Philippe JEAN-PIERRE

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• Type de publi. : Article dans une revue
• Date de publi. : 24/09/2020
• Auteurs : Jacqueline María Valverde-VillegasMar Naranjo-GomezMélusine DurandDavid RutagweraAnne-Sophie BedinChipepo KankasaSégolène DebiesseNicolas NagotEdouard TuaillonPhilippe Van De PerreJean-Pierre Moles
• Organismes : Pathogénèse et contrôle des infections chroniques (PCCI) Pathogenesis and Control of Chronic and Emerging Infections Pathogénèse et contrôle des infections chroniques (PCCI) Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB) Pathogénèse et contrôle des infections chroniques (PCCI) Pathogenesis and Control of Chronic and Emerging Infections Pathogénèse et contrôle des infections chroniques (PCCI) University of Zambia, School of Veterinary Medicine, Lusaka, Zambia Pathogénèse et contrôle des infections chroniques (PCCI) Pathogenesis and Control of Chronic and Emerging Infections University of Zambia, School of Veterinary Medicine, Lusaka, Zambia Pathogénèse et contrôle des infections chroniques (PCCI) Pathogenesis and Control of Chronic and Emerging Infections Pathogénèse et contrôle des infections chroniques (PCCI) CHU Montpellier = Montpellier University Hospital Pathogenesis and Control of Chronic and Emerging Infections Pathogénèse et contrôle des infections chroniques (PCCI) CHU Montpellier = Montpellier University Hospital Pathogenesis and Control of Chronic and Emerging Infections Pathogénèse et contrôle des infections chroniques (PCCI) CHU Montpellier = Montpellier University Hospital Pathogenesis and Control of Chronic and Emerging Infections Pathogénèse et contrôle des infections chroniques (PCCI) Pathogenesis and Control of Chronic and Emerging Infections
• Publié dans Frontiers in Cellular and Infection Microbiology le 29/10/2020

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Résumé : Human milk is a significant source of different CD133 + and/or CD34 + stem/progenitor-like cell subsets in healthy women but their cell distribution and percentages in this compartment of HIV-positive women have not been explored. To date, a decrease of CD34 + hematopoietic stem and progenitor cell frequencies in peripheral blood and bone marrow of HIV-positive patients has been reported. Herein, human milk and peripheral blood samples were collected between day 2-15 post-partum from HIV-positive and HIV-negative women, and cells were stained with stem cell markers and analyzed by flow cytometry. We report that the median percentage of CD45 +/high CD34 − CD133 + cell subset from milk and blood was significantly higher in HIV-positive than in HIV-negative women. The percentage of CD45 dim CD34 − CD133 + cell subset from blood was significantly higher in HIV-positive than HIV-negative women. Moreover, percentages of CD45 dim CD34 + , CD45 dim CD34 + CD133 − , and CD45 +high CD34 + CD133 − cell subsets from blood were significantly lower in HIV-positive than HIV-negative women. The CD133 + stem/progenitor-like cell subsets are increased in early human milk and blood of HIV-positive women and are differentially distributed to CD34 + cell subset frequencies which are decreased in blood.

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Fichiers liés : The CD133+ Stem Progenitor-Like.pdf

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• Type de publi. : Communication dans un congrès
• Date de publi. : 23/09/2020
• Auteurs : Aymen SendiPierre FauKatia FajerwergMyrtil L KahnPhilippe Menini
• Organismes : Équipe MICrosystèmes d'Analyse Laboratoire de chimie de coordination Laboratoire de chimie de coordination Laboratoire de chimie de coordination Équipe MICrosystèmes d'Analyse

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Résumé : In this work, the authors present a new approach to detect and discriminate sub-ppm level of formaldehyde with metal oxide semiconductors (MOS) gas sensors based on nanostructured layers of SnO2, CuO, or a combination of the two. These sensitive layers are deposited on silicon micro-hotplates and operated with a pulsed temperature modulation between 100 and 500°C under 50% of relative humidity (%RH). This method allows a very specific sensor response to formaldehyde compared to other gases such as CO or NO2. This sensor set up (combination of sensitive layers and pulsed temperature mode) opens the way toward an efficient formaldehyde detection method for indoor air quality applications.

