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@ARTICLE{Hildebrandt:126726,
      author       = {W. Hildebrandt and R. Sauer and G. Bonaterra and K. A. Dugi
                      and L. Edler$^*$ and R. Kinscherf},
      title        = {{O}ral {N}-acetylcysteine reduces plasma homocysteine
                      concentrations regardless of lipid or smoking status.},
      journal      = {The American journal of clinical nutrition},
      volume       = {102},
      number       = {5},
      issn         = {1938-3207},
      address      = {Bethesda, Md.},
      publisher    = {Soc.},
      reportid     = {DKFZ-2017-02754},
      pages        = {1014 - 1024},
      year         = {2015},
      abstract     = {Elevated 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.},
      keywords     = {Antihypertensive Agents (NLM Chemicals) / Antioxidants (NLM
                      Chemicals) / Triglycerides (NLM Chemicals) / Homocysteine
                      (NLM Chemicals) / Cholesterol (NLM Chemicals) / Glutathione
                      (NLM Chemicals) / Cysteine (NLM Chemicals) / Acetylcysteine
                      (NLM Chemicals)},
      cin          = {C060},
      ddc          = {570},
      cid          = {I:(DE-He78)C060-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:26447155},
      doi          = {10.3945/ajcn.114.101964},
      url          = {https://inrepo02.dkfz.de/record/126726},
}