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Hirano T, Hayashi T, Sugita H, Tamasawa A, Goto S, Tomoyasu M, Yamamoto T, Ohara M, Terasaki M, Kushima H, Ito Y, Yamagishi S, Mori Y. Prospective randomized comparative study of the effect of pemafibrate add-on or double statin dose on small dense low-density lipoprotein-cholesterol in patients with type 2 diabetes and hypertriglyceridemia on statin therapy. J Diabetes Investig 2023; 14:1401-1411. [PMID: 37647503 PMCID: PMC10688129 DOI: 10.1111/jdi.14076] [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: 06/19/2023] [Revised: 07/23/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023] Open
Abstract
AIMS/INTRODUCTION Small dense low-density lipoprotein (sdLDL) is a more potent atherogenic lipoprotein than LDL. As sdLDL-cholesterol (C) levels are determined by triglyceride and LDL-C levels, pemafibrate and statins can reduce sdLDL-C levels. However, it remains unclear whether adding pemafibrate or increasing statin doses would more effectively reduce sdLDL-C levels in patients receiving statin therapy. MATERIALS AND METHODS A total of 97 patients with type 2 diabetes and hypertriglyceridemia who were treated with statins were randomly assigned to the pemafibrate 0.2 mg/day addition or statin dose doubled, and followed for 12 weeks. sdLDL-C was measured by our established homogenous assay. RESULTS The percentage and absolute reductions of sdLDL-C levels were significantly greater in the pemafibrate add-on group than the statin doubling group (-32.8 vs -8.1%; -16 vs -3 mg/dL, respectively). Triglyceride levels were reduced only in the pemafibrate add-on group (-44%), and LDL-C levels were reduced only in the statin doubling group (-8%), whereas levels of non-high-density lipoprotein-C and apolipoprotein B were similarly decreased (7-9%) in both groups. The absolute reductions of sdLDL-C levels were closely associated with decreased triglyceride, LDL-C, non-high-density lipoprotein-C and apolipoprotein B. In the subgroup analysis, the effect of pemafibrate add-on on sdLDL-C reductions was observed irrespective of baseline lipid parameters or statin type. No serious adverse effects were observed in both groups. CONCLUSIONS In patients with type 2 diabetes and hypertriglyceridemia, the addition of pemafibrate to a statin is superior to doubling a statin in reducing sdLDL-C without increasing adverse effects.
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Affiliation(s)
- Tsutomu Hirano
- Diabetes CenterEbina General HospitalEbinaJapan
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Toshiyuki Hayashi
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
- Yurakubashi ClinicTokyoJapan
| | - Hiroe Sugita
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | | | - Satoshi Goto
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
- Goto IinNaraJapan
| | - Masako Tomoyasu
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Takeshi Yamamoto
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Makoto Ohara
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Michishige Terasaki
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Hideki Kushima
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Yasuki Ito
- Clinical Diagnostics DepartmentDenka Co., Ltd.TokyoJapan
| | - Sho‐ichi Yamagishi
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
| | - Yusaku Mori
- Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
- Anti‐Glycation Research Section, Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan
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Osonoi T, Tamasawa A, Osonoi Y, Ofuchi K, Katoh M, Saito M. Canagliflozin Increases Postprandial Total Glucagon-Like Peptide 1 Levels in the Absence of α-Glucosidase Inhibitor Therapy in Patients with Type 2 Diabetes: A Single-Arm, Non-randomized, Open-Label Study. Diabetes Ther 2019; 10:2045-2059. [PMID: 31506889 PMCID: PMC6848431 DOI: 10.1007/s13300-019-00689-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION To investigate canagliflozin-induced changes in postprandial total glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) levels in patients with type 2 diabetes mellitus (T2DM). METHODS Forty-five patients with T2DM who had inadequate glycemic control (glycated hemoglobin ≥ 6.5%) with diet and exercise alone (n = 15, drug naïve) and in combination with either a stable dose of the α-glucosidase inhibitor acarbose (n = 15) or metformin (n = 15) received canagliflozin, a sodium-glucose cotransporter 2 inhibitor, at 100 mg once daily for 12 weeks. The primary endpoint was the change from baseline to week 12 in postprandial glucose and plasma levels of total GLP-1 and GIP during a meal tolerance test (MTT). RESULTS Canagliflozin significantly reduced postprandial blood glucose (mean difference - 40.2 mg/mL at 60 min) and increased postprandial total GLP-1 (mean difference 1.8 pg/mL at 60 min) during an MTT. A transient reduction in the postprandial GIP level at only 30 min (mean difference - 80.3 pg/mL) during an MTT was observed. No changes in postprandial GLP-1 or GIP levels were seen after canagliflozin treatment as an add-on to acarbose in patients with T2DM. Acarbose treatment significantly decreased postprandial total GIP levels (P < 0.05) and tended to increase postprandial total GLP-1 levels (P = 0.07) compared to the other two treatments prior to canagliflozin. CONCLUSION Canagliflozin 100 mg increased postprandial total GLP-1 levels in the absence of acarbose, suggesting that it may upregulate GLP-1 secretion through delayed glucose absorption in the upper intestine, as with the α-glucosidase inhibitor. TRIAL REGISTRATION University Hospital Medical Information Network, UMIN000018345. FUNDING Mitsubishi Tanabe Pharma Corporation.
