1
|
Scheen AJ, Marre M, Thivolet C. Prognostic factors in patients with diabetes hospitalized for COVID-19: Findings from the CORONADO study and other recent reports. Diabetes Metab 2020; 46:265-271. [PMID: 32447101 PMCID: PMC7241378 DOI: 10.1016/j.diabet.2020.05.008] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 02/07/2023]
Abstract
Diabetes mellitus is challenging in the context of the COVID-19 pandemic. The prevalence of diabetes patients hospitalized in intensive care units for COVID-19 is two- to threefold higher, and the mortality rate at least double, than that of non-diabetes patients. As the population with diabetes is highly heterogeneous, it is of major interest to determine the risk factors of progression to a more serious life-threatening COVID-19 infection. This brief review discusses the main findings of CORONADO, a prospective observational study in France that specifically addressed this issue as well as related observations from other countries, mainly China and the US. Some prognostic factors beyond old age have been identified: for example, an increased body mass index is a major risk factor for requiring respiratory assistance. Indeed, obesity combines several risk factors, including impaired respiratory mechanics, the presence of other comorbidities and inappropriate inflammatory responses, partly due to ectopic fat deposits. While previous diabetic microvascular (renal) and macrovascular complications also increase risk of death, the quality of past glucose control had no independent influence on hospitalized diabetes patient outcomes, but whether the quality of glucose control might modulate risk of COVID-19 in non-hospitalized diabetes patients is still unknown. In addition, no negative signs regarding the use of RAAS blockers and DPP-4 inhibitors and outcomes of COVID-19 could be identified. Hyperglycaemia at the time of hospital admission is associated with poor outcomes, but it may simply be considered a marker of severity of the infection. Thus, the impact of glucose control during hospitalization on outcomes related to COVID-19, which was not investigated in the CORONADO study, is certainly deserving of specific investigation.
Collapse
Affiliation(s)
- A J Scheen
- Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU Liège, University of Liège, Liège, Belgium.
| | - M Marre
- UMR_S 1138, Metabolic Inflammation in Diabetes and its Complications, Cordeliers Research Centre, 75006 PARIS, France; President of the FFRD and the Clinique Ambroise Paré, 92200 Neuilly-sur-Seine, France
| | - C Thivolet
- President of the SFD and DIAB-eCARE, Centre for Diabetes, Hospices Civils de Lyon, University of Lyon, Lyon, France
| |
Collapse
|
2
|
Matar O, Potier L, Abouleka Y, Hallot-Feron M, Fumeron F, Mohammedi K, Hadjadj S, Roussel R, Velho G, Marre M. Relationship between renal capacity to reabsorb glucose and renal status in patients with diabetes. Diabetes Metab 2020; 46:488-495. [PMID: 32259661 DOI: 10.1016/j.diabet.2020.03.002] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/04/2020] [Accepted: 03/19/2020] [Indexed: 10/24/2022]
Abstract
AIMS Interindividual variability in capacity to reabsorb glucose at the proximal renal tubule could contribute to risk of diabetic kidney disease. Our present study investigated, in patients with diabetes, the association between fractional reabsorption of glucose (FRGLU) and degree of renal disease as assessed by urinary albumin excretion (UAE) and estimated glomerular filtration rate (eGFR). METHODS FRGLU [1-(glucose clearance/creatinine clearance)] was assessed in 637 diabetes patients attending our tertiary referral centre, looking for correlations between FRGLU and UAE (normo-, micro-, macro-albuminuria) and Kidney Disease: Improving Global Outcomes (KDIGO) eGFR categories: >90 (G1); 90-60 (G2); 59-30 (G3); and<30-16 (G4) mL/min/1.73 m2. Patients were stratified by admission fasting plasma glucose (FPG) into three groups: low (<6mmol/L); intermediate (6-11mmol/L); and high (>11mmol/L). RESULTS Median (interquartile range, IQR) FRGLU levels were blood glucose-dependent: 99.90% (0.05) for low (n=106); 99.90% (0.41) for intermediate (n=288); and 96.36% (12.57) for high (n=243) blood glucose categories (P<0.0001). Also, FRGLU increased with renal disease severity in patients in the high FPG group: normoalbuminuria, 93.50% (17.74) (n=135); microalbuminuria, 96.56% (5.94) (n=77); macroalbuminuria, 99.12% (5.44) (n=31; P<0.001); eGFR G1, 94.13% (16.24) (n=111); G2, 96.35% (11.94) (n=72); G3 98.88% (7.59) (n=46); and G4, 99.11% (2.20) (n=14; P<0.01). On multiple regression analyses, FRGLU remained significantly and independently associated with UAE and eGFR in patients in the high blood glucose group. CONCLUSION High glucose reabsorption capacity in renal proximal tubules is associated with high UAE and low eGFR in patients with diabetes and blood glucose levels>11mmol/L.
Collapse
Affiliation(s)
- O Matar
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - L Potier
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - Y Abouleka
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - M Hallot-Feron
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France
| | - F Fumeron
- UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - K Mohammedi
- Faculté de médecine Paul-Broca, université de Bordeaux, Bordeaux, France
| | - S Hadjadj
- Inserm, CNRS, Institut du thorax, université de Nantes, Nantes, France
| | - R Roussel
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - G Velho
- Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France
| | - M Marre
- Service de diabétologie, endocrinologie et nutrition, hôpital Bichat, Assistance publique-hôpitaux de Paris, Paris, France; UFR de médecine, université de Paris, Paris, France; Inserm, Centre de recherches des Cordeliers, Sorbonne université, université de Paris, Paris, France; CMC Ambroise-Paré, Neuilly-sur-Seine, France.
| |
Collapse
|
3
|
Capehorn M, Catarig AM, Furberg J, Janez A, Price H, Tadayon S, Vergès B, Marre M. Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes & Metabolism 2020; 46:100-109. [DOI: 10.1016/j.diabet.2019.101117] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/28/2019] [Accepted: 09/01/2019] [Indexed: 02/07/2023]
|
4
|
Guerci B, Charbonnel B, Gourdy P, Hadjadj S, Hanaire H, Marre M, Vergès B. Efficacy and adherence of glucagon-like peptide-1 receptor agonist treatment in patients with type 2 diabetes mellitus in real-life settings. Diabetes & Metabolism 2019; 45:528-535. [DOI: 10.1016/j.diabet.2019.01.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 01/05/2019] [Accepted: 01/14/2019] [Indexed: 12/25/2022]
|
5
|
Fumeron F, Nicolas A, Bastard JP, Fellahi S, Wigger L, Ibberson M, Cruciani-Guglielmacci C, Le Stunff H, Velho G, Magnan C, Marre M, Balkau B, Roussel R. Dairy consumption is associated with lower plasma dihydroceramides in women from the D.E.S.I.R. cohort. Diabetes Metab 2019; 46:144-149. [PMID: 31212089 DOI: 10.1016/j.diabet.2019.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/15/2019] [Accepted: 06/09/2019] [Indexed: 12/20/2022]
Abstract
AIM In the D.E.S.I.R. cohort, higher consumption of dairy products was associated with lower incidence of hyperglycaemia, and dihydroceramide concentrations were higher in those who progressed to diabetes. Our aim here was to study the relationships between dairy consumption and concentrations of dihydroceramides and ceramides. METHODS In the D.E.S.I.R. cohort, men and women aged 30-65 years, volunteers from West-Central France, were included in a 9-year follow-up with examinations every 3 years, including food-frequency questionnaires. Two items concerned dairy products (cheese, other dairy products except cheese). At each examination, dihydroceramides and ceramides were determined by mass spectrometry in a cohort subset; in the present study, the 105 people who did not progress to type 2 diabetes were analyzed, as the disorder per se might be a confounding factor. RESULTS Higher consumption of dairy products (except cheese) was associated with total plasma dihydroceramides during the follow-up, but only in women (P=0.01 for gender interaction). In fact, dihydroceramide levels were lower in women with high vs low consumption (P=0.03), and were significantly increased during follow-up (P=0.01) in low consumers only. There was also a trend for lower ceramides in women with high dairy (except cheese) intakes (P=0.08). Cheese was associated with dihydroceramide and ceramide changes during follow-up (P=0.04 for both), but no clear trend was evident in either low or high consumers. CONCLUSION These results show that, in women, there is an inverse association between fresh dairy product consumption and predictive markers (dihydroceramides) of type 2 diabetes.
Collapse
Affiliation(s)
- F Fumeron
- Centre de Recherche des Cordeliers, Inserm UMR-S 1138, 15 rue de l'école de Médecine, 75006 Paris, France; Université de Paris, UMR-S 1138, 15 rue de l'école de Médecine, 75006 Paris, France.
