This research was supported by the Banbury Foundation; NIAAA; WHO/ISBRA; and, in Australia, by the National Health and Medical Research Council.
CDT, GGT, and AST As Markers of Alcohol Use: The WHO/ISBRA Collaborative Project
Article first published online: 11 APR 2006
Alcoholism: Clinical and Experimental Research
Volume 26, Issue 3, pages 332–339, March 2002
How to Cite
Conigrave, K. M., Degenhardt, L. J., Whitfield, J. B., Saunders, J. B., Helander, A., Tabakoff, B. and on behalf of the WHO/ISBRA Study Group (2002), CDT, GGT, and AST As Markers of Alcohol Use: The WHO/ISBRA Collaborative Project. Alcoholism: Clinical and Experimental Research, 26: 332–339. doi: 10.1111/j.1530-0277.2002.tb02542.x
CDTect™ kits were supplied by Pharmacia Diagnostics, Uppsala, Sweden; and by Axis Biochemicals, Oslo, Norway.
- Issue published online: 11 APR 2006
- Article first published online: 11 APR 2006
- Received for publication April 4, 2001; accepted December 6, 2001.
- Biological Markers;
- Carbohydrate Deficient Transferrin;
- Gamma Glutamyltransferase;
Background: Estimates of the performance of carbohydrate deficient transferrin (CDT) and gamma glutamyltransferase (GGT) as markers of alcohol consumption have varied widely. Studies have differed in design and subject characteristics. The WHO/ISBRA Collaborative Study allows assessment and comparison of CDT, GGT, and aspartate aminotransferase (AST) as markers of drinking in a large, well-characterized, multicenter sample.
Methods: A total of 1863 subjects were recruited from five countries (Australia, Brazil, Canada, Finland, and Japan). Recruitment was stratified by alcohol use, age, and sex. Demographic characteristics, alcohol consumption, and presence of ICD-10 dependence were recorded using an interview schedule based on the AUDADIS. CDT was assayed using CDTect™ and GGT and AST by standard methods. Statistical techniques included receiver operating characteristic (ROC) analysis. Multiple regression was used to measure the impact of factors other than alcohol on test performance.
Results: CDT and GGT had comparable performance on ROC analysis, with AST performing slightly less well. CDT was a slightly but significantly better marker of high-risk consumption in men. All were more effective for detection of high-risk rather than intermediate-risk drinking. CDT and GGT levels were influenced by body mass index, sex, age, and smoking status.
Conclusions: CDT was little better than GGT in detecting high- or intermediate-risk alcohol consumption in this large, multicenter, predominantly community-based sample. As the two tests are relatively independent of each other, their combination is likely to provide better performance than either test alone. Test interpretation should take account sex, age, and body mass index.