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    Jan 23, 2021
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    Whole blood NAD and NADP concentrations are not depressed in subjects with clinical pellagra

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    Authors
    Creeke, P I
    Dibari, F
    Cheung, E
    van den Briel, T
    Kyroussis, E
    Seal, A J
    Affiliation
    Centre for International Health and Development, Institute of Child Health, London, UK; World Food Programme, Luanda, Angola; World Food Programme, Rome, Italy; Medecins sans Frontieres-Belgium, Kuito, Angola
    Issue Date
    2007-09-01
    
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    Journal
    Journal of Nutrition
    Abstract
    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 micromol/mmol creatinine and 1-MN <1.3 micromol/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.
    URI
    http://hdl.handle.net/10144/129972
    PubMed ID
    17709435
    Additional Links
    http://jn.nutrition.org/cgi/content/full/137/9/2013
    Type
    Article
    Language
    en
    ISSN
    0022-3166
    Collections
    Nutrition

    entitlement

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