Detection of alcoholic liver disease

Table 1 The royal college of physicians (UK) advice on 'safe' and at risk drinking[5]

	Men(units per week)	Women(units per week)
Low risk	21	14
Hazardous	22-49	15-35
Harmful	50+	36+

The problems related to alcohol misuse are preventable. There is a need for an effective screening method for the early detection of alcohol misuse so as to provide support services and then the monitoring of progress. To do this effectively there is a need for objective markers of alcohol misuse.

Table 2 Sensitivity and specificity of markers for detection of hazardous and dependent alcohol use

		Sensitivity(%)	Specificity(%)
MCV	Hazardous consumption	20-30	64-100
	Dependence/alcoholism	40-50	64-100
AST	Hazardous consumption	10-30	> 90
	Dependence/alcoholism	35-50	> 90
ALT	Hazardous consumption	10-20	> 80
	Dependence/alcoholism	20-50	> 80
GGT	Hazardous consumption	20-50	55-100
	Dependence/alcoholism	60-90	55-100

Adapted from Conigrave et al[23]