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Ossima AN, Brzustowski A, Paradis V, Van Beers B, Postic C, Laouénan C, Pol S, Castéra L, Gautier JF, Czernichow S, Vallet-Pichard A, Larger E, Serfaty L, Zins M, Valla D, Zaleski ID. Factors associated with high costs of patients with metabolic dysfunction-associated steatotic liver disease: an observational study using the French CONSTANCES cohort. Clin Diabetes Endocrinol 2024; 10:9. [PMID: 38659082 PMCID: PMC11044468 DOI: 10.1186/s40842-023-00163-4] [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: 08/28/2023] [Accepted: 12/07/2023] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND & AIMS Despite its high prevalence in the western world metabolic dysfunction-associated steatotic liver disease (MASLD) does not benefit from targeted pharmacological therapy. We measured healthcare utilisation and identified factors associated with high-cost MASLD patients in France. METHODS The prevalent population with MASLD (including non-alcoholic steatohepatitis) in the CONSTANCES cohort, a nationally representative sample of 200,000 adults aged between 18 and 69, was linked to the French centralised national claims database (SNDS). Study participants were identified by the fatty liver index (FLI) over the period 2015-2019. MASLD individuals were classified according as "high-cost" (above 90th percentile) or "non-high cost" (below 90th percentile). Factors significantly associated with high costs were identified using a multivariate logistic regression model. RESULTS A total of 14,437 predominantly male (69%) participants with an average age of 53 ± SD 12 years were included. They mainly belonged to socially deprived population groups with co-morbidities such as diabetes, high blood pressure, mental health disorders and cardiovascular complications. The average expenditure was €1860 ± SD 4634 per year. High-cost MASLD cost €10,863 ± SD 10,859 per year. Conditions associated with high-cost were mental health disorders OR 1.79 (1.44-2.22), cardiovascular diseases OR 1.54 (1.21-1.95), metabolic comorbidities OR 1.50 (1.25-1.81), and respiratory disease OR 1.50 (1.11-2.00). The 10% high-cost participants accounted for 58% of the total national health care expenditures for MASLD. CONCLUSION Our results emphasize the need for comprehensive management of the comorbid conditions which were the major cost drivers of MASLD.
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Affiliation(s)
- Arnaud Nze Ossima
- DRCI- Health economics, Assistance Publique-Hôpitaux de Paris, Hôpital de l'Hôtel Dieu, 75004, Paris, France
| | - Angélique Brzustowski
- Université Paris Cité, INSERM, Centre de recherche sur l'inflammation, F-75018, Paris, France
| | - Valérie Paradis
- Université Paris Cité, Paris, France AP-HP, Hôpital Beaujon, 92110 Clichy, France Service Anatomie et cytologie pathologiques, INSERM, Centre de recherche sur l'inflammation, F-75018, Paris, France
| | | | - Catherine Postic
- Université Paris Cité, INSERM, Centre de recherche sur l'inflammation, F-75018, Paris, France
| | - Cédric Laouénan
- Université Paris Cité, INSERM, IAME UMR 1137, Paris, France, AP-HP.Nord, Hôpital Bichat, Département d'Epidémiologie Biostatistique et Recherche Clinique, Paris, France
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, F-75018 Paris, France AP-HP, Hôpital Bichat Service DEBRC, 75018, Paris, France
| | - Stanislas Pol
- Liver department, Hôpital Cochin-APHP, Université Paris Cité, Paris, France
| | - Laurent Castéra
- Hepatology department, Hôpital Beaujon, AP-HP, Université Paris Cité, INSERM UMR 1149, CRI, Clichy, France
| | - Jean-François Gautier
- Université Paris Cité, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière group and Inserm U1151, Service de diabétologie et d'endocrinologie - Centre Universitaire du Diabète et de ses Complications, Paris, France
| | - Sebastien Czernichow
- Université de Paris-Cité and Université Sorbonne Paris Nord, Paris, France, Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France, Centre of Research in Epidemiology and Statistics (CRESS-U1153), Inserm, INRAE, Paris, France
| | | | - Etienne Larger
- Université Paris Cité, Diabetology department, Hôpital Cochin-APHP, Paris, France
| | - Lawrence Serfaty
- Université de Strasbourg, Hepatogastroenterology Service, Hôpital Hautepierre, Hôpitaux Universitaires de Strasbourg 67000, Strasbourg, France, INSERM UMR_S938, Sorbonne Université, Paris, France
| | - Marie Zins
- UMS 11 Inserm, Versailles-Saint Quentin University, Versailles, France
| | - Dominique Valla
- Université Paris Cité, INSERM, Centre de recherche sur l'inflammation, F-75018, Paris, France
- Service hépatologie, AP-HP, Hôpital Beaujon, 92110, Clichy, France
| | - Isabelle Durand Zaleski
- DRCI- Health economics, Assistance Publique-Hôpitaux de Paris, Hôpital de l'Hôtel Dieu, 75004, Paris, France.
- Universite Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, Service de Santé Publique, Henri Mondor-Albert- Chenevier, 94000 Créteil, France, Centre of Research in Epidemiology and Statistics (CRESS-U1153),Inserm, INRAE, Paris, France.
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2
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Bachelot G, Lamaziere A, Czernichow S, Faure C, Racine C, Levy R, Dupont C. Machine learning approach to assess the association between anthropometric, metabolic, and nutritional status and semen parameters. Asian J Androl 2024:00129336-990000000-00174. [PMID: 38624205 DOI: 10.4103/aja20247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/29/2024] [Indexed: 04/17/2024] Open
Abstract
ABSTRACT Many lifestyle factors, such as nutritional imbalance leading to obesity, metabolic disorders, and nutritional deficiency, have been identified as potential risk factors for male infertility. The aim of this study was to evaluate the relationship between semen parameters and anthropometric, metabolic and nutritional parameters. Relationship was first assessed individually, then after the application of a previously constructed and validated machine learning score that allows their combination. Anthropometric, metabolic, antioxidant, micronutrient, and sperm parameters from 75 men suffering from idiopathic infertility from four infertility centers in France (Jean-Verdier ART Center Hospital, Bondy; North Hospital ART Center, Saint-Étienne; Navarre Polyclinic ART Center, Pau; and Cochin Hospital ART Center, Paris) between September 2009 and December 2013 were collected. After assessing standard correlation analysis, a previously built machine learning model, providing a score ranging from 0 (the poorest) to 1 (the most favorable), was calculated for each man in the study cohort. This machine learning model, which separates infertile/fertile men with unexplained infertility on the basis of their bioclinical signature, provides a more holistic evaluation of the influence of the considered markers (anthropometric, metabolic, and oxidative status). We observed a significant correlation of some anthropometric, metabolic, and nutritional disorders with some sperm characteristics. Moreover, an unfavorable machine learning score was associated with a high level of sperm DNA fragmentation. Favorable anthropometric, metabolic, and oxidative patterns, which may reflect an appropriate lifestyle, appear to positively impact overall health, in particular reproductive function. This study, consistent with previous publications, suggests that beyond semen quality parameters, in an essential assessment of male fertility, other key factors should be taken into account. In this regard, the application of emerging artificial intelligence techniques may provide a unique opportunity to integrate all these parameters and deliver personalized care.
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Affiliation(s)
- Guillaume Bachelot
- Sorbonne University School of Medicine, Saint-Antoine Research Center, INSERM UMR 938, 27 rue Chaligny, Paris 75012, France
- Reproductive Biology Department-CECOS, Tenon Hospital, AP-HP.Sorbonne University, Paris 75020, France
- Clinical Metabolomics Department, Saint-Antoine Hospital, AP-HP, 27 rue Chaligny, Paris 75012, France
| | - Antonin Lamaziere
- Sorbonne University School of Medicine, Saint-Antoine Research Center, INSERM UMR 938, 27 rue Chaligny, Paris 75012, France
- Clinical Metabolomics Department, Saint-Antoine Hospital, AP-HP, 27 rue Chaligny, Paris 75012, France
| | - Sebastien Czernichow
- Nutrition Department, Obesity Specialist Centre, Georges Pompidou European Hospital, AP-HP, Paris 75015, France
| | - Celine Faure
- Reproductive Biology Department-CECOS, Tenon Hospital, AP-HP.Sorbonne University, Paris 75020, France
| | - Chrystelle Racine
- Sorbonne University School of Medicine, Saint-Antoine Research Center, INSERM UMR 938, 27 rue Chaligny, Paris 75012, France
| | - Rachel Levy
- Sorbonne University School of Medicine, Saint-Antoine Research Center, INSERM UMR 938, 27 rue Chaligny, Paris 75012, France
- Reproductive Biology Department-CECOS, Tenon Hospital, AP-HP.Sorbonne University, Paris 75020, France
| | - Charlotte Dupont
- Sorbonne University School of Medicine, Saint-Antoine Research Center, INSERM UMR 938, 27 rue Chaligny, Paris 75012, France
- Reproductive Biology Department-CECOS, Tenon Hospital, AP-HP.Sorbonne University, Paris 75020, France
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3
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Hansel B, Sabatier P, Kadouch D, Poghosyan T, Arapis K, Rives-Lange C, Czernichow S, Jannot AS, Carette C. Bariatric Surgery Should Be Proposed in Certain Septuagenarian Patients with Obesity. Obes Surg 2023; 33:2608-2610. [PMID: 37347397 DOI: 10.1007/s11695-023-06655-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023]
Abstract
Bariatric surgery (BS) is rarely performed on patients aged 70 and over, due to the fear of adverse effects, particularly related to sarcopenia. We examined the outcome of obese patients who underwent BS after the age of 69 in the French population. Operated subjects were matched with non-operated obese patients (n = 1307 in each group after matching). We showed that BS was associated with a reduction in mortality and no increase in the risks of rehospitalization or fracture events.
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Affiliation(s)
- Boris Hansel
- Unité de Nutrition-Prévention, Service de Chirurgie cardiaque, Université Paris Cité, AP-HP.Nord, Hôpital Bichat Claude Bernard, LVTS, UMR 1148, Inserm, 46 Rue Henri Huchard, Paris, France.
| | - Pierre Sabatier
- Université Paris Cité, AP-HP.Centre, Hôpital Européen Georges Pompidou, HeKA, UMR 1138, Centre de Recherche Des Cordeliers, Inserm, INRIA Paris, Paris, France
| | - Diana Kadouch
- Unité de Nutrition-Prévention, Service de Chirurgie cardiaque AP-HP.Nord, Hôpital Bichat Claude Bernard, Paris, France
| | - Tigran Poghosyan
- Université Paris Cité, AP-HP.Nord, Hôpital Bichat Claude Bernard, Service de Chirurgie DigestiveUMR 1149, Inserm, Paris, France
| | | | - Claire Rives-Lange
- Université Paris Cité, AP-HP.Centre, Hôpital Européen Georges Pompidou, Paris, France
- UMR1153, Inserm, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS Team, Paris, France
| | - Sebastien Czernichow
- Université Paris Cité, AP-HP.Centre, Hôpital Européen Georges-Pompidou, Service de Nutrition, Centre Spécialisé Obésité, Paris, France
- Université Paris Cité, AP-HP.Centre, Hôpital Européen Georges-Pompidou, Inserm, CIC1418, Paris, France
| | - Anne-Sophie Jannot
- Université Paris Cité, AP-HP.Centre, Hôpital Européen Georges Pompidou, HeKA, UMR 1138, Centre de Recherche Des Cordeliers, Inserm, INRIA Paris, Paris, France
| | - Claire Carette
- Université Paris Cité, AP-HP.Centre, Hôpital Européen Georges-Pompidou, Service de Nutrition, Centre Spécialisé Obésité, Paris, France
- Université Paris Cité, AP-HP.Centre, Hôpital Européen Georges-Pompidou, Inserm, CIC1418, Paris, France
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Baratte C, Willemetz A, Ribeiro-Parenti L, Carette C, Msika S, Bado A, Czernichow S, Le Gall M, Poghosyan T. Analysis of the Efficacy and the Long-term Metabolic and Nutritional Status of Sleeve Gastrectomy with Transit Bipartition Compared to Roux-en-Y Gastric Bypass in Obese Rats. Obes Surg 2023; 33:1121-1132. [PMID: 36729363 DOI: 10.1007/s11695-023-06477-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 01/12/2023] [Accepted: 01/19/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE Sleeve gastrectomy with transit bipartition (SG-TB) could be an attractive alternative to Roux-en-Y gastric bypass (RYGB) on weight loss and improvement of comorbidities in patients with obesity. However, there is little long-term data. Translational research on a rat model could allow long-term projection to assess efficacy and safety of SG-TB. The aim of this research was to evaluate the long-term efficacy and safety of SG-TB compared to RYGB and SHAM in rat model. MATERIALS AND METHODS Ninety-four male obese Wistar rats were distributed into 3 groups: SG-TB (n = 34), RYGB (n = 32), and SHAM (control group, n = 28). The percentage of total weight loss (%TWL), coprocalorimetry, glucose and insulin tolerance test, insulin, GLP-1, PYY, and GIP before and after surgery were assessed. The animals were followed over 6 months (equivalent to 16 years in humans). RESULTS At 6 months, %TWL was significantly greater(p = 0.025) in the SG-TB group compared to the RYGB group. There was no difference between the groups (p = 0.86) in malabsorption 15 and 120 days postoperatively. Glucose tolerance was significantly improved (p = 0.03) in the SG-TB and RYGB groups compared to the preoperative state. Insulin secretion, at 3 months, was significantly more important in the SG-TB group (p = 0.0003), compared to the RYGB and SHAM groups. GLP-1 secretion was significantly increased in the SG-TB and RYGB groups compared to the preoperative state (p = 0.001) but similar between SG-TB and RYGB animals (p = 0.72). CONCLUSION In a rat model, at long term compared to RYGB, SG-TB provides greater and better-maintained weight loss and an increased insulin secretion without impairing nutritional status.
