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Biomedical subjects

A Kettaneh

Publications and source records attributed to A Kettaneh.

At least 19 recordsLinked to original sources

High plasma leptin predicts an increase in subcutaneous adiposity in children and adults.

OBJECTIVE: To investigate the hypothesis that plasma leptin may predict adiposity changes. DESIGN: A population-based cohort study. SETTING: Fleurbaix and Laventie, in the north of France. SUBJECTS: In all, 1175 subjects participated, of whom 946 completed measurements at baseline (1999) and follow-up (2001). After excluding 64 subjects obese at baseline, 882 subjects (478 adults, 404 children 8 years and over) were included in the analysis. INTERVENTIONS: We measured plasma leptin concentrations at baseline and various adiposity parameters at baseline and follow-up. Partial correlation coefficients (r(p)) between baseline plasma leptin and each adiposity indicator at follow-up were calculated with adjustment for baseline age, pubertal stage, adiposity and familial correlations between siblings. RESULTS: Changes in body mass index and percentage body fat were not related to baseline plasma leptin. High baseline plasma leptin predicted an increase (r(p) (P-value)) in the sum of the four skinfolds (0.18 (<0.0001)), the waist circumference (0.16 (0.0003)) and the waist-to-hip ratio (0.29 (<0.0001)) in adults only, and in the hip circumference in adults (0.20 (<0.0001)) and children (0.22 (<0.0001)). After adjustment for a set of four adiposity variables at baseline (percentage body fat, skinfolds, waist and hip circumferences), baseline plasma leptin predicted only changes in the sum of the four skinfolds in adults (0.15 (0.001)), with similar tendency although not significant in children (0.08 (0.13)). CONCLUSIONS: A high leptin relative to baseline fat mass predicts fat mass gain over time, mainly in the subcutaneous location.

Adult↗

Growth curves of anthropometric indices in a general population of French children and comparison with reference data.

BACKGROUND: The description of growth patterns of the different anthropometric measurements mainly used in epidemiological studies is useful to better understand the development of obesity in children and its consequences. OBJECTIVE: Our aim was to establish growth curves of anthropometric indices in a general population of French children born during the 1980s and to compare them with the French reference curves based on children born in the 1950s. DESIGN: As part of the Fleurbaix Laventie Ville Santé Studies I and II (FLVS), 441 girls and 467 boys were examined at least twice between 1993 and 2001. Height, weight and four skinfold thicknesses were measured. Body mass index (BMI), sum of peripheral and truncal skinfolds and truncal-to-peripheral ratio were calculated. Mean growth curves from ages 5 to 17 years were assessed for these indices, calculating means and 95% confidence interval per 1 year age group and by gender. RESULTS: Trajectories with age differed importantly according to the index considered; BMI was the one with the smallest difference between genders and the most linear shape with age. From the age of 5 years and after, the FLVS children were on average taller and had a higher subcutaneous adiposity than children born 30 years earlier. Truncal-to-peripheral ratio was higher in our population; this difference became more marked with puberty in girls. DISCUSSION: This study suggests the existence of a secular trend towards a precocious accelerated growth, and a more truncal adiposity distribution, especially in girls. It is a disquieting trend considering its expected consequences on adult health.

Adiposity↗

Severe strongyloidiasis in corticosteroid-treated patients.

Severe strongyloidiasis, caused by Strongyloides stercoralis, is a preventable life-threatening disease that can occur in any corticosteroid-treated patient who has travelled to a country with infested soil, even if the contact occurred up to 30 years previously. This diagnosis should be considered in corticosteroid-treated patients who experience either unusual gastrointestinal or pulmonary symptoms, or who suffer from unexplained sepsis caused by Gram-negative bacilli. Peripheral eosinophilia is not observed systematically and, even if present, is moderate in most cases. Ivermectine is the best prophylactic and therapeutic option, and thiabendazole should no longer be used. However, guidelines for the prevention and management of S. stercoralis infection in such patients have not yet been established.

Adrenal Cortex Hormones↗

Human leukocyte antigens and susceptibility to tuberculosis: a meta-analysis of case-control studies.

OBJECTIVE: To evaluate the association between human leukocyte antigens (HLA) of the major histocompatibility complex (MHC) and thoracic tuberculosis (TB) in immunocompetent adults. DESIGN: We searched Medline, Pascal, Pascal Biomed and Francis databases (all years) with the terms 'tuberculosis' and 'HLA'. Case-control studies were included that reported frequencies for the full range of antigens analysed by serological methods in healthy controls and adult patients not treated with glucocorticoids or immunosuppressive drugs, human immunodeficiency virus status negative or not reported, no debilitating chronic disease, and with a diagnosis of thoracic TB based on microbiological or histological criteria. Two authors independently abstracted the data and resolved disagreements by consensus. RESULTS: We summarised 60 HLA antigens reported in at least four of 22 studies totalling 1988 patients and 2897 controls. A lower risk of thoracic TB was found in carriers of B13 (OR 0.64, 95% CI 0.50-0.81, P < 0.0001), DR3 (OR 0.72, 95% CI 0.59-0.89, P = 0.002), and DR7 antigens (OR 0.65, 95% CI 0.53-0.80, P < 0.0001). Carriers of DR8 were at higher risk for thoracic TB (OR 1.72, 95% CI 1.21-2.46, P = 0.003). For these antigens, we found no significant heterogeneity between samples or evidence of publication bias. The risk of thoracic TB tended to be higher in carriers of DR2 (OR 1.67, 95% CI 1.16-2.41, P = 0.006), but the results were not consistent between studies (P value for heterogeneity < 0.0001). CONCLUSION: Susceptibility to TB is modulated by class I and II HLA antigens. However, these results based on the serological determination of antigens require confirmation by DNA-based methods to precisely identify those alleles involved.

