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1.
Clin Nutr ; 40(7): 4624-4632, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34229268

RESUMO

BACKGROUND AND AIMS: Vitamin B6 is involved in a large spectrum of physiological processes and comprises of the vitamers pyridoxamine (PM), pyridoxal (PL), pyridoxine (PN), and their phosphorylated derivatives including the biological active pyridoxal 5'-phosphate (PLP). While PN toxicity is known to complicate several treatments, PM has shown promise in relation to the treatment of metabolic and age-related diseases by blocking oxidative degradation and scavenging toxic dicarbonyl compounds and reactive oxygen species. We aimed to assess the metabolization of oral PM supplements in a single and three daily dose. MATERIALS AND METHODS: We optimized and validated a method for the quantification of the B6 vitamers in plasma and urine using ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). Five healthy volunteers were recruited to study PM metabolization after a single oral dose of 200 mg PM or a three daily dose of 67 mg PM. A third protocol was implemented as control for dietary intake. Venous blood samples, 24 h urine and fasted second void urine samples were collected. RESULTS: After a single oral dose of 200 mg PM, plasma PM increased in the first 3 h to a maximum of 2324 ± 266 nmol/L. While plasma PM levels returned to baseline after ~10 h of PM intake, PLP increased to a maximum of 2787 ± 329 nmol/L and reached a plateau. We found a small increase of PN to a maximum of 13.5 ± 2.1 nmol/L; it was nearly undetectable after ~12 h. With a three daily dose of 67 mg PM we observed an increase and decline of plasma PM, PL, and PN concentrations after each PM intake. PLP showed a similar increase as in the single dose protocol and accumulated over time. CONCLUSION: In this study we showed high plasma levels of PM after oral PM supplementation. We found steadily increasing levels of the biologically active PLP, with minimal formation of PN. The B6 vitamer PM is an interesting supplement as an inhibitor of harmful processes in metabolic diseases and for the treatment of vitamin B6 deficiency. CLINICAL TRIAL REGISTRY: The study was approved by the Medical Ethics Committee of Maastricht University (NL) and was registered at ClinicalTrials.gov as NCT02954588.


Assuntos
Suplementos Nutricionais , Piridoxamina/administração & dosagem , Vitamina B 6/sangue , Vitamina B 6/urina , Adulto , Cromatografia Líquida de Alta Pressão , Feminino , Voluntários Saudáveis , Humanos , Masculino , Fosfato de Piridoxal/sangue , Fosfato de Piridoxal/urina , Piridoxamina/sangue , Piridoxamina/urina , Piridoxina/sangue , Piridoxina/urina , Espectrometria de Massas em Tandem , Deficiência de Vitamina B 6/terapia
2.
Circ Genom Precis Med ; 13(5): 541-547, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33079603

RESUMO

BACKGROUND: The blood metabolome incorporates cues from the environment and the host's genetic background, potentially offering a holistic view of an individual's health status. METHODS: We have compiled a vast resource of proton nuclear magnetic resonance metabolomics and phenotypic data encompassing over 25 000 samples derived from 26 community and hospital-based cohorts. RESULTS: Using this resource, we constructed a metabolomics-based age predictor (metaboAge) to calculate an individual's biological age. Exploration in independent cohorts demonstrates that being judged older by one's metabolome, as compared with one's chronological age, confers an increased risk on future cardiovascular disease, mortality, and functionality in older individuals. A web-based tool for calculating metaboAge (metaboage.researchlumc.nl) allows easy incorporation in other epidemiological studies. Access to data can be requested at bbmri.nl/samples-images-data. CONCLUSIONS: In summary, we present a vast resource of metabolomics data and illustrate its merit by constructing a metabolomics-based score for biological age that captures aspects of current and future cardiometabolic health.