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Affiliation(s)
- Clement Baratte
- Université de Paris Cité, F-75015, Paris, France.,INSERM, U1149, Centre de Recherche sur l'Inflammation, 75018, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de chirurgie digestive, œsogastrique et bariatrique, Centre Spécialisé Obésité (CSO) Ile de France Nord, Hôpital Bichat-Claude Bernard, 16 rue Henri Huchard, 75018, Paris, France
| | - Alexandra Willemetz
- Université de Paris Cité, F-75015, Paris, France.,INSERM, U1149, Centre de Recherche sur l'Inflammation, 75018, Paris, France
| | - Lara Ribeiro-Parenti
- Université de Paris Cité, F-75015, Paris, France.,INSERM, U1149, Centre de Recherche sur l'Inflammation, 75018, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de chirurgie digestive, œsogastrique et bariatrique, Centre Spécialisé Obésité (CSO) Ile de France Nord, Hôpital Bichat-Claude Bernard, 16 rue Henri Huchard, 75018, Paris, France
| | - Claire Carette
- Université de Paris Cité, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris, service de Nutrition, Centre Spécialisé Obésité (CSO) Ile de France Sud, Hôpital Européen Georges Pompidou, 75015, Paris, France
| | - Simon Msika
- Université de Paris Cité, F-75015, Paris, France.,INSERM, U1149, Centre de Recherche sur l'Inflammation, 75018, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de chirurgie digestive, œsogastrique et bariatrique, Centre Spécialisé Obésité (CSO) Ile de France Nord, Hôpital Bichat-Claude Bernard, 16 rue Henri Huchard, 75018, Paris, France
| | - Andre Bado
- Université de Paris Cité, F-75015, Paris, France.,INSERM, U1149, Centre de Recherche sur l'Inflammation, 75018, Paris, France
| | - Sebastien Czernichow
- Université de Paris Cité, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris, service de Nutrition, Centre Spécialisé Obésité (CSO) Ile de France Sud, Hôpital Européen Georges Pompidou, 75015, Paris, France.,Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004, Paris, France
| | - Maude Le Gall
- Université de Paris Cité, F-75015, Paris, France.,INSERM, U1149, Centre de Recherche sur l'Inflammation, 75018, Paris, France
| | - Tigran Poghosyan
- Université de Paris Cité, F-75015, Paris, France. .,INSERM, U1149, Centre de Recherche sur l'Inflammation, 75018, Paris, France. .,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de chirurgie digestive, œsogastrique et bariatrique, Centre Spécialisé Obésité (CSO) Ile de France Nord, Hôpital Bichat-Claude Bernard, 16 rue Henri Huchard, 75018, Paris, France.
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5
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Carette C, Rives-Lange C, Czernichow S. Medications for the treatment of obesity. J Visc Surg 2023; 160:S12-S14. [PMID: 36725455 DOI: 10.1016/j.jviscsurg.2022.12.002] [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] [Indexed: 01/31/2023]
Abstract
After several years with no real therapeutic alternatives, the management of obesity is entering a new era with the development of new surgical and endoscopic bariatric techniques, digital therapeutics and the arrival of new classes of drugs. New medication treatments aim to reduce food intake, targeting the hypothalamic regulation of food intake and satiety. The mechanism of their action remains poorly understood but, combines weight reduction and amelioration of cardiometabolic risk factors with a favorable benefit-risk balance and known side effects, mainly digestive. The future will tell us how these drugs will find their place in the management of this chronic disease that is obesity.
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Affiliation(s)
- C Carette
- Paris Cité University, Nutrition Department, Specialized Obesity Center, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, Paris, France
| | - C Rives-Lange
- Paris Cité University, Nutrition Department, Specialized Obesity Center, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, Paris, France
| | - S Czernichow
- Paris Cité University, Nutrition Department, Specialized Obesity Center, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, Paris, France.
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Rives-Lange C, Zimmer A, Merazka A, Carette C, Martins-Bexinga A, Hauw-Berlemont C, Guerot E, Jannot A, Diehl J, Czernichow S, Hermann B. Evolution of the nutritional status of COVID-19 critically-ill patients: A prospective observational study from ICU admission to three months after ICU discharge. Clin Nutr 2022; 41:3026-3031. [PMID: 34134915 PMCID: PMC8142813 DOI: 10.1016/j.clnu.2021.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 03/11/2021] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Malnutrition following intensive care unit (ICU) stay is frequent and could be especially prominent in critically ill Coronavirus Disease 2019 (COVID-19) patients as they present prolonged inflammatory state and long length stay. We aimed to determine the prevalence of malnutrition in critically ill COVID-19 patients both at the acute and recovery phases of infection. METHODS We conducted a prospective observational study including critically ill COVID-19 patients requiring invasive mechanical ventilation discharged alive from a medical ICU of a university hospital. We collected demographic, anthropometric and ICU stay data (SAPS2, recourse to organ support and daily energy intake). Nutritional status and nutritional support were collected at one month after ICU discharge (M1) by phone interview and at 3 months after ICU discharge (M3) during a specialized and dedicated consultation conducted by a dietitian. Malnutrition diagnosis was based on weight loss and body mass index (BMI) criteria following the Global Leadership Initiative on Malnutrition. Primary outcome was the prevalence of malnutrition at M3 and secondary outcomes were the evolution of nutritional status from ICU admission to M3 and factors associated with malnutrition at M3. RESULTS From march 13th to may 15th, 2020, 38 patients were discharged alive from the ICU, median [IQR] age 66 [59-72] years, BMI 27.8 [25.5-30.7] kg/m2 and SAPS2 47 [35-55]. Thirty-three (86%) patients were followed up to M3. Prevalence of malnutrition increased during the ICU stay, from 18% at ICU admission to 79% at ICU discharge and then decreased to 71% at M1 and 53% at M3. Severe malnutrition prevailed at ICU discharge with a prevalence of 55% decreasing 32% at M3. At M3, the only factors associated with malnutrition in univariate analysis were the length of invasive mechanical ventilation and length of ICU stay (28 [18-44] vs. 13 [11-24] days, P = 0.011 and 32 [22-48] vs. 17 [11-21] days, P = 0.006, respectively), while no ICU preadmission and admission factors, nor energy and protein intakes distinguished the two groups. Only 35% of undernourished patients at M3 had benefited from a nutritional support. CONCLUSION Malnutrition is frequent, protracted and probably underrecognized among critically ill Covid-19 patients requiring invasive mechanical ventilation with more than half patients still being undernourished three months after ICU discharge. A particular attention should be paid to the nutritional status of these patients not only during their ICU stay but also following ICU discharge.
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Affiliation(s)
- C. Rives-Lange
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France,Université de Paris, F-75015, Paris, France,METHODS Team, INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France,Corresponding author. Service de Nutrition, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris, France
| | - A. Zimmer
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France
| | - A. Merazka
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France
| | - C. Carette
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France,Université de Paris, F-75015, Paris, France,Assistance Publique-Hôpitaux de Paris (APHP), Centre D’Investigation Clinique, INSERM, U1418, Hôpital Européen Georges Pompidou, Paris, France
| | - A. Martins-Bexinga
- Université de Paris, F-75015, Paris, France,METHODS Team, INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France
| | - C. Hauw-Berlemont
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Réanimation Médicale, Hôpital Européen Georges Pompidou, Paris, France
| | - E. Guerot
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Réanimation Médicale, Hôpital Européen Georges Pompidou, Paris, France
| | - A.S. Jannot
- Université de Paris, F-75015, Paris, France,Assistance Publique-Hôpitaux de Paris (AP-HP), Service D'informatique Médicale, Biostatistiques et Santé Publique, Hôpital Européen Georges Pompidou, Paris, France
| | - J.L. Diehl
- Université de Paris, F-75015, Paris, France,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Réanimation Médicale, Hôpital Européen Georges Pompidou, Paris, France,Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique - Hôpitaux de Paris-Centre (APHP-CUP), F-75015, Paris, France
| | - S. Czernichow
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Hôpital Européen Georges Pompidou, Paris, France,Université de Paris, F-75015, Paris, France,METHODS Team, INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France
| | - B. Hermann
- Université de Paris, F-75015, Paris, France,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Réanimation Médicale, Hôpital Européen Georges Pompidou, Paris, France,Institut Du Cerveau et de La Moelle épinière - ICM, Inserm U1127, CNRS UMR 7225, F-75015, Paris, France
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7
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Poghosyan T, Bertrand T, Rives-Lange C, Krivan S, Baratte C, Le Gall M, Czernichow S, Chevallier JM. Reply to Letter to the Editor: France and One Anastomosis Gastric Bypass (OAGB): a "Witch Hunt". Obes Surg 2022; 32:3773-3774. [PMID: 36068423 DOI: 10.1007/s11695-022-06263-x] [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] [Received: 08/24/2022] [Revised: 08/24/2022] [Accepted: 09/01/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Tigran Poghosyan
- Université de Paris Cité, F-75015, Paris, France. .,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Chirurgie Digestive, Oncologique et Bariatrique, Hôpital Européen Georges Pompidou, Paris, France.
| | - Thibaud Bertrand
- Université de Paris Cité, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Chirurgie Digestive, Oncologique et Bariatrique, Hôpital Européen Georges Pompidou, Paris, France
| | - Claire Rives-Lange
- Université de Paris Cité, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France
| | - Sylvia Krivan
- 2nd Department of General Surgery, Upper Digestive Tract Surgery Center, IASO Group (General clinic), Athens, Greece
| | - Clement Baratte
- Université de Paris Cité, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Chirurgie Digestive, Oncologique et Bariatrique, Hôpital Européen Georges Pompidou, Paris, France
| | - Maude Le Gall
- Université de Paris Cité, F-75015, Paris, France.,Inserm UMRS 1149, Paris, France
| | - Sebastien Czernichow
- Université de Paris Cité, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France
| | - Jean-Marc Chevallier
- Université de Paris Cité, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Chirurgie Digestive, Oncologique et Bariatrique, Hôpital Européen Georges Pompidou, Paris, France
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8
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Sermondade N, Dupont C, Faure C, Léger D, Czernichow S, Lévy R, Caetano G. P-687 Sleep parameters and sleep disorders in male and female subjects presenting idiopathic infertility: the ALIFERT case-control study. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
To evaluate the association between sleep parameters, sleep disorders and idiopathic infertility.
Summary answer
Some sleep parameters, such as bedtime, sleep latency and chronotypes, might be associated with male and female fertility.
What is known already
Some studies suggested that sleep might play an important role in reproductive health. Short sleep duration might interfere with the menstrual cycle, sperm parameters or natural fertility. The biological clock chronotype was found to be associated with fertility, with altered sperm parameters in the “evening” type and more reproductive troubles in the “intermediate” type when compared to the “morning” type. Irregular and night work schedules were also associated with some degree of fertility dysfunction, such as irregular menstrual cycles, a longer time to pregnancy, or male infertility. However, the interrelations between sleep and fertility are not fully elucidated.
Study design, size, duration
Fertile and infertile couples were recruited in the ALIFERT cross-sectional case–control multicentric study, between September 2009 and December 2013. The study group consisted of 94 infertile men and 95 infertile women, presenting with a primary idiopathic infertility of more than 12 months. The control group consisted in 85 fertile men and 86 fertile women who had a spontaneously conceived child under 2 years of age with a time to pregnancy less than 12 months.
Participants/materials, setting, methods
Male and female participants answered the French version of the Pittsburgh Sleep Quality Index, including questions about sleep timing and duration and symptoms of sleep disorders. Sleep parameters were compared between infertile and fertile participants for each sex, and between partners. The Wilcoxon-Mann-Whitney test was used to compare differences in sleep parameters due to a non-normal distribution, and the Fisher's exact test was used for qualitative variables.
Main results and the role of chance
Bedtime was significantly later for infertile compared to fertile male participants (p = 0.03). Infertile female participants had significantly later wake time, greater sleep latency and sleep apnea symptoms compared to fertile female participants (p ≤ 0.02). Fertile participants of both sexes were more frequently moderate morning types compared to infertile participants (p ≤ 0.04). No differences were observed regarding total sleep time, time spent in bed, sleep efficacy, insomnia, hypersomnia, or periodic leg movement symptoms. Infertile couples had more frequently different chronotypes than fertile couples (p = 0.02). Differences in wake time between partners were significantly greater among infertile couples (p < 0.01), but no differences were observed for bedtime, time spent in bed and total sleep time (p ≥ 0.22).
Limitations, reasons for caution
Sleep parameters were evaluated based on self-reported questionnaire. Further studies including objective measures of sleep will be needed to allow a more objective determination of sleep parameters. A discussion about mechanistic hypothesis should also be considered to better understand the links between sleep and fertility.
Wider implications of the findings
Sleep could be an original and innovative parameter to consider in the reproduction field. Further investigation is needed to elucidate how sleep and reproductive functions are interrelated and how sleep might constitute a useful modifiable target in infertility management.
Trial registration number
NCT01093378
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Affiliation(s)
- N Sermondade
- Hopital Tenon- AP-HP, Biologie de la Reproduction - CECOS , Paris, France
| | - C Dupont
- Hopital Tenon- AP-HP, Biologie de la Reproduction - CECOS , Paris, France
| | - C Faure
- Hopital Tenon- AP-HP, Biologie de la Reproduction - CECOS , Paris, France
| | - D Léger
- Hôtel-Dieu- AP-HP, Centre du sommeil et de la vigilance , Paris, France
| | - S Czernichow
- Hôpital Européen Georges Pompidou- AP-HP , Service de Nutritio, Paris, France
| | - R Lévy
- Hopital Tenon- AP-HP, Biologie de la Reproduction - CECOS , Paris, France
| | - G Caetano
- Hôtel-Dieu- AP-HP, Centre du sommeil et de la vigilance , Paris, France
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9
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Rives-Lange C, Poghosyan T, Rassy N, Carette C, Phan A, Goeau-Brissonnière M, de Castelbajac F, Merazka A, Czernichow S. The future of bariatric surgery research: A worldwide mapping of registered trials. Obes Rev 2022; 23:e13433. [PMID: 35174619 DOI: 10.1111/obr.13433] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/16/2021] [Accepted: 12/16/2021] [Indexed: 11/27/2022]
Abstract
The bariatric surgery (BS) research landscape is a continuous evolving. Since the first described procedure, numerous different techniques have been developed by surgical teams. In this context, we conducted a systematic mapping of upcoming randomized controlled trials (RCTs) in BS for people with obesity. In June 2021, we performed a systematic review of RCTs evaluating BS versus another surgical procedure or versus a medical control group, through a search in ClinicalTrials.gov. There was no restriction on outcomes for study selection. A total of 62 RCTs were included, totaling 10,800 potential individuals to be included, with planned Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy surgeries the most common. The median number of patients planned to be enrolled is 78 (IQR: 50-143). Mean follow-up time is 12 months in 55% of trials and 4 years or more in 23%. The most frequent (81% of RCTs) outcomes to be investigated are obesity-related diseases with the study of type 2 diabetes, followed by weight loss, quality of life, and surgical complications. The rising number of BS procedures around the world has been followed by a subsequent surge in BS research. An increase in interest is observed in outcomes such as obesity-related diseases, intermediate metabolic markers, quality of life, and body composition.
