V. Vautier

Centre Hospitalier Universitaire de Bordeaux, Burdeos, Aquitaine, France

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Publications (11)11.86 Total impact

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    ABSTRACT: AIM: The objective of this study was to investigate low-grade inflammation in children with type 1 diabetes (T1D) and its association with cortisol levels as well as its bioavailability through 11β-hydroxy steroid dehydrogenase type 1 (11β-HSD1) activity. METHODS: Children with T1D (n=45) and their non-diabetic siblings (n=28) participated in the study. Interleukin-6 (IL-6) and high-sensitivity C-reactive protein (CRPhs) were measured between 1400 and 1800h. Glucocorticoid metabolites were measured in the first morning urine on clinic day and 11β-HSD1 activity was estimated by tetrahydrocortisol/tetrahydrocortisone (THF/THE) ratio. RESULTS: Diabetic patients presented with an increased THF/THE ratio compared with controls (median: 0.68 [range: 0.45-1.18] vs 0.45 [0.27-0.98], respectively; P<10(-3)). There was no difference between diabetic patients and controls for IL-6 (0.6ng/mL [0.6-6.8] vs 0.6 [0.6-2.2], respectively; P=0.43) and CRPhs (0.4mg/L [0-7.4] vs 0.3 [0-8.2]; P=0.26, respectively). When adjusted for age, gender and BMI, the THF/THE ratio was significantly associated with CRPhs (β=0.32, P=0.02) in diabetic patients, but not in controls. CONCLUSION: Low-grade inflammation assessed by plasma CRPhs and IL-6 concentrations was not detectable in our cohort of T1D children. Nocturnal 11β-HSD1 activity was increased and associated with plasma CRPhs concentration in diabetic patients. These results may be explained by either a direct or inflammation-mediated effect of the relative hepatic lack of insulin due to subcutaneous insulin therapy.
    Diabetes & Metabolism 11/2012; · 2.39 Impact Factor
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    Diabetes care 01/2012; 35(1):e1. · 7.74 Impact Factor
  • P Barat, S Tastet, V Vautier
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    ABSTRACT: Type 1 diabetes, whose incidence is increasing in the youngest children, could have a long-term neuropsychological impact. Mood disorders are more frequent and some elements of cognitive performance, although within normal ranges, could decrease. In this review, we detail the contribution of animal models to current physiopathological knowledge. We summarize the main clinical studies regarding mood and cognitive performance in diabetic children. Finally, the advantages of imaging in this domain as related to brain development in children are discussed.
    Archives de Pédiatrie 03/2011; 18(4):432-40. · 0.36 Impact Factor
  • Diabetes & Metabolism - DIABETES METAB. 01/2011; 37(1).
  • Diabetes & Metabolism - DIABETES METAB. 01/2011; 37(1).
  • Diabetes & Metabolism - DIABETES METAB. 01/2010; 36.
  • V Vautier, P Moulin, B Guérin, P Barat
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    ABSTRACT: Neonatal thyrotoxicosis is a rare disease. The goal of this study was to analyse main neonatal symptoms, clinical complications and patient's care. This retrospective study concerned the newborns admitted with neonatal thyrotoxicosis between 1992 and 2004 in the neonatal department of Bordeaux, Toulouse and Pau hospital. Seven of these patients were included in the study. All of the newborns had permanent tachycardia and 3 of them had respiratory failure. Two patients had potentially lethal clinical complications. The first had goitre with tracheal compression. The second developed global heart failure on his 13th day of life. The onset of antithyroid drug treatment was between the 3rd and the 18th day of life. Mean duration of treatment was 50 days. Occurring complications were neutropenia in 3 patients and hypothyroidism in 1 patient. The children were tracked during their first year, and all had normal growth and normal neurological development. The main prognostic factor is the early onset of antithyroid treatment. In our study, 2 patients had potentially lethal clinical complications. Adequate care depends on early spotting of high-risk newborn.
    Archives de Pédiatrie 12/2007; 14(11):1310-4. · 0.36 Impact Factor
  • V. Vautier, P. Moulin, B. Guérin, P. Barat
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    ABSTRACT: Neonatal thyrotoxicosis is a rare disease. The goal of this study was to analyse main neonatal symptoms, clinical complications and patient's care.
    Archives De Pediatrie - ARCHIVES PEDIATRIE. 01/2007; 14(11):1310-1314.
