骨代谢标志物与不同类型骨质疏松症的相关性研究

目的:比较不同类型骨质疏松症患者血清中骨代谢标志物的水平差异以及骨代谢标志物之间的相关性。方法:采用免疫电化学发光法检测2016年6月至2017年12月在我院确诊为骨质疏松无骨折患者134例,骨质疏松伴骨折患者118例,甲状旁腺功能亢进合并骨质疏松症患者126例和我院体检中心健康人群116例受试对象血清中I型前胶原氨基端延长肽(Procollagen type I N-terminal peptide,P1NP)、骨钙素(N-terminal midfragment of osteocalcin,N-MID)、I型胶原羧基端肽β特殊序列(βisomer of the C-terminal telopeptide of type I collagen,β-CrossLaps)、血清25羟维生素D(25-hydroxyvitamin D,25-OH(vit)D)、甲状旁腺素(Parathyroid hormone,PTH)的水平。结果:三种不同类型骨质疏松症患者血清中PINP及β-Crosslaps的水平均明显高于健康对照组(P0.05),其中PTH增高性骨质疏松组增加最为明显;各组受试对象中女性患者血清25-OH(vit)D水平均明显低于同组男性患者(P0.05),PINP、β-CrossLaps、N-MID的水平与同组男性患者相比均呈增加的趋势;Pearson相关性分析结果显示PTH与25-OH(vit)D呈负相关,PINP与N-MID,β-CrossLaps与N-MID,PINP与β-CrossLaps均呈正相关(P0.05)。结论:分析骨代谢标志在不同类型骨质疏松症患者血清中的水平差异及骨代谢标志物之间的相关性,可合理评价骨组织的转换率,有利于早期发现骨代谢紊乱,能更有效地预防骨质疏松症的发生与发展,减少骨质疏松合并骨折的发生率。     

骨合成促进剂治疗骨质疏松症的优势*

背景：骨质疏松引发的骨折及其并发症严重影响老年人及绝经妇女生活质量。 目的：旨在探究主要骨合成促进剂的研究新进展,以促进其临床应用。 方法：由第一作者应用计算机检索PubMed、中国期刊全文数据库(CNKI)、维普数据库和万方数据库1997年1月至2012年8月相关文献。在标题、摘要、关键词中以“bone formation,osteoporosis,osteoblast,osteoclast,bone metabolism,PTH,Wnt signaling,medicine,target,inhibitor”或“骨合成,骨质疏松,成骨细胞,破骨细胞,骨代谢,甲状旁腺激素,Wnt信号,药物,靶目标,抑制剂”为检索词进行检索。初检得到398篇文献,最终选择40篇文献进行综述。 结果与结论：骨合成促进剂不同于传统单纯抗骨吸收骨质疏松药物,能进一步增加骨量,对骨折风险的降低亦有一定作用。骨合成促进剂治疗骨质疏松有重要的临床价值。甲状旁腺激素及甲状旁腺激素相关肽,Wnt信号通路相关分泌型糖蛋白分子抑制剂如抗硬化蛋白(Selerostin)抗体、Dkk1抑制剂、sFRP抑制剂、GSK3β抑制剂等是骨质疏松相关骨合成促进剂中的研究热点,但临床应用于同样存在一些局限性。     

骨折患者血清25-羟基维生素D和甲状旁腺素水平与骨密度的相关性

目的探究骨折患者血清25-羟基维生素D(250HD)和甲状旁腺素(PTH)水平与骨密度的相关性。方法选择2015年12月至2017年12月于我院骨科住院治疗的110例骨折患者作为研究对象,所有患者均行骨密度检查,根据骨密度T值将患者分为正常组、骨质减少组、骨质疏松组。测定骨质疏松四项标志物即血清250HD、PTH、血清1型胶原氨基端前肽(PINP)、β胶原降解产物(β-CTX)水平。结果正常组各部位骨密度值显著高于骨量减少组、骨质疏松组(P<0.05);骨量减少组各部位骨密度值显著高于骨质疏松组,差异具有统计学意义(P <0.05);骨量正常患者血清250HD显著高于骨量减少、骨质疏松组(P <0. 05);血清PINP、PTH水平均显著低于骨量减少、骨质疏松组(P <0. 05);相关性分析示骨质疏松患者血清250HD与腰椎1-4、全髓关节及股骨颈骨密度值呈正相关关系(P<0. 05)。结论骨质疏松患者血清中250HD明显下降,与患者骨密度呈正相关,PTH水平虽在骨质疏松患者中明显上升,但其与骨密度无相关性。     