Assuntos
Envelhecimento/genética , Biomarcadores/metabolismo , Metabolômica/métodos , Interface Usuário-Computador , Doenças Cardiovasculares/genética , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/patologia , Humanos , Países Baixos , Modelos de Riscos Proporcionais , Espectroscopia de Prótons por Ressonância Magnética , Fatores de Risco
3.
J Nutr ; 150(12): 3171-3179, 2020 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-33119768

RESUMO

BACKGROUND: A low vitamin D and K status has been associated with increased cardiovascular disease (CVD) risk but the evidence of their combined effect on cardiovascular health is limited. OBJECTIVES: Our study aimed to investigate the prospective association of vitamin D and K status with subclinical measures of cardiovascular health and all-cause mortality among a population of Dutch Caucasians. METHODS: We performed an observational prospective study on 601 participants of the Hoorn Study (mean ± SD age: 70 ± 6 y, 50.4% women, BMI: 27.2 ± 4.0 kg/m2), of whom 321 underwent an echocardiogram in 2000-2001 and 2007-2009. Vitamin D and K status was assessed at baseline by serum 25-hydroxyvitamin D [25(OH)D] and plasma desphospho-uncarboxylated matrix-gla protein (dp-ucMGP)-high concentrations indicate low vitamin K status. Vital status was assessed from baseline until 2018. We studied the association of categories of 25(OH)D (stratified by the clinical cutoff of 50 mmol/L) and dp-ucMGP (stratified by the median value of 568 pmol/L) with echocardiographic measures using linear regression and with all-cause mortality using Cox regression, adjusted for confounders. RESULTS: Compared with markers of normal vitamin D and K status, markers of low vitamin D and K status were prospectively associated with increased left ventricular mass index (5.9 g/m2.7; 95% CI: 1.8, 10.0 g/m2.7). Participants with low vitamin D and K status were also at increased risk of all-cause mortality with an HR of 1.64 (95% CI: 1.12, 2.39) compared with normal vitamin D and K status. CONCLUSIONS: A combination of low vitamin D and K status is associated with adverse cardiac remodeling and increased risk of all-cause mortality in men and women. Future studies should investigate whether vitamin D and K supplementation could help to improve cardiovascular health and to decrease CVD risk.


Assuntos
Doenças Cardiovasculares , Mortalidade , Vitamina D/sangue , Vitamina K/sangue , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Deficiência de Vitamina D/sangue , Deficiência de Vitamina K/sangue
5.
Neurology ; 92(16): e1899-e1911, 2019 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-30944236

RESUMO

OBJECTIVE: To identify a plasma metabolomic biomarker signature for migraine. METHODS: Plasma samples from 8 Dutch cohorts (n = 10,153: 2,800 migraine patients and 7,353 controls) were profiled on a 1H-NMR-based metabolomics platform, to quantify 146 individual metabolites (e.g., lipids, fatty acids, and lipoproteins) and 79 metabolite ratios. Metabolite measures associated with migraine were obtained after single-metabolite logistic regression combined with a random-effects meta-analysis performed in a nonstratified and sex-stratified manner. Next, a global test analysis was performed to identify sets of related metabolites associated with migraine. The Holm procedure was applied to control the family-wise error rate at 5% in single-metabolite and global test analyses. RESULTS: Decreases in the level of apolipoprotein A1 (ß -0.10; 95% confidence interval [CI] -0.16, -0.05; adjusted p = 0.029) and free cholesterol to total lipid ratio present in small high-density lipoprotein subspecies (HDL) (ß -0.10; 95% CI -0.15, -0.05; adjusted p = 0.029) were associated with migraine status. In addition, only in male participants, a decreased level of omega-3 fatty acids (ß -0.24; 95% CI -0.36, -0.12; adjusted p = 0.033) was associated with migraine. Global test analysis further supported that HDL traits (but not other lipoproteins) were associated with migraine status. CONCLUSIONS: Metabolic profiling of plasma yielded alterations in HDL metabolism in migraine patients and decreased omega-3 fatty acids only in male migraineurs.


Assuntos
Lipoproteínas HDL/metabolismo , Transtornos de Enxaqueca/sangue , Adulto , Idoso , Biomarcadores/sangue , Estudos de Coortes , Ácidos Graxos Ômega-3/sangue , Feminino , Humanos , Masculino , Metaboloma , Metabolômica , Pessoa de Meia-Idade , Ressonância Magnética Nuclear Biomolecular , Espectroscopia de Prótons por Ressonância Magnética , Fatores Sexuais
6.
Am J Clin Nutr ; 104(6): 1712-1719, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27935525

