Direkte Ethanolmetabolite in Blut und Urin: Relevanz in Diagnose und Therapie alkoholbezogener Störungen

Direct Ethanol Metabolites. Currently available biological state markers of alcohol intake are limited in two basic respects: (1) Their time spectra are limited to only recent intake (e.g. serum ethanol detects only use within the past several hours) or long-term, chronic intake through measurement of adverse consequences of heavy drinking on end-organ functioning (gamma glutamyl transpeptidase [GGT], mean corpuscular volume [MCV]) and (2) a variety of confounds due to age, gender, other ingested substances and non-alcohol-associated diseases. In light of the limitations of these currently available markers, direct ethanol metabolites, positive only after ethanol intake, have gained interest. These markers include ethyl glucuronide (EtG), ethyl sulfate (EtS), phosphatidylethanol (PEth) and fatty acid ethyl esters (FAEEs). Each of these measures is positive in serum or urine for a characteristic time spectrum after the cessation of ethanol intake: EtG and EtS in urine up to 7 days, PEth in whole blood for 2–3 weeks. Additionally, EtG and FAEE can be detected in hair for months. Complementary use of these markers together with other biological state markers and self report measures is expected to lead to significant improvement in treatment outcome, therapy efficacy, and reduction of health, social and socio-economic consequences of excessive alcohol consumption. J Neurol Neurochir Psychiatr 2009; 10 (3): 82–5.