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Objective: To assess the profile of metabolic syndrome (MS) in a hypertensive population in Mali. Patients and methods: Prospective study from June 1, 2022 to June 31, 2022, in the cardiology department of the Mother-Child University Hospital in Bamako, Luxembourg. Our study sample consisted of adult hypertensive patients, aged 18 years and older, received as an outpatient. Patients were included in our study after informed consent. The SM was established based on International Diabetes Federation (IDF) definitions. Results: Out of 520 patients, 238 were included in our study. The prevalence of SM was 30.2% according to IDF criteria. There was a female predominance (66%). The mean age was 57 ± 5 years. Grade II hypertension was in the majority with 39%. Seventy-five percent of patients with metabolic syndrome had 3 risk factors. Ischemic stroke was the most common complication with a rate of 12%. Dual therapy was indicated in 59.23% of patients. Calcium channel blockers were the most prescribed with a rate of 74.5%. SM is a reality in Mali. Adequate preventive measures are necessary to limit its progression. [ABSTRACT FROM AUTHOR]

L'hépatopathie stéatosique métabolique (Non-alcoholic fatty liver disease – NAFLD, ou plus récemment Metabolic Dysfunction Associated Steatotic Liver Disease – MASLD) est la première cause de perturbation du bilan hépatique. Sa prévalence mondiale est estimée à 25 %. La MASLD est suspectée, dans un contexte métabolique, devant la présence d'une stéatose hépatique, d'une cytolyse hépatique modérée ou d'une hyperferritinémie. La sévérité de la maladie dépend du stade de fibrose hépatique qui peut être suspectée en pratique clinique par des tests sanguins simples tels que le FIB-4 ou le NAFLD fibrosis Score, accessibles à tous. Le traitement repose sur des mesures hygiénodiététiques associant une perte pondérale avec une augmentation de l'activité physique et un régime de type méditerranéen. Seule une petite minorité de patients atteints de MASLD développera une maladie hépatique avancée nécessitant un suivi spécialisé en hépato-gastroentérologie. Compte tenu de la prévalence élevée de la MASLD, l'identification de ces patients ne pourra pas s'envisager sans la participation de l'ensemble des médecins (généralistes et spécialistes). Non-alcoholic fatty liver disease (NAFLD) or recently called Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD), is the leading cause of liver disease, with an estimated worldwide prevalence of 25%. MASLD is suspected, in a metabolic condition, in the presence of hepatic steatosis, moderate hepatic cytolysis or hyperferritinemia. The severity of the disease depends on the stage of liver fibrosis, which can be suspected in clinical practice by simple blood tests such as the FIB-4 or NAFLD fibrosis Score. The treatment is based on lifestyle intervention combining weight loss, increased physical activity and a Mediterranean-style diet. Only a small minority of patients with MASLD will develop advanced liver disease and require liver specialist. Given the high prevalence of MASLD, the identification of these patients cannot be envisaged without the taking part in the screening of all physicians (general practitioners and specialists). [ABSTRACT FROM AUTHOR]

Hyperferritinaemia is a frequent anomaly, which is admittedly not very specific, but is also of great diagnostic value if the clinician is able to observe a certain number of interpretation rules. Physiologically, ferritin is a protein synthesised mainly by the liver and designed to store iron in the liver, macrophages and erythrocytes. Despite this, pathophysiology tells us that the increase in ferritinemia goes far beyond iron overload to encompass other factors, in particular inflammation, cell lysis and distribution abnormalities. In the vast majority of cases, the cause of hyperferritinaemia can be identified using a global approach that incorporates the ferritinaemia value, the history and the patient’s clinical and biological context, without having to go through the transferrin saturation coefficient and in-depth liver investigations. Recourse to CST, MRI, genetic tests or even liver biopsy is only necessary in rare situations where the most obvious causes cannot be identified. Finally, recent years have seen the arrival of other entities, in particular SARS-COV2 infection, where ferritin has proved to be of great value both diagnostically and prognostically. [ABSTRACT FROM AUTHOR]

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Évaluer la relation entre les valeurs du CAP (Controlled Attenuation Parameter) et les différents paramètres du syndrome métabolique. Il s'agit d'une étude transversale incluant tous les patients âgés de plus de 18 ans et présentant une maladie chronique du foie, adressés à l'hôpital pour une évaluation non invasive de la fibrose hépatique. La mesure de l'élasticité hépatique et du CAP a été réalisée de façon concomitante en utilisant la sonde M ou XL du Fibroscan par des opérateurs entraînés. La prévalence du syndrome métabolique chez les patients avec un CAP ≥ 238 dB/m était plus élevée que chez les patients avec un CAP < 238 dB/m, et elle augmentait de façon significative avec l'augmentation de la sévérité de la stéatose hépatique (p < 0,001). Les valeurs du CAP étaient significativement plus élevées chez les patients présentant un syndrome métabolique et ces valeurs augmentaient de façon significative avec l'augmentation du nombre de paramètres du syndrome métabolique (p < 0,001). En analyse univariée, il existait une relation linéaire positive statistiquement significative entre le CAP et les paramètres du syndrome métabolique sauf la glycémie et le taux d'HDLc. En analyse multivariée, seuls le tour de taille et le taux de triglycérides étaient significativement liés aux valeurs du CAP. Cette étude montre qu'il existe une corrélation significative entre le CAP et les différents paramètres du syndrome métabolique. Le CAP pourrait être un indicateur de risque et de sévérité du syndrome métabolique. The aim of this study is to investigate the relationship between CAP (Controlled Attenuation Parameter) values and the different components of the metabolic syndrome. This is a cross-sectional study including all patients over 18 years of age with chronic liver disease who were referred to our center for a non-invasive assessment of liver fibrosis. The measurement of hepatic elasticity and CAP was carried out concomitantly using the M or XL probe of Fibroscan® by trained operators. The prevalence of metabolic syndrome in patients with CAP ≥ 238 dB/m was higher than in patients with CAP < 238 dB/m, and significantly increased with the severity of hepatic steatosis (p < 0.001). CAP values were higher in patients with metabolic syndrome and significantly increased with the increase in the number of metabolic syndrome components (p < 0.001). In univariate analysis, there was a statistically significant positive linear relationship between CAP values and components of metabolic syndrome except for blood glucose and HDLc level. In multivariate analysis, only waist circumference and triglycerides level were significantly related to CAP values. This study shows that there is a significant correlation between CAP and the different components of the metabolic syndrome. CAP could be an indicator of risk and severity of metabolic syndrome. [ABSTRACT FROM AUTHOR]

