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Dietetics, Nutrition and Biological Sciences

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/23

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End date: 2009Subject: search.filters.subject.Critical Illness

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    The relationship between plasma and red cell B-vitamin concentrations in critically-ill patients
    (Elsevier, 2005-07-28) Quasim, Tara; McMillan, Donald C.; Talwar, Dinesh; Vasilaki, Katerina; O'Reilly, Denis St J.; Kinsella, John
    Background and aims: Low vitamin B-complex status has been associated with poorer outcome in critically-ill patients. However, these findings have been based on indirect methods. Using direct methods for assessing vitamin status, we examined the effect of B-complex vitamin supplementation by measuring plasma and red blood cell B1, B2 and B6-vitamin concentrations in critically-ill patients. Methods: Thiamine diphosphate (TDP), flavin adenine dinucleotide (FAD) and pyridoxal phosphate (PLP) concentrations were measured in plasma and red cells of normal subjects (n ¼ 49) and ITU patients (n ¼ 41). Results: Compared with the normal subjects, critically-ill patients had higher C- reactive protein and lower albumin concentrations (Po0:001). Also, plasma FAD and PLP were lower (Po0:001) and red cell concentrations of both were higher (Po0:01) in critically-ill patients. Critically-ill patients were grouped according to whether (n ¼ 23) or not (n ¼ 18) they had been supplemented with B-complex vitamins. Compared with non-supplemented group, the supplemented group had significantly higher red cell TDP and PLP concentrations (Po0:01). Plasma FAD and PLP concentrations did not differ significantly between the groups. Conclusions: The results of the present study suggest that direct measurements of red cell FAD and PLP are more responsive to supplementation than plasma measurements in the critically-ill patient.
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    Relation between pyridoxal and pyridoxal phosphate concentrations in plasma, red cells, and white cells in patients with critical illness
    (Oxford University Press, 2008-07-01) Vasilaki, Katerina; McMillan, Donald C.; Kinsella, John; Duncan, Andrew; O'Reilly, Denis St J.; Talwar, Dinesh
    Background: Evidence suggests that the relation between plasma and red cell vitamin B-6 concentrations is perturbed as part of the systemic inflammatory response in critically ill patients. Objective: The aim was to examine the cross-sectional and longitudinal interrelations between pyridoxal (PL) and pyridoxal phosphate (PLP) concentrations in plasma and red and white cells in patients with critical illness. Design: PLP and PL concentrations were measured by HPLC in plasma and red and white cells in normal subjects (n 126) and critically ill patients (n 96) on admission and on follow-up. Results: On admission, compared with the controls, median plasma PLP and PL (P 0.001 and 0.01, respectively) and red cell PLP and PL (P0.001 and0.05, respectively) andtheir ratio (PLP:PL) in plasma and red cells (P 0.001 and 0.01, respectively) were significantly lower in the critically ill. In critically ill patients, plasma PLP:PL was significantly lower than red cell PLP:PL (P 0.001) and white cell PLP:PL (P 0.008). Plasma PL concentration was directly associated with both red cell PL (rs 0.73, P 0.001) and white cell PL (rs 0.68, P 0.001). Red cell PL and white cell PL were directly associated with red cell PLP (rs 0.82, P 0.001) and white cell PLP (rs 0.68, P 0.001), respectively. Longitudinal measurements (n 48) were similar. Conclusions: The relation between plasma PLP and PL was significantly perturbed in critical illness. This effect was less pronounced in red and white cells. Therefore, these results confirm the hypothesis that intracellular PLP concentrations are more likely to be a reliable measure of status than are plasma measurements in the critically ill patient.