RESUMO

BACKGROUND: Evidence has suggested that protein from dairy may be less detrimental to renal health than protein from nondairy products. However, to our knowledge, no previous studies have used cystatin C-based measures of the estimated glomerular filtration rate (eGFR). OBJECTIVE: We investigated the associations of sources of protein and dairy with the change in the eGFR in persons with a normal or mildly decreased eGFR. DESIGN: We included 3798 participants, aged 26-65 y, from the Doetinchem Cohort study who were examined ≥3 times 5 y apart. Intakes of protein and dairy and subtypes of protein and dairy were assessed at each round. With the use of the Chronic Kidney Disease Epidemiology Collaboration equation, the eGFR was estimated from cystatin C with all available samples per participant examined in one assay run. Generalized estimating equation models, which were adjusted for lifestyle, biological, and other dietary factors (monounsaturated fat, polyunsaturated fat, phosphorus, magnesium, calcium, and vitamin D) were performed. RESULTS: The mean baseline eGFR in the total cohort and in subjects with a mildly decreased eGFR (≥1 eGFR of 60-90 mL · min-1 · 1.73 m-2 during follow-up; n = 1326) was 108.6 and 95.2 mL · min-1 · 1.73 m-2, and the mean annual decline in both groups was 1.01 and 1.34 mL · min-1 · 1.73 m-2, respectively. Intakes of total, vegetable, animal, and nondairy protein, dairy protein, cheese, total dairy, high-fat dairy, and fermented dairy were not associated with eGFR changes. In individuals with a mildly decreased eGFR, higher consumption of milk, milk products, and low-fat dairy was associated with less annual decline in the eGFR (P-trend = 0.003). These associations were partially explained by dietary components of dairy (monounsaturated fat, polyunsaturated fat, phosphorus, magnesium, calcium, and vitamin D; P-trend < 0.04). CONCLUSIONS: Higher low-fat dairy consumption, but not sources of protein, is associated with less annual decline in the eGFR, particularly in individuals with a mildly decreased eGFR. These associations are partly attributable to other major components of dairy. Confirmation of these results will improve our ability to understand the role of dairy consumption in the prevention of renal dysfunction.


Assuntos
Laticínios/análise , Proteínas Alimentares/administração & dosagem , Rim/fisiologia , Adulto , Idoso , Animais , Cálcio da Dieta/administração & dosagem , Estudos de Coortes , Cistatina C/urina , Dieta com Restrição de Gorduras , Gorduras na Dieta/administração & dosagem , Ingestão de Energia , Exercício Físico , Ácidos Graxos Monoinsaturados/administração & dosagem , Ácidos Graxos Insaturados/administração & dosagem , Feminino , Taxa de Filtração Glomerular , Humanos , Estudos Longitudinais , Magnésio/administração & dosagem , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Fósforo/administração & dosagem , Fatores de Risco , Vitamina D/administração & dosagem
7.
Am J Clin Nutr ; 103(5): 1370-7, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26984487

RESUMO

BACKGROUND: Although coffee consumption and tea consumption have been linked to diabetes, the relation with kidney function is less clear and is underresearched. OBJECTIVE: We investigated the prospective associations of coffee and tea consumption with estimated glomerular filtration rate (eGFR). DESIGN: We included 4722 participants aged 26-65 y from the Doetinchem Cohort Study who were examined every 5 y for 15 y. Coffee and tea consumption (in cups/d) were assessed at each round. eGFR was assessed by using the Chronic Kidney Disease Epidemiology Collaboration equation based on both plasma creatinine and cystatin C. We determined the association between categories of coffee and tea intake and 1) eGFR and 2) subsequent annual changes in eGFR by using generalized estimating equation analyses. RESULTS: Baseline mean ± SD eGFR was 108.0 ± 14.7 mL · min(-1) · 1.73 m(-2) Tea consumption was not associated with eGFR. Those individuals who drank >6 cups coffee/d had a 1.33 (95% CI: 0.24, 2.43) mL · min(-1) · 1.73 m(-2) higher eGFR than those who drank <1 cup/d (P-trend = 0.02). This association was most apparent among those with a median age of ≥46 y at baseline, with eGFR being 2.47 (95% CI: 0.42, 4.51) mL · min(-1) · 1.73 m(-2) higher in participants drinking >6 cups/d compared with <1 cup/d (P-trend = 0.02). Adjustment for biological risk factors and coffee constituents did not attenuate the associations. Neither coffee nor tea consumption was associated with changes in eGFR. CONCLUSIONS: Coffee consumption was associated with a slightly higher eGFR, particularly in those aged ≥46 y. The absence of an association with eGFR changes suggests that the higher eGFR among coffee consumers is unlikely to be a result of glomerular hyperfiltration. Therefore, low to moderate coffee consumption is not expected to be a concern for kidney health in the general population.


