Carbohydrate-deficient transferrin (CDT) and heavy alcohol consumption.

Alcohol abuse is an important social problem potentially leading to isolation, physical consequences and severe pathologies. Alcohol intoxication is correlated to car accidents, injuries and violence. Developing effective strategies to prevent, diagnose and treat alcohol abuse is therefore a social and medical priority. CDT is considered the most specific biomarker of chronic alcohol abuse. In this review, after a short introduction on CDT biochemistry and metabolism, pre-analytical, analytical and post-analytical phases of its measurement are discussed. Given the availability of several methods to measure CDT, including HPLC, capillary electrophoresis and immunoassays, their analytical performances are briefly summarized. The lack of CDT standardization led to the creation of a working group under the IFCC to define the target analyte, select and validate a reference method and establish procedures for the production of reference materials. Preliminary results and critical problems related to the standardization process are discussed. Finally, sensitivity and specificity of CDT to detect heavy alcohol intake, cut-off estimate and data interpretation are reviewed.