Fasting insulin sensitivity indices are not better than routine clinical variables at predicting insulin sensitivity among Black Africans: a clamp study in sub-Saharan Africans
Identifieur interne : 003946 ( Main/Exploration ); précédent : 003945; suivant : 003947Fasting insulin sensitivity indices are not better than routine clinical variables at predicting insulin sensitivity among Black Africans: a clamp study in sub-Saharan Africans
Auteurs : Eugene Sobngwi [Cameroun] ; Andre-Pascal Kengne [Afrique du Sud, Australie] ; Justin B. Echouffo-Tcheugui [États-Unis] ; Simeon Choukem [Cameroun] ; Joelle Sobngwi-Tambekou [Cameroun] ; Eric V. Balti [Cameroun, Belgique] ; Mark S. Pearce [Royaume-Uni] ; Valentin Siaha [Cameroun] ; Aissa S. Mamdjokam [Cameroun] ; Valery Effoe [Cameroun, États-Unis] ; Eric Lontchi-Yimagou [Cameroun] ; Oliver T. Donfack [Cameroun] ; Barbara Atogho-Tiedeu [Cameroun] ; Philippe Boudou [France] ; Jean-Francois Gautier [France] ; Jean-Claude Mbanya [Cameroun]Source :
- BMC Endocrine Disorders [ 1472-6823 ] ; 2014.
Abstract
We aimed to evaluate the predictive utility of common fasting insulin sensitivity indices, and non-laboratory surrogates [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)] in sub-Saharan Africans without diabetes.
We measured fasting glucose and insulin, and glucose uptake during 80/mU/m2/min euglycemic clamp in 87 Cameroonians (51 men) aged (SD) 34.6 (11.4) years. We derived insulin sensitivity indices including HOMA-IR, quantitative insulin sensitivity check index (QUICKI), fasting insulin resistance index (FIRI) and glucose-to-insulin ratio (GIR). Indices and clinical predictors were compared to clamp using correlation tests, robust linear regressions and agreement of classification by sex-specific thirds.
The mean insulin sensitivity was M = 10.5 ± 3.2 mg/kg/min. Classification across thirds of insulin sensitivity by clamp matched with non-laboratory surrogates in 30-48% of participants, and with fasting indices in 27-51%, with kappa statistics ranging from −0.10 to 0.26. Fasting indices correlated significantly with clamp (/r/=0.23-0.30), with GIR performing less well than fasting insulin and HOMA-IR (both p < 0.02). BMI, WC and WHtR were equal or superior to fasting indices (/r/=0.38-0.43). Combinations of fasting indices and clinical predictors explained 25-27% of variation in clamp values.
Fasting insulin sensitivity indices are modest predictors of insulin sensitivity measured by euglycemic clamp, and do not perform better than clinical surrogates in this population.
Url:
DOI: 10.1186/1472-6823-14-65
PubMed: 25106496
PubMed Central: 4130121
Affiliations:
- Afrique du Sud, Australie, Belgique, Cameroun, France, Royaume-Uni, États-Unis
- Caroline du Nord, Géorgie (États-Unis), Nouvelle-Galles du Sud, Région de Bruxelles-Capitale, Île-de-France
- Bruxelles, Paris, Sydney
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Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation></author><author><name sortKey="Boudou, Philippe" sort="Boudou, Philippe" uniqKey="Boudou P" first="Philippe" last="Boudou">Philippe Boudou</name><affiliation wicri:level="3"><nlm:aff id="I13">Unit of Transfer in Molecular Oncology and Hormonology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Unit of Transfer in Molecular Oncology and Hormonology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Gautier, Jean Francois" sort="Gautier, Jean Francois" uniqKey="Gautier J" first="Jean-Francois" last="Gautier">Jean-Francois Gautier</name><affiliation wicri:level="3"><nlm:aff id="I14">Department of Diabetes and Endocrinology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Diabetes and Endocrinology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Mbanya, Jean Claude" sort="Mbanya, Jean Claude" uniqKey="Mbanya J" first="Jean-Claude" last="Mbanya">Jean-Claude Mbanya</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon</nlm:aff><country 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last="Sobngwi">Eugene Sobngwi</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>National Obesity Centre, Yaounde Central Hospital, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I12">Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation></author><author><name sortKey="Kengne, Andre Pascal" sort="Kengne, Andre Pascal" uniqKey="Kengne A" first="Andre-Pascal" last="Kengne">Andre-Pascal Kengne</name><affiliation wicri:level="1"><nlm:aff