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000126726 0247_ $$2doi$$a10.3945/ajcn.114.101964
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000126726 0247_ $$2ISSN$$a0095-9871
000126726 0247_ $$2ISSN$$a1938-3207
000126726 0247_ $$2ISSN$$a1938-3215
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000126726 037__ $$aDKFZ-2017-02754
000126726 041__ $$aeng
000126726 082__ $$a570
000126726 1001_ $$aHildebrandt, Wulf$$b0
000126726 245__ $$aOral N-acetylcysteine reduces plasma homocysteine concentrations regardless of lipid or smoking status.
000126726 260__ $$aBethesda, Md.$$bSoc.$$c2015
000126726 3367_ $$2DRIVER$$aarticle
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000126726 520__ $$aElevated total plasma homocysteine (tHcy) is considered to be an independent cardiovascular disease risk factor, although tHcy lowering by B-vitamins improves only certain clinical endpoints. N-acetylcysteine (NAC), a thiol-containing antioxidant, acutely lowers tHcy and possibly also blood pressure. However, to our knowledge, at present no conclusive long-term evaluation exists that controls for factors such as hyperlipidemia, smoking, medication, and disease stage, all of which affect the thiol redox state, including tHcy.We reanalyzed 2 double-blind, placebo-controlled trials in unmedicated middle-aged men, one in a hyperlipidemic group (HYL group; n = 40) and one in a normolipidemic group (NOL group; n = 42), each stratified for smokers and nonsmokers.We evaluated the effect of 4 wk of oral NAC (1.8 g/d) on tHcy (primary endpoint), plasma thiol (cysteine), and intracellular glutathione concentrations as well as on blood pressure. The HYL group had total cholesterol >220 mg/dL or triglycerides >150 mg/dL.NAC treatment significantly (P = 0.001, multivariate analysis of variance for repeated measures) lowered postabsorptive plasma concentrations of tHcy by -11.7% ± 3.0% (placebo: 4.1% ± 3.6%) while increasing those of cysteine by 28.1% ± 5.7% (placebo: 4.0% ± 3.4%) with no significant impact of hyperlipidemia or smoking. Moreover, NAC significantly decreased systolic (P = 0.003) and diastolic (P = 0.017) blood pressure within all subjects with a significant reduction in diastolic pressure in the HYL group (P = 0.008) but not in the NOL group. An explorative stepwise multiple regression analysis identified 1) post-treatment cysteine as well as 2) pretreatment tHcy and 3) albumin plasma concentrations as being significant contributors to tHcy reduction.Four weeks of oral NAC treatment significantly decreased plasma tHcy concentrations, irrespective of lipid or smoking status, and lowered systolic blood pressure in both normolipidemic and hyperlipidemic men, with significant diastolic blood pressure reductions in the HYL group only. Increased oral intake of cysteine may therefore be considered for primary or secondary prevention of vascular events with regard to the 2 independent risk factors of hyperhomocysteinemia and arterial hypertension.
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000126726 650_7 $$2NLM Chemicals$$aAntihypertensive Agents
000126726 650_7 $$2NLM Chemicals$$aAntioxidants
000126726 650_7 $$2NLM Chemicals$$aTriglycerides
000126726 650_7 $$00LVT1QZ0BA$$2NLM Chemicals$$aHomocysteine
000126726 650_7 $$097C5T2UQ7J$$2NLM Chemicals$$aCholesterol
000126726 650_7 $$0GAN16C9B8O$$2NLM Chemicals$$aGlutathione
000126726 650_7 $$0K848JZ4886$$2NLM Chemicals$$aCysteine
000126726 650_7 $$0WYQ7N0BPYC$$2NLM Chemicals$$aAcetylcysteine
000126726 7001_ $$aSauer, Roland$$b1
000126726 7001_ $$aBonaterra, Gabriel$$b2
000126726 7001_ $$aDugi, Klaus A$$b3
000126726 7001_ $$0P:(DE-He78)621efe295db6fdfa7f9f95011a5ea943$$aEdler, Lutz$$b4$$udkfz
000126726 7001_ $$aKinscherf, Ralf$$b5
000126726 773__ $$0PERI:(DE-600)1496439-9$$a10.3945/ajcn.114.101964$$gVol. 102, no. 5, p. 1014 - 1024$$n5$$p1014 - 1024$$tThe American journal of clinical nutrition$$v102$$x1938-3207$$y2015
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000126726 9141_ $$y2015
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