Effect of food on the availability of iron from three multivitamin/mineral supplements during pregnancy

Iron absorption profiles of two reformulated prenatal multivitamin/mineral supplements (Stuartnatal 1 + 1 and Stuart Prenatal) were compared with those of Materna 1.60 in 24 healthy women in their second or third trimester of pregnancy. In an assessment of the effect of food on the availability of the iron, each woman received single doses of two of the three prenatal supplements while fasting and after a standardized meal. Reformulated Stuartnatal and reformulated Stuart Prenatal provided amounts of iron well above the 3.5-mg recommended daily allowance (RDA) during pregnancy; Materna provided amounts of iron only slightly above the RDA. Iron absorption values obtained when the supplements were administered to fasting women were not significantly different from those obtained after postprandial administration. No adverse effects were reported with any of the study formulations.     

Availability of iron from four prenatal multivitamin/multimineral products

Iron absorption from four prenatal multivitamin/multimineral preparations was compared in 36 healthy pregnant women in their second or third trimester of pregnancy. The products studied were the currently marketed formulations of Stuartnatal 1 + 1, Stuart Prenatal, Materna, and Natalins Rx. Each fasted subject received each of the four preparations, according to a randomized sequence, at intervals of three to seven days between drug administrations. Stuartnatal 1 + 1 demonstrated the best iron absorption. Total iron absorbed from Stuartnatal 1 + 1 and Stuart Prenatal was well above the additional daily 3.5 mg recommended during pregnancy. Following administration of Materna the amount of iron was only slightly above that recommended, and following Natalins Rx it was well below. All formulations were generally well tolerated by the subjects.     

Serum ferritin levels after multivitamin iron ingestion during teenage pregnancy

The postabsorptive serum ferritin levels following normal dosages of prenatal multivitamin/multimineral supplements were studied in 17 pregnant teenagers, whose fetuses were between 16 and 20 weeks gestational age. The purpose of the study was to determine the effect of a single oral dose of differing prenatal multivitamin/multimineral tablets containing 60 or 65 mg of elemental iron on the postabsorptive serum ferritin levels. Each woman was randomly tested following the ingestion of one of three different tablets, both in a fed and a fasting state. Blood samples were obtained for ferritin measurement immediately prior to ingestion of the prenatal tablet, with or without a standard meal, and at 1, 3, 6, and 8 hours postabsorption. The group mean serum ferritin levels increased dramatically during the fasting state following ingestion of the Stuart Prenatal tablet and decreased when the Stuartnatal 1 + 1 or Materna 1.60 was ingested. The opposite results were observed when the tablets were ingested postprandially. The results of the study indicate that Stuart Prenatal was most suitable for consumption while fasting (ie, at the hour of sleep), and both Stuartnatal 1 + 1 and Materna 1.60 with a meal.     

A placebo-controlled comparative trial of various prenatal vitamin formulations in pregnant women

The iron-delivery characteristics of three commercially available prenatal vitamin-mineral supplements were studied in a placebo-controlled, randomized cross-over comparison in 40 low-risk women during their second and third trimesters of pregnancy. Each formulation was ingested immediately after a standardized meal. The serum iron concentration was measured at one, three, and six hours after administration. With two of the supplements (Stuart-natal 1 + 1 and Stuart Prenatal tablets), the mean serum iron level at six hours was significantly higher than the mean level at three hours. In contrast, Materna gave the same mean serum level at three hours and at six hours. Calculations of the mean total number of milligrams of iron absorbed after a single dose were 5.7 for Stuart Prenatal, 5.2 for Stuartnatal 1 + 1, and 4.4 for Materna. The results from this study indicate that Stuartnatal 1 + 1, when administered correctly, does provide substantially more iron than the accepted daily requirement during pregnancy.     

