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Ardilouze JL, Gobeil F, Cheng R, Ménard J, Bovan D, Messier V, Savard M, Baillargeon JP, Rabasa-Lhoret R. Can a Mixture of Insulin and a Nonsteroidal Anti-inflammatory Drug Prolong Insulin Pump Catheter Wear Time in Adults With Type 1 Diabetes? Can J Diabetes 2023; 47:180-184. [PMID: 36050255 DOI: 10.1016/j.jcjd.2022.07.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/22/2022] [Accepted: 07/29/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Jean-Luc Ardilouze
- Endocrinology Division, University of Sherbrooke, Sherbrooke, Québec, Canada; Research Centre of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada.
| | - Fernand Gobeil
- Research Centre of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada; Pharmacology-Physiology Department, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Ran Cheng
- Institut de recherches cliniques de Montréal, Montréal, Québec, Canada; Endocrinology Division, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Julie Ménard
- Research Centre of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Danijela Bovan
- Institut de recherches cliniques de Montréal, Montréal, Québec, Canada
| | - Virginie Messier
- Institut de recherches cliniques de Montréal, Montréal, Québec, Canada
| | - Martin Savard
- Pharmacology-Physiology Department, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Jean-Patrice Baillargeon
- Endocrinology Division, University of Sherbrooke, Sherbrooke, Québec, Canada; Research Centre of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Rémi Rabasa-Lhoret
- Institut de recherches cliniques de Montréal, Montréal, Québec, Canada; Endocrinology Division, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Department of Nutrition, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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Sotorník R, Suissa R, Ardilouze JL. Could Overt Diabetes Be Triggered by Abuse of Selective Androgen Receptor Modulators and Growth Hormone Secretagogues? A Case Report and Review of the Literature. Clin Diabetes 2022; 40:373-379. [PMID: 35983415 PMCID: PMC9331610 DOI: 10.2337/cd21-0044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Richard Sotorník
- Canadian Medical, Prague, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Jean-Luc Ardilouze
- Division of Endocrinology, University Hospital Center, Sherbrooke, Canada
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Ardilouze A, Bouchard P, Hivert MF, Simard C, Allard C, Garant MP, Ménard J, Ouellet A, Houde G, Pesant MH, Baillargeon JP, Ardilouze JL. Self-Monitoring of Blood Glucose: A Complementary Method Beyond the Oral Glucose Tolerance Test to Identify Hyperglycemia During Pregnancy. Can J Diabetes 2019; 43:627-635. [DOI: 10.1016/j.jcjd.2019.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/24/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
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Taleb N, Messier V, Ott-Braschi S, Ardilouze JL, Rabasa-Lhoret R. Perceptions and experiences of adult patients with type 1 diabetes using continuous subcutaneous insulin infusion therapy: Results of an online survey. Diabetes Res Clin Pract 2018; 144:42-50. [PMID: 30077691 DOI: 10.1016/j.diabres.2018.07.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 03/26/2018] [Revised: 06/28/2018] [Accepted: 07/30/2018] [Indexed: 01/22/2023]
Abstract
AIMS To assess perceptions of patients using subcutaneous insulin infusion (CSII) about metabolic control, pump malfunctions, technical and insertion site adverse events (AEs) related to infusion sets/catheters as well as patients' practices. METHODS Online survey (from June 2016 to January 2017) using an actualized 39-item questionnaire directed to adults with type 1 diabetes (T1D) using CSII therapy and living in the province of Quebec, Canada. RESULTS Participants with T1D (n = 115, 72% females, 39.7 ± 14.0 years, diabetes duration: 20.9 ± 12.2 years, CSII use: 6.2 ± 4.1 years) adequately completed the survey. Infusion sets were changed every 3.3 ± 0.9 day. Improved glucose control and decreased number/severity of hypoglycemic episodes were reported by 80% and 68%/50% of subjects, respectively. Over the past year of CSII use, participants perceived no increase in anxiety/worry (84%), no negative impact on life (89%) or on time off from work/school (82%). Conversely, many experienced at least one clinical AEs at insertion site [pain (84%), adhesion (76%), irritation (69%), lipodystrophy (45%)] and technical issues [blockage (52%), cannula kinking (50%), pump stop (55%), air bubbles (46%)]. No significant association was observed between catheter wear-time and AEs. All participants had one or more problems related to CSII use, although only 37% reported addressing these issues with health professionals. CONCLUSION Our study suggests that patients positively perceived CSII use although they experienced a high frequency of clinical and technical AEs. This warrants further attention by health professionals, investigators and manufacturers to optimize CSII therapy.
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Affiliation(s)
- Nadine Taleb
- Institut de recherches cliniques de Montréal, 110, avenue des Pins Ouest, Montreal, Quebec H2W 1R7, Canada; Department of Biomedical Sciences, Faculty of Medicine, Université de Montréal, 2900, Édouard-Montpetit, Montreal, Quebec H3T 1J4, Canada
| | - Virginie Messier
- Institut de recherches cliniques de Montréal, 110, avenue des Pins Ouest, Montreal, Quebec H2W 1R7, Canada
| | - Sylvie Ott-Braschi
- Institut de recherches cliniques de Montréal, 110, avenue des Pins Ouest, Montreal, Quebec H2W 1R7, Canada; Centre Hospitalier de l'Université de Montréal, 3840, rues Saint-Urbain, Montreal, Quebec H2W 1T8, Canada
| | - Jean-Luc Ardilouze
- Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001-12(e) Avenue Nord, Sherbrooke, Québec J1H 5N4, Canada
| | - Rémi Rabasa-Lhoret
- Institut de recherches cliniques de Montréal, 110, avenue des Pins Ouest, Montreal, Quebec H2W 1R7, Canada; Centre Hospitalier de l'Université de Montréal, 3840, rues Saint-Urbain, Montreal, Quebec H2W 1T8, Canada; Department of Nutrition, Faculty of Medicine, Université de Montréal, 2405, chemin de la Côte-Sainte-Catherine, Montréal, Québec H3T 1A8, Canada; Montreal Diabetes Research Center, 900 Saint-Denis, Montréal, Québec H2X 0A9, Canada.
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Bonato L, Taleb N, Gingras V, Messier V, Gobeil F, Ménard J, Ardilouze JL, Rabasa-Lhoret R. Duration of Catheter Use in Patients with Diabetes Using Continuous Subcutaneous Insulin Infusion: A Review. Diabetes Technol Ther 2018; 20:506-515. [PMID: 29958025 DOI: 10.1089/dia.2018.0110] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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] [Indexed: 12/26/2022]
Abstract
Increasing proportions of patients with diabetes use continuous subcutaneous insulin infusion (CSII) therapy mostly due to its clinical efficacy and flexibility for insulin dosing and adjustments. Some challenges are nevertheless associated with this technology. A key and underlooked component of CSII technical difficulties is the subcutaneous catheter used to infuse insulin. Several adverse events (AEs) have been experienced by patients in relation to catheters, such as blockage, kinking, and insertion site reactions, including irritation, infections, lipohypertrophies etc., all of which could compromise the metabolic control. With the objective of minimizing these AEs, recommendations for changing catheters every 2-3 days have historically been provided by manufacturers based on reports derived from small studies and anecdotal data. The aim of this review was to provide an updated analysis of current recommendations and patients' practices in relation to frequency of catheter change. Our main findings are: (1) adequately designed and powered studies investigating optimal catheter wearing time are still lacking; (2) increasing catheter wearing time is generally associated with increased frequency of catheter AEs; (3) however, interpatient variability is large, with some individuals needing to change their catheters every 2-3 days, whereas others probably being able to keep them in place for longer periods without problems. Further research is thus warranted to provide more solid and evidence-based recommendations while exploring personalized approaches at the same time. Increasing catheter wear life without significant side effects is an important goal to simplify CSII therapy and reduce its associated costs and burdens.
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Affiliation(s)
- Lisa Bonato
- 1 Research Platform on obesity, metabolism and diabetes, Institut de Recherches Cliniques de Montréal (IRCM) , Montréal, Québec, Canada
| | - Nadine Taleb
- 1 Research Platform on obesity, metabolism and diabetes, Institut de Recherches Cliniques de Montréal (IRCM) , Montréal, Québec, Canada
- 2 Department of Biomedical Sciences, Faculty of Medecine, Université de Montréal , Édouard-Montpetit, Montréal, Québec, Canada
| | - Véronique Gingras
- 1 Research Platform on obesity, metabolism and diabetes, Institut de Recherches Cliniques de Montréal (IRCM) , Montréal, Québec, Canada
- 3 Department of Nutrition, Faculty of Medecine, Université de Montréal , Chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada
| | - Virginie Messier
- 1 Research Platform on obesity, metabolism and diabetes, Institut de Recherches Cliniques de Montréal (IRCM) , Montréal, Québec, Canada
| | - Fernand Gobeil
- 4 Department of Pharmacology and Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke , Sherbrooke, Québec, Canada
- 5 Diabetes, obesity and cardiovscular complications axis, Research Center of the Centre Hospitalier Universitaire de Sherbrooke , Sherbrooke, Québec, Canada
| | - Julie Ménard
- 5 Diabetes, obesity and cardiovscular complications axis, Research Center of the Centre Hospitalier Universitaire de Sherbrooke , Sherbrooke, Québec, Canada
| | - Jean-Luc Ardilouze
- 5 Diabetes, obesity and cardiovscular complications axis, Research Center of the Centre Hospitalier Universitaire de Sherbrooke , Sherbrooke, Québec, Canada
- 6 Endocrine Division, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke , Sherbrooke, Québec, Canada
| | - Rémi Rabasa-Lhoret
- 1 Research Platform on obesity, metabolism and diabetes, Institut de Recherches Cliniques de Montréal (IRCM) , Montréal, Québec, Canada
- 3 Department of Nutrition, Faculty of Medecine, Université de Montréal , Chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada
- 7 Montréal Diabetes Research Center , Saint-Denis Montréal, Québec, Canada
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Léveillé- P, Hamel M, Ardilouze JL, Pasquier JC, Deacon C, Whittingstall K, Plourde M. Pilot study of EEG in neonates born to mothers with gestational diabetes mellitus. Int J Dev Neurosci 2018; 66:37-44. [PMID: 29360555 DOI: 10.1016/j.ijdevneu.2018.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/04/2017] [Revised: 01/15/2018] [Accepted: 01/15/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The goal was to evaluate whether there was neurodevelopmental deficits in newborns born to mothers with gestational diabetes mellitus (GDM) compared to control newborns born to healthy mothers. METHODS Forty-six pregnant women (21 controls and 25 GDM) were recruited. Electroencephalogram (EEG) was recorded in the newborns within 48 h after birth. The EEG signal was quantitatively analyzed using power spectral density (PSD); coherence between hemispheres was calculated in paired channels of frontal, temporal, central and occipital regions. RESULTS The left centro-occipital PSD in control newborns was 12% higher than in GDM newborns (p = 0.036) but was not significant after adjustment for gestational age. While coherence was higher in the frontal regions compared to the occipital regions (p < 0.001), there was no difference between the groups for the fronto-temporal, frontal-central, centro-occipital and tempo-occipital regions. CONCLUSION Our results support that EEG differences between groups were mainly modified by gestational age and less by GDM status of the mothers. However, there is a need to confirm this result with a higher number of mother-newborns. Quantitative EEG in GDM newborns within 48 h after birth is feasible. This study emphasizes the importance of controlling blood glucose during GDM to protect infant brain development.
