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OBJECTIVE: Mean arterial pressure (MAP) plays a significant role in regulating tissue perfusion and urine output (UO). The optimal MAP target in critically ill patients remains a subject of debate. We aimed to explore the relationship between MAP and UO. DESIGN: A retrospective observational study. SETTING: A general ICU in a tertiary medical center. PATIENTS: All critically ill patients admitted to the ICU for more than 10 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: MAP values and hourly UO were collected in 5,207 patients. MAP levels were categorized into 10 groups of 5 mm Hg (from MAP < 60 mm Hg to MAP > 100 mg Hg), and 656,423 coupled hourly mean MAP and UO measurements were analyzed. Additionally, we compared the UO of individual patients in each MAP group with or without norepinephrine (NE) support or diuretics, as well as in patients with acute kidney injury (AKI).Hourly UO rose incrementally between MAP values of 65-100 mm Hg. Among 2,226 patients treated with NE infusion, mean UO was significantly lower in the MAP less than 60 mm Hg group (53.4 mL/hr; 95% CI, 49.3-57.5) compared with all other groups (p < 0.001), but no differences were found between groups of 75 less than or equal to MAP. Among 2500 patients with AKI, there was a linear increase in average UO from the MAP less than 60 mm Hg group (57.1 mL/hr; 95% CI, 54.2-60.0) to the group with MAP greater than or equal to 100 mm Hg (89.4 mL/hr; 95% CI, 85.7-93.1). When MAP was greater than or equal to 65 mm Hg, we observed a statistically significant trend of increased UO in periods without NE infusion. CONCLUSIONS: Our analysis revealed a linear correlation between MAP and UO within the range of 65-100 mm Hg, also observed in the subgroup of patients treated with NE or diuretics and in those with AKI. These findings highlight the importance of tissue perfusion to the maintenance of diuresis and achieving adequate fluid balance in critically ill patients.
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Presión Arterial , Enfermedad Crítica , Unidades de Cuidados Intensivos , Humanos , Estudios Retrospectivos , Masculino , Femenino , Persona de Mediana Edad , Presión Arterial/efectos de los fármacos , Presión Arterial/fisiología , Anciano , Lesión Renal Aguda/fisiopatología , Lesión Renal Aguda/orina , Lesión Renal Aguda/diagnóstico , Norepinefrina/orina , Micción/efectos de los fármacos , Micción/fisiologíaRESUMEN
INTRODUCTION AND OBJECTIVES: Hepatorenal syndrome (HRS) is a serious complication of cirrhosis treated with various medications. We aim to evaluate terlipressin and albumin's effectiveness and safety compared to albumin and noradrenaline in adult hepatorenal disease patients. MATERIALS AND METHODS: Clinical trials from four databases were included. Cochrane's approach for calculating bias risk was utilized. We rated the quality evaluation by Grading of Recommendations Assessment, Development, and Evaluation (GRADE). We included the following outcomes: serum creatinine (mg/dl), urine output (ml/24 h), mean arterial pressure (mmHg), reversal rate of HRS, mortality rate, blood plasma renin activity (ng/ml/h), plasma aldosterone concentration (pg/ml), urine sodium (mEq/l), and creatinine clearance (ml/min). RESULTS: Our analysis of nine clinical studies revealed that the noradrenaline group was associated with higher creatinine clearance (MD = 4.22 [0.40, 8.05]), (P = 0.03). There were no significant differences in serum creatinine levels (MD = 0.03 [-0.07, 0.13]), urinary sodium (MD = -1.02 [-5.15, 3.11]), urine output (MD = 32.75 [-93.94, 159.44]), mean arterial pressure (MD = 1.40 [-1.17, 3.96]), plasma renin activity (MD = 1.35 [-0.17, 2.87]), plasma aldosterone concentration (MD = 55.35 [-24.59, 135.29]), reversal rate of HRS (RR = 1.15 [0.96, 1.37]), or mortality rate (RR = 0.87 [0.74, 1.01]) between the two groups (p-values > 0.05). CONCLUSIONS: Noradrenaline is a safe alternative medical therapy for HRS.
