The need for improved methods of diet assessment for developing and monitoring food policy in Eastern Europe.

There is increasing evidence that diseases of major public health importance are causally related to nutritional imbalance. Development of nutrition policy to improve the nutritional status of a population requires reliable information about food consumption and its impact on the health of the population. Available methods are useful but not accurate enough. Assessment of the nutritional status of representative samples of the general population requires improved methods of dietary intake assessment. A combination of different methods provides more reliable information than the use of a single method. For example, comparison of food balance sheets and households budget surveys provides more useful information than either method alone. An international effort should be undertaken to identify reliable methods of dietary assessment suitable for all countries. Because the development of new methods would be time consuming, efforts should be focused on the selection of existing methods, their improvement, standardization, and implementation. International organizations such as the Food and Agriculture Organization and the World Health Organization should give high priority to the improvement of methods useful in nutritional epidemiological studies.

Homocysteine content of plasma proteins in ischemic heart disease.

It has been shown previously that accumulation of homocysteine produces atheromatous changes. The present study was done on 26 male survivors of myocardial infarction 2-3 months after the acute phase and 26 healthy males of the same age (30-60 years). The concentrations of homocysteine, its derivatives and other amino acids were determined in acid hydrolyzate of plasma and in deproteinized plasma. The plasma proteins of survivors of myocardial infarction were found to contain a high concentration of homocysteine. The average value was 958 +/- 84 mumol/l of plasma, which was about 25 times the quantity found in the control group. Large differences were also found in alpha-amino adipic acid and cystathionine concentrations. These substances were found in significantly higher concentrations in the plasma of the survivors compared to controls. The high positive correlation between homocysteine and alpha-amino adipic acid level (r = 0.83; P less than 0.001) suggests a common source of these 2 compounds in the analyzed samples. The levels of the other 15 measured amino acids were not significantly different in the 2 groups. The results support the homocysteine theory and suggest a method for more exact diagnosis of atherosclerosis.

Influence of bezafibrate and colestipol on LDL-cholesterol, LDL-apolipoprotein B and HDL-cholesterol in hyperlipoproteinaemia.

A significant increase of LDL-apolipoprotein B by 13% and LDL-cholesterol by 19% was observed in a group of 9 patients with hyperlipoproteinaemia Type III after bezafibrate treatment. Additional administration of colestipol caused a significant decrease of both LDL-apolipoprotein B by 18% and LDL-cholesterol by 25%. In 10 patients of hyperlipoproteinaemia Type IIb a significant decrease of both LDL-apolipoprotein B by 28% and LDL-apolipoprotein B by 18% was observed after bezafibrate therapy. When bezafibrate was given together with colestipol a further decrease of both LDL-cholesterol by 17% and LDL-apolipoprotein B by 16% occurred. HDL-cholesterol concentration increased significantly in both groups of hyperlipaemic patients during therapy. This may be the effect of both bezafibrate and colestipol. It is concluded that bile acid resins may effectively prevent the LDL-cholesterol concentration increase observed sometimes after clofibrate analogues.

The effect of thermally oxidized soya bean oil on metabolism of chylomicrons. Increased uptake and degradation of oxidized chylomicrons in cultured mouse macrophages.

Oral administration of thermally oxidized soya bean oil (TO) increased the level of lipid peroxides in human plasma, mainly in chylomicrons. No changes were observed after fresh oil (FO) intake. Human chylomicrons obtained after TO ingestion were rich in lipid peroxides and degraded more rapidly by cultured mouse macrophages than chylomicrons after FO. The uptake of TO chylomicrons by macrophages occurred via a saturable process and was partially inhibited by beta-very low density lipoprotein as well as by acetyl-low density lipoprotein and fucoidin. A 48-h incubation of macrophages with TO chylomicrons caused a 10-fold higher accumulation of cholesterol ester mass in the cells than the incubation with FO chylomicrons. These studies suggest that chylomicrons containing lipid peroxides may be taken up by mouse macrophages by mediation of beta-VLDL receptor as well as by acetyl-LDL receptor, and show a potential pathway by which chylomicrons obtained after ingestion of heated oil could contribute to accumulation of cholesterol esters in macrophages.

The influence of clofibrate on lipid and protein components of very low density lipoproteins in type IV hyperlipoproteinaemia.

After 30 days of clofibrate administration to 11 patients with type IV hyperlipoproteinemia, a significant fall was observed in serum triglyceride and cholesterol levels. In the VLDL fraction the concentrations of triglycerides, cholesterol and apo B were significantly decreased. The apo CII/apo CIII ratio was raised. Cholesterol concentration changes in LDL and HDL fractions were not significant.

Plasma glucosamine and galactosamine in ischemic heart disease.

