G B Nolph

Atherogenesis and the homocysteine-folate-cobalamin triad: do we need standardized analyses?

BACKGROUND Bioscientists, physicians and nutritionists are newly interested in the homocysteine-folate-cobalamin triad, in part because homocysteine may be important both in atherogenesis and thrombogenesis. Homocysteine imbalance may be an early marker for cobalamin disorders because cobalamin is a cofactor in remethylation of homocysteine to methionine. METHODS In 139 men and 32 women of similar mean age of 65 years, we measured markers which have been cited as risk for atherosclerosis: serum homocysteine, folate, total cobalamin, holotranscobalamin I and II, (TCI and TCII), total serum cholesterol (SCHOL), high density lipoprotein cholesterol (HDLC), triglycerides (STG) as well as red blood cell (RBC) folate, food records and body composition by whole body counting of potassium-forty (40K). RESULTS Statistical relationships among the data showed healthy women had lower mean serum homocysteine and their mean RBC folate and TCI and TCII were higher than men. Eighty-three subjects had TCII much lower than 60 pg/ml (subnormal), yet only 11 of these men and two women had total cobalamin < 200 pg/ml (abnormal). Fifty-two subjects with serum homocysteine greater than 17.5 nmol/ml had TCII less than 60 pg/ml, suggesting serum homocysteine may be a marker for early cobalamin negative balance. None of the subjects in the study had serum folate below abnormal values, i.e., less than 1.6 mg/ml. All subjects had RBC folate within normal range. Serum homocysteine showed inverse relationship with RBC folate and serum total cobalamin, TCI and TCII. CONCLUSIONS 1) importance of using serum holotranscobalamin TCI and TCII as markers of cobalamin deficiency, 2) necessity to use documented quantitative components of dietary intake if strong comparisons are to be made among quantitative values of serum or plasma homocysteine, folate, cobalamin, and nutrients in food intake.

Effects of cholesterol and fat modification of self-selected diets on serum lipids and their specific fatty acids in normocholesterolemic and hypercholesterolemic humans.

A 6-month crossover diet plan was employed to study the effects on human serum lipids of adding margarine or butter to otherwise self-selected diets that included two eggs daily. Two groups of subjects were studied: 51 free-living normocholesterolemic and 20 hypercholesterolemic (greater than 240 mg dl). Four-day diet records in each interval showed that subjects ate about 16% of total dietary fat as either butter or margarine. Blood samples taken every 6 weeks showed variable mean serum total cholesterol (SCHOL), high-density-lipoprotein cholesterol (HDL-C), and serum triglycerides (STG). The normocholesterolemic subjects who ate butter first had by 24 weeks mean SCHOL values equal to their entry values; those who ate margarine first had increased SCHOL values throughout the study. By the end of the study, the hypercholesterolemic subjects showed either no change or a slight decrease in both SCHOL and HDL-C values. Specific fatty acids were distributed differently in the serum fractions of triacylglycerol (TGFA), cholesteryl esters (CEFA), and phospholipids (PLFA). These distributions remained constant in both normocholesterolemic and hypercholesterolemic subjects regardless of the type and amount of fat consumed.

Eggs, Serum Lipids, Emotional Stress, and Blood Pressure in Medical Students

Emotional stress that occurred as a result of anticipation and participation in final exams did not change mean serum total cholesterol or high density lipoprotein cholesterol significantly in 26 male students who had eaten two eggs daily while maintaining a controlled diet for 12 wk. These same men continued to maintain a controlled diet but abstained from eating eggs for 12 wk which resulted in a statistically significant lower total cholesterol level at the end of 6 wk and on the day of final exams at the end of 12 wk. Mean values for high-density lipoprotein cholesterol in abstainers were significantly reduced at the end of 6 wk, but did not change further by 12 wk. Mean serum triglycerides values were variable. Blood pressures were not changed significantly.

Comparison of body composition measured by total body potassium and infrared interactance.

OBJECTIVE The purpose of this study was to find how closely a near infrared instrument (IRI), Futrex 5000, would compare to whole body counting (WBC) of potassium-40 (40K) in assessing body composition. DESIGN We measured lean body mass (LBM) and percent total body fat (PCF) in 177 males and 27 females by total body potassium (TBK) and by infrared interactance (IRI). TBK was assessed by 2 pi whole body counter (WBC) and IRI by Futrex (F) instrument. These subjects were measured for TBK and for IRI within 1 week of each other. RESULT A large mean difference (p < or = 0.001) was found between the results using the two instruments: IRI data for LBM were higher and PCF lower compared to TBK. CONCLUSION As shown by repeated TBK measurements over a 22-year period in these same volunteers, this technique is reliable. The IRI assessments did not come to a close fit with TBK.