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Affiliation(s)
- Pauline Léveillé-
- Research Center on Aging, Centre intégré de santé et services sociaux de l'Estrie-Centre hospitalier de l'Université de Sherbrooke, 1036 Belvédère Sud, Sherbrooke, Quebec, J1H 4C4, Canada; Department of Physiology, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Institute of Nutrition and Functional Foods, Laval University, Quebec, QC, Canada
| | - Mathieu Hamel
- Research Center on Aging, Centre intégré de santé et services sociaux de l'Estrie-Centre hospitalier de l'Université de Sherbrooke, 1036 Belvédère Sud, Sherbrooke, Quebec, J1H 4C4, Canada
| | - Jean-Luc Ardilouze
- Department of Physiology, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Centre de recherche du CHUS, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Jean-Charles Pasquier
- Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Centre de recherche du CHUS, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Charles Deacon
- Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Kevin Whittingstall
- Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Centre de recherche du CHUS, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada.
| | - Mélanie Plourde
- Research Center on Aging, Centre intégré de santé et services sociaux de l'Estrie-Centre hospitalier de l'Université de Sherbrooke, 1036 Belvédère Sud, Sherbrooke, Quebec, J1H 4C4, Canada; Institute of Nutrition and Functional Foods, Laval University, Quebec, QC, Canada; Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada.
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Ardilouze JL, Shen GX, Lipscombe L, Halperin I, Salamon E, Ludwig S, Woo V, Menard J, Ouellet A, Pesant MH, Hivert MF, Baillargeon JP. Early Diabetes Screening, Before Hospital Discharge, in Postpartum Women with Gestational Diabetes: A New Validated Method. Can J Diabetes 2017. [DOI: 10.1016/j.jcjd.2017.08.051] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Patenaude J, Lacerte G, Lacroix M, Guillemette L, Allard C, Doyon M, Battista MC, Moreau J, Ménard J, Ardilouze JL, Perron P, Hivert MF. Associations of Maternal Leptin with Neonatal Adiposity Differ according to Pregravid Weight. Neonatology 2017; 111:344-352. [PMID: 28095377 DOI: 10.1159/000454756] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 11/28/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND During pregnancy, maternal circulating leptin is released by maternal adipose tissue and the placenta, and may have a role in fetal development. OBJECTIVES We investigated maternal leptinemia and glycemia associations with neonatal adiposity, taking into account pregravid weight status. METHODS We included 235 pregnant women from the Genetics of Glucose Regulation in Gestation and Growth prospective cohort with data: blood samples collected during the 2nd trimester, an oral glucose tolerance test (OGTT), and the measured leptin and glucose levels. As an integrated measure of maternal leptin exposure, we calculated the area under the curve for maternal leptin at the OGTT (AUCleptin). Within 72 h of delivery, we measured the triceps, biceps, subscapular, and suprailiac skinfold thicknesses (SFTs); the sum of these SFTs represented neonatal adiposity. We conducted a regression analysis to assess the maternal metabolic determinants of neonatal adiposity, adjusting for parity, smoking status, maternal triglyceride levels, gestational weight gain, placental weight, delivery mode, neonate sex, and gestational age at delivery. RESULTS The pregravid BMI of the participating women was 23.3 (21.2-27.0). In the 2nd trimester, maternal AUCleptin was 1,292.0 (767.0-2,222.5) (ng × min)/mL, and fasting glucose levels were 4.2 ± 0.4 mmol/L. At delivery, the neonatal sum of 4 SFTs was 17.9 ± 3.3 mm. Higher maternal leptinemia was associated with higher neonatal adiposity (β = 4.23 mm [SE = 1.77] per log-AUCleptin; p = 0.02) in mothers with a BMI ≥25, independently of confounders and maternal glycemia, but not in mothers with a BMI <25. Higher maternal fasting glucose was associated with higher neonatal adiposity (β = 0.88 mm [SE = 0.30] per SD glucose; p = 0.005) in mothers with a BMI <25, independently of confounders and maternal leptinemia. CONCLUSION Maternal leptinemia may be associated with neonatal adiposity in offspring from overweight/obese mothers, independently of maternal glycemia.
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Affiliation(s)
- Julie Patenaude
- Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
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Léveillé P, Ardilouze JL, Pasquier JC, Deacon C, Whittingstall K, Plourde M. Fatty acid profile in cord blood of neonates born to optimally controlled gestational diabetes mellitus. Prostaglandins Leukot Essent Fatty Acids 2016; 115:48-52. [PMID: 27914513 DOI: 10.1016/j.plefa.2016.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/12/2016] [Accepted: 10/12/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the fatty acid profile of cord blood phospholipids (PL), cholesteryl esters (CE), triglycerides (TG) and non-esterified fatty acids (NEFA) in neonates born to mothers with gestational diabetes mellitus (GDM) compared to non-diabetic mothers. METHODS The offspring of 30 pregnant women (15 non-diabetic controls, 15 with diet- or insulin-controlled GDM) were recruited before delivery. Cord blood was collected. After lipid extraction, PL, CE, TG and NEFA were separated by thin layer chromatography and analysed by gas chromatography. RESULTS In GDM vs. control mothers, maternal glycated haemoglobin (A1C, mean±SD) was not different between groups: 5.3±0.5% vs. 5.3±0.3% (p=0.757), respectively. Cord plasma fatty acids were not different in TG, CE and NEFA between GDM and non-diabetic mothers. However, in PL, levels of palmitate, palmitoleate, oleate, vaccinate and di-homo-gamma-linolenate were significantly lower, with a trend for lower arachidonate (p=0.078), in neonates born to GDM mothers compared to controls. CONCLUSION In contrast to other studies on cord blood docosahexaenoic acid (DHA) levels in GDM mothers, we did not found lower levels of DHA in cord PL, CE, TG or NEFA in neonates born to GDM compared to non-diabetic mothers.
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Affiliation(s)
- Pauline Léveillé
- Research Center on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke, 1036 Belvédère Sud Sherbrooke, Québec, Canada J1H 4C4; Department of Physiology, Université de Sherbrooke, 3001, 12e avenue Nord Sherbrooke, Québec, Canada J1H 5N4
| | - Jean-Luc Ardilouze
- Department of Physiology, Université de Sherbrooke, 3001, 12e avenue Nord Sherbrooke, Québec, Canada J1H 5N4; Department of Medicine, Université de Sherbrooke, 3001, 12e avenue Nord Sherbrooke, Québec, Canada J1H 5N4; Centre de recherche du CHUS, 3001, 12e avenue Nord Sherbrooke, Québec, Canada J1H 5N4
| | - Jean-Charles Pasquier
- Department of Medicine, Université de Sherbrooke, 3001, 12e avenue Nord Sherbrooke, Québec, Canada J1H 5N4; Centre de recherche du CHUS, 3001, 12e avenue Nord Sherbrooke, Québec, Canada J1H 5N4
| | - Charles Deacon
- Department of Medicine, Université de Sherbrooke, 3001, 12e avenue Nord Sherbrooke, Québec, Canada J1H 5N4
| | - Kevin Whittingstall
- Department of Medicine, Université de Sherbrooke, 3001, 12e avenue Nord Sherbrooke, Québec, Canada J1H 5N4
| | - Mélanie Plourde
- Research Center on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke, 1036 Belvédère Sud Sherbrooke, Québec, Canada J1H 4C4; Department of Medicine, Université de Sherbrooke, 3001, 12e avenue Nord Sherbrooke, Québec, Canada J1H 5N4.
