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Biomedical subjects

K Pietrzik

Publications and source records attributed to K Pietrzik.

At least 37 records · Page 2Linked to original sources

Bioavailability of oral vitamins, minerals, and trace elements in perspective.

Bioavailability of orally administered vitamins, minerals, and trace elements is subject to a complex set of influences. Still, administrative regulation is necessary on how to quantify it. The most common approach to this problem is to determine the fraction of an oral dose that reaches the systemic circulation. For micronutrients, however, this approach has to consider the physiological plasma concentration as well as the mechanisms that regulate intestinal absorption and distribution of micronutrients between functional and storage compartments in response to the demand. The rate of exchange between these compartments has an impact on the delivery of such compounds into the plasma compartment as well as on the plasma clearance. Monitoring the area under the plasma concentration time curve after oral administration is an inadequate tool for bioavailability determination if there are substantial impacts of homeostatic mechanisms on the plasma concentration of a micronutrient. In nutritional science the term "bioavailability" encompasses the sum of impacts that may reduce or foster the metabolic utilisation of a nutrient. Bioavailability in this sense can be quantified by the rate by which deficiency symptoms are cured or by the weight gain during growth. both of these endpoints, again, are influenced by homeostatic mechanisms. To exemplify the scope of impacts on parameters that are commonly used to quantify the bioavailability of oral micronutrient preparations the basic traits of homeostatic regulation are summarised and compared for iron, magnesium, vitamin A, folic acid, and vitamin B12. The mechanisms that adapt absorption, distribution, and excretion of these five micronutrients to the demand differ to such an extent that no common approach can be derived to consider these impacts in bioavailability determination. In consequence, therefore, we recommend to define and regulate individual strategies for bioavailability testing for each micronutrient with regulated kinetics.

Administration, Oral↗

Parasitological and nutritional situation of school children in the Sukaraja district, West Java, Indonesia.

A parasitological survey of children aged 8 to 10 years from ten schools located in the rural district Sukaraja, West Java, Indonesia was conducted in December 1995. A total of 348 fecal samples were examined by using modified Kato-Katz thick smear techniques, 365 blood samples for the measurement of hemoglobin concentration, and anthropometric data were obtained from 404 participants. Four nematode (hookworm taken as one species), two cestode and nine protozoan species were detected, but no trematode infection was observed. Among helminths, soil-transmitted nematode infections were predominant, Trichuris trichiura with a prevalence of 76% being the most common infection, followed by Ascaris lumbricoides (44%). Hookworm and Enterobius vermicularis were found in 9% and 3% of the children examined, respectively. Among protozoa, Blastocystis hominis was by far the most common species, detected in 60% of volunteers cases. For the helminths A. lumbricoides, T. trichiura and hookworm, school to school differences in parasite prevalence and infection intensity were observed; these were probably due to different socioeconomic and sanitary-environmental conditions. Intensity of Ascaris and hookworm infection tended to be highly over-dispersed; 85% of the worms identified were harbored by 15% and 7% of the children, respectively. Nutritional status was characterized by an average anemia rate of 13% and a prevalence of 51% stunting. All nutritional indicators differed significantly from school to school. Intensity of geohelminths infection could not be associated to the observed nutritional indicators. Thus, there must be additional factors contributing to the studied nutritional indicators of the school children which overlay a possible influence of moderate to heavy worm burden.

Anemia, Iron-Deficiency↗

Causes and consequences of hyperhomocyst(e)inemia.

Increased plasma concentrations of the sulfur-containing amino acid homocyst(e)ine are designated as hyperhomocyst(e)inemia. Various definitions have been used to derive cut-off levels for hyperhomocyst(e)inemia. The classification by Kang is now generally used distinguishing moderate, intermediate and severe hyperhomocyst(e)inemia. A variety of causes are discussed for the etiology of the disease which can be grouped into genetic and nongenetic factors. Severe hyperhomocyst(e)inemia is accompanied by homocystinuria and several other symptoms occurring early in life. Treatment is mandatory for normal development and prevention of premature atherosclerosis. Even less severe forms of hyperhomocyst(e)inemia imply a substantially elevated risk for vascular diseases. Etiology and severity of defect(s) leading to hyperhomocyst(e)inemia are the basis for treatment. In genetic defects, supplementation with the cofactor(s) of the affected enzyme is used to enhance enzyme activity. Alternative routes in the pathway may also be enhanced. Nongenetic hyperhomocyst(e)inemia often requires correction of suboptimal vitamin concentrations. Nutritive doses of the vitamins may be sufficient for treatment of less severe forms as well as for prevention of hyperhomocyst(e)inemia.

Aged↗

[Micronutrients in pregnancy].

During pregnancy the demands for energy and far more for micronutrients are increased. Discrepancies between the intake of certain micronutrients such as iodine, iron and folic acid and the recommended quantities during pregnancy are to be expected. Consequences of an unsufficient supply of these micronutrients might be goitre, anemia and with special reference to folic acid the occurrence of neural tube defects. Deficiency can be prevented by careful choice of food. Supplementation with special micronutrients is necessary before respective during pregnancy however for example to prevent neural tube defects by periconceptional supplementation with folic acid.

