Biomedical subjects

P Lumb

Publications and source records attributed to P Lumb.

At least 19 recordsLinked to original sources

PubMed2005

Cardiovascular risk in women with polycystic ovarian syndrome (PCOS).

AIMS: Studies have suggested that polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risk. The aim of this study was to examine cardiovascular risk profiles in women with PCOS compared with healthy age and weight matched control subjects using novel biochemical and biophysical markers. METHODS: After ethics committee approval, 11 women with PCOS and 12 controls were recruited (mean age, 32; SD, 6.5 years; mean body mass index (BMI), 33.1; SD, 5.9 kg/m2). Serum was analysed for lipid and lipoprotein profile (total and high density lipoprotein cholesterol, triglycerides, apolipoprotein B-100, apolipoprotein A1, lipoprotein (a)), and sialic acid, fibrinogen, homocysteine, and C reactive protein (CRP) concentrations. Endothelial function was also assessed by a standard venous occlusion plethysmography technique to measure reactive hyperaemic forearm blood flow (RH), and expressed as per cent increase from baseline. RESULTS: There were no significant differences in glucose, lipid, or lipoprotein concentrations between the two groups. Furthermore, sialic acid (PCOS: mean, 70.5; SD, 149 mg/litre; controls: mean, 71.3; SD, 112 mg/litre), fibrinogen (PCOS: mean, 3.1; SD, 1.0 g/litre; controls: mean, 3.3; SD, 0.7 g/litre), CRP (PCOS: mean, 4.6; SD, 4.2 mg/litre; controls: mean, 5.41 SD, 5.5 mg/litre), and RH (PCOS: mean, 158.7; SD, 135.5%; controls: mean, 200.1; SD, 114.2%) were similar. CONCLUSIONS: There were no differences in surrogate markers of the processes linked to enhanced cardiovascular risk between patients with PCOS and weight matched controls.

Adolescent↗

PubMed2004

The response of serum apolipoprotein H to an oral fat load.

BACKGROUND: We tested the hypothesis that serum apolipoprotein H (apo H) concentration increases after an oral fat load. Such a study would give valuable insight into whether apo H was influenced by the postprandial state. METHODS: Ten male subjects aged 24-48 years were fed 62.5 g of total fat (saturates 12 g, monounsaturates 35.3 g, polyunsaturates 12.5 g). Venous blood was sampled hourly for 5 h post-oral fat load. RESULTS: No significant change in serum apo H concentration occurred following the oral fat load. However, serum apo H in the baseline samples correlated significantly with subject body mass index (r = 0.683, P < 0.05), body fat mass (r = 0.778, P < 0.01), lean body mass (r = 0.693, P < 0.05), serum triglyceride (r = 0.732, P < 0.02), serum insulin (r = 0.808, P < 0.01) and insulin resistance index (r = 0.794, P < 0.01). In stepwise multiple linear regression model, with serum apo A1, apo B, lipoprotein(a), total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, plasma glucose and insulin and apo H as the dependent variable, insulin remained in the model (r = 0.81, P < 0.01). Conversely, with body mass index, body fat mass, lean body mass and waist/hip ratio in the model and apo H as dependent variable, only body fat mass remained in the model (r = 0.78, P < 0.01). CONCLUSIONS: Serum apo H may be involved in insulin resistance and relates to various indices of adipose tissue, including body fat mass. However, serum apo H concentrations do not significantly change postprandially.

Adult↗

PubMed2003

Serum sialic acid, a reputed cardiovascular risk factor, is related to serum leptin concentrations in Fijians.

