Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta-analysis.
Journal: Alcoholism, clinical and experimental research
Volume: 45
Issue: 6
Year of Publication: 2021
Affiliated Institutions:
Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Center for Global Health, Massachusetts General Hospital, Boston, MA, USA.
National Institute for Medical Research, Mwanza Centre, Mwanza, Tanzania.
Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa.
University of San Francisco, San Francisco, CA, USA.
Department of Social and Behavioral Sciences, NYU School of Global Public Health, New York, NY, USA.
Department of Psychology and Psychiatry and Behavioral Neuroscience, Center for Addiction Research, University of Cincinnati, Cincinnati, OH, USA.
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Department of Psychology, Syracuse University, Syracuse, NY, USA.
Department of Epidemiology, University of Florida, Gainesville, FL, USA.
Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Center for Research Development and Scholarship, Vanderbilt University, Nashville, TN, USA.
University of Illinois at Chicago, Chicago, IL, USA.
Department of Family Medicine, Division of Addiction Medicine, University at Buffalo, Buffalo, NY, USA.
Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, USA.
Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
West Haven VA Healthcare System, United States Department of Veterans Affairs, West Haven, CT, USA.
Yale School of Medicine, New Haven, CT, USA.
National Institutes of Health, National Institute of Alcohol Abuse and Alcoholism, Bethesda, MD, USA.
Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
Abstract summary
Objective measurement of alcohol consumption is important for clinical care and research. Adjusting for self-reported alcohol use, we conducted an individual participant data (IPD) meta-analysis to examine factors associated with the sensitivity of phosphatidylethanol (PEth), an alcohol metabolite, among persons self-reporting unhealthy alcohol consumption.We identified 21 eligible studies and obtained 4073 observations from 3085 participants with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) positive scores (≥3 for women and ≥4 for men) and PEth measurements. We conducted 1-step IPD meta-analysis using mixed effects models with random intercepts for study site. We examined the associations between demographic (sex, race/ethnicity, and age) and biologic (body mass index-BMI, hemoglobin, HIV status, liver fibrosis, and venous versus finger-prick blood collection) variables with PEth sensitivity (PEth≥8 ng/ml), adjusting for the level of self-reported alcohol use using the AUDIT-C score.One third (31%) of participants were women, 32% were African, 28% African American, 28% White, and 12% other race/ethnicity. PEth sensitivity (i.e., ≥8 ng/ml) was 81.8%. After adjusting for AUDIT-C, we found no associations of sex, age, race/ethnicity, or method of blood collection with PEth sensitivity. In models that additionally included biologic variables, those with higher hemoglobin and indeterminate and advanced liver fibrosis had significantly higher odds of PEth sensitivity; those with higher BMI and those living with HIV had significantly lower odds of PEth sensitivity. African Americans and Africans had higher odds of PEth sensitivity than whites in models that included biologic variables.Among people reporting unhealthy alcohol use, several biological factors (hemoglobin, BMI, liver fibrosis, and HIV status) were associated with PEth sensitivity. Race/ethnicity was associated with PEth sensitivity in some models but age, sex, and method of blood collection were not. Clinicians should be aware of these factors, and researchers should consider adjusting analyses for these characteristics where possible.
Authors & Co-authors:
Hahn Judith A JA
Murnane Pamela M PM
Vittinghoff Eric E
Muyindike Winnie R WR
Emenyonu Nneka I NI
Fatch Robin R
Chamie Gabriel G
Haberer Jessica E JE
Francis Joel M JM
Kapiga Saidi S
Jacobson Karen K
Myers Bronwyn B
Couture Marie Claude MC
DiClemente Ralph J RJ
Brown Jennifer L JL
So-Armah Kaku K
Sulkowski Mark M
Marcus Gregory M GM
Woolf-King Sarah S
Cook Robert L RL
Richards Veronica L VL
Molina Patricia P
Ferguson Tekeda T
Welsh David D
Piano Mariann R MR
Phillips Shane A SA
Stewart Scott S
Afshar Majid M
Page Kimberly K
McGinnis Kathleen K
Fiellin David A DA
Justice Amy C AC
Bryant Kendall K
Saitz Richard R
Study Outcome
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