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Décrire l'évolution du syndrome métabolique et de ses différents composants, six mois et un an après sleeve gastrectomie. Il s'agit d'une étude prospective menée auprès de 40 patients obèses (7 hommes et 33 femmes) ayant bénéficié d'une sleeve gastrectomie entre 2016 et 2018. Les données cliniques et biologiques ont été recueillies avant l'intervention, à six mois et un an après chirurgie. Le syndrome métabolique a été défini en se référant aux critères diagnostiques de la fédération internationale du diabète émises en 2009. L'insulinorésistance a été évaluée suivant la méthode HOMA (homeostasis model assessment) et définie par un indice de HOMA-IR ≥ 2,4. L'âge moyen était de 34,6 ± 8,2 ans. L'indice de masse corporelle (IMC) moyen était de 50,2 ± 8,3 kg/m2. La fréquence du syndrome métabolique est passée de 67 % (27 patients) avant l'intervention à 12 % (5 patients) après six mois (p < 0,05) et à 7 % (3 patients) une année après la SG (p < 0,05), soit un taux de rémission de 89 %. La fréquence de l'insulinorésistance est passée de 89 % avant l'intervention à 4 % après un an (p < 0,05). Le pourcentage moyen de perte d'excès pondéral (PEP) était de 40,2 ± 14 % à six mois et de 55,8 ± 20,5 % à un an. La sleeve gastrectomie améliore significativement l'insulinorésistance et tous les composants du syndrome métabolique à court terme. Ces bénéfices métaboliques pourraient contribuer à la réduction du risque cardiovasculaire chez le sujet obèse à long terme. Describe the evolution of metabolic syndrome and its components, six months and one year after sleeve gastrectomy. It is a prospective study including 40 obese patients (7 men and 33 women) who underwent sleeve gastrectomy between 2016 and 2018. Clinical and biological parameters were collected before the intervention, at six months and one year after surgery. Metabolic syndrome has been defined according to the international diabetes federation's diagnostic criteria of 2009. Insulin resistance was assessed using the HOMA (homeostasis model assessment) method and defined by a HOMA-IR index ≥ 2.4. The mean patients' age was 34.6 ± 8.2 years. The mean body mass index (BMI) was 50.2 ± 8.3 kg/m2. The frequency of metabolic syndrome decreased from 67% (27 patients) before the intervention to 12% (5 patients) after six months (P <0.05) and to 7% (3 patients) one year after sleeve gastrectomy (P < 0.05), the remission's rate was 89%. The frequency of insulin resistance decreased from 89% before intervention to 4% after one year (P < 0.05). Mean excess weight loss (EWL) was 40.2 14% at six months and 55.8 20.5% at one year. Sleeve gastrectomy improves significantly insulin resistance and all components of the metabolic syndrome in the short-term. These metabolic benefits could contribute to the reduction of cardiovascular risk in obese subjects in the long-term. [ABSTRACT FROM AUTHOR]

Le déficit en testostérone (DT) se caractérise par des signes cliniques évocateurs de ce déficit, confirmé par un dosage biologique du taux de testostérone ou de l'activité des androgènes sériques. Nous n'aborderons pas les hypogonadismes congénitaux qui relèvent d'une problématique plus directement endocrinologique. Au cours du vieillissement chez l'homme un certain nombre d'auteurs Matsumoto, 2002 ; Walter, 1932 ont décrit des signes évoquant une diminution de la testostérone comme une diminution de la libido, des érections, une fatigue psychique et physique, des troubles du plaisir et de l'éjaculation, l'apparition d'une gynécomastie, une diminution de la masse musculaire et une augmentation de la masse grasse, une involution testiculaire et parfois une ostéoporose. Parmi tous ces symptômes, beaucoup relèvent de la sphère sexuelle et interpellent le sexologue. Par ailleurs, certaines situations pathologiques comme un diabète, un syndrome métabolique, une maladie cardiovasculaire, un surpoids, la prise d'opioïdes, d'anticonvulsivants, d'antirétroviraux, l'inefficacité ou la perte secondaire d'efficacité des Ipde5 sont des circonstances devant faire rechercher un DT. Il nous a semblé utile de faire le point sur les situations à risque de DT et sur les signes cliniques devant alerter le sexologue. Nous ne reprendrons pas les dosages biologiques qui serons développés dans le chapitre suivant. Testosterone deficiency (TD) is defined by clinical signs suggestive of this deficiency, confirmed by a biological assay of the testosterone level or the activity of serum androgens. We will not discuss congenital hypogonadisms, which are related to a more directly endocrinological problem. During aging in men, a number of authors have described signs suggesting a decrease in testosterone such as a decrease in libido, erections, mental and physical fatigue, pleasure and ejaculation disorders, the onset of gynecomastia, decreased muscle mass and increased fat mass, testicular involution and sometimes osteoporosis. Among all these symptoms, many relate to the sexual sphere and challenge the sexologist. In addition, certain pathological situations such as diabetes, metabolic syndrome, cardiovascular disease, overweight, taking opioids, anticonvulsants, antiretrovirals, ineffectiveness or secondary loss of effectiveness of Ipde5 are circumstances that should lead to the search for a TD. It seemed useful to us to take stock of the risk situations for TD and the clinical signs that should alert the sex therapist. We will not go over the biological assays, which will be developed in the next chapter. [ABSTRACT FROM AUTHOR]

Résumé Les stéatopathies hépatiques métaboliques, regroupent l’ensemble des manifestations hépatiques, associées au syndrome métabolique et à l’insulinorésistance. Elles sont caractérisées par une surcharge graisseuse hépatique dont le spectre va de la stéatose à la stéatohépatite, la cirrhose et le carcinome hépatocellulaire. La prise en charge nutritionnelle par la prescription d’un régime type méditerranéen (RM) hypocalorique et la pratique d’une activité physique adaptée sont à la base du traitement des stéatopathies métaboliques. L’objectif habituellement fixé est une perte pondérale de 10%. L’amaigrissement a un effet bénéfique sur l’insulinorésistance et le diabète, diminue le risque cardiovasculaire et améliore les lésions histologiques hépatiques. [Abstract The metabolic liver steatopathies includes all of hepatic events associated with metabolic syndrome, and insulin resistance. They are characterized by hepatic fat overload whose spectrum ranges from steatosis to steatohepatitis, cirrhosis and hepatocellular carcinoma. The nutritional management by the prescription of a low calorie Mediterranean-style diet (MD), and practice of adapted physical activity are the mainstay of metabolic steatopathies treatment. The objective set is usually a weight loss of 10%, which has a beneficial effect on insulin resistance, and diabetes, reduces cardiovascular risk, and improves liver histological lesions.]

