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Riveline JP, Mallone R, Tiercelin C, Yaker F, Alexandre-Heymann L, Khelifaoui L, Travert F, Fertichon C, Julla JB, Vidal-Trecan T, Potier L, Gautier JF, Larger E, Lefaucheur JP. Validation of the Body Scan ®, a new device to detect small fiber neuropathy by assessment of the sudomotor function: agreement with the Sudoscan ®. Front Neurol 2023; 14:1256984. [PMID: 38020587 PMCID: PMC10644320 DOI: 10.3389/fneur.2023.1256984] [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: 07/11/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background Sudomotor dysfunction is one of the earliest manifestations of small fiber neuropathy (SFN), reflecting the alteration of sympathetic C fiber innervation of the sweat glands. Among other techniques, such innervation can be assessed by measuring electrochemical skin conductance (ESC) in microsiemens (μS). In this study, ESC was measured at the feet to detect distal SFN. For this objective, the performance of a new device, the Body Scan® (Withings, France), intended for home use, was compared with that of a reference device, the Sudoscan® (Impeto Medical, France), which requires a hospital setting. Methods In patients with diabetes with or without neuropathy or non-diabetic patients with lower-limb neuropathy, the diagnostic performance of the Body Scan® measurement was assessed by calculating its sensitivity (Se) and specificity (Sp) to detect at least moderate SFN (Se70 and Sp70), defined by a value of feet ESC ≤ 70 μS and > 50 μS on the Sudoscan® measure, or severe SFN (Se50 and Sp50), defined by a value of feet ESC ≤ 50 μS on the Sudoscan® measure. The agreement between the two devices was assessed with the analysis of Bland-Altman plots, mean absolute error (MAE), and root mean squared error (RMSE) calculations. The repeatability of the measurements was also compared between the two devices. Results A total of 147 patients (52% men, mean age 59 years old, 76% diabetic) were included in the analysis. The sensitivity and specificity to detect at least moderate or severe SFN were: Se70 = 0.91 ([0.83, 0.96]), Sp70 = 0.97 ([0.88, 0.99]), Se50 = 0.91 ([0.80, 0.98]), and Sp50 = 0.99 ([0.94, 1]), respectively. The bias and 95% limits of agreement were 1.5 [-5.4, 8.4]. The MAE was 2.9 and the RMSE 3.8. The intra-sample variability was 2.0 for the Body Scan® and 2.3 for the Sudoscan®. Conclusion The ESC measurements provided by the Body Scan® were in almost perfect agreement with those provided by the reference device, the Sudoscan®, which validates the accuracy of the Body Scan® for the detection of SFN. By enabling simple, rapid, and autonomous use by the patient at home, this new technique will facilitate screening and monitoring of SFN in daily practice. Clinical trial registration ClinicalTrials.gov, identifier NCT05178459.
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Affiliation(s)
| | | | | | - Fetta Yaker
- Diabetology Department, Cochin Hospital, Paris, France
| | | | - Lysa Khelifaoui
- Diabetology – Endocrinology and Nutrition Department, Bichat-Claude-Bernard Hospital, Paris, France
| | - Florence Travert
- Diabetology – Endocrinology and Nutrition Department, Bichat-Claude-Bernard Hospital, Paris, France
| | - Claire Fertichon
- Diabetology – Endocrinology and Nutrition Department, Bichat-Claude-Bernard Hospital, Paris, France
| | - Jean-Baptiste Julla
- Diabetology and Endocrinology Department, Lariboisière Hospital, Paris, France
| | | | - Louis Potier
- Diabetology – Endocrinology and Nutrition Department, Bichat-Claude-Bernard Hospital, Paris, France
| | | | | | - Jean-Pascal Lefaucheur
- Unité de Neurophysiologie Clinique, Hôpital Henri Mondor, AP-HP, Créteil, France
- EA4391 (ENT), Faculté de Santé, Université Paris Est Créteil, Créteil, France
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Diedisheim M, Pecquet C, Julla JB, Carlier A, Potier L, Hartemann A, Jacqueminet S, Vidal-Trecan T, Gautier JF, Dubois Laforgue D, Fagherazzi G, Roussel R, Larger E, Sola-Gazagnes A, Riveline JP. Prevalence and Description of the Skin Reactions Associated with Adhesives in Diabetes Technology Devices in an Adult Population: Results of the CUTADIAB Study. Diabetes Technol Ther 2023; 25:279-286. [PMID: 36763338 DOI: 10.1089/dia.2022.0513] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Objective: The use of continuous glucose monitoring (CGM) systems and continuous subcutaneous insulin infusion (CSII) devices adhering to the skin can lead to skin reactions. The objective was to determine the prevalence and consequences of skin reactions at CGM or CSII sites in a large unbiased population. Research Design and Methods: This is a cross-sectional multicenter study. All adult patients with diabetes seen in consultation over a period of 7 months and using or having used a system with skin adhesives (in the last 10 years) were included and filled out a self-assessment questionnaire. Results: Among 851 patients, skin reaction was reported in 28% with CGM and 29% with CSII. Patients reporting reactions were more frequently women using CGM and CSII, and CGM users had type 1 more often than type 2 diabetes (P < 0.001). Manifestations were similar for reactions to CGM and CSII: redness and pruritus in 70%-75% of patients with reactions, pain in 20%-25%, and vesicles and desquamation in 12%-15%. Manifestations occurred within the first 24 h of first use in 22%-24% of patients with reactions to CGM and CSII, but after more than 6 months in 38% and 47% of patients with reactions to CGM and CSII, respectively. Device use was definitively stopped in 12% of patients with reactions to CGM (3.2% of all users) and 7% with reactions to CSII (2.1% of all users). Conclusions: Skin reactions were common, with similar presentations in CGM and CSII users. Manifestations suggested skin irritation rather than allergies. These reactions rarely led to the definitive discontinuation of the use of the device.
