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Gamma-Glutamyltransferase Activity (GGT) Is a Long-Sought Biomarker of Redox Status in Blood Circulation: A Retrospective Clinical Study of 44 Types of Human Diseases. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8494076. [PMID: 35707277 PMCID: PMC9192220 DOI: 10.1155/2022/8494076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/05/2022] [Indexed: 12/09/2022]
Abstract
Background and Aim. Redox equilibria are critical for life, but the biomarkers of redox status are currently unavailable. Gamma-glutamyltransferase (GGT) is an essential factor for modulating redox equilibrium through glutathione. In clinical practice, increased circulating GGT activity is used as a hepatobiliary disease biomarker. However, increased circulating GGT activities have also been observed in cancers, heart disease, diabetes, hyperuricemia, inflammation, renal insufficiency, and other diseases, explained by its role in maintaining redox equilibrium inside and outside cells. Previous studies on GGT were mainly limited to one type of disease at one time. In the current study, we systematically compared the GGT levels in 44 different human diseases to test if it could serve as a redox status biomarker in blood circulation. Methods. The clinical GGT data from 168,858 patients with 44 diseases and 132,357 healthy control in the clinical laboratory of our hospital over the past five years were retrieved. All data were analyzed with SPSS, RStudio V.1.3.1073, and python libraries 3.8. Results. Thirty-eight out of 44 diseases had significantly increased (
) circulating GGT activities, whereas gastric cancer, anemia, renal cyst, cervical cancer, preeclampsia, and knee-joint degenerative diseases had significantly decreased (
) GGT activities compared to the healthy control. ROC analyses showed that GGT was an excellent biomarker for liver cancer (
), pancreatitis (
), or hepatic encephalopathy (
). All pancreas-related diseases had more than 8-fold increases in GGT activity span than the healthy control, while pancreatic cancer had a 12-fold increase (1021 U/L vs. 82 U/L). The knee-joint degenerative disease had the lowest median and narrowest GGT activity range (63 U/L). Furthermore, most diseases’ lowest to highest GGT activities were beyond the healthy control in both directions. Conclusions. Thirty-eight out of 44 diseases were in overall oxidative states defined by the increased GGT median values. In contrast, knee-joint degenerative disease, gastric cancer, anemia, renal cyst, cervical cancer, and preeclampsia were in overall antioxidative states. Moreover, most diseases swing between oxidative and antioxidative states, evidenced by the increased lowest to highest GGT activity ranges than the healthy control. Liver- and pancreas-related abnormalities were responsible for significantly increased GGT activities. Our overall results suggested that circulating GGT was a redox status biomarker.
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Singh KK, Kapoor A, Khanna R, Sahu A, Kapoor V, Kumar S, Garg N, Tewari S, Goel P. Serum Gamma Glutamyltransferase (GGT) in coronary artery disease: Exploring the Asian Indian Connection. Ann Card Anaesth 2022; 25:408-413. [PMID: 36254903 PMCID: PMC9732951 DOI: 10.4103/aca.aca_62_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND There is a need to identify novel markers for CAD, independent of traditional CV risk factors. One of these is gamma-glutamyl transferase (GGT), a marker of increased oxidative stress. Given the high prevalence of CAD in Asian Indians, the link of GGT and CAD in them needs to be studied. AIM To assess GGT in patients with angiographically documented CAD. METHODS AND RESULTS Two hundred patients aged 58.1 ± 9.95 years, 73% males, hypertension 56%, diabetes 40% were included. Mean GGT was 63.6 ± 44.33 (10-269 U/L). The levels of GGT progressively increased in those with single/double or triple-vessel CAD (36.5, 61.5, and 87 U/L, respectively, P < 0.001). Using objective criteria of CAD burden (SYNTAX and Gensini scores), we reaffirmed these findings. GGT in patients with SYNTAX tertiles 0-22, 23-32, and ≥ 33 was 33, 62, and 97 U/L, respectively and in Gensini tertiles 0-17.65, 17.66-56.65, ≥56.66 was 32, 52, and 88 U/L, respectively, all P < 0.001. SYNTAX score ≥ 23 was present in only 23% patients in GGT tertile 1 (<41 U/L), whereas60% and 94% in GGT tertiles 2 and 3 had SYNTAX ≥ 23. Significant positive correlation was seen between GGT and SYNTAX (r = 0.634) and Gensini score (r = 0.772). CONCLUSIONS In this study, GGT had an independent correlation with angiographic severity of CAD and SYNTAX and Gensini scores. Although the existing evidence seems biologically plausible, more studies are needed to explore the potential role of this inexpensive marker for predicting disease burden in patients with CAD.
