Au cours de l'obésité, le Tissu Adipeux blanc (TAB) est le siège d'un important remaniement de sa Matrice Extracellulaire avec des amas fibrotiques autour des adipocytes et des vaisseaux. Cette organisation caractéristique semble avoir une incidence dans la physiopathologie de l'obésité. Les composés spécifiques à la Membrane Basale ont été mis en évidence autour des adipocytes et des cellules endothéliales et leur expression est fortement induite dans l'adipocyte obèse. L'expression de COL4A1 est positivement corrélée à l'insulino-résistance de sujets présentant une obésité modérée. De plus, dans un autre groupe de sujets massivement obèses candidats à la chirugie bariatrique, la diminution de l'expression génique de COL4A1 est à relier avec l'amélioration de l'insulino-résistance après l'intervention. Enfin, nous observons que, dans le TAB, l'expression de COL4A1 est positivement associée à l'expression génique de deux facteurs de croissance pro-fibrotiques, le TGF 1 et le TGF 3, dans le TAB. La culture tridimensionnelle d'adipocytes ou de cellules endothéliales exposés à ces deux facteurs induit un phénotype fibro-inflammatoire dans ces types cellulaires. Néanmoins, le traitement par le TGF 1 ou TGF 3 induit uniquement dans les cellules endothéliales une sur-expression de COL4A1 et non dans les adipocytes.En conclusion, nos données proposent un nouvel acteur de la fibrose du TAB au cours de l'obésité, la Membrane Basale adipocytaire et vasculaire, participant ainsi à la dysfonction tissulaire et métabolique. / During obesity, White Adipose Tissue (WAT) undergoes an important remodeling of its Extracellular Matrixwith fibrotic depots around adipocytes and vessels. This typical organization seems to have an impact in the pathophysiology of obesity. Basement Membrane components were detected around adipocytes and endothelial cells and their expression were significantly increased in obese adipocytes. COL4A1 expression in WAT is positively correlated to insulin-resistance parameters in moderate obese subjects, and its reduction is associated to insulin-resistance improvement after gastric bypass in a group of morbidly obese subjects. Finally, we demonstrated a postive correlation between COL4A1 expression and two pro-fibrotic growth factor (TGF1 and TGF3) in obese WAT. In vitro treatment of isolated adipocytes and endothelial cells with these TGF isoforms induced inflammatory and fibrotic phenotype. However, TGF1 and TGF3 exposure only provoked COL4A1 over-expression in endothelial cells, and not in adipocytes. In conclusion, our work have highlighted a new actor in WAT fibrosis during obesity, adipocytes and endothelial cells Basement Membrane, participating in the pathological alterations of obese adipose tissue and metabolism.

Evidence suggests that obesity adversely affects brain function. High body mass index, hypertension, dyslipidemia, insulin resistance, and diabetes are risk factors for increasing cognitive decline. Tart cherries (Prunus Cerasus L.) are rich in anthocyanins and components that modify lipid metabolism. This study evaluated the effects of tart cherries on the brain in diet-induced obese (DIO) rats. DIO rats were fed with a high-fat diet alone or in association with a tart cherry seeds powder (DS) and juice (DJS). DIO rats were compared to rats fed with a standard diet (CHOW). Food intake, body weight, fasting glycemia, insulin, cholesterol, and triglycerides were measured. Immunochemical and immunohistochemical techniques were performed. Results showed that body weight did not differ among the groups. Blood pressure and glycemia were decreased in both DS and DJS groups when compared to DIO rats. Immunochemical and immunohistochemical techniques demonstrated that in supplemented DIO rats, the glial fibrillary acid protein expression and microglial activation were reduced in both the hippocampus and in the frontal cortex, while the neurofilament was increased. Tart cherry intake modified aquaporin 4 and endothelial inflammatory markers. These findings indicate the potential role of this nutritional supplement in preventing obesity-related risk factors, especially neuroinflammation.

