Further arguments against including trisialo-Fe2-transferrin in carbohydrate-deficienttransferrin (CDT): a study on male alcoholics and hazardous drinkers.
Torsten Arndt, Aleksander Korzec, Marij Bär, Jürgen Kropf
Med Sci Monit 2002; 8(6): CR411-418
BACKGROUND: We attempted to determine whether including trisialo-Fe2-transferrinin carbohydrate-deficient transferrin (CDT) affects the diagnostic accuracy of CDT as a marker of chronicexcessive alcohol intake.MATERIAL/METHODS: The criterion standard tests for the diagnosis of alcoholismand alcohol intake were the Composite International Diagnostic Interview (CIDI) and the Timeline-Followback(TLFB). The study groups (alcohol intake in each of the last 4 weeks before blood sampling) were comprisedof 56 controls (280 g/week, no alcoholism),63 alcoholics (>280 g/week, alcoholism diagnosis). CDT analysis was performed with %CDTri-TIA, whichincludes about 50% of trisialo-Fe2-transferrin in CDT, and ChronAlcoI.D, which excludes this transferrinisoform from CDT.RESULTS: Depending on the cut-offs for the CDT/transferrin ratio (upper or lower limitof the test-specific borderlines) and on the patient group, the diagnostic sensitivity was 28.1%-72.3%for %CDTri-TIA, as opposed to 50.0%-82.5% for ChronAlcoI.D. The diagnostic accuracy was 62.8%-78.5% for%CDTri-TIA and 71.8%-86.6% for ChronAlcoI.D. The latter test consistently showed higher diagnostic sensitivityand accuracy than %CDTri-TIA. The diagnostic specificity was 85.7%-98.2% for %CDTri-TIA and 91.1%-92.2%for ChronAlcoI.D. The areas under the ROC curve were 0.810%-0.885 for %CDTri-TIA and 0.867%-0.896 forChronAlcoI.D.CONCLUSIONS: The present study and data from the literature indicate that including partsof trisialo-Fe2-transferrin by the %CDTri-TIA test significantly reduces the diagnostic sensitivity andthus accuracy of CDT as a marker of chronic excessive alcohol use.
Keywords: Adult, Alcoholism, Case-Control Studies, Predictive Value of Tests, Sensitivity and Specificity, Transferrin