183 results on '"Yoshihiko, Nishio"'
Search Results
2. Effect of ipragliflozin on carotid intima-media thickness in type 2 diabetes patients
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Atsushi, Tanaka, Masataka, Sata, Yosuke, Okada, Hiroki, Teragawa, Kazuo, Eguchi, Michio, Shimabukuro, Isao, Taguchi, Kazuo, Matsunaga, Yumiko, Kanzaki, Hisako, Yoshida, Tomoko, Ishizu, Shinichiro, Ueda, Masafumi, Kitakaze, Toyoaki, Murohara, Koichi, Node, Yoshihiko, Nishio, Mitsuru, Ohishi, Kazuomi, Kario, Wataru, Shimizu, Hideaki, Jinnouchi, Hirofumi, Tomiyama, Koji, Maemura, Makoto, Suzuki, Shinichi, Ando, Haruo, Kamiya, Tomohiro, Sakamoto, Mamoru, Nanasato, Munehide, Matsuhisa, Junya, Ako, Yoshimasa, Aso, Masaharu, Ishihara, Kazuo, Kitagawa, Akira, Yamashina, Yumi, Ikehara, Ayako, Takamori, Miki, Mori, Kaori, Yamaguchi, Machiko, Asaka, Tetsuya, Kaneko, Masashi, Sakuma, Shigeru, Toyoda, Takahisa, Nasuno, Michiya, Kageyama, Jojima, Teruo, Iijima, Toshie, Haruka, Kishi, Hirotsugu, Yamada, Kenya, Kusunose, Daiju, Fukuda, Shusuke, Yagi, Koji, Yamaguchi, Takayuki, Ise, Yutaka, Kawabata, Akio, Kuroda, Yuichi, Akasaki, Mihoko, Kurano, Satoshi, Hoshide, Takahiro, Komori, Tomoyuki, Kabutoya, Yukiyo, Ogata, Yuji, Koide, Hiroaki, Kawano, Satoshi, Ikeda, Satoki, Fukae, Seiji, Koga, Yukihito, Higashi, Shinji, Kishimoto, Masato, Kajikawa, Tatsuya, Maruhashi, Yoshiaki, Kubota, Yoshisato, Shibata, Nehiro, Kuriyama, Ikuko, Nakamura, Kanemitsu, Hironori, Bonpei, Takase, Yuichi, Orita, Chikage, Oshita, Yuko, Uchimura, Ruka, Yoshida, Yukihiko, Yoshida, Hirohiko, Suzuki, Yasuhiro, Ogura, Mayuho, Maeda, Masaki, Takenaka, Takumi, Hayashi, Mirai, Hirose, Itaru, Hisauchi, Toshiaki, Kadokami, Ryo, Nakamura, Junji, Kanda, Masaaki, Hoshiga, Koichi, Sohmiya, Arihiro, Koyosue, Hiroki, Uehara, Naoto, Miyagi, Toshiya, Chinen, Kentaro, Nakamura, Chikashi, Nago, Suguru, Chiba, Sho, Hatano, Yoshikatsu, Gima, Masami, Abe, Masayoshi, Ajioka, Hiroshi, Asano, Yoshihiro, Nakashima, Hiroyuki, Osanai, Takahiro, Kanbara, Yusuke, Sakamoto, Mitsutoshi, Oguri, Shiou, Ohguchi, Kunihiko, Takahara, Kazuhiro, Izumi, Kenichiro, Yasuda, Akihiro, Kudo, Noritaka, Machii, Ryota, Morimoto, Yasuko, Bando, Takahiro, Okumura, Toru, Kondo, Shin-Ichiro, Miura, Yuhei, Shiga, Joji, Mirii, Makoto, Sugihara, Tadaaki, Arimura, Junko, Nakano, Kazuhisa, Kodama, Nobuyuki, Ohte, Tomonori, Sugiura, Kazuaki, Wakami, Yasuhiko, Takemoto, Minoru, Yoshiyama, Taichi, Shuto, Kazuo, Fukumoto, Kenichi, Tanaka, Satomi, Sonoda, Akemi, Tokutsu, Takashi, Otsuka, Fumi, Uemura, Kenji, Koikawa, Megumi, Miyazaki, Maiko, Umikawa, Manabu, Narisawa, Machi, Furuta, Hiroshi, Minami, Masaru, Doi, Kazuhiro, Sugimoto, Susumu, Suzuki, Akira, Kurozumi, and Kosuke, Nishio
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Ipragliflozin ,Type 2 diabetes ,Pharmacology (medical) ,Carotid intima-media thickness ,Atherosclerosis ,Cardiology and Cardiovascular Medicine - Abstract
Aims To examine the effects of a 24-month treatment with ipragliflozin on carotid intima-media thickness (IMT) in type 2 diabetes patients. Methods and results In this multicenter, prospective, randomized, open-label, and blinded-endpoint investigator-initiated clinical trial, adults with type 2 diabetes and haemoglobin A1C (HbA1c) of 6.0–10.0% (42–86 mmol/mol) were randomized equally to ipragliflozin (50 mg daily) and non-sodium-glucose cotransporter-2 (SGLT2) inhibitor use of standard-care (control group) for type 2 diabetes and were followed-up to 24 months. The primary endpoint was the change in mean common carotid artery IMT (CCA-IMT) from baseline to 24 months. A total of 482 patients were equally allocated to the ipragliflozin (N = 241) and control (N = 241) groups, and 464 patients (median age 68 years, female 31.7%, median type 2 diabetes duration 8 years, median HbA1c 7.3%) were included in the analyses. For the primary endpoint, the changes in the mean CCA-IMT from baseline to 24 months were 0.0013 [95% confidence interval (CI), −0.0155–0.0182] mm and 0.0015 (95% CI, −0.0155–0.0184) mm in the ipragliflozin and control groups, respectively, with an estimated group difference (ipragliflozin-control) of −0.0001 mm (95% CI, −0.0191–0.0189; P = 0.989). A group difference in HbA1c change at 24 months was also non-significant between the treatment groups [−0.1% (95% CI, −0.2–0.1); P = 0.359]. Conclusion Twenty-four months of ipragliflozin treatment did not affect carotid IMT status in patients with type 2 diabetes recruited in the PROTECT study, relative to the non-SGLT2 inhibitor-use standard care for type 2 diabetes.
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- 2022
3. Relationship between diabetic complications and the nutritional index in untreated diabetes
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Shuji Horinouchi, Mihoko Harada, Sakiko Ikeda, Remi Horinouchi, Misako Kubo, Yuma Tashiro, Ayako Ijuin, Miki Mukai, and Yoshihiko Nishio
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Endocrinology, Diabetes and Metabolism ,Internal Medicine - Published
- 2022
4. A Rare Case of Painless Destructive Thyroiditis Resulting in Thyroid Storm
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Miwa Makino, Nobuyuki Koriyama, Nami Kojima, and Yoshihiko Nishio
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Internal Medicine ,General Medicine - Published
- 2023
5. Food-dependent Cushing’s syndrome due to unilateral adrenocortical adenoma with cortisol secretion without ACTH elevation detected in peripheral blood by the CRH test: a case report
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Miwa Makino, Nobuyuki Koriyama, Nami Kojima, Takuya Tobo, and Yoshihiko Nishio
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Endocrinology ,Endocrinology, Diabetes and Metabolism - Published
- 2023
6. Delayed postoperative hyponatremia in patients with acromegaly: incidence and predictive factors
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Ryutaro Makino, Shingo Fujio, Tomoko Hanada, Masanori Yonenaga, Shigeru Kawade, Hiroshi Hashiguchi, Yoshihiko Nishio, Nayuta Higa, Kazunori Arita, Koji Yoshimoto, and Ryosuke Hanaya
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Endocrinology ,Endocrinology, Diabetes and Metabolism - Abstract
Delayed postoperative hyponatremia (DPH) is a unique complication of transsphenoidal surgery (TSS) in pituitary tumors. Growth hormone (GH) enhances renal sodium reabsorption; however, the association between postoperative GH reduction and DPH in acromegaly is unclear. This study was performed to clarify the incidence of and the predictive factors for DPH in patients with acromegaly who underwent TSS.Ninety-four patients with active acromegaly were examined retrospectively. During the postoperative course, patients with serum sodium levels ≤ 134 mEq/L were classified into the DPH group. We compared basic clinical characteristics, tumor characteristics, and preoperative and postoperative examination findings between the DPH and non-DPH groups.DPH occurred in 39 patients (41.5%), and the lowest serum sodium levels were generally observed during postoperative days (PODs) 7-9. They needed a 3-day longer hospital stay than those without DPH. The DPH group had lower preoperative body weight and body mass index. In addition, a transient increase in body weight during PODs 5-7 occurred with a transient decrease in urinary volume in the DPH group. Preoperative and postoperative GH and insulin-like growth factor-1 levels did not differ between the two groups.The findings suggested that lower preoperative weight and a postoperative transient gain in body weight are associated with an increased risk of DPH in acromegaly patients undergoing transsphenoidal surgery.
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- 2022
7. Dietary obesity and glycemic excursions cause a parallel increase in STEAP4 and pro-inflammatory gene expression in murine PBMCs
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Sigfrid Casmir Shayo, Shigeru Kawade, Kazuma Ogiso, Yoshihiko Nishio, Hiroshi Hashiguchi, and Takahisa Deguchi
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Chemokine ,medicine.medical_specialty ,biology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Insulin ,medicine.medical_treatment ,Inflammation ,medicine.disease ,Peripheral blood mononuclear cell ,Endocrinology ,Antigen ,Diabetes mellitus ,Internal medicine ,Gene expression ,Internal Medicine ,medicine ,biology.protein ,Original Article ,medicine.symptom ,business ,Glycemic - Abstract
BACKGROUND: The balance between pro-atherogenic and anti-atherogenic factors is very crucial in the development of atherosclerotic lesions. Although the expression of the six-transmembrane epithelial antigen of the prostate 4 (STEAP4) in myeloid cells is known to be atheroprotective, there is not a single study reporting on the status of STEAP4 expression in circulating monocytes in the early stages of diet-induced obesity or in events of glycemic excursions. METHODS: We induced glycemic spikes twice daily for a 1-week duration to rats fed on regular chow and western diet, and analyzed gene expression changes in the peripheral blood mononuclear cells (PBMCs). We also conducted experiments on RAW 264.7 cells to gain insight into some of our in vivo findings. RESULTS: Diet-induced obesity and glycemic excursions independently caused a significant increase in STEAP4 mRNA expression in PBMCs. This was also accompanied by an induction of a substantial number of pro-inflammatory cytokines, chemokines, and chemokine receptors. However, the combined effect of western diet and hyperglycemic spikes was subtle and non-additive. In the in vitro setting, either glucose spikes, persistent hyperglycemia, or a combination of palmitic acid and insulin resulted in a parallel increase in expression of STEAP4 and pro-inflammatory genes. This was, however, significantly abrogated with 4-octyl itaconate or attenuated by inhibitors of p38MAPK and NF-kB. CONCLUSIONS: STEAP4 expression in mononuclear cells is induced by increasing inflammation or oxidative stress. The observed increase in STEAP4 expression in circulating monocytes due to visceral obesity or glycemic excursions is a compensatory response. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13340-021-00542-1.
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- 2021
8. Development of predictive equation and score for 5-year metabolic syndrome incidence in Japanese adults
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Anwar Ahmed Salim, Shin Kawasoe, Takuro Kubozono, Satoko Ojima, Takeko Kawabata, Hiroshi Hashiguchi, Yoshiyuki Ikeda, Masaaki Miyata, Hironori Miyahara, Koichi Tokushige, Yoshihiko Nishio, and Mitsuru Ohishi
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Multidisciplinary - Abstract
Background Predicting metabolic syndrome (MetS) is important for identifying high-risk cardiovascular disease individuals and providing preventive interventions. We aimed to develop and validate an equation and a simple MetS score according to the Japanese MetS criteria. Methods In total, 54,198 participants (age, 54.5±10.1 years; men, 46.0%), with baseline and 5-year follow-up data were randomly assigned to ‘Derivation’ and ‘Validation’ cohorts (ratio: 2:1). Multivariate logistic regression analysis was performed in derivation cohort and scores were assigned to factors corresponding to β-coefficients. We evaluated predictive ability of the scores using area under the curve (AUC), then applied them to validation cohort to assess reproducibility. Results The primary model ranged 0–27 points had an AUC of 0.81 (sensitivity: 0.81, specificity: 0.81, cut-off score: 14), and consisted of age, sex, blood pressure (BP), body mass index (BMI), serum lipids, glucose measurements, tobacco smoking, and alcohol consumption. The simplified model (excluding blood tests) ranged 0–17 points with an AUC of 0.78 (sensitivity: 0.83, specificity: 0.77, cut-off score: 15) and included: age, sex, systolic BP, diastolic BP, BMI, tobacco smoking, and alcohol consumption. We classified individuals with a score Conclusion We developed a primary score, an equation model, and a simple score. The simple score is convenient, well-validated with acceptable discrimination, and could be used for early detection of MetS in high-risk individuals.
