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Exercise-induced albuminuria vs circadian variations in blood pressure in type 1 diabetes

World Journal of Diabetes 2017年第2期8卷 74-79页

作者： Isabelle Hota Tadida Meli Aurel T Tankeu mesmin y dehayem David Chelo Jean Jacques N Noubiap Eugene Sobngwi Institut Supérieur des Sciences de la Santé Université des Montagnes Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences National Obesity Center Yaoundé Central Hospital Mother and Child Center of the Chantal Biya Foundation Department of Medicine Groote Schuur Hospital and University of Cape Town

AIM To investigated the relationship between exerciseinduced ambulatory blood pressure measurement(ABPM) abnormalities in type 1 diabetes mellitus(T1DM) adolescents. METHODS We conducted a case-control at the National Obesity Center of the yaoundé Central Hospital, Cameroon. We compared 24 h ABPM and urinary albumin-to-creatinine ratio(ACR) at rest and after a standardized treadmill exercise between 20 Cameroonian T1 DM patients and 20 matched controls. T1 DM adolescents were aged 12-18 years, with diabetes for at least one year, without proteinuria, with normal office blood pressure(BP) and renal function according to the general referencepopulation. Non-diabetic controls were adolescents of general population matched for sex, age and *** Mean duration of diabetes was 4.2 ± 2.8 years. The mean 24 h systolic blood pressure(SBP) and diastolic blood pressure(DBP) were respectively 116 ± 9 mm Hg in the diabetic group vs 111 ± 8 mm Hg in the nondiabetic(P = 0.06), and 69 ± 7 mm Hg vs 66 ± 5 mm Hg(P = 0.19). There was no difference in the diurnal pattern of BP in diabetes patients and non-diabetic controls(SBP: 118 ± 10 mm Hg vs 114 ± 10 mm Hg, P = 0.11; DBP: 71 ± 7 mm Hg vs 68 ± 6 mm Hg, P = 0.22). Nighttime BP was higher in the diabetic group with respect to SBP(112 ± 11 mm Hg vs 106 ± 7 mm Hg, P = 0.06) and to the mean arterial pressure(MAP)(89 ± 9 mm Hg vs 81 ± 6 mm Hg, P = 0.06). ACR at rest was similar in both groups(5.5 mg/g vs 5.5 mg/g, P = 0.74), but significantly higher in diabetes patients after exercise(10.5 mg/g vs 5.5 mg/g, P = 0.03). SBP was higher in patients having exercise-induced albuminuria(116 ± 10 mm Hg vs 108 ± 10 mm Hg, P = 0.09). CONCLUSION Exercise-induced albuminuria could be useful for early diagnosis of kidney damage in adolescents with T1 DM.

关键词： Albuminuria Blood pressure Ambulatory blood pressure measurement Exercise Type 1 diabetes

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Exercise-induced albuminuria and circadian blood pressure abnormalities in type 2 diabetes

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World Journal of Nephrology 2017年第4期6卷 209-216页

作者： Aurel T Tankeu Fran,ois Folefack Kaze Jean Jacques Noubiap David Chelo mesmin yefou dehayem Eugene Sobngwi Fran ois Folefack KazeMesmin Yefou DehayemEugene SobngwiDepartment of Internal Medicine and SpecialtiesFaculty of Medicine and Biomedical SciencesYaoundé1364Cameroon National Obesity Center YaoundéCentral HospitalYaoundé1364Cameroon Division of Nephrology University Teaching HospitalYaoundé1364Cameroon Department of Medicine Groote Schuur Hospital and University of Cape TownCape Town 7925South Africa Mother and Child Center of the Chantal Biya Foundation Yaoundé1364Cameroon

