Unexpected adverse effect of metyrapone: A case report

O24 Obésité et perception oro-sensorielle des lipides alimentaires : impact sur la triglycéridémie et le taux de cholécystokinine

Increased erythrocytes n-3 and n-6 polyunsaturated fatty acids is significantly associated with a lower prevalence of steatosis in patients with type 2 diabetes

Summary Background & aims Non-alcoholic fatty liver disease (NAFLD) is commonly associated with obesity, metabolic syndrome and type 2 diabetes. Although dietary fat contributes substantially to the accumulation of liver fat, the role of individual fatty acids in this accumulation is unclear. Objective In this study, we set out to determine whether liver fat content (LFC), was associated with red blood cell fatty acid (RBC-FA) composition in people with type 2 diabetes. Design, settings, and participants One hundred and sixty-two type 2 diabetic patients were included in this study. LFC was measured using 1H-MR Spectroscopy. RBC-FA composition was measured by gas chromatography. Results One…

Liver carbohydrate and lipid metabolism of insulin-deficient mice is altered by trans-10, cis-12 conjugated linoleic acid.

Feeding mice the trans-10, cis-12 (t10c12) conjugated linoleic acid (CLA) isomer is associated with lipodystrophy, insulin resistance, hyperinsulinemia, and liver steatosis. It has been hypothesized that CLA-induced liver steatosis is the result of increased hepatic lipogenesis stimulated by high insulin levels. We studied the effects of a 12-d t10c12CLA treatment (1 g/100 g diet) on liver carbohydrate and lipid metabolism in control and streptozotocin (STZ)-injected mice. STZ mice were characterized by insulin deficiency, hypertriglyceridemia, and depletion of liver triglyceride and glycogen. Remarkably, feeding t10c12CLA to diabetic mice (STZ-CLA) normalized these variables. Reconstitutio…

Effet secondaire inattendu de la métyrapone : à propos d’un cas

Introduction L’hypercorticisme est une pathologie rare et l’utilisation de la metyrapone est peu frequente. Le surdosage en metyrapone se traduit habituellement par des symptomes gastro-intestinaux et une insuffisance surrenalienne aigue. Observation Un diagnostic d’hypercorticisme est realise chez un homme de 28 ans. Un traitement par metyrapone 250 mg deux fois par jour a debute pour controler l’hypercorticisme. Le patient est hospitalise pour une intoxication medicamenteuse volontaire avec 100 comprimes de metyrapone. Un diagnostic d’insuffisance surrenalienne aigue est pose devant des douleurs abdominales, des vomissements, une asthenie et une hypotension. Il ne presente pas de myalgies…

Mass Concentration of Plasma Phospholipid Transfer Protein in Normolipidemic, Type IIa Hyperlipidemic, Type IIb Hyperlipidemic, and Non–Insulin-Dependent Diabetic Subjects as Measured by a Specific ELISA

Abstract —Mean plasma phospholipid transfer protein (PLTP) concentrations were measured for the first time by using a competitive enzyme-linked immunosorbent assay. PLTP mass levels and phospholipid transfer activity values, which were significantly correlated among normolipidemic plasma samples ( r =0.787, P <0.0001), did not differ between normolipidemic subjects (3.95±1.04 mg/L and 575±81 nmol · mL −1 · h −1 , respectively; n=30), type IIa hyperlipidemic patients (4.06±0.84 mg/L and 571±43 nmol · mL −1 · h −1 , respectively; n=36), and type IIb hyperlipidemic patients (3.90±0.79 mg/L and 575±48 nmol · mL −1 · h −1 , respectively; n=33). No significant correlations with plasma lipid p…

Liraglutide reduces plasma PCSK9 in patients with type 2 diabetes not treated with statins

Dyslipidaemia in type 2 diabetes mellitus (T2DM), which increases cardiovascular risk, includes abnormal metabolism of low-density lipoproteins (LDL). Our group has recently shown that liraglutide increases LDL catabolism in patients with T2DM and that it reduces the expression of PCSK9 (a major inhibitor of LDL-receptor expression) in vitro and in mice. This prompted us to study the effect of liraglutide on plasma PCSK9 level in patients with T2DM.We studied prospectively 82 patients with T2DM (51 without statins, 31 with statins). Plasma PCSK9 and plasma lipids were measured before and six months after the initiation of a treatment with liraglutide at a dose of 1.2 mg/day.Plasma PCSK9 was…

Nésidioblastose traitée par pasiréotide LAR : à propos d’un cas

Resume Une patiente de 56 ans, diabetique de type 2, presentait des episodes d’hypoglycemies, qui ont persiste apres arret du traitement antidiabetique. Une epreuve de jeune authentifie une hypoglycemie organique, a 0,34 g/L, insulinemie a 6 mUI/L, peptide C a 1,9 ng/mL (normes : 0,5–3,0 ng/mL) et proinsuline a 3,72, puis 4,5 pmol/L (normes : 1,28–3,84 pmol/L). Aucune lesion n’est retrouvee au scanner ou a l’echo-endoscopie. La scintigraphie a la somatostatine est negative. Ces elements font ainsi porter le diagnostic de nesidioblastose. Des traitements par diazoxide et octreotide sont successivement mis en place, sans succes. Sous pasireotide LAR, les hypoglycemies disparaissent, avec meme…

Activation of adipose tissue cannabinoid receptors 1 (CB1R) alters antilipolytic action of insulin and increases lipolysis in mice

MEN1 Disease Occurring Before 21 Years Old: A 160-Patient Cohort Study From the Groupe d'étude des Tumeurs Endocrines

Multiple endocrine neoplasia Type-1 (MEN1) in young patients is only described by case reports.To improve the knowledge of MEN1 natural history before 21 years old.Obtain a description of the first symptoms occurring before 21 years old (clinical symptoms, biological or imaging abnormalities), surgical outcomes related to MEN1 Neuro Endocrine Tumors (NETs) occurring in a group of 160 patients extracted from the "Groupe d'étude des Tumeurs Endocrines" MEN1 cohort.The first symptoms were related to hyperparathyroidism in 122 cases (75%), pituitary adenoma in 55 cases (34%), nonsecreting pancreatic tumor (NSPT) in 14 cases (9%), insulinoma in 20 cases (12%), gastrinoma in three cases (2%), mal…

Acute activation of cannabinoid receptors by anandamide reduces gastrointestinal motility and improves postprandial glycemia in mice.

