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Coupaye M.,Pitie Salpetriere Hospital | Coupaye M.,Institute of Cardiology Metabolism and Nutrition | Coupaye M.,French Reference Center for Prader Willi Syndrome | Coupaye M.,Childrens Hospital | And 48 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2013

Context: Children with Prader-Willi syndrome (PWS) who receive GH treatment have improved growth and body composition; however, data are lacking for adults when treatment is discontinued after completion of growth. Objectives: Our aim was to compare body composition and metabolic status in adults with PWS according to GH treatment in childhood and adolescence. Design: 64 adults (mean age: 25.4 years) with a genetic diagnosis of PWS were evaluated: 20 received GH in childhood (T), which had been discontinued at the time of this study, and 44 did not receive GH (C). Mean duration of treatment in the T group was 4.4 ± 2.7 years, age at baseline was 11.8 ± 2.7 years, mean time between the end of treatment and the current evaluation was 7.0 ± 4.4 years. Main Outcomes Measures: Dual-energy X-ray absorptiometry was used to assess body composition and fasting biological analyses evaluated metabolic status. Results (mean ± SD): Body mass index and percentage of fat mass were significantly lower in the T group (32.4 ± 10.3 vs 41.2 ± 11.1 kg/m2, P = 0.05 and 44.0 ± 9.6 vs 50.1 ± 7.2%, P = 0.02, respectively). Insulinemia and HOMA-IR in non-diabetic subjects were significantly lower in the T group (5.8 ± 5.9 vs 13.9 ± 11.6 μUI/ml, P = 0.03, and 1.6 ± 1.3 vs 2.7 ± 2.1, P = 0.04, respectively). Non-diabetic and diabetic subjects from the T group had a significantly lower HbA1c. Lipid profiles were similar between groups. Conclusions: GH treatment in childhood and adolescence is associated with significantly decreased bodymass index and improved body composition and metabolic status in adults with PWS at several years after discontinuing treatment. Copyright © 2013 by The Endocrine Society.


Eschwege E.,French Institute of Health and Medical Research | Eschwege E.,University Paris - Sud | Basdevant A.,Hopital Pitie Salpetriere | Basdevant A.,Institute of Cardiology Metabolism and Nutrition | And 4 more authors.
Diabetes and Metabolism | Year: 2015

Aim: This analysis estimates the prevalence of type 2 diabetes mellitus (T2DM) in French adults participating in the ObEpi (obesity epidemiology) 2012 survey and also proposes a description of that population, according to comorbidities, treatments and sociodemographic factors related to the disease. Methods: A self-administered questionnaire was posted to 20,000 households from the Kantar Health panel. In total, 25,714 adults aged ≥ 18 years and representative of the French population completed the survey between January and March 2012. Results: The prevalence of T2DM was 5.5 ± 0.3% (95% CI) in this representative sample of the adult French population. Average age of patients was 65.9years; 55% were men. Mean body mass index was 29.9 kg/m2 (men: 29.4 kg/m2, women: 30.6 kg/m2; P<0.01); the prevalence of obesity was 43.1% (men: 39.9%, women: 47.1%; P<0.01). Patient-reported treatments for comorbidities were frequent: high blood pressure, 59.1%; dyslipidaemia, 59.9%; myocardial infarction/angina pectoris, 9.7%; revascularization, 7.8%; heart failure, 7.4%; sleep apnoea, 8.3%; and osteoarthritis, 10.7%. With regards to known treatments, 81.4% of patients were taking oral antidiabetic drugs (OADs), and 15.3% were using insulin therapy. Also, 18.8% of diabetic respondents reported financial hardship. Conclusion: T2DM remains a disease of major concern: compared with the non-diabetic population, all parameters surveyed showed unfavourable ratings, particularly for women. © 2014 Elsevier Masson SAS.

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