Directional dominance on stature and cognition in diverse human populations.

Homozygosity has long been associated with rare, often devastating, Mendelian disorders, and Darwin was one of the first to recognize that inbreeding reduces evolutionary fitness. However, the effect of the more distant parental relatedness that is common in modern human populations is less well understood. Genomic data now allow us to investigate the effects of homozygosity on traits of public health importance by observing contiguous homozygous segments (runs of homozygosity), which are inferred to be homozygous along their complete length. Given the low levels of genome-wide homozygosity prevalent in most human populations, information is required on very large numbers of people to provide sufficient power. Here we use runs of homozygosity to study 16 health-related quantitative traits in 354,224 individuals from 102 cohorts, and find statistically significant associations between summed runs of homozygosity and four complex traits: height, forced expiratory lung volume in one second, general cognitive ability and educational attainment (P < 1 × 10(-300), 2.1 × 10(-6), 2.5 × 10(-10) and 1.8 × 10(-10), respectively). In each case, increased homozygosity was associated with decreased trait value, equivalent to the offspring of first cousins being 1.2 cm shorter and having 10 months' less education. Similar effect sizes were found across four continental groups and populations with different degrees of genome-wide homozygosity, providing evidence that homozygosity, rather than confounding, directly contributes to phenotypic variance. Contrary to earlier reports in substantially smaller samples, no evidence was seen of an influence of genome-wide homozygosity on blood pressure and low density lipoprotein cholesterol, or ten other cardio-metabolic traits. Since directional dominance is predicted for traits under directional evolutionary selection, this study provides evidence that increased stature and cognitive function have been positively selected in human evolution, whereas many important risk factors for late-onset complex diseases may not have been.

Switch to etravirine for HIV-positive patients receiving statin treatment: a prospective study.

BACKGROUND: Lifestyle changes and statins are the cornerstones in management of dyslipidaemia in patients with HIV infection. Replacement of an antiretroviral therapy (ART) component is a proposed therapeutic strategy to reduce cardiovascular risk. In dyslipidaemic patients with HIV infection, we assessed the efficacy of replacing boosted protease inhibitor (bPI) or efavirenz (EFV) by etravirine (ETR) as an alternative to statin therapy. MATERIALS AND METHODS: A prospective, open-label, multicentre, 12-week study of patients with HIV infection on ART including bPI or EFV, and statin treatment. Four weeks after statin interruption, bPI or EFV was switched to ETR (400 mg, 8 weeks) if serum low-density lipoprotein cholesterol (LDL-C) was ≥ 3 mM. The primary endpoint was the proportion of patients on ETR with no indication for statin treatment at study completion. Serum levels of HIV RNA, lipids and biomarkers of cardiovascular disease were also measured. (ClinicalTrials.gov: NCT01543035). RESULTS: The 31 included patients had a HIV-1 RNA < 50 copies/mL (median age, 52 years; median CD4, 709 cell/mL; median LDL-C, 2·89 mM), 68% were on EFV, and 32% were on bPI. At week 4, 27 patients switched to ETR. At study completion, 15 patients (56%) on ETR did not qualify for statin treatment. After the ETR switch, serum levels of the cardiovascular biomarkers sICAM and MCP1/CCL2 decreased by 11·2% and 18·9%, respectively, and those of CCL5/RANTES and tissue inhibitor of metalloproteinase-1 increased by 14·3% and 13·4%, respectively, indicating reduced cardiovascular risk. There were no notable treatment-related adverse events. CONCLUSIONS: Replacing bPI or EFV by ETR is a viable strategy to obviate primary prevention statin treatment.

Five year trends in dyslipidaemia prevalence and management in Switzerland: The CoLaus study.

