Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
Volume 39, Issue 10
Displaying 1-10 of 10 articles from this issue
  • Gen Yoshino, Seiichi Furukawa, Tsutomu Hirano, Hirokuni Naito, Tsutomu ...
    1996 Volume 39 Issue 10 Pages 757-763
    Published: October 30, 1996
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    The present study was conducted in order to examine the effect of an α-glucosidase inhibitor, acarbose, on plasma lipoproteins, especially on the plasma remnant-like particle (RLP) fraction and low density lipoprotein (LDL) particle size, in 32 patients with non-insulin dependent diabetes mellitus (NIDDM) subjects (16 male, 24 on diet and 8 on sulfonylureas). Patients who were obese, who had thyroid, renal or hepatic diseases, or those taking steroids, diuretics, β-blockers, or hypolipidemic drugs were excluded. After more than one month of stabilized blood glucose control with diet or sulfonylureas, acarbose (100 or 150mg/day) was administered. The dose was increased to 300mg/day in 3 divided doses by the 2nd month. Fasting plasma glucose and hemoglobin Alc levels tended to decrease during the 3 months of the study period but the differences were not significant. There were no significant changes in plasma levels of cholesterol, free fatty acids, apolipoprotein (apo) Al, apo B and apo E after treatment. RLP-triglyceride levels showed a significant decrease at the 3rd month while total triglyceride and RLP-cholesterol showed no significant decrease after treatment. Eighteen patients with small sized LDL (diameter less than 25.5 nm) demonstrated significantly increased LDL size at the 3rd month. Their average plasma triglyceride was significantly suppressed from the 2nd month. Although the precise mechanisms are not known, acarbose exerted favorable effects on NIDDM patients through reducing the population of atherogenic lipoproteins such as remnant-like lipoproteins and small sized LDL.
    Download PDF (994K)
  • Hiroyuki Hosojima, Eiji Miyauchi, Shinpei Morimoto, Itaru Yamamoto
    1996 Volume 39 Issue 10 Pages 765-774
    Published: October 30, 1996
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    The relationship between the resistive index (RI), pulsatility index (PI) or the acceleration index (AI) of renal interlobular arteries and the progression of diabetic nephropathy were studied using duplex Doppler sonography in 159 diabetic patients, 22 age-matched non-diabetic patients with hypertension, and 18 age-matched non-diabetic subjects without hypertension. The three parameters of renal blood flow obtained from this method were higher in diabetic patients than in nondiabetic subjects without hypertension. The RI and the Al, however, were higher in non-diabetic patients with hypertension than in those without hypertension. In diabetic patients, the 3 parameters increased in parallel with the increases in albumin excretion. The AI was the most strongly positively correlated with serum creatinine and urinary albumin excretion in all diabetic patients. The three parameters were inversely correlated with glomerular filtration rate (GFR) and renal plasma flow (RPF).
    These results indicate that all three parameters (RI, PI and AI) of these arteries markedly increased in diabetic patients, especially in those with overt nephropathy, and suggest that the AI and RI or PI values may be useful in the evaluation of the progression of nephropathy in diabetic patients.
    Download PDF (1481K)
  • Fukashi Ishibashi, Yukio Shiraishi, Katsuya Wada
    1996 Volume 39 Issue 10 Pages 775-781
    Published: October 30, 1996
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    Serum glycated transferrin (GTf) levels were determined in 55 NIDDM patients and 32 healthy controls. To eliminate globulin and albumin, serum was mixed with 40% PEG and centrifuged, and the supernatant was applied to a Blue Sepharose column. Then, GTf and nonGTf in the effluent were separated on an affinity column. Finally, transferrin in these effluents was assayed by the latex agglutination method. After albumin was washed out of the Blue Sepharose column, it was applied to an affinity column and assayed for glycated albumin (GA) and nonGA by ELISA. In NIDDM patients the GTf level (5.6±0.4%) was lower than that of HbA1c (9.2±0.4%) and GA (17.1±0.9%), and more than twice the level of GTf in controls (2.3±0.1%). As a whole subject group, serum GTf was closely correlated with FPG (r=0.74), HbA1c (r=0.84) and GA (r=0.85). Because the dlurnal variation of GTf in 5 admitted NIDDM patients before (11.4±0.5-10.7±0.6%) and after (6.7±0.5-5.9±0.4%) rapid glycemic control was negligible, ambient plasma glucose did not influence GTf. When the decline in serum GTf and GA due to rapid glycemic control was compared, t112 for GTf and GA was 6.6 and 9.0 days, respectively. These results suggest that serum GTf reflects the glycemic state as accurately as currently available parameters (FPG, HbAlc and GA), and indicates glycemia over a shorter period than GA.
