Increase of electronegative-LDL-fraction ratio and IDL-cholesterol in chronic kidney disease patients with hemodialysis treatment

Background

It is known that the increased level of IDL and oxidized LDL are associated with risk of cardiovascular disease, and the lipoprotein abnormalities accelerate atherosclerosis. Cardiovascular disease is a major cause of mortality in chronic kidney disease patients with hemodialysis treatment (HD-Ps). Therefore, the estimation of lipoprotein profiles is important for prevention of cardiovascular disease in HD-Ps. We previously established an anion-exchange chromatographic method for measurement of cholesterol level in subclasses of HDL and LDL, IDL, VLDL, and chylomicron. An electronegative-LDL-fraction contained minimally oxidized-LDL. Lipoprotein profile can be accurately and conveniently determined by the new method.

Finding

In this study, lipoprotein profiles in HD-Ps and age-matched healthy subjects were estimated by using our established anion-exchange chromatographic method. The ratio of electronegative-LDL-cholesterol to total LDL-cholesterol and IDL-cholesterol in HD-Ps were significant higher than those in healthy subjects.

Conclusions

The results suggest that the ratio of electronegative-LDL-cholesterol to total LDL-cholesterol and IDL-cholesterol obtained by the new method may serve as useful markers for risk of cardiovascular disease in HD-Ps.

The Underlying Mechanisms for Olanzapine-induced Hypertriglyceridemia

Olanzapine is an efficacious antipsychotic drug often used in the treatment for schizophrenia or bipolar disorder, however, sometimes induces metabolic disorders. We will introduce a patient with bipolar disorder, who has been treated by olanzapine and showed severe hypertriglyceridemia. As a result of measurements of parameters associated with lipid metabolism, very-low density lipoprotein was most important lipoprotein for olanzapin-induced hypertriglyceridemia. The cessation of olanzapine significantly decreased high-sensitivity C-reactive protein and increased adiponectin, proposing that inflammation and reduced adiponectin level may be associated with olanzapin-induced hypertriglyceridemia.

Therapeutic Application of Diacylglycerol Oil for Obesity: Serotonin Hypothesis

Characteristics for the serum lipid abnormalities in the obesity/metabolic syndrome are elevated fasting, postprandial triglyceride (TG), and decreased high-density lipoprotein-cholesterol (HDL-C). Diacylglycerol (DAG) oil ingestion has been reported to ameliorate postprandial hyperlipidemia and prevent obesity by increasing energy expenditure, due to the intestinal physiochemical dynamics that differ from triacylglycerol (TAG). Our study demonstrated that DAG suppresses postprandial increase in TG-rich lipoprotein, very low-density lipoprotein (VLDL), and insulin, as compared with TAG in young, healthy individuals. Interestingly, our study also presented that DAG significantly increases plasma serotonin, which is mostly present in the intestine, and mediates thermogenesis, proposing a possible mechanism for a postprandial increase in energy expenditure by DAG. Our other study demonstrated that DAG suppresses postprandial increase in TG, VLDL-C, and remnant-like particle-cholesterol, in comparison with TAG in an apolipoprotein C-II deficient subject, suggesting that DAG suppresses postprandial TG-rich lipoprotein independently of lipoprotein lipase. Further, to understand the molecular mechanisms for DAG-mediated increase in serotonin and energy expenditure, we studied the effects of 1-monoacylglycerol and 2-monoacylglycerol, distinct digestive products of DAG and TAG, respectively, on serotonin release from the Caco-2 cells, the human intestinal cell line. We also studied effects of 1- and 2-monoacylglycerol, and serotonin on the expression of mRNA associated with β-oxidation, fatty acids metabolism, and thermogenesis, in the Caco-2 cells. 1-monoacylglycerol significantly increased serotonin release from the Caco-2 cells, compared with 2-monoacylglycerol by approximately 40%. The expression of mRNA of acyl-CoA oxidase (ACO), fatty acid translocase (FAT), and uncoupling protein-2 (UCP-2), was significantly higher in 1-MOG-treated Caco-2 cells, than 2-MOG-treated cells. The expression of mRNA of ACO, medium-chain acyl-CoA dehydrogenase, FAT, and UCP-2, was significantly elevated in serotonin-treated Caco-2 cells, compared to cells incubated without serotonin. In conclusion, our clinical and in vitro studies suggested a possible therapeutic application of DAG for obesity, and obesity-related metabolic disorders.Key words: Diacylglycerol, intestine, obesity, serotonin, thermogenesis

