Increased plasminogen activator inhibitor activity in non insulin dependent diabetic patients--relationship with plasma insulin.

Type 2 diabetic patients are known to frequently have a high insulin level and were recently described as having high plasminogen activator inhibitor (PAI) activity, compared to normal controls. As we have shown in several clinical conditions (normal subjects, obese patients, angina pectoris patients) that plasma PAI activity was linked with plasma insulin, we have studied in 38 type 2 diabetic patients the relationship between PAI activity, insulin and other parameters. Patients showed higher level of PAI activity, as well as plasma glucose, insulin, triglyceride, cholesterol and Apolipoprotein B levels than normal controls; highest values were observed with diabetic patients also affected by coronary artery disease. A significant correlation was found between PAI activity and insulin (r = 0.60, p less than 0.001), body mass index (r = 0.32, p less than 0.05) and Apolipoprotein B (r = 0.33, p less than 0.05). The two latter correlations disappeared after adjustment for insulin. These results are in agreement with our previous report showing an in vitro effect of insulin on the synthesis of PAI by a hepatocellular cell line. Hyperinsulinemia presented by type 2 diabetic patients may increase the hepatic synthesis of PAI, inducing an hypofibrinolysis, which could play a role in the development of the vascular complications. Attempts to reduce hyperinsulinemia could have a favorable effect by lowering PAI activity.

Enzyme secretion by human endothelial cells infected with Rickettsia conorii.

When cultured endothelial cells from the human umbilical vein were infected with rickettsia conorii, a greater increase was noticed in the inhibitor of plasminogen activator than in tissue type plasminogen activator. This could be linked to clinical observation of coagulation abnormalities in Boutonneuse fever (BF). Otherwise, transaminase levels increased significantly in the supernatant of R. conorii infected endothelial cells which could explain the increased levels of these enzyme in BF.

[Comparative study of LpAI lipoparticles, HDL cholesterol and apolipoprotein AI in a control population, in a group of subjects with coronary diseases, and in a group of subjects with angiographically normal coronary vessels]. / Etude comparative des lipoparticules LpAI, du cholestérol HDL et de l'apoprotéine AI, dans une population témoin, dans un groupe de sujets coronariens, et dans un groupe de sujets à coronaires angiographiquement normales.

A new method for directly measuring LpAI lipoparticles containing apolipoprotein AI, but not apolipoprotein AII, is now disponible for laboratories. Concentrations of LpAI were measured in serum from 158 presumably healthy normolipidemic subjects (72 male, 86 female), for the age group 30-60 years. Concentrations of LpAI were also measured in subjects with angiographically defined coronary artery disease (coro+) and without angiographically defined coronary artery disease (coro-). After comparison of the groups, lipoprotein particle LpAI did not appear to be a better discriminative marker than HDL cholesterol or apolipoprotein AI for atherogen risk.

[Lipid indicators of vascular risk. A cross-sectional study of a group of coronary patients, a group of subjects with normal coronary angiography and a control group]. / Les marqueurs lipidiques du risque vasculaire. Etude transversale d'un groupe d'hommes coronariens, d'un groupe à coronaires angiographiquement normales et d'un groupe témoin.

During a transverse survey, 3 groups of men with the same weight and age were compared. Group I included 42 patients with coronary disease documented by coronarography, group 2 included 19 subjects with normal coronary angiograms, and group 3 included 27 healthy controls who had not undergone coronarography. Subjects presenting diabetes or any factor associated with secondary dyslipidemia or able to modify lipid levels were excluded from study. The following parameters were measured: total cholesterol (Chol), triglycerides (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), apoprotein A1 (apoA1), apoprotein B (apoB), lipoprotein (a) or Lp(a), fibrinogen, insulinemia and plasminogen activator inhibitor activity (PAI). The levels of chol, LDL-C and ApoB were the same in the 3 groups. The levels of TG, HDL-C, apoA1 and the ApoA-1/APoB ratio were significantly different between groups 1 and 2, on the one hand, and groups 1 and 3, on the other hand. The levels of Lp(a) and insulin were similar in the 3 groups. Fibrinogen levels were slightly higher in group 1 than in group 3. There was no significant difference between groups 1 and 2 with regard to any of the parameters. Subjects with angiographically normal coronary arteries and subjects with documented coronary disease exhibited similar lipid abnormalities. In this study, TG, HDL-chol, apoA1 and the apoB ratio were better predictors of cardiovascular risk than Chol, LDL-C or apoB.

[Minimal lipid anomalies in a group of men with early coronary disease compared to a control group]. / Anomalies lipidiques minimes dans un groupe d'hommes coronariens précoces comparé à un groupe témoin.