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Affiliation(s)
- Marc Diedisheim
- Diabetology Department, Cochin Hospital, APHP, Paris, France
- Institut Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, Université Paris Cité, IMMEDIAB Laboratory, Paris, France
| | | | - Jean-Baptiste Julla
- Institut Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, Université Paris Cité, IMMEDIAB Laboratory, Paris, France
- Diabetology and Endocrinology Department, Lariboisière Hospital, Féderation de Diabétologie, APHP, Paris, France
| | - Aurelie Carlier
- Diabetology Department, Bichat Hospital, APHP, Paris, France
| | - Louis Potier
- Institut Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, Université Paris Cité, IMMEDIAB Laboratory, Paris, France
- Diabetology Department, Bichat Hospital, APHP, Paris, France
| | - Agnès Hartemann
- Diabetology Department, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | | | - Tiphaine Vidal-Trecan
- Diabetology and Endocrinology Department, Lariboisière Hospital, Féderation de Diabétologie, APHP, Paris, France
| | - Jean-François Gautier
- Institut Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, Université Paris Cité, IMMEDIAB Laboratory, Paris, France
- Diabetology and Endocrinology Department, Lariboisière Hospital, Féderation de Diabétologie, APHP, Paris, France
| | | | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Ronan Roussel
- Diabetology Department, Bichat Hospital, APHP, Paris, France
| | - Etienne Larger
- Diabetology Department, Cochin Hospital, APHP, Paris, France
| | | | - Jean-Pierre Riveline
- Institut Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, Université Paris Cité, IMMEDIAB Laboratory, Paris, France
- Diabetology and Endocrinology Department, Lariboisière Hospital, Féderation de Diabétologie, APHP, Paris, France
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Dillinger JG, Patin C, Bonnin P, Vidal-Trecan T, Paven E, Gautier JF, Riveline JP, Amah G, Henry P. Elevated Brain Natriuretic Peptide and High Brachial Pulse Pressure in Patients With Diabetes. Am J Hypertens 2022; 35:414-422. [PMID: 34969077 DOI: 10.1093/ajh/hpab179] [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: 06/23/2021] [Revised: 10/14/2021] [Accepted: 12/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Heart failure (HF) is frequent in patients with diabetes mellitus (DM), and early detection improves prognosis. We investigated whether analysis of brachial blood pressure (BP) in daily practice can identify patients with DM and high risk for subsequent HF, as defined by brain natriuretic peptide (BNP) >50 pg/ml. METHODS 3,367 outpatients with DM without a history of cardiovascular disease were enrolled in a prospective study. RESULTS Age (mean ± SD) was 56 ± 14 years, 57% were male, 78% had type 2 DM, and HbA1C was 7.4 ± 1.4%. A history of hypertension was recorded in 43% of patients and uncontrolled BP was observed in 13%. BNP concentration (mean ± SD) was 21 ± 21 ng/l and 9% of patients had high risk of incident HF. Brachial pulse pressure (PP) was the best BP parameter associated with high risk of incident HF compared with diastolic, systolic, or mean BP (area under the receiver operating characteristic curve: 0.70, 0.65, 0.57, and 0.57, respectively). A multivariate analysis demonstrated that elevated PP was independently associated with high risk of incident HF (odds ratio [95% confidence interval, CI]: 2.1 [1.5-2.8] for PP ≥65 mm Hg). Study of central aortic BP and pulse wave velocity on 117 patients demonstrated that high risk of incident HF was associated with increased arterial stiffness and subendocardial ischemia. After a mean follow-up of 811 days, elevated PP was associated with increased all-cause mortality (hazard ratio [95% CI]: 1.7 [1.1-2.8]). CONCLUSIONS Brachial PP is powerful and independent "easy to record" BP parameter associated with high risk of incident HF in diabetic patients.
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Affiliation(s)
- Jean-Guillaume Dillinger
- Université de Paris, AP-HP, Hôpital Lariboisière, Département de Cardiologie, Paris, France
- Université de Paris, AP-HP, Hôpital Lariboisière, Physiologie Clinique—Explorations Fonctionnelles, Paris, France
| | - Charlotte Patin
- Université de Paris, AP-HP, Hôpital Lariboisière, Département de Cardiologie, Paris, France
| | - Philippe Bonnin
- Université de Paris, AP-HP, Hôpital Lariboisière, Physiologie Clinique—Explorations Fonctionnelles, Paris, France
| | - Tiphaine Vidal-Trecan
- Université de Paris, AP-HP, Hôpital Lariboisière, Centre Universitaire du Diabète et de ses Complications, Paris, France
| | - Elise Paven
- Université de Paris, AP-HP, Hôpital Lariboisière, Département de Cardiologie, Paris, France
| | - Jean-François Gautier
- Université de Paris, AP-HP, Hôpital Lariboisière, Centre Universitaire du Diabète et de ses Complications, Paris, France
| | - Jean-Pierre Riveline
- Université de Paris, AP-HP, Hôpital Lariboisière, Centre Universitaire du Diabète et de ses Complications, Paris, France
| | - Guy Amah
- Université de Paris, AP-HP, Hôpital Lariboisière, Physiologie Clinique—Explorations Fonctionnelles, Paris, France
| | - Patrick Henry
- Université de Paris, AP-HP, Hôpital Lariboisière, Département de Cardiologie, Paris, France
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Zureik A, Julla JB, Erginay A, Vidal-Trecan T, Juddoo V, Gautier JF, Massin P, Tadayoni R, Riveline JP, Couturier A. Prevalence, severity stages, and risk factors of diabetic retinopathy in 1464 adult patients with type 1 diabetes. Graefes Arch Clin Exp Ophthalmol 2021; 259:3613-3623. [PMID: 34264396 DOI: 10.1007/s00417-021-05298-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 03/16/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To determine the prevalence of diabetic retinopathy (DR) and its risk factors in adult type 1 diabetes (T1D) patients METHODS: In this cross-sectional study, all T1D patients followed in the University Center for Diabetes and its Complications of Lariboisière Hospital (Paris, France) between January 2017 and February 2019 were included. Ophthalmologic and systemic data were collected from electronic records. The association between DR (and each grade) and associated factors were estimated by univariate and multivariate analyses using logistic regression models. RESULTS A total of 1464 patients (46.2% of women, mean age: 42.2 ± 15.8 years) were included. The mean hemoglobin A1c (HbA1c) was 7.8 ± 1.7% and the mean diabetes duration was 20.5 ± 13.5 years. DR prevalence was 50.1% (47.4-52.6) and the prevalence of mild, moderate, and severe non-proliferative DR and proliferative DR was 19.1%, 9.4%, 3.9%, and 17.6%, respectively. DR was significantly associated with male gender, an older age, former and current smoking status, a higher BMI, the presence of nephropathy and neuropathy, higher HBA1c, and longer diabetes duration. Patients with HbA1c > 10% had an adjusted odds ratio (OR) of 3.25 (1.77-6.01) of having DR compared to patients with HbA1c < 6.5%. Patients with a diabetes duration > 30 years had an adjusted OR of 24.87 (14.82-42.67) higher of having DR compared to patients with a diabetes duration < 10 years. CONCLUSION In this study, 50.1% of adult T1D patients had DR and 17.6% had proliferative DR. Diabetes duration and HbA1c were major risk factors.