| | - A Nicolas
- Centre de Recherche des Cordeliers, Inserm UMR-S 1138, 15 rue de l'école de Médecine, 75006 Paris, France; Sorbonne Université, 15 rue de l'école de Médecine, 75006 Paris, France
| | - J-P Bastard
- AP-HP, Biochemistry and Hormonology Department, Tenon Hospital, 4 Rue de la Chine, 75020 Paris, France
| | - S Fellahi
- AP-HP, Biochemistry and Hormonology Department, Tenon Hospital, 4 Rue de la Chine, 75020 Paris, France
| | - L Wigger
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland; Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - M Ibberson
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - C Cruciani-Guglielmacci
- Unité de Biologie Fonctionnelle et Adaptative, CNRS UMR 8251, Université de Paris, 4 rue Marie-Andrée Lagroua Weill Hallé, 75013 Paris, France
| | - H Le Stunff
- UMR 9198 Institut des Neurosciences Paris Saclay (Neuro-PSI), Université Paris-Sud, Université Paris-Saclay, bâtiment 447, 91405 Orsay cedex, France
| | - G Velho
- Centre de Recherche des Cordeliers, Inserm UMR-S 1138, 15 rue de l'école de Médecine, 75006 Paris, France
| | - C Magnan
- Unité de Biologie Fonctionnelle et Adaptative, CNRS UMR 8251, Université de Paris, 4 rue Marie-Andrée Lagroua Weill Hallé, 75013 Paris, France
| | - M Marre
- Centre de Recherche des Cordeliers, Inserm UMR-S 1138, 15 rue de l'école de Médecine, 75006 Paris, France; Université de Paris, UMR-S 1138, 15 rue de l'école de Médecine, 75006 Paris, France; Diabetology, Endocrinology, Nutrition, APHP - Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France
| | - B Balkau
- Centre for Research in Epidemiology and Population Health (CESP), INSERM, UMR-S 1018, University Paris-Sud, University Versailles Saint-Quentin, 16 av. Paul Vaillant Couturier 94800 Villejuif, France
| | - R Roussel
- Centre de Recherche des Cordeliers, Inserm UMR-S 1138, 15 rue de l'école de Médecine, 75006 Paris, France; Université de Paris, UMR-S 1138, 15 rue de l'école de Médecine, 75006 Paris, France; Diabetology, Endocrinology, Nutrition, APHP - Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France
| |
Collapse
|
6
|
Lingvay I, Marre M, Uusinarkaus K, Woo V, Thomsen HF, Wijayasinghe N, Davies M, Lüdemann J. Semaglutid ermöglichte eine überlegene Gewichtsabnahme über die klinischen Studien SUSTAIN 1 – 5 hinweg. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- I Lingvay
- Department of Clinical Science Dallas, Dallas, United States
| | - M Marre
- Hospital Bichat-Claude Bernard, Paris, Paris, France
| | - K Uusinarkaus
- CSHP/DaVita Clinical Research, Colorado Springs, United States
| | - V Woo
- University of Manitoba, Winnipeg, Canada
| | | | | | - M Davies
- University of Leicester, Leicester, United Kingdom
| | - J Lüdemann
- Schwerpunktpraxis für Diabetes, Gefäß- & Ernährungsmedizin, Falkensee, Germany
| |
Collapse
|
7
|
Barbieux P, György B, Gand E, Saulnier PJ, Ducrocq G, Halimi JM, Feigerlova E, Hulin-Delmotte C, Llaty P, Montaigne D, Rigalleau V, Roussel R, Sosner P, Zaoui P, Ragot S, Marre M, Tregouët DA, Hadjadj S. No prognostic role of a GWAS-derived genetic risk score in renal outcomes for patients from French cohorts with type 1 and type 2 diabetes. Diabetes Metab 2018. [PMID: 29540294 DOI: 10.1016/j.diabet.2018.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- P Barbieux
- Service d'endocrinologie, CHU de Poitiers, 86000 Poitiers, France
| | - B György
- Inserm UMR-S1166, Sorbonne universités, UPMC université Paris 06, 75013, Paris, France; ICAN Institute for Cardiometabolism and Nutrition, 75013 Paris, France
| | - E Gand
- CHU de Poitiers, pôle Dune, 86000 Poitiers, France
| | - P-J Saulnier
- UFR médecine pharmacie, centre d'investigation clinique, université de Poitiers, 86000 Poitiers, France; CHU de Poitiers, centre d'investigation clinique, 86000 Poitiers, France; Inserm, CIC 1402 & U1082, 86000 Poitiers, France
| | - G Ducrocq
- Inserm U698, 75018 Paris, France; Département de cardiologie, groupe hospitalier Bichat Claude-Bernard, Assistance publique-Hôpitaux de Paris (AP-HP), 75018 Paris, France
| | - J-M Halimi
- Service néphrologie, dialyse et transplantation, CHU de Tours, 37000 Tours, France; Inserm, centre d'investigation clinique 0202, 37000 Tours, France
| | - E Feigerlova
- Service d'endocrinologie, CHU de Poitiers, 86000 Poitiers, France; UFR médecine pharmacie, centre d'investigation clinique, université de Poitiers, 86000 Poitiers, France; CHU de Poitiers, centre d'investigation clinique, 86000 Poitiers, France; Inserm, CIC 1402 & U1082, 86000 Poitiers, France
| | | | - P Llaty
- Service de cardiologie, CHU de Poitiers, 86000 Poitiers, France
| | - D Montaigne
- Service d'explorations fonctionnelles cardiovasculaires, CHU de Lille, 59000 Lille, France; Université de Lille, 59000 Lille, France; Inserm, U1011, 59000 Lille, France; EGID, 59000 Lille, France; Institut Pasteur de Lille, 59019 Lille, France
| | - V Rigalleau
- Service endocrinologie, diabétologie maladies métaboliques et nutrition, CHU de Bordeaux, 33604 Pessac cedex, France; Université Victor-Segalen, faculté de médecine, 33000 Bordeaux, France
| | - R Roussel
- UMR_S 1138, centre de recherche des Cordeliers, Sorbonne Paris-Cité, université Paris-Diderot, 75006 Paris, France; Diabetologie endocrinologie nutrition, DHU FIRE, AP-HP, hôpital Bichat, 75018 Paris, France; Inserm UMR-S 1138, centre de recherche des Cordeliers, 75006 Paris, France
| | - P Sosner
- Service de cardiologie, CHU de Poitiers, 86000 Poitiers, France; Complexe médico-sportif Mon Stade, 75013 Paris, France; Laboratoire MOVE (EA 6314), université de Poitiers, 86000 Poitiers, France
| | - P Zaoui
- Service néphrologie, dialyse et transplantation, CHU de Grenoble, 38000 Grenoble, France; Faculté de médecine, université Grenoble Alpes, 38000 Grenoble, France
| | - S Ragot
- UFR médecine pharmacie, centre d'investigation clinique, université de Poitiers, 86000 Poitiers, France; CHU de Poitiers, centre d'investigation clinique, 86000 Poitiers, France; Inserm, CIC 1402 & U1082, 86000 Poitiers, France
| | - M Marre
- UMR_S 1138, centre de recherche des Cordeliers, Sorbonne Paris-Cité, université Paris-Diderot, 75006 Paris, France; Diabetologie endocrinologie nutrition, DHU FIRE, AP-HP, hôpital Bichat, 75018 Paris, France; Inserm UMR-S 1138, centre de recherche des Cordeliers, 75006 Paris, France
| | - D-A Tregouët
- Inserm UMR-S1166, Sorbonne universités, UPMC université Paris 06, 75013, Paris, France; ICAN Institute for Cardiometabolism and Nutrition, 75013 Paris, France
| | - S Hadjadj
- Service d'endocrinologie, CHU de Poitiers, 86000 Poitiers, France; UFR médecine pharmacie, centre d'investigation clinique, université de Poitiers, 86000 Poitiers, France; CHU de Poitiers, centre d'investigation clinique, 86000 Poitiers, France; Inserm, CIC 1402 & U1082, 86000 Poitiers, France; UFR médecine pharmacie, université de Poitiers, 86000 Poitiers, France.
| | | | | |
Collapse
|
8
|
Blomster JI, Zoungas S, Woodward M, Neal B, Harrap S, Poulter N, Marre M, Williams B, Chalmers J, Hillis GS. The impact of level of education on vascular events and mortality in patients with type 2 diabetes mellitus: Results from the ADVANCE study. Diabetes Res Clin Pract 2017; 127:212-217. [PMID: 28395214 DOI: 10.1016/j.diabres.2017.03.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 03/16/2017] [Indexed: 11/29/2022]
Abstract
AIMS The relationship between educational level and the risk of all-cause mortality is well established, whereas the association with vascular events in individuals with type 2 diabetes is not well described. Any association may reflect a link with common cardiovascular or lifestyle-based risk factors. METHODS The relationships between the highest level of educational attainment and major cardiovascular events, microvascular complications and all-cause mortality were explored in a cohort of 11,140 individuals with type 2 diabetes. Completion of formal education before the age of 16 was categorized as a low level of education. Regional differences between Asia, East Europe and Established Market Economies were also assessed. RESULTS During a median of 5years of follow up, 1031 (9%) patients died, 1147 (10%) experienced a major cardiovascular event and 1136 (10%) a microvascular event. After adjustment for baseline characteristics and risk factors, individuals with lower education had an increased risk of cardiovascular events (hazard ratio (HR) 1.31, 95% CI 1.16-1.48, p<0.0001), microvascular events (HR 1.23, 95% CI 1.08-1.39, p=0.0013) and all-cause mortality (HR 1.34, 95% CI 1.18-1.52, p<0.0001). In regional analyses the increased risk of studied outcomes associated with lower education was weakest in Established Market Economies and strongest in East Europe. CONCLUSIONS A low level of education is associated with an increased risk of vascular events and death in patients with type 2 diabetes, independently of common lifestyle associated cardiovascular risk factors. The effect size varies between geographical regions.
Collapse
Affiliation(s)
- J I Blomster
- The George Institute for Global Health, University of Sydney, Sydney, Australia; University of Turku, Turku, Finland.
| | - S Zoungas
- The George Institute for Global Health, University of Sydney, Sydney, Australia; School of Public Health, Monash University, Melbourne, Australia
| | - M Woodward
- The George Institute for Global Health, University of Sydney, Sydney, Australia; Department of Epidemiology, Johns Hopkins University, Baltimore, USA; The George Institute for Global Health, University of Oxford, UK
| | - B Neal
- The George Institute for Global Health, University of Sydney, Sydney, Australia
| | - S Harrap
- Department of Physiology, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - N Poulter
- Imperial College London and Hammersmith Hospital, London, UK
| | - M Marre
- Service d'Endocrinologie Diabétologie Nutrition, Groupe Hospitalier Bichat-Claude Bernard, Paris, France
| | - B Williams
- University College London and the National Institute for Health Research UCL Hospitals Biomedical Research Centre, London, UK
| | - J Chalmers
- The George Institute for Global Health, University of Sydney, Sydney, Australia
| | - G S Hillis
- The George Institute for Global Health, University of Sydney, Sydney, Australia; Department of Cardiology, Royal Perth Hospital, Perth, Australia
| |
Collapse
|
9
|
Moutairou A, Roussel R, Charbonnel B, El Boustany R, Nicolas A, Leye A, Mohammedi K, Marre M, Detournay B, Potier L. Short-term effect of severe hypoglycaemia on glycaemic control in the Diabetes Control and Complications Trial. Diabetes & Metabolism 2017; 43:187-190. [DOI: 10.1016/j.diabet.2016.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 08/10/2016] [Indexed: 11/25/2022]
|
10
|
Nicolas A, Aubert R, Bellili-Muñoz N, Balkau B, Bonnet F, Tichet J, Velho G, Marre M, Roussel R, Fumeron F. T-cadherin gene variants are associated with type 2 diabetes and the Fatty Liver Index in the French population. Diabetes & Metabolism 2017; 43:33-39. [DOI: 10.1016/j.diabet.2016.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/26/2016] [Accepted: 05/10/2016] [Indexed: 11/30/2022]
|
11
|
Lamri A, Bonnefond A, Meyre D, Balkau B, Roussel R, Marre M, Froguel P, Fumeron F. Interaction between GPR120 p.R270H loss-of-function variant and dietary fat intake on incident type 2 diabetes risk in the D.E.S.I.R. study. Nutr Metab Cardiovasc Dis 2016; 26:931-936. [PMID: 27212621 DOI: 10.1016/j.numecd.2016.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 10/13/2015] [Revised: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND AIMS GPR120 (encoded by FFAR4) is a lipid sensor that plays an important role in the control of energy balance. GPR120 is activated by long chain fatty acids (FAs) including omega-3 FAs. In humans, the loss of function p.R270H variant of the gene FFAR4 has been associated with a lower protein activity, an increased risk of obesity and higher fasting plasma glucose levels. The aim of this study was to investigate whether p.R270H interacts with dietary fat intake to modulate the risk of type 2 diabetes (T2D, 198 incident; 368 prevalent cases) and overweight (787 incident and 2891 prevalent cases) in the prospective D.E.S.I.R. study (n = 5,212, 9 years follow-up). METHODS AND RESULTS The association of p.R270H with dietary fat and total calories was assessed by linear mixed models. The interaction between p.R270H and dietary fat on T2D and overweight was assessed by logistic regression analysis. The p.R270H variant had a minor allele frequency of 1.45% and was not significantly associated with total calories intake, fat intake or the total calories derived from fat (%). However, there was a significant interaction between p.R270H and dietary fat modulating the incidence of T2D (Pinteraction = 0.02) where the H-carriers had a higher risk of T2D than RR homozygotes in the low fat intake category only. The interaction between p.R270H and fat intake modulating the incidence and prevalence of overweight was not significant. CONCLUSION The p.R270H variant of GPR120 modulates the risk of T2D in interaction with dietary fat intake in the D.E.S.I.R.
