Erythrocyte selenium concentration as a marker of selenium status.

Background & Aims: Plasma selenium concentration and glutathione peroxidase (GPx) activity are commonly used as markers of selenium nutritional status. However, plasma selenium concentrations fall independently of selenium status during the acute phase response and GPx is analytically problematic. The assay for erythrocyte selenium is robust and concentrations are unaffected by the systemic inflammatory response.

Quantitative data on the magnitude of the systemic inflammatory response and its effect on micronutrient status based on plasma measurements.

Background: Plasma concentrations of several trace elements and vitamins decrease because of the systemic inflammatory response. Thus, low values do not necessarily indicate deficiency.

Objective: The magnitude of this effect on plasma micronutrient concentrations was investigated to provide guidance on the interpretation of routine clinical results.

A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study.

Introduction: Components of the systemic inflammatory response, combined to form inflammation-based prognostic scores (modified Glasgow Prognostic Score (mGPS), Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), Prognostic Index (PI), Prognostic Nutritional Index (PNI)) have been associated with cancer specific survival. The aim of the present study was to compare the prognostic value of these scores.

Methods: Patients (n=27,031) who had an incidental blood sample taken between 2000 and 2007 for C-reactive protein, albumin, white cell, neutrophil, lymphocyte and platelet counts, as well as a diagnosis of cancer (Scottish Cancer Registry) were identified.

The relation between acute changes in the systemic inflammatory response and plasma 25-hydroxyvitamin D concentrations after elective knee arthroplasty.

Background: Studies indicate that low plasma 25-hydroxyvitamin D [25(OH)D] is associated with a range of disease processes, many of which are inflammatory. However, other lipid-soluble vitamins decrease during the systemic inflammatory response, and this response may confound the interpretation of plasma 25(OH)D.

Objective: The objective was to examine whether plasma 25(OH)D concentrations change during evolution of the systemic inflammatory response.

Plasma dimethylarginines during the acute inflammatory response.

Introduction: Asymmetric dimethylarginine (ADMA) concentrations are increased in critically ill patients and may play a role in multiple organ failure. However, plasma ADMA concentrations during the development of the inflammatory response have not been documented. We measured plasma ADMA, as well as urinary excretion of its major metabolite dimethylamine, and nitrate as a marker of nitric oxide synthase (NOS) activity, in a cohort of patients undergoing elective knee arthroplasty that is known to provoke a significant inflammatory response.

Relation between riboflavin, flavin mononucleotide and flavin adenine dinucleotide concentrations in plasma and red cells in patients with critical illness.

Background: There is some evidence that the relationship between plasma and red cell vitamin B2 concentrations is perturbed in the critically ill patient. The aim of the present study was to examine the longitudinal interrelationships between riboflavin, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD) in plasma and red cells in patients with critical illness.

Methods: Riboflavin, FMN and FAD concentrations were measured, by HPLC, in plasma and red cells in healthy subjects (n=119) and in critically ill patients (n=125) on admission and on follow-up.

Home parenteral nutrition in Scotland: frequency of monitoring, adequacy of review and consequence for complication rates.

Background And Aims: Home parenteral nutrition (HPN) has been a major advance in the management of patients with gastrointestinal failure. It demands regular monitoring to ensure optimal intake, assess treatment response, and minimize complications. The Scottish Home Parenteral Nutrition Managed Clinical Network (MCN) produced a guideline advising three-monthly monitoring of biochemistry, micronutrients, vitamins, weight, and anthropometry.

Assessing proteinuria in chronic kidney disease: protein-creatinine ratio versus albumin-creatinine ratio.

Background: Quantification of proteinuria is important in the assessment of chronic kidney disease (CKD). The aim of this study was to investigate the optimal test to identify significant proteinuria.

Methods: We retrospectively assessed the relationship between total protein:creatinine ratio (TPCR), albumin:creatinine ratio (ACR) and 24-h urine total protein in 6842 patients with CKD focusing on performance at thresholds of 0.

Assessment of vitamin E status in patients with systemic inflammatory response syndrome: plasma, plasma corrected for lipids or red blood cell measurements?

Background: There is some evidence that the plasma vitamin E status is perturbed as part of systemic inflammatory response and correcting this with other plasma markers may not lead to reliable results. The aim of the present study was to examine the longitudinal inter-relationships between plasma and red blood cell vitamin alpha-tocopherol in patients with systemic inflammatory response syndrome.

