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Gin H, Rorive M, Gautier S, Condomines M, Saint Aroman M, Garrigue E. Treatment by a moisturizer of xerosis and cracks of the feet in men and women with diabetes: a randomized, double-blind, placebo-controlled study. Diabet Med 2017. [PMID: 28627029 DOI: 10.1111/dme.13402] [Citation(s) in RCA: 7] [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: 11/27/2022]
Abstract
AIM To evaluate a moisturizer containing urea, glycerine and petrolatum for healing deep open fissures on the feet of people with diabetes. If left untreated, open fissures, an entry point for bacteria, can lead to infection, ulceration and further complications. METHODS This randomized, double-blind, multicentre study at 19 hospitals, general practices and diabetologists in France and Belgium included participants with diabetes and a deep open target fissure on their heel. Participants were randomized to test cream or placebo (1 : 1) for 4 weeks. Complete target fissure healing after 4 weeks (primary criterion) and 2 weeks, target fissure closure, overall fissure healing and xerosis were assessed. RESULTS Some 167 participants were randomized (80 to test cream; 87 to placebo); all were included in the efficacy analyses. The percentage of participants with complete target fissure healing after 4 weeks was higher with test cream than placebo (46.3% vs. 33.3%): the difference did not reach statistical significance (P = 0.088). Fewer participants still had a deep open target fissure with test cream than placebo, the difference was statistically significant and clinically relevant after 2 (24.7% vs. 42.7%, P = 0.027) and 4 weeks (6.4% vs. 24.1%, P = 0.002). The difference in overall fissure healing between test cream and placebo was significant (P < 0.001) and test cream resulted in greater xerosis improvement (P < 0.001 and P = 0.002 at 2 and 4 weeks, respectively). CONCLUSION The activity of the test cream for treating feet fissures of people with diabetes was confirmed by an improvement in open fissure healing and xerosis. The cream was well tolerated.
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Affiliation(s)
- H Gin
- Service de diabétologie, Hospital Haut-Lévêque, 33604, Pessac, France
| | - M Rorive
- Hospitalier Universitaire de Liège, Domaine Universitaire du Sart Tilman, B-4000, Liège, Belgium
| | - S Gautier
- Institut de Recherche Pierre Fabre, CRDPF, 3 avenue Hubert Curien, BP 13562 - 31035, Toulouse Cedex 1, France
| | - M Condomines
- Institut de Recherche Pierre Fabre, CRDPF, 3 avenue Hubert Curien, BP 13562 - 31035, Toulouse Cedex 1, France
| | - M Saint Aroman
- Institut de Recherche Pierre Fabre, CRDPF, 3 avenue Hubert Curien, BP 13562 - 31035, Toulouse Cedex 1, France
| | - E Garrigue
- Institut de Recherche Pierre Fabre, CRDPF, 3 avenue Hubert Curien, BP 13562 - 31035, Toulouse Cedex 1, France
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Cadic C, Vitiello S, Gin H, Neveu PJ, Dupuy B. Embedded Adrenal Cells Graft Reduced Local and Early Nonspecific Inflammatory Phenomena Which Follow Agarose Beads Implantation. Cell Transplant 2017; 1:349-54. [PMID: 1344307 DOI: 10.1177/096368979200100503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/16/2022] Open
Abstract
Microencapsulation of adrenal cells is proposed for reducing the nonspecific inflammatory reaction observed around polymer implants. This hypothesis was tested by comparing both host cellular reaction and the surrounding graft cell populations which appeared either when agarose embedded cells or when empty agarose beads were implanted. Our results showed that the fibrotic material that surrounded the implanted empty agarose microbeads was not as severe and important when adrenal cells were present. Similarly, T lymphocyte population surrounding the graft was considerably reduced together with the percentage of CD4 and CD8 positive cell subpopulations. The activation macrophage marker IaD disappeared. Our results support the hypothesis that embedded adrenal cells may be a suitable solution for reducing early inflammatory events due to microcapsules implantation.
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Affiliation(s)
- C Cadic
- INSERM U.306, Université de Bordeaux II
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3
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Rajaobelina K, Farges B, Nov S, Maury E, Cephise-Velayoudom FL, Gin H, Helmer C, Rigalleau V. Skin autofluorescence and peripheral neuropathy four years later in type 1 diabetes. Diabetes Metab Res Rev 2017; 33. [PMID: 27235334 DOI: 10.1002/dmrr.2832] [Citation(s) in RCA: 20] [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] [Received: 01/15/2016] [Revised: 05/17/2016] [Accepted: 05/24/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Advanced glycation end products (AGEs) are involved in diabetes complications. We aimed to investigate whether the accumulation of AGEs measured by skin autofluorescence (sAF) was associated with signs of diabetic peripheral neuropathy and to sensitivity, pain, motor and autonomic function 4 years later in patients with type 1 diabetes. METHODS At baseline, 188 patients (age 51 years, diabetes duration 22 years) underwent skin autofluorescence measurement using the AGE Reader. Four years later, signs of diabetic peripheral neuropathy were defined as the presence of neuropathic pain and/or feet sensory loss or foot ulceration. Neurological tests were systematically performed: vibration perception threshold by neuroesthesiometry, neuropathic pain by the Douleur Neuropathique en 4 Questions score, muscle strength by dynamometry and electrochemical skin conductance. Multivariate analyses were adjusted by age, sex, height, body mass index, tobacco, HbA1c , diabetes duration, estimated glomerular filtration rate and albumin excretion rate. RESULTS At the 4-year follow-up, 13.8% of patients had signs of diabetic peripheral neuropathy. The baseline sAF was higher in those with signs of diabetic peripheral neuropathy (2.5 ± 0.7 vs 2.1 ± 0.5 arbitrary units (AU), p < 0.0005). In the multivariate analysis, a 1 SD higher skin autofluorescence at baseline was associated with an increased risk of signs of neuropathy (OR = 2.68, p = 0.01). All of the neurological tests were significantly altered in the highest quartile of the baseline sAF (>2.4 AU) compared with the lowest quartiles after multivariate adjustment. CONCLUSION This non-invasive measurement of skin autofluorescence may have a value for diabetic peripheral neuropathy in type 1 diabetes and a potential clinical utility for detection of diabetic peripheral neuropathy. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- K Rajaobelina
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - B Farges
- Nutrition-Diabetology Department, Haut-Lévêque Hospital, Pessac, France
| | - S Nov
- Nutrition-Diabetology Department, Haut-Lévêque Hospital, Pessac, France
| | - E Maury
- Nutrition-Diabetology Department, Haut-Lévêque Hospital, Pessac, France
| | | | - H Gin
- Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- Nutrition-Diabetology Department, Haut-Lévêque Hospital, Pessac, France
| | - C Helmer
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - V Rigalleau
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- Nutrition-Diabetology Department, Haut-Lévêque Hospital, Pessac, France
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Freyburger G, Gin H, Dousseau F, Lorient-Rouoaut M, Boisseau M. Erythrocyte membrane fluidity in diabetics: fluorescence measurement and rheological analysis. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1988-8203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- G. Freyburger
- Laboratoire d’Hématologie, INSERM U8, Cardiol. Av. Haut-Lévêque, 33600 Pessac
| | - H. Gin
- Service des Maladie Infectieuses, Pr Aubertin, Hal Pellegrin Tripode, 33000 Bordeaux, France
| | - F. Dousseau
- Centre de Recherches Paul Pascal, Domaine de Brivazac, 33400 Talence
| | | | - M.R. Boisseau
- Laboratoire d’Hématologie, INSERM U8, Cardiol. Av. Haut-Lévêque, 33600 Pessac
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Maury E, Savel J, Grouthier V, Rajaobelina K, Corvo L, Lorrain S, Gonzalez C, Gin H, Barberger-Gateau P, Rigalleau V. Is skin autofluorescence a marker of metabolic memory in pregnant women with diabetes? Diabet Med 2015; 32:1575-9. [PMID: 25981634 DOI: 10.1111/dme.12803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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] [Accepted: 05/13/2015] [Indexed: 12/30/2022]
Abstract
AIM To determine whether skin autofluorescence can help to detect those who have previously had abnormal glucose levels among women referred for diabetes during pregnancy. METHODS Using an advanced glycation end product reader (AGE Reader(tm) (;) DiagnOptics BV, Groningen, the Netherlands), we measured forearm skin autofluorescence at 24-30 weeks of gestation in all women who were referred to our Nutrition Diabetology unit for diabetes during pregnancy. RESULTS The study included 230 women (200 with gestational diabetes and 30 with pre-gestational diabetes, of whom 21 had Type 1 and nine had Type 2 diabetes) and a reference group of 22 normoglycaemic non-pregnant women. Skin autofluorescence was significantly higher in women with pre-gestational diabetes (1.97 ± 0.44 arbitary units) compared with gestational diabetes (1.77 ± 0.32 arbitary units; P = 0.003) and lower in the reference group (1.60 ± 0.32 arbitary units; P = 0.009 vs all pregnant women). Among women with gestational diabetes, 71 had a history of hyperglycaemia (i.e. gestational diabetes or macrosomia in a previous pregnancy or discovery of diabetes before 24th gestational week in the present pregnancy). These women had higher levels of skin autofluorescence (1.83 ± 0.35 arbitary units) than women with gestational diabetes without previous history of hyperglycaemia (1.73 ± 0.30 arbitary units; P = 0.04, non-significant, adjusted for age). Skin autofluorescence increased with the number of criteria present for previous hyperglycaemia (P for trend = 0.008) and was significantly associated with having two or three criteria for hyperglycaemia after adjusting for age (P = 0.02). CONCLUSIONS Skin autofluorescence could reflect previous long-term hyperglycaemia in pregnant women, and could therefore be a marker of metabolic memory.
