Sample preparation for the analysis of isoflavones from soybeans and soy foods

This manuscript provides a review of the actual state and the most recent advances as well as current trends and future prospects in sample preparation and analysis for the quantification of isoflavones from soybeans and soy foods. Individual steps of the procedures used in sample preparation, including sample conservation, extraction techniques and methods, and post-extraction treatment procedures are discussed. The most commonly used methods for extraction of isoflavones with both conventional and "modern" techniques are examined in detail. These modern techniques include ultrasound-assisted extraction, pressurized liquid extraction, supercritical fluid extraction and microwave-assisted extraction. Other aspects such as stability during extraction and analysis by high performance liquid chromatography are also covered.

Temperature-dependent growth of Botrytis cinerea isolates from potted plants

Botrytis cinereo is a common aggressive saprophyte fungus which also invades injured plant tissues, causing Botrytis blight (Grey mould) in many ornamental plants, including potted flowering plants. Several B. cinerea isolates from potted plants (Pelargonium x hortorum, Lantana camara, Lonicera japonica, Hydrangea macrophylla, and Cyclamen persicum) affected by Botrytis blight in the south of Spain were studied and identified by PCR. The isolates showed phenotypic differences between them, as previously reported by the authors. In this work we demonstrate that these isolates show different temperature-dependent growth phenomena, expressed as mycelial growth rates, conidiation (measured as the number of conidia per colony and time of appearance), mass of both aerial and submerged mycelia, and sclerotia production. Growth rates were assessed from differences in colony area and mass of both aerial and submerged mycelium growing in potato dextrose agar culture medium (PDA). Three temperatures were used to measure these variables (6, 16, and 26 degrees C) and to establish the differences among isolates by modelling the effects of temperature on the growth variables. B. cinerea showed a high degree of phenotypic variability and differences in its growth kinetics, depending on temperature and isolate in question. The isolate from P. x hortorum showed the greatest conidiation although this process did not depend on the temperatures assayed. The growth rate of the isolates from P. x hortorum was the highest. The growth rates in all the isolates were determined and the growth kinetics could be fitted to a typical equation of fungi growing on solid culture medium. The isolate from P. x hortorum was the most vigorous, while the least vigorous was the isolate from L. japonica. A relationship between mycelial growth rate, conidiation and aerial mycelium could be established. A temperature of 26 degrees C accelerated sclerotia production, but only in the isolate from C. persicum. Such phenotypical variability and differences in growth rates may result in a differential response in plant-pathogen interactions when isolates attack hosts at different temperatures, meaning that a variety of plant protection strategies should be considered when B. cinerea attacks these potted plants.

[Assessment of calf circumference as an indicator of the risk for hyponutrition in the elderly]

BACKGROUND

Undernutrition is a very common situation among elderly, that is associated with increased morbidity and mortality rates. On the other hand, calf circumference (CC) is a direct anthropometric measurement, related to fat free mass. An early detection of an elderly undernutrition situation, based on CC assessment, could contribute to prevent its development and consequences.

OBJECTIVE

To analyse the relationship between CC and a possible undernutrition situation, based on the application of the Mini Nutritional Assessment (MNA) test, among Spanish subjects of 65 or more years old, including the gender and age influences.

SUBJECTS AND METHODS

A cross-sectional study was carried out to assess the nutritional situation of an ambulatory population, from every area of Spanish geography (n = 22007), using the questionnaire MNA. Every subject surveyed was 65 or more years old when the test was done.

RESULTS

There were statistically significant differences between subjects with a CC < 31 cm and those with CC >or= 31 cm, both men and women, in weight, height, body mass index (BMI), MNA total score and undernutrition classification. On the other hand, it was found that those elders with lower CC showed a higher undernutrition risk, both men and women, in every age range studied.

CONCLUSIONS

It does exit an association between CC of Spanish subjects of 65 or more years old and the risk of developing undernutrition. That association is similar among men and women, and in all age ranges.