La problématique de la surcharge pondérale est pandémique. Un nombre important d’études épidémiologiques robustes mettent en évidence un gradient socio-économique (SSE) en lien avec cette problématique: le risque de surpoids ou d'obésité diminuerait graduellement avec l’accroissement du SSE. Toutefois, les données canadiennes récentes montrent que ce gradient est inversé pour les hommes au Canada. Nos objectifs sont (1) de vérifier si ce phénomène de gradient SSE inversé s’applique autant à l’embonpoint, qu’à l’obésité; (2) nous présenterons et discuterons trois grandes hypothèses susceptibles d'expliquer les inégalités sociales de surcharges pondérales (sociodémographique, habitudes de vie et psychosociale). Méthodologie : nous réalisons nos analyses à partir d’un échantillon de personnes âgées de 25 à 65 ans ayant répondu aux questions de l’Enquête sur la santé dans les collectivités canadiennes cycle 2.2 volet-nutrition (ESCC 2.2). Nous choisissons d’utiliser les données de cette enquête principalement pour ses mesures anthropométriques. Nous utilisons deux indicateurs SSE : le revenu et l’éducation. Nous utilisons des régressions logistiques simples et multinomiales. Nos résultats montrent des gradients SSE inversés entre hommes et femmes pour les liens entre le revenu et l’obésité, mais non pour l’embonpoint. Nous observons des gradients SSE avec l’éducation, mais principalement pour les femmes et l’obésité. Que pour les hommes aucune des hypothèses explicatives n’aura su atténuer l’effet du revenu, tant pour l’embonpoint que pour l’obésité. Chez les femmes l’effet de l’éducation et des habitudes de vie expliquent majoritairement l’effet du revenu sur l’obésité. Conclusion : nous montrons par nos résultats qu’en se concentrant uniquement que sur les aspects individuels de la surcharge pondérale, nous limitons notre compréhension des inégalités sociales en matière de surcharge pondérale, particulièrement celles entre le genre. / Overweight and obesity are an epidemic health problem Worldwide. A large number of Epidemiological studies demonstrate social gradient (SES) whit this problematic: the higher the socioeconomic level of the household the lower the Overweight or Obesity rate are. Recent Canadian data shows that the likelihood of being overweight follows a socio economic (SES) gradient. However, the risk increases with the SES for men and decreases for women. Our aims are (1) to examine if this gender-reversed SES gradient is observable for pre-obesity as well as for obesity; and (2) to which extent this gradient can be explained by, socio-demographic, psychosocial and behavioural factors. Methods: Data was derived from a subsample of Canadian adults (25-65 years) who responded to the Canadian Community Health Survey (CCHS 2.2, Statistics Canada). We choose this survey because the BMI is derived from anthropometric measures of weight and height. We used two SES indicators: education level and measure of income sufficiency calculated by Statistics Canada. Multinomial logistic regressions were used to test our hypotheses’. Our results show a gender-reversed gradient for obesity but not for pre-obesity. Pre-obesity is significantly and positively associated to SES for men, but no significant relationship was found for women. For men, socio-demographic, behavioural and psychosocial factors neither contribute in explaining the relationship between SES and pre-obesity or obesity. For women, behavioural factors, mainly physical activity, contribute, however marginally, to reducing the gap between the poorest and the richest. In conclusion, these results show that targeting individual factors is a limited approach towards reducing overweight social inequalities.

