The Association Between Serum Riboflavin and Flavin Mononucleotide With Pancreatic Cancer: Findings From a Prospective Cohort Study

OBJECTIVES

Vitamin B2 (riboflavin) has a prime role in metabolic reactions imperative to cell cycle and proliferation. We investigated the associations between serum concentrations of riboflavin flavin mononucleotide with the risk of pancreatic cancer in a nested case-control study involving 58 cases and 104 matched controls.

METHODS

The Singapore Chinese Health Study, an ongoing prospective cohort study of 63,257 Chinese Singaporeans. Conditional logistic regression method was used to evaluate these associations with adjustment for potential confounders including the level of education, body mass index, smoking status, alcohol consumption, history of diabetes, serum cotinine and pyridoxal 5'-phosphate, estimated glomerular filtration rate, and total methyl donors (ie, the sum of serum choline, betaine, and methionine).

RESULTS

The risk of pancreatic cancer increased with increasing level of serum riboflavin in a dose-dependent manner, especially in men (Ptrend = 0.003). The odds ratio (95% confidence intervals) of pancreatic cancer for the second and third tertiles of serum riboflavin, compared with the lowest tertile, were 9.92 (1.65-59.77) and 25.59 (3.09-212.00), respectively. This positive association was stronger in individuals with a longer follow-up period (≥7 years).

CONCLUSIONS

The findings suggest a potential role of riboflavin in the development of pancreatic cancer, especially in men.

Kynurenine pathway activation and deviation to anthranilic and kynurenic acid in fibrosing chronic graft-versus-host disease

Fibrosing chronic graft-versus-host disease (cGVHD) is a debilitating complication of allogeneic stem cell transplantation (alloSCT). A driver of fibrosis is the kynurenine (Kyn) pathway, and Kyn metabolism patterns and cytokines may influence cGVHD severity and manifestation (fibrosing versus gastrointestinal [GI] cGVHD). Using a liquid chromatography-tandem mass spectrometry approach on sera obtained from 425 patients with allografts, we identified high CXCL9, high indoleamine-2,3-dioxygenase (IDO) activity, and an activated Kyn pathway as common characteristics in all cGVHD subtypes. Specific Kyn metabolism patterns could be identified for non-severe cGVHD, severe GI cGVHD, and fibrosing cGVHD, respectively. Specifically, fibrosing cGVHD was associated with a distinct pathway shift toward anthranilic and kynurenic acid, correlating with reduced activity of the vitamin-B2-dependent kynurenine monooxygenase, low vitamin B6, and increased interleukin-18. The Kyn metabolite signature is a candidate biomarker for severe fibrosing cGVHD and provides a rationale for translational trials on prophylactic vitamin B2/B6 supplementation for cGVHD prevention.

High IDO activity and an activated Kyn pathway are common in all cGVHD subtypes

Specific Kyn metabolism patterns were identified for gastrointestinal and fibrosing cGVHD

A pathway shift toward anthranilic and kynurenic acid was found in fibrosing cGVHD

A rationale for vitamin B2/B6 adjustment for cGVHD prevention is presented

The Homozygous Hemoglobin EE Variant Is Associated with Poorer Riboflavin Status in Cambodian Women of Reproductive Age

BACKGROUND

Riboflavin is required for erythropoiesis, which is increased in people with hemoglobinopathies due to increased hemolysis and erythrocyte turnover. Dietary intake and status of riboflavin is poor in Cambodia, where hemoglobinopathies are common.

OBJECTIVE

We assessed the association between genetic hemoglobin disorders and riboflavin status in women of reproductive age in Cambodia.

METHODS

Venous blood samples from 515 Cambodian women of reproductive age, 18-45 y, were analyzed for biomarker status of riboflavin [erythrocyte glutathione reductase activation coefficient (EGRac)], genetic hemoglobin (Hb) disorders, and hematological indices. Linear regression analysis was used to estimate the association between EGRac with Hb, ferritin, and Hb genotypes. EGRac was log transformed in the analyses, and the regression coefficients represent the geometric mean differences.

RESULTS

Genetic Hb disorders were present in 57% of the population, with the homozygous hemoglobin E variant (Hb EE) occurring in ∼10% of women (n = 53). Deficient (EGRac ≥1.40) or marginal riboflavin status (EGRac ≥1.30 and <1.40) was observed in 92% (n = 475) of women. The variant Hb EE genotype was associated with 18% (95% CI: 9%, 28%) higher geometric mean EGRac values than the normal Hb AA genotype (P < 0.001).

CONCLUSIONS

Although riboflavin biomarker deficiency or marginal status is widely prevalent in Cambodian women, lower riboflavin status was observed more frequently in women with the Hb EE genotype than in women with normal Hb AA. The relation between genetic Hb disorders and riboflavin warrants further investigation. This trial was registered at clinicaltrials.gov as NCT01593423 and NCT02481375.

[The association between the whole blood riboflavin level and the occurrence, development and prognosis of esophageal squamous cell carcinoma]

Objective: To investigate the association between the whole blood riboflavin level and the occurrence, development and prognosis of esophageal squamous cell carcinoma (ESCC) in China. Methods: From March 2014 to September 2018, ESCC patients from three hospitals (the Affiliated Hospital of Medical College of Shantou University, Shantou Central Hospital in Southern Chaoshan area and First Affiliated Hospital of Zhengzhou University in Northern Taihang Mountain) were selected as a case group; non-esophageal patients who had a physical examination were selected as a control group. The case and control group were paired by age (±5 years) and a 1:1 ration. A total of 1 528 subjects were enrolled including 764 patients in the case group and 764 patients in the control group. About 3-5 ml venous blood samples were collected, and the erythrocyte glutathione reductase activity coefficient (GRAC) was measured to assess the whole blood riboflavin level. A multivariate conditional logistic regression model was used to analyze the association between the GRAC and the risk of ESCC. The association between the GRAC and the prognosis of ESCC was analyzed by using Cox proportional risk regression model based on 288 patients with complete survival data. They were divided into two groups, the high GRAC group (GRAC≥7.87) group and the low GRAC group (GRAC<7.87) according to the strongest correlation between the total survival time, survival outcome and GRAC (GRAC=7.87). Results: Among the 1 528 patients, 958 patients were from Southern Chaoshan area, including 479 patients in the case group with an average age about (59.90±9.34) years and 479 patients in the control group with an average age about (59.55±8.77) years. Other 570 patients were from Northern Taihang Mountain area, including 285 patients in the case group with an average age (58.39±5.19) years and 285 patients in the control group with an average age about (58.74±4.57) years. The multivariate conditional logistic regression showed that the OR (95%CI) of the GRAC and the risk of ESCC was 1.009 (0.998-1.019). The Cox proportional hazard regression model analysis showed that the HR (95%CI) of the high GRAC group was 1.712 (1.034-2.824) compared with the low GRAC group in the 50-70 years group. Conclusion: The whole blood riboflavin level might not be associated with the occurrence of ESCC. The high whole blood riboflavin level would be more beneficial to the prognosis of ESCC patients aged 50-70 years.

Association between Postpartum Nutritional Status and Postpartum Depression Symptoms

Taiwanese women may practice traditional confinement after childbirth, and no study has investigated the nutritional status and the effects of postpartum depression on such women. The aim of this study was to investigate the association between nutritional status and postpartum depression at 6-8 weeks postpartum. A cross-sectional study was conducted on postpartum women who returned to the obstetrics and gynecology clinic for routine examination from January 2016 to September 2017. A total of 344 women received assessments based on the Edinburgh Postnatal Depression Scale (EPDS). An EPDS score of ≥10 indicated the presence of postpartum depressive symptoms (PPDS). A total of 97 women without such symptoms and 23 with PPDS completed nutritional parameter analyses and questionnaires. The results showed that the prevalence of postpartum depression (PPD) was 8.4%. The proportion was 70% for those who practiced confinement at home, significantly higher than for those in the non-PPDS group (45%). The overall psychological stress score was significantly higher and the postpartum care satisfaction score was significantly lower in those with PPDS compared to those without. In terms of nutritional biomarkers, the plasma riboflavin levels in the PPDS group were significantly lower than those in their symptomless counterparts (13.9%). The vitamin D insufficiency and deficiency rates in the non-PPD and PPDS groups were 35%, 41%, 48%, 26%, respectively. However, compared with those in the non-PPDS group, those with PPDS had significantly higher ratios of Σn-6/Σn-3, C20:3n-6/C18:3n-6, and C20:4n-6/(C20:5n-3 + C22:6n-3) (by 8.2%, 79.7%, and 8.8%, respectively), whereas they had lower ratios of C22:6n-3/C22:5n-6 (by 15.5%). Higher plasma riboflavin and erythrocyte C16:1n-9, C24:1n-9, C18:3n-6, and C20:5n-3 levels and lower Σn-6 fatty acid and C22:5n-6 levels decreased the risk of PPD after type of confinement, overall mental stress scores, and postpartum care satisfaction scores were adjusted for the logistic regression analysis. In conclusion, the plasma riboflavin level and erythrocyte fatty acid composition are potentially major contributors to PPD development.

