BACKGROUND:Cerebrotendinous xanthomatosis (CTX) is caused by biallelic mutations in the CYP27A1 gene, which encodes sterol 27-hydroxylase. Reduced activity of this enzyme decreases bile acid synthesis and increases cholestanol production. Cholestanol, a metabolic intermediate, can be used as a diagnostic marker; however, patients with CTX have been reported to have normal cholestanol levels. Cholesterol and bile acid metabolism is likely to be extensively disrupted even in these patients with CTX. OBJECTIVE:We aimed to clarify whether sterol markers, including oxysterols, can be used to screen for and diagnose CTX and assess treatment efficacy. METHODS:Fourteen patients with CTX (homozygotes, n = 7; compound heterozygotes, n = 5; unidentified, n = 2), 6 carriers, and 24 healthy controls were enrolled. We analyzed 9 sterol markers, including 4 oxysterols, using gas chromatography-mass spectrometry. We measured these markers in patients with CTX before and after treatment with chenodeoxycholic acid (CDCA) and/or lipid-lowering agents. RESULTS:Cholestanol and sterol markers of cholesterol synthesis and absorption were 1.3 to 8.3 times higher in patients with CTX than in carriers and controls. These marker levels decreased significantly in patients with CTX after treatment. Compared to carriers and controls, patients with CTX had extremely low levels of 27-hydroxycholesterol (27-OHC) and extremely high levels of 7α-hydroxycholesterol (7α-OHC). During treatment, 7α-OHC levels decreased significantly, while 27-OHC levels remained low. Receiver operating characteristic analysis demonstrated excellent diagnostic performance. The area under the curve was 1.000 for low 27-OHC and 0.991 for elevated 7α-OHC, outperforming cholestanol (0.903). CONCLUSION:Sterol markers, including oxysterols, can be used to screen for and diagnose CTX and to assess treatment efficacy with CDCA and/or lipid-lowering agents.

BackgroundTo clarify the fundamental characteristics of the Japan Society of Clinical Chemistry reference measurement procedure (JSCC RMP) for glycated albumin (GA), an additional performance study was performed and the correlation between the HPLC method and JSCC RMP was re-evaluated.MethodsRepeatability, detection limit, addition recovery, uncertainty of measurement, inter-laboratory comparison, correlation between JSCC RMP and HPLC method were evaluated.ResultsThe coefficient of variation (CV) of the total repeatability for the nine pretreated samples including isotope dilution and hydrolysis, defining that the averages of each of nine MS measurement samples are independent measurement vials, was 1.0%(n = 9). The limit of detection and Quantification of the GA values were 7.4 and 29.5 mmol/mol, respectively. Addition recovery rates were 99.6%-100.4%. The strong correlation (r = 0.999) of measured six serum samples between two laboratories was observed. Certified values and expanded uncertainties for JCCRM 611-2 (M, H, HH) using the JSCC RMP were as follows: JCCRM 611-2M: 232 and 9 mmol/mol, JCCRM611-2H: 359 and 14 mmol/mol, JCCRM611-2HH: 556 and 22 mmol/mol, respectively. The regression equation obtained using the Passing-Bablok method was GA (%)HPLC = 0.0523 × GA (mmol/mol) JSCC RMP + 1.315.ConclusionThe basic performance of the JSCC reference procedure for GA measurement was good, and similar results were obtained at other facilities, so it was considered to be robust and suitable as a reference method for GA measurement. Additionally, an equation was established to convert JSCC RMP (mmol/mol) values to the HPLC% values used in clinical practice.