Serotonin levels in platelet-poor plasma and whole blood in people with type 2 diabetes with chronic kidney disease

AIMS

Patients with diabetes mellitus (DM) are prone to atherosclerosis. Atherosclerosis activates platelets; activated platelets release serotonin, and therefore, evaluation of serotonin levels in blood could be a valuable biomarker for future risk of cardiovascular events.

METHODS

Plasma serotonin levels obtained from patients with DM complicated with chronic kidney disease were measured using HPLC and were compared to serotonin levels of healthy control subjects. Patients with DM were classified into 2 subgroups of mildly (group 1) and moderately/severely (group 2) impaired renal function.

RESULTS

Serotonin concentration in platelet-poor plasma for group 1 was significantly higher than that of healthy control subjects (p < 0.01), and was significantly higher than that of patients from group 2 (p < 0.05). The concentration of serotonin in whole blood for group 2 patients was significantly lower than that measured from healthy control subjects (p < 0.01). The ratio of the plasma to whole blood level was significantly elevated in both groups 1 and 2 compared with healthy controls (p < 0.01).

CONCLUSIONS

Our results indicate that platelets are activated to release serotonin into plasma in diabetic patients with mildly impaired renal function. When renal damage is advanced, platelets are over-activated to release serotonin.

Release reaction of brain-derived neurotrophic factor (BDNF) through PAR1 activation and its two distinct pools in human platelets

Brain-derived neurotrophic factor (BDNF) is a cytokine that plays important roles in the survival, development, and plasticity of neurons. BDNF is also expressed in peripheral tissues and cells. In this article, we report the BDNF release reaction through thrombin stimulation and its localization in human platelets. Platelets from healthy volunteers were subjected to PAR1-AP or PAR4-AP stimulation. Release of BDNF was measured by ELISA. Localization of BDNF in resting and thrombin-activated platelets was examined by immunoelectron microscopy and sucrose gradient ultracentrifugation following western blotting. BDNF was released dose-dependently with PAR1-AP concentrations with drastic release at low PAR1-AP concentrations and gently release at high PAR1-AP concentrations. Maximum BDNF release was approximately 37% at 132 μM PAR1-AP. In contrast, 3.8% BDNF was released with 1.13 mM PAR4-AP stimulation. In immunoelectron microscopy and sucrose gradient ultracentrifugation analyses, BDNF was detected not only in α-granules but also cytoplasm in of the resting platelets, and it was distributed in the swollen open canalicular system fused to α-granules at 1 min and disappeared at 5 min after stimulation by thrombin. However, BDNF in cytoplasm remained throughout platelet activation. In conclusions, we demonstrate that BDNF is released from platelets through predominately PAR1 regulation. Furthermore, we identified two pools of BDNF in the α-granules and cytoplasm of human platelets, and only BDNF in α-granules is released through platelet activation.

Profiles of inflammatory markers and lipoprotein subclasses in patients undergoing continuous ambulatory peritoneal dialysis

BACKGROUND

Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) often have inflammation and dyslipidemia that accelerate to atherosclerosis. This study aimed to evaluate chronic inflammation and dyslipidemia in CAPD patients.

METHODS

We measured inflammatory markers and lipoprotein subclasses in 20 CAPD patients (12 men and 8 women, aged 59.5 ± 9.9 y) and 20 gender-matched controls. Lipoproteins were separated by high-performance liquid chromatography (HPLC) using an anion-exchange column.