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Ardilouze A, Bouchard P, Allard C, Baillargeon JP, Simard C, Hivert MF, Ménard J, Houde G, Pesant MH, Perron P, Ouellet A, Ardilouze JL. Improving Diagnosis of Gestational Diabetes Mellitus? 75g-OGTT vs. SMBG. Can J Diabetes 2016. [DOI: 10.1016/j.jcjd.2016.08.058] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Affiliation(s)
- Jean-Luc Ardilouze
- Endocrinology Division, University of Sherbrooke, Sherbrooke, Quebec Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec
| | - Julie Ménard
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec
| | - Fernand Gobeil
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec Department of Pharmacology-Physiology, University of Sherbrooke, Sherbrooke, Quebec
| | | | - Ghislaine Houde
- Endocrinology Division, University of Sherbrooke, Sherbrooke, Quebec Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec
| | - Marie-Hélène Pesant
- Endocrinology Division, University of Sherbrooke, Sherbrooke, Quebec Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec
| | - Rémi Rabasa-Lhoret
- Department of Nutrition, University of Montreal, Montreal, Quebec Institut de recherches cliniques de Montreal, Montreal, Quebec
| | - Jean-Patrice Baillargeon
- Endocrinology Division, University of Sherbrooke, Sherbrooke, Quebec Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec
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Lacroix M, Battista MC, Doyon M, Moreau J, Patenaude J, Guillemette L, Ménard J, Ardilouze JL, Perron P, Hivert MF. Higher maternal leptin levels at second trimester are associated with subsequent greater gestational weight gain in late pregnancy. BMC Pregnancy Childbirth 2016; 16:62. [PMID: 27004421 PMCID: PMC4802837 DOI: 10.1186/s12884-016-0842-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 03/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Excessive gestational weight gain (GWG) is associated with adverse pregnancy outcomes. In non-pregnant populations, low leptin levels stimulate positive energy balance. In pregnancy, both the placenta and adipose tissue contribute to circulating leptin levels. We tested whether maternal leptin levels are associated with subsequent GWG and whether this association varies depending on stage of pregnancy and on maternal body mass index (BMI). METHODS This prospective cohort study included 675 pregnant women followed from 1(st) trimester until delivery. We collected anthropometric measurements, blood samples at 1(st) and 2(nd) trimester, and clinical data until delivery. Maternal leptin was measured by ELISA (Luminex technology). We classified women by BMI measured at 1(st) trimester: BMI < 25 kg/m(2) = normal weight; 25 ≤ BMI < 30 kg/m(2) = overweight; and BMI ≥ 30 kg/m(2) = obese. RESULTS Women gained a mean of 6.7 ± 3.0 kg between 1(st) and 2(nd) trimester (mid pregnancy GWG) and 5.6 ± 2.5 kg between 2(nd) and the end of 3(rd) trimester (late pregnancy GWG). Higher 1(st) trimester leptin levels were associated with lower mid pregnancy GWG, but the association was no longer significant after adjusting for % body fat (%BF; β = 0.38 kg per log-leptin; SE = 0.52; P = 0.46). Higher 2(nd) trimester leptin levels were associated with greater late pregnancy GWG and this association remained significant after adjustment for BMI (β = 2.35; SE = 0.41; P < 0.0001) or %BF (β = 2.01; SE = 0.42; P < 0.0001). In BMI stratified analyses, higher 2(nd) trimester leptin levels were associated with greater late pregnancy GWG in normal weight women (β = 1.33; SE = 0.42; P =0.002), and this association was stronger in overweight women (β = 2.85; SE = 0.94; P = 0.003--P for interaction = 0.05). CONCLUSIONS Our results suggest that leptin may regulate weight gain differentially at 1(st) versus 2(nd) trimester of pregnancy: at 2(nd) trimester, higher leptin levels were associated with greater subsequent weight gain--the opposite of its physiologic regulation in non-pregnancy--and this association was stronger in overweight women. We suspect the existence of a feed-forward signal from leptin in second half of pregnancy, stimulating a positive energy balance and leading to greater weight gain.
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Affiliation(s)
- Marilyn Lacroix
- Department of Medicine, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke, Québec, Canada
| | - Marie-Claude Battista
- Department of Medicine, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke, Québec, Canada
| | - Myriam Doyon
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12th Avenue North, wing 9, door 6, Sherbrooke, Québec, Canada
| | - Julie Moreau
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12th Avenue North, wing 9, door 6, Sherbrooke, Québec, Canada
| | - Julie Patenaude
- Department of Medicine, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke, Québec, Canada
| | - Laetitia Guillemette
- Department of Medicine, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke, Québec, Canada
| | - Julie Ménard
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12th Avenue North, wing 9, door 6, Sherbrooke, Québec, Canada
| | - Jean-Luc Ardilouze
- Department of Medicine, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke, Québec, Canada.,Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12th Avenue North, wing 9, door 6, Sherbrooke, Québec, Canada
| | - Patrice Perron
- Department of Medicine, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke, Québec, Canada.,Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12th Avenue North, wing 9, door 6, Sherbrooke, Québec, Canada
| | - Marie-France Hivert
- Department of Medicine, Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke, Québec, Canada. .,Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12th Avenue North, wing 9, door 6, Sherbrooke, Québec, Canada. .,Diabetes Center, Massachusetts General Hospital, 50 Staniford Street, Boston, MA, USA. .,Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, 401 Park Drive, suite 401, Boston, MA, USA.
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Ruchat SM, Allard C, Doyon M, Lacroix M, Guillemette L, Patenaude J, Battista MC, Ardilouze JL, Perron P, Bouchard L, Hivert MF. Timing of Excessive Weight Gain During Pregnancy Modulates Newborn Anthropometry. J Obstet Gynaecol Can 2016; 38:108-17. [PMID: 27032734 DOI: 10.1016/j.jogc.2015.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 06/02/2015] [Accepted: 08/23/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Excessive gestational weight gain (GWG) is associated with increased birth weight and neonatal adiposity. However, timing of excessive GWG may have a differential impact on birth outcomes. The objective of this study was to compare the effect of early and mid/late excessive GWG on newborn anthropometry in the context of the Canadian clinical recommendations that are specific for first trimester and for second/third trimesters based on maternal pre-pregnancy BMI. METHODS We included 607 glucose-tolerant women in our main analyses, after excluding women who had less than the recommended total GWG. Maternal body weight was measured in early pregnancy, mid-pregnancy, and late pregnancy. Maternal and fetal clinical outcomes were collected, including newborn anthropometry. Women were divided into four groups according to the Canadian guidelines for GWG in the first and in the second/third trimesters: (1) "overall non-excessive" (reference group); (2) "early excessive GWG"; (3) "mid/late excessive GWG"; and (4) "overall excessive GWG." Differences in newborn anthropometry were tested across GWG categories. RESULTS Women had a mean (±SD) pre-pregnancy BMI of 24.7 ± 5.2 kg/m(2) and total GWG of 15.3 ± 4.4 kg. Women with mid/late excessive GWG gave birth to heavier babies (gestational age-adjusted birth weight z-score 0.33 ± 0.91) compared with women in the reference group (0.00 ± 0.77, P = 0.007), whereas women with early excessive GWG gave birth to babies of similar weight (gestational age-adjusted z-score 0.01 ± 0.86) to the reference group (0.00 ± 0.77, P = 0.84). When we stratified our analyses and investigated women who gained within the recommendations for total GWG, mid/late excessive GWG specifically was associated with greater newborn size, similar to our main analyses. CONCLUSION Excessive GWG in mid/late pregnancy in women who did not gain weight excessively in early pregnancy is associated with increased birth size, even in those who gained within the Canadian recommendations for total GWG.
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Affiliation(s)
- Stephanie-May Ruchat
- Department of Biochemistry, Université de Sherbrooke, Sherbrooke QC; ECOGENE-21, Chicoutimi Hospital, Chicoutimi QC
| | - Catherine Allard
- Department of Mathematics, Université de Sherbrooke, Sherbrooke QC
| | | | - Marilyn Lacroix
- Department of Medicine, Université de Sherbrooke, Sherbrooke QC
| | | | - Julie Patenaude
- Department of Medicine, Université de Sherbrooke, Sherbrooke QC
| | | | | | - Patrice Perron
- ECOGENE-21, Chicoutimi Hospital, Chicoutimi QC; Department of Medicine, Université de Sherbrooke, Sherbrooke QC
| | - Luigi Bouchard
- Department of Biochemistry, Université de Sherbrooke, Sherbrooke QC; ECOGENE-21, Chicoutimi Hospital, Chicoutimi QC
| | - Marie-France Hivert
- Department of Medicine, Université de Sherbrooke, Sherbrooke QC; Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston MA; Massachusetts General Hospital, Boston MA
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Guillemette L, Allard C, Lacroix M, Patenaude J, Battista MC, Doyon M, Moreau J, Ménard J, Bouchard L, Ardilouze JL, Perron P, Hivert MF. Genetics of Glucose regulation in Gestation and Growth (Gen3G): a prospective prebirth cohort of mother-child pairs in Sherbrooke, Canada. BMJ Open 2016; 6:e010031. [PMID: 26842272 PMCID: PMC4746442 DOI: 10.1136/bmjopen-2015-010031] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE We initiated the Genetics of Glucose regulation in Gestation and Growth (Gen3G) prospective cohort to increase our understanding of biological, environmental and genetic determinants of glucose regulation during pregnancy and their impact on fetal development. PARTICIPANTS Between January 2010 and June 2013, we invited pregnant women aged ≥ 18 years old who visited the blood sampling in pregnancy clinic in Sherbrooke for their first trimester clinical blood samples: 1034 women accepted to participate in our cohort study. FINDINGS TO DATE At first and second trimester, we collected demographics and lifestyle questionnaires, anthropometry measures (including fat and lean mass estimated using bioimpedance), blood pressure, and blood samples. At second trimester, women completed a full 75 g oral glucose tolerance test and we collected additional blood samples. At delivery, we collected cord blood and placenta samples; obstetrical and neonatal clinical data were abstracted from electronic medical records. We also collected buffy coats and extracted DNA from maternal and/or offspring samples (placenta and blood cells) to pursue genetic and epigenetic hypotheses. So far, we have found that low adiponectin and low vitamin D maternal levels in first trimester predict higher risk of developing gestational diabetes. FUTURE PLANS We are now in the phase of prospective follow-up of mothers and offspring 3 and 5 years postdelivery to investigate the consequences of maternal dysglycaemia during pregnancy on offspring adiposity and metabolic profile. TRIAL REGISTRATION NUMBER NCT01623934.
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Affiliation(s)
- Laetitia Guillemette
- Faculty of Medicine and Life Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Catherine Allard
- Faculty of Sciences, Department of Mathematics, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marilyn Lacroix
- Faculty of Medicine and Life Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Julie Patenaude
- Faculty of Medicine and Life Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-Claude Battista
- Faculty of Medicine and Life Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Myriam Doyon
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Julie Moreau
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Julie Ménard
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Luigi Bouchard
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculty of Medicine and Life Sciences, Department of Biochemistry, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- ECOGENE-21 and Lipid Clinic, Chicoutimi Hospital, Saguenay, Quebec, Canada
| | - Jean-Luc Ardilouze
- Faculty of Medicine and Life Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Patrice Perron
- Faculty of Medicine and Life Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-France Hivert
- Faculty of Medicine and Life Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts, USA
- Massachusetts General Hospital, Boston, Massachusetts, USA
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15
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Guillemette L, Lacroix M, Allard C, Patenaude J, Battista MC, Doyon M, Moreau J, Ménard J, Ardilouze JL, Perron P, Côté AM, Hivert MF. Preeclampsia is associated with an increased pro-inflammatory profile in newborns. J Reprod Immunol 2015; 112:111-4. [PMID: 26454417 DOI: 10.1016/j.jri.2015.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 08/06/2015] [Accepted: 09/15/2015] [Indexed: 10/23/2022]
Abstract
Hypertensive disorders of pregnancy (HDP) lead to high rates of maternal and fetal morbidity. Existing studies on inflammatory marker TNFα in HDP offspring are inconsistent. We performed a population-based cohort study of 636 pregnancies, including normotensive (NT) women and women with preeclampsia (PE) or gestational hypertension (GH). TNFα was measured in maternal blood in the first and second trimesters and in cord blood at the time of delivery. Cord blood TNFα was higher in offspring delivered of women with PE (6.53 [4.94-8.38]pg/mL) versus those delivered of NT women (5.13 [4.11-6.72]pg/mL; p=0.01), independent of confounders. Maternal TNFα levels were not different among groups (p>0.1) in either the first or second trimester.