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Affiliation(s)
- Takeshi Osonoi
- Naka Kinen Clinic, 745-5 Nakadai, Naka, Ibaraki, 311-0113, Japan
| | - Atsuko Tamasawa
- Naka Kinen Clinic, 745-5 Nakadai, Naka, Ibaraki, 311-0113, Japan
| | - Yusuke Osonoi
- Naka Kinen Clinic, 745-5 Nakadai, Naka, Ibaraki, 311-0113, Japan
| | - Kensuke Ofuchi
- Naka Kinen Clinic, 745-5 Nakadai, Naka, Ibaraki, 311-0113, Japan
| | - Makoto Katoh
- Naka Kinen Clinic, 745-5 Nakadai, Naka, Ibaraki, 311-0113, Japan.
| | - Miyoko Saito
- Naka Kinen Clinic, 745-5 Nakadai, Naka, Ibaraki, 311-0113, Japan
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Sumida Y, Murotani K, Saito M, Tamasawa A, Osonoi Y, Yoneda M, Osonoi T. Effect of luseogliflozin on hepatic fat content in type 2 diabetes patients with non-alcoholic fatty liver disease: A prospective, single-arm trial (LEAD trial). Hepatol Res 2019; 49:64-71. [PMID: 30051943 DOI: 10.1111/hepr.13236] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [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: 07/11/2018] [Revised: 07/16/2018] [Accepted: 07/19/2018] [Indexed: 12/12/2022]
Abstract
AIMS No pharmacological therapies are approved for non-alcoholic fatty liver disease (NAFLD). Luseogliflozin, a sodium glucose cotransporter 2 inhibitor, has been developed for the treatment of adults with type 2 diabetes (T2DM). The aim of this prospective, single-arm study is to evaluate the efficacy of luseogliflozin on hepatic fat content and glycated hemoglobin (HbA1c) in T2DM patients with NAFLD. METHODS Forty T2DM patients with NAFLD were treated with luseogliflozin 2.5 mg/day for 24 weeks. Primary end-points were changes in HbA1c and hepatic steatosis evaluated by magnetic resonance imaging-hepatic fat fraction from baseline. Secondary end-points were changes in metabolic and hepatic function-related parameters, including hepatic fibrosis markers (Fibrosis-4 index, NAFLD fibrosis score, type IV collagen 7S. and Wisteria floribunda agglutinin-positive Mac-2 binding protein). RESULTS Not only HbA1c and transaminase activities but also hepatic fat content were significantly decreased after 24 weeks of therapy with luseogliflozin. The reduction of hepatic fat content was significantly correlated with the reduction of alanine aminotransferase. Although hepatic fibrosis markers were unchanged, serum ferritin levels reduced and serum albumin significantly increased after the treatment. CONCLUSION Luseogliflozin can be a novel promising agent for the treatment of T2DM patients with NAFLD. Prospective randomized controlled trials are warranted to confirm this impact of luseogliflozin onT2DM with NAFLD.