BACKGROUND: Serum sialic acid (TSA) has been shown to be a cardiovascular risk factor and an acute phase reactant, with elevated concentrations associated with increased cardiovascular mortality and to precede the onset of type 2 diabetes. AIM: The purpose of this present study was to test the hypothesis that serum TSA may be related to serum leptin concentrations in healthy individuals. METHODS: Thirty Fijian individuals were studied (8 males and 22 females). They were urban Melanesians living in Raiwaga, a suburb of Suva in Fiji. RESULTS: Serum TSA significantly correlated with subject body mass index (BMI, rho 0.39, P<0.05) and serum leptin concentration (rho 0.44, P<0.05). In stepwise multiple regression analysis serum TSA independently correlated with subject waist/hip ratio (r(2)=0.167, P<0.02) and diastolic blood pressure (r(2)=0.300, P<0.01) but not with age, BMI, serum insulin-like growth factor binding protein (IGFBP-1), fasting plasma glucose or systolic or diastolic blood pressure. CONCLUSIONS: Serum TSA is related to markers of obesity and adipose tissue metabolism which may help to explain why it is a reputed cardiovascular risk factor and why elevated serum TSA concentrations precede the development of type 2 diabetes mellitus.

Adult↗

PubMed2003

Effect of treatment of chronic periodontitis on levels of serum markers of acute-phase inflammatory and vascular responses.

AIMS: Recent epidemiological work suggests an association between periodontal disease severity and cardiovascular disease risk. This study aimed to ascertain if circulating levels of cardiovascular and systemic inflammatory markers could be modified following treatment of periodontal disease. METHOD: Adult subjects were recruited from those awaiting periodontal treatment and randomised to either immediate (test, n=24) or delayed treatment (control, n=15). Demographic and clinical data were collected and venous blood was taken before and either 6 weeks after completion of treatment or after an equivalent 3-month control period. Periodontal examination included probing depth, loss of attachment, plaque scores and bleeding scores. Blood was analysed to determine serum and plasma fibrinogen, C-reactive protein, sialic acid, tumour necrosis factor-alpha and interleukin -6 and -1beta. Effects of treatment were assessed by paired tests and analysis of variance by treatment group with baseline covariates. RESULTS: Treatment improved plaque and bleeding scores and reduced probing depths (p<0.002). However, there were no statistically significant changes in levels of any of the systemic markers. CONCLUSION: Improvement in periodontal health did not influence the levels of vascular markers.

Acute-Phase Proteins↗

PubMed2002

Serum lipoprotein (A) and apolipoproteins during pregnancy and postpartum in normal women.

This study was designed to investigate whether serum lipoprotein (a) is affected by pregnancy and to relate this to changes in other lipids, lipoproteins and apolipoproteins. The study involved twenty-nine healthy Caucasian pregnant women at term and 27 non-pregnant women matched for age who acted as controls. Samples of venous blood were obtained from 29 pregnant women at term (between 37 and 42 weeks) and 22 of these women provided a second sample after 12 weeks post-partum. Twenty-seven non-pregnant women acted as controls. Samples were taken for Lp(a) and also cholesterol, triglyceride, HDL-cholesterol, apolipoprotein (apo) A and B1. No significant difference was found in the serum concentrations of Lp(a). However, the pregnant women had significantly higher serum concentrations of cholesterol, triglyceride, apo A1 and B (P<0.001) than the controls. The ratio of apo A1: apo B was significantly lower than controls (P<0.001). HDL-cholesterol was not altered by pregnancy but was lower (P<0.05) than the controls after a period of 12 weeks post-partum. Despite a hyperlipidaemia in pregnancy the serum concentrations of Lp(a) are not affected suggesting different metabolic control for this lipoprotein.

Adult↗

PubMed2002

Measurement of urine total sialic acid: comparison of an automated ultraviolet enzymatic method with a colorimetric assay.

An automated ultraviolet (UV) enzymatic assay for urine total sialic acid (SA), performed on a Cobas Fara analyser, is described and compared with the colorimetric Warren method, which is used widely to determine urine SA. Intra-assay coefficient of variation (CV) for urine total SA determination was 0.83% for the UV assay and 3.5% for the Warren method. Inter-assay CVs were 1.8% and 5.6%, respectively. Recovery of urine total SA ranged from 89% for the UV assay to 61% for the Warren method. Both were linear over a range of urine SA from 20 to 240 mg/L The UV assay was automated, took approximately 20 min to produce a result and avoided the need for solvent extraction; however, the reagents were expensive in comparison to those required for the Warren method. Urine samples with a creatinine concentration > 14 mmol/L were diluted with distilled water to optimise SA recovery by the UV method. Urine SA:creatinine ratios for normals were 4.7 (+/- 1.7) g/mol with the Warren method and 4.5 (+/- 1.0) g/mol for the UV method. Similarly, in type-2 diabetic patients, urine SA:creatinine ratios were 7.6 (+/- 2.3) g/mol (P<0.001) and 8.5 (+/- 2.9) g/mol (P<0.001), respectively.

