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Volume 40, Issue 8
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Kazuhisa Suzuki, Hiroshi Taniguchi1997 Volume 40 Issue 8 Pages 497-502
Published: August 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (948K) -
Mitsuya Totsuka, You Miyashita, Yoshiaki Ito, Shouichirou Hashiguchi, ...1997 Volume 40 Issue 8 Pages 503-511
Published: August 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIndividuals with a small band at the α side of β lipoproteins are often detected by PAG discelectrophoresis especially in diabetes mellitus (DM) patients. We characterized this particle and investigated the effect of the DM condition on the appearance of the particle and its relation to diabetic retinopathy and nephropathy. The subjects were 167 nondiabetic persons (control) and 112 DM patients. Electron microscopy and gel filtration studies showed that fast β lipoprotein was the smallest among LDL subfractions. The incidence of fast β lipoprotein in DM subjects was 4.8 times higher than that in control subjects. In controls, fast β lipoprotein-positive subjects had higher TG and lower HDL-C levels than those in negative subjects. TC and Lp (a) levels were not significantly different among those subjects. In DM patients, the positive subjects did not have higher TG levels, only lower HDL-C levels, than negative subjects. TC, Lp (a) and HbA1c levels were not significantly different among them. Fast β lipoprotein had a tendency to coexist with the midband. Incidences of fast β lipoproteins in patients with diabetic retinopathy and nephropathy were higher than those in patients complications. Fast β lipoproteins were greatly increased by the DM condition and might be involved in the development of retinopathy and nephropathy.View full abstractDownload PDF (2906K) -
Fukashi Ishibashi1997 Volume 40 Issue 8 Pages 513-520
Published: August 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSBlood and urinary ACE activity (colorimetry) and angiotensin-II (AG-II, RIA) levels were determined before and after infusion of L-arginine (LA), which inhibits tubular reabsorption of proteins, in 48 NIDDM patients with (NIDDM-II, N =22) or without microalbuminuria (MAU)(NIDDM-I, N =26) and in healthy controls (N =20) to elucidate the pathogenetic role of renal AG-II in the development of MAU. LA induced 2-to 4-fold increases in urinary ACE activity and AG-II, while it did not influence blood ACE activity and AG-II in all groups. No differences were found in blood ACE activity and AG-II among the three subject groups. On the other hand, urinary ACE activity (27.1±2.5→65.7±5.1 mIU/hr) and AG-II (20.8±3.4→74.1±5.8 ng/hr) in the NIDDM-II group were the highest, and those in the NIDDM-I group (ACE: 19.0±2.2→49.9 ± 3.4 mIU/hr, AG-II: 16.8±3.5 →56.5±6.3 ng/hr) were higher than in the controls (ACE: 13.9±2.6 →38.4±3.5 mIU/hr, AG-II: 11.4±2.6→37.9±3.9 ng/hr). In the group as a whole, urinary ACE activity and AG-II were correlated with AER and glomerular filtration of albumin, and inversely correlated with the rate of tubular reabsorption of albumin before and after LA, the stronger correlations being found after LA (ACE: r=0.40 vs AER, r=0.47 vs GCA, r=-0.39 vs TRRA, AG-II: r=0.50 vs AER, r=0.46 vs GCA, r=-0.54 vs TRRA). On the other hand, blood ACE activity and AG-II did not have a significant correlation with either of them (r=-0.22-0.13). These results indicate that renal AG-II, produced by ACE, plays a permissive role in the development of MAU in NIDDM.View full abstractDownload PDF (1505K) -
Naoki Nakashima, Takashi Sugimura, Yasuhiro Ono, Taito Esaki, Toshihik ...1997 Volume 40 Issue 8 Pages 521-529
Published: August 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe adrenal androgens dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEA-S) reportedly have anti-diabetic and anti-atherosclerotic effects. We investigated the concentrations of plasma adrenal androgens and other steroid hormones in diabetic subjects. In 59 adult diabetic men not receiving insulin therapy who were outpatients at our hospital and 32 healthy controls, we estimated the fasting plasma concentrations of DHEA, DHEA-S, testosterone, estradiol, cortisol, blood glucose (FBG), HbA1c, and immunoreactive insulin (IRI). After 6 months of glycemic control, we again measured the same parameters in 28 of the diabetic patients. In all participants, DHEA-S showed significant negative correlations with FBG (r=-0.24) and HbA1c (r=-0.25). Plasma DHEA concentrations in relative hyperinsulinemic patients (IRI≥10μU/ml, n=25) were significantly lower than those in a normoinsulinemic patients (IRI<10μU/ml, n=66 ; 1.91±1.32 ng/ml, mean±SD, vs. 2.42±1.12 ng/ml, p<0.01, respectively). After the glycemic control, plasma DHEA-S concentrations increased significantly (p<0.05) in the patients with improved HbA1c levels (HbA1c≥1%, n=6). Plasma DHEA concentrations increased significantly (p<0.05) in the patients with decreased IRI levels (n=12). The present results indicate that in adult diabetic men, parameters reflecting a state of diabetic control are related to plasma DHEA-S concentrations, while plasma IRI levels are related to plasma DHEA concentrations.View full abstractDownload PDF (1236K) -
Eisuke Maehata, Minoru Inoue, Masao Yano, Teruo Shiba, Minoru Yamakado ...1997 Volume 40 Issue 8 Pages 531-537
Published: August 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe measurement of urinary albumin (U-Alb) is considered essential for the early diagnosis of early stages of diabetic nephropathy, with microalbuminuria defined as an albumin excretion index of greater than 30 mg/g creatinine and less than 300 mg/g creatinine. This report examines the urinary glycated albumin/serum glycated albumin (GA ratio) as a measure of the threshold for the onset of diabetic nephropathy.
