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Hardel AS, Flye Sainte Marie H, Lorrain S, Iacobelli S, Lazaro G, Boukerrou M, Tran PL. [Pregnancy after intrauterine insemination following hysterosalpingo-foam-sonography or hysterosalpingography]. Gynecol Obstet Fertil Senol 2024:S2468-7189(24)00093-X. [PMID: 38547932 DOI: 10.1016/j.gofs.2024.03.010] [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] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/09/2024] [Accepted: 03/18/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To compare clinical pregnancy rates following intrauterine insemination performed after hysterosalpingography (HSG) or hysterosalpingo-foam-sonography (HyFoSy). MATERIAL AND METHODS This is a retrospective study including 242 intrauterine insemination (IUI) performed between 2015 and 2020 at the fertility center of the Reunion Island. Among these inseminations, 121 with previous HSG and 121 with previous HyFoSy were matched. The main outcome of interest was clinical pregnancy rate. Secondary outcomes were birth rate and time to pregnancy after tubal patency test. RESULTS The pregnancy rate after insemination was 9.9% for the HSG group and 11.6% for the HyFoSy group, with no statistically significant difference between the groups (P=0.66). The live birth rate was similar in the two groups (7.4% for HSG and 10.7% for HyFoSy; P=0.37). Over half (57.1%) of the pregnancies occurred within 6 months after HyFoSy, whereas only 8.3% after HSG. CONCLUSION IUI results are not influenced by HyFoSy compared to HSG with regard to the pregnancy rates. Use of HyFoSy in infertility assessment allows global evaluation and more rapid adapted management. This approach could optimize management of patients undergoing IUI.
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Affiliation(s)
- Anne-Sophie Hardel
- Service de gynécologie-obstétrique, centre hospitalier universitaire Sud-Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion
| | - Hélène Flye Sainte Marie
- Service de gynécologie-obstétrique, centre hospitalier universitaire Sud-Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion
| | - Simon Lorrain
- Centre d'études périnatales de l'Océan Indien (UR 7388), université de la Réunion, Saint-Pierre, Réunion
| | - Silvia Iacobelli
- Centre d'études périnatales de l'Océan Indien (UR 7388), université de la Réunion, Saint-Pierre, Réunion; Réanimation néonatale et pédiatrique, néonatologie, centre hospitalier universitaire Sud Réunion, Saint-Pierre cedex, Réunion
| | - Glorianne Lazaro
- Empartners, 760 Newtown Yardely Rd Suite 112, Newtown, PA, 18940, États-Unis
| | - Malik Boukerrou
- Service de gynécologie-obstétrique, centre hospitalier universitaire Sud-Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion; Centre d'études périnatales de l'Océan Indien (UR 7388), université de la Réunion, Saint-Pierre, Réunion; Université de la Réunion, UFR santé, 40, avenue de Soweto, Terre Sainte, BP 373, 97455 Saint-Pierre cedex, Réunion
| | - Phuong Lien Tran
- Service de gynécologie-obstétrique, centre hospitalier universitaire Sud-Réunion, BP 350, 97448 Saint-Pierre cedex, Réunion; Université de la Réunion, UFR santé, 40, avenue de Soweto, Terre Sainte, BP 373, 97455 Saint-Pierre cedex, Réunion; Inserm, CIC 1410, Reunion University Hospital, 97448 Saint-Pierre, Réunion.
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de Beaumais TA, Lorrain S, Mamhoudi N, Simonin M, Martinez Vinson C, Medard Y, Petit A, Jacqz-Aigrain E. Key factors associated with 6-thioguanine and 6-methylmercaptopurine nucleotide concentrations in children treated by thiopurine for acute leukaemia and inflammatory bowel disease. Br J Clin Pharmacol 2024; 90:209-219. [PMID: 37621013 DOI: 10.1111/bcp.15894] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/10/2023] [Accepted: 08/05/2023] [Indexed: 08/26/2023] Open
Abstract
AIMS Azathioprine (AZA) and 6-mercaptopurine are prescribed in acute lymphoblastic leukaemia (ALL) and inflammatory bowel diseases (IBD). Metabolism to active 6-thioguanine (6TGN) and 6-methylmercaptopurine nucleotides (6MMPN) is variable but therapeutic drug monitoring (TDM) remains debatable. This study reports on factors impacting on red blood cell (RBC) metabolites concentrations in children to facilitate TDM interpretation. METHODS The first paediatric TDM samples received during year 2021 were analysed, whatever indication and thiopurine drug. Target concentration ranges were 200-500, <6000 pmol/8 × 108 RBC for 6TGN and 6MMPN. RESULTS Children (n = 492) had IBD (64.8%), ALL (22.6%) or another autoimmune disease (12.6%): mean ages at TDM were 7.5 in ALL and 13.7 years in IBD (P < .0001). ALL received 6-mercaptopurine (mean dose 1.7 mg/kg/d with methotrexate), IBD received AZA (1.9 mg/kg/d with anti-inflammatory drugs and/or monoclonal antibodies). Median 6TGN and 6MMPN concentrations were 213.7 [interquartile range: 142.5; 309.6] and 1144.6 [419.4; 3574.3] pmol/8 × 108 RBC, 38.8% of patients were in the recommended therapeutic range for both compounds. Aminotransferases and blood tests were abnormal in 57/260 patients: 8.1% patients had high alanine aminotransaminase, 3.4% of patients had abnormal blood count. Factors associated with increased 6TGN were age at TDM and thiopurine methyltransferase genotype in ALL and AZA dose in IBD. The impact of associated treatment in IBD patients was also significant. CONCLUSION TDM allowed identification of children who do not reach target levels or remain over treated. Including TDM in follow-up may help physicians to adjust dosage with the aim of reducing adverse effects and improve treatment outcome.
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Affiliation(s)
- Tiphaine Adam de Beaumais
- Department of Biological Pharmacology and Pharmacogenetics, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, France
| | - Simon Lorrain
- Centre d'Etudes Périnatales de l'Océan Indien (UR 7388), Université de La Réunion, Saint-Pierre, France
| | - Naura Mamhoudi
- Department of Biological Pharmacology and Pharmacogenetics, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, France
- University Paris Cité, Paris, France
| | - Mathieu Simonin
- Department of Pediatric Hematology and Oncology, Hôpital Armand Trousseau, Assistance Publique - Hôpitaux de Paris, France
- Sorbonne University, Paris, France
| | - Christine Martinez Vinson
- University Paris Cité, Paris, France
- Department of Pediatric Gastroenterology and Nutrition, Hôpital Robert Debré, Assistance Publique - Hôpitaux de Paris, France
| | - Yves Medard
- Department of Biological Pharmacology and Pharmacogenetics, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, France
| | - Arnaud Petit
- Department of Pediatric Hematology and Oncology, Hôpital Armand Trousseau, Assistance Publique - Hôpitaux de Paris, France
- Sorbonne University, Paris, France
| | - Evelyne Jacqz-Aigrain
- Department of Biological Pharmacology and Pharmacogenetics, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, France
- University Paris Cité, Paris, France
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Iacobelli S, Commins M, Lorrain S, Gouyon B, Ramful D, Richard M, Grondin A, Gouyon JB, Bonsante F. Paraben exposure through drugs in the neonatal intensive care unit: a regional cohort study. Front Pharmacol 2023; 14:1200521. [PMID: 37361223 PMCID: PMC10285404 DOI: 10.3389/fphar.2023.1200521] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Background and objectives: Environmental factors influence the development of very preterm infants (VPIs, born at less than 32 weeks of gestation). It is important to identify all potential sources of paraben exposure in these vulnerable infants. We aimed to quantify paraben exposure via drug administration in a cohort of VPI cared for in neonatal intensive care units (NICUs). Methods: A prospective, observational study was carried out over a five-year period in a regional setting (two NICUs using the same computerized order-entry system). The main outcome was exposure to paraben-containing drugs. The secondary outcomes were: time of the first exposure, daily intake, number of infants exceeding paraben acceptable daily intake (ADI: 0-10 mg/kg/d), duration of exposure, and cumulative dose. Results: The cohort consisted of 1,315 VPIs [BW 1129.9 (±360.4) g]. Among them, 85.5% were exposed to paraben-containing drugs. In 40.4% of infants, the first exposure occurred during the second week of life. Mean paraben intake and duration of exposure were, respectively, 2.2 (±1.4) mg/kg/d and 33.1 (±22.3) days. The cumulative paraben intake was 80.3 (±84.6) mg/kg. The ADI was exceeded in 3.5% of exposed infants. Lower GA was associated with higher intake and longer exposure (p < 0.0001). The main molecules involved in paraben exposure were: sodium iron feredetate, paracetamol, furosemide, and sodium bicarbonate + sodium alginate. Conclusion: Commonly used drugs are potential source of parabens, and ADI can be easily exceeded in VPIs cared for in NICUs. Efforts are needed to identify paraben-free alternative formulations for these vulnerable infants.
