Gestational diabetes and endothelial function: impact of gestational insulin resistance on reactive hyperhemia index

Our aim was to characterize endothelial function in gestational diabetes by evaluating the reactive hyperemia index (RHI, LnRHI). A prospective, descriptive and comparative study was conducted on a population of pregnant women aged over 20 and under 36, located in the gestational age group 24-38th week of amenorrhea. They were divided into two groups. Group 1 (G1): group of pregnancies without diabetes, consists of pregnant women with no risk factor for gestational diabetes and with normal fasting blood glucose. Group 2 (G2): group of pregnancies with diabetes, includes pregnancies whose oral glucose tolerance tests (OGTT) came back positive. Anthropo-physiological parameters (age, weight, height, blood pressure (PA) and biochemical parameters (glycemia, insulinemia, HOMA-IR, cholesterol, triglycerides) were measured. RHI and LnRHI were determined at Endopat 2000. The two groups were matched for age, weight, heart rate (HR) and blood pressure (BP). Levels of glucose (G1:0.76±0.11; G2:1.11±0.11; p˂0.0001), insulin (G1:7.67±4.35; G2:22.9±3.75; p˂0.0001), HOMA-IR (G1:1.51±0.97; G2:6.29±1.23; p˂0.0001), total cholesterol (G1:1±0.81; G2:2.49±0.74; p=0.002), HDL cholesterol (G1:0.45±0.23; G2: 0.8±0.19; p=0.004, LDL cholesterol (G1:0.42±0.54; G2:1.39±0.6; p=0.004), triglycerides (G1:0.65±0.49; G2:1.48±0.27; p=0.0018), were significantly higher in the diabetic group. Both RHI and LnRHI were negatively correlated with HOMA-IR (respectively, r=-0.8931, p<0.0001; r=-0.8938; p<0.0001). HOMA-IR index was independently associated with levels of RHI and LnRHI (respectively r²=0.797; p<0.0001); (r²=0.804; p<0.0001)). Thus, gestational insulin resistance would be associated with a change in endothelial function such as a decrease in endothelium-dependent vasodilatation reflecting endothelial dysfunction, hence an increase in cardiovascular risk

Insulin resistance and arterial stiffness: impact of gestational diabetes on pulse wave velocity

Background: Gestational diabetes is an intolerance of glucose with the first appearance during the pregnancy. This hyperglycaemia status, because of the pre-existing insulin-resistance, constitute a favourable land of arterial stiffness. The aim of this study is to determine the impact of non obese gestational diabetes on arterial stiffness by measuring the pulse wave velocity (PWV).Methods: We recruited 60 pregnant women aged from 20 to 35 years old. They were between twentieth four and thirtieth five weeks of gestational age. Subjects were divided into two groups: the first group (G1), considered as control group, included 25 normoglycemic pregnant subjects without any history of illness or risk factors of gestational diabetes; the second group (G2) included 35 women with Gestational Diabetes Mellitus (GDM). All pregnant women had not history of smoking, were not taking decoction or medicine, which could disturb pregnancy evolution. Anthropo-physiological and biochemical parameters studied, were: age, body mass index (BMI), blood pressure (BP), triglyceride, cholesterol and HOMA-IR index. The PWV between finger and toe (PWVft) was measured by pOpmètre®.Results: The two groups are matched by age (G1:28±4ans; G2:29±3ans) and BMI (G1:25.6±1.27; G2:26.9±1.3). Blood pressure (BP) values are in normal interval (systolic BP: [110-132mmHg]; diastolic BP: [63-87mmHg]; mean BP: [79-103mmHg]). Total cholesterol (G1:0.95±0.08;G2:2.4±0.7; p˂0.0001), HDL cholesterol (G1:0.44±0.02; G2:0.76±0.2; p˂0.0001, LDL cholesterol (G1:0.40±0.05; G2:1.3±0.5; p˂0.0001), triglyceride (G1:0.57±0.45; G2:1.6±0.4;p˂0.0001), HOMA.IR (G1:1.31±1.05; G2:7.4±1.07; p˂0.01), PWVft (G1:5.99±1.23; G2:10.3±1.9; p˂0.0001) are significantly higher in diabetic group. PWVft is positively correlate to HOMA-IR index, total cholesterol, LDL cholesterol and triglycerides (r=0.3348, p=0.032; r=0.5275, p˂0.0001; r=0.4855,p˂0.0001; r=0.5581, p˂0.0001respectively).Conclusions: Gestational diabetes might induce an increase of pulse wave velocity expressing increment of arterial stiffness. This last constitute an early underlying cardiovascular risk.