International audience; The endocannabinoid system (ECS) is associated with an alteration of glucose homeostasis dependent on cannabinoid receptor-1 (CB1R) activation. However, very little information is available concerning the consequences of ECS activation on intestinal glucose absorption. Mice were injected intraperitoneally with anandamide, an endocannabinoid binding both CB1R and CB2R. We measured plasma glucose and xylose appearance after oral loading, gastrointestinal motility, and glucose transepithelial transport using the everted sac method. Anandamide improved hyperglycemia after oral glucose charge whereas glucose clearance and insulin sensitivity were impaired, pointing out so…

No Improvement of High-Density Lipoprotein (HDL) Vasorelaxant Effect Despite Increase in HDL Cholesterol Concentration in Type 2 Diabetic Patients Treated With Glitazones

Abstract Context: High-density lipoproteins (HDLs) from type 2 diabetic patients are unable to counteract the inhibitory effect of oxidized low-density lipoproteins (ox-LDLs) on vasorelaxation. We hypothesized that glitazones, which improve glycemic control and dyslipidemia, could correct this abnormality. Objectives and Design: We compared the ability of HDL from controls (n = 12) and from type 2 diabetic patients before and after 6 months of treatment with either rosiglitazone (n = 11) or pioglitazone (n = 8) to counteract the inhibitory effect of ox-LDL on vasodilatation of rabbit aorta rings. Results: Rosiglitazone induced a decrease in hemoglobin A1c (7.7% ± 1.1% vs 9.8% ± 1.0%, P = .0…

P129 L’obésité interfère avec la détection oro-sensorielle des acides gras à longue chaîne chez l’homme

Application of the new eLIFT test for the non-invasive diagnosis of advanced liver fibrosis in people with type 2 diabetes

Prevalence and impact of metabolic syndrome on hospital outcomes in acute myocardial infarction.

The impact of metabolic syndrome after acute myocardial infarction (AMI) has not yet been studied. In a population-based sample of patients with AMI, we sought to determine the prevalence of metabolic syndrome in patients with AMI, its impact on hospital outcomes, and to assess the relative influence of each of the components of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III definition of metabolic syndrome on the risk of death and heart failure.A total of 633 unselected, consecutive patients hospitalized with AMI were categorized according to the NCEP ATP III metabolic syndrome criteria (presence of/=3 of the following: hyperglycemia; triglyceride level/=…

PNPLA3 polymorphism influences liver fibrosis in unselected patients with type 2 diabetes

Context: Recently, it has been shown that an allele in the adiponutrin (PNPLA3) gene was strongly associated with increased liver fat content (LFC) and liver fibrosis independent of visceral adiposity and insulin resistance. Objective: In this study, we set out to determine whether the PNPLA3 rs738409 polymorphism was associated with liver fibrosis in unselected patients with type 2 diabetes. Design, setting and participants: Two hundred and thirty-four patients with type 2 diabetes were included in this study. Main outcome measures: LFC was evaluated using 1H-MR spectroscopy; fibrosis was measured using the non-invasive FibroTest®. Results: Advanced liver fibrosis (stage F2 or above) was o…

Apolipoprotein CI is a physiological regulator of cholesteryl ester transfer protein activity in human plasma but not in rabbit plasma

Plasma cholesteryl ester transfer protein (CETP) activity is high in rabbits, intermediate in humans, and nondetectable in rodents. Human apolipoprotein CI (apoCI) was found to be a potent inhibitor of CETP. The aim of this study was to compare the ability of rabbit and human apoCI to modulate the interaction of CETP with HDLs and to evaluate to which extent apoCI contributes to plasma cholesteryl ester transfer rate in normolipidemic humans and rabbits. Rabbit apoCI gene was cloned and sequenced, rabbit and human apoCI were purified to homogeneity, and their ability to modify the surface charge properties and the CETP inhibitory potential of HDL were compared. It is demonstrated that unlik…

Quels sont les patients diabétiques de type 2 à risque d’interactions médicamenteuses ?

[Hedonic perception and taste of food in patients with type 2 diabetes - Impact of treatment with a GLP-1: Liraglutide] / P19 Perception hédonique et gustative des aliments chez les patients diabétiques de type 2 - Impact du traitement par un analogue du GLP-1 : le Liraglutide

Special Issue 2 : Résumés des communications de la réunion scientifique de la SFD, de la SFD Paramédical et de l'AJD ; WOS: 000302819400145; International audience

No change in apolipoprotein AI metabolism when subcutaneous insulin infusion is replaced by intraperitoneal insulin infusion in type 1 diabetic patients.

In type 1 diabetic patients, the replacement of subcutaneous insulin infusion by intraperitoneal insulin infusion restores the normal physiological gradient between the portal vein and the peripheral circulation, which is likely to modify HDL metabolism. This stable isotope kinetic study was designed to compare HDL apolipoprotein (apo) AI metabolism in seven type 1 diabetic patients first treated by continuous subcutaneous insulin infusion by an external pump and then 3 months after the beginning of intraperitoneal insulin infusion by an implantable pump. Glycaemic control was comparable under subcutaneous and intraperitoneal insulin infusion (HbA1c=7.34+/-0.94% versus 7.24+/-1.00%, NS). HD…

3q27.3 microdeletional syndrome: a recognisable clinical entity associating dysmorphic features, marfanoid habitus, intellectual disability and psychosis with mood disorder.

Abstract: Background Since the advent of array-CGH, numerous new microdeletional syndromes have been delineated while others remain to be described. Although 3q29 subtelomeric deletion is a well-described syndrome, there is no report on 3q interstitial deletions. Methods We report for the first time seven patients with interstitial deletions at the 3q27.3q28 locus gathered through the Decipher database, and suggest this locus as a new microdeletional syndrome. Results The patients shared a recognisable facial dysmorphism and marfanoid habitus, associated with psychosis and mild to severe intellectual disability (ID). Most of the patients had no delay in gross psychomotor acquisition, but ha…

Association tabac et diabète de type 2 : preuves et mécanismes physiopathologiques

Resume Depuis plusieurs annees, de nombreuses etudes epidemiologiques montrent un lien entre tabagisme et diabete de type 2 (DT2). En effet, selon les differentes etudes epidemiologiques, le risque de diabete est augmente de 21 % a 61 % chez les fumeurs, selon l’intensite du tabagisme. Plusieurs mecanismes physiopathologiques sont mis en avant pour expliquer l’association entre le tabagisme et le developpement du DT2 : (1) une augmentation de la graisse abdominale plus importante chez les fumeurs que dans la population generale liee a une augmentation de la secretion de GH, de l’ACTH et des androgenes induite par la nicotine, et a une activite anti-œstrogenes des alcaloides du tabac ; (2) u…

Mécanismes possibles des effets bénéfiques cardiovasculaires des inhibiteurs SGLT2

Resume Les inhibiteurs du sodium-glucose cotransporteur 2 (SGLT2) ont montre, dans plusieurs etudes prospectives, leur benefice cardiovasculaire avec plus particulierement une diminution rapide et tres significative des hospitalisations pour insuffisance cardiaque. Les mecanismes precis rendant compte de l’amelioration de la fonction myocardique sous inhibiteurs SGLT2 ne sont pas encore eclaircis, mais plusieurs hypotheses peuvent etre avancees. Il est suggere que les inhibiteurs SGLT2 reduiraient la precharge et la postcharge ventriculaires principalement via un effet diuretique (diurese osmotique) et une vasodilatation arterielle. Les inhibiteurs SGLT2 augmentent la concentration plasmati…

Personality types in individuals with type 1 and type 2 diabetes

Objective The Type A personality, characterized by impatience, strong career ambition and competitiveness, is associated with greater sensitivity to external stress. Type 1 diabetes (T1D) is an auto-immune disease, which is potentially influenced by stress, unlike type 2 diabetes (T2D). The aim of this study was to assess whether individuals with T1D and T2D exhibited significant differences on the Type A personality scale. We also assessed personality in patients with thyroid auto-immune diseases to validate potential links between auto-immune disease and Type A personality. Design and methods The Bortner questionnaire was used to assess Type A personality in 188 patients with T1D, 430 pa…

Type 1 diabetes is not associated with an increased prevalence of hepatic steatosis

Aim Non-alcoholic fatty liver disease (NAFLD) is commonly associated with Type 2 diabetes. Recently, it has been suggested that NAFLD is also frequently associated with Type 1 diabetes and diabetic complications. In this study, we set out to determine whether Type 1 diabetes was associated with liver fat content measured using magnetic resonance imaging. Methods One hundred and twenty-eight patients with Type 1 diabetes, 264 patients with Type 2 diabetes and 67 participants without diabetes were included in this study. Hepatic steatosis was defined as a liver fat content > 5.5%. Results People with Type 1 diabetes and controls were similar for age and BMI. Liver fat content was significantl…

Higher risk of death among MEN1 patients with mutations in the JunD interacting domain: a Groupe d'etude des Tumeurs Endocrines (GTE) cohort study.

