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Alkoholkonsummarker

Markers of ethanol consumption

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Zusammenfassung

Alkoholkonsummarker sind im Körper gebildete Stoffe, die eine stattgehabte Alkoholaufnahme anzeigen. Diese Biomarker der Äthanolaufnahme sind bei unverändert hohem Alkoholkonsum in der Bevölkerung für klinische, forensische und verkehrsmedizinische Fragestellungen von hoher Relevanz. Während vormals nur die indirekten Marker wie „carbohydrate deficient transferrin“, γ-Glutamyltransferase und mittleres korpuskuläres Erythrozytenvolumen zur Diagnostik herangezogen wurden, wird in jüngerer Zeit den direkten Konsummarkern vermehrt Beachtung geschenkt. Die indirekten Marker setzen längerfristig gesteigerten Alkoholkonsum voraus, da sie z. B. eine Zellschädigung oder eine Enzyminduktion anzeigen und dadurch Hinweise auf eine übermäßige Alkoholaufnahme geben. Ein geringer Prozentsatz des aufgenommenen Äthanols wird nichtoxidativ in einer Phase-II-Reaktion durch Kopplung an körpereigene Substanzen, wie z. B. Glukuronsäure oder Phosphatidylcholin, verstoffwechselt. Die dadurch gebildeten Verbindungen stellen direkte Alkoholkonsummarker dar, die teilweise bereits nach Konsum kleinster Mengen Äthanols entstehen. Die Einsatzmöglichkeiten der Alkoholkonsummarker sind vielfältig. Hohe Markerkonzentrationen lassen eine Früherkennung von Alkoholmissbrauch und -abhängigkeit zu und dienen auf diesem Wege der Gesundheitsfürsorge. In der Arbeitsmedizin steht die Unfallvermeidung im Vordergrund; in der Verkehrsmedizin und im Rahmen von Alkoholentwöhnungstherapien wird anhand der Marker eine geforderte Abstinenz überprüft.

Abstract

Ethanol consumption markers are formed endogenously and are indicative of the ingestion of ethanol. Due to the high and wide-spread ethanol consumption in the population these biomarkers are of high relevance for clinical and forensic questions as well as issues of traffic medicine. In former times the so-called indirect markers, such as carbohydrate-deficient transferrin, γ-glutamyltransferase and mean corpuscular volume were mainly used for diagnostic purposes but nowadays more attention is paid to the direct markers. Long-term increased intake of ethanol causes abnormal concentrations and deviations of indirect markers because they indicate cell damage or enzyme induction and therefore evidence of excessive ethanol consumption. In contrast direct markers are metabolites of ethanol itself and are formed in a non-oxidative phase II reaction by conjunction of ethanol and endogenous substances such as glucuronic acid or phosphatidylcholine. Some direct markers even occur after the uptake of trace amounts of ethanol. The use of ethanol consumption markers is manifold and high marker concentrations can contribute to an early diagnosis of ethanol misuse and dependency. In the field of occupational health markers of consumption of ethanol are applied to prevent accidents. In traffic medicine and in withdrawal therapy the markers are used for monitoring alcohol abstinence therapy and treatment adherence.

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  1. Institut für Rechtsmedizin, Universitätsklinikum Freiburg, Albertstr. 9, 79104, Freiburg, Deutschland

    A. Thierauf, M. Große Perdekamp, W. Weinmann & V. Auwärter

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  1. A. Thierauf
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  2. M. Große Perdekamp
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  3. W. Weinmann
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  4. V. Auwärter
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Correspondence to A. Thierauf.

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Thierauf, A., Große Perdekamp, M., Weinmann, W. et al. Alkoholkonsummarker. Rechtsmedizin 21, 69–79 (2011). https://doi.org/10.1007/s00194-010-0729-6

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  • DOI: https://doi.org/10.1007/s00194-010-0729-6

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