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Résumé Introduction La bio-impédancemétrie (BIA) perd en précision chez les athlètes très minces ou très lourds à cause de limitations du modèle traditionnel qui assimile le corps à un cylindre. Ces limitations sont corrigées par un modèle plus proche de la réalité anatomique, utilisé par la BIA segmentaire. Synthèse des faits Nous avons testé un nouveau dispositif utilisant cette approche, le Biacorpus RX4000 (Healthnesslink, France), que nous avons validé d’abord contre la DEXA et ensuite utilisé chez une équipe de rugbymen. La validation chez 96 sujets couvrant un éventail de IMC 13–48 kg/m 2 a montré pour la masse grasse (MG) une concordance remarquable ( r = 0,988 ; erreur moyenne 0,532 [95 % intervalle de confiance, IC : −0,495 ; 1,56]) avec DEXA. La composition de chaque segment est prédite avec précision ( r = 0,823–0,958). Dans une équipe de 29 rugbymen (âge : 18–31 ans ; indice de masse corporelle moyen : 29 [allant de 21 à 41 kg/m 2 ]), nous avons trouvé un % moyen de masse grasse de 18,46 %, la masse musculaire étant en moyenne du double de la masse grasse. Alors que ni la masse musculaire mesurée avec BIA, ni la BCM n’étaient prédictifs des mesures de performance de sprint, le temps de 10 m en sprint était fortement corrélé à la masse grasse ( r = 0,738, p < 0,01) et au pourcentage de masse grasse ( r = 0,750, p < 0,01). De même le temps mis à effectuer le test de sprints répétés de Gacon 45-15 était corrélé à la masse grasse ( r = 0,783, p < 0,01) et au % FM de masse grasse ( r = 0,693, p < 0,01). Conclusion Ainsi, cette technique nouvelle de BIA segmentaire fournit une détermination plus précise de la masse maigre et de la masse grasse chez les sujets minces et obèses, et fournit des mesures fortement corrélées avec la performance au sprint et au test de Gacon chez les rugbymen, mettant en évidence l’effet négatif d’un excès de masse grasse sur cette performance. Summary Introduction We previously reported highly significant correlations between body cell mass (BCM) measured by BIA and aerobic capacity in rugby players. However, BIA loses precision in slim or heavy athletes due to limitations of the model that are overcome with segmental BIA. Synthesis of the facts We tested a new device using this approach, the RX4000 Biacorpus (Healthnesslink, France), that we validated first against DEXA and then applied to a team of rugby players. Validation in 96 subjects covering a range of BMI 13–48 kg/m 2 showed for fat mass (MG) a remarkable agreement ( r = 0.988; average error 0.532 [95% confidence interval, CI: −0.495; 1.56]) with DEXA. The composition of each segment is accurately predicted ( r = 0.823–0.958). In a team of 29 rugby players (age: 18–31 yr; mean body mass index 29 (ranging from 21–41 kg/m 2 ), we found an average % of fat mass of 18,46% and muscle mass was on the average two-fold bigger than fat mass. However, neither muscle mass nor BCM measured with BIA were predictor of measurements of sprint performance, while the time of 10 m sprint was strongly correlated to fat mass ( r = 0.738, P < 0.01) and to % fat mass ( r = 0.750, P < 0.01) as did the time to perform Gacon's 45-15 repeated sprint test (FM r = 0.783, P < 0.01; % FM r = 0.693, P < 0.01). Conclusion Thus, this new segmental BIA technique provides a markedly improved determination of fat and fat free mass in lean and obese subjects and provides measurements strongly correlated with sprint and repeated test performance in rugby players, emphasizing the negative effect of excess fat mass on this performance. [ABSTRACT FROM AUTHOR]

The observation of ambiguous genitalia in the newborn signals a medical, surgical and psychological emergency. The most crucial decision will be the choice of sex assignment. Rapid and precise diagnosis is thus essential. In XY newborns with normal/high plasma testosterone (T), partial androgen insensitivity syndrome (PAIS) is usually the first diagnosis evoked, which implies an androgen receptor (AR) defect. The diagnosis of steroid-5-alpha-reductase deficiency is rarely considered by the paediatrician. We report three new SRD5A2 gene mutations in four newborns from France, Morocco and Turkey. The newborns presented with ambiguous genitalia and normal plasma T values and the initial diagnosis\PAIS. In all four cases, normal sequences of the complete AR gene excluded this diagnosis and raised the hypothesis of 5α-reductase deficiency. The entire coding region (5 exons) of the SRD5A2 gene was assessed by PCR and direct sequencing analysis. For patient 1, we identified a new homozygous 2bp deletion in exon 1 (c.122_123delAG). Patient 2 had a known homozygous mutation, p.G115D, in exon 2. New compound heterozygous mutations in exon 4 (p.A215V) and exon 5 (p.X255Q) were found in patient 3. Patient 4 presented a new substitution in exon 1 (p.S14R) associated with a known polymorphism (p.V89L). Our data confirm our previous experience and clearly demonstrate that a 5-α reductase defect should be considered in all XY newborns with ambiguous genitalia and normal plasma T secretion, whatever their geographic area or ethnic group; moreover, this defect was not linked to specific phenotype. Early molecular diagnosis is indispensable for the crucial decision of the newborn's sex of rearing. [ABSTRACT FROM AUTHOR]

