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Attafi IM, Albeishy MY, Hakami AM, Attafi MA, Khardali IA. Habitual khat chewing alters urinary inorganic profile in adult healthy males. Drug Metab Pers Ther 2021; 36:295-298. [PMID: 34821129 DOI: 10.1515/dmpt-2020-0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 04/07/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Khat (Catha edulis) is a stimulant plant, and it is abusive to induce euphoria, alertness and activity. Concomitant use of medications and khat chewing predisposes to the appearance of drug interactions result in treatment failure or toxicity. This study determined the changes in the urinary inorganic profile in adult healthy males who are chewing khat compared with non-khat chewer males. METHODS A total of 40 adult non-smoker healthy males (20 khat chewer and 20 non-khat chewer) aged 24-30 years were selected. Khat chewer samples were positive for cathinone and cathine and negative for other drug of abuse, while non-khat chewer samples were negative for drug of abuse include cathinone and cathine. Samples were selected according to their results in immunoassay and gas chromatography mass spectrometry (GCMS) analysis. Cathine and cathinone were confirmed using liquid chromatography mass spectrometry (LC-MSMS) analysis. Inorganic profile includes titanium (Ti), cobalt (Co), copper (Cu), zinc (Zn), cadmium (Cd), and lead (Pb) were determined by using inductively coupled plasma-mass spectrometry (ICP-MS). RESULTS The levels of Ti, Co, Zn, Cd, and Pb in urine were significantly higher among the khat chewer group compared with non-khat chewer. Ti, Cd, Co, Pb and Zn urine levels were 0.5-, 1.5-, 1.15-, 5-, and 8.2-fold higher in the khat chewer group compared to non-khat chewer, respectively. CONCLUSIONS We suggested that continuous khat chewing has a long term effect on metabolic pathway of therapeutic drugs that result in toxicity or failure of therapy.
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Affiliation(s)
- Ibraheem M Attafi
- Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Mohammed Y Albeishy
- Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Ahmed M Hakami
- Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Mohammad A Attafi
- Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Ibrahim A Khardali
- Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
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Attafi IM, Albeishy MY, Hakami AM, Attafi MA, Khardali IA. Habitual khat chewing alters urinary inorganic profile in adult healthy males. Drug Metab Pers Ther 2021; 0:dmdi-2020-0161. [PMID: 33951761 DOI: 10.1515/dmdi-2020-0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 04/07/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Khat (Catha edulis) is a stimulant plant, and it is abusive to induce euphoria, alertness and activity. Concomitant use of medications and khat chewing predisposes to the appearance of drug interactions result in treatment failure or toxicity. This study determined the changes in the urinary inorganic profile in adult healthy males who are chewing khat compared with non-khat chewer males. METHODS A total of 40 adult non-smoker healthy males (20 khat chewer and 20 non-khat chewer) aged 24-30 years were selected. Khat chewer samples were positive for cathinone and cathine and negative for other drug of abuse, while non-khat chewer samples were negative for drug of abuse include cathinone and cathine. Samples were selected according to their results in immunoassay and gas chromatography mass spectrometry (GCMS) analysis. Cathine and cathinone were confirmed using liquid chromatography mass spectrometry (LC-MSMS) analysis. Inorganic profile includes titanium (Ti), cobalt (Co), copper (Cu), zinc (Zn), cadmium (Cd), and lead (Pb) were determined by using inductively coupled plasma-mass spectrometry (ICP-MS). RESULTS The levels of Ti, Co, Zn, Cd, and Pb in urine were significantly higher among the khat chewer group compared with non-khat chewer. Ti, Cd, Co, Pb and Zn urine levels were 0.5-, 1.5-, 1.15-, 5-, and 8.2-fold higher in the khat chewer group compared to non-khat chewer, respectively. CONCLUSIONS We suggested that continuous khat chewing has a long term effect on metabolic pathway of therapeutic drugs that result in toxicity or failure of therapy.