BackgroundAlthough preβ1-high-density lipoprotein (preβ1-HDL) promotes cholesterol efflux, high fasting preβ1-high-density lipoprotein levels after breakfast are reduced in patients with poorly controlled type 2 diabetes.ObjectiveThis study investigated whether preβ1-high-density lipoprotein binds to triglyceride (TG)-rich lipoproteins (TGRLs) in the postprandial state and is released during lipolysis.MethodsWe measured preβ1-high-density lipoprotein concentrations, lecithin-cholesterol acyltransferase (LCAT) activity, and LCAT-dependent preβ1-high-density lipoprotein conversion before and after breakfast in patients with diabetes. We also performed in vitro studies using TGRLs. Preβ1-high-density lipoprotein was quantified by enzyme-linked immunosorbent assay and native two-dimensional gradient gel (N-2D-gel) electrophoresis.ResultsBefore breakfast, the diabetes group had higher preβ1-high-density lipoprotein concentrations than the healthy controls; after breakfast, levels in the two groups were similar. Neither LCAT mass nor the LCAT-dependent preβ1-high-density lipoprotein conversion rate changed after breakfast. Mixing of fasting plasma with chylomicrons or very-low-density lipoprotein (VLDL) reduced the preβ1-high-density lipoprotein level by 15% ± 4% and 45% ± 10%, respectively. N-2D-gel electrophoresis showed that preβ1-high-density lipoprotein was generated by bacteria-derived TG lipase only from postprandial VLDL of patients with type 2 diabetes.ConclusionPreβ1-high-density lipoprotein binds to TGRLs in the postprandial state and is released during lipolysis, implying that postprandial hyperlipidemia impairs reverse cholesterol transport in patients with poorly controlled type 2 diabetes.

Background Carnitine is essential for fatty acid metabolism. Free carnitine (FCA) is excreted in the urine in the glomerulus, but is partly reabsorbed by a carnitine transporter. The mechanism underlying the decrease in serum carnitine level during pregnancy is unclear. Objective To investigate whether low carnitine level is associated with increased renal excretion in pregnant women. Methods We recruited 43 healthy pregnant and 25 non-pregnant women. Total carnitine (TCA) and FCA levels were measured using the enzymatic cycling method, and the acylcarnitine (ACA) level was calculated. Fractional excretion (FE) was calculated as carnitine clearance divided by creatinine clearance. Results The mean TCA, FCA, and ACA levels were lower at 12 weeks of gestation in pregnant than non-pregnant women ( P < .001); the levels decreased further at 36 weeks, reaching 39%, 36%, and 52% of those in non-pregnant women, respectively ( P < .001). The FEs were 3–4-fold higher in pregnant women than non-pregnant women. Pregnant women had a lower serum FCA/TCA ratio than non-pregnant women (0.788 ± 0.098 vs 0.830 ± 0.074, respectively; P < .05), whereas the urine FCA/TCA ratio was similar between the groups. Conclusion Low carnitine level is associated with increased renal excretion during late pregnancy.

AIM:Lipoprotein (a) [Lp(a)] is a well-established risk factor for cardiovascular disease independent of low-density lipoprotein-cholesterol (LDL-C). The Lp(a) concentrations were inconsistent between the immunoassays. This study aimed to investigate whether harmonization of Lp(a) measurements can be achieved using a serum panel value assigned with the IFCC-endorsed mass spectrometry-based reference measurement procedure (IFCC-MS-RMP). METHODS:We measured the Lp(a) concentrations using five Lp(a) immunoassays in 40 panel sera provided by the Centers for Disease Control and Prevention (CDC), and 500 Japanese subjects enrolled in the Bunkyo Health Study. Of the five immunoassays, only the Roche Lp(a) assay was traceable to the WHO-IFCC reference material SRM2B. Lp(a) concentrations in CDC samples were also determined by IFCC-MS-RMP, provisionally calibrated to SRM2B. Lp(a) concentrations were expressed in mass units (mg/dL) for most reagents, but in SI units (nmol/L) for Roche's reagent and IFCC-MS-RMP. RESULTS:In the CDC panel sera, all immunoassays, including Roche's reagent, showed good correlations with IFCC-MS-RMP. In the Bunkyo Health Study samples, all immunoassays showed good correlations with Roche's reagent (rs, 0.986-0.998) although the slopes of the regression lines ranged from 0.292 to 0.579. After recalibration with the CDC's panel sera, Lp(a) results of Bunkyo Health Study samples were converted to the equivalent values determined by the IFCC-MS-RMP, thus resulting in a marked reduction in the intermethod CV among the assays. CONCLUSION:We achieved harmonization of Lp(a) measurements with five immunoassays using a serum panel value assigned with the IFCC-MS-RMP.

