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Yamanouchi Y, Senbonmatsu T, Yamaguchi T, Inoue I, Goto S, Soma T, Maruyama Y, Adachi M, Shinozuka N, Muramatsu T. Medical Record Survey after Comprehensive Health Checkup Referral and Its Contribution to the Early Detection of Cancer. J Pers Med 2023; 14:59. [PMID: 38248760 PMCID: PMC10821117 DOI: 10.3390/jpm14010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Comprehensive health checkups in Japan are a preventive method to detect cancer and metabolic diseases. Unlike group medical examinations, individual examinations in health checkups are possible, with additional tests possible for disease detection. However, it is difficult to accurately ascertain the results from only the report after referral to a medical institution in individuals suspected of having cancer who need to be examined. We aimed to conduct a medical record survey of patients referred to the Hospital after undergoing a comprehensive health checkup and investigate the contribution of comprehensive health checkups to the detection of cancer more accurately. The subjects were 1763 examinees who were referred to various departments of our hospital because of doubtful cancer from 23,128 examinees who underwent comprehensive health checkups in our center from January 2018 to December 2022 for 5 years. The medical record survey demonstrated that cancer was detected in more than twice as many individuals as reported and other sources. Early-stage cancers require a significantly longer time to establish a definitive diagnosis. In conclusion, short-term reports from the referring hospital are insufficient for a final diagnosis, and long-term follow-up is extremely important to increase the diagnosis rates of cancer for comprehensive health checkups.
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Affiliation(s)
- Yoko Yamanouchi
- Preventive Medicine Center, Saitama Medical University Hospital, Saitama 350-0495, Japan (T.S.)
- Department of Rehabilitation Medicine, Saitama Medical University School of Medicine, Saitama 350-0495, Japan
| | - Takaaki Senbonmatsu
- Research Administration Center, Saitama Medical University, Saitama 350-0495, Japan; (T.S.)
| | - Takumi Yamaguchi
- Research Administration Center, Saitama Medical University, Saitama 350-0495, Japan; (T.S.)
| | - Ikuo Inoue
- Preventive Medicine Center, Saitama Medical University Hospital, Saitama 350-0495, Japan (T.S.)
- Department of Endocrinology and Diabetology, Saitama Medical University School of Medicine, Saitama 350-0495, Japan
| | - Seiichi Goto
- Preventive Medicine Center, Saitama Medical University Hospital, Saitama 350-0495, Japan (T.S.)
| | - Tomoyuki Soma
- Preventive Medicine Center, Saitama Medical University Hospital, Saitama 350-0495, Japan (T.S.)
- Department of Respiratory Medicine, Saitama Medical University School of Medicine, Saitama 350-0495, Japan
| | - Yoshiaki Maruyama
- Preventive Medicine Center, Saitama Medical University Hospital, Saitama 350-0495, Japan (T.S.)
- Unicus-Kawagoe Preventive Medicine Center, Saitama 350-0495, Japan
| | - Masaki Adachi
- Preventive Medicine Center, Saitama Medical University Hospital, Saitama 350-0495, Japan (T.S.)
- Unicus-Kawagoe Preventive Medicine Center, Saitama 350-0495, Japan
| | - Nozomi Shinozuka
- Department of General Surgery, Saitama Medical University School of Medicine, Saitama 350-0495, Japan
| | - Toshihiro Muramatsu
- Preventive Medicine Center, Saitama Medical University Hospital, Saitama 350-0495, Japan (T.S.)
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Tamura Y, Kaga H, Abe Y, Yoshii H, Seino H, Hiyoshi T, Kuribayashi N, Inoue I, Watada H. Efficacy and Safety of 5-Aminolevulinic Acid Combined with Iron on Skeletal Muscle Mass Index and Physical Performance of Patients with Sarcopenia: A Multicenter, Double-Blinded, Randomized-Controlled Trial (ALADDIN Study). Nutrients 2023; 15:2866. [PMID: 37447194 DOI: 10.3390/nu15132866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
Sarcopenia is a geriatric syndrome characterized by decreased physical performance, muscle mass, and strength. Since the intake of 5-aminolevulinic acid (ALA) with iron can increase muscle mass and mitochondria in mice and elevate physical exercise performance in humans, the beneficial effects of ALA in patients with sarcopenia are expected, but this remains unexplored in the literature. This study aimed to assess the efficacy and dose dependency of ALA combined with iron in sarcopenia by measuring skeletal muscle mass index (SMI). Subjects with sarcopenia were enrolled and randomized into the ALA and sodium ferrous citrate (SFC) intake groups (ALA50/SFC29, ALA100/SFC29, ALA150/SFC29, ALA 100/SFC57, and ALA0/SFC29 placebo) and ingested the assigned study food for 12 weeks. The primary endpoint, the change in SMI from baseline to week 12, did not differ significantly between the groups. Hand grip significantly increased or tended to increase from baseline after 12 weeks with all doses of ALA or SFC compared with the placebo group. No consistent changes were observed in the other endpoints, including calf circumference, physical function, or quality of life (QOL). Although this study suggests safe administration and the possibility of ALA improving hand grip strength in patients with sarcopenia, further investigation is required.
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Affiliation(s)
- Yoshifumi Tamura
- Department of Sports Medicine and Sportology, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hideyoshi Kaga
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yasuko Abe
- Department of Internal Medicine, Yokufukai Hospital, Social Welfare Foundation, Tokyo 168-0071, Japan
- Department of Insured Medical Care Management, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology and Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo 136-0075, Japan
| | - Hiroaki Seino
- Seino Internal Medical Clinic, Fukushima 963-8851, Japan
| | - Toru Hiyoshi
- Division of Diabetes and Endocrinology, Japanese Red Cross Medical Center, Tokyo 150-893, Japan
| | | | - Ikuo Inoue
- Preventive Medicine Research Center, Saitama Medical University Hospital, Saitama 350-0495, Japan
- Department of Endocrinology and Diabetology, Saitama Medical University School of Medicine, Saitama 350-0495, Japan
| | - Hirotaka Watada
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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Takenaka Y, Inoue I, Hirasaki M, Ikeda M, Kakinuma Y. Temporal inhibition of the electron transport chain attenuates stress‐induced cellular senescence by prolonged disturbance of proteostasis in human fibroblasts. FEBS J 2023. [PMID: 37002713 DOI: 10.1111/febs.16785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/07/2023] [Accepted: 03/29/2023] [Indexed: 04/04/2023]
Abstract
We previously developed a stress-induced premature senescence (SIPS) model in which normal human fibroblast MRC-5 cells were treated with either the proteasome inhibitor MG132 or the vacuolar-type ATPase inhibitor bafilomycin A1 (BAFA1). To clarify the involvement of mitochondrial function in our SIPS model, MRC-5 cells were treated with MG132 or BAFA1 along with an inhibitor targeting either the electron transport chain complex I or complex III, or with a mitochondrial uncoupler. SIPS induced by MG132 or BAFA1 was significantly attenuated by short-term co-treatment with the complex III inhibitor, antimycin A (AA), but not the complex I inhibitor, rotenone or the mitochondrial uncoupler, carbonyl cyanide 3-chlorophenylhydrazone. By co-treatment with AA, mitochondrial and intracellular reactive oxygen species levels, accumulation of protein aggregates and mitochondrial unfolded protein responses (UPRmt ) were remarkably suppressed. Furthermore, AA co-treatment suppressed the hyperpolarization of the mitochondrial membrane and the induction of mitophagy observed in MG132-treated cells and enhanced mitochondrial biogenesis. These findings provide evidence that the temporal inhibition of mitochondrial respiration exerts protective effects against the progression of premature senescence caused by impaired proteostasis.
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Affiliation(s)
- Yasuhiro Takenaka
- Department of Physiology Graduate School of Medicine, Nippon Medical School Tokyo Japan
- Department of Diabetes and Endocrinology Saitama Medical University Saitama Japan
| | - Ikuo Inoue
- Department of Diabetes and Endocrinology Saitama Medical University Saitama Japan
| | - Masataka Hirasaki
- Department of Clinical Cancer Genomics, International Medical Center Saitama Medical University Saitama Japan
| | - Masaaki Ikeda
- Department of Physiology Saitama Medical University Saitama Japan
| | - Yoshihiko Kakinuma
- Department of Physiology Graduate School of Medicine, Nippon Medical School Tokyo Japan
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Yasuda S, Suzuki S, Yanagisawa S, Morita H, Haisa A, Satomura A, Nakajima R, Oikawa Y, Inoue I, Shimada A. HLA typing of patients who developed subacute thyroiditis and Graves' disease after SARS-CoV-2 vaccination: a case report. BMC Endocr Disord 2023; 23:54. [PMID: 36879263 PMCID: PMC9988595 DOI: 10.1186/s12902-023-01287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 01/27/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Cases of subacute thyroiditis (SAT) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination have been reported. A human leukocyte antigen (HLA) allele, HLA-B*35, appears to be involved in the pathogenesis of SAT. CASE PRESENTATION We conducted HLA typing of one patient with SAT and another with both SAT and Graves' disease (GD), which developed after SARS-CoV-2 vaccination. Patient 1, a 58-year-old Japanese man, was inoculated with a SARS-CoV-2 vaccine (BNT162b2; Pfizer, New York, NY, USA). He developed fever (38 °C), cervical pain, palpitations, and fatigue on day 10 after vaccination. Blood chemistry tests revealed thyrotoxicosis and elevated serum C-reactive protein (CRP) and slightly increased serum antithyroid-stimulating antibody (TSAb) levels. Thyroid ultrasonography revealed the characteristic findings of SAT. Patient 2, a 36-year-old Japanese woman, was inoculated twice with a SARS-CoV-2 vaccine (mRNA-1273; Moderna, Cambridge, MA, USA). She developed fever (37.8 °C) and thyroid gland pain on day 3 after the second vaccination. Blood chemistry tests revealed thyrotoxicosis and elevated serum CRP, TSAb, and antithyroid-stimulating hormone receptor antibody levels. Fever and thyroid gland pain persisted. Thyroid ultrasonography revealed the characteristic findings of SAT (i.e., slight swelling and a focal hypoechoic area with decreased blood flow). Prednisolone treatment was effective for SAT. However, thyrotoxicosis causing palpitations relapsed thereafter, for which thyroid scintigraphy with 99mtechnetium pertechnetate was conducted, and the patient was diagnosed with GD. Thiamazole treatment was then initiated, which led to improvement in symptoms. CONCLUSION HLA typing revealed that both patients had the HLA-B*35:01, -C*04:01, and -DPB1*05:01 alleles. Only patient 2 had the HLA-DRB1*11:01 and HLA-DQB1*03:01 alleles. The HLA-B*35:01 and HLA-C*04:01 alleles appeared to be involved in the pathogenesis of SAT after SARS-CoV-2 vaccination, and the HLA-DRB1*11:01 and HLA-DQB1*03:01 alleles were speculated to be involved in the postvaccination pathogenesis of GD.
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Affiliation(s)
- Shigemitsu Yasuda
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
| | - Seiya Suzuki
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Shinnosuke Yanagisawa
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Hideo Morita
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Akifumi Haisa
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Atsushi Satomura
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Ritsuko Nakajima
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Yoichi Oikawa
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
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Shimada A, Toda K, Inoue I, Yamada T, Oikawa Y. Combination of anti-CD25 antibody and poly I:C treatment in pregnant NOD mice may be used as "pregnancy-related" type 1 diabetes model. J Diabetes Investig 2022; 13:1489-1495. [PMID: 35533022 PMCID: PMC9434566 DOI: 10.1111/jdi.13829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/09/2022] [Accepted: 05/05/2022] [Indexed: 11/28/2022] Open
Abstract
Aims/Introduction Some women develop type 1 diabetes during pregnancy or immediately after delivery. However, the underlying pathophysiology remains largely unknown, probably because of the lack of a suitable animal model. In this study, we administered pregnant NOD mice with an anti‐CD25 antibody to reduce regulatory T cells along with poly I:C and examined the onset of diabetes. Materials and Methods Anti‐CD25 antibody and poly I:C were intraperitoneally administered to mated female NOD mice. Mice delivered within 3 weeks after the treatment, and the onset of diabetes during pregnancy or within 6 weeks after delivery was examined. Some mice were killed 1 week after treatment, and their spleen and pancreas were excised to examine the expression levels of cytokines and for histological examination. Results Half of the mice treated with anti‐CD25 antibody plus poly I:C developed diabetes, as compared with none of the poly I:C‐injected mice (P < 0.05). The ratios of interleukin‐18/forkhead box P3 and granzyme B/forkhead box P3 were higher in the pancreas of anti‐CD25 antibody plus poly I:C‐treated mice than in the pancreas of control mice. The insulitis score decreased in the pancreas of anti‐CD25 antibody plus poly I:C‐injected pregnant NOD mice. Conclusions We describe the use of anti‐CD25 antibody to reduce regulatory T cells and poly I:C as a Toll‐like receptor 3 stimulator to mimic viral infection in a pregnant NOD mouse, which can be used as a model of ‘pregnancy‐related’ type 1 diabetes.
