Autoimmune Thyroid, Celiac and Addison’s Diseases Related to HLA-DQ Types in Young Patients with Type 1 Diabetes in Belgium

Objective: To define the prevalence of auto antibodies (Ab) to different organs in young patients with type 1 diabetes (type 1DM). Methods: Ab to thyroid, celiac and adrenal disease was analyzed in 831 type 1 DM patients. Results: Hundred twenty-three (14.8%) had positive thyroid Ab. The risk of developing thyroid Ab was increased in girls (HR 2.3;95% CI 1.6 - 3.2, p < 0.0001). Thirty-three (3.9%) patients had positive endomysium Ab (3.1% in girls and 3.5% in boys, p = NS). Adrenal Ab was detected in 5 patients. The DQA1*0301-DQB1*0301 haplotype was more prevalent in patients with thyroid Ab (p = 0.0281);DQA1*301-DQB1*302 and DQA1*501-DQB1*201 in patients with endo- mysium Ab (p = 0.0251 and p < 0.0001). All patients with adrenal Ab were DQA1*301-DQB1*302 positive. Conclusions: Type 1D patients should be screened annually for thyroid autoimmunity and celiac disease. The DQA1*0301-DQB1*0301 haplotype seems to confer susceptibility to thyroid autoimmunity, DQA1*301-DQB1*302 and DQA1*501-DQB1*201 to celiac disease and DQA1*301-DQB1*302 to adrenal autoimmunity.

Flexofytol^(■) (A Belgian Curcumin Extract)for the Treatment of Aged Patients with Osteoarthritis and Comorbidity

Introduction: Currently, the therapeutic arsenal of osteoarthritis includes several extracts of Curcuma including Flexofytol&reg;, a bio-optimized extract of Curcuma longa. However, in older patients, indications for treatment might be limited by comorbidity and polymedication. Therefore, we aimed to assess the benefits and risks of Flexofytol&reg;, in an older population with comorbidities. Patients and Methods: This retrospective observational study included 31 patients over age 70 years (medianage: 77 years, range 71 - 81) that were treated with Flexofytol for painful osteoarthritis of the knee or lumbar spine. These patients were initially weakened by diabetes (48%) and/or renal insufficiency (71%), or they were taking anticoagulants (35%). The effects of Flexofytol&reg;, were evaluated at 0, 6 and 12 weeks with visual analog scales for pain and disability and the SF-12 Quality of Life questionnaire. Adverse effects and drug interactions of Flexofytol&reg;, were evaluated. In particular, we evaluated renal function, diabetes parameters and coagulation tests. The data were analyzed with Kruskal-Wallis and Wilcoxon-Mann-Withney non-parametric tests. Results: Patients with Flexofytol&reg;, showed significant improvement: pain improved by 50% (p = 0.0002) and functional disability improved by 33% (p = 0.0075). A series of quality of life parameters improved within the first 6 weeks of treatment and up to 3 months of treatment without impacting renal function, metabolic parameters or coagulation tests. We observed no significant adverse effects. Conclusion: In conclusion, our results suggested that Flexofytol&reg;, may be useful in the management of painful osteoarthritis, particularly in older patients that are fragile due to comorbidity and polymedication. These initial results must be confirmed in future studies.

Synofit Premium in Refractory Low Back Pain: A Retrospective Observational Study

In this retrospective observational study, information about pain and quality of life was collected for analysis from medical records of 85 patients with chronic low back pain who were treated for 3 months with Synofit? Premium (2 - 3 capsules daily), a liquid mixture of green-lipped mussel from New Zealand, blackcurrant leaf, and curcuma extract. Within the first 6 weeks of therapy, a significant clinical benefit was observed for relief from pain, need for pain-relieving drugs, and the interference of pain with personal care and lifting. This benefit was more pronounced at 3 months. The mixture was well tolerated without significant side effects. Adherence was estimated to be “good” to “very good.” Patients assessed global improvement and efficacy as “sufficient” to “good.” Based on this study, the mode of action of Synofit? Premium appears mainly to be analgesic, as reported by patients, and allows them to reduce the consumption of other pain-relieving substances and improve their quality of life. In conclusion, Synofit? Premium holds potential as a promising candidate alternative therapy for relief of low back pain and likely other painful rheumatic conditions, with almost no or minor side effects.

Inverse relationship between glomerular hyperfiltration and C-peptide level in Type 1 diabetes

Background: Increased glomerular filtration rate (GFR) commonly develops in early diabetes and is closely correlated with the development of diabetic nephropathy. Objective: The aim was to study the relationship between GFR, C-peptide level and other parameters at diagnosis of Type 1 diabetes. Methods: We determined GFR, Cpeptide level, glycated hemoglobin (HbA1c), body mass index (BMI) SDS and loss of weight at diagnosis of Type 1 diabetes in 495 children (231 females). Linear and multiple regression analysis was used to test for the associations between GFR and other parameters. Results: In the 495 patients, GFR median (interquartile range) was increased vs normal values (p = 0.0001). GFR was significantly negatively correlated with age (p < 0.001) and C-peptide level (p = 0.001), and positively correlated with weight loss (p = 0.02). The multiple regression analysis showed that age (p = 0.001) and C-peptide level (p = 0.05) were independently and negatively related to GFR. Conclusions: This study shows that, at onset of Type 1 diabetes, higher the GFR, younger the age and lower the C-peptide level are. The role of this hyperfiltration in the development of later nephropathy and the putative preventive effect of C-peptide administration need to be evaluated.

Short Report of a Preliminary Open Study of <i>Synofit-Containing Bio-Curcumin, Greenlipped Mussel and Blackcurrant Leaf Extract</i>in Arthritis

To evaluate the potential benefit of Synofit—an association of Curcumin, Perna canaliculus green-mussels and blackcurrant leaf extracts, a real life open study was performed among 86 adult out patients suffering from Fibromyalgia (n = 22), low back pain (n = 33) or knee osteoarthritis (n = 31) who accepted to take 3 tablets a day during 1 week then 2 capsules of Synofit during 2 months in addition to their conventional therapy (mainly analgesics and anti-inflammatory) and then to report their evaluation of this complementary treatment. Statistical analysis included paired t test and when possible Wilcoxon signed rank test. Accordingly, the intermediate analysis showed that already within 4 weeks of treatment, an improvement quoted as “light” was statistically reported in patients with low back pain and knee osteoarthritis but not among those with fibromyalgia on pain, physical condition, global assessment of a benefit, quality of life but not on joint stiffness (although joint stiffness considered for the whole group was statistically improved). The limited number of patients and time duration of the study and the absence of double blind controlled study do not allow concluding on the efficacy but these preliminary analyses obtained from an intermediate analysis are encouraging for further studies.