Obesity: Basdevant A

Fried M, Hainer V, Basdevant A, Buchwald H, Dietel M, Finer N, Greve JW, Horber F, Mathus-Vliegen E, Scopinaro N, Steffen R, Tsigos C, Weiner R, Widhalm K. · Klinické centrum pro minimálne invazivní a bariatrickou chirurgii ISCARE a 1. lékarská fakulta Univerzity Karlovy, Praha, Cesko. · Vnitr Lek. · Pubmed #18630623 No free full text.

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Fried M, Hainer V, Basdevant A, Buchwald H, Deitel M, Finer N, Greve JW, Horber F, Mathus-Vliegen E, Scopinaro N, Steffen R, Tsigos C, Weiner R, Widhalm K, Anonymous00354. · Clinical Center for Minimally Invasive and Bariatric Surgery, Prague, Czech Republic. · Obes Surg. · Pubmed #17476884 No free full text.

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Fried M, Hainer V, Basdevant A, Buchwald H, Deitel M, Finer N, Greve JW, Horber F, Mathus-Vliegen E, Scopinaro N, Steffen R, Tsigos C, Weiner R, Widhalm K. · Clinical Center for Minimally Invasive and Bariatric Surgery, 1st Medical Faculty, Charles University, Prague, Czech Republic. · Int J Obes (Lond). · Pubmed #17325689 No free full text.

Abstract: In 2005, for the first time in European history, an extraordinary Expert panel named 'The BSCG' (Bariatric Scientific Collaborative Group), was appointed through joint effort of the major European Scientific Societies which are active in the field of obesity management. Societies that constituted this panel were: IFSO - International Federation for the Surgery of Obesity, IFSO-EC - International Federation for the Surgery of Obesity - European Chapter, EASO - European Association for Study of Obesity, ECOG - European Childhood Obesity Group, together with the IOTF (International Obesity Task Force) which was represented during the completion process by its representative. The BSCG was composed not only of the top officers representing the respective Scientific Societies (four acting presidents, two past presidents, one honorary president, two executive directors), but was balanced with the presence of many other key opinion leaders in the field of obesity. The BSCG composition allowed the coverage of key disciplines in comprehensive obesity management, as well as reflecting European geographical and ethnic diversity. This joint BSCG expert panel convened several meetings which were entirely focused on guidelines creation, during the past two years. There was a specific effort to develop clinical guidelines, which will reflect current knowledge, expertise and evidence based data on morbid obesity treatment.

Basdevant A. · No affiliation provided · Rev Med Interne. · Pubmed #12829213 No free full text.

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Basdevant A. · No affiliation provided · J Chir (Paris). · Pubmed #12410134 No free full text.

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Bart S, Ciangura C, Thibault F, Cardot V, Richard F, Basdevant A, Chartier-Kastler E. · Service d'urologie et de transplantation rénale et pancréatique, groupe hospitalier Pitié-Salpêtrière, AP-HP, faculté de médecine, université Pierre-et-Marie-Curie Paris-5, France. · Prog Urol. · Pubmed #18760738 No free full text.

Abstract: In France, the prevalence of urinary incontinence is about 44%. Obesity, defined by a Body Mass Index (BMI) above 30kg/m(2), is well established as a risk factor of stress urinary incontinence. Odds ratio (OR) varies between 1.7 and 2.4. Urge or mixed incontinence also occurs in obesity. Urinary incontinence epidemiology is not well-known in obese women. Weight loss, obtained by a weight reduction diet program or bariatric surgery, improves urinary symptoms of stress, urge or mixed incontinence. Functional outcome of urge incontinence surgery is not influenced by obesity. Typically, functional outcome and morbidity of tension-free vaginal tape are not influenced by BMI variations.

Veyrie N, Servajean S, Berger N, Loire P, Basdevant A, Bouillot JL. · Unité de chirurgie viscérale et digestive, Hôtel-Dieu, Assistance Publique des Hôpitaux de Paris, Université Paris V René Descartes, Paris, France. · Gastroenterol Clin Biol. · Pubmed #17483774 No free full text.

