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December 11, 1981, Vol 246, No. 23 >
ARTICLE | December 11, 1981

Biochemical Diagnosis of Alcoholism: Title and subTitle BreakA Test of the Discriminating Capabilities of γ-Glutamyl Transpeptidase and Mean Corpuscular Volume FREE

Michael J. Eckardt, PhD; Ralph S. Ryback, MD; Robert R. Rawlings, MS; Barry I. Graubard, MA
[+] Author Affiliations

Reprint requests to Laboratory of Preclinical Studies, Division of Intramural Research, NIAAA, 12501 Washington Ave, Rockville, MD 20852 (Dr Eckardt).


JAMA. 1981;246(23):2707-2710. doi:10.1001/jama.1981.03320230031020
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References

Quadratic discriminant analysis was conducted between 121 medically documented male alcoholics who presented for treatment and 130 male nonalcoholic outpatients who were concerned about the possibility of venereal disease. Analysis of γ-glutamyl transpeptidase (GGT) and mean corpuscular volume (MCV) resulted in correct classification of 94% of nonalcoholics but only 36% of alcoholics. In contrast, analysis of 24 commonly ordered clinical laboratory tests produced correct classification of 100% of nonalcoholics and 98% of alcoholics. Transforming the laboratory-determined values to a normal-abnormal dichotomy on the basis of reference values improved the classification accuracy of GGT and MCV to 77%. However, consideration of ten of the other tests resulted in an accuracy of 98% for alcoholics and 95% for nonalcoholics.

(JAMA 1981;246:2707-2710)

REFERENCES

1 +
Rosalki SB, Rau D:  Serum gamma-glutamyl-transpeptidase activity in alcoholism . Clin Chim Acta 1972;;39:41-47.
2 +
Wu A, Slavin G, Levi AJ:  Elevated serum gamma-glutamyl-transferase (transpeptidase) and histological liver damage in alcoholism . Am J Gastroenterol 1976;;65:318-323.
3 +
Wu A, Chanarin I, Levi AJ:  Macrocytosis of chronic alcoholism . Lancet 1974;;1:829-831.
4 +
Unger KW, Johnson D Jr:  Red blood cell mean corpuscular volume: A potential indicator of alcohol usage in a working population . Am J Med Sci 1974;;267:281-289.
5 +
Whitehead TP, Clarke CA, Whitfield AGW:  Biochemical and haematological markers of alcohol intake . Lancet 1978;;1:978-981.
6 +
Bagrel A, d'Houtaud A, Gueguen R, et al:  Relations between reported alcohol consumption and certain biological variables in an 'unselected' population . Clin Chem 1979;;25:1242-1246.
7 +
Aronsen KF, Hanson A, Nosslin B:  The value of gamma-glutamyl transpeptidase in differentiating viral hepatitis from obstructive jaundice: A statistical comparison with alkaline phosphatase . Acta Chir Scand 1965;;130:92-99.
8 +
Dragosics B, Ferenci P, Pesendorfer F, et al:  Gamma-glutamyl transpeptidase (GGTP): Its relationship to other enzymes for diagnosis of liver disease . Prog Liver Dis 1976;;5:436-449.
9 +
Adjarov D, Iwanow ED:  Neue Aspekte der klinischen Bedeutung der gamma-Glutamyl-Transpeptidase bestimmung im Serum . Acta Hepatogastroenterol 1973;;20:315-324.
10 +
Rosalki SB, Tarlow D, Rau D:  Plasma gamma-glutamyl transpeptidase elevation in patients receiving enzyme-inducing drugs . Lancet 1971;;2:376-377.
11 +
Helman N, Rubenstein LS:  The effects of age, sex, and smoking on erythrocytes and leukocytes . Am J Clin Pathol 1975;;63:35-44.
12 +
Okuno T:  Smoking and blood changes . JAMA 1973;;225:1387-1388.
13 +
Papoz L, Warnet JM, Pequignot G, et al:  Alcohol consumption in a healthy population: Relationship to γ-glutamyl transferase activity and mean corpuscular volume . JAMA 1981;; 245:1748-1751.
14 +
Ryback RS, Eckardt MJ, Pautler CP:  Biochemical and hematological correlates of alcoholism . Res Commun Chem Path Pharmacol 1980;;27:533-550.
15 +
Lachenbruch PA, Sneeringer C, Revo LT:  Robustness of the linear and quadratic discriminant function to certain types of nonnormality . Commun Statistics 1973;;1:39-56.
16 +
Marks S, Dunn OJ:  Discriminant functions when covariance matrices are unequal . J Am Stat Assoc 1974;;69:555-559.
17 +
Eckardt MJ, Feldman DJ:  Biochemical correlates of alcohol abuse , in Seixas FA (ed): Currents in Alcoholism . New York, Grune & Stratton Inc, 1978;, vol 3, pp 545-554.
18 +
Lachenbruch PA:  An almost unbiased method of obtaining confidence intervals for the probability of misclassification in discriminant analysis . Biometrics 1967;;23:639-645.
19 +
Ryback RS, Eckardt MJ:  Toward a biochemical definition of alcoholism , in Hanin I, Usdin E (eds): Biological Markers in Psychiatry and Neurology , to be published.