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Albúminas , Síndrome Hepatorrenal , Norepinefrina , Terlipresina , Vasoconstrictores , Humanos , Terlipresina/uso terapéutico , Síndrome Hepatorrenal/tratamiento farmacológico , Norepinefrina/uso terapéutico , Norepinefrina/orina , Norepinefrina/sangre , Albúminas/uso terapéutico , Resultado del Tratamiento , Vasoconstrictores/uso terapéutico , Vasoconstrictores/efectos adversos , Adulto , Creatinina/sangre , Lipresina/análogos & derivados , Lipresina/uso terapéutico , Lipresina/efectos adversosRESUMEN
Twenty-four-hour urine measurements play a crucial role in the diagnosis, follow-up and treatment of various diseases. There are different approaches to the collection of urine in patients who need to collect multiple urine samples at a time, especially in hospitals with heavy workloads. In this study, we compared the sodium, potassium, chloride, amylase, calcium, creatinine, phosphorus, microalbumin, protein, magnesium, urea, uric acid, adrenaline, noradrenaline, dopamine, metanephrine, normetanephrine, vanillylmandelic acid, 5-hydroxyindoleacetic acid and homovanillic acid results of 24-h urine samples analyzed immediately without acid addition, which we accepted as the reference and baseline measurement, with the results of the samples analyzed after waiting for 24 h without acid addition, analyzed immediately with acid addition and analyzed after waiting for 24 h with acid addition. Chloride, microalbumin, amylase and protein tests, which are recommended to be measured in the sample without preservatives, are affected by acid addition. Adrenaline, noradrenaline and dopamine, which are the tests recommended to be measured in acid-added urine are degraded in the samples without acid, and the levels of metanephrine and normetanephrine were not significantly degraded in the absence of preservatives.
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Metanefrina , Normetanefrina , Amilasas , Cloruros , Dopamina/orina , Epinefrina/orina , Humanos , Norepinefrina/orina , Normetanefrina/orinaRESUMEN
Pheochromocytoma (Pheo) is a tumor derived from chromaffin cells. It can be studied using 18F-dihydroxyphenylalanine (DOPA)-positron emission tomography (PET) due to its overexpression of L-type amino acid transporters (LAT1 and LAT2). The oncogenic pathways involved are still poorly understood. This study examined the relationship between 18F-DOPA-PET uptake and LAT1 expression, and we explored the role of miR-375 and putative target genes. A consecutive series of 58 Pheo patients were retrospectively analyzed, performing 18F-DOPA-PET in 32/58 patients. Real-time quantitative PCR was used to assess the expression of LAT1, LAT2, phenylethanolamine N-methyltransferase (PNMT), miR-375, and the major components of the Hippo and Wingless/Integrated pathways. Principal germline mutations associated with hereditary Pheo were also studied. Pheo tissues had significantly higher LAT1, LAT2, and PNMT mRNA levels than normal adrenal tissues. MiR-375 was strongly overexpressed. Yes-associated protein 1 and tankyrase 1 were upregulated, while beta-catenin, axin2, monocarboxylate transporter 8, and Frizzled 8 were downregulated. A positive relationship was found between 18F-DOPA-PET SUV mean and LAT1 gene expression and for 24 h-urinary norepinephrine and LAT1. This is the first experimental evidence of 18F-DOPA uptake correlating with LAT1 overexpression. We also demonstrated miR-375 overexpression and downregulated (Wnt) signaling and identified the Hippo pathway as a new potentially oncogenic feature of Pheo.
