Plasma carnitine concentrations in cardiomyopathy patients

Carnitine is an essential cofactor for the beta-oxidation of fats. Both hypertrophic and congestive cardiomyopathies have been reported in primary and secondary carnitine deficiency. Conversely in avian cardiomyopathy models abnormally elevated plasma and tissue carnitine concentrations have been described. We measured plasma carnitine concentrations in 25 cardiomyopathy patients. In 14 patients with either hypertrophic or congestive cardiomyopathy plasma carnitine concentrations were abnormally elevated. Patients with secondary cardiomyopathies tended to have normal carnitine values. One patient with systemic carnitine deficiency was diagnosed. Her cardiac function normalized with L-carnitine replacement. Six of 14 patients with high plasma carnitine concentrations died. None of the 10 with low or normal plasma carnitine have died. Plasma carnitine determination may be a useful adjunct in the diagnostic evaluation of idiopathic cardiomyopathy.     

Plasma adrenomedullin concentrations in patients with adrenal pheochromocytoma.

BACKGROUND: The hypotensive peptide adrenomedullin was first isolated in extracts of human pheochromocytoma. There is, however, no information available on the behaviour of circulating adrenomedullin or on the correlation with catecholamines in patients with pheochromocytoma. OBJECTIVES: 1) to investigate whether plasma adrenomedullin levels were changed in 10 patients with pheochromocytoma when compared to 21 healthy subjects and 16 patients with essential hypertension; 2) to determine whether or not adrenomedullin has a counter-regulatory role in catecholamine excess in pheochromocytoma or is responsible for hemodynamic modifications before and after tumour resection; 3) to determine tissue distribution of iradrenomedullin in the pheochromocytoma. METHODS: Plasma adrenomedullin and catecholamine levels were measured in all patients with pheochromocytoma before and four weeks after tumour removal. In the four patients undergoing resection of tumours, plasma levels of adrenomedullin were measured at different time-points during surgery. RESULTS: The mean plasma adrenomedullin concentrations ( SD) in patients with pheochromocytoma (37.9 +/- 6pg/ml) were significantly higher (p<0.0001) than those in normal subjects (13.7 +/- 6.1 pg/mI) and patients with essential hypertension (22.5 +/- 9.lpg/ml). Adrenomedullin levels correlated with plasma noradrenaline (r = 0.516, p = 0.0124). In all patients with pheochromocytoma, plasma adrenomedullin concentrations decreased after removal of tumours (from 37.9 +/- 6 to 10.9 +/- 4.6 pg/ml; p < 0.0001). In the four patients studied during surgery, baseline plasma adrenomedullin and noradrenaline levels were markedly elevated, and increased significantly with tumour manipulation, decreasing 24 hours after operation. Adrenal medulla cells surrounding the pheochromocytoma site stained for ir-adrenomedullin, whereas only isolated cells of pheochromocytoma stained for the peptide. CONCLUSIONS: This study demonstrates that circulating adrenomedullin is increased in pheochromocytoma, and is also correlated with plasma noradrenaline levels. Adrenomedullin may represent an additional biochemical parameter for clinical monitoring of patients with pheochromocytoma.     

Plasma chromium concentrations in normal infants and cystic fibrosis patients

Plasma Cr concentrations have been studied in normal children aged 0–14 yr. Levels ranged from 0.65 to 0.88 μg/1 and did not change with age. Plasma concentrations of CF patients given 0.5–0.75 μg Cr/kg/d in addition to their diet were similar to normal values. There was no correlation between these plasma values and growth retardation.     

Plasma leptin decreases during lactation in insectivorous bats

We previously demonstrated high leptin levels during late pregnancy in little brown bats (Myotis lucifugus). We now extend these observations to a second species, the big brown bat (Eptesicus fuscus), and also report that leptin increases after the first trimester of pregnancy. Leptin decreased to baseline 1 week following parturition, with a half-time decay of 2 days. During lactation, leptin was significantly correlated with body mass in E. fuscus, but not in M. lucifugus. No circadian pattern of leptin was observed in M. lucifugus. The decrease in post-partum leptin in bats may be partly explained by loss of putative placental leptin. The continued decrease may reflect depletion of body fat during this energy demanding period, at least in Eptesicus. Changes in leptin during lactation appeared to be independent of circadian effects and time of sampling. Our study provides additional evidence that leptin increases during pregnancy and declines during lactation in a free-ranging mammal, supporting the hypothesis that leptin plays important but yet undetermined roles in reproduction. Accepted: 4 October 1998     

Long-term hypoxia increases leptin receptors and plasma leptin concentrations in the late-gestation ovine fetus