Validation of the Brazilian Healthy Eating Index-Revised Using Biomarkers in Children and Adolescents

The Brazilian Healthy Eating Index-Revised (BHEI-R) can be used to determine overall dietary patterns. We assessed the BHEI-R scores in children and adolescents, aged from 9 to 13 years old, and associated its component scores with biomarkers of health and dietary exposure. Three 24-h recalls were used to generate BHEI-R. Biomarkers were analyzed in plasma and red blood cells. Correlation tests, agreement, and covariance analyses were used to associate BHEI-R components with biomarkers. Data from 167 subjects were used. The strongest correlations were between fruits, vegetables and legumes with omega-6 and omega-3 fatty acids, and β-carotene intakes. Milk and dairy correlated with plasma retinol and pyridoxine. All components rich in vegetable and animal protein sources correlated with plasma creatine. Total BHEI-R scores were positively associated with intakes of omega-6, omega-3, fiber and vitamin C, and inversely associated with energy and saturated fat intakes of individuals. Plasma β-carotene and riboflavin biomarkers were positively associated with total BHEI-R. An inadequate food consumption pattern was captured by both biomarkers of health and dietary exposure. BHEI-R was validated for the above dietary components and can be associated with metabolomics and nutritional epidemiological data in future pediatric studies.

Separation and preconcentration of riboflavin from human plasma using polythionine coated magnetite/hydroxyapatite nanocomposite prior to analysis by surfactant-enhanced fluorimetry

The exploration of novel adsorption properties of conductive polymers based on hybridization with biocompatible nanomaterials receives an increasing interest. In this regard, hydroxyapatite (HA) bioceramic is of critical importance mainly owing to its facile synthesis, high surface area, economic and low toxicity in biological environments. In this work, we first prepared and characterized a magnetite/hydroxyapatite (Fe₃O₄/HA) nanocomposite using the bio-waste chicken eggshell via an attractive green way that involved low cost and irrespective of toxicity. Then, polythionine as a novel class of conductive polymers was in situ coated on the synthesized magnetic bioceramic for the separation and preconcentration of riboflavin (vitamin B₂) in human plasma before its fluorimetric determination. Considering the putative role of riboflavin in protecting against cancer and cardiovascular diseases, it is essential to evaluate this vitamin in biological fluids. The described method possesses a linear range of 0.75-262.5μgL^-1 (R²=0.9985) and a detection limit of 0.20μgL^-1 (signal-to-noise ratio of 3). The relative standard deviations (RSDs) for single-sorbent repeatability and sorbent-to-sorbent reproducibility were less than 4.0% and 7.6% (n=5), respectively. The respective enrichment factor and extraction recovery of the method found to be 35.7 and 98.4%. The analytical performance of method for riboflavin was characterized by good consistency of the results with those obtained by the enzyme-linked immunosorbent assay (ELISA) conventional method (p-value of <0.05). The optimized protocol intended for control determinations of riboflavin in human subjects and is addressed to clinical laboratories.

B-Vitamin Intake from Diet and Supplements and Breast Cancer Risk in Middle-Aged Women: Results from the Prospective NutriNet-Santé Cohort

Experimental studies suggest a protective effect of B-vitamins on breast cancer risk, potentially modulated by alcohol intake. However, epidemiological studies are limited, especially regarding non-folate B-vitamins. Furthermore, few studies included quantitative assessment of supplemental intake. This prospective study aimed to investigate the associations between intakes of B-vitamins (dietary, supplemental, total) and breast cancer risk. 27,853 women aged ≥45 years from the NutriNet-Santé cohort (2009–2016) were included, with a median follow-up time of 4.2 years. Dietary data were collected using repeated 24 h records. A specific questionnaire assessed dietary supplement use over a 12-month period. A composition database of 8000 supplements was developed. Associations were characterized by multivariable Cox models, and 462 incident breast cancers were diagnosed. Dietary (HR_Q4vs.Q1 = 0.74 (0.55, 0.99), P-trend = 0.05), supplemental (HR_Q4vs.Q1 = 0.61 (0.38, 0.98), P-trend = 0.05), and total (HR_Q4vs.Q1 = 0.67 (0.50, 0.91), P-trend = 0.01) pyridoxine intakes were inversely associated with breast cancer risk. Total thiamin intake was borderline inversely associated with breast cancer risk (HR_{per 1-unit increment} = 0.78 (0.61, 1.00), P = 0.05). Statistically significant interactions between alcohol consumption and B-vitamin (thiamin, riboflavin, niacin, pantothenic acid, pyridoxine, folate, and cobalamin) supplemental intake were observed, the latter being inversely associated with breast cancer risk in non-to-low alcohol drinkers but not in higher drinkers. This large prospective study, including quantitative assessment of supplemental intake, suggests a potential protective effect of pyridoxine and thiamin on breast cancer risk in middle-aged women.

Micronutrient-Fortified Milk and Academic Performance among Chinese Middle School Students: A Cluster-Randomized Controlled Trial

Many children suffer from nutritional deficiencies that may negatively affect their academic performance. This cluster-randomized controlled trial aimed to test the effects of micronutrient-fortified milk in Chinese students. Participants received either micronutrient-fortified (n = 177) or unfortified (n = 183) milk for six months. Academic performance, motivation, and learning strategies were estimated by end-of-term tests and the Motivated Strategies for Learning Questionnaire. Blood samples were analyzed for micronutrients. In total, 296 students (82.2%) completed this study. Compared with the control group, students in the intervention group reported higher scores in several academic subjects (p < 0.05), including languages, mathematics, ethics, and physical performance at the end of follow-up. Students in the intervention group showed greater self-efficacy and use of cognitive strategies in learning, and reported less test anxiety (p < 0.001). Moreover, vitamin B₂ deficiency (odds ratio (OR) = 0.18, 95% confidence interval (CI): 0.11~0.30) and iron deficiency (OR = 0.34, 95% CI: 0.14~0.81) were less likely in the students of the intervention group, whereas vitamin D, vitamin B₁₂, and selenium deficiencies were not significantly different. “Cognitive strategy” had a partial mediating effect on the test scores of English (95% CI: 1.26~3.79) and Chinese (95% CI: 0.53~2.21). Our findings suggest that micronutrient-fortified milk may improve students’ academic performance, motivation, and learning strategies.

Plasma Riboflavin Level is Associated with Risk, Relapse, and Survival of Esophageal Squamous Cell Carcinoma

Riboflavin is an essential micronutrient for normal cellular activity, and deficiency may result in disease, such as cancer. We performed a case-control study to explore the association of riboflavin levels with risk and prognosis of esophageal squamous cell carcinoma (ESCC). Plasma riboflavin levels, as measured by enzyme-linked immunosorbent assay (ELISA), in ESCC patients were significantly lower than in those of healthy controls (7.04 ± 6.34 ng/ml vs. 9.32 ± 12.40 ng/ml; P < 0.05). Moreover, there was an inverse relationship between riboflavin level and risk of ESCC (odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95-0.99, P =  0.02). The 5-year relapse-free and overall survival rates were significantly lower when riboflavin levels were ≤0.8 ng/ml than >0.8 ng/ml (relapse-free survival rate: 29.4% vs. 54.8%; overall survival rate: 28.6% vs. 55.6%). Plasma riboflavin level was an independent protective factor for both relapse-free (hazard ratio (HR) = 0.325, 95% CI = 0.161-0.657, P = 0.002) and overall survival of ESCC patients (HR = 0.382, 95% CI = 0.190-0.768, P = 0.007). In conclusion, plasma riboflavin levels are significantly related to risk and prognosis of ESCC patients, suggesting that moderate supplementation of riboflavin will decrease risk and prevent recurrence of ESCC and also improve prognosis of ESCC patients.