Because of the importance of glycosaminoglycans and glycoproteins in the pathogenesis of atherosclerosis, the hexosamine concentrations of plasma were determined in 28 male survivors of acute myocardial infarction and in 50 healthy males aged 30-60 years. Glucosamine and galactosamine were determined by ion-exchange chromatography of hydrolyzed whole plasma and hydrolyzed deproteinized plasma. Considerably higher plasma levels of non-protein-bound hexosamine (500 nmol/ml) and lower levels of protein-bound hexosamines (3770 nmol/ml) were observed in the ischemic heart disease group, compared with the plasma levels of non-protein-bound hexosamine (320 nmol/ml) and protein-bound hexosamine (4260 nmol/ml) of the control group. This difference is due to changes in glucosamine concentration. The galactosamine concentration is similar in the two groups. The ratio of non-protein-bound to protein-bound hexosamines in patients is about twice as high as the ratio found in controls. The glucosamine/galactosamine ratio of protein-free plasma is significantly higher in patients (12.1) than in controls (8.3). These changes in plasma hexosamines correlate with increased plasma homocysteine, cholesterol, and triglycerides observed in the patient group. The findings show that characteristic quantitative and qualitative changes in plasma hexosamine levels accompany atherosclerosis. Determination of these substances may be helpful in diagnosis and management of patients with atherosclerosis.

Reduction of plasma lipid and homocysteine levels by pyridoxine, folate, cobalamin, choline, riboflavin, and troxerutin in atherosclerosis.

Elevated plasma homocysteine and lipid levels are risk factors for atherosclerosis. The plasma levels of homocysteine, determined in acid hydrolyzates of plasma, were found to be correlated with total cholesterol (r = 0.47, P less than 0.001), triglycerides (r = 0.40, P less than 0.01), and body mass index (r = 0.42, P less than 0.01) in 52 males, aged 30-60. A group of 12 male survivors of acute myocardial infarction was given pyridoxine, folate, cobalamin, choline, riboflavin, and troxerutin for 21 days. The plasma concentrations of homocysteine and alpha-amino adipic acid declined to 68% (P less than 0.001) and 57% (P less than 0.001) of the pretreatment values, and the cholesterol, triglycerides, and LDL apo B declined to 79% (P less than 0.001), 68% (P less than 0.01), and 63% (P less than 0.001) of the pretreatment values, respectively. The results suggest a new strategy for control of the metabolic abnormalities in atherosclerosis through the use of naturally occurring, non-toxic nutrients which minimize homocysteine accumulation.

Fat distribution and gender differences in serum lipids in men and women from four European communities.

We studied male/female differences in serum lipids in randomly selected 38-year-old men (n = 337) and women (n = 342) from various cities in The Netherlands, Sweden, Italy, and Poland. Overall, men had higher triglycerides and total cholesterol levels and lower HDL-levels compared to women (P less than 0.001). Adjustment for smoking habits, city, and body mass index did not remove the gender difference. Further adjustments for waist circumference alone and waist/hip and waist/thigh circumference ratio removed the gender differences in serum triglycerides and total cholesterol. Only adjustment for waist/thigh ratio removed the gender difference in HDL-cholesterol but linear relationships were different in men and women. The average male/female difference in serum lipids, particularly for total and LDL-cholesterol varied considerably among centers. In analyses of the data from the separate centers we found that sex differences in serum triglycerides and HDL-cholesterol in all 4 centers disappeared when adjusted for waist circumference alone and for waist/hip and waist/thigh ratio. For total and LDL-cholesterol, however, adjustment for circumference ratios tended to increase the male/female difference in 2 of the 4 centers. It is concluded that, in European men and women, fat distribution may be responsible for male/female differences in serum triglycerides but that such conclusions are less clear for HDL-, total- and LDL-cholesterol.

Zoophilic and geophilic dermatophytoses among farmers and non-farmers in Eastern Poland.

The study was aimed at assessing the frequency of zoophilic and geophilic fungal infections among farmers compared to non-farmers in eastern Poland. The study was carried out on adult patients with a suspicion of fungal infection of skin or its appendages. Skin scrapings or nail fragments were cultured on Sabouraud agar with chloramphenicol and cycloheximide for at least 3 weeks, and then identified based on macroscopic and microscopic morphology. In total, 116 subjects were included into the farmers group, 67 females and 49 males, aged 18-88 (median 53) years. Dermatophyte infection was found in 64 farmers (55.2%). Anthropophilic dermatophytes were identified in 61 farmers (52.6%), whereas zoophilic or geophilic dermatophytes - in only 5 farmers (4.3%). Trichophyton verrucosum was found in 3 cases, while T. terrestrae and Microsporum gypseum - 1 case each. The control group comprised 74 non-farmers, 40 females and 34 males, aged 18-93 (median 47) years. Among them, dermatophyte infection was found in 35 (47.3%) patients. Anthropophilic dermatophytes were identified in 30 (40.5%), whereas zoophilic or geophilic dermatophytes in 6 persons (8.1%): M. canis in 2 patients, and T. verrucosum, T. mentagrophytes var. mentagrophytes (granulosum), M. nanum, and T. terrestrae - 1 case each. There were no significant differences between farmers and non-farmers. Zoophilic and geophilic fungi identified in our study were responsible either for superficial mycosis and/or onychomycosis, no case of deep mycoses or scalp infections were found. Our data suggest that zoophilic and geophilic dermatophytoses are not frequent among eastern-Polish farmers.

