[Influence of the rat diet enrichment with oat ß-gucans on the assimilation of B group vitamins, mineral elements and lipid metabolism].

Despite the widespread use of oat ß-glucans as ingredient of foods and dietary supplements, there is insufficient data on their effect on the metabolism of vitamins and minerals. The purpose of the study was to evaluate the effect of including oat bran with a high content of ß-glucans (ß-glucan) in the diet on the absorption of micronutrients and lipid metabolism in growing rats deficient in vitamins D, group B and trace elements (iron, copper, zinc). Material and methods. After the development of micronutrient deficiency (for 23 days), in order to assess the effect of oat bran (5%) with a high content of ß-glucans on the correction of the micronutrient status of growing male Wistar rats (with initial body weight of 70.7±0.7 g), the missing micronutrients were introduced in the semi-synthetic diet deficient in vitamins D, group B, iron, copper and zinc within 7 days either along with ß-glucan (1.47%) or without its addition. Indicators of micronutrient sufficiency (riboflavin serum concentration, daily urinary excretion of thiamine, riboflavin and 4-pyridoxic acid, measured by fluorometric methods; serum concentration and urinary excretion of calcium, magnesium, iron, zinc, copper, phosphorus, measured by the atomic absorption method or using standard methods on a biochemical analyzer) and the biochemical parameters of blood serum were compared with the parameters of rats adequately provided with all micronutrients throughout the experiment. Results. Replenishment of missing micronutrients in the diet of rats with deficiency in vitamins D and group B, iron, copper and zinc for 7 days led to the elimination of deficiency of vitamins B1, B2 and B6, regardless of the presence of ß-glucans in the diet. At the same time, against the background of the presence of ß-glucans in the feed, an increase in the absorption of iron was observed, as evidenced by an increase by 1.73 times in iron blood plasma level (р<0.05) and a tendency towards its urinary excretion decrease by 1.60 fold (р<0.10) compared to animals from the control group. Adding oat bran with ß-glucans to the feed did not lead to a decrease in blood plasma level of total cholesterol and low-density lipoproteins cholesterol. The levels of high-density lipoprotein cholesterol and triglycerides in rats of all three groups did not have statistically significant differences. Conclusion. The presence of ß-glucans in the diet had virtually no effect on the absorption of B vitamins and improved the absorption of iron.

[Vitamin supply of patients with type 2 diabetes mellitus complicated by nephropathy].

Insufficient vitamin content in the diet is a risk factor for the development of various diseases and their progression, and drug therapy can also contribute to the development of a deficiency of these micronutrients. Data on vitamin sufficiency of patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN) are needed to develop measures to improve it. The aim of the research was to compare vitamin status of patients with T2DM without DN and those with T2DM complicated by nephropathy by assessing vitamin blood level and urinary excretion. Material and methods. In a single-stage research, 57 patients with T2DM and concomitant obesity (14 men, 43 women aged 42-75 years) have been examined. The 1st group included 26 patients with T2DM (7 men and 19 women, BMI 41.5±1.7 kg/m2) with glycated hemoglobin (HbA1c) - 8.0±1.4%, blood serum glucose level 8.1±0.6 mmol/l, glomerular filtration rate (GFR) - 86.7±3.0 ml/min per 1.73 m2, microalbuminuria - 18.0±2.0 mg/day. The 2nd group included 31 patients with T2DM complicated by DN (7 men and 24 women, BMI 42.5±1.3 kg/m2), with an HbA1c level of 6.4±0.2%, blood serum glucose level 6.8±0.3 mmol/l, GFR - 62.8±2.7 ml/min per 1.73 m2, microalbuminuria - 59.5±22.5 mg/day. The determination of vitamins С (ascorbic acid), A (retinol), E (α- and γ-tocopherols), D [25(OH)D], B2 (riboflavin) and ß-carotene in blood serum and vitamins C (ascorbic acid), B1 (thiamine), B2 (riboflavin) and B6 (4-pyridoxic acid) in the morning portion of urine collected on an empty stomach within 40-120 min was carried out. The vitamin status was assessed based on the concentration of vitamins in blood serum and urinary excretion relative to the lower limit of the norm, as well as using the criteria for the optimal supply and 2 molar ratios. Results. Compared to patients with T2DM without nephropathy, patients with DN were better provided with vitamins B2, A and ß-carotene: vitamin B2 deficiency was found 3.2 fold less often (in 9.7%), ß-carotene - 1.8 fold less often (in 35.5%), nonoptimal retinol level occurred twice less often (in 41.9%). At the same time, serum α-tocopherol level below the optimal level was found in 67.7% of individuals versus 50% among patients with T2DM without nephropathy, with a significantly reduced urinary excretion of vitamins B1 and B2. With the exception of one man, the rest of the DN patients had a deficiency or lack of vitamin D. The characteristic features of the vitamin status of patients in both groups were the complete absence of individuals who were simultaneously optimally provided with all the studied vitamins and ß-carotene (when assessing the vitamin status using both the absolute serum vitamer levels and 2 additional molar ratios), and a high frequency of detection of several simultaneously non-optimal vitamin status indicators. A negative correlation was found between blood serum level of ß-carotene and glycemia (ρ=-0.359, p=0.006), as well as GFR (ρ=-0.289, р=0.029) and positive with high-density lipoprotein cholesterol (ρ=0.423, р=0.001), that indicated the need to increase this antioxidant blood level in patients with T2DM. The presence of a negative correlation between the concentration ratio of vitamins C and E and glucosuria (ρ=-0.288, p=0.033) and postprandial glycemia (ρ=-0.313, p=0.031) indicated the need to maintain it at an optimal level. Conclusion. For patients with T2DM and concomitant obesity, vitamin D and ß-carotene turned out to be the most problematic, since their reduced levels are detected more often than other vitamins. In addition to the optimal blood level of vitamins C and E, it is extremely important for them to maintain the blood molar ratio of ascorbic acid and α-tocopherol at an optimal level. The purposefully development of specialized vitamin complexes containing effective doses is necessary for patients with DN.