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- 2023
9. Repeated glucose spikes and insulin resistance synergistically deteriorate endothelial function and bardoxolone methyl ameliorates endothelial dysfunction
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Kazuma Ogiso, Sigfrid Casmir Shayo, Shigeru Kawade, Hiroshi Hashiguchi, Takahisa Deguchi, and Yoshihiko Nishio
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Blood Glucose ,Male ,NF-E2-Related Factor 2 ,Physiology ,Science ,Carbohydrates ,Gene Expression ,Aorta, Thoracic ,Biochemistry ,Endocrinology ,Medicine and Health Sciences ,Genetics ,Animals ,Obesity ,Oleanolic Acid ,Rats, Wistar ,Aorta ,Nutrition ,Metabolic Syndrome ,Multidisciplinary ,Endocrine Physiology ,Organic Compounds ,Superoxide Dismutase ,Monosaccharides ,Organic Chemistry ,Body Weight ,Chemical Compounds ,Biology and Life Sciences ,Proteins ,Rats ,Diet ,Enzymes ,Chemistry ,Glucose ,Dismutases ,Physiological Parameters ,Diet, Western ,Physical Sciences ,Cardiovascular Anatomy ,Enzymology ,Blood Vessels ,Medicine ,Endothelium, Vascular ,Insulin Resistance ,Anatomy ,Research Article ,Catalases - Abstract
BackgroundBoth insulin resistance and postprandial glucose spikes are known for their potential to induce vascular endothelial dysfunction in individuals with metabolic syndrome. However, these factors are inextricable, and therefore, their relative contributions to inducing endothelial dysfunction remain elusive. In this study, we aimed to disentangle the effects of these factors and clarify whether bardoxolone methyl (CDDO-Me), a novel nuclear factor erythroid 2-related factor 2 (Nrf2) activator, protects against glucose spike-induced endothelial dysfunction.MethodsWe induced glucose spikes twice daily for a duration of 1 week to rats fed a standard/control diet (CD) and Western-type diet (WTD). Endothelium-dependent relaxation (EDR) was evaluated using isolated thoracic aortas. Gene expression and dihydroethidium (DHE)-fluorescence studies were carried out; the effect of CDDO-Me on aortic endothelial dysfunction in vivo was also evaluated.ResultsNeither WTD-induced insulin resistance nor pure glucose spikes significantly deteriorated EDR. However, under high-glucose (20 mM) conditions, the EDR of thoracic aortas of WTD-fed rats subjected to glucose spikes was significantly impaired. In this group of rats, we observed significantly enhanced DHE fluorescence as a marker of reactive oxygen species, upregulation of an oxidative stress-related gene (NOX2), and downregulation of an antioxidant gene (SOD2) in the thoracic aortas. As expected, treatment of the thoracic aorta of this group of rats with antioxidant agents significantly improved EDR. We also noted that pretreatment of aortas from the same group with CDDO-Me attenuated endothelial dysfunction, accompanied by a correction of the redox imbalance, as observed in gene expression and DHE fluorescence studies.ConclusionsFor the first time, we showed that insulin resistance and glucose spikes exert a synergistic effect on aortic endothelial dysfunction. Furthermore, our study reveals that CDDO-Me ameliorates endothelial dysfunction caused by glucose spikes in a rat model of metabolic syndrome.
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- 2022
10. Basal insulin ameliorates post-breakfast hyperglycemia via suppression of post-breakfast proinsulin/C-peptide ratio and fasting serum free fatty acid levels in patients with type 2 diabetes
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Yoshihiko Nishio, Kazuma Ogiso, Takahiko Obo, Nobuyuki Koriyama, and Akinori Tokito
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Serum free fatty acid ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Basal insulin ,Insulin ,medicine.medical_treatment ,digestive, oral, and skin physiology ,030209 endocrinology & metabolism ,Type 2 diabetes ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Postprandial ,Endocrinology ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Original Article ,In patient ,business ,Proinsulin - Abstract
BACKGROUND: In general, basal insulin targets fasting plasma glucose (FPG) levels, and prandial insulin targets postprandial glucose (PPG) levels. However, the effects of basal insulin on PPG levels are controversial. We investigated the effect of basal insulin on postprandial hyperglycemia using a test meal at breakfast as well as compared differences between degludec and glargine. METHODS: A total of 20 participants with type 2 diabetes were randomly assigned to degludec (n = 10) or glargine (n = 10). We initiated basal–bolus insulin therapy and titrated only basal insulin until FPG was
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- 2020
11. A Thyroid-stimulating Hormone (TSH) Producing Adenoma in a Patient with Severe Hypothyroidism: Thyroxine Replacement Reduced the TSH Level and Tumor Size
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Kazunori Arita, Fauziah C. Ummah, Rofat Askoro, Tomoko Takajo, Yoshihiko Nishio, Yushi Nagano, Hiroshi Arimura, and Shingo Fujio
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medicine.medical_specialty ,Pituitary gland ,endocrine system ,TSHoma ,primary hypothyroidism ,endocrine system diseases ,business.industry ,TRH ,Pituitary tumors ,Primary hypothyroidism ,Case Report ,medicine.disease ,Prolactin ,Autoimmune thyroiditis ,medicine.anatomical_structure ,Endocrinology ,Thyroid-stimulating hormone ,Pituitary adenoma ,Internal medicine ,medicine ,business ,hormones, hormone substitutes, and hormone antagonists ,Hormone ,thyroxine - Abstract
We treated an extremely rare thyroid-stimulating hormone (TSH)-producing pituitary adenoma in a 63-year-old woman with severe hypothyroidism due to autoimmune thyroiditis. She was presented with dizziness and fatigue. The blood level of TSH, prolactin, and fT4 was 288.2 μIU/mL, 72.9 ng/mL, and 0.24 ng/dL, respectively. Magnetic resonance imaging demonstrated a large pituitary tumor, 31 mm in height, and a normal pituitary gland. Preoperative thyroxine replacement reduced the TSH level to 2.05 μIU/mL and produced a significant reduction in the tumor volume. Histopathologically, the surgically removed tumor was a TSH-producing pituitary adenoma.
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- 2019
12. Correction to: Dietary obesity and glycemic excursions cause a parallel increase in STEAP4 and pro-inflammatory gene expression in murine PBMCs
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Sigfrid Casmir Shayo, Kazuma Ogiso, Shigeru Kawade, Hiroshi Hashiguchi, Takahisa Deguchi, and Yoshihiko Nishio
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Endocrinology, Diabetes and Metabolism ,Internal Medicine ,Correction - Abstract
The balance between pro-atherogenic and anti-atherogenic factors is very crucial in the development of atherosclerotic lesions. Although the expression of the six-transmembrane epithelial antigen of the prostate 4 (STEAP4) in myeloid cells is known to be atheroprotective, there is not a single study reporting on the status of STEAP4 expression in circulating monocytes in the early stages of diet-induced obesity or in events of glycemic excursions.We induced glycemic spikes twice daily for a 1-week duration to rats fed on regular chow and western diet, and analyzed gene expression changes in the peripheral blood mononuclear cells (PBMCs). We also conducted experiments on RAW 264.7 cells to gain insight into some of our in vivo findings.Diet-induced obesity and glycemic excursions independently caused a significant increase in STEAP4 mRNA expression in PBMCs. This was also accompanied by an induction of a substantial number of pro-inflammatory cytokines, chemokines, and chemokine receptors. However, the combined effect of western diet and hyperglycemic spikes was subtle and non-additive. In the in vitro setting, either glucose spikes, persistent hyperglycemia, or a combination of palmitic acid and insulin resulted in a parallel increase in expression of STEAP4 and pro-inflammatory genes. This was, however, significantly abrogated with 4-octyl itaconate or attenuated by inhibitors of p38MAPK and NF-kB.STEAP4 expression in mononuclear cells is induced by increasing inflammation or oxidative stress. The observed increase in STEAP4 expression in circulating monocytes due to visceral obesity or glycemic excursions is a compensatory response.The online version contains supplementary material available at 10.1007/s13340-021-00542-1.
- Published
- 2021
13. Repeated Glucose Spikes and Insulin Resistance Synergistically Increase Endothelial Function Vulnerability to High Glucose Levels through Redox Imbalance, and Bardoxolone Methyl (CDDO-Me) Ameliorates Endothelial Dysfunction
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Kazuma Ogiso, Sigfrid Casmir Shayo, Shigeru Kawade, Hiroshi Hashiguchi, Takahisa Deguchi, and Yoshihiko Nishio
- Abstract
BackgroundGlucose spikes (GSs) observed after a meal in metabolic syndrome have been reported to cause endothelial dysfunction. However, other insulin resistance-related factors can affect GS-induced endothelial dysfunction. To eliminate these confounding factors, we investigated the separate and combined effects of GSs and insulin resistance due to diet-induced obesity on endothelial function and clarified whether bardoxolone methyl (CDDO-Me), a novel nuclear factor erythroid 2-related factor 2 (Nrf2) activator, protects against GS-induced endothelial dysfunction.MethodsIn the first cohort, eight-week-old male Wistar rats were assigned to one of four groups: 1) control diet (CD)-GS (-); 2) CD-GS (+); 3) Western-type diet (WTD)-GS (-); and 4) WTD-GS (+). Rats were fed a CD or WTD for 13 weeks and intraperitoneally injected with saline or glucose for 1 week twice daily at 20 weeks of age. In the second cohort, four groups from the first cohort were additionally divided into vehicle and CDDO-Me (3 mg/kg) groups. At 21 weeks of age, endothelial function was evaluated using isolated thoracic aortas under normal (5.5 mM) and high-glucose (20 mM) conditions. Gene expression was analyzed, and superoxide anion was evaluated by dihydroethidium (DHE) staining of aortas.ResultsIn the first cohort, endothelium-dependent relaxation (EDR) in the CD-GS (+) or WTD-GS (-) group was comparable to that in the CD-GS (-) group, but it deteriorated in the WTD-GS (+) group only under high-glucose conditions. Antioxidant agents, such as superoxide dismutase, catalase, apocynin (a NOX inhibitor) and Mito-TEMPO (a mitochondrial-targeted superoxide scavenger), improved endothelial function. In this group, upregulation of NOX2 expression and downregulation of SOD2 and catalase expression were observed in the aortas, and DHE intensity was enhanced. In the second cohort, pretreatment of the WTD-GS (+) group with CDDO-Me attenuated this endothelial dysfunction accompanied by a correction of redox imbalance in gene expression and an attenuation of DHE intensity.ConclusionWe demonstrated that GSs and insulin resistance synergistically increased endothelial function vulnerability to high-glucose levels through redox imbalance, although each factor alone had little effect on endothelial function. Furthermore, we showed that pretreatment with CDDO-Me ameliorated endothelial dysfunction caused by GSs in metabolic syndrome model rats.
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- 2021
14. IV. Diabetic Peripheral Neuropathies
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Yoshihiko Nishio and Takahisa Deguchi
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Pathology ,medicine.medical_specialty ,business.industry ,Medicine ,General Medicine ,business ,Peripheral - Published
- 2019
15. Secular changes in clinical manifestations of kidney disease among Japanese adults with type 2 diabetes from 1996 to 2014
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Yoshihiko Nishio, Satoshi Ugi, Shinji Kume, Daisuke Koya, Hiroshi Maegawa, Masakazu Haneda, Atsunori Kashiwagi, Katsutaro Morino, and Shin-ichi Araki
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Blood Glucose ,Male ,Time Factors ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Type 2 diabetes ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Gastroenterology ,Diabetic nephropathy ,Cohort Studies ,0302 clinical medicine ,Japan ,Risk Factors ,Prevalence ,Diabetic Nephropathies ,General Medicine ,Articles ,Middle Aged ,Prognosis ,female genital diseases and pregnancy complications ,Clinical Science and Care ,Disease Progression ,Original Article ,Female ,medicine.symptom ,Glomerular Filtration Rate ,medicine.medical_specialty ,Renal function ,030209 endocrinology & metabolism ,albuminuria ,Diseases of the endocrine glands. Clinical endocrinology ,03 medical and health sciences ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Risk factor ,Aged ,Glycated Hemoglobin ,business.industry ,diabetic nephropathy ,medicine.disease ,RC648-665 ,diabetic kidney disease ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,Albuminuria ,Microalbuminuria ,business ,Biomarkers ,Kidney disease ,Follow-Up Studies - Abstract
Aims/Introduction Diabetic kidney disease is characterized by increased albuminuria and/or a reduced glomerular filtration rate (GFR). We analyzed secular changes in the prevalence of albuminuria and reduced estimated GFR (eGFR) in Japanese patients with type 2 diabetes, and identified factors associated with these changes. Materials and Methods Using 1996, 2001, 2006 and 2014 cohort data from the Japanese serial cross‐sectional studies conducted at Shiga University of Medical Science, secular changes in the prevalence of diabetic kidney disease (albuminuria and/or reduced eGFR), patient characteristics and their associations were analyzed. Results The prevalence of microalbuminuria and macroalbuminuria decreased over time, whereas the prevalence of moderately reduced eGFR (30–60 mL/min/1.73 m2) and severely reduced eGFR (
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- 2019
16. Association between changes in the mRNA expression of platelet-activating factor receptor in peripheral blood mononuclear cells and progression of diabetic nephropathy
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Akira Kikuchi, Kayo Uemura, Yuko Ikeda, Atsushi Shinnakasu, Yoshihiko Nishio, Kiyoaki Yamamoto, Aiko Arimura, Hiroshi Arimura, Hiroshi Hashiguchi, Takahisa Deguchi, Sahar Ghavidel Darestani, Mihoko Kurano, and Yukari Dochi
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medicine.medical_specialty ,Creatinine ,business.industry ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Type 2 diabetes ,030204 cardiovascular system & hematology ,medicine.disease ,Peripheral blood mononuclear cell ,Nephropathy ,Diabetic nephropathy ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,chemistry ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Outpatient clinic ,Original Article ,Microalbuminuria ,business - Abstract
INTRODUCTION: Several studies have recently pointed out the role of many inflammatory mediators in the progression of diabetes complications. We had previously demonstrated that mRNA expression of platelet-activating factor receptor (PAFR) in peripheral blood mononuclear cells (PBMCs) was associated with urinary albumin to creatinine ratio (ACR) and forearm flow-mediated dilatation in patients with type 2 diabetes. In an attempt to elucidate this association, patients were followed up for 1 year. MATERIALS AND METHODS: We recruited 95 patients from the hospital outpatient clinic, among whom 86 were followed up for 1 year (normoalbuminuria: 40 patients, microalbuminuria: 25 patients, macroalbuminuria: 21 patients). We then measured their baseline and 12 month characteristics and collected blood samples to extract PBMCs and measure gene expressions. RESULTS: Despite higher mRNA expression of PAFR in PBMCs among patients with macroalbuminuria, the rise in its value was not associated with biomarkers of nephropathy, while baseline values were not associated with progression of nephropathy. Moreover, changes in mRNA expression of PAFR were correlated with changes in ACR in all patients (r = 0.225, p = 0.037) and estimated glomerular filtration rate in patients with macroalbuminuria (r = − 0.438, p = 0.047) during the follow-up period. CONCLUSION: Our findings indicate that even though no causal relationship exists between diabetic nephropathy and elevated expression of PAFR in PBMCs, their close association signifies the presence of another common mechanism that could induce both events. Given these findings, the PAF/PAFR interaction could clarify corresponding mechanisms involved in diabetic complications. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13340-019-00394-w) contains supplementary material, which is available to authorized users.
