Serum uric acid level of Thai individuals in comparison with the nutritional status and some other physical and biochemical parameters.

Serum uric acid levels were measured in a total of 287 adults of Thai origin in Bangkok and the rural area. Mean values and range were found to exceed slightly serum uric acid concentration as reported from western countries. There was no significant difference between the Bangkok group and the group from the rural area but males and females differed significantly in their serum uric acid levels. A significant positive correlation to the ratio between weight to height as an index of the nutritional status was found.

Are proteinase inhibitors a factor for the derangement of homoeostasis in protein-energy malnutrition?

In protein-energy malnutrition essential amino acids for the synthesis of proteins are derived from the mobilization of endogenous proteins in order to maintain homoeostasis. Data are presented to support the hypothesis that proteinase inhibitors, which increase rapidly at the onset of infection, interrupt this catabolic effect which is the normal adaptive response to protein-energy malnutrition.

Protection against cancer through nutritionally-induced increase of endogenous proteinase inhibitors--a hypothesis.

Population groups with a diet low in calories, fat and animal protein, but high in vegetables and fibre, have a low incidence of cancer of the colon, rectum, breast and prostate. It is proposed that such a diet protects against cancer by stimulating an increase of endogenous proteinase inhibitors (PI), in particular, alpha 2-macroglobulin (AM), above those of individuals on a diet rich in calories, fat and animal protein. Evidence in support of this hypothesis is discussed. In various models, PI has been shown to be anticarcinogenistic. Preschool and school children who although on a diet apparently below the requirements for protein and calories were still considered healthy, have been found to have increased AM levels. Raised PI levels have also been observed in rats low on protein and energy and restriction of food intake in an inbred colony of rats reduced the incidence of radiation-induced tumours.

Albumin, prealbumin, transferrin and serum proteinase inhibitors in asymptomatic and hospitalized Thai alcohol drinkers.

Findings on Quetelet's index and on levels of serum albumin, prealbumin and transferrin as well as the serum proteinase inhibitors (PI) alpha 2-macroglobulin, alpha 1-protease inhibitor and alpha 1-antichymotrypsin support the hypothesis that PI levels reflect the nutritional status of alcohol drinkers.

Serum proteins and nutritional status of free-living Thai elderly.

Fifty-six Thai males and 146 Thai females aged 60 years and above visiting a special clinic for the elderly were investigated. The serum protein and immunoglobulin of these elderly were assessed. Anthropometric measurements were also taken. From a random sample of the group, the dietary intake of main nutrients was determined by a 24 h recall method with the help of food models. Weight, height and mid-arm muscle circumference of males were greater than those of females. Triceps skinfold thickness was less in the males than in the females. Forty-seven per cent of the individuals investigated had alpha1-antitrypsin levels below 200 mg/dl and 25.4% had IgG levels of 200 mg/dl and 39% IgA levels above 450 mg/dl. The males tend to consume more calories in the form of carbohydrates than the females. The nutritional density of fat was less than 20% in the males. A negative correlation between serum albumin and height and a positive correlation between serum IgG and tricep skinfold thickness were found. Weight was found to have a positive correlation with calories, carbohydrates and fat. Height correlated positively with calories, protein and carbohydrates. Serum prealbumin correlated with fat intake. It is concluded that, except for alpha1-antitrypsin, IgA, serum proteins are found in a range normally detected also in elderlies in western countries. Body composition does not relate to level of protein intake.

Serum lipid pattern in urban and rural Thai population.

Serum cholesterol, triglyceride, phospholipid, total lipid and weight to height ratio were studied in 172 individuals from Bangkok, mainly university staff, and in 247 individuals from rural areas of northeast Thailand. Total lipid and phospholipid levels were statistically significant higher and triglyceride lower in the Bangkok group compared with the group from the rural areas. A cholesterol level did not differ significantly between the groups. The results are discussed in respect of a possible difference in the nutritional status between the individuals from the urban and rural area.

Measurements of B1, B2, B6 status in children and their mothers attending a well-baby clinic in Bangkok.

The status of thiamin, riboflavin and pyridoxine in 717 healthy children aged 1-60 months and 569 mothers aged 16-45 years attending a well-baby clinic in Bangkok were determined by using the erythrocyte enzymes, transketolase, glutathione oxidoreductase, aspartate aminotransferase and measuring the degree of stimulation with the coenzymes thiamin pyrophosphate, flavin adenine dinucleotide and pyridoxal phosphate respectively. Cut-off points for the upper limit of the normal ranges for the respective activation coefficients were established from the data obtained.

Lipid profile, anthropometry and dietary intake of 132 Thai vegetarians.

The anthropometric measurements, lipid pattern and dietary intake of 64 male and 68 female Thai vegetarians (mostly lacto-vegetarians) were investigated. 32 males and 36 females on an ordinary Thai diet served as controls. Nutritional anthropometric variables and serum lipid concentrations, which the exception of triglycerides, were found to be lower in the vegetarian group than in the control group. The vegetarians consumed more energy than the controls. No difference in the protein intake was observed in both groups. Fat intake was, however, lower and carbohydrate intake higher in the vegetarian group. Also in the vegetarian group, HDL-cholesterol fraction correlated negatively with anthropometric measurements. Other fractions show only a weak correlation, if at all, in this group. A good correlation to all serum lipid variables determined to anthropometric measurement was observed in the control group.

Vitamin B12, folic acid and haematological status of 132 Thai vegetarians.

Serum vitamin B12, folic acid and haematological variables of 132 Thai vegetarians (64 males and 68 females) were investigated. Forty-seven healthy omnivorous individuals served as controls. No statistical differences in haemoglobin concentration, packed red cell volume and mean corpuscular haemoglobin concentration between the vegetarians and controls had been detected. In the female vegetarians, the haemoglobin concentration and packed red cell volume were, however, statistically lower. No significant differences in the white cell counts and platelet counts were observed in both groups. A significant increase of basophilic stippling and reticulocytes was observed in the vegetarians. Serum vitamin B12 decreased and serum folic acid levels increased according to the duration of vegetarianism in the vegetarians. In the females practicing vegetarianism for 6-10 years or more, the proportion of serum vitamin B12 deficiencies was particularly high. The high percentage of vitamin B12 deficiency in the vegetarians might be related to megaloblastic anaemia. This form of anaemia is commonly associated with the presence of basophilic stippling. Therefore, the increased presence of basophilic stippling and reticulocytes might indicate a mild stage of this type of anaemia among the vegetarians.

Vitamin B1, B2 and B6 in relation to anthropometry, hemoglobin and albumin of newborns and their mothers from northeast Thailand.

The weight and height measurements of fifty-three mothers and their newborns residing in the northeast of Thailand were recorded. Hemoglobin, albumin and cord blood samples were taken immediately after delivery. The vitamin B1, B2 and B6 status of the women and their newborns was assessed through functional tests. Vitamin B1 and B2 status of the newborns was found to be generally better than those of their mothers. This is not so, however, for vitamin B6. The rate of deficiency in the mothers was highest for vitamin B2 (54.7%). The mothers' height, hemoglobin and albumin concentrations and their vitamin B2 status correlated with those of their children at birth. 50% of low birth weight deliveries (2500 g and below) were included in this study. The risk of a low birth weight delivery cannot, however, be explained by any of the biochemical variables. Although the rate of low birth weight is used commonly to determine mother and child health care, this paper shows that for Hb, albumin, Vitamins B1, B2 and B6, it is not an effective indicator used to determine nutritional deficiencies in mothers.

Anthropometry, lipid- and vitamin status of 215 health-conscious Thai elderly.

A survey was carried out on 59 males and 146 females aged 60 years and above from a special clinic for the elderly in Bangkok. All of these subjects had no major complaints of ill health and, judging by their appearance, they seemed to be apparently healthy. 6.8% of the males and 11% of the females were found to be over-nourished. Less than 15% of all the individuals under investigation were suffering from hypertension, hyperglycaemia and hyperuricaemia. 35% of the males but only 13% of the females were anemic. The lipid status of the females was generally worse with statistically higher median values for total cholesterol, LDL-cholesterol and triglycerides than the males. There was no significant difference in the variation of HDL-cholesterol between the sexes. High vitamin C, B2 and B6 deficiency rates were observed in both the males and the females.

