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Biomedical subjects

R Gueguen

Publications and source records attributed to R Gueguen.

At least 19 recordsLinked to original sources

Determinants of arterial stiffness in an apparently healthy population over 60 years.

Arterial stiffness assessed by the pulse wave velocity (PWV), a non-invasive and reproducible method, predicts cardiovascular morbidity and mortality. The main determinants of arterial stiffness are well established in younger and middle-aged populations, but much less in the elderly. The aim of this study was to describe the determinants of arterial stiffness in elderly apparently healthy subjects. The study included 221 voluntary subjects born before 1944 (mean age 67.4+/-5.0 years), who had a standard health check-up at the 'Centre de Médecine Préventive' of Nancy. Arterial stiffness was evaluated by measuring the carotid-femoral PWV with the PulsePen automatic device. Clinical and biological parameters were evaluated at the same day. Measurements were valid and analysed in 207 subjects (94 women). Mean PWV was 9.39+/-2.64 m/s. Men showed higher PWV values than women (9.99+/-2.56 vs 8.66+/-2.56, P<0.001). In univariate analysis, PWV was correlated with age (r=0.26, P<0.001) and mean arterial pressure (MAP) (r=0.40, P<0.001), and these relationships were similar in men and women. Subjects with hypertension (P<0.001), diabetes mellitus (P<0.001) and obesity (P<0.01) had higher values of PWV. In multiple regression analysis, PWV correlated positively and independently with age, male gender, MAP and diabetes mellitus. In conclusion, in an apparently healthy elderly population, the main determinants of arterial stiffness are the age, MAP, diabetes and gender. Our study also shows that the gender-related differences in arterial stiffness observed in middle-aged subjects are maintained in the elderly.

Age Factors↗

[Blood pressure control by antihypertensive agents in people older than 60].

PURPOSE: The prevalence or hypertension increases with aging, reaching more than 50% in people aged 60 years and older. The increase of systolic blood pressure is a major risk of cardiovascular event. METHODS: With the aim of assessing risk factors in old people "in apparent good health", we analysed blood pressure and treatments in people aged 60 years and older who had a periodic check-up that was adapted to older people. RESULTS: This check-up concerned, between April and December 2003, 1638 people with a mean age of 68 years (SD 5.7): 815 men and 823 women. Fourty percent had a systolic blood pressure (SBP) >or=140 mmHg (44% of men, 36% of women); 6% (8% of men, 4% of women) had a diastolic blood pressure (DBP) >or=90 mmHg. A treatment for hypertension was followed by 473 people: 31% of men and 26% of women. Fifty percent were controlled for the SBP and the DBP. Fourty-two percent were not controlled for the SBP, but were controlled for the DBP. Seven percent were not controlled for the SBP nor the DBP. Only 3 subjects (<1%) were not controlled for the DBP, whereas they were controlled for SBP. CONCLUSION: These results, combined with data of literature on the predominant role of SBP in cardio-vascular risk, as compared with DBP, underline the need for a better treatment of systolic hypertension in older people.

Age Factors↗

Determination of serum cystatin C: biological variation and reference values.

Human cystatin C is a low molecular weight protein which has been proposed as a better marker of glomerular filtration rate than creatinine. To be able to interpret results obtained in different patient populations it is necessary to define cystatin C reference values. We measured serum concentration of cystatin C in 1223 subjects using a particle-enhanced nephelometric assay. Subjects were aged 4 to 79 years and were selected among apparently healthy individuals who came to the Centre for Preventive Medicine in Vandoeuvre-Lès-Nancy, France. We observed a Gaussian distribution of cystatin C concentration in serum. We did not find any effect of age or gender in children, hormonal status in women (puberty, menopause, oral contraceptives or hormone replacement therapy) or alcohol intake. Cystatin C concentration was slightly lower in female than in male adults below the age of 60 years. Cystatin C levels significantly increased above the age of 60 in both males and females, probably due to physiological aging of renal function. No other significant differences were observed between males and females. Using multiple regression analysis, moderate correlations were observed between body mass index and cystatin C, and between smoking and cystatin C, but these were not biologically significant. According to the literature, only methylprednisolone and cyclosporin A increased and decreased cystatin C levels, respectively. The reference values for cystatin C obtained in a carefully selected population were 0.75+/-0.089 mg/l for children aged 4-19 years, 0.74+/-0.100 mg/l for males and 0.65+/-0.085 mg/l for females (aged 20-59 years), and 0.83+/-0.103 mg/l for older individuals (> or =60 years).

