Effect of hypertriglyceridemia in dyslipidemia-induced impaired glucose tolerance and sex differences in dietary features associated with hypertriglyceridemia among the Japanese population: The Gifu Diabetes Study

AIMS/INTRODUCTION

The mechanisms underlying hypertriglyceridemia-induced impaired glucose tolerance in Japanese individuals remain unclear. We aimed to evaluate the effect of hypertriglyceridemia on glucose metabolism in comparison with that of increased low-density lipoprotein or decreased high-density lipoprotein levels and to elucidate the sex differences in hypertriglyceridemia-related dietary intake among Japanese individuals.

MATERIALS AND METHODS

We randomly selected 898 (384 men and 514 women) participants aged 40-78 years in the Gifu Diabetes Study; those taking medication for dyslipidemia or diabetes mellitus were excluded. Serum levels of glucose metabolism parameters and the food frequency were measured cross-sectionally. The glycated hemoglobin was measured again after 5 years.

RESULTS

Glucose metabolism parameters and the percentage of individuals with impaired glucose tolerance were significantly higher in the high triglyceride group in men and women. Similar trends were observed in the low high-density lipoprotein group, but only in men. Meanwhile, only the homeostasis model assessment of insulin resistance was higher in the high low-density lipoprotein group. In non-obese men, the percentage of energy intake from alcohol per total daily energy intake was significantly greater in the high triglyceride group. In obese women, the total energy intake was significantly greater in the high triglyceride group. At the 5-year follow up, the risk of elevated glycated hemoglobin levels with hypertriglyceridemia was increased in men.

CONCLUSIONS

Hypertriglyceridemia is a stronger risk factor for impaired glucose tolerance than increased low-density lipoprotein or decreased high-density lipoprotein. For dietary habits, increased daily alcohol energy intake in non-obese men and increased total energy intake in obese women were associated with hypertriglyceridemia.

Alcohol-induced impaired insulin secretion in a Japanese population: 5-year follow up in the Gifu Diabetes Study

AIMS/INTRODUCTION

Although moderate alcohol consumption lowers the risk of type 2 diabetes in European populations, the same cannot be assumed for Japanese patients with diabetes related to low insulin secretion rather than resistance. We aimed to evaluate the effects of daily alcohol consumption on glucose tolerance and diabetes development risk in Japanese populations.

MATERIALS AND METHODS

This retrospective study randomly enrolled 452 men and 659 women aged 40-78 years in 2005 (Gifu, Japan). The participants completed a 75-g oral glucose tolerance test and medical questionnaire. The homeostasis model assessment of insulin resistance, homeostasis model assessment of β-cell function and insulinogenic index were used to estimate insulin sensitivity and secretion. The relationships between alcohol consumption and these parameters were analyzed using logistic regression after adjusting for potential confounders. The 5-year changes in hemoglobin A1c levels were also evaluated.

RESULTS

The adjusted odds ratios for elevated homeostasis model assessment of β-cell function values (<40%) in the 0-19.9 g/day, 20.0-39.9 g/day and ≥ 40 g/day alcohol consumption groups were 0.98, 1.46 and 2.68, respectively. Alcohol consumption induced a significant decrease in the insulin secretion level among the ≥40 g/day drinkers, especially in men. However, there was no risk of increased insulin resistance based on the homeostasis model assessment of insulin resistance (<2.5) results. The 5-year risk of elevated hemoglobin A1c levels (≥6.5%) was increased according to increase in alcohol consumption in both men and women.

CONCLUSIONS

Daily alcohol consumption was associated with reduced insulin secretion and an increased diabetes development risk in Japanese populations.

Negative effect of a previous diagnosis of diabetes on quality of life in a Japanese population: The Gifu Diabetes Study

Objective

To evaluate the effect of a previous indication of hyperglycemia or previous diagnosis of diabetes on quality of life (QOL) in a randomly selected population from Gifu City, Japan.

Methods

In total, 452 males and 648 females were enrolled in this study. We collected information on previous indications of hyperglycemia and previous diagnoses of diabetes using a self-reported questionnaire. Participants also completed the World Health Organization Quality of Life-26 (WHOQOL-26) questionnaire and provided blood samples for the measurement of fasting plasma glucose and glycated hemoglobin levels. A 75-g oral glucose tolerance test was also performed. We compared QOL scores between the previous indication of hyperglycemia group and previous diagnosis of the diabetes group to those of the control group.

Results

WHOQOL-26 scores were significantly lower in the previous diagnosis of diabetes group than in the control group (3.23 ± 0.43 vs. 3.45 ± 0.43; p < 0.01). However, WHOQOL-26 scores in the previous indication of hyperglycemia group were not significantly different from those of the control group. Lowering of WHOQOL-26 scores was significantly affected by the previous diagnosis of diabetes not by the plasma glucose levels.

Conclusions

Our study suggests that a previous diagnosis of diabetes has a negative effect on QOL in a Japanese population. Health promotion and education that take QOL into account should be considered for people diagnosed with diabetes.

