Ethanol and ethanol metabolites

In the Forensic Toxicology and Pharmacology of Drugs of Abuse research group we especially focus on research regarding ethanol and its metabolites. Ethanol is still the most important drug regarding traffic safety and is also a highly relevant drug in both fatal and non-fatal intoxications.

The ongoing research especially focuses on three aspects of ethanol in forensic toxicology.

Firstly, we perform research that improves the interpretation of post mortem ethanol findings. Since ethanol is a putrefactive product that is formed post mortem, methods are needed to determine if ethanol was ingested before death.

Secondly, we perform research that improves the interpretation of the “hip-flask defence”. This is an expression describing suspects claiming that alcohol intake occurred after for instance a car accident, so that impairment was not present at the time of driving. Objective methods are needed to interpret these cases.

Thirdly, we do research which tries to find strengths and weaknesses regarding the alcohol marker PEth.

Photo: Pixabay

Ongoing projects

Frequency of post mortem ethanol formation in blood, urine and vitreous humor

In this project, we use a large data material from Oslo University Hospital (n=2500) together with a large material from Linkøping University (n=8000). In the material from Oslo University Hospital, the ethanol metabolites EtG and EtS are analysed as markers of post mortem ethanol formation and in the material from Linkøping University putrefactive alcohols are analysed as a marker of post mortem ethanol formation. We then compare the two methods and are able to describe which frequency of post mortem formation of ethanol that is seen on each ethanol concentration level, both in blood, but also in urine and vitreous humor.

Use of the alcohol marker PEth

Together with other researchers at Oslo University Hospital and Fürst medicinal laboratory, we perform studies trying to find strengths and weaknesses using the alcohol marker PEth. Using results from 6700 patients we showed that PEth was a much more sensitive marker than CDT and we also showed that formation of PEth was not related to age and sex. In a recent study, we also showed that alcohol consumption was closely related to abnormal values of the clinical markers ferritin and HDL-C, in addition to GGT and AST, which is well known to have a relation to alcohol consumption.

Photo: Pixabay

Previous projects

  • Use of ethyl glucuronide in hair and nail as a biomarker for alcohol consumption: Opportunities and limitations. PhD thesis by Jan Toralf Fosen 2021
  • Evaluating the hip-flask defence using analytical data from ethanol and ethyl glucuronide. A comparison of two models
  • The relationship between ingested dose of ethanol and amount of ethyl glucuronide formed in blood
  • Ethanol elimination rates at low concentrations based on two consecutive blood samples
  • Evaluation of the hip-flask defence by determination of ethyl glucuronide and ethyl sulphate concentrations in blood
  • Alcohol hangover as a cause of impairment in apprehended drivers

Collaboration

  • Robert Kronstrand (Associate professor), Dep. of clinical chemistry and clinical sciences, Linköping University, Sweden
  • Fredrik Kugelberg (Associate professor), Dep. of clinical chemistry and clinical sciences, Linköping University, Sweden
  • Luca Morini (Associate professor), Dep. of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
  • Jørg Mørland (professor emeritus), Norwegian Institute of Public Health, Norway
  • Thor Hilberg (Dr. Med), Fürst medicinal laboratory, Norway

Press and Media Reports

If you have questions about the projects or suggestions for research collaboration, please contact: Gudrun Høiseth (gudrho@ous-hf.no) at the Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.

Publications

Sidqey D, Liane VH, Kristoffersen L (2021)
Quantitative Determination of Ethyl Glucuronide and Ethyl Sulfate in Postmortem and Antemortem Whole Blood Using Phospholipid Removal 96-Well Plate and UHPLC-MS-MS
J Anal Toxicol, 45 (4), 378-388
DOI 1093/jat/bkaa108, PubMed 32816025

Fosen JT, Mørland J, Høiseth G (2020)
The Relationship Between Ingested Dose of Ethanol and Amount of Ethyl Glucuronide Formed in Blood
J Anal Toxicol, 44 (8), 861-863
DOI 1093/jat/bkaa090, PubMed 32743665

