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Duvillard L, Pais de Barros JP, Rouland A, Simoneau I, Denimal D, Bouillet B, Petit JM, Vergès B. No effect of liraglutide on high density lipoprotein apolipoprotein AI kinetics in patients with type 2 diabetes. Diabetes Metab 2024; 50:101535. [PMID: 38653365 DOI: 10.1016/j.diabet.2024.101535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/26/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024]
Abstract
AIM The catabolism of high density lipoprotein (HDL) apolipoprotein AI (apoAI) is accelerated in patients with type 2 diabetes (T2D), related to hypertriglyceridemia, insulin resistance and low plasma adiponectin levels. Since liraglutide is likely to partly correct these abnormalities, we hypothesized that it might have a beneficial effect on HDL apoAI kinetics in patients with T2D. METHODS An in vivo kinetic study of HDL apoAI was performed in 10 patients with T2D before and after 6 months of treatment with 1.2 mg/day of liraglutide, using a bolus of l-[1-13C]leucine followed by a 16-hour constant infusion. RESULTS Liraglutide reduced BMI (34.9 ± 4.7 vs 36.6 ± 4.9 kg/m2, P = 0.012), HbA1c (7.1 ± 1.1 vs 9.6 ± 2.6%, P = 0.003), HOMA-IR (5.5 ± 1.9 vs 11.6 ± 11.2, P = 0.003), fasting triglycerides (1.76 ± 0.37 vs 2.48 ± 0.69 mmol/l, P < 0.001) and triglycerides during kinetics (2.34 ± 0.81 vs 2.66 ± 0.65 mmol/l, P = 0.053). Plasma HDL cholesterol and adiponectin concentrations were unchanged (respectively 0.97 ± 0.26 vs 0.97 ± 0.19 mmol/l, P = 1; 3169 ± 1561 vs 2618 ± 1651 µg/l, P = 0.160), similar to triglyceride content in HDL (5.13 ± 1.73 vs 5.39 ± 1.07%, P = 0.386). Liraglutide modified neither HDL apoAI fractional catabolic rate (0.35 ± 0.11 vs 0.38 ± 0.11 pool/day, P = 0.375), nor its production rate (0.44 ± 0.13 vs 0.49 ± 0.15 g/l/day, P = 0.375), nor its plasma concentration (1.26 ± 0.19 vs 1.29 ± 0.14 g/l, P = 0.386). CONCLUSION Six months of treatment with 1.2 mg/day of liraglutide had no effect on the kinetics of HDL apoAI in patients with T2D. The lack of decrease in triglyceride content in HDL related to an only moderate decrease in triglyceridemia, probably greatly explains these results. Insufficient improvement of insulin sensitivity and adiponectinemia may also be implied.
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Affiliation(s)
- Laurence Duvillard
- University of Burgundy-INSERM LNC UMR1231, Dijon, France; Department of Biochemistry, Dijon Bourgogne University Hospital, Dijon, France.
| | - Jean-Paul Pais de Barros
- University of Burgundy-INSERM LNC UMR1231, Dijon, France; Lipidomic Analytical Platform, University of Burgundy, Dijon, France
| | - Alexia Rouland
- University of Burgundy-INSERM LNC UMR1231, Dijon, France; Department of Endocrinology and Metabolic Diseases, Dijon Bourgogne University Hospital, Dijon, France
| | - Isabelle Simoneau
- Department of Endocrinology and Metabolic Diseases, Dijon Bourgogne University Hospital, Dijon, France
| | - Damien Denimal
- University of Burgundy-INSERM LNC UMR1231, Dijon, France; Department of Biochemistry, Dijon Bourgogne University Hospital, Dijon, France
| | - Benjamin Bouillet
- University of Burgundy-INSERM LNC UMR1231, Dijon, France; Department of Endocrinology and Metabolic Diseases, Dijon Bourgogne University Hospital, Dijon, France
| | - Jean-Michel Petit
- University of Burgundy-INSERM LNC UMR1231, Dijon, France; Department of Endocrinology and Metabolic Diseases, Dijon Bourgogne University Hospital, Dijon, France
| | - Bruno Vergès
- University of Burgundy-INSERM LNC UMR1231, Dijon, France; Department of Endocrinology and Metabolic Diseases, Dijon Bourgogne University Hospital, Dijon, France
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Denimal D, Béland-Bonenfant S, Pais-de-Barros JP, Rouland A, Bouillet B, Duvillard L, Vergès B, Petit JM. Plasma ceramides are associated with MRI-based liver fat content but not with noninvasive scores of liver fibrosis in patients with type 2 diabetes. Cardiovasc Diabetol 2023; 22:310. [PMID: 37940926 PMCID: PMC10634084 DOI: 10.1186/s12933-023-02049-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND There is growing evidence that ceramides play a significant role in the onset and progression of non-alcoholic fatty liver disease (NAFLD), a highly prevalent condition in patients with type 2 diabetes associated with hepatic and cardiovascular events. However, the relationship between plasma ceramide levels and NAFLD severity in type 2 diabetes remains unclear. The main purpose of the present study was to investigate whether circulating levels of ceramides in patients with type 2 diabetes are associated with liver steatosis assessed by the highly accurate magnetic resonance imaging proton density fat fraction (MRI-PDFF). The secondary objective was to assess the relationship between plasma ceramides and noninvasive scores of liver fibrosis. METHODS In this cross-sectional single-center study, plasma concentrations of 7 ceramides were measured by liquid chromatography-mass spectrometry in 255 patients with type 2 diabetes (GEPSAD cohort). Liver fat content was assessed by MRI-PDFF, and noninvasive scores of liver fibrosis (i.e. Fibrosis-4 index, NAFLD Fibrosis Score, FibroTest® and Fibrotic NASH Index) were calculated. A validation cohort of 80 patients with type 2 diabetes was also studied (LIRA-NAFLD cohort). RESULTS Liver steatosis, defined as a liver fat content > 5.56%, was found in 62.4 and 82.5% of individuals with type 2 diabetes in the GEPSAD and LIRA-NAFLD cohorts, respectively. In GEPSAD, MRI-PDFF-measured liver fat content was positively associated with plasma levels of total ceramides (r = 0.232, p = 0.0002), and 18:0, 20:0, 22:0 and 24:0 ceramides in univariate analysis (p ≤ 0.0003 for all). In multivariate analysis, liver fat content remained significantly associated with total ceramides (p = 0.001), 18:0 (p = 0.006), 22:0 (p = 0.0009) and 24:0 ceramides (p = 0.0001) in GEPSAD, independently of age, diabetes duration, body mass index and dyslipidemia. Overall, similar relationship between plasma ceramides and liver fat content was observed in the LIRA-NAFLD validation cohort. No significant association was found between plasma ceramides and noninvasive scores of fibrosis after adjustment for age in both cohorts. CONCLUSIONS Plasma ceramide levels are associated with liver steatosis in patients with type 2 diabetes, independently of traditional risk factors for NAFLD. The independent association between plasma ceramides and liver steatosis adds new insights regarding the relationship between ceramides and NAFLD in type 2 diabetes.
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Affiliation(s)
- Damien Denimal
- University of Burgundy, INSERM LNC UMR1231, Dijon, F-21000, France.
- Department of Biochemistry, CHU Dijon Bourgogne, Dijon, F-21079, France.