Collapse
Affiliation(s)
- A Lamri
- Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherches des Cordeliers, Research Unit 1138, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - A Bonnefond
- CNRS-UMR8199, Lille Pasteur Institute, Lille, France; Lille University, Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, Lille, France
| | - D Meyre
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
| | - B Balkau
- INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Villejuif, France; Universities of St Quentin-Versailles and Paris Sud 11, UMRS 1018, Villejuif, France
| | - R Roussel
- Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherches des Cordeliers, Research Unit 1138, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; Assistance Publique Hôpitaux de Paris (APHP), Bichat Hospital, Department of Diabetology, Endocrinology and Nutrition, Paris, France
| | - M Marre
- Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherches des Cordeliers, Research Unit 1138, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France; Assistance Publique Hôpitaux de Paris (APHP), Bichat Hospital, Department of Diabetology, Endocrinology and Nutrition, Paris, France
| | - P Froguel
- CNRS-UMR8199, Lille Pasteur Institute, Lille, France; Lille University, Lille, France; European Genomic Institute for Diabetes (EGID), FR 3508, Lille, France
| | - F Fumeron
- Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherches des Cordeliers, Research Unit 1138, Paris, France; Paris Diderot University, Sorbonne Paris Cité, Paris, France.
| |
Collapse
|
12
|
Halimi S, Potier L, Mosnier-Pudar H, Penfornis A, Roussel R, Boultif Z, Monguillon P, Renard E, Serusclat P, Marre M, Charbonnel B. Programme L&Vous : premiers enseignements de l’Observatoire National de l’Utilisation, en vie réelle, de l’Insuline Basale par les patients diabétiques de Type 2. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1957-2557(15)30221-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
13
|
Kolonko A, Chudek J, Kujawa-Szewieczek A, Czerwienska B, Wiecek A, Levin A, Madore F, Rigatto C, Barrett B, Muirhead N, Holmes DT, Clase CM, Tang M, Djurdjev O, Ponte B, Pruijm M, Ackermann D, Vuistiner P, Guessous I, Ehret G, Paccaud F, Mohaupt M, Pechere-Bertschi A, Burnier M, Martin PY, Devuyst O, Bochud M, Roussel R, Velho G, Bankir L, Balkau B, Alhenc-Gelas F, Marre M, Bouby N, Corradi V, Martino F, Gastaldon F, Scalzotto E, Nalesso F, Fortunato A, Giavarina D, Ronco C. COPEPTIN IN CKD. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu124] [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: 11/14/2022] Open
|
14
|
van Dieren S, Kengne AP, Chalmers J, Beulens JWJ, Davis TME, Fulcher G, Heller SR, Patel A, Colagiuri S, Hamet P, Mancia G, Marre M, Neal B, Williams B, Peelen LM, van der Schouw YT, Woodward M, Zoungas S. Intensification of medication and glycaemic control among patients with type 2 diabetes - the ADVANCE trial. Diabetes Obes Metab 2014; 16:426-32. [PMID: 24251579 DOI: 10.1111/dom.12238] [Citation(s) in RCA: 14] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/02/2013] [Accepted: 11/02/2013] [Indexed: 02/04/2023]
Abstract
AIMS The aim of this study was to assess associations between patient characteristics, intensification of blood glucose-lowering treatment through oral glucose-lowering therapy and/or insulin and effective glycaemic control in type 2 diabetes. METHODS 11 140 patients from the Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE) trial who were randomized to intensive glucose control or standard glucose control and followed up for a median of 5 years were categorized into two groups: effective glycaemic control [haemoglobin A1c (HbA1c) ≤ 7.0% or a proportionate reduction in HbA1c over 10%] or ineffective glycaemic control (HbA1c > 7.0% and a proportionate reduction in HbA1c less than or equal to 10%). Therapeutic intensification was defined as addition of an oral glucose-lowering agent or commencement of insulin. Pooled logistic regression models examined the associations between patient factors, intensification and effective glycaemic control. RESULTS A total of 7768 patients (69.7%), including 3198 in the standard treatment group achieved effective glycaemic control. Compared to patients with ineffective control, patients with effective glycaemic control had shorter duration of diabetes and lower HbA1c at baseline and at the time of treatment intensification. Treatment intensification with addition of an oral agent or commencement of insulin was associated with a 107% [odds ratio, OR: 2.07 (95% confidence interval, CI: 1.95-2.20)] and 152% [OR: 2.52 (95% CI: 2.30-2.77)] greater chance of achieving effective glycaemic control, respectively. These associations were robust after adjustment for several baseline characteristics and not modified by the number of oral medications taken at the time of treatment intensification. CONCLUSIONS Effective glycaemic control was associated with treatment intensification at lower HbA1c levels at all stages of the disease course and in both arms of the ADVANCE trial.
Collapse
Affiliation(s)
- S van Dieren
- The George Institute for Global Health, University of Sydney, Sydney, Australia; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Ryden L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N, Deaton C, Escaned J, Hammes HP, Huikuri H, Marre M, Marx N, Mellbin L, Ostergren J, Patrono C, Seferovic P, Uva MS, Taskinen MR, Tendera M, Tuomilehto J, Valensi P, Zamorano JL. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 2014. [DOI: 10.1093/eurheartj/ehu076] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
16
|
Roussel R, Chaignot C, Weill A, Travert F, Hansel B, Ricordeau P, Alla F, Marre M, Allemand H. Utilisation des fibrates en prévention primaire chez les diabétiques de type 2 à haut risque cardiovasculaire. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2013.11.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
17
|
Blomster JI, Chow CK, Zoungas S, Woodward M, Patel A, Poulter NR, Marre M, Harrap S, Chalmers J, Hillis GS. The influence of physical activity on vascular complications and mortality in patients with type 2 diabetes mellitus. Diabetes Obes Metab 2013; 15:1008-12. [PMID: 23675676 DOI: 10.1111/dom.12122] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [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: 02/04/2013] [Revised: 03/24/2013] [Accepted: 04/23/2013] [Indexed: 11/30/2022]
Abstract
AIMS There is limited evidence regarding the association between physical activity and vascular complications, particularly microvascular disease, in patients with type 2 diabetes. METHODS From the 11 140 patients in the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron modified release Controlled Evaluation) trial, the effect of physical activity, categorized as none, mild, moderate or vigorous, and the number of sessions within a week, was examined in multivariable regression models adjusted for potential confounders. The study end-points were major cardiovascular events, microvascular complications and all-cause mortality. RESULTS Forty-six percent of participants reported undertaking moderate to vigorous physical activity for >15 min at least once in the previous week. During a median of 5 years of follow-up, 1031 patients died, 1147 experienced a major cardiovascular event and 1136 a microvascular event. Compared to patients who undertook no or mild physical activity, those reporting moderate to vigorous activity had a decreased risk of cardiovascular events (HR: 0.78, 95% CI: 0.69-0.88, p < 0.0001), microvascular events (HR: 0.85, 95% CI: 0.76-0.96, p = 0.010) and all-cause mortality (HR: 0.83, 95% CI: 0.73-0.94, p = 0.0044). CONCLUSIONS Moderate to vigorous, but not mild, physical activity is associated with a reduced incidence of cardiovascular events, microvascular complications and all-cause mortality in patients with type 2 diabetes.
Collapse
Affiliation(s)
- J I Blomster
- The George Institute for Global Health and University of Sydney, Sydney, Australia; University of Turku, Turku, Finland
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Bode BW, Buse JB, Fisher M, Garg SK, Marre M, Merker L, Renard E, Russell-Jones DL, Hansen CT, Rana A, Heller SR. Insulin degludec improves glycaemic control with lower nocturnal hypoglycaemia risk than insulin glargine in basal-bolus treatment with mealtime insulin aspart in Type 1 diabetes (BEGIN(®) Basal-Bolus Type 1): 2-year results of a randomized clinical trial. Diabet Med 2013; 30:1293-7. [PMID: 23710902 PMCID: PMC4264937 DOI: 10.1111/dme.12243] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2013] [Indexed: 11/29/2022]
Abstract
AIMS The goal of this study was to compare the long-term safety and efficacy of the basal insulin analogue, insulin degludec with insulin glargine (both with insulin aspart) in Type 1 diabetes, over a 2-year time period. METHODS This open-label trial comprised a 1-year main trial and a 1-year extension. Patients were randomized to once-daily insulin degludec or insulin glargine and titrated to pre-breakfast plasma glucose values of 3.9-4.9 mmol/l. RESULTS The rate of nocturnal confirmed hypoglycaemia was 25% lower with insulin degludec than with insulin glargine (P = 0.02). Rates of confirmed hypoglycaemia, severe hypoglycaemia and adverse events, and reductions in glycated haemoglobin and fasting plasma glucose were similar between groups. Despite achieving similar glycaemic control, insulin degludec-treated patients used 12% less basal and 9% less total daily insulin than did insulin glargine-treated patients (P < 0.01). CONCLUSIONS Long-term basal therapy using insulin degludec in Type 1 diabetes required lower doses and was associated with a 25% lower risk for nocturnal hypoglycaemia than insulin glargine.
Collapse
Affiliation(s)
- B W Bode
- Atlanta Diabetes Associates, Atlanta, GA, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Monteiro MB, Patente TA, Mohammedi K, Queiroz MS, Azevedo MJ, Canani LH, Parisi MC, Marre M, Velho G, Corrêa-Giannella ML. Sex-specific associations of variants in regulatory regions of NADPH oxidase-2 (CYBB) and glutathione peroxidase 4 (GPX4) genes with kidney disease in type 1 diabetes. Free Radic Res 2013; 47:804-10. [PMID: 23919599 DOI: 10.3109/10715762.2013.828347] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Oxidative stress is involved in the pathophysiology of diabetic nephropathy. The superoxide-generating nicotinamide adenine dinucleotide phosphate-oxidase 2 (NOX2, encoded by the CYBB gene) and the antioxidant enzyme glutathione peroxidase 4 (GPX4) play opposing roles in the balance of cellular redox status. In the present study, we investigated associations of single nucleotide polymorphisms (SNPs) in the regulatory regions of CYBB and GPX4 with kidney disease in patients with type 1 diabetes. Two functional SNPs, rs6610650 (CYBB promoter region, chromosome X) and rs713041 (GPX4 3'untranslated region, chromosome 19), were genotyped in 451 patients with type 1 diabetes from a Brazilian cohort (diabetic nephropathy: 44.6%) and in 945 French/Belgian patients with type 1 diabetes from Genesis and GENEDIAB cohorts (diabetic nephropathy: 62.3%). The minor A-allele of CYBB rs6610650 was associated with lower estimated glomerular filtration rate (eGFR) in Brazilian women, and with the prevalence of established/advanced nephropathy in French/Belgian women (odds ratio 1.75, 95% CI 1.11-2.78, p = 0.016). The minor T-allele of GPX4 rs713041 was inversely associated with the prevalence of established/advanced nephropathy in Brazilian men (odds ratio 0.30, 95% CI 0.13-0.68, p = 0.004), and associated with higher eGFR in French/Belgian men. In conclusion, these heterogeneous results suggest that neither CYBB nor GPX4 are major genetic determinants of diabetic nephropathy, but nevertheless, they could modulate in a gender-specific manner the risk for renal disease in patients with type 1 diabetes.
Collapse
Affiliation(s)
- M B Monteiro
- Laboratório de Endocrinologia Celular e Molecular (LIM-25), Faculdade de Medicina da Universidade de São Paulo , São Paulo-SP , Brazil
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Hillis GS, Lowe G, Woodward M, Rumley A, Harrap S, Marre M, Hamet P, Patel A, Poulter N, Chalmers J. Inflammatory markers and the risk of vascular complications and mortality in type 2 diabetes mellitus. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
21
|
Bonnefond A, Yengo L, Philippe J, Dechaume A, Ezzidi I, Vaillant E, Gjesing AP, Andersson EA, Czernichow S, Hercberg S, Hadjadj S, Charpentier G, Lantieri O, Balkau B, Marre M, Pedersen O, Hansen T, Froguel P, Vaxillaire M. Reassessment of the putative role of BLK-p.A71T loss-of-function mutation in MODY and type 2 diabetes. Diabetologia 2013; 56:492-6. [PMID: 23224494 DOI: 10.1007/s00125-012-2794-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 11/13/2012] [Indexed: 12/31/2022]
Abstract
AIMS/HYPOTHESIS MODY is believed to be caused by at least 13 different genes. Five rare mutations at the BLK locus, including only one non-synonymous p.A71T variant, were reported to segregate with diabetes in three MODY families. The p.A71T mutation was shown to abolish the enhancing effect of BLK on insulin content and secretion from pancreatic beta cell lines. Here, we reassessed the contribution of BLK to MODY and tested the effect of BLK-p.A71T on type 2 diabetes risk and variations in related traits. METHODS BLK was sequenced in 64 unelucidated MODY samples. The BLK-p.A71T variant was genotyped in a French type 2 diabetes case-control study including 4,901 cases and 4,280 controls, and in the DESIR (Data from an Epidemiological Study on the Insulin Resistance Syndrome) and SUVIMAX (Supplementation en Vitamines et Mineraux Antioxydants) population-based cohorts (n = 6,905). The variant effects were assessed by logistic and linear regression models. RESULTS No rare non-synonymous BLK mutations were found in the MODY patients. The BLK p.A71T mutation was present in 52 normoglycaemic individuals, making it very unlikely that this loss-of-function mutation causes highly penetrant MODY. We found a nominal association between this variant and increased type 2 diabetes risk, with an enrichment of the mutation in the obese diabetic patients, although no significant association with BMI was identified. CONCLUSIONS/INTERPRETATION No mutation in BLK was found in our MODY cohort. From our findings, the BLK-p.A71T mutation may weakly influence type 2 diabetes risk in the context of obesity; however, this will require further validation.
