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Sankoda A, Suzuki H, Imaizumi M, Yoshihara A, Kobayashi S, Katai M, Hamada K, Hidaka Y, Yoshihara A, Nakamura H, Kubota S, Kakita-Kobayashi M, Iwase A, Sugiyama T, Ota E, Arata N. Effects of Levothyroxine Treatment on Fertility and Pregnancy Outcomes in Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Thyroid 2024; 34:519-530. [PMID: 38368537 DOI: 10.1089/thy.2023.0546] [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: 02/19/2024]
Abstract
Background: Subclinical hypothyroidism, defined by elevated thyrotropin (TSH) and normal free thyroxine levels, is associated with adverse pregnancy outcomes, including preterm birth, pre-eclampsia, and small for gestational age. Despite the uncertainty regarding the effectiveness of levothyroxine (LT4) treatment on pregnancy outcomes in subclinical hypothyroidism, LT4 is widely administered with a pre-treatment threshold TSH level of 2.5 mU/L. The aim of this study is to investigate the efficacy of periconceptional LT4 treatment for subclinical hypothyroidism, including TSH levels >2.5 mU/L, and identify the characteristics of subclinical hypothyroidism that can benefit from LT4 treatment. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials from inception to February 2023. We analyzed the pooled effects of LT4 on subclinical hypothyroidism before and during pregnancy. The main outcomes before pregnancy were live birth, pregnancy, and miscarriage. The main outcomes during pregnancy were live birth, miscarriage, and preterm birth. We conducted subgroup analyses to compare the effects of LT4 on subclinical hypothyroidism with TSH levels of 2.5-4.0 and >4.0 mU/L. Results: Of the 888 studies identified, 27 full-text articles were screened for eligibility. Five studies on pre-conception treatment with 768 participants and eight studies on treatment during early pregnancy with 2622 participants were analyzed. One of the two studies on pre-conception treatment in subclinical hypothyroidism with TSH >4.0 mU/L had high risk of bias and the other was composed of 64 participants. Pre-conception LT4 treatment had no significant effect in improving rates of live births and pregnancies, or reducing miscarriages (risk ratio [RR], 95% confidence interval): 1.41 (0.84-2.36), 1.73 (0.88-3.39), and 0.46 (0.11-2.00), respectively. LT4 treatment during pregnancy was not significantly associated with higher rates of live births (RR 1.03, 0.98-1.09) nor decreased miscarriage rates (RR 1.01, 0.66-1.53). The effect of LT4 treatment on preterm birth during pregnancy was significantly different depending on the TSH values (p = 0.04); a positive effect was shown in the subclinical hypothyroidism subgroup with TSH >4.0 mU/L (RR 0.47, 0.20-1.10), while no significant effect was observed in the subgroup with TSH 2.5-4.0 mU/L (RR 1.35, 0.79-2.31). Conclusions: Pre-conceptional LT4 treatment for subclinical hypothyroidism does not improve fertility or decrease the incidence of miscarriages. However, further well-designed studies are needed for pre-conceptional treatment, especially in TSH >4.0 mU/L. LT4 treatment during pregnancy had a positive effect on preterm birth; nevertheless, this was only applicable to subclinical hypothyroidism with TSH >4.0 mU/L.
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Affiliation(s)
- Akiko Sankoda
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Hitomi Suzuki
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
- Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Misa Imaizumi
- Department of Clinical Studies, Radiation Effects Research Foundation, Nagasaki, Japan
| | - Ai Yoshihara
- Department of Internal Medicine, Ito Hospital, Tokyo, Japan
| | - Sakiko Kobayashi
- Department of Endocrinology, Metabolism and Nephrology, NHO Tokyo Medical Center, Tokyo, Japan
| | - Miyuki Katai
- Health Services Center, National Graduate Institute for Policy Studies, Tokyo, Japan
| | | | - Yoh Hidaka
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Aya Yoshihara
- Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Hannah Nakamura
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | | | | | - Akira Iwase
- Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Naoko Arata
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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Kasuga Y, Miyakoshi K, Yokoyama M, Nakanishi S, Iwama N, Ichikawa R, Abiko A, Harashima S, Sugiyama T. Use of the Japanese gestational diabetes mellitus diagnostic strategy during the COVID-19 pandemic in Japan: A questionnaire survey. J Obstet Gynaecol Res 2024. [PMID: 38522428 DOI: 10.1111/jog.15929] [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: 12/18/2023] [Accepted: 03/12/2024] [Indexed: 03/26/2024]
Abstract
AIM Some concerns exist that diagnosis of gestational diabetes mellitus (GDM) may be missed when the simplified diagnostic criteria of the Japanese Society of Diabetes and Pregnancy (JSDP) for GDM (published during the COVID-19 pandemic) are used. Moreover, limited data is available regarding how widespread these diagnostic criteria are used when managing GDM during the COVID-19 pandemic. Therefore, this study aimed to determine how GDM diagnosis has changed during the COVID-19 pandemic in Japan. METHODS The changes in GDM diagnosis during the COVID-19 pandemic were investigated using an online questionnaire to 2159 obstetric facilities in Japan. The questionnaire collected data on facility type, awareness of Japanese GDM diagnostic strategies, modifications to diagnostic methods for early and late GDM, and opinions on GDM management, with the pandemic divided into seven periods. RESULTS We received responses from 593 facilities (27%). Approximately 90% of the facilities did not change their diagnostic process for early GDM or late GDM (occurring after 24 weeks gestation). However, during the COVID-19 pandemic, 19 facilities discontinued the use of 75-g oral glucose tolerance tests before 24 weeks of gestation, and 17 facilities discontinued it after 24 weeks of gestation, instead using the aforementioned Japanese GDM diagnostic strategy. CONCLUSIONS Although a limited number of facilities modified their diagnostic method in response to the COVID-19 pandemic, this study demonstrated that those that adjusted their diagnostic method primarily used the Japanese COVID-19 GDM strategy by the JSDP.
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Affiliation(s)
- Yoshifumi Kasuga
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Kei Miyakoshi
- Department of Obstetrics and Gynecology, International Catholic Hospital, Tokyo, Japan
| | - Maki Yokoyama
- Department of Obstetrics and Gynecology, Uwajima City Hospital, Uwajima, Ehime, Japan
| | - Sayuri Nakanishi
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Raishi Ichikawa
- Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Atsuko Abiko
- Department of Diabetology and Endocrinology, Japanese Asahikawa Red Cross Hospital, Asahikawa, Hokkaido, Japan
| | - Shinichi Harashima
- Department of Internal Medicine, Kyoto Goshominami Harashima Clinic, Kyoto, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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Yoshida A, Takata Y, Tabara Y, Maruyama K, Inoue S, Osawa H, Sugiyama T. Interaction effect between low birthweight and resistin gene rs1862513 variant on insulin resistance and type 2 diabetes mellitus in adulthood: Toon Genome Study. J Diabetes Investig 2024. [PMID: 38421160 DOI: 10.1111/jdi.14163] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/11/2024] [Accepted: 02/01/2024] [Indexed: 03/02/2024] Open
Abstract
AIMS/INTRODUCTION Gene-environment interactions are considered to critically influence type 2 diabetes mellitus development; however, the underlying mechanisms and specific interactions remain unclear. Given the increasing prevalence of low birthweight (LBW) influenced by the intrauterine environment, we sought to investigate genetic factors related to type 2 diabetes development in individuals with LBW. MATERIALS AND METHODS The interaction between 20 reported type 2 diabetes susceptibility genes and the development of type 2 diabetes in LBW (<2,500 g) individuals in a population-based Japanese cohort (n = 1,021) was examined by logistic regression and stratified analyses. RESULTS Logistic regression analyses showed that only the G/G genotype at the rs1862513 locus of the resistin gene (RETN), an established initiator of insulin resistance, was closely related to the prevalence of type 2 diabetes in individuals with LBW. Age, sex and current body mass index-adjusted stratified analyses showed a significant interaction effect of LBW and the RETN G/G genotype on fasting insulin, homeostatic model assessment 2-insulin resistance, Matsuda index and the prevalence of type 2 diabetes (all P-values for interaction <0.05). The adjusted odds ratio for type 2 diabetes in the LBW + G/G genotype group was 7.33 (95% confidence interval 2.43-22.11; P = 0.002) compared with the non-LBW + non-G/G genotype group. Similar results were obtained after excluding the influence of malnutrition due to World War II. CONCLUSIONS Simultaneous assessment of LBW and the RETN G/G genotype can more accurately predict the risk of future type 2 diabetes than assessing each of these factors alone, and provide management strategies, including early lifestyle intervention in LBW population.
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Affiliation(s)
- Ayaka Yoshida
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Yasunori Takata
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Koutatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University, Toon, Ehime, Japan
| | - Shota Inoue
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Haruhiko Osawa
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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Tagami K, Iwama N, Hamada H, Tomita H, Kudo R, Kumagai N, Wang H, Izumi S, Watanabe Z, Ishikuro M, Obara T, Tatsuta N, Metoki H, Ota C, Sugiyama T, Kuriyama S, Arima T, Yaegashi N, Saito M. Maternal birth weight as an indicator of early and late gestational diabetes mellitus: The Japan Environment and Children's Study. J Diabetes Investig 2024. [PMID: 38391358 DOI: 10.1111/jdi.14159] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/20/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
AIMS This study aimed to investigate the association of maternal birth weight (MBW) with early and late gestational diabetes mellitus (GDM). METHODS A total of 69318 pregnant Japanese women were included in this birth cohort study. The associations between maternal birth weight and early gestational diabetes mellitus (diagnosed at <24 gestational weeks) and late GDM (diagnosed at ≥24 gestational weeks) were investigated using a multinomial logistic regression model, with an maternal birth weight of 3000-3499 g as the reference category. RESULTS Lower maternal birth weight was associated with higher odds of developing early and late gestational diabetes mellitus (P < 0.0001 and P < 0.0001, respectively). The adjusted odds ratios (aORs) for early gestational diabetes mellitus in participants with a MBW of <2500 g and 2500-2999 g were 1.345 (95% confidence interval [CI]: 0.912-1.984) and 1.338 (95% CI: 1.098-1.629), respectively. The aORs for late gestational diabetes mellitus in participants with a MBW of <2500 g and 2500-2999 g were, 1.657 (95% CI: 1.298-2.115) and 1.218 (95% CI: 1.058-1.402), respectively. CONCLUSIONS Regardless of the gestational age when gestational diabetes mellitus was diagnosed, a lower maternal birth weight was associated with an increased risk of gestational diabetes mellitus. Furthermore, the association of a MBW <2500 g with late gestational diabetes mellitus tended to be stronger than that with early gestational diabetes mellitus.
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Affiliation(s)
- Kazuma Tagami
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Hirotaka Hamada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hasumi Tomita
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Rie Kudo
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Natsumi Kumagai
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hongxin Wang
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Seiya Izumi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Zen Watanabe
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Mami Ishikuro
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Taku Obara
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Nozomi Tatsuta
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Chiharu Ota
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Shinichi Kuriyama
- Division of Molecular Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Nobuo Yaegashi
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Maternal and Fetal Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Judge PK, Staplin N, Mayne KJ, Wanner C, Green JB, Hauske SJ, Emberson JR, Preiss D, Ng SYA, Roddick AJ, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Massey D, Landray MJ, Baigent C, Haynes R, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Kinoshita M, Maeo S, Kobayashi Y, Eihara Y, Ono M, Sato M, Sugiyama T, Kanehisa H, Isaka T. Triceps surae muscle hypertrophy is greater after standing versus seated calf-raise training. Front Physiol 2023; 14:1272106. [PMID: 38156065 PMCID: PMC10753835 DOI: 10.3389/fphys.2023.1272106] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/29/2023] [Indexed: 12/30/2023] Open
Abstract
Background: The triceps surae muscle plays important roles in fundamental human movements. However, this muscle is relatively unresponsive to resistance training (difficult to hypertrophy) but prone to atrophy with inactivity compared with other muscles. Thus, identifying an effective training modality for the triceps surae is warranted. This study compared triceps surae muscle hypertrophy after standing/knee-extended versus seated/knee-flexed plantarflexion (calf-raise) training, where the gastrocnemius is lengthened and shortened, respectively. Methods: Fourteen untrained adults conducted calf-raise training with one leg in a standing/knee-extended position and the other leg in a seated/knee 90°-flexed position at 70% of one-repetition maximum. Each leg performed 10 repetitions/set, 5 sets/session, 2 sessions/week for 12 weeks. Before and after the intervention, magnetic resonance imaging scans were obtained to assess muscle volume of each and the whole triceps surae. Results: Muscle volume significantly increased in all three muscles and the whole triceps surae for both legs (p ≤ 0.031), except for the gastrocnemius muscles of the seated condition leg (p = 0.147-0.508). The changes in muscle volume were significantly greater for the standing than seated condition leg in the lateral gastrocnemius (12.4% vs. 1.7%), medial gastrocnemius (9.2% vs. 0.6%), and whole triceps surae (5.6% vs. 2.1%) (p ≤ 0.011), but similar between legs in the soleus (2.1% vs. 2.9%, p = 0.410). Conclusion: Standing calf-raise was by far more effective, therefore recommended, than seated calf-raise for inducing muscle hypertrophy of the gastrocnemius and consequently the whole triceps surae. This result and similar between-condition hypertrophy in the soleus collectively suggest that training at long muscle lengths promotes muscle hypertrophy.
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Affiliation(s)
- Momoka Kinoshita
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Sumiaki Maeo
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Yuuto Kobayashi
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Yuuri Eihara
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Munetaka Ono
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Mauto Sato
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Takashi Sugiyama
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Hiroaki Kanehisa
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
- Department of Physical Education, National Institute of Fitness and Sports in Kanoya, Kanoya, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
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Yano A, Liu S, Suzuki Y, Imai M, Mogi M, Sugiyama T. Single-cell transcriptomic architecture and cellular communication circuits of parametrial adipose tissue in pregnant mice. Life Sci 2023; 334:122214. [PMID: 37907153 DOI: 10.1016/j.lfs.2023.122214] [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] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/16/2023] [Accepted: 10/25/2023] [Indexed: 11/02/2023]
Abstract
AIMS The activity and interactions of cellular subpopulations in the adipose tissue microenvironment are critical for the coordination of local and systemic adaptation during pregnancy. With a particular interest in parametrial adipose tissue (PmAT), single-cell RNA-sequencing (scRNA-seq) was utilized to unveil the gestative cellular composition and functional shift. MATERIALS AND METHODS To identify cell-type-enriched transcriptome profiles, a total of 18,074 cells in adipose tissue were studied. The cell populations were cataloged, and signaling crosstalk between adipocytes and other composition factions via soluble and membrane-bound factors were evaluated. KEY FINDINGS A marked decline of pregnancy adipocytes and relative elevation of non-adipocyte fractions were observed. A subpopulation of adipocytes, Adipo_5, with unique properties in the response to estrogen and the embryonic processes involved in pregnancy, was defined. Interactome analysis revealed the potential contribution of PmAT to the establishment of maternal-fetal immune tolerance. During gestation, adipocytes shut down outgoing signaling, resulting in deterioration of the resistin-related incoming signaling network in B cells, which would therefore benefit tissue-specific maternal-fetal tolerance. Furthermore, a subpopulation of adipocytes, Aipo_2, was also considered to take part in a paradigm shift in the process of pregnancy-induced chemical stiffness-triggered vesicular remodeling via the THBS signaling pathway network. SIGNIFICANCE These data-derived findings will encourage investigation into the role of pregnant PmTA in pregnancy-related immunological, hypertensive and metabolic disorders, with the ultimate goal of establishing preventive strategies to mitigate these pregnancy-related health challenges. This translational aspect of our work holds significant promise for improving maternal and fetal well-being.
