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Franc S, Joubert M, Daoudi A, Fagour C, Benhamou P, Rodier M, Boucherie B, Benamo E, Schaepelynck P, Guerci B, Dardari D, Borot S, Penfornis A, D'Orsay G, Mari K, Reznik Y, Randazzo C, Charpentier G. Efficacy of two telemonitoring systems to improve glycaemic control during basal insulin initiation in patients with type 2 diabetes: The TeleDiab-2 randomized controlled trial. Diabetes Obes Metab 2019; 21:2327-2332. [PMID: 31173451 PMCID: PMC6771866 DOI: 10.1111/dom.13806] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/24/2019] [Accepted: 06/05/2019] [Indexed: 11/27/2022]
Abstract
TeleDiab-2 was a 13-month randomized controlled trial evaluating the efficacy and safety of two telemonitoring systems to optimize basal insulin (BI) initiation in subjects with inadequately controlled type 2 diabetes (HbA1c, 7.5%-10%). A total of 191 participants (mean age 58.7 years, mean HbA1c 8.9%) were randomized into three groups: group 1(G1, standard care, n = 63), group 2 (G2, interactive voice response system, n = 64) and group 3 (G3, Diabeo-BI app software, n = 64). The two telemonitoring systems proposed daily adjustments of BI doses, in order to facilitate the achievement of fasting blood glucose (FBG) values targeted at ~100 mg/dL. At 4 months follow-up, HbA1c reduction was significantly higher in the telemonitoring groups (G2: -1.44% and G3: -1.48% vs. G1: -0.92%; P < 0.002). Moreover, target FBG was reached by twice as many patients in the telemonitoring groups as in the control group, and insulin doses were also titrated to higher levels. No severe hypoglycaemia was observed in the telemonitoring groups and mild hypoglycaemia frequency was similar in all groups. In conclusion, both telemonitoring systems improved glycaemic control to a similar extent, without increasing hypoglycaemic episodes.
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Affiliation(s)
- Sylvia Franc
- CERITD (Centre for Studies and Research for the Intensification of Diabetes Treatment)Bioparc Genopole CampusEvryFrance
- Department of DiabetesSud‐Francilien HospitalCorbeil‐EssonnesFrance
| | | | - Ahmed Daoudi
- CERITD (Centre for Studies and Research for the Intensification of Diabetes Treatment)Bioparc Genopole CampusEvryFrance
| | - Cédric Fagour
- Department of Diabetology and EndocrinologyFort‐de‐France University HospitalFort de FranceFrance
| | - Pierre‐Yves Benhamou
- Department of Diabetology, Endocrinology and Nutrition DiseasesGrenoble University HospitalGrenobleFrance
| | - Michel Rodier
- Department of Metabolic Diseases and EndocrinologyNimes University HospitalNimesFrance
| | - Beatrix Boucherie
- CERITD (Centre for Studies and Research for the Intensification of Diabetes Treatment)Bioparc Genopole CampusEvryFrance
| | - Eric Benamo
- Department of Endocrinology and Metabolic DiseasesAvignon University HospitalAvignonFrance
| | - Pauline Schaepelynck
- Department of Endocrinology, Diabetes and Metabolic DiseasesMarseille University HospitalMarseilleFrance
| | - Bruno Guerci
- Department of Endocrinology, Diabetes and NutritionNancy University HospitalNancyFrance
| | - Dured Dardari
- CERITD (Centre for Studies and Research for the Intensification of Diabetes Treatment)Bioparc Genopole CampusEvryFrance
- Department of DiabetesSud‐Francilien HospitalCorbeil‐EssonnesFrance
| | - Sophie Borot
- Department of Diabetology and EndocrinologyBesançon University HospitalBesançonFrance
| | - Alfred Penfornis
- Department of DiabetesSud‐Francilien HospitalCorbeil‐EssonnesFrance
| | | | - Karine Mari
- Randomised Clinical Trials (RCTs') Department of StatisticsLyonFrance
| | - Yves Reznik
- Diabetes Care UnitCaen University HospitalCaenFrance
| | - Caroline Randazzo
- CERITD (Centre for Studies and Research for the Intensification of Diabetes Treatment)Bioparc Genopole CampusEvryFrance
| | - Guillaume Charpentier
- CERITD (Centre for Studies and Research for the Intensification of Diabetes Treatment)Bioparc Genopole CampusEvryFrance
- Department of DiabetesSud‐Francilien HospitalCorbeil‐EssonnesFrance
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Pupier E, Fagour C, Tavitian M, Pezzino S, Rigalleau V. Physical activity levels of patients with type 2 diabetes in hospital and at home. Acta Diabetol 2018; 55:107-109. [PMID: 29119249 DOI: 10.1007/s00592-017-1067-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022]
Affiliation(s)
- E Pupier
- Diabetologie-Endocrinologie-Nutrition, Hôpital Haut-Lévèque, Avenue Magellan, 33600, Pessac, France.
