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Khalil C.A.,Groupe Hospitalier Bichat Claude Bernard | Khalil C.A.,Institute National Of La Sante Et Of La Recherche Medicale Unite 695 | Khalil C.A.,University Paris Diderot | Mohammedi K.,Groupe Hospitalier Bichat Claude Bernard | And 14 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2011

Introduction: High total adiponectin (ADPN) levels were reported in type 1 diabetes (T1D) and related to long diabetes duration and nephropathy. We studied whether ADPN and its specific isoforms were elevated in T1D without microangiopathy and whether they were related to kidney function. Materials and Methods: Total, high, medium, and low molecular weight ADPN and insulin levels were measured in 47 consecutive normoalbuminuric, normotensive T1D patients without retinopathy and in 47 age-, sex-, and body mass index-matched controls. Glomerular filtration rate was estimated by 51Cr-EDTA plasma clearance. Results: Total and high molecular weight ADPN ratio were higher in T1D patients than in controls. ADPN levels were not related to anthropometric measures, whereas they were in controls. In T1D, ADPN levels were not related to glycosylated hemoglobin, diabetes duration, or glomerular filtration rate. Peripheral insulin levels were higher in T1D patients than in controls, but they were not related to ADPN levels. In controls, insulin levels were positively related to total ADPN. Conclusion: In T1D without microangiopathy, high ADPN levels could not be related to anthropometric diabetes parameters, kidney function, or high insulin levels. The nature of this elevation remains unknown. Copyright © 2011 by The Endocrine Society. Source


Mohammedi K.,Groupe Hospitalier Bichat Claude Bernard | Mohammedi K.,University Paris Diderot | Mohammedi K.,Institute National Of La Sante Et Of La Recherche Medicale Unite 695 | Roussel R.,Groupe Hospitalier Bichat Claude Bernard | And 18 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2011

Context: Type B insulin resistance syndrome is a rare condition characterized by the presence of autoantibodies directed against the insulin receptor. It has been reported in association with autoimmune diseases such as systemic lupus erythematosus. Objective: We report a case of type B insulin resistance syndrome in a patient with HIV infection on highly active antiretroviral therapy (HAART). Patient and Methods: A 27-yr-old African woman with ketosis-prone diabetes and HIV infection developed severe insulin resistance after the initiation of HAART. Standard oral glucose tolerance tests using 75 g of glucose performed 1, 2, and 3 months after the initiation of HAART showed severe hyperinsulinemia and hypoglycemia. Six months later, she developed symptomatic hyperglycemia resistant to high-dose insulin therapy. To determine the cause of insulin resistance, we assayed the titer of insulin receptor autoantibodies in the serum of the patient. Results: Plasma insulin receptor autoantibodies were present at the time of marked hyperglycemia and insulin resistance, confirming the diagnosis of type B insulin resistance syndrome. Simultaneously the diagnosis of immune reconstitution inflammatory syndrome was established according to increased CD4 T cell count, decreased plasma HIV1-RNA level, and tuberculosis reactivation, shortly after institution of HAART. Corticosteroid therapy improved insulin resistance and hyperglycemia. Conclusion: We report the first case of type B insulin resistance syndrome associated with immune reconstitution inflammatory syndrome in an HIV-infected patient. Copyright © 2011 by The Endocrine Society. Source

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