[Dietary vitamins intakes status of elderly people of 6 minitoring areas in Zhejiang Province in 2010-2012]

OBJECTIVE

To assess the situations of dietary vitamins intakes among aged 60 years old adults in different areas of Zhejiang Province, and analyze the food sources of vitamins.

METHODS

Data were obtained from the 2010-2012 Chinese National Nutrition and Health Survey in Zhejiang Province. Dietary intakes among elderly people of vitamin A, vitamin B_1, vitamin B_2, vitamin C, vitamin E and their sources were acquired by 24-hour dietary recalls for 3 days in different areas.

RESULTS

The elderly people' intakes of VA(296. 85(174. 32, 500. 28) μg RAE/d), VB_1(0. 68(0. 47, 0. 96) mg/d), VB2(0. 65(0. 47, 0. 90) mg /d) and VC(54. 54(33. 65, 83. 82) mg/d) were generally low. Intakes of vitamin B_1, vitamin C and vitamin E were significantly different in different areas( χ~2=41. 201, 39. 262 and 19. 474, P<0. 001). The food sources of vitamins were slightly variant.

CONCLUSION

The insufficient status of vitamins intakes among elderly people in Zhejiang was serious, and there were differences among elderly people from different areas in intakes and food sources of vitamins.

Prospective study of serum B vitamins levels and oesophageal and gastric cancers in China

B vitamins play an essential role in DNA synthesis and methylation, and may protect against oesophageal and gastric cancers. In this case-cohort study, subjects were enrolled from the General Population Nutrition Intervention Trial in Linxian, China. Subjects included 498 oesophageal squamous cell carcinomas (OSCCs), 255 gastric cardia adenocarcinomas (GCAs), and an age- and sex-matched sub-cohort of 947 individuals. Baseline serum riboflavin, pyridoxal phosphate (PLP), folate, vitamin B12, and flavin mononucleotide (FMN) were measured for all subjects. We estimated the associations with Cox proportional hazard models, with adjustment for potential confounders. Compared to those in the lowest quartile of serum riboflavin, those in the highest had a 44% lower risk of OSCC (HR: 0.56, 95% CI: 0.41 to 0.75). Serum vitamin B12 as a continuous variable was observed to be significantly inversely associated with OSCC (HR: 0.95, 95% CI: 0.89 to 1.01, P for score test = 0.041). Higher serum FMN levels were significantly associated with increased risk of OSCC (HR: 1.08, 95% CI: 1.01 to 1.16) and GCA (HR: 1.09, 95% CI: 1.00 to 1.20). Our study prompted that B vitamins have the potential role as chemopreventive agents for upper gastrointestinal cancers.

Associations of Milk Consumption and Vitamin B₂ and Β12 Derived from Milk with Fitness, Anthropometric and Biochemical Indices in Children. The Healthy Growth Study

The benefits of dairy consumption seem to extend beyond its significant contribution to ensuring nutrient intake adequacy as indicated by the favourable associations with several health outcomes reported by different studies. The aims of the present study were to examine the associations of milk consumption with fitness, anthropometric and biochemical indices in children and further explore whether the observed associations are attributed to vitamins B₂ and B₁₂ derived from milk. A representative subsample of 600 children aged 9-13 years participating in the Healthy Growth Study was examined. Data were collected on children's dietary intake, using 24 h recalls, as well as on fitness, anthropometric and biochemical indices. Regression analyses were performed for investigating the research hypothesis, adjusting for potential confounders and for B-vitamin status indices (i.e., plasma riboflavin, methylmalonic acid and total homocysteine concentrations), dietary calcium intake and plasma zinc concentrations that could possibly act as effect modifiers. Milk consumption was positively associated with the number of stages performed in the endurance run test (ERT) (β = 0.10; p = 0.017) and negatively with body mass index (BMI) (β = -0.10; p = 0.014), after adjusting for several potential confounders and effect modifiers. Dietary intakes of vitamin B₂ and B₁₂ derived from milk were also positively associated with the number of ERT stages (β = 0.10; p = 0.015 and β = 0.10; p = 0.014 respectively). In conclusion, higher intake of milk as well as vitamin B₂ and B₁₂ derived from milk were independently associated with higher cardiorespiratory fitness in Greek preadolescents. The key roles of these B-vitamins in substrate oxidation, energy production, haemoglobin synthesis and erythropoiesis could provide a basis for interpreting these associations. However, further research is needed to confirm this potential interpretation.

A Protein Extract from Chicken Reduces Plasma Homocysteine in Rats

The present study aimed to evaluate effects of a water-soluble protein fraction of chicken (CP), with a low methionine/glycine ratio, on plasma homocysteine and metabolites related to homocysteine metabolism. Male Wistar rats were fed either a control diet with 20% w/w casein as the protein source, or an experimental diet where 6, 14 or 20% w/w of the casein was replaced with the same amount of CP for four weeks. Rats fed CP had reduced plasma total homocysteine level and markedly increased levels of the choline pathway metabolites betaine, dimethylglycine, sarcosine, glycine and serine, as well as the transsulfuration pathway metabolites cystathionine and cysteine. Hepatic mRNA level of enzymes involved in homocysteine remethylation, methionine synthase and betaine-homocysteine S-methyltransferase, were unchanged, whereas cystathionine gamma-lyase of the transsulfuration pathway was increased in the CP treated rats. Plasma concentrations of vitamin B2, folate, cobalamin, and the B-6 catabolite pyridoxic acid were increased in the 20% CP-treated rats. In conclusion, the CP diet was associated with lower plasma homocysteine concentration and higher levels of serine, choline oxidation and transsulfuration metabolites compared to a casein diet. The status of related B-vitamins was also affected by CP.

Folate and nutrients involved in the 1-carbon cycle in the pretreatment of patients for colorectal cancer

To assess the ingestion of folate and nutrients involved in the 1-carbon cycle in non-treated patients with colorectal adenocarcinoma in a reference center for oncology in southeastern Brazil. In total, 195 new cases with colorectal adenocarcinoma completed a clinical evaluation questionnaire and a Food Frequency Questionnaire (FFQ). Blood samples from 161 patients were drawn for the assessment of serum folate. A moderate correlation was found between serum concentrations of folate, folate intake and the dietary folate equivalent (DFE) of synthetic supplements. Mulatto or black male patients with a primary educational level had a higher intake of dietary folate. Of patients obtaining folate from the diet alone or from dietary supplements, 11.00% and 0.10%, respectively, had intake below the recommended level. Of the patients using dietary supplements, 35% to 50% showed high levels of folic acid intake. There was a prevalence of inadequacy for vitamins B2, B6 and B12, ranging from 12.10% to 20.18%, while 13.76% to 22.55% of patients were likely to have adequate choline intake. The considerable percentage of patients with folate intake above the recommended levels deserves attention because of the harmful effects that this nutrient may have in the presence of established neoplastic lesions.