| | - C Fagour
- Endocrinologie-Diabétologie-Nutrition, Hôpital Pierre-Zobda-Quitman, CHU de Martinique - Equipe de recherche ECM/LAMIA EA4540, Université des Antilles, Guyane, France
| | - M Tavitian
- Diabetologie-Endocrinologie-Nutrition, Hôpital Haut-Lévèque, Avenue Magellan, 33600, Pessac, France
| | - S Pezzino
- Diabetologie-Endocrinologie-Nutrition, Hôpital Haut-Lévèque, Avenue Magellan, 33600, Pessac, France
| | - V Rigalleau
- Diabetologie-Endocrinologie-Nutrition, Hôpital Haut-Lévèque, Avenue Magellan, 33600, Pessac, France
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Carrère P, Fagour C, Sportouch D, Gane-Troplent F, Hélène-Pelage J, Lang T, Inamo J. Diabetes mellitus and obesity in the French Caribbean: A special vulnerability for women? Women Health 2017; 58:145-159. [PMID: 28095137 DOI: 10.1080/03630242.2017.1282396] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The objective of this study was to analyze the prevalence, awareness, treatment, and control of diabetes and its risk factors among French Caribbean adults. This cross-sectional study included 18-74-year olds (N = 2252; 56.5 percent women) who underwent a heath examination in Guadeloupe during July-December 2014. Diabetes was defined as using antidiabetic treatment, or fasting glucose ≥7 mmol/l, and glycated hemoglobin (HbA1c) ≥6.5 percent; diabetes control was defined as HbA1c < 7 percent. Multilevel logistic regression was used. Diabetes prevalence was 8.2 percent for women and 5 percent for men (age-adjusted odds ratio [aOR] for women = 2.0; 95 percent confidence interval [CI]: 1.4-2.9). The proportion of women with diabetes who were aware of it was 84.5 versus 67.3 percent in men (aOR = 2.7; 95 percent CI: 1.2-6.2). Nearly, all diagnosed participants were being treated. In less than a third of diabetics in both sexes was diabetes control obtained. Most women (55.3 percent) had a waist circumference at or above the National Cholesterol Education Program thresholds versus 14 percent of men (aOR = 9.3; 95 percent CI: 7.5-11.7), which wholly accounted for excess diabetes in women. In women, obesity and diabetes were associated with low education and income. In this French Caribbean sample, abdominal obesity and diabetes affected more women. Diabetes was rarely controlled. A comprehensive women's health policy for the prevention of abdominal obesity and diabetes is needed.
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Affiliation(s)
- Philippe Carrère
- a Department of General Medicine , University of the French West Indies and Guiana , Pointe-à-Pitre , Guadeloupe , France.,b Laboratory of Epidemiology and Analysis in Public Health , UMR1027 INSERM, University of Toulouse III Paul Sabatier , Toulouse , France.,c Guadeloupean Association for the Management and Conduct of Health Examinations and the Promotion of Health (AGREXAM) , Pointe-à-Pitre , Guadeloupe , France
| | - Cédric Fagour
- d Endocrinology-Diabetology-Nutrition Unit , University Hospital, Fort-de-France , Martinique , France.,e Clinical Epidemiology and Medicine Research Team , EA4540 LAMIA, University of the French West Indies and Guiana , Pointe-à-Pitre , Guadeloupe , France
| | - Dan Sportouch
- a Department of General Medicine , University of the French West Indies and Guiana , Pointe-à-Pitre , Guadeloupe , France.,b Laboratory of Epidemiology and Analysis in Public Health , UMR1027 INSERM, University of Toulouse III Paul Sabatier , Toulouse , France
| | - Franciane Gane-Troplent
- a Department of General Medicine , University of the French West Indies and Guiana , Pointe-à-Pitre , Guadeloupe , France
| | - Jeannie Hélène-Pelage
- a Department of General Medicine , University of the French West Indies and Guiana , Pointe-à-Pitre , Guadeloupe , France
| | - Thierry Lang
- b Laboratory of Epidemiology and Analysis in Public Health , UMR1027 INSERM, University of Toulouse III Paul Sabatier , Toulouse , France
| | - Jocelyn Inamo
- b Laboratory of Epidemiology and Analysis in Public Health , UMR1027 INSERM, University of Toulouse III Paul Sabatier , Toulouse , France.,f Department of Cardiology , University of the French West Indies and Guiana , Fort-de-France , Martinique , France
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Rozé B, Najioullah F, Fergé JL, Apetse K, Brouste Y, Cesaire R, Fagour C, Fagour L, Hochedez P, Jeannin S, Joux J, Mehdaoui H, Valentino R, Signate A, Cabié A. Zika virus detection in urine from patients with Guillain-Barré syndrome on Martinique, January 2016. ACTA ACUST UNITED AC 2016; 21:30154. [PMID: 26967758 DOI: 10.2807/1560-7917.es.2016.21.9.30154] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 03/03/2016] [Indexed: 11/20/2022]
Abstract
We report two cases of Guillain-Barré syndrome who had concomitant Zika virus viruria. This viruria persisted for longer than 15 days after symptom onset. The cases occurred on Martinique in January 2016, at the beginning of the Zika virus outbreak. Awareness of this possible neurological complication of ZikV infection is needed.