The - 11391 G/A polymorphism of the adiponectin gene promoter is associated with metabolic syndrome traits and the outcome of an energy-restricted diet in obese subjects

Adiponectin is an adipose tissue-specific hormone that is commonly decreased in obese subjects. Furthermore, single-nucleotide polymorphisms (SNPs) of the adiponectin gene have been associated with metabolic phenotypes. The present study investigated whether the adiponectin gene promoter variant -11391 G/A (rs17300539) could predict the risk of developing traits characterizing the metabolic syndrome (MetS) and the impact of weight management. The -11391 G/A SNP was genotyped in 180 Spanish volunteers (BMI: 31.4+/-3.2 kg/m (2); age: 35+/-5 years). Clinical measurements were determined at baseline, following an 8-week low-calorie diet (LCD), and at 32 and 60 weeks. At baseline, the GG genotype was associated with higher HOMA-IR, insulin and triacylglyceride concentrations than other genotypes (p<0.05) and was also related with a higher risk of insulin resistance (OR: 2.437, p=0.025) and MetS clinical manifestations (OR: 3.236, p=0.003). Following the LCD, the increased risk in GG subjects compared with others disappeared (p>0.05). By 32 weeks after dietary therapy (n=84), GG carriers had recovered the risk of metabolic comorbidities (OR: 2.420, p=0.043). This risk was even more evident after 60 weeks (OR: 2.875, p=0.014). These data show an increased risk of insulin resistance and MetS complications in obese subjects of the -11391 GG genotype. The risk was markedly reduced during an energy-restricted diet, but was not sustained. Carriage of the A allele therefore confers protection from weight regain, and the effect is particularly evident 32-60 weeks after the dietary intervention, when improvement in GG subjects had disappeared.

G allele of the -930A>G polymorphism of the CYBA gene is associated with insulin resistance in obese subjects

It has been shown that NADPH oxidase plays a role in oxidative stress which has been involved in the development of metabolic syndrome. The -930A/G polymorphism of the CYBA gene (that codes p22phox, a major component of the NADPH oxidase) has been associated with human hypertension and with a reduction in NADPH oxidase activity. In this work, we have examined the influence of the -930A/G polymorphism on obesity risk and insulin resistance in a case-control study of Spanish subjects (n=313). In the obese group (n=159), there was a statistically significant association between the GG genotype of the -930A/G polymorphism of the CYBA gene and fasting insulin levels and HOMA index. This outcome agrees with previous findings concerning functional analyses of this polymorphism and reinforces the hypothesis that insulin resistance is associated with oxidative stress. In conclusion, a protective effect in carriers of the -930A/G polymorphism of the p22phox gene against insulin resistance in a population of Spanish obese adults has been found.

Vitamin C supplementation influences body fat mass and steroidogenesis-related genes when fed a high-fat diet

An enhanced oxidative stress status has been documented in obese patients and animal models, and a depletion of the antioxidant mechanisms in these conditions is a common feature. Therefore, we have tested the hypothesis that food supplementation with an antioxidant molecule such as vitamin C could prevent fat deposition induced by a high-fat diet in rodents. Ascorbic acid dietary supplementation reduced body weight and the retroperitoneal and subcutaneous fat depots in cafeteria diet-induced obese rats, without affecting food intake. Microarray technology has been applied in rat subcutaneous fat to assess the molecular mechanisms underlying the depletion of fat stores induced by ascorbic acid. Thus, expression of genes involved in cell proliferation, regulation of transcription, and host response are upregulated while a number of genes participating in lipid metabolism, cell adhesion, differentiation, and steroidogenesis (such as steroidogenic acute regulatory protein and hydroxysteroid 11-beta dehydrogenase 2) are downregulated. These data provide new insights to understand that not only calories count in weight gain, but also that the antioxidant status and other mechanisms affecting energy conversion efficiency could participate in energy homeostasis, in which glucocorticoids could be involved.