International audience; Multiple endocrine neoplasia syndrome type 1 (MEN1), which is secondary to mutation of the MEN1 gene, is a rare autosomal-dominant disease that predisposes mutation carriers to endocrine tumors. Although genotype-phenotype studies have so far failed to identify any statistical correlations, some families harbor recurrent tumor patterns. The function of MENIN is unclear, but has been described through the discovery of its interacting partners. Mutations in the interacting domains of MENIN functional partners have been shown to directly alter its regulation abilities. We report on a cohort of MEN1 patients from the Groupe d'étude des Tumeurs Endocrines. Patients with a…

Les hypertriglycéridémies à l’origine de pancréatite aiguë

Resume La pancreatite aigue secondaire aux hypertriglyceridemies est en constante augmentation, et est vraisemblablement plus grave que les pancreatites aigues d’autres origines. Il convient donc de connaitre les caracteristiques specifiques, ainsi que les facteurs de risque associes a cette pancreatite, afin de pouvoir la reperer precocement. Un diagnostic precis permet un traitement specifique de l’episode, avec parfois necessite de recourir a la plasmapherese. Determiner l’etiologie de l’hypertriglyceridemie est primordial afin de pouvoir la prendre en charge de facon optimale, et ainsi diminuer la survenue des pancreatites aigues.

Circulating Apelin is increased in patients with type 1 or type 2 diabetes and is associated with better glycaemic control

SummaryContext Apelin is an adipokine expressed in several tissues and it appears to be involved in energy metabolism. Objective The aim of this study was to determine serum apelin levels in a large cohort of patients with type 1 and type 2 diabetes and control subjects and to correlate the results with glycaemic control. Design and Participants One hundred and thirty patients with type 1 diabetes, 98 patients with type 2 diabetes and 162 controls were enrolled in the study. Apelin levels were measured by enzyme-linked immunosorbent assay. Results Serum apelin levels were significantly higher in type 1 and type 2 diabetic patients than in controls (P < 0·0001). Serum apelin levels were high…

A low-carbohydrate high-fat diet initiated promptly after diagnosis provides clinical remission in three patients with type 1 diabetes

O29 Diminution du contenu en sphingosine-1-phosphate dans les lipoprotéines de haute densité (HDL) au cours du diabète de type 1

Introduction La fonctionnalite des HDL des patients diabetiques de type 1 (DT1) est alteree. Ces anomalies sont en partie attribuables a des modifications glycoxydatives mais pourraient egalement s'expliquer par des variations de la composition en phospholipides et sphingolipides a la surface des HDL, molecules qui jouent un role important dans les differentes fonctions des HDL. Patients et methodes Nous avons recrute 43 patients DT1 (âge : 44,3±16,1 ; 17 hommes, 19 femmes) et 36 sujets controles normolipidemiques (âge : 40,3±14,6 ; 18 hommes, 25 femmes). Nous avons etabli la composition en phospholipides et sphingolipides des HDL par chromatographie liquide couplee a la spectrometrie de ma…

Liver Fat Content in People with Pituitary Diseases: Influence of Serum IGF1 Levels

AbstractNon-alcoholic fatty liver disease (NAFLD) is commonly associated with obesity, metabolic syndrome, and type 2 diabetes. NAFLD is also seen in patients with endocrinopathies. However, the relationship between endocrine diseases and the development of NAFLD is not well known. In this study, we set out to determine whether liver fat content (LFC) was associated with IGF1 levels in people with pituitary diseases (PD). Eighty-nine patients with pituitary diseases and 74 healthy controls were included in this study. LFC was measured using MRI. Hepatic steatosis was defined as LFC&gt;5.5%. Patients with PD were older, and had a higher BMI than healthy controls. LFC was significantly higher…

Bénéfices cardiovasculaires et rénaux des inhibiteurs de SGLT2 : mécanismes de la protection

Resume Les inhibiteurs de SGLT2 ont montre, dans plusieurs etudes prospectives, leur benefice cardiovasculaire et renal avec, plus particulierement, une diminution rapide et tres significative des hospitalisations pour insuffisance cardiaque et des evenements renaux severes : doublement de la creatinine ou recours a l’epuration extra-renale. Le lien fort entre la physiopathologie de l’insuffisance cardiaque et renale explique l’analyse commune des hypotheses de protection de cette classe medicamenteuse. Les mecanismes precis rendant compte de l’amelioration de la fonction myocardique et renale sous inhibiteurs de SGLT2 ne sont pas encore eclaircis, mais plusieurs hypotheses peuvent etre ava…

Depression and obesity, data from a national administrative database study: Geographic evidence for an epidemiological overlap

BackgroundDepression and obesity are two major conditions with both psychological and somatic burdens. Some data suggest strong connections between depression and obesity and more particularly associated prevalence of both disorders. However, little is known about the geographical distribution of these two diseases. This study aimed to determine if there is spatial overlap between obesity and depression using data from the entire French territory.MethodsData for 5,627 geographic codes for metropolitan France were collected from the two national hospital databases (PMSI-MCO and RIM-P) for the year 2016. We identified people who were depressed, obese or both registered in the two public medic…

Système endocannabinoïde : effets sur le métabolisme glucidique, mais aussi lipidique

Resume Le systeme endocannabinoide (SEC) est compose de recepteurs couples aux proteines G : Cannabinoid type 1-receptor (CB 1 -R) et Cannabinoid type 2-receptor (CB 2 -R), de leurs ligands endogenes (anandamide [AEA], et 2-acylglycerol [2-AG]), et des enzymes responsables de leur synthese et de leur degradation. Bien que les recepteurs CB 1 -R et CB 2 -R furent initialement decrits au niveau du systeme nerveux central, ils sont presents dans de nombreux tissus peripheriques, ou ils sont impliques dans le metabolisme, la croissance, et l’inflammation. Apres le retrait commercial du rimonabant, pour des effets secondaires psychiatriques, un agoniste inverse du recepteur CB 1 (CB 1 -R), desti…

Simultaneous Inhibition of Peripheral CB1R and iNOS Mitigates Obesity-Related Dyslipidemia Through Distinct Mechanisms.

