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Combination of nephro- and hepatotoxicity of alcohol to improve diagnostic performance of markers of alcohol abuse
Currently available biological markers have limitations in their diagnostic performance. Combination of two or more markers allows improving sensitivity and specificity of chronic alcohol abuse.
Three markers of hepatotoxicity, asparaginine and alanine aminotransferase (AST, ALT), γ-glutamyl transferase (GGT), and two markers of nefrotoxicity of alcohol, β-hexosaminidase (HEX) and alanineaminopeptidase (AAP) were studied in alcohol dependent patients undergoing detoxification (n=73) and abstinent for at least 6 weeks (n=36).
HEX in urine, and GGT in serum were the best singular tests as measured by the areas under the ROC plots (AUC ROC) (0.85 and 0.88, respectively). They were statistically independent. Their combination, created by means of stepwise discriminate analysis, gave a new marker, γ-HEX expressed by the formula: γ-HEX=-0.72*ln(HEX)-0.59*ln (GGT). The results obtained from this combination were better (AUC ROC 0.93) than those of any singular marker examined in this work.
The results of the study show that the application of combination of markers based on nephrotoxic and hepatotoxic influence of alcohol could improve diagnostic performance of markers