Adult↗

PubMed2002

Serum sialic acid, a possible cardiovascular risk factor is not increased in Fijian Melanesians with impaired glucose tolerance or impaired fasting glucose.

BACKGROUND: Serum total sialic acid (TSA) has been shown to be a strong cardiovascular risk factor with increased concentrations being associated with increased mortality. Serum TSA is also elevated in patients with type 2 diabetes including those with micro- and macrovascular complications. We wished, therefore, to test the hypothesis that serum TSA may be abnormal in individuals with impaired glucose tolerance (IGT) and impaired fasting glucose (IFG), in Fijian Melanesians. METHOD: Twenty-one subjects with IGT (17 women and four men) were recruited along with 20 subjects with IFG (14 women and six men) and 22 normal subjects (12 women and 10 men). Serum TSA was 2.18 +/- 0.027 mmol//L, 2.19 +/- 0.033 mmol/L and 2.24 +/- 0-042 mmol/L in the three groups, respectively, which was not statistically different. Both systolic and diastolic blood pressure were, however, higher in the IGT group compared with the IFG and normal groups (P<0.04). CONCLUSION: Serum TSA is not elevated in Fijian Melanesians with IGT and IFG although it is reported to be elevated in type 2 diabetes mellitus in other populations. Further research is needed to establish why serum TSA is a potent independent cardiovascular risk factor and is elevated in type 2 diabetes mellitus in some populations.

Adult↗

PubMed2001

The response of serum sialic acid and other acute phase reactants to an oral fat load in healthy humans.

BACKGROUND: Elevated serum total sialic acid (TSA) has been shown to be associated with increased cardiovascular mortality. It has been postulated that atherogenesis is a postprandial phenomenon. We tested the hypothesis that serum TSA and other acute phase proteins, namely C-reactive protein (CRP) and fibrinogen, may be related to the postprandial state. METHODS: Ten healthy male subjects, aged 24-48 years, were fed 62.5 g of total fat (saturates 12 g, monounsaturates 35.3 g and polyunsaturates 12.5 g) in the form of strawberry flavoured Calogen. Venous blood was sampled hourly for 5 h. Concentrations of serum triglyceride, TSA and acute phase proteins were measured. RESULTS: Serum triglyceride concentration increased postprandially, peaking at 240 min. Serum CRP and plasma fibrinogen did not significantly increase after the oral fat load. However, serum TSA did increase from baseline (0.599+/-0.051 g/l) in response to the oral fat load, peaking at 120 min post-oral fat load (0.633+/-0.066 g/l, P<0.02). There was a significant correlation between serum TSA and plasma fibrinogen at baseline (rho=0.62, P=0.05) but not for serum CRP (rho=-0.22) or triglyceride (rho=0.21). CONCLUSIONS: We conclude that serum TSA increases postprandially and this finding gives further insight as to why the former is considered to be a cardiovascular risk factor.

Journal Article↗

PubMed2001

Serum apolipoprotein H and its relationship to blood pressure, serum lipids, fasting plasma glucose and insulin in normal individuals.

Apolipoprotein H (apo H), also known as beta2-glycoprotein 1, has recently become of interest in the field of haemostasis. As apo H is elevated in diabetes mellitus and dyslipidaemia, we wished to test the hypothesis that serum apo H concentration was related to fasting plasma glucose and insulin as well as blood pressure, body mass index, hip/waist ratio and serum lipids in normal individuals. Eighty-one healthy young individuals (46 females and 35 males) were studied. Their age was 20.7 +/- 0.75 years. Serum apo H significantly correlated with fasting plasma glucose (r = 0.24, P = 0.03) and serum LDL cholesterol (r = 0.30, P = 0.006). In the females serum apo H significantly correlated with serum cholesterol concentration (r = 0.30, P = 0.04) and in males with serum HDL cholesterol concentration (r = 0.35, P = 0.04). In multifactorial regression analysis for serum apo H and the other variables for the 81 subjects, only gender and fasting plasma glucose remained statistically significant in the model. Serum apo H concentrations would be expected to increase by 21.7 mg/L for each single mmol/L increase in fasting plasma glucose (95% CI 2.3-41 2), P = 0.029, and to increase by 17.0 mg/L if the gender is male (95% Cl 0.7-332), P= 0.041.