Abstract: With the increased incidence of obesity in the developed countries, and the failure of medical treatments, bariatric surgery has increased rapidly. Although laparoscopic gastroplasty is the most popular bariatric intervention in France, the gold standard tends to be the laparoscopic gastric bypass. The severe weight loss caused by this type of procedure induces specific middle or long term complications such as biliary lithiasis. In this literature we describe different physiopathological mechanisms of lithiasis after gastric bypass by coeliosurgery or gastroplasty, their diagnosis, and preventive treatment to avoid these complications.

Poitou Bernert C, Ciangura C, Coupaye M, Czernichow S, Bouillot JL, Basdevant A. · Nutrition Department, Reference Clinic for Obesity, APHP, Hôtel-Dieu, 75181 Paris cedex 04, France. · Diabetes Metab. · Pubmed #17258928 links to  free full text

Abstract: In recent years, the recourse to obesity surgery to treat morbid obesities has grown. The number of "malabsorptive" interventions, such as the gastric bypass (RYGB: Roux-en-Y gastric bypass) increases each year. The RYGB, which combines two mechanisms promoting weight loss, restriction and malabsorption, has proven its effectiveness in term of weight loss and improvement of obesity-associated co-morbidities. However this intervention involves a profound change in digestive physiology and is the source of nutritional and metabolic complications. The deficits observed most frequently concern proteins, iron, calcium, vitamin B12 and vitamin D. The deficiencies in vitamin B1 are rare but potentially serious. Multidisciplinary follow-up is essential to ensure prevention, diagnosis and treatment of these complications. Based on an analysis of the literature, this article summarizes the various nutritional complications observed after RYGB and the means to diagnose it. It proposes practical recommendations for follow-up, preventive supplementation and treatment of these deficiencies, both generally and in the more specific case of a pregnancy after RYGB.

Laville M, Romon M, Chavrier G, Guy-Grand B, Krempf M, Chevallier JM, Marmuse JP, Basdevant A. · Department of Endocrinology-Diabetology, Nutrition, Hopital E. Herriot, University Lyon 1, France. · Obes Surg. · Pubmed #16354530 No free full text.

Abstract: In France, 1,000 obese persons per month undergo a bariatric operation. Obesity surgery requires coordination and monitoring of aftercare. The French public health-care insurer asked the medical associations involved in obesity management to provide guidelines for obesity surgery. The recommendations were developed by the national associations of Obesity, Nutrition and Diabetes: the Association Française d'Etudes et de Recherches sur l'Obésité (AFERO), member of the EASO and IASO; the Association de Langue Française pour l'Etude du Diabète et des Maladies Métaboliques (ALFEDIAM); the Société Française de Nutrition (SFN); and the Société Française de Chirurgie de l'Obésité (SOFCO). This article presents the short version of the guidelines.

Basdevant A. · Service de Nutrition, Hôtel-Dieu, Université Paris 6, 75181 Paris. · Bull Acad Natl Med. · Pubmed #15146608 No free full text.

Abstract: Obesity is a chronic disease. At the initial phase, behavioral and environmental factors play a key role in the constitution of adipose tissue excess. Progressively biological alterations of adipose tissue metabolism lead to some degree of irreversibility of the disease and contribute to the development of its metabolic and cardio-vascular complications.

Basdevant A. · Service de Nutrition, Hôtel Dieu, F75181 Paris Cedex 04. · Ann Pharm Fr. · Pubmed #15107724 No free full text.

Abstract: Obesity is a chronic disease. At the initial phase, behavioral and environmental factors play a key role in the constitution of adipose tIssue excess. Progressively biological alterations of adipose tIssue metabolism lead to some degree of irreversibility of the disease and contribute to the development of its metabolic and cardio-vascular complications.

