The aim of the study is to evaluate the contribution of ethanol metabolite detection in postmortem cases by showing the connection between the presence of ethanol metabolites, which are indicators of alcohol consumption, and the detection of potential postmortem ethanol formation in decomposed and diabetic cases. Determination of ethanol consumption before death is often one of the most important questions in death investigations. Postmortem ethanol formation or degradation products in the blood make it difficult to distinguish antemortem consumption or postmortem formation of ethanol and eventually may lead to misinterpretation. Decomposed bodies and diabetic cases are vulnerable to postmortem ethanol formation due to putrefaction, fermentation or other degradations. Ethyl glucuronide (EtG) and ethyl sulfate (EtS) are two metabolites of ethanol produced only in the antemortem time interval. In this study, EtG and EtS levels in urine and vitreous humor samples of 27 postmortem cases, including diabetic and degraded bodies were compared to ethanol results of their blood, urine and vitreous humor samples. EtG and EtS in urine and vitreous humor were analyzed by liquid chromatography–tandem mass spectrometry, and ethanol was assayed by routine headspace gas chromatography–flame ionization detector. These cases were devoid of other influences from forensically relevant drugs, so ethanol and/or glucose were among the only positive findings in these cases. The results of this pilot study indicate the postmortem ethanol concentrations do not correlate with the measured EtG and EtS values but are beneficial in rulings of accidental or natural deaths. This preliminary study gives additional data to help distinguish between antemortem ethanol intake and postmortem formation. EtG and EtS were well correlated positively with antemortem ethanol use instead of forming spontaneously in samples from decedents who are decomposing or have a history of diabetic hyperglycemia.

中文翻译：

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评估葡萄糖醛酸乙酯和硫酸乙酯水平的相容性以评估腐烂和糖尿病死后病例的酒精消耗量

该研究的目的是通过显示乙醇代谢物（酒精消耗指标）的存在与在腐烂和糖尿病病例中检测潜在的死后乙醇形成之间的联系来评估乙醇代谢物检测在死后病例中的贡献。确定死前的乙醇消耗量通常是死亡调查中最重要的问题之一。血液中的死后乙醇形成或降解产物使得难以区分死前消耗或死后乙醇形成，最终可能导致误解。由于腐败、发酵或其他降解，腐烂的尸体和糖尿病患者易受死后乙醇形成的影响。葡萄糖醛酸乙酯 (EtG) 和硫酸乙酯 (EtS) 是仅在生前时间间隔内产生的两种乙醇代谢物。在这项研究中，将 27 个死后病例的尿液和玻璃体液样本中的 EtG 和 EtS 水平与他们的血液、尿液和玻璃体液样本的乙醇结果进行了比较，其中包括糖尿病和退化的尸体。尿液和玻璃体液中的 EtG 和 EtS 采用液相色谱-串联质谱法分析，乙醇采用常规顶空气相色谱-火焰离子化检测器测定。这些病例没有法医相关药物的其他影响，因此乙醇和/或葡萄糖是这些病例中唯一的阳性发现。该试点研究的结果表明，死后乙醇浓度与测得的 EtG 和 EtS 值无关，但有利于裁定意外或自然死亡。这项初步研究提供了额外的数据，以帮助区分生前乙醇摄入和死后形成。EtG 和 EtS 与死前乙醇的使用呈正相关，而不是在来自正在分解或有糖尿病高血糖病史的死者的样本中自发形成。