The interaction between copper and coronary risk indicators.

We studied the effects of external copper exposure on plasma copper, serum lipids, lipoproteins and apolipoproteins in workers who have excessive contact with copper. Fifty-eight healthy Turkish males who were working in the copper processing industry and 33 control subjects were examined. Copper concentration was measured by flame atomic absorption spectrometry, lipid and lipoprotein levels were detected by spectrophotometry and apolipoproteins were measured with a nephelometer. There was no significant difference in plasma copper between the workers and the controls. However, in the worker group, the mean levels of TC, LDL-C, apoAI, apoB and Lp (a) were significantly higher while the mean level of HDL-C was significantly lower than that of the controls. In addition, there was a significant positive correlation between plasma copper and LDL-C only in the workers group. Our findings suggest that excessive contact with copper may contribute to coronary risk factors.

Magnesium, zinc and iron levels in pre-eclampsia.

OBJECTIVE: To determine the change in erythrocyte and plasma magnesium, plasma zinc and serum iron concentrations in pre-eclampsia. METHODS: Twenty women with pre-eclampsia and 20 control subjects matched for gestational age were examined. The levels of magnesium, zinc and iron in all subjects were measured by flame atomic absorption spectrometry. In the pre-eclamptic women, who were supplemented with magnesium salts, these measurements were repeated after delivery. RESULTS: The intraerythrocytic magnesium levels before supplementation were significantly lower in the pre-eclamptic patients than in the healthy pregnant women (0.98 +/- 0.15 vs. 1.35 +/- 0.30 mmol/l; p < 0.001) and increased (to 1.25 +/- 0.25 mmol/l) after treatment with magnesium. The plasma magnesium and zinc, and the serum iron concentrations were not significantly different between the pre-eclamptic and the healthy pregnant women. CONCLUSIONS: Our results suggest that low cellular magnesium levels in women with pre-eclampsia may contribute to the development of hypertension in these patients, and that the measurements of plasma zinc and serum iron concentrations are of doubtful clinical value in the management of pre-eclampsia.

Levels of stable metabolites of prostacyclin and thromboxane A2 and their ratio in normotensive and preeclamptic pregnant women during the antepartum and postpartum periods.

OBJECTIVE: To measure the levels of the circulating metabolites of prostacyclin and thromboxane A2 during the antepartum and postpartum periods in severe preeclamptic and eclamptic patients as well as in normotensive pregnant women. METHODS: 6-Keto-prostaglandin F1alpha (6-keto-PGF1alpha) and thromboxane B2 (TxB2) were measured in the plasma of 15 severe preeclamptic, 15 eclamptic, and 15 normotensive pregnant women during the antepartum and postpartum (5th day) periods. At the same time blood pressure measurements were obtained. Kruskal-Wallis, Wilcoxon rank-sum, and Wilcoxon's signed-rank tests were used for statistical analysis. RESULTS: 1) There was no significant difference in the levels of 6-keto-PGF1alpha and TxB2 of the normotensive pregnant women between the antepartum and the postpartum (5th day) periods. 2) In the severe preeclamptic and eclamptic groups, 6-keto-PGF1alpha levels showed significant increase after the delivery (P < 0.01, and P < 0.001, respectively). 3) In the severe preeclamptic and eclamptic groups TxB2 levels showed significant decrease after delivery (P < 0.01, and P < 0.001, respectively). 4) The 6-keto-PGF1alpha/TxB2 ratio both during the antepartum and the postpartum (5th day) periods showed significant differences between the severe preeclamptic and normotensive, and between the eclamptic and normotensive groups (P < 0.001, and P < 0.001 respectively). 5) No correlation was observed between the mean arterial pressure and the antepartum levels of 6-keto-PGF1alpha TxB2 or their ratios. CONCLUSIONS: Our study was able to demonstrate a significant difference in circulating metabolites of prostacyclin and TxA2 between normotensive pregnant women and those with severe preeclampsia and eclampsia. But no correlation was observed between the blood pressure and the antepartum 6-keto-PGF1alpha, TxB2 levels or their ratios. 6-keto-PGF1alpha levels increased and TxB2 levels decreased in the postpartum period (5th day). However, the 6-keto-PGF1alpha/TxB2 ratio was still low in the severe preeclamptic and eclamptic patients when compared with the control group. This situation shows that the pathophysiologic mechanism does not improve completely within a few days after delivery.

The levels of lipids, lipoproteins and apolipoproteins in healthy people in the central region of the Black Sea.