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Affiliation(s)
- Silvia Iacobelli
- Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion, Site Sud, Saint Pierre, France
- Centre d’Études Périnatales de l’Océan Indien, Université de la Réunion, Saint-Pierre, France
| | - Marie Commins
- Centre d’Études Périnatales de l’Océan Indien, Université de la Réunion, Saint-Pierre, France
| | - Simon Lorrain
- Centre d’Études Périnatales de l’Océan Indien, Université de la Réunion, Saint-Pierre, France
| | - Beatrice Gouyon
- Centre d’Études Périnatales de l’Océan Indien, Université de la Réunion, Saint-Pierre, France
| | - Duksha Ramful
- Service de Réanimation Néonatale, CHU La Réunion, Saint-Denis, France
| | - Magali Richard
- Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion, Site Sud, Saint Pierre, France
| | - Anthony Grondin
- Service de Réanimation Néonatale, CHU La Réunion, Saint-Denis, France
| | - Jean-Bernard Gouyon
- Centre d’Études Périnatales de l’Océan Indien, Université de la Réunion, Saint-Pierre, France
| | - Francesco Bonsante
- Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion, Site Sud, Saint Pierre, France
- Centre d’Études Périnatales de l’Océan Indien, Université de la Réunion, Saint-Pierre, France
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Iacobelli S, Allamèle-Moutama K, Lorrain S, Gouyon B, Gouyon JB, Bonsante F. Postnatal corticosteroid exposure in very preterm infants: A French cohort study. Front Pharmacol 2023; 14:1170842. [PMID: 37089932 PMCID: PMC10113548 DOI: 10.3389/fphar.2023.1170842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/27/2023] [Indexed: 04/09/2023] Open
Abstract
Background: Postnatal corticosteroids (PC) are widely used in very preterm infants. International reports and national multicenter trials describe a marked variability across countries and inter-sites, in the use of PC. Few information is available on therapeutic indications and prescription characteristics of PC.Aim: The main objective of this study was to describe the exposure to PC in a large cohort of preterm infants born at less than 32 weeks of gestation, according to the prescription data of 41 tertiary-care NICUs in France. Secondary objectives were to describe therapeutic indications, day of life (DOL) of the first exposure, route of administration, duration, cumulative dose for each drug, and differences in exposure rates across centers.Methods: We conducted a prospective observational cohort analysis from January 2017 to December 2021, in 41 French tertiary-care NICUs using the same computerized order-entry system.Results: In total, 13,913 infants [birth weight 1144.8 (±365.6) g] were included. Among them, 3633 (26.1%) were exposed to PC, 21.8% by systemic and 10.1% by inhaled route. Within the study population, 1,992 infants (14.3%) received the first corticosteroid treatment in the first week of life and 1641 (11.8%) after DOL 7. The more frequent indications were prevention and/or treatment of bronchopulmonary dysplasia, and arterial hypotension. Hydrocortisone was the more often prescribed molecule. For systemic PC the first exposure occurred in mean at DOL 9.4 (±13.5), mean duration of treatment was 10.3 (±14.3) days, and the cumulative dose (expressed as the equivalent dose of hydrocortisone) was in median [IQR] 9.0 [5.5–28.8] mg/kg. For inhaled PC, the first exposure occurred in mean at DOL 34.1 (±19.7), and mean duration of treatment 28.5 (±24.4) days. The exposure rate ranged from a minimum of 5% to a maximum of 56% among centers, and significantly increased over the study period (p < 0.0001).Conclusion: In this French cohort of very preterm infants, around one patient out to five was exposed to PC during hospital stay in the NICU. The exposure occurred early, starting from the first week of life. Exposure rate widely varied among centers. Pharmacoepidemiology studies are useful to increase knowledge on corticosteroid utilization patterns in preterm infants.
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Affiliation(s)
- Silvia Iacobelli
- Néonatologie, Réanimation Néonatale et Pédiatrique, CHU Saint Pierre, Saint Pierre, France
- Centre d'Etudes Périnatales de l'Océan Indien (UR 7388), Université de la Réunion, Saint Pierre, France
| | - Käliani Allamèle-Moutama
- Centre d'Etudes Périnatales de l'Océan Indien (UR 7388), Université de la Réunion, Saint Pierre, France
| | - Simon Lorrain
- Centre d'Etudes Périnatales de l'Océan Indien (UR 7388), Université de la Réunion, Saint Pierre, France
| | - Béatrice Gouyon
- Centre d'Etudes Périnatales de l'Océan Indien (UR 7388), Université de la Réunion, Saint Pierre, France
| | - Jean-Bernard Gouyon
- Centre d'Etudes Périnatales de l'Océan Indien (UR 7388), Université de la Réunion, Saint Pierre, France
| | - Francesco Bonsante
- Néonatologie, Réanimation Néonatale et Pédiatrique, CHU Saint Pierre, Saint Pierre, France
- Centre d'Etudes Périnatales de l'Océan Indien (UR 7388), Université de la Réunion, Saint Pierre, France
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Louvel L, Lorrain S, von Theobald P. Satisfaction of patients in pain management delivering in Reunion Island with or without neuraxial analgesia. J Gynecol Obstet Hum Reprod 2021; 50:102106. [PMID: 33705992 DOI: 10.1016/j.jogoh.2021.102106] [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] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 02/17/2021] [Accepted: 02/23/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Neuraxial analgesia (NA) rate during labour in Reunion Island is below the average rate in continental France. Our study objective was to know if the patients that deliver with or without NA were satisfied. We also wanted to identify the reasons of this lower rate. METHOD This was a multicentre prospective observational study led in the seven Reunion Island maternity hospitals including all patients who delivered after 24 weeks of gestation onwards during two weeks in 2019 and excluding scheduled caesarean sections. Included patients received a satisfaction questionnaire the day after delivery and returned it before leaving. RESULTS Of the 497 patients who met the inclusion criteria, 303 questionnaires were analysable. 216 patients had NA (71.3 %) and 87 patients (28.7 %) delivered without. A total of 88.0 % of patients with NA were satisfied with pain management compared to 83.9 % without. There was no significant difference between the groups (p=0.68). Among patients who delivered without NA, it was their choice in 55.2 % of cases. They wanted the most natural birth possible in 87.5 % of cases. Birth without NA in opposition to their wish was related to too rapid dilation in 90.0 % of lowerecases. DISCUSSION No significant difference in satisfaction between women who delivered with or without NA was found. The lower regional NA rate seems to be linked to a choice to give birth as naturally as possible and to too fast dilation at the time of requesting NA.
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Affiliation(s)
- Lauriane Louvel
- Service de Gynécologie Obstétrique, hôpital Félix-Guyon, CHU de la Réunion, allée des Topazes, CS 11021 97405 Saint-Denis cedex, Réunion, France.
| | - Simon Lorrain
- Centre d'Etudes Périnatales de l'Océan Indien (CEPOI), EA 7388, Université et CHU de la Réunion, Site Sud, BP 350, 97448 Saint-Pierre cedex, Réunion, France
| | - Peter von Theobald
- Service de Gynécologie Obstétrique, hôpital Félix-Guyon, CHU de la Réunion, allée des Topazes, CS 11021 97405 Saint-Denis cedex, Réunion, France
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Martin-Mons S, Lorrain S, Iacobelli S, Gouyon B, Gouyon JB. Antibiotics Prescription Over Three Years in a French Benchmarking Network of 23 Level 3 Neonatal Wards. Front Pharmacol 2021; 11:585018. [PMID: 33568992 PMCID: PMC7868323 DOI: 10.3389/fphar.2020.585018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 11/13/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Prescribing antibiotics to newborns is challenging, as excess antibiotics are a risk factor for increased morbidity and mortality. The objective of this study was to describe the evolution of antibiotic exposure over three years in a large network of level 3 neonatal wards where each center is informed yearly of its own results and the results of other centers and has full autonomy to improve its performance. Patients and Methods: This is a prospective, observational study of antibiotics prescriptions over the 2017–2019 period in a network of 23 French level 3 neonatal wards. The network relied on an internal benchmarking program based on a computerized prescription ordering system. Among others, antibiotics exposure, treatment duration, and antibiotics spectrum index were analyzed. Results: The population consisted of 39,971 neonates (51.5% preterm), 44.3% of which were treated with antibiotics. Of the treated patients, 78.5% started their first antibiotic treatment in the first three days of life. Antibiotic exposure rate significantly declined from 2017 to 2019 (from 46.8% to 42.8%, p < 0.0001); this decline was significant in groups with gestational age >26 weeks, but not in the group with extremely low gestational age <27 weeks. Gentamicin, cefotaxime, amoxicillin (ampicillin), vancomycin, and amikacin were the antibiotics most prescribed. The lower the gestational age, the higher the exposure for cefotaxime, vancomycin, and amikacin. Compared to 2017, cefotaxime exposure in 2019 declined by 12.6%, but the change was only significant in the gestational age group of 32–36 weeks (17.4%) and at term (20.3%). The triple combination of antibiotics in the first three days decreased by 28.8% from 2017 to 2019, and this was significant in each gestational age group. During the study, the delayed ending of antibiotics in unconfirmed early-onset neonatal infection increased from 9.6% to 11.9%. Conclusion: This study showed that a strategy characterized by the collection of information via a computerized order-entry system, analysis of the results by a steering committee representative of all neonatal wards, and complete autonomy of neonatal wards in the choice of prescription modalities, is associated with a significant reduction in the use of antibiotics in newborns with gestational age greater than 26 weeks.
