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Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest. [ABSTRACT FROM AUTHOR]

Objective: The increasing prevalence of obesity is expected to promote the demand for endocrine testing. To facilitate evidence guided testing, we aimed to assess the prevalence of endocrine disorders in patients with obesity. The review was carried out as part of the Endocrine Work-up for the Obesity Guideline of the European Society of Endocrinology. Design: Systematic review and meta-analysis of the literature. Methods: A search was performed in MEDLINE, EMBASE, Web of Science and COCHRANE Library for original articles assessing the prevalence of hypothyroidism, hypercortisolism, hypogonadism (males) or hyperandrogenism (females) in patients with obesity. Data were pooled in a random-effects logistic regression model and reported with 95% confidence intervals (95% CI). Results: Sixty-eight studies were included, concerning a total of 19.996 patients with obesity. The pooled prevalence of overt (newly diagnosed or already treated) and subclinical hypothyroidism was 14.0% (95% CI: 9.7-18.9) and 14.6% (95% CI: 9.2-20.9), respectively. Pooled prevalence of hypercortisolism was 0.9% (95% CI: 0.3-1.6). Pooled prevalence of hypogonadism when measuring total testosterone or free testosterone was 42.8% (95% CI: 37.6-48.0) and 32.7% (95% CI: 23.1-43.0), respectively. Heterogeneity was high for all analyses. Conclusions: The prevalence of endocrine disorders in patients with obesity is considerable, although the underlying mechanisms are complex. Given the cross-sectional design of the studies included, no formal distinction between endocrine causes and consequences of obesity could be made. [ABSTRACT FROM AUTHOR]

Background: Super obese patients are recommended to lose weight before bariatric surgery. The effect of intragastric balloon (IGB)-induced weight loss before laparoscopic gastric bypass (LGBP) has not been reported. The aim of this prospective randomized multicenter study was to compare the impact of preoperative 6-month IGB with standard medical care (SMC) in LGBP patients. Methods: Patients with BMI >45 kg/m selected for LGBP were included and randomized to receive either SMC or IGB. After 6 months (M6), the IGB was removed and LGBP was performed in both groups. Postoperative follow-up period was 6 months (M12). The primary endpoint was the proportion of patients requiring ICU stay >24 h; secondary criteria were weight changes, operative time, hospitalization stay, and perioperative complications. Results: Only 115 patients were included (BMI 54.3 ± 8.7 kg/m), of which 55 underwent IGB insertion. The proportion of patients who stayed in ICU >24 h was similar in both groups ( P = 0.87). At M6, weight loss was significantly greater in the IGB group than in the SMC group ( P < 0.0001). Three severe complications occurred during IGB removal. Mean operative time for LGBP was similar in both groups ( P = 0.49). Five patients had 1 or more surgical complications, all in the IGB group ( P = 0.02). Both groups had similar hospitalization stay ( P = 0.59) and weight loss at M12 ( P = 0.31). Conclusion: IGB insertion before LGBP induced weight loss but did not improve the perioperative outcomes or affect postoperative weight loss. [ABSTRACT FROM AUTHOR]

Copyright of Obésité is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The primary driver for efficient biological nutrient removal (BNR) in activated sludge treatment is the sufficient supply of soluble carbon. Several methods have been proposed to increase available carbon sources and enhance BNR. This study examines the effect of ultrasonic equipment and mechanical disintegration technologies on surplus activated sludge (SAS), to release additional soluble chemical oxygen demand (SCOD) and volatile fatty acids (VFA), as a carbon food source for BNR. A laboratory sonicator with a maximum power of 550W, a 3KW SONIXTM radial horn and a deflaker declared to be used in the paper industry were investigated. All caused significant release of SCOD, up to 48 fold. The maximum concentration of VFA reached (from 0-1 mg l-1), was 530 mg l-1. To assess the likely impact to BNR, batch (2l) anaerobic lab tests examining the use of disintegrated sludge on phosphorus and nitrogen removal were completed. Phosphorus removal was estimated by observing the phosphate release under anaerobic conditions and up to 460% more release was observed relative to controls. In addition, denitrification rates were improved by over 106%. Ultrasonic and mechanical disintegration technologies have been shown to release soluble carbon for BNR, with subsequent laboratory nitrogen and phosphorus removal efficiencies observed to be comparable to acetate. [ABSTRACT FROM AUTHOR]

