References of "PAQUOT, Nicolas"
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See detailSujets « métaboliquement obèses » de poids normal. Première partie: diagnostic, physiopathologie et prévalence
Beck, Emmanuel ULg; Paquot, Nicolas ULg; Scheen, André ULg

in Obésité (2008), 3(3), 184-193

Obesity, particularly abdominal obesity, is the main risk factor for metabolic syndrome. However, some non-obese individuals are metabolically abnormal and therefore probably have an increased risk of ... [more ▼]

Obesity, particularly abdominal obesity, is the main risk factor for metabolic syndrome. However, some non-obese individuals are metabolically abnormal and therefore probably have an increased risk of cardiovascular disease. The present review paper aims to describe the main characteristics of the metabolically obese normal-weight (MONW) syndrome, analyse its etiopathogenesis and pathophysiology and, finally, assess its prevalence in various populations. [less ▲]

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See detailSujets « métaboliquement obèses » de poids normal. Seconde partie: pronostic et prise en charge
Beck, Emmanuel ULg; Paquot, Nicolas ULg; Scheen, André ULg

in Obésité (2008), 3(4), 280-285

Metabolically obese normal-weight (MONW) individuals are frequently not detected because of a falsely reassuring body weight. However, they have most of the metabolic syndrome markers known to be ... [more ▼]

Metabolically obese normal-weight (MONW) individuals are frequently not detected because of a falsely reassuring body weight. However, they have most of the metabolic syndrome markers known to be associated with a higher risk of type 2 diabetes, cardiovascular disease and mortality. The present review paper aims to describe the clinical consequences to which MONW people are exposed and the main principles of managing this syndrome [less ▲]

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See detailInhibition des recepteurs CB1 et metabolisme du glucose: rimonabant dans le diabete de type 2.
Scheen, André ULg; Paquot, Nicolas ULg; Van Gaal, Luc F

in Revue Médicale Suisse (2008), 4(168), 1812-7

Endocannabinoid system is overactivated in individuals with abdominal obesity. CBI receptors, first individualized in the brain, are also expressed in the adipocyte, the skeletal muscle, the liver, the ... [more ▼]

Endocannabinoid system is overactivated in individuals with abdominal obesity. CBI receptors, first individualized in the brain, are also expressed in the adipocyte, the skeletal muscle, the liver, the gut, and the pancreas. Their blockade improves glucose tolerance and lipid profile, thanks increased insulin sensitivity and adiponectin levels. Rimonabant, a selective antagonist of CBI receptors, improves glucose control in patients with type 2 diabetes, treated with diet alone, metformin, sulfonylurea or insulin, while it also reduces body weight and other risk factors. Ongoing studies aim at further demonstrating the potential of rimonabant in the management of type 2 diabetes, in the prevention of type 2 diabetes and in the protection against cardiovascular complications in (diabetic) patients with abdominal obesity. [less ▲]

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See detailInhibitors of cannabinoid receptors and glucose metabolism.
Scheen, André ULg; Paquot, Nicolas ULg

in Current Opinion in Clinical Nutrition & Metabolic Care (2008), 11(4), 505-11

PURPOSE OF REVIEW: Abdominal obesity is closely related to type 2 diabetes and overactivity of the endocannabinoid system. The present review aims at evaluating the role of endocannabinoid system in ... [more ▼]

PURPOSE OF REVIEW: Abdominal obesity is closely related to type 2 diabetes and overactivity of the endocannabinoid system. The present review aims at evaluating the role of endocannabinoid system in glucose dysregulation and the effects of cannabinoid 1 receptor blockade on glucose metabolism in both animal models and overweight/obese humans, especially with type 2 diabetes. RECENT FINDINGS: Cannabinoid 1 receptors have been identified not only in the brain, but also in the adipose tissue, the gut, the liver, the skeletal muscle and even the pancreas, all organs playing a key role in glucose metabolism and type 2 diabetes. Rimonabant, the first selective cannabinoid 1 receptor blocker in clinical use, has been shown to reduce body weight, waist circumference, glycated haemoglobin, triglycerides, insulin resistance index, and to increase HDL cholesterol and adiponectin concentrations in patients with type 2 diabetes, confirming data on nondiabetic overweight/obese patients. Almost half of the metabolic changes, including glycated haemoglobin reduction, could not be explained by weight loss, in agreement with direct peripheral effects. SUMMARY: Cannabinoid 1 blockade reduces food intake and body weight and improves metabolic regulation beyond just weight loss. Because of its positive effect on glucose metabolism, rimonabant deserves consideration in the treatment of overweight/obese patients with type 2 diabetes. [less ▲]