INTRODUCTION: La stéatopathie métabolique est-elle une priorité de santé en Afrique? Le but était d´étudier les facteurs épidémiologiques et les manifestations hépatiques (anomalies biologiques et la stéatose échographique) associés au syndrome métabolique (SM) chez les adultes suivis en ambulatoire. METHODES: étude multicentrique transversale avec un suivi longitudinal des patients. Elle a été menée de mars 2015 à août 2019 dans la ville de Ouagadougou. Etaient inclus les malades présentant un SM selon les critères harmonisés pour les africains subsahariens. RESULTATS: la fréquence du SM était à 15,74%. Il y a eu un recrutement 3,8 fois plus rapide de patients la dernière année. Les femmes (57,04) étaient majoritaires; l´âge moyen de 44,69 ans. Le surpoids et l´obésité concernaient 87,32%. Les composantes du SM retrouvées étaient: la dyslipidémie (64,79%), l´hyperglycémie (49,30%), l´HTA (45,07%), le tour de taille moyen de 98,68 cm chez les hommes et de 101,13 cm chez les femmes. L´infection virale B était associée chez 19,01% et celle au HIV chez 1,40%. Une patiente présentait un syndrome de polykystose ovarienne. Une tradithérapie était en cours chez 14,08%. Les transaminases étaient normales chez 73,94%. Une stéatose hépatique échographique était retrouvée chez 71,13%. Le Fibroscan® avait été effectué par 40,42%. Le résultat de la stéatose était discordant de celui échographique chez 56,14%. CONCLUSION: pour réduire le SM et ses composantes, il est nécessaire de lutter contre l´obésité (surtout féminine). Une meilleure accessibilité au Fibroscan® permettra d´améliorer sa prise en charge au Burkina Faso.

Le rôle du microbiote intestinal au sein d'un axe « intestin–articulation » est de plus en plus étudié dans l'arthrose. Le microbiote intestinal, notamment via son rôle dans l'inflammation systémique de bas grade, pourrait être impliqué dans la destruction articulaire et la douleur arthrosique. Ses mécanismes d'action dans l'arthrose demeurent complexes, avec, d'une part, une action directe de la dysbiose intestinale sur l'arthrose impliquant l'inflammation, et, d'autre part, un effet indirect via son rôle dans le syndrome métabolique et l'obésité. Les travaux menés dans l'arthrose chez la souris se sont principalement intéressés au rôle du microbiote intestinal dans la destruction articulaire dans des modèles d'arthrose métabolique. Chez l'Homme, les travaux ont surtout porté sur des marqueurs indirects du microbiote, tels que le lipopolysaccharide, ou des métabolites, tels que ceux dérivés du tryptophane. Aussi, la dysbiose intestinale pourrait être un des facteurs explicatifs de la douleur arthrosique. Mieux comprendre le rôle du microbiote intestinal dans l'arthrose pourrait aboutir à l'identification de nouvelles cibles thérapeutiques. The role of the intestinal microbiota within a "gut–joint" axis is increasingly studied in osteoarthritis. The intestinal microbiota, particularly via its role in low-grade systemic inflammation, could be involved in joint destruction and osteoarthritic pain. Its mechanisms of action in osteoarthritis remain complex, with, on the one hand, a direct action of intestinal dysbiosis on osteoarthritis involving systemic inflammation, and, on the other hand, an indirect effect via the promotion of metabolic syndrome and obesity. The published works in mice have mainly focused on the role of the intestinal microbiota in joint destruction in metabolic models of osteoarthritis. In humans, works have focused on indirect markers of the gut microbiota, such as lipopolysaccharide, or metabolites, such as tryptophan-derived ones. Also, intestinal dysbiosis could be one of the explanatory factors of osteoarthritic pain. A better understanding of the role of the intestinal microbiota in osteoarthritis could lead to the identification of new therapeutic targets. [ABSTRACT FROM AUTHOR]

associated with metabolic syndrome (MS) in adults followed up on an ambulatory basis. Methods: we conducted a cross-sectional and multicenter study based on longitudinal follow-up of patients in the city of Ouagadougou from March 2015 to August 2019. All patients with MS according to Harmonized Guidelines™ for sub-Saharan Africa were enrolled. Results: MS rate was 15.74%. Recruitment of patients was 3.8 times faster in the last year. The majority of patients were women (57.04); the average age of patients was 44.69 years. Overweight and obesity accounted for 87.32%. MS components included: dyslipidemia (64.79%), hyperglycemia (49.30%), PAH (45.07%), mean waist size (men: 98.68 cm; women: 101.13 cm). B virus infection was associated with MS in 19.01% of cases and HIV was associated with MS in 1.40% of cases. One female patient had polycystic ovary syndrome (PCOS). Patients on traditional therapy accounted for 14.08%. Transaminase levels were normal in 73.94% of cases. Hepatic steatosis on ultrasound were found in 71.13% of cases. Fibroscan® was performed in 40-42% cases. Fibroscan® results were discordant with ultrasound results in 56.14% of cases. Conclusion: this study highlights the importance of fighting against obesity (in particular obesity in women) in reducing MS and its components. A better accessibility to Fibroscan® could improve management of patients in Burkina Faso. [ABSTRACT FROM AUTHOR]

Introduction: the aim of this study was to correlate the metabolic syndrome with the level of the physical activity in a population from Marrakech, Morocco. Methods: the study was conducted at Ibn Zohr Regional Hospital in Marrakech. The body mass index (BMI) was calculated to assess the degree of obesity of each subject. To determine the level of physical activity, we used the short version of the IPAQ (International Physical Activity Questionnaire); Blood parameters were measured by a Biochemistry Automaton. All statistical analyzes were performed using SPSS software. Results: a total of 300 subjects participated in the study, which 57.3% were female and 42.7% were male with a sex ratio of 0.74. The average age of our population was 51.6± 13.42 years old. Seventynine of the participants (26.3%) had a metabolic syndrome, with a predominance of female: 60 women (34.9%) and 19 men (14.8%). There is a significant relationship between level of physical activity and the presence of metabolic syndrome (P = 0.002), between physical activity level and BMI and waist circumference (p < 0.001) and (p = 0.003) respectively. Conclusion: the result shows a significant association between obesity, metabolic syndrome and the level of the physical activity, which would encourage us to encourage the application of lifestyle rules, including physical activity, which remains one of the best preventive actions against this pathology. [ABSTRACT FROM AUTHOR]

Résumé: Le cholangiocarcinome représente moins de 3 % des néoplasies digestives. Ce terme regroupe des entités distinctes telles que le cholangiocarcinome intra-hépatique et le cholangiocarcinome extra-hépatique. Ce dernier est lui-même subdivisé en cholangiocarcinome péri-hilaire et cholangiocarcinome du bas cholédoque. Malheureusement, on déplore encore l'absence de code topographique spécifique pour le cholangiocarcinome péri-hilaire contribuant à des erreurs épidémiologiques et compliquant l'étude de ces entités différentes. Il existe, au niveau mondial, des différences importantes de l'incidence en raison de la grande variabilité des facteurs de risque associés à ce type de cancer. Récemment, l'augmentation dans les pays occidentaux de la stéatose hépatique et de l'obésité explique la hausse des taux d'incidence dans ces pays. En France, il semblerait que l'incidence du cholangiocarcinome soit globalement en augmentation dans les deux sexes, excepté pour le cholangiocarcinome extra-hépatique en diminution chez la femme. Attribuer un code topographique spécifique au cholangiocarcinome péri-hilaire semble indispensable afin de disposer d'études fiables. The cholangiocarcinoma account for less than 3% of digestive neoplasms. This tumor is subdivided in two categories, extrahepatic and intrahepatic cholangiocarcinoma, which is divided into peri-hilar cholangiocarcinoma and low bile duct cholangiocarcinoma. The lack of a specific topographic code for peri-hilar cholangiocarcinoma makes clinical research difficult and calls into question the reliability of historical studies. The risk factors associated with this type of cancer are geographically variable, which consequently explains the different incidence rates estimated worldwide. Hepatic steatosis and obesity are increasing in Western countries that reflect the increased incidence rates of cholangiocarcinoma in these countries. In France, the incidence of cholangiocarcinoma is increasing in both sex except for extrahepatic cholangiocarcinoma that is decreasing in women. Assigning a specific topographic code to perihilar cholangiocarcinoma seems crucial in order to have reliable studies. [ABSTRACT FROM AUTHOR]

