[Show abstract][Hide abstract] ABSTRACT: Advanced glycoxidation end-products (AGEs) are involved in age-related conditions and diabetic complications. Diet intake contributes to their circulating concentrations.
To measure serum and urinary AGEs in non-diabetic volunteers and relate their concentration to body composition, blood chemistry and dietary ingestion.
We studied 41 adult men (31 middle-aged adults and 10 elderly). A nutritional assessment including a dietary recall designed for detection of AGE ingestion (specifically carboxymethyl-lysine(CML)), and anthropometric measurements were performed. Also serum lipoproteins, insulin, glucose, leptin and C reactive protein (CRP). AGEs were measured in serum and urine samples using size exclusion chromatography and flow injection assay (FIA); the technical procedures were first employed in 11 heterogeneous diabetics, as positive controls for this methodology.
Serum and urinary chromatograms indicated that areas under the curve were not different in younger compared with elderly adults. AGEs did not correlate with dietary intake, body composition, nor metabolic parameters, however they correlated significantly with renal function and CRP concentration.
In these non-diabetic volunteers, with low CML intake, serum and urinary concentration of AGEs were not related to dietary intake. AGEs were related to renal function and CRP, but not to body composition, lipoproteins, insulin and glucose.
Full-text · Article · Feb 2007 · Biological research
[Show abstract][Hide abstract] ABSTRACT: To report the association of lean body mass with nutritional, social and economic factors and its functional consequences in free living healthy elderly subjects.
Healthy elderly subjects of low socioeconomic level were studied. Monthly income, marital status, anthropometric measures and fall risk were assessed. Mini Nutritional Assessment score was calculated. Body composition and bone mineral density were measured by double beam X ray absorptiomentry. Fasting serum lipids, fasting and postprandial insulin and glucose levels were measured. Hand grip, quadriceps and biceps strengths and maximal inspiratory and expiratory pressures were measured.
One hundred and nine subjects (56 women), aged 75 +/- 4 years old were studied. Lean body mass was 34.1 +/- 4 and 49.2 +/- 5.4 kg in women and men respectively (p < 0.001), fat mass was 22.8 +/- 7.1 and 20.7 +/- 6.4 kg in women and men respectively (p= NS). Lean body mass correlated with hand grip, quadriceps and biceps muscle strengths in men and with quadriceps and biceps strength in women. Men that exercised regularly had higher quadriceps strength and maximal expiratory pressure. Total body fat correlated positively with fasting and postprandial serum insulin levels.
In this sample, lean body mass is directly related to muscle strength mostly in men. On the other hand, total fat mass is related to serum insulin levels.
Full-text · Article · Feb 2004 · The Journal of Nutrition Health and Aging
[Show abstract][Hide abstract] ABSTRACT: To assess the effects of a one year nutritional supplementation and resistance training program on muscle strength and walking capacity in the elderly.
Elderly subjects from two outpatient clinics received a nutritional supplement, that provided 400 Kcal, 15 g/protein and 50% of vitamin DRVs per day. Half the subjects receiving and not receiving the supplement were randomly assigned to a resistance exercise training program with two sessions per week. Every six months, body composition using DEXA, limb muscle strength, maximal inspiratory and expiratory pressures and walking capacity were assessed.
One hundred forty nine subjects were considered eligible and 101 (31 supplemented and trained, 28 supplemented, 16 trained and 26 without supplementation nor training) completed the year of follow up. Overall compliance with the supplement was 48 22 % and trained subjects attended 56 21% of programmed sessions. No changes in fat free mass were observed in any of the groups, but fat mass increased from 22.5 7.3 to 23.2 7.3 kg in all groups (p < 0.001). Upper and lower limb strength and walking capacity increased significantly in trained subjects whether supplemented or not. Maximal inspiratory pressure and right hand grip strength increased only in the supplemented and trained group.
Resistance training improved muscle strength and walking capacity.
