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C. , F. L. Velayoudom-cephise, A. , C. Helmer, K. Rajaobelina et al., AGEs : advanced Glycation end-products) jouent un rôle probable dans les complications vasculaires du diabète. Leurs propriétés optiques permettent une évaluation rapide et non invasive de leur accumulation dans l'organisme par la mesure de l'Autofluorescence cutanée (AFC). L'AFC prédit les complications macrovasculaires dans le diabète de type 2, mais ceci n'a pas été démontré dans le diabète de type 1 (DT1). L'objectif principal de cette étude était de rechercher une association entre la mesure de l'AFC

. , 246 patients DT1 ont été inclus. La mesure d'autofluorescence, les données cliniques (âge, sexe, IMC, antécédents) et biologiques (glycémie, HbA1C, fonction rénale, bilan lipidique) ont été recueillis, 2009.

, une durée de diabète de 21,4 ans (±13,8), une HbA1c à 7,6% (± 1,1). Parmi ces patients DT1 20,6% (n=50) étaient porteurs d'une pompe externe à insuline, 8% (n=143), d'âge moyen 51,2 ans (±16.7) avec un IMC à, vol.58

, Une macroangiopathie antérieure était présente dans 9

, L'AFC des patients ayant présenté un ECV était en 2009 à 2.46 (±0.71) UA vs 2.10 (±0.55) pour les autres patients (p=0.02). Dans un modèle de COX après ajustement sur les facteurs classiques de risque cardiovasculaire (âge, sexe, durée de diabète, BMI, HTA, tabac, lipides sériques, albuminurie, traitement par statines en 2009 et présence d'une macroangiopathie initiale en 2009), l'association entre AFC en, Au total 18 patients ont présenté un ECV : 4 infarctus du myocarde, 2 gangrènes et 17 revascularisations au cours des 7 années de, p.2, 2009.

, Une valeur élevée d'AFC est prédictive de l'apparition d'ECV chez les patients diabétiques de type 1

C. , F. L. Velayoudom-cephise, A. , C. Helmer, K. Rajaobelina et al., Advanced Glycation end-products play a role in diabetic vascular complications. Their optical properties allow to non invasively evaluate their accumulation in tissue by measuring skin autofluorescence (SAF). SAF predicts macrovascular complications in type 2 diabetes mellitus but it was not demonstrated in type 1 diabetes. The aim of our study was to search for an association between SAF and macrovascular event (MVE) incidence: myocardial infarction, stroke

, SAF measurement, clinical (age, sex, BMI, comorbidities) and biological data (glycemia, HbA1C, renal parameters, blood lipids) were recorded. MVE were registered at visit in the center or phone call to medical practitioner until 2016. They were mainly men 58.8% (n=143), mean age 51.2 years (±16.7) with BMI 24.9 kg/m2 (± 4.1), diabetes duration 21.4 years (±13.8), HbA1C 7.6% (± 1.1). Among these DT1 patients, 25.7% (n=59) were smokers, 44.9% (n=109) had arterial hypertension, LDL cholesterol was 1.04 (± 0.29) g/L. Estimated Glomerular Filtration Rates (CKD-EPI) was 86.3 ml/min/1.73m2 (±26.6) and albumin excretion rates was 54, 246 subjects with type 1 diabetes patients were included, 2009.

, After adjustment for cardiovascular risk factors (age, sex, diabetes duration, BMI, hypertension, smoking status, blood lipids, albumin excretion rates, statins treatment and MVE previous to 2009), the association between high level SAF in 2009 and MVE incidence during seven years was still significant, 18 patients had new MVE : 4 myocardial infarctions, 2 gangrene, 17 artery revascularizations, 2009.

, Je ne tromperai jamais leur confiance et n'exploiterai pas le pouvoir hérité des circonstances pour forcer les consciences. Je donnerai mes soins à l'indigent et à quiconque me les demandera. Je ne me laisserai pas influencer par la soif du gain ou la recherche de la gloire. admis(e) dans l'intimité des personnes, je tairai les secrets qui me seront confiés. reçu(e) à l'intérieur des maisons, je respecterai les secrets des foyers et ma conduite ne servira pas à corrompre les moeurs. Je ferai tout pour soulager les souffrances. Je ne prolongerai pas abusivement les agonies. Je ne provoquerai jamais la mort délibérément. Je préserverai l'indépendance nécessaire à l'accomplissement de ma mission, Au moment d'être admis(e) à exercer la médecine, je promets et je jure d'être fidèle aux lois de l'honneur et de la probité

, Que les hommes et mes confrères m'accordent leur estime si je suis f idèle à mes promesses, J'apporterai mon aide à mes confrères ainsi qu'à leurs familles dans l'adversité