Background: Insulin resistance (IR) is exacerbated during pregnancy via increases in insulin counterregulatory hormones. Maternal lipids are strong determinants of neonatal growth, although triglyceride-rich lipoproteins (TGRLs) cannot be transferred directly to the fetus through the placenta. The catabolism of TGRLs under physiological IR and the reduced synthesis of lipoprotein lipase (LPL) are poorly understood. We examined the association of maternal and umbilical cord blood (UCB)-LPL concentrations with maternal metabolic parameters and fetal development. Methods: Changes in anthropometric measures and lipid-, glucose-, and insulin-related parameters, including maternal and UCB-LPL concentrations, were examined in 69 women during pregnancy. The relationship between those parameters and neonatal birth weight was assessed. Results: Parameters reflecting glucose metabolism did not change during pregnancy, whereas those associated with lipid metabolism and IR changed markedly, particularly in the second and third trimesters. In the third trimester, the maternal LPL concentration gradually decreased, by 54%, whereas the UCB-LPL concentration was similar to 2-fold higher than the maternal LPL concentration. Univariate and multivariate analyses showed that the UCB-LPL concentration was a significant determinant of neonatal birth weight, together with placental birth weight. Conclusion: The LPL concentration in UCB reflects neonatal development under a decreased LPL concentration in maternal serum.

Background: Oxysterols are cholesterol oxidation derivatives with diverse biological activities. How-ever, little is known about the oxysterol levels in treatment-naive patients with type 2 diabetes. Objective: We utilized gas chromatography-mass spectrometry to investigate the potential associa-tion between oxysterol concentrations and type 2 diabetes and atherosclerosis in treatment-naive patients diagnosed with type 2 diabetes. Methods: This case-control study enrolled 53 eligible patients with type 2 diabetes and 50 healthy volunteers. We compared serum oxysterol concentrations between the two groups; we examined the correlation between the oxysterol concentrations and the carotid plaque score in the type 2 diabetes group. Results: Univariate analysis revealed significant differences in the concentrations of oxys-terols (i.e., cholesterol-5 & alpha;, 6 & alpha;-epoxide; cholesterol-5 /3, 6 /3-epoxide; 7/3-hydroxycholesterol; and 25-hydroxycholesterol [25-HC]) and other cardiovascular risk factors between the two groups. The 25 -HC concentration was almost twofold greater in the type 2 diabetes group than in the healthy volun-teers (median [interquartile range]: 8.52 [6.37-11.26] vs. 4.58 [3.45-5.44] ng/mL). After adjusting for multiple covariates, such as age, body mass index, mean arterial pressure, and triglyceride, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol levels, only the concentration of 25-HC showed a significant association with type 2 diabetes. However, the univariate analysis failed to demon -

