Serum Concentrations of 25-Hydroxyvitamin D and Depression in a General Middle-Aged to Elderly Population in Finland.

OBJECTIVES: Low concentrations of serum 25-hydroxyvitamin D [25(OH)D] have been postulated to associate with an increased prevalence of depression. As there are a limited number of publications on this issue, we examined the association between serum 25(OH)D and depression in a general middle-aged or older population. DESIGN: A population-based cross-sectional study. SETTING AND PARTICIPANTS: A total of 1602 men and women from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) in Eastern Finland, aged 53-73 y in 1998-2001, were analysed. MEASUREMENTS: Depressive symptoms were assessed with the DSM-III depression scale, and those individuals who had scores over 4 (range 0-12) or had reported undergoing current antidepressant therapy, were considered as suffering from depression. Associations were estimated in serum 25(OH)D tertiles using logistic regression. RESULTS: Among the participants, 183 subjects (11.4%) were considered to have depression. The mean age of the subjects was 62.6 years (SD 6.4, range 53.4-73.8 years). The mean serum 25(OH)D concentration was 43.8 nmol/L (SD 17.7, range 8.5-112.8 nmol/L), concentrations <50 nmol/L were observed in 65.0% of the subjects, and only 5.0% displayed concentrations ≥75 nmol/L. After multivariable adjustments, the odds ratios for having depression in the tertiles (from highest to the lowest) of serum 25(OH)D were 1, 1.35 (95 % CI: 0.87, 2.09) and 1.64 (95 % CI: 1.03, 2.59), P for trend=0.036. CONCLUSION: These findings indicate that a lower concentration of serum 25(OH)D is associated with a higher prevalence of depression in an elderly general population.

Omega-6 polyunsaturated fatty acids, serum zinc, delta-5- and delta-6-desaturase activities and incident metabolic syndrome.

BACKGROUND: The associations of n-6 polyunsaturated fatty acids (PUFA) with metabolic syndrome have been poorly explored. We investigated the associations of the serum n-6 PUFA and the activities of enzymes involved in the PUFA metabolism, delta-5-desaturase (D5D) and delta-6-desaturase (D6D) with risk of incident metabolic syndrome. We also investigated whether zinc, a cofactor for these enzymes, modifies these associations. METHODS: A prospective follow-up study was conducted on 661 men who were aged 42-60 years old at baseline in 1984-1989 and who were re-examined in 1998-2001. RESULTS: Men in the highest versus the lowest serum total omega-6 PUFA tertile had a 70% lower multivariate-adjusted risk of incident metabolic syndrome [odds ratio (OR) = 0.30; 95% confidence interval (CI) = 0.18-0.51, Ptrend < 0.001]. Inverse associations were also observed for linoleic acid, arachidonic acid and D5D activity. By contrast, men in the highest tertile of D6D activity had an 84% higher risk (OR = 1.84; 95% CI = 1.15-2.94, Ptrend = 0.008). Similar associations were observed with many of the metabolic syndrome components at the re-examinations. Most associations were attenuated after adjustment for body mass index. Finally, the associations of D6D and LA were stronger among those with a higher serum zinc concentration. CONCLUSIONS: Higher serum total n-6 PUFA, linoleic acid and arachidonic acid concentrations and D5D activity were associated with a lower risk of developing metabolic syndrome and higher D6D activity was associated with a higher risk. The role of zinc also needs to be investigated in other populations.

LDL oxidative modification and carotid atherosclerosis: results of a multicenter study.

OBJECTIVE: Serum LDL conjugated diene concentration is a marker of oxidative modification of LDL. We investigated the relationship between LDL conjugated dienes and cross-sectional subclinical atherosclerosis assessed by carotid IMT in high-risk subjects of a multicenter study. METHODS: Serum LDL conjugated dienes and ultrasonographically assessed carotid intima-media thickness (IMT(mean), IMT(max) and IMT(mean-max)) were available for 553 subjects from Finland, France, Italy, the Netherlands, and Sweden. RESULTS: In multivariate regression analysis, gender (p < 0.001), age (p < 0.001), systolic blood pressure (IMT(mean), p = 0.01; IMT(mean-max), p = 0.05) and serum LDL conjugated dienes (p = 0.02 for both IMT(mean) and IMT(mean-max)) were the strongest determinants of IMT variation, adjusted for study center, ultrasound videotape reader and serum LDL cholesterol. Pack-years of smoking, added into the regression model, did not destroy the significant association between increased serum LDL conjugated dienes and IMT. Ratio of LDL conjugated dienes to LDL particle cholesterol was higher in subjects of Northern recruiting centers than of Southern centers (r = 0.39, p < 0.0001). CONCLUSIONS: There was a cross-sectional association between in vivo increased LDL oxidative modification and subclinical atherosclerosis after adjustment for traditional risk factors. The subjects in Northern countries of Europe had more oxidatively modified lipids per cholesterol in LDL particle than subjects in Southern countries.