BACKGROUND AND AIMS: Data from prospective cohorts describing dyslipidaemia prevalence and treatment trends are lacking. Using data from the prospective CoLaus study, we aimed to examine changes in serum lipid levels, dyslipidaemia prevalence and management in a population-based sample of Swiss adults. METHODS AND RESULTS: Cardiovascular risk was assessed using PROCAM. Dyslipidaemia and low-density lipoprotein cholesterol (LDL-C) target levels were defined according to the Swiss Group for Lipids and Atherosclerosis. Complete baseline and follow up (FU) data were available for n = 4863 subjects during mean FU time of 5.6 years. Overall, 32.1% of participants were dyslipidaemic at baseline vs 46.3% at FU (p < 0.001). During this time, lipid lowering medication (LLM) rates among dyslipidaemic subjects increased from 34.0% to 39.2% (p < 0.001). In secondary prevention, LLM rates were 42.7% at baseline and 53.2% at FU (p = 0.004). In multivariate analysis, LLM use among dyslipidaemic subjects, between baseline and FU, was positively associated with personal history of CVD, older age, hypertension, higher BMI and diabetes, while negatively associated with higher educational level. Among treated subjects, LDL-C target achievement was positively associated with diabetes and negatively associated with personal history of CVD and higher BMI. Among subjects treated at baseline, LLM discontinuation was negatively associated with older age, male sex, smoking, hypertension and parental history of CVD. CONCLUSIONS: In Switzerland, the increase over time in dyslipidaemia prevalence was not paralleled by a similar increase in LLM. In a real-life setting, dyslipidaemia management remains far from optimal, both in primary and secondary prevention.

Serum biochemistry of 4-day-old ostriches (Struthio camelus)

An analysis was made of 30 four-day-old ostriches to evaluate their protein, metabolite, mineral, and serum enzyme profiles, to correlate them with the birds' sex. The values obtained were: Total proteins 3.59±0.72g/dL, albumin 1.04±0.14g/dL, globulins 2.51±0.56g/dL, A:G ratio 0.43± 0.07, total cholesterol 615.10±101.15mg/dL, high density lipoprotein cholesterol (HDL-C) 132.72±20.33mg/dL, low density lipoprotein cholesterol (LDL-C) 454.93±90.81mg/dL, very low density lipoprotein cholesterol (VLDL-C) 27.45±9.96mg/dL, triglycerides 137.23±49.78mg/dL, uric acid 6.24±2.15mg/dL, urea 18.27±12.33mg/dL, creatinine 0.30±0.04mg/dL, total calcium 9.38± 0.76mg/dL, ionized calcium 7.17±0.64mg/dL, phosphorus 6.96±0.91mg/dL, Ca:P ratio 1.37±0.21, iron 24.74±13.02µg/dL, sodium 142.03±6.17mEq/L, chlorides 109.59± 4.99mEq/L, aspartate aminotransferase (AST) 200.67±31.42 U/L, alanine aminotransferase (ALT) 3.90±1.92 U/L, γ-glutamyltransferase (GGT) 1.18±0.73 U/L, alkaline phosphatase (ALP) 597.30± 231.36 U/L, and creatine kinase (CK) 2348.30±755.60 U/L. Males and females showed significant differences in total proteins, globulins, alkaline phosphatase, A:G ratio, and uric acid.

Depressive symptoms and C-reactive protein in a Brazilian urban community

Psychological depression is an independent risk factor for coronary artery disease. C-reactive protein has been implicated as a mediator of the effect of psychological depression. Several studies have found that individuals, especially men, who report higher levels of psychological depression also have higher levels of C-reactive protein. The current study was undertaken to replicate these results in a Brazilian population, in which there is a much wider range of variation in both background characteristics (such as socioeconomic status) and coronary artery disease risk factors. A sample of 271 individuals was interviewed using the Center for Epidemiological Studies Depression Scale. Fasting blood samples were obtained and evaluated for C-reactive protein (assessed by a turbidimetric immunoassay using a Dade Behring kit) analysis in a subsample (N = 258) of individuals. The mean ± SD C-reactive protein for the entire sample was 0.43 ± 0.44, with 0.42 ± 0.48 for men and 0.43 ± 0.42 mg/L for women. Data were analyzed using multiple regression analysis, controlling for age, sex, body mass index, socioeconomic status, tobacco use, and both total cholesterol and low-density lipoprotein cholesterol. Higher reported depressive symptoms were correlated with higher C-reactive protein for men (partial r = 0.298, P = 0.004) and with lower C-reactive protein for women (partial r = -0.154, P = 0.059). The differences in the associations for men and women could be a result of differential effects of sex hormones on stress reactivity and immune response. On the other hand, this difference in the associations may be related to gender differences in the disclosure of emotion and the effect that self-disclosure has on physical health and immune response.

