ABSTRACT
The aim of this study was to validate two computerized methods of obtaining a diet history (DH and EBIS). The food consumption of 12 men and eight women was calculated by weighing each food item over a period of 8 days. Thereafter the diet history was taken over this period by using both programs alternatively. The intake of energy, protein, fat and carbohydrates, and 10 further nutrients was evaluated and the percentage difference calculated. In general, the intake of nutrients calculated from the diet history tended to be underestimated by most of the people interviewed. The mean daily intake of the nutrients calculated from the DH program deviates from -34% to +20% (mean SD = 48.1) and -35% to +15% for EBIS (mean SD = 28.1). In conclusion, both computerized methods proved useful for epidemiological studies, but not for the determination of deficiencies in individuals.
Subject(s)
Diet Records , Software , Aged , Computers , Dietary Carbohydrates/administration & dosage , Dietary Fats/administration & dosage , Dietary Fiber/administration & dosage , Dietary Proteins/administration & dosage , Energy Intake , False Negative Reactions , Female , Humans , Male , Middle Aged , Nutrition AssessmentABSTRACT
BACKGROUND/AIMS: The proinflammatory effects of endotoxemia, which is often observed in alcohol-abusing patients with various degrees of liver disease, may be modulated by changes in the concentration of endotoxin binding factors. Therefore, the plasma endotoxin concentration and the overall endotoxin binding capacity of whole blood were measured in these patients. METHODS: Patients with minor (A1; n=27), more pronounced (A2; n=13), cirrhotic alcoholic liver disease (A3; n=18), and non-alcoholic cirrhosis (NC; n=6), and 15 healthy control persons (HC) were included in the study. Endotoxin plasma levels were determined using a standardized limulus assay. A modified assay was applied to additionally detect tightly bound endotoxin. To measure the endotoxin-binding capacity, aliquots of whole blood were incubated with serial dilutions of endotoxin, supernatants were obtained, and endotoxin retrieval was estimated by addition of limulus lysate, followed by photometric measurement of the maximal reaction velocity (dODmax). Endotoxin binding capacity equals the endotoxin concentration at which dODmax reaches a predefined threshold. RESULTS: All groups of alcohol abusers had significantly elevated endotoxin plasma levels with a considerable portion of 'bound' endotoxin. Conversely, the endotoxin binding capacity was markedly diminished, mainly in patients with more advanced liver disease (A1: 85.8% of the control value [non-significant vs. controls]; A2: 25.4% [p<0.05]; A3: 43.6% [p<0.02], NC: 43.2%). CONCLUSIONS: The endotoxin-binding capacity is diminished in patients with alcoholic and non-alcoholic cirrhosis, as well as in less advanced alcoholic liver disease. Reduced endotoxin binding may contribute to the adverse effects of endotoxemia.
Subject(s)
Endotoxins/blood , Escherichia coli , Liver Diseases, Alcoholic/blood , Adult , Aged , Alcohol Drinking/adverse effects , Binding Sites , Chronic Disease , Endotoxemia/blood , Endotoxemia/diagnosis , Endotoxemia/etiology , Female , Humans , Limulus Test , Liver Cirrhosis, Alcoholic/blood , Liver Cirrhosis, Alcoholic/complications , Liver Cirrhosis, Alcoholic/diagnosis , Liver Cirrhosis, Biliary/blood , Liver Cirrhosis, Biliary/complications , Liver Cirrhosis, Biliary/diagnosis , Liver Diseases, Alcoholic/complications , Liver Diseases, Alcoholic/diagnosis , Male , Middle AgedABSTRACT
Plasma levels of endotoxin and tumor necrosis factor alpha (TNF alpha) and the cytokine response of isolated monocytes were examined in chronic alcohol abusers with various degrees of liver disease. In 35 patients - 19 with alcoholic fatty liver (AF), 7 with alcoholic hepatitis (AH), 9 with cirrhosis (AC) - and in 15 healthy controls (HC), plasma levels of endotoxin were measured in the limulus assay, and plasma TNF alpha in an immunoassay. The cytokine response of monocytes stimulated in vitro with low doses of endotoxin (range: 25 pg/ml to 2.5 ng/ml) was determined in a cytolytic TNF bioassay and in TNF alpha and interleukin-6 (IL-6) immunoassays. All patient groups had elevated plasma endotoxin levels, whereas plasma TNF alpha was elevated only in AC (43.1 +/- 15.2 vs. HC: 5.0 +/- 1.1 pg/ml). Monocytes from all patient groups released increased amounts of bioactive TNF: AF 5.39 +/- 1.70, AH 7.10 +/- 3.28, AC 2.44 +/- 0.54 vs. HC 1.21 +/- 0.30 ng/ml (stimulation with 2.5 ng/ml endotoxin over 3 hrs.). Similar results were obtained in the TNF alpha immunoassay. Increased release of IL-6 from monocytes was shown only for AF, while values in AC were comparable to those in HC. These data confirm that endotoxemia is frequent in chronic alcoholics. In concert with an increased cytokine response of the monocyte/macrophage system, endotoxemia might contribute to the pathogenesis of alcoholic liver disease.