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Affiliation(s)
- Laetitia Guillemette
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada
| | - Marilyn Lacroix
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada
| | - Catherine Allard
- Département de mathématiques, Faculté des sciences, Université de Sherbrooke, 2500, boul. de l'Université, Sherbrooke J1K 2R1, QC, Canada
| | - Julie Patenaude
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada
| | - Marie-Claude Battista
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada
| | - Myriam Doyon
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada
| | - Julie Moreau
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada
| | - Julie Ménard
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada
| | - Jean-Luc Ardilouze
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada; Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada
| | - Patrice Perron
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada; Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada
| | - Anne-Marie Côté
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada; Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada
| | - Marie-France Hivert
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada; Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001 12(e) Avenue Nord, Sherbrooke J1H 5N4, QC, Canada; Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, 133 Brookline Avenue, Boston 02215, MA, USA; Diabetes Unit, Massachusetts General Hospital, 55 Fruit Street, Boston 02114, MA, USA.
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Sotorník R, Baillargeon JP, Gagnon-Auger M, Ménard J, Brassard P, Ardilouze JL. Regulation of blood flow in adipose tissue: involvement of the cholinergic system. Am J Physiol Endocrinol Metab 2015; 309:E55-62. [PMID: 25968573 DOI: 10.1152/ajpendo.00016.2015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 05/08/2015] [Indexed: 01/24/2023]
Abstract
Acetylcholine (Ach) has vasodilatory actions. However, data are conflicting about the role of Ach in regulating blood flow in subcutaneous adipose tissue (ATBF). This may be related to inaccurate ATBF recording or to the responder/nonresponder (R/NR) phenomenon. We showed previously that healthy individuals are R (ATBF increases postprandially by >50% of baseline BF) or NR (ATBF increases ≤50% postprandially). Our objective was to assess the role of the cholinergic system on ATBF in R and NR subjects. ATBF was manipulated by in situ microinfusion of vasoactive agents (VA) in AT and monitored by the (133)Xenon washout technique (both recognized methods) at the VA site and at the control site. We tested incrementally increasing doses of Ach (10(-5), 10(-3), and 10(-1) mol/l; n = 15) and Ach receptor antagonists (Ra) before and after oral administration of 75-g glucose using atropine (muscarinic Ra; 10(-4) mol/l, n = 13; 10(-5) mol/l, n = 22) and mecamylamine (nicotinic Ra; 10(-3) mol/l, n = 15; 10(-4) mol/l, n = 10). Compared with baseline [2.41 (1.36-2.83) ml·100 g(-1)·min(-1)], Ach increased ATBF dose dependently [3.32 (2.80-5.09), 6.46 (4.36-9.51), and 10.31 (7.98-11.52), P < 0.0001], with no difference between R and NR. Compared with control side, atropine (both concentrations) had no effect on fasting ATBF; only atropine 10(-4) mol/l decreased post-glucose ATBF [iAUC: 1.25 (0.32-2.91) vs. 1.98 (0.64-2.94); P = 0.04]. This effect was further apparent in R. Mecamylamine had no impact on fasting and postglucose ATBF in R and NR. Our results suggest that the cholinergic system is implicated in ATBF regulation, although it has no role in the blunting of ATBF response in NR.
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Affiliation(s)
- Richard Sotorník
- Department of Medicine, Division of Endocrinology, University Hospital Center of Sherbrooke, University of Sherbrooke, Sherbrooke, Quebec, Canada; and
| | - Jean-Patrice Baillargeon
- Department of Medicine, Division of Endocrinology, University Hospital Center of Sherbrooke, University of Sherbrooke, Sherbrooke, Quebec, Canada; and Clinical Research Center, University Hospital Center of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Maude Gagnon-Auger
- Department of Medicine, Division of Endocrinology, University Hospital Center of Sherbrooke, University of Sherbrooke, Sherbrooke, Quebec, Canada; and
| | - Julie Ménard
- Department of Medicine, Division of Endocrinology, University Hospital Center of Sherbrooke, University of Sherbrooke, Sherbrooke, Quebec, Canada; and Clinical Research Center, University Hospital Center of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Pascal Brassard
- Department of Medicine, Division of Endocrinology, University Hospital Center of Sherbrooke, University of Sherbrooke, Sherbrooke, Quebec, Canada; and Clinical Research Center, University Hospital Center of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean-Luc Ardilouze
- Department of Medicine, Division of Endocrinology, University Hospital Center of Sherbrooke, University of Sherbrooke, Sherbrooke, Quebec, Canada; and Clinical Research Center, University Hospital Center of Sherbrooke, Sherbrooke, Quebec, Canada
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17
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Allard C, Sahyouni E, Menard J, Houde G, Pesant MH, Perron P, Ouellet A, Moutquin JM, Ardilouze JL, Hivert MF. Gestational Diabetes Mellitus Identification Based on Self-Monitoring of Blood Glucose. Can J Diabetes 2015; 39:162-8. [DOI: 10.1016/j.jcjd.2014.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 08/15/2014] [Accepted: 09/04/2014] [Indexed: 10/24/2022]
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18
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Allard C, Desgagné V, Patenaude J, Lacroix M, Guillemette L, Battista MC, Doyon M, Ménard J, Ardilouze JL, Perron P, Bouchard L, Hivert MF. Mendelian randomization supports causality between maternal hyperglycemia and epigenetic regulation of leptin gene in newborns. Epigenetics 2015; 10:342-51. [PMID: 25800063 PMCID: PMC4622547 DOI: 10.1080/15592294.2015.1029700] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/16/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022] Open
Abstract
Leptin is an adipokine that acts in the central nervous system and regulates energy balance. Animal models and human observational studies have suggested that leptin surge in the perinatal period has a critical role in programming long-term risk of obesity. In utero exposure to maternal hyperglycemia has been associated with increased risk of obesity later in life. Epigenetic mechanisms are suspected to be involved in fetal programming of long term metabolic diseases. We investigated whether DNA methylation levels near LEP locus mediate the relation between maternal glycemia and neonatal leptin levels using the 2-step epigenetic Mendelian randomization approach. We used data and samples from up to 485 mother-child dyads from Gen3G, a large prospective population-based cohort. First, we built a genetic risk score to capture maternal glycemia based on 10 known glycemic genetic variants (GRS10) and showed it was an adequate instrumental variable (β = 0.046 mmol/L of maternal fasting glucose per additional risk allele; SE = 0.007; P = 7.8 × 10(-11); N = 467). A higher GRS10 was associated with lower methylation levels at cg12083122 located near LEP (β = -0.072 unit per additional risk allele; SE = 0.04; P = 0.05; N = 166). Direction and effect size of association between the instrumental variable GRS10 and methylation at cg12083122 were consistent with the negative association we observed using measured maternal glycemia. Lower DNA methylation levels at cg12083122 were associated with higher cord blood leptin levels (β = -0.17 log of cord blood leptin per unit; SE = 0.07; P = 0.01; N = 170). Our study supports that maternal glycemia is part of causal pathways influencing offspring leptin epigenetic regulation.
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Key Words
- BMI, Body Mass Index
- CDA, Canadian Diabetes Association
- CHUS, Centre hospitalier universitaire de Sherbrooke
- CpGs, CG dinucleotides
- DNA methylation
- DNAm, DNA methylation
- DOHaD, Developmental Origins of Health and Disease
- GCT, Glucose Challenge Test
- GDM, Gestational Diabetes Mellitus
- GRS, Genetic Risk Score
- IADPSG, International Association of the Diabetes and Pregnancy Study Groups
- IV, Instrumental Variable
- MAGIC, Meta-Analyses of Glucose and Insulin-related traits Consortium
- MDS, Multidimensional Scaling
- MR, Mendelian Randomization
- Mendelian randomization
- OGTT, Oral Glucose Tolerance Test
- SGA, Small for Gestational Age
- SNPs, Single Nucleotide Polymorphisms
- TSLS, Two-Stage Least Square
- fetal programming
- gestational diabetes
- glycemia
- leptin
- mQTL, methylation Quantitative Trait Locus
- obesity
- pregnancy
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Affiliation(s)
- C Allard
- Department of Mathematics; Faculty of Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
| | - V Desgagné
- Department of Biochemistry; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de Recherche Clinique ECOGENE-21; CSSS de Chicoutimi; Chicoutimi, QC Canada
| | - J Patenaude
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
| | - M Lacroix
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
| | - L Guillemette
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
| | - MC Battista
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
| | - M Doyon
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
| | - J Ménard
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
| | - JL Ardilouze
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
| | - P Perron
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
| | - L Bouchard
- Department of Biochemistry; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
- Centre de Recherche Clinique ECOGENE-21; CSSS de Chicoutimi; Chicoutimi, QC Canada
| | - MF Hivert
- Department of Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, QC Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke; Sherbrooke, QC Canada
- Department of Population Medicine; Harvard Pilgrim Health Care Institute; Harvard Medical School; Boston, MA USA
- Diabetes Unit; Massachusetts General Hospital; Boston, MA USA
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Dupont FO, Hivert MF, Allard C, Ménard J, Perron P, Bouchard L, Robitaille J, Pasquier JC, Auray-Blais C, Ardilouze JL. Glycation of fetal hemoglobin reflects hyperglycemia exposure in utero. Diabetes Care 2014; 37:2830-3. [PMID: 25011951 DOI: 10.2337/dc14-0549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The lifetime risk of metabolic diseases in offspring of women with gestational diabetes mellitus (GDM) depends, at least in part, on the impact of glycemic fetal programming. To quantify this impact, we have developed and validated a unique mass spectrometry method to measure the percentage of glycated hemoglobin in cord blood. RESEARCH DESIGN AND METHODS This case-control study includes 37 GDM women and 30 pregnant women with normal glucose tolerance (NGT). RESULTS Glycation of the α-chain (Glα) was higher in neonates from GDM (2.32 vs. 2.20%, P < 0.01). Glα strongly correlated with maternal A1C measured at delivery in the overall cohort (r = 0.67, P < 0.0001) as well as in each group (GDM: r = 0.66, P < 0.0001; NGT: r = 0.50, P = 0.01). CONCLUSIONS Thus, Glα may reflect hyperglycemic exposure during the last weeks of fetal development. Future studies will confirm Glα is a predictive biomarker of prenatally programmed lifetime metabolic health and disease.