id="I3">South African Medical Research Council & University of Cape Town, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>South African Medical Research Council & University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="I4">The George Institute for Global Health, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The George Institute for Global Health, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Echouffo Tcheugui, Justin B" sort="Echouffo Tcheugui, Justin B" uniqKey="Echouffo Tcheugui J" first="Justin B" last="Echouffo-Tcheugui">Justin B. Echouffo-Tcheugui</name><affiliation wicri:level="2"><nlm:aff id="I5">Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Choukem, Simeon" sort="Choukem, Simeon" uniqKey="Choukem S" first="Simeon" last="Choukem">Simeon Choukem</name><affiliation wicri:level="1"><nlm:aff id="I6">Faculty of Health Sciences, University of Buea, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Faculty of Health Sciences, University of Buea, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I7">Department of Internal Medicine, Douala General Hospital, Douala, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Internal Medicine, Douala General Hospital, Douala</wicri:regionArea><wicri:noRegion>Douala</wicri:noRegion></affiliation></author><author><name sortKey="Sobngwi Tambekou, Joelle" sort="Sobngwi Tambekou, Joelle" uniqKey="Sobngwi Tambekou J" first="Joelle" last="Sobngwi-Tambekou">Joelle Sobngwi-Tambekou</name><affiliation wicri:level="1"><nlm:aff id="I8">Centre of Higher Education in Health Sciences, Catholic University of Central Africa, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Centre of Higher Education in Health Sciences, Catholic University of Central Africa, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation></author><author><name sortKey="Balti, Eric V" sort="Balti, Eric V" uniqKey="Balti E" first="Eric V" last="Balti">Eric V. Balti</name><affiliation wicri:level="1"><nlm:aff id="I2">National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>National Obesity Centre, Yaounde Central Hospital, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="I9">Diabetes Research Center, Brussels Free University-(VUB), Brussels, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Diabetes Research Center, Brussels Free University-(VUB), Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="Pearce, Mark S" sort="Pearce, Mark S" uniqKey="Pearce M" first="Mark S" last="Pearce">Mark S. Pearce</name><affiliation wicri:level="1"><nlm:aff id="I10">Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Health & Society, Newcastle University, Newcastle upon Tyne</wicri:regionArea><wicri:noRegion>Newcastle upon Tyne</wicri:noRegion></affiliation></author><author><name sortKey="Siaha, Valentin" sort="Siaha, Valentin" uniqKey="Siaha V" first="Valentin" last="Siaha">Valentin Siaha</name><affiliation wicri:level="1"><nlm:aff id="I2">National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>National Obesity Centre, Yaounde Central Hospital, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation></author><author><name sortKey="Mamdjokam, Aissa S" sort="Mamdjokam, Aissa S" uniqKey="Mamdjokam A" first="Aissa S" last="Mamdjokam">Aissa S. Mamdjokam</name><affiliation wicri:level="1"><nlm:aff id="I2">National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>National Obesity Centre, Yaounde Central Hospital, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation></author><author><name sortKey="Effoe, Valery" sort="Effoe, Valery" uniqKey="Effoe V" first="Valery" last="Effoe">Valery Effoe</name><affiliation wicri:level="1"><nlm:aff id="I2">National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>National Obesity Centre, Yaounde Central Hospital, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:aff id="I11">Wake Forest Institute for Regenerative Medicine, Wake Forest University, Winston-Salem, North Carolina, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Wake Forest Institute for Regenerative Medicine, Wake Forest University, Winston-Salem, North Carolina</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Lontchi Yimagou, Eric" sort="Lontchi Yimagou, Eric" uniqKey="Lontchi Yimagou E" first="Eric" last="Lontchi-Yimagou">Eric Lontchi-Yimagou</name><affiliation wicri:level="1"><nlm:aff id="I12">Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation></author><author><name