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P265 ASSESSMENT OF OXIDATIVE STRESS MARKERS RELATED TO ATHEROSCLEROSIS IN PRE-HYPERTENSIVE WOMEN
136 P263 MALNUTRITION COMBINED WITH LOW SKIN BLOOD FLOW IN DIALYSIS PATIENTS MAY PREDICT FUTURE DEVELOPMENT OF NON-HEALING WOUNDS E. Mistrik1 , S. Dusilova Sulkova1 , V. Blaha1 , L. Sobotka1 . 1 Department of gerontology and metabolism, University Hospital, Hradec Kralove, Czech Republic Rationale: Malnutrition associated with non-healing wounds is frequent problem in patients on chronic hemodialysis (HD). The aim of present study was to estimate the influence of peripheral blood flow changes on development of foot defects in HD patients. Methods: Peripheral skin blood flow was measured using Laser Doppler Line Scanner (LDLS® , Moor, Devon, UK) in 10 different areas (AI) of dorsal part of instep and fingers of each foot before and during HD ultrafiltration (897±465 mL) in 31 HD patients (10 female, 21 male; age 36 79 y, BMI = 28±5.0). No peripheral skin defects or apparent acute disease or infection were detected in any patient at the time of LDLS measurement. Foots of patients were carefully followed next 18 months. Two-sample t-test, one-way ANOVA, Spearman correlation coefficient and Kaplan Meier log-rank analysis were used for statistical analysis. Results: Significant and constant decrease of skin blood flow during HD was found (p < 0.001). Skin blood flow before HD and during HD correlated with serum albumin (r = 0.36, p = 0.05; r = 0.47, p = 0.007), respectively. Nine patients developed a skin defects during the follow-up period. Peripheral blood flow at the beginning of the study in these subjects was significantly lower compared to patients with no defects before (p = 0.001) and during hemodialysis (p = 0.0006). Significantly larger proportion of patients with normal perfusion remained defect-free in comparison to patients with critical perfusion (93% vs. 38%, p = 0.002, Kaplan Meier analysis). Conclusion: Skin blood flow correlates with albumin in HD patients. This may be impaired and HD procedure leads to further decrease, often below critical value. Low skin blood flow combined with low serum albumin in dialysis patients may predict future development of skin defects. Supported by research grants: IGA MH CR No. NR/9259 3, MSM 0021620820 Disclosure of Interest: None declared.
P264 HOW TO DECREASE MICROALBUMINURIA IN TYPE 2 DIABETIC PATIENTS USING MICRONUTRIENTS SUPPLEMENTATION? M. Farvid1 , F. Homayoni1 , S. Rabiee1 , T. Neyestani2 . 1 Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shaheed Beheshti University of Medical Sciences, 2 Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Tehran, Iran (Islamic Republic of) Rationale: The main objective of this study was to find the effect of magnesium plus zinc, vitamins C plus E, and a combination of these micronutrients with vitamin B
Poster presentations groups on urinary albumin excretion in type 2 diabetic patients. Methods: In a randomized, double-blind, placebo controlled clinical trial, 67 type 2 diabetic patients were randomly divided into three groups, each group receiving one of the following daily supplement for 4 months; group MV: 250 mg Mg and 20 mg Zn, 200 mg vitamin C and 100 mg vitamin E (n = 23), group MVB: 250 mg Mg and 20 mg Zn, 200 mg vitamin C and 100 mg vitamin E, 10 mg vitamin B1, 10 mg vitamin B2, 10 mg vitamin B6, 10 mg vitamin B12 and 1 mg folic acid (n = 22), group P: placebo (n = 22). Urinary albumin excretion was determined at the beginning and at the end of the trial. Treatment effects were analyzed by general linear modeling. Results: Results indicate that after 3 months of supplementation, levels of urinary albumin excretion decreased in the MV and MVB groups by 60% and 39%, respectively (P = 0.009 and P = 0.041, respectively). There was no significant change in the levels of these parameters in the placebo group. Conclusion: In conclusion, the results of the present study confirm the results of previous study and provide evidence for the effects of combination of magnesium, zinc, and vitamins C and E supplementation on improvement of glomerular function in type 2 diabetic patients. Disclosure of Interest: Grant/research support
