Phosphatidylethanol is Superior to Carbohydrate‐Deficient Transferrin and γ‐Glutamyltransferase as an Alcohol Marker and is a Reliable Estimate of Alcohol Consumption Level
Abstract
Background: In clinical practice as well as research situations, it is of great importance to get reliable information about a patient's alcohol consumption. The aim of the study was to investigate the correlation of alcohol biomarkers (phosphatidylethanol [PEth], carbohydrate‐deficient transferrin [CDT], γ‐glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase) to retrospective as well as diary‐based alcohol self‐reports and to examine whether it is possible to correlate a biomarker result to a more precise level of alcohol consumption. Methods: One hundred and sixty alcohol‐dependent patients were included in a randomized, placebo‐controlled clinical trial of pharmacotherapy for alcohol dependence, of which 115 (76 men and 39 women) completed the study. Retrospective alcohol consumption data were collected at baseline, and alcohol diaries were used during the study. Blood samples for determination of alcohol biomarkers were collected on 5 occasions during the study. Results: PE th and CDT showed a better correlation with alcohol consumption documented in the diary (PE th rs = 0.56 and CDT rs = 0.35) than with retrospective consumption data (PE th rs = 0.23 and CDT rs = 0.22). An even higher correlation (rs = 0.63) was seen between the 2 alcohol biomarkers PE th and CDT. At all consumption levels, PE th had the highest sensitivity of all biomarkers studied. Conclusions: PE th was the biomarker with the best correlation to self‐reported alcohol consumption. PE th was superior to CDT owing to its substantially higher sensitivity but also due to its closer correlation to self‐report. PE th values can be translated into an approximate level of alcohol consumption and PE th appears to be a more reliable measure of alcohol consumption than self‐reports.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Phosphatidyl-ethanol blood concentration will serve as an objective marker of alcohol consumption to corroborate self-reported drinking data.
“Phosphatidyl-ethanol (PEth) blood concentration (*), which will serve as an objective marker of alcohol consumption [101] to corroborate the self-reported drinking data.”
Cites
Bush, K. (1998) · Archives of Internal Medicine · doi:10.1001/archinte.158.16.1789 · Cited by 6,196 · see citing works
Sobell, L. C., & Sobell, M. B. (1992) · Measuring Alcohol Consumption · doi:10.1007/978-1-4612-0357-5_3 · Cited by 4,110 · see citing works
Rehm, J., Mathers, C., Popova, S., Thavorncharoensap, M., Teerawattananon, Y., & Patra, J. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60746-7 · Cited by 3,870 · see citing works
Detecting Alcoholism: The CAGE Questionnaire
Ewing, J. A. (1984) · JAMA · doi:10.1001/jama.1984.03350140051025 · Cited by 3,005 · see citing works
AUDIT‐C as a Brief Screen for Alcohol Misuse in Primary Care
Bradley, K. A., Rubinsky, A. D., Volk, R. J., Williams, E. C., Frank, D., & Kivlahan, D. R. (2007) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2007.00403.x · Cited by 1,634 · see citing works
Boca, F. K. D., & Darkes, J. (2003) · Addiction · doi:10.1046/j.1359-6357.2003.00586.x · Cited by 1,138 · see citing works
Validity of self-reported alcohol use: a literature review and assessment.
