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Chen B, Zeng J, Fan M, You Q, Wang C, Wang K, Qin M, Xu S. A longitudinal study on the impact of the TyG Index and TG/HDL-C ratio on the risk of type 2 diabetes in Chinese patients with prediabetes. Lipids Health Dis 2024; 23:262. [PMID: 39175004 PMCID: PMC11340070 DOI: 10.1186/s12944-024-02239-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 08/05/2024] [Indexed: 08/24/2024] Open
Abstract
OBJECTIVE To elucidate the impact and predictive value of the Triglyceride Glucose Index (TyG) and the ratio of Triglycerides to High-Density Lipoprotein Cholesterol (TG/HDL-C) in identifying the risk of diabetes progression in Chinese individuals with prediabetes. METHODS This longitudinal study enrolled 15,012 prediabetic adults from the Rich Healthcare Group between 2010 and 2016. Diabetes was defined as self-reported diabetes or a fasting glucose level ≥ 7.0 mmol/L. The Cox proportional hazards models was utilized to assess the relationship between the two indices and the risk of developing diabetes. The predictive efficacy of the two markers was gauged by the area under the curve (AUC). RESULTS Over a median follow-up period of 2.87 years, 1,730 (11.5%) prediabetic participants developed diabetes. The adjusted hazard ratios for the top quartile of the TyG index and the TG/HDL-C ratio were 2.03 (95% confidence interval [CI]: 1.71-2.40) and 2.59 (95% CI: 2.20-3.05), respectively, compared to the lowest quartile. A significant trend of increasing diabetes risk with higher quartiles of both indices was observed. The AUC for the adjusted prediction model for prediabetes-to-diabetes transition was 0.726 for the TyG index and 0.710 for the TG/HDL-C ratio. The difference in AUCs was statistically significant (P = 0.03). CONCLUSIONS The baseline TyG index or TG/HDL-C ratio was significantly associated with an increased risk of diabetes in prediabetic individuals. The TyG index demonstrated superior predictive accuracy, underscoring its importance in preventing diabetes in prediabetic individuals.
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Affiliation(s)
- Bo Chen
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
- Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Jingjing Zeng
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
- Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Menglin Fan
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
- Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Qiqi You
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
- Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Chenyue Wang
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
- Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Ke Wang
- Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
- Department of Preventive Medicine, Medical College, Hubei University of Arts and Science, Xiangyang, 441053, China
| | - Minghui Qin
- Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
- Department of Traditional Chinese Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Art and Science, Xiangyang, Hubei, China.
| | - Shaoyong Xu
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
- Center for Clinical Evidence-Based and Translational Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
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Zhong H, Luo L, Wang X, Xiao Y. Association between triglyceride to HDL cholesterol ratio and a risk of diabetes mellitus: a systematic review and meta-analysis. Lab Med 2024:lmae052. [PMID: 39066659 DOI: 10.1093/labmed/lmae052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVE The aim of this study was to investigate the link between the triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C) and the occurrence of type 2 diabetes mellitus (T2DM). METHODS PubMed, Embase, and Scopus databases were searched for cohort and case-control studies that reported on the link between TG/HDL-C and a risk of T2DM, with no restrictions on criteria used for the definition and categorization of low and high TG/HDL-C ratios. RESULTS A total of 20 studies were included. There was considerable variability in terms of categorization of low or normal and higher TG/HDL-C ratio among the studies. Patients with high TG/HDL-C ratio had markedly higher risk of developing T2DM compared with patients with low or normal TG/HDL-C. Each unit increase in the ratio correlated with the increased risk of diabetes. Subgroup analysis based on sex showed an increased risk of T2DM in males and females with a high ratio compared with the group with a low/normal ratio. CONCLUSION Higher TG/HDL-C ratio correlates with increased risk of T2DM. Despite limitations, the study demonstrates a possible value of using TG/HDL-C ratio as a biomarker for diabetes risk.