Collapse
Affiliation(s)
- A Bonnefond
- CNRS-UMR-8199, Lille Pasteur Institute, 1 rue du Professeur Calmette, 59019 Lille Cedex, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Albrechtsen A, Grarup N, Li Y, Sparsø T, Tian G, Cao H, Jiang T, Kim SY, Korneliussen T, Li Q, Nie C, Wu R, Skotte L, Morris AP, Ladenvall C, Cauchi S, Stančáková A, Andersen G, Astrup A, Banasik K, Bennett AJ, Bolund L, Charpentier G, Chen Y, Dekker JM, Doney ASF, Dorkhan M, Forsen T, Frayling TM, Groves CJ, Gui Y, Hallmans G, Hattersley AT, He K, Hitman GA, Holmkvist J, Huang S, Jiang H, Jin X, Justesen JM, Kristiansen K, Kuusisto J, Lajer M, Lantieri O, Li W, Liang H, Liao Q, Liu X, Ma T, Ma X, Manijak MP, Marre M, Mokrosiński J, Morris AD, Mu B, Nielsen AA, Nijpels G, Nilsson P, Palmer CNA, Rayner NW, Renström F, Ribel-Madsen R, Robertson N, Rolandsson O, Rossing P, Schwartz TW, Slagboom PE, Sterner M, Tang M, Tarnow L, Tuomi T, van’t Riet E, van Leeuwen N, Varga TV, Vestmar MA, Walker M, Wang B, Wang Y, Wu H, Xi F, Yengo L, Yu C, Zhang X, Zhang J, Zhang Q, Zhang W, Zheng H, Zhou Y, Altshuler D, ‘t Hart LM, Franks PW, Balkau B, Froguel P, McCarthy MI, Laakso M, Groop L, Christensen C, Brandslund I, Lauritzen T, Witte DR, Linneberg A, Jørgensen T, Hansen T, Wang J, Nielsen R, Pedersen O. Exome sequencing-driven discovery of coding polymorphisms associated with common metabolic phenotypes. Diabetologia 2013; 56:298-310. [PMID: 23160641 PMCID: PMC3536959 DOI: 10.1007/s00125-012-2756-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 09/28/2012] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS Human complex metabolic traits are in part regulated by genetic determinants. Here we applied exome sequencing to identify novel associations of coding polymorphisms at minor allele frequencies (MAFs) >1% with common metabolic phenotypes. METHODS The study comprised three stages. We performed medium-depth (8×) whole exome sequencing in 1,000 cases with type 2 diabetes, BMI >27.5 kg/m(2) and hypertension and in 1,000 controls (stage 1). We selected 16,192 polymorphisms nominally associated (p < 0.05) with case-control status, from four selected annotation categories or from loci reported to associate with metabolic traits. These variants were genotyped in 15,989 Danes to search for association with 12 metabolic phenotypes (stage 2). In stage 3, polymorphisms showing potential associations were genotyped in a further 63,896 Europeans. RESULTS Exome sequencing identified 70,182 polymorphisms with MAF >1%. In stage 2 we identified 51 potential associations with one or more of eight metabolic phenotypes covered by 45 unique polymorphisms. In meta-analyses of stage 2 and stage 3 results, we demonstrated robust associations for coding polymorphisms in CD300LG (fasting HDL-cholesterol: MAF 3.5%, p = 8.5 × 10(-14)), COBLL1 (type 2 diabetes: MAF 12.5%, OR 0.88, p = 1.2 × 10(-11)) and MACF1 (type 2 diabetes: MAF 23.4%, OR 1.10, p = 8.2 × 10(-10)). CONCLUSIONS/INTERPRETATION We applied exome sequencing as a basis for finding genetic determinants of metabolic traits and show the existence of low-frequency and common coding polymorphisms with impact on common metabolic traits. Based on our study, coding polymorphisms with MAF above 1% do not seem to have particularly high effect sizes on the measured metabolic traits.
Collapse
Affiliation(s)
- A. Albrechtsen
- Centre of Bioinformatics, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - N. Grarup
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
| | - Y. Li
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - T. Sparsø
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
| | | | - H. Cao
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - T. Jiang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - S. Y. Kim
- Department of Integrative Biology, University of California, 3060 Valley Life Sciences, Bldg #3140, Berkeley, CA 94720-3140 USA
| | - T. Korneliussen
- Centre of Bioinformatics, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Q. Li
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - C. Nie
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - R. Wu
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - L. Skotte
- Centre of Bioinformatics, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - A. P. Morris
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - C. Ladenvall
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University and Lund University Diabetes Centre, Malmö, Sweden
| | - S. Cauchi
- UMR CNRS 8199, Genomic and Metabolic Disease, Lille, France
| | - A. Stančáková
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - G. Andersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
| | - A. Astrup
- Department of Human Nutrition, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - K. Banasik
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
| | - A. J. Bennett
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - L. Bolund
- Institute of Human Genetics, Aarhus University, Aarhus, Denmark
| | - G. Charpentier
- Department of Endocrinology-Diabetology, Corbeil-Essonnes Hospital, Corbeil-Essonnes, France
| | - Y. Chen
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - J. M. Dekker
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - A. S. F. Doney
- Diabetes Research Centre, Biomedical Research Institute, University of Dundee, Ninewells Hospital, Dundee, UK
- Pharmacogenomics Centre, Biomedical Research Institute, University of Dundee, Ninewells Hospital, Dundee, UK
| | - M. Dorkhan
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University and Lund University Diabetes Centre, Malmö, Sweden
| | - T. Forsen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Vasa Health Care Center, Vaasa, Finland
| | - T. M. Frayling
- Genetics of Complex Traits, Institute of Biomedical and Clinical Science, Peninsula Medical School, University of Exeter, Exeter, UK
- Diabetes Genetics, Institute of Biomedical and Clinical Science, Peninsula Medical School, University of Exeter, Exeter, UK
| | - C. J. Groves
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Y. Gui
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - G. Hallmans
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - A. T. Hattersley
- Genetics of Complex Traits, Institute of Biomedical and Clinical Science, Peninsula Medical School, University of Exeter, Exeter, UK
- Diabetes Genetics, Institute of Biomedical and Clinical Science, Peninsula Medical School, University of Exeter, Exeter, UK
| | - K. He
- Chinese PLA General Hospital, Beijing, China
| | - G. A. Hitman
- Centre for Diabetes, Blizard Institute, Queen Mary University of London, London, UK
| | - J. Holmkvist
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
- Vipergen Aps, Copenhagen, Denmark
| | - S. Huang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
- School of Bioscience and Biotechnology, South China University of Technology, Guangzhou, China
| | - H. Jiang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - X. Jin
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - J. M. Justesen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
| | - K. Kristiansen
- Department of Biology, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - J. Kuusisto
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - M. Lajer
- Steno Diabetes Center, Gentofte, Denmark
| | - O. Lantieri
- Institut inter Regional pour la Santé (IRSA), La Riche, France
| | - W. Li
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - H. Liang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - Q. Liao
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - X. Liu
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - T. Ma
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - X. Ma
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - M. P. Manijak
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
| | - M. Marre
- Department of Endocrinology, Diabetology and Nutrition, Bichat-Claude Bernard University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
- Inserm U695, Université Denis Diderot Paris 7, Paris, France
| | - J. Mokrosiński
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
- Laboratory for Molecular Pharmacology, Department of Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A. D. Morris
- Diabetes Research Centre, Biomedical Research Institute, University of Dundee, Ninewells Hospital, Dundee, UK
- Pharmacogenomics Centre, Biomedical Research Institute, University of Dundee, Ninewells Hospital, Dundee, UK
| | - B. Mu
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - A. A. Nielsen
- Department of Clinical Biochemistry, Vejle Hospital, Vejle, Denmark
| | - G. Nijpels
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - P. Nilsson
- Department of Clinical Sciences, Medicine, Lund University, Malmö, Sweden
| | - C. N. A. Palmer
- Diabetes Research Centre, Biomedical Research Institute, University of Dundee, Ninewells Hospital, Dundee, UK
- Pharmacogenomics Centre, Biomedical Research Institute, University of Dundee, Ninewells Hospital, Dundee, UK
| | - N. W. Rayner
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - F. Renström
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Skåna University Hospital, Lund University, Malmö, Sweden
| | - R. Ribel-Madsen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
| | - N. Robertson
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - O. Rolandsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - P. Rossing
- Steno Diabetes Center, Gentofte, Denmark
| | - T. W. Schwartz
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
- Laboratory for Molecular Pharmacology, Department of Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - P. E. Slagboom
- Section of Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Netherlands Center for Healthy Ageing, Leiden, the Netherlands
| | - M. Sterner
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University and Lund University Diabetes Centre, Malmö, Sweden
| | | | - M. Tang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - L. Tarnow
- Steno Diabetes Center, Gentofte, Denmark
| | | | - T. Tuomi
- Department of Medicine, Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - E. van’t Riet
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - N. van Leeuwen
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - T. V. Varga
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Skåna University Hospital, Lund University, Malmö, Sweden
| | - M. A. Vestmar
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
- Laboratory for Molecular Pharmacology, Department of Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M. Walker
- Diabetes Research Group, School of Clinical Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - B. Wang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - Y. Wang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - H. Wu
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - F. Xi
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - L. Yengo
- UMR CNRS 8199, Genomic and Metabolic Disease, Lille, France
| | - C. Yu
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - X. Zhang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - J. Zhang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - Q. Zhang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - W. Zhang
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - H. Zheng
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - Y. Zhou
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
| | - D. Altshuler
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA USA
- Broad Institute of Harvard and MIT, Cambridge, MA USA
| | - L. M. ‘t Hart
- Section of Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - P. W. Franks
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Skåna University Hospital, Lund University, Malmö, Sweden
- Department of Nutrition, Harvard School of Public Health, Boston, MA USA
| | - B. Balkau
- Inserm CESP U1018, Villejuif, France
| | - P. Froguel
- UMR CNRS 8199, Genomic and Metabolic Disease, Lille, France
- Genomic Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - M. I. McCarthy
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
- Oxford National Institute for Health Research Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - M. Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - L. Groop
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University and Lund University Diabetes Centre, Malmö, Sweden
| | - C. Christensen
- Department of Internal Medicine and Endocrinology, Vejle Hospital, Vejle, Denmark
| | - I. Brandslund
- Department of Clinical Biochemistry, Vejle Hospital, Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - T. Lauritzen
- Department of General Practice, Aarhus University, Aarhus, Denmark
| | | | - A. Linneberg
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
| | - T. Jørgensen
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Medicine, University of Aalborg, Aalborg, Denmark
| | - T. Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - J. Wang
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
- BGI-Shenzhen, Beishan Industrial Zone, Yantian District, 518083 Shenzhen, China
- Department of Biology, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - R. Nielsen
- Centre of Bioinformatics, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
- Department of Integrative Biology, University of California, 3060 Valley Life Sciences, Bldg #3140, Berkeley, CA 94720-3140 USA
- Department of Statistics, University of California, Berkeley, CA USA
| | - O. Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, DIKU Building, Universitetsparken 1, 2100 Copenhagen Ø, Denmark
- Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
- Hagedorn Research Institute, Gentofte, Denmark
- Institute of Biomedical Science, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
23
|
Ferrarezi DAF, Bellili-Muñoz N, Dubois-Laforgue D, Cheurfa N, Lamri A, Reis AF, Le Feuvre C, Roussel R, Fumeron F, Timsit J, Marre M, Velho G. Allelic variations of the vitamin D receptor (VDR) gene are associated with increased risk of coronary artery disease in type 2 diabetics: the DIABHYCAR prospective study. Diabetes Metab 2013; 39:263-70. [PMID: 23352876 DOI: 10.1016/j.diabet.2012.11.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 11/29/2012] [Accepted: 11/29/2012] [Indexed: 12/13/2022]
Abstract
AIM Vitamin D deficiency is associated with coronary artery disease (CAD), and the actions of vitamin D are mediated by binding to a specific nuclear vitamin D receptor (VDR). This study investigated the associations of VDR gene variants with CAD in two cohorts of type 2 diabetes patients. METHODS A cohort of 3137 subjects from the prospective DIABHYCAR study (CAD incidence: 14.8%; follow-up: 4.4 ± 1.3 years) and an independent, hospital-based population of 713 subjects, 32.3% of whom had CAD, were assessed. Three SNPs in the VDR gene were genotyped: rs1544410 (BsmI); rs7975232 (ApaI); and rs731236 (TaqI). RESULTS In the DIABHYCAR cohort, an association was observed between the A allele of BsmI and incident cases of CAD (HR: 1.16, 95% CI: 1.05-1.29; P = 0.002). Associations were also observed between BsmI (P = 0.01) and TaqI (P = 0.04) alleles and baseline cases of CAD. The AAC haplotype (BsmI/ApaI/TaqI) was significantly associated with an increased CAD prevalence at the end of the study compared with the GCT haplotype (OR: 1.12, 95% CI: 1.02-1.28; P = 0.04). In a cross-sectional study of the independent hospital-based cohort, associations of ApaI (P = 0.009) and TaqI (P = 0.03) alleles with CAD were observed, with similar haplotype results (OR: 1.33, 95% CI: 1.03-1.73; P = 0.03). CONCLUSION The haplotype comprising the minor allele of BsmI, major allele of ApaI and minor allele of TaqI of VDR (AAC) was associated with an increased risk of CAD in type 2 diabetes patients. This effect was independent of the effects of other known cardiovascular risk factors.
