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Background@#Vitamins are nutrients essential for human health. They act as coenzymes that help trigger important chemical reactions necessary for energy production. Reference values for vitamins help physicians evaluate the health status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some water-soluble vitamins of Mongolian adults.@*Materials and Methods@#Three hundred and forty healthy adults (170 males and 170 females) of 17 to 69 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the Resolution No.76 of 2018 of the Medical Ethics Review Committee of the Ministry of Health. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of vitamins B<sub>6</sub>, B<sub>9</sub>, B<sub>12</sub> and vitamin C were measured using a high performance liquid chromatography method. The lower- and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs.@*Results@#The mean blood level of vitamin C was 11.88 mg/L (95% CI 10.47-13.29) for men and 9.62 mg/L (95% CI 8.11-11.13) for women. The calculated reference interval for males was 1.40-19.40 mg/L and 1.17-18.04 mg/L for females. The mean concentration of vitamin B<sub>12</sub> in the blood of males was 938.45 ng/L (95% CI 747.22-1129.68) and that of females was 864.03 ng/L (95% CI 603.81-1124.25). The reference interval for vitamin B<sub>12</sub> was 233.03-1597.00 ng/L in men and 132.45-1623.86 ng/L in women. The mean level of vitamin B<sub>9</sub> was 8.47 ng/mL (95% CI 5.64-11.30) for men and 6.91 ng/mL (95% CI 4.89-8.93) for women. The calculated reference interval for this vitamin in males was 1.04-24.74 ng/mL and that in females was 1.04-21.46 ng/mL. As for vitamin B<sub>6</sub>, the mean concentration for men was 44.42 ng/mL (95% CI 37.01-51.83) and for women was 34.67 ng/mL (95% CI 29.97-39.39) with the reference intervals of 5.90-79.02 ng/mL for men and 5.27-61.72 ng/mL for women. @*Conclusion@#The reference values for vitamins B<sub>6</sub>, B<sub>9</sub>, B<sub>12</sub> and vitamin C of Mongolian adults do not differ significantly from those observed in other populations. The calculated reference intervals can be used in the practice of health laboratories.
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Background@#We set the average value and reference range of blood plasma proteins (total protein, albumin, transferrin, retinol binding protein, prealbumin) to be used to assess the nutritional status of Mongolian adult. According to step by step research methodology, 170 women, 170 men and a total of 340 people were surveyed using a combination of questionnaires and analytic methods. @*Methods@#The total protein and albumin content of the collected samples was analyzed by colorimetric method using “Humalyzer 2000” semi automatic analyzer and prealbumin, transferring and retinol binding protein was analyzed by ELISA method of “ELX 880”. The lower limit of the reference value of the identified parameters was calculated to be 2.5 per centil and the upper limit was 97.5 per centil.@*Results@#Determining average and reference range of proteins in the plasma of a total 340 participants, the average of total protein was 74.54(CI 95%; 72.67-76.38) g/l for men, and 73.59(CI 95%; 72.39-74.79) g/l for women, while the reference range was 55.26-95.79 g/l for men and 58.38-84.72 g/l for women. According to determined above, there is no statistically significant difference in gender (p>0.40). The average albumin level is 48.20(CI 95%; 47.04-49.36) g/l for men and 46.28(CI 95%; 45.32-47.24) g/l for women, while reference range is 37.14-60.01 g/l for men and 34.97-57.60 g/l for women. It means there is a statistically significant difference for the gender (p=0.012). The average prealbum level is 332.43(CI 95%; 311.28-353.58) mg/l for men, 381.67(CI 95%; 360.98-402.36) mg/l for women, while reference range is 171.3-485.0 mg/l for men and 215.5-535.0 mg/l for women. It means there is a statistically significant difference for the gender (p=0.0012). The average range of transferrin 4.01(CI 95%; 3.76-4.26) g/l for men and 4.43(CI 95%; 4.20-4.66) g/l for women while reference range is 2.20-6.92 g/l for men and 2.58-7.05 g/l for women, is a statistically significant difference for the gender (p=0.017). The average level of retinol binding protein is 1.73(CI 95%; 1.61-1.85) μmol/l for men and 2.01(CI 95%; 1.89-2.13) μmol/l for women, while reference range is 0.73-3.08 μmol/l for men and 0.73-3.08 μmol/l for women, is a statistically significant difference for the gender (p=0.0017). @*Conclusions@#For the first time we conducted a study to determine the average amount and reference range of proteins needed to assess the nutritional status of adults (total protein, albumin, prealbumin, transferring, retinol binding protein) according to international standard methods, which is relatively high compared to other researchers. According to the result of the study, it is not possible to directly follow the result of researchers from other countries and the reference range of blood proteins directly to Mongolians. The result of this study has become an important innovation in practice and treatment, as medical professionals have been able to use it in their diagnosis and treatment.