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Affiliation(s)
- Ibraheem M Attafi
- Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Mohammed Y Albeishy
- Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Ahmed M Hakami
- Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Mohammad A Attafi
- Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Ibrahim A Khardali
- Poison Control & Medical Forensic Chemistry Center, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
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Zeng HL, Zhang B, Wang X, Yang Q, Cheng L. Urinary trace elements in association with disease severity and outcome in patients with COVID-19. ENVIRONMENTAL RESEARCH 2021; 194:110670. [PMID: 33387537 PMCID: PMC7772999 DOI: 10.1016/j.envres.2020.110670] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 12/06/2020] [Accepted: 12/21/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND The dynamics of urinary trace elements in patients with COVID-19 still remains to be investigated. METHODS A retrospective study was performed on a cohort of 138 confirmed COVID-19 patients for their urinary levels of essential and/or toxic metals including chromium, manganese, copper, arsenic, selenium, cadmium, mercury, thallium and lead according to the different disease severity (severe or non-severe) and outcome (recovered or deceased). RESULTS Urinary concentrations of chromium, manganese, copper, selenium, cadmium, mercury and lead after creatinine adjustment were found to be higher in severe patients than the non-severe cases with COVID-19. And among the severe cases, these elements were also higher in the deceased group than the recovered group. When the weeks of the post-symptom onset were taken in account, the changes of these urinary elements were existed across the clinical course since the disease onset. These urinary elements were found to be mostly positively inter-correlated, and further positively correlated with other laboratory inflammatory parameters including serum cytokines (IL-1B, IL2R, IL6, IL8, IL10, TNFα), ferritin, and neutrophil count and white blood cell count. As a independently predictive factor, urinary creatinine-adjusted copper of ≥25.57 μg/g and ≥99.32 μg/g were associated with significantly increased risk of severe illness and fatal outcome in COVID-19, respectively. CONCLUSIONS These results suggest abnormities in urinary levels of the trace metals were tightly associated with the severe illness and fatal outcome of COVID-19.
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Affiliation(s)
- Hao-Long Zeng
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Zhang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Wang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Yang
- Institute of Food Science and Engineering, Wuhan Polytechnic University, Wuhan, China.
| | - Liming Cheng
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Ngala RA, Awe MA, Nsiah P. The effects of plasma chromium on lipid profile, glucose metabolism and cardiovascular risk in type 2 diabetes mellitus. A case - control study. PLoS One 2018; 13:e0197977. [PMID: 29975702 PMCID: PMC6033385 DOI: 10.1371/journal.pone.0197977] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 05/13/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The study was aimed at determining the effect of plasma chromium concentration on the metabolism of glucose, and lipids and their subsequent cardiovascular risk in patients with type 2 diabetes in the Bolgatanga district of Ghana. MATERIAL AND METHODS Fasting blood glucose and lipids profile were determined by enzymatic assay using the BT 5000® Random Access Chemistry Analyzer. Fasting serum insulin and High sensitive C-reactive protein were determined by ELISA, a solid phase direct sandwich immunoassay method. HOMA-IR, which is based on fasting blood sample for insulin and glucose concentrations measured in a single blood sample, was used to calculate insulin resistance. Plasma chromium was measured using an atomic Absorption Spectrometer. RESULTS Patientswith diabeteshad significantly (p<0.0001) increased LDL, TC, TG, VLDL, insulin, CRP and HOMAIR and a significantly reduced plasma chromium (p<0.0001) (0.53± 0.02μg/l and 0.11±0.01μg/l control and case respectively). Low Cr (p ≤0.001) was associated with high blood pressure, obesity and lipid dysregulation. Plasma Cr significantly correlated negatively with blood pressure and LDL. CONCLUSION Lower plasma Cr level was associated with hyperglycaemia, hyperinsulinemia, hypertension, insulin resistance and high inflammation marker HsCRP.