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Affiliation(s)
- Claire Rives-Lange
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France.,University of Paris, Paris, France.,INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France
| | - Tigran Poghosyan
- University of Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Digestive Surgery, European Hospital Georges Pompidou, Paris, France
| | - Nathalie Rassy
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - Claire Carette
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France.,University of Paris, Paris, France.,Clinical Investigation Center 1418, Assistance Publique-Hôpitaux de Paris (AP-HP), European Hospital Georges Pompidou, Paris, France
| | - Aurelie Phan
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France
| | - Marc Goeau-Brissonnière
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France
| | - Flore de Castelbajac
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France
| | - Amel Merazka
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France
| | - Sebastien Czernichow
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France.,University of Paris, Paris, France.,INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France
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10
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Soubrier M, Viguier M, Peyrin-Biroulet L, Czernichow S. AB1457 OPALE: A PROSPECTIVE OBSERVATIONAL STUDY OF THE REAL-WORLD USE OF AN ADALIMUMAB BIOSIMILAR AND EVALUATION OF NUTRITIONAL STATUS ON THE THERAPEUTIC RESPONSE. PATIENTS NUTRITIONAL STATUS AT BASELINE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundChronic inflammatory diseases treatment has been greatly improved since the introduction of TNF inhibitors and later, of their biosimilars. In addition, epidemiological and interventional studies suggest a pathophysiological or therapeutic role, respectively, of nutrition in Inflammatory Rheumatic Diseases (IRDs).ObjectivesThe objective of the OPALE observational study was to describe in real life the profile of patients treated with an adalimumab biosimilar and to assess the impact of nutrition on disease evolution and response to treatment.MethodsThe study planned a one-year follow-up of patients with at least three visits: inclusion, six months and one year. In this study, 754 patients treated with Fresenius-Kabi adalimumab were included: 54.4 % of patients with an IRD, 42.8 % with Inflammatory Bowel Disease (IBD) and 2.8 % patients with a psoriasis. Patients’ condition was assessed using a Clinical Global Impression of disease scale (CGI, primary end point of the study). Nutritional status was assessed through clinical data (weight, BMI (Body Mass Index), abdominal circumference) and the available biological analyses results. Screening for sarcopenia was based on a SARC-F score ≥ 4. Nutritional behavior was assessed using a diet questionnaire with a list of 48 foods divided into 6 classes (Fruits & vegetables, meat, fish & eggs, dairy products & fats, starchy foods, sweet foods and drinks). Foods voluntarily withdrawn due to illness and those avoided at acute flare-ups were recommended to be reported. This analysis aims to describe IRD patients’ nutritional status at baseline.ResultsFrom 754 included patients, 410 patients presented with an IRD (Psoriatic Arthritis (PsA), n= 80 / Rheumatoid Arthritis (RA), n=102 / SpondyloArthritis (SpA), n=228). Mean patients’ age was 47.7± 14.1 years, 56% are female, mean BMI was 26.0 ± 5.4 kg/m2. From this IRD population, 28.5% of patients have a family history of chronic inflammatory disease.Mean disease duration was of 6.4 ± 8.4 years. Concerning the previous IRD treatment, 47.4% of patients had previously been treated by methotrexate among them 58% were still receiving this treatment at inclusion. Among IRD patients recruited in OPALE study, 72.8% received Fresenius Kabi adalimumab as their first biotherapy. Most of patients were assessed on the CGI scale as markedly ill (50.7%) or moderately ill (29.9%) and 110 patients (37.3%) had a score ≥ 4 on the SARC-F questionnaire (mean age 48.9 ± 14.1 years and mean BMI 27.2 ±5.6 kg/m2).Concerning the disease history at baseline, the descriptive analysis of self-administered questionnaire shows that 68.3% of patients may have changed their nutritional behavior because of their illness, by banishing several foods (mean number: 12.7 ± 10.1). These restrictions are increased during flare-ups: 32.7% of patients removed an average of 6.0 ± 5.8 additional foods number. These changes are in part based on the patients’ own beliefs: 17% of them consider that certain foods can improve their illness, 35% of patients think they have identified the foods likely to make it worse (Table 1).Table 1.Patient-reported influence of certain foods on diseasePsARASpATOTAL IRD(n=60)(n=72)(n=177)(n=309)Patients identifying foods with negative influence21225810137.5% [24.9% - 51.5%]32.4% [21.5% - 44.8%]36.0% [28.6% - 44.0%]35.4% [29.9% - 41.3%]Patients identifying foods with positive influence912274816.4% [7.8% - 28.8%]17.6% [9.5% - 28.8%]17.2% [11.7% - 24.0%]17.1% [12.9% - 22.1%]ConclusionThese preliminary baseline data from OPALE observational study confirm the risk of decreased muscle mass in IRD. Mean BMI of patients screened for sarcopenia is higher than that of non-sarcopenic patients (respectively 27.2 ± 5.6 kg/m2 and 25.6 ± 4.8 kg/m2; p=0.02). These results plead for a systematic screening for sarcopenia in IRD patients. The risk of sarcopenia could be further aggravated by inappropriate nutritional behaviors aimed at excluding food groups, which would justify dietary education of these IRD patients.Disclosure of InterestsMartin SOUBRIER Consultant of: Fresenius Kabi, Manuelle VIGUIER Consultant of: Fresenius Kabi, Laurent Peyrin-Biroulet Consultant of: Fresenius Kabi, Sebastien Czernichow Consultant of: Fresenius Kabi
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11
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Rives-Lange C, Rassy N, Carette C, Phan A, Barsamian C, Thereaux J, Moszkowicz D, Poghosyan T, Czernichow S. Seventy years of bariatric surgery: A systematic mapping review of randomized controlled trials. Obes Rev 2022; 23:e13420. [PMID: 35040249 DOI: 10.1111/obr.13420] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 09/16/2021] [Revised: 12/12/2021] [Accepted: 12/12/2021] [Indexed: 12/31/2022]
Abstract
While research publications on bariatric surgery (BS) have grown significantly over the past decade, there is no mapping of the existing body of evidence on this field of research. We performed a systematic review followed by a mapping of randomized controlled trials (RCTs) in BS for people with obesity. From January 2020 to December 2020, we performed a systematic review of RCTs evaluating BS, versus another surgical procedure, or versus a medical control group, through a search of Embase and PubMed. There was no restriction on outcomes for study selection. A total of 114 RCTs were included, most (73.7%) of which were based on a comparison with Roux-en-Y gastric bypass (RYGB) and conducted between 2010 and 2020. Only 15% of the trials were multicenter and few (3.5%) were international. The median number of patients enrolled was 61 (interquartile range [IQR]: 47.3-100). Follow-up time was 1 to 2 years in 36% and 22.8% of the trials, respectively. Weight loss was the most studied criterion (87% of RCTs), followed by obesity-related diseases, and medical and surgical complications (73%, 54%, and 47% of RCTs, respectively). Nutritional deficiency frequency, body composition, and mental health were little studied (20%, 18% and 5% of RCTs, respectively). Our literature review revealed that much research in BS is wasted because of replication of RCTs on subjects for which there is already body of evidence, with small populations and follow-up times mostly below 2 years. Yet several research questions remain unaddressed, and there are few long-term trials. Future studies should take into account the experience of the past 70 years of research in this field.
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Affiliation(s)
- Claire Rives-Lange
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France.,University of Paris, Paris, France.,INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France
| | - Nathalie Rassy
- Department of Cancer Medicine, Gustave Roussy, Paris, France
| | - Claire Carette
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France.,University of Paris, Paris, France.,Clinical Investigation Center 1418, Assistance Publique-Hôpitaux de Paris (AP-HP), European Hospital Georges Pompidou, Paris, France
| | - Aurelie Phan
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France
| | - Charles Barsamian
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France
| | - Jeremie Thereaux
- Department of General, Digestive and Metabolic Surgery, La Cavale Blanche University Hospital, Brest, France
| | - David Moszkowicz
- University of Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Digestive Surgery, Louis-Mourier Hospital, Paris, France
| | - Tigran Poghosyan
- University of Paris, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Digestive Surgery, European Hospital Georges Pompidou, Paris, France
| | - Sebastien Czernichow
- Assistance Publique-Hôpitaux de Paris (AP-HP), Nutrition Department, European Hospital Georges Pompidou, Paris, France.,University of Paris, Paris, France.,INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France
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12
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Rives-Lange C, Rassy N, Carette C, Phan A, Barsamian C, Thereaux J, Moszkowicz D, Poghosyan T, Czernichow S. Soixante-dix ans de chirurgie bariatrique : une revue systématique des essais contrôlés randomisés. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Peyrin-Biroulet L, Soubrier M, Viguier M, Czernichow S. Étude observationnelle évaluant l’état nutritionnel de patients atteints d’une maladie inflammatoire chronique et traités par un biosimilaire de l’adalimumab. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Okamba-Belle D, Fayol A, Wack M, Hirlemann M, Domenge O, Jannot AS, Czernichow S, Hulot JS, Carette C. Dépistage de l’insuffisance cardiaque par dosage systématique du BNP dans une cohorte de patients avec obésité sévère : étude OLECOEUR. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.165] [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: 11/29/2022]
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15
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Tarhini A, Rives-Lange C, Jannot AS, Baratte C, Beaupel N, Guillet V, Krivan S, Le Gall M, Carette C, Czernichow S, Chevallier JM, Poghosyan T. One-Anastomosis Gastric Bypass Revision for Gastroesophageal Reflux Disease: Long Versus Short Biliopancreatic Limb Roux-en-Y Gastric Bypass. Obes Surg 2022; 32:970-978. [PMID: 35037131 DOI: 10.1007/s11695-022-05892-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 12/19/2022]
Abstract
PURPOSE One-anastomosis gastric bypass (OAGB) may be associated with refractory gastroesophageal reflux disease (GERD). The nature of this GERD remains unclear. This complication can be treated either with an additional enteroenterostomy without shortening of gastric pouch (long biliopancreatic limb Roux-en-Y gastric bypass (L-BPL-RYGB)) or revision to conventional short biliopancreatic limb Roux-en-Y gastric bypass (S-BPL-RYGB). The objective of this study is to compare the aforementioned procedures in terms of efficacy on GERD symptoms. MATERIALS AND METHODS Retrospective analysis between October 2012 and June 2020. RESULTS Fifty-two patients underwent OAGB revision to S-BPL-RYGB (n = 21) or L-BPL-RYGB (n = 31) secondary to GERD. Investigation with pH impedance prior to revision was performed in 15 patients showing biliary reflux (BR) in 7 (46.6%), acid reflux (AR) in 6 (40%), and no confirmation in 2. Patients with AR had a revision to S-BPL-RYGB, whereas patients with BR underwent L-BPL-RYGB. Among the patients without pH metry results (n = 37), S-BPL-RYGB was performed for associated disabling digestive disorders or nutritional deficiencies. GERD was treated in 68% of patients with L-BPL-RYGB versus 95% of patients after S-BPL-RYGB. Patients, whose decision for revisional procedure was based on the results of pH impedance testing, did not reveal refractory GERD. CONCLUSION L-BPL-RYGB seems appropriate in patients with BR, whereas conversion to S-BPL-RYGB should be preferred if AR is present.
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Affiliation(s)
- Ahmad Tarhini
- Université de Paris, 75015, Paris, France.,Service de Chirurgie Digestive, Oncologique et Bariatrique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | - Claire Rives-Lange
- Université de Paris, 75015, Paris, France.,Service de Nutrition, Centre Spécialisé Obésité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | - Anne-Sophie Jannot
- Université de Paris, 75015, Paris, France.,Service d'informatique Médicale, Biostatistiques et Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | - Clement Baratte
- Université de Paris, 75015, Paris, France.,Service de Chirurgie Digestive, Oncologique et Bariatrique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | | | - Vincent Guillet
- Université de Paris, 75015, Paris, France.,Service de Chirurgie Digestive, Oncologique et Bariatrique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | - Sylvia Krivan
- Department of Digestive Surgery, Royal Derby Hospital, Derby, UK
| | - Maude Le Gall
- Université de Paris, 75015, Paris, France.,Inserm UMRS 1149, Paris, France
| | - Claire Carette
- Université de Paris, 75015, Paris, France.,Service de Nutrition, Centre Spécialisé Obésité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | - Sebastien Czernichow
- Université de Paris, 75015, Paris, France.,Service de Nutrition, Centre Spécialisé Obésité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,Inserm, Information Sciences To Support Personalized Medicine, Cordeliers Research Center, Paris, France
| | - Jean-Marc Chevallier
- Université de Paris, 75015, Paris, France.,Service de Chirurgie Digestive, Oncologique et Bariatrique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France
| | - Tigran Poghosyan
- Université de Paris, 75015, Paris, France. .,Service de Chirurgie Digestive, Oncologique et Bariatrique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France. .,Inserm UMRS 1149, Paris, France.
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16
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Kachaner A, Rives-Lange C, Radu A, Czernichow S, Ranque B, Pouchot J, Lafont E. Ketoacidosis in a non-diabetic lactating woman: A case report and literature review. Eur J Clin Nutr 2021; 76:775-777. [PMID: 34675399 DOI: 10.1038/s41430-021-01013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 09/15/2021] [Indexed: 11/09/2022]
Abstract
We report the case of a 36-year-old woman who developed non-diabetic ketoacidosis following a low carbohydrate diet in order to lose weight while actively breast feeding her newborn. She was admitted in intensive care unit because of severe metabolic acidosis. She rapidly recovered after refeeding process. Lactation ketoacidosis, a special condition that occurs in non-diabetic breastfeeding women, is rare and life-threatening. This report highlights the importance of nutritional education of lactating women in the post-partum period.