[Efficacy and safety of treating hyperlipidemia type II with fluvastatin in patients with arterial hypertension]. / Skutecznosc i bezpieczenstwo leczenia hiperlipidemii typu II za pomoca fluwastatyny u chorych z nadcisnieniem tetniczym.

62 patients with hyperlipidemia II and hypertension were 8 weeks on low fat and low cholesterol diet (acc. to EAS recommendations). If LDL-Ch > or = 4.1 mmol/l the diet was continued and 12 weeks treatment by fluvastatin (Lescol, Sandoz Pharma Ltd) started with control every 4 weeks Preliminary dosage 20 mg once daily in the evening increased to 40 mg if LDL-Ch > 3.5 mmol/l. After 12 weeks the mean level of T.Chol decreased by 21%, LDL-Ch by 29%, LDL-Ch/HDL-Ch by 31% and T.Chol/HDL-Ch by 24%. HDL-Ch increased by 8% and TG decreased by 5% but not significantly. The first goal of treatment (LDL-Ch < 4.14 mmol/l) achieved 73% and second (LDL-Ch < or = 3.5 mmol/l)-43.3% patients. In 2 patients treatment was discontinued (in one due to severe alimentary symptoms and in second-due to infection of respiratory tract with increase of SGOT and SGPT) and in next 2 the dosage was decreased to 20 mg/day (due to transitory alimentary symptoms).

[Obesity as a risk factor for ischemic heart disease]. / Otylosc jako czynnik zagrozenia choroba niedokrwienna serca.

The occurrence of risk factors for ischaemic heart disease in obesity is discussed. The presented view is based on the review of literature and own preliminary experiences. The importance of the distribution of the fatty tissue was shown for the medical practice. Android-type obesity increases the probability of the occurrence of metabolic disturbances leading to ischaemic heart disease.

[Effect of combined treatment with lovastatin and colestipol on serum lipids and lipoproteins]. / Wplyw skojarzonego leczenia lovastatinem i kolestipolem na lipidy i lipoproteiny surowicy.

In 20 men with hypercholesterolaemia or mixed hyperlipaemia the effect was evaluated of treatment with Lovastatin and Colestipol on lipoproteins. Administration of the drugs in combination or alone decreased significantly the concentrations of total cholesterol (TC), LDL cholesterol (LDL-chol), and apolipoprotein B (apo B). The combination of Lovastatin in dose of 40 mg with Colestipol in dose of 10 g decreased more favourably the concentrations of TC (34.7%), LDL-chol (44.3%), and apo B (22.4%) than administration of each of the drugs alone in higher doses i.e. Lovastatin 80 mg (TC--26.8%, LDL-chol--31.8%, apo B--16.9%) or Colestipol 20 g (TC -20.0%, LDL-chol-26.3%, apo B-10.8%). The treatment with Lovastatin and Colestipol failed to change significantly the concentrations of triglycerides, HDL cholesterol and AI and AII apolipoproteins. The combined therapy was better tolerated than monotherapy.

[Effect of CRP preparation on serum lipids in patients with hyperlipidemia]. / Wplyw preparatu CRP na lipidy surowicy u pacjentów z hiperlipidemia.

In a group of 18 patients with essential hyperlipidaemia the influence was studied of multivitamin CRP preparation given for 12 weeks, on lipid peroxides, cholesterol and triglycerides in the serum. The level of lipid peroxides was decreased significantly. This effect was associated with the increase of the serum level of vitamin E. A decrease was also found of the levels of total cholesterol and LDL-cholesterol.

[The effect of Medicago spp. on growth of Trichophyton mentagrophytes in microculture]. / Wplyw lucerny na wzrost Trichophyton mentagrophytes w mikrohodowli.

The study aimed at assessing effect of dried root and aerial parts of Medicago spp. on growth of Trichophryton mentagrophytes. Fungus strains were inoculated onto microcultures with Sabouraud agar supplemented each with 1 g of dried and pulverised roots or aerial parts of 3 species: Medicago arabica, M. sativa, and M. murex. The strongest inhibitory effect on T. mentagrophytes growth was that of aerial parts of M. arabica (median diameter 6 mm compared to 13 mm of control), followed by root of M. arabica (10 mm) and root of M. murex (10.5 mm)--in all cases p < 0.001. Slight inhibitory effect was also found in the case of aerial parts of M. murex (median diameter 12 mm, p = 0.03). In contrast, M. sativa has shown stimulating effect on growth of T. mentagrophytes (15 mm for root and 16.5 mm for aerial part, p<0.001).