Obésité: où en sommes-nous ?

Antioxidant activity and Hypolipidemic effect of Ficus carica leaf and twig extracts in Triton WR-1339-induced hyperlipidemic mice

BACKGROUND/AIM: The hypolipidemic potential of both leaf and twig extracts of Ficus carica on experimental hyperlipidaemia induced by Triton WR-1339, in Swiss albino mice was investigated. In addition, the phenolic, flavonoid and anthocyanin contents of these extracts and their antioxidant activities were determined. These properties may have a synergistic effect on hyperlipidaemia. MATERIALS AND METHODS: Leaf and twig samples of F. carica were harvested and collected. The study of antioxidant activity of phenolic compounds was determined by the radical DPPH*, ABTS*+ and FRAP assays. The experimental design was carried out using acute oral toxicity study and Triton model hyperlipidaemia on Swiss albino adult male mice. The animals were observed continuously during the 14 days of the study for any physical signs of toxicity. On the 15th day, the animals were sacrificed by decapitation under anesthesia and the organs were observed for macroscopic pathological lesions. Hyperlipidaemia was induced in the mice by a single intravenous (iv) injection of Triton WR 1339 (300 mg/kg body weight), and the antihyperlipidemic effect of each extract, studied at 150 and 300 mg, was tested by gavage. After 24 hours of administration, serum from blood samples was used to estimate the various parameters of the lipid profile namely TC, TG, LDL and HDL. RESULTS: The results of the phenolic and flavonoid compounds of Ficus carica leaves and twigs varied from 12.84 to 19.78 mg gallic acid equivalents (GAE) and 5.02 to 9.72 mg EQ/g dry matter, respectively. The scavenging activity (IC50) against the radical DPPH* and ABTS*+ varied from 346.2 to 461.38 μg/mL and 288.3 to 369.01 μg/mL for twigs and leaves respectively, and from 50.82 to 54.2 μg/mL for FRAP assay. The acute toxicity study showed no mortality and clinical signs of toxicity in the tested doses. The LD50 value of extracts of twigs and leaves of Ficus carica is greater than 5000 mg/kg. The results revealed that the administration of Ficus carica (FC) leaf and twig extracts resulted in a significant (p < 0.05) decline in levels of serum triglycerides, total cholesterol, LDL-c, and VLDL-c, while the serum high-density lipoprotein cholesterol was significantly increased. The decrease rate of the lipid parameters differs significantly (p < 0.05) from the leaf and twig extracts and depends also on the administered dose. CONCLUSION: Ficus carica leaf and twig extracts may contain compounds able to lower plasma lipid concentrations, could contribute significantly to the total antioxidant properties and be beneficial in the treatment of hyperlipidaemia.

Risk of biliary complications in bariatric surgery

Gallstones are commonly observed after rapid weight loss, particularly after bariatric surgery. Preventive measures of gallstone formation and potential related complications are still debated. This study aimed to propose a standardized strategy according to the results of the literature. Thus, preventive measures should be determined according to patient status (evaluated clinically and by routine ultrasound) and the type of bariatric surgery. Cholecystectomy should be performed in patients with symptomatic gallstones irrespective of the planned operation, or for asymptomatic gallstones during a gastric by-pass. In other settings, ursodesoxycholic acid should be given postoperatively for 6 months.

Obesity in Mediterranean region (1997-2007): a systematic review

The objective of this review is to determine the distribution of obesity by geographical location, income, age and sex in the Mediterranean region during the last decade. A meta-analysis was conducted for 102 articles cited during the period (1997-2007) in Medline database (for 17 Mediterranean countries) searched during the summer of 2007 using the word 'obesity' and its related keywords. The study showed that adults were more obese than children in all Mediterranean continents and in different levels of income. The prevalence of obesity among European children was higher than among Asians. Also, European adults were more obese than European children. The total female adults were found to be more obese (median: 25.3%) than male adults (median: 20.0%). The regression model analysis indicated that male adults were more likely to be obese in the Euro-Med region. Taking different factors into consideration, it was noticed that Mediterranean adults, especially those in the European region, are at higher risk of obesity. Awareness programmes addressing the importance of adopting healthy dietary habits combined with physical activity should target the whole community in general and adults in particular. The findings could guide health planners for better management of obesity.