Selenium intake reduces serum C3, an early marker of metabolic syndrome manifestations, in healthy young adults

OBJECTIVES

To evaluate the associations between serum complement factor 3 (C3) and several anthropometrical, biochemical and lifestyle features in healthy young adults, emphasizing on the putative effect of selenium intake on C3 concentrations.

METHODS

This study enrolled 100 healthy young adults aged 18-34 years. Anthropometric and blood pressure measurements and lifestyle features were analyzed. Fasting blood samples were collected for the measurement of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, triacylglycerols and C3 concentrations. Nail samples were collected for the analysis of selenium concentrations.

RESULTS

Values of BMI (P=0.034), sum of skinfold thicknesses (STs) (P=0.021), body fat mass (BFM) (P=0.023), percentage of overweight subjects (P=0.007), serum triacylglycerols (P=0.012) and nail selenium (P=0.001) were significantly different between subjects above and below the median of serum C3 concentrations. The following correlations with serum C3 were identified tricipital ST (P=0.033), sum of STs (P=0.012), BMI (P=0.008), BFM (P=0.018), waist-to-height ratio (P=0.016), serum glucose (P=0.045), serum triacylglycerols (P=0.001) and nail selenium (P=0.006). Circulating C3 showed a positive association with several adiposity markers such as BMI (P=0.001), waist circumference (P=0.006), waist-to-height ratio (P=0.002), BFM (P=0.025), as well as serum glucose (P=0.027) and triacylglycerols (P<0.001), whereas nail selenium was a statistically significant negative predictor of C3 concentrations (P=0.018).

CONCLUSIONS

C3 seems to be related with selenium status and several anthropometrical and biochemical measurements linked to metabolic syndrome in apparently healthy young adults. These findings suggest a possible role for selenium intake in the modulation of C3, whose assessment may be an early marker of metabolic syndrome manifestations.

Sirtuin gene expression in human mononuclear cells is modulated by caloric restriction

BACKGROUND

Sirtuins may provide novel targets for treating some diseases associated with oxidative stress, such as obesity and its comorbidities. However, there are a few in vivo studies in humans about the potential role of sirtuins as therapeutic targets among obese patients undergoing caloric restriction. Therefore, the aim of this study was to assess if the gene expression of sirtuins is modulated in peripheral blood mononuclear cells (PBMC) by a hypocaloric diet devised to lose weight in humans.

MATERIALS AND METHODS

Gene expression of two sirtuins (SIRT1 and SIRT2) in the PBMC of obese subjects (32.3 +/- 5.5 kg m(-2)) before and following an 8-week hypocaloric diet was investigated. NADH-coenzyme Q reductase (NDUFS2) and cytochrome c oxidase assembly protein (COX15) gene expression was selected together with plasma antioxidant power and nitric oxide as markers of antioxidant status. A quantitative real-time polymerase chain reaction approach was performed to assess the nutrigenomics outcome. Moreover, 2-keto[1-(13)C]isocaproate breath test (KICA-BT) parameters were evaluated to study mitochondrial oxidation in vivo.

RESULTS

The intervention up-regulated the expression of both sirtuins, being inversely associated with total antioxidant capacity and directly related to nitric oxide, mitochondrial oxidation assessed by the KICA-BT and the expression of the mitochondrial proteins COX15 and NDUFS2.

CONCLUSION

SIRT1 and SIRT2 may serve as key regulators for some obesity comorbidities related to antioxidant status, while PBMC could be a model to study the effect of the sirtuin response in obesity therapy.