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Affiliation(s)
- Yoshio Sumida
- Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan
| | - Kenta Murotani
- Biostatistics Center, Graduate School of Medicine, Kurume University, Fukuoka, Japan
| | - Miyoko Saito
- Nakakinen Clinic Medical Corporation Kenseikai, Ibaraki, Japan
| | - Atsuko Tamasawa
- Nakakinen Clinic Medical Corporation Kenseikai, Ibaraki, Japan
| | - Yusuke Osonoi
- Nakakinen Clinic Medical Corporation Kenseikai, Ibaraki, Japan
| | - Masashi Yoneda
- Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan
| | - Takeshi Osonoi
- Nakakinen Clinic Medical Corporation Kenseikai, Ibaraki, Japan
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Osonoi T, Nakamoto S, Saito M, Tamasawa A, Ishida H, Osonoi Y. Efficacy of ipragliflozin as monotherapy or as add-on therapy with other oral antidiabetic medications for treating type 2 diabetes in Japanese patients with inadequate glycemic control: A subgroup analysis based on patient characteristics. J Diabetes Investig 2018; 9:341-353. [PMID: 28644562 PMCID: PMC5835480 DOI: 10.1111/jdi.12705] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 04/07/2017] [Accepted: 06/14/2017] [Indexed: 01/04/2023] Open
Abstract
AIMS/INTRODUCTION The aim of the present study was to evaluate the efficacy and safety of ipragliflozin in treating Japanese type 2 diabetes patients with inadequate glycemic control by investigating diurnal variations of blood glucose and body composition. MATERIALS AND METHODS This was an investigator-initiated, multicenter, prospective study with a 6-month treatment period. The primary outcome investigated was change in hemoglobin A1c levels from baseline. Secondary outcomes included changes in fasting plasma glucose, insulin resistance, variations in 24-h glucose levels detected by continuous glucose monitoring, bodyweight, body composition, waist circumference and serum lipids. Adverse events were evaluated throughout the study. RESULTS A total of 98 patients completed the study. Over the 6-month period, ipragliflozin-treated patients showed reduction in hemoglobin A1c levels by 0.3%, fasting plasma glucose levels by 13.0 mg/dL, bodyweight by 2.1 kg, body fat mass by 1.5 kg and extracellular water by 0.3 kg, as well as a decrease in systolic/diastolic blood pressures. Significant reductions from baseline in mean amplitude of glucose excursions and standard deviation, and the reduced frequency of hyperglycemia were confirmed. High-density lipoprotein cholesterol was also significantly improved. Notably, the subgroup analysis of hemoglobin A1c levels, bodyweight, waist circumference, and body composition based on age, sex and body mass index showed similar reductions within each subgroup. The incidences of adverse events and adverse drug reactions were 20.0% and 1.0%, respectively, over the 6-month period. CONCLUSIONS Ipragliflozin is a useful oral antidiabetic medication for patients with a wide range of background characteristics.
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Affiliation(s)
- Takeshi Osonoi
- Department of Internal MedicineNaka Kinen ClinicNakaIbarakiJapan
| | - Shinya Nakamoto
- Department of Internal MedicineNaka Kinen ClinicNakaIbarakiJapan
| | - Miyoko Saito
- Department of Internal MedicineNaka Kinen ClinicNakaIbarakiJapan
| | - Atsuko Tamasawa
- Department of Internal MedicineNaka Kinen ClinicNakaIbarakiJapan
| | - Hidenori Ishida
- Department of Internal MedicineNaka Kinen ClinicNakaIbarakiJapan
| | - Yusuke Osonoi
- Department of Internal MedicineNaka Kinen ClinicNakaIbarakiJapan
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Hamamura M, Mita T, Osonoi Y, Osonoi T, Saito M, Tamasawa A, Nakayama S, Someya Y, Ishida H, Gosho M, Kanazawa A, Watada H. Relationships Among Conventional Cardiovascular Risk Factors and Lifestyle Habits With Arterial Stiffness in Type 2 Diabetic Patients. J Clin Med Res 2017; 9:297-302. [PMID: 28270889 PMCID: PMC5330772 DOI: 10.14740/jocmr2870w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2017] [Indexed: 11/21/2022] Open
Abstract