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Affiliation(s)
- Robert Amadu Ngala
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Martin Akilla Awe
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Paul Nsiah
- Department of Chemical Pathology, University of Cape Coast,- Ghana
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Dioni L, Sucato S, Motta V, Iodice S, Angelici L, Favero C, Cavalleri T, Vigna L, Albetti B, Fustinoni S, Bertazzi P, Pesatori A, Bollati V. Urinary chromium is associated with changes in leukocyte miRNA expression in obese subjects. Eur J Clin Nutr 2017; 71:142-148. [PMID: 27731332 PMCID: PMC5222989 DOI: 10.1038/ejcn.2016.197] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 08/09/2016] [Accepted: 08/20/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND/OBJECTIVES Epidemiological studies suggest a link between chromium (Cr) status and cardiovascular disease. Increased urinary excretion of Cr was reported in subjects with diabetes compared with non-diabetic controls and those with non-diabetic insulin resistance. Epigenetic alterations have been linked to the presence of Cr, and microRNA (miRNA) expression has been implicated in the pathogenesis of metabolic diseases and cardiovascular diseases (CVDs). We investigated the association between Cr excretion and miRNA expression in leukocytes from obese subjects. We also examined the relationship between altered miRNA expression and selected clinical parameters to further investigate mechanisms linking Cr to metabolic diseases and CVDs. SUBJECTS/METHODS We analyzed urinary Cr in 90 Italian subjects using inductively coupled plasma-mass spectrometry. Peripheral blood miRNA levels were screened with TaqMan Low-Density Array Human MicroRNA A. Cr level-associated expression of miRNAs was detected with multivariate regression analyses, and the top 10 candidate miRNAs were selected for validation. We also used multivariate regression analyses to assess possible associations between validated miRNAs and glycated hemoglobin (A1c) and blood pressure (BP). The validated miRNAs were further investigated by functional analysis with Ingenuity Pathway Analysis software. RESULTS Urinary Cr levels (mean: 0.35 μg/l; s.d.=0.24) ranged from 0.05 to 1.27 μg/l. In the screening phase, 43 miRNAs were negatively associated with Cr. Of the top 10 miRNAs selected for validation, nine (miR-451, miR-301, miR-15b, miR-21, miR-26a, miR-362-3p, miR-182, miR-183 and miR-486-3p) were downregulated in association with Cr (P-false discovery rate (FDR)<0.10). miR-451 expression was associated with A1c (β=-0.06; P=0.0416), whereas miR-486-3p expression was associated both with diastolic (β=2.1; P=0.004) and systolic BP (β=3.3; P=0.003). CONCLUSIONS These results indicate that miR-451 and miR-486-3p are involved in the link between Cr levels and metabolic diseases and CVDs.
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Affiliation(s)
- L Dioni
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - S Sucato
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - V Motta
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - S Iodice
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - L Angelici
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - C Favero
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - T Cavalleri
- Laboratory of Molecular Gastroenterology, Department of Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Italy
| | - L Vigna
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Milan, Italy
| | - B Albetti
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - S Fustinoni
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Milan, Italy
| | - P Bertazzi
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Milan, Italy
| | - A Pesatori
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Milan, Italy
| | - V Bollati
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Milan, Italy
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Gutierrez JL, Arentson-Lantz EJ. Dietary Management of Glycemic Control in Older Adults. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0159-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Monnot AD, Christian WV, Paustenbach DJ, Finley BL. Correlation of blood Cr(III) and adverse health effects: Application of PBPK modeling to determine non-toxic blood concentrations. Crit Rev Toxicol 2014; 44:618-37. [DOI: 10.3109/10408444.2014.926472] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Abstract
These proceedings will review the role of chelation in five metals-aluminum, cadmium, chromium, cobalt, and uranium-in order to illustrate various chelation concepts. The process of "chelation" can often be oversimplified, leading to incorrect assumptions and risking patient harm. For chelation to be effective, two critical assumptions must be fulfilled: the presumed "metal toxicity" must correlate with a given body or a particular compartment burden, and reducing this compartmental or the body burden (through chelation) attenuates toxicity. Fulfilling these assumptions requires an established dose-response relationship, a validated, reproducible means of toxicity assessment (clinical, biochemical, or radiographical), and an appropriate assessment mechanisms of body or compartment burden. While a metal might "technically" be capable of chelation (and readily demonstrable in urine or feces), this is an insufficient endpoint. Clinical relevance must be affirmed. Deferoxamine is an accepted chelator for appropriately documented aluminum toxicity. There is a very minimal treatment window in order to address chelation in cadmium toxicity. In acute toxicity, while no definitive chelation benefit is described, succimer (DMSA), diethylenetriaminepentaacetate (DTPA), and potentially ethylenediaminetetraacetic acid (EDTA) have been considered. In chronic toxicity, chelation is unsupported. There is little evidence to suggest that currently available chromium chelators are efficacious. Similarly, scant human evidence exists with which to provide recommendation for cobalt chelation. DTPA has been recommended for cobalt radionuclide chelation, although DMSA, EDTA, and N-acetylcysteine have also been suggested. DTPA is unsupported for uranium chelation. Sodium bicarbonate is currently recommended, although animal evidence is conflicting.