Diabetic dyslipidemia, characterized by increased plasma triglycerides and decreased HDL cholesterol levels, is a major factor contributing to nonalcoholic steatohepatitis and cardiovascular risk in type 2 diabetes. Activation of the cannabinoid-1 receptor (CB1R) and activation of inducible nitric oxide synthase (iNOS) are associated with nonalcoholic steatohepatitis progression. Here, we tested whether dual-targeting inhibition of hepatic CB1R and iNOS improves diabetic dyslipidemia in mice with diet-induced obesity (DIO mice). DIO mice were treated for 14 days with (S)-MRI-1867, a peripherally restricted hybrid inhibitor of CB1R and iNOS. (R)-MRI-1867, the CB1R-inactive stereoisomer that …

Intravoxel incoherent motion diffusion-weighted imaging in nonalcoholic fatty liver disease: a 3.0-T MR study.

International audience; PURPOSE: To compare pure molecular diffusion, D, perfusion-related diffusion, D*, and perfusion fraction, f, determined from diffusion-weighted (DW) magnetic resonance (MR) imaging on the basis of the intravoxel incoherent motion (IVIM) theory in patients with type 2 diabetes with and without liver steatosis. MATERIALS AND METHODS: This prospective study was approved by the appropriate ethics committee, and written informed consent was obtained from all patients. Between December 2009 and September 2011, 108 patients with type 2 diabetes (51 men, 57 women; mean age, 50 years) underwent 3.0-T single-voxel point-resolved proton MR spectroscopy of the liver (segment VII…

Influence du liraglutide (analogue du GLP-1) sur les caractéristiques hédoniques de la prise alimentaire et les performances gustatives, chez les patients diabétiques de type 2

ENDOCRINE SIDE EFFECTS OF ANTI-CANCER DRUGS: Effects of anti-cancer targeted therapies on lipid and glucose metabolism

During the past years, targeted therapies for cancer have been developed using drugs that have significant metabolic consequences. Among them, the mammalian target of rapamycin (mTOR) inhibitors and, to a much lesser extent, the tyrosine kinase inhibitors (TKIs) are involved. mTOR plays a key role in the regulation of cell growth as well as lipid and glucose metabolism. Treatment with mTOR inhibitors is associated with a significant increase in plasma triglycerides and LDL cholesterol. mTOR inhibitors seem to increase plasma triglycerides by reducing the activity of the lipoprotein lipase which is in charge of the catabolism of triglyceride-rich lipoproteins. The increase in LDL cholesterol…

Inability of HDL from abdominally obese subjects to counteract the inhibitory effect of oxidized LDL on vasorelaxation.

Abdominal obesity is associated with a decreased plasma concentration of HDL cholesterol and with qualitative modifications of HDL, such as triglyceride enrichment. Our aim was to determine, in isolated aorta rings, whether HDL from obese subjects can counteract the inhibitory effect of oxidized low density lipoprotein (OxLDL) on endothelium-dependent vasodilation as efficiently as HDL from normolipidemic, lean subjects. Plasma triglycerides were 74% higher (P < 0.005) in obese subjects compared with controls, and apolipoprotein A-I (apoA-I) and HDL cholesterol concentrations were 12% and 17% lower (P < 0.05), respectively. HDL from control subjects significantly reduced the inhibitory effe…

Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Background The European Atherosclerosis Society Familial Hypercholesterolaemia Studies Collaboration (FHSC) global registry provides a platform for the global surveillance of familial hypercholesterolaemia through harmonisation and pooling of multinational data. In this study, we aimed to characterise the adult population with heterozygous familial hypercholesterolaemia and described how it is detected and managed globally. Methods Using FHSC global registry data, we did a cross-sectional assessment of adults (aged 18 years or older) with a clinical or genetic diagnosis of probable or definite heterozygous familial hypercholesterolaemia at the time they were entered into the registries. Dat…

The use of statins in people at risk of developing diabetes mellitus: Evidence and guidance for clinical practice

Reducing low-density lipoprotein cholesterol (LDL-C) levels using statins is associated with significant reductions in cardiovascular (CV) events in a wide range of patient populations. Although statins are generally considered to be safe, recent studies suggest they are associated with an increased risk of developing Type 2 diabetes (T2D). This led the US Food and Drug Administration (FDA) to change their labelling requirements for statins to include a warning about the possibility of increased blood sugar and HbA1c levels and the European Medicines Agency (EMA) to issue guidance on a small increased risk of T2D with the statin class. This review examines the evidence leading to these clai…

Diabetes is not associated with COVID-19-related mortality in older institutionalized people

Diabetes & Metabolism - Sous presse. Manuscrit accepte. Disponible en ligne depuis le mercredi 27 janvier 2021

Physiopathologie de la dyslipidémie du diabète de type 2 : nouvelles perspectives

Resume La dyslipidemie du diabete de type 2 (DT2) est un facteur en cause dans l’augmentation du risque cardiovasculaire au cours du DT2. La dyslipidemie du DT2 est caracterisee non seulement par des anomalies quantitatives des lipoproteines, mais aussi par des anomalies qualitatives et cinetiques a potentiel atherogene. Les anomalies quantitatives caracteristiques sont l’hypertriglyceridemie et la diminution du HDL-cholesterol. Les anomalies qualitatives comprennent une augmentation des VLDL de grande taille enrichies en cholesterol esterifie et triglycerides (VLDL1) et des LDL petites et denses, ainsi qu’une augmentation des triglycerides au sein des LDL et des HDL, une glycation des apol…

Impact of the COVID‐19 Epidemic on hospitalization for diabetic foot ulcers during lockdown: A French nationwide population‐based study

AIMS/HYPOTHESIS: The aim of this study was to examine the impact of the COVID-19 epidemic on the hospitalization rates for diabetic foot ulcer (DFU), osteomyelitis and lower limb revascularization procedure in people with DFU. METHODS: This nationwide retrospective cohort study included hospital data on all people hospitalized in France for diabetes in weeks 2-43 in 2020, including the COVID-19 lockdown period, compared to same period in 2019. RESULTS: The number of hospitalizations for DFU decreased significantly in weeks 12-19 (during the lockdown) (p < 10-4 ). Hospitalization for foot osteomyelitis also decreased significantly in weeks 12-19 (p < 10-4 ). The trend was the same for lower …

People with insulin-treated diabetes have achieved an original educational program for the use of flash glucose monitoring: results from a cohort of 814 subjects

International audience

Liraglutide Increases the Catabolism of Apolipoprotein B100–Containing Lipoproteins in Patients With Type 2 Diabetes and Reduces Proprotein Convertase Subtilisin/Kexin Type 9 Expression

OBJECTIVE Dyslipidemia observed in type 2 diabetes (T2D) is atherogenic. Important features of diabetic dyslipidemia are increased levels of triglyceride-rich lipoproteins and small dense LDL particles, which all have apolipoprotein B100 (apoB100) as a major apolipoprotein. This prompted us to study the effect of the GLP-1 agonist liraglutide on the metabolism of apoB100-containing lipoproteins. RESEARCH DESIGN AND METHODS We performed an in vivo kinetic study with stable isotopes (L-[1-13C]leucine) in 10 patients with T2D before and after 6 months of treatment with liraglutide (1.2 mg/day). We also evaluated in mice the effect of liraglutide on the expression of genes involved in apoB100-…

