The relationship between plasma albumin, alkaline phosphatase and pyridoxal phosphate concentrations in plasma and red cells: Implications for assessing vitamin B6 status

Talwar, Dinesh; Catchpole, Andrew; Wadsworth, John; Toole, Barry

doi:10.1016/j.clnu.2019.12.012

Cited by 14 publications

(13 citation statements)

References 27 publications

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“…In conditions associated with low albumin (e.g. inflammation) or altered alkaline phosphatase activity, red cell PLP measurements are more likely to be reliable than plasma measurements in differentiating true from apparent vitamin B6 deficiency and to guide vitamin B6 supplementation [416,417]. Additionally, intracellular measurements appear to obviate the need for plasma adjustment for albumin to assess MN status [102].…”

Section: Effect Of Inflammationmentioning

confidence: 99%

ESPEN micronutrient guideline

et al. 2022

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Section: Effect Of Inflammationmentioning

confidence: 99%

ESPEN micronutrient guideline

et al. 2022

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“…PLP was also associated with reduced risk of liver transplantation or death independent of other risk scores, that is, Amsterdam-Oxford model for PSC (hazard ratio, 0.67 per quartile increase in plasma PLP; 95% confidence interval, 0.51-0.88; P ¼ .003) (Supplementary Table 7). PLP may be metabolized by alkaline phosphatase, 33 and the 2 showed a moderate inverse correlation (r ¼ -.38, P < .001), but alkaline phosphatase was not independently associated with survival when added to the model (Supplementary Table 6).…”

Section: Basic and Translational Biliarymentioning

confidence: 99%

Altered Gut Microbial Metabolism of Essential Nutrients in Primary Sclerosing Cholangitis

et al. 2021

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BACKGROUND & AIMS:To influence host and disease phenotype, compositional microbiome changes, which have been demonstrated in patients with primary sclerosing cholangitis (PSC), must be accompanied by functional changes. We therefore aimed to characterize the genetic potential of the gut microbiome in patients with PSC compared with healthy controls (HCs) and patients with inflammatory bowel disease (IBD). METHODS: Fecal DNA from 2 cohorts (1 Norwegian and 1 German), in total comprising 136 patients with PSC (58% with IBD), 158 HCs, and 93 patients with IBD without PSC, were subjected to metagenomic shotgun sequencing, generating 17 billion pairedend sequences, which were processed using HUMAnN2 and MetaPhlAn2, and analyzed using generalized linear models and random effects meta-analyses. RESULTS: Patients with PSC had fewer microbial genes compared with HCs (P < .0001). Compared with HCs, patients with PSC showed enrichment and increased prevalence of Clostridium species and a depletion of, for example, Eubacterium spp and Ruminococcus obeum. Patients with PSC showed marked differences in the abundance of genes related to vitamin B6 synthesis and branched-chain amino acid synthesis (Q fdr < .05). Targeted metabolomics of plasma from an independent set of patients with PSC and controls found reduced concentrations of vitamin B6 and branched-chain amino acids in PSC (P < .0001), which strongly associated with reduced liver transplantation-free survival (log-rank P < .001). No taxonomic or functional differences were detected between patients with PSC with and without IBD. CONCLUSIONS: The gut microbiome in patients with PSC exhibits large functional differences compared with that in HCs, including microbial metabolism of essential nutrients. Alterations in related circulating metabolites associated with disease course, suggesting that microbial functions may be relevant for the disease process in PSC.

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“…RC PLP is unaffected by APR 13,14,42 . There is a strong correlation between plasma and RC PLP in the absence of APR, but there is a lack of concordance between the two in the presence of APR 43 .…”

Section: Inflammation and Mn Blood Levelsmentioning

confidence: 86%

“…There is a strong correlation between plasma and RC PLP in the absence of APR, but there is a lack of concordance between the two in the presence of APR 43 . RC PLP correlates with white cell PLP both in the absence and presence of APR 42 …”

Section: Inflammation and Mn Blood Levelsmentioning

confidence: 96%

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Pitfalls in the interpretation of blood tests used to assess and monitor micronutrient nutrition status

Berger¹,

Talwar

Shenkin

2022

Nut in Clin Prac

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Assessment of micronutrient (MN) status is of particular importance in patients who require medical nutrition therapy, especially those requiring parenteral nutrition. Blood testing is generally the only tool available in clinical settings to assess MN status. However, using plasma or serum concentration faces pitfalls mainly because of the impact of inflammation that diverts the MNs from the circulating compartment. This review aims to review the blood tests that are useful and provide information about how to integrate functional markers of status to reach a clinically relevant diagnosis. Most impacted, with a significant and proportional decrease in plasma concentrations, are iron, selenium, zinc, thiamin, folic acid, cobalamin, and vitamins A, C, and D; copper is the only MN for which the plasma concentration increases. Therefore, a surrogate marker of inflammation, C‐reactive protein, must always be determined simultaneously. Validated intracellular and functional tests are proposed to improve status assessment. A protocol is suggested for tests required both on commencing and during nutrition support. A timely turnaround of analysis is essential for results to be clinically useful. In some cases, the appropriate provision of MNs should be commenced before results have been obtained to confirm the clinical assessment. Laboratory tests of MN status are an area prone to misuse and misinterpretation. The appropriate use and interpretation of such tests are essential to ensure the correct management of nutrition problems.

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The relationship between plasma albumin, alkaline phosphatase and pyridoxal phosphate concentrations in plasma and red cells: Implications for assessing vitamin B6 status

Cited by 14 publications

References 27 publications

ESPEN micronutrient guideline

ESPEN micronutrient guideline

Altered Gut Microbial Metabolism of Essential Nutrients in Primary Sclerosing Cholangitis

Pitfalls in the interpretation of blood tests used to assess and monitor micronutrient nutrition status

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