Phosphatidylethanol (PEth); the Superior Direct Alcohol Biomarker against Mean Corpuscular Volume (MCV), Aspartate Amino Transferase (AST), Alanine Aminotransferase (ALT), Gamma-Glutamyl Transferase (GGT) and Carbohydrate-Deficient Transferrin (CDT)

As ethanol itself is metabolised and excreted quickly from the body, assessing alcohol consumption with a blood test relies on other markers indicative of consumption. Traditional tests include Liver Function Testing (LFT), Carbohydrate Deficient Transferrin (CDT) Testing, and a Full Blood Count (FBC). Phosphatidylethanol (PEth) testing, on the other hand, is a direct biomarker of alcohol consumption, can only be detected when alcohol has been consumed, and is directly correlated with the level of alcohol consumed There are some difficulties when testing alcohol in blood to determine if alcohol had been abused. Due to these challenges in testing alcohol consumption behaviours across society, in the most recent decades, intensive research has been conducted to find reliable biomarkers that are efficient enough to discriminate chronic excessive drinking. Initially, the markers are divided into two categories direct and indirect alcohol biomarkers. Indirect biomarkers, which is a secondary biomarker, detect the effects of alcohol on organ systems by measuring the elevated levels of the body chemistry after alcohol consumption. The most commonly used indirect biomarkers are mean corpuscular volume (MCV), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT) and carbohydrate-deficient transferrin (CDT). With the indirect biomarkers, more than one factor (including alcohol) can lead to an elevation in the measured level in blood. Smoking and several Pharmaceutical drugs may increase (induce) the concentration of GGT in the blood. In addition, chronic disease or Vitamin B12/folate deficiencies can increase the mean corpuscular volume (MCV). CDT can also be affected by factors such as hormonal changes and other diseases and deficiencies [1]. Phosphatidylethanol (PEth) is a direct biomarker. The test is not a new method for monitoring alcohol consumption. There are a number of old and new studies that proved the superiority of PEth test over the other indirect blood alcohol markers. PEth exhibits high diagnostic sensitivity and specificity for detecting active chronic excessive drinking behaviours. Phosphatidylethanol (PEth) is produced in the presence of low quantities of alcohol [1]. On average, PEth can be detected for nearly 28 days depending on the consumed amounts [2-4].