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Yagi K, Okazaki S, Ohbatake A, Nakaya M, Liu J, Arite E, Miyamoto Y, Ito N, Nakano K, Yamaaki N, Honoki H, Fujisaka S, Chujo D, Tsunoda SI, Yanagimoto K, Nozue T, Yamada M, Ooe K, Araki T, Nakashima A, Azami Y, Sodemoto Y, Tadokoro K, Nagano M, Noguchi T, Nohara A, Origasa H, Niida Y, Tada H. Negative correlation between organ heteroplasmy, particularly hepatic heteroplasmy, and age at death revealed by post-mortem studies of m.3243A > G cases. Mol Genet Metab 2023; 140:107691. [PMID: 37660570 DOI: 10.1016/j.ymgme.2023.107691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/27/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023]
Abstract
Mitochondrial DNA m.3243A > G mutation causes mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and its associated multi-organ disorders, including diabetes. To clarify associations between m.3243A > G organ heteroplasmy and clinical phenotypes, including the age at death, we combined genetic and pathological examinations from seven unreported and 36 literature cases of autopsied subjects. Clinical characteristics of subjects were as follows: male, 13; female, 28; unknown, 2; the age at death, 36.9 ± 20.2 [4-82] years; BMI, 16.0 ± 2.9 [13.0-22.3]; diabetes, N = 21 (49%), diabetes onset age 38.6 ± 14.2 years; deafness, N = 27 (63%); stroke-like episodes (StLEp), N = 25 (58%); congestive heart failure (CHF), N = 15 (35%); CHF onset age, 51.3 ± 14.5 years. Causes of death (N = 32) were as follows: cardiac, N = 13 (41%); infection, N = 8 (25%); StLEp, N = 4 (13%); gastrointestinal, N = 4 (13%); renal, N = 2 (6%); hepatic, N = 1 (2%). High and low heteroplasmies were confirmed in non-regenerative and regenerative organs, respectively. Heteroplasmy of the liver, spleen, leukocytes, and kidney for all subjects was significantly associated with the age at death. Furthermore, the age at death was related to juvenile-onset (any m.3243A > G-related symptoms appeared before 20) and stroke-like episodes. Multiple linear regression analysis with the age at death as an objective variable showed the significant contribution of liver heteroplasty and juvenile-onset to the age at death. m.3243A > G organ heteroplasmy levels, particularly hepatic heteroplasmy, are significantly associated with the age at death in deceased cases.
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Affiliation(s)
- Kunimasa Yagi
- Center for Clinical Genomics, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan; Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan; First Department of Internal Medicine, Toyama University, Toyama 934-0194, Japan.
| | - Satoko Okazaki
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Azusa Ohbatake
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Masako Nakaya
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Jianhui Liu
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan; First Department of Internal Medicine, Toyama University, Toyama 934-0194, Japan
| | - Eiko Arite
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Yukiko Miyamoto
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Naoko Ito
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Kaoru Nakano
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Naoto Yamaaki
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Hisae Honoki
- First Department of Internal Medicine, Toyama University, Toyama 934-0194, Japan
| | - Shiho Fujisaka
- First Department of Internal Medicine, Toyama University, Toyama 934-0194, Japan
| | - Daisuke Chujo
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan; First Department of Internal Medicine, Toyama University, Toyama 934-0194, Japan
| | - Shin-Ichiro Tsunoda
- Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, Yokohama 247-8581, Japan
| | - Kunio Yanagimoto
- Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, Yokohama 247-8581, Japan
| | - Tsuyoshi Nozue
- Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, Yokohama 247-8581, Japan
| | - Masayo Yamada
- Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, Yokohama 247-8581, Japan
| | - Kotaro Ooe
- Department of Internal Medicine, Saiseikai Kanazawa Hospital, Kanazawa 920-0353, Japan
| | - Tsutomu Araki
- Department of Internal Medicine, Saiseikai Kanazawa Hospital, Kanazawa 920-0353, Japan
| | - Akikatsu Nakashima
- Department of Internal Medicine, Ishikawa Prefectural Central Hospital, Kanazawa 920-8530, Japan
| | | | | | - Kenichi Tadokoro
- Bio Medical Laboratory (BML), Inc., 1361-1 Matoba, Kawagoe, Saitama 350-1101, Japan
| | - Makoto Nagano
- Bio Medical Laboratory (BML), Inc., 1361-1 Matoba, Kawagoe, Saitama 350-1101, Japan
| | - Tohru Noguchi
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
| | - Atushi Nohara
