Transferrin-Carbohydrate Deficient (TCD): Updating on the most studied and used biochemical marker in the field of alcoholology

Alcohol use and abuse is a important current issue, in addiction it is a social problem leading to isolation, physical consequences and several pathologies. Alcohol intoxication is correlated to accidents, injuries and violence. Developing effective strategies to prevent, diagnose and cure alcohol abuse is a priority as well as to have sure evidences. Carbohydrate-deficient transferrin (CDT) is the most specific biomarker of alcohol abuse. In this review biochemistry, metabolism and definition are showed. Pre-analytical, analytical and post-analytical phases are discussed In this review several CDT applications in hospital , in rehabilitation and in forensic setting are presented. HPLC, CZE and immunoassay methods are presented. The need of standardization of the measurement of CDT is explained, because defining main target analyte, reference method and materials are important to have the same result with different methods. Some criticisms on the standardization process are showed. Diagnostic sensitivity and specificity are discussed and how correctly calculated the cut off and a correct interpretation of data are reported. Guide-lines by SIBioC-GITF are reminded.