Le mycobiome digestif comprend l’ensemble des espèces de champignons contenu dans le tube digestif. Au cours de cette thèse, nous avons réalisé dans un premier temps une revue de la littérature sur le mycobiome digestif afin d’établir le répertoire des espèces de champignons décrites dans le tube digestif et leur implication dans les infections digestives et systémiques. Puis dans un second temps, notre travail expérimental a combiné l’approche culture et l’approche moléculaire basée sur le séquençage des clones pour explorer la diversité du mycobiome digestif. Nous avons répertorié une variété d’amorces PCR dans la littérature ciblant le gène 18S rRNA et ITS rRNA. En appliquant ces outils moléculaires et la culture à l’analyse d’une selle chez un sujet obèse nous avons détecté 16 espèces de champignons dont 11 espèces sont associées à l’alimentation avec 8 espèces de champignons observées pour la première fois dans les selles.Ensuite, la même approche appliquée à une selle collectée chez un sujet anorexique a permis de détecter 8 espèces de champignons dont 5 espèces associées au régime alimentaire du sujet et 3 espèces retrouvées pour la première fois dans les selles humaines.Dans un dernier temps en utilisant la même méthodologie, nous nous sommes intéressés à la diversité du mycobiome en fonction de l’origine géographique des sujets. Pour cela, nous avons exploré la communauté du mycobiome dans les selles provenant des quatre continents Afrique, Asie, Amérique et l’Europe. Dans ce travail, nous avons détecté 40 espèces de champignons provenant de l’environnement dont certains pathogènes opportunistes. / The human gut mycobiome, comprising of all fungal species detected in the gut. The Human Microbiome Project and the Metagenomics of the Human intestinal tract projects has led to new interest in the study of the human gut mycobiome. Recently, culture-independent approaches including PCR-based molecular clone libraries sequencing and high-throughput sequencing allowed to explore the diversity of gut mycobiota. In this thesis, firstly, we reviewed fungal species described in the human gut and their implication in systemic infections. We reported from literature fungal species described in healthy individuals compared to repertoire described in diseased individuals.Secondly, in our experimental work we used molecular and culture approaches to explore gut mycobiota diversity related to host physiology. We selected various set of PCR primers from literature targeting 18S rRNA gene and ITS rRNA gene. Combining molecular and culture tools in stool specimen from an obese individual we detected 16 fungal species, 11 were linked to food and 8 species were found for first in the human stools. Using the same approaches in an anorexic individual stool we identified 8 fungal species, five were associated to subjected diet collected and three fungal species were observed for the first time in the human stools. From these two studies, we observed that the gut mycobiome diversity is part associated to diet.Using the same methodology, we to explored gut mycobiota diversity according to different geographical locations. For this, fungal diversity was screened in stools samples from four continents Africa, America, Asia and Europe.

No description available.

Introdução: A obesidade é uma doença crônica que aumenta sua prevalência progressivamente no mundo todo. Uma das suas principais complicações é a doença hepática gordurosa não alcoólica (DHGNA), que pode apresentar-se de forma assintomática, com esteatose hepática, esteato-hepatite, cirrose e hepatocarcinoma. Está associada à dislipidemia, hipertensão, diabetes, síndrome metabólica e resistência insulínica. O padrão ouro para seu diagnóstico é a biopsia hepática, considerado método invasivo. Medidas indiretas são usadas para auxiliar na sua detecção, como dados do exame físico, exames de bioquímica e de imagem. Objetivo: Diagnosticar DHGNA usando a ressonância nuclear magnética (RNM) como método não invasivo, correlacionando-a com achados clínicos e laboratoriais. Metodologia: Estudo transversal de 50 crianças e adolescentes seguidas no Ambulatório de Obesidade do Hospital das Clínicas da FMRP-USP. Foram submetidas à questionário sobre histórico pessoal e familiar, à exame físico, exames laboratoriais (lipidograma, transaminases, glicemia