Bovine ferritin iron bioavailability in man

The bioavailability of ferritin iron was evaluated in human subjects using radiolabelled [⁵⁵Fe]ferritin isolated from bovine spleen and liver. Preliminary studies with bovine spleen ferritin labelled in vitro demonstrated an inappropriately high absorption compared with ferritin labelled in vivo , and the latter was therefore used in all subsequent absorption studies. In 10 subjects, geometric mean absorption from 5 mg of ferritin iron was 3.8% when taken without and 3.2% when taken with food ( P  >0.05). These values were significantly lower than absorption from the same dose of iron given as ferrous sulphate, which averaged 24.1% without and 8.2% with food. When the iron dose was increased 10-fold, absorption of ferritin iron averaged only 0.6–0.7% with or without food as compared with 7.9% without and 2.6% with food when the iron was given as ferrous sulphate. In a further study, mean absorption from bovine spleen ferritin of 4.0% did not differ significantly from the mean of 2.7% observed with bovine liver ferritin. These findings confirm previous studies indicating that ferritin iron is poorly absorbed. Furthermore, its use as a pharmaceutical iron preparation cannot be advocated.     

Is absorption of high-dose oral iron sufficient in peritoneal dialysis patients?

OBJECTIVE: Iron supplementation plays a major role in erythropoietin-treated end-stage renal disease patients. For peritoneal dialysis (PD) patients, oral iron substitution is more convenient than intravenous therapy. However, disturbed iron absorption and adverse effects may be limiting factors for oral treatment. Nevertheless, we compared the response to a high-dose and low-dose oral iron absorption test between PD patients and healthy control subjects. PATIENTS AND INTERVENTIONS: In 34 PD patients and 15 healthy control subjects, blood samples were taken at baseline as well as 2, 4, and 8 hours after oral intake of 4 tablets iron sulfate (105 mg elemental iron per tablet). In a subgroup of 6 PD patients and 6 control subjects, the oral iron absorption test was repeated using 1 tablet iron sulfate. RESULTS: There was no significant difference in the increase in serum iron during the test between the two groups. As known for healthy subjects, iron absorption was significantly better in PD patients with absolute iron deficiency compared to those with functional iron deficiency. Iron-repleted PD patients showed the lowest iron absorption, indicating that a high dose of oral iron did not overwhelm the ability of the bowel tract to reject unneeded iron. Increasing the oral iron dose from 1 to 4 tablets was followed by a better response in a small subgroup of PD patients compared to control subjects. Side effects such as nausea and vomiting occurred more frequently during high-dose oral iron in control subjects than in PD patients (20% vs 8.8%). CONCLUSION: High-dose oral iron is well absorbed in iron-depleted PD patients. This kind of oral iron therapy should be considered in some subgroups of PD patients with iron deficiency, particularly in those patients with poor vascularization of arm veins or intolerance to intravenous iron preparations.     

ABSORPTION OF LOW AND THERAPEUTIC DOSES OF FERRIC MALTOL, A NOVEL FERRIC IRON COMPOUND, IN IRON DEFICIENT SUBJECTS USING A SINGLE DOSE IRON ABSORPTION TEST

Ferric maltol is a novel ferric iron compound with potential use as an oral therapy for iron deficiency anaemia. Using a single, low dose iron absorption test we compared absorption of ferric maltol with absorption of ferrous sulphate in 21 iron deficient subjects. Absorption of 10 mg of ferric maltol as either aqueous solution or a single tablet compared favourably with that of an equivalent dose of ferrous sulphate. At a higher, more therapeutic dose of 60 mg elemental iron as tablets, absorption of ferric maltol appeared to be both more rapid and total absorption greater, than that seen with ferrous sulphate. We conclude that iron from ferric maltol, both at low dose and higher, more therapeutic doses, is at least as well absorbed as from ferrous sulphate. Ferric maltol is the first ferric iron formulation to be absorbed to a degree equivalent to that of ferrous iron salts and may represent a viable form of administration for ferric iron in the treatment of iron deficiency anaemia.     

