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Biomedical subjects

M Marre

Publications and source records attributed to M Marre.

152 records · Page 9Linked to original sources
PubMedDate not supplied

[Larger waist circumference is a predictive factor for the occurrence of microalbuminuria in a non-diabetic population].

Obesity and insulin resistance are directly associated with the presence of microalbuminuria. However, the prospective relationship between abdominal adiposity and the occurrence of micro-albuminuria has been little studied in a non-diabetic population. From the DESIR cohort, we examined whether waist circumference was associated with the incidence of micro-albuminuria at 6 years (D6). The study evaluated 2738 non-diabetic subjects without micro-albuminuria at inclusion who were then followed prospectively. At 6 years, 254 individuals (9.3%) had developed pathological micro-albuminuria (> or =20 mg/l) measured at micturation. In both sexes, the incidence of micro-albuminuria was associated with increased waist circumference and blood pressure, but not with blood glucose levels, lipid parameters or body mass index. Subjects with a higher waist circumference at inclusion were at a higher risk of having micro-albuminuria at 6 years compared to those with a normal waist circumference. Logical regression analysis showed that waist circumference as a continuous value, or greater than 94 cm for males and 88 cm for females, were predictive factors for the incidence of micro-albuminuria, after adjustment for age, hypertension, ACE inhibitor usage, fibrinogen, and blood glucose level. Abdominal adiposity is thus linked in both sexes to the development of microalbuminuria, which underlines the importance of measuring waist circumference when assessing risk factors for renal lesions in non-diabetic hypertensives.

Adiposity↗
PubMedDate not supplied

Vascular and insulinotropic effects of YC 170, a calcium agonist, on isolated perfused rat pancreas.

To explore simultaneously the effects on insulin secretion and on vascular tone of YC 170, a new dihydropyridine derivative calcium agonist, isolated perfused rat pancreases were studied for insulin output and for duodenopancreatic resistances before, during and after exposure to YC 170 10(-4) M (n = 15) or its solvent (n = 10). Although insulin was stimulated transiently during the five first minutes following addition of YC 170 (p less than 0.01) the integrated insulin output measured during the whole experiments was not different with YC 170 from that observed with solvent. Conversely, the initial duodenopancreatic resistances (22 +/- 4 mmHg.ml-1.min-1) rose progressively with YC 170 up to maximal values at the end of experiments (104 +/- 28 mmHg.ml-1.min-1; p less than 0.01); no significant variation occurred with solvent. Vascular and insulinotropic effects of YC 170 can be dissociated, suggesting variable abilities to promote calcium transport across membranes of smooth muscle cells and of pancreatic B-cells.

Animals↗
PubMedDate not supplied

Dissociated effects of nicardipine on vascular tone and insulin secretion.

Because Ca2+ antagonists may alter glucose homeostasis by blocking calcium entry into pancreatic beta-cells, this risk was evaluated for nicardipine, a new dihydropyridine derivative with vasodilatory effects. It was tested in vitro for its vascular and insulinotropic effects on isolated perfused rat pancreases. In vivo, an oral glucose tolerance test (OGTT) was conducted, and blood pressure was recorded in eight hypertensive patients with glucose intolerance who were given 90 mg/day nicardipine for 2 weeks in a single-blind placebo-controlled study. In vitro, insulin output was inhibited by 10(-4) M nicardipine but not by 10(-8) M and 10(-6) M, whereas significant changes in intrapancreatic perfusate flow indicated that vascular resistance was similarly reduced by all three concentrations. In vivo, blood pressure diminished significantly after nicardipine, but neither glucose tolerance nor insulin release was further impaired during OGTT. From these in vitro data and this short-term clinical follow-up, it is suggested that nicardipine reduces vascular tone at doses lower than those required to inhibit insulin secretion.

Adult↗
PubMedDate not supplied

[Value of combined subcutaneous infusion of insulin and metformin in 10 insulin-dependent obese diabetics].

Combined continuous subcutaneous insulin infusion (CSII) and metformin (M) was tested in 10 overweighted insulin requiring diabetic patients (body mass index 27.9 +/- 4.9 kg/m2). They were still poorly controlled (HbA1 9.6 +/- 0.8%) despite large doses of lente insulin (Novo) (51.7 +/- 19.6 IU/24 h) injected once daily. With CSII after two weeks on placebo (P) they were enrolled in a randomized double blind cross-over trial with two successive one month periods of M (2550 mg/day) or P. At the end of the two-weeks period CSII--initial P, the daily regular insulin requirement decreased significantly (40.1 +/- 18.1). During M and P body weight and HbA1 were unchanged (respectively 28.6 +/- 6.0 vs 29.0 +/- 59 kg/m2 and 7.7 +/- 1.1 vs 7.7 +/- 0.8%). With M daily insulin requirements decreased significantly (32.0 +/- 16.8 vs 38.4 +/- 18.2 IU, p less than 0.05). During test-meals, M compared to placebo also reduced peripheral free insulin concentrations (-24.9 +/- 26.0%) while plasma glucose and C peptide remained comparable. In the conditions of this study, combined CSII and M reduced the insulin resistance observed in overweighted insulin requiring diabetic patients.

Adult↗
PubMedDate not supplied

[New antihypertensive therapy in diabetics].

According to the W.H.O. criteria (160/95 mmHg), arterial hypertension is present in about one third of diabetic patients. But the W.H.O. criteria are not appropriate in insulin-dependent diabetics. There is increasing evidence that a slight increase of blood pressure values may have a deleterious effect on various localizations of diabetic angiopathy. Arterial blood pressure is a major predictive factor for stroke or death due to coronary heart disease. The incidence and prevalence of diabetic retinopathy are significantly correlated with systolic and/or diastolic blood pressure values. In patients with incipient diabetic nephropathy, a slight elevation of blood pressure values is usually observed, an antihypertensive treatment may reduce albumin excretion rate and may prevent clinical diabetic nephropathy. Antihypertensive treatment is the more effective and the best tolerated of all interventions dedicated to reduce albumin excretion. Calcium antagonists and angiotensin converting enzyme inhibitors are at the present time the drugs to be used in the treatment of hypertensive diabetic patients as they are more effective and better tolerated than the usual antihypertensive agents. A part from their antihypertensive effect, they also improve cardiac, cerebral and intra-renal haemodynamics.

Angiotensin-Converting Enzyme Inhibitors↗
PubMedDate not supplied

[Vascular wall and diabetes mellitus: what complications and why?].

The absolute risk of cardiovascular events is three times higher in diabetics than in non-diabetics. This risk can be due either to specific microvascular complications, or to macrovascular complications, which are non-specific but more frequent, earlier, and of poorer prognosis in diabetics than in non-diabetics. The link between hyperglycaemia and microvascular diseases has been well established in insulin-dependent diabetes. Conversely, no specific treatment strategy has been established to decrease cardiovascular risk in non-insulin-dependent diabetes, especially taking into consideration the level of hyperglycaemia.

Diabetes Mellitus, Type 1↗