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Nagasaki T, Miyake M, Sato S, Murase K, Kawaguchi T, Matsumoto T, Nakatsuka Y, Mori Y, Ikeda HO, Sunadome H, Hamada S, Takahashi N, Togawa J, Kanai O, Uiji S, Wakamura T, Tabara Y, Tsujikawa A, Matsuda F, Hirai T, Chin K. Associations between Nocturnal Hypoxemia and Retinal Nerve Fiber Layer Thinning: The Nagahama Study. Ann Am Thorac Soc 2024; 21:644-650. [PMID: 38241090 DOI: 10.1513/annalsats.202304-355oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 01/18/2024] [Indexed: 01/21/2024] Open
Abstract
Rationale: There have been meta-analyses that showed reduced retinal nerve fiber layer (RNFL) thickness, which is a surrogate marker of glaucoma, in patients with obstructive sleep apnea (OSA). However, the sample sizes in these reports were small (<300), and the mechanism of RNFL thinning in patients with OSA was not revealed.Objectives: To investigate the relationship of RNFL thickness with nocturnal hypoxemia or hypoxemic burden in a large-scale study.Methods: In this epidemiological study, 8,309 community residents were enrolled. The actigraphy-modified 3% oxygen desaturation index (acti-ODI3%) and cumulative percentage of sleep time with oxygen saturation <90% (acti-CT90) modified by objective sleep duration using actigraphy were measured. The hypoxemic burden is shown as acti-CT90. Circumpapillary RNFL thickness was determined using optical coherence tomography.Results: Multivariable logistic analysis models revealed that an increase in acti-CT90 was significantly associated with mean RNFL thinning after adjusting for several factors in participants without glaucoma diagnosed or treated previously (β = -0.037; P = 0.009). There were significant differences in mean RNFL thickness among participants stratified according to acti-CT90 (>1.5 vs. ⩽1.5; P = 0.04). Although acti-ODI3% was significantly associated with acti-CT90 (β = 0.72; P < 0.0001), acti-ODI3% was not significantly associated with mean RNFL thickness in the multivariable logistic analysis (β = -0.011; P = 0.48). In addition, acti-CT90 was significantly associated with mean RNFL thickness both in the elderly (⩾60 yr; β = -0.058; P = 0.002) and nonelderly (<60 yr; β = -0.054; P = 0.007).Conclusions: Acti-CT90, but not acti-ODI3%, was associated with mean RNFL thinning in participants irrespective of age in the elderly or nonelderly. Further prospective studies are required to investigate whether the prevention of hypoxic burden, which was shown as acti-CT90 in this study, is favorable for RNFL thinning.
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Affiliation(s)
- Tadao Nagasaki
- Department of Respiratory Care and Sleep Control Medicine
- Department of Respiratory Medicine
| | | | - Susumu Sato
- Department of Respiratory Care and Sleep Control Medicine
| | | | | | | | | | - Yuki Mori
- Department of Ophthalmology and Visual Sciences, and
| | | | | | | | | | - Jumpei Togawa
- Department of Respiratory Care and Sleep Control Medicine
| | - Osamu Kanai
- Department of Respiratory Care and Sleep Control Medicine
| | - Sayaka Uiji
- Nursing Science, Human Health Sciences, Faculty of Medicine, Kyoto University, Kyoto, Japan; and
| | - Tomoko Wakamura
- Nursing Science, Human Health Sciences, Faculty of Medicine, Kyoto University, Kyoto, Japan; and
| | - Yasuharu Tabara
- Center for Genomic Medicine, Graduate School of Medicine, and
| | | | | | | | - Kazuo Chin
- Department of Respiratory Care and Sleep Control Medicine
- Center for Genomic Medicine, Graduate School of Medicine, and
- Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, Tokyo, Japan
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Sunadome H, Murase K, Tabara Y, Matsumoto T, Minami T, Kanai O, Nagasaki T, Takahashi N, Hamada S, Tanizawa K, Togawa J, Uiji S, Wakamura T, Komenami N, Setoh K, Kawaguchi T, Morita S, Takahashi Y, Nakayama T, Hirai T, Sato S, Matsuda F, Chin K. Associations between Sleep-Disordered Breathing and Serum Uric Acid and Their Sex Differences: The Nagahama Study. Nutrients 2023; 15:4237. [PMID: 37836522 PMCID: PMC10574205 DOI: 10.3390/nu15194237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/22/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Sleep-disordered breathing (SDB) is often accompanied by noncommunicable diseases (NCDs), including gout. However, the association between serum uric acid (sUA) levels and NCDs is complicated in patients with SDB. We aimed to clarify this issue utilizing large-scale epidemiological data. This community-based study included 9850 inhabitants. SDB and its severity were assessed by a 3% oxygen desaturation index (3% ODI) corrected for sleep duration using wrist actigraphy. The associations between sUA and moderate to severe SDB (MS-SDB) and sUA and NCDs in patients with MS-SDB were analyzed. A total of 7895 subjects were eligible. In females, the prevalence of MS-SDB increased according to an elevation in sUA levels even after adjusting for confounders, and sUA ≥ 5 mg/dL was the threshold. These were not found in males. There was a positive interaction between sUA ≥ 5 mg/dL and female sex for MS-SDB. In females with MS-SDB, the prevalence of diabetes mellitus (DM) increased according to an elevation in sUA levels, and those with sUA ≥ 5 mg/dL showed a higher prevalence of DM than their counterparts. There is a clear correlation between sUA levels and the severity of SDB, and elevated sUA poses a risk for DM in females with MS-SDB.