Association of ApoE polymorphisms with prevalent hypertension in 1406 older adults: the Bambuí Health Aging Study (BHAS)

Apolipoprotein E (ApoE) polymorphism influences lipid metabolism, but its association with arterial hypertension is controversial. The objective of this study was to examine the association between ApoE polymorphism and prevalent hypertension in a large unselected population of older adults. Participants from the baseline of the Bambuí Health Aging Study whose ApoE genes had been genotyped were selected for this study (N = 1406, aged 60-95 years). These subjects represented 80.7% of the total elderly residents in Bambuí city, MG, Brazil. Hypertension was defined as a systolic blood pressure ³140 mmHg and/or a diastolic blood pressure ³90 mmHg, or the use of anti-hypertensive medication. The exposure variable was the ApoE genotype as follows: e3 carriers, e3e3; e2 carriers, e2e2 or e2e3, and e4 carriers, e3e4 or e4e4. Potential confounding variables were age, gender, traditional cardiovascular risk factors, uric acid, and creatinine levels. The prevalence of hypertension was 61.3%. Compared with the e3 homozygotes, neither the e2 nor the e4 carrier status was associated with hypertension (adjusted prevalence ratios = 0.94, 95%CI = 0.83-1.07 and 0.98, 0.89-1.07, respectively). On the other hand, the e2 allele carriers had lower LDL cholesterol levels (P < 0.001) and the e4 carriers had higher LDL cholesterol levels (P = 0.036). This study provides epidemiologic evidence that the ApoE genotype is not associated with prevalent hypertension in old age.

Association between apolipoprotein E genotype, serum lipids, and colorectal cancer in Brazilian individuals

We evaluated genetic variants of apolipoprotein E (APOE HhaI) and their association with serum lipids in colorectal cancer (CRC), together with eating habits and personal history. Eight-seven adults with CRC and 73 controls were studied. APOE*2 (rs7412) and APOE*4 (rs429358) were identified by polymerase chain reaction-restriction fragment length polymorphism. APOE gene polymorphisms were similar in both groups, but the ε4/ε4 genotype (6%) was present only in controls. The patients had reduced levels (mean ± SD) of total cholesterol and low-density lipoprotein cholesterol fraction (180.4 ± 49.5 and 116.1 ± 43.1 mg/dL, respectively) compared to controls (204.2 ± 55.6, P = 0.135 and 134.7 ± 50.8 mg/dL; P = 0.330, respectively) indicating that they were not statistically significant after the Bonferroni correction. The APOE*4 allele was associated with lower levels of total cholesterol, low- and high-density lipoprotein cholesterol fraction and increased levels of very low-density lipoprotein cholesterol fraction and triglycerides only among patients (P = 0.014). There was a positive correlation between the altered lipid profile and increased body mass indexes in both groups (P < 0.010). Moreover, a higher rate of hypertension and overweight was observed in controls (P < 0.002). In conclusion, the presence of the ε4/ε4 genotype only in controls may be due to a protective effect against CRC. Lower lipid profile values among patients, even those on lipid-rich diets associated with the APOE*4 allele, suggest alterations in the lipid synthesis and metabolism pathways in CRC.

Association of CYP7A1 -278A>C polymorphism and the response of plasma triglyceride after dietary intervention in dyslipidemic patients