Full-text · Article · Jan 2004 · The Journal of Nutrition Health and Aging
[Show abstract][Hide abstract] ABSTRACT: Body composition changes and loss of functionality in the elderly are related to substandard diets and progressive sedentariness. The aim of this study was to assess the impact of an 18-mo nutritional supplementation and resistance training program on health functioning of elders. Healthy elders aged > or = 70 y were studied. Half of the subjects received a nutritional supplement. Half of the supplemented and nonsupplemented subjects were randomly assigned to a resistance exercise training program. Every 6 mo, a full assessment was performed. A total of 149 subjects were considered eligible for the study and 98 (31 supplemented and trained, 26 supplemented, 16 trained and 25 without supplementation or training) completed 18 mo of follow-up. Compliance with the supplement was 48%, and trained subjects attended 56% of programmed sessions. Activities of daily living remained constant in the supplemented subjects and decreased in the other groups. Body weight and fat-free mass did not change. Fat mass increased from 22.2 +/- 7.6 to 24.1 +/- 7.7 kg in all groups. Bone mineral density decreased less in both supplemented groups than in the nonsupplemented groups (ANOVA, P < 0.01). Serum cholesterol remained constant in both supplemented groups and in the trained groups, but it increased in the control group (ANOVA, P < 0.05). Upper and lower limb strength, walking capacity and maximal inspiratory pressure increased in trained subjects. In conclusion, patients who were receiving nutritional supplementation and resistance training maintained functionality, bone mineral density and serum cholesterol levels and improved their muscle strength.
No preview · Article · Sep 2001 · Journal of Nutrition
[Show abstract][Hide abstract] ABSTRACT: Background: Liver damage is more prevalent among obese alcoholics, and cytochrome P-450-2E1(CYP2E1) induction is involved in its pathogenesis. Objectives: The study was undertaken to assess microsomal function, in alcoholic and nonalcoholic male subjects with different body compositions, through pharmacokinetics of chlorzoxazone (CLZ). We also intended to study the relationship between CLZ hydroxylation and urinary levels of 8-hydroxydiguanosine, and between CLZ levels and liver histology. Methods: Serial measurements of CLZ serum concentration, after a 750 mg dose, were performed in 17 alcoholics (9 normal weight and 8 obese) and 21 nonalcoholic subjects (10 normal weight and 11 obese). Concentration of 6-hydroxy-chlorzoxazone (6-OH-CLZ) was determined at the second hour. Anthropometry, clinical laboratory tests, and urinary 8-hydroxydiguanosine concentrations were measured. Liver biopsies were performed in alcoholics. Results: Five biopsies revealed severe lesions, one in normal-weight and four in obese patients (p = NS). Area under the curve (AUC) of CLZ was higher in normal-weight controls compared with the rest of the groups (ANOVAp = 0.001). This parameter correlated negatively with adiposity in nonalcoholic subjects and did not correlate with liver histology. 6-OH-CLZ/CLZ ratio was lower in normal-weight controls, compared with obese subjects and normal-weight alcoholics (p = 0.02). Both alcoholism and obesity were included as predictors of CLZ AUC in a multiple regression analysis. The two-factor ANOVA showed an additive effect of centripetal body fat distribution and alcoholism. Urinary 8-hydroxydiguanosine levels were extremely variable. Conclusions: Centripetal adiposity and alcoholism are associated with induction of CYP2E1. This may explain the higher prevalence of liver damage among obese alcoholics and also nonalcoholic steatohepatitis.
No preview · Article · May 2000 · Alcoholism Clinical and Experimental Research
[Show abstract][Hide abstract] ABSTRACT: Alcoholism is a serious public health problem in Chile and the best treatment strategy for this problem is far from being clear.
To assess the long term results of an alcoholism rehabilitation program.
One hundred eighty two alcoholics admitted for treatment of their alcoholism were followed during two years in a special clinic. The effects of length of alcoholism, withdrawal symptoms on admission and the presence of histological liver damage on long term outcome were assessed using life table analysis.
During the two years period, 75% of patients were lost from control and 63% relapsed in their alcoholic ingestion. None of the above mentioned parameters had an effect on relapse or loss from follow up.
There are high attrition and failure rates and the length of alcoholism, degree of initial withdrawal and liver damage do not influence the long term results of this program.
No preview · Article · Apr 1997 · Revista medica de Chile
[Show abstract][Hide abstract] ABSTRACT: An elevation of serologic markers of hepatic fibrogenesis has been reported in liver diseases of different etiologies. Among these, the N-terminal type III procollagen (P-III-P) and the P1 proteolytic fragment of laminin (P1 laminin) increase in alcoholic liver damage, in proportion to the progression of this condition.
To study serum levels of P-III-P and P1 laminin in asymptomatic alcoholics with and without liver damage and decompensated alcoholic cirrhotics, compared to normal controls.
Serum P-III-P and laminin levels were measured in asymptomatic alcoholics during detoxification treatment. Liver biopsies were obtained, in order to detect liver damage, which was graded with a numeric score, considering values over 6 as severe damage. Serum fibrogenesis markers were also measured in a group of decompensated alcoholic cirrhotics.