RESULTS

High-sensitivity C-reactive protein and serum amyloid A protein (SAA) were higher among CAPD patients vs. controls (1.6 ± 2.2 vs. 0.8 ± 1.2 mg/l, p<0.05; 11.9 ± 12.8 vs. 4.5 ± 2.4 mg/l). HPLC analysis revealed that chylomicron, VLDL, and IDL cholesterol levels were higher among CAPD vs. controls. In contrast, HDL cholesterol was lower among CAPD patients vs. controls. In the subgroup analysis, SAA levels were significantly lower among patients receiving CAPD for >3 y than among controls. However, IDL cholesterol was consistently higher among CAPD patients vs. controls.

CONCLUSIONS

CAPD patients have chronic inflammation and dyslipidemia. IDL cholesterol is the only lipoprotein subclass that is consistently elevated regardless of CAPD duration. More attention should be paid to dyslipidemia in the management of the CAPD patients.

A molecular mechanism for diacylglycerol-mediated promotion of negative caloric balance

AIMS

A substitution of diacylglycerol (DAG) oil for triacylglycerol (TAG) oil in diet has been reported to reduce body fat and body weight, possibly by increasing postprandial energy expenditure (EE). We have previously studied plasma serotonin, which increases EE and exists in the small intestine, in individuals who ingested TAG and DAG oil, and found that DAG ingestion elevates plasma serotonin levels by about 50% compared with TAG ingestion. We studied the molecular mechanisms for DAG-mediated increase in serotonin and EE.

METHODS

We studied effects of 1-monoacylglycerol and 2-monoacylglycerol, distinct digestive products of DAG and TAG, respectively, on serotonin release from the Caco-2 cells (the human intestinal cell line, n = 8). Further, we studied effects of 1- and 2-monoacylglycerol, and serotonin on expression of mRNA associated with β-oxidation, FA metabolism, and thermogenesis, in the Caco-2 cells (n = 5).

RESULTS

1-monoacylglycerol (100 μM 1-monooleyl glycerol [1-MOG]) significantly increased serotonin release from the Caco-2 cells compared with 2-monoacylglycerol (100 μM 2-MOG) by 36.6%. Expression of mRNA of acyl-CoA oxidase (ACO), fatty acid translocase (FAT), and uncoupling protein-2 (UCP-2) were significantly higher in 100 μM 1-MOG-treated Caco-2 cells than 100 μM 2-MOG-treated cells by 12.8%, 23.7%, and 35.1%, respectively. Further, expression of mRNA of ACO, medium-chain acyl-CoA dehydrogenase, FAT, and UCP-2 were significantly elevated in serotonin (400 nM)-treated Caco-2 cells compared with cells incubated without serotonin by 28.7%, 30.1%, and 39.2%, respectively.

CONCLUSIONS

Our study demonstrated that 1-monoacylglycerol, a digestive product of DAG, increases serotonin release from the Caco-2 cells, and enhances expression of genes associated with β-oxidation, FA metabolism, and thermogenesis, and that serotonin increases expression of these genes, proposing a novel molecular mechanism for DAG-mediated promotion of negative caloric balance.

Analysis of cholesterol levels in lipoprotein(a) with anion-exchange chromatography

We previously established an analysis method for determining the cholesterol levels of five major lipoprotein classes [HDL, LDL, intermediate density lipoprotein (IDL), VLDL, and chylomicrons] in serum by an anion-exchange (AEX)-HPLC method, but lipoprotein(a) [Lp(a)], a well-known risk factor for atherosclerotic diseases, was not determinable. Therefore, we established new AEX-HPLC separation conditions for analyzing the cholesterol levels of six lipoprotein classes, including Lp(a). Serum lipoproteins were separated by HPLC with a diethylaminoethyl-ligand nonporous polymer-based column by elution with a stepwise gradient of the sodium perchlorate concentration. In this improved method, HDL, LDL, IDL, VLDL, chylomicrons, and Lp(a) were each eluted from the column. The cholesterol levels of the eluted lipoproteins were measured enzymatically by a postcolumn reaction. The within-day assay and between-day assay coefficients of variation for the lipoprotein cholesterol levels were in the ranges of 0.29-11.86% and 0.57-11.99%, respectively. The Lp(a) cholesterol levels determined by AEX-HPLC were significantly correlated with the amounts of Lp(a) protein measured by an immunoturbidimetry method available commercially (r = 0.9503, P < 0.0001). Taken together, this AEX-HPLC method may be effectively applied to the analysis of serum lipoproteins with high levels of Lp(a).