Inhibiteurs PCSK9 en pratique clinique : données et interrogations

Resume Les inhibiteurs de la « proprotein convertase subtilisin/kexin type 9 » (PCSK9) sont de nouveaux traitements de l’hypercholesterolemie. Ils induisent une diminution marquee du taux de LDL-cholesterol plasmatique de 50 a 60 %. Parallelement, ils reduisent significativement le risque d’evenements cardiovasculaires, comme cela a ete demontre dans plusieurs etudes prospectives. Par ailleurs, les inhibiteurs PCSK9 diminuent le taux plasmatique de lipoproteine (a) [Lp(a)] d’environ 25 %. Il semble que cette reduction du taux de Lp(a) participe au benefice cardiovasculaire, note avec les inhibiteurs PCSK9, en particulier chez les patients ayant des valeurs de base de Lp(a) augmentees. Les m…

Thérapies ciblées et diabète

Successful Control of Hypoglycemia with Pasireotide LAR in a Patient with Inappropriate Insulin Secretion

Introduction Inappropriate insulin secretion could be due to several diseases. Nesidioblastosis is characterized by diffuse hyperplasia of pancreatic beta cells, causing organic hypoglycemia. No pancreatic lesions are found on the imaging of patients with this condition. Diazoxide is used as a first-line treatment but can be poorly tolerated because of its side effects, and therapeutic failure is possible. Somatostatin analogues have limited efficacy because of their poor affinity to somatostatin (SST) receptors. Pasireotide is a somatostatin analogue with a much higher affinity to SST receptors, especially SST5, and it could thus be more efficient for treating nesidioblastosis-related hypo…

P4570Prognostic interest of HbA1c and plasma glucose assessment on one-year mortality in non-diabetic patients after acute myocardial infarction

Abstract Background The usefulness of the combined assessment of HbA1c and plasma glucose (PG) in acute myocardial infarction (AMI) in nondiabetic patients remains unclear. Purpose In a large observational study, we aimed to identify the prognostic values of these biomarkers regarding one-year all-cause mortality in nondiabetic patients after AMI. Methods From the “obseRvatoire des Infarctus de Côte d'Or” (RICO) survey database, we included all consecutive nondiabetic patients with AMI (n=6617) from May 2001 to December 2016. Exclusion criteria were: admission known or unknown diabetes, in-hospital death. The primary endpoint was all-cause one-year mortality. The secondary endpoints were: M…

Utility of Cardiac Magnetic Resonance to assess association between admission hyperglycemia and myocardial damage in patients with reperfused ST-segment elevation myocardial infarction

Abstract Aims to investigate the association between admission hyperglycemia and myocardial damage in patients with ST-segment elevation myocardial infarction (STEMI) using Cardiac Magnetic Resonance (CMR). Methods We analyzed 113 patients with STEMI treated with successful primary percutaneous coronary intervention. Admission hyperglycemia was defined as a glucose level ≥ 7.8 mmol/l. Contrast-enhanced CMR was performed between 3 and 7 days after reperfusion to evaluate left ventricular function and perfusion data after injection of gadolinium-DTPA. First-pass images (FP), providing assessment of microvascular obstruction and Late Gadolinium Enhanced images (DE), reflecting the extent of in…

Obesity interferes with the orosensory detection of long-chain fatty acids in humans

Background: The association between the orosensory detection of lipids, preference for fatty foods, and body mass index (BMI; in kg/m 2 ) is controversial in humans. Objective: We explored the oral lipid-sensing system and the orosensory-induced autonomic reflex system in lean and obese subjects. Design: Lean (BMI: 19 to ,25; n = 30) and obese (BMI .30; n = 29) age-matched men were enrolled. Their oral threshold sensitivity to linoleic acid (LA) was determined by using a 3-alternative forced-choice ascending procedure, and their eating habits were established by the analysis of 4 consecutive 24-h food-consumption diaries. The effect of brief oral lipid stimulations on plasma triglyceride [(…

Chronic Hyperinsulinemia Does Not Increase the Production Rate of High-Density Lipoprotein Apolipoprotein AI

Objective— In vitro studies showed that insulin stimulates the production of apolipoprotein AI (apoAI). Thus, we hypothesized that chronic hyperinsulinemia could contribute to the increase in the production of high-density lipoprotein apoAI that is observed in metabolic syndrome. Approach and Results— We performed an in vivo kinetic study with stable isotope in 7 patients with insulinoma who showed hyperinsulinemia but no insulin resistance, 8 patients with insulin resistance, and 16 controls. Insulinemia was 3.1× ( P &lt;0.01) higher in patients with insulinoma or insulin resistance than in controls in the fasting state and, respectively, 3.5× and 2.6× ( P &lt;0.05) higher in the fed stat…

Hyperglycémie induite par l’analogue de somatostatine pasiréotide au cours de la maladie de Cushing

Resume La maladie de Cushing entraine une morbi-mortalite importante, avec des complications cardiovasculaires, metaboliques, respiratoires et psychiatriques, une demineralisation osseuse, ainsi qu’une sensibilite accrue aux infections. Parmi les complications metaboliques, il est observe une forte prevalence d’intolerance au glucose, d’hyperglycemie a jeun, et de diabete. Bien que la chirurgie hypophysaire soit le traitement de reference, en cas de recidive, d’echec ou d’inoperabilite, d’autres strategies therapeutiques, telles que des medicaments agissant sur la synthese du cortisol, la radiotherapie, peuvent etre proposees. Enfin, en derniere intention, une surrenalectomie bilaterale peu…

Type A competitiveness traits correlate with downregulation of c-Fos expression in patients with type 1 diabetes.

International audience; AimType A personality has been associated with increased survival in people with type 1 diabetes (T1D). Systemic low-grade inflammation may play a critical role, as suggested in recent reports, although the links between the inflammatory circulating transcriptome and Type A remain unknown. This prompted our exploration of the potential associations between Type A personality and c-Fos gene expression, a candidate gene closely linked to inflammatory processes, in T1D.MethodsType A personality was assessed by Bortner questionnaire in patients with T1D, and two subscales – ‘speed’ and ‘competitiveness’ – were used to measure these specific dimensions of Type A. Expressi…

Fewer Type A personality traits in type 2 diabetes patients with diabetic foot ulcer.

