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Ciragil P, Kurutas EB, Gul M, Kilinc M, Aral M, Guven A. The effects of oxidative stress in urinary tract infection during pregnancy. Mediators Inflamm 2006; 2005:309-11. [PMID: 16258199 PMCID: PMC1533893 DOI: 10.1155/mi.2005.309] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to determine the effect of urinary
tract infection (UTI) on antioxidant systems and lipid
peroxidation (LPO) levels during pregnancy. We also
investigated if these antioxidant systems and LPO levels differed
in each trimester. One hundred forty-three nonpregnant women, as a
control group, and 77 pregnant women were included in the study.
Urine cultures were performed according to standard techniques.
Catalase (CAT), superoxide dismutase (SOD), and LPO levels were
measured using a spectrophotometer. UTI was observed in 14 of
77 pregnant women and the isolated microorganisms were
Escherichia coli, Klebsiella pneumoniae, and
Staphylococcus saprophyticus. CAT, SOD, and LPO levels
were increased in pregnant women compared with nonpregnant women
(P < .01). CAT, SOD activities, and LPO levels were increased from
the first trimester to the third trimester in pregnancy without
UTI. However, CAT and SOD activities were decreased, LPO levels
were increased from the first trimester to the third trimester in
pregnancy with UTI (P < .01). Pregnancy causes oxidative stress
and also UTI during pregnancy may aggravate oxidative stress.
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Pajk T, Rezar V, Levart A, Salobir J. Efficiency of apples, strawberries, and tomatoes for reduction of oxidative stress in pigs as a model for humans. Nutrition 2006; 22:376-84. [PMID: 16413749 DOI: 10.1016/j.nut.2005.08.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2005] [Accepted: 08/24/2005] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The present study investigated the potency of apples, strawberries, and tomatoes in decreasing oxidative stress in pigs as a model for humans. METHODS Forty-eight growing pigs were individually penned in metabolic cages and divided into six groups. All groups received isocaloric daily rations composed of a basal diet supplemented with starch, linseed oil, linseed oil and apples, linseed oil and strawberries, linseed oil and tomatoes, or linseed oil, apples, strawberries and tomatoes. Oxidative stress was evaluated at the beginning and at the end of the 22-d experimental period by measuring the degree of DNA damage in mononuclear blood cells, the concentration of malondialdehyde (MDA) in plasma, the MDA excretion rate, the concentration of tocopherols in plasma, plasma total antioxidant status, and erythrocyte glutathione peroxidase concentration. RESULTS The results confirmed that the linseed oil diet significantly increased MDA formation in the body and DNA damage to mononuclear blood cells in comparison with the starch diet. Although the MDA concentration in plasma was significantly decreased in all fruit groups, urine MDA excretion rate was decreased only in the linseed oil/apple and linseed oil/apple/strawberry/tomato groups. Supplementation with fruit significantly decreased DNA damage, was more pronounced in the linseed oil/apple and linseed oil/apple/strawberry/tomato groups. Significantly lower glutathione peroxidase concentrations were observed only in the linseed oil/strawberry group. CONCLUSIONS Our findings support the hypothesis that supplementation with apples, strawberries, or tomatoes effectively decreases oxidative stress by decreasing MDA formation in the body and by protecting mononuclear blood cells against increased DNA damage. This effect was particularly pronounced in the group supplemented with a fruit mixture; among the single fruit supplements, the most beneficial effect was obtained with apples.
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Rezar V, Pajk T, Levart A, Salobir K, Krsnik M, Osredkar J, Salobir J. Relevance of Meat Fat Content and Fruit and Vegetable Intake for the Oxidative Status of Pigs. ANNALS OF NUTRITION AND METABOLISM 2006; 50:74-80. [PMID: 16282681 DOI: 10.1159/000089690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2004] [Accepted: 05/23/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of the present study was to evaluate the effect of substituting lean meat with fat meat on oxidative stress in a diet with or without fruit and vegetables. METHODS Thirty-two pigs were divided into groups and fed isocaloric daily rations: LM+FV (balanced diet with lean meat and fruit and vegetables); FM+FV (as LM+FV, but lean meat was substituted with fat meat); LM-FV (as LM+FV, but without fruit and vegetables), and FM-FV (as FM+FV, but without fruit and vegetables). Oxidative stress was evaluated by measuring the 24-hour urine malondialdehyde excretion rate, the degree of leukocyte nuclear DNA damage, the concentration of tocopherols in blood plasma, erythrocyte glutathione peroxidase activity and the total antioxidant status of plasma. RESULTS The substitution of lean meat with fat meat modestly increased the rate of leukocyte DNA damage only in the diet with fruit and vegetables but had no effect in the group deprived of fruit and vegetables. Regardless of the fruit and vegetable content of the diet, the substitution of lean meat with fat meat did not affect any other parameters measured. In comparison to both fruit- and vegetable-containing diets, the deprivation of fruits and vegetables in the LM-FV and FM-FV groups significantly increased the rate of leukocyte DNA damage and reduced the plasma alpha-tocopherol level (significant only for FM+FV). CONCLUSION The substitution of fat meat with lean meat in a diet with or without fruit and vegetables has only a marginal or no effect on oxidative stress. But fruit and vegetable exclusion markedly increased the level of oxidative stress.
