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Publications (11)20.41 Total impact

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    ABSTRACT: The growth hormone (GH)-insulin-like growth factor-1 (IGF-1) axis is dramatically altered in patients with anorexia nervosa (AN). The aim of the present study was to investigate whether GH and IGF-1 could be predictors of outcome in patients with a restrictive form of AN. Blood levels of GH, IGF-1, adipocytokines, ghrelin, insulin, glucose, and sex and thyroid hormones were measured in eleven women inpatients with AN and in ten healthy women controls. Three stages were compared during refeeding: admission (T0), when BMI reached 16 kg/m2 (T1) and at discharge when BMI reached 17·5 kg/m2 (T2). Clinical status was assessed 6 months after discharge from hospital (T3), and remission was defined by the maintenance of a BMI ≥ 17·5 kg/m2. AN patients in remission (AN-R; n 6) had significantly higher GH levels at admission than those who relapsed (AN-NR; n 5) (P < 0·05). During refeeding (Δ = T2 - T0), the AN-R group differed from the AN-NR group only by both GH level decrease (P < 0·05) and BMI increase (P < 0·05). In multiple regression analysis, ΔGH was associated negatively and significantly and Δleptin and Δbody fat mass levels were associated positively and significantly with BMI at T3 and explained 88 % of its variability (r 2 0·88, P < 0·05). The present study suggests that a low GH level at admission and the absence of its decrease after weight recovery could predict short-term relapse in women suffering from a restrictive form of AN.
    The British journal of nutrition 11/2012; · 3.45 Impact Factor
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    ABSTRACT: Hemorphin peptides exhibit biological activities that interfere with the endorphin system, the inflammatory response, and blood-pressure control. VV-hemorphin-7 and LVV-hemorphin-7 peptides exert a hypotensive effect, in particular, by inhibiting the renin-angiotensin system. Furthermore, levels of circulating hemorphin-7 peptides have been found to be decreased in diseases such as type 1 and type 2 diabetes. Because type 2 diabetes and obesity share common features, such as insulin resistance, microinflammation, high glomerular-filtration rate (GFR), and cardiovascular risk, we evaluated serum VV-hemorphin-7 like immunoreactivity (VVH7-i.r.) levels, using an enzyme-linked immunosorbent assay method, on a group of 54 obese subjects without diabetes or hypertension, compared with a group of 33 healthy normal-weight subjects. Circulating VVH7-i.r. levels were significantly decreased in the obese group compared with the control group (1.98 ± 0.19 vs. 4.86 ± 0.54 µmol/l, respectively, P < 0.01), and a significant negative correlation between VVH7-i.r. and diastolic blood pressure (DBP) was found in obese patients (r = -0.35, P = 0.011). There was no significant correlation between VVH7-i.r. level and insulin resistance, metabolic syndrome, or GFR. The decreased serum hemorphin-7 found in obese subjects, as in diabetes, may contribute to the development of hypertension and to the cardiovascular risk associated with these metabolic diseases.
    Obesity 07/2012; · 3.92 Impact Factor
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    ABSTRACT: Low plasma high-density lipoprotein-cholesterol (HDL-c) level is commonly present in obesity and represents an independent cardiovascular risk factor. However, obese patients are a very heterogeneous population and the factors and mechanisms that contribute to low HDL-c remain unclear. The aim of this study was to investigate the association between plasma HDL-c levels and plasma hormonal profiles (insulin, adiponectin, resistin, leptin and ghrelin) in subsets of class II and III obese patients. Fasting plasma levels of glucose, total cholesterol, LDL-c, HDL-c, triglycerides, free fatty acids, apoproteins A-I, B-100, B-48, C-II, C-III, insulin, hs-CRP, adipocytokines (adiponectin, resistin, leptin), unacylated ghrelin, body composition (DXA) and resting energy expenditure were measured in three subsets of obese patients: 17 metabolically abnormal obese (MAO) with metabolic syndrome and the typical metabolic dyslipidaemia, 21 metabolically healthy obese (MHO) without metabolic syndrome and with a normal lipid profile, and 21 isolated low HDL-c obese patients (LHO) without metabolic syndrome, compared to 21 healthy lean control subjects. Insulin resistance (HOMA-IR) increased gradually from MHO to LHO and from LHO to MAO patients (p < 0.05 between MHO and MAO and between LHO and MAO). In multiple regression analysis, serum unacylated ghrelin levels were only positively and independently associated with HDL-c levels in the LHO group (p = 0.032). These results suggest that, in class II and III obese patients with an isolated low HDL-c phenotype, unacylated ghrelin is positively associated with HDL-c level independently of insulin resistance and CRP levels, and may contribute to the highly prevalent low HDL-c level seen in obesity.