AIMTo investigate the relationship between circadian vari-ations in blood pressure （BP） and albuminuria at rest, and during exercise in non-hypertensive type 2 diabetes （T2D） *** conducted a cross-sectional study in well controlled T2D patients, non-hypertensive, without clinical pro-teinuria and normal creatinine clearance. In each parti-cipant, we recorded the BP using ambulatory bloodTankeu AT et al . Exercise-induced albuminuria and BP in T2DMpressure monitoring （ABPM） for 24-h, and albuminuria at rest and after a standardized treadmill *** enrolled 27 type 2 patients with a median age of 52; and a mean duration of diabetes and HbA1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively. Using a 24-h ABPM, we recorded a mean diurnal systolic blood pressure （SBP） of 128 ± 17 mmHg vs nocturnal of 123 ± 19 mmHg （ P = 0.004）, and mean diurnal diastolic blood pressure （DBP） of 83 ± 11 mmHg vs nocturnal 78 ± 14 mmHg （ P = 0.002）. There was a signifcant difference between albuminuria at rest [median = 23 mg, interquartile range （IQR） = 10-51] and after exercise （median = 35 mg, IQR = 23-80, P 〈 0.001）. Patients with exercise induced albuminuria had an increase in nocturnal BP values on all three components （128 mmHg vs 110 mmHg, P = 0.03 for SBP; 83 mmHg vs 66 mmHg, P = 0.04; 106 vs 83, P = 0.02 for mean arterial pressure）, as well as albuminuric patients at rest. Moreover, exercise induced albuminuria detect a less increase in nocturnal DBP （83 vs 86, P = 0.03） than resting *** induced albuminuria is associated with anincrease in nocturnal BP values in T2D patients.

关键词： Albuminuria Ambulatory measurement of blood pressure Exercise Type 2 diabetes mellitus

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Congenital Lipodystrophy: A Case Series Report from Cameroon

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Open Journal of Pediatrics 2020年第1期10卷 231-235页

作者： Suzanne Sap Ngo Um Jocelyn Tony Ritha Mbono yannick Tekel Isabelle Mekone mesmin dehayem Koki Ndombo Department of Paediatrics University of Yaounde I Yaounde Cameroon Mother and Child Center of the Chantal Biya Foundation Yaounde Cameroon University of Douala Douala Cameroon yaounde Central Hospital Yaounde Cameroon

Congenital lipodystrophy is a group of rare syndrome characterized by the absence of subcutaneous tissue. Affecting less per million live birth, this condition associate metabolic disturbance including severe insulin resistance and progeroid appearance. Diagnosis may be fortuitous or related to complications as presented in the present case series. Lipodystrophy can be generalized or localized. Acquired lipodystrophy is associated with some drugs like antiretroviral. Thus, the condition is well described in African HIV patients but data on congenital forms from Sub Saharan Africa are sparse, justifying the present report. We present four cases, with peculiar appearance associated with increased blood triglycerides. Two on four of the patients presented diabetes mellitus. Genetic testing was not available, questioning the actual guidelines of diagnosis for our context.

关键词： Lipodystrophy Diabetes Children

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Central Corneal Thickness of Diabetic Patients in yaoundé: Case Control Study

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Open Journal of Ophthalmology 2023年第1期13卷 136-142页

作者： Chantal Nanfack Ngoune Marie Evodie Akono Zoua Arlette Nomo Christelle Noëlle Nganso Nankep mesmin dehayem Christelle Noche Domngang Giles Kagmeni Faculty of Medicine and Biomedical Sciences Yaoundé Gyneco-Obstetric and Pediatric Hospital University of Yaoundé I Yaoundé Cameroon

Background: To compare central corneal thickness (CCT) values measured in diabetic eyes and compare the CCT values in normal patients without diabetes. Methods: A total of 83 diabetic patients and 83 non-diabetic patients were prospectively enrolled in this comparative case series. CCT was measured using a Topcon CT-1P non-contact automated pachymeter, and values were compared. Results: Mean age was 57 ± 11 years, with a range of 23 and 80 years. The mean CCT was 508.87 ± 35.83 μm for diabetic patients and 513.41 ± 37.22 μm for non-diabetic patients. There was no statistically significant difference between the CCT of diabetic patients compared to non-diabetic patients (p = 0.260). We did not find a significant correlation between the CCT of diabetic patients and clinical characteristics of diabetes. However, there was a positive and statistically significant linear correlation between the CCT of diabetic patients and intra ocular pressure (IOP). Conclusion: The mean CCT in diabetic patients was lower than in non-diabetic control patients, although there was no statistically significant difference.