The effects of regular consumption of a multiple micronutrient fortified milk beverage on the micronutrient status of school children and on their mental and physical performance

Multiple micronutrient deficiencies exist in school going children in India and bridging the gap between nutrient intake and requirements is an effective way to combat the deficiencies. This study aimed to test the effect of a multi-micronutrient fortified malt and cocoa based milk beverage on the micronutrient status, cognition, physical performance and nutritional deficiencies of 7-10 years old south Indian children. A randomized, double blind placebo controlled study design was used with normal healthy children from low to middle income families, aged 7-10 years randomly assigned to receive either a multi-micronutrient fortified or an unfortified milk based control drink. The drinks were provided 6 days/week for 5 months. Assessments included anthropometry, blood biochemistry, physical performance and cognition at baseline and endline. The baseline characteristics of the study groups were similar. The changes in body weight and height were similar between the groups at the end of the study. Levels of vitamin B12, red cell folate and vitamin B2 significantly improved in the intervention group, while vitamin D, selenium and body iron showed no difference. The Hemoglobin (Hb) and serum ferritin levels of the control group decreased at endline, while those in the intervention group maintained their levels. The serum transferrin receptor levels increased in both the groups. The prevalence of iron deficiency and Vitamin B2 deficiency were significantly lower in the intervention group at endline. Overall improvement in cognitive and physical performance was seen in both the groups at endline, with no significant differences between the groups. The micronutrient fortified milk based drink was efficacious in improving the micronutrient status of Vitamin B2, Vitamin B12 and red cell folate and in preventing a decline in Hb level compared to an unfortified milk based drink. It also reduced anemia and the risk of deficiencies of iron, and B12, in apparently healthy children. ClinicalTrials.gov IdentifierNCT01415557. Clinical Trial RegistryIndia - REF/2012/12/004332.

Circulating biomarkers of one-carbon metabolism in relation to renal cell carcinoma incidence and survival

BACKGROUND

The etiology of renal cell carcinoma (RCC) is only partially understood, but a metabolic component appears likely. We investigated biomarkers of one-carbon metabolism and RCC onset and survival.

METHODS

The European Prospective Investigation into Cancer and Nutrition (EPIC) recruited 385747 participants with blood samples between 1992 and 2000, and this analysis included 556 RCC case-control pairs. A subsequent replication study included 144 case-control pairs nested within the Melbourne Collaborative Cohort Study (MCCS). Plasma concentrations of vitamin B2, vitamin B6, folate, vitamin B12, methionine and homocysteine were measured in prediagnostic samples and evaluated with respect to RCC risk using conditional and unconditional logistic regression models, and to all-cause mortality in RCC cases using Cox regression models. All statistical tests were two-sided.

RESULTS

EPIC participants with higher plasma concentrations of vitamin B6 had lower risk of RCC, the odds ratio comparing the 4(th) and 1(st) quartiles (OR4vs1) being 0.40 95% confidence interval [CI] = 0.28 to 0.57, P trend < .001. We found similar results after adjusting for potential confounders (adjusted P trend < .001). In survival analysis, the hazard ratio for all-cause mortality in RCC cases when comparing the 4(th) and 1(st) quartiles (HR4vs1) of vitamin B6 was 0.57 (95% CI = 0.37 to 0.87, P trend < .001). Subsequent replication of these associations within the MCCS yielded very similar results for both RCC risk (OR4vs1 = 0.47, 95% CI = 0.23 to 0.99, P trend = .07) and all-cause mortality (HR4vs1 = 0.56, 95% CI = 0.27 to 1.17, P trend = .02). No association was evident for the other measured biomarkers.

CONCLUSION

Study participants with higher circulating concentrations of vitamin B6 had lower risk of RCC and improved survival following diagnosis in two independent cohorts.

Effect of supplementation with a lipid-based nutrient supplement on the micronutrient status of children aged 6-18 months living in the rural region of Intibucá, Honduras

BACKGROUND

Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children.

METHODS

A 12-month randomised controlled trial was conducted among children aged 6-18 months living in Intibucá, Honduras. Communities (n = 18) were randomised into clusters matched by poverty indicators (9 intervention, n = 160 and 9 controls, n = 140). Intervention participants received LNS. All children received food vouchers and nutrition education. Primary outcomes included measures of micronutrient status: at baseline, 6 and 12 months' blood were collected for assessment of folate, iron, zinc, riboflavin, and vitamin B12 status; haemoglobin was measured every 3 months; and dietary and anthropometry collected monthly. Longitudinal analyses were based on intent to treat and LNS adherence. Generalised estimating equations were used in the estimation of generalised linear regression models specified for the data.

RESULTS

At 6-month follow-up, children in the intervention group had a lower proportion classified as deficient for B12 (43.6%) compared with the control (67.7%; P = 0.03). The intervention group had a higher mean concentration for folate at 6 months (P = 0.06), and improvements continued through 12 months for folate (P = 0.002) and vitamin A deficiency (P = 0.03). This pattern of results, with improved significance, remained in subanalysis based on LNS adherence.

CONCLUSION

These data demonstrate that LNS improved select micronutrient status in young non-malnourished Honduran children.

Lower concentrations of B-vitamin subgroups in the serum and amniotic fluid correlate to cleft lip and palate appearance in the offspring of A/WySn mice

PURPOSE

The pathogenesis and prevention of cleft lip and palate (CL/P) have been studied mainly in clinical and animal experiments. A prophylactic poly-B-vitamin substitution during the first months of pregnancy has provided the most encouraging results for the prevention of CL/P recurrence in families at risk. In vitro studies of the palatal organ in an A/WySn mouse model have confirmed the positive influence of B-vitamins on palatal development. The present animal study was performed to analyze different B-vitamin concentrations in the serum and amniotic fluid of A/WySn mice according to the appearance of CL/P in their offspring.

MATERIAL AND METHODS

Concentrations of different B-vitamins (B1, B2, B3, B5, B6, and folic acid) in serum and amniotic fluid were analyzed by high-performance liquid chromatographic detection. Immunohistochemical staining against thiamin-1 receptor was performed on histologic midface sections of A/WySn fetuses with (n = 12) and without (n = 14) CL/P.

RESULTS

Vitamin B5 (P < .001) and folic acid (P < .004) concentrations in the amniotic fluid of dams with CL/P were significantly lower than in dams without CL/P. Serum concentrations of folic acid (P = .5) and B5 (P = .4) showed no difference between the 2 groups. Dams with CL/P had significantly lower thiamine concentrations in serum (P = .01) and amniotic fluid (P < .001). Histologic midface sections presented high thiamin-1 receptor expression in the palatal shelf of fetuses with CL/P.

CONCLUSION

A decreased use or uptake of some B-vitamin subgroups (B1, B5, and folic acid) in amniotic fluid and serum (vitamin B1) was correlated to an increased cleft appearance in A/WySn mice. The high thiamin-1 receptor expression in the palatal tissue of mouse fetuses with CL/P may be caused by a decreased availability of vitamin B1.

[The study on the relationship between serum folic acid and vitamin B2 levels and esophageal cancer]

OBJECTIVE

To study the relationship between serum folic acid and VB2 levels and esophageal cancer.

METHOD

The enzyme-linked immunosorbent assay was used to observe the serum folic acid and vitamin B2 levels of the 1:1:1 paired of 106 groups, which include 106 cases of esophageal cancer, 106 cases of esophageal precancerous lesions and 106 cases of normal control group.

RESULTS

The levels of folic acid and VB2 in serum of esophageal cancer group and esophageal precancerous lesions group were significantly lower than normal control group (P<0.05), the level of folic acid in serum of esophageal cancer group was significantly lower than esophageal precancerous lesions group (P<0.05), but the difference of the serum VB2 of esophageal cancer group and esophageal precancerous lesions group was not statistically significant (P>0.05).

CONCLUSION

The folic acid and vitamin B2 deficiency has the relationship with the esophageal cancer occurrence and development.

Association of the plasma and tissue riboflavin levels with C20orf54 expression in cervical lesions and its relationship to HPV16 infection

Riboflavin deficiency can cause a variety of metabolic problems that lead to skin and mucosal disorders. Limited evidence suggests that high intake of riboflavin may reduce overall risks of cancer. However, association of this deficiency with cervical cancer and precancerous lesions are still not definitively known. In this study, we characterized the relationship between plasma and tissue riboflavin levels and C20orf54 protein expression in patients with cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (CSCC) as well as the relationship of these levels with human papillomavirus virus 16, 18 (HPV16/18) infections. High-performance liquid chromatography (HPLC) was used to measure blood riboflavin levels in patients with CIN and CSCC, and an enzyme-linked immunosorbent assay (ELISA) was used to determine tissue riboflavin levels in patients with CSCC and matched normal mucous epithelia. The expression of C20orf54 in fresh CSCC and matched tissues were detected by qRT-PCR and western blot, respectively. And it was further confirmed by immunohistochemistry (IHC) with formalin-fixed, paraffin-embedded CIN and CSCC. An HPV genotyping chip was used to analyze HPV infection and typing. The results showed that patients with CIN and CSCC had decreased plasma riboflavin levels as compared with normal controls. There was also significantly decreased riboflavin in tissues from CSCC patients, when compared with normal cervical epithelia. C20orf54 expression were significantly up-regulated in CSCC compared to matched control on both mRNA and protein level. Tissue riboflavin levels were significantly lower in HPV16/18 positive tissue compared with HPV16/18-negative tissue, and an inverse association was found between tissue riboflavin levels and C20orf54 mRNA and protein expression in CSCC. Additionally, C20orf54 was significantly correlated with tumor stages. In conclusion, C20orf54 tend to play a protective role in Uyghur cervical carcinogenesis of which modulating riboflavin absorption, and it is also related with HPV infection.