Lipids, lipoproteins and apolipoproteins are among the risk factors for the most serious health problem of the age--coronary artery disease (CAD). They vary from country to country, from area to area within a country, depending on genetic, environmental, dietary and many other factors. Our aim was to determine the levels of lipids, lipoproteins and apolipoproteins in healthy people in the central Black Sea region of Turkey. Subjects included 1348 volunteers (682 women, 666 men) referred to the Medical Faculty hospital from the study area. The population consisted of healthy people or those whose disease was not affecting the metabolism of lipids. Cholesterol, triglyceride and HDL-cholesterol levels in the obtained serum samples were measured spectrophotometrically, while apolipoprotein A-I, apolipoprotein B, apolipoprotein E and lipoprotein(a) levels were measured nephelometrically. The levels of lipid parameters were as follows: total cholesterol for men was 4.22 +/- 1.00 mmol/l (mean arithmetic +/- SD), triglyceride 1.20 mmol/l (0.30-4.44) [geometric mean (range)], HDL-cholesterol 0.88 +/- 0.22 mmol/l, LDL-cholesterol 2.69 +/- 0.85 mmol/l, apolipoprotein A-I 1.26 +/- 0.22 mmol/l apolipoprotein B 1.12 +/- 0.32 mmol/l, apolipoprotein E 0.037 +/- 0.012 mmol/l and lipoprotein(a) 0.25 g/l (0.03-2.75); total cholesterol for women was 4.53 +/- 1.00 mmol/l, triglyceride 1.05 mmol/l (0.28-4.50), HDL-cholesterol 1.08 +/- 0.26 mmol/l, LDL-cholesterol 2.87 +/- 0.88 mmol/l, apolipoprotein A-I 1.45 +/- 0.25 mmol/l, apolipoprotein B 1.11 +/- 0.31 mmol/l, apolipoprotein E 0.039 +/- 0.011 mmol/l and lipoprotein(a) 0.22 g/l (0.03 2.16). In conclusion, our study in four different regions in Turkey reflected that the people living in the central Black Sea region are less vulnerable to the risk of CAD, although at a relatively higher risk compared to some other countries.

Plasma Atrial Natriuretic Peptide Levels in Preeclampsia and Eclampsia

> Objective: There is a reduction in intravascular volume in patients with preeclampsia and eclampsia. Since the secretion of atrial natriuretic peptide (ANP) by human atrial myocytes is stimulated by increased intraatrial pressure or atrial distention, we sought to determine whether circulating maternal plasma ANP concentrations were lower in patients with severe preeclampsia and eclampsia compared with normal pregnant women. Methods: Fifteen patients with mild preeclampsia, 15 with severe preeclampsia, 15 with eclampsia, and 38 normotensive pregnant women were taken as the control group. All the women were age-matched and in their third trimester. The level of ANP in these patients was measured during the third trimester and in the postpartum period by a specific radioimmunoassay. At the same time, routine laboratory tests for eclampsia and preeclampsia such as uric acid, creatinine, and urine protein levels were obtained. Results: ANP levels were significantly higher in the antepartum periods in women with mild preeclampsia (20.7 +/- 6), severe preeclampsia (28.9 +/- 9), and eclampsia (26.6 +/- 6.5) than those in normotensive pregnant women (15.7 +/- 3.5; P < 0.05 and P < 0.001, respectively). As the severity of preeclampsia increased, the mean values of ANP became higher. Conclusions: ANP levels in preeclamptic and eclamptic women were found to be higher than those in normotensive pregnant women. There is a correlation between the severity of toxemia and plasma ANP levels. The mechanism(s) responsible for the elevation requires further investigation.

Serum creatine phosphokinase, lactic dehydrogenase, estradiol, progesterone and testosterone levels in male patients with acute myocardial infarction and unstable angina pectoris.

In order to study predisposing effects of sex hormones in acute myocardial infarction and in unstable angina pectoris, serum estradiol, progesterone, testosterone, creatine phosphokinase (CPK), and lactic dehydrogenase (LDH) levels were measured in 26 male patients with acute myocardial infarction, and in 14 male patients with unstable angina pectoris, and in 15 healthy male patients as a control. Serum estradiol levels in the patient groups were significantly higher than the control group (p < 0.001). There was not any significant difference between the serum testosterone levels of the patients and of the control group (p > 0.05). The serum progesterone levels in hyper acute phase of acute myocardial infarction were higher than control (p < 0.05), but were the same on the second and third days (p > 0.05). There was a positively good correlation between the serum CPK and LDH levels in acute myocardial infarction and the serum estradiol levels r = 0.66; 0.70; p < 0.05). These results suggest that hyper estrogenemia may be a risk factor for myocardial infarct in middle-aged men.

