Fructose and saturated fats predispose hyperinsulinemia in lean male rat offspring

Background  

Early exposure to suboptimal nutrition during perinatal period imposes risk to metabolic disorders later in life. Fructose intake has been associated with increases in de novo lipogenesis, dyslipidemia, insulin resistance, and obesity. Excess consumption of saturated fat is associated with metabolic disorders.     

Cost-effectiveness of alternative approaches in the management of dyspepsia

OBJECTIVES: To assess the cost-effectiveness of alternative initial strategies in the management of uninvestigated dyspepsia in adult patients presenting to a primary care physician in Canada. METHODS: Clinical decision-making was modeled based on outcomes data from the literature and expert opinion. Costs were obtained from official reimbursement lists, and a detailed microcosting analysis of a gastroscopy. Costs were analysed over a one-year period after initial presentation, including consideration of a single relapse of symptoms. The main outcome was a symptomatic cure. The seven management strategies based on different initial tests were endoscopy, double-contrast barium meal, empirical eradication therapy, empirical antisecretory treatment, urea breath test (UBT), laboratory serology, and sequential testing (laboratory serology followed, if Helicobacter pylori positive, by UBT). RESULTS: In patients under age 45, endoscopy, double-contrast barium meal, and sequential testing were not cost-effective approaches. UBT was the most effective and most costly strategy costing 8,238 dollars per additional patient cure compared with laboratory serology. In patients over age 45, UBT was again the most effective and most costly strategy, but endoscopy was the most reliable in detecting gastric cancers. Clinical variables that impacted these findings were the probability of symptomatic relapse in patients with nonulcer dyspepsia (NUD) after successful versus failed H. pylori eradication, the probability of finding a duodenal ulcer (DU) in a young dyspeptic patient, the specificity of UBT, and the prevalence of H. pylori in patients with DU. CONCLUSIONS: A "test-and-treat" approach was favored, with UBT being the most effective but most costly initial test in adult dyspeptics under age 45. The choice of the most cost-effective approach is dependent on the benefits of H. pylori eradication in patients with NUD. In patients over age 45, UBT is the most effective and most costly, but endoscopy results in the early detection of most gastric cancers.     

世界华人消化杂志和World Journal of Gastroenterology2006年工作总结

世界胃肠病学杂志社于2006-12-22在北京鹭鹭酒家东方店举行了第三次工作会议,总结了2006年《世界华人消化杂志》和《World Journal of Gastroenterology》各项编辑出版工作,国家自然科学基金委员会杂志部祖广安主     

Folic acid and vitamin B-12 supplementation does not favorably influence uracil incorporation and promoter methylation in rectal mucosa DNA of subjects with previous colorectal adenomas

Adequate folate availability is necessary to sustain normal DNA synthesis and normal patterns of DNA methylation and these features of DNA can be modified by methylenetetrahydrofolate reductase (MTHFR) C677T genotype. This study investigated the effect of MTHFR C677T genotype and daily supplementation with 5 mg folic acid and 1.25 mg vitamin B-12 on uracil misincorporation into DNA and promoter methylation. Subjects (n = 86) with a history of colorectal adenoma and MTHFR CC or TT genotype were randomly assigned to receive folic acid plus vitamin B-12 or placebo for 6 mo. Uracil misincorporation and promoter methylation of 6 tumor suppressor and DNA repair genes were assessed in DNA from rectal biopsies at baseline and after the intervention. The biomarkers did not differ between the treated group and the placebo group after 6 mo compared with baseline. The uracil concentration of DNA increased in the treated group (5.37 fmol/microg DNA, P = 0.02), whereas it did not change in the placebo group (P = 0.42). The change from baseline of 4.01 fmol uracil/microg DNA tended to differ between the groups (P = 0.16). An increase in promoter methylation tended to occur more often in the intervention group than in the placebo group (OR = 1.67; P = 0.08). This study suggests that supplementation with high doses of folic acid and vitamin B-12 may not favorably influence uracil incorporation and promoter methylation in subjects with previous colorectal adenomas. Because such alterations may potentially increase the risk of neoplastic transformation, more research is needed to fully define the consequences of these molecular alterations.     

MAT1A variants modulate the effect of dietary fatty acids on plasma homocysteine concentrations

Background and AimDietary n-3 polyunsaturated fatty acids (PUFAs) are associated with decreased plasma homocysteine (Hcy), an important biomarker for cardiovascular disease. The S-adenosylmethionine synthetase type-1 (MAT1A), an essential enzyme in the conversion of methionine to S-adenosylmethionine, plays a key role in homocysteine metabolism. This study investigated the interaction between dietary fatty acids and MAT1A genotypes on plasma Hcy concentrations among Boston Puerto Ricans.Methods and ResultsPlasma Hcy and MAT1A genotypes were determined in 994 subjects of the Boston Puerto Rican Health Study. Dietary fatty acid intakes were assessed by interviews using a questionnaire adapted from the NCI/Block food frequency form.ResultIn the cross-sectional analysis, genetic variant MAT1A 3U1510 displayed a significant interaction with dietary n-3:n-6 PUFA ratio in determining plasma Hcy (p-value for interaction = 0.025). 3U1510G homozygotes had significantly lower plasma Hcy concentration than major allele homozygotes and heterozygotes (AA + AG) (p-value for trend = 0.019) when the n-3:n-6 ratio was >0.09. Two other MAT1A variants, d18777 and i15752, also showed significant interactions with different constituents of dietary fat influencing Hcy concentrations. Furthermore, haplotypes consisting of three variants displayed a strong interaction with n3:n6 ratio influencing Hcy concentrations.ConclusionsOur results suggest that MAT1A genotypes appear to modulate effects of dietary fat on plasma Hcy.     

Holter Recordings with Continuous Marker Annotations: A New Tool in Pacemaker Diagnostics

Pacemakers provide marker annotations to facilitate the interpretation of pacemaker electrocardiograms (ECGs) and can be used in cases of suspected pacemaker malfunction or to understand pacemaker behavior. Due to the need for a programmer, only short-term evaluations are possible. We evaluated a prototype Telemetry Data Logger (TDL) designed to continuously transfer markers from the pacemaker to a conventional Holter recorder. A miniaturized telemetry receiving coil was attached to patient's skin above the pacemaker, which was programmed to transmit markers continuously. The TDL, which receives and converts markers into eight positive and eight negative deflections, ranging from -2.5 to +2.5 mV in amplitude, was connected to one channel of a conventional Holter recorder (Tracker 2). We performed 20 Holters in 13 patients who had implanted VDDB or DDDR devices from the same manufacturer and evaluated three versions of software. Marker transmission was possible in all patients, producing Holter ECGs with complete marker annotations. Artifacts occurred < 4 % of the time. A 50-ms rectangular pulse was optimal for marker interpretation. The device, which was easy to use and well accepted by the patients, assisted in the diagnosis of inappropriate pacemaker programming, even when the surface ECG seemed to show regular pacemaker function. In the presence of low quality surface ECGs, marker annotations allowed the assessment of pacemaker function. The capability to annotate the onset of special algorithms, like tachycardia termination algorithms or mode switching, facilitates interpretation of pacemaker behavior, enabling a reliable assessment of the appropriateness of such algorithms. Conclusion: The TDL effectively enables pacemaker markers to be inscribed onto a conventional Holter recording, facilitating the interpretation of pacemaker ECGs and the diagnosis of inappropriate pacemaker programming even when not discernible from the surface ECG alone.