- Department of Internal Medicine, Ishikawa Prefectural Central Hospital, Kanazawa 920-8530, Japan
| | - Hideki Origasa
- The Institute of Statistical Mathematics, Toyama University, Toyama 934-0194, Japan
| | - Yo Niida
- Center for Clinical Genomics, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan
| | - Hayato Tada
- Second Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa 920-8641, Japan
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Yagi K, Imamura T, Tada H, Liu J, Miyamoto Y, Ohbatake A, Ito N, Shikata M, Enkaku A, Takikawa A, Honoki H, Fujisaka S, Chujo D, Origasa H, Kinugawa K, Tobe K. Fragmented QRS on electrocardiography as a predictor for diastolic cardiac dysfunction in type 2 diabetes. J Diabetes Investig 2022; 13:1052-1061. [PMID: 35092353 PMCID: PMC9153843 DOI: 10.1111/jdi.13759] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 11/28/2022] Open
Abstract
Aims/Introduction Diastolic cardiac dysfunction in type 2 diabetes (DD2D) is a critical risk of heart failure with preserved ejection fraction. However, there is no established biomarker to detect DD2D. We aimed to investigate the predictive impact of fragmented QRS (fQRS) on electrocardiography on the existence of DD2D. Materials and Methods We included in‐hospital patients with type 2 diabetes without heart failure symptoms who were admitted to our institution for glycemic management between November 2017 and April 2021. An fQRS was defined as an additional R′ wave or notching/splitting of the S wave in two contiguous electrocardiography leads. DD2D was diagnosed according to the latest guidelines of the American Society of Echocardiography. Results Of 320 participants, 122 patients (38.1%) had fQRS. DD2D was diagnosed in 82 (25.6%). An fQRS was significantly associated with the existence of DD2D (odds ratio 4.37, 95% confidence interval 2.33–8.20; p < 0.0001) adjusted for seven potential confounders. The correlation between DD2D and diabetic microvascular disease was significant only among those with fQRS. Classification and regression tree analysis showed that fQRS was the most relevant optimum split for DD2D. Conclusions An fQRS might be a simple and promising predictor of the existence of DD2D. The findings should be validated in a larger‐scale cohort.
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Affiliation(s)
- Kunimasa Yagi
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Teruhiko Imamura
- 2nd Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Hayato Tada
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Jianhui Liu
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Yukiko Miyamoto
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Azusa Ohbatake
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Naoko Ito
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Masataka Shikata
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Asako Enkaku
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Akiko Takikawa
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Hisae Honoki
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Shiho Fujisaka
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Daisuke Chujo
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
- 2nd Department of Internal Medicine Kanazawa University Graduate School of Medical Science 13‐1 Takaramachi Kanazawa 920‐0934 Japan
| | - Hideki Origasa
- Biostatistics and Clinical Epidemiology University of Toyama Graduate School of Medicine and Pharmaceutical Sciences 2630 Sugitani Toyama 934‐0194 Japan
| | - Koichiro Kinugawa
- 2nd Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
| | - Kazuyuki Tobe
- 1st Department of Internal Medicine University of Toyama 2630 Sugitani Toyama 934‐0194 Japan
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Yagi K, Imamura T, Tada H, Chujo D, Liu J, Shima Y, Ohbatake A, Miyamoto Y, Okazaki S, Ito N, Nakano K, Shikata M, Enkaku A, Takikawa A, Honoki H, Fujisaka S, Origasa H, Tobe K. Diastolic Cardiac Function Improvement by Liraglutide Is Mainly Body Weight Reduction Dependent but Independently Contributes to B-Type Natriuretic Peptide Reduction in Patients with Type 2 Diabetes with Preserved Ejection Fraction. J Diabetes Res 2021; 2021:8838026. [PMID: 33855087 PMCID: PMC8019623 DOI: 10.1155/2021/8838026] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 02/15/2021] [Accepted: 03/06/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES A single-arm prospective study was conducted among Japanese patients with type 2 diabetes having preserved ejection fraction. The aim was to investigate (1) whether liraglutide therapy could improve B-type natriuretic peptide (BNP) levels and diastolic cardiac function assessed by the E-wave to E' ratio (E/E') using transthoracic echocardiography (TTE), and (2) whether E/E' contributed to BNP improvement independent of bodyweight reduction (UMIN000005565). METHODS Patients with type 2 diabetes and left ventricular ejection fraction (LVEF) ≥ 40% without heart failure symptoms were enrolled, and daily injection with liraglutide (0.9 mg) was introduced. Cardiac functions were assessed by TTE before and after 26 weeks of liraglutide treatment. Diastolic cardiac function was defined as septal E/E' ≥ 13.0. RESULTS Thirty-one patients were analyzed. BNP and E/E' improved, with BNP levels declining from 36.8 ± 30.5 pg/mL to 26.3 ± 25.9 pg/mL (p = 0.0014) and E/E' dropping from 12.7 ± 4.7 to 11.0 ± 3.3 (p = 0.0376). The LVEF showed no significant changes. E/E' improved only in patients with E/E' ≥ 13.0. Favorable changes in E/E' were canceled when adjusted for body mass index (BMI). Multivariate linear regression analysis revealed that the left ventricular diastolic diameter and ∆E/E'/∆BMI contributed to ∆BNP/baseline BNP (p = 0.0075, R 2 = 0.49264). CONCLUSIONS Liraglutide had favorable effects on BNP and E/E' but not on LVEF. E/E' improvement was only seen in patients with diastolic cardiac function. Body weight reduction affected the change of E/E'. The BMI-adjusted E/E' significantly contributed to the relative change of BNP. GLP-1 analog treatment could be considered a therapeutic option against diabetic diastolic cardiac dysfunction regardless of body weight. This trial is registered with the University Hospital Medical Information Network in Japan, with clinical trial registration number: UMIN000005565.
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Affiliation(s)
- Kunimasa Yagi
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Teruhiko Imamura
- 2nd Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Hayato Tada
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Daisuke Chujo
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Jianhui Liu
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Yuuki Shima
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Azusa Ohbatake
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Yukiko Miyamoto
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Satoko Okazaki
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Naoko Ito
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Kaoru Nakano
- 2nd Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-0934, Japan
| | - Masataka Shikata
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Asako Enkaku
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Akiko Takikawa
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Hisae Honoki
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Shiho Fujisaka
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
| | - Hideki Origasa
- Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 934-0194, Japan
| | - Kazuyuki Tobe
- 1st Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 934-0194, Japan
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Sawamura T, Karashima S, Nagase S, Nambo H, Shimizu E, Higashitani T, Aono D, Ohbatake A, Kometani M, Demura M, Furukawa K, Takeda Y, Yoneda T. Effect of sodium-glucose cotransporter-2 inhibitors on aldosterone-to-renin ratio in diabetic patients with hypertension: a retrospective observational study. BMC Endocr Disord 2020; 20:177. [PMID: 33256676 PMCID: PMC7706199 DOI: 10.1186/s12902-020-00656-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 11/20/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Plasma aldosterone-to-renin ratio (ARR) is popularly used for screening primary aldosteronism (PA). Some medications, including diuretics, are known to have an effect on ARR and cause false-negative and false-positive results in PA screening. Currently, there are no studies on the effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors, which are known to have diuretic effects, on ARR. We aimed to investigate the effects of SGLT2 inhibitors on ARR. METHODS We employed a retrospective design; the study was conducted from April 2016 to December 2018 and carried out in three hospitals. Forty patients with diabetes and hypertension were administered SGLT2 inhibitors. ARR was evaluated before 2 to 6 months after the administration of SGLT2 inhibitors to determine their effects on ARR. RESULTS No significant changes in the levels of ARR (90.9 ± 51.6 vs. 81.4 ± 62.9) were found. Body mass index, diastolic blood pressure, heart rate, fasting plasma glucose, and hemoglobin A1c were significantly decreased by SGLT2 inhibitors. Serum creatinine was significantly increased. CONCLUSION SGLT2 inhibitor administration yielded minimal effects on ARR and did not increase false-negative results in PA screening in patients with diabetes and hypertension more than 2 months after administration.