Midanik, L. (1988) · British Journal of Addiction · doi:10.1111/j.1360-0443.1988.tb00526.x · Cited by 539 · see citing works
SAUNDERS, J. B., AASLAND, O. G., AMUNDSEN, A., & GRANT, M. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb00822.x · Cited by 480 · see citing works
Rustad, P., Felding, P., Franzson, L., Kairisto, V., Lahti, A., Mårtensson, A., Petersen, P. H., Simonsson, P., Steensland, H., & Uldall, A. (2004) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365510410006324 · Cited by 404 · see citing works
Aradóttir, S., Asanovska, G., Gjerss, S., HANSSON, P., & Alling, C. (2006) · Alcohol and Alcoholism · doi:10.1093/alcalc/agl027 · Cited by 258 · see citing works
Self-citationBiochemical markers of alcoholism
Hannuksela, M. L., Liisanantti, M. K., Nissinen, A. E. T., & Savolainen, M. J. (2007) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm.2007.190 · Cited by 195 · see citing works
Northcote, J., & Livingston, M. (2011) · Alcohol and Alcoholism · doi:10.1093/alcalc/agr138 · Cited by 195 · see citing works
Vogeser, M., & Parhofer, K. G. (2007) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-2007-981458 · Cited by 177 · see citing works
Molecular Species of the Alcohol Biomarker Phosphatidylethanol in Human Blood Measured by LC-MS
Helander, A., & Zheng, Y. (2009) · Clinical Chemistry · doi:10.1373/clinchem.2008.120923 · Cited by 176 · see citing works
Varga, A., Hansson, P., Johnson, G., & Alling, C. (2000) · Clinica Chimica Acta · doi:10.1016/s0009-8981(00)00291-6 · Cited by 174 · see citing works
Improved HPLC Method for Carbohydrate-deficient Transferrin in Serum
Helander, A., Husa, A., & Jeppsson, J. (2003) · Clinical Chemistry · doi:10.1373/clinchem.2003.023341 · Cited by 170 · see citing works
Bortolotti, F., Paoli, G. D., & Tagliaro, F. (2006) · Journal of Chromatography B · doi:10.1016/j.jchromb.2006.05.005 · Cited by 166 · see citing works
Phosphatidylethanol in blood (B‐PEth): A marker for alcohol use and abuse
Isaksson, A., Walther, L., Hansson, T., et al. (2011) · Drug Testing and Analysis · doi:10.1002/dta.278 · Cited by 164 · see citing works
Self-citationPhosphatidylethanol formation in rat organs after ethanol treatment
Alling, C., Gustavsson, L., Månsson, J., et al. (1984) · Biochimica et Biophysica Acta (BBA) - Lipids and Lipid Metabolism · doi:10.1016/0005-2760(84)90060-2 · Cited by 160 · see citing works
An abnormal phospholipid in rat organs after ethanol treatment
Alling, C., Gustavsson, L., & Änggård, E. (1983) · FEBS Letters · doi:10.1016/0014-5793(83)80474-8 · Cited by 160 · see citing works
Gnann, H., Weinmann, W., & Thierauf, A. (2012) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2012.01768.x · Cited by 159 · see citing works
Stewart, S., Koch, D., Willner, I. R., Anton, R. F., & Reuben, A. (2014) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.12442 · Cited by 157 · see citing works
Hartmann, S., Aradóttir, S., Graf, M., Wiesbeck, G. A., Lesch, O., Ramskogler, K., Wolfersdorf, M., Alling, C., & Wurst, F. M. (2006) · Addiction Biology · doi:10.1111/j.1369-1600.2006.00040.x · Cited by 147 · see citing works
Wurst, F. M., Thon, N., Aradóttir, S., Hartmann, S., Wiesbeck, G. A., Lesch, O., Skala, K., Wolfersdorf, M., Weinmann, W., & Alling, C. (2009) · Addiction Biology · doi:10.1111/j.1369-1600.2009.00185.x · Cited by 139 · see citing works
Varga, A., Hansson, P., Lundqvist, C., & Alling, C. (1998) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1998.tb03989.x · Cited by 135 · see citing works
Kechagias, S., Dernroth, D. N., Blomgren, A., Hansson, T., Isaksson, A., Walther, L., Kronstrand, R., Kågedal, B., & Nyström, F. H. (2015) · Alcohol and Alcoholism · doi:10.1093/alcalc/agv038 · Cited by 131 · see citing works
Self-citationHahn, J. A., Dobkin, L. M., Mayanja, B., Emenyonu, N. I., Kigozi, I., Shiboski, S. C., Bangsberg, D. R., Gnann, H., Weinmann, W., & Wurst, F. M. (2011) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2011.01669.x · Cited by 127 · see citing works
