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Le Touquet – Paris-Plage, France

Genser L.,Institute Of Cardiometabolisme Et Nutrition | Genser L.,Paris-Sorbonne University | Genser L.,French Institute of Health and Medical Research | Poitou C.,Institute Of Cardiometabolisme Et Nutrition | And 14 more authors.
Medecine/Sciences | Year: 2016

The increasing incidence of obesity and associated metabolic complications is a worldwide public health issue. The role of the gut in the pathophysiology of obesity, with an important part for microbiota, is becoming obvious. In rodent models of diet-induced obesity, the modifications of gut microbiota are associated with an alteration of the intestinal permeability increasing the passage of food or bacterial antigens, which contribute to low-grade inflammation and insulin resistance. In human obesity, intestinal permeability modification, and its role in the crosstalk between gut microbiota changes and inflammation at systemic and tissular levels, are still poorly documented. Hence, further characterization of the triggering mechanisms of such inflammatory responses in obese subjects could enable the development of personalized intervention strategies that will help to reduce the risk of obesity-associated diseases. © 2016 médecine/sciences - Inserm. Source

Feve B.,University Pierre and Marie Curie | Feve B.,Institute Of Cardiometabolisme Et Nutrition | Bastard J.-P.,University Pierre and Marie Curie | Bastard J.-P.,Institute Of Cardiometabolisme Et Nutrition
Obesite | Year: 2014

A large number of studies indicate that a growing part of cancers are influenced by obesity. In obese individuals, cancers are more frequent and more aggressive, especially for post-menopausal breast cancer. The pathophysiological mechanisms that underlie the relationship between obesity and breast cancer carcinogenesis are complex and associate both an increased inflammation and angiogenesis, and altered plasma levels of several growth factors and hormones including insulin, IGF-1, adiponectin, leptin, and oestrogens.More specifically, a sum of epidemiological, genetic, and experimental studies converge to suggest an anti-carcinogenic role for adiponectin. This could lead to the development of new therapeutic strategies through a modulation of the signaling of this adipose tissue-derived hormone. © 2014 Springer-Verlag France. Source

Faucher P.,Institute Of Cardiometabolisme Et Nutrition | Faucher P.,University Pierre and Marie Curie | Poitou C.,Institute Of Cardiometabolisme Et Nutrition | Poitou C.,University Pierre and Marie Curie
Revue du Rhumatisme Monographies | Year: 2015

Obesity is currently a matter of public health due to its concerning increasing prevalence during the last decade. The management for obesity and for associated diseases is thus a priority. Obesity is a complex chronic disease at the pathophysiological level as well as at the management level. It is a heterogeneous disease regarding the phenotype, which evolves in several stages (formation, continuation, worsening) whose deciding factors are numerous. That is why it is not a unique disease, there are various types of obesities occurring in various medical situations. The development of fat is induced by genetic factors, which express themselves according to environmental and behavioural factors. This leads to an imbalance of the energetic balance due to changes related to food intake and reduced physical activity. There are also psychosocial and biological factors, such as modifications of fat tissue and its interactions with other tissues involved in the regulation of the energetic homeostasis and the development of associated diseases. The therapeutic strategy needs to adapt to the type of obesity, in particular at the progressive stage of the disease, taking into account the etiological factors in question. Managing obese patients is thus an exercise of general and personalized medicine, requiring a time for a medical assessment and for a multidisciplinary evaluation in order to better set the management goals. © 2015. Source

Genser L.,Institute Of Cardiometabolisme Et Nutrition | Vatier C.,Institute Of Cardiometabolisme Et Nutrition | Vatier C.,University Pierre and Marie Curie | Keophyphath M.,AdipoPhyt SAS | And 8 more authors.
Obesite | Year: 2013

Adipose tissue (AT) is now well recognized as an endocrine organ involved in energy homeostasis regulation acting both on the central nervous system and at the local level via its hormonal secretion such as leptin. Recently, the abdominal subcutaneous AT, which is easily accessible by using several procedures, became one of the important parameters used to phenotype morbidly obese patients. Indeed, morphologic and functional modifications such as, adipocyte hypertrophia, inflammation and fibrosis are associated with obesity-related metabolic complications. The objectives of this article are to present the various techniques of abdominal subcutaneous AT biopsies, as well as further information which they can bring. The less morbid technique is the subcutaneous AT needle aspiration, which is currently used in several indications including morbidly obese patient phenotyping. However, it does not allow a complete histological study because it generally provides unstructured AT samples. Surgical AT biopsy, which requires a cutaneous section, is more invasive than the needle aspiration. However, it allows a good quality complete histological study, but with a lesser AT amount than the needle aspiration. © 2013 Springer-Verlag France. Source

Le Beyec J.,University Pierre and Marie Curie | Le Beyec J.,Service Of Biochimie Endocrinienne Et Oncologique Unite | Cugnet-Anceau C.,University of Lyon | Dominique Pepin,Service Of Biochimie Endocrinienne Et Oncologique Unite | And 10 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2013

Context: Severe early-onset obesity with major hyperphagia associated with hypogonadotropic hypogonadism is recognized as the main clinical presentation of leptin (LEP) or LEP receptor (LEPR) gene complete deficiency. In a few reported cases, homozygous mutations have been found in patients from consanguineous families. Care of LEPR-deficient patients is complicated because they cannot benefit from LEP treatment. Furthermore, gastric surgerymaynot be recommended in such genetic hypothalamic obesity. Objective: We investigated in a morbidly obese patient the genetic origin of his obesity and evaluated the benefit of bariatric surgery in this case. Subject and Methods: The patient exhibited severe early-onset obesity with hyperphagia and delayed puberty in a nonobese family. He had clinical and hormonal follow-up from 3 to 26 years of age. Gastroplasty procedures were undertaken when he was 16 and 18 years old. LEPR genetic analysis of the patient and his relatives was performed. Results: A new homozygous LEPR sequence frameshift, predicted to generate a truncated protein from a premature stop codon in exon 14, wasidentified in the proband inherited fromtwopaternal copies of chromosome 1 (isodisomy). Vertical ring gastroplasty was sufficient to induce and maintain a 40-kg weight loss into adulthood. Conclusion: We described the first case of a patient with chromosome 1 uniparental isodisomy revealed by molecular analysis of LEPR. In this case, gastroplasty may be partially effective for weight control as illustrated. Copyright © 2013 by The Endocrine Society. Source

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