Adult↗

PubMed2000

No difference in serum sialic acid in type 2 diabetic patients from the United Arab Emirates with and without diabetic retinopathy.

Serum total sialic acid (TSA) has recently been shown to be related to diabetic retinopathy. However, there is some controversy as this may be true in European Type 2 diabetic patients but not South Asians. There are few data looking at serum TSA expression in Arab Type 2 diabetic patients from the United Arab Emirates (UAE) and we wished to test the hypothesis that there may be different serum TSA expression in Arab Type 2 diabetic patients as regard to retinopathy. Sixty-five Type 2 diabetic patients from the UAE were studied (19 male and 46 female, age 57.5+/-9.8 (45-74) years, duration of diabetes 9.4+/-5.7 (0-22) years. The serum TSA in 13 patients with diabetic retinopathy was 757+/-130 mg/l and 782+/-163 mg/l in those without retinopathy (NS). There was no significant correlation between serum TSA and patient age, serum fructosamine, diabetes duration, or blood pressure. As in South Asians serum TSA does not appear to be elevated in Type 2 diabetic patients from the United Arab Emirates with diabetic retinopathy.

Aged↗

PubMed2000

Serum sialic acid in young type-1 diabetic patients.

It is well established that serum total sialic acid (TSA) is elevated in patients with type-2 diabetes mellitus (NIDDM) compared to non-diabetics. However, it is not clear whether serum TSA is also elevated in type-1 diabetic patients (IDDM). Twenty-one type-1 patients were studied along with age and sex matched normal non-diabetic subjects (ten males and 11 females). Their ages were 24.8+/-3.4 years (20-30) and 23.5+/-3.9 years (18-30) respectively. The duration of diabetes mellitus was 12.6+/-6.7 years (1-24) with a HBA1c of 9.0+/-2.2% (6.0-14.9). There was no significant difference in serum TSA of the type-1 diabetic patients 689+/-107 mg/l versus 670+/-119 mg/l in the normal subjects. Nor was there a significant correlation between serum TSA with patient age (r = -0.31), urine albumin/creatinine ratio (ACR) (r = 0.25), HBA1c (r = 0.36), plasma random glucose (r = -0.04) or diabetes duration (r = -0.09) in the diabetic patients. However, there was a significant correlation between serum TSA and mean daily insulin dose (r = 0.51, P<0.02) and also serum cholesterol and triglyceride (r = 0.58, P<0.01 and r = 0.49, P<0.04, respectively) in the type-1 diabetic patients. In summary, we conclude that serum TSA is not elevated in young type-1 diabetic patients compared with normal age and sex matched control subjects. However, the relationship between serum TSA and serum lipids and also mean daily insulin dose merits further research.

Adolescent↗

PubMed2000

Forensic web watch 4.

Finding dedicated sites on the World Wide Web (WWW) touching upon issues related to the autopsy which could be of use to forensic practitioners is, as with other areas of forensic medicine and science, a time-consuming task. Unfortunately, one has to wade through lists related to 'Alien autopsy' sites and even 'Furby autopsy' sites that are generated by the most commonly used web search engines, which have been featured in earlier web reviews. Numerous sites containing large archives of autopsy photographs are available on the web. However, many of these sites represent the darker side of the WWW as they are often presented purely for titillation. Unfortunately, one can equate these sites to the modern-day version of the Victorian 'freak show'--Typically, these sites ask for your Visa card number to view their contents, and several have links to pornography sites; one even links to a Satanist site. Luckily a few of these sites do now require age confirmation codes. As many of these sites show autopsy photographs from real cases one has to ask how these were obtained and who is placing them on the WWW. This review does not list any of these sites for obvious reasons, but it does draw the reader's attention to sites touching upon issues related to autopsies which forensic practitioners may wish to visit or use.