Background While conventional cardiovascular risk factors and certain lifestyle habits are associated with arterial stiffness in patients with type 2 diabetes mellitus (T2DM), it is still unknown whether they are actually associated with arterial stiffness even after adjustment for conventional cardiovascular risk factors and lifestyle habits. The aim of this study was to identify variables that are associated with brachial-ankle pulse wave velocity (baPWV). Methods The study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. Lifestyle habits were analyzed using self-reported questionnaires. The associations among conventional cardiovascular risk factors and lifestyle habits with baPWV were investigated by multivariable linear regression analysis. Results The mean age of the study subjects was 57.8 ± 8.6 years, and 62.8% of those were males. The mean HbA1c was 7.0±1.0%, and the estimated duration of T2DM was 9.9 ± 7.2 years. Multiple linear regression analysis that included age and gender demonstrated that age and male sex were positively associated with baPWV. In a model adjusted for numerous conventional cardiovascular risk factors and lifestyle habits, age, duration of T2DM, systolic blood pressure, serum uric acid, urinary albumin excretion and poor sleep quality were positively associated with baPWV, while body mass index was negatively associated with baPWV. Conclusions In Japanese T2DM, in addition to several conventional cardiovascular risk factors, poor sleep quality was associated with baPWV even after adjustment for numerous conventional cardiovascular risk factors and lifestyle habits.
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Affiliation(s)
- Misako Hamamura
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Tomoya Mita
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan; Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Yusuke Osonoi
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Takeshi Osonoi
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, Ibaraki 311-0113, Japan
| | - Miyoko Saito
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, Ibaraki 311-0113, Japan
| | - Atsuko Tamasawa
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, Ibaraki 311-0113, Japan
| | - Shiho Nakayama
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Yuki Someya
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Hidenori Ishida
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, Ibaraki 311-0113, Japan
| | - Masahiko Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Akio Kanazawa
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan; Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan; Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan; Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan; Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan
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Kobori M, Yagihashi S, Shiina N, Shiozawa N, Haginoya A, Ojima M, Douguchi S, Tamasawa A, Saitou M, Baba M, Osonoi T. Four-year sequential nerve conduction changes since first visit in Japanese patients with early type 2 diabetes. J Diabetes Investig 2016; 8:369-376. [PMID: 27736033 PMCID: PMC5415466 DOI: 10.1111/jdi.12583] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/08/2016] [Accepted: 09/19/2016] [Indexed: 01/24/2023] Open
Abstract
Aims/Introduction Despite being the most common complication of diabetes, the pattern of clinical development of diabetic neuropathy is not well‐known. In the present study, we retrospectively examined sequential changes in nerve conduction studies (NCS) for 4 years to characterize the way neuropathic changes develop in patients with type 2 diabetes. Materials and Methods We randomly selected 158 patients with type 2 diabetes who newly visited Naka Memorial Clinic, Ibaraki, Japan, and underwent serial 4‐year NCS. Records of clinical profile, signs and symptoms of neuropathy, and NCS data from median and tibial nerves were extracted to determine the progression of neuropathy. NCS data were represented by motor nerve conduction velocities, amplitudes of compound muscle action potentials (CMAPs) and minimal latencies of F‐wave. Results The prevalence of clinical neuropathy in 158 cases was 30% at baseline and 29% at the end of the study, with improvement of glycated hemoglobin (8.6–6.9%). Over 4 years, there were no changes of the signs and symptoms of neuropathy. Motor nerve conduction velocities were slightly improved or consistent at the fourth year compared with those at the beginning (+1.5% in median nerve, P < 0.05; +0.8%, not significant in the tibial nerve). The extent of the glycated hemoglobin correction correlated with the improvement of motor nerve conduction velocity. In contrast, CMAPs of both median and tibial nerves were decreased (−11.6%, P < 0.01; −3.7%, P < 0.05, respectively). For the decrease in CMAPs, no specific risk factors were identified by logistic regression analysis. Conclusions The present study showed progressive decline of CMAPs despite improved glycemic controls or the lack of NCV slowing in patients with early type 2 diabetes.
