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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Whole blood NAD and NADP concentrations are not depressed in subjects with clinical pellagra
Journal of Nutrition, Volume 137, No. 9, Year 2007
Notification
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Description
Population surveys for niacin deficiency are normally based on clinical signs or on biochemical measurements of urinary niacin metabolites. Status may also be determined by measurement of whole blood NAD and NADP concentrations. To compare these methods, whole blood samples and spot urine samples were collected from healthy subjects (n = 2) consuming a western diet, from patients (n = 34) diagnosed with pellagra and attending a pellagra clinic in Kuito (central Angola, where niacin deficiency is endemic), and from female community control subjects (n = 107) who had no clinical signs of pellagra. Whole blood NAD and NADP concentrations were measured by microtiter plate-based enzymatic assays and the niacin urinary metabolites 1-methyl-2-pyridone-5-carboxamide (2-PYR) and 1-methylnicotinamide (1-MN) by HPLC. In healthy volunteers, inter- and intra-day variations for NAD and NADP concentrations were much lower than for the urinary metabolites, suggesting a more stable measure of status. However, whole blood concentrations of NAD and NADP or the NAD:NADP ratio were not significantly depressed in clinical pellagra. In contrast, the concentrations of 2-PYR and 1-MN, expressed relative to either creatinine or osmolality, were lower in pellagra patients and markedly higher following treatment. The use of the combined cut-offs (2-PYR <3.0 μmol/mmol creatinine and 1-MN <1.3 μmol/mmol creatinine) gave a sensitivity of 91% and specificity of 72%. In conclusion, whole blood NAD and NADP concentrations gave an erroneously low estimate of niacin deficiency. In contrast, spot urine sample 2-PYR and 1-MN concentrations, relative to creatinine, were a sensitive and specific measure of deficiency. © 2007 American Society for Nutrition.
Authors & Co-Authors
Creeke, Paul I.
United Kingdom, London
Ucl Great Ormond Street Institute of Child Health
Dibari, Filippo
United Kingdom, London
Ucl Great Ormond Street Institute of Child Health
Cheung, Edith
Angola, Luanda
World Food Programme
Van Den Briel, Tina
Italy, Rome
World Food Program, Italy
Kyroussis, Eustace
Switzerland, Geneva
Medecins Sans Frontieres
Seal, Andrew J.
United Kingdom, London
Ucl Great Ormond Street Institute of Child Health
Statistics
Citations: 40
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1093/jn/137.9.2013
ISSN:
00223166
Research Areas
Food Security
Health System And Policy
Study Design
Cross Sectional Study
Study Locations
Angola
Participants Gender
Female