Methods: alpha-tocopherol concentrations were measured, by HPLC, in plasma and red blood cells in normal subjects (n=67) and in critically ill patients with systemic inflammatory response syndrome (n=82) on admission and on follow-up.

HPLC analysis of asymmetric dimethylarginine (ADMA) and related arginine metabolites in human plasma using a novel non-endogenous internal standard.

Background: Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthesis which has been implicated in the endothelial dysfunction. Methods for ADMA measurement often yield widely differing results, and few methods simultaneously offer satisfactory accuracy and precision. We describe a fully validated HPLC method for analysis of arginine and its methylated derivatives in human plasma using a novel internal standard.

Vitamin antioxidants, lipid peroxidation, tumour stage, the systemic inflammatory response and survival in patients with colorectal cancer.

Both the tumour growth and progression and the systemic inflammatory response have the potential to increase oxidative stress. We therefore examined the relationship between lipid-soluble antioxidant vitamins, lipid peroxidation, the systemic inflammatory response and survival in patients with primary operable (n = 53) and advanced inoperable (n = 53) colorectal cancer. Compared with those patients with primary operable colorectal cancer, patients with unresectable liver disease had significantly lower median concentrations of alpha-tocopherol (p < 0.

Relation between pyridoxal and pyridoxal phosphate concentrations in plasma, red cells, and white cells in patients with critical illness.

Background: Evidence suggests that the relation between plasma and red cell vitamin B-6 concentrations is perturbed as part of the systemic inflammatory response in critically ill patients.

Objective: The aim was to examine the cross-sectional and longitudinal interrelations between pyridoxal (PL) and pyridoxal phosphate (PLP) concentrations in plasma and red and white cells in patients with critical illness.

Design: PLP and PL concentrations were measured by HPLC in plasma and red and white cells in normal subjects (n = 126) and critically ill patients (n = 96) on admission and on follow-up.

Acute inflammatory response does not affect erythrocyte concentrations of copper, zinc and selenium.

Background & Aims: Measuring the nutritional status of trace elements in plasma is invalidated in the presence of a systemic inflammatory response. We examined the potential of erythrocytes to assess copper, zinc and selenium status in such situations.

Methods: Venous blood samples were withdrawn pre-operatively and at 12, 24, 48, 72 and 168 h post-operatively from 11 patients (6 males and 5 females) who were admitted for elective knee arthroplasty.

HPLC method for plasma vitamin K1: effect of plasma triglyceride and acute-phase response on circulating concentrations.

Background: The plasma concentration of vitamin K(1) (phylloquinone) is the most reliable index for assessing vitamin K status. Our aim was to analytically validate an HPLC method for quantifying phylloquinone in plasma and to examine the effect of plasma triglyceride concentration on the phylloquinone reference interval. We also examined the effect of acute-phase response on phylloquinone concentration in plasma.

Assessment of dietary intake and trace element status in patients with ileal pouch-anal anastomosis.

Purpose: Panproctocolectomy and ileal pouch-anal anastomosis is the operation of choice for patients with ulcerative colitis and familial polyposis. The long-term nutritional consequences after pouch surgery are unknown. We have assessed the nutritional status of the essential trace elements-zinc, copper, manganese, and selenium-in patients several years (median, 10 (range, 2-15) years) after surgery.

Randomized controlled trial of homocysteine-lowering vitamin treatment in elderly patients with vascular disease.

Background: Homocysteine is an independent risk factor for vascular disease and is associated with dementia in older people. Potential mechanisms include altered endothelial and hemostatic function.

Objective: We aimed to determine the effects of folic acid plus vitamin B-12, riboflavin, and vitamin B-6 on homocysteine and cognitive function.

The relationship between the acute changes in the systemic inflammatory response, lipid soluble antioxidant vitamins and lipid peroxidation following elective knee arthroplasty.

Background And Aims: The aim of the present study was to examine the time course of the change in the concentrations of plasma retinol, alpha-tocopherol, lutein, lycopene, alpha-carotene, beta-carotene (antioxidant vitamins) and malondialdehyde (lipid peroxidation) in patients following elective knee arthroplasty.

Methods: Patients (n=20) who underwent an elective knee arthroplasty, had venous blood samples withdrawn pre-operatively and at 12, 24, 48, 72 and 168 h after the start of surgery for the analysis of circulating concentrations of C-reactive protein, albumin, cholesterol, triglycerides and malondialdehyde and also the lipid soluble antioxidants vitamins.

