Search

International audience; The diabetic foot ulcer (DFU) is a common and serious complication of diabetes. There is also a strong relationship between the environment of the person living with a DFU and the prognosis of the wound. Financial insecurity seems to have a major impact, but this effect can be moderated by social protection systems. Socioeconomic and socio-educational deprivations seem to have a more complex relationship with DFU risk and prognosis. The area of residence is a common scale of analysis for DFU as it highlights the effect of access to care. Yet it is important to understand other levels of analysis because some may lead to over-interpretation of the dynamics between social deprivation and DFU. Social deprivation and DFU are both complex and multifactorial notions. Thus, the strength and characteristics of the correlation between the risk and prognosis of DFU and social deprivation greatly depend not only on the way social deprivation is calculated, but also on the way questions about the social deprivation−DFU relationship are framed. This review examines this complex relationship between DFU and social deprivation at the individual level by considering the social context in which the person lives and his or her access to healthcare.

The objective of this study was to assess the impact of the COVID-19 pandemic on patients’ perceptions regarding infection risk and vaccination in subjects suffering from chronic diseases. A prospective observational multicentric study conducted from December 2020 to April 2021 in three French University Hospitals. Patients with chronic diseases were proposed to complete a questionnaire regarding the impact of the COVID-19 pandemic on infectious risk knowledge and vaccination. A total of 1151 patients were included and analyzed (62% of which were people with diabetes). The COVID-19 pandemic increased awareness of infectious risks by 19.3%, significantly more in people with diabetes (23.2%, from 54.4% to 67.0%, p &lt, 0.01) when compared to the other high-risk patients (12.5%, from 50.5% to 56.8%, p = 0.06). Respectively, 30.6% and 16.5% of patients not up-to-date for pneumococcal and flu vaccines reported wanting to update their vaccination due to the COVID-19 pandemic. By contrast, the proportion of patients against vaccines increased during the COVID-19 pandemic (6.0% vs. 9.5%, p &lt, 0.01). The COVID-19 pandemic has led to a small increase in awareness regarding the risks of infection in patients with chronic diseases, including people with diabetes, but without any change in willingness to be vaccinated. This underlines the urgent need to sensibilize people with diabetes to infection risk and the importance of vaccination.

Access to in vitro fertilization (IVF) for obese women varies across centers, and the impact of obesity on IVF outcomes is widely discussed. We assessed the impact of obesity and its severity on live birth rate (LBR) after IVF. We included women treated for IVF in our center. Data were prospectively collected in the BabySentryTM software. LBR per cycle and cumulative LBR including all attempts of the couple were calculated, considering transfer of both fresh and frozen embryos. Of 1588 included women (2379 controlled ovarian stimulations), 70.2%, 19.5%, 7.9%, and 2.4% were normal-weight, overweight, class I obesity, and class II/III obesity, respectively. For each cycle, LBR did not differ according to BMI category. Adjusted odds ratios (95% confidence intervals) for obtaining a live birth at the first cycle were 1.11 (0.78&ndash, 1.58) for overweight, 1.17 (0.70&ndash, 1.95) for class I obese, and 1.05 (0.48&ndash, 2.31) for class II/III obese women, as compared with normal-weight women. Similarly, no significant associations were found at cycles 2, 3, and 4. Cumulative LBR increased with the number of cycles, independently of the BMI class (p log-rank = 0.91). After adjustment, obesity status did not impact significantly the miscarriage rate, regardless of the cycle. In conclusion, neither women obesity nor its severity impacted the cumulative LBR after IVF.

Obesity is characterized by an alteration in body composition (BC), however, it is not known whether this alteration is modified by aging or sex. The aims of this study were to analyze BC in individuals with obesity based on age and sex and to determine the prevalence of sarcopenia. Seven hundred and fifty-five obese individuals were subdivided into four age groups. The hole (WB) and segmental BC were determined using dual-energy X-ray absorptiometry (DXA). In men, the WB lean tissue mass (LTM) and fat mass (FM) adjusted by weight and height were relatively constant with age. In women, the WBLTM was higher and WBFM was lower in the &gt, 65 group compared to the 18&ndash, 34 group. A decrease in the LTM and FM at lower limbs and an increase in the trunk were observed, particularly in women, inducing a lower appendicular lean mass index (ALMI, appendicular LTM/height2) in the &gt, 34 group in both sexes. This study demonstrated that even though the WBLTM and FM are relatively constant with age, individuals with obesity present a localized redistribution of these two components. This body composition change leads to a decrease of the ALMI with age, one of the criteria included in the sarcopenia definition.

Lean body mass (LBM) is a determinant of areal bone mineral density (aBMD) through its mechanical actions and quite possibly through its endocrine functions. The threefold aims of this study are: to determine the effects of obesity (OB) on aBMD and myokines, to examine the potential link between myokines and bone parameters, and to determine whether the effects of LBM on aBMD are mediated by myokines. aBMD and myokine levels were evaluated in relation to the body mass index (BMI) in 179 women. Compared with normal-weight controls (CON, n = 40), women with OB (n = 139) presented higher aBMD, myostatin and follistatin levels and lower irisin levels. Except for irisin levels, all differences between the OB and CON groups were accentuated with increasing BMI. For the whole population (n = 179), weight, BMI, fat mass (FM) and LBM were positively correlated with aBMD at all bone sites, while log irisin were negatively correlated. The proportion of the LBM effect on aBMD was partially mediated (from 14.8% to 29.8%), by log irisin, but not by follistatin or myosin. This study showed that myokine levels were greatly influenced by obesity. However, irisin excepted, myokines do not seem to mediate the effect of LBM on bone tissue.