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See detailL'etude clinique du mois. United Kingdom Prospective Diabetes Study: 10 ans plus tard.
Scheen, André ULg; Paquot, Nicolas ULg; Lefebvre, Pierre ULg

in Revue Médicale de Liège (2008), 63(10), 624-9

A 10-year post-trial monitoring of patients with newly diagnosed type 2 diabetes randomised in the "United Kingdom Prospective Diabetes Study" (UKPDS) demonstrated a continued reduction in microvascular ... [more ▼]

A 10-year post-trial monitoring of patients with newly diagnosed type 2 diabetes randomised in the "United Kingdom Prospective Diabetes Study" (UKPDS) demonstrated a continued reduction in microvascular risk (-24%, p = 0.001) and emergent risk reductions for myocardial infarction (-15%, p = 0.01) and death from any cause (-13%, p = 0.007), despite an early loss of glycaemic differences ("legacy effect"). A continued benefit after metformin therapy was evident during the ten-year post-trial follow-up among overweight patients (-33%, p = 0.005 for myocardial infarction and -27%, p = 0.002 for death from any cause). In contrast, the benefits of previously improved blood pressure control were not sustained when between-groups differences in blood pressure were lost during follow-up, except for a reduced risk for peripheral vascular disease. These observations are strong arguments in favour of an early optimisation of blood glucose control and of a sustained control of blood pressure in patients with type 2 diabetes. [less ▲]

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See detailCystatin C or Creatinine for Detection of Stage 3 Chronic Kidney Disease in Anorexia Nervosa.
Delanaye, Pierre ULg; Cavalier, Etienne ULg; Radermecker, Régis ULg et al

in Nephron. Clinical Practice (2008), 110(3), 158-163

Background: Patients with anorexia nervosa (AN) are at a high risk of renal failure. Chronic kidney disease (CKD) is often missed in these patients because the serum creatinine is a poor marker of kidney ... [more ▼]

Background: Patients with anorexia nervosa (AN) are at a high risk of renal failure. Chronic kidney disease (CKD) is often missed in these patients because the serum creatinine is a poor marker of kidney function. We studied the utility of cystatin C to detect renal failure in this population. Method: Twenty-seven AN patients were studied. Glomerular filtration rates (GFR) were measured with the chromium-51- ethylenediaminetetraacetate ((51)Cr-EDTA) method. We compared the ability of creatinine and cystatin C to detect stage 3 CKD (GFR below 60 ml/min) by ROC curve analysis. Results: In this cohort, there is no correlation between GFR and serum creatinine, but there is a significant correlation between cystatin C and GFR. By ROC analysis, the cystatin C concentration is better than the serum creatinine concentration for the detection of stage 3 CKD (area under the curve of 0.86 vs. 0.61, p = 0.05). Conclusion: Plasma cystatin C is better than serum creatinine in detecting stage 3 CKD in patients with AN. [less ▲]

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See detailLe cerveau, un organe gluco-dependant. Effets deleteres de l'hypoglycemie et de l'hyperglycemie.
Radermecker, Régis ULg; Philips, Jean-Christophe ULg; Jandrain, Bernard ULg et al

in Revue Médicale de Liège (2008), 63(5-6), 280-6

Glucose is almost the only energy substrate for the brain. Such glucose dependence explains why any large variation of plasma glucose levels could lead to cerebral dysfunction, which may be severe and ... [more ▼]

Glucose is almost the only energy substrate for the brain. Such glucose dependence explains why any large variation of plasma glucose levels could lead to cerebral dysfunction, which may be severe and progress to a coma. Hypoglycaemic coma, the most common one, has a pure metabolic origin (neuroglucopenia) whereas hyperglycaemic coma is more complex and mainly due to osmotic disturbances. Besides acute changes of plasma glucose concentrations, it is generally recognized that more subtle chronic or recurrent glucose abnormalities could also result in brain dysfunction. However, such clinical consequences are more difficult to assess in clinical practice. Nevertheless, learning perturbations in young patients with type 1 diabetes and memory losses, sometimes severe and subject to progress to dementia ("diabetic encephalopathy") in older type 1 or type 2 diabetic patients, have been reported, although with some controversy. The present paper summarizes the current knowledge of both acute and chronic cerebral dysfunctions following perturbations of blood glucose levels in diabetic patients. [less ▲]

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See detailPharmacologic treatment of obesity, food intake, and reversal of metabolic disorders.
SCHEEN, André ULg; PAQUOT, Nicolas ULg

in Current Research in Nutrition & Food intake (2007), 3

The present paper is reviewing the current place of weight-reducing drugs in the overall management of overweight/obese subjects, especially those with metabolic disorders and type 2 diabetes. Anti ... [more ▼]

