Elsevier

Forensic Science International

Volume 82, Issue 2, 30 September 1996, Pages 153-163
Forensic Science International

Post mortem markers of chronic alcoholism

https://doi.org/10.1016/0379-0738(96)01986-XGet rights and content

Abstract

We compared the post mortem diagnostic value of γ-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT), alcoholic liver disease (ALD), blood alcohol concentration (BAC), the presence of multiple bruises and poor hygiene of the feet as markers of chronic alcoholism (heavy continuous drinking) in 32 alcoholics with 32 age-sex matched controls drawn from a forensic autopsy population. Alcoholics and controls were selected on the basis of positive and negative medical history but controls were excluded if BAC exceeded 70 mg%. Femoral venous blood, urine and vitreous humour alcohol concentrations were determined by headspace gas chromatography (GC). BAC was positive in 19 alcoholics (mean 234 mg%, range 2–570 mg%) and six controls (mean 32 mg%, range 2–52 mg%). Serum GGT was measured by a kinetic photometric method, and CDT by both isoelectric focusing/laser densitometry and by a commercial radioimmunoassay kit (CDTect). Features of alcoholic liver disease were graded histologically using two weighted scoring systems. Eleven alcoholics tested positive for GGT, CDTq and ALD, nine were positive for two tests, five for one test and three were negative for all three tests. No controls were positive for all three tests but six were positive for two tests and nine for only one test; 17 were negative for all three tests. Using the normal clinical cut-off values GGT, CDTq and CDTect gave poor specificity which was improved at moderate cost to sensitivity by raising cut off values for each test. Comparison of receiver operating characteristic curves, likelihood ratios and post-test odds showed CDT to be the best individual test, followed by ALD and GGT. Quantitation of CDT by IEF/laser densitometry performed slightly better than MAEC/RIA by CDTect. CDT shows considerable promise as a post mortem marker of chronic alcoholism.

References (20)

  • A.A. Mihas et al.

    Laboratory markers of ethanol intake and abuse: a critical appraisal

    Am. J. Med. Sci.

    (1992)
  • D.J. Pounder

    Problems in the necropsy diagnosis of alcoholic liver disease

    Am. J. Forensic Med. Pathol.

    (1984)
  • R. Anton et al.

    Two methods for measuring carbohydrate-deficient transferrin in inpatient alcoholics and healthy controls compared

    Clin. Chem.

    (1994)
  • K.M. Conigrave et al.

    Diagnostic tests for alcohol consumption

    Alcohol Alcohol.

    (1995)
  • M. Piette et al.

    Gamma glutamyltransferase: applications in forensic pathology: 1. Study of blood serum recovered from human bodies

    Med. Sci. Law

    (1987)
  • H. Stibler

    Carbohydrate-deficient transferrin in serum: a new marker of potentially harmful alcohol consumption reviewed

    Clin. Chem.

    (1991)
  • E. Girela et al.

    Carbohydrate-deficient transferrin (CDT) as indicator of alcohol misuse: evaluation of problems in the methodology

    Alcohol Alcohol.

    (1991)
  • M. Yamauchi et al.

    Serum level of carbohydrate-deficient transferrin as a marker of alcoholic liver disease

    Alcohol Alcohol.

    (1993)
  • Y. Xin et al.

    Measurement of carbohydrate-deficient transferrin by isoelectric focusing, western blotting and by micro anion-exchange chromatography/radioimmunassay

    Alcohol Alcohol.

    (1992)
  • D.W. Sadler et al.

    Organomegaly in chronic alcoholics

    Am. J. Forensic Med. Pathol.

    (1995)
There are more references available in the full text version of this article.

Cited by (0)

View full text