P-III-P levels were significantly higher in cirrhotic patients compared to alcoholics with or without liver damage and to normal controls. Laminin was not different between groups. P-III-P did not correlate with histologic score in asymptomatic patients.
In this study P-III-P and P1 laminin were not usefull discriminators of severe liver damage among asymptomatic alcoholics; their levels were found to rise significantly only when liver disease has become clinically evident.
No preview · Article · Feb 1997 · Revista medica de Chile
[Show abstract][Hide abstract] ABSTRACT: Excessive ethanol ingestion induces hypoandrogenism in male subjects. To confirm its presence and to study its relationship with the degree of liver damage and alcohol abstinence, plasma sex hormones were measured in alcoholic patients without liver failure, after two different abstinence periods. Patients were 30 male chronic alcoholics admitted to the Alcoholism Ward for treatment of their addiction. On admission, we measured: testosterone (T), estradiol (E), follicle stimulating hormone (FSH), luteinizing hormone (LH) and sex-hormone binding globulin (SHBG). A liver biopsy was also performed. These measurements were repeated at discharge and were also done in 15 normal volunteers. On admission (mean abstinence 1.9 +/- 1.7 days) total T was similar to controls, FSH was lower (p < 0.02) and high levels of SHBG were found (3.5 fold increase, as compared to controls). Histologically, 9 patients had normal liver; 14 had moderate alterations and 7 showed marked alterations. Hormonal values were not different in these 3 groups. At discharge, 11.1 +/- 4.7 days after admission, T, E and FSH did not show significant changes but LH decreased (8.2 +/- 5.2 mIU/ml vs 12.9 +/- 4.1, p < 0.001); SHBG also decreased (65.4 +/- 21.6 nmol/l vs 117.2 +/- 33.3, p < 0.001) to values that still were twice those of controls. It is concluded that alcoholic patients without clinical signs of liver failure have normal plasma testosterone levels, irrespective of their histologic liver alterations and high plasma SHBG levels that decreased significantly after a short abstinence. The concomitant LH decrease suggests that hypoandrogenism is likely in these patients. Fast changes in SHBG levels rise the possibility that this protein is candidate marker of alcoholism.
No preview · Article · Sep 1995 · Journal of endocrinological investigation
[Show abstract][Hide abstract] ABSTRACT: Alcohol ingestion promotes lipoperoxidation and alters cellular antioxidant mechanisms. Alpha-tocopherol levels decrease in alcoholics as severity of liver damage increases. The aim of this protocol was to study the effects of a long-term oral 500 mg vitamin E daily supplementation in decompensated ambulatory alcoholic cirrhotics.
67 subjects were included in this double blind trial; 33 patients received vitamin E and 34 patients received placebo tablets of identical appearance during 1 year. Each month, the patients were seen by a nurse practitioner who was in charge of detecting alcohol ingestion and checking adherence to treatment. Every 3 months, the patients underwent a medical examination, and blood samples were taken for clinical laboratory analysis and serum vitamin E measurement.
Alpha-tocopherol levels were significantly lower in patients with more severe liver disease. This difference was not significant when vitamin E levels were corrected by cholesterol. Oral supplementation significantly increased serum vitamin E levels in the experimental group. Alcohol ingestion and hospitalization rates were similar in both groups. Life table analysis did not show significant differences in mortality between the two groups.
Vitamin E supplementation with adequate doses of an alpha-tocopheryl acetate formulation during 1 year did not influence hepatic laboratory parameters, mortality or hospitalization rates of decompensated alcoholic cirrhotics, although serum levels of the vitamin significantly increased.
No preview · Article · May 1995 · Journal of the American College of Nutrition
[Show abstract][Hide abstract] ABSTRACT: This study was designed to measure the effect of chronic alcohol intake on leucine turnover in outpatients with stable alcoholic liver cirrhosis.
Protein turnover rate was measured using L [1-14C] leucine in ten outpatients with proven alcoholic cirrhosis and in five healthy controls. After the performance of the turnover, the patients were divided in two groups depending on the evidence of alcohol ingestion in the previous month.
Non-abstinent patients had a significantly higher leucine flux and non-oxidative disposal (73.8 +/- 25.4 and 65.9 +/- 21.6) than abstinent cirrhotic patients (48.9 +/- 9.5 and 43.7 +/- 9.0) and normal controls 37.3 +/- 8.9 and 31.1 +/- 7.6 mumol/m2/min (p < 0.01). Leucine oxidation and serum leucine levels were similar in the three groups.