[Vitamin and mineral status of oarsmen during the training-competition cycles]

Vitamin and minerals status of 30 sportsmen aged 16.8 +/- 0.2 years (trained in boat racing 5.0 +/- 0.3 years) during the training--competition cycles in autumn and winter has been studied. A significant decrease of vitamin A level in the range of reference limits was found in 30.8% of sportsmen during autumn season, but such decrease was revealed in 100% of examined sportsmen during winter Vitamin B1 and B2 deficiency has been detected in both seasons. The portion of persons with vitamin B2 deficiency increased during training cycles. A significant decrease of magnesium (in 56.3% of sportsmen) and sodium level (in 33.3% of sportsmen) was detected during autumn season. Irrespective of the season a significant decrease of blood serum of calcium (in 40.0-66.7% of sportsmen); potassium (in 53.3-66.7% of sportsmen according to both absolute and individual data); chlorides (in 50.0-90.0% of sportsmen), and iron (in 53.3-60.0% of sportsmen) has been revealed. The data obtained indicate the need for diagnostics and correction of vitamin and minerals status in sportsmen.

[The state of the antioxidant status of children of different ages]

The parameters of lipid peroxidation (blood plasma content of primary products of lipid peroxidation and the end of TBA-active products) and indexes of antioxidant protection (total antioxidant activity, the content of fat-soluble vitamins A and E in blood plasma and riboflavin in blood) has been evaluated in 75 healthy children living in Irkutsk. All respondents were divided into three age periods: preschool age (3-6 years old, mean 4.7 +/- 1.0 - 21 children), primary school age (7-8 years, 7.6 +/- 0.4, - 28 children) and middle-school age (9-11 years, 9.9 +/- 0.7, 26 children). We used spectrophotometric and fluorometric methods. Identified the distinctive features of the metabolic reactions in children at different ages. The increase of the content of the primary products of lipid peroxidation in the early school years and of the end of TBA-active products for children of secondary school age in comparison with the preschool children has been determined. At the same time an increase in the level of total antioxidant activity and fat-soluble vitamins and riboflavin content in young and middle-school aged children in comparison with the pre-school children has been observed. The measurement of vitamins status demonstrated the insufficiency of alpha-tocopherol in half of pre-school children, in 36% of primary school children and 38% of children of secondary school age. Retinol and riboflavin deficiency has been detected in a small proportion of children of all ages. In this regard, the additional supply with vitamins of children in pre-school and middle-school period is essential.

[Effect of some vitamins on activity of immunocompetent cells]

The content of vitamins A, E, B1, B2, B6 in lymphocytes and serum of blood was studied with simultaneous determination of CD3+, CD5+, CD4+, CD8+, CD16+, CD25+, CD71+, CD95+, and HLADR+ populations. According to cellular immunity response, patients were divided into two groups--with physiological norm and deficiency. It was established that, irrespective of the group, the content of vitamins A, E, B6 in blood serum does not change, while the concentration of B1 and B2 in the group with physiological norm is greater than that in the group with deficiency. In the group with deficiency of cellular immunity, increased level of endocellular vitamins A, E, B2 and B6 was revealed. Concentration of thiamine in both blood serum and lymphocytes in the group with physiological norm was greater than in the group with deficiency of cellular immunity.

[Peculiarities of vitamin status in men and women with cardiovascular disease and obesity]

We explored the characteristics of the vitamin status in 471 patients with cardiovascular diseases, according to sex, and BMI values. All patients underwent examination of the system Nutritest-IP: studying their actual meals at home, determined anthropometric measurement, body composition, using biochemical methods evaluated the state of the protein, lipid and carbohydrate metabolism, the functional state of liver and biliary tract, hemostasis, vitamin provision. The results suggest a lack of availability of patients with vitamins C and B group. The number of patients with deficient serum beta-carotene increased proportional to body mass index. The concentration of beta-carotene decreased and vitamin E - increased in blood serum proportionally to increase the degree of obesity. Thus the availability of vitamins in the blood serum depends from sex and body mass index values of the patients. These data suggest that the rate of supply of vitamins are reliable markers to assess the adequacy of the diet consumed by the content of vitamins in people with normal body weight. Appraisingly the content of beta-carotene and vitamin E in the serum of patients it should be taken into account that they have overweight or obese, and abnormality of lipid spectrum of blood serum.

Comparison of blood levels of riboflavin and folate with dietary correlates estimated from a semi-quantitative food-frequency questionnaire in older persons in Portugal

Since information regarding biochemical parameters of riboflavin and folate status is limited in some populations of older adults, a food-frequency questionnaire is often used to estimate riboflavin and folate status. However, the performance of this type of questionnaire among this age group has not been comprehensively evaluated. Thus, we sought to assess riboflavin and folate status in older adults living in Portugal and to validate findings from a semiquantitative food-frequency questionnaire (FFQ), by comparison to these blood measures. We used a cross-sectional study to investigate riboflavin in red blood cells (as Glutathione Reductase Activity Coefficient; EGRAC) and folate in the serum of 88 older persons (66.7% female), aged between 60 and 94 years, recruited from seven adult day care community centers in Porto, Portugal. Forty-six subjects had low EGRAC levels (<1.2), with a group mean concentration of 1.17 and median of 1.10 (range 1.00-2.10). For daily riboflavin dietary intakes from FFQ, the mean was 3.34 mg, the median 3.37 mg, and range 0.66-4.81 mg. The Spearman correlation between these two measures was r = 0.073, (P = 0.497) and Pearson correlation, after adjustment for energy, was r = 0.263, P = 0.013. All participants were above the 7 nmol/L serum folate cut-off for adequacy. Spearman correlation coefficient between serum and FFQ measures was r = -0.10, (P = 0.359), and the Pearson correlation, after adjustment for energy and following log(e) transformation, was r = -0.58, (P = 0.593). Thus riboflavin and folate intakes estimated by FFQ correlated poorly with EGRAC and folate serum values.

[Effect of dietary fat on vitamin status of rats]

The influence of low (1%) and high (31%) diet fat content (sunflower-seed oil and lard 1:1 at a ratio of 1:1) on vitamin A, E, B1 and B2 status of growing Wistar rats (8 rats per group) with initial body weight 80-100 g has been investigated. The semi-synthetic diet contained vitamin mixture in doses covering the physiological requirement of these animals. The increase of fat content (31%) in the diet due to the presence of vitamin E in sunflower-seed oil automatically lead to 1,7-fold increase consumption of this vitamin compared to the control group. Diet fat content did not affect the level of vitamins B1 and B2 in rat liver. Excessive intake of fat and vitamin E for 6 weeks did not influence on the content of blood plasma vitamin E and rat liver vitamin A occurs at the same time, while significant 1,9 fold elevation of liver vitamin E level and 26 per cent increase of blood plasma vitamin A concentration. The almost complete exclusion of fat from the diet had no effect on blood plasma level of alpha-tocopherol and retinol, but resulted in a significant decrease of vitamins A and E content in rat liver by 40 per cent, indicating a deterioration of sufficiency with these fat-soluble vitamins. The analysis of the results obtained in this investigation and literature data have suggested that under excessive as well as under decreased consumption of fat there is a risk of the development of polyhypovitaminosis. Vitamin complex supplementation is required to prevent a possible worsening of vitamin status under diets with modified fatty component.