Lipid profile frequency and the prevalence of dyslipidaemia from biochemical tests at Saint Louis University Hospital in Senegal

Introduction: The aim of this study was to evaluate the frequency of lipid profile requests and the  prevalence of dyslipidemia in patients at the biochemistry laboratory of St. Louis University Hospital, as well as their correlation with sex and age. Methods: This was a retrospective study reviewing 14,116  laboratory results of patients of both sexes, over a period of six months (January-June 2013) regardless of the indication for the request. The lipid parameters included were: Total cholesterol, HDL-cholesterol, LDL-cholesterol, trig lycerides with normal values defined as follows: Total cholesterol (&lt;2g/l), HDL- cholesterol (&gt;0,40g/l), LDL- cholesterol (&lt;1,30g/l) and Triglycerides (&lt;1,50g/l). Results: The average age of our study population was 55.15 years with a female predorminance (M/F=0.60). The age group most represented was that between 55-64 years. The frequency of lipid profile request in our sample was 9.41% (or 1,329). The overall prevalence of isolated hypercholesterolemia, hyperLDLaemia,  hypoHDLaemia, hypertriglyceridaemia, and mixed hyperlipidemia were respectively 60.91%, 66.27%, 26.58%, 4.57% and 2.75%. Hypercholesterolemia, hyperLDLaemia, hypertriglyceridaemia and mixed hyperlipidaemia were higher in women with respectively 66.22%, 67.98%, 4.58%, 2.89% than in men (52.01%, 62.81%, 4.44% and 2.40% respectively). On the other hand, the prevalence of hypoHDLaemia was higher in males (32.19%) compared to females (23.76%). Hypercholesterolemia correlated  significantly with age and sex. Conclusion: Our study showed a relatively low request rate for lipid profile and a high prevalence of dyslipidaemia hence the importance of conducting a major study on the prevalence of dyslipidaemia and associated factors in the Senegalese population.Key words: Lipid profile, dyslipidaemia, prevalence, Senega

Effects of lenten fasting on body composition and biochemical parameters

Background: The catholic lenten fasting is the period of 40 days of fasting that precedes Easter. It is one of religious fasting less documented in the scientific literature. Thus the aim of our study was to evaluate the evolution of anthropometric and body composition and biochemical profile during Catholic lenten fasting.Methods: We conducted a prospective study, which took place during the period between one week before at the end of lenten fasting. Eleven fasters (4 women and 7 men), aged between 18 and 59 years were included in present study. Anthropometric, body composition parameters and biochemical profile were evaluated one week before, at 15th day and at the end of Lenten fasting.Results: Weight, body mass index (BMI) and visceral fat decreased significantly at the end of Lenten fasting. Lipid profile changed significantly during this fasting period. Total cholesterol (TC), low density lipoprotein – cholesterol (LDL-C) and triglycerides decreased significantly with fasting. High density lipoprotein – cholesterol (HDL-C) was remained unchanged during this fasting period while TC/HDL ratio was significantly decreased at the end of Lent.Conclusions: Present study showed that the fasting of Lent seems to have beneficial effects on reducing cardiovascular risk factors. Further studies are required to better understand the physiological mechanisms involved for a therapeutic use

Dyslipidemia, obesity and other cardiovascular risk factors in the adult population in Senegal

