References of "PAQUOT, Nicolas"
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See detailAnti-inflammatory agents to treat or prevent type 2 diabetes, metabolic syndrome and cardiovascular disease.
Esser, Nathalie ULg; Paquot, Nicolas ULg; Scheen, André ULg

in Expert opinion on investigational drugs (in press)

Introduction: There is a growing body of evidence to suggest that chronic silent inflammation is a key feature in abdominal obesity, metabolic syndrome, type 2 diabetes (T2DM) and cardiovascular disease ... [more ▼]

Introduction: There is a growing body of evidence to suggest that chronic silent inflammation is a key feature in abdominal obesity, metabolic syndrome, type 2 diabetes (T2DM) and cardiovascular disease (CVD). These observations suggest that pharmacological strategies, which reduce inflammation, may be therapeutically useful in treating obesity, type 2 diabetes and associated CVD. Area covered: The article covers novel strategies, using either small molecules or monoclonal antibodies. These strategies include: approaches targeting IKK-b-NF-kB (salicylates, salsalate), TNF-alpha (etanercept, infliximab, adalimumab), IL-1beta (anakinra, canakinumab) and IL-6 (tocilizumab), AMP-activated protein kinase activators, sirtuin-1 activators, mammalian target of rapamycin inhibitors and C-C motif chemokine receptor 2 antagonists. Expert opinion: The available data supports the concept that targeting inflammation improves insulin sensitivity and beta-cell function; it also ameliorates glucose control in insulin-resistant patients with inflammatory rheumatoid diseases as well in patients with metabolic syndrome or T2DM. Although promising, the observed metabolic effects remain rather modest in most clinical trials. The potential use of combined anti-inflammatory agents targeting both insulin resistance and insulin secretion appears appealing but remains unexplored. Large-scale prospective clinical trials are underway to investigate the safety and efficacy of different anti-inflammatory drugs. Further evidence is needed to support the concept that targeting inflammation pathways may represent a valuable option to tackle the cardiometabolic complications of obesity. [less ▲]

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See detailLes inhibiteurs de la PSCK9: une innovation majeure dans le traitement des dyslipidémies ?
PAQUOT, Nicolas ULg

in ABD- le supplément du médecin (2014), 57(6), 6-7

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See detailComment gérer la nutrition artificielle chez un patient diabétique ?
PAQUOT, Nicolas ULg; DE FLINES, Jenny ULg; Preiser, Jean-Charles

in Nutrition Clinique et Metabolisme (2014)

Hyperglycaemia in patients receiving enteral or parenteral nutrition is a major problem due to its high prevalence and possible consequences interms of morbidity and mortality. However, the management of ... [more ▼]

Hyperglycaemia in patients receiving enteral or parenteral nutrition is a major problem due to its high prevalence and possible consequences interms of morbidity and mortality. However, the management of diabetes/stress hyperglycaemia during artificial nutrition remains largely unknown,especially in non-critically ill patients. The indications and access routes for artificial nutrition are not different in patients with diabetes/stressdiabetes than in non-diabetics. We do not recommend using enteral formulas designed for patients with diabetes. The glycaemic objective mustbe individualized. We recommend a preprandial blood glucose levels between 100 and 140 mg/dL (5.5 and 7.8 mmol/L) and postprandial levelsbetween 140 and 180 mg/dL (7.8 and 10 mmol/L). A frequent monitoring of capillary glycaemias is mandatory. The best drug treatment for treatinghyperglycaemia/diabetes is insulin and we recommend to adapt the theoretical insulin action to the nutrition infusion regimen. The managementof these patients needs the help of a multidisciplinary experimented staff. [less ▲]

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See detailMetabolically healthy overweight and obesity
Esser, Nathalie ULg; SCHEEN, André ULg; PAQUOT, Nicolas ULg

in Annals of Internal Medicine (2014), 160(7), 514

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See detailInteret d'une combinaison agoniste des recepteurs du GLP-1 et insuline basale dans le traitement du diabete de type 2.
Scheen, André ULg; Paquot, Nicolas ULg

in Revue medicale suisse (2014), 10(439), 1549-54

The complex pathophysiology of type 2 diabetes and its natural evolution, characterized by a progressive loss of glucose control due to the exhaustion of insulin secretion, lead to consider new ... [more ▼]

