Combining markers of nephrotoxicity and hepatotoxicity for improved monitoring and detection of chronic alcohol abuse
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Ewa Taracha
Abstract
Background: Most of the commonly used markers of chronic alcohol abuse reflect alcohol hepatotoxicity; however, such abuse is deleterious to the kidneys as well. Combined use of serum markers of liver origin and urinary markers of kidney origin may be of diagnostic advantage.
Methods: The study was performed in 73 male alcoholics undergoing detoxification and 36 male alcoholics who had maintained abstinence for ≥6weeks. Factor analysis, discriminant analysis and receiver operating characteristic (ROC) analysis were used to assess the discriminative power of two urinary markers of alcohol nephrotoxicity, namely β-N-acetylhexosaminidase (Hex, EC 3.2.1.52) and alanine aminopeptidase (EC 3.4.11.2), and of three serum markers of alcohol hepatotoxicity, namely aspartate aminotransferase (EC 2.6.1.1), alanine aminotransferase (EC 2.6.1.2) and γ-glutamyltransferase (GGT, EC 2.3.2.2), and of their quantitative combinations.
Results: The discriminative power of the urinary markers matched that of the serum markers. Hex and GGT appeared to be the best for discriminating the study groups. Their combination given by the equation G&H=0.62×ln(GGT)+0.72×ln(Hex) showed excellent discriminative ability (ROC area under the curve 0.92) that was significantly higher than that of any single marker in this report, indicating superior diagnostic accuracy of the compound marker.
Conclusions: Kidney-derived urinary markers, particularly Hex, can complement or replace, if necessary, serum markers of chronic alcohol abuse that relate to alcohol hepatotoxicity. The compound marker proposed seems a promising tool for the monitoring and perhaps detection of chronic alcohol abuse and warrants further studies.
Clin Chem Lab Med 2006;44:1446–52.
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©2006 by Walter de Gruyter Berlin New York
Artikel in diesem Heft
- Initiation and progression of atherosclerosis – enzymatic or oxidative modification of low-density lipoprotein?
- Blood transfusions in athletes. Old dogmas, new tricks
- Molecular detection of tyrosinase transcripts in peripheral blood from patients with malignant melanoma: correlation of PCR sensitivity threshold with clinical and pathologic disease characteristics
- Increase in and clearance of cell-free plasma DNA in hemodialysis quantified by real-time PCR
- Lipoprotein lipase gene polymorphism at the PvuII locus and serum lipid levels in Guangxi Hei Yi Zhuang and Han populations
- Interpretation of cardiac troponin T behaviour in size-exclusion chromatography
- Point-of-care C-reactive protein testing in febrile children in general practice
- Improvement in HPLC separation of porphyrin isomers and application to biochemical diagnosis of porphyrias
- Measurement of late-night salivary cortisol with an automated immunoassay system
- Combining markers of nephrotoxicity and hepatotoxicity for improved monitoring and detection of chronic alcohol abuse
- Stone or stricture as a cause of extrahepatic cholestasis – do liver function tests predict the diagnosis?
- Insulin resistance and enhanced protein glycation in men with prehypertension
- Prevalence-dependent decision limits for the early detection of type 2 diabetes mellitus in venous blood, venous plasma and capillary blood during glucose challenge
- Analytical performance and clinical utility of the INNOTEST® PHOSPHO-TAU(181P) assay for discrimination between Alzheimer's disease and dementia with Lewy bodies
- Variations in assay protocol for the Dako cystatin C method may change patient results by 50% without changing the results for controls
- Approved IFCC recommendation on reporting results for blood glucose: International Federation of Clinical Chemistry and Laboratory Medicine Scientific Division, Working Group on Selective Electrodes and Point-of-Care Testing (IFCC-SD-WG-SEPOCT)
- National survey on the pre-analytical variability in a representative cohort of Italian laboratories
- 10% CV concentration for the fourth generation Roche cardiac troponin T assay derived from Internal Quality Control data
- Biological variation of non-SI traceable biological quantities: example of proteins
- Effect of tibolone therapy on lipids and coagulation indices
- Acknowledgement
- Contents Volume 44, 2006
- Author Index
- Subject Index
Artikel in diesem Heft
- Initiation and progression of atherosclerosis – enzymatic or oxidative modification of low-density lipoprotein?
- Blood transfusions in athletes. Old dogmas, new tricks
- Molecular detection of tyrosinase transcripts in peripheral blood from patients with malignant melanoma: correlation of PCR sensitivity threshold with clinical and pathologic disease characteristics
- Increase in and clearance of cell-free plasma DNA in hemodialysis quantified by real-time PCR
- Lipoprotein lipase gene polymorphism at the PvuII locus and serum lipid levels in Guangxi Hei Yi Zhuang and Han populations
- Interpretation of cardiac troponin T behaviour in size-exclusion chromatography
- Point-of-care C-reactive protein testing in febrile children in general practice
- Improvement in HPLC separation of porphyrin isomers and application to biochemical diagnosis of porphyrias
- Measurement of late-night salivary cortisol with an automated immunoassay system
- Combining markers of nephrotoxicity and hepatotoxicity for improved monitoring and detection of chronic alcohol abuse
- Stone or stricture as a cause of extrahepatic cholestasis – do liver function tests predict the diagnosis?
- Insulin resistance and enhanced protein glycation in men with prehypertension
- Prevalence-dependent decision limits for the early detection of type 2 diabetes mellitus in venous blood, venous plasma and capillary blood during glucose challenge
- Analytical performance and clinical utility of the INNOTEST® PHOSPHO-TAU(181P) assay for discrimination between Alzheimer's disease and dementia with Lewy bodies
- Variations in assay protocol for the Dako cystatin C method may change patient results by 50% without changing the results for controls
- Approved IFCC recommendation on reporting results for blood glucose: International Federation of Clinical Chemistry and Laboratory Medicine Scientific Division, Working Group on Selective Electrodes and Point-of-Care Testing (IFCC-SD-WG-SEPOCT)
- National survey on the pre-analytical variability in a representative cohort of Italian laboratories
- 10% CV concentration for the fourth generation Roche cardiac troponin T assay derived from Internal Quality Control data
- Biological variation of non-SI traceable biological quantities: example of proteins
- Effect of tibolone therapy on lipids and coagulation indices
- Acknowledgement
- Contents Volume 44, 2006
- Author Index
- Subject Index
