Gene expression profile following an oral unsaturated fat load in abdominal obese subjects.

PURPOSE: Our aim was to evaluate the postprandial effect of an oral fat load test (OFLT) rich in unsaturated fatty acids on gene expression profile in peripheral blood mononuclear cells (PBMC) from subjects with abdominal obesity as an insulin resistance model and controls. METHODS: A total of 20 controls and 20 abdominal obese patients were studied. Metabolic parameters and oxidative stress markers were measured with standardized protocols. The whole gene expression at fasting state and after the OFLT (0, 4 and 8 h) was analysed using human HT-12-v4 expression beadchips, from Illumina. RESULTS: We found a significant decrease in plasma glucose, insulin and oxidative stress markers in abdominal obese patients and controls. We found beneficial metabolic postprandial gene expression in three genes: FKBP5, DDIT4 and DHRS9. Following an OFLT, the postprandial mRNA expression of FKBP5, and DDIT4 was downregulated while that of DHRS9 was overexpressed, both in nondiabetic normolipidemic subjects and in insulin-resistant subjects with abdominal obesity. CONCLUSIONS: Our results suggest that an OFLT rich in unsaturated fatty acids downregulates the expression of FKBP5, coding for the glucocorticoid receptor pathway, and that of DDIT4, involved in the oxidative stress response. These changes could favourably influence the insulin resistance and oxidative stress status in the postprandial state.

[Hyperplasia of the pancreatic islets or nesidioblastosis in adults? Apropos 2 cases]. / Hiperplasia de islotes pancreáticos o nesidioblastosis del adulto? A propósito de dos casos.

Nesidioblastosis is an anatomopathological situation defined as the transformation or the exocrine ductal epithelium into endocrine tissue which can be hormonally active or inactive. In this study we present two cases which to our knowledge fulfil criteria for nesidioblastosis. Both patients were male (73 and 45 years, respectively) who were admitted to our department because they presented hypoglycemia. Blood examination revealed the existence of an hyperinsulinism although axial computerized tomography, pancreatic echocardiography and selective angiography of the celiac arterial trunk failed to demonstrate the presence of the tumor in either of the two cases. Due to the persistence of the clinical picture in the first case and to the intolerance to the diazoxide in the second patient, a subtotal pancreatectomy was performed in both cases. The surgical procedure involved removal of the 80% and 75% of the head and body respectively. Both patients are presently free of symptoms although the first patient in under diazoxide therapy due to persistent hypoglycemia (more spaced crisis).

[Cardiovascular risk factors in patients surviving a myocardial infarction]. / Factores de riesgo cardiovascular en pacientes sobrevivientes a infarto de miocardio.

We studied the risk factors of coronary disease in 52 patients (46 male and 6 female) survivors of myocardial infarction (MI). We found that a group of patients under 40 years old had predominant lipid alteration (100%) being hypercholesterolemia (CT greater than or equal to 260 mg/dl), the decrease of HDL-C levels (less than or equal to 35 mg/dl) and the increase of the atherogenic index (CT/HDL-C greater than or equal to 6) being the most frequent. At the same time, we observed an important association between several risk factors, such as tobacco consumption (58.5%), sedentary life (56.1%), lipid alterations (hypercholesterolemia: 46.3%, decrease of HDL-C: 41.4%, increase of atherogenic index: 60.9%) in the group of patients under 40 years old. These data show that the alterations of lipid metabolism are risk factors frequently observed in young patients with ischemic cardiac disease.