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Affiliation(s)
- Alexandra Kachaner
- Université de Paris, Paris, France.,Service de médecine interne, Hôpital Européen Georges-Pompidou, Paris, France
| | - Claire Rives-Lange
- Université de Paris, Paris, France.,Service de nutrition, Hôpital Européen Georges-Pompidou, Paris, France
| | - Alina Radu
- Université de Paris, Paris, France.,Service de nutrition, Hôpital Européen Georges-Pompidou, Paris, France
| | - Sebastien Czernichow
- Université de Paris, Paris, France.,Service de nutrition, Hôpital Européen Georges-Pompidou, Paris, France
| | - Brigitte Ranque
- Université de Paris, Paris, France.,Service de médecine interne, Hôpital Européen Georges-Pompidou, Paris, France
| | - Jacques Pouchot
- Université de Paris, Paris, France.,Service de médecine interne, Hôpital Européen Georges-Pompidou, Paris, France
| | - Emmanuel Lafont
- Université de Paris, Paris, France. .,Service de médecine interne, Hôpital Européen Georges-Pompidou, Paris, France.
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Hamieh N, Descatha A, Zins M, Goldberg M, Czernichow S, Plessz M, Roquelaure Y, Lemogne C, Matta J, Airagnes G. Physical exertion at work and addictive behaviors: tobacco, cannabis, alcohol, sugar and fat intake. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
This study examined the prospective association of physical exertion at work with risk of tobacco, cannabis, alcohol use and sugar and fat consumption.
Methods
Volunteers of the French population-based CONSTANCES cohort currently employed were included from 2012 to 2017 for tobacco and cannabis outcomes (n = 100,612), and from 2012 to 2016 for alcohol and sugar and fat outcomes (n = 75,414). High level of physical exertion was defined as a score ≥12 at the Rating Perceived Exertion Borg scale. Substance use was self-reported and patterns of sugar and fat intakes were obtained from principal component analysis and used in quartiles. Generalized linear models computed odds of substance use and sugar and fat consumption at follow-up according to baseline physical exertion at work, while adjusting for sociodemographic factors, depressive symptoms and baseline level of consumption.
Results
High physical exertion was associated with tobacco use, i.e.: increased odd of relapse in former smokers (OR = 1.13, 95% confidence interval (CI):1.02-1.24), and increased number of cigarettes per day in current smokers (OR = 1.54, 95%CI:1.33-1.78) with dose-dependent relationships (P for trend<0.001). It was also associated with increased odd of cannabis use at least once per month compared to no use in the past year (OR = 1.31, 95%CI:1.03-1.66) and with increased odds of sugar and fat consumption (OR = 1.06, 95%CI:1.01-1.11 and OR = 1.13, 95%CI:1.07-1.18, for third and fourth quartiles compared to the first, respectively).
Conclusions
The associations between physical exertion at work and subsequent tobacco and cannabis use and sugar and fat consumption should be taken into account for information and prevention strategies.
Key messages
The associations between physical exertion at work and subsequent tobacco and cannabis use and sugar and fat consumption should be taken into account for information and prevention strategies. High physical exertion at work was positively associated with subsequent tobacco and cannabis use and sugar and fat consumption.
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Affiliation(s)
- N Hamieh
- DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France
| | - A Descatha
- Poison Control Center, Academic Hospital CHU Angers, Angers, France
- UMR_S 1085, University of Angers, Centre Hospitalier Universitaire d'Angers, Université de Rennes, INSERM, École des Hautes Études en Santé Publique, Institut de Recherche en Santé, Environnement et Travail, Angers, France
| | - M Zins
- Population-based Epidemiological Cohorts Unit, UMS 011, INSERM, Villejuif, France
- Faculty of Health, School of Medicine, Université de Paris, Paris, France
| | - M Goldberg
- Population-based Epidemiological Cohorts Unit, UMS 011, INSERM, Villejuif, France
- Faculty of Health, School of Medicine, Université de Paris, Paris, France
| | - S Czernichow
- Faculty of Health, School of Medicine, Université de Paris, Paris, France
- Service de Nutrition, AP-HP.Centre-Université de Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - M Plessz
- Centre Maurice Halbwachs, UMR 8097, INRAE, Paris, France
| | - Y Roquelaure
- Centre de Consultations de Pathologie Professionnelle, University of Angers, Centre Hospitalier Universitaire d'Angers, Université de Rennes, Angers, France
- UMR_S 1085, INSERM, EHESP, Irset, Angers, France
| | - C Lemogne
- UMR_S1266, Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l’adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - J Matta
- Population-based Epidemiological Cohorts Unit, UMS 011, INSERM, Villejuif, France
| | - G Airagnes
- DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France
- Population-based Epidemiological Cohorts Unit, UMS 011, INSERM, Villejuif, France
- Faculty of Health, School of Medicine, Université de Paris, Paris, France
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18
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Mellon G, Hammas K, Burdet C, Duval X, Carette C, El-Helali N, Massias L, Mentré F, Czernichow S, Crémieux AC. Population pharmacokinetics and dosing simulations of amoxicillin in obese adults receiving co-amoxiclav. J Antimicrob Chemother 2021; 75:3611-3618. [PMID: 32888018 DOI: 10.1093/jac/dkaa368] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/27/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pneumonia, skin and soft tissue infections are more frequent in obese patients and are most often treated by co-amoxiclav, using similar dosing regimens to those used for non-obese subjects. No data are available on amoxicillin pharmacokinetics among obese subjects receiving co-amoxiclav. MATERIALS AND METHODS Prospective, single-centre, open-label, non-randomized, crossover pharmacokinetic trial having enrolled obese otherwise healthy adult subjects. A first dose of co-amoxiclav (amoxicillin/clavulanate 1000/200 mg) was infused IV over 30 min, followed by a second dose (1000/125 mg) administered orally, separated by a washout period of ≥24 h. We assayed concentrations of amoxicillin by a validated ultra HPLC-tandem MS technique. We estimated population pharmacokinetic parameters of amoxicillin by non-linear mixed-effect modelling using the SAEM algorithm developed by Monolix. RESULTS Twenty-seven subjects were included in the IV study, with 24 included in the oral part of the study. Median body weight and BMI were 109.3 kg and 40.6 kg/m2, respectively. Amoxicillin pharmacokinetics were best described by a two-compartment model with first-order elimination. Mean values for clearance, central volume, intercompartmental clearance and peripheral volume were, respectively, 14.6 L/h, 9.0 L, 4.2 L/h and 6.4 L for amoxicillin. Oral bioavailability of amoxicillin was 79.7%. Amoxicillin Cmax after oral administration significantly reduced with weight (P = 0.013). Dosing simulations for amoxicillin predicted that most of the population will achieve the pharmacodynamic target of fT>MIC ≥40% with the regimen of co-amoxiclav 1000/200 mg (IV) or 1000/125 mg (oral) q8h for MICs titrated up to 0.5 mg/L (IV) and 1 mg/L (oral). CONCLUSIONS Pharmacokinetic/pharmacodynamic goals for amoxicillin can be obtained in obese subjects.
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Affiliation(s)
- G Mellon
- AP-HP, Tropical and Infectious Diseases department, Hôpital Saint-Louis, Paris, France
| | - K Hammas
- CIC-EC 1425, INSERM, F-75018 Paris, France.,AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France
| | - C Burdet
- CIC-EC 1425, INSERM, F-75018 Paris, France.,AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France.,Université de Paris, IAME, INSERM, F-75018 Paris, France
| | - X Duval
- CIC-EC 1425, INSERM, F-75018 Paris, France.,Université de Paris, IAME, INSERM, F-75018 Paris, France
| | - C Carette
- AP-HP, Nutrition department, Hôpital Georges-Pompidou, Paris, France
| | - N El-Helali
- Microbiology Laboratory, Hôpital Paris Saint Joseph, Paris, France
| | - L Massias
- Université de Paris, IAME, INSERM, F-75018 Paris, France.,AP-HP, Toxicology Laboratory, Hôpital Bichat, Paris, France
| | - F Mentré
- CIC-EC 1425, INSERM, F-75018 Paris, France.,AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France.,Université de Paris, IAME, INSERM, F-75018 Paris, France
| | - S Czernichow
- AP-HP, Nutrition department, Hôpital Georges-Pompidou, Paris, France.,Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France
| | - A-C Crémieux
- AP-HP, Tropical and Infectious Diseases department, Hôpital Saint-Louis, Paris, France
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19
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Poghosyan T, Rives-Lange C, Carette C, Girardeau Y, Jannot AS, Czernichow S. Time of Bariatric Surgery and Hospitalization for SARS-CoV-2: a Nationwide Study. Obes Surg 2021; 31:3893-3895. [PMID: 33934296 PMCID: PMC8088484 DOI: 10.1007/s11695-021-05449-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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Tigran Poghosyan
- Université de Paris, F-75015, Paris, France. .,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Chirurgie Digestive, Oncologique et Bariatrique, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France. .,INSERM, UMRS 1149 Centre de Recherche sur l'Inflammation, Paris Montmartre, Paris, France.
| | - Claire Rives-Lange
- Université de Paris, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France.,INSERM, UMR 1153, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Paris, France
| | - Claire Carette
- Université de Paris, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France
| | - Yannick Girardeau
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service d'informatique médicale, biostatistiques et santé publique, Hôpital Européen Georges Pompidou, Paris, France
| | - Anne-Sophie Jannot
- Université de Paris, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service d'informatique médicale, biostatistiques et santé publique, Hôpital Européen Georges Pompidou, Paris, France.,INSERM, Cordeliers Research Center, Information sciences to support personalized medicine, Paris, France
| | - Sebastien Czernichow
- Université de Paris, F-75015, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France.,INSERM, UMR 1153, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Paris, France
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20
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Rives-Lange C, Girardeau Y, Poghosyan T, Ciangura C, Coupaye M, Carette C, Nizard J, Jannot AS, Czernichow S. Étude de la natalité avant et après chirurgie bariatrique. NUTR CLIN METAB 2021. [DOI: 10.1016/j.nupar.2021.01.089] [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: 10/21/2022]
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21
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Czernichow S, Bain SC, Capehorn M, Bøgelund M, Madsen ME, Yssing C, McMillan AC, Cancino A, Panton UH. Costs of the COVID-19 pandemic associated with obesity in Europe: A health-care cost model. Clin Obes 2021; 11:e12442. [PMID: 33554456 PMCID: PMC7988570 DOI: 10.1111/cob.12442] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 09/07/2020] [Revised: 12/03/2020] [Accepted: 12/17/2020] [Indexed: 02/06/2023]
Abstract
Excess weight is associated with severe outcomes of coronavirus disease 2019 (COVID-19). We aimed to estimate the total secondary care costs by body mass index (BMI, kg/m2 ) category when hospitalized due to COVID-19 in Europe during the first wave of the pandemic from January to June 2020. Building a health-care cost model, this study aimed to estimate the total costs of COVID-19. Information on risk of hospitalization, admission to intensive care unit (ICU) and risk of ventilation were based on published data. Average cost per patient and in total were calculated based on risks of admission to ICU, risk of invasive mechanical ventilation and length of hospital stay when hospitalized and published costs associated with hospitalization. The total direct costs of secondary care during the first wave of COVID-19 in Europe were estimated at EUR 13.9 billon, whereof 76% accounted for treating people with overweight and obesity. The average cost per hospital admission increased with BMI, from EUR 15831 for BMI <25 kg/m2 to EUR 30982 for BMI ≥40 kg/m2 . This study reveals that excess weight contributes disproportionally to the costs of COVID-19. This might reflect that overweight and obesity caused the COVID-19 pandemic to result in more severe outcomes for citizens and higher secondary care costs throughout Europe.
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Affiliation(s)
- Sebastien Czernichow
- Service de NutritionUniversité de ParisParisFrance
- Assistance Publique‐Hôpitaux de Paris (AP‐HP)Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges PompidouParisFrance
- METHODS TeamINSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS)ParisFrance
| | - Stephen C. Bain
- Diabetes Research UnitSwansea University Medical School and Swansea Bay University Health BoardSwanseaWalesUK
| | - Matthew Capehorn
- Rotherham Institute for Obesity (RIO)Clifton Medical CentreRotherhamSouth YorkshireUK
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22
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Nuzzo A, Czernichow S, Hertig A, Ledoux S, Poghosyan T, Quilliot D, Le Gall M, Bado A, Joly F. Prevention and treatment of nutritional complications after bariatric surgery. Lancet Gastroenterol Hepatol 2021; 6:238-251. [PMID: 33581762 DOI: 10.1016/s2468-1253(20)30331-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 07/03/2020] [Revised: 09/29/2020] [Accepted: 10/09/2020] [Indexed: 12/19/2022]
Abstract
Obesity and the corresponding burden of related diseases is a major public health issue worldwide that is reaching pandemic proportions. Bariatric surgery is the only intervention that has been shown to result in substantial and lasting weight loss, and a decrease in overall mortality for patients with severe obesity. Consequently, the population of patients having undergone this procedure is increasing. Multifactorial weight-dependent and independent mechanisms underlying metabolic diseases could also drive preventable, but potentially life-threatening, long-term nutritional complications. However, given post-bariatric patients are prone to functional gastrointestinal symptoms and substantial weight loss, nutritional complications might be challenging. This Review is focused on the prevention and treatment of nutritional complications after bariatric surgery in the clinical setting.
