Muscularity and adiposity in addition to net acid excretion as predictors of 24-h urinary pH in young adults and elderly.

OBJECTIVE: In patients with nephrolithiasis, an inverse relationship between 24-h urinary pH (24h-UpH) and body weight has been reported. Whether body composition indices and 24h-UpH are similarly associated in healthy subjects needs investigation. DESIGN: Cross-sectional, retrospective analysis. SETTING: Dortmund, Germany and Gothenburg, Sweden. SUBJECTS: Healthy young adults (18-23 years; n=117) and elderly (55-75 years; n=85) having a mean body mass index (BMI) of 22.80+/-3.4 and 25.3+/-3.9 kg/m2, respectively. METHODS: Anthropometric data, 24h-UpH, and 24-h urinary excretion rates of net acid (NAE), creatinine, and urea were determined. After adjusting for urea (reflecting protein intake), renal creatinine output was used as a biochemical marker for muscularity. The BMI served as a marker of adiposity. RESULTS: NAE, body weight, and BMI were significantly (P<0.05) higher, and height and creatinine significantly lower in the elderly, whereas body-surface area (BSA) was not different. Step-wise multiple regression analysis using BSA-corrected urinary variables revealed NAE as the primary predictor of 24h-UpH (with R2 values of 0.64 and 0.68 in young adults and elderly, respectively, P<0.0001), followed by urea (P<0.0001), creatinine (P<0.05), and BMI (P<0.05 for the young adults and P=0.12 for the elderly). These associations were negative for NAE and BMI, and positive for urea and creatinine. CONCLUSIONS: Muscularity (i.e. creatinine adjusted for urea) and particularly in the group of young adults, adiposity (i.e. BMI) proved to be modest, but significant predictors of 24h-UpH. Future research should focus on more obese subjects in whom insulin resistance and particular kidney functions should also be examined to further substantiate the role of obesity in low-urine pH-associated conditions, for example, nephrolithiasis.

Reversibility of Na+/Mg2+ antiport in rat erythrocytes.

Rat erythrocytes loaded with Mg2+ plus Na+ performed Mg2+ uptake under an intracellular/extracellular Na+ gradient. Mg2+ uptake was coupled to Na+ release at a stoichiometric ratio of 1 Mg2+/2 Na+.Mg2+ uptake was inhibited by amiloride, imipramine and quinidine. Mn2+ was taken up by the same transporter as Mg2+. Similar results had been found for net Mg2+ efflux via Na+/Mg2+ antiport in such rat erythrocytes. Hence, it can be concluded that Na+/Mg2+ antiport in Mg(2+)-loaded rat erythrocytes operates reversibly according to the direction of the Na+ gradient which is a contributing driving force. Net Mg2+ influx was dependent on ATP which increased the affinity of intracellular Mg2+ by activating Na+/Mg2+ antiport. Mg2+ uptake was increased by phorbol ester and inhibited by staurosporine, indicating that ATP may function via protein phosphorylation by protein kinase C.

Characterization of Na(+)-dependent Mg2+ efflux from Mg2(+)-loaded rat erythrocytes.

Na(+)-dependent Mg2+ efflux from Mg2(+)-loaded rat erythrocytes was determined from the increase of extracellular Mg2+ concentration or decrease of intracellular Mg2+ content, as measured by means of atomic absorption spectrophotometry. Mg2+ efflux was specifically combined with the uptake of Na+ at a stoichiometric ratio of 2Na+:1Mg2+, indicating electroneutral Na+/Mg2+ antiport. Na+/Mg2+ antiport depended on intracellular ATP and was inhibited by amiloride and quinidine, but was insensitive to strophanthin. Net Mg2+ efflux was only occurring at increased concentration of intracellular Mg2+ ([Mg2+]i), and stopped when the physiological Mg2+ content was reached. Intracellular Mg2+ acted cooperatively with a Hill coefficient of 2.4, which may indicate gating of Na+/Mg2+ antiport at increased [Mg2+]i. At increased intracellular Na+ concentration, Na+ competed with intracellular Mg2+ for Mg2+ efflux and Na+ could leave the rat erythrocyte via this transport system. Na+/Mg2+ antiport was working asymmetrically with respect to extra- and intracellular Na+ and Mg2+, and did not perform net Mg2+ uptake.

Interactions of polyamines in the measurement of free magnesium concentration by mag-fura-2 and 31P-NMR.

Polyamines, particularly spermine, in physiological concentrations interact with mag-fura-2 and the mag-fura-2/Mg2+ complex, resulting in reduced values of free Mg2+ concentration. Similarly, polyamines interact with ATP and MgATP. Thus, free Mg2+ concentration, as measured by 31P-NMR or mag-fura-2, is underestimated in the presence of polyamines, particularly of spermine.

Activation of Na+/Mg2+ antiport in thymocytes by cAMP.