Bovine ferritin iron bioavailability in man

The bioavailability of ferritin iron was evaluated in human subjects using radiolabelled [⁵⁵Fe]ferritin isolated from bovine spleen and liver. Preliminary studies with bovine spleen ferritin labelled in vitro demonstrated an inappropriately high absorption compared with ferritin labelled in vivo, and the latter was therefore used in all subsequent absorption studies. In 10 subjects, geometric mean absorption from 5 mg of ferritin iron was 3.8% when taken without and 3.2% when taken with food (P >0.05). These values were significantly lower than absorption from the same dose of iron given as ferrous sulphate, which averaged 24.1% without and 8.2% with food. When the iron dose was increased 10-fold, absorption of ferritin iron averaged only 0.6–0.7% with or without food as compared with 7.9% without and 2.6% with food when the iron was given as ferrous sulphate. In a further study, mean absorption from bovine spleen ferritin of 4.0% did not differ significantly from the mean of 2.7% observed with bovine liver ferritin. These findings confirm previous studies indicating that ferritin iron is poorly absorbed. Furthermore, its use as a pharmaceutical iron preparation cannot be advocated.     

Coadministration of gatifloxacin and multivitamin preparation containing minerals: potential treatment failure in an elderly patient

OBJECTIVE: To report a case of probable treatment failure in a patient receiving gatifloxacin and a multivitamin preparation containing minerals. CASE SUMMARY: A 77-year-old white woman was prescribed gatifloxacin for hospital-acquired bacterial pneumonia. She was also receiving calcium carbonate 500 mg twice daily and a multivitamin preparation containing minerals once a day. Three days after gatifloxacin was started, the patient was still febrile, coughing, and not responding clinically. It was noted that nurses were administering the gatifloxacin tablet at the same time as the multivitamin tablet. The time of administration for gatifloxacin was changed to 6 hours after the patient received her multivitamin preparation. Two days later, she clinically improved. DISCUSSION: Studies have shown that the bioavailability of gatifloxacin is decreased with concurrent administration of antacids containing aluminum or magnesium; dietary supplements containing zinc, magnesium, and iron; multivitamin preparations containing minerals; and sucralfate. An objective causality assessment revealed that the adverse drug effect was probable. CONCLUSIONS: This case illustrates the need to recognize this potential interaction and to know how to avoid possible treatment failure.     

7931名早孕期女性营养素补充剂使用状况调查

  目的  了解我国早孕期女性营养素补充剂的使用现状,并分析其影响因素。  方法  本研究数据来自中国孕产妇队列研究(Chinese Pregnant Women Cohort Study,CPWCS),该项目于2017年7月25日至2018年7月24日招募早孕期女性,应用在线问卷的方式调查孕妇营养素补充剂使用状况,包括是否使用营养素补充剂及使用种类。采用多因素Logistic回归分析各种营养补充剂使用的影响因素。  结果  共入选7931名符合纳入标准的早孕期女性。其中使用营养素补充剂7431名(93.7%,7431/7931),各类营养素补充剂使用率由高至低依次为叶酸(88.7%,7034/7931)、复合维生素(43.5%,3451/7931)、钙(29.0%,2297/7931)、维生素D(23.8%,1891/7931)、益生菌(22.4%,1778/7931)、铁(21.9%,1739/7931)、膳食纤维(18.9%,1497/7931)及二十二碳六烯酸(17.0%,1350/7931)。使用2种及以上营养素补充剂者最多(60.0%,4678/7931),其次为使用1种营养素补充剂者(34.7%,2753/7931),未使用营养素补充剂者最少(6.3%,500/7931)。多因素Logistic回归分析表明,孕妇年龄、孕妇及其配偶文化程度是影响早孕期孕妇使用营养素补充剂的主要因素。  结论  早孕期女性使用营养素补充剂较普遍,其种类以叶酸、复合维生素为主,存在同时使用多种营养素补充剂的现象。孕妇及其配偶的社会经济地位与营养素补充剂的使用有关。     