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Affiliation(s)
- Toshitaka Sawamura
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
- Division Department of Diabetes and Endocrinology and Internal Medicine, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, Fukui 910-8526 Japan
| | - Shigehiro Karashima
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Satoshi Nagase
- Department of Laboratory Sciences, Faculty of Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Hidetaka Nambo
- School of Electrical, Information and Communication Engineering, College of Science and Engineering, Kanazawa University, Kanazawa, Japan
| | - Eiko Shimizu
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Takuya Higashitani
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
- Division Department of Diabetes and Endocrinology and Internal Medicine, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, Fukui 910-8526 Japan
| | - Daisuke Aono
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Azusa Ohbatake
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Mitsuhiro Kometani
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Masashi Demura
- Department of Hygiene, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Kenji Furukawa
- Health Care Center, Japan Advanced Institute of Science and Technology, 1-1 Asahidai, Nomi, Ishikawa 923-1292 Japan
| | - Yoshiyu Takeda
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
| | - Takashi Yoneda
- Division of Endocrine and Diabetes, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
- Division Department of Internal Medicine, Houju memorial hospital, 11-71 Midorigaoka, Nomi, Ishikawa 923-1226 Japan
- Institute of Liberal Arts and Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
- Department of Health Promotion and Medicine of the Future, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 Japan
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Ohbatake A, Yagi K, Karashima S, Shima Y, Miyamoto Y, Asaka H, Okazaki S, Kometani M, Kawashiri MA, Takeda Y, Yoneda T, Chujo D. C-Peptide Area Under the Curve at Glucagon Stimulation Test Predicts Glucose Improvements by GLP-1 Receptor Analogue: A Retrospective Observational Study. Diabetes Ther 2019; 10:673-681. [PMID: 30788807 PMCID: PMC6437227 DOI: 10.1007/s13300-019-0586-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Despite the widespread use of glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1ras) to improve glycemic regulation, with a low risk of hypoglycemia and weight reduction, their effectiveness varies among individuals. This study aimed to identify predictors of the efficacy of GLP-1ra on Hemoglobin A1c (HbA1c) in patients with insulin-independent diabetes. METHODS In total, 58 patients with insulin-independent diabetes were included. Patients were included if their β-cell function was evaluated via a glucagon stimulation test (GST) before the introduction of GLP-1ra therapy. β-Cell function-related indices, such as the C-peptide index (CPI), increments in C-peptide immunoreactivity (CPR) after glucagon stimulation (ΔCPR), and the area under the CPR curve (CPR-AUC) during the GST, were evaluated. HbA1c and body weight (BW) were measured at 6 and 12 months after the initiation of GLP-1ra. RESULTS A univariate regression analysis revealed a significant correlation between CPR-AUC and changes in HbA1c at 6 months and with changes in BW at 6 and 12 months. A multivariate regression analysis revealed that CPR-AUC was significantly correlated with changes in HbA1c at 6 months. A receiver-operating characteristic analysis revealed that 21.9 ng/ml·min CPR-AUC was the optimal cut-off value to predict an HbA1c level < 7%, i.e., 53 mmol/mol. CONCLUSION Residual β-cell function, as assessed via CPR-AUC in the GST, is an effective predictor of the efficacy of GLP-1ras.
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Affiliation(s)
- Azusa Ohbatake
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Kunimasa Yagi
- First Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Shigehiro Karashima
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yuki Shima
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yukiko Miyamoto
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Hiroyuki Asaka
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Satoko Okazaki
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Mitsuhiro Kometani
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Masa-Aki Kawashiri
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yoshiyu Takeda
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Takashi Yoneda
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
- Department of Health Promotion and Medicine of the Future, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
- Institute of Liberal Arts and Science, Kanazawa University, Kanazawa, Japan
| | - Daisuke Chujo
- Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
- Department of Diabetes, Endocrinology, and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan.