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Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Transportador de Aminoácidos Neutros Grandes 1/genética , MicroARNs/genética , Feocromocitoma/diagnóstico por imagen , Tomografía de Emisión de Positrones/métodos , Proteínas Adaptadoras Transductoras de Señales/genética , Neoplasias de las Glándulas Suprarrenales/genética , Neoplasias de las Glándulas Suprarrenales/patología , Neoplasias de las Glándulas Suprarrenales/orina , Adulto , Anciano , Anciano de 80 o más Años , Dihidroxifenilalanina/administración & dosificación , Dihidroxifenilalanina/análogos & derivados , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , Persona de Mediana Edad , Norepinefrina/orina , Feniletanolamina N-Metiltransferasa/genética , Feocromocitoma/genética , Feocromocitoma/patología , Feocromocitoma/orina , Estudios Retrospectivos , Carga Tumoral , Regulación hacia Arriba , Vía de Señalización WntRESUMEN
Short sleep duration and poor sleep quality are associated with cardiovascular risk, and sympathetic nervous system (SNS) dysfunction appears to be a key contributor. The present review will characterize sympathetic function across several sleep disorders and insufficiencies in humans, including sleep deprivation, insomnia, narcolepsy, and obstructive sleep apnea (OSA). We will focus on direct assessments of sympathetic activation, e.g., plasma norepinephrine and muscle sympathetic nerve activity, but include heart rate variability (HRV) when direct assessments are lacking. The review also highlights sex as a key biological variable. Experimental models of total sleep deprivation and sleep restriction are converging to support several epidemiological studies reporting an association between short sleep duration and hypertension, especially in women. A systemic increase of SNS activity via plasma norepinephrine is present with insomnia and has also been confirmed with direct, regionally specific evidence from microneurographic studies. Narcolepsy is characterized by autonomic dysfunction via both HRV and microneurographic studies but with opposing conclusions regarding SNS activation. Robust sympathoexcitation is well documented in OSA and is related to baroreflex and chemoreflex dysfunction. Treatment of OSA with continuous positive airway pressure results in sympathoinhibition. In summary, sleep disorders and insufficiencies are often characterized by sympathoexcitation and/or sympathetic/baroreflex dysfunction, with several studies suggesting women may be at heightened risk.
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Trastornos del Sueño-Vigilia/fisiopatología , Sistema Nervioso Simpático/fisiopatología , Animales , Humanos , Norepinefrina/sangre , Norepinefrina/orina , Trastornos del Sueño-Vigilia/metabolismo , Trastornos del Sueño-Vigilia/terapia , Sistema Nervioso Simpático/metabolismo , Sistema Nervioso Simpático/fisiologíaRESUMEN
Urinary catecholamines (CAs) have been examined for the screening of pheochromocytomas. The decision to perform screening is based on symptoms suggesting secondary hypertension or hyperactivities of the sympathetic nervous system. To elucidate the usefulness of urinary fractions and ratios of CAs, 79 patients in whom 24-h excretions of urinary CAs including adrenaline (AD), noradrenaline (NA) and dopamine (DA) had been examined from 2015 until 2020 were retrospectively analyzed. There were no significant differences in urinary CA levels between two age groups, gender groups and two BMI groups. Patients with histories of preexisting hypertension and diabetes showed significantly higher levels of urinary NA excretion, and the urinary ratio of NA/DA was also increased in the patients with a history of hypertension. Heart rate (HR) was significantly correlated with the urinary ratio of NA/DA. Serum free thyroxine (FT4) concentration and ratio of FT4/thyrotropin (TSH) were correlated with the level of urinary AD. The levels of TSH and FT4/TSH showed negative and positive correlations, respectively, with the urinary NA/DA ratio. Thus, increases of HR are related to the enhanced conversion of DA to NA and increased thyroid hormones are involved in the increase in urinary AD and the conversion of DA to NA. History of lifestyle-related diseases and changes of HR and thyroid functions need to be considered for the evaluation of urinary CAs and their ratios.