sortKey="Donfack, Oliver T" sort="Donfack, Oliver T" uniqKey="Donfack O" first="Oliver T" last="Donfack">Oliver T. Donfack</name><affiliation wicri:level="1"><nlm:aff id="I12">Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation></author><author><name sortKey="Atogho Tiedeu, Barbara" sort="Atogho Tiedeu, Barbara" uniqKey="Atogho Tiedeu B" first="Barbara" last="Atogho-Tiedeu">Barbara Atogho-Tiedeu</name><affiliation wicri:level="1"><nlm:aff id="I12">Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Laboratory of Molecular Medicine and Metabolism, Biotechnology Centre, Nkolbisson, University of Yaounde 1, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation></author><author><name sortKey="Boudou, Philippe" sort="Boudou, Philippe" uniqKey="Boudou P" first="Philippe" last="Boudou">Philippe Boudou</name><affiliation wicri:level="3"><nlm:aff id="I13">Unit of Transfer in Molecular Oncology and Hormonology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Unit of Transfer in Molecular Oncology and Hormonology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Gautier, Jean Francois" sort="Gautier, Jean Francois" uniqKey="Gautier J" first="Jean-Francois" last="Gautier">Jean-Francois Gautier</name><affiliation wicri:level="3"><nlm:aff id="I14">Department of Diabetes and Endocrinology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Diabetes and Endocrinology, Saint-Louis University Hospital, Assistance Publique - Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Mbanya, Jean Claude" sort="Mbanya, Jean Claude" uniqKey="Mbanya J" first="Jean-Claude" last="Mbanya">Jean-Claude Mbanya</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">National Obesity Centre, Yaounde Central Hospital, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>National Obesity Centre, Yaounde Central Hospital, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Endocrine Disorders</title><idno type="eISSN">1472-6823</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>We aimed to evaluate the predictive utility of common fasting insulin sensitivity indices, and non-laboratory surrogates [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)] in sub-Saharan Africans without diabetes.</p></sec><sec><title>Methods</title><p>We measured fasting glucose and insulin, and glucose uptake during 80/mU/m<sup>2</sup>/min euglycemic clamp in 87 Cameroonians (51 men) aged (SD) 34.6 (11.4) years. We derived insulin sensitivity indices including HOMA-IR, quantitative insulin sensitivity check index (QUICKI), fasting insulin resistance index (FIRI) and glucose-to-insulin ratio (GIR). Indices and clinical predictors were compared to clamp using correlation tests, robust linear regressions and agreement of classification by sex-specific thirds.</p></sec><sec><title>Results</title><p>The mean insulin sensitivity was M = 10.5 ± 3.2 mg/kg/min. Classification across thirds of insulin sensitivity by clamp matched with non-laboratory surrogates in 30-48% of participants, and with fasting indices in 27-51%, with kappa statistics ranging from −0.10 to 0.26. Fasting indices correlated significantly with clamp (/r/=0.23-0.30), with GIR performing less well than fasting insulin and HOMA-IR (both p < 0.02). BMI, WC and WHtR were equal or superior to fasting indices (/r/=0.38-0.43). Combinations of fasting indices and clinical predictors explained 25-27% of variation in clamp values.</p></sec><sec><title>Conclusion</title><p>Fasting insulin sensitivity indices are modest predictors of insulin sensitivity measured by euglycemic clamp, and do not perform better than clinical surrogates in this population.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Danaei, G" uniqKey="Danaei G">G Danaei</name></author><author><name sortKey="Finucane, Mm" uniqKey="Finucane M">MM Finucane</name></author><author><name sortKey="Lu, Y" uniqKey="Lu Y">Y Lu</name></author><author><name sortKey="Singh, Gm" uniqKey="Singh G">GM Singh</name></author><author><name sortKey="Cowan, Mj" uniqKey="Cowan M">MJ Cowan</name></author><author><name sortKey="Paciorek, Cj" uniqKey="Paciorek C">CJ Paciorek</name></author><author><name sortKey="Lin, Jk" uniqKey="Lin J">JK Lin</name></author><author><name sortKey="Farzadfar, F" 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Dieren</name></author><author><name sortKey="Beulens, Jw" uniqKey="Beulens J">JW Beulens</name></author><author><name sortKey="Kengne, Ap" uniqKey="Kengne A">AP