    Download PDF (1216K)
  • Akio Ohnishi, Tsuyoshi Tanimoto, Joji Nagaki, Tomio Jinnouchi, Hiroshi ...
    1996 Volume 39 Issue 10 Pages 783-788
    Published: October 30, 1996
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    The aldose reductase (AR) levels in erythrocytes of peripheral blood were determined in 98 NIDDM patients by the ELISA method to elucidate relationships between AR levels and clinical findings and diabetic complications such as neuropathy, retinopathy, nephropathy and cataract. AR levels showed no significant correlation with age, duration of diabetes, fasting blood glucose and HbA1c. In 44 patients with duration of diabetes equal to and less than 10 years, the AR levels in patients with neuropathy (n=24) were significantly higher (P<0.05) than those in patients without neuropathy (n=20). In the same group of the patients, the AR levels were significantly higher (P<0.05) in patients wih retinopathy (n=23), than those in patients without retinopathy (n=21). However, AR levels were not significantly different between the patients with and without cataract, and between the patients with and without nephropathy. Therefore, we concluded that high AR levels are related to the development of diabetic complications at least in the early stages of NIDDM.
    Download PDF (994K)
  • Analysis of Lipid Peroxide in Erythrocyte Membranes and Antioxidant Effect of Nilvadipine to Lipid Peroxidation
    Masayuki Inoue, Hidetoshi Hashimoto
    1996 Volume 39 Issue 10 Pages 789-796
    Published: October 30, 1996
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    Significantly elevated levels of 7-keto cholestadiene (KD) and significantly reduced levels of poly-unsaturated fatty acids (linolic acid, arachidonic acid and docosahexaenoic acid) were found in the lipid fractions of diabetic erythrocyte membranes when compared with controls. These alterations suggest that there is significant oxidative stress in diabetes. In particular, the levels of KD were correlated to the values of HbAic. Cholesta-3, 5-diene (Die) peroxidation stimulated by ultraviolet-B irradiation generating free radicals was found to produce KD. The inhibitory effect of a Ca anatagonist, nilvadipine, on Die peroxidation by UV-B irradiation was studied. Nilvadipine inhibited the peroxidation of Die to KD and was considered to be an antioxidant of lipid peroxidation. Nilvadipine was thought to be useful in the treatment of diabetes with hypertension.
    Download PDF (1285K)
  • Tsutomu Hirano, Seishi Nagano, Koichi Kashiwazaki, Masatomi Tsuji, Mit ...
    1996 Volume 39 Issue 10 Pages 797-802
    Published: October 30, 1996
    Released on J-STAGE: August 04, 2011
    JOURNAL FREE ACCESS
    A 42-year-old woman had been treated for chronic thyroiditis with L-thyroxine over a 20 year period. At the age of 40 years hyperglycemia and glycosuria were first noted at an annual medical check, at which time the patient had also noted acanthosis nigricans. At the time of admission, the patient had hypergammaglobulinemia, low levels of complement and an increased erythrocyte sedimentation rate. Anti-thyroglobulin antibody, anti-nuclear antibody (speckled pattern), anti-Scl-70 antibody, and anti-RNP antibody were all positive. An oral-glucose tolerance test revealed that plasma glucose levels were 141-412mg/dl, and that insulin levels and c-peptide levels were 350-1800, μU/ml and 8.9-31.0ng/ml, respectively. Thesuppression of plasma glucose andnon-esterified fatty acid by exogonous insulin infusion was impaired. Anti-insulin receptor antibodies were detected in her serum by the radioreceptor assay using human placenta membrane. Tests for anti-insulin antibody were negative. This report describes a very rare case showing preceding chronic thyroiditis and subsequently developed diabetes caused by anti-insulin receptor antibodies.