Abstract Aim Type A personality—characterized by time urgency, strong drive, and a need for achievement and competitiveness—has been shown to be associated with reduced mortality in patients with diabetes. However, it is not known whether a Type A personality might protect against diabetic foot ulcer (DFU). This prompted our present analysis of the association between Type A personality and DFU. Methods The Bortner Scale questionnaire was used to assess Type A personality in 386 patients with type 2 diabetes (T2D), including 104 patients also presenting with, and 282 presenting without, DFU. Additional questionnaires were used to assess perceived stress and depression. Results Type A Bortne…

Whole-exome sequencing identifies the first French MODY 6 family with a new mutation in the NEUROD1 gene

Abstract Aim The aim of the present study was to identify the affected gene in a French family with maturity-onset diabetes of the young (MODY) using whole-exome sequencing (WES). Methods WES was performed in one patient with MODY, and candidate variants were confirmed in members of the immediate family by Sanger sequencing. Results In the proband, a new heterozygous missense mutation (c.340A>C) was identified in the NEUROD1 gene by WES analysis and confirmed by Sanger sequencing. Additional Sanger sequencing of the proband's sister and mother revealed the same heterozygous mutation. The proband and his sister displayed typical clinical characteristics of MODY, while their mother had the sa…

Identification de nouveaux antagonistes des récepteurs aux endocannabinoïdes à action périphérique susceptibles d'améliorer les paramètres glucido-lipidiques chez la souris obèse

Identification de nouveaux antagonistes des récepteurs aux endocannabinoïdes à action périphérique susceptibles d'améliorer les paramètres glucido-lipidiques chez la souris obèse. 30. réunion de l’association française d’étude et de recherche sur l’Obésite (AFERO)

Interférences des traitements par biotine avec les immunodosages : il est temps de trouver une solution à long terme !

La Presse Medicale - In Press.Proof corrected by the author Available online since vendredi 22 decembre 2017

Frequent and severe hypoglycaemia detected with continuous glucose monitoring in older institutionalised patients with diabetes.

AbstractBackgroundLittle is known about the prevalence of hypoglycaemia in older people with diabetes. However, the HbA1c goal is ≥8% for institutionalised patients with treatments that can cause hypoglycaemia.PurposeWe aimed to assess the prevalence of hypoglycaemia with continuous glucose monitoring and to evaluate the link with HbA1C in older institutionalised patients with diabetes taking potentially hypoglycaemia-inducing drugs.DesignProspective, multicentre study carried out in six geriatric care centres in the Côte d’Or region of France between January 2019 and July 2020.Settings, subjects and methodsA FreeStyle Libre Pro® (FSLP) was worn for up to 14 days in blinded mode in 42 patie…

Glycemic Variability Assessment with a 14-Day Continuous Glucose Monitoring System: When and How Long to Measure MAGE (Mean Amplitude of Glucose Excursion) for Optimal Reliability?

Mean amplitude of glucose excursion (MAGE) is considered as the “gold standard” for assessing the short-term within-day glycemic variability (GV), which is an important component of overall glycemic control. A 14-day continuous glucose monitoring system is now widely used and allows easier assessment of GV. However, it is still unknown whether MAGE, usually calculated on a 48-hour period is identical whatever the time during the 14-day lifespan of the sensor and whether a longer time period might give additional information. We evaluated in 68 patients with type 1 diabetes, MAGE during three 2-day periods (day1-day3; day6-day8; day11-day13) and during periods of 3 days and 4 days. MAGE cal…

Effets de la corticothérapie systémique sur le métabolisme des HDL

Resume La prise exogene de glucocorticoides (GC) est responsable de nombreux effets secondaires, notamment metaboliques. Les effets sur le metabolisme lipidique ne se limitent pas aux triglycerides, mais concernent egalement les HDL. Meme si les donnees disponibles sont peu nombreuses, elles montrent que les GC entrainent une augmentation des taux plasmatiques de HDL-cholesterol et de la taille des particules HDL, independante de l’effet anti-inflammatoire des GC. Les mecanismes sous-jacents a ces augmentations restent actuellement meconnus. Alors que les patients traites par GC presentent une augmentation de la morbidite cardiovasculaire et que l’alteration de la fonctionnalite des HDL est…

Liver methylene fraction by dual- and triple-echo gradient-echo imaging at 3.0T: Correlation with proton MR spectroscopy and estimation of robustness after SPIO administration

Purpose To assess the systematic errors in liver methylene fraction (LMF) resulting from fat–fat interference effects with dual- and triple-echo gradient-recalled-echo Dual/Triple GRE) sequences and to test the robustness of these sequences after iron overloading. Materials and Methods Forty type-2 diabetic patients underwent LMF measurement by 3.0T 1H magnetic resonance spectroscopy (corrected for T1 and T2 decays) as the reference standard and liver fat fraction (%Fat) measurement by four Dual/Triple GRE sequences with 20° and 60° flip angle (α), corrected for T1 recovery. The same four sequences were repeated in eight patients after ferumoxide injection. Corrections for systematic errors…

Glycated albumin with loss of fatty acid binding capacity contributes to enhanced arachidonate oxygenation and platelet hyperactivity: relevance in patients with type 2 diabetes.

High plasma concentrations of nonesterified fatty acids (NEFAs), transported bound to serum albumin, are associated with type 2 diabetes (T2D). The effects of albumin on platelet function were investigated in vitro. Modifications of albumin, such as those due to glycoxidation, were found in patients with T2D, and the consequences of these modifications on biological mechanisms related to NEFA handling were investigated. Mass spectrometry profiles of albumin from patients with T2D differed from those from healthy control subjects. Diabetic albumin showed impaired NEFA binding capacity, and both structural and functional alterations could be reproduced in vitro by incubating native albumin wi…

Glycation des HDL et conséquences chez le patient diabétique

Resume Les HDL ont un role majeur dans l’homeostasie vasculaire. Leur action protectrice passe notamment par leur recepteur specifique SR-BI (pour scavenger receptor de classe B type 1 ). La glycation des HDL, phenomene majeur observe au cours d’un diabete, a de nombreuses consequences nefastes vasculaires. La glycation des HDL entraine une augmentation de leur catabolisme, un defaut du transport inverse du cholesterol, une perte de leurs proprietes anti-inflammatoires et anti-oxydantes, notamment sur les LDL oxydees, lipoproteines atherogenes presentes en abondance dans les maladies chroniques. Cliniquement, cela se traduit par une dysfonction endotheliale, phenomene cardiovasculaire delet…

Impact of Fasting Glycemia on Short-Term Prognosis after Acute Myocardial Infarction

The prognosis of patients with acute myocardial infarction (MI), according to the new criteria for impaired fasting glucose (IFG) (FG 100-126 mg/dl), has not been evaluated.A total of 2353 patients with acute MI and surviving at d 5 after admission were analyzed for short-term morbidity and mortality. FG was obtained at d 4 and 5. Patients were classified as diabetes mellitus (known diabetes or FGor = 126 mg/dl), high IFG (110or = FG126 mg/dl), low IFG (100or = FG110 mg/dl), and normal fasting glucose (NFG) (FG100 mg/dl).Among the 2353 patients, 968 (41%) had diabetes mellitus, 262 (11%) had high IFG, 332 (14%) had low IFG, and 791 (34%) had NFG. Compared with NFG patients, 30-d cardiovascu…

Different effects of pioglitazone and rosiglitazone on lipid metabolism in mouse cultured liver explants.

Background Pioglitazone (PIO) and rosiglitazone (ROSI) are widely used as oral antidiabetic agents for treatment of type 2 diabetes. Although these medications exert similar effects on blood glucose, recent clinical studies indicated that PIO has a more pronounced beneficial effect on lipid parameters than ROSI. In order to get further insight into the lipid effects of both drugs, we tested whether PIO, compared to ROSI, could exert direct effects on lipid liver metabolism in relation with plasma lipids. Methods We performed in vitro studies using mice liver slices incubated 21 h either with ROSI (1 µmol/L) or PIO (7.5 µmol/L). Results We showed that both glitazones slightly reduced HMG-CoA…

GLP-1 receptor agonists in NAFLD.