Vitamin B1, B2 and B6 during the course of pregnancy of rural and urban women in northeast Thailand.

The vitamin B1, B2 and B6 status was investigated in a group of rural and urban pregnant women in the northeast of Thailand during the course of pregnancy. The vitamin status of all three vitamins did not change during the course of pregnancy even for the group of rural women. Differences between the group of village women and those females from a high socio-economic urban fraction of the population were only observed for the vitamin B2 status. The B2-dependent enzyme activation coefficient varies between 46.5 up to 56.7% for the rural and between 8.9 to 18.5% for the urban women. Vitamin B6 deficiencies as measured by the activation coefficient varied above 30% up to 40% and more for both groups of women. A functional significance could only be established for vitamin B2 deficiency. The increase of the activation coefficient correlated with an increase in the serum concentration levels of transferrin. Transferrin in turn was inversely correlated with haemoglobin.

Serum leptin and lipid profiles in Thai obese and overweight subjects.

The weight, height, body mass index (BMI), waist/hip ratio, serum leptin and lipid profiles of 48 overweight (BMI > or = 25.00). Thai males and 166 overweight Thai females, compared with 26 males and 81 females in a control group (BMI = 18.5-24.9 kg/m2), were investigated. Subjects for the study were those persons who turned up regularly for physical check-ups at the out-patient department, general practice section of the Rajvithi Hospital, Bangkok. The study was conducted between March-October, 1998. Statistically significantly higher levels of serum leptin, cholesterol, LDL-C, LDL-C/HDL-C ratio and triglyceride were found in the overweight compared with the control subjects. The median serum leptin concentration in overweight subjects was 19.6 (2.0-60.0 ng/ml) compared with 9.0 (range 1.0-30.0 ng/ml) in the control subjects (p < 0.001). The median values of leptin serum concentrations in the overweight and obese males were significantly higher than those of the overweight and obese females. A total of 66.7% (32 out of 48) of the overweight and obese males had elevated leptin levels, while elevated leptin levels were found in 87.3% (145 out of 166) of the overweight and obese females. A total of 18.8% and 21.1% of the overweight and obese males and females respectively had cholesterol concentrations of > or = 6.48 mmol/l. However, the prevalence of low HDL-C (HDL-C < or = 0.91 mmol/l) was found to be 41.7% in the overweight and obese males and 4.2% in the overweight and obese females. Statistically significant associations were found between weight, height, BMI, waist, hip, waist/hip ratio, HDL-C, and serum leptin in both overweight male and female subjects. A negative correlation was found between serum leptin and LDL-C/HDL-C ratio in both the overweight and obese subjects.

Nutritional status and serum lipids of a rural population in Northeast Thailand--an example of health transition.

An investigation was undertaken in Northeast Thailand, a country undergoing rapid health transition, to find out whether there is a likelihood that the nutritional and lipid pattern of an adult population in Northeast Thailand is related to coronary heart disease in the same way as in western countries. In a cross-sectional study, the body mass index (BMI) and the waist-hip ratio as well as the important plasma lipids were determined. The nutritional status and the lipid profile of the predominantly middle-aged population is characterised by a generally favourable nutritional status and lipid concentrations, where the distribution, indicated by the medians, of the relevant variables over the total population is concerned. A rather high proportion of individuals was found to be overnourished and to have high triglyceride levels. Individuals with high triglyceride levels run a risk of developing coronary heart disease only when the LDL-HDL fraction is above 5. Only 3% of the total population investigated had a LDL-HDL ratio above that value. Since hypertriglyceridaemia is also linked to the insulin-resistant syndrome, it is concluded that, if the mortality of coronary heart disease increases in future, then this must be accounted probably more to the after-effects of the insulin-resistant syndrome than to the direct effect of an atherogenic lipid pattern. This view is supported by a high prevalence of impaired glucose tolerance (IGT) and non-insulin dependent diabetes mellitus (NIDDM) in the population under survey. Preventive measures in the area should concentrate among others on reducing overnutrition, especially among women, and increasing physical activity and screening for NIDDM.

