L’obésité abdominale est associée à de nombreuses complications métaboliques, telles que la résistance à l’insuline, le diabète de type 2 et les maladies cardiovasculaires. Récemment, il a été suggéré que ces anomalies métaboliques sont étroitement associées à la taille des adipocytes, cellules constitutives du tissu adipeux. En effet, plusieurs travaux suggèrent que plus les adipocytes sont gros, plus ils produisent des adipokines pro-inflammatoires, responsables de l’inflammation chronique associée à l’obésité. Dans ce contexte, le but de ce travail de thèse était, dans un premier temps, d’établir les répartitions en fréquences de tailles des adipocytes dans différentes situations physiologiques et physiopathologiques et dans différents dépôts adipeux à l’aide du Multisizer IV Coulter counter et dans un second temps de corréler la taille des adipocytes à leurs fonctions physiologiques. D’une part, nous avons montré que quels que soient les dépôts adipeux, les répartitions en fréquences de tailles des adipocytes ont toutes le même profil, elles sont bimodales avec une population de petits adipocytes (diamètre < nadir) et une population de gros adipocytes (diamètre > nadir). La privation en insuline (diabète de type I) entraînant une diminution de 60% de la masse du tissu adipeux, altére profondément la répartition bimodale en fréquences de tailles des adipocytes. La supplémentation en insuline de ces animaux diabétiques restaure la cellularité du tissu adipeux et la répartition en fréquences de tailles des adipocytes, suggérant un rôle régulateur majeur de l’insuline sur ces paramètres. La restriction calorique partielle, nous a permis de mettre en évidence un phénomène d’hystérésis dans certains tissus adipeux. De plus, à partir des données de restriction calorique prolongée il a été possible d’établir un modèle prédisant la cinétique des changements de tailles des adipocytes et de la répartition en fréquences de tailles. D’autre part, après avoir séparé les adipocytes en deux populations : les gros (diamètre > 50 µm) et les petits adipocytes (diamètre < 50 µm) nous avons montré que les petits adipocytes sont plus sensibles à l’insuline que les gros. Nous avons aussi constaté que les gros adipocytes sont plus lipolytiques que les petits adipocytes. Ces données sont en accord avec le modèle établi montrant que les échanges avec le micro-environnement tissulaire sont surtout dépendants de la surface des membranes cellulaires. Ainsi, nos résultats mettent en évidence que si la quantité de tissu adipeux est importante, sa qualité, dont la répartition en fréquences de tailles des adipocytes, est également importante et pourrait servir de paramètre prédictif du développement des désordres métaboliques. / Abdominal obesity is associated with several metabolic complications such as insulin resistance, type 2 diabetes and cardiovascular diseases. Recently, it has been suggested that these metabolic abnormalities are closely related to the size of adipocytes, cells constituting adipose tissue. Indeed, numerous studies suggested that the more adipocytes are larger, the more they produce pro-inflammatory adipokines which are responsible for obesity-associated chronic inflammation. In this context, the aim of this work was, in the first time, to establish the size frequency distributions of adipocytes in different physiological and pathological situations and in different fat depots using the Coulter counter Multisizer IV, and in the second time to correlate the size of the adipocytes to their physiological functions. On the one hand, we have shown that, all adipocyte size frequency distributions have the same profile regardless of fat depots, they are bimodal with both the population of small adipocytes (diameter < nadir) and the population of large adipocytes (diameter > nadir). Deprivation of insulin (type I diabetes) resulting in a decrease of 60% of adipose tissue mass, profoundly alters the bimodal distribution of adipocyte size frequency. Insulin supplementation of these diabetic animals restores cellularity of adipose tissue and the size-frequency distribution of adipocytes, suggesting a major regulatory role of insulin on these parameters. Partial caloric restriction has allowed us to a hysteresis phenomenon in some adipose tissues. In addition, following data from extended caloric restriction it has been possible to develop a model predicting the kinetic of changes concerning both the size of adipocytes and the frequency distribution. On the other hand, after separating the adipocytes in two populations: large (diameter > 50 microns) and small adipocytes (diameter < 50 microns), we have shown that small adipocytes are more insulin-sensitive than large ones. We also observed that larger adipocytes are more lipolytic than smaller ones. These data are in agreement with the established model showing that the interactions with the tissue microenvironment are mainly dependent on the surface of cell membranes. Thus, our results show that if the amount of adipose tissue is important, the quality which noticed by the adipocyte size frequency distributions is also important and could be used as a marker to predict the development of metabolic disorders.

Blood glucose management in Type 1 diabetes is crucial in preventing several diabetic complications. Blood glucose management is a complex task requiring diabetics too carefully administer the correct dosages of insulin by taking their blood glucose levels, food consumption, exercise, stress, illnesses and several other factors into account. Improved bolus calculation greatly aids in controlling blood glucose levels within a tight range. This study investigates how the ets-concept (Equivalent Teaspoons Sugar-concept) can be used to develop products to calculate insulin boluses. A cellular phone based software application was developed to calculate insulin boluses using the ets-concept. This product was tested in a clinical trial. A blood glucose characterization procedure was also developed to characterize the blood glucose response of a Type 1 diabetic to carbohydrate ingestion and insulin administration. The characterization procedure was used during the clinical trial to characterize patients in order to customize the bolus calculation products for the specific diabetic user. / Thesis (Ph.D. (Mechanical Engineering)--North-West University, Potchefstroom Campus, 2006

Blood glucose management in Type 1 diabetes is crucial in preventing several diabetic complications. Blood glucose management is a complex task requiring diabetics too carefully administer the correct dosages of insulin by taking their blood glucose levels, food consumption, exercise, stress, illnesses and several other factors into account. Improved bolus calculation greatly aids in controlling blood glucose levels within a tight range. This study investigates how the ets-concept (Equivalent Teaspoons Sugar-concept) can be used to develop products to calculate insulin boluses. A cellular phone based software application was developed to calculate insulin boluses using the ets-concept. This product was tested in a clinical trial. A blood glucose characterization procedure was also developed to characterize the blood glucose response of a Type 1 diabetic to carbohydrate ingestion and insulin administration. The characterization procedure was used during the clinical trial to characterize patients in order to customize the bolus calculation products for the specific diabetic user. / Thesis (Ph.D. (Mechanical Engineering)--North-West University, Potchefstroom Campus, 2006