Assuntos
Café/efeitos adversos , Taxa de Filtração Glomerular , Chá/efeitos adversos , Adulto , Idoso , Ácido Ascórbico/administração & dosagem , Índice de Massa Corporal , Cafeína/administração & dosagem , Creatinina/sangue , Cistatina C/sangue , Gorduras na Dieta , Fibras na Dieta/administração & dosagem , Ingestão de Energia , Exercício Físico , Humanos , Estilo de Vida , Modelos Logísticos , Estudos Longitudinais , Magnésio/administração & dosagem , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
8.
Diabetes ; 65(4): 956-66, 2016 04.
Artigo em Inglês | MEDLINE | ID: mdl-26718500

RESUMO

Obesity is associated with an increased risk for the development of type 2 diabetes and vascular complications. Advanced glycation end products are increased in adipose tissue and have been associated with insulin resistance, vascular dysfunction, and inflammation of adipose tissue. Here, we report that delayed intervention with pyridoxamine (PM), a vitamin B6 analog that has been identified as an antiglycating agent, protected against high-fat diet (HFD)-induced body weight gain, hyperglycemia, and hypercholesterolemia, compared with mice that were not treated. In both HFD-induced and db/db obese mice, impaired glucose metabolism and insulin resistance were prevented by PM supplementation. PM inhibited the expansion of adipose tissue and adipocyte hypertrophy in mice. In addition, adipogenesis of murine 3T3-L1 and human Simpson-Golabi-Behmel Syndrome preadipocytes was dose- and time-dependently reduced by PM, as demonstrated by Oil Red O staining and reduced expression of adipogenic differentiation genes. No ectopic fat deposition was found in the liver of HFD mice. The high expression of proinflammatory genes in visceral adipose tissue of the HFD group was significantly attenuated by PM. Treatment with PM partially prevented HFD-induced mild vascular dysfunction. Altogether, these findings highlight the potential of PM to serve as an intervention strategy in obesity.


Assuntos
Inflamação/prevenção & controle , Resistência à Insulina , Obesidade/tratamento farmacológico , Paniculite/prevenção & controle , Piridoxamina/administração & dosagem , Células 3T3-L1 , Tecido Adiposo/metabolismo , Tecido Adiposo/patologia , Animais , Arritmias Cardíacas/metabolismo , Arritmias Cardíacas/patologia , Células Cultivadas , Dieta Hiperlipídica , Esquema de Medicação , Doenças Genéticas Ligadas ao Cromossomo X/metabolismo , Doenças Genéticas Ligadas ao Cromossomo X/patologia , Gigantismo/metabolismo , Gigantismo/patologia , Cardiopatias Congênitas/metabolismo , Cardiopatias Congênitas/patologia , Humanos , Inflamação/metabolismo , Deficiência Intelectual/metabolismo , Deficiência Intelectual/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Obesos , Obesidade/etiologia , Obesidade/metabolismo , Paniculite/metabolismo , Tempo para o Tratamento
9.
Am J Hypertens ; 28(7): 868-76, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25523296