Mg2+ efflux from Mg(2+)-loaded rat thymocytes was stimulated by 0.1 mM dibutyryl cAMP (db cAMP). The activation of Mg2+ efflux by db cAMP was more expressed at lower Mg(2+)-loading. cAMP induced only a very small increase in the concentration of intracellular free Mg2+ which cannot explain the activation of Na+/Mg2+ antiport. From these results it was concluded that cAMP increases the affinity of the Na+/Mg2+ antiporter for intracellular Mg2+, probably by phosphorylation.

Induction of Mn2+/H+ antiport in chicken erythrocytes by intracellular Mg2+ and Mn2+.

Chicken erythrocytes preloaded with Mg2+ exchange one extracellular Mn2+ for two intracellular H+. Chicken erythrocytes preloaded with Mn2+ alone or with Mg2+ plus Mn2+ performed efflux of Mn2+, which was higher at pH 6 than at pH 7.4, indicating reversibility of Mn2+/H+ antiport. Mn2+/H+ antiport was not inhibited by 1 mM KCN plus 1 mM iodoacetic acid or 1 mM amiloride. Mn2+ influx was activated by anions. Mn2+ efflux via Mn2+/H+ antiport was inhibited by competition between H+ and K+.

Na+-independent Mg2+ efflux from Mg2+-loaded human erythrocytes.

Net Mg2+ efflux from Mg2+-loaded human erythrocytes was maximal after reincubation in sucrose. Net Mg2+ efflux was not inhibited by furosemide or bumetanide and, therefore, was not performed by the (Na,K,Cl)- or (K,Cl)-cotransport system. A component of net Mg2+ efflux was inhibited by extracellular NaC1, KCl, LiCl, choline Cl and SITS, in analogy to the inhibition of net Cl- and SITS. Therefore, it was concluded that net Mg2+ efflux is dependent on net Cl- efflux for charge compensation. Cl- -dependent net Mg2+ efflux was inhibited by amiloride. Only 10% of the maximal net Mg2+ efflux may depend on extracellular Na+.

Characterization of Na(+)-independent Mg2+ efflux from erythrocytes.

Na(+)-independent Mg2+ efflux from Mg2(+)-loaded human, rat and chicken erythrocytes was reduced by extracellular Cl-. Na(+)-independent Mg2+ efflux at low extracellular Cl- concentration (sucrose medium) was inhibited by SITS and was nearly insensitive to SITS in 150 mM choline Cl medium. The inhibition of Mg2+ efflux by extracellular Cl- and DIDS could be overcome by the lipophilic permeant tetraphenylphosphonium cation. Na(+)-independent Mg2+ efflux from human and rat erythrocytes in sucrose and choline Cl medium was inhibited by cAMP and by amiloride and amiloride analogues. The results indicate that Na(+)-independent Mg2+ efflux in high Cl- medium is performed by a similar or the same Mg2+ efflux system, operating in sucrose medium in which the efflux of Mg2+ is accompanied by the efflux of Cl- for charge compensation.

Characterization of Mg2+ efflux from human, rat and chicken erythrocytes.

Net Mg2+ efflux from Mg2+-loaded, human, rat and chicken erythrocytes was measured in sucrose, NaCl and choline Cl medium. Thus, Na+-dependent (NaCl minus choline Cl) and Na+-independent Mg2+ efflux (in sucrose) were determined. Na+-dependent Mg2+ efflux amounted to 0.16, 8.9 and 1.57 mmol/l cells x 30 min, Na+-independent Mg2+ efflux amounted to 0.89, 1.55 and 0.37 mmol/l cells x 30 min for human, rat and chicken erythrocytes. Na+-dependent Mg2+ efflux was inhibited by quinidine. Na+-independent Mg2+ efflux was inhibited by SITS and Cl-. A small fraction of Na+-independent Mg2+ efflux (in choline Cl) was resistant to SITS and Cl-. Ca2+ loading increased Mg2+ efflux similar to K+ efflux (Gardos effect). This effect was differently expressed in human and chicken erythrocytes.

Isoproterenol-induced Mg2+ uptake in liver.

Isoproterenol increased the Mg2+ content of hepatocytes after injection into rats or after addition to collagenase-dispersed hepatocytes. cAMP also the increased cellular Mg2+ content of isolated hepatocytes. This effect was prevented by staurosporine. Phorbol ester had no effect on the Mg2+ content of isolated hepatocytes, and after injection of isoproterenol into rats, protein kinase C of liver was not affected. It was concluded that isoproterenol induced long-term Mg2+ influx via the activation of protein kinase A which can be inhibited by staurosporine.

Characterization of furosemide-sensitive Mg2+ influx in Yoshida ascites tumor cells.

