Kan örneklerinde dört farklı etanol biyobelirtecinin eş zamanlı tayini: 257 postmortem örnek ile adli toksikolojide kullanılmak üzere geliştirilen ve doğrulanan bir yöntem

Year 2024, Volume: 49 Issue: 3, 688 - 695, 30.09.2024

Göksun Demirel , Yeter Erol Öztürk

https://doi.org/10.17826/cumj.1490327

Abstract

Amaç: Etil alkol en yaygın ve yasal olarak erişilebilen intoksikan maddedir. Ancak aşırı tüketimi, önemli sağlık riskleri de dahil olmak üzere çok sayıda olumsuz sosyal sonuçla ilişkilidir. Alkol kullanımının hızlı ve basit bir şekilde teşhis edilmesi, uygun ve etkili tedavinin başlatılması için gereklidir ve adli toksikolojik analizlerde kritik öneme sahiptir. Etanol biyobelirteçleri alkol kullanım bozukluklarının tespiti, teşhisi ve tedavisinde klinik faydaya sahiptir.
Gereç ve Yöntem: Adli vakalardan alınan kan örneklerinde dört farklı alkol biyobelirteci olan etil glukuronid (EtG), etil sülfat (EtS), N-asetiltaurin (NAcT) ve 16:0/18:1- fosfatidil etanolün (PEth) eşzamanlı tayini için bir analitik yöntem geliştirilmiş, alkol kötüye kullanımı ve bağımlılığının doğru bir şekilde izlenmesi için doğrulanmış ve onaylanmıştır. Analizler sıvı kromatografi-kütle spektrometresi sistemi kullanılarak gerçekleştirilmiştir.
Bulgular: Türkiye Adli Tıp Kurumu'ndan yaşları 16-80 arasında değişen (ortalama 44±14.82) 255 erkek ve 2 kadın olgudan 257 kan ve vitreus örneği toplanmış ve etanol biyobelirteçleri ve hesaplanan etanol konsantrasyonları için analiz edilmiştir. Toplam 257 kan örneğinin etanol içerdiği ve konsantrasyonlarının 12.0 ila 444.0 mg/dL arasında değiştiği tespit edilmiştir. Vitreus konsantrasyonları 23 mg/dL ile 597 mg/dL arasında değişmektedir. Kan örneklerinde EtG, EtS, NAcT ve PEth için tespit limiti (LOD) sırasıyla 3,1, 3,9, 7,3 ve 5,7 ng/mL idi. EtG, EtS, NAcT ve PEth için miktar belirleme limiti (LOQ) kan örneklerinde sırasıyla 7,8, 8,4, 18,3 ve 13,1 ng/mL'dir.
Sonuç: Geliştirilen yöntem, farklı biyolojik örneklerde alkol kullanımı ve bağımlılığının biyobelirteçlerinin doğru ve eş zamanlı tanımlanması için adli toksikolojide değerli bir araç olarak potansiyel taşımaktadır.

Keywords

Etil glukuronid (EtG), Etil sülfat (EtS), N-asetiltaurin (NAcT) 16:0/18:1- fosfatidiletanol (PEth), Alkol biyobelirteçleri

Ethical Statement

Ethical approval was obtained by the Ethics Committee of the Cukurova University (approval number: 129/06.01.2023).

Simultaneous determination of four ethanol biomarkers in blood: avalidated method for use in forensic toxicology in 257 postmortem samples

Abstract

Purpose: Ethyl alcohol is the most widely and legally available intoxicating substance. However, excessive consumption is associated with numerous negative social consequences, including the potential for significant health risks. Rapid and simple diagnosis of alcohol use is necessary to initiate appropriate and effective treatment and is critical in forensic toxicological analysis. Ethanol biomarkers have clinical utility in the detection, diagnosis, and treatment of alcohol use disorders.
Materials and Methods: An analytical method for the simultaneous determination of four different alcohol biomarkers ethyl glucuronide (EtG), ethyl sulphate (EtS), N-acetyltaurine (NAcT), and 16:0/18:1-phosphatidyl ethanol (PEth) in blood samples from forensic cases was developed, validated and verified for the accurate monitoring of alcohol abuse and dependence. Analyses were performed using a liquid chromatography-mass spectrometry system.
Results: 257 blood and vitreous samples were collected from 255 male and 2 female subjects aged 16-80 years (average 44±14.82) from the Forensic Medicine Council of Turkey and analyzed for ethanol biomarkers and calculated ethanol concentrations. A total of 257 blood samples were found to contain ethanol, with concentrations ranging from 12.0 to 444.0 mg/dL. Vitreous concentrations ranged from 23 mg/dL to 597 mg/dL. The limit of detection (LOD) for EtG, EtS, NAcT, and PEth were 3.1, 3.9, 7.3, and 5.7 ng/mL respectively in blood samples. The limit of quantification (LOQ) for EtG, EtS, NAcT, and PEth were 7.8, 8.4, 18.3, and 13.1 ng/mL, respectively in blood samples.
Conclusion: The method has potential in forensic toxicology as an invaluable tool for the accurate and simultaneous identification of biomarkers of alcohol use and dependence in different biological samples.

Keywords

Ethyl glucuronide (EtG), Ethyl sulfate (EtS), N-acetyltaurine (NAcT) 16:0/18:1-phosphatidylethanol (PEth), Alcohol biomarkers

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