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Affiliation(s)
- Akira Shimada
- Dept. of Endocrinology and Diabetes, Saitama Medical University
| | - Kyoko Toda
- Dept. of Endocrinology and Diabetes, Saitama Medical University
| | - Ikuo Inoue
- Dept. of Endocrinology and Diabetes, Saitama Medical University
| | - Taketo Yamada
- Dept. of Endocrinology and Diabetes, Saitama Medical University.,Dept. of Pathology, Saitama Medical University
| | - Yoichi Oikawa
- Dept. of Endocrinology and Diabetes, Saitama Medical University
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Yamanouchi Y, Maeda K, Shinoda Y, Majima M, Lee J, Inoue I, Maruyama Y, Kurabayashi H. Can outpatient rehabilitation be continued during the COVID-19 pandemic? A report from a Japanese regional medical university hospital. Arch Rehabil Res Clin Transl 2022; 4:100199. [PMID: 35531050 PMCID: PMC9060708 DOI: 10.1016/j.arrct.2022.100199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective To describe the operation of an outpatient rehabilitation practice at a Japanese hospital severely affected by the coronavirus disease 2019 (COVID-19) pandemic. Design Analytical observational study. Setting Outpatient rehabilitation department in Saitama, Japan. Participants Number (N=953) of outpatients from January 2019 to July 2021. Interventions Not applicable. Main Outcome Measures This paper begins with a review of the infection control measures that were initiated after declaration of a state of emergency in April 2020. The effects of the pandemic were then examined by comparing the daily average number of outpatients from January 2020 to July 2021 with that noted for the same duration during 2019. Results In April 2020, the average daily number of patients decreased by 77.1% compared with the number in 2019 and was further decreased by 65.7% and 63.7% in May and June 2020, respectively. The time limitations on rehabilitation were lifted in June, and the number of patients increased by 82.3% in July 2020. Thereafter, it remained at approximately 80% throughout the rest of the year compared with that noted in 2019. From January 2021 to July 2021, the number of patients approached the number noted during normal practice or was even higher. Conclusions The implementation of infection control measures, adjustments to procedures, and widespread vaccination permitted the continuation of our outpatient practice.
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Affiliation(s)
- Yoko Yamanouchi
- Department of Rehabilitation Medicine, Saitama Medical University School of Medicine, Moroyama Saitama Prefecture, Japan.,Preventive Medicine Research Center, Saitama Medical University Hospital, Moroyama Saitama Prefecture, Japan
| | - Kyoko Maeda
- Department of Rehabilitation Medicine, Saitama Medical University School of Medicine, Moroyama Saitama Prefecture, Japan
| | - Yusuke Shinoda
- Department of Rehabilitation Medicine, Saitama Medical University School of Medicine, Moroyama Saitama Prefecture, Japan
| | - Mitsuru Majima
- Department of Rehabilitation Medicine, Saitama Medical University School of Medicine, Moroyama Saitama Prefecture, Japan
| | - Jongseok Lee
- Department of Rehabilitation Medicine, Saitama Medical University School of Medicine, Moroyama Saitama Prefecture, Japan
| | - Ikuo Inoue
- Preventive Medicine Research Center, Saitama Medical University Hospital, Moroyama Saitama Prefecture, Japan.,Department of Endocrinology and Diabetology, Saitama Medical University School of Medicine, Saitama Prefecture, Japan
| | - Yoshiaki Maruyama
- Preventive Medicine Research Center, Saitama Medical University Hospital, Moroyama Saitama Prefecture, Japan
| | - Hitoshi Kurabayashi
- Department of Rehabilitation Medicine, Saitama Medical University School of Medicine, Moroyama Saitama Prefecture, Japan
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Ikegami Y, Takenaka Y, Saito D, Shimada A, Inoue I. Anagliptin Monotherapy for Six Months in Patients With Type 2 Diabetes Mellitus and Hyper-Low-Density Lipoprotein Cholesterolemia Reduces Plasma Levels of Fasting Low-Density Lipoprotein Cholesterol and Lathosterol: A Single-Arm Intervention Trial. J Clin Med Res 2021; 13:502-509. [PMID: 34925661 PMCID: PMC8670767 DOI: 10.14740/jocmr4623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/10/2021] [Indexed: 11/11/2022] Open
Abstract
Background Anagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, has been shown to decrease plasma low-density lipoprotein cholesterol (LDL-C) levels. The objective of our study was to elucidate the mechanisms responsible for the anagliptin-mediated improvements in high LDL-C levels (hyper-LDL cholesterolemia). Methods We prospectively examined the effects of anagliptin monotherapy on fasting plasma lathosterol, sitosterol, and campesterol levels in patients with type 2 diabetes mellitus and hyper-LDL cholesterolemia for 6 months. We examined 14 patients who did not use hypoglycemic or lipid-lowering drugs for 4 months before initiating the study. Plasma variables related to glucose and lipid metabolism were measured before and after 6 months of treatment and pre- and postprandially using the cookie-loading test. Results After treatment, anagliptin monotherapy (n = 14) significantly decreased fasting LDL-C (175.6 to 148.5 mg/dL, mean values before and after the treatment, respectively) and plasma lathosterol levels (3.56 to 2.49 mg/dL), whereas it did not lower fasting sitosterol or campesterol levels. Furthermore, fasting plasma lathosterol levels were negatively correlated with preprandial glucagon-like peptide-1 (GLP-1) levels after anagliptin treatment. Conclusions Anagliptin monotherapy may have a beneficial effect on lipid metabolism, which could be mediated by the inhibition of hepatic cholesterol synthesis rather than the inhibition of intestinal lipid transport.
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Affiliation(s)
- Yuichi Ikegami
- Department of Endocrinology and Diabetes, Saitama Medical University, Faculty of Medicine, 38 Morohongo, Moroyamacho, Irumagun, Saitama 350-0495, Japan.,These authors contributed equally to this work
| | - Yasuhiro Takenaka
- Department of Endocrinology and Diabetes, Saitama Medical University, Faculty of Medicine, 38 Morohongo, Moroyamacho, Irumagun, Saitama 350-0495, Japan.,Department of Physiology, Graduate School of Medicine, Nippon Medical School, 1-25-16 Nezu, Bunkyo, Tokyo 113-0031, Japan.,These authors contributed equally to this work
| | - Daigo Saito
- Department of Endocrinology and Diabetes, Saitama Medical University, Faculty of Medicine, 38 Morohongo, Moroyamacho, Irumagun, Saitama 350-0495, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, Saitama Medical University, Faculty of Medicine, 38 Morohongo, Moroyamacho, Irumagun, Saitama 350-0495, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Faculty of Medicine, 38 Morohongo, Moroyamacho, Irumagun, Saitama 350-0495, Japan.,Preventive Medicine Research Center, Saitama Medical University, 38 Morohongo, Moroyamacho, Irumagun, Saitama 350-0495, Japan
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Ito D, Inoue K, Saito D, Hamaguchi K, Kaneko K, Sumita T, Inukai K, Inoue I, Shimada A. Effects of Dapagliflozin Compared with Sitagliptin and Metformin in Drug-Naïve Japanese Patients with Type 2 Diabetes: A 12-Week, Open-Label, Randomized, Active-Controlled Trial. Diabetes Ther 2021; 12:3201-3215. [PMID: 34709582 PMCID: PMC8586398 DOI: 10.1007/s13300-021-01176-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 10/15/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION To compare the efficacy and tolerability of dapagliflozin with those of sitagliptin and metformin in patients with type 2 diabetes who have never received glucose-lowering agents. METHODS In this randomized, 12-week, open-label, active-controlled trial, 32 patients were randomly assigned to receive dapagliflozin 5 mg, sitagliptin 50 mg, or metformin 1000 mg per day for 12 weeks. At baseline and at week 12, the patients underwent a meal tolerance test (MTT). RESULTS After 12 weeks of treatment, the changes in fasting and postprandial plasma glucose and plasma glucose area under the curve (AUC)0-120 min levels during the MTT from baseline were significantly improved in the three study groups, and there were no significant differences among the three study groups (P < 0.05). The mean changes in glycated hemoglobin (HbA1c) from baseline to week 12 were - 0.96%, - 1.24%, and - 1.40% in the dapagliflozin, sitagliptin, and metformin groups, respectively. Although there was no significant difference among the three study groups, the lowering effect of HbA1c tended to be greater in the metformin group than in the dapagliflozin group. In contrast, the insulin AUC0-120 min levels at week 12 significantly decreased only in the dapagliflozin group (P = 0.049). Similarly, body weight was significantly reduced only in the dapagliflozin group (- 2.1 kg [- 2.7%], P = 0.047). Moreover, dapagliflozin significantly improved serum adiponectin levels (P = 0.003). However, there were no significant differences in the changes in these glycemic and metabolic parameters among the three study groups. No serious adverse events were documented in any group. CONCLUSIONS Dapagliflozin exerted beneficial effects similar to sitagliptin and metformin on glycemic parameters. In addition, dapagliflozin significantly reduced body weight and insulin AUC levels and improved serum adiponectin levels. Therefore, we suggest that these three hypoglycemic agents could be viable first-line medications for drug-naïve Japanese patients with type 2 diabetes. TRIAL REGISTRATION University Hospital Medical Information Network (UMIN000024427).
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Affiliation(s)
- Daisuke Ito
- Department of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
- Department of Internal Medicine, Ogawa Red Cross Hospital, Saitama, Japan.
| | - Kazuyuki Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Daigo Saito
- Department of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Keiko Hamaguchi
- Department of Nursing, Ogawa Red Cross Hospital, Saitama, Japan
| | - Kimie Kaneko
- Department of Nursing, Ogawa Red Cross Hospital, Saitama, Japan
| | - Takashi Sumita
- Department of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
- Department of Internal Medicine, Ogawa Red Cross Hospital, Saitama, Japan
| | - Kouichi Inukai
- Department of Diabetes and Endocrinology, Higashiyamato Hospital, Tokyo, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
- Department of Health Service Center, Saitama Medical University, Saitama, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
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Takenaka Y, Inoue I, Nakano T, Ikeda M, Kakinuma Y. Prolonged disturbance of proteostasis induces cellular senescence via temporal mitochondrial dysfunction and subsequent mitochondrial accumulation in human fibroblasts. FEBS J 2021; 289:1650-1667. [PMID: 34689411 DOI: 10.1111/febs.16249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/15/2021] [Accepted: 10/22/2021] [Indexed: 01/18/2023]
Abstract
Proteolytic activity declines with age, resulting in the accumulation of aggregated proteins in aged organisms. To investigate how disturbance in proteostasis causes cellular senescence, we developed a stress-induced premature senescence (SIPS) model, in which normal human fibroblast MRC-5 cells were treated with the proteasome inhibitor MG132 or the vacuolar-type ATPase inhibitor bafilomycin A1 (BAFA1) for 5 days. Time-course studies revealed a significant increase in intracellular reactive oxygen species (ROS) and mitochondrial superoxide during and after drug treatment. Mitochondrial membrane potential initially decreased, suggesting temporal mitochondrial dysfunction during drug treatment, but was restored along with mitochondrial accumulation after drug treatment. AMP-activated protein kinase alpha was notably activated during treatment; thereafter, intracellular ATP levels significantly increased. SIPS induction by MG132 or BAFA1 was partially attenuated by co-treatment with vitamin E or rapamycin, in which the levels of ROS, mitochondrial accumulation, and protein aggregates were suppressed, implying the critical involvement of oxidative stress and mitochondrial function in SIPS progression. Rapamycin co-treatment also augmented the expression of HSP70 and activation of AKT, which could recover proteostasis and promote cell survival, respectively. Our study proposes a possible pathway from the disturbed proteostasis to cellular senescence via excess ROS production as well as functional and quantitative changes in mitochondria.
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Affiliation(s)
- Yasuhiro Takenaka
- Department of Physiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.,Department of Diabetes and Endocrinology, Saitama Medical University, Japan
| | - Ikuo Inoue
- Department of Diabetes and Endocrinology, Saitama Medical University, Japan
| | - Takanari Nakano
- Department of Biochemistry, Saitama Medical University, Japan
| | - Masaaki Ikeda
- Department of Physiology, Saitama Medical University, Japan
| | - Yoshihiko Kakinuma
- Department of Physiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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10
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Yamada Y, Sugi K, Gatate Y, Senbonmatsu T, Inoue I, Fukushima K, Iguchi A, Nakajima H, Muramatsu T, Nakano S, Tada H. Premature Acute Myocardial Infarction in a Young Patient With Sitosterolemia. CJC Open 2021; 3:1085-1088. [PMID: 34505049 PMCID: PMC8413244 DOI: 10.1016/j.cjco.2021.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/18/2021] [Indexed: 11/15/2022] Open
Abstract
Sitosterolemia is a rare, inherited, autosomal recessive disorder of lipid metabolism characterized by increased levels of plant sterols, such as sitosterol and campesterol, xanthomas, and accelerated atherosclerosis. In a 15-year-old boy exhibiting ST-elevation acute myocardial infarction, lipid panels, including plant sterol, and genetic testing for the ATP-binding cassette sub-family G member 5 (ABCG5) gene mutation, confirmed the diagnosis of sitosterolemia. A comprehensive lipid panel and genetic testing should be considered in patients with premature coronary artery disease to prevent disease progression through dietary and pharmacologic interventions specific to sitosterolemia.