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Background@#Minerals are important for the proper body functioning. They also play a role in preventing and fighting diseases. Reference values for minerals help physicians evaluate the mineral status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some minerals to be used for evaluation of the nutrition status of Mongolians.@*Materials and Methods@#Two hundred and forty healthy adults (120 males and 120 females) of 17 to 70 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the ethical committee of the Ministry of Health of Mongolia. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of iron (Fe), zinc (Zn) and copper (Cu) were measured by graphite furnace atomic absorption spectrometry. The lower and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs. @*Results@#The mean level of blood iron was 30.50 µmol/L (95% CI 29.71-31.29) for men and 30.91 µmol/L (95% CI 30.03-31.79) for women. The calculated reference interval for males was 21.39-37.72 µmol/L and 19.87-39.67 µmol/L for females. The mean concentration of zinc in the blood of males was 11.00 µmol/L (95% CI 10.69-11.31) and that of females was 11.79 µmol/L (95% CI 11.39-12.19). The reference interval for blood zinc was 8.20-14.92 µmol/L in men and 8.52-16.67 µmol/L in women. The mean level of blood copper was 15.28 µmol/L (95% CI 14.64-15.89) for men and 18.08 µmol/L (95% CI 17.30-18.86) for women. The calculated reference interval for copper in males was 9.72-22.34 µmol/L and that in females was 11.18-27.27 µmol/L.@*Conclusion@#The reference values for zinc, copper and iron of Mongolian adults do not differ significantly from those observed in other countries. The calculated reference intervals can be used for evaluation of the nutrition status and making clinical decisions.
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Background@#Iodine is a micronutrient essential for mental and physical development. One of ways to prevent from iodine deficiency is sufficient intake of iodine with food. The WHO approved method for assessment of the population’s iodine status is measurement of the concentration of iodine in urine.@*Goal@#The goal of the survey was to assess the iodine status in 6-11 years old children and pregnant women.@*Materials and Method@#1697 children of 6-11 years of age and 900 pregnant women were selected from 21 aimags and Ulaanbaatar city. Concentrations of iodine in their urine were determined using the Sandell-Kolthoff reaction method.@*Results@#The median amount of urinary iodine in 6-11-year-old children was 143.45 µg/L which was within the WHO recommended range (100.0-199.9 µg/L). 31.82% of the surveyed children had their urinary iodine less than 100 µg/L which indicated a risk of iodine deficiency. The highest frequency of children with urinary iodine less than 100 µg/L was observed in western regions (53.9%) and the lowest percentage was observed in eastern regions (17.8%).</br> The median concentration of urinary iodine in pregnant women was 111.35 100 µg/L which was lower than the WHO recommended value (≥150 µg/L). The median amount of urinary iodine was 127.81 µg/L for the women in Ulaanbaatar city and for those in rural areas was 108 µg/L. The overall percentage of the women with low urinary iodine was 64.1%. @*Conclusions@#</br> 1. The median urinary iodine concentration in 6-11 years old children is within the WHO recommended range, whereas the median concentration in pregnant women is lower than the WHO recommended value. </br> 2. 31.8% of the surveyed children and 64.1% of the pregnant women are at risk of iodine deficiency. </br> 3. The frequency of iodine deficiency is highest in western region and is lowest in eastern and central regions.
