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Volume 32, Issue 12
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[in Japanese]1989 Volume 32 Issue 12 Pages 851-852
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (424K) -
Ryuichi Fujiwara, Yasunori Kutsumi, Takio Hayashi, Toshitaka Tamai, So ...1989 Volume 32 Issue 12 Pages 853-857
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo clarify the coronary risk factors in borderline diabetes, we investigated plasma lipid and apolipoprotein concentrations and insulin response to glucose ingestion in 41 normolipidemic males (total cholesterol <230 mg/dl, triglycerides <150 mg/dl) undergoing selective coronary angiography. The patients were divided into two groups: patients with coronary artery disease (CAD: n=28) and those with normal coronary arteries (NCA: n=13). The conventional risk factors such as age, obesity, smoking and hypertension were not different in the two groups. The total cholesterol and triglyceride concentrations were significantly higher in the CAD group, whereas HDL cholesterol concentrations were significantly lower in the CAD group. The CAD group had a lower level of apolipoprotein A-I and a higher level of apolipoprotein B. The insulin areas (ΣIRI) and early insulin response (ΔIRI) assessed by the 75 g oral glucose tolerance test were significantly higher in the CAD group. Multivariate analysis confirmed the independent effects of apolipoprotein A-I and apolipoprotein B levels on the severity of CAD. The present data demonstrated the importance of lipid and apolipoprotein metabolism in the development of CAD in normolipidemic borderline diabetic patients. In addition, the results indicated that endogenous hyperinsulinemia might be a marker of enhanced liability to the development of CAD.View full abstractDownload PDF (963K) -
Akira Tanaka, Kiyomaro Shima, Yaeko Nakajo, Yoshinori Fujinuma, Yasuhi ...1989 Volume 32 Issue 12 Pages 859-865
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSSimvastatin is known as an inhibitor of HMG-CoA reductase, which is a rate-limiting enzyme in cholesterol synthesis. To evaluate the effects of Simvastatin on hypercholesterolemia (more than 220 mg/dl) in 9 non-insulin-dependent diabetics, 2.5 mg/day of this substance was given once daily for 3 months. Changes in the levels of serum lipid, apoprotein (Apo) and hemoglobin Al (Hb-A1), lipoprotein particle size and fasting blood glucose (FBG) were observed. Serum levels of total cholesterol (TC), Apo-B and Apo-E were significantly decreased, with the maximum percentages being 20.1, 17.1 and 13.8%, respectively, while those of triglyceride, HDL-cholesterol (HDL-C), Apo-A I, Apo-All, Apo-C II and Apo-CHI did not show any significant changes. In addition, no significant changes were observed in the levels of FBG, Hb-Al and the body mass index (BMI) throughout the observation period.
Simvastatin did not affect glucose tolerance but reduced the concentration of TC and Apo-B, suggesting its effectiveness in the prevention of arteriosclerosis in diabetics. The investigation of lipoprotein particle size indicated that the action of Simvastatin may be principally that of decreasing the number of LDL particles, without changing LDL and HDL sizes.View full abstractDownload PDF (1054K) -
Kyo Sanoyama, Narihito Yoshioka, Masako Takai1989 Volume 32 Issue 12 Pages 867-872
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe investigated the clinical backgrounds and outcomes of ninety-three pregnant women who were found to have impaired glucose tolerance for the first time during pregnancy (gestational diabetes mellitus, GDM).
In most subjects, impairment of glucose tolerance improved significantly (p<0.001) after delivery, accompanied by a decrease in early insulin response during the oral glucose tolerance test (OGTT). 40.8% of the subjects were found to have normal glucose tolerances during the OGTT after delivery. GDM patients with no family history in relatives under 34 years of age showed remarkable improvement in glucose intolerance with a normal insulinogenic index after delivery, while GDM patients with a family history in relatives over 35 years of age showed less improvement.
During pregnancy most subjects attained good glycemic control and there were few maternal or fetal problems.