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Affiliation(s)
- Mariko Kobori
- Kensei-kai Naka Memorial Clinic, Naka-city, Ibaraki, Japan
| | - Soroku Yagihashi
- Kensei-kai Naka Memorial Clinic, Naka-city, Ibaraki, Japan.,Department of Pathology and Molecular Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Norie Shiina
- Kensei-kai Naka Memorial Clinic, Naka-city, Ibaraki, Japan
| | - Nana Shiozawa
- Kensei-kai Naka Memorial Clinic, Naka-city, Ibaraki, Japan
| | - Akiko Haginoya
- Kensei-kai Naka Memorial Clinic, Naka-city, Ibaraki, Japan
| | - Misato Ojima
- Kensei-kai Naka Memorial Clinic, Naka-city, Ibaraki, Japan
| | | | | | - Miyoko Saitou
- Kensei-kai Naka Memorial Clinic, Naka-city, Ibaraki, Japan
| | - Masayuki Baba
- Department of Neurology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Takeshi Osonoi
- Kensei-kai Naka Memorial Clinic, Naka-city, Ibaraki, Japan
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Osonoi Y, Mita T, Osonoi T, Saito M, Tamasawa A, Nakayama S, Someya Y, Ishida H, Kanazawa A, Gosho M, Fujitani Y, Watada H. Relationship between dietary patterns and risk factors for cardiovascular disease in patients with type 2 diabetes mellitus: a cross-sectional study. Nutr J 2016; 15:15. [PMID: 26847556 PMCID: PMC4743161 DOI: 10.1186/s12937-016-0132-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 01/21/2016] [Indexed: 12/15/2022] Open
Abstract
Background While some dietary patterns are associated with the incidence of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), the relationship between dietary pattern and risk factors for CVD in patients with T2DM remains to be clarified. The aim of this study was to identify dietary patterns and investigate the relationship between dietary patterns and potential risk factors for CVD in patients with T2DM. Methods The study participants comprised 726 Japanese T2DM outpatients free of history of CVD. Life styles were analyzed using self-reported questionnaires. The relationship between dietary patterns, identified by factor analysis, and potential risk factors for CVD was investigated by linear and logistic regression analyses. Results Six dietary patterns were identified by factor analysis. Especially, three dietary patterns were associated with risk factors for CVD. The “Seaweeds, Vegetables, Soy products and Mushrooms” pattern, characterized by high consumption of seaweeds, soy products and mushrooms, was associated with lower use of diabetes medication and healthier lifestyles. The “Noodle and Soup” pattern, characterized by high consumption of noodle and soup was associated with higher body mass index, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase and triglyceride levels. The “Fruit, Dairy products and Sweets” pattern was associated with lower γ-glutamyl transpeptidase levels, blood pressure, albuminuria and brachial-ankle pulse wave velocity. Conclusions The findings suggested that dietary patterns correlated with risk factors for CVD in T2DM patients.
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Affiliation(s)
- Yusuke Osonoi
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan. .,Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Takeshi Osonoi
- Naka Memorial Clinic, 745-5, Nakadai, Naka, Ibaraki, 311-0113, Japan.
| | - Miyoko Saito
- Naka Memorial Clinic, 745-5, Nakadai, Naka, Ibaraki, 311-0113, Japan.
| | - Atsuko Tamasawa
- Naka Memorial Clinic, 745-5, Nakadai, Naka, Ibaraki, 311-0113, Japan.
| | - Shiho Nakayama
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Yuki Someya
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Hidenori Ishida
- Naka Memorial Clinic, 745-5, Nakadai, Naka, Ibaraki, 311-0113, Japan.
| | - Akio Kanazawa
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan. .,Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Masahiko Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Yoshio Fujitani
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan. .,Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Bunkyoku, Tokyo, 113-8421, Japan. .,Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Bunkyoku, Tokyo, 113-8421, Japan. .,Sportology Center, Juntendo University Graduate School of Medicine, Bunkyoku, Tokyo, 113-8421, Japan.