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Affiliation(s)
- Akiko Yano
- Department of Obstetrics & Gynecology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan; Department of Pharmacology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Shuang Liu
- Department of Pharmacology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan.
| | - Yasuyuki Suzuki
- Department of Pharmacology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan; Department of Anesthesiology, Saiseikai Matsuyama Hospital, Matsuyama, Japan; Research Division, Saiseikai Research Institute of Health Care and Welfare, Tokyo, Japan
| | - Matome Imai
- Department of Obstetrics & Gynecology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan; Department of Pharmacology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Takashi Sugiyama
- Department of Obstetrics & Gynecology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan
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Kusagawa Y, Kurihara T, Maeo S, Sugiyama T, Kanehisa H, Isaka T. A classification of the plantar intrinsic foot muscles based on the physiological cross-sectional area and muscle fiber length in healthy young adult males. J Foot Ankle Res 2023; 16:75. [PMID: 37950300 PMCID: PMC10638735 DOI: 10.1186/s13047-023-00676-2] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Plantar intrinsic foot muscles (PIFMs) are composed of 10 muscles and play an essential role in achieving functional diversity in the foot. Previous studies have identified that the morphological profiles of PIFMs vary between individuals. The morphological profiles of a muscle theoretically reflect its output potentials: the physiological cross-sectional area (PCSA) of a muscle is proportional to its maximum force generation, and the muscle fiber length (FL) is its shortening velocity. This implies that the PCSA and FL may be useful variables for characterizing the functional diversity of the individual PIFM. The purpose of this study was to examine how individual PIFMs can be classified based on their PCSA and FL. METHODS In 26 healthy young adult males, the muscle volume and muscle length of seven PIFMs (abductor hallucis, ABDH; abductor digiti minimi, ABDM; adductor hallucis oblique head, ADDH-OH; ADDH transverse head, ADDH-TH; flexor digitorum brevis, FDB; flexor hallucis brevis, FHB; quadratus plantae, QP) were measured using magnetic resonance imaging. The PCSA and FL of each of the seven PIFMs were then estimated by combining the data measured from the participants and those of muscle architectural parameters documented from cadavers in previous studies. A total of 182 data samples (26 participants × 7 muscles) were classified into clusters using k-means cluster analysis. The optimal number of clusters was evaluated using the elbow method. RESULTS The data samples of PIFMs were assigned to four clusters with different morphological profiles: ADDH-OH and FHB, characterised by large PCSA and short FL (high force generation and slow shortening velocity potentials); ABDM and FDB, moderate PCSA and moderate FL (moderate force generation and moderate shortening velocity potentials); QP, moderate PCSA and long FL (moderate force generation and rapid shortening velocity potentials); ADDH-TH, small PCSA and moderate FL (low force generation and moderate shortening velocity potentials). ABDH components were assigned equivalently to the first and second clusters. CONCLUSIONS The approach adopted in this study may provide a novel perspective for interpreting the PIFMs' function based on their maximal force generation and shortening velocity potentials.
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Affiliation(s)
- Yuki Kusagawa
- Research Organization of Science and Technology, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga, 525-8577, Japan.
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan.
| | - Toshiyuki Kurihara
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
- Faculty of Science, Yamaguchi University, Yamaguchi, Yamaguchi, Japan
| | - Sumiaki Maeo
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Takashi Sugiyama
- Research Organization of Science and Technology, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga, 525-8577, Japan
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Hiroaki Kanehisa
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
- National Institute of Fitness and Sports in Kanoya, Kanoya, Kagoshima, Japan
| | - Tadao Isaka
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
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Nakashiba T, Ogoh K, Iwano S, Sugiyama T, Mizuno-Iijima S, Nakashima K, Mizuno S, Sugiyama F, Yoshiki A, Miyawaki A, Abe K. Development of two mouse strains conditionally expressing bright luciferases with distinct emission spectra as new tools for in vivo imaging. Lab Anim (NY) 2023; 52:247-257. [PMID: 37679611 PMCID: PMC10533401 DOI: 10.1038/s41684-023-01238-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/01/2023] [Indexed: 09/09/2023]
Abstract
In vivo bioluminescence imaging (BLI) has been an invaluable noninvasive method to visualize molecular and cellular behaviors in laboratory animals. Bioluminescent reporter mice harboring luciferases for general use have been limited to a classical luciferase, Luc2, from Photinus pyralis, and have been extremely powerful for various in vivo studies. However, applicability of reporter mice for in vivo BLI could be further accelerated by increasing light intensity through the use of other luciferases and/or by improving the biodistribution of their substrates in the animal body. Here we created two Cre-dependent reporter mice incorporating luciferases oFluc derived from Pyrocoeli matsumurai and Akaluc, both of which had been reported previously to be brighter than Luc2 when using appropriate substrates; we then tested their bioluminescence in neural tissues and other organs in living mice. When expressed throughout the body, both luciferases emitted an intense yellow (oFluc) or far-red (Akaluc) light easily visible to the naked eye. oFluc and Akaluc were similarly bright in the pancreas for in vivo BLI; however, Akaluc was superior to oFluc for brain imaging, because its substrate, AkaLumine-HCl, was distributed to the brain more efficiently than the oFluc substrate, D-luciferin. We also demonstrated that the lights produced by oFluc and Akaluc were sufficiently spectrally distinct from each other for dual-color imaging in a single living mouse. Taken together, these novel bioluminescent reporter mice are an ideal source of cells with bright bioluminescence and may facilitate in vivo BLI of various tissues/organs for preclinical and biomedical research in combination with a wide variety of Cre-driver mice.
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Affiliation(s)
- Toshiaki Nakashiba
- Experimental Animal Division, RIKEN BioResource Research Center, Tsukuba, Japan.
| | - Katsunori Ogoh
- Corporate Research and Development Center, Olympus Corporation, Hachioji, Japan
| | - Satoshi Iwano
- Laboratory for Cell Function and Dynamics, RIKEN Center for Brain Science, Wako, Japan
- Institute for Tenure Track Promotion, University of Miyazaki, Miyazaki, Japan
| | - Takashi Sugiyama
- Corporate Research and Development Center, Olympus Corporation, Hachioji, Japan
- R&D Division, Evident Corporation, Hachioji, Japan
| | - Saori Mizuno-Iijima
- Experimental Animal Division, RIKEN BioResource Research Center, Tsukuba, Japan
| | - Kenichi Nakashima
- Gene Engineering Division, RIKEN BioResource Research Center, Tsukuba, Japan
| | - Seiya Mizuno
- Laboratory Animal Resource Center in Transborder Medical Research Center, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Fumihiro Sugiyama
- Laboratory Animal Resource Center in Transborder Medical Research Center, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Atsushi Yoshiki
- Experimental Animal Division, RIKEN BioResource Research Center, Tsukuba, Japan
| | - Atsushi Miyawaki
- Laboratory for Cell Function and Dynamics, RIKEN Center for Brain Science, Wako, Japan
| | - Kuniya Abe
- Technology and Development Team for Mammalian Genome Dynamics, RIKEN BioResource Research Center, Tsukuba, Japan
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Kubo A, Matsubara K, Matsubara Y, Nakaoka H, Sugiyama T. The Influence of Nicotine on Trophoblast-Derived Exosomes in a Mouse Model of Pathogenic Preeclampsia. Int J Mol Sci 2023; 24:11126. [PMID: 37446304 DOI: 10.3390/ijms241311126] [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: 05/22/2023] [Revised: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
Preeclampsia (PE) is a serious complication of pregnancy with a pathogenesis that is not fully understood, though it involves the impaired invasion of extravillous trophoblasts (EVTs) into the decidual layer during implantation. Because the risk of PE is actually decreased by cigarette smoking, we considered the possibility that nicotine, a critical component of tobacco smoke, might protect against PE by modifying the content of exosomes from EVTs. We investigated the effects of nicotine on our PE model mouse and evaluated blood pressure. Next, exosomes were extracted from nicotine-treated extravillous trophoblasts (HTR-8/SVneo), and the peptide samples were evaluated by DIA (Data Independent Acquisition) proteomic analysis following nano LC-MS/MS. Hub proteins were identified using bioinformatic analysis. We found that nicotine significantly reduced blood pressure in a PE mouse model. Furthermore, we identified many proteins whose abundance in exosomes was modified by nicotine treatment of EVTs, and we used bioinformatic annotation and network analysis to select five key hub proteins with potential roles in the pathogenesis or prevention of PE. EVT-derived exosomes might influence the pathogenesis of PE because the cargo delivered by exosomes can signal to and modify the receiving cells and their environment.
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Affiliation(s)
- Ayane Kubo
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Ehime, Japan
| | - Keiichi Matsubara
- Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Ehime, Japan
| | - Yuko Matsubara
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Ehime, Japan
| | - Hirotomo Nakaoka
- Advanced Research Support Center, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Ehime, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Ehime, Japan
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12
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Komine-Aizawa S, Yamada N, Haruyama Y, Deguchi M, Fukuda M, Kawana K, Kobashi G, Miyagi E, Yamada H, Sugiyama T, Hayakawa S. The Factors Influencing Pregnant Women's Selection of Media Sources to Obtain Information on COVID-19 in Japan in 2021. Vaccines (Basel) 2023; 11:vaccines11040805. [PMID: 37112717 PMCID: PMC10143418 DOI: 10.3390/vaccines11040805] [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: 02/14/2023] [Revised: 03/30/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Pregnant women presumably gather information about the coronavirus disease 2019 (COVID-19) from various sources. However, it is difficult for pregnant women who are not medical professionals to source the appropriate information because of the infodemic related to the COVID-19 pandemic. Therefore, the objective of our study was to investigate how pregnant women gathered information about COVID-19 and COVID-19 vaccination. To address this issue, we conducted an online questionnaire survey between 5 October and 22 November 2021, which was approved by the Ethics Committee of Nihon University School of Medicine. We received 4962 responses after excluding 1179 insufficient answers. Our study found that age, occupation, and infection-risk anxiety influenced the selection of media for obtaining information. Pregnant women who were older, medical professionals, public servants, or educators tended to rely on specialized medical websites, whereas housewives tended to use mass media, social media, and sources with uncertain scientific evidence. Additionally, the number of weeks of gestation and the method of conception (natural or assisted reproductive conception) affected the selection of media. The accessibility of COVID-19 information for pregnant women was determined by their social background and pregnancy status. We need to continue making efforts to ensure that appropriate information is readily available to pregnant women and their families.
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Affiliation(s)
- Shihoko Komine-Aizawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Naotake Yamada
- Institute of Journalism and Media, Nihon University, Tokyo 101-8375, Japan
| | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Masashi Deguchi
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Mitsuru Fukuda
- College of Risk Management, Nihon University, Tokyo 154-8513, Japan
| | - Kei Kawana
- Division of Obstetrics and Gynecology, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama 236-0004, Japan
| | - Hideto Yamada
- Center for Recurrent Pregnancy Loss, Teine Keijinkai Hospital, Sapporo 006-8555, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
| | - Satoshi Hayakawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo 173-8610, Japan
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13
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Mukai Y, Kudo Y, Sugiyama T, Kato K. Measures for pregnant women with coronavirus disease 2019 at the National University Hospital: 34th National University Perinatal Medical Center Conference. J Obstet Gynaecol Res 2023. [PMID: 37016489 DOI: 10.1111/jog.15650] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/22/2023] [Indexed: 04/06/2023]
Abstract
As 2 years have passed since the outbreak of coronavirus disease 2019 (COVID-19), we had an examination of the measures taken at the perinatal medical and child centers during this period at 42 National University Hospital. The first questionnaire survey was conducted during March 17-25, 2022 and the second questionnaire survey was conducted during April 4-30, 2022. For the treatment of pregnant women with COVID-19, a public health center-coordinated triage system had been created and implemented in each region and prefecture. The issues related to the hospital management of pregnant women with COVID-19 include the hindrances to the normal functioning of the center, the limited number of hospital beds and medical care systems as the beds were dedicated to patients with COVID-19, and the problems associated with the mode of delivery. There were no set rules regarding the management of mothers and babies at delivery and thereafter. Initially, cesarean delivery was allowed in almost all cases to reduce the risk of exposure to medical staff. Furthermore, many institutions did not permit expressed breast milk feeding and direct breastfeeding during the quarantine period. The COVID-19 pandemic has been created a shortage of healthcare delivery systems. It is expected that the emergence of new infectious diseases and pandemics will cause the same pressure on systems providing healthcare in the future.
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Affiliation(s)
- Yurika Mukai
- Department of Obstetrics and Gynecology, Hiroshima University, Hiroshima, Japan
| | - Yoshiki Kudo
- Department of Obstetrics and Gynecology, Hiroshima University, Hiroshima, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University, Matsuyama, Ehime, Japan
| | - Kiyoko Kato
- Department of Obstetrics and Gynecology, Kyushu University, Fukuoka, Japan
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Kawasaki M, Arata N, Sugiyama T, Moriya T, Itakura A, Yasuhi I, Uchigata Y, Kawasaki E, Sone H, Hiramatsu Y. Risk of fetal undergrowth in the management of gestational diabetes mellitus in Japan. J Diabetes Investig 2023; 14:614-622. [PMID: 36734310 PMCID: PMC10034960 DOI: 10.1111/jdi.13977] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 12/07/2022] [Accepted: 01/08/2023] [Indexed: 02/04/2023] Open
Abstract
AIMS/INTRODUCTION In Japan, the increasing frequency of underweight among women of reproductive age and the accompanying increase in the rate of low birth weight (LBW) are social issues. The study aimed to establish a prospective registry system for gestational diabetes mellitus (GDM) in Japan and to clarify the actual status of GDM according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. MATERIALS AND METHODS Pregnant women with gestational diabetes mellitus and those in the normal glucose tolerance (NGT) group were enrolled in the Diabetes and Pregnancy Outcome for Mother and Baby study from October 2015. Pregnant women with positive glucose screening in early and mid-to-late pregnancy underwent a 75 g oral glucose tolerance test by gestational week 32. Gestational diabetes mellitus was diagnosed according to IADPSG criteria. Women with a positive glucose screening test at mid-to-late pregnancy but NGT were enrolled as references (NGT group). Treatment for gestational diabetes mellitus and maternal and neonatal pregnancy data were prospectively collected on outcomes. RESULTS In total 1,795 singleton pregnancies (878 women with GDM and 824 NGT women) were analyzed. The risk of LBW and small-for-gestational age in the GDM group was significantly higher than in the NGT group. A similar relationship was found for LBW risk in the non-overweight/obese group but not in the overweight/obese group. CONCLUSIONS We established a prospective GDM registry system in Japan. In the management of GDM in Japan, suppression of maternal weight gain may be associated with reduced fetal growth, especially in non-overweight/obese women with GDM; however, further investigation is required.