Association between plasma biomarkers, CDK5 polymorphism and the risk of Alzheimer's disease

In this study we evaluated biochemical blood serum parameters and the association of Cyclin-dependent kinase 5 (CDK5) gene polymorphisms with the risk of Alzheimer's disease (AD) in the Polish population. We observed an elevated total cholesterol, low-density lipoproteins (LDL) and homocysteine levels and lower concentrations of high-density lipoproteins (HDL) and vitamin B12 in AD patients. However, the analyzed CDK5 polymorphisms were not associated with the biochemical parameters. Moreover, we found no association between the studied polymorphisms and the risk of AD in the Polish population. The meta-analysis of previously published and current study was performed. In conclusion, our study demonstrated that alteration of cholesterol, LDL, HDL, homocysteine and B12 concentration may be an important factor in pathogenesis of AD.

[A comparison and significance of plasma riboflavin levels in patients with esophageal squamous cell carcinoma versus Linzhou healthy migrants in Changzhi of Shanxi]

OBJECTIVE

To study the relationship between plasma riboflavin levels and esophageal squamous cell carcinoma.

METHODS

We detected and compared plasma concentrations of riboflavin in patients with esophageal squamous cell carcinoma (ESCC) and immigrants of Linzhou living in Changzhi. Plasma riboflavin levels were quantified in 445 ESCC patients, 689 healthy control subjects and 347 immigrants of Linzhou living in Changzhi by using enzyme-linked immunosorbent assay.

RESULTS

The plasma riboflavin levels in patients with ESCC were significantly lower than those in the healthy controls and immigrants of Linzhou living in Changzhi [(731.69 ± 330.67) µg/L vs (1090.43 ± 445.08) µg/L, (731.69 ± 330.67) µg/L vs (897.58 ± 177.78) µg/L, respectively, all P < 0.05], and the plasma riboflavin levels of the healthy controls were higher than those in the immigrants of Linzhou living in Changzhi (P < 0.05).

CONCLUSION

Patients with ESCC have decreased plasma riboflavin levels as compared with the healthy controls and immigrants of Linzhou living in Changzhi, there exists a lack of riboflavin in ESCC patients, but the specific mechanism needs further study.

[Determination of serum vitamin B1 and B2 with HPLC]

OBJECTIVE

To develop a HPLC method for the determination of serum vitamin B1 (VB1) and vitamin B2 (VB2) simultaneously.

METHODS

Serum samples were pretreated at ambient temperature on a C18 reversed phase chromatographic column, methanol plus phosphate buffer was used for mobile phase, vitamin B1 and B2 contents of serum samples eluted from a Sep-park C18 column were detected with a photodiode array detector. The influences of retention time, the volume and the proportion of eluent on the recovery of samples were investigated.

RESULTS

Recoveries were ranged from 82.67 to 96.89%. The coefficient of variation was < 10%. The linearity and correlation coefficient was 0.9985 and 0.9995, respectively. The contents of serum VB1 and VB2 in obese people were lower than those in healthy controls.

CONCLUSION

A HPLC method of determining serum VB1 and VB2 was established. Serum VB1 and VB2 level in obese people was low.

A U-shaped relationship between plasma folate and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition

Folate intake has shown an inverse association with pancreatic cancer; nevertheless, results from plasma measurements were inconsistent. The aim of this study is to examine the association between plasma total homocysteine, methionine, folate, cobalamin, pyridoxal 5'-phosphate, riboflavin, flavin mononucleotide and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). We conducted a nested case-control study in the EPIC cohort, which has an average of 9.6 years of follow-up (1992-2006), using 463 incident pancreatic cancer cases. Controls were matched to each case by center, sex, age (± 1 year), date (± 1 year) and time (± 3 h) at blood collection and fasting status. Conditional logistic regression was used to calculate the odds ratios (OR) and 95% confidence intervals (CI), adjusting for education, smoking status, plasma cotinine concentration, alcohol drinking, body mass index and diabetes status. We observed a U-shaped association between plasma folate and pancreatic cancer risk. The ORs for plasma folate ≤ 5, 5-10, 10-15 (reference), 15-20, and > 20 nmol/L were 1.58 (95% CI=0.72-3.46), 1.39 (0.93-2.08), 1.0 (reference), 0.79 (0.52-1.21), and 1.34 (0.89-2.02), respectively. Methionine was associated with an increased risk in men (per quintile increment: OR=1.17, 95% CI=1.00-1.38) but not in women (OR=0.91, 95% CI=0.78-1.07; p for heterogeneity <0.01). Our results suggest a U-shaped association between plasma folate and pancreatic cancer risk in both men and women. The positive association that we observed between methionine and pancreatic cancer may be sex dependent and may differ by time of follow-up. However, the mechanisms behind the observed associations warrant further investigation.

Patients with gastrointestinal tract disorders receiving parenteral nutrition need a higher dose of vitamin C

BACKGROUND/AIMS

Appropriateness of the vitamin doses in Japanese commercial multi-vitamin preparations for parenteral nutrition therapy was investigated in patients with gastrointestinal tract disorder by evaluating the vitamin status (blood concentrations and urinary excretions of vitamins B1, B2, B6, and C) of them.

METHODOLOGY

Commercial multivitamin preparations were administered continuously with a commercial PN solution over 5 days to 10 patients with gastrointestinal tract disorder. Blood concentrations of vitamins B1, B2, B6, and C were measured on the mornings of day 1, day 4, and day 6. Urinary excretions were measured in 24-h urine collections collected after day 3 and after day 5.

RESULTS

Blood concentrations of vitamins B1, B2, and B6 increased but remained within or slightly above the normal throughout the study, and urinary excretion values were normal in all patients. However, blood vitamin C concentration surpassed the lower limit of normal (5.5 microg/mL) only on day 6. Urinary vitamin C excretion was below normal (20.0 mg/day) in all and 7 patients on days 3 and 5, respectively.

CONCLUSIONS

In patients with gastrointestinal tract disorder, the doses of vitamins B1, B2, and B6 of Japanese commercial multi-vitamin preparations are adequate but that of vitamin C (100 mg/day) is inadequate and should be increased.

[Influence wheat bran on organism vitamin (experiment on rats)]

The inclusion of wheat bran (at a dose of 2,3 and 4,6% of the dry weight) in the semi-synthetic diet of rats under combined deficiency of vitamins (20 and 50% of the adequate level) did not have a significant effect on vitamins C, B1 and B2 liver levels, riboflavin blood plasma level, and thiamine and riboflavin urinary excretion. The consumption of bran in high dose has been accompanied by a decrease of retinol blood plasma level on 19-28% but it has no effect on liver retinol palmitate content. Bran intake in both doses resulted in a deterioration of rats sufficiency with vitamin E, which had been confirmed by a simultaneous significant decrease of blood plasma alpha-tocopherol concentration on 31-40%, and its liver level on 23-43%. The results obtained indicate the advisability of vitamin E enrichment of diets with a high content of dietary fiber.

[Effect of dietary fats and supplementary coenzyme Q10 on vitamin provision in animals]

The full replacement of fatty component of a diet (sunflower-seed oil and lard 1:1) on enriched with alpha-tocopherol acetate fish oil under additional coenzyme Q10 intake led to the strengthening of lipid peroxidation (LP) and to some decrease of vitamins A and E level in liver and blood serum whereas replacement by linen oil was accompanied by the expressed deterioration of these vitamins sufficiency, but didn't influence on the LP intensity. The use of palm-oil as a fatty component didn't effect on the investigated parameters. The influences of a fatty component on vitamins B1 and B2 level in rat liver and blood serum has not revealed.

Riboflavin supplementation and biomarkers of cardiovascular disease in the elderly

BACKGROUND

High levels of total plasma homocysteine are potentially harmful in the elderly.

OBJECTIVE

To investigated the effects of oral riboflavin supplementation on plasma total homocysteine, ferritin, uric acid and C-reactive protein concentration in elderly people with a low riboflavin status. We performed a four-week randomized, placebo-controlled, double-blind trial of riboflavin supplementation in seven Portuguese day social centers.

