Vitamin metabolism in children with insulin-dependent diabetes mellitus.
Effect of length of illness, severity, and degree of disruption of substance metabolism
Vopr Med Khim (RUSSIA) Jul-Aug 1994, 40 (4) p33-8
Correlation between the state of vitamin metabolism and the impairments in carbohydrate,
lipid and protein metabolism was studied in 35 children of 9-13 years of age with
diabetes mellitus of various severity standing for up to 7 years. Deterioration
of riboflavin metabolism in insulin-dependent diabetes mellitus, expressed as an
increase of the vitamin excretion with urine, was augmented with prolongation of
the disease duration; the deterioration was sometimes related to the value of glycemia
and glucosuria, being the indicative symptom of the disease. In spite of some limitations
in validity of experiments related to insufficient number of children in some groups,
a decrease in excretion of 1-methyl nicotinamide with urine was detected in all
the children with the comatose state, in acidoketosis and glucosuria (above 20 g/day),
whereas normal content of nicotinamide coenzymes was found in erythrocytes. Deficiency
in vitamins B1, B6 and C was observed more often (5-100%) in children with elevated
content of cholesterol as compared with 7-67% of children exhibiting normal level
of cholesterol. Optimization of vitamins B and C consumption in children as well
as use of any means for correction of these vitamins deficiency are discussed.
[Metabolism of B group vitamins in patients with insulin-dependent and
non-insulin dependent forms of diabetes mellitus]
Vopr Med Khim (RUSSIA) Sep-Oct 1993, 39 (5) p26-9
Metabolism of vitamins B, involving evaluation of these vitamins content in blood
and excretion of their metabolites with urine, was studied in adult healthy persons
as well as in patients with insulin-dependent and -independent forms of diabetes
mellitus. Distinct alterations in metabolism of vitamin B2 were detected in the
insulin-dependent diabetes: its content in erythrocytes and the rate of excretion
with urine were increased. This phenomenon made some problems in evaluation of riboflavin
consumption in patients with diabetes mellitus of the I type, while parameters of
vitamin consumption in insulin-independent diabetes were similar to those of healthy
persons. Parameters of metabolism of vitamins B1, B6 and PP were not different in
patients with insulin-dependent and -independent forms of diabetes mellitus. Rates
of excretion of 4-pyridoxic acid, 1-methyl nicotinamide, thiamine with urine as
well as concentration of the corresponding vitamins in blood were similar to those
parameters of healthy persons.
[Patients with type-II diabetes mellitus and neuropathy have nodeficiency
of vitamins A, E, beta-carotene, B1, B2, B6, B12 and folic acid]
Med Klin (GERMANY) Aug 15 1993, 88 (8) p453-7
The present study was aimed to determine the vitamin status of vitamins A, E,
beta-carotene, B1, B2, B6, B12 and folate in plasma using HPLC and vitamins B1,
B2 and B6 in erythrocytes using the apoenzyme stimulation test with the Cobas-Bio
analyzer in 29 elderly type II diabetic women with (G1: n = 17, age: 68.6 3.2 years)
and without (G2: n = 12, age: 71.8 2.7 years) diabetic polyneuropathy. The basic
parameters as age, hemoglobin A1c, fructosamine and duration of the disease did
not differ in both groups. Furthermore, retinopathy was assessed with fundoscopy
and nephropathy with creatinine clearance. The creatinine clearance (G1: 50.6 3.4
vs. G2: 63.6 3.7 ml/min, 2p < 0.025) and the percentage of retinopathy (G1: 76.5%
vs. G2: 16.7%, 2p = 0.002) were different indicating that G1 had significantly more
severe late complications than G2. Current plasma levels of all measured vitamins
(A, E, beta-carotene, B1, B2, B6, B12 and folate) and the status of B1, B2 and B6
in erythrocytes did not vary between the two groups (2p > 0.1). In summary, we found
a lack of association between the actual vitamin condition in plasma and erythrocytes
and diabetic neuropathy.