Measurement of cholesterol concentrations of major serum lipoprotein classes in haemodialysis patients by anion-exchange chromatography

BACKGROUND

Increased triglyceride (TG)-rich lipoproteins and decreased HDL that are implicated in the progression of atherosclerotic vascular diseases, are present in serum samples of patients undergoing haemodialysis (HD) therapy. Therefore, it is important to measure serum TG-rich lipoprotein concentrations to prevent the diseases.

METHODS

The cholesterol concentrations of lipoprotein classes in serum samples from the HD patients (n = 18) and healthy subjects (n = 18) were analysed by our recently developed method of high-performance liquid chromatography (HPLC), in which the lipoprotein classes were separated using an anion-exchange column, and the cholesterol concentrations of each of those were measured enzymatically using a post-column reaction. The ability of fractionated lipoprotein cholesterol determination by this HPLC method is mostly equivalent to the determination ability of an ultracentrifugation (UC).

RESULTS

HDL, LDL, and TG-rich lipoproteins, i.e. IDL, VLDL and chylomicrons, were well separated in the chromatograms. HDL cholesterol concentrations in the HD patients were significantly lower than in the healthy subjects (P < 0.0001), and IDL cholesterol concentrations and VLDL cholesterol concentrations in the HD patients were significantly higher than in the healthy subjects (P < 0.05). Profiles of these measured lipoprotein values were consistent with the previously reported lipoprotein values, measured ultracentrifugally characteristic of HD patients.

CONCLUSION

These results suggest that the HPLC method may be sufficiently applied to the assessment of serum lipoprotein profile in HD patients in place of the other method including an UC.

Characteristic comparison of triglyceride-rich remnant lipoprotein measurement between a new homogenous assay (RemL-C) and a conventional immunoseparation method (RLP-C)

BACKGROUND

Increased serum remnant lipoproteins are supposed to predict cardiovascular disease in addition to increased LDL. A new homogenous assay for remnant lipoprotein-cholesterol (RemL-C) has been developed as an alternative to remnant-like particle-cholesterol (RLP-C), an immunoseparation assay, widely used for the measurement of remnant lipoprotein cholesterol.

METHODS

We evaluated the correlations and data validation between the 2 assays in 83 subjects (49 men and 34 women) without diabetes, hypertension and medications for hyperlipidemia, diabetes, and hypertension, and investigated the characteristics of remnant lipoproteins obtained by the two methods (RLP-C and RemL-C) and their relationships with IDL-cholesterol determined by our developed HPLC method.

RESULTS

A positive correlation was significantly found between the two methods (r = 0.853, 95%CI 0.781-0.903, p < 0.0001). Bland & Altman analysis revealed that RemL-C values were likely to be significantly higher than RLP-C values, particularly in samples with high levels of remnant lipoproteins. Several data dissociations between the RemL-C and RLP-C were also observed. The HPLC chromatograms show high concentrations of chylomicron cholesterol in serum samples with RemL-C level < RLP-C level, but high concentrations of IDL-cholesterol in samples with RemL-C level > RLP-C level. RemL-C (r = 0.339, 95%CI 0.152-0.903; p = 0.0005) significantly correlated with IDL-cholesterol, but not RLP-C (r = 0.17, 95%CI -0.047-0.372; p = 0.1237) in all the samples (n = 83).

CONCLUSION

These results suggest that there is generally a significant correlation between RemL-C and RLP-C. However, RemL-C assay is likely to reflect IDL more closely than RLP-C.