RESUMO

BACKGROUND: It has been hypothesized that arterial stiffness leads to generalized microvascular dysfunction and that individuals with type 2 diabetes mellitus (T2DM) are particularly prone to the detrimental effects of arterial stiffness. However, evidence for an association between stiffness and markers of generalized microvascular dysfunction is lacking. We therefore investigated the association between arterial stiffness and skin microvascular function in individuals without and with T2DM. METHODS: Cross-sectional data were used of The Supplementation en Vitamines et Mineraux Antioxydants 2 (SUVIMAX2) Study (n = 284/62.2 years/48.6% women/0% T2DM (by design)) and The Maastricht Study (n = 737/59.7 years/45.2% women/28.8% T2DM (by design)). Arterial stiffness was determined by carotid-femoral pulse wave velocity (cfPWV). Skin capillaroscopy was used to determine capillary density at baseline, and during reactive hyperemia and venous congestion. Laser Doppler flowmetry was used to assess acetylcholine- and local heating-induced vasoreactivity, and skin flowmotion. RESULTS: In The SUVIMAX2 Study, cfPWV (per +1 SD) was not associated with baseline capillary density (regression coefficient: -0.48 (95% confidence interval: 2.37; 1.41)) or capillary recruitment during venous congestion (0.54% (-0.74; 1.81%)). In addition, cfPWV was not associated with acetylcholine (-0.02% (-0.14; 0.10%)) or local heating-induced vasoreactivity (0.03% (-0.07; 0.12%)). In The Maastricht Study, in individuals without T2DM, cfPWV was not associated with baseline capillary density (-1.20 (-3.17; 0.77)), and capillary recruitment during reactive hyperemia (1.22% (-0.41; 2.84%)) or venous congestion (1.50% (-0.25; 3.25%)). In addition, cfPWV was not associated with flowmotion (-0.01 (-0.07; 0.06)). Results were adjusted for age and sex. Additional adjustments for confounders did not materially change these results. Results were qualitatively similar in individuals with T2DM. CONCLUSIONS: Arterial stiffness is not associated with skin microvascular function, irrespective of the presence of T2DM.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/etiologia , Microcirculação , Microvasos/fisiopatologia , Pele/irrigação sanguínea , Rigidez Vascular , Acetilcolina/farmacologia , Adulto , Idoso , Velocidade do Fluxo Sanguíneo , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatologia , Angiopatias Diabéticas/diagnóstico , Angiopatias Diabéticas/fisiopatologia , Feminino , França , Humanos , Fluxometria por Laser-Doppler , Masculino , Microcirculação/efeitos dos fármacos , Angioscopia Microscópica , Microvasos/efeitos dos fármacos , Pessoa de Meia-Idade , Países Baixos , Estudos Prospectivos , Análise de Onda de Pulso , Fluxo Sanguíneo Regional , Temperatura Cutânea , Vasodilatação , Vasodilatadores/farmacologia
10.
Clin Nephrol ; 78(4): 263-72, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22981031

RESUMO

BACKGROUND: Arterial stiffness is increased in chronic kidney disease (CKD). Intervention studies aimed at reduction of arterial stiffness in dialysis patients have been disappointing. We therefore investigated the effect of pravastatin, vitamin E, and homocysteine lowering on arterial compliance and distensibility coefficients in mild-to-moderate CKD. METHODS: This is a sub-study of the ATIC study, a randomized, double-blind trial in 93 CKD patients. The treatment group received pravastatin to which vitamin E supplementation was added after 6 months and homocysteine lowering therapy after another 6 months. Measurement of the distensibility coefficient (DC) and the compliance coefficient (CC) of the common carotid (CCA), femoral (FA) and brachial artery (BA) was performed at 0, 6, 12, 18 months. Young's elastic modulus (YEM) was measured in the common carotid artery. RESULTS: After 18 months, CCA-DC increased from mean (SD) 15.15 (6.67) to 16.52 (6.37) × 10-3kPa-1 in the treatment and decreased from 18.44 (8.19) to 16.26 (7.35) in the placebo group (p = 0.057). CCA-CC increased from 0.64 (0.24) to 0.71 (0.26) mm2kPa-1 in the treatment and decreased from 0.77 (0.28) to 0.69 (0.25) in the placebo group (p < 0.0001). FA-DC had increased from 6.64 (3.45) to 11.46 (6.83) in the treatment group, and from 6.46 (2.85) to 7.08 (2.73) in the placebo group (p = 0.0001). FA-CC had increased from 0.46 (0.24) to 0.74 (0.44) in the treatment group, and from 0.48 (0.27) to 0.53 (0.21) in the placebo group (p = 0.008). BA-DC and CC, and CCA YEM were not significantly different between the groups. CONCLUSION: In patients with mild-to-moderate CKD, 18 months of treatment consisting of pravastatin, vitamin E and homocysteine lowering resulted in significant improvement of compliance and distensibility in CCA and FA. Since pravastatin was used throughout the observation period, it remains unclear whether the beneficial effects are attributable solely to the ongoing effect of pravastatin treatment, or if the additional interventions further slowed the progression of vascular stiffness. Therefore, larger studies with a longer period of follow-up observing the separate effects are needed.


