Vitamin B12 deficiency: is it underestimated in pregnant women?
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Developing Countries↗
Biomedical subjects
Dorothy J VanderJagt
Publications and source records attributed to Dorothy J VanderJagt.
Plasma and urinary free amino acid concentrations in preeclamptic women in northern Nigeria.
BACKGROUND: Preeclampsia/eclampsia is one of the major causes of maternal and fetal mortality in Nigeria and many other countries in sub-Saharan Africa. We determined if serum and urine concentrations of amino acids were abnormal in women with this disorder of pregnancy in Gombe, Nigeria. METHODS: Free amino acids were measured in serum and urine of women (ages, 15 to 40 years) with preeclampsia/eclampsia (n=37) and their pregnant age and gestational age matched controls (n=16). RESULTS: The concentrations of 19 of the 20 serum amino acids that are common in proteins were not significantly different between the control and preeclamptic groups. Phenylalanine was increased in the preeclamptic women compared to the controls (p<0.05); however, the difference between the two values was small (119 vs. 104 umol/l, respectively). The concentrations of urine free amino acids were indexed to urine creatinine (i.e., nmol/mg creatinine). Five amino acids were significantly elevated in the urine of preeclamptic patients vs. the control group: proline (100%, p<0.05), the branched amino acids, valine (80%, p<0.05), leucine (61%, p<0.05), isoleucine (49%, p=0.01), and methionine (52%, p<0.005). On the other hand, the concentrations of a nutritionally non-essential amino acid, glycine (p=0.01), and an essential amino acid, histidine (p=0.01), were both reduced by about one-third in the urine of the preeclamptic women. CONCLUSIONS: Our findings indicate that there are disturbances in urinary amino acid excretion but not in the serum amino acid profile in the preeclamptic patients. The degree of aminoaciduria is probably not sufficient to significantly affect overall nitrogen balance or precipitate a deficiency of one or more of the essential amino acids.
Adult↗
Pulmonary function of herdsmen.
OBJECTIVE: To determine whether the pulmonary function deficit documented previously in Fulani children is also present in adult Fulani herdsmen in northern Nigeria. SUBJECTS AND METHODS: The subjects for this study consisted of adult Fulani men from the hamlet of Magama Gumau and adult non-Fulani men from the city of Jos. Age, height, weight, mid-arm circumference (MAC), triceps skin-fold thickness, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow during the middle half of the FVC maneuver (FEF25-75%), and peak expiratory flow rate (PEF) were measured. Body mass index (BMI) and FEV1/FVC were calculated for all subjects. Multiple regression analysis was performed to identify correlations between pulmonary function parameters and anthropometric variables. RESULTS: The 44 Fulani subjects and 28 urban subjects were well-matched for age and height. The Fulani men weighed significantly less than the urban men (58.5+/-9.4 versus 67.4+/-11.3 kg, p <0.001) and consequently had significantly lower BMI, MAC, and triceps skin-fold thickness. The only significant difference in pulmonary function parameters between the two groups was in FEV1/FVC (0.93+/-0.1 versus 0.85+/-0.1, p <0.001). Small but significant correlations were found between pulmonary function parameters and anthropometric variables for both study populations. CONCLUSIONS: The pulmonary function deficits documented previously in Fulani children and adolescents were not present in adult Fulani men. However, the observed elevation in FEV1/FVC in the rural Fulani men as compared to their urban counterparts, which is often seen in restrictive pulmonary patterns, deserves further study.
Adult↗
Abnormalities in the fatty-acid composition of the serum phospholipids of stroke patients.
The incidence of cardiovascular diseases, stroke, and myocardial infarction is increasing in sub-Saharan Africa. Since dietary polyunsaturated fatty acids (PUFA) are protective of the cardiovascular system in humans, we were interested in the question of the PUFA status of adults in northern Nigeria who had experienced a recent stroke. We collected blood from 21 consecutive admissions for stroke (15 male patients, mean age 39.3 years and six females, mean age 40.7 years) to the Federal Medical Centre in Gombe, Nigeria and analyzed the fatty-acid composition of the serum phospholipids. Blood was collected from 30 healthy controls for comparison. The contribution palmitic acid made to the fatty-acid total was greatly decreased in the phospholipids of the stroke patients (29.2% versus 37.2 %, p < 0.001). However, the phospholipids of the stroke patients had significantly higher percentages of 20-, 22-, and 24-carbon saturated fatty acids, as well as higher proportions of the omega-6 fatty-acid, arachidonic acid (11.4 versus 8.14%, p < 0.001), and the omega-3 fatty-acid, docosahexaenoic acid (3.21 versus 1.80%, p < 0.001). Using the percentages and melting points of the individual fatty acids, we estimated that the acyl chains of the serum phospholipids of the stroke patients had a lower mean melting point than the controls (27.8 versus 34.6 degrees C, p < 0.001). Assuming that serum phospholipids are surrogates for tissue phospholipids, we conclude that the tissue membranes of the stroke patients may be considerably more fluid than those of the controls.
