Correlation between Serum Dopamine-β-hydroxylase (DBH) Activity and Activities of Daily Living (ADL) in the Aged

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  • 老年者における血清ｄｏｐａｍｉｎｅ‐β‐ｈｙｄｒｏｘｙｌａｓｅ（ＤＢＨ）と日常生活動作（ＡＤＬ）との関連について
  • ロウネンシャ ニ オケル ケッセイ dopamine ベータ hydroxyl

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The levels of dopamine-β-hydroxylase (DBH), the enzyme responsible for conversion of dopamine to noradrenaline, vary widely in the normal population, but are maintained relatively constant in each individual.<br>We investigated the serum DBH activity in 52 patients in a geriatric hospital and 14 nursing home residents. Average age of these subjects is 79.8 years (male 76.6, female 80.8). 66 subjects (17 males, 49 females) were divided into four groups (A, B, C, D) by two criteria, namely, dementia and bedridden state: A group (dementia, bedridden), B group (dementia, non-bedridden), C group (non-dementia, bedridden), and D group (non-dementia, non-bedridden). Blood sampling was done after fasting overnight while the subjects were still in bed early in the morning. The sera were stored in a deep freezer at -20°C and assayed by the photometric method of Nagatsu and Udenfriend.<br>On the other hand, activities of daily living (ADL) of these 66 subjects were evaluated according to the ADL Scale of Yokufukai Geriatric Hospital. This Scale consists of 12 items including“food intake”, “standing”, “ambulation”, “clothing”, “vision”, “hearing”, “communication”. Each item has five stages, and the better the stage of ADL is, the higher the score is (maximum score 65, minimum score 13).<br>The correlation coefficient between serum DBH activity and ADL score in D group was 0.57 (p<0.02), the highest of all groups. However, the correlation coefficients in other groups were low and not statistically significant. This would mean that serum DBH activity and physical activity are considerably parallel in the non-demented, old people who can take care of themselves.<br>It has been shown that acute changes of sympathetic activity in man may be reflected by changes in DBH activity. So we investigated changes in serum DBH activity by physical exercise in 11 additional subjects (5 males, 6 females) with comparatively high ADL score. The work load was 200 meter rapid walking in the aisle of the ward in the afternoon. Blood samples were collected at sitting position just before, immediately after, and 30 minutes after rapid walking, respectively. In this work load test, the heart rate and blood pressure did not change significantly in all subjects. The levels of serum DBH activity elevated in all men, producing a mean increase of 32.7%, while in women, only two of 6 subjects showed the rise and remaining four the decline, producing a mean decrease of 18.8%. This paradoxical reduction in serum DBH activity of women might result from insufficient work load.<br>Although it has been suggested that serum DBH activity could be a useful indicator of sympathetic nervous system activity, normal range of this enzyme is very wide (1-100 International Unit). Transient changes in serum DBH activity by physical exercise would reflect alterations in sympathetic nervous activity. Therefore, it will be reasonable to determine not only the basal value, but also the changes in serum DBH activity by physical stress in detecting a subtle reflection of underlying sympathetic nervous activity.

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