Phosphatidylethanol Levels in a Group of Life Insurance Applicants Tested for Carbohydrate-Deficient Transferrin.

Abstract

Objective.—: To compare the alcohol biomarkers phosphatidylethanol (PEth) and carbohydrate-deficient transferrin (CDT) in a convenience sample of life insurance applicants.

Background.—: PEth is a direct measure of alcohol consumption, which may have some advantages in the detection of problematic alcohol use when compared to CDT.

Methods.—: A total of 619 life insurance applicants were tested for both PEth and CDT. Linear models were constructed to assess the relationship between these two markers and other laboratory values. Classification and regression tree (CART) models were also constructed to identify clusters of individuals with high levels of either marker.

Results.—: The correlation between PEth and CDT was 0.52. PEth was positive in 23% of the sample at a threshold of 200 ng/ml, while CDT was positive in 11% at a threshold of 1.5%. CART models showed that GGT and AST were the most important predictors of PEth positivity, while HDL and AST were the most important predictors of CDT positivity.

Conclusion.—: PEth may be a more sensitive marker of alcohol intake than CDT, and may be useful as a reflex test from other laboratory values in both the clinical and life insurance setting.