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Exercise training decreases blood viscosity in athletes parallel with metabolic improvements mostly characterized by an increase in insulin sensitivity. Patients with low insulin sensitivity exhibit a host of metabolic disorders that may also benefit from regular training. However, the hemorheologic aspects of training in such subjects are not known and we aimed at characterizing them. Subjects: Thirty-two obese insulin resistant subjects were tested before and after 2 months. Twenty-one of them were trained (3 ± 45 min/wk) at a level defined by exercise calorimetry and corresponding to the power at which lipid oxidation reaches a maximum (LIPOX[sub max]) and eleven served as controls. The two groups were matched for age and body mass index. There was no weight change in controls while the 2 months training period decreased weight by 2.5 kg (p < 0.02). This change was totally explained by a loss in fat mass (-2.7 kg, p < 0.02) while fat free mass remained unchanged. Blood rheology was unchanged in the control group while training improved plasma viscosity η[sub pl] (before: 1.43 ± 0.03 mPa.s; after: 1.35 ± 0.03 mPa.s, p < 0.02). There was no change in either hematocrit, red cell rigidity or red cell aggregation. The balance of substrates oxidation shifted towards a higher use of lipids (point of crossover where subjects oxidize 70% carbohydrates 30% lipids: before 39.3 ± 6.9 watts; after 70.8 ± 6 watts, p < 0.001; point where lipid oxidation is maximal (LIPOX[sub max]) before: 16.5 ± 1.4 watts; after: 21.4 ± 1.3 watts, p < 0.001) and V[sub O[sub 2 max]] increased by 74% (p < 0.01). Consistent with observations in athletes, the metabolic and ergometric improvements induced by training reduces η[sub pl] in sedentary, insulin resistant patients, but at those low levels training does not appear to induce "autohemodilution" (as reflected by hematocrit) neither it improves red cell deformability or aggregation... [ABSTRACT FROM AUTHOR]

We previously reported in populations exhibiting all the spectrum of insulin sensitivity (SI) values correlations between SI and blood viscosity η suggesting that high η is an additional symptom of the insulin resistance syndrome. However, due to the elevation of insulinemia (I) which is usually associated with insulin resistance it remained to determine whether this relationship was explained by SI or I. We analyzed SI with the minimal model procedure in 108 nondiabetic subjects and analyzed correlations of SI with blood rheology (η, RBC aggregation and rigidity). Across quartiles of SI (defined after log transformation since distribution of SI was not normal), hematocrit and red cell rigidity remained stable, while aggregability and plasma viscosity (ηp) increased in the lowest quartile. SI was correlated to only two rheological parameters: ηp (r = -0.280, p = 0.005) and Myrenne index M1 (r = -0.219, p = 0.044). Among SI, I, age and BMI multivariate analysis selected only BMI as a determinant of either whole blood viscosity (ηwb: r = -0.301, p = 0.004) and RBC disaggregation threshold (γD: r = -0.331, p = 0.013), only I as determinant of M1 (r = 0.254, p = 0.03), and a combination of BMI (p = 0.009) and SI (p = 0.007) for ηp. Although age and obesity are factors of hyperviscosity, the hemorheological disturbances found in insulin resistance are not fully statistically "explained" by those two factors. While hyperaggregability (measured with M1) is rather related to hyperinsulinism, ηp is influenced by SI and should be further investigated as a simple marker for the follow up of insulin-resistant states. [ABSTRACT FROM AUTHOR]

Objectives: Antisynthetase syndrome (ASyS) is a rare autoimmune disease. We aimed to determine clinical, biological, radiological, and evolutive profiles of ASyS patients with anti-PL7 or anti-PL12 autoantibodies., Methods: We performed a retrospective study that included adults with overt positivity for anti-PL7/anti-PL12 autoantibodies and at least one Connors' criterion., Results: Among 72 patients, 69% were women, 29 had anti-PL7 and 43 anti-PL12 autoantibodies, median age was 60.3 years, and median follow-up period was 52.2 months. At diagnosis, 76% of patients had interstitial lung disease, 61% had arthritis, 39% myositis, 25% Raynaud's phenomenon, 18% mechanic's hands, and 17% had fever. The most frequent pattern on initial chest computed tomography was non-specific interstitial pneumonia and 67% had fibrosis at last follow-up. During follow-up, 12 patients had pericardial effusion (18%), 19 had pulmonary hypertension (29%), 9 (12.5%) had neoplasms, and 14 (19%) died. Sixty-seven patients (93%) received at least one steroid or immunosuppressive drug. Patients with anti-PL12 autoantibodies were younger (p=0.01) and more frequently exhibited anti-SSA autoantibodies (p=0.01); patients with anti-PL7 autoantibodies had more severe weakness and higher maximum creatine kinase levels (p=0.03 and 0.04, respectively). Initial severe dyspnoea was more common in patients from the West Indies (p=0.009), with lower predicted values of forced vital capacity, forced expiratory volume in 1s, and total lung capacity (p=0.01, p=0.02, p=0.01, respectively) contributing to a more severe 'respiratory' initial presentation., Conclusions: The high mortality and significant numbers of cardiovascular events, neoplasms and lung fibrosis in anti-PL7/12 patients justify close monitoring and question addition of antifibrotic drugs., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose., (Copyright © 2023 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)

Objectives: Evaluate vitamin D supplementation and vitamin D status during normal pregnancy in Martinique, a Caribbean region with sufficient sunshine for endogenous vitamin D production all year around; and "to validate" or not the necessity of supplementing pregnant women with vitamin D in Martinique., Patients and Methods: A prospective evaluation of their vitamin D status was performed over a winter four-month period on 63 healthy women seen at term delivery. Maternal blood sampling for assays of serum 25 (OH)D, calcium, phosphates and alkaline phosphatase activity was realized in working room. All included women answered a questionnaire allowing to know various parameters known to influence vitamin D and calcium status, as their origin, their food habits, their exposure to sunshine, their supplementation or not with vitamin D during pregnancy., Results: The sample represented 15% of the pregnant women seen in the department over the study period; 16% of the women had received vitamin D supplementation during pregnancy; at delivery, mean 25-(OH)D serum level in the total cohort was 32.6+/-10.7 ng/ml, with no value below 13 ng/ml; serum calcium and phosphates levels were in the normal range., Conclusion: These data suggest that, during normal pregnancy, and in the absence of any particular risk factor, systematic vitamin D supplementation is not required in the Martinique region.