Objective.-To evaluate the effect of topiramate migraine prophylaxis on subject responsiveness to triptans used for acute symptomatic migraine treatment. Background.-Clinical experience suggests that prophylactic migraine treatment may enhance the efficacy of symptomatic medications used to treat acute migraine attacks. Methods.-This open-label, single-arm multicenter study consisted of a 6-week baseline period followed by a 16-week topiramate treatment period. Subjects meeting International Headache Society (IHS) criteria for migraine with and without aura signed consent and entered the baseline period. Those with 3 to 12 migraine periods per month during baseline received topiramate prophylactic treatment. Only patients who completed at least 12 weeks of topiramate treatment were included in the data analysis. Results.-Of 55 patients screened, 40 subjects entered the topiramate treatment period and 21 subjects received at least 12 weeks of treatment. Mean final dose of topiramate was 124 mg per day (range 50 to 200 mg per day). During the baseline period, the mean percentage of attacks rendered pain-free at 2 hours for the 21 subjects was 46.9% (SD = 31.9), while during the topiramate treatment period it was 44.6% (SD = 32.2) (P= .8). On topiramate, after the first 8 weeks of dosage titration, patients experienced a mean of 3.68 migraine attacks/month, compared to 4.31 during the baseline period (P < .03). Thirteen subjects discontinued because of adverse events. The most commonly reported adverse events were paresthesia, fatigue, anxiety, and dizziness. Conclusion.-Although topiramate prophylaxis did reduce migraine attack frequency, in this pilot study topiramate prophylactic migraine treatment did not increase the proportion of patients pain-free 2 hours after symptomatic triptan therapy. [ABSTRACT FROM AUTHOR]

Adiponectin is an adipocyte-derived hormone that plays an important role in lipid metabolism and glucose homeostasis. Objectives of this study were 1) to determine the presence and distribution of adiponectin and its receptors 1 and 2 (adipoR1 and adipoR2) in porcine tissues; 2) to characterize pig adiponectin, adipoR1, and adipoR2 mRNA levels in various fiat depots from three different breeds of pigs; and 3) to study, in stromal-vascular cell culture, the effects of leptin and tumor necrosis factor-α (TNFα) on pig adiponectin, adipoR1, and adipoR2 gene expression. To this end, fat Chinese Upton Meishan (UM, n = 10), lean Ham Line (HL, n = 10), and Large White (LW, n = 10) gilts were used. We report the isolation of partial cDNA sequences of pig adipoR1 and adipoR2. Porcine deduced AA sequences share 97 to 100% homology with human and murine sequences. Pig adipoR1 mRNA is abundant in skeletal muscle, visceral fat, and s.c. fat tissues, whereas adipoR2 mRNA is predominantly expressed in liver, heart, skeletal muscle, and visceral and s.c. fat tissues. Pig adiponectin mRNA levels in s.c. and visceral fat tissues were not associated with plasma insulin and glucose in fasting animals. Subcutaneous (r = -0.44, P < 0.05), visceral (r = 0.43, P < 0.05), and total body fat (r = -0.42, P < 0.05) weights were negatively correlated with adiponectin mRNA levels measured in visceral, but not s.c., fat. Pig adipoR1 and adipoR2 mRNA levels, in visceral fat, were less expressed in fat UM gilts than in the lean HL gilts (P < 0.05). Inverse associations were found between s.c. (r = -0.57, P < 0.01), visceral (r = -0.46, P < 0.05), and total body fat (r = -0.56, P < 0.01) weights and adipoR2 mRNA levels in visceral fat only. We were unable to find such associations for adipoR1 mRNA levels in the overall gilt population. The current study demonstrated that TNFα downregulates adiponectin and adipoR2, but not adipurl, mRNA levels in stromal-vascular cell culture. Moreover, leptin significantly decreased adiponectin mRNA levels, whereas there was no effect on adiponectin receptors. We conclude that adiponectin and adipoR2 mRNA levels, but not adipoR1, are modulated in pig visceral fat tissues. Furthermore, our results indicate that TNFα interferes with adiponectin function by downregulation of adipoR2 but not of adipoR1 mRNA levels in pigs. [ABSTRACT FROM AUTHOR]