- Published
- 2019
17. Central pontine myelinolysis during treatment of hyperglycemic hyperosmolar syndrome: a case report
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Yoshihiko Nishio, Maki Ikeda, Nami Kojima, Nobuyuki Koriyama, and Koshi Kusumoto
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030213 general clinical medicine ,medicine.medical_specialty ,Case Report ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Hypovolemia ,Internal medicine ,Diabetes mellitus ,medicine ,Osmotic demyelination syndrome ,Disseminated intravascular coagulation ,lcsh:RC648-665 ,Hypernatremia ,business.industry ,Hyperosmolar syndrome ,Hyperglycemic hyperosmolarity syndrome ,General Medicine ,medicine.disease ,Ketoacidosis ,Central pontine myelinolysis ,Diffusion-weighted imaging ,medicine.symptom ,Hyponatremia ,business ,030217 neurology & neurosurgery - Abstract
Background Central pontine myelinolysis (CPM) is a non-inflammatory demyelinating lesion of the pons. CPM and extrapontine demyelination (EPM) are together termed osmotic demyelination syndrome (ODS), a known and serious complication of acute correction of hyponatremia. Conversely, hyperglycemic hyperosmolarity syndrome (HHS) develops in patients with type 2 diabetes who still have some insulin secretory ability due to infection, non-compliance with treatment, drugs, and coexisting diseases, and is often accompanied by ketosis. HHS represents a life-threatening endocrine emergency (mortality rate, 10–50%) associated with marked hyperglycemia and severe dehydration. HHS may develop ODS, and some cases have been associated with hypernatremia. Case presentation The patient was an 87-year-old woman with hyperglycemia, dehydration, malnutrition, and potential thrombus formation during long-term bed rest. HHS was suspected to have developed due to progression of hyperglycemia and dehydration caused by pneumonia. Furthermore, ketoacidosis developed from ketosis and prerenal renal failure associated with circulating hypovolemia shock, which was also associated with disseminated intravascular coagulation. Treatment was started with continuous intravenous injection of fast-acting insulin and low-sodium replacement fluid. In addition, ceftriaxone sodium hydrate, heparin sodium, thrombomodulin α, human serum albumin, and dopamine hydrochloride were administered. Blood glucose, serum sodium, serum osmolality, and general condition (including vital, infection/inflammatory findings, and disseminated intravascular coagulation) improved promptly, but improvements in disturbance of consciousness were poor. Diffusion-weighted imaging of the brain 72 h after starting treatment showed no obvious abnormalities, but high-intensity signals in the midline of the pons became apparent 30 days later, leading to definitive diagnosis of CPM. Conclusions Fluctuation of osmotic pressure by treatment from hyperosmolarity due to hyperglycemia and hypernatremia in the presence of risk factors such as malnutrition, severe illness, and metabolic disorders may be a cause of CPM onset. When treating HHS with risk factors, the possibility of progression to ODS needs to be kept in mind.
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- 2020
18. Long-term safety and efficacy of alogliptin, a DPP-4 inhibitor, in patients with type 2 diabetes: a 3-year prospective, controlled, observational study (J-BRAND Registry)
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Masakazu Kobayashi, Hirohito Sone, Haruhiko Osawa, Daisuke Koya, Takanori Miura, Yoshihito Atsumi, Udai Nakamura, Eiichi Araki, Hitoshi Shimano, Yukio Tanizawa, Jiro Nakamura, Yuichiro Yamada, Nobuya Inagaki, Atsuko Abiko, Hideki Katagiri, Michio Hayashi, Keiko Naruse, Shimpei Fujimoto, Masazumi Fujiwara, Kenichi Shikata, Yosuke Okada, Tsutomu Yamazaki, Sou Nagai, Katsuyuki Yanagisawa, Hiromichi Kijima, Shinji Taneda, Shigeyuki Saitoh, Daisuke Ikeda, Fuminori Hirano, Haruhiko Yoshimura, Mitsutaka Inoue, Masahiko Katoh, Osamu Nakagaki, Chiho Yamamoto, Akitsuki Morikawa, Shin Furukawa, Takeshi Koshiya, Hajime Sugawara, Takumi Uchida, Noe Takakubo, Yasushi Ishigaki, Susumu Suzuki, Takashi Shimotomai, Naoki Tamasawa, Jun Matsui, Takashi Goto, Toshihide Oizumi, Shinji Susa, Makoto Daimon, Hiroshi Murakami, Takashi Sugawara, Hiroaki Akai, Mari Nakamura, Yoshiji Ogawa, Takao Yokoshima, Tsuyoshi Watanabe, Michio Shimabukuro, Kazuhisa Tsukamoto, Motoei Kunimi, Jo Satoh, Atushi Okuyama, Kazutaka Ogawa, Hideyuki Eguchi, Mamoru Kimura, Hiroshi Kouno, Yohei Horikawa, Shin Ikejima, Masaru Saitoh, Naoyoshi Minami, Akihiro Sekikawa, Toyoyoshi Uchida, Toshihide Kawai, Nobuya Fujita, Ken Tomotsune, Shigeo Yamashita, Motoji Naka, Toru Hiyoshi, Tomotaka Katoh, Kumiko Hamano, Kouichi Inukai, Takuma Kondo, Kazuhiro Tsumura, Yoko Matsuzawa, Masahiro Mimura, Masahiko Kawasumi, Izumi Takei, Masafumi Matsuda, Ichiro Tatsuno, Nobuyuki Banba, Akihiko Ando, Masao Toyoda, Daisuke Suzuki, Takahiro Iijima, Yasumichi Mori, Yutaka Uehara, Yoshihiko Satoh, Kazuaki Yahata, Yoshimasa Asoh, Koichiro Kuwabara, Souichi Takizawa, Yasushi Tanaka, Koutaroh Yokote, Masako Tohgo, Takanobu Itoi, Shigeru Miyazaki, Hiroshi Itoh, Teruo Shiba, Takahisa Hirose, Mariko Higa, Masanobu Yamada, Osamu Ogawa, Masatoshi Kuroki, Shinobu Satoh, Makoto Ujihara, Kenjiroh Yamanaka, Hajime Koyano, Tadashi Yamakawa, Kenichiroh Takahashi, Kazuki Orime, Tsutomu Hirano, Jiroh Morimoto, Takashi Itoh, Yuzoh Mizuno, Naoyuki Yamamoto, Han Miyatake, Mina Yamaguchi, Kenji Yamane, Masahiko Kure, Satoko Kawabe, Masahumi Kakei, Masashi Yoshida, Hiroyuki Itoh, Nobuaki Minami, Kazuki Kobayashi, Yusuke Fujino, Makoto Shibuya, Midori Hosokawa, Isao Nozaki, Chigure Nawa, Tamio Ieiri, Takayuki Watanabe, Yoshio Katoh, Takuyuki Katabami, Michiko Handa, Issei Shimada, Kenichi Ohya, Yoshihiro Ogawa, Takanobu Yoshimoto, Jiroh Nakamura, Naotsuka Okayama, Kenro Imaeda, Syuko Yoshioka, Masako Murakami, Takashi Murase, Yoshihiko Yamada, Yutaka Yano, Hiromitsu Sasaki, Yasuhiro Sumida, Osamu Yonaha, Hiroshi Sobajima, Mitsuyasu Ito, Atushi Suzuki, Atsuko Ishikawa, Takehiko Ichikawa, Shogo Asano, Shinobu Goto, Sakuma Hiroya, Hiroshi Murase, Shozo Ogawa, Hideki Okamoto, Kotaro Nagai, Koji Nagayama, Masanori Yoshida, Norio Takahashi, Kazuhisa Takami, Tsuneo Ono, Takanobu Morihiro, Daisuke Tanaka, Noriko Takahara, Satoshi Miyata, Mamiko Tsugawa, Koichiro Yasuda, Seiji Muro, Masanori Emoto, Ikuo Mineo, Ichiro Shiojima, Takeshi Kurose, Makoto Ohashi, Yumiko Kawabata, Mitsushige Nishikawa, Emiko Nomura, Yasuyuki Nishimura, Yasuhiro Ono, Yasuhisa Yamamoto, Keigo Naka, Taizo Yamamoto, Rika Usuda, Hiroshi Akahori, Seika Kato, Hiroyuki Konya, Yutaka Umayahara, Takashi Seta, Hideki Taki, Masashi Sekiya, Shinichi Mogami, Sumie Fujii, Toshiyuki Hibuse, Shingo Tsuji, Hirofumi Sumi, Yasuro Kumeda, Akinori Kogure, Kenji Furukawa, Akira Kuroe, Hideaki Sawaki, Narihiro Hibiki, Yoshihiro Kitagawa, Yukihiro Bando, Akira Ono, Rikako Uenaka, Seitaro Omoto, Yuki Kita, Eiko Ri, Ryutaro Numaguchi, Sachiko Kawashima, Ichiro Kisimoto, Kiminori Hosoda, Yoshihiko Araki, Tetsuroh Arimura, Mitsuru Hashiramoto, Koumei Takeda, Akira Matsutani, Yasushi Inoue, Fumio Sawano, Nozomu Kamei, Yasuo Ito, Miwa Morita, Yoshiaki Oda, Rui Kishimoto, Katsuhiro Hatao, Tomoatsu Mune, Fumiko Kawasaki, Hiroki Teragawa, Ken Yaga, Keita Ishii, Kyouji Hirata, Tatsuaki Nakatou, Yutaka Nitta, Naoki Fujita, Masayasu Yoneda, Masatoshi Tsuru, Shinichirou Ando, Toshiaki Kakiba, Michihiro Toyoshige, Tsuguka Shiwa, Hiroaki Miyaoka, Yasumi Shintani, Takenori Sakai, Tetsuji Niiya, Shinpei Fujimoto, Hisaka Minami, Yoshihiko Noma, Masaaki Tamaru, Yoshitaka Sayou, Tomoyo Oyama, Masamoto Torisu, Yuichi Fujinaka, Yoshitaka Kumon, Shozo Miyauchi, Morikazu Onji, Toru Nakamura, Yousuke Okada, Toshihiko Yanase, Kenro Nishida, Syuji Nakamura, Kunihisa Kobayashi, Nobuhiko Wada, Moritake Higa, Koji Matsushita, Yoshihiko Nishio, Ryoji Fujimoto, Yasuyuki Kihara, Shinichiro Mine, Tadashi Arao, Hiromi Tasaki, Yasuto Matsuo, Hirofumi Matsuda, Kohei Uriu, Kazuko Kanda, Kazuo Ibaraki, Yoshio Kaku, Yasuhiro Takaki, Iwaho Hazekawa, Kenji Ebihara, Eiichiro Watanabe, Iku Sakurada, Kazuhisa Muraishi, Tamami Oshige, Junichi Yasuda, Toyoshi Iguchi, Noriyuki Sonoda, Masahiro Adachi, Isao Ichino, Yuko Horiuchi, Souichi Uekihara, Shingo Morimitsu, Mitsuhiro Nakazawa, Tadashi Seguchi, and Kengo Kaneko
- Subjects
Blood Glucose ,safety ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Type 2 diabetes ,Hypoglycemia ,Group B ,Diseases of the endocrine glands. Clinical endocrinology ,dipeptidyl peptidase 4 ,Japan ,Piperidines ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Hypoglycemic Agents ,Prospective Studies ,Adverse effect ,Uracil ,Aged ,Dipeptidyl-Peptidase IV Inhibitors ,business.industry ,Incidence (epidemiology) ,Type 2 Diabetes Mellitus ,registries ,medicine.disease ,RC648-665 ,Diabetes Mellitus, Type 2 ,type 2 ,diabetes mellitus ,Clinical care/Education/Nutrition ,business ,Alogliptin - Abstract
IntroductionGiven an increasing use of dipeptidyl peptidase-4 (DPP-4) inhibitors to treat patients with type 2 diabetes mellitus in the real-world setting, we conducted a prospective observational study (Japan-based Clinical Research Network for Diabetes Registry: J-BRAND Registry) to elucidate the safety and efficacy profile of long-term usage of alogliptin.Research design and methodsWe registered 5969 patients from April 2012 through September 2014, who started receiving alogliptin (group A) or other classes of oral hypoglycemic agents (OHAs; group B), and were followed for 3 years at 239 sites nationwide. Safety was the primary outcome. Symptomatic hypoglycemia, pancreatitis, skin disorders of non-extrinsic origin, severe infections, and cancer were collected as major adverse events (AEs). Efficacy assessment was the secondary outcome and included changes in hemoglobin A1c (HbA1c), fasting blood glucose, fasting insulin and urinary albumin.ResultsOf the registered, 5150 (group A: 3395 and group B: 1755) and 5096 (3358 and 1738) were included for safety and efficacy analysis, respectively. Group A patients mostly (>90%) continued to use alogliptin. In group B, biguanides were the primary agents, while DPP-4 inhibitors were added in up to ~36% of patients. The overall incidence of AEs was similar between the two groups (42.7% vs 42.2%). Kaplan-Meier analysis revealed the incidence of cancer was significantly higher in group A than in group B (7.4% vs 4.8%, p=0.040), while no significant incidence difference was observed in the individual cancer. Multivariate Cox regression analysis revealed that the imbalanced patient distribution (more elderly patients in group A than in group B), but not alogliptin usage per se, contributed to cancer development. The incidence of other major AE categories was with no between-group difference. Between-group difference was not detected, either, in the incidence of microvascular and macrovascular complications. HbA1c and fasting glucose decreased significantly at the 0.5-year visit and nearly plateaued thereafter in both groups.ConclusionsAlogliptin as a representative of DPP-4 inhibitors was safe and durably efficacious when used alone or with other OHAs for patients with type 2 diabetes in the real world setting.