血清骨代谢标记物P1NP和β-CrossLaps对骨质疏松症的疗效评价

背景:研究发现1型原胶原N-端前肽(P1NP)和β-胶原特殊序列(β-CrossLaps)2种骨代谢标记物与骨质疏松存在密切的相关性,骨代谢标记物与骨密度的联合检测对诊断骨质疏松症有一定临床意义,是预测骨折的理想指标,能弥补骨密度检查的不足。目的:介绍20年来国内外关于骨代谢标记物在治疗骨质疏松症的药物功效监测和骨折风险的预测这两方面的应用,探讨骨代谢标记物1型原胶原N-端前肽和β-胶原特殊序列在骨质疏松症治疗效果评估中的检测意义及在骨质疏松性骨折风险评估中的价值。方法:以骨代谢标记物(Serum bone metabolic markers);骨质疏松症(Osteoporosis);骨密度(Bone mineral density)为检测词,检索CNKI数据库和SCI数据库2000至2014年相关研究文献,筛选后纳入44篇符合标准的文献进行综述。结果与结论:文章分析了血清骨代谢标记物1型原胶原N-端前肽和β-胶原特殊序列的来源与检测机制,对比检测血清骨代谢标记物1型原胶原N-端前肽、β-胶原特殊序列水平变化在骨质疏松症疗效评估中的优势。血清骨代谢标记物不仅可以反映骨代谢的动态平衡状况,而且其水平的改变显著早于骨密度的变化,特别是血清骨代谢标记物1型原胶原N-端前肽和β-胶原特殊序列对骨质疏松症的早期诊断、抗骨质疏松药物疗效判定都有重要价值。     

骨转换生化标志物在DM2并发骨质疏松的临床应用价值

目的:探讨骨转换生化标志物在2型糖尿病(DM2)患者并发骨质疏松的早期诊断价值.方法:选择112例DM2患者,根据受试者的骨密度值分为骨质疏松组和非骨质疏松组,对比两组DM2患者的总Ⅰ型前胶原氨基端延长肽(TPINP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、甲状旁腺素(PTH)和血清钙(Ca2+)指标之间的差异.结...     

促骨形成药物的研究进展

骨质疏松症所引起的脆性骨折严重影响老年人的健康和生活质量。目前,抗骨质疏松治疗的药物主要有骨吸收抑制剂和骨形成促进剂两大类;而临床用于治疗的大多为骨吸收抑制药物,仅有重组人甲状旁腺激素是唯一上市的治疗骨折疏松的促骨形成药物。胰岛素样生长因子-1、钙离子受体拮抗剂、骨形成蛋白、Wnt信号通路阻滞剂等一批新型促骨形成药物正在体内和体外实验之中。随着研究的不断深入,这些促骨形成药物必将会有广阔的应用前景。     

绝经后2型糖尿病并发骨质疏松患者骨转换标志物的变化及探讨

目的探究绝经后2型糖尿病并发骨质疏松患者骨转换标志物的变化及检测意义。方法选取我院在2016年2月~2017年2月收治的100例绝经后女性患者进行研究,经诊断确诊后的50例绝经后骨质疏松患者作为对照组,50例绝经后2型糖尿病并发骨质疏松患者作为研究组,观察对比研究组患者骨转换标志物的相关因素分析、两组患者生化指标以及两组患者骨密度。结果研究组患者空腹血糖(FBG)、糖化血红蛋白(HbA1c)、碱性磷酸酶(ALP)以及抗酒石酸酸性磷酸酶(TRAP-5b)、甲状旁腺素(PTH)、血肌酐(Scr)、显著高于对照组患者(P0.05),血清25羟维生素D(250HD)明显低于对照组患者(P0.05);研究组患者与对照组患者骨密度之间无明显差异(P0.05);N端中段骨钙素(N-MID)与糖尿病病程呈负相关以及抗酒石酸酸性磷酸酶(TRAP-5b)、I型胶原羧基端交联肽(CTX)与骨密度呈负相关。结论经检测发现2型糖尿病主要通过影响破骨细胞的活性进而影响骨代谢,绝经后2型糖尿病并发骨质疏松患者骨转换标志物可能是抗酒石酸酸性磷酸酶,对指标的检测有助于疾病的早期诊断。     

重组人甲状旁腺激素(1-34)促成骨作用及在口腔领域的应用

文题释义： 特立帕肽(teriparatide)：即重组人甲状旁腺激素(1-34)(rhPTH 1-34),2002年经美国食品药品监督管理局(FDA)批准应用于骨质疏松症的治疗,是第一代骨合成代谢药。它可以直接刺激新骨的成骨细胞形成,实现有效的合成代谢,在口腔领域的研究也表现出良好的促进种植体-骨结合及牙周再生等效果。 甲状旁腺激素：由甲状旁腺主细胞合成与分泌,是含84个氨基酸残基的单链多肽,位于人类甲状旁腺激素分子氨基端(N-端)的1-34位氨基酸序列是其生物活性部位。甲状旁腺激素是调节人体钙磷内环境稳态及骨代谢的重要激素,间歇低剂量给予甲状旁腺激素对骨骼发挥合成代谢作用。 背景：重组人甲状旁腺激素(1-34)(recombinant human parathyroid hormone 1-34,rhPTH 1-34),即特立帕肽,为甲状旁腺激素氨基端片段,作为骨合成代谢药,因可以直接刺激新骨形成、增加骨量而成为研究热点,也因其强大的成骨效应引起口腔领域的关注与应用。 目的：对特立帕肽的成骨机制、有效性和安全性及其在口腔领域的研究进展进行综述。 方法：第一作者检索近20年PubMed数据库、万方数据库收录的相关文章。英文检索词为“rhPTH(1-34),teriparatide,osteoporosis,stomatology,Jaw,implant-osseointegration,periodontal”,中文检索词为“重组人甲状旁腺激素(1-34),特立帕肽,骨质疏松,口腔医学,颌骨,种植体-骨结合,牙周”。共选取56篇文献进行综述。 结果与结论：特立帕肽可以直接刺激新骨的成骨细胞形成,实现有效的合成代谢,其在口腔领域的研究表现出良好的促进种植体-骨结合、牙周再生、骨缺损愈合及提高正畸稳定性的效果,在口腔领域有良好的应用前景,但仍需要更多更高质量的动物实验及临床研究证实。未来甲状旁腺激素类药物及其类似物可与骨组织工程技术有机结合,更好地促进骨修复,同时也更好地服务于口腔颌面部的修复治疗。 ORCID: 0000-0002-2333-4260(董西玲) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