[Influence of multiple insufficiency of vitamin D and B group vitamins, calcium and magnesium in the diet of rats on micronutrient sufficiency and plasma biochemical indicators].

The lack of vitamins D, B group, calcium and magnesium is common for the diet of the Russian population. It has been previously demonstrated that that the elimination of B vitamin deficiency is a necessary condition for the implementation of vitamin D biological functions. The aim of the research was to assess the effect of a combined deficiency of vitamins D and B group, calcium and magnesium in the diet of rats on biomarkers of micronutrient sufficiency and plasma biochemical indicators. Material amd methods. Male Wistar rats with an initial body weight of 66±1 g were randomly assigned to one of five groups. The rats of the 1st group (Control) were fed a standard semi-synthetic diet (SD) for 28 days. The combined deficit of vitamins D and B group, calcium and magnesium in rats of four experimental groups was caused by a 5-fold decrease in their content in the vitamin mixture and 2-fold decrease in their content in mineral mixture of the SD for 23 days. Over the next 5 days, the rats of 2nd group (+В+D+Ca+Mg) were fed a diet replenished for all missing vitamins and minerals, the rats of 3rd group (-В+D+Ca+Mg) were fed a diet with continued deficiency of B group vitamins, the rats of the 4th group (+В+D-Ca-Mg) were fed a diet with continued lack of calcium and magnesium, the diet of the 5th group (-B-D-Ca-Mg) was not replenished. Vitamins B1 and B2 in lyophilized liver and brain and urine, riboflavin in plasma and 4-pyridoxic acid in urine were determined by fluorimetric methods, 25(OH)D in plasma was determined by ELISA, the level of vitamins A and E in blood plasma and lyophilized liver, of vitamin E in whole brain - by HPLC. Biochemical parameters of blood plasma were determined using a biochemical analyzer. Results. In rats of the 5th group (-B-D-Ca-Mg), there were 3.4-fold increase (p<0.05) in iron plasma level, 1.7-fold elevation (p<0.10) in alkaline phosphatase activity, and 1.8-fold decrease (p<0.05) in alanine aminotransferase (ALT) activity on the background of the increase in α-tocopherol blood plasma level by 26.7% (p<0.05) and liver content by 2.0 fold (p<0.05) relative to the indicators in animals who hadn't passed the deficiency of micronutrients (Control) and / or from the 2nd group (+B+D+Ca+Mg). The lack of B group vitamins in the diet, which persisted during the correction of vitamin D, calcium and magnesium deficiency in rats of the 3rd group (-B+D+Ca+Mg), inhibited the recovery of diagnostically significant biochemical parameters of blood plasma (namely, an increased level of glucose, iron, triglycerides, cholesterol, α-tocopherol, increased alkaline phosphatase activity and reduced ALT activity) to the level in animals of the control group and/or rats fed the diet replenished for all missing micronutrients (+B+D+Ca+Mg). Conclusion. Combined deficiency of several micronutrients led to changes in biochemical blood parameters. Reduced intake of calcium and magnesium during the correction of the lack of vitamins D and B group in the diet can have a negative impact on vitamin B2 status. Even under normal dietary vitamin E intake the combined deficiency of several other micronutrients affected the metabolism of this vitamin (increased levels of vitamin E in the liver and blood plasma of animals). Chronic combined alimentary deficit of B vitamins, calcium and magnesium, which is characteristic in the diet of the Russian population, reduces vitamin D bioavailability, which justifies the expediency of using vitamin-mineral complexes.

[Efficiency of vitamin D deficit correction depending on rats' supply with B vitamins].