[Methicillin-resistant Staphylococcus aureus bacteremia. Predictor factors for an isolate with a vancomycin minimal inhibitory concentration > or =2 mg/l]

A greater rate of treatment failures with vancomycin in methicillin-resistant Staphylococcus aureus (MRSA) bacteremia has been reported recently when the minimum inhibitory concentration (MIC) is > or =2 mg/l. This study has aimed to evaluate if there are clinical and/or epidemiological factors that predict isolation of a MRSA strain with MIC of vancomycin of > or =2 mg/L in the bacteremia episodes collected during a 15 year period (January 1991 to December 2005) in a tertiary urban hospital. During the study period, a total of 478 episodes of MRSA bacteremia were studied prospectively. The following clinical variables were recorded for each one: age, gender, comorbidity, previous administration of vancomycin or another antibiotic, prognosis of baseline diseases, bacteremia focus, shock, empiric antibiotic received and mortality. The MIC of vancomycin of 419 strains (88%) was determined with the E-test. In 216 (52%) of the isolations the MIC of vancomycin was 1.50 mg/L, in 110 (26%) of the cases it was < or =1 mg/l and in 93 (22%) 2 mg/l. Uni-and multivariate analyses were made, comparing the clinical variables of the patients infected by strains with MIC of vancomycin > or =2 mg/l regarding the MIC strains < or =1 mg/l. In the last 3 years of the study (2003-2005) the proportion of the strains with MIC of vancomycin > or =2 mg/l was significantly greater than those isolated with MIC < or = 1 mg/L (44 % vs 3 %; p<0.001). In the multivariate analysis, the only clinical characteristic associated independently to the isolation of a strain with MIC > or =2 mg/l was the nosocomial-acquired infection OR (95 % CI): 1.94 (1.04-3.63); p=0.04. Although the isolation of a MRSA strain with MIC of vancomycin > or =2 mg/l is more frequent in the nosocomial-acquired bacteremia episodes, in the clinical practice, it is not a useful predictive parameter because the frequency of isolation of these strains in the community is also high.

Treatment of obesity in children and adolescents. How nutrition can work?

Overweight appears when persistent positive energy imbalances occur for long periods of time. Knowledge of dietary risk factors during childhood and adolescence is needed in order to design preventive measures against the increase in the prevalence of obesity and its consequences but is, however, largely missing. Longitudinal studies in children have not found clear causal associations between energy intake or diet composition and overweight development. Research has been ongoing to develop effective intervention studies for obese children but it is not clear which intervention is the most effective in assisting overweight/obese children to improve body composition without affecting growth rates. The objective of this article is to review the available knowledge on dietary risk factors for the development of childhood obesity, to discuss different dietary treatment strategies, and to propose an evidence-based approach to treat obese adolescents.

[Validity of self-reported body mass index in the National Health Survey]

OBJECTIVE

To assess the validity of self-reported body mass index in the National Health Survey.

METHODS

120 participants were selected and questioned about their weight and height with exactly the same questions that the National Health Survey uses. Afterwards, and once informed consent was obtained, participants were weighed and measured, and this data was used as the gold standard.

RESULTS

On average, participants underestimated their weight by 1.39 kg, overestimated their height by 0.55 cm and underestimated their body mass index by 0.71 kg/m2. The sensitivity of self-reported self reported body mass index (BMI) to detect overweight was 77%, the specificity was 97%, the positive predictive value was 0.95 and the negative predictive value was 0.86. The Kappa index was 0.76 and the quadratically weighted Kappa index was 0.85. The correlation coefficient between self-reported and measured BMI was 0.96 and the intra-class correlation coefficient was 0.97.

CONCLUSIONS

Self-reported data is an efficient way of obtaining information about BMI, although with limitations, because self-reported data tends to underestimate weight and overestimate height, thus underestimating BMI and the proportion of participants with elevated BMI.