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Affiliation(s)
- Maki Kawasaki
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Naoko Arata
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Tatsumi Moriya
- Health Care Center, Kitasato University, Sagamihara, Japan
| | - Atsuo Itakura
- Department of Obstetrics and Gynecology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Ichiro Yasuhi
- Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Yasuko Uchigata
- Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Eiji Kawasaki
- Department of Diabetes and Endocrinology, Shin-Koga Hospital, Kurume, Fukuoka, Japan
| | - Hirohito Sone
- Department of Hematology, Endocrinology, and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan
| | - Yuji Hiramatsu
- Okayama City General Medical Center, Okayama City, Japan
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Kato H, Saeki N, Imai M, Onji H, Yano A, Yoshida S, Sakaue T, Fujioka T, Sugiyama T, Imai Y. LIM1 contributes to the malignant potential of endometrial cancer. Front Oncol 2023; 13:1082441. [PMID: 36969081 PMCID: PMC10036843 DOI: 10.3389/fonc.2023.1082441] [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: 10/28/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
IntroductionThe incidence of endometrial cancer (EC) has been increasing worldwide. However, because there are limited chemotherapeutic options for the treatment of EC, the prognosis of advanced-stage EC is poor.MethodsGene expression profile datasets for EC cases registered in The Cancer Genome Atlas (TCGA) was reanalyzed. Highly expressed genes in advanced-stage EC (110 cases) compared with early-stage EC (255 cases) were extracted and Gene Ontology (GO) enrichment analysis was performed. Among the enriched genes, Kaplan-Meier (KM) plotter analysis was performed. Candidate genes expression was analyzed in HEC50B cells and Ishikawa cells by RT-qPCR. In HEC50B cells, LIM homeobox1 (LIM1) was knocked down (KD) and cell proliferation, migration, and invasion ability of the cells were evaluated. Xenografts were generated using LIM1-KD cells and tumor growth was evaluated. Ingenuity Pathway Analysis (IPA) of RNA-seq data using LIM-KD cells was performed. Expression of phospho-CREB and CREB-related proteins were evaluated in LIM1-KD cells by western blotting and in xenograft tissue by immunofluorescent staining. Two different CREB inhibitors were treated in HEC50B and cell proliferation was evaluated by MTT assay.ResultsReanalysis of TCGA followed by GO enrichment analysis revealed that homeobox genes were highly expressed in advanced-stage EC. Among the identified genes, KM plotter analysis showed that high LIM1 expression was associated with a significantly poorer prognosis in EC. Additionally, LIM1 expression was significantly higher in high-grade EC cell lines, HEC50B cells than Ishikawa cells. Knockdown of LIM1 showed reduced cell proliferation, migration and invasion in HEC50B cells. Xenograft experiments revealed that tumor growth was significantly suppressed in LIM1-KD cells. IPA of RNA-seq data using LIM-KD cells predicted that the mRNA expression of CREB signaling-related genes was suppressed. Indeed, phosphorylation of CREB was decreased in LIM1-KD cells and LIM1-KD cells derived tumors. HEC50B cells treated by CREB inhibitors showed suppression of cell proliferation.Conclusion and discussionCollectively, these results suggested that high LIM1 expression contributed to tumor growth via CREB signaling in EC. Inhibition of LIM1 or its downstream molecules would be new therapeutic strategies for EC.
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Affiliation(s)
- Hiroaki Kato
- Department of Obstetrics & Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Noritaka Saeki
- Division of Medical Research Support, Advanced Research Support Center, Ehime University, Toon, Ehime, Japan
- Division of Integrative Pathophysiology, Proteo-Science Center, Ehime University, Toon, Ehime, Japan
| | - Matome Imai
- Department of Obstetrics & Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Hiroshi Onji
- Department of Obstetrics & Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Akiko Yano
- Department of Obstetrics & Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Shuhei Yoshida
- Department of Pathophysiology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Tomohisa Sakaue
- Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
- Division of Cell Growth and Tumor Regulation, Proteo-Science Center, Toon, Ehime, Japan
| | - Toru Fujioka
- Department of Obstetrics & Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Takashi Sugiyama
- Department of Obstetrics & Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Yuuki Imai
- Division of Integrative Pathophysiology, Proteo-Science Center, Ehime University, Toon, Ehime, Japan
- Department of Pathophysiology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
- *Correspondence: Yuuki Imai,
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Shimozawa Y, Kurihara T, Kusagawa Y, Hori M, Numasawa S, Sugiyama T, Tanaka T, Suga T, Terada RS, Isaka T, Terada M. Point Prevalence of the Biomechanical Dimension of Dysfunctional Breathing Patterns Among Competitive Athletes. J Strength Cond Res 2023; 37:270-276. [PMID: 35612946 DOI: 10.1519/jsc.0000000000004253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/28/2023]
Abstract
ABSTRACT Shimozawa, Y, Kurihara, T, Kusagawa, Y, Hori, M, Numasawa, S, Sugiyama, T, Tanaka, T, Suga, T, Terada, RS, Isaka, T, and Terada, M. Point prevalence of the biomechanical dimension of dysfunctional breathing patterns among competitive athletes. J Strength Cond Res 37(2): 270-276, 2023-There is growing evidence of associations between altered biomechanical breathing patterns and numerous musculoskeletal and psychological conditions. The prevalence of dysfunctional and diaphragmatic breathing patterns is unknown among athletic populations. The purpose of this study was to examine the prevalence of dysfunctional and diaphragmatic breathing patterns among athletic populations with a clinical measure to assess the biomechanical dimension of breathing patterns. Using a cross-sectional design, 1,933 athletes across multiple sports and ages were screened from 2017 to 2020. Breathing patterns were assessed using the Hi-Lo test in the standing position. Scores of the Hi-Lo test were determined based on the presence or absence of abdominal excursion, anterior-posterior chest expansion, superior rib cage migration, and shoulder elevation. The Hi-Lo test scores were used to categorize observational breathing mechanics as dysfunctional and diaphragmatic breathing patterns. The prevalence of athletes with dysfunctional breathing patterns was 90.6% (1,751 of 1,933). Athletes with diaphragmatic breathing patterns accounted for 9.4% of all athletes in our sample (182 of 1,933). There were no differences in the proportion of breathing patterns between male and female athletes ( p = 0.424). Breathing patterns observations were associated with sport-setting categories ( p = 0.002). The highest percentages of dysfunctional breathers were in middle school student athletes (93.7%), followed by elementary school student athletes (91.2%), high school student athletes (90.6%), professional/semiprofessional athletes (87.5%), and collegiate athletes (84.8%). The current study observed that dysfunctional breathing patterns (90.6%) in the biomechanical dimension were more prevalent than diaphragmatic breathing pattern (9.4%) among competitive athletes. These results suggest that clinicians may need to consider screening breathing patterns and implementing intervention programs aimed to improve the efficiency of biomechanical dimensions of breathing patterns in athletic populations. This study may help raise awareness of impacts of dysfunctional breathing patterns on athletes' health and performance.
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Affiliation(s)
- Yuka Shimozawa
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Toshiyuki Kurihara
- Research Organization of Science and Technology, Ritsumeikan University, Shiga, Japan
| | - Yuki Kusagawa
- Graduate School of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Miyuki Hori
- Graduate School of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Shun Numasawa
- Medical Science Committee of Osaka Basketball Association, Osaka, Japan ; and
| | - Takashi Sugiyama
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Takahiro Tanaka
- Graduate School of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Tadashi Suga
- Research Organization of Science and Technology, Ritsumeikan University, Shiga, Japan
| | | | - Tadao Isaka
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, Shiga, Japan
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17
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Ono D, Wang H, Hung CJ, Wang HT, Kon N, Yamanaka A, Li Y, Sugiyama T. Network-driven intracellular cAMP coordinates circadian rhythm in the suprachiasmatic nucleus. Sci Adv 2023; 9:eabq7032. [PMID: 36598978 DOI: 10.1126/sciadv.abq7032] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
The mammalian central circadian clock, located in the suprachiasmatic nucleus (SCN), coordinates the timing of physiology and behavior to local time cues. In the SCN, second messengers, such as cAMP and Ca2+, are suggested to be involved in the input and/or output of the molecular circadian clock. However, the functional roles of second messengers and their dynamics in the SCN remain largely unclear. In the present study, we visualized the spatiotemporal patterns of circadian rhythms of second messengers and neurotransmitter release in the SCN. Here, we show that neuronal activity regulates the rhythmic release of vasoactive intestinal peptides from the SCN, which drives the circadian rhythms of intracellular cAMP in the SCN. Furthermore, optical manipulation of intracellular cAMP levels in the SCN shifts molecular and behavioral circadian rhythms. Together, our study demonstrates that intracellular cAMP is a key molecule in the organization of the SCN circadian neuronal network.
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Affiliation(s)
- Daisuke Ono
- Department of Neuroscience II, Research Institute of Environmental Medicine, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
- Department of Neural Regulation, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Huan Wang
- State Key Laboratory of Membrane Biology, Peking University School of Life Sciences, Beijing, China
| | - Chi Jung Hung
- Department of Neuroscience II, Research Institute of Environmental Medicine, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
- Department of Neural Regulation, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Hsin-Tzu Wang
- Institute of Transformative Bio-Molecules (WPI-ITbM), Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
- Laboratory of Animal Integrative Physiology, Graduate School of Bioagricultural Sciences, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
- Department of Biological Sciences, School of Science, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Naohiro Kon
- Institute of Transformative Bio-Molecules (WPI-ITbM), Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
- Laboratory of Animal Integrative Physiology, Graduate School of Bioagricultural Sciences, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan
| | - Akihiro Yamanaka
- Chinese Institute for Brain Research (CIBR), Beijing, 102206, China
| | - Yulong Li
- State Key Laboratory of Membrane Biology, Peking University School of Life Sciences, Beijing, China
| | - Takashi Sugiyama
- Advanced Optics and Biological Engineering, Evident Corporation, Tokyo, Japan
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18
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Yasuoka T, Iwama N, Ota K, Hasegawa J, Metoki H, Saito M, Sugiyama T, Suzuki N. Pregnancy outcomes among female childhood, adolescent, and young adult cancer survivors assessed using internet-based nationwide questionnaire surveys in Japan. J Matern Fetal Neonatal Med 2022; 35:10667-10675. [PMID: 36567113 DOI: 10.1080/14767058.2022.2155037] [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: 12/27/2022]
Abstract
OBJECTIVE Female cancer survivors planning to become pregnant are concerned about the impact of cancer treatment on their ability to maintain normal pregnancy and the negative impact on their offspring. However, studies on the pregnancy outcomes of cancer survivors in Japan are limited. Therefore, this study aimed to investigate the pregnancy outcomes of female cancer survivors by comparing them with women without a history of malignant tumors in Japan. METHODS This cross-sectional study included 3308 subjects, based on an internet-based questionnaire (self-reported) survey conducted in Japan. Differences in pregnancy outcomes, including multiple pregnancies, stillbirth, preterm birth (PTB), and infant birthweight, between cancer survivors and subjects without a history of malignant tumors, were evaluated using a generalized linear mixed-effects model with adjustment for possible confounding factors. RESULTS Of 3308 subjects included in this study, 629 (19.0%) were cancer survivors, among whom cervical (40.4%), breast (19.1%), and thyroid (7.0%) malignancies were most frequent. 71 (2.2%) and 53 (1.6%) participants had a history of multiple pregnancies and stillbirth, respectively; 385 (11.8%), 179 (5.5%), and 137 (4.2%) participants, respectively, had histories of PTB at less than 37, 34, and 32 weeks of gestation. Further, 302 (10.7%), 326 (11.6%), and 330 (11.7%) participants delivered to low birthweight (LBW), small-for-gestational-age (SGA), and large-for-gestational-age (LGA) infants, respectively. Subjects with a history of cervical or breast cancers had significantly higher odds of PTB at <37 weeks of gestation (adjusted odds ratios [ORs], 1.87 [95% CI: 1.25-2.81] and 2.61 [95% CI: 1.77-3.86], respectively), preterm LBW infants (adjusted ORs, 2.70 [95% CI: 1.39-5.24] and 2.76 [95% CI: 1.03-7.38], respectively), and LGA infants (1.98 [95% CI: 1.36-2.89] and 1.99 [95% CI: 1.14-3.49], respectively), compared to those without a history of a malignant tumor. Subjects with a history of thyroid cancer had significantly higher odds of stillbirth (adjusted OR, 5.11 [95% CI: 1.11-23.5]). CONCLUSION Cancer survivors had a higher risk of adverse pregnancy outcomes than those without a history of malignant tumors in Japan. Healthcare providers should consider the high likelihood of adverse pregnancy outcomes during preconception counseling for cancer survivors.
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Affiliation(s)
- Toshiaki Yasuoka
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kuniaki Ota
- Faculty of Medicine, Department of Obstetrics and Gynecology, Toho University, Tokyo, Japan
| | - Junichi Hasegawa
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, Miyagi, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan.,Department of Maternal and Fetal Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
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19
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Morikawa M, Sugiyama T, Hiramatsu Y, Sagawa N. Screening methods for gestational diabetes mellitus in Japan in 2018: a retrospective cohort study using a national surveillance questionnaire. Endocr J 2022; 69:1313-1322. [PMID: 35781264 DOI: 10.1507/endocrj.ej22-0072] [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
This study aimed to investigate the relationship between gestational diabetes mellitus (GDM) screening methods and GDM incidences. In 2018, a national questionnaire was administered at 231 institutions (56.6%) of all 408 perinatal medical centers in Japan. Of 100,485 women, 2,982 (3.0%) were diagnosed with GDM during their first pregnancy period (FPP) and 7,289 (7.3%) were diagnosed with GDM during their middle pregnancy period (MPP). The proportion of women diagnosed with GDM during FPP and MPP using 95 mg/dL as the cutoff value (CV) for random plasma glucose (PG) at FPP (4.3% and 9.2%) was significantly higher than that of women diagnosed with GDM using 100 mg/dL as the CV for random PG (2.7% and 6.9%, p < 0.0001, respectively). Compared with women screened for GDM using "random PG and random PG," women who were screened for GDM using "random PG and 50-g glucose challenge test (GCT)" had a significantly higher incidence of GDM (6.6% versus 8.9%, p < 0.0001). Using random PG and 50-g GCT, the incidence of GDM among women diagnosed at MPP using a CV of 95 mg/dL at FPP was significantly higher than that of women diagnosed using a CV of 100 mg/dL (16.5% versus 7.8%: p < 0.0001). While, using "random PG and random PG," the incidences of GDM among women were similar between institutions using a CV of 100 mg/dL and those using a CV of 95 mg/dL at FPP (6.7% versus 6.9%: p = 0.3581). This study showed random PG as a first-step screening method in MPP may overlook women with GDM.
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Affiliation(s)
- Mamoru Morikawa
- Department of Obstetrics and Gynecology, Kansai Medical University, Osaka, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Yuji Hiramatsu
- Department of Obstetrics and Gynecology, Okayama City Hospital, Okayama, Japan
| | - Norimasa Sagawa
- Department of Obstetrics and Gynecology, Rakuwakai Otowa Hospital, Kyoto, Japan
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20
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Eihara Y, Takao K, Sugiyama T, Maeo S, Terada M, Kanehisa H, Isaka T. Heavy Resistance Training Versus Plyometric Training for Improving Running Economy and Running Time Trial Performance: A Systematic Review and Meta-analysis. Sports Med Open 2022; 8:138. [PMID: 36370207 PMCID: PMC9653533 DOI: 10.1186/s40798-022-00511-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/21/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND As an adjunct to running training, heavy resistance and plyometric training have recently drawn attention as potential training modalities that improve running economy and running time trial performance. However, the comparative effectiveness is unknown. The present systematic review and meta-analysis aimed to determine if there are different effects of heavy resistance training versus plyometric training as an adjunct to running training on running economy and running time trial performance in long-distance runners. METHODS Electronic databases of PubMed, Web of Science, and SPORTDiscus were searched. Twenty-two studies completely satisfied the selection criteria. Data on running economy and running time trial performance were extracted for the meta-analysis. Subgroup analyses were performed with selected potential moderators. RESULTS The pooled effect size for running economy in heavy resistance training was greater (g = - 0.32 [95% confidence intervals [CIs] - 0.55 to - 0.10]: effect size = small) than that in plyometric training (g = -0.13 [95% CIs - 0.47 to 0.21]: trivial). The effect on running time trial performance was also larger in heavy resistance training (g = - 0.24 [95% CIs - 1.04 to - 0.55]: small) than that in plyometric training (g = - 0.17 [95% CIs - 0.27 to - 0.06]: trivial). Heavy resistance training with nearly maximal loads (≥ 90% of 1 repetition maximum [1RM], g = - 0.31 [95% CIs - 0.61 to - 0.02]: small) provided greater effects than those with lower loads (< 90% 1RM, g = - 0.17 [95% CIs - 1.05 to 0.70]: trivial). Greater effects were evident when training was performed for a longer period in both heavy resistance (10-14 weeks, g = - 0.45 [95% CIs - 0.83 to - 0.08]: small vs. 6-8 weeks, g = - 0.21 [95% CIs - 0.56 to 0.15]: small) and plyometric training (8-10 weeks, g = 0.26 [95% CIs - 0.67 to 0.15]: small vs. 4-6 weeks, g = - 0.06 [95% CIs 0.67 to 0.55]: trivial). CONCLUSIONS Heavy resistance training, especially with nearly maximal loads, may be superior to plyometric training in improving running economy and running time trial performance. In addition, running economy appears to be improved better when training is performed for a longer period in both heavy resistance and plyometric training.
