[PPAR alpha-L162V, frequency and relationship with type 2 diabetes among black Senegalese people]. / PPARalpha-L162V: fréquence et relation avec le diabète de type 2 dans une population noire sénégalaise.

PPARs are supposed to be involved in pathogenesis of diabetes and its complications. According to some authors, L162V PPARalpha gene polymorphism would be associated to dyslipidemia susceptibility during diabetes, whereas for some authors, it rather would confer resistance to these metabolic abnormalities. The aim of this study is to search the relationship between this polymorphism and the occurrence of diabetes and its complications within a Senegalese black population constituted of 261 diabetic and 128 controls, by comparing alleles frequencies. Genomic analysis for alleles identification has been performed by the allelic discrimination technic TaqMan 5' Nuclease, after DNA extraction (Nucleon Bacc2. Amersham Int.). The results of genetic variants analysis revealed that L162V PPARalpha polymorphism would not be present among Senegalese black population, and consequently, should not be involved in diabetes onset.

[Prevalence of antiphospholipid antibodies in patients with sickle cell disease]. / Prévalence des anticorps antiphospholipides au cours de la drépanocytose homozygote.

Structural abnormalities in erythrocyte membrane are more and more claimed as a determinant factor in the sickle cell disease pathogenesis. This being would have been provided by a new anionic phospholipids distribution and conformation. Phosphatidyl-serine exposing and phosphatidic acid enhancing would induce specific immunoglobulins synthesis. In this study, assessment of antiphospholipid antibodies prevalence was carried out among sickle cell trait patients (n = 35) and homozygous patients (n = 59) as compared to healthy subjects (n = 39). Antiphospholipid antibodies, assayed by ELISA procedure, were significantly higher among the homozygous patients than the sickle cell trait patients ones and highlighted as compared to healthy subjects. Pathologic data were only observed among homozygous patients. These specific antibodies, associated with thrombosis and haemolysis, would have constitute a morbid link and a therapeutic target of this sickness, dominated by homodynamic troubles.

[Dispersion of biochemical analysis results in Dakar: preliminary results]. / Etude de la dispersion des résultats d'analyses biochimiques à Dakar: résultats préliminaires.

Now and then, the conflicting character of results of some analyses is prejudicial to patients (financial and particullary psychological repercussions), to the laboratories (renown) and to the practitioners (difficulties of interpreting). After a study of the dispersion of some analyses results, the authors propose a creation of an Interlaboratory Quality Control in Clinical Biochemistry in Senegal.

[Biochemical profile of Senegalese women on oral contraceptives]. / Profil biochimique des femmes Sénégalaises sous contraceptifs oraux.

By its many advantages, pills are one of the most used methods in the world and in Senegal. On the other hand, exist side effects which can limit their utilization. Our study concern 35 women using between 12 and 36 months mini pills, which might produce low side effects. In our users, biochemical parameters are modified but not pathologic. By our results, we think that in the following 5 or 10 years, these alterations might increase; so, we raise the alarm and propose a biological following up of the oral contraceptive users.

[Phospholipid composition and content of the erythrocyte membrane in carriers of sickle cell trait]. / Contribution à l'étude de la composition et de la teneur en phospholipides de la membrane des hématies des sujets porteurs du trait drépanocytaire.

By its frequency, but also by its morbidity and mortality, sickle cell disease is a real problem of public health in Senegal. It is an inherited disease of the red blood cell, characterized by vaso-occlusive manifestations in several organs, and chronic hemolytic anemia. Out of this work carried upon subjects presenting sickle cell trait (AS), we especially studied the membrane phospholipids. The aims of this study was to identify and to measure the major phospholipids of the red blood cell membrane (lecithin, lysolecithin, cephalin, lysocephalin and sphingomyelin). We noted a significant decrease of the lecithine rates, associated with significant accumulation of lysophosphatidyl choline implied in hemolysis disorders. We have also noted a significant increase of sphingomyelin which might be involved in the adhesive phenomena of the sickle cells. These preliminary results, allow to consider eventual new therapeutics, at least to reduce the clinical disorders of this painful disease.