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Affiliation(s)
- Felix O Dupont
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-France Hivert
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada Endocrine Division, Université de Sherbrooke, Sherbrooke, QC, Canada Harvard Pilgrim Health Care Institute, Department of Population Medicine, Harvard Medical School, Boston, MA
| | - Catherine Allard
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Julie Ménard
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Patrice Perron
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada Endocrine Division, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Luigi Bouchard
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada Department of Biochemistry, Université de Sherbrooke, Sherbrooke, QC, Canada ECOGENE-21 and Lipid Clinic, Chicoutimi Hospital, Saguenay, QC, Canada
| | - Julie Robitaille
- Department of Food Science and Nutrition, Laval University, Quebec, QC, Canada
| | - Jean-Charles Pasquier
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada Department of Gynaecology-Obstetrics, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Christiane Auray-Blais
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Luc Ardilouze
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada Endocrine Division, Université de Sherbrooke, Sherbrooke, QC, Canada
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Mahdavian M, Baillargeon JP, Ménard J, Hivert MF, Moutquin JM, Ouellet A, Perron P, Houde G, Ardilouze JL. First Trimester 50 g Glucose Challenge Test (GCT) Predicts Gestational Diabetes Mellitus at 24–28 Weeks of Pregnancy. Can J Diabetes 2014. [DOI: 10.1016/j.jcjd.2014.07.061] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ardilouze JL, Dupont FO, Allard C, Hivert MF, Ménard J, Ouellet A, Pasquier JC, Auray-Blais C. Glycation of Fetal Hemoglobin Reflects Hyperglycemia Exposure in Utero. Can J Diabetes 2014. [DOI: 10.1016/j.jcjd.2014.07.063] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ardilouze JL, Ménard J, Hivert MF, Houde G, Perron P, Ouellet A, Pasquier JC, Baillargeon JP. A New Method to Screen Type 2 Diabetes in Women Who Had Gestational Diabetes Mellitus: OGTT 2 Days After Delivery, Before Hospital Discharge. Can J Diabetes 2014. [DOI: 10.1016/j.jcjd.2014.07.062] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ardilouze JL, Ménard J, Hivert MF, Houde G, Perron P, Moutquin JM, Ouellet A, Baillargeon JP. Gestational Diabetes Mellitus: A Randomized Study Comparing Insulin Therapy to a Combination of Half Maximal Dosages of Metformin and Glyburide. Can J Diabetes 2014. [DOI: 10.1016/j.jcjd.2014.07.064] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lacroix M, Battista MC, Doyon M, Houde G, Ménard J, Ardilouze JL, Hivert MF, Perron P. Lower vitamin D levels at first trimester are associated with higher risk of developing gestational diabetes mellitus. Acta Diabetol 2014; 51:609-16. [PMID: 24526261 DOI: 10.1007/s00592-014-0564-4] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 01/27/2014] [Indexed: 02/06/2023]
Abstract
The progressive increase of insulin resistance observed in pregnancy contributes to the pathophysiology of gestational diabetes mellitus (GDM). There is controversy whether vitamin D deficiency contributes to abnormal glycemic regulation in pregnancy. We tested the associations between first trimester 25-hydroxyvitamin D (25OHD) levels and: 1) the risk of developing GDM; 2) insulin resistance/sensitivity, beta cell function and compensation indices in a large population-based prospective cohort of pregnant women. Participants (n = 655) were seen at first (6-13 weeks) and second (24-28 weeks) trimesters for blood samples. At first trimester, 25OHD levels were measured. At second trimester, glucose and insulin were measured 3 times during the oral glucose tolerance test to estimate insulin resistance (HOMA-IR), beta cell function (HOMA-B), insulin sensitivity (Matsuda index), insulin secretion (AUCins/gluc) and beta cell compensation (ISSI-2). Based on IADPSG criteria, 54 participants (8.2 %) developed GDM. Lower first trimester 25OHD levels were associated with higher risk of developing GDM even after adjustment for vitamin D confounding factors and GDM risk factors (OR = 1.48 per decrease of one SD in 25OHD levels; P = 0.04). Lower first trimester 25OHD levels were associated with higher HOMA-IR (r = - 0.08; P = 0.03), lower Matsuda index (r = 0.13; P = 0.001) and lower ISSI-2 (r = 0.08; P = 0.04). After adjustment for confounders, we found no significant association with HOMA-B and AUCins/gluc. Our results suggest that low levels of 25OHD at first trimester are (1) an independent risk factor for developing GDM and (2) associated with insulin resistance at second trimester.
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Affiliation(s)
- Marilyn Lacroix
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
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Guillemette L, Lacroix M, Battista MC, Doyon M, Moreau J, Ménard J, Ardilouze JL, Perron P, Hivert MF. TNFα dynamics during the oral glucose tolerance test vary according to the level of insulin resistance in pregnant women. J Clin Endocrinol Metab 2014; 99:1862-9. [PMID: 24517151 DOI: 10.1210/jc.2013-4016] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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] [Indexed: 12/20/2022]
Abstract
INTRODUCTION TNFα is suspected to play a role in inflammation and insulin resistance leading to higher risk of metabolic impairment. Controversies exist concerning the role of TNFα in gestational insulin resistance. We investigated the interrelations between TNFα and insulin resistance in a large population-based cohort of pregnant women. METHODS Women (n = 756) were followed prospectively at 5-16 weeks and 24-28 weeks of pregnancy. Anthropometric measures and blood samples were collected at both visits. A 75-g oral glucose tolerance test (OGTT) was conducted at the second trimester to assess insulin sensitivity status (homeostasis model of assessment of insulin resistance and Matsuda index). TNFα was measured at the first trimester (nonfasting) and at each time point of the OGTT. RESULTS Participants were 28.4 ± 4.4 years old and had a mean body mass index of 25.5 ± 5.5 kg/m(2) at first trimester. Median TNFα levels were 1.56 (interquartile range, 1.18-2.06) pg/mL at first trimester and 1.61 (interquartile range, 1.12-2.13) pg/mL at second trimester (1 h after glucose load). At second trimester, higher TNFα levels were associated with higher insulin resistance index levels (r = 0.37 and -0.30 for homeostasis model of assessment of insulin resistance and Matsuda index, respectively; P < .0001), even after adjustment for age, body mass index, triglycerides, and adiponectin. Women with higher insulin resistance showed a continuing decrease in TNFα levels during the OGTT, whereas women who were more insulin sensitive showed an increase in TNFα at hour 1 and a decrease at hour 2 of the test. CONCLUSION Higher insulin resistance is associated with higher levels of circulating TNFα at first and second trimesters of pregnancy. TNFα level dynamics during an OGTT at second trimester vary according to insulin-resistance state.
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Affiliation(s)
- Laetitia Guillemette
- Department of Medicine (L.G., M.L. M.-C.B., J.-L.A. P.P., M.-F.H.), Université de Sherbrooke, Québec, Canada J1H 5N4; Centre de Recherché Clinique Étienne-Le Bel of the Centre Hospitalier Universitaire de Sherbrooke (M.D., J.Mo., J.Mé., J.-L.A., M.-F.H.), Sherbrooke, Québec, Canada J1H 5N4; Department of Population Medicine (M.-F.H.), Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts 02215; and Massachusetts General Hospital (M.-F.H.), Boston, Massachusetts 02114
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Joncas SX, Poirier P, Ardilouze JL, Carrier N, Fayad T, Farand P. Delayed efficient anticoagulation with heparin in patients with a weight of 110 kg and more treated for acute coronary syndrome. Obesity (Silver Spring) 2013; 21:1753-8. [PMID: 23404940 DOI: 10.1002/oby.20029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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] [Received: 04/17/2011] [Accepted: 07/03/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The use of a weight-based nomogram is considered as standard care for prescribing appropriate doses of unfractionated heparin (UFH). Because of the need for multiple other medications that may affect bleeding and that clinical data have relied on similar dosing algorithms, maximum initial bolus and infusion rates have been suggested (capped initial dose). Whether these weight-based heparin nomograms properly address therapeutic dosing in obese patients remains questionable. DESIGN AND METHODS Thirty patients treated for acute coronary syndrome and weighing ≥110 kg were retrospectively compared with 90 controls (three groups of 30 patients, weighting 50-69.9, 70-89.9, or 90-109.9 kg), all treated with UFH, July 2008 to April 2009. The primary end point was the time required to obtain a threshold activated partial thromboplastin time (aPTT). RESULTS Mean time to achieve threshold aPTT was longer for obese patients weighing ≥110 kg than for controls (31.47 vs. 12.89 hours; P < 0.0001). At 24 hours, 63% of obese patients weighing ≥110 kg had not reached threshold aPTT vs. 7% of controls (P < 0.0001). However, threshold infusion rate did not differ between weight categories (13.0 vs. 13.1 U/kg/h; P = NS) and approximated the initial infusion rate recommended by nomograms without applying the dose cap (12 U/kg/h). CONCLUSIONS Adequate anticoagulation time doubled in patients weighing ≥110 kg, suggesting that these patients were not receiving appropriate heparin doses initially to achieve threshold aPTT rapidly. Using initial infusion rate recommended by a nomogram without capping for total body weight is suggested as acceptable in this study. This approach should be further evaluated in a prospective study.