Abstract: Introduction. – Rhythmic gymnastic is an early maturity sport discipline which associated intensive training and caloric undernutrition. These constraints might potentially induce an alteration of growth and pubertal development. Synthesis. – The aim of this medical follow-up was to evaluate the effect of intensive training (20 to 25 hours/week) on the growth and the pubertal development of young gymnasts (10–17 years) by the evaluation of clinical, radiological and biological parameters. Conclusion. – This medical follow-up started to 3 years and conducted in about forty gymnasts (10–17 years) highlights pubertal development abnormalities which require a medical estrogens substitution in certain athletes. This type of medical follow-up should be extended to other discipline at early maturity. [Copyright &y& Elsevier]

Background: Comorbidity of bipolar disorder (BD) and eating disorders (ED) is common and increases the course and severity of BD. However, the impact of comorbid BD on the clinical profile of ED patients remains unclear. Most studies have focused on patients primarily assessed for BD and data on patients with a primary diagnosis of ED are sparse. We investigated the association between a dual diagnosis and severity in terms of clinical, neuropsychological dimensions and daily functioning.Method: Two hundred and sixty-one patients with ED were consecutively recruited. BD was screened with the MINI and further confirmed in the French expert centre network. The severity of ED symptoms was assessed with the EDE-Q and EDI-2, daily functioning with the FAST. The neurocognitive assessment targeted attention, set-shifting and decision-making.Results: Forty-nine patients screened positive for BD, but diagnosis was confirmed in only thirty patients (11.5% of the cohort). After multiple adjustments, comorbidity was associated with greater severity on the total score and three subscales of the EDE-Q and on four of the ten dimensions of the EDI-2. Comorbid BD was associated with lower daily functioning but not with lower neuropsychological performance.Limitations: Sample referred to specialist clinics not large enough to authorize an analysis by subtype and cross-sectional evaluation.Conclusion: The association between ED and BD increases ED severity for most of these core features. It negatively impacts daily functioning. The results also highlight issues about the validity of screening tools to detect BD in patients with ED. [ABSTRACT FROM AUTHOR]

Introduction – Endurance athletes frequently present an exercise induced hypoxemia at sub-maximal or maximal exercise.Methods – The results of a recent study that compared two groups of highly trained athletes, one with exercise induced hypoxemia and the other without, suggested that a difference in training volume (4 hours per week) and/or training intensity may explain the difference in the exercise-induced hypoxemia observed. The aim of the study was to evaluate the effects of volume and/or intensity of training on exercise induced desaturation in triathletes during a competitive season.Conclusions – This study showed that exercise induced desaturation was related to both volume and intensity of training in triathletes. [Copyright &y& Elsevier]

Investigates whether four months of intensified training would result in modified plasma insulin-like growth factor I, insulin-like growth factor binding protein 1 (IGFBP-1) or IGFBP-3 in eight competitive cyclists and eight sedentary individuals. Relationship with glucose disposal; Measurement of insulin sensitivity and glucose effectiveness.