| | - Sarah Béland-Bonenfant
- University of Burgundy, INSERM LNC UMR1231, Dijon, F-21000, France
- Department of Endocrinology and Diabetology, CHU Dijon Bourgogne, Dijon, F-21000, France
| | | | - Alexia Rouland
- University of Burgundy, INSERM LNC UMR1231, Dijon, F-21000, France
- Department of Endocrinology and Diabetology, CHU Dijon Bourgogne, Dijon, F-21000, France
| | - Benjamin Bouillet
- University of Burgundy, INSERM LNC UMR1231, Dijon, F-21000, France
- Department of Endocrinology and Diabetology, CHU Dijon Bourgogne, Dijon, F-21000, France
| | - Laurence Duvillard
- University of Burgundy, INSERM LNC UMR1231, Dijon, F-21000, France
- Department of Biochemistry, CHU Dijon Bourgogne, Dijon, F-21079, France
| | - Bruno Vergès
- University of Burgundy, INSERM LNC UMR1231, Dijon, F-21000, France
- Department of Endocrinology and Diabetology, CHU Dijon Bourgogne, Dijon, F-21000, France
| | - Jean-Michel Petit
- University of Burgundy, INSERM LNC UMR1231, Dijon, F-21000, France
- Department of Endocrinology and Diabetology, CHU Dijon Bourgogne, Dijon, F-21000, France
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Tarris G, Rouland A, Guillen K, Loffroy R, Lariotte AC, Rat P, Bouillet B, Andrianiaina H, Petit JM, Martin L. Case Report: Giant insulinoma, a very rare tumor causing hypoglycemia. Front Endocrinol (Lausanne) 2023; 14:1125772. [PMID: 37234805 PMCID: PMC10206132 DOI: 10.3389/fendo.2023.1125772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/17/2023] [Indexed: 05/28/2023] Open
Abstract
Insulinomas, with an incidence of 4 cases per million individuals per year, remain amongst the most frequent functional neuroendocrine tumors. The usual diameter of insulinomas usually remains under 3 cm of major axis. However, 44 exceptional cases of "giant insulinomas", have been reported worldwide, generally exceeding 9 cm in major axis. In this article, we report the case of a 38-year-old woman whom suffered from chronic hypoglycemia despite treatment with diazoxide. Abdominal CT-scan revealed a 88 x 73 mm mass located at the tail of the pancreas. Following surgical excision, histopathological analysis confirmed G1 neuroendocrine tumor, with focal cytoplasmic expression of insulin in tumor cells. After a 16-month follow-up period, the patient didn't address any specific complaint, and no disease recurrence and/or metastasis were observed. A 68Ga-DOTATATE-PET scan was performed 6 months after surgery, which came back normal. Genetic evaluation has not been performed in our patient. The physiopathology of giant insulinomas remain unexplained, however with possible relationship with type 1 multiple endocrine neoplasia, sporadic somatic YY1 mutations and possible transformation of bulky non-functional pancreatic neuroendocrine tumors to a functional phenotype, with slow insulin secretion. While giant insulinomas remain rare in the literature, multicentric genetic analysis of tumor samples might reveal unique features of this rare subtype of neuroendocrine pancreatic tumors. Insulinomas of large size tend to have greater malignancy and higher rates of invasiveness. Careful follow-up, especially for liver and lymph node metastases, must be performed using functional imaging techniques to avoid disease relapse.
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Affiliation(s)
- Georges Tarris
- Department of Pathology, University Hospital of Dijon, Dijon, France
| | - Alexia Rouland
- Department of Endocrinology and Diabetology, University Hospital of Dijon, Dijon, France
| | - Kévin Guillen
- Department of Radiology, University Hospital of Dijon, Dijon, France
| | - Romaric Loffroy
- Department of Radiology, University Hospital of Dijon, Dijon, France
| | | | - Patrick Rat
- Department of Digestive and Bariatric Surgery, University Hospital of Dijon, Dijon, France
| | - Benjamin Bouillet
- Department of Endocrinology and Diabetology, University Hospital of Dijon, Dijon, France
| | | | - Jean-Michel Petit
- Department of Endocrinology and Diabetology, University Hospital of Dijon, Dijon, France
| | - Laurent Martin
- Department of Pathology, University Hospital of Dijon, Dijon, France
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Denimal D, Bergas V, Pais-de-Barros JP, Simoneau I, Demizieux L, Passilly-Degrace P, Bouillet B, Petit JM, Rouland A, Bataille A, Duvillard L, Vergès B. Liraglutide reduces plasma dihydroceramide levels in patients with type 2 diabetes. Cardiovasc Diabetol 2023; 22:104. [PMID: 37143040 PMCID: PMC10158384 DOI: 10.1186/s12933-023-01845-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/29/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Emerging evidence supports that dihydroceramides (DhCer) and ceramides (Cer) contribute to the pathophysiology of insulin resistance and liver steatosis, and that their circulating concentrations are independently associated with cardiovascular outcomes. Circulating DhCer levels are increased in patients with type 2 diabetes (T2D). On the other hand, the GLP-1 receptor agonist liraglutide reduces major adverse cardiac events, insulin resistance and liver steatosis in T2D patients. The main purpose of the present study was therefore to investigate whether liraglutide decreases circulating levels of DhCer and Cer in T2D patients, which could be a mechanism involved in its cardiometabolic benefits. The secondary purpose was to assess the relationship between liraglutide-induced changes in DhCer/Cer levels and insulin resistance and liver steatosis. METHODS Plasma concentrations of 11 DhCer and 15 Cer species were measured by a highly-sensitive mass spectrometry system in 35 controls and 86 T2D patients before and after 6 months of liraglutide (1.2 mg/day). Insulin resistance was estimated by the triglyceride-glucose (TyG) index. Liver fat content (LFC) was assessed in 53 patients by proton magnetic resonance spectroscopy. RESULTS Plasma levels of total DhCer, 7 DhCer and 7 Cer species were increased in T2D patients compared to controls. Liraglutide decreased total DhCer by 15.1% (p = 0.005), affecting 16:0 (p = 0.037), 18:0 (p < 0.0001), 18:1 (p = 0.0005), 20:0 (p = 0.0003), 23:0 (p = 0.005) and 24:1 (p = 0.04) species. Total plasma Cer did not significantly change after liraglutide (p = 0.18), but 5 Cer species decreased significantly, i.e. 18:0 and 18:1 (both p < 0.0001), 19:0 and 24:1 (both p < 0.01) and 26:1 (p = 0.04). In multivariate analysis, the reduction in DhCer after liraglutide was independently associated with the reduction in LFC (p = 0.0005) and in TyG index (p = 0.05). CONCLUSIONS Liraglutide reduces plasma levels of numerous DhCer and Cer species in T2D patients, which may contribute to the cardiovascular benefit observed in the LEADER trial. The independent association between the decrease in plasma DhCer level with the reduction in LFC and TyG index adds new insights regarding the relationship between DhCer, liver steatosis and insulin resistance. Trial registration ClinicalTrials.gov identifier: NCT02721888.
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Affiliation(s)
- Damien Denimal
- University of Burgundy, INSERM LNC UMR1231, 21000, Dijon, France.
- Department of Biochemistry, CHU Dijon Bourgogne, 21079, Dijon, France.
| | - Victoria Bergas
- University of Burgundy, INSERM LNC UMR1231, 21000, Dijon, France
- Lipidomic Analytical Platform, University of Burgundy, 21000, Dijon, France
| | - Jean-Paul Pais-de-Barros
- University of Burgundy, INSERM LNC UMR1231, 21000, Dijon, France
- Lipidomic Analytical Platform, University of Burgundy, 21000, Dijon, France
| | - Isabelle Simoneau
- University of Burgundy, INSERM LNC UMR1231, 21000, Dijon, France
- Department of Endocrinology and Diabetology, CHU Dijon Bourgogne, 21000, Dijon, France
| | | | | | - Benjamin Bouillet
- University of Burgundy, INSERM LNC UMR1231, 21000, Dijon, France
- Department of Endocrinology and Diabetology, CHU Dijon Bourgogne, 21000, Dijon, France
| | - Jean-Michel Petit
- University of Burgundy, INSERM LNC UMR1231, 21000, Dijon, France
- Department of Endocrinology and Diabetology, CHU Dijon Bourgogne, 21000, Dijon, France
| | - Alexia Rouland
- University of Burgundy, INSERM LNC UMR1231, 21000, Dijon, France
- Department of Endocrinology and Diabetology, CHU Dijon Bourgogne, 21000, Dijon, France
| | | | - Laurence Duvillard
- University of Burgundy, INSERM LNC UMR1231, 21000, Dijon, France
- Department of Biochemistry, CHU Dijon Bourgogne, 21079, Dijon, France
| | - Bruno Vergès
- University of Burgundy, INSERM LNC UMR1231, 21000, Dijon, France
- Department of Endocrinology and Diabetology, CHU Dijon Bourgogne, 21000, Dijon, France
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Legris P, Bouillet B, Pâris J, Pistre P, Devaux M, Bost S, Simoneau I, Manfredi S, Drouillard A, Bastie JN, Chaix M, Massoud P, Rouland A, Aho S, Boulin M, Petit JM. Glycemic control in people with diabetes treated with cancer chemotherapy: contribution of continuous glucose monitoring. Acta Diabetol 2023; 60:545-552. [PMID: 36637528 DOI: 10.1007/s00592-023-02032-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/05/2023] [Indexed: 01/14/2023]
Abstract
AIMS The aim of our study was to assess, with Continuous Glucose Monitoring (CGM), exhaustive information on the glucose profile in people with diabetes starting chemotherapy. We also evaluated the adaptation of glucose-lowering drugs following analysis of CGM recordings. METHODS Eighty-five people with diabetes starting chemotherapy were included in the ONCODIAB study. A CGM was worn for up to fourteen days in blinded mode before and after the diabetologist's intervention to evaluate the impact of modifying the glucose-lowering drugs. RESULTS Time spent in range was 67.2 ± 24.2%. Time below the target glucose range (TBR) (< 70 mg/dl) was 8.9% in all the study population. TBR was significantly higher in patients treated with at least one drug due to the risk of hypoglycemia compared to the others (11.5% vs. 4.4%, p = 0.009). Sixty-five patients had available sensor data for the two recordings. Forty-one patients (51.9%) saw a decrease in their antidiabetic treatment after the diabetologist's intervention guided by the first CGM recording. We observed a significant reduction in the time spent below the target glucose range (70-55 mg/dl) between the two CGM recordings (10.3 ± 14.6% vs. 6.3 ± 9.4%, p = 0.016 and 3.8 ± 8.4% vs. 1.2 ± 2.9%, p = 0.012, respectively). CONCLUSIONS CGM use in blinded mode could be an interesting tool to reduce the risk of hypoglycemia in people with diabetes starting chemotherapy. Our findings fully support the recommendation that assessing hypoglycemia risk should be mandatory in patients with diabetes before starting chemotherapy.