Alcohol intake in alcoholic cirrhotic patients has a catabolic effect that could be associated with the nutritional imbalances observed in alcoholic liver disease.
No preview · Article · Mar 1995 · Journal of the American College of Nutrition
[Show abstract][Hide abstract] ABSTRACT: We studied leucine turnover using a primed infusion of [1-14C]-L-leucine and glucose turnover using a primed infusion of [6-3H]-D-glucose in five alcoholic patients without liver damage and five age-matched controls. Infusions were maintained for 6 hr, and at the end of the 3rd hour, a 0.8 g/kg iv ethanol load was administered in 20 min. Leucine flux, nonoxidative disposal and oxidation rates, and glucose rate of appearance were calculated during the 3rd and 6th hours of infusion. Ethanol disappearance rate and the percentage completely metabolized to CO2 and H2O in 3 hr were also calculated. Compared with controls, alcoholics had significantly higher basal leucine flux (55.6 +/- 12 vs. 37.3 +/- 9.3 microM/m2/min) and nonoxidative disposal (48.7 +/- 8.7 vs. 31.1 +/- 7.5 microM/m2/min). No differences were observed in basal glucose appearance rates in alcoholics and controls (397.6 +/- 115.2 vs. 349.4 +/- 120.6 microM/m2/min). Compared with controls, alcoholics had a higher alcohol disappearance rate (2.72 +/- 0.59 vs. 1.84 +/- 0.43 mM/kg/min) and percentage of ethanol metabolized to CO2 and H2O in 3 hr (40.6 +/- 10.2 vs. 22.9 +/- 6.9%). After the ethanol load, both leucine turnover and glucose rate of appearance decreased significantly only in alcoholics. There was a positive correlation between the change in leucine flux and ethanol disappearance rate and percentage metabolized to CO2 and H2O in alcoholics.
No preview · Article · Jan 1994 · Alcoholism Clinical and Experimental Research
[Show abstract][Hide abstract] ABSTRACT: Looking for a noninvasive method to predict liver histologic alterations in alcoholic patients without clinical signs of liver failure, we studied 187 chronic alcoholics recently abstinent, divided in 2 series. In the model series (n = 94) several clinical variables and results of common laboratory tests were confronted to the findings of liver biopsies. These were classified in 3 groups: 1. Normal liver; 2. Moderate alterations; 3. Marked alterations, including alcoholic hepatitis and cirrhosis. Multivariate methods used were logistic regression analysis and a classification and regression tree (CART). Both methods entered gamma-glutamyltransferase (GGT), aspartate-aminotransferase (AST), weight and age as significant and independent variables. Univariate analysis with GGT and AST at different cutoffs were also performed. To predict the presence of any kind of damage (Groups 2 and 3), CART and AST > 30 IU showed the higher sensitivity, specificity and correct prediction, both in the model and validation series. For prediction of marked liver damage, a score based on logistic regression and GGT > 110 IU had the higher efficiencies. It is concluded that GGT and AST are good markers of alcoholic liver damage and that, using sample cutoffs, histologic diagnosis can be correctly predicted in 80% of recently abstinent asymptomatic alcoholics.
No preview · Article · May 1993 · Revista medica de Chile
[Show abstract][Hide abstract] ABSTRACT: A hand dynamometer was used to measure muscle strength in 207 patients admitted to the Gastroenterology service of a general hospital. Validation of international standards in a normal population of both sexes and different ages revealed that our normals perform at the 25% percentile of international values. Results were correlated with other measurements of nutritional status, namely anthropometric measurements, serum albumin level and tuberculin test. Compared to normals, muscle strength was significantly (p < 0.01) lower in patients with body mass index under 19, cutaneous tricipital folding < 85%, brachial circumference < 85%, and serum albumin < 3.5 g/dl. No difference in muscle strength between tuberculin positive or negative subjects was observed. None of the nutritional parameter was helpful to predict complications in patients submitted to surgery. Thus, muscle strength is a useful parameter to evaluate nutritional status but, similar to other measurements, is not predictive of surgical complications.