This study was designed to test the hypothesis that long-term hypoxia (LTH) increases fetal plasma leptin and fetal adipose or placental leptin expression and alters hypothalamic and adrenocortical leptin receptor (OB-R) expression. Pregnant ewes were maintained at high altitude (3,820 m) from day 30 to approximately 130 days of gestation. Reduced Po2 was maintained in the laboratory by nitrogen infusion through a maternal tracheal catheter. On day 132, normoxic control and LTH fetuses underwent surgical implantation of vascular catheters (n=6 for each group). Five days after surgery, maternal and fetal arterial blood samples were collected for leptin, insulin, and glucose analysis. Placental tissue, periadrenal fat, and fetal hypothalami and adrenal glands were collected from additional control (n=7) and LTH (n=8) fetuses for analysis of leptin mRNA by quantitative, real-time, RT-PCR (qRT-PCR). There was a significant (P<0.03) elevation in fetal plasma leptin in the LTH fetuses (3.5+/-0.7 ng/ml) vs. control (1.1+/-0.1 ng/ml). There were no differences in either glucose or insulin concentrations between the two groups. Periadrenal adipose leptin mRNA was significantly higher in the LTH group compared with control, as was placental leptin expression. The levels of leptin mRNA in adipose were approximately 70 times higher vs. placenta. LTH significantly reduced expression of OB-Ra (short-isoform) in the hypothalamus (P=0.0156), while resulting in a significant increase in adrenal OB-Rb (long-form) expression (P<0.03). Our data suggest that leptin is a hypoxia-inducible gene in the ovine fetus and OB-R expression is altered by LTH. These changes may be responsible in part, for our previously observed alterations in fetal hypothalamic-pituitary-adrenal function following LTH.     

Two novel PAH gene mutations detected in Italian phenylketonuric patients

We report the identification by denaturing gradient gel electrophoresis and sequence analysis of two new phenylalanine hydroxylase (PAH) gene mutations (IVS4nt-2 and N207S) in single chromosomes of two unrelated Italian phenylketonuric (PKU) patients. Interestingly, mutation Y204C, found on the second mutant allele of family F1, has been previously detected in Chinese patients. Haplotype analysis showed that the latter mutation is linked to the same haplotype (H4) in both Chinese and Italian patients, suggesting a common origin. In vivo assessment of mutation severity indicates that N207S is associated with classic PKU. The identification of these two new mutations further extends the remarkable heterogeneity of the PAH locus in the Italian population. Received: 23 May 1996     

Serum leptin concentrations in patients with combined hyperlipidemia: relationship to serum lipids and lipoproteins

Leptin is a protein hormone produced predominantly by adipocytes. Serum leptin concentrations in healthy individuals positively correlate with the body fat content and body mass index, i.e. they are higher in obese than in lean subjects. The relations between serum leptin concentration and serum lipids and lipoproteins is not yet clear. The aim of our study was to compare serum leptin concentrations in 22 randomly selected patients with untreated combined hyperlipidemia and 19 healthy control subjects matched for age and the body mass index. The relationship was studied between serum leptin concentrations and serum lipids (total, HDL, LDL cholesterol and triglycerides) and lipoproteins (lipoprotein (a), apolipoprotein B). It was found that serum leptin levels in patients with combined hyperlipidemia did not significantly differ from those of control subjects (6.69+/-4.3 vs 5.78+/-3.2 ng.ml(-1)). Serum leptin concentrations in both groups correlated positively with the body mass index. The relationship between leptin concentrations and lipid or lipoprotein levels found in any of the studied groups was not statistically significant. We conclude that serum leptin concentrations in patients with combined hyperlipidemia as well as in healthy control subjects reflect the body fat content and have no significant relation to serum lipids or lipoproteins.     

Plasma leptin levels strongly correlate with plasma renin activity in patients with essential hypertension.

Previous studies demonstrated elevated plasma leptin and angiotensinogen (PRA) levels in essential hypertension. However, a few studies investigated the relationship between leptin and angiotensinogen levels in both lean and overweight/ obese hypertensives. The aim of the present study was therefore to examine the relationship between blood pressure, leptin and plasma renin activity in normotensives and in both lean and overweight/obese patients with essential hypertension. Two groups of subjects who were carefully matched for age, gender, waist:hip ratio and body mass index (BMI) were studied: 28 normotensives (NT) (age: 40.1+/-9.1 years old, BMI: 28.1+/-3.6 kg/m2, male/female: 18/10) and 33 newly diagnosed mild to moderate essential hypertensives (EHT) (age: 38.9+/-10 years old, BMI: 27.9+/-4.8 kg/m2, male/female: 22/11). No significant differences in age, gender, waist:hip ratio, fasting blood glucose and BMI were detected between EHT and NT groups. However, systolic and diastolic pressures, mean arterial blood pressures, plasma leptin levels and PRA were significantly higher in EHT group than in NT group (P = 0.001). Plasma leptin levels were strongly correlated with BMI in EHT (r=0.67, P = 0.001) and NT groups (r=0.44, P = 0.001). Plasma leptin levels were correlated with plasma PRA levels in both EHT and NT groups (r = 0.66 and r = 0.44; both P < 0.05, respectively). There was no correlation between leptin or PRA and systolic, diastolic pressures, or mean arterial blood pressures. Furthermore, the patients were divided as lean (n=16) and overweight/obese (n = 17) and compared with BMI-matched controls. In both subgroups, plasma leptin and PRA levels were also higher than those of controls. Our results showed that elevated plasma leptin and PRA are associated with hypertension in both lean and overweight/obese hypertensives. Moreover, plasma leptin was significantly correlated with plasma angiotensinogen levels. These findings suggest that adipose mass is an important determinant of blood pressure, although the mechanism is not clear.     

