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Test measures health risk of heavy alcohol use by Dick Peterson Public Relations  An alcohol blood test used for research by MUSC’s Center for Drug and Alcohol Programs has found clinical use among physicians who want to screen patients for disease risk, for appropriate treatment in trauma cases and in pre-operative assessments. And because of MUSC’s experience with the test, a growing number of prominent institutions and pharma-ceutical companies around the country send their blood specimens to CDAP’s lab for processing. “It’s called carbohydrate deficient transferrin,” said Ray Anton, M.D., the center’s director. He explained that the test, designated as %CDT, is an effective measure of heavy alcohol use over an extended period and is particularly useful where alcohol poses a risk to a patient’s health. An estimated 80 percent of the American population drinks alcoholic beverages at some level from light to heavy. That should lead physicians to consider alcohol consumption when treating coronary artery disease, stroke, some forms of cancer, hypertension, gastro-esophageal reflux disease and other digestive disorders, Anton said. Alcohol consumption can alter the effect of medications. Heavy alcohol use adds significant risk in trauma cases and surgery. “You don’t have to be an alcohol abuser to fall into the category of heavy alcohol use,” Anton said. He said that %CDT testing is not an indicator of alcoholism. But it does indicate a level at which alcohol consumption becomes a significant health risk, about four to six standard drinks per day. Anton explained that carbohydrate deficient transferrin is an abnormal form of a naturally occurring transferrin protein. Transferrin, which is derived in the liver, under normal circumstances transports iron from the intestines to the bone marrow for the production of blood cells and elsewhere where needed. As a result of drinking from four to six standard alcohol drinks daily, an individual’s liver produces the abnormal carbohydrate deficient transferrin and places it in the bloodstream. If the percent of CDT is elevated (more than 2.5 percent of total transferrin), it may suggest the person is drinking at a potentially harmful level, Anton said. Because it is not a 100 percent reliable test, Anton recommends the %CDT test be supplemented with a similar test, the gamma-glutamyl transferrase (GGT). He said that the GGT is cheap and has been around for years but it suffers from lack of specificity. Other diseases and medications may elevate the test. The %CDT test, on the other hand, is specific for heavy alcohol use, indicating the level of sustained lifestyle drinking over a matter of weeks.  “As an indicator of the aggregate heavy use of alcohol, the %CDT can be particularly useful in talking with a patient,” Anton said. “Trying to talk to people about alcohol use is cumbersome, but with this blood test we have objective evidence of alcohol’s threat to health.” Anton hopes that a confrontation with the evidence will become a motivator to action for the person contemplating change in their heavy drinking lifestyle. “One does not have to be an alcohol abuser to have harmful health consequences of drinking,” Anton said. “This test takes some of the guess work out of discussing the potential role of alcohol on a person’s health.” He said that repeat testing over time can also serve as a reinforcer toward maintaining changed behavior. In this fashion it may work like cholesterol monitoring or hemoglobin A1c for diabetes monitoring. Cynthia Dominick, manager of MUSC’s Clinical Neurobiology Laboratories said that an increasing number of hospitals and research projects at the University of Pittsburgh, State University at New York, Yale, and Harvard, are contracting with the lab in the Institute of Psychiatry to process the test. “The mechanism is in place at MUSC. Just order the test through the normal laboratory process,” she said, “the blood will get to us and the result will be available in 24 hours,” indicating that the test should provide an easy way to detect and monitor alcohol-related health problems. Call Dominick at her laboratory number, 792-5440, for more information on the %CDT test.   Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.