No effect on adenoma formation in Min mice after moderate amount of flaxseed.

BACKGROUND & AIM: The mammalian lignan enterolactone (ENL) produced from plant lignans, e. g. secoisolariciresinol diglycoside (SDG), may protect against various cancers in humans. The present work aims to evaluate the effect of flaxseed on tumour formation in multiple intestinal neoplasia (Min) mice, a model for colon tumorigenesis. DESIGN: Male and female Min mice were fed either with a non-fibre control diet or the same diet supplemented with 0.5 % (w/w) defatted flaxseed meal. Conversion of SDG to the mammalian lignans enterodiol (END) and ENL in the gut, and plasma ENL, were measured by HPLC with coulometric electrode array detector (CEAD) and timeresolved fluoroimmunoassay, respectively. Wild-type mice were also fed with the experimental diets in order to see whether lignan metabolism is different in Min and wild-type mice. RESULTS: The total number of adenomas or their size in the small intestine was not different in the flaxseed and control groups. The flaxseed group had a tendency for a decreased number of colon adenomas in both genders. Gender and genotype based differences were found in the intestinal ENL levels. When compared to Min females, Min males in the flaxseed group had several fold higher ENL levels in the small intestine (Min males 125 +/- 124.5 nmol/g vs. females 22.8 +/- 16.0 nmol/g, P = 0.048) and caecum (47.6 +/- 31.6 nmol/g vs. females 14.5 +/- 6.6 nmol/g, P = 0.001). Presence of adenomas in the gut influences the intestinal lignan metabolism. Min mice had less intestinal END and ENL as compared with the wild-type mice (P < 0.05). Mean plasma ENL increased 7-fold during the flaxseed feeding (7 nmol/L in control vs. 50 nmol/L in flaxseed group) but no differences between gender and genotype were found. The plasma ENL level did not correlate with adenoma number in the small intestine and colon. CONCLUSION: The number of intestinal adenomas in the Min mouse model is not related to ENL level in plasma nor is it associated with the levels of intestinal lignans. A gender difference in ENL lignan metabolism was found in the gut but not in the plasma.

Phloem fortification in rye bread elevates serum enterolactone level.

OBJECTIVE: To analyse the lignan content of phloem powder enriched rye bread and to study the dose-response relationship of the effect of dietary plant lignans derived from phloem on intestinal production of enterolactone by measuring enterolactone concentration in serum. DESIGN: A randomized double-blind supplementation trial. SUBJECTS: Seventy-five non-smoking men recruited by newspaper advertisements. INTERVENTION: Subjects were randomized to three study groups receiving either rye bread high in phloem (HP, 14% of rye flour substituted with phloem powder), rye bread low in phloem (LP, 7% of rye flour substituted with phloem powder) or placebo rye bread. Participants consumed 70 g of study bread daily for 4 weeks and provided serum samples for enterolactone analysis at baseline and at the end of the intervention. RESULTS: There was a significant increase in serum enterolactone concentration in the LP and HP groups compared with the placebo group (P=0.009 and P=0.003, respectively). Considerable interindividual differences were observed in the response to dietary lignans within the study groups. CONCLUSIONS: Our results indicate that plant lignans attached to insoluble fibre layer in phloem can be further metabolized and converted to enterolactone presumably by the bacteria present in the colon. Phloem powder is useful source of lignans for functional foods aimed to elevate serum enterolactone levels. SPONSORSHIP: Phloem powder and the study breads were provided by Finnpettu Oy and Linkosuo Oy, respectively. The clinical study work was sponsored in part by Oy Jurilab Ltd.

Isoflavone content of the soy based supplements.

A large number of soy isoflavone products with indications of possible health effects are available on the market. Fifteen different soy based products were analyzed using high performance liquid chromatography (HPLC) with coulometric electrode array detector to determine the total amount of isoflavones in aglycones after the hydrolysis and identify the different forms of the isoflavone conjugates. The aim of the study was to evaluate how well the isoflavone content data supplied by the producers correspond to our analysis results. Only one product contained isoflavones measured in aglycones the same amount as was the value given by the producer. The total amount of the isoflavones in aglycones ranged from 0.121 to 201 mg/g. Measured amounts of isoflavones in aglycones after the hydrolysis were in general lower than the values in the product labels. Product data were often confusing and the concrete amount of isoflavones was difficult to find out.