Objectif. L’objectif de notre étude est d’évaluer la pression artérielle et la pression différentielle chez les patients atteints du syndrome métabolique (SM), afin de déceler et de prévenir les complications cardiovasculaires qui peuvent survenir chez ces patients. Matériels et méthodes. L’analyse des cas‑témoin a été faite sur un total de 1528 patients, dans un cabinet de médecine familiale, les sujets étant répartis en deux groupes: le lot avec SM et le groupe témoin (sans SM). Le groupe avec SM se composait de 388 patients diagnostiqués selon les critères harmonisés. Le groupe témoin sans SM était composé de 1140 patients n’ayant pas présenté au moins trois critères diagnostiques du syndrome métabolique. Résultats. La pression différentielle, les valeurs calculées pour les patients atteints de syndrome métabolique ont été généralement plus élevées que le taux moyen escompté à 40 mmHg, avec une valeur moyenne de 47,86 ± 12,02 mmHg. Le groupe de contrôle a une valeur moyenne (40,28 ±12.20 mmHg) du pouls, une pression significativement plus faible (p

Analyser l'effet d'un entraînement intermittent de 12 semaines sur les paramètres du syndrome métabolique et sur le rapport ApoprotéineB/ApoprotéineA–I chez les enfants obèses. Cinquante-deux enfants obèses (MC : 81,35 ± 3,1 kg ; taille : 1,62 ± 0,03 m ; IMC : 30,8 ± 0,7 kg/m2) dont 26 ont participé au protocole d'entraînement intermittent et 26 ont constitué le groupe contrôle. Deux épreuves d'exercices maximale et métabolique ont été réalisées à une semaine d'intervalle avant et après le programme d'entraînement pour mesurer respectivement la consommation maximale d'oxygène et l'oxydation lipidique. Les paramètres anthropométriques, les apoprotéines A–I, apoprotéine B et biochimiques sont mesurés avant et après le programme. Le programme d'entraînement comporte trois séances de deux heures par semaine. Après le programme, la consommation maximale d'oxygène, les lipides de haute densité et l'oxydation lipidique ont augmenté significativement. L'indice de masse corporelle, la glycémie et les triglycérides ont baissé significativement. Le rapport ApoprotéineB/ApoprotéineA–I a diminué significativement (p < 0,01) ainsi que les pressions systolique et diastolique respectivement chez les filles et chez les garçons de 7, 11, 6 et 15 %. Parmi le groupe entraîné, 16 ne sont plus atteints de syndrome métabolique après l'entraînement. Aucune variation significative n'a été observée chez les contrôles. This study was to analyzed the effect of a 12-week intermittent training on the metabolic syndrome parameters and the ApoB/ApoA–I ratio in obese children. Fifty two obese children (body mass: 81,35 ± 3,1 kg, height: 1,62 ± 0,03 m, body mass index: 30,8 ± 0,7 kg/m2), 26 of whom participated in the intermittent training and 26 constituted the control group. Two maximal and metabolic exercises tests were performed one week apart before and after the training program to measure maximum oxygen consumption and lipid oxidation, respectively. Anthropometric measures, ApoA–I, ApoB and biochemical tests are measured before and after the program. The training program consists of three two-hour sessions per week. After the program, maximum oxygen uptake, high-density lipids and lipid oxidation increased significantly. Body mass index, blood glucose and triglycerides dropped significantly. The ratio ApoB/ApoA–I decreased significantly (P < 0.01) as well as systolic and diastolic pressures respectively in girls and boys of 7, 11, 6 and 15%. Among the trained group, 16 are no longer suffering from metabolic syndrome after training. No significant variation was observed in the controls. [ABSTRACT FROM AUTHOR]

La prise en charge du rhumatisme psoriasique est complexe du fait des manifestations articulaires hétérogènes, des manifestations cutanées et des comorbidités très fréquentes qui contribuent à l'altération de la qualité de vie et à l'augmentation de la morbi-mortalité. Les comorbidités cardiovasculaires et métaboliques sont au premier plan, représentées par les maladies cardiovasculaires, le syndrome métabolique, le diabète de type 2 et la stéatose hépatique non alcoolique. Au-delà des mécanismes inflammatoires bien connus dans le développement des maladies cardiovasculaires au cours des rhumatismes inflammatoires chroniques, le tissu adipeux et la production d'adipokines jouent un rôle déterminant. L'anxiété, la dépression, la fibromyalgie sont également des comorbidités majeures à prendre en compte. Le dépistage et la prise en charge d'autres comorbidités communes aux rhumatismes inflammatoires chroniques (cancers, infections) ont fait l'objet de recommandations et font désormais partie des bonnes pratiques alors que certaines comorbidités émergentes (syndrome d'apnée du sommeil, bronchite chronique obstructive, dysfonction sexuelle) n'ont fait pour l'instant l'objet que de peu d'études et nécessiteront une meilleure évaluation pour améliorer la prise en charge des patients. Le dépistage systématique et les recommandations des sociétés savantes sont nécessaires et utiles mais soulèvent la question de l'applicabilité en pratique et de l'inertie médicale. L'implication des infirmières d'éducation thérapeutique et le développement des infirmières en pratique avancée sont des enjeux importants pour améliorer la prévention et la gestion globale des patients atteints de maladie chronique. Psoriatic arthritis is a heterogeneous disease including various rheumatologic and skin manifestations. Frequent comorbidities contribute to impaired quality of life and increased morbidity and mortality. Metabolic and cardiovascular comorbidities, represented by cardiovascular diseases, metabolic syndrome, type 2 diabetes and non-alcoholic fatty liver disease, account for a considerable burden. Beyond the role of inflammation in the development of cardiovascular diseases during chronic inflammatory rheumatic diseases, adipose tissue and the production of adipokines may play a critical role. Moreover, anxiety, depression, and fibromyalgia are also major comorbidities that need to be addressed. Recommendations for the management of comorbidities common to chronic inflammatory rheumatic diseases (cancers, infections) have been proposed and are now part of good practice. Fewer studies have addressed emerging comorbidities (sleep apnea syndrome, chronic obstructive bronchitis, sexual dysfunction) and they will require a better evaluation to improve the holistic management of patients. Systematic screenings and management recommendations have been found to be useful for patients but raise the question of implementation of recommendation and clinical inertia. The involvement of rheumatology nurses and the development of advanced practice nurses are important issues for improving prevention and overall management of patients with chronic diseases. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MS) is considered as a cardiovascular risk factor and has become a major public health issue. It exacerbates the risks, which are already high among diabetics. The purpose of this study is to determine the rates of metabolic syndrome and other cardiovascular risk factors (CRFs) in type 2 diabetics. We conducted a cross-sectional descriptive and analytical study in the Department of Endocrinology at the Befelatanana General Hospital, Antananarivo, over a period of 7 months. The diagnosis of MS was based on IDF harmonized criteria (2009). A total of 219 patients with type 2 diabetes were involved in the study, of whom 189 had metabolic syndrome (86.30%). MS was predominant in female patients (55.88%). On average, the mean age of patients was 58,58 years, BMI was 24.28 kg/m² and abdominal circumference was 87,40 cm. Diabetes developed, in average, over 4.36 years (75.8% of patients had imbalance). Apart from hyperglycemia, arterial hypertension (AH) was the most common component of MS, followed by hypoHDLemia, abdominal obesity and hypertriglyceridemia between the two genders. Other most commonly reported cardiovascular risk factors associated with diabetes were dyslipidemia, followed by overweight or obesity, albuminuria and smoking. Overweight or obesity were cardiovascular risk factors significantly associated with MS. MS rate was very high in type 2 diabetics with several other CRFs. Adequate management of these risk factors is necessary to reduce the number of patients with MS as well as its consequences in order to improve survival. [ABSTRACT FROM AUTHOR]

Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization 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.)

L'arthrose associée au syndrome métabolique est un phénotype clinique défini par ses facteurs de risque (obésité et syndrome métabolique) et qui se caractérise par une inflammation de bas grade chronique. L'obésité est un facteur de risque reconnu de gonarthrose, mais aussi d'arthrose digitale. Le syndrome métabolique augmente le risque d'arthrose avec à la fois un effet cumulatif des maladies métaboliques mais aussi un rôle indépendant et propre de chaque maladie métabolique (diabète, dyslipidémie ou hypertension artérielle). Plusieurs mécanismes expliquent l'augmentation des cas incidents d'arthrose chez le sujet obèse. Tout d'abord, l'excès de masse grasse est responsable d'une augmentation des contraintes mécaniques. Le tissu adipeux est aussi responsable de la production endocrine de médiateurs pro-inflammatoires (cytokines, adipokines, acides gras, radicaux libres oxygénés) ayant un rôle néfaste sur les tissus articulaires. Plus récemment, la dysbiose et la sarcopénie du sujet obèse ont été impliquées dans cette association. L'arthrose, qu'elle soit métabolique ou pas, est associée à une surmortalité cardiovasculaire qui peut s'expliquer par la sédentarité mais aussi par les facteurs de risques communs ainsi que par l'inflammation de bas grade, présente en cas de maladie métabolique. Enfin, la prévention primaire et la prise en charge de l'obésité et du syndrome métabolique pourraient permettre de ralentir la survenue et la progression de l'arthrose. [ABSTRACT FROM AUTHOR]

HDL has long been considered as 'good cholesterol', beneficial to the whole body and in particular to cardio-vascular health. However, HDL is a complex particle that undergoes dynamic remodeling through interactions with various enzymes and tissue types throughout its life cycle. In this review, we explore the novel understanding of HDL as a multifaceted class of lipoprotein, with multiple subclasses of different size, molecular composition, receptor interactions, and functionality, in health and disease. Further, we report on emergent HDL based therapeutics tested in small and larger scale clinical trials and their mixed successes. [ABSTRACT FROM AUTHOR]

Points essentiels • L'hyperuricémie peut être la conséquence ou la cause d'une comorbidité. • Il y a discordance entre les études observationnelles (lien hyperuricémie-comorbidités) et les essais cliniques (pas de bénéfice démontré d'un traitement hypouricémiant sur les comorbidités). • Devant une hyperuricémie asymptomatique (même associé à des dépôts d'urate), il n'est pas recommandé (EULAR, BSR, ACR) de mettre en route un traitement hypouricémiant. • Il est impératif de prendre en charge médicalement les comorbidités. • Les modifications thérapeutiques du mode de vie, la perte de poids et la pratique d'exercice physique ont un intérêt en terme de santé globale. Résumé Il n'y a pas de consensus sur la définition de l'hyperuricémie asymptomatique (valeur seuil, prise en compte des données de l'échographie). La fréquence des comorbidités associées à l'hyperuricémie a augmenté depuis 20 ans, l'hyperuricémie (et/ou la goutte) pouvant être la conséquence ou la cause d'une comorbidité. Le lien causal entre uricémie et comorbidités, notamment cardiométaboliques et rénales, n'est pas démontré par les études de randomisation Mendélienne malgré les preuves fournies par les études épidémiologiques. Il est encore trop tôt actuellement, compte tenu de la discordance entre les études observationnelles et les essais cliniques, d'établir des recommandations concernant les bénéfices éventuels d'un traitement hypouricémiant (THU) pour chaque patient ayant une hyperuricémie asymptomatique. Le rapport bénéfice/risque d'un THU reste incertain. Le risque de développer ultérieurement une goutte (estimé à 50 %) doit être confronté au risque thérapeutique cutané et cardiovasculaire des inhibiteurs de la xanthine oxydase. En revanche, il est impératif de prendre en charge médicalement les comorbidités (arrêter les médicaments hyperuricémiants, privilégier les médicaments hypouricémiants). Les modifications thérapeutiques du mode de vie, la perte de poids et la pratique d'exercice physique ont un intérêt en termes de santé globale. Il faut attendre les résultats d'études d'intervention de puissance suffisante avec des critères principaux pertinents pour démontrer le bénéfice d'un THU sur les comorbidités. [ABSTRACT FROM AUTHOR]

Liver steatosis is the hepatic manifestation of the metabolic syndrome, and is one of the leading causes of chronic liver disease. The treatment of dysmetabolic cirrhosis with liver failure and/or hepatocellular carcinoma is liver transplantation (LT). With an increase of 170% in 10 years, it is now the second indication of listing for LT in the United States. At listing, patients with dysmetabolic cirrhosis are older, with numerous cardiovascular (CV) and renal comorbidities, and this requires multidisciplinary pre-transplant assessment. After LT, 5-year survival is similar to other indications, despite an increased immediate CV mortality. The leading causes of death are infectious, cancers and CV. Obesity is an independent factor of increasing morbidity and mortality after LT. The recurrence of the initial disease is frequent: 30% to 90% of the patients present recurrent liver steatosis at 5 years, and 30% progress towards cirrhosis. No specific immunosuppressive regimen is recommended, but the toxicity profiles must probably be taken into account. In these patients, the only etiological treatment is that of obesity, in the absence of specific therapy for non-alcoholic steatohepatitis. The place of bariatric surgery has to be defined, probably sleeve gastrectomy, in a stable patient, 6 to 12 months after LT. [ABSTRACT FROM AUTHOR]