Female↗

The role of homocysteine, folate and other B-vitamins in the development of atherosclerosis.

Recently, elevated homocysteine blood concentrations have been identified as an independent risk factor for the development of atherosclerotic lesions. The amino acid homocysteine is metabolized in the human body involving the vitamins folic acid, B12 and B6 as essential cofactors and coenzymes, respectively. There is an inverse relationship between the status of the relevant B-vitamins and the homocysteine blood concentration. Supplementation of these vitamins results in a significant reduction of the homocysteine level. Nutritive amounts seem to be sufficient to obtain this reduction, even in the case of elevated homocysteine levels.

Arteriosclerosis↗

The short-term effect of dietary pectin on plasma levels and renal excretion of dehydroepiandrosterone sulfate.

Studies specifically investigating the effects of single dietary components on plasma levels of dehydroepiandrosterone (DHEA) and its sulfate ester (DHEAS) are rare. Especially no data is available with regard to specific dietary fibers. Therefore, the impact of pectin (a representative fiber that affects the enterohepatic recirculation of bile acids) was studied in a randomized crossover trial consisting of three diet periods characterized by the same food supply and daily doses of 0 g, 15 g or 30 g pectin. Blood and 24-h-urine samples were collected at the end of each 4-day diet period from 6 healthy male volunteers. Plasma levels of DHEA, cortisol and the major binding protein of DHEAS albumin remained unchanged with the varying pectin supplements. Also, no changes were observed for several urinary analytes including urinary DHEAS. However, effects of pectin intake (30, 15 versus 0 g/d) were seen for plasma DHEAS (9.3 +/- 2.8, 9.2 +/- 2.6, 8.0 +/- 3.1 mumol/L, p < 0.01) and total plasma cholesterol (4.4 +/- 0.7, 4.5 +/- 0.7, 4.7 +/- 0.8 mmol/L, p = 0.1). Obviously, the altered intake of fiber in the form of pectin affects plasma concentrations of DHEAS and cholesterol in an opposite direction. The reason for this is not known but a dietetically induced modulation of the binding properties of plasma albumin for DHEAS appears possible. Our findings suggest that the target tissue-available, not protein-bound fraction of circulating DHEAS (as reflected by the renal DHEAS output) is not necessarily altered when total plasma concentrations of DHEAS vary.

Adult↗

A moderate increase in daily protein intake causing an enhanced endogenous insulin secretion does not alter circulating levels or urinary excretion of dehydroepiandrosterone sulfate.

To study the effect of a moderate increase in insulin secretion produced by an increased daily protein intake on dehydroepiandrosterone sulfate (DHEAS), a balanced randomized crossover trial consisting of three strictly controlled dietary regimens was performed in six healthy male volunteers. The basic diet (B) contained 50 g protein/d; diets P and M (also basic diets) were enriched with either 32 g protein/d (P) or 10 mmol L-methionine/d (M). Methionine was given (as a specific nonprotein source of endogenously derived sulfate) to control for possible confounding effects on DHEAS due to an increased sulfate supply. At the end of each 4-day diet period, blood and 24-hour urine samples were collected. Fasting plasma levels of testosterone, cortisol, insulin-like growth factor-I (IGF-I), and insulin, as well as urinary output of total (hot acid-cleaved) testosterone conjugates and 3alpha-androstanediol glucuronide, did not show significant changes in response to dietary manipulations. Endogenous sulfate availability (as reflected by renal sulfate output per 24 hours) approximately doubled with diets P and M. However, plasma levels (6.3 +/- 1.5, 6.8 +/- 1.8, and 6.9 +/- 2.1 micromol/L for B, P, and M, respectively) and urinary excretion (8.8 +/- 9.8, 9.4 +/- 11.2, 8.0 +/- 8.3 micromol/d) of DHEAS remained unaffected. Considering the clear increments (P < .01) in urinary C-peptide excretion with diet P (20.4 +/- 10.3 nmol/d) versus diets B and M (12.6 +/- 5.1 and 13.2 +/- 3.6 nmol/d), respectively, our results suggest that a moderately strong diet-induced increase in daily insulin secretion does not alter urinary and plasma levels of DHEAS.

Adult↗

Re-examination of the effect of hCG on plasma levels and renal excretion of dehydroepiandrosterone sulfate in healthy males.