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Affiliation(s)
- Benoît Rozé
- Infectious and Tropical diseases Unit, Universitary Hospital of Martinique, Fort de France, France
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Godard-Sebillotte C, Dramé M, Fagour C, Basileu T, Godaert L. When Symptomatic Treatment Becomes Antitumor Treatment for Vipoma: Opportunity for Frail Elderly Adults. J Am Geriatr Soc 2016; 64:449-50. [PMID: 26889855 DOI: 10.1111/jgs.13968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | - Moustapha Dramé
- Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
| | - Cédric Fagour
- Department of Endocrinology, Martinique General Hospital, Fort-de-France, France
| | - Tatiana Basileu
- Department of Geriatrics, Martinique General Hospital, Fort-de-France, France
| | - Lidvine Godaert
- Department of Geriatrics, Martinique General Hospital, Fort-de-France, France
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Avila M, Dyment DA, Sagen JV, St-Onge J, Moog U, Chung BHY, Mo S, Mansour S, Albanese A, Garcia S, Martin DO, Lopez AA, Claudi T, König R, White SM, Sawyer SL, Bernstein JA, Slattery L, Jobling RK, Yoon G, Curry CJ, Merrer ML, Luyer BL, Héron D, Mathieu-Dramard M, Bitoun P, Odent S, Amiel J, Kuentz P, Thevenon J, Laville M, Reznik Y, Fagour C, Nunes ML, Delesalle D, Manouvrier S, Lascols O, Huet F, Binquet C, Faivre L, Rivière JB, Vigouroux C, Njølstad PR, Innes AM, Thauvin-Robinet C. Clinical reappraisal of SHORT syndrome with PIK3R1 mutations: toward recommendation for molecular testing and management. Clin Genet 2015; 89:501-506. [PMID: 26497935 DOI: 10.1111/cge.12688] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/10/2015] [Accepted: 10/16/2015] [Indexed: 12/01/2022]
Abstract
SHORT syndrome has historically been defined by its acronym: short stature (S), hyperextensibility of joints and/or inguinal hernia (H), ocular depression (O), Rieger abnormality (R) and teething delay (T). More recently several research groups have identified PIK3R1 mutations as responsible for SHORT syndrome. Knowledge of the molecular etiology of SHORT syndrome has permitted a reassessment of the clinical phenotype. The detailed phenotypes of 32 individuals with SHORT syndrome and PIK3R1 mutation, including eight newly ascertained individuals, were studied to fully define the syndrome and the indications for PIK3R1 testing. The major features described in the SHORT acronym were not universally seen and only half (52%) had four or more of the classic features. The commonly observed clinical features of SHORT syndrome seen in the cohort included intrauterine growth restriction (IUGR) <10th percentile, postnatal growth restriction, lipoatrophy and the characteristic facial gestalt. Anterior chamber defects and insulin resistance or diabetes were also observed but were not as prevalent. The less specific, or minor features of SHORT syndrome include teething delay, thin wrinkled skin, speech delay, sensorineural deafness, hyperextensibility of joints and inguinal hernia. Given the high risk of diabetes mellitus, regular monitoring of glucose metabolism is warranted. An echocardiogram, ophthalmological and hearing assessments are also recommended.
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Affiliation(s)
- M Avila
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Service de Pédiatrie 1, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - D A Dyment
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - J V Sagen
- Hormone Laboratory, Haukeland University Hospital, Bergen, Norway.,KJ Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - J St-Onge
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,CHU Dijon, Laboratoire de Génétique Moléculaire, Dijon, France
| | - U Moog
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - B H Y Chung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - S Mo
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - S Mansour
- SW Thames Regional Genetics Service, St. George's Hospital Medical School, London, SW17 0RE, UK
| | - A Albanese
- Paediatric Endocrine Unit, St George's Hospital, London, UK
| | - S Garcia
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain.,Instituto de Salud Carlos III, Unit 753, Centro de Investigacion Biomedica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - D O Martin
- Department of Ophthalmology, Hospital Central de la Cruz Roja San Jose y Santa Adela, Madrid, Spain
| | - A A Lopez
- Puerta de Hierro, University Hospital, Madrid, Spain
| | - T Claudi
- Department of Medicine, Bodø, Norway
| | - R König
- Department of Human Genetics, University of Frankfurt, Frankfurt, Germany
| | - S M White
- Victorian Clinical genetics Services, Murdoch Childrens Research institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - S L Sawyer
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - J A Bernstein
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - L Slattery
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - R K Jobling
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - G Yoon
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - C J Curry
- Genetic Medicine/, University of California, San Francisco, CA, USA
| | - M L Merrer
- Département de Génétique, Hôpital Necker Enfants Malades, Paris, France
| | - B L Luyer
- Service de Pédiatrie, CH Le Havre, Le Havre, France
| | - D Héron
- Département de Génétique et Centre de Référence "Déficiences intellectuelles de causes rares", Paris, France
| | | | - P Bitoun
- Service de Pédiatrie, Bondy, France
| | - S Odent
- Service de Génétique clinique, Rennes, France.,UMR CNRS 6290 IGDR, Universitė Rennes, Rennes, France
| | - J Amiel
- Département de Génétique, Hôpital Necker Enfants Malades, Paris, France
| | - P Kuentz
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France
| | - J Thevenon
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, FHU-TRANSLAD, Dijon, France
| | - M Laville
- Département d'Endocrinologie, Diabétologie et Nutrition, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.,Institut National de la Santé et de la Recherche Médicale Unité 1060, Centre Européen pour la nutrition et la Santé, Centre de Recherche en Nutrition Humaine Rhône-Alpes, Université Claude Bernard Lyon, Pierre-Bénite, France
| | - Y Reznik
- Service d'Endocrinologie, Centre Hospitalier Universitaire Côte-de-Nacre, Caen, France
| | - C Fagour
- Département d'Endocrinologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - M-L Nunes
- Département d'Endocrinologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - D Delesalle
- Service de pédiatrie, CH de Valencienne, Valencienne, France
| | - S Manouvrier
- Centre de Référence CLAD NdF - Service de génétique clinique Guy Fontaine, CHRU de Lille - Hôpital Jeanne de Flandre, Lille, France
| | - O Lascols
- INSERM, UMR_S938, Centre de Recherche Saint-Antoine, Paris, France.,UPMC Univ Paris 06, Paris, France.,ICAN, Institute of Cardiometabolism And Nutrition, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France.,AP-HP, Hôpital Saint-Antoine, Laboratoire Commun de Biologie et Génétique Moléculaires, Paris, France