The complex pathophysiology of type 2 diabetes and its natural evolution, characterized by a progressive loss of glucose control due to the exhaustion of insulin secretion, lead to consider new complementary therapeutic options. Even at the insulin-requiring stage, the addition of a glucagon-like peptide-1 (GLP-1) receptor agonist is beneficial. Besides their incretinomimetic activity (which may decrease with the loss of beta-cell mass/function), GLP-1 receptor agonists reduce glucagon secretion, slow down gastric emptying and diminish appetite through a central effect. These combined effects permit to improve glucose control, while reducing daily insulin doses, together with less weight gain (or even weight loss) and generally less hypoglycaemia. Fixed insulin glargine-lixisenatide and insulin degludec-liraglutide are currently in development. [less ▲]

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See detailLa nutrition de la personne âgée
ALLEPAERTS, Sophie ULg; DE FLINES, Jenny ULg; PAQUOT, Nicolas ULg

in Revue Médicale de Liège (2014), 69(5-6), 244-250

Ageing of the body predisposes to a high incidence of undernutrition in the elderly person wherever he or she is living, but the prevalence of malnutrition is particularly high in hospitalized or ... [more ▼]

Ageing of the body predisposes to a high incidence of undernutrition in the elderly person wherever he or she is living, but the prevalence of malnutrition is particularly high in hospitalized or instutionalized patients. Early detection of malnutrition is important because malnutrition may have significant consequences and evaluation of nutritional status has to be a routine screening in the elderly. There is no single parameter which supplies a full assessment of the patient’s nutritional status. It is then necessary to use screening tools for the identification of patients at nutritional risk, based on anamnestic, antropometric and biologic data. The MNA (Mini Nutritional Assessment) test is a simple, non invasive, well-validated screening tool for malnutrition in the elderly and is recommended for early detection of risks on malnutrition. Numerous conditions in relationship with physiological ageing, comorbidity, polymedication and the way of life of the individual predispose to undernutrition. Healthy nutrition in older patients should respect the guidelines for protein and energy requirements, excepted in severely ill patients and/or in case of malnutrition in which case the protein-energy intake should be increased. [less ▲]

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See detailLe diabete du sujet age: du defi epidemiologique a une approche personnalisee.
Scheen, André ULg; Paquot, Nicolas ULg; Bauduceau, B.

in Revue medicale de Liege (2014), 69(5-6), 323-8

Diabetes mellitus is a common chronic disease in the elderly, being either a known disease with a long history (type 1 or even more often type 2 diabetes) and then frequently associated with various ... [more ▼]

Diabetes mellitus is a common chronic disease in the elderly, being either a known disease with a long history (type 1 or even more often type 2 diabetes) and then frequently associated with various diabetic complications, or a recently diagnosed diabetes that may, however, have been ignored for a rather long time. In this latter case, diabetes may present as the occurrence or aggravation of one or several geriatric syndromes that overall result in a loss of autonomy. The global geriatric assessment, the estimation of life expectancy and the justification of glucose-lowering treatments should be performed at regular intervals in elderly diabetic people as they determine the right choice of glucose target levels and the best selection of glucose-lowering agents. Medications that can induce hypoglycaemia should ideally be avoided, especially in the frailty older population. The benefit-risk ratio of the proposed therapies should be analyzed first, and then regularly reassessed because of a potentially rapidly progressing condition. The recommended approach is a tailored management of diabetes that should integrate the clinical, functional and psycho-social aspects of elderly individuals. [less ▲]

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See detailInflammation as a link between obesity, metabolic syndrome and type 2 diabetes
ESSER, Nathalie ULg; Legrand, Sylvie ULg; Piette, Jacques ULg et al

in Diabetes Research & Clinical Practice (2014)

It is recognized that a chronic low-grade inflammation and an activation of the immune system are involved in the pathogenesis of obesity-related insulin resistance and type 2 diabetes. Systemic ... [more ▼]

