References of "Luyckx, Françoise"
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See detailNon-alcoholic steatohepatitis: association with obesity and insulin resistance, and influence of weight loss.
Luyckx, Françoise ULg; Lefebvre, Pierre ULg; Scheen, André ULg

in Diabètes & Métabolism (2000), 26(2), 98-106

Non-alcoholic steatohepatitis (NASH) is a disease of emerging identity and importance, and is now considered as one of the commonest liver diseases in western countries. It is frequently associated with ... [more ▼]

Non-alcoholic steatohepatitis (NASH) is a disease of emerging identity and importance, and is now considered as one of the commonest liver diseases in western countries. It is frequently associated with severe obesity, especially abdominal adiposity, and is intimately related to various clinical and biological markers of the insulin resistance syndrome. Especially, both the prevalence and the severity of liver steatosis are related to male sex, body mass index, waist circumference, hyperinsulinaemia, hypertriglyceridaemia and impaired glucose tolerance or type 2 diabetes. A substantial weight loss following gastroplasty is accompanied by a marked reduction in the prevalence and the severity of the various biological abnormalities of the metabolic syndrome and, concomitantly, by an important regression of liver steatosis in most obese patients. However, in some patients, this rapid and drastic weight loss may result in a mild increase in inflammatory lesions (hepatitis), despite the regression of steatosis, which might result from the rapid mobilization of fatty acids or cytokines from adipose tissue, especially visceral fat. The intimate relationship between NASH and obesity leads to the concept that NASH may be considered as another disease of affluence, as is the insulin resistance syndrome and perhaps being part of it. [less ▲]

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See detailLe dosage des auto-anticorps anti-GAD et anti-IA 2: une aide au diagnostic precoce du diabete de type 1.
Luyckx, Françoise ULg; Delcourt, Sandrine ULg; Philips, Jean-Christophe ULg et al

in Revue Médicale de Liège (2000), 55(3), 169-75

Diabetes mellitus is a frequent metabolic disease characterised by a complex and inconstant phenotypic expression that complicates the classification of patients and sometimes delays their optimal ... [more ▼]

Diabetes mellitus is a frequent metabolic disease characterised by a complex and inconstant phenotypic expression that complicates the classification of patients and sometimes delays their optimal management. In that slowly progressive disease leading to severe and irreversible complications, the use of early and specific genetic, immunological and/or metabolic markers may help in the classification of diabetic patients and in the orientation of therapeutic strategies; furthermore, it is also an essential aid in the early screening of subjects at risk of developing the disease. The assessment of classical immunological markers, such as islet cell antibodies (ICA) or anti-insulin antibodies (IAA) has been recently completed by the screening of new promising markers such as GAD- and IA2-antibodies. The presence of these markers confirms the autoimmune component of the disease and thus supports the diagnosis of type 1 diabetes, even if clinical symptoms are absent or inconsistent. In addition, it represents a strong argument in favour of the initiation of specific immunological therapies to preserve B-cell number and function. [less ▲]

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See detailRecommandations pour le traitement de l'obesite.
Luyckx, Françoise ULg; Scheen, André ULg

in Revue Médicale de Liège (2000), 55(5), 367-71

Obesity represents a major medical problem which is now considered more seriously from a scientific, clinical and economical point of view. Such an evolution was mandatory when considering the usual ... [more ▼]

Obesity represents a major medical problem which is now considered more seriously from a scientific, clinical and economical point of view. Such an evolution was mandatory when considering the usual contempt for what is now considered as a chronic disease and especially the charlatanism which was observed among medical and non-medical spheres. Hence, as for numerous other pathologies, international guidelines have recently been published to optimize the management of obesity, from the view point of efficacy and, more particularly, safety. We will summarize the main recommendations as far as diet and physical treatment, pharmacotherapy and bariatric surgery are concerned. Finally, we will briefly describe general guidelines on the management of obese subjects taking into account the degree of weight excess and the presence of complications. [less ▲]

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See detailComment j'explore ... les anomalies du metabolisme glucidique, de l'insulinosecretion et de la sensibilite a l'insuline avec une hyperglycemie provoquee par voie orale.
Luyckx, Françoise ULg; Scheen, André ULg

in Revue Médicale de Liège (2000), 55(9), 881-5

Oral glucose tolerance test (OGTT) has been widely used for the diagnosis of diabetes mellitus, gestational diabetes, impaired glucose tolerance or reactive hypoglycaemia. Simultaneous measurements of ... [more ▼]

