Nine-year incident diabetes is predicted by fatty liver indices: the French D.E.S.I.R. study

<p>Abstract</p> <p>Background</p> <p>Fatty liver is known to be linked with insulin resistance, alcohol intake, diabetes and obesity. Biopsy and even scan-assessed fatty liver are not always feasible in clinical practice. This report evaluates the predictive ability of two recently published markers of fatty liver: the Fatty Liver Index (FLI) and the NAFLD fatty liver score (NAFLD-FLS), for 9-year incident diabetes, in the French general-population cohort: Data from an Epidemiological Study on the Insulin Resistance syndrome (D.E.S.I.R).</p> <p>Methods</p> <p>At baseline, there were 1861 men and 1950 women, non-diabetic, aged 30 to 65 years. Over the follow-up, 203 incident diabetes cases (140 men, 63 women) were identified by diabetes-treatment or fasting plasma glucose ≥ 7.0 mmol/l. The FLI includes: BMI, waist circumference, triglycerides and gamma glutamyl transferase, and the NAFLD-FLS: the metabolic syndrome, diabetes, insulin, alanine aminotransferase, and asparate aminotransferase. Logistic regression was used to determine the odds ratios for incident diabetes associated with categories of the fatty liver indices.</p> <p>Results</p> <p>In comparison to those with a FLI < 20, the age-adjusted odds ratio (95% confidence interval) for diabetes for a FLI ≥ 70 was 9.33 (5.05-17.25) for men and 36.72 (17.12-78.76) for women; these were attenuated to 3.43 (1.61-7.28) and 11.05 (4.09 29.81), after adjusting on baseline glucose, insulin, hypertension, alcohol intake, physical activity, smoking and family antecedents of diabetes; odds ratios increased to 4.71 (1.68-13.16) and 22.77 (6.78-76.44) in those without an excessive alcohol intake. The NAFLD-FLS also predicted incident diabetes, but with odds ratios much lower in women, similar in men.</p> <p>Conclusions</p> <p>These fatty liver indexes are simple clinical tools for evaluating the extent of liver fat and they are predictive of incident diabetes. Physicians should screen for diabetes in patients with fatty liver.</p

Vers une meilleure estimation du pourcentage de graisse

Cette étude a pour but d'établir une nouvelle expression du pourcentage de graisse de telle manière que la relation entre la masse grasse et ce pourcentage soit la plus élevée possible. Validation de cette nouvelle expression avec 4 populations distinctes

Etude exploratoire des capacités phonologiques chez les enfants présentant un déficit de langage

Research on the language of autiste and dysphasia subjects remained essentially descriptive, resting (basing) most of the time on descriptions of deficit of speech and not of language. The comment of this study is to know more exactly presence or not of a disturbance of the phonological system at these children. Paradigm of the category-specific identification on an opposition of place of articulation was tested with these children, compared with children witnesses. Results seem to show that the difficulty of identification of the children is less in intra-category-specific identification than in inter-category-specific.Les recherches sur le langage des sujets autistes et dysphasiques sont restées essentiellement descriptives, reposant la plupart du temps sur des descriptions de deficit de langage et non de bilan de langue. Le propos de cette étude est de connaître plus précisément la présence ou non d'une perturbation du système phonologique chez ces enfants-là. Le paradigme de l'identification catégorielle sur une opposition de lieu d'articulation fut testé auprès de ces enfants, comparés à des enfants témoins. Les résultats semblent montrer que la difficulté d'identification des enfants est moins en identification intra-catégorielle qu'en inter-catégorielle

Consequences of change in waist circumference on cardio-metabolic risk-factors over 9-years. The D.E.S.I.R. Study: Cardio-metabolic effects of 9-year waist change

Obesity and abdominal adiposity have been shown to be risk factors for cardiovascular disease and particularly for diabetes in prospective studies (1-8). In cross sectional studies both are related with risk factors for these diseases (9-12), but there are few publications on the effects of changes in abdominal adiposity (13). We characterise men and women who gained and lost abdominal adiposity over nine years and describe the incidence and the improvement in cardio-metabolic risk factors according to changes in waist circumferenc