Adult↗
Phase angle correlates with n-3 fatty acids and cholesterol in red cells of Nigerian children with sickle cell disease.
OBJECTIVE: To determine the cholesterol content and fatty acid composition of red cell membrane phospholipids (PL) of children with sickle cell disease (SCD) and to correlate these levels with whole body phase angle that is related to the integrity and function of cell membranes. STUDY DESIGN: Blood samples were obtained from 69 children with SCD and 72 healthy age- and gender-matched controls in Nigeria for the determination of the cholesterol content and proportions of fatty acids in red cell PL. Bioelectrical impedance analysis was used to obtain resistance (R) and reactance (Xc) from which phase angle was calculated as arctan Xc/R. Cholesterol (normalized to lipid phosphorus) and the proportions of individual fatty acids were correlated with phase angle. RESULTS: The proportions of palmitic (p < 0.001), stearic acid (p = 0.003) and cholesterol (p < 0.001) were significantly higher in the red cells of children with SCD, whereas the proportions of arachidonic acid and docosahexaenoic acid were reduced (p = 0.03 and < 0.001, respectively) compared to controls. The phase angle was inversely correlated with the proportions of palmitic acid (p = 0.03) and oleic acid (p < 0.001) and cholesterol (p = 0.003). Three n-3 polyunsaturated fatty acids-eicosapentaenoic acid, docosapentaenoic acid and docosahexaenoic acid- were positively correlated with phase angle (p < 0.001). CONCLUSIONS: The fatty acid composition and cholesterol content of tissue membranes in SCD correlate with the phase shift measured by bioelectrical impedance analysis. Phase angle measurements may provide a non-invasive method for monitoring interventions aimed at altering the lipid composition of membranes.
Journal Article↗
Evaluation of aminoaciduria in severely traumatized patients.
BACKGROUND: It has been documented in the literature that hypocalcemia, hypoaminoacidemia, and hyperaminoaciduria are sequelae of trauma. The aminoaciduria of patients with different types and severity of traumatic injuries was investigated. METHODS: Eight severely traumatized patients (ISS range, 20-43 years) and eight age-, gender-, and weight-matched controls were studied. Plasma and urine were collected 2.5-72 h after admission. Quantification of 28 amino acids in plasma and urine was performed by reversed-phase high-performance liquid chromatography. Urine concentrations of amino acids were indexed to creatinine. RESULTS: The patients' mean serum concentrations of 4 amino acids (arginine, threonine, isoleucine, and glutamine) were significantly decreased, 2 others (tryptophan and glutamic acid) were significantly increased, and 22 were unchanged (p-value< or =0.05). Fractional (urinary) excretion of 11 amino acids was increased in the patients. The patients' serum total calcium and albumin concentrations were decreased, but the mean ionized calcium concentration was not significantly different from the controls. CONCLUSIONS: The results of this study showed that aminoaciduria involving many amino acids is common for patients with different traumatic injuries and that the aminoaciduria is correlated with a reduction of the total serum calcium concentration.
Adult↗
Bioelectrical impedance analysis of the body composition of children and adolescents with sickle cell disease.
OBJECTIVES: To examine the body composition of children and adolescents with sickle cell disease (SCD) using bioelectrical impedance analysis and to determine if the impedance parameters resistance, reactance, and phase angle are able to distinguish between subjects with SCD and age- and gender matched controls. STUDY DESIGN: Total body resistance and reactance were obtained for a total of 53 subjects with SCD (27 male and 26 female) between 10 and 18 years of age and 49 control subjects (23 male and 26 female). The fat-free mass, body cell mass, phase angle, and capacitance were also determined. Group comparisons were made using the 2-sample t test. RESULTS: Male subjects with SCD had significantly lower fat-free mass (37.5 +/- 8.8 vs 43.9 +/- 12.3 kg, P =.04), body cell mass (17.4 +/- 4.3 vs 21.7 +/- 5.8 kg,P =.005), and body fat (3.7 +/- 2.6 vs 6.6 +/- 4.7 kg, P =.008) compared with controls. No significant differences in any body composition components were found for the female subjects. Both male and female subjects had significantly lower phase angle measurements (P <.001 and.006, respectively) than their respective controls, indicating possible alterations in cell membrane properties because of an imbalance in membrane composition or function. CONCLUSIONS: Bioelectrical impedance analysis can be used to determine body composition differences in children with SCD. The phase angle may provide a useful method to monitor the efficacy of therapeutic interventions in patients with SCD.