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Osonoi Y, Mita T, Osonoi T, Saito M, Tamasawa A, Nakayama S, Someya Y, Ishida H, Kanazawa A, Gosho M, Fujitani Y, Watada H. Poor sleep quality is associated with increased arterial stiffness in Japanese patients with type 2 diabetes mellitus. BMC Endocr Disord 2015; 15:29. [PMID: 26084960 PMCID: PMC4472398 DOI: 10.1186/s12902-015-0026-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 06/01/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While poor sleep quality can worsen cardiovascular risk factors such as glucose and lipid profiles in patients with type 2 diabetes mellitus (T2DM), the relationship between sleep quality and atherosclerosis remains largely unknown. The aim of this study was to examine this relationship. METHODS The study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. The relationships between sleep quality (assessed by the Pittsburgh Sleep Quality Index (PSQI)) and various clinical and laboratory parameters were investigated. RESULTS The mean PSQI was 5.1 ± 3.0 (±SD). Patients were divided into three groups based on the total PSQI score; subjects with good sleep quality (n = 462), average sleep quality (n = 185), and poor sleep quality (n = 77). In the age/gender-adjusted model, patients with poor sleep quality tended to be obese, evening type and depressed. However, other lifestyles showed no significant trends. Alanine aminotransferase, fasting blood glucose, HbA1c, systolic blood pressure, urinary albumin excretion, and brachial-ankle pulse wave velocity (baPWV) tended to be higher in patients with poor sleep quality. High baPWV was the only parameter that correlated with poor sleep in a model adjusted for several other lifestyle factors. CONCLUSIONS Our study indicates that poor sleep quality in T2DM patients correlates with increased arterial wall stiffness, a marker of atherosclerosis and a risk factor for cardiovascular diseases.
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Affiliation(s)
- Yusuke Osonoi
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
| | - Tomoya Mita
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
- Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
| | - Takeshi Osonoi
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, 311-0113, Ibaraki, Japan.
| | - Miyoko Saito
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, 311-0113, Ibaraki, Japan.
| | - Atsuko Tamasawa
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, 311-0113, Ibaraki, Japan.
| | - Shiho Nakayama
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
| | - Yuki Someya
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
| | - Hidenori Ishida
- Naka Memorial Clinic, 745-5, Nakadai, Naka City, 311-0113, Ibaraki, Japan.
| | - Akio Kanazawa
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
- Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
| | - Masahiko Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
| | - Yoshio Fujitani
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
- Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
- Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, 113-8421, Tokyo, Japan.
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9
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Osonoi T, Saito M, Tamasawa A, Ishida H, Tsujino D, Nishimura R, Utsunomiya K. Effect of hemodialysis on plasma glucose profile and plasma level of liraglutide in patients with type 2 diabetes mellitus and end-stage renal disease: a pilot study. PLoS One 2014; 9:e113468. [PMID: 25526642 PMCID: PMC4272272 DOI: 10.1371/journal.pone.0113468] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 10/27/2014] [Indexed: 11/28/2022] Open
Abstract