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Affiliation(s)
- Silas W Smith
- Department of Emergency Medicine, Division of Medical Toxicology, New York University School of Medicine, New York, NY, USA,
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Masharani U, Gjerde C, McCoy S, Maddux BA, Hessler D, Goldfine ID, Youngren JF. Chromium supplementation in non-obese non-diabetic subjects is associated with a decline in insulin sensitivity. BMC Endocr Disord 2012. [PMID: 23194380 PMCID: PMC3537689 DOI: 10.1186/1472-6823-12-31] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The use of chromium supplements is widespread for the prevention and treatment of diabetes mellitus but there are conflicting reports on efficacy, possibly reflecting discrepant effects across different populations. In the present studies, we test the hypothesis that chromium supplementation raises serum chromium levels and correspondingly improves insulin sensitivity. METHODS A double blind placebo-controlled randomized trial was conducted on 31 non-obese, normoglycemic subjects. After baseline studies, the subjects were randomized to placebo or chromium picolinate 500 μg twice a day. The primary endpoint was change in insulin sensitivity as measured by euglycemic hyperinsulinemic clamp. Pre-specified secondary endpoints included fasting lipids, blood pressure, weight, body composition measured by DXA scan. RESULTS After 16 weeks of chromium picolinate therapy there was no significant change in insulin sensitivity between groups (p=0.83). There was, however, a strong association between serum chromium and change in insulin resistance (β = -0.83, p=0.01), where subjects with the highest serum chromium had a worsening of insulin sensitivity. This effect could not be explained by changes in physiological parameters such as body weight, truncal fat and serum lipids with chromium therapy. CONCLUSIONS Chromium therapy did not improve insulin sensitivity in non-obese normoglycemic individuals. Further, subjects who have high serum chromium levels paradoxically had a decline in insulin sensitivity. Caution therefore should be exercised in recommending the use of this supplement. TRIAL REGISTRATION The study was registered on the NIH registry (clinicaltrials.gov) and the identifier is NCT00846248.
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Affiliation(s)
- Umesh Masharani
- Department of Medicine, Diabetes Center, University of California San Francisco, 400 Parnassus Avenue, San Francisco, CA, 94143-1222, USA
| | - Christine Gjerde
- Department of Medicine, Diabetes Center, University of California San Francisco, 400 Parnassus Avenue, San Francisco, CA, 94143-1222, USA
| | - Shelley McCoy
- Department of Medicine, Diabetes Center, University of California San Francisco, 400 Parnassus Avenue, San Francisco, CA, 94143-1222, USA
| | - Betty A Maddux
- Department of Medicine, Diabetes Center, University of California San Francisco, 400 Parnassus Avenue, San Francisco, CA, 94143-1222, USA
| | - Danielle Hessler
- Department of Family Medicine, University of California, San Francisco, CA, USA
| | - Ira D Goldfine
- Department of Medicine, Diabetes Center, University of California San Francisco, 400 Parnassus Avenue, San Francisco, CA, 94143-1222, USA
| | - Jack F Youngren
- Department of Medicine, Diabetes Center, University of California San Francisco, 400 Parnassus Avenue, San Francisco, CA, 94143-1222, USA
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