Alcohol dehydrogenase: An indicator of hepatic damage or a marker in alcohol dependence

Aims: Due to paucity of Indian data on ADH, the study was planned to examine its usefulness as a biological marker for alcohol dependence, and as an indicator of alcoholic liver dysfunction Methods: Seventy alcohol dependent patients and 50 normal healthy control subjects were included. A single point estimation of serum levels of Alcohol Dehydrogenase, Aspartate Amino Tranferase, Alanine Amino Tranferase, and Gamma Glutamyl Transferase was performed. On the basis of severity of liver dysfunction, the study group was divided in 2 subgroups. Results: Alcohol Dehydrogenase levels were higher in patients of alcohol dependence as compared with controls but did not reach the significance levels. Using Gamma Glutamyl Transferase and Aspartate Amino Tranferase as reference standard, levels of Alcohol Dehydrogenase were significantly higher in patients of alcohol dependence with sever liver dysfunction as compared with those without severe liver dysfunction. Stepwise discriminant analysis indicated that Aspartate Amino Tranferase and Gamma Glutamyl Transferase best identified patients of alcohol dependence from normal controls with good diagnostic accuracy. Serum levels of Alcohol Dehydrogenase showed good sensitivity but poor specificity and low kappa value. Conclusion: The study provides evidence for use of serum ADH level as a useful indicator of alcoholic liver dysfunction, but does not support the hypothesis for it being a useful marker for alcohol dependence.