Tissue concentrations of water-soluble vitamins in normal and diabetic
rats.
Int J Vitam Nutr Res (SWITZERLAND) 1993, 63 (2) p140-4
Changes in circulating and tissue concentrations of several vitamins have been
reported in diabetic animals and human subjects. In this study, the effect of short-term
(2 weeks) streptozotocin diabetes on folate, B6, B12, thiamin, nicotinate, pantothenate,
riboflavin and biotin in liver, kidney, pancreas, heart, brain and skeletal muscle
of rats was investigated. The tissue distribution of vitamins varied widely in normal
rats. Diabetes significantly lowered folate in kidney, heart, brain, and muscle;
B6 in brain; B12 in heart; thiamin in liver and heart; nicotinate in liver, kidney,
heart and brain; pantothenate in all tissues; riboflavin in liver, kidney, heart,
and muscle. These results indicate that experimental diabetes causes a depression
of several water-soluble vitamins in various tissues of rats.
Malnutrition in geriatric patients: diagnostic and prognostic significance
of nutritional parameters.
Ann Nutr Metab (SWITZERLAND) 1992, 36 (2) p97-112
Nutritional status was assessed in 300 geriatric patients aged 75 years or more
using clinical, anthropometric, biochemical and immunologic methods. Relations between
different assessment methods and their prognostic significance with regard to 18-month
mortality were examined. For biochemical variables 10% (prealbumin, vitamin B6)
to 37% (vitamins A and C) were below conventional limits. In 44% of the patients
lymphocytes were diminished. 44% were anergic. Judgement of nutritional status by
clinical impression resulted in 22% being deemed undernourished. Clinical diagnosis
of undernutrition was associated with low anthropometric measurements (p less than
0.05 for all parameters) and a high prevalence of low biochemical values (p less
than 0.05 for albumin, prealbumin, transferrin, vitamin A, vitamin B1). The mean
values of all anthropometric variables, plasma proteins, vitamins A and C were significantly
lower in patients who died within the following 18 months compared to survivors.
The greatest prognostic significance was related to the clinical diagnosis of malnutrition.
We conclude that clinical assessment is useful for the evaluation of nutritional
status in geriatric patients and the best of numerous nutritional parameters to
estimate risk of long-term mortality.
Drug therapy during pregnancy.
Curr Opin Obstet Gynecol (UNITED STATES) Feb 1992, 4 (1) p43-7
A randomized prospective trial has shown that folic acid started before conception
and continued for the first trimester reduces the risk of recurrence of neural tube
defects by 72% in women with a previously affected child. Carbamazepine exposure
in utero is associated with a 1% risk of spina bifida. Long-term follow-up of antenatal
exposure to phenobarbital and carbamazepine in two groups of infants shows no neurologic
differences between the two groups. Magnesium sulfate is more effective in prevention
of recurrent eclamptic seizures than phenytoin. During pregnancy, the need for thyroxine
increases in many women. Vitamin B6 and ginger are both effective for nausea and
vomiting in early pregnancy. Low-dose aspirin does not change the course of preeclampsia
when it is started after the diagnosis is made. Angiotensin-converting enzyme inhibitors
cause significant disturbances of fetal and neonatal renal function. Prophylactic
beta-adrenergic agents fail to prevent prematurity in twins. Oral tocolysis with
magnesium chloride or ritodrine is no more effective than observation alone. The
risk of primary pulmonary hypertension in the newborn after indomethacin tocolysis
is increased with prolonged therapy. Lithium causes polyhydramnios from fetal diabetes
insipidus in utero. Treatment of Ureaplasma urealyticum infection with erythromycin
during pregnancy does not eliminate the organism from the lower genital tract and
does not improve perinatal outcome. (21 Refs.)
Changes on levels of B6 vitamin and aminotransferase in the liver of diabetic
animals.