Les études récentes menées chez des patients atteints de maladie d'Addison (MA) ont permis de révéler que cette pathologie, même traitée, reste grevée d'une morbi-mortalité non négligeable. L'objectif de notre étude était de déterminer les effets délétères de la substitution glucocorticoïde au long cours principalement sur le plan métabolique et cardiovasculaire. Il s'agit d'une étude rétrospective qui a inclu 28 patients ayant une MA traitée, évoluant depuis plus que 15 ans. L'âge moyen était de 58,53 ans avec une prédominance féminine à 65%. La durée moyenne de suivi était de 17,87 ans. La dose d'hydrocortisone était initialement à 32,5mg/j (20,52 mg/m2) et à 27,9mg/j (16,41mg/m2) au moment de l'étude. La prévalence du syndrome métabolique (SM) au cours de la MA était de 35,71% après une durée de traitement supérieur à 15 ans. On note au terme du suivi que 28,57% des patients étaient obèses. Vingt-cinq (25)% des patients avaient développé une HTA et un diabète de type 2. La prévalence de la dyslipidémie était passé de 3,57% à 42,85%. Un seul patient avait présenté un infarctus de myocarde à 25 ans de suivi. Les facteurs favorisant la survenue du SM dans notre étude étaient l'ancienneté de la maladie et la perte du poids à la découverte de la maladie. L'ajustement du traitement substitutif au cours de la maladie d'Addison reste un enjeu au vu de la morbi-mortalité liée au surdosage. Un suivi régulier, et une approche thérapeutique personnalisée sont nécessaires pour améliorer le pronostic de ses patients.

Lifestyle factors such as diet quality, physical inactivity or lack of regular physical activity that can lead to overweight, obesity or metabolic syndrome are risk factors for male infertility. The mechanisms involved are numerous and complex. Among those, hormonal dysfunctions, caused by obesity and metabolic syndrome, chronic inflammation and systemic oxidative are well known. This subject is of importance because usually the phenomenon can be reversible. Thus, weight loss, optimizing physical activity and a rebalancing diet could allow an improvement of men's reproductive functions. Finally, the possible consequences of an unfavourable paternal preconceptional environment in the offspring's' health should also be considered in the information given to patients. [ABSTRACT FROM AUTHOR]

Aim Metabolic syndrome (MetS) is a clinical disorder with widespread prevalence. In the current study, we aimed to investigate the serum values of macrophage inhibitory cytokine (MIC)-1, vascular endothelial growth factor (VEGF) and markers of oxidative stress among patients with metabolic syndrome. Material and methods Twenty obese patients with MetS and 20 obese apparently healthy controls were participated in the current case-control study. The participants’ body mass index (BMI), waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP) were measured. Serum levels of total cholesterol (TC), triglyceride (TG), low and high density lipoprotein cholesterol (LDL-c and HDL-c), vascular endothelial growth factor (VEGF), MIC-1 (macrophage inhibitory cytokine 1), superoxide dismutase (SOD) and glutathione peroxidase (GPX) were also determined by commercial ELIZA kits. Results Participants in MetS group had higher levels of WC, DBP and higher serum concentrations of TG and TC compared with control group ( P < 0.05). Serum VEGF and MIC-1 levels were significantly higher in patients with MetS compared with control subjects ( P < 0.05). There was a significant and positive association between serum levels of VEGF and LDL ( P = 0.027; β = 0.453) in all of the study participants. Moreover, an inverse association between serum GPX with DBP and between SOD with WC were also seen ( P < 0.05). Conclusion The higher serum values of MIC-1 and VEGF in patients with MetS and the negative association of VEGF with serum LDL concentrations opened a new window about the possible pathologic role of these factors in the etiology or pathophysiology of MetS. Further studies are warranted for solidification of achieved results. [ABSTRACT FROM AUTHOR]

Recent studies conducted in patients with Addison's disease (AD) highlighted that this disease, even after treatment, is a significant cause of morbi-mortality. This study aims to determine the cardiovascular and metabolic deleterious impact of long-course glucocorticoid substitution therapy. We conducted a retrospective study of 28 patients with treated Addison's disease evolving for more than 15 years. The average age of patients was 58, 53 years, with a female predominance (65%). The average follow-up period was 17, 87 years. Initial dose of hydrocortisone was 32, 5 mg/day (20.52 mg/m²) and 27, 9 mg/day (16,41mg/m²) at the time of the study. The prevalence of the metabolic syndrome (MS) in patients with AM was 35.71% after a period of treatment longer than 15 years. At the end of the follow-up period, 28.57% of patients were obese; 25% of patients had developed AH (arterial hypertension) and type 2 diabetes. The prevalence of dyslipidemia went from 3.57% to 42.85%. Only one patient had myocardial infarction at 25-year follow-up. Factors favoring the onset of MS in our study were history of disease and weight loss at the moment of diagnosis. Adjustment of substitution therapy is a challenge in patients with Addison's disease due to morbi-mortality associated with overdose. A regular follow-up and a personalized therapeutic approach are necessary to improve patients' prognosis. [ABSTRACT FROM AUTHOR]

Les facteurs alimentaires (sucres, acides gras trans technologiques, sel et excédent calorique) et comportementaux (sédentarité) ont largement contribué à l'augmentation vertigineuse de l'incidence de l'obésité, du diabète, de l'hypertension artérielle et par conséquent des maladies cardiovasculaires dans le monde. Depuis les années soixante et soixante-dix, les cardiologues préconisent de réduire la consommation alimentaire d'acides gras (AG) saturés, sans discernement, et celle de cholestérol à 300 mg/j, ainsi que de limiter les lipides en général. Parallèlement l'industrie alimentaire développait une alimentation low fat avec un remplacement des graisses alimentaires par l'utilisation massive des hydrates de carbone et du sucre. L'excès de fructose pur ou issu du clivage enzymatique du saccharose aboutit à une lipogenèse hépatique de novo, une oxydation des particules du cholestérol liées à une lipoprotéine de basse densité (LDL-C), une adiposité viscérale, une résistance à l'insuline et une augmentation des niveaux de glycation non enzymatique des protéines. Le métabolisme du fructose aboutit en outre à la formation d'acide urique, qui est un inhibiteur du NO - ce mécanisme physiopathologique favorisant l'hypertension artérielle. La surconsommation de glucides couplée à l'absence de dépense énergétique conduit donc non seulement à la formation de stéatose hépatique (NASH) et de tissu adipeux périphérique mais également à l'incapacité à les « brûler », ce qui conduit indirectement à l'insulinorésistance. Souvent couplés au sucre dans la nourriture transformée, les AG trans sont responsables d'une augmentation du LDL-C, et tout particulièrement des particules LDL petites et denses. Réduire l'apport surtout en sucre et en acides gras trans industriels (nourriture transformée) est probablement la modalité la plus efficace pour agir sur le poids, le profil cardiométabolique et par conséquent sur le pronostic cardiovasculaire à long terme. [ABSTRACT FROM AUTHOR]

