[Nephroprotection in young type 1 diabetic patients treated with converting enzyme inhibitor]. / Néphroprotection chez le jeune diabétique de type 1 traité par inhibiteur d'enzyme de conversion. Résultats préliminaires d'une étude prospective.

CONTEXT: Diabetic nephritis is a renal microangiopathy that represents a major cause of morbidity and mortality in diabetic patients. It is expressed either by microalbunuria, proteinuria or renal failure, depending on the stage of the diabetes. In this context, angiotensin converting enzyme inhibitors (ACEI) slow down the progression of renal damage. OBJECTIVE: To assess the nephroprotector effects of ACEI in young type 1 Moroccan diabetics with varying stages of renal damage. Methods Prospective study including 29 patients exhibiting a diabetic nephropathy and/or hypertension having been followed-up for 1 year and treated with ACEI. The following parameters were analysed on inclusion, at six months and after 1 year of treatment: systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), urinary excretion of albumin, 24-hour proteinuria, creatininemia, creatinine clearance, glycosylated haemoglobin, kalemia, total cholesterol and triglycerides. RESULTS: The mean age of our patients was of 23.6 +/- 5.5 years, the age at onset of diabetes was of 9.3 +/- 2.6 years. According to the renal damage, we determined 4 groups of patients: Group I: microalbuminuria (10 patients), Group II: proteinuria (7 patients), Group III: renal failure (6 patients), Group IV: isolated hypertension (6 patients). Study of the progression of the clinical and biological parameters, during treatment with converting enzyme inhibitors (combined with diuretics in Groups II and III) revealed: In Group I: a decrease in urinary excretion of albumin, which returned to normal in 3 cases, in Group II: a decrease in the proteinuria, which became a microalbuminuria in 4 cases, in Group III: a stabilisation of renal function concomitant to a reduction in proteinuria, in Group IV: a significant reduction in mean arterial pressure. CONCLUSION: One year of treatment with ACEI appears effective on reducing proteinuria levels and stabilising the renal function in young type 1 diabetic patients.

[Apolipoprotein E polymorphism in a Moroccan population: allele frequency and relation to plasma lipid concentrations]. / Polymorphisme de l'apolipoprotéine E dans une population marocaine: fréquence allélique et relation avec les paramétres lipidiques plasmatiques.

To date, no data are available on relationship between apolipoprotein E (apo E) polymorphism and lipid levels in Moroccan population. The present work reports an apo E polymorphism repartition in Moroccan population and relationship between this polymorphism and the levels of plasma cholesterol, triglycerides, apo A1, B and E. Blood samples from 168 healthy Moroccan individuals from Rabat area (90 men and 78 women), aged from 20 to 50 years (32 9 years), were analysed for serum apo E, A1 and B, triglycerides, and total cholesterol. In parallel, genotyping by means of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) was performed. The apo E allelic frequencies were 11% for epsilon4, 84% for epsilon3 and 5% for epsilon2. There were correlation between apo E alleles and serum lipid concentrations, E2/E3 carriers had significantly higher level of apo E than E3/E3, and E4/E3 carriers had significantly higher total cholesterol apo B and triglycerides than E3/E3 and E2/E3 carriers. The total cholesterol and apo B concentrations are significantly higher in women than in men but the triglycerides are lower. The apo A1 concentration is independent of both sex and apo E genotype. Thus, the results demonstrate an influence of apo E alleles on serum cholesterol, triglycerides, apo E and apo B concentrations among healthy Moroccan.