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Affiliation(s)
- Yoshihiro Yamada
- Department of Cardiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Keiki Sugi
- Department of Cardiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yodo Gatate
- Department of Cardiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Takaaki Senbonmatsu
- Department of Cardiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Kenji Fukushima
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, Saitama, Japan
| | - Atsushi Iguchi
- Department of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroyuki Nakajima
- Department of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Toshihiro Muramatsu
- Department of Cardiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Shintaro Nakano
- Department of Cardiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hayato Tada
- Department of Cardiovascular and Internal Medicine, Kanazawa University School of Medicine, Ishikawa, Japan
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11
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Nakano T, Aochi H, Hirasaki M, Takenaka Y, Fujita K, Tamura M, Soma H, Kamezawa H, Koizumi T, Shibuya H, Inomata R, Okuda A, Murakoshi T, Shimada A, Inoue I. Effects of Pparγ1 deletion on late-stage murine embryogenesis and cells that undergo endocycle. Dev Biol 2021; 478:222-235. [PMID: 34246625 DOI: 10.1016/j.ydbio.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 07/01/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
Peroxisome proliferator-activated receptor (PPAR) γ1, a nuclear receptor, is abundant in the murine placenta during the late stage of pregnancy (E15-E16), although its functional roles remain unclear. PPARγ1 is encoded by two splicing isoforms, namely Pparγ1canonical and Pparγ1sv, and its embryonic loss leads to early (E10) embryonic lethality. Thus, we generated knockout (KO) mice that carried only one of the isoforms to obtain a milder phenotype. Pparγ1sv-KO mice were viable and fertile, whereas Pparγ1canonical-KO mice failed to recover around the weaning age. Pparγ1canonical-KO embryos developed normally up to 15.5 dpc, followed by growth delays after that. The junctional zone of Pparγ1canonical-KO placentas severely infiltrated the labyrinth, and maternal blood sinuses were dilated. In the wild-type, PPARγ1 was highly expressed in sinusoidal trophoblast giant cells (S-TGCs), peaking at 15.5 dpc. Pparγ1canonical-KO abolished PPARγ1 expression in S-TGCs. Notably, the S-TGCs had unusually enlarged nuclei and often occupied maternal vascular spaces, disturbing the organization of the fine labyrinth structure. Gene expression analyses of Pparγ1canonical-KO placentas indicated enhanced S-phase cell cycle signatures. EdU-positive S-TGCs in Pparγ1canonical-KO placentas were greater in number than those in wild-type placentas, suggesting that the cells continued to endoreplicate in the mutant placentas. These results indicate that PPARγ1, a known cell cycle arrest mediator, is involved in the transition of TGCs undergoing endocycling to the terminal differentiation stage in the placentas. Therefore, PPARγ1 deficiency, induced through genetic manipulation, leads to placental insufficiency.
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Affiliation(s)
- Takanari Nakano
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
| | - Hidekazu Aochi
- Department of Anatomy, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Masataka Hirasaki
- Division of Developmental Biology, Research Center for Genomic Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yasuhiro Takenaka
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Saitama, Japan; Department of Physiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Koji Fujita
- Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan
| | - Masaru Tamura
- Technology and Development Team for Mouse Phenotype Analysis, RIKEN BioResource Research Center, Tsukuba, Ibaraki, Japan
| | - Hiroaki Soma
- Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan; Department of Obstetrics & Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Hajime Kamezawa
- Department of Anatomy, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Takahiro Koizumi
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Hirotoshi Shibuya
- Technology and Development Team for Mouse Phenotype Analysis, RIKEN BioResource Research Center, Tsukuba, Ibaraki, Japan
| | - Reiko Inomata
- Department of Anatomy, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Akihiko Okuda
- Division of Developmental Biology, Research Center for Genomic Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Takayuki Murakoshi
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Akira Shimada
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Ikuo Inoue
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
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12
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Kayamori Y, Nakamura M, Kishi K, Miida T, Nishimura K, Okamura T, Hirayama S, Ohmura H, Yoshida H, Ai M, Tanaka A, Sumino H, Murakami M, Inoue I, Teramoto T, Yokoyama S. Comparison of the Japan Society of Clinical Chemistry reference method and CDC method for HDL and LDL cholesterol measurements using fresh sera. Pract Lab Med 2021; 25:e00228. [PMID: 34095414 PMCID: PMC8145738 DOI: 10.1016/j.plabm.2021.e00228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/16/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives In 2009, the Japan Society of Clinical Chemistry (JSCC) recommended a reference method for the measurement of serum high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels. This automated method uses cholesterol esterase-cholesterol dehydrogenase to measure cholesterol levels in fractions obtained after ultracentrifugation and dextran sulfate/magnesium chloride precipitation. In the present study, using fresh samples, we compared the LDL-C and HDL-C levels measured using this method with those measured using the traditional Centers for Disease Control and Prevention (CDC)-beta-quantification (BQ) method. Design and methods: Using both the JSCC and CDC-BQ methods, LDL-C/HDL-C levels were measured in 47 non-diseased and 126 diseased subjects, whose triglyceride levels were lower than 11.29 mmol/L (1000 mg/dL). Results For LDL-C, the equation of the line representing the correlation between the two methods was y = 0.991x + 0.009 mmol/L; r = 0.999; and Sy/x = 0.025 mmol/L, where x is the mean LDL-C level measured using the CDC-BQ method. Similarly, for HDL-C, the equation of the line representing the correlation between the two methods was y = 0.988x + 0.041 mmol/L, r = 0.999, and Sy/x = 0.019 mmol/L, where x is the mean HDL-C level measured using the CDC-BQ method. Conclusions The JSCC method agreed with the CDC-BQ method in cases of both non-diseased and diseased subjects, including those with dyslipidemia. Using both the JSCC and BQ methods, LDL-C/HDL-C levels were measured. The JSCC method agrees with the BQ method. The JSCC reference method is an accurate, simple, and automatable method. The JSCC method is suitable for quantitative analysis of LDL-C and HDL-C levels.
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Key Words
- AK, Abell-Kendall
- BFr-C, bottom fraction-cholesterol
- BQ, beta-quantification
- Beta-quantification
- CD, cholesterol dehydrogenase
- CDC, Centers for Disease Control and Prevention
- CHE, cholesterol esterase
- Cholesterol dehydrogenase
- DM, n-dodecyl-β-maltopyranoside
- EDDA, ethylenediamine-N,N′-diacetic acid
- EDTA·2Na, ethylenediamine-N,N′,N′,N′-tetraacetic acid, disodium salt, dihydrate
- HDL-C, high-density lipoprotein-cholesterol
- HDL-cholesterol
- HEPES, 2-[4-(2-hydroxyethyl)-1-piperazinyl] ethanesulfonic acid
- Homogeneous assay
- LB, Liebermann-Burchard
- LDL-C, low-density lipoprotein-cholesterol
- LDL-cholesterol
- NIST, National Institute of Standards and Technology
- Reference method
- SRM, Standard Reference Material
- Syx, standard deviation of the regression line
- TC, total cholesterol
- TG, triglycerides
- apo, apolipoprotein
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Affiliation(s)
- Yuzo Kayamori
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan
| | - Masakazu Nakamura
- Department of Preventive Cardiology, Lipid Reference Laboratory, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan (retired in 2018)
| | - Koji Kishi
- Bio-Reagent Material Development, Bio-Diagnostic Reagent Technology Center, Sysmex Corporation, 1-1-2, Murotani, Nishi-ku, Kobe, 651-2241, Japan
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University Graduate School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Satoshi Hirayama
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hirotoshi Ohmura
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital, 161-1 Kashiwashita, Kashiwa City, Ciba, 277-8567, Japan
| | - Masumi Ai
- Tokyo Medical and Dental University, Medical Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Akira Tanaka
- Nutrition Clinic, Kagawa Nutrition University, 3-9-21 Chiyoda, Sakado City, Saitama, 350-0288, Japan
| | - Hiroyuki Sumino
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Masami Murakami
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Tamio Teramoto
- Teikyo Academic Research Center, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Shinji Yokoyama
- Department of Food and Nutritional Sciences, Practice Center for Registered Dietitian, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi, 487-8501, Japan
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13
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Yasuda S, Inoue K, Iida S, Oikawa Y, Namba A, Isshiki M, Inoue I, Kamei Y, Shimada A, Noda M. Differences in the birthweight of infants born to patients with early- or mid-to-late-detected gestational diabetes mellitus who underwent guideline-based glycemic control. J Diabetes Complications 2021; 35:107850. [PMID: 33483230 DOI: 10.1016/j.jdiacomp.2021.107850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/24/2020] [Accepted: 12/31/2020] [Indexed: 11/26/2022]
Abstract
AIMS To examine the effects of strict glycemic control on the birthweight of infants born to Japanese patients with early- or mid-to-late-detected gestational diabetes mellitus (ed- or md-GDM). METHODS We retrospectively examined the characteristics of 101 patients with GDM who underwent guideline-based glycemic control. A 75-g oral glucose tolerance test was conducted to diagnose GDM at gestational weeks 11-15 (ed-GDM subgroup) and 24-28 (md-GDM subgroup). RESULTS Infant birthweight was significantly lower in the ed-GDM subgroup (n = 25) than in the md-GDM subgroup (n = 76) (2688.3 ± 470.4 g vs. 3052.4 ± 383.1 g, p < 0.05), and the proportion of low-birthweight infants (<2500 g) was significantly higher in the ed-GDM subgroup than in the md-GDM subgroup (32.0% vs. 5.3%, p < 0.005). Fasting plasma glucose (FPG) levels during early treatment and before delivery were significantly lower in the ed-GDM subgroup than in the md-GDM subgroup (76.1 ± 10.4 mg/dL vs. 85.5 ± 9.6 mg/dL, p < 0.001; 80.5 ± 10.4 mg/dL vs. 90.4 ± 10.3 mg/dL, p < 0.0001). CONCLUSIONS Patients with ed-GDM showed significantly lower FPG levels during treatment compared to those with md-GDM, presumably indicating an association with the delivery of low-birthweight infants.
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Affiliation(s)
- Shigemitsu Yasuda
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
| | - Kazuyuki Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Shinichiro Iida
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Yoichi Oikawa
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Akira Namba
- Department of Obstetrics and Gynecology, Saitama Medical University Hospital, Saitama, Japan
| | - Masashi Isshiki
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Yoshimasa Kamei
- Department of Obstetrics and Gynecology, Saitama Medical University Hospital, Saitama, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan; Department of Diabetes, Metabolism and Endocrinology, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
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14
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Koizumi T, Kaneda H, Komiyama N, Inoue I, Muramatsu T, Nakajima K. Lipoprotein Profiles before Heparin Administration in Patients with or without Coronary Thrombosis Following Atherosclerosis. Ann Vasc Dis 2021; 14:31-38. [PMID: 33786097 PMCID: PMC7991705 DOI: 10.3400/avd.oa.20-00146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: The correlation between lipoproteins and arterial thrombosis is not fully elucidated, and no data exist in terms of lipoprotein profiles before heparin administration in patients with coronary arterial thrombosis (CAT). This cross-sectional study aimed to evaluate the lipoprotein profile before heparin administration in 63 ST-segment elevation myocardial infarction (STEMI) patients with CAT. Methods: The lipoprotein profile was measured via polyacrylamide gel electrophoresis prior to heparin administration for primary percutaneous coronary intervention for STEMI. Age- and sex-matched subjects with <25% stenosis in stable coronary artery disease were enrolled as controls. Results: In the pre-heparin serum, the fraction of very-low-density lipoprotein (P=0.75) in STEMI patients was not different from that in controls, and the fraction of intermediate-density lipoprotein (P<0.01) in STEMI patients was significantly lower than that in controls. Although the fraction of small dense low-density lipoprotein (s-LDL) in STEMI patients was significantly higher than that in controls (P<0.01), 44% (28/63) of STEMI patients were negative for s-LDL. Conclusion: Although lipoproteins are a risk factor for atherosclerosis, lipoprotein profiles with CAT following atherosclerosis in STEMI are different from those profiles without CAT in stable coronary artery disease.
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Affiliation(s)
- Tomomi Koizumi
- Department of Cardiovascular Medicine, Mito Medical Center, National Hospital Organization, Higashi-Ibaraki, Ibaraki, Japan
| | - Hideaki Kaneda
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | | | - Ikuo Inoue
- Department of Endocrinology, Saitama Medical University, Moro, Saitama, Japan
| | - Toshihiro Muramatsu
- Department of Cardiology, Saitama International Medical Center, Hidaka, Saitama, Japan
| | - Katsuyuki Nakajima
- Laboratory of Clinical Nutrition and Medicine, Kagawa Nutrition University, Tokyo, Japan
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15
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Yasuda S, Inoue I, Shimada A. Neurofibromatosis Type 1 with Concurrent Multiple Endocrine Disorders: Adenomatous Goiter, Primary Hyperparathyroidism, and Acromegaly. Intern Med 2021; 60:2451-2459. [PMID: 34334593 PMCID: PMC8381186 DOI: 10.2169/internalmedicine.4981-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We encountered a 70-year-old Japanese woman with neurofibromatosis type 1 (NF1) who had a history of pheochromocytoma and concurrently developed adenomatous goiter, primary hyperparathyroidism, and acromegaly. The patient had a somatotroph adenoma of the adenohypophysis that predisposed her to multinodular goiter. Three parathyroid tumors were detected by cervical ultrasonography and cervicothoracic computed tomography. Genetic analyses did not reveal genetic alterations (e.g. loss-of-function mutation) in the causative genes of endocrine tumors, including MEN1, RET, VHL, CDKN1B, and CDKN2C. The NF1 gene could not be analyzed genetically due to the patient's refusal. The pathophysiologic mechanisms of endocrinopathy concurrence in NF1 remain to be elucidated.