Some human "carbohydrate-rich" serum proteins in protein-energy malnutrition.

The human serum proteins with a carbohydrate portion of more than 10 per cent in the molecule, alpha1-acid glycoprotein, alpha1-antichymotrypsin, alpha1B-glycoprotein and alpha2HS-glycoprotein were studied in thirteen cases of protein-energy malnutrition. The "acute phase reactant" proteins alpha1-acid glycoprotein and alpha1-antichymotrypsin were found to be increased above the controls, whereas the other "glycoproteins" either decreased or did not change significantly. Also albumin, prealbumin and transferrin were found to be low in the cases of protein-energy malnutrition.

alpha 1-antitrypsin phenotype PiMZ, a risk factor for liver cirrhosis but not for liver cancers in Thailand.

The risk of developing liver cirrhosis, hepatoma (HCC) and bile duct carcinoma (BDC) have been associated with homozygous alpha 1-antitrypsin (AT) deficiency especially linked to the Z allele. While the association between liver cancers and AT deficiency remains debatable, the risk of adult AT deficiency carriers to develop liver cirrhosis has not been assessed quantitatively. Liver cancers and liver diseases with subsequent liver cirrhosis are highly prevalent in tropical countries such as Thailand and heterozygous AT phenotypes are rather common in this country as well. The aim of this study was to assess the risk of developing liver cirrhosis, HCC and BDC by means of case-control studies with Thai patients and controls in connection with AT deficiency. For hepatitis, HCC and BDC to association with AT deficiency was detected. Carriers of PiMZ phenotype in Thailand have a high risk to develop liver cirrhosis (odds. ratio of 10.8, 95% confidence interval = 1.3-88.1). Patients with predisposing diseases should be screened for Pi phenotypes so that rigorous measures to combat the occurrence of liver cirrhosis can be implemented.

Erythrocyte antioxidant enzymes and blood pressure in relation to overweight and obese Thai in Bangkok.

The specific activities of antioxidant enzymes, [eg superoxide dismutases (SOD), glutathione peroxidase (GPX) and catalase (CAT)], anthropometric measurements, including waist/hip ratio of 48 male and 167 female overweight persons (body mass index (BMI) > or = 25.0 kg/m2) compared with a 26 male and 80 female control group (BMI = 18.5-24.9 kg/m2) of Thai volunteers who attended the Out-patient Department, General Practice Section, Rajvithi Hospital, Bangkok, for a physical check-up during March-October, 1998, were investigated. There was a slightly significant difference between the median age of the sexes. The medians of height, weight, and waist/hip ratio in males were significantly higher than those in female overweight and obese subjects. The median of arm circumference (AC), mid arm muscle circumference (MAMC) in males was significantly higher than those in female overweight and obese subjects (p < 0.05). The prevalences of hypertension based on systolic and diastolic blood pressure of > or = 160/> or = 95 mmHg, were 8.3% and 37.5% for males and 5.4% and 18.6% for females, respectively. There was no significant difference between the median of antioxidant enzymes (SOD, GPX and CAT) between the sexes. No significant differences in the antioxidant enzymes in male overweight/obese persons and normal controls were presented, whereas antioxidant enzymes in female overweight/obese persons were statistically lower than in control females (p < 0.05). A significantly higher SOD, GPX, and CAT status was observed in normal subjects compared with overweight/obese subjects (p < 0.01). A higher prevalence of SOD < or = 2,866 U/gHb, GPX (< or = 15.96 U/gHb in females was found, compared with males. A high percentage of lower catalase (CAT < or = 19.2x10(4) IU/gHb) was found in both sexes (64.5% in males and 64.5% in females). In obese subjects (BMI > or = 30.0 kg/m2), there were significantly positive relationships between systolic and diastolic blood pressure, systolic blood pressure and waist/hip ratio, and SOD could be related to weight, BMI as well as GPX and CAT, whereas the opposite result was observed for age and SOD.

