Use of biomarkers for alcohol use disorders in clinical practice

Authors

  • Tim Neumann,

    1. Department of Anesthesiology and Intensive Care Medicine, Universitaetsmedizin-Berlin Charité, Charité Campus Mitte Berlin, Germany
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  • Claudia Spies

    Corresponding author
    1. Department of Anesthesiology and Intensive Care Medicine, Universitaetsmedizin-Berlin Charité, Charité Campus Mitte Berlin, Germany
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Claudia Spies MD
Professor of Anesthesiology
Klinik fuer Anaesthesiologie und operative
Intensivmedizin
Universitaetsmedizin Charité-Berlin
Charité Campus Mitte
Schumannstr. 20/21
10117 Berlin
Germany
Tel: 0049 30 450 531 052
Fax: 0049 30 450531911
E-mail: claudia.spies@charite.de

ABSTRACT

Background  Biomedical markers may provide additive objective information in screening and confirmation of acute or recent consumption, intoxication, relapse, heavy drinking, hazardous/harmful use/abuse and dependence and alcohol use related organ dysfunction (alcohol use-related disorders: AUDs).

Aims  To review the use of biomarkers in clinical practice to detect AUDs.

Findings  About one-fifth of the patients seen in clinical practice have AUDs, which offer a variety of treatment options if diagnosed. The diagnosis of AUDs relies on clinical and alcohol-related history, physical examination, questionnaires and laboratory values. No clinical available laboratory test [e.g. for acute abuse: alcohol in blood or breath; for chronic alcohol abuse: γ-glutamyl transferase (GGT), mean corpuscular volume (MCV), carbohydrate-deficient transferrin (CDT)] is reliable enough on its own to support a diagnosis of alcohol dependence, harmful use or abuse. Sensitivities, specificities and the predictive values may vary considerably according to patient and control group characteristics (e.g. gender, age or related comorbidity). In patient groups with limited cooperation markers may be helpful when considering treatment options.

Conclusions  More research is needed to determine the value of markers (single or combined, with questionnaires) in the context of clinical decision-making algorithms in defined settings and with defined dichotomous outcome variables.

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