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Biomedical subjects

J F Brun

Publications and source records attributed to J F Brun.

At least 73 records · Page 4Linked to original sources
PubMed1996

Increased insulin sensitivity and basal insulin effectiveness in postprandial reactive hypoglycaemia.

Glucose clamp experiments have shown that patients with reactive postprandial hypoglycaemia (PRH) frequently have an increased glucose disposal, but the relative involvement of insulin sensitivity (SI) and glucose effectiveness (Sg) in this process remains unknown. The minimal model approach was used to compare 13 patients in whom moderate reactive hypoglycaemia ( < 3.3 mmol) had been previously diagnosed and 13 matched controls. The intravenous glucose tolerance test (IVGTT, 0.5 g/kg glucose IV) with 0.02 U/kg insulin given at the 19th min and frequent sampling over 180 min shows that PRH patients exhibit a higher glucose tolerance coefficient Kg (2.99 +/- 0.26 vs 2.19 +/- 0.12; P < 0.02), higher SI [22.9 +/- 6.4 vs 7.18 +/- 0.14 min-1/(microU/ml). 10(-4); P < 0.01] and higher Sg (3.84 +/- 0.35 vs 2.92 +/- 0.79 min-1. 10(-2); P < 0.05). The increase in Sg is explained by an increase in its component basal insulin effectiveness (BIE: 1.2 +/- 0.27 min-1.10(-2) in PRH subjects vs 0.58 +/- 0.07; P < 0.05) rather than an increase in Sg at zero insulin. The increase in BIE results from the high values of SI. In 4 PRH subjects SI and Sg were within the normal range, and the increase in Kg evidenced in the 9 others was explained by an increase in SI alone in 3 cases, in Sg alone in 1 case, and both SI and Sg in 5 cases. Thus, in sedentary subjects, the previously reported rise in tissue glucose assimilation is mainly explained by an increased insulin-mediated glucose disposal rather than non-insulin-mediated glucose disposal.

Adult↗
PubMed1996

[Rheology and occlusive arterial disease of the legs].

Peripheral occlusive arterial disease (P.O.A.D.) is one of the situations in which hemorheological abnormalities are usually described. However the clinical relevance of hemorheological measurements in angiologic practice remains to be defined. The aim of the study was to investigate whether hemorheological disturbances are associated with alterations in oxygen diffusion and prognosis of the arterial disease. Three groups of patients were included in this work. First, a study was realized on 160 nondiabetic P.O.A.D patients (suffering from intermittent claudication to critical limb ischemia) in order to evaluate the possible influence of hemorheological disturbances on oxygen diffusion in distal tissue. A control group of 30 subjects matched for age and sex was also studied. A second study was performed on 80 diabetic P.O.A.D. patients (stage III and IV of Leriche and Fontaine classification) to determinate if hemorheological parameters could be considered as prognostic factors in the P.O.A.D. course. Hemorheological parameters were determined on different devices: red blood cell (RBC) aggregation by Myrenne aggregometer, blood and plasma viscosities by MT 90 falling ball viscometer. Transcutaneous oxygen pressure was measured by Radiometer TCM2 oxygen monitor. Several rheological parameters of non diabetic patients suffering from P.O.A.D. were significantly higher than those of control group subjects : blood viscosity (p < 0.05), plasma viscosity (p < 0.001), erythrocyte rigidity index (p < 0.01) and fibrinogen level (p < 0.0001). In the nondiabetic patients TcPO2 was negatively correlated with RBC aggregation, erythrocyte rigidity index and hematocrit /viscosity ratio. The diabetic patients who needed major amputation (above or below knee) presented significantly increased hemorheological parameters (blood viscosity, RBC aggregation, RBC rigidity index, hematocrit/viscosity ratio, fibrinogen level) compared to diabetic who had not been major amputated (no amputation or only toes' amputation). Our finding suggests that hemorheological factors (1) may influence oxygen transfer to distal tissues by maldistribution of blood flow and (2) may have prognostic significance in chronic peripheral occlusive arterial disease.