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Fichiers liés : SEIA_2020_Abstract_vinit.pdf

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• Type de publi. : Ouvrage (y compris édition critique et traduction)
• Date de publi. : 22/09/2020
• Auteurs : Marina EudesEmmanuel GuematchaJean-Pierre MassiasXavier PhilippePascal Plas
• Organismes : Centre de droit international de Nanterre Institut des sciences juridique et philosophique de la Sorbonne - UMR 8103

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Résumé : L'Annuaire de Justice transitionnelle contribue à susciter et diffuser une pensée francophone sur la justice transitionnelle, comprise comme incluant divers thèmes allant de la justice pénale (nationale ou internationale) aux commissions vérité et réconciliation, ainsi que l'ensemble des mesures prises à l'issue d'un conflit armé ou d'un régime autoritaire. Dans ces hypothèses de retour à la paix ou de transition démocratique, il s'agit d'analyser les réponses offertes par le droit et d'autres sciences humaines pour que des sociétés meurtries affrontent leur passé et préparent leur avenir dans les meilleures conditions. Outre une ouverture internationale et pluridisciplinaire assumée, l'Annuaire réunit des contributions écrites par des universitaires mais aussi des praticiens, jeunes ou confirmés, qu'il s'agisse de mémoires de recherche réalisés par des étudiants en master 2, d'actes de colloques académiques, de témoignages de praticiens de la justice pénale ou transitionnelle ou encore d'études sur des expériences passées ou à venir, avec une perspective comparatiste dans le temps et dans l'espace.

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• Type de publi. : Communication dans un congrès
• Date de publi. : 21/09/2020
• Auteurs : Meven PhilippeRichard J SoareSusan J. ConwayJean-Pierre WilliamsLauren E Mc KeownEtienne GodinJordan Hawkswell
• Organismes : Laboratoire de Planétologie et Géodynamique [UMR 6112] Geography Department, Dawson college Laboratoire de Planétologie et Géodynamique [UMR 6112] Earth, Planetary and Space Sciences, University of California, Los Angeles, CA, USA School of Natural Sciences, Trinity College Université Laval [Québec]

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Fichiers liés : EPSC2020-385-print.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 21/09/2020
• Auteurs : Alvaro Cobo‐calvoAnne RuizFabien RollotGeorgina ArrambideRomain DeschampsElisabeth MaillartCaroline PapeixBertrand AudoinAnne Fabienne LépineHélène MaureyHélène ZéphirDamien BiottiJonathan CironFrançoise Durand-DubiefNicolas CollonguesXavier AyrignacPierre M LabaugePierre MeyerEric ThouvenotBertrand BourreAlexis MontcuquetMikael CohenPhilippe HorelloMar TintoréJérôme de SèzeSandra VukusicKumaran DeivaRomain Marignier
• Organismes : Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL] Vall d'Hebron University Hospital [Barcelona] Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center Fondation Eugène Devic EDMUS Vall d'Hebron University Hospital [Barcelona] Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP] CHU Pitié-Salpêtrière [AP-HP] CHU Pitié-Salpêtrière [AP-HP] Institut de Neurosciences de la Timone Service de pédiatrie spécialisée et médecine infantile (neurologie, pneumologie, maladies héréditaires du métabolisme) [Hôpital de la Timone - APHM] Service de neurologie [Le Kremlin Bicêtre] Lille Neurosciences & Cognition - U 1172 Département Neurologie [CHU Toulouse] Département Neurologie [CHU Toulouse] Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL] CIC Strasbourg Département de neurologie [Montpellier] Département de neurologie [Montpellier] Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] Centre Hospitalier Régional Universitaire [Montpellier] Service de Neurologie [CHU Nimes] Service de neurologie [Rouen] Service de Neurologie [CHU Limoges] Service de Neurologie [CHU Nice] Immunologie des Maladies Virales et Autoimmunes Vall d'Hebron University Hospital [Barcelona] CIC Strasbourg Hospices Civils de Lyon Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center Fondation Eugène Devic EDMUS Service de neurologie [Le Kremlin Bicêtre] Immunologie des Maladies Virales et Autoimmunes Hospices Civils de Lyon Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
• Publié dans Annals of Neurology le 26/10/2020

