Elevation of total plasma concentration of homocysteine (t-Hcy) is an important and independent risk factor for cardiovascular disease. Hypothyroidism is possibly also associated with an increased risk for coronary artery disease, which may be related to atherogenic changes in lipid profile. Because hypothyroidism decreases hepatic levels of enzymes involved in the remethylation pathway of homocysteine, we prospectively evaluated fasting and postload t-Hcy in patients before and after recovery of euthyroidism. Fasting and postload t-Hcy levels were higher in 40 patients with peripheral hypothyroidism (14 with autoimmune thyroiditis and 26 treated for thyroid cancer) in comparison with those of 26 controls (13.0 +/- 7.5 vs. 8.5 +/- 2.6 micromol/L, p < .01, respectively, and 49.9 +/- 37.3 vs. 29.6 +/- 8.4 micromol/L p < .001, respectively). On univariate analysis, fasting Hcy was positively related to thyrotropin (TSH) and inversely related to folates. Multivariate analysis confirmed TSH as the strongest predictor of t-Hcy independent of age, folate, vitamin B12, and creatinine. Thyroid hormone replacement significantly decreased fasting but not postload t-Hcy. We conclude that t-Hcy is elevated in hypothyroidism. The association of hyperhomocysteinemia and lipid abnormalities occurring in hypothyroidism may represent a dynamic atherogenic state. Thyroid hormone failed to completely normalize t-Hcy. Potential benefit of treatment with folic acid in combination with thyroid hormone replacement has to be tested given that hypothyroid patients were found to have lower levels of folate.

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La pathologie des in sectes au service du génie génétique

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Background In France, between 9 and 10 millions of persons suffer from symptoms of osteoarthritis (OA), ie. 17 % of the global population[1]. This disease is the second cause of disability in our country[2] and can be responsible for an important loss of quality of life. In 2002, a socio-economical study(2) showed that, in the last ten years before the study, the number of persons suffering from OA progressed by 54 %, trigerring a 156 % increase in medical costs directly linked to OA. A more recent study[3] established the cost of OA treatment to around 3 billions euros per year. Paradoxically, the two public health objectives connected to OA and defined by the August 9, 2004 Law (objectives #085 and #087) have been left without action or evaluation[4]. Overall, as a public health and medical cost challenge, OA has been largely ignored in our country. Objectives To create a sense of urgency and challenge around this disease, AFLAR, the historical non-profit organization involved in the fight against OA and the only French patient organization dealing with this issue, decided to create the National Alliance against Osteoarthrosis. Methods This National Alliance is composed of various professionnals and institutions involved in OA medical care : patient organizations, medical associations, healthcare professional boards. Starting on november 2011, these experts met and discussed to define National Alliance objectives as well as various actions to be developed. Results National Alliance members agreed on the following objectives : To bring together all the professionals involved in OA care and to trigger a global mobilization around this underestimated public health issues To stimulate collective thinking around the challenges linked to OA care To develop awareness and visibility actions To disseminate prevention messages, especially regarding the role of physical activity To identify and relay the needs of people affected by OA To increase the involvement of local and national governing bodies Four actions have been proposed to reach these objectives : To fight against misconceptions through educational messages dissemination To initiate a large online national survey To launch a web portal which will gather all AFLAR OA-related activities To develop a regional prevention project Conclusions National Alliance against Osteoarthritis projects synergize efforts from each member’s expertise. Innovative through the diversity of its participants, this Alliance will undoubtedly contribute to amplify our country’s mobilization against OA. References Le Pen C. Les conséquences socioéconomiques de l’arthrose en France. La Revue du Rhumatisme 72 (2005) 1326–1330 Fautrel et col. Joint Bone Spine 2005 May ; 72(3) : 235-40 Grange L et coll. : Osteoarthritis in France the cost of ambulatory care in 2010. 2012 World Congress on Osteoarthritis (Barcelone) : 26-29 avril 2012 Rapport du Haut Conseil de Santé publique d’avril 2010 : Objectifs de santé publique Évaluation des objectifs de la loi du 9 août 2004 – Propositions (p...

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