Discovery of novel chemotypes to a G-protein-coupled receptor through ligand-steered homology modeling and structure-based virtual screening

Melanin-concentrating hormone receptor 1 (MCH-R1) is a G-protein-coupled receptor (GPCR) and a target for the development of therapeutics for obesity. The structure-based development of MCH-R1 and other GPCR antagonists is hampered by the lack of an available experimentally determined atomic structure. A ligand-steered homology modeling approach has been developed (where information about existing ligands is used explicitly to shape and optimize the binding site) followed by docking-based virtual screening. Top scoring compounds identified virtually were tested experimentally in an MCH-R1 competitive binding assay, and six novel chemotypes as low micromolar affinity antagonist "hits" were identified. This success rate is more than a 10-fold improvement over random high-throughput screening, which supports our ligand-steered method. Clearly, the ligand-steered homology modeling method reduces the uncertainty of structure modeling for difficult targets like GPCRs.

Is obesity an independent prognosis factor in woman breast cancer?

BACKGROUND

Breast cancer and obesity represent important public health issues in most western countries. A number of studies found a negative prognosis effect of obesity or excess of weight in woman breast cancer. However, to date, this issue remains controversial. The objectives of this study were to confirm the prognosis role of obesity on a large cohort of patients and to investigate a potential independent effect.

MATERIALS AND METHODS

We constituted a cohort of 14,709 patients who were recruited and treated at the Curie Institute (Paris) from 1981 to 1999. These patients were followed prospectively for a first unilateral invasive breast cancer without distant metastasis. Obesity was defined by a Body Mass Index (BMI) above 30 kg/m(2) according to the World Health Organization recommendations.

RESULTS

Obese patients (8%) presented more extended tumors at diagnosis time suggesting a delayed breast cancer diagnosis. However, obesity appeared as a negative prognosis factor for several events in respectively univariate and multivariate survival analysis: metastasis recurrence (HR = 1.32[1.19-1.48]; HR = 1.12[1.00-1.26]), disease free interval (1.20[1.08-1.32]; 1.10[0.99-1.22]), overall survival (1.43[1.28-1.60]; 1.12[0.99-1.25]) and second primary cancer outcome (1.57[1.19-2.07]; 1.43[1.09-1.89]). Even if obese patients presented more advanced tumors at diagnosis time, multivariate analysis showed that there was a relevant independent effect. Other BMI codings, distinguishing overweight patients or using BMI as a continuous variable, showed a consistent correlation between BMI's value and prognosis effect. Interaction analysis revealed a more important obesity effect in the presence of tumor estrogen receptors and among limited extent tumors.

CONCLUSIONS

This survey confirms the prognosis role of obesity on one of the largest cohort by investigating several prognosis events. While independent obesity effect linked to hormonal disorders appeared consistent as obesity's mechanism, we stress that obesity prognosis effect was also related to breast cancer presentation at diagnosis time.

[Determinants of success and recurrence after suburetral free tape procedure for female urinary incontinence]

OBJECTIVE

To provide a critical assessment on the tension free vaginal tape procedure used to support the urethra in female urinary incontinence.

MATERIAL AND METHODS

We identified articles related to Tension free vaginal tape through a MEDLINE search of English published literature from May 1998 to May 2006. Randomised control trial (RCTs) and retrospective clinical trials were selected including 478 publications on TVT (Tension-free Vaginal Tape), 55 on TOT) (Transobturator Tape), 17 on SPARC (Supra Pubic Arc), 2 on TPP) (Pre Pubic TVT). For the analysis of the functional results of the tape were not available: papers with a mean follow-up under 6 months, the invitation papers or non reviewed manuscript, the redundant papers in the same department, specific case control study.

RESULTS/DISCUSSION

Preoperative age over 70years old and morbid obesity do not seem to be a risk factor for failure of the TVT procedure; however, there is an increase of de novo urgency for age over 70 years old and BMI over 35. Suburetral tape procedure is highly effective in women with intrinsic sphincter deficiency. The urethral hypermobility increases the efficacy of the procedure, however women with fixed urethra, are at significantly increased risks for failure of the procedure. In the same way, preoperative mixed urinary incontinence and voiding difficulties alter the success rate of the procedure. The mode of anaesthesia and the topography of the tape (retropubic or transobturator) have no incidence on the results. There is a definite learning curve (n=20) for the efficiency and the morbidity of the procedure. Cranial topography of the tape and associated procedures are associated with urgency and voiding difficulties.

CONCLUSION

The prognosis factors having an effect on the success of the procedure are the urethral mobility, the mixed urinary incontinence, the learning curve, and the type of protheses.