Carbohydrate-Deficient Transferrin (CDT)

Liver

Report in 120Hrs

At Home

No Fasting Required

Details

Marker of chronic alcohol abuse.

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Carbohydrate-Deficient Transferrin (CDT) Test Information Guide

Why is it done?
- Detects recent alcohol consumption and chronic heavy alcohol use by measuring abnormal forms of transferrin protein that accumulate with prolonged alcohol intake
- Screening for alcohol use disorder and assessing severity of alcohol dependence in patients suspected of problematic drinking
- Monitoring abstinence and compliance with treatment programs in patients enrolled in alcohol rehabilitation or recovery programs
- Evaluating patients with liver disease or suspected alcoholic cirrhosis to determine if alcohol is contributing to hepatic damage
- Assessing candidates for organ transplantation, particularly liver transplants, to determine suitability and alcohol abstinence capability
- Legal and workplace testing situations where objective evidence of alcohol use is required
Normal Range
- Normal Range Values: < 20 mg/L (or < 1.3% of total transferrin)
- Units of Measurement: mg/L or percentage (%) of total transferrin
- Negative/Normal Result: CDT level below the cutoff value indicates no significant recent heavy alcohol consumption or successful alcohol abstinence
- Positive/Abnormal Result: CDT level ≥ 20 mg/L suggests recent heavy alcohol consumption (approximately 50-60 grams of alcohol daily for 7-10 days or longer)
- Interpretation Context: Normal ranges may vary slightly between laboratories; results should be interpreted by healthcare providers within clinical context
Interpretation
- Elevated CDT Levels (≥ 20 mg/L): Indicates recent heavy alcohol consumption within the past 2-3 weeks; higher values suggest greater alcohol intake; typical sensitivity of 70-80% for detecting chronic heavy drinking
- Borderline Results (15-20 mg/L): May warrant repeat testing and clinical correlation; can indicate moderate alcohol consumption or individual metabolic variation
- Normal/Low Levels (< 20 mg/L): Suggests either no significant recent heavy alcohol use or successful alcohol abstinence; useful for monitoring treatment compliance
- Time-Window Limitation: CDT can only detect alcohol use from approximately 2-3 weeks prior; does not detect sporadic or moderate drinking
- Factors Affecting Results: Liver disease, genetic variants affecting transferrin glycosylation, certain medications, pregnancy, genetic transferrin variants (CDT isoforms), and malnutrition can influence results
- Clinical Significance: Best used as one marker among multiple indicators of alcohol use; should be combined with clinical assessment, liver function tests, and patient history for comprehensive evaluation
Associated Organs
- Primary Organ System: Hepatic (liver) system; transferrin is synthesized in the liver and is a major acute-phase reactant affected by hepatic function and alcohol metabolism
- Common Associated Conditions: Alcoholic cirrhosis, alcoholic hepatitis, fatty liver disease (steatosis), liver fibrosis, alcohol use disorder, hepatic steatofibrosis
- Diagnosis-Related Diseases: Chronic liver disease, end-stage liver disease, elevated liver enzymes (AST/ALT), hyperammonemia, hepatic encephalopathy, portal hypertension
- Systemic Complications: Pancreatitis, gastric ulcers, esophageal varices, ascites, coagulopathy, thrombocytopenia, hepatorenal syndrome, malnutrition and metabolic disorders
- Neurological Effects: Wernicke-Korsakoff syndrome, peripheral neuropathy, cognitive impairment, cerebellar degeneration, and hepatic encephalopathy associated with chronic alcohol use
Follow-up Tests
- Liver Function Tests (LFTs): AST (aspartate aminotransferase), ALT (alanine aminotransferase), bilirubin, alkaline phosphatase, GGT (gamma-glutamyl transferase), albumin to assess hepatic function and damage
- Complementary Alcohol Biomarkers: Ethyl glucuronide (EtG), ethyl sulfate (EtS), phosphatidylethanol (PEth), mean corpuscular volume (MCV), and liver enzyme ratios (AST/ALT) for corroborating alcohol use findings
- Imaging Studies: Abdominal ultrasound or hepatic elastography to evaluate for liver cirrhosis, fibrosis, fatty infiltration, and structural liver damage
- Coagulation Studies: Prothrombin time (PT), INR, platelet count to assess hepatic synthetic function and bleeding risk in advanced liver disease
- Viral Hepatitis Screening: Hepatitis A, B, and C antibodies/antigens to exclude concurrent viral hepatitis in patients with elevated CDT and liver dysfunction
- Complete Blood Count (CBC): To evaluate for anemia, leukopenia, and thrombocytopenia associated with chronic alcohol use and liver disease
- Monitoring Frequency: For treatment monitoring: initial test, then every 2-4 weeks during early recovery; monthly for 3-6 months; quarterly for long-term follow-up; increased frequency if relapse suspected
- Psychological Assessment: Formal psychological/psychiatric evaluation for alcohol use disorder diagnosis, co-morbid mental health conditions, and treatment planning
Fasting Required?
- Fasting Requirement: No - Fasting is NOT required for CDT testing; the test can be performed at any time of day regardless of meal intake
- Sample Collection: Blood sample collection via venipuncture; patient should inform phlebotomist of current medications and medical conditions
- Medications to Report: Inform healthcare provider of all medications, particularly disulfiram (Antabuse), naltrexone, acamprosate, gabapentin, and any herbal supplements that may influence results
- Pre-Test Preparation: No special preparation needed; can eat and drink normally before the test; wear loose-fitting clothing for easy blood draw access
- Important Considerations: Liver disease, genetic transferrin variants, and certain medications may affect test results; inform provider of medical history; results are most reliable when combined with other clinical findings

How our test process works!