Phenotypical differences among B. cinerea isolates from ornamental plants

B. cinerea is a common pathogenic fungus which causes Botrytis blight (Grey mould) in most ornamental plants. It may be responsible for serious preharvest diseases and postharvest losses in fruits, vegetables and flowers. In this work, several B. cinerea isolates from ornamental plants (Chamelaucium uncinatum, Pelargonium x hortorum, Euphorbia pulcherrima, Lantana camara, Lonicera japonica, Hydrangea macrophylla, and Cyclamen persicum) affected by Botrytis blight in the south of Spain were studied. All the isolates were confirmed as B. cinerea by PCR using a specific 750-bp molecular marker, which is present in all strains of this species but absent from other species of Botrytis. The isolates were evaluated by reference to mature conidia length, sclerotia production, and growth rate. Conidia, conidiophores and hyphae were described by light microscopy and some by cryogenic scanning electron microscopy (Cryo-SEM). Conidium length was measured by using an eyepiece micrometer at 400x power, whereas the growth rate was assessed from differences in colony diameter between the third and fourth day of growth in potato-dextrose agar culture medium at 26 degrees C. B. cinerea showed a high degree of phenotypical variability among isolates, not only as regards visual aspects of the colonies but also in some morphological structures such as conidium length, conidiophores, sclerotia production, and hyphae. Differences were also observed in the growth rates. Conidiation was insignificant in the isolates from H. macrophylla, and P. x hortorum, where the overall appearance was white in all the growing stages, whereas isolates from L. camara, C. persicum and C. uncinatum were mainly grey or brown in mature stages. The longest conidia were obtained in isolates from H. macrophylla and C. persicum (17-18 microm) and the lowest in C. uncinatum (9 microm). All the isolates, except L. camara, developed mature sclerotia after approximately 16 days in the conditions used. H. macrophylla had around 72 sclerotia per colony, whereas C. persicum had only nine after 28 days. The growth rate of isolates from L. camara was the highest (1.64 cm/day). Such phenotypical variability may result in a differential response to plant growth regulators if plants are infected by Botrytis in the early stages of growth. In this way, we confirm, as we have done in other published studies, that isolates show different responses to some plant hormones and inhibitors.

Decreasing gradient of antibiotic concentration in the lumen of catheters locked with vancomycin

The purpose of this study was to investigate if vancomycin concentration is maintained along the lumen of dialysis catheters after 48 h of lock therapy. Each lumen of nine catheters (three subclavian and six femoral) was locked with 2,500 mg/l of vancomycin for 48 h. After that period, the content of the lumen was aspirated with three different syringes of 0.4 ml each to measure the proximal, medial and distal vancomycin concentration. Vancomycin concentration was measured using a homogeneous particle-enhanced turbidimetric inhibition immunoassay. A non-parametric ANOVA, by means of a rank transformation on the antibiotic concentration, was used to assess the influence of the catheter segment (proximal, medial and distal) and the catheter type (femoral or subclavian). A significant decrease in vancomycin concentration from proximal to distal segments was observed (p < 0.001). In addition, the vancomycin concentration in subclavian catheters was significantly higher than in femoral catheters (p < 0.001). In our study there was a decreasing gradient in vancomycin concentration from proximal to distal segments of the catheter. This may explain the failure of antibiotic lock-therapy.

[Inflammatory biomarkers: the link between obesity and associated pathologies]

[corrected] of this article is to review biomarkers that have been suggested in recent years as the link between inflammation, obesity and associated co-morbidities, as well as some questions that yet remain unclear. Increasing evidence indicates the important role of inflammation in the etiology of major public health problems. In the last years, several studies have proposed that obesity might be a inflammatory disorder. In addition, oxidative stress has been suggested as a potential inductor of inflammatory status and susceptibility to obesity and related disorders. Several biomarkers are being suggested as the link between obesity, insulin resistance, cardiovascular disease and metabolic syndrome, such as tumor necrosis factor alfa, interleukin-6 and -18, angiotensinogen, transforming grow factor beta, plasminogen activator inhibitor-1, leptin, resistin, C-reactive protein, serum amyloid A, sialic acid, fibrinogen, markers of endothelial dysfunction (von Willebrand factor, ICAMs, VCAMs), complement factor 3, haptoglobin, Zinc-alpha2-glycoprotein, eotaxin, visfatin, apelin, alpha1-antitrypsin, vaspin, omentin, retinol binding protein 4, ceruloplasmin, adiponectin and desnutrin. Some of this biomarkers are good predictors of cardiovascular risk (plasminogen activator inhibitor-1, sialic acid, fribrinogen, complement factor 3, C-reactive protein), adiposity (leptin, visfatin, resistin, haptoglobin) and/or insulin resistance (sialic acid, C-reactive protein, plasminogen activator inhibitor-1, von Willebrand factor). However, it is currently unclear the role of many of them concerning inflammatory processes in humans, as well as the factors involved in their regulation.

