Carbohydrate-Deficient Transferrin Evaluation Over Time Has Usefulness for Confirming Sobriety of Alcohol Rehabilitation Program Patients

Background

For treating severe alcohol-related liver disease (ALD), abstinence from alcohol is essential. Because underreporting can occur, abstinence biomarkers are necessary during hepatology outpatient service. This study assesses whether serial changes of the serum carbohydrate-deficient transferrin to transferrin ratio (%CDT) reflect patient abstinence.

Methods

We retrospectively investigated serial %CDT measurements and laboratory data from two outpatient settings: patients in an alcohol rehabilitation program (A), and ALD patients at a hepatology clinic (H) who attempted abstinence with self-diary monitoring. Using group A data, correlation coefficients were determined between the number of days from the last drink (abstinence days) and laboratory data. Linear approximation was applied for significant coefficients. Using these results, %CDT was validated for group H.

Results

Group A data were 223 data samples from 55 cases with abstinence days. Four (7%) were diagnosed as having cirrhosis. Eighteen patients continued abstinence over 30 days. %CDT (Rho = −0.50, p < 0.001) and GGT (Rho = −0.34, p < 0.01) were negatively correlated with abstinence days. For %CDT, negative linear approximation was maintained with the number of days (y = 2.01–0.004 x).

Group H data were 18 cases, of which 12 (66%) were diagnosed as cirrhosis cases. Seven patients reported continued abstinence for 8 weeks, during which time %CDT values dropped significantly. The group H %CDT was higher than the group A %CDT, perhaps because of severer liver disease.

Conclusion

The %CDT trend assessment is useful to support continued, multi-month self-reported abstinence from alcohol, but it must be interpreted carefully in severe liver disorder cases.