Association between variants of lipoprotein lipase and coronary heart disease in a Tunisian population

Objective

Coronary artery disease (CAD) is a complex multifactorial disease due to the interaction of multiple genes variations and environmental factors. Genetic variants of lipoprotein lipase (LPL), a key enzyme in the hydrolysis of triglyceride rich particles, may contribute to CAD. We analysed here the frequency of LPL variants (p.Asp9Asn, p.Asn291Ser and p.Ser447X) in a Tunisian population as well as their association with circulating lipid level and risk of CAD.

Patients and methods

LPL variations were investigated by PCR-RFLP and lipid parameters were measured in 135 patients and 109 controls.

Results

The frequency of the p.Asp9Asn variation was 10.37% in CAD patients versus 3.66% in controls. The frequency for the p.Ser447X variation was 8.8% in CAD patients versus 13.7% in controls. There was no significant association between these two variants and CAD. The p.Asn291Ser mutation variation was absent in this population. In healthy subjects, heterozygote carriers of the p.Asp9Asn substitution had a significant increase level of total cholesterol (4.2 ± 0.9 mmol/L vs 5.6 ± 1.2 mmol/L; P = 0.01) and a decreased level of HDL-cholesterol (1.36 ± 0.3 mmol/L vs 0.93 ± 0.1 mmol/L; P = 0.045).

Conclusion

There was no significant association between genetic variants of the LPL gene and CAD in this Tunisian population. The very low frequency of the p.Asn291Ser variation may be an ethnic specificity of Tunisians.     

Contribution of amoebic coculture to recovery of Legionella isolates from respiratory samples: prospective analysis over a period of 32 months

We evaluated the contribution of amoebic coculture to the recovery of Legionella spp. from 379 respiratory samples. The sensitivity of axenic culture was 42.1%. The combination of axenic culture with amoebic coculture increased the Legionella isolation rate to 47.1%. Amoebic coculture was particularly efficient in isolating Legionella spp. from respiratory samples contaminated with oropharyngeal flora.     

Estimation of the intake of anthocyanidins and their food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Anthocyanidins are bioactive flavonoids with potential health-promoting effects. These may vary among single anthocyanidins considering differences in their bioavailability and some of the mechanisms involved. The aim of the present study was to estimate the dietary intake of anthocyanidins, their food sources and the lifestyle factors (sex, age, BMI, smoking status, educational level and physisical activity) involved among twenty-seven centres in ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthocyanidin intake and their food sources for 36?037 subjects, aged between 35 and 74 years, in twenty-seven redefined centres were obtained using standardised 24?h dietary recall software (EPIC-SOFT). An ad hoc food composition database on anthocyanidins (cyanidin, delphinidin, malvidin, pelargonidin, peonidin, petunidin) was compiled using data from the US Department of Agriculture and Phenol-Explorer databases and was expanded by adding recipes, estimated values and cooking factors. For men, the total anthocyanidin mean intake ranged from 19·83 (se 1·53) mg/d (Bilthoven, The Netherlands) to 64·88 (se 1·86) mg/d (Turin, Italy), whereas for women the range was 18·73 (se 2·80) mg/d (Granada, Spain) to 44·08 (se 2·45) mg/d (Turin, Italy). A clear south to north gradient intake was observed. Cyanidins and malvidins were the main anthocynidin contributors depending on the region and sex. Anthocyanidin intake was higher in non-obese older females, non-smokers, and increased with educational level and physical activity. The major food sources were fruits, wine, non-alcoholic beverages and some vegetables. The present study shows differences in both total and individual anthocyanidin intakes and various lifestyle factors throughout Europe, with some geographical variability in their food sources.     

Food photographs in nutritional surveillance: errors in portion size estimation using drawings of bread and photographs of margarine and beverages consumption

Food photographs are widely used as instruments to estimate portion sizes of consumed foods. Several food atlases are available, all developed to be used in a specific context and for a given study population. Frequently, food photographs are adopted for use in other studies with a different context or another study population. In the present study, errors in portion size estimation of bread, margarine on bread and beverages by two-dimensional models used in the context of a Belgian food consumption survey are investigated. A sample of 111 men and women (age 45-65 years) were invited for breakfast; two test groups were created. One group was asked to estimate portion sizes of consumed foods using photographs 1-2?d after consumption, and a second group was asked the same after 4?d. Also, real-time assessment of portion sizes using photographs was performed. At the group level, large overestimation of margarine, acceptable underestimation of bread and only small estimation errors for beverages were found. Women tended to have smaller estimation errors for bread and margarine compared with men, while the opposite was found for beverages. Surprisingly, no major difference in estimation error was found after 4?d compared with 1-2?d. Individual estimation errors were large for all foods. The results from the present study suggest that the use of food photographs for portion size estimation of bread and beverages is acceptable for use in nutrition surveys. For photographs of margarine on bread, further validation using smaller amounts corresponding to actual consumption is recommended.     