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Justification@#Iodine is a micronutrient essential for human health. 92% of the required iodine human organism obtains with food. One of methods to supply the required amount of iodine is the use of iodised salt. The overall goal of our study was to determine the actual consumption of iodised salt by households. @*Materials and Methods@#Samples of salt consumed by 20173 households from five regions (Western, Mountainous, Central, Eastern regions and Ulaanbaatar city) of Mongolia were collected and their iodine contents were determined according to MNS 5168:2002.@*Results@#Out of the total analyzed salt samples, 19.1 % were non-iodised, 2.8% had low iodine content, 77.5% had appropriate level of iodine and 0.6% had high level of iodine.</br> When the salt iodine contents were evaluated by the country regions, it was revealed that the households in Western (31.4%) and Mountainous (20.57%) regions consumed salt that was not iodised. 84.5% of the Ulaanbaatar city households consumed salt with appropriate level of iodine.@*Conclusions@#</br> 1. 19.1 % of the surveyed households consume non-iodised salt, 2.8% consume salt with low iodine content, 77.5% consume salt with appropriate level of iodine and 0.6% consume salt with high level of iodine.</br> 2. The iodine level is appropriate in 84.5% of salt consumed by Ulaanbaatar city households.
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Background@#Iodine deficiency may result in a goiter, developmental delays and other health problems. The simplest way for the iodine deficiency prevention is consumption of iodine-rich food products. In our country, the iodine consumption is supported by edible salt iodization. Human organism excretes 80% of iodine with urine, therefore the urinary iodine level is considered as an indicator for the iodine status of an individual.@*Goal@#The goal of our study was to evaluate a correlation between the levels of iodine in salt and in urine.@*Materials and Methods@#2173 samples of household salt and urine samples of 1697 school-age children were collected covering 20 aimags and Ulaanbaatar city. Levels of iodine in the salt samples were determined using a titration method, and for the determination of iodine concentrations in urine the SandellKolthoff’s reaction was used. The correlation between two sets of values was assessed with Pearson’s correlation coefficient.@*Results@#The sample collection was organized so that the aimags were divided into 6 to 8 clusters, each cluster comprising 12 to 15 households or children. Therefore, average values of the iodine concentrations in salt and urine of each cluster were used for the correlation assessment. The result of the statistical analysis showed a high variation in correlation between salt iodine and urinary iodine at the aimag level, but the overall correlation at the country level was strong positive (r=0.7).@*Conclusion@#The hypothesis that the correlation between the iodine amount excreted by children from a certain location and the level of iodine in salt consumed by households in the same location is strong, was not confirmed at the aimag level, but the correlation was strong positive at the country level.
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Background@#Screening programs for the detection of inherited disorders of amino acid metabolism is mandatory in most countries. Various laboratory methods are used for this purpose. We tested a high-performance liquid chromatography method for the separation of amino acids in blood and urine samples. @*Materials and Methods@#All reagents were of the HPLC grade purity,water used for t he analysis was deionized and reagents and samples were ultrafiltrated using a micropartition system.</br> The analysis was performed using the HPLC system with two pumps, a C18 column and a UV detector. All evaporations were done using a vacuum concentrator.</br> Amino acids were derivatized using a solution of ethanol, water, triethylamine and phenyl isothiocyanate. The amino acid derivatives were separated using a linear gradient with two solvents: solvent A (sodium acetate : acetonitrile) and solvent B (water : acetonitrile). </br> Amino acid standards of 20, 50, 100, 200, 500, 750 and 1000 µM were prepared in 1 mM hydrochloric acid. </br> The EDTA blood as well as urine samples were spun at 1500 g for 15 min and then ultracentrifuged at 1500 g for 30 min.@*Results@#Experiments with various chromatographic conditions showed that factors which influenced the amino acids separation were the type of columns, mobile phase composition, flow-rate, gradient programs and timings.</br> After studying the effects of changes in individual parameters of chromatographic conditions, the following method parameters were chosen: pre-column derivatization agent –PITC, separation column – C18, mobile phase –solvent A: sodium acetate : acetonitrile (98:2) and solvent B: water : acetonitrile (40:60), gradient – linear, flow-rate – 1.2 mL/min. With this method 22 amino acids were separated within 35 minutes.@*Conclusion@#The developed method is simple and can be used by medical laboratories for the detection of inborn errors of amino acid metabolism.