| | - F Huet
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Service de Pédiatrie 1, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - C Binquet
- Centre d'Investigation Clinique-Epidémiologique Clinique/essais cliniques du CHU de Dijon, Dijon, France
| | - L Faivre
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, FHU-TRANSLAD, Dijon, France
| | - J-B Rivière
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,CHU Dijon, Laboratoire de Génétique Moléculaire, Dijon, France
| | - C Vigouroux
- INSERM, UMR_S938, Centre de Recherche Saint-Antoine, Paris, France.,UPMC Univ Paris 06, Paris, France.,ICAN, Institute of Cardiometabolism And Nutrition, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France.,AP-HP, Hôpital Saint-Antoine, Laboratoire Commun de Biologie et Génétique Moléculaires, Paris, France
| | - P R Njølstad
- Department of Pediatrics, Haukeland, University Hospital, Bergen, Norway
| | - A M Innes
- Department of Medical Genetics, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute for Child and Maternal Health, University of Calgary, Calgary, Canada
| | - C Thauvin-Robinet
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, FHU-TRANSLAD, Dijon, France
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Lafont M, Fagour C, Haissaguerre M, Darancette G, Wagner T, Corcuff JB, Tabarin A. Per-operative hemodynamic instability in normotensive patients with incidentally discovered pheochromocytomas. J Clin Endocrinol Metab 2015; 100:417-21. [PMID: 25405501 DOI: 10.1210/jc.2014-2998] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The per-operative hemodynamic behavior of normotensive incidentally discovered pheochromocytomas is poorly documented. OBJECTIVE To compare the per-operative hemodynamic instability and early postoperative outcome of normotensive pheochromocytomas, hypertensive pheochromocytomas, and benign non-pheochromocytoma adrenal incidentalomas (AIs). DESIGN Retrospective cohort treated in a single center. PATIENTS AND METHODS Fifty patients (10 normotensive pheochromocytomas, 24 hypertensive pheochromocytomas, and 16 AIs) were anesthetized and operated on by the same team, using laparoscopy in 78% of cases. Before surgery, 60% of normotensive and 95.8% of hypertensive pheochromocytomas received pretreatment with α-receptor or calcium channel blockers. All of the patients received the same intraoperative hemodynamic monitoring, including continuous direct intra-arterial pressure recording. RESULTS All the features of hemodynamic instability, with the exception of the diastolic pressure nadir and fluid volume requirements, differed between hypertensive pheochromocytomas and AIs. Conversely, all features of hemodynamic instability were similar in hypertensive and normotensive pheochromocytomas. More specifically, by comparison with AIs, normotensive pheochromocytomas displayed higher maximal systolic pressure; more hypertensive, severe hypertensive, and hypotensive episodes; and a higher minimal heart rate, and also required more interventions to treat undesirable blood pressure elevations. Postoperative complications, all of which were mild, were more frequent in hypertensive pheochromocytomas than in normotensive pheochromocytomas (P < .03). CONCLUSIONS Normotensive pheochromocytomas have roughly comparable per-operative hemodynamic instability to hypertensive pheochromocytomas and differ markedly from non-pheochromocytoma AIs. It is therefore crucial to identify normotensive pheochromocytomas among AIs when surgery is scheduled and to apply the standard of care for pheochromocytoma anesthesia.
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Affiliation(s)
- M Lafont
- Departments of Endocrinology (M.L., M.H., A.T.), Anesthesiology (G.D.), Endocrine Surgery (T.W.), and Nuclear Medicine (J.B.C.), Centre Hospitalier Universitaire (CHU) Bordeaux and University of Bordeaux, 33604 Pessac, France; and Department of Endocrinology (C.F.), CHU Fort-de-France, 97261 Fort-de-France, Martinique
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Gonzalez C, Fagour C, Maury E, Gatta-Cherifi B, Salandini S, Pierreisnard A, Masquefa-Giraud P, Gin H, Rigalleau V. P142 L’évolution précoce de la DER et du QR sous traitement injectable prédit l’évolution pondérale des patients diabétiques de type 2 non contrôlés. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70474-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Haissaguerre M, Courel M, Caron P, Denost S, Dubessy C, Gosse P, Appavoupoulle V, Belleannée G, Jullié ML, Montero-Hadjadje M, Yon L, Corcuff JB, Fagour C, Mazerolles C, Wagner T, Nunes ML, Anouar Y, Tabarin A. Normotensive incidentally discovered pheochromocytomas display specific biochemical, cellular, and molecular characteristics. J Clin Endocrinol Metab 2013; 98:4346-54. [PMID: 24001749 DOI: 10.1210/jc.2013-1844] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT A number of incidentally discovered pheochromocytomas are not associated with hypertension. The characteristics of normotensive incidentally discovered pheochromocytomas (NIPs) are poorly known. OBJECTIVE The purpose of this work was to assess the clinical, hormonal, histological, and molecular features of NIPs. DESIGN This was a retrospective cohort recruited from 2001 to 2011 in 2 tertiary care medical departments. PATIENTS AND METHODS Clinical, biological, and radiological investigations performed in 96 consecutive patients with sporadic unilateral pheochromocytomas were examined; 47 patients had overt pheochromocytomas responsible for hypertension. Among the patients with incidental pheochromocytomas, 28 had hypertension and 21 were normotensive (NIPs). A total of 62 tumors were examined to determine the Pheochromocytoma of the Adrenal Gland Scale Score, and 29 were studied for the expression of 16 genes involved in chromaffin cell function. RESULTS Tumor size and metaiodobenzylguanidine (MIBG) scintigraphy results were similar for hypertensive pheochromocytomas (HPs) and NIPs. Patients with NIPs displayed reduced summed levels of urinary catecholamines and metanephrines and, more specifically, reduced levels of adrenaline and metadrenaline compared with those of patients with HPs (P < .001). Urinary metanephrines had 98% diagnostic sensitivity in patients with HPs and only 75% in patients with NIPs (P < .01). Tumor diameter positively correlated with the total amount of urinary concentrations of metanephrines in patients with HPs (P < .001) but not in patients with NIPs. NIPs displayed global decreased chromaffin gene expression (reaching significance for 5 of them) and 2 corresponding proteins (phenylethanolamine N-methyltransferase and secretogranin II) and a significant increase in the cellularity, mitotic activity, and presence of atypical mitosis (P < .05). CONCLUSIONS NIPs differ from pheochromocytomas responsible for hypertension and display features of altered chromaffin differentiation. These tumors may be misdiagnosed with the use of the usual biological diagnostic tools.