THE ABSORPTION OF IRON AFTER PARTIAL GASTRECTOMY

Iron-absorption tests were performed in 31 patients who hadhad a partial gastrectomy, and 18 of these were anaemic. Testswere also performed in 14 patients before and after partialgastrectomy. The absorption of haemoglobin iron was impaired in patientswith postgastrectomy anaemia. Some of these also absorbed lessinorganic iron than anaemic control subjects but the majorityabsorbed it well. Absorption of iron when taken orally and when introduced intothe jejunum was measured in five normal volunteers. Althoughinorganic iron was absorbed equally as well from the jejunumas after oral administration, the absorption of haemoglobiniron from the jejunum was impaired. Absorption of inorganic iron was increased in three subjectswith postgastrectomy anaemia when a whole hog stomach extractwas added to the ingested iron. The significance of these findings in relation to the developmentof postgastrectomy anaemia is discussed. ² Present address: Manchester Royal Infirmary.     

Effect of desirable fasting triglycerides on the postprandial response to dietary fat.

BACKGROUND: The National Cholesterol Education Program (NCEP) recently revised the "desirable" fasting triglyceride (TG) to < 150 mg/dL, and levels exceeding 200 mg/dL are defined as "high." METHODS: To evaluate the postprandial response to dietary fat, 50 studies were conducted in nonobese, normocholesterolemic subjects. Following an overnight fast, subjects consumed an oral fat load (70 g/m2), and postprandial triglyceride (ppTG) measurements were assessed at 2, 4, 6, and 8 hours. Subjects were divided by fasting TG cutpoints of 100 and 150 mg/dL. RESULTS: The prevalence of ppTG samples exceeding 200 mg/dL was significantly lower with fasting TG < 100 mg/dL (n = 116) compared with TG 100 to 150 mg/dL (n = 56) (8% versus 25%; p = .004, chi-square analysis). In addition, fasting TG < 100 mg/dL (n = 29) was associated with a reduced mean 4-hour peak ppTG level compared with fasting TG > 100 mg/dL (n = 21) (125 mg/dL versus 249.8 mg/dL; p < .0001). Multiple linear regression analysis identified fasting TG as the most important determinant of the postprandial response after adjustment for other covariates (p = .0005). CONCLUSIONS: Because ppTG-rich lipoproteins contribute to coronary heart disease risk, fasting TG < 100 mg/dL may be a more desirable cutpoint than fasting TG < 150 mg/dL in coronary heart disease risk factor assessment.     

Comparisons between absorption of vitamin E in patients with chronic pancreatitis and healthy controls: the bioavailability of vitamin E

The fasting serum levels of alpha-tocopherol were determined by high-pressure liquid chromatography in 13 patients with chronic pancreatitis of whom 7 were positive for pancreatic calcification (CCP) and 6, negative (NCP) and 10 healthy subjects. The fasting serum levels of alpha-tocopherol were significantly lower in patients with chronic pancreatitis (7.2 +/- 1.1 micrograms/ml for CCP and 7.9 +/- 0.6 for NCP) than in healthy subjects (11.3 +/- 0.7 micrograms/ml). Vitamin E absorption was determined in those with chronic pancreatitis and in healthy subjects after postprandial oral administration of 400 mg of vitamin E, using soft capsules which contained tocopherol nicotinate along with an appropriate amount of a suspension of an ester of fatty acids with glycerol and middle chain triacylglycerol. The mean absorption of vitamin E was 12.7 +/- 2.0 micrograms/ml X hr for healthy subjects, 9.1 +/- 3.1 micrograms/ml X hr for CCP and 13.0 +/- 2.7 micrograms/ml X hr for NCP, respectively. There was no significant difference in vitamin E absorption between patients with chronic pancreatitis and healthy subjects. Further, the rate of hydrolysis of tocopherol nicotinate did not significantly differ between healthy subjects and patients with chronic pancreatitis. It is of interest to note that vitamin E absorption in patients with chronic pancreatitis was increased by the postprandial use of an oily suspension type preparation of tocopherol nicotinate.     