Results: Over the study period of 0-168 h there was a significant increase in circulating C-reactive protein concentrations (peak 48 h, P<0.

Vitamin antioxidants, lipid peroxidation and the systemic inflammatory response in patients with prostate cancer.

The relationship between lipid soluble antioxidant vitamins, lipid peroxidation, disease stage and the systemic inflammatory response were examined in healthy subjects (n = 14), patients with benign prostate hyperplasia BPH (n = 20), localized (n = 40) and metastatic (n = 38) prostate cancer. Prostate cancer patients had higher concentrations of malondialdehyde (p < 0.05) and lower circulating concentrations of lutein (p < 0.

Outcomes of pregnancy complicated by thyroid disease.

Aims: To perform a case note review of pregnancies complicated by thyroid dysfunction to determine management and therapeutic intervention in relation to pregnancy outcome.

Methods: A retrospective case note analysis of 81 ongoing pregnancies in 70 pregnant women with a history of thyroid dysfunction over a period of 5 years at the Glasgow Royal Maternity Hospital (GRMH), Glasgow, Scotland, United Kingdom. The results of thyroid function tests and whether a change in treatment was instituted were recorded.

Elevated alanine aminotransferase predicts new-onset type 2 diabetes independently of classical risk factors, metabolic syndrome, and C-reactive protein in the west of Scotland coronary prevention study.

We examined the association of serum alanine aminotransferase (ALT) with features of the metabolic syndrome and whether it predicted incident diabetes independently of routinely measured factors in 5,974 men in the West of Scotland Coronary Prevention Study. A total of 139 men developed new diabetes over 4.9 years of follow-up.

The relationship between plasma and red cell concentrations of vitamins thiamine diphosphate, flavin adenine dinucleotide and pyridoxal 5-phosphate following elective knee arthroplasty.

Background & Aims: Water soluble vitamins B1, B2 and B6 are essential precursors for a wide variety of coenzymes involved in intermediary metabolism and their status is usually assessed from blood samples. The aim of the study was to examine the relationship between plasma and intra-cellular B-vitamins following the systemic inflammatory response of surgery.

Methods: Patients (n = 10) who underwent an elective knee arthroplasty, had venous blood samples withdrawn pre-operatively and at 12, 24, 48, 72 and 168 h after the start of surgery for the analysis of circulating concentrations of C-reactive protein and albumin and also plasma and/ or red cell thiamine diphosphate (TDP), flavin adenine dinucleotide (FAD), pyridoxal 5-phosphate (PLP) as indicators of vitamins B1, B2, and B6 status respectively.

Interleukin-6, fibrin D-dimer, and coagulation factors VII and XIIa in prediction of coronary heart disease.

Objective: Activated inflammation and activated blood coagulation are believed to increase the risk of coronary thrombosis and are related. We therefore compared plasma IL-6 (a key cytokine in the inflammatory process), fibrin D-dimer (a marker of fibrin turnover), and coagulation factors VII and XIIa (initiators of extrinsic and intrinsic blood coagulation, respectively) as predictors of coronary risk in the West of Scotland Coronary Prevention Study of pravastatin in men with hypercholesterolemia.

Methods And Results: 485 men who had had a coronary event (nonfatal myocardial infarction, death from coronary heart disease, or revascularization) were matched for age and smoking status with 934 controls.

Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study.

Background: The National Cholesterol Education Program (NCEP) recently proposed a simple definition for metabolic syndrome. Information on the prospective association of this definition for coronary heart disease (CHD) and type 2 diabetes is currently limited.

Methods And Results: We used a modified NCEP definition with body mass index in place of waist circumference.

Optimisation and validation of a sensitive high-performance liquid chromatography assay for routine measurement of pyridoxal 5-phosphate in human plasma and red cells using pre-column semicarbazide derivatisation.

There are few studies in which direct measurement of vitamin B6 status in both plasma and red cells has been assessed. The aims of the present study were to evaluate the use of a simple, robust HPLC method of direct pyridoxal 5'-phosphate (PLP) measurement in plasma and red cells and to assess its use in establishing reference ranges in a healthy population. A reverse phase HPLC method with pre-column derivatisation using semicarbazide for the simultaneous measurement of PLP, its degradation product, 4-pyridoxic acid (PA) and pyridoxal (PL) in plasma and red cells was developed.