Adolescent↗

Genetic influences on lipid metabolism trait variability within the Stanislas Cohort.

The contribution of 17 polymorphisms within 13 candidate genes on lipid trait variability was investigated by a multiplex assay in 772 men and 780 women coming for a health checkup examination. The studied genes were APOE, APOB, APOC3, CETP, LPL, PON, MTHFR, FGB, GpIIIa, SELE, ACE, and AGT. We found that APOB-Thr71Ile, APOE-(112/158), APOC3-1100C/T, and SELE-98G/T polymorphisms had a significant effect on lipid traits (P < or = 0.001 to P < or = 0.01). Genetic effects accounted for 3.5-5.7% of variation in apolipoprotein B (apoB)-related traits among men, and for 5.7-9.0% among women. The contribution of APOE polymorphism on apoB-related traits variability was two to three times more important in women than in men. We found suggestive evidence for interactive effects between genetics and age, smoking status, and oral contraceptives. Increase of LDL-cholesterol and apoB concentrations with age was stronger among the epsilon4 carriers in women, and apolipoprotein A-I (apoA-I) concentration decreased with age in epsilon4 male carriers. The effect of epsilon2 allele on LDL-cholesterol was more important in the oral contraceptive users. In nonsmokers only, the APOC3-1100C allele in women was related to lower apoB-related traits concentrations, and in men to higher apoA-I and HDL-cholesterol concentrations. In conclusion, this work, in addition to the reinforcement of the already known associations between APOB, APOE, and APOC3 genes and lipids, leads to new perspectives in the complex relationships among genes and environmental factors. The newly observed relationships between E-selectine gene and lipid concentrations support the hypotheses of multiple metabolic pathways contributing to the complexity of lipids variability.

Adult↗

The French paradox and wine drinking.

Despite a high level of risk factors such as cholesterol, diabetes, hypertension and a high intake of saturated fat, French males display the lowest mortality rate from ischaemic heart disease and cardiovascular diseases in Western industrialized nations (36% lower than the USA and 39% lower than the UK). By contrast, mortality from all causes is only 8% lower than in the USA and 6% than in the UK, owing to a high level of cancer and violent deaths. In a recent study of 34,000 middle-aged men from Eastern France with a follow-up of 12 years we have observed that for 48 g of alcohol (mostly wine) per day as the mean intake, mortality from cardiovascular diseases was lower by 30%, all-cause mortality was reduced by 20%, but mortality by cancer and violent death was increased compared with abstainers. Thus the so-called 'French Paradox' (a low mortality rate specifically from cardiovascular diseases) may be due mainly to the regular consumption of wine.

Adult↗

Genetics strongly determines the wall thickness of the left and right carotid arteries.

In 76 supposedly healthy families, we investigated the familial resemblance of left and right carotid intima-media thickness (IMT) measured by B-mode ultrasonography and the impact of the common apolipoprotein E (apo E) polymorphism and the insertion/deletion polymorphism of the angiotensin-converting enzyme (ACE). Genetic factors accounted for about 30% of IMT variation. The insertion/deletion ACE polymorphism did not influence carotid IMT, whereas apoE polymorphism explained about 1.5% of only right carotid IMT variability independently of cholesterol levels. The apo epsilon2 and apo epsilon4 alleles were associated with lower right carotid IMT than was the apo epsilon3 allele. We conclude that genetic factors strongly contribute to IMT variability in healthy people and that the apo E polymorphism may be one of these factors.

Analysis of Variance↗

Objectives, design and recruitment of a familial and longitudinal cohort for studying gene-environment interactions in the field of cardiovascular risk: the Stanislas cohort.

The main objective of the Stanislas cohort is to study the role and the contribution of genetic and environmental factors to cardiovascular status. We plan: a) to describe the degree of association of a large number of cardiovascular risk indicators with cardiovascular endpoints, b) to evaluate the contribution of genetic and that of environmental factors to this association, c) to follow the evolution of these risk indicators during a period of at least ten years, d) to search for the determinants influencing this evolution. The principal variables studied are: a) blood pressure, cardiac mass, and wall thickness of carotid and femoral arteries, b) obesity and fat mass, c) indicators of lipid metabolism, d) genetic polymorphisms of several cardiovascular risk candidate genes, e) food, tobacco and alcohol consumption, f) consumption of drugs and anti-oxidant vitamins. Between September 1993 and August 1995, 1006 families consisting of the two biological parents with at least two children were recruited totalling 4295 individuals. This cohort will be followed up until 2004. There will be two health examinations five and ten years after the initial examination. A bank of blood samples (serum and plasma) in liquid nitrogen and DNA (-80 degrees C) has been established.