The GA ratio was 2.099±0.300 in 11 subjects (age 61.5±3.5 years) in the healthy control group, 2.097±0.577 in 14 subjects (age 60.4±3.6 years) in the normoalbuminuria group, 1.271±0.394 in 15 subjects (age 59.1±9.7 years) in the microalbuminuria group (Micro group), and 0.950±0.075 in 13 subjects (age 60.5±11.8 years) in the macroalbuminuria group (Macro group).
The GA ratio decreased from approximately 2.000 in the Normo group to a cluster at 1.000 in the Macro group. The point of intersection between the distribution line of a GA ratio of about 1.000 and the regression curve for the GA ratio determined by the polynomial method corresponded to an albumin excretion index of about 150 mg/g. creatinine.View full abstractDownload PDF (1149K) -
Shuichi Katou, Yutaka Mori, Junichi Yokoyama, Shoichi Hata, Yuichi Mur ...1997 Volume 40 Issue 8 Pages 539-546
Published: August 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe examined the effect of exercise and food restriction on fat distribution and glucose tolerance in genetically obese-hyperglycemic OLETF rats characterized by mesenteric fat accumulation. A total of 40 male OLETF rats aged 6 weeks were randomly divided into five groups. Swimming exercise was practiced 6 days in a week for 1 hour a day, to Group 1 rats from the 1st week through to the 18th week, in Group 2 rats from the 1st week through to the 9th week, and in Group 3 rats from the 10th week to the 18th week. Group 4 was restricted to 70% of the food intake of Group 5 (control). The food intake and body weight in Group 2 significantly increased after the interruption of exercise, but there was no significant difference in the food intake between Groups 1 or 3 and Group 5. Body weight in Group 1 and Group 4 was significantly decreased compared with Group 5, although there was no significant difference between Group 3 and Group 5. An oral glucose tolerance test in the 19th week showed a significant decrease in plasma glucose in Group 3 and Group 4. Insulin levels after glucose load in Group 4 decreased significantly compared with Group 5. With fat distribution, the weight (per 100 g BW) in mesenteric, retroperitoneal, epididymal and subcutaneous fat tissue significantly decreased in Group 4, but the weight in mesenteric fat tissue significantly decreased (p<0.01) in Groups 1 and 3 compared with Group 5. Histologically, the hypertrophic islets which were observed in Group 5 were noticeably suppressed in Groups 1, 3 and 4. In conclusion, exercise and food restriction resulted in significant improvement in mesenteric fat accumulation and glucose intolerance in OLETF rats.View full abstractDownload PDF (3413K) -
Shigeo Aono, Nobuo Matsuura, Shin Amemiya, Yutaka Igarashi, Yasuko Uch ...1997 Volume 40 Issue 8 Pages 547-555
Published: August 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThis study of the social circumstances and life-style of patients with insulin-dependent diabetes mellitus (IDDM) was done as a first step to establish effective methods for the education about this disease of both patients and the general population. We analyzed employment, income, marital status, and related circumstances of the 1013 patients (354 men and 659 women) aged 18 years or more who answered a questionaire that we prepared and gave to patients at our hospitals and related hospitals.
