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Alcohol and alcohol-related diseases have become a major cause of death in Western countries. The most sensitive and specific of the commonly used bio-markers of alcohol intake are carbohydrate-deficient transferrin (CDT), and the combination of γ-glutamyl-transferase (GGT) and CDT. Other widely used laboratory markers are GGT, mean corpuscular volume of erythrocytes and the ratio of aspartate aminotransferase to alanine aminotransferase. Blood ethanol levels reveal recent alcohol use. However, more specific and sensitive biomarkers to improve the detection of excessive alcohol use at an early stage are needed. New biomarkers, not yet used in routine clinical work, include phosphatidylethanol, fatty acid ethyl esters, ethyl glucuronide, sialic acid, and acetaldehyde adducts.