Afef Bahlous

Bone mineral density of young boy soccer players at different pubertal stages: relationships with hormonal concentration.

OBJECTIVES To examine the effects of soccer in relation with the hormonal concentration, on the bone mass of young Tunisian players at different pubertal stages. METHODS Two groups of 152 young boys (age: 13.3+/-0.9 years) participated in this study: (1) 91 soccer players, and (2) 61 non-athletic boys used as control subjects. The bone mineral density (BMD) and the bone mineral content (BMC) were measured by dual-energy X-ray absorptiometry (DXA). Pubertal stages were assessed, and serum concentrations of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), growth hormone (GH) and the total testosterone were measured. RESULTS The BMD and BMC for whole body, lumbar spine, femoral neck, pelvis and lower limbs were higher in soccer players than in controls (p<0.001). In early puberty, the soccer players also exhibited significantly greater BMD and BMC in the whole body and in weight-bearing bones compared with the controls (p<0.001). However, there was no intersubject variability due to puberty in either BMD or BMC. The pubescent soccer players had significantly higher hormonal concentrations of IGF-1 and IGFBP-3 than their counterpart controls (p<0.05). Moreover, the whole body BMD was significantly (p<0.001) correlated with GH, IGF-1 and IGFBP-3 but not with the testosterone concentrations. CONCLUSION The soccer participation of boys is generally associated with the improvement of their bone mass which is mainly marked at early and late puberty. The relationships between somatotropic axis hormones and BMD of the players may be linked to the parallel development of these two parameters during puberty.

Association of serum levels of aggrecan ARGS, NITEGE fragments and radiologic knee osteoarthritis in Tunisian patients

OBJECTIVES Proteolytic degradation of aggrecan is a hallmark of the pathology of osteoarthritis. The aim of this study was to develop enzyme-linked immunosorbent assay (ELISA) to quantify the serum levels of specific aggrecan fragments generated by aggrecanases-mediated cleavage. We investigated the relationships between these two aggrecan degradations fragments and urinary CTX-II levels. METHODS The competitive ELISAs employ a polyclonal antibody raised against the aggrecan fragments containing two neoepitopes NITEGE(373)and (374)ARGSVI. We measured serum levels of ARGSV and NITEGE in 125 women with knee osteoarthritis (mean±SD age of 53.6±7.6 years, mean±SD disease duration of 3.6±3.8 years), and 57 women age-matched controls. RESULTS Aggrecan neoepitopes assays showed an intra- and inter-assay imprecision (CV) lower than 20% for both tests and good linearity. Median serum ARGSVI (by 18%; P=0.002), and NITEGE (36.4%; P<0.001) levels were significantly decreased in patients with knee osteoarthritis compared with controls. Minimal joint space width was negatively correlated with ARGSVI (r=-0.368, P=0.04) and NITEGE (r=-0.274, P=0.038) in knee osteoarthritis patients. Median urinary CTX-II levels were significantly increased by 39.5% (P=0.001) in knee OA patients compared with controls. CONCLUSION Markers of degradation aggrecan were analyzed for the first time in an African osteoarthritis population. These markers can be used to monitor aggrecanase activity in human joint disease. Their combination with CTX-II can improve clinical investigation of patients with osteoarthritis patients.

Prevalence of vitamin D deficiency in mothers and their newborns in a Tunisian population

To assess vitamin D status in mothers and their newborns and identify predictive factors of vitamin D deficiency.

Prevalence of hemoglobin variants in a diabetic population at high risk of hemoglobinopathies and optimization of HbA1c monitoring by incorporating HPLC in the laboratory workup

Background In Tunisia, diabetes mellitus and hemoglobinopathies are major public health problems. Glycated hemoglobin (HbA1c) is recommended for long-term monitoring of diabetes mellitus, but the presence of hemoglobin variants may interfere with HbA1c measurement. The aim was to determine the prevalence of hemoglobin variants in Tunisian diabetics and optimize the monitoring of diabetics using HbA1c. Methods The study enrolled 9,792 Tunisian diabetic patients. HbA1c was measured by cation-exchange high-pressure liquid chromatography (HPLC). All the chromatograms were analyzed for the presence of Hb variants. Results We identified 228 cases (2.33%) of Hb variants with D-10 HPLC (Bio-Rad): 191 with HbA/S trait, 27 with HbA/C trait, and 10 hemoglobin variants with the mention ‘Variant-Window’ on the chromatograms and subsequently identified as HbA/S on Variant I HPLC (Bio-Rad). Thus, the prevalence of HbS was 2.05%. We did not find any homozygous variant. All HbA1c results were reported to the treating physician. Conclusions To evaluate glycated hemoglobin in populations with a high prevalence of hemoglobinopathies, we should use the HPLC method, which is easy, economical, and reliable. Based on an algorithm, hemoglobin variants visualized on HPLC should be reported to the physician to improve the management of patients.

Hereditary Xanthinuria with Recurrent Urolithiasis Occurring in Infancy

Introduction: Hereditary xanthinuria, due to a purine metabolism disorder, is a rare cause of urinary lithiasis in children. Case: We report the case of a three and half-year old child, who presented recurrent urinary lithiasis that, has led to the destruction of the right kidney. Infrared spectrophotometric analysis of the calculus showed that it was composed of 100% xanthine. Laboratory tests revealed hypouricemia and hypouricosuria with elevated urinary excretion of oxypurines. These findings led to a diagnosis of hereditary xanthinuria. Conclusions: Early diagnosis of this rare disease is essential to avoid its complications. Metabolic causes must be sought in children with lithiasis.

P123 Dépistage du diabète type 2 chez le personnel paramédical de l’hôpital Charles Nicolle de Tunis

Introduction Le diabete est un probleme de sante publique, representant un cout financier important en raison du taux eleve de complications degeneratives. De ce fait son depistage revet une importance primordiale d’autant plus que cette pathologie est caracterisee par une phase asymptomatique. Le but de notre travail est d’evaluer les differentes methodes de depistage du diabete de type 2 chez une population asymptomatique. Materiels et Methodes C’est une etude prospective interessant 460 patients appartenant au personnel paramedical de l’hopital Charles Nicolle de Tunis. on a pratique un examen clinique et une mesure la glycemie au doigt (GAD). Mais 213 personnes seulement ont beneficie d’un bilan biologique comprenant une HGPO (75 g), une HbA1C et un bilan lipidique. Resultats Dans notre serie, 266 sujets ont des antecedents familiaux de diabete (57,8 %) et 10 parmi les femmes ont des antecedents de diabete gestationnel (2,9 %). Une GAD = 2 g/l est retrouvee chez 6 personnes. Une GAD entre 1,4 g/l et 2 g/l est retrouvee chez 21 personnes. Chez les sujets ayant eu une HGPO (75 g), 9 ont un diabete (4,3 %), 20 ont une intolerance au glucose (9,66 %) et 3 ont une hyperglycemie moderee a jeun -HGMJ- (1,45 %). Pour les diabetiques, 3 ont une GAD = 2 g/l, 2 ont une GAD entre 1,4 et 2 g/l et 4 ont une GAD Dans le groupe des intolerants au glucose, 4 ont une GAD entre 1,4 et 2 g/l et 16 ont une GAD Dans le groupe ayant une HGMJ, 2 ont une GAD entre 1,4 et 2 g/l et un a une GAD Conclusion Plusieurs etudes ont montre l’interet du depistage du diabete de type 2. Cependant les modalites du programme de depistage n’ont pas ete definies avec precision.