Perception catégorielle dans une tâche de discrimination de phonèmes et apprentissage de la lecture

Marc Delahaie, Liliane Sprenger-Charolles, Willy Serniclaes, Catherine Billard, Jean Tichet, Sandrine Pointeau, Sylviane Vol. "Categorical perception and learning to read. Phonological awareness, and particularly phonemic awareness are predictive reading factors which have been intensively studied. On the contrary, very few studies have been made concerning the incidence of categorical perception on learning to read. Now, in an alphabetical system, written word recognition by the phonological route involves the abilities to isolate and to discriminate phonems. In the present study, perceptual discrimination of speech sounds, pseudo-words recognition by the phonological route abilities, and also parental socio-cultural level of 227 kindergartners have been investigated in a longitudinal study over two years. Results show that before learning to read, very few children are "categorical”, and on the other hand that learning to read as well as the parental socio-cultural level might constitute some predictive categorical perception factors.Les capacités métaphonologiques, et particulièrement les capacités métaphonémiques, sont des prédicteurs de l’apprentissage de la lecture qui ont été très intensivement étudiés. Très peu d’études ont par contre porté sur l’incidence des capacités précoces de catégorisation phonémique sur cet apprentissage. Or, dans une écriture alphabétique, la mise en place de la procédure phonologique de lecture nécessite de pouvoir d’une part isoler et d’autre part discriminer les phonèmes. Dans la présente étude, on a examiné l’évolution sur deux années des capacités de perception catégorielle d’un groupe de 227 enfants initialement scolarisés en Grande Section de Maternelle, en contrôlant leurs habiletés d’identification de logatomes écrits et leurs caractéristiques socio-démographiques. Les résultats indiquent que les habiletés de perception catégorielle ne sont que partiellement développées chez l’enfant pré-lecteur, et d’autre part que l’apprentissage de la lecture, mais également la qualité de la médiation linguistique orale intra-familiale, pourraient constituer des facteurs de leur émergence.Delahaie Marc, Sprenger-Charolles Liliane, Serniclaes Willy, Billard Catherine, Tichet Jean, Pointeau Sandrine, Vol Sylviane. Perception catégorielle dans une tâche de discrimination de phonèmes et apprentissage de la lecture. In: Revue française de pédagogie, volume 147, 2004. pp. 91-105

: GGT and development of metabolic syndrome

International audienceOBJECTIVE: Among hepatic enzymes, gamma-glutamyltransferase (GGT) is the main predictor of type 2 diabetes incidence, although it has not been shown that GGT predicts pre-diabetes states. Our aim was to study the association of GGT with the development of the metabolic syndrome (MetS). RESEARCH DESIGN AND METHODS: We analyzed the 3-year data from the Data from Epidemiological Study on the Insulin Resistance Syndrome prospective cohort of 1,656 men and 1,889 women without MetS at baseline, according to the International Diabetes Federation definition. RESULTS: Over 3 years, 309 participants developed the MetS. After adjustment for age, alcohol intake, physical activity, smoking habits, and alanine aminotransferase (ALT), the odds ratios for incident MetS increased across baseline GGT quartiles (1, 1.96, 2.25, and 3.81 in men, P < 0.03; and 1, 1.23, 1.80, and 1.58 in women, P < 0.05). After additional adjustment for insulin resistance markers (fasting insulin or homeostasis model assessment of insulin resistance index), the association was attenuated and the linear relation no longer significant in both sexes (P = 0.08, P = 0.16). However, men in the highest in comparison to the lowest quartile of GGT retained a significant risk for incident MetS. In women, there was no longer a significant risk. GGT was significantly associated with the 3-year incidence of individual components of the MetS. The incidence of the MetS also increased with ALT, but after adjustment on GGT this association remained significant only in women. CONCLUSIONS: GGT, a predictor of type 2 diabetes, was associated with a risk of incident MetS. This association was mainly related with insulin resistance but was independent of other confounding factors