Oral glucose tolerance test (OGTT) has been widely used for the diagnosis of diabetes mellitus, gestational diabetes, impaired glucose tolerance or reactive hypoglycaemia. Simultaneous measurements of plasma glucose and insulin levels also allow to derive indices of insulin secretion and insulin sensitivity. Whereas OGTT is not considered anymore as the first choice for the diagnosis of diabetes mellitus, it remains useful for studying abnormalities of glucose metabolism as well as of insulin secretion and insulin action. [less ▲]

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See detailUne étiologie immunologique à l'hyperprolactinemie: la macroprolactinémie
Lebrun, Yves ULg; Luyckx, Françoise ULg; Brue, T. et al

in Revue Médicale de Liège (1999), 54(9), 759-63

Besides classical etiologies of hyperprolactinaemia (pregnancy, pharmacological treatments, pituitary or hypothalamic perturbations), another less known cause may explain a spectacular idiopathic ... [more ▼]

Besides classical etiologies of hyperprolactinaemia (pregnancy, pharmacological treatments, pituitary or hypothalamic perturbations), another less known cause may explain a spectacular idiopathic elevation of plasma concentrations of prolactin hormone. Macroprolactinaemia is characterized by the presence of a circulating high molecular weight complex of prolactin with an immunoglobulin G. In this article, we report the cases of 3 female patients for whom size exclusion chromatography technique permitted to give a precise biological diagnosis and to avoid heavy, expensive, time consuming and unnecessary clinical investigations or therapeutic actions. Patients with macroprolactinaemia do not exhibit clinical features of classical hyperprolactinaemia, notably as regard to menstrual and fertility disturbances. [less ▲]

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See detailSevere/extreme obesity: a medical disease requiring a surgical treatment?
Scheen, André ULg; Luyckx, Françoise ULg; Desaive, Claude ULg et al

in Acta Clinica Belgica (1999), 54(3), 154-61

Obesity poses a serious health hazard and its treatment is often disappointing. Surgical approaches have been proposed for treating severe obesity (body mass index or BMI > or = 35 kg/m2) with ... [more ▼]

Obesity poses a serious health hazard and its treatment is often disappointing. Surgical approaches have been proposed for treating severe obesity (body mass index or BMI > or = 35 kg/m2) with comorbidities or extreme obesity (BMI > or = 40 kg/m2). Before accepting bariatric surgery as alternative treatment, the four following prerequisites should be met: 1. the medical condition is serious enough; 2. it can not be treated satisfactorily with classical means; 3. the surgical treatment is effective in improving the clinical situation; and 4. bariatric surgery is safe enough, so that the benefits clearly outweigh the risks. On the basis of the literature and our own experience, it appears that gastric reduction surgery may be considered as a valuable alternative for treating severe/extreme obesity, despite the possible occurrence of perioperative and, more frequently, late complications, provided that it is performed by an experienced and multidisciplinary team in well-selected patients. [less ▲]

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See detailNon-alcoholic steatohepatitis.
Luyckx, Françoise ULg; Scheen, André ULg; Lefebvre, Pierre ULg

in Lancet (1999), 354(9186), 1298-9

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See detailComment je traite ... une obesite severe et ses anomalies metaboliques par une gastroplastie.
Luyckx, Françoise ULg; Scheen, André ULg; Letiexhe, Michel ULg et al

in Revue Médicale de Liège (1999), 54(3), 138-42

Severe obesity, defined as a body mass index > or = 35 kg/m2, is frequently associated with various biological abnormalities, particularly in the presence of intra-abdominal adiposity. The most important ... [more ▼]

Severe obesity, defined as a body mass index > or = 35 kg/m2, is frequently associated with various biological abnormalities, particularly in the presence of intra-abdominal adiposity. The most important disorders belong to the so-called insulin resistance syndrome, metabolic syndrome or syndrome X: hyperinsulinaemia, impaired glucose tolerance or type 2 diabetes, dyslipidaemias, hyperuricaemia, hyperfibrinogenaemia. All these metabolic abnormalities are considered as cardiovascular risk factors. They are also correlated with the severity of the liver steatosis which is commonly observed in individuals with severe obesity. We report our experience of the evolution of these metabolic abnormalities after a marked weight loss induced by gastroplasty. We will analyse the favourable effects of bariatric surgery on insulin sensitivity, biological components of the metabolic syndrome, type 2 diabetes and liver steatosis. [less ▲]