In vitro metabolism of plant lignans: new precursors of mammalian lignans enterolactone and enterodiol.

The metabolism of the plant lignans matairesinol, secoisolariciresinol, pinoresinol, syringaresinol, arctigenin, 7-hydroxymatairesinol, isolariciresinol, and lariciresinol by human fecal microflora was investigated to study their properties as mammalian lignan precursors. The quantitative analyses of lignan precursors and the mammalian lignans enterolactone and enterodiol were performed by HPLC with coulometric electrode array detector. The metabolic products, including mammalian lignans, were characterized as trimethylsilyl derivatives by gas chromatography-mass spectrometry. Matairesinol, secoisolariciresinol, lariciresinol, and pinoresinol were converted to mammalian lignans only. Several metabolites were isolated and tentatively identified as for syringaresinol and arctigenin in addition to the mammalian lignans. Metabolites of 7-hydroxymatairesinol were characterized as enterolactone and 7-hydroxyenterolactone by comparison with authentic reference compounds. A metabolic scheme describing the conversion of the most abundant new mammalian lignan precursors, pinoresinol and lariciresinol, is presented.

Sensitive high-performance liquid chromatographic method for profiling phytoestrogens using coulometric electrode array detection: application to plasma analysis.

An HPLC method for profiling 13 phytoestrogens and their metabolites using coulometric electrode array detection was developed. Sensitivity of the method was slightly less than that of our GC-MS method, but significantly higher compared to the HPLC methods using diode-array or UV detection. Detection limits varied from 3.4 (secoisolariciresinol) to 40.3 (genistin) pg on column. Signal linearities ranged from the detection limits to 61 ng on column. Resolution values for the peak pairs varied from 1.1 (O-desmethylangolensin-anhydrosecoisolariciresinol) to 16 (daidzin-genistin). Intra- and interassay retention time variations were negligible and detector response variation was eliminated by frequent calibration. Chromatographic method was applied to plasma analyses and 6 of the 13 compounds were detected. Method accuracy for those six analytes varied from 69% (enterodiol) to 118% (genistein). Intraassay precision CVs ranged from 1.5% (enterolactone, 12.4 nmol/liter) to 14% (genistein, 245 nmol/liter) and interassay precision CVs ranged from 9.9% (daidzein, 67.4 nmol/liter) to 44% (enterodiol, 1.20 nmol/liter).

HLA types in women with cervical human papillomavirus (HPV) lesions prospectively followed up for 10 years.

Certain genotypes of HPV have been recently implicated in the etiology of carcinoma of the uterine cervix. In order to determine whether HLA antigen-controlled immunoregulatory functions have a role in the pathogenesis of HPV infections, class I and II HLA antigen typing was carried out on a series of 96 randomly selected women who were part of a cohort of 530 women prospectively followed up for cervical HPV infections in our clinic since 1981. The frequency of the DQ3 antigen, which has previously been reported to be increased among cervical cancer patients, was decreased in our HPV patients compared with the control group of Finnish women, but it was slightly increased in HPV16-infected women (P = 0.0812). However, we were able to demonstrate that HLA-DR5 antigen is significantly increased (i) in patients with high grade cervical intraepithelial neoplasia (CIN) (P < 0.02), and (ii) in women harbouring the high risk HPV type 16 (P = 0.0003), thus confirming earlier reports of an association of this HLA antigen and cervical cancer. Such a close association between the high risk HPV type 16 with an HLA antigen might have important implications in the possible immunogenetic basis of the increased risk for squamous cell carcinoma of the uterine cervix.

Infections and other illnesses of children in day-care centers in Helsinki. II: The economic losses.

The economic consequences of illnesses among children in day-care centers (DCCs) were estimated in Helsinki during a one-year period, 1985-1986. The municipal DCCs took care of altogether 14,882 children at the end of 1985. In terms of money value in 1990, the total loss due to illnesses among all DCC children was $22,485,000 (1 US dollar = 3.80 FIM). Nearly half (46%) of this loss was caused by illnesses among children under three years of age, although these represent only 20% of the children in day care. The losses were $3,535 per child place in use among children under three years of age and $1,012 among older children. Economic losses due to the guardian's absence from work totalled $1,623, deficient utilization of DCCs $1,254, visits to a physician $169, hospitalization $221, paid care of children at home $219 and antibiotic courses $12 per child place in use for those under the age of three years. The corresponding figures for older children were 541, 248, 95, 51, 73 and 4 dollars per child. More than 90% of illnesses and costs were caused by infectious diseases. Because the costs due to illnesses among children under three years of age were more than three times as high as those for older children, preference should be given to home care and family day care for younger children and efforts should be made to find out how to build healthy DCCs for them.