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1 +
Rosalki SB, Rau D:  Serum gamma-glutamyl-transpeptidase activity in alcoholism . Clin Chim Acta 1972;;39:41-47.
2 +
Wu A, Slavin G, Levi AJ:  Elevated serum gamma-glutamyl-transferase (transpeptidase) and histological liver damage in alcoholism . Am J Gastroenterol 1976;;65:318-323.
3 +
Wu A, Chanarin I, Levi AJ:  Macrocytosis of chronic alcoholism . Lancet 1974;;1:829-831.
4 +
Unger KW, Johnson D Jr:  Red blood cell mean corpuscular volume: A potential indicator of alcohol usage in a working population . Am J Med Sci 1974;;267:281-289.
5 +
Whitehead TP, Clarke CA, Whitfield AGW:  Biochemical and haematological markers of alcohol intake . Lancet 1978;;1:978-981.
6 +
Bagrel A, d'Houtaud A, Gueguen R, et al:  Relations between reported alcohol consumption and certain biological variables in an 'unselected' population . Clin Chem 1979;;25:1242-1246.
7 +
Aronsen KF, Hanson A, Nosslin B:  The value of gamma-glutamyl transpeptidase in differentiating viral hepatitis from obstructive jaundice: A statistical comparison with alkaline phosphatase . Acta Chir Scand 1965;;130:92-99.
8 +
Dragosics B, Ferenci P, Pesendorfer F, et al:  Gamma-glutamyl transpeptidase (GGTP): Its relationship to other enzymes for diagnosis of liver disease . Prog Liver Dis 1976;;5:436-449.
9 +
Adjarov D, Iwanow ED:  Neue Aspekte der klinischen Bedeutung der gamma-Glutamyl-Transpeptidase bestimmung im Serum . Acta Hepatogastroenterol 1973;;20:315-324.
10 +
Rosalki SB, Tarlow D, Rau D:  Plasma gamma-glutamyl transpeptidase elevation in patients receiving enzyme-inducing drugs . Lancet 1971;;2:376-377.
11 +
Helman N, Rubenstein LS:  The effects of age, sex, and smoking on erythrocytes and leukocytes . Am J Clin Pathol 1975;;63:35-44.
12 +
Okuno T:  Smoking and blood changes . JAMA 1973;;225:1387-1388.
13 +
Papoz L, Warnet JM, Pequignot G, et al:  Alcohol consumption in a healthy population: Relationship to γ-glutamyl transferase activity and mean corpuscular volume . JAMA 1981;; 245:1748-1751.
14 +
Ryback RS, Eckardt MJ, Pautler CP:  Biochemical and hematological correlates of alcoholism . Res Commun Chem Path Pharmacol 1980;;27:533-550.
15 +
Lachenbruch PA, Sneeringer C, Revo LT:  Robustness of the linear and quadratic discriminant function to certain types of nonnormality . Commun Statistics 1973;;1:39-56.
16 +
Marks S, Dunn OJ:  Discriminant functions when covariance matrices are unequal . J Am Stat Assoc 1974;;69:555-559.
17 +
Eckardt MJ, Feldman DJ:  Biochemical correlates of alcohol abuse , in Seixas FA (ed): Currents in Alcoholism . New York, Grune & Stratton Inc, 1978;, vol 3, pp 545-554.
18 +
Lachenbruch PA:  An almost unbiased method of obtaining confidence intervals for the probability of misclassification in discriminant analysis . Biometrics 1967;;23:639-645.
19 +
Ryback RS, Eckardt MJ:  Toward a biochemical definition of alcoholism , in Hanin I, Usdin E (eds): Biological Markers in Psychiatry and Neurology , to be published.

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