DESIGN

Eighty-eight individuals (66.7% female), aged between 60 and 94 years, volunteered to participate in the study following interview. Forty-two subjects, with an erythrocyte glutathione reductase activation coefficient (EGRAC) >or= 1.2, were included in the intervention trial. All subjects gave informed consent. Study subjects were administered 10 mg riboflavin (n=21) or placebo (n=21) each day for 28 days.

RESULTS

Riboflavin supplementation significantly decreased plasma tHcy (P=0.005) and EGRAC (P=0.014), but not plasma ferritin, uric acid or C-reactive protein.

CONCLUSIONS

In this elderly group, we found that 10 mg/day oral riboflavin supplementation lowered plasma homocysteine concentrations in subjects with low riboflavin status.

Quantitative profiling of biomarkers related to B-vitamin status, tryptophan metabolism and inflammation in human plasma by liquid chromatography/tandem mass spectrometry

Vitamins B2 and B6 serve as cofactors in enzymatic reactions involved in tryptophan and homocysteine metabolism. Plasma concentrations of these vitamins and amino acids are related to smoking and inflammation, and correlate with other markers of immune activation. Large-scale studies of these relations have been hampered by lack of suitable analytical methods. The assay described includes riboflavin, five vitamin B6 forms (pyridoxal 5'-phosphate, pyridoxal, 4-pyridoxic acid, pyridoxine and pyridoxamine), tryptophan and six tryptophan metabolites (kynurenine, kynurenic acid, anthranilic acid, 3-hydroxykynurenine, xanthurenic acid and 3-hydroxyanthranilic acid), cystathionine, neopterin and cotinine. Trichloroacetic acid containing 13 isotope-labelled internal standards was added to 60 microL of plasma, the mixture was centrifuged, and the resulting supernatant used for analysis. The analytes were separated within 5 min on a stable-bond C8 column by a gradient-type mobile phase containing acetonitrile, heptafluorobutyric acid and high concentration (650 mmol/L) of acetic acid, and detected using electrospray ionization tandem mass spectrometry (ESI-MS/MS). The mobile phase ensured sufficient separation and high ionization efficiency of all analytes. Recoveries were 75-123% and within-day and between-day coefficients of variance (CVs) were 2.5-9.5% and 5.4-16.9%, respectively. Limits of detection ranged from 0.05 to 7 nmol/L. The method enables quantification of endogenous plasma concentrations of 16 analytes related to B-vitamin status and inflammation, and may prove useful in large-scale epidemiological studies.

Choline intake, plasma riboflavin, and the phosphatidylethanolamine N-methyltransferase G5465A genotype predict plasma homocysteine in folate-deplete Mexican-American men with the methylenetetrahydrofolate reductase 677TT genotype

We previously showed that provision of the folate recommended dietary allowance and either 300, 550, 1100, or 2200 mg/d choline for 12 wk resulted in diminished folate status and a tripling of plasma total homocysteine (tHcy) in men with the methylenetetrahydrofolate reductase (MTHFR) 677TT genotype. However, the substantial variation in tHcy within the 677TT genotype at wk 12 implied that several factors were interacting with this genotype to affect homocysteine. As an extension of this work, the present study sought to identify the main predictors of wk-12 plasma tHcy, alone and together with the MTHFR C677T genotype (29 TT, 31 CC), using linear regression analysis. A basic model explaining 82.5% of the variation (i.e. adjusted R(2) = 0.825) was constructed. However, the effects of the variables within this model were dependent upon the MTHFR C677T genotype (P for interaction < or = 0.021). Within the 677TT genotype, serum folate (P = 0.005) and plasma riboflavin (P = 0.002) were strong negative predictors (inversely related) explaining 12 and 15%, respectively, of the variation in tHcy, whereas choline intake (P = 0.003) and serum creatinine (P < 0.001) were strong positive predictors, explaining 19 and 25% of the variation. None of these variables, except creatinine (P = 0.021), correlated with tHcy within the 677CC genotype. Of the 8 additional polymorphisms tested, none appeared to influence tHcy. However, when creatinine was not in the model, the phosphatidylethanolamine N-methyltransferase 5465G-->A variant predicted lower tHcy (P < 0.001); an effect confined to the MTHFR 677TT genotype. Thus, in folate-deplete men, several factors with roles in 1-carbon metabolism interact with the MTHFR C677T genotype to affect plasma tHcy.

Effects of supplementation with multivitamin and mineral on blood pressure and C-reactive protein in obese Chinese women with increased cardiovascular disease risk

OBJECTIVE

To investigate the effect of supplementation with multivitamin and mineral on blood pressure and C-reactive protein (CRP) in obese women with increased cardiovascular disease risk as having hypertension, hyperglycemia or hyperlipemia.

SUBJECTS AND METHODS

128 obese Chinese women aged 18-55 years with increased cardiovascular disease risk participated in a 26-week randomized, double-blind, placebo-controlled trial. Subjects were randomized to four groups, and received either one tablet of high-dose multivitamin and mineral supplement (MMS), or one tablet of low-dose MMS (Low MMS), or calcium 162 mg (Calcium) or identical placebo (Placebo) daily during the study. Diastolic blood pressure (DBP), systolic blood pressure (SBP) and serum concentrations of CRP were measured at baseline and end-trial.

RESULTS

At baseline, the subjects had an average age of 42.0+/-7.1 years and BMI of 30.9+/-2.8 kg/m2. There were no significant differences between the four groups in baseline characteristics. One hundred and seventeen subjects completed the study. After 26-week supplementation, both SBP and DBP were significantly lower in the MMS group compared to the placebo group (p < 0.05). There was also a non-significant trend of lower DBP at 26-week in the MMS and calcium groups compared to baseline (p < 0.08). At 26-week, the MMS group also had significantly lower serum concentrations of CRP compared with that of baseline and the placebo group (p < 0.05).

CONCLUSIONS

Our results showed that supplementation with adequate multivitamin and mineral supplement could reduce blood pressure and serum CRP in obese women with increased cardiovascular disease risk.

[About recommended daily intake values of vitamins A, E, C and B2]

On the basis of studies of dependence of vitamins contents in blood serum from daily consumption of vitamins it has been allowed to prove following sizes of recommended daily intake: of vitamin A -- 900 microg retinol equivalents, vitamin C -- 90 mg, vitamin E -- 15 mg, vitamin B2 -- 1,8 mg. The evaluation of vitamin receipt on the basis of analysis of dietary intake for the last month before admission using the food frequency method and the elaborated values allows with sufficient probability to judge about adequate sufficiency of an organism with these vitamins.

Vitamins B2, B6, and B12 and risk of new colorectal adenomas in a randomized trial of aspirin use and folic acid supplementation

BACKGROUND

Folate, other vitamin B cofactors, and genes involved in folate-mediated one-carbon metabolism all may play important roles in colorectal neoplasia. In this study, we examined the associations between dietary and circulating plasma levels of vitamins B(2), B(6), and B(12) and risk colorectal adenomas.

METHODS

The Aspirin/Folate Polyp Prevention Study is a randomized clinical trial of folic acid supplementation and incidence of new colorectal adenomas in individuals with a history of adenomas (n = 1,084). Diet and supplement use were ascertained through a food frequency questionnaire administered at baseline. Blood collected at baseline was used to determine plasma B-vitamin levels. We used generalized linear regression to estimate risk ratios (RR) and 95% confidence intervals (95% CI) as measures of association.

RESULTS

We found a borderline significant inverse association with plasma B(6) [pyridoxal 5'-phosphate (PLP)] and adenoma risk (adjusted RR Q4 versus Q1, 0.78; 95% CI, 0.61-1.00; P(trend) = 0.08). This association was not modified by folic acid supplementation or plasma folate. However, the protective association of PLP with adenoma risk was observed only among subjects who did not drink alcohol (P(interaction) = 0.03). Plasma B(2) (riboflavin) was inversely associated with risk of advanced lesions (adjusted RR Q4 versus Q1, 0.51; 95% CI, 0.26-0.99; P(trend) = 0.12). No significant associations were observed between adenoma risk and plasma vitamin B(12) or dietary intake of vitamin B(2) and B(6). When we examined specific gene-B-vitamin interactions, we observed a possible interaction between methylenetetrahydrofolate reductase -C677T and plasma B(2) on risk of all adenomas.