Surgical improvement and expansion of immunosuppression have led to the successful development of solid organ transplantation. But long-term medical complications persist and are responsible for a decline in survival from the first year after transplantation. After one year, recurrence of liver disease, chronic rejection, metabolic syndrome, cardiovascular disorders, kidney dysfunction and malignancies are leading causes of morbidity and mortality in this population. Diagnosis, management and prevention of complications after liver trans- plantation are important to improve long term outcomes. Therefore, maximizing long-term graft survival and reducing the need for retransplantation is paramount. Diligent management of modifiable post-liver transplantation factors including diabetes, hypertension and renal insufficiency may impact long- term mortality. Standardised follow-up combined with organised screening for medical and surgical complications is therefore essential to improve survival after transplantation. [ABSTRACT FROM AUTHOR]

Given the association between subclinical hypothyroidism and metabolic syndrome, we wanted to explore if high-fat, simple-carbohydrate (HFSC) diet affects hypothalamus-pituitary-thyroid axis. One-month-old male C57BL/6J mice were fed with control (C) and HFSC (T) feed ( n = 18 each), respectively, for 5 months. There was a significant increase in triiodothyronine in the T group (13.5%) compared with the age-matched C group by the fifth month. Thyroid-stimulating hormone was significantly higher (1 month: 1.9-fold; 3 months: 2.66-fold; 5 months: 3.5-fold) from the first to fifth months in the T group compared with age-matched C group. Thyrotropin-releasing hormone (TRH) gene expression showed significant decrease (1 month: 83.2%; 5 months: 40.7%) in the T group compared with the age-matched C group. TRHR1 showed significant decrease in the T group compared with the age-matched C group throughout the study (1 month: 82.8%; 3 months: 45.7%; 5 months: 75.2%). However, TRHR2 showed dynamic change during the study. Initially there was significant (1 month: 0.104-fold) downregulation, followed by significant upregulation (3 months: 3.6-fold) and downregulation (0.73-fold) by the fifth month in the T group compared with the age-matched C group. There was marked depletion of functional follicular cells and colloid substance in the thyroid glands of the T group by the fifth month compared with the C group. Leptin receptors ObRa (1 month: 48.25%; 5 months: 88%) and ObRb (1 month: 46.9%; 5 months: 63.3%) were significantly downregulated in the T group compared with the age-matched C group in the first and fifth months of feeding the respective diets. The expression of p-STAT3, a transcription factor known to have a role in energy balance, intermediate metabolism, and leptin signalling was seen to decrease significantly (6.25-fold) in the hypothalamus of the T group compared with the age-matched C group. In conclusion, HFSC feed disrupts the hypothalamus-pituitary-thyroid axis in male C57BL/6J mice. [ABSTRACT FROM AUTHOR]

The percentage of women who are obese at the time of conception or during pregnancy is increasing, with animal and human studies demonstrating that offspring born to obese dams or mothers are at increased risk for obesity and the metabolic syndrome. Our goal was to confirm in an experimental model of metabolic syndrome in the dam, whether the offspring would be at increased risk of obesity. Conversely, we observed that male offspring born to dams with metabolic syndrome had no alterations in their body mass profiles, whereas female offspring born to dams with metabolic syndrome were heavier at weaning, but exhibited no perturbations in energy metabolism. Moreover, they gained weight at a reduced rate versus female offspring born to healthy dams, and thus weighed less at study completion. Hence, our findings suggest that factors other than increased adiposity and insulin resistance during pregnancy are responsible for the increased risk of obesity in children born to obese mothers. [ABSTRACT FROM AUTHOR]

Variations in skeletal muscle peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), carntine palmitoyltransferase-1 (CPT-1), perilipin protein 2 (PLIN2), and adipose tissue triglyceride lipase (ATGL), and comparative gene identification-58 (CGI-58) have been described as playing important roles in the metabolic regulation of lipid oxidation, and may influence intramyocellular lipid (IMCL) and muscle lipid droplet size (LDS). While acute changes in caloric balance and/or aerobic capacity may affect lipid metabolism, the influence of sustained weight loss derived from caloric restriction with weight loss (CWL) compared with exercise training with weight loss (EWL) on the abovementioned parameters has not been fully elucidated. Using a combination of metabolic feeding and/or supervised exercise training, we evaluated the influence of stabilized weight loss elicited by CWL compared with EWL without the confounding influence of acute alterations in caloric balance on molecular markers of mitochondrial metabolism and lipid droplet size in middle-aged overweight individuals with impaired glucose tolerance. There were no significant changes in PGC-1α, CPT-1, PLIN2, ATGL and, CGI-58 messenger RNA (mRNA) in CWL and EWL. While there were no changes in ATGL mRNA in CWL, there was a strong trend ( P = 0.05) for the ΔATGL mRNA in EWL with stabilized weight loss. There were no significant changes in IMCL or LDS within skeletal muscle in CWL or EWL, respectively. In conclusion, under the conditions of chronic caloric balance following dietary or exercise-based interventions, mediators of mitochondrial function, IMCL and LDS, were largely unaffected. Future studies should focus on intervention-based changes in protein expression and/or phosphorylation and the relationship to physiological endpoints. [ABSTRACT FROM AUTHOR]

Mechanical activity of the heart is adversely affected in metabolic syndrome (MetS) characterized by increased body mass and marked insulin resistance. Herein, we examined the effects of high carbohydrate intake on cardiac function abnormalities by evaluating in situ heart work, heart rate, and electrocardiograms (ECGs) in rats. MetS was induced in male Wistar rats by adding 32% sucrose to drinking water for 22-24 weeks and was confirmed by insulin resistance, increased body weight, increased blood glucose and serum insulin, and increased systolic and diastolic blood pressures in addition to significant loss of left ventricular integrity and increased connective tissue around myofibrils. Analysis of in situ ECG recordings showed a markedly shortened QT interval and decreased QRS amplitude with increased heart rate. We also observed increased oxidative stress and decreased antioxidant defense characterized by decreases in serum total thiol level and attenuated paraoxonase and arylesterase activities. Our data indicate that increased heart rate and a shortened QT interval concomitant with higher left ventricular developed pressure in response to β-adrenoreceptor stimulation as a result of less cyclic AMP release could be regarded as a natural compensation mechanism in overweight rats with MetS. In addition to the persistent insulin resistance and obesity associated with MetS, one should consider the decreased heart work, increased heart rate, and shortened QT interval associated with high carbohydrate intake, which may have more deleterious effects on the mammalian heart. [ABSTRACT FROM AUTHOR]

A rapid rise in obesity, as well as physical inactivity, in industrialized countries is associated with fructose-consumption-mediated metabolic syndrome having a strong association with cardiovascular disease. Although insulin resistance is thought to be at the core, visceral obesity, hypertension, and hypertriglyceridemia are also considered important components of this metabolic disorder. In addition, various other abnormalities such as inflammation, oxidative stress, and elevated levels of uric acid are also part of this syndrome. Lifestyle changes through improved physical activity, as well as nutrition, are important approaches to minimize metabolic syndrome and its deleterious effects. [ABSTRACT FROM AUTHOR]

