biomarkers can be very useful for research purposes. GGT is found in various tissues throughout the body including the liver, kidney, spleen, pancreas, brain, and heart Mihas and Tavassoli, When alcohol is ingested, the alcohol becomes a catalyst inducing the enzymes involved in the synthesis of D-glucaric acid allowing urinary D-glucaric acid levels to be used as screening tests for alcohol abuse.
Acetaldehyde adducts Acetaldehyde adducts form in the liver during chronic exposure to alcohol due to the activity of ethanol dehydrogenase and a microsomal ethanol oxidizing system. The elevations are attributed to the direct effect of alcohol on developing erythroblasts and indirectly to the presence of folate deficiency.
Moreover, the availability of biomarkers might lead to earlier interventions for preventing FAS, serve as an indicator for evaluating FAS prevention outcomes, help identify instances of maternal under-reporting of alcohol use, and facilitate research on possible dose-response relations between alcohol exposure and adverse health effects, including FAS, ARBD, and ARND.
Unfortunately, discrepancies have been reported which would limit the validity of this test Mihas and Tavassoli, Page Share Cite Suggested Citation: Although a positive response to the CAGE questions is not diagnostic of alcohol use disorders, answering yes to two or more questions is highly suspicious and warrants further evaluation.
The CAGE questions have proven useful in screening for alcoholism. American Journal of Obstetrics and Gynecology ; Aminotransferases Aspartate aminotransferase AST or glutamate oxaloacetate transaminase and its correlate, alanine aminotransferase ALTrepresent the most frequently measured enzymes for liver disease and the most sensitive indicators of hepatocyte necrosis.
To date, several laboratory tests, including blood alcohol levels, creatine phosphokinase, D-glucaric acid, urinary dolichol, and erythrocyte d-aminolevulinic acid dehydrase, are being explored as possible markers.
The National Academies Press. K C Do you sometimes feel the need to Cut Down on your drinking? These steps are discussed under indicated prevention. Urinary dolichol and erythrocyte d-aminolevulinic acid dehydrase tests are still under investigation as possible biomarkers for alcohol exposure.
How many drinks can you hold? Another brief screening test, the TWEAK, has been found to be somewhat more sensitive but less specific in identifying women who are risk drinkers Russell, ; see Box E Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover Eye-Opener?
Biomarkers Given the limits of self-reports of alcohol use in many circumstances, an efficient, nonintrusive, valid, and inexpensive biologic marker of alcohol use would be an important tool for alcohol treatment research.
Some may indicate recent alcohol exposure, other chronic alcohol exposure, and other liver damage, the latter finding suggesting possible chronic alcohol abuse. The ratio of AP to GGT has been used as a rather sensitive marker of excessive consumption of alcohol, but the incomplete understanding of its biosynthesis has limited its value in diagnosing patients Mihas and Tavassoli, Overall, however, the clinical usefulness of these markers thus far have been less than promising.
Furthermore, suggesting such screening may pose difficulties for the relationship between the physician and the pregnant woman making further prenatal care less likely.
A 7-point scale is used to score the test. Has a friend or family member ever told you about things you said or did while you were drinking that you could not remember? A total of 2 or more points indicates the respondent is likely to be a risk drinker. Several have been analyzed for gender differences and the effect of pregnancy and one has been analyzed for its relation to fetal outcome.
Alcohol Health and Research World ; A positive response to the Worry question scores 2 points, and a positive response to the last three questions scores 1 point each.
However, the validity of the test may be hampered by the fact that elevated GGT serum levels occur in both alcoholic and nonalcoholic liver disease, as well as in individuals taking drugs that induce hepatic enzymes Mihas and Tavassoli, A Have people ever Annoyed you by criticizing your drinking?FAS Community Resource Center Information about Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorders (FASD) Headquarters: Tucson, Arizona ***** Serving the World.
Read chapter 7 Prevention of Fetal Alcohol Syndrome: It sounds simple: Women who drink while pregnant may give birth to children with defects, so women.Download