Introduction: According to the WHO, 50% of deaths worldwide (40.1% in developing countries) are due to chronic non-communicable diseases (NCDs). Of these chronic NCDs, cardiovascular diseases remain the leading cause of death and disability in developed countries. The Framingham study has shown the importance of hypercholesterolemia as a primary risk factor. In Senegal, the epidemiology of  dyslipidemia and obesity are still poorly understood due to the lack of comprehensive studies on their  impact on the general population. This motivated this study to look into the key epidemiologic and socio-demographic determinants of these risk factors. Methods: It was a cross-sectional descriptive epidemiological survey which included 1037 individuals selected by cluster sampling. Data were collected using a questionnaire following the WHO STEPwise approach. Socio-demographic, health and biomedical variables were collected. P value Results: The average age was 48 years with a female predominance (M: F of 0.6). The literacy rate was 65.2% and 44.7% of participants were from rural areas. The prevalence of hypercholesterolemia, hyperLDLemia, hypoHDLemia, hypertriglyceridemia and mixed hyperlipidemia were 56%, 22.5%, 12.4%, 7.11% and 1.9% respectively. One in four was obese (BMI&gt; 30kg/m2) and 34.8% had abdominal obesity. The main factors significantly associated with dyslipidemia were obesity, urban dwelling, physical inactivity and a family history of dyslipidemia. Conclusion: The prevalence of dyslipidemia, obesity and other risk factors in the population was high needing immediate care for those affected and implementation of prevention strategies.Key words: Dyslipidemia, obesity, cardiovascular, risk factors, Saint Loui

Prévalence des dyslipidémies au laboratoire de biochimie du CHU Aristide le Dantec de Dakar, Sénégal

Introduction: l'objectif de cette étude était d'évaluer la prévalence des dyslipidémies chez les patients reçus au laboratoire de Biochimie de l'Hôpital Aristide Le Dantec pour le dosage d'un paramètre lipidique au cours de l'année 2013. Méthodes: il s'agit d'une étude rétrospective portant sur 1356 patients âgés de 10 à 94 ans reçus au laboratoire de Biochimie du CHU Le Dantec de janvier à décembre 2013. Etaient inclus dans l'étude, tous les patients ayant au moins un paramètre du bilan lipidique dont les résultats étaient enregistrés dans le registre du laboratoire. Le cholestérol total, le cholestérol HDL, le cholestérol LDL ainsi que les triglycérides ont été dosés grâce à des méthodes enzymatiques sur un automate de Biochimie de type Cobas Integra 400 (Roche Diagnostics). Résultats: la prévalence des dyslipidémies dans notre population d'étude est de 39,30%. Les prévalences de l'hypercholestérolémie, l'hypoHDLémie, l'hyperLDLémie, l'hypertriglycéridémie et l'hyperlipidémie mixte étaient respectivement : 30,89% ; 7,30% ; 31,19% ; 0,51% ; 7,22%. Les sujets de 40 à 59 ans semblaient être plus exposés et on note une prédominance féminine en ce qui concerne l'hypercholestérolémie (54,17% vs 45,82%), l'hypoHDLémie (54,54% vs45, 45%), et l'hyperlipidémie mixte (51,08% vs 48,97%). Enfin les dyslipidémies étaient fortement corrélées à l'HTA et l'obésité. Conclusion: la forte prévalence des dyslipidémies retrouvée dans notre étude démontre l'intérêt d'étudier la prévalence des facteurs de risque cardio-vasculaires en particulier les dyslipidémies dans la population sénégalaise.The Pan African Medical Journal 2016;2

Dyslipidemia, obesity and other cardiovascular risk factors in the adult population in Senegal