Ziegler O, Basdevant A, Bernard-Harlaut M, Poulain JP, Ricour C. · Service de Diabétologie, Maladies Métaboliques et Maladies de la Nutrition, CHU de Nancy. · Ann Endocrinol (Paris). · Pubmed #14707904 No free full text.

Abstract: Obesity prevalence is rapidly growing, particularly in children and young adolescents. It is proved to be important to prevent it within a public health strategy. Primary prevention of obesity should not be focused on obesity itself, but should be part of a global public health national policy, targeted to improve the nutritional status of the community, to reduce the risk for chronic diseases, to improve the health status and the quality of life of the general population. This overall prevention programme should be conducted on a large scale, at all level of the country infrastructure and sectors of society, and should acquired a strong local and regional support from communities, consumers and government, but it has also to be particularly focused on young subjects (and their family and school workers), especially in groups with low socio-economic status. Secondary prevention should be particularly focused on children with a high-risk for obesity and/or those with potential associated risk factors. Medical involvement is of a particular importance in this secondary prevention, to identify and to manage these at-risk children and young adolescents. The various approaches from a paediatrician, a physician specialised in human nutrition, a sociologist and a consumer representative are presented in this review.

Basdevant A. · Service de Nutrition, Hôtel-Dieu, 1, place du Parvis-Notre-Dame, 75181 Paris cedex 04, France. · Ann Endocrinol (Paris). · Pubmed #11994681 No free full text.

Abstract: Obesity is now the more prevalent nutritional disease in the world. Mainly related to the evolution of life style, in particular sedentary, food availability and palatability and eating disorders, this disease is also dependent on psychological and environmental factors together with biological (genetic or not) determinants. Obesity includes a great variety of clinical, pathophysiological situations. This nutritional disease results from a long term, chronic, autoaggravating process. Complications related to the excess of adipose mass accumulation are metabolic, mechanic and cellular. The clinician task is to analyse in a given subject the relative influence of the pathophysiological factors, the predominant and more severe complications to adapt a tailored medical strategy.

Charles MA, Basdevant A, Eschwege E. · INSERM U 258, Villejuif et Hôtel-Dieu, Paris, France. · Ann Endocrinol (Paris). · Pubmed #11994680 No free full text.

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Basdevant A. · Service de Nutrition, Hôtel Dieu, 75181 Paris cedex 04. · Ann Endocrinol (Paris). · Pubmed #11148331 No free full text.

Abstract: Obesity is currently the most frequent nutritional disease in the world. In France, the prevalence of obesity is 8 to 10% of the adult population. This prevalence is increasing among children and adolescents. The World Health Organization considers that the current epidemic justifies prevention and management strategies adapted to local situations. "Recommendations for diagnosis, prevention and treatment of obesity" have been developed in France.

Basdevant A, Boute D, Borys JM. · Department of Nutrition, Hôtel Dieu, Paris, France. · Int J Obes Relat Metab Disord. · Pubmed #10385274 No free full text.

Abstract: The International Obesity Task Force (IOTF) concluded that the prevention of weight gain is easier, less expensive and more effective than treating obesity after it has fully developed. The objective of prevention programmes is to reduce the exposure of populations to the environmental causes of obesity. Public health prevention is based on education and behavioural changes aiming at promoting physical activity and a less energy dense diet. Effective management of overweight in children proved to reduce the number who carry their weight problems into adulthood. It has been proposed that school could play an important role in encouraging healthy eating habits. School-based prevention strategies consider the child as the target of the education programme. A complementary approach considers that the child could play an active role in the transmission of the message of prevention. It is the hypothesis of a prospective intervention study in northern France, the 'Fleurbaix-Laventie-Ville-Santé' Study, that nutritional education of children aged 6-12y at school may not only improve their nutritional knowledge but also influence the dietary habits of the family. Preliminary results indicate that the education programme resulted in encouraging changes in dietary habits, mainly a decreased intake of lipid-rich foods in the family. The effects on body weight evolution remain to be evaluated. The study is in progress with a 10-year follow-up.