No preview · Article · Jun 1992 · Revista medica de Chile
[Show abstract][Hide abstract] ABSTRACT: A preoperative nutritional assessment including anthropometry, biochemical indices and global subjective assessment was performed for 127 patients admitted for elective gastrointestinal surgery. Of these, 24 were subjected to minor surgery, 65 to intermediate surgery and 38 to major procedures. Patients were followed postoperatively, recording complications or mortality. Intermediate and major surgery patients had lower triceps skinfold thickness and mid-arm circumference and greater weight loss than did minor surgery patients. Thirty-six percent of the patients suffered complications. No association was found between preoperative nutritional status and incidence of postoperative complications. Six patients died and they showed greater preoperative weight loss (21 +/- 6.5 vs 12 +/- 1.4%) and lower serum albumin levels (25 +/- 4 vs 35 +/- 1 g/l) than patients who survived complications. Global subjective assessment classified 43% of survivors as malnourished, compared to 100% of patients who died.
No preview · Article · Mar 1992 · Journal of the American College of Nutrition
[Show abstract][Hide abstract] ABSTRACT: Subject global assessment of nutritional status was performed on 175 patients admitted to the medical-surgical gastroenterology service of a general hospital by a first-year resident and a specialist in clinical nutrition who were not aware of each other's evaluation. Patients were classified as well nourished or moderately or severely undernourished. Simultaneously, anthropometry was performed, serum albumin measured, and two units of PPD inoculated. A 79% concordance between the global subjective assessments made by the residents and the specialists was found. Patients in the three groups had significantly different weight, midarm circumference, triceps skinfold, and serum albumin values, whereas the total lymphocyte count and the percentage of negative PPD reactions were not significantly different. Subjective global assessment is a useful tool for the evaluation of nutritional status, even when used by inexperienced professionals.
[Show abstract][Hide abstract] ABSTRACT: We evaluated the results of essential amino acids supplementation added to a protein restricted diet (0.6 g/kg/day) in patients with advanced renal failure (creatinine clearance under 20 ml/min). A diet containing food with high biologic value was used as control. Diets were tested during 7 months. Anthropometric and nutritional (serum albumin and transferrin) values were normal in both groups both at the beginning and at the end of the treatment period. A slight increase in weight in the natural diet group and in serum phosphorus level in the amino acid supplemented group was observed. Two patients in each group required chronic dialysis, renal function remaining stable in the rest. We conclude that both forms of diet supplementation were effective in preserving nutritional status possibly in delaying deterioration of renal function in patients with advanced renal failure.
No preview · Article · Apr 1990 · Revista medica de Chile
[Show abstract][Hide abstract] ABSTRACT: The effects of a nutritional support in hospitalized patients with alcoholic cirrhosis and liver failure were studied in a controlled protocol. Thirty-six patients were included, 17 were randomly assigned to an experimental group and the rest to a control group. Experimentals received a diet aiming at 50 kcal (209 kJ)/kg bodyweight/d and 1.5 g protein/kg bodyweight/d (as proteins of high biological value). Controls received the standard diet prescribed by the attending physician. The severity of liver failure and the nutritional status on admission were similar in both groups. The measured energy intake in controls was 1813 +/- 121 kcal/d (7589 +/- 506 kJ/d) and 2707 +/- 71 kcal/d (1131 +/- 297 kJ/d) in experimentals (P less than 0.001). The protein intake in controls was 47 +/- 3.8 g/d and in experimentals 80 +/- 3 g/d (P less than 0.001). There were seven deaths during the study period (two experimentals and five controls). No differences were observed in the evolution of liver failure, hepatic encephalopathy or nutritional status between both study groups. It is concluded that a higher energy and protein intake in these patients does not have adverse effects and is associated with a non-significant reduction in mortality.
No preview · Article · Oct 1989 · European Journal of Clinical Nutrition
[Show abstract][Hide abstract] ABSTRACT: Glucose intolerance is frequently found in alcoholic patients and an impaired insulin response has been documented in them. To look for alternative mechanisms that could explain this intolerance, a glucose turnover using tritiated glucose and an euglycemic glucose clamp were performed to measure the glucose production rate and peripheral insulin sensitivity, respectively. Two groups of recently abstinent chronic male alcoholic patients without evidence of liver damage were studied. The glucose turnover technique showed a higher basal glucose production rate in alcoholics, compared with normal volunteers (2.83 +/- 0.29 vs. 1.84 +/- 0.22 mg/kg/min); an intravenous ethanol load significantly increased this rate. The euglycemic glucose clamp did not show peripheral insulin resistance in alcoholics, compared with controls.
No preview · Article · Feb 1989 · Annals of Nutrition and Metabolism