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Lee KH, Bartsch H, Nair J, Yoo DH, Hong YC, Cho SH, Kang D. Effect of short-term fasting on urinary excretion of primary lipid peroxidation products and on markers of oxidative DNA damage in healthy women. Carcinogenesis 2006; 27:1398-403. [PMID: 16401636 DOI: 10.1093/carcin/bgi337] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The goal of this study was to determine whether short-term fasting changes in urinary biomarkers related to oxidative stress: malondialdehyde (MDA), 8-isoprostaglandin F2alpha (8-isoPGF), 8-hydroxydeoxy-guanosine (8-OHdG) and 1,N6-ethenodeoxyadenosine (epsilondA) among female volunteers participating in the short-term fasting program in South Korea. The study subjects were 52 healthy women (mean age 28, range 15-48 years old) who provided urine samples both before and after the fasting program (average 7.2, range: 3-11 days). Urinary MDA was measured by HPLC-UV and epsilondA levels were measured by immuno-affinity purification followed by HPLC-fluorescence detection. Urinary 8-OHdG and 8-isoPGF concentrations were determined by ELISA. Plasma leptin levels were also measured by radioimmunoassay. Information on demographic characteristics, personal habits (smoking and alcohol consumption) and previous medical history were collected by a self-administered questionnaire. Percent loss of body weight (average 6.3%, 4.28 +/- 0.25 kg) was significantly correlated with fasting duration (r = 0.70, n = 52, P < 0.01). The plasma leptin levels after fasting (5.89 +/- 1.10 ng/ml) were significantly lower than before fasting (6.91 +/- 1.13 ng/ml) (n = 27, P = 0.05). Urinary MDA levels after fasting (0.18 +/- 1.10 mg/g creatinine) were significantly lower than before fasting (0.37 +/- 1.11) (n = 51, P < 0.01). Urinary 8-isoPGF also were significantly reduced after fasting (n = 47, P < 0.01). However, there was no significant difference in 8-OHdG or epsilondA. There was a statistically significant correlation between % change of urinary MDA level with % change of 8-isoPGF level (partial correlation coefficient r = 0.57, n = 46, P = 0.01). The correlations between % change of 8-OHdG and plasma leptin was also significant (partial correlation coefficient r = 0.51, n = 27, P = 0.02). Our results demonstrate that the short-term fasting reduces lipid peroxidation products but does not affect oxidative stress-induced DNA damage.
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Zhou H, Kato A, Miyaji T, Yasuda H, Fujigaki Y, Yamamoto T, Yonemura K, Takebayashi S, Mineta H, Hishida A. Urinary marker for oxidative stress in kidneys in cisplatin-induced acute renal failure in rats. Nephrol Dial Transplant 2005; 21:616-23. [PMID: 16384831 DOI: 10.1093/ndt/gfi314] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Establishment of non-invasive urinary biomarkers for the prediction of acute renal failure (ARF) is important. We evaluated whether urinary oxidative stress markers reflect intrarenal oxidative stress in cisplatin (CDDP)-induced ARF, and whether these markers can be used for the prediction of future ARF. METHODS Urinary malondialdehyde (MDA) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were measured up to day 14 post-CDDP (6 mg/kg) injection in rats. MDA and 8-OHdG expressions were examined in kidneys. RESULTS CDDP induced an increase in serum creatinine (Scr), blood urea nitrogen (BUN), and tubular damage at day 5, increased urinary MDA excretion and MDA expression in kidneys at day 1 (but returned to basal values by day 3), increased urinary excretion of 8-OHdG at day 5 till day 14 (though the number of 8-OHdG-positive tubular cells increased at day 5 and then gradually decreased). Urinary MDA levels at day 1 correlated significantly with Scr (rho = 0.721, P < 0.01) and tubular damage score (rho = 0.840, P < 0.01) at day 5. CONCLUSION Our findings demonstrated divergent changes of urinary oxidative stress markers in CDDP-induced ARF, and suggested that urinary MDA may be a useful marker for the prediction of the development of CDDP-induced ARF.
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Agarwal R. Smoking, oxidative stress and inflammation: impact on resting energy expenditure in diabetic nephropathy. BMC Nephrol 2005; 6:13. [PMID: 16303055 PMCID: PMC1308817 DOI: 10.1186/1471-2369-6-13] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2005] [Accepted: 11/22/2005] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Inflammation is associated with increased resting energy expenditure (REE) in patients with chronic kidney disease. Oxidative stress, on the other hand, appears not to increase REE. Smoking is a common mechanism for generating oxidative stress and inflammation. Whether smokers have increased REE and if so, whether it is accounted for by the pro-oxidant and inflammatory state is not known. METHODS A case control study of 11 smokers and 24 non-smokers with overt diabetic nephropathy was performed to evaluate the chronic effect of smoking on REE. REE (indirect calorimetry), glomerular filtration rate (iothalamate clearance), markers of oxidative stress (urinary and plasma malondialdehyde (MDA), and protein carbonyls) and inflammation (C-reactive protein, tumor necrosis factor-alpha, interleukin-6) were measured on two occasions four months apart. RESULTS Biomarkers of inflammation (C-reactive protein) and oxidative stress (urinary and plasma MDA) were increased in smokers. REE was increased in smokers, 24.3 kcal/kg/day compared to 21 kcal/kg/day (p = 0.009) in non-smokers. After adjusting for age, GFR, MDA, C-reactive protein, and hemoglobin A1C the difference in REE between the two groups persisted (adjusted difference 3.51 kcal/kg/d, 95% confidence interval 0.59-6.45, p = 0.020). CONCLUSION Patients with overt diabetic nephropathy who smoke have a higher REE, oxidative and inflammatory state. Elevated REE is not attributable to heightened oxidative stress and inflammatory state. Smoking is an independent risk factor for elevated REE in patients with diabetic nephropathy and provides an additional mechanism by which it may lead to poor outcomes.
