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Gellen B, Thorin-Trescases N, Sosner P, Gand E, Saulnier PJ, Ragot S, Fraty M, Laugier S, Ducrocq G, Montaigne D, Llaty P, Rigalleau V, Zaoui P, Halimi JM, Roussel R, Thorin E, Hadjadj S. ANGPTL2 is associated with an increased risk of cardiovascular events and death in diabetic patients. Diabetologia 2016; 59:2321-2330. [PMID: 27491833 DOI: 10.1007/s00125-016-4066-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 07/12/2016] [Indexed: 01/24/2023]
Abstract
AIMS/HYPOTHESIS A high serum angiopoietin-like 2 (ANGPTL2) concentration is an independent risk factor for developing diabetes and is associated with insulin resistance and atherosclerosis. In this work, we have examined the impact of serum ANGPTL2 on improving cardiovascular (CV) risk stratification in patients with type 2 diabetes. METHODS A prospective, monocentric cohort of consecutive type 2 diabetes patients (the SURDIAGENE cohort; total of 1353 type 2 diabetes patients; 58% men, mean ± SD age 64 ± 11 years) was followed for a median of 6.0 years for death as primary endpoint and major adverse CV events (MACE; i.e. CV death, myocardial infarction or stroke) as a secondary endpoint. Patients with end-stage renal disease, defined as a requirement for dialysis or a history of kidney transplantation, were excluded. Patients were grouped into quartiles according to ANGPTL2 concentrations at inclusion: <11.2 (Q1), 11.2-14.7 (Q2), 14.8-19.5 (Q3) or >19.5 (Q4) ng/ml. RESULTS During follow up, 367 patients (representing 4.5% of the total person-years) died and 290 patients (representing 3.7% of the total person-years) presented with MACE. Both the survival and MACE-free survival rates were significantly different between ANGPTL2 quartiles (logrank 82.12, p < 0.0001 for death; and logrank 65.14, p < 0.0001 for MACE). Patients with ANGPTL2 concentrations higher than 19.5 ng/ml (Q4) had a significantly higher risk of death and MACE than those with ANGPTL2 levels of 19.5 ng/ml or less (Q1-3) (HR for death 2.44 [95% CI 1.98, 3.00], p < 0.0001; HR for MACE 2.43 [95% CI 1.92, 3.06], p < 0.0001) after adjustment for sex, age and established CV risk factors. Using ANGPTL2 concentrations, prediction of the risk of mortality, as assessed by integrated discrimination improvement (IDI), was significantly improved (IDI 0.006 ± 0.002, p = 0.0002). CONCLUSIONS/INTERPRETATION In patients with type 2 diabetes, serum ANGPTL2 concentrations were independently associated with death and MACE. Therefore, ANGPTL2 is a promising candidate biomarker for improving risk stratification in type 2 diabetes patients, and may prove to be a valuable therapeutic target.
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Affiliation(s)
- Barnabas Gellen
- ELSAN, Polyclinique de Poitiers, 1 Rue de la Providence, F-8600, Poitiers, France.
- Department of Cardiology, CHU Henri Mondor, Créteil, France.
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, France.