Aged↗
PubMed1996

[Blood viscosity is correlated with insulin resistance].

The insulin resistance syndrome (or syndrome X) is a cluster of symptoms (dyslipidemia, impaired glucose tolerance, overweight, hypertension) associated with a higher risk of atherosclerosis. It has been suggested that hemorheological abnormalities, often found in association with most of these symptoms, may be a part of this syndrome, and possibly play a role in the circulatory abnormalities. In 22 nondiabetic women (20-54 years) presenting a wide range of body mass index (from 20 to 48 kg/m2), insulin sensitivity was assessed with the minimal model procedure, over a 180 min intravenous glucose tolerance test with frequent sampling. The insulin sensitivity index SI (i.e. the slope of the dose-response relationship between insulin increased above baseline and glucose disposal) ranges between 0.1 and 20.1 x 10(-4) min-1/microU/ml) i.e all the range of insulin sensitivity. SI was negatively correlated with blood viscosity (r = -0.530 p < 0.02), body mass index (r = 0.563 p < 0.01) and baseline insulinemia (r = 0.489 p < 0.05). These correlations were independent of each other and were not explained by relationships between SI and fibrinogen or blood lipids. Thus, blood fluidity is correlated with insulin sensitivity when it is measured with an accurate technique, suggesting that blood hyperviscosity is a symptom of insulin resistance that might be involved in the cardiovascular risk of this syndrome.

Adult↗
PubMed1995

Evaluation of a standardized hyperglucidic breakfast test in postprandial reactive hypoglycaemia.

The oral glucose tolerance test is not specific for diagnosing postprandial reactive hypoglycaemia, since it too frequently induces low blood glucose values in subjects who have never complained of symptoms of this. By contrast, the mixed meal tests are deceptive for this purpose because they do not induce hypoglycaemia in subjects who have complained of of hypoglycaemic symptoms. We investigated the frequency of hypoglycaemia after a standardized hyperglucidic breakfast test in three groups of subjects:group A, 43 control subjects; group B, 38 postprandial reactive hypoglycaemic patients; group C, 1193 asymptomatic subjects undergoing assessment of glycoregulation. In the 38 subjects with suspected reactive hypoglycaemia the mean blood glucose nadir was 3.48 +/- 0.08 mmol/l, i.e. lower than in control subjects (4.83 +/- 0.13 p < 0.0001). Blood glucose levels less than 3.3 mmol/l were found in 47.3% of subjects with suspected postprandial reactive hypoglycaemia (group B), i.e more frequently than in control subjects (group A: 2.2% p = 1.6 x 10(-6)) and asymptomatic subjects (group C: 1% p = 8 x 10(-22)). This markedly higher frequency of low blood glucose values in subjects with postprandial symptoms compared with control and asymptomatic subjects suggests that this test detects a tendency to hypoglycaemia after a standardized hyperglucidic breakfast. Since this test mimics average French eating habits, the results suggest that the patients undergo such symptoms in their everyday life, and that the hyperglucidic breakfast test is a simple alternative to ambulatory glucose sampling for diagnosis of postprandial reactive hypoglycaemia.

Adult↗
PubMed1995

Effects of zamic as a means for zinc supplementation in growing children.

We investigated the effects of zinc supplementation in case of moderate growth retardation in which GH treatment could not be used. Zamic (ZA, an association containing arginine, L-methionine, and zinc; from Aguettant pharmaceuticals) was compared with arginine aspartate (AA) (5 g) in a crossover randomized trial (6 mo of each treatment at random order over 1 yr). We present preliminary results of 24 children who completed the study (3 girls, 21 boys, age 9-13 yr). Subjects had to be prepubertal, with no GH deficiency diagnosed. In 15 subjects growth velocity was lower than 5 mm/mo: In this case ZA improved growth velocity (rising from 3.105 +/- 0.229 to 5.4 +/- 0.69 mm/mo p < 0.01), whereas the effect of AA was not significant. The increase in growth velocity was higher with ZA (+2.44 +/- 0.657 mm/mo) than AA (+0.438 +/- 0.450 mm/mo) p < 0.05. These results suggest that ZA is more efficient than AA, consistent with the hypothesis that zinc needs are increased in those children in this period of life.