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Résumé : Objective: The main objective was to compare clinical features, disease course, and myelin oligodendrocyte glycoprotein (MOG) antibody (Ab) dynamics between children and adults with MOG-Ab-associated disease (MOGAD). Methods: This retrospective multicentric, national study included 98 children and 268 adults with MOGAD between January 2014 and September 2019. Cox regression model for recurrent time-to-event data and Kaplan-Meier curves for time to antibody negativity were performed for the objectives. Results: Isolated optic neuritis was the most frequent clinical presentation in both children (40.8%) and adults (55.9%, p = 0.013), and acute disseminated encephalomyelitis syndrome was more frequent in children (36.7% vs 5.6%, p < 0.001). Compared to adults, children displayed better recovery (Expanded Disability Status Scale ≥ 3.0 at last follow-up reached only by 10 of 97 [10.3%] vs 66/247 [26.7%], p < 0.001). In the multivariate analysis, adults were at higher risk of relapse than children (hazard ratio = 1.41, 95% confidence interval [CI] = 1.12-1.78, p = 0.003). At 2 years, 64.2% (95% CI = 40.9-86.5) of nonrelapsing children became MOG-Ab negative compared to 14.1% (95% CI = 4.7-38.3) of relapsing children (log-rank p < 0.001), with no differences observed in adults (log-rank p = 0.280). Interpretation: MOGAD patients differ in the clinical presentation at onset, showing an age-related shift in the clinical features across age groups. Compared to children, adults have a higher risk of relapse and worse functional recovery. Finally, children with monophasic disease become MOG-Ab negative earlier than relapsing children, but this is not true in adults. Considering these differences, management and treatment guidelines should be considered independently in children and adults.

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Fichiers liés : 2021Cobo-Calvo et al., Clinical features.pdf

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• Type de publi. :
• Date de publi. : 19/09/2020
• Auteurs : Pierre JésusPhilippe FayemendyHuguette SourisseauGéraldine LautrettePierre-Marie PreuxPhilippe CouratierJean-Claude Desport
• Organismes : Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Service de Neurologie [CHU Limoges] Neuroépidémiologie Tropicale Service de l'Information Médicale et de l'Évaluation [CHU Limoges] Laboratoire de Biostatistique et d'Informatique Médicale Service de Neurologie [CHU Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale

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Résumé : Rationale: About 50-60% of Amyotrophic Lateral Sclerosis (ALS) is characterized by an increase of metabolic rate. The increase of metabolic rate in ALS is defined by more than +10% of resting energy expenditure (REE) variation between measured REE (mREE) and calculated REE (cREE). However, the REE variation during ALS is a prognostic factor for the survival in patients with a REE variation over +20%. The present study aimed to study the relevant threshold of REE variation according to several cREE formulas to screen patients with the higher evolving risk. Methods: Nutritional assessments and body composition (by bioimpedance analysis) were performed in ALS patients. mREE was measured by IC and cREE was calculated using HB 1919 and 1984, World Schofield, De Lorenzo, Johnstone, Mifflin, WHO/FAO, Owen, Fleisch, Wang, Rosenbaum and Nelson formulas. Functional (Functional Rating Scale – Revised[ALSFRS-R] slope between diagnosis and last assessment) and Respiratory (Forced vital capacity [FVC] slope between diagnosis and last assessment) evolution and survival by Log-rank test (Hazard Ratio [HR], confidence interval [CI] 95%) according to two thresholds of REE variation 10% and 20% were studied. Results: 315 ALS patients with a median age at IC of 66.6 years (Interquartile range: 56.9–74.1) with a sex ratio of 1.0 were included. Depending on the predictive equation, REE variation over 10% and 20% was found in 35.2% to 76.3% and in 14.6% to 53.3% of ALS patients, respectively. Patients with REE variation over 10% with HB 1919 had a worst respiratory evolution (-3.2 %/month (-6.2 − -1.5), p = 0.03). Patients with REE variation over 20% with HB 1919 and HB 1984 had a lower survival (HR = 1.42 (1.10 − 1.99), p = 0.01; HR =1.38 (1.06 − 1.92), p = 0.02, respectively). Moreover, with this same threshold with Mifflin formula patients had a worst functional (-1.4 point/month (-2.2 − -0.6), p = 0.02) and respiratory (-3.5 %/month (-6.5 − -1.5), p = 0.03) evolution and a lower survival (HR = 1.42 (1.14 − 1.83), p = 0.003). Conclusion: In clinical practice REE formulas, such as HB 1919, HB 1984 or Mifflin, can be used as a reference value compared to IC to screen metabolic changes in ALS patients. With these formulas the threshold of REE variation of 20% seems the most interesting to screen at diagnosis ALS patients with a higher evolving risk.

