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Objectives Osteoprotegerin (OPG), a soluble member of tumor necrosis factor receptor superfamily that inhibits bone resorption, has been suggested as a cardiovascular risk factor in humans. In this study, we aim to investigate the potential relationship between OPG and MetS (MetS) in a sub-Saharan African population. Methods Four hundred and eleven volunteers (152 men, 259 women) aged ≥ 18 years recruited from the general population in Douala and Edea, Cameroon participated in this study. Anthropometric parameters measured and blood samples were collected for glucose, serum lipids and OPG concentrations measurements. Mean differences of the variables in different groups were compared using Students’ t test. We performed logistic regressions to analyze the impact of independent factors on the relation between OPG and MetS outcome. MetS was defined using the Joint Interim Statement 2009. Results OPG levels did not vary significantly between both men and women with and without MetS (both P > 0.05). However, with high fasting blood glucose (≥ 5.6 mmol/L) had a significantly higher OPG level than those with lower glucose level ( P = 0.014). In multiple logistic regression analysis, MetS did not show any significant association with serum OPG levels in men and women after adjusting for age, physical activity, alcohol consumption and menopausal status in women ( P = 0.720 and P = 0.930 respectively). Conclusion This study failed to demonstrate any relationship between OPG and MetS. Nevertheless, the positive association between blood glucose and OPG levels reveals that OPG might be involved in cardiovascular risk development in this sub-Saharan African population.

Saxagliptin, a dipeptidyl peptidase-4 inhibitor, has been the focus of a large clinical development programme, including Phase 3 randomized vs placebo-controlled clinical trials as add-on therapy in patients with type 2 diabetes (T2D) with inadequate glycemic control using initial monotherapy (metformin, glibenclamide, thiazolidinedione). This clinical programme has shown saxagliptin to be effective in the control of fasting and postprandial glycemic parameters, in addition to a good overall safety profile. The present paper aims at reviewing the overall short-term and long-term efficacy of saxagliptin in its Phase 3 development program and tries to pinpoint some factors that may be more predictive of treatment response in clinical practice. In individual and pooled analyses of the three pivotal add-on to monotherapy trials, saxagliptin (5mg once daily) led to significant reductions in HbA(1c) from baseline to 24 weeks. Additional analyses showed that reductions in HbA(1c) were maintained in the long-term, notably for 102 weeks, in combination with metformin. Data have also shown that the absolute reduction in HbA(1c) seen with saxagliptine from baseline to Week 24 was numerically greater with an elevated baseline HbA(1c). In these recently published pooled analyses, clinically pertinent reductions in HbA(1c) were also obtained with saxagliptin across a wide range of subgroups of T2D patients when examined either by specific baseline demographic characteristics or by β-cell function indices such as the HOMA-β.

Contexte Le risque d’insuffisance surrenale chez les femmes atteintes d’un deficit en 21-hydroxylase non classique (D21OH-NC) est inconnu. L’indication d’un traitement substitutif reste controversee. Objectif Evaluer la fonction glucocorticoide et mineralocorticoide de la surrenale des femmes avec un D21OH-NC. Protocole Etude prospective controlee chez 20 patientes avec un D21OH-NC avec mutations bi-alleliques de CYP21A2 et une 17-hydroxyprogesterone plasmatique sous Synacthene > 10 ng/mL, et chez 20 femmes volontaires saines appariees. Etude des reponses a l’hypoglycemie insulinique et a la depletion sodee (furosemide et un regime pauvre en sel). PHRC AOR11-111, ClinicalTrials.gov Id: NCT01862380 . Resultats Les resultats des 13 premieres patientes et 7 volontaires saines sont presentees ici : – le pic de cortisolemie sous hypoglycemie insulinique etait significativement plus bas chez les patientes que chez les femmes controles : 18,0 μg/dL (14,2–22,8) vs 23,2 μg/dL (18,4–28,7), p = 0,0022. Un pic de cortisolemie ≥ 18 μg/dL etait obtenu chez tous les controles et seulement chez 50 % de patientes D21OH-NC ; – apres 15 heures de depletion sodee, l’aldosterone plasmatique etait comparable entre les deux groupes mais la renine active etait plus elevee chez les D21OH-NC que chez les femmes saines : 99 mUI/L (52–146) vs 42 mUI/L (24–62), p = 0,0152. Les resultats de l’ensemble des patients seront detailles lors du congres. Conclusion Un sous groupe de femmes avec un D21OH-NC a une reserve glucocorticoide et mineralocorticoide de la surrenale diminuee. La signification clinique de ce deficit partiel et inconstant n’est pas etablie. Mais par precaution, un traitement substitutif dans les situations de stress aigu pourrait etre propose.

Introduction Evidence est une etude observationnelle post Autorisation de Mise sur le Marche conduite a la demande de la Haute Autorite de Sante et de la Commission de la Transparence. Son objectif est d’evaluer en condition de vie reelle l’efficacite, la maintenance et les conditions d’utilisation du liraglutide (analogue du GLP-1 humain) chez des patients diabetiques de type 2 Materiels et methodes Il s’agit d’une etude multicentrique nationale, prospective de 2 ans. L’objectif primaire est d’evaluer le pourcentage de patients encore sous traitement a 2 ans et avec une HbA1c 2 300 diabetologues/endocrinologues et 19 273 medecins generalistes suivant des patients diabetiques traites par antidiabetique injectable et issus de la base CEGEDIM ont ete tires au sort et contactes par courrier, telephone ou courriel Resultats 16 % des medecins contactes (3 493 medecins) ont accepte l’etude. 2 475 centres ont ete inities (672 specialistes et 1 803 generalistes, soit respectivement 29 % et 9 % des medecins contactes et 40 % ont recrute au moins un patient (45 % et 55 % respectivement). 3 110 patients ont ete inclus dans l’etude en 12 mois. Les medecins (âge moyen de 51 ans, 36 % de femmes), travaillaient dans des communautes urbaines de moins de 100 000 habitants pour 59 % d’entre eux et en region parisienne pour 9 % Conclusion Malgre les difficultes a recruter des medecins, le nombre de patients inclus a atteint l’objectif fixe. L’etude Evidence permettra d’apporter des informations sur l’efficacite, la maintenance et la tolerance au liraglutide apres 2 ans et dans des conditions de vie reelle