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Chang JM, Kuo MC, Kuo HT, Chiu YW, Chen HC. Increased glomerular and extracellular malondialdehyde levels in patients and rats with diabetic nephropathy. ACTA ACUST UNITED AC 2005; 146:210-5. [PMID: 16194682 DOI: 10.1016/j.lab.2005.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2005] [Revised: 05/14/2005] [Accepted: 05/19/2005] [Indexed: 10/25/2022]
Abstract
Results from animal experiments have suggested that reactive oxygen species (ROS) play an important role in tissue damage associated with diabetes. To determine whether ROS are involved in patients with diabetic nephropathy, we measured the plasma and urinary levels of malondialdehyde (MDA), an important marker of lipid peroxidation, and assessed the immunoreactivity of MDA and superoxide dismutase (SOD) in glomeruli of patients and experimental rats with diabetic nephropathy. Both plasma and urinary MDA levels were significantly higher in patients with diabetic glomerulosclerosis (DGS) than those of diabetic patients without proteinuria, proteinuric patients without diabetes, and normal controls. In DGS patients, the plasma MDA was significantly correlated with urinary MDA (p<0.05). The urinary MDA, but not plasma MDA, was significantly correlated with the degree of glomerulosclerosis and the index of mesangial expansion (both p<0.01) in DGS patients. The immunostaining score of glomerular MDA and SOD were also significantly higher in DGS patients than in control kidneys. In rats with diabetes for more than one month, the glomerular immunostaining for both MDA and SOD were also significantly higher than in controls rats, and both were increased with the progression of diabetes. Our results suggest that oxidative stress is involved in the pathogenesis and the progression of DGS.
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Mercken EM, Hageman GJ, Schols AMWJ, Akkermans MA, Bast A, Wouters EFM. Rehabilitation decreases exercise-induced oxidative stress in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2005; 172:994-1001. [PMID: 16040783 DOI: 10.1164/rccm.200411-1580oc] [Citation(s) in RCA: 127] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The effect of exercise at different intensities as well as the effect of intensive supervised pulmonary rehabilitation on oxidative stress were studied for chronic obstructive pulmonary disease (COPD). Eleven patients with COPD and 11 healthy age-matched control subjects performed a maximal and submaximal exercise cycle ergometry test at 60% of peak workload. Patients with COPD performed these tests before and after 8 wk of pulmonary rehabilitation. Measurements were done before, immediately after, and 4 h after both exercise tests. At rest, increased oxidative stress was observed in patients compared with control subjects, as measured by urinary malondialdehyde (MDA; p < 0.05) and hydrogen peroxide (H2O2) in breath condensate (p < 0.05). In healthy control subjects, a significant increase in urinary MDA was observed 4 h after both exercise tests (p = 0.05), whereas H2O2 significantly increased immediately after maximal exercise (p < 0.05). In patients with COPD, before rehabilitation, reactive oxygen species-induced DNA damage in peripheral blood mononuclear cells, urinary MDA, and plasma uric acid were significantly increased after both exercise tests (p < 0.05), whereas no significant increase was observed in plasma MDA. In contrast, exhaled H2O2 was only significantly increased after maximal exercise (p < 0.02). Although after rehabilitation peak workload was increased by 24%, a similar oxidative stress response was found. Remarkably, a decrease in reactive oxygen species-induced DNA damage was detected after exercise at submaximal intensity despite increased exercise duration of 73%. In summary, patients with COPD had increased pulmonary and systemic oxidative stress both at rest and induced by exercise. In addition, pulmonary rehabilitation increased exercise capacity and was associated with reduced exercise-induced oxidative stress.
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Goulart M, Batoréu MC, Rodrigues AS, Laires A, Rueff J. Lipoperoxidation products and thiol antioxidants in chromium exposed workers. Mutagenesis 2005; 20:311-5. [PMID: 15985443 DOI: 10.1093/mutage/gei043] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hexavalent chromium is an established carcinogenic agent, which is not directly reactive with DNA. Its genotoxicity involves a reduction step, producing reactive oxygen species and radicals, and also lower valence forms which form stable complexes with intracellular macromolecules. The trivalent form of chromium may directly react with the genetic material and has also been shown to generate oxidative damage in vitro. To further evaluate the importance of in vivo oxidative DNA damage in the toxicity of each valence form, we conducted a comparative study on hexavalent and trivalent chromium-exposed workers (manual metal arc stainless steel welders and leather tanning workers), focusing on the total oxidative status by quantifying the level of lipoperoxidation products in urine. Thiol antioxidants are important in response to oxidative stress, and therefore, the concentration of glutathione and cysteine in peripheral blood lymphocytes was also determined. Chromium exposure was evaluated by quantifying total chromium in plasma and urine. Both groups had a significant increase in lipid peroxidation products expressed as malondialdehyde (MDA) in urine (tanners 1.42 +/- 0.61 micromol/g creatinine, welders 1.67 +/- 1.13 micromol/g creatinine versus controls 0.81 +/- 0.26 micromol/g creatinine, P < 0.005 in both cases) but only welders had a significant decrease in glutathione concentration in lymphocytes. There was a positive correlation between chromium in plasma and urinary MDA in welders, but not in tanners. This work is part of a larger study of which major results have been published previously including cytogenetics and DNA-protein cross-links in workers exposed to the two different forms of chromium. These results are compared with the results of oxidative damage from this study.