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- 2020
19. Neurofibromatosis type 1 associated with hypophosphatemic osteomalacia due to hypersecretion of fibroblast growth factor 23: a case report
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Takahiko Obo, Kazuma Ogiso, Nobuyuki Koriyama, Akinori Tokito, and Yoshihiko Nishio
- Subjects
Fibroblast growth factor 23 ,Pathology ,medicine.medical_specialty ,Neurofibromatosis 1 ,Tumor suppressor gene ,Hypophosphatemia ,Paraneoplastic Syndromes ,lcsh:Medicine ,Case Report ,030209 endocrinology & metabolism ,03 medical and health sciences ,Paracrine signalling ,0302 clinical medicine ,medicine ,Humans ,Whole Body Imaging ,Vitamin D ,Neurofibromatosis ,Radionuclide Imaging ,Autocrine signalling ,Aged ,Neoplasms, Connective Tissue ,Osteomalacia ,business.industry ,25-hydroxyvitamin D3 ,lcsh:R ,General Medicine ,medicine.disease ,Fibroblast Growth Factors ,Fibroblast Growth Factor-23 ,030220 oncology & carcinogenesis ,Arm ,Immunohistochemistry ,Female ,business ,Tumor-induced osteomalacia ,Neurofibromatosis type 1 - Abstract
Background Neurofibromatosis type 1 is characterized by multiple café au lait spots and cutaneous and plexiform neurofibromas, and is one of the most common autosomal dominant hereditary disorders caused by mutations of the neurofibromatosis type 1 tumor suppressor gene. Osteomalacia in neurofibromatosis type 1 is very rare and is characterized by later onset in adulthood. In humans, fibroblast growth factor 23, which is a causative factor of tumor-induced osteomalacia, is not only a paracrine and autocrine factor, but is also a physiological regulator of phosphate balance in normal serum. Case presentation Our patient was a 65-year-old Japanese woman whose neurofibromas began to appear when she was in elementary school. At age 28, she was diagnosed as having neurofibromatosis type 1. A spinal compression fracture and multiple rib fractures were identified in 2012 and 2017, respectively. Her laboratory findings revealed hypophosphatemia due to renal phosphate wasting and a high serum level of fibroblast growth factor 23. Neurofibromas located on the surface of her right forearm and left upper arm, in which a slight abnormal accumulation of tracers was observed on 111indium-pentetreotide scintigraphy, were surgically removed, but there was no improvement in hypophosphatemia or serum fibroblast growth factor 23 after surgery. Therefore, we administered eldecalcitol, which also failed to produce improvement in abnormal data. Subsequent combination with dibasic calcium phosphate hydrate led to improvement in some of the abnormalities, including hypophosphatemia. Immunohistochemical staining using anti-human fibroblast growth factor 23 antibody revealed slightly positive results, however, only one out of three amplifications of the fibroblast growth factor 23 gene was observed by real-time polymerase chain reaction, and no clear fibroblast growth factor 23 gene expression in the resected neurofibromas could be confirmed. Conclusions We here describe a first rare case of a 65-year-old woman with neurofibromatosis type 1 associated with hypophosphatemic osteomalacia in which a high serum fibroblast growth factor 23 level was confirmed.
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- 2020
20. Growth hormone deficiency with late-onset hypothalamic hypoadrenocorticism associated with respiratory and renal dysfunction: a case report
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Kazuma Ogiso, Satoshi Kubo, Nobuyuki Koriyama, Yoshihiko Nishio, Akinori Tokito, Koshi Kusumoto, and Nami Kojima
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medicine.medical_specialty ,Empty Sella turcica ,Endocrinology, Diabetes and Metabolism ,Case Report ,030209 endocrinology & metabolism ,Adrenocorticotropic hormone ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Short stature ,Hypopituitarism ,Growth hormone deficiency ,Hypercapnia ,03 medical and health sciences ,0302 clinical medicine ,Anterior pituitary ,Internal medicine ,Respiratory muscle ,medicine ,Humans ,Respiratory function ,Childhood-onset growth hormone deficiency (GHD) ,Restricted ventilation disorder ,Renal Insufficiency, Chronic ,Dwarfism, Pituitary ,Hypoxia ,Aged ,lcsh:RC648-665 ,business.industry ,Empty Sella Syndrome ,Late-onset secondary hypoadrenocorticism ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,Endocrinology ,Growth hormone (GH) ,Estimated glomerular filtration rate (eGFR) ,Disease Progression ,Female ,Panhypopituitarism ,medicine.symptom ,Respiratory Insufficiency ,Luteinizing hormone ,business ,030217 neurology & neurosurgery ,Adrenal Insufficiency ,Hormone - Abstract
BackgroundThe prevalence of childhood-onset growth hormone (GH) deficiency (GHD) is estimated to be approximately 1 in 5000 or more, with the cause unknown in most cases (idiopathic isolated GHD). However, additional disorders of secretion of other pituitary hormones reportedly develop over time, with a frequency of 2–94% (median, 16%). Furthermore, median times to development of other anterior pituitary hormone deficiencies have been reported to be 6.4–9.4 years. On the other hand, adult patients affected by childhood-onset GHD reportedly develop impaired ventilation function due to reduced lung volumes and respiratory pressures, probably due to reductions in respiratory muscle strength. In addition, GH is known to play a role in stimulating the glomerular filtration rate (GFR), and the estimated GFR (eGFR) is decreased in patients with GHD.Case presentationThis case involved a 65-year-old woman. Her short stature had been identified at around 3 years of age, but no effective treatments had been provided. The patient was mostly amenorrheic, and hair loss became apparent in her late 30s. She developed hyperuricemia, dyslipidemia, and hypertension at 45 years of age. In addition, the patient was diagnosed with hypothyroidism at 50 years of age. At 58 years of age, endocrinological examination showed impaired secretion of thyroid-stimulating hormone, luteinizing hormone/follicle-stimulating hormone, and growth hormone, and magnetic resonance imaging showed an empty sella turcica. However, secretion ability of adrenocorticotropic hormone was retained. At 63 years of age, respiratory function tests confirmed a markedly restricted ventilation disorder (vital capacity, 0.54 L; percentage predicted vital capacity, 26.9%). Renal function had also decreased (eGFR, 25.0 mL/min/1.73 m2). Furthermore, she was diagnosed with hypothalamic secondary hypoadrenocorticism. The patient developed CO2narcosis at 65 years of age, and noninvasive positive pressure ventilation was started.ConclusionsThe rare case of a 65-year-old woman with childhood-onset GHD with panhypopituitarism, including late-onset secondary hypoadrenocorticism in her 60s, associated with severely impaired respiratory function and renal dysfunction, was reported. In GHD patients with risk factors for progression from isolated GHD to combined pituitary hormone deficiency, such as empty sella turcica, lifelong endocrinological monitoring may be important.
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- 2020
21. Japanese Adult-Onset Type 1 Diabetic Sisters with Different Disease States: A Case Report
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Koshi Kusumoto, Maki Ikeda, Nobuyuki Koriyama, Yoshihiko Nishio, and Nami Kojima
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Type 1 diabetes ,biology ,business.industry ,Insulin ,medicine.medical_treatment ,Haplotype ,Autoantibody ,General Medicine ,Human leukocyte antigen ,Disease ,medicine.disease ,Zinc Transporter 8 ,Immunology ,medicine ,biology.protein ,Antibody ,business - Abstract
We encountered type 1 diabetic sisters with different islet-associated antibodies and pancreatic β-cell injury rates. The younger sister had different disease susceptibility human leukocyte antigen (HLA) haplotypes (DRB1*0901-DQB1*0303/DRB1*0802-DQB1*0302) on both chromosomes, while the older sister showed a disease susceptibility HLA haplotype (DRB1*0901-DQB1*0303/-) on one chromosome. Furthermore, the younger sister was positive for anti-glutamic acid decarboxylase antibody (GADA), anti-insulinoma-associated protein-2 antibody (IA-2A), and zinc transporter 8 antibody (ZnT8A), and showed depleted endogenous insulin secretory ability at the time of diagnosis. On the other hand, the older sister was positive only for GADA and ZnT8A, and the ability to secrete endogenous insulin was relatively retained at onset. From our cases and existing reports, we verified that: 1) having a HLA haplotype for disease susceptibility on both chromosomes; 2) having HLA-DQ8 and HLA-A24, -DQA1*03 and -DR9; 3) having more islet autoantibodies including IA-2A and ZnT8A may be involved in accelerating the progression of type 1 diabetes by enhancing the damage to pancreatic β-cells.
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- 2020
22. Long-Term Observation of Improvement in Liver Fibrosis Index by A Glucagon-Like Peptide-1 Receptor Agonist in A Patient with Type 2 Diabetes: A Case Report
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Akinori Tokito, Nobuyuki Koriyama, and Yoshihiko Nishio
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Liraglutide ,Type 2 Diabetes Mellitus ,General Medicine ,Type 2 diabetes ,medicine.disease ,digestive system ,Gastroenterology ,digestive system diseases ,Liver biopsy ,Internal medicine ,Nonalcoholic fatty liver disease ,medicine ,Blood test ,business ,Exenatide ,Glucagon-like peptide 1 receptor ,medicine.drug - Abstract
We describe a 51-year-old man with type 2 diabetes and hepatic dysfunction with suspected nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH). No liver biopsy was performed. His blood test showed a decrease in platelet count (PLT) of 6.3 × 104/μL. Serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were increased, and the AST/ALT ratio (AAR) exceeded 1. FIB4 index, an index of liver fibrosis, was remarkably high at 7.65. On abdominal computed tomography (CT), hepatic parenchyma was visualized as a low absorption area (CT value: 36 HU, L/S ratio
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- 2020
23. mRNA expression of platelet activating factor receptor (PAFR) in peripheral blood mononuclear cells is associated with albuminuria and vascular dysfunction in patients with type 2 diabetes
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Hiroshi Hashiguchi, Takahisa Deguchi, Atsushi Shinnakasu, Yuko Ikeda, Yukari Dochi, Mihoko Kurano, Kiyoaki Yamamoto, Sahar Ghavidel Darestani, Yoshihiko Nishio, Akira Kikuchi, and Kayo Uemura
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Male ,0301 basic medicine ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Renal function ,Platelet Membrane Glycoproteins ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Muscle, Smooth, Vascular ,Receptors, G-Protein-Coupled ,Diabetic nephropathy ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,RNA, Messenger ,Macrovascular disease ,Creatinine ,business.industry ,nutritional and metabolic diseases ,General Medicine ,Middle Aged ,medicine.disease ,030104 developmental biology ,Diabetes Mellitus, Type 2 ,chemistry ,Cardiovascular Diseases ,Leukocytes, Mononuclear ,Female ,Microalbuminuria ,medicine.symptom ,business - Abstract
Renal dysfunction in addition to diabetes is a serious risk factor for cardiovascular events. We hypothesized that some of the changes in gene expression in blood cells cause renal dysfunction and macrovascular disease through impaired endothelial function. This study aimed to define which changes in gene expression in peripheral blood mononuclear cells (PBMCs) are related to renal function parameters and endothelial function of large arteries in patients with type 2 diabetes mellitus (T2DM).We recruited 95 patients with T2DM. After matching for gender, age, BMI and HbA1c levels, the patient cohort included 42 with normoalbuminuria, 28 with microalbuminuria, and 25 with macroalbuminuria. All patients in the three groups were assessed for urinary albumin to creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), flow-mediated dilatation (FMD), and mRNA expression in PBMCs.The mRNA expression of platelet activating factor receptor (PAFR) differed most markedly between the three groups and was significantly higher in the macroalbuminuric group (p 0.001 vs. normoalbuminuric group; p 0.05 vs. microalbuminuric group). PAFR mRNA expression significantly correlated with log transformed ACR (ρ = 0.424, p 0.001) but not eGFR. PAFR mRNA expression also had a significant negative correlation with FMD (ρ = -0.379, p 0.001). Furthermore, the prevalence of macrovascular complications, particularly stroke, was significantly higher in patients with elevated PAFR mRNA expression in PBMCs.PAFR overexpression in PBMCs may link diabetic nephropathy to macroangiopathy through impairment of endothelial function in patients with T2DM.
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- 2018
24. The Combination Therapy of Fenofibrate and Ezetimibe Improved Lipid Profile and Vascular Function Compared with Statins in Patients with Type 2 Diabetes
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Atsushi Shinnakasu, Mihoko Kurano, Hiroshi Hashiguchi, Takahisa Deguchi, Akira Kikuti, Hiroshi Arimura, Yoshihiko Nishio, Aiko Arimura, and Kiyoaki Yamamoto
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Male ,0301 basic medicine ,Very low-density lipoprotein ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Triglyceride ,chemistry.chemical_compound ,0302 clinical medicine ,Fenofibrate ,Hypolipidemic Agents ,medicine.diagnostic_test ,Anticholesteremic Agents ,Middle Aged ,Prognosis ,Lipids ,Small dense LDL ,Original Article ,Drug Therapy, Combination ,Female ,lipids (amino acids, peptides, and proteins) ,Cardiology and Cardiovascular Medicine ,medicine.drug ,medicine.medical_specialty ,Statin ,HDL ,medicine.drug_class ,03 medical and health sciences ,Ezetimibe ,Internal medicine ,Internal Medicine ,medicine ,Humans ,business.industry ,Cholesterol ,Biochemistry (medical) ,nutritional and metabolic diseases ,Endothelial function ,medicine.disease ,030104 developmental biology ,Endocrinology ,Diabetes Mellitus, Type 2 ,chemistry ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Lipid profile ,Biomarkers ,Follow-Up Studies ,Lipoprotein - Abstract
Aim: Elevated level of serum triglyceride (TG) is a characteristic of type 2 diabetes. We evaluated the clinical significance of intervention for the serum TG levels in the fasting and postprandial states in patients with type 2 diabetes. Methods: Fifty patients with type 2 diabetes, treated with statins, were selected and divided into two groups. One group was treated with a combination of fenofibrate and ezetimibe (F/E group) and the other group with statins (statin group) for 12 weeks. The lipoprotein profile of both groups was compared using high-performance liquid chromatography, and the vascular function was assessed using flow-mediated dilation (FMD) at the forearm. Results: The levels of very low-density lipoprotein (VLDL) cholesterol, malondialdehyde low-density lipoprotein (MDA-LDL), total TG, chylomicron-TG, VLDL-TG, and HDL-TG decreased in the F/E group, whereas those of HDL cholesterol increased. Furthermore, the peak particle size of LDL increased, but that of HDL decreased in the F/E group. The combination treatment significantly improved the FMD. The change in the cholesterol level in a very small fraction of HDL was a significant independent predictor for determining the improvement of FMD (p < 0.01). Conclusions: Compared with the treatment with statins, the treatment with the combination of fenofibrate and ezetimibe effectively controlled the LDL cholesterol and TG levels, increased the HDL cholesterol level, especially in its small fraction, and improved vascular function of patients with type 2 diabetes.