The effect of hemodialysis on the plasma glucose profile and liraglutide level after liraglutide injection was investigated in patients with diabetes and end-stage renal disease (ESRD). Either 0.6 mg or 0.9 mg liraglutide was subcutaneously administered daily to 10 Japanese type 2 diabetic patients with ESRD. Hemodialysis was conducted on days 1 and 3. Plasma liraglutide and glucose concentrations were measured by enzyme-linked immunosorbent assay and a continuous glucose monitoring system, respectively. The safety profile of liraglutide was also assessed. Hemodialysis had no effect on the pharmacokinetic parameters of liraglutide in patients with diabetes and ESRD; the maximum plasma concentration (Cmax), tmax, area under the concentration-time curve (AUC), and CL/f were unaltered. Similarly, hemodialysis did not affect the mean or minimum glucose levels, AUC, or duration of hyperglycemia (>180 mg/dL) and hypoglycemia (<70 mg/dL) following liraglutide administration. However, significant increases in mean amplitude of glycemic excursions (MAGE) and standard deviation (SD) as markers of glucose fluctuation, and the maximum glucose level were observed during hemodialysis. No adverse events, including hypoglycemia, were observed after liraglutide injection, either off-hemodialysis (day 2) or on-hemodialysis (day 3). Liraglutide was well tolerated in patients with type 2 diabetes and ESRD undergoing hemodialysis. The present results suggested that hemodialysis did not affect the pharmacokinetic profile of liraglutide or most glycemic indices, with the exception of MAGE, SD, and the maximum glucose level. These results suggested that it may be possible to use liraglutide during hemodialysis for diabetes with ESRD, without dose adjustment. Trial Registration UMIN Clinical Trials Registry (UMIN-CTR) UMIN000010159
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Affiliation(s)
- Takeshi Osonoi
- Nakakinen Clinic, Department of Internal Medicine, Naka, Ibaraki, Japan
- * E-mail:
| | - Miyoko Saito
- Nakakinen Clinic, Department of Internal Medicine, Naka, Ibaraki, Japan
| | - Atsuko Tamasawa
- Nakakinen Clinic, Department of Internal Medicine, Naka, Ibaraki, Japan
| | - Hidenori Ishida
- Nakakinen Clinic, Department of Internal Medicine, Naka, Ibaraki, Japan
| | - Daisuke Tsujino
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Rimei Nishimura
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Kazunori Utsunomiya
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
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10
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Osonoi Y, Mita T, Osonoi T, Saito M, Tamasawa A, Nakayama S, Someya Y, Ishida H, Kanazawa A, Gosho M, Fujitani Y, Watada H. Morningness–eveningness questionnaire score and metabolic parameters in patients with type 2 diabetes mellitus. Chronobiol Int 2014; 31:1017-23. [DOI: 10.3109/07420528.2014.943843] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Osonoi T, Saito M, Tamasawa A, Ishida H, Osonoi Y. Effects of sitagliptin or mitiglinide as an add-on to acarbose on daily blood glucose fluctuations measured by 72 h subcutaneous continuous glucose monitoring in Japanese patients with type 2 diabetes: a prospective randomized study. Expert Opin Pharmacother 2014; 15:1325-35. [PMID: 24866329 DOI: 10.1517/14656566.2014.920323] [Citation(s) in RCA: 7] [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] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Postprandial hyperglycemia and blood glucose fluctuations increase the risk of macroangiopathy in patients with type 2 diabetes mellitus (T2DM). However, few studies have examined the effects of oral hypoglycemic drugs on blood glucose fluctuations in daily life. METHODS Twenty-nine T2DM patients treated with acarbose were randomized to receive either sitagliptin (14 patients) or mitiglinide (15 patients) together with acarbose for 4 weeks. Patients were then switched to a combination of 10 mg mitiglinide and 0.2 mg voglibose for 4 weeks. All patients wore a continuous glucose monitoring (CGM) device for 5 - 7 days in week 3 of each treatment period. RESULTS The percentage of blood glucose levels in the hyperglycemic range, blood glucose indices derived from 24-h CGM profiles and the glycemic parameters (HbA1c, glycated albumin and fasting plasma glucose) were significantly improved by adding sitagliptin or mitiglinide to ongoing acarbose therapy. These parameters also tended to improve in the mitiglinide/voglibose combination period. CONCLUSION Daily blood glucose fluctuations were significantly improved by adding sitagliptin or mitiglinide to acarbose, and improved after switching to the mitiglinide/voglibose combination. Larger controlled studies are needed to verify the effects of adding sitagliptin or mitiglinide to acarbose on glucose fluctuations.