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Affiliation(s)
- Magalie Haissaguerre
- Department of Endocrinology, Haut Leveque Hospital, Avenue de Magellan, 33604 Pessac, France.
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Franc S, Borot S, Ronsin O, Quesada JL, Dardari D, Fagour C, Renard E, Leguerrier AM, Vigeral C, Moreau F, Winiszewski P, Vambergue A, Mosnier-Pudar H, Kessler L, Reffet S, Guerci B, Millot L, Halimi S, Thivolet C, Benhamou PY, Penfornis A, Charpentier G, Hanaire H. Telemedicine and type 1 diabetes: is technology per se sufficient to improve glycaemic control? Diabetes Metab 2013; 40:61-66. [PMID: 24139705 DOI: 10.1016/j.diabet.2013.09.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 08/15/2013] [Accepted: 09/02/2013] [Indexed: 11/26/2022]
Abstract
AIM In the TELEDIAB-1 study, the Diabeo system (a smartphone coupled to a website) improved HbA1c by 0.9% vs controls in patients with chronic, poorly controlled type 1 diabetes. The system provided two main functions: automated advice on the insulin doses required; and remote monitoring by teleconsultation. The question is: how much did each function contribute to the improvement in HbA1c? METHODS Each patient received a smartphone with an insulin dose advisor (IDA) and with (G3 group) or without (G2 group) the telemonitoring/teleconsultation function. Patients were classified as "high users" if the proportion of "informed" meals using the IDA exceeded 67% (median) and as "low users" if not. Also analyzed was the respective impact of the IDA function and teleconsultations on the final HbA1c levels. RESULTS Among the high users, the proportion of informed meals remained stable from baseline to the end of the study 6months later (from 78.1±21.5% to 73.8±25.1%; P=0.107), but decreased in the low users (from 36.6±29.4% to 26.7±28.4%; P=0.005). As expected, HbA1c improved in high users from 8.7% [range: 8.3-9.2%] to 8.2% [range: 7.8-8.7%] in patients with (n=26) vs without (n=30) the benefit of telemonitoring/teleconsultation (-0.49±0.60% vs -0.52±0.73%, respectively; P=0.879). However, although HbA1c also improved in low users from 9.0% [8.5-10.1] to 8.5% [7.9-9.6], those receiving support via teleconsultation tended to show greater improvement than the others (-0.93±0.97 vs -0.46±1.05, respectively; P=0.084). CONCLUSION The Diabeo system improved glycaemic control in both high and low users who avidly used the IDA function, while the greatest improvement was seen in the low users who had the motivational support of teleconsultations.
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Affiliation(s)
- S Franc
- Department of Diabetes, Sud-Francilien Hospital, Corbeil-Essonnes, France; Centre d'Études et de Recherches pour l'Intensification du Traitement du Diabète (CERITD), Corbeil-Essonnes, France.
| | - S Borot
- Department of Endocrinology-Metabolism and Diabetology-Nutrition, Jean-Minjoz Hospital, Besançon, France
| | - O Ronsin
- Department of Diabetes, Sainte-Marguerite University Hospital, Marseille, France
| | - J-L Quesada
- Department of Biostatistics, CIC-Inserm, University Hospital, Grenoble, France
| | - D Dardari
- Centre d'Études et de Recherches pour l'Intensification du Traitement du Diabète (CERITD), Corbeil-Essonnes, France
| | - C Fagour
- Department of Endocrinology, University Hospital Pessac, Pessac, France
| | - E Renard
- Department of Endocrinology, University Hospital, Montpellier, France
| | - A-M Leguerrier
- Department of Endocrinology, University Hospital, Rennes, France
| | - C Vigeral
- Department of Diabetes, Hôtel-Dieu University Hospital, Paris, France
| | - F Moreau
- Department of Endocrinology, University Hospital, Strasbourg, France
| | - P Winiszewski
- Department of Endocrinology, Belfort Hospital, Belfort, France
| | - A Vambergue
- Clinique Marc Linquette, Department of Endocrinology and Diabetology, Lille, France
| | | | - L Kessler
- Department of Endocrinology, University Hospital, Strasbourg, France
| | - S Reffet
- Department of Endocrinology, Édouard-Herriot Hospital, Lyon, France
| | - B Guerci
- Diabetology, Nutrition, Metabolic disorders, Brabois Hospital and Center of Clinical Investigation ILCV, University Hospital, Nancy, France
| | - L Millot
- Department of Endocrinology, Bellevue Hospital, Saint-Étienne, France
| | - S Halimi
- Department of Endocrinology, Diabetology, Nutrition University Hospital, Grenoble, France; University J Fourier 1, Grenoble, France
| | - C Thivolet
- Department of Endocrinology, Édouard-Herriot Hospital, Lyon, France
| | - P-Y Benhamou
- Department of Endocrinology, Diabetology, Nutrition University Hospital, Grenoble, France
| | - A Penfornis
- Department of Endocrinology-Metabolism and Diabetology-Nutrition, Jean-Minjoz Hospital, Besançon, France
| | - G Charpentier
- Department of Diabetes, Sud-Francilien Hospital, Corbeil-Essonnes, France; Centre d'Études et de Recherches pour l'Intensification du Traitement du Diabète (CERITD), Corbeil-Essonnes, France
| | - H Hanaire
- Department of Diabetes, Rangueil University Hospital, Toulouse, France
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Thauvin-Robinet C, Auclair M, Duplomb L, Caron-Debarle M, Avila M, St-Onge J, Le Merrer M, Le Luyer B, Héron D, Mathieu-Dramard M, Bitoun P, Petit JM, Odent S, Amiel J, Picot D, Carmignac V, Thevenon J, Callier P, Laville M, Reznik Y, Fagour C, Nunes ML, Capeau J, Lascols O, Huet F, Faivre L, Vigouroux C, Rivière JB. PIK3R1 mutations cause syndromic insulin resistance with lipoatrophy. Am J Hum Genet 2013; 93:141-9. [PMID: 23810378 DOI: 10.1016/j.ajhg.2013.05.019] [Citation(s) in RCA: 133] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 05/10/2013] [Accepted: 05/23/2013] [Indexed: 11/18/2022] Open