Journal Article↗

PubMed1999

Plasma sialic acid and coronary artery atheromatous load in patients with stable chest pain.

Serum or plasma sialic acid and C-reactive protein have recently been shown to be cardiovascular risk factors. Our aim was to determine whether plasma sialic acid or C-reactive protein concentration correlate with atheromatous load on coronary angiography. Plasma sialic acid concentration and plasma C-reactive protein concentration were determined in 128 consecutive patients attending day case coronary angiography. Patients were excluded for previous coronary angioplasty, coronary artery bypass grafting, recent myocardial infarction, acute or chronic inflammatory disease and proximal occlusions precluding analysis of distal coronary anatomy. Total cholesterol, triglyceride, HDL cholesterol and glucose concentrations were assayed on fasting samples of venous blood. Angiograms were graded according to a semisubjective scoring system. There was no significant correlation between plasma sialic acid (r = 0.19, P = 0.07), or C-reactive protein concentration (r = 0.17, P = 0.13) and atheromatous load. There was no significant correlation between sialic acid (P = 0.13), or C-reactive protein concentration (P = 0.32) and the number of diseased coronary vessels. The difference in plasma sialic acid concentration between those with normal coronary angiograms and those with coronary artery disease did not reach significance (P = 0.08). Plasma sialic acid concentration correlated with C-reactive protein (r = 0.58, P = 0.0001), serum triglyceride (r = 0.32, P = 0.002), and blood cholesterol concentration (r = 0.22, P = 0.04). Plasma sialic acid concentration does not correlate with atheromatous load on coronary angiography in patients with stable angina.

Adult↗

PubMed1999

Serum apolipoprotein H and its relationship to lipids and other apolipoproteins in normal human men and women.

Apolipoprotein H (apo H), also known as beta-2-glycoprotein I, has recently become of considerable interest in the field of haemostasis. Because of the possible involvement of apo H in lipid pathways, we wished to test the hypothesis that the serum concentration of apo H was related to serum lipids and other apolipoproteins in normal individuals. One hundred and twenty-three healthy young subjects (67 women and 56 men) aged 22.7 +/- 0.70 years (mean +/- SD) were recruited. Serum level of apo H was higher in male subjects that in age-matched female subjects (167.6 +/- 47.5 mg/l versus 148.8 +/- 30.5 mg/l; P < 0.04). Serum levels of apo H were significantly correlated with serum concentration of cholesterol, but only in female subjects (r = 0.28, P < 0.02). No significant correlations were found between serum levels of apo H and triglycerides, high-density lipoprotein cholesterol, apo A1, apo B or lipoprotein (a) in either of the sexes.

Adult↗

PubMed1998

The relationship between the female menopause and serum sialic acid, a known cardiovascular risk factor.

Serum total sialic acid (SA) has recently been reported as a cardiovascular risk factor. The risk of cardiovascular disease increases after the menopause in females. However, there are little data looking at the relationship between serum SA and the menopause. Overall 92 females were studied. The women were divided into five groups: the first three groups were age-matched pre-menopausal (n = 20), peri-menopausal (n = 10) and post-menopausal women (n = 20). In order to study serum SA changes with adult female age we also studied 14 young pre-menopausal women and 28 elderly women. There was no significance difference between the serum SA concentration in the age-matched pre-, peri- or post-menopausal women (62.7 +/- 10.4 mg/dl, 61.7 +/- 4.5 mg/dl, 62.9 +/- 7.0 mg/dl respectively). Furthermore, there was no significant difference between the serum SA in the "young" women (64.7 +/- 9.8 mg/dl) and that of the peri-, pre- or post-menopausal women. However, in the elderly women the serum SA was elevated (75.6 +/- 16.6 mg/dl) with P < 0.05 for each comparison group. In conclusion, serum SA does not seem to change at the time of the female menopause although in elderly women (average age 75.6 +/- 16.6 years) it increases. The reason for this increase is not known and may merit further research.