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85
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Guerra LN, Ríos de Molina MDC, Miler EA, Moiguer S, Karner M, Burdman JA. Antioxidants and methimazole in the treatment of Graves' disease: effect on urinary malondialdehyde levels. Clin Chim Acta 2005; 352:115-20. [PMID: 15653105 DOI: 10.1016/j.cccn.2004.08.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2004] [Revised: 08/24/2004] [Accepted: 08/24/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND We have postulated that metabolic oxidation could be the source of signs and symptoms of hyperthyroidism. The present study was designed to evaluate urinary malondialdehyde levels in Graves' disease and compare this oxidative stress biomarker with the clinical evolution of patients suffering this illness. METHODS We evaluated the concentration of urinary and serum malondialdehyde (MDA) in 36 patients with Graves' disease. Patients were treated with the antithyroid drug methimazole (MMI; Group A) or antioxidant mixture (200 mg vitamin E, 3 mg beta-carotene, 250 mg vitamin C, 1 mg Cu, 7.5 mg Zn, 1.5 mg Mn, and 15 microg Se; Group B). RESULTS MDA concentrations were higher in hyperthyroid patients compared to euthyroid controls, and a positive correlation was observed between serum and urinary MDA levels. Group A decreased urinary MDA to control values. There was a positive correlation between the clinical score and the heart rate of patients with urinary MDA before and during the treatment with MMI (Group A). Similar results were observed after treatment with the antioxidant mixture. CONCLUSIONS Urinary MDA might be a good parameter in the follow-up of patients during MMI treatment. We proposed that oxidative stress correlates with signs and symptoms of hyperthyroidism.
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Ozguner F, Armagan A, Koyu A, Caliskan S, Koylu H. A novel antioxidant agent caffeic acid phenethyl ester prevents shock wave-induced renal tubular oxidative stress. ACTA ACUST UNITED AC 2005; 33:239-43. [PMID: 15877224 DOI: 10.1007/s00240-005-0470-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2004] [Accepted: 02/11/2005] [Indexed: 01/23/2023]
Abstract
The aim of this study was to evaluate the effects of the novel free radical scavenger caffeic acid phenethyl ester (CAPE) on extracorporeal shock wave lithotripsy (ESWL) induced renal impairment. The study was performed using 30 rabbits which were divided into two groups, each exposed to 3,000 shock waves at 18 kV: (1) control group, (2) ESWL+CAPE treated group. Malodialdehyde (MDA), urine N-acetyl-beta-glucosaminidase (NAG) activity, uric acid and white cell counts were used as markers of oxidative stress. Following shock wave exposure there was a significant rise in MDA, NAG and uric acid and white cell counts. CAPE reduced the rise in MDA, NAG, uric acid and white cell counts. Thus CAPE treatment to a great extent prevented the induction of these renal changes. Our results suggest that the antioxidant capacity of the kidney tissue was reduced after ESWL treatment and that the tissue was exposed to oxidant stress. We conclude that CAPE treatment provided significant protection against ESWL induced free radical damage.
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87
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Kim YJ, Hong YC, Lee KH, Park HJ, Park EA, Moon HS, Ha EH. Oxidative stress in pregnant women and birth weight reduction. Reprod Toxicol 2005; 19:487-92. [PMID: 15749262 DOI: 10.1016/j.reprotox.2004.10.007] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2004] [Revised: 09/11/2004] [Accepted: 10/15/2004] [Indexed: 10/25/2022]
Abstract
The purpose of this study is to evaluate the role of maternal oxidative stress in lowering neonatal birth weight. Women (N=261) with singleton pregnancy were analyzed for biomarker levels of oxidative stress after recruitment at the time of hospitalization for delivery in Korea between 2000 and 2001. Among the neonates, 247 births were full-term infants and 14 births were pre-term infants. Biomarkers measured for oxidative stress were maternal urinary 8-hydroxydeoxyguanosine (8-OH-dG) and malondialdehyde (MDA). The women with pre-term infants had higher concentrations of urinary 8-OH-dG and MDA than those with full-term babies. The concentrations of maternal urinary 8-OH-dG and MDA were inversely associated with birth weight of full-term deliveries after adjusting for potential confounders including maternal age, body mass index, dietary intake, alcohol consumption, smoking exposure, occupational status, and neonatal sex (P<0.05). This study demonstrates that increase of 8-OH-dG and MDA concentrations in urine of pregnant women were associated with reduced birth weight in full-term deliveries.
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Kuo HT, Kuo MC, Chiu YW, Chang JM, Guh JY, Chen HC. Increased glomerular and extracellular malondialdehyde levels in patients and rats with focal segmental glomerulosclerosis. Eur J Clin Invest 2005; 35:245-50. [PMID: 15816993 DOI: 10.1111/j.1365-2362.2005.01488.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Evidence suggests an increase in oxidative stress in patients with chronic kidney disease, as glomerulosclerosis is the prerequisite for chronic kidney disease; whether the oxidative stress already exists early on is not known. MATERIALS AND METHODS In this study we measured the plasma and urinary levels of malondialdehyde (MDA), the end product of lipid peroxidation, and assessed the immunoreactivity of MDA and superoxide dismutase (SOD) in glomeruli of patients and rats with primary focal segmental glomerulosclerosis (FSGS), and compared our findings with those of minimal change disease (MCD) and normal controls (NC). RESULTS Our results showed that plasma MDA level was significantly increased in patients with FSGS compared with both patients with MCD and normal controls. The urinary MDA level was also significantly increased and was significantly correlated with plasma MDA level in patients with FSGS. The immunostaining for glomerular MDA and SOD was significantly higher in the patients with FSGS than in either the patients with MCD or NC, and was also significantly higher in rats with puromycin aminonucleoside (PAN)-induced FSGS than in rats with MCD. Glomerular MDA level was significantly correlated with the degree of glomerulosclerosis in the patients with FSGS. CONCLUSIONS Our data suggest that oxidative stress occurs early on before the onset of renal failure, and may play an important role in the pathogenesis of glomerulosclerosis.
