Table 1.
Main data extracted from the selected articles.
| Study and Year | Type of Study | Number of Subjects | Clinical Setting | Subjects Stratification | Type of Sample | Form of Measured PEth | Analytical Method LOQ * Cut-Off # | AUC-ROC of PEth | Other Markers |
|---|---|---|---|---|---|---|---|---|---|
| Aboutara et al., 2022 [27] | Cross-sectional | 234 patients attending a liver and kidney clinic | Outpatients | By self-reported alcohol intake and by period of time assessed | DBS from EDTA-blood | 16:0/18:1 16:0/18:2 16:0/20:4 18:0/18:1 18:0/18:2 18:1/18:1 |
LC/MS/MS 16:0/18:1: 8.6 ng/mL * 16:0/18:2: 6.0 ng/mL * 16:0/20:4: 7.7 ng/mL * 18:0/18:1: 6.1 ng/mL * 18:0/18:2: 7.5 ng/mL * 18:1/18:1: 6.6 ng/mL * 10 ng/mL # |
For PEth cut-off ≥10 ng/mL and a consumption in the last 4 weeks: ≥24 g/week: 16:0/18:1: 0.78 16:0/18:2: 0.76 16:0/20:4: 0.71 18:0/18:1: 0.70 18:0/18:2: 0.70 18:1/18:1: 0.66 ≥ 84 g/week: 16:0/18:1: 0.93 16:0/18:2: 0.89 16:0/20:4: 0.82 18:0/18:1: 0.82 18:0/18:2: 0.82 18:1/18:1: 0.78 |
uEtG hEtG CDT AST ALT GGT MCV |
| Afshar et al., 2022 [28] | Prospective clinical | 251 patients attending a trauma center | Inpatients | By AUDIT score: “No unhealthy alchol use” if AUDIT < 5 (F) or <8 (M) “Unhealthy alcohol use” if AUDIT ≥ 5 (F) or ≥8 (M) |
DBS from EDTA-blood | 16:0/18:1 | LC/MS/MS 8 ng/mL * 25 ng/mL # |
For PEth cut-off 25 ng/mL: 0.93 (CI: 0.92–0.93) In the external validation: 0.83 (CI: 0.72–0.94) |
uEtS uEtG CDT GGT BAC |
| Afshar et al., 2017 [29] | Cohort | 122 subjects: From medical and burn ICU (n = 33) From alcohol detoxification unit (n = 51) Healty volunteers (n = 38) (93 M / 29 F)” |
Inpatients Outpatients |
By AUDIT score: “Any alcohol misuse” if AUDIT ≥5 (F) or ≥8 (M) “Severe alcohol misuse” if AUDIT ≥13 (F) or ≥16 (M) |
DBS from whole blood | 16:0/18:1 | LC/MS/MS 4 ng/mL * 250 ng/mL # 400 ng/mL # |
By AUDIT For PEth as a continuous measure for any alcohol misuse: 0.927 (CI: 0.877–0.977) For PEth as a continuous measure for severe alcohol misuse: 0.906 (CI: 0.850–0.962) By AUDIT-C For PEth as a continuous measure for any alcohol misuse: 0.948 (CI: 0.910–0.956) For PEth as a continuous measure for severe alcohol misuse: 0.913 (CI: 0.856–0.971) |
BAC |
| Baggio et al., 2020 [30] | Single-center with a cross-sectional design | 233 subjects of army recrutiment centre (233 M/0 F) |
By AUDIT score: “Low score” if AUDIT < 13 “High score” if AUDIT ≥ 13 |
DBS from whole blood | 16:0/18:1 | LC/MS/MS 90 ng/mL # 210 ng/mL # (excessive chronic drinking) |
0.617 | hEtG | |
| Cherrier et al., 2020 [31] | Cross-sectional | 183 subjects (121 M/62 F) |
Outpatients | By age: Middle age subjects (35–59 years) Older age subjects (over 60 years) By AUDIT-C score: “Subjects at-risk for excessive alcohol consumption” if AUDIT-C ≥ 6 “Subjects without risk for excessive alcohol consumption” if AUDIT-C < 6 |
EDTA-Whole blood | 16:0/18:1 16:0/18:2 Total PEth |