Coronary microcirculation dysfunction may be associated with myocardial perfusion defects on thallium imaging in diabetic patients without coronary artery stenosis. Microvascular coronary adaptation to increased myocardial oxygen demand in response to sympathetic stimulation evoked by the cold pressor test was examined in 22 type 2 diabetic patients with thallium imaging defects and in 15 control subjects. Both the diabetic patients and control subjects had angiographically normal coronary arteries and no other risk factors. Despite a similar increase in the rate-pressure product in the two groups (22.6 +/- 12.4% in diabetic patients and 31.8 +/- 8.2% in control subjects, NS), coronary blood flow increase in the left anterior descending artery (mean flow velocity measured by intracoronary Doppler multiplied by the cross-sectional area measured by digital angiography) was significantly lower in diabetic patients than in control subjects (14.7 +/- 19.8 vs. 75.5 +/- 13.5%, respectively; P = 0.0001). In addition, when there was a positive correlation between the two parameters in control subjects (r = 0.651, P < 0.01), there was no relationship in diabetic patients (r = 0.054). In conclusion, vasodilation of the coronary microcirculation in response to sympathetic stimulation evoked by the cold pressor test is impaired in type 2 diabetic patients without epicardial artery lesions. This microvascular impairment during sympathetic stimulation may explain exercise-induced myocardial perfusion abnormalities observed in these patients and may impair microcirculatory coronary vasodilation during current life stress episodes such as exercise, mental stress, or cold exposition. [ABSTRACT FROM AUTHOR]

This study was designed to test the hypothesis that poly(ADP-ribose) polymerase (PARP) plays a role in the repair of damage to mitochondrial DNA (mtDNA). A rat insulinoma cell line was transfected with a PARP antisense vector that was under the control of a dexamethasone promoter. Transfected cells were selected for stable integration of the antisense vector. Several cell lines containing the antisense vector were isolated. For these studies, one of these lines (clone 5) was chosen for further evaluation. When cells were treated with dexamethasone for 72 h, PARP activity was diminished by 60%. Western blot analysis revealed a concomitant reduction in PARP protein. When clone 5 cells were exposed to the simple methylating agent methylnitrosourea (MNU) without previous treatment with dexamethasone, repair of lesions in mtDNA was found to be similar to that seen in wild-type cells or in wild-type cells treated with dexamethasone. However, when clone 5 cells were pretreated with dexamethasone for 72 h, repair of MNU-induced damage was significantly inhibited. To ascertain whether the PARP activity that was inhibited by the antisense treatment was the same as that found in the nucleus, repair studies were performed on fibroblasts derived from PARP knockout mice and their normal wild-type controls. Attenuated repair was also seen in the cells in which the gene for PARP was inactivated. These are the first studies to demonstrate that PARP can facilitate the repair of simple alkylation damage to mtDNA. [ABSTRACT FROM AUTHOR]

Abstract While bulimia nervosa (BN) typically begins in girls during late adolescence, puberty and associated developmental changes have been linked to negative body image and onset of a variety of psychological problems. This study aimed to identify early psychopathological signs, which could have marked the period of puberty in subjects whom later developed BN. In a case control study, we compared 49 girls with BN according to DSM-IV, aged between 18 and 20 years, to 49 girls of the same age, who were free of any past or current psychiatric diagnosis. Psychiatrists or clinical psychologists, using a semi-structured clinical interview including retrospective assessment of the emotional and behavioural changes that had occurred in puberty evaluated both groups. Before the onset of a clinical eating disorder, the subjects with BN presented significantly more often than controls weight related concerns, attitudes of withdrawal and social isolation, and negative changes in their body image and self-image, as well as in their relationships with siblings and peers. The results suggest that early psychological distress precedes the onset of an eating disorder in many cases, and that prevention efforts should be directed towards peripubertal psychopathology. [ABSTRACT FROM AUTHOR]

