Post-mortem data on chronic alcohol abuse can be difficult to obtain due to putrefaction, inadequate background information at time of autopsy, and lack of distinctive pathological characteristics. However, diagnosis of chronic alcohol abuse can aid in death investigations and assist in establishing the cause and the manner of death. A well established biomarker of chronic alcohol abuse is Carbohydrate-Deficient Transferrin (CDT) (Bortolotti, 2006). Transferrin (Tf) is an iron transport serum glycoprotein consisting of two oligosaccharide chains. CDT is a subset of hypoglycosylated isoforms typically losing one or both glycan chains. Consuming 50-80 grams of alcohol a day for at least 7 days increases CDT serum values. After abstinence CDT returns to normal values in about 2-3 weeks. According to a sound body of literature, the diagnostic sensitivity of this marker ranges from 70-80%, while diagnostic specificity is about 100%. CDT value is expressed as percentage ratio of total transferrin; in non alcohol abusers being below 1.8% (Delanghe, 2009). Notwithstanding CDT is a worldwide recognized marker of chronic alcohol abuse, few studies are published on post-mortem applications largely because of the analytical problems caused by the post-mortem blood. The aim of this work was to investigate the possible use of this marker in post-mortem cases, developing an analytical method based on capillary zone electrophoresis suitable for the analysis of post-mortem samples. 498 post-mortem blood samples from the Office of the Chief Medical Examiner (OCME) in Connecticut were obtained with no restrictions. Measurement of CDT was done by capillary zone electrophoresis using a Beckman Coulter ProteomeLab PA 800 using a UV detector at 200 nm in the forward direction. All data was analyzed using 32 Karat software version 7.0. Of the 498 samples, only 72 samples resulted in interpretable electropherograms. CDT value in these samples ranged from 0.43-13.04% (average 2.39%, SD 2.49%). 27 subjects showed CDT values higher than the established cut-off of 1.8% (used to distinguish between normal subjects and alcohol abusers) suggesting a condition of chronic alcohol abuse. Of the 30 cases with anatomo-pathological findings consistent with chronic alcohol abuse, 16 also had an increased %CDT. Moreover, 24 subjects indicated a recent alcohol intake as demonstrated by the determination of blood alcohol content (BAC) (range 0.03-0.41%). Of these subjects, 18 were above the legal limit of 0.08%. Capillary zone electrophoresis of post-mortem samples was useful in evaluating CDT to determine chronic alcohol abuse in autopsy cases.
Determination of Carbohydrate-Deficient Transferrin in Post-Mortem Blood Samples by Using Capillary Electrophoresis: Analytical and Interpretative Issues
Vandoros, Anthula Virginia
2014
Abstract
Post-mortem data on chronic alcohol abuse can be difficult to obtain due to putrefaction, inadequate background information at time of autopsy, and lack of distinctive pathological characteristics. However, diagnosis of chronic alcohol abuse can aid in death investigations and assist in establishing the cause and the manner of death. A well established biomarker of chronic alcohol abuse is Carbohydrate-Deficient Transferrin (CDT) (Bortolotti, 2006). Transferrin (Tf) is an iron transport serum glycoprotein consisting of two oligosaccharide chains. CDT is a subset of hypoglycosylated isoforms typically losing one or both glycan chains. Consuming 50-80 grams of alcohol a day for at least 7 days increases CDT serum values. After abstinence CDT returns to normal values in about 2-3 weeks. According to a sound body of literature, the diagnostic sensitivity of this marker ranges from 70-80%, while diagnostic specificity is about 100%. CDT value is expressed as percentage ratio of total transferrin; in non alcohol abusers being below 1.8% (Delanghe, 2009). Notwithstanding CDT is a worldwide recognized marker of chronic alcohol abuse, few studies are published on post-mortem applications largely because of the analytical problems caused by the post-mortem blood. The aim of this work was to investigate the possible use of this marker in post-mortem cases, developing an analytical method based on capillary zone electrophoresis suitable for the analysis of post-mortem samples. 498 post-mortem blood samples from the Office of the Chief Medical Examiner (OCME) in Connecticut were obtained with no restrictions. Measurement of CDT was done by capillary zone electrophoresis using a Beckman Coulter ProteomeLab PA 800 using a UV detector at 200 nm in the forward direction. All data was analyzed using 32 Karat software version 7.0. Of the 498 samples, only 72 samples resulted in interpretable electropherograms. CDT value in these samples ranged from 0.43-13.04% (average 2.39%, SD 2.49%). 27 subjects showed CDT values higher than the established cut-off of 1.8% (used to distinguish between normal subjects and alcohol abusers) suggesting a condition of chronic alcohol abuse. Of the 30 cases with anatomo-pathological findings consistent with chronic alcohol abuse, 16 also had an increased %CDT. Moreover, 24 subjects indicated a recent alcohol intake as demonstrated by the determination of blood alcohol content (BAC) (range 0.03-0.41%). Of these subjects, 18 were above the legal limit of 0.08%. Capillary zone electrophoresis of post-mortem samples was useful in evaluating CDT to determine chronic alcohol abuse in autopsy cases.File | Dimensione | Formato | |
---|---|---|---|
Thesis 2014 AVV.pdf
accesso aperto
Dimensione
773.87 kB
Formato
Adobe PDF
|
773.87 kB | Adobe PDF | Visualizza/Apri |
I documenti in UNITESI sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
https://hdl.handle.net/20.500.14242/112396
URN:NBN:IT:UNIVR-112396