We investigated the effect of the -278A>C polymorphism in the CYP7A1 gene on the response of plasma lipids to a reduced-fat diet for 6 to 8 weeks in a group of 82 dyslipidemic males with a mean age of 46.0 ± 11.7 years. Individuals who presented at least one high alteration in total cholesterol, low-density lipoprotein cholesterol or triglyceride values were considered to be dyslipidemic. Exclusion criteria were secondary dyslipidemia due to diabetes mellitus, renal, liver, or thyroid disease. None of the subjects were using lipid-lowering medication. Baseline and follow-up lipid concentrations were measured. The genotypes were determined by the digestion of PCR products with the BsaI restriction endonuclease. There were statistically significant reductions in plasma total cholesterol, low-density lipoprotein cholesterol and triglyceride concentrations after dietary intervention. The minor allele C has a frequency of 43%. Carriers of the C allele had significantly lower triglyceride concentrations (P = 0.02) than AA homozygotes. After adjustment of covariates, subjects with the AC and CC genotypes showed a greater reduction in triglyceride concentrations compared to subjects with the AA genotype. Multiple linear regression analyses showed that the AC and CC CYP7A1 genotypes accounted for 5.2 and 6.2% of triglyceride concentration during follow-up and adjusted percent of change of triglyceride concentration, respectively. The present study provides evidence that -278A>C polymorphism in the CYP7A1 gene can modify triglyceride concentrations in response to a reduced fat diet in a dyslipidemic male population. This gene represents a potential locus for a nutrigenetic directed approach.

Changes in the hormone and lipid profile of obese adolescent Saudi females with acne vulgaris

Acne vulgaris is a multifactorial disease affecting a majority of the adolescent population. The objective of this study was to test for a correlation between fasting serum lipid profiles and levels of testosterone, insulin, leptin, and interleukin 1-β (IL-1β) and the incidence of severe acne vulgaris in obese adolescent females. Four groups of adolescent females were studied: obese with acne, obese without acne, non-obese with acne, and non-obese without acne. Obese females with acne, compared to obese females without acne and non-obese subjects, had significantly higher serum triglycerides, low-density lipoprotein cholesterol and apolipoprotein-B (apo-B) (mean ± SD: 197 ± 13.7 vs 171 ± 11.5, 128 ± 8.3 vs 116 ± 7.7, 96 ± 13.7 vs 85 ± 10.3 mg/dL, respectively) but significantly lower high-density lipoprotein cholesterol and apo-A1 levels (40 ± 3.3 vs 33 ± 3.5 and 126 ± 12 vs 147 ± 13 mg/dL). Serum testosterone, insulin and leptin levels were significantly higher in obese subjects with or without acne compared to non-obese females with or without acne (3 ± 0.5 vs 2.1 ± 0.47, 15.5 ± 3.3 vs 11.6 ± 3, 0.9 ± 0.2 vs 0.6 ± 0.15 nmol/mL, respectively). Serum IL-1b was significantly elevated in obese and non-obese subjects with acne compared to subjects without acne; in those without acne, these levels were higher in obese than non-obese subjects (2.4 ± 0.2, 1.4 ± 0.1 vs 1.8 ± 0.12 and 1.3 ± 0.11 pg/mL, respectively). Our results indicate that there is a relationship between obesity (BMI >27) and acne. By early recognition, the etiology and treatment protocol of acne may prevent unwanted conditions.

A high-carbohydrate diet enhances the adverse effect of the S2 allele of APOC3 SstI polymorphism on the TG/HDL-C ratio only in young Chinese females

Both genetic background and diet have profound effects on plasma lipid profiles. We hypothesized that a high-carbohydrate (high-CHO) diet may affect the ratios of serum lipids and apolipoproteins (apo) differently in subjects with different genotypes of the SstI polymorphism in the apoCIII gene (APOC3). Fifty-six healthy university students (27 males and 29 females, 22.89 ± 1.80 years) were given a washout diet of 54% carbohydrate for 7 days, followed by a high-CHO diet of 70% carbohydrate for 6 days without total energy restriction. Serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apoB100, apoAI, and the APOC3 SstI polymorphism were analyzed. The ratios of serum lipids and apoB100/apoAI were calculated. At baseline, the TG/HDL-C ratio was significantly higher in females, but not in males, with the S2 allele. The differences in the TG/HDL-C ratio between genotypes remained the same after the washout and the high-CHO diet in females. When compared with those before the high-CHO diet, the TC/HDL-C (male S2 carriers: 3.13 ± 1.00 vs 2.36 ± 0.65, P = 0.000; male subjects with the S1S1 genotype: 2.97 ± 0.74 vs 2.09 ± 0.55, P = 0.000; female S2 carriers: 2.68 ± 0.36 vs 2.24 ± 0.37, P = 0.004; female subjects with the S1S1 genotype: 2.69 ± 0.41 vs 2.09 ± 0.31, P = 0.000) and LDL-C/HDL-C (male S2 carriers: 1.44 ± 0.71 vs 1.06 ± 0.26, P = 0.012; male subjects with the S1S1 genotype: 1.35 ± 0.61 vs 1.01 ± 0.29, P = 0.005; female S2 carriers: 1.18 ± 0.33 vs 1.00 ± 0.18, P = 0.049; female subjects with the S1S1 genotype: 1.18 ± 0.35 vs 1.04 ± 0.19, P = 0.026) ratios were significantly decreased after the high-CHO diet regardless of gender and of genotype of the APOC3 SstI polymorphism. However, in female S2 carriers, the TG/HDL-C (1.38 ± 0.46 vs 1.63 ± 0.70, P = 0.039) ratio was significantly increased after the high-CHO diet. In conclusion, the high-CHO diet has favorable effects on the TC/HDL-C and LDL-C/HDL-C ratios regardless of gender and of genotype of the APOC3 SstI polymorphism. Somehow, it enhanced the adverse effect of the S2 allele on the TG/HDL-C ratio only in females.