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Neoplasias de las Glándulas Suprarrenales , Hipertensión , Catecolaminas/orina , Dopamina/orina , Frecuencia Cardíaca , Humanos , Norepinefrina/orina , Estudios Retrospectivos , Tirotropina , TiroxinaRESUMEN
OBJECTIVE: Women living with HIV (WLWH) experience psychosocial stress related to social-structural vulnerabilities. To investigate neuroendocrine pathways linking stress and increased cardiovascular disease risk among WLWH, we evaluated associations between psychosocial stress (i.e., perceived stress, posttraumatic stress, and experiences of race- and gender-based harassment) and a composite neuroendocrine biomarker index among WLWH and women without HIV. METHODS: In 2019-2020, Women's Interagency HIV Study participants in Washington, DC completed a questionnaire and provided blood and 12-hour overnight urine samples for testing of serum dehydroepiandrosterone sulfate (DHEA-S) and urinary free cortisol, epinephrine, and norepinephrine. Psychosocial stress was measured using the Perceived Stress Scale, PTSD Checklist-Civilian Version, and Racialized Sexual Harassment Scale. Latent profile analysis was used to classify participants into low (38%), moderate (44%), and high (18%) stress groups. Composite biomarker index scores between 0-4 were assigned based on participants' number of neuroendocrine biomarkers in high-risk quartiles (≥75th percentile for cortisol, epinephrine, and norepinephrine and ≤25th percentile for DHEA-S). We evaluated associations between latent profile and composite biomarker index values using multivariable linear regression, adjusting for socio-demographic, behavioral, metabolic, and HIV-related factors. RESULTS: Among 90 women, 62% were WLWH, 53% were non-Hispanic Black, and median age was 55 years. In full multivariable models, there was no statistically significant association between psychosocial stress and composite biomarker index values among all women independent of HIV status. High (vs. low) psychosocial stress was positively associated with higher mean composite biomarker index values among all monoracial Black women (adjusted ß = 1.32; 95% CI: 0.20-2.43), Black WLWH (adjusted ß = 1.93; 95% CI: 0.02-3.83) and Black HIV-negative women (adjusted ß = 2.54; 95% CI: 0.41-4.67). CONCLUSIONS: Despite a null association in the overall sample, greater psychosocial stress was positively associated with higher neuroendocrine biomarker concentrations among Black women, highlighting a plausible mechanism by which psychosocial stress could contribute to cardiovascular disease risk.
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Epinefrina/orina , Infecciones por VIH , VIH-1 , Hidrocortisona/orina , Norepinefrina/orina , Estrés Psicológico/orina , Biomarcadores/orina , District of Columbia , Femenino , Infecciones por VIH/psicología , Infecciones por VIH/orina , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Factores SocioeconómicosRESUMEN
A hydrogel based on titanium dioxide/MXene with polyvinyl alcohol/graphene oxide (TiO2/MXene-PVA/GO) composite was successfully formulated and applied to modify a screen-printed carbon electrode (SPCE) for urinary norepinephrine (NE) detection. The characterization confirmed that a nanocomposite hydrogel structure of TiO2/MXene-PVA/GO was formed. The as-prepared hydrogel substantially enhanced the sensor performances due to electrocatalytic activity of TiO2, high conductivity of MXene, and auto-sample preconcentration via PVA/GO hydrogel. The electrochemical behavior of NE was investigated by cyclic voltammetry and amperometry. Under optimized conditions, the TiO2/MXene-PVA/GO hydrogel/SPCE response due to the oxidation of NE at +0.4 V (vs. Ag|AgCl) is proportional to the concentration of NE over 0.01 to 1.00 µM (R2 = 0.9968) and 1.00 to 60.0 µM (R2 = 0.9936) ranges with a detection limit (3σ) of 6 nM without interferent effect from common interferences in urine. Furthermore, this sensor was employed for urinary NE determination and validated by high performance liquid chromatography (HPLC) with a UV detector at 280 nm; the average recovery was found to be 97.6 to 102%, with a relative standard deviation (RSD) less than 4.9%. This device was sensitive enough to evaluate an early stage of neurological disorder via detecting clinically relevant NE level. Eventually, it was integrated with pantyliners which could be a potential wearable sensor in the near future.
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Técnicas Electroquímicas/métodos , Hidrogeles/química , Enfermedades del Sistema Nervioso/diagnóstico , Norepinefrina/orina , Humanos , Enfermedades del Sistema Nervioso/patologíaRESUMEN
[Figure: see text].