Partially Mg2+-depleted Yoshida ascites tumor cells took up Mg2+ after reincubation in Mg2+- and HCO3(-)-containing media. Mg2+ influx was insensitive to ouabain, amiloride and disulfonic stilbenes, but was noncompetitively inhibited by furosemide (Ki = 0.4 mM) and bumetanide. Mg2+ influx obeyed Michaelis-Menten kinetics with respect to Mg2+ concentration (Km = 1.1 mM) and was sigmoidal with respect to HCO3- concentration. Electroneutral Mg2+, HCO3- cotransport was supposed to be the mechanism of Mg2+ influx.

Species-specific Mn2+/Mg2+ antiport from Mg2(+)-loaded erythrocytes.

Mg2(+)-loaded rat erythrocytes performed Mn2+/Mg2+ antiport, which was nonspecifically stimulated by anions and cations. Mn2+/Mg2+ antiport was shown to operate via the Na+/Mg2+ antiporter because extracellular Na+ and Mn2+ inhibited the intracellular uptake of each other's ions competitively. Furthermore, Mn2+/Mg2+ antiport and Na+/Mg2+ antiport were identically inhibited by various amiloride derivatives. Na+/Mg2+ antiport of chicken and human erythrocytes cannot perform Mn2+/Mg2+ antiport although chicken erythrocytes took up more Mn2+ than rat erythrocytes.

Characterization and development of metallothionein in fetal forelimbs, brain and liver from the mouse.

The presence of the low molecular weight protein metallothionein (MT) has been investigated in fetal forelimbs, brain and liver from the mouse with the aim of using the protein as a biochemical marker for the early recognition of potential teratogenic agents in the future. Forelimbs, brain and liver were taken from mouse fetuses at ages ranging from 12 to 18 d. Each type of organ was homogenized and centrifuged at 9000 x g. The analysis of MT in the supernatants (S9) with the Cd-heme saturation method detected in all three cases the presence of a low molecular weight, Cd-binding protein whose concentration increased with the age of the fetus. Analysis of the S9 fractions using gel- and anion exchange-chromatography and polyacrylamide gel electrophoresis demonstrated the existence of a protein analogue to the hepatic MT in forelimbs and brain.

Supplementation with alkaline minerals reduces symptoms in patients with chronic low back pain.

The cause of low back pain is heterogeneous, it has been hypothesised that a latent chronic acidosis might contribute to these symptoms. It was tested whether a supplementation with alkaline minerals would influence symptoms in patients with low back pain symptoms. In an open prospective study 82 patients with chronic low back pain received daily 30 g of a lactose based alkaline multimineral supplement (Basica) over a period of 4 weeks in addition to their usual medication. Pain symptoms were quantified with the "Arhus low back pain rating scale" (ARS). Mean ARS dropped highly significant by 49% from 41 to 21 points after 4 weeks supplemention. In 76 out of 82 patients a reduction in ARS was achieved by the supplementation. Total blood buffering capacity was significantly increased from 77.69 +/- 6.79 to 80.16 +/- 5.24 mmol/L (mean +/- SEM, n = 82, p < 0.001) and also blood pH rose from 7.456 +/- 0.007 to 7.470 +/- 0.007 (mean +/- SEM, n = 75, p < 0.05). Only intracellular magnesium increased by 11% while other intracellular minerals were not significantly changed in sublingual tissue as measured with the EXA-test. Plasma concentrations of potassium, calcium, iron, copper, and zinc were within the normal range and not significantly influenced by the supplementation. Plasma magnesium was slightly reduced after the supplemenation (-3%, p < 0.05). The results show that a disturbed acid-base balance may contribute to the symptoms of low back pain. The simple and safe addition of an alkaline multimineral preparate was able to reduce the pain symptoms in these patients with chronic low back pain.

Effects of salicylate and zinc deficiency on the serum concentrations of magnesium, calcium, and parathyroid hormone.

Oral application of 700 mg/kg salicylic acid to pregnant and non-pregnant female rats caused an increase of serum Mg2+ and a decrease of serum Ca2+ concentration. The salicylate effect was drastically enhanced by Zn deficiency. The increase in serum Mg2+ is probably caused by the nephrotoxicity of salicylate. The decrease of serum Ca2+ concentration is combined with an increase of parathyroid hormone concentration in serum. Probably, salicylate and Zn deficiency inhibit Ca2+ mobilization by parathyroid hormone in bone.

Induction of hepatic metallothionein by salicylate in adult rats.

Application of salicylate increased the concentration of metallothionein (MT) in liver of pregnant rats as well as of adult male rats, whereas in fetal liver, MT was reduced by salicylate. Induction of MT synthesis by salicylate is an indirect effect because in cultured hepatocytes salicylate did not induce MT synthesis. Salicylate increased MT also in adrenalectomized rats. Indomethacin induced the same concentration of MT in maternal liver as salicylate. However, indomethacin had no effect on MT in fetal liver. Induction of MT in adult liver by salicylate and indomethacin was independent of zinc.