Abstract Introduction: According to the WHO, 50% of deaths worldwide (40.1% in developing countries) are due to chronic non-communicable diseases (NCDs). Of these chronic NCDs, cardiovascular diseases remain the leading cause of death and disability in developed countries. The Framingham study has shown the importance of hypercholesterolemia as a primary risk factor. In Senegal, the epidemiology of dyslipidemia and obesity are still poorly understood due to the lack of comprehensive studies on their impact on the general population. This motivated this study to look into the key epidemiologic and socio-demographic determinants of these risk factors. Methods: It was a cross-sectional descriptive epidemiological survey which included 1037 individuals selected by cluster sampling. Data were collected using a questionnaire following the WHO STEPwise approach. Socio-demographic, health and biomedical variables were collected. P value Results: The average age was 48 years with a female predominance (M: F of 0.6). The literacy rate was 65.2% and 44.7% of participants were from rural areas. The prevalence of hypercholesterolemia, hyperLDLemia, hypoHDLemia, hypertriglyceridemia and mixed hyperlipidemia were 56%, 22.5%, 12.4%, 7.11% and 1.9% respectively. One in four was obese (BMI&gt; 30kg/m2) and 34.8% had abdominal obesity. The main factors significantly associated with dyslipidemia were obesity, urban dwelling, physical inactivity and a family history of dyslipidemia. Conclusion: The prevalence of dyslipidemia, obesity and other risk factors in the population was high needing immediate care for those affected and implementation of prevention strategies

Management of a global health crisis: first COVID-19 disease feedback from Overseas and French-speaking countries medical biologists

The French society of clinical biology “Biochemical markers of COVID-19” has set up a working group with the primary aim of reviewing, analyzing and monitoring the evolution of biological prescriptions according to the patient’s care path and to look for markers of progression and severity of the disease. This study covers all public and private sectors of medical biology located in metropolitan and overseas France and also extends to the French-speaking world. This article presents the testimonies and data obtained for the “Overseas and French-speaking countries” sub-working group made up of 45 volunteer correspondents, located in 20 regions of the world. In view of the delayed spread of the SARS-CoV-2 virus, the overseas regions and the French-speaking regions have benefited from feedback from the first territories confronted with COVID-19. Thus, the entry of the virus or its spread in epidemic form could be avoided, thanks to the rapid closure of borders. The overseas territories depend very strongly on air and/or sea links with the metropolis or with the neighboring continent. The isolation of these countries is responsible for reagent supply difficulties and has necessitated emergency orders and the establishment of stocks lasting several months, in order to avoid shortages and maintain adequate patient care. In addition, in countries located in tropical or intertropical zones, the diagnosis of COVID-19 is complicated by the presence of various zoonoses (dengue, Zika, malaria, leptospirosis, etc.).La Société française de biologie clinique « Marqueurs biochimiques deCOVID-19 » a constitué un groupe de travail ayant pour but premier de faire le point, d’analyser, de suivre l’évolution des prescriptions biologiques en fonction du parcours de soins du patient et de rechercher des marqueurs d’évolutivité et de gravité de la maladie. Cette étude recouvre tous les secteurs publics et privés de la biologie médicale situés en France métropolitaine et ultra-marine et s’étend également à la francophonie. Dans cet article, sont présentés les témoignages et données obtenus pour le sous-groupe de travail « Outre-mer et francophonie » composé de 45 correspondants volontaires, répartis dans 20 régions du monde. Au vu d’une propagation décalée du virus SARS-CoV-2, les régions d’Outremer et les régions francophones ont bénéficié des retours d’expériences des premiers territoires confrontés au COVID-19. Ainsi, l’entrée du virus ou sa propagation sous forme épidémique ont pu être évitées grâce à la fermeture rapide des frontières. Les territoires ultramarins dépendent très fortement des liaisons aériennes et/ou maritimes avec la métropole ou avec le continent voisin. L’isolement de ces pays est responsable de difficultés d’approvisionnement en réactifs et a nécessité des commandes en urgence et la mise en place de stocks de plusieurs mois, afin d’éviter les pénuries et de maintenir une prise en charge adéquate des patients. De plus, dans les pays situés en zones tropicales ou intertropicales, le diagnostic de COVID-19 est compliqué par la présence de diverses zoonoses (dengue, Zika, paludisme, leptospirose, etc.)