Adolescent↗
Hypocholesterolemia in Nigerian children with sickle cell disease.
Reports of circulating lipids of children with sickle cell disease (SCD) in Nigeria disagree on the question of whether these children are at increased risk of cardiovascular disease (CVD). We therefore analyzed the serum of 40 females and 37 males with SCD, age 5-19 years, and equal numbers of age-matched controls for total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and homocysteine. Using bioelectrical impedance analysis, we documented a significant reduction in the per cent fat-free mass in the SCD males and increases in the per cent body fat in both the male and female children with SCD. Marked hypocholesterolemia was present in both genders (means, 100-102 mg/dl) and the LDL-cholesterol levels of the male and female subjects with SCD (54 mg/dl) were below the lower limit of the reference range (59-137 mg/dl). Serum triglycerides in the SCD subjects were in the middle of the reference range for children. Although the mean HDL-cholesterol levels of the SCD males (23.1 mg/dl) and females (24.5 mg/dl) were well below the lower limit of the reference range (35-84 mg/dl), respectively, the LDL-cholesterol/HDL-cholesterol ratios of the SCD subjects were not abnormal. The mean serum homocysteine concentrations of the male and female SCD subjects (9.4-9.6 micromol/l) were at the high end of the normal range. Collectively, these results indicate that children with SCD in northern Nigeria are not at increased risk of CVD. However, their marked hypocholesterolemia should be a cause of concern about the overall mortality and general well-being.
Adolescent↗
Serum lipid profiles and risk of cardiovascular disease in three different male populations in northern Nigeria.
The Fulani of northern Nigeria are indigenous semi-nomadic pastoralists whose diet consists largely of dairy products. Despite their consumption of relatively large amounts of saturated fats, an earlier study showed that their total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and serum triglyceride levels fall within the reference range of values for North Americans. Men in the cities of Jos and Abuja, two populations who also reside in northern Nigeria, differ from the Fulani with regard to diet and activity level. Males in both Jos and Abuja have diets consisting of high protein or carbohydrate and are more sedentary than the Fulani subjects. The main aims of the study were to measure the concentrations of various lipids in the blood serum of male urban dwellers in Jos and Abuja and to compare their blood lipid profiles with those of the rural Fulani (mean age 33.9 years). Blood serum samples from 118 men in Jos (mean age 37.9 years) and 77 men in Abuja (mean age 34.4 years) were analyzed for total cholesterol, triglycerides, LDL, HDL, homocysteine, folate, and vitamin B12. In addition to height and weight, systolic and diastolic blood pressures were measured. The mean total cholesterol, triglyceride, HDL and LDL values for the three groups of subjects fell within or close to the accepted range of values for North Americans. However, the Fulani males had HDL values (mean, 33.9 mg/dL) below the range of values prescribed for North Americans (>40 mg/dL). Moreover, the Fulani men and the men in Abuja had a total cholesterol/ HDL ratio of 4.2 and 4.0 respectively, which exceed the accepted value (< or =3.5) prescribed by the Columbia University. In all three populations, the incidence ofhomocysteinaemia (serum homocysteine > 12.4 micromol/L) was very high. Their mean homocysteine levels ranged from 14.7 to 16.7 pmol/L and could not be accounted for by folate or vitamin B12 status. The mean blood pressures of the Abuja (127/77 mm Hg) and the Fulani (120/74 mm Hg) men were within the normotensive range (<130/85 mm Hg). However, the mean blood pressures of the Jos males (131/85 mm Hg) indicated borderline hypertension. These data indicate that, with regard to serum lipids, urban and rural adult Nigerian males have generally favourable risk factors for cardiovascular disease when compared with healthy North Americans. All three sub-populations, however, have levels of homocysteine that are cause for concern vis-à-vis their overall health status.
Adult↗