Abetalipoproteinemia (ABL) is a rare autosomal recessive disorder caused by biallelic pathogenic mutations in the MTTP gene. Deficiency of microsomal triglyceride transfer protein (MTTP) abrogates the assembly of apolipoprotein (apo) B-containing lipoprotein in the intestine and liver, resulting in malabsorption of fat and fat-soluble vitamins and severe hypolipidemia. Patients with ABL typically manifest steatorrhea, vomiting, and failure to thrive in infancy. The deficiency of fat-soluble vitamins progressively develops into a variety of symptoms later in life, including hematological (acanthocytosis, anemia, bleeding tendency, etc.), neuromuscular (spinocerebellar ataxia, peripheral neuropathy, myopathy, etc.), and ophthalmological symptoms (e.g., retinitis pigmentosa). If left untreated, the disease can be debilitating and even lethal by the third decade of life due to the development of severe complications, such as blindness, neuromyopathy, and respiratory failure. High dose vitamin supplementation is the mainstay for treatment and may prevent, delay, or alleviate the complications and improve the prognosis, enabling some patients to live to the eighth decade of life. However, it cannot fully prevent or restore impaired function. Novel therapeutic modalities that improve quality of life and prognosis are awaited. The aim of this review is to 1) summarize the pathogenesis, clinical signs and symptoms, diagnosis, and management of ABL, and 2) propose diagnostic criteria that define eligibility to receive financial support from the Japanese government for patients with ABL as a rare and intractable disease. In addition, our diagnostic criteria and the entry criterion of low-density lipoprotein cholesterol (LDL-C) ＜15 mg/dL and apoB ＜15 mg/dL can be useful in universal or opportunistic screening for the disease. Registry research on ABL is currently ongoing to better understand the disease burden and unmet needs of this life-threatening disease with few therapeutic options.

Objectives: In 2009, the Japan Society of Clinical Chemistry (JSCC) recommended a reference method for the measurement of serum high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels. This automated method uses cholesterol esterase-cholesterol dehydrogenase to measure cholesterol levels in fractions obtained after ultracentrifugation and dextran sulfate/magnesium chloride precipitation. In the present study, using fresh samples, we compared the LDL-C and HDL-C levels measured using this method with those measured using the traditional Centers for Disease Control and Prevention (CDC)-beta-quantification (BQ) method. Design: and methods: Using both the JSCC and CDC-BQ methods, LDL-C/HDL-C levels were measured in 47 non-diseased and 126 diseased subjects, whose triglyceride levels were lower than 11.29 mmol/L (1000 mg/dL). Results: For LDL-C, the equation of the line representing the correlation between the two methods was y = 0.991x + 0.009 mmol/L; r = 0.999; and Sy/x = 0.025 mmol/L, where x is the mean LDL-C level measured using the CDC-BQ method. Similarly, for HDL-C, the equation of the line representing the correlation between the two methods was y = 0.988x + 0.041 mmol/L, r = 0.999, and Sy/x = 0.019 mmol/L, where x is the mean HDL-C level measured using the CDC-BQ method. Conclusions: The JSCC method agreed with the CDC-BQ method in cases of both non-diseased and diseased subjects, including those with dyslipidemia.

Fungi are usually identified by evaluating morphological characteristics. As fungi are rarely encountered in routine microbiology, it is important to have a suitable guide for the accurate identification of medically important fungi. This study was designed to improve identification of medically important fungi. A total of 20 clinical and reference fungal isolates, were used in this study. The examinations were conducted during the training period in the departments of clinical laboratory and dermatology at Juntendo University Hospital. For the identification of filamentous fungi, conventional culture, colony characteristics, and microscopic findings were collected via photographs. The macroscopic and microscopic morphologies of filamentous fungi showed similar characteristics to those of references. The chromogenic differential media, CHROMagar, was used for the identification of Candida spp. and Malassezia spp. Matrix-assisted laser desorption ionization-time of flight mass spectroscopy was used to rapidly and accurately identify Candida at the species level. Fourteen filamentous fungi and six yeasts were identified in this study using general resources such as Sabouraud dextrose agar (SDA), potato dextrose agar (PDA), and lactophenol cotton blue. The 14 fungi exhibited colony characteristics and microscopic findings on SDA and PDA at 30℃ for 2-14 d. In conclusion, using appropriate guides as tools for identification and implementing new testing technologies will enable the accurate identification of fungi. CHROMagar is extremely useful in rapid identification of common yeast species, improving and streamlining the work flow in clinical microbiology laboratories in the Kingdom of Thailand.

