Sex-specific fat mass ratio cutoff value identifies a high prevalence of cardio-metabolic disorders in people living with HIV.

BACKGROUND AND AIMS: HIV-associated lipodystrophy syndrome (HALS) contributes to the increased cardiovascular risk connoting people living with HIV (PLHIV). HALS recognition, based on clinical ground, may be inaccurate urging an objective instrumental diagnosis. The aim of this study is to search for the DXA-derived fat mass ratio (FMR) threshold, among those suggested for the diagnosis of HALS, able to identify PLHIV at high cardiovascular risk. METHODS AND RESULTS: In a cross-sectional analysis of 101 PLHIV (age 53 ± 11 years, men 55%) and 101 age- and sex-matched uninfected controls, DXA-derived FMR and anthropometric as well as cardio-metabolic parameters were assessed. PLHIV showed a higher FMR (1.15 ± 0.42 vs 0.95 ± 0.18, p < 0.01) together with a greater cardio-metabolic derangement than controls, in spite of lower BMI (24.3 ± 4.3 vs 26.9 ± 4.0 kg/m2, p < 0.01) and fat mass index (FMI, 6.6 ± 3.0 vs 9.2 ± 3.1 kg/m2, p < 0.01). Particularly, PLHIV with HALS (n = 28), defined as those with a FMR above 1.260 and 1.329 for men and women, respectively, had a greater prevalence of type 2 diabetes mellitus (18% vs 1%), insulin resistance (68% vs 27%), hypertriglyceridemia (50% vs 29%), hypertension (61% vs 30%) and metabolic syndrome (32% vs 10%) than those without HALS (p < 0.05 for all comparisons) and controls. At multivariate analyses, FMR in PLHIV was significantly associated (p < 0.05) with fasting glucose (ß [95%CI] = 0.5, [0.1-0.9]), insulin (44.6, [14.9-74.2]), HOMA-IR (1.6, [0.5-2.7]), triglycerides (1.0, [ 0.2-1.8]) and HDL-cholesterol (-2.1, [-3.9/-0.4]) levels. CONCLUSION: Sex-specific FMR thresholds, proposed for diagnosis of HALS, could represent new indices of cardio-metabolic derangement in PLHIV.

Correlation between pancreatic islet uncoupling protein-2 (UCP2) mRNA concentration and insulin status in rats.

Hypothesizing that UCP2 may influence insulin secretion by modifying the ATP/ADP ratio within pancreatic islets, we have investigated the expression of intraislet UCP2 gene in rats showing insulin oversecretion (non-diabetic Zucker fa/fa obese rats, glucose-infused Wistar rats) or insulin undersecretion (fasting and mildly diabetic rats). We found that in Zucker fa/fa obese rats, hyperinsulinemia (1222+/-98 pmol/l vs. 128+/-22 pmol/l in lean Zucker rats) was accompanied by a significant increase in UCP2 mRNA levels. In rat submitted to a 5 day infusion with glucose, hyperinsulinemia (1126+/-101 pmol/l vs. 215+/-25 pmol/l in Wistar control rats), coincided with an enhanced intraislet UCP2 gene expression, whereas a 8h or a 2 day-infusion did not induce significant changes in UCP2 mRNA expression. In rats made hypoinsulinemic and mildly diabetic by the injection of a low dose of streptozotocin, and in 4-day-fasting rats (plasma insulin 28+/-5 pmol/l) UCP2 gene expression was sharply decreased. A 3-day-fast was ineffective. The data show the existence of a time-dependent correlation between islet mRNA UCP2 and insulin that may be interpreted as an adaptative response to prolonged insulin excess.

[The inter-metacarpo-phalangeal spaces]. / Etude des espaces inter-métacarpo-phalangiens.

The study of the inter-metacarpophalangeal spaces on 20 human bodies raises the question of the existence of bursae at this level, in line with recent studies (BOSSEY, MIDY) suggesting that such bursae are present at the level of the foot. Careful dissection and histological studies revealed characteristics compatible with both of the following hypotheses: either there are bursae not described until now in anatomy textbooks, or these are virtual spaces limited by a cul-de-sac of the aponeuroses of the hand in the 2nd, 3rd and 4th spaces. Tissue analysis that could determine more specifically the nature of the limiting membrane of these spaces, as well as pathological studies demonstrating the occurrence of common anomalies of bursae in these spaces, are required in order to conclude definitively on the nature of the inter-metecarpophalangeal spaces.

[Contents of the transversal foramen of the seventh cervical vertebra]. / Le contenu du trou transversaire de la septième vertèbre cervicale.

The purpose of our study was to evaluate the individual variations of the foramen sometimes has the same dimensions as the foramen of the other cervical vertebrae, but it can also be smaller, or absent. In cases where the foramen is present in the seventh cervical vertebra, vascular or nerve structures (or both) can be occasionally observed within. When the transverse foramina are found to contain none of the above structures, what then is to be found within this space? According to our results, the transverse foramina of the seventh cervical vertebra almost universally contain vascular and nerve branches as well as fibrous and adipose tissue. This report concerns the results of the macroscopic and microscopic studies concerning the contents of the transverse foramina of the seventh cervical vertebra.

A comparative study of the spaces between the metacarpal and metatarsal heads.

The study of the spaces between the metacarpal heads on 23 cadavers, raises the question of the existence of bursae at this level. This is in line with recent studies suggesting that such bursae are present at this level in the foot. Careful dissection and histological studies revealed characteristics compatible with both of the following hypotheses: either the existence of bursae not described until now in anatomy text-books, or spaces limited by a cul-de-sac of the aponeuroses of the hand in the 2nd, 3rd and 4th digits. Tissue analyses that could determine more specifically the nature of the limiting membrane of these spaces, as well as pathological studies demonstrating the occurrence of common anomalies of bursae in these spaces, are required in order to conclude definitively the nature of the spaces between the metacarpal heads. The gross anatomical and histological characteristics of the spaces between the metacarpal and metatarsal heads and of their limiting membranes were compared and found to be analogous in our series.