David Faeh

Association of cigarettes smoked daily with obesity in a general adult population.

Objective: We analyzed the cross‐sectional association between obesity and smoking habits, taking into account diet, physical activity, and educational level.

Dose-dependent positive association between cigarette smoking, abdominal obesity and body fat: cross-sectional data from a population-based survey.

BackgroundAlthough smokers tend to have a lower body-mass index than non-smokers, smoking may favour abdominal body fat accumulation. To our knowledge, no population-based studies have assessed the relationship between smoking and body fat composition. We assessed the association between cigarette smoking and waist circumference, body fat, and body-mass index.MethodsHeight, weight, and waist circumference were measured among 6,123 Caucasians (ages 35-75) from a cross-sectional population-based study in Switzerland. Abdominal obesity was defined as waist circumference ≥102 cm for men and ≥88 cm for women. Body fat (percent total body weight) was measured by electrical bioimpedance. Age- and sex-specific body fat cut-offs were used to define excess body fat. Cigarettes smoked per day were assessed by self-administered questionnaire. Age-adjusted means and odds ratios were calculated using linear and logistic regression.ResultsCurrent smokers (29% of men and 24% of women) had lower mean waist circumference, body fat percentage, and body-mass index compared with non-smokers. Age-adjusted mean waist circumference and body fat increased with cigarettes smoked per day among smokers. The association between cigarettes smoked per day and body-mass index was non-significant. Compared with light smokers, the adjusted odds ratio (OR) for abdominal obesity in men was 1.28 (0.78-2.10) for moderate smokers and 1.94 (1.15-3.27) for heavy smokers (P = 0.03 for trend), and 1.07 (0.72-1.58) and 2.15 (1.26-3.64) in female moderate and heavy smokers, respectively (P < 0.01 for trend). Compared with light smokers, the OR for excess body fat in men was 1.05 (95% CI: 0.58-1.92) for moderate smokers and 1.15 (0.60-2.20) for heavy smokers (P = 0.75 for trend) and 1.34 (0.89-2.00) and 2.11 (1.25-3.57), respectively in women (P = 0.07 for trend).ConclusionAmong smokers, cigarettes smoked per day were positively associated with central fat accumulation, particularly in women.

Diabetes and pre-diabetes are associated with cardiovascular risk factors and carotid/femoral intima-media thickness independently of markers of insulin resistance and adiposity

BackgroundImpaired glucose regulation (IGR) is associated with detrimental cardiovascular outcomes such as cardiovascular disease risk factors (CVD risk factors) or intima-media thickness (IMT). Our aim was to examine whether these associations are mediated by body mass index (BMI), waist circumference (waist) or fasting serum insulin (insulin) in a population in the African region.MethodsMajor CVD risk factors (systolic blood pressure, smoking, LDL-cholesterol, HDL-cholesterol,) were measured in a random sample of adults aged 25–64 in the Seychelles (n = 1255, participation rate: 80.2%).According to the criteria of the American Diabetes Association, IGR was divided in four ordered categories: 1) normal fasting glucose (NFG), 2) impaired fasting glucose (IFG) and normal glucose tolerance (IFG/NGT), 3) IFG and impaired glucose tolerance (IFG/IGT), and 4) diabetes mellitus (DM). Carotid and femoral IMT was assessed by ultrasound (n = 496).ResultsAge-adjusted levels of the major CVD risk factors worsened gradually across IGR categories (NFG < IFG/NGT < IFG/IGT < DM), particularly HDL-cholesterol and blood pressure (p for trend < 0.001). These relationships were marginally attenuated upon further adjustment for waist, BMI or insulin (whether considered alone or combined) and most of these relationships remained significant. With regards to IMT, the association was null with IFG/NGT, weak with IFG/IGT and stronger with DM (all more markedly at femoral than carotid levels). The associations between IMT and IFG/IGT or DM (adjusted by age and major CVD risk factors) decreased only marginally upon further adjustment for BMI, waist or insulin. Further adjustment for family history of diabetes did not alter the results.ConclusionWe found graded relationships between IGR categories and both major CVD risk factors and carotid/femoral IMT. These relationships were only partly accounted for by BMI, waist and insulin. This suggests that increased CVD-risk associated with IGR is also mediated by factors other than the considered markers of adiposity and insulin resistance. The results also imply that IGR and associated major CVD risk factors should be systematically screened and appropriately managed.

O22 Effet préventif des protéines sur l’accumulation de triglycérides hépatiques induite par une alimentation riche en graisses

Introduction Une consommation elevee de proteines favorise la perte ponderale et la regulation de l’homeostasie du glucose chez des personnes en surpoids, intolerantes au glucose. Ce projet s’interesse aux effets metaboliques des proteines sur le metabolisme hepatique des lipides. Patients et methodes Dix jeunes hommes sains et sedentaires ont recu aleatoirement 3 alimentations differentes ; une alimentation controle (proteines : 15, lipides : 30, glucides : 55), ou deux alimentations hypercaloriques enrichies de 30 % en graisses saturees (11 : 46 : 43) dont l’une supplementee par 1,5 g/kg de proteines (24 : 40 : 36). Apres 4 jours, l’accumulation de triglycerides hepatiques etait mesuree par resonnance magnetique nucleaire, l’oxydation des substrats par calorimetrie indirecte, la sensibilite hepatique et globale a l’insuline par un clamp hyperinsulinemique euglycemique et les metabolites par dosage plasmatique. Resultats Par rapport au controle une alimentation riche en graisses a augmente de facon significative l’accumulation de lipides intrahepatiques de 90 %, la leptine de 18 % et l’inhibiteur de l’activateur tissulaire du plasminogene de 39 % (pour tous, P Conclusion Un apport proteique eleve permet de prevenir l’accumulation de triglycerides hepatiques et l’augmentation de l’inhibiteur de l’activateur tissulaire du plasminogene induit par un regime gras.