Effects of diacylglycerol on glucose, lipid metabolism, and plasma serotonin levels in lean Japanese

OBJECTIVE

Diacylglycerol (DAG)-rich oil has been suggested to suppress postprandial hyperlipidemia and promote negative caloric balance by increasing energy expenditure (EE), due to small intestine physiochemical dynamics that differ from triacylglycerol (TAG). We studied the effect of DAG on postprandial glucose/insulin metabolism by loading of carbohydrate with oil. Further, to reveal the mechanism for increased EE by DAG, we measured plasma serotonin, which is mostly present in the small intestine and mediates peripheral sympathetic thermogenesis.

METHODS AND PROCEDURES

Randomized crossover study with 2-week wash-out interval between differing fat ingestion. Seven male, lean, Japanese students ingested DAG or TAG oil with 40 g of carbohydrate. Measurements of metabolic parameters were performed before and at 2, 4, and 6 h after fat ingestion. Plasma serotonin levels and cholesterol concentration in each lipoprotein were measured using high-performance liquid chromatography (HPLC).

RESULTS

The substitution of DAG for TAG decreased very-low-density lipoprotein-cholesterol (VLDL-C) by 45.6% at 2 h, and decreased serum insulin by 41.3% at 4 h after ingestion. The incremental area under the curve (IAUC) for VLDL-C was positively correlated with the IAUC for insulin. Concurrently, DAG elevated plasma serotonin levels by 47.3% at 2 h, while TAG did not influence.

DISCUSSION

This study indicates that the substitution of DAG for TAG suppresses the postprandial increase in serum VLDL-C and insulin. This study also demonstrates that DAG ingestion increases plasma serotonin, proposing a possible mechanism for a postprandial increase in EE by DAG.

Comparative study between anion-exchange HPLC and homogeneous assay methods in regard to the accuracy of high- and low-density lipoprotein cholesterol measurement

OBJECTIVES

A convenient method based on anion-exchange HPLC was recently developed to determine cholesterol levels of lipoproteins (HDL, LDL, IDL, VLDL, and chylomicron). The present study was performed to compare this HPLC method to homogenous assay in regard to measurement accuracy of HDL and LDL cholesterol.

DESIGN AND METHODS

Serum samples (n=105), including three samples from cholestasis patients, were measured by homogenous assay with Cholestest-LDL and CholestestN-HDL (Daiichi Chemicals, Tokyo) and by HPLC as reported previously (J Lipid Res 2003; 44: 1404-12).

RESULTS

The homogenous assay for HDL cholesterol correlated strongly with the HPLC method for HDL cholesterol (r=0.976). Two samples from cholestasis patients could not be measured by homogenous assay but were measured by HPLC. The homogenous assay for LDL cholesterol correlated modestly with the HPLC method for LDL cholesterol (r=0.823). Three outlier samples, from cholestasis patients with serum cholesterol levels >17 mmol/L, were observed in this correlation analysis. Homogenous assay data showed that these LDL cholesterol levels were 15.2-34.7 mmol/L. However, HPLC data showed that these LDL cholesterol levels were 3.6-8.2 mmol/L, and that the major lipoprotein fractions were VLDL and IDL. The difference in LDL cholesterol levels (homogenous assay data minus HPLC data) was positively correlated with VLDL cholesterol levels.

CONCLUSIONS

When measuring samples from cholestasis patients, homogenous assay may give inaccurate results. In contrast, the HPLC method is likely to be capable of accurately measuring HDL and LDL cholesterol levels without the involving VLDL.

Platelet release of β-thromboglobulin and platelet factor 4 and serotonin in plasma samples

OBJECTIVES

Platelet release of alpha granule-derived CXC chemokines and dense granule-derived serotonin in plasma samples was evaluated.

METHODS

Concentrations of the CXC chemokines beta-TG and PF4 were assayed by an enzyme immunoassay; serotonin was measured by an HPLC method.

RESULTS

Beta-TG and PF4 were more easily released than serotonin by in vitro procedures. Use of the anti-platelet cocktail CTAD and preservation of the samples at 4 degrees C were necessary to accurately measure beta-TG and PF4, but not serotonin.

CONCLUSIONS

Assaying serotonin may be useful for assessing platelet activation in vivo as a laboratory test because of facile preparation of plasma samples.

