Usefulness of Biochemical Markers in Alcohol Dependence

Background: Identification of alcohol dependence is crucial in preventing adverse health effects and social consequences of excessive alcohol consumption. The blood tests used traditionally as markers of excessive drinking are the liver enzymes, gamma glutamyltransferase (GGT), aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and the red blood cell volume (mean corpuscular volume; MCV). Here, we evaluate the usefulness of these markers, their association with pattern of alcohol consumption and their practical application in management and treatment of alcohol dependent individuals. Methods: This was a longitudinal study on 50 alcohol dependent individuals and 50 healthy controls. Detailed information about socio-demographic characteristics and alcohol consumption was recorded through psychiatric interview performa. CAGE questionnaire was applied as a screening tool. Diagnosis of alcohol dependence was confirmed as per ICD-10 criteria. All the subjects underwent laboratory testing for biochemical markers which were estimated by semi automated analyzer. The data thus generated was statistically analyzed by using chi-square test, t-test, ANOVA and Pearson product moment correlation analysis. Results: The values for GGT, MCV and AST were significantlyhigh (p<0.001) in study group than control group. GGT was found to be significantly related to the amount of alcohol consumption (<0.001). The correlation of GGT was also found to be highly significant with the increasing frequency of alcohol consumption (r= .488, p<0.001). GGT was found to be most sensitive marker i.e., 64% while HDL-c was found to be having more specificity (100%). Diagnostic accuracy of GGT was found to be highest of all markers(77%). Conclusion: These biochemical markers tests are widely available and relatively inexpensive. While having limited sensitivity and specificity in detection of excessive drinking, they also provide valuable data on complications of drinking, comorbid conditions that may be affected by drinking and, in some cases, prognosis