アルコール関連遺伝子多型を妥当基準としたエタノールパッチテストの信頼性：季節差や測定者間誤差の視点から

抄録

 High/low alcohol tolerance is determined by genetic polymorphisms of ADH2 and ALDH2. Currently, operators conduct ethanol patch testing for assessment of alcohol tolerance in a subjective manner; therefore, the test results may vary among individuals. The present study was designed to verify the reliability of ethanol patch testing, with a focus on changes in skin color due to seasons. Two operators were assigned to perform ethanol patch tests, and alcohol-related genetic polymorphisms were evaluated to verify the results.
 The study included 129 healthy students from Utsunomiya University (age range: 21-24 years). These students were selected because they met the eligibility criteria for the study (all necessary information had to be available, i.e. results for all questionnaire items and patch tests, as well as genetic analysis). Alcohol-related genes tested in this study were ADH2 and ALDH2. During the ethanol patch tests, two operators examined the subjects' cutaneous reactions immediately after lint pad had been removed from their skin, and at 10 min after removal.
 Ethanol patch test to the subjects was performed twice: once in summer and once in winter. We also administered a questionnaire to assess the students' views on alcohol and drinking habits. According to the cutaneous reactions examined at 10 min, there was significant concordance between the results of ethanol patch tests and ALDH2 genetic polymorphisms. The results of the patch tests performed by the 2 operators (A and B) in summer showed that the concordance rate between the operators was 93.8% (κ coefficient: 0.889; 95% confidence interval: 0.815-0.962, p<0.001) for the cutaneous reactions at 10 min after lint pad removal. Moreover, the same operator's data showed that the concordance rate between the results of the summer and winter patch tests was 70% or higher. These findings suggest that ethanol patch testing is a reliable assay of alcohol tolerance, although the results may be influenced by seasons and individual operator subjectivity. Therefore, during ethanol patch tests, it is important to take into account test conditions such as the time of year and skin color, and to evaluate the results comprehensively.