The neuropeptide 26RFa in the human gut and pancreas: potential involvement in glucose homeostasis

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Cell-To-Cell Communication in Bilateral Macronodular Adrenal Hyperplasia Causing Hypercortisolism

International audienceIt has been well established that, in the human adrenal gland, cortisol secretion is not only controlled by circulating corticotropin but is also influenced by a wide variety of bioactive signals, including conventional neurotransmitters and neuropeptides, released within the cortex by various cell types such as chromaffin cells, neurons, cells of the immune system , adipocytes, and endothelial cells. These different types of cells are present in bilateral macronodular adrenal hyperplasia (BMAH), a rare etiology of primary adrenal Cushing's syndrome, where they appear intermingled with adrenocortical cells in the hyperplastic cortex. In addition, the genetic events, which cause the disease, favor abnormal adrenal differentiation that results in illicit expression of paracrine regulatory factors and their receptors in adrenocortical cells. All these defects constitute the molecular basis for aberrant autocrine/paracrine regulatory mechanisms, which are likely to play a role in the patho-physiology of BMAH-associated hypercortisolism. The present review summarizes the current knowledge on this topic as well as the therapeutic perspectives offered by this new pathophysiological concept

Glycemic Risk Index (GRI) variability in type 1 diabetes adults with HbA1c ≤ 7%: insights for clinical evaluation and intervention.

The glycemic risk index (GRI) is a new composite indicator derived from continuous glucose monitoring (CGM) data that assesses glycemic control quality by weighting hypoglycemic events more heavily than hyperglycemia and extreme hypo/hyperglycemia [...]

Actualité sur l’implication du système peptidergique 26RFa/GPR103 dans la régulation de la glycémie

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Excess Body Mass Index Loss at 3 Months: A Predictive Factor of Long-Term Result after Sleeve Gastrectomy

Introduction. Laparoscopic Sleeve Gastrectomy (SG) is considered as successful if the percentage of Excess Body Mass Index Loss (% EBMIL) remains constant over 50% with long-term follow-up. The aim of this study was to evaluate whether early % EBMIL was predictive of success after SG. Methods. This retrospective study included patients who had SG with two years of follow-up. Patients had follow-up appointments at 3 (M3), 6, 12, and 24 months (M24). Data as weight and Body Mass Index (BMI) were collected systematically. We estimated the % EBMIL necessary to establish a correlation between M3 and M24 compared to % EBMIL speeds and calculated a limit value of % EBMIL predictive of success. Results. Data at operative time, M3, and M24 were available for 128 patients. Pearson test showed a correlation between % EBMIL at M3 and that at M24 (r=0.74;  p<0.0001). % EBMIL speed between surgery and M3 (p=0.0011) was significant but not between M3 and M24. A linear regression analysis proved that % EBMIL over 20.1% at M3 (p<0.0001) predicted a final % EBMIL over 50%. Conclusions. % EBMIL at M3 after SG is correlated with % EBMIL in the long term. % EBMIL speed was significant in the first 3 months. % EBMIL over 20.1% at M3 leads to the success of SG

Discordance Between Glycated Hemoglobin A 1 c and the Glucose Management Indicator in People With Diabetes and Chronic Kidney Disease

International audienceIntroduction: Assessment of glucose exposure via glycated hemoglobin A 1 c (HbA 1 c) has limitations for interpretation in individuals with diabetes and chronic kidney disease (CKD). The glucose management indicator (GMI) derived from continuous glucose monitoring (CGM) data could be an alternative. However, the concordance between HbA 1 c measured in laboratory and GMI (HbA 1 c-GMI) is uncertain in individuals with CKD. The purpose of this study is to analyze this discrepancy. Material and method: We performed a multicentric, retrospective, observational study. A group of individuals with diabetes and CKD (n = 170) was compared with a group of individuals with diabetes without CKD (n = 185). All individuals used an intermittently scanned continuous glucose monitoring (isCGM). A comparison of 14-day and 90-day glucose data recorded by the isCGM was performed to calculate GMI and the discordance between lab HbA 1 c and GMI was analyzed by a Bland-Altman method and linear regression. Results: HbA 1 c-GMI discordance was significantly higher in the CKD group versus without CKD group (0.78 ± 0.57 [0.66-0.90] vs 0.59 ± 0.44 [0.50-0.66]%, P 0.5% was found in 68.2% of individuals with CKD versus 42.2% of individuals without CKD. We suggest a new specific formula to estimate HbA 1 c from the linear regression between HbA 1 c and mean glucose CGM, namely CKD-GMI = 0.0261 × 90-day mean glucose (mg/L) + 3.5579 ( r 2 = 0.59). Conclusions: HbA1c-GMI discordance is frequent and usually in favor of an HbA1c level higher than the GMI value, which can lead to errors in changes in glucose-lowering therapy, especially for individuals with CKD. This latter population should benefit from the CGM to measure their glucose exposure more precisely

Neuropeptide Y and α-MSH Circadian Levels in Two Populations with Low Body Weight: Anorexia Nervosa and Constitutional Thinness

International audienceContext Anorexia nervosa (AN) presents an adaptive appetite regulating profile including high levels of ghrelin and 26RFa (orexigenic) and low levels of leptin and PYY (anorexigenic). However , this adaptive mechanism is not effective in promoting food intake. The NPY/proopiome-lanocortin (POMC) system plays a crucial role in the regulation of feeding behavior as NPY is the most potent orexigenic neuropeptide identified so far and as the POMC-derived pep-tide α-MSH drastically reduces food intake, and this peptidergic system has not been thoroughly studied in AN. Objective The aim of the present study was thus to investigate whether a dysfunction of the NPY/ POMC occurs in two populations with low body weight, AN and constitutional thinness (CT). Design and Settings This was a cross-sectional study performed in an endocrinological unit and in an academic laboratory. Investigated Subjects Three groups of age-matched young women were studied: 23 with AN (AN), 22 CT and 14 normal weight controls

Le neuropeptide 26RFa : un nouveau régulateur de l’homéostasie énergétique

International audienc

Effect of human QRFPR ligands in the insulin tolerance test in mice.

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