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All tissues in the body convert absorbed niacin into its main metabolically active form, the coenzyme nicotinamide adenine dinucleotide (NAD). More than 400 enzymes require NAD to catalyze reactions in the body, which is more than for any other vitamin-derived coenzyme [1]. NAD is also converted into another active form, the coenzyme nicotinamide adenine dinucleotide phosphate (NADP), in all tissues except skeletal muscle [4].
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Most dietary niacin is in the form of nicotinic acid and nicotinamide, but some foods contain small amounts of NAD and NADP. The body also converts some tryptophan, an amino acid in protein, to NAD, so tryptophan is considered a dietary source of niacin.
When NAD and NADP are consumed in foods, they are converted to nicotinamide in the gut and then absorbed [4]. Ingested niacin is absorbed primarily in the small intestine, but some is absorbed in the stomach [1-3].
Table 1 lists the current RDAs for niacin as mg of niacin equivalents (NE) [2]. The FNB defines 1 NE as 1 mg niacin or 60 mg of the amino acid tryptophan (which the body can convert to niacin). Niacin RDAs for adults are based on niacin metabolite excretion data. For children and adolescents, niacin RDAs are extrapolated from adult values on the basis of body weight. The AI for infants from birth to 6 months is for niacin alone, as young infants use almost all the protein they consume for growth and development; it is equivalent to the mean intake of niacin in healthy, breastfed infants. For infants aged 7-12 months, the AI for niacin is in mg NE and is based on amounts consumed from breast milk and solid foods.
People with inadequate riboflavin, pyridoxine, and/or iron intakesPeople who do not consume enough riboflavin (vitamin B2), pyridoxine (vitamin B6), or iron convert less tryptophan to niacin because enzymes in the metabolic pathway for this conversion depend on these nutrients to function [2,22].
People with Hartnup diseaseHartnup disease is a rare genetic disorder involving the renal, intestinal, and cellular transport processes for several amino acids, including tryptophan. The disease interferes with the absorption of tryptophan in the small intestine and increases its loss in the urine via the kidneys [2,23,24]. As a result, the body has less available tryptophan to convert to niacin.
People with carcinoid syndromeCarcinoid syndrome is caused by slow-growing tumors in the gastrointestinal tract that release serotonin and other substances. It is characterized by facial flushing, diarrhea, and other symptoms. In those with carcinoid syndrome, tryptophan is preferentially oxidized to serotonin and not metabolized to niacin [2]. As a result, the body has less available tryptophan to convert to niacin.
There are equations that report GFR as a normalized value to body surface area (mL/min/1.73 m2). While these may appear to circumvent the issue of obesity, these values need to be converted to a non-normalized GFR (mL/min) for the purposes of drug dosing. In the process of conversion, however, the non-normalized value will also overestimate GFR in obese patients.
There are primarily two laboratory methods for measuring serum creatinine: a number of conventional (older) methods (eg, alkaline picrate), and the newer IDMS method. The conventional methods have a positive bias (falsely elevated by up to 20%) because they detected non-creatinine chromagens.24 The conventional assay method is most susceptible to bias when serum creatinine is within the normal range. The NKDEP guidelines25 recommend that all laboratories convert their systems to use the newer, more accurate IDMS method. According to the NKDEP, almost all laboratories are expected to convert to the IDMS method by the end of 2010.
Note that this calculator automatically converts to and from IDMS as indicated based on the CrCl/GFR equation. All equations before the MDRD equation use non-IDMS creatinine values, the MDRD equation has two equations for either assay, and the CKD-EPI equation is only standardized for IDMS. The following equations are used to convert between IDMS and non-IDMS:26
The niacin coenzymes NAD and NADP are synthesized in all tissues of the body from nicotinic acid or nicotinamide. Tissue concentrations of NAD appear to be regulated by the concentration of extracellular nicotinamide, which in turn is under hepatic control and is hormonally influenced. Hydrolysis of hepatic NAD allows the release of nicotinamide for transport to tissues that lack the ability to synthesize the NAD and NADP coenzymes from tryptophan. In the liver some excess plasma nicotinamide is converted to storage NAD (i.e., NAD not bound to enzymes). Tryptophan and nicotinic acid also contribute to storage NAD following the biosynthetic pathway, going through NAMN, which is then reamidated to NAD. In the degradation of NAD, the nicotinamide formed can be reconverted to NAD via nicotinamide ribonucleotide. Nicotinamide can be deamidated in the intestinal tract by intestinal microflora (Bernofsky, 1980).
Clinical pellagra may represent various degrees of combined niacin and riboflavin deficiencies (Carpenter and Lewin, 1985). Deficiencies of other micronutrients (e.g., pyridoxine and iron) required to convert tryptophan to niacin may also contribute to the appearance of pellagra. Because pellagra is a late and serious manifestation of deficiency, it was determined that the average requirement must exceed the amount required to prevent pellagra.
The data in Table 6-1 also suggest a CV of the niacin requirement that is greater than 10 percent. The wide variation in the efficiency of converting tryptophan to niacin may contribute to the large apparent variation. Thus, a CV of 15 percent is used; the RDA is defined as equal to the EAR plus twice the CV to cover the needs of 97 to 98 percent of the individuals in the group (therefore, for niacin the RDA is 130 percent of the EAR).
The data in Table 6-1 suggest a CV for the niacin requirement that is greater than 10 percent. The wide variation in the efficiency of converting tryptophan to niacin may contribute to the larger apparent variation. Thus, a CV of 15 percent is used because information is not available on the standard deviation of the requirement for pregnant women; the RDA is defined as equal to the EAR plus twice the CV to cover the needs of 97 to 98 percent of the individuals in the group (therefore, for niacin the RDA is 130 percent of the EAR).
The data in Table 6-1 suggest a CV for the niacin requirement that is greater than 10 percent. The wide variation in the efficiency of converting tryptophan to niacin may contribute to the larger apparent variation. Thus, a CV of 15 percent is used because information is not available on the standard deviation of the requirement during lactation; the RDA is defined as equal to the EAR plus twice the CV to cover the needs of 97 to 98 percent of the individuals in the group (therefore, for niacin the RDA is 130 percent of the EAR).
WebP includes the lightweight encoding and decoding library libwebpand the command line tools cwebp and dwebp for convertingimages to and from the WebP format, as well as tools for viewing, muxing andanimating WebP images. The full source code is available on thedownload page.
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Pesticide and fertilizer recommendations often are made on a pounds-per-acre or tons-per-acre basis for field production. However, greenhouse and nursery operators, landscape professionals and orchardists often must convert these recommendations to smaller areas, such as row feet or square feet per tree or per pot. Pints, cups, ounces, tablespoons and teaspoons often are the common units of measure. Metric units of measure can further complicate conversion.
Niacin is a generic descriptor for the closely related compounds, nicotinic acid and its amide nicotinamide, which act similarly as nutrients. The amino acid tryptophan is converted to nicotinamide with an average conversion efficiency of 60:1 and can thus contribute to requirements (Horwitt et al 1981) although this can vary depending on a number of dietary and metabolic factors (McCormick 1988).
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