骨质疏松症患者骨代谢相关指标比较分析

目的 分析骨质疏松症患者检验指标的差异,探讨骨质疏松性骨折与骨代谢标志物间的相关性,为骨质疏松性骨折的治疗与预防提供一定的参考依据.方法 随机选取505例受试者,分为骨质疏松合并骨折组(291例)和骨质疏松未合并骨折组(214例),检测总25-羟基维生素D[25(OH)D]、骨钙素(N-MID)、I型前胶原N端肽(PINP)、β-胶原特殊序列(β-cross Laps)、甲状旁腺素(PTH)、血钙(Ca)、血磷(P)、血镁(Mg)、碱性磷酸酶(ALP)、白蛋白(ALB)、D-二聚体(D-dimer)、血红蛋白(H GB),对这些指标在单纯骨质疏松组患者和骨质疏松性骨折组患者中的差异进行统计分析.结果 试验组(骨质疏松骨折组)和对照组(骨质疏松未骨折组),试验组年龄、血清PINP、血清钙和血清碱性磷酸酶水平高于对照组,血清25(OH)D和D-二聚体水平低于对照组,试验组与对照组男/女,组间比较差异有统计学意义(P<0.05).试验组男73例和女218例资料比较,男性患者血清钙、骨钙素、β-cross Laps、磷、PINP、镁低于女性患者,组内比较差异有统计学意义(P<0.05).对照组男87例和女127例资料比较,男性患者血清PTH高于女性患者,组内比较差异有统计学意义(P<0.05).结论 老年骨质疏松患者随着年龄增大,骨量丢失加快,骨折的风险也在不断提高.不同性别的骨质疏松骨折患者代谢指标存在差异,这提示我们在临床中要考虑不同性别骨质疏松患者的发病主导因素,积极地监测血液中骨代谢指标的变化,为骨质疏松患者制定合理的饮食加药物方案,干预其生活方式,对于降低骨质疏松患者骨折发生的风险具有重要的临床意义.     

骨重建失衡导致骨质疏松发生的作用机制及其药物治疗策略

背景:目前骨重建失衡被认为是造成骨质疏松的关键因素,如在骨质疏松发生过程中干预重建失衡,则可一定程度逆转骨质疏松状态并改善预后。破骨抑制和成骨诱导性药物则是针对此致病机制的靶点药物。因此综述性回顾骨质疏松的骨重建失衡机制对于骨质疏松药物治疗具有指导意义,破骨抑制和成骨诱导性药物的临床应用现状和治疗效果也急需进行系统性总结,以起到临床用药指导的作用。目的:综述骨质疏松的骨重建失衡发生机制,并总结破骨抑制药物和成骨诱导药物针对骨重建失衡的调节作用机制,对比2种药物的临床作用效果,为骨质疏松的药物治疗选择进行指导。方法:检索PubMed、WebofScience、中国知网数据库建库至2020年2月发表的相关文献,英文检索词为"osteoporosis,bone remodeling,antiresorptive,anabolic,bisphosphonate,RANKL inhibitor,PTH analogue,anti-sclerostin antibody",中文检索词为"骨质疏松,骨重建,破骨抑制,成骨诱导,双膦酸盐,RANKL抑制剂,甲状旁腺素类似物,抗硬化素抗体"。共检索到相关文献144篇,按照纳入与排除标准,最终纳入84篇文献进行总结。结果与结论:①骨质破坏发生后,可引起机体发生骨重塑,而骨重塑则会导致可逆性非可逆性两种类型的骨缺失发生;②可逆性骨缺失约历时3个月,依次经历骨吸收、骨重填和新骨矿化过程,修复后的骨量和骨质均优;③而不可逆性骨缺失则存在破骨-成骨失衡,虽然也有一定的新骨形成,但新生的骨质较差,易再次发生骨结构破坏;④双膦酸盐、RANKL抑制性抗体属于破骨抑制药物,其作用机制为减慢骨重建速率以减少逆转期骨吸收量,但新生骨量和质量也会相应减少;⑤而特里帕肽、甲状旁腺素类似物等成骨诱导类药物则利于缺损骨质修复,完善破坏的哈弗氏管系统结构,使得新生骨质获得优良的力学强度。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.