Alcohol Biomarkers

This chapter provides an overview of various alcohol biomarkers (state markers and emerging genetic markers) with an emphasis on the application of these markers in various clinical settings. Traditional state biomarkers of alcohol use are indirect biomarkers, which are elevated in a person consuming moderate to heavy amounts of alcohol. These biomarkers are elevated due to the toxicity of alcohol in a particular organ. For example, liver enzymes such as γ-glutamyl transferase, alanine aminotransferase, and aspartate aminotransferase are elevated after heavy alcohol consumption because alcohol has toxic effects on the liver. Mean corpuscular volume was the first U.S. Food and Drug Administration-approved biomarker of alcohol abuse; carbohydrate-deficient transferrin is also an indirect marker. In addition, serum and urine hexosaminidase and sialic acid are indirect biomarkers of alcohol abuse. Direct biomarkers of alcohol consumption include alcohol metabolites such as ethyl glucuronide and ethyl sulfate or biomolecules derived from the interaction of alcohol with other molecules, such as fatty acid ethyl ester and phosphatidyl ethanol.