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See detailL'obesite feminine: souci esthetique ou probleme medical?
Luyckx, Françoise ULg; Scheen, André ULg; Lefebvre, Pierre ULg

in Revue Médicale de Liège (1999), 54(4), 262-7

Women more and more frequently refer to medical doctors for treating weight excess. Even if the primum movens is usually a pure esthetic concern, medical aspects should not be neglected. Indeed, if ... [more ▼]

Women more and more frequently refer to medical doctors for treating weight excess. Even if the primum movens is usually a pure esthetic concern, medical aspects should not be neglected. Indeed, if obesity with gynoid adipose tissue distribution is less deleterious than android obesity from a metabolic point of view, severe obesity is frequently associated with cardiovascular risk factors which may hinder the prognosis of these female patients. Other complications are common in obese women, such as oestrogen-related cancers, osteoarticular problems and psychological disturbances. Various therapeutic approaches are available which permit an encouraging weight loss and a rapid improvement of risk factors. Unfortunately, long-term results are often disappointing, essentially because of the difficulty to follow on the long term a strict diet regimen and practice physical exercise and because of the usual unrealistic expectations of the obese women who consult medical doctors. [less ▲]

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See detailDysthyroidies et dyslipidemies.
Deschampheleire, M.; Luyckx, Françoise ULg; Scheen, André ULg

in Revue Médicale de Liège (1999), 54(9), 746-50

While overt thyroid disturbances, characterized by symptoms and/or clinical signs with abnormal serum levels of thyroid hormones, are generally associated with perturbations in the lipid profile, the ... [more ▼]

While overt thyroid disturbances, characterized by symptoms and/or clinical signs with abnormal serum levels of thyroid hormones, are generally associated with perturbations in the lipid profile, the situation is less clear as far as subclinical thyroid disturbances, defined by isolated abnormalities of thyroid stimulating hormone (TSH) levels, are concerned. In severe hyperthyroidism, a decrease of total cholesterol, LDL cholesterol and apoprotein B concentrations is generally observed. These biological parameters are normalized when appropriate antithyroid treatment is given. In profound hypothyroidism, on the contrary, elevated levels of total and LDL cholesterol levels are observed, which decrease after hormonal replacement. In both cases, the changes in serum levels of HDL cholesterol, triglycerides and lipoprotein (a) are less systematic, both before and after treatment. Lipid abnormalities associated with subclinical thyroid disturbances remain controversial. However, two recent meta-analyses have shown higher LDL cholesterol levels in presence of subclinical hypothyroidism and a significant reduction of such lipid abnormality after administration of thyroxine. Furthermore, they demonstrated a higher prevalence of subclinical hypothyroidism in a population with hypercholesterolaemia when compared to a population with normal cholesterol levels. Finally, a significant reduction in both total and LDL cholesterol concentrations has been reported after administration of thyroxine in a small group of hypercholesterolaemic patients with basal TSH levels in the upper range of normal values. In view of the results of the literature, strategies are proposed to help the clinician in the management of patients with overt or subclinical thyroid disturbances, associated with dyslipidaemia. [less ▲]

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See detailComment j'explore ... un sujet avec un exces ponderal ou une obesite.
Scheen, André ULg; Luyckx, Françoise ULg

in Revue Médicale de Liège (1999), 54(6), 553-6

The evaluation of an obese subject aims at better understanding the disease, its causes and consequences, in order to optimize its management. Schematically, this task can be done in three successive ... [more ▼]

The evaluation of an obese subject aims at better understanding the disease, its causes and consequences, in order to optimize its management. Schematically, this task can be done in three successive steps. First, it is necessary to analyse data from the past, by asking about family and personal history. Then, the present data should be carefully analysed, especially the severity of overweight, its type of distribution and the importance of associated complications. Finally, it is mandatory to project these data into the future, in order to assess the final prognosis of the obese patient allowing a better definition of the goals and the therapeutical strategies. [less ▲]