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Affiliation(s)
- Yuuri Eihara
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan.
| | - Kenji Takao
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Takashi Sugiyama
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Sumiaki Maeo
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Masafumi Terada
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Hiroaki Kanehisa
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
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21
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Seegers LM, Araki M, Nakajima A, Yuki H, Yonetsu T, Soeda T, Kurihara O, Higuma T, Minami Y, Adriaenssens T, Nef H, Lee H, Sugiyama T, Kakuta T, Jang IK. Cardiovascular risk factors and underlying pathology and prevalence of lipid plaques in women with acute coronary syndromes in different age groups. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1199] [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: 11/14/2022] Open
Abstract
Abstract
Background
An incidence of cardiovascular events increases with age in women. The relationship between cardiovascular risk factors, and the underlying pathology and the prevalence of lipid plaques has not been systematically studied in different age groups in women presented with acute coronary syndromes (ACS).
Purpose
We investigated the underlying pathology and the prevalence of lipid plaques in culprit lesions by optical coherence tomography (OCT) in women with different risk factors.
Methods
A total of 382 women who underwent pre-intervention OCT imaging were included. The underlying pathology and the prevalence of lipid plaques in the culprit lesion was compared between women with and without cardiovascular risk factors (i.e. hypertension, smoking, hyperlipidemia, diabetes mellitus, family history and chronic kidney disease) in three different age groups (<60 yr, 60–70 yr, >70 yr).
Results
The relative prevalence of plaque erosion was higher in younger women (<60 yr) and decreased with age (from 51% to 28%, p<0.001). There was no significant difference in the prevalence of lipid plaques between women with and without risk factors, except a higher prevalence of lipid plaques in current smokers compared to non-smokers (79% vs. 63%, p=0.003). In women with hyperlipidemia, the prevalence of lipid plaques was modest in young ages (<60 yr), but increased steeply with age (p<0.001). The increasing age trend for lipid plaque was also observed in women with hypertension (p=0.03) and current smokers (p=0.01). In women with diabetes mellitus and family history, the prevalence of lipid plaques was high even in young ages (<60 yr) and did not increase with age.
Conclusion
The prevalence of plaque erosion was higher in younger women (<60 yr) and decreased with age. Current smokers had significantly higher prevalence of lipid plaque. Patients with diabetes and positive family history had a higher prevalence of lipid plaque at young age. The prevalence of lipid plaques increased with age particularly in women with hyperlipidemia and hypertension.
Funding Acknowledgement
Type of funding sources: Foundation.
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Affiliation(s)
- L M Seegers
- Mass General Hopital (MGH) , Boston , United States of America
| | - M Araki
- Mass General Hopital (MGH) , Boston , United States of America
| | - A Nakajima
- Mass General Hopital (MGH) , Boston , United States of America
| | - H Yuki
- Mass General Hopital (MGH) , Boston , United States of America
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Soeda
- Nara Medical University , Nara , Japan
| | - O Kurihara
- Nippon Medical School Chiba Hokusoh Hospital , Inzai , Japan
| | - T Higuma
- Toyoko Hospital, St. Marianna University School of Medicine , Kawasaki , Japan
| | - Y Minami
- Kitasato University School of Medicine , Kanagawa , Japan
| | | | - H Nef
- Justus-Liebig University of Giessen , Giessen , Germany
| | - H Lee
- Massachusetts General Hospital - Harvard Medical School, Biostatistics Center , Boston , United States of America
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - I K Jang
- Mass General Hopital (MGH) , Boston , United States of America
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22
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Hada M, Hoshino M, Sugiyama T, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. the diagnostic value of left-anterior-descending artery velocity assessed by transthoracic Doppler echocardiography for microvascular dysfunction in stenotic left-anterior-descending artery. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.167] [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
Index of microcirculatory resistance (IMR) has been used as a clinical measure of microvascular function. Transthoracic Doppler echocardiography (TDE) can provide information on the functional status of coronary artery circulation. This study aims to assess the diagnostic value of left-anterior-descending artery (LAD) flow velocity by TDE for microvascular dysfunction.
Methods
Consecutive patients who were scheduled for elective percutaneous coronary intervention (PCI) for LAD lesions were prospectively enrolled in the single tertiary-care center between April 2020 and July 2021. Pre-PCI LAD diastolic peak velocity (DPV) by TDE at rest and hyperemia were measured. By invasive coronary angiography, quantitative coronary angiography and invasive wire-based physiological indices including fractional flow reserve (FFR) and index of microcirculatory resistance (IMR) were measured.
Results
A total of 104 patients were studied. Median FFR and IMR values were 0.70 (0.60–0.74) and 20.68 (14.92–31.69), respectively. No significant relationship was observed between FFR and IMR. The prevalence of microvascular dysfunction defined as IMR≥25 was 39.4%. Basal DPV was 25 (20–33) cm/sec, and hyperemic DPV was 51 (41–67) cm/sec. In lesions with IMR≥25, reference diameter (RD) was significantly greater [2.63 (2.22–3.19) mm vs 2.39 (2.09–2.66) mm, p=0.019], basal DPV was lower [26 (18–29) cm/sec vs 29 (22–37) cm/sec, p=0.022)] and hyperemic DPV was lower [49 (19–54) cm/sec vs 56 (42–70) cm/sec, p=0.023] compared to lesions with IMR<25. ROC analysis showed basal DPV and RD are significant predictors of IMR≥25 [basal DPV: AUC 0.633 (0.525–0.742), best cutoff 29cm/sec RD: AUC 0.636 (0.523–0.750), best cutoff 2.84mm]. Multivariable logistic regression analysis showed basal DPV<29cm/sec and RD>2.84mm are independent predictors for IMR≥25 [Odds ratio: 3.08 (1.22–7.78), p=0.017; odds ratio 4.40 (1.55–12.50), p=0.005].
Conclusion
Basal DPV by non-invasive pre-PCI TDE and reference diameter can predict lesions with coexisting microvascular dysfunction in LAD territory with functionally significant lesions without the need of vasodilator-induced hyperemia and a wire-based invasive physiological measurement.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hada
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
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23
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Nogami K, Hoshino M, Kanaji Y, Sugiyama T, Misawa T, Hada M, Yamaguchi M, Nagamine T, Teng Y, Ueno H, Matsuda K, Sayama K, Kakuta T. Prognostic implications of unrecognized myocardial infarction before elective percutaneous coronary intervention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.292] [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
A non-negligible proportion of myocardial infarction (MI) is not clinically recognized and unrecognized myocardial infarction (UMI) is associated with adverse outcomes.
Purpose
To determine the prevalence and prognostic significance of UMI by delayed-enhancement cardiac magnetic resonance (DE-CMR) before elective percutaneous coronary intervention (PCI).
Methods
In this prospective, single-center study, 236 patients with stable coronary artery disease undergoing elective and uncomplicated PCI were studied. All patients underwent DE-CMR before PCI. The prevalence of UMI was evaluated and the association of clinical and CMR-derived variables with primary MACE, defined as cardiovascular death, nonfatal MI, hospitalization for heart failure, unplanned late revascularization, and ischemic stroke was investigated.
Results
In the final analysis of 213 patients, 63 patients (29.6%) showed UMI. Target territory UMI was observed in 38 (17.8% of total, 60.3% of patients with UMI). UMI was significantly associated with sex, diabetes mellitus, left ventricular ejection fraction, SYNTAX score and fractional flow reserve in target vessels. During follow-up periods (median, 23 months), MACE was observed in 17 (27.0%) of patients with UMI, and 17 (11.3%) without (P=0.001). In a multivariable model, UMI (hazard ratio [HR] 2.18, 95% confidential interval, 1.10–4.33, P=0.001) remained as an independent predictor of MACE. Kaplan–Meier analysis indicated that the presence of UMI was significantly associated with higher incidence of MACE.
Conclusions
The prevalence of UMI in patients undergoing elective PCI was 29.6%. UMI was independently associated with an increased risk of MACE after successful PCI. Given the non-negligible prevalence and potential clinical significance of UMI, clinical studies comparing PCI and guideline directed medical therapy (GDMT) versus GDMT only strategy might have to take the presence of UMI into consideration.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Teng
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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24
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Sayama K, Hoshino M, Kanaji Y, Sugiyama T, Misawa T, Hada M, Nagamine T, Nogami K, Teng Y, Ueno H, Matsuda K, Yonetsu T, Kakuta T. Prognostic implication of unrecognized myocardial infarction in patients with non-ST-segment-elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.287] [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: 11/12/2022] Open
Abstract
Abstract
Background
Prognostic value of unrecognized non-infarct-related territory (non-IR) myocardial infarction (UMI) in patients with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) remains to be elucidated.
Purpose
This study sought to evaluate the prevalence of non-IR UMI and its prognostic value in patients with first NSTE-ACS presentation.
Methods
This retrospective single-center analysis was conducted in patients with NSTE-ACS without prior history of coronary artery disease, who underwent uncomplicated urgent percutaneous coronary intervention (PCI) within 48 hours of admission between August 2014 and January 2018. All patients underwent postprocedural cardiac magnetic resonance imaging (CMR) within 30 days after PCI. Non-IR UMI was defined as the presence of non-IR delayed gadolinium enhancement with an ischemic distribution pattern. We investigated the association of non-IR UMI, other CMR findings and baseline clinical characteristics with major adverse cardiac events (MACE), defined as all-cause death, non-fatal myocardial infarction, ischemic stroke, late revascularization and hospitalization for congestive heart failure.
Results
A total of 168 NSTE-ACS patients were included (124 males (73.8%); 66±11 years). Non-IR UMI was detected in 28 patients (16.7%). During a median follow-up of 32 months (15–58), MACE occurred in 10 (35.7%) patients with non-IR UMI, and 20 (14.3%) patients without (P=0.013). Patients with MACE showed higher frequency of non-IR UMI in RCA territory and multi vessel disease, higher level of NT-proBNP at admission, higher Genisini score, and greater extent of UMI. Cox's proportional hazards analysis showed that the presence of non-IR UMI was an independent predictor of MACE (HR 2.34, 95% CI 1.02–5.37, P=0.045), after adjusting confounding factors, such as multi vessel disease and serum levels of NT-proBNP at admission. The discriminant efficacy (IDI and NRI) of predicting MACE was significantly improved when the presence of non-IR UMI added to the reference clinical risk model. Kaplan-Meier analysis revealed that patients with non-IR UMI were significantly associated with poor prognosis. (Figure 1).
Conclusions
In patients with NSTE-ACS undergoing urgent PCI, the prevalence of non-IR UMI was 16.7%. Non-IR UMI provided prognostic information independent of conventional risk factors.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Teng
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Division of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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25
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Nagamine T, Hoshino M, Matsuda K, Misawa T, Sugiyama T, Sasano T, Sayama S, Ueno H, Hada M, Yonetsu T, Kakuta T. Identification of coronary plaque rupture or erosion by preprocedural computed tomography angiography in patients with non-st-segment elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1182] [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
The frequent pathological cause of acute coronary thrombosis is plaque rupture or erosion. A previous CT angiographic study failed to discriminate OCT-defined intact fibrous cap culprit lesions (IFC lesions) from those with ruptured fibrous cap (RFC group) in patients with acute coronary syndrome (ACS) and chronic coronary syndrome.
Objectives
This study aimed to evaluate the diagnostic efficacy of preprocedural coronary CT imaging to identify optical coherence tomography (OCT)-defined plaque rupture or erosion at culprit lesions in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).
Methods
Consecutive patients with suspected NSTE-ACS who underwent preprocedural non-contrast CT and CT angiography (CCTA) were studied. Patients with at least one lesion with more than 50% stenosis at the proximal segment on CCTA were subsequently assessed by invasive coronary angiography and OCT. ALL CT and OCT examination were performed within 24 hours from presentation. The diagnosis of intact fibrous cap or ruptured fibrous cap was made by OCT for the angiographically most severely stenosed lesion. Cases of ambiguous OCT diagnosis such as massive thrombosis or calcified nodule precluding the fibrous cap assessment were excluded from the final analysis.
Results
In the final analysis of 176 patients, OCT identified 87 RFC plaques and 89 IFC plaques for the culprit lesions, respectively. In IFC group, lower prevalence of diabetes mellitus (24.7% vs. 41.4%, P=0.025) and lower peak cardiac marker elevation (CPK, 159 vs. 272 U/L, P<0.001) were observed. On CT, the prevalence of low attenuation plaque, positive remodeling, napkin ring sign, spotty calcification, calcium score (CAC), and culprit vessel pericoronary adipose tissue attenuation (FAI) were all significantly low in IFC group. Multivariate regression analysis to predict IFC at culprit lesions revealed that the absence of low attenuation plaque, the absence of napkin ring sign, zero CAC, and low FAI were independent predictors of IFC. When stratified by the number of these 4 CT factors, the presence of IFC were stratified as 0%, 23.6%, 50%, 77.8%, and 100% (P<0.001), respectively. Adding non-contrast CT factor of zero CAC to the reference model including age, sex, DM, EF, low attenuation plaque, napkin ring sign, and FAI, can increase the incremental discriminatory and reclassification performance for the prediction of IFC (C-statistic 0.828 NRI: 0.37, 95% CI: 0.095–0.646, P=0.008 and IDI: 0.042, 95% CI: 0.012–0.071, P=0.005).
Conclusions
Preprocedural comprehensive CT imaging including CAC and pericoronary adipose tissue inflammation could identify IFC or RFC culprit lesions defined by OCT. Further studies are needed to confirm our preliminary results and if CT imaging in NSTE-ACS provides prognostic information or specific therapeutic approach such as conservative therapy or non-stenting strategy before invasive angiography.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - S Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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26
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Hada M, Hoshino M, Sugiyama T, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Diagnostic value of computed tomography myocardial perfusion to detect coexisting microvascular dysfunction in patients with obstructive epicardial coronary disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.217] [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
The usefulness of computed tomography myocardial perfusion (CTP) to assess hemodynamically significant epicardial coronary artery lesions has been previously reported. However, the diagnostic value of quantitative evaluation of absolute coronary flow by CTP to detect microvascular dysfunction remains unknown.
Purpose
The aim of study is to assess the diagnostic value of CTP to evaluate coronary microvascular dysfunction (CMD) in patients with significant epicardial coronary stenosis, and to analyze the predicting factors for lesions with CMD.
Methods
Sixty-eight chronic coronary syndrome patients with de novo single functionally significant stenosis (Fractional flow reserve [FFR] <0.80) were investigated. CMD was defined by the index of microcirculatory resistance (IMR) ≥25. Clinical characteristics and CTP findings were compared between the two groups with and without CMD (CMD, n=29, non-CMD, n=39, respectively). The computed tomography angiography (CCTA) assessment included CTP findings and quantitative and qualitative assessment of plaques.
Results
In wire-based analysis, FFR, coronary flow reserve (CFRwire) and IMR were 0.68 (0.59–0.74), 1.71 (1.24–2.88), and 22.6 (15.1–34.5), respectively.
In CTP analysis, culprit territory regional absolute myocardial blood flow (MBF) at rest (rest-MBF) and hyperemia (hyperemic-MBF) were evaluated semi-automatically. CTP-derived CFR (CFRCTP) was calculated as hyperemic-MBF divided by rest-MBF. Rest and hyperemic-MBF and CFRCTP were 0.83 (0.64–1.03) ml/min/g, 2.14 (1.30–2.92) ml/min/g, and 2.19 (1.44–3.37).