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Affiliation(s)
- Alexandre Nuzzo
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Gastroenterology, IBD and Intestinal Failure, Beaujon Hospital, Clichy, France; Université de Paris, Paris, France
| | - Sebastien Czernichow
- Université de Paris, Paris, France; AP-HP, Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1153, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Paris, France
| | - Alexandre Hertig
- AP-HP, Department of Nephrology, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Séverine Ledoux
- Université de Paris, Paris, France; AP-HP, Service des Explorations Fonctionnelles, Centre Spécialisé Obésité, Hôpital Louis Mourier, Colombes, France; INSERM, UMR 1149, Centre de Recherche sur l'Inflammation Paris Montmartre, Paris, France
| | - Tigran Poghosyan
- Université de Paris, Paris, France; Service de Chirurgie Digestive, Oncologique et Bariatrique, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France; INSERM, UMR 1149, Centre de Recherche sur l'Inflammation Paris Montmartre, Paris, France
| | - Didier Quilliot
- Unité Multidisciplinaire de Chirurgie de l'Obésité, Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre les Nancy Cedex, France
| | - Maude Le Gall
- Université de Paris, Paris, France; INSERM, UMR 1149, Centre de Recherche sur l'Inflammation Paris Montmartre, Paris, France
| | - André Bado
- Université de Paris, Paris, France; INSERM, UMR 1149, Centre de Recherche sur l'Inflammation Paris Montmartre, Paris, France
| | - Francisca Joly
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Gastroenterology, IBD and Intestinal Failure, Beaujon Hospital, Clichy, France; Université de Paris, Paris, France; INSERM, UMR 1149, Centre de Recherche sur l'Inflammation Paris Montmartre, Paris, France.
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23
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Quilliot D, Coupaye M, Ciangura C, Czernichow S, Sallé A, Gaborit B, Alligier M, Nguyen-Thi PL, Dargent J, Msika S, Brunaud L. Recommendations for nutritional care after bariatric surgery: Recommendations for best practice and SOFFCO-MM/AFERO/SFNCM/expert consensus. J Visc Surg 2021; 158:51-61. [PMID: 33436155 DOI: 10.1016/j.jviscsurg.2020.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Nutritional care after bariatric surgery is an issue of major importance, especially insofar as risk of deficiency has been extensively described in the literature. Subsequent to the deliberations carried out by a multidisciplinary working group, we are proposing a series of recommendations elaborated using the Delphi-HAS (official French health authority) method, which facilitates the drawing up of best practice and consensus recommendations based on the data of the literature and on expert opinion. The recommendations in this paper pertain to dietary management and physical activity, multivitamin and trace element supplementation and the prevention and treatment of specific deficiencies in vitamins B1, B9, B12, D and calcium, iron, zinc, vitamins A, E and K, dumping syndrome and reactive hypoglycemia.
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Affiliation(s)
- D Quilliot
- French Speaking Society of Clinical Nutrition and Metabolism (SFNCM), France.
| | - M Coupaye
- French Association for the Study and Research on Obesity (AFERO), France
| | - C Ciangura
- French Association for the Study and Research on Obesity (AFERO), France
| | - S Czernichow
- French Speaking Society of Clinical Nutrition and Metabolism (SFNCM), France
| | - A Sallé
- French Association for the Study and Research on Obesity (AFERO), France
| | - B Gaborit
- French Association for the Study and Research on Obesity (AFERO), France
| | - M Alligier
- French Obesity Research Center of Excellence (FORCE), France
| | - P-L Nguyen-Thi
- Medical Evaluation Department, Department of Clinical Research Support PARC, University of Lorraine, CHRU Nancy, Nancy, France
| | - J Dargent
- French and Francophone Society of Obesity Surgery and Metabolic Disorders (SO.FF.CO.MM), France
| | - S Msika
- French and Francophone Society of Obesity Surgery and Metabolic Disorders (SO.FF.CO.MM), France
| | - L Brunaud
- French and Francophone Society of Obesity Surgery and Metabolic Disorders (SO.FF.CO.MM), France
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24
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Bain SC, Czernichow S, Bøgelund M, Madsen ME, Yssing C, McMillan AC, Hvid C, Hettiarachchige N, Panton UH. Costs of COVID-19 pandemic associated with diabetes in Europe: a health care cost model. Curr Med Res Opin 2021; 37:27-36. [PMID: 33306421 DOI: 10.1080/03007995.2020.1862775] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Diabetes is associated with progression to severe COVID-19. The objective of this study was to estimate to what extent the increased risk among people with diabetes could impact the secondary care costs of COVID-19 throughout Europe during the first wave of the COVID-19 pandemic from January to June 2020. METHODS Applying a health care cost model based on inputs from data published in international peer-reviewed journals, identified via a rapid literature review this study aimed to estimate the total secondary sector costs of COVID-19. Estimates of unit costs were based on data from Denmark, France, Spain and the UK. We calculated average costs per patient without diabetes and according to four diabetes categories based on risk of hospitalization, admission to intensive care unit, ventilator support and length of hospital stay. RESULTS The estimated cost per hospital admission during the first wave of COVID-19 in Europe ranged between EUR 25,018 among people with type 2 diabetes in good glycaemic control to EUR 57,244 among people with type 1 diabetes in poor glycaemic control, reflecting higher risk of intensive care, ventilator support and longer hospital stay according to diabetes category, while the corresponding cost for people without diabetes was estimated at EUR 16,993. The total direct costs of secondary care of COVID-19 in Europe were estimated at EUR 13.9 billion. Thus, 23.5% of the total costs accounted for treating people with diabetes. CONCLUSIONS This study highlights the importance of a greater focus on prevention and adequate treatment of diabetes and the need for special attention to avoid infection with COVID-19 to the extent possible among those already diagnosed with diabetes.
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Affiliation(s)
- Stephen C Bain
- Diabetes Research Unit, Swansea University Medical School and Swansea Bay University Health Board, Swansea, UK
| | - Sebastien Czernichow
- Faculté de Santé, Université de Paris, Paris, France
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France
- INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France
| | | | | | | | | | - Christian Hvid
- Novo Nordisk North West Europe Pharmaceuticals A/S, Copenhagen, Denmark
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25
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Lurbe I Puerto K, Bruzzi M, Rives-Lange C, Poghosyan T, Bretault M, Chatellier G, Vilfaillot A, Chevallier JM, Czernichow S, Carette C. Telemedicine intervention on physical activity recovery after bariatric surgery: the MyGoodTrip randomized controlled trial (Preprint). JMIR Form Res 2020; 7:e26077. [PMID: 36976624 PMCID: PMC10132008 DOI: 10.2196/26077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 10/19/2021] [Accepted: 01/25/2023] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite bariatric surgery showing significant weight loss trajectories for many patients, a substantial proportion regain weight after the first year following surgery. The addition of telemedicine to standard care could support patients with engaging in a more active lifestyle and thus improve clinical outcomes. OBJECTIVE Our aim was to evaluate a telemedicine intervention program dedicated to the promotion of physical activity including digital devices, teleconsultation, and telemonitoring the first 6 months following bariatric surgery. METHODS This study employed a mixed methods design based on an open-label randomized controlled trial. Patients were included during the first week after bariatric surgery; then, they were randomized into 2 intervention groups: The TelePhys group received a monthly telemedicine consultation focusing on physical activity coaching, while the TeleDiet group received a monthly telemedicine consultation involving diet coaching. Data were collected using a watch pedometer and body weight scale, both of which were connected wirelessly. The primary outcome was the difference between the 2 groups in the mean numbers of steps at the first and sixth postoperative months. Weight change was also evaluated, and focus groups and interviews were conducted to enrich the results and capture perceptions of the telemedicine provided. RESULTS Among the 90 patients (mean age 40.6, SD 10.4 years; 73/90, 81% women; 62/90, 69% gastric bypass), 70 completed the study until the sixth month (n=38 TelePhys; n=32 TeleDiet), and 18 participants agreed to be interviewed (n=8 Telephys; n=10 TeleDiet). An increase in the mean number of steps between the first and sixth months was found in both groups, but this change was significant only in the TeleDiet group (P=.01). No difference was found when comparing both intervention groups. Interviewed participants reported having appreciated the teleconsultations, as the individualized tailored counseling helped them to make better choices about behaviors that could increase their likelihood of a daily life in better health. Weight loss followed by social factors (such as social support) were identified as the main facilitators to physical activity. Family responsibilities, professional constraints as well as poor urban policies promoting physical activity, and lack of accessibility to sport infrastructure were their major barriers to postoperative lifestyle adherence. CONCLUSIONS Our study did not show any difference in mobility recovery after bariatric surgery related to a telemedicine intervention dedicated to physical activity. The early postoperative timing for our intervention may explain the null findings. eHealth interventions aiming to change behaviors and carried out by clinicians require support from structured public health policies that tackle patients' obesogenic environment in order to be efficient in their struggle against sedentary lifestyle-related pathologies. Further research will need to focus on long-term interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT02716480, https://clinicaltrials.gov/ct2/show/NCT02716480.
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Affiliation(s)
- Katia Lurbe I Puerto
- Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Matthieu Bruzzi
- Service de Chirurgie Digestive, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Claire Rives-Lange
- Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université de Paris, Paris, France
- METHODS team, Epidemiology and Biostatistics Sorbonne Paris Cité Center, INSERM 1153, Paris, France
| | - Tigran Poghosyan
- Service de Chirurgie Digestive, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université de Paris, Paris, France
| | - Marion Bretault
- Service de Nutrition, Centre Spécialisé Obésité, Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancour, France
| | - Gilles Chatellier
- Université de Paris, Paris, France
- Unité de recherche clinique, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Aurelie Vilfaillot
- Unité de recherche clinique, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Marc Chevallier
- Service de Chirurgie Digestive, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université de Paris, Paris, France
| | - Sebastien Czernichow
- Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université de Paris, Paris, France
- METHODS team, Epidemiology and Biostatistics Sorbonne Paris Cité Center, INSERM 1153, Paris, France
| | - Claire Carette
- Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France
- Université de Paris, Paris, France
- Centre d'investigation clinique, INSERM 1418, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
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26
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Matta J, Hoertel N, Airagnes G, Czernichow S, Kesse-Guyot E, Limosin F, Goldberg M, Zins M, Lemogne C. Dietary Restrictions and Depressive Symptoms: Longitudinal Results from the Constances Cohort. Nutrients 2020; 12:nu12092700. [PMID: 32899666 PMCID: PMC7551036 DOI: 10.3390/nu12092700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 08/25/2020] [Indexed: 01/18/2023] Open
Abstract
Cross-sectional results have suggested a linear association between the number of dietary exclusions and depressive symptoms. This longitudinal study aimed to examine the direction of this association. Methods: In the population-based Constances cohort, depressive symptoms were defined by a score ≥19 on the Centre of Epidemiologic Studies-Depression (CES-D) scale. Diet was measured with a 24-item qualitative food frequency questionnaire (FFQ). Both variables were available at inclusion (from 2012 to 2014) and on follow-up (2015 for the CES-D and 2017 for diet). Food exclusion was categorized into five different groups: No exclusion, exclusion of one, two, three, or ≥4 food groups according to the self-reported number of food groups rarely or never consumed. Logistic regressions were conducted, either taking depressive symptoms as the outcome on follow-up with dietary exclusions at baseline as predictor or with the opposite, adjusting for age, sex, education, income, alcohol intake, smoking, physical activity, and anemia. The path analysis included outcomes and covariates in one model. Results: The median follow-up was three years. A total of 29,337 participants (53.4% women, 48.15 ± 12.9 y.o.) had complete CES-D data and 25,356 (53.56% women, 49.05 ± 12.8 y.o.) FFQ data. Dietary exclusion at inclusion predicted depressive symptoms at follow-up (odds ratio [95% confidence interval]: 2.35 [1.62–3.40] for ≥4 excluded items compared to no exclusions). Depressive symptoms at inclusion predicted dietary exclusions at follow-up (3.45 [1.93–6.16] for ≥4 excluded items). In the path analysis, the standardized estimate of the association between dietary exclusions at inclusion and depressive symptoms at follow-up was by far higher than the opposite (0.1863 and 0.00189, respectively, both p < 0.05). Conclusions: The association of dietary exclusion with subsequent depression is stronger than the opposite association.
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Affiliation(s)
- Joane Matta
- Inserm, Cohortes Epidémiologiques en Population, UMS 011, 94800 Villejuif, France; (G.A.); (M.G.); (M.Z.)
- Correspondence:
| | - Nicolas Hoertel
- Faculté de Santé, Université de Paris, UFR de Médecine, 75006 Paris, France; (N.H.); (S.C.); (F.L.); (C.L.)
- Service de Psychiatrie et d’Addictologie de l’adulte et du sujet âgé, Hôpital Corentin-Celton, AP-HP.Centre—Université de Paris, 75015 Paris, France
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), Université de Paris, INSERM, UMR_S1266, 75014 Paris, France
| | - Guillaume Airagnes
- Inserm, Cohortes Epidémiologiques en Population, UMS 011, 94800 Villejuif, France; (G.A.); (M.G.); (M.Z.)
- Centre Ambulatoire d’Addictologie, Hôpital européen Georges-Pompidou, AP-HP.Centre—Université de Paris, 75015 Paris, France
| | - Sebastien Czernichow
- Faculté de Santé, Université de Paris, UFR de Médecine, 75006 Paris, France; (N.H.); (S.C.); (F.L.); (C.L.)
- Dép artement de Nutrition, Centre Spécialisé Obésité IdF, Hôpital européen Georges-Pompidou, AP-HP.Centre—Université de Paris, 75015 Paris, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord Université, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center—Université de Paris (CRESS), 93017 Bobigny, France;
| | - Frederic Limosin
- Faculté de Santé, Université de Paris, UFR de Médecine, 75006 Paris, France; (N.H.); (S.C.); (F.L.); (C.L.)
- Service de Psychiatrie et d’Addictologie de l’adulte et du sujet âgé, Hôpital Corentin-Celton, AP-HP.Centre—Université de Paris, 75015 Paris, France
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), Université de Paris, INSERM, UMR_S1266, 75014 Paris, France
| | - Marcel Goldberg
- Inserm, Cohortes Epidémiologiques en Population, UMS 011, 94800 Villejuif, France; (G.A.); (M.G.); (M.Z.)
| | - Marie Zins
- Inserm, Cohortes Epidémiologiques en Population, UMS 011, 94800 Villejuif, France; (G.A.); (M.G.); (M.Z.)
- Faculté de Santé, Université de Paris, UFR de Médecine, 75006 Paris, France; (N.H.); (S.C.); (F.L.); (C.L.)
| | - Cédric Lemogne
- Faculté de Santé, Université de Paris, UFR de Médecine, 75006 Paris, France; (N.H.); (S.C.); (F.L.); (C.L.)