Assuntos
Homocisteína/sangue , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Nefropatias/tratamento farmacológico , Pravastatina/administração & dosagem , Rigidez Vascular/efeitos dos fármacos , Vitamina E/administração & dosagem , Adulto , Idoso , Artéria Braquial/fisiopatologia , Artéria Carótida Primitiva/fisiopatologia , Doença Crônica , Método Duplo-Cego , Feminino , Artéria Femoral/fisiopatologia , Humanos , Nefropatias/sangue , Nefropatias/fisiopatologia , Masculino , Pessoa de Meia-Idade
11.
Clin Endocrinol (Oxf) ; 71(5): 666-72, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19226272

RESUMO

OBJECTIVE: Vitamin D deficiency is common among the elderly and may contribute to cardiovascular disease. The aim of our study was to elucidate whether low serum levels of 25-hydroxyvitamin D [25(OH)D] are associated with an increased risk of all-cause and cardiovascular mortality. DESIGN AND PATIENTS: The Hoorn Study is a prospective population-based study among older men and women. MEASUREMENTS: Fasting serum 25(OH)D was determined in 614 study participants at the follow-up visit in 2000-2001, the baseline for the present analysis. To account for sex differences and seasonal variations of 25(OH)D levels we formed sex-specific quartiles, which were calculated from the 25(OH)D values of each season. RESULTS: After a mean follow-up period of 6.2 years, 51 study participants died including 20 deaths due to cardiovascular causes. Unadjusted Cox proportional hazard ratios (HRs; with 95% confidence intervals) for all-cause and cardiovascular mortality in the first when compared with the upper three 25(OH)D quartiles were 2.24 (1.28-3.92; P = 0.005) and 4.78 (1.95-11.69; P = 0.001), respectively. After adjustment for age, sex, diabetes mellitus, smoking status, arterial hypertension, high-density lipoprotein-cholesterol, glomerular filtration rate and waist-to-hip ratio, the HRs remained significant for all-cause [1.97 (1.08-3.58; P = 0.027)] and for cardiovascular mortality [5.38 (2.02-14.34; P = 0.001)]. CONCLUSIONS: Low 25(OH)D levels are associated with all-cause mortality and even more pronounced with cardiovascular mortality, but it remains unclear whether vitamin D deficiency is a cause or a consequence of a poor health status. Therefore, intervention studies are warranted to evaluate whether vitamin D supplementation reduces mortality and cardiovascular diseases.


Assuntos
Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/mortalidade , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/mortalidade , Vitamina D/análogos & derivados , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Vitamina D/sangue
12.
World J Gastroenterol ; 15(8): 955-60, 2009 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-19248194

RESUMO

AIM: To investigate the effect of vitamin supplements on homocysteine levels in patients with celiac disease. METHODS: Vitamin B6, folate, vitamin B12, and fasting plasma homocysteine levels were measured in 51 consecutive adults with celiac disease [median (range) age 56 (18-63) years; 40% men, 26 (51%) had villous atrophy, and 25 (49%) used B-vitamin supplements] and 50 healthy control individuals matched for age and sex. Finally, the C677T polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) was evaluated in 46 patients with celiac disease and all control individuals. RESULTS: Patients with celiac disease and using vitamin supplements had higher serum vitamin B6 (P = 0.003), folate (P < 0.001), and vitamin B12 (P = 0.012) levels than patients who did not or healthy controls (P = 0.035, P < 0.001, P = 0.007, for vitamin B6, folate, and vitamin B12, respectively). Lower plasma homocysteine levels were found in patients using vitamin supplements than in patients who did not (P = 0.001) or healthy controls (P = 0.003). However, vitamin B6 and folate, not vitamin B12, were significantly and independently associated with homocysteine levels. Twenty-four (48%) of 50 controls and 23 (50%) of 46 patients with celiac disease carried the MTHFR thermolabile variant T-allele (P = 0.89). CONCLUSION: Homocysteine levels are dependent on Marsh classification and the regular use of B-vitamin supplements is effective in reduction of homocysteine levels in patients with celiac disease and should be considered in disease management.