Hemoglobin A1c and Fasting Plasma Glucose Levels as Predictors of Retinopathy at 10 Years: The French DESIR Study.: Baseline HbA1c,fasting glucose and 10-year retinopathy

International audienceOBJECTIVE: To evaluate the predictive values of hemoglobin A(1c) (HbA(1c)) and fasting plasma glucose (FPG) for retinopathy 10 years after the baseline examination. METHODS: Seven hundred men and women from the DESIR (Data From an Epidemiological Study on the Insulin Resistance Syndrome) Study underwent evaluation for retinopathy using a nonmydriatic digital camera. During the preceding 9 years, 235 had diabetes mellitus (treated or FPG level of ≥126 mg/dL at least once), 227 had an impaired FPG level (110-125 mg/dL) at least once, and 238 always had glucose levels within reference limits (<110 mg/dL). RESULTS: Compared with those without retinopathy, the 44 participants with retinopathy at 10 years had higher baseline mean (SD) levels of FPG (130 [49] vs 106 [22] mg/dL) and HbA(1c) (6.4% [1.6%] vs 5.7% [0.7%]) (both, P < .001). The frequency of retinopathy at 10 years, standardized according to the distribution of glycemia across the entire DESIR population, was 3.6%. In our population, FPG levels of 108 and 116 mg/dL had positive predictive values of 8.4% and 14.0%, respectively, for retinopathy at 10 years; HbA(1c) levels of 6.0% and 6.5% had positive predictive values of 6.0% and 14.8%, respectively. After 10 years of follow-up, retinopathy was equally frequent in participants with impaired FPG levels and in those who became diabetic during the study (8.6% and 6.7%, respectively), lower than in those with diabetes at baseline (13.9%). CONCLUSION: Because the positive predictive values for retinopathy increase sharply from 108 mg/dL for FPG and from 6.0% for HbA(1c) levels, these thresholds are proposed to identify those at risk of retinopathy 10 years later

Calcium consumption and insulin resistance syndrome parameters. Data from the Epidemiological Study on the Insulin Resistance Syndrome (DESIR).: Calcium consumption and insulin resistance syndrome parameters

BACKGROUND AND AIM: A number of studies have investigated the role of dietary calcium in lipid metabolism and weight regulation, and the influence of dairy products on the incidence of insulin resistance syndrome. In this study we have examined the relationship between dietary calcium and the established parameters of the insulin resistance syndrome. METHODS AND RESULTS: The study population (n=4372) was taken from the DESIR (Data from the Epidemiological Study on the Insulin Resistance Syndrome) cohort. Data for parameters relating to the syndrome were recorded, including glucose, serum insulin, triglycerides, HDL-cholesterol, waist circumference and blood pressure. Total energy, calcium and alcohol intake were estimated using a food-frequency questionnaire. Relationships between dietary calcium density and the above parameters were analyzed by multiple linear regression models, adjusted for age, smoking, alcohol consumption and physical activity. From one quartile of calcium density to the next, mean systolic and diastolic blood pressures and insulin concentrations decreased in women by 0.9mmHg, 0.5mmHg and 2.4%, respectively, and HDL-cholesterol increased by 0.007mmol/l (all p<0.05) after adjustment for age, smoking, alcohol intake and physical activity. In men, there was an increase of 0.2kg/m(2) in the body mass index(BMI) and a decrease of 0.4mmHg in diastolic blood pressure (both p<0.05). CONCLUSIONS: These results confirm a beneficial association between dietary calcium and arterial blood pressure, insulin and HDL-cholesterol levels in women, whereas in men there was only a beneficial association with diastolic blood pressure

Effects of genetic susceptibility for type 2 diabetes on the evolution of glucose homeostasis traits before and after diabetes diagnosis: data from the D.E.S.I.R. Study.