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Affiliation(s)
- Abir Zureik
- University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France.
| | - Jean-Baptiste Julla
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France
| | - Ali Erginay
- University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France
| | - Tiphaine Vidal-Trecan
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France
| | - Vanessa Juddoo
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France
| | - Jean-François Gautier
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France
| | - Pascale Massin
- University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France
| | - Ramin Tadayoni
- University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France
| | - Jean-Pierre Riveline
- Department of Diabetology and Endocrinology, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, Paris, France. Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, Paris, France. Université de Paris, Paris, France
| | - Aude Couturier
- University of Paris, Ophthalmology Department, AP-HP, Lariboisière Hospital, F-75010, Paris, France.
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5
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Julla JB, Jacquemier P, Fagherazzi G, Vidal-Trecan T, Juddoo V, Jaziri A, Mersel H, Venteclef N, Roussel R, Massin P, Couturier A, Gautier JF, Riveline JP. Is the Consensual Threshold for Defining High Glucose Variability Implementable in Clinical Practice? Diabetes Care 2021; 44:1722-1725. [PMID: 34099517 DOI: 10.2337/dc20-1847] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 04/14/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Estimating glycemic variability (GV) through within-day coefficient of variation (%CVw) is recommended for patients with type 1 Diabetes (T1D). High GV (hGV) is defined as %CVw > 36%. However, continuous glucose monitoring (CGM) devices provide exclusively total CV (%CVT). We aimed to assess consequences of this disparity. RESEARCH DESIGN AND METHODS We retrospectively calculated both %CVT and %CVw of consecutive T1D patients from their CGM raw data during 14 days. Patients with hGV with %CVT >36% and %CVw ≤36% were called the "inconsistent GV group". RESULTS A total of 104 patients were included. Mean ± SD %CVT and %CVw were 42.4 ± 8% and 37.0 ± 7.4% respectively (P < 0.0001). Using %CVT, 81 patients (73.6%) were classified as having hGV, whereas 59 (53.6%) using %CVw (P < 0.0001) corresponding to 22 patients (21%) in the inconsistent GV population. CONCLUSIONS Evaluation of GV through %CV in patients with T1D is highly dependent on the calculation method and then must be standardized.
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Affiliation(s)
- Jean-Baptiste Julla
- Department of Diabetology and Endocrinology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.,Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Université de Paris, Paris, France
| | - Pauline Jacquemier
- Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Université de Paris, Paris, France.,Air Liquide Healthcare Explor Center Medicotechnical, Paris, France
| | - Guy Fagherazzi
- U1018 INSERM/Center for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif, France.,Faculty of Medicine, Paris-South Paris Saclay University, Villejuif, France.,UMR 970 INSERM, Cardiovascular Research Center, University of Paris, Paris, France.,Digital Epidemiology Hub, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Tiphaine Vidal-Trecan
- Department of Diabetology and Endocrinology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Vanessa Juddoo
- Department of Diabetology and Endocrinology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Asma Jaziri
- Department of Diabetology and Endocrinology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Hanane Mersel
- Department of Diabetology and Endocrinology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Nicolas Venteclef
- Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Université de Paris, Paris, France
| | - Ronan Roussel
- Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Université de Paris, Paris, France.,Department of Diabetology, Endocrinology, and Nutrition, Bichat-Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Pascale Massin
- Ophthalmology Department, Centre Universitaire du Diabète et de ses Complications, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Aude Couturier
- Department of Ophthalmology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Université Paris 7 - Sorbonne Paris Cité, Paris, France
| | - Jean-François Gautier
- Department of Diabetology and Endocrinology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.,Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Université de Paris, Paris, France
| | - Jean-Pierre Riveline
- Department of Diabetology and Endocrinology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France .,Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Université de Paris, Paris, France
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6
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Gaborit B, Julla JB, Besbes S, Proust M, Vincentelli C, Alos B, Ancel P, Alzaid F, Garcia R, Mailly P, Sabatier F, Righini M, Gascon P, Matonti F, Houssays M, Goumidi L, Vignaud L, Guillonneau X, Erginay A, Dupas B, Marie-Louise J, Autié M, Vidal-Trecan T, Riveline JP, Venteclef N, Massin P, Muller L, Dutour A, Gautier JF, Germain S. Glucagon-like Peptide 1 Receptor Agonists, Diabetic Retinopathy and Angiogenesis: The AngioSafe Type 2 Diabetes Study. J Clin Endocrinol Metab 2020; 105:5582609. [PMID: 31589290 DOI: 10.1210/clinem/dgz069] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 05/20/2019] [Accepted: 10/03/2019] [Indexed: 12/21/2022]
Abstract
AIMS Recent trials provide conflicting results on the association between glucagon-like peptide 1 receptor agonists (GLP-1RA) and diabetic retinopathy (DR). The aim of the AngioSafe type 2 diabetes (T2D) study was to determine the role of GLP-1RA in angiogenesis using clinical and preclinical models. METHODS We performed two studies in humans. In study 1, we investigated the effect of GLP-1RA exposure from T2D diagnosis on the severity of DR, as diagnosed with retinal imaging (fundus photography). In study 2, a randomized 4-week trial, we assessed the effect of liraglutide on circulating hematopoietic progenitor cells (HPCs), and angio-miRNAs.We then studied the experimental effect of Exendin-4, on key steps of angiogenesis: in vitro on human endothelial cell proliferation, survival and three-dimensional vascular morphogenesis; and in vivo on ischemia-induced neovascularization of the retina in mice. RESULTS In the cohort of 3154 T2D patients, 10% displayed severe DR. In multivariate analysis, sex, disease duration, glycated hemoglobin (HbA1c), micro- and macroangiopathy, insulin therapy and hypertension remained strongly associated with severe DR, while no association was found with GLP-1RA exposure (o 1.139 [0.800-1.622], P = .47). We further showed no effect of liraglutide on HPCs, and angio-miRNAs. In vitro, we demonstrated that exendin-4 had no effect on proliferation and survival of human endothelial cells, no effect on total length and number of capillaries. Finally, in vivo, we showed that exendin-4 did not exert any negative effect on retinal neovascularization. CONCLUSIONS The AngioSafe T2D studies provide experimental and clinical data confirming no effect of GLP-1RA on angiogenesis and no association between GLP-1 exposure and severe DR.