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Affiliation(s)
- Hongjing Zhong
- Health Management Center, Xiamen Humanity, Hospital Fujian Medical University, Xiamen City, Fujian Province, China
| | - Laiming Luo
- Health Management Center, Xiamen Humanity, Hospital Fujian Medical University, Xiamen City, Fujian Province, China
| | - Xiaomei Wang
- Health Management Center, Xiamen Humanity, Hospital Fujian Medical University, Xiamen City, Fujian Province, China
| | - Yao Xiao
- Health Management Center, Xiamen Humanity, Hospital Fujian Medical University, Xiamen City, Fujian Province, China
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Shimodaira M, Minemura Y, Nakayama T. Elevated triglyceride/high-density lipoprotein-cholesterol ratio as a risk factor for progression to prediabetes: a 5-year retrospective cohort study in Japan. J Diabetes Metab Disord 2024; 23:655-664. [PMID: 38932848 PMCID: PMC11196436 DOI: 10.1007/s40200-023-01329-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/02/2023] [Indexed: 06/28/2024]
Abstract
Purpose The triglyceride-to-high-density lipoprotein-cholesterol (TG/HDL-C) ratio is considered an alternative marker for insulin resistance. This longitudinal retrospective study investigated the relationship between TG/HDL-C ratio and the risk of progression to prediabetes. Methods We investigated 24,604 Japanese participants (14,609 men and 9,995 women) who underwent annual medical health checkups in 2017 (baseline) and 2022. All participants had no diabetes and prediabetes at baseline. No lipid-lowering medications were taken during the follow-up period. Participants were divided into four groups according to the quartiles of TG/HDL-C ratio at baseline. Multivariable-adjusted Cox regression analysis was conducted to examine hazard ratios (HRs) of progression to prediabetes. Receiver operating characteristic curves were used to determine the optimal cutoff value of TG/HDL-C ratio for prediction of prediabetes. Results Compared with the lowest TG/HDL-C ratio quartile (Q1) group, the adjusted HRs (95% confidence intervals (CI)) of progression to prediabetes in the Q2, Q3, and Q4 groups, respectively, were 1.17 (0.92-1.47), 1.26 (1.01-1.56), and 1.77 (1.41-2.23) for men and 1.07 (0.60-1.11), 1.19 (1.08-1.29), and 1.58 (1.18-2.31) for women. For every 1 unit increase in TG/HDL-C ratio, the adjusted HRs (95% CI) for progression to prediabetes was 1.09 (1.04-1.13) in men and 1.10 (1.04-1.15) in women. The optimal TG/HDL-C ratio cutoffs were 1.71 and 0.97 in men and women, respectively, but the area under the curve was > 0.70 in both sexes. Conclusion High TG/HDL-C ratio is a risk factor for progression to prediabetes in Japanese men and women, but it had low discriminative ability in predicting prediabetes risk. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01329-8.
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Affiliation(s)
- Masanori Shimodaira
- Department of Internal Medicine, Takara Clinic, 2511 Kanae-nagokuma, Iida-shi, Nagano, 395-0804 Japan
- Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1 Ooyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610 Japan
| | - Yu Minemura
- Department of Internal Medicine, Takara Clinic, 2511 Kanae-nagokuma, Iida-shi, Nagano, 395-0804 Japan
| | - Tomohiro Nakayama
- Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1 Ooyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610 Japan
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Huang H, Pu J, Zhou Y, Fan Y, Zhang Y, Li Y, Chen Y, Wang Y, Yu X, Dmitry B, Zhou Z, Wang J. A spontaneous hyperglycaemic cynomolgus monkey presents cognitive deficits, neurological dysfunction and cataract. Clin Exp Pharmacol Physiol 2024; 51:e13863. [PMID: 38650114 DOI: 10.1111/1440-1681.13863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/10/2024] [Accepted: 03/28/2024] [Indexed: 04/25/2024]
Abstract
Chronic hyperglycaemia is a chief feature of diabetes mellitus and complicates with many systematic anomalies. Non-human primates (NHPs) are excellent for studying hyperglycaemia or diabetes and associated comorbidities, but lack behavioural observation. In the study, behavioural, brain imaging and histological analysis were performed in a case of spontaneously hyperglycaemic (HGM) Macaca fascicularis. The results were shown that the HGM monkey had persistent body weight loss, long-term hyperglycaemia, insulin resistance, dyslipidemia, but normal concentrations of insulin, C-peptide, insulin autoantibody, islet cell antibody and glutamic acid decarboxylase antibody. Importantly, an impaired working memory in a delayed response task and neurological dysfunctions were found in the HGM monkey. The tendency for atrophy in hippocampus was observed by magnetic resonance imaging. Lenticular opacification, lens fibres disruptions and vacuole formation also occurred to the HGM monkey. The data suggested that the spontaneous HGM monkey might present diabetes-like characteristics and associated neurobehavioral anomalies in this case. This study first reported cognitive deficits in a spontaneous hyperglycaemia NHPs, which might provide evidence to use macaque as a promising model for translational research in diabetes and neurological complications.