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Affiliation(s)
- Shigemitsu Yasuda
- Department of Endocrinology and Diabetes, Saitama Medical University, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, Saitama Medical University, Japan
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16
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Nakano T, Inoue I, Takenaka Y, Ito R, Kotani N, Sato S, Nakano Y, Hirasaki M, Shimada A, Murakoshi T. Ezetimibe impairs transcellular lipid trafficking and induces large lipid droplet formation in intestinal absorptive epithelial cells. Biochim Biophys Acta Mol Cell Biol Lipids 2020; 1865:158808. [PMID: 32860884 DOI: 10.1016/j.bbalip.2020.158808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/30/2020] [Accepted: 08/18/2020] [Indexed: 01/26/2023]
Abstract
Ezetimibe inhibits Niemann-Pick C1-like 1 (NPC1L1) protein, which mediates intracellular cholesterol trafficking from the brush border membrane to the endoplasmic reticulum, where chylomicron assembly takes place in enterocytes or in the intestinal absorptive epithelial cells. Cholesterol is a minor lipid constituent of chylomicrons; however, whether or not a shortage of cholesterol attenuates chylomicron assembly is unknown. The aim of this study was to examine the effect of ezetimibe, a potent NPC1L1 inhibitor, on trans-epithelial lipid transport, and chylomicron assembly and secretion in enterocytes. Caco-2 cells, an absorptive epithelial model, grown onto culture inserts were given lipid micelles from the apical side, and chylomicron-like triacylglycerol-rich lipoprotein secreted basolaterally were analyzed after a 24-h incubation period in the presence of ezetimibe up to 50 μM. The secretion of lipoprotein and apolipoprotein B48 were reduced by adding ezetimibe (30% and 34%, respectively). Although ezetimibe allowed the cells to take up cholesterol normally, the esterification was abolished. Meanwhile, oleic acid esterification was unaffected. Moreover, ezetimibe activated sterol regulatory element-binding protein 2 by approximately 1.5-fold. These results suggest that ezetimibe limited cellular cholesterol mobilization required for lipoprotein assembly. In such conditions, large lipid droplet formation in Caco-2 cells and the enterocytes of mice were induced, implying that unprocessed triacylglycerol was sheltered in these compartments. Although ezetimibe did not reduce the post-prandial lipid surge appreciably in triolein-infused mice, the results of the present study indicated that pharmacological actions of ezetimibe may participate in a novel regulatory mechanism for the efficient chylomicron assembly and secretion.
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Affiliation(s)
- Takanari Nakano
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Saitama, Japan.
| | - Ikuo Inoue
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yasuhiro Takenaka
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Saitama, Japan; Department of Physiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Rina Ito
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Norihiro Kotani
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Sawako Sato
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yuka Nakano
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Masataka Hirasaki
- Division of Developmental Biology, Research Center for Genomic Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Akira Shimada
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Takayuki Murakoshi
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Saitama, Japan
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17
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Teratani T, Tomita K, Toma-Fukai S, Nakamura Y, Itoh T, Shimizu H, Shiraishi Y, Sugihara N, Higashiyama M, Shimizu T, Inoue I, Takenaka Y, Hokari R, Adachi T, Shimizu T, Miura S, Kanai T. Redox-dependent PPARγ/Tnpo1 complex formation enhances PPARγ nuclear localization and signaling. Free Radic Biol Med 2020; 156:45-56. [PMID: 32553752 DOI: 10.1016/j.freeradbiomed.2020.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/30/2020] [Accepted: 06/04/2020] [Indexed: 02/06/2023]
Abstract
The nuclear receptor peroxisome proliferator-activated receptor (PPAR)γ has been implicated in the pathogenesis of various human diseases including fatty liver. Although nuclear translocation of PPARγ plays an important role in PPARγ signaling, details of the translocation mechanisms have not been elucidated. Here we demonstrate that PPARγ2 translocates to the nucleus and activates signal transduction through H2O2-dependent formation of a PPARγ2 and transportin (Tnpo)1 complex via redox-sensitive disulfide bonds between cysteine (Cys)176 and Cys180 of the former and Cys512 of the latter. Using hepatocyte cultures and mouse models, we show that cytosolic H2O2/Tnpo1-dependent nuclear translocation enhances the amount of DNA-bound PPARγ and downstream signaling, leading to triglyceride accumulation in hepatocytes and liver. These findings expand our understanding of the mechanism underlying the nuclear translocation of PPARγ, and suggest that the PPARγ and Tnpo1 complex and surrounding redox environment are potential therapeutic targets in the treatment of PPARγ-related diseases.
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Affiliation(s)
- Toshiaki Teratani
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kengo Tomita
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan.
| | - Sachiko Toma-Fukai
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan; Complex Molecular Systems Laboratory, Nara Institute of Science and Technology, Takayama-cho, Ikoma-shi, Nara, 630-0192, Japan
| | - Yutaro Nakamura
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Toshimasa Itoh
- Laboratory of Drug Design and Medicinal Chemistry, Showa Pharmaceutical University, 3-3165 Higashi-Tamagawagakuen, Machida, Tokyo, 194-8543, Japan
| | - Hikaru Shimizu
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yasunaga Shiraishi
- Division of Environmental Medicine, National Defense Medical College Research Institute, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Nao Sugihara
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Masaaki Higashiyama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Takahiko Shimizu
- Department of Advanced Aging Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, 350-0495, Japan
| | - Yasuhiro Takenaka
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, 350-0495, Japan; Department of Physiology, Graduate School of Medicine, Nippon Medical School, 1-25-16 Nezu, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Ryota Hokari
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Takeshi Adachi
- Division of Cardiology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan
| | - Toshiyuki Shimizu
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Soichiro Miura
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama, 359-8513, Japan; International University of Health and Welfare Graduate School, 1-24-1 Minami-Aoyama, Minato-ku, Tokyo, 107-0062, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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18
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Satomura A, Oikawa Y, Haisa A, Inoue I, Noda M, Shimada A. Bodyweight threshold for sudden onset of ketosis might exist in ketosis-prone type 2 diabetes patients. J Diabetes Investig 2020; 11:499-501. [PMID: 31339666 PMCID: PMC7078091 DOI: 10.1111/jdi.13120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/21/2019] [Accepted: 07/22/2019] [Indexed: 11/27/2022] Open
Abstract
Ketosis-prone type 2 diabetes is recognized as atypical diabetes. These patients are often male, characterized by obesity, sudden onset of ketosis and a transient decrease in insulin secretion capacity that can be recovered with temporal insulin therapy. Here, we report a male patient with ketosis-prone type 2 diabetes who was followed up for 8 years. During the follow-up period, his bodyweight fluctuated and he experienced four episodes of critical ketosis recurrence in association with bodyweight gain. He discontinued insulin therapy after each ketosis episode within the first 4 years, but thereafter, he had to continue insulin therapy because of decreased insulin secretion capacity. Interestingly, his peak bodyweight just before the repeated ketosis episode gradually decreased, and the insulin secretion capacity after the recovery from repeated ketosis decreased in parallel with his peak bodyweight. This long-term clinical course might be a clue to understand the pathophysiology of ketosis-prone type 2 diabetes.
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Affiliation(s)
- Atsushi Satomura
- Department of Endocrinology and DiabetesSchool of MedicineSaitama Medical UniversitySaitamaJapan
| | - Yoichi Oikawa
- Department of Endocrinology and DiabetesSchool of MedicineSaitama Medical UniversitySaitamaJapan
| | - Akifumi Haisa
- Department of Endocrinology and DiabetesSchool of MedicineSaitama Medical UniversitySaitamaJapan
| | - Ikuo Inoue
- Department of Endocrinology and DiabetesSchool of MedicineSaitama Medical UniversitySaitamaJapan
| | - Mitsuhiko Noda
- Department of Endocrinology and DiabetesSchool of MedicineSaitama Medical UniversitySaitamaJapan
| | - Akira Shimada
- Department of Endocrinology and DiabetesSchool of MedicineSaitama Medical UniversitySaitamaJapan
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19
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Yasuda S, Hikima Y, Kabeya Y, Iida S, Oikawa Y, Isshiki M, Inoue I, Shimada A, Noda M. Clinical characterization of patients with primary aldosteronism plus subclinical Cushing's syndrome. BMC Endocr Disord 2020; 20:9. [PMID: 31931803 PMCID: PMC6958814 DOI: 10.1186/s12902-020-0490-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 01/08/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Primary aldosteronism (PA) plus subclinical Cushing's syndrome (SCS), PASCS, has occasionally been reported. We aimed to clinically characterize patients with PASCS who are poorly profiled. METHODS A population-based, retrospective, single-center, observational study was conducted in 71 patients (age, 58.2 ± 11.2 years; 24 males and 47 females) who developed PA (n = 45), SCS (n = 12), or PASCS (n = 14). The main outcome measures were the proportion of patients with diabetes mellitus (DM), serum potassium concentration, and maximum tumor diameter (MTD) on the computed tomography (CT) scans. RESULTS The proportion of DM patients was significantly greater in the PASCS group than in the PA group (50.0% vs. 13.9%, p < 0.05), without a significant difference between the PASCS and SCS groups. Serum potassium concentration was significantly lower in the PASCS group than in the SCS group (3.2 ± 0.8 mEq/L vs. 4.0 ± 0.5 mEq/L; p < 0.01), without a significant difference between the PASCS and PA groups. Among the 3 study groups of patients who had a unilateral adrenal tumor, MTD was significantly greater in the PASCS group than in the PA group (2.7 ± 0.1 cm vs. 1.4 ± 0.1 cm; p < 0.001), without a significant difference between the PASCS and SCS groups. CONCLUSIONS Any reference criteria were not obtained that surely distinguish patients with PASCS from those with PA or SCS. However, clinicians should suspect the presence of concurrent SCS in patients with PA when detecting a relatively large adrenal tumor on the CT scans.
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Affiliation(s)
- Shigemitsu Yasuda
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
| | - Yusuke Hikima
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Yusuke Kabeya
- Department of Home Care Medicine, Sowa Hospital, Sagamihara, Kanagawa, Japan
| | - Shinichiro Iida
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Yoichi Oikawa
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Masashi Isshiki
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
| | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
- Department of Diabetes, Metabolism and Endocrinology, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
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20
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Fuchigami A, Shigiyama F, Kitazawa T, Okada Y, Ichijo T, Higa M, Hiyoshi T, Inoue I, Iso K, Yoshii H, Hirose T, Kumashiro N. Efficacy of dapagliflozin versus sitagliptin on cardiometabolic risk factors in Japanese patients with type 2 diabetes: a prospective, randomized study (DIVERSITY-CVR). Cardiovasc Diabetol 2020; 19:1. [PMID: 31910850 PMCID: PMC6945792 DOI: 10.1186/s12933-019-0977-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/24/2019] [Indexed: 12/19/2022] Open
Abstract
Background Few prospective studies have compared the cardiovascular benefits of sodium-glucose cotransporter-2 (SGLT2) inhibitors and dipeptidyl peptidase 4 (DPP-4) inhibitors. We aimed to clarify the efficacy of dapagliflozin versus sitagliptin for modulating cardiometabolic risk factors including high glycated hemoglobin (HbA1c) levels, hypoglycemia, and body weight. Methods This prospective, randomized, open-label, blinded-endpoint, parallel-group trial enrolled 340 Japanese patients with early-stage type 2 diabetes receiving metformin alone or no glucose-lowering agents, who were randomized to receive dapagliflozin or sitagliptin for 24 weeks. The primary endpoint was the proportion of patients who achieved the composite endpoint of HbA1c level maintenance < 7.0% (53 mmol/mol), avoidance of hypoglycemia (maintenance of sensor glucose ≥ 3.0 mmol/L or ≥ 54 mg/dL), and ≥ 3.0% body weight loss from baseline. Secondary endpoints included components of the primary endpoint, other metabolic indices, and glucose variability indices measured using flash glucose monitoring. Results Clinical characteristics of patients were age, 58.1 ± 12.2 years; known duration of diabetes, 5.8 ± 6.1 years; body weight, 74.7 ± 14.2 kg; body mass index, 27.9 ± 4.1 kg/m2; and HbA1c level, 7.8 ± 0.8% at baseline. The achievement ratio of primary endpoint was significantly higher in the dapagliflozin group than in the sitagliptin group (24.4% vs. 13.8%, P < 0.05). While the rates of HbA1c level maintenance < 7.0% (53 mmol/mol) and avoidance of hypoglycemia were comparable between the groups (49.4 vs. 50.0% and 88.7 vs. 92.3% for dapagliflozin vs. sitagliptin, respectively), body weight loss of ≥ 3.0% was significantly achieved in the dapagliflozin group (54.4 vs. 19.6%, P < 0.001). Moreover, dapagliflozin was superior to sitagliptin regarding several secondary endpoints that modulate cardiometabolic risk, namely reducing fasting plasma glucose, insulin, uric acid, increasing high-density lipoprotein cholesterol, and suppressing the increase in serum creatinine and the decrease in estimated glomerular filtration rate. On the other hand, sitagliptin was superior to dapagliflozin in suppressing glucose variability. Conclusions Compared to sitagliptin, dapagliflozin was significantly more effective at improving cardiometabolic risk factors, suggesting that SGLT2 inhibitors might be more suitable than DPP-4 inhibitors for preventing cardiovascular events in patients with early-stage but inadequately controlled type 2 diabetes. Trial registration Trial number, UMIN000028014; registered on June 30, 2017
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Affiliation(s)
- Ayako Fuchigami
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Fumika Shigiyama
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Toru Kitazawa
- Division of Diabetes, Endocrinology and Metabolism, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yosuke Okada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takamasa Ichijo
- Department of Diabetes and Endocrinology, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
| | - Mariko Higa
- Department of Diabetes and Endocrinology, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
| | - Toru Hiyoshi
- Division of Diabetes and Endocrinology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Kaoru Iso
- Department of Internal Medicine, Japan Community Health Care Organization Tokyo Kamata Medical Center, Tokyo, Japan
| | - Hidenori Yoshii
- Department of Medicine, Diabetology and Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Takahisa Hirose
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Naoki Kumashiro
- Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan.
