Assessment of nutritional status and analytical methodsMethods for measuring sulfur amino acid metabolismHoffer, L. JohnAuthor Information Lady Davis Institute for Medical Research, Jewish General Hospital, and Department of Medicine, McGill University, Montreal, Quebec, Canada Correspondence to L. John Hoffer, MD, PhD, Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote-Ste-Catherine Road West, Montreal, Quebec, Canada H3T 1E2. Tel: +1 514 340 8260; fax: +1 514 340 7502; e-mail: [email protected] Abbreviations e Hcy: steady-state plasma enrichment of homocysteine e MET: steady-state plasma enrichment of methionine ESRD: end-stage renal disease HPLC: high-performance liquid chromatography RaMET: rate of appearance of methionine RM: remethylation pathway SAA: sulfur amino acid TM: transmethylation pathway TS: transsulfuration pathway Current Opinion in Clinical Nutrition and Metabolic Care: September 2002 - Volume 5 - Issue 5 - p 511-517 Buy Abstract Purpose of review The importance of sulfur amino acid metabolism has become increasingly apparent in recent years. Methionine and cysteine are precursors of glutathione, which plays an important role in intracellular antioxidant/free radical defenses. Homocysteine is a non-protein-bound sulfur amino acid strongly implicated in the pathogenesis of several diseases. Both glutathione and homocysteine are affected by abnormalities in sulfur amino acid metabolism that occur in the clinical setting. Recent findings The Storch-Young model, which determines methionine turnover and homocysteine remethylation by means of a tracer methionine infusion, has been improved by using plasma homocysteine (rather than methionine) enrichment in the model. A complex new tracer method involving the use of tracer serine, methionine, and leucine has been described to determine the effects of folate or pyridoxine deficiency on sulfur amino acid-methyl transfer reactions in humans. The etiology of hyperhomocysteinemia in chronic renal failure is controversial; new concepts in this area are described. There is new interest in the subspecies of homocysteine in the circulation. A new method is described for measuring the extremely low plasma concentrations of reduced homocysteine, using gas chromatography-mass spectrometry. Plasma S-adenosylhomocysteine, measured by fluorescence high-performance liquid chromatography, has been suggested as being superior to homocysteine as a predictor of the risk of vascular disease. Summary This review highlights and critiques the above recent developments, and points out some of the complexities and pitfalls in designing and interpreting human metabolic studies involving the sulfur amino acids. © 2002 Lippincott Williams & Wilkins, Inc.