Plasma malondialdehyde and serum trace element concentrations in patients with active pulmonary tuberculosis

Increased amounts of reactive oxygen species (ROS) are produced as a consequence of a phagocyte respiratory burst during pulmonary inflammation. The aim of our study was to assess the concentration of malondialdehyde (MDA) and trace metals in patients with active pulmonary tuberculosis (TB). Eighty-three subjects were enrolled into the study and prospectively divided into three groups: 22 subjects with healthy controls (group I), 21 patients with inactive pulmonary TB (group II), and 40 patients with active pulmonary TB (group III). Before beginning the therapy, plasma MDA and serum concentrations of zinc (Zn), copper (Cu), albumin, and iron (Fe) were measured. The concentration of MDA and Cu in group III were higher than in the other groups (p<0.0001). The serum Zn and albumin levels were significantly lower in group III compared with healthy controls (p<0.05). There was a positive correlation between MDA and erythrocyte sedimentation rate (r=+0.647, p<0.0001; Spearman’s test). Our data indicated increased circulating levels of MDA and changed serum trace metal levels in active pulmonary TB. Trace metal levels must be closely followed during the diseases process and further studies are needed to assess the role of antioxidants as adjuvant therapy in patients with active pulmonary TB.     

Perceived psychological stress and serum leptin concentrations in Japanese men

Objective: To examine epidemiologically whether subjects with higher stress perception levels have higher leptin concentrations. Research Methods and Procedures: In this cross‐sectional study, the study population comprised 1062 male workers at local government offices in central Japan. Self‐administered questionnaires were distributed in 1997. Awareness of stress was assessed by the question: “Do you have much stress in your life?” and participants were asked to select from four possible responses: “very much,” “much,” “ordinary,” or “little.” Blood samples were also collected after fasting 12 hours overnight to determine serum leptin concentrations. Results: The mean (standard deviation) age and BMI were 50.2 (6.4) years and 23.3 (2.6) kg/m², respectively. Crude leptin concentrations according to stress categories were 2.86, 3.26, 3.32, and 3.54 ng/mL, respectively, and leptin concentrations adjusted for age, BMI, physical activity, drinking and smoking habits, overtime work, shift work, sleep duration, and availability of confidants were 2.96, 3.24, 3.34, and 3.43 ng/mL for “little,” “ordinary,” “much,” and “very much,” respectively (p = 0.03 by one‐way analysis of covariance; p < 0.01 by test of linear trend). Significant associations were also observed among the level of perceived psychological stress and work‐related stressors, variables related to sleep, and other psychological variables. Discussion: This study showed that subjects who perceived psychological stress had high leptin levels, which provides epidemiological evidence that psychological stress may have the potential effect of increasing blood levels of the pleiotropic peptide, leptin.     

Plasma and erythrocyte manganese concentrations

This study was carried out to assess manganese (Mn) status after an acute episode of myocardial infarction. Plasma and erythrocyte Mn concentrations were measured from admission to hospital to day 15 postadmission in 21 patients suffering from acute myocardial infarction and in three control groups. The determination of Mn in these biological fluids was performed by electrothermal atomic absorption spectrometry. Plasma Mn was higher (p<0.01) and erythrocyte Mn was similar in the acute myocardial infarction group compared to healthy age-matched control group. Plasma and erythrocyte Mn remained unchanged during the 2 wk after acute myocardial infarction and were not correlated to enzyme activities. A decrease of erythrocyte Mn with age, expressed in nmol/L, was noted (p<0.02). These results suggest that plasma and erythrocyte Mn do not provide an indication of myocardial damage. Nonetheless, Mn status in elderly merits further attention.     

Serum leptin concentrations in young insulin-sensitive and insulin-resistant volunteers.