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Affiliation(s)
- Pauline Legris
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, Dijon, France
| | - Benjamin Bouillet
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, Dijon, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - Justine Pâris
- Department of Pharmacy, University Hospital, Dijon, France
| | - Pauline Pistre
- Department of Pharmacy, University Hospital, Dijon, France
| | | | - Stephanie Bost
- Department of Pharmacy, University Hospital, Dijon, France
| | - Isabelle Simoneau
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, Dijon, France
| | - Sylvain Manfredi
- Department of Hepato-Gastroenterology and Digestive Oncology, University Hospital and EPICAD LNC UMR 1231, University of Burgundy & Franche-Comté, Dijon, France
| | - Antoine Drouillard
- Department of Hepato-Gastroenterology and Digestive Oncology, University Hospital and EPICAD LNC UMR 1231, University of Burgundy & Franche-Comté, Dijon, France
| | - Jean-Noel Bastie
- Department of Clinical Hematology, University Hospital and SAPHIIT UMR 1231, University of Burgundy & Franche-Comté, Dijon, France
| | - Marie Chaix
- Department of Oncology, University Hospital Dijon, Dijon, France
| | - Pamela Massoud
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, Dijon, France
| | - Alexia Rouland
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, Dijon, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - Serge Aho
- Hospital Epidemiology and Infection Control Department, Dijon University Hospital, Dijon, France
| | - Mathieu Boulin
- Department of Pharmacy, University Hospital, Dijon, France
- Department of Pharmacy, University Hospital and EPICAD LNC UMR 1231, University of Burgundy & Franche-Comté, Dijon, France
| | - Jean-Michel Petit
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, Dijon, France.
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France.
- Service de Diabétologie, Centre Hospitalier Universitaire François Mitterrand, BP 77908, 21079, Dijon, Cedex, France.
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Rouland A, Masson D, Lagrost L, Vergès B, Gautier T, Bouillet B. Role of apolipoprotein C1 in lipoprotein metabolism, atherosclerosis and diabetes: a systematic review. Cardiovasc Diabetol 2022; 21:272. [PMID: 36471375 PMCID: PMC9724408 DOI: 10.1186/s12933-022-01703-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Apolipoprotein C1 (apoC1) is a small size apolipoprotein whose exact role is not totally clarified but which seems to modulate significantly the metabolism of lipoproteins. ApoC1 is involved in the metabolism of triglyceride-rich lipoproteins by inhibiting the binding of very low density lipoproteins (VLDL) to VLDL-receptor (VLDL-R), to low density lipoprotein receptor (LDL-R) and to LDL receptor related protein (LRP), by reducing the activity of lipoprotein lipase (LPL) and by stimulating VLDL production, all these effects leading to increase plasma triglycerides. ApoC1 takes also part in the metabolism of high density lipoproteins (HDL) by inhibiting Cholesterol Ester Transfer Protein (CETP). The functionality of apoC1 on CETP activity is impaired in diabetes that might account, at least in part, for the increased plasma CETP activity observed in patients with diabetes. Its different effects on lipoprotein metabolism with a possible role in the modulation of inflammation makes the net impact of apoC1 on cardiometabolic risk difficult to figure out and apoC1 might be considered as pro-atherogenic or anti-atherogenic depending on the overall metabolic context. Making the link between total plasma apoC1 levels and the risk of cardio-metabolic diseases is difficult due to the high exchangeability of this small protein whose biological effects might depend essentially on its association with VLDL or HDL. The role of apoC1 in humans is not entirely elucidated and further studies are needed to determine its precise role in lipid metabolism and its possible pleiotropic effects on inflammation and vascular wall biology. In this review, we will present data on apoC1 structure and distribution among lipoproteins, on the effects of apoC1 on VLDL metabolism and HDL metabolism and we will discuss the possible links between apoC1, atherosclerosis and diabetes.
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Affiliation(s)
- Alexia Rouland
- grid.31151.37Endocrinology and Diabetology Unit, University Hospital, Dijon, France ,grid.493090.70000 0004 4910 6615INSERM/University of Bourgogne Franche-Comté, LNC UMR1231, Dijon, France
| | - David Masson
- grid.493090.70000 0004 4910 6615INSERM/University of Bourgogne Franche-Comté, LNC UMR1231, Dijon, France ,LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Laurent Lagrost
- grid.493090.70000 0004 4910 6615INSERM/University of Bourgogne Franche-Comté, LNC UMR1231, Dijon, France ,LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Bruno Vergès
- grid.31151.37Endocrinology and Diabetology Unit, University Hospital, Dijon, France ,grid.493090.70000 0004 4910 6615INSERM/University of Bourgogne Franche-Comté, LNC UMR1231, Dijon, France
| | - Thomas Gautier
- grid.493090.70000 0004 4910 6615INSERM/University of Bourgogne Franche-Comté, LNC UMR1231, Dijon, France ,LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Benjamin Bouillet
- grid.31151.37Endocrinology and Diabetology Unit, University Hospital, Dijon, France ,grid.493090.70000 0004 4910 6615INSERM/University of Bourgogne Franche-Comté, LNC UMR1231, Dijon, France ,grid.31151.37Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079 Dijon, France
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7
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Donadieu J, Bou Mitri F, Beaupain B, Alajidi N, Viallard JF, Paih JPL, Yacoub M, Leblanc T, Quero L, Rouland A, Labbe L, Deback C, Bellanne-Chantelot C, Emile JF. ELANE neutropenia and solid tumors: Four cases from the French severe chronic neutropenia registry. Pediatr Blood Cancer 2022; 69:e29923. [PMID: 35969146 DOI: 10.1002/pbc.29923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/10/2022]
Abstract
Neutropenia related to ELANE gene mutations predisposes patients to infection and leukemia/myelodysplasia, but little is known about the predisposition to cancer. Among a cohort of 147 patients, we identified four with malignant solid tumors (papillary thyroid cancer, anal squamous cell cancer, papillary renal cell carcinoma, and adrenocortical carcinoma), all aged 25-50 years. Three occurred with cyclic neutropenia, and one occurred with severe chronic neutropenia. Previous radiotherapy was identified as a risk factor in one patient. No genetic predisposition was identified in the three other patients.
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Affiliation(s)
- Jean Donadieu
- French Registry for Severe Chronic Neutropenia, Armand-Trousseau Hospital, APHP, Paris, France
| | - Fares Bou Mitri
- French Registry for Severe Chronic Neutropenia, Armand-Trousseau Hospital, APHP, Paris, France
| | - Blandine Beaupain
- French Registry for Severe Chronic Neutropenia, Armand-Trousseau Hospital, APHP, Paris, France
| | - Nathalie Alajidi
- Onco-hematology Unit, Pediatic Department, Children Hospital, Groupe Hospitalier Pellegrin, Bordeaux, France
| | - Jean Francois Viallard
- Internal Medicine and Infectious Disease Department, Haut-Lévêque Hospital, University of Bordeaux, Bordeaux, France
| | | | - Mokrane Yacoub
- Pathology Department, Bordeaux University Hospital, Bordeaux, France
| | | | - Laurent Quero
- Oncology and Radiotherapy Department, Hopital Saint Louis, APHP, Paris, France
| | - Alexia Rouland
- Endocrinology Department, Dijon University Hospital, Dijon, France
| | - Louis Labbe
- Endocrinology Department, Hotel Dieu, Le Creusot, France
| | - Claire Deback
- Virology Department, Paul Brousse Hospital, Villejuif, France
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Durlach V, Vergès B, Al-Salameh A, Bahougne T, Benzerouk F, Berlin I, Clair C, Mansourati J, Rouland A, Thomas D, Thuillier P, Tramunt B, Le Faou AL. Smoking and diabetes interplay: A comprehensive review and joint statement. Diabetes Metab 2022; 48:101370. [PMID: 35779852 DOI: 10.1016/j.diabet.2022.101370] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
Evidence shows that smoking increases the risk of pre-diabetes and diabetes in the general population. Among persons with diabetes, smoking has been found to increase the risk of all-cause mortality and aggravate chronic diabetic complications and glycemic control. The current paper, which is a joint position statement by the French-Speaking Society on Tobacco (Société Francophone de Tabacologie) and the French-Speaking Society of Diabetes (Société Francophone du Diabète), summarizes the data available on the association between smoking and diabetes and on the impact of smoking and smoking cessation among individuals with type 1, type 2, and gestational diabetes mellitus. It also provides evidence-based information about the pharmacological and behavioral strategies for smoking cessation in these patients.