Assuntos
Doença Celíaca/sangue , Doença Celíaca/tratamento farmacológico , Homocisteína/sangue , Complexo Vitamínico B/uso terapêutico , Adolescente , Adulto , Creatinina/metabolismo , Suplementos Nutricionais , Feminino , Ácido Fólico/sangue , Humanos , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Pessoa de Meia-Idade , Ácido Pantotênico/sangue , Polimorfismo de Nucleotídeo Único , Vitamina B 12/sangue , Adulto Jovem
13.
Arch Intern Med ; 167(12): 1262-70, 2007 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-17592099

RESUMO

BACKGROUND: Patients with chronic kidney disease have an increased risk of cardiovascular disease. Oxidative stress has been proposed to play a role in the development of cardiovascular disease among these patients. METHODS: We conducted a randomized, double-blind trial in 93 patients (Cockcroft-Gault equation: creatinine clearance, 38+/-15 [mean+/-SD] mL/min per 1.73 m2 [0.63+/-0.25 mL/s per m2]) to investigate the effect of a treatment strategy designed primarily to achieve stepwise oxidative stress reduction on common carotid intima-media thickness (CC-IMT), brachial artery flow-mediated dilatation (BA-FMD), albuminuria, and renal function. The treatment group received a regimen of pravastatin to which vitamin E supplementation was added after 6 months and homocysteine-lowering therapy after another 6 months. Blood pressure in both groups was managed according to a standard protocol. The placebo group received matching placebos. Measurement of CC-IMT and BA-FMD was performed at randomization after 6, 12, and 18 months. Patients were followed up for 2 years. Generalized estimating equations were used for analysis. RESULTS: Compared with placebo, active treatment was associated with a decrease in CC-IMT (after 18 months: from 0.68 to 0.63 mm in the treatment group and from 0.65 to 0.71 mm in the placebo group; P<.001), an increase in BA-FMD (after 18 months: from 4.66% to 7.56% in the treatment group and from 6.21% to 4.73% in the placebo group; P<.001), and an attenuated increase in urinary albumin excretion over time (P=.04 for between-group difference after 24 months), but no effect was observed on renal function. CONCLUSION: In patients with mild to moderate chronic kidney disease, 18 months of a treatment strategy along with well-controlled blood pressure reduced CC-IMT and urinary albumin excretion and increased BA-FMD. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00384618.


Assuntos
Artéria Carótida Primitiva/diagnóstico por imagem , Taxa de Filtração Glomerular/fisiologia , Homocisteína/antagonistas & inibidores , Falência Renal Crônica/tratamento farmacológico , Pravastatina/uso terapêutico , Vitamina E/uso terapêutico , Vitaminas/uso terapêutico , Administração Oral , Artéria Carótida Primitiva/fisiopatologia , Método Duplo-Cego , Quimioterapia Combinada , Endotélio Vascular/fisiopatologia , Ensaio de Imunoadsorção Enzimática , Feminino , Ácido Fólico/administração & dosagem , Ácido Fólico/uso terapêutico , Seguimentos , Homocisteína/sangue , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Falência Renal Crônica/metabolismo , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo , Pravastatina/administração & dosagem , Piridoxina/administração & dosagem , Piridoxina/uso terapêutico , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Ultrassonografia , Vitamina E/administração & dosagem , Vitaminas/administração & dosagem
14.
Am J Clin Nutr ; 85(3): 755-61, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17344497

RESUMO

BACKGROUND: Inadequate vitamin D status is common in many populations around the world. OBJECTIVE: The aim was to evaluate potentially modifiable determinants of vitamin D status in an older population. DESIGN: This was a cross-sectional study from a population-based cohort including 538 white Dutch men and women aged 60-87 y. Vitamin D status was assessed by plasma 25-hydroxyvitamin D [25(OH)D] concentrations. RESULTS: In the winter period, 51% of the subjects had 25(OH)D concentrations <50.0 nmol/L. Greater body fatness and less time spent on outdoor physical activity were associated with worse vitamin D status. Regular use of vitamin D-fortified margarine products [odds ratio (OR) in a comparison of intake of >or=20 g/d with none: 0.41; 95% CI: 0.20, 0.86; P for trend < 0.001], fatty fish (OR for servings of >or=2/mo versus none: 0.41; 95% CI: 0.16, 1.04; P for trend = 0.01), and vitamin D-containing supplements (OR for >or= 1/d versus none: 0.33; 95% CI: 0.17, 0.63; P for trend < 0.001) were inversely associated with vitamin D inadequacy [25(OH)D <50.0 nmol/L]. We estimated that combined use of margarine products (20 g/d), fatty fish (100 g/wk), and vitamin D supplements (>or=1/d) was associated with a 16.8 nmol/L higher 25(OH)D concentration than was the use of none of these. However, none of the participants reached these intakes for all 3 factors. CONCLUSION: Because few foods are vitamin D-fortified and the amounts of vitamin D in supplements are low, it is difficult to achieve adequate vitamin D status through increasing intakes in the Netherlands and in countries with similar policies.


