Specific markers for chronic alcohol use are carbohydrate-deficient transferrin (CDT) and phosphatidylethanol (PEth). Nonspecific markers include gamma-glutamyl transferase (GGT), mean corpuscular volume (MCV), aspartate aminotransferase (AST), and alanine aminotransferase (ALT).
While no test is accurate 100% of the time, alcohol blood tests are the most accurate method to determine the amount of alcohol in a person's body.
The biochemical markers for chronic alcohol consumption that have been most commonly studied are serum GGT, AST, ALT, mean corpuscular volume (MCV) and carbohydrate-deficient transferrin (CDT)[82-84]. An AST to ALT ratio over 2 is highly suggestive of ALD[85,86].
Gamma-glutamyl transpeptidase test.
This is an enzyme that is made in the liver, pancreas, and biliary tract. This test is often performed to assess liver function, to provide information about liver diseases, and to detect alcohol ingestion.
An elevated level of serum aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) in an alcoholic or a heavy consumer indicates alcohol-induced organ damage. The use of test combinations significantly improves the information received with single serum enzyme determinations.
In typical viral or toxic liver injury, the serum ALT level rises more than the AST value, reflecting the relative amounts of these enzymes in hepatocytes. However, in alcoholic hepatitis, the ratio of AST to ALT is greater than 1 in 90 percent of patients and is usually greater than 2.
An elevated serum AST in relation to serum ALT (alanine aminotransferase) has been proposed as an indicator that alcohol has induced organ damage. Thus, when AST/ALT ratio is >1.5, this is considered as highly suggestive that alcohol is the cause of the patient's liver injury (Correia et al., 1981; Salaspuro, 1987).
Diagnosing alcohol-related liver disease
If a doctor suspects ARLD, they'll usually arrange a blood test to check how well your liver is working. They may also ask about your alcohol consumption. It's important to be totally honest about how much and how often you drink alcohol to avoid further unnecessary testing.
Generally, symptoms of alcoholic liver disease include abdominal pain and tenderness, dry mouth and increased thirst, fatigue, jaundice (which is yellowing of the skin), loss of appetite, and nausea. Your skin may look abnormally dark or light. Your feet or hands may look red.
Alcohol: Alcohol can affect blood sugar and fat levels, giving inaccurate results to blood tests that require fasting. If a person is being asked to fast before a blood test, they should also refrain from drinking alcohol. Smoking: Smoking can also affect blood test results.
The first stage of alcoholic liver disease is hepatic steatosis, which involves the accumulation of small fat droplets under liver cells approaching the portal tracts. More advanced disease is characterized by marked steatosis, hepatocellular necrosis, and acute inflammation, known as alcoholic hepatitis.
Alcohol Related Cirrhosis: The most serious form of ALD, it occurs when the entire liver is scarred, causing the liver to shrink and harden. This can lead to liver failure. Usually the damage cannot be reversed. Between 10 to 20 percent of heavy drinkers develop cirrhosis typically after 10 or more years of drinking.
Fatty liver is most commonly diagnosed by a routine liver function test drawn from your blood. The alanine aminotransferase (ALT) is a specific marker for liver inflammation and is typically elevated in individuals with a fatty liver.
Acute liver failure can develop quickly in an otherwise healthy person, and it is life-threatening. If you or someone you know suddenly develops a yellowing of the eyes or skin; tenderness in the upper abdomen; or any unusual changes in mental state, personality or behavior, seek medical attention right away.
Acute liver failure causes fatigue, nausea, loss of appetite, discomfort on your right side, just below your ribs, and diarrhea. Acute liver failure is a serious condition. It requires medical care right away. If treatments are not effective, you may be a candidate for a liver transplant.
Liver failure occurs when your liver isn't working well enough to perform its functions (for example, manufacturing bile and ridding your body of harmful substances). Symptoms include nausea, loss of appetite, and blood in the stool. Treatments include avoiding alcohol and avoiding certain foods.
Gamma–Glutamyltransferase
Elevated serum GGT level remains the most widely used marker of alcohol abuse. Levels typically rise after heavy alcohol intake that has continued for several weeks (Allen et al. 1994).
Liver enzymes are typically elevated, and tests of liver function may be abnormal. Up to 35% of heavy drinkers develop alcoholic hepatitis, and of these 55% already have cirrhosis. AH can be mild or severe. Mild AH may be reversed with abstinence.
An ALT test result of >100 IU/l is a clear indicator of serious liver disease, but a mildly elevated ALT result (30–100 IU/l) is often ascribed to the use of medication (for example statins) or alcohol, obesity, or, for lower ALT levels (<50 IU/l), considered as part of the normal distribution of test results.
Avoiding alcohol, smoking, and environmental toxins. Alcohol can increase damage to the liver, so people with high ALT levels should avoid consuming alcohol to protect the liver from further damage.
Findings In this cross-sectional study of 1519 participants, high-intensity binge drinking was associated with increased cholesterol, triglyceride, and liver function enzyme levels.
Each time your liver filters alcohol, some of the liver cells die. The liver can develop new cells, but prolonged alcohol misuse (drinking too much) over many years can reduce its ability to regenerate. This can result in serious and permanent damage to your liver. ARLD is common in the UK.