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Aterosclerosis/etiología , Enfermedades Cardiovasculares/etiología , Epinefrina/orina , Hidrocortisona/orina , Hipertensión/etiología , Norepinefrina/orina , Anciano , Anciano de 80 o más Años , Aterosclerosis/etnología , Aterosclerosis/orina , Enfermedades Cardiovasculares/orina , Etnicidad , Femenino , Humanos , Hipertensión/orina , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
For correct and reliable experimental in vivo assessment of antistress effect of various bioactive substances, appropriate biomodels reproducing stress and organism response to stress in laboratory animals should be chosen. We chose treadmill test for simulating exhaustive physical load and forced immobilization accompanied by disorders of physiological and psychological condition. Verification of the models used indicates their wide applicability for testing certain biological manifestations under reproduced stress exposure.
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Adaptación Fisiológica , Ansiedad/fisiopatología , Aprendizaje por Laberinto/fisiología , Estrés Fisiológico , Estrés Psicológico/fisiopatología , Alanina Transaminasa/sangre , Animales , Ansiedad/sangre , Aspartato Aminotransferasas/sangre , Reacción de Prevención , Biomarcadores/sangre , Biomarcadores/orina , Glucemia/metabolismo , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Dopamina/orina , Electrochoque/psicología , Epinefrina/orina , Prueba de Esfuerzo , Inmovilización/psicología , Masculino , Norepinefrina/orina , Ratas , Ratas Wistar , Estrés Psicológico/sangre , Triglicéridos/sangre , Aumento de Peso/fisiologíaRESUMEN
BACKGROUND: Vaginal paraganglioma are rare, atypical, solitary tumors which originate from the female genital tract. Sacrococcygeal teratoma are also rare neoplasms which derive from one (or more) primordial germ cell layers. Here we report a unique case of vaginal paraganglioma with sacrococcygeal teratoma. CASE PRESENTATION: A 44-year-old female experienced paroxysmal hypertension, palpitations and dizziness for almost six years. Enhanced CT and MRI highlighted two abnormal soft tissue lesions located in the left vaginal wall and coccyx anteriorly, and Iodine-131 metaiodobenzylguanidine (131I-MIBG) demonstrated abnormal radioactive uptake in perineum area. Endocrine tests showed elevated plasma normetanephrine (NMN) and 24 h urine norepinephrine. There was a well-circumscribed soft tissue lesion of approximately 3.5 cm in the left lateral vaginal wall which could be palpated during bimanual examination, together with a 1.5 cm tumor in the posterior wall of the rectum. We completely resected the two lesions in stages with the support of a senior gynecologist and general surgeons. Postoperative histopathological examinations suggested the vaginal paraganglioma and mature sacrococcygeal teratoma. Targeted sanger sequencing for the 36 mostly common paraganglioma-related genes, with a depth of 1000x, revealed no mutations. Post-operatively, plasma NMN and 24 h urine norepinephrine returned to the normal range and her symptoms completely disappeared. CONCLUSIONS: We reported an extremely rare case and the successful treatment of functional vaginal paraganglioma coexisting with adult sacrococcygeal teratoma.
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Paraganglioma/patología , Paraganglioma/cirugía , Teratoma/patología , Teratoma/cirugía , Neoplasias Vaginales/patología , Neoplasias Vaginales/cirugía , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Norepinefrina/orina , Normetanefrina/sangre , Región Sacrococcígea/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Genetic approach using rat congenic lines between SHRSP/Izm and WKY/Izm identified stromal interaction molecule 1 (Stim1), an essential component of store-operated Ca2+ entry (SOCE), as a promising candidate gene responsible for the exaggerated sympathetic response to stress in SHRSP. Since SHRSP has a nonsense mutation in Stim1 resulting in the expression of a truncated form of STIM1 that caused reduction of SOCE activity in primary cultured cerebral astrocytes, we created SHRSP/Izm knocked-in with the wild-type Stim1 (KI SHRSP) by the CRISPR/Cas9 method to investigate whether the functional recovery of STIM1 would mitigate sympatho-excitation to stress in vivo in SHRSP. No potential off-target nucleotide substitutions/deletions/insertions were found in KI SHRSP. Western blotting and fluorescent Ca2+ imaging of astrocytes confirmed wild-type STIM1 expression and restored SOCE activity in astrocytes from KI SHRSP, respectively. Blood pressure (BP) measured by the tail-cuff method at 12, 16, and 20 weeks of age did not significantly differ between SHRSP and KI SHRSP, while the heart rate of KI SHRSP at 16 and 20 weeks of age was significantly lower than that of age-matched SHRSP. Unexpectedly, the sympathetic response to stress (evaluated with urinary excretion of norepinephrine under cold stress and BP elevation under cold/restraint stress) did not significantly differ between SHRSP and KI SHRSP. The present results indicated that the functional deficit of STIM1 was not a genetic determinant of the exaggerated sympathetic response to stress in SHRSP and that it would be necessary to explore other candidates within the congenic fragment on chromosome 1.