Liver blood flow rate and glucose metabolism in hemorrhagic hypotension and shock.

Liver blood flow was measured in dogs using 133Xe clearance technique under control conditions and during various stages of hypotension and of hemorrhagic shock. Initial liver mean blood flow rate in all dogs combined are 101.9 +/- 11.5 ml/100 gm liver/min and was not significantly altered in the control group. Liver blood flow rate was reduced in the experimental group during hemorrhagic hypotension and shock and was correlated with the severity of the disease. Peripheral vasodilatation was observed in one subgroup of experimental animals while severe vasoconstriction was found in another subgroup. Glucose concentrations in the hepatic vein were significantly above that of arterial and portal venous blood; all experimental animals were hyperglycemic. The outflow of glucose from the liver was increased during shock in ten animals. It was, however, reduced in 17 animals.

Net insulin secretion and IRI response to 1 mg glucose during OGTT.

Dogs in postabsorbtive state were anesthetized with IV nembutal. Their femoral arteries were catheterized, and the abdomens were entered via a midline incision. A small branch of the pancreatic artery and a corresponding small vein were catheterized. 133Xe was injected through the artery, and the the pancreatic blood flow rate (PBFR) was determined. Net insulin secretion was calculated using the insulin concentration of pancreatic vein-artery difference and pancreatic plasma flow rate (PPFR). After control studies an oral glucose tolerance test (2 g/kg body wt.) was performed. Under control studies the mean value of net insulin secretion was 3,753.2 +/- 699.1 microunits/100 g P/min and the maximum values were 10,610.2 +/- 3,658.7 and 11,108.0 +/- 2,852.6 microunits/100 g P/min at 20 and 60 min after glucose loading, respectively (P less than 0.05). Insulin response per mg of glucose was 83.2 +/- 12.2 microunits under control conditions. Twenty minutes after glucose loading this figure rose to 173.4 +/- 41.7 microunits/mg glucose and at 60 min 207.9 +/- 49.2 microunits/mg glucose.

Pancreatic blood flow in hemorrhagic shock.

Pancretic blood flow rates were determined using a 133Xe washout technique in a total of 40 dogs, 14 of which were used as a control group and the remaining 26 as the experimental group. The initial pancreatic blood flow rates of control group and of the experimerntal group were 85.1 +/- 10.1 ml/100 g/min of pancreas/min and 81.1 +/- 5.4 ml/100 g/min respectively. These values were not significantly different from each other (P > 0.05). In the control group the blood flow was determined 3 times at 30 min intervals. These mean values were 73.0 +/- 9.4, 74.6 +/- 8.7, and 79.4 +/- 10.4 m/100 g/min respectively (P > 0.05). The dogs in the experimental group were bled and the peripheral arterial blood pressure was reduced stepwise to 80, 50, and 30 mm Hg. At each level at 30 min of stabilization period the pancreatic blood flow rates were 49.8 +/- 3.7, 29.3 +/- 2.3 and 20.2 +/- 2.3 ml/100 g/min respectively. These mean values were very significantly reduced compared to those of the control group at 30 min (P < 0.02), at 60 and 90 min (P > 0.001). They were also very significantly different from their own initial values (P < 0.001). The metabolic consequences of this reduction in pancreatic blood flow are discussed.

Hepatic blood flow during rapid intravenous glucose tolerance test.

Twenty-nine dogs anesthetized with Na-pentobarbital were laparatomized and liver blood flow was measured by 133Xe clearance method. Fifteen dogs of the experimental group were subjected to rapid i.v. glucose tolerance test whereas 14 animals of the control group were treated identically except for infusion of glucose. It was found that the arterial and the portal venous blood glucose rose significantly during the glucose tolerance test. Liver blood flow in the experimental group was 123.8 ml/100 g L/min after operative procedures. It reached 171.9 ml/100 g L/min at 10 min after infusion of glucose (P < 0.01). At 20, 30, and 40 min of the test it was 145.4 (P < 0.05), 143.4 (P < 0.01), 135.1 (P < 0.05) mg/100 g L/min, respectively. Liver blood flow did not change significantly during the observation period in the control series. It is concluded that glucose loading may produce some metabolic effects secondary to rising liver blood flow in addition to changes induced by its rising concentration.