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• Type de publi. :
• Date de publi. : 19/09/2020
• Auteurs : F. RebièrePhilippe FayemendyHuguette SourisseauN. CalmelPierre-Marie PreuxPhilippe CouratierPierre JésusJean-Claude Desport
• Organismes : Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service de l'Information Médicale et de l'Évaluation [CHU Limoges] Laboratoire de Biostatistique et d'Informatique Médicale Neuroépidémiologie Tropicale Service de Neurologie [CHU Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges]

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Résumé : Rationale: Amyotrophic lateral sclerosis (ALS) is a severe neurological disease very often accompanied by malnutrition. Nutritional status and body composition are factors associated with survival. The total body bioelectric impedance analysis (BIA) with a validated equation (Desport et al.) allows to assess the body composition during this disease, but requires the appropriate equipment. Measuring body composition using the four skin folds is simple to perform but not validated in ALS. The aim of our work was to study the agreement of measurements of Fat-Free Mass (FFM) by BIA compared to the skin folds method. Methods: We included all the measurements between 2000 and 2018, for which the ALS patients had a BIA and the measurement of the four skin folds. Skin fold measurements (tricipital, bicipital, subscapular and super-iliac) were performed 3 times on each side and then averaged. The Fat Mass (FM) obtained from the formula of Siri and Durnin & Womersley, allowed us to obtain the FFMsf (weight minus FM). The BIA was performed at 50 kHz. The FFMimp in BIA was calculated using the validated equation of Desport et al. also requiring the measurement of the tricipital skin fold. The correlation between the two methods was evaluated by linear regression and the agreement by the Bland-Altman method. Results: 1045 measurements were studied. The mean age of the patients was 65.0 ± 11.6 years and the sex ration M / F ratio was of 1.1. In BIA, the mean FFMimp was of 46.1 ± 9.1 kg and FFMsf of 44.5 ± 9.3 kg. There was a good correlation between the two methods (R = 0.91, p <0.0001). On the other hand, the agreement limits on the Bland and Altman graph were +5.7 and -8.9 kg, with an average risk of error of 16.4% which is not acceptable in clinical practice. FFMsf underestimated the FFM on average with 1.6 ± 3.7 kg (3.6%) compared to the FFMimp obtained by BIA. Conclusion: The measurement of body composition in ALS by skin folds method underestimates the FFM compared to the BIA with reference formula. The limits of agreement are important and not acceptable in clinical practice. This suggests that this method, although simple and inexpensive, cannot be used to determine FFM in ALS patients.