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), Université de Paris, INSERM, UMR_S1266, 75014 Paris, France
- Service de Psychiatrie de l’adulte, Hôpital Hôtel-Dieu, AP-HP.Centre—Université de Paris, 75004 Paris, France
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Robert M, Poghosyan T, Delaunay D, Pelascini E, Iceta S, Sterkers A, Barsamian C, Khamphommala L, Bin Dorel S, Maucort-Boulch D, Czernichow S, Disse E. Prospective multicentre randomised trial comparing the efficacy and safety of single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) versus Roux-en-Y gastric bypass (RYGB): SADISLEEVE study protocol. BMJ Open 2020; 10:e037576. [PMID: 32873678 PMCID: PMC7467507 DOI: 10.1136/bmjopen-2020-037576] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Despite the non-negligible weight loss failure rate at midterm, Roux-en-Y gastric bypass (RYGB) remains the reference procedure in the treatment of morbid obesity with metabolic comorbidities. A recently emerged procedure, the single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), could be more effective on weight loss with similar morbidity and lower weight loss failure rate than RYGB. We propose the first randomised, open, multicentre superiority trial comparing the SADI-S to RYGB (SADISLEEVE). METHODS AND ANALYSIS The main objective is to demonstrate the superiority at 2 years after surgery of the SADI-S compared with RYGB in term of excess weight loss percentage. The secondary objectives are the evaluation of nutritional status, metabolic outcomes, overall complication rates and quality of life, within 2 years after surgery. Key inclusion criteria are obese patients with body mass index (BMI) ≥40 kg/m2 or ≥35 kg/m2 with at least one comorbid condition and candidate to a first bariatric procedure or after failure of sleeve gastrectomy. Patients randomised by minimisation in two arms, based on centre, surgery as a revisional procedure, presence of type 2 diabetes and BMI >50 kg/m2 will be included over 2 years.A sample size of 166 patients in each group will have a power of 90% to detect a probability of 0.603 that excess weight loss in the RYGB arm is less than excess weight loss in the SADI-S arm with a 5% two-sided significance level. With a drop-out rate of 10%, it will be necessary to include 183 patients per group. ETHICS AND DISSEMINATION The study was approved by Institutional Review Board of Centre Hospitalier Universitaire Morvan (CPP1089-HPS1). Study was also approved by the French national agency for drug safety (2018061500148). Results will be reported in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER NCT03610256.
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Affiliation(s)
- Maud Robert
- Department of Digestive and Bariatric Surgery, Hospices Civils de Lyon, Hôpital Edouard Herriot, CarMeN Laboratory, INSERM 1060, Université Claude Bernard Lyon 1, Lyon, France
| | - Tigran Poghosyan
- Department of Digestive, Oncologic and Bariatric Surgery; Specialized Center for Obesity Management, Assistance Publique - Hôpitaux de Paris, Hôpital européen Georges Pompidou, Inserm UMRS 1149, Université de Paris, Paris, France
| | - Dominique Delaunay
- Department of Digestive and Bariatric Surgery, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Elise Pelascini
- Department of Digestive and Bariatric Surgery, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Sylvain Iceta
- Department of Endocrinology, Diabetology and Nutrition, Specialized Center for Obesity Management, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Adrien Sterkers
- Department of Digestive, Hepatobiliary Surgery, Centre Hospitalier Privé Saint-Grégoire, Saint-Gregoire, Bretagne, France
| | - Charles Barsamian
- Department of Nutrition, Specialized Center for Obesity Management, Assistance Publique - Hôpitaux de Paris, Hôpital européen Georges Pompidou, Université de Paris, Paris, France
| | - Litavan Khamphommala
- Department of Digestive, Hepatobiliary Surgery, Centre Hospitalier Privé Saint-Grégoire, Saint-Gregoire, Bretagne, France
| | | | - Delphine Maucort-Boulch
- Department of Biostatistics, Hospices Civils de Lyon, Hôpital Edouard Herriot, Université Lyon 1, Lyon, France
| | - Sebastien Czernichow
- Department of Nutrition, Specialized Center for Obesity Management, Assistance Publique - Hôpitaux de Paris, Hôpital européen Georges Pompidou, Université de Paris, Paris, France
- Equipe METHODS, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153) Inserm, Paris, France
| | - Emmanuel Disse
- Department of Endocrinology, Diabetology and Nutrition, Specialized Center for Obesity Management, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
- CarMeN Lab, INSERM U1060, Lyon, France
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Feral-Pierssens AL, Rives-Lange C, Matta J, Rodwin VG, Goldberg M, Juvin P, Zins M, Carette C, Czernichow S. Forgoing health care under universal health insurance: the case of France. Int J Public Health 2020; 65:617-625. [PMID: 32474715 DOI: 10.1007/s00038-020-01395-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/08/2020] [Accepted: 05/19/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We investigate the reliability of a survey question on forgone healthcare services for financial reasons, based on analysis of actual healthcare use over the 3-year period preceding response to the question. We compare the actual use of different health services by patients who report having forgone health care to those who do not. METHODS Based on a prospective cohort study (CONSTANCES), we link survey data from enrolled participants to the Universal Health Insurance (UHI) claims database and compare use of health services of those who report having forgone health care to controls. We present multivariable logistic regression models and assess the odds of using different health services. RESULTS Compared to controls, forgoing care participants had lower odds of consulting GPs (OR = 0.83; 95% CI 0.73, 0.93), especially specialists outside hospitals (gynecologists: 0.74 (0.69, 0.78); dermatologists: 0.81 (0.78-0.85); pneumologists 0.82 (0.71-0.94); dentists 0.71 (0.68, 0.75)); higher odds of ED visits (OR = 1.25; 95% CI 1.19, 1.31); and no difference in hospital admissions (OR = 1.02; 95% CI 0.97, 1.09). Participants with lower occupational status and income had higher odds of forgoing health care. CONCLUSIONS The perception of those who report having forgone health care for financial reasons is consistent with their lower actual use of community-based ambulatory care (CBAC). While UHI may be necessary to improve healthcare access, it does not address the social factors associated with the population forgoing health care for financial reasons.
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Affiliation(s)
- Anne-Laure Feral-Pierssens
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France. .,Assistance Publique Hôpitaux de Paris, Emergency Department, Georges Pompidou European Hospital, Paris, France. .,Improving Emergency Care - IMPEC federation, Paris, France.
| | - Claire Rives-Lange
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Georges Pompidou European Hospital, Centre Spécialisé Obésité, Paris, France.,Paris University, Paris, France.,INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS Team, Paris, France
| | - Joane Matta
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
| | - Victor G Rodwin
- Département Epidémiologie et Systèmes de Santé, UniSanté, Lausanne, Switzerland.,Wagner School of Public Service, New York University, New York, USA
| | - Marcel Goldberg
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France.,Paris University, Paris, France
| | - Philippe Juvin
- Assistance Publique Hôpitaux de Paris, Emergency Department, Georges Pompidou European Hospital, Paris, France.,Improving Emergency Care - IMPEC federation, Paris, France.,Paris University, Paris, France
| | - Marie Zins
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France.,Paris University, Paris, France
| | - Claire Carette
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Georges Pompidou European Hospital, Centre Spécialisé Obésité, Paris, France.,CIC1418, INSERM, Georges Pompidou European Hospital, Paris, France
| | - Sebastien Czernichow
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Georges Pompidou European Hospital, Centre Spécialisé Obésité, Paris, France.,Paris University, Paris, France.,INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS Team, Paris, France
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Poghosyan T, Levenson G, Bruzzi M, Rives-Lange C, Czernichow S, Chevallier JM, Douard R. Fistulojejunostomy for Chronic Fistula After Sleeve Gastrectomy. Obes Surg 2020; 30:3638-3639. [PMID: 32388707 DOI: 10.1007/s11695-020-04660-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The most dreadful complication after sleeve gastrectomy (SG) is staple line leak. Its rate varies between 1 and 2%. With the development of interventional endoscopy, its treatment is currently fairly standardized and allows healing in the majority of cases without revisional surgery. However, if endoscopic treatment fails, surgical treatment becomes unavoidable. Fistulojejunostomy is a surgical option in the management of chronic fistula after SG. Laparoscopic fistulojejunostomy in a patient with chronic fistula after SG is difficult but feasible. This procedure allows complete healing and nutritional recovery in the case of failure of other endoscopic modalities.
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Affiliation(s)
- Tigran Poghosyan
- Department of Digestive, Oncologic and Bariatric Surgery, AP-HP, Hôpital Européen Georges Pompidou and UFR Paris Descartes, Université de Paris, 20 Rue Leblanc, 75015, Paris, France.
| | - Guillaume Levenson
- Department of Digestive, Oncologic and Bariatric Surgery, AP-HP, Hôpital Européen Georges Pompidou and UFR Paris Descartes, Université de Paris, 20 Rue Leblanc, 75015, Paris, France
| | - Matthieu Bruzzi
- Department of Digestive, Oncologic and Bariatric Surgery, AP-HP, Hôpital Européen Georges Pompidou and UFR Paris Descartes, Université de Paris, 20 Rue Leblanc, 75015, Paris, France
| | - Claire Rives-Lange
- Department of Nutrition, AP-HP, Hôpital Européen Georges Pompidou and UFR Paris Descartes, Université de Paris, Paris, France
| | - Sebastien Czernichow
- Department of Nutrition, AP-HP, Hôpital Européen Georges Pompidou and UFR Paris Descartes, Université de Paris, Paris, France
| | - Jean-Marc Chevallier
- Department of Digestive, Oncologic and Bariatric Surgery, AP-HP, Hôpital Européen Georges Pompidou and UFR Paris Descartes, Université de Paris, 20 Rue Leblanc, 75015, Paris, France
| | - Richard Douard
- Department of Digestive, Oncologic and Bariatric Surgery, AP-HP, Hôpital Européen Georges Pompidou and UFR Paris Descartes, Université de Paris, 20 Rue Leblanc, 75015, Paris, France
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Mifsud F, Czernichow S, Carette C, Cynober L, Neveux N, Rives-Lange C. Évolution de la citrulline plasmatique après chirurgie bariatrique dans la cohorte BARIASPERM. NUTR CLIN METAB 2020. [DOI: 10.1016/j.nupar.2020.02.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Martin C, Ait Boudaoud A, Radu A, Barsamian C, Larger E, Ngo S, chatenoud L, Czernichow S, Rives-Lange C, Carette C. Positivité des anticorps anti GAD et/ou IA2 dans une cohorte de patients diabétiques et obèses sévères éligibles à une chirurgie bariatrique. NUTR CLIN METAB 2020. [DOI: 10.1016/j.nupar.2020.02.215] [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: 10/24/2022]
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Abstract
In some cases, in addition to the usual difficulties that the bariatric surgeon may encounter during standard bariatric procedures, anatomical anomalies such as situs inversus can pose an additional technical challenge. A 58-year-old patient with total situs inversus underwent Roux-en-Y gastric bypass (RYGB) surgery in our department. The main difficulty was the realization of a mirrored RYGB. Laparoscopic RYGB in a patient with situs inversus totalis is feasible but requires significant concentration and three-dimensional coordination to perform the mirrored procedure.
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Affiliation(s)
- Tigran Poghosyan
- Department of Digestive, Oncologique and Bariatric Surgery, AP-HP, Hôpital Européen Georges Pompidou and Univsersité de Paris, UFR Paris Descartes, Paris, France.
| | - Matthieu Bruzzi
- Department of Digestive, Oncologique and Bariatric Surgery, AP-HP, Hôpital Européen Georges Pompidou and Univsersité de Paris, UFR Paris Descartes, Paris, France
| | - Claire Rives-Lange
- Department of Nutrition, AP-HP, Hôpital Européen Georges Pompidou and Univsersité de Paris, UFR Paris Descartes, Paris, France
| | - Sebastien Czernichow
- Department of Nutrition, AP-HP, Hôpital Européen Georges Pompidou and Univsersité de Paris, UFR Paris Descartes, Paris, France
| | - Jean-Marc Chevallier
- Department of Digestive, Oncologique and Bariatric Surgery, AP-HP, Hôpital Européen Georges Pompidou and Univsersité de Paris, UFR Paris Descartes, Paris, France
| | - Richard Douard
- Department of Digestive, Oncologique and Bariatric Surgery, AP-HP, Hôpital Européen Georges Pompidou and Univsersité de Paris, UFR Paris Descartes, Paris, France
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Barsamian C, Carette C, Sasso M, Poghosyan T, Bedossa P, Emile JF, Parlier D, Miette V, Bouillot JL, Czernichow S, Rives-Lange C. Diagnostic of hepatic fibrosis with the XL probe of the Fibroscan versus biopsies in patients candidates to bariatric surgery. Clin Nutr ESPEN 2020; 37:226-232. [PMID: 32359748 DOI: 10.1016/j.clnesp.2020.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/02/2020] [Accepted: 02/15/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS The risks of the histological evaluation for metabolic liver disease in severe obese subjects led to the development of the Fibroscan® device. The main objective of our study is to evaluate the diagnostic performance of XL probe for the measurement of hepatic fibrosis compared to histological examination, in obese subjects operated from bariatric surgery. METHODS We included patients free from chronic liver diseases. Liver measurement and controlled attenuation parameter (CAP) were carried out using the Fibroscan®. Liver biopsies were performed during bariatric surgery and evaluated by two pathologists. Correlation between vibration-controlled transient elastography (VCTE) and fibrosis stage was assessed using the Kendall correlation coefficient. Diagnosis performance was assessed using receiver-operating-characteristic curve analysis together with its 95% confidence interval. Cut-off value maximizing the Youden index was computed together with specificity, sensitivity, positive and negative predictive values. RESULTS The average age and body mass index were 41 years and 43 kg/m2, respectively (n = 108). Forty-one percent of patients presented fibrosis on the histological results. The Kendall correlation coefficient between fibrosis stage and liver stiffness measurement (LSM) was κ = 0.33, p<10-5. ROC analysis for the detection of fibrosis indicated the following values: 0.70 [0.60-0.79] for F≥1, 0.83 [0.72-0.92] for F≥2, 0.90 [0.83-0.97] for F≥3. Optimal cut-offs maximizing the Youden index were 7.0 kPa for F≥1, 8.1 kPa for F≥2 and 8.7 kPa for F≥3. CONCLUSION Fibroscan® appears to be reliable for detection of significant and severe fibrosis in severe obese patients such as candidates for bariatric surgery. CLINICAL TRIAL NUMBER NCT03548597.