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Affiliation(s)
- Bénédicte Gaborit
- Aix Marseille University, INSERM, INRA, C2VN, Marseille, France
- Endocrinology, Metabolic Diseases and Nutrition Department, Assistance Publique Hôpitaux de Marseille, France
| | - Jean-Baptiste Julla
- Department of Diabetes and Endocrinology, Assistance Publique - Hôpitaux de Paris, Lariboisière Hospital, University Paris-Diderot Paris-7, Paris, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Samaher Besbes
- Center for Interdisciplinary Research in Biology (CIRB), College de France - Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research University, Paris, France
| | - Matthieu Proust
- Center for Interdisciplinary Research in Biology (CIRB), College de France - Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research University, Paris, France
| | - Clara Vincentelli
- Aix Marseille University, INSERM, INRA, C2VN, Marseille, France
- Endocrinology, Metabolic Diseases and Nutrition Department, Assistance Publique Hôpitaux de Marseille, France
| | - Benjamin Alos
- Center for Interdisciplinary Research in Biology (CIRB), College de France - Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research University, Paris, France
| | - Patricia Ancel
- Aix Marseille University, INSERM, INRA, C2VN, Marseille, France
| | - Fawaz Alzaid
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Rodrigue Garcia
- Center for Interdisciplinary Research in Biology (CIRB), College de France - Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research University, Paris, France
| | - Philippe Mailly
- Center for Interdisciplinary Research in Biology (CIRB), College de France - Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research University, Paris, France
| | | | - Maud Righini
- Department of Ophtalmology, AP HM, Marseille, France
| | - Pierre Gascon
- Department of Ophtalmology, AP HM, Marseille, France
- Aix Marseille University, CNRS, INT, Inst Neurosci Timone, Marseille, France
| | - Frédéric Matonti
- Department of Ophtalmology, AP HM, Marseille, France
- Aix Marseille University, CNRS, INT, Inst Neurosci Timone, Marseille, France
| | - Marie Houssays
- Aix Marseille University, APHM, INSERM, CIC1409, Hôpital de la Conception, Marseille, France
| | - Louisa Goumidi
- Aix Marseille University, INSERM, INRA, C2VN, Marseille, France
| | - Lucile Vignaud
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | - Ali Erginay
- Department of Ophthalmology, Lariboisière Hospital, AP HP, University Paris-Diderot Paris-7, Paris, France
| | - Bénédicte Dupas
- Department of Ophthalmology, Lariboisière Hospital, AP HP, University Paris-Diderot Paris-7, Paris, France
| | - Jennifer Marie-Louise
- Department of Ophthalmology, Lariboisière Hospital, AP HP, University Paris-Diderot Paris-7, Paris, France
| | - Marianne Autié
- Department of Ophthalmology, Lariboisière Hospital, AP HP, University Paris-Diderot Paris-7, Paris, France
| | - Tiphaine Vidal-Trecan
- Department of Diabetes and Endocrinology, Assistance Publique - Hôpitaux de Paris, Lariboisière Hospital, University Paris-Diderot Paris-7, Paris, France
| | - Jean-Pierre Riveline
- Department of Diabetes and Endocrinology, Assistance Publique - Hôpitaux de Paris, Lariboisière Hospital, University Paris-Diderot Paris-7, Paris, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Nicolas Venteclef
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Pascale Massin
- Department of Ophthalmology, Lariboisière Hospital, AP HP, University Paris-Diderot Paris-7, Paris, France
| | - Laurent Muller
- Center for Interdisciplinary Research in Biology (CIRB), College de France - Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research University, Paris, France
| | - Anne Dutour
- Aix Marseille University, INSERM, INRA, C2VN, Marseille, France
- Endocrinology, Metabolic Diseases and Nutrition Department, Assistance Publique Hôpitaux de Marseille, France
| | - Jean-François Gautier
- Department of Diabetes and Endocrinology, Assistance Publique - Hôpitaux de Paris, Lariboisière Hospital, University Paris-Diderot Paris-7, Paris, France
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, Paris, France
| | - Stéphane Germain
- Center for Interdisciplinary Research in Biology (CIRB), College de France - Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research University, Paris, France
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7
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Dubucs X, Julla JB, Vidal-Trecan T, Riveline JP, Gautier JF. The use of statins in the elderly is associated with less severe hypoglycemia in patient with diabetes. Diabetes Res Clin Pract 2020; 162:108034. [PMID: 32004694 DOI: 10.1016/j.diabres.2020.108034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/21/2019] [Revised: 01/06/2020] [Accepted: 01/27/2020] [Indexed: 01/02/2023]
Abstract
Three hundred and eighty-nine older patients with diabetes attending an ambulatory diabetes center were included to determine risk factors of severe hypoglycemia (SH). Thirty-three (8.5%) patients had at least one severe hypoglycemia. In multivariate analyze, statin was associated with lower risk and insulin was associated with higher risk of SH.
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Affiliation(s)
- Xavier Dubucs
- Purpan Toulouse University Hospital, Emergency Department, Place du Docteur Joseph Baylac, 31052 Toulouse, France.
| | - Jean-Baptiste Julla
- AP-HP, Lariboisière Hospital, Department of Diabetes and Endocrinology, University Paris 7 Denis-Diderot, Sorbonne Paris Cité, Paris, France; INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Paris F-75006, France.
| | - Tiphaine Vidal-Trecan
- AP-HP, Lariboisière Hospital, Department of Diabetes and Endocrinology, University Paris 7 Denis-Diderot, Sorbonne Paris Cité, Paris, France.
| | - Jean-Pierre Riveline
- AP-HP, Lariboisière Hospital, Department of Diabetes and Endocrinology, University Paris 7 Denis-Diderot, Sorbonne Paris Cité, Paris, France; INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Paris F-75006, France.
| | - Jean-François Gautier
- AP-HP, Lariboisière Hospital, Department of Diabetes and Endocrinology, University Paris 7 Denis-Diderot, Sorbonne Paris Cité, Paris, France; INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Paris F-75006, France.