e insulina basal) e RNM de abdome para cálculo da de gordura hepática, visceral e subcutânea. Resultados: Diagnosticado esteatose hepática em 14 (28%) dos participantes, sendo 8 com esteatose grave (porcentagem de gordura >18%) e 4 não grave (porcentagem gordura hepática entre 9 e 18%). Houve diferença estatisticamente significante entre a gordura hepática detectada pela RNM e o gênero masculino, triglicérides, TGO, TGP, relação TGO/TGP e acantose nigricans. O cálculo do Homeostasis Model Assessment Insulin Resistance (HOMA-IR) e da síndrome metabólica não apresentaram relação positiva com a porcentagem de gordura hepática. Conclusão: A frequência de esteatose hepática, utilizando a RNM como ferramenta diagnóstica, foi inferior à encontrada na literatura. Dos parâmetros estudados, os melhores preditores de esteatose hepática foram triglicérides, TGO, TGP, relação TGO/TGP, gênero masculino, acantose nigricans e Z escore para IMC elevado / Introduction: Obesity is a chronic disease whose prevalence progressively increasing worldwide. One of its main complications is non-alcoholic fatty liver disease (NAFLD), which may occur in an asymptomatic form, as simple fatty liver, steatohepatites (NASH), cirrhosis and hepatocellular carcinoma. This disease is associated with dyslipidemia, hypertension, diabetes, metabolic syndrome and insulin resistance. The gold standard for diagnosis is a liver biopsy, considered to be an invasive method. Indirect measures are used to aid its diagnosis, such as physical, biochemical and imaging tests. Objective: Diagnosing NAFLD using MRI as non-invasive method and correlating it with clinical and laboratory findings. Methodology: A cross-sectional study of 50 children and adolescents followed at the Obesity clinic of the University Hospital, FMRP-USP. A questionnaire about personal and family history was aplplied and each subject was submitted to physical examination, laboratory tests (lipip profile, transaminases, glycemia and basal insulin) and magnetic resonance imaging (MRI) of the abdomen for calculation of hepatic, visceral and subcutaneous fat. Results: Fatty liver disease was diagnosed in 14 (28%) of the participants, 8 of them with severe steatosis (fat percentage > 18%) and 4 with milder steatosis (fat percentage between 9 and 18%). There was a statistically significant difference between the hepatic fat detected by MRI and male gender, triglycerides, AST, ALT, AST/ALT ratio and acanthosis nigricans. The calculation of the Homeostasis Model Assessment Insulin Resistance (HOMA-IR) and of the metabolic syndrome did not show a positive relationship with the percentage of hepatic fat. Conclusion: The frequency of hepatic steatosis using MRI as a diagnostic tool, was lower than the values reported in the literature. Among the parameters studied, the best predictors of liver steatosis were triglycerides, AST, ALT, AST/ALT ratio, male gender, acanthosis nigricans and Z score for high body mass index

Introdução: A obesidade é uma doença crônica que aumenta sua prevalência progressivamente no mundo todo. Uma das suas principais complicações é a doença hepática gordurosa não alcoólica (DHGNA), que pode apresentar-se de forma assintomática, com esteatose hepática, esteato-hepatite, cirrose e hepatocarcinoma. Está associada à dislipidemia, hipertensão, diabetes, síndrome metabólica e resistência insulínica. O padrão ouro para seu diagnóstico é a biopsia hepática, considerado método invasivo. Medidas indiretas são usadas para auxiliar na sua detecção, como dados do exame físico, exames de bioquímica e de imagem. Objetivo: Diagnosticar DHGNA usando a ressonância nuclear magnética (RNM) como método não invasivo, correlacionando-a com achados clínicos e laboratoriais. Metodologia: Estudo transversal de 50 crianças e adolescentes seguidas no Ambulatório de Obesidade do Hospital das Clínicas da FMRP-USP. Foram submetidas à questionário sobre histórico pessoal e familiar, à exame físico, exames laboratoriais (lipidograma, transaminases, glicemia e insulina basal) e RNM de abdome para cálculo da de gordura hepática, visceral e subcutânea. Resultados: Diagnosticado esteatose hepática em 14 (28%) dos participantes, sendo 8 com esteatose grave (porcentagem de gordura >18%) e 4 não grave (porcentagem gordura hepática entre 9 e 18%). Houve diferença