Steen Stender

Coenzyme Q10 in health and disease

The literature concerning the importance of coenzyme Q10 in health and disease has been reviewed. Usual dietary intake together with normal in vivo synthesis seems to fulfil the demands for Q10 in healthy individuals. The importance of Q10 supplementation for general health has not been investigated in controlled experiments. The literature allows no firm conclusions about the significance of Q10 in physical activity. In different cardiovascular diseases, including cardiomyopathy, relatively low levels of Q10 in myocardial tissue have been reported. Positive clinical and haemodynamic effects of oral Q10 supplementation have been observed in double-blind trials, especially in chronic heart failure. These effects should be further examined. No important adverse effects have been reported from experiments using daily supplements of up to 200u2005mg Q10 for 6–12 months and 100u2005mg daily for up to 6u2005y.

Association of beta‐adrenergic receptor polymorphisms and mortality in carvedilol‐treated chronic heart‐failure patients

AIMnPharmacogenetics can be used as a tool for stratified pharmacological therapy in cardiovascular medicine. We investigated whether a predefined combination of the Arg389Gly polymorphism in the adrenergic β(1) -receptor gene (ADRB1) and the Gln27Glu polymorphism in the adrenergic β(2) -receptor gene (ADRB2) could predict survival in carvedilol- and metoprolol-treated chronic heart failure (HF) patients.nnnMETHODSnFive hundred and eighty-six HF patients (carvedilol n= 82, metoprolol n= 195) were genotyped for ADRB1 Arg389Gly (rs1801253) and ADRB2 Gln27Glu (rs1042714). The end-point was all-cause mortality, and median follow-up time was 6.7 years. Patients were classified into two functional genotype groups: group 1 combination of Arg389-homozygous and Gln27-carrier (46%) and group 2 any other genotype combination (54%). Results were fitted in two multivariate Cox models.nnnRESULTSnThere was a significant interaction between functional genotype group and carvedilol treatment (adjusted(1) P= 0.033, adjusted(2) P= 0.040). Patients treated with carvedilol had shorter survival in functional genotype group 1 (P= 0.004; adjusted(1) hazard ratio (HR) 2.67, 95% CI 1.27, 5.59, P= 0.010; adjusted(2) HR 2.05, 95% CI 1.06, 3.95, P= 0.033). There was no interaction between genotype group and metoprolol treatment (P= 0.61), and there was no difference in overall survival between genotype groups (P= 0.69).nnnCONCLUSIONSnA combination of ADRB1 Arg389-homozygous and ADRB2 Gln27-carrier in HF patients treated with carvedilol was associated with a two-fold increase in mortality relative to all other genotype combinations. There was no difference in survival in metoprolol-treated HF patients between genotype groups. Patients in genotype group 1 may benefit more from metoprolol than carvedilol treatment.

Monitoring of dietary changes by telephone interviews: results from Denmark.

OBJECTIVESnTo monitor trends in Danish food habits with respect to selected key elements, from 1995 to 1998, and to evaluate the appropriateness of the method developed for that purpose.nnnDESIGN AND METHODnTwo cross-sectional population surveys, in 1995 and 1998. Data collection by computer-assisted telephone interviews including 10 food-frequency questions, questions on type of fat used on sandwiches and drinking milk, and check questions on the previous day. Reproducibility was tested in a subgroup (n = 222) in the 1998 survey.nnnSETTINGnThe Danish Nutrition Council initiated the survey.nnnSUBJECTSnMen and women aged 15-90 years, 1007 in 1995 and 1024 in 1998. Samples of private telephone numbers were drawn from regional telephone registers, geographically stratified. Participation rates were 62%.nnnRESULTSnSignificant differences were observed between 1995 and 1998, some of these in accordance with dietary guidelines (decreased use of whole milk and fat spread on bread, increased use of skimmed milk, salad vegetables, rice/pasta and fish). Other changes were opposite to dietary guidelines (increased use of soft butter, decreased use of soft margarine and low-fat spreads, potatoes, and fresh fruit). Differences in average consumption frequency amounted to 4-13%. Several results were confirmed by comparison with other data, and the reproducibility of the method was acceptable. Data were suitable for analysis of food use patterns, a relevant approach when assessing food habits in a lifestyle context.nnnCONCLUSIONSnThe changes observed illustrate the dynamics of food habits and the need for frequent monitoring. This simple telephone method may be a valuable tool for that purpose, as a supplement to national dietary surveys, also in a public health context.