Zinc supplementation in burn patients

Micronutrient supplementation is a common practice throughout many burn centers across North America; however, uncertainty pertaining to dose, duration, and side effects of such supplements persists. The authors prospectively collected data from 23 hospitalized patients with burn sizes ranging from 10 to 93% TBSA. Each patient received a daily multivitamin and mineral supplement, 50 mg zinc (Zn) daily, and 500 mg vitamin C twice daily. Supplements were administered orally or enterally. Albumin, prealbumin, C-reactive protein, serum Zn, and serum copper were measured weekly during hospital admission until levels were within normal reference range. Our study concluded that 50 mg daily dose of Zn resulted in normal serum levels in 19 of 23 patients at discharge; 50 mg Zn supplementation did not interfere with serum copper levels; and Zn supplements, regardless of administration route, did not result in gastrointestinal side effects.     

Pharmacology of Cefuroxime as the 1-acetoxyethyl ester in volunteers.

Cefuroxime axetil is a new orally absorbed prodrug of the antibiotic cefuroxime. The results of pharmacological studies in 52 healthy volunteers are presented. Intact cefuroxime axetil was not detected in the systemic circulation, indicating that deesterification to yield cefuroxime occurs rapidly after absorption. The bioavailability as measured by urinary recovery of cefuroxime was 40 to 50% if the drug was taken after food and 30% if the drug was taken after overnight fasting. Absorption was similar for three different formulations at 500 mg and independent of dose over the range of 250 mg to 1 g. When the drug was taken after food, serum levels and urinary recoveries were significantly greater for cefuroxime than for ampicillin, but when the drug was taken after fasting the values were similar for the two drugs. The kinetic behavior of cefuroxime axetil and ampicillin was not influenced by repeated dosing at 250 mg. Cefuroxime axetil was well tolerated. Although changes in bowel flora and habit were noted during repeated dosing, these changes were no greater than with ampicillin.     

Multivitamin supplements may affect warfarin anticoagulation in susceptible patients

OBJECTIVE: To report an interaction of a multivitamin preparation containing small amounts of vitamin K(1) (25 microg) with warfarin in a case series and to assess the prevalence of vitamin K(1) deficiency in ambulatory anticoagulated patients. CASE SUMMARIES: We describe 3 patients whose anticoagulation was stabilized with warfarin in whom initiation or cessation of a self-prescribed multivitamin supplement delivering 25 microg of vitamin K(1) daily was associated with an otherwise unexplained significant fall or rise in international normalized ratio (INR), respectively, with major thrombosis or hemorrhage in 2. This interaction was rated probable on the Naranjo probability scale. Suspecting vitamin K(1) deficiency as an explanation for this oversensitivity, we assessed the prevalence of vitamin K(1) deficiency in our clinic by determining plasma vitamin K(1) levels in 179 stable consecutive patients, finding very low levels (<0.1 ng/mL) in 22 of 179 (12%). DISCUSSION: Vitamin K(1) supplements of 25 microg daily are far below the dose thought to affect anticoagulant control. We hypothesize that, in our patients, unsuspected vitamin K(1) deficiency caused an oversensitivity to small vitamin K(1) supplements. In patients with low vitamin K(1) status, even such low doses represent a significant increment in daily intake, thus lowering the sensitivity to warfarin. Our analysis suggests that low vitamin K(1) status exists in a small, but important, minority of ambulatory patients undergoing anticoagulation. CONCLUSIONS: Clinicians should instruct anticoagulated patients to report the use of multivitamin supplements and inquire about it in cases of unexplained INR changes.     