In the lesions with CMD, hyperemic-MBF was significantly lower than those without CMD (1.68 [0.84–2.44] vs 2.31 [1.67–3.34] ml/min/g, p=0.015) and the prevalence of CFRCTP<2.0 was higher in the lesions with CMD than those without CMD (62.1% vs 28.2%, p=0.007).
CCTA analysis showed that fibrofatty and necrotic core component (FFNC) volume was greater in the lesions with CMD than in the lesions without CMD (31.8 [19.0–48.9] vs 25.1 [17.2–32.1] mm3, p=0.045). The multivariable logistic regression analysis, hyperemic-MBF and FFNC volume were independent predictors for lesions with CMD (Odds ratio [OR] 0.583 [0.355–0.958], p=0.033 and OR 1.040 [1.010–1.070], p=0.018).
Conclusion
Quantitative assessment of absolute coronary flow by CTP and comprehensive plaque analysis by CCTA may help detect coexisting subtended microvascular dysfunction in patients with functionally significant epicardial coronary lesions. Further studies are needed to elucidate the clinical significance of coexisting CMD in CCS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hada
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
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27
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Hoshino M, Sugiyama T, Kanaji Y, Hada M, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Multimodality coronary imaging to predict non-culprit territory unrecognized myocardial infarction assessed by cardiac magnetic resonance in non-ST-elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.349] [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
Objectives
This study sought to assess the predictors of coherence tomography (OCT) and coronary computed tomography angiographic (CCTA) findings for non-infarct-related (non-IR) territory unrecognized myocardial infarction (UMI) in patients with first non-ST-elevation acute coronary syndrome (NSTE-ACS) presentation.
Background
UMI detected by cardiac magnetic resonance (CMR) is associated with adverse outcomes in patients with both acute coronary syndrome and chronic coronary syndrome. However, the association between the presence of UMI and findings of multimodality coronary imaging remains unknown.
Methods
We investigated 69 patients with a first clinical episode of NSTE-ACS, who underwent pre-PCI 320-slice CCTA, uncomplicated urgent percutaneous coronary intervention (PCI) with OCT assessment within 48 hours of admission, and post-PCI CMR. UMI was assessed on late gadolinium enhancement (LGE-CMR) by identifying regions of hyperenhancement with an ischemic distribution pattern in non-IR territories (non-IR UMI).
Results
Non-IR UMI was detected in 11 patients (15.9%). ROC analysis revealed the optimal cut-off value of PCATA in culprit vessel for predicting the presence of non-IR UMI were −71.3. Lower ejection fraction, higher Gensini score, high pericoronary inflammation (>−71.3), OCT-defined culprit lesion plaque rupture (OCT-PR), and OCT-defined culprit lesion cholesterol crystal (OCT-CC) were significantly associated with the presence of non-IR UMI (Figure 1A). OCT findings are shown in Figure 1B. Patients with non-IR UMI had a higher prevalence of OCT-PR and OCT-CC than those without. Compared with patients without non-IR UMI, the prevalence of high pericoronary inflammation was higher in patients with non-IR UMI (Figure 1C). When the total cohort was divided into four groups according to the numbers of aforementioned OCT-derived risk factors and PCATA, patients with all of these UMI risk factors showed 46.2% (6/13) prevalence of non-IR UMI, whereas none of 15 patients without these factors showed non-IR UMI (Figure 1D).
Conclusions
When culprit lesion showed OCT-PR, OCT-CC, and high PCATA, about half of these patients are likely to have non-IR UMI. The integrated CCTA and OCT assessment may help identify the presence of non-IR UMI, potentially providing prognostic information in first NSTE-ACS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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28
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Ueno H, Hoshino M, Sugiyama T, Kanaji Y, Hada M, Misawa T, Nagamine T, Nogami K, Sayama K, Matsuda K, Yonetsu T, Sasano T, Kakuta T. Prognostic implications of fractional flow reserve and coronary flow reserve after newer-generation drug-eluting stent implantation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1212] [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: 11/14/2022] Open
Abstract
Abstract
Background
FFR after percutaneous coronary intervention (PCI) has been reported to provide prognostic information. However, limited data are available regarding the prognostication by CFR in patients treated with elective PCI using newer generation DES.
Purpose
This study aimed to assess the prognostic value of post-procedural fractional flow reserve (FFR) and coronary flow reserve (CFR) after newer-generation drug-eluting stent implantation (DES).
Methods
A total of 466 stenoses in 466 patients underwent FFR-guided PCI. FFR and CFR measurements before and after PCI by a pressure-temperature sensor-tipped wire were performed. Follow-up data were studied to determine the predictors of target vessel failure (TVF), defined as death, target vessel-related nonfatal myocardial infarction, and unplanned clinically driven target vessel late revascularization. Prognostic value of post-PCI CFR was compared with that of FFR or FFR/CFR combination.
Results
After PCI completion, 13.7% showed post-PCI FFR ≤0.80 and 44.2% exhibited post-PCI CFR <2.5. Discordant results were observed in 42.5% (198/466). During 2.7 (1.8–3.3) years follow-up, 57 (12.2%) TVF were documented. The multivariable Cox proportional hazard regression analysis revealed that post-PCI FFR and post-PCI CFR were independent prognostic factors. ROC analysis revealed that the optimal cut-off values of post-PCI FFR and CFR values were 0.85 and 2.26, respectively. Significant differences in TVF were detected according to post-PCI FFR (≤0.85 vs >0.85: 17.8% vs 8.9%, P<0.05) and post-PCI CFR (≤2.26 vs >2.26: 20.5% vs 7.2%, P<0.01), although the reclassification ability for TVF was improved only with post-PCI CFR (net reclassification index 0.598; P<0.01; integrated discrimination index 0.038; P<0.01), but not with post-PCI FFR, in comparison with the clinical model. Compared with patients with FFR >0.85, those with post-PCI FFR ≤0.85 and CFR ≤2.26 showed significantly higher risk of TVF (8.9% vs 28.9%, P<0.01, HR 4.24, 95% CI 2.40–7.50, P<0.01), whereas those with post-PCI FFR <0.85 and CFR >2.26 had similar TVF risk (8.9% vs 9.2%, P=1.00, HR 1.01, 95% CI 0.47–2.16, P=0.97).
Conclusions
After PCI completion with newer-generation DES, discordant results between FFR and CFR were observed in 42.5%. Compared with post-PCI CFR, post-PCI FFR provided limited reclassification ability for TVF. Among patients with lower post-PCI FFR, only patients with lower post-PCI CFR showed significantly higher risk of TVF than those with higher post-PCI FFR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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29
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Travieso A, Mejia-Renteria H, Jeronimo-Baza A, Hyun Jung J, Doh JH, Nam CW, Shin ES, Hoshino M, Sugiyama T, Kanaji Y, Gonzalo N, Lee JM, Kakuta T, Koo BK, Escaned J. Hyperaemic and non-hyperaemic pressure indices of coronary stenosis severity in patients with chronic kidney disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1124] [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
Evidence regarding the use of pressure indices for the assessment of coronary stenoses in patients with chronic kidney disease (CKD) is scarce.
Methods
We assessed the relation between eGFR, FFR and resting Pd/Pa in 1147 consecutive patients (1316 vessels) included in the International Collaboration of Comprehensive Physiologic Assessment Study. We also compared FFR and Pd/Pa against a standardized cut-off of coronary flow reserve (CFR<2.0). Finally, we examined the occurrence of vessel-oriented composite outcome (VOCO: cardiac death, vessel-specific revascularization, vessel-specific myocardial infarction) across negative/positive results of both FFR and CFR in patients with and without CKD.
Results
FFR increases as renal function worsens (beta −10.5, 95% CI −20.0 to −11.03, p=0.030), a relation that was not seen with resting Pd/Pa (beta −6.14, 95% CI −19.9 to 6.78, p=0.351). Both indices had similar diagnostic accuracies for the detection of a CFR<2.0 in the presence of CKD (AUC 0.629 for FFR vs 0.663 for resting Pd/Pa, p=0.192). However, CKD patients showed a higher proportion of vessels with negative FFR but low CFR (24.5% vs 13.4%, p=0.015).
CFR decreased linearly with deteriorating eGFR, and this was mainly driven by higher resting coronary flow in CKD patients (p=0.026), while hyperaemic coronary flow remained similar (p=0.403). IMR did not change significantly with eGFR (beta −0.02, 95% −0.09 to 0.05, p=0.557).
The incidence of VOCO was higher in patients with CKD and FFR>0.80 when compared to non-CKD patients and FFR>0.80 (12.7% vs 6.90%, p=0.062). Prognosis was worse for those with CKD, negative FFR and CFR<2.0 (20.59% vs. 8.44% in non-CKD, p=0.038).
Conclusions
The assessment of a given coronary stenosis in patients with CKD with either FFR or resting Pd/Pa is equivalent when compared to underlying coronary flow. In CKD, impaired CFR is caused by a state of increased resting flow. The assessment of CFR on top of standard pressure wire examination significantly improves prognostic stratification in CKD patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Travieso
- San Carlos Clinical Hospital , Madrid , Spain
| | | | | | - J Hyun Jung
- Sejong General Hospital , Bucheon , Korea (Republic of)
| | - J H Doh
- Ilsan Paik Hospital , Ilsan , Korea (Republic of)
| | - C W Nam
- Dongsan Medical Center. Keimyung University , Daegu , Korea (Republic of)
| | - E S Shin
- Ulsan University Hospital , Ulsan , Korea (Republic of)
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Ibaraki , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Ibaraki , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Ibaraki , Japan
| | - N Gonzalo
- San Carlos Clinical Hospital , Madrid , Spain
| | - J M Lee
- Samsung Medical Center , Seoul , Korea (Republic of)
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Ibaraki , Japan
| | - B K Koo
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - J Escaned
- Seoul National University Hospital , Seoul , Korea (Republic of)
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30
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Hamaya R, Yonetsu T, Ueno H, Hoshino M, Sugiyama T, Sasano T, Kakuta T. Robust association between changes in coronary flow capacity following PCI and vessel-oriented outcomes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1122] [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: 11/12/2022] Open
Abstract
Abstract
Backgrounds
While trials show a comparative effectiveness of percutaneous coronary intervention (PCI) against medical therapy with respect to patient outcomes, deferring all elective PCI might be too simplistic, given the prognostic benefit differential according to several factors. Coronary flow capacity (CFC) is a potentially useful coronary flow (CF)-related physiologic marker of ischemia for guiding PCI indication [1,2]. However, the physiological/prognostic mechanics of the CFC guidance, which could be assessed by CFC changes following PCI, have not been investigated.
Objectives
To assess the determinants and prognostic implication of the change in the CFC status following PCI.
Methods
From a single center registry, 450 patients with chronic coronary syndrome (CCS) who underwent fractional flow reserve (FFR)-guided PCI with pre-/post-PCI coronary physiological assessments by thermodilution-method were included. CFC status was defined as follows [1]; normal CFC as CFR ≥2.80 with hyperemic CF (hCF) ≥3.70; mildly reduced CFC as CFR <2.80 and ≥2.10, combined with hCF <3.70 and ≥2.56; moderately reduced CFC as CFR <2.10 and ≥1.70, and 1/Tmn <2.56 and ≤2.00; and severely reduced CFC otherwise (CFR <1.70 and hCF <2.00). Associations between PCI-related changes in thermodilution method-derived CFC categories and incident target vessel failure (TVF) during a median follow-up of 4.3 (IQR: 2.5, 6.9) years were assessed by multivariate COX proportional hazard models.
Results
The mean (SD) age was 67.1 (10.0) years and there were 75 (16.7%) women. There were no differences in survival according to pre-PCI CFC status (P for linear trends = 0.22). Compared with patients showing no change in CFC categories after PCI, patients with category worsened, +1, +2, and +3 category improved had the hazard ratio (95% CI) for incident TVF of 2.27 (0.95, 5.43), 0.85 (0.33, 2.22), 0.45 (0.12, 1.63), and 0.14 (0.016, 1.30), respectively (P for linear trends = 0.0017). The relevant Kaplan-Meier curves were illustrated in the Figure, which highlights a best survival in those with +3 categories improvement (severely reduced to normal CFC) and worst in worsened CFC. After adjustment for confounders, one additional improvement in CFC status was associated with 0.61 (0.45, 0.83) times the hazard of TVF. CFC changes ≥3 categories were largely predicted by pre-PCI CFC with area under the curve of 0.94 (95% CI: 0.93, 0.96), and 48.6% of the variability of continuous CFC changes in ranks was explained solely by pre-PCI CFC, while only 12.4% by FFR.
Conclusion
CFC improvement following PCI, which was largely determined by the pre-PCI CFC status, was associated with lower risk of incident TVF in patients with CCS who underwent PCI. Therefore, CFC changes provide a mechanistic explanation on a potential favorable effect of PCI on reducing vessel-oriented outcome in lesions with reduced CFC and low FFR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Hamaya
- Harvard T. H. Chan School of Public Health , Boston , United States of America
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiology , Tokyo , Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, cardiology , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, cardiology , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, cardiology , Tsuchiura , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Cardiology , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, cardiology , Tsuchiura , Japan
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31
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Nagamine T, Masahiro H, Sayama K, Matsuda K, Ueno H, Misawa T, Hada M, Sugiyama T, Yonetsu T, Sasano T, Kakuta T. Prevalence and culprit lesion plaque characteristics on optical coherence tomography in patients with non-st-segment elevation acute coronary syndrome with zero coronary calcification on coronary CTA. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1183] [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
CAC evaluated by non-contrast computed tomography is a marker of atherosclerosis. However, the characteristic features of CCTA and optical coherence tomography (OCT) of culprit lesions in patients with NSTE-ACS showing zero CAC remain unknown.
Objectives
This study aimed to assess the prevalence and characteristic features of culprit lesions on coronary CT angiography (CCTA) and optical coherence tomography (OCT) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) showing zero coronary artery calcium (CAC).
Methods
A total of 176 consecutive patients with NSTE-ACS who underwent preprocedural CCTA and OCT were studied. Patients were divided into two groups according to their CAC (zero-CAC and non-zero-CAC groups). Baseline characteristics, CCTA and OCT findings were compared between these two groups.
Results
The prevalence of patients with zero-CACS was 15.9% (28/176). Patients in zero CAC group were younger (mean age, 55 vs. 65 years, P<0.001) and had a lower prevalence of diabetes (10.7 vs 37.2%, P=0.012) than non-zero CAC group. In zero CAC group, the lower prevalence of napkin ring sign (3.5% vs. 28.4%, P=0.028), smaller LV mass index (77.7 vs. 83.9, P=0.04), lower prevalence on spotty calcification (0 vs. 83.8%, P<0.001), lower epicardial fat volume (111.3 vs. 142.6 cm3, P=0.025), and lower pericoronary adipose tissue attenuation (−71.5 vs. −70.2 HU, P=0.07) on CCTA were observed. On OCT, the frequency of plaque erosion (82.1 vs. 44.6%, P<0.001) was significantly higher in zero-CACS group. The prevalence of lipid-rich plaque (46.4 vs. 86.5%, P<0.001), thin-cap fibroatheroma (17.9 vs. 46%, P=0.006), macrophage accumulation (46.4 vs. 81.8%, P<0.001) and cholesterol crystal (7 vs. 41.9%, P<0.001) were all significantly lower in zero-CAC group.
Conclusions
Zero CAC NSTE-ACS was not rare. Zero-CAC NSTE-ACS was characterized by specific phenotypes defined by the combined assessment of CCTA and OCT. Further studies are warranted if these characteristics of NSTE-ACS on preprocedural imaging studies provide prognostic information or guidance of a specific therapeutic approach.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Masahiro
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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Araki M, Sugiyama T, Nakajima A, Yonetsu T, Seegers LM, Dey D, Lee H, McNulty I, Yasui Y, Teng Y, Nagamine T, Kakuta T, Jang IK. Level of vascular inflammation is higher in acute coronary syndromes compared to chronic coronary disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1181] [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: 11/14/2022] Open
Abstract
Abstract
Background
Vascular inflammation has been recognized as one of the key factors in the pathogenesis of acute coronary syndromes (ACS). Peri-coronary adipose tissue (PCAT) attenuation by computed tomography angiography (CTA) has emerged as a marker specific for coronary artery inflammation. We examined the relationship between clinical presentation and coronary artery inflammation assessed by PCAT attenuation and coronary plaque characteristics.