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Background:Quality of hospital meals must meet the needs of patients, have a positive effect on disease treatment, and contain nutrients and calorie that fully meet physiological requirements.Goal:We aimed to determine the levels of basic nutrients and the content of calorie in patient meals of public and private hospitals, and evaluate their compliance with policy requirements.Material and Methods:Eighty nine meals for in-patients of three public and three private hospitals were analyzed for the content of protein, fat, carbohydrates, salt and calorie.Results:Analysis results revealed that 100 gr of in-patient meals contained on average 31.97 g of solids, 7.53 g of protein, 17.84 g of carbohydrates, 5.95 g of fat and 155.41 kcal of calorie. The mean level of salt in hospital meals was 2.73 mg/g which was within the WHO recommended range.Conclusions:1. The ratio of nutrients in hospital meals is inappropriate.2. Hospitals should quarterly monitor the levels of nutrients in in-patient meals, and serve meals prepared in view of the analyses results.
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Introduction@#Oligophrenia makes 7.3% of all mental disorders in our country. It is known that almost 4% of all diagnosed cases of oligophrenia developed as a result of an inherited disturbance of amino acid metabolism. In most countries, the frequencies of inherited diseases of amino acid metabolism in the population are determined, and preventive screening programs of newborns are implemented. No study has been conducted so far into the issue of inherited diseases of amino acid metabolism in the Mongolian population. The goal of our survey was to detect inherited disorders of amino acid metabolism in the population at risk. @*Materials and Methods@#The collection of samples and the laboratory analysis were carried out in the following two stages: </br>1. The screening analysis of 514 individuals diagnosed with mental retardation was performed by paper chromatography; </br>2. The positivecases detected by the screening were analyzed using high-performance liquid chromatography. @*Results@#The screening testing detected twelve potential disturbances of amino acid metabolism. Out of the twelve positive cases four individuals refused to participate in the confirmatory stage of the survey. Among the remained eight individuals, cases of hypertyrosinemia, hypervalinemia, hyperglycinemia, hyperlysinemia and pyridoxine-dependent epilepsy were detected. @*Conclusions@#</br>1. The fact that cases of inherited disorders of amino acid metabolism were detected among mentally retarded individuals show that the disorder is one of causes of oligophrenia. </br>2. A screening program of newborns should be implemented for early detection of inherited disorders of amino acid metabolism. </br>3. A genetic counselling and testing centre could assist in reduction of number of individuals with inherited disorders.
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Background:In the scope of the “School Lunch” program initiated by the Government of Mongolia, pupils of primary schools are served with meals prepared in school canteens and food products provided by food manufacturers. The safety of the provided food products must be monitored and evaluated. The purpose of our study was to evaluate the safety of the meals and food products being given to pupils in the frame of the above program.Materials and methods:Nutritious values and safety of 31 samples of school canteen meals and food products of 5 general education schools were determined using microbiological analysis methods based on Mongolian national standards. Results:The analysis results revealed that the total number of microbes in canteen meals fluctuated between 1х102 and 4х102, and no pathogens were detected in the analyzed samples. The quality of all pastry products met the Mongolian standard hygiene requirements. The variation of the total number of microbes in dairy products was 2х105 -4х105, and no pathogens were found in dairy products.Conclusion:Microbiological analyses show that the food products supplied by the contractual companies in the frame of “Lunch” program and meals from the school canteens meet Mongolian hygiene requirements.
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Background@#The “School Lunch” program was initiated by the Government of Mongolia in 2006. The purpose of our study was to assess nutritious values of the meals and food products being given to pupils of general education schools in the frame of the program.@*Materials and methods@#Nutritious values of 32 samples of school canteen meals and food products of 5 general education schools were determined using chemical analysis methods. @*Results@#The average calorie content of the analyzed meals was 181.07-271.08 kcal, and the average content of vitamin C was 0.28-0.84 mg/g. The energy value of bakery products was high (110.97-436.23kcal) whereas their vitamin C content was low (0.34 mg/g). The calorie content in dairy products was reasonably high (46.17-52.85kcal), and the average level of calcium was 95.84-103.1mg/g, of iron was 0.7-1.7mg/g and of vitamin C was 0.28-0.84 mg/g.@*Conclusions@#</br>1.The study results highlight the necessity of broadening the variety of food products given to schoolchildren in the frame of the “Lunch” program. </br>2.Fruits and vegetables, the main source of minerals and vitamins, make a small percentage of the food products given to school children, and bakery products rich of calorie prevail in the menu.