    Download PDF (720K)
  • Yasushi Hirokawa, Shoji Sumitomo, Ayumi Yawata, Youjiro Kawai, Masaya ...
    1996 Volume 39 Issue 10 Pages 803-808
    Published: October 30, 1996
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    The case of a 66-year-old woman with acute onset IDDM is reported. In October 1993, she experienced headache and fever and visited a nearby hospital for treatment. However, her symptoms were not relieved, and two weeks later she experienced diabetic ketoacidosis and was admitted to Kawasaki Medical School Hospital. Her serum was positive for antinuclear antibodies and contained a high level of antibody against the EB virus (EBV) capsid antigen. She exhibited eosinophilia and was flomoxef positive in the lymphocyte-stimulating test. Many atypical (nontuberculous) mycobacteria were cultured from her stool and sputum. HLA typing results were A: 3/24 (9);B: 44 (12)/61 (40);Cw: 5/-, DR: 1/6, DQ: 1/-. Anti-islet cell antibody and the islet cell surface antibody were both negative. Uric C-peptide immunoreactivity (CPR) was less than 1μg/day for the whole period of hospitalization except for a few days. The glucagon test was negative at plasma CPR.
    The best conjecture as to the etiology in this case was EBV infection. This case was also considered rare because it was suggested that the atypical mycobacterial infection was caused by malnutrition, and that it changed the sensitivity of immunological activity.
    Download PDF (737K)
  • Masahiro Yamamoto, Akitoshi Kawakubo, Satoshi Kakiya, Katsushi Tsukiya ...
    1996 Volume 39 Issue 10 Pages 809-813
    Published: October 30, 1996
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    A 39-year-old woman was diagnosed with insulin autoimmune syndrome (IAS) based on hypoglycemia, increased 125I-insulin binding (51%), a TIRI of 720 μU/ml, a FIRI of 130μU and CPR at 4.2ng/ml in 1977. We observed the patient for 10 years since IAS was known to remit spontaneously. However, she gained 13 kg of body weight and became hypertensive during this period. Fasting CPR was elevated to 11.5ng/ml and hypoglycemic attacks became more frequent in 1994. We treated twice with 1000 mg a day of methylprednisolone. Following this fasting CPR fell to 2.4ng/ml and was associated with a fall in 125I-insulin binding to 10%. She became asymptomatic. Steroid pulse therapy may effectively suppress insulin antibody formation in IAS, resulting in reduction of body weight and blood pressure.
    Download PDF (642K)
  • Takao Shimizu, Fujiko Sasakuma, Kyoichi Hasegawa, Akira Sasaki
    1996 Volume 39 Issue 10 Pages 815-818
    Published: October 30, 1996
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    We report interference with C-peptide assay by and-murine antibodies observed in two diabetic patients. The Daiichi C-peptide kit III (method 1), a two-antibody method, uses mouse monoclonal antibody (mmab) for the second antibody. Its use in Japan exceeded 50% in 1995. When determined by method 1, CPR values of our patients were high compared with the values of IRI. Fasting values of IRI and CPR were 2μU/ml and 3.3 ng/ml, respectively in case 1. These values were 5 and 9.5, respectively, in case 2, although no interference was observed in samples obtained 1.8 years earlier. Neither patient had detectable antibodies against insulin or C-peptide. Their proinsulin levels were not increased. When the same samples were assayed by Shionogi C-peptide RIA (method 2) which does not use mmab, CPR values were reduced to 0.7 ng/ml in both patients. The slope of the linear regression lines between CPR values determined by these two methods seems to reflect the degree of interference. Treatment of sera with polyethyleneglycol or protein A eliminated the interference in method 1. When the second antibody in method 1 was changed to rabbit polyclonal antibody, CPR values became close to those obtained by method 2. Addition of mouse IgG also decreased interference. We conclude that anti-murine antibodies in serum interfere with the second antibody reaction in method 1, resulting in abnormally high CPR values.
    Download PDF (574K)
  • 1996 Volume 39 Issue 10 Pages 819-832
    Published: October 30, 1996
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    Download PDF (3472K)
feedback
Top