LC/MS/MS 16:0/18:1: 0.009 μmol/L * 16:0/18:2: 0.03 μmol/L * |
- | GGT AST ALT Bilirubin |
| Francis et al., 2015 [32] | Cross-sectional | 202 college students and casual labourers (161 M/41 F) |
Outpatients | By AUDIT score: “Low risk drinking” if AUDIT < 8 “Risk drinking” if AUDIT ≥ 8 By AUDIT-C score: “No hazardous drinking” if AUDIT-C < 6 “Hazardous drinking” if AUDIT-C ≥ 6 By TLFB: “Heavy alcohol intake” if were consumed ≥6 S.D. per drinking event |
EDTA-Whole blood | 16:0/18:1 | LC/MS/MS 0.01 μmol/L * 0.01 μmol/L # (any alcohol intake) 0.30 μmol/L # (heavy alcohol intake) |
AUDIT ≥ 8 use against PEth for heavy alcohol use: 0.89 (0.83–0.92) AUDIT-C ≥ 6 use against PEth for heavy alcohol use: 0.89 (0.84–0.93) |
- |
| Gerbase et al., 2020 [33] | Prospective cross-sectional | 238 adult patients presenting for trauma (161 M/77 F) |
ER department of Novo Hamburgo (population: 250,000) in South Brazil | “By AUDIT-C score: “No alcohol misuse” if AUDIT-C < 3 (F) or <4 (M) “Any level of alcohol misuse” if AUDIT-C ≥ 3 (F) or ≥4 (M) “Severe alcohol misuse” if AUDIT-C ≥ 6” |
EDTA-Whole blood | 16:0/18:1 | LC-MS/MS 1.67 ng/mL * 18,3 ng/mL# (any alcohol misuse) 23,9 ng/mL# (severe alcohol misuse) |
For PEth cut-off 18.3 ng/mL to detect any alcohol misuse based on AUDIT-C ≥ 3 (F) or ≥4 (M): 0.791 (CI: 0.722–0.860) For PEth cut-off 29.3 ng/mL to detect severe alcohol misuse based on AUDIT-C ≥ 6: 0.885 (CI: 0.830–0.939) |
- |
| Jorgenrud et al., 2021 [34] | Cross-sectional | 2874 patients in Oslo: 931 with AUDIT-QF data and PEth levels ≥ 0.030 μM 3009 patients in Moscow: 953 with AUDIT-QF data and PEth levels ≥ 0.030 μM |
2 Hospitals in Oslo and Moscow | By AUDIT-QF: “Harmful alcohol use”: ≥5 (M)/≥4 (F) By weekly grams of alcohol: “Harmful alcohol use”: ≥350 g of alcohol |
Whole blood | 16:0/18:1 | UHPLC-MS/MS ≥300 μmol/L # (excessive alcohol use) |
For PEth as a continuous variable ≥ 0.030 μM (AUDIT-QF ≥ 5 (men)/4 (women) as cutoff for harmful alcohol use): Oslo: 0.633 (CI: 0.596–0.669) Moscow: 0.685 (CI: 0.651–0.718, p < 0.001) For PEth as a continuous variable ≥ 0.030 μM (weekly grams of alcohol ≥ 350 as cutoff for harmful alcohol use): Oslo: 0.856 (CI: 0.798–0.914) Moscow: 0.746 (CI: 0.700–0.793, p < 0.001) |
- |
| Kechagias et al., 2015 [35] |
Prospective randomized | 44 subjects (12 M/32 F) |
Department of Clinical Chemistry, University Hospital, Lund, Sweden | Randomization to alcohol abstention or to alcohol consumption: Abstention: avoid any sort of alcohol intake during the three study months Consumption: 300 mL of red wine (32–33 g of alcohol) per 24 h (M); 150 mL of red wine (16–16.5 g of alcohol) per 24 h (F). |
Whole blood | 16:0/18:1 | LC-MS/MS 0.005 μmol/L * (3.5 ng/mL) |
For PEth to descriminate between abstention and moderate daily consumption of red wine for 3 months: 0.92 (CI: 0.82–1) | CDT MCV GGT AST ALT |