Case-Control Studies↗

[Preeclampsia and antiphospholipid syndrome. Uterine artery Doppler evaluation].

INTRODUCTION: Women with persistently high resistance in uterine arteries have an increased risk of the subsequent development of preeclampsia. Doppler investigation provides a non-invasive method for the study of the uteroplacental blood flow. In pregnant women the antiphospholipid syndrome is associated to an increased risk of preeclampsia and complications related to uteroplacental insufficiency, and the role of uterine artery Doppler is discussed. CURRENT KNOWLEDGE AND KEY POINTS: In normal pregnancy, impedance to flow in the uterine arteries decreases with gestation, as the likely consequence of the physiologic change of spiral arteries into low-resistance vessels. In women with preeclampsia or related complications, the abnormal persistence of high resistance to flow in the uterine arteries correlates with maternal and neonatal outcome. In one study including patients with antiphospholipid syndrome, a high resistance index in the uterine arteries at 22-24 weeks gestation strongly predicted the subsequent development of preeclampsia. In another study including patients with lupus anticoagulant, persistent bilateral notches at 22-24 weeks gestation may identify preeclampsia and fetal growth restriction with a high sensitivity, specificity, positive and negative predictive value. The treatment may improve the uteroplacental blood flow and is a possible confounding factor which needs further evaluation. FUTURE PROSPECTS AND PROJECTS; In patients with antiphospholipid antibodies a higher impedance has been observed in the uterine artery, suggesting a possible vascular dysfunction precluding to impaired trophoblastic invasion and placental thrombosis, as probable mechanisms in the complications. If confirmed, these findings might have important implications for the management of these patients.

Adult↗

Reliability of bioimpedance analysis compared with other adiposity measurements in children: the FLVS II Study.

OBJECTIVE: To evaluate the reproducibility of the measurement of% body fat by bipedal biometrical impedance analysis (BIA) compared with anthropometric measurements of adiposity in children and the correlations between these methods in children and adults. METHODS: A cross-sectional study in a total of 1080 adults and children enrolled in 1999 in the Fleurbaix-Laventie Ville Santé II (FLVS II) population-based study in northern France. The reproducibility of anthropometrical and BIA methods was determined by a nested analysis of variance of repeated measurements by 2 investigators and a bipedal BIA device (Tanita TBF 310) in 64 pupils of two 5th grade classes. The correlation of BIA and anthropometric adiposity measurements with the unknown relative fat mass or volume of the body estimated by a latent adiposity variable (LAV) was established by the triads' method in 1080 subjects of the FLVS II cohort. RESULTS: The reproducibility was similar for the sum of skinfolds, waist circumference and BIA% fat measurements (intraclass correlation coefficients: 0.979-0.992). Correlation coefficient between BIA body fat% and the LAV was higher than 0.86 in all sex and Tanner stage related groups, and similar in children and adults, except in pubertal boys (0.76). CONCLUSION: With a high level of reproducibility, foot-to-foot BIA analysis provides a valuable measurement of total% fat for epidemiologic studies in children. However further studies are needed before extrapolating these results to overweight children.

Adipose Tissue↗

Anthropometric relationships between parents and children throughout childhood: the Fleurbaix-Laventie Ville Santé Study.

BACKGROUND: The study of parent-child anthropometric relationships and their evolution over time may help to better understand familial risk factors for childhood obesity. METHODS: In a population-based cohort of 124 nuclear families (Fleurbaix-Laventie Ville Santé Study (FLVS) I and II), various anthropometric parameters were measured in both parents and their children, first when the children were prepubescent and again at the end of puberty. Troncular adiposity repartition was estimated by calculating troncular to peripheral skinfolds ratio and waist-to-hip circumferences ratio. Birth and infancy heights and weights were also obtained from the children's health booklets. Parent-child correlations were estimated in infancy, before and at the end of the child's puberty. A prospective analysis was performed to predict the changes in the children's measurements over puberty according to their parents' corresponding baseline values. RESULTS: BMI and weight correlations at birth were high (>0.30) with the mother and low (<0.10) with the father, then they converged to an intermediate level at 2 y and remained between 0.2 and 0.3 thereafter. Correlations for waist circumference were already present at the prepubertal period and persisted on the same level at the postpubertal period, whereas correlations for subcutaneous adiposity - measured by four skinfolds - and for adiposity distribution - measured by ratios - were higher at the postpubertal period. Moreover, the prospective approach showed that mother's BMI predicted the evolution of her children's BMI over puberty, whereas this relationship was observed more specifically with the father concerning adiposity distribution parameters. CONCLUSION: Maternal adiposity may act early in life on the adiposity of the child. Maternal and paternal adiposities seem to have quite distinct effects at two key periods of the child's adiposity development such as the prenatal and pubertal periods.

