**7. References**

98 Biomarker

Composition Table only describes the composition of raw liver, an error exists between the quantity of vitamin intake obtained from the Food Composition Table and the actual intake from cooked liver. Nutrient intakes were calculated using this Food Composition Table which did not take account of cooking loss for the above foods, and thus this might cause potential low level of accuracy. There might be also a technical issue. Urinary intact folates were measured by a microbiological assay in the cross-sectional studies. However, folates are catabolized into *p*-aminobenzoylglutamate and the acetylated form, *p*-

Urinary water-soluble vitamins can be used as potential biomarker not only for estimation of its intake but also evaluation for its nutritional status. The intervention study comprehensively investigated urinary water-soluble vitamin values in subjects consuming semi-purified diet with vitamin mixture for 7 days (Shibata et al., 2005). The study revealed the mean values and ranges for each water-soluble vitamin except vitamin B12 in the subjects with vitamin mixture based on DRIs for Japanese. Based on these results, we propose the reference values for urinary water-soluble vitamins to show adequate nutritional status in Table 7. When urinary excretion of some vitamins is lower than the lower reference value, subject may not intake its vitamin enough for DRIs. When urinary vitamin is higher than the upper value, subject may intake its vitamin supplement. These reference values may be useful for first screening to check one's vitamin nutritional status and vitamin supplement

> Vitaminsa Reference values Vitamin B1 300-2400 (nmol/d) Vitamin B2 200-1800 (nmol/d) Vitamin B6 3.0-16.0 (μmol/d)

Niacin 50-300 (μmol/d) Pantothenic acid 10-60 (μmol/d) Folate 15-80 (nmol/d) Biotin 50-300 (nmol/d) Vitamin C 150-2400 (μmol/d) aUrinary excretion for each vitamin corresponds to thiamin for vitamin B1, riboflavin for vitamin B2, 4-PIC for vitamin B6, the sum of nicotinamide, MNA, 2-Py and 4-Py for niacin equivalent, the sum of

Recent studies have induced great advances for urinary water-soluble vitamins as biomarkers for its intakes. Measuring urinary water-soluble vitamin levels can be the good approach for assessing dietary vitamin intake in groups, and for simply evaluation of its nutritional status in individuals. However, there is limitation for its use; urinary vitamins have not been suitable biomarker to estimate its intake in individuals yet. More accurate

Vitamin B12 ---

reduced and oxidized ascorbic acid and 2,3-diketogluconic acid for vitamin C.

Table 7. Proposed reference values for urinary water-soluble vitamins in adults.

acetamidobenzoylglutamate, which are excreted into the urine (Wolfe et al., 2003).

**4. Reference values for urinary water-soluble vitamins** 

intake.

**5. Conclusion** 

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**6** 

*Sweden* 

**Potential Muscle Biomarkers of Chronic** 

*Rehabilitation Medicine, Faculty of Health Sciences, Linköping University, Linköping, and Pain and Rehabilitation Centre, University Hospital, Linköping,* 

Approximately 20% of the European population report severe chronic pain (Breivik et al., 2006), with higher prevalences in women and in lower income groups (Gerdle et al., 2004; Larsson et al., 2007). Common chronic pain conditions are localized neck-shoulder pain including trapezius myalgia (prevalence in population 10-20%) (Lidgren, 2008), chronic whiplash associated disorders (WAD) (prevalence in the population 1.5%) (Guez et al., 2002), and chronic widespread pain (CWSP) (prevalence in population 5-10%) (Gerdle et al., 2008a). Chronic pain is associated with disability, low quality of life, and substantial

**1.2 Development of chronic myalgia – Chronic trapezius myalgia as an example** 

There is a connection between physical demands, psychosocial demands, and the risk of persistent muscle pain (Bernard, 1997; Punnett & Wegman, 2004); however, the mechanisms behind chronic myalgia are poorly understood. Myalgia usually starts with a feeling of tiredness and stiffness. At the beginning, the initial intermittent stage, pain can be alleviated for short or long periods. Chronic regional myalgia (CRM) in the neck-shoulder area often gradually becomes more easily triggered and more diffuse and can be spread to include most of the body (CWSP). CWSP includes fibromyalgia, a subgroup characterized by widespread hyperalgesia. The risk factors for the transition from a local/regional pain condition to CWSP are poorly understood (Larsson et al., in press). The diagnoses CRM (e.g., chronic trapezius myalgia) and CWSP are settled by careful anamnesis and clinical examinations that reveal

Acute pain results from a complex integrated series of events at peripheral and central levels. In healthy subjects, mechanisms related to acute pain might not necessarily be valid

socioeconomic costs (Breivik et al., 2006; Phillips, 2006; SBU, 2006).

tender muscle at palpation corresponding to the reported painful areas.

**1.3 Neurobiological alterations in chronic pain** 

in subjects with subchronic, intermittent, or chronic pain.

**1. Introduction 1.1 Epidemiology**  **Myalgia in Humans – A Systematic** 

**Review of Microdialysis Studies** 

Björn Gerdle and Britt Larsson