Abstract
Short stature, hyperextensibility of joints and/or inguinal hernia, ocular depression, Rieger anomaly, and teething delay (SHORT) syndrome is a developmental disorder with an unknown genetic cause and hallmarks that include insulin resistance and lack of subcutaneous fat. We ascertained two unrelated individuals with SHORT syndrome, hypothesized that the observed phenotype was most likely due to de novo mutations in the same gene, and performed whole-exome sequencing in the two probands and their unaffected parents. We then confirmed our initial observations in four other subjects with SHORT syndrome from three families, as well as 14 unrelated subjects presenting with syndromic insulin resistance and/or generalized lipoatrophy associated with dysmorphic features and growth retardation. Overall, we identified in nine affected individuals from eight families de novo or inherited PIK3R1 mutations, including a mutational hotspot (c.1945C>T [p.Arg649Trp]) present in four families. PIK3R1 encodes the p85α, p55α, and p50α regulatory subunits of class IA phosphatidylinositol 3 kinases (PI3Ks), which are known to play a key role in insulin signaling. Functional data from fibroblasts derived from individuals with PIK3R1 mutations showed severe insulin resistance for both proximal and distal PI3K-dependent signaling. Our findings extend the genetic causes of severe insulin-resistance syndromes and provide important information with respect to the function of PIK3R1 in normal development and its role in human diseases, including growth delay, Rieger anomaly and other ocular affections, insulin resistance, diabetes, paucity of fat, and ovarian cysts.
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Affiliation(s)
- Christel Thauvin-Robinet
- Equipe d'Accueil 4271, Génétique des Anomalies du Developpement, Université de Bourgogne, F-21079 Dijon, France.
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Fagour C, Gonzalez C, Pezzino S, Florenty S, Rosette-Narece M, Gin H, Rigalleau V. Low physical activity in patients with type 2 diabetes: the role of obesity. Diabetes Metab 2012; 39:85-7. [PMID: 23159129 DOI: 10.1016/j.diabet.2012.09.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 05/28/2012] [Accepted: 09/19/2012] [Indexed: 12/11/2022]
Abstract
AIMS Few studies have described ambulatory activity in free-living individuals with type 2 diabetes mellitus (T2DM) using motion sensors, and none included a control group. For this reason, our study compared the physical-activity levels of outpatients with T2DM with subjects without diabetes, and examined the relationship between body mass index (BMI) and physical-activity parameters. METHODS Physical-activity levels in 70 outpatients with T2DM and 30 age-, gender- and employment-matched individuals without diabetes were measured using the SenseWear Armband™, a monitoring device validated against doubly labelled water, to assess total energy expenditure. Patients wore the SenseWear Armband™ on their right arm continuously every day for 1 week. RESULTS Total energy expenditure (<300 kcal/day), number of steps (<1500/day), physical-activity duration (<130 min/day) and active energy expenditure/day (<300 kcal) were all significantly lower (P<0.05) in patients with T2DM. These measures were inversely correlated with BMI, and remained significant after adjusting for age, gender, employment status and the presence of diabetes. CONCLUSION Outpatients with T2DM have lower physical-activity levels than their matched controls, a characteristic that is related to their higher BMI.
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Affiliation(s)
- C Fagour
- Endocrinologie-Diabétologie-Nutrition, Hôpital Pierre-Zobda-Quitman, CHU de Fort-de-France, 97200 Fort-de-France, Martinique.
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13
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Manzo N, Salloum N, Nestler U, Memia-Zolo D, Warter A, Fagour C. Les adénomes hypophysaires opérés avec 5-Ala et microscope PENTERO ne montrent guère de fluorescence. Étude conjointe : neurosurgery (France) et neurosurgery (Allemagne). Neurochirurgie 2011. [DOI: 10.1016/j.neuchi.2011.09.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fagour C, Pezzino S, Florenty S, Gonzalez C, Rosette-Narece M, Gin H, Rigalleau V. PO8 - Les patients DT2 ont un faible niveau d’activité physique : rôle de l’obésité. Diabetes & Metabolism 2011. [DOI: 10.1016/s1262-3636(11)70586-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
OBJECTIVE Physical inactivity is often suspected in hospitalized patients with type 2 diabetes but has yet to be quantified. RESEARCH DESIGN AND METHODS We measured the level of physical activity of 36 hospitalized (H) and 36 free-living nonhospitalized (NH) type 2 diabetic subjects with actimeters (SenseWear Arm-Band). RESULTS The number of steps (H: 4,381 +/- 3,742 steps/24 h, NH: 7,220 +/- 4,763 steps/24 h; P < 0.01), duration of physical activity (H: 45 +/- 57 min/24 h, NH: 148 +/- 116 min/24 h; P < 0.005), and physical activity expenditure (H: 287 +/- 390 kcal/24 h, NH: 1,035 +/- 1,006 kcal/24 h; P < 0.005) were two- to threefold lower in the hospitalized patients. Simple advice enabled us to increase their recorded levels of physical activity by approximately 50% (P < 0.005), and a further 50% (P < 0.05) was obtained by the use of a pedometer. CONCLUSIONS The physical inactivity of hospitalized patients with type 2 diabetes is significant and remediable, although the advice given must take into account the existence of sensory neuropathy and silent myocardial ischemia.