415 enfants parisiens ont #aaet#aae suivis de 3 mois #aga 3 ans, #aga l'aide de 4 questionnaires portant sur leur sant#aae, leur d#aaeveloppement, leur environnement familial et social, leur mode de grade. Une m#aaethode d'analyse typologique a permis d'#aaetudier la nature et l'#aaevolution de la symptomatologie fonctionnelle et de d#aaefinir 3 groupes homog#aaenes: enfants dont l'#aaetat satisfaisant #opGSR#cp, enfants ayant des troubles divers et fr#aaequents #opGHR#cp, groupe interm#aaediaire #opGFR#cp, Le suivi de ces enfants #aga l'expiration de leur 1re ann#aaee d'#aaecole primaire #op7 ans#cp a #aaet#aae assur#aae. Les r#aaesultats de cette derni#agere #aaetape montrent une persistance de certains troubles #opsant#aae, sommeil#cp, une diversification des troubles avec l'age #optroubles psychosomatiques, troubles scolaires, troubles de la communication#cp, une relation entre sexe et niveau de risque, le r#afole “aggravant” plut#afot que d#aaeterminant des variables socio-culturelles. Cette #aaetude apporte donc des #aael#aaements int#aaeressants #aga la discussion de la valeur pronostique des troubles pr#aaecoces. † Travail de l'Unit de Recherche sur les Sociopathics, Inserm, u. 185. 44 Chemin de Ronde, 78110 Le V#aaesinet. Accept#aae le 7 Janvier, 1986. The Editor gratefully acknowledges permission to reprint this paper in translation. It first appeared in ‘Archives Fran#alcaise de Pedriatrie! 42. 1985. [ABSTRACT FROM PUBLISHER]

Sexual assault on children and adolescents has become a common topic of study, but there has been little research into the specific characteristics of the population of male victims. A national survey representative of school-age adolescents in France enabled us to study 465 adolescents reporting sexual assault (121 boys, 344 girls; mean age 15.4, SD 2.5 years). Girls were shown to be more frequently affected by certain medicopsychological symptoms: nightmares, multiple somatic complaints and some items concerning mood disorders. On the other hand, behavioural symptoms were much more frequently expressed in boys, in particular: repeated suicide attempts, running away, fits of violence and substance use. Boys presenting these symptoms should be questioned as a matter of routine concerning a history of sexual assault. [ABSTRACT FROM AUTHOR]

A cohort study of 327 French adolescents was carried out from 1983 to 1985 to investigate 1) the prevalence, incidence and remission rates of alcohol consumption 2) the significance of alcohol consumption before age 16 and its evolution. Among the young people with high alcohol consumption at age 16 (20%), 40% (30% among boys, 68% among girls) decrease their consumption at age 17 or 18. There are great differences between problem drinkers at age 16, and the others. They reveal more risky behaviour, more psychosomatic symptoms and have a more active life style. Even if they decrease their alcohol consumption between age 16 and their 18, their behaviour and psychosomatic problems persist. [ABSTRACT FROM AUTHOR]

A group of 3,287 French school pupils between the age of 12 to 20 years, of whom 14.4% had sought consultation for depression, were investigated in order to analyse the factors related to the type of medical help obtained. Multivariate analyses showed that severe emotional distress alone did not explain the help-seeking behavior. Thus, among those adolescents with the same anxio-depressive level, girls, older adolescents, adolescents with parents living apart, with health worries, and adolescents often absent from school more often sought help for depression. Socio economic status, however, did not correlate with a higher level of consultation for depression. Adolescents attending medical services for depression had a higher consultation rate, for any reason, with general practitioners and with school nurses, in whom they confided more often than their counterparts. Nonmedical professionals also seemed to contribute to accessing to medical help for depression. Overall, those who consulted for depression, in very limited numbers turned to mental health services (8.4%). [ABSTRACT FROM AUTHOR]

A group of 3,287 French school pupils between the age of 12 to 20 years, of whom 14.4% had sought consultation for depression, were investigated in order to analyse the factors related to the type of medical help obtained. Multivariate analyses showed that severe emotional distress alone did not explain the help-seeking behavior. Thus, among those adolescents with the same anxio-depressive level, girls, older adolescents, adolescents with parents living apart, with health worries, and adolescents often absent from school more often sought help for depression. Socioeconomic status, however, did not correlate with a higher level of consultation for depression. Adolescents attending medical services for depression had a higher consultation rate, for any reason, with general practitioners and with school nurses, in whom they confided more often than their counterparts. Nonmedical professionals also seemed to contribute to accessing to medical help for depression. Overall, those who consulted for depression, in very limited numbers turned to mental health services (8.4%). [ABSTRACT FROM AUTHOR]