Nutrtion and Chronic Diseases II P265 ASSESSMENT OF OXIDATIVE STRESS MARKERS RELATED TO ATHEROSCLEROSIS IN PRE-HYPERTENSIVE WOMEN F. Siassi1 , F. Amirkhizi1 , M. Djalali1 , S. Minaie1 , A. Dorosty1 . 1 Nutrition and Biochemistry, Scool of Public Health, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of) Rationale: The purpose of this cross-sectional study was to examine the association between pre-hypertension status and oxidative stress markers in a random sample of cardiovascular disease-free women. Methods: In this study, 160 women of 20 45 years of age were randomly selected. General information data were gathered from each sample using questionnaires and faceto-face interviews. Blood pressure (BP) was measured for each subject. Body weight, height, and waist and hip circumferences were measured and body mass index (BMI) and waist-to-hip ratio (WHR) were calculated for each subject. Venous blood samples were drawn from the subjects, and plasma was separated. In this study, the oxidative stress status was assessed by measuring the concentrations of plasma malonedialdehyde (MDA) and total antioxidant capacity (TAC) levels. Data were analyzed using Chi-squared test, Pearson’s correlation coefficient and multiple linear regression analysis. Twotailed values of P < 0.05 were considered as statistically significant. Results: Our results show that both systolic and diastolic blood pressures were inversely correlated with TAC
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(p < 0.01) and positively correlated with MDA levels (p < 0.01). Particularly, compared to the normotensive subjects, the pre-hypertensives had 19% lower TAC (p < 0.05) and 22% higher MDA levels (p < 0.01), after correcting for multiple comparisons and adjusting for age, body mass index, waist-to-hip ratio, and other potential confounders. Table: Oxidative stress markers and blood pressure status (Data are presented as mean±SD) Oxidative stress Normotensive Pre-hypertensive Hypertensive P-Value markers (n = 75) (n = 53) (n = 32) MDA (mmol/L) TAC (mmol/L)
1.84±0.64 3.56±0.84
2.38±0.79 2.89±0.57
3.41±0.96 1.98±0.39
<0.001 <0.001
Conclusion: Our findings revealed an association between pre-hypertension and oxidative stress markers linked to atherosclerosis process. Thus, the identification of the underlying molecular mechanisms in pre-hypertension, which seem to include oxidative stress, may serve as an important lead for developing potentially new treatment modalities in this group of patients at risk for future cardiovascular complications.
(r = 0.295, p=.011), fatigue (r = 0.304, p = 0.009), social impairment (r = 0.342, p = 0.003), and QoL (r = 0.381, p = 0.001). Table 1: Venous access complications Complication type
% patients, Average during Complications occurrence whole HPN per VA year period (range)
Infectious VA complications 76% Occlusions 42% Other complications 31% (e.g. exit site infection)
3.5±4.3 (0 20) 1.07±1.3 1.9±3.2 (0 17) 0.27±0.5 1.1±1.7 (0 7) 0.24±0.6
Conclusion: Vascular access-related complications remain the major drawback of HPN treatment and are experienced by the vast majority of HPN patients in the Netherlands. Our consistent finding is that these access-related complications significantly influence QoL and confer depression, social impairment, and fatigue in a rate-dependent manner. Taken together, our findings underscore the need for preventive strategies in this respect. Disclosure of Interest: None declared.
Disclosure of Interest: None declared.