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MESH Headings
- Adult
- Biomarkers/metabolism
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/metabolism
- Diabetes, Gestational/blood
- Diabetes, Gestational/epidemiology
- Diabetes, Gestational/metabolism
- Female
- Fluorescence
- Forearm
- France/epidemiology
- Fructosamine/blood
- Glycated Hemoglobin/analysis
- Glycation End Products, Advanced/metabolism
- Humans
- Pregnancy
- Pregnancy Trimester, Second
- Pregnancy Trimester, Third
- Pregnancy in Diabetics/blood
- Pregnancy in Diabetics/metabolism
- Recurrence
- Risk
- Skin/metabolism
- Spectrometry, Fluorescence
- Up-Regulation
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Affiliation(s)
- E Maury
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - J Savel
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
| | - V Grouthier
- Department of Gynaecology, CHU Bordeau, Pellegrin Hospital, Bordeaux, France
| | - K Rajaobelina
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - L Corvo
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
| | - S Lorrain
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - C Gonzalez
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
| | - H Gin
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
| | - P Barberger-Gateau
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - V Rigalleau
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
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Rosen C, Jones N, Chase KA, Grossman LS, Gin H, Sharma RP. Self, Voices and Embodiment: A Phenomenological Analysis. J Schizophr Res 2015; 2:1008. [PMID: 27099869 PMCID: PMC4834921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The primary aim of this study was to examine first-person phenomenological descriptions of the relationship between the self and Auditory Verbal Hallucinations (AVHs). Complex AVHs are frequently described as entities with clear interpersonal characteristics. Strikingly, investigations of first-person (subjective) descriptions of the phenomenology of the relationship are virtually absent from the literature. METHOD Twenty participants with psychosis and actively experiencing AVHs were recruited from the University of Illinois at Chicago. A mixed-methods design involving qualitative and quantitative components was utilized. Following a priority-sequence model of complementarity, quantitative analyses were used to test elements of emergent qualitative themes. RESULTS The qualitative analysis identified three foundational constructs in the relationship between self and voices: 'understanding of origin,' 'distinct interpersonal identities,' and 'locus of control.' Quantitative analyses further supported identified links of these constructs. Subjects experienced their AVHs as having identities distinct from self and actively engaged with their AVHs experienced a greater sense of autonomy and control over AVHs. DISCUSSION Given the clinical importance of AVHs and emerging strategies targeting the relationship between the hearer and voices, our findings highlight the importance of these relational constructs in improvement and innovation of clinical interventions. Our analyses also underscore the value of detailed voice assessments such as those provided by the Maastricht Interview are needed in the evaluation process. Subjects narratives shows that the relational phenomena between hearer and AVH(s) is dynamic, and can be influenced and changed through the hearers' engagement, conversation, and negotiation with their voices.
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Affiliation(s)
- C Rosen
- University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, USA
| | - N Jones
- Stanford University, Department of Anthropology, 450 Serra Mall, Stanford, USA
| | - KA Chase
- University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, USA
| | - LS Grossman
- University of Illinois at Chicago, Neuropsychiatric Institute, Department of Psychiatry, USA
| | - H Gin
- University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, USA
| | - RP Sharma
- University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, USA
- Jesse Brown Veterans Affairs Medical Center, USA
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Aparicio M, Gin H, de Precigout V, Marot D, Winnock S, Morel D, Bouchet JL, Potaux L. Compliance with low-protein diet by uremic patients: three years' experience. Contrib Nephrol 2015; 81:71-8. [PMID: 2093514 DOI: 10.1159/000418738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- M Aparicio
- Département de Néphrologie, Hôpital du Tripode, Bordeaux, France
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Rigalleau V, Cougnard-Gregoire A, Nov S, Gonzalez C, Maury E, Lorrain S, Gin H, Barberger-Gateau P. Association of advanced glycation end products and chronic kidney disease with macroangiopathy in type 2 diabetes. J Diabetes Complications 2015; 29:270-4. [PMID: 25468311 DOI: 10.1016/j.jdiacomp.2014.10.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/21/2014] [Accepted: 10/23/2014] [Indexed: 11/16/2022]
Abstract
AIMS Accumulation of advanced glycation end-products (AGEs), may explain the major contribution of chronic kidney disease (CKD) to cardiovascular events in patients with type 2 diabetes (T2D) related to their impaired renal function. The aim of this study was to analyze the factors associated with AGE assessed by skin autofluorescence and their association with macroangiopathy in T2D. METHODS We measured skin autofluorescence in patients hospitalized for T2D. Glomerular filtration rates were estimated (eGFR) by the EPI-CKD formula. Associations between skin autofluorescence, renal function and macroangiopathy were explored by multivariate analyses adjusting for diabetes duration and control. RESULTS The 418 patients had T2D since 13.3 (SD 9.8) years on average, high mean HbA1C: 8.9%, (SD 1.8), (74 mmol/mol, (SD 15)) and often renal complications (49.4% with CKD). Their mean skin autofluorescence was 2.53 (SD 0.62) A.U. In multivariate linear regression, skin autofluorescence was significantly associated with age (+0.20 for ten more years, p<0.0001), renal insufficiency (-0.07 for less 10 mL/min/1.73 m² eGFR, p<0.0001) and smoking (+0.21, p=0.0004). Autofluorescence (p=0.01), but not CKD, was associated with macroangiopathy independent of diabetes duration and control. CONCLUSIONS Accumulation of AGEs is independently associated with renal insufficiency and macroangiopathy in patients with T2D.
