Re: "Serum copper and the risk of acute myocardial infarction: a prospective population study in men in eastern Finland".
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Biomedical subjects
Publications and source records attributed to L M Klevay.
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In each of two experiments, adult, male Sprague-Dawley rats were deprived of copper and were subjected to the chronic stress of close confinement. A 2 X 2 factorial design was used because both copper deficiency and stress have been implicated in the regulation of blood pressure and are implicated in a major consequence of human hypertension--ischemic heart disease. Copper deficiency was verified by a decrease in copper in several organs. Both copper deficiency and stress increased blood pressure; results were independent. Sodium in heart was increased by deficiency in both experiments, but was increased in brain in only the second experiment. The combination of stress and deficiency produced an increase in mortality in one of two experiments. A decrease in cholesterol in plasma due to stress is consistent with earlier data from rats but is in contrast to data from humans. Both stress and copper deficiency produce potentially adverse changes in cardiovascular physiology and the chemistry of brain, heart and other organs. These results may be germane to humans because stress is frequent and some diets are low in copper.
Because of an epidemiologic association of decreased risk of death from ischemic heart disease with moderate use of alcoholic beverages, and because numerous abnormalities found in people with ischemic heart disease are also found in animals deficient in copper, rats were fed a diet deficient in copper and were given either beer or water to drink. Rats drinking beer lived nearly six times as long and had lower plasma cholesterol, less cardiac enlargement, and higher liver copper. Apparent absorption and biological half-life of oral radiocopper were increased by beer. The effects were not attributable to alcohol, chromium, or copper in beer. Beer intakes were similar to those of some people in the United States. Results may explain seasonal cycles in plasma cholesterol and may be germane to the epidemiology of ischemic heart disease because diets in the United States seem to be low in copper.
Biochemical indices of nutrition status assessed in 28 healthy persons aged greater than 60 y were related to cognitive performance and electroencephalographic (EEG) indices of neuropsychological function. Performance data were most frequently related to indices of nutrition status when tasks were demanding. Numerous correlations were also found between EEG indices and indices of thiamin, riboflavin, and iron nutriture. Certain observations, such as a decrement in alpha-wave activity in the EEG of subjects with low thiamin status, suggest that subtle neuropsychological impairment can occur in association with mild deficits in nutrition status. Other findings indicate that EEG frequency responses of older subjects with high iron status are similar to those of younger persons; however, these data are more difficult to interpret. The results suggest that further research on nutrition and neuropsychological function will lead to a better understanding of the role of nutrition in maintaining the functional integrity of the aging brain.
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Atherosclerosis is a complex process beginning early in life and often leading to death from ischemic heart disease in middle age. Hundreds of factors are said to contribute to this risk. More than 50 similarities between animals deficient in copper and people with ischemic heart disease have been identified. Some of the more important characteristics of this illness have been produced in experiments in which men and women were fed diets low in copper. Diets with similarly low amounts of copper are readily available to the population at large. More aspects of the anatomy, biochemistry, chemistry, epidemiology, pathogenesis and pathophysiology of ischemic heart disease can be explained by considering this illness to be a problem of copper deficiency than by considering any of several other explanations that have been offered.
Copper deficiency adversely affects the extracellular matrix of the arterial wall, leading to cardiovascular lesions. To study the lesions resulting from copper deficiency, the composition of proteoglycans from aortas of copper-deficient rats was compared with proteoglycans of aortas from copper-supplemented rats. Copper deficiency in rats was verified by copper levels in adrenal glands (mean +/- SE, 0.37 +/- 0.07 vs 1.03 +/- 0.17 micrograms/g wet wt in supplemented rats). The proteoglycans were isolated from the aorta by extraction with 4 M guanidine-HCl and by digestion of the tissue with elastase. The proteoglycans were purified by CsCl isopycnic centrifugation and fractionated by gel filtration. The fractions were characterized for molecular size and glycosaminoglycan composition. Total uronate in the aortas from copper-deficient rats was 25% greater than in aortas from copper-supplemented rats, and the proteoglycans from copper-deficient rat aortas were of greater molecular size. Among the glycosaminoglycans the concentration (microgram/mg tissue) of isomeric chondroitin sulfates, particularly dermatan sulfate, was greater in copper-deficient animals than in copper-supplemented animals. These observations are similar to earlier findings in experimental atherosclerosis and to a response of cardiovascular connective tissue to injury.