P266 CENTRAL VENOUS CATHETER RELATED COMPLICATIONS AND EXPERIENCED PROBLEMS IN HPN DEPENDENT PATIENTS G. Huisman-de Waal1 , M.W.J. Versleijen2 , T. van Achterberg1 , J. Jansen2 , H. Sauerwein3 , L. Schoonhoven1 , G.J.A. Wanten2 . 1 IQ Healthcare, Nursing Science, 2 Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, 3 Endocrinology and Metabolism, University Medical Centre, Amsterdam, Netherlands Rationale: More than 35 years after its introduction, venous access (VA)-related complications remain the most important drawback of home parenteral nutrition (HPN) treatment. In addition to these complications, HPN patients also experience significant psychosocial problems in daily life, mainly comprising depression, social impairment and fatigue. The aim of the present retrospective analysis is to present an overview of VA-related complications in the population of patients on HPN in the Netherlands and to assess whether these adversities are related to the experienced psychosocial problems and quality of life (QoL). Methods: Information on VA-related complications was collected retrospectively from the medical records of all 110 adult patients who had been on HPN for more than 3 months in The Netherlands in 2006. In addition, a survey was performed in 75 patients of this group to characterize the experienced psychosocial problems and assess their association with VA-related complications. Results: The majority of patients experienced venous access complications (table 1). Most importantly, our analysis showed a significant relation between the rate of VA-related complications, and psychosocial complaints, in the form of depression
P267 IS B-HYDROXY-B-METHYLBUTYRATE (HMB) THE BIOACTIVE METABOLITE OF L-LEUCINE (LEU) IN MUSCLE? MOLECULAR EVIDENCE AND POTENTIAL IMPLICATIONS M. Manzano1 , M.D. Giron2 , R. Salto2 , N. Sevillano2 , R. Rueda1 , J.M. Lopez-Pedrosa1 . 1 Research and Development, Abbott Nutrition, 2 Biochemistry and Molecular Biology II, University of Granada, Granada, Spain Rationale: It has been reported that Leu is able to stimulate muscle protein synthesis through the mammalian target of rapamycin (mTOR) pathway. However, a central issue that remains unresolved is if HMB, Leu metabolite produced by the alpa-ketoisocaproate dioxygenase (alpha-KICD) activity, may be the major player mediating this effect. In the present study we examined the potential role of HMB in the Leu-signaling pathway involving mTOR in L6 myotube cells. Methods: The effects of either Leu (10 mM) or HMB (50 mM) on the phosphorylative status of mTOR and updown-protein kinases (PKB/Akt, P70 S6 kinases) were analyzed in cells by western blot, transfected or not with a construct that over-express alpha-KICD, and in the presence or absence of mesotrione, a specific inhibitor of alpha-KICD. Results: HMB stimulated phosphorylation of mTOR, PKB/Akt, P70 S6 kinases in both transfected and nontransfected cells, while Leu only exerted this effect in transfected cells. Mesotrione blocked the effects of Leu on phosphorylation of mTOR, PKB/Akt and P70 S6 kinases while did not have significant effects on the HMB induced mTOR phosphorylation. Neither Leu nor HMB significantly modified the total levels of mTOR. Conclusion: Results obtained in transfected cell with Leu and HMB in presence of the inhibitor mesotrione, clearly support that HMB is the real active bio-metabolite of Leu
P264 HOW TO DECREASE MICROALBUMINURIA IN TYPE 2 DIABETIC PATIENTS USING MICRONUTRIENTS SUPPLEMENTATION? M. Farvid1 , F. Homayoni1 , S. Rabiee1 , T. Neyestani2 . 1 Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shaheed Beheshti University of Medical Sciences, 2 Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Tehran, Iran (Islamic Republic of) Rationale: The main objective of this study was to find the effect of magnesium plus zinc, vitamins C plus E, and a combination of these micronutrients with vitamin B