Enhanced ototoxicity of gentamicin and salicylate caused by Mg deficiency and Zn deficiency.

In rats, Mg deficiency caused a moderate hearing loss, measured by means of evoked potentials at 10 and 20 kHz, which was repaired after refeeding a normal diet. Application of 700 mg/kg salicylic acid or injection of 5 x 100 mg/kg gentamicin also caused a reversible hearing loss in normally fed rats. Treatment of Zn-deficient rats with salicylic acid produced a stronger although reversible hearing loss than in normally fed salicylate-treated rats. Treatment of Mg-deficient rats with gentamicin induced a strong hearing loss that was nearly complete and irreversible in 9 of 25 rats.

Maternal and fetal iron accumulation in Zn-deficient and salicylate-treated rats.

Nonhemoglobin Fe (non Hb-Fe) content in fetal serum and liver is much higher than in maternal serum and liver. After feeding a Zn-deficient diet to pregnant rats from d 0 to 21, non Hb-Fe content in maternal and fetal serum and liver was increased. After oral application of salicylic acid (300 mg/kg) from d 16 to 20 to normally fed and Zn-deficient dams, non Hb-Fe content in maternal and particularly in fetal serum and liver was drastically increased. In the kidney, Fe was accumulated to a small amount resulting from Zn deficiency and salicylate treatment. Fe accumulation in the liver occurred in all cell fractions, particularly in microsomes. Fe accumulation was confirmed and extended histochemically by Prussian blue staining. It is assumed that salicylate increases intestinal Fe resorption and fetal transfer of Fe. It is discussed that salicylate nephrotoxicity and its enhancement by Zn deficiency is not caused by an Fe-dependent mechanism.

Effect of valproate on zinc metabolism in fetal and maternal rats fed normal and zinc-deficient diets.

Pregnant Wistar rats fed control and Zn-deficient diets received daily oral doses of 0, 100, and 300 mg/kg sodium valproate from d 16 to 20 of gestation. Only the highest valproate doses induced a small reduction in fetal body weight in the normally fed group. Zinc deficiency caused a drastic reduction in maternal and only a small reduction in fetal serum Zn concentrations. Valproate treatment had no effect on maternal and fetal serum Zn concentrations.Valproate reduced fetal liver Zn content only in the normally fed group. The reduction of liver Zn content resulted from the reduction of Zn-metallothionein. Valproate did not affect total Zn and Zn-metallothionein in kidneys. Three percent of the Zn-deficient fetuses developed hydronephrosis and hydrops. Valproate treatment drastically enhanced the occurrence of fetal hydronephrosis and hydrops. Valproate induced fetal liver necroses, independent of Zn nutrition.

Fluid regulation during prolonged physical strain with water and food deprivation in healthy, trained men.

The aim of this study was to investigate fluidregulating mechanisms, with special regard to the role of plasma proteins in the control of plasma volume (PV), and the role of the superficial tissues as a water storage organ of the body during prolonged physical strain. 29 male subjects (mean age 22.2 +/- 2.8 years) were studied during a 5 day period of survival training with multifactorial strain including restricted water intake (11 H2O.day-1) and food intake (628 kJ.day-1) additionally to physical exercise and sleep deprivation (20 h within 5 days). Under field conditions the heart rate was monitored continuously, and body mass, body composition, thickness of the shell tissues, and blood parameters were measured at (T1), after 72 h (T2), after 120 h (T3) and in the recovery period after 48 h (T4) and 72 h (T5). The estimated energy expenditure was approximately 24,000 kJ.day-1. The mean decrease of body mass was 6.77 kg (9.5%) at T3 (p < 0.001), 0.95 kg (1.3%) at T4 (p < 0.05) and 0.68 kg (0.9%) at T5 (n.s.). A reduction of total body water of 3.8 1 was estimated at T3. Serum creatinine ([Cr]) was raised at T3 by 18.5% (p < 0.0001). No relationship was found between [Cr] and other parameters. The PV decreased by 3.7% (p < 0.0001) at T2, increased by 1.6% (p < 0.0001) at T3 and was not different to baseline at T4 (+0.2%; n.s.). Total protein concentration ([TP]) increased at T2 (11.7%; p < 0.0001) and T3 (2.6%; p < 0.01), and decreased (p < 0.0001) at T4 (8.2%) and T5 (5.7%). Plasma proteins shifted into the intravascular space at T2 and T3 and moved out of the intravascular space at T4 and T5. This gives support to the hypothesis that one of the counterregulatory mechanisms maintaining PV during prolonged exercise is provided by protein shifts from the extravascular into the intravascular space. Our data provide evidence that this mechanism assists PV homeostasis efficiently over a period of 120 h with multifactorial strain, even under conditions with a fluid loss of almost 8% of the total body water.