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See detailMedical aspects of obesity.
Scheen, André ULg; Luyckx, Françoise ULg

in Acta Chirurgica Belgica (1999), 99(3), 135-9

Obesity poses a serious health hazard and its treatment is often disappointing. Major advances have been made during recent years in the understanding of body weight regulation, with the discovery of ... [more ▼]

Obesity poses a serious health hazard and its treatment is often disappointing. Major advances have been made during recent years in the understanding of body weight regulation, with the discovery of leptin, a protein produced by adipocytes and acting on the central nervous system to reduce food intake, and that of beta-3 adrenergic receptors and uncoupling proteins which contribute to stimulate energy expenditure. Numerous metabolic complications are associated with abdominal obesity and most of them, such as diabetes mellitus, dyslipidaemias and arterial hypertension, appear to be linked to insulin resistance and may be part of the socalled metabolic syndrome or syndrome X. While very-low-calorie diets are usually effective in the short-term, they cannot, in the long-term and for most patients, solve the problem of severe obesity. Pharmacological antiobesity treatment may include drugs that reduce food intake, drugs that increase energy expenditure and drugs that affect nutrient partitioning or metabolism. All of these pharmacological approaches have potential efficacy, but unfortunately serious limitations. This is also the case of mechanical means, such as intragastric balloons. Consequently, bariatric surgery may be considered as a valuable alternative therapy in well-selected patients with morbid obesity refractory to classical treatments. In conclusion, obesity is a chronic disease and should be treated as such with reasonable expectations. [less ▲]

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See detailTraitement ultime du diabete de type 2: insulinotherapie intensive ou chirurgie bariatrique?
Scheen, André ULg; Paquot, Nicolas ULg; Triches, K. et al

in Journées Annuelles de Diabetologie de l'Hôtel-Dieu (1998)

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See detailEffects of gastroplasty on body weight and related biological abnormalities in morbid obesity.
Luyckx, Françoise ULg; Scheen, André ULg; Desaive, Claude ULg et al

in Diabètes & Métabolism (1998), 24(4), 355-61

Obesity is a prevalent metabolic disorder associated with high morbidity and mortality rates. Medical treatment rarely succeeds, and bariatric surgery has been proposed as an alternative therapy. The ... [more ▼]

Obesity is a prevalent metabolic disorder associated with high morbidity and mortality rates. Medical treatment rarely succeeds, and bariatric surgery has been proposed as an alternative therapy. The purpose of this non-controlled retrospective study was to evaluate time-course changes in body weight in severely obese patients who underwent vertical ring gastroplasty or adjustable silicone gastric banding, and to assess the prevalence and potential reversibility of several of the biological abnormalities associated with morbid obesity. From an initial cohort comprising 658 patients, regular body weight measurements and biological data were obtained in 505 patients [419 females, 86 males; age 36 +/- 11 years; body mass index 42.7 +/- 6.9 kg/m2; (mean +/- SD)] with a mean follow-up of 26 +/- 14 months. Mean weight loss was 32 +/- 16 kg. Most weight reduction occurred within the first 6 months, followed by near-stabilisation or even slight weight regain. Most biological parameters were obtained before surgery and after at least 6 months of follow-up. The high prevalence and severity of metabolic disturbances associated with the insulin resistance syndrome (hyperglycaemia, hyperinsulinaemia, decreased HDL cholesterol, hypertriglyceridaemia, elevated fibrinogen levels and hyperuricaemia) before gastroplasty were significantly decreased after weight loss. No major biological deficiencies were observed following gastroplasty, except low iron serum levels. It is concluded that marked weight loss associated with gastroplasty involved a remarkable reduction in the prevalence and severity of several biological abnormalities classically considered as cardiovascular risk factors. [less ▲]

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See detailPharma clinics. Comment je traite ... un patient diabetique avec obesite severe.
Scheen, André ULg; Triches, K.; Luyckx, Françoise ULg et al

in Revue Médicale de Liège (1998), 53(7), 386-9

Obesity plays a crucial role in type 2 diabetes pathophysiology and a major weight loss markedly improves glycaemic control. The common failure of classical treatments leads to the use of more aggressive ... [more ▼]