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Affiliation(s)
- V Rigalleau
- Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
| | - A Cougnard-Gregoire
- Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - S Nov
- Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - C Gonzalez
- Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France
| | - E Maury
- Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - S Lorrain
- Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - H Gin
- Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France
| | - P Barberger-Gateau
- Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
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Rajaobelina K, Cougnard-Gregoire A, Delcourt C, Gin H, Barberger-Gateau P, Rigalleau V. P234: L’autofluorescence cutanée des produits de glycation avancés : marqueur de mémoire métabolique chez les personnes âgées. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70876-3] [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: 10/24/2022]
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El Hamrani D, Bouzier-Sore A, Gin H, Gallis J, Beauvieux M. O51: Augmentation rapide du métabolisme glucidique cérébral au cours d’un régime de type « Western » comportant du fructose et/ou un apport modéré d’éthanol : étude par spectroscopie de résonance magnétique nucléaire chez le rat. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70627-2] [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: 11/17/2022]
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Berger L, Rossi J, Domenge F, Calleja J, Gin H, Rigalleau V. Influence de chaussures thérapeutiques sur la répartition des pressions plantaires chez le sujet sain. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.476] [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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Berger L, Rossi J, Domenge F, Calleja J, Gin H, Rigalleau V. Effects of therapeutic shoes on plantar pressure distribution on healthy subjects. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.436] [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: 11/28/2022]
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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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Maury E, Savel J, Grouthier V, Lorrain S, Gonzalez C, Gin H, Barberger-Gateau P, Rigalleau V. P083 Autofluorescence cutanée : un marqueur de la mémoire métabolique chez les patientes enceintes diabétiques. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70415-1] [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: 12/01/2022]
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Beauvieux MC, Naulin J, Bouzier-Sore AK, Sumessur T, de Mascarel A, Castaing C, Gin H, Gallis JL. P108 Le fructose, caractéristique d’un régime de type Western, induit des changements précoces dans les profils métaboliques. Étude RMN dans le foie et le tissu adipeux chez le rat. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70440-0] [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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Genevieve M, Vivot A, Gonzalez C, Raffaitin C, Barberger-Gateau P, Gin H, Rigalleau V. Skin autofluorescence is associated with past glycaemic control and complications in type 1 diabetes mellitus. Diabetes Metab 2013; 39:349-54. [PMID: 23643347 DOI: 10.1016/j.diabet.2013.03.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 03/01/2013] [Accepted: 03/12/2013] [Indexed: 11/20/2022]
Abstract
As skin autofluorescence (AF) can assess subcutaneous accumulation of fluorescent advanced glycation end-products (AGEs), this study aimed to investigate whether it was linked to glycaemic control and complications in patients with type 1 diabetes mellitus (T1DM). Using the AGE Reader™, AF was measured in T1DM patients referred to Haut-Levêque Hospital (Bordeaux, France); data on their HbA1c levels measured every 6months as far back as the last 5years were also collected. The association of AF with the patients' past glucose control, based on their latest HbA1c values, and the means of the last five and 10 HbA1c values, and with diabetic complications was also examined by linear regression analysis. The sample included 300 patients: 58% were male; the mean age was 49 (SD 17) years and the mean diabetes duration was 21 (SD 13) years. The median skin AF measurement was 2.0 [25th-75th percentiles: 1.7-2.4] arbitrary units (AU), and this was associated with age (β=0.15 per 10years, P<0.001) and diabetes duration (β=0.17 per 10years, P<0.001). After adjusting for age and estimated glomerular filtration rate (eGFR), the skin AF measurement was also related to the means of the last five and 10 HbA1c values (β=0.10 per 1% of HbA1c, P=0.005, and β=0.13 per 1% of HbA1c, P=0.001, respectively). In addition, the skin AF was associated with retinopathy (P<0.001), albuminuria (P<0.001) and decreased eGFR (P<0.001). In conclusion, the skin AF is related to the long-term glucose control and diabetic complications.
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Affiliation(s)
- M Genevieve
- Nutrition-Diabétologie, Bordeaux hospital, 33600 Pessac, France; Université Bordeaux Segalen, 33000 Bordeaux, France
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Berger L, Domengé F, Calleja J, Gin H, Rigalleau V. Effets de la chaussure thérapeutique de décharge avec ou sans orthèse plantaire sur le contrôle postural chez le sujet sain. Neurophysiol Clin 2012. [DOI: 10.1016/j.neucli.2012.09.081] [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: 11/25/2022] Open
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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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Blin P, Lassalle R, Dureau-Pournin C, Ambrosino B, Bernard MA, Abouelfath A, Gin H, Le Jeunne C, Pariente A, Droz C, Moore N. Insulin glargine and risk of cancer: a cohort study in the French National Healthcare Insurance Database. Diabetologia 2012; 55:644-53. [PMID: 22222504 PMCID: PMC3268990 DOI: 10.1007/s00125-011-2429-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [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: 06/06/2011] [Accepted: 12/02/2011] [Indexed: 01/07/2023]
Abstract
AIMS/HYPOTHESIS Using the Echantillon Généraliste de Bénéficiaires: random 1/97 permanent sample of the French national healthcare insurance system database (EGB), we investigated whether, as previously suspected, the risk of cancer in insulin glargine (A21Gly,B31Arg,B32Arg human insulin) users is higher than in human insulin users. The investigation period was from 1 January 2003 to 30 June 2010. METHODS We used Cox proportional hazards time-dependent models that were stratified on propensity score quartiles for use of insulin glargine vs human insulin, and adjusted for insulin, biguanide and sulfonylurea possession rates to assess the risk of cancer or death in all or incident exclusive or predominant (≥ 80% use time) users of insulin glargine compared with equivalent human insulin users. RESULTS Only type 2 diabetic patients were studied. Exposure rates varied from 2,273 and 614 patient-years for incident exclusive users of insulin glargine or human insulin, respectively, to 3125 and 2341 patient-years for all patients predominantly using insulin glargine or human insulin, respectively. All-type cancer HRs with insulin glargine vs human insulin ranged from 0.59 (95% CI 0.28, 1.25) in incident exclusive users to 0.58 (95% CI 0.34, 1.01) in all predominant users. Cancer risk increased with exposure to insulin or sulfonylureas in these patients. Adjusted HRs for death or cancer associated with insulin glargine compared with human insulin ranged from 0.58 (95% CI 0.32, 1.06) to 0.56 (95% CI 0.36, 0.87). CONCLUSIONS/INTERPRETATION There was no excess risk of cancer in type 2 diabetic patients on insulin glargine alone compared with those on human insulin alone. The overall risk of death or cancer in patients on insulin glargine was about half that of patients on human insulin, thereby excluding a competitive risk bias.
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Affiliation(s)
- P. Blin
- Department of Pharmacology, Bat du Tondu, Case 40, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
- Inserm CIC-P0005, Bordeaux, France
| | - R. Lassalle
- Department of Pharmacology, Bat du Tondu, Case 40, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
- Inserm CIC-P0005, Bordeaux, France
| | - C. Dureau-Pournin
- Department of Pharmacology, Bat du Tondu, Case 40, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
- Inserm CIC-P0005, Bordeaux, France
| | - B. Ambrosino
- Department of Pharmacology, Bat du Tondu, Case 40, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
- Inserm CIC-P0005, Bordeaux, France
| | - M. A. Bernard
- Department of Pharmacology, Bat du Tondu, Case 40, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
- Inserm CIC-P0005, Bordeaux, France
| | - A. Abouelfath
- Department of Pharmacology, Bat du Tondu, Case 40, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
- Inserm CIC-P0005, Bordeaux, France
| | - H. Gin
- CHU de Bordeaux, Bordeaux, France
- Université Bordeaux Segalen, Bordeaux, France
| | | | - A. Pariente
- Department of Pharmacology, Bat du Tondu, Case 40, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
- Inserm CIC-P0005, Bordeaux, France
- CHU de Bordeaux, Bordeaux, France
- Inserm U657, Bordeaux, France
| | - C. Droz
- Department of Pharmacology, Bat du Tondu, Case 40, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
- Inserm CIC-P0005, Bordeaux, France
- Inserm U657, Bordeaux, France
| | - N. Moore
