Determination of Carbohydrate-deficient Transferrin Levels by Using Capillary Electrophoresis in a Korean Population

Hee-Won Moon; Yeo-Min Yun; Serim Kim; Won Hyeok Choe; Mina Hur; Jin Q Kim

doi:10.3343/kjlm.2010.30.5.477

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Moon, Yun, Kim, Choe, Hur, and Kim: Determination of Carbohydrate-deficient Transferrin Levels by Using Capillary Electrophoresis in a Korean Population

Original Article

Korean J Leg Med 2010;30(5):477-484.

Published online: 14 January 2010

DOI: https://doi.org/10.3343/kjlm.2010.30.5.477

Determination of Carbohydrate-deficient Transferrin Levels by Using Capillary Electrophoresis in a Korean Population

Hee-Won Moon, M.D.¹, Yeo-Min Yun, M.D.¹, Serim Kim, M.D.¹, Won Hyeok Choe, M.D.², Mina Hur, M.D.¹, Jin Q Kim, M.D.³

¹Departments of Laboratory Medicine, Seoul, Korea

²Internal Medicine, Konkuk University School of Medicine, Seoul, Korea

³Konkuk University, Seoul, Korea

Corresponding author: Jin Q Kim, M.D. Konkuk University, 1 Hwayang-dong, Gwangjin-gu, Seoul 143-701, Korea Tel: +82-2-2218-5185, Fax: +82-2-2218-5995 E-mail: president@konkuk.ac.kr

^∗ This study was supported by grant No. 21-2003-50 from the Seoul National University Hospital (SNUH) Research Fund.

Revised 16 February 201029 April 2010 Accepted 22 July 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

Carbohydrate-deficient transferrin (CDT) levels have rarely been determined in an Asian population. We evaluated the analytical performance of a test for measuring CDT levels by using capillary electrophoresis (EP).

Methods:

We determined the precision of CDT measurement by using capillary EP and nephelometry and compared the CDT values obtained using both the methods. We included healthy control subjects, abstinent patients with liver disease, and individuals consuming varying amounts of alcohol.

Results:

The CDT measurement by using capillary EP were correlated well with those CDT measurement by using nephelometry, N Latex CDT assay, Y=0.5706X+1.581, R=0.930. The results obtained from both methods showed good qualitative agreement with each other (κ coefficient=0.61). Genetic variants of transferrin isoforms were detected in 4.1% of the tested population. Both the CDT and γ-glutamyl transpeptidase (GGT) levels in the abstinent patients with liver disease were significantly higher than those in healthy abstinent individuals (0.9% vs. 0.5%, 109.5 mg/dL vs. 28.5 mg/dL, respectively), but the difference in CDT values in the 2 groups was less pronounced for the CDT values. Individuals who had a mean daily alcohol intake of more than 60 g/day showed significantly higher CDT levels than those who had a mean daily alcohol intake of less than 60 g/day (1.9% vs. 0.7%, P=0.03).

Conclusions:

The CDT test using capillary EP showed good performance, and this method has several advantages such as automation and detection of variant forms. Thus, CDT can be a more useful marker than GGT for monitoring alcohol abstinence, especially in patients with liver disease.

Keywords: CDT, Capillary electrophoresis, Liver disease

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Fig. 1.

Correlation (A) and difference (B) between %CDT levels by capillary electrophoresis and N Latex CDT method. Abbreviation: CDT, carbohydrate-deficient transferring.

Fig. 2.

Distribution of %CDT using capillary electrophoresis (A) and GGT (B) in healthy abstinent individuals and abstinent patients with liver disease.

Abbreviations: CDT, carbohydrate-deficient transferrin; GGT, γ-glutamyl transpeptidase.

Fig. 3.

Receiver operating characteristic curves of %CDT using capillary electrophoresis for detection of alcohol consumptions according to each target amount of daily alcohol consumption (A: mean alcohol 40 g/day or more, B: 60 g/day or more, C: 120 g/day or more, N=83).

Abbreviation: AUC, area under ROC curves.

Table 1.

Precision of %CDT using capillary electrophoresis

Analyte	Mean (%)	Within-run precision SD (CV, %)	Total precision SD (CV, %)
Normal control	0.51	0.04 (6.9)	0.03 (6.6)
Abnormal control	6.96	0.13 (1.8)	0.31 (4.5)

Abbreviations: CDT, carbohydrate-deficient transferrin.

Table 2.

Distribution of %CDT using capillary electrophoresis and GGT in healthy abstinent individuals and abstinent patients with liver disease

	Healthy abstinent individuals (N=42)	Abstinent liver disease (N=28)	P value
%CDT
Mean (SD)	0.5 (0.2)	0.9 (0.7)	0.002
Positive rate	0/42 (0.0%)	1/28 (3.5%)	0.217
GGT (mg/dL)
Mean (SD)	28.5 (15.1)	109.5 (75.7)	<0.001
Positive rate	0/42 (0.0%)	8/27 (29.6%)	<0.001

Abbreviations: CDT, carbohydrate-deficient transferrin; GGT, γ-glutamyl transpeptidase.

Table 3.

Distribution of %CDT values according to mean alcohol consumption

Alcohol consumption (g/day)	N of subjects (N=83)	%CDT
Alcohol consumption (g/day)	N of subjects (N=83)	Mean (SD)	Median (range)
<30	46	0.5 (0.2)	0.5(0.0-1.0)
31-60	8	1.2(0.5)	1.0(0.8-2.1)
61-120	15	1.2(0.9)	1.1(0.3-3.8)
>120	14	2.1 (3.2)	1.2(0.6-13.0)
<60	54	0.6 (0.4)	0.6(0.0-2.1)
>60	29	1.7(2.4)	1.2(0.3-13.0)
		∗P=0.034

^∗ Statistical analysis was performed between two groups according to the mean alcohol consumption, <60 g/day vs. >60 g/day.

Abbreviations: CDT, carbohydrate-deficient transferrin.

Table 4.

Distribution of %CDT values according to number of abstinent days

Abstinent day	N of patients	%CDT		P value
Abstinent day	N of patients	Mean (SD)	Median (range)	P value
≤3d	20	2.0 (2.7)	1.1 (0.5-13.0)	0.110∗
≥7d	12	1.0(0.4)	1.0(0.3-1.4)	0.314^†
>7d	12	0.9 (0.3)	1.1 (0.5-1.3)

Statistical analysis was performed for comparison of number of abstinent day ∗<3 d vs. >3 d and

^† <7 d vs. >7 d.

Abbreviations: CDT, carbohydrate-deficient transferrin.

Table 5.

Sensitivities and specificities of %CDT using capillary electrophoresis at different cut-off limits for detecting each amount of mean alcohol consumptions (N=83)

%CDT cut off	Target amount of mean alcohol consumption
	40 g/day or more		60 g/day or more		120 g/day or more
	Sensitivity	Specificity	Sensitivity	Specificity	Sensitivity	Specificity
0.75	76.7%	73.2%	76.7%	63.8%	86.7%	63.3%
0.85	69.8%	85.7%	76.7%	78.3%	86.7%	70.2%
0.95	60.5%	75.0%	70.0%	82.6%	80.0%	75.0%

Abbreviations: CDT, carbohydrate-deficient transferrin.

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