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Affiliation(s)
- Vincent Durlach
- Champagne-Ardenne University, UMR CNRS 7369 MEDyC & Cardio-Thoracic Department, Reims University Hospital, Reims, France.
| | - Bruno Vergès
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France; INSERM LNC-UMR1231, University of Burgundy, Dijon, France
| | - Abdallah Al-Salameh
- Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France; PériTox = UMR-I 01, University of Picardy Jules Verne, Amiens, France
| | - Thibault Bahougne
- Department of Endocrinology and Diabetology, Strasbourg University Hospital, Strasbourg, France; Institute of Cellular and Integrative Neuroscience, CNRS UPR-3212, Strasbourg, France
| | - Farid Benzerouk
- Cognition Health and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France; Department of Psychiatry, Reims University Hospital, Reims, France
| | - Ivan Berlin
- Department of Pharmacology, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - Carole Clair
- Department of Training, Research and Innovation, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Jacques Mansourati
- EA 4324 ORPHY, University of Western Brittany, Brest, France; Department of Cardiology, University Hospital of Brest, Brest, France
| | - Alexia Rouland
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France
| | - Daniel Thomas
- Institute of Cardiology, Hôpital Pitié-Salpêtrière, Sorbonne University, Paris, France
| | - Philippe Thuillier
- Department of Endocrinology, Diabetology and Metabolic Diseases, University Hospital of Brest, Brest, France
| | - Blandine Tramunt
- Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, Franc; Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France
| | - Anne-Laurence Le Faou
- Outpatient Addiction Center, Georges Pompidou European Hospital, AP-HP, Sorbonne Paris Cité, Paris, France
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9
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Bardou M, Rouland A, Martel M, Loffroy R, Barkun AN, Chapelle N. Review article: obesity and colorectal cancer. Aliment Pharmacol Ther 2022; 56:407-418. [PMID: 35707910 DOI: 10.1111/apt.17045] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/01/2021] [Accepted: 05/11/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Obesity is a growing global public health problem. More than half the European and North American population is overweight or obese. Colon and rectum cancers are still the second leading cause of cancer death worldwide, and epidemiological data support an association between obesity and colorectal cancers (CRCs). AIM To review the literature on CRC epidemiology in obese subjects, assessing the effects of obesity, including childhood or maternal obesity, on CRC, diagnosis, management, and prognosis, and discussing targeted prophylactic measures. METHOD We searched PubMed for obesity/overweight/metabolic syndrome and CRC. Other key words included 'staging', 'screening', 'treatment', 'weight loss', 'bariatric surgery' and 'chemotherapy'. RESULTS In Europe, about 11% of CRCs are attributed to overweight and obesity. Epidemiological data suggest that obesity is associated with a 30%-70% increased risk of colon cancer in men, the association being less consistent in women. Visceral fat or abdominal obesity seems to be of greater concern than subcutaneous fat obesity, and any 1 kg/m2 increase in body mass index confers more risk (hazard ratio 1.03). Obesity might increase the likelihood of recurrence or mortality of the primary cancer and may affect initial management, including accurate staging. The risk maybe confounded by different factors, including lower adherence to organised CRC screening programmes. It is unclear whether bariatric surgery helps reduce rectal cancer risk. CONCLUSIONS Despite a growing body of evidence linking obesity to CRC, many questions remain unanswered, including whether we should screen patients with obesity earlier or propose prophylactic bariatric surgery for certain patients with obesity.
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Affiliation(s)
- Marc Bardou
- INSERM-Centre d'Investigations Cliniques 1432 (CIC 1432), CHU Dijon-Bourgogne, Dijon, France.,UFR Sciences Santé, Université de Bourgogne-Franche Comté, Dijon, France
| | - Alexia Rouland
- Endocrinology Department, CHU Dijon-Bourgogne, Dijon, France
| | - Myriam Martel
- Department of Clinical Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | | | - Alan N Barkun
- Division of Gastroenterology, McGill University Health Centre, Montréal, Québec, Canada
| | - Nicolas Chapelle
- Department of Gastroenterology, Digestive Diseases Institute, CHU de Nantes, Nantes, France.,INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, ITUN5, Nantes, France
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10
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Vergès B, Pignol E, Rouland A, Bouillet B, Baillot-Rudoni S, Quilot E, Djeffal A, Petit JM. Glycemic Variability Assessment with a 14-Day Continuous Glucose Monitoring System: When and How Long to Measure MAGE (Mean Amplitude of Glucose Excursion) for Optimal Reliability? J Diabetes Sci Technol 2022; 16:982-987. [PMID: 33567877 PMCID: PMC9264451 DOI: 10.1177/1932296821992060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mean amplitude of glucose excursion (MAGE) is considered as the "gold standard" for assessing the short-term within-day glycemic variability (GV), which is an important component of overall glycemic control. A 14-day continuous glucose monitoring system is now widely used and allows easier assessment of GV. However, it is still unknown whether MAGE, usually calculated on a 48-hour period is identical whatever the time during the 14-day lifespan of the sensor and whether a longer time period might give additional information. We evaluated in 68 patients with type 1 diabetes, MAGE during three 2-day periods (day1-day3; day6-day8; day11-day13) and during periods of 3 days and 4 days. MAGE calculated at the three 2-day periods were identical and not different from MAGE of the 3-day or 4-day periods.
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Affiliation(s)
- Bruno Vergès
- Department of Endocrinology-Diabetology,
CHU Dijon, Dijon, France
- University of Burgundy, INSERM LNC
UMR1231, Dijon, France
- Bruno Vergès, MD, PhD, Service
Endocrinologie, Diabétologie et Maladies Métaboliques, CHU-Dijon, 14 rue
Gaffarel, Dijon, 21000, France.
| | - Elise Pignol
- Department of Endocrinology-Diabetology,
CHU Dijon, Dijon, France
| | - Alexia Rouland
- Department of Endocrinology-Diabetology,
CHU Dijon, Dijon, France
- University of Burgundy, INSERM LNC
UMR1231, Dijon, France
| | - Benjamin Bouillet
- Department of Endocrinology-Diabetology,
CHU Dijon, Dijon, France
- University of Burgundy, INSERM LNC
UMR1231, Dijon, France
| | | | - Emilienne Quilot
- Department of Endocrinology-Diabetology,
Macon Hospital, Macon, France
| | | | - Jean Michel Petit
- Department of Endocrinology-Diabetology,
CHU Dijon, Dijon, France
- University of Burgundy, INSERM LNC
UMR1231, Dijon, France
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11
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Bouillet B, Tscherter P, Vaillard L, Nonciaux C, Hourdain P, Ravier A, Rouland A, Petit JM, Vergès B, Quilot E. Frequent and severe hypoglycaemia detected with continuous glucose monitoring in older institutionalised patients with diabetes. Age Ageing 2021; 50:2088-2093. [PMID: 34324624 DOI: 10.1093/ageing/afab128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Little is known about the prevalence of hypoglycaemia in older people with diabetes. However, the HbA1c goal is ≥8% for institutionalised patients with treatments that can cause hypoglycaemia. PURPOSE We aimed to assess the prevalence of hypoglycaemia with continuous glucose monitoring and to evaluate the link with HbA1C in older institutionalised patients with diabetes taking potentially hypoglycaemia-inducing drugs. DESIGN Prospective, multicentre study carried out in six geriatric care centres in the Côte d'Or region of France between January 2019 and July 2020. SETTINGS, SUBJECTS AND METHODS A FreeStyle Libre Pro® (FSLP) was worn for up to 14 days in blinded mode in 42 patients taking at least one potentially hypoglycaemia-inducing antidiabetic drug. RESULTS Two hundred and forty-two hypoglycaemic events were detected in 79% (n = 33) of patients wearing the FSLP. One or more hypoglycaemic event was detected in 100% of patients with HbA1C < 7% and in 79% of patients with HbA1C ≥ 8% (P = 0.02). The time spent in hypoglycaemia was higher in patients with HbA1C < 7% than those with HbA1C ≥ 8% (P = 0.015). Time spent <54 mg/dl was detected in 45% of patients. CONCLUSIONS We report a very high prevalence of hypoglycaemia, with a significant proportion of severe hypoglycaemia, in older institutionalised patients with diabetes taking potentially hypoglycaemia-inducing drugs. Having HbA1C < 7% exposes patients to a higher risk of hypoglycaemia, but this risk remains also high in patients with HbA1C ≥ 8%. In this population, continuous glucose monitoring could be considered an effective tool to detect hypoglycemia, which is associated with increased risk of cardiovascular events, falling, fractures, cognitive impairment and mortality.