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Affiliation(s)
- Séverine Martin-Mons
- Centre D'Etudes Périnatales de L'Océan Indien (Université de La Réunion), CHU de La Réunion Site Sud, Saint-Pierre, France.,Société LogipremF, Saint-Pierre, France
| | - Simon Lorrain
- Centre D'Etudes Périnatales de L'Océan Indien (Université de La Réunion), CHU de La Réunion Site Sud, Saint-Pierre, France
| | - Silvia Iacobelli
- Centre D'Etudes Périnatales de L'Océan Indien (Université de La Réunion), CHU de La Réunion Site Sud, Saint-Pierre, France
| | - Béatrice Gouyon
- Centre D'Etudes Périnatales de L'Océan Indien (Université de La Réunion), CHU de La Réunion Site Sud, Saint-Pierre, France.,Société LogipremF, Saint-Pierre, France
| | - Jean-Bernard Gouyon
- Centre D'Etudes Périnatales de L'Océan Indien (Université de La Réunion), CHU de La Réunion Site Sud, Saint-Pierre, France
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von Theobald P, Bohrer M, Lorrain S, Iacobelli S. Risk factors associated with severe perineal tears: A five-year study. J Gynecol Obstet Hum Reprod 2020; 49:101820. [PMID: 32450305 DOI: 10.1016/j.jogoh.2020.101820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Our aim was to describe risk factors associated with 34DPT in operative and non-operative vaginal deliveries, over a five-year period. STUDY DESIGN This was a retrospective cohort study including 39,227 vaginal deliveries from 2013 to 2017 in a single French University Hospital. Annual characteristics of the analyzed population were recorded. Univariate logistic regression was used to evaluate the association between these characteristics and 34DPT. Multivariate analysis was used to identify combinations of risk factors associated with instrumental delivery. RESULTS The rate of perineal tears was constantly rising but rate of 34DPT was stable, ranging between 0.8 and 1.4% over the study period. Cesarean section rate was stable between 18.8% and 19.6%. Rate of diabetes, preeclampsia and obesity (BMI < 40) was increasing and episiotomy rate decreasing (from 19.8% to 11.8%). Operative deliveries rate remained stable between 11 and 12.8%. Multivariate regression showed that gestational age over 39 weeks (aOR 1.18, 95% CI [1.02; 1.35]), birth weight over 3500 g (aOR 1.62, 95% CI [1.05; 2.49]) were associated with 34DPT in patients without operative vaginal deliveries but not episiotomy. Gestational age (aOR 1.71, 95% CI [1.18; 2.47]), episiotomy (aOR 0.55, 95% CI [0.38; 0.79]) and diabetes (aOR 1.73, 95% CI [1.15; 2.61]) were associated with 34DPT among patients with operative vaginal deliveries. CONCLUSION In a tertiary medical center model with low cesarean section rate, factors associated with 34DPT were different among patients with or without operative vaginal delivery. The question of the protective effect of mediolateral episiotomy against 34DPT in case of operative delivery deserves further investigations.
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Affiliation(s)
- P von Theobald
- Centre d'Études Périnatales de l'Océan Indien (CEPOI) - EA7388, Centre Hospitalier Universitaire de la Réunion, Saint-Pierre Cedex, La Réunion, France; Service de Gynécologie et Obstétrique, CHU de la Réunion, Hôpital Félix Guyon, Allée des Topazes, CS 11021, 97405 Saint Denis de La Réunion Cedex, France.
| | - M Bohrer
- Département d'Informatique Médicale, CHU de la Réunion, Hôpital Félix Guyon, Allée des Topazes, CS 11021, 97405 Saint Denis de La Réunion Cedex, France
| | - S Lorrain
- Centre d'Études Périnatales de l'Océan Indien (CEPOI) - EA7388, Centre Hospitalier Universitaire de la Réunion, Saint-Pierre Cedex, La Réunion, France
| | - S Iacobelli
- Centre d'Études Périnatales de l'Océan Indien (CEPOI) - EA7388, Centre Hospitalier Universitaire de la Réunion, Saint-Pierre Cedex, La Réunion, France; Réanimation Néonatale et Pédiatrique, Néonatologie, Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France
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Panes A, Pariente A, Bénard-Laribière A, Lassalle R, Dureau-Pournin C, Lorrain S, Tournier M, Fourrier-Réglat A. Use of benzodiazepines and z-drugs not compliant with guidelines and associated factors: a population-based study. Eur Arch Psychiatry Clin Neurosci 2020; 270:3-10. [PMID: 30539229 DOI: 10.1007/s00406-018-0966-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 06/04/2018] [Accepted: 12/06/2018] [Indexed: 10/27/2022]
Abstract
Benzodiazepines and z-drugs are primarily indicated for the treatment of sleep disorders and anxiety symptoms. Their frequent long-term use contrasts with the international guidelines that limit treatment duration to a maximum of 4 weeks. The objective of this study was to assess the frequency of their use that was not in accordance with guidelines in the French general population between 2007 and 2012 and associated characteristics. A cohort of 67,550 benzodiazepine new users was set up in an exhaustive database for health-care reimbursements and representative of the French population. Benzodiazepine use not in accordance with guidelines was defined as the concomitant dispensation of several benzodiazepines, the dispensation of treatment over a period longer than recommended, or a new dispensing within the 2 months following the end of a previous treatment of maximum recommended duration, considering that French recommendations distinguish between hypnotic (4 weeks) and anxiolytic benzodiazepines (12 weeks). Benzodiazepine use not in accordance with guidelines was high, in about 30% of new hypnotic users and 20% of new anxiolytic users. Its frequency was stable over the study period. Associated characteristics were similar for new hypnotic or anxiolytic users, i.e.. older age, treatment initiation by a psychiatrist, presence of a chronic disease, hospitalization, or another psychotropic treatment. These findings provide a solid basis for establishing a public health policy to reduce benzodiazepine use not compliant with guidelines. They should be further explored in patients most at risk in the present study, e.g., patients treated by a psychiatrist.
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Affiliation(s)
- Arnaud Panes
- Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, University of Bordeaux, 33000, Bordeaux, France.
