The non-alcoholic fatty liver (NAFLD) is an aquired metabolic liver disease as a consequence of triglyceride accummulation within the liver cells. It is accompanied by necrobiotic inflammatory reaction, fibrosis and also by liver cirrhosis. Its differentiation from alcoholic fatty liver (AFLD) looks sometimes to be difficult. It is simple knowing the clear anamnesis, but if the individual does not want to inform us about the alcohol consumption, the differentiation is not very easy.
Aim of the study: The aim was to determine the value of carbohydrate deficient transferrin (CDT) in patients with non-alcoholic fatty liver, as well as to analyse the high values according to the anamnesis.
Patients and methods: The group of patients consisted of 39 individuals, whose ultrasound examination showed the signs characteristic of fatty liver. The sex rate was: 21 female and 18 male patients. The values of CDT, body mass index (BMI) and HOMA index were determined. The mean value of CDT was: 239±0,52% (in male 2.51±0.61, in female 2.28±0.4). No significant difference was found between the two sexes. The diversity of CDT values was normal. The value of BMI belonged to the overweight area without any significant difference between the two sexes.
Conclusion: On the basis of the results the NAFLD and the AFLD can be diffenrentiated according to the CDT value, and this value could be a higher specific value than the activity of gammaglutamyl transpeptidase, though also in this relation the valuations of anamnesis and other factors are very important for achieving the correct diagnosis.
[1]. E. Bugianesi J. McCullough G. Marchesini 2005 Insulin Resistance: A metabolic pathway to chronic liver disease Hepatology 5 987–1000.
[2]. O. James C. Day 1998 Steatohepatitis:a tale of two hits? Gastro enterology 114 842–845.
[3]. P. Angulo J. Keach K. Batts et al.1999 Independent predictors of liver fibrosis in patients with non-alcoholic steatohepatitis Hepatology 30 1356–1362.
[4]. J. Fehér G. Lengyel A. Blázovics 1998 Oxidative stress in the liver and biliary tract diseases Scand. J. Gastro enterol. 33. Suppl. 228–238.
[5]. U. Behrens T. Worner L. Braly et al.1988 Carbohydrate-deficient transferrin, a marker for chronic alcohol consumption in different ethnic populations Alkohol Clin Exp.Res. 12 427–432.
[6]. M. Rubio J. Caballera R. Deulofen et al.1997 Carbohydrate-Deficient Transferrin as a Marker of Alcohol Consumption in Male Patients with Liver Disease Alcoholism: Clin. Exp. Res. 21 5 923.
[7]. M. Salaspuro 1999 Carbohydrate-deficient transferrin as ompared to other markers of alcoholism: a systematic review Alcohol 19 261–271.
[8]. J. P. Bergström A. Helander 2008 Influence of alcohol use, ethnicity, age, gender, BMI and smoking on the serum transferrin glycoform pattern: Implications for use of carbohydrate -deficient transferrin (CDT) as alcohol biomarker Clin.Chim. Acta 388 59–67.
[9]. Gy. Szabó L. Környei E. Keller et al.2007 The value of carbohydrate deficient transferrin in the Hungarian population according to the sex and age (in Hung.) Orv. Hetil. 30 1405–1409.
[10]. D. E. Heggli A. Aurebekk B. Granum et al.1996 Should tri-sialo-transferrins be included when calculating carbohydrate-deficient transferrin for diagnosing elevated alcohol intake? Alcohol 31 381–384.
[11]. T. M. De Feo S. Fargion L. Duca et al.1999 Carbohydrate-deficient transferrin, a sensitive marker of chronic alcohol abuse, is highly influenced by body iron Hepatology 29 658–663.
[12]. O. Niemela 2007 Biomarkers and alcoholism Clin. Chim. Acta 377 39–49.
[13]. H. Gjerde J. Johnsen G. E. Bjoerneboe J. Moerland 1988 A comparison of serum carbohydrate-deficient transferrin with other biological markers of excessive drinking Scand. J. Clin. Lab. Invest. 48 1–6.