Increased intestinal permeability as a cause of fluctuating postprandial blood glucose levels in Type 1 diabetic patients

BACKGROUND: In diabetic patients, postprandial glucose levels, which have a major impact on metabolic control, are determined by the rate of nutrient delivery into the intestine, absorption of nutrients from the small intestine, and the metabolism of the absorbed nutrients by the liver. The present study addresses whether Type 1 diabetic patients have increased intestinal permeability and intestinal permeability predicts postprandial glucose variability. MATERIAL AND METHODS: Thirty Type 1 diabetic patients together with 15 sex- and age-matched healthy controls were enrolled in the study. After an overnight fasting all patients and controls received 100 micro Ci 51Cr of EDTA as a radioactive tracer and the percentage of the isotope excreted in a 24-h urinary specimen was the permeability measure. Instant blood glucose was measured just before the test, and the patients performed and recorded self-monitoring of fasting and 2nd-hour postprandial blood glucose levels during the following week. RESULTS: We found that intestinal permeability is increased in Type 1 diabetic patients compared with age- and sex-matched healthy controls. Increased intestinal permeability is related at least in part to the instant blood glucose level and the presence of diabetic autonomic neuropathy. CONCLUSION: Increased intestinal permeability leads to higher variation in postprandial blood glucose levels, thereby worsening metabolic control.     

Iron absorption after single pharmacological oral iron loading test in patients on chronic peritoneal dialysis and in healthy volunteers.

OBJECTIVE: Oral iron is poorly absorbed in chronic dialysis patients. We tested the hypothesis that a superpharmacologic dose of iron sulfate (260 mg elemental iron) administered on an empty stomach results in significant iron absorption in these patients. DESIGN: A prospective open controlled trial. SETTING: Outpatient department of a university hospital. PATIENTS: Nine stable chronic peritoneal dialysis (PD) patients and seven normal control subjects. METHOD: All subjects ingested a single dose of 4 tablets of iron sulfate (260 mg elemental iron total) in the morning while fasting. OUTCOME MEASURES: Serum iron concentrations at baseline, and at 2 and 4 hours after the oral dose were compared between the two groups. RESULTS: The control group showed a significant rise in mean [standard error (SE)] serum iron concentration, from a baseline value of 76.5 +/- 7 microg/dL to 191 +/- 10.5 microg/dL at 2 hours and to 190 +/- 24 microg/dL at 4 hours. This result represents a percentage rise of 164% +/- 32% at 2 hours and 152% +/- 28.5% at 4 hours. In the PD patients, a significant rise in serum iron concentration was also seen, from a baseline value of 64 +/- 8 microg/dL to 130 +/- 3 microg/dL at 2 hours and 111 +/- 18 microg/dL at 4 hours. This result represents a percentage rise of 105% = 29% at 2 hours and 77% +/- 23.5% at 4 hours. However, the absolute change in serum iron concentration in PD patients at 2 and 4 hours was approximately equal to 50% of the change in control subjects at those time points. None of the PD patients experienced gastrointestinal side effects; 4 control subjects experienced mild side effects. CONCLUSION: Despite impaired oral iron absorption in chronic dialysis patients, a large pharmacologic dose given orally can result in significant iron absorption and may prove to be a more efficient means of oral iron supplementation therapy in these patients.     

Efficacy of multivitamin supplementation containing vitamins B6 and B12 and folic acid as adjunctive treatment with a cholinesterase inhibitor in Alzheimer's disease: a 26-week, randomized, double-blind, placebo-controlled study in Taiwanese patients