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Astrocitos/metabolismo , Sistema Cardiovascular/fisiopatología , Estrés Fisiológico/genética , Molécula de Interacción Estromal 1/genética , Molécula de Interacción Estromal 1/metabolismo , Sistema Nervioso Simpático/fisiopatología , Animales , Presión Sanguínea , Sistemas CRISPR-Cas , Proteínas de Unión al Calcio/metabolismo , Técnicas de Sustitución del Gen , Frecuencia Cardíaca , Masculino , Proteínas de la Membrana/metabolismo , Mutación , Norepinefrina/orina , Fenotipo , Ratas , Ratas Endogámicas SHR , Estrés Fisiológico/fisiologíaRESUMEN
Caffeine, a naturally occurring purine-based alkaloid, is the most consumed psychostimulant worldwide. Since caffeine pharmacokinetics shows extreme interindividual variability, it is not easy to establish its toxic dose. Only a few cases of death due to acute caffeine intoxication have been described so far, the majority of which attributable to massive assumption of caffeine-based medications. We present a case of acute caffeine overdose due to ingestion of pure caffeine. The extremely high blood concentration of caffeine determined a strong cardiovascular response, leading to fatal arrhythmia, as supported by histological evidence of myocardial injury. Quantitation of catecholamines and their metabolites in urine samples was performed and showed level near the highest limit of normal ranges for norepinephrine and high level of epinephrine. Contraction band is a pathological modification of the myocell caused by the catecholaminergic action and can occur in conditions of alteration due to the interaction between calcium and catecholamines. We demonstrated the ß1-adrenoceptor involvement in our fatal case by immunohistochemical analysis.
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Arritmias Cardíacas/inducido químicamente , Cafeína/envenenamiento , Estimulantes del Sistema Nervioso Central/envenenamiento , Frecuencia Cardíaca/efectos de los fármacos , Receptores Adrenérgicos beta 1/metabolismo , Adulto , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/metabolismo , Arritmias Cardíacas/fisiopatología , Cafeína/farmacocinética , Estimulantes del Sistema Nervioso Central/farmacocinética , Epinefrina/orina , Resultado Fatal , Femenino , Humanos , Norepinefrina/orinaRESUMEN
Multiple stressors, including 24-h-shifts characterise the working environment of physicians, influencing well-being, health and performance. We aimed to evaluate the effect of the stressor 24-h-shift on the adrenal medullary and sympathoneural system in physicians with the hypothesis that shift work might have different impacts on both systems. Twenty-two physicians collected two 12-h-urine samples ("daytime" and "nighttime") during a 24-h shift ("on-duty") and on a free weekend ("off-duty"), respectively. Urinary excretion rates per m2 body surface area were assessed for the catecholamines epinephrine, norepinephrine and their respective free O-methylated metabolites metanephrine and normetanephrine by LC-MS/MS-analysis. The stressor provoked differential responses of epinephrine and norepinephrine. Epinephrine excretion rates showed significant increases from off to on duty. The largest proportional change (off-duty to on-duty) for epinephrine was observed for nighttime (205%), the increase for daytime was 84%. An increase in norepinephrine from off to on duty was only visible for nighttime collections. For the catecholamine metabolites, normetanephrine paralleled norepinephrine and exhibited an increase in excretion from off to on duty during nighttime collections of 53% whereas there was no change during daytime collections (3%). In conclusion: Whilst the 24-h-shift-work stressor in physicians activates the sympatho-adrenomedullary system, represented by epinephrine, the sympathoneural response through norepinephrine reflects mainly an ambulatory position during working hours.