The present paper is reviewing the current place of weight-reducing drugs in the overall management of overweight/obese subjects, especially those with metabolic disorders and type 2 diabetes. Anti-obesity agents should be carefully evaluated in long-term (1-2 years) randomized controlled trials. Recent systematic reviews and meta-analysis assessed both the safety and efficacy of the two drugs currently used in the treatment of obesity, i.e. orlistat, a gastric and pancreatic lipase inhibitor that reduces fat absorption from the gut, and sibutramine, a combined norepinephrine and serotonin reuptake inhibitor that regulates food intake. Rimonabant, a new compound acting as selective blocker of CB1 receptors of the endocannabinoid system, raises much interest as it promotes weight reduction by a central effect and also exerts peripheral effects targeting cardiometabolic risk. Special attention will be paid to beneficial metabolic effects resulting from (even moderate) weight loss and to possible additional effects beyond weight reduction. [less ▲]

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See detailLes incretinomimetiques et incretinopotentiateurs dans le traitement du diabete de type 2.
Scheen, André ULg; Radermecker, Régis ULg; Philips, Jean-Christophe ULg et al

in Revue Médicale Suisse (2007), 3(122), 18841886-8

Glucagon-like peptide-1 (GLP-1) is a gut hormone secreted in response to a meal ingestion, which is rapidly degraded by a specific enzyme, dipeptidylpeptidase-4 (DPP-4). It enhances insulin secretion in a ... [more ▼]

Glucagon-like peptide-1 (GLP-1) is a gut hormone secreted in response to a meal ingestion, which is rapidly degraded by a specific enzyme, dipeptidylpeptidase-4 (DPP-4). It enhances insulin secretion in a glucose-dependent manner, inhibits glucagon secretion, retards gastric emptying,... Two pharmacological approaches have been developed to increase the abnormally low GLP-1 levels in type 2 diabetic patients: either to subcutaneously inject an agent closed to GLP-1 (exenatide), which is partially resistant to the action of DPP-4, either to orally administer a selective DPP-4 inhibitor (sitagliptin,...). These new drugs offer improved blood glucose control of type 2 diabetic patients, without inducing hypoglycaemia and with favourable effects on body weight. [less ▲]

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See detailLe traitement du diabète de type 2: entre insulinosensibilisateurs et insulinosécrétagogues
Scheen, A. J.; Radermecker, R. P.; Philips, J. C. et al

in Revue Médicale de Liège (2007), 62 Spec No

Type 2 diabetes is a complex disease characterized by a dual defect of insulin secretion and insulin sensitivity, which may vary from patient to patient, but also along the natural history of the disease ... [more ▼]

Type 2 diabetes is a complex disease characterized by a dual defect of insulin secretion and insulin sensitivity, which may vary from patient to patient, but also along the natural history of the disease in a particular patient. Besides the lifestyle changes, the treatment strategy comprises the administration of agents that promote insulin secretion and/or that improve insulin sensitivity. Drugs facilitating weight loss also improve glucose control by reducing insulin resistance. A global approach should be recommended to reduce the high cardiovascular risk of diabetic patients. The present article aims at summarizing our contribution to the development of drugs designed for the treatment of type 2 diabetes. [less ▲]

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See detailActualites therapeutiques en diabetologie
Paquot, Nicolas ULg; Philips, J. C.; Radermecker, Régis ULg et al

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 317-23

The recent epidemic of type 2 diabetes and the recognition that achieving specific glycemic goals can reduce morbidity have made the effective treatment of hyperglycemia a priority. The new therapeutic ... [more ▼]

The recent epidemic of type 2 diabetes and the recognition that achieving specific glycemic goals can reduce morbidity have made the effective treatment of hyperglycemia a priority. The new therapeutic agents and the development of algorithms for the adjustment of therapy might contribute to an improved management of the disease. Moreover, type 2 diabetes is frequently associated with other co-morbidities (obesity, hypertension, dyslipidaemia, prothrombotic state). The appropriate management of patients with type 2 diabetes requires a global approach targeting each risk factor in order to reduce cardiovascular morbidity and mortality. This challenge represents a major public health issue. In type 1 diabetes patients, intensive therapy such as in the Diabetes Control and Complications Trial (DCCT) has been shown to obtain long-term beneficial effects on the reduction of the risk of progressive retinopathy, neuropathy and nephropathy and of the risk of cardiovascular disease. This benefit reinforces the original DCCT message that intensive therapy should be implemented as early as possible in people with type 1 diabetes. The recent development of new insulin analogues and the technical improvements of portable insulin pumps might contribute to obtain such a better metabolic control. [less ▲]

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See detailActualites therapeutiques dans le domaine de l'obesite.
Rorive, Marcelle ULg; De Flines, Jenny ULg; Paquot, Nicolas ULg et al

in Revue Médicale de Liège (2007), 62(5-6), 329-34

The management of an obese patient aims not only at obtaining a durable weight loss, but also at attenuating various associated risk factors. This latter objective may already be obtained with a rather ... [more ▼]