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Affiliation(s)
- Hongdi Huang
- National Resource Center for Non-Human Primates, Kunming Primate Research Center and National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Jianglin Pu
- Deparment of Nephrology, The First Affiliated Hospital of Kunming Medical University and Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming, China
| | - Yufang Zhou
- National Resource Center for Non-Human Primates, Kunming Primate Research Center and National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Yang Fan
- National Resource Center for Non-Human Primates, Kunming Primate Research Center and National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Yali Zhang
- National Resource Center for Non-Human Primates, Kunming Primate Research Center and National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Yanling Li
- National Resource Center for Non-Human Primates, Kunming Primate Research Center and National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Yangzhuo Chen
- National Resource Center for Non-Human Primates, Kunming Primate Research Center and National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yun Wang
- National Resource Center for Non-Human Primates, Kunming Primate Research Center and National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Xiaomei Yu
- National Resource Center for Non-Human Primates, Kunming Primate Research Center and National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Bulgin Dmitry
- Research Institute of Medical Primatology, National Research Centre "Kurchatov Institute", Sochi, Russia
| | - Zhu Zhou
- Deparment of Nephrology, The First Affiliated Hospital of Kunming Medical University and Yunnan Province Clinical Research Center for Chronic Kidney Disease, Kunming, China
| | - Jianhong Wang
- National Resource Center for Non-Human Primates, Kunming Primate Research Center and National Research Facility for Phenotypic and Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
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Wang G, Chen Y, Liu X, Ma S, Jiang M. Global research trends in prediabetes over the past decade: Bibliometric and visualized analysis. Medicine (Baltimore) 2024; 103:e36857. [PMID: 38241546 PMCID: PMC10798732 DOI: 10.1097/md.0000000000036857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/13/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECT This study aimed to investigate global research advances and hot trends in prediabetes in the last decade based on a bibliometric analysis of publications. Publications from 2013 to 2022 were retrieved from the Web of Science Core Collection database through a topic search. With the use of CiteSpace, VOS viewer, and Bibliometrix R software packages, the number of publications, production categories, countries/regions, institutions, authors, journals, references, and keywords were comprehensively analyzed to sort out the hot spots and directions of prediabetes and predict the future research directions. A total of 13,223 papers were recruited for this study by the end of March 3, 2023. A generally increasing trend was observed in the number of annual publications. PLOS ONE (journal), USA (national), and the University of Copenhagen (institutional) published the most papers in this research area. The top 3 contributor authors were Tuomilehto Jaakko, Rathmann Wolfgang, and Peters Annette. "Intestinal microbiota" (2020-2022) was the most populated keyword in terms of intensity, and "biomarkers," "gut microbiota," and "metabolomics" were the most populated keywords in the last 3 years. "Prediabetes: a high-risk state for diabetes development-2012" was the strongest burst reference. This study summarized the research hotspots and trends in prediabetes research in the last decade. Frontier research can be found in the journal Diabetes Care and Journal of Clinical Endocrinology Metabolism. Prediabetes research focuses on preventing risk factors to reduce the prevalence of prediabetes, and current research hotspots focus on gut microbes and metabolism-related biomarkers.
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Affiliation(s)
- Guoyu Wang
- Department of Traditional Chinese Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yafei Chen
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinxin Liu
- Department of Traditional Chinese Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Siyi Ma
- Department of Traditional Chinese Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Min Jiang
- Department of Traditional Chinese Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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Mo Z, Hu H, Han Y, Cao C, Zheng X. Association between high-density lipoprotein cholesterol and reversion to normoglycemia from prediabetes: an analysis based on data from a retrospective cohort study. Sci Rep 2024; 14:35. [PMID: 38168464 PMCID: PMC10762102 DOI: 10.1038/s41598-023-50539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
The available evidence on the connection between high-density lipoprotein cholesterol (HDL-C) levels and the reversion from prediabetes (Pre-DM) to normoglycemia is currently limited. The present research sought to examine the connection between HDL-C levels and the regression from Pre-DM to normoglycemia in a population of Chinese adults. This historical cohort study collected 15,420 Pre-DM patients in China who underwent health screening between 2010 and 2016. The present research used the Cox proportional hazards regression model to investigate the connection between HDL-C levels and reversion from Pre-DM to normoglycemia. The Cox proportional hazards regression model with cubic spline functions and smooth curve fitting was employed to ascertain the nonlinear association between HDL-C and reversion from Pre-DM to normoglycemia. Furthermore, a set of sensitivity analyses and subgroup analyses were employed. Following the adjustment of covariates, the findings revealed a positive connection between HDL-C levels and the likelihood of reversion from Pre-DM to normoglycemia (HR 1.898, 95% CI 1.758-2.048, P < 0.001). Furthermore, there was a non-linear relationship between HDL-C and the reversion from Pre-DM to normoglycemia in both genders, and the inflection point of HDL-C was 1.540 mmol/L in males and 1.620 mmol/L in females. We found a strong positive correlation between HDL-C and the reversion from Pre-DM to normoglycemia on the left of the inflection point (Male: HR 2.783, 95% CI 2.373-3.263; Female: HR 2.217, 95% CI 1.802-2.727). Our sensitivity analysis confirmed the robustness of these findings. Subgroup analyses indicated that patients with SBP < 140 mmHg and ever smoker exhibited a more pronounced correlation between HDL-C levels and the reversion from Pre-DM to normoglycemia. In contrast, a less robust correlation was observed among patients with SBP ≥ 140 mmHg, current and never smokers. This study provides evidence of a positive and nonlinear association between HDL-C levels and the reversion from Pre-DM to normoglycemia in Chinese patients. Implementing intensified intervention measures to control the HDL-C levels of patients with Pre-DM around the inflection point may substantially enhance the likelihood of regression to normoglycemia.
