Biochemical evaluation of chronic alcohol abuse within the framework of driver's license regranting

In this thesis, biomarkers for diagnosing and monitoring of chronic alcohol abuse were investigated, with special attention for their performance in a driverU+2019s license regranting program. In Chapter 3, we focused on the use of carbohydrate deficient transferrin (CDT) as a biomarker of chronic alcoholism in rehabilitation research. During 2.5 years CDT results were collected from 3977 drivers. These data were used to evaluate the program and to calculate a cut-off for CDT that is suitable within a forensic context. This study also indicated some imperfections of CDT as a biomarker in about 2% of the drivers. The presence of transferrin (Tf) variants may cause difficulties for accurate quantification of the CDT. In Chapter 4 we have investigated how various commercial methods performed in the presence of Tf variants. We have shown that the different methods are not interchangeable in genetic Tf variants. In addition to the presence of Tf variants, quantification difficulties are also encountered in the presence of paraproteins, liver cirrhosis, etc. ... From this perspective, we have examined the microheterogeneity of U+03B2-hexosaminidase, in concordance to CDT in Chapter 5. By using iso-electric focusing and fluorimetry, we were able to determine deglycosylated U+03B2-hexosaminidase (HEX = 7). We found a good correlation with CDT and the determination of HEX-7 could be useful in those cases where CDT cannot be quantified properly. Chapter 6 deals with the use of indirect alcohol biomarkers for predicting relapse of driving under the influence of alcohol. The ROAD-index was calculated and found to be good predictor of drunkdriving recidivism. This index could help in guiding relicensing decisions and the therapy schemes.

Jaar van publicatie:2013

Toegankelijkheid:Closed