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Epinefrina/orina , Norepinefrina/orina , Estrés Laboral/orina , Médicos , Horario de Trabajo por Turnos , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Caracteres SexualesAsunto(s)
Paraganglioma/diagnóstico , Neoplasias Ureterales/diagnóstico , Obstrucción Ureteral/diagnóstico , Niño , Femenino , Humanos , Norepinefrina/sangre , Norepinefrina/orina , Normetanefrina/sangre , Normetanefrina/orina , Paraganglioma/sangre , Paraganglioma/orina , Neoplasias Ureterales/sangre , Neoplasias Ureterales/orina , Obstrucción Ureteral/sangre , Obstrucción Ureteral/orinaRESUMEN
BACKGROUND: Experiences of discrimination are a risk factor for subsequent cardiovascular disease. However, there is a lack of longitudinal research examining associations between discrimination and urinary catecholamines. This is surprising given the likely mediating role of sympathetic nervous system dysregulation in the association between psychosocial stress and cardiovascular morbidity. PURPOSE: The current study examined the 3 year longitudinal association between experiences of discrimination and urinary catecholamines. METHODS: The sample included 149 college students (mean age at baseline = 18.8, standard deviation = 0.96; 45% Black/African American; 55% White/European American). Concentrations of epinephrine and norepinephrine-urinary catecholamines with established links to psychosocial stress exposure and subsequent morbidity-were determined from 12 hr overnight samples. RESULTS: Results indicated that experiences of discrimination were associated with increases in both epinephrine (ß = .284, standard error [SE] = .117, p = .015) and norepinephrine (ß = .306, SE = .114, p = .001). These longitudinal associations persisted after adjusting for negative affect, depression, and rejection sensitivity and did not vary as a function of race/ethnicity. CONCLUSIONS: Results suggest that examination of overnight urinary catecholamines as a biological mediator of associations between experiences of discrimination and cardiovascular morbidity is warranted.
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Epinefrina/orina , Etnicidad , Norepinefrina/orina , Discriminación Social , Estudiantes , Adolescente , Catecolaminas/orina , Femenino , Humanos , Estudios Longitudinales , Masculino , Estados Unidos , Universidades , Adulto JovenRESUMEN
BACKGROUND: Interindividual variability in 24-hour energy expenditure (24EE) during energy-balance conditions is mainly determined by differences in body composition and demographic factors. Previous studies suggested that 24EE might also be influenced by sympathetic nervous system activity via catecholamine (norepinephrine, epinephrine) secretion. Therefore, we analyzed the association between catecholamines and energy expenditure in 202 individuals from a heterogeneous population of mixed ethnicities. METHODS: Participants (nâ =â 202, 33% female, 14% black, 32% white, 41% Native American, 11% Hispanic, age: 36.9â ±â 10.3 y [meanâ ±â SD], percentage body fat: 30.3â ±â 9.4) resided in a whole-room calorimeter over 24 hours during carefully controlled energy-balance conditions to measure 24EE and its components: sleeping metabolic rate (SMR), awake-fed thermogenesis (AFT), and spontaneous physical activity (SPA). Urine samples were collected, and 24-h urinary epinephrine and norepinephrine excretion rates were assessed by high-performance liquid chromatography. RESULTS: Both catecholamines were associated with 24EE and SMR (norepinephrine: +27 andâ +19 kcal/d per 10 µg/24h; epinephrine: +18 andâ +10 kcal/d per 1 µg/24h) in separate analyses after adjustment for age, sex, ethnicity, fat mass, fat-free mass, calorimeter room, temperature, and physical activity. In a multivariate model including both norepinephrine and epinephrine, only norepinephrine was independently associated with both 24EE and SMR (both Pâ <â .008), whereas epinephrine became insignificant. Neither epinephrine nor norepinephrine were associated with adjusted AFT (both Pâ =â .37) but epinephrine was associated with adjusted SPA (+0.5% per 1 µg/24h). CONCLUSIONS: Our data provide compelling evidence that sympathetic nervous system activity, mediated via norepinephrine, is a determinant of human energy expenditure during nonstressed, eucaloric conditions.