| | - Antoine Pariente
- Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, University of Bordeaux, 33000, Bordeaux, France.,CHU Bordeaux, Pôle de Santé Publique, Service D'information Médicale, 33000, Bordeaux, France
| | - Anne Bénard-Laribière
- Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, University of Bordeaux, 33000, Bordeaux, France
| | | | | | | | - Marie Tournier
- Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, University of Bordeaux, 33000, Bordeaux, France.,Centre Hospitalier Charles Perrens, 33000, Bordeaux, France
| | - Annie Fourrier-Réglat
- Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, University of Bordeaux, 33000, Bordeaux, France.,CHU Bordeaux, Pôle de Santé Publique, Service D'information Médicale, 33000, Bordeaux, France.,CIC1401, 33000, Bordeaux, France
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Gouyon B, Martin-Mons S, Iacobelli S, Razafimahefa H, Kermorvant-Duchemin E, Brat R, Caeymaex L, Couringa Y, Alexandre C, Lafon C, Ramful D, Bonsante F, Binson G, Flamein F, Moussy-Durandy A, Di Maio M, Mazeiras G, Girard O, Desbruyeres C, Mourdie J, Escourrou G, Flechelles O, Abasse S, Rosenthal JM, Pages AS, Dorsi M, Karaoui L, ElGellab A, Le Bail Dantec F, Yangui MA, Norbert K, Kugbe Y, Lorrain S, Pignolet A, Garnier EM, Lapillonne A, Mitanchez D, Jacqz-Aigrain E, Gouyon JB. Characteristics of prescription in 29 Level 3 Neonatal Wards over a 2-year period (2017-2018). An inventory for future research. PLoS One 2019; 14:e0222667. [PMID: 31536560 PMCID: PMC6752821 DOI: 10.1371/journal.pone.0222667] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022] Open
Abstract
Objectives The primary objective of this study is to determine the current level of patient medication exposure in Level 3 Neonatal Wards (L3NW). The secondary objective is to evaluate in the first month of life the rate of medication prescription not cited in the Summary of Product Characteristics (SmPC). A database containing all the medication prescriptions is collected as part of a prescription benchmarking program in the L3NW. Material and methods The research is a two-year observational cohort study (2017–2018) with retrospective analysis of medications prescribed in 29 French L3NW. Seventeen L3NW are present since the beginning of the study and 12 have been progressively included. All neonatal units used the same computerized system of prescription, and all prescription data were completely de-identified within each hospital before being stored in a common data warehouse. Results The study population includes 27,382 newborns. Two hundred and sixty-one different medications (International Nonproprietary Names, INN) were prescribed. Twelve INN (including paracetamol) were prescribed for at least 10% of patients, 55 for less than 10% but at least 1% and 194 to less than 1%. The lowest gestational ages (GA) were exposed to the greatest number of medications (18.0 below 28 weeks of gestation (WG) to 4.1 above 36 WG) (p<0.0001). In addition, 69.2% of the 351 different combinations of an medication INN and a route of administration have no indication for the first month of life according to the French SmPC. Ninety-five percent of premature infants with GA less than 32 weeks received at least one medication not cited in SmPC. Conclusion Neonates remain therapeutic orphans. The consequences of polypharmacy in L3NW should be quickly assessed, especially in the most immature infants.
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Affiliation(s)
- Béatrice Gouyon
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | - Séverine Martin-Mons
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | - Silvia Iacobelli
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | | | | | - Roselyne Brat
- Centre Hospitalier Régional d’Orléans, Orléans, France
| | | | - Yvan Couringa
- Centre Hospitalier Andrée-Rosemon, Guyane Française, France
| | | | | | - Duksha Ramful
- Centre Hospitalier Universitaire de La Réunion – Site Nord, Saint Denis, Réunion, France
| | - Francesco Bonsante
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | | | | | | | | | - Gaël Mazeiras
- Centre Hospitalier de la Côte Basque, Bayonne, France
| | | | | | - Julien Mourdie
- Hôpital Jacques Monod – Groupe Hospitalier du Havre, Montivilliers, France
| | | | - Olivier Flechelles
- Centre Hospitalier Universitaire de Fort-de-France, Fort de France, Martinique, France
| | | | | | - Anne-Sophie Pages
- Centre Hospitalier Public du Cotentin, Cherbourg-en-Cotentin, France
| | - Marine Dorsi
- Centre Hospitalier Territorial Gaston-Bourret, Dumbéa, Nouvelle Calédonie, France
| | | | | | | | | | | | - Yaovi Kugbe
- Centre Hospitalier de l’Ouest Guyanais – Franck Joly, Saint Laurent du Maroni, Guyane Française, France
| | - Simon Lorrain
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | - Anaelle Pignolet
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | - Elodie Marie Garnier
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
| | | | | | | | - Jean-Bernard Gouyon
- Centre d’Etudes Périnatales de l’Océan Indien (EA 7388), Centre Hospitalier Universitaire de La Réunion – Site Sud, Saint Pierre, Réunion, France
- * E-mail:
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10
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Blin P, Samama CM, Sautet A, Benichou J, Lignot-Maleyran S, Lamarque S, Lorrain S, Lassalle R, Droz-Perroteau C, Mismetti P, Moore N. Comparative effectiveness of direct oral anticoagulants versus low-molecular weight heparins for the prevention of venous thromboembolism after total hip or knee replacement: A nationwide database cohort study. Pharmacol Res 2018; 141:201-207. [PMID: 30583081 DOI: 10.1016/j.phrs.2018.12.018] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Venous thromboembolism (VTE) after total knee or hip replacement (TKR, THR) is usually prevented with low-molecular weight heparin (LMWH), and increasingly by direct oral anticoagulants (DOAC). The aim of the present study was to compare the benefit-risk and medical costs of DOAC vs. LMWH in a real-life setting. METHODS All patients with THR or TKR in France between Jan-1st 2013 and Sep-30th 2014, discharged to home, were identified and followed-up for 3 months in the French nationwide claims database, SNDS. DOAC users were 1:1 matched with LWMH users on gender, age and propensity score. Relative risks (RR) of hospitalized VTE, hospitalized bleeding and death were estimated using quasi-Poisson models. Medical costs were calculated according to the societal perspective, including total cost for outpatient claims and national DRG costs for hospitalisations. RESULTS Most DOAC users (≥ 98.8%) were matched to a LMWH patient. For the 63,238 matched THR patients, the 3-month absolute risk of VTE was 0.9‰ with DOAC and 2.5‰ with LMWH (RR = 0.35 [0.23 to 0.54]), of bleeding 1.8‰ and 2.1‰ (0.88 [0.62-1.25]), death 0.7‰ and 1.1‰ (0.68 [0.40-1.15]). For the 31,440 matched TKR patients, risks were 1.6‰ and 2.3‰ (0.69 [0.42-1.16]) for VTE, 2.4‰ and 3.8‰ (0.64 [0.43 to 0.97]) for bleeding, and 0.6‰ and 0.8‰ (0.69 [0.30-1.62]) for all-cause death. Mean medical costs were 28% and 21% lower with DOAC than LMWH for THR and TKR, respectively. This nationwide study found a very low risk of VTE, hospitalized bleeding and death after THR or TKR discharge in patients with VTE prevention in real-life setting, with better benefit-risk profiles of DOAC compared to LMWH, and associated cost savings.
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Affiliation(s)
- Patrick Blin
- Bordeaux Pharmacoepi, Inserm CIC1401, Bordeaux University, 33076, Bordeaux, France.