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Affiliation(s)
- Kunal K. Singh
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Aditya Kapoor
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India,Address for correspondence: Dr. Aditya Kapoor, Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow - 226 014, Uttar Pradesh, India. E-mail:
| | - Roopali Khanna
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Ankit Sahu
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Vishwas Kapoor
- Department of Biostatistics and Health Informatics, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Sudeep Kumar
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Naveen Garg
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Satyendra Tewari
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
| | - Pravin Goel
- Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh, India
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Topal S, Kızıltunç E, Sezenöz B, Candemir M, Ünlü S, Küçükbardaslı M, Bal AN, Kılıç HK, Erbaş G, Abacı A. Gamma-glutamyl transferase to albumin ratio can predict severity of coronary artery disease detected by coronary computed tomography angiography. Anatol J Cardiol 2021; 25:653-660. [PMID: 34498597 DOI: 10.5152/anatoljcardiol.2021.36330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Gamma-glutamyl transferase (GGT) to albumin ratio (GAR) has been shown to be helpful to diagnose and determine the severity of coronary artery disease (CAD). Coronary computed tomography angiography (CCTA) is a guide recommended non-invasive test that provides information about the presence, severity, and morphology of coronary plaques. In this study, our main aim was to investigate the relationship between the presence, morphology, and severity of coronary plaques detected via CCTA and GAR in patients with low to moderate risk for undiagnosed CAD. METHODS Nine hundred and sixty six patients were included who underwent CCTA. The severity of CAD and plaque morphology were investigated. CT-adapted Leaman score (CT-LeSc) was calculated to determine the extent of the CAD. The study population was further evaluated in three groups according to tertiles of GAR. RESULTS Atherosclerotic plaques were more common in the male gender and older patients with conventional cardiovascular risk factors. GAR was significantly lower in patients with normal CCTA than in patients with a non-obstructive plaque or obstructive plaque on CCTA. Patients in upper GAR tertiles had a higher coronary calcium score (CACS) and CT-LeSc. GAR was one of the independent predictors to predict severe stenotic plaque and high CACS. CONCLUSION GAR can independently predict the presence, extent, and severity of CAD determined by CT-LeSc. We believe as a cheap, safe, and widely available tool, GAR would be useful in the diagnosis of CAD.
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Affiliation(s)
- Salih Topal
- Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey
| | - Emrullah Kızıltunç
- Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey
| | - Burak Sezenöz
- Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey
| | - Mustafa Candemir
- Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey
| | - Serkan Ünlü
- Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey
| | | | - Ayşe Nihan Bal
- Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey
| | - Hüseyin Koray Kılıç
- Department of Radiology, Faculty of Medicine, Gazi University; Ankara-Turkey
| | - Gonca Erbaş
- Department of Radiology, Faculty of Medicine, Gazi University; Ankara-Turkey
| | - Adnan Abacı
- Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey
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Zhang N, Ji C, Yang H, Liu L, Bao X, Zhou Y, Yuan C. The value of anti-rods and rings antibodies in patients with nonhepatitis virus infection: A single-center retrospective study from Southwest China. Medicine (Baltimore) 2021; 100:e26026. [PMID: 34011109 PMCID: PMC8137087 DOI: 10.1097/md.0000000000026026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/15/2021] [Accepted: 04/26/2021] [Indexed: 02/05/2023] Open
Abstract
ABSTRACT The aim of this study was to retrospectively investigate the clinical significance of anti-rods and rings (anti-RR) antibodies in nonhepatitis virus infection patients from Southwest China.Anti-RR antibodies were determined by indirect immunofluorescence assay in a group of 19,935 individuals with antinuclear antibodies test from January 2017 to December 2019. The laboratory and clinical data were collected. Finally, 66 samples with anti-RR antibodies (0.33%) were detected.In Wilcoxon rank sum test, gamma glutamyl transferase (Z = -3.364, P = .001), alpha-l-fucosidase (AFU) (Z = -2.312, P = .021), uric acid (Z = -1.634, P = .047) and red blood cell distribution width (Z = -2.285, P = .022) were higher in metabolic disease group than nonmetabolic disease group. In independent-samples t test, endogenous creatinine clearance was higher in metabolic disease group than nonmetabolic disease group (t = 2.061, P = .045). During the follow-up period of 37 patients with anti-RR antibodies for 1 to 60 months, the titers of anti-RR were significantly increased in the metabolic disease group (Z = -2.346, P = .019). In binary logistic regression analysis, triglycerides (odds ratio 3.679, 95% confidence interval 1.467-24.779, P = .048) was associated with elevated titers of anti-RR antibodies.In summary, anti-RR in non-hepatitis patients may be a manifestation of metabolic disorders, and has a certain correlation with routine laboratory indicators, which is worthy of the attention from clinicians.