Methods
Patients with ACS or stable angina pectoris (SAP) who underwent pre-intervention coronary CTA and optical coherence tomography (OCT) were enrolled. PCAT attenuation was measured around the culprit lesion and in the proximal 40 mm of all coronary arteries. PCAT attenuation and OCT findings were compared between patients with ACS versus SAP.
Results
Among 471 patients (ACS: 198, SAP: 273), PCAT attenuation was higher in ACS patients than in SAP patients both at the culprit plaque level (−67.5±9.6 Hounsfield unit [HU] vs. −71.5±11.0 HU, p<0.001) and the culprit vessel level (−68.3±7.7 HU vs. −71.1±7.9 HU, p<0.001). The mean PCAT attenuation of all 3 coronary arteries was also significantly higher in ACS patients than in SAP patients (−68.8±6.3 HU vs. −70.5±7.1 HU, p=0.007). After adjusting patient characteristics, not only thin-cap fibroatheroma (OR: 2.44; 95% CI: 1.63–3.65) and macrophages (OR: 2.07; 95% CI: 1.34–3.21) but also PCAT attenuation in the culprit plaque (OR: 1.04; 95% CI: 1.02–1.06) was associated with the clinical presentation of ACS.
Conclusions
PCAT attenuation at culprit plaque, culprit vessel, and pan-coronary levels was higher in ACS patients than in SAP patients. Vascular inflammation appears to play a crucial role in the development of ACS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Araki
- Massachusetts General Hospital , Boston , United States of America
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - A Nakajima
- Massachusetts General Hospital , Boston , United States of America
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - L M Seegers
- Massachusetts General Hospital , Boston , United States of America
| | - D Dey
- Cedars-Sinai Medical Center , Los Angeles , United States of America
| | - H Lee
- Massachusetts General Hospital , Boston , United States of America
| | - I McNulty
- Massachusetts General Hospital , Boston , United States of America
| | - Y Yasui
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Teng
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - I K Jang
- Massachusetts General Hospital , Boston , United States of America
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Sugiyama T, Kanaji Y, Hoshino M, Hada M, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Relationship between OCT-derived plaque characteristics, CTA-derived coronary inflammation, and CMR-derived global coronary flow reserve in patients with acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.346] [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: 11/12/2022] Open
Abstract
Abstract
Background
The presence of layered plaque is suggestive of recurrent thrombotic events. However, the impact of layered plaque detected by optical coherence tomography (OCT) on coronary inflammation and coronary flow reserve remains unclear.
Purpose
We aimed to investigate the association of OCT-derived layered plaque with pericoronary adipose tissue inflammation assessed by coronary computed tomography angiography (cCTA) and global coronary flow reserve (G-CFR) assessed by cardiac magnetic resonance imaging (CMR) in patients with acute coronary syndrome (ACS).
Methods
We investigated 88 patients with first ACS who underwent preprocedural cCTA and OCT imaging of the culprit lesion, and CMR after percutaneous coronary intervention (PCI). All patients were divided into four groups according to the OCT-derived culprit plaque characteristics: layered vs. non-layered plaque; and plaque rupture vs. plaque erosion. Coronary inflammation was assessed by the mean value of pericoronary adipose tissue (PCAT) attenuation (−190 to −30 HU) of the three major coronary vessels. G-CFR was obtained by quantifying absolute coronary sinus flow at rest and during maximum hyperemia. CCTA and CMR findings were compared between the groups.
Results
In a total of 88 patients, layered plaque [L] with plaque rupture [PR] was observed in 25 patients, layered plaque with plaque erosion [PE] was observed in 26 patients, non-layered plaque [NL] with PR was observed in 23 patients, and non-layered plaque with PE was observed in 14 patients, respectively. Three-vessel-PCAT attenuation value (L-PR vs. L-PE vs. NL-PR vs. NL-PE; −68.13±6.18 vs. −69.01±6.72 vs. −69.76±4.04 vs. −74.61±5.63 HU, P=0.009) and culprit vessel PCAT attenuation value (L-PR vs. L-PE vs. NL-PR vs. NL-PE; −66.39±7.38 vs. −68.94±8.06 vs. −70.01±5.76 vs. −75.45±6.60 HU, P=0.003) showed the graded difference between the four groups. G-CFR value also showed the graded difference between the four groups (L-PR vs. L-PE vs. NL-PR vs. NL-PE; 2.26 [1.80–2.87] vs. 2.24 [1.72–3.13] vs. 2.97 [2.24–3.83] vs. 3.18 [2.67–4.08], P=0.022).
Conclusions
The presence of layered plaque at the culprit lesion was associated with high PCATA and low G-CFR in patients with ACS. Detection of layered plaque may indicate increased pericoronary inflammation and impaired coronary flow reserve, potentially providing the risk stratification in patients with ACS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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34
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Kusagawa Y, Kurihara T, Maeo S, Sugiyama T, Kanehisa H, Isaka T. Associations of muscle volume of individual human plantar intrinsic foot muscles with morphological profiles of the foot. J Anat 2022; 241:1336-1343. [PMID: 36001459 PMCID: PMC9644943 DOI: 10.1111/joa.13753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/22/2022] [Revised: 07/21/2022] [Accepted: 08/11/2022] [Indexed: 01/17/2023] Open
Abstract
Human plantar intrinsic foot muscles consist of 10 muscles that originate and insert within the sole of the foot. It is known that the anatomical cross‐sectional area (ACSA) and muscle thickness of two plantar intrinsic foot muscles, the flexor hallucis brevis (FHB) and abductor hallucis (ABH), associate with morphological parameters of the foot, such as total and truncated foot length and navicular height. However, it is unclear how the size for each of the plantar intrinsic foot muscles associates with various morphological profiles of the foot. This study aimed to elucidate this subject. By using magnetic resonance imaging (MRI), serial images of the right foot were obtained in 13 young adult men without foot deformities. From the obtained MR images, ACSA for each of the individual plantar intrinsic foot muscles was analyzed along the foot length, and then its muscle volume (MV) was calculated. The analyzed muscles were the abductor digiti minimi (ABDM), ABH, adductor hallucis oblique head (ADDH‐OH), adductor hallucis transverse head (ADDH‐TH), flexor digitorum brevis (FDB), FHB, and quadratus plantae (QP). Furthermore, MV of the whole plantar intrinsic foot muscle (WHOLE) was defined as the total MVs of all the analyzed muscles. As morphological parameters, total foot length, truncated foot length, forefoot width, ball circumference, instep circumference, navicular height, great toe eversion angle, and little toe inversion angle were measured using a laser three‐dimensional foot scanner in standing and sitting conditions. In addition, navicular drop (ND) and normalized truncated navicular height (NTNH) were also calculated as medial longitudinal arch (MLA) height indices. The MV of WHOLE was significantly associated with the forefoot width, ball circumference, and instep circumference (r = 0.647–0.711, p = 0.006–0.013). Positive correlations were found between the forefoot width and MV of FHB, FDB, and QP (r = 0.564–0.653, p = 0.015–0.045), between the ball circumference and MV of QP (r = 0.559, p = 0.047), between the instep circumference and MV of FHB (r = 0.609, p = 0.027), and between the little toe inversion angle and MV of QP (r = 0.570, p = 0.042). The MVs of ABH, ABDM, and ADDH‐OH were not significantly correlated with any morphological parameters of the foot. Similarly, no significant correlations were found between MV of each muscle and either of the MLA height indices (ND and NTNH). Thus, the current results indicate that forefoot width and circumferential parameters (instep and ball circumference), not MLA height, associate with the size of the whole plantar intrinsic foot muscles, especially those specialized in toe flexion (FHB, FDB, and QP).
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Affiliation(s)
- Yuki Kusagawa
- Graduate School of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Toshiyuki Kurihara
- Faculty of Science and Engineering, Kokushikan University, Setagaya, Japan
| | - Sumiaki Maeo
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Takashi Sugiyama
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Hiroaki Kanehisa
- National Institute of Fitness and Sports in Kanoya, Kanoya, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
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Maeo S, Wu Y, Huang M, Sakurai H, Kusagawa Y, Sugiyama T, Kanehisa H, Isaka T. Triceps brachii hypertrophy is substantially greater after elbow extension training performed in the overhead versus neutral arm position. Eur J Sport Sci 2022:1-11. [PMID: 35819335 DOI: 10.1080/17461391.2022.2100279] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 11/03/2022]
Abstract
The biarticular triceps brachii long head (TBLong) is lengthened more in the overhead than neutral arm position. We compared triceps brachii hypertrophy after elbow extension training performed in the overhead vs. neutral arm position. Using a cable machine, 21 adults (14 males and 7 females, age: 23.4 ± 1.6 y, height: 1.69 ± 0.09 m, body mass: 64.5 ± 12.4 kg) conducted elbow extensions (90-0°) with one arm in the overhead (Overhead-Arm) and the other arm in the neutral (Neutral-Arm) position at 70% one-repetition maximum (1RM), 10 reps/set, 5 sets/session, 2 sessions/week for 12 weeks. Training load was gradually increased (+5% 1RM/session) when the preceding session was completed without repetition failure. 1RM of the assigned condition and MRI-measured muscle volume of the TBLong, monoarticular lateral and medial heads (TBLat+Med), and whole triceps brachii (Whole-TB) were assessed pre- and post-training. Training load and 1RM increased in both arms similarly (+62-71% at post, P = 0.285), while their absolute values/weights were always lower in Overhead-Arm (-34-39%, P < 0.001). Changes in muscle volume in Overhead-Arm compared to Neutral-Arm were 1.5-fold greater for the TBLong (+28.5% vs. +19.6%, Cohen's d = 1.272, P < 0.001), 1.4-fold greater for the TBLat+Med (+14.6% vs. +10.5%, d = 1.106, P = 0.002), and 1.4-fold greater for the Whole-TB (+19.9% vs. +13.9%, d = 1.427, P < 0.001). In conclusion, triceps brachii hypertrophy was substantially greater after elbow extension training performed in the overhead versus neutral arm position, even with lower absolute loads used during the training.
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Affiliation(s)
- Sumiaki Maeo
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Yuhang Wu
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Meng Huang
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Hikaru Sakurai
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Yuki Kusagawa
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Takashi Sugiyama
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Hiroaki Kanehisa
- National Institute of Fitness and Sports in Kanoya, Kanoya, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
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36
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Enomoto S, Yoshihara K, Kondo E, Iwata A, Tanaka M, Tabata T, Kudo Y, Kondoh E, Mandai M, Sugiyama T, Okamoto A, Saito T, Enomoto T, Ikeda T. Trends in Pregnancy-Associated Cervical Cancer in Japan between 2012 and 2017: A Multicenter Survey. Cancers (Basel) 2022; 14:cancers14133072. [PMID: 35804845 PMCID: PMC9264791 DOI: 10.3390/cancers14133072] [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: 05/17/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 02/04/2023] Open
Abstract
Large-scale data on maternal and neonatal outcomes of pregnancy-associated cervical cancer in Japan are scarce, and treatment strategies have not been established. This multicenter retrospective observational study investigated clinical features and trends in pregnancy-associated cervical cancer treatments at 523 hospitals in Japan. We included cervical cancer cases that were histologically diagnosed (between 1 January 2012, and 31 December 2017), and their clinical information was retrospectively collected. Of 40 patients diagnosed with pregnancy-associated cervical cancer at ≥22 gestational weeks, 34 (85.0%) were carefully followed until delivery without intervention. Of 163 diagnosed at <22 gestational weeks, 111 continued and 52 terminated their pregnancy. Ninety patients with stage IB1 disease had various treatment options, including termination of pregnancy. The 59 stage IB1 patients who continued their pregnancy were categorized by the primary treatment into strict follow-up, conization, trachelectomy, and neoadjuvant chemotherapy groups, with no significant differences in progression-free or overall survival. The birth weight percentile at delivery was smaller in the neoadjuvant chemotherapy group than in the strict follow-up group (p = 0.029). Full-term delivery rate was relatively higher in the trachelectomy group (35%) than in the other groups. Treatment decisions for pregnancy-associated cervical cancer are needed after estimating the stage, considering both maternal and fetal benefits.
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Affiliation(s)
- Sayako Enomoto
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu 514-8507, Japan; (S.E.); (T.I.)
| | - Kosuke Yoshihara
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan;
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu 514-8507, Japan; (S.E.); (T.I.)
- Correspondence: (E.K.); (T.E.); Tel.: +81-59-232-1111 (E.K.); +81-25-227-2320 (T.E.)
| | - Akiko Iwata
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan;
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan;
| | - Tsutomu Tabata
- Department of Obstetrics and Gynecology, Tokyo Women’s Medical University, Tokyo 162-8666, Japan;
| | - Yoshiki Kudo
- Department of Obstetrics and Gynecology, Hiroshima University Graduate School of Medicine, Hiroshima 739-0046, Japan;
| | - Eiji Kondoh
- Department of Obstetrics and Gynecology, Kumamoto University School of Medicine, Kumamoto 860-8556, Japan;
| | - Masaki Mandai
- Department of Obstetrics and Gynecology, Kyoto University School of Medicine, Kyoto 606-8507, Japan;
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University School of Medicine, Ehime 791-0295, Japan;
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo 105-8471, Japan;
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo 060-8543, Japan;
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan;
- Correspondence: (E.K.); (T.E.); Tel.: +81-59-232-1111 (E.K.); +81-25-227-2320 (T.E.)
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu 514-8507, Japan; (S.E.); (T.I.)
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Suemori K, Taniguchi Y, Okamoto A, Murakami A, Ochi F, Aono H, Hato N, Osawa H, Miyamoto H, Sugiyama T, Yamashita M, Tauchi H, Takenaka K. Two-year seroprevalence surveys of SARS-CoV-2 antibodies among outpatients and healthcare workers in Japan. Jpn J Infect Dis 2022; 75:523-526. [PMID: 35650038 DOI: 10.7883/yoken.jjid.2022.155] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We have conducted two-year seroprevalence surveys of SARS-CoV-2 antibodies among outpatients and healthcare workers (HCWs) at Ehime University Hospital. We collected data for outpatients and HCWs in June 2020 (1st survey), December 2020 (2nd survey), July 2021 (3rd survey) and December 2021 (4th survey) focusing on demographics, occupation, and the seroprevalence of anti-SARS-CoV-2 antibodies. Blood samples were obtained from randomly selected outpatients who visited our hospital for medical care and from HCWs undergoing regular medical checks with opt-out informed consent. SARS-CoV-2 antibody positivity was evaluated using two laboratory-based quantitative tests. The total number of participants enrolled was 6,369 (1st survey: 1000 outpatients and 743 HCWs, 2nd survey: 1000 outpatients and 407 HCWs, 3rd survey: 1000 outpatients and 804 HCWs, 4th survey: 1000 outpatients and 415 HCWs). The prevalence of SARS-CoV-2 antibodies among outpatients and HCWs was 0~0.1% and 0~0.124% during the research period, respectively, and changed little over time. These findings suggest that the magnitude of COVID-19 infection during the pandemic among outpatients and HCWs in this rural hospital might have been small.