estatisticamente significante entre a gordura hepática detectada pela RNM e o gênero masculino, triglicérides, TGO, TGP, relação TGO/TGP e acantose nigricans. O cálculo do Homeostasis Model Assessment Insulin Resistance (HOMA-IR) e da síndrome metabólica não apresentaram relação positiva com a porcentagem de gordura hepática. Conclusão: A frequência de esteatose hepática, utilizando a RNM como ferramenta diagnóstica, foi inferior à encontrada na literatura. Dos parâmetros estudados, os melhores preditores de esteatose hepática foram triglicérides, TGO, TGP, relação TGO/TGP, gênero masculino, acantose nigricans e Z escore para IMC elevado / Introduction: Obesity is a chronic disease whose prevalence progressively increasing worldwide. One of its main complications is non-alcoholic fatty liver disease (NAFLD), which may occur in an asymptomatic form, as simple fatty liver, steatohepatites (NASH), cirrhosis and hepatocellular carcinoma. This disease is associated with dyslipidemia, hypertension, diabetes, metabolic syndrome and insulin resistance. The gold standard for diagnosis is a liver biopsy, considered to be an invasive method. Indirect measures are used to aid its diagnosis, such as physical, biochemical and imaging tests. Objective: Diagnosing NAFLD using MRI as non-invasive method and correlating it with clinical and laboratory findings. Methodology: A cross-sectional study of 50 children and adolescents followed at the Obesity clinic of the University Hospital, FMRP-USP. A questionnaire about personal and family history was aplplied and each subject was submitted to physical examination, laboratory tests (lipip profile, transaminases, glycemia and basal insulin) and magnetic resonance imaging (MRI) of the abdomen for calculation of hepatic, visceral and subcutaneous fat. Results: Fatty liver disease was diagnosed in 14 (28%) of the participants, 8 of them with severe steatosis (fat percentage > 18%) and 4 with milder steatosis (fat percentage between 9 and 18%). There was a statistically significant difference between the hepatic fat detected by MRI and male gender, triglycerides, AST, ALT, AST/ALT ratio and acanthosis nigricans. The calculation of the Homeostasis Model Assessment Insulin Resistance (HOMA-IR) and of the metabolic syndrome did not show a positive relationship with the percentage of hepatic fat. Conclusion: The frequency of hepatic steatosis using MRI as a diagnostic tool, was lower than the values reported in the literature. Among the parameters studied, the best predictors of liver steatosis were triglycerides, AST, ALT, AST/ALT ratio, male gender, acanthosis nigricans and Z score for high body mass index

The obesity epidemic continues to be a major concern in the United States. The World Health Organization reported that 1.4 billion adults were either obese or overweight. African American (AA) women have the highest incidence of obesity worldwide. The obesity rate among AAs has continued to rise over the past 2 decades. The problem is that AA women prepare and consume high caloric foods that contribute to obesity. This qualitative descriptive study explored the perceptions that obese AA women have about altering how they prepare soul food to make it a healthier soul food. The empowerment model and the health belief model were used to frame this study. Data were collected using a non-probability purposeful sampling strategy. The sample for this study consisted of 4 focus groups with 6-7 obese AA women (n = 25) who prepare and consume high caloric soul foods and have a body mass index of 30 and above. Focus group transcripts were analyzed using a constant comparative analysis and NVivo 11 computer software. It was found that obese AA women were willing to alter their traditional soul food preparation only if it tastes good. It was also found that participants would maintain new healthier eating behaviors depending on the taste, availability of recipes to use, low cost of healthy ingredients, accessibility of the ingredients, learning how to substitute various herbs and spices, and amount of food waste. Barriers that could limit participation in an intervention designed to develop healthier eating habits were identified as ignorance and laziness, transportation issues, lack of motivation, lack of education, lack of time, no incentives, and bad reviews.