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Affiliation(s)
- Sandrine Pezzino
- Nutrition-Diabétologie, Hôpital Haut-Lévêque, Avenue de Magellan, Pessac, France
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Fagour C, Gonzalez C, Suberville C, Higueret P, Rabemanantsoa C, Beauvieux MC, Gin H, Rigalleau V. Early decrease in resting energy expenditure with bedtime insulin therapy. Diabetes & Metabolism 2009; 35:332-5. [DOI: 10.1016/j.diabet.2009.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 04/15/2009] [Accepted: 04/22/2009] [Indexed: 10/20/2022]
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Mauclère-Denost S, Duron-Martinaud S, Nunes ML, Gatta B, Fagour C, Rault A, Gosse P, Tabarin A. [Surgical excision of subclinical cortisol secreting incidentalomas: Impact on blood pressure, BMI and glucose metabolism]. Ann Endocrinol (Paris) 2009; 70:211-7. [PMID: 19457469 DOI: 10.1016/j.ando.2009.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 03/27/2009] [Accepted: 03/31/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To compare clinical, vascular and metabolic parameters before and after surgery in patients with subclinical cortisol secreting incidentalomas. PATIENTS AND METHODS Eight patients were investigated before and 12 months after removal of the mass on hemodynamic (blood pressure by MAPA procedure), anthropometric (body weight, body mass index), and metabolic parameters (glucose level, HbA(1c)). RESULTS In the whole group, 75% of patients displayed decrease in blood pressure (cessation of at least one hypotensive medication) and 33% of them were definitely cured of hypertension. Seventy-one percent of patients lost body weight and 37.5% lost more than 5%. In the whole group of patients, glucose level decreased by 1.1% and medical treatment was discontinuated in two of three diabetic patients. CONCLUSION Subclinical cortisol secreting adrenal incidentalomas are associated with cardiovascular risk factors that may be corrected after removal of the mass. Therefore, surgery may be an appropriate choice in patients with subclinical Cushing's syndrome to improve hypertension, body weight and impaired glucose level. Controlled studies comparing surgical treatment to a medical follow-up including optimal cardiovascular risk factors treatment are needed to define the usefulness of surgery in hypertensive patients with subclinical cortisol secreting incidentalomas.
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Affiliation(s)
- S Mauclère-Denost
- Service d'endocrinologie-diabète et maladies métaboliques, USN Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France
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Fagour C, Bardet S, Rohmer V, Arimone Y, Lecomte P, Valli N, Tabarin A. Usefulness of adrenal scintigraphy in the follow-up of adrenocortical incidentalomas: a prospective multicenter study. Eur J Endocrinol 2009; 160:257-64. [PMID: 18974229 DOI: 10.1530/eje-08-0299] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Prognostic factors for progression of benign adrenocortical adenomas (AI) remain poorly known. We assessed the usefulness of (131)I-6-beta-iodomethylnorcholesterol scintigraphy (IMS) to predict the occurrence of adrenal hyperfunction or mass enlargement. DESIGN Fifty-one consecutive inpatients with unilateral AI and normal 24-h urinary free cortisol (UFC) were enrolled in a multicenter observational prospective study to investigate the relationship between the scintigraphic pattern and the progression of biological abnormalities of the hypothalamo-pituitary-adrenal axis or tumor size. RESULTS Biochemically defined 'subclinical' Cushing's syndrome (SCS) was found at baseline in 47% of patients. Unilateral uptake (UU) was significantly associated with SCS (P<0.05). During the follow-up (4.3+/-1.6-year): 53% of patients showed unchanged hormonal evaluation, 29% displayed intermittent SCS and 18% showed definitive hormonal progression of SCS but without overt biochemical hypercortisolism. UU was associated with persistence of SCS and hormonal progression (P<0.01). In multivariate analysis, UU and impaired 1 mg dexamethasone suppression were independently associated with hormonal progression. Three patients with UU developed clinical CS despite persistently normal UFC. Tumor size increased in 10% patients and was not associated with any scintigraphic pattern. CONCLUSION Evolution of SCS toward overt biochemical CS in patients with AI is a rare event during a 4-year follow-up. UU is predictive for the occurrence of SCS, its persistence and progression within the spectrum of SCS. Further studies aiming to establish the clinical consequences of SCS are needed to recommend IMS as a complementary evaluation in patients with AI and biochemical SCS.
