Lipoprotein kinetics in patients with analbuminemia. Evidence for the role of serum albumin in controlling lipoprotein metabolism.

In vitro data suggested that albumin is a key factor controlling apolipoprotein (apo) synthesis by hepatocytes. Studies in analbuminemic rats have shown an increase in secretion of apoB-containing lipoprotein from the liver. We studied the kinetic aspects of apoB- and apoAI-containing lipoprotein metabolism in two sisters with analbuminemia using a constant 14-hour infusion of leucine labeled with stable isotopes. Compared with control subjects, total cholesterol was higher in the two patients (432 and 461 versus 155 +/- 14 mg/dL), as was apoB (257 and 230 versus 72 +/- 7 mg/dL). Triglycerides were slightly increased (134 and 105 versus 89 +/- 9 mg/dL), whereas apoAI was lower (109 and 105 versus 124 +/- 6 mg/dL). VLDL-apoB production was higher, as was the production of IDL-apoB and LDL-apoB (32.8 and 36.0 versus 24.8 +/- 5.9, 32.1 and 27.2 versus 16.4 +/- 2.3, and 14.1 and 17.6 versus 10.3 +/- 1.2 mg.kg-1.d-1, respectively). The fractional catabolic rate of all the apoB-containing lipoproteins was decreased (0.23 and 0.37 versus 0.48 +/- 0.05, 0.27 and 0.28 versus 0.62 +/- 0.08, and 0.012 and 0.009 versus 0.022 +/- 0.002.h-1, respectively). A similar mechanism could explain the dyslipidemia observed in other conditions associated with low albumin levels, such as nephrotic syndrome.

Kinetic aspects of acetate metabolism in healthy humans using [1-13C] acetate.

Acetate metabolism in humans is not well known. Kinetic aspects of acetate were investigated in the postabsorptive state on healthy subjects. In a first study, six subjects were infused with a primed constant infusion of [1-13C]acetate for 3 h and a prime of NaH13CO3. No difference was found between arterialized and venous tracer enrichments from the arm, although arterialized acetate concentrations were higher (74 +/- 12 vs. 59 +/- 14 mumol/l, P < 0.05), suggesting that the hand muscles used but did not produce acetate in the postabsorptive state. Total body flux of acetate was 8.4 +/- 0.6 mumol.kg-1.min-1, of which 69 +/- 5% was oxidized. Acetate contributed to 6.5 +/- 0.4% of the basal energy expenditure. In a second study, five volunteers were submitted to a gastric infusion for 3 h followed by an intravenous infusion of [1-13C]acetate for 3 h. Higher fluxes were observed with the tracer gastric infusion, and the first-pass removal of acetate within the splanchnic bed was 60 +/- 7%. Acetate contributes significantly to the energy supply of the body. It is mainly used by the liver when produced in the gut.

A minimal model using stable isotopes to study the metabolism of apolipoprotein B-containing lipoproteins in humans.

A protocol using stable isotopes, developed to measure apolipoprotein B turnover in humans, was tested by intravenous infusion of [2H3]-leucine into 5 normolipidemic volunteers during a 14-h fast. Tracer-to-tracee ratio curves were analyzed by four different approaches: linear regression, monoexponential regression, a minimal compartmental model (3 compartments) and a complex model (4 compartments and two shunt pathways). The three-compartment model was validated by qualitative analysis of data obtained after injection of a [2H3]-leucine bolus. This simple model gave an FCR of 0.48 +/- 0.05 h-1 for VLDL, 0.62 +/- 0.08 h-1 for IDL and 0.022 +/- 0.002 h-1 for LDL. The total production rate of apolipoprotein B in plasma was 24.8 +/- 6.5 mg.kg-1.day-1. Kinetic parameters were similar for the complex model which showed no improvement in fit. Lower estimates were observed with the non-compartmental approaches.

Measurement of mevalonic acid in human urine by bench top gas chromatography-mass spectrometry.

Urinary excretion of mevalonate was reported to be correlated with endogenous cholesterol biosynthesis. A method is described whereby mevalonate (MVA) concentration in urine is determined by bench top gas chromatography-mass spectrometry after extraction as mevalonalactone (MVL) and conversion to mevalonolactone mono-TMS derivative. Within- and between-assay coefficients of variation were 4.02% and 8%, respectively. The mean concentration of MVA in 24-h urine collections from ten normolipidemic urinary subjects was 203 +/- 49.6 ng/ml (range: 44-576 ng/ml). Administration of 40 mg of Pravastatin (an HMG-CoA reductase inhibitor) significantly decreased (approximately 50%) the night concentration of MVA in five healthy volunteers. This assay could be useful for investigation of endogenous cholesterol synthesis rate in various dyslipidemias and in response to drug treatment.

Measurement of whole body acetate turnover in healthy subjects with stable isotopes.

Colonic fermentation of dietary fibres produces short-chain fatty acids (e.g. acetate, propionate). Measurements of whole body acetate turnover was used in order to estimate the production of colonic short-chain fatty acids in human subjects. However, higher flux rates for acetate have been reported in human studies with stable isotopes as compared to radioactive tracers. The reasons for this discrepancy are unclear. In this study, the stable isotope (1-13C)acetate was used and a method was developed to measure its enrichment in plasma. Variations between and within assays were less than 5%. The standard curve was linear from 0.5% to 10% enrichment. When this tracer was infused for 160 min in six healthy volunteers, acetate turnover was found to be 7.5 +/- 1 mumol kg-1 min-1, which is similar to data reported with radioactive tracers. We assumed that the higher flux rate previously observed with stable isotope tracers was related to differences in the physiological status of the subjects involved in these studies.