To reinvestigate the effect of hCG on circulating and urinary dehydroepiandrosterone sulfate (DHEAS), a hCG stimulation test (5000 IU administered i.m. at 8.30 h on 3 consecutive days) was performed in 6 healthy males (aged 24 to 35 years). Blood specimens and 24-h urine samples were collected immediately before the first and directly after the last hCG administration. Contrary to previous findings in normal men, the present study revealed significant DHEAS responses after testicular stimulation with hCG: plasma DHEAS increased from 7.9 +/- 2.3 to 9.6 +/- 2.2 mumol/L (P < 0.05) and urinary DHEAS from 5.7 +/- 3.6 to 9.3 +/- 5.2 mumol/day (P < 0.05). There was also a marked rise (P < 0.05) in the urinary excretion of total 17-ketosteroid sulfates. Clear increases of unconjugated plasma dehydroepiandrosterone as well as of circulating and renally excreted androstenedione and testosterone definitely confirmed an adequate Leydig cell stimulation. Significant post-hCG changes were additionally observed for plasma and urinary 3 alpha-androstanediol glucuronide (149% and 79% increases, respectively) and for urinary cortisol (21% decrease). Significant correlations were found for the post-hCG percent increases of plasma androstenedione versus plasma DHEAS (r = 0.86) and for the percent increases of plasma testosterone versus urinary DHEAS (r = 0.98), indicating that the extent of gonadal androgen elevations in the circulation of normal men is a determinant of DHEAS increases in blood or urine. These findings provide an explanation for the frequently observed sex differences for DHEAS in adults.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Measurement of urinary androgen sulfates without previous hydrolysis: a tool to investigate adrenarche. Validation of a commercial radioimmunoassay for dehydroepiandrosterone sulfate.

A commercial 125I radioimmunoassay designed for the quantification of dehydroepiandrosterone sulfate (DHEAS) in blood samples was tested for its direct applicability to 24-hour urine samples from children and adults. Average recoveries in parallelism and spiking experiments were found to be near 100%. Intra- and inter-assay coefficients of variation were below 10%. Urinary DHEAS concentrations determined directly by the radioimmunoassay (x) differed only slightly from corresponding radioimmunoassay values (y) obtained after C18 reversed-phase extraction and LH-20 chromatography (y = 0.85x + 0.12; r = 0.99). Cross-reactivity data from related steroids suggested only a small contribution to the DHEAS titer by other steroids. In 8-year-old children compared to preadrenarchal children (4 years old) a clearly increased median daily urinary DHEAS output could be observed both for absolute excretion data (0.163 versus 0.05 mumol/d, P < 0.01) and for excretion values related to body surface area (0.181 versus 0.071 mumol/d/1.73 m2, P < 0.05). However, this "onset of adrenarche" was no longer statistically significant when urinary creatinine was taken as adjustment parameter for renal androgen sulfate output. After correction with the individual body surface area, rises of urinary DHEAS from childhood to adulthood were nearly in the order of the literature data on age-corresponding serum increases of DHEAS. In conclusion, the direct radioimmunological quantification of DHEAS in 24-hour urine samples with subsequent correction for individual body surface area appears to present a physiologically meaningful way to assess the adrenal gland's secretory activity for this androgen sulfate.

Adrenal Glands↗

Chronic insulin treatment, but not chronic ACTH administration increases plasma dehydroepiandrosterone sulfate levels in adolescent male rats.

The chronic effect of daily i. m. administration of ACTH (1 U/kg bodyweight (BW), group A) and of insulin (15/kg BW, group B) on circulating dehydroepiandrosterone sulfate (DHEA-S) and testosterone was investigated in postpubertal male Wistar rats. NaCl-injected animals served as controls (group C). After at least 8 days under the respective hormone or NaCl treatment "basally" circulating testosterone levels were slightly suppressed in insulin- (1.56 +/- 0.86 ng/ml) and markedly reduced (0.54 +/- 0.21 ng/ml) in ACTH-treated rats vs. controls (2.33 +/- 0.69 ng/ml). DHEA-S levels, however, nearly doubled under chronic insulin administration (0.4 +/- 0.18 ng/ml) in comparison to the groups A (0.22 +/- 0.11 ng/ml) and C (0.23 +/- 0.09 ng/ml). Food intake and weight gain were also elevated (vs. groups A and C) as were the basal plasma corticosterone levels (vs. group C) in insulin treated rats. Following an acute ACTH stimulation test (12 U/kg BW i.m.) performed in all three treatment groups, plasma DHEA-S showed a further increase in the animals receiving insulin (0.75 +/- 0.32 ng/ml), whereas no response was detectable in rats from group A (0.27 +/- 0.13 ng/ml) or C (0.24 +/- 0.11 ng/ml). Further measurements of corticosterone or testosterone responses following endocrinological stimulation tests with supraphysiological doses of either ACTH or human chorionic gonadotropin (hCG) indicated that a lowering in the catabolism (metabolic clearance) of corticosteroids or androgens could not be the cause for the elevated DHEA-S levels seen after daily insulin injections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Glands↗

[Folic acid supply in pregnancy--results of a prospective longitudinal study].

After discussing the problem of folic acid requirements and supply during pregnancy, the results of a longitudinal study on 162 pregnant women are presented. By measuring biochemical and morphological changes in two subgroups (non-substituted vs unspecifically substituted), the necessity of a substitution with folic acid is discussed, as there might be additional requirements for the pregnant and the foetal organism. Concentrations of folic acid in the maternal plasma and in the erythrocytes as well as the segmentation rate and hypersegmentation of the granulocytes show a clear decrease in pregnancy. At the same time there was a significant difference between the subjects substituted and not substituted; the foetus and newborn levels were much higher than their mothers' concentrations. Moreover, there was a correlation between red cells folic acid levels in the last trimester and duration and outcome of pregnancy. These results indicate a substitution with folic acid for certain populations in pregnancy, which are highlighted.

Adolescent↗