La détermination de la dépense énergétique de repos (DER) et de la composition corporelle sont des éléments importants dans l'évaluation nutritionnelle des patients atteints d'anorexie mentale (AN). La DER de patients souffrant d'AN est diminuée en comparaison de celle de sujets sans AN suggérant une adaptation connue de la dépense énergétique à la sous-alimentation chronique. Ces modifications sont généralement attribuées aux changements de leur composition corporelle, réduction de leur masse maigre (MM) métaboliquement active. Cependant, des phénomènes thermogéniques peuvent se produire en fonction des profils cliniques des patients AN (restrictif ou purgatif) pouvant impacter le turnover (entrée et sortie) énergétique, lui-même pouvant être estimé par la DER. L'objectif principal de cette étude était de déterminer et comparer les profils de DER mesurée dans les deux types d'AN (restrictif : AN-R et purgatif : AN-BP). Dans un second temps, afin d'estimer leur adaptation métabolique, le lien entre la DER mesurée et théorique ainsi que l'impact de la composition corporelle ont été analysés. Le caractère « hypométabolique » (DER mesurée inférieure à la DER théorique) a été également étudié. La dépense énergétique de repos a été mesurée par calorimétrie indirecte (Quark RMR, Cosmed, Rome, Italy) après une nuit de jeune et calculée théoriquement avec l'équation de Harris et Benedict. La composition corporelle a été obtenue par anthropométrie et par impédancemétrie. Cette étude observationnelle rétrospective a inclus 89 patients AN (IMC moyen 17,6 ± 2,2 kg/m2), majoritairement de sexe féminin (92 %), dont 48 patients AN-R et 41 patients AN-BP, de 24,8 ± 8,7 ans et 26,0 ± 7,9 ans, et de 47,1 ± 7,0 et 49,3 ± 8,7 kg, p = NS, respectivement. La dépense énergétique mesurée était significativement plus faible dans le groupe AN-R que dans le groupe AN-BP (1101,9 ± 210,3 versus 1221,8 ± 194,7 kcal/j respectivement, p = 0,007). Aucune différence significative n'a été trouvée entre les deux groupes en termes de DER théorique (p = 0,7). Entre AN-R et AN-BP, la masse maigre n'était pas différente (37,7 ± 5,3 vs 37,6 ± 5,4 kg, p = NS) mais la masse grasse était plus élevée chez AN-BP (9,4 ± 4,2 vs 11,7 ± 4,7 kg, p < 0,02). Par rapport à la DER théorique et comparé aux AN-BP, les patients AN-R étaient statistiquement plus hypométaboliques (37,5 % versus 9,8 % ; p = 0,002). Enfin, malgré une relation significative entre la DER et la masse maigre dans les 2 groupes (r2 = 0,23 et r2 = 0,49), il n'y avait pas de différence significative entre les droites de corrélation (p = 0,39) suggérant l'absence de contribution de la masse maigre dans ces différences de DER entre les groupes AN-R et AN-BP. Les résultats indiquent que la DER des patients AN-R est inférieure à celle de patients AN-BP avec une prévalence plus forte de patients AN-R « hypométaboliques », ceci de façon indépendante aux changements de la composition corporelle. Ces données suggèrent un rôle du maintien de l'ingestion alimentaire dans un processus thermogénique passant par des médiateurs encore à définir. [ABSTRACT FROM AUTHOR]

Patients with eating disorders (EDs) frequently report a history of childhood trauma (CT). We investigated whether certain subtypes of CT are associated with more severe features of EDs, independently of psychiatric comorbidity, and whether they act additively. One hundred and ninety-two patients with DSM-V-defined EDs were consecutively recruited. Five clinical characteristics were assessed: restraint, eating, shape and weight concerns on the EDE-Q, and daily functioning. CT was assessed by the childhood traumatism questionnaire. The clinical features were associated with at least one CT subtype (emotional, sexual or physical abuse, emotional neglect). Multivariate analyses adjusted for lifetime comorbid psychiatric disorders revealed that emotional abuse independently predicted higher eating, shape and weight concerns and lower daily functioning, whereas sexual and physical abuse independently predicted higher eating concern. A dose-effect relationship characterised the number of CT subtypes and the severity of the clinical features, suggesting a consistent and partly independent association between CT and more severe clinical and functional characteristics in EDs. Emotional abuse seems to have the most specific impact on ED symptoms. Last, not all CT subtypes have the same impact but they do act additively. [ABSTRACT FROM AUTHOR]

Background: In order to study the effect of a competitive triathlon season on maximal oxygen uptake (VO2max ), aerobic power (AeP) and anaerobic performance (AnP) of the lower limbs, eight triathletes performed exercise tests after: (1) a pre-competition period (Pre-COMP) (2) a competitive period (COMP), and (3) a low (volume and intensity) training period (Post-COMP). The tests were a vertical jump-and-reach test and an incremental exercise test on a cycle ergometer. Ventilatory data were collected every minute during the incremental test with an automated breath-by-breath system and the heart-rate was monitored using a telemetric system . Results: No changes in VO2max were observed, whereas AeP decreased after Post-COMP compared to Pre-COMP and COMP and AnP decreased during COMP compared to Pre-COMP and Post-COMP. In addition, second ventilatory threshold (VT2 ) and power output at first ventilatory threshold (VT1 ) and VT2 decreased after Post-COMP . Conclusion: This study showed that six weeks of low volume and intensity of training is too long a period to preserve adaptations to training, although a stable maximal oxygen uptake throughout the triathlon season was observed. Moreover, the AnP decrease during COMP was probably in relation with the repetitive nature of the training mode and/or triathlon competitions . [ABSTRACT FROM AUTHOR]