关键词： Cornea Central Thickness Diabetic Retinopathy Diabetes Intra Ocular Pres-sure

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Clinical, Psycho-Social and Metabolic Profile of Women with Hirsutism in yaounde

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Open Journal of Endocrine and Metabolic Diseases 2022年第11期12卷 225-237页

作者： Francine Mendane Ekobena Martine Claude Etoa Etoga Laurence Carole Ngo yon mesmin dehayem Sandrine Ongnesseck Nengom Eliane Ngassam Vanessa Balla Eugène Sobngwi Jean Claude Mbanya Internal Medicine Essos Hospital Centre Yaoundé Cameroon Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon National Obesity Centre Diabetes and Metabolic Diseases Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Medicine and pharmaceutical Sciences University of Douala Douala Cameroon Regional Hospital of Nkongsamba Nkongsamba Cameroon

Background: Hirsutism is a clinical situation in Cameroon which is poorly elucidated due to a paucity of clinical and biological data;hence our interest in this study. The aim of this work was to describe the clinical, psycho-social and metabolic profile of women with hirsutism in yaoundé. Materials and Methods: This was a descriptive cross-sectional study carried out from May 2013 to December 2013. Participants were recruited by announcement through social media. Our study included women at least 18 years old, not in menopausal, not pregnant, not breastfeeding, with hirsutism regardless of severity. They were assessed through an interrogation, anthropometric parameters, a physical examination using the modified Ferriman and Gallwey score, the measurement of fasting capillary blood glucose and a lipid profile. The psycho-social assessment was carried out using a pre-designed questionnaire on the participant’s perception and daily experience with hirsutism. The metabolic syndrome was established according to the criteria of the International Diabetes Federation of 2005 and the National Cholesterol Education Program-third adult treatment panel of 2001. Results: We recruited 60 women aged 27.6 ± 7.0 years. The median Ferriman and Gallwey score was 12. The mean duration of evolution was 9 years. A family history of hirsutism was found in 88.8% of the participants, especially in the mother. Signs of virilization were found in 3.3% of the participants. Association was found between menstrual cycle abnormalities and severity of hirsutism (p = 0.023). Psycho-socially, 58.8% of women found hirsutism normal. The metabolic syndrome was found in 21.7% and 18.3% according to the IDF and NCEP-ATP III, respectively. Conclusion: Hirsutism in our context seems normal to most of our participants. It is, however, associated with menstrual irregularities, signs of virilization and metabolic syndrome. As a result, hirsutism merits further study on a large-scale with emphasis on etiology

关键词： Hirsutism hyperandrogenism yaoundé Ferriman and Gallwey

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Short-Term Effects of Liraglutide versus Vildagliptin on Insulin Secretion and Sensitivity in Type 2 Diabetes: A Single Blinded Randomized Controlled Trial (LIRAVIS Study)

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Journal of Diabetes Mellitus 2023年第1期13卷 45-57页

作者： Martine Claude Etoa Etoga Estelle Amandine Well Simeon Pierre Choukem mesmin dehayem Francine Mendane Mekobe Anne Boli Ongmeb Astasselbe Hadja Inna Jean Claude Mbanya Eugene Sobngwi National Obesity Center Yaoundé Central Hospital Yaoundé Cameroon Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Internal Medicine Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Health and Human Development (2HD) Research Network Douala Cameroon Internal Medicine Essos Hospital Centre Yaoundé Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Internal Medicine Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Laboratory of Molecular Medicine and Metabolism Biotechnology Center University of Yaoundé 1 Yaoundé Cameroon

