Levels of trace elements in blood in healthy aging subjects.

The effects of age and sex on the serum levels of trace elements were determined after an overnight fast in 80 ambulatory, disease-free adults who had undergone rigorous health screening. Significant age and sex differences were found for Mn. Blood levels of Cu and Zn showed both age and sex differences. No age or sex differences were found for Pb, Cd, Cr, Ni, Se, and Al.

Influence of age and sex on 19 blood variables in healthy subjects.

Normal values exist for all clinical chemical tests, but it is not very clear what is normal for healthy elderly subjects. Therefore, routine blood variables were determined in 80 ambulatory, disease-free persons who had undergone rigorous health screening. The subjects were divided into the following age groups: 20 (+/- 3), 40 (+/- 3), 60 (+/- 3), and 80 (+/- 5) years, with 10 males and 10 females per age group. Blood variables were determined after an overnight fast. It was found that even with conservative statistical measures more than half of the variables were significantly affected by age or sex. Significant age differences were found for total cholesterol, triglycerides, sodium, and ASAT. Urea, creatinine, gamma-GT, phosphate, alkaline phosphatase, and albumin were characterized by both age and sex differences. No age or sex differences were found for glucose, potassium, chloride, calcium, calcium ion, iron, magnesium, total protein, and ALAT. The findings suggest that the age or sex-related changes of a number of blood variables such as cholesterol, triglycerides, and liver enzymes are not only of statistical significance, but are also of clinical relevance.

Value of fasting blood glucose and serum fructosamine as a measure of diabetic control in non-insulin-dependent diabetes mellitus.

The predictive values of fasting blood glucose and serum fructosamine for monitoring longterm diabetic control were investigated in 98 non-insulin dependent diabetic patients. The HbA1c percentage was taken as standard in this study. Despite a significant correlation, the predictive values of the parameters studied for an acceptable HbA1c-value appeared to be low (37% and 44% respectively), possibly due to differences in periods of time in which these parameters can change during variable metabolic control. In addition, the serum fructosamine value may vary due to variations in serum albumin and lipid content. It is concluded that the fasting blood glucose and serum fructosamine values cannot replace HbA1c measurement for monitoring diabetic control, but are additional for assessment of this control over short-and longterm periods of time.

Screening for micro-albuminuria with Micro-Bumintest tablets and albumin/creatinine ratio.

The value of Micro-Bumintest tablets and the albumin/creatinine ratio in first morning (FM) urine samples to screen for micro-albuminuria in diabetic patients was evaluated. The A/C ratio in FM urine was highly correlated with the urinary albumin excretion (UAE) rate in micrograms/min in timed overnight (0) urine (R = 0.95, p < 0.001). The sensitivity, specificity and positive and negative predictive values of an A/C ratio > 3.0 to predict micro-albuminuria defined as an UAE > 20 micrograms/min were 94, 92, 92 and 94% respectively. The day-to-day fluctuation of albumin excretion varied between 10 and 105%. The sensitivity, specificity and positive and negative predictive values of micro-bumintest tablet reactions on FM urine samples to predict an A/C ratio > 3.0 were 93, 59, 63 and 91% respectively. It is concluded that for screening of micro-albuminuria the A/C ratio in FM urine is as precise as timed 0 urine collection, but with more comfort for the patient. Micro-Bumintest tablets are useful as an initial screening test and will decrease the number of quantitative albumin measurements in the screening programme by about 30% if only urine samples with positive tablet test are selected for a further investigation. Because of considerable day-to-day fluctuation of urinary albumin excretion several urine samples should be investigated before presence of incipient diabetic nephropathy is assumed.

Urine Test Strips: How reproducible are readings?

In an experiment, multiple reagent test strips from 90 urine samples were examined twice: observed visually by one of two persons and analyzed by spectrophotometry. Interobserver and intra-observer agreement were calculated and expressed as Cohen's K. Interobserver and intra-observer agreement were moderate to good, but lower than one might expect. Enhancing discoloration of the test pads could improve reproducibility.

The reproducibility of urinalysis using multiple reagent test strips.

Ninety urine samples were examined twice by 3 "observers" (two persons, using only visual observation, and one person using a spectrophotometric analyser) using multiple reagent teststrips. To determine reproducibility, inter- and intra-observer agreement were calculated and expressed as Cohen's kappa and as weighted kappa. The results show negligible intra-observer differences between the visual and spectrophotometric observation. The lack of agreement between inter- and intra-observer urinalysis results, using multiple reagent test strips was disappointing, considering the simplicity of the test procedure. Further improvement of reproducibility, e.g. by enhancing the discoloration of the test pads, is necessary. Reproducibility is not improved by using a spectrophotometric analyser instead of visual reading of the test strips.