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Liu J, Yagi K, Nohara A, Chujo D, Ohbatake A, Fujimoto A, Miyamoto Y, Kobayashi J, Yamagishi M. High frequency of type 2 diabetes and impaired glucose tolerance in Japanese subjects with the angiopoietin-like protein 8 R59W variant. J Clin Lipidol 2017; 12:331-337. [PMID: 29397342 DOI: 10.1016/j.jacl.2017.12.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/30/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Angiopoietin-like protein 8 (ANGPTL8) is considered to be metabolically multifunctional. One notable function still to be elucidated definitively is a betatrophic role in protecting and preserving pancreatic beta-cell function. There is, however, a paucity of data regarding the role of ANGPTL8 in the etiology of type 2 diabetes (T2D), but some findings of human research have suggested the potential for significant involvement. OBJECTIVE To examine the frequency of T2D and impaired glucose tolerance (IGT) in Japanese subjects with the ANGPTL8 R59W variant. METHODS ANGPTL8 R59W (Rs2278426, c.194C > T) was determined by polymerase chain reaction-restriction fragment length polymorphism using the restriction enzyme FokI in 797 consecutive Japanese individuals. Subjects with triglyceride levels greater than or equal to 150 mg/dL were considered to be hypertriglyceridemic. RESULTS Genotype frequencies of ANGPTL8 R59W were as follows: wild-type RR (C/C) 53.5%, RW (C/T) 36.6%, and WW (T/T) 9.9%. T2D and IGT were significantly prevalent in WW and RW subjects relative to RR among all 797 subjects (P = .0138) and also in hypertriglyceridemic subjects (P = .0015). In multiple logistic regression models for the existence of T2D and IGT in hypertriglyceridemic subjects, the odds ratio for heterozygote RW and homozygote WW genotypes to wild-type RR was 2.406 (P = .0017) after controlling the risk factors of age, gender, and body mass index as covariates. CONCLUSIONS The frequency of ANGPTL8 R59W is significantly higher in Japanese subjects than in other ethnic groups. The rates of T2D and IGT were greater in subjects with the R59W variant. These findings indicate that ANGPTL8 is a participant in diabetes and a potential therapeutic target for T2D prevention, especially in East Asians.
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Affiliation(s)
- Jianhui Liu
- Department of Internal Medicine, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan.
| | - Kunimasa Yagi
- Department of Internal Medicine, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan; First Department of Internal Medicine, Toyama University, Toyama, Japan
| | - Atsushi Nohara
- Department of Internal Medicine, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Daisuke Chujo
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Azusa Ohbatake
- Department of Internal Medicine, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Aya Fujimoto
- Department of Internal Medicine, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Yukiko Miyamoto
- Department of Internal Medicine, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Junji Kobayashi
- Department of General Medicine, Kanazawa Medical University, Kahoku, Japan
| | - Masakazu Yamagishi
- Department of Internal Medicine, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
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Yamaaki N, Yagi K, Kobayashi J, Nohara A, Ito N, Asano A, Nakano K, Liu J, Okamoto T, Mori Y, Ohbatake A, Okazaki S, Takeda Y, Yamagishi M. Impact of serum retinol-binding protein 4 levels on regulation of remnant-like particles triglyceride in type 2 diabetes mellitus. J Diabetes Res 2013; 2013:143515. [PMID: 23671852 PMCID: PMC3647570 DOI: 10.1155/2013/143515] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Accepted: 02/12/2013] [Indexed: 11/21/2022] Open
Abstract
Background. Although retinol-binding protein 4 (RBP4) associates with insulin resistance and remnant-like particles triglyceride (RLP-TG) elevated in the insulin resistant state, few data exist regarding the relationship between RBP4 and RLP-TG. Subjects and Methods. The study included 92 Japanese type 2 diabetic mellitus (T2DM) male patients (age 60.5 ± 13.6 years, body mass index (BMI) 24.7 ± 4.1 kg/m(2), waist circumference (WC) 88.4 ± 10.7 cm, and HbA1c (NGSP) 7.2 ± 1.9%). Patients on medications affecting insulin sensitivity, including fibrates, biguanides, and thiazolidinedione, were excluded. Visceral fat area (VFA) and subcutaneous fat area (SFA) were measured by computed tomography. Results. RBP4 levels showed a significant positive correlation with RLP-TG (r = 0.2544 and P = 0.0056), TG (r = 0.1852 and P = 0.041), RLP-TG/TG (r = 0.23765 and P = 0.0241), and age (r = -0.2082 and P = 0.0219), although there was no significant correlation with VFA, SFA, adiponectin levels, or homeostasis model of assessment insulin resistance (HOMA-R). Multiple regression analysis revealed that RBP4 was an independent determinant of RLP-TG (P = 0.0193) but was not a determinant of TG. Conclusions. RBP4 correlates positively with serum RLP-TG independent of fat accumulation in T2DM. RBP4 may regulate remnant metabolism independent of glycemic control in T2DM.
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Affiliation(s)
- Naoto Yamaaki
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Kunimasa Yagi
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
- *Kunimasa Yagi:
| | - Junji Kobayashi
- Department of General Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku 920-0293, Japan
| | - Atsushi Nohara
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Naoko Ito
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Akimichi Asano
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Kaoru Nakano
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Jianhui Liu
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Takuya Okamoto
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Yukiko Mori
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Azusa Ohbatake
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Satoko Okazaki
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Yoshiyu Takeda
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
| | - Masakazu Yamagishi
- Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8640, Japan
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