Collapse
Affiliation(s)
- D A F Ferrarezi
- Inserm, Research Unit 695, 16, rue Henri-Huchard, 75018 Paris, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Hillis G, Lowe G, Rumley A, Li Q, Harrap S, Marre M, Hamet P, Patel A, Poulter N, Chalmers J. Inflammatory Biomarker Levels and The Risk of Vascular Complications and Mortality in Type 2 Diabetes Mellitus. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.155] [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]
|
25
|
Hallab M, Compaore A, Mohammedi K, Travert F, Marre M. P6.23 ARTERIAL STIFFNESS MEASUREMENT IN OBESE PATIENTS WITH A NEW DEVICE: POPMETRE®. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
26
|
Freemantle N, Balkau B, Danchin N, Wang E, Marre M, Vespasiani G, Kawamori R, Home PD. Factors influencing initial choice of insulin therapy in a large international non-interventional study of people with type 2 diabetes. Diabetes Obes Metab 2012; 14:901-9. [PMID: 22519930 PMCID: PMC3466417 DOI: 10.1111/j.1463-1326.2012.01613.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 11/27/2011] [Accepted: 04/16/2012] [Indexed: 11/30/2022]
Abstract
AIM To use baseline characteristics of the Cardiovascular Risk Evaluation in people with type 2 Diabetes on Insulin Therapy study population to identify factors that could explain the choice of insulin therapy when beginning insulin. METHODS The source, non-interventional, longitudinal, long-term study involves 314 centres in 12 countries in five regions. People were enrolled having started any insulin regimen in the previous 12 months. To identify factors associated with the choice of insulin regimen, multivariable backward logistic regression was performed on eligible physician and participant explanatory variables. RESULTS Participants (N = 3031) had mean age 62 years, diabetes duration 11 years, body mass index 29.3 kg/m² and an HbA1c of 9.5%. Participants in Japan had less hypertension, smoked more and used fewer concomitant medications than those of other regions. Only physician location (rural or urban) influenced the choice of insulin in Japan. In the other four-regions-combined, physician location, specialty, sex and practice type influenced choice of insulin as did participant location, baseline HbA1c, use of glucose-lowering therapies and prior insulin secretagogue use. CONCLUSION Choice of initial insulin regimen was influenced by several physician and participant characteristics in Canada and Europe, but only by physician location in Japan.
Collapse
Affiliation(s)
- N Freemantle
- Department of Primary Care and Population Health, University College London, UK.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Zoungas S, Chalmers J, Ninomiya T, Li Q, Cooper ME, Colagiuri S, Fulcher G, de Galan BE, Harrap S, Hamet P, Heller S, MacMahon S, Marre M, Poulter N, Travert F, Patel A, Neal B, Woodward M. Association of HbA1c levels with vascular complications and death in patients with type 2 diabetes: evidence of glycaemic thresholds. Diabetologia 2012; 55:636-43. [PMID: 22186981 DOI: 10.1007/s00125-011-2404-1] [Citation(s) in RCA: 211] [Impact Index Per Article: 17.6] [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: 08/11/2011] [Accepted: 11/04/2011] [Indexed: 01/14/2023]
Abstract
AIMS/HYPOTHESIS There is conflicting evidence regarding appropriate glycaemic targets for patients with type 2 diabetes. Here, we investigate the relationship between HbA(1c) and the risks of vascular complications and death in such patients. METHODS Eleven thousand one hundred and forty patients were randomised to intensive or standard glucose control in the Action in Diabetes and Vascular disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. Glycaemic exposure was assessed as the mean of HbA(1c) measurements during follow-up and prior to the first event. Adjusted risks for each HbA(1c) decile were estimated using Cox models. Possible differences in the association between HbA(1c) and risks at different levels of HbA(1c) were explored using linear spline models. RESULTS There was a non-linear relationship between mean HbA(1c) during follow-up and the risks of macrovascular events, microvascular events and death. Within the range of HbA(1c) studied (5.5-10.5%), there was evidence of 'thresholds', such that below HbA(1c) levels of 7.0% for macrovascular events and death, and 6.5% for microvascular events, there was no significant change in risks (all p > 0.8). Above these thresholds, the risks increased significantly: every 1% higher HbA(1c) level was associated with a 38% higher risk of a macrovascular event, a 40% higher risk of a microvascular event and a 38% higher risk of death (all p < 0.0001). CONCLUSIONS/INTERPRETATION In patients with type 2 diabetes, HbA(1c) levels were associated with lower risks of macrovascular events and death down to a threshold of 7.0% and microvascular events down to a threshold of 6.5%. There was no evidence of lower risks below these levels but neither was there clear evidence of harm.
Collapse
Affiliation(s)
- S Zoungas
- The George Institute for Global Health, PO Box M201, Missenden Road, Camperdown, NSW 2050, Sydney, NSW, Australia.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Amar J, Serino M, Lange C, Chabo C, Iacovoni J, Mondot S, Lepage P, Klopp C, Mariette J, Bouchez O, Perez L, Courtney M, Marre M, Klopp P, Lantieri O, Doré J, Charles MA, Balkau B, Burcelin R. Involvement of tissue bacteria in the onset of diabetes in humans: evidence for a concept. Diabetologia 2011; 54:3055-61. [PMID: 21976140 DOI: 10.1007/s00125-011-2329-8] [Citation(s) in RCA: 205] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 09/09/2011] [Indexed: 10/17/2022]
Abstract
AIMS/HYPOTHESIS Evidence suggests that bacterial components in blood could play an early role in events leading to diabetes. To test this hypothesis, we studied the capacity of a broadly specific bacterial marker (16S rDNA) to predict the onset of diabetes and obesity in a general population. METHODS Data from an Epidemiological Study on the Insulin Resistance Syndrome (D.E.S.I.R.) is a longitudinal study with the primary aim of describing the history of the metabolic syndrome. The 16S rDNA concentration was measured in blood at baseline and its relationship with incident diabetes and obesity over 9 years of follow-up was assessed. In addition, in a nested case-control study in which participants later developed diabetes, bacterial phylotypes present in blood were identified by pyrosequencing of the overall 16S rDNA gene content. RESULTS We analysed 3,280 participants without diabetes or obesity at baseline. The 16S rDNA concentration was higher in those destined to have diabetes. No difference was observed regarding obesity. However, the 16S rDNA concentration was higher in those who had abdominal adiposity at the end of follow-up. The adjusted OR (95% CIs) for incident diabetes and for abdominal adiposity were 1.35 (1.11, 1.60), p = 0.002 and 1.18 (1.03, 1.34), p = 0.01, respectively. Moreover, pyrosequencing analyses showed that participants destined to have diabetes and the controls shared a core blood microbiota, mostly composed of the Proteobacteria phylum (85-90%). CONCLUSIONS/INTERPRETATION 16S rDNA was shown to be an independent marker of the risk of diabetes. These findings are evidence for the concept that tissue bacteria are involved in the onset of diabetes in humans.
Collapse
Affiliation(s)
- J Amar
- Inserm U1027, University Paul Sabatier, CHU, Hôpital Rangueil, Avenue Jean Pouhles, Toulouse, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Amar J, Serino M, Lange C, Chabot C, Bouchez O, Mariette J, Perez L, Courntey M, Marre M, Klopp P, Lantieri O, Dore J, Charles MA, Balkau B, Burcelin R. PREDICTIVE VALUE OF BLOOD BACTERIAL DNA ON THE ONSET OF TYPE 2 DIABETES FROM GENERAL POPULATION. J Hypertens 2011. [DOI: 10.1097/00004872-201106001-00288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
30
|
Cheurfa N, Brenner GM, Reis AF, Dubois-Laforgue D, Roussel R, Tichet J, Lantieri O, Balkau B, Fumeron F, Timsit J, Marre M, Velho G. Decreased insulin secretion and increased risk of type 2 diabetes associated with allelic variations of the WFS1 gene: the Data from Epidemiological Study on the Insulin Resistance Syndrome (DESIR) prospective study. Diabetologia 2011; 54:554-62. [PMID: 21127832 DOI: 10.1007/s00125-010-1989-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 10/22/2010] [Indexed: 12/01/2022]
Abstract
AIMS/HYPOTHESIS We investigated associations of allelic variations in the WFS1 gene with insulin secretion and risk of type 2 diabetes in a general population prospective study. METHODS We studied 5,110 unrelated French men and women who participated in the prospective Data from Epidemiological Study on the Insulin Resistance Syndrome (DESIR) study. Additional cross-sectional analyses were performed on 4,472 French individuals with type 2 diabetes and 3,065 controls. Three single nucleotide polymorphisms (SNPs) were genotyped: rs10010131, rs1801213/rs7672995 and rs734312. RESULTS We observed statistically significant associations between the major alleles of the three variants and prevalent type 2 diabetes in the DESIR cohort at baseline. Cox analyses showed an association between the G-allele of rs10010131 and incident type 2 diabetes (HR 1.34, 95% CI 1.08-1.70, p = 0.007). Similar results were observed for the G-allele of rs1801213 and the A-allele of rs734312. The GGA haplotype was associated with an increased risk of diabetes as compared with the ACG haplotype (HR 1.26, 95% CI 1.04-1.42, p = 0.02). We also observed statistically significant associations of the three SNPs with plasma glucose, HbA(1c) levels and insulin secretion at baseline and throughout the study in individuals with type 2 diabetes or at risk of developing diabetes. However, no association was observed in those who remained normoglycaemic at the end of the follow-up. Associations between the three variants and type 2 diabetes were replicated in cross-sectional studies of type 2 diabetic patients in comparison with a non-diabetic control group. CONCLUSIONS/INTERPRETATION The most frequent haplotype at the haplotype block containing the WFS1 gene modulated insulin secretion and was associated with an increased risk of type 2 diabetes.
Collapse
Affiliation(s)
- N Cheurfa
- INSERM, Research Unit 695, 16 rue Henri Huchard, 75018, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Abi Khalil C, Mohammedi K, Aubert R, Travert F, Hadjadj S, Roussel R, Fumeron F, Marre M. Intensifying glycaemic control with insulin reduces adiponectin and its HMW isoform moderately in type 2, but not in type 1, diabetes. Diabetes Metab 2011; 37:259-61. [PMID: 21306933 DOI: 10.1016/j.diabet.2010.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Revised: 12/28/2010] [Accepted: 12/31/2010] [Indexed: 12/12/2022]
Abstract
INTRODUCTION As the impact of diabetes control was not tested on adiponectin (ADPN) levels, this study was designed to assess whether or not controlling hyperglycaemia can affect ADPN. PATIENTS AND METHODS A total of 15 T1D and 48 T2D patients with HbA(1c) greater than 10% were studied at the time of hospitalization for uncontrolled diabetes. Total, and high-, medium- and low-molecular-weight (HMW, MMW, LMW) ADPN were measured at the time of study inclusion, on days 1 and 8, and at 1, 3 and 6 months after insulin treatment. RESULTS While diabetes control improved, total and HMW APDN decreased on days 1 and 8, but remained steady thereafter in T2D patients. In T1D patients, ADPN levels remained unchanged throughout the study. CONCLUSION Glycaemic control with insulin reduces ADPN in T2D patients in the short-term, but was ineffective in T1D.