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Lacroix M, Battista MC, Doyon M, Ménard J, Ardilouze JL, Perron P, Hivert MF. Lower adiponectin levels at first trimester of pregnancy are associated with increased insulin resistance and higher risk of developing gestational diabetes mellitus. Diabetes Care 2013; 36:1577-83. [PMID: 23300287 PMCID: PMC3661817 DOI: 10.2337/dc12-1731] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Accepted: 11/30/2012] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the associations between adiponectin levels and 1) the risk of developing gestational diabetes mellitus (GDM), and 2) insulin resistance/sensitivity, β-cell function, and compensation indices in a prospective cohort representative of the general population of pregnant women. RESEARCH DESIGN AND METHODS We performed anthropometric measurements and collected blood samples at 1st (6-13 weeks) and 2nd (24-28 weeks) trimesters. Diagnosis of GDM was made at 2nd trimester based on a 75-g oral glucose tolerance test (International Association of the Diabetes and Pregnancy Study Groups criteria). Insulin was measured (ELISA; Luminex) to estimate homeostasis model assessment of insulin resistance (HOMA-IR), β-cell function (HOMA-B), insulin sensitivity (Matsuda index), insulin secretion (AUC(insulin/glucose)), and β-cell compensation (insulin secretion sensitivity index-2). Adiponectin was measured by radioimmunoassay. RESULTS Among the 445 participants included in this study, 38 women developed GDM. Women who developed GDM had lower 1st-trimester adiponectin levels (9.67 ± 3.84 vs. 11.92 ± 4.59 µg/mL in women with normal glucose tolerance). Lower adiponectin levels were associated with higher risk of developing GDM (OR, 1.12 per 1 µg/mL decrease of adiponectin levels; P = 0.02, adjusted for BMI and HbA1c at 1st trimester). Adiponectin levels at 1st and 2nd trimesters were associated with HOMA-IR (both: r = -0.22, P < 0.0001) and Matsuda index (r = 0.28, P < 0.0001, and r = 0.29, P < 0.0001). After adjustment for confounding factors, we found no significant association with HOMA-B and AUC(insulin/glucose). CONCLUSIONS Pregnant women with lower adiponectin levels at 1st trimester have higher levels of insulin resistance and are more likely to develop GDM independently of adiposity or glycemic measurements.
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Affiliation(s)
- Marilyn Lacroix
- Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Myriam Doyon
- Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Julie Ménard
- Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Jean-Luc Ardilouze
- Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Patrice Perron
- Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Marie-France Hivert
- Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
- General Medicine Division, Massachusetts General Hospital, Boston, Massachusetts
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Sotorník R, Gagnon-Auger M, Brassard P, Ardilouze JL. Restoring ATBF: Dreaming the impossible dream? Clin Hemorheol Microcirc 2013; 53:295-6. [PMID: 23075999 DOI: 10.3233/ch-2012-1630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Battista MC, Labonté M, Ménard J, Jean-Denis F, Houde G, Ardilouze JL, Perron P. Dietitian-coached management in combination with annual endocrinologist follow up improves global metabolic and cardiovascular health in diabetic participants after 24 months. Appl Physiol Nutr Metab 2012; 37:610-20. [DOI: 10.1139/h2012-025] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This 24 month study evaluated the effect of dietitian coaching combined with minimal endocrinologist follow up on the glycemic control and cardiovascular risks of diabetic participants, compared with conventional endocrinologist follow up. Participants with type 1 or type 2 diabetes were assigned to either the control group with conventional endocrinologist follow up (C; n = 50) or the dietitian-coached group (DC; n = 51) with on-site diabetes self-management education every 3 months combined with annual endocrinologist followup. Over the 24 month intervention, weight (–0.7 vs. +2.1 kg; p = 0.04), BMI (+0.3 vs. +0.7 kg/m2; p = 0.009), and waist circumference (–1.3 vs. +2.4 cm; p = 0.01) significantly differed between the DC and control groups. HbA1C dropped significantly in participants of the DC versus the control group (–0.6% vs.–0.3%; p = 0.04). This was accompanied by improved overall energy intake (–548 vs. –74 kcal/day; p = 0.04). However, no link associated glycemic control to nutrient intake or intensiveness of pharmacotherapy. Coaching by a dietitian improves glycemic control and reduces certain cardiovascular risk factors in diabetic subjects, demonstrating that a joint dietitian–endocrinologist model of care provides a convenient strategy for cardiovascular risk management in the diabetic population.
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Affiliation(s)
- Marie-Claude Battista
- Division of Endocrinology, Department of Medicine, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001, 12th Ave North, Sherbrooke, QC J1H 5N4, Canada
| | - Mélissa Labonté
- Division of Endocrinology, Department of Medicine, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001, 12th Ave North, Sherbrooke, QC J1H 5N4, Canada
| | - Julie Ménard
- Division of Endocrinology, Department of Medicine, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001, 12th Ave North, Sherbrooke, QC J1H 5N4, Canada
| | - Farrah Jean-Denis
- Division of Endocrinology, Department of Medicine, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001, 12th Ave North, Sherbrooke, QC J1H 5N4, Canada
| | - Ghislaine Houde
- Division of Endocrinology, Department of Medicine, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001, 12th Ave North, Sherbrooke, QC J1H 5N4, Canada
| | - Jean-Luc Ardilouze
- Division of Endocrinology, Department of Medicine, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001, 12th Ave North, Sherbrooke, QC J1H 5N4, Canada
| | - Patrice Perron
- Division of Endocrinology, Department of Medicine, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001, 12th Ave North, Sherbrooke, QC J1H 5N4, Canada
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Abstract
According to Fick's principle, any metabolic or hormonal exchange through a given tissue depends on the product of the blood flow to that tissue and the arteriovenous difference. The proper function of adipose tissue relies on adequate adipose tissue blood flow (ATBF), which determines the influx and efflux of metabolites as well as regulatory endocrine signals. Adequate functioning of adipose tissue in intermediary metabolism requires finely tuned perfusion. Because metabolic and vascular processes are so tightly interconnected, any disruption in one will necessarily impact the other. Although altered ATBF is one consequence of expanding fat tissue, it may also aggravate the negative impacts of obesity on the body's metabolic milieu. This review attempts to summarize the current state of knowledge on adipose tissue vascular bed behavior under physiological conditions and the various factors that contribute to its regulation as well as the possible participation of altered ATBF in the pathophysiology of metabolic syndrome.
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Affiliation(s)
- Richard Sotornik
- Diabetes and Metabolism Research Group, Division of Endocrinology, Department of Medicine, Centre Hospitalier, Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Hivert MF, Allard C, Menard J, Ouellet A, Ardilouze JL. Impact of the Creation of a Specialized Clinic for Prenatal Blood Sampling and Follow-up Care in Pregnant Women. Journal of Obstetrics and Gynaecology Canada 2012; 34:236-242. [DOI: 10.1016/s1701-2163(16)35194-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dupont FO, Gagnon R, Ménard J, Auray-Blais C, Ardilouze JL. Evaluation of the glycemic control in neonates: a novel technical approach for measuring fetal-glycated hemoglobin. J Perinatol 2011; 31:807; author reply 808. [PMID: 22124519 DOI: 10.1038/jp.2011.70] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sénéchal M, Arguin H, Bouchard DR, Carpentier AC, Ardilouze JL, Dionne IJ, Brochu M. Weight gain since menopause and its associations with weight loss maintenance in obese postmenopausal women. Clin Interv Aging 2011; 6:221-5. [PMID: 21966216 PMCID: PMC3180518 DOI: 10.2147/cia.s23574] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To examine the association between weight gain since menopause and weight regain after a weight loss program. Methods Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up. Results All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders. Conclusion Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women.
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Affiliation(s)
- M Sénéchal
- Research Centre on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC
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Dupont FO, Gagnon R, Ardilouze JL, Auray-Blais C. Determination of Glycated and Acetylated Hemoglobins in Cord Blood by Time-of-Flight Mass Spectrometry. Anal Chem 2011; 83:5245-52. [DOI: 10.1021/ac200555v] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Jean-Luc Ardilouze
- Division of Endocrinology, Department of Medicine, Centre hospitalier universitaire de Sherbrooke, 3001, 12th Avenue North, Sherbrooke (Québec), Canada J1H 5N4
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Martin E, Brassard P, Gagnon-Auger M, Yale P, Carpentier AC, Ardilouze JL. Subcutaneous adipose tissue metabolism and pharmacology: a new investigative technique. Can J Physiol Pharmacol 2011; 89:383-91. [DOI: 10.1139/y11-039] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
According to the Fick principle, any metabolic or hormonal exchange through a given tissue depends on the product of blood flow by arteriovenous difference. Because adipose tissue plays dual storage and endocrine roles, regulation of adipose tissue blood flow (ATBF) is of pivotal importance. Monitoring ATBF in humans can be achieved through different methodologies, such as the 133Xe washout technique, considered to be the “gold standard”, as well as microdialysis and other methods that are not well validated as of yet. This report describes a new method, called “adipose tissue microinfusion” or “ATM”, which simultaneously quantifies ATBF by combining the 133Xe washout technique together with variations of ATBF induced by local infusion of vasoactive agents. The most appropriate site for ATM investigation is the subcutaneous adipose tissue of the anterior abdominal wall. This innovative method conveniently enables the direct comparison of the effects on ATBF of any vasoactive compound, drug, or hormone against a contralateral saline control. The ATM method improves the accuracy and feasibility of physiological and pharmacological studies on the regulation of ATBF in vivo in humans.
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Affiliation(s)
- Elizabeth Martin
- Diabetes and Metabolism Research Group, Division of Endocrinology, Department of Medicine, Sherbrooke University Hospital Centre, Sherbrooke, QC J1H 5N4, Canada
| | - Pascal Brassard
- Diabetes and Metabolism Research Group, Division of Endocrinology, Department of Medicine, Sherbrooke University Hospital Centre, Sherbrooke, QC J1H 5N4, Canada
| | - Maude Gagnon-Auger
- Diabetes and Metabolism Research Group, Division of Endocrinology, Department of Medicine, Sherbrooke University Hospital Centre, Sherbrooke, QC J1H 5N4, Canada
| | - Philippe Yale
- Diabetes and Metabolism Research Group, Division of Endocrinology, Department of Medicine, Sherbrooke University Hospital Centre, Sherbrooke, QC J1H 5N4, Canada
| | - André C. Carpentier
- Diabetes and Metabolism Research Group, Division of Endocrinology, Department of Medicine, Sherbrooke University Hospital Centre, Sherbrooke, QC J1H 5N4, Canada
| | - Jean-Luc Ardilouze
- Diabetes and Metabolism Research Group, Division of Endocrinology, Department of Medicine, Sherbrooke University Hospital Centre, Sherbrooke, QC J1H 5N4, Canada
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Abstract
INTRODUCTION Gestational diabetes mellitus (GDM), the most frequent medical complication of pregnancy, is associated with several adverse outcomes over the short- and long-term for both mother and offspring. Standard treatment for GDM consists of insulin injections. Oral hypoglycemic agents (OHAs), on the other hand, are still the subject of controversy. Although OHAs are seemingly as efficient as insulin and may provide better quality of life, congenital malformations and unknown long-term effects are still feared. AREAS COVERED Recent data on the pharmacokinetics of two OHAs (glyburide and metformin) and their clinical use for GDM are reviewed, with a focus on clinical trials and observational studies comparing insulin with glyburide or metformin (1960 - 2010). The review will provide a comprehensive overview of the pros and cons of OHA usage, an appreciation of OHAs' efficiency for the purpose of controlling glycemia and embryogenetic basics relating to congenital malformations. EXPERT OPINION While insulin treatment is an effective therapy for controlling maternal glycemia, it nevertheless requires sufficient education and skills on the part of the patient to manage properly and may cause hypoglycemia, fear and anxiety. Oral treatment as a more user-friendly alternative may thus facilitate the control of GDM in some patients.
