The diagnostic value of a discriminant score in the detection of alcohol abuse.

Abstract

To detect alcoholism and alcohol consumption in its early phase, the diagnostic values of a discriminant score and a combination of laboratory tests were examined. Seventy-eight men with a well-documented history of chronic alcoholism, 76 male heavy drinkers, and 165 male controls were classified according to self-reported alcohol consumption and the Malmö-modified Michigan Alcoholism Screening Test. The present study documented the efficiency of the acetaldehyde-induced hemoglobin fraction, ie, HbA1ach in heavy drinkers, aspartate aminotransferase in alcoholics, and, additionally, mean corpuscular volume and gamma-glutamyltransferase in both groups of alcohol abusers. The discriminant score, formed from gamma-glutamyltransferase, HbA1ach, and the mean corpuscular volume, gave a sensitivity of 72% and a specificity of 73% in detecting heavy drinkers as compared with the best single discriminant, ie, mean corpuscular volume, with a sensitivity of 60% and a specificity of 69%. The best discriminant score values for alcoholics were the result of the combination of aspartate aminotransferase, mean corpuscular volume, high-density lipoprotein cholesterol, triglycerides, and alkaline phosphatase, giving a sensitivity of 91% and a specificity of 96%. In conclusion, I recommend the use of a discriminant score for the detection of alcohol abuse in clinical settings and especially in its early phase. The results of this study also confirm the assumption that alcohol abuse in all phases, like alcoholism and heavy drinking, may not be detected optimally with the use of only one marker or even combinations of them.