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Xu J, Guo CJ, Yang JJ, Wei JY, Li YF, Pang W, Jiang YG, Cheng S. [Intervention of antioxidant system function of aged rats by giving fruit juices with different antioxidant capacities]. ZHONGHUA YU FANG YI XUE ZA ZHI [CHINESE JOURNAL OF PREVENTIVE MEDICINE] 2005; 39:80-3. [PMID: 15842822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE To observe the effects of fruit juices with different antioxidant capacity on antioxidant system function of aged rats. METHODS Thirty Wistar rats were randomly divided into three groups: pomegranate juice and apple juice as two experimental groups, while distilled water as normal control group. They were administrated fruit juices or distilled water respectively by gavage daily for 4 weeks. At the end of experiment, the antioxidant system function was assessed. RESULTS The aged rats in pomegranate juice group showed significantly higher serum antioxidant capacity (0.90 +/- 0.13) mmol/L than that in control group (0.79 +/- 0.10) mmol/L (P < 0.05). The concentrations of serum carbonyl and oxLDL were decreased significantly in pomegranate juice group as compared to the control group (P < 0.05). The percentage of injured blood lymphocyte DNA and the ratio of tail length/total length were declined significantly in pomegranate juice group (P < 0.05 and P < 0.01 respectively). The apple juice showed no effects except decreased ratio of tail length/total length of injured lymphocyte DNA. There were no changes in concentrations of serum vitamin C, vitamin E, urinary 8-OH-dG excretion and the activities of serum SOD, GSH-Px, CAT among three groups. CONCLUSIONS The pomegranate juice should possess higher antioxidant capacity and might improve the antioxidant system function of aged rats, while the apple juice is relatively lower in antioxidant capacity and not very effective. The polyphenols in pomegranate juice might be the important functional components.
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Collard KJ, Godeck S, Holley JE. Blood transfusion and pulmonary lipid peroxidation in ventilated premature babies. Pediatr Pulmonol 2005; 39:257-61. [PMID: 15668937 DOI: 10.1002/ppul.20190] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Urinary malondialdehyde (MDA; a biochemical marker of lipid peroxidation) is increased following the receipt of blood transfusions in premature babies. This indicates an increased level of oxidative damage somewhere in the body. The aim of this study was to determine whether the lung may be a site of increased oxidative damage following blood transfusions. This was achieved by examining the relationship between blood transfusion and levels of MDA in bronchoalveolar lavage (BAL) fluid from ventilated premature babies. The study was a retrospective analysis of data obtained from a group of 42 ventilated premature babies of less than 32 weeks' gestation. Twenty-seven babies received blood transfusions, and 9 received at least one transfusion during the first week of life when daily BAL samples were being taken. Pulmonary epithelial lining fluid (ELF) was sampled by BAL daily during the first week of life and weekly thereafter. MDA was measured by an established high performance liquid chromatography (HPLC) technique. There was a significant positive correlation between volume of blood transfusions received and peak and mean ELF MDA levels (r=0.810, peak; r=0.740, mean; n=21). During the first week of life, when daily samples were being taken, the mean ELF MDA level after blood transfusion (1.829 microM; SE, 0.529) was significantly greater than before transfusion (0.928 microM; SE, 0.297) (n=9). In babies who received 2 transfusions within the first week (n=5), the MDA level was elevated further following the second transfusion (2.825 microM; SE, 0.346). The results of this study indicate that pulmonary oxidative damage increases after the receipt of blood transfusions. Babies receiving blood transfusions show a greater incidence of pulmonary oxidative stress and poor clinical outcome. This may simply reflect that the sickest babies are those most in need of blood transfusion, and that there is no causal relationship. However, the possibility of a causal relationship between blood transfusions and oxidative damage exists and should be investigated.
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Korchazhkina O, Yang Y. Methyl malondialdehyde is not suitable as an internal standard for malondialdehyde detection in urine after derivatisation with 2,4-dinitrophenylhydrazine. J Chromatogr B Analyt Technol Biomed Life Sci 2005; 806:295-8. [PMID: 15171942 DOI: 10.1016/j.jchromb.2004.03.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2003] [Revised: 02/25/2004] [Accepted: 03/26/2004] [Indexed: 11/17/2022]
Abstract
A previously described method of measurement of malondialdehyde (MDA) in human urine after derivatisation with 2,4-dinitrophenylhydrazine (DNPH) was tested for a possibility of using methyl malondialdehyde (MeMDA) as an internal standard. Despite structural similarity, those compounds were found to produce different yields of derivatisation under the same conditions depending on urine matrix. We conclude, that MeMDA is not suitable as an internal standard for the measurement of MDA in urine under previously reported conditions when DNPH is used as a deriviatising agent.