CONCLUSION

Our results suggest that high levels of PLP and B(2) may protect against colorectal adenomas.

[Estimation of vitamin B2 status of organism by means of twenty-four hour riboflavin urinary excretion]

On the basis of examination of dependence of twenty-four hour riboflavin urinary excretion from its blood plasma level, of interrelation between daily and hour riboflavin urinary excretion, and also the analysis of a level of twenty-four hour riboflavin urinary excretion of persons with a normal riboflavin blood plasma level, the criterion of adequate sufficiency with vitamin B2 of adults on daily riboflavin urinary excretion has been determined, its value approximate 1,1 mg per day.

[Analysis of vitamin C, B2 and A provision in patients with obesity and cardiovascular: comparable data on the basis of foodstuff consumption and blood serum level detection]

Comparative analysis of vitamin C, B2 and A sufficiency evaluation of the patients suffering from obesity and cardiovascular diseases has been done by means of rated vitamin intake on the basis of foodstuff consumption frequency and blood serum level detection. According to both methods the surveyed had optimal sufficiency with vitamin C. At lowered in comparison with recommended receipt of these vitamins with a diet in 56-94% of patients retinol blood serum concentration was within the limits of norm, while only 15% of patients had lowered concerning the bottom border of norm riboflavin blood serum level.

Influence of preconditioning-like hypoxia on the liver of developing methyl-deficient rats

Deficiency in nutritional determinants of homocysteine (HCY) metabolism, such as vitamin B(12) and folate, during pregnancy is known to influence HCY levels in the progeny, which in turn may exert adverse effects during development, including liver defects. Since short hypoxia has been shown to induce tolerance to subsequent stress in various cells including hepatocytes, and as vitamins B deficiency and hypoxic episodes may simultaneously occur in neonates, we aimed to investigate the influence of brief postnatal hypoxia (100% N(2) for 5 min) on the liver of rat pups born from dams fed a deficient regimen, i.e., depleted in vitamins B(12), B(2), folate, and choline. Four experimental groups were studied: control, hypoxia, deficiency, and hypoxia + deficiency. Although hypoxia transiently stimulated HCY catabolic pathways, it was associated with a progressive increase of hyperhomocysteinemia in deficient pups, with a fall of cystathionine beta-synthase activity at 21 days. At this stage, inducible NO synthase activity was dramatically increased and glutathione reductase decreased, specifically in the group combining hypoxia and deficiency. Also, hypoxia enhanced the deficiency-induced drop of the S-adenosylmethionine/S-adenosylhomocysteine ratio. In parallel, early exposure to the methyl-deficient regimen induced oxidative stress and led to hepatic steatosis, which was found to be more severe in pups additionally exposed to hypoxia. In conclusion, brief neonatal hypoxia may accentuate the long-term adverse effects of impaired HCY metabolism in the liver resulting from an inadequate nutritional regimen during pregnancy, and our data emphasize the importance of early factors on adult disease.

MTHFR Gene polymorphisms, B-vitamins and hyperhomocystinemia in young and middle-aged acute myocardial infarction patients

We have examined the prevalence of the C677T and A1298C single nucleotide polymorphisms (SNPs) in the methylenetetrahydrofolate reductase (MTHFR) gene in healthy Tamilians and in patients with acute myocardial infarction and related this polymorphism to plasma homocysteine concentrations, serum folate, serum cobalamin and riboflavin status. The SNPs in the MTHFR gene were determined by polymerase chain reaction-restriction fragment length polymorphism analysis. Plasma homocysteine, serum folate and serum cobalamin concentrations were analyzed using an automated chemiluminescence method and riboflavin status was assessed by measuring the erythrocyte glutathione reductase activity using spectrophotometric method. Out of the 200 young and middle-aged (<48 years) individuals included in the study, 100 were acute myocardial infarction (AMI) patients and 100 were healthy individuals with no documented history of heart diseases. There was a significant increase in homocysteine levels among the AMI patients as compared to the healthy controls (p<0.001). The results of this study indicate that hyperhomocystinemia is more prevalent in Tamilian AMI patients and that the MTHFR C677T and A1298C SNPs are not associated with hyperhomocystinemia. Folate status was found to be within normal range in all the study subjects. There was no correlation between homocysteine and different biochemical variables including cobalamin, folate and riboflavin. However, serum cobalamin was found to be significantly decreased in AMI patients when compared to controls (p<0.001). The simultaneous presence of decreased serum cobalamin status, hyperhomocystinemia and mutant genotype for both the SNPs might lead to an increased risk for the occurrence of AMI. Further intervention trials including the supplementation of cobalamin may prove whether homocysteine level decrease in response to the supplementation of cobalamin in individuals with hyperhomocystinemia and mutant genotype for both the above mentioned SNPs.

Quantification of the bioavailability of riboflavin from foods by use of stable-isotope labels and kinetic modeling

BACKGROUND

Discrepancies have been reported between estimates of the prevalence of riboflavin deficiency based on intakes of riboflavin and estimates based on measures of riboflavin status. One reason for this may be an overestimate of the bioavailability of riboflavin from foods, about which relatively little is known.

OBJECTIVE

We aimed to quantify the bioavailability of riboflavin from milk and spinach by using stable-isotope labels and a urinary monitoring technique and by a plasma appearance method based on kinetic modeling.

DESIGN

Twenty healthy women aged 18-65 y were recruited for a randomized crossover study performed with extrinsically labeled (13C) milk and intrinsically labeled (15N) spinach as sources of riboflavin. An intravenous bolus of labeled riboflavin was administered with each test meal to assess the apparent volume of distribution of riboflavin in plasma.

RESULTS

No significant differences were noted in riboflavin absorption from the spinach meal and from the milk meal according to either the urinary monitoring technique (60 +/- 8.0% and 67 +/- 5.4%, respectively; P = 0.549) or the plasma appearance method (20 +/- 2.8% and 23 +/- 5.3%, respectively; P = 0.670).

CONCLUSIONS

A large fraction of newly absorbed riboflavin is removed by the liver on "first pass." The plasma appearance method therefore underestimates riboflavin bioavailability and should not be used to estimate riboflavin bioavailability from foodstuffs. Urinary monitoring suggests that riboflavin from spinach is as bioavailable as is riboflavin from milk.

The methylenetetrahydrofolate reductase 677C-->T polymorphism as a modulator of a B vitamin network with major effects on homocysteine metabolism

Folates are carriers of one-carbon units and are metabolized by 5,10-methylenetetrahydrofolate reductase (MTHFR) and other enzymes that use riboflavin, cobalamin, or vitamin B6 as cofactors. These B vitamins are essential for the remethylation and transsulfuration of homocysteine, which is an important intermediate in one-carbon metabolism. We studied the MTHFR 677C-->T polymorphism and B vitamins as modulators of one-carbon metabolism in 10,601 adults from the Norwegian Colorectal Cancer Prevention (NORCCAP) cohort, using plasma total homocysteine (tHcy) as the main outcome measure. Mean concentrations of plasma tHcy were 10.4 micromol/liter, 10.9 micromol/liter, and 13.3 micromol/liter in subjects with the CC (51%), CT (41%), and TT (8%) genotypes, respectively. The MTHFR 677C-->T polymorphism, folate, riboflavin, cobalamin, and vitamin B6 were independent predictors of tHcy in multivariate models (P<.001), and genotype effects were strongest when B vitamins were low (P<or=.006). Conversely, the MTHFR polymorphism influenced B vitamin effects, which were strongest in the TT group, in which the estimated tHcy difference between subjects with vitamin concentrations in the lowest compared with the highest quartile was 5.4 micromol/liter for folate, 4.1 micromol/liter for riboflavin, 3.2 micromol/liter for cobalamin, and 2.1 micromol/liter for vitamin B6. Furthermore, interactions between B vitamins were observed, and B vitamins were more strongly related to plasma tHcy when concentrations of other B vitamins were low. The study provides comprehensive data on the MTHFR-B vitamin network, which has major effects on the transfer of one-carbon units. Individuals with the TT genotype were particularly sensitive to the status of several B vitamins and might be candidates for personalized nutritional recommendations.