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Measurement of 3-methylhistidine in spot urine from HIV-infected persons: an alternative screening method for muscle protein degradation to serum CK

Purpose of the study

3-methylhistidine (3-MH) acts as an in vivo label of the rate of myofibrillar protein breakdown. The aim of this study was to evaluate 3-MH measurement in spot urine as a simple screening method for muscle protein degradation in HIV-infected persons compared to creatine kinase (CK) measurement in blood.

Methods

We prospectively measured serum creatinine (mg/dl) and serum CK (U/L) and 3-MH (μmol/L) in spot urine from 162 HIV-positive subjects at each visit. 3-MH was determined by HPLC after derivatization with fluorescamine.

Summary of results

162 HIV-positive subjects were screened; two patients were excluded because of renal dysfunction. 160 HIV-positive patients (101 male) entered the study and a total of 397 visits were analysed. The median age at all visits was 44 years (range 21–75). Body mass index (BMI) was 24.8 ± 5.1 (men 24.93 ± 0.29, women 24.5 ± 0.48). Patients were without antiretroviral treatment (ART) at 24% of visits and had an undetectable serum HIV load (<50 copies/ml) at 50% of visits. The median CD4 count was 437 cells/μl (SD 205.1). CK, creatinine and 3-MH did not correlate with the number of visits.

A positive correlation with the BMI was found for CK and creatinine, but not for 3-MH. Compared to men, women had significantly lower levels of 3-MH (195.5 ± 10.5 vs. 252.2 ± 9.6, p = 0.0002), creatinine (0.68 ± 0.01 vs. 0.85 ± 0.01, p < 0.0001) and CK (106 ± 7.6 vs. 156.9 ± 8.2, p < 0.0001). Patients with CK levels above 300 U/L (n = 31) had significantly higher 3-MH levels than patients with CK below 50 U/L (n = 41) (p = 0.037). Otherwise there was no correlation between CK and 3-MH. ART in general, and zidovudine (177 visits) and tenofovir (90 visits) in particular, did not influence the levels of CK, creatinine and 3-MH.

Conclusion

In conclusion, measurement of 3-MH on spot urine samples is not useful for assessing changes in muscular protein degradation. A meat-free diet, 24-hour urine collection and refraining from physical activity might reduce confounding factors of 3-MH secretion.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Venhoff, A., Bissé, E., Epting, T. et al. Measurement of 3-methylhistidine in spot urine from HIV-infected persons: an alternative screening method for muscle protein degradation to serum CK. JIAS 11, P210 (2008). https://doi.org/10.1186/1758-2652-11-S1-P210

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  • DOI: https://doi.org/10.1186/1758-2652-11-S1-P210

Keywords

  • Creatine Kinase
  • Zidovudine
  • Tenofovir
  • Myofibrillar Protein
  • Serum Creatine Kinase