Socio-demographic characteristics and health status of urban Thai elderly.

Socio-demographic and health status of 205 elderly aged 60-90 years who attended a special clinic for the elderly at Rajvithi Hospital were investigated. All of the subjects had no major complaints and seemed to be apparently healthy. Socio-economic situation, life-style pattern and other health related information was assessed. Nearly all of the elderly lived with their relatives. Quite a high number of the females had never attended school. Almost 60% of the elderly had no regular income. The health situation of the individuals under investigation seemed to be satisfactory. The majority did not smoke and did not drink alcohol. There are indications that in the future more of the elderly population will stay alone and will face economical problems because of the absence of general social security scheme for Thailand.

The vitamin B1, B2 and B6 status of school children in two resettlement areas in Northeast Thailand.

The vitamin B1, B2 and B6 status of school children were studied in the Khon Kaen resettlement and irrigation area and in the Lam-takong settlement in northease Thailand using the in vitro tests based on the erythrocyte transketolase, glutathione reductase and glutamate-oxaloacetate transaminase activities. Healthy school children from the Khon Kaen University School were selected as a reference group. The results demonstrate that the vitamin B1 status in the resettlement area is sufficient, but about 20% to 35% of all the children show evidence of vitamin B2 and B6 deficiencies. It is noticed that besides a high prevalence of parasitic infections and poor hygienic conditions the protein and vitamin intake is low and improvement of the situation is necessary.

Socio-economic, health and nutritional status of the villagers in the Nong Wai irrigation area, Khon Kaen, Northeast Thailand.

Studies were carried out from June 1974 to May 1975 on the socio-economic status, health and nutritional status of the people in 4 villages, in the irrigation area of the Nong Wai Pioneer Agricultural Project of Khon Kaen Province, Northeast Thailand. The result obtained were compared with those in 2 non-irrigated villages in the same province, in order to identify the health and nutritional problems which might arise during the water resource development in the irrigation area. It was found that in the irrigated villages 90% of the peoples were farmers, while in the non-irrigated villages all were farmers. The socio-economic status of the people in the irrigated villages was much better than those in the non-irrigated ones. The income per family in the former was about three times greater than that in the latter. In the study of the health conditions of the villagers, the vulnerable age group including pre-school children under 7 years of age and school children in the elementary school class 1 and class 2, aged 7-9 years old, served as subjects for investigation. Haematological and physical examinations revealed many children with mild to moderate anaemia, vitamin B2 deficiency and a few cases of hepatomegaly. Anaemic children were found to be more prevalent in the non-irrigated villages than in the irrigated area. The overall parasitic infection rates in children in the irrigated and non-irrigated villages were similar with respect to severity of the infection. Hookworm infection, opisthorchiasis, strongyloidiasis and giardiasis were the leading parasitic infections, while amoebiasis was rare. Ascariasis and trichuriasis were not found. However, the first two helminthic infections had a low grade of intensity. The nutritional status of pre-school children, showed that there were more children with good growth in the irrigated villages than in the non-irrigated one. Serum proteins, albumin and globulin, and urinary urea nitrogen-creatinine ratio revealed normal findings indicating that the children had sufficient protein intake. The results of the urinary hydroxyproline-creatinine index suggested that many of the children in both groups of the villages were at marginal malnutrition status. Surveys on domestic animals including cattle, buffaloes, pigs, and field rats revealed no important zoonotic diseases except leptospirosis in a few rats. Some fish were found to harbour metacercariae of Opisthorchis viverrini, while some snails were positive for cercariae of O. viverrini, Schistosoma spindale, and Echinostoma malayanum. The overall findings indicated that the water resource development by establishing better irrigation, resulted in an improved socio-economic and nutritional status among the villagers, but health conditions and associated parasitic diseases and some nutritional deficiency still existed in the children. However, the findings from this study provide only preliminary data concerning the socio-economic status, health, and nutritional status of the villagers in the irrigation area...