Implications of decreased serum adiponectin for type IIb hyperlipidaemia and increased cholesterol levels of very-low-density lipoprotein in type II diabetic patients

The present study was performed to investigate the relevance of cholesterol levels of plasma lipoproteins [HDL (high-density lipoprotein), LDL (low-density lipoprotein), IDL (immediate-density lipoprotein), VLDL (very-LDL) and chylomicrons] determined by a novel HPLC method, with adiponectin, which is decreased in Type II diabetes and assumed to be involved in dysregulated metabolism and atherogenesis. Type II diabetic patients who were not treated with insulin, statins and fibrates were enrolled. Study subjects included Type II diabetic patients with normolipidaemia (DM-NL; n=15), type 4 hyperlipidaemia (DM-T4HL; n=13), Type IIa hyperlipidaemia (DM-T2aHL; n=15) and Type IIb hyperlipidaemia (DM-T2bHL; n=13). Fasting blood samples were collected. The serum adiponectin level was lower in DM-T2bHL than in any of the other groups. Cholesterol levels of each lipoprotein fraction, serum triacylglycerol (triglyceride), remnant-like particle-cholesterol, fasting plasma glucose, HbA1c (glycated haemoglobin), age, gender difference and BMI (body mass index) were incorporated into a stepwise regression analysis as independent variables. VLDL-cholesterol correlated inversely with adiponectin independently of age, BMI, gender difference and glycaemic control. Although the mechanisms remain to be explored, serum adiponectin was reduced particularly in Type II diabetics with type IIb hyperlipidaemia and correlated inversely with VLDL-cholesterol. Measuring VLDL-cholesterol may be helpful for understanding the pathological features of diabetic dyslipidaemia.

Increased serum iron may contribute to enhanced oxidation of low-density lipoprotein in smokers in part through changes in lipoxygenase and catalase

BACKGROUND

Increased oxidative stress is considered to be causative for cardiovascular disease (CVD) in smokers, but its mechanisms are still unclear. We compared oxidative stress markers between male smokers and male nonsmokers.

METHODS

Twenty-three healthy men (11 nonsmokers and 12 smokers) were enrolled, and blood samples after 12 h of fasting were collected to assess plasma lipids and oxidative stress markers. The effects of iron loading on 12-lipoxygenase (12-LO) expression and activity in human umbilical vein endothelial cells (HUVECs) were tested in vitro to investigate the relevance of iron to oxidation potential in vivo.

RESULTS

Higher levels of plasma-oxidized low-density lipoprotein (LDL) and lipid peroxide (LPO), and higher oxidizability of LDL were observed in smokers than in nonsmokers. Higher levels of serum iron and lower levels of plasma vitamin E were observed in smokers than in nonsmokers. Stepwise multiple regression analysis showed that serum iron was an independent determinant for both plasma-oxidized LDL and lag time of LDL oxidation. Iron loading enhanced 12-LO expression threefold and its activity 1.5-fold. Moreover, iron loading decreased catalase expression by 50% and significantly reduced its activity by 75%.

CONCLUSIONS

Enhanced oxidative stress in smokers may be due to increased iron levels. Iron-induced modulation of expression and activity of 12-LO and catalase may be relevant to increased iron-related oxidative stress as observed in smokers.

[Relevance of lipoprotein cholesterol levels measured by HPLC method to appearance midband on electrophoresis and remnant-like particle (RLP)-cholesterol levels]

We have recently developed an HPLC method able to separate five lipoproteins (HDL, LDL, IDL, VLDL and chylomicron) followed by cholesterol measurement on each lipoprotein. As an application of this method, this study focused on analyses of triglyceride (TG)-rich lipoproteins, one of risk factor for atherosclerosis. The appearance of midband on electrophoresis is conceivably implicated in atherogenesis. The present study revealed that cholesterol levels in VLDL, IDL and LDL were significantly higher in midband-positive sera than negative sera. Cholesterol levels in remnant-like proteins, another atherogenic indicator, were significantly related to those in VLDL and Chylomicron measured by the present HPLC method. In conclusion, this novel HPLC method can provide valuable information for analyses on TG-rich lipoproteins.