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Affiliation(s)
| | | | - Hao Yang
- Department of Clinical Laboratory
| | | | - Xiao Bao
- Department of Rheumatology, Peoples Hospital of Deyang City, Deyang
| | - Yusha Zhou
- Department of Clinical Laboratory, West China Hospital of Sichuan University, Chengdu, China
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Zamarrón-Licona E, Rodríguez-Pérez JM, Posadas-Sánchez R, Vargas-Alarcón G, Baños-González MA, Borgonio-Cuadra VM, Pérez-Hernández N. Variants of PCSK9 Gene Are Associated with Subclinical Atherosclerosis and Cardiometabolic Parameters in Mexicans. The GEA Project. Diagnostics (Basel) 2021; 11:diagnostics11050774. [PMID: 33925815 PMCID: PMC8145882 DOI: 10.3390/diagnostics11050774] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/17/2021] [Accepted: 04/23/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Coronary artery disease (CAD) is a chronic, inflammatory, and complex disease associated with vascular risk factors. Nowadays, the coronary artery calcium (CAC) is a specific marker of the presence and extent of atherosclerosis. Additionally, CAC is a predictor of future coronary events in asymptomatic individuals diagnosed with subclinical atherosclerosis (CAC > 0). In this study, our aim is to evaluate the participation of two polymorphisms of the PCSK9 gene as genetic markers for developing subclinical atherosclerosis and cardiometabolic risk factors in asymptomatic individuals. Methods: We analyzed two PCSK9 polymorphisms (rs2479409 and rs615563) in 394 individuals with subclinical atherosclerosis and 1102 healthy controls using real time- polymerase chain reaction (PCR). Results: Under various inheritance models adjusted for different confounding factors, the rs2479409 polymorphism was associated with an increased risk of developing subclinical atherosclerosis (OR = 1.53, P recessive = 0.041). Both polymorphisms were significantly associated with several cardiometabolic parameters. Conclusions: Our data suggest that rs2479409 polymorphism could be envisaged as a risk marker for subclinical atherosclerosis.
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Affiliation(s)
- Erasmo Zamarrón-Licona
- Departamento de Biología Molecular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México 14080, Mexico; (E.Z.-L.); (J.M.R.-P.); (G.V.-A.)
| | - José Manuel Rodríguez-Pérez
- Departamento de Biología Molecular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México 14080, Mexico; (E.Z.-L.); (J.M.R.-P.); (G.V.-A.)
| | - Rosalinda Posadas-Sánchez
- Departamento de Endocrinología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México 14080, Mexico;
| | - Gilberto Vargas-Alarcón
- Departamento de Biología Molecular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México 14080, Mexico; (E.Z.-L.); (J.M.R.-P.); (G.V.-A.)
| | - Manuel Alfonso Baños-González
- Centro de Investigación y Posgrado, División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86150, Mexico;
| | | | - Nonanzit Pérez-Hernández
- Departamento de Biología Molecular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México 14080, Mexico; (E.Z.-L.); (J.M.R.-P.); (G.V.-A.)