| | - Nathalie Thorin-Trescases
- Department of Surgery, Faculty of Medicine, Université de Montréal, Montreal Heart Institute, Montreal, QC, Canada
| | - Philippe Sosner
- CHU de Poitiers Centre d'Investigation Clinique, Poitiers, France
- Université de Poitiers, Laboratoire MOVE (EA 6314), Poitiers, France
- Centre Médico-Sportif Mon Stade, Paris, France
| | - Elise Gand
- CHU de Poitiers, Pôle Dune, Poitiers, France
| | - Pierre-Jean Saulnier
- CHU de Poitiers Centre d'Investigation Clinique, Poitiers, France
- Inserm, CIC 1402, Poitiers, France
- UFR Médecine Pharmacie, Université de Poitiers, Poitiers, France
| | - Stéphanie Ragot
- CHU de Poitiers Centre d'Investigation Clinique, Poitiers, France
| | | | - Stéphanie Laugier
- UFR Médecine Pharmacie, Université de Poitiers, Poitiers, France
- Endocrinologie-Diabétologie, CHU de Poitiers, Poitiers, France
| | - Grégory Ducrocq
- Département Hospitalo-Universitaire FIRE, APHP, Hôpital Bichat, Paris, France
- Faculté de Médecine, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- Inserm U-1148, Paris, France
| | - David Montaigne
- CHU Lille, Service d'Explorations Fonctionnelles Cardiovasculaires, Hôpital Cardiologique, Lille, France
- Faculté de Médecine, Université de Lille, Lille, France
- Inserm U1011, Lille, France
- EGID, Lille, France
- Institut Pasteur de Lille, Lille, France
| | - Pierre Llaty
- CHU de Poitiers Centre d'Investigation Clinique, Poitiers, France
| | - Vincent Rigalleau
- CHU Bordeaux, Haut-Lévêque Hospital, Nutrition-Diabetology Department, Pessac, France
| | - Philippe Zaoui
- CHU de Grenoble, Service Néphrologie, Dialyse et Transplantation, Grenoble, France
- Faculté de Médecine, Université Joseph Fournier, Grenoble, France
| | - Jean-Michel Halimi
- CHU de Tours, Service Néphrologie, Dialyse et Transplantation, Tours, France
| | - Ronan Roussel
- Département Hospitalo-Universitaire FIRE, APHP, Hôpital Bichat, Paris, France
- Faculté de Médecine, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Eric Thorin
- Department of Surgery, Faculty of Medicine, Université de Montréal, Montreal Heart Institute, Montreal, QC, Canada
| | - Samy Hadjadj
- CHU de Poitiers Centre d'Investigation Clinique, Poitiers, France
- Inserm, CIC 1402, Poitiers, France
- UFR Médecine Pharmacie, Université de Poitiers, Poitiers, France
- Endocrinologie-Diabétologie, CHU de Poitiers, Poitiers, France
- Inserm U1082, Poitiers, France
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Baran K, Laugier S, Cramail H. Fractionation of functional polystyrenes, poly(ethylene oxide)s and poly(styrene)-b-poly(ethylene oxide) by liquid chromatography at the exclusion-adsorption transition point. J Chromatogr B Biomed Sci Appl 2001; 753:139-49. [PMID: 11302439 DOI: 10.1016/s0378-4347(00)00372-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The paper reports the fractionation of functional polystyrenes (PSs) and poly(ethylene oxide)s (PEOs) as well as their block copolymers, by liquid chromatography at the exclusion adsorption transition point (EATP-LC), also called "critical conditions" mode. In this specific elution mode (EATP-LC), the fractionation is only governed by the nature and the number of functions attached to the polymer backbone, independent of the molar mass distribution of the whole sample. Functional polystyrenes (alpha- and/or alpha,omega-alcohol-, acetal-, aldehyde- and acidic-PS) could be readily separated from non-functional polystyrenes under various chromatographic conditions. The technique also allowed the fractionation of poly(ethylene oxide)s and PS-PEO block copolymers. In the latter cases, moderately polar columns (grafted silica) and water-based polar eluents were required to obtain a satisfactory fractionation.
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Affiliation(s)
- K Baran
- Laboratoire de Modélisation Avancée des Systèmes Thermiques et Ecoulements Réels, ENSCPB-Université Bordeaux, Talence Cedex, France
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Abstract
Clinical observations on ciguatera were collected between 1964 and 1977 on 3,009 patients from several South Pacific island groups. Patients generally presented with neurologic symptoms such as parasthesia, vertigo, and ataxia, in addition to gastrointestinal symptoms such as diarrhea, abdominal pain, nausea, and vomiting. Patients with this illness usually became symptomatic less than 24 hours after ingestion of the fish and most patients (76.8%) developed symptoms in less than 12 hours. Significant differences in certain symptoms were noted between Melanesian and Polynesian ethnic groups, suggesting a susceptibility difference, or a difference in the nature of the toxin found in different areas of the Pacific. Being poisoned multiple times appeared to result in a clinically more severe illness than disease observed in patients experiencing ciguatera for the first time.
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