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Koba S, Inoue I, Cyrille M, Lu C, Inomata H, Shimauchi J, Kajinami K. Evolocumab vs. Ezetimibe in Statin-Intolerant Hyperlipidemic Japanese Patients: Phase 3 GAUSS-4 Trial. J Atheroscler Thromb 2019; 27:471-484. [PMID: 31748467 PMCID: PMC7242224 DOI: 10.5551/jat.50963] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Aim: In patients with hyperlipidemia, intolerance to statins presents a challenge in reducing the risk of events associated with cardiovascular disease. This phase 3, randomized, double-blind trial in Japanese patients with statin intolerance aimed to evaluate the efficacy and safety of evolocumab vs. ezetimibe in lowering low-density lipoprotein-cholesterol (LDL-C). Methods: This study was conducted in a 12-week, double-blind period followed by an open-label extension designed to characterize 1 year of evolocumab treatment. Statin intolerance was defined as failure of two or more statins due to myalgia, myositis, or rhabdomyolysis. Eligible patients were randomized at 2:2:1:1 into four groups: 420 mg evolocumab every 4 weeks (Q4W) + oral placebo daily, 140 mg evolocumab every 2 weeks (Q2W) + oral placebo daily, subcutaneous (SC) placebo Q4W + 10 mg ezetimibe daily, and SC placebo Q2W + 10 mg ezetimibe daily. Results: Sixty-one patients were randomized to evolocumab (n = 40) or ezetimibe (n = 21). For the co-primary endpoints of percent change from the baseline in mean LDL-C to the mean of weeks 10 and 12 and to week 12, the evolocumab-ezetimibe treatment differences were −39.4% (95% CI, −47.2% to −31.5%) and −40.1% (95% CI, −48.7% to −31.6%), respectively (adjusted p < 0.0001). The most common adverse events were diarrhea (9.5%) and nasopharyngitis (12.5%) in the ezetimibe and evolocumab groups, respectively, during the double-blind period and nasopharyngitis (29%) during the open-label extension. Conclusion: Evolocumab was superior to ezetimibe in reducing LDL-C during the 12-week double-blind period in this population of Japanese patients with statin intolerance, with efficacy and safety results maintained for 1 year. Trial registration: ClinicalTrials.gov, NCT02634580
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Affiliation(s)
- Shinji Koba
- Department of Medicine, Division of Cardiology, Showa University School of Medicine
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University
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Kajinami K, Tsukamoto K, Koba S, Inoue I, Yamakawa M, Suzuki S, Hamano T, Saito H, Saito Y, Masuda S, Nakayama T, Okamura T, Yamashita S, Kagawa T, Kaneyama J, Kuriyama A, Tanaka R, Hirata A. Statin Intolerance Clinical Guide 2018. J Atheroscler Thromb 2019; 27:375-396. [PMID: 31588101 PMCID: PMC7192817 DOI: 10.5551/jat.50948] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
| | | | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University
| | - Masashi Yamakawa
- Department of Endocrinology and Diabetes, Yokohama City University Medical Center
| | | | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui
| | | | - Yoshiro Saito
- Division of Medicinal Safety Science, National Institute of Health Sciences
| | | | - Takeo Nakayama
- Graduate School of Medicine and Public Health, Kyoto University
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
| | - Shizuya Yamashita
- Department of Cardiovascular Medicine, Rinku General Medical Center.,The Institute of Scientific and Industrial Research, Osaka University
| | - Tatehiro Kagawa
- Division of Hepatology and Gastroenterology, Department of Internal Medicine, Tokai University School of Medicine
| | - Junji Kaneyama
- Department of Cardiovascular Medicine, Tokyo Medical University
| | - Akira Kuriyama
- Emergency and Critical Care Center, Kurashiki Central Hospital
| | - Rumi Tanaka
- Department of Pharmacy, Kyushu University Hospital
| | - Aya Hirata
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
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23
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Umemoto N, Hasegawa K, Iio Y, Inoue I, Sumi T, Sugiura T, Taniguchi T, Asai T, Yamada M, Ishii H, Murohara T, Shimizu K. P2434Digital zoom decreases radiation exposure dose up to 30% in percutaneous coronary intervention. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Interventional cardiology is gaining greater popularity worldwide with each passing year. Reduction of exposure dose is a very imminent and an important issue in cardiology procedure. Although a newer radiation reduction technique, device and procedure are very valuable and expected, we should consider about therapy technique, radiation technique, devices, and the way to protection. Digital zoom digitally enlarges images in real time by up to 2.5-fold at lower doses than those used with traditional field of view changes. In our phantom examination the average dose reduction of digital zoom was 27%.
Methods and results
This study is designated as single-center, retrospective, not-randomized, observation study. 2101 eligible cases were collected. We assigned the cases of PCI without the use of Digital zoom to the Conventional group and those involving the use of Digital zoom to the Digital zoom group. There were 806 patients in the Conventional group and 1195 in the Digital zoom group. Because we had begun using Digital zoom from January 2015 onwards, all patients in the Conventional group had undergone PCI from January 2013 to December 2014 and all patients in the Digital zoom group had undergone PCI from January 2015 to December 2016. In addition, we calculated the RAK/minute and DAP/minute for an accurate assessment. To minimize the difference of characteristics between two groups, propensity score including all baseline variables was performed. Furthermore, Predictors of radiation exposure were investigated using multivariable least square methods. Inter group differences were observed in DAP, RAK, DAP/min, and RAK/min (Digital zoom group vs conventional group: DAP, 16000 cGy cm2 [from 1st quartile to 3rd quartile; 10300–24400] vs 20700 [13400–29500], p<0.001; DAP/min, 557 cGy cm2/min [392–737] vs 782 [571–1010], p<0.01; RAK, 1590 Gy [990–2410] vs 1850 [1220–2720], p<0.01; RAK/min, 54.7 Gy/min [38.5–73.2] vs 71.2 [51.5–93.0], p<0.01). Even after propensity score matching, intergroup differences in DAP (810 cases), DAP/min (811 cases), RAK (746 cases), and RAK/min (744 cases) persisted. Furthermore, the least squares method showed that Digital zoom is an important predictor of DAP (β=0.17, p<0.01) and RAK (β=0.12, p<0.01).
Conclusion
Digital zoom is an old and cost-free technique, but one of most powerful reduction of exposure method. Propensity score adjustment and least square methods show that digital zoom is one of independent effective method.
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Affiliation(s)
- N Umemoto
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Aichi, Japan
| | - K Hasegawa
- Ichinomiya Municipal Hospital, Department of Radiology, ichinomiya, Aichi, Japan
| | - Y Iio
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Aichi, Japan
| | - I Inoue
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Aichi, Japan
| | - T Sumi
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Aichi, Japan
| | - T Sugiura
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Aichi, Japan
| | - T Taniguchi
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Aichi, Japan
| | - T Asai
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Aichi, Japan
| | - M Yamada
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Aichi, Japan
| | - H Ishii
- Nagoya University Hospital, Department of Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University Hospital, Department of Cardiology, Nagoya, Japan
| | - K Shimizu
- Ichinomiya Municipal Hospital, Department of Cardiology, Ichinomiya, Aichi, Japan
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Oikawa Y, Sakamoto K, Satomura A, Haisa A, Katsuki T, Hattori Y, Inoue I, Noda M, Shimada A. Significance of peripheral mononuclear cells producing interferon-γ in response to insulin B:9-23-related peptides in subtypes of type 1 diabetes. Clin Immunol 2019; 208:108260. [PMID: 31525445 DOI: 10.1016/j.clim.2019.108260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 10/26/2022]
Abstract
Type 1 diabetes is largely caused by β-cell destruction through anti-islet autoimmunity. Reportedly, interferon (IFN)-γ-secreting peripheral blood mononuclear cells (PBMCs) specific to four insulin B-chain amino acid 9-23-related peptides (B:9-23rPep) were increased in type 1 diabetes participants. This study aimed to investigate the PBMC frequencies in subtypes of type 1 diabetes using enzyme-linked immunospot assay. In this cross-sectional study, peripheral blood samples were obtained from 148 participants including 72 with acute-onset type 1 diabetes (AT1D), 51 with slowly progressive insulin-dependent diabetes mellitus (SPIDDM), and 25 with type 2 diabetes. The frequency of B:9-23rPep-specific IFN-γ-producing PBMCs was significantly higher in AT1D participants than in SPIDDM and type 2 diabetes participants. Meanwhile, a significant inverse correlation was observed between the PMBC frequencies and insulin secretion capacity in SPIDDM participants. These findings suggest that the increased peripheral B:9-23rPep-specific IFN-γ immunoreactivity reflects decreased functional β-cell mass and greater disease activity of type 1 diabetes.
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Affiliation(s)
- Yoichi Oikawa
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan.
| | - Kumiko Sakamoto
- Cellular Immunology Analysis Section, Genetic and Chromosome Analysis Department, SRL Inc., Tokyo, Japan
| | - Atsushi Satomura
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Akifumi Haisa
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Takeshi Katsuki
- Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Yutaka Hattori
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan; Department of Diabetes, Metabolism and Endocrinology, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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25
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Yasuda S, Iuchi T, Goto A, Katanoda K, Iida S, Oikawa Y, Namba A, Isshiki M, Inoue I, Kamei Y, Shimada A, Noda M. Weight control before and during pregnancy for patients with gestational diabetes mellitus. J Diabetes Investig 2019; 10:1075-1082. [PMID: 30548799 PMCID: PMC6626955 DOI: 10.1111/jdi.12989] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/29/2018] [Accepted: 12/09/2018] [Indexed: 11/28/2022] Open
Abstract
AIMS/INTRODUCTION The aim of the present study was to examine the associations of pregestational body mass index (BMI) and gestational weight change with birthweight for gestational age in Japanese mothers with gestational diabetes mellitus (GDM). MATERIALS AND METHODS We retrospectively examined the clinical and laboratory characteristics of 101 mothers with GDM (pregestational BMI 24.7 ± 5.8 kg/m2 ; maternal age at delivery 34.7 ± 5.1 years; gestational age 38.5 ± 1.4 weeks) at a single center from January 2011 to December 2016. RESULTS Gestational weight changes were 6.22 ± 5.39 kg, and infant birthweights were 2,987.3 ± 393.6 g. Multivariable analysis showed that, in all mothers, pregestational BMI and gestational weight change were positively associated with infant birthweight (P < 0.001 and P = 0.007, respectively). Pregestational BMI, but not gestational weight change, was positively associated with infant birthweight (P = 0.007) in 31 mothers with GDM who had pregestational BMI ≥25 kg/m2 ; in 68 mothers with GDM who had pregestational BMI 18.5-24.9 kg/m2 , only gestational weight gain was positively associated with infant birthweight (P = 0.039). Two mothers had pregestational BMI <18.5 kg/m2 . No statistically significant interactions of pregestational BMI with gestational weight change were found (P = 0.158). CONCLUSIONS In mothers with GDM, pregestational BMI ≥25 kg/m2 and excessive gestational weight gain were significantly associated with increased infant birthweight. A prospective multicenter clinical study enrolling a larger number of mothers with GDM will be required to verify the effects of adequately controlling pregestational and gestational weights on infant birthweight for gestational age.