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    ABSTRACT: Two of every thousand pregnancies are complicated by Graves' disease. Diagnosis is suggested by maternal disorders (tachycardia, exophthalmia, weight loss.) or fetal disorders (tachycardia, intra-uterine growth retardation, preterm birth.). Due to transfer into the fetal compartment of maternal antibodies which stimulate the fetal thyroid by binding to the thyroid thyrotropin (TSH) receptor, only 1% of children born to these mothers are described as having hyperthyroidism. Neonatal thyrotoxicosis disappears with clearance of the maternal antibodies; clinical signs usually disappear during the first four Months of life. The most frequent neonatal clinical signs of thyrotoxicosis are tachycardia, goiter, hyperexcitability, poor weight gain, hepatosplenomegaly, stare and eyelid retraction. Diagnosis is based on determination of the blood level of triiodothyronine (T3), thyroxine (T4) and TSH. To confirm the nature of hyperthyroidism, thyroid-stimulating immunoglobulins (TSI) should be assayed. The kinetics of TSI provides a guide for therapeutic adaptation and disappearance of TSI is a sign of recovery. Rare cases of familial non-autoimmune hyperthyroidism have been shown to be caused by germline mutation of the thyrotropin receptor. We report a case of severe neonatal hyperthyroidism which led to the diagnosis of maternal Graves' disease.
    Annales d Endocrinologie 05/2004; 65(2):125-30. · 1.02 Impact Factor
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    ABSTRACT: Mlle F., 20 ans, (G4P0 : une grossesse extra-utérine, deux fausses couches précoces en 12 mois) a accouché à 34 semaines d’aménorrhée (SA) d’un nouveau-né eutrophique. Cette grossesse est marquée par une tachycardie maternelle et foetale rapportée à une anémie maternelle à 6,2 g/dl. À la naissance, l’apgar est à 7 puis 10 ; après une détresse respiratoire transitoire d’évolution simple apparaît une hyperexcitabilité permanente associée à des mouvements oculaires anormaux. Le signalement par Mlle F. d’une consommation de cannabis en fin de grossesse pour lutter contre des difficultés d’endormissement fait alors penser à un syndrome de sevrage. Le traitement substitutif par morphinique débuté à J10 est inefficace. Puis le tableau clinique initial associant hyperexcitabilité, trémulations, tachycardie sinusale à 180/ minute se complète d’une diarrhée incoercible et de signes d’insuffisance cardiaque ; on observe aussi une exophtalmie avec fixité du regard et un goitre. Le diagnostic d’hyperthyroïdie néonatale se confirme : T3 : 25,8 pmol/l (N : 2,8-6,5) ; T4 : 67,5 pmol/l (N : 10,3-27) ; TSH < 0,01 mUI/l (N : 0,18-5). Une maladie de Basedow maternelle est suspectée sur les signes cliniques : palpitations, tachycardie, diarrhée, thermophobie, éclat du regard, tremblement fin des extrémités, goiter vasculaire. L’hyperthyroïdie maternelle est confirmée biologiquement. Les anticorps anti-récepteurs de la TSH de type stimulant sont positifs chez la mère : 68,5UI/l (N < 2) et l’enfant : 58,3 UI/l. Les antithyroïdiens de synthèse sont débutés à J15 de vie associés pendant 36 heures à un traitement par β-bloquant et digitalo-diurétique. Le Neomercazole® est arrêté à 2 mois de vie, le développement staturo-pondéral et psychomoteur sont satisfaisants. Conclusion L’originalité de notre observation repose sur la présentation sévère d’une maladie rare : l’hyperthyroïdie néonatale et sur le diagnostic secondaire de maladie de Basedow maternelle.
    Fuel and Energy Abstracts 01/2004; 33(1):83-83.
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    ABSTRACT: Two of every thousand pregnancies are complicated by Graves’ disease. Diagnosis is suggested by maternal disorders (tachycardia, exophthalmia, weight loss…) or fetal disorders (tachycardia, intra-uterine growth retardation, preterm birth…). Due to transfer into the fetal compartment of maternal antibodies which stimulate the fetal thyroid by binding to the thyroid thyrotropin (TSH) receptor, only 1% of children born to these mothers are described as having hyperthyroidism. Neonatal thyrotoxicosis disappears with clearance of the maternal antibodies; clinical signs usually disappear during the first four months of life. The most frequent neonatal clinical signs of thyrotoxicosis are tachycardia, goiter, hyperexcitability, poor weight gain, hepatosplenomegaly, stare and eyelid retraction. Diagnosis is based on determination of the blood level of triiodothyronine (T3), thyroxine (T4) and TSH. To confirm the nature of hyperthyroidism, thyroid-stimulating immunoglobulins (TSI) should be assayed. The kinetics of TSI provides a guide for therapeutic adaptation and disappearance of TSI is a sign of recovery. Rare cases of familial non-autoimmune hyperthyroidism have been shown to be caused by germline mutation of the thyrotropin receptor. We report a case of severe neonatal hyperthyroidism which led to the diagnosis of maternal Graves’ disease.
    Annales D Endocrinologie - ANN ENDOCRINOL. 01/2004; 65(2):125-130.