Quantitation of three‐month intraindividual variability and influence of sex and menstrual cycle phase on CYP1A2, N‐acetyltransferase‐2, and xanthine oxidase activity determined with caffeine phenotyping

Objective To evaluate intraindividual variability and the effects of sex and menstrual cycle phase on the activity of cytochrome P450 1A2 (CYP1A2), N‐acetyltransferase 2 (NAT2), and xanthine oxidase. Methods Ten white men were given 2 mg/kg caffeine orally every 14 days for 3 months. The same dosage of caffeine was given to 10 premenopausal white women during the midfollicular and midluteal phases of three complete menstrual cycles. Phenotype was determined with urinary caffeine metabolite ratios. Results For CYP1A2, mean metabolic ratio (±SD) was 5.97 ± 2.78 during the midfollicular phase and 5.32 ± 1.99 during the midluteal phase (p = 0.2) For extensive and poor metabolizers of NAT2, mean midfollicular phase metabolite ratios were 0.71 ± 0.060 and 0.37 ± 0.030, and mean midluteal phase metabolite ratios were 0.69 ± 0.076 and 0.39 ± 0.053 (p = 0.9). For xanthine oxidase, mean midfollicular phase metabolite ratio was 0.63 ± 0.06 and mean midluteal phase metabolite ratio was 0.63 ± 0.05 (p = 0.3). Among the men, mean CYP1A2, NAT2 rapid and slow acetylator, and xanthine oxidase indices were 9.42 ± 10.18, 0.66 ± 0.021, 0.31 ± 0.056, and 0.64 ± 0.03. There were no differences in metabolite ratios between men and women for CYP1A2, NAT2 extensive metabolizers, or xanthine oxidase. A statistically significant sex difference was found for poor metabolizers of NAT2 (p < 0.05). Median coefficients of variation for CYP1A2, NAT2 extensive and poor metabolizers, and xanthine oxidase ratios were 16.8% (range, 4.5% to 49.3%), 2.9% (range, 2.2% to 4.7%), 13.4% (range, 7.5% to 27.2%), and 4.5% (range, 2.3% to 13.0%). Conclusion Stratification by menstrual cycle phase or sex need not be performed for pharmacokinetic or clinical investigations of substrates for CYP1A2, NAT2, or xanthine oxidase in which the subjects are adults. Clinical Pharmacology & Therapeutics (1998) 63, 540–551; doi: