Carbohydrate-Deficient Transferrin as a Biomarker for Screening At-Risk Drinking in Elderly Men / 가정의학회지

BACKGROUND: Carbohydrate-deficient transferrin (CDT) is a useful biomarker to identify excessive alcohol consumption; however, few studies have validated the %CDT cut-off value in elderly men. This study estimated the optimal %CDT cut-off value that could identify excessive alcohol consumption in men aged ≥65 years. METHODS: This retrospective study included 120 men who visited the department of family medicine at Chungnam National University Hospital for health check-up between January 2010 and August 2013. At-risk drinking included heavy- and binge drinking. Heavy drinking was defined as more than seven standard drinks/wk, and binge drinking was defined as more than three standard drinks/d. The cut-off %CDT values for at-risk drinking were determined using receiver operating characteristic (ROC) curves. RESULTS: Based on the ROC curves, the optimal %CDT cut-off values in ≥65-year-old men were 1.95% for at-risk drinking, 1.81% for heavy drinking, and 2.07% for binge drinking. The sensitivity, specificity, and positive and negative predictive values were 58.7%, 83.6%, 69.2%, and 76.2% for at-risk drinking, respectively. The AUROC were >0.7 for all three evaluated cut-offs. CONCLUSION: Our results suggest that the %CDT cut-off value for at-risk drinking in elderly Korean men (≥65 years) should be readjusted to a lower value of 1.95%.

Development of a Simple Tool for Identifying Alcohol Use Disorder in Female Korean Drinkers from Previous Questionnaires / 가정의학회지

BACKGROUND: This study aimed to develop a simple tool for identifying alcohol use disorders in female Korean drinkers from previous questionnaires. METHODS: This research was conducted on 400 women who consumed at least one alcoholic drink during the past month and visited the health promotion center at Chungnam National University Hospital between June 2013 to May 2014. Drinking habits and alcohol use disorders were assessed by structured interviews using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria. The subjects were also asked to answer the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption, CAGE (Cut down, Annoyed, Guilty, Eye-opener), TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), TACE (Tolerance, Annoyed, Cut down, Eye-opener), and NET (Normal drinker, Eye-opener, Tolerance) questionnaires. The area under receiver operating characteristic (AUROC) of each question of the questionnaires on alcohol use disorders was assessed. After combining two questions with the largest AUROC, it was compared to other previous questionnaires. RESULTS: Among the 400 subjects, 58 (14.5%) were identified as having an alcohol use disorder. Two questions with the largest AUROC were question no. 7 in AUDIT, "How often during the last year have you had a feeling of guilt or remorse after drinking?" and question no. 5 in AUDIT, "How often during the past year have you failed to do what was normally expected from you because of drinking?" with an AUROC (95% confidence interval [CI]) of 0.886 (0.850-0.915) and 0.862 (0.824-0.894), respectively. The AUROC (95% CI) of the combination of the two questions was 0.958 (0.934-0.976) with no significant difference as compared to the existing AUDIT with the largest AUROC. CONCLUSION: The above results suggest that the simple tool consisting of questions no. 5 and no. 7 in AUDIT is useful in identifying alcohol use disorders in Korean female drinkers.