The presence of family histories of diabetes and aging of pregnant women were negative factors with respect to improvement in glucose tolerance after delivery. Risks of maternal and fetal problems can be avoided by strict glycemic control during pregnancy.View full abstractDownload PDF (976K) -
Fukashi Ishibashi, Kazuhiko Hatta, Kazufumi Ishida, Seiryo Takashina1989 Volume 32 Issue 12 Pages 873-877
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSGlomerular hyperfiltration (GHF) is considered one of the pathogenetic factors of diabetic nephropathy. ANP increased glomerular perfuslion pressure and induced sodium diuresis. In experimental diabetes mellitus plasma ANP levels are increased, but normalized by insulin administration. These findings suggesta probable role of ANP in the development of GHF in diabetes mellitus. In the present study, 13 recently-diagnosed NIDDM patients were studied in order to elucidate the possible role of hANP in GHF in NIDDM. Before and after strict glycemic control 24-hour hANP profiles, daily urine cGMP output and renal hemodynamics (GFR, RPF and FF) were assessed, and relationships between them were tested. No significant correlations between plasma hANP and urine cGMP or between cGMP and either GFR or FF were found. A possible conclusion is that hANP may not play a significant role in the development of GHF in recently-diagnosed NIDDM.View full abstractDownload PDF (882K) -
Masaya Sakurada, Azuma Kanatsuka, Naotake Hashimoto, Takahide Yamaguch ...1989 Volume 32 Issue 12 Pages 879-885
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe investigated the sequence of proton, potassium and calcium ionic events in perifused rat pancreatic islets prelabeled with 45Ca++. Butyric acid, a permeable weak acid, stimulated changes in 45Ca++ efflux and insulin release from islets prelabeled with 45Ca++. Raising the extracellular potassium concentration from 5.5 to 20 mM, or 0.2 mM 9-aminoacridine, which decreases the potassium permeabillity of the plasma membrane, stimulated 45Ca++ efflux and insulin release from the islets. We had demonstrated that monensin, a monovalent electroneutral ionophore, inhibits the second phase of insulin release and 45Ca++ efflux in response to glucose. However, this drug did not have any effect on the 45Ca++ effflux and insulin secretion induced by 20 mM K+, and slightly but significantly inhibited 9-aminoacridine-induced insulin secretion without inhibiting 45Ca++ efflux. This study pharmacologically confirmed the hypothesis that decreases in cytosolic pH may be involved in the mechanism of insulin secretion and this chage is followed by a reduction in the K+ permeability of the plasma membrane and an increase in Ca++ flux, resulting in insulin secretion.View full abstractDownload PDF (1168K) -
Yoko Eguchi, Yukimasa Hirata, Sumiko Hasumi, Kenshi Yao, Hiroshi Ishiz ...1989 Volume 32 Issue 12 Pages 887-892
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSInsulin autoimmune syndrom (IAS) is one of the causes of spontaneous hypoglycemia in Japan. Although the HLA-types were reported in 26 patients in Japan during 1970 to 1988, there has been no statistical analysis of HLA-types in IAS. In this study the results of that determination of HLA-type were gathered and compared with HLA-types of the general Japanese population. In the patients with IAS, the frequency of each of HLA-A 11, B 15 (Bw 62), CW 4 and DR 4 was much higher than that of each correspondent type in the general population, and an especially significant difference was detected in the inside of BW 62, CW 4 and DR 4. The remarkably high frequency of B 15 (BW 62), CW 4 and in DR 4 in IAS was not related to the use of drugs containing a SH group which might provoke IAS, nor to the age of onset of IAS. In conclusion, patients with IAS in Japan had some specific types of HLA-antigens associated with susceptibility this syndrome.View full abstractDownload PDF (1024K) -
Shunji Hoshiyama1989 Volume 32 Issue 12 Pages 893-899
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSEffect of hemodialysis on insulin receptor binding of erythrocytes was studied in chronic renal failure patients with diapetes (DN, n=7) or without diabetes (ND, n=7). There was a significant decrease in insulin binding before hemodialysis in both groups compared with healthy controls [DN: 3.4±0.5, ND: 4.2±0.8 vs N/C: 7.9±0.4%(p<0.05)]. In the DN group, there was a significant increase in insulin binding after hemodialysis [3.4±0.5% vs 5.8±0.8%(p<0.05)]. Scatchard analysis indicated that this change was due to an increase in the affinity of receptors for insulin.
To investigate the mechanism of change in insulin receptor binding in uremia, in vitro incubation studies with uremic serum or methylguanidine (MG) were carried out. Insulin binding was decreased in a dose-dependent manner at a MG concentration ranging from 10 to 100 ng/ml. There was a tendency for improvement in insulin binding 12 hours after elimination of MG from the medium (from 81±6% to 83±8%). In the uremic serum experiments, insulin binding increased significantly 12 hours after elimination of serum from the incubation medium [from 69±2% to 78±3%(p<0.05)].