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Peiro G, Alary J, Cravedi JP, Rathahao E, Steghens JP, Guéraud F. Dihydroxynonene mercapturic acid, a urinary metabolite of 4-hydroxynonenal, as a biomarker of lipid peroxidation. Biofactors 2005; 24:89-96. [PMID: 16403967 DOI: 10.1002/biof.5520240110] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The objective of our study was to compare the information obtained through the use of three different urinary biomarkers of lipoperoxidation during the time course of a bromotrichloromethane (BrCCl3) induced oxidative stress in rats. These biomarkers were malondialdehyde (MDA) measured by LC/MS after derivatization, the isoprostane 8-iso-PGF2alpha measured by enzyme immunoassay and 1,4-dihydroxynonene mercapturic acid (DHN-MA), the major 4-hydroxynonenal urinary metabolite [1], measured by LC-MS. Male Wistar rats received a single dose of 100 microL/kg BrCCl3 per os and lipid peroxidation was estimated every day for a 4-day-period after treatment. MDA, 8-iso-PGF2alpha and DHN-MA significantly increased in response to BrCCl3 treatment for this period of time, and DHN-MA showed the main increase during the 24-48 h period after treatment.
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Wilber RL, Holm PL, Morris DM, Dallam GM, Subudhi AW, Murray DM, Callan SD. Effect of FIO2 on Oxidative Stress during Interval Training at Moderate Altitude. Med Sci Sports Exerc 2004; 36:1888-94. [PMID: 15514503 DOI: 10.1249/01.mss.0000145442.25016.dd] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the effect of different fractions of inspired oxygen (FIO2) on oxidative stress during a high-intensity interval workout in trained endurance athletes residing at altitude. METHODS Subjects (N = 19) were trained male cyclists who were residents of moderate altitude (1800-1900 m). Testing was conducted at 1860 m (PB 610-612 torr, PIO2 approximately 128 torr). Subjects performed three randomized, single-blind trials consisting of a standardized interval workout (6 x 100 kJ) while inspiring a medical-grade gas with FIO2 0.21 (PIO2 approximately 128 torr), FIO2 0.26 (PIO2 approximately 159 torr), and FIO2 0.60 (PIO2 approximately 366 torr). Serum lipid hydroperoxides (LOOH) and whole-blood reduced glutathione (GSH) were measured 60 min preexercise and immediately postexercise, and analyzed using standard colorimetric assays. Urinary malondialdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) were measured 24 h preexercise and 24 h postexercise, and analyzed via HPLC and ELISA, respectively. RESULTS Compared with the control trial (FIO2 0.21), total time (min:s) for the 100-kJ work interval was faster (5% in FIO2 0.26; 8% in FIO2 0.60 (P < 0.05)) and power output (W) was higher (5% in FIO2 0.26, 8% in FIO2 0.60 (P < 0.05)) in the supplemental oxygen trials. There was a significant pre- versus postexercise main effect (P < 0.05) for LOOH and GSH; however, there were no significant differences in LOOH or GSH between the FIO2 trials. MDA and 8-OHdG were unaffected by either the interval training session or FIO2. CONCLUSION Supplemental oxygen used in conjunction with high-intensity interval training at altitude ("live high + train low via supplemental O2" (LH + TLO2)) results in a significant improvement in exercise performance without inducing additional free radical oxidative stress as reflected in hematological and urinary biomarkers.
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Weinbrenner T, Fitó M, de la Torre R, Saez GT, Rijken P, Tormos C, Coolen S, Albaladejo MF, Abanades S, Schroder H, Marrugat J, Covas MI. Olive oils high in phenolic compounds modulate oxidative/antioxidative status in men. J Nutr 2004; 134:2314-21. [PMID: 15333722 DOI: 10.1093/jn/134.9.2314] [Citation(s) in RCA: 165] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of the present study was to evaluate whether olive oils high in phenolic compounds influence the oxidative/antioxidative status in humans. Healthy men (n = 12) participated in a double-blind, randomized, crossover study in which 3 olive oils with low (LPC), moderate (MPC), and high (HPC) phenolic content were given as raw doses (25 mL/d) for 4 consecutive days preceded by 10-d washout periods. Volunteers followed a strict very low-antioxidant diet the 3 d before and during the intervention periods. Short-term consumption of olive oils decreased plasma oxidized LDL (oxLDL), 8-oxo-dG in mitochondrial DNA and urine, malondialdehyde in urine (P < 0.05 for linear trend), and increased HDL cholesterol and glutathione peroxidase activity (P < 0.05 for linear trend), in a dose-dependent manner with the phenolic content of the olive oil administered. At d 4, oxLDL after MPC and HPC, and 8-oxo-dG after HPC administration (25 mL, respectively), were reduced when the men were in the postprandial state (P < 0.05). Phenolic compounds in plasma increased dose dependently during this stage with the phenolic content of the olive oils at 1, 2, 4, and 6 h, respectively (P < 0.01). Their concentrations increased in plasma and urine samples in a dose-dependent manner after short-term consumption of the olive oils (P < 0.01). In conclusion, the olive oil phenolic content modulated the oxidative/antioxidative status of healthy men who consumed a very low-antioxidant diet.