Mitochondrial oxidative stress and inflammation: an slalom to obesity and insulin resistance

Mitochondria, in addition to energy transformation, play a role in important metabolic tasks such as apoptosis, cellular proliferation, heme/steroid synthesis as well as in the cellular redox state regulation. The mitochondrial phosphorylation process is very efficient, but a small percentage of electrons may prematurely reduce oxygen forming toxic free radicals potentially impairing the mitochondria function. Furthermore, under certain conditions, protons can reenter the mitochondrial matrix through different uncoupling proteins (UCPs), affecting the control of free radicals production by mitochondria. Disorders of the mitochondrial electron transport chain, overgeneration of reactive oxygen species (ROS) and lipoperoxides or impairments in antioxidant defenses have been reported in situations of obesity and type-2 diabetes. On the other hand, obesity has been associated to a low degree pro-inflammatory state, in which impairments in the oxidative stress and antioxidant mechanism could be involved. Indeed, reactive oxygen species have been attributed a causal role in multiple forms of insulin resistance. The scientific evidence highlights the importance of investigating the relationships between oxidative stress and inflammation with obesity/diabetes onset and underlines the need to study in mitochondria from different tissues, the interactions of such factors either as a cause or consequence of obesity and insulin resistance.

Linoleic acid decreases leptin and adiponectin secretion from primary rat adipocytes in the presence of insulin

Obesity rates have dramatically increased over the last few decades and, at the same time, major changes in the type of fatty acid intake have occurred. Linoleic acid, an n-6 polyunsaturated fatty acid, is an essential fatty acid occurring in high amounts in several western diets. A potential role of this fatty acid on obesity has been suggested. Controversial effects of linoleic acid on insulin sensitivity have also been reported. Thus, the aim of this study was to examine the direct effects of linoleic acid on leptin and adiponectin production, two adipokines known to influence weight gain and insulin sensitivity. Because insulin-stimulated glucose metabolism is an important regulator of leptin production, the effects of linoleic acid on adipocyte metabolism were also examined. For this purpose, isolated rat adipocytes were incubated with linoleic acid (1-200 microM) in the absence or presence of insulin. Linoleic acid (1-200 microM) significantly decreased insulin-stimulated leptin secretion and expression (P < 0.05), however, no changes in basal leptin production were observed. Linoleic acid also induced a significant decrease (approximately 20%) in adiponectin secretion (P < 0.05), but only in the presence of insulin and at the highest concentration tested (200 microM). This fatty acid did not modify either glucose uptake or lactate production and the percentage of glucose metabolized to lactate was not changed either. Together, these results suggest that linoleic acid seems to interfere with other insulin signalling pathway different from those controlling glucose uptake and metabolism, but involved in the regulation of leptin and adiponectin production.

[Efficiency and mitochondrial metabolism: an etiological axis for obesity?]

Obesity, an increasing prevalent disease, appears as a consequence of an energetic umbalance that might be related to the efficiency of the cellular energetic machinery involving the mitochondria. In this organelle takes place the oxidative phosphorylation, that ends with the transformation of the nutrients to energy and the ATP production. During this process, free radicals of high oxidative power maybe blocked by endogenous antioxidants like the glutathion, in collaboration with the contribution of antioxidants supplied by the diet. The discovery of mitochondrial uncoupling proteins (UCPs) opened a new field of investigation, emphasizing the role of UCP1 or thermogenin, which generates an energy dissipation as heat and diminishing the amount of formed ATP and ROS and forcing the cell that expresses the UCP1 to oxidize more nutrients to obtain energy. Also, genetic studies have been carried out about UCP2 and UCP3 polymorphisms that relate them to obesity.