Aradóttir, S., Seidl, S., Wurst, F. M., Jönsson, B., & Alling, C. (2004) · Alcoholism Clinical and Experimental Research · doi:10.1097/01.alc.0000145687.41646.e5 · Cited by 110 · see citing works
Zheng, Y., Beck, O., & Helander, A. (2011) · Clinica Chimica Acta · doi:10.1016/j.cca.2011.04.022 · Cited by 109 · see citing works
Varenicline for Treatment of Alcohol Dependence: A Randomized, Placebo‐Controlled Trial
de Bejczy, A., Löf, E., Walther, L., Guterstam, J., Hammarberg, A., Asanovska, G., Franck, J., Isaksson, A., & Söderpalm, B. (2015) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.12854 · Cited by 107 · see citing works
Self-citationBajunirwe, F., Haberer, J. E., Boum, Y., Hunt, P. W., Mocello, A. R., Martin, J. N., Bangsberg, D. R., & Hahn, J. A. (2014) · PLoS ONE · doi:10.1371/journal.pone.0113152 · Cited by 107 · see citing works
Blood Phosphatidylethanol as a Marker of Alcohol Abuse: Levels in Alcoholic Males during Withdrawal
Hansson, P., Caron, M. H., Johnson, G., et al. (1997) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1997.tb03736.x · Cited by 106 · see citing works
Nalesso, A., Viel, G., Cecchetto, G., et al. (2011) · Journal of Chromatography A · doi:10.1016/j.chroma.2011.09.068 · Cited by 92 · see citing works
Stewart, S. H., Reuben, A., Brzezinski, W. A., et al. (2009) · Alcohol and Alcoholism · doi:10.1093/alcalc/agp039 · Cited by 86 · see citing works
Phosphatidylethanol and Alcohol Consumption in Reproductive Age Women
Stewart, S., Law, T. L., Randall, P. K., & Newman, R. (2009) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2009.01113.x · Cited by 82 · see citing works
Assessing the drinking status of liver transplant patients with alcoholic liver disease
Allen, J. P., Wurst, F. M., Thon, N., et al. (2012) · Liver Transplantation · doi:10.1002/lt.23596 · Cited by 80 · see citing works
[National harmonization of the alcohol biomarker PEth].
Helander, A., & Hansson, T. (2013) · PubMed · Cited by 80 · see citing works
Self-citationMarques, P. R., Tippetts, S., Allen, J., Javors, M. A., Alling, C., Yegles, M., Pragst, F., & Wurst, F. M. (2009) · Addiction · doi:10.1111/j.1360-0443.2009.02738.x · Cited by 79 · see citing works
Kip, M., Spies, C., Neumann, T., Nachbar, Y., Alling, C., Aradóttir, S., Weinmann, W., & Wurst, F. M. (2008) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2008.00696.x · Cited by 71 · see citing works
Bergstrom, J. P., & Helander, A. (2008) · Alcohol and Alcoholism · doi:10.1093/alcalc/agn017 · Cited by 59 · see citing works
Diagnostic sensitivity of carbohydrate deficient transferrin in heavy drinkers
Fagan, K. J., Irvine, K. M., McWhinney, B. C., et al. (2014) · BMC Gastroenterology · doi:10.1186/1471-230x-14-97 · Cited by 47 · see citing works
Jain, J. P., Evans, J. L., Briceño, A., et al. (2014) · Alcohol and Alcoholism · doi:10.1093/alcalc/agu037 · Cited by 46 · see citing works
Short-term treatment for alcohol-related problems
Andréasson, S., Hansagi, H., & OsterLund, B. (2002) · Alcohol · doi:10.1016/s0741-8329(02)00231-8 · Cited by 39 · see citing works
Marques, P. R., Hansson, T., Isaksson, A., et al. (2011) · Traffic Injury Prevention · doi:10.1080/15389588.2010.544048 · Cited by 35 · see citing works
Self-citationBertholet, N., Winter, M. R., Cheng, D. M., Samet, J. H., & Saitz, R. (2014) · Alcohol and Alcoholism · doi:10.1093/alcalc/agu016 · Cited by 26 · see citing works
Skipper, G. E., Thon, N., DuPont, R. L., et al. (2013) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.12121 · Cited by 22 · see citing works
Wurst, F. M., Haber, P., Wiesbeck, G. A., Watson, B., Wallace, C., Whitfield, J. B., Halter, C. C., Weinmann, W., & Conigrave, K. M. (2007) · Addiction Biology · doi:10.1111/j.1369-1600.2007.00076.x · Cited by 18 · see citing works
Revealing Alcohol Abuse: To Ask or to Test?