BACKGROUND: Pre beta 1-high-density lipoprotein (HDL) is a lipid-poor cholesterol acceptor that is converted to lipid-rich HDL by lecithin-cholesterol acyltransferase (LCAT). In patients receiving hemodialysis, Pre beta 1-HDL metabolism is hampered even if HDL cholesterol is normal. Hemodialysis may affect Pre beta 1-HDL metabolism by releasing lipases from the vascular wall due to heparin. OBJECTIVES: We investigated whether pre beta 1-HDL metabolism is delayed in patients with chronic kidney disease (CKD) who are not receiving hemodialysis. METHODS: We examined 44 patients with Stage 3 or higher CKD and 22 healthy volunteers (Control group). The patients with CKD were divided into those without renal replacement therapy (CKD group, n = 22) and those undergoing continuous ambulatory peritoneal dialysis (CAPD group, n = 22). Plasma pre beta 1-HDL concentrations were determined by immunoassay. During incubation at 37 degrees C, we used 5,5-dithio-bis (2-nitrobenzoic acid) (DTNB) to inhibit LCAT activity and defined the conversion halftime of pre beta 1-HDL (CHTpre beta 1) as the time required for the difference in pre beta 1-HDL concentration in the presence and absence of 5,5-DTNB to reach half the baseline concentration. RESULTS: The absolute and relative pre beta 1-HDL concentrations were higher, and CHTpre beta 1 was longer in the CKD and CAPD groups than in the Control group. Pre beta 1-HDL concentration was significantly correlated with CHTpre beta 1 but not with LCAT activity in patients with CKD and CAPD. CONCLUSION: Pre beta 1-HDL metabolism is delayed in patients with CKD who are not on hemodialysis. This pre beta 1-HDL metabolic delay may progress as renal function declines. (C) 2020 National Lipid Association. All rights reserved.

BACKGROUND: Triglyceride (TG) is a tri-ester composed of a glycerol and 3 fatty acids. Degradation of TG in adipose tissue is increased in the fasting state but inhibited in the postprandial state. Although insulin suppresses adipose TG degradation, patients with insulin resistance have high concentrations of insulin and free glycerol (FG) in the fasting state. OBJECTIVE: We examined whether the fasting FG concentration reflects visceral obesity and insulin sensitivity in middle-aged Japanese men. METHODS: We measured the fasting serum FG concentration in 72 males aged 30 to 50 years using a simple enzymatic method. The subjects were divided into tertiles according to their homeostasis model assessment of insulin resistance (HOMA-IR). Besides routine glucose- and lipid-related parameters, we determined insulin sensitivity as the rate of glucose disappearance in a 2-step hyperinsulinemic-euglycemic clamp and the abdominal visceral fat area (VFA) by magnetic resonance imaging. RESULTS: The highest HOMA-IR tertile group had a higher fasting FG concentration than the middle-and lowest-tertile groups (0.077 +/- 0.024 vs 0.063 +/- 0.017 and 0.061 +/- 0.016 mmol/L, P < .05 and P < .01). The FG concentration was positively correlated with VFA (rs = 0.36; P < .01) and the HOMA-IR score (rs = 0.26, P < .05) but negatively correlated with insulin sensitivity (rs = -0.26, P < .05). Multivariate regression analysis revealed that the FG concentration is independently associated with VFA and insulin sensitivity. CONCLUSION: The fasting FG concentration reflects VFA and insulin sensitivity in middle-aged Japanese men. The fasting FG concentration may be a potential surrogate marker of visceral obesity and insulin resistance in outpatients. (C) 2020 National Lipid Association. All rights reserved.