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• Type de publi. : Communication dans un congrès
• Date de publi. : 19/09/2020
• Auteurs : Pierre JésusHuguette SourisseauGéraldine LautrettePhilippe CouratierN. CalmelPhilippe FayemendyPierre-Marie PreuxJean-Claude Desport
• Organismes : Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Service de Neurologie [CHU Limoges] Service de Neurologie [CHU Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service de l'Information Médicale et de l'Évaluation [CHU Limoges] Laboratoire de Biostatistique et d'Informatique Médicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale

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Résumé : Rationale: About 5%e10% of ALS patients suffer from frank ALS/FTD. In ALS, the increase of resting energy expenditure (REE) is a prognostic factor for the survival. No studies have investigated nutritional and metabolic status in ALS/FTD and its impact on survival. The aims of this study were i) to study nutritional and metabolic status of ALS/FTD compared to ALS patients, ii) to study the survival according to the disease and the metabolic status. Methods: Three months after diagnosis, nutritional assessments and body composition (by bioimpedance analysis) were performed in all patients. REE measured (mREE) by indirect calorimetry and calculated (cREE) by Harris and Benedict 1919 formula were used for the calculation of REE variation. Neurological (bulbar onset), functional (ALS Functional Rating Scale e Revised [ALSFRS-R]) and respiratory (Forced Vital Capacity [FVC]) assessments were collected. Survival by Log-rank test (Hazard Ratio [HR], confidence interval 95%) and multivariate analysis with Cox model were also used. Results were expressed as median (interquartile range). Results: 446 patients were included, 421 ALS patients and 25 (5.6%) ALS/FTD patients. Age at diagnosis and sex were not significantly different. ALS/ FTD patients had more bulbar onset (100.0% vs. 34.5%, p<0.0001). ALSFRSR was not significantly different but FVC was lower in ALS/FTD patients (79.5% (61.0 e 95.3) vs. 93.0% (70.8 e 106.3), p¼0.042). ALS/FTD patients had a lower body mass index (21.8 kg/m2 (19.8 e 25.8) vs. 24.3 kg/m2 (22.2e 27.5), p¼0.014), were more malnourished (24.0% vs. 8.3%, p¼0.008) and with a higher weight loss (-10.3% (-15.4 e -5.7) vs -5.0% (-11.3 e -0.2), p¼0.004). Body composition was not significantly different between the two groups. However, ALS/FTD had less often a REE variation over 10% (32.0% vs. 53.9%, p¼0.03). ALS/FTD patients had more often gastrostomy placement (68.0% vs. 40.1%, p¼0.006). In univariate analysis, ALS/FTD patients had an increased risk of death compared to ALS patients (HR ¼ 1.97 [1.31 e 2.97], p¼0.001) but not in multivariate analysis. In multivariate analysis, regardless of type of ALS (ALS and ALS/DFT) a higher fat mass (þ1%)was associated with a reduced risk of death (HR ¼ 0.98 [0.96 e 0.99], p¼0.03) and a greater weight loss (-1%) with an increased risk of death (HR ¼ 1.03 [1.02 e 1.05], p<0.0001). Conclusion: ALS/FTD patients would seem to have a lower survival compared to patients with ALS alone. However, this is not found after adjustment in multivariate analysis. Regardless of the form of ALS, as described previously in literature, nutritional status and body composition were associated with the risk of death. Early nutritional assessment and management are essential in this severe neurodegenerative disease whatever the form of ALS

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• Type de publi. : Communication dans un congrès
• Date de publi. : 19/09/2020
• Auteurs : F. DesbordesPhilippe FayemendyHuguette SourisseauN. CalmelPierre-Marie PreuxPhilippe CouratierPierre JésusJean-Claude Desport
• Organismes : Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service de l'Information Médicale et de l'Évaluation [CHU Limoges] Laboratoire de Biostatistique et d'Informatique Médicale Neuroépidémiologie Tropicale Service de Neurologie [CHU Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges]