Adolescent↗
PubMed1995

Influence of short-term submaximal exercise on parameters of glucose assimilation analyzed with the minimal model.

After exercise, glucose uptake in tissues increases by insulin-dependent and -independent mechanisms. We evaluated whether these two effects of exercise on glucose disposal can be detected with the minimal model technique. Seven healthy volunteers were submitted at random order to two frequently sampled intravenous glucose tolerance test (FSIVGTTs), one at rest and the other 25 minutes after a 15-minute exercise test. This exercise included 5 minutes of increasing workload on a cycloergometer followed by 10 minutes at 85% of the maximal theoretic heart rate. Bergman's minimal model of insulin action was used to analyze the two FSIVGTTs and produced the following parameters: coefficient of glucose tolerance (Kg), ie, the slope of the exponential decrease in glycemia between 4 and 19 minutes after intravenous glucose; insulin sensitivity (Sl); and glucose effectiveness at basal insulin (Sg). Sg was divided into its two components: basal insulin effectiveness ([BIE] Sl x basal insulin) and glucose effectiveness at zero insulin ([GEZI] Sg-BIE). After the exercise bout, subjects had an increased Kg (3.44 +/- 0.44 v 2.06 +/- 0.28 x 10(-2).min-1, P < .02), Sl (11.43 +/- 1.27 v 6.23 +/- 0.97 x 10(-4) microU/mL.min-1, P < .01), and Sg (4.40 +/- 0.55 v 2.81 +/- 0.36 x 10(-2).min-1, P < .02). The increase in Sg was mainly explained by a 60% increase in GEZI (3.6 +/- 0.57 v 2.25 +/- 0.36 x 10(-2).min-1, P < .02), but also by an increase in BIE (0.80 +/- 0.12 v 0.47 +/- 0.08 x 10(-2).min-1, P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Plasma beta-endorphin, corticotrophin and growth hormone responses to exercise in pubertal and prepubertal children.

An increase in plasma beta-endorphin concentrations during exercise has been reported in adult men and women by several investigators. However, very little is known about this physiological hormonal response to exercise in children. In this study, we investigated plasma beta-endorphin, ACTH and GH responses to exercise in 40 prepubertal and pubertal children. Subjects were recruited as part of a population of children and adolescents presenting growth retardation and were selected on the basis of the absence of any clinical or biological signs of endocrine or metabolic disease. There were 16 girls and 24 boys with 24 prepubertal and 16 pubertal individuals. A standardised 15 min workload on cycloergometer was used to progressively increase the heart rate of the children up to 90% of the theoretical maximal value. Exercise resulted in a significant increase (p < 0.01) in plasma beta-endorphin (mean +/- SEM) (4.26 +/- 0.47 vs 5.74 +/- 0.56 fmol/ml), ACTH (3.71 +/- 0.41 vs 6.2 +/- 0.62 fmol/ml) and GH (147 +/- 29 vs 364 +/- 67 fmol/ml). The percentage of children with significant hormonal response to exercise was about 75% for each of the 3 hormones but only 3 of the 40 children studied did not show any hormonal response to exercise. Exercise-induced increases in plasma beta-endorphin and ACTH were significantly correlated (p < 0.01). By contrast, there was no significant relationship between GH and beta-endorphin or ACTH values. Furthermore, whereas exercise-induced plasma GH increase was significantly higher in pubertal than in prepubertal children (p < 0.001), corresponding beta-endorphin and ACTH levels were quite similar in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

The magnitude, the kinetics and the metabolic efficiency of first-phase insulin response to intravenous glucose are related.