- Department of Pharmacology, Bat du Tondu, Case 40, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France
- Inserm CIC-P0005, Bordeaux, France
- CHU de Bordeaux, Bordeaux, France
- Inserm U657, Bordeaux, France
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Gonzalez C, De Ledinghen V, Vergniol J, Foucher J, Chermak F, Carlier S, Maury E, Cherifi B, Gin H, Rigalleau V. P070 La stéatose hépatique des patients biopsiés pour NASH est associée à leurs apports alimentaires glucidiques. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70137-6] [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: 10/14/2022]
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Pierreisnard A, Gin H, Schaeverbeke T, Barnetche T, Gonzalez C, Richez C, Poursac N, Rigalleau V. P199 Effets métaboliques d’un inhibiteur du récepteur de l’interleukine-6 dans la polyarthrite rhumatoïde : étude prospective. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70266-7] [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: 11/26/2022]
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Rubin S, Le Piffer AL, Rougier MB, Korobelnik JF, Goizet C, Marchal C, Mesli S, Redonnet-Vernhet I, Gonzalez C, Gin H, Rigalleau V. P200 Cécité corticale régressive sous diététique chez un adulte porteur de phénylcétonurie. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70267-9] [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: 10/14/2022]
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Hartemann A, Attal N, Bouhassira D, Dumont I, Gin H, Jeanne S, Said G, Richard JL. Painful diabetic neuropathy: Diagnosis and management. Diabetes & Metabolism 2011; 37:377-88. [DOI: 10.1016/j.diabet.2011.06.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 06/13/2011] [Indexed: 01/01/2023]
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Grelaud A, Grolleau A, Demeaux JL, Abouelfath A, Boisseau MR, Lassalle R, Toussaint C, Robinson P, Guérard M, Droz-Perroteau C, Gin H, Moore N. Résultats de Prisme ; une étude pilote sur l’effet à un an d’une prise en charge multidisciplinaire du syndrome métabolique. Rev Epidemiol Sante Publique 2011. [DOI: 10.1016/j.respe.2011.08.054] [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: 11/25/2022] Open
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Bonnet F, Gauthier E, Gin H, Hadjadj S, Halimi JM, Hannedouche T, Rigalleau V, Romand D, Roussel R, Zaoui P. Expert consensus on management of diabetic patients with impairment of renal function. Diabetes & Metabolism 2011; 37 Suppl 2:S1-25. [DOI: 10.1016/s1262-3636(11)70961-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Genevieve M, Gonzalez C, Raffaitin C, Gin H, Rigalleau V. L’autofluorescence cutanée est associée à la sévérité de la néphropathie chez le patient diabétique de type 1. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.221] [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: 10/17/2022]
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Gin H, Baudoin R, Raffaitin CH, Rigalleau V, Gonzalez C. Non-invasive and quantitative assessment of sudomotor function for peripheral diabetic neuropathy evaluation. Diabetes Metab 2011; 37:527-32. [PMID: 21715211 DOI: 10.1016/j.diabet.2011.05.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 05/03/2011] [Accepted: 05/04/2011] [Indexed: 10/18/2022]
Abstract
AIMS Perturbation of pain sensation is considered one of the major initiating risk factors for diabetic foot ulcer. Sweat dysfunction leading to abnormal skin conditions, including dryness and fissures, can increase foot ulcer risk. The aim of this study was to evaluate Sudoscan™, a new, quick, non-invasive and quantitative method of measuring sudomotor dysfunction as a co-indicator of the severity of diabetic polyneuropathy (DPN). METHODS A total of 142 diabetic patients (age 62±18 years, diabetes duration 13±14 years, HbA(1c) 8.9±2.5%) were measured for vibration perception threshold (VPT), using a biothesiometer, and for sudomotor dysfunction, using electrochemical sweat conductance (ESC) based on the electrochemical reaction between sweat chloride and electrodes in contact with the hands and feet. Retinopathy status was also assessed, as well as reproducibility between two ESC measurements and the effect of glycaemia levels. RESULTS ESC measurements in the feet of patients showed a descending trend from 66±17 μS to 43±39 μS, corresponding to an ascending trend in VPT threshold from <15 V to >25 V (P=0.001). Correlation between VPT and ESC was -0.45 (P<0.0001). Foot ESC was lower in patients with fissures, while VPT was comparable. Both VPT and foot ESC correlated with retinopathy status. Bland-Altman plots indicated good reproducibility between two measurements, and between low and high glycaemia levels. CONCLUSION Sudoscan™ is a reproducible technique with results that are not influenced by blood glucose levels. Sweating status may be a quantitative indicator of the severity of polyneuropathy that may be useful for the early prevention of foot skin lesions.
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Affiliation(s)
- H Gin
- Service de diabétologie, hôpital Haut-Lévêque, 33604 Pessac, France.
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Rigalleau V, Beauvieux MC, Gonzalez C, Raffaitin C, Lasseur C, Combe C, Chauveau P, De la Faille R, Rigothier C, Barthe N, Gin H. Estimation of renal function in patients with diabetes. Diabetes Metab 2011; 37:359-66. [PMID: 21680218 DOI: 10.1016/j.diabet.2011.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 05/07/2011] [Indexed: 01/02/2023]
Abstract
Diabetes is the leading cause of chronic kidney disease (CKD), which makes estimation of renal function crucial. Serum creatinine is not an ideal marker of glomerular filtration rate (GFR), which also depends on digestive absorption, and the production of creatinine in muscle and its tubular secretion. Formulas have been devised to estimate GFR from serum creatinine but, given the wide range of GFR, proteinuria, body mass index and specific influence of glycaemia on GFR, the uncertainty of these estimations is a particular concern for patients with diabetes. The most popular recommended formulas are the simple Cockcroft-Gault equation, which is inaccurate and biased, as it calculates clearance of creatinine in proportion to body weight, and the MDRD equation, which is more accurate, but systematically underestimates normal and high GFR, being established by a statistical analysis of results from renal-insufficient patients. This underestimation explains why the MDRD equation is repeatedly found to give a poor estimation of GFR in patients with recently diagnosed diabetes and is a poor tool for reflecting GFR decline when started from normal, as well as the source of unexpected results when applied to epidemiological studies with a 60mL/min/1.73m(2) threshold as the definition of CKD. The more recent creatinine-based formula, the Mayo Clinic Quadratic (MCQ) equation, and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) improve such underestimation, as both were derived from populations that included subjects with normal renal function. Determination of cystatin C is also promising, but needs standardisation.
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Affiliation(s)
- V Rigalleau
- Service de Nutrition-Diabétologie, Hôpital Haut-Lévêque, avenue de Magellan, 33600 Pessac, France.
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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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Raffaitin C, Féart C, Le Goff M, Amieva H, Helmer C, Akbaraly TN, Tzourio C, Gin H, Barberger-Gateau P. Metabolic syndrome and cognitive decline in French elders: the Three-City Study. Neurology 2011; 76:518-25. [PMID: 21288982 DOI: 10.1212/wnl.0b013e31820b7656] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine associations between metabolic syndrome (MetS) and its individual components with risk of cognitive decline on specific cognitive functions. METHODS Participants were 4,323 women and 2,764 men aged 65 and over enrolled in the longitudinal Three-City Study. Cognitive decline, defined as being in the worst quintile of the distribution of the difference between baseline score and either 2- or 4-year follow-up, was assessed by the Mini-Mental State Examination (MMSE, global cognitive function), the Isaacs Set Test (IST, verbal fluency), and the Benton Visual Retention Test (BVRT, visual working memory). MetS was defined by National Cholesterol Education Program-Adult Treatment Panel III criteria (at least 3 of 5 cardio-metabolic abnormalities: hypertension, high waist circumference, hypertriglyceridemia, low high-density lipoprotein [HDL] cholesterol, hyperglycemia). Proportional hazards models were adjusted for age, gender, educational level, center, baseline cognitive score, APOE4 genotype, and other potential confounders. RESULTS MetS at baseline was associated with an increased risk of cognitive decline on MMSE (hazard ratio [HR] = 1.22 [1.08-1.37]; p = 0.001) and BVRT (HR = 1.13 [1.01-1.26]; p = 0.03) but not on IST (HR = 1.11 [0.95-1.29]; p = 0.18). Among MetS components, hypertriglyceridemia and low HDL cholesterol were significantly associated with higher decline on MMSE; diabetes, but not elevated fasting glycemia, was significantly associated with higher decline on BVRT and IST. CONCLUSIONS MetS as a whole and several of its components had a negative impact on global cognitive decline and specific cognitive functions in older persons.
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Affiliation(s)
- C Raffaitin
- Diabetology–Nutrition Unit, University Hospital of Bordeaux, Pessac, France.
