Biomarkers in Alcohol Use Disorder

Öz

In recent years, significant advances have been made in the biological assessment of heavy alcohol use. These advances include the development of new laboratory tests, the formulation of algorithms to combine results across multiple measures, and broader applications of biomarkers in alcohol use disorder treatment and research. Alcohol drinking is arguably the oldest social habit worldwide, is highly prevalent in many cultures, and contributes significantly to the global burden of health and social problems. Although many studies have been published on scientific platforms about biomarkers for the detection of alcohol use disorder, a few basic questions remain. First of all, dose-response relationships need to be specified. In screening for alcohol problems, there may be some “questioning of suspicion” before a particular biomarker is used. This questioning of suspicion involves an inadequate self-report or equivocal findings on clinical examination. Findings: While biomarkers are subject to many of the usual psychometric issues regarding validity and reliability, the considerations for their evaluation are different. Instead, the main criteria for evaluating biomarkers are; Criterion validity is concerned with stability, test-retest consistency, and reliability in clinical interpretation. This performance information is also valid for new reagents such as CDT (Carbonhydrate Deficient Transferrin), especially for which fully automated testing procedures have been developed. With the use of biomarkers, the analytical approach in clinical decision-making becomes clearer. Therefore, it is critical to measure the increasing information value of biomarkers and to search for effective algorithms. This article specifically addresses general issues regarding biomarkers used as diagnostic-screening tests.

Anahtar Kelimeler

• CDT
• GGT
• ethylglucuronid
• alcoholism
• biomarker

Alkol Kullanım Bozukluğunda Biyobelirteçler

Öz

Son yıllarda, ağır alkol kullanımının biyolojik olarak değerlendirilmesinde önemli ilerlemeler kaydedilmiştir. Bu ilerlemeler, yeni laboratuvar testlerinin geliştirilmesini, sonuçları birden fazla ölçüm üzerinde birleştirmek için algoritmaların formüle edilmesini ve alkol kullanım bozukluğu tedavisi ve araştırmasında biyobelirteçlerin daha kapsamlı uygulamalarını içermektedir. Alkol alımı, muhtemelen dünya çapındaki en eski sosyal alışkanlıktır, birçok kültürde oldukça yaygındır ve sağlık ve sosyal sorunların küresel yüküne önemli ölçüde katkıda bulunur. Alkol kullanım bozukluğu tespitine yönelik biyobelirteçler hakkında yayınlanan çok sayıda çalışmalar bilimsel platformlarda yer almasına rağmen, halen birkaç temel soru devam etmektedir. Herşeyden önce, doz-yanıt ilişkilerinin belirtilmesi gerekir. Alkol sorunlarının taranmasında, belirli bir biyobelirteç kullanılmadan önce belirli bir “şüphe sorgulaması” olabilir. Bu şüphe sorgulaması, kişinin yetersiz bir öz bildirimi veya klinik muayenede belirsiz bulgular içerir. Biyobelirteçler, geçerlilik ve güvenilirlikle ilgili olağan psikometrik konuların çoğuna tabi olsa da, değerlendirmeleriyle ilgili hususlar farklıdır. Bunun yerine, biyobelirteçlerin değerlendirilmesindeki başlıca kriterler; ölçüt geçerliliği, kararlılık, test-tekrar tutarlılığı ve klinik yorumlamada güvenilirlik ile ilgilidir. Bu performans bilgileri, özellikle tam otomatik test prosedürlerinin geliştirildiği CDT (Carbonhydrate Deficient Transferrin) gibi yeni belirteçler için de geçerli durumdadır. Biyobelirteçlerin kullanımı ile klinik karar vermedeki çözümsel yaklaşım daha netlik kazanmaktadır. Bu nedenle biyobelirteçlerin artan bilgi değerini ölçmek ve beraberinde etkili algoritmaların araştırılması kritik öneme sahiptir. Bu makalemiz özellikle tanısal-tarama testi olarak kullanılan biyobelirteçlerle ilgili genel konuları ele almaktadır.

Anahtar Kelimeler

• biyobelirteç
• CDT
• alkolizm
• Etil glukuronid

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