Collapse
Affiliation(s)
- C Abi Khalil
- Service de Diabétologie, Endocrinologie et Nutrition, Hôpital Bichat, Assistance publique des Hôpitaux de Paris, 46, rue Henri-Huchard, 75877 Paris cedex 18, France
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Alkhalaf A, Bakker SJL, Bilo HJG, Gans ROB, Navis GJ, Postmus D, Forsblom C, Groop PH, Vionnet N, Hadjadj S, Marre M, Parving HH, Rossing P, Tarnow L. A polymorphism in the gene encoding carnosinase (CNDP1) as a predictor of mortality and progression from nephropathy to end-stage renal disease in type 1 diabetes mellitus. Diabetologia 2010; 53:2562-8. [PMID: 20711718 PMCID: PMC2974933 DOI: 10.1007/s00125-010-1863-0] [Citation(s) in RCA: 19] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2010] [Accepted: 07/05/2010] [Indexed: 12/31/2022]
Abstract
AIMS/HYPOTHESIS Homozygosity for a five leucine repeat (5L-5L) in the carnosinase gene (CNDP1) has been found to be cross-sectionally associated with a low frequency of diabetic nephropathy (DN), mainly in type 2 diabetes. We prospectively investigated in patients with type 1 diabetes whether: (1) 5L-5L is associated with mortality; (2) there is an interaction of 5L-5L with DN or sex for prediction of mortality; and (3) 5L-5L is associated with progression to end-stage renal disease (ESRD). METHODS In this prospective study in white European patients with type 1 diabetes, individuals with DN were defined by persistent albuminuria ≥ 300 mg/24 h. Controls without nephropathy were defined by persistent (>15 years) normoalbuminuria < 30 mg/24 h. Leucine repeats were assessed with a fluorescent DNA analysis system. Onset of ESRD was defined by need to start chronic dialysis or kidney transplantation. RESULTS The study involved 916 patients with DN and 1,170 controls. During follow-up for 8.8 years, 107 patients (14%) with 5L-5L died compared with 182 patients (13.8%) with other genotypes (p = 0.99). There was no significant interaction of 5L-5L with DN for prediction of mortality (p = 0.57), but a trend towards interaction with sex (p = 0.08). In patients with DN, HR for ESRD in 5L-5L vs other genotypes was not constant over time, with increased risk for 5L-5L beyond 8 years of follow-up (p = 0.03). CONCLUSIONS/INTERPRETATION CNDP1 polymorphism was not associated with mortality, and nor was there an interaction of this polymorphism with DN for prediction of mortality in patients with type 1 diabetes. CNDP1 polymorphism predicts progression to ESRD in patients with DN, but only late after baseline measurements.
Collapse
Affiliation(s)
- A Alkhalaf
- Department of Internal Medicine, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Lee CC, Stolk RP, Adler AI, Patel A, Chalmers J, Neal B, Poulter N, Harrap S, Woodward M, Marre M, Grobbee DE, Beulens JW. Association between alcohol consumption and diabetic retinopathy and visual acuity-the AdRem Study. Diabet Med 2010; 27:1130-7. [PMID: 20854380 DOI: 10.1111/j.1464-5491.2010.03080.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS We investigated the association between alcohol consumption and diabetic retinopathy and deterioration of visual acuity in individuals with Type 2 diabetes. METHODS We conducted a cohort analysis of 1239 participants with Type 2 diabetes aged 55-81 years enrolled in the AdRem study, a sub-study of the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial. Current and past consumption of wine, spirits and beer was measured by self-report. Moderate and heavy alcohol consumption was defined as 1-14 and >14 drinks/week, respectively. Diabetic retinopathy, measured by mydriatic stereoscopic seven-field retinal photography, was defined by a 2-step progression in the Early Treatment of Diabetic Retinopathy Study (ETDRS) score or the presence of any retinal vascular lesions. Deterioration of visual acuity was defined by a decrease of two lines in best vision in either eye, measured corrected, or through a pinhole using a Snellen chart. RESULTS In a mean follow-up of 5.5 years, we identified 182 participants with a 2-step progression in the ETDRS score, 640 participants with the presence of any retinal vascular lesions and 693 participants with a deterioration of visual acuity. Current moderate consumption of alcohol, compared with no current consumption, was not associated with presence or progression of diabetic retinopathy; however, it was associated with higher risk of deterioration of visual acuity (multivariable-adjusted OR 1.83; 95% CI 1.34-2.48; P<0.001). CONCLUSIONS Alcohol consumption is associated with increased risk of deterioration of visual acuity, but not with retinopathy in individuals with Type 2 diabetes.
Collapse
Affiliation(s)
- C C Lee
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Zoungas S, Chalmers J, Kengne AP, Pillai A, Billot L, de Galan B, Marre M, Neal B, Harrap S, Poulter N, Patel A. The efficacy of lowering glycated haemoglobin with a gliclazide modified release-based intensive glucose lowering regimen in the ADVANCE trial. Diabetes Res Clin Pract 2010; 89:126-33. [PMID: 20541825 DOI: 10.1016/j.diabres.2010.05.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 05/12/2010] [Accepted: 05/17/2010] [Indexed: 12/18/2022]
Abstract
The aim of these analyses was to examine the efficacy of the intensive gliclazide MR-based glucose lowering regimen used in the ADVANCE trial in lowering the level of glycated haemoglobin (HbA1c). All 11,140 randomised patients were included in analyses of treatment efficacy. Treatment efficacy was also examined in subgroups defined by baseline characteristics and treatments. At the end of 5 years follow-up, the mean HbA1c was reduced from 7.5% at baseline to 6.5% in those on intensive glucose control and to 7.3% in those on standard glucose control. With intensive glucose lowering greater proportions achieved HbA1c levels of < or =7.0%, < or =6.5% and < or =6.0%. With intensive glucose lowering substantial reductions in HbA1c were observed across subgroups defined by baseline age, sex, duration of diabetes, BMI, HbA1c or treatment regimen (p<0.0001). The main independent predictors of reduction in HbA1c during follow-up were baseline HbA1c, duration of diabetes and BMI. There was no weight gain in the intensive glucose control group and severe hypoglycaemia was uncommon, though more frequent than in the standard control group. Intensive glucose control with a gliclazide MR-based regimen was well tolerated and consistently effective in lowering HbA1c across a broad range of patient with type 2 diabetes.
Collapse
Affiliation(s)
- S Zoungas
- The George Institute For International Health, University of Sydney, Sydney, Australia; School of Public Health, Monash University, Melbourne, Australia
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Bellili NM, Foucan L, Fumeron F, Mohammedi K, Travert F, Roussel R, Balkau B, Tichet J, Marre M. Associations of the -344 T>C and the 3097 G>A polymorphisms of CYP11B2 gene with hypertension, type 2 diabetes, and metabolic syndrome in a French population. Am J Hypertens 2010; 23:660-7. [PMID: 20224556 DOI: 10.1038/ajh.2010.44] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Aldosterone can affect both blood pressure (BP) and glucose metabolism. We assessed the association of two polymorphisms -344 T>C and the 3097 G>A in the aldosterone synthase gene (CYP11B2) with prevalent and incident hypertension (HT), type 2 diabetes (T2D), and the metabolic syndrome (MetS). METHODS We studied the 5,212 participants to D.E.S.I.R. (Data from Epidemiologic Study on the Insulin Resistance syndrome), a cohort from French general population. Genotyping was done by a TaqMan assay. Analysis of covariance, multivariate logistic regression (adjusted for age, MetS components) and haplotype analysis were performed. RESULTS The prevalences and 9-year incidences were 16.7 and 36.1% for HT, 2.6 and 6.2% for T2D, and 19.3 and 25.1% for the MetS. Risk for incident HT was reduced with the AA genotype of 3097 G>A, adjusted odds ratios (OR): 0.67; p = 0.04. The prevalence of HT was lower in women carrying the C allele of -344 T>C, OR 0.75; p = 0.03 for the TC genotype and 0.69; p = 0.03 for the CC genotype. In men, incident T2D was associated with both polymorphisms, adjusted OR for -344 T>C: 1.63; p = 0.04 for TC genotype and 2.12; p = 0.008 for CC genotype; for the 3097 G>A: the AA genotype was associated with a lower risk, OR 0.23; p = 0.02. In men, incident MetS was associated with 3097 G>A, OR: 0.57; p = 0.02 for AA genotype. Significant associations between haplotype combinations and the prevalence or incidence of the three diseases were also found. CONCLUSION The -344 T>C and 3097 G>A polymorphisms in the CYP11B2 are associated with T2D, hypertension and the MetS in European subjects with gender variations.
Collapse
|
36
|
Kengne AP, Patel A, Colagiuri S, Heller S, Hamet P, Marre M, Pan CY, Zoungas S, Grobbee DE, Neal B, Chalmers J, Woodward M. The Framingham and UK Prospective Diabetes Study (UKPDS) risk equations do not reliably estimate the probability of cardiovascular events in a large ethnically diverse sample of patients with diabetes: the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) Study. Diabetologia 2010; 53:821-31. [PMID: 20157695 DOI: 10.1007/s00125-010-1681-4] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [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: 11/08/2009] [Accepted: 01/14/2010] [Indexed: 02/04/2023]
Abstract
AIMS/HYPOTHESIS Available multivariable equations for cardiovascular risk assessment in people with diabetes have been derived either from the general population or from populations with diabetes. Their utility and comparative performance in a contemporary group of patients with type 2 diabetes are not well established. The aim of this study was to evaluate the performance of the Framingham and UK Prospective Diabetes Study (UKPDS) risk equations in participants who took part in the Action in Diabetes and Vascular disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial. METHODS The 4-year risks of cardiovascular disease (CVD) and its constituents were estimated using two published Framingham and the UKPDS risk equations in 7,502 individuals with type 2 diabetes without prior known CVD at their enrolment in the trial. RESULTS The risk of major CVD was overestimated by 170% (95% CI 146-195%) and 202% (176-231%) using the two Framingham equations. The risk of major coronary heart disease was overestimated by 198% (162-238%) with the UKPDS, and by 146% (117-179%) and 289% (243-341%) with the two different Framingham equations, respectively. The risks of stroke events were also overestimated with the UKPDS and one of the Framingham equations. The ability of these equations to rank risk among ADVANCE participants was modest, with c-statistics ranging from 0.57 to 0.71. Results stratified by sex, treatment allocation and ethnicity were broadly similar. CONCLUSIONS/INTERPRETATION Application of the Framingham and UKPDS risk equations to a contemporary treated group of patients with established type 2 diabetes is likely to substantially overestimate cardiovascular risk.
