L. Sáez

Effect of folic acid supplementation on homocysteine concentration and association with training in handball players

BackgroundStrenuous physical activity can alter the status of folic acid, a vitamin directly associated with homocysteine (Hcy); alterations in this nutrient are a risk factor for cardiovascular disease. Handball players are a population at risk for nutrient deficiency because of poor dietary habits.ObjectiveThe aims of this study were to evaluate nutritional status for macronutrients and folic acid in members of a high-performance handball team, and determine the effect of a nutritional intervention with folic acid supplementation and education.DesignA total of 14 high-performance handball players were monitored by recording training time, training intensity (according to three levels of residual heart rate (RHR): <60%, 60%–80% and >80%), and subjective perceived exertion (RPE) during a 4-month training period. Nutritional, laboratory and physical activity variables were recorded at baseline (Week 0), after 2 months of dietary supplementation with 200 μg folic acid (50% of the recommended daily allowance) (Week 8) and after 2 months without supplementation (Week 16). We compared training load and analyzed changes in plasma concentrations of Hcy before and after the intervention.ResultsBivariate analysis showed a significant negative correlation (P < 0.01) between Hcy and folic acid concentrations (r = −0.84) at Week 8, reflecting a significant change in Hcy concentration (P < 0.05) as a result of hyperhomocysteinemia following the accumulation of high training loads. At Week 16 we observed a significant negative correlation (P < 0.01) between Hcy concentration and training time with an RHR <60%, indicating that aerobic exercise avoided abrupt changes in Hcy and may thus reduce the risk of cardiovascular accidents in high-performance athletes.ConclusionIntegral monitoring and education are needed for practitioners of handball sports to record their folic acid status, a factor that directly affects Hcy metabolism. Folic acid supplementation may protect athletes against alterations that can lead to cardiovascular events related to exertion during competition.

Characterization of L-cysteine capped CdTe quantum dots and application to test Cu(II) deficiency in biological samples from critically ill patients.

The catalytic activity of copper ion gives, from the physiological point of view, a central role in many biological processes. Variations in the composition and location of cellular copper have been addressed given their physiological and pathological consequences. In this paper L-cysteine capped CdTe quantum dots is used for the fluorimetric determination of Cu(II) in biological samples from healthy individuals and patients admitted to the Intensive Care Units (ICU). An acceptable homogeneity in the CdTe QDs size has been obtained with an average value of 3 nm. No significant alterations in the spectral properties were observed for 2 months when stored in vacutainers at 6°C and a concentration of approximately 2 μM. Data from oxidative stress markers such superoxide dismutase, total antioxidant capacity and DNA damage can be correlated with a Cu(II) deficiency for the ICU patients as measured by flame-atomic absorption spectroscopy (FAAS) and inductively coupled plasma source mass spectrometry (ICP-MS). Aqueous solutions 0.3 μM of L-cysteine capped CdTe QDs in MOPS buffer (6 mM, pH 7.4) used at 21°C in the range 15-60 min after preparation of the sample for the measurements of fluorescence gives contents in Cu(II) for erythrocytes in good agreement with those obtained in FAAS and ICP-MS but the comparative ease of use makes the fluorimetric technique more suitable than the other two techniques for routine analysis.

Association between erythrocyte concentrations of magnesium and zinc in high-performance handball players after dietary magnesium supplementation