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Introduction Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are the principal enzymes involved in catabolism of ethanol in human body. Alcohol is initially metabolized by ADH to acetaldehyde, which is consequently oxidized by ALDH to acetic acid. Individuals with low activity of alcohol-metabolizing enzymes show low tolerance to alcohol and are therefore rapidly intoxicated. Two studies on polymorphism of alcohol metabolizing enzyme genes in Mongolian population have been implemented to the date, but no assessment study of the serum activity of the enzymes have been conducted. Materials and Methods Fasting morning blood samples were collected from 240 adults 25-54 years of age (124 males and 118 females) from all provinces and the capital city of Mongolia. The serum levels of ADH and ALDH were determined using an enzyme-linked immunosorbent assay. Result: The mean serum level of ADH was 17.6 ng/mL and of ALDH was 15.91 ng/mL. The mean levels of the two enzymes of the surveyed from UB city were significantly lower than of those who lived in rural areas (p=0.000 for both ADH and ALDH). When the survey participants were divided into three age groups (25-34 years, 35-44 years and 45-54 years of age) and their mean levels of ADH and ALDH were compared, no significant age-related differences were found (p>0.05).
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Goal: To determine average values of serum total cholesterol, triglycerides, high density lipid cholesterol and low density lipid cholesterol of Mongolian adults, and compare the average values by age groups, gender and regions. Materials and Methods: Serum was separated from morning blood samples collected from 1737 individuals 15-64 years of age (707 males and 1030 females) from 21 aimags and Ulaanbaatar city, and stored at-30°C until analysis. Mean levels of cholesterol, triglycerides, HDL and LDL were determined using photometric system. Results: The overall mean serum level of cholesterol was 159.06 mg/dl (95% CI 155.58-162.53), of triglycerides was 121.65 mg/dl (95% CI 116.77-126.53), of HDL was 61.12 mg/dl (95% CI 59.77-62.47), and of LDL was 130.53 mg/dl (95% CI 128.26-132.80). When the survey participants were divided into five age groups (15-24, 25-34, 35-44, 45-54 and 55-64 years of age) and their mean levels of cholesterol, triglycerides, HDL and LDL were compared, no statistically significant differences were observed between age groups. When the mean levels of lipids were compared between sexes, statistically significant differences were observed for cholesterol and triglycerides, and no statistically significant differences were observed for HDl and LDL.
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The serum activity levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are important biochemical indicators of changes in the liver and coronary system function. The correct determination of changes in the activity levels of the transferases is essential for differential diagnosis and appropriate treatment of the diseases. Goal: The aim of this study was to determine the mean activity levels of ALT and AST of the Mongolian population. Materials and Methods: Serum was separated from morning blood samples collected from 1732 individuals 15-64 years of age (706 males, 1026 females) from 21 aimags and Ulaanbaatar city, and stored at -30°C until analysis. Activity levels of alanine aminotransferase and aspartate aminotransferase were determined using photometric system. Results: The overall mean serum activity level of AST was 25.52 U/L and of ALT was 22.60 U/L. No statistically significant differences were observed between the surveyed from Ulaanbaatar and from rural area as well as between sexes (p>0.05 for both ALT and AST). When the survey participants were divided into five age groups (15-24 years, 25-34 years, 35-44 years, 45-54 years and 55-64 years of age) and their mean activity levels of AST and ALT were compared, it was observed that the activity of both enzymes increased with age (p<0.05)
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The serum activity levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are important biochemical indicators of changes in the liver and coronary system function. The correct determination of changes in the activity levels of the transferases is essential for differential diagnosis and appropriate treatment of the diseases. Goal: The aim of this study was to determine the mean activity levels of ALT and AST of the Mongolian population. Materials and Methods: Serum was separated from morning blood samples collected from 1732 individuals 15-64 years of age (706 males, 1026 females) from 21 aimags and Ulaanbaatar city, and stored at -30°C until analysis. Ac¬tivity levels of alanine aminotransferase and aspartate aminotransferase were determined using photometric system. Results: The overall mean serum activity level of AST was 25.52 U/L and of ALT was 21.31 U/L. No statistically sig¬nificant differences were observed between the surveyed from Ulaanbaatar and from rural area, but the mean activity level of both enzymes was statistically significantly lower in women than in men (р<0.05 for both ALT and AST). When the survey participants were divided into five age groups (15-24 years, 25-34 years, 35-44 years, 45-54 years and 55-64 years of age) and their mean activity levels of AST and ALT were compared, it was observed that the activity of both enzymes increased with age (p<0.05).