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Affiliation(s)
- Shigemitsu Yasuda
- Department of Endocrinology and DiabetesSaitama Medical UniversitySaitamaJapan
| | - Takujiro Iuchi
- Department of Endocrinology and DiabetesSaitama Medical UniversitySaitamaJapan
| | - Atsushi Goto
- Epidemiology and Prevention GroupCenter for Public Health SciencesNational Cancer CenterTokyoJapan
| | - Kota Katanoda
- Division of Cancer Statistics IntegrationCenter for Cancer Control and Information ServicesNational Cancer CenterTokyoJapan
| | - Shinichiro Iida
- Department of Endocrinology and DiabetesSaitama Medical UniversitySaitamaJapan
| | - Yoichi Oikawa
- Department of Endocrinology and DiabetesSaitama Medical UniversitySaitamaJapan
| | - Akira Namba
- Department of Obstetrics and GynecologySaitama Medical University HospitalJapan
| | - Masashi Isshiki
- Department of Endocrinology and DiabetesSaitama Medical UniversitySaitamaJapan
| | - Ikuo Inoue
- Department of Endocrinology and DiabetesSaitama Medical UniversitySaitamaJapan
| | - Yoshimasa Kamei
- Department of Obstetrics and GynecologySaitama Medical University HospitalJapan
| | - Akira Shimada
- Department of Endocrinology and DiabetesSaitama Medical UniversitySaitamaJapan
| | - Mitsuhiko Noda
- Department of Endocrinology and DiabetesSaitama Medical UniversitySaitamaJapan
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Saito D, Oikawa Y, Mizutani G, Inoue K, Hatano M, Inoue I, Noda M, Shimada A. Clinical characteristics of anti-glutamic acid decarboxylase antibody-positive fulminant type 1 diabetes. Endocr J 2019; 66:329-336. [PMID: 30760658 DOI: 10.1507/endocrj.ej18-0417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This research aimed to examine the relationship between anti-glutamic acid decarboxylase antibody (GADA) titers and clinical parameters at onset and to clarify the association between clinical severity and GADA titers in GADA-positive fulminant type 1 diabetes. This cross-sectional observational study included 20 cases with GADA-positive fulminant type 1 diabetes (4 cases from our hospital and 16 from cases reported in the literature). The association between GADA titers and clinical parameters [age, sex, body weight, body mass index, period from appearance of any prodromal symptoms to diagnosis, period from development of hyperglycemic symptoms to diagnosis, GADA titer, HbA1c level, blood pH and HCO3- level, serum levels of ketone bodies and pancreatic exocrine enzymes] were analyzed. Spearman's rank correlation coefficient (rs) was used for the correlation analysis. The results showed that there was a significant inverse correlation between GADA titers and the "period from appearance of any prodromal symptoms to diagnosis" (rs = -0.559, p < 0.05). Moreover, GADA titers were inversely correlated with blood pH and HCO3- level (rs = -0.576, p < 0.05, rs = -0.578, p < 0.05, respectively), and positively correlated with serum levels of total ketone bodies, acetoacetate, and 3-hydroxybutyrate (rs = 0.661, p < 0.05; rs = 0.700, p < 0.05; and rs = 0.782, p < 0.01, respectively). These findings suggest that higher GADA titers may be linked to more severe clinical severity of GADA-positive fulminant type 1 diabetes at onset. This association may be attributed to possible pre-existence of autoimmunity-related β-cell damage before the onset of fulminant type 1 diabetes.
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Affiliation(s)
- Daigo Saito
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Yoichi Oikawa
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Gen Mizutani
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Kazuyuki Inoue
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Masako Hatano
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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27
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Saito D, Oikawa Y, Yano Y, Ikegami Y, Satomura A, Isshiki M, Kurihara S, Inoue I, Noda M, Shimada A. Detailed Time Course of Decline in Serum C-Peptide Levels in Anti-Programmed Cell Death-1 Therapy-Induced Fulminant Type 1 Diabetes. Diabetes Care 2019; 42:e40-e41. [PMID: 30659072 DOI: 10.2337/dc18-1673] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/18/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Daigo Saito
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Yoichi Oikawa
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Yuya Yano
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Yuichi Ikegami
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Atsushi Satomura
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Masashi Isshiki
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Susumu Kurihara
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan
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Nakano T, Inoue I, Murakoshi T. A Newly Integrated Model for Intestinal Cholesterol Absorption and Efflux Reappraises How Plant Sterol Intake Reduces Circulating Cholesterol Levels. Nutrients 2019; 11:nu11020310. [PMID: 30717222 PMCID: PMC6412963 DOI: 10.3390/nu11020310] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 12/27/2022] Open
Abstract
Cholesterol homeostasis is maintained through a balance of de novo synthesis, intestinal absorption, and excretion from the gut. The small intestine contributes to cholesterol homeostasis by absorbing and excreting it, the latter of which is referred to as trans-intestinal cholesterol efflux (TICE). Because the excretion efficiency of endogenous cholesterol is inversely associated with the development of atherosclerosis, TICE provides an attractive therapeutic target. Thus, elucidation of the mechanism is warranted. We have shown that intestinal cholesterol absorption and TICE are inversely correlated in intestinal perfusion experiments in mice. In this review, we summarized 28 paired data sets for absorption efficiency and fecal neutral sterol excretion, a surrogate marker of TICE, obtained from 13 available publications in a figure, demonstrating the inverse correlation were nearly consistent with the assumption. We then offer a bidirectional flux model that accommodates absorption and TICE occurring in the same segment. In this model, the brush border membrane (BBM) of intestinal epithelial cells stands as the dividing ridge for cholesterol fluxes, making the opposite fluxes competitive and being coordinated by shared BBM-localized transporters, ATP-binding cassette G5/G8 and Niemann-Pick C1-like 1. Furthermore, the idea is applied to address how excess plant sterol/stanol (PS) intake reduces circulating cholesterol level, because the mechanism is still unclear. We propose that unabsorbable PS repeatedly shuttles between the BBM and lumen and promotes concomitant cholesterol efflux. Additionally, PSs, which are chemically analogous to cholesterol, may disturb the trafficking machineries that transport cholesterol to the cell interior.
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Affiliation(s)
- Takanari Nakano
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Saitama 350-0495, Japan.
| | - Ikuo Inoue
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Saitama 350-0495, Japan.
| | - Takayuki Murakoshi
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Saitama 350-0495, Japan.
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29
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Hatano M, Inoue I, Kurihara S, Ono H, Matsuda M, Kakei M, Inukai T, Aso Y, Katayama S. Long-Term Efficacy and Safety of Add-On Therapy of Sitagliptin to a Very Small Dose of Glimepiride Versus a Small Dose of Glimepiride Over Eighteen Months. J Endocrinol Metab 2019. [DOI: 10.14740/jem621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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30
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Sakai G, Saito D, Nakajima R, Hatano M, Noguchi Y, Kurihara S, Katayama S, Inoue I, Noda M, Shimada A. Intrinsic insulin secretion capacity might be preserved by discontinuing anti-programmed cell death protein 1 antibody treatment in 'anti-programmed cell death protein 1 antibody-induced' fulminant type 1 diabetes. J Diabetes Investig 2018; 9:448-449. [PMID: 29504279 PMCID: PMC5835468 DOI: 10.1111/jdi.12662] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/20/2017] [Accepted: 03/22/2017] [Indexed: 11/29/2022] Open
Abstract
Intrinsic insulin secretion capacity may be preserved by discontinuing anti-PD-1 antibody treatment in 'anti-PD-1 antibody-induced'fulminant type 1 diabetes.
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Affiliation(s)
- Gota Sakai
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Iruma Saitama, Japan
| | - Daigo Saito
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Iruma Saitama, Japan
| | - Ritsuko Nakajima
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Iruma Saitama, Japan
| | - Masako Hatano
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Iruma Saitama, Japan
| | - Yuichi Noguchi
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Iruma Saitama, Japan
| | - Susumu Kurihara
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Iruma Saitama, Japan
| | - Shigehiro Katayama
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Iruma Saitama, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Iruma Saitama, Japan
| | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Iruma Saitama, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama, Iruma Saitama, Japan
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31
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Ito D, Inoue K, Sumita T, Hamaguchi K, Kaneko K, Yanagisawa M, Inukai K, Inoue I, Noda M, Shimada A. Long-Term Effects of Ipragliflozin on Diabetic Nephropathy and Blood Pressure in Patients With Type 2 Diabetes: 104-Week Follow-up of an Open-Label Study. J Clin Med Res 2018; 10:679-687. [PMID: 30116437 PMCID: PMC6089574 DOI: 10.14740/jocmr3491w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 06/27/2018] [Indexed: 01/02/2023] Open
Abstract
Background In our previous study, we investigated the efficacy of ipragliflozin, a sodium-glucose cotransporter (SGLT) 2 inhibitor on diabetic nephropathy in patients with type 2 diabetes and demonstrated that ipragliflozin significantly improved diabetic nephropathy in addition to reducing HbA1c and body weight. Herein, we conducted post-trial monitoring to determine whether these lowering effects on blood glucose and body weight or the beneficial effects on diabetic nephropathy were maintained long-term (104 weeks) after starting ipragliflozin treatment. Methods Initially, during a 24-week interventional trial period, a 50 mg dose of ipragliflozin was administered to 50 patients with type 2 diabetes without changing other treatments. During the post-trial monitoring period, these patients returned to hospital-based diabetes care according to their clinical needs. We continued monitoring their clinical data for 104 weeks in each hospital and analyzed the results on an intention-to-treat basis. Results The improvements in glycemic control and body weight reduction provided by 24-week ipragliflozin administration were maintained for 104 weeks. Despite a transient decrease during the intervention period, the estimated glomerular filtration rate (eGFR) was restored to near the baseline level at 104 weeks. Notably, in patients with diabetic nephropathy, the median urinary albumin-to-creatinine ratio (UACR) was significantly decreased from 119.2 (98.9 - 201.8) at baseline to 36.9 (19.7 - 204.7) mg/gCr at 104 weeks. In addition, eGFR was stable for 104 weeks, showing no decrease. In contrast, a significant positive correlation between UACR and blood pressure observed at 24 weeks disappeared after discontinuation of the intervention therapy. Conclusions The well-controlled HbA1c and body weight reductions were maintained for 104 weeks of post-trial follow-up. Moreover, ipragliflozin significantly reduced urinary albumin excretion in patients with diabetic nephropathy without decreasing eGFR.
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Affiliation(s)
- Daisuke Ito
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.,Department of Internal Medicine, Ogawa Red Cross Hospital, Saitama, Japan
| | - Kazuyuki Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Takashi Sumita
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.,Department of Internal Medicine, Ogawa Red Cross Hospital, Saitama, Japan
| | - Keiko Hamaguchi
- Department of Nursing, Ogawa Red Cross Hospital, Saitama, Japan
| | - Kimie Kaneko
- Department of Nursing, Ogawa Red Cross Hospital, Saitama, Japan
| | | | - Kouichi Inukai
- Department of Diabetes and Endocrinology, Higashiyamato Hospital, Tokyo, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
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Takase M, Shirai M, Matsushita H, Umehara H, Wakabayashi S, Doi A, Inoue I. The severity of unilateral spatial neglect was positively correlated with that of Pusher syndrome. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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33
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Mizutani G, Hikima Y, Satomura A, Iuchi T, Nakajima R, Miyashita Y, Yasuda S, Oikawa Y, Isshiki M, Inoue I, Noda M, Shimada A. Administration of thiamazole for Graves' disease might trigger the onset of type 1 diabetes. J Diabetes Investig 2018; 9:1228-1229. [PMID: 29900683 PMCID: PMC6123042 DOI: 10.1111/jdi.12784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/10/2017] [Accepted: 11/27/2017] [Indexed: 11/29/2022] Open
Abstract
Thiamazole might trigger the onset of type 1 diabetes.
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Affiliation(s)
- Gen Mizutani
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Yusuke Hikima
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Atsushi Satomura
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Takujiro Iuchi
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Ritsuko Nakajima
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Yumi Miyashita
- Division of RI Laboratory, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Shigemitsu Yasuda
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Yoichi Oikawa
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Masashi Isshiki
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan.,Division of RI Laboratory, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, Biomedical Research Center, Saitama Medical University, Moroyama, Saitama, Japan
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Takenaka Y, Inoue I, Nakano T, Ikeda M, Kakinuma Y, Ikegami Y, Shimada A, Noda M. Evaluation of Teneligliptin Effects on Transcriptional Activity of PPARγ in Cell-Based Assays. J NIPPON MED SCH 2018; 85:95-101. [PMID: 29731503 DOI: 10.1272/jnms.2018_85-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The antidiabetic drug teneligliptin is a novel dipeptidyl peptidase-4 (DPP-4) inhibitor with a thiazolidine-specific structure. This study aimed to investigate whether teneligliptin can activate PPARγ directly and/or indirectly in cell-based assays. METHODS Promoter assays using the reporter construct driven under the control of the SV40 promoter and the PPAR response element (PPRE) were performed. Luciferase activity was measured after a 3-day incubation of vector-transduced cells with various concentrations of teneligliptin. RESULTS Treatment of the cells with 50 μM teneligliptin significantly transactivated a reporter gene. The presence of the PPARγ antagonist, GW9662, did not affect the activation of PPRE-reporter expression by teneligliptin. CONCLUSION We found that teneligliptin could increase PPARγ activity in cell-based assays irrespective of the PPARγ ligand-binding domain.