IF 4.101; International audience; Non-alcoholic fatty liver disease (NAFLD) is very common in patients with type 2 diabetes (T2D), with approximately two-thirds having a diagnosis of the disease. Currently, the only validated treatment for NAFLD is weight loss. A number of studies of animal models and human trials have evaluated the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on liver fat content and suggest that the treatment could represent a new alternative for NAFLD management. In this review, our focus is on the main studies regarding the effects of GLP-1RAs on NAFLD. Also, the mechanisms that might explain their beneficial effects on liver diseases are analyzed.

Distinct patterns of heparin affinity chromatography VLDL1 and VLDL2 subfractions in the different dyslipidaemias

Very low density lipoprotein (VLDL) 1 and 2 were fractionated by heparin affinity chromatography into a bound and an unbound fraction and the different subfractions were quantified in 17 normolipidaemic (NL), 13 hypercholesterolaemic (HC), 10 hypertriglyceridaemic (HTG) and 11 combined hyperlipidaemic subjects (CHL). Unbound VLDL1 and VLDL2 were, respectively, 1.9- and 2.2-fold richer in triglycerides than bound VLDL1 and VLDL2. In HTG and CHL the concentration of all the VLDL subfractions was increased and plasma triglyceride level was correlated to unbound VLDL1 and to bound VLDL1 (respectively, r=0.86 (p<0.001) and r=0.77 (p<0.01) in HTG and r=0.73 (p<0.001) and r=0.62 (p<0.05) in CHL). …

Overactivation of the endocannabinoid system alters the antilipolytic action of insulin in mouse adipose tissue.

Evidence has accumulated that obesity-related metabolic dysregulation is associated with overactivation of the endocannabinoid system (ECS), which involves cannabinoid receptor 1 (CB1R), in peripheral tissues, including adipose tissue (AT). The functional consequences of CB1R activation on AT metabolism remain unclear. Since excess fat mobilization is considered an important primary event contributing to the onset of insulin resistance, we combined in vivo and in vitro experiments to investigate whether activation of ECS could alter the lipolytic rate. For this purpose, the appearance of plasma glycerol was measured in wild-type and CB1R−/− mice after acute anandamide administration or inh…

40(th) EASD Annual Meeting of the European Association for the Study of Diabetes : Munich, Germany, 5-9 September 2004

Are older patients with diabetes still being overtreated in French long-term care homes?

Abstract Background Diabetes management has not been evaluated in French nursing homes (NHs) for 10 years. Objectives The present study aimed to compare the management of diabetes with guidelines in older patients living in NHs. Design Observational, retrospective and multicentre study carried out in 13 NH in the Cote d’Or region of France. Settings and subjects Between January and June 2018, all NH residents older than 65 years and known to have diabetes (n = 148) were included. Methods Epidemiological, clinical and biological data and diabetes characteristics were collected from the medical records. Results The average glycated haemoglobin (HbA1C) was 7.2 ± 1.2%. In total, 51% of patients…

Potential influence of Type A personality on plasma C-reactive protein levels in people with diabetes

IF 4.693; Aim. Type A personality, although classically known as a factor linked to increased vascular risk, has recently been associated with increased survival in patients with diabetes. As low-grade inflammation predicts a poor outcome, the present study explored the potential associations between Type A and plasma levels of C-reactive protein (CRP) in diabetes. Methods. Type A personality was assessed by the Bortner questionnaire in people with diabetes. The association between Type A and plasma CRP levels was examined by multivariable linear regression, and structural equation modelling (SEM) was performed to determine the impact of the major clinical, biological and psychological conf…

Treatment by GLP-1 agonist modulates hedonic response to food and taste sensitivity in type 2 diabetes

Context: Besides their potential action in the treatment of type 2 diabetes mellitus (T2DM), GLP-1 analogues have been shown to decrease satiety and food intake. However, little is known about their effects on food hedonic and taste perceptions. Objective: The objective of the study was to investigate the impact of GLP-1 analogue Liraglutide on the liking and wanting component of the food reward system as well as on taste sensitivity in T2DM patients. . Research design and methods: Thirty T2DM patients were studied before and after 3 months of daily Liraglutide treatment (1.2 mg). In each trial, blood samples were collected and body mass composition was analyzed by dual-energy X-ray absorpt…

French Endocrine Society Guidance on endocrine side effects of immunotherapy.

The management of cancer patients has changed due to the considerably more frequent use of immune checkpoint inhibitors (ICPIs). However, the use of ICPI has a risk of side effects, particularly endocrine toxicity. Since the indications for ICPI are constantly expanding due to their efficacy, it is important that endocrinologists and oncologists know how to look for this type of toxicity and how to treat it when it arises. In view of this, the French Endocrine Society initiated the formulation of a consensus document on ICPI-related endocrine toxicity. In this paper, we will introduce data on the general pathophysiology of endocrine toxicity, and we will then outline expert opinion focusing…

O45 L’activation des récepteurs aux endocannabinoïdes CB1R du tissu adipeux inhibe l’action anti-lipolytique de l’insuline

Introduction Il est maintenant bien etabli que l’obesite est associee a une suractivation du systeme endocannabinoide (SEC). Des travaux recents suggerent que le blocage des recepteurs aux endocannabinoides 1 (CB1R) peripheriques conduit a une amelioration du metabolisme glucidique et lipidique independamment des effets centraux modulant la prise alimentaire. Le role du SEC dans le tissu adipeux etant encore mal defini, cette etude vise a preciser les consequences de l’activation des CB1R sur la lipolyse. Materiels et methodes Les effets de l’anandamide (endocannabinoide) sur l’activite lipolytique estimee par la production de glycerol plasmatique ont ete testes chez la souris in vivo apres…

Deleterious effect of glycation on the ability of HDL to counteract the inhibitory effect of oxidized LDL on endothelium-dependent vasorelaxation

Background Contrary to high-density lipoprotein (HDL) from normolipidaemic and normoglycaemic subjects, HDL from diabetic patients loses its ability to reverse the inhibition of vasorelaxation induced by oxidized low-density lipoprotein (LDL). The aim of this study was to analyze the role of glycation, a major abnormality observed in diabetes, on the impairment of the vasorelaxant effect of HDL. Methods HDL from healthy subjects was glycated in vitro by incubation in glucose 200 mmol/L for 3 days. Vasoreactivity was evaluated by the relaxation response to acetylcholine of rabbit aorta rings pre-contracted with noradrenaline, before and after 2 h incubation with or without different lipoprot…

Endocrine side-effects of new anticancer therapies: Overall monitoring and conclusions

IF 0.795 (2017); International audience; The present final consensus statement of the French Society of Endocrinology lays out the assessments that are to be systematically performed before and during anticancer treatment by immunotherapy, tyrosine kinase inhibitors or mTOR inhibitors, even without onset of any endocrinopathy. It also discusses the CTCAE adverse event grading system in oncology and the difficulty of implementing it for endocrine side-effects of these anticancer treatments. Notably, this is why certain treatment steps applied in other side-effects (e.g., high-dose corticosteroids, contraindications to immunotherapy, etc.) need to be discussed before implementation for endocr…