Obesity plays a crucial role in type 2 diabetes pathophysiology and a major weight loss markedly improves glycaemic control. The common failure of classical treatments leads to the use of more aggressive weight-reduction approaches, such as very-low-calorie diets (VLCDs), anti-obesity drugs or even bariatric surgery. VLCDs are very successful in the short-term but rather disappointing in the long-term. Anti-obesity compounds only induce a modest mean weight reduction, even if some patients appear to be better responders. Interestingly, serotoninergic agents increase insulin sensitivity and glycaemic control, independently of weight loss. Bariatric surgery provides the most impressive results. In well-selected subjects, gastroplasty (either vertical ring gastroplasty or adjustable silicone gastric banding) generally induces a considerable weight loss which results in a remarkable and sustained glycaemic control improvement and allows the reduction, or even the suppression, of any antidiabetic treatment. This ultimate solution should not be neglected after failure of medical approaches, provided that the indication is correct, the surgical procedure is performed in a specialized centre and the followup is well organized by a multidisciplinary team. [less ▲]

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See detailInfluence of the A-->G (-3826) uncoupling protein-1 gene (UCP1) variant on the dynamics of body weight before and after gastroplasty in morbidly obese subjects.
Luyckx, Françoise ULg; Scheen, André ULg; Proenza, A. M. et al

in International Journal of Obesity & Related Metabolic Disorders (1998), 22(12), 1244-5

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See detailLiver abnormalities in severely obese subjects: effect of drastic weight loss after gastroplasty.
Luyckx, Françoise ULg; Desaive, Claude ULg; Thiry, Albert ULg et al

in International Journal of Obesity & Related Metabolic Disorders (1998), 22(3), 222-6

OBJECTIVE: To examine the factors associated with liver steatosis in severely obese subjects and to test the potential reversibility of fatty liver after weight loss. DESIGN: Retrospective clinical study ... [more ▼]

OBJECTIVE: To examine the factors associated with liver steatosis in severely obese subjects and to test the potential reversibility of fatty liver after weight loss. DESIGN: Retrospective clinical study. SUBJECT: 528 obese patients before bariatric surgery and 69 obese subjects of the initial cohort evaluated before and 27+/-15 months after gastroplasty. MEASUREMENTS: Fatty deposition (scored as mild, moderate or severe) and inflammatory changes were evaluated in liver biopsies; clinical (body mass index (BMI), age, gender, duration of obesity) and biological (glucose, triglycerides, liver enzymes) parameters were related to histological findings. RESULTS: 74% of the 528 biopsies showed fatty change, estimated as mild in 41% of cases, moderate in 32% and severe in 27%. The prevalence of steatosis was significantly higher in men than in women (91% vs 70%, P = 0.001) and in patients with impaired glucose tolerance or type 2 diabetes compared with nondiabetics (89% vs 69% P = 0.001). The severity of the steatosis was associated with BMI (P = 0.002) but not with the duration of obesity or the age of the patient. When compared with patients without fatty change, those with liver steatosis had significantly higher fasting plasma glucose (5.5 mmol/l vs 5.1 mmol/l, P = 0.007) and triglycerides (1.8 mmol/l vs 1.3 mmol/l, P = 0.002). Mean serum liver enzyme activities (alkaline phosphatase, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl-transpeptidase (gammaGT) were significantly (P < 0.001) increased in patients with fatty change but remained within laboratory reference values. In the 69 patients who have been evaluated after a marked weight reduction (-32+/-19kg), 45% of the biopsies were considered as normal (vs 13% before, P < 0.001) while pure fatty change was still observed in 38% of the patients (vs 83% before, P = 0.001). However, the severity of the steatosis was significantly (P < 0.001) reduced (mild: 62% vs 21%; moderate: 23% vs 37%; severe: 15% vs 42%). In addition, a significant increase of hepatitis was observed in 26% of the biopsies (vs 14% before, P < 0.05). CONCLUSIONS: Liver steatosis in obese subjects is associated with men, diabetic status, BMI, higher fasting glucose and hypertriglyceridaemia. Postgastroplasty weight loss reduces liver steatosis, but seems to increase the incidence of inflammatory lobular hepatitis. [less ▲]

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See detailComment j'explore ... le syndrome d'insulinoresistance grace a ses marqueurs biologiques.
Luyckx, Françoise ULg; Scheen, André ULg; Gielen, Jean-Louis ULg et al

in Revue Médicale de Liège (1997), 52(10), 686-91

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