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Résumé : Rationale: Amyotrophic lateral sclerosis (ALS) is a rare disease with a poor prognosis. Body composition is a prognostic factor for survival. During ALS, body composition can be assessed by total body biolelectric impedancemetry analysis (BIA) using a validated reference formula (Desport et al.). This formula is more complex to use than the direct measurement obtained by a BIA device. The aim of the study was to compare the agreement for the Fat-Free Mass (FFM) obtained by BIA with reference formula or with the formula of the device. Methods: The data from January 2015 to January 2019, were extracted from our database and from the BIA devise Bodystat Quadscan 4000® used in consultation. Each ALS patient had a measurement of FFM (FFM) by direct measurement of the device (FFMdev) and by the reference formula (FFMref) also requiring the measurement of the tricipital skin fold. A simple regression test was applied between the two values of FFM and the agreement was determined using the method of Bland and Altman. The repeatability coefficient was studied for the impedance at 50 kHz, from 6 consecutive measurements in 15 patients. Results: The study population included 343 ALS patients. The mean age was of 66.5 years ± 11.0 years, the male / female sex ratio was of 1. The FFMref was of 43.9 ± 9.8 kg and the FFMdev was of 41.7 ± 11.0 kg. The repeatability coefficient of the impedance at 50 kHz was of 0.53 ± 1.28%. The correlation between the two types of measures was very good (R at 0.90, p <0.0001). On the other hand, the limits of agreement on the Bland and Altman graph were + 7.6 and -11.9 kg, with an average risk of error of 12.3% which is not acceptable in clinical practice. FFMdev underestimated the FFM on average with 2.2 ± 5.0 kg (5.0%) compared to the FFMref. Conclusion: Measuring the FFM directly on the BIA device is associated with a too important risk of error to be able to be used in clinical practice, despite simple use and good repeatability of the measurements. For the measurement of FFM duri

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• Type de publi. :
• Date de publi. : 19/09/2020
• Auteurs : Pierre JésusPhilippe FayemendyN. CalmelHuguette SourisseauGéraldine LautrettePierre-Marie PreuxPhilippe CouratierJean-Claude Desport
• Organismes : Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Service de Neurologie [CHU Limoges] Neuroépidémiologie Tropicale Service de l'Information Médicale et de l'Évaluation [CHU Limoges] Laboratoire de Biostatistique et d'Informatique Médicale Service de Neurologie [CHU Limoges] Neuroépidémiologie Tropicale Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges] Neuroépidémiologie Tropicale

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Résumé : Rationale: The increase of resting energy expenditure (REE) variation in ALS is a prognostic factor for the survival mainly in patients with a REE variation over +20%. Measurement of REE by indirect calorimetry (IC) compared to REE predicted with formula (Harris and Benedict [HB] 1919, HB 1984 or Mifflin) is necessary to obtain the REE variation. However, IC is not available in many centres. Jésus et al. formula is a validate formula to predict REE in ALS and can be used in the absence of an IC. The aim of this work was to study the survival of ALS patients according to REE variation with IC or Jésus formula. Methods: Nutritional assessments and body composition fat-free mass (FFM) and fat mass (FM) (by bioimpedance analysis) were performed in ALS patients at diagnosis. REE was measured by IC (mREE) and by Jésus formula (Jésus REE) using FFM, FM and sex. cREE was calculated using HB 1919, HB 1984 and Mifflin. REE variation (%) was calculated according to the formula: (mREE or Jésus REE) – cREE / cREE * 100. Survival was studied by Log-rank test (Hazard Ratio [HR], confidence interval [CI] 95%) according REE variation under or over 20%. Results: 395 ALS patients with a median age at IC of 66.8 years (Interquartile range: 58.6–74.1) with a sex ratio of 1.1 were included. Median body mass index was of 22.4 kg/m2 (22.2 – 27.5). REE was of 1500 kcal/24h (1274 – 1708) with IC and not significantly different than with Jésus formula 1500 kcal/24h (1291 – 1679) (p=0.83). With REE measured by IC, REE variation over 20% was found in 21.0%, 18.0% and 43.0% with HB 1919, HB 1984 and Mifflin formulas as cREE respectively. With Jésus REE, REE variation over 20% was found in 5.1%, 1.5% and 25.6% with HB 1919, HB 1984 and Mifflin formulas as cREE, respectively. REE variation over 20% was more frequently found using IC than with Jésus formula (p<0.0001). Survival according to the IC and Jésus formula with HB 1919 and Mifflin formula as cREE is presented in table 1. With HB 1984 survival was not significantly different in ALS patients with REE variation under or over 20%.

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