Adiposity↗

Changes in physical activity explain paradoxical relationship between baseline physical activity and adiposity changes in adolescent girls: the FLVS II study.

OBJECTIVE: To investigate in adolescents relationships between habitual physical activity (PA) and changes in several indicators of adiposity. DESIGN: Longitudinal population-based study. The Fleurbaix-Laventie Ville Sante II (FLVS II) study in Northern France. SUBJECTS: A total of 222 boys and 214 girls aged 8-18 y, not obese at inclusion. MEASUREMENTS: PA (Modifiable Activity Questionnaire) and adiposity (body mass index (kg/m2), percent body fat by bioimpedance analysis, sum of four skinfolds, waist circumference) were assessed in 1999 and 2001. Adiposity indicators adjusted for age and pubertal stage were compared between groups of baseline PA and between groups of PA changes, separately by sex. RESULTS: At baseline, PA was not associated with adiposity indicators in both sexes. In girls only, being in the group with the highest age-relative level of moderate PA at baseline predicted the highest adiposity gain from baseline to follow-up, for all indicators. After adjustment for baseline values, all adiposity indicators were higher at follow-up in girls who had decreased their relative level of moderate PA during follow-up. In boys, changes in adiposity during follow-up were not significantly different across groups of PA changes. However, the sum of skinfolds at follow-up, adjusted for baseline value, tended to be higher in those who decreased their vigorous PA level and lower in those who increased it. CONCLUSION: In adolescent girls, a decrease in PA rather than inactivity per se may result in increased adiposity over time.

Adipose Tissue↗

[Micronutrients status of Ile-de-France inhabitants. A literature review].

PURPOSE: A review of the literature about micronutrients status of Ile-de-France inhabitants. CURRENT KNOWLEDGE AND KEY POINTS: During the last decades, substantial changes in the French diet had an impact on micronutrients intake. Over this time, several studies conducted in Ile-de-France showed that a large part of its inhabitants is subject to an increased risk of mild to severe deficiency in one or more micronutrient(s). Teenagers and subjects over 70 years-old are groups at risk for vitamin D deficiency. During the 1980s, iron intake was insufficient in a majority of menstruating women and iron deficiency was common during pregnancy. Vitamin C deficiency is constantly present in homeless people and often associated with an insufficient intake in a number of micronutrients. FUTURE PROSPECTS AND PROJECTS: Identification of the groups at risk favours a better adequacy of preventive action on micronutrient deficiencies in this population. However, the efficacy of prevention is to be determined. Controlled trials of micronutrients' supplementation may be useful to value the beneficial effects of micronutrient supplementation on the incidence of cardiovascular diseases and cancer.

Adolescent↗

Relationships between physical activity and plasma leptin levels in healthy children: the Fleurbaix-Laventie Ville Santé II Study.

OBJECTIVE: To study the relationships between physical activity and plasma leptin levels in children from a population-based study, taking into account puberty stages. DESIGN: Subjects were part of the Fleurbaix-Laventie Ville Santé (FLVS) II Study, a longitudinal study on the determinants of weight gain in children and their parents. At baseline examination, 253 girls and 257 boys aged 8-18 y were examined. MEASUREMENTS: : Height and weight were measured, adiposity was assessed by the sum of four skinfold thicknesses (SSK). Pubertal stage was assigned according to Tanner. Leisure-time physical activity (LTPA) was assessed by the Modifiable Activity Questionnaire and ambulatory activity by pedometer recording over a week. A fasting blood sample was obtained to determine plasma leptin and insulin levels. RESULTS: Plasma leptin was higher in girls compared to boys (8.3 (1.6-36.5) ng/ml vs 2.2 (0.1-15.3) ng/ml, P<0.001). Multivariate analyses were performed with leptin as dependent variable, and number of steps by day, Tanner stage, insulin and SSK as independent variables. In girls, leptin was negatively correlated to number of steps/day (P<0.001) and positively to SSK (P<0.001) and insulinemia (P<0.001). In boys, leptin was correlated to insulinemia (P<0.001), SSK (P<0.001), Tanner stage (P<.0001), but not to physical activity. CONCLUSION: Physical activity is negatively related to leptin levels in girls only and this association is independent of fasting plasma insulin. In children, fasting insulinemia remains associated with leptin levels after taking into account adiposity, physical activity and Tanner stage.

Adolescent↗