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- 2017
25. Hypothalamic AMP-Activated Protein Kinase Regulates Biphasic Insulin Secretion from Pancreatic β Cells during Fasting and in Type 2 Diabetes
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Masakazu Haneda, Masami Chin-Kanasaki, Satoshi Ugi, Yukihiro Fujita, Tsuyoshi Yanagimachi, Shinji Kume, Keiko Kondo, Takashi Uzu, Sawako Kitahara, Shin-ich Araki, Hisazumi Araki, Shiro Maeda, Daisuke Koya, Akihiro Sekine, Atsunori Kashiwagi, Motoyuki Kondo, Hiroshi Maegawa, Kiyosumi Maeda, and Yoshihiko Nishio
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0301 basic medicine ,SNS, sympathetic nervous system ,Male ,Sympathetic Nervous System ,Time Factors ,18F-FDG, 2-[fluorine-18]-2-deoxy-d-glucose ,OGTT, oral glucose tolerance test ,Insulins ,lcsh:Medicine ,Type 2 diabetes ,AMP-Activated Protein Kinases ,ACC, acetyl CoA carboxylase ,IPITT, intraperitoneal insulin tolerance test ,chemistry.chemical_compound ,0302 clinical medicine ,AMP-activated protein kinase ,Insulin-Secreting Cells ,Pancreatic β cell ,Kg, glucose disappearance rate ,lcsh:R5-920 ,biology ,Insulin secretion ,Diabetes ,GIP, glucose-dependent insulinotropic polypeptide ,LETO, Long-Evans Tokushima Otsuka ,Brain ,GLP-1, glucagon-like peptide-1 ,General Medicine ,Fasting ,Glucagon-like peptide-1 ,Denervation ,CT, computed tomography ,Organ Specificity ,OLETF, Otsuka Long-Evans Tokushima Fatty ,SNPs, single nucleotide polymorphisms ,First-phase GSIS ,lcsh:Medicine (General) ,Research Paper ,Cell physiology ,HOMA-β, homeostasis model assessment beta-cell function index ,medicine.medical_specialty ,endocrine system ,FSIVGTT, frequently sampled intravenous glucose tolerance test ,SUV, standardized uptake value ,Hypothalamus ,2-DG, 2-deoxy-d-glucose ,General Biochemistry, Genetics and Molecular Biology ,PET, positron emission tomography ,AIR, acute insulin response ,GSIS, glucose-stimulated insulin secretion ,03 medical and health sciences ,Fluorodeoxyglucose F18 ,Internal medicine ,Diabetes mellitus ,medicine ,Animals ,Humans ,Secretion ,Protein kinase A ,Pancreas ,ICV, intracerebroventricular ,business.industry ,lcsh:R ,SD, Sprague-Dawley ,AICAR, 5-aminoimidazole-4-carboxamide-1-β-d-ribofuranoside ,PNx, pancreatic denervation ,Glucose Tolerance Test ,medicine.disease ,Rats ,AMPK, AMP-activated protein kinase ,Disease Models, Animal ,030104 developmental biology ,Endocrinology ,Glucose ,chemistry ,Diabetes Mellitus, Type 2 ,Starvation ,Positron-Emission Tomography ,biology.protein ,business ,2-Deoxy-D-glucose ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery - Abstract
Glucose-stimulated insulin secretion (GSIS) by pancreatic β cells is biphasic. However, the physiological significance of biphasic GSIS and its relationship to diabetes are not yet fully understood. This study demonstrated that impaired first-phase GSIS follows fasting, leading to increased blood glucose levels and brain glucose distribution in humans. Animal experiments to determine a possible network between the brain and β cells revealed that fasting-dependent hyperactivation of AMP-activated protein kinase in the hypothalamus inhibited first-phase GSIS by stimulating the α-adrenergic pancreatic nerve. Furthermore, abnormal excitability of this brain-β cell neural axis was involved in diabetes-related impairment of first-phase GSIS in diabetic animals. Finally, pancreatic denervation improved first-phase GSIS and glucose tolerance and ameliorated severe diabetes by preventing β cell loss in diabetic animals. These results indicate that impaired first-phase GSIS is critical for brain distribution of dietary glucose after fasting. Furthermore, β cells in individuals with diabetes mistakenly sense that they are under conditions that mimic prolonged fasting. The present study provides additional insight into both β cell physiology and the pathogenesis of β cell dysfunction in type 2 diabetes., Highlights • Fasting-induced hypothalamic AMPK activation inhibited first-phase GSIS by stimulating the α-adrenergic nerve. • The brain-pancreas neural axis was involved in β cell dysfunction and glucose intolerance in diabetes. • Pancreatic denervation improved first-phase GSIS, glucose tolerance and β cell survival in type 2 diabetic animals. Glucose-stimulated insulin secretion (GSIS) from pancreatic β cells is biphasic. Furthermore, first-phase GSIS is inhibited in type 2 diabetes. This study revealed that fasting reduced first-phase GSIS by signaling via the brain-pancreatic β cell neural axis, which is essential for maintaining glucose supply to the brain at re-feeding after fasting. Abnormal excitability of this neural axis was also associated with impaired first-phase GSIS in type 2 diabetes. Surgical pancreatic denervation improved diabetes in an animal study. The present data reveal that diabetic β cells exist under conditions that mimic starvation and provide a therapeutic potency of pancreatic denervation against diabetes., Graphical Abstract Image 2
- Published
- 2016
26. Effects of glycemic control and hypoglycemia on Thrombus formation assessed using automated microchip flow chamber system: an exploratory observational study
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Mihoko Kurano, Takashi Ito, Takahisa Deguchi, Tomoka Nagasato, Hiroshi Arimura, Atsushi Shinnakasu, Ikuro Maruyama, Yoshihiko Nishio, Aiko Arimura, Kiyoaki Yamamoto, and Hiroshi Hashiguchi
- Subjects
medicine.medical_specialty ,Thrombogenicity ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Hypoglycemia ,03 medical and health sciences ,0302 clinical medicine ,Glycemic control ,Internal medicine ,Diabetes mellitus ,medicine ,030212 general & internal medicine ,Thrombus ,Glycemic ,Angiology ,business.industry ,lcsh:RC633-647.5 ,Research ,Insulin tolerance test ,Hematology ,lcsh:Diseases of the blood and blood-forming organs ,medicine.disease ,Hyperglycemia ,Cardiology ,business - Abstract
Background Thrombus formation is an important factor affecting cardiovascular events and venous thromboembolism in type 2 diabetes. However, it is unclear whether glycemic control reduces thrombogenicity. We investigated the effect of short-term glycemic control (STUDY 1) and hypoglycemia (STUDY 2) on thrombus formation using an automated microchip flow chamber system. Methods For STUDY 1, we recruited 10 patients with type 2 diabetes. Before and after 2 weeks of treatment, blood glucose was analyzed with a continuous glucose monitoring system, and thrombogenicity was analyzed with an automated microchip flow chamber system. For STUDY 2, we recruited 10 subjects without diabetes who underwent an insulin tolerance test. We evaluated the change in thrombogenic potential with hypoglycemia. Results STUDY1: The mean blood glucose level reduced from 10.1 ± 2.6 to 6.9 ± 0.97 mM (P
- Published
- 2019
27. Evaluation of a Novel Glucose Area Under the Curve (AUC) Monitoring System: Comparison with the AUC by Continuous Glucose Monitoring
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Satoshi Ugi, Atsunori Kashiwagi, Katsutaro Morino, Seiki Okada, Toshiyuki Sato, Hiromu Nakajima, Toshihiro Watanabe, Hiroshi Maegawa, Yasuo Kikkawa, and Yoshihiko Nishio
- Subjects
Glucose area under the curve ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Extracellular fluid ,03 medical and health sciences ,0302 clinical medicine ,Interstitial fluid ,Diabetes mellitus ,Glucose monitoring ,Medicine ,030212 general & internal medicine ,Continuous glucose monitoring ,lcsh:RC648-665 ,Postprandial glycemic excursion ,business.industry ,Area under the curve ,Monitoring system ,Glucose excursion ,medicine.disease ,Surgery ,Postprandial ,Others ,Original Article ,business ,Biomedical engineering - Abstract
Background Management of postprandial hyperglycemia is a key aspect in diabetes treatment. We developed a novel system to measure glucose area under the curve (AUC) using minimally invasive interstitial fluid extraction technology (MIET) for simple monitoring of postprandial glucose excursions. In this study, we evaluated the relationship between our system and continuous glucose monitoring (CGM) by comparing glucose AUC obtained using MIET with that obtained using CGM for a long duration. Methods Twenty diabetic inpatients wearing a CGM system were enrolled. For MIET measurement, a plastic microneedle array was applied to the skin as pretreatment, and hydrogels were placed on the pretreated area to collect interstitial fluid. Hydrogels were replaced every 2 or 4 hours and AUC was predicted on the basis of glucose and sodium ion levels. Results AUC predicted by MIET correlated well with that measured by CGM (r=0.93). Good performances of both consecutive 2- and 4-hour measurements were observed (measurement error: 11.7%±10.2% for 2 hours and 11.1%±7.9% for 4 hours), indicating the possibility of repetitive measurements up to 8 hours. The influence of neither glucose fluctuation nor average glucose level over the measurement accuracy was observed through 8 hours. Conclusion Our system showed good relationship with AUC values from CGM up to 8 hours, indicating that single pretreatment can cover a large portion of glucose excursion in a day. These results indicated possibility of our system to contribute to convenient monitoring of glucose excursions for a long duration.
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- 2016
28. Duality of n-3 Polyunsaturated Fatty Acids on Mcp-1 Expression in Vascular Smooth Muscle: A Potential Role of 4-Hydroxy Hexenal
- Author
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Hirotaka Iwasaki, Takeshi Imamura, Atsunori Kashiwagi, Katsutaro Morino, Atsushi Ishikado, Fumiyuki Nakagawa, Masashi Tawa, Hiroshi Maegawa, Tomio Okamura, Satoshi Ugi, Yoshihiko Nishio, Kohji Nagayama, Osamu Sekine, Takashi Okada, and Daisuke Sato
- Subjects
Male ,eicosapentaenoic acid ,Time Factors ,monocyte chemotactic protein 1 ,4-hydroxy hexenal ,docosahexaenoic acid ,Vascular smooth muscle ,Aorta, Thoracic ,p38 Mitogen-Activated Protein Kinases ,Muscle, Smooth, Vascular ,Rats, Sprague-Dawley ,Tandem Mass Spectrometry ,Cells, Cultured ,Chemokine CCL2 ,chemistry.chemical_classification ,Nutrition and Dietetics ,food and beverages ,Eicosapentaenoic acid ,medicine.anatomical_structure ,Biochemistry ,Docosahexaenoic acid ,RNA Interference ,lipids (amino acids, peptides, and proteins) ,Signal transduction ,lcsh:Nutrition. Foods and food supply ,Signal Transduction ,Polyunsaturated fatty acid ,medicine.medical_specialty ,Docosahexaenoic Acids ,NF-E2-Related Factor 2 ,p38 mitogen-activated protein kinases ,Myocytes, Smooth Muscle ,Down-Regulation ,lcsh:TX341-641 ,In Vitro Techniques ,CCL2 ,Biology ,Transfection ,Article ,Internal medicine ,medicine ,Animals ,Aldehydes ,Dose-Response Relationship, Drug ,Monocyte ,Endocrinology ,chemistry ,Chromatography, Liquid ,Food Science - Abstract
N-3 polyunsaturated fatty acids such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) have protective effects against atherosclerosis. Monocyte chemotactic protein (MCP)-1 is a major inflammatory mediator in the progression of atherosclerosis. However, little is known about the regulation of MCP-1 by DHA and EPA in vessels and vascular smooth muscle cells (VSMCs). In this study, we compared the effect of DHA and EPA on the expression of Mcp-1 in rat arterial strips and rat VSMCs. DHA, but not EPA, suppressed Mcp-1 expression in arterial strips. Furthermore, DHA generated 4-hydroxy hexenal (4-HHE), an end product of n-3 polyunsaturated fatty acids (PUFAs), in arterial strips as measured by liquid chromatography-tandem mass spectrometry. In addition, 4-HHE treatment suppressed Mcp-1 expression in arterial strips, suggesting 4-HHE derived from DHA may be involved in the mechanism of this phenomenon. In contrast, Mcp-1 expression was stimulated by DHA, EPA and 4-HHE through p38 kinase and the Keap1-Nuclear factor erythroid-derived 2-like 2 (Nrf2) pathway in VSMCs. In conclusion, there is a dual effect of n-3 PUFAs on the regulation of Mcp-1 expression. Further study is necessary to elucidate the pathological role of this phenomenon.
- Published
- 2015
29. Switching from Sitagliptin to Alogliptin under Treatment with Pioglitazone Increases High Molecular Weight Adiponectin in Type 2 Diabetes: A Prospective Observational Study
- Author
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Ayako Ijuin, Kazuma Ogiso, Nobuyuki Koriyama, Akinori Tokito, Yoshihiko Nishio, and Michihisa Jougasaki
- Subjects
medicine.medical_specialty ,Adiponectin ,business.industry ,Dipeptidyl peptidase-4 inhibitor ,Type 2 diabetes ,medicine.disease ,Endocrinology ,Sitagliptin ,Internal medicine ,Statistical significance ,Medicine ,business ,Body mass index ,Pioglitazone ,Alogliptin ,medicine.drug - Abstract
Background: There are few clinical trials addressing the difference in pleiotropic effects among dipeptidyl peptidase (DPP)-4 inhibitors. We aimed to identify difference in effects on biochemical markers of inflammation, oxidative stress, and atherosclerosis between two DPP-4 inhibitors in patients with type 2 diabetes. Methods: We prospectively observed twenty subjects with type 2 diabetes before and after a practical medication change from a treatment with pioglitazone and sitagliptin 50 mg to a combination tablet containing the same dose of pioglitazone and alogliptin 25mg, which was actually identical to switching from sitagliptin to alogliptin. After 3 months, changes from baseline in clinical data and various biochemical markers were evaluated. In particular, body mass index (BMI) and hemoglobin A1c (HbA1c) were additionally followed after 12 months for evaluation of chronic outcomes. Results: Among markers, serum levels of high molecular weight (HMW) adiponectin significantly increased from 6.9 ± 3.6 μg/ml to 8.2 ± 4.0 μg/ml (P = 0.0045). Although no clinical data changed after 3 months, significant improvements in HbA1c and BMI were observed after 12 months. Their rates of changes tended to inversely correlate with the increased percentages of serum HMW adiponectin levels during initial 3 months, but they did not reach statistical significance. Conclusions: In spite of pretreatment with pioglitazone, additional increase in serum HMW adiponectin levels was demonstrated after switching from sitagliptin to alogliptin. Given multiple favorable roles of adiponectin in metabolic and cardiovascular states, alogliptin, at least when combined with pioglitazone, would be beneficial in treatment of type 2 diabetes.