In the general population, one in five couples experiences difficulty in conceiving a child. The role of obesity on women’s fecundity has become a focus of attention in recent years. Successful treatment of infertility through Assisted Reproductive Technology (ART) is also compromised by the presence of obesity, which occurs in 30 % of women seeking treatment. A negative correlation exists between increased body mass index (BMI) and the number of collected oocytes and a lower birth rate after ART. Furthermore, a number of studies have established that weight loss improves natural conception rates in overweight women. Whether weight management can improve success rates in overweight / obese women undergoing in vitro fertilisation (IVF) has not been studied. The purpose of this project was to explore the role of short–term weight loss on potential pregnancy outcomes in overweight / obese women undergoing IVF programme. However, to establish this relationship, we proposed to carry out two studies to assess the following: (I) The feasibility of very low calorie diet (VLCD) during IVF treatment with respect to duration, level of restriction and tolerability of the diet during hormonal down regulation in women (Chapter 2). (II) How energy restriction may affect the quality of an early embryo in diet - induced obese mice with respect to various body weight and caloric intake (Chapter 3). In study (I), women preferred a shorter dietary intervention with greater energy restriction (456 kcal per day) to gradual energy restriction (1200 kcal / day for the first week, and afterward, 456 kcal / day) prior to oocyte transfer. Women were able to comply with the VLCD during IVF treatment and both dietary groups achieved a significant weight loss (mean 6.3 %). In study (II), by using obese mice, the effect of rapid weight loss (mean 12 %) was observed after 5 days of energy restriction. Ovulation rate was greater in the Obese group (HFD) (55.6%) and equal in both Control (CD) and Energy Restricted (HF / ER) (44.4 %) groups. The HF / ER group showed higher fertilisation rate (80 %) than HFD and CD (55% and 45.5%, correspondingly). The blastocyst stage was reached by half of the cultured embryos in both HF / ER and HFD groups and 33 % in the CD group. The quality of embryos that completed blastocyst formation did not differ between groups. However, postfertilisation development in females fed a high fat diet was slower compared to CD and HF / ER groups. In conclusion, this work illustrated a weight management prior conception and use of VLCD during IVF treatment in clinical study needs further investigation with regard to the dietary duration, level of energy restriction and how this combination will influence IVF treatment outcomes. Furthermore, as we were unable to determine the question of how the dietary intervention affects the quality of oocytes and the animal study illustrated a promising result, thus further studies are required. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1311579 / Thesis (M.Med.Sc.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008

In the general population, one in five couples experiences difficulty in conceiving a child. The role of obesity on women’s fecundity has become a focus of attention in recent years. Successful treatment of infertility through Assisted Reproductive Technology (ART) is also compromised by the presence of obesity, which occurs in 30 % of women seeking treatment. A negative correlation exists between increased body mass index (BMI) and the number of collected oocytes and a lower birth rate after ART. Furthermore, a number of studies have established that weight loss improves natural conception rates in overweight women. Whether weight management can improve success rates in overweight / obese women undergoing in vitro fertilisation (IVF) has not been studied. The purpose of this project was to explore the role of short–term weight loss on potential pregnancy outcomes in overweight / obese women undergoing IVF programme. However, to establish this relationship, we proposed to carry out two studies to assess the following: (I) The feasibility of very low calorie diet (VLCD) during IVF treatment with respect to duration, level of restriction and tolerability of the diet during hormonal down regulation in women (Chapter 2). (II) How energy restriction may affect the quality of an early embryo in diet - induced obese mice with respect to various body weight and caloric intake (Chapter 3). In study (I), women preferred a shorter dietary intervention with greater energy restriction (456 kcal per day) to gradual energy restriction (1200 kcal / day for the first week, and afterward, 456 kcal / day) prior to oocyte transfer. Women were able to comply with the VLCD during IVF treatment and both dietary groups achieved a significant weight loss (mean 6.3 %). In study (II), by using obese mice, the effect of rapid weight loss (mean 12 %) was observed after 5 days of energy restriction. Ovulation rate was greater in the Obese group (HFD) (55.6%) and equal in both Control (CD) and Energy Restricted (HF / ER) (44.4 %) groups. The HF / ER group showed higher fertilisation rate (80 %) than HFD and CD (55% and 45.5%, correspondingly). The blastocyst stage was reached by half of the cultured embryos in both HF / ER and HFD groups and 33 % in the CD group. The quality of embryos that completed blastocyst formation did not differ between groups. However, postfertilisation development in females fed a high fat diet was slower compared to CD and HF / ER groups. In conclusion, this work illustrated a weight management prior conception and use of VLCD during IVF treatment in clinical study needs further investigation with regard to the dietary duration, level of energy restriction and how this combination will influence IVF treatment outcomes. Furthermore, as we were unable to determine the question of how the dietary intervention affects the quality of oocytes and the animal study illustrated a promising result, thus further studies are required. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1311579 / Thesis (M.Med.Sc.) -- University of Adelaide, School of Paediatrics and Reproductive Health, 2008