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Affiliation(s)
- Yasuhiro Takenaka
- Department of Physiology, Graduate School of Medicine, Nippon Medical School
| | - Ikuo Inoue
- Department of Diabetes and Endocrinology, Saitama Medical University
| | | | - Masaaki Ikeda
- Department of Physiology, Saitama Medical University
| | - Yoshihiko Kakinuma
- Department of Physiology, Graduate School of Medicine, Nippon Medical School
| | - Yuichi Ikegami
- Department of Diabetes and Endocrinology, Saitama Medical University
| | - Akira Shimada
- Department of Diabetes and Endocrinology, Saitama Medical University
| | - Mitsuhiko Noda
- Department of Diabetes and Endocrinology, Saitama Medical University
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Kurozumi A, Okada Y, Satoh H, Inoue I, Chimori H, Akita E, Shiraiwa T, Fujitani Y, Mita T, Gosho M, Watada H. Effects of linagliptin monotherapy compared with voglibose on postprandial lipid profiles in Japanese patients with type 2 diabetes: linagliptin study of effects on postprandial blood glucose (L-STEP) sub-study 1. Endocr J 2018; 65:415-425. [PMID: 29367471 DOI: 10.1507/endocrj.ej17-0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Recently, we reported that linagliptin had equivalent efficacy to voglibose in reducing postprandial blood glucose levels in drug-naïve patients with type 2 diabetes (L-STEP Study). As a sub-study of the L-STEP Study we examined the effect of linagliptin on postprandial lipids profile. Between October 2012 and April 2014, the study enrolled patients with type 2 diabetes mellitus who had inadequate glycemic control. Patients were randomly assigned to either the linagliptin group (5 mg once daily, n = 85) or the voglibose group (0.2 mg/meal thrice daily, n = 71). Meal tolerance tests were performed at baseline (week 0) and endpoint (week 12). The increments in 4-h postprandial triglyceride, remnant lipoprotein cholesterol (RLP-C), and apolipoprotein B48 (ApoB48) from baseline to endpoint in the linagliptin group were lower (p < 0.001, p = 0.025 and p < 0.001). 4-h postprandial ApoB48 at endpoint was lower in the linagliptin group (p = 0.007), and positive correlation was detected between change of ApoB48 and changes in both triglyceride (r = 0.67, p < 0.001) and RLP-C (r = 0.73, p < 0.001) at 4 h. This study revealed that in drug-naïve Japanese patients with relatively mild type 2 diabetes mellitus, linagliptin improves not only postprandial blood glucose level but also levels of lipids such as TG and RLP-C by reducing the ApoB48 level compared with voglibose.
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Affiliation(s)
- Akira Kurozumi
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Hiroaki Satoh
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ikuo Inoue
- Division of Diabetes and Endocrinology, Saitama Medical University, Saitama, Japan
| | | | | | | | - Yoshio Fujitani
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masahiko Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Nakano T, Inoue I, Takenaka Y, Ikegami Y, Kotani N, Shimada A, Noda M, Murakoshi T. Luminal plant sterol promotes brush border membrane-to-lumen cholesterol efflux in the small intestine. J Clin Biochem Nutr 2018; 63:102-105. [PMID: 30279620 PMCID: PMC6160726 DOI: 10.3164/jcbn.17-116] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 12/19/2017] [Indexed: 11/22/2022] Open
Abstract
Plant sterols are used as food additives to reduce intestinal cholesterol absorption. They also increase fecal neutral sterol (FNS) excretion irrespective of the absorption inhibition. Intestine-mediated reverse cholesterol transport, or trans-intestinal cholesterol efflux (TICE), provides the major part of the increase of FNS excretion. However, it is unknown whether plant sterols stimulate TICE or not. We have shown previously that TICE can be evaluated by brush border membrane (BBM)-to-lumen cholesterol efflux. Thus, we examined whether luminal plant sterols stimulate BBM-to-lumen cholesterol efflux in the intestinal tract or not in mice. Cannulated upper jejunum that had been pre-labeled with orally given 3H-cholesterol, was flushed and perfused to collect 3H-cholesterol effluxed back into the lumen from the BBM to estimate the efflux efficiency. Adding 0.5 mg/ml of plant sterols, but not cholesterol, in the perfusion solution doubled the efflux. Plant sterols enter the BBM and are effluxed back to the lumen rapidly, in which process cholesterol transporters in the BBM are involved. We thus speculate that phytosterols alter cholesterol flux in the BBM; thereby, increases BBM-to-lumen cholesterol efflux, resulting in the increased TICE.
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Affiliation(s)
- Takanari Nakano
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Iruma, Saitama 350-0495, Japan
| | - Ikuo Inoue
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Iruma, Saitama 350-0495, Japan
| | - Yasuhiro Takenaka
- Department of Physiology, Nippon Medical School, Bunkyo-ku, Tokyo 113-8602, Japan
| | - Yuichi Ikegami
- Department of Physiology, Nippon Medical School, Bunkyo-ku, Tokyo 113-8602, Japan
| | - Norihiro Kotani
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Iruma, Saitama 350-0495, Japan
| | - Akira Shimada
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Iruma, Saitama 350-0495, Japan
| | - Mitsuhiko Noda
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Iruma, Saitama 350-0495, Japan
| | - Takayuki Murakoshi
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Iruma, Saitama 350-0495, Japan
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Sakai G, Inoue I, Suzuki T, Sumita T, Inukai K, Katayama S, Awata T, Yamada T, Asano T, Katagiri H, Noda M, Shimada A, Ono H. Effects of the Activation of Three Major Hepatic Akt Substrates on Glucose Metabolism in Male Mice. Endocrinology 2017; 158:2659-2671. [PMID: 28498916 DOI: 10.1210/en.2016-1969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 05/08/2017] [Indexed: 01/21/2023]
Abstract
Insulin suppresses glucose output from the liver via Akt activation; however, which substrate of Akt plays the major role in transducing this effect is unclear. We tested the postnatal expression of Akt-unresponsive, constitutively active mutants of three major Akt substrates widely considered to regulate glucose metabolism [i.e., FoxO1, PGC1α, and glycogen synthase kinase-3β (GSK3β)] using adenoviral gene delivery to the mouse liver. We performed physiological hyperinsulinemic-euglycemic clamp studies using these mice under awake and nonrestrained conditions with blood sampling via an arterial catheter. Hepatic expression of constitutively active FoxO1 induced significant hepatic and systemic insulin resistance. However, neither the expression of constitutively active PGC1α nor that of GSK3β significantly changed insulin sensitivity. Simultaneous expression of all three mutants together induced no further insulin resistance compared with that of the FoxO1 mutant. The glycogen content in the liver was significantly reduced by constitutively active GSK3β expression. In cultured hepatocytes, constitutively active PGC1α induced markedly stronger transcriptional enhancement of gluconeogenic key enzymes than did constitutively active FoxO1. From these results, we conclude that FoxO1 has the most prominent role in transducing insulin's effect downstream from Akt to suppress hepatic glucose output, involving mechanisms independent of the transcriptional regulation of key gluconeogenic enzymes.
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Affiliation(s)
- Gota Sakai
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama 350-0495, Japan
| | - Ikuo Inoue
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama 350-0495, Japan
| | - Tokuko Suzuki
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama 350-0495, Japan
| | - Takashi Sumita
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama 350-0495, Japan
| | - Kouichi Inukai
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama 350-0495, Japan
| | - Shigehiro Katayama
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama 350-0495, Japan
| | - Takuya Awata
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama 350-0495, Japan
| | - Tetsuya Yamada
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai 980-8577, Japan
| | - Tomoichiro Asano
- Department of Medical Science, Graduate School of Medicine, University of Hiroshima, Hiroshima City 739-0046, Japan
| | - Hideki Katagiri
- Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai 980-8577, Japan
| | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama 350-0495, Japan
| | - Akira Shimada
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama 350-0495, Japan
| | - Hiraku Ono
- Department of Endocrinology and Diabetes, Saitama Medical University, Moroyama 350-0495, Japan
- Biomedical Research Center, Division of RI Laboratory, Saitama Medical University, Moroyama 350-0495, Japan
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Higaki T, Shiode N, Nishioka K, Takeuchi A, Harima A, Oi K, Dai K, Kawase T, Nakama Y, Suenari K, Otsuka M, Sakai K, Shimatani Y, Masaoka Y, Inoue I. P524Angiographic outcomes after the combined use of paclitaxel-coated balloon and excimer laser coronary angioplasty for drug-eluting stent in-stent restenosis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Inoue I, Kubota R, Yanagi S, Akita M, Nakano T, Katayama S, Shimada A, Noda M. The New Molecular Entity Evolocumab, One Kind of PCSK9 Inhibitor, Reduce Plasma Small Size LDL-Cholesterol Levels by Using a New Standardized Method of Measuring LDL Size. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojmip.2017.71001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Nakano T, Inoue I, Takenaka Y, Ono H, Katayama S, Awata T, Murakoshi T. Ezetimibe Promotes Brush Border Membrane-to-Lumen Cholesterol Efflux in the Small Intestine. PLoS One 2016; 11:e0152207. [PMID: 27023132 PMCID: PMC4811413 DOI: 10.1371/journal.pone.0152207] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 03/10/2016] [Indexed: 11/19/2022] Open
Abstract
Ezetimibe inhibits Niemann-Pick C1-like 1 (NPC1L1), an apical membrane cholesterol transporter of enterocytes, thereby reduces intestinal cholesterol absorption. This treatment also increases extrahepatic reverse cholesterol transport via an undefined mechanism. To explore this, we employed a trans-intestinal cholesterol efflux (TICE) assay, which directly detects circulation-to-intestinal lumen 3H-cholesterol transit in a cannulated jejunal segment, and found an increase of TICE by 45%. To examine whether such increase in efflux occurs at the intestinal brush border membrane(BBM)-level, we performed luminal perfusion assays, similar to TICE but the jejunal wall was labelled with orally-given 3H-cholesterol, and determined elevated BBM-to-lumen cholesterol efflux by 3.5-fold with ezetimibe. Such increased efflux probably promotes circulation-to-lumen cholesterol transit eventually; thus increases TICE. Next, we wondered how inhibition of NPC1L1, an influx transporter, resulted in increased efflux. When we traced orally-given 3H-cholesterol in mice, we found that lumen-to-BBM 3H-cholesterol transit was rapid and less sensitive to ezetimibe treatment. Comparison of the efflux and fractional cholesterol absorption revealed an inverse correlation, indicating the efflux as an opposite-regulatory factor for cholesterol absorption efficiency and counteracting to the naturally-occurring rapid cholesterol influx to the BBM. These suggest that the ezetimibe-stimulated increased efflux is crucial in reducing cholesterol absorption. Ezetimibe-induced increase in cholesterol efflux was approximately 2.5-fold greater in mice having endogenous ATP-binding cassette G5/G8 heterodimer, the major sterol efflux transporter of enterocytes, than the knockout counterparts, suggesting that the heterodimer confers additional rapid BBM-to-lumen cholesterol efflux in response to NPC1L1 inhibition. The observed framework for intestinal cholesterol fluxes may provide ways to modulate the flux to dispose of endogenous cholesterol efficiently for therapeutic purposes.
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Affiliation(s)
- Takanari Nakano
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
- * E-mail:
| | - Ikuo Inoue
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Yasuhiro Takenaka
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Hiraku Ono
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Shigehiro Katayama
- Department of Diabetes and Endocrinology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Takuya Awata
- Department of Diabetes, Endocrinology and Metabolism, International University of Health and Welfare Hospital, Nasushiobara-shi, Tochigi, Japan
| | - Takayuki Murakoshi
- Department of Biochemistry, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
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Abstract
We herein present a 60-year-old man with adrenocortical carcinoma who had gynecomastia. An endocrinological examination revealed increased levels of serum estradiol and dehydroepiandrosterone-sulfate (DHEA-S) and reduced levels of free testosterone. Magnetic resonance imaging showed an adrenal tumor with heterogeneous intensity. Iodine-131 adosterol scintigraphy showed an increased uptake at the same site. Because feminizing adrenocortical carcinoma was suspected, right adrenalectomy was performed; the pathological diagnosis was adrenocortical carcinoma. The results of immunostaining indicated a virilizing tumor. Aromatase activity was identified on RT-PCR. As disorganized steroidogenesis is pathologically present in adrenocortical carcinoma, this diagnosis should be made with caution.
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Affiliation(s)
- Masako Hatano
- Department of Endocrinology and Diabetes, Saitama Medical University, Japan
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Ito D, Iuchi T, Kurihara S, Inoue I, Katayama S, Inukai K. Efficacy and Clinical Characteristics of Liraglutide in Japanese Patients With Type 2 Diabetes. J Clin Med Res 2015; 7:694-9. [PMID: 26251684 PMCID: PMC4522987 DOI: 10.14740/jocmr2237w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2015] [Indexed: 02/06/2023] Open
Abstract
Background Liraglutide was first released in Japan as a long-acting once-daily glucagon-like peptide-1 receptor agonist. The maximum dose in Japan is 0.9 mg/day, which is half of that used in the United States and the European Union (1.8 mg/day). The efficacy of this maximum allowable dose of liraglutide for Japanese patients and the profiles of those patients for whom this agent should be recommended remain unclear. Methods This study aimed to examine the effective use of liraglutide in Japanese type 2 diabetic patients. We administered liraglutide to 60 patients, who had been managed with oral hypoglycemic agents or diet and exercise therapy only, during a period of 6 months. Results Though HbA1c levels significantly decreased, by approximately 1.5%, after 6 months of liraglutide administration, no significant changes in body weights were observed. The 0.6 mg dose was effective in approximately 40% of patients. In contrast, the effects of a dose increase from 0.6 mg to 0.9 mg were small. The greatest efficacy, as shown by a 2.5% HbA1c decrease, was achieved in non-obese patients. Thus, efficacy decreased as the degree of obesity increased. In addition, efficacy was higher in patients who had a diabetes duration of less than 10 years and was also higher in the group that had a low sulfonylurea (SU) index, when we define the SU index as mg/glimepiride × years of treatment. Conclusions As appetite suppressions and associated decreases in body weights were not observed in obese patients, the efficacy of liraglutide at 0.9 mg did not appear to be high. Rather, it appeared to be highly effective for patients who were non-obese and for whom amelioration of blood glucose elevations could be anticipated via the stimulation of insulin secretion. Therefore, we found that liraglutide at doses of 0.9 mg was highly effective in non-obese patients who were in the early stages of diabetes and was particularly effective in patients who had not yet been administered SU agents.