We investigated the relationship between the kinetics, the magnitude and the metabolic efficiency of first-phase insulin response (FPIR) to intravenous glucose. Twenty healthy control subjects and fifty first degree relatives of Type 1 diabetic patients were studied using a standardized protocol for the intravenous glucose tolerance test (IVGTT). The first significant increase in plasma insulin concentrations above baseline appeared as early as the 2nd min (1 min before the end of glucose injection, fast response) in 80% of controls and 70% of relatives, and at the 3rd min or later (delayed response) in the remaining subjects. The greatest delay in insulin release (5th min) was observed in 4 of 6 relatives of Type 1 diabetic patients with impaired FPIR. In the controls and the relatives, the subjects with a fast insulin response had a significantly higher FPIR (controls 215.4 +/- 93.5 vs 59.7 +/- 5.6 microU/ml, p < 0.001 and relatives 143.5 +/- 61.8 vs 55.9 +/- 27.7 microU/ml, p < 0.001) and showed better glucose assimilation (controls 3.05 +/- 1.05 vs 1.64 +/- 0.16%/min, p < 0.05 and relatives 2.6 +/- 0.96 vs 1.6 +/- 0.85%/min, p < 0.01) during IVGTT than the subjects with a delayed response. Moreover, for normal FPIR values in the group of relatives of Type 1 diabetic patients, a fast response was associated with a significantly better glucose assimilation as assessed by the incremental area under the glucose curve (358.6 +/- 64.7 vs 539.2 +/- 67.7 mmol/l per 90 min, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Determination of urinary testosterone and epitestosterone during pubertal development: a cross-sectional study in 141 normal male subjects.

OBJECTIVES: Exogenous testosterone administration is classically detected by measuring the ratio of testosterone to epitestosterone in urine. Athletes are considered to be positive for drug abuse if the urinary testosterone to epitestosterone ratio is greater than 6. We aimed at investigating the urinary excretion of testosterone and epitestosterone during pubertal development. DESIGN: We performed a cross-sectional study of 141 normal male subjects between ages 8 and 26 years. PATIENTS: We studied 141 subjects: 32 at stage 1 of Tanner, 27 at stage 2, 30 at stage 3, 25 at stage 4 and 27 at stage 5. MEASUREMENTS: Subjects performed a 24-hour urine collection. Urinary testosterone and epitestosterone were measured by gas chromatography-mass spectrometry with selected ion monitoring. RESULTS: Urinary testosterone was 20.5 +/- 1.7 nmol/24 h (mean +/- SEM) at stage 1, 49 +/- 2.9 at stage 2, 98.8 +/- 3.4 at stage 3, 371.8 +/- 21.8 at stage 4 and 403.4 +/- 16.1 nmol/24h at stage 5. Urinary epitestosterone was 13.1 +/- 1.5 nmol/24h at stage 1, 29.1 +/- 3.3 at stage 2, 48.3 +/- 3.7 at stage 3, 156.3 +/- 14.8 at stage 4 and 221.1 +/- 18.6 nmol/24h at stage 5. The urinary excretions of both steroids increased significantly during puberty and were highly correlated with chronological age (P < 0.001). Comparison of the correlation slopes (P < 0.001) showed that the urinary profiles of testosterone and epitestosterone are not parallel during pubertal development. Two subjects presented a testosterone to epitestosterone ratio above 6, corresponding to a low urinary concentration of epitestosterone, without pathological explanation. CONCLUSION: Testosterone and epitestosterone do not present the same urinary profiles throughout puberty. Marked increases of the testosterone to epitestosterone ratio can be observed at this period and may interfere with doping tests.

Adolescent↗
PubMed1993

[Study of urinary excretion of testosterone and epitestosterone glucuronides in children and adolescents].

Urinary testosterone to epitestosterone ratio (T/E) is used as a marker for illegal exogenous testosterone use. Mean value in healthy adults is 1.13 and 6 is the upper limit of the accepted range. Urinary excretion of these two steroids were studied in 57 children and teenagers at different pubertal stages, using gas chromatography coupled with mass spectrometry with selective ion detection. Urinary excretion of testosterone and epitestosterone increased significantly during puberty. Mean T/E ratio remained fairly constant but interindividual variations were marked and in one subject the T/E ratio exceeded 6. These data suggest that this test may yield false-positive results in adolescents.