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8
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Riveline JP, Baz B, Nguewa JL, Vidal-Trecan T, Ibrahim F, Boudou P, Vicaut E, Brac de la Perrière A, Fetita S, Bréant B, Blondeau B, Tardy-Guidollet V, Morel Y, Gautier JF. Exposure to Glucocorticoids in the First Part of Fetal Life is Associated with Insulin Secretory Defect in Adult Humans. J Clin Endocrinol Metab 2020; 105:5609147. [PMID: 31665349 DOI: 10.1210/clinem/dgz145] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/25/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE High glucocorticoid levels in rodents inhibit development of beta cells during fetal life and lead to insulin deficiency in adulthood. To test whether similar phenomena occur in humans, we compared beta-cell function in adults who were exposed to glucocorticoids during the first part of fetal life with that of nonexposed subjects. RESEARCH DESIGN AND METHODS The study was conducted in 16 adult participants exposed to glucocorticoids during the first part of fetal life and in 16 nonexposed healthy participants with normal glucose tolerance who were matched for age, sex, and body mass index (BMI). Exposed participants had been born to mothers who were treated with dexamethasone 1 to 1.5 mg/day from the sixth gestational week (GW) to prevent genital virilization in children at risk of 21-hydroxylase deficiency. We selected offspring of mothers who stopped dexamethasone before the 18th GW following negative genotyping of the fetus. Insulin and glucagon secretion were measured during an oral glucose tolerance test (OGTT) and graded intravenous (IV) glucose and arginine tests. Insulin sensitivity was measured by hyperinsulinemic-euglycemic-clamp. RESULTS Age, BMI, and anthropometric characteristics were similar in the 2 groups. Insulinogenic index during OGTT and insulin sensitivity during the clamp were similar in the 2 groups. In exposed subjects, insulin secretion during graded IV glucose infusion and after arginine administration decreased by 17% (P = 0.02) and 22% (P = 0.002), respectively, while glucagon secretion after arginine increased. CONCLUSION Overexposure to glucocorticoids during the first part of fetal life is associated with lower insulin secretion at adult age, which may lead to abnormal glucose tolerance later in life.
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Affiliation(s)
- Jean-Pierre Riveline
- Department of Diabetes and Endocrinology, Lariboisière Hospital, APHP, Paris, France
- Paris Diderot- Paris VII University, Paris, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMRS 1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Baz Baz
- Department of Diabetes and Endocrinology, Lariboisière Hospital, APHP, Paris, France
| | - Jean-Louis Nguewa
- Department of Diabetes and Endocrinology, Lariboisière Hospital, APHP, Paris, France
| | - Tiphaine Vidal-Trecan
- Department of Diabetes and Endocrinology, Lariboisière Hospital, APHP, Paris, France
| | - Fidaa Ibrahim
- Unit of Hormonal Biology, Department of Biochemistry, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Philippe Boudou
- Unit of Hormonal Biology, Department of Biochemistry, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Eric Vicaut
- Assistance Publique-Hôpitaux de Paris, Clinical Research Unit, Fernand Widal Hospital, Sorbonne Paris Cité, Paris Diderot University, Paris, France
| | - Aude Brac de la Perrière
- Fédération d'endocrinologie Hopital Louis Pradel Groupement Hospitalier Est 28 av Doyen Lepine BRON
| | - Sabrina Fetita
- Department of Diabetes and Endocrinology, Lariboisière Hospital, APHP, Paris, France
| | - Bernadette Bréant
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMRS 1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Bertrand Blondeau
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMRS 1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Véronique Tardy-Guidollet
- Department of Biochemistry and Molecular Biology, Groupement Hospitalier Est 59 Boulevard Pinel Bron, France
| | - Yves Morel
- Department of Biochemistry and Molecular Biology, Groupement Hospitalier Est 59 Boulevard Pinel Bron, France
| | - Jean-François Gautier
- Department of Diabetes and Endocrinology, Lariboisière Hospital, APHP, Paris, France
- Paris Diderot- Paris VII University, Paris, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMRS 1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
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9
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Paven E, Dillinger JG, Bal Dit Sollier C, Vidal-Trecan T, Berge N, Dautry R, Gautier JF, Drouet L, Riveline JP, Henry P. Determinants of aspirin resistance in patients with type 2 diabetes. Diabetes Metab 2019; 46:370-376. [PMID: 31783142 DOI: 10.1016/j.diabet.2019.11.002] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/20/2019] [Accepted: 11/11/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cardiovascular disease is a leading cause of mortality among patients with type 2 diabetes mellitus (T2DM). Numerous patients with T2DM show resistance to aspirin treatment, which may explain the higher rate of major adverse cardiovascular events observed compared with non-diabetes patients, and it has recently been shown that aspirin resistance is mainly related to accelerated platelet turnover with persistent high platelet reactivity (HPR) 24h after last aspirin intake. The mechanism behind HPR is unknown. The aim of this study was to investigate the precise rate and mechanisms associated with HPR in a population of T2DM patients treated with aspirin. METHODS Included were 116 consecutive stable T2DM patients who had attended our hospital for their yearly check-up. HPR was assessed 24h after aspirin intake using light transmission aggregometry (LTA) with arachidonic acid (AA) and serum thromboxane B2 (TXB2) measurement. Its relationship with diabetes status, insulin resistance, inflammatory markers and coronary artery disease (CAD) severity, using calcium scores, were investigated. RESULTS Using LTA, HPR was found in 27 (23%) patients. There was no significant difference in mean age, gender ratio or cardiovascular risk factors in patients with or without HPR. HPR was significantly related to duration of diabetes and higher fasting glucose levels (but not consistently with HbA1c), and strongly related to all markers of insulin resistance, especially waist circumference, HOMA-IR, QUICKI and leptin. There was no association between HPR and thrombopoietin or inflammatory markers (IL-6, IL-10, indoleamine 2,3-dioxygenase activity, TNF-α, C-reactive protein), whereas HPR was associated with more severe CAD. Similar results were found with TXB2. CONCLUSION Our results reveal that 'aspirin resistance' is frequently found in T2DM, and is strongly related to insulin resistance and severity of CAD, but weakly related to HbA1c and not at all to inflammatory parameters. This may help to identify those T2DM patients who might benefit from alternative antiplatelet treatments such as twice-daily aspirin and thienopyridines.