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Rigalleau V, Beauvieux MC, Gallis JL, Gin H, Schneiter P, Tappy L. Glucose flux in controlled hyperglycaemia before and after oral glucose ingestion in men with mild type 2 diabetes. Diabetes & Metabolism 2010; 36:234-9. [DOI: 10.1016/j.diabet.2010.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 01/07/2010] [Accepted: 01/11/2010] [Indexed: 11/17/2022]
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Bairras C, Redonnet A, Dabadie H, Gin H, Atgie C, Pallet V, Higueret P, Noël-Suberville C. RARgamma and TRbeta expressions are decreased in PBMC and SWAT of obese subjects in weight gain. J Physiol Biochem 2010; 66:29-37. [PMID: 20387030 DOI: 10.1007/s13105-010-0006-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Accepted: 01/22/2010] [Indexed: 10/19/2022]
Abstract
In order to evaluate the expression of nuclear receptors at the peripheral level in obese subjects, messenger RNA (mRNA) levels of different isoforms of retinoic acid receptor (RAR), triiodothyronine (TR), and peroxisome proliferator-activated receptor (PPAR) were determined and compared in peripheral mononuclear blood cells (PBMC) and subcutaneous white adipose tissue (SWAT). Twelve lean subjects and 68 obese subjects divided into weight gain (WG), weight-stable (WS), and weight loss (WL) groups were studied. Nuclear receptor mRNA levels were assessed in PBMC and SWAT using a quantitative real-time reverse transcription polymerase chain reaction method. mRNA levels of RARgamma were significantly lower in PBMC of obese subjects (WG -19%, WS -30%, and WL -24.7%) as in SWAT of WG (-50%). Lower mRNA levels of TRbeta were observed in PBMC and SWAT of WG (-50.7% and -28%, respectively) just as for TRalpha in PBMC of WG (-19%). In contrast, retinoid X receptors alpha (RXRalpha) and RARalpha mRNA levels were higher in PBMC of obese subjects (+53% and +54.5% in WG, +56% and +67% in WS, and +68% and +49.7% in WL, respectively), while expression of RXRalpha was lower in SWAT of WG (-24.5%). As for PPARgamma, its mRNA level was significantly higher in PBMC of WG subjects (+34%) while its expression was not modified in SWAT, contrary to the PPARgamma2 isoform which was significantly higher. These data show that in both adipose tissue and blood compartment of obese subjects, expressions of RARgamma and TRbeta were downregulated. Thus, we suggest that the expression in PBMC of obese subjects may constitute new cellular indicators of nuclear receptor retinoid and thyroid status.
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Affiliation(s)
- C Bairras
- Unité de Nutrition et Neurosciences (U2N), Université Bordeaux 1, Avenue des Facultés, 33405 Talence, France
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Marre M, Pinget M, Gin H, Thivolet C, Hanaire H, Robert JJ, Fontaine P. Insulin detemir improves glycaemic control with less hypoglycaemia and no weight gain: 52-week data from the PREDICTIVE study in a cohort of French patients with type 1 or type 2 diabetes. Diabetes Metab 2010; 35:469-75. [PMID: 19914118 DOI: 10.1016/j.diabet.2009.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Revised: 05/29/2009] [Accepted: 06/24/2009] [Indexed: 10/20/2022]
Abstract
AIM PREDICTIVE (an ongoing multinational observational study) provides an opportunity to explore the impact of insulin detemir use in routine clinical practice. Here, we report on long-term (52-week) data from a French cohort of patients (n=1772), comprising 643 with type 1 diabetes and 1129 with type 2 diabetes. METHODS Patients were prescribed insulin detemir at their physician's discretion and assessed at various visits (baseline, 12 weeks, 26 weeks and 52 weeks). The primary endpoint was the frequency of serious adverse drug reactions, including major hypoglycaemia. Secondary endpoints included minor and nocturnal hypoglycaemia, glycaemic control (HbA(1c), fasting blood glucose and variability of fasting blood glucose) and weight change. RESULTS The incidence of serious adverse drug reactions was low throughout the study, seen in 10 patients with type 1 diabetes (14 events, 1.6%) and seven with type 2 diabetes (seven events, 0.6%). In both type 1 and type 2 diabetes cohorts, the overall minor and nocturnal hypoglycaemic events were reduced from baseline (P<0.001), with no clinically significant changes in weight from baseline to endpoint. After 52 weeks of treatment with insulin detemir, glycaemic control improved, with reductions in: HbA(1c), by -0.6% and -0.8% in type 1 and type 2 diabetes patients, respectively; fasting blood glucose, by -1.4mmol/L and -1.9mmol/L respectively; and FBG variability, by -0.8mmol/L and -0.3mmol/L, respectively (P<0.0001 for all). CONCLUSION Patients treated with insulin detemir in a clinical healthcare setting improved their glycaemic control with no increases in hypoglycaemia, adverse events or weight compared with baseline.
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Affiliation(s)
- M Marre
- Department of Endocrinology, Diabetology and Nutrition, Bichat Claude Bernard Hospital, Paris cedex 18, 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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Laloi-Michelin M, Meas T, Ambonville C, Bellanné-Chantelot C, Beaufils S, Massin P, Vialettes B, Gin H, Timsit J, Bauduceau B, Bernard L, Bertin E, Blickle JF, Cahen-Varsaux J, Cailleba A, Casanova S, Cathebras P, Charpentier G, Chedin P, Crea T, Delemer B, Dubois-Laforgue D, Duchemin F, Ducluzeau PH, Bouhanick B, Dusselier L, Gabreau T, Grimaldi A, Guerci B, Jacquin V, Kaloustian E, Larger E, Lecleire-Collet A, Lorenzini F, Louis J, Mausset J, Murat A, Nadler-Fluteau S, Olivier F, Paquis-Flucklinger V, Paris-Bockel D, Raynaud I, Reznik Y, Riveline JP, Schneebeli S, Sonnet E, Sola-Gazagnes A, Thomas JL, Trabulsi B, Virally M, Guillausseau PJ. The clinical variability of maternally inherited diabetes and deafness is associated with the degree of heteroplasmy in blood leukocytes. J Clin Endocrinol Metab 2009; 94:3025-30. [PMID: 19470619 DOI: 10.1210/jc.2008-2680] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [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: 01/01/2023]
Abstract
CONTEXT Maternally inherited diabetes and deafness (MIDD) is a rare form of diabetes with a matrilineal transmission, sensorineural hearing loss, and macular pattern dystrophy due to an A to G transition at position 3243 of mitochondrial DNA (mtDNA) (m.3243A>G). The phenotypic heterogeneity of MIDD may be the consequence of different levels of mutated mtDNA among mitochondria in a given tissue. OBJECTIVE The aim of the present study was thus to ascertain the correlation between the severity of the phenotype in patients with MIDD and the level of heteroplasmy in the blood leukocytes. PARTICIPANTS The GEDIAM prospective multicenter register was initiated in 1995. Eighty-nine Europid patients from this register, with MIDD and the mtDNA 3243A>G mutation, were included. Patients with MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) or with mitochondrial diabetes related to other mutations or to deletions of mtDNA were excluded. RESULTS A significant negative correlation was found between levels of heteroplasmy and age of the patients at the time of sampling for molecular analysis, age at the diagnosis of diabetes, and body mass index. After adjustment for age at sampling for molecular study and gender, the correlation between heteroplasmy levels and age at the diagnosis of diabetes was no more significant. The two other correlations remained significant. A significant positive correlation between levels of heteroplasmy and HbA(1c) was also found and remained significant after adjustment for age at molecular sampling and gender. CONCLUSIONS These results support the hypothesis that heteroplasmy levels are at least one of the determinants of the severity of the phenotype in MIDD.
