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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.


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.


PubMed | Institute National Of La Sante Et Of La Recherche Medicale Unite 695
Type: Journal Article | Journal: The Journal of clinical endocrinology and metabolism | Year: 2010

The six-transmembrane protein of prostate 2 (STAMP2) has been shown to be involved in insulin resistance in animal models, but in humans, its role is far from understood. Our hypothesis was that genetic variation of STAMP2 could be associated with insulin resistance phenotypes such as the metabolic syndrome (MetS) in humans.Our objective was to search for associations between STAMP2 polymorphisms and the MetS in humans.Nine single-nucleotide polymorphisms (SNPs) were tested for associations with the International Diabetes Federation-defined MetS and its constituent parameters in 5212 French Caucasians from the prospective study, Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR), with a 9-yr follow-up. Methods included logistic regression and analysis of covariance adjusting for confounding variables and testing for interactions.None of the SNPs was significantly associated with the prevalence or the incidence of the MetS. The rs12386756 was marginally associated with two parameters of the MetS [triglycerides (P = 0.04) and fasting glucose (P = 0.05)]. An interaction effect between this SNP and fat intake was observed on high-density lipoprotein-cholesterol levels (P = 0.01) and systolic blood pressure (P = 0.03) that is consistent with an interrelation between STAMP2 and nutrition. Three SNPs were associated with insulin levels, but these SNPs were not associated with other features of the MetS.These findings suggest that the common polymorphisms of STAMP2 are unlikely to significantly contribute to the risk of the MetS in the general population, but relationships with insulin and interactions with fat intake need to be replicated.

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