- Published
- 2015
30. A fish-based diet intervention improves endothelial function in postmenopausal women with type 2 diabetes mellitus: A randomized crossover trial
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Atsunori Kashiwagi, Katsutaro Morino, Takeshi Yoshizaki, Osamu Sekine, Fumiyuki Nakagawa, Satoshi Ugi, Hiroshi Maegawa, Motoyuki Kondo, Keiko Nakao, Atsushi Ishikado, Yoshihiko Nishio, and Keiko Kondo
- Subjects
Aging ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Cohort Studies ,Endocrinology ,Japan ,Internal medicine ,Fatty Acids, Omega-3 ,Epidemiology ,medicine ,Animals ,Humans ,Plethysmograph ,Reactive hyperemia ,Aged ,chemistry.chemical_classification ,Cross-Over Studies ,Postmenopausal women ,Chemistry ,Fishes ,Type 2 Diabetes Mellitus ,Middle Aged ,Atherosclerosis ,Dietary Fats ,Crossover study ,Diet Records ,Postmenopause ,Diabetes Mellitus, Type 2 ,Seafood ,Eicosanoids ,%22">Fish ,Female ,Endothelium, Vascular ,Diabetic Angiopathies ,Polyunsaturated fatty acid - Abstract
The beneficial effects of fish and n-3 polyunsaturated fatty acids (PUFAs) consumption on atherosclerosis have been reported in numerous epidemiological studies. However, to the best of our knowledge, the effects of a fish-based diet intervention on endothelial function have not been investigated. Therefore, we studied these effects in postmenopausal women with type 2 diabetes mellitus (T2DM).Twenty-three postmenopausal women with T2DM were assigned to two four-week periods of either a fish-based diet (n-3 PUFAs ≧ 3.0 g/day) or a control diet in a randomized crossover design. Endothelial function was measured with reactive hyperemia using strain-gauge plethysmography and compared with the serum levels of fatty acids and their metabolites. Endothelial function was determined with peak forearm blood flow (Peak), duration of reactive hyperemia (Duration) and flow debt repayment (FDR).A fish-based dietary intervention improved Peak by 63.7%, Duration by 27.9% and FDR by 70.7%, compared to the control diet. Serum n-3 PUFA levels increased after the fish-based diet period and decreased after the control diet, compared with the baseline (1.49 vs. 0.97 vs. 1.19 mmol/l, p0.0001). There was no correlation between serum n-3 PUFA levels and endothelial function. An increased ratio of epoxyeicosatrienoic acid/dihydroxyeicosatrienoic acid was observed after a fish-based diet intervention, possibly due to the inhibition of the activity of soluble epoxide hydrolase.A fish-based dietary intervention improves endothelial function in postmenopausal women with T2DM. Dissociation between the serum n-3 PUFA concentration and endothelial function suggests that the other factors may contribute to this phenomenon.
- Published
- 2014
31. A high-fiber, low-fat diet improves periodontal disease markers in high-risk subjects: a pilot study
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Hiroshi Maegawa, Keiko Kondo, Yasutami Shigeta, Satoshi Ugi, Osamu Sekine, Atsunori Kashiwagi, Katsutaro Morino, Takeshi Yoshizaki, Atsushi Ishikado, Taketoshi Makino, George L. King, Hiromi Iwakawa, Sadae Kajiwara, Mika Kurihara, Hiromichi Imanaka, Yoshihiko Nishio, Syoko Uesaki, and Keiko Nakao
- Subjects
Adult ,Blood Glucose ,Dietary Fiber ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Bleeding on probing ,Pilot Projects ,Systemic inflammation ,Gastroenterology ,Body Mass Index ,Impaired glucose tolerance ,Endocrinology ,Periodontal disease ,Diabetes mellitus ,Internal medicine ,Glucose Intolerance ,Dietary Carbohydrates ,medicine ,Humans ,Insulin ,Diet, Fat-Restricted ,Periodontal Diseases ,Triglycerides ,Nutrition and Dietetics ,business.industry ,Body Weight ,Cholesterol, HDL ,Cholesterol, LDL ,Feeding Behavior ,Middle Aged ,medicine.disease ,Low fat diet ,Dietary Fats ,Surgery ,C-Reactive Protein ,Clinical attachment loss ,Female ,Dietary Proteins ,Waist Circumference ,medicine.symptom ,Energy Intake ,business ,Body mass index ,Biomarkers - Abstract
Periodontal disease is related to aging, smoking habits, diabetes mellitus, and systemic inflammation. However, there remains limited evidence about causality from intervention studies. An effective diet for prevention of periodontal disease has not been well established. The current study was an intervention study examining the effects of a high-fiber, low-fat diet on periodontal disease markers in high-risk subjects. Forty-seven volunteers were interviewed for recruitment into the study. Twenty-one volunteers with a body mass index of at least 25.0 kg/m(2) or with impaired glucose tolerance were enrolled in the study. After a 2- to 3-week run-in period, subjects were provided with a test meal consisting of high fiber and low fat (30 kcal/kg of ideal body weight) 3 times a day for 8 weeks and followed by a regular diet for 24 weeks. Four hundred twenty-five teeth from 17 subjects were analyzed. Periodontal disease markers assessed as probing depth (2.28 vs 2.21 vs 2.13 mm; P < .0001), clinical attachment loss (6.11 vs 6.06 vs 5.98 mm; P < .0001), and bleeding on probing (16.2 vs 13.2 vs 14.6 %; P = .005) showed significant reductions after the test-meal period, and these improvements persisted until the follow-up period. Body weight (P < .0001), HbA1c (P < .0001), and high-sensitivity C-reactive protein (P = .038) levels showed improvement after the test-meal period; they returned to baseline levels after the follow-up period. In conclusion, treatment with a high-fiber, low-fat diet for 8 weeks effectively improved periodontal disease markers as well as metabolic profiles, at least in part, by effects other than the reduction of total energy intake.
- Published
- 2014
32. Median neuropathy at the wrist as an early manifestation of diabetic neuropathy
- Author
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Yumiko Arimura, Tadashi Uto, Yukari Dochi, Kimiyoshi Arimura, Yoshihiko Nishio, Shuji Horinouchi, Takahisa Deguchi, Hiroshi Takashima, Aiko Arimura, and Tomonori Nakamura
- Subjects
medicine.medical_specialty ,Diabetic neuropathy ,business.industry ,Endocrinology, Diabetes and Metabolism ,Median Neuropathy ,Articles ,General Medicine ,Wrist ,medicine.disease ,Gastroenterology ,Median nerve ,Surgery ,medicine.anatomical_structure ,Median neuropathy ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Clinical significance ,business ,Carpal tunnel syndrome ,Sensory nerve - Abstract
Aims/Introduction To elucidate the clinical significance of median neuropathy at the wrist (MN) in patients with diabetes. Materials and Methods In total, 340 patients with diabetes who were hospitalized for glycemic control were enrolled in the present study. The diagnoses of MN and diabetic polyneuropathy (DPN) were based on electrophysiological criteria. A total of 187 patients were divided into four subgroups: patients without MN or DPN; patients with MN without DPN; patients with MN and DPN; and patients with DPN without MN. Intergroup comparisons of clinical characteristics and results of nerve conduction studies were carried out. Results A total of 71 patients had neither MN nor DPN; 25 had MN, but no DPN; 55 had MN and DPN; and 36 had DPN, but no MN. In comparison with the MN and DPN group, the MN without DPN group included more patients in the early phase of diabetes (diagnosed within the past 5 years) and fewer patients with diabetic microangiopathy. Comparative median nerve conduction studies showed significantly lower motor and sensory nerve conduction velocities, longer F-wave latencies, and smaller sensory nerve action potentials in patients with MN and DPN than in those without DPN. Conclusions MN in patients with diabetes could be attributed to an impairment in axonal function at common entrapment sites, and could be used to identify an early manifestation of diabetic neuropathy.
- Published
- 2014
33. Early skin denervation in hereditary and iatrogenic transthyretin amyloid neuropathy
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Ayane Izaki, Mayumi Mizukami, Yukihiro Inomata, Konen Obayashi, Yukio Ando, Teruaki Masuda, Yohei Misumi, Yasuteru Inoue, Hiroaki Motokawa, Masayoshi Tasaki, Genki Suenaga, Sayaka Matsumoto, Yoshihiko Nishio, Taro Yamashita, Aiko Arimura, Yukako Yanagisawa, Takahisa Deguchi, and Mitsuharu Ueda
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Heterozygote ,Iatrogenic Disease ,Prodromal Symptoms ,Nerve fiber ,Amyloid Neuropathies ,Gastroenterology ,Asymptomatic ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Severity of illness ,medicine ,Humans ,Prealbumin ,Skin ,Denervation ,Amyloid Neuropathies, Familial ,biology ,business.industry ,Amyloidosis ,nutritional and metabolic diseases ,Middle Aged ,medicine.disease ,Amyloid Neuropathy ,Transthyretin ,030104 developmental biology ,medicine.anatomical_structure ,Early Diagnosis ,Mutation ,biology.protein ,Biomarker (medicine) ,Female ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Objective:To elucidate early skin denervation in hereditary transthyretin (TTR) amyloidosis and iatrogenic TTR amyloidosis.Methods:We investigated intraepidermal nerve fiber density (IENFD) and clinical findings in 32 patients with hereditary TTR amyloidosis, 11 asymptomatic mutation carriers, 6 patients with iatrogenic TTR amyloidosis, and 23 healthy volunteers.Results:IENFD values were reduced in patients with the V30M mutation (1.9 ± 2.1 per 1 mm), patients with non-V30M mutations (5.8 ± 3.2 per 1 mm), and patients with iatrogenic TTR amyloidosis (3.5 ± 1.8 per 1 mm) compared with healthy volunteers (11.8 ± 3.2 per 1 mm) (p < 0.01). Skin denervation also occurred, even in presymptomatic V30M mutation carriers (5.0 ± 2.2 per 1 mm). The IENFD was correlated with disease duration (ρ = −0.533, p = 0.002) and various peripheral neuropathy parameters such as sensory impairment in the Kumamoto clinical score (ρ = −0.575, p = 0.001), heat-pain detection threshold (ρ = −0.704, p < 0.001), and sural sensory nerve action potential (ρ = 0.481, p = 0.005). TTR amyloid deposits frequently occurred in connective tissues and vessels of the dermal reticular layer in patients with hereditary TTR amyloidosis and those with iatrogenic TTR amyloidosis.Conclusions:Patients with hereditary TTR amyloidosis and those with iatrogenic TTR amyloidosis may show early skin denervation even in the presymptomatic stage. IENFD may thus be useful for early diagnosis and may serve as a biomarker in clinical trials for hereditary and iatrogenic TTR amyloidosis.
- Published
- 2016
34. Fiber-rich diet with brown rice improves endothelial function in type 2 diabetes mellitus: A randomized controlled trial
- Author
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Satoshi Ugi, Fumio Nikami, Keiko Kondo, Yoshihiko Nishio, Katsuyuki Miura, Ken-ichi Nemoto, Fumiyuki Nakagawa, Hisatomi Arima, Katsutaro Morino, Taketoshi Makino, Hiroshi Maegawa, Keiko Nakao, Makoto Suwa, Atsushi Ishikado, Motonobu Matsumoto, and Osamu Sekine
- Subjects
Dietary Fiber ,Male ,Physiology ,medicine.medical_treatment ,lcsh:Medicine ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Biochemistry ,0302 clinical medicine ,Endocrinology ,Japan ,Medicine and Health Sciences ,Insulin ,030212 general & internal medicine ,lcsh:Science ,Multidisciplinary ,Organic Compounds ,Monosaccharides ,Area under the curve ,Middle Aged ,Plants ,Type 2 Diabetes ,Body Fluids ,Chemistry ,Postprandial ,Blood ,Experimental Organism Systems ,Physical Sciences ,Brown rice ,Female ,Anatomy ,Research Article ,medicine.medical_specialty ,Endocrine Disorders ,Carbohydrates ,Research and Analysis Methods ,Blood Plasma ,03 medical and health sciences ,Plant and Algal Models ,Diagnostic Medicine ,Internal medicine ,Diabetes mellitus ,medicine ,Diabetes Mellitus ,Humans ,Grasses ,Reactive hyperemia ,Aged ,Nutrition ,Diabetic Endocrinology ,business.industry ,lcsh:R ,Organic Chemistry ,Organisms ,Chemical Compounds ,Type 2 Diabetes Mellitus ,Biology and Life Sciences ,Oryza ,medicine.disease ,Hormones ,Diet ,Glucose ,Diabetes Mellitus, Type 2 ,Diet and Type 2 Diabetes ,Glucose Tolerance Tests ,Metabolic Disorders ,lcsh:Q ,Endothelium, Vascular ,Rice ,business - Abstract
Background & Aims A fiber-rich diet has a cardioprotective effect, but the mechanism for this remains unclear. We hypothesized that a fiber-rich diet with brown rice improves endothelial function in patients with type 2 diabetes mellitus. Methods Twenty-eight patients with type 2 diabetes mellitus at a single general hospital in Japan were randomly assigned to a brown rice (n = 14) or white rice (n = 14) diet and were followed for 8 weeks. The primary outcome was changes in endothelial function determined from flow debt repayment by reactive hyperemia using strain-gauge plethysmography in the fasting state. Secondary outcomes were changes in HbA1c, postprandial glucose excursions, and markers of oxidative stress and inflammation. The area under the curve for glucose after ingesting 250 kcal of assigned rice was compared between baseline (T0) and at the end of the intervention (T1) to estimate glucose excursions in each group. Results Improvement in endothelial function, assessed by fasting flow debt repayment (20.4% vs. −5.8%, p = 0.004), was significantly greater in the brown rice diet group than the white rice diet group, although the between-group difference in change of fiber intake was small (5.6 g/day vs. −1.2 g/day, p
- Published
- 2016
35. Ezetimibe prevents hepatic steatosis induced by a high-fat but not a high-fructose diet
- Author
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Yoshihiko Nishio, Yasuhiro Maeno, Takeshi Yoshizaki, Satoshi Ugi, Shinji Kume, Yoshio Nagai, Masateru Ushio, Atsunori Kashiwagi, Katsutaro Morino, Hiroshi Maegawa, and Osamu Sekine
- Subjects
Male ,medicine.medical_specialty ,Physiology ,Lipoproteins ,Endocrinology, Diabetes and Metabolism ,Blotting, Western ,Electrophoretic Mobility Shift Assay ,Fructose ,Diet, High-Fat ,Real-Time Polymerase Chain Reaction ,Mice ,Ezetimibe ,Physiology (medical) ,Internal medicine ,Pyruvic Acid ,Nonalcoholic fatty liver disease ,medicine ,Hyperinsulinemia ,Animals ,Intestinal Mucosa ,Apolipoproteins B ,Cell Nucleus ,biology ,Chemistry ,Anticholesteremic Agents ,Fatty liver ,Glucose Tolerance Test ,Lipid Metabolism ,medicine.disease ,Diet ,Fatty Liver ,Intestines ,Fatty acid synthase ,Enterocytes ,Endocrinology ,Liver ,Lipogenesis ,Mice, Inbred CBA ,Intestinal cholesterol absorption ,biology.protein ,Azetidines ,RNA ,Steatosis ,Azo Compounds ,medicine.drug - Abstract
Nonalcoholic fatty liver disease is the most frequent liver disease. Ezetimibe, an inhibitor of intestinal cholesterol absorption, has been reported to ameliorate hepatic steatosis in human and animal models. To explore how ezetimibe reduces hepatic steatosis, we investigated the effects of ezetimibe on the expression of lipogenic enzymes and intestinal lipid metabolism in mice fed a high-fat or a high-fructose diet. CBA/JN mice were fed a high-fat diet or a high-fructose diet for 8 wk with or without ezetimibe. High-fat diet induced hepatic steatosis accompanied by hyperinsulinemia. Treatment with ezetimibe reduced hepatic steatosis, insulin levels, and glucose production from pyruvate in mice fed the high-fat diet, suggesting a reduction of insulin resistance in the liver. In the intestinal analysis, ezetimibe reduced the expression of fatty acid transfer protein-4 and apoB-48 in mice fed the high-fat diet. However, treatment with ezetimibe did not prevent hepatic steatosis, hyperinsulinemia, and intestinal apoB-48 expression in mice fed the high-fructose diet. Ezetimibe decreased liver X receptor-α binding to the sterol regulatory element-binding protein-1c promoter but not expression of carbohydrate response element-binding protein and fatty acid synthase in mice fed the high-fructose diet, suggesting that ezetimibe did not reduce hepatic lipogenesis induced by the high-fructose diet. Elevation of hepatic and intestinal lipogenesis in mice fed a high-fructose diet may partly explain the differences in the effect of ezetimibe.