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Hong CC, Tang BK, Rao V, Agarwal S, Martin L, Tritchler D, Yaffe M, Boyd NF. Cytochrome P450 1A2 (CYP1A2) activity, mammographic density, and oxidative stress: a cross-sectional study. Breast Cancer Res 2004; 6:R338-51. [PMID: 15217501 PMCID: PMC468635 DOI: 10.1186/bcr797] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2003] [Revised: 02/18/2004] [Accepted: 03/31/2004] [Indexed: 02/05/2023] Open
Abstract
Introduction Mammographically dense breast tissue is a strong predictor of breast cancer risk, and is influenced by both mitogens and mutagens. One enzyme that is able to affect both the mitogenic and mutagenic characteristics of estrogens is cytochrome P450 1A2 (CYP1A2), which is principally responsible for the metabolism of 17β-estradiol. Methods In a cross-sectional study of 146 premenopausal and 149 postmenopausal women, we examined the relationships between CYP1A2 activity, malondialdehyde (MDA) levels, and mammographic density. In vivo CYP1A2 activity was assessed by measuring caffeine metabolites in urine. Levels of serum and urinary MDA, and MDA–deoxyguanosine adducts in DNA were measured. Mammograms were digitized and measured using a computer-assisted method. Results CYP1A2 activity in postmenopausal women, but not in premenopausal women, was positively associated with mammographic density, suggesting that increased CYP1A2 activity after the menopause is a risk factor for breast cancer. In premenopausal women, but not in postmenopausal women, CYP1A2 activity was positively associated with serum and urinary MDA levels; there was also some evidence that CYP1A2 activity was more positively associated with percentage breast density when MDA levels were high, and more negatively associated with percentage breast density when MDA levels were low. Conclusion These findings provide further evidence that variation in the activity level of enzymes involved in estrogen metabolism is related to levels of mammographic density and potentially to breast cancer risk.
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Weinberger B, Anwar M, Henien S, Sosnovsky A, Hiatt M, Jochnowitz N, Witz G, Hegyi T. Association of Lipid Peroxidation with Antenatal Betamethasone and Oxygen Radical Disorders in Preterm Infants. Neonatology 2004; 85:121-7. [PMID: 14631157 DOI: 10.1159/000074968] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2003] [Accepted: 08/14/2003] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Premature infants are highly susceptible to 'oxygen radical diseases' (ORD), including bronchopulmonary dysplasia, intraventricular hemorrhage/white matter injury, retinopathy of prematurity, and necrotizing enterocolitis. The incidence of ORD is reduced following antenatal treatment with betamethasone. Oxidant-mediated injury is characterized at the cellular level by peroxidation of lipid membranes. This results in the generation of malondialdehyde (MDA), which can be quantified indirectly by measurement of thiobarbituric acid-reacting substances (TBARS). There is currently no effective way to quantify the risk for ORD. In this study, we analyzed the correlation of early urinary MDA and TBARS with prenatal betamethasone administration and with the development of ORD. METHODS Preterm infants (<30 weeks gestation, n = 25) born at St. Peter's University Hospital were enrolled. Urine samples were collected during the first 10 days of life and stored at -70 degrees C for 0-21 days. TBARS were quantified by spectrophotometric assay, and malondialdehyde levels measured by HPLC. Subjects were screened for the subsequent development of ORD. Betamethasone administration was defined as one or more doses > or =24 h prior to delivery. RESULTS Urinary MDA levels increased on days 2-3 and 5-10 relative to day 1 from birth. Maximal urinary MDA concentrations were significantly higher in the ORD group compared to controls, and there was a trend toward increased urinary TBARS in the presence of ORD. Infants receiving prenatal betamethasone demonstrated higher maximal urinary TBARS values during the first 10 days of life than control infants. The length of sample storage from 0 to 3 weeks at -70 degrees C did not significantly affect TBARS measurements. CONCLUSIONS Elevated urinary MDA measurements in the first 10 days are correlated with the risk for ORD. Urinary TBARS concentrations, which are correlated with MDA measurements, can be quantified rapidly and are stable for short-term storage. Our findings suggest that urinary TBARS may be adaptable as a practical tool for assessing the risk for ORD in neonatal intensive care unit patients, allowing clinicians to optimize the use of preventive strategies. Antenatal betamethasone is associated with increased urinary TBARS in the first 10 days of life, indicating that the protective effects of corticosteroids are not mediated through reductions in oxidant-mediated lipid peroxidation.
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Bergman V, Leanderson P, Starkhammar H, Tagesson C. Urinary excretion of 8-hydroxydeoxyguanosine and malondialdehyde after high dose radiochemotherapy preceding stem cell transplantation. Free Radic Biol Med 2004; 36:300-6. [PMID: 15036349 DOI: 10.1016/j.freeradbiomed.2003.11.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2003] [Revised: 10/27/2003] [Accepted: 11/14/2003] [Indexed: 10/26/2022]
Abstract
The urinary excretion of the hydroxylated DNA base 8-hydroxydeoxyguanosine (8-OHdG) and the lipid peroxidation product malondialdehyde (MDA) was monitored in 11 patients with hematological malignancies undergoing total body irradiation and high-dose chemotherapy preceding bone marrow transplantation. Nine patients showed a prompt increase in urinary 8-OHdG (8-25 times the initial baseline level) on days 0-7 after irradiation onset; the excretion then decreased during the aplastic period and increased again when engraftment took place (in 7 patients). A significant positive correlation was found between urinary 8-OHdG and whole blood leukocyte count, both on day 5 (p =.04, r =.72) and on day 22 (p =.009, r =.80) after irradiation onset. One patient who lacked the first peak of 8-OHdG excretion showed low blood leukocyte counts (less than 2 x 10(9)/l) before therapy onset; this patient, however, later had a successful engraftment and then also showed considerable increases in both 8-OHdG excretion and leukocyte count. These observations suggest leukocytes play a part in the excretion of 8-OHdG after conditioning therapy preceding bone marrow transplantation. As opposed to the biphasic 8-OHdG excretion, the excretion of MDA showed a single peak appearing on days 11-19 after radiochemotherapy onset, i.e., during the period in which the patients suffered from cytopenia, mucositis, and other side effects of the treatment. It is suggested, therefore, that these clinical manifestations are associated with increased lipid peroxidation. Altogether, these findings illustrate the utility of serial urinary samples for monitoring oxidative stress due to conditioning therapy in clinical practice. They also demonstrate that different oxidative stress markers may behave quite differently regarding their appearance in the urine after whole-body oxidative stress.