| Lowery et al., 2018 [36] | Cross-sectional | 140 brain dead organ donors 62% (n = 87) from the Gift of Hope (GOH) donor cohort 38% (n = 53) from the Loyola University Medical Center (LUMC) cohort |
Itasca, IL. Loyola University Medical Center (LUMC) | By UNOS definition: “Heavy alcohol use” consumption ≥ 2 S.D./day By CDC definition: “Heavy alcohol use”: >1 S.D. per day on average or ≥4 S.D. consumed on one occasion in one month (F) or >2 S.D. per day on average or ≥5 S.D. consumed on one occasion in one month (M) |
Whole blood | 16:0/18:1 | Online-SPE-LC-MS/MS 8 ng/mL * LOD: 2 ng/mL |
For PEth cut-off ≥84 ng/mL to detect alcohol misuse: 0.86 (CI: 0.76–0.94) | AST ALT GGT CDT |
| Piano et al., 2015 [37] | Cross-sectional | 103 subjects (36 M/67 F) |
Participants of a larger ongoing study examinating the cardiovascular effects of binge drinking | By Alcohol Intake Questionaire (AIQ) “Alcohol abstainers”: ≤1 S.D. per month in the last 2–3 years (and abstention cannot be due to a medical illness or prior alcohol abuse) “Moderate or social drinkers”: ≤3 S.D. per sitting with ≤1–2 times per week (M); ≤2 S.D. per sitting with ≤1–2 times in a given week in the last 5 years (F). “Binge drinkers”: ≥5 S.D. either on one occasion or within a 2-h period in the last 30 days (M); ≥4 S.D. on one occasion or in a 2-h period in the last 30 days (F); binge drinkers must have had ≥2 binge drinking episodes in the last month. |
Venous whole blood Venous DBS |
16:0/18:1 | HPLC LC/MS/MS Whole blood: 20 ng/mL * >20 ng/mL # (moderate to heavy drinking) DSB: 8 ng/mL * >8 ng/mL # (moderate to heavy drinking) |
- | - |
| Schrock et al., 2017 [9] | Cross-sectional study | 300 subjects (203 M/94 F/3 not specified) |
Outpatients | By AUDIT-C: Group A “Abstinence” (Group A) if AUDIT-C is 0 Group B “Moderate consumption” (Group B) if AUDIT-C is 1–3 (F) or 1–4 (M) Group C “Excessive consumption” (Group C) if AUDIT-C is ≥4 (F) or ≥5 (M) |
Whole blood | 16:0/18.1 16:0/18:2 |
Online-SPE-LC–MS/MS 20 ng/mL * LOD: 10 ng/mL 112 ng/mL # (for PEth 16:0/18:1, to distinguish moderate from excessive consumers) 67 ng/mL # (for PEth 16:0/18:2, to distinguish moderate from excessive consumers) |
- | - |
PEth: Phosphatidylethanol. S.D.: Standard Drink. AUDIT: Alcohol Use Disorders Identification Test. DBS: dried blood spot. Online-SPE-LC–MS/MS: online solid-phase extraction and liquid chromatography-tandem mass spectrometry. LC MS/MS: Liquid chromatography–mass spectrometry. UHPLC-MS/MS: ultra-high performance liquid chromatography–mass spectrometry. BAC: blood alcohol concentration. uEtG: urinary ethylglucuronid. hEtG: hair ethylglucuronid. CDT: Carbohydrate-deficient transferrin. AST: aspartate aminotransferase. ALT: alanine aminotransferase. GGT: gamma-glutamyl transferase. MCV: mean corpuscular volume. In the 8th column the symbol * identifies the Limit of Quantitation (LOQ) while the symbol # identifies the interpretative cut-off chosen by the authors.