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Affiliation(s)
- C Barsamian
- APHP. Centre-Université de Paris, Hôpital Européen Georges-Pompidou, Service de Nutrition Paris, France
| | - C Carette
- APHP. Centre-Université de Paris, Hôpital Européen Georges-Pompidou, Service de Nutrition Paris, France
| | | | - T Poghosyan
- Université de Paris, Paris, France; APHP. Centre-Université de Paris, Hôpital Européen Georges-Pompidou, Service de Chirurgie Digestive, Paris, France
| | - P Bedossa
- Département d'Anatomie Pathologie, APHP, Hôpital Bichat-Beaujon, Paris, France
| | - J F Emile
- Service d'anatomopathologie, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | - D Parlier
- Service d'hépato-gastroentérologie, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | | | - J L Bouillot
- Service de Chirurgie Digestive, Hôpital Saint Joseph, Paris, France
| | - S Czernichow
- APHP. Centre-Université de Paris, Hôpital Européen Georges-Pompidou, Service de Nutrition Paris, France; Université de Paris, Paris, France.
| | - C Rives-Lange
- APHP. Centre-Université de Paris, Hôpital Européen Georges-Pompidou, Service de Nutrition Paris, France; Université de Paris, Paris, France
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Matta J, Carette C, Zins M, Goldberg M, Lemogne C, Czernichow S. Obesity moderates the benefit of retirement on health: A 21-year prospective study in the GAZEL cohort. J Psychosom Res 2020; 131:109938. [PMID: 32035345 DOI: 10.1016/j.jpsychores.2020.109938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/10/2019] [Revised: 01/15/2020] [Accepted: 01/18/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Self-rated health and depressive symptoms have been shown to improve upon retirement. Participants with obesity might benefit more of retirement because of the extra work-related burden they are carrying. The present study aimed to investigate whether the association between retirement and health changes may depend upon obesity in the large French GAZEL occupational cohort during 21 years of follow-up. METHODS 17,655 men and women were included in the analyses. Self-rated health was measured on a scale from 1 to 8 with 8 being very bad. Depressive symptoms were measured at four time points by the CES-D score. Mixed models examined the association of self-rated health or depressive symptoms with time (i.e. from -10 years before to +10 years after retirement), retirement, body mass index (BMI), and their interactions. RESULTS Regardless of retirement, BMI was associated with poorer health. Positive BMI by time interactions showed a less favorable time course of both health indicators in the presence versus the absence of obesity (0.024 versus 0.014 and - 0.19 versus -0.07 points per year for self-rated health and depressive symptoms, respectively). However, negative BMI by retirement interactions showed that the improvement of health observed upon retirement was stronger in with the presence versus the absence of obesity (-0.4 versus -0.3 and - 2.42 versus -1.70 points for self-rated health and depressive symptoms, respectively). CONCLUSION Improvement upon retirement was observed in the presence of obesity and was even higher than in the presence of normal weight and overweight.
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Affiliation(s)
- Joane Matta
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France.
| | - Claire Carette
- AP-HP.Centre-Université de Paris, Hôpital européen Georges-Pompidou, Service de Nutrition, Paris, France
| | - Marie Zins
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France; Université de Paris, Faculté de Médecine Paris Descartes, Paris, France
| | - Marcel Goldberg
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France
| | - Cédric Lemogne
- Université de Paris, Faculté de Médecine Paris Descartes, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France; AP-HP.Centre-Université de Paris, Hôpital européen Georges-Pompidou, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Paris, France
| | - Sebastien Czernichow
- AP-HP.Centre-Université de Paris, Hôpital européen Georges-Pompidou, Service de Nutrition, Paris, France; Université de Paris, Faculté de Médecine Paris Descartes, Paris, France.
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35
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Martin C, Ait Boudaoud A, Poghosyan T, Zhu J, Larger E, Greenfield JR, Czernichow S, Rives-Lange C, Carette C. Prevalence of anti-GAD and IA2 autoantibodies in a French cohort of patients with diabetes eligible for bariatric surgery. Diabetes Metab 2019; 46:407-409. [PMID: 31874247 DOI: 10.1016/j.diabet.2019.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 12/11/2019] [Accepted: 12/16/2019] [Indexed: 12/17/2022]
Affiliation(s)
- C Martin
- Nutrition Department, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - A Ait Boudaoud
- Diabetes Department, Georges Pompidou European Hospital, AP-HP, Paris, France; Paris University, Paris, France
| | - T Poghosyan
- Digestive Surgery Department, Georges Pompidou European Hospital, AP-HP, Paris, France; Paris University, Paris, France
| | - J Zhu
- Biological Immunology Department, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France
| | - E Larger
- Paris University, Paris, France; Diabetes Department, Cochin Hospital, AP-HP, Paris, France
| | - J R Greenfield
- Department of Diabetes and Endocrinology, St. Vincent's Hospital, Sydney, NSW, Australia; Diabetes and Metabolism, Garvan Institute of Medical Research, Sydney, NSW, Australia; St Vincent's Clinic School, University of New South Wales, Sydney, NSW, Australia
| | - S Czernichow
- Nutrition Department, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, 75015 Paris, France; Diabetes Department, Georges Pompidou European Hospital, AP-HP, Paris, France; Paris University, Paris, France
| | - C Rives-Lange
- Nutrition Department, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, 75015 Paris, France; Paris University, Paris, France
| | - C Carette
- Nutrition Department, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, 75015 Paris, France.
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Lloret-Linares C, Daali Y, Abbara C, Carette C, Bouillot JL, Vicaut E, Czernichow S, Declèves X. CYP450 activities before and after Roux-en-Y gastric bypass: correlation with their intestinal and liver content. Surg Obes Relat Dis 2019; 15:1299-1310. [PMID: 31262651 DOI: 10.1016/j.soard.2019.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/06/2019] [Accepted: 05/09/2019] [Indexed: 02/08/2023]
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Bretault M, Carette C, Zaharia R, Vychnevskaia K, Bouillot JL, Czernichow S, Raffin-Sanson ML. Liraglutide 3mg as a weight-loss strategy after failed bariatric surgery in a patient with hypothalamic obesity following craniopharyngioma. Diabetes Metab 2019; 46:514-515. [PMID: 31362076 DOI: 10.1016/j.diabet.2019.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 07/05/2019] [Accepted: 07/21/2019] [Indexed: 11/29/2022]
Affiliation(s)
- M Bretault
- Department of Endocrinology-Nutrition, Ambroise-Paré Hospital, AP-HP, 9, avenue Charles de-Gaulle, 92100 Boulogne-Billancourt, France.
| | - C Carette
- Department of Nutrition, Georges-Pompidou Hospital, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - R Zaharia
- Department of Endocrinology-Nutrition, Ambroise-Paré Hospital, AP-HP, 9, avenue Charles de-Gaulle, 92100 Boulogne-Billancourt, France
| | - K Vychnevskaia
- Department of Visceral and Metabolic Surgery, Ambroise-Paré Hospital, AP-HP, 9, avenue Charles de-Gaulle, 92100 Boulogne-Billancourt, France
| | - J-L Bouillot
- Department of Visceral and Metabolic Surgery, Ambroise-Paré Hospital, AP-HP, 9, avenue Charles de-Gaulle, 92100 Boulogne-Billancourt, France
| | - S Czernichow
- Department of Nutrition, Georges-Pompidou Hospital, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - M-L Raffin-Sanson
- Department of Endocrinology-Nutrition, Ambroise-Paré Hospital, AP-HP, 9, avenue Charles de-Gaulle, 92100 Boulogne-Billancourt, France
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Challine A, Katsahian S, Gaujoux S, Dousset B, Lazzati A, Czernichow S. Impact de l’immunonutrition orale sur la morbidité post opératoire : une étude de cohorte nationale. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.01.012] [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
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Rives-Lange C, Challine A, Danoussou D, Katsahian S, Ait Boudaoud A, Gaujoux S, Dousset B, Carette C, Lazzati A, Czernichow S. Impact de l’immunonutrition orale sur la morbidité postopératoire en chirurgie oncologique digestive : une étude de cohorte à l’échelle nationale. NUTR CLIN METAB 2019. [DOI: 10.1016/j.nupar.2019.01.366] [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: 10/27/2022]
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Thereaux J, Lesuffleur T, Czernichow S, Basdevant A, Msika S, Nocca D, Millat B, Fagot-Campagna A. Multicentre cohort study of antihypertensive and lipid-lowering therapy cessation after bariatric surgery. Br J Surg 2018; 106:286-295. [PMID: 30325504 DOI: 10.1002/bjs.10999] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/05/2018] [Accepted: 08/17/2018] [Indexed: 12/13/2022]
Abstract
Abstract
Background
Few studies have assessed changes in antihypertensive and lipid-lowering therapy after bariatric surgery. The aim of this study was to assess the 6-year rates of continuation, discontinuation or initiation of antihypertensive and lipid-lowering therapy after bariatric surgery compared with those in a matched control group of obese patients.
Methods
This nationwide observational population-based cohort study used data extracted from the French national health insurance database. All patients undergoing gastric bypass or sleeve gastrectomy in France in 2009 were matched with control patients. Mixed-effect logistic regression models were used to analyse factors that influenced discontinuation or initiation of treatment over a 6-year interval.
Results
In 2009, 8199 patients underwent primary gastric bypass (55·2 per cent) or sleeve gastrectomy (44·8 per cent). After 6 years, the proportion of patients receiving antihypertensive and lipid-lowering therapy had decreased more in the bariatric group than in the control group (antihypertensives: –40·7 versus –11·7 per cent respectively; lipid-lowering therapy: –53·6 versus –20·2 per cent; both P < 0·001). Gastric bypass was the main predictive factor for discontinuation of therapy for hypertension (odds ratio (OR) 9·07, 95 per cent c.i. 7·72 to 10·65) and hyperlipidaemia (OR 11·91, 9·65 to 14·71). The proportion of patients not receiving treatment at baseline who were subsequently started on medication was lower after bariatric surgery than in controls for hypertension (5·6 versus 15·8 per cent respectively; P < 0·001) and hyperlipidaemia (2·2 versus 9·1 per cent; P < 0·001). Gastric bypass was the main protective factor for antihypertensives (OR 0·22, 0·18 to 0·26) and lipid-lowering medication (OR 0·12, 0·09 to 0·15).
Conclusion
Bariatric surgery is associated with a good discontinuation of antihypertensive and lipid-lowering therapy, with gastric bypass being more effective than sleeve gastrectomy.
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Affiliation(s)
- J Thereaux
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
- Department of General, Digestive and Metabolic Surgery, La Cavale Blanche University Hospital, and Groupe d'Étude de la Thrombose de Bretagne Occidentale, EA 3878, University of Bretagne Occidentale, Brest, France
| | - T Lesuffleur
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - S Czernichow
- Department of Nutrition, Hôpital Européen Georges Pompidou, Centre Spécialisé Obésité Ile de France Sud, Assistance Publique–Hôpitaux de Paris (AP-HP) and University Paris Descartes, Paris, France
| | - A Basdevant
- Department of Heart and Nutrition, Institute of Cardiometabolism and Nutrition, ICAN, AP-HP, Pitié-Salpêtrière Hospital, and France Sorbonne Universities, University Pierre et Marie Curie-Paris 6, Paris, France
| | - S Msika
- Department of General, Digestive and Metabolic Surgery, Louis Mourier Hospital, AP-HP, Diderot Paris 7 University, Colombes, France
| | - D Nocca
- Department of Surgery, Faculty of Medicine of Montpellier, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - B Millat
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - A Fagot-Campagna
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
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Simon JM, Thomas F, Czernichow S, Hanon O, Lemogne C, Simon T, Pannier B, Danchin N. Hyperglycaemia is associated with cancer-related but not non-cancer-related deaths: evidence from the IPC cohort. Diabetologia 2018; 61:1089-1097. [PMID: 29305626 DOI: 10.1007/s00125-017-4540-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 12/01/2017] [Indexed: 12/11/2022]
Abstract
AIMS/HYPOTHESIS Hyperglycaemia has been associated with the incidence of all and specific types of cancer, distinct from the risks related to diabetes. The relationships between blood glucose and mortality rates related to all and specific cancers were analysed in comparison with all-cause or non-cancer-related mortality rates in a large, general primary care population in France. METHODS Between January 1991 and December 2008, 301,948 participants (193,221 men and 108,727 women), aged 16-95 years (mean ± SD 44.8 ± 12.0 years for men and 45.1 ± 14.2 years for women), had a health check at the IPC Centre. All data collected in standard conditions during the health checks-up were used for statistical analysis All examinations were performed under fasting conditions and included a blood glucose measurement. Participants with known diabetes (<9%) were excluded from the analysis. Participants were classified into quintiles based on their blood glucose measurement and were followed for a maximum of 17 years (mean ± SD 9.2 ± 4.7 years) to assess all-cause, cancer and non-cancer mortality rates. RESULTS A non-linear relationship was observed between cancer mortality rates and blood glucose quintile after adjustment for age and sex. There was a significant association between the group with the highest blood glucose level and cancer-related death (multivariate Cox model, HR [95% CI] 1.17 [1.03, 1.34]), while the group with normoglycaemia showed no association with cancer-related deaths. We did not observe a relationship between blood glucose and all-cause or non-cancer mortality rates. An excess risk of death was observed in the highest blood glucose quintile for gastrointestinal cancer and leukaemia. Adjustments for diabetes and aspirin use did not modify the results. However, this excess risk disappeared with use of glucose-lowering agents (HR [95% CI] 1.03 [0.74, 1.43]). CONCLUSIONS/INTERPRETATION Hyperglycaemia is associated with significantly higher rates of cancer-related deaths, particularly in gastrointestinal cancer and leukaemia, but not with non-cancer-related deaths. The association is retained when taking into account confounding factors, including chronic aspirin treatment.
