Validated fluorimetric HPLC analysis of acetaldehyde in hemoglobin fractions separated by cation exchange chromatography: three new peaks associated with acetaldehyde

Alcoholic macrocytosis--is there a role for acetaldehyde and adducts?

Although alcohol abuse is known to cause a wide array of adverse effects on blood cell formation, the molecular mechanisms by which alcohol exerts its toxic actions have remained poorly defined. Elevated mean corpuscular volume (MCV), macrocytosis, is the most typical morphological abnormality induced by excessive ethanol consumption. This paper reviews recent data indicating that acetaldehyde, the first metabolite of ethanol, may play a role in the haematological derangements in peripheral blood cells and in bone marrow of alcoholic patients. Studies in experimental animals and in human alcoholics have shown that acetaldehyde can bind to proteins and cellular constituents forming stable adducts. Elevated adduct levels have been found from the erythrocytes of alcohol abusers, which may also be associated with ethanol-induced effects in haematopoiesis and adverse consequences in cellular functions.

Chromatographic methods for the determination of markers of chronic and acute alcohol consumption

The development in chromatographic methods for the determination of markers of alcohol consumption is summarized in this review. The markers included in this article are ethanol in body fluids, ethanol congeners, fatty acid ethyl esters (FAEEs), ethyl glucuronide (EtG), cocaethylene (CE), carbohydrate-deficient transferrin (CDT), phosphatidylethanol (PEth), 5-hydroxytryptophol (5-HTOL), dolichol, ketone bodies, acetaldehyde-protein adducts, and salsolinol (SAL). Some of these markers for alcohol consumption do not only indicate previous ethanol ingestion, but also approximate the amount of intake and the time when ethanol ingestion last occurred. Basic information about the procedures, work-up, and chromatographic conditions are summarized in tables. Also the main metabolic pathways and reaction schemes are demonstrated in figures. Some examples of typical applications are presented. The author points out that in many of the reviewed papers validation data of the procedures as well as specificities and sensitivities were not clearly presented and consequently were not comparable.

Prevalence of ethanol consumption may be higher in women than men in a university health service population as determined by a biochemical marker: whole blood-associated acetaldehyde above the 99th percentile for teetotalers

To estimate ethanol consumption by university students attending a student health facility, a biochemical marker of alcohol intake [whole blood associated acetaldehyde (WBAA)] was quantified by fluorimetric HPLC. Over a two year period we studied blood samples, coded by date and sex, from 645 females and 332 males, and compared the results to previously established reference ranges for teetotalers by sex. Men had higher absolute values for WBAA than women (9.9 versus 9.5 microM in the present study). However, significantly greater numbers of women (74%) than men (44%) had WBAA levels above the 99th percentile for teetotalers. Variations occurred during the academic year, with significant elevations occurring in the late fall and winter months. Testing of WBAA levels in a student health service may be important especially for women to facilitate counseling on the dangers of alcohol abuse.

What is hemoglobin A1c? An analysis of glycated hemoglobins by electrospray ionization mass spectrometry

Hemoglobin A1c (HbA1c) is a stable minor Hb variant formed in vivo by posttranslational modification by glucose, originally identified by using cation exchange chromatography, and containing primarily glycated N-terminal β-chains. However, the structure(s) of the quantified species has not been elucidated, and the available methods lack a reference standard. We used electrospray ionization mass spectrometry to determine the extent of glycation of samples separated by boronate affinity and/or cation exchange chromatography. Analyses of clinical samples were consistent with the curvilinear relationship of patient glucose and HbA1c. As glycation increased, the ratio of β-chain to α-chain glycation increased, and the number of glycation sites on the β-chain increased, although these were relatively minor components. We found several glycated species that cochromatographed with HbA1c on cation exchange, including species with both glycated α- and β-chains, nonglycated α- and glycated β-chains, and multiply glycated β-chains. The combined use of affinity and cation exchange chromatography with structural confirmation by electrospray ionization mass spectrometry was found to be useful in producing samples of sufficient purity for the standardization of glycohemoglobin clinical assays.

Determination of biological markers for alcohol abuse

Alcoholism is one of the most frequent addictions and an important subject in forensic medicine and clinical toxicology. Several laboratory abnormalities are associated with excessive alcohol consumption. They are useful in the diagnosis of alcoholism especially during the follow-up of various treatment programs. The biological markers mostly used for diagnosis of alcoholism are presented. Especially, methods for the determination of the following diagnostic tools are reviewed: congener alcohols, gamma-glutamyltransferase, aspartate and alanine aminotransferase, beta-hexosaminidase, erythrocyte aldehyde dehydrogenase, alpha-amino-n-butyric acid to leucine ratio, macrocytosis, carbohydrate-deficient transferrin, (apo)lipoproteins, fatty acid ethyl esters, blood acetate, acetaldehyde adducts, 5-hydroxytryptophol, dolichol and condensation products. No laboratory test exists that is reliable enough for the exact diagnosis of alcoholism. The combination of physician interview, questionnaire and laboratory markers is necessary for the diagnosis of alcoholism.

Chromatographically identified alcohol-induced haemoglobin adducts as markers of alcohol abuse among women

BACKGROUND

Alcohol-induced changes in haemoglobin have been suggested as potential biochemical markers of alcohol abuse. In this study, we investigated the diagnostic value of alcohol-induced haemoglobin adducts among women.

METHODS

Whole (Hb fractions) and affinity-purified (AHb fractions) haemolysates from 87 women in three groups (a) social drinkers (n=31), (b) heavy drinkers (n=27) and (c) alcoholic subjects (n=29) - were analysed by HPLC-CEC.

RESULTS

Three fractions (HbA 1a2, HbA1dl and AHbA1d1) showed significant differences (P<0.05) between the groups and a significant positive correlation (P<0.05) with self-reported alcohol consumption (r=0.58-0.76) as determined by the Malmö modified Michigan Alcoholism Screening Test (MmMAST) and structured CAGE questionnaire (r=0.58-0.76). HbA1a2, HbA1d1 and AHbA1d1 had specificities of 97%, 97% and 100% respectively and detected 41%, 33% and 78% of heavy drinkers with overall accuracies (OAs) of 71%, 67% and 90%. Sensitivities in the detection of alcoholic subjects were 86% (OA=92%), 76% (OA=87%) and 81 % (OA=91%) respectively. The fractions had higher OAs than traditional markers of alcohol abuse.

CONCLUSION

This study indicates that at least three alcohol-induced haemoglobin adducts occurring in vivo can be measured with promising diagnostic efficiency among women.