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Biomarcadores/orina , Metabolismo Energético , Norepinefrina/orina , Sueño/fisiología , Termogénesis , Adolescente , Adulto , Anciano , Metabolismo Basal , Composición Corporal , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Adulto JovenAsunto(s)
Avalanchas , Epinefrina/orina , Norepinefrina/orina , Adulto , Asfixia , Síndrome de Aplastamiento , Desastres , Femenino , Humanos , Hipotermia/orina , Italia , Masculino , Traumatismo Múltiple , Factores de TiempoRESUMEN
Catecholamine neurotransmitters, specifically, dopamine (DA), epinephrine (EP), and norepinephrine (NE), are known as substantial indicators of various neurological diseases. Developing rapid detection methods capable of simultaneously screening their concentrations is highly desired for early clinical diagnosis of such diseases. To this aim, we have designed an optical sensor array using three fluorescent dyes with distinct emission bands and have monitored variations in their emission profiles upon the addition of DA, EP, and NE in the presence of gold ions. Because of the different reducing power of catecholamines, differently sized gold nanoparticles (GNPs) with different levels of aggregation were generated, resulting in different amounts of spectral overlap between the absorption band of the in situ generated plasmonic GNPs and the emission bands of the fluorescent dyes. These energy-transfer-based fingerprint profiles were used to discriminate the neurotransmitters by applying pattern recognition methods including linear discriminant analysis (LDA) and artificial neural networks (ANN) and to determine their concentration using multiple linear regression (MLR). Our proposed array also showed a good performance in the discrimination of DA, EP, and NE in complex biological media such as human urine.
Asunto(s)
Dopamina/orina , Epinefrina/orina , Transferencia Resonante de Energía de Fluorescencia/métodos , Redes Neurales de la Computación , Norepinefrina/orina , Análisis por Matrices de Proteínas/métodos , Humanos , Resonancia por Plasmón de Superficie/métodosRESUMEN
OBJECTIVES: The aim of this study was to investigate the effect of repeated binge drinking and moderate alcohol consumption in young adults on arterial stiffness and sympathetic activity. METHODS: We enrolled 49 healthy young adults, free of cardiovascular diseases (25 men; age: 23.5â±â0.4 years; BMI: 23.4â±â0.4âkg/m; meanâ±âS.E). Individuals included were those with a history of repeated binge drinking (>2 years duration; nâ=â20), drank at moderate levels (MODs, >5 years duration; nâ=â16) and abstained from alcohol (last 2-3 years; nâ=â13). Arterial stiffness was assessed using carotid to femoral pulse wave velocity (cfPWV) and sympathetic activity was assessed using 24-h urinary norepinephrine levels. Also measured was aortic SBP and augmentation index (AIx), a measure of wave reflection. RESULTS: Binge drinkers and MODs had higher cfPWV than alcohol abstainers (0.6 and 0.5âm/s, respectively; Pâ≤â0.04). In addition, binge drinkers had higher urinary norepinephrine levels than MODs and alcohol abstainers (Pâ<â0.05). Higher cfPWV were correlated with higher norepinephrine levels (râ=â0.35. Pâ=â0.02). Aortic SBP (Pâ=â0.2) and AIx (Pâ=â0.96) were similar among binge drinkers, MODs and alcohol abstainers. CONCLUSION: Our findings suggest that repeated exposure to alcohol, regardless of drinking pattern, may increase aortic arterial stiffness in healthy young adults. In addition, sympathetic activation, reflected by increased 24-h urinary norepinephrine levels, may contribute to alcohol-induced arterial stiffening in young adults.