A group of 27 men with early coronary disease (mean age: 52 years) with cholesterol levels below 6.45 mmol/l and triglycerides levels below 2.3 mmol/l, who underwent a coronary angiography, is compared with a control group of 18 men (CG) with normal angiography. The only significant differences between the two groups are: a triglycerides levels slightly higher in the CM group (1.55 + 0.4 mmol/l) vs 1.18 +/- 0.37 mmol/l, p 0.001), a HDL-cholesterol level slightly lower in the CM group (1.08 +/- 0.19 mmol/l vs 1.26 +/- 0.21 mmol/l, p 0.01) and an Apo AI/Apo B ratio slightly lower in the CM group (1.02 +/- 0.24 vs 1.18 +/- 0.17, p 0.005). In the CM group, 21 patients in 27 present a lipid abnormality requiring, according to the European consensus recommendations, the prescription of hygieno-dietetic measures. In the CM group, 10 patients in 18 present a minimal lipid abnormality, also requiring hygieno-dietetic measures. These results are compared with the recommendations of the European consensus.

Is the HpO phenomenon in tropical populations really genetic?

Long-term studies of 98 unselected adults from a rural African community in Mali where malaria is endemic showed that the haptoglobin level of the blood increased significantly after 1 year of continuous anti-malarial treatment. This seems to indicate that hypo- or anhaptoglobinaemia in populations like this may in a considerable number of cases have a non-genetic basis.

Endemic goiter in Morocco (Skoura-Toundoute areas in the high atlas).

Endemic goiter in Morocco is localized in the Rif and Atlas mountains. In this study, performed in the Skoura-Toundoute areas (high Atlas), we demonstrate that iodine deficiency is the main factor involved in the development of endemic goiter. However it may not constitute the only etiological factor. The median urinary iodine excretion, measured on untimed samples, was low both in goitrous patients, m = 18 micrograms/l (n = 109) and in non goitrous subjects, m = 24 micrograms/l (n = 47). The value found in a nonendemic region (Casablanca) was much higher m = 117 micrograms/l (n = 67). Another approach to evaluate iodine intake per day was the analysis of iodine content of some samples of cereals (barley, wheat and corn), drinking water, sea and rock salt, cow and breast milk. Iodine content is low, specially in the endemic area: barley = 90 micrograms/kg (n = 1); wheat = 227 micrograms/kg (n = 1); corn = 91 micrograms/kg (n = 1); water = 0.92 to 1.30 micrograms/l (n = 3); cow milk = 6 to 33 micrograms/l (n = 10) breast milk = 10 to 55 micrograms/l (n = 14); rock salt = 420 to 660 micrograms/kg (n = 8); sea salt = 90 to 160 micrograms/kg (n = 4). Sodium chloride intake per day, estimated by the measurement of sodium and chloride urinary excretion, is normal both in the Skoura-Toundoute areas (10.7 g and 9.8 g for goitrous and nongoitrous subjects, respectively) and in Casablanca (10.9 g for control persons). Altogether the results demonstrate the importance of introducing the practice of iodinated salt in the prophylaxis of endemic goiter in this area.

Pericentric inversion, inv(9) (p22 q32), in the father of a child with a duplication-deletion of chromosome 9 and gene dosage effect for adenylate kinase-1.

A pericentric inversion of chromosome 9 was detected in the father of a child with partial trisomy involving the long arms and partial monosomy of the short arms of chromosome 9. A gene dosage effect was demonstrated for adenylate kinase 1 in erythrocytes.

Clinical, enzyme, and cytogenetic investigations in three new cases of trisomy 8p.

Three new cases of partial trisomy of the chromosome 8 short arm are reported. The observations confirm and extend certain clinical, enzyme, and chromosomal data in this type of chromosomal anomaly.

[Partial trisomy 21]. / Trisomie 21 partielle.

Three mentally retarded children with partial trisomy 21 who looked like children with complete trisomy 21 had increased activity of superoxide dismutase A. This emphases the pathogenic role of the 21q22 band in this condition.

Malaria and anemia of pregnancy in an African savanna zone. Epidemiological, hematological, biological and immunological study of 2 villages of the Bamako region, Republic of Mali. / Paludisme et anémie de la grossesse en zone de savane africaine. Etude épidémiologique, hématologique, biologique et immunologique dans deux villages de la région de Bamako, République du Mali.

An haematological, biological, parasitological and immunological study about anaemia of pregnancy was carried out in two rural village of Mali Republic, where P. flaciparum malaria is hyper-endemic. The 25 pregnant women found in the villages were compared with 23 controls. One could observe that anaemia more often normochromic and regenerative usually appears during the second trimestre of pregnancy. Only a few cases with haemaglobin levels below 8 g. % are hypochromic. Serum transferrin levels were slightly higher among pregnant. None among 31 bone marrows examined showed megaloblastic changes. Haptoglobin levels below 10 mg. % were observed in 3/4 of the pregnant women versus 1/4 in controls. Like some others, this study confirms the primary responsability of malaria haemolysis in the aetiology of anaemia of pregnancy and the interest of systematic chemoprophylaxis, at least from the third month of pregnancy. Vitamin and iron therapy is to consider therafter in hyper-endemic areas of P. falciparum malaria when nutritional problems are not predominant.