[Serotonin: a novel marker for atherosclerotic vascular disease]

Serotonin is released from nerve terminals distributed at the intestinal chromaffin cells, which are taken up into platelets. The serotonin is released at the site where platelets are activated in such situations as atherosclerotic vascular lesions. Therefore, we assumed that the serotonin level could be a suitable marker for atherosclerosis. We developed a new high-performance liquid chromatographic (HPLC) method, including a column-switching system and a post-column reaction with benzylamine, for measurement of serotonin levels in samples from patients with coronary heart disease. The vacuum tubes containing the 3mg/ml (7.4mmol/l) of ethylenediaminetetraacetic acid dipotassium (EDTA2K) were used for collecting the samples of platelet-poor plasma (PPP) because the concentration of anticoagulant in the commercially available vacuum tube containing the 1-2mg/ml (2.5-5.0mmol/l) of EDTA2K was not enough. The serotonin levels in PPP and whole blood of healthy subjects and 4 groups of patients with effort angina pectoris (e-AP), unstable angina (u-AP), old myocardial infarction (OMI), and vasospstic angina pectoris (VSAP), were determined by using the developed method. The serotonin levels in PPP from patients of u-AP, OMI, and VSAP were significantly higher than those of healthy subjects(p<0.001, p<0.005, and p<0.001). The ratio of PPP to whole blood of all disease groups were significantly higher than those of healthy subjects (p<0.001). From these findings, we propose that serotonin is useful as a novel marker for atherosclerotic vascular disease.

The ratio of plasma to whole-blood serotonin may be a novel marker of atherosclerotic cardiovascular disease

Because atherosclerotic vascular lesions stimulate platelets, the platelets release serotonin (5-hydroxytryptamine, aka 5-HT). We therefore measured 5-HT concentrations not only in platelet-poor plasma but also in whole blood as a means of assessing vascular lesions. The plasma concentration of 5-HT tended to increase with age, whereas that in whole blood decreases. Therefore the ratio of the plasma to the whole-blood concentration of 5-HT (P/WB) increases with age. This may be a result of the activation of platelets in older subjects with atherosclerotic vascular damage. Patients who underwent coronary angiography (CAG) were classified into 4 groups according to diagnosis: effort-induced angina pectoris (eAP), old myocardial infarction (OMI), vasospastic angina pectoris (VSAP), and unstable angina (uAP). The mean plasma 5-HT concentration was significantly (P <.01) greater in patients with eAP, uAP, OMI, and VSAP than in healthy controls, whereas the concentration in whole blood was lower in patients with eAP than in healthy controls. When the P/WB ratios were calculated, the mean levels in all disease groups were significantly higher than that in the healthy controls. These findings suggested that 5-HT is released into the plasma from the platelets and that the concentration in the platelets decreases in patients with atherosclerosis.

High-performance liquid chromatographic method with column-switching and post-column reaction for determination of serotonin levels in platelet-poor plasma

OBJECTIVES

Measurement of serotonin concentrations in blood is considered to be important for the clinical studies of diseases involving vascular endothelial injury. We have developed a high-performance liquid chromatographic (HPLC) method for measurement of serotonin level in platelet-poor plasma (PPP).

METHODS

Venous blood samples were collected using vacuum tubes containing ethylenediaminetetraacetic acid (EDTA) dipotassium salt; the optimum concentration in blood was 7.4 mmol/l. Serotonin in samples was separated by HPLC with a column-switching system, and was specifically converted into a fluorescent derivative with benzylamine for convenient detection.

RESULTS

The between-day assay coefficient of variation for a serotonin level (5.1 nmol/l) in PPP was 6.2%. The mean concentration of serotonin in PPP in healthy subjects was 5.7 +/- 3.0 nmol/l. The serotonin levels in PPP in patients with ischemic heart disease were significantly higher than those in healthy subjects (P = 0.001).

CONCLUSIONS

The developed method had sufficient performance to determine serotonin levels in PPP from patients with ischemic heart disease.