| | - Charles-Marc Samama
- Cochin University Hospital, Paris Descartes University, Paris, 75014, France
| | - Alain Sautet
- Saint-Antoine University Hospital, Paris, 75010, France
| | | | | | - Stéphanie Lamarque
- Bordeaux Pharmacoepi, Inserm CIC1401, Bordeaux University, 33076, Bordeaux, France
| | - Simon Lorrain
- Bordeaux Pharmacoepi, Inserm CIC1401, Bordeaux University, 33076, Bordeaux, France
| | - Régis Lassalle
- Bordeaux Pharmacoepi, Inserm CIC1401, Bordeaux University, 33076, Bordeaux, France
| | | | | | - Nicholas Moore
- Bordeaux Pharmacoepi, Inserm CIC1401, Bordeaux University, 33076, Bordeaux, France; INSERM U1219, Bordeaux, 33076, France
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11
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Blin P, Demoly P, Drouet M, Falissard B, Lignot-Maleyran S, Maizi H, Lorrain S, Lassalle R, Droz-Perroteau C, Moore N, Molimard M. An observational cohort study of the use of five-grass-pollen extract sublingual immunotherapy during the 2015 pollen season in France. Allergy Asthma Clin Immunol 2018; 14:38. [PMID: 30258465 PMCID: PMC6151918 DOI: 10.1186/s13223-018-0262-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 04/30/2018] [Indexed: 11/10/2022] Open
Abstract
Background Allergic rhinitis affects around one quarter of the Western European population. Prophylactic allergen immunotherapy may be useful to reduce the risk of acute symptomatic attacks (hayfever). A five-grass pollen extract sublingual immunotherapy (5GPE-SLIT) has been developed for the treatment of allergic rhinitis to grass pollen. The objective of this study was to describe real-world treatment patterns with 5GPE-SLIT in France with respect to the prescribing information. Methods This prospective cohort study was conducted by 90 community and hospital allergists. Adults and children (> 5 years old) starting a first treatment with 5GPE-SLIT prior to the 2015 pollen season were eligible. Data was collected at the inclusion visit and at the end of the pollen season. The primary outcome variable was compatibility of 5GPE-SLIT prescription with the prescribing information. This was determined with respect to four variables: (1) interval between 5GPE-SLIT initiation and onset of the pollen season ≥ 3 months, (2) age of patient ≥ 5 years, (3) intermittent symptoms or mild symptom severity (4) confirmatory diagnostic test. At study end, symptoms reported during the pollen season and any modifications to treatment or adverse events were documented. Results 280 adults and 203 children were enrolled. The prescribing information was respected for 82.5% of adults and 86.7% of children. A skin test was performed for all patients. 5GPE-SLIT was started 3–5 months before the pollen season for 85.3%. Treatment was discontinued before the start of the pollen season in 11.0% of patients overall, generally because of an adverse event (78.8% of discontinuations). The mean duration of treatment was 5.2 months in adults and 5.6 months in children. At the end of follow-up, symptoms during the pollen season were intermittent for 75.0% of adults and 85.7% of children, and severity was mild for 61.8 and 66.0% respectively. During 5GPE-SLIT, the following symptoms reported during the previous year were not reported again in > 50% of patients: nasal congestion, rhinorrhoea, repeated sneezing, conjunctivitis and nasal pruritus. Conclusions 5GPE-SLIT use was generally consistent with prescribing recommendations and was associated with an improvement of AR severity, with resolution of the principal AR symptoms in around half the patients treated. Trial registration EUPAS9358. Registered 13 May 2015. Not prospectively registered. http://www.encepp.eu/encepp/viewResource.htm?id=16229 Electronic supplementary material The online version of this article (10.1186/s13223-018-0262-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patrick Blin
- 1Bordeaux PharmacoEpi, Université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France.,CIC Bordeaux, CIC Bordeaux CIC1401, Bordeaux Cedex, France
| | - Pascal Demoly
- 3Allergy Department, CHRU de Montpellier, Montpellier, France
| | | | | | - Séverine Lignot-Maleyran
- 1Bordeaux PharmacoEpi, Université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France.,CIC Bordeaux, CIC Bordeaux CIC1401, Bordeaux Cedex, France
| | - Hélène Maizi
- 1Bordeaux PharmacoEpi, Université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France.,CIC Bordeaux, CIC Bordeaux CIC1401, Bordeaux Cedex, France
| | - Simon Lorrain
- 1Bordeaux PharmacoEpi, Université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France.,CIC Bordeaux, CIC Bordeaux CIC1401, Bordeaux Cedex, France
| | - Régis Lassalle
- 1Bordeaux PharmacoEpi, Université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France.,CIC Bordeaux, CIC Bordeaux CIC1401, Bordeaux Cedex, France
| | - Cécile Droz-Perroteau
- 1Bordeaux PharmacoEpi, Université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France.,CIC Bordeaux, CIC Bordeaux CIC1401, Bordeaux Cedex, France
| | - Nicholas Moore
- 1Bordeaux PharmacoEpi, Université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France.,CIC Bordeaux, CIC Bordeaux CIC1401, Bordeaux Cedex, France.,CHU INSERM U1219, Bordeaux, France
| | - Mathieu Molimard
- CHU INSERM U1219, Bordeaux, France.,7Pharmacology Department, CHU de Bordeaux, Bordeaux, France
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12
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Lassalle R, Lignot-Maleyran S, Micon S, Lorrain S, Jové J, Larrey D, Meunier L, Pageaux GP, Droz-Perroteau C, Moore N. Exposition médicamenteuse et risque d’insuffisance hépatique aiguë conduisant à l’inscription sur liste de transplantation (IHAT) : résultats de l’étude SALT-III chez des adultes en France. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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13
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Farland LV, Lorrain S, Missmer SA, Dartois L, Cervenka I, Savoye I, Mesrine S, Boutron-Ruault MC, Kvaskoff M. Endometriosis and the risk of skin cancer: a prospective cohort study. Cancer Causes Control 2017; 28:1011-1019. [PMID: 28799019 DOI: 10.1007/s10552-017-0939-2] [Citation(s) in RCA: 17] [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: 04/09/2017] [Accepted: 08/03/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Endometriosis has been associated with an increased risk of skin melanoma. However, associations with other skin cancer types and how they compare with melanoma are unclear. Our objective was to prospectively investigate the relationships between endometriosis and risk of non-melanoma and melanoma skin cancers. METHODS E3N is a prospective cohort of 98,995 French women aged 40-65 years in 1990. Data on surgically confirmed endometriosis and skin cancer diagnoses were collected every 2-3 years through self-report, with skin cancer cases confirmed through pathology reports. Hazard Ratios (HR) and 95% confidence intervals (CIs) were calculated using Cox regression models. RESULTS Between 1990 and 2008, 535 melanoma, 247 squamous-cell carcinoma (SCC), and 1,712 basal-cell carcinoma (BCC) cases were ascertained. Endometriosis was associated with an increased overall risk of skin cancer (HR 1.28, 95% CI 1.05-1.55). When considering skin cancer type, endometriosis was associated with melanoma risk (HR 1.64, 95% CI 1.15-2.35), but not with SCC (HR 1.21, 95% CI 0.62-2.36) or BCC (HR 1.16, 95% CI 0.91-1.48) (non-melanoma skin cancers combined: HR 1.17, 95% CI 0.93-1.46), although no heterogeneity was detected across skin cancer types (Phomogeneity = 0.13). CONCLUSION These data support an association between a personal history of endometriosis and the risk of skin cancer and suggest that the association is strongest for melanoma.
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Affiliation(s)
- Leslie V Farland
- Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA, 02115, USA.,Department of Obstetrics, Gynaecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Simon Lorrain
- Univ. Bordeaux, ISPED, Centre INSERM U897-Epidémiologie-Biostatistique, 33000, Bordeaux, France
| | - Stacey A Missmer
- Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA, 02115, USA.,Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, 02115, Boston, MA, USA.,Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, 49503, USA
| | - Laureen Dartois
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Iris Cervenka
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Isabelle Savoye
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Sylvie Mesrine
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Marie-Christine Boutron-Ruault
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Marina Kvaskoff
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France. .,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.
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14
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Blin P, Samama CM, Sautet A, Mismetti P, Benichou J, Lignot-Maleyran S, Lamarque S, Lorrain S, Lassalle R, Droz-Perroteau C, Moore N. Bénéfice et risques des anticoagulants oraux directs comparativement aux héparines de bas poids moléculaire dans la prévention thromboembolique après une prothèse totale de hanche ; cohorte de près de 100 000 patients issus de la base nationale du Sniiram. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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15
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Blin P, Demoly P, Drouet M, Falissard B, Lignot-Maleyran S, Maizi H, Lorrain S, Lassalle R, Droz-Perroteau C, Moore N, Molimard M. Évaluation d’Oralair ® dans la rhinite allergique en conditions réelles d’utilisation : résultats d’une cohorte française. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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16
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Allès B, Samieri C, Lorrain S, Jutand MA, Carmichael PH, Shatenstein B, Gaudreau P, Payette H, Laurin D, Barberger-Gateau P. Nutrient Patterns and Their Food Sources in Older Persons from France and Quebec: Dietary and Lifestyle Characteristics. Nutrients 2016; 8:225. [PMID: 27104557 PMCID: PMC4848693 DOI: 10.3390/nu8040225] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 03/24/2016] [Accepted: 03/31/2016] [Indexed: 12/21/2022] Open
Abstract
Background: Dietary and nutrient patterns have been linked to health outcomes related to aging. Food intake is influenced by environmental and genetic factors. The aim of the present study was to compare nutrient patterns across two elderly populations sharing a common ancestral cultural background, but living in different environments. Methods: The diet quality, lifestyle and socioeconomic characteristics of participants from the Three-City Study (3C, France, n = 1712) and the Québec Longitudinal Study on Nutrition and Successful Aging (NuAge, Quebec, Canada, n = 1596) were analyzed. Nutrient patterns and their food sources were identified in the two samples using principal component analysis. Diet quality was compared across sample-specific patterns by describing weekly food intake and associations with the Canadian Healthy Eating Index (C-HEI). Results: Three nutrient patterns were retained in each study: a healthy, a Western and a more traditional pattern. These patterns accounted for 50.1% and 53.5% of the total variance in 3C and NuAge, respectively. Higher education and non-physical occupations over lifetime were associated with healthy patterns in both studies. Other characteristics such as living alone, having a body mass index lower than 25 and being an ex-smoker were associated with the healthy pattern in NuAge. No association between these characteristics and the nutrient patterns was noted in 3C. The healthy and Western patterns from each sample also showed an inverse association with C-HEI. Conclusion: The two healthy patterns showed important similarities: adequate food variety, consumption of healthy foods and associations with common sociodemographic factors. This work highlights that nutrient patterns derived using a posteriori methods may be useful to compare the nutritional quality of the diet of distinct populations.