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Affiliation(s)
- E Paven
- Department of Cardiology, Lariboisière Hospital, AP-HP, University of Paris and Inserm U942, 75010 Paris, France; University Centre for the Study of Diabetes and its Complications, Lariboisière Hospital, APHP, University of Paris, 75010 Paris, France
| | - J-G Dillinger
- Department of Cardiology, Lariboisière Hospital, AP-HP, University of Paris and Inserm U942, 75010 Paris, France; University Centre for the Study of Diabetes and its Complications, Lariboisière Hospital, APHP, University of Paris, 75010 Paris, France
| | | | - T Vidal-Trecan
- Department of Endocrinology, Lariboisière Hospital, AP-HP, University of Paris, 75010 Paris, France; University Centre for the Study of Diabetes and its Complications, Lariboisière Hospital, APHP, University of Paris, 75010 Paris, France
| | - N Berge
- Vessels and Blood Institute, 75010 Paris, France
| | - R Dautry
- Department of Radiology, Lariboisière Hospital, AP-HP, University of Paris, 75010 Paris, France
| | - J-F Gautier
- Department of Endocrinology, Lariboisière Hospital, AP-HP, University of Paris, 75010 Paris, France; University Centre for the Study of Diabetes and its Complications, Lariboisière Hospital, APHP, University of Paris, 75010 Paris, France
| | - L Drouet
- Vessels and Blood Institute, 75010 Paris, France
| | - J-P Riveline
- Department of Endocrinology, Lariboisière Hospital, AP-HP, University of Paris, 75010 Paris, France; University Centre for the Study of Diabetes and its Complications, Lariboisière Hospital, APHP, University of Paris, 75010 Paris, France
| | - P Henry
- Department of Cardiology, Lariboisière Hospital, AP-HP, University of Paris and Inserm U942, 75010 Paris, France; University Centre for the Study of Diabetes and its Complications, Lariboisière Hospital, APHP, University of Paris, 75010 Paris, France.
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10
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Haddad N, Vidal-Trecan T, Baroudjian B, Zagdanski AM, Arangalage D, Battistella M, Gautier JF, Lebbe C, Delyon J. Acquired generalized lipodystrophy under immune checkpoint inhibition. Br J Dermatol 2019; 182:477-480. [PMID: 31077337 DOI: 10.1111/bjd.18124] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2019] [Indexed: 01/10/2023]
Abstract
Immune checkpoint inhibitors are now the standard of care in the treatment of several types of cancer. Cutaneous immune-related adverse events (irAEs) are usually of low grade and reversible, while endocrine irAEs are generally irreversible and managed with hormone replacement therapy. We report a 47-year-old patient, treated with the anti-programmed cell death (PD)1 antibody pembrolizumab for a metastatic melanoma, who developed severe lipodystrophy after 10 months of treatment, characterized by the loss of subcutaneous fat tissue, central obesity and insulin resistance with a decreased leptin level. Histological analysis of a cutaneous biopsy revealed subcutaneous fat cell destruction associated with oedema, the presence of lipophages, and a CD3+ lymphocytic infiltrate involving the panniculus. This led to the diagnosis of anti-PD-1-induced acquired generalized lipodystrophy, after ruling out differential diagnoses (i.e. genetic and systemic autoimmune diseases). No corticosteroids were introduced considering the high risk of inducing severe metabolic complications, and pembrolizumab was discontinued as complete response of the melanoma was achieved. However, after 12 months of follow-up, lipodystrophy and its severe metabolic complications are still ongoing. What's already known about this topic? Anti-programmed cell death (PD)1 agents are now a standard of care in the treatment of several cancers, including melanoma. Endocrine and cutaneous immune-related adverse events (irAEs) are among the most frequent irAEs (14-30% and 30-40%, respectively) in patients treated with immune checkpoint inhibitors. What does this study add? Acquired generalized lipodystrophy can occur during anti-PD1 therapy and is associated with severe metabolic complications. With the increase in anti-PD1 prescription in several cancer types, clinicians must be aware of the whole range of irAEs that may occur.