Microbial and clinical determinants of time-to-positivity in patients with bacteraemia

Time-to-positivity is useful in the diagnosis of catheter-related bacteraemia and as a predictor of an endovascular source in patients with Staphylococcus aureus bacteraemia. However, this parameter has been evaluated for only a limited number of microorganisms. In the present study, time-to-positivity was recorded for 1872 episodes of significant monomicrobial bacteraemia diagnosed at a teaching hospital during a 2-year period, and the associated microbial and clinical variables were investigated. According to multivariate analysis, Streptococcus pneumoniae, beta-haemolytic streptococci, Escherichia coli, Klebsiella, Enterobacter, Citrobacter and Aeromonas were characterised by fast growth, with an endovascular source, shock, liver cirrhosis and neutropenia also predicting a short time-to-positivity. For patients not receiving appropriate antibiotics, detection of Gram-positive cocci in clusters within 14 h was predictive of Staph. aureus; a time-to-positivity of >21 h ruled out the possibility that a Gram-positive organism in chains was a beta-haemolytic streptococcus or Strep. pneumoniae, and a time-to-positivity of < or =12 h meant that it was very unlikely that a Gram-negative bacillus was a non-fermenter. A time-to-positivity of < or =8 h was predictive of a non-urinary tract source in patients with E. coli bacteraemia, and detection of growth within 13 h predicted an endovascular source in those with Staph. aureus bacteraemia. In conclusion, time-to-positivity depended on the microorganism, original source and clinical variables involved. Although this measurement may provide some early clues concerning the microorganisms involved and the source of bacteraemia, its clinical impact remains to be defined.

Sp1-mediated transcription is involved in the induction of leptin by insulin-stimulated glucose metabolism

We have previously demonstrated that insulin-stimulated glucose metabolism, and not insulin per se, mediates the effects of insulin to increase the transcriptional activity of the leptin promoter in adipocytes. Here, we sought to identify the specific cis-acting DNA elements required for the upregulation of leptin gene transcription in response to insulin-mediated glucose metabolism. To accomplish this, 3T3-L1 cells and primary rat adipocytes were transfected with a series of luciferase reporter genes containing portions of the mouse leptin promoter. Using this method, we identified an element between -135 and -95 bp (relative to the transcriptional start site) that mediated transcription in response to insulin-stimulated glucose metabolism in adipocytes. This effect was abolished by incubation with 2-deoxy-d-glucose, a competitive inhibitor of glucose metabolism. Gel shift electrophoretic mobility shift assays confirmed that the stimulatory effect of insulin-mediated glucose metabolism on leptin transcription was mediated by a previously identified Sp1 site. Consistent with these findings, incubation of primary rat adipocytes with WP631, a specific inhibitor of specificity protein (Sp)1-dependent transcription, inhibited glucose- and insulin-stimulated, but not basal, leptin secretion. Together, these findings support a key role for Sp1 in the transcriptional activation of the leptin gene promoter by insulin-mediated glucose metabolism.

A novel mutation Thr162Arg of the melanocortin 4 receptor gene in a Spanish children and adolescent population

OBJECTIVE

The melanocortin 4 receptor gene (MC4R) is involved in body weight regulation. While many studies associated MC4R mutations with childhood obesity, information on MC4R mutations in Spanish children and adolescents is lacking. Our objective was to screen a population of children and adolescents from the north of Spain (Navarra) for MC4R mutations and to study the phenotypes of carriers and their families. In addition, functional assays were performed for a novel MC4R mutation.

METHODS

The study was composed of 451 Spanish children and adolescents (49% boys), aged 5-18 year. According to the International Obesity Task Force (IOTF) criteria, the groups included 160 obese, 132 overweight and 159 normal-weight control subjects.