Currently, research on athletes focuses on optimizing the nutritional status in order to adjust their minerals requirements. This study was designed to evaluate baseline nutritional status and the effect of a nutritional intervention based on magnesium (Mg) supplementation, on plasma and erythrocyte concentrations of Mg and zinc (Zn), and their relationship with training load. We analyzed training load by recording the training volume, intensity and rating of perceived exertion (RPE) during a four-month period, in 14 high-performance handball players. Intensity was studied in different levels of residual heart rate (RHR). We analyzed nutrient intake and plasma and erythrocyte concentrations of Mg and Zn by FAAS. All biomarkers were measured at baseline, after two months of dietary supplementation with Mg, and after two months without supplementation. RPE was associated with training volume at different intensities of RHR. Mg supplementation significantly increased plasma Mg levels during the supplemented period and preserved for subsequent changes in the non-supplemented period. Erythrocyte concentrations of Mg and Zn show associations between baseline and Mg supplementation. Mg levels were associated with training volume at different intensities after supplementation. In conclusion, our findings in high-performance handball players show that during competition, there is a relationship between erythrocyte Zn and Mg levels, regardless of Mg supplementation or Zn intake. Mg dietary supplementation tended to preserve changes in mineral levels during training and competition.

PP027-SUN BIOMARKERS OF SELENIUM STATUS IN CRITICALLY ILL PATIENTS

Rationale: Deficient status in selenium, a cofactor of the antioxidant enzyme glutathione peroxidase (GPx), together with hypercatabolic state, can affect the clinical course during the patient’s stay in the intensive care unit (ICU). The resulting increase in oxidative stress has been recognized as a central mechanism in the pathophysiology of critical illnesses, particularly the appearance of multiorgan failure. Methods: A blood sample was obtained on the day of admission in the ICU from 65 critically ill patients in Granada province (southern Spain) who fulfilled the inclusion criteria. Selenium was measured with inductively coupled plasma mass spectrometry (ICP-MS). GPx was measured indirectly as enzyme activity (reduction of organic peroxides by c-GPx), and selenoprotein P was measured by SEPP1 enzyme-linked immunoassay. Results: On admission to the ICU, GPx enzyme activity was below the reference value ( 24 U/mL). Mean plasma concentration of selenium was 56±12.9mg/dL, and on the day of admission 67.7% of the patients were selenium deficient. By day 7 of their ICU stay this proportion had increased significantly to 100% (p < 0.05). Below-normal values of SEPP1 (<3.43 mg/L) were found in 77.3% of the patients on the day of admission, and this proportion had increased to 100% by the end of their ICU stay. Conclusion: During their ICU stay, antioxidant GPx enzyme activity increased and plasma concentration of selenium decreased in the patients we studied. This selenium deficiency can lead to increased stress and increased demands on endogenous antioxidant synthesis. Selenium intake should be monitored in order to ensure optimum antioxidant response and palliate the adverse effects of this nutritional deficiency.

PP242 ASSOCIATION BETWEEN HOMOCYSTEINE AND B VITAMIN IN CRITICAL CARE PATIENT DURING ICU STAY

Rationale: Nearly one-third of intensive care patients are obese, thus understanding the consequences of obesity on critical illness has great public health importance. Hence the aim of the study was to assess the impact of excess weight and obesity in the outcome of a critically ill patient. Methods: 130 patients admitted in the intensive care unit (ICU) were included in the study. In order to make the assessment, it was used demographic data, Acute Physiology and Chronic Health Evaluation II (APACHE II), weight, height, body mass index (BMI), days of mechanical ventilation, number of nosocomial infections, ICU mortality and hospital mortality. The data was collected from each clinical process during patient remaining time in the ICU. BMI was used to characterize nutritional state, allowing the classification in normal weight, excess weight and obesity. Results: 84 (64.4%) males and 46 (35.6%) females with an average age of 61.6±18.7 years old were enrolled in the study. Patients remained in the ICU in an average of 13.8±9.9 days. 39% (51) had a normal BMI, 38% (49) had excess weight and 17% (22) were obese. The average of APACHE II score in the three groups was 19.9±8.2, 21.1±7.8 and 21.6±7.3, respectively. The group that was presented with more nosocomial infections was the normal BMI group (16), followed by the excess weight group (11) and the obese group (6). Conclusion: The present study did not found a statistically significant relation between higher BMI and the prevalence of nosocomial infections. However, as it has been demonstrated, the impact of obesity in morbidity and mortality in the general population is grand, so continued research efforts will be needed to address the impact of excess weight in a critically ill patient.