Prevalence of insulin resistance syndrome in southwestern France and its relationship with inflammatory and hemostatic markers

OBJECTIVE: To assess the prevalence and relationships of insulin resistance syndrome (IRS) with inflammatory and hemostatic markers in a representative sample of the population of Southwestern France aged 35-64 years. RESEARCH DESIGN AND METHODS: In this cross-sectional study, data were collected from 597 men and 556 women and were assessed regarding BMI, blood pressure, total and HDL cholesterol levels, triglyceride level, glucose level, plasma insulin level, white blood cell count, fibrinogen level, factor VII level, von Willebrand factor, C-reactive protein level, soluble intercellular adhesion molecule, soluble vascular cell adhesion molecule-1, and soluble CD(14). Insulin resistance was defined by homeostasis model assessment > or =3.8. RESULTS: Prevalence of IRS was higher in men than in women (23 vs. 12%, respectively; P < 0.001) and increased with age in both sexes (9, 24, and 34% for age groups 35-44, 45-54, and 55-64 years, respectively, for men and 4, 10, and 21% for women). After adjusting for age, alcohol consumption, tobacco smoking, and also for menopause in women, subjects (men and women) with IRS had significantly higher white blood cell count, factor VII levels, coagulating factor VII levels, and C-reactive protein levels than the other subjects. In men, further increases in soluble intercellular adhesion molecule and soluble vascular cell adhesion molecule-1 were noted, whereas in women, the differences were borderline significant. Conversely, no differences were found in fibrinogen, von Willebrand factor, and soluble CD(14) in both sexes. CONCLUSIONS: IRS is relatively common in residents of Southwestern France and is related to a deleterious increase in hemostatic and inflammatory parameters.     

Mitochondrial Biogenesis and Fragmentation as Regulators of Muscle Protein Degradation

Mitochondria form a dynamic network that rapidly adapts to cellular energy demand. This adaptation is particularly important in skeletal muscle because of its high metabolic rate. Indeed, muscle energy level is one of the cellular checkpoints that lead either to sustained protein synthesis and growth or protein breakdown and atrophy. Mitochondrial function is affected by changes in shape, number, and localization. The dynamics that control the mitochondrial network, such as biogenesis and fusion, or fragmentation and fission, ultimately affect the signaling pathways that regulate muscle mass. Regular exercise and healthy muscles are important players in the metabolic control of human body. Indeed, a sedentary lifestyle is detrimental for muscle function and is one of the major causes of metabolic disorders such as obesity and diabetes. This article reviews the rapid progress made in the past few years regarding the role of mitochondria in the control of proteolytic systems and in the loss of muscle mass and function.     

Procalcitonin and pyelonephritis in children

PURPOSE OF REVIEW: In the past few years, procalcitonin has been proposed as a sensitive and specific inflammatory marker in various fields of medicine, especially in infectivology, where it has been used to discriminate between bacterial infections, viral infections and inflammation processes. Recently, different studies have emerged in the literature on the use of this marker to identify renal involvement in febrile urinary tract infections. RECENT FINDINGS: Procalcitonin seems to be a valid biological marker, with an acceptable sensitivity and specificity, which predicts a renal involvement of the infection (pyelonephritis), in comparison with the low specificity of C-reactive protein. Procalcitonin also seems to be correlated with the degree of the involvement at the moment of diagnosis of febrile urinary tract infections and with scarring. SUMMARY: Renal involvement has always been the main diagnostic objective in children with febrile urinary tract infections. If more studies confirm the correlation between procalcitonin, renal involvement during urinary infections and scar formation, we will finally have a noninvasive tool that can identify children at risk of complications and in need of a close follow-up as early as their first episode of febrile urinary tract infection.