Bullous pemphigoid (BP) is an autoimmune blistering skin disease characterized by subepidermal bullae and circulating autoantibodies that bind to components of the hemidesmosome adhesion complex. The diagnosis of BP is based on clinical criteria and laboratory examinations, including direct and indirect immunofluorescence and the enzyme-linked immunosorbent assay (ELISA). Direct immunofluorescence and serological classic indirect immunofluorescence by using human salt-split skin sections and/or monkey esophagus sections have been mainly tested for BP. Antibodies targeting the structural hemidesmosomal proteins BP180 and BP230 have been shown to play a crucial role in the development of BP, and the detection of anti-BP180 antibodies by using an immunoassay ELISA or a chemiluminescent enzyme immunoassay (CLEIA) is routinely performed in Japan. We report on an 82-year-old man who was diagnosed with BP and followed up by testing anti-BP180 antibody. The patient responded well to the treatment, exhibiting a decreased anti-BP180 antibody that fluctuates in parallel with disease activity until a negative result, whereas the IIF test result was still positive. This discrepancy may be related to the fact that the IIF test detects the reaction of antibodies not only anti-BP180 but also anti-BP230. This study demonstrated that the enzyme immunoassay of anti-BP180 is useful as a part of routine examination for follow-up of disease activity and initial diagnosis of BP.

Purpose of review Lipoprotein-X (Lp-X) is an abnormal lipoprotein containing abundant free cholesterol and phospholipids, as well as some apolipoprotein E (apoE). Serum Lp-X increases in patients with cholestasis and lecithin-cholesterol acyltransferase deficiency, as well as in those receiving intravenous lipid emulsion. Lp-X is often associated with skin xanthomas in cholestatic patients. However, earlier studies showed that Lp-X is not taken up by murine macrophages, but exerts antiatherogenic actions. In this review, we discuss the heterogeneity of Lp-X and its potential atherogenicity. Recent findings Mass spectrometry revealed that Lp-X of cholestatic patients is similar in lipid composition to low-density lipoprotein (LDL) and high-density lipoprotein, but not to bile acids, suggesting that Lp-X is synthesized in the liver. Palmar xanthomas appear in patients with cholestasis, but regress over months after improvement of hypercholesterolemia. Lp-X isolated from cholestatic patients is rich in apoE, and causes more lipid accumulation than oxidized LDL and acetyl LDL in human monocyte-derived macrophages. Summary Lp-X is heterogeneous in apoE content. Lp-X is taken up in cholestatic patients by apoE-recognizing lipoprotein receptors. Further research is warranted to fully understand the atherogenicity of Lp-X and the clinical significance of elevated Lp-X concentrations, particularly in cholestatic patients.

PurposeThe proportion of elderly individuals (age ≥65 years) in Japan reached 27.7% in 2017, the highest in the world. A serious social problem in a super-aged society is the rise in the number of elderly people who need long-term care (LTC), which is mainly due to cerebrovascular disease, dementia, age-related frailty, falls and fractures, and joint disease. We hypothesised that decreased muscle mass, muscle strength and insulin sensitivity are the common risk factors for these diseases related to needing LTC. We developed a prospective cohort study of elderly subjects in an urban community to test this hypothesis. The primary objective is to prospectively investigate associations between muscle mass, muscle strength, and insulin sensitivity and incidence of main disease and risk factors of needing LTC. The primary outcomes are the incidence of cerebrovascular disease and cognitive decline.ParticipantsParticipants were 1629 people aged 65–84 years living in 13 communities in an urban area (Bunkyo-ku, Tokyo, Japan). Average age was 73.1±5.4 years.Findings to dateWe obtained baseline data on cognitive function, cerebral small vessel disease (SVD) determined by brain MRI, body composition, bone mineral density, arteriosclerosis, physical function, muscle mass, muscle strength and insulin sensitivity. Mild cognitive impairment and dementia were observed in 18.1% and 3.3% of participants, respectively. The prevalence of cerebral SVD was 24.8%. These characteristics are similar to those previously reported in elderly Japanese subjects.Future plansWe will ask participants about their health status, including incidence of cerebrovascular disease, falls, fractures and other diseases every year by mail. We plan to re-evaluate cognitive function, brain MRI parameters and other parameters at 5 and 10 years after the baseline evaluation. We will evaluate whether low muscle function (muscle mass, muscle strength or insulin sensitivity) is a risk factor for cognitive decline or cerebrovascular disease.