- Published
- 2013
36. Omega-3 polyunsaturated fatty acid has an anti-oxidant effect via the Nrf-2/HO-1 pathway in 3T3-L1 adipocytes
- Author
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Motoyuki Kondo, Hiroshi Maegawa, Osamu Sekine, Satoshi Ugi, Fumiyuki Nakagawa, Atsushi Ishikado, Liu Yang, Takeshi Yoshizaki, Yoshihiko Nishio, Chisato Kusunoki, Atsunori Kashiwagi, and Katsutaro Morino
- Subjects
medicine.medical_specialty ,Docosahexaenoic Acids ,NF-E2-Related Factor 2 ,Biophysics ,Adipose tissue ,medicine.disease_cause ,Biochemistry ,Antioxidants ,Superoxide dismutase ,Mice ,3T3-L1 Cells ,Internal medicine ,Fatty Acids, Omega-3 ,Adipocytes ,medicine ,Animals ,Molecular Biology ,chemistry.chemical_classification ,biology ,Glutathione peroxidase ,Membrane Proteins ,Water ,3T3-L1 ,Cell Biology ,Eicosapentaenoic acid ,Oxidative Stress ,Endocrinology ,Eicosapentaenoic Acid ,chemistry ,Docosahexaenoic acid ,biology.protein ,lipids (amino acids, peptides, and proteins) ,Heme Oxygenase-1 ,Oxidative stress ,Polyunsaturated fatty acid - Abstract
Oxidative stress is produced in adipose tissue of obese subjects and has been associated with obesity-related disorders. Recent studies have shown that omega-3 polyunsaturated fatty acid (ω3-PUFA) has beneficial effects in preventing atherosclerotic diseases and insulin resistance in adipose tissue. However, the role of ω3-PUFA on adipocytes has not been elucidated. In this study, 3T3-L1 adipocytes were treated with ω3-PUFA and its metabolites, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), or 4-hydroxy hexenal (4-HHE). ω3-PUFA and its metabolites dose-dependently increased mRNA and protein levels of the anti-oxidative enzyme, heme oxygenase-1 (HO-1); whereas no changes in the well-known anti-oxidant molecules, superoxide dismutase, catalase, and glutathione peroxidase, were observed. Knockdown of nuclear factor erythroid 2-related factor 2 (Nrf-2) significantly reduced EPA, DHA or 4-HHE-induced HO-1 mRNA and protein expression. Also, pretreatment with ω3-PUFA prevented H(2)O(2)-induced cytotoxicity in a HO-1 dependent manner. In conclusion, treatment with EPA and DHA induced HO-1 through the activation of Nrf-2 and prevented oxidative stress in 3T3-L1 adipocytes. This anti-oxidant defense may be of high therapeutic value for clinical conditions associated with systemic oxidative stress.
- Published
- 2013
37. Intraepidermal nerve fiber density and nerve conduction study parameters correlate with clinical staging of diabetic polyneuropathy
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Tadashi Uto, Soroku Yagihashi, Kimiyoshi Arimura, Yoshihiko Nishio, Tomonori Nakamura, Aiko Arimura, Yumiko Arimura, Takahisa Deguchi, Hiroshi Takashima, and Kazuhiro Sugimoto
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pathology ,Diabetic neuropathy ,Endocrinology, Diabetes and Metabolism ,Coefficient of variation ,Neural Conduction ,Urology ,Action Potentials ,Down-Regulation ,Nerve Tissue Proteins ,Nerve fiber ,Severity of Illness Index ,Polyneuropathies ,Nerve Fibers ,Endocrinology ,Diabetic Neuropathies ,Japan ,Diabetic polyneuropathy ,Diabetes mellitus ,Internal Medicine ,Humans ,Medicine ,Stage (cooking) ,Aged ,medicine.diagnostic_test ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Kinetics ,medicine.anatomical_structure ,Diabetes Mellitus, Type 2 ,Practice Guidelines as Topic ,Nerve conduction study ,Female ,Epidermis ,business ,Ubiquitin Thiolesterase - Abstract
Aim and methods To assess the usefulness of the diagnostic and staging criteria for diabetic polyneuropathy (DP) by the Diabetic Neuropathy Study Group in Japan (DNSGJ) we examined clinical features, intraepidermal nerve fiber densities (IENFD) and nerve conduction studies (NCS) and coefficient of variation of the R-R intervals (CVR-R) in 44 patients with diabetes. Results The patients were classified into stage I ( n = 20), II ( n = 6), III + IV ( n = 12), and V ( n = 6) according to the staging criteria by DNSGJ. IENFD decreased as stages progressed (13.8 ± 7.1 fiber/mm in stage I to 0.8 ± 1.3 fiber/mm in stage V). Compound motor and sensory action potential and motor and sensory nerve conduction velocity decreased with progressing stage. F-wave latency prolonged as stages progressed. CVR-R decreased with progressing stage (4.41% ± 2.65% in stage I to 1.33% ± 0.57% in stage V). IENFD correlated with the various parameters of NCS ( r = 0.378–0.636, p r = 0.399, p = 0.007). Conclusions Clinical staging for DP by DNSGJ reflects the results of small and large fiber neuropathy.
- Published
- 2013
38. 1. Clinical Laboratory Test for Diabetes: Topics in HbA1c
- Author
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Yoshihiko Nishio
- Subjects
medicine.medical_specialty ,Clinical laboratory test ,business.industry ,medicine ,Medical physics ,General Medicine ,business ,Laboratory testing - Published
- 2013
39. Smoking, Smoking Cessation, and Measures of Subclinical Atherosclerosis in Multiple Vascular Beds in Japanese Men
- Author
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Takashi Hisamatsu, Katsuyuki Miura, Hisatomi Arima, Aya Kadota, Sayaka Kadowaki, Sayuki Torii, Sentaro Suzuki, Naoko Miyagawa, Atsushi Sato, Masahiro Yamazoe, Akira Fujiyoshi, Takayoshi Ohkubo, Takashi Yamamoto, Kiyoshi Murata, Robert D. Abbott, Akira Sekikawa, Minoru Horie, Hirotsugu Ueshima, Yasutaka Nakano, Emiko Ogawa, Hiroshi Maegawa, Itsuko Miyazawa, Kenichi Mitsunami, Kazuhiko Nozaki, Akihiko Shiino, Isao Araki, Teruhiko Tsuru, Ikuo Toyama, Hisakazu Ogita, Souichi Kurita, Toshinaga Maeda, Naomi Miyamatsu, Toru Kita, Takeshi Kimura, Yoshihiko Nishio, Yasuyuki Nakamura, Tomonori Okamura, Emma J.M. Barinas‐Mitchell, Daniel Edmundowicz, Atsushi Hozawa, Nagako Okuda, Aya Higashiyama, Shinya Nagasawa, Yoshikuni Kita, Yoshitaka Murakami, Naoyuki Takashima, Takashi Kadowaki, Seiko Ohno, Keiko Kondo, Yoshino Saito, Maryam Zaid, Takahiro Ito, Takeshi Shibukawa, and Masaki Sumi
- Subjects
Carotid Artery Diseases ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Time Factors ,Epidemiology ,Cross-sectional study ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Carotid Intima-Media Thickness ,cumulative pack-years exposure ,Coronary artery disease ,0302 clinical medicine ,prevention ,Japan ,Risk Factors ,Odds Ratio ,Prevalence ,Medicine ,030212 general & internal medicine ,Original Research ,education.field_of_study ,Middle Aged ,Plaque, Atherosclerotic ,Primary Prevention ,Cardiology ,Cardiology and Cardiovascular Medicine ,Adult ,medicine.medical_specialty ,Population ,Aortic Diseases ,smoking ,Peripheral Arterial Disease ,03 medical and health sciences ,Asian People ,Internal medicine ,Tobacco Smoking ,Humans ,Ankle Brachial Index ,cumulative pack‐years exposure ,Risk factor ,Vascular Calcification ,education ,Aged ,business.industry ,Odds ratio ,Atherosclerosis ,medicine.disease ,Former Smoker ,coronary artery calcification ,smoking cessation ,Cross-Sectional Studies ,lcsh:RC666-701 ,Subclinical atherosclerosis ,Asymptomatic Diseases ,Smoking cessation ,business - Abstract
Background:Smoking is an overwhelming, but preventable, risk factor for cardiovascular diseases (CVD), although smoking prevalence remains high in developed and developing countries in East Asia., Methods and results:In a population-based sample of 1019 Japanese men aged 40 to 79 years, without CVD, we examined cross-sectional associations of smoking status, cumulative pack-years, daily consumption, and time since cessation, with subclinical atherosclerosis at 4 anatomically distinct vascular beds, including coronary artery calcification, carotid intima-media thickness (CIMT) and plaque, aortic artery calcification (AoAC), and ankle-brachial index. Current, former, and never smoking were present in 32.3%, 50.0%, and 17.7%, respectively. Compared to never smokers, current smokers had significantly higher risks of subclinical atherosclerosis in all 4 circulations (eg, odds ratios for coronary artery calcification >0, 1.79 [95% CIs, 1.16-2.79]; CIMT >1.0 mm, 1.88 [1.02-3.47]; AoAC >0, 4.29 [2.30-7.97]; and ankle-brachial index 1.0 mm, 1.94 [1.13-3.34]; and AoAC >0, 2.55 [1.45-4.49]). Dose-response relationships of pack-years and daily consumption, particularly with CIMT, carotid plaque, AoAC, and ankle-brachial index, were observed among both current and former smokers, and even a small amount of pack-years or daily consumption among current smokers was associated with coronary artery calcification and AoAC, whereas time since cessation among former smokers was linearly associated with lower burdens of all atherosclerotic indices., Conclusions:Cigarette smoking was strongly associated with subclinical atherosclerosis in multiple vascular beds in Japanese men, and these associations attenuated with time since cessation.
- Published
- 2016
40. [Achilles tendon reflex, vibration sensation threshold, and nerve conduction study for the evaluation of the large fiber neuropathy in diabetes mellitus]
- Author
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Takahisa, Deguchi and Yoshihiko, Nishio
- Subjects
Neurologic Examination ,Diabetic Neuropathies ,Touch ,Reflex ,Neural Conduction ,Humans ,Achilles Tendon ,Vibration - Published
- 2016
41. [Epidemiology of coronary heart diseases in the patients with diabetes]
- Author
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Yoshihiko, Nishio
- Subjects
Diabetes Complications ,Risk Factors ,Diabetes Mellitus ,Humans ,Blood Pressure ,Coronary Disease ,Lipid Metabolism - Published
- 2016
42. Investigation of the clinical significance of the growth hormone-releasing peptide-2 test for the diagnosis of secondary adrenal failure
- Author
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Singo Fujio, Atsushi Shinnakasu, Yoshihiko Nishio, Takahisa Deguchi, Kiyoaki Yamamoto, Hiroshi Arimura, Hiroshi Hashiguchi, Aiko Arimura, Kazunori Arita, Akira Kikuchi, and Mika Habu
- Subjects
Adult ,Male ,endocrine system ,medicine.medical_specialty ,Pituitary disorder ,Somatotropic cell ,Adolescent ,Hydrocortisone ,Corticotropin-Releasing Hormone ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Adrenocorticotropic hormone ,Hypothalamic disease ,03 medical and health sciences ,Corticotropin-releasing hormone ,Young Adult ,0302 clinical medicine ,Endocrinology ,Adrenocorticotropic Hormone ,Predictive Value of Tests ,Internal medicine ,medicine ,Adrenal insufficiency ,Humans ,Dwarfism, Pituitary ,Aged ,Aged, 80 and over ,business.industry ,Human Growth Hormone ,Insulin tolerance test ,Middle Aged ,medicine.disease ,030220 oncology & carcinogenesis ,Administration, Intravenous ,Female ,Pituitary-Adrenal Function Tests ,business ,Oligopeptides ,hormones, hormone substitutes, and hormone antagonists ,Hypothalamic Diseases ,medicine.drug ,Adrenal Insufficiency - Abstract
The aim of this study was to evaluate the ability of the growth hormone-releasing peptide-2 (GHRP-2) test to clinically diagnose hypothalamo-pituitary-adrenal (HPA) axis failure. We performed an insulin tolerance test (ITT), CRH stimulation test, and GHRP-2 test on 47 patients suspected of having a hypothalamo-pituitary disorder. Patients with pituitary disorders had significantly lower ACTH responses to the GHRP-2 test compared to patients with hypothalamic disorders and the control group. In contrast, peak cortisol levels in response to the GHRP-2 test were significantly lower in both hypothalamic and pituitary disorder cases compared with the control group. Assignment of a cut-off value of 11.6 μg/dL for the peak serum cortisol level demonstrated that the GHRP-2 test was able to predict secondary hypoadrenalism with 88.9% specificity and 89.7% sensitivity. The responses of ACTH and cortisol to the GHRP-2 test had no correlation to the CRH test, suggesting the involvement of a different mechanism of ACTH secretion. These results indicate that the GHRP-2 test may induce ACTH secretion from the pituitary gland through direct stimulation. Although the GHRP-2 test does not have the same predictive value as the insulin tolerance test (ITT), it has similar diagnostic potential as the CRH stimulation test for evaluating HPA axis failure.