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Affiliation(s)
- Cédric Fagour
- Department of Endocrinology, University Hospital of Bordeaux, Hôpital Haut Leveque, Avenue de Magellan, 33600 Pessac, France
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Fagour C, Sorel G, Inamo J, Couffinhal T. [The prevalence of abnormal glucose regulation after myocardial infarction: Comparative study in two French ethnic groups]. Ann Endocrinol (Paris) 2008; 69:433-9. [PMID: 18466875 DOI: 10.1016/j.ando.2008.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2007] [Revised: 02/17/2008] [Accepted: 03/12/2008] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The aim of this study was to compare the prevalence of abnormal glucose tolerance in patients stemming from two French ethnic groups and admitted for acute coronary syndrome (ACS) to intensive coronary care unit. MATERIALS AND METHODS During a period of six months, 53 and 60 consecutive patients were enrolled at Fort-de-France (Martinique, French West Indies, Afrocaribbeans, group F) and at Bordeaux (France, Europeans, group B), respectively. Glucometabolic state was classified according to medical history and fasting glycemia measured from the fourth day after ACS. RESULTS At baseline, 36% of the patients of group F and 20% of the patients of group B had previously known diabetes (p=0.06). Prevalence of hypertension was higher in Afrocaribbeans than in Europeans (60 versus 40%, p<0.05). According to fasting glycemia, newly detected diabetes were found in six Afrocaribbeans and only one was found in Europeans; two patients in group F and three patients in group B displayed impaired fasting glycemia. As a whole, 51% of Afrocaribbeans and 27% of Europeans showed abnormal glucose tolerance (p<0.05). Furthermore, Afrocaribbeans displayed lower levels of triglycerides and higher levels of HDL cholesterol than Europeans (p<0.05). CONCLUSION Our study suggested a higher prevalence of impaired glucose metabolism in French Afrocaribbeans than in European counterparts after ACS. Furthermore, French Afrocaribbeans displayed a more favorable lipoprotein profile. These characteristics look like that of the American and British Afrocaribbeans, maybe because of a common genetic origin.
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Affiliation(s)
- C Fagour
- Service d'endocrinologie et de diabétologie, CHU de Bordeaux, hôpital Haut-Lévêque, avenue de Magellan, 33604 Pessac, France.
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Le Carvennec M, Fagour C, Adenis-Lamarre E, Perlemoine C, Gin H, Rigalleau V. Body composition of obese subjects by air displacement plethysmography: The influence of hydration. Obesity (Silver Spring) 2007; 15:78-84. [PMID: 17228034 DOI: 10.1038/oby.2007.533] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We investigated whether air displacement plethysmography (ADP) could detect small changes in body composition of obese subjects with alterations in hydration. RESEARCH METHODS AND PROCEDURES Ten obese subjects (mean BMI, 39.3 +/- 2.8 kg/m2) entered the ADP chamber without and with oil (1, 2, or 4 liters), water (1, 2, or 4 liters), or mixed (1 liter oil + 1 liter water or 2 liters oil + 2 liters water) loads. Real and measured changes in body composition were compared by regression analysis and Bland-Altman procedures. RESULTS The ADP-measured changes in volume did not differ from the real values and were strongly correlated with them (r = 0.98). In all cases, loads of differing composition and similar volume led to different values of fat, fat-free mass, and percentage fat. Water was detected as increased fat-free mass only with loads of > or =2 liters, most of the water being falsely detected as increased fat mass. The observed changes were correlated with the real ones for fat mass (r = 0.68; p < 0.0001), fat-free mass (r = 0.66; p < 0.0001), and percentage fat (r = 0.61; p < 0.0001), but fat mass changes were overestimated by approximately 1 kg, and fat-free mass changes were underestimated by approximately 1 kg. This underestimation increased with the highest water loads, as shown by the Bland-Altman plot (r = -0.27; p < 0.05). Percentage fat changes were overestimated by 0.8% (p < 0.001); the magnitude of the error was correlated with the weight of the water load (r = 0.62; p < 0.0001). DISCUSSION ADP accurately measures changes in body volume, discriminating small changes in body composition. It overestimates changes in adiposity, as most of the increased hydration is detected as an enlarged fat mass.
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Affiliation(s)
- Marie Le Carvennec
- Nutrition-Diabétologie, USN, Hôpital Haut-Lévêque, Avenue de Magellan, 33600 Pessac, France
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Secchiutti A, Fagour C, Perlemoine C, Gin H, Durrieu J, Rigalleau V. Air displacement plethysmography can detect moderate changes in body composition. Eur J Clin Nutr 2006; 61:25-9. [PMID: 16855541 DOI: 10.1038/sj.ejcn.1602482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To determine the sensitivity of air displacement plethysmography (APD) for evaluation of changes in body composition in normal subjects. DESIGN Comparison of measurements with and without oil or water loads. SUBJECTS AND METHODS Ten healthy volunteers were analyzed, without and with 1 l and 2 l of oil or water. The measured and true changes in fat mass and fat-free mass were compared by paired t-tests. A correlation study and a Bland & Altman procedure was performed on the 60 measurements of adiposity changes in 30 subjects carrying 0.5 l (n=8 x 2), 1 l (n=10 x 2) and 2 l (n=12 x 2) oil and water loads. RESULTS Fat-free mass increased when the 10 subjects were carrying water. When they carried oil, fat mass increased, however, a approximately 0.5 kg increase of fat-free mass was also detected. Two liters loads led to distinct changes: +1.49+/-0.59 kg fat and +0.50+/-0.60 kg fat-free with oil and +0.37+/-0.57 kg fat and +1.70+/-0.56 kg fat-free with water (both P<0.001). Mixed loads (+1 l oil and 1 l water) led to detect +0.85+/-0.48 kg fat and +1.09+/-0.45 kg fat-free (both P<0.005 vs without load). For the 30 subjects analyzed thrice, measured changes in fat and fat-free mass were slightly underestimated (-15%, NS) but correlated with the true changes. Measured changes in adiposity were correlated with the true changes, with no bias as indicated by the Bland & Altman procedure. CONCLUSION APD detects approximately 2 kg changes in fat or fat-free mass in small populations.
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Affiliation(s)
- A Secchiutti
- Nutrition-Diabétologie, USN, Hopital Haut-Lévêque, Pessac, France
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