Phosphatidylethanol in blood as a marker of chronic alcohol use: a systematic review and meta-analysis

Abstract

The present paper aims at a systematic review of the current knowledge on phosphatidylethanol (PEth) in blood as a direct marker of chronic alcohol use and abuse. In March 2012, the search through "MeSH" and "free-text" protocols in the databases Medline/PubMed, SCOPUS, Web of Science, and Ovid/Embase, combining the terms phosphatidylethanol and alcohol, provided 444 records, 58 of which fulfilled the inclusion criteria and were used to summarize the current evidence on the formation, distribution and degradation of PEth in human blood: (1), the presence and distribution of different PEth molecular species (2), the most diffused analytical methods devoted to PEth identification and quantization (3), the clinical efficiency of total PEth quantification as a marker of chronic excessive drinking (4), and the potential utility of this marker for identifying binge drinking behaviors (5). Twelve papers were included in the meta-analysis and the mean (M) and 95% confidence interval (CI) of total PEth concentrations in social drinkers (DAI ≤ 60 g/die; M = 0.288 μM; CI 0.208-0.367 μM) and heavy drinkers (DAI > 60 g/die; M = 3.897 μM; CI 2.404-5.391 μM) were calculated. The present analysis demonstrates a good clinical efficiency of PEth for detecting chronic heavy drinking.

Figure 1

Search strategy and paper selection for inclusion in the systematic review and/or in the meta-analysis.

Figure 2

Schematic representation of the results of the meta-analysis performed on the 12 papers described in Tables 1 and 2. The investigated populations were classified based on daily alcohol intake (DAI): social drinkers (DAI ≤ 60 g/die), and heavy drinkers (DAI > 60 g/die). The black diamond represents the calculated mean and 95% CI for each subgroup. Lower case letters in brackets refer to multiple groups of subjects included in the selected studies (see Table 1).