Postoperative anticonvulsant prophylaxis for patients treated for cerebral aneurysms

The incidences of postoperative seizures and side effects were evaluated in 193 patients with cerebral aneurysm who received anticonvulsant prophylaxis and underwent 224 craniotomies for cerebral aneurysms between 1993 and 1995. The patients were 73 males and 120 females aged between 31 and 80 years. One hundred and sixteen patients had ruptured cerebral aneurysms and 108 had unruptured aneurysms. Phenytoin followed by valproic acid were administered. Early postoperative seizures occurred in five patients (4 with ruptured and 1 with unruptured aneurysms) within 14 days after surgery. Late postoperative seizures occurred in four different patients with ruptured aneurysms more than 14 days after surgery. The presence of cortical lesions detected by cerebral computed tomography and occurrence of symptomatic vasospasm were correlated with the occurrence of early postoperative seizure (p < 0.05). Three of the four patients with late postoperative seizure had cortical lesions and two were receiving continued medication. Side effects that warranted discontinuation of therapy were seen in the follow-up period in 12.9% of patients. Anticonvulsant prophylaxis is not recommended due to the higher incidence of side effects than seizure, except in patients in poor clinical condition for the purpose of brain protection. Otherwise, anticonvulsant medication should be initiated at the time of the initial seizure attack.

Ruptured anterior spinal artery aneurysm: a case report

BACKGROUND

Spinal artery aneurysms are rare, and are usually found in association with arteriovenous malformations or coarctation of the aorta.

CASE REPORT

A 42-year-old man with a ruptured anterior spinal artery aneurysm is presented here. He experienced subarachnoid hemorrhage, which was confirmed by computed tomography. Magnetic resonance imaging revealed an aneurysm in front of the upper part of the medulla. Angiography demonstrated bilateral vertebral artery occlusion. Distal vertebral arteries and the basilar artery were perfused via the dilated anterior spinal artery, which originates in the right subclavian artery. The aneurysm was located at the distal part of the anterior spinal artery, and was successfully clipped through a lateral suboccipital craniotomy 2 months after bleeding from the aneurysm. After rehabilitation, the patient was able to walk with no apparent neurologic deficit.

CONCLUSIONS

This case suggests that the anterior spinal artery as a collateral route after bilateral vertebral artery occlusion is under hemodynamic stress, resulting in aneurysm formation and rupture.

Single-molecule imaging of RNA polymerase-DNA interactions in real time

Using total internal reflection fluorescence microscopy, we have directly observed individual interactions of single RNA polymerase molecules with a single molecule of lambda-phage DNA suspended in solution by optical traps. The interactions of RNA polymerase molecules were not homogeneous along DNA. They dissociated slowly from the positions of the promoters and sequences common to promoters at a rate of approximately 0.66 s-1, which was more than severalfold smaller than the rate at other positions. The association rate constant for the slow dissociation sites was 9.2 x 10(2) bp-1 M-1 s-1. The frequency of binding to the fast dissociation sites was dependent on the A-T composition; it was larger in the AT-rich regions than in the GC-rich regions. RNA polymerase molecules on the fast dissociation sites underwent linear diffusion (sliding) along DNA. The binding to the slow dissociation sites was greatly enhanced when DNA was released to a relaxed state, suggesting that the binding depended on the strain exerted on the DNA. The present method is potentially applicable to the examination of a wide variety of protein-nucleic acid interactions, especially those involved in the process of transcription.

Intrameatal tumours presenting as a hearing disturbance: case reports of meningioma and lymphoma

This paper presents two patients with chronic progressive hearing disturbance. Each patients had an intrameatal tumour, part of which extended to the cerebellopontine (CP) angle. In both cases, the patients were initially diagnosed with an acoustic neurinoma. A 63-year-old male experienced a hearing disturbance in the left ear for 1.5 years prior to visiting our hospital. Magnetic resonance (MR) imaging revealed a mass which was surgically resected. The tumour originated from the intrameatal dura mater. Histologically, the tumour was a meningioma. Similarly, a 53-year-old male presented with systemic lymphoma diagnosed 10 months earlier, and a hearing disturbance in the right ear that began 3 months prior to visiting our hospital. MR imaging prior to chemotherapy revealed a mass which extended to the CP angle. Part of the tumour in the CP angle disappeared after chemotherapy, suggesting a secondary lymphoma. Another tumour appeared later in Meckel's cave on the left side; however, it decreased in size following repeated chemotherapy. The present results indicate that differential diagnosis of intrameatal tumours and acoustic neurinomas may be difficult due to the small tumour size. Recent progress in neuroradiology may allow distinction of intrameatal tumours as a separate tumour classification. Our second patient is the sixth reported case of a CP angle lymphoma in the literature.

[A case report; ganglion cyst of a cervical facet joint]

Ganglion or synovial cyst typically occurs in peripheral joints and tendon sheaths such as elbow joint or wrist joint, but rarely in the spinal facet joint. From reported cases the most common site involved seems to be the lumbar facet joint. Only three cases of cervical ganglion or synovial cyst have so far been found in the literature. A case of cervical ganglion cyst was reported. The patient was a 2-year-old boy who was found to have a tumor in the midline of the nape. He had no history of trauma. Neurological and physical examination revealed no abnormalities. On CT scan a round low dense lesion with clear margin was found in the nape. Enhanced CT scan showed ring-like enhancement. Magnetic resonance (MR) imaging showed a well defined lesion of high intensity on T1- and T2-weighted images. At operation, the lesion was found to form a cyst containing old hematoma, and the cyst wall seemed to be fixed to the cervical spinal facet joint. The tumor was histologically diagnosed as ganglion cyst.