Background: We aimed to evaluate the short-term metabolic effects of a GLP-1a, (liraglutide) versus a DPP-4i, (vildagliptin) in a group of sub-Saharan type 2 diabetes patients. Methods: We conducted a randomized controlled single blinded clinical trial in 14 uncontrolled type 2 diabetes patients (HbA1c ≥ 53 mmol/mol) with mean duration of diabetes of 8 [1 - 12] years and median age of 57 [49 - 61] years. Baseline treatment consisted of metformin in monotherapy or metformin plus sulfonylureas. Participants were randomly allocated to 2 groups of add-on 1.2 mg/day subcutaneous liraglutide in group 1 or 100 mg/day of oral vildagliptin in group 2 for 2 weeks. In all participants, insulin secretion in response to mixed meal tolerance test, insulin sensitivity by 80 mU/m2/min hyperinsulinemic-euglycemic clamp, body composition, and lipid profile were measured before and after intervention. Results: At the end of intervention, insulin sensitivity remained unchanged both with liraglutide from 6.6 [4.2 - 7.9] to 6.9 [4.3 - 10.8] mg/kg/min;p = 0.61 and vildagliptin from 7.1 [5.3 - 9.0] to 6.5 [5.6 - 9.4] mg/kg/min (p = 0.86). The area under the C-peptide curve varied from 5.5 [1.0 - 10.9] to 14.9 [10.8 - 17.2] nmol/L/120min, p = 0.09 in group 1 and from 1.1 [0.5 - 14.1] to 13.0 [9.6 - 16.9] nmol/L/120min (p = 0.17) in group 2. LDL Cholesterol levels decreased significantly with liraglutide from 0.85 g/L [0.51 - 1.02] to 0.54 g/L [0.50 - 0.73] (p = 0.04) but not with Vildagliptin. Body weight tended to decrease in group 1 (−0.6 kg) versus modest increase in group 2 (+1.1 kg). Conclusion: Short-term metabolic effects of Liraglutide and Vildagliptin add-on therapy are comparable in sub-Saharan type 2 diabetes patients with a more favorable trend for Liraglutide on body weight, lipid profile, and insulin secretion.

关键词： Insulin Sensitivity Insulin Secretion Liraglutide Vildagliptin Incretinomimetics

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Transient Hypogonadism Induced by SARS-CoV-2 during COVID-19 in Men Aged under 65 years

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Open Journal of Endocrine and Metabolic Diseases 2022年第1期12卷 1-8页

作者： Etoa Etoga Martine Claude Biwole Sida Ghislaine Ama Moor Vicky Ongmeb Boli Anne Ndi Manga Jean Arnaud dehayem yefou mesmin Mendane Mekobe Francine Jean Claude Mbanya Sobngwi Eugène Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Endocrinology and Metabolic Diseases Unit Yaoundé Central Hospital Yaoundé Cameroon Department of Physiologic Sciences and Biochemistry Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Background: The presence of the angiotensin-converting enzyme 2 (ACE2) receptor, the main entry receptor for SARS-CoV-2 in lung alveolar tissue, in Sertoli and Leydig cells of the adult testis, may suggest possible testicular involvement during SARS-CoV-2 infection. Our aim was to investigate the impact of COVID-19 on gonadal function in men. Methods: This was a cross-sectional descriptive and analytical study in a population of men aged below 65 years of age with SARS-CoV-2. Not included in the study were any subjects on testosterone replacement therapy or with a known condition that could create hypogonadism. We recruited patients through a questionnaire and then performed total testosterone and SHBG analysis at 8 hours and 2 months post infection by ELISA. We used the Spearman Rho test for statistical analysis of correlations. The significance level was set at 0.05. Results: The sample consisted of 40 male COVID positive patients with a mean age of 46.4 ± 11.8 years. Eight patients were reviewed after infection. The mean total testosterone was 11 ng/ml ± 2.4 and the SHBG was 113 nmol/l ± 66.9 during infection. In the 8 patients reviewed after infection, median total testosterone decreased during infection (11 ng/ml) and increased after infection (12.7 ng/ml), this result was statistically significant (P = 0.028). Median SHBG during infection was increased (115.7 nmol/l) and after infection was decreased (82 nmol/l). There was a statistically significant (P = 0.04) and positive correlation between serum testosterone and SHBG levels in patients with severe infection. Conclusion: There could be a transient relative hypogonadism during SARS-CoV-2 infection, more marked in the severe forms of the disease with a tendency to improve after infection.

