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Biomedical subjects

Frédéric Dadoun

Publications and source records attributed to Frédéric Dadoun.

2 recordsLinked to original sources
PubMed2006

Insulin resistance induced by hydrocortisone is increased in patients with abdominal obesity.

Glucocorticoids hypersensitivity may be involved in the development of abdominal obesity and insulin resistance. Eight normal weight and eight obese women received on two occasions a 3-h intravenous infusion of saline or hydrocortisone (HC) (1.5 microg x kg(-1) x min(-1)). Plasma cortisol, insulin, and glucose levels were measured every 30 min from time(-30) (min) (time(-30)) to time(240). Free fatty acids, adiponectin, and plasminogen activator inhibitor-1 (PAI-1) levels were measured at time(-30), time(180), and time(240). At time(240), subjects underwent an insulin tolerance test to obtain an index of insulin sensitivity (K(ITT)). Mean(30-240) cortisol level was similar in control and obese women after saline (74 +/- 16 vs. 75 +/- 20 microg/l) and HC (235 +/- 17 vs. 245 +/- 47 microg/l). The effect of HC on mean(180-240) insulin, mean(180-240) insulin resistance obtained by homeostasis model assessment (HOMA-IR), and K(ITT) was significant in obese (11.4 +/- 2.0 vs. 8.2 +/- 1.3 mU/l, P < 0.05; 2.37 +/- 0.5 vs. 1.64 +/- 0.3, P < 0.05; 2.81 +/- 0.9 vs. 3.32 +/- 1.02%/min, P < 0.05) but not in control women (3.9 +/- 0.6 vs. 2.8 +/- 0.5 mU/l; 0.78 +/- 0.1 vs. 0.49 +/- 0.1; 4.36 +/- 1.1 vs. 4.37 +/- 1.2%/min). In the whole population, the quantity of visceral fat, estimated by computerized tomography scan, was correlated with the increment of plasma insulin and HOMA-IR during HC infusion [Delta mean(30-240) insulin (r = 0.61, P < 0.05), Delta mean(30-240) HOMA-IR (r = 0.66, P < 0.01)]. The increase of PAI-1 between time(180) and time(240) after HC was higher in obese women (+25%) than in controls (+12%) (P < 0.05), whereas no differential effect between groups was observed for free fatty acids or adiponectin. A moderate hypercortisolism, equivalent to that induced by a mild stress, has more pronounced consequences on insulin sensitivity in abdominally obese women than in controls. These deleterious effects are correlated with the amount of visceral fat.

Abdominal Fat↗
PubMed2002

Screening for primary hyperparathyroidism before thyroid surgery: A prospective study.

BACKGROUND: Misdiagnosed primary hyperparathyroidism (PHPT) during thyroid surgery may lead to a difficult reoperation. Because PHPT is often asymptomatic, calcium measurements have been recommended before thyroid surgery, but no study has focused on the results of a prospective PHPT screening. METHODS: The prospective study of 748 patients consisted of 2-step screening of calcium measurement in all patients (normal range, 2.2 to 2.6 mmol/L, 8.8 to 10.4 mg/dL). If the calcium level was greater than 2.49 mmol/L (9.9 mg/dL), parathyroid hormone level (PTH; normal range, 11 to 65 pg/mL) and second calcium measurements were obtained. Positive screening was defined by 2 calcium levels greater than 2.49 mmol/L (9.9 mg/dL) and PTH level greater than 49 pg/mL. In patients with negative screening, we evaluated the number of parathyroid incidentalomas. In patients with positive screening, we rated parathyroid adenomas discovered as "easily accessible" or "requiring specific dissection." We assumed that the former could have been incidentally found by a surgeon unaware of calcium value. The cost estimation was based on French national health system databases. RESULTS: In the 9 patients with positive screening, 9 had parathyroid adenomas, 3 of them requiring specific dissection. In the 739 patients with negative screening, 12 had surgical incidentalomas and 2 had postoperative PHPT diagnosis. CONCLUSIONS: Our screening was not exhaustive, but it avoided a reoperation for missed PHPT in 3 patients. Population screening cost less than 3 reoperations. Other strategies, more exhaustive and/or cost-effective, should be investigated.

Adolescent↗