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Affiliation(s)
- M Laloi-Michelin
- Department of Internal Medicine B, Hôpital Lariboisière, 2 Rue Ambroise Paré, Paris Cedex 10, France
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Raffaitin C, Gin H, Empana J, Helmer C, Berr C, Tzourio C, Portet F, Dartigues J, Alperovitch A, Barberger-Gateau P. P88 Syndrome métabolique et risque de maladie d’Alzheimer ou de démence vasculaire incidente : étude au sein de la cohorte 3C. Diabetes & Metabolism 2009. [DOI: 10.1016/s1262-3636(09)71886-5] [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: 11/16/2022]
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Raffaitin C, Gin H, Empana JP, Helmer C, Berr C, Tzourio C, Portet F, Dartigues JF, Alpérovitch A, Barberger-Gateau P. Syndrome métabolique et risque de maladie d’Alzheimer ou de démence vasculaire incidente : étude au sein de la cohorte 3C. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.162] [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: 11/25/2022] Open
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Andrieu S, Barberger-Gateau P, Raffaitin C, Berr C, Tzourio C, Dartigues JF, Gin H, Fitten LJ, Ortiz F, Fairbanks L, Bartzokis G, Lu P, Ringman J, Heyn PC, Locher JL, Salvà A, Andrieu S, Fernández E, Vellas B, van de Rest O, Geleijnse JM, Kok FJ, van Staveren WA, Beekman ATF, Hoefnagels WHL, de Groot CPGM, Angevaren M, Aufdemkampe G, Verhaar HJJ, Aleman A, Vannees L, Arkin S, Florez H, Gerstein H, Sheridan P, Bosch J, Goldberg R, Kaspar KM, Drawert SM, Marcus RL, Kidde J, Dibble L, Addison O, LaStayo PC, Scarmeas N, Stern Y, Schupf N, Luchsinger JA, Sharkey JR, Laditka JN, Laditka SB, Liu R, Hochhalter A, Robare JF, Türner N, Judge M, Foster TC, Erdos B, Cudykier I, Scarpace PJ, Weiss LA, Bergstrom J, Kritz-Silverstein D, Barrett-Connor E, Yurko-Mauro K, Nelson E, Quinn J, Sattler FR, Castaneda-Sceppa C, Binder EF, Schroeder ET, Wang Y, Bhasin S, Kawakubo M, Stewart Y, Hahn C, Colletti P, Roubenoff R, Yarasheski KE, Azen SP, Aoki Y, Yamamoto T, Otuka T, Blanc-Bisson C, Bourdel-Marchasson I, Bocock MA, Keller HH, Bowman G, Baxter J, Oken B, Frei B, Traber M, Leonard S, Kaye J, Shannon J, Quinn J, Carlsson M, Gustafson Y, Eriksson S, Littbrand H, Håglin L, Danthiir V, Wilson C, Nettelbeck T, Burns N, Wittert G, Noakes M, Clifton P, DiMaria-Ghalili RA, Grieger JA, Nowson CA, Wattanapenpaiboon NT, Holstein J, Robinson C, Hartmann C, Rueb S, Heffel L, Dintaman S, Reynolds J, Fleming L, Crull M, Goldey J, Serper LL, Hubbard R, Westengard J, Horning M, Ishige Y, Aoki Y, Keller HH, Keller HH, LaStayo PC, Marcus RL, Smith S, Kidde J, Dibble L, Butler C, Hill M, LaStayo PC, Marcus RL, Dibble L, Kidde J, Peters C, Meier W, Laughlin GA, Kritz-Silverstein D, von Muhlen D, Barrett-Connor E, Olariu L, Petcu M, Tulcan C, Pup M, Otilingam P, Gate M, Pasinetti GM, Ray B, Chauhan NB, Bailey JA, Lahiri DK, Shatenstein B, Kergoat MJ, Reid I, Chicoine ME, Vaz L, Stewart R, Sabbah W, Tsakos G, D’Aiuto F, Watt RG, Sturman M, Kelly J, Fleischman D, Leurgans S, Bennett D, Morris MC, Suominen MH, Muurinen S, Soini H, Pitkälä KH, Yamamoto T, Fujinoki C, Aoki Y. 3rd IANA (International Academy on Nutrition and Aging) Meeting Nutrition, Exercise & Alzheimer and Clinical Trials on Sarcopenia August 1–2, 2008 Hyatt Regency Tamaya Resort 1300 Tuyuna Trail Santa Ana Pueblo, NM USA. J Nutr Health Aging 2008. [DOI: 10.1007/bf02982702] [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: 10/21/2022]
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Massin P, Dubois-Laforgue D, Meas T, Laloi-Michelin M, Gin H, Bauduceau B, Bellanné-Chantelot C, Bertin E, Blickle JF, Bouhanick B, Cahen-Varsaux J, Casanova S, Charpentier G, Chedin P, Dupuy O, Grimaldi A, Guerci B, Kaloustian E, Lecleire-Collet A, Lorenzini F, Murat A, Narbonne H, Olivier F, Paquis-Flucklinger V, Virally M, Vincenot M, Vialettes B, Timsit J, Guillausseau PJ. Retinal and renal complications in patients with a mutation of mitochondrial DNA at position 3,243 (maternally inherited diabetes and deafness). A case-control study. Diabetologia 2008; 51:1664-70. [PMID: 18581092 DOI: 10.1007/s00125-008-1073-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [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] [Received: 02/28/2008] [Accepted: 05/19/2008] [Indexed: 11/25/2022]
Abstract
AIMS/HYPOTHESIS We assessed the prevalence and determinants of retinal and renal complications in patients with maternally inherited diabetes and deafness (MIDD). METHODS This was a multicentre prospective study comparing the prevalence of retinopathy and renal disease in 74 patients with MIDD and 134 control patients matched for sex, age and clinical presentation at onset of diabetes, duration of diabetes and current treatment. Comparisons were adjusted for HbA(1c) and hypertension. RESULTS In MIDD patients, HbA(1c) (7.6 +/- 1.6 vs 8.5 +/- 2.0%, p < 0.002), systolic blood pressure (126.6 +/- 16.2 vs 133.1 +/- 17.3 mmHg, p < 0.007) and prevalence of hypertension (33.8 vs 64.2%, p < 0.0001) were lower than in control patients. Prevalence of diabetic retinopathy was 3.7-fold lower in MIDD patients (6/74, 8 vs 40/134, 29.6%, p < 0.0001). Differences between groups remained significant after adjustment for hypertension, systolic blood pressure and HbA(1c). In MIDD, urinary albumin excretion (314.8 vs 80.1 mg/24 h, p = 0.035) and creatinine plasma levels (103.5 vs 82.2 micromol/l, p = 0.0178) were higher and GFR was lower. Impaired renal function (GFR <60 ml/min) was four- to sixfold more frequent in MIDD. Differences between MIDD and control diabetic patients further increased when adjusted for HbA(1c) and systolic blood pressure (p < 0.0001). Adjustment for treatment with an ACE inhibitor or angiotensin II receptor antagonist did not modify the results. CONCLUSIONS/INTERPRETATION This study indicates that diabetic retinopathy is less prevalent in MIDD than in control diabetes. This suggests that retinal alterations due to mitochondrial disease may have a protective role. By contrast, nephropathy is far more frequent in MIDD, suggesting the presence of a specific renal disease independent of diabetic nephropathy.
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Affiliation(s)
- P Massin
- APHP, Department of Ophthalmology, Lariboisiere Hospital, University Paris 7 Denis-Diderot, Paris, France
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Rigalleau V, Beauvieux MC, Le Moigne F, Lasseur C, Chauveau P, Raffaitin C, Perlemoine C, Barthe N, Combe C, Gin H. Cystatin C improves the diagnosis and stratification of chronic kidney disease, and the estimation of glomerular filtration rate in diabetes. Diabetes Metab 2008; 34:482-9. [PMID: 18703370 DOI: 10.1016/j.diabet.2008.03.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2007] [Revised: 03/16/2008] [Accepted: 03/19/2008] [Indexed: 11/26/2022]
Abstract
AIMS Estimation of glomerular filtration rate (GFR) is recommended to diagnose and stratify chronic kidney disease (CKD). Can cystatin-C (cysC) assay improve the results in diabetic patients? METHODS In 124 diabetic patients with a wide range of GFR, as determined by 51Cr-EDTA clearance (i-GFR), we estimated 'e-GFR' by: the recommended Cockcroft-Gault (CG) formula and Modification of Diet in Renal Disease (MDRD) study equation; the new Mayo Clinic quadratic (MCQ) equation; the recently proposed composite estimation including both serum creatinine and cysC; and a simplified approach dividing the MDRD by cysC if less than 1.10mg/L. RESULTS The highest diagnostic accuracy (receiver operating characteristic [ROC] curves) and the highest proportions of well-stratified patients were obtained by cysC and the MDRD which, however, underestimated i-GFR for patients without CKD (-17%, P<0.001). The CG overestimated GFR in KDOQI stages 1 and 2, ignored stage 5 and was the least accurate. The MCQ equation overrepresented stage 2, overestimating GFR at this stage (+23%, P<0.005). The composite estimation (54.7+/-27.0mL per minute 1.73m(2)) correlated best with i-GFR (56.1+/-35.3; r=0.90, P<0.001), and did not significantly differ from it across the entire population and within each Kidney Disease Outcome Quality Initiative (KDOQI) stage but was also biased (Bland-Altman procedure). Simply dividing the MDRD by cysC ifless than1.10mg/L produced a comparable performance and eliminated the bias. CONCLUSION The recommended creatinine-based estimations of GFR need to be improved. CysC assay helps in the diagnosis and stratification of CKD and leads to better estimates of GFR in diabetic patients without any substantial increase in complexity.