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Affiliation(s)
- Ana Cristina Maymone
- Division of Endocrinology, Department of Medicine, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12th Avenue North, Sherbrooke (Québec) J1H 5N4, Canada
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Gagnon-Auger M, du Souich P, Baillargeon JP, Martin E, Brassard P, Ménard J, Ardilouze JL. Dose-dependent delay of the hypoglycemic effect of short-acting insulin analogs in obese subjects with type 2 diabetes: a pharmacokinetic and pharmacodynamic study. Diabetes Care 2010; 33:2502-7. [PMID: 20841613 PMCID: PMC2992178 DOI: 10.2337/dc10-1126] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Injected volume and subcutaneous adipose tissue blood flow (ATBF) affect insulin absorption. Pharmacokinetics of short-acting insulin analogs were established by assessing injection of small doses in lean subjects, healthy or with type 1 diabetes. In obese patients, however, daily dosages are larger and ATBF is decreased. This study assessed the kinetics of a short-acting insulin analog in obese subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS Euglycemic clamps after subcutaneous lispro injections were performed. Six healthy control subjects received 10 units. Seven obese (BMI 38.3 ± 7.0 kg/m(2)) subjects with type 2 diabetes received 10, 30, and 50 units. Plasma lispro was measured by specific radioimmunoassay and ATBF by the (133)Xe-washout technique. RESULTS ATBF was 64% lower in subjects with type 2 diabetes than in control subjects. After 10 units injection, time to lispro plasma peak (T(max)) was similar (48.3 vs. 55.7 min; control subjects versus type 2 diabetic subjects), although maximal concentration (C(max))/dose was 41% lower in subjects with type 2 diabetes, with lower and delayed maximal glucose infusion rate (GIR(max): 9.0 vs. 0.6 mg/kg/min, P < 0.0001, 69 vs. 130 min, P < 0.0001, respectively). After 30- and 50-unit injections, T(max) (88.6 and 130.0 min, respectively) and time to GIR(max) (175 and 245 min) were further delayed and dose related (r(2) = 0.51, P = 0.0004 and r(2) = 0.76, P < 0.0001, respectively). CONCLUSIONS Absorption and hypoglycemic action of increasing dosages of lispro are critically delayed in obese subjects with type 2 diabetes.
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Affiliation(s)
- Maude Gagnon-Auger
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Mahdavian M, Hivert MF, Baillargeon JP, Menard J, Ouellet A, Ardilouze JL. Gestational diabetes mellitus: simplifying the international association of diabetes and pregnancy diagnostic algorithm using fasting plasma glucose: comment on agarwal, dhatt, and shah. Diabetes Care 2010; 33:e145; author reply e146. [PMID: 20980424 DOI: 10.2337/dc10-1454] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Masoud Mahdavian
- Division of Endocrinology, Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-France Hivert
- Division of Endocrinology, Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean-Patrice Baillargeon
- Division of Endocrinology, Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Julie Menard
- Division of Endocrinology, Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Annie Ouellet
- Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean-Luc Ardilouze
- Division of Endocrinology, Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada
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Gagnon C, Ménard J, Bourbonnais A, Ardilouze JL, Baillargeon JP, Carpentier AC, Langlois MF. Comparison of Foot-to-Foot and Hand-to-Foot Bioelectrical Impedance Methods in a Population with a Wide Range of Body Mass Indices. Metab Syndr Relat Disord 2010; 8:437-41. [DOI: 10.1089/met.2010.0013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Claudia Gagnon
- Department of Medicine, Division of Endocrinology, Centre de recherche clinique Etienne-Le Bel, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Julie Ménard
- Department of Medicine, Division of Endocrinology, Centre de recherche clinique Etienne-Le Bel, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Annie Bourbonnais
- Department of Medicine, Division of Endocrinology, Centre de recherche clinique Etienne-Le Bel, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Jean-Luc Ardilouze
- Department of Medicine, Division of Endocrinology, Centre de recherche clinique Etienne-Le Bel, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Jean-Patrice Baillargeon
- Department of Medicine, Division of Endocrinology, Centre de recherche clinique Etienne-Le Bel, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
| | - André C. Carpentier
- Department of Medicine, Division of Endocrinology, Centre de recherche clinique Etienne-Le Bel, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Marie-France Langlois
- Department of Medicine, Division of Endocrinology, Centre de recherche clinique Etienne-Le Bel, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
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Ardilouze JL, Mahdavian M, Baillargeon JP. Brick by brick: metformin for gestational diabetes mellitus? Expert Rev Endocrinol Metab 2010; 5:353-357. [PMID: 30861684 DOI: 10.1586/eem.10.9] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Evaluation of: Balani J, Hyer SL, Rodin DA, Shehata H. Pregnancy outcomes in women with gestational diabetes treated with metformin or insulin: a case-control study. Diabet. Med. 26(8), 798-802 (2009). This paper reviews a case-control study, reported by Balani et al., comparing maternal and neonatal outcomes of women treated for gestational diabetes mellitus with either metformin or insulin. A cohort of 100 women treated with metformin alone, without insulin rescue, was compared with a retrospective cohort of 100 women treated with insulin. Results favored metformin. This paper discusses issues related to the safety and efficiency of metformin treatment during pregnancy, the attitudes of pregnant women toward treatment options, public health policy and the worldwide gestational diabetes mellitus epidemic, as well as the financial burden of therapy, particularly for developing countries. It also looks at the pathophysiology of gestational diabetes mellitus and the need for clinical trial assessment of combination oral-hypoglycemic therapy.
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Affiliation(s)
- Jean-Luc Ardilouze
- a Endocrine Division, Department of Medicine, University of Sherbrooke, 3001, 12ème avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada
| | - Masoud Mahdavian
- a Endocrine Division, Department of Medicine, University of Sherbrooke, 3001, 12ème avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada
| | - Jean-Patrice Baillargeon
- a Endocrine Division, Department of Medicine, University of Sherbrooke, 3001, 12ème avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada
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Sénéchal M, Arguin H, Bouchard DR, Carpentier AC, Ardilouze JL, Dionne IJ, Brochu M. Interindividual variations in resting metabolic rate during weight loss in obese postmenopausal women A pilot study. Metabolism 2010; 59:478-85. [PMID: 19846179 DOI: 10.1016/j.metabol.2009.07.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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] [Received: 12/19/2008] [Accepted: 07/03/2009] [Indexed: 12/25/2022]
Abstract
The objective of the study was to examine if decreases in resting metabolic rate (RMR) take place early in the weight loss process and if they remain throughout the duration of the weight loss intervention. Twenty obese postmenopausal women (61.8 +/- 5.9 years) participated in a 15-week weight loss program. After the fifth week, subjects were characterized as having an increased (>5%) or a decreased (<5%) RMR based on baseline values. Afterward, they were followed for an additional 10 weeks. Outcome measures were as follows: fat mass ([FM] total, trunk), lean body mass (total, trunk), RMR, resting heart rate (RHR), and physical activity level. After 5 weeks, significant decreases were observed for lean body mass, FM, and RHR (P < .05), whereas no overall changes in physical activity level and RMR were observed. However, on an individual basis, large variations in RMR were observed (ranging from -320 to +330 kcal/d). Analyses showed that subjects characterized as either having an increased or a decreased RMR after the fifth week maintained these adaptations at the end of intervention. Finally, subjects displaying a decreased RMR during weight loss had a significantly higher RMR and lower FM accumulations at baseline (total and trunk) compared with those with an increased RMR. Interindividual variations in RMR took place early in the weight loss process and were maintained over the duration of the weight loss program in our cohort of obese postmenopausal women. Baseline RMR, changes in RHR, and FM accumulations (total and trunk) seem to be important factors to consider when studying the effects of weight loss on RMR.
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Affiliation(s)
- Martin Sénéchal
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, Canada J1H 4C4.
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Kamga-Ngandé CN, Carpentier AC, Nadeau-Marcotte F, Ardilouze JL, Baillargeon JP, Bellabarba D, Houde G, Langlois MF. Effectiveness of a Multidisciplinary Program for Management of Obesity: The Unité d’Enseignement, de Traitement et de Recherche sur l’Obésité (UETRO) Database Study. Metab Syndr Relat Disord 2009; 7:297-304. [PMID: 19558274 DOI: 10.1089/met.2008.0063] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carole N. Kamga-Ngandé
- Department of Medicine, Division of Endocrinology, Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Québec, Canada
| | - André C. Carpentier
- Department of Medicine, Division of Endocrinology, Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Québec, Canada
| | - Frédérique Nadeau-Marcotte
- Department of Medicine, Division of Endocrinology, Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Québec, Canada
| | - Jean-Luc Ardilouze
- Department of Medicine, Division of Endocrinology, Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Québec, Canada
| | - Jean-Patrice Baillargeon
- Department of Medicine, Division of Endocrinology, Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Québec, Canada
| | - Diego Bellabarba
- Department of Medicine, Division of Endocrinology, Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Québec, Canada
| | - Ghislaine Houde
- Department of Medicine, Division of Endocrinology, Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Québec, Canada
| | - Marie-France Langlois
- Department of Medicine, Division of Endocrinology, Centre de Recherche Clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Québec, Canada
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Arguin H, Bouchard DR, Labonté M, Carpentier A, Ardilouze JL, Dionne IJ, Brochu M. Correlation between the rate of weight loss and changes in body composition in obese postmenopausal women after 5 weeks: a pilot study. Appl Physiol Nutr Metab 2008; 33:347-55. [DOI: 10.1139/h08-004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Approximately 25% of weight lost during restrictive diets (without exercise) is lean body mass (LBM). No study has yet investigated the impact of the rate of weight loss (RWL) on LBM and fat mass (FM). The purpose of this study was to investigate the relationships between the RWL and body composition in older obese women. Twenty obese postmenopausal women aged between 51 and 74 years enrolled in a 5 week dietary weight loss intervention. Subjects were characterized according to their RWL (low RWL < 0.74 kg·week–1 (n = 9) vs. high RWL ≥ 0.74 kg·week–1 (n = 11)). Total and trunk FM and LBM (by dual-energy X-ray absorptiometry) were measured before and after weight loss. A significant correlation was observed between the RWL (kg·week–1) and changes in LBM (kg·week–1) (r = 0.75; p = 0.0002). However, no association was observed with changes in FM (kg·week–1) (r = 0.40; p = 0.08). Both groups showed a similar decrease in FM (low RWL, –2.7 ± 0.9 kg,; high RWL, –3.2 ± 0.8 kg; p = 0.38), whereas losses in LBM were significantly higher in the high RWL than in the low RWL group (–1.6 ± 1.2 kg vs. –0.4 ± 1.1 kg; p = 0.05). An RWL > 0.74 kg·week–1 was associated with a greater loss of LBM, but had no extra benefits on FM after a 5 week weight loss program. Current guidelines, which recommend RWL up to 0.91 kg·week–1, might not be optimal to prevent decreases in LBM in postmenopausal women when no exercise is added.
