Abstract
BACKGROUND: Phosphatidylethanol 16:0/18:1 (PEth) is a widely used alcohol marker, but how sex, body size and composition and kidney function affect the dose-response relationship between alcohol consumption and PEth is not fully understood. OBJECTIVE: The aim of the study was to investigate whether sex, age, body size and composition and kidney function influence the estimate of alcohol consumed at a given PEth concentration. METHODS: This is a longitudinal population-based cohort study including 24 902 participants from the Trøndelag Health Study (HUNT4). Associations were assessed using a regression model. FINDINGS: When analysed together, sex and soft lean mass were statistically significant independent predictors of alcohol consumption at a given PEth concentration. To achieve the same PEth concentration as a female, a male with identical body composition could on average consume 21% more alcohol, according to our model. Independent of sex, a person with 10% higher soft lean mass could consume 3.9% more alcohol to achieve the same PEth concentration. When soft lean mass was excluded, height and body weight became significant predictors. CONCLUSIONS: Sex, body composition and body size may have an impact on the dose-response relationship between alcohol consumption and PEth concentration. Thus, these factors will contribute to the uncertainty when estimating ethanol intake from a given PEth concentration.