Despite the presence of combined deficiency of vitamins D and group B among the population of Russia, the intake of cholecalciferol is often recommended without correcting the supply with B group vitamins, which are involved in ensuring the biological functions of vitamin D. The aim of the study was to compare the effectiveness of vitamin D deficit correction by replenishing its content in the diet to an adequate level without eliminating the deficit of B vitamins and by restoring vitamin D level in combination with B vitamins. Material and methods. The experiment was carried out on male Wistar rats (n=33) with an initial body weight of 69.5±0.8 g. Combined deficit of vitamins D and B group in rats (n=24) was caused by a 5-fold decrease in their content in the vitamin mixture of a semi-synthetic diet for 23 days. Over the next 7 days, in order to correct vitamin deficiency, 12 rats (group «-B+D¼) were fed a diet, replenished up to 100% for vitamin D with continued deficiency of B group vitamins, and 12 rats (group «+B+D¼) were fed a diet replenished for all missing vitamins. Animals of the control group (n=9) received a full semi-synthetic diet during the entire experiment. The concentration of vitamins A and E in blood plasma and lyophilized liver and whole brain was determined by HPLC, vitamins B1 and B2 in the liver, brain and urine, riboflavin in plasma and 4-pyridoxic acid in urine - by fluorimetric methods, 25(OH)D in blood plasma was determined by ELISA. The content of calcium, magnesium, iron, manganese, zinc and copper in freeze-dried liver and brain was determined by atomic absorption method, biochemical parameters of blood and urine were determined using a biochemical analyzer. Results. The only vitamin D addition to the feed with a persisting deficiency of B vitamins did not restore the concentration of 25(OH)D and osteocalcin to the level in control animals sufficiently provided with all vitamins. In animals of the "-B+D" group, 25(OH)D plasma level was reduced by 17.3% (p<0.10), osteocalcin - by 11.7% (p<0.05), the activity of aspartate aminotransferase was 1.5 fold less, alanine aminotransferase - 2.3 fold (p<0.05), lactate dehydrogenase - by 14.9% (p<0.10), while the concentration of iron exceeded 2.7 times, glucose - by 15.0%, calcium - by 8.0%, creatinine - by 8.7% (p<0.05), urea - by 32.1%, direct bilirubin - by 24.2% (p<0.10 ) compared with corresponding indicator in rats of the control group. The level of cholesterol and HDL cholesterol was 14.7% and 15.9% higher (p<0.10) than in animals of the «+B+D¼ group. Conclusions. Deficiency of B vitamins inhibits the restoration of adequate supply with vitamin D. In the presence of a lack of B vitamins in rats, vitamin D deficit and its consequences cannot be completely eliminated. Adequate supply with vitamins D and B group are synergistic factors in maintaining the level of glucose, cholesterol in blood plasma and other diagnostically significant parameters.

[Evaluation of vitamin status of workers of oil-processing enterprises (Samara Region) according to the data on vitamin consumption and blood serum level].

Vitamin status of 77 employees of oil refineries (39 men and 38 women aged 22 to 62 years, body mass index - 25.0±4.7 kg/m2) has been assessed in autumn. The sufficiency with vitamins A, E, D, B2, B12, folate and beta-carotene was evaluated by determination in blood plasma, daily intake of vitamins B1, B2, niacin, C, A and betacarotene was calculated by frequency of food consumption during previous month. All surveyed were sufficiently supplied with vitamins A, B12 and folate (reduced level was detected in 0-2.6%). The content of tocopherols referred to triglycerides was reduced in 33% of the workers, in men it was 2 fold more likely (p<0.05) than in women (43.6 vs 21.1%). Vitamin D insufficiency took place in 23.4% of individuals, vitamin B2 and beta-carotene - in 44.2%. A reduced blood plasma content of one vitamin was detected in 39.0% of the surveyed, while two vitamins - in 24.7% persons, 2.2 fold more often (p<0.05) in men than in women. Multivitamin insufficiency was detected in 10.4% of workers. Reduced blood plasma level of at least one vitamin-antioxidant was detected in 46.8% (in 61.5% of men and 31.6% of women, p<0.05). 26.0% of surveyed were provided with all 6 vitamins and beta-carotene. Reduced relative to RDA daily intake of antioxidant vitamins (ascorbic acid and beta-carotene) was observed in 64.9 and 100% of individuals, B group vitamins (niacin, B2 and B1) - in 48.1-64.9%, vitamin A - in 42.9%.

[Diagnosis and endoscopic treatment of stenosing papillitis].

The results of endoscopic papillosphincterotomy (EPST), performed in 2000-2008 yrs in 462 patients for stenosing papillitis, were analyzed. Typical EPST was performed in 166 (35.9%) patients and atypical one--in 296 (64.1%). Complications after performance of typical EPST had occurred in 9 (5.4%) patients and after atypical one--in 12 (4.1%). All the patients are alive.

[Atypical endoscopic papillotomy in diagnostic-treatment algorhythm for obstruction of terminal part of the common biliary duct].

The results of atypical endoscopic papillotomy with subsequent transpapillary intervention, performed in the clinic in 2001-2006 for the diagnosis-treatment aim in 1090 patients, suffering obstruction of terminal part of common biliary duct, were studied. Complications had occurred in 62 (5.7%) patients, bleeding--in 34 (3.1%) of them. All the patients had survived.