文档介绍：Carbohydrate-deficient Transferrin as a Marker ofChronic Alcohol Abuse: A Critical Review ofPreanalysis, Analysis, and Interpretation Torsten Arndt Background: Carbohydrate-deficient transferrin (CDT) is used for diagnosis of chronic alcohol abuse. Some 200–300 reports on CDT have been published in impact factor-listed journals. The aims of this review were to condense the current knowledge and to resolve remain- ing issues on CDT. Approach: The literature (1976–2000) was searched us- ing MEDLINEand Knowledge Server with “alcohol and CDT” as the search items. The data were reviewed systematically, checked for redundancy, anized in sequence based on the steps involved in CDT analy- sis. Content: The review is divided into sections based on microheterogeneity of human serum transferrin (Tf), definition of CDT, structure of human serum CDT, pathomechanisms of ethanol-induced CDT increase, preanalysis, analysis, and medical interpretation (post- analysis). Test-specific cutoff values for serum CDTand causes of false positives and negatives for chronic alco- hol abuse are discussed and summarized. Summary: Asialo- and disialo-Fe 2-Tf, which lack one or plete N-glycans, and monosialo-Fe 2-Tf (struc- ture remains unclear) are collectively referred to as CDT. Diminished mRNA concentration and glycoprotein gly- cosyltransferase activities involved in Tf N-glycan syn- thesis and increased sialidase activity most likely ac- count for alcohol-induced increases in CDT. Knowledge about in vivo and in vitro effects on serum CDT is poor. Reliable CDT and non-CDT fractionation is needed for CDT measurement. Analysis methods with different analytical specificities and recoveries decreased parability of values and statistical parameters of the diagnostic efficiency of CDT. CDT is the most specific marker of chronic alcohol abuse to date. Efforts should concentrate on the pathomechanisms (in vivo), prean- alysis, and standardization of CDT analysis. ? 2001 American Association for Clin