It is recognized that a chronic low-grade inflammation and an activation of the immune system are involved in the pathogenesis of obesity-related insulin resistance and type 2 diabetes. Systemic inflammatory markers are risk factors for the development of type 2 diabetes and its macrovascular complications. Adipose tissue, liver, muscle and pancreas are themselves sites of inflammation in presence of obesity. An infiltration of macrophages and other immune cells is observed in these tissues associated with a cell population shift from an anti-inflammatory to a pro-inflammatory profile. These cells are crucial for the production of pro-inflammatory cytokines, which act in an autocrine and paracrine manner to interfere with insulin signaling in peripheral tissues or induce β-cell dysfunction and subsequent insulin deficiency. Particularly, the pro-inflammatory interleukin-1β is implicated in the pathogenesis of type 2 diabetes through the activation of the NLRP3 inflammasome. The objectives of this review are to expose recent data supporting the role of the immune system in the pathogenesis of insulin resistance and type 2 diabetes and to examine various mechanisms underlying this relationship. If type 2 diabetes is an inflammatory disease, anti-inflammarory therapies could have a place in prevention and treatment of type 2 diabetes. [less ▲]

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See detailDiabète et nutrition artificielle : principes de prise en charge
Quilliot, Didier; Malgras, Aurélie; PAQUOT, Nicolas ULg et al

in Nutrition Clinique et Metabolisme (2013), 27(4), 230-235

At home as in the hospital, the diabetic patients are at high risk of malnutrition. In patients with hyperglycemia in artificial nutrition, the primary objective is to to cover their protein needs and ... [more ▼]

At home as in the hospital, the diabetic patients are at high risk of malnutrition. In patients with hyperglycemia in artificial nutrition, the primary objective is to to cover their protein needs and their caloric needs and to optimize accordingly the antidiabetic treatment. Insulin therapy is the treatment of choice. The use of low glycaemic index is probably better, especially for oral supplementation. An equivalent parenteral carbohydrate intake has a hyperglycaemic effect more important than with the oral or enteral way. The management of hyperglycemia in artificial nutrition requires defining glycemic goals, tailored to the patient, to the type and the sequences of artificial nutrition, establishing patterns of insulin therapy and providing accurate adaptation rules. Above the basal requirement, insulin therapy sufficient to meet caloric exposure must be prescribed appropriate in timing with the artificial nutrition. The use of sliding scale as monotherapy is ineffective. This management requires forming the nurse team. The acute phase has passed, the disease stabilized, it is sometimes possible to introduce oral antidiabetic drugs and stop insulin. In this case, we apply the same prescription rules to these drugs as for the patient fed orally. [less ▲]

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See detailObesity phenotype is related to NLRP3 inflammasome activity and immunological profile of visceral adipose tissue
ESSER, Nathalie ULg; L'Homme, Laurent ULg; DE ROOVER, Arnaud ULg et al

in Diabetologia (2013), 56

Aims/hypothesis Obesity is a heterogeneous condition comprising both individuals who remain metabolically healthy (MHO) and those who develop metabolic disorders (metabolically unhealthy, MUO). Adipose ... [more ▼]

Aims/hypothesis Obesity is a heterogeneous condition comprising both individuals who remain metabolically healthy (MHO) and those who develop metabolic disorders (metabolically unhealthy, MUO). Adipose tissue is also heterogeneous in that its visceral component is more frequently associated with metabolic dysfunction than its subcutaneous component. The development of metabolic disorders is partly mediated by the NLR family pyrin domain containing-3 (NLRP3) inflammasome, which increases the secretion of inflammatory cytokines via activation of caspase-1. We compared the immunological profile and NLRP3 activity in adipose tissue between MUO and MHO individuals. Methods MHO and MUO phenotypes were defined, respectively, as the absence and the presence of the metabolic syndrome. Cellular composition and intrinsic inflammasome activity were investigated by flow cytometry, quantitative RTPCR and tissue culture studies in subcutaneous and visceral adipose tissue from 23 MUO, 21 MHO and nine lean individuals. Results We found significant differences between the three study groups, including an increased secretion of IL-1β, increased expression of IL1B and NLRP3, increased number of adipose tissue macrophages and decreased number of regulatory T cells in the visceral adipose tissue of MUO patients compared with MHO and lean participants. In macrophages derived from visceral adipose tissue, both caspase-1 activity and IL-1β levels were higher in MUO patients than in MHO patients. Furthermore, caspase-1 activity was higher in CD11c+CD206+ adipose tissue macrophages than in CD11c−CD206+ cells. Conclusions/interpretation The MUO phenotype seems to be associated with an increased activation of the NLPR3 inflammasome in macrophages infiltrating visceral adipose tissue, and a less favourable inflammatory profile compared with the MHO phenotype. [less ▲]

