Combination of the CAGE and serum gamma-glutamyl transferase: an effective screening tool for alcohol use disorder and alcohol dependence

Young Min Choe,1,2 Boung Chul Lee,2,3 Ihn-Geun Choi,2,4 Guk-Hee Suh,1,2 Dong Young Lee,5 Jee Wook Kim1,21Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi, Republic of Korea; 2Department of Psychiatry, Hallym University College of Medicine, Chuncheon,...

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Autores principales:	Choe YM, Lee BC, Choi IG, Suh GH, Lee DY, Kim JW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	CAGE gamma-glutamyl transferase (GGT) alcohol use disorders identification test (AUDIT) alcohol use disorder (AUD) alcohol dependence (AD) Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/6ce4e2249e504441b8ac2c6bae7a21da
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spelling	oai:doaj.org-article:6ce4e2249e504441b8ac2c6bae7a21da2021-12-02T03:41:21ZCombination of the CAGE and serum gamma-glutamyl transferase: an effective screening tool for alcohol use disorder and alcohol dependence1178-2021https://doaj.org/article/6ce4e2249e504441b8ac2c6bae7a21da2019-05-01T00:00:00Zhttps://www.dovepress.com/combination-of-the-cage-and-serum-gamma-glutamyl-transferase-an-effect-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Young Min Choe,1,2 Boung Chul Lee,2,3 Ihn-Geun Choi,2,4 Guk-Hee Suh,1,2 Dong Young Lee,5 Jee Wook Kim1,21Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi, Republic of Korea; 2Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea; 3Department of Neuropsychiatry, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea; 4Department of Neuropsychiatry, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea; 5Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of KoreaPurpose: The CAGE is a convenient test for alcohol-related disorder due to its brevity, but it is not as effective as the alcohol use disorders identification test (AUDIT). Gamma-glutamyl transferase (GGT) is an objective blood biochemical marker of excessive alcohol intake; however, it has low sensitivity. This study tested the performance of the combined use of CAGE and GGT to screen problem drinking (PD), alcohol use disorder (AUD), and alcohol dependence (AD).Methods: A total of 394 subjects composed of 91 normal controls and 303 subjects with PD were enrolled in this study. Of the PD subjects, 147 were diagnosed with AUD (77 alcohol abuse and 70 AD). A series of multiple logistic regression models for PD, AUD, and AD discrimination were used to obtain new combined CAGE and GGT scores after adjusting for age and gender (CAGE+GGT). A receiver operating characteristic curve analysis was conducted to determine how well the CAGE+GGT score discriminated between individuals with PD, AUD, and AD.Results: The discrimination accuracy of the AUDIT for PD was significantly better than that of the CAGE or the CAGE+GGT (z=6.927, p<0.0001; z=5.301, p<0.0001, respectively). The CAGE and the CAGE+GGT were better than the AUDIT at discriminating AUD (z=2.535, p=0.0112; z=2.894, p=0.0038, respectively). The discrimination accuracy of the AUDIT for AD was significantly better than that of the CAGE and GGT (z=3.233, p=0.0012; z=6.529, p<0.0001, respectively), but the CAGE+GGT was comparable with the AUDIT (z=1.652, p=0.0985).Conclusion: Our findings support the combined use of the CAGE questionnaire and serum GGT level as a sensitive and useful tool for AD screening.Keywords: CAGE, gamma-glutamyl transferase, alcohol use disorders identification test, alcohol use disorder, alcohol dependenceChoe YMLee BCChoi IGSuh GHLee DYKim JWDove Medical PressarticleCAGEgamma-glutamyl transferase (GGT)alcohol use disorders identification test (AUDIT)alcohol use disorder (AUD)alcohol dependence (AD)Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1507-1515 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	CAGE gamma-glutamyl transferase (GGT) alcohol use disorders identification test (AUDIT) alcohol use disorder (AUD) alcohol dependence (AD) Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	CAGE gamma-glutamyl transferase (GGT) alcohol use disorders identification test (AUDIT) alcohol use disorder (AUD) alcohol dependence (AD) Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Choe YM Lee BC Choi IG Suh GH Lee DY Kim JW Combination of the CAGE and serum gamma-glutamyl transferase: an effective screening tool for alcohol use disorder and alcohol dependence
description	Young Min Choe,1,2 Boung Chul Lee,2,3 Ihn-Geun Choi,2,4 Guk-Hee Suh,1,2 Dong Young Lee,5 Jee Wook Kim1,21Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi, Republic of Korea; 2Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea; 3Department of Neuropsychiatry, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea; 4Department of Neuropsychiatry, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea; 5Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of KoreaPurpose: The CAGE is a convenient test for alcohol-related disorder due to its brevity, but it is not as effective as the alcohol use disorders identification test (AUDIT). Gamma-glutamyl transferase (GGT) is an objective blood biochemical marker of excessive alcohol intake; however, it has low sensitivity. This study tested the performance of the combined use of CAGE and GGT to screen problem drinking (PD), alcohol use disorder (AUD), and alcohol dependence (AD).Methods: A total of 394 subjects composed of 91 normal controls and 303 subjects with PD were enrolled in this study. Of the PD subjects, 147 were diagnosed with AUD (77 alcohol abuse and 70 AD). A series of multiple logistic regression models for PD, AUD, and AD discrimination were used to obtain new combined CAGE and GGT scores after adjusting for age and gender (CAGE+GGT). A receiver operating characteristic curve analysis was conducted to determine how well the CAGE+GGT score discriminated between individuals with PD, AUD, and AD.Results: The discrimination accuracy of the AUDIT for PD was significantly better than that of the CAGE or the CAGE+GGT (z=6.927, p<0.0001; z=5.301, p<0.0001, respectively). The CAGE and the CAGE+GGT were better than the AUDIT at discriminating AUD (z=2.535, p=0.0112; z=2.894, p=0.0038, respectively). The discrimination accuracy of the AUDIT for AD was significantly better than that of the CAGE and GGT (z=3.233, p=0.0012; z=6.529, p<0.0001, respectively), but the CAGE+GGT was comparable with the AUDIT (z=1.652, p=0.0985).Conclusion: Our findings support the combined use of the CAGE questionnaire and serum GGT level as a sensitive and useful tool for AD screening.Keywords: CAGE, gamma-glutamyl transferase, alcohol use disorders identification test, alcohol use disorder, alcohol dependence
format	article
author	Choe YM Lee BC Choi IG Suh GH Lee DY Kim JW
author_facet	Choe YM Lee BC Choi IG Suh GH Lee DY Kim JW
author_sort	Choe YM
title	Combination of the CAGE and serum gamma-glutamyl transferase: an effective screening tool for alcohol use disorder and alcohol dependence
title_short	Combination of the CAGE and serum gamma-glutamyl transferase: an effective screening tool for alcohol use disorder and alcohol dependence
title_full	Combination of the CAGE and serum gamma-glutamyl transferase: an effective screening tool for alcohol use disorder and alcohol dependence
title_fullStr	Combination of the CAGE and serum gamma-glutamyl transferase: an effective screening tool for alcohol use disorder and alcohol dependence
title_full_unstemmed	Combination of the CAGE and serum gamma-glutamyl transferase: an effective screening tool for alcohol use disorder and alcohol dependence
title_sort	combination of the cage and serum gamma-glutamyl transferase: an effective screening tool for alcohol use disorder and alcohol dependence
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/6ce4e2249e504441b8ac2c6bae7a21da
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Combination of the CAGE and serum gamma-glutamyl transferase: an effective screening tool for alcohol use disorder and alcohol dependence

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