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Affiliation(s)
- Koichiro Suemori
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Japan
| | - Yumi Taniguchi
- Clinical Laboratory Department, Ehime University Hospital, Japan
| | - Ai Okamoto
- Clinical Laboratory Department, Ehime University Hospital, Japan
| | - Akiko Murakami
- Clinical Laboratory Department, Ehime University Hospital, Japan
| | - Fumihiro Ochi
- Department of Pediatrics, Ehime University Graduate School of Medicine, Japan
| | - Harutaka Aono
- Division of Nursing, Ehime University Hospital, Japan
| | - Naohito Hato
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Japan
| | - Haruhiko Osawa
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Japan
| | - Hitoshi Miyamoto
- Clinical Laboratory Department, Ehime University Hospital, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University School of Medicine, Japan
| | - Masakatsu Yamashita
- Department of Immunology, Ehime University Graduate School of Medicine, Japan
| | - Hisamichi Tauchi
- Department of Pediatrics, Ehime University Graduate School of Medicine, Japan
| | - Katsuto Takenaka
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Japan
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Komine-Aizawa S, Haruyama Y, Deguchi M, Hayakawa S, Kawana K, Kobashi G, Miyagi E, Yamada H, Sugiyama T. The vaccination status and adverse effects of COVID-19 vaccine among pregnant women in Japan in 2021. J Obstet Gynaecol Res 2022; 48:1561-1569. [PMID: 35537777 PMCID: PMC9347631 DOI: 10.1111/jog.15285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/24/2022] [Revised: 03/22/2022] [Accepted: 04/27/2022] [Indexed: 11/27/2022]
Abstract
To investigate the vaccination status and adverse reactions to the COVID‐19 vaccine among pregnant women in Japan, we conducted an online questionnaire survey from October 5 to November 22, 2021. The number of participants in the online survey was 6576. Of the participants, 4840 (73.6%) were vaccinated twice, and 557 (8.5%) were vaccinated once. A total of 1179 (17.9%) responders had never been vaccinated against COVID‐19. The most frequent adverse reaction was local pain at the injection site. The incidence of local adverse reactions was almost identical after the first and the second vaccinations, while systemic reactions, such as fever and fatigue/malaise, and adverse reactions outside the vaccination site such as headache and arthralgia, were more frequent after the second vaccination than after the first vaccination. Regarding the obstetrical complications, uterine tension and/or contraction was observed in 1.65% of the pregnant women after the first vaccination and in 2.98% after the second vaccination, and uterine pain appeared in 1.06% of the pregnant women after the second vaccination. However, serious symptoms, such as hemorrhage, decreased fetal movement, edema, increased blood pressure, and amniorrhexis, were seen in less than 1% of vaccinated women after both the first and second vaccinations. This study clarified the characteristics of vaccination, adverse reactions, and obstetrical symptoms in pregnant women in Japan who had the COVID‐19 vaccine up to the second dose. As a booster vaccination is currently underway, further study is needed to improve the management of pregnant women during the current pandemic.
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Affiliation(s)
- Shihoko Komine-Aizawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Tochigi, Japan
| | - Masashi Deguchi
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoshi Hayakawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Kei Kawana
- Division of Obstetrics and Gynecology, Nihon University School of Medicine, Tokyo, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, Tochigi, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Hideto Yamada
- Center for Recurrent Pregnancy Loss, Teine Keijinkai Hospital, Sapporo, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Japan
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Ueno M, Liu S, Kiyoi T, Sugiyama T, Mogi M. Perinatal low-fat dietary intervention affects glucose metabolism in female adult and aging offspring. Geriatr Gerontol Int 2022; 22:441-448. [PMID: 35355401 DOI: 10.1111/ggi.14378] [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: 10/20/2021] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 11/28/2022]
Abstract
AIM Diabetes confers a high risk of developing poor health in later life in women. Based on the Developmental Origins of Health and Disease theory, the present study was undertaken to investigate the efficacy of perinatal fat restriction in maternal high-fat-exposed female offspring to maintain glucose homeostasis in later life between adulthood and aging. METHODS Low-fat dietary intervention during either gestation or lactation was performed using a high-fat diet-induced maternal obesity mouse model (HFD mice). Physiological metabolic parameters, including body weight and serum levels of total cholesterol and triglycerides, were monitored. Glucose tolerance test and insulin sensitivity test were performed in 12- and 70-week-old offspring. Insulin-positive islet cells were also observed using immunohistochemical staining. RESULTS HFD significantly induced abnormal weight gain, hyperlipidemia and impairment of both glucose tolerance and insulin sensitivity in offspring. Standard diet intake after weaning improved weight gain, serum total cholesterol level and glucose tolerance, but not insulin sensitivity, in 70-week-old offspring. Only perinatal fat restriction during both gestation and lactation, followed by standard food intake for the rest of their life, provided adequate efficacy to restore insulin sensitivity in aging female progeny. CONCLUSIONS Perinatal low-fat intervention may prevent deterioration of glucose metabolism. To improve the health status over a female's lifespan, appropriate nutritional intervention during the early developmental stage may reset the disease trajectory and prevent the onset and development of diabetes. Geriatr Gerontol Int 2022; 22: 441-448.
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Affiliation(s)
- Megumi Ueno
- Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Japan.,Department of Obstetrics & Gynecology, Ehime University School of Medicine, Toon, Japan
| | - Shuang Liu
- Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takeshi Kiyoi
- Department of Pharmacology, Kanazawa Medical University, Uchinada, Japan
| | - Takashi Sugiyama
- Department of Obstetrics & Gynecology, Ehime University School of Medicine, Toon, Japan
| | - Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Japan
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Kusagawa Y, Kurihara T, Maeo S, Sugiyama T, Kanehisa H, Isaka T. Associations between the size of individual plantar intrinsic and extrinsic foot muscles and toe flexor strength. J Foot Ankle Res 2022; 15:22. [PMID: 35313927 PMCID: PMC8935701 DOI: 10.1186/s13047-022-00532-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background The size of the plantar intrinsic and extrinsic foot muscles has been shown to be associated with toe flexor strength (TFS). Previous studies adopted the size of limited plantar intrinsic foot muscles or a compartment containing several muscles as an independent variable for TFS. Among the plantar intrinsic and extrinsic foot muscles, therefore, it is unclear which muscle(s) primarily contributes to TFS production. The present study aimed to clarify this subject. Methods In 17 young adult men, a series of anatomical cross-sectional area of individual plantar intrinsic and extrinsic foot muscles was obtained along the foot length and the lower leg length, respectively, using magnetic resonance imaging. Maximal anatomical cross-sectional area (ACSAmax) and muscle volume (MV) for each constituent muscle of the plantar intrinsic foot muscles (flexor hallucis brevis; flexor digitorum brevis, FDB; abductor hallucis; adductor hallucis oblique head, ADDH-OH; adductor hallucis transverse head, ADDH-TH; abductor digiti minimi; quadratus plantae) and extrinsic foot muscles (flexor hallucis longus; flexor digitorum longus) were measured. TFS was measured with a toe grip dynamometry. Results TFS was significantly associated with the ACSAmax for each of the ADDH-OH (r = 0.674, p = 0.003), ADDH-TH (r = 0.523, p = 0.031), and FDB (r = 0.492, p = 0.045), and the MV of the ADDH-OH (r = 0.582, p = 0.014). As for the ADDH-OH, the correlation coefficient with TFS was not statistically different between ACSAmax and MV (p = 0.189). Stepwise multiple linear regression analysis indicated that ACSAmax and MV of the ADDH-OH alone explained 42 and 29%, respectively, of the variance in TFS. Conclusion The ADDH-OH is the primary contributor to TFS production among the plantar intrinsic and extrinsic foot muscles as the result of the stepwise multiple linear regression analysis.
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Ueno M, Liu S, Kiyoi T, Mogi M, Sugiyama T. Long-term impact of maternal dietary intervention on metabolic homeostasis in male offspring in mice. J Nutr Biochem 2022; 104:108971. [DOI: 10.1016/j.jnutbio.2022.108971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 10/10/2021] [Accepted: 01/21/2022] [Indexed: 12/12/2022]
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Kawamoto Y, Nishihara T, Aono J, Nandate H, Hamada T, Yasuoka T, Matsumoto T, Yamaguchi O, Sugiyama T, Yorozuya T. Perioperative management of emergent cesarean section in a patient with peripartum cardiomyopathy and orthopnea: a case report. J Int Med Res 2021; 49:3000605211063077. [PMID: 34898316 PMCID: PMC8678898 DOI: 10.1177/03000605211063077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 12/11/2022] Open
Abstract
Perioperative management of pregnant women with heart failure is difficult. Management of anesthesia in pregnant women is especially difficult because all of the currently available choices present challenges. We report a patient with peripartum cardiomyopathy (PPCM) who required an emergent cesarean section and discuss the possible tactics for managing anesthesia. A 40-year-old primipara with severe cardiac and respiratory failure required an emergent cesarean section at 39+1 gestational weeks. Her left ventricular ejection fraction was between 10% and 15%, and she had orthopnea. General anesthesia was planned after inserting sheaths for percutaneous cardiopulmonary support from the femoral artery and vein. However, when the patient was asked to lie down on the operation bed, she panicked and resisted because of labor pain and dyspnea. Therefore, anesthesia was induced instead of the initial plan. Finally, we successfully managed the anesthesia and delivered the newborn. There are no alternatives to general anesthesia in patients with PPCM presenting with orthopnea. Anesthesia induction in the supine position is impossible in such patients owing to dyspnea. Anesthesia should be started with light sedation in the sitting position, and ketamine or low-dose remifentanil may be an option to maintain maternal hemodynamics and prevent neonatal asphyxia.
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Affiliation(s)
- Yuko Kawamoto
- Department of Anesthesia and Perioperative Medicine, 38050Ehime University Graduate School of Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Tasuku Nishihara
- Department of Anesthesia and Perioperative Medicine, 38050Ehime University Graduate School of Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Jun Aono
- Department of Cardiology, Pulmonology, Hypertension, and Nephrology, 38050Ehime University Graduate School of Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Hideyuki Nandate
- Department of Anesthesia and Perioperative Medicine, 38050Ehime University Graduate School of Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Taisuke Hamada
- Department of Anesthesia and Perioperative Medicine, 38050Ehime University Graduate School of Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Toshiaki Yasuoka
- Department of Obstetrics and Gynecology, 38050Ehime University Graduate School of Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Takashi Matsumoto
- Department of Obstetrics and Gynecology, 38050Ehime University Graduate School of Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Osamu Yamaguchi
- Department of Cardiology, Pulmonology, Hypertension, and Nephrology, 38050Ehime University Graduate School of Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, 38050Ehime University Graduate School of Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Toshihiro Yorozuya
- Department of Anesthesia and Perioperative Medicine, 38050Ehime University Graduate School of Medicine, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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Ueta K, Mizuguchi N, Sugiyama T, Isaka T, Otomo S. The Motor Engram of Functional Connectivity Generated by Acute Whole-Body Dynamic Balance Training. Med Sci Sports Exerc 2021; 54:598-608. [PMID: 34772904 PMCID: PMC8920009 DOI: 10.1249/mss.0000000000002829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 12/02/2022]
Abstract
Purpose Whole-body dynamic balance is necessary for both athletic activities and activities of daily living. This study aimed to investigate the effect of acute dynamic balance training on neural networks. Methods We evaluated resting-state functional connectivity (rs-FC), white matter fiber density, fiber-bundle cross-section, and gray matter volume in 28 healthy young adults (14 women) before and after 30 min of slackline training using a randomized, counterbalanced crossover design. Results The rs-FC between the left lateral prefrontal cortex (PFC) and the foot area of the primary sensorimotor (SM1) cortex increased significantly after slackline training compared with that after a control condition involving ergometer-based aerobic exercise. In addition, changes in rs-FC between the left lateral PFC and the primary sensorimotor were correlated with performance changes after training (i.e., offline process) rather than online learning. We also observed a main effect of time between the hippocampus and the cingulate cortex, including the anterior areas, and between the bilateral lateral PFC. Although we observed no structural changes, fiber density in the commissural fiber pathway before the first balance assessment was correlated with initial balance capability. Conclusions Our findings demonstrate that acute whole-body dynamic balance training alters specific rs-FC, and that this change is associated with performance changes after training. In addition, rs-FC changes in cognitive regions were modulated by both acute dynamic balance training and aerobic exercise. These findings have the potential to influence various fields (e.g., sports neuroscience, neurorehabilitation) and may aid in the development of methods that can improve motor and cognitive performance.
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Affiliation(s)
- Kenji Ueta
- College of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan Research Organization of Science and Technology, Ritsumeikan University, Kusatsu, Shiga, Japan
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Chu LCH, Sugiyama T, Ma RCW. Recent updates and future perspectives on gestational diabetes mellitus: An important public health challenge. J Diabetes Investig 2021; 12:1944-1947. [PMID: 34529362 PMCID: PMC8565418 DOI: 10.1111/jdi.13670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 12/26/2022] Open
Abstract
Leo Chu, Takashi Sugiyama, and Ronald Ma provide their perspective on recent updates on research in gestational diabetes mellitus, including updates on the epidemiology, diagnosis, and long-term follow-up of women with gestational diabetes mellitus. They also provide a summary of current challenges and a perspective on research gaps on this important clinical and public health problem.
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Affiliation(s)
- Leo Check Hei Chu
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong KongChina
| | - Takashi Sugiyama
- Department of Obstetrics and GynecologyEhime University Graduate School of MedicineToon, EhimeJapan
| | - Ronald Ching Wan Ma
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong KongChina
- Hong Kong Institute of Diabetes and ObesityThe Chinese University of Hong KongHong KongChina
- Li Ka Shing Institute of Health SciencesThe Chinese University of Hong KongHong KongChina
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45
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Sugiyama T, Ishii N, Ebihara Y, Shiomi K, Mochizuki H. Detailed Analysis of Neurological Symptoms and Sensory Disturbances Due to Chronic Arsenic Exposure in Toroku, Japan. Int J Environ Res Public Health 2021; 18:ijerph182010749. [PMID: 34682489 PMCID: PMC8535450 DOI: 10.3390/ijerph182010749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 01/10/2023]
Abstract
As a result of population growth and the development of tube wells, humans’ exposure to arsenic has increased over the past few decades. The natural course of organ damage secondary to arsenic exposure is not yet well understood. In Toroku, Japan, an arsenic mine was intermittently operated from 1920 to 1962, and residents were exposed to high concentrations of arsenic. In this paper, we analyzed 190 consecutive residents for whom detailed records of neurological symptoms and findings were obtained from 1974 to 2005. All participants were interviewed regarding the presence of general, skin, hearing, respiratory, and neurological symptoms. Neurological symptoms were classified into extremity numbness or pain, constipation, dyshidrosis, sensory loss, and muscle atrophy. Superficial and vibratory sensation was also evaluated. More than 80% of participants experienced extremity numbness, and numbness was the most common neurological symptom. Numbness was associated with superficial sensory disturbance, and was correlated with the subsequent development of other neurological symptoms, including autonomic and motor symptoms. No previous studies have investigated the natural course of chronic arsenic intoxication; thus, these data serve as a guide for detecting early symptoms due to arsenic exposure.
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Affiliation(s)
- Takashi Sugiyama
- Division of Respirology, Rheumatology, Infectious Diseases and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan; (K.S.); (H.M.)
- Correspondence: ; Tel.: +81-985-85-2965
| | - Nobuyuki Ishii
- Department of Neurology, Chiyoda Hospital, Miyazaki 883-0064, Japan;
| | - Yuka Ebihara
- Department of Neurology, Ebihara General Hospital, Miyazaki 884-0006, Japan;
| | - Kazutaka Shiomi
- Division of Respirology, Rheumatology, Infectious Diseases and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan; (K.S.); (H.M.)
| | - Hitoshi Mochizuki
- Division of Respirology, Rheumatology, Infectious Diseases and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan; (K.S.); (H.M.)