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Affiliation(s)
- Benjamin Bouillet
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - Pauline Tscherter
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, France
| | | | | | | | | | - Alexia Rouland
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - Jean Michel Petit
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - Bruno Vergès
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - Emilienne Quilot
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
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12
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Vergès B, Hassid J, Rouland A, Bouillet B, Simoneau I, Petit JM, Duvillard L. Liraglutide reduces plasma PCSK9 in patients with type 2 diabetes not treated with statins. Diabetes Metab 2021; 48:101284. [PMID: 34551355 DOI: 10.1016/j.diabet.2021.101284] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 08/27/2021] [Accepted: 09/05/2021] [Indexed: 01/20/2023]
Abstract
AIM Dyslipidaemia in type 2 diabetes mellitus (T2DM), which increases cardiovascular risk, includes abnormal metabolism of low-density lipoproteins (LDL). Our group has recently shown that liraglutide increases LDL catabolism in patients with T2DM and that it reduces the expression of PCSK9 (a major inhibitor of LDL-receptor expression) in vitro and in mice. This prompted us to study the effect of liraglutide on plasma PCSK9 level in patients with T2DM. METHODS We studied prospectively 82 patients with T2DM (51 without statins, 31 with statins). Plasma PCSK9 and plasma lipids were measured before and six months after the initiation of a treatment with liraglutide at a dose of 1.2 mg/day. RESULTS Plasma PCSK9 was significantly reduced by liraglutide treatment (214.9 ± 56.4 vs 244.5 ± 99.2 ng/ml, P = 0.024) in patients not on statins, but not in patients treated with statins (301.1 ± 91.5 vs 281.2 ± 96.9 ng/ml, P = 0.41). In patients not on statins, a very significant 17% decrease in plasma PCSK9 was observed in patients with baseline haemoglobin A1c (HbA1c) < 10% (n = 33; mean = -45.0 ng/ml, P = 0.013), when it was not observed in patients with baseline HbA1c ≥ 10% (n = 18; mean = +5.2 ng/ml, P = 0.75). In multivariate analysis, baseline HbA1c was an independent factor associated with plasma PCSK9 reduction, in patients not on statins. CONCLUSION Treatment with liraglutide induces a significant reduction of plasma PCSK9 in patients with T2DM not on statins. This is in line with the acceleration of LDL catabolism that has been observed with liraglutide. However, this decrease in plasma PCSK9 is significantly influenced by glycaemic control and is not observed in patients with poorly controlled T2DM.
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Affiliation(s)
- Bruno Vergès
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France; University of Burgundy, INSERM LNC UMR1231, Dijon, France.
| | - Jonathan Hassid
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France
| | - Alexia Rouland
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France; University of Burgundy, INSERM LNC UMR1231, Dijon, France
| | - Benjamin Bouillet
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France; University of Burgundy, INSERM LNC UMR1231, Dijon, France
| | - Isabelle Simoneau
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France; University of Burgundy, INSERM LNC UMR1231, Dijon, France
| | - Jean-Michel Petit
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France; University of Burgundy, INSERM LNC UMR1231, Dijon, France
| | - Laurence Duvillard
- University of Burgundy, INSERM LNC UMR1231, Dijon, France; CHU Dijon, Department of Biochemistry, Dijon, France
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13
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Vergès B, Duvillard L, Pais de Barros JP, Bouillet B, Baillot-Rudoni S, Rouland A, Petit JM, Degrace P, Demizieux L. Liraglutide Increases the Catabolism of Apolipoprotein B100-Containing Lipoproteins in Patients With Type 2 Diabetes and Reduces Proprotein Convertase Subtilisin/Kexin Type 9 Expression. Diabetes Care 2021; 44:1027-1037. [PMID: 33531418 DOI: 10.2337/dc20-1843] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/10/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Dyslipidemia observed in type 2 diabetes (T2D) is atherogenic. Important features of diabetic dyslipidemia are increased levels of triglyceride-rich lipoproteins and small dense LDL particles, which all have apolipoprotein B100 (apoB100) as a major apolipoprotein. This prompted us to study the effect of the GLP-1 agonist liraglutide on the metabolism of apoB100-containing lipoproteins. RESEARCH DESIGN AND METHODS We performed an in vivo kinetic study with stable isotopes (L-[1-13C]leucine) in 10 patients with T2D before and after 6 months of treatment with liraglutide (1.2 mg/day). We also evaluated in mice the effect of liraglutide on the expression of genes involved in apoB100-containing lipoprotein clearance. RESULTS In patients with T2D, liraglutide treatment significantly reduced plasma apoB100 (0.93 ± 0.13 vs. 1.09 ± 0.11 g/L, P = 0.011) and fasting triglycerides (1.76 ± 0.37 vs. 2.48 ± 0.69 mmol/L, P = 0.005). The kinetic study showed a significant increase in indirect catabolism of VLDL1-apoB100 (4.11 ± 1.91 vs. 2.96 ± 1.61 pools/day, P = 0.005), VLDL2-apoB100 (5.17 ± 2.53 vs. 2.84 ± 1.65 pools/day, P = 0.008), and IDL-apoB100 (5.27 ± 2.77 vs. 3.74 ± 1.85 pools/day, P = 0.017) and in catabolism of LDL-apoB100 (0.72 ± 0.22 vs. 0.56 ± 0.22 pools/day, P = 0.005). In mice, liraglutide increased lipoprotein lipase (LPL) gene expression and reduced proprotein convertase subtilisin/kexin type 9 (PCSK9), retinol-binding protein 4 (RBP4), and tumor necrosis factor-α (TNF-α) gene expression in adipose tissue and decreased PCSK9 mRNA and increased LDL receptor protein expression in liver. In vitro, liraglutide directly reduced the expression of PCSK9 in the liver. CONCLUSIONS Treatment with liraglutide induces a significant acceleration of the catabolism of triglyceride-rich lipoproteins (VLDL1, VLDL2, IDL) and LDL. Liraglutide modifies the expression of genes involved in apoB100-containing lipoprotein catabolism. These positive effects on lipoprotein metabolism may reduce cardiovascular risk in T2D.
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Affiliation(s)
- Bruno Vergès
- Department of Endocrinology-Diabetology, CHU Dijon, Dijon, France .,INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | - Laurence Duvillard
- INSERM LNC UMR1231, University of Burgundy, Dijon, France.,Department of Biochemistry, CHU Dijon, Dijon, France
| | - Jean Paul Pais de Barros
- INSERM LNC UMR1231, University of Burgundy, Dijon, France.,Lipidomic Analytical Platform, University of Burgundy, Dijon, France
| | - Benjamin Bouillet
- Department of Endocrinology-Diabetology, CHU Dijon, Dijon, France.,INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | | | - Alexia Rouland
- Department of Endocrinology-Diabetology, CHU Dijon, Dijon, France.,INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | - Jean Michel Petit
- Department of Endocrinology-Diabetology, CHU Dijon, Dijon, France.,INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | - Pascal Degrace
- INSERM LNC UMR1231, University of Burgundy, Dijon, France
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14
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Vergès B, Brands R, Fourmont C, Petit JM, Simoneau I, Rouland A, Legris P, Bouillet B, Chauvet-Gélinier JC. Fewer Type A personality traits in type 2 diabetes patients with diabetic foot ulcer. Diabetes Metab 2021; 47:101245. [PMID: 33722768 DOI: 10.1016/j.diabet.2021.101245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 12/30/2022]
Abstract
AIM Type A personality-characterized by time urgency, strong drive, and a need for achievement and competitiveness-has been shown to be associated with reduced mortality in patients with diabetes. However, it is not known whether a Type A personality might protect against diabetic foot ulcer (DFU). This prompted our present analysis of the association between Type A personality and DFU. METHODS The Bortner Scale questionnaire was used to assess Type A personality in 386 patients with type 2 diabetes (T2D), including 104 patients also presenting with, and 282 presenting without, DFU. Additional questionnaires were used to assess perceived stress and depression. RESULTS Type A Bortner scores were significantly lower in T2D patients with vs without DFU (166.64 ± 38.76 vs 178.79 ± 36.61, respectively; P = 0.005). In patients with DFU, the prevalence of Type A personality traits was significantly lower than in those without DFU (48% vs 64.5%, respectively; P = 0.005) whereas, in contrast, Type B personality traits (the opposite of Type A) were more prevalent (52% vs 35.5%, respectively; P = 0.005). On multivariate analysis, Type A Bortner scores were negatively associated with DFU (P = 0.008) independently of age, gender, BMI, depression scores or perceived stress. CONCLUSION The Type A personality, characterized by competitiveness and a need for achievement, is significantly less frequently seen in T2D patients with DFU. On the other hand, the Type B personality is much more prevalent in such patients. It may be that the Type B personality, which is characterized by fewer problem-focused coping strategies and a decreased adherence to care, might favour the development of DFU.