Årving A, Høiseth G, Hilberg T, Trydal T, Husa A, Djordjevic A, Kabashi S, Vindenes V, Bogstrand ST (2020)
Comparison of the Diagnostic Value of Phosphatidylethanol and Carbohydrate-Deficient Transferrin as Biomarkers of Alcohol Consumption
Alcohol Clin Exp Res, 45 (1), 153-162
DOI 1111/acer.14503, PubMed 33164220

Höiseth G, Nilsson GH, Lundberg R, Forsman M, Kronstrand C, Nyström I, Oscarsson C, Ericsson E, Cherma MD, Ahlner J, Kugelberg FC, Kronstrand R (2020)
Evaluating the hip-flask defence using analytical data from ethanol and ethyl glucuronide. A comparison of two models
Forensic Sci Int, 316, 110409
DOI 1016/j.forsciint.2020.110409, PubMed 32871451

Fosen JT, Høiseth G, Sempio C, Giarratana N, Enger A, Mørland J, Morini L (2018)
Hair EtG: Alterations in segment levels accompanying hair growth
Drug Test Anal, 11 (1), 112-118
DOI 1002/dta.2474, PubMed 30084156

Fosen JT, Morini L, Sempio C, Giarratana N, Enger A, Mørland J, Høiseth G (2017)
Ethyl Glucuronide Elimination Kinetics in Fingernails and Comparison to Levels in Hair
Alcohol Alcohol, 52 (5), 580-586
DOI 1093/alcalc/agx035, PubMed 28591773

Fosen JT, Morini L, Sempio C, Ganss R, Mørland J, Høiseth G (2016)
Levels of Hair Ethyl Glucuronide in Patients with Decreased Kidney Function: Possibility of Misclassification of Social Drinkers
Alcohol Clin Exp Res, 40 (3), 451-6
DOI 1111/acer.12970, PubMed 26853225

Høiseth G, Wiik E, Kristoffersen L, Mørland J (2016)
Ethanol elimination rates at low concentrations based on two consecutive blood samples
Forensic Sci Int, 266, 191-196
DOI 1016/j.forsciint.2016.05.039, PubMed 27295074

Høiseth G, Berg-Hansen GO, Mørland J (2015)
Evaluation of the hip-flask defence by determination of ethyl glucuronide and ethyl sulphate concentrations in blood
Forensic Sci Int, 257, 398-402
DOI 1016/j.forsciint.2015.10.017, PubMed 26555501

Høiseth G, Fosen JT, Liane V, Bogstrand ST, Mørland J (2014)
Alcohol hangover as a cause of impairment in apprehended drivers
Traffic Inj Prev, 16 (4), 323-8
DOI 1080/15389588.2014.938324, PubMed 25023858

Krabseth H, Mørland J, Høiseth G (2014)
Assistance of ethyl glucuronide and ethyl sulfate in the interpretation of postmortem ethanol findings
Int J Legal Med, 128 (5), 765-70
DOI 1007/s00414-014-1031-z, PubMed 24935750

Høiseth G, Magnus P, Knudsen GP, Jansen MD, Næss O, Tambs K, Mørland J (2013)
Is ADH1C genotype relevant for the cardioprotective effect of alcohol?
Alcohol, 47 (2), 81-4
DOI 1016/j.alcohol.2012.12.005, PubMed 23321361

Høiseth G, Morini L, Ganss R, Nordal K, Mørland J (2012)
Higher levels of hair ethyl glucuronide in patients with decreased kidney function
Alcohol Clin Exp Res, 37 Suppl 1, E14-6
DOI 1111/j.1530-0277.2012.01882.x, PubMed 22698262

Høiseth G, Nordal K, Pettersen E, Mørland J (2012)
Prolonged urinary detection times of EtG and EtS in patients with decreased renal function
Alcohol Clin Exp Res, 36 (7), 1148-51
DOI 1111/j.1530-0277.2011.01713.x, PubMed 22316172

Høiseth G, Yttredal B, Karinen R, Gjerde H, Mørland J, Christophersen A (2010)
Ethyl glucuronide concentrations in oral fluid, blood, and urine after volunteers drank 0.5 and 1.0 g/kg doses of ethanol
J Anal Toxicol, 34 (6), 319-24
DOI 1093/jat/34.6.319, PubMed 20663284