Adult↗

Biological variations and genetic reference values for apolipoprotein E serum concentrations: results from the STANISLAS cohort study.

Serum apolipoprotein (apo) E concentrations were determined by immunoturbidimetry in 4284 subjects from 4 to 71 years of age and belonging to 1003 nuclear families recruited for the STANISLAS cohort study between January 1994 and August 1995. Values for apo E ranged from 16 to 169 mg/L, with a geometric mean +/- SD values of 46.6 +/- 13.8 mg/L in the overall sample. The interindividual variability varied from 24.6% to 32.0% among family members. Females exhibited higher apo E values than males until the age of 17-26 years. Conversely, after the age of 26 years, serum apo E concentrations were higher in men than in women. Biological factors affecting serum apo E concentrations were described in fathers, mothers, sons, and daughters and explained up to 32.0% of the apo E variability in daughters and 19.0% in fathers. The main biological factors affecting apo E concentrations were the following: apo E polymorphism, waist-to-hip ratio, oral contraceptive intake, puberty, body mass index, age, and gender. Given the importance of apo E polymorphism in the regulation of apo E concentrations, we recommend the use of genetic-based reference values for the clinical interpretation of serum apo E concentrations.

Adolescent↗

Combined effects of lipoprotein lipase and apolipoprotein E polymorphisms on lipid and lipoprotein levels in the Stanislas cohort.

We have genotyped 1101 supposedly healthy subjects from the Stanislas cohort for the lipoprotein lipase (LPL) gene Ser417(C)-->stop (G) polymorphism and/or for the apolipoprotein (apo)E common polymorphism. Genotypic effects of the two polymorphisms on fasting serum triglycerides (TG), total cholesterol (Tchol), high density lipoprotein-cholesterol (HDLc), low density lipoprotein-cholesterol (LDLc), apoB, apoA-I, and apoE levels were studied separately for each polymorphism and in conjunction. epsilon 4 allele and high apoE levels were associated with high levels of LDLc, Tchol, apoB, and TG. The G allele of LPL was significantly associated with low TG levels. We found a clear interaction between the LPL/apoE polymorphisms and apoE levels on serum TG variation. Total variability of TG levels in women and men of 42.31% and 53.62% respectively, were mainly explained by apoE concentration and these two polymorphisms. ApoE and LPL genes simultaneously modulated TG levels.

Adult↗

Effects of apo B and apo E gene polymorphisms on lipid and apolipoprotein concentrations after a test meal.

The role of apo B signal peptide and apo E polymorphisms, and individual factors (age, sex, etc.) have been investigated on the interindividual variability of the postprandial response of 274 subjects ingesting a 1.260-KJ milkshake. The mean postprandial response, observed during 4 h, is significantly positive for total cholesterol (P < 0.005), LDL-cholesterol (P < 0.0001), triglycerides (P < 0.001), apo E (P < 0.0001) and glucose (P < 0.0001), whereas HDL-cholesterol, apo A-I and apo B do not present mean postprandial variation. Independently of the mean response, some parameters present a large interindividual variability of response, which is significantly influenced by cofactors, such as weight or BMI, for total and LDL-cholesterol, apo B and apo E or tobacco use for HDL-cholesterol. Sex has no effect on any lipid levels. Total, LDL-cholesterol and apo E responses are correlated with their corresponding fasting values. ApoB signal peptide polymorphism is not involved in the postprandial responses, whereas apo E polymorphism explains a significant part of the variability of HDL-cholesterol and apo A-I responses.

Adult↗

Apolipoprotein E genotype epsilon 4/epsilon 2 in the STANISLAS Cohort Study--dominance of the epsilon 2 allele?

Apolipoprotein (apo) E has been discussed as a marker for cardiovascular risk, but information about lipid traits in healthy individuals having one of the rare apoE genotypes (epsilon 4/epsilon 2, epsilon 2/epsilon 2 or epsilon 4/epsilon 4) is scarce. Our work was designed to answer the following questions: 1. Are the allelic effects of epsilon 2 and epsilon 4 on lipid traits additive or dominant? 2. If there is additivity, do the allelic effects of epsilon 2 and epsilon 4 have the same magnitude? 3. Are the allelic effects neutralised in epsilon 4/ epsilon 2 individuals who are under the influence of both rare alleles? Allelic effects on apoB and apoE serum levels were codominant. Allelic models are thus not adequate to study the influence of apoE polymorphism on these traits. Allelic effects were additive for total cholesterol, LDL-C, HDL-C and apoAI, with epsilon 2 having a greater impact than epsilon 4. Serum levels differed significantly between epsilon 4/epsilon 2 and epsilon 3/epsilon 3 individuals only for apoE (p < 0.001) and for apoB (p < 0.05).