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Affiliation(s)
- Bruno Vergès
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France; University of Burgundy, INSERM LNC UMR1231, Dijon, France.
| | - Roxane Brands
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France
| | - Coralie Fourmont
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France
| | - Jean-Michel Petit
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France; University of Burgundy, INSERM LNC UMR1231, Dijon, France
| | - Isabelle Simoneau
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France; University of Burgundy, INSERM LNC UMR1231, Dijon, France
| | - Alexia Rouland
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France; University of Burgundy, INSERM LNC UMR1231, Dijon, France
| | - Pauline Legris
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France
| | - Benjamin Bouillet
- CHU Dijon, Department of Endocrinology-Diabetology, Dijon, France; University of Burgundy, INSERM LNC UMR1231, Dijon, France
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15
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Rouland A, Bouillet B, Legris P, Simoneau I, Petit JM, Vergès B. Successful Control of Hypoglycemia with Pasireotide LAR in a Patient with Inappropriate Insulin Secretion. Clin Pharmacol 2021; 13:33-37. [PMID: 33574715 PMCID: PMC7872904 DOI: 10.2147/cpaa.s278978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/26/2020] [Indexed: 12/27/2022] Open
Abstract
Introduction Inappropriate insulin secretion could be due to several diseases. Nesidioblastosis is characterized by diffuse hyperplasia of pancreatic beta cells, causing organic hypoglycemia. No pancreatic lesions are found on the imaging of patients with this condition. Diazoxide is used as a first-line treatment but can be poorly tolerated because of its side effects, and therapeutic failure is possible. Somatostatin analogues have limited efficacy because of their poor affinity to somatostatin (SST) receptors. Pasireotide is a somatostatin analogue with a much higher affinity to SST receptors, especially SST5, and it could thus be more efficient for treating nesidioblastosis-related hypoglycemia. Observation A 56 years-old diabetic woman had symptoms of hypoglycemia, persistent after treatment’s withdrawal. A fasting test authentify an organic hypoglycemia, at 34mg/dL, a plasma insulin level at 6mUI/L above the 5 mU/L threshold, a C-peptide level at 1.9 ng/mL above the threshold of 0.6, and an insulin/C-peptide ratio 0.066, below the threshold of 1. No lesions were found on CT-scan or endoscopic ultrasound. Somatostatin receptor scintigraphy was also negative. Diazoxide and octreotide failed to improve the recurrence of hypoglycemia episodes. With pasireotide LAR, hypoglycemia disappeared and glycemia increased. Hyperglycemia was controlled with sitagliptin. The patient has now been treated with pasireotide LAR for two years, with no more episode of hypoglycemia until now. Discussion We present the first case of nesidioblastosis treatment with pasireotide LAR, with success. Patients diagnosed with nesidioblastosis and diazoxide-resistant hypoglycemia, or who experience difficulties with other treatments, could use pasireotide LAR in conjunction with glycemia monitoring, particularly if they are diabetic.
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Affiliation(s)
- Alexia Rouland
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France
| | - Benjamin Bouillet
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France.,French National Health and Medical Research Body Unit, Lipid-Nutrition-Cancer-1231, University of Burgundy, Dijon, 21000, France
| | - Pauline Legris
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France
| | - Isabelle Simoneau
- French National Health and Medical Research Body Unit, Lipid-Nutrition-Cancer-1231, University of Burgundy, Dijon, 21000, France
| | - Jean-Michel Petit
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France.,French National Health and Medical Research Body Unit, Lipid-Nutrition-Cancer-1231, University of Burgundy, Dijon, 21000, France
| | - Bruno Vergès
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France.,French National Health and Medical Research Body Unit, Lipid-Nutrition-Cancer-1231, University of Burgundy, Dijon, 21000, France
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16
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Vergès B, Rouland A, Baillot-Rudoni S, Brindisi MC, Duvillard L, Simoneau I, Legris P, Petit JM, Bouillet B. Increased body fat mass reduces the association between fructosamine and glycated hemoglobin in obese type 2 diabetes patients. J Diabetes Investig 2020; 12:619-624. [PMID: 32767822 PMCID: PMC8015815 DOI: 10.1111/jdi.13383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/21/2020] [Accepted: 08/02/2020] [Indexed: 01/23/2023] Open
Abstract
Obesity is increasing in patients with type 2 diabetes. A possible reduced association between fructosamine and glycated hemoglobin (HbA1c) in obese individuals has been previously discussed, but this has never been specifically evaluated in type 2 diabetes, and the potential influence of body fat mass and fat distribution has never been studied. We studied 112 type 2 diabetes patients with assessment of fat mass, liver fat and fat distribution. Patients with body mass index (BMI) above the median (34.9 kg/m2 ), versus BMI below the median, had a correlation coefficient between fructosamine and HbA1c significantly reduced (r = 0.358 vs r = 0.765). In the whole population, fructosamine was correlated negatively with BMI and fat mass. In multivariate analysis, fructosamine was associated with HbA1c (positively) and fat mass (negatively), but not with BMI, liver fat or fat distribution. The association between fructosamine and HbA1c is significantly reduced in the most obese type 2 diabetes patients, and this is mostly driven by increased fat mass.
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Affiliation(s)
- Bruno Vergès
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France.,INSERM LNC-UMR1231, University of Burgundy, Dijon, France
| | - Alexia Rouland
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France
| | - Sabine Baillot-Rudoni
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France
| | - Marie-Claude Brindisi
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France
| | - Laurence Duvillard
- INSERM LNC-UMR1231, University of Burgundy, Dijon, France.,Department of Biochemistry, CHU Dijon, Dijon, France
| | - Isabelle Simoneau
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France.,INSERM LNC-UMR1231, University of Burgundy, Dijon, France
| | - Pauline Legris
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France
| | - Jean-Michel Petit
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France.,INSERM LNC-UMR1231, University of Burgundy, Dijon, France
| | - Benjamin Bouillet
- Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France.,INSERM LNC-UMR1231, University of Burgundy, Dijon, France
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Abstract
Thyroiditis is a frequent and mostly benign disease that can sometimes disrupt the thyroid balance. Their diagnosis, as well as their aetiology, is a necessary step in the management of the patients. Painful thyroiditis includes acute thyroiditis of infectious origin and subacute thyroiditis. The first one can be treated by antibiotics or antifungals depending on the germ found. The second one will be treated with non-steroidal anti-inflammatory drugs or corticosteroids. In cases of Hashimoto's thyroiditis with overt hypothyroidism, replacement therapy with L-thyroxine will be adapted to the TSH level. As amiodarone treatment provides dysthyroidism, the thyroid status should be monitored regularly. Hypothyroidism will be treated using thyroid replacement therapy. Hyperthyroidism imposes a stop of amiodarone when it is possible. Treatment with synthetic antithyroid drugs (propyl-thio-uracil) or corticosteroids could be used whether there is an underlying thyroid disease or not. Immunotherapies with anti-PD-1/PDL1 or anti-CTLA-4 can also provide dysthyroidism. A monitoring of the thyroid assessment needs to be done in these patients, even if there are no clinical signs, which are not very specific in this context. The treatment of hypothyroidism will be based on thyroid replacement therapy according to the TSH level and the presence or absence of anti-TPO antibodies. Treatment of symptomatic hyperthyroidism may involve a prescription of beta-blockers, or synthetic antithyroid drugs in case of positive anti-TSH receptor antibodies. In all cases, it is desirable to contact an endocrinologist to confirm the diagnosis hypothesis and to decide on a suitable treatment.
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Affiliation(s)
- A Rouland
- Service d'endocrinologie, diabétologie, maladies métaboliques, CHU de Dijon, 2, boulevard Maréchal-de-Lattre-de-Tassigny, 21000 Dijon, France; Unité Inserm LNC-UMR 1231, université de Bourgogne-Franche-Comté, Dijon, France
| | - P Buffier
- Service d'endocrinologie, diabétologie, maladies métaboliques, CHU de Dijon, 2, boulevard Maréchal-de-Lattre-de-Tassigny, 21000 Dijon, France
| | - J-M Petit
- Service d'endocrinologie, diabétologie, maladies métaboliques, CHU de Dijon, 2, boulevard Maréchal-de-Lattre-de-Tassigny, 21000 Dijon, France; Unité Inserm LNC-UMR 1231, université de Bourgogne-Franche-Comté, Dijon, France
| | - B Vergès
- Service d'endocrinologie, diabétologie, maladies métaboliques, CHU de Dijon, 2, boulevard Maréchal-de-Lattre-de-Tassigny, 21000 Dijon, France; Unité Inserm LNC-UMR 1231, université de Bourgogne-Franche-Comté, Dijon, France
| | - B Bouillet
- Service d'endocrinologie, diabétologie, maladies métaboliques, CHU de Dijon, 2, boulevard Maréchal-de-Lattre-de-Tassigny, 21000 Dijon, France; Unité Inserm LNC-UMR 1231, université de Bourgogne-Franche-Comté, Dijon, France.