Infections and other illnesses of children in day-care centers in Helsinki. I: Incidences and effects of home and day-care center variables.

Illnesses among children attending municipal day-care centers (DCCs) were followed in a prospective study in Helsinki during 1985-1986. The study comprised 1,905 follow-up years among children in 29 DCCs. The mean number of illness periods was 4.9 per follow-up year, 7.9 for those under the age of three years and 3.8 for older children. The corresponding average numbers of days of illness were 23, 39 and 17. The most common diagnoses were upper respiratory tract infections (46.0%), diarrhea (17.2%), otitis media (12.9%), eye infections (4.0%), acute tonsillitis (3.2%), and bronchitis (3.0%). The six most common diagnoses, all infections, caused 86% of periods and 79% of days of illness. The ten most common infectious diseases caused 90.9% of absence periods, surgical operations 1.8%, and injuries 0.8%. In children under three years of age, a small area and volume of a DCC, lack of fully mechanized ventilation, and lack of separate facilities were associated with a higher incidence of one or all of the six most common infections. A large number of children at a DCC and small homes were associated with a high incidence of one or all of the most common infections among both younger and older children. The effects of passive smoking, number of siblings, number of household members, and incomes of families were not statistically significant.

T-lymphocyte subsets defined by double immunofluorescence in multiple sclerosis.

T-lymphocyte subpopulations were studied in the blood of 25 multiple sclerosis patients and 25 healthy age and sex-matched controls. Monoclonal antibodies labelled with different fluorochromes were used to define the percentages of CD4 (helper/inducer) and CD8 (suppressor/cytotoxic) positive cells and to dissect them into phenotypic subgroups. The results confirm the decrease in CD8 positive cells in the blood associated with multiple sclerosis. The subset showing the most marked decrease was the CD11 marker negative population, which has been reported to be associated with cytotoxicity rather than suppression. There was no significant decrease in the percentage of cells positive for both CD4 and CD45R markers reported to contain suppressor-inducer or naive T-helper cells in the MS patients. The results suggest that further dissection of T-cell subpopulations may clarify our understanding of this disease process.

Lymphocyte subsets in the cerebrospinal fluid in active multiple sclerosis.

We studied the relative number of lymphocyte subsets in the cerebrospinal fluid (CSF) of patients with active multiple sclerosis. The cells were double-labeled with monoclonal antibodies and were studied using a fluorescence-activated cell analyzer. The number of Leu2+Leu15+ cells and Leu3+Leu18+ cells was markedly reduced in the CSF but not in the peripheral blood of the patients. The number of Leu3+Leu18+ cells was reduced also in the CSF of control patients (patients with other inflammatory or infectious neurological diseases).

IgA, IgG and IgM anti-blood group A antibodies induced by pneumococcal vaccine.

Pneumococcal polysaccharide vaccine contaminated with blood group A-like substance stimulated long-lasting production of anti-A antibodies in 10 of 11 subjects with O or B blood group. ELISA using blood group A substance as antigen detected increased IgA anti-A levels 18 months after vaccination in 82% of O and B subjects, the corresponding values being 73% for IgG and 18% for IgM. In females of O or B blood group becoming pregnant with a fetus of group A or AB, prior immunization to blood group A substance may cause a potential risk for haemolytic disease of the newborn.

Tumour-associated antigens in primary mouse fibroblasts induced by transformation with bovine papillomavirus type 1.

Bovine papillomavirus type 1 (BPV 1) DNA was used to transform primary fibroblasts of C57BL/6J mice. Transformation frequency in these cells was much lower than in C127 cells and not associated with the appearance of morphologically distinct foci. However, continuous lines of transformed C57BL/6J cells were developed by serial subculturing of transfected cells. These transformed cell lines showed phenotypic properties associated with transformation including abnormal karyotypes. They contained variable amounts of viral DNA, but the copy number was in the same range as in six C127 transformants tested for comparison. In two cell lines monomeric viral DNA in an episomal form was detected. Slowly migrating viral sequences in these and in the third line were probably episomal concatamers, but the possibility of integration could not be excluded. There was some variation in immunogenicity, but all cell lines induced a cell-mediated immune response in syngeneic mice detected by the chromium release assay. In addition to BPV 1-transformed cell lines, the effector cells also reacted against an unidentified antigen shared by 2 cell lines transformed by SV40 and UV irradiation, respectively.