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Affiliation(s)
- V Rigalleau
- Nutrition-diabétologie, hôpital Haut-Lévêque, avenue de Magellan, 33600 Pessac, France; Université de Bordeaux-II Victor-Segalen, 33000 Bordeaux, France.
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Halimi JM, Hadjadj S, Aboyans V, Allaert FA, Artigou JY, Beaufils M, Berrut G, Fauvel JP, Gin H, Nitenberg A, Renversez JC, Rusch E, Valensi P, Cordonnier D. [Microalbuminuria and urinary albumin excretion: French guidelines]. Ann Biol Clin (Paris) 2008; 66:277-284. [PMID: 18558566 DOI: 10.1684/abc.2008.0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
UNLABELLED Measurement of urinary albumin excretion (UAE) may be done on a morning urinary sample or on a 24 hour-urine sample. Values defining microalbuminuria are: - 24-hour urine sample: 30-300 mg/24 hours - Morning urine sample: 20-200 mg/mL or 30-300 mg/g creatinine or 2.5-25 mg/mmol creatinine (men) or 3.5-35 mg/mol (women). - Timed urine sample: 20-200 mug/min. The optimal use of semi-quantitative urine test-strip is not clearly defined. It is generally believed that microalbuminuria reflects a generalized impairment of the endothelium; however, no definite proof has been shown in humans. In diabetic subjects, microalbuminuria is a marker of increased risk of cardiovascular (CV) and renal morbidity and mortality in type 1 and type 2 diabetic subjects. The increase in UAE during follow-up is also a marker of CV and renal risk in type 1 and type 2 diabetic subjects; its decrease during follow-up is associated with lower risks. In non-diabetic subjects, microalbuminuria is a marker of increased risk for diabetes mellitus, deterioration of the renal function, CV morbidity and all-cause mortality. It is a marker of increased risk for the development of hypertension in normotensive subjects, and is associated with unfavorable outcome in patients with cancer and lymphoma. Persistence or elevation of UAE overtime is associated with deleterious outcome in some hypertensive subjects. Measurement of UAE may be recommended in hypertensive subjects with 1 or 2 CV risk factors in whom CV risk remains difficult to assess, and in those with refractory hypertension: microalbuminuria indicates a high CV risk and must lead to strict control of arterial pressure. Studies focused on microalbuminuria in non-diabetic, non-hypertensive subjects are limited; most of them suggest that microalbuminuria predicts CV complications and deleterious outcome as it is in diabetic or hypertensive subjects. Subjects with a history of CV or cerebrovascular disease have an even greater CV risk if microalbuminuria is present than if it is not; however, in all cases, therapeutic intervention must be aggressive regardless of whether microalbuminuria is present or not. It is not recommended to measure UAE in non-diabetic non-hypertensive subjects in the absence of history of renal disease. Monitoring of renal function (UAE, serum creatinine and estimation of GFR) is annually recommended in all subjects with microalbuminuria. MANAGEMENT in patients with microalbuminuria, weight reduction, sodium restriction (< 6 g/day), smoking cessation, strict glucose control in diabetic subjects, strict arterial pressure control are necessary; in diabetic subjects: use of maximal doses of ACEI or ARB are recommended; ACEI/ARB and thiazides have synergistic actions on arterial pressure and reduction of UAE; in non-diabetic subjects, any of the five classes of anti-hypertensive medications (ACEI, ARB, thiazides, calcium channel blockers or beta-blockers) can be used.
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Affiliation(s)
- J M Halimi
- Service de néphrologie-immunologie clinique, CHU de Tours, France.
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Rigalleau V, Lasseur C, Beauvieux MC, Chauveau P, Raffaitin C, Perlemoine C, Barthe N, Combe C, Gin H. Use of metformin according to estimated glomerular filtration rate: the threshold and the equation are important. Diabet Med 2007; 24:1498-9. [PMID: 18042087 DOI: 10.1111/j.1464-5491.2007.02262.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rigalleau V, Beauvieux MC, Lasseur C, Chauveau P, Raffaitin C, Perlemoine C, Barthe N, Combe C, Gin H. Prediction of mortality rate in type 2 diabetes: estimated glomerular filtration rate underestimates the true rate. Diabetologia 2007; 50:2410-1. [PMID: 17846746 DOI: 10.1007/s00125-007-0796-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Accepted: 06/28/2007] [Indexed: 11/24/2022]
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Halimi JM, Hadjadj S, Aboyans V, Allaert FA, Artigou JY, Beaufils M, Berrut G, Fauvel JP, Gin H, Nitenberg A, Renversez JC, Rusch E, Valensi P, Cordonnier D. Microalbuminuria and urinary albumin excretion: French clinical practice guidelines. Diabetes & Metabolism 2007; 33:303-9. [PMID: 17702622 DOI: 10.1016/j.diabet.2007.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Revised: 06/26/2007] [Accepted: 06/27/2007] [Indexed: 11/26/2022]
Abstract
Urinary albumin excretion (UAE) may be assayed on a morning urinary sample or a 24 h-urine sample. Values defining microalbuminuria are: 1) 24-h urine sample: 30-300 mg/24 h; 2) morning urine sample: 20-200 mg/ml or 30-300 mg/g creatinine or 2.5-25 mg/mmol creatinine (men) or 3.5-35 mg/mmol (women); 3) timed urine sample: 20-200 mug/min. The optimal use of semi-quantitative urine test-strip is not clearly defined. It is generally believed that microalbuminuria reflects a generalized impairment of the endothelium; however, no definite proof has been obtained in humans. IN DIABETIC SUBJECTS Microalbuminuria is a marker of increased risk of cardiovascular (CV) and renal morbidity and mortality in type 1 and type 2 diabetic subjects. The increase in UAE during follow-up is associated with greater CV and renal risks in type 1 and type 2 diabetic subjects; its decrease during follow-up is associated with lower risks. IN NON-DIABETIC SUBJECTS: Microalbuminuria is a marker of increased risk for diabetes mellitus, deterioration of renal function, CV morbidity and all-cause mortality. It is a marker of increased risk for the development of hypertension in normotensive subjects, and is associated with unfavorable outcome in patients with cancer and lymphoma. Persistence of elevated UAE during follow-up is associated with poor outcome in some hypertensive subjects. Measurement of UAE may be recommended in hypertensive medium-risk subjects with 1 or 2 CV risk factors in whom CV risk remains difficult to assess, and in those with refractory hypertension: microalbuminuria indicates a high CV risk and must lead to strict control of arterial pressure. Studies focused on microalbuminuria in non-diabetic non-hypertensive subjects are limited; most of them suggest that microalbuminuria predicts CV complications and deleterious outcome. Subjects with a history of CV or cerebrovascular disease have an even greater CV risk if microalbuminuria is present than if it is not; however, in all cases, therapeutic intervention must be aggressive regardless of whether microalbuminuria is present or not. It is not recommended to measure UAE in non-diabetic non-hypertensive subjects in the absence of history of renal disease. Monitoring of renal function (UAE, serum creatinine and estimation of GFR) is recommended annually in all subjects with microalbuminuria. MANAGEMENT In patients with microalbuminuria, weight reduction, sodium restriction (<6 g per day), smoking cessation, strict glucose control in diabetic subjects, strict arterial pressure control are necessary; in diabetic subjects: use of maximal doses of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) are recommended; ACEI/ARB and thiazides have synergistic actions on arterial pressure and reduction of UAE; in non-diabetic subjects, any of the five classes of anti-hypertensive medications (ACEI, ARB, thiazides, calcium channel blockers or beta-blockers) can be used.