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18
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Rouland A, Chauvet-Gelinier JC, Sberna AL, Crevisy E, Buffier P, Mouillot T, Petit JM, Vergès B. Personality types in individuals with type 1 and type 2 diabetes. Endocr Connect 2020; 9:EC-19-0499.R2. [PMID: 32101526 PMCID: PMC7077523 DOI: 10.1530/ec-19-0499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/25/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The Type A personality, characterized by impatience, strong career ambition and competitiveness, is associated with greater sensitivity to external stress. Type 1 diabetes (T1D) is an auto-immune disease, which is potentially influenced by stress, unlike type 2 diabetes (T2D). The aim of this study was to assess whether individuals with T1D and T2D exhibited significant differences on the Type A personality scale. We also assessed the personality in patients with thyroid auto-immune diseases to validate potential links between auto-immune disease and Type A. DESIGN AND METHODS The Bortner questionnaire was used to assess Type A personality in 188 patients with T1D, 430 patients with T2D and 85 patients with auto-immune thyroid disease (Graves' disease or Hashimoto thyroiditis). RESULTS Type A Bortner scores were significantly higher in T1D patients than in T2D patients (188±34 vs 177±36, p<0.0001). Patients with auto-immune thyroid diseases and T1D patients had similar Type A Bortner scores (189±33 vs 188±34, p=0.860). CONCLUSION Patients with auto-immune T1D have higher Type A scores than T2D patients. Furthermore, patients with auto-immune thyroid disease also have elevated Type A scores similar to those observed in type 1 diabetes, suggesting that an elevated Type A score in T1D is potentially related to its autoimmune origin. This suggests a possible link between Type A personality and auto-immune diseases via stress-triggering psychobiological pathways. The different personality score between T1D and T2D is an important factor to consider that could influence the diabetes self-care coping strategies and long-term prognosis.
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Affiliation(s)
- A Rouland
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France
| | - J-C Chauvet-Gelinier
- Psychiatry Unit, Department of Neurosciences, Dijon University Hospital, Dijon, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - A-L Sberna
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - E Crevisy
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France
| | - P Buffier
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France
| | - T Mouillot
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France
| | - J-M Petit
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - B Vergès
- Endocrinology Diabetics and Metabolic Disorders Department, Dijon University Hospital, Dijon, France
- INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
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19
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Bouillet B, Rouland A. [Intake of high dose biotin: A cause of artificial hyperthyroidism]. Rev Med Interne 2019; 41:123-125. [PMID: 31813616 DOI: 10.1016/j.revmed.2019.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 11/17/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Many hormone immunoassays use the biotin streptavidin interaction to immobilize immune complexes. The intake of high dose biotin can interfere with immunoassays using the biotin streptavidin interaction. The biotin-immunoassay interference generates falsely low or falsely high tests of hormones according to the type of immunoassay used. CASE REPORT A 70-year-old patient, with progressive multiple sclerosis, was referred to our hospital for thyrotoxicosis. She was found to have markedly elevated thyroid hormones level (T3-T4) and decreased thyrotropin (TSH) level but she had no symptoms of hyperthyroidism. An ingestion of biotin, that is more and more frequent in patients with progressive multiple sclerosis, was found. Thyroid function tests normalized after discontinuation of biotin treatment. CONCLUSION The discrepancy between a clinical exam which is not indicative of thyrotoxicosis and markedly abnormal thyroid function tests should lead to a search for biotin intake, which can interfere with thyroid function tests.
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Affiliation(s)
- B Bouillet
- Service d'endocrinologie, diabétologie et maladies métaboliques, centre hospitalier universitaire, 21079 Dijon, France; Unité Inserm LNC-UMR 1231, université de Bourgogne, 21000 Dijon, France.
| | - A Rouland
- Service d'endocrinologie, diabétologie et maladies métaboliques, centre hospitalier universitaire, 21079 Dijon, France; Unité Inserm LNC-UMR 1231, université de Bourgogne, 21000 Dijon, France
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20
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Bouillet B, Gautier T, Rouland A, Duvillard L, Petit JM, Lagrost L, Vergès B. Plasma apolipoprotein C1 concentration is associated with plasma triglyceride concentration but not with visceral fat and liver fat content in people with type 1 diabetes. Acta Diabetol 2019; 56:1155-1157. [PMID: 31119457 DOI: 10.1007/s00592-019-01367-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/08/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Benjamin Bouillet
- Endocrinology, Diabetology Department, University Hospital of Dijon, 2 Boulevard du Maréchal de Lattre de Tassigny, BP 77908, 21079, Dijon, France.
- INSERM LNC-UMR 1231, University of Bourgogne, Dijon, France.
| | - Thomas Gautier
- INSERM LNC-UMR 1231, University of Bourgogne, Dijon, France
| | - Alexia Rouland
- Endocrinology, Diabetology Department, University Hospital of Dijon, 2 Boulevard du Maréchal de Lattre de Tassigny, BP 77908, 21079, Dijon, France
- INSERM LNC-UMR 1231, University of Bourgogne, Dijon, France
| | | | - Jean-Michel Petit
- Endocrinology, Diabetology Department, University Hospital of Dijon, 2 Boulevard du Maréchal de Lattre de Tassigny, BP 77908, 21079, Dijon, France
- INSERM LNC-UMR 1231, University of Bourgogne, Dijon, France
| | | | - Bruno Vergès
- Endocrinology, Diabetology Department, University Hospital of Dijon, 2 Boulevard du Maréchal de Lattre de Tassigny, BP 77908, 21079, Dijon, France
- INSERM LNC-UMR 1231, University of Bourgogne, Dijon, France
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21
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Bouillet B, Rouland A, Petit JM, Vergès B. A low-carbohydrate high-fat diet initiated promptly after diagnosis provides clinical remission in three patients with type 1 diabetes. Diabetes Metab 2019; 46:511-513. [PMID: 31301353 DOI: 10.1016/j.diabet.2019.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/25/2019] [Accepted: 06/29/2019] [Indexed: 10/26/2022]
Affiliation(s)
- B Bouillet
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, France; Inserm Unit, LNC-UMR 1231, University of Burgundy, Dijon, France.
| | - A Rouland
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, France; Inserm Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - J M Petit
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, France; Inserm Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
| | - B Vergès
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, France; Inserm Unit, LNC-UMR 1231, University of Burgundy, Dijon, France
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22
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Rouland A, Fourmont C, Sberna AL, Aho Glele LS, Mouillot T, Simoneau I, Vergès B, Petit JM, Bouillet B. Malnutrition in type 2 diabetic patients does not affect healing of foot ulcers. Acta Diabetol 2019; 56:171-176. [PMID: 30284047 DOI: 10.1007/s00592-018-1233-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/21/2018] [Indexed: 12/30/2022]
Abstract
AIM Protein-energy malnutrition is known to be involved in wound healing. While wound healing in patients with diabetic foot ulcers (DFU) is a complex and multifactorial process, the role of malnutrition in this case has rarely been explored. The objective of this study was to determine whether the nutritional status of diabetic patients influences the healing of DFU. METHODS 48 patients were included in this prospective, single-center study. All patients with comorbidities or factors involving malnutrition or influencing biological measurements were excluded. Patients were followed up for 24 weeks. RESULTS The malnutrition rate was 29.2% at baseline and 25.6% at the end of the study. The difference was not significant. Of the 35 patients with wound healing, 29% were undernourished at inclusion and 17% at the end of the study. Of the 12 patients without wound healing, 50% were undernourished at inclusion, and 42% at the end of the study. These differences were not significant. Rate and speed of wound healing were not associated with malnutrition at inclusion. 15% of patients without malnutrition at baseline had final malnutrition. CONCLUSION We demonstrated that wound healing was not affected by the initial presence of malnutrition. In our study, there is no evidence to support nutritional intervention to improve wound healing in diabetic patients. Nevertheless, malnutrition is responsible for an increase in morbidity and mortality and it is essential to identify malnutrition systematically for all patients with DFU, initially and during follow-up to treat it quickly and efficiently.
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Affiliation(s)
- A Rouland
- Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079, Dijon, France
| | - C Fourmont
- Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079, Dijon, France
| | - A L Sberna
- Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079, Dijon, France
- Unité INSERM, LNC-UMR 1231, Université de Bourgogne, Dijon, France
| | - L S Aho Glele
- Service d'épidémiologie et d'hygiène hospitalière, Hôpital François Mitterrand, CHU de Dijon, Dijon, France
| | - T Mouillot
- Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079, Dijon, France
| | - I Simoneau
- Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079, Dijon, France
| | - B Vergès
- Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079, Dijon, France
- Unité INSERM, LNC-UMR 1231, Université de Bourgogne, Dijon, France
| | - J M Petit
- Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079, Dijon, France
- Unité INSERM, LNC-UMR 1231, Université de Bourgogne, Dijon, France
| | - Benjamin Bouillet
- Service Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital François Mitterrand, CHU Dijon, BP 77908, 21079, Dijon, France.
- Unité INSERM, LNC-UMR 1231, Université de Bourgogne, Dijon, France.