Høiseth G, Yttredal B, Karinen R, Gjerde H, Christophersen A (2010)
Levels of ethyl glucuronide and ethyl sulfate in oral fluid, blood, and urine after use of mouthwash and ingestion of nonalcoholic wine
J Anal Toxicol, 34 (2), 84-8
DOI 1093/jat/34.2.84, PubMed 20223100

Høiseth G, Karinen R, Christophersen A, Mørland J (2009)
Practical use of ethyl glucuronide and ethyl sulfate in postmortem cases as markers of antemortem alcohol ingestion
Int J Legal Med, 124 (2), 143-8
DOI 1007/s00414-009-0393-0, PubMed 19937334

Høiseth G, Morini L, Polettini A, Christophersen AS, Johnsen L, Karinen R, Mørland J (2009)
Serum/whole blood concentration ratio for ethylglucuronide and ethyl sulfate
J Anal Toxicol, 33 (4), 208-11
DOI 1093/jat/33.4.208, PubMed 19470223

Høiseth G, Morini L, Polettini A, Christophersen A, Mørland J (2009)
Blood kinetics of ethyl glucuronide and ethyl sulphate in heavy drinkers during alcohol detoxification
Forensic Sci Int, 188 (1-3), 52-6
DOI 1016/j.forsciint.2009.03.017, PubMed 19395207

Høiseth G, Morini L, Polettini A, Christophersen A, Mørland J (2009)
Ethyl glucuronide in hair compared with traditional alcohol biomarkers--a pilot study of heavy drinkers referred to an alcohol detoxification unit
Alcohol Clin Exp Res, 33 (5), 812-6
DOI 1111/j.1530-0277.2009.00900.x, PubMed 19298326

Høiseth G, Bernard JP, Stephanson N, Normann PT, Christophersen AS, Mørland J, Helander A (2008)
Comparison between the urinary alcohol markers EtG, EtS, and GTOL/5-HIAA in a controlled drinking experiment
Alcohol Alcohol, 43 (2), 187-91
DOI 1093/alcalc/agm175, PubMed 18230699

Høiseth G, Karinen R, Johnsen L, Normann PT, Christophersen AS, Mørland J (2007)
Disappearance of ethyl glucuronide during heavy putrefaction
Forensic Sci Int, 176 (2-3), 147-51
DOI 1016/j.forsciint.2007.08.002, PubMed 17884319

Høiseth G, Kristoffersen L, Larssen B, Arnestad M, Hermansen NO, Mørland J (2007)
In vitro formation of ethanol in autopsy samples containing fluoride ions
Int J Legal Med, 122 (1), 63-6
DOI 1007/s00414-007-0166-6, PubMed 17387502

Høiseth G, Bernard JP, Karinen R, Johnsen L, Helander A, Christophersen AS, Mørland J (2007)
A pharmacokinetic study of ethyl glucuronide in blood and urine: applications to forensic toxicology
Forensic Sci Int, 172 (2-3), 119-24
DOI 1016/j.forsciint.2007.01.005, PubMed 17306943

Høiseth G, Karinen R, Christophersen AS, Olsen L, Normann PT, Mørland J (2006)
A study of ethyl glucuronide in post-mortem blood as a marker of ante-mortem ingestion of alcohol
Forensic Sci Int, 165 (1), 41-5
DOI 1016/j.forsciint.2006.02.045, PubMed 16564658

Kristoffersen L, Smith-Kielland A (2005)
An automated alcohol dehydrogenase method for ethanol quantification in urine and whole blood
J Anal Toxicol, 29 (5), 387-9
DOI 1093/jat/29.5.387, PubMed 16105266

Kristoffersen L, Stormyhr LE, Smith-Kielland A (2006)
Headspace gas chromatographic determination of ethanol: the use of factorial design to study effects of blood storage and headspace conditions on ethanol stability and acetaldehyde formation in whole blood and plasma
Forensic Sci Int, 161 (2-3), 151-7
DOI 10.1016/j.forsciint.2006.03.034, PubMed 16843627

 
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