Adult↗

Apo B signal peptide insertion/deletion polymorphism is involved in postprandial lipoparticles' responses.

The changes in postprandial concentrations of five lipoparticles (LpC-III, LpC-III:B, LpC-IIInoB, LpA-I and LpA-I:A-II) were studied on 144 apparently healthy (71 male and 73 female) subjects during the 4 h following the ingestion of a 1.260 kJ milkshake. The influence of apo B signal peptide polymorphisms, apo E polymorphism, and other factors including age, gender, BMI, tobacco and alcohol consumption on the postprandial responses of lipoparticles was investigated. Apo-A-I-containing lipoparticles were not influenced during the 4 h following the test meal except for LpA-I:A-II, which decreased in women. LpA-I:A-II is the only particle that showed a gender-dependent change in postprandial concentration. Apo-CIII-containing lipoparticles showed significant postprandial variations. Particles containing both apo B and apo C-III (total LpC-III and LpC-III:B), mainly present in VLDL fraction, had significantly different postprandial responses among the genotypes of the apo B signal peptide polymorphism. Homozygotes for Del allele showed a decrease of LpC-III:B concentrations over the 4 h, whereas Ins/Ins homozygotes and Ins/Del heterozygotes had a peak in concentration at 2 h. The apo B signal peptide polymorphism explained 2.3% of the variance of LpCIII:B, whereas apo E polymorphism did not influence the postprandial concentrations of any lipoparticles.

Adult↗

[Changes in blood cholesterol levels over a 10-year period; value of a single sample for predicting future blood cholesterol levels].

The aim of this study was to report the serum cholesterol changes over a 10 year period in 12,238 subjects aged 4 to 64 years (mean 28 +/- 14 years) based on 3 health check-ups at an average of 5.5 yearly intervals between 1973 and 1989, and to determine the value of a single sample for predicting the serum cholesterol level at 5 and 10 years, and the influence of blood pressure and Quetelet index on this predictability. After identification of the influencing factors, the different variables were adjusted using a step-by-step regression analysis. The correlation coefficients calculated between the adjusted cholesterol level at the first examination and that measured at 5 and 10 years, were all significant (0.38 to 0.59) and varied with age at the time of the first examination and gender. The positive predictive value of having a cholesterol level higher than the 90th centile at 5 and 10 years when it was already higher than this value at the first examination varied from 26 to 46% respectively with respect to the subgroups. The sensitivity of the test was 25 to 48%. The negative predictive value and specificity were 93 to 95%. The lowering of this threshold to the 80th centile increased the positive predictive value from 35 to 45% and decreased the specificity from 94 to 87% for the whole population. When the first two sampling results, five years apart, were taken into consideration simultaneously, the predictive value of having a raised cholesterol level at 10 years increased from 35 to 61%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Blood and plasma glutathione measured in healthy subjects by HPLC: relation to sex, aging, biological variables, and life habits.

We report an HPLC method for measuring the concentrations of reduced (GSH) and total (GSHt) free glutathione in human plasma and whole blood. The chromatographic step was coupled with a postcolumn derivatization reaction and fluorometric detection. The linear range was 0.81-13.02 mumol/L, and the detection limit was 0.13 mumol/L. In healthy adults (ages 18-73 years), mean concentrations were 941 +/- 155 mumol/L for GSHt and 849 +/- 63 mumol/L for GSH in blood (107 men, 94 women), and 3.39 +/- 1.04 mumol/L for GSH in plasma (66 men, 58 women). Blood GSHt but not GSH was significantly lower in children (32 boys, 32 girls: 872 +/- 157 mumol/L) than in adults. Blood GSHt and GSH appeared to be correlated positively with the number of cigarettes smoked per day and the regular practice of physical exercise, and negatively with alcohol abstinence. We observed positive correlations between blood GSHt and cholesterol and calcium concentrations, and between blood GSH and cholesterol concentration.

Adolescent↗

[Future of blood pressure in young adults during a 15-year follow-up].