Adolescent↗
PubMed1991

[Hemorrheological parameters during normal labor and uterine contraction].

Considering the modified fluidity of blood during numerous kind of stress, the authors studied blood rheology during delivery as an example of a particularly severe stress. The authors measured blood and plasma viscosity and erythrocyte aggregation in 77 pregnant at the following stages of delivery: below 4 cm dilatation; more than 4 cm dilatation; during fetus expulsion, during after birth delivery. Apparent blood viscosity and viscosity adjusted to 45% hematocrit rose to reach a peak during expulsion (p less than 0.01) then to become normal again during placenta delivery (p less than 0.01). Hematocrit and plasmatic viscosity showed no changes during labour and expulsion. In addition erythrocyte aggregation was lowering during expulsion and delivery (stage with physiological defibrination). Rising blood viscosity might be explained by a red blood cell rigidification measured by the increasing of "Tk" (p less than 0.01) and by a nonsignificant increase of the filterability index measured by hemorheometer. In conclusion, delivery is accompanied by a blood hyperviscosity essentially related to a transient red blood cell rigidification.

Adult↗
PubMed1991

[Hemorrheological characteristics of fetal blood drawn in utero from the cord].

Extensive studies of hemorheology of cord blood (drawn just after delivery) have evidentiated a peculiar rheological pattern: less filterable red cells, reduced erythrocyte aggregation, lowered plasma viscosity. This pattern has been suggested to be important for maintaining a sufficient O2 supply to fetal tissues, by avoiding hyperviscosity despite increased RBC rigidity. However, cord blood at birth is not exactly fetal blood and we are not yet aware of studies of fetal blood drawn in utero several weeks before delivery. For this reason, we investigated the rheological properties of fetal blood during intrauterine cord venepunctures in 27 pregnant women (25-30 week's gestation) who were explored for detection of fetal genetic or infectious diseases. Fetuses have lower plasma viscosity (p less than 0.001), lower RBC flexibility (measured by filterability on the Hémorhéomètre) (p less than 0.01) and higher hematocrit/viscosity ratio (p less than 0.01) than their mothers. While no temporal modification during the studied period (20-40 wk) was detected for hematocrit and plasma viscosity, RBC filterability (rigidity) seems to exhibit a 'U shaped curve' with a nadir between 25 and 30 weeks. This pilot study supports the hypothesis that the previously reported rheological properties of cord blood at birth reflect to some extent those of intra-uterine fetal blood.

Blood Viscosity↗
PubMed1991

In vitro effects of somatostatin on red cell filterability measured by three methods.

Somatostatin is an ubiqutary neuropeptide and hormone which has been reported to exert hemodynamic effects and to bind to receptors on the red cell membrane. We investigated its effects on red cell deformability by three filtration methods: (a) filtration of red cells resuspended at hematocrit 8% in Tris-Albumin-Glucose buffer under atmospheric pressure; (b) filtration of red cells resuspended at hematocrit on native plasma at 8% hematocrit under a negative pressure of 5 cm of water; (c) filtrability of whole blood under a negative pressure of 20 cm of water. Aprotinin (Antagosan*) was added to the different suspensions in order to avoid rapid destruction of somatostatin. Increased quantities of somatostatin (from 1 pg/ml to 1 microgram/ml) were obtained by adding natural somatostatin (Modustatin*) to the media, before they were incubated at 37 C for 30 minutes. In 11 samples from healthy subjects, somatostatin was shown to increase red cell flow rate in technique (c) (+ 118%, p less than 0.05) and to reduce red cell rigidity index in technique (b) (- 71%, p less than 0.025) whereas a nonsignificant similar tendency (- 56%) was observed with technique (a). Similar results (p less than 0.05) are observed when adding somatostatin to blood of diabetics. These in vitro data suggest that somatostatin, like other previously studied hormones, may modify red cell deformability.

Erythrocyte Deformability↗
PubMed1991

Increased albumin excretion rate during a standardized exercise-test in diabetics with lowered blood filterability.