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23
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Vergès B, Duvillard L, Pais de Barros JP, Bouillet B, Baillot-Rudoni S, Rouland A, Sberna AL, Petit JM, Degrace P, Demizieux L. Liraglutide Reduces Postprandial Hyperlipidemia by Increasing ApoB48 (Apolipoprotein B48) Catabolism and by Reducing ApoB48 Production in Patients With Type 2 Diabetes Mellitus. Arterioscler Thromb Vasc Biol 2018; 38:2198-2206. [DOI: 10.1161/atvbaha.118.310990] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objective—
Treatment with liraglutide, a GLP-1 (glucagon-like peptide-1) agonist, has been shown to reduce postprandial lipidemia, an important feature of diabetic dyslipidemia. However, the underlying mechanisms for this effect remain unknown. This prompted us to study the effect of liraglutide on the metabolism of ApoB48 (apolipoprotein B48).
Approach and Results—
We performed an in vivo kinetic study with stable isotopes (D
8
-valine) in the fed state in 10 patients with type 2 diabetes mellitus before treatment and 6 months after the initiation of treatment with liraglutide (1.2 mg/d). We also evaluated, in mice, the effect of a 1-week liraglutide treatment on postload triglycerides and analysed in vitro on jejunum, the direct effect of liraglutide on the expression of genes involved in the biosynthesis of chylomicron. In diabetic patients, liraglutide treatment induced a dramatic reduction of ApoB48 pool (65±38 versus 162±87 mg;
P
=0.005) because of a significant decrease in ApoB48 production rate (3.02±1.33 versus 6.14±4.27 mg kg
-1
d
-1
;
P
=0.009) and a significant increase in ApoB48 fractional catabolic rate (5.12±1.35 versus 3.69±0.75 pool d
-1
;
P
=0.005). One-week treatment with liraglutide significantly reduced postload plasma triglycerides in mice and liraglutide, in vitro, reduced the expression of ApoB48, DGAT1 (diacylglycerol O-acyltransferase 1), and MTP (microsomal transfer protein) genes.
Conclusions—
We show that treatment with liraglutide induces a significant reduction of the ApoB48 pool because of both a reduction of ApoB48 production and an increase in ApoB48 catabolism. In vitro, liraglutide reduces the expression of genes involved in chylomicron synthesis. These effects might benefit cardiovascular health.
Clinical Trial Registration—
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02721888.
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Affiliation(s)
- Bruno Vergès
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| | - Laurence Duvillard
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| | - Jean Paul Pais de Barros
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
- Lipidomic Analytical Platform, Bâtiment B3, Dijon, France (J.P.P.d.B.)
| | - Benjamin Bouillet
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| | - Sabine Baillot-Rudoni
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
| | - Alexia Rouland
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
| | - Anne-Laure Sberna
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
| | - Jean-Michel Petit
- From the Department of Endocrinology-Diabetology (B.V., B.B, S.B.-R., A.R., A.-L.S., J.M.P.)
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| | - Pascal Degrace
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
| | - Laurent Demizieux
- Department of Biochemistry (L.D.), University Hospital, Dijon, France
- INSERM LNR UMR1231, University of Burgundy and Franche-Comté, Dijon, France (B.V., L.D., J.P.P.d.B., B.B., J.-M.P., P.D., L.D.)
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24
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Affiliation(s)
- Alexia Rouland
- Service d'Endocrinologie, Diabétologie, Maladies Métaboliques, CHU Dijon, Dijon, France
| | - Amandine Nguyen
- Service d'Endocrinologie, Diabétologie, Maladies Métaboliques, CHU Dijon, Dijon, France
| | - Coralie Fourmont
- Service d'Endocrinologie, Diabétologie, Maladies Métaboliques, CHU Dijon, Dijon, France
| | - Marion Lapray
- Service d'Endocrinologie, Diabétologie, Maladies Métaboliques, CHU Dijon, Dijon, France
| | - Bruno Vergès
- Service d'Endocrinologie, Diabétologie, Maladies Métaboliques, CHU Dijon, Dijon, France
- INSERM Unit, LNC-UMR 1231, Université de Bourgogne, Dijon, France
| | - Jean Michel Petit
- Service d'Endocrinologie, Diabétologie, Maladies Métaboliques, CHU Dijon, Dijon, France
- INSERM Unit, LNC-UMR 1231, Université de Bourgogne, Dijon, France
| | - Benjamin Bouillet
- Service d'Endocrinologie, Diabétologie, Maladies Métaboliques, CHU Dijon, Dijon, France
- INSERM Unit, LNC-UMR 1231, Université de Bourgogne, Dijon, France
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25
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Sberna AL, Bouillet B, Rouland A, Brindisi MC, Nguyen A, Mouillot T, Duvillard L, Denimal D, Loffroy R, Vergès B, Hillon P, Petit JM. European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD) and European Association for the Study of Obesity (EASO) clinical practice recommendations for the management of non-alcoholic fatty liver disease: evaluation of their application in people with Type 2 diabetes. Diabet Med 2018; 35:368-375. [PMID: 29247558 DOI: 10.1111/dme.13565] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 12/11/2022]
Abstract
AIMS To evaluate the application of the recently proposed recommendations by the European Association for the Study of the Liver, European Association for the Study of Diabetes and European Association for the Study of Obesity for the diagnosis, treatment and follow-up of non-alcoholic fatty liver disease in people with Type 2 diabetes. METHODS A total of 179 people with Type 2 diabetes were included in this study. Liver fat content (assessed using proton magnetic resonance spectroscopy), fatty liver index score, non-alcoholic fatty liver disease fibrosis score, and SteatoTest and FibroTest scores were determined. RESULTS According to proton magnetic resonance spectroscopy, 68.7% of participants had steatosis (liver fat content >5.5%). The application of the guidelines using several combinations (fatty liver index + non-alcoholic fatty liver disease fibrosis scores, Steatotest + FibroTest scores, proton magnetic resonance spectroscopy + non-alcoholic fatty liver disease fibrosis score, proton magnetic resonance spectroscopy + FibroTest) resulted in a referral to a liver clinic for 33.5-84.9% people with Type 2 diabetes. CONCLUSIONS The application of these new algorithms for the diagnosis, and follow-up of non-alcoholic fatty liver disease would lead to an excessive number of people with Type 2 diabetes being referred to a liver clinic. We suggest that new clinical and/or biological biomarkers of steatosis and fibrosis be specifically validated in people with Type 2 diabetes.
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Affiliation(s)
- A L Sberna
- University Bourgogne Franche-Comté, INSERM-LNC UMR 1231, Dijon, France
- Department of Diabetes and Endocrinology, CHU François Mitterand, Dijon, France
| | - B Bouillet
- University Bourgogne Franche-Comté, INSERM-LNC UMR 1231, Dijon, France
- Department of Diabetes and Endocrinology, CHU François Mitterand, Dijon, France
| | - A Rouland
- Department of Diabetes and Endocrinology, CHU François Mitterand, Dijon, France
| | - M C Brindisi
- University Bourgogne Franche-Comté, INSERM-LNC UMR 1231, Dijon, France
- Department of Diabetes and Endocrinology, CHU François Mitterand, Dijon, France
| | - A Nguyen
- Department of Diabetes and Endocrinology, CHU François Mitterand, Dijon, France
| | - T Mouillot
- Department of Diabetes and Endocrinology, CHU François Mitterand, Dijon, France
| | - L Duvillard
- University Bourgogne Franche-Comté, INSERM-LNC UMR 1231, Dijon, France
| | - D Denimal
- University Bourgogne Franche-Comté, INSERM-LNC UMR 1231, Dijon, France
| | - R Loffroy
- Department of Radiology, CHU François Mitterand, Dijon, France
| | - B Vergès
- University Bourgogne Franche-Comté, INSERM-LNC UMR 1231, Dijon, France
- Department of Diabetes and Endocrinology, CHU François Mitterand, Dijon, France
| | - P Hillon
- University Bourgogne Franche-Comté, INSERM-LNC UMR 1231, Dijon, France
| | - J M Petit
- University Bourgogne Franche-Comté, INSERM-LNC UMR 1231, Dijon, France
- Department of Diabetes and Endocrinology, CHU François Mitterand, Dijon, France
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Maillet T, Vinit J, Rouland A, Gandon C, Mausservey C. Polychondrite atrophiante associée à une méningite : à propos d’un cas de rémission sous immunosuppresseurs. Presse Med 2016; 45:938-939. [DOI: 10.1016/j.lpm.2016.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 04/25/2016] [Accepted: 06/05/2016] [Indexed: 11/29/2022] Open
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Maillet T, Nguyen-Baranoff D, Rouland A, Vinit J, Gandon C, Martha B, Salles E, Mausservey C. Pneumopathie interstitielle à l’azathioprine : à propos d’un nouveau cas et revue de la littérature. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.026] [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]
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