Genetic association of SNPs in the FTO gene and predisposition to obesity in Malaysian Malays

The common variants in the fat mass- and obesity-associated (FTO) gene have been previously found to be associated with obesity in various adult populations. The objective of the present study was to investigate whether the single nucleotide polymorphisms (SNPs) and linkage disequilibrium (LD) blocks in various regions of the FTO gene are associated with predisposition to obesity in Malaysian Malays. Thirty-one FTO SNPs were genotyped in 587 (158 obese and 429 non-obese) Malaysian Malay subjects. Obesity traits and lipid profiles were measured and single-marker association testing, LD testing, and haplotype association analysis were performed. LD analysis of the FTO SNPs revealed the presence of 57 regions with complete LD (D’ = 1.0). In addition, we detected the association of rs17817288 with low-density lipoprotein cholesterol. The FTO gene may therefore be involved in lipid metabolism in Malaysian Malays. Two haplotype blocks were present in this region of the FTO gene, but no particular haplotype was found to be significantly associated with an increased risk of obesity in Malaysian Malays.

Effects of rosiglitazone on serum paraoxonase activity and metabolic parameters in patients with type 2 diabetes mellitus

Human serum paraoxonase contributes to the anti-atherogenic effect of high-density lipoprotein cholesterol (HDL-C) and has been shown to protect both low-density lipoprotein cholesterol (LDL-C) and HDL-C against lipid peroxidation. We investigated the effects of rosiglitazone on paraoxonase activity and metabolic parameters in patients with type 2 diabetes mellitus [50 patients (30 males, 20 females); mean±SD age: 58.7±9.2 years, body mass index: 28.2±4.1'kg/m2], in whom glucose control could not be achieved despite treatment with metformin, sulphonylurea, and/or insulin. The patients were given 4'mg/day rosiglitazone for 3 months in addition to their usual treatment. Serum paraoxonase activity, malondialdehyde, homocysteine, and lipid profile were measured at the time of initiation and at the end of therapy with rosiglitazone. After rosiglitazone therapy, serum levels of HDL-C, apolipoprotein A-1, and paraoxonase activity increased significantly (P<0.05) and malondialdehyde, homocysteine, lipoprotein(a), and glucose levels decreased significantly (P<0.05), but no significant changes in levels of total cholesterol and apolipoprotein B were observed. Triglyceride levels also increased significantly (P<0.05). Rosiglitazone treatment led to an improvement in glycemic control and to an increase in paraoxonase activity and HDL-C levels. Although rosiglitazone showed favorable effects on oxidant/antioxidant balance and lipid profile, further studies are needed to determine the effect of rosiglitazone on cardiovascular risk factors and cardiovascular morbidity and mortality.