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See detailUnsaturated fatty acids prevent activation of NLRP3 inflammasome in human monocytes/macrophages
L'Homme, Laurent ULg; Esser, Nathalie ULg; Riva, Laura ULg et al

in Journal of Lipid Research (2013), 54

The NLRP3 inflammasome is involved in many obesity-associated diseases such as type 2 diabetes, atherosclerosis and gouty arthritis through its ability to induce IL-1β release. The molecular link between ... [more ▼]

The NLRP3 inflammasome is involved in many obesity-associated diseases such as type 2 diabetes, atherosclerosis and gouty arthritis through its ability to induce IL-1β release. The molecular link between obesity and inflammasome activation is still unclear but free fatty acids have been proposed as one triggering event. Here we reported opposite effects of saturated fatty acids (SFAs) compared to unsaturated fatty acids (UFAs) on NLRP3 inflammasome in human monocytes/macrophages. Palmitate and stearate, both SFAs, triggered IL-1β secretion in a caspase-1/ASC/NLRP3-dependent pathway. Unlike SFAs, the UFAs oleate and linoleate did not lead to IL-1β secretion. In addition, they totally prevented the IL-1β release induced by SFAs and, with less efficiency, by a broad range of NLRP3 inducers including nigericin, alum and MSU. UFAs did not affect the transcriptional effect of SFAs suggesting a specific effect on the NLRP3 activation. These results provide a new antiinflammatory mechanism of UFAs by preventing the activation of the NLRP3 inflammasome and therefore the IL-1β processing. By this way, UFAs might play a protective role in NLRP3-associated diseases. [less ▲]

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See detailComment gérer la nutrition artificielle chez un patient diabétique ?
PAQUOT, Nicolas ULg; DE FLINES, Jenny ULg; Preiser, Jean-Charles

in Journée de développement professionnel continu de la SFNEP (2013, September 11)

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See detailObésité et carences préopératoires
DE FLINES, Jenny ULg; BRUWIER, Laurent; DE ROOVER, Arnaud ULg et al

in Nutrition Clinique et Metabolisme (2013), 27(2), 82-86

It is a common belief that nutritional deficiencies are rare in the Western world due to a wide variety of food supply. However, obese people usually consume dense-energy food but of poor nutritional ... [more ▼]

It is a common belief that nutritional deficiencies are rare in the Western world due to a wide variety of food supply. However, obese people usually consume dense-energy food but of poor nutritional value that lacks proteins, vitamins, minerals and fiber; consequently, a high prevalence of micronutrient deficiencies in obese subjects has been reported. Moreover, bariatric surgery has been proven the most effective treatment of morbid obesity, but micronutrient deficiency following bariatric surgery is a major concern, worsening pre-operative nutritional deficiencies. In this article, we reviewed the litterature and highlighted the prevalence of nutritional deficiencies in the morbidly obese population prior to bariatric surgery, clinical consequences of these deficiencies and practical recommendations for these subjects. [less ▲]

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See detailL’ALCOOLISME, UN MODÈLE D’ADDICTION AUX COMPLICATIONS SOMATIQUES MULTIPLES
PAQUOT, Nicolas ULg; DE FLINES, Jenny ULg; SCHEEN, André ULg

in Revue Médicale de Liège (2013), 68(5-6), 272-280

Alcoholism is, after smoking, the most common addiction in our society. It is associated with multiple familial, social and professional negative consequences. In addition, alcohol disturbs cellular ... [more ▼]

Alcoholism is, after smoking, the most common addiction in our society. It is associated with multiple familial, social and professional negative consequences. In addition, alcohol disturbs cellular metabolism and its excessive chronic consumption may lead to multiple dysfunctions that can provoke somatic complications targeting numerous tissues or organs. The present article describes the most important ones involving the liver, the digestive tract, the heart, both the central and peripheral nervous system, and bone marrow. We also discuss the metabolic disturbances associated with chronic alcohol consumption, among which those affecting glucose regulation, lipid profile, uric acid and various vitamins. Finally, we describe the nutritional deficiencies that may be observed in alcoholic people and may contribute to aggravate somatic complications. [less ▲]

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See detailDifférences d’activité de l’inflammasome NLRP3 entre sujets obèses avec et sans anomalies métaboliques
Esser, Nathalie ULg; L'Homme, Laurent ULg; DE ROOVER, Arnaud ULg et al

in Diabètes & Métabolism (2013, March), 39(suppl 1), 102

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