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Grants
- 25293141, 26670313, 26293198, 17H04182, 17H04126, 17H04123, 18K18450 Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology in Japan
- dk0207006, dk0207027, ek0109070, ek0109283, ek0109196, ek0109348, kk0205008, ek0210066, ek0210096, ek0210116, and le0110005 Grants from the Center of Innovation Program and the Global University Project from Japan Science and Technology Agency, Japan Agency for Medical Research and Development (AMED)
- H29-intractable diseases-general-027 The Intractable Respiratory Diseases and Pulmonary Hypertension Research Group from the Ministry of Health, Labour and Welfare of Japan
- H28-iryo-ippan-016, H30-iryo-ippan-009 The Health, Labour and Welfare Sciences Research Grants, and Research on Region Medical
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Affiliation(s)
- Hironobu Sunadome
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (S.S.)
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (S.S.)
| | - Yasuharu Tabara
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka 420-0881, Japan
| | - Takeshi Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (T.N.)
| | - Takuma Minami
- Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Osamu Kanai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (T.N.)
| | - Tadao Nagasaki
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (T.N.)
| | - Naomi Takahashi
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (S.S.)
| | - Satoshi Hamada
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan;
| | - Kiminobu Tanizawa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (T.N.)
| | - Jumpei Togawa
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (S.S.)
| | - Sayaka Uiji
- Nursing Science, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan; (S.U.); (T.W.)
| | - Tomoko Wakamura
- Nursing Science, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan; (S.U.); (T.W.)
| | - Naoko Komenami
- Department of Food and Nutrition, Kyoto Women’s University, Kyoto 605-8501, Japan;
| | - Kazuya Setoh
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan;
| | - Yoshimitsu Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan (T.N.)
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan (T.N.)
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (T.N.)
| | - Susumu Sato
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (S.S.)
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Kazuo Chin
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan (S.S.)
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
- Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, Tokyo 173-8610, Japan
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Tong M, Gu C, Yu Q, Ma J. Serum JKAP reflects Th2 and Th17 cell levels, and diabetic nephropathy risk and severity in diabetes mellitus patients. Biomark Med 2023; 17:701-710. [PMID: 38179996 DOI: 10.2217/bmm-2023-0422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
Objective: This study aimed to explore the potency of serum JKAP for estimating diabetic nephropathy risk in diabetes mellitus (DM) patients. Methods: Serum JKAP was detected in 212 DM patients. According to urinary albumin-to-creatinine ratio, DM patients were divided into normoalbuminuria, microalbuminuria and macroalbuminuria groups. Results: JKAP declined in the macroalbuminuria group versus normoalbuminuria group (p < 0.001). In DM patients, JKAP inversely correlated with Th17 cells (p < 0.001) but positively related to Th2 cells (p = 0.003). After adjustment, JKAP independently estimated lower risks of albuminuria (microalbuminuria + macroalbuminuria; odds ratio = 0.966, p < 0.001) and macroalbuminuria (odds ratio = 0.948; p = 0.002). Conclusion: Serum JKAP reflects increased Th2 cells, decreased Th17 cells, and lower diabetic nephropathy risk and severity in DM patients.
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Affiliation(s)
- Meili Tong
- Department of Internal Medicine, Harbin Traditional Chinese Medicine Hospital, Harbin, 150070, China
| | - Changrui Gu
- Department of Endocrinology, Heilongjiang Ruijing Diabetes Hospital, Harbin, 150096, China
| | - Qiuzhi Yu
- Department of Endocrinology, Heilongjiang Ruijing Diabetes Hospital, Harbin, 150096, China
| | - Jian Ma
- Department of Endocrinology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China
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