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He Z, Tonb DJF, Dabney KW, Miller F, Shah SA, Brenn BR, Theroux MC, Mehta DI. Cytokine release, pancreatic injury, and risk of acute pancreatitis after spinal fusion surgery. Dig Dis Sci 2004; 49:143-9. [PMID: 14992449 DOI: 10.1023/b:ddas.0000011616.79909.3c] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Acute pancreatitis after posterior spinal fusion in children is associated with high intraoperative blood loss. Inflammation, oxidative stress, and pancreatitis markers were assessed during this period. Five of the 17 patients studied developed acute pancreatitis 3-7 days after surgery. Intraoperative blood loss (4850 +/- 2315 vs 1322 +/- 617 ml) and peak tumor necrosis factor alpha levels (15.29 +/- 5.3 vs 8.27 +/- 4.6 pg/ml) in the immediate postoperative period were significantly higher in these five patients than in controls, respectively. No differences were noted in serum interleukin 8, interleukin 6, pancreatis-associated protein, or urine malondialdehyde levels. Urine trypsin-associated peptide, elevated initially in all patients, was significantly higher in the acute pancreatitis group at diagnosis. Length of stay was significantly longer in the acute pancreatitis group. Greater blood loss and peak tumor necrosis factor alpha are associated with subsequent risk of acute pancreatitis, suggesting a role of ischemia-reperfusion injury.
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Huang HS, Ma MC, Chen CF, Chen J. Lipid peroxidation and its correlations with urinary levels of oxalate, citric acid, and osteopontin in patients with renal calcium oxalate stones. Urology 2003; 62:1123-8. [PMID: 14665375 DOI: 10.1016/s0090-4295(03)00764-7] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine whether lipid peroxidation plays a role in patients with calcium oxalate kidney stones and to determine the correlation of lipid peroxidation with tubular damage and the major urinary risk factors. We also used the isoenzymes of glutathione S-transferase (GST) to examine which parts of the renal tubules were injured in patients with renal stones. METHODS This clinical study included two study groups. Group 1 included 32 normal volunteers, and group 2 included 32 patients with calcium oxalate kidney stones. A 24-hour urine sample was collected from each subject, and the levels of Ca, P, Mg, oxalate, citrate, N-acetyl-beta-glucosaminidase (NAG), beta-galactosidase (GAL), alphaGST, piGST, osteopontin (OPN), thiobarbituric acid-reactive substances (TBARS), and malondialdehyde (MDA) were examined. RESULTS Hyperoxaluria, hypocitraturia, and low urinary OPN were the major abnormalities found in the patients with stones. Elevated urinary alphaGST, NAG, and GAL were also noted in the patients with stones; however, urinary piGST showed no statistically significant difference compared with the controls. Urinary TBARS and MDA had statistically significant correlations with alphaGST, GAL, NAG, Ca, and oxalate, but had no correlation with piGST, citrate, OPN, Mg, and P. Urinary citrate had a negative, linear, and statistically significant correlation with alphaGST, GAL, and NAG. CONCLUSIONS Lipid peroxidation correlated with hyperoxaluria and renal tubular damage, indicating that hyperoxaluria can induce tubular cell injury and that this injury may be due to the production of free radicals in patients with calcium oxalate stones. Renal tubular damage in patients with stones may be limited to the proximal tubules.
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Koletzko B, Sauerwald U, Keicher U, Saule H, Wawatschek S, Böhles H, Bervoets K, Fleith M, Crozier-Willi G. Fatty acid profiles, antioxidant status, and growth of preterm infants fed diets without or with long-chain polyunsaturated fatty acids. Eur J Nutr 2003; 42:243-53. [PMID: 14569405 DOI: 10.1007/s00394-003-0418-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2002] [Accepted: 02/25/2003] [Indexed: 10/26/2022]
Abstract
Long-chain polyunsaturated fatty acids (LCP) are considered conditionally essential nutrients for the infant born prematurely, and attempts are being made to match fatty acid profiles of formula and breast fed infants. In this double-blind, randomized study we investigated the effects of a formula enriched with both n-6 and n-3 LCP on plasma fatty acid profiles, antioxidant status and growth of premature infants. 29 infants received either a formula devoid of LCP or a LCP supplemented formula (0.5 g/100 g fat linoleic acid metabolites, 0.8 g/100 g fat alpha-linolenic acid metabolites). 17 breast fed infants served as a control group. At study entry as well as two and four weeks later, plasma and urine samples were collected, growth data obtained and food tolerance was documented. At the end of the four week study period, plasma docosahexaenoic acid (DHA) levels of supplemented infants were significantly higher than those of unsupplemented infants and similar to those of infants fed human milk. Plasma n-6 LCP concentrations including arachidonic acid (AA) were similar between groups. The plasma alpha-tocopherol levels of breast fed and supplemented infants were similar and tended to be lower than in infants fed the formula devoid of LCP. Urinary malondialdehyde (MDA) excretion of formula fed infants was significantly higher compared to infants fed human milk, but did not differ between the two formula groups. Parameters of growth and milk tolerance did not differ between groups. Our results demonstrate that plasma LCP levels similar to those of breast fed infants can be achieved with the LCP supplemented formula used in this trial, without evidence of adverse effects of the LCP enrichment.
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