[Rational prescription if protein evaluation in the diagnosis and follow up of protein-energy malnutrition]. / Pour une prescription raisonnée du bilan protidique dans le diagnostic et la surveilance de la malnutrition protéino-énergétique.

In our countries, a good prescription of analysis would help to reduce hospital costs without modifying the efficiency of the diagnosis approach. In this work, the authors establish a bond between medicos and biologists by a good indication of protein check-up in the diagnosis and follow up of protein-energy malnutrition (PEM). After a discriminant analysis of all the results of protein check-up, two groups of markers are individualized depending on whether the PEM is accompanied or not by inflammatory complications. Finally, they recommend a systematic prescription of the useful group in case of inflammation associated with PEM, because infectious and parasitic diseases are almost constant among our malnourished infants.

[Protein profile of Senegalese children presenting with nephrotic syndrome]. / Particularités du profil protéique de l'enfant sénégalais présentant un syndrome néphrotique.

In Senegal, nephrotic syndrome usually occurs upon malnutrition that confers it its specificity and has brought us to establish the proteinic profile of Senegalese children suffering from it, in the aim to improve its treatment. Twenty children on the average of six years, hospitalized for nephrotic syndrome, were chosen. They were compared to 20 healthy children of the same age group, and 20 other children hospitalized for a non-renal inflammatory syndrome. For each subject were dosed total blood proteins and albumin. The protein electrophoresis has permitted to evaluate the alpha-1, alpha-2, beta and gamma globulins. We have observed predominance of boys with a 2.33 sex ratio. Our patients presenting a nephrotic syndrome were about six years old; no case has been noted before two years. Total proteins and albumin have decreased respectively to 52.10 g/l and 16 g/l. This diminishing is essentially linked to the massive urinary escape of plasmatic proteins and would explain partly the increase of lipids. The alpha-1 globulins were equally lowered but the alpha-2 globulins were increased by 40% of total proteins. Beta globulins have decreased, following the evolution of gamma globulins. In Senegal, The early age of nephrotic syndrome occurrence and the biological perturbations of the proteinic profile, recommend global and quick treatment considering food recovery and nutrition. The correction of these parameters being able to constitute in one hand an element of accessible and reliable supervision, and one the other hand the basis of complete treatment.

[Assessment of the level of urinary iodine deficiency in children of Senegalese central regions]. / Evaluation de la teneur en iode urinaire chez les enfants des régions centrales du Sénégal.

Iodine deficiency disorders (IDD) are a major public health problem in Senegal, where strategies of salt iodization were adopted in the southern and eastern regions. The aim of this study led in four districts (Koungheul, Bambey, Mekhe and Kebemer), was to estimate by a questionnaire, the women knowleges, attitudes and practices (KAP) concerning IDD, and to measure children urinary iodine excretion by the Sandell-Kolthoff method to assess a potential deficiency. Six hundred ninety eight households were selected covering 1336 women (age 15 to 49 years) and 400 children (age 6 to 12 years). Sixty three per cent of the women knew the goiter, 89% of them considered that it was a disease and only 0.6% knew the role of iodized salt in the treatment. On the other hand, 20% of the children presented a normal range of urinary iodine excretion superior to 100 microg/l, the deficiency was light (50 to 100 microg/l) in 38% of the children, moderate (25 to 50 microg/l) in 27% and severe (< 25 microg/l) in 15% of them. These results show that other Senegalese regions are concerned by iodine deficiency disorders and need information, education and iodine supplementation programmes, notably for children and young women.

[Phospholipid levels in exploration of cerebral atherosclerosis in African Senegalese population]. / Intérêt du dosage des phospholipides dans l'exploration de l'athérosclérose cérébrale en milieu africain Sénégalais.