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Affiliation(s)
- Daisuke Ito
- Division of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan ; Division of Internal Medicine, Ogawa Red Cross Hospital, 1525, Ogawa, Ogawa, Hiki-gun, Saitama 355-0397, Japan
| | - Takujiro Iuchi
- Division of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan
| | - Susumu Kurihara
- Division of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan
| | - Ikuo Inoue
- Division of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan
| | - Shigehiro Katayama
- Division of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan
| | - Kouichi Inukai
- Division of Diabetes and Endocrinology, Higashiyamato Hospital, 1-13-12, Nangai, Higashiyamato, Tokyo 207-0014, Japan
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Matsuura H, Shingu T, Inoue I, Kajiyama G, Kusaka M, Matsumoto K, Kido K. Significance of intracellular cations and calcium-regulating hormones on salt sensitivity in patients with essential hypertension. Contrib Nephrol 2015; 90:11-8. [PMID: 1959335 DOI: 10.1159/000420117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Although the existence of salt sensitivity in essential hypertensives has been well known, the precise mechanism(s) has not yet been elucidated. The aim of this study was to clarify the relation between the responses in blood pressure, extra- and intracellular cations and calcium-regulating hormones to oral NaCl loading in essential hypertensives. After oral NaCl loading, mean blood pressure, urinary excretions of calcium and magnesium, and PLT[Ca2+]i were significantly increased. [Ca2+]o and E[Mg]i were decreased. The changes (delta) in mean blood pressure by NaCl loading positively correlated with delta PLT[Ca2+]i and delta PTH, and negatively with delta[Ca2+]o and delta E[Mg]i. Delta PLT[Ca2+]i positively correlated with delta PTH and negatively with delta[Ca2+]o and delta E[Mg]i. From these results, the blood pressure response to oral NaCl loading is associated with the alternation of [Ca2+]i metabolism in which the changes in magnesium metabolism and calcium-regulating hormones may be involved.
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Affiliation(s)
- H Matsuura
- 1st Department of Internal Medicine, Hiroshima University School of Medicine, Japan
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Takenaka Y, Inoue I, Nakano T, Shinoda Y, Ikeda M, Awata T, Katayama S. A Novel Splicing Variant of Peroxisome Proliferator-Activated Receptor-γ (Pparγ1sv) Cooperatively Regulates Adipocyte Differentiation with Pparγ2. PLoS One 2013; 8:e65583. [PMID: 23840343 PMCID: PMC3686765 DOI: 10.1371/journal.pone.0065583] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 04/25/2013] [Indexed: 11/28/2022] Open
Abstract
Peroxisome proliferator-activated receptors (PPARs) are nuclear receptors that regulate expression of a number of genes associated with the cellular differentiation and development. Here, we show the abundant and ubiquitous expression of a newly identified splicing variant of mouse Pparγ (Pparγ1sv) that encodes PPARγ1 protein, and its importance in adipogenesis. The novel splicing variant has a unique 5′-UTR sequence, relative to those of Pparγ1 and Pparγ2 mRNAs, indicating the presence of a novel transcriptional initiation site and promoter for Pparγ expression. Pparγ1sv was highly expressed in the white and brown adipose tissues at levels comparable to Pparγ2. Pparγ1sv was synergistically up-regulated with Pparγ2 during adipocyte differentiation of 3T3-L1 cells and mouse primary cultured preadipocytes. Inhibition of Pparγ1sv by specific siRNAs completely abolished the induced adipogenesis in 3T3-L1 cells. C/EBPβ and C/EBPδ activated both the Pparγ1sv and Pparγ2 promoters in 3T3-L1 preadipocytes. These findings suggest that Pparγ1sv and Pparγ2 synergistically regulate the early stage of the adipocyte differentiation.
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Affiliation(s)
- Yasuhiro Takenaka
- Department of Diabetes and Endocrinology, Saitama Medical University, Saitama, Japan
- * E-mail: (YT); (II)
| | - Ikuo Inoue
- Department of Diabetes and Endocrinology, Saitama Medical University, Saitama, Japan
- * E-mail: (YT); (II)
| | - Takanari Nakano
- Department of Biochemistry, Saitama Medical University, Saitama, Japan
| | | | - Masaaki Ikeda
- Department of Physiology, Saitama Medical University, Saitama, Japan
| | - Takuya Awata
- Department of Diabetes and Endocrinology, Saitama Medical University, Saitama, Japan
| | - Shigehiro Katayama
- Department of Diabetes and Endocrinology, Saitama Medical University, Saitama, Japan
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Yamaguchi T, Nakaoka H, Yamamoto K, Fujikawa T, Kim Y, Yano K, Haga S, Katayama K, Shibusawa T, Park SB, Maki K, Kimura R, Inoue I. Genome‐wide association study of degenerative bony changes of the temporomandibular joint. Oral Dis 2013; 20:409-15. [DOI: 10.1111/odi.12141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/07/2013] [Accepted: 05/18/2013] [Indexed: 01/05/2023]
Affiliation(s)
- T Yamaguchi
- Department of Orthodontics School of Dentistry Showa University TokyoJapan
| | - H Nakaoka
- Division of Human Genetics National Institute of Genetics ShizuokaJapan
| | - K Yamamoto
- Division of Genome Analysis Research Center for Genetic Information Medical Institute of Bioregulation Kyushu University Fukuoka Japan
| | - T Fujikawa
- Department of Orthodontics School of Dentistry Showa University TokyoJapan
| | - Y‐I Kim
- Department of Orthodontics Pusan National University Dental Hospital Yangsan Korea
| | - K Yano
- Verde Orthodontic Dental Clinic TokyoJapan
| | - S Haga
- Department of Orthodontics School of Dentistry Showa University TokyoJapan
| | - K Katayama
- Department of Orthodontics School of Dentistry Showa University TokyoJapan
| | - T Shibusawa
- Department of Orthodontics School of Dentistry Showa University TokyoJapan
| | - SB Park
- Department of Orthodontics Pusan National University Dental Hospital Yangsan Korea
| | - K Maki
- Department of Orthodontics School of Dentistry Showa University TokyoJapan
| | - R Kimura
- Faculty of Medicine University of the Ryukyus Okinawa Japan
| | - I Inoue
- Division of Human Genetics National Institute of Genetics ShizuokaJapan
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Shirai K, Saiki A, Oikawa S, Teramoto T, Yamada N, Ishibashi S, Tada N, Miyazaki S, Inoue I, Murano S, Sakane N, Satoh-Asahara N, Bujo H, Miyashita Y, Saito Y. The effects of partial use of formula diet on weight reduction and metabolic variables in obese type 2 diabetic patients—Multicenter trial. Obes Res Clin Pract 2013; 7:e43-54. [DOI: 10.1016/j.orcp.2012.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 03/28/2012] [Accepted: 03/30/2012] [Indexed: 10/28/2022]
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Yang F, Inoue I, Kumagai M, Takahashi S, Nakajima Y, Ikeda M. Real-time analysis of the circadian oscillation of the Rev-Erb β promoter. J Atheroscler Thromb 2012; 20:267-76. [PMID: 23221024 DOI: 10.5551/jat.14381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Rev-Erb β gene plays crucial roles in circadian rhythm, lipid and glucose metabolism, and several diseases. The molecular mechanisms of the transcriptional regulation of Rev-Erb β that generate and determine the phase of the circadian oscillation remain unclear. METHODS We analyzed the Rev-Erb β promoter by luciferase reporter assays, real-time bioluminescence monitoring assays and electrophoretic mobility shift assays. RESULTS Luciferase reporter assays indicated that only the 5' region and exon 1 have obvious promoter activity. Real-time bioluminescence monitoring assays revealed that E1, E2, E3, D boxes are important for maintenance of the amplitude of Rev-Erb β oscillation. Based on EMSA results, REV-ERBβ binds ROREs in the Bmal1 promoter region and inhibits Bmal1 promoter activity. CONCLUSION We provide direct evidence that three E-boxes and one D-box located in the first intron are crucial for the phase of circadian oscillation in Rev-Erb β expression and that the sequences upstream from its transcription start site function as a promoter with no circadian regulation. We also found that the E1 box affects the Rev-Erb β oscillation phase. Our results offer new insight into the role of Rev-Erb β in the circadian rhythm system.
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Affiliation(s)
- Fang Yang
- Department of Neurology, Meitan General Hospital, Beijing, China
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Miida T, Nishimura K, Okamura T, Hirayama S, Ohmura H, Yoshida H, Miyashita Y, Ai M, Tanaka A, Sumino H, Murakami M, Inoue I, Kayamori Y, Nakamura M, Nobori T, Miyazawa Y, Teramoto T, Yokoyama S. A multicenter study on the precision and accuracy of homogeneous assays for LDL-cholesterol: Comparison with a beta-quantification method using fresh serum obtained from non-diseased and diseased subjects. Atherosclerosis 2012; 225:208-15. [DOI: 10.1016/j.atherosclerosis.2012.08.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 08/09/2012] [Accepted: 08/16/2012] [Indexed: 10/28/2022]
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Nagasaka H, Miida T, Inui A, Inoue I, Tsukahara H, Komatsu H, Hiejima E, Fujisawa T, Yorifuji T, Hiranao KI, Okajima H, Inomata Y. Fatty liver and anti-oxidant enzyme activities along with peroxisome proliferator-activated receptors γ and α expressions in the liver of Wilson's disease. Mol Genet Metab 2012; 107:542-7. [PMID: 22940187 DOI: 10.1016/j.ymgme.2012.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 08/05/2012] [Accepted: 08/05/2012] [Indexed: 01/07/2023]
Abstract
BACKGROUND The mechanisms of liver damage and steatosis in Wilson's disease (WD) presenting accumulation of copper generating oxidants remain unclear. Recent studies have shown that peroxisome proliferator-activated receptors (PPARs), in particular PPARs α and γ, regulate fat content of the liver together with the anti-oxidant and anti-inflammation systems. However, such PPARs have never been studied in WD. METHODS We examined PPARs along with the liver damage and steatosis of WD using liver specimens from affected patients exhibiting mild liver damage (group I, n = 5), moderate or greater liver damage (group II, n = 10) and fulminant hepatic failure (group III, n = 5), and from asymptomatic carriers (group H, n = 4). RESULTS PPAR α expression was increased over the control levels in groups H and I but was decreased in groups II and III in parallel with the progression of liver damage (group H = I>II>III). PPAR γ expression was inversely increased (group H<I<II<III). Mn-dependent superoxide dismutase (Mn-SOD), CuZn-SOD, and catalase activities were decreased in the affected three groups, and were increased in group H. Among group II exhibiting substantial inter-individual variances in parameters, the severity of steatosis showed a significant positive correlation with PPAR γ expression (p<0.001) but not PPAR α expression. CuZn-SOD activity was positively correlated with PPARα expression (p<0.05) but not PPAR γ expression. CONCLUSION These results suggest that changes of PPARs γ and α are associated with the steatosis and the impairment of anti-oxidant system in the liver of WD.
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Affiliation(s)
- Hironori Nagasaka
- Department of Pediatrics, Takarazuka City Hospital, 4-5-1 Kohama-cho, Takarazuka 665-0827, Japan.
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Mitsunaga S, Suzuki Y, Kuwana M, Sato S, Kaneko Y, Homma Y, Narita A, Kashiwase K, Okudaira Y, Inoue I, Kulski JK, Inoko H. Associations between six classical HLA loci and rheumatoid arthritis: a comprehensive analysis. ACTA ACUST UNITED AC 2012; 80:16-25. [PMID: 22471586 DOI: 10.1111/j.1399-0039.2012.01872.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Although the HLA region contributes to one-third of the genetic factors affecting rheumatoid arthritis (RA), there are few reports on the association of the disease with any of the HLA loci other than the DRB1. In this study we examined the association between RA and the alleles of the six classical HLA loci including DRB1. Six HLA loci (HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1) of 1659 Japanese subjects (622 cases; 488 anti-cyclic citrullinated peptides (CCP) antibody (Ab) positive (82.6%); 103 anti-CCP Ab negative (17.4%); 31 not known and 1037 controls) were genotyped. Disease types and positivity/negativity for CCP autoantibodies were used to stratify the cases. Statistical and genetic assessments were performed by Fisher's exact tests, odds ratio, trend tests and haplotype estimation. None of the HLA loci were significantly associated with CCP sero-negative cases after Bonferroni correction and we therefore limited further analyses to using only the anti CCP-positive RA cases and both anti-CCP positive and anti-CCP negative controls. Some alleles of the non-DRB1 HLA loci showed significant association with RA, which could be explained by linkage disequilibrium with DRB1 alleles. However, DPB1*02:01, DPB1*04:01 and DPB1*09:01 conferred RA risk/protection independently from DRB1. DPB1*02:01 was significantly associated with the highly erosive disease type. The odds ratio of the four HLA-loci haplotypes with DRB1*04:05 and DQB1*04:01, which were the high-risk HLA alleles in Japanese, varied from 1.01 to 5.58. C*07:04, and B*15:18 showed similar P-values and odds ratios to DRB1*04:01, which was located on the same haplotype. This haplotype analysis showed that the DRB1 gene as well as five other HLA loci is required for a more comprehensive understanding of the genetic association between HLA and RA than analyzing DRB1 alone.
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Affiliation(s)
- S Mitsunaga
- Department of Molecular Life Sciences, Division of Basic Medical Science and Molecular Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
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