The aim of this study was to compare metabolic profiles and serum leptin concentrations between young insulin-sensitive and insulin-resistant subjects. A cross-sectional study was performed in 32 healthy, non-obese, young volunteers. Assessing of insulin sensitivity, serum leptin concentration, serum uric acid, creatinine levels and lipid profile were done on all subjects. An insulin suppression test modified with octreotide was performed to assess insulin sensitivity. Steady state glucose (SSG) and steady state insulin concentrations were calculated. Based on the SSG data, the volunteers were divided into four quartiles, considering as insulin-sensitive individuals those from quartile 1 to quartile 3, and insulin-resistant subjects those in quartile 4. Characteristics of both groups were compared, including metabolic profile and leptin levels. After dividing SSG into quartiles, 24 subjects were considered as insulin-sensitive individuals, and 8 were assessed as insulin-resistant subjects. Total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly higher in the insulin-resistant group than in the insulin-sensitive group. Serum leptin concentration was significantly higher (p=0.05) in insulin-resistant women (6.1 +/- 3.1 ng/ml) than those considered as insulin-sensitive (3.7 +/- 2.3 ng/ml). In conclusion, insulin-resistant subjects had higher concentrations of total cholesterol and LDL-cholesterol compared to insulin-sensitive individuals. Serum leptin level was higher in insulin-resistant women than those considered as insulin-sensitive.     

Plasma corticosterone concentrations in the perinatal rat

1. Plasma corticosterone concentrations were determined in the foetal rat during the gestational period from day 18·5 to term and in postnatal rats over the first few hours after delivery. 2. The plasma corticosterone concentrations in foetal rats are as high as six times maternal values at day 19 of gestation and are approximately equal to maternal values from day 20 to term. 3. In postnatal rats the plasma corticosterone concentrations rise 3·5-fold on average within 5hr. of delivery. 4. The results are discussed in relation to the function of adrenal steroids in postnatal liver development.     

A missense mutation in the bovine leptin receptor gene is associated with leptin concentrations during late pregnancy

The leptin receptor (LEPR) gene consists of 20 exons divided over 1.75 Mb. Parts of bovine LEPR exon 4 (79 bp), exon 11 (95 bp) and exon 20 (513 bp) of 20 cows (Holstein-Friesian) were sequenced (AJ580799; AJ580800; AJ580801) in an attempt to find polymorphisms. In exons 4 and 11 no SNPs were found. In exon 20, a T to C missense mutation was found at nucleotide 115, which causes an amino acid substitution at residue 945 (T945M). Frequencies for alleles C and T were 0.93 and 0.07 respectively, in a population of 323 Holstein-Friesian cows and TT animals were not detected. Using genotypes of these cows an association study was performed for leptin concentrations during late pregnancy and lactation. Leptin concentrations were determined by radioimmunoassay (RIA). The T945M mutation showed an association with circulating leptin concentrations only during late pregnancy (P < 0.05) but not during lactation (P > 0.05). The CC genotype had higher concentrations than the CT genotype during this period. A combined effect with previously described leptin polymorphisms on prepartum leptin concentrations was observed, with one genotype combination having significantly lower levels of leptin up to 50 days, but interaction effects were not significant. The T945M polymorphism may have induced a structural change in the intracellular domain of the LEPR, which may have influenced the signal transduction pathway. However, the effect was found only for the heterozygous genotype because the TT genotype was not detected in this population of 323 Holstein-Friesian cows.     

Plasma copper concentrations in pathological pregnancies.

Copper is an essential element required for the formation of many enzymes with important roles in the human body. During pregnancy, the maternal serum copper concentration is increased due to the higher levels of ceruloplasmin that are the result of elevated oestrogen levels. The aim of this work was to investigate maternal plasma copper concentrations in relation to various pathological conditions during pregnancy. A total of 319 maternal plasma samples were analysed: 103 taken from women in the first trimester, 73 in the second trimester, 99 in the third trimester of pregnancy and 44 at delivery. The plasma concentration of copper during each trimester of normal pregnancy was taken as a reference value. Group comparisons performed by analysis of variance (ANOVA) followed by Dunnett test indicated substantially lower plasma concentrations of copper in pathological conditions diagnosed during the first trimester of pregnancy (spontaneous abortion, threatened abortion, missed abortion and blighted ovum). No significant differences in maternal plasma blood copper concentrations were found in pathological conditions (threatened abortion, threatened preterm delivery and pyelonephritis) diagnosed in the second trimester of pregnancy. Significant differences in plasma copper concentrations were found in the third trimester, for which finding the Dunnett test indicated the cholestasis group to be responsible. Except for twin pregnancy, a tendency to higher plasma copper concentrations, however not statistically significant, was observed in other pathological conditions during the third trimester (gestosis, intrauterine growth retardation, preterm labour).