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Affiliation(s)
- Benjamin Allès
- Centre INSERM U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, F-33000, France.
- Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, F-33000, France.
- Québec Center of Excellence on Aging, CHU de Québec Research Center, Quebec City, QC G1S 4L8, Canada.
- Faculty of Pharmacy, Laval University, Quebec City, QC G1V 0A6, Canada.
| | - Cécilia Samieri
- Centre INSERM U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, F-33000, France.
- Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, F-33000, France.
| | - Simon Lorrain
- Centre INSERM U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, F-33000, France.
- Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, F-33000, France.
| | - Marthe-Aline Jutand
- Centre INSERM U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, F-33000, France.
- Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, F-33000, France.
| | - Pierre-Hugues Carmichael
- Québec Center of Excellence on Aging, CHU de Québec Research Center, Quebec City, QC G1S 4L8, Canada.
| | - Bryna Shatenstein
- Département de Nutrition, Université de Montréal, Montréal, QC H3T 1A8, Canada.
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-est-de-l'Île-de-Montréal, Montréal, QC H3W 1W5, Canada.
| | - Pierrette Gaudreau
- Department of Medicine, University of Montreal, Montreal, QC H3C 3J7, Canada.
- Centre Hospitalier de l'Université de Montréal Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada.
| | - Hélène Payette
- Research Center on Aging-Centre Intégré Universitaire de Santé et des Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (CIUSS de l'Estrie-CHUS), Sherbrooke, QC J1H 4C4, Canada.
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada.
| | - Danielle Laurin
- Québec Center of Excellence on Aging, CHU de Québec Research Center, Quebec City, QC G1S 4L8, Canada.
- Faculty of Pharmacy, Laval University, Quebec City, QC G1V 0A6, Canada.
| | - Pascale Barberger-Gateau
- Centre INSERM U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, F-33000, France.
- Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, F-33000, France.
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Fiore M, Pillois X, Lorrain S, Bernard MA, Moore N, Sié P, Viallard JF, Nurden P. A diagnostic approach that may help to discriminate inherited thrombocytopenia from chronic immune thrombocytopenia in adult patients. Platelets 2016; 27:555-62. [PMID: 27025585 DOI: 10.3109/09537104.2016.1143920] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Inherited thrombocytopenia (IT) is a heterogeneous group of rare diseases that are often confused with immune thrombocytopenia (ITP). The objective of this study was to supply clinicobiological elements that allow a distinction to be drawn between IT and chronic ITP. We then compared 23 adult patients with IT and 9 patients with chronic ITP. Our study revealed six discriminating criteria: (i) an age of discovery <34 years: positive predictive value (PPV) = 88.2% [63.6; 98.5], (ii) a family history of thrombocytopenia: PPV = 100.0% [82.4; 100.0], (iii) a personal history of bleeding: PPV = 100% [76.8; 100.0], (iv) a mean platelet volume >11 fL: PPV = 93.3% [68.1; 99.8], (v) an excess of giant platelets on blood smear: 100.0% [76.8; 100.0], and (vi) a percentage >44% of platelets with a surface area >4 µm(2) in electron microscopy: PPV = 83.3% [58.6; 96.4]. If at least three of these criteria were combined, it was possible to distinguish IT from chronic ITP with 91.3% [72.0; 98.9] sensitivity and PPV = 100.0% [66.4; 100.0] specificity. The secondary objective of this study was to assess the prevalence of potential IT diagnosis in patients with chronic thrombocytopenia of uncertain origin. Applying our diagnostic approach to a series of 20 cases allowed us to estimate that 40% of them could be suffering from IT. Finally, our diagnostic approach may help to correctly distinguish IT from chronic ITP, particularly in the context of macrothrombocytopenia.
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Affiliation(s)
- Mathieu Fiore
- a Laboratory of Haematology , Bordeaux University Hospital Centre , Pessac , France.,b Reference Centre for Platelet Disorders , Bordeaux University Hospital Centre , Pessac , France
| | - Xavier Pillois
- b Reference Centre for Platelet Disorders , Bordeaux University Hospital Centre , Pessac , France
| | - Simon Lorrain
- c Clinical Investigation Centre , Bordeaux University Hospital Centre , Bordeaux , France
| | - Marie-Agnès Bernard
- c Clinical Investigation Centre , Bordeaux University Hospital Centre , Bordeaux , France
| | - Nicholas Moore
- c Clinical Investigation Centre , Bordeaux University Hospital Centre , Bordeaux , France
| | - Pierre Sié
- b Reference Centre for Platelet Disorders , Bordeaux University Hospital Centre , Pessac , France.,d Laboratory of Haematology , Toulouse University Hospital Centre , Toulouse , France
| | | | - Paquita Nurden
- b Reference Centre for Platelet Disorders , Bordeaux University Hospital Centre , Pessac , France.,f Rythmology and Cardiac Modeling Institute (LIRYC) , Xavier Arnozan Hospital Centre , Pessac , France
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Maury E, Savel J, Grouthier V, Rajaobelina K, Corvo L, Lorrain S, Gonzalez C, Gin H, Barberger-Gateau P, Rigalleau V. Is skin autofluorescence a marker of metabolic memory in pregnant women with diabetes? Diabet Med 2015; 32:1575-9. [PMID: 25981634 DOI: 10.1111/dme.12803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2015] [Indexed: 12/30/2022]
Abstract
AIM To determine whether skin autofluorescence can help to detect those who have previously had abnormal glucose levels among women referred for diabetes during pregnancy. METHODS Using an advanced glycation end product reader (AGE Reader(tm) (;) DiagnOptics BV, Groningen, the Netherlands), we measured forearm skin autofluorescence at 24-30 weeks of gestation in all women who were referred to our Nutrition Diabetology unit for diabetes during pregnancy. RESULTS The study included 230 women (200 with gestational diabetes and 30 with pre-gestational diabetes, of whom 21 had Type 1 and nine had Type 2 diabetes) and a reference group of 22 normoglycaemic non-pregnant women. Skin autofluorescence was significantly higher in women with pre-gestational diabetes (1.97 ± 0.44 arbitary units) compared with gestational diabetes (1.77 ± 0.32 arbitary units; P = 0.003) and lower in the reference group (1.60 ± 0.32 arbitary units; P = 0.009 vs all pregnant women). Among women with gestational diabetes, 71 had a history of hyperglycaemia (i.e. gestational diabetes or macrosomia in a previous pregnancy or discovery of diabetes before 24th gestational week in the present pregnancy). These women had higher levels of skin autofluorescence (1.83 ± 0.35 arbitary units) than women with gestational diabetes without previous history of hyperglycaemia (1.73 ± 0.30 arbitary units; P = 0.04, non-significant, adjusted for age). Skin autofluorescence increased with the number of criteria present for previous hyperglycaemia (P for trend = 0.008) and was significantly associated with having two or three criteria for hyperglycaemia after adjusting for age (P = 0.02). CONCLUSIONS Skin autofluorescence could reflect previous long-term hyperglycaemia in pregnant women, and could therefore be a marker of metabolic memory.