    Nutrition & Metabolism 03/2012; 9(1):17. · 3.16 Impact Factor
  • Diabetes & Metabolism - DIABETES METAB. 01/2011; 37(1).
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    Diabetic Medicine 06/2010; 27(6):725-7. · 3.24 Impact Factor
  • Diabetes & Metabolism - DIABETES METAB. 01/2010; 36.
  • e-SPEN the European e-Journal of Clinical Nutrition and Metabolism 01/2010; 5(1).
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    ABSTRACT: There is little agreement on what constitutes remission in anorexia nervosa. This study compared the medical, psychological, and social status of 2 female populations previously treated for anorexia nervosa and differing in their achievement of normal weight. One hundred forty-one patients responded to a questionnaire documenting morphometric parameters, subjective perception of outcome, concerns about body shape and diet, and quality of familial, emotional, and professional life. Two groups were defined according to body mass index (BMI): normal (n = 69) with BMI > or = 18.5 kg/m(2), and subnormal (n = 72) with BMI < 18.5 kg/m(2). In addition, subgroups (21 in each category) were interviewed. An age-matched control population composed of 156 women, either students or Health Services employees, responded to a similar questionnaire. Only a minority of patients assessed themselves as recovered, and there was no statistically significant difference in perception of recovery between normal BMI and subnormal BMI groups (27.5% and 15.3%, respectively). As expected, underweight patients reported significantly more frequent purging behaviors, amenorrhea, recent hospitalization, and prolonged student status. In contrast, there were no significant differences in terms of pregnancy rate, psychiatric comorbidities, social integration, sexual activity, and self-assessment of professional and familial life. In comparison to control subjects, former anorexia patients with normalized BMI more frequently reported vomiting, fear of high-calorie foods, and treatment for depression. These few long-term advantages observed after BMI normalization suggest that normalization of nutritional status remains an important target in anorexia nervosa. However, the persistence of psychological distress after nutritional recovery confirms that more effective treatments are needed that target long-term psychological recovery.
    Journal of the American College of Nutrition 08/2009; 28(4):397-404. · 1.74 Impact Factor
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    ABSTRACT: Low circulating VVH7-like immunoreactivity (VVH7 i.r) level was amazingly observed in human diabetic sera. Here, we examined the impact of diabetes type, clinico-biological features and metabolic control on circulating VVH7 i.r level in this disease. ELISA test was used to measure VVH7 i.r in sera of 120 diabetic patients (type 1 diabetes in 64, type 2 diabetes in 56). Three enzymatic tests were also applied to determine serum cathepsin D (CD), dipeptidyl peptidase IV (DPP-IV) and angiotensin-converting enzyme (ACE) activities. A subgroup of 24 type 1 diabetic patients negative for microalbuminuria and hypertension were submitted to an ambulatory blood pressure monitoring to evaluate the relationship between VVH7 i.r level and blood pressure parameters. The mean serum concentration of VVH7 i.r was drastically reduced in diabetic patients (0.91+/-0.93 micromol/l versus 5.63+/-1.11 micromol/l in controls) (p<0.001). A negative correlation between VVH7 i.r level and daytime diastolic blood pressure existed in type 1 diabetic patients. There was no association of low VVH7 i.r with either type of diabetes or HbA1c level. An increase of cathepsin D activity was found in serum of diabetic patients compared to controls (0.47 U/ml versus 0.15 U/ml, respectively) whereas DPPIV activity was significantly decreased in diabetic sera (50.81 U/ml versus 282.10 U/l respectively). Diminution of VVH7 i.r in sera of diabetic patients was confirmed but still remained unexplained. Relationships between higher systolic blood pressure and decrease of VVH7 i.r reinforce the need to investigate this pathway in this disease to elucidate its role in macro- and micro-angiopathy.