Collapse
Affiliation(s)
- A P Kengne
- The George Institute for International Health, University of Sydney, PO Box M201, Level 10 KGV Building, RPAH, Missenden Road, Camperdown, Sydney, NSW 2050, Australia.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Marre M, Pinget M, Gin H, Thivolet C, Hanaire H, Robert JJ, Fontaine P. Insulin detemir improves glycaemic control with less hypoglycaemia and no weight gain: 52-week data from the PREDICTIVE study in a cohort of French patients with type 1 or type 2 diabetes. Diabetes Metab 2010; 35:469-75. [PMID: 19914118 DOI: 10.1016/j.diabet.2009.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Revised: 05/29/2009] [Accepted: 06/24/2009] [Indexed: 10/20/2022]
Abstract
AIM PREDICTIVE (an ongoing multinational observational study) provides an opportunity to explore the impact of insulin detemir use in routine clinical practice. Here, we report on long-term (52-week) data from a French cohort of patients (n=1772), comprising 643 with type 1 diabetes and 1129 with type 2 diabetes. METHODS Patients were prescribed insulin detemir at their physician's discretion and assessed at various visits (baseline, 12 weeks, 26 weeks and 52 weeks). The primary endpoint was the frequency of serious adverse drug reactions, including major hypoglycaemia. Secondary endpoints included minor and nocturnal hypoglycaemia, glycaemic control (HbA(1c), fasting blood glucose and variability of fasting blood glucose) and weight change. RESULTS The incidence of serious adverse drug reactions was low throughout the study, seen in 10 patients with type 1 diabetes (14 events, 1.6%) and seven with type 2 diabetes (seven events, 0.6%). In both type 1 and type 2 diabetes cohorts, the overall minor and nocturnal hypoglycaemic events were reduced from baseline (P<0.001), with no clinically significant changes in weight from baseline to endpoint. After 52 weeks of treatment with insulin detemir, glycaemic control improved, with reductions in: HbA(1c), by -0.6% and -0.8% in type 1 and type 2 diabetes patients, respectively; fasting blood glucose, by -1.4mmol/L and -1.9mmol/L respectively; and FBG variability, by -0.8mmol/L and -0.3mmol/L, respectively (P<0.0001 for all). CONCLUSION Patients treated with insulin detemir in a clinical healthcare setting improved their glycaemic control with no increases in hypoglycaemia, adverse events or weight compared with baseline.
Collapse
Affiliation(s)
- M Marre
- Department of Endocrinology, Diabetology and Nutrition, Bichat Claude Bernard Hospital, Paris cedex 18, France.
| | | | | | | | | | | | | |
Collapse
|
38
|
Chabouis A, Berdugo M, Meas T, Erginay A, Laloi-Michelin M, Jouis V, Guillausseau PJ, M’Bemba J, Chaine G, Slama G, Cohen R, Reach G, Marre M, Chanson P, Vicaut E, Massin P. Benefits of Ophdiat®, a telemedical network to screen for diabetic retinopathy: A retrospective study in five reference hospital centres. Diabetes & Metabolism 2009; 35:228-32. [DOI: 10.1016/j.diabet.2008.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Revised: 12/02/2008] [Accepted: 12/04/2008] [Indexed: 10/20/2022]
|
39
|
Marre M, Shaw J, Brändle M, Wan Bebakar WM, Azmi Kamaruddin N, Jorma S, Zdravkovic M, Le Thi T, Colagiuri S. Verglichen mit der Kombination von Rosiglitazon und einem Sulfonylharnstoff (SH) bietet Liraglutid, das bei Typ 2 Diabetes zusätzlich zu einem SH gegeben wird, eine signifikant bessere Blutzuckereinstellung und eine vorteilhafte Gewichtsveränderung. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1221935] [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: 10/20/2022]
|
40
|
Marre M, Shaw J, Brändle M, Bebakar WMW, Kamaruddin NA, Strand J, Zdravkovic M, Le Thi TD, Colagiuri S. Liraglutide, a once-daily human GLP-1 analogue, added to a sulphonylurea over 26 weeks produces greater improvements in glycaemic and weight control compared with adding rosiglitazone or placebo in subjects with Type 2 diabetes (LEAD-1 SU). Diabet Med 2009; 26:268-78. [PMID: 19317822 PMCID: PMC2871176 DOI: 10.1111/j.1464-5491.2009.02666.x] [Citation(s) in RCA: 645] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIM To compare the effects of combining liraglutide (0.6, 1.2 or 1.8 mg/day) or rosiglitazone 4 mg/day (all n >or= 228) or placebo (n = 114) with glimepiride (2-4 mg/day) on glycaemic control, body weight and safety in Type 2 diabetes. METHODS In total, 1041 adults (mean +/- sd), age 56 +/- 10 years, weight 82 +/- 17 kg and glycated haemoglobin (HbA(1c)) 8.4 +/- 1.0% at 116 sites in 21 countries were stratified based on previous oral glucose-lowering mono : combination therapies (30 : 70%) to participate in a five-arm, 26-week, double-dummy, randomized study. RESULTS Liraglutide (1.2 or 1.8 mg) produced greater reductions in HbA(1c) from baseline, (-1.1%, baseline 8.5%) compared with placebo (+0.2%, P < 0.0001, baseline 8.4%) or rosiglitazone (-0.4%, P < 0.0001, baseline 8.4%) when added to glimepiride. Liraglutide 0.6 mg was less effective (-0.6%, baseline 8.4%). Fasting plasma glucose decreased by week 2, with a 1.6 mmol/l decrease from baseline at week 26 with liraglutide 1.2 mg (baseline 9.8 mmol/l) or 1.8 mg (baseline 9.7 mmol/l) compared with a 0.9 mmol/l increase (placebo, P < 0.0001, baseline 9.5 mmol/l) or 1.0 mmol/l decrease (rosiglitazone, P < 0.006, baseline 9.9 mmol/l). Decreases in postprandial plasma glucose from baseline were greater with liraglutide 1.2 or 1.8 mg [-2.5 to -2.7 mmol/l (baseline 12.9 mmol/l for both)] compared with placebo (-0.4 mmol/l, P < 0.0001, baseline 12.7 mmol/l) or rosiglitazone (-1.8 mmol/l, P < 0.05, baseline 13.0 mmol/l). Changes in body weight with liraglutide 1.8 mg (-0.2 kg, baseline 83.0 kg), 1.2 mg (+0.3 kg, baseline 80.0 kg) or placebo (-0.1 kg, baseline 81.9 kg) were less than with rosiglitazone (+2.1 kg, P < 0.0001, baseline 80.6 kg). Main adverse events for all treatments were minor hypoglycaemia (< 10%), nausea (< 11%), vomiting (< 5%) and diarrhoea (< 8%). CONCLUSIONS Liraglutide added to glimepiride was well tolerated and provided improved glycaemic control and favourable weight profile.
Collapse
Affiliation(s)
- M Marre
- Service d'Endocrinologie Diabétologie Nutrition, Groupe Hospitalier Bichat-Claude Bernard, Paris, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Blonde L, Home P, Vespasiani G, Admane K, Marre M. Patterns of cardiovascular risk and disease amongst people with type 2 diabetes starting insulin: baseline characteristics in the CREDIT study. Can J Diabetes 2009. [DOI: 10.1016/s1499-2671(09)33283-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
42
|
Duesing K, Fatemifar G, Charpentier G, Marre M, Tichet J, Hercberg S, Balkau B, Froguel P, Gibson F. Strong association of common variants in the CDKN2A/CDKN2B region with type 2 diabetes in French Europids. Diabetologia 2008; 51:821-6. [PMID: 18368387 DOI: 10.1007/s00125-008-0973-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Accepted: 02/11/2008] [Indexed: 10/22/2022]
Abstract
AIMS/HYPOTHESIS Genome-wide association studies (GWASs) recently identified common variants in the CDKN2A/CDKN2B region on chromosome 9p as being strongly associated with type 2 diabetes. Since these association signals were not picked up by the French-Canadian GWAS, we sought to replicate these findings in the French Europid population and to further characterise the susceptibility variants at this novel locus. METHODS We genotyped 20 single nucleotide polymorphisms (SNPs) spanning the CDKN2A/CDKN2B locus in our type 2 diabetes case-control cohort. The association between CDKN2A/CDKN2B SNPs and quantitative metabolic traits was also examined in the normoglycaemic participants comprising the control cohort. RESULTS We report replication of the strong association of rs10811661 with type 2 diabetes found in the GWASs (P= 3.8 X 10(-7); OR 1.43 [95% CI 1.24-1.64]). The other CDKN2A/CDKN2B susceptibility variant, rs564398, did not attain statistical significance (p = 0.053; OR 1.11 [95% CI 1.00-1.24]) in the present study. We also obtained several additional nominal association signals (p < 0.05) at the CDKN2A/CDKN2B locus; however, only the rs3218018 result (p = 0.002) survived Bonferroni correction for multiple testing (adjusted p = 0.04). CONCLUSIONS/INTERPRETATION Our comprehensive association study of common variation spanning the CDKN2A/CDKN2B locus confirms the strong association between the distal susceptibility variant rs10811661 and type 2 diabetes in the French population. Further genetic and functional studies are required to identify the aetiological variants at this locus and determine the cellular and physiological mechanisms by which they act to modulate type 2 diabetes susceptibility.
Collapse
Affiliation(s)
- K Duesing
- Genomic Medicine, Imperial College London, Hammersmith Campus, Du Cane Rd, London, W12 0NN, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Duesing K, Charpentier G, Marre M, Tichet J, Hercberg S, Froguel P, Gibson F. Evaluating the association of common LMNA variants with type 2 diabetes and quantitative metabolic phenotypes in French Europids. Diabetologia 2008; 51:76-81. [PMID: 17994215 DOI: 10.1007/s00125-007-0857-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Accepted: 09/27/2007] [Indexed: 11/25/2022]
Abstract
AIMS/HYPOTHESIS In the present study, we sought to examine the evidence that LMNA variants are associated with type 2 diabetes and quantitative metabolic traits in French Europid individuals. METHODS We genotyped 24 single nucleotide polymorphisms (SNPs) spanning the LMNA gene in 3,093 case-control participants. The association between LMNA SNPs and quantitative metabolic traits was also examined in the 1,674 normoglycaemic adults who made up the control cohort. RESULTS SNP rs505058, a synonymous SNP (D446D) in exon 7, showed nominal evidence of association with type 2 diabetes [p = 0.003, odds ratio (OR) 1.30 (95% CI 1.09-1.56)] in French Europids. A meta-analysis of available rs505058 genotype data from 7,819 participants provided support for a modest association of rs505058 with type 2 diabetes [p = 0.003, OR 1.19 (95% CI 1.06-1.35)]. We found no evidence (p = 0.91) that the tag SNP rs4641 is associated with type 2 diabetes. However, a meta-analysis of all available rs4641 genotype data in a total of 15,591 participants produced borderline evidence of association [p = 0.054, OR 1.05 (95% CI 1.00-1.11)]. SNP rs6669212, in the 3' untranslated region of LMNA, exhibited suggestive associations with WHR (p = 0.013), fasting serum levels of total cholesterol (p = 0.023) and triacylglycerol (p = 0.015). We emphasise that these quantitative trait associations are not corrected for multiple testing. CONCLUSIONS/INTERPRETATION The available data do not support a major effect of common LMNA variation on type 2 diabetes susceptibility in northern Europeans. Further large-scale studies are required to conclusively establish the extent to which LMNA variants have an impact on quantitative metabolic traits.
Collapse
Affiliation(s)
- K Duesing
- Genomic Medicine, Imperial College, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | | | | | | | | | | | | |
Collapse
|
44
|
Gutierrez-Aguilar R, Benmezroua Y, Balkau B, Marre M, Helbecque N, Charpentier G, Polychronakos C, Sladek R, Froguel P, Neve B. Minor contribution of SMAD7 and KLF10 variants to genetic susceptibility of type 2 diabetes. Diabetes Metab 2007; 33:372-8. [PMID: 17931948 DOI: 10.1016/j.diabet.2007.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Revised: 06/22/2007] [Accepted: 06/27/2007] [Indexed: 01/15/2023]
Abstract
BACKGROUND Transgenic mice over-expressing SMAD7 in pancreatic beta-cells develop type 2 diabetes (T2D). The expression of SMAD7 is affected by KLF11, which contains gene variants that have previously been shown to be involved in genetic susceptibility to T2D, and by the highly homologous KLF10. This study aims to assess the genetic contribution of SMAD7 and KLF10 gene variants to T2D susceptibility in the French population. METHODS We screened both genes to identify rare and frequent variants by direct sequencing and then genotyped these variants. Six frequent variants of SMAD7 and six of KLF10 were analyzed in 349 T2D patients and 349 normoglycaemic adult subjects. Variants with statistically significant differences in allele and/or genotype distribution were further analyzed in a population sample of 1.712 T2D patients and 1.072 normoglycaemic subjects. RESULTS Two variants showed a significant association under a recessive model: The intronic SMAD7 IVS2 -21 had an odds ratio of 0.62 (P=0.007, 95% CI=0.44-0.88; P=0.034 when adjusting for age, sex and BMI by logistic regression), and the KLF10 3'UTR +1002 variant had an Odds Ratio of 0.81 (P=0.009, 95% CI=0.69-0.95; P=0.042 when adjusting for age, sex and BMI). CONCLUSION Although the observed association of SMAD7 and KLF10 gene variants with T2D is modest, they may weakly contribute to a particular genetic background that increases the susceptibility to development of T2D.