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Affiliation(s)
- Hélène Arguin
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
- Department of Social and Preventive Medicine, Division of Kinesiology, Laval University, Ste-Foy, QC G1K 7P4, Canada
- Étienne-Le Bel Clinical Research Centre, Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada
| | - Danielle R. Bouchard
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
- Department of Social and Preventive Medicine, Division of Kinesiology, Laval University, Ste-Foy, QC G1K 7P4, Canada
- Étienne-Le Bel Clinical Research Centre, Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada
| | - Mélissa Labonté
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
- Department of Social and Preventive Medicine, Division of Kinesiology, Laval University, Ste-Foy, QC G1K 7P4, Canada
- Étienne-Le Bel Clinical Research Centre, Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada
| | - André Carpentier
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
- Department of Social and Preventive Medicine, Division of Kinesiology, Laval University, Ste-Foy, QC G1K 7P4, Canada
- Étienne-Le Bel Clinical Research Centre, Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada
| | - Jean-Luc Ardilouze
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
- Department of Social and Preventive Medicine, Division of Kinesiology, Laval University, Ste-Foy, QC G1K 7P4, Canada
- Étienne-Le Bel Clinical Research Centre, Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada
| | - Isabelle J. Dionne
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
- Department of Social and Preventive Medicine, Division of Kinesiology, Laval University, Ste-Foy, QC G1K 7P4, Canada
- Étienne-Le Bel Clinical Research Centre, Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada
| | - Martin Brochu
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
- Department of Social and Preventive Medicine, Division of Kinesiology, Laval University, Ste-Foy, QC G1K 7P4, Canada
- Étienne-Le Bel Clinical Research Centre, Centre hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke, QC J1H 5N4, Canada
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Ardilouze JL, Menard J, Ouellet A, Houde G. Self-Monitoring Blood Glucose (SMBG): a new method for screening and diagnosis of Gestational HyperGlycemia (GHG). Can J Diabetes 2008. [DOI: 10.1016/s1499-2671(08)24185-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gagnon-Auger M, Baillargeon J, Martin E, Menard J, Ardilouze JL. Critical Delay of the Hypoglycemic Effect of Short- Acting Insulin Analogues in Obese Subjects with Type 2 Diabetes Mellitus. Can J Diabetes 2008. [DOI: 10.1016/s1499-2671(08)24026-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Constant F, Ménard J, Ouellet A, Houde G, Ardilouze JL. Gestational Diabetes Mellitus (GDM) screening: assessment of CDA and ADA recommendations. Can J Diabetes 2008. [DOI: 10.1016/s1499-2671(08)24186-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Roberge C, Carpentier AC, Langlois MF, Baillargeon JP, Ardilouze JL, Maheux P, Gallo-Payet N. Adrenocortical dysregulation as a major player in insulin resistance and onset of obesity. Am J Physiol Endocrinol Metab 2007; 293:E1465-78. [PMID: 17911338 DOI: 10.1152/ajpendo.00516.2007] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [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: 12/20/2022]
Abstract
The aim of this review is to explore the dysregulation of adrenocortical secretions as a major contributor in the development of obesity and insulin resistance. Disturbance of adipose tissue physiology is one of the primary events in the development of pathologies associated with the metabolic syndrome, such as obesity and type 2 diabetes. Several studies indicate that alterations in metabolism of glucocorticoids (GC) and androgens, as well as aldosterone in excess, are involved in the emergence of metabolic syndrome. Cross talk among adipose tissue, the hypothalamo-pituitary complex, and adrenal gland activity plays a major role in the control of food intake, glucose metabolism, lipid storage, and energy balance. Perturbation of this cross talk induces alterations in the regulatory mechanisms of adrenocortical steroid synthesis, secretion, degradation, and/or recycling, at the level of the zonae glomerulosa (aldosterone), fasciculata (GC and GC metabolites), and reticularis (androgens and androgen precursors DHEA and DHEAS). As a whole, these adrenocortical perturbations contribute to the development of metabolic syndrome at both the paracrine and systemic level by favoring the physiological dysregulation of organs responsive to aldosterone, GC, and/or androgens, including adipose tissue.
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Affiliation(s)
- Claude Roberge
- Department of Medicine, Faculty of Medicine, Université de Sherbrooke, 3001, 12th Ave. North, Sherbrooke, QC, Canada J1H 5N4
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Ménard J, Payette H, Dubuc N, Baillargeon JP, Maheux P, Ardilouze JL. Quality of life in type 2 diabetes patients under intensive multitherapy. Diabetes & Metabolism 2007; 33:54-60. [PMID: 17258926 DOI: 10.1016/j.diabet.2006.09.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Accepted: 09/02/2006] [Indexed: 11/20/2022]
Abstract
AIM To assess the impact of an intensive multitherapy (IMT) on perceived quality of life (QOL), attitudes, knowledge and diabetes self-management in patients with poorly controlled type 2 diabetes. METHODS A 12-month randomized trial was conducted in 72 patients with type 2 diabetes, HbA1c>or=8%, blood pressure (BP)>130/80 mmHg and dyslipidemia. Subjects were assigned to the IMT or control group, each n=36. IMT consisted in monthly visits including clinical and biochemical assessment, education sessions on diet, physical exercise, medical management of diabetes and associated diseases and adjustments in medication. Control patients were under the care of their physicians. We developed and validated a diabetes-specific questionnaire assessing QOL, attitudes, knowledge, diabetes self-management and socio-demographic data for this study. Outcomes were measured at 0, 6 and 12 months. RESULTS Subjects were 54.8+/-8.1 years old (duration of diabetes: 10.3+/-7.2 years). At baseline, questionnaires showed no difference in QOL between groups. At 12 months, QOL improved significantly in the IMT group when compared to controls (+13.2+/-10.3/+5.6+/-13.2%, P=0.003), particularly with respect to the satisfaction scale (+25.3+/-13.9/+5.4+/-21.7%, P<0.001). QOL was not affected by complications or hypoglycaemic episodes. QOL scores improved in IMT subjects who began insulin therapy during the trial. Attitude scores, in the high normal range at baseline, did not change. Knowledge (+18.2+/-26.3/+8.9+/-30.4%, P=0.047) and diabetes self-management (+22.6+/-35.3/+6.8+/-20.1%, P<0.001) improved. CONCLUSIONS In poorly controlled subjects, QOL improved statistically despite the inherent constraints imposed by IMT.
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Affiliation(s)
- J Ménard
- Research Group on Diabetes and Metabolism, Clinical Research Center, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12th North Avenue, Sherbrooke, J1H 5N4 Quebec, Canada
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Ménard J, Payette H, Baillargeon JP, Maheux P, Lepage S, Tessier D, Ardilouze JL. Efficacy of intensive multitherapy for patients with type 2 diabetes mellitus: a randomized controlled trial. CMAJ 2005; 173:1457-66. [PMID: 16293781 PMCID: PMC1316161 DOI: 10.1503/cmaj.050054] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [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: 11/01/2022] Open
Abstract
BACKGROUND National guidelines for managing diabetes set standards for care. We sought to determine whether a 1-year intensive multitherapy program resulted in greater goal attainment than usual care among patients with poorly controlled type 2 diabetes mellitus. METHODS We identified patients with poorly controlled type 2 diabetes receiving outpatient care in the community or at our hospital. Patients 30-70 years of age with a hemoglobin A1c concentration of 8% or greater were randomly assigned to receive intensive multitherapy (n = 36) or usual care (n = 36). RESULTS The average hemoglobin A1c concentration at entry was 9.1% (standard deviation [SD] 1%) in the intensive therapy group and 9.3% (SD 1%) in the usual therapy group. By 12 months, a higher proportion of patients in the intensive therapy group than in the control group had achieved Canadian Diabetes Association (CDA) goals for hemoglobin A(1c) concentrations (goal < or = 7.0%: 35% v. 8%), diastolic blood pressure (goal < 80 mm Hg: 64% v. 37%), low-density lipoprotein cholesterol (LDL-C) levels (goal < 2.5 mmol/L: 53% v. 20%) and triglyceride levels (goal < 1.5 mmol/L: 44% v. 14%). There were no significant differences between the 2 groups in attaining the targets for fasting plasma glucose levels, systolic blood pressure or total cholesterol:high-density lipoprotein cholesterol ratio. None of the patients reached all CDA treatment goals. By 18 months, differences in goal attainment were no longer evident between the 2 groups, except for LDL-C levels. Quality of life, as measured by a specific questionnaire, increased in both groups, with a greater increase in the intensive therapy group (13% [SD 10%] v. 6% [SD 13%], p < 0.003). INTERPRETATION Intensive multitherapy for patients with poorly controlled type 2 diabetes is successful in helping patients meet most of the goals set by a national diabetes association. However, 6 months after intensive therapy stopped and patients returned to usual care, the benefits had vanished.
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Affiliation(s)
- Julie Ménard
- Diabetes and Metabolism Research Group, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.
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