Poster presentations groups on urinary albumin excretion in type 2 diabetic patients. Methods: In a randomized, double-blind, placebo controlled clinical trial, 67 type 2 diabetic patients were randomly divided into three groups, each group receiving one of the following daily supplement for 4 months; group MV: 250 mg Mg and 20 mg Zn, 200 mg vitamin C and 100 mg vitamin E (n = 23), group MVB: 250 mg Mg and 20 mg Zn, 200 mg vitamin C and 100 mg vitamin E, 10 mg vitamin B1, 10 mg vitamin B2, 10 mg vitamin B6, 10 mg vitamin B12 and 1 mg folic acid (n = 22), group P: placebo (n = 22). Urinary albumin excretion was determined at the beginning and at the end of the trial. Treatment effects were analyzed by general linear modeling. Results: Results indicate that after 3 months of supplementation, levels of urinary albumin excretion decreased in the MV and MVB groups by 60% and 39%, respectively (P = 0.009 and P = 0.041, respectively). There was no significant change in the levels of these parameters in the placebo group. Conclusion: In conclusion, the results of the present study confirm the results of previous study and provide evidence for the effects of combination of magnesium, zinc, and vitamins C and E supplementation on improvement of glomerular function in type 2 diabetic patients. Disclosure of Interest: Grant/research support
Nutrtion and Chronic Diseases II P265 ASSESSMENT OF OXIDATIVE STRESS MARKERS RELATED TO ATHEROSCLEROSIS IN PRE-HYPERTENSIVE WOMEN F. Siassi1 , F. Amirkhizi1 , M. Djalali1 , S. Minaie1 , A. Dorosty1 . 1 Nutrition and Biochemistry, Scool of Public Health, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of) Rationale: The purpose of this cross-sectional study was to examine the association between pre-hypertension status and oxidative stress markers in a random sample of cardiovascular disease-free women. Methods: In this study, 160 women of 20 45 years of age were randomly selected. General information data were gathered from each sample using questionnaires and faceto-face interviews. Blood pressure (BP) was measured for each subject. Body weight, height, and waist and hip circumferences were measured and body mass index (BMI) and waist-to-hip ratio (WHR) were calculated for each subject. Venous blood samples were drawn from the subjects, and plasma was separated. In this study, the oxidative stress status was assessed by measuring the concentrations of plasma malonedialdehyde (MDA) and total antioxidant capacity (TAC) levels. Data were analyzed using Chi-squared test, Pearson’s correlation coefficient and multiple linear regression analysis. Twotailed values of P < 0.05 were considered as statistically significant. Results: Our results show that both systolic and diastolic blood pressures were inversely correlated with TAC
Nutrtion and Chronic Diseases II
137
(p < 0.01) and positively correlated with MDA levels (p < 0.01). Particularly, compared to the normotensive subjects, the pre-hypertensives had 19% lower TAC (p < 0.05) and 22% higher MDA levels (p < 0.01), after correcting for multiple comparisons and adjusting for age, body mass index, waist-to-hip ratio, and other potential confounders. Table: Oxidative stress markers and blood pressure status (Data are presented as mean±SD) Oxidative stress Normotensive Pre-hypertensive Hypertensive P-Value markers (n = 75) (n = 53) (n = 32) MDA (mmol/L) TAC (mmol/L)
1.84±0.64 3.56±0.84
2.38±0.79 2.89±0.57
3.41±0.96 1.98±0.39
<0.001 <0.001
Conclusion: Our findings revealed an association between pre-hypertension and oxidative stress markers linked to atherosclerosis process. Thus, the identification of the underlying molecular mechanisms in pre-hypertension, which seem to include oxidative stress, may serve as an important lead for developing potentially new treatment modalities in this group of patients at risk for future cardiovascular complications.
