HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY IMPROVES DIAGNOSTIC EFFICIENCY OF CARBOHYDRATE-DEFICIENT TRANSFERRIN

Carbohydrate-deficient transferrin (CDT) is considered a usefulbiochemical marker of regular high alcohol intake. CDT was measuredin the sera of 51 alcohol abusers, 20 patients with nonalcoholicliver disease and 30 healthy controls with an alcohol intakeof <30g/day. The mean CDT levels of these three groups respectivelywere determined with high-performance liquid chromatography(HPLC; 4.6 ± 5.2%; 0.7 ± 0.2%; 0.7 ± 0.2%)and with a radioimmunoassay after microcolumn anion-exchangechromatography (MAEC/RIA; 34.2 ± 26.9 U/1; 16.9 ±3.8 U/1; 18.0 ± 5.7 U/1). CDT levels in patients withsevere alcohol abuse (161.6 ± 96.4g/day) were significantlyhigher than in the two other groups under investigation (P <0.0001). In heavily drinking subjects, the mean daily alcoholintake correlated with aspartate aminotransferase levels (ASAT)but not with the CDT levels determined either with HPLC or MAEC/RIA.With both methods, the CDT levels were slightly higher in patientswith an ASAT concentration >30 U/1, which may indicate anadvanced liver damage (P < 0.05). Analysis of receiver-operatingcharacteristic (ROC) plots demonstrated that the diagnosticaccuracy of the HPLC method, which determines the relative amountof CDT, was significantly higher than the established MAEC/RIAmethod, which measures the absolute amount of CDT (area underthe ROC curve: 0.95 ± 0.02 vs 0.73 ± 0.05; P <0.0001). At a specificity of >95%, the sensitivity of CDTdetermined with HPLC and MAEC/RIA was 80 and 47%, respectively.In addition, HPLC may be a useful and reliable method for thedetermination of this important biochemical marker, since theHPLC chromatogram is a visible document of the successful isotransferrinseparation and measurement.