RESULTS

One novel (Thr162Arg) and three known nonsynonymous mutations in the MC4R gene (Ser30Phe, Thr150Ile, Ala244Glu) were detected heterozygously. The MC4R mutations were found in three male (one obese and two overweight) and two female subjects (one obese and one overweight). The novel mutation did not appear to lead to an impaired receptor function. An unequivocal relationship of MC4R mutations with obesity in pedigrees together with an impaired function of the encoded receptor could not be established for any of the mutations.

CONCLUSIONS

The presence of heterozygous MC4R mutations in obese and overweight subjects indicates that these mutations may be a susceptibility factor for obesity development, but lifestyle factors, such as exercise or sedentary activities, may modify their effect.

Usefulness of teicoplanin for preventing methicillin-resistant Staphylococcus aureus infections in orthopedic surgery

In order to gather more data on the use of teicoplanin for reducing MRSA infections in high-risk populations, the present study was conducted. At a hospital in Barcelona, Spain, there was a high prevalence of MRSA infections among patients who underwent surgery for femoral neck fracture during the first 5 months of 2002 (period A) when cefuroxime was the antibiotic prophylaxis. During the following 12 months (period B) 600 mg of teicoplanin was added to cefuroxime. The rates of overall and MRSA infection during period A were 5.07 and 2.73%, respectively. Pulsed-field gel electrophoresis demonstrated there was no clonal relationship among MRSA strains. No nasal carriers of MRSA were detected among health workers. During period B the rates of overall and MRSA infection were 2.36 and 0.19%, respectively. Both rates were statistically significantly lower than those in period A (p<0.05). These results suggest teicoplanin may be useful in patients undergoing orthopedic surgery when the prevalence of MRSA is high.

Conjugated linoleic acid inhibits glucose metabolism, leptin and adiponectin secretion in primary cultured rat adipocytes

Conjugated linoleic acid (CLA) supplementation has been reported to induce insulin resistance in animals and humans, however, the underlying mechanisms remain unclear. The aim of this study was to examine the direct effects of CLA on leptin and adiponectin secretion, two hormones with actions known to influence insulin sensitivity. Isolated rat adipocytes were incubated with CLA (1-200microM) in the absence and presence of insulin (1.6nM). CLA inhibited both basal and insulin-stimulated leptin gene expression and secretion (-30 to -40%, P<0.05-0.01). CLA also inhibited basal adiponectin production (-20 to -40%, P<0.05-0.01), but not in the presence of insulin. CLA (50-200muM) decreased basal glucose uptake (P<0.05-0.01) and significantly increased the proportion of glucose metabolized to lactate (P<0.01). Insulin treatment partially prevented the inhibitory effects of CLA on glucose uptake and induced a significant increase (P<0.05-0.01) in the percentage of glucose metabolized to lactate. A strong inverse relationship was observed between the increase in the anaerobic utilization of glucose and the decreases of both leptin and adiponectin secretion. In addition, lipolysis and the expression of the adipogenic transcription factor PPARgamma were decreased by CLA. These results indicate that CLA inhibits leptin and adiponectin secretion and suggest that increased anaerobic metabolism of glucose may be involved in these effects. The inhibition of PPARgamma could also mediate the inhibition of adiponectin induced by CLA. Furthermore, the inhibition of leptin and adiponectin production induced by CLA may contribute to insulin resistance observed in CLA-treated animals and humans.

Treatment of acute post-surgical infection of joint arthroplasty

The best antibiotic regimen for acute prosthetic joint infection, treated without removal of the implant, has not been well-defined. This study describes the use of a protocol based on oral rifampicin combinations to treat 47 cases that were followed prospectively for a 2-year period. The regimen used most commonly was levofloxacin 500 mg/24 h plus rifampicin 600 mg/24 h for a mean duration of 2.7 +/- 1 months. The cure rate was 76.9%, and the only independent risk-factor associated with treatment failure was infection caused by methicillin-resistant Staphylococcus aureus or Enterococcus spp. (OR 17.6, p 0.003). Overall, the results suggested that use of oral antibiotics, including rifampicin, for 2-3 months was a good treatment option.