Summary Objective To determine the influence of the level of physical activity on physical fitness, body composition and lipid profile and further explore the associations between fitness with these health outcomes in a population of overweight/obese adults. Methods Forty overweight/obesity participants with a caloric intake between a negative balance of 500 kcal/day and their estimated required energy intake were classified according to their level of physical activity. Anthropometric (weight and height), body composition (waist-to-hip ratio, percentage of body fat and fat-free mass), clinical measurements (blood pressure), physical fitness (cardiorespiratory fitness – 6MWT –, handgrip strength and lower-limb muscle strength – MVC –) and lipid profile (total cholesterol – TC –, low – LDL – and high-density lipoprotein cholesterol – HDL –, triglyceride – TG –, and plasma glucose) were determined. Results Significant differences in MVC and fat-free mass were found between participants with different physical level. Significant associations between all the body composition measures and the strength-related variables (handgrip and MVC) in both physical activity categories also were found. In addition, associations between triglycerides, LDL and total cholesterol with muscle strength and cardiorespiratory fitness were observed only in the low physical activity group. Moreover, MVC explained up to 39% of the variance in metabolic syndrome in those with a moderate level of physical activity. Conclusions Correlations between physical fitness (especially in strength) and health risk factors depending on the level of physical activity were found. [ABSTRACT FROM AUTHOR]

Résumé Objectif Étudier le lien entre le syndrome métabolique (SM) et l’activité de la maladie chez les patients atteints de polyarthrite rhumatoïde (PR). Méthodes Le registre des polyarthrites rhumatoïdes de l’hôpital Siriraj est une étude de cohorte prospective débutée en mai 2011. Un total de 267 patients disposant de données complètes en février 2015 a été inclus dans ces analyses. Toutes les données cliniques et biologiques relatives à l’activité de la maladie, le statut fonctionnel et les paramètres du SM selon le National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) ont été collectées. Des analyses univariée et multivariée selon la méthode pas à pas descendante ont été menées pour identifier les facteurs associés au SM. Résultats La majorité des patients (88 %) étaient des femmes, d’âge moyen (±écart-type) 59 ans (± 11,1). Un SM était retrouvé chez 43 (16 %) des patients. La proportion de patients en rémission selon le DAS28 (moyenne ajustée sur le temps du DAS28 < 2,6) était plus faible chez les patients avec un SM comparativement aux patients sans SM (2,3 % vs. 16,5 %, p = 0,02). L’analyse de régression logistique multiple a identifié 4 facteurs indépendants associés au SM qui comprenaient l’âge ( odds ratio [OR] 1,01, intervalle de confiance à 95 % [IC] 0,98 à 1,05), l’indice de masse corporelle (OR 1,2, IC 95 % 1,1 à 1,3), le niveau d’éducation ≤ 12 ans (OR 5,92, IC 95 % 1,47 à 23,83), et la rémission de la maladie (OR 0,11, IC 95 % 0,01 à 0,93). Ce modèle prédisait correctement 84 % des cas. Conclusion Le taux de rémission est significativement plus bas chez les patients PR atteints du SM. L’activité de la PR, l’indice de masse corporelle et le niveau d’éducation sont associés au SM chez les patients atteints de PR. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) is a major health problem which is now recognized by governmental agencies. NAFLD is a spectrum of diseases including non-alcoholic fatty liver (NAFL), non-alcoholic steatohepatitis (NASH) and its complications: fibrosis, cirrhosis and hepatocellular carcinoma. Worldwide, 25% of the general population have NAFL, and 1.5 to 6.5% have NASH. These high frequencies are linked to the epidemic of overweight and obesity. As for obesity, NAFLD is a complex and heterogeneous disease. The mechanisms, the clinical occurrence, the associated diseases and the natural history imply multiple genetic and environmental factors. Insulin-resistance may play a central but not exclusive role in the occurrence of NASH. NAFLD such as obesity and type 2 diabetes is a multisystem disease associated with various complications (cardio-vascular events, hepatic and extra hepatic cancers, chronic kidney disease. . .). Advances in the knowledge of the mechanisms of NAFLD led to the development of new pharmacological or non pharmacological treatments, which are undergoing clinical trials. The management of patients with NAFLD must be well structured, particularly because the liver biopsy, which is still the gold standard, cannot be performed in all suspected subjects. There is a need to develop and validate new non-invasive tools based on analyses of serum or on physical assessment that allow reliable assessment of fibrosis, the NASH and steatosis. Their availability will allow easy screening, diagnosis and follow-up of patients. [ABSTRACT FROM AUTHOR]

L'hypothyroïdie fruste (HF) est définie biologiquement par une élévation isolée du taux de thyréostimuline (TSH), sans anomalie de la concentration des hormones thyroïdiennes libres. Sa découverte est souvent faite de manière fortuite chez un sujet asymptomatique. Contrairement à l'hypothyroïdie avérée dont les répercussions cliniques, métaboliques et cardiovasculaires sont bien établies, les répercussions de l'HF restent controversées. L'amélioration du profil métabolique et celle du pronostic cardiovasculaire par le traitement hormonal substitutif sont encore incertains, notamment lorsqu'il s'agit d'une forme modérée d'HF avec un taux de TSH inférieur à 10 μUI/mL. [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.)

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.)

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.)

An often-overlooked comorbidity of type 2 diabetes (T2D) is increased fracture risk. Since traditional T2D therapies focus solely on glucose homeostasis, there is an increased need for effective treatment strategies that improve both metabolic and bone health. The current study evaluated if previously reported protective effects of exercise (EX) on cortical bone geometry and biomechanical properties are due to the prevention of obesity compared with obese Otsuka Long-Evans Tokushima Fatty (OLETF) rats or the unique skeletal effects of exercise. Four-week-old male OLETF rats were randomly assigned to 1 of 3 groups, each fed a standard rodent chow diet until 40 weeks of age: ad libitum-fed sedentary (O-SED), ad libitum-fed EX (O-EX), or a control group body-weight−matched to the O-EX group by caloric restriction (O-CR). Ad libitum-fed sedentary Long-Evans Tokushima Otsuka (L-SED) rats were used as a lean control. EX or CR prevented the excess body mass accumulation and elevated HbA1c observed in O-SED. Total-body bone mineral density was greater in O-EX than O-CR, but similar to L-SED and O-SED. O-EX and O-CR had lower osteocalcin and TRAP5b than O-SED and L-SED. EX or CR prevented the ∼3-fold increase in CTx in O-SED versus L-SED. EX increased femoral cortical mass accumulation and expansion at the mid-diaphysis compared with O-CR. EX or CR significantly increased tissue-level stiffness and strength compared with O-SED and L-SED, but O-EX had greater whole-bone stiffness than all other groups. In summary, EX has distinct advantages over CR for improving bone biomechanical properties in hyperphagic OLETF rats. [ABSTRACT FROM AUTHOR]