BACKGROUND: This research investigated the sensitivity and specificity of heavy and binge drinking for screening of alcohol use disorder. METHODS: This retrospective study was conducted with 976 adults who visited the Sun Health Screening Center for health screenings in 2015. Daily drinking amount, drinking frequency per week, and weekly drinking amount were investigated. Using criteria from the National Institute on Alcohol Abuse and Alcoholism, participants were classified as normal drinkers, heavy drinkers, or binge drinkers, and grouped by age and sex. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of heavy and binge drinking were compared for the diagnosis of alcohol abuse and alcohol dependence using the Diagnostic and Statistical Manual of Mental Disorders (DSM) 4th edition-text revision and alcohol use disorder using the DSM 5th edition. RESULTS: The sensitivity of heavy and binge drinking for the diagnosis of alcohol abuse, alcohol dependence, and alcohol use disorder were 51.7%, 43.8%, and 35.3%, and 69.0%, 62.5%, and 48.2%, respectively. The specificity of these were 90.1%, 91.7%, and 95.5%, and 84.3%, 86.8%, and 91.2%, respectively. The PPV of these were 24.8%, 40.5%, and 72.7%, and 21.7%, 38.0%, and 65.2%, respectively. The NPV of these were 96.7%, 92.6%, and 81.2%, and 97.8%, 94.7%, and 83.7%, respectively. CONCLUSION: Heavy and binge drinking did not show enough diagnostic power to screen DSM alcohol use disorder although they did show high specificity and NPV.
Adult ; Alcoholism ; Alcohol Drinking ; Binge Drinking* ; Diagnosis* ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND: Alcohol is personal and social problem around the world. Though binge drinking is associated with the elevation of arbohydrate deficient trasnferrin and r-glutamyl transpeptidase, studies of the relationship between heavy drinking and other biological markers are rare. The purpose of this study is to investigate the association between heavy drinking and CBC figures through flushing and non flushing using both NIAAA and Korean guidelines. METHODS: The subjects were 581 Korean adult males: who had undergone a comprehensive medical evaluation at Chungnam National University Hospital between June and December of 2013. 98 of total were non-drinkers, 225 of them flushers, and the rest 258 of them were non-flushers. One standard drink is defined as any drink that contains 14 grams of alcohol. Criteria for immoderate drinking was applied to greater than 14 glasses/week and more than 8 glasses on any day for a non-flush group with reference to the United States' guideline (National Institute in Alcohol Abuse and Alcoholism, NIAAA) and South Korean guideline, and it was also applied to greater than seven glasses/week, and more than four glasses on any day for a flushing group. It was to investigate whether immoderate drinking would be predictable according to increased mean corpuscular volume (MCV), decreased hemoglobin (Hb), and decreased platelet (PLT). Our investigation was to find the correlation with the increased MCV, decreased Hb, and decreased PLT as a means of predictions for immoderate drinking. The study was to examine the CBC's predictability of immoderate drinking through a combination of increased MCV, decreased Hb, or decreased PLT. If one of these three items were abnormal: group A, if two of the three items were abnormal: group B. RESULTS: Predictability of group A was 23.1% in flushing drinkers and 21.7% in non-flushing drinkers for US NIAAA immoderate drinking, whereas 30.8% in flushing drinkers and 30.4% in non-flushing drinkers considering Korean guideline immoderate drinking. Predictability of B group was 100% in flushing and non-flushing drinkers for both NIAAA guidelines and Korean guidelines. CONCLUSIONS: It is desirable for physicians to use any combination of the three CBC indicators (increased MCV, decreased Hb, or decreased PLT) for predicting immoderate drinking.