Expert opinion on the metabolic complications of mTOR inhibitors

Abstract Using mTOR inhibitors (mTORi) as anticancer drugs led to hyperglycemia (12–50%) and hyperlipidemia (7–73%) in phase-III trials. These high rates require adapted treatment in cancer patients. Before initiating mTORi treatment, lipid profile screening should be systematic, with fasting glucose assay in non-diabetic patients and HbA1C in diabetic patients. After initiation, lipid profile monitoring should be systematic, with fasting glucose assay in non-diabetic patients, every 2 weeks for the first month and then monthly. The HbA1C target is ≤ 8%, before and after treatment initiation in known diabetic patients and in case of onset of diabetes under mTORi. LDL-cholesterol targets sho…

Liraglutide Reduces Postprandial Hyperlipidemia by Increasing ApoB48 (Apolipoprotein B48) Catabolism and by Reducing ApoB48 Production in Patients With Type 2 Diabetes Mellitus

Objective— Treatment with liraglutide, a GLP-1 (glucagon-like peptide-1) agonist, has been shown to reduce postprandial lipidemia, an important feature of diabetic dyslipidemia. However, the underlying mechanisms for this effect remain unknown. This prompted us to study the effect of liraglutide on the metabolism of ApoB48 (apolipoprotein B48). Approach and Results— We performed an in vivo kinetic study with stable isotopes (D 8 -valine) in the fed state in 10 patients with type 2 diabetes mellitus before treatment and 6 months after the initiation of treatment with liraglutide (1.2 mg/d). We also evaluated, in mice, the effect of a 1-week liraglutide treatment on postload triglycerides an…

CO-74: Altérations majeures du sphingophospholipidome des lipoprotéines de haute densité (HDL) de patients avec syndrome métabolique et glycémie normale

Rationnel Les phospholipides et sphingolipides jouent un role primordial dans la fonctionnalite et le role anti-atherogene des HDL. Ces proprietes sont alterees chez les patients porteurs d'un syndrome metabolique avant meme l'apparition d'une hyperglycemie. Nous avons donc recherche si les HDL de ces patients presentaient des anomalies de leur sphingophospholipidome. Patients et Methodes Par chromatographie liquide couplee a la spectrometrie de masse en tandem, nous avons quantifie 80 especes moleculaires des principales classes de phospholipides et sphingolipides des HDL2 et HDL3, chez 26 patients avec un syndrome metabolique et une glycemie a jeun nor-male (14 hommes, 12 femmes, âge moye…

Impacts of obesity on the oro-sensory perception of lipids in Human

Accumulating evidences support the existence of a fatty acid taste both in rodents and humans. A recent study performed in lean subjects suggests the existence of a positive correlation between the oro-sensory perception of dietary lipids and body mass index (BMI) in Human. It was extrapolated that obesity might promote overconsumption of fatty foods by decreasing the detection of lipids in oral cavity. To explore this hypothesis, linoleic acid (LA) detection threshold was determined in lean (18>BMI 30, n=29) volunteers using a 3-alternative force choice ascending concentration presentation procedure in conditions known to minimize other sensory cues. A large distribution of LA detection wa…

Large-scale screening of lipase acid deficiency in at risk population

International audience; BACKGROUND: Lysosomal acid lipase deficiency (LALD, OMIM#278000) is a rare lysosomal disorder with an autosomal recessive inheritance. The main clinical manifestations are related to a progressive accumulation of cholesteryl esters, triglycerides or both within the lysosome in different organs such as the liver, spleen, and cardiovascular system. A wide range of clinical severity is associated with LALD including a severe very rare antenatal/neonatal/infantile phenotype named Wolman disease and a late-onset form named cholesteryl ester storage disease (CESD). METHODS: This study aimed to investigate a cohort of at-risk patients (4174) presenting with clinical or biol…

P259 Identification de nouveaux antagonistes des récepteurs aux endocannabinoïdes à action périphérique susceptibles d’améliorer les paramètres glucido-lipidiques chez la souris obèse

Introduction Le systeme endocannabinoide (SEC) est une cible therapeutique potentielle pour lutter contre l’obesite. Ainsi, le Rimonabant®, un antagoniste des recepteurs aux endocannabinoides 1 (CB1R) diminue la masse corporelle et ameliore les parametres glucido-lipidiques de patients obeses. Neanmoins, ce medicament a ete retire du marche suite a des effets centraux induisant des troubles neuropsychiatriques. L’objectif de cette etude est d’identifier des analogues du Rimonabant® a action peripherique susceptibles d’avoir des effets benefiques sur le metabolisme glucido-lipidique de la souris. Materiels et methodes Des analogues du Rimonabant® ne passant pas la barriere hemato-encephaliqu…

Type A personality is not associated with poor glycaemic control: Data from cross-sectional and longitudinal surveys of people with type 1 or type 2 diabetes.

Diabetes & Metabolism - In Press.Proof corrected by the author Available online since lundi 8 aout 2016

Hormonal and psychological factors linked to the increased thermic effect of food in malnourished fasting anorexia nervosa

In patients with anorexia nervosa (AN), weight gain is lower than that expected from the energy content of the meals. Thus we investigated the thermic effect of food (TEF) in relation to subjective feelings and plasma hormone levels in a group of AN patients.TEF, feelings (14 items), and plasma release of beta-endorphin, ACTH, cortisol, dopamine, and catecholamines were evaluated in 15 AN patients (body mass index, 13.6 +/- 1.2 kg.m(-2)) and in 15 healthy women after three gastric loads (0, 300, 700 kcal) infused by a nasogastric tube in a blind design.In AN, the blind loads induced an energy-dependent increase in TEF (P0.001), which was higher than that observed in healthy women (P0.001). …

Thyroïdites : où en est-on en 2019 ?

Thyroiditis is a frequent and mostly benign disease that can sometimes disrupt the thyroid balance. Their diagnosis, as well as their aetiology, is a necessary step in the management of the patients. Painful thyroiditis includes acute thyroiditis of infectious origin and subacute thyroiditis. The first one can be treated by antibiotics or antifungals depending on the germ found. The second one will be treated with non-steroidal anti-inflammatory drugs or corticosteroids. In cases of Hashimoto's thyroiditis with overt hypothyroidism, replacement therapy with L-thyroxine will be adapted to the TSH level. As amiodarone treatment provides dysthyroidism, the thyroid status should be monitored re…

Increased body fat mass reduces the association between fructosamine and glycated hemoglobin in obese type 2 diabetes patients

Abstract Obesity is increasing in patients with type 2 diabetes. A possible reduced association between fructosamine and glycated hemoglobin (HbA1c) in obese individuals has been previously discussed, but this has never been specifically evaluated in type 2 diabetes, and the potential influence of body fat mass and fat distribution has never been studied. We studied 112 type 2 diabetes patients with assessment of fat mass, liver fat and fat distribution. Patients with body mass index (BMI) above the median (34.9 kg/m2), versus BMI below the median, had a correlation coefficient between fructosamine and HbA1c significantly reduced (r = 0.358 vs r = 0.765). In the whole population, fructosami…