Environmental tobacco smoke exposure during pregnancy has limited effect on infant birthweight and umbilical vein endothelial nitric oxide synthase

Women who smoke, deliver significantly smaller infants. These infants have reduced levels of the vasodilator endothelial nitric oxide synthase (eNOS) levels in the umbilical vessels, which may reduce fetal growth. Serum cotinine, the degradation product of nicotine, can be used to determine the level of tobacco exposure. Newborns of environmental smokers are suggested to be smaller and shorter in weight, length, and head circumference. eNOS levels have not yet been studied in these infants. We investigated the existence of a relation between maternal environmental tobacco smoke exposure, eNOS activity, concentration, and birthweight.

O481 Gestational age-specific reference intervals for 32 chemical, 13 hematological, 10 coagulation and 3 thyroid laboratory tests during 391 uncomplicated pregnancy, vaginal delivery and early postpartum period

Objective: To design a method by which any laboratory information system (LIS) can present gestational age-specific reference values known to differ from reference values in non-pregnant individuals. Methods: In LIS the usual test name is given a period suffix and defined as a separate test with the correct gestational age-specific reference values. The test with its period suffix appears on the ordering screen or sheet as a new test, although the analysis performed is exactly the same as usual. In this way “D-dimer” may in addition appear as “D-dimer gestation week 35–42” etc. Also packages with a period suffix may be defined, for instance “Preeclampsia gestation week 35–42” containing a number of tests all with the same period suffix ordered simultaneously by only one click or tick on the name of the package with its suffix. Results: Test results will appear on the final lab report with relevant gestational age-specific reference values. If the LIS allows a special typography for results outside reference values, this will also be the case for test results in the pregnant woman, but only if they are outside the gestational age-specific reference interval. In our hospital, with 2000 deliveries yearly, such gestational age-specific ordering has been established for 30 different commonly used chemical tests each with a period suffix for relevant gestation weeks and for day-1-postpartum. Conclusion: The lab report now shows test results and appropriate reference values not only for non pregnant but also for pregnant women. The traditional need of pocket folders for reference values during pregnancy has been eliminated.

O482 Gestational-age specific reference intervals for CA 125 during uncomplicated pregnancy, delivery and early postpartum period

Objective: To design a method by which any laboratory information system (LIS) can present gestational age-specific reference values known to differ from reference values in non-pregnant individuals. Methods: In LIS the usual test name is given a period suffix and defined as a separate test with the correct gestational age-specific reference values. The test with its period suffix appears on the ordering screen or sheet as a new test, although the analysis performed is exactly the same as usual. In this way “D-dimer” may in addition appear as “D-dimer gestation week 35–42” etc. Also packages with a period suffix may be defined, for instance “Preeclampsia gestation week 35–42” containing a number of tests all with the same period suffix ordered simultaneously by only one click or tick on the name of the package with its suffix. Results: Test results will appear on the final lab report with relevant gestational age-specific reference values. If the LIS allows a special typography for results outside reference values, this will also be the case for test results in the pregnant woman, but only if they are outside the gestational age-specific reference interval. In our hospital, with 2000 deliveries yearly, such gestational age-specific ordering has been established for 30 different commonly used chemical tests each with a period suffix for relevant gestation weeks and for day-1-postpartum. Conclusion: The lab report now shows test results and appropriate reference values not only for non pregnant but also for pregnant women. The traditional need of pocket folders for reference values during pregnancy has been eliminated.

O480 A simple method for presenting laboratory test results from pregnant women with gestational age-specific reference values in laboratory information systems, which usually only take age and gender into account

Objective: To design a method by which any laboratory information system (LIS) can present gestational age-specific reference values known to differ from reference values in non-pregnant individuals. Methods: In LIS the usual test name is given a period suffix and defined as a separate test with the correct gestational age-specific reference values. The test with its period suffix appears on the ordering screen or sheet as a new test, although the analysis performed is exactly the same as usual. In this way “D-dimer” may in addition appear as “D-dimer gestation week 35–42” etc. Also packages with a period suffix may be defined, for instance “Preeclampsia gestation week 35–42” containing a number of tests all with the same period suffix ordered simultaneously by only one click or tick on the name of the package with its suffix. Results: Test results will appear on the final lab report with relevant gestational age-specific reference values. If the LIS allows a special typography for results outside reference values, this will also be the case for test results in the pregnant woman, but only if they are outside the gestational age-specific reference interval. In our hospital, with 2000 deliveries yearly, such gestational age-specific ordering has been established for 30 different commonly used chemical tests each with a period suffix for relevant gestation weeks and for day-1-postpartum. Conclusion: The lab report now shows test results and appropriate reference values not only for non pregnant but also for pregnant women. The traditional need of pocket folders for reference values during pregnancy has been eliminated.