关键词： COVID-19 Testosterone Severity

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Prevalence and Correlates of Macrovascular Complications at Type 2 Diabetes Diagnosis in a Tertiary Hospital in yaoundé, Cameroon

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Journal of Diabetes Mellitus 2023年第4期13卷 269-283页

作者： Francine Mendane Ekobena Martine Claude Etoa Etoga mesmin dehayem Carole Laurence Ngo yon Pauline Ngo Balôgôg Guy Dieudonné Mvogo André Pascal Kengne Eugène Sobngwi Jean Claude Mbanya Internal Medicine Unit Essos Hospital Center Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Endocrinology and Metabolic Diseases Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Medicine and pharmaceutical Sciences University of Douala Douala Cameroon Medical Analysis Laboratory Essos Hospital Center Yaoundé Cameroon Department of Public Health Kesmonds International University Ngaoundéré Cameroon Department of Medicine University of Cape Town Cape Town South Africa Non-Communicable Diseases Research Unit South African Medical Research Council Cape Town South Africa

Introduction: The presence of vascular complications at type 2 diabetes (T2D) diagnosis is a heavy burden for developing countries. We aimed to determine the prevalence and correlates of macrovascular complications at T2D diagnosis in yaoundé, Cameroon. Materials and Methods: We conducted a cross-sectional study at the Essos Hospital Center in yaoundé from January 2017 to June 2021. We recruited patients newly diagnosed with T2D who, simultaneously, with assessed macrovascular complications including stroke, myocardial infarction (MI) and arterial foot ulcer (AFU). Correlates were investigated using Chi square test and logistic regressions. The significance level was set at 5%. Results: In all, 286 newly diagnosed diabetic patients (51.7% being men) were included. The mean age was 52.6 ± 12.3 years. Prevalent cardiovascular risk factors at diabetes diagnosis were a dyslipidemia (63.6%), sedentary lifestyle (57.7%) and family history of type 2 diabetes (51.6%). The prevalence of macrovascular complications was 17.5% with 8.4% stroke, 5.6% myocardial infarction and 3.4% arterial foot ulcer. Hypertension was associated with all macrovascular complications (p Conclusion: Macrovascular complications are frequent at type 2 diabetes diagnosis and are represented by stroke and myocardial infarction in our study, highlighting the importance of cardiovascular risk evaluation and reduction in people with diabetes right from diagnosis.

关键词： Diabetes Mellitus Macrovascular Complications Cameroon

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Burden, Type, and Associated Factors of Thyroid Dysfunction in Patients with Heart Failure in Sub-Saharan Africa: A Cross-Sectional Study

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World Journal of Cardiovascular Diseases 2021年第11期11卷 485-497页

作者： Liliane Mfeukeu-Kuate Honoré Kemnang yemele Ahmadou Musa Jingi Martine Etoa Jan Rene Nkeck Jerome Boombhi Sylvie Ndongo Amougou Chris Nadege Nganou-Gninjio mesmin yefou dehayem Ama Moor Vicky Faculty of Medicine and Biomedical Sciences The University of Yaounde Yaounde Cameroun The yaounde Central Hospital Yaounde Cameroun Faculty of Health Sciences The University of Bamenda Bamenda Cameroon Faculty of Medicine and Pharmaceutical Sciences The University of Douala Douala Cameroun The yaounde General Hospital Yaounde Cameroon The yaounde University Teaching Hospital Yaounde Cameroun