Serum iron concentration increases in marathon athletes after running due to mechanical destruction of red blood cells (hemolysis). This study was performed to examine whether serum iron concentration increases after regular Judo exercise, and if so, whether such post-exercise iron increase is caused by hemolysis. We examined biochemical parameters related to red blood cell and iron metabolism in 16 male competitive Judo athletes before and after traditional exercise training composed of basic movements and freestyle matchup. The parameters were adjusted for changes in plasma volume based on simultaneously measured albumin concentration. The red blood cell count, hemoglobin concentration, and hematocrit levels decreased significantly, by 6.0–8.4%, after Judo exercise. The serum iron concentration and transferrin saturation increased significantly, from 87 ± 34 μg/dL to 98 ± 29 μg/dL and from 27.1 ± 9.7% to 31.2 ± 9.0%, respectively. Furthermore, the serum free hemoglobin level increased by 33.9% (p < 0.05), and haptoglobin concentration decreased by 19.2% (p < 0.001). A significant negative correlation was observed between Δ haptoglobin concentration and Δ serum iron concentration (r = − 0.551, p = 0.027). The results of this study indicate that serum iron concentration increases significantly after Judo exercise due to hemolysis.

BACKGROUND:LR11 is a member of the low-density lipoprotein (LDL) receptor family with high expression in neurons. Some cell surface LR11 is cleaved and secreted into the cerebrospinal fluid (CSF) as soluble LR11 (sLR11). Patients with Alzheimer's disease (AD), particularly apolipoprotein E4 carriers, have high CSF-sLR11 and low CSF-amyloid β (Aβ) concentrations. Therefore, we assessed whether sLR11 is bound to CSF-high-density lipoprotein (HDL) and whether sLR11 competes with Aβ in binding to apoE in CSF-HDL. METHODS:We measured CSF-sLR11 concentrations (50 controls and 16 patients with AD) using enzyme immunoassay. sLR11 and apoE distribution in the CSF was evaluated using non-denaturing two-dimensional gel electrophoresis (N-2DGE). ApoE bound to sLR11 or Aβ was identified using co-immunoprecipitation assay. RESULTS:CSF-sLR11 concentrations were higher in patients with AD than controls (adjusted for sLR11 using phospholipid). N-2DGE analysis showed that sLR11 and Aβ comigrated with a large apoE-containing CSF-HDL. Moreover, fewer apoE was bound to Aβ when a higher amount of apoE was bound to sLR11 in patients with AD who presented with ε4/4. CONCLUSION:sLR11 binds to CSF-HDL and competes with Aβ in binding to apoE in CSF-HDL, indicating that sLR11 affects Aβ clearance via CSF-HDL.

Background and Study Aim: Weight control and exercise measures are integral to preparing for judo competitions. As such, a good understanding of these two areas is key to doing well in competitions, but until now, no research has thoroughly addressed them. The aim of this study was knowledge about biochemical, muscular and neural indicators during regular and pre-competition conditioning training periods of the male judo athletes (at least the rank of first dan and over 10 years practice). Material and Methods: Sixteen judo competitors participated in this study. Blood components as analysed through samples, muscular and neural response times and body composition variables were examined. Food and water intake was also recorded. Comparisons were drawn, and conclusions were made comparing samples and data from regular and pre-competition conditioning periods. Results: A comparison of water and caloric intake during practice between regular and pre-competition training periods showed no significant differences. Blood samples from the pre-competition sample set showed higher concentrations of the blood components analysed. Quicker muscular contraction and neural response times were recorded during pre-competition training when compared to those from regular season training. Conclusions: Improved performance resulted from competitors' reduced liquid intake and exercise intensity Biochemical, muscular and neural data may assist coaches and athletes in assessing their physical condition in a way that could support better training and competition outcomes.