- Published
- 2016
43. Treatable glomerular hyperfiltration in patients with active acromegaly
- Author
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Manoj Bohara, Koji Takano, Hiroshi Arimura, Yasuyuki Kinoshita, Hirofumi Hirano, Mika Habu, R. Hanaya, Shingo Fujio, Kazunori Arita, Yoshihiko Nishio, and Chihaya Koriyama
- Subjects
Adenoma ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Urology ,Renal function ,030209 endocrinology & metabolism ,Kidney Function Tests ,03 medical and health sciences ,chemistry.chemical_compound ,Young Adult ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Acromegaly ,Medicine ,Humans ,Pituitary Neoplasms ,030212 general & internal medicine ,Young adult ,Aged ,Body surface area ,Creatinine ,business.industry ,Case-control study ,General Medicine ,Middle Aged ,medicine.disease ,Pathophysiology ,Treatment Outcome ,chemistry ,Case-Control Studies ,Female ,business ,Glomerular hyperfiltration ,Glomerular Filtration Rate - Abstract
ObjectiveThe glomerular filtration rate (GFR) is increased in patients with active acromegaly. The aim of this study is to elucidate whether renal function deteriorates in patients with acromegaly and whether this deterioration is reversible after surgical remission.Design/methodsA case–control study of 48 acromegalic patients who were surgically cured (cases) and 48 patients with nonfunctioning pituitary adenomas (NFomas, controls) was conducted. We performed clinical and biochemical examinations before surgery and 3months post-surgery. The GFR of each patient was estimated (estimated GFR, eGFR) using their serum creatinine, age, sex, and body surface area, and postoperative changes in the eGFR were assessed.ResultsThe preoperative eGFR was significantly higher in patients with acromegaly than in those with NFoma (99.8 vs 75.1mL/min respectively,PPP=0.12). Among the acromegalic patients, the postoperative decreases in the eGFR were more prominent in patients with a preoperatively high or normal vs low eGFR.ConclusionsOur data demonstrated a significant post-surgical eGFR decrease in patients with acromegaly, but not in patients with NFomas. This change in the eGFR was reversible in acromegalic patients with a high/normal preoperative eGFR, but not in those with a low preoperative eGFR. This suggests that the reversible pathophysiological change in some patients is functional but not organic.
- Published
- 2016
44. Factors associated with progression of diabetic nephropathy in Japanese elderly patients with type 2 diabetes: Sub-analysis of the Japanese Elderly Diabetes Intervention Trial
- Author
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Yasuo Ohashi, Hideki Ito, Atsunori Kashiwagi, Hiroshi Maegawa, Atsushi Araki, Hiroyuki Umegaki, Satoshi Iimuro, Shin-ichi Araki, Yoshihiko Nishio, Takashi Sakurai, and Takashi Uzu
- Subjects
medicine.medical_specialty ,Proteinuria ,business.industry ,Renal function ,Type 2 diabetes ,medicine.disease ,Surgery ,Nephropathy ,Diabetic nephropathy ,Diabetes mellitus ,Internal medicine ,medicine ,Albuminuria ,Microalbuminuria ,medicine.symptom ,business - Abstract
Aim: Diabetic nephropathy is a serious complication in patients with type 2 diabetes. The aim of this study was to explore the factors associated with the progression of this complication in elderly patients with type 2 diabetes. Methods: This retrospective study of a subgroup of patients registered with the Japanese Elderly Diabetes Intervention Trial included 621 Japanese patients with type 2 diabetes mellitus (age ≥65 years, 346 with normoalbuminuria, 190 with microalbuminuria and 85 with overt proteinuria). Multivariate Cox proportional hazard regression model with a backward stepwise procedure was applied to select factors with significant effects on worsening of nephropathy stage and the doubling of serum creatinine. Results: During the follow up (median 52 months), 21% of patients progressed from normoalbuminuria and microalbuminuria to a worse nephropathy stage. Aging, female sex and high-density lipoprotein cholesterol were identified as independent and significant factors that worsen nephropathy stage. Also, 6.1% of patients showed doubling of serum creatinine during follow up. A positive history of cardiovascular disease, hyperuricemia and conventional therapy were identified as significant factors involved in the doubling of serum creatinine. The cumulative incidence of the doubling of serum creatinine was significantly lower in the intensive therapy group than the conventional therapy group (P = 0.016), although that of progression of nephropathy stage was similar in the two groups. Conclusions: We identified several factors associated with the progression of diabetic nephropathy in elderly patients with type 2 diabetes. The results suggest that multiple risk factor intervention seems important in preventing deterioration of renal dysfunction. Geriatr Gerontol Int 2012; 12 (Suppl. 1): 127–133.
- Published
- 2012
45. [Cardiovascular complications of diabetes]
- Author
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Yoshihiko, Nishio
- Subjects
Diabetes Complications ,Cardiovascular Diseases ,Risk Factors ,Humans ,Blood Pressure ,Lipid Metabolism ,Prognosis - Abstract
Several lines of epidemical evidence have shown that type 2 diabetes is the most important risk factor for cardiovascular diseases (CVD). It has been shown that the risk of primary prevention of CVD in patients with diabetes is equal to that of the secondary prevention in general population. In this manuscript, recent reports on the cardiac tests to detect the cardiovascular lesions will be reviewed. The data suggest that MDCT is a promising test even in the patients with diabetes. Furthermore, recent evidence of the treatment of diabetes with insulin or the drugs available recently such as DPP-4 inhibitors and SGLT-2 inhibitors will be reviewed.
- Published
- 2015
46. Efficacy and tolerability of vildagliptin in type 2 diabetic patients on hemodialysis
- Author
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Tomoko Okabe, Chieko Takagi, Naoko Takeda, Shin-ichi Araki, Yoshihiko Nishio, Atsunori Kashiwagi, Morihiro Kondo, Keiko Kondo, Daisuke Koya, Keiji Isshiki, Masakazu Haneda, Takashi Uzu, Shinji Kume, and Hiroshi Maegawa
- Subjects
medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,General Medicine ,Hypoglycemia ,medicine.disease ,Gastroenterology ,Postprandial ,Tolerability ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Vildagliptin ,Hemodialysis ,Adverse effect ,business ,Glycemic ,medicine.drug - Abstract
Anti-diabetic agent-related hypoglycemia is a serious complication in type 2 diabetic patients on hemodialysis. Therefore, we assessed the efficacy and tolerability of 24 weeks of monotherapy with vildagliptin, a dipeptidyl peptidase four inhibitor, which is a new class of antidiabetic agent. This open-label, single-arm clinical trial was performed on 26 patients on hemodialysis. The primary assessments were changes in postprandial glucose level and glycated albumin (GA). During the study, three patients dropped out, and data from 23 patients were analyzed. Significant reductions were seen in postprandial glucose (−2.60 ± 3.80 mmol/L, P
- Published
- 2011
47. Arterial stiffness and renal impairment in non-proteinuric type 2 diabetic patients
- Author
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Keiko Nakao, Hiroshi Maegawa, Masami Chin-Kanasaki, Shin-ichi Araki, Naoko Deji, Shinji Kume, Toshiro Sugimoto, Atsunori Kashiwagi, Hisazumi Araki, Hiromichi Kawai, Yoshihiko Nishio, Keiji Isshiki, and Takashi Uzu
- Subjects
medicine.medical_specialty ,Ambulatory blood pressure ,business.industry ,Endocrinology, Diabetes and Metabolism ,Renal function ,General Medicine ,Type 2 diabetes ,medicine.disease ,Pulse pressure ,Endocrinology ,Internal medicine ,Internal Medicine ,Albuminuria ,medicine ,Cardiology ,Arterial stiffness ,medicine.symptom ,business ,Pulse wave velocity ,Blood sampling - Abstract
Aims/Introduction: Although increases in urinary protein excretion generally precede a decline in the glomerular filtration rate, non-proteinuric renal impairment is common in patients with diabetes. In the present study, we examined the relationship between indices of arterial stiffness and renal function in type 2 diabetic patients without proteinuria. Methods: Blood sampling, 24-h urine collection, brachial–ankle pulse wave velocity, and 24-h ambulatory blood pressure monitoring were performed in type 2 diabetic patients without overt proteinuria. The ambulatory arterial stiffness index was calculated as (1 – the regression slope of diastolic/systolic ambulatory blood pressure). Estimated glomerular filtration rate (eGFR)was calculated using the simplified prediction equation proposed by the Japanese Society of Nephrology. Results: Of 213 non-proteinuric patients with type 2 diabetes, 60 (28.2%) had a reduced eGFR (
- Published
- 2011
48. The role of sleep disturbance and depression in patients with type 2 diabetes
- Author
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Satoshi Ugi, Yoshihiko Nishio, Naoto Yamada, Akiko Yagi, Masako Okawa, Hiroshi Maegawa, Hiromichi Kawai, Makoto Imai, Atsunori Kashiwagi, and Takashi Uzu
- Subjects
Sleep disorder ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Insulin ,medicine.medical_treatment ,Type 2 diabetes ,medicine.disease ,humanities ,Pittsburgh Sleep Quality Index ,Quality of life ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,Physical therapy ,Medicine ,Risk factor ,business ,Depression (differential diagnoses) - Abstract
The importance of sleep disturbance and depression in patients with type 2 diabetes is unclear. Our objective was to evaluate their effects on the quality of life (QOL) of patients with type 2 diabetes. For the study, 270 patients were recruited from the Shiga Prospective Observational Follow-up Study for Diabetic Complications. Depressive symptoms, sleep disturbance, and QOL were assessed by use of the Zung Self-Rating Depression Scale (SDS), the Pittsburgh Sleep Quality Index (PSQI), and SF-8, respectively, after evaluation of their metabolic control and complications. Furthermore, 141 patients were recruited to repeat the same study after 6–12 (mean 7.3) months. Significant correlations were found among sleep disturbance, depression, and QOL in patients with type 2 diabetes. Patients undergoing insulin therapy had significantly higher SDS scores, meaning more depressive symptoms, than those not undergoing insulin therapy. Patients with painful neuropathy had higher PSQI and SDS scores and lower physical component of the QOL score than patients without painful neuropathy. In the follow-up observation it was found that the presence of neuropathy and elevated HbA1c level were predictors of increasing PSQI score and SDS score, respectively. It was found that the presence of painful neuropathy was a risk factor for sleep disturbance for type 2 diabetic patients. Sleep disturbance and depressive symptoms correlated significantly with the QOL scores of patients with type 2 diabetes, suggesting the importance of these indices for better management of diabetic patients.
- Published
- 2011
49. Laparoscopic sleeve gastrectomy leads to rapid improvement of glucose tolerance and insulin secretion with enhanced glucagon-like peptide (GLP-1) secretion
- Author
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Toru Tani, Azusa Kamo, Satoshi Ugi, Chisato Kusunoki, Kazunori Kasama, Tetsuya Hashimoto, Yoshihiko Nishio, Hiroshi Yamamoto, Atsunori Kashiwagi, Kazuhiro Ikeda, and Hiroshi Maegawa
- Subjects
endocrine system ,medicine.medical_specialty ,Sleeve gastrectomy ,business.industry ,Endocrinology, Diabetes and Metabolism ,Insulin ,medicine.medical_treatment ,digestive, oral, and skin physiology ,Area under the curve ,Carbohydrate metabolism ,medicine.disease ,Glucagon ,Impaired glucose tolerance ,Endocrinology ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Ghrelin ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
To examine the effect of laparoscopic sleeve gastrectomy (LSG) on glucose metabolism. LSG was performed in two patients with diabetes and one with impaired glucose tolerance. An oral glucose tolerance test (OGTT) was performed preoperatively and 3 months postoperatively. Plasma glucose, insulin, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) levels were measured during the OGTT. Fasting ghrelin levels were also measured. Two diabetic patients discontinued oral hypoglycemic agents or insulin immediately post-surgery, and the HbA1c level was improved. The area under the curve for insulin and GLP-1 was increased after surgery. In contrast, GIP secretion did not change significantly. Fasting ghrelin levels were decreased in all patients. LSG can lead to a rapid improvement of glucose tolerance with enhanced insulin secretion. Increased GLP-1 secretion and decreased ghrelin levels may play a role in improvement of glucose tolerance and insulin secretion after LSG.
- Published
- 2010
50. Effects of hyperglycemia on oxidative stress and antioxidant potential in patients with type 2 diabetes
- Author
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Motoyoshi Ikebuchi, Hiroshi Maegawa, Atsunori Kashiwagi, and Yoshihiko Nishio
- Subjects
medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Miglitol ,Type 2 Diabetes Mellitus ,Type 2 diabetes ,medicine.disease ,medicine.disease_cause ,Glimepiride ,Endocrinology ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Metabolic syndrome ,business ,Oxidative stress ,Glycemic ,medicine.drug - Abstract
Many in vitro studies have suggested that oxidative stress induced by hyperglycemic conditions has a pivotal role in the pathogenesis of vascular complications in diabetics. This study intended to evaluate the oxidative stress and antioxidant potential in patients with type 2 diabetes mellitus (DM), and to clarify the relation between oxidative stress and metabolic derangements including chronic hyperglycemia. We measured the levels of derivatives of reactive oxidative metabolites (ROM) and biological antioxidant potential (BAP) in 59 patients with type 2 DM and 10 healthy controls. Diabetic patients showed a significant increase in ROM levels and a decrease in adjusted BAP/ROM ratios compared with those of control. But no differences were found in BAP levels between the two groups. ROM levels were found to positively correlate with HbA1c, plasma glucose, and waist size, and adjusted BAP/ROM ratios negatively correlated with HbA1c, plasma glucose, waist size, and serum triglycerides. Stepwise multiple regression analysis indicated that HbA1c and waist size were independent factors contributing to the elevated ROM levels. The ROM level in patients with type 2 DM with metabolic syndrome was significantly higher than that in patients without metabolic syndrome. Glycemic control with glimepiride or miglitol for 3 months reduced ROM levels significantly by 9%. These results clearly demonstrate that glycemic control and visceral obesity are independently associated with an increasing oxidative stress in patients with type 2 DM.
- Published
- 2010
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