International audienceOBJECTIVE: To assess the impact of genetic susceptibility on evolution toward type 2 diabetes (T2D) by analyzing time trajectories of fasting glucose, glycated hemoglobin (HbA(1c)), insulin sensitivity (homeostasis model assessment [HOMA2%S]), and β-cell secretion (HOMA2%B) in a large nondiabetic cohort. We also examined whether baseline HbA(1c) modified the effect of genetic predisposition on the time trajectories. RESEARCH DESIGN AND METHODS: Time trajectories were drawn in 4,744 participants from the French Data from an Epidemiological Study on the Insulin Resistance Syndrome (D.E.S.I.R.) cohort based on samples collected every 3 years over a 9-year follow-up. Trajectories were analyzed according to the TCF7L2 common variant, a family history of T2D, and a combination of at-risk alleles from nine T2D-associated genes. RESULTS: There was a marked decrease in HOMA2%B in parallel to a steep increase in HbA(1c) over the 3 years before incident diabetes, which was not influenced by genetic predisposition when considered alone. However, after the onset of T2D, the TCF7L2 at-risk variant was associated with a greater decrease in HOMA2%B. There was a joint effect of a family history of T2D with the presence of the TCF7L2 risk allele with a greater rise in HbA(1c) conferred by the coexistence of a family history and the T risk allele. An HbA(1c) ≥5.7% at baseline was associated with a greater increase in both glycemia and HbA(1c) levels in the presence of a combination of diabetes at-risk alleles. CONCLUSIONS: After incident T2D, TCF7L2 at-risk variants were associated with a faster decrease in β-cell function compared with those with the CC genotype. There was a joint effect of family history of T2D and TCF7L2 risk variant on the rise in glycemia and the decrease in insulin secretion at the end of follow-up, suggesting the joint influence of the combination of diabetes genetic predisposition with familial factors on the evolution of glycemia over time

Comparing incident diabetes as defined by fasting plasma glucose or by HbA(1c). The AusDiab, Inter99 and DESIR studies.: HbA1c, FPG and prediction of diabetes

International audienceAIM: We examined the ability of fasting plasma glucose and HbA(1c) to predict 5-year incident diabetes for an Australian cohort and a Danish cohort and 6-year incident diabetes for a French cohort, as defined by the corresponding criteria. METHODS: We studied 6025 men and women from AusDiab (Australian), 4703 from Inter99 (Danish) and 3784 from DESIR (French), not treated for diabetes and with fasting plasma glucose < 7.0 mmol/l and HbA(1c) < 48 mmol/mol (6.5%) at inclusion. Diabetes was defined as fasting plasma glucose ≥ 7.0 mmol/l and/or treatment for diabetes or as HbA(1c) ≥ 48 mmol/mol (6.5%) and/or treatment for diabetes. RESULTS: For AusDiab, incident fasting plasma glucose-defined diabetes was more frequent than HbA(1c) -defined diabetes (P(McNemar)<0.0001), the reverse applied to Inter99 (P(McNemar) < 0.007) and for DESIR there was no difference (P(McNema)=0.17). Less than one third of the incident cases were detected by both criteria. Logistic regression models showed that baseline fasting plasma glucose and baseline HbA(1c) predicted incident diabetes defined by the corresponding criteria. The standardized odds ratios (95% confidence interval) for HbA(1c) were a little higher than for fasting plasma glucose, but not significantly so. They were respectively, 5.0 (4.1-6.1) and 4.1 (3.5-4.9) for AusDiab, 5.0 (3.6-6.8) and 4.8 (3.6-6.3) for Inter99, 4.8 (3.6-6.5) and 4.6 (3.6-5.9) for DESIR. CONCLUSIONS: Fasting plasma glucose and HbA(1c) are good predictors of incident diabetes defined by the corresponding criteria. Despite Diabetes Control and Complications Trial-alignment of the three HbA(1c) assays, there was a large difference in the HbA(1c) distributions between these studies, conducted some 10 years ago. Thus, it is difficult to compare absolute values of diabetes prevalence and incidence based on HbA(1c) measurements from that time