[Association of Waldenström's and Paget's diseases (review of the literature in relation to 1 case)].
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Biomedical subjects
Publications and source records attributed to C Fievet.
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Circadian variations in serum lipoprotein levels in relation to meals were investigated in 10 healthy subjects on a normal diet. Lunch and dinner produced a concomitant increase in triglycerides and the apo-B of very low density lipoproteins (d less than 1.006). The increase observed after dinner was of the same degree as after lunch but was more prolonged; this longer duration was unrelated to the nocturnal increase in free fatty acids. Apo-A1 levels also rose slightly after lunch and dinner, and so did HDL-cholesterol which, however, decreased during the night. These results suggest that in normal subjects the intravascular lipolytic activity is reduced during the night.
Plasma levels of apoproteins B and A, triglycerides, VLDL + LDL-cholesterol and HDL-cholesterol were simultaneously measured in an ambulatory population of 477 subjects (206 male and 271 female). VLDL + LDL-cholesterol and apo B values were similar in males and females and significantly increased with age. Conversely, HDL-cholesterol and apo A values were higher in females than in males and remained stable with age. HDL-cholesterol and apo A correlated inversely with triglycerides. Overweight, alcohol and smoking introduced significant changes in the parameters studied.
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The aim of the present study was to evaluate the serum and lipoprotein levels of choline--containing phospholipids (lecithin, lysolecithin and sphingomyelin) in a group of type I diabetic patients in fair metabolic control. Forty-eight male adult diabetic patients without macroproteinuria were compared with 48 healthy controls matched for age and body weight. Total cholesterol and phospholipids were assessed in plasma and in apolipoprotein B (apoB) and non apoB containing lipoprotein particles (Lp B and Lp non B particles) separated using precipitation with Concanavalin A. When compared to the control group, diabetic patients have significantly lower serum phospholipids and phospholipids and cholesterol content of LpB particles. All the other parameters studied were similar in the two groups. The phospholipids/cholesterol ratio, calculated in LpB particles is also significantly reduced in the diabetic group. These results strongly suggest a depletion in the choline containing phospholipid content of LpB particles and therefore an alteration of the surface components of atherogenic particles in type I diabetes mellitus.
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The excess risk of cardiovascular disease in Type 1 diabetes mellitus compared to non diabetic subjects is only partially explained by standard risk factors. Several studies suggest that Lp(a) concentrations are increased in Type 1 diabetes mellitus, but data are still controversial. Moreover, a high cardiovascular risk has been reported in diabetic patients with persistent proteinuria. Therefore, the aim of this study was to compare the Lp(a) particle levels in insulin-dependent diabetic patients with or without increased urinary albumin excretion. Cross-sectional study of Lp(a) plasma levels in a population of 140 insulin-dependent diabetic patients: 83 without increased proteinuria, 14 with borderline elevation of urinary albumin excretion, 27 with micro- and 16 with macro-proteinuria. Simultaneous determination of plasma lipids, fasting blood glucose and HbA1c was performed. The mean plasma Lp(a) concentrations and the distribution of the levels were comparable in all of the diabetic patient groups. No relationship existed between Lp(a) and HbA1c, fasting blood glucose or any lipid plasma levels. No influence of albumin excretion rate on Lp(a) levels was observed. These data provide no evidence of a specific contribution of Lp(a) particles to the increased morbidity and mortality from cardiovascular disease observed among patients with nephropathy.