Collapse
Affiliation(s)
- R Gutierrez-Aguilar
- CNRS, UMR8090, Institute of Biologie, Institut Pasteur de Lille and Université de Lille 2, Lille, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Meyre D, Bouatia-Naji N, Vatin V, Veslot J, Samson C, Tichet J, Marre M, Balkau B, Froguel P. ENPP1 K121Q polymorphism and obesity, hyperglycaemia and type 2 diabetes in the prospective DESIR Study. Diabetologia 2007; 50:2090-6. [PMID: 17704904 DOI: 10.1007/s00125-007-0787-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2007] [Accepted: 06/29/2007] [Indexed: 01/22/2023]
Abstract
AIMS/HYPOTHESIS We assessed the predictive value of ectonucleotide pyrophosphatase/phosphodiesterase 1 gene (ENPP1) SNPs with regard to the risk of developing obesity and/or type 2 diabetes in a large French general population. METHODS We genotyped the ENPP1 SNPs K121Q (rs1044498), IVS20delT-11 (rs1799774) and A/G+1044TGA (rs7754561) in 5,153 middle-aged participants of the Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort. RESULTS At baseline, the K121Q polymorphism was not associated either with BMI (p = 0.98) or with class I obesity (odds ratio [OR] 0.99, p = 0.81), but showed a borderline association with class II obesity (OR 1.65, p = 0.02). The K121Q variant was not associated with any trait during the 9-year follow-up. Pooled analyses both at baseline and at follow-up failed to show any association with hyperglycaemia (OR 1.08, p = 0.28) or type 2 diabetes (OR 1.15, p = 0.38). However, we did show an association of the Q121 allele with the risk of hyperglycaemia (OR 1.45, p = 0.001; n = 265) and type 2 diabetes (OR 1.65, p = 0.01; n = 103) in participants reporting a family history of type 2 diabetes. These results did not remain significant after a Bonferroni correction. The IVS20delT-11 and A/G+1044TGA polymorphisms and the three-allele risk haplotype (K121Q, IVS20delT-11 and A-->G+1044TGA [QdelTG]) were not associated with any trait, either at baseline or at follow-up. CONCLUSIONS/INTERPRETATION In a general French population we did not find an association of the QdelTG risk haplotype with adult obesity and type 2 diabetes. We detected nominal evidence of association between the K121Q polymorphism and both severe adult obesity at baseline and the risk of hyperglycaemia or type 2 diabetes in participants with a family history of type 2 diabetes in pooled analyses both at baseline and follow-up.
Collapse
Affiliation(s)
- D Meyre
- CNRS 8090-Institute of Biology, Pasteur Institute, Lille, France
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Patel A, MacMahon S, Chalmers J, Neal B, Woodward M, Billot L, Harrap S, Poulter N, Marre M, Cooper M, Glasziou P, Grobbee DE, Hamet P, Heller S, Liu LS, Mancia G, Mogensen CE, Pan CY, Rodgers A, Williams B. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 2007; 370:829-40. [PMID: 17765963 DOI: 10.1016/s0140-6736(07)61303-8] [Citation(s) in RCA: 1380] [Impact Index Per Article: 81.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Blood pressure is an important determinant of the risks of macrovascular and microvascular complications of type 2 diabetes, and guidelines recommend intensive lowering of blood pressure for diabetic patients with hypertension. We assessed the effects of the routine administration of an angiotensin converting enzyme (ACE) inhibitor-diuretic combination on serious vascular events in patients with diabetes, irrespective of initial blood pressure levels or the use of other blood pressure lowering drugs. METHODS The trial was done by 215 collaborating centres in 20 countries. After a 6-week active run-in period, 11 140 patients with type 2 diabetes were randomised to treatment with a fixed combination of perindopril and indapamide or matching placebo, in addition to current therapy. The primary endpoints were composites of major macrovascular and microvascular events, defined as death from cardiovascular disease, non-fatal stroke or non-fatal myocardial infarction, and new or worsening renal or diabetic eye disease, and analysis was by intention-to-treat. The macrovascular and microvascular composites were analysed jointly and separately. This trial is registered with ClinicalTrials.gov, number NCT00145925. FINDINGS After a mean of 4.3 years of follow-up, 73% of those assigned active treatment and 74% of those assigned control remained on randomised treatment. Compared with patients assigned placebo, those assigned active therapy had a mean reduction in systolic blood pressure of 5.6 mm Hg and diastolic blood pressure of 2.2 mm Hg. The relative risk of a major macrovascular or microvascular event was reduced by 9% (861 [15.5%] active vs 938 [16.8%] placebo; hazard ratio 0.91, 95% CI 0.83-1.00, p=0.04). The separate reductions in macrovascular and microvascular events were similar but were not independently significant (macrovascular 0.92; 0.81-1.04, p=0.16; microvascular 0.91; 0.80-1.04, p=0.16). The relative risk of death from cardiovascular disease was reduced by 18% (211 [3.8%] active vs 257 [4.6%] placebo; 0.82, 0.68-0.98, p=0.03) and death from any cause was reduced by 14% (408 [7.3%] active vs 471 [8.5%] placebo; 0.86, 0.75-0.98, p=0.03). There was no evidence that the effects of the study treatment differed by initial blood pressure level or concomitant use of other treatments at baseline. INTERPRETATION Routine administration of a fixed combination of perindopril and indapamide to patients with type 2 diabetes was well tolerated and reduced the risks of major vascular events, including death. Although the confidence limits were wide, the results suggest that over 5 years, one death due to any cause would be averted among every 79 patients assigned active therapy.
Collapse
Affiliation(s)
- Anushka Patel
- Cardiovascular Division, The George Institute for International Health, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Bonnet F, Marre M, Halimi JM, Stengel B, Lange C, Laville M, Tichet J, Balkau B. [Larger waist circumference is a predictive factor for the occurrence of microalbuminuria in a non-diabetic population]. Arch Mal Coeur Vaiss 2006; 99:660-2. [PMID: 17061439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Obesity and insulin resistance are directly associated with the presence of microalbuminuria. However, the prospective relationship between abdominal adiposity and the occurrence of micro-albuminuria has been little studied in a non-diabetic population. From the DESIR cohort, we examined whether waist circumference was associated with the incidence of micro-albuminuria at 6 years (D6). The study evaluated 2738 non-diabetic subjects without micro-albuminuria at inclusion who were then followed prospectively. At 6 years, 254 individuals (9.3%) had developed pathological micro-albuminuria (> or =20 mg/l) measured at micturation. In both sexes, the incidence of micro-albuminuria was associated with increased waist circumference and blood pressure, but not with blood glucose levels, lipid parameters or body mass index. Subjects with a higher waist circumference at inclusion were at a higher risk of having micro-albuminuria at 6 years compared to those with a normal waist circumference. Logical regression analysis showed that waist circumference as a continuous value, or greater than 94 cm for males and 88 cm for females, were predictive factors for the incidence of micro-albuminuria, after adjustment for age, hypertension, ACE inhibitor usage, fibrinogen, and blood glucose level. Abdominal adiposity is thus linked in both sexes to the development of microalbuminuria, which underlines the importance of measuring waist circumference when assessing risk factors for renal lesions in non-diabetic hypertensives.
Collapse
Affiliation(s)
- F Bonnet
- Service d'endocrinologie-diabétologie, hôpital Edouard-Herriot, INSERM U449, Lyon.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Hadjadj S, Aubert R, Fumeron F, Pean F, Tichet J, Roussel R, Marre M. Increased plasma adiponectin concentrations are associated with microangiopathy in type 1 diabetic subjects. Diabetologia 2005; 48:1088-92. [PMID: 15875155 DOI: 10.1007/s00125-005-1747-x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Accepted: 01/27/2005] [Indexed: 11/29/2022]
Abstract
AIMS/HYPOTHESIS Insulin resistance is related to an increased risk of diabetic retinopathy and nephropathy in type 1 diabetes. Patients with insulin resistance and/or macrovascular disease have abnormally low levels of adiponectin. The aim of this study was to investigate the relationships between adiponectin and renal and retinal diabetic complications in type 1 diabetic patients. METHODS In this 6-year prospective follow-up observational study, we evaluated the severity of retinopathy at baseline and determined the incident risk of microalbuminuria in 126 normoalbuminuric patients with type 1 diabetes. Each patient was age- and sex-matched to two non-diabetic control subjects. RESULTS Plasma adiponectin concentrations were significantly higher in diabetic subjects than in control subjects (p < 0.0001). The adiponectin concentration was significantly higher in patients with severe diabetic retinopathy than in those without (39.1+/-14.0 vs 29.0+/-13.0 microg/ml, p = 0.0005). The 18 patients who developed persistent microalbuminuria had higher adiponectin concentrations than the other patients (35.8+/-14.5 vs 30.6+/-13.7 microg/ml). Increased adiponectin concentrations were independently associated with the occurrence of microalbuminuria (p = 0.0158) after adjustment for baseline urinary albumin concentration (p = 0.004), sex (p = 0.0054), blood pressure (NS) and metabolic control (NS). CONCLUSIONS/INTERPRETATION The elevated adiponectin concentrations observed in subjects with microvascular disease may indicate an altered regulation of this adipocytokine in patients with complications associated with type 1 diabetes.
Collapse
Affiliation(s)
- S Hadjadj
- Department of Endocrinology and Diabetology, University Hospital, BP 577, 86021, Poitiers Cedex, France.
| | | | | | | | | | | | | |
Collapse
|
49
|
Massin P, Aubert JP, Eschwege E, Erginay A, Bourovitch JC, BenMehidi A, Nougarède M, Bouée S, Fagnani F, Tcherny MS, Jamet M, Bouhassira M, Marre M. Evaluation of a screening program for diabetic retinopathy in a primary care setting Dodia (Dépistage ophtalmologique du diabète) study. Diabetes & Metabolism 2005; 31:153-62. [PMID: 15959421 DOI: 10.1016/s1262-3636(07)70181-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this observational study was to evaluate the screening for diabetic retinopathy (DR) using eye fundus photography taken by a nonmydriatic camera and transmitted trough the Internet to an ophthalmological reading centre, as compared to a dilated eye examination performed by an ophthalmologist. METHODS A total of 456 and 426 diabetic patients were included by two different groups of primary care physicians (PCPs), 358 being screened with the non-mydriatic camera (experimental group) and 320 with dilated eye fundus exam (control group). RESULTS The proportion of screened patients for whom PCPs received a screening report within the 6-month follow-up period was 74,1% for the experimental group and 71,5% for the control group. Screening for DR was negative in 77,6% of patients with eye fundus photographs vs 89,6% with dilated eye examination. DR was diagnosed in 62 patients (17,3%) with eye fundus photographs versus 31 with dilated eye examination (10,4%). Referral to an ophthalmologist was required in 59 reports of patients with photographs (16.5%), 23 of them due to high grade DR. Finally, the non-mydriatic camera was found of little inconvenience by patients. CONCLUSION The telemedical approach to DR screening proved to be effective in providing primary care practitioners with information about their patient's eye status. This screening method allowed to identify patients requiring prompt referral to the ophthalmologist for further complete eye examination. In conclusion, this study provided successful results of DR screening using fundus photography in primary care patients, and strongly supports the need to further extend this screening program in a larger number of French sites.
Collapse
Affiliation(s)
- P Massin
- Ophthalmology Department, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris Cedex 10, France.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Manic H, Marechaud R, Leroux S, Petit Paris I, Mauco G, Boissonnot M, Bauduceau B, Guerci B, Hadjadj S, Marre M. 263 Variants génétiques du transporteur de glucose GLUT 1 et sévérité de la rétinopathie chez le sujet diabétique de type 2. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74661-1] [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: 11/16/2022]
|