Phosphatidylethanol (PEth) in practice: A specific and proportional marker of alcohol consumption

Abstract

Alcohol abuse causes more than three million deaths a year, or one in twenty, more than three-quarters of them men. Alcohol abuse accounts for over 5% of the global burden of disease. In this context, objective clinical and biochemical tests are essential to characterize drinking patterns, quantify the amount of ethanol ingested daily and enable effective management of these patients. We recently investigated the feasibility and benefits of measuring phosphatidylethanol (PEth) in daily medical practice for the management of alcohol dependence in the outpatient setting. We report the results of a quantification of palmitoyl-2-oleoyl-glycero-3-phosphoethanol (PEth 16:0/18:1) in comparison with biological indicators (SGOT, SGPT GGT) on a group of volunteers followed as outpatients for alcohol problems. Methods: In this prospective study, a total population of 57 volunteers consulting a private addictology practice was recruited for PEth tests, 21 of which were complemented by biological tests including SGOT, SGPT GGT assays. A file was completed specifying the methods of alcohol use, the quantities consumed (AU) and the Alcohol Use Disorders Identification Test (AUDIT) score. Blood samples are collected in a 10 µL drop, using a medical device (VAMS from Neoteryx, USA), air-dried. The dry samples are extracted and reconstituted with methanol. The analyzes carried out by high pressure liquid chromatography coupled with high resolution mass spectrometry. Results and discussion: 57 volunteers (19 F and 38 M) aged between 20 and 70 were included. These volunteers had the Quantities consumed (AU/d) at 6.7 (0-20) and the Alcohol Use Disorders Identification Test (AUDIT) score at 17.8 (0-30). A strong positive correlation of 0.88 (n=57) was observed between PEth concentrations and levels of daily alcohol consumption. The usual biology, the "hepatic assessment" provides little or no information on the risks associated with alcohol consumption with correlation coefficient estimated at 0.28 for GGT, 0.09 for SGOT and 0.00 for SGPT. PEth degradation was 13% for samples stored at room temperature, compared with those stored at +4°C and -80°C. Conclusion: PEth is a specific and proportional marker of alcohol consumption. Measuring PEth enables us to accurately gauge the reality of alcohol consumption and adapt it to care and prevention contexts. This measurement of phosphatidylethanol (PEth) can be carried out as part of a consultation, at a distance from the analysis centers. Finally, the PEth, along with the interpretation tools described in this article, is an important help in the management of alcohol dependence.