In the investigation of atherosclerosis, cholesterol and its fractions, triglycerides and glucose are more tested than phospholipids. We were interested by this category of lipids in Senegalese suffering from cerebrovascular disease. We did not find differences between healthy and non healthy subjects for the total phospholipids; but the high density lipoprotein phospholipids were significantly lowered in non healthy subjects. This decrease might explain in part, the atherosclerosis strike. Practicians should pay more attention in this lipidic parameter, using the reference values established in Senegalese.

[Defects in peroxidation of erythrocyte phospholipids in sickle cell trait]. / Lésions péroxydatives des phospholipides érythrocytaires au cours de la drépanocytose AS.

The sickle cell disease pathophysiology is provided by several events including deoxyhemoglobin S polymerization and hemorrheological troubles. Classically, such disorders have been known to concern only the homozygous SS and heterozygous SC profiles. However, troubles are more and more described since early years in the sickle cell trait patients and the pathogenesis factors are unknown. Our study focussed on phospholipids which are the basic and functional constituent elements of erythrocyte plasmic membrane. Assaying the membrane lipids extracted by Folch method and lipid standards (cholesterol, phosphatidic acid, lysophosphatidyl-choline, phosphatidyl-choline, lysophosphatidyl-ethanolamine, phosphatidyl-ethanolamine, sphingomyelin) was carried out by HPLC among 91 sickle cell trait patients as compared to 78 healthy subjects. The main abnormalities observed were an empoverishement in phosphatidyl-choline contrasting with an accumulation of membrane lysophosphatidyl-choline, lysophosphatidyl-ethanolamine, phosphatidic acid and sphingomyelin in sickle cell patients. These results suggest that sickle cell trait harmlessness is not actual. The accumulation of lysophosphatidyl-choline, by its cytolytic biomembrane perturbing properties, predispose therefore the sickled red cell to the haemolysis phenomena and allow to forecast deeper disturbances among homozygous subjects. These morbid disorders attributable to lipid peroxidation would justify an antioxidant treatment during the sickle cell disease.

[Evaluation of erythrocyte deformability in subjects with sickle cell trait during a soccer game: effect of hydration ad libitum]. / Évaluation de la déformabilité érythrocytaire des sujets porteurs de trait drépanocytaire au cours d'un match de football : effet de l'hydratation ad libitum.

This study compared erythrocyte changes between a group of subjects with sickle cell trait (SCT) and controls (subjects without hemoglobinopathy) during a soccer game in two conditions: with and without hydration. Erythrocyte deformability of subjects was assessed by the coefficient of erythrocyte rigidity (Tk) which was calculated before and after football match. Our results showed a significant increase in erythrocyte rigidity (Tk) in SCT at the end of physical activities without hydration; however when water was provided ad libitum their Tk decreased significantly, reaching values of controls. And adequate hydration is recommended in subjects with sickle cell trait during and after exercise.

Lipid peroxidation abnormalities in hemodialyzed patients.

In order to test the existence of a possible oxidative damage during hemodialysis, plasma conjugated dienes (CD), plasma and red blood cell (RBC) thiobarbituric acid (TBA) reactants were investigated in 25 patients receiving regular dialysis treatment (RDT). The RBC TBA reactant concentration was significantly increased in RDT patients in comparison with healthy subjects. The extracellular antioxidant systems were evaluated by the assay of plasma antioxidant activity, plasma tocopherol, urate, transferrin, haptoglobin and ceruloplasmin levels. Except urate and transferrin, none of these parameters were different between the two groups. On the other hand, in RDT patients, RBC superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities were significantly lower than in healthy subjects. There was an inverse correlation between decreased RBC GPX and RBC TBA reactant concentration. These results show in RDT patients the existence of an oxidizing stress, mainly intracellular, which could be due, in part, to a decrease in SOD and GPX activities.