Basdevant A, Laville M, Ziegler O, Anonymous00173, Anonymous00174, Anonymous00175. · No affiliation provided · Diabetes Metab. · Pubmed #11976568 links to  free full text

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Clément K, Viguerie N, Poitou C, Carette C, Pelloux V, Curat CA, Sicard A, Rome S, Benis A, Zucker JD, Vidal H, Laville M, Barsh GS, Basdevant A, Stich V, Cancello R, Langin D. · INSERM Avenir Paris 6 University, EA 3502, Nutrition Department, AP/HP, Hôtel-Dieu, Paris, France. · FASEB J. · Pubmed #15522911 links to  free full text

Abstract: Adipose tissue produces inflammation and immunity molecules suspected to be involved in obesity-related complications. The pattern of expression and the nutritional regulation of these molecules in humans are poorly understood. We analyzed the gene expression profiles of subcutaneous white adipose tissue from 29 obese subjects during very low calorie diet (VLCD) using cDNA microarray and reverse transcription quantitative PCR. The patterns of expression were compared with that of 17 non-obese subjects. We determined whether the regulated genes were expressed in adipocytes or stromavascular fraction cells. Gene expression profiling identified 100 inflammation-related transcripts that are regulated in obese individuals when eating a 28 day VLCD but not a 2 day VLCD. Cluster analysis showed that the pattern of gene expression in obese subjects after 28 day VLCD was closer to the profile of lean subjects than to the pattern of obese subjects before VLCD. Weight loss improves the inflammatory profile of obese subjects through a decrease of proinflammatory factors and an increase of anti-inflammatory molecules. The genes are expressed mostly in the stromavascular fraction of adipose tissue, which is shown to contain numerous macrophages. The beneficial effect of weight loss on obesity-related complications may be associated with the modification of the inflammatory profile in adipose tissue.

Pascal-Sébaoun S, Milosevic D, Orvoën-Frija E, Léger D, Basdevant A, Laaban JP. · Service de Pneumologie et de Réanimation, Hôtel Dieu, Paris. · Presse Med. · Pubmed #10682046 No free full text.

Abstract: OBJECTIVE: Assess the diagnostic contribution of cyclic nocturnal variations in heart rate in sleep apnea syndrome. PATIENTS AND METHODS: Holter recordings performed in a population of 30 patients with massive obesity defined as a body mass index greater than 40 kg/m2 and sleep apnea syndrome defined by an apnea index greater than 5 apneas per hour were analyzed retrospectively. The control group was composed of 15 patients with massive obesity but without sleep apnea syndrome. High variability in nocturnal heart rate was assessed using a visual criterion defined as repeated episodes of progressive reduction in heart rate followed by a sudden acceleration reaching a difference of 30 bpm between the highest and lowest heart rate and occurring at least 5 times during one consecutive hour of recording. RESULTS: Increased nocturnal variability in heart rate was evidenced in all the patients with sleep apnea syndrome (30/30) but was not observed in any of the control subjects (0/15). CONCLUSION: These results suggest that Holter recordings can be a useful tool for the diagnosis of sleep apnea syndrome.

Tordjman J, Poitou C, Hugol D, Bouillot JL, Basdevant A, Bedossa P, Guerre-Millo M, Clement K. · INSERM, U872, Eq7, 15 Rue de l'Ecole de Medicine, 75007 Paris, France. · J Hepatol. · Pubmed #19464069 No free full text.

