Pharmacopsychiatry 2003; 36 - 326
DOI: 10.1055/s-2003-825569

Further significance for the diagnostic and therapeutic usefulness of the non oxidative direct ethanol metabolites ethyl glucuronide (EtG), fatty acid ethyl esters (FAEEs) and phosphatidyl ethanol (PEth) in comparison to traditional markers

FM Wurst 1, G Wiesbeck 1, S Forster 2, G Bechtel 2, M Wolfersdorf 2, P Huber 5, S Alexson 4, T Gilg 3, K Jachau 6, A Varga 7, C Alling 7, G Skipper 8, F Pragst 9, A Auwìrter 9, W Weinmann 10
  • 1Psychiatric University Clinic , University of Basel, Switzerland
  • 2State Mental Hospital Bayreuth, Germany
  • 3Department Central Laboratory, University of Basel, Switzerland
  • 4Department of Clinical Chemistry, University of Huddinge, Sweden
  • 5Department of Legal Medicine, University of Munich, Germany
  • 6Department of Legal Medicine, University of Magdeburg, Germany
  • 7Department of Clinical Chemistry, University of Lund, Sweden
  • 8Alabama Physician Health Program, Montgomery, USA
  • 9Department of Legal Medicine, University of Berlin, Germany
  • 10Department of Legal Medicine, University of Freiburg, Germany

Mainly in the last decade, some non-oxidative direct ethanol metabolites – fatty acid ethyl esters (FAEE), ethyl glucuronide (EtG) and phosphatidyl ethanol (PEth) – have been studied as biomarkers of ethanol intake. The presented study is to our best knowledge the first to compare in a single study these direct ethanol metabolites with traditional markers and self reports.

Patients and methods: 16m, 4f alcohol withdrawal patients were included. PEth was determined using HPLC, EtG with an LC-MS-MS method, FAEE and methanol with GC/MS, %CDT with a commercial test. Results: %CDT identified in 47.1%, MCV in 38.8% and GGT in 72.2% chronic intake of higher amounts of ethanol correctly, whereas, CFAEE (hair) identified 94.4% and PEth reached 100%. Conclusion: EtG in urine and FAEE in serum disclose recent ethanol intake after ethanol has left the body, FAEE in hair and PEth are candidates as excellent markers reflecting longer lasting intake of larger amounts of ethanol.

Wurst F. M. and Metzger J. W. on behalf of the WHO/ISBRA study on biological state and trait markers of alcohol use and dependence (2002) The direct ethanol metabolite Ethyl glucuronide is a useful marker of recent alcohol consumption. Alcohol Clin Exp Res 26: 1114–1119

Wurst F. M., Vogel R., Jachau K., Varga A., Alling C., Skipper G.E., Alt A. (2003) Ethyl glucuronide detects recent alcohol use in forensic psychiatric inpatients. Alcohol Clin Exp Res 27: 471–476