(r = 0.295, p=.011), fatigue (r = 0.304, p = 0.009), social impairment (r = 0.342, p = 0.003), and QoL (r = 0.381, p = 0.001). Table 1: Venous access complications Complication type
% patients, Average during Complications occurrence whole HPN per VA year period (range)
Infectious VA complications 76% Occlusions 42% Other complications 31% (e.g. exit site infection)
3.5±4.3 (0 20) 1.07±1.3 1.9±3.2 (0 17) 0.27±0.5 1.1±1.7 (0 7) 0.24±0.6
Conclusion: Vascular access-related complications remain the major drawback of HPN treatment and are experienced by the vast majority of HPN patients in the Netherlands. Our consistent finding is that these access-related complications significantly influence QoL and confer depression, social impairment, and fatigue in a rate-dependent manner. Taken together, our findings underscore the need for preventive strategies in this respect. Disclosure of Interest: None declared.
Disclosure of Interest: None declared.
P266 CENTRAL VENOUS CATHETER RELATED COMPLICATIONS AND EXPERIENCED PROBLEMS IN HPN DEPENDENT PATIENTS G. Huisman-de Waal1 , M.W.J. Versleijen2 , T. van Achterberg1 , J. Jansen2 , H. Sauerwein3 , L. Schoonhoven1 , G.J.A. Wanten2 . 1 IQ Healthcare, Nursing Science, 2 Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, 3 Endocrinology and Metabolism, University Medical Centre, Amsterdam, Netherlands Rationale: More than 35 years after its introduction, venous access (VA)-related complications remain the most important drawback of home parenteral nutrition (HPN) treatment. In addition to these complications, HPN patients also experience significant psychosocial problems in daily life, mainly comprising depression, social impairment and fatigue. The aim of the present retrospective analysis is to present an overview of VA-related complications in the population of patients on HPN in the Netherlands and to assess whether these adversities are related to the experienced psychosocial problems and quality of life (QoL). Methods: Information on VA-related complications was collected retrospectively from the medical records of all 110 adult patients who had been on HPN for more than 3 months in The Netherlands in 2006. In addition, a survey was performed in 75 patients of this group to characterize the experienced psychosocial problems and assess their association with VA-related complications. Results: The majority of patients experienced venous access complications (table 1). Most importantly, our analysis showed a significant relation between the rate of VA-related complications, and psychosocial complaints, in the form of depression
P267 IS B-HYDROXY-B-METHYLBUTYRATE (HMB) THE BIOACTIVE METABOLITE OF L-LEUCINE (LEU) IN MUSCLE? MOLECULAR EVIDENCE AND POTENTIAL IMPLICATIONS M. Manzano1 , M.D. Giron2 , R. Salto2 , N. Sevillano2 , R. Rueda1 , J.M. Lopez-Pedrosa1 . 1 Research and Development, Abbott Nutrition, 2 Biochemistry and Molecular Biology II, University of Granada, Granada, Spain Rationale: It has been reported that Leu is able to stimulate muscle protein synthesis through the mammalian target of rapamycin (mTOR) pathway. However, a central issue that remains unresolved is if HMB, Leu metabolite produced by the alpa-ketoisocaproate dioxygenase (alpha-KICD) activity, may be the major player mediating this effect. In the present study we examined the potential role of HMB in the Leu-signaling pathway involving mTOR in L6 myotube cells. Methods: The effects of either Leu (10 mM) or HMB (50 mM) on the phosphorylative status of mTOR and updown-protein kinases (PKB/Akt, P70 S6 kinases) were analyzed in cells by western blot, transfected or not with a construct that over-express alpha-KICD, and in the presence or absence of mesotrione, a specific inhibitor of alpha-KICD. Results: HMB stimulated phosphorylation of mTOR, PKB/Akt, P70 S6 kinases in both transfected and nontransfected cells, while Leu only exerted this effect in transfected cells. Mesotrione blocked the effects of Leu on phosphorylation of mTOR, PKB/Akt and P70 S6 kinases while did not have significant effects on the HMB induced mTOR phosphorylation. Neither Leu nor HMB significantly modified the total levels of mTOR. Conclusion: Results obtained in transfected cell with Leu and HMB in presence of the inhibitor mesotrione, clearly support that HMB is the real active bio-metabolite of Leu