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Affiliation(s)
- J-M Halimi
- Service de Néphrologie-Immunologie Clinique, CHU de Tours, 37044 Tours cedex, France.
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Corcuff JB, Krim E, Tison F, Foubert-Sanier A, Guehl D, Burbaud P, Cuny E, Baillet L, Gin H, Rigalleau V, Perlemoine C. Letters to the Editor. Br J Nutr 2007; 95:1028-9. [PMID: 16611397 DOI: 10.1079/bjn20051678] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Dufaitre-Patouraux L, Riveline JP, Renard E, Melki V, Belicar-Schaepelynck P, Selam JL, Guerci B, Millot L, Brun JM, Fermon C, Catargi B, Gin H, Jeandidier N, Lejeune PJ, Lassmann-Vague V. Continuous intraperitoneal insulin infusion does not increase the risk of organ-specific autoimmune disease in type 1 diabetic patients: results of a multicentric, comparative study. Diabetes Metab 2007; 32:427-32. [PMID: 17110897 DOI: 10.1016/s1262-3636(07)70300-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIM The purpose of this national multicenter prospective study by the French EVADIAC group was to investigate the possibility that continuous intraperitoneal insulin infusion using an implanted pump (CIpii) increases the risk of autoimmune disease in type 1 diabetic patients as it increased anti-insulin immunogenicity. METHODS Prevalence of clinical (Hashimoto's disease, hyperthyroidism, gastric atrophic disease and vitiligo) and subclinical (presence of anti-thyroperoxidase antibodies, anti-intrinsic factor antibodies, abnormal TSH levels) autoimmune diseases was estimated by comparing two groups of patients already treated by either CIpii (n=154) or external pump (CSII) (n=121) for an average of 6 years. Incidence of autoimmune disease was determined by comparing the same measurements one year after inclusion. RESULTS No significant difference was observed for the total prevalence of clinical and subclinical auto-immune thyroid and gastric di-seases (35.6% and 3.2% respectively in the CIpii group versus 40.4% and 2.6% in the CSII group). No significant difference for the incidence of clinical and subclinical auto-immune diseases was observed: 7.2% and 0% in CIpii and 7.3% and 1.7% in CSII. CONCLUSION As previously shown AIA (anti-insulin antibodies) levels were higher in CIpii than in CSII (32.9% vs 20.2%, P<0.0001) but no correlation was observed with either clinical or subclinical autoimmune disease. This large-scale study eliminates the possibility that CIpii increases the risk of autoimmune disease.
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Abstract
OBJECTIVE We investigated whether loss of bone is detectable during follow-up of diabetic patients with chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS In 40 initially non-dialysed diabetic patients with CKD (isotopic glomerular filtration rate < 60 ml/min/1.73 m(2) or albumin excretion rate > 30 mg/24 h), body composition (DEXA scan) and glomerular filtration rate (GFR determined from (51)Cr-EDTA clearance) were measured at a 2-year interval, and compared by paired t-tests. RESULTS The 40 patients, mainly with Type 2 diabetes (n = 28), were men (n = 28), aged 65 +/- 11 years, with diabetes duration 18 +/- 11 years. GFR was initially 38.0 (range 8-89) ml/min/1.73 m(2). CKD progressed during follow-up: eight started haemodialysis and GFR declined in the 32 others (P < 0.05 vs. initial). T-scores for total body (initial -0.61 +/- 1.11, final -1.11 +/- 1.40; P < 0.001) and femoral neck (initial -1.88 +/- 0.15, final -2.07 +/- 0.15; P < 0.05) declined. Ten patients were osteopaenic at baseline (no osteoporosis), whereas most were osteopaenic (n = 21, P < 0.05) and five were osteoporotic at final assessment. The 16 patients who became osteopaenic or osteoporotic during follow-up did not differ from the others for the type of diabetes, age, GFR, albumin excretion rate, HbA(1c), GFR reduction and the requirement for dialysis during follow-up. They were all men (P < 0.01 by chi-squared test), with reduced initial total body T-score (-1.20 +/- 0.82, others -0.32 +/- 1.13; P < 0.05) and a lower body mass index (24.6 +/- 4.3; others 27.7 +/- 4.3; P < 0.05). CONCLUSION Bone loss, especially in the femoral neck, is progressive in diabetic patients with CKD.
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Affiliation(s)
- V Rigalleau
- Université de Bordeaux 2-Victor Segalen, Bordeaux, France.
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Gin H, Vambergue A, Vasseur C, Rigalleau V, Dufour P, Roques A, Romon M, Millet D, Hincker P, Fontaine P. Blood ketone monitoring: a comparison between gestational diabetes and non-diabetic pregnant women. Diabetes & Metabolism 2006; 32:592-7. [PMID: 17296512 DOI: 10.1016/s1262-3636(07)70313-0] [Citation(s) in RCA: 18] [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] [Subscribe] [Scholar Register] [Received: 03/20/2006] [Accepted: 06/01/2006] [Indexed: 11/22/2022]
Abstract
AIM To measure ketonemia in a control population of pregnant women and in a population of women with gestational diabetes (GDM). To define a normal ketonemia threshold for the controls and to determine whether or not this value could play a role in the clinical management of women with GDM. METHOD Fifty-six women with a normal OGTT and 49 women with GDM were included and monitored from the 25th to the 37th week of pregnancy. Control subjects agreed to perform glycaemia and ketonemia self-monitoring 3 times a day. In addition, women with GDM were asked to measure their postprandial glycaemia. Glycaemia and ketonemia measurements were performed using Optium meters. Subjects kept a 24-hour food record twice a week. RESULTS The mean ketonemia was lower in the control group than in the GDM group (0.01+/-0.10 vs. 0.04+/-0.009 mmol/l; P<0.001). Ketonemia values measured before the midday meal and prior to the evening meal were lower for control subjects than for GDM patients (P=0.002 and P=0.005). Fasting ketonemia was unrelated to ketonuria in the GDM group, whereas there was a correlation in the control group (P=0.006). At least one chronic increase in ketonemia levels was observed in 47% of the women with GDM, compared with only 12% of controls. The lowest levels of evening glycaemia correlated with the highest levels of ketonemia; women with GDM reported lower food and carbohydrate intakes than controls (P<0.001). CONCLUSION This work has enabled the establishment of ketonemia reference standards in non-diabetic pregnant women. If ketonemia does indeed indicate overly restrictive dietary behavior, this parameter could be employed for monitoring adherence to the nutritional recommendations for GDM.
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Affiliation(s)
- H Gin
- Bordeaux, University Medical Center.
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Richez C, Blanco P, Gin H, Schaeverbeke T. Development of type 1 diabetes mellitus in a patient with rheumatoid arthritis receiving anti-tumor necrosis factor alpha. Clin Exp Rheumatol 2006; 24:607. [PMID: 17181936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
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Abstract
Two attitudes can be proposed, one consisting of making a diagnosis of neuropathy, the other seeking to grade the stage that it has reached in order to give a prognosis and above all determine the right way in which to educate the patient. In order to do this, it is important for the diagnosis to be thorough. It should be based both on listening to what the patient has to say and examining him/her. It is vital to listen to the patient because the warning signs are discreet, yet very evocative, and they will be a great help in making a positive diagnosis. They should not be confused with signs of arterial damage. They should then be interpreted by means of clinical examination and the tools that are available, i.e. essentially monitoring the osteo-tendinous reflexes and sensory signs. The sensory signs can only be studied with high-quality instruments, i.e. either a monofilament of proven technical quality and that should be used with care in line with good clinical practice recommendations, or by using a graduated tuning fork, or a neuroesthesiometer which will make it possible to obtained graduated responses, not simply binary responses of the "yes/no" variety. A whole series of scores have been put forward combining both functional and physical signs, making it possible to try to quantify the stage reached and the extent of the neuropathy. It is only by using a thorough and regularly applied routine that we can progress to establishing a better prognosis and providing a better educational service for the patient.
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Affiliation(s)
- H Gin
- Service de Diabétologie-Nutrition, Université de Bordeaux II, 33604 Pessac, France.
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