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MESH Headings
- Adult
- Biomarkers/metabolism
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/metabolism
- Diabetes, Gestational/blood
- Diabetes, Gestational/epidemiology
- Diabetes, Gestational/metabolism
- Female
- Fluorescence
- Forearm
- France/epidemiology
- Fructosamine/blood
- Glycated Hemoglobin/analysis
- Glycation End Products, Advanced/metabolism
- Humans
- Pregnancy
- Pregnancy Trimester, Second
- Pregnancy Trimester, Third
- Pregnancy in Diabetics/blood
- Pregnancy in Diabetics/metabolism
- Recurrence
- Risk
- Skin/metabolism
- Spectrometry, Fluorescence
- Up-Regulation
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Affiliation(s)
- E Maury
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - J Savel
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
| | - V Grouthier
- Department of Gynaecology, CHU Bordeau, Pellegrin Hospital, Bordeaux, France
| | - K Rajaobelina
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - L Corvo
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
| | - S Lorrain
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - C Gonzalez
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
| | - H Gin
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
| | - P Barberger-Gateau
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
| | - V Rigalleau
- Nutrition Diabetology Unit, CHU Bordeaux, Haut Lévèque Hospital, Pessac, France
- University of Bordeaux, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux, France
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Ferland G, Feart C, Presse N, Lorrain S, Bazin F, Helmer C, Berr C, Annweiler C, Rouaud O, Dartigues JF, Fourrier-Reglat A, Barberger-Gateau P. Vitamin K Antagonists and Cognitive Function in Older Adults: The Three-City Cohort Study. J Gerontol A Biol Sci Med Sci 2015; 71:1356-62. [PMID: 26576841 DOI: 10.1093/gerona/glv208] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 10/22/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND A growing body of evidence supports a beneficial role for vitamin K in brain and cognition, notably in studies where animals are rendered vitamin K deficient by warfarin, a potent vitamin K antagonist (VKA). Given VKAs are commonly used oral anticoagulants in older persons, we investigated the relationship between VKA therapy and cognitive performances over 10 years in participants of the Three-City study. METHODS The Three-City cohort included 7,133 nondemented community dwellers, aged 65 years or older at baseline. Exposures to VKAs and platelet aggregation inhibitors, another antithrombotic agent, were determined at baseline. Participants underwent cognitive assessment at baseline and every 2 years over 10 years. Associations were analyzed with mixed linear models adjusting for many covariates including VKA and platelet aggregation inhibitor indications. RESULTS About 239 (3.4%) and 1,192 (16.7%) of the participants were treated with VKAs and platelet aggregation inhibitors at baseline, respectively. VKA treatment was significantly associated with worse performances on Benton Visual Retention Test assessing visual memory (adjusted mean difference -0.29; p = .02 in multivariate models) and Isaacs Set Test assessing verbal fluency (adjusted mean difference -1.37; p = .0009) at baseline. Treatment with VKAs was not associated with global cognitive functioning on the Mini Mental State Examination, neither with rate of subsequent decline in scores on all three cognitive tests. No associations were found between platelet aggregation inhibitors and cognitive performances or rate of decline. CONCLUSION These findings do not indicate a long-term detrimental effect of VKAs on cognition, but the risk-benefit balance of VKA treatment still deserves further research.
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Affiliation(s)
- Guylaine Ferland
- Département de Nutrition, Faculté de Médecine, Université de Montréal, Quebec, Canada
| | - Catherine Feart
- University of Bordeaux and INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
| | - Nancy Presse
- Faculté de Pharmacie, Université de Montréal, Quebec, Canada
| | - Simon Lorrain
- University of Bordeaux and INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France. Present address: INSERM CIC1401, Amélie Raba-Léon, Bordeaux, France
| | - Fabienne Bazin
- CHU Bordeaux, France. University of Bordeaux, INSERM U657, France
| | - Catherine Helmer
- University of Bordeaux and INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France. INSERM, CIC 1401 Bordeaux, Clinical Epidemiology Unit, France
| | - Claudine Berr
- INSERM, U1061, Hôpital La Colombière Montpellier, France. Université Montpellier 1, France. Centre de Mémoire de Ressources et de Recherche Languedoc Roussillon, Hôpital Gui de Chauliac, Montpellier, France
| | - Cedric Annweiler
- Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, UPRES EA4638, UNAM, Angers University Hospital, France. Robarts Research Institute, The University of Western Ontario, London, Canada
| | - Olivier Rouaud
- Centre Mémoire Ressources et Recherche, CHU Dijon, Bocage Central, France
| | - Jean-François Dartigues
- University of Bordeaux and INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France
| | - Annie Fourrier-Reglat
- CHU Bordeaux, France. University of Bordeaux, INSERM U657, France. INSERM, CIC1401, Pharmacoepidemiology Unit, Bordeaux, France
| | - Pascale Barberger-Gateau
- University of Bordeaux and INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France
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20
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Hamza N, Berke B, Cheze C, Marais S, Lorrain S, Abdouelfath A, Lassalle R, Carles D, Gin H, Moore N. Effect of Centaurium erythraea Rafn, Artemisia herba-alba Asso and Trigonella foenum-graecum L. on liver fat accumulation in C57BL/6J mice with high-fat diet-induced type 2 diabetes. J Ethnopharmacol 2015; 171:4-11. [PMID: 26023031 DOI: 10.1016/j.jep.2015.05.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 05/08/2015] [Accepted: 05/16/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Centaurium erythraea Rafn (CE), Artemisia herba-alba Asso (AHA) and Trigonella foenum-graecum L. (TFG) are traditionally used to treat type 2 diabetes in Algeria, previous studies have found that extracts of these plants were effective to treat or prevent experimental diabetes induced by high-fat diet (HFD). AIM OF THE STUDY Describe the additional effects of these extracts on lipid tissue deposition in HFD. MATERIALS AND METHODS Male C57BL/6J mice were fed with HFD to induce type 2 Diabetes. Groups of mice were given plant extracts orally at 2g/kg/bodyweight daily for 20 weeks during establishment of diabetes, or for 18 weeks after confirmation of diabetes at the 17th week. Liver and other tissue samples were stained with Oil Red O. RESULTS Liver steatosis was confirmed with HFD. CE, AHA and TFG extracts improved liver steatosis by the end of the preventive (20 weeks) and curative periods (35 weeks). This was most marked for CE extract (p<0.05), less so with TFG and AHA. No steatosis was found in other tissues. CONCLUSION CE extract had a clear hepatoprotective effect in this mouse model of diet-induced type 2 diabetes. AHA and TFG had a minimal or no significant effect on steatosis. Beyond its effect as an antidiabetic agent, CE may also be promising to prevent or treat non-alcoholic liver steatosis.
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Affiliation(s)
- Nawel Hamza
- Département de Pharmacologie, Université de Bordeaux, Bordeaux, France; Département de Nutrition, Université des frères Mentouri, INATAA, Constantine, Algerie.
| | - Bénédicte Berke
- Département de Pharmacologie, Université de Bordeaux, Bordeaux, France
| | - Catherine Cheze
- Département de Pharmacologie, Université de Bordeaux, Bordeaux, France
| | - Sébastien Marais
- Bordeaux Imaging Center, UMS 3420 CNRS, Université de Bordeaux, Bordeaux, France
| | - Simon Lorrain
- Département de Pharmacologie, Université de Bordeaux, Bordeaux, France
| | | | - Regis Lassalle
- Département de Pharmacologie, Université de Bordeaux, Bordeaux, France
| | - Dominique Carles
- Unité de pathologie fœtoplacentaire, Université de Bordeaux, CHU de Bordeaux, Hôpital Pellegrin, Bordeaux, France
| | - Henri Gin
- Service de Nutrition Diabétologie et Maladies Métaboliques, CHU de Bordeaux, Haut-Levèque, Bordeaux, France
| | - Nicholas Moore
- Département de Pharmacologie, Université de Bordeaux, Bordeaux, France.
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Rigalleau V, Cougnard-Gregoire A, Nov S, Gonzalez C, Maury E, Lorrain S, Gin H, Barberger-Gateau P. Association of advanced glycation end products and chronic kidney disease with macroangiopathy in type 2 diabetes. J Diabetes Complications 2015; 29:270-4. [PMID: 25468311 DOI: 10.1016/j.jdiacomp.2014.10.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/21/2014] [Accepted: 10/23/2014] [Indexed: 11/16/2022]
Abstract
AIMS Accumulation of advanced glycation end-products (AGEs), may explain the major contribution of chronic kidney disease (CKD) to cardiovascular events in patients with type 2 diabetes (T2D) related to their impaired renal function. The aim of this study was to analyze the factors associated with AGE assessed by skin autofluorescence and their association with macroangiopathy in T2D. METHODS We measured skin autofluorescence in patients hospitalized for T2D. Glomerular filtration rates were estimated (eGFR) by the EPI-CKD formula. Associations between skin autofluorescence, renal function and macroangiopathy were explored by multivariate analyses adjusting for diabetes duration and control. RESULTS The 418 patients had T2D since 13.3 (SD 9.8) years on average, high mean HbA1C: 8.9%, (SD 1.8), (74 mmol/mol, (SD 15)) and often renal complications (49.4% with CKD). Their mean skin autofluorescence was 2.53 (SD 0.62) A.U. In multivariate linear regression, skin autofluorescence was significantly associated with age (+0.20 for ten more years, p<0.0001), renal insufficiency (-0.07 for less 10 mL/min/1.73 m² eGFR, p<0.0001) and smoking (+0.21, p=0.0004). Autofluorescence (p=0.01), but not CKD, was associated with macroangiopathy independent of diabetes duration and control. CONCLUSIONS Accumulation of AGEs is independently associated with renal insufficiency and macroangiopathy in patients with T2D.