BACKGROUND: Elevated serum homocysteine levels have been associated with the development of Alzheimer's dementia (AD). The combined use of a mecobalamin capsule preparation, which contains vitamin B12 0.5 mg with an active methyl base, and an over-the-counter nutritional supplement that contains folic acid 1 mg and pyridoxine hyperchloride 5 mg may be effective as a homocysteine-lowering vitamin regimen. OBJECTIVE: The aim of this study was to determine whether oral multivitamin supplementation containing vitamins B6 and B12 and folic acid would improve cognitive function and reduce serum homocysteine levels in patients with mild to moderate AD. METHODS: This randomized, double-blind, placebocontrolled trial was conducted at En Chu Kong Hospital, Taipei, Taiwan. Male and female patients aged >50 years with mild to moderate AD and normal folic acid and vitamin B12 concentrations were enrolled. All patients received treatment with an acetylcholinesterase inhibitor and were randomized to receive add-on mecobalamin (B12) 500 mg + multivitamin supplement, or placebos, PO QD for 26 weeks. The multivitamin contained pyridoxine (B6) 5 mg, folic acid 1 mg, and other vitamins and iron. Serum homocysteine level was measured and cognitive tests were conducted at baseline and after 26 weeks. The primary efficacy outcome was change in cognition, measured as the change in score from baseline to week 26 on the Alzheimer's Disease Assessment Scale 11-item Cognition subscale. Secondary efficacy outcomes included changes in function in performance of activities of daily living (ADLs) and concentrations of homocysteine, B12, and folic acid. Tolerability was assessed by comparing the 2 study groups with respect to physical examination findings, including changes in vital signs, laboratory test abnormalities, concomitant medication use, and compliance of study medication was assessed using an interview with the patient's caregiver, as well as the monitoring of adverse events (AEs) throughout the study. RESULTS: Eighty-nine patients (45 men, 44 women; all Taiwanese; mean [SD] age, 75 [7.3] years) were enrolled and randomized. Overall, there were no significant differences in cognition or ADL function scores between the 2 groups. At week 26, the mean (SD) between-group difference in serum homocysteine concentration versus placebo was -2.25 (2.85) micromol/L (P = 0.008), and the mean serum concentrations of vitamin B12 and folic acid were significantly higher (but within normal range) in the multivitamin group compared with placebo (., +536.9 [694.4] pg/mL [P < 0.001] and +13.84 ng/mL [11.17] [P = 0.012] at 26 weeks, respectively). The 2 most common AEs were muscle pain (11.1% and 6.8%) and insomnia (8.9% and 9.1%) in the multivitamin and placebo groups, respectively. CONCLUSIONS: In this population of patients with mild to moderate AD in Taiwan, a multivitamin supplement containing vitamins B(6) and B(12) and folic acid for 26 weeks decreased homocysteine concentrations. No statistically significant beneficial effects on cognition or ADL function were found between multivitamin and placebo at 26 weeks.     

Postprandial lipemic response and lipoprotein composition in subjects with low or high cholesterol absorption efficiency

BACKGROUND: The purpose of this study was to investigate the effect of differences in cholesterol absorption efficiency on the postprandial lipemia and lipoprotein composition. METHODS: Fifteen healthy subjects were divided into low and high cholesterol absorbers on the basis of serum cholestanol to cholesterol ratio. A high-performance liquid chromatographic method with evaporative light scattering detection was developed for quantitation of free and esterified cholesterol, triglycerides and major phospholipids from the same lipid extract in two runs utilizing the same internal standard. RESULTS: The free cholesterol to phosphatidylcholine ratio of chylomicrons was higher in the high cholesterol absorption group. The total increase of cholesterol in combined chylomicron and very low density lipoprotein (VLDL) fraction was also higher in this group. Chylomicron free cholesterol and cholesterol ester responses correlated with fasting low density lipoprotein (LDL) cholesterol. VLDL and VLDL1 triglyceride responses correlated inversely with fasting insulin and homeostasis model assessment of insulin resistance. CONCLUSIONS: High cholesterol absorption efficiency was seen in chylomicrons as higher cholesterol to phosphatidylcholine ratio during the postprandial peak. Chylomicron cholesterol response was linked to fasting LDL cholesterol and low VLDL triglyceride response to fasting insulin.