Abstract: BACKGROUND/AIMS: Recently we showed that macrophage accumulation in omental adipose tissue is associated with liver fibro-inflammation in morbidly obese subjects. Here, we evaluated the influence of glycemic status and extended the analysis to the spectrum of obesity-linked liver damage. METHODS: Liver biopsies, subcutaneous and omental adipose tissue were collected in 132 obese subjects during gastric bypass surgery. HAM56+ adipose tissue macrophages were counted in subjects classified by liver histopathology and by their degree of insulin resistance. RESULTS: In the whole population, the number of omental macrophages increased with the score of steatosis, the non-alcoholic fatty liver disease activity score, the stage of fibrosis and with fibro-inflammation index. None of these relationships were significant with subcutaneous macrophage count. In insulin-sensitive participants, omental macrophages accumulation was higher in subjects with high indexes of fibro-inflammation (p=0.012 vs. low indexes). In insulin-resistant including type 2 diabetic participants, omental macrophage count was higher both in subjects with high scores of steatosis and in subjects with high indexes of fibro-inflammation (p<0.05 vs. low scores). CONCLUSIONS: Macrophage accumulation in omental adipose tissue is associated with aggravated steatosis and fibro-inflammation in insulin-resistant obese subjects independently of altered glycemic status.

Fried M, Hainer V, Basdevant A, Buchwald H, Dietel M, Finer N, Greve JW, Horber F, Mathus-Vliegen E, Scopinaro N, Steffen R, Tsigos C, Weiner R, Widhalm K. · Klinické centrum pro minimálne invazivní a bariatrickou chirurgii ISCARE a Univerzita Karlova--1.lékarská fakulta, Praha, Ceská republika. · Rozhl Chir. · Pubmed #19174948 No free full text.

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Clément K, Le Stunff C, Meirhaeghe A, Dechartres A, Ferrieres J, Basdevant A, Boitard C, Amouyel P, Bougnères P. · Endocrinology and Nutrition Department, Pitié-Salpétrière Hospital, Paris, France. · Mol Genet Metab. · Pubmed #19097921 No free full text.

Abstract: We recently reported that rs361072, a promoter C/T variant of p110beta, the catalytic subunit of PI3-kinase, was associated with a protection from insulin resistance (IR) in Caucasian adolescents in proportion of their body mass. We tested if this cis-regulatory QTL is associated with IR and type 2 diabetes in 7885 middle-aged obese and non-obese adults of European ancestry. We genotyped rs361072 in 1139 non-diabetic obese (NDO) European adults, in whom IR was estimated by the HOMA-IR index. We also studied 427 type 2 diabetic obese adults (DO) and 424 diabetic non-obese (DNO) adults to test whether their disease status was associated with a decreased prevalence of the protective variant. The prevalence of rs361072 and association with IR was also examined in 5895 non-obese non-diabetic adults (NDNO). rs361072 was associated with HOMA-IR (p=4.10(-4)) in NDO, so that C/C patients had a 17% decrease of this index (p=0.002). A statistical trend (p=1.1.10(-2)) for the same genotypic differences was also observed in NDNO adults, but of insignificant magnitude (4.2%). The distribution of rs361072 genotype was comparable in NDO, DO, DNO and NDNO individuals. Allele C of rs361072 is associated with a protection from IR in obese and non-obese adults, but has no significant effect, however, on diabetes risk in obese or non-obese Europeans.

Mimoun E, Aggoun Y, Pousset M, Dubern B, Bouglé D, Girardet JP, Basdevant A, Bonnet D, Tounian P. · Department of Pediatric Gastroenterology and Nutrition, Armand-Trousseau Hospital, AP-HP, and INSERM, U872 Nutriomique, University Pierre and Marie Curie-Paris 6, Paris, France. · J Pediatr. · Pubmed #18571538 No free full text.