Plasma levels and placental expression of vaspin in pregnant women with diabetes mellitus

The present study aimed to investigate visceral adipose tissue-specific serpin (vaspin) concentrations in serum and term placentas and relate these values to insulin resistance and lipid parameters in women with gestational diabetes mellitus (GDM). A total of 30 GDM subjects and 27 age-matched pregnant women with normal glucose tolerance (NGT, control) were included. Serum glucose, glycated hemoglobin (HbA1c), lipid profile, insulin, and vaspin were measured at the end of pregnancy, and homeostasis model of assessment-insulin resistance (HOMA-IR) values were calculated. Vaspin mRNA and protein levels in placentas were measured by real-time fluorescence quantitative reverse transcription polymerase chain reaction (RT-qPCR) and Western blotting, respectively. Serum vaspin levels were significantly lower in the GDM group than in controls (0.49±0.24 vs 0.83±0.27 ng/mL, respectively; P<0.01). Three days after delivery, serum vaspin levels were significantly decreased in subjects with GDM (0.36±0.13 vs0.49±0.24 ng/mL, P<0.01). However, in the GDM group, serum vaspin levels were not correlated with the parameters evaluated. In contrast, in the control group, serum vaspin levels were positively correlated with triglycerides (TG; r=0.45, P=0.02) and very low-density lipoprotein cholesterol (VLDL-C; r=0.42, P=0.03). Placental mRNA vaspin (0.60±0.32 vs0.68±0.32, P=0.46) and protein (0.30±0.08 vs0.39±0.26; P=0.33) levels in the GDM group did not differ significantly from those in the control group, but were negatively correlated with neonatal birth weight in the GDM group (r=-0.48, P=0.03; r=-0.88; P<0.01). Our findings indicated that vaspin may be an important adipokine involved in carbohydrate and lipid metabolism and may also play a role in fetal development.

Transition nutritionnelle et double fardeau de la malnutrition chez des adultes de Ouagadougou au Burkina Faso (Afrique de l’Ouest)