Both streptozotocin and chlorozotocin, the 2-chloroethyl analogue of streptozotocin, are diabetogenic chemicals in rodents. Although these chemicals are similar structurally, they appear to act on pancreatic B cells via different mechanisms [1, 2]. In studies here, damage and repair of DNA after exposure of an insulin-secreting cell line to streptozotocin and chlorozotocin were assessed by nucleoid sedimentation and alkaline elution. Equitoxic concentrations of streptozotocin and chlorozotocin caused significant single-strand breakage of DNA ( p<0.005). These lesions were repaired in a time-dependent manner, with most repair completed by 24-h post-exposure to chemicals. Additionally, chlorozotocin caused DNA-DNA and DNA-protein crosslinks in insulinoma cells. When proteinase K was included in the crosslinking assay, a substantial proportion of the chlorozotocin-associated crosslinks proved to be DNA interstrand in nature. Analysis of the amount of interstrand crosslinking in insulinoma cells after exposure to chlorozotocin for 1 h showed that formation of interstrand crosslinks was slow. Increasing amounts appeared over a 24-h period. These results suggest that the formation of irreversible DNA interstrand crosslinks may be a critical factor in cytotoxicity and diabetogenicity caused by chlorozotocin. [ABSTRACT FROM AUTHOR]

Antibodies produced in the mouse by repeated intraperitoneal injections of partly purified atrial natriuretic factor (low molecular weight peptide (LMWP) and high molecular weight peptide (HMWP)) have been used to localize these factors by immunohistochemistry (immunofluorescence and immunoperoxidase method) and by immunocytochemistry (protein A-gold technique) in the heart of rats and of a variety of animal species including man and in the rat salivary glands. Immunofluorescence and the immunoperoxidase method gave identical results: in the rat, atrial cardiocytes gave a positive reaction at both nuclear poles while ventricular cardiocytes were consistently negative. The cardiocytes of the right atrial appendage were more intensely reactive than those localized in the left appendage. A decreasing gradient of intensity was observed from the subpericardial to the subendocardial cardiocytes. The cardiocytes of the interatrial septum were only lightly granulated. Sodium deficiency and thirst (deprivation of drinking water for 5 days) produced, as already shown at the ultrastructural level, a marked increase in the reactivity of all cardiocytes from both atria with the same gradient of intensity as in control animals. Cross-reactivity of intragranular peptides with the rat antibodies allowed visualization of specific granules in a variety of animal species (mouse, guinea pig, rabbit, rat, dog) and in human atrial appendages. No reaction could be elicited in the frog atrium and ventricle although, in this species, specific granules have been shown to be present by electron microscopy in all cardiac chambers. With the protein A-gold technique, at the ultrastructural level, single labeling (use of one antibody on one face of a fine section) or double labeling (use of two antibodies on the two faces of a fine section) showed that the two peptides are localized simultaneously in all three types (A, B and D) of specific granules. In the rat salivary glands, immunofluorescence and the immunoperoxidase method showed reactivity exclusively in the acinar cells. The reaction was most intense in the acinar cells of the parotid gland. In the sublingual gland, only the serous cells, sometimes forming abortive 'demi-lunes', were reactive. In the submaxillary gland, the reaction was weaker and distributed seemingly haphazardly in the gland. The most constantly reactive cells were localized near the capsule while many cells did not contain visible reaction product. [ABSTRACT FROM AUTHOR]

Human adipose tissue (hAT) is constituted of structural units termed lobules, the organization of which remains to be defined. Here we report that lobules are composed of two extracellular matrix compartments, i.e., septa and stroma, delineating niches of CD45−/CD34+/CD31− progenitor subsets characterized by MSCA1 (ALPL) and CD271 (NGFR) expression. MSCA1+ adipogenic subset is enriched in stroma while septa contains mainly MSCA1−/CD271− and MSCA1−/CD271high progenitors. CD271 marks myofibroblast precursors and NGF ligand activation is a molecular relay of TGFβ-induced myofibroblast conversion. In human subcutaneous (SC) and visceral (VS) AT, the progenitor subset repartition is different, modulated by obesity and in favor of adipocyte and myofibroblast fate, respectively. Lobules exhibit depot-specific architecture with marked fibrous septa containing mesothelial-like progenitor cells in VSAT. Thus, the human AT lobule organization in specific progenitor subset domains defines the fat depot intrinsic capacity to remodel and may contribute to obesity-associated cardiometabolic risks. In human adipose tissue (AT), adipocytes are organized into units of lobules. Here the authors identify distinct fibrous septal and stromal compartments within AT lobules that differ in composition and potential between subcutaneous and visceral regions and are disturbed in obesity and metabolic syndrome. [ABSTRACT FROM AUTHOR]

Focuses on a study which tested the hypothesis that insulin-treated type 2 diabetic patients might return to the maximal weight they reached before the onset of diabetes- and insulin deficiency-induced weight loss. Methodology; Results; Interpretation of findings.