Patients unemployed or unable to work because of disabilities accounted for 6.5% of men and 6.8% of women. Estimated income was lower in male patients than in age-and sex-matched siblings (x2test, p<0.05). Patients refused a job because of, or probably because of, their diabetes accounted for 35% of men and 36% of women. Thirty-six percent of men and 41% of women reported concealing their disease at their place of employment at some time. Some 91% of patients fund medical expenditures at least something of a burden. Both men and women were less likely to be married than the general Japanese population. The results suggested that education of patients and of society as a whole could improve the long-term prognosis and quality of life for patients with IDDM.View full abstractDownload PDF (1403K) -
Kazuo Ichikawa, Yoshihiko Sato, Satoru Suzuki, Akihiro Sakurai, Teiji ...1997 Volume 40 Issue 8 Pages 557-562
Published: August 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 63-year-old man with diabetes mellitus developed a high fever, and swelling of the right cheek due to periodontal infection. He was transferred to our hospital as the symptoms worsened and were accompanied by neck swelling, dyspnea, confusion, and a high blood glucose level despite antibiotic therapy. Chest radio graphy and computed tomography revealed a gas-forming mediastinal abscess, pleural and pericardial effusion, and cervical cellulitis. His diseases were diagnosed as mediastinitis, peripharyngitis, and cervical cellulitis from odontogenic infection associated with a diabetic hyperosmolar state. He was treated by administration of antibiotics, gamma globulin, and granulocyte colony-stimulating factor, surgical drainage, and intermittent flushing of the mediastinal cavity with 0.2%povidone-iodine, along with fluid transfusion and insulin administration. Tracheotomy and mechanical ventilation were also required. Although bronchopneumonia developed during his hospitalization, overall treatment was successful. After discharge, blood HbA1c levels have been maintained at between 6. 0 and 7.0%by diet therapy. It should be noted that mediastinitis may occur as a rare complication of oropharyngeal infection in patients with underlying disorders such as diabetes mellitus.View full abstractDownload PDF (4112K) -
Normalization of First Phase Insulin Secretion in a Japanese Adolescent Suffering Soft Drink KetosisIkuo Yamamori, Yoko Kato-Watanabe, Masato Katahira, Kazushige Tachikaw ...1997 Volume 40 Issue 8 Pages 563-567
Published: August 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSSoft drink ketosis is a subset of NIDDM characterized by an acute ketotic onset following excessive ingestion of soft drinks in obese people, predominantly seen in Japanese adolescents. Insulin dependency in the early course resembles that of IDDM, although most patients clearly show clinical features of NIDDM afterwards. A 19 year-old obese Japanese male was admitted to the hospital with marked hyperglycemia (56.1 mmol/l, HbA1c 13.6%) and ketosis. His body mass index was 32.4 two months before admission. He was treated initially with regular insulin (maximum 56 U daily), followed by NPH insulin for a total of 33 days. Fasting plasma glucose was maintained at around 4 mmol/l. Twenty-four hour urinary C-peptide excretion was 69 Eg on the 4th hospital day. He had lost nearly 20 kg (final BMI 25.0). A seventy-five gram oral glucose tolerance test on the 39 th hospital day disclosed a normal glucose profile with marked first phase insulin response (insulinogenic index at 4.13). It is likely that both preservation of intrinsic insulin secretary reserve even at onset, and intensive extrinsic insulin administration might be the keys for the exceptionally normalized first phase insulin secretion in this case.View full abstractDownload PDF (686K) -
Kyuzi Kamoi, Tetsurou Kobayashi, Eisuke Takazakura, Masayuki Itou, Kaz ...1997 Volume 40 Issue 8 Pages 569-572
Published: August 30, 1997
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo improve blood glucose levels worsened by treatment with short-acting neutral insulin without buffer (A) switched from that with buffer (B) on CSII, we treated 7 IDDM patients by various devices with heparin in A solution or two needle sizes with A, or with short-acting acidified insulin (C) on CSII. After treatment with A, blood glucose levels increased significantly (P<0.01) becoming unstable in four patients, but were not significantly changed in three patients. Increased glucose levels were observed on Day 1 and peaked on Day 2 after treatment with A when a syringe was used for three days, the needles being changed daily. Addition of heparin Na to A solution improved the glucose levels, but heparin Ca solution did not. The effect of C was similar to that of B. Insulin precipitation was not observed in the tubes and needles. The results show that treatment with heparin Na of a short-acting neutral insulin solution without buffer or with short-acting acidified insulin is effective in patients worsened by CSII with short-acting neutral insulin without buffer, indicating that insulin absorption by the blood may be disturbed in the outlet of the needle under subcutaneous tissue by ions and fibrination on influence of material of the tube or syringe and intrinsic factors in the patients.View full abstractDownload PDF (526K)
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