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Affiliation(s)
- Takeshi Osonoi
- NakaKinen Clinic , 745-5, Nakadai, Naka, Ibaraki , Japan
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12
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Tamasawa N, Tamasawa A, Takebe K, Hayakari M. The effect of dietary 7-ketocholesterol, inhibitor of sterol synthesis, on hepatic microsomal cholesterol 7 alpha-hydroxylase activity in rat. Biochim Biophys Acta 1994; 1214:20-6. [PMID: 8068724 DOI: 10.1016/0005-2760(94)90004-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A group of oxygenated sterols has been identified as physiological regulators of hepatic cholesterol biosynthesis. However, the regulatory effects of these oxysterols on cholesterol 7 alpha-hydroxylase, the rate-limiting enzyme in bile acid biosynthesis, is not clearly elucidated. We administered 0.1% 7-ketocholesterol (15 mg/day), a strong inhibitor of sterol synthesis, to rats orally for 6 days. Then, the levels of accumulated oxysterols in liver microsomes and microsomal 7 alpha-hydroxylase activity were determined. The results were compared to those in the groups of rats treated with either control diet or diets containing 0.1 or 1% cholesterol, 0.1% butylated hydroxytoluene, 3% cholestyramine or 1% taurocholate. 7-Ketocholesterol feeding resulted in significant increase of both 7-ketocholesterol and 7 beta-hydroxycholesterol in microsomal fraction (449.4 +/- 36.8 and 438.2 +/- 46.8 ng/mg protein, respectively; mean +/- S.E.). Hepatic microsomal 7 alpha-hydroxylase activity in the rats fed 7-ketocholesterol was significantly elevated as compared with those of control rats; 44.70 +/- 5.97 vs. 16.57 +/- 2.46 pmol/min per mg protein. Addition of BHT to 7-ketocholesterol reduced the accumulation of 7 beta-hydroxycholesterol, and the stimulatory effect of 7-ketocholesterol on 7 alpha-hydroxylase activity was suppressed. Our results demonstrate that oxysterols do not inhibit but rather stimulate hepatic microsomal 7 alpha-hydroxylase.
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Affiliation(s)
- N Tamasawa
- Third Department of Internal Medicine, Hirosaki University School of Medicine, Horosaki, Japan
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13
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Tamasawa A, Onuma T, Tsutsui M, Boku A, Ochiai S, Takebe K. Lipid composition of platelets in patients with non-insulin-dependent diabetes mellitus: studies before and after treatment of diabetes. Diabet Med 1994; 11:268-72. [PMID: 8033525 DOI: 10.1111/j.1464-5491.1994.tb00270.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The study was designed to investigate whether impaired composition of platelet lipids in untreated diabetic patients improved after diabetic treatment. Fourteen untreated patients with non-insulin-dependent diabetes mellitus (NIDDM) and 15 healthy control subjects were studied. In the diabetic patients, the ratio of free cholesterol to phospholipid (FC/PL) in platelets of 0.33 +/- 0.02 (mean +/- SEM) at pre-treatment, which was statistically (p < 0.05) higher than that of 0.26 +/- 0.02 in control subjects, was significantly decreased to the value of 0.29 +/- 0.02 (p < 0.01) after insulin therapy. Platelet FC level of 9.77 +/- 0.77 micrograms 10(-8) cells pre-treatment was significantly (p < 0.01) reduced to the value of 7.72 +/- 0.38 micrograms 10(-8) cells post-treatment. Platelet PL level showed no significant changes after the treatment. There was a significantly (p < 0.01) positive correlation between the decrease in FC/PL of platelets and that in haemoglobin A1c (HbA1c) after treatment for diabetes (rs = -0.729). These results indicate that the impaired lipid composition in platelets can be improved after an adequate glycaemic control in patients with NIDDM.
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Affiliation(s)
- A Tamasawa
- Third Department of Internal Medicine, Hirosaki University School of Medicine, Japan
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Abstract
An analytical method for the determination of cholesterol sulfate (CS) in plasma using gas-liquid chromatography was developed. We measured plasma CS concentrations in patients with liver cirrhosis and hypercholesterolemia as examples of disorders that involve aberrations in cholesterol metabolism. Patients with liver cirrhosis had plasma CS concentrations that were significantly higher than those of control subjects (444.6 +/- 51.7 vs. 253.0 +/- 24.6 micrograms/dL, mean +/- SE). The levels of other lipids were lower in cirrhotics, although the differences were not significant. There was no correlation between the levels of CS and sulfated bile acids in cirrhotic patients. CS levels in plasma were also higher in subjects with hypercholesterolemia (413.7 +/- 44.5 micrograms/dL); however, the ratio of CS to total cholesterol (TC) clearly differed between cirrhotics and hypercholesterolemic subjects (1.44 +/- 0.11 x 10(-3) vs. 3.31 +/- 0.63 x 10(-3); P < 0.05). Both in subjects with hypercholesterolemia and in healthy controls, the CS/TC ratio was similar and CS accounted for roughly 0.14% of the TC concentration.
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Affiliation(s)
- N Tamasawa
- Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan
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