Albumin excretion rate in urine is a marker of early, reversible stages of diabetic nephropathy. Does abnormal blood rheology represent an additional risk factor in this multifactorial process? We investigated a possible link between red cell filterability and microalbuminuria during an exercise test (exercise is supposed to improve the detection of excessive microalbuminuria). 77 diabetics (27 females, 50 males, age: 15-60 yr) underwent a 20 min inframaximal progressively increasing workload on cycloergometer, rising heart rate up to 200 minus the age. Filterability of whole blood and washed red cells were measured on 5 microns polycarbonate sieves reused after ultrasonic cleaning. Whole blood filterability was found to be impaired in 35 subjects (group A) and normal in 41 (group B). Groups A and B were matched for age, sex, blood pressure, glycemic equilibrium, and duration of disease. Microalbuminuria was higher in A at rest (39.79 +/- 13.83 micrograms/min vs 12.9 +/- 3.21, p less than 0.01) and after exercise (91.80 +/- 20.79 vs 42.23 +/- 7.85, p less than 0.01). The slopes of regression lines between resting Microalbuminuria and blood pressure were greater in group A than in group B (p less than 0.01). No relationship between microalbuminuria and washed red cell filterability was detected. This study confirms on a larger scale a previous report of our team. Some hemorheologic disorders detectable with whole blood filterability (but not with washed red cell filtration) are associated with an increase in resting and postexercise microalbuminuria.

Adolescent↗
PubMed1989

Immunoreactive somatomedin C in children from Morocco: a biological marker of nutritional growth retardation?

Somatomedin C (Sm-C) is supposed to be a sensitive marker of malnutrition. Its relationship to growth and protein intake was investigated in 47 Moroccan children. The children (mean age: 7.5 +/- 2 yr) had no endocrine abnormality. Anthropometric parameters were measured, together with blood levels of Sm-C and growth hormone (GH). Lower values of Sm-C were found in the following situations: (a) growth retardation (more than -2 Sd, N = 23; Sm-C = 3.61 +/- 0.42 nmol/l vs. 13.38 +/- 1.52, P less than 0.02); (b) body weight less than 80% of expected weight for height (N = 8; Sm-C = 4.84 +/- 0.97 vs. 10.33 +/- 1.19, P less than 0.02); (c) boys with meat consumption less than 3 times per wk (N = 15; Sm-C = 4.03 +/- 0.71 vs. 12.35 +/- 2.01, P less than 0.002). Thus, lower values of Sm-C are found in association with weight insufficiency and lower protein intake. As has previously been assumed, serum Sm-C, which is regulated by nutrition, may be a sensitive tool in the assessment of nutritional status in developing countries such as Morocco. Furthermore, it could explain some cases of growth retardation in states of malnutrition.

Adolescent↗
PubMed1989

A correlation between microalbuminuria and anti-insulin antibodies in type I diabetics.

A link between circulating anti-insulin antibodies and diabetic glomerulopathy has been suggested. This paper presents two different studies aiming to detect a relationship between incipient nephropathy (indicated by microalbuminuria) and anti-insulin antibodies. In 64 type I diabetics, overnight urinary albumin excretion during an exercise-test was found to be correlated with systolic blood pressure (r = 0.258 p less than 0.05), anti-insulin antibodies (r = 0.258 p less than 0.05), and glycosylated hemoglobin (r = 0.258 p less than 0.05) whereas no correlation was found among these three parameters. In another group of 80 type I diabetics, urinary albumin excretion during a standardized exercise-test was also correlated with anti-insulin antibodies (r = 0.360 p less than 0.001). In this latter group, diabetics with elevated (greater than 200 microU/ml) levels of anti-insulin antibodies had higher values of microalbuminuria after exercise (p less than 0.001) when compared to those with lower or undetectable levels, although they did not differ with respect to blood pressure and glycemic control. Therefore, we confirm preliminary reports indicating a statistical relationship between anti-insulin antibodies and microalbuminuria. We hypothesize that anti-insulin antibodies may be an additional factor of risk in the pathogenesis of early (reversible) stages of diabetic nephropathy.

Adult↗