IGF-I, IGFBP-3 and breast cancer risk in women: The European Prospective Investigation into Cancer and Nutrition (EPIC)

Blood concentrations of insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) have recently been associated with breast cancer risk, notably in women who developed breast cancer at a young age. Prospective studies published so far, however, were relatively small and odds ratio (OR) estimates imprecise. We present the results of a large prospective case-control study nested within the European Prospective Investigation into Cancer and Nutrition on total IGF-I, IGFBP-3 and breast cancer risk including 1081 incident cases of invasive breast cancer and 2098 matched control subjects. Increasing IGF-I and IGFBP-3 concentrations were associated with a significant increase in breast cancer risk in women who developed breast cancer after 50 years of age (highest vs lowest quintile OR 1.38 (95% confidence interval (CI) 1.02-1.86), P = 0.01, and 1.44 (95% CI 1.04-1.98), P = 0.01, respectively), but no relationship was observed in younger women (OR = 1.03 (95% CI 0.60-1.77), P = 0.81 for IGF-I, and OR = 0.92 (95% CI 0.50-1.70), P = 0.69 for IGFBP-3). There was, however, significant heterogeneity in the relationship of breast cancer with serum IGF-I and IGFBP-3 levels depending on the time interval between blood donation and tumor diagnosis. A reduction in breast cancer risk with increasing IGF-I concentrations was observed in cases with a diagnosis of cancer less than 2 years after blood donation, (OR = 0.76 (95% CI 0.57-1.03)), while an increase in risk was observed for women with a later diagnosis (above or equal to two years after blood collection, OR = 1.51 (95% CI 1.19-1.91)). A similar pattern was observed for IGFBP-3. This study confirms previous findings for an association of serum IGF-I and IGFBP-3 concentrations with breast cancer risk, particularly for women with a later diagnosis of cancer, but it does not support the hypothesis of an involvement of IGF-I in younger women.     

Feasibility of laparoscopic treatment of duodenal ulcers: results of 160 cases

AIM: The objective of this study is to evaluate the feasibility, efficacy and safety of laparoscopic repair for perforated duodenal ulcer. METHODS: One hundred and sixty patients were treated by coelioscopic procedure for a perforated duodenal ulcer. The procedure consists on a suture of perforated ulcer associated with a peritoneal lavage. A medical treatment of Helicobacter pylori associated with an inhibitor of the protons pomp was conducted. RESULTS: The coelioscopic procedure permitted to confirm the diagnostic of perforated duodenal ulcer in all cases. A simple suture of the ulcer was done in 155 cases. The conversion was compulsory in 5 cases, because of difficulties of the peritoneal lavage in 2 cases, a bleeding associated with perforation of the ulcer in one case and associated stenosis in 2 cases. Mean duration was 90 min (extremes 50 - 120 min). Complications occur in 3,1%. They were post - operative peritonitis in 3 cases and duodenal fistulae in 2 cases.All patients were reviewed at 16 months. A recurrence, either clinical or endoscopic occurs in 4 cases because of no adhesion to medical treatment. CONCLUSION: Coelioscopic treatment of perforated duodenal ulcer is a safe and efficacy method. It permits to avoid potential septic and parietal complications of laparotomy. The actual efficacy of medical treatment mustn't allow place to the radical treatment of ulcerous illness.     

Moderate phenotypic expression of familial hypercholesterolemia in Tunisia

BackgroundAutosomal Dominant Hypercholesterolemia (ADH) is an autosomal dominant disease caused by mutations in the low density lipoprotein receptor (LDLR), apolipoprotein B (APOB), and proprotein convertase subtilisin/kexin type 9 (PCSK9) genes. Xanthomas and coronary heart diseases (CHD) at an early age are the major clinical manifestations of the disease.Methods16 families with familial hypercholesterolemia from different regions in Tunisia participated in the study. Mutations within the LDLR gene were screened through DNA sequencing. Lipids values were measured by standard enzymatic methods.ResultsWe present here thirty five homozygotes and fifty six heterozygotes. Homozygotes presented extensive xanthomatosis, variable clinical manifestations of CHD, and total cholesterol levels in males and females of 17.26 ± 4.18 and 17.64 ± 2.59 mmol/L respectively. HDL-cholesterol levels were 0.62 ± 0.24 and 1.00 ± 0.61 mmol/L for males and females, respectively. None of the heterozygotes had tendon xanthomas (except for one female aged 62), eight had corneal arcus, and nine developed CHD mean between 46 and 88 years old. Total cholesterol levels in males and females ranged from 4.60 to 8.90 and from 4.30 to 10.50 mmol/L, respectively.ConclusionTunisian FH heterozygotes are characterized by a moderate clinical and biological expression of the disease.     

Comparison of nutrients in the food composition tables available in the nine European countries participating in EPIC. European Prospective Investigation into Cancer and Nutrition

Food composition tables were studied from nine European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC): Denmark, France, Germany, Greece, Great Britain, Italy, The Netherlands, Spain and Sweden. They were compared from the point view of availability, definition, analytical methods, and mode of expression of the nutrients of interest for EPIC, and it was seen that most of the nutrients in the tables are analysed and expressed in a compatible way. For some nutrients, however, common methods and definitions (folate, dietary fibre), or modes of expression (energy, protein, carbohydrates, carotenes, vitamin A and E) have not yet been agreed upon, so values are not comparable. For vitamin C a wide range of values are found due to the high natural variation in foods. For compiled tables, an additional problem is the use of several sources which may mean that the nutritional values are not comparable within the same table; and these values cannot be converted if the source is not stated. In addition, some tables were compiled using food composition values produced over 20 years ago with outdated analytical methods. In view of the inconsistent values for some nutrients and due to the large amount of foods reported within EPIC, it was concluded that standardised food composition tables have to be developed for the nine European countries involved in EPIC in order to provide comparable nutrient intake data.