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Affiliation(s)
- N Haddad
- Department of Dermatology, AP-HP Saint-Louis Hospital, F-75010, Paris, France
| | - T Vidal-Trecan
- Department of Endocrinology, AP-HP Lariboisière Hospital, F-75010, Paris, France
| | - B Baroudjian
- Department of Dermatology, AP-HP Saint-Louis Hospital, F-75010, Paris, France
| | - A-M Zagdanski
- Department of Radiology, AP-HP Saint-Louis Hospital, F-75010, Paris, France.,Université de Paris, Paris, France
| | - D Arangalage
- Department of Cardiology, AP-HP Bichat Hospital, F-75018, Paris, France.,Université de Paris, INSERM U1148, F-75018, Paris, France
| | - M Battistella
- Department of Pathology, AP-HP Saint-Louis Hospital, F-75010, Paris, France.,Université de Paris, INSERM U1165, F-75010, Paris, France
| | - J-F Gautier
- Department of Endocrinology, AP-HP Lariboisière Hospital, F-75010, Paris, France.,Université de Paris, Paris, France
| | - C Lebbe
- Department of Dermatology, AP-HP Saint-Louis Hospital, F-75010, Paris, France.,Université de Paris, INSERM U976, HIPI équipe-1, F-75010, Paris, France
| | - J Delyon
- Department of Dermatology, AP-HP Saint-Louis Hospital, F-75010, Paris, France.,Université de Paris, INSERM U976, HIPI équipe-1, F-75010, Paris, France
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11
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Gauci ML, Boudou P, Baroudjian B, Vidal-Trecan T, Da Meda L, Madelaine-Chambrin I, Basset-Seguin N, Bagot M, Pages C, Mourah S, Resche-Rigon M, Pinel S, Sassier M, Rouby F, Eftekhari P, Lebbé C, Gautier JF. Occurrence of type 1 and type 2 diabetes in patients treated with immunotherapy (anti-PD-1 and/or anti-CTLA-4) for metastatic melanoma: a retrospective study. Cancer Immunol Immunother 2018; 67:1197-1208. [PMID: 29808365 PMCID: PMC11028208 DOI: 10.1007/s00262-018-2178-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 10/03/2017] [Accepted: 05/24/2018] [Indexed: 12/13/2022]
Abstract
Anti-PD-1 and anti-CTLA-4 antibodies cause immune-related side effects such as autoimmune type 1 diabetes (T1D). It has also been suggested that by increasing TNF-α, IL-2 and IFN-γ production, anti-PD-1 and/or anti-CTLA-4 treatment could affect pancreatic beta cell function and insulin sensitivity. This study was based on a retrospective observational analysis from 2 July 2014 to 27 June 2016, which evaluated the occurrence of T1D and changes in glycemia and C-reactive protein (CRP) plasma concentrations in patients undergoing anti-PD-1 and/or anti-CTLA-4 treatment for melanoma at the Saint Louis Hospital. All cases of T1D that developed during immunotherapy registered in the French Pharmacovigilance Database (FPVD) were also considered. Among the 132 patients included, 3 cases of T1D occurred. For the remaining subjects, blood glucose was not significantly affected by anti-PD-1 treatment, but CRP levels (mg/l) significantly increased during anti-PD-1 treatment (p = 0.017). However, 1 case of type 2 diabetes (T2D) occurred (associated with a longer therapy duration). Moreover, glycemia of patients pretreated (n = 44) or concomitantly treated (n = 8) with anti-CTLA-4 tended to increase during anti-PD-1 therapy (p = 0.068). From the FPVD, we obtained 14 cases of T1D that occurred during immunotherapy and were primarily characterized by the rapidity and severity of onset. In conclusion, in addition to inducing this rare immune-related diabetes condition, anti-PD-1 treatment appears to increase CRP levels, a potential inflammatory trigger of insulin resistance, but without any short-term impact on blood glucose level.
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Affiliation(s)
- Marie-Léa Gauci
- AP-HP Dermatology Department, Saint-Louis Hospital, INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, 1, Avenue Claude Vellefaux, 75010, Paris, France.
| | - Philippe Boudou
- AP-HP Hormonology Department, Saint-Louis Hospital, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Barouyr Baroudjian
- AP-HP Dermatology Department, Saint-Louis Hospital, INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - Tiphaine Vidal-Trecan
- AP-HP Diabetology Department, Lariboisière Hospital, INSERM U1138; Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Laetitia Da Meda
- AP-HP Dermatology Department, Saint-Louis Hospital, INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - Isabelle Madelaine-Chambrin
- AP-HP Pharmacology Department, Saint-Louis Hospital, INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Nicole Basset-Seguin
- AP-HP Dermatology Department, Saint-Louis Hospital, INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - Martine Bagot
- AP-HP Dermatology Department, Saint-Louis Hospital, INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - Cécile Pages
- AP-HP Dermatology Department, Saint-Louis Hospital, INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - Samia Mourah
- AP-HP Pharmacogenomic Laboratory, Saint-Louis Hospital, INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Matthieu Resche-Rigon
- AP-HP Statistics Department, Saint-Louis Hospital, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Sylvine Pinel
- AP-HP Regional Pharmacologilance Center, Fernand Widal Hospital, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Marion Sassier
- Regional Pharmacovigilance Center of Caen, Caen University Hospital, Caen, France
| | - Franck Rouby
- Department of Clinical Pharmacology, Regional Pharmacovigilance Center of Marseille, Aix-Marseille University, Marseille, France
| | - Pirayeh Eftekhari
- AP-HP Regional Pharmacologilance Center, Fernand Widal Hospital, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Céleste Lebbé
- AP-HP Dermatology Department, Saint-Louis Hospital, INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - Jean-François Gautier
- AP-HP Diabetology Department, Lariboisière Hospital, INSERM U1138; Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
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12
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Fabre S, Clerson P, Launay JM, Gautier JF, Vidal-Trecan T, Riveline JP, Platt A, Abrahamsson A, Miner JN, Hughes G, Richette P, Bardin T. Accuracy of the HumaSens plus point-of-care uric acid meter using capillary blood obtained by fingertip puncture. Arthritis Res Ther 2018; 20:78. [PMID: 29720236 PMCID: PMC5932794 DOI: 10.1186/s13075-018-1585-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 12/30/2017] [Accepted: 03/28/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The uric acid (UA) level in patients with gout is a key factor in disease management and is typically measured in the laboratory using plasma samples obtained after venous puncture. This study aimed to assess the reliability of immediate UA measurement with capillary blood samples obtained by fingertip puncture with the HumaSensplus point-of-care meter. METHODS UA levels were measured using both the HumaSensplus meter in the clinic and the routine plasma UA method in the biochemistry laboratory of 238 consenting diabetic patients. HumaSensplus capillary and routine plasma UA measurements were compared by linear regression, Bland-Altman plots, intraclass correlation coefficient (ICC), and Lin's concordance coefficient. Values outside the dynamic range of the meter, low (LO) or high (HI), were analyzed separately. The best capillary UA thresholds for detecting hyperuricemia were determined by receiver operating characteristic (ROC) curves. The impact of potential confounding factors (demographic and biological parameters/treatments) was assessed. Capillary and routine plasma UA levels were compared to reference plasma UA measurements by liquid chromatography-mass spectrometry (LC-MS) for a subgroup of 67 patients. RESULTS In total, 205 patients had capillary and routine plasma UA measurements available. ICC was 0.90 (95% confidence interval (CI) 0.87-0.92), Lin's coefficient was 0.91 (0.88-0.93), and the Bland-Altman plot showed good agreement over all tested values. Overall, 17 patients showed values outside the dynamic range. LO values were concordant with plasma values, but HI values were considered uninterpretable. Capillary UA thresholds of 299 and 340 μmol/l gave the best results for detecting hyperuricemia (corresponding to routine plasma UA thresholds of 300 and 360 μmol/l, respectively). No significant confounding factor was found among those tested, except for hematocrit; however, this had a negligible influence on the assay reliability. When capillary and routine plasma results were discordant, comparison with LC-MS measurements showed that plasma measurements had better concordance: capillary UA, ICC 0.84 (95% CI 0.75-0.90), Lin's coefficient 0.84 (0.77-0.91); plasma UA, ICC 0.96 (0.94-0.98), Lin's coefficient 0.96 (0.94-0.98). CONCLUSIONS UA measurements with the HumaSensplus meter were reasonably comparable with those of the laboratory assay. The meter is easy to use and may be useful in the clinic and in epidemiologic studies.
