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Adli Vakalarda Etil Glukuronid ve Etil Sülfat Analizinin Önemi: Olgu Bildirileri
The Importance of Ethyl Glucuronide and Ethyl Sulphate Analysis in Forensic Cases
Turkiye Klinikleri J Foren Sci Leg Med. 2019;16(1):64-9
doi: 10.5336/forensic.2018-62293
Makale Dili: TR
Tam Metin
ÖZET
Postmortem dönemde etanol oluşabilmesi adli otopsi örneklerinde saptanan etanolün doğru yorumlanmasını zorlaştırmaktadır. Etil glukuronid (EtG), ve etil sülfat (EtS) antemortem alkol alımını doğrulamak amacıyla sıklıkla kullanılan biyobelirteçlerdir. Yarılanma ömürleri etanole göre uzun olduğundan ve postmortem oluşmadıklarından kanda etanolün saptanamadığı durumlarda, etil glukuronid ve etil sülfat varlığı alkolün ekzojen alımını göstermektedir. Bu özellikleri sayesinde postmortem kan analizleri sonucunda saptanan etanolün antemortem kullanıma mı, yoksa postmortem oluşuma mı bağlı olduğunun ayırt edilmesinde kullanılmaktadır. Ayrıca, failin olay yerinden kaçıp saatler sonra güvenlik güçlerine teslim olduğu vakalarda saptanan kan alkol düzeyinin sıfır olması hâlinde, olay anındaki alkol durumunun değerlendirilmesine de katkı sağlamaktadır. Bu çalışmada Adli Tıp Kurumu 5. İhtisas Kuruluna gönderilen vakalar arasından etanol ile birlikte EtG ve EtS'nin birlikte analiz edildiği, rapor içeriği açısından farklılık gösteren olgular sunulmuş ve bu belirteçlerin öneminin literatür ışığında tartışılması amaçlanmıştır.
Anahtar Kelimeler: Adli tıp; etanol; etil glukuronid; etil sülfat; etanol metabolitleri
Postmortem dönemde etanol oluşabilmesi adli otopsi örneklerinde saptanan etanolün doğru yorumlanmasını zorlaştırmaktadır. Etil glukuronid (EtG), ve etil sülfat (EtS) antemortem alkol alımını doğrulamak amacıyla sıklıkla kullanılan biyobelirteçlerdir. Yarılanma ömürleri etanole göre uzun olduğundan ve postmortem oluşmadıklarından kanda etanolün saptanamadığı durumlarda, etil glukuronid ve etil sülfat varlığı alkolün ekzojen alımını göstermektedir. Bu özellikleri sayesinde postmortem kan analizleri sonucunda saptanan etanolün antemortem kullanıma mı, yoksa postmortem oluşuma mı bağlı olduğunun ayırt edilmesinde kullanılmaktadır. Ayrıca, failin olay yerinden kaçıp saatler sonra güvenlik güçlerine teslim olduğu vakalarda saptanan kan alkol düzeyinin sıfır olması hâlinde, olay anındaki alkol durumunun değerlendirilmesine de katkı sağlamaktadır. Bu çalışmada Adli Tıp Kurumu 5. İhtisas Kuruluna gönderilen vakalar arasından etanol ile birlikte EtG ve EtS'nin birlikte analiz edildiği, rapor içeriği açısından farklılık gösteren olgular sunulmuş ve bu belirteçlerin öneminin literatür ışığında tartışılması amaçlanmıştır.
Anahtar Kelimeler: Adli tıp; etanol; etil glukuronid; etil sülfat; etanol metabolitleri
ABSTRACT
Postmortem ethanol formation makes it difficult to correctly interpret the ethanol detected in forensic autopsy specimens. Ethyl glucuronide (EtG), and ethyl sulfate (EtS) are frequently used biomarkers with the goal of confirming ante-mortem alcohol intake. In cases where ethanol can not be detected, the presence of EtG and EtS indicate the exogenous intake of alcohol, because their half-life is longer than ethanol and they do not occur postmortem. By means of these properties, postmortem blood analysis is used to distinguish whether the detected ethanol is by antemortem use or postmortem formation. It also contributes to the assessment of the alcohol status at the time of the incident, if the level of blood alcohol detected in cases where the perpetrator escapes from the scene and is delivered to security forces hours after the incident is zero. In this study, the cases which were analyzed together with ethanol, EtG and EtS from among the cases sent to the 5th Specialization Board of the Council of Forensic Medicine and the differences in the content of the report were presented and the significance of these markers was discussed in the light of the literature.
Keywords: Forensic medicine; ethanol; ethyl glucuronide; ethyl sulfate; ethanol's metabolite
Postmortem ethanol formation makes it difficult to correctly interpret the ethanol detected in forensic autopsy specimens. Ethyl glucuronide (EtG), and ethyl sulfate (EtS) are frequently used biomarkers with the goal of confirming ante-mortem alcohol intake. In cases where ethanol can not be detected, the presence of EtG and EtS indicate the exogenous intake of alcohol, because their half-life is longer than ethanol and they do not occur postmortem. By means of these properties, postmortem blood analysis is used to distinguish whether the detected ethanol is by antemortem use or postmortem formation. It also contributes to the assessment of the alcohol status at the time of the incident, if the level of blood alcohol detected in cases where the perpetrator escapes from the scene and is delivered to security forces hours after the incident is zero. In this study, the cases which were analyzed together with ethanol, EtG and EtS from among the cases sent to the 5th Specialization Board of the Council of Forensic Medicine and the differences in the content of the report were presented and the significance of these markers was discussed in the light of the literature.
Keywords: Forensic medicine; ethanol; ethyl glucuronide; ethyl sulfate; ethanol's metabolite
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