Tracking of BP and their determinants were investigated among 2,752 young adults, aged 20-35 years (1,209 men and 1,543 women) in a longitudinal study conducted since 1974 at the Center for Preventive Medicine in Nancy-Vandoeuvre. Prevalence of hypertension (BP > 160/95 mmHg or hypertensive drugs) rose over 15 years from 2.1% to 6.8%. Subjects with antihypertensive drugs were about 3.5% after 15 years of follow up (mean age at the fourth examination: 44 years). Coefficients correlation between initial BP and BP at 5, 10 and 15 years were 0.43, 0.38 and 0.35 for systolic BP, 0.28, 0.24 and 0.26 for diastolic BP in population without antihypertensive drugs. The part of variance for BP at the fourth examination explained by variables from previous examinations was low (27% for systolic BP and 13 or 17% according to sex for diastolic BP). The main variable in the regression was always the BP at the third examination; 69.3% of subjects with high BP (> 140/90 mmHg or treated for hypertension) were well classified in a discriminant analysis. These results underline the difficulty to predict BP and hypertension in a general population, suggest to take into account pathogenic predictors in further studies and allow us to propose selective prevention of future hypertensive.

Adult↗

Sources of variability of human plasma apolipoprotein A-IV levels and relationships with lipid metabolism.

Plasma apolipoprotein (apo) A-IV concentration was determined by immunoelectrophoretic assay (EIA) in 119 nuclear families. No significant effect of concomitants such as age, weight, height, body mass index, tobacco, and alcohol consumption was observed on apo A-IV levels in men and in boys. In women, contraceptive use and hormonal status affected apo A-IV levels. In girls, only age influenced the quantitative phenotype. After adjusting by specific concomitants significant correlations were observed between apo A-IV levels and triglycerides, apolipoprotein A-I and apo B levels, suggesting a role of apolipoprotein A-IV in the hepatic lipid metabolism. Intrafamilial correlations were estimated to investigate the plausibility of a common family factor. The results obtained in this study showed a significant correlation between family members with the exception of mother-daughter pairs. Using a variance components model, the contribution of genetic and environmental factors was then investigated. Different statistical models were used and two major hypotheses were statistically acceptable: the first hypothesis supports that shared and specific environmental factors explain 35 and 65%, respectively, of the total adjusted plasma apo A-IV variation. The fraction of apo A-IV variability attributable to genetic factors was null. The second hypothesis supports that the fraction of variability attributable to apo A-IV genetic variation is 67% and the common spouse environmental factors are responsible for 33% of the total variability and no specific environmental effect was found. Among the two hypotheses, taking account of the metabolism function, we support the first one without excluding gene-environment interactions which could mask the genetic influence.

Adult↗

Segregation analyses of four urinary caffeine metabolite ratios implicated in the determination of human acetylation phenotypes.

Human acetylation phenotypes were determined with caffeine (137X) as the test substance, improved by measuring urinary caffeine metabolites with a previously described HPLC method. Caffeine, 5-acetylamino-6-formylamino-3-methyluracil (AFMU), 1-methylxanthine (IX), 1-methyluric acid (IU), 1,7-dimethylxanthine (17X), and 1,7-dimethyluric acid (17U) were quantified. This study tested the hypothesis, suggested by previous studies, that the acetylation polymorphism is strongly influenced by a major gene. Phenotypes were assessed by using four urinary caffeine metabolite ratios: AFMU/1X, AFMU/[1X + 1U + 17U], AFMU/[AFMU + 1X + 1U], and AFMU/[1X + 1U + 17X + 17U] in a population included 281 nuclear family members who were healthy volunteer subjects. Each urinary ratio revealed strong familial aggregation with correlations between parents and offspring varying from 0.340 to 0.486 as a function of the ratio considered, and between sibs from 0.410 to 0.512 whereas correlations among spouses were not significant, excluding an effect of environmental factors. Segregation analyses were conducted upon these four ratios testing a series of specific models of inheritance and gave evidence for single locus control of N-acetyltransferase (NAT) activity, with Mendelian codominant transmission using the AFMU/1X, AFMU/[1X + 1U + 17U], and AFMU/[1X + 1U + 17X + 17U] ratios. The slow allelic frequencies were 0.739, 0.753, and 0.724, respectively, and the phenotypic concordance was 90 to 92% with the AFMU/1X ratio. The familial aggregation observed in using the AFMU/[AFMU + 1X + 1U] ratio was consistent with a recessive transmission for the allele controlling the homozygous slow phenotype. This last ratio is not convenient to differentiate rapid heterozygous and homozygous phenotype. Considering the number of misclassified subjects, this study would be completed by genotyping the same families as demonstrated by some authors who predicted 97.5% of acetylation phenotype when using PCR-based DNA amplification test.

Acetylation↗