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Affiliation(s)
- Stéphanie Fabre
- Inserm U1132, Rheumatology Department, Lariboisière Hospital, Paris Diderot University, 2 rue Ambroise Paré, 75010 Paris, France
| | | | - Jean-Marie Launay
- Inserm U942, Biochemistry and Molecular Biology Department, Lariboisière Hospital, Paris Diderot University, Paris, France
| | | | | | | | - Adam Platt
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - Anna Abrahamsson
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | | | - Glen Hughes
- Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - Pascal Richette
- Inserm U1132, Rheumatology Department, Lariboisière Hospital, Paris Diderot University, 2 rue Ambroise Paré, 75010 Paris, France
| | - Thomas Bardin
- Inserm U1132, Rheumatology Department, Lariboisière Hospital, Paris Diderot University, 2 rue Ambroise Paré, 75010 Paris, France
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13
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Paven E, Dillinger J, Bal Dit Sollier C, Vidal-Trecan T, Launay J, Dautry R, Gautier J, Drouet L, Riveline J, Henry P. Determinants of aspirin loss of efficacy in type 2 diabetic patients. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.194] [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]
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14
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Paven E, Dillinger J, Vidal-Trecan T, Dautry R, Leblanc H, Sideris G, Manzo-Silberman S, Gautier J, Riveline J, Henry P. What is the best age range to perform coronary artery calcification score in type 2 diabetic patients? Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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15
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Paven E, Dillinger J, Vidal-Trecan T, Dautry R, Leblanc H, Sideris G, Manzo-Silberman S, Gautier J, Riveline J, Henry P. Can troponin I measurement predict coronary artery calcification score in asymptomatic type 2 diabetic patients? Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.042] [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: 10/18/2022]
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Gauci ML, Laly P, Vidal-Trecan T, Baroudjian B, Gottlieb J, Madjlessi-Ezra N, Da Meda L, Madelaine-Chambrin I, Bagot M, Basset-Seguin N, Pages C, Mourah S, Boudou P, Lebbé C, Gautier JF. Autoimmune diabetes induced by PD-1 inhibitor-retrospective analysis and pathogenesis: a case report and literature review. Cancer Immunol Immunother 2017; 66:1399-1410. [PMID: 28634815 PMCID: PMC11028556 DOI: 10.1007/s00262-017-2033-8] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [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: 01/25/2017] [Accepted: 06/12/2017] [Indexed: 12/16/2022]
Abstract
Anti-PD-1 antibody treatment is approved in advanced melanoma and provides median overall survival over 24 months. The main treatment-related side effects are immune-related adverse events, which include rash, pruritus, vitiligo, thyroiditis, diarrhoea, hepatitis and pneumonitis. We report a case of autoimmune diabetes related to nivolumab treatment. A 73-year-old man was treated in second line with nivolumab at 3 mg/kg every two weeks for metastatic melanoma. At 6 weeks of treatment, he displayed diabetic ketoacidosis. Nivolumab was withheld 3.5 weeks and insulin therapy was initiated, enabling a normalization of glycaemia and the disappearance of symptoms. Laboratory investigations demonstrated the presence of islet cell autoantibodies, while C-peptide was undetectable. Retrospective explorations on serum banked at week 0 and 3 months before the start of nivolumab, already showed the presence of autoantibodies, but normal insulin, C-peptide secretion and glycaemia. Partial response was obtained at month 3, and nivolumab was then resumed at the same dose. The clinical context and biological investigations before, at and after nivolumab initiation suggest the autoimmune origin of this diabetes, most likely induced by anti-PD-1 antibody in a predisposed patient. The role of PD-1/PD-L1 binding is well known in the pathogenesis of type 1 diabetes. Therefore, this rare side effect can be expected in a context of anti-PD-1 treatment. Glycaemia should be monitored during PD-1/PD-L1 blockade. The presence of autoantibodies before treatment could identify individuals at risk of developing diabetes, but systematic titration may not be relevant considering the rarity of this side effect.
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Affiliation(s)
- Marie-Léa Gauci
- AP-HP Dermatology Department, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France.
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France.
| | - Pauline Laly
- AP-HP Dermatology Department, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Tiphaine Vidal-Trecan
- AP-HP Diabetology Department, Lariboisière Hospital, Paris, France
- INSERM U1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Barouyr Baroudjian
- AP-HP Dermatology Department, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Jérémy Gottlieb
- AP-HP Dermatology Department, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Nika Madjlessi-Ezra
- AP-HP Dermatology Department, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Laetitia Da Meda
- AP-HP Dermatology Department, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Isabelle Madelaine-Chambrin
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
- AP-HP Pharmacology Department, Saint-Louis Hospital, Paris, France
| | - Martine Bagot
- AP-HP Dermatology Department, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Nicole Basset-Seguin
- AP-HP Dermatology Department, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Cécile Pages
- AP-HP Dermatology Department, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Samia Mourah
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
- AP-HP Pharmacogenomic Laboratory, Saint-Louis Hospital, Paris, France
| | - Philippe Boudou
- AP-HP Hormonology Department, Saint-Louis Hospital, Paris, France
- Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Céleste Lebbé
- AP-HP Dermatology Department, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France
- INSERM U976, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Jean-François Gautier
- AP-HP Diabetology Department, Lariboisière Hospital, Paris, France
- INSERM U1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
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Dillinger J, Vidal-Trecan T, Merat B, Sideris G, Kevorkian J, Gautier J, Riveline J, Henry P. Are the LDL-cholesterol targets from the ESC/EASD guidelines achievable in diabetic patients? Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30323-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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