    Peptides 12/2008; 30(2):256-61. · 2.52 Impact Factor
  • Diabetes & Metabolism - DIABETES METAB. 01/2008; 34.
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    ABSTRACT: AimSporadic malignant insulinoma (SMI) is a rare disease, and the consequent paucity of data in the literature and the development of aggressive treatments for liver metastases have led us to retrospectively analyze a series of 12 cases of SMI.MethodsEvery patient presenting with SMI, according to the WHO 2004 histopathology criteria, between 1970 and June 2005 in Marseille was included in the study. Patients with multiple endocrine neoplasia type 1 (MEN-1) and tumours of uncertain malignant potential were excluded.ResultsThe ratio of male/female was 4/8, and mean age at diagnosis was 52.5 years. A 48-h fasting test in 10 patients was conclusive in nine, after a mean duration of 12 h 45 min. SMI size ranged from 7–120 mm (mean 30.3 mm). Six patients had liver metastases and one had isolated lymph-node invasion. Surgery was performed in 12 patients. Five persisting diseases (mean follow-up of 1.8 years) required other treatments (chemoembolization, radiofrequency thermoablation [RFTA], liver transplantation); one patient relapsed 8.5 years after surgery; six were still in complete remission (mean follow-up of 5.8 years), and one patient had died by the time of the 24-month follow-up.ConclusionAggressive sequential multimodal therapy can prolong the survival of patients with SMI even in the presence of liver metastases.RésuméIntroductionLes insulinomes malins sporadiques sont une pathologie rare. Le manque d’informations sur cette pathologie dans la littérature et le développement de traitements agressifs sur les métastases hépatiques nous ont conduit à analyser de façon rétrospective une série de 12 cas d’insulinome malin sporadique.Patients et MéthodesTous les patients d’une métropole régionale présentant un insulinome malin selon les critères de l’OMS de 2004, hors néoplasie endocrinienne multiple de type 1 et tumeurs à risque d’évoluer vers la malignité, avec confirmation anatomopathologique entre 1970 et juin 2005 ont été inclus.RésultatsLe sex-ratio était de 4H/8F avec un âge moyen au diagnostic de 52,5 ans. L’épreuve de jeûne a pu être effectuée chez dix patients et a été interrompue chez neuf d’entre eux après une durée moyenne de 12 heures 45 minutes. La taille moyenne des tumeurs réséquées était de 7 à 120 mm (moyenne 30,3 mm). Les 12 patients ont été opérés. Six patients avaient une ou des métastases hépatiques et une patiente avait un envahissement ganglionnaire adjacent au pancréas. Après la chirurgie, six patients avaient une maladie persistante (suivi moyen de 1,8 ans) appelant d’autres traitements (chimioembolisation, radiofréquence, transplantation hépatique, analogues de la somatostatine…), un patient a récidivé 8,5 ans après la chirurgie, six patients sont en rémission complète (suivi moyen de 5,8 ans). Seulement une patiente est décédée après 24 mois de traitement.ConclusionCette étude rétrospective illustre la grande variabilité du pronostic des insulinomes malins sporadiques. Leur habituel bas grade de malignité et leur évolution lente conduit à permettre des traitements agressifs sur les métastases hépatiques. La prise en charge de ces patients demande une collaboration multidisciplinaire pour pouvoir améliorer leur survie.
    Diabetes & Metabolism 01/2008; · 2.39 Impact Factor