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Affiliation(s)
- Zihe Mo
- Department of Physical Examination, DongGuan Tungwah Hospital, Dongguan, 523000, Guangdong Province, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002, Sungang West Road, Futian District, Shenzhen, 518000, Guangdong Province, China.
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Second People's Hospital, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong Province, China.
| | - Xiaodan Zheng
- Department of Neurology, Shenzhen Samii Medical Center, The Fourth People's Hospital of Shenzhen, No. 1 Jinniu West Road, Shijing Street, Pingshan District, Shenzhen, 518000, Guangdong Province, China.
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Yuge H, Okada H, Hamaguchi M, Kurogi K, Murata H, Ito M, Fukui M. Triglycerides/HDL cholesterol ratio and type 2 diabetes incidence: Panasonic Cohort Study 10. Cardiovasc Diabetol 2023; 22:308. [PMID: 37940952 PMCID: PMC10634002 DOI: 10.1186/s12933-023-02046-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Previous studies have investigated the association between the ratio of triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) and the incidence of diabetes in adults and discovered that a high TG/HDL-C ratio was linked to an elevated risk of new-onset diabetes. However, the comparison of predicting diabetes development among lipid profiles including the TG/HDL-C ratio, and the ratio of TG/HDL-C cut-off value has received limited attention. We examined the relationship between diabetes onset and the TG/HDL-C ratio in addition to the applicable cut-off value for predicting diabetes onset. METHODS This study included 120,613 participants from the health examination database at Panasonic Corporation from 2008 to 2017. Cox regression analysis employing multivariable models was used to investigate the association between lipid profiles, particularly the ratio of TG/HDL-C and the development of type 2 diabetes (T2D). The multivariable model was adjusted for age, sex, BMI, systolic blood pressure, plasma glucose levels after fasting, smoking status, and exercise habits. Areas under time-dependent receiver operating characteristic (ROC) curves (AUCs) were employed to assess the prediction performance and cut-off values of each indicator. A fasting plasma glucose level of 126 mg/dL, a self-reported history of diabetes, or usage of antidiabetic medicines were used to identify T2D. RESULTS During the course of the study, 6,080 people developed T2D. The median follow-up duration was 6.0 (3-10) years. Multivariable analysis revealed that the ratio of TG/HDL-C (per unit, HR; 1.03 [95% CI 1.02-1.03]) was substantially linked to the risk of incident T2D. AUC and cut-off points for the ratio of TG/HDL-C for T2D development after 10 years were 0.679 and 2.1, respectively. Furthermore, the AUC of the ratio of TG/HDL-C was considerably larger compared to that of LDL-C, HDL-C, and TG alone (all P < 0.001). We discovered an interaction effect between sex, BMI, and lipid profiles in subgroup analysis. Females and participants having a BMI of < 25 kg/m2 showed a higher correlation between lipid profile levels and T2D onset. CONCLUSIONS The ratio of TG/HDL-C was found to be a stronger predictor of T2D development within 10 years than LDL-C, HDL-C, or TG, indicating that it may be useful in future medical treatment support.
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Affiliation(s)
- Hiroki Yuge
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan.
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, 5-55 Sotojima-Cho, Moriguchi, 570-8540, Japan.
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Kazushiro Kurogi
- Department of Health Care Center, Panasonic Health Insurance Organization, 5-55 Sotojima-Cho, Moriguchi, 570-8540, Japan
| | - Hiroaki Murata
- Department of Orthopedic Surgery, Matsushita Memorial Hospital, 5-55 Sotojima-Cho, Moriguchi, 570-8540, Japan
| | - Masato Ito
- Department of Health Care Center, Panasonic Health Insurance Organization, 5-55 Sotojima-Cho, Moriguchi, 570-8540, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
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