ArticleHepatic medicine : evidence and research2023
Confounders of Serum Phosphatidylethanol: Role of Red Blood Cell Turnover and Cirrhosis.
Article in Hepatic medicine : evidence and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 12 citations in OpenAlex.
- Alcohol-aware risk stratification and subtype-specific care pathways across metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction and alcohol-associated liver disease, and alcohol-associated liver disease.Clinical and molecular hepatology · 2026Review
- Exploring Phosphatidylethanol Cutoffs for Self-Reported Unhealthy Alcohol Use: An International Multi-Site Analysis.Alcohol, clinical & experimental research · 2026Article
- Validation of blood phosphatidylethanol as an alcohol consumption biomarker in patients with alcohol use disorder and liver disease at a liver transplant center.Alcohol, clinical & experimental research · 2025Article
- Phosphatidylethanol and ethyl glucuronide to categorize alcohol consumption in alcohol-related cirrhosis.JHEP reports : innovation in hepatology · 2025Article
- Editorial: Revolutionising Steatotic Liver Disease Diagnosis With Phosphatidylethanol-Authors' Reply.Alimentary pharmacology & therapeutics · 2025Article
- Utilising paired measurements of phosphatidylethanol to monitor early success in alcohol abstinence.Drug and alcohol review · 2025Article
- Alcohol-Associated Liver Disease Outcomes: Critical Mechanisms of Liver Injury Progression.Biomolecules · 2024Review
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Ethyl glucuronide (EtG), ethyl sulfate (EtS) and phosphatidylethanol (PEth) are considered specific direct biomarkers for detecting alcohol consumption. However, PEth, which is produced in red blood cells (RBC), varies considerably between patients for unknown reasons. We here studied various confounders of PEth elimination including fibrosis after alcohol withdrawal. Patients and Methods: EtG, EtS and PEth together with routine laboratory and clinical parameters were studied in 100 Caucasian heavy drinkers prior and after alcohol detoxification. In addition, fibrosis stage and degree of steatosis were assessed by transient elastography (Fibroscan, Echosens, Paris). Results: All three biomarkers were highly correlated (0.61-0.72) with initial serum alcohol levels, but only PEth correlated with daily alcohol consumption. After alcohol withdrawal, PEth significantly decreased within 6.1 days from 1708 to 810 ng/mL (half-life varied from 1.6 to 15.2 days). Both levels of serum alcohol but also EtG and EtS were higher in patients with liver cirrhosis as compared to patients without fibrosis despite comparable alcohol consumption suggesting a decreased alcohol elimination in patients with cirrhosis. PEth was also elevated in cirrhosis but not significantly. In contrast, PEth elimination rate was significantly higher in patients with enhanced RBC turnover and signs of alcohol-mediated hemolytic anemia with elevated ferritin, LDH and increased mean corpuscular volume (MCV). Conclusion: We here demonstrate that alcohol elimination is decreased in patients with liver cirrhosis. In patients with cirrhosis, PEth levels are both affected in opposite directions by enhanced red blood cell turnover and elevated alcohol levels. Our data have important implications for the use and interpretation of PEth in the clinical setting.
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