Background: Various thyroid abnormalities have been reported during heart failure (HF). The present study aimed to evaluate the burden, type, and associated factors of thyroid disorders in Cameroonian patients with heart failure. Materials and Methods: We conducted a cross-sectional study from January to May 2020, involving volunteer adults followed for heart failure at the Yaoundé Central Hospital. Those receiving treatment that could cause thyroid dysfunction were excluded. Thyroid hormone levels (TSH, free T3, and free T4) were measured by enzyme-linked immunosorbent assay. Results: A total of 63 patients (30 women;47.6%) were included. The median age was 65 (IQR: 56 - 70) years. The main etiology of heart failure was hypertension (52.4%) followed by valvular heart disease (14.3%). Thyroid dysfunction was seen in 38 (60.3%, [95% CI: 47.2 - 72.4]) patients, of which 30 (79%) had hypothyroidism and 8 (21%) had hyperthyroidism. The most frequent thyroid dysfunction was Low T3 syndrome in 27% (95% CI: 16.6 - 39.7) of the study population followed sub-clinical hypothyroidism in 19.1% (95% CI: 10.3 -yle="white-space:normal;font-family:;" "=""> 30.9) of patients. Patients with HF and reduced ejection fraction (HFrEF) were more likely to have hypothyroidism than those with preserved ejection fraction (OR: 3.5, [95% CI: 1.2 - 9.9], p = 0.016). Also, patients with more than one hospital admission in the past 12 mo

关键词： Thyroid Dysfunction Heart Failure Sub-Saharan Africa

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Insulin Sensitivity of Term Newborns Exposed in Utero to HIV and Antiretrovirals in yaoundé

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Open Journal of Endocrine and Metabolic Diseases 2023年第9期13卷 161-172页

作者： Francine Mendane Ekobena Audrey Christance Donfack Hortence Fouedjio Suzanne Ngo Um Sap Martine Claude Etoa Etoga mesmin dehayem Anne Boli Ongmeb Gabriel Loni Ekali Jean Claude Mbanya Eugène Sobngwi Internal Medicine Unit Essos Hospital Center Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Obstetrics and Gynecology Unit Yaoundé Central Hospital Yaoundé Cameroon Mother and Child Center Chantal Biya Foundation Yaoundé Cameroon Endocrinology and Metabolic Diseases Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Health Sciences of Bamenda Bamenda Cameroon Biotechnology Center University of Yaoundé 1 Yaoundé Cameroon

Introduction: Antiretrovirals (ARVs) and the human immunodeficiency virus (HIV) are implicated in the onset of insulin resistance. They cross the placental barrier thereby inducing early modifications of the fetal environment. The aim of our study was to assess insulin sensitivity in full-term newborns exposed in utero to HIV and ARVs in yaoundé. Materials and Methods: We conducted an analytical cross-sectional study in 2 maternities in the city of yaoundé from November 2021 to June 2022. We generated two groups of newborns (NBs): one group born to HIV positive mothers on ARVs and the other control group born to HIV negative mothers. Clinical data from mothers and NBs were collected. A homeostatic model assessment of insulin resistance (HOMA-IR) like index with C peptide served to assess insulin sensitivity. We used the Spearman correlation to measure the strength of association between insulin sensitivity and the different variables. A p-value Results: Of 70 neonates included, 35 were born to HIV positive mothers on ARVs and 35 to HIV negative mothers. The median age of HIV positive and negative mothers was 30 (27 - 32) and 34 (24 - 47) years, respectively (p = 0.791). The body mass index before pregnancy as well as the average newborn weights were comparable in both groups. The ARV protocol associating Tenofovir, Lamivudine, Efavirenz was used by 97.1% of HIV positive mothers. In the exposed NBs group, C peptide was significantly lower (p y higher (p y. Conclusion: Newborns exposed to HIV and ARVs had lower C peptide levels and were more sensitive to insulin. Close metabolic monitoring of these newborns would allow early diagnosis and management of any glucose regulation disorder.

关键词： Insulin Sensitivity Newborns Antiretrovirals HIV C Peptide HOMA-IR

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