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Affiliation(s)
- Jean-Marc Simon
- Centre IPC, 6-14 rue La Pérouse, 75016, Paris, France
- Hopital Pitié Salpétrière, APHP, Paris, France
| | | | - Sebastien Czernichow
- Hopital HEGP, APHP, Paris, France
- Hôpitaux Universitaires Paris Ouest, APHP, Paris, France
| | - Olivier Hanon
- Centre IPC, 6-14 rue La Pérouse, 75016, Paris, France
- Hopital Broca, APHP, Paris, France
| | - Cedric Lemogne
- Hopital HEGP, APHP, Paris, France
- Hôpitaux Universitaires Paris Ouest, APHP, Paris, France
- Inserm U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Tabassome Simon
- Hopital Saint Antoine, APHP, Université Pierre et Marie Curie, Paris, France
| | - Bruno Pannier
- Centre IPC, 6-14 rue La Pérouse, 75016, Paris, France.
- Hopital Manhès, Fleury-Merogis, France.
| | - Nicolas Danchin
- Centre IPC, 6-14 rue La Pérouse, 75016, Paris, France
- Hopital HEGP, APHP, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine, Paris, France
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Feral-Pierssens AL, Carette C, Rives-Lange C, Matta J, Goldberg M, Juvin P, Zins M, Czernichow S. Obesity and emergency care in the French CONSTANCES cohort. PLoS One 2018; 13:e0194831. [PMID: 29579083 PMCID: PMC5868832 DOI: 10.1371/journal.pone.0194831] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 03/09/2018] [Indexed: 12/29/2022] Open
Abstract
Context Obese patients are raising specific questions in emergency care such as equipment issues or urgent procedures. Even though obesity prevalence and subsequent health expenditure are increasing worldwide, there is scarce literature about their specific resource utilization of Emergency Departments (ED). These few studies do not take into account both socio-economic situation and comorbidities which are well-known factors influencing healthcare use. Our objective was to assess the emergency care resource utilization of obese individuals (Body Mass Index (BMI) ≥ 30kg.m-2) compared to normal-weight individuals taking into account comorbidities and social-economic situations. Methods The French CONSTANCES epidemiologic cohort is a randomly selected sample of French adults. Participants data are linked to the National Health Insurance Database collecting all medical acts. The rate of ED visits of obese (and each obesity class) and normal-weight participants were compared considering confounding factors (comorbidities, various socio-economic data). The primary endpoint was to have visited the ED between 2010 and 2013. Sex-separated analysis and multivariate logistic regression models were performed and adjusted odds-ratios [OR] (95% Confidence Intervals [CI]) were calculated. Results We included 21,035 normal-weight and 5,003 obese participants. Obese participants visited the ED more often than normal-weight participants (men: 30.5% vs. 26.7%; women: 30.3% vs. 24.4%, P<0.001). Obese participants presented more comorbidities and a lower socio-economic situation than normal-weight participants. After adjustment, obese participants had a higher risk of visiting ED (men: OR = 1.18; 95% CI: 1.04–1.33; and women: OR = 1.36; 95% CI: 1.22–1.52), with a higher risk for class III participants (BMI ≥ 40 kg.m-2) (men: OR = 2.18; CI 95%: 1.32–3.63; and women: OR = 1.85; 95% CI: 1.38–2.49). Conclusion Obese individuals have a higher level of emergency care resource utilization than normal-weight individuals and it increases with severe obesity. Further studies are needed to better understand their healthcare pathways leading to EDs.
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Affiliation(s)
- Anne-Laure Feral-Pierssens
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
- Assistance Publique Hôpitaux de Paris, Emergency Department, Georges Pompidou european Hospital, Paris, France
- * E-mail:
| | - Claire Carette
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Georges Pompidou european Hospital, Centre Spécialisé Obésité IdF, Paris, France
| | - Claire Rives-Lange
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Georges Pompidou european Hospital, Centre Spécialisé Obésité IdF, Paris, France
- Paris Descartes University, Paris, France
| | - Joane Matta
- Nutrition Department, Faculty of Agricultural and Food Sciences, Holy Spirit University, Jounieh, Lebanon
| | - Marcel Goldberg
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
- Paris Descartes University, Paris, France
| | - Philippe Juvin
- Assistance Publique Hôpitaux de Paris, Emergency Department, Georges Pompidou european Hospital, Paris, France
- Paris Descartes University, Paris, France
| | - Marie Zins
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
- Paris Descartes University, Paris, France
| | - Sebastien Czernichow
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Georges Pompidou european Hospital, Centre Spécialisé Obésité IdF, Paris, France
- Nutrition Department, Faculty of Agricultural and Food Sciences, Holy Spirit University, Jounieh, Lebanon
- INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France
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Ait Boudaoud A, Rives-Lange C, Radu A, Rubin F, Carette C, Barsamian C, Czernichow S. A 78-Year-Old Man With Historical Goiter. J Endocr Soc 2018; 2:290-292. [PMID: 29600295 PMCID: PMC5838822 DOI: 10.1210/js.2018-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/05/2018] [Indexed: 12/02/2022] Open
Affiliation(s)
- Amel Ait Boudaoud
- Diabetology, Endocrinology and Nutrition Department, Hospital European Georges Pompidou (AP-HP), Paris, France.,University Paris V Descartes, Paris, France
| | - Claire Rives-Lange
- Diabetology, Endocrinology and Nutrition Department, Hospital European Georges Pompidou (AP-HP), Paris, France.,University Paris V Descartes, Paris, France
| | - Alina Radu
- Diabetology, Endocrinology and Nutrition Department, Hospital European Georges Pompidou (AP-HP), Paris, France
| | - François Rubin
- Otorinolaryngology and Surgery Department, Hospital European Georges Pompidou (AP-HP), Paris, France.,University Paris V Descartes, Paris, France
| | - Claire Carette
- Diabetology, Endocrinology and Nutrition Department, Hospital European Georges Pompidou (AP-HP), Paris, France.,University Paris V Descartes, Paris, France
| | - Charles Barsamian
- Diabetology, Endocrinology and Nutrition Department, Hospital European Georges Pompidou (AP-HP), Paris, France
| | - Sebastien Czernichow
- Diabetology, Endocrinology and Nutrition Department, Hospital European Georges Pompidou (AP-HP), Paris, France.,University Paris V Descartes, Paris, France
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Thereaux J, Lesuffleur T, Païta M, Czernichow S, Basdevant A, Msika S, Millat B, Fagot-Campagna A. Long-term follow-up after bariatric surgery in a national cohort. Br J Surg 2017; 104:1362-1371. [PMID: 28657109 DOI: 10.1002/bjs.10557] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 02/20/2017] [Accepted: 03/05/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Lifelong medical follow-up is mandatory after bariatric surgery. The aim of this study was to assess the 5-year follow-up after bariatric surgery in a nationwide cohort of patients. METHODS All adult obese patients who had undergone primary bariatric surgery in 2009 in France were included. Data were extracted from the French national health insurance database. Medical follow-up (medical visits, micronutrient supplementation and blood tests) during the first 5 years after bariatric surgery was assessed, and compared with national and international guidelines. RESULTS Some 16 620 patients were included in the study. The percentage of patients with at least one reimbursement for micronutrient supplements decreased between the first and fifth years for iron (from 27.7 to 24.5 per cent; P < 0.001) and calcium (from 14·4 to 7·7 per cent; P < 0·001), but increased for vitamin D (from 33·1 to 34·7 per cent; P < 0·001). The percentage of patients with one or more visits to a surgeon decreased between the first and fifth years, from 87·1 to 29·6 per cent (P < 0·001); similar decreases were observed for visits to a nutritionist/endocrinologist (from 22·8 to 12·4 per cent; P < 0·001) or general practitioner (from 92·6 to 83·4 per cent; P < 0·001). The mean number of visits to a general practitioner was 7·0 and 6·1 in the first and the fifth years respectively. In multivariable analyses, male sex, younger age, absence of type 2 diabetes and poor 1-year follow-up were predictors of poor 5-year follow-up. CONCLUSION Despite clear national and international guidelines, long-term follow-up after bariatric surgery is poor, especially for young men with poor early follow-up.
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Affiliation(s)
- J Thereaux
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France.,Department of General, Digestive and Metabolic Surgery, La Cavale Blanche University Hospital, and University of Bretagne Occidentale, EA, 3878, Brest, France
| | - T Lesuffleur
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - M Païta
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - S Czernichow
- Department of Nutrition, Hôpital Européen Georges-Pompidou, Paris Descartes University, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Institut National de la Santé et de la Recherche Médicale Unité Mixe de Service 011, Villejuif, France
| | - A Basdevant
- Institute of Cardiometabolism and Nutrition, Heart and Nutrition Department, AP-HP, Pitié-Salpêtrière Hospital, and Sorbonne Universities, University Pierre et Marie Curie, Paris, France
| | - S Msika
- Department of General, Digestive and Metabolic Surgery, Louis Mourier Hospital, AP-HP, Diderot Paris 7 University, Paris, France
| | - B Millat
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - A Fagot-Campagna
- Department of Statistics, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Paris, France
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46
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Bretault M, Laroche S, Lacorte JM, Barsamian C, Polak M, Raffin-Sanson ML, Touraine P, Bouillot JL, Czernichow S, Carette C. Postprandial GLP-1 Secretion After Bariatric Surgery in Three Cases of Severe Obesity Related to Craniopharyngiomas. Obes Surg 2016; 26:1133-7. [PMID: 26922186 DOI: 10.1007/s11695-015-1977-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Craniopharyngiomas are rare cerebral tumors associated with severe obesity after hypothalamic surgery. A meta-analysis showed significant weight loss at 1 year after bariatric surgery in these patients even though more modest than in common causes of obesity. We hypothesized that this discrepancy could be partly explained by differences in GLP-1 secretion after surgery since patients with craniopharyngioma present a significantly higher degree of insulin resistance and hyperinsulinism than common obese control. We report three cases of bariatric surgery in patients presenting with hypothalamique obesity related to craniopharyngiomas. At 18 months, the mean weight loss was 20 kg with expected insulin resistance decrease. Before surgery, standardized test meal shows abolition of postprandial GLP-1 secretion in all patients with a progressive restoration in the patients with gastric bypass (GBP) surgery.
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Affiliation(s)
- Marion Bretault
- Department of Nutrition, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvelines, Boulogne-Billancourt, 92100, France
| | - Suzanne Laroche
- Department of Nutrition, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvelines, Boulogne-Billancourt, 92100, France
| | - Jean-Marc Lacorte
- Department of Oncology and Endocrine Biochemistry, Pitié-Salpétrière Hospital, AP-HP, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06F-75005, Paris, France.,INSERM, UMR_S 1166, Institute of Cardio-Metabolism and Nutrition (ICAN), Paris, France
| | - Charles Barsamian
- Department of Nutrition, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvelines, Boulogne-Billancourt, 92100, France
| | - Michel Polak
- Pediatric Endocrine Unit, Necker Enfants-Malades Hospital, AP-HP, Université Paris-Descartes, Paris, France
| | - Marie-Laure Raffin-Sanson
- Department of Endocrinology, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvelines, Boulogne-Billancourt, France
| | - Philippe Touraine
- Endocrine and Reproductive Medicine Division, Pitié-Salpétrière Hospital, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Jean-Luc Bouillot
- Department of Metabolic Surgery, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvelines, Boulogne-Billancourt, France
| | - Sebastien Czernichow
- Department of Nutrition, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvelines, Boulogne-Billancourt, 92100, France.,INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
| | - Claire Carette
- Department of Nutrition, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvelines, Boulogne-Billancourt, 92100, France.
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Poghosyan T, Lazzati A, Moszkowicz D, Danoussou D, Vychnevskaia K, Azoulay D, Czernichow S, Carette C, Bouillot JL. Conversion of sleeve gastrectomy to Roux-en-Y gastric bypass: an audit of 34 patients. Surg Obes Relat Dis 2016; 12:1646-1651. [DOI: 10.1016/j.soard.2016.02.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/25/2016] [Accepted: 02/25/2016] [Indexed: 01/07/2023]
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Lassalle M, Fezeu L, Couchoud C, Hannedouche T, Massy Z, Czernichow S. Obésité et accès à la greffe rénale parmi des patients démarrant une dialyse : une étude de cohorte prospective. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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49
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Clerte M, Carette C, Wagner S, Vilaine E, Brodin-Sartorius A, Bretault M, Czernichow S, Massy Z. Mesure du débit de filtration glomérulaire (mDFG) avant et 6 mois après chirurgie bariatrique – étude pilote monocentrique. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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50
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Bretault M, Czernichow S, Ouvry L, Bouillot JL, Barsamian C, Carette C. Evolution of hypothalamic lipoma after Roux-en-Y gastric bypass. Eur J Clin Nutr 2016; 70:1451-1453. [PMID: 27507066 DOI: 10.1038/ejcn.2016.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/06/2016] [Accepted: 07/11/2016] [Indexed: 11/09/2022]
Abstract
Severe obesity is a common consequence of hypothalamic region diseases and their treatment. Only two previous case reports have described hypothalamic lipomas in children with obesity. We described a case of an adult with severe obesity associated with hypothalamic lipoma attached to the third ventricle floor who underwent Roux-en-Y gastric bypass. He lost 38 and 59 kg at 6 and 12 months after surgery, respectively. Weight loss after bariatric surgery was as expected in this patient with severe obesity. At 6 and 12 months, brain magnetic resonance imaging (MRI) showed stability in lipoma's size.
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Affiliation(s)
- M Bretault
- Department of Nutrition, Ambroise Paré Hospital, AP-HP, Versailles Saint-Quentin en Yvelines University, Boulogne-Billancourt, France
| | - S Czernichow
- Department of Nutrition, European Georges Pompidou Hospital, Paris Descartes University, Paris, France.,Inserm, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France
| | - L Ouvry
- Department of Nutrition, Ambroise Paré Hospital, AP-HP, Versailles Saint-Quentin en Yvelines University, Boulogne-Billancourt, France
| | - J L Bouillot
- Department of Surgery, Ambroise Paré Hospital, AP-HP, Versailles Saint-Quentin en Yvelines University, Boulogne-Billancourt, France
| | - C Barsamian
- Department of Nutrition, European Georges Pompidou Hospital, Paris Descartes University, Paris, France
| | - C Carette
- Department of Nutrition, European Georges Pompidou Hospital, Paris Descartes University, Paris, France
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