Adult ; Alcoholism ; Binge Drinking ; Biomarkers ; Blood Cell Count* ; Blood Platelets ; Chungcheongnam-do ; Drinking* ; Erythrocyte Indices ; Eyeglasses ; Flushing* ; Glass ; Humans ; Male ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Social Problems

BACKGROUND: In Korea, few studies have been performed on screening instruments for the detection of at-risk drinking and alcohol use disorders in the elderly. This study evaluated the validity of three screening instruments in elderly male drinkers. METHODS: The subjects were 242 Korean men aged > or = 65 years. Face-to-face interviews were used to identify at-risk drinking and alcohol use disorders. At-risk drinking was defined according to the criteria for heavy or binge drinking of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV-text revision. The Alcohol Use Disorder Identification Test (AUDIT), Short Michigan Alcoholism Screening Test-geriatric version (SMAST-G), and cut down, annoyed, guilty, eye-opener (CAGE) questionnaire were used as the alcohol-screening instruments. Based on the diagnostic interview results, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of the instruments were compared. RESULTS: For identification of at-risk drinking, the AUDIT AUROC demonstrated greater diagnostic power than did those of SMAST-G and CAGE (both P < 0.001). In screening for alcohol use disorders, the AUDIT AUROC was also significantly higher than those of SMAST-G and CAGE (both P < 0.001). The sensitivity and specificity of screening for at-risk drinking with an AUDIT score > or = 7 were 77.3% and 85.1%, respectively, whereas those for the alcohol use disorders with an AUDIT score > or = 11 were 91.3% and 90.8%, respectively. CONCLUSION: The results suggest that the AUDIT is the most effective tool in identifying problem drinkers among elderly male drinkers.
Aged ; Alcoholism ; Binge Drinking ; Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Humans ; Korea ; Male ; Mass Screening ; Michigan ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Alcohol Use Disorders Identification Test (AUDIT) is effective in identifying problem drinking. This study purposed to evaluate the usefulness of AUDIT in identifying problem drinking among Korean university students whose drinking characteristic is different from adults. METHODS: The subjects were 235 students who had visited the Health Service Center of Chungnam National University. All subjects had a diagnostic interview for the presence of at-risk drinking and alcohol use disorder. At-risk drinking was defined according to the criteria of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed by the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV TR). At-risk drinking or alcohol use disorder was classified into problem drinking. At the same time, a survey was conducted using three screening tools: AUDIT, cut down, annoyed, guilty feelings, eye opener (CAGE), and cut down, under influence, guilty feelings, eye opener (CUGE). Area under receiver operating characteristic curve (AUROC) of the questionnaires to the results of interviews were compared. RESULTS: Seventy one students were at-risk drinkers and 46 had alcohol use disorder, and 75 were classified into problem drinkers. For identification of problem drinking, AUROC of AUDIT was 0.970 in men and 0.989 in women. For CAGE, it was 0.650 in men and 0.747 in women. For CUGE, it was 0.689 in men and 0.745 in women. CONCLUSION: Above results suggest that AUDIT is most effective in identifying university students' problem drinking.
Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Eye ; Female ; Health Services ; Humans ; Male ; Mass Screening ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; ROC Curve

BACKGROUND: This study was done to validate the three single questions about binge drinking for identifying problem drinkers. METHODS: Two hundred sixty-one patients (133 men) were interviewed by family physicians for the presence of problem drinking which was defined as at-risk drinking or alcohol use disorders according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guideline and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The three single questions (the largest amount of drinking in a day; days of drinking 1.5 bottle [1 bottle in women] or more of Soju [Korean alcoholic beverage, 56 g of alcohol/bottle]; and days of getting drunk during the recent 3 months) were validated against the interview results. RESULTS: Among 261 interviewees, 31.4% were at-risk drinkers, 30.2% had a current alcohol use disorder, and 36.8% had either or both conditions. The first question, considering 4 drinks or more for men and 3 drinks or more for women as positive, showed a sensitivity of 93.8% and specificity of 75.0% in men, and 86.6% and 86.7% in women, respectively. The second question with cut-point of 1 in both gender showed 81.3% and 86.5% in men, respectively and 80.0% and 89.4%, respectively in women. The third question with cut-point of 3 in both gender showed 61.7% and 92.3% in men, respectively and 46.7% and 91.2%, respectively in women. The area under the Receiver Operating Characteristic curve of the first question was 0.937 in men and 0.970 in women, for the second question, 0.906 and 0.915, and for the third question, 0.768 and 0.764, respectively. CONCLUSIONS: The first question (the largest amount of drinking in a day during the recent 3 months) and the second question (days of drinking 1.5 bottle [1 bottle in women] or more of Soju during the recent 3 months) were considered useful in detecting problem drinkers.