Cette étude s’inscrit dans le cadre du projet « Pôle francophone africain sur le Double Fardeau Nutritionnel » (DFN) du laboratoire TRANSNUT, centre collaborateur OMS sur la transition nutritionnelle du Département de Nutrition de l’Université de Montréal, en collaboration avec ses partenaires au Burkina Faso, à savoir l’Institut de Recherche en Sciences de la Santé (IRSS) et l’Institut Supérieur des Sciences de la Population (ISSP). Elle est l’une des premières à s’intéresser au double fardeau de la malnutrition en Afrique francophone. Cette étude avait pour objectif de démontrer l’existence du double fardeau de la malnutrition parmi les adultes de Ouagadougou au Burkina Faso, d’en donner l’ampleur et d’identifier ses liens avec les facteurs du mode de vie. Plus spécifiquement, elle visait à décrire les carences nutritionnelles, les facteurs de risque cardiométabolique (FRCM), et la typologie du double fardeau de la malnutrition; examiner les caractéristiques du mode de vie des adultes et leurs liens avec le double fardeau de la malnutrition selon les conditions économique, et enfin d’examiner l’association entre inflammation subclinique, les carences nutritionnelles et les FRCM selon les facteurs du mode de vie. Ces objectifs faisaient suite à nos principales hypothèses qui stipulaient que : parmi les adultes de Ouagadougou, le phénotype de double fardeau de la malnutrition le plus fréquemment observé est l’association de surpoids/obésité avec une ou plusieurs carences nutritionnelles, surtout chez les femmes, puis qu’une alimentation de piètre qualité, en lien avec de mauvaises conditions socioéconomiques et de vie est associée tant aux FRCM qu’aux carences nutritionnelles, contribuant ainsi au double fardeau de malnutrition, et enfin qu’un état d’inflammation subclinique joue un rôle de médiateur entre le mode de vie et aussi bien les carences nutritionnelles que les FRCM. Afin de répondre à ces objectifs, une étude transversale descriptive et analytique a été conduite auprès d’un échantillon aléatoire de 330 adultes âgés de 25 à 60 ans recrutés au sein de l’Observatoire de Population de Ouagadougou, situé à la partie nord de la ville. Cet échantillon a été subdivisé en terciles du score de possessions matérielles, proxy du statut socioéconomique, avec 110 personnes respectivement dans chaque strate de niveau socioéconomique bas, moyen et élevé. Chaque participant a fourni des données sociodémographiques, anthropométriques, cliniques et comportementales; il a aussi fourni un échantillon de sang. Les principales variables de l’étude étaient les suivantes : l’âge, les conditions socioéconomiques (insécurité alimentaire, éducation et proxy du revenu), le mode de vie (les apports alimentaires et la qualité de l’alimentation, l’activité physique, la consommation d’alcool et de tabac, la perception de l’image corporelle, le stress psychosocial); l’inflammation subclinique; les FRCM [surpoids/obésité, tension artérielle élevée (TAE) ou hypertension artérielle (HTA), hyperglycémie, dyslipidémie et insulino-résistance]; les carences nutritionnelles (maigreur, anémie, carence en fer et en vitamine A). Des phénotypes de double fardeau de la malnutrition ont été identifiés en combinant FRCM et carences nutritionnelles. Les résultats ont montré une prévalence élevée de surpoids/obésité, d’obésité abdominale, d’hypertension artérielle, d’hyperglycémie, de résistance à l’insuline et du taux de lipoprotéine de haute densité (HDL-C) bas, respectivement de 24,2 %, 12,5 %, 21,9 %, 22,3 %, 25,1 % et 30,0 %. En utilisant les seuils plus sensibles de la Fédération Internationale du Diabète (FID), l’obésité abdominale, la tension artérielle élevée (TAE), l’hyperglycémie était respectivement de 23,5 %; 36,1 % et 34,5 %. Des carences nutritionnelles étaient également présentes, l’anémie, la carence en fer et en vitamine A, ainsi que la maigreur atteignant respectivement 25,5 %, 15,4 %, 12,7 % et 9,7 % de la population étudiée. Les femmes étaient significativement plus touchées que les hommes autant par les FRCM que par les carences nutritionnelles. Le double fardeau de la malnutrition touchait 23,5 % des personnes et même 25,8 % avec les seuils de la FID pour l’obésité abdominale, la TAE, et l’hyperglycémie. Les deux principaux phénotypes observés étaient : l’association de « surpoids/obésité avec au moins une carence en micronutriment », touchant 7,8 % (11,8 % ♀ vs. 3,4 % ♂) des personnes et l’association d’au moins un FRCM autre que le surpoids/obésité avec au moins une carence en micronutriment, qui touchait 9.0 % (12,4 % ♀ vs. 5,4 % ♂) des personnes. La prévalence de ces phénotypes était plus élevée en utilisant les seuils de la FID plutôt que les seuils de l’OMS. Près de 72,9 % des personnes ou 81,2 % (seuils de la FID) avaient au moins un FRCM. Nous avons identifié à partir de l’analyse typologique, deux schémas alimentaires; « urbain » et « traditionnel », dans cette étude. Les carences nutritionnelles étaient davantage associées au schéma alimentaire « traditionnel », alors que les FRCM se retrouvaient dans les deux schémas alimentaires. Le schéma « urbain » regroupait significativement plus d’hommes et de personnes de niveau socioéconomique élevé, alors que les personnes de niveau socioéconomique bas et les femmes étaient proportionnellement plus nombreuses dans le schéma « traditionnel ». Le temps dévolu aux activités sédentaires était significativement plus important que celui consacré aux activités d’intensité modérée à vigoureuse. L’activité physique était inversement associée à l’indice de masse corporelle (IMC), au tour de taille (TT), à la masse grasse corporelle, à la tension artérielle systolique (TAS) et diastolique (TAD), à la triglycéridémie et au taux de lipoprotéine de faible densité (LDL-C). L’IMC et le TT augmentaient en outre avec le temps de sédentarité. Ainsi, le double fardeau de malnutrition était associé au statut socioéconomique bas, au sexe féminin et à la sédentarité. Nous avons aussi trouvé que 39,4 % des personnes avaient une inflammation subclinique qui était associée de façon indépendante et positive à la ferritinémie, à l’IMC, au TT et à la masse grasse corporelle, et négativement au HDL-C. L’exploration du stress psychosocial et de l’image corporelle a révélé une association entre le stress psychosocial, l’HTA et une perception positive de l’embonpoint. Les personnes ayant peut-être accusé un retard de croissance à l’enfance (d’après l’indice de Cormic) étaient significativement plus touchées par le surpoids/obésité, l’obésité abdominale et la résistance à l’insuline. Ces résultats nous ont permis d’atteindre nos objectifs, mais aussi de vérifier nos hypothèses de recherche. Comme on peut le constater, les FRCM sont une réalité à Ouagadougou, qui se compliquent par leur coexistence avec des carences en micronutriments dont la prévalence est tout aussi importante. Une transition nutritionnelle est en cours dans cette ville et contribue au bouleversement des comportements alimentaires et du style de vie favorisant l’émergence de ce double fardeau, dans un contexte où le passé nutritionnel de la population offre des conditions idéales pour un niveau de risque particulièrement élevé pour ces FRCM. Cependant, l’évolution de cette prévalence pourrait être inversée ou tout au moins ralentie si des actions étaient entreprises dès maintenant.

