It has been highlighted that postprandial hyperinsulinemia-associated hypoglycemia sometimes happens in patients with morbid obesity after metabolic surgeries. In the present study, Dr. Yukako Yamamoto and her colleague provide a line of convincing data demonstrating that a 75 g glucose- and high fat-containing cookie meal test is useful in severely obese subjects to precisely evaluate glucose intolerance and postprandial dyslipidemia without occurrence of hyperinsulinemia-associated hypoglycemia. The cookie meal test may open a fresh avenue to conveniently monitor fuel homeostasis in the course of multidisciplinary therapies for obese-diabetic patients.
A variety of factors including dysregulation of renin-angiotensin-aldosterone system in both systemically and locally are well known to affect the progression of diabetic nephropathy (DN).To our surprise, however, the possible association between the plasma renin activity (PRA) and renal outcomes in patients with DN still remains obscure. In the present article, Dr. Kazuyoshi Kuma and colleague elegantly addressed such a unsolved question in a 2 year-prospective study, highlighting that low in PRA is an independent risk for the progression of DN in a Japanese cohort.
X-linked hypophosphatemia (XLH) in known to substantially secrete FGF23, thereby causing renal phosphate loss, chronic hypophosphatemia and a variety of involvement in skeletal system. However, the reality in clinics has not been fully examined. In the present study, via the online questionnaire methods, Ito N et al. comprehensively evaluate the current status and health-related quality of life in patients with XLH living in Japan and Korea, providing us with the latest knowledge and insight into XHL.
Convincing and conveniently-evaluated molecular biomarkers for prediction and assessment of metabolic syndrome are warranted to realize precision health as well as precision medicine in lifestyle-related diseases. In the present study, Yamazaki M and colleague provide intriguing evidence that level of DNA methylation of the gene encoding thioredoxin-interacting protein, a key inhibitor of cellular oxidation, is significantly decreased in peripheral blood cells from subjects with metabolic syndrome. Further extensive studies are strongly expected to see whether such a status of hypomethylation is clinically relevant to the extent of systemic oxidative stress and would be reversible in response to a line of lifestyle modifications or metabolic surgeries.
In this issue, Kamma H and colleague highlight the update of general rules for the description of thyroid cancer proposed by Japanese Society of Thyroid Pathology and Japan Association of Endocrine Surgery. This article is strongly expected to lay a brand-new cornerstone in transferring Japanese diagnostic standard on thyroid cancer for the world.
In this issue, Sugawara L and colleague provide a line of convincing results of genetic analyses on neurophysin II (NPII) in a pedigree of neurohypophyseal diabetes insipidus.