[The effects of the cholesterol synthesis inhibitor simvastatin in patients with hypercholesterolemia with and without diabetes mellitus]. / De effecten van de cholesterolsyntheseremmer simvastatine bij patiënten met hypercholesterolemie met en zonder diabetes mellitus.

We studied the short-term effects of simvastatin on lipid variables in 33 dyslipidemic patients without and 18 with diabetes mellitus who were on a lipid-lowering diet for at least 3 months. Six diabetic patients had type I, and 12 had type II diabetes mellitus, of whom 5 were using insulin. In the whole group total cholesterol decreased by 28%, from 9.35 (SD 2.10) mmol/l to 6.69 (SD 1.47) mmol/l after 3 months and 6.60 (SD 1.27) mmol/l after 6 months (mean daily dose of simvastatin 21 (SD 12) mg). Calculated LDL-cholesterol showed a decrease of 38%, HDL-cholesterol increased by 10% and plasma triglycerides decreased by 13%. In patients receiving 10, 20, or 40 mg simvastatin daily, the following changes were observed: total cholesterol -26, -31 and -34% and LDL-cholesterol -37, -38 and -39%, respectively. The effect of simvastatin in the diabetic patients was comparable with that in the non-diabetic individuals, although in the diabetics LDL-cholesterol before therapy was lower, as was the daily dose of simvastatin after 6 months (14 versus 24 mg). In the diabetic patients blood glucose control, measured as HbA1c, was not affected. One patient discontinued therapy because of stomach complaints. Our results show that a low daily dose (10 mg) of simvastatin effectively lowers plasma total and LDL-cholesterol and that the drug can be safely used in diabetic patients.

Plasma urea, creatinine, uric acid, albumin, and total protein concentrations before and after 15-, 25-, and 42-km contests.

One hundred fourteen volunteers (34 +/- 8 years) took part in an endurance training study to be completed after 18-20 months with a marathon. Ultimately, 60 males and 18 females achieved that goal. The training program, carefully supervised, was divided into three periods with a maximum of 45, 70, and 110 km/week training volume and concluded with contests of 15, 25, and 42.2 km, respectively. The competitive distance always exceeded the maximal distance covered in any previous training session. Three days before and 3 and 5 days after each race 35 subjects were selected to perform a progressive treadmill test and the remaining subjects participated in field tests of 400 and 1000 m. Before and after three contests of 15, 25, and 42.195 km the plasma concentration of urea, creatinine, uric acid, albumin, and total protein were determined. Both sexes demonstrated an increase of the plasma concentrations of urea, creatinine, and uric acid after the contests. Plasma albumin concentration decreased 2 days after the contests and total protein did not change. In females the decrease of the elevated plasma urea concentration after the marathon from the 1st day to the 3rd day post-exercise was faster than in males. The increase of plasma creatinine and uric acid concentrations were hardly dependent on the contest's distance.

[Levels of fasting blood glucose and serum fructosamine for monitoring of glucose control in patients with non-insulin-dependent diabetes mellitus]. / Bepaling van de waarden van nuchter bloedglucose en fructosamine in het serum voor beoordeling van de glucoseregulering bij patiënten met niet van insuline afhankelijke diabetes mellitus.

The predictive values of fasting blood glucose and serum fructosamine for monitoring long-term diabetic control were investigated in 98 non-insulin dependent diabetic patients. The HbAlc percentage was taken as standard in this study. Despite a significant correlation, the predictive values of the parameters studied for an acceptable HbAlc-value appeared to be low (37% and 44% respectively), possibly due to differences in periods of time in which these parameters can change during variable metabolic control. In addition, the serum fructosamine value may vary due to variations in serum albumin and lipid content. It is concluded that the fasting blood glucose and serum fructosamine values cannot replace HbAlc measurement for monitoring diabetic control, but are supplementary for assessment of this control over short- and long-term periods of time.

Electrophoresis of gamma-glutamyltranspeptidase on cellogel. The appearance of the alpha2-beta band in positive LP-X sera.

Fractionations of serum gamma-glutamyltranspeptidase (gamma-GT) and determinations of the "abnormal serum lipoprotein X" (LP-X) have been carried out in sera from patients with different hepatobiliary disorders. LP-X was used to demonstrate or exclude cholestasis. One gamma-GT fraction, alpha2-beta, may be of interest to distinguish between extrahepatic obstruction and intrahepatic cholestasis as was revealed by statistical analysis.