Étude du trafic cellulaire de la convertase de proprotéine PCSK9 responsable de la dégradation du récepteur des lipoprotéines de faible densité (LDLR)

Les maladies cardiovasculaires (MCV) sont la principale cause de mortalité dans les pays industrialisés. L'hypercholestérolémie constitue un facteur de risque majeur pour les MCV. Elle est caractérisée par des niveaux élevés de lipoprotéines de faible densité (LDL, aussi appelé “mauvais cholestérol”). La présence prolongée de haut niveaux de LDL dans la circulation augmente le risque de formation de plaques athérosclérotiques, ce qui peut conduire à l'obstruction des artères et l'infarctus du myocarde. Le LDL est normalement extrait du sang par sa liaison au récepteur du LDL (LDLR) qui est responsable de son endocytose dans les hépatocytes. Des études génétiques humaines ont identifié PCSK9 (proprotein convertase subtilisin/kexin type 9) comme le troisième locus responsable de l'hypercholestérolémie autosomique dominante après le LDLR et son ligand l’apolipoprotéine B-100. PCSK9 interagit avec le LDLR et induit sa dégradation, augmentant ainsi les niveaux plasmatiques de LDL. Les mutations gain de fonction (GF) de PCSK9 sont associées à des niveaux plasmatiques élevés de LDL et à l'apparition précoce des MCV, alors que les mutations perte de fonction (PF) de PCSK9 diminuent le risque de MCV jusqu’à ~ 88% grâce à une réduction du LDL circulant. De ce fait, PCSK9 constitue une cible pharmacologique importante pour réduire le risque de MCV. PCSK9 lie le LDLR à la surface cellulaire et/ou dans l'appareil de Golgi des hépatocytes et provoque sa dégradation dans les lysosomes par un mécanisme encore mal compris. Le but de cette étude est de déterminer pourquoi certaines mutations humaines de PCSK9 sont incapables de dégrader le LDLR tandis que d'autres augmentent sa dégradation dans les lysosomes. Plusieurs mutations GF et PF de PCSK9 ont été fusionnées à la protéine fluorecente mCherry dans le but d'étudier leur mobilité moléculaire dans les cellules hépatiques vivantes. Nos analyses quantitatives de recouvrement de fluorescence après photoblanchiment (FRAP) ont montré que les mutations GF (S127R et D129G) avaient une mobilité protéique plus élevée (> 35% par rapport au WT) dans le réseau trans- Golgien. En outre, nos analyses quantitatives de recouvrement de fluorescence inverse après photoblanchiment (iFRAP) ont montré que les mutations PF de PCSK9 (R46L) avaient une mobilité protéique plus lente (<22% par rapport au WT) et une fraction mobile beaucoup plus petite (<40% par rapport au WT). Par ailleurs, nos analyses de microscopie confocale et électronique démontrent pour la toute première fois que PCSK9 est localisée et concentrée dans le TGN des hépatocytes humains via son domaine Cterminal (CHRD) qui est essentiel à la dégradation du LDLR. De plus, nos analyses sur des cellules vivantes démontrent pour la première fois que le CHRD n'est pas nécessaire à l'internalisation de PCSK9. Ces résultats apportent de nouveaux éléments importants sur le mécanisme d'action de PCSK9 et pourront contribuer ultimement au développement d'inhibiteurs de la dégradation du LDLR induite par PCSK9.