Kengne</name></author><author><name sortKey="Peelen, Lm" uniqKey="Peelen L">LM Peelen</name></author><author><name sortKey="Rutten, Ge" uniqKey="Rutten G">GE Rutten</name></author><author><name sortKey="Woodward, M" uniqKey="Woodward M">M Woodward</name></author><author><name sortKey="Van Der Schouw, Yt" uniqKey="Van Der Schouw Y">YT van der Schouw</name></author><author><name sortKey="Moons, Kg" uniqKey="Moons K">KG Moons</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Australie</li><li>Belgique</li><li>Cameroun</li><li>France</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Caroline du Nord</li><li>Géorgie (États-Unis)</li><li>Nouvelle-Galles du Sud</li><li>Région de Bruxelles-Capitale</li><li>Île-de-France</li></region><settlement><li>Bruxelles</li><li>Paris</li><li>Sydney</li></settlement></list><tree><country name="Cameroun"><noRegion><name sortKey="Sobngwi, Eugene" sort="Sobngwi, Eugene" uniqKey="Sobngwi E" first="Eugene" last="Sobngwi">Eugene Sobngwi</name></noRegion><name sortKey="Atogho Tiedeu, Barbara" sort="Atogho Tiedeu, Barbara" uniqKey="Atogho Tiedeu B" first="Barbara" last="Atogho-Tiedeu">Barbara Atogho-Tiedeu</name><name sortKey="Balti, Eric V" sort="Balti, Eric V" uniqKey="Balti E" first="Eric V" last="Balti">Eric V. Balti</name><name sortKey="Choukem, Simeon" sort="Choukem, Simeon" uniqKey="Choukem S" first="Simeon" last="Choukem">Simeon Choukem</name><name sortKey="Choukem, Simeon" sort="Choukem, Simeon" uniqKey="Choukem S" first="Simeon" last="Choukem">Simeon Choukem</name><name sortKey="Donfack, Oliver T" sort="Donfack, Oliver T" uniqKey="Donfack O" first="Oliver T" last="Donfack">Oliver T. Donfack</name><name sortKey="Effoe, Valery" sort="Effoe, Valery" uniqKey="Effoe V" first="Valery" last="Effoe">Valery Effoe</name><name sortKey="Lontchi Yimagou, Eric" sort="Lontchi Yimagou, Eric" uniqKey="Lontchi Yimagou E" first="Eric" last="Lontchi-Yimagou">Eric Lontchi-Yimagou</name><name sortKey="Mamdjokam, Aissa S" sort="Mamdjokam, Aissa S" uniqKey="Mamdjokam A" first="Aissa S" last="Mamdjokam">Aissa S. Mamdjokam</name><name sortKey="Mbanya, Jean Claude" sort="Mbanya, Jean Claude" uniqKey="Mbanya J" first="Jean-Claude" last="Mbanya">Jean-Claude Mbanya</name><name sortKey="Mbanya, Jean Claude" sort="Mbanya, Jean Claude" uniqKey="Mbanya J" first="Jean-Claude" last="Mbanya">Jean-Claude Mbanya</name><name sortKey="Siaha, Valentin" sort="Siaha, Valentin" uniqKey="Siaha V" first="Valentin" last="Siaha">Valentin Siaha</name><name sortKey="Sobngwi Tambekou, Joelle" sort="Sobngwi Tambekou, Joelle" uniqKey="Sobngwi Tambekou J" first="Joelle" last="Sobngwi-Tambekou">Joelle Sobngwi-Tambekou</name><name sortKey="Sobngwi, Eugene" sort="Sobngwi, Eugene" uniqKey="Sobngwi E" first="Eugene" last="Sobngwi">Eugene Sobngwi</name><name sortKey="Sobngwi, Eugene" sort="Sobngwi, Eugene" uniqKey="Sobngwi E" first="Eugene" last="Sobngwi">Eugene Sobngwi</name></country><country name="Afrique du Sud"><noRegion><name sortKey="Kengne, Andre Pascal" sort="Kengne, Andre Pascal" uniqKey="Kengne A" first="Andre-Pascal" last="Kengne">Andre-Pascal Kengne</name></noRegion></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Kengne, Andre Pascal" sort="Kengne, Andre Pascal" uniqKey="Kengne A" first="Andre-Pascal" last="Kengne">Andre-Pascal Kengne</name></region></country><country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Echouffo Tcheugui, Justin B" sort="Echouffo Tcheugui, Justin B" uniqKey="Echouffo Tcheugui J" first="Justin B" last="Echouffo-Tcheugui">Justin B. Echouffo-Tcheugui</name></region><name sortKey="Effoe, Valery" sort="Effoe, Valery" uniqKey="Effoe V" first="Valery" last="Effoe">Valery Effoe</name></country><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Balti, Eric V" sort="Balti, Eric V" uniqKey="Balti E" first="Eric V" last="Balti">Eric V. Balti</name></region></country><country name="Royaume-Uni"><noRegion><name sortKey="Pearce, Mark S" sort="Pearce, Mark S" uniqKey="Pearce M" first="Mark S" last="Pearce">Mark S. Pearce</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Boudou, Philippe" sort="Boudou, Philippe" uniqKey="Boudou P" first="Philippe" last="Boudou">Philippe Boudou</name></region><name sortKey="Gautier, Jean Francois" sort="Gautier, Jean Francois" uniqKey="Gautier J" first="Jean-Francois" last="Gautier">Jean-Francois Gautier</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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