Assuntos
Calcifediol/sangue , Vitamina D/metabolismo , Tecido Adiposo/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Dieta , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Obesidade/sangue , Obesidade/metabolismo , Fumar
16.
Cardiovasc Res ; 57(2): 563-71, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12566129

RESUMO

OBJECTIVE: In a combination of in vivo and in vitro studies, we investigated mechanisms via which alpha-tocopherol, a lipid soluble form of vitamin E, can directly affect endothelial activation as induced by H(2)O(2) and TNFalpha. METHODS: We measured effects of alpha-tocopherol on H(2)O(2)-induced lipid peroxidation as determined with a fluorescent C-11 BODIPY(581/591) probe and on adhesion molecule expression in cultured endothelial cells. In 20 healthy volunteers treated with increasing doses of alpha-tocopherol up to 800 IU/ml for 12 weeks, plasma levels of soluble cell adhesion molecules (sCAMs) and C-reactive protein were measured. RESULTS: We showed that alpha-tocopherol protects cultured endothelial cells against H(2)O(2)-induced lipid peroxidation, while TNFalpha did not induce lipid peroxidation. Moreover, alpha-tocopherol attenuated H(2)O(2)-, but not TNFalpha-induced increases in adhesion molecule expression. In healthy persons, alpha-tocopherol decreased plasma levels of sE-selectin from 65+/-6 to 60+/-6 ng/ml (P=0.002), sVCAM from 893+/-31 to 853+/-23 ng/ml (P=0.022), and sICAM from 483+/-21 to 463+/-16 ng/ml (P=0.048). C-Reactive protein, as a sensitive marker of low grade inflammation, was not significantly affected. CONCLUSION: alpha-Tocopherol specifically inhibits lipid peroxidation-induced endothelial activation in vitro. The observed vitamin E-induced decrease in sCAMs in control subjects suggests that lipid peroxidation can take place in healthy individuals. Although vitamin E supplementation may be especially effective in specific groups of patients exposed to increased oxidative stress, our study suggests that vitamin E supplementation can be of benefit in healthy individuals as well.


Assuntos
Antioxidantes/farmacologia , Moléculas de Adesão Celular/metabolismo , Endotélio Vascular/efeitos dos fármacos , Peroxidação de Lipídeos/efeitos dos fármacos , alfa-Tocoferol/farmacologia , Proteína C-Reativa/metabolismo , Células Cultivadas , Endotélio Vascular/metabolismo , Humanos , Peróxido de Hidrogênio/farmacologia , Peroxidação de Lipídeos/fisiologia , Estresse Oxidativo/efeitos dos fármacos , Solubilidade , Fator de Necrose Tumoral alfa/farmacologia
17.
Food Nutr Bull ; 23(3 Suppl): 113-9, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12362777

RESUMO

With intravenous infusion of doubly-labeled [2H3C-1(-13)C-] methionine and stable isotope enrichments in plasma free methionine and carbon dioxide in breath air, whole body transmethylation, transsulfuration, and remethylation rates can be calculated. This technique demonstrated impaired recycling as the major disturbance to explain hyperhomocysteinemia in patients with end-stage renal failure, and can be used to optimize interventions with folate, B6, and B12 supplementation in this patient group. Intravenous infusion of [2,3,3-(2)H3] serine has also been applied to demonstrate the appearance of [2H2]- as well as [2H1]-methionine in plasma and protein, suggesting transfer of a one-carbon group from serine via 5,10-methylenetetrahydrofolate in human hepatocyte cytosol and mitochondria, respectively. In sheep, tissue free methionine enrichments after infusion of universally labeled [U-13C] methionine showed the highest remethylation activity in postmortem investigation of jejunum, liver, and kidney tissue samples, but no such activity in muscle and brain samples. Methods to quantitate one-carbon acceptor metabolism pathways and folate metabolism have recently become available.


Assuntos
Homocisteína/metabolismo , Hiper-Homocisteinemia/fisiopatologia , Metionina/metabolismo , Óxido de Deutério , Ácido Fólico/metabolismo , Humanos , Hiper-Homocisteinemia/complicações , Infusões Intravenosas , Falência Renal Crônica/complicações , Metilação , Serina/metabolismo , Tomografia Computadorizada de Emissão , Trítio
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