Alling, C., Chick, J., Anton, R. F., Mayfield, R. D., Salaspuro, M. P., Helander, A., & Harris, R. A. (2005) · Alcoholism Clinical and Experimental Research · doi:10.1097/01.alc.0000171489.55856.a5 · Cited by 16 · see citing works
Sillanaukee, P., van der Gaag, M. S., Sierksma, A., Hendriks, H., Strid, N., Pönniö, M., & Nikkari, S. T. (2003) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2003.tb02721.x · Cited by 16 · see citing works
Sillanaukee, P., van der Gaag, M. S., Sierksma, A., Hendriks, H., Strid, N., Pönniö, M., & Nikkari, S. T. (2003) · PubMed · doi:10.1097/01.alc.0000047302.67780.fa · Cited by 15 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Kahler, C. W., Pantalone, D. W., Mastroleo, N. R., Liu, T., Bove, G., Ramratnam, B., Monti, P. M., & Mayer, K. H. (2018) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000322 · Cited by 88 · see citing works
“The many deleterious effects of heavy drinking on HIV care outcomes underscore the need to develop and evaluate interventions to reduce heavy drinking in PLWH. Men, and in particular men who have sex with men (MSM), have the highest rates of heavy drinking and alcohol use disorders among PLWH (Crane et al., 2017; Hart…”
InfluentialHahn, J. A., Murnane, P. M., Vittinghoff, E., Muyindike, W. R., Emenyonu, N. I., Fatch, R., Chamie, G., Haberer, J. E., Francis, J. M., Kapiga, S., et al. (2021) · Alcoholism: Clinical and Experimental Research · doi:10.1111/acer.14611 · Cited by 87 · see citing works
GLP-1 signaling and alcohol-mediated behaviors; preclinical and clinical evidence
Jerlhag, E. (2018) · Neuropharmacology · doi:10.1016/j.neuropharm.2018.01.013 · Cited by 72 · see citing works
Vanderijst, L., Hever, F., Buot, A., Dauré, C., Benoit, J., Hanak, C., Veeser, J., Morgiève, M., Campanella, S., Kornreich, C., et al. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05502-y · Cited by 13 · see citing works
“…number of drinks per day (*, ▲ ) measured with the TLFB; • The percentage of days of abstinence (*, ▲ ) measured with the TLFB; • Phosphatidyl-ethanol (PEth) blood concentration (*), which will serve as an objective marker of alcohol consumption [101] to corroborate the self-reported drinking data.”
MethodGichane, M. W., Camlin, C. S., Getahun, M., Emenyonu, N., Woolf-King, S., Sanyu, N., Katusiime, A., Fatch, R., Muyindike, W., & Hahn, J. A. (2023) · Substance Use & Misuse · doi:10.1080/10826084.2023.2244066 · Cited by 1 · see citing works
- Authors
- Walther, L., de Bejczy, A., Löf, E., Hansson, T., Andersson, A., Guterstam, J., Hammarberg, A., Asanovska, G., Franck, J., Söderpalm, B., & Isaksson, A.
- Affiliations
- Lund University (SE)
- Addiction Biology Unit Section of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Sahlgrenska University Hospital (SE)
- Division of Clinical Chemistry and Pharmacology Department of Laboratory Medicine University Hospital Lund University Lund Sweden
- Karolinska Institutet (SE)
- Corresponding author
- Isaksson, Anders
- Venue
- Alcoholism: Clinical and Experimental Research
- Publisher
- Wiley
- Published
- 2015-10-27
- Volume
- 39
- Issue
- 11
- Pages
- 2200-2208
- ISSN
- 0145-6008 (ISSN-L)
- 1530-0277
- OpenAlex
- W1948002101
- Cited by
- 112
- References
- 50
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 16 · 2023: 9 · 2022: 10 · 2021: 14 · 2020: 6 · 2019: 7 · 2018: 15 · 2017: 10 · 2016: 6 · 2015: 2
- FWCI
- 8.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alcoholism Clinical and Experimental Research (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Pfizer (4477, 2576)
- Fredrik och Ingrid Thurings Stiftelse
- Hjärnfonden
- Medicinska Forskningsrådet (4477, 2576)
- Stiftelserna Wilhelm och Martina Lundgrens
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
- Keywords
- phosphatidylethanol, carbohydrate-deficient transferrin, gamma-glutamyl transferase, alcohol biomarkers, alcohol consumption assessment, alcoholism, aspartate aminotransferase, alanine aminotransferase, biomarker sensitivity
- MeSH terms
- Adult, Aged, Alcohol Drinking, Alcoholism, Female, gamma-Glutamyltransferase, Humans, Male, Middle Aged, Retrospective Studies, Transferrin, Biomarkers, Glycerophospholipids, Self Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