Cervical smears in assessment of the natural history of human papillomavirus infections in prospectively followed women.

The value of cervical (Papanicolaou) smears in monitoring the natural history of cervical human papillomavirus (HPV) infections was assessed in a series of 513 women prospectively followed since 1981. On each clinic visit, the patients were subjected to colposcopy accompanied by cervical smears and/or punch biopsies. The latter were analyzed by light microscopy for concomitant cervical intraepithelial neoplasia (CIN) and by transmission electron microscopy (TEM) for HPV particles as well as for HPV structural proteins. The stromal immunocompetent cell (ICC) infiltrates were phenotypically characterized using monoclonal antibodies for T-cell subsets, NK and K cells and Langerhans cells. HPV DNA typing was accomplished by Southern blot, spot and in situ hybridization using probes for HPV 6, 11, 16, 18 and 31. Lesions showing only changes consistent with HPV infection (HPV-NCIN) were associated with less severe atypia in cervical smears than were lesions with coexistent CIN (HPV-CIN). Normal smears were observed, however, in 24.7% of the cases with HPV-NCIN lesions, in 11.5% of cases with HPV-CIN I lesions but only exceptionally in cases with HPV-CIN II and III lesions (2.2% and 3.3%). The percentages of the different ICC phenotypes did not correlate with the atypia in cervical smears, but there was a shift towards the lower values of the T-helper/T-suppressor (OKT4+/OKT8+) cell ratio in parallel with increasing atypia. The possibility of latent HPV infection was suggested by the detection of viral particles, HPV antigens and HPV DNA in lesions shedding normal cells in the smears. The high-risk HPV types 16 and 18 were associated with the highest frequency of severely atypical cells; in the majority of cases, the low-risk types HPV 6 and 11 presented with less severe atypia. The first cervical smear seems to be of value as a predictor of the natural history of HPV lesions, as indicated by the fact that regression was inversely and progression directly related to initial cellular atypia. The present results confirm the intimate association between HPV infections and CIN. Although the biologic potential of the HPV infections seems to be dependent on multiple factors, routine cervical smears, because of their potential value in monitoring the natural history of this infection, should constitute an important means in the prospective follow-up of these patients.

NK activity and NK-like non-specific cytolysis after PPD, rubella and measles antigen stimulation in multiple sclerosis.

Blood samples were collected from 14 pairs of multiple sclerosis (MS) patients and from age- and sex-matched healthy controls. The cytotoxic activity of peripheral blood mononuclear cells was tested against the K562 cell line on the day of collection and again after 3 days in vitro culture with medium or with purified protein derivative of tuberculin (PPD), inactivated rubella virus or inactivated measles virus antigen. Lymphocytes from MS patients had a lower spontaneous cytotoxic activity compared to the controls both on the day of collection (P less than 0.025) and after 3 days in culture with medium alone (P less than 0.025). The activity decreased during in vitro culture in both groups, but the decrease was greater among MS patients (P less than 0.05). In cultures with antigens, a strong increase of NK-like cell-mediated cytolysis (NK-like CMC) was noted especially in cultures stimulated with PPD. There were no significant differences in the increase of the activity among MS patients and control subjects. A significant correlation between the increase of NK-like CMC and the lymphocyte blast transformation response induced by each antigen was found.

Characterization of in vivo activated lymphocytes found in the peripheral blood of patients undergoing cardiac operation.

We studied in vivo lymphocyte activation in patients who underwent cardiac operation. A large number of deoxyribonucleic acid-synthesizing cells characterized by 3H-thymidine uptake and morphologically atypical lymphocytes were found after operation in the peripheral blood samples of patients, the peak level occurring on the sixth or seventh postoperative day. Most of the deoxyribonucleic acid-synthesizing cells were in the B cell fraction. The number of antibody secreting cells in the patients' peripheral blood samples was found increased from the normal level after operation. Immunoglobulin A-secreting cells were the most elevated fraction. The percentage of helper (OKT4) and suppressor (OKT8) cells in the postoperative samples was not significantly different from that in the preoperative samples. Only a few were Ia antigen positive cells. Co-culture of patients' B cells with their own T cells and with the T cells taken from two healthy controls revealed no signs of any helper or suppressor effect on these antibody-secreting cells. The results show that after cardiac operation the peripheral blood of patients contains an increased number of immunoglobulin secreting cells. The regulatory T-lymphocytes seem not to have any effect in vitro on these in vivo activated cells.