Sixteen healthy men aged 27.2 +/- 1.2 yr (mean +/- SEM) were tested to volitional exhaustion using the Balke, Bruce, and Ellestad treadmill protocols. Balke resulted in a greater (p less than 0.01) time to exhaustion and total work output, but a lower (p less than 0.05) peak oxygen consumption (ml.kg-1.min-1), and a lower (p less than 0.0001) cumulative net oxygen debt. Oxygen debt, expressed as a percent of total net oxygen cost, was smaller (p less than 0.001) on the Balke than the Bruce and Ellestad protocols (9.9 +/- 0.5, 18.7 +/- 0.6, and 19.3 +/- 0.6%, respectively). The rate of increase in oxygen consumption (p less than 0.0001) and blood lactate concentration (p less than 0.05) were lower on the Balke than on the Bruce and Ellestead protocols. Therefore, the observed differences in oxygen debt and lactate concentrations probably reflect differences in the rate of energy requirement, aerobic and anaerobic metabolism and physiological stress associated with each protocol.
The effect of an interaction between Cu status and dietary NaCl level on kidney structure, water balance, and the plasma renin-angiotensin-aldosterone system (RAAS) was examined in 64 male Sprague-Dawley rats (178 gm) fed a copper-supplemented diet (CuS) (10 micrograms Cu per gram) or a copper-deficient diet (CuD) (less than 0.7 micrograms Cu per gram), with (CuSNa, CuDNa) or without 3% NaCl for 42 days. NaCl did not affect growth, fluid retention, or kidney ultrastructure in Cu-supplemented rats. Cu deficiency decreased growth rate and kidney Cu, increased plasma cholesterol concentration, and suppressed plasma RAAS. NaCl increased the magnitude of these changes in Cu-deficient rats. The mortality rate was higher in CuDNa (8/16) than in Cu-deficient (2/16) rats. An acute renal failure syndrome characterized by tissue edema, pleural effusion, and ascites occurred in rats fed CuDNa. Bioelectric impedence analysis indicated that body water content was similar in rats fed CuS, CuSNa, and CuD but was higher in edematous and nonedematous rats fed CuDNa. Transmission electron microscopy indicated that glomeruli from Cu-deficient rats were poorly perfused and often occluded by expanded mesangium and contained numerous lysozome-like bodies. Fusion of podocyte foot processes, derangement of glomerular basement membrane, and hypertrophy and lipid accumulation by glomerular capillary endothelium were present in tissue from rats fed CuDNa. These results indicate that Cu deficiency reduces NaCl tolerance in rats. Ultrastructural changes in kidney tissue and the suppression of RAAS in rats fed CuDNa suggest that the edema and ascites result from acute renal failure and not from increased fluid and electrolyte reabsorption.
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Heart rate and blood pressure responses during supine rest, orthostasis, and sustained handgrip exercise at 30% maximal voluntary contraction were determined in eight healthy women aged 18-36 years who consumed diets varying in copper and ascorbic acid content. Copper retention and plasma copper concentration were not affected by diet. Enzymatic, but not immunoreactive, ceruloplasmin was lower (p less than 0.05) after the low copper and high ascorbic acid diet periods. Diet had no effect on resting supine heart rates, orthostatic responses in heart rate and blood pressure, or standing resting blood pressure. Systolic and diastolic blood pressures were increased significantly (p less than 0.05) during the handgrip test at the end of the low copper and ascorbic acid supplementation periods. Also, the ratio of enzymatic to immunoreactive ceruloplasmin decreased significantly during these dietary treatments. The mean arterial blood pressure at the end of the handgrip test was negatively (p less than 0.0004) correlated with the ceruloplasmin ratios. These findings indicate a functional alteration in human blood pressure regulation during mild copper depletion.
Atherosclerosis and hypercholesterolemia have been produced in rabbits since 1913 by feeding them cholesterol. These experiments have a great influence on current thinking about the etiology and possible prevention of ischemic heart disease. Male, New Zealand White rabbits were fed 0.5% dietary cholesterol. Cholesterol and copper in plasma increased sixty-fold and 50%, respectively. Liver copper decreased 74% and hematocrit decreased 26%. Iron was unchanged in heart and liver, but was increased in kidney. Zinc was decreased in heart, but was unchanged in liver or kidney. Changes in organ iron and zinc were smaller than the decrease in liver copper. Similar experiments with higher doses of dietary cholesterol may have resulted in copper deficiency. It may be appropriate to revise interpretations of data from these experiments and to reformulate hypothesis based on the data. Results are consonant with the theoretical implication of copper metabolism and copper deficiency in the etiology and pathogenesis of ischemic heart disease.
Illnesses are classified by whether or not etiologies are comprehensible or incomprehensible. The comprehensible diseases are divided into those due to four classes of etiologic agents: toxicity, heredity, infection and deficiency. Cooperations between two members of these classes are described to illustrate the concepts of hereditary intoxication, infectious intoxication, toxic deficiency, hereditary infection, hereditary deficiency and infectious deficiency. Examples in which cooperations among members of three or four classes of etiologic agents are required to produce illness also are provided. It is concluded that there are only four known ways of becoming ill and that cooperations can explain much variability of human disease.
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