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Kawasaki M, Mito A, Waguri M, Sato Y, Abe E, Shimada M, Fukuda S, Sasaki Y, Fujikawa K, Sugiyama T, Ota E, Nakazawa J, Okoshi T, Takimoto H, Honda Y, Inoue E, Hiramatsu Y, Arata N. Protocol for an interventional study to reduce postpartum weight retention in obese mothers using the internet of things and a mobile application: a randomized controlled trial (SpringMom). BMC Pregnancy Childbirth 2021; 21:582. [PMID: 34425784 PMCID: PMC8381573 DOI: 10.1186/s12884-021-03998-w] [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: 04/15/2021] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obese pregnant women are known to experience poorer pregnancy outcomes and are at higher risk of postnatal arteriosclerosis. Hence, weight control during and after pregnancy is important for reducing these risks. The objective of our planned randomized controlled trial is to evaluate whether the rate of change in body weight in obese women before pregnancy to 12 months postpartum would be lower with the use of an intervention consisting of Internet of Things (IoT) devices and mobile applications during pregnancy to 1 year postpartum compared to a non-intervention group. METHODS Women will be recruited during outpatient maternity checkups at four perinatal care institutions in Japan. We will recruit women at less than 30 weeks of gestation with a pre-pregnancy body mass index ≥ 25 kg/m2. The women will be randomly assigned to an intervention or non-intervention group. The intervention will involve using data (weight, body composition, activity, sleep) measured with IoT devices (weight and body composition monitor, activity, and sleep tracker), meal records, and photographs acquired using a mobile application to automatically generate advice, alongside the use of a mobile application to provide articles and videos related to obesity and pregnancy. The primary outcome will be the ratio of change in body weight (%) from pre-pregnancy to 12 months postpartum compared to before pregnancy. DISCUSSION This study will examine whether behavioral changes occurring during pregnancy, a period that provides a good opportunity to reexamine one's habits, lead to lifestyle improvements during the busy postpartum period. We aim to determine whether a lifestyle intervention that is initiated during pregnancy can suppress weight gain during pregnancy and encourage weight loss after delivery. TRIAL REGISTRATION UMIN: UMIN (University hospital Medical Information Network) 000,041,460. Resisted on 18th August 2020. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047278.
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Affiliation(s)
- Maki Kawasaki
- Department of Health Policy, National Center for Child Health and Development, 2-10-1, OkuraTokyo, Setagaya, 157-8535, Japan.,Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, 2-10-1, OkuraTokyo, Setagaya, 157-8535, Japan
| | - Asako Mito
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, 2-10-1, OkuraTokyo, Setagaya, 157-8535, Japan
| | - Masako Waguri
- Department of Obstetric Medicine, Osaka Women's and Children's Hospital, Murodo-cho, Izumi, Osaka, 840594-1101, Japan
| | - Yuichi Sato
- Obstetrics & Gynecology, TATE DEBARI Sato Hospital, 96, Wakamatsu-cho, Takasaki, Gunma, 370-0836, Japan
| | - Emiko Abe
- Department of Obstetrics and Gynecology, Ehime Prefectural Central Hospital, 83, Matusyama City, Ehime, Kasuga-cho, 790-0024, Japan
| | - Mayumi Shimada
- Department of Obstetric Medicine, Osaka Women's and Children's Hospital, Murodo-cho, Izumi, Osaka, 840594-1101, Japan
| | - Sayuri Fukuda
- Obstetrics & Gynecology, TATE DEBARI Sato Hospital, 96, Wakamatsu-cho, Takasaki, Gunma, 370-0836, Japan
| | - Yuki Sasaki
- Link and Communication Inc, 4-1, Kioi-cho, Chiyoda, Tokyo, 102-0094, Japan
| | - Kei Fujikawa
- Department of Obstetric Medicine, Osaka Women's and Children's Hospital, Murodo-cho, Izumi, Osaka, 840594-1101, Japan
| | - Takashi Sugiyama
- Department of Obsterics and Gynecology, Ehime Uiversity Graduate School of Medicine, Touon City, Ehime, Sitsukawa, 454791-0295, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Sciences, St. Lukes International University, 10-1, Akashi-cho, Tyuuou, Tokyo, 1104-0044, Japan
| | - Jin Nakazawa
- Faculty of Environment and Information Studies, Keio University, Fujisawa City, Kanagawa, Endo, 5322252-0882, Japan
| | - Tadashi Okoshi
- Graduate School of Media and Governance, Fujisawa City, Kanagawa, Endo, 5322252-0882, Japan
| | - Hidemi Takimoto
- National Institute of Health and Nutrition, 23-1, Toyama, Shinjuku, Tokyo, 162-8636, Japan
| | - Yuka Honda
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, 2-10-1, OkuraTokyo, Setagaya, 157-8535, Japan
| | - Eisuke Inoue
- Showa University Research Administration Center, Showa University, 1-5-8, Hatanodai, ShinagawaTokyo, 142-8555, Japan
| | - Yuji Hiramatsu
- Okayama City General Medical Center, 3-20-1, KitanagaseomotemachiOkayama City, Okayama, 700-8557, Japan
| | - Naoko Arata
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, 2-10-1, OkuraTokyo, Setagaya, 157-8535, Japan.
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Yasuoka T, Iwama N, Ota K, Harada M, Hasegawa J, Yaegashi N, Sugiyama T, Suzuki N, Osuga Y. Pregnancy outcomes in children, adolescents, and young adults that survived cancer: A nationwide survey in Japan. J Obstet Gynaecol Res 2021; 47:3352-3361. [PMID: 34155729 DOI: 10.1111/jog.14909] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/25/2021] [Accepted: 06/10/2021] [Indexed: 11/27/2022]
Abstract
AIM Recent advances in cancer treatment have improved the prognosis of child, adolescent, and young adult (CAYA) cancer survivors. This study aimed to examine the current status of pregnancy outcomes among female cancer survivors in Japan. METHODS The first questionnaire was sent to 633 major tertiary institutions certified by the Japan Society of Obstetrics and Gynecology to identify institutions managing cases of pregnant cancer survivors between January 2011 and December 2015. The second questionnaire was sent only to institutions with pregnant cancer survivors during the study period. RESULTS We analyzed 2242 singleton deliveries of cancer survivors based on the responses received in the second questionnaire (199/255 responses; 78.0%). The three most frequent types of malignant tumors were uterine cervical (23.4%), breast (17.6%), and thyroid cancers (17.5%). Conception was aided by the use of assisted reproductive technology in 17.0% of the patients. The proportions of mothers aged 35-39.9 and ≥ 40 years were 36.5% and 11.8%, respectively. The prevalence of preterm birth (PTB) at <37, <34, and < 32 weeks' gestation were 16.7%, 6.8%, and 4.3%, respectively. The proportion of infants with low birth weight (LBW) was 18.9%. CONCLUSION The present study findings suggest that advanced maternal age was common among pregnant cancer survivors and these survivors often gave birth to PTB and LBW infants in Japan. The likelihood of adverse pregnancy outcomes should be considered by healthcare providers when planning counseling and perinatal care for cancer survivors.
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Affiliation(s)
- Toshiaki Yasuoka
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kuniaki Ota
- Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan
| | - Miyuki Harada
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junichi Hasegawa
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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Sugiyama T, Murao N, Kadowaki H, Takao K, Miyakawa T, Matsushita Y, Katagiri T, Futatsugi A, Shinmyo Y, Kawasaki H, Sakai J, Shiomi K, Nakazato M, Takeda K, Mikoshiba K, Ploegh HL, Ichijo H, Nishitoh H. ERAD components Derlin-1 and Derlin-2 are essential for postnatal brain development and motor function. iScience 2021; 24:102758. [PMID: 34355142 PMCID: PMC8324814 DOI: 10.1016/j.isci.2021.102758] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 09/05/2020] [Revised: 04/15/2021] [Accepted: 06/18/2021] [Indexed: 01/20/2023] Open
Abstract
Derlin family members (Derlins) are primarily known as components of the endoplasmic reticulum-associated degradation pathway that eliminates misfolded proteins. Here we report a function of Derlins in the brain development. Deletion of Derlin-1 or Derlin-2 in the central nervous system of mice impaired postnatal brain development, particularly of the cerebellum and striatum, and induced motor control deficits. Derlin-1 or Derlin-2 deficiency reduced neurite outgrowth in vitro and in vivo and surprisingly also inhibited sterol regulatory element binding protein 2 (SREBP-2)-mediated brain cholesterol biosynthesis. In addition, reduced neurite outgrowth due to Derlin-1 deficiency was rescued by SREBP-2 pathway activation. Overall, our findings demonstrate that Derlins sustain brain cholesterol biosynthesis, which is essential for appropriate postnatal brain development and function. Derlin-1 and Derlin-2 are essential for postnatal brain development and function Chemical chaperon does not ameliorate the phenotype of Derlin-deficient neuron Derlin regulates SREBP-2 activation and promotes brain cholesterol biosynthesis Derlin-mediated cholesterol biosynthesis is essential for neurite outgrowth
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Affiliation(s)
- Takashi Sugiyama
- Laboratory of Biochemistry and Molecular Biology, Department of Medical Sciences, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Naoya Murao
- Laboratory of Biochemistry and Molecular Biology, Department of Medical Sciences, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Hisae Kadowaki
- Laboratory of Biochemistry and Molecular Biology, Department of Medical Sciences, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Keizo Takao
- Department of Behavioral Physiology, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan.,Section of Behavioral Patterns, Center for Genetic Analysis of Behavior, National Institute for Physiological Sciences, Japan
| | - Tsuyoshi Miyakawa
- Division of Systems Medical Science, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - Yosuke Matsushita
- Division of Genome Medicine, Institute for Genome Research, Tokushima University, Tokushima 770-8503, Japan
| | - Toyomasa Katagiri
- Division of Genome Medicine, Institute for Genome Research, Tokushima University, Tokushima 770-8503, Japan
| | - Akira Futatsugi
- Department of Basic Medical Sciences, Kobe City College of Nursing, 3-4 Gakuen-nishi-machi, Nishi-ku, Kobe 651-2103, Japan
| | - Yohei Shinmyo
- Department of Medical Neuroscience, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Hiroshi Kawasaki
- Department of Medical Neuroscience, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Juro Sakai
- Division of Metabolic Medicine, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo 153-8904, Japan.,Division of Molecular Physiology and Metabolism, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Kazutaka Shiomi
- Division of Neurology, Respirology, Endocrinology, and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Masamitsu Nakazato
- Division of Neurology, Respirology, Endocrinology, and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
| | - Kohsuke Takeda
- Department of Cell Regulation, Graduate School of Biomedical Sciences, Nagasaki University, 1-14 Bunkyo-machi, Nagasaki 852-8521, Japan
| | - Katsuhiko Mikoshiba
- RIKEN Center for Life Science Technologies (CLST), Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan.,Shanghai Institute for Advanced Immunochemical Studies (SIAIS), Shanghai Tech University, Shanghai, China.,Department of Biomolecular Science, Faculty of Science, Toho University, Funabashi, Japan
| | - Hidde L Ploegh
- Boston Children's Hospital and Harvard Medical School, 1 Blackfan Circle, Boston, MA 02115, USA
| | - Hidenori Ichijo
- Laboratory of Cell Signaling, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo 113-0033, Japan
| | - Hideki Nishitoh
- Laboratory of Biochemistry and Molecular Biology, Department of Medical Sciences, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.,Frontier Science Research Center, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
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49
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Matsubara K, Matsubara Y, Uchikura Y, Takagi K, Yano A, Sugiyama T. HMGA1 Is a Potential Driver of Preeclampsia Pathogenesis by Interference with Extravillous Trophoblasts Invasion. Biomolecules 2021; 11:biom11060822. [PMID: 34072941 PMCID: PMC8227282 DOI: 10.3390/biom11060822] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/18/2022] Open
Abstract
Preeclampsia (PE) is a serious disease that can be fatal for the mother and fetus. The two-stage theory has been proposed as its cause, with the first stage comprising poor placentation associated with the failure of fertilized egg implantation. Successful implantation and placentation require maternal immunotolerance of the fertilized egg as a semi-allograft and appropriate extravillous trophoblast (EVT) invasion of the decidua and myometrium. The disturbance of EVT invasion during implantation in PE results in impaired spiral artery remodeling. PE is thought to be caused by hypoxia during remodeling failure-derived poor placentation, which results in chronic inflammation. High-mobility group protein A (HMGA) is involved in the growth and invasion of cancer cells and likely in the growth and invasion of trophoblasts. Its mechanism of action is associated with immunotolerance. Thus, HMGA is thought to play a pivotal role in successful pregnancy, and its dysfunction may be related to the pathogenesis of PE. The evaluation of HMGA function and its changes in PE might confirm that it is a reliable biomarker of PE and provide prospects for PE treatment through the induction of EVT proliferation and invasion during the implantation.
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Affiliation(s)
- Keiichi Matsubara
- Department of Regional Pediatrics and Perinatology, Graduate School of Medicine, Ehime University, Ehime, Toon-shi 791-0295, Shitsukawa, Japan
- Correspondence:
| | - Yuko Matsubara
- Department of Obstetrics and Gynecology, School of Medicine, Ehime University, Ehime, Toon-shi 791-0295, Shitsukawa, Japan; (Y.M.); (Y.U.); (K.T.); (A.Y.); (T.S.)
| | - Yuka Uchikura
- Department of Obstetrics and Gynecology, School of Medicine, Ehime University, Ehime, Toon-shi 791-0295, Shitsukawa, Japan; (Y.M.); (Y.U.); (K.T.); (A.Y.); (T.S.)
| | - Katsuko Takagi
- Department of Obstetrics and Gynecology, School of Medicine, Ehime University, Ehime, Toon-shi 791-0295, Shitsukawa, Japan; (Y.M.); (Y.U.); (K.T.); (A.Y.); (T.S.)
| | - Akiko Yano
- Department of Obstetrics and Gynecology, School of Medicine, Ehime University, Ehime, Toon-shi 791-0295, Shitsukawa, Japan; (Y.M.); (Y.U.); (K.T.); (A.Y.); (T.S.)
| | - Takashi Sugiyama
- Department of Obstetrics and Gynecology, School of Medicine, Ehime University, Ehime, Toon-shi 791-0295, Shitsukawa, Japan; (Y.M.); (Y.U.); (K.T.); (A.Y.); (T.S.)
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50
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Sugiyama T, Maeo S, Kurihara T, Kanehisa H, Isaka T. Change of Direction Speed Tests in Basketball Players: A Brief Review of Test Varieties and Recent Trends. Front Sports Act Living 2021; 3:645350. [PMID: 33997779 PMCID: PMC8117963 DOI: 10.3389/fspor.2021.645350] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/24/2021] [Indexed: 11/25/2022] Open
Abstract
Change of direction speed (CODS) is essential for basketball performance, extensively assessed by various tests. This review aimed to summarize the CODS test varieties for basketball players on publications until 2019 and identify recent trends regarding what types of tests have gained attention in the 2010s. Electronic literature searches were conducted using three databases with relevant keywords. 104 studies were found eligible, conducting CODS tests 159 times in total with 48 test varieties. To facilitate distinctions between the tests, each test was categorized into one of three types based on the distinctive movement characteristics and changing angles as follows: Defensive (involving lateral shuffling), 180°-turn (exerting only 180°-turns), and Cutting (performing diagonal- or side-cut). We then counted the number of publications and adopted times reported per year for each test, and calculated the adoption rate for each categorized test type. The first CODS test performed in basketball players was the T-Test, reported in 1991, and this was the most commonly adopted test (44/159 times). The 2010s saw abrupt increases in the number of publications (1990s-2000s-2010s: 5-9-90) and test varieties (4-7-44). The adoption rates in the 2010s were similar among the three types (i.e., Defensive/180°-turn/Cutting: 37%/30%/33%), with the Cutting type gradually increasing over the last three decades (1990s-2000s-2010s: 0%-9%-33%). These results suggest that while CODS performances in basketball players are increasingly studied with various tests, recent studies give equal weight to all of the three categorized test types, with increasing adoption of the Cutting type, to assess specific CODS performances.
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Affiliation(s)
- Takashi Sugiyama
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Sumiaki Maeo
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Toshiyuki Kurihara
- Research Organization of Science and Technology, Ritsumeikan University, Shiga, Japan
| | - Hiroaki Kanehisa
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
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