[14]. J. Fehér G. Lengyel Gy. Szabó 2006 Carbohydrate-deficient transferrin as the marker of alcohol consumption (in Hung.) Orv. Hetil. 147 1915–1920.
[15]. H. Stibler J. Jaecken 1990 Carbohydrate deficient serum transferrin in a new systemic hereditary syndrome Arch. Dis. Child. 65 107–111.
[16]. I. Murawaki H. Sugisaki I. Yuasa 1997 Serum carbohydrate-deficient transferrin in patients with nonalcoholic liver disease and with hepatocellular carcinoma Clinica Chimica Acta 259 97–108.
[17]. H. Myrick S. Henderson R. Anton 2001 Utility of a new assay for carbonhydrate-deficient transferrin (BIORAD %CDT TIA to monitor abstinence during treatment outcome study Alcohol Clin. Exp. Res. 25 1330–1334.
[18]. H. Koch G. Meerkerk J. Zaat et al.2004 Accuracy of carbonhydrate transferrin in the detection of excessive alkohol consumption: Systematic rewiev Alcohol Alcohol. 39 75–85.
[19]. F. Henry F. Froehlich R. Perret et al.1999 Microheterogenity of serum glycoproteins in patients with chronic alcohol abuse compared with carbonhydrate-deficient glycoprotein syndrome type I Clin. Chem. 45 1408–1413.
[20]. H. Bell C. C. M. Tallaksen E. Haug K. Try 1994 A comparison between two commercial methods for determining carbohydrate deficient transferrin (CDT) Scand. J. Clin. Lab. Invest. 54 453–457.
[21]. Y. Xin A. S. Rosman J. M. Lasker C. S. Lieber 1992 Measurement of carbohydrate-deficient transferrin by isoelectric focusing/western blotting and by micro anion-exchange chromatography/radioimmunoassay: comparison of diagnostic accuracy Alcohol Alcohol 27 425–433.
[22]. H. Bell C. M. E. Tallaksen K. Try E. Haug 1994 Carbohydrate-deficient transferrin and other markers of high alcohol consumption: A study of 502 patients admitted consecutively to a medical department Alcohol Clin. Exp. Res. 18 1103–1108.
[23]. P. Sillanaukee N. Massot P. Jousilahti et al.2000 Dose response of laboratory markers to alcohol consumption in a general population Am. J. Epidemiol. 152 747–751.
[24]. Gy. Szabó E. Keller L. Környei et al.2008 The results of carbohydrate-deficient transferrin after occupational compound exposition (in Hung.) Orv. Hetil. 149 413–417.
[25]. K. Viitala 1998 Carbohydrate-deficient transferrin (CDT) and serum antibodies against acetaldehyde adducts as markers of alcohol abuse Acta Universitatis Ouluensis Medica Oulu.
[26]. D. Steiskal V. Ruzicka G. Fanfrdlova et al.2005 High adiponectin and TNF-alfa levels in moderate drinkers suffering for liver steatosis: comparison with non-drinkers suffering from similar hepatopathy Biomed. Papers 149 93–99.
[27]. P. C. Sharpe R. McBride G. P. Archbold 1996 Biochemical markers of alcohol abuse QJM 89 137–144.
[28]. B. Hock M. Schwarz I. Domke et al.2005 Validity of carbohydrate-deficient transferrin (%CDT), gamma-glutamyltransferase (gamma-GT) and mean corpuscular erythrocyte volume (MCV) as biomarkers for chronic alcohol abuse: a study in patients with alcohol dependence and liver disorders of non-alcoholic and alcoholic origin Addiction 100 1477–1486.
[29]. T. Ohtsuka Tsutsumi et al.2005 Use of Serum Carbohydrate-Deficient Transferrin Values to Exclude Alcoholic Hepatitis from Non-Alcoholic Steatohepatitis: A Pilot Study Proceedings of the 24th Meeting of the Japanese Society for Biomedical Research on Alcohol, Naza, Japan, March 3–4, 2004 Clinical & Experimental Research Alcoholism 236S–239S.