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Affiliation(s)
- V Rigalleau
- Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France.
| | - A Cougnard-Gregoire
- Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - S Nov
- Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - C Gonzalez
- Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France
| | - E Maury
- Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - S Lorrain
- Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - H Gin
- Nutrition-Diabétologie, Bordeaux Hospital, F-33600 Pessac, France; Univ. Bordeaux, F-33000 Bordeaux, France
| | - P Barberger-Gateau
- Univ. Bordeaux, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
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Feart C, Lorrain S, Ginder Coupez V, Samieri C, Letenneur L, Paineau D, Barberger-Gateau P. Adherence to a Mediterranean diet and risk of fractures in French older persons. Osteoporos Int 2013; 24:3031-41. [PMID: 23783645 DOI: 10.1007/s00198-013-2421-7] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 06/07/2013] [Indexed: 12/27/2022]
Abstract
UNLABELLED Prevention of fractures is a considerable public health challenge. In a population-based cohort of French elderly people, a diet closer to a Mediterranean type had a borderline significant deleterious effect on the risk of fractures, in part linked to a low consumption of dairy products and a high consumption of fruits. INTRODUCTION Higher adherence to the Mediterranean diet (MeDi) is linked to a lower risk of several chronic diseases, but its association with the risk of fractures is unclear. Our aim was to investigate the association between MeDi adherence and the risk of fractures in older persons. METHODS The sample consisted of 1,482 individuals aged 67 years or older, from Bordeaux, France, included in the Three-City Study in 2001-2002. Occurrences of hip, vertebral and wrist fractures were self-reported every 2 years over 8 years, and 155 incident fractures were recorded. Adherence to the MeDi was evaluated at baseline by a MeDi score, on a 10-point scale based on a food frequency questionnaire and a 24-h recall. Multivariate Cox regression tests were performed to estimate the risk of fractures according to MeDi adherence. RESULTS Higher MeDi adherence was associated with a non-significant increased risk of fractures at any site (hazard ratio [HR] per 1-point increase of MeDi score = 1.10, P = 0.08) in fully adjusted model. Among MeDi components, higher fruits consumption (>2 servings/day) was significantly associated with an increased risk of hip fractures (HR = 1.95, P = 0.04), while low intake of dairy products was associated with a doubled risk of wrist fractures (HR = 2.03, P = 0.007). An inverse U-shaped association between alcohol intake and risk of total fracture was observed (HR high vs. moderate = 0.61, P for trend = 0.03). CONCLUSIONS Greater MeDi adherence was not associated with a decreased risk of fractures in French older persons. The widely recognized beneficial effects of the MeDi do not seem to apply to bone health in these people.
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Affiliation(s)
- C Feart
- Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, 33000, Bordeaux, France,
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Maury E, Savel J, Grouthier V, Lorrain S, Gonzalez C, Gin H, Barberger-Gateau P, Rigalleau V. P083 Autofluorescence cutanée : un marqueur de la mémoire métabolique chez les patientes enceintes diabétiques. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70415-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Feart C, Lorrain S, Ginder Coupez V, Paineau D, Barberger-Gateau P. Régime méditerranéen et risque de fractures chez les sujets âgés : résultats de l’étude trois-Cités, Bordeaux, France. Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Carriere C, Lorrain S, Langevin C, Maurice S, Barberger-Gateau P, Thibault H. Impact d’un projet d’amélioration de l’offre alimentaire dans des collèges et lycées, Aquitaine, France. Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Samieri C, Lorrain S, Buaud B, Vaysse C, Berr C, Peuchant E, Cunnane SC, Barberger-Gateau P. Relationship between diet and plasma long-chain n-3 PUFAs in older people: impact of apolipoprotein E genotype. J Lipid Res 2013; 54:2559-67. [PMID: 23801662 PMCID: PMC3735952 DOI: 10.1194/jlr.p036475] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 06/07/2013] [Indexed: 11/20/2022] Open
Abstract
The main risk factors for Alzheimer's disease, age and the ε4 allele of the APOE gene (APOE4), might modify the metabolism of n-3 PUFAs and in turn, their impact on cognition. The aim of this study was to investigate the association between dietary fat and plasma concentrations of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in elderly persons, taking the APOE4 genotype into account. The sample was composed of 1,135 participants from the Three-City study aged 65 years and over, of whom 19% were APOE4 carriers. Mean plasma proportions of EPA [1.01%, standard deviation (SD) 0.60] and DHA (2.41%, SD 0.81) did not differ according to APOE4. In multivariate models, plasma EPA increased with frequency of fish consumption (P < 0.0001), alcohol intake (P = 0.0006), and female gender (P = 0.02), and decreased with intensive consumption of n-6 oils (P = 0.02). The positive association between fish consumption and plasma DHA was highly significant whatever the APOE genotype (P < 0.0001) but stronger in APOE4 noncarriers than in carriers (P = 0.06 for interaction). Plasma DHA increased significantly with age (P = 0.009) in APOE4 noncarriers only. These findings suggest that dietary habits, gender, and APOE4 genotype should be considered when designing interventions to increase n-3 PUFA blood levels in older people.
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Affiliation(s)
- Cécilia Samieri
- University Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - Simon Lorrain
- University Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - Benjamin Buaud
- ITERG-Equipe Nutrition Métabolisme et Santé, F-33000 Bordeaux, France
| | - Carole Vaysse
- ITERG-Equipe Nutrition Métabolisme et Santé, F-33000 Bordeaux, France
| | - Claudine Berr
- INSERM, U1061-Neuropsychiatry: Epidemiological and Clinical Research, F-34000 Montpellier, France
- University Montpellier I, UMR1061, F-34000 Montpellier, France
| | - Evelyne Peuchant
- INSERM, Biothérapies des maladies génétiques et cancers, U1035, F-33000 Bordeaux, France
- University Bordeaux, Biothérapies des maladies génétiques et cancers, U1035, F-33000, Bordeaux, France
- CHU de Bordeaux, F-33000 Bordeaux, France
| | - Stephen C. Cunnane
- Research Center on Aging, Dept of Medicine, University Sherbrooke, Sherbrooke, QC, Canada
| | - Pascale Barberger-Gateau
- University Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
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Samieri C, Ginder Coupez V, Lorrain S, Letenneur L, Allès B, Féart C, Paineau D, Barberger-Gateau P. Nutrient patterns and risk of fracture in older subjects: results from the Three-City Study. Osteoporos Int 2013; 24:1295-305. [PMID: 22976577 DOI: 10.1007/s00198-012-2132-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [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: 05/21/2012] [Accepted: 08/27/2012] [Indexed: 01/21/2023]
Abstract
UNLABELLED We investigated the association between nutrient patterns and risk of fractures in 1,482 older subjects. Patterns associated with higher intakes of Ca, P, vitamin B12, proteins and unsaturated fats, and moderate alcohol intake, provided by diets rich in dairies and charcuteries, were related to a lower risk of wrist and hip fractures. INTRODUCTION The purpose of this study was to investigate the relationship between patterns of nutrient intake and the risk of fractures in older subjects. METHODS Among 1,482 participants from the Bordeaux sample of the Three-City (3C) Study who completed a 24-h dietary recall and a food frequency questionnaire, we examined the association between patterns of nutrient intake derived from principal component analysis and 8-year incidence of self-reported fractures of the hip, the wrist, and the vertebrae. RESULTS A "nutrient-dense" pattern rich in Ca and P, iron, vitamins B including B12, vitamins C and E, alcohol, proteins, and unsaturated fats, and characterized by a higher consumption of fruits and vegetables, meats and fish, cheese and milk, charcuteries, cereals, rice, pasta, and potatoes, was associated with a 19% (95% CI 2-34%, P=0.03) lower risk of wrist fractures. The same pattern was associated with a 14% (95% CI 2-25%) lower risk of fractures at any site. A "south-western French" pattern rich in Ca, P, vitamins D and B12, retinol, alcohol, proteins, and fats-including unsaturated fats; poor in vitamins C, E, and K, carotenes, folates, and fibers; and related to a higher consumption of cheese, milk, and charcuterie and a lower consumption of fruits and vegetables was related to a 33% lower risk of hip fractures (95% CI 3-39%, P=0.03). CONCLUSIONS Higher intakes of Ca, P, vitamin B12, proteins, and unsaturated fats and moderate alcohol, provided by dietary patterns rich in cheese, milk, and charcuteries, were related to a lower risk of wrist and hip fractures in our cohort.
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Affiliation(s)
- C Samieri
- Department of Nutritional Epidemiology, Inserm U897, Bordeaux, 33076, France.
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Barthélémy I, Thibaud J, Vulin A, Bertoldi D, Goyenvalle A, Lorrain S, Dreyfus P, Carlier P, Garcia L, Blot S. T.O.1 Functional evaluation of dystrophic dogs treated by exon-skipping. Neuromuscul Disord 2007. [DOI: 10.1016/j.nmd.2007.06.456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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