Alcoholic Beverages ; Binge Drinking ; Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Female ; Humans ; Male ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Physicians, Family ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: The aspartate transaminase (AST)/alanine transferase (ALT) ratio increases with alcohol consumption. This study investigated AST/ALT ratio according to alcohol drinking and predictive power of AST/ALT ratio for heavy drinking in Korean men. METHODS: In 2015, 830 men with no history of disease or medication affecting liver function values were selected. Using 14 g of alcohol as the standard glass, odd ratios (ORs) of AST/ALT ratio over 1 among the drinking group were compared with the non-drinking group by multiple logistic analyses. Screening of heavy drinkers was conducted according to both NIAAA and Korean guidelines. Using AST/ALT ratio >1, sensitivity, specificity, positive predictive values, negative predictive values, positive likelihood ratios, negative likelihood ratios and odds ratios were investigated. RESULTS: After correcting for age, body mass index, exercising, and smoking history, ORs (95% confidence interval) of AST/ALT >1 were 1.607 (1.048-2.464) in <8 glasses group, 2.172 (1.160-4.065) in the 14 glasses group, and 3.670 (2.218-6.053) in the >14 glasses group. When AST/ALT >1 in the drinking group, sensitivity, specificity, positive predictive values, negative predictive values, likelihood ratios (LR)+, LR- and OR according to NIAAA guidelines, were 57.2%, 52.7%, 23.2%, 76.8%, 1.21 (1.04-1.41), 0.81 (0.67-0.98), and 1.49 (1.05-2.01), respectively. By Korean guidelines, these values were 55.2%, 55.3%, 33.7%, 66.3%, 1.24 (1.03-1.36), 0.84 (0.72-0.98), and 1.40 (1.04-1.89), respectively. CONCLUSIONS: Healthy male adults showed a positive correlation between risk of AST/ALT >1 and drinking amount compared to the non-drinking group. Use of the AST/ALT >1 in combination with other blood markers to predict excessive drinking is advisable.
Adult* ; Alanine Transaminase* ; Alanine* ; Alcohol Drinking* ; Aspartate Aminotransferases* ; Aspartic Acid* ; Body Mass Index ; Drinking ; Eyeglasses ; Glass ; Humans ; Liver ; Male* ; Mass Screening ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Odds Ratio ; Sensitivity and Specificity ; Smoke ; Smoking ; Transferases

This study investigated advantages and potential risks associated with drinking alcohol in Koreans based on the alcohol flush reaction. Our investigation reviewed published studies and examined moderate-drinking levels for Koreans based on modified National Institute on Alcohol Abuse and Alcoholism guidelines. Fourteen articles out of a total 198 publications were searched using PubMed, EMBASE, KoreaMed, and RISS (Research Information Sharing Service) databases and selected for review. Individuals without alcohol flush reaction (non-flushers) exhibited lower risks associated with insulin resistance, metabolic syndrome, and hyperhomocysteinemia and their 10-year cardiovascular disease risk when alcohol consumption was ≤8 drinks/wk. Conversely, risks associated with insulin resistance, metabolic syndrome, high blood pressure, prediabetes or type-2 diabetes, and high intraocular pressure and increases in carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels were present when >8 drinks were consumed. For individuals with flushing reaction (flushers), advantages were reported in relation to risks of hyperhomocysteinemia when alcohol consumption was ≤4 drinks/wk, whereas consumption of >4 drinks/wk increased the risk of insulin resistance, metabolic syndrome, high blood pressure, pre-diabetes or type-2 diabetes, high-risk colorectal adenoma, and high intraocular pressure and increased carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels. The moderate drinking level for Koreans is ≤8 drinks/wk for men aged ≤65 years and ≤4 drinks/wk for men aged over 65. For women, these limits should be half of those for men. Furthermore, individuals with flushing reaction should maintain an alcohol consumption level half of that for non-flushers.
Adenoma ; Alcohol Drinking ; Blood Glucose ; Cardiovascular Diseases ; Drinking ; Female ; Flushing ; Humans ; Hyperhomocysteinemia ; Hypertension ; Information Dissemination ; Insulin Resistance ; Intraocular Pressure ; Male ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Prediabetic State ; Transferases ; Transferrin