Adolescent↗

PubMed1998

Serum total sialic acid, a reputed cardiovascular risk factor, and its relationship to lipids, plasma fasting insulin, blood pressure and body mass index in normal individuals.

1. Serum sialic acid is a reputed cardiovascular risk factor, but the reason why this is so is not clear. We therefore studied its relationship with other known cardiovascular risk factors (particularly those associated with insulin resistance) in 100 healthy young subjects (54 females and 46 males, age 20.7+/-0.89 years). 2. There was a significant univariate correlation between serum total sialic acid and fasting plasma insulin. Serum total sialic acid also correlated with fasting plasma glucose concentration and serum cholesterol and triacylglycerol. 3. In females there was a strong univariate correlation between serum total sialic acid and plasma fasting insulin and glucose concentrations, although in males there was a weaker univariate correlation between serum total sialic acid and fasting plasma glucose and the insulin resistance index. In addition, serum total sialic acid significantly correlated with systolic blood pressure, fasting serum cholesterol and triacylglycerol concentrations and body mass index in the females. In males serum total sialic acid significantly positively correlated with fasting serum cholesterol and triacylglycerol concentrations, and correlated inversely with the hip/waist ratio. 4. In multiple regression analysis of the 100 subjects serum total sialic acid correlated independently with fasting serum cholesterol, glucose and also plasma insulin concentrations. In females serum total sialic acid independently correlated with systolic and diastolic blood pressure, and serum cholesterol and fasting plasma glucose concentrations, although there was no significant independent correlation between serum total sialic acid and any of the other variables in the males.

Adult↗

PubMed1998

Influence of plasma phytanic acid levels in Refsum's disease on the behaviour of the erythrocyte membrane sodium-lithium countertransporter.

BACKGROUND: Abnormal behaviour of the erythrocyte membrane sodium-lithium countertransporter (SLC) is associated with plasma triglyceride concentrations. Refsum's disease is characterized by progressive neurological dysfunction and accumulation of phytanic acid, an isoprenoid fatty acid, in fat-containing tissues. METHODS: This study explored the effects of plasma phytanic acid on SLC kinetics in nine Caucasian patients with Refsum's disease and in age- and sex-matched Caucasian control subjects. RESULTS: A dose-dependent association was seen between countertransporter maximal velocity and phytanic acid content of low-density lipoprotein (LDL)-cholesterol (r = -0.61, r = -0.65 respectively; P = 0.05, P = 0.04) and high-density lipoprotein (HDL)-cholesterol (r = -0.81, -0.82 respectively; P = 0.005, P = 0.003). No significant association was seen with the sodium affinity of the transporter (r = -0.44, P = 0.20, for LDL; and -0.43, P = 0.21, for high-density lipoprotein). CONCLUSION: These findings suggest that phytanic acid may alter the behaviour of the sodium-lithium countertransporter.

Antiporters↗

PubMed1998

Carotid endarterectomy surgery and ICU admissions: a regional anesthesia perspective.

Stroke is a major cause of mortality and morbidity in the United States. This study was performed to determine whether the authors' practice of monitoring the majority of patients in the postanesthesia care unit for 2 hours, selectively admitting the recovering carotid endarterectomy patients to the intensive care unit when feasible, and using regional anesthesia for the majority of cases, resulted in adverse outcomes or compromised the safety of the operation at a tertiary care academic medical center. The records of 337 patients (a total of 420 procedures) who underwent carotid endatertectomy surgery without concurrent heart surgery during a consecutive 18-month period ending in June, 1995 were reviewed. Regional anesthesia was the technique used in 97% of the procedures. Shunt placement was deemed necessary in 7% of the procedures. Postoperative strokes occurred in approximately 1% of patients. No shunted patients had a postoperative stroke. The rate of admission to intensive care units was 4%. Blood pressure control accounted for 73% of the patients admitted to intensive care units. Most patients required 2 hours of monitoring in the postanesthesia care unit before triage to the appropriate level of postoperative care. These results suggest that a monitoring period of 2 hours in the postanesthesia care unit allows for safe assessment of the postoperative carotid endarterectomy patient, and that routine intensive care unit admission after carotid endarterectomy surgery is not necessary.

Adult↗