These results suggest that some factors, such as MG, in uremic serum have inhibitory effects on insulin receptor binding.View full abstractDownload PDF (1093K) -
Tsukasa Murakami, Junichi Tajiri, Shiro Noguchi, Yasuyuki Ohta1989 Volume 32 Issue 12 Pages 901-905
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 40-year-old woman taking an antithyroid drug for Graves' disease was overcome by somnolence resulting from hypoglycemia (plasma glucose 34 mg/dl). Although she had never received insulin injections, antibodies against insulin were found in her serum, and a large amount of immunoreactive insulin was extracted. The immunoglobulin class of the antibodies was IgG and light chains were predominantly of the kappa type. The percent 125I-insulin binding in her serum was high, and was diminished by the addition of cold human insulin. HLA haplotype of the patient was HLA-A 24, A 11, B 7, Bw 60, Cw 3, Cw 7. She was diagnosed as having insulin autoimmune syndrome and was treated with high dose methylprednisolone which relieved her of the hypoglycemia, and subtotal thyroidectomy was subsequently performed. Six months after the episode of hypoglycemia, the patient was in a euthyroid state and had no hypoglycemic attacks in spite of the presence of autoantibodies against insulin in her serum. Methimazole seemed to trigger the production of autoantibodies against insulin in this patient and methylprednisolone pulse therapy was effective.View full abstractDownload PDF (752K) -
Nobuo Hatamori, Yuki Yamashiro, Koichi Machida, Koichi Yokono, Hiroshi ...1989 Volume 32 Issue 12 Pages 907-909
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe immunogenetic disorders of Type 1 diabetes were assessed by measuring the serum levels of soluble interleukin-2 receptors (sIL-2R) by enzyme-linked immunosorbent assay. Type 1 diabetic patients had significantly higher levels of sIL-2R in their sera (381±47 U/m/) than normal subjects (220±29U/m/, p<0.005). However, Type 2 (non-insulin-dependent) diabetic patients did not (260±58U/m/, p: NS). The mean level of sIL-2R on islet cell antibody (ICA)-positive Type 1 diabetic patients (501±73U/mi) was significantly higher than that in ICA-negative patients (256±43U/m/, p<0.01). These elvevated levels of sIL-2R in ICA-positive patients were observed in both newly diagnosed (within 3 months after onset) and long-term (>1yr) Type 1 diabetic patients (498±110U/m/ and 503±101U/m/, respectively). Neither the plasma glucose nor the glycosylated haemoglobin level was correlated with the level of sIL-2R. These results suggest a significant role of activation of IL-2R-positive cells in Type 1 diabetes.View full abstractDownload PDF (529K) -
Ryuzo Kawamori, Minoru Kubota, Takao Watarai, Shigenobu Ishida, Masahi ...1989 Volume 32 Issue 12 Pages 911-913
Published: December 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe authors demonstrated that in most non-obese NIDDM patients with secondary failure on sulfonylurea, 3 injections of sufficient regular insulin before each meal enabled to regulate glycemia throughout the day.
Out of 25 insulin-treated non-obese NIDDM patients with secondary failure on sulfonylurea, 5 showed a high fasting plasma glucose level (160±11mg/dl) in spite of having a normal plasma glucose concentration at 10 PM (113±20mg/dl). In these patients, the urinary C-peptide excretion rate from 10 PM to 7 AM was 0.56±0.49μg/h [age: 57.8±12.3 (M±SD), estimated durataion of DM 17.0±7.7, duration of sulfonylurea administration: 14.8±6.3years]
These patients were given glibenclamide 1.25-5mg/day at 10 PM as well as regular insulin 30 min before each meal.
After combined insulin-sulfonylurea therapy, complete normalization of both meal-related and pre-breakfast glycemia (109±29mg/dl) was established and the urinary C-peptide excretion rate from 10PM to 7 AM increased to 1.50±0.64μg/h.
It was demostrated that, in non-obese NIDDM patients with secondary failure on sulfonylurea whose basal insulin secretion was decreased, treatment with prandial regular insulin injections and sulfonylurea before sleep could control glycemia throughout the day.View full abstractDownload PDF (509K)
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