- Correspondence: ; Tel.: +52-55-55732911 (ext. 26301)
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Zhang R, Wang Q. Comparability of four clinical laboratory measurement methods for GGT and commutability of candidate reference materials. J Clin Lab Anal 2020; 34:e23557. [PMID: 32914473 PMCID: PMC7755790 DOI: 10.1002/jcla.23557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 03/01/2020] [Accepted: 03/03/2020] [Indexed: 12/30/2022] Open
Abstract
Background This study was conducted to evaluate the progress in the standardization of the gamma‐glutamyl transferase (GGT) to achieve metrological traceability of routine in vitro diagnosis (IVD) medical devices. Methods We collected 25 single fresh frozen serum samples for GGT analysis. Candidate reference materials (RMs), calibrators, internal quality controls (IQC), and external quality assessment (EQA) materials from the National Center for Clinical Laboratory (NCCL), Beijing Center for Clinical Laboratory (BCCL), and College of American Pathologists (CAP) were randomly added to these serum samples. A total of 42 samples were examined using IFCC reference method and four different IVD medical devices to perform the comparability and commutability study. Results The four IVD medical devices achieved trueness assessment within the measurement range. Linear analysis showed the agreement of Siemens ADVIA 2400, Hitachi 7600‐020/BioSino, Beckman AU 5800, and Roche Cobas 501 with the reference method. These assay pairs were comparable at the medical decision levels. The GGT in‐house candidate RMs, and Beckmann and Roche calibrators were all within the limits of the 95% prediction intervals, the commutability of BioSino calibrators was indeterminate, and some internal and external quality controls were not commutable for comparisons of certain IVD medical devices vs the reference method. Conclusions By comparing with the reference method, we found that performance of GGT conventional measurement systems to be traceable to the higher order references was improved. The commutable materials for calibration and trueness controls of routine methods were significant to promote the standardization of GGT analysis.
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Affiliation(s)
- Rui Zhang
- Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Qingtao Wang
- Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China.,Beijing Center for Clinical Laboratories, Beijing, China
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Fujii H, Doi H, Ko T, Fukuma T, Kadono T, Asaeda K, Kobayashi R, Nakano T, Doi T, Nakatsugawa Y, Yamada S, Nishimura T, Tomatsuri N, Sato H, Okuyama Y, Kimura H, Kishimoto E, Nakabe N, Shima T. Frequently abnormal serum gamma-glutamyl transferase activity is associated with future development of fatty liver: a retrospective cohort study. BMC Gastroenterol 2020; 20:217. [PMID: 32650722 PMCID: PMC7350574 DOI: 10.1186/s12876-020-01369-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/06/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease is characterized by excessive hepatic fat accumulation. Some individuals frequently present elevated gamma-glutamyl transferase (GGT) levels without fatty liver ultrasound images and other abnormal liver enzymes levels. However, whether these individuals are at an elevated risk for developing fatty liver is unclear. We compared fatty liver change rates and risk factors between individuals with frequently elevated GGT levels and those with normal levels. METHODS We designed a retrospective cohort study on the basis of complete medical checkup records. One group of individuals had presented normal serum GGT levels during the observation period (Normal-GGT group, n = 2713). Another group had had abnormal elevated serum GGT levels frequently (Abnormal-GGT group, n = 264). We determined the fatty liver change incident rates before and after propensity score matching. We explored confounding factors affecting fatty changes in each group using univariate and multivariate Cox models. RESULTS The change incidence rates were 5.80/1000 and 10.02/1000 person-years in the Normal-GGT and Abnormal-GGT groups, respectively. After propensity score matching, the incidence rates were 3.08/1000 and 10.18/1000 person-years in the Normal-GGT and Abnormal-GGT groups, respectively (p = 0.026). The factors associated with fatty liver changes in the Normal-GGT group included body mass index (BMI), hemoglobin, alanine aminotransferase (ALT), albumin, triglyceride (TG), fasting blood sugar, and high-density lipoprotein levels. Those in the Abnormal-GGT group were platelet counts and TG. In our multivariable analysis, BMI, ALT, albumin, and TG levels were independent predictors of fatty changes in the Normal-GGT group, and high TG level was the only independent predictor in the Abnormal-GGT group. CONCLUSIONS The incidence rate of fatty liver change in the Abnormal-GGT group was higher than that in the Normal-GGT group. Consecutive elevated GGT levels increase the risk for fatty liver, and high TG levels in those individuals further independently increase the risk.
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Affiliation(s)
- Hideki Fujii
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan.
| | - Haruna Doi
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Tetsuhisa Ko
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Taito Fukuma
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Toru Kadono
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Kohei Asaeda
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Reo Kobayashi
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Takahiro Nakano
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Toshifumi Doi
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Yoshikazu Nakatsugawa
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Shinya Yamada
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Takeshi Nishimura
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Naoya Tomatsuri
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Hideki Sato
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Yusuke Okuyama
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Hiroyuki Kimura
- Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Etsuko Kishimoto
- Department of Center for Health promotion, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Nami Nakabe
- Department of Center for Health promotion, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Takatomo Shima
- Department of Center for Health promotion, Japanese Red Cross Kyoto Daiichi Hospital, Hon-machi15-749, Higashiyama-ku, Kyoto, 605-0981, Japan
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