Diabetes Res Clin Pract (NETHERLANDS) May-Jun 1990, 9 (2) p109-14
We measured aminotransferase activity and vitamin B6 content in the livers of
diabetic mice. Two different types of mice were used for the measurements, spontaneously
non-obese diabetic (NOD) or alloxan-induced diabetic (Allo) mice, and control mice
were either non-diabetic NOD or Institute of Cancer Research (ICR). The liver of
diabetic mice had more aspartate aminotransferase (AST) activity than those of normal
mice. The diabetic livers also had more vitamin B6 than did normal livers, and pyridoxamine
(PM) levels were particularly high but pyridoxal (PL) levels were not. ICR livers
showed hepatic alanine aminotransferase activities inversely correlated with blood
glucose concentrations, while diabetic livers did not. The abundance of AST and
B6 in the diabetic liver is consistent with the great need for gluconeogenic substrate
there. This is understandable in that most aminotransferases require B6 vitamins,
and especially the correlation between s-AST and PM levels was recognized in the
diabetic liver. Conversely, the AST and PM levels were negatively correlated in
normal mice. A metabolic shift towards gluconeogenesis apparently produces more
B6 and PM while it induced holo-AST synthesis.
[Hemochromatotic cirrhosis complicating pyridoxine-sensitive hereditary
sideroblastic anemia. Case report]
Ann Med Interne (Paris) (FRANCE) 1983, 134 (4) p327-32
A further case of sporadic congenital sideroblastic anaemia is reported. Despite
no contributing factors such as blood transfusion, oral ingestion of iron or alcoholic
beverages, were present excessive iron stores occurred with consecutive tissue damage
resulting in cirrhosis of the liver, portal hypertension and diabetes mellitus.
HLA phenotype was A3 B7 as in primary hemochromatosis. Correction of anemia was
obtained by vitamin B6 administration. Improvement of iron overload was achieved
through the use of daily subcutaneous infusions of the iron chelating drug desferrioxamine
with a portable infusion pump.
[Vitamin status in diabetic neuropathy (thiamine, riboflavin, pyridoxin,
cobalamin and tocopherol)]
Z Ernahrungswiss (GERMANY, WEST) Mar 1980, 19 (1) p1-13
Investigations on the vitamin pattern of diabetic neuropathy: thiamine, riboflavin,
pyridoxine, cobalamin and tocopherol. The contents of the vitamins mentioned above
have been measured in the blood of 119 patients (53 diabetic neuropathies, 66 diabetics
without neuropathy). The incidence of neuropathy shows a strong correlation with
the duration of the diabetic state, but not with sex, nor with concomitant diseases
such as adipositas, hypertension, heart and circulatory diseases, except retinopathia
diabetica. Most of the diabetics in our study are well supplied with vitamins B1,
B2, and E; B6 and B12 are occasionally low, but there is no statistically relevant
difference between diabetic controls and neuropathies. Adipose patients have neither
a markedly different vitamin content nor a different calory uptake from non-adipose
patients. A general trend towards reduced total calory uptake is seen in old age,
men (lower protein intake) and women (lower carbohydrate intake) obviously differing
somewhat in their habits. The influence of therapy on the vitamin pattern is not
clear cut, except for patients under diet and biguanide-therapy showing a higher
proportion of low or subnormal B12 values. The increased frequency of neuropathies
in patients treated with sulfonyl-urea approaches only the limits of significance
and needs further investigations.
Failure of pyridoxine to improve glucose tolerance in diabetics.
J Clin Endocrinol Metab (UNITED STATES) Jan 1980, 50 (1) p198-200
A study was undertaken to test the effect of pyridoxine supplementation on glucose
tolerance in diabetes mellitus. Thirteen adult maturity-onset diabetics were studied.
Seven were vitamin B6 deficient, as assessed by the stimulation of erythrocyte glutamic
oxaloacetic transaminase in vitro by pyridoxal phosphate. All patients received
pyridoxine hydrochloride (40 mg twice daily) for 3 weeks. Pyridoxine supplmentation
did not bring about any significant alterations in either the oral glucose tolerance
or the insulin response to glucose.
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