Abstract: OBJECTIVE: We investigated whether metabolic syndrome, defined in 3 different ways (2 commonly used and 1 novel) is associated with arterial alterations in obese children. STUDY DESIGN: The study group comprised 384 obese children age 2.5 to 18 years. Blood pressure, fasting blood glucose, blood insulin, plasma lipids, and body composition were measured. Noninvasive ultrasound measurements were obtained in 161 patients to investigate arterial mechanical properties and endothelial function. RESULTS: The prevalence of metabolic syndrome was 10.4%. Intima-media thickness correlated positively with low-density lipoprotein cholesterol (r = .21; P < .01) and negatively with high-density lipoprotein cholesterol (r = -.17; P < .05). In adolescents (11 to 18 years), cross-sectional vascular compliance correlated negatively with abdominal fat (r = -.22; P = .02). The only synergistic effects among individual metabolic syndrome components was an effect of insulinemia and systolic blood pressure on cross-sectional compliance (4.05; P < .05). No significant difference in vascular variables was found between the patients with and without metabolic syndrome using any of the 3 definitions. CONCLUSION: Metabolic syndrome in obese children is not related to arterial variables, whereas several of its individual components are associated with vascular alterations. These data suggest that the value of the metabolic syndrome as a predictor of future cardiovascular events in children remains to be prospectively evaluated. In the meantime, individual cardiovascular risk factors should be evaluated and controlled.

Spielmann N, Mutch DM, Rousseau F, Tores F, Hager J, Bertrais S, Basdevant A, Tounian P, Dubern B, Galan P, Clément K. · INSERM, Nutriomique U872, Paris, France; Centre de Recherche des Cordeliers, Université Pierre et Marie Curie - Paris 6, UMR S 872, Paris, France. · Clin Genet. · Pubmed #18565099 No free full text.

Abstract: Cathepsin S (CTSS) is a cysteine protease that has a central role in remodeling the extracellular matrix and, as such, has been implicated in the etiology of cardiovascular disease. This study used five tag single nucleotide polymorphisms (tSNPs) to screen the CTSS gene in healthy lean (n = 1891) and obese French populations (n = 477) for their association with various phenotypes: body mass index, waist-to-hip ratio, glycemia, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (Apo-A1) and apolipoprotein B. Significant associations were identified between rs11576175 tSNP (A/G) and Apo-A1 and HDL-C plasma levels in a sex-specific manner. Lean female subjects homozygous for the minor A-allele had higher levels of circulating Apo-A1 (p = 0.0003), while lean male A/A carriers had higher levels of HDL-C (p = 0.007) compared with the other genotypes. In the obese cohort, associations were found between three tSNPs and Apo-A1 levels in adult female subjects: rs10888390 (G/A), p = 0.01; rs10888394 (T/C), p = 0.03; and rs1136774 (C/T), p = 0.02; however, only rs10888390 remained significant in a combined model (p = 0.03). These results provide the first evidence that CTSS sequence variations are associated with two human metabolic risk factors for cardiovascular diseases: plasma Apo-A1 and HDL-C concentrations.

Charles MA, Eschwège E, Basdevant A. · INSERM, Unit 780 Research in Epidemiology and Biostatistics, Villejuif, France. · Obesity (Silver Spring). · Pubmed #18535547 links to  free full text

Abstract: The objective of the study was to describe the prevalences of obesity in French adults over a 9-year period. Mailed questionnaire surveys, in 1997, 2000, 2003, and 2006, sampled 20,000 representative French households by the method of quotas. Weight, height, and waist circumference were reported by all members of the selected households > or = 18-years. Obesity was defined according to the WHO criteria, BMI > 30 kg/m2. The prevalence of adult obesity increased progressively from 8.6% (95% confidence interval: 8.2-8.8) in 1997 to 13.1% (12.7-13.5) in 2006. The increase affected all ages, socioeconomic strata, and regions. Although the prevalence of obesity increased in parallel in men and women from 1997 to 2003, the rate of increase was lower in men between 2003 and 2006. These surveys showed a sharp increase in the prevalence of obesity in France in recent years contrasting with a stable prevalence in the 1980s. The results of the first Obepi surveys prompted the French government to implement a Nutrition and Health National Plan in 2001. Regular monitoring of obesity prevalence in France and neighboring countries is needed to compare future trends.