The management of an obese patient aims not only at obtaining a durable weight loss, but also at attenuating various associated risk factors. This latter objective may already be obtained with a rather moderate weight reduction (5-10% of initial body weight). The first step should favour life-style changes (diet and physical exercise), eventually together with a psychological support. In case of insufficient success, a pharmacological approach may be considered, in addition to life-style advices. Pharmacotherapy currently includes drugs that act on the central nervous system to decrease appetite (sibutramine), in the gastrointestinal tract to diminish fat absorption (orlistat) or at both central and peripheral sites (rimonabant). In case of extreme obesity or severe obesity associated with comorbidities, refractory to medical approaches, bariatric surgery may represent the only solution to obtain a major and sustained weight loss, together with a significant improvement of associated risk factors. Gastroplasty, especially laparoscopic gastric banding, has become very popular in our country. However, because of several limitations, it is increasingly replaced by derivative procedures, especially gastric bypass. In all cases, a multidisciplinary, integrated and individualized approach should be recommended, using realistic goals and targeting long-term weight reduction and improved health. [less ▲]

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See detailLe point sur la controverse a propos de la rosiglitazone.
Scheen, André ULg; De Flines, Jenny ULg; Paquot, Nicolas ULg

in Revue Médicale de Liège (2007), 62(9), 560-5

The present article aims at summarizing the recent controversy about rosiglitazone (Avandia), an insulin sensitizer used as oral antidiabetic agent in the treatment of type 2 diabetes. We will present and ... [more ▼]

The present article aims at summarizing the recent controversy about rosiglitazone (Avandia), an insulin sensitizer used as oral antidiabetic agent in the treatment of type 2 diabetes. We will present and briefly discuss 1) the results of the meta-analysis that raised suspicion about a possible excess of coronary complications with rosiglitazone; 2) the more favourable results of the large prospective clinical trial RECORD, but which are currently limited to an interim analysis; and 3) the reassuring data from several large US databases comparing the cardiovascular prognosis of type 2 diabetic patients treated with different antidiabetic drugs. We will conclude, referring to the recent position statement of the Advisory Committee of the Food and Drug Administration, by providing some practical recommendations. [less ▲]

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See detailTabac et poids corporel
PAQUOT, Nicolas ULg

in Patient Care (2006), (juin), 6-9

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See detailPhysiopathologie de l'hyperglycemie post-prandiale
Scheen, A. J.; Paquot, Nicolas ULg

in Journées Annuelles de Diabetologie de l'Hôtel-Dieu (2006)

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See detailLa place des micronutriments en medecine.
Paquot, Nicolas ULg; Scheen, André ULg

in Revue Médicale de Liège (2006), 61(5-6), 464-70

Adequate micronutrient intake throughout life course is essential for the maintenance of health. Micronutrients are necessary for the maintenance of intermediary metabolism, play a crucial role as co ... [more ▼]

Adequate micronutrient intake throughout life course is essential for the maintenance of health. Micronutrients are necessary for the maintenance of intermediary metabolism, play a crucial role as co-factors or co-enzymes in the activity of virtually all enzymes, and have important functions to neutralise the deleterious effects of oxidant species. Claims have been made for the benefits of micronutrient supplementation. Clinical benefit of a supplementation is obvious in those individuals who are severely depleted and at risk of complications. More recently, the concept of subclinical deficit has been developed, which essentially relies upon biochemical abnormalities the interpretation of which remains doubtful in most instances. Symptomatology related to such subclinical deficit is non specific and the potential advantages of micronutrient supplements remain marginal and largely not well-established. In contrast, provision of excess supplements to individuals who do not need them may be harmful. In the general population, a well-balanced diet supplies an adequate intake of micronutrient. Further research is needed to identify the best markers of micronutrient and antioxidant status, so that at risk patients can be identified and appropriate supplementation provided accordingly. New large-scale trials of different doses of micronutrients, based on precise outcome markers, are required to optimise intakes in different groups of patients as well as in the general population. [less ▲]

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See detailLe diabete de type 1 et la maladie coeliaque.
Mathieu, Sandrine ULg; Stassen, A.; Paquot, Nicolas ULg et al

in Revue Médicale de Liège (2006), 61(9), 637-42

Celiac disease is more prevalent in type 1 diabetic patients than in the general population. The exact reason for this association remains unknown. Two hypotheses are taken into consideration: either a ... [more ▼]

Celiac disease is more prevalent in type 1 diabetic patients than in the general population. The exact reason for this association remains unknown. Two hypotheses are taken into consideration: either a common genetic background or an immune response against Langerhans islets triggered by celiac disease. This review presents recent data about this association and its consequences in clinical practice. [less ▲]

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