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1.
Sci Rep ; 11(1): 19992, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620897

RESUMO

The importance of maintaining the remission of nonalcoholic fatty liver disease (NAFLD) has been overlooked. Here we aimed to clarify factors causing NAFLD recurrence. In this retrospective cohort study over 10.8 ± 5.4 years, we investigated 1260 male health check-up participants diagnosed with NAFLD who achieved remission. The data were compared between the maintained remission and recurrence group. Among all participants, 618 (49.0%) showed NAFLD recurrence at the last visit. Participants in the maintained remission group continued to lose weight (72.7 ± 9.1, 68.7 ± 8.5 and 68.2 ± 8.9 kg), whereas those in the recurrence group lost and regained weight (72.9 ± 9.9, 69.7 ± 9.3 and 73.0 ± 10.4 kg). Receiver operating characteristic curve analysis showed a weight regain of + 1.5 kg as the cutoff value for recurrence. The proportion of regular exercisers at the last visit was 34.6% in the maintained remission group and 24.5% in the recurrence group (p < 0.0001). Multivariable analysis revealed the amount of weight regain (in 1 kg increments; adjusted odds ratio, 1.29; 95% confidence interval, 1.24-1.34) and regular exercise at the last visit (adjusted odds ratio, 0.67; 95% confidence interval, 0.55-0.89) were independently associated with recurrence. These findings demonstrate a weight regain of 1.5 kg or more and lack of exercise were associated with NAFLD recurrence.

2.
Clin Med Insights Endocrinol Diabetes ; 14: 11795514211040539, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34602832

RESUMO

Background: The safe method of instructing insulin dose reduction in combination with SGLT2 inhibitors, dapagliflozin for patients with type 1 diabetes mellitus has not been clarified. In this study, we conducted a stratified, 2-arm, parallel comparative study with the primary endpoint of decreasing the frequency of hypoglycemia by instructing basal insulin dose reduction. Methods: The study has a multicenter, open-label, 2-arm design; 60 type 1 diabetes mellitus patients are being recruited from 7 hospitals. Study subjects have been stratified into 2 groups based on the ratio of basal insulin daily dose (Basal) to total daily insulin dose (TDD). The subjects whose Basal/TDD ratio is <0.4 are instructed not to reduce Basal but to reduce bolus insulin dose by 10% (group A), and subjects with a Basal/TDD ratio >0.4 will be instructed to reduce Basal by 10% (group B). The primary outcome is the daily frequency of hypoglycemia during the intervention period (SGLT2 inhibitor administration), as determined by self-monitoring of blood glucose. We aimed to confirm a greater reduction in frequency of hypoglycemia in group B (reduced Basal), than in group A (non-reduction of Basal and reduced insulin effect levels by 10%). Baseline hypoglycemia was set at 7 ± 6 times/month. The minimum sample size required to achieve a significance of .05 for a 1-sided t-test with a statistical power at 80% is determined. When the sample size is 26 patients in 1 group, the percentage increase in hypoglycemia exceeds 60%, and the sample size is considered sufficient. Discussion: In this pilot study, we assumed that, given a sufficient Basal, hypoglycemia would be more frequent in patients with type 1 diabetes when combined with SGLT2 inhibitors, provided the Basal was not reduced.

3.
J Diabetes Investig ; 2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34665938

RESUMO

AIMS/INTRODUCTION: Metformin is associated with the risk of gastrointestinal complications and probiotic Bifidobacterium bifidum G9-1 (BBG9-1) can improve the symptoms of diarrhea. This study aimed to clarify the effects of probiotic BBG9-1 on the gastrointestinal symptoms of type 2 diabetes mellitus patients using metformin. MATERIALS AND METHODS: In this open-label single-arm exploratory study, 40 patients (mean age, 64.0±9.4 years) were administered probiotic BBG9-1 for 10 weeks. Changes in the gastrointestinal symptom rating scale total score, which was the primary endpoint, gastrointestinal symptom rating scale subscale scores, HbA1c levels, and gut microbiota after the administration of probiotic BBG9-1 were evaluated by the Student's t-test. RESULTS: The gastrointestinal symptom rating scale total score was significantly improved (from 2.02±0.51 to 1.59±0.43, change, -0.43±0.49, p<0.001). Moreover, all gastrointestinal symptom rating scale subscale scores, including diarrhea (from 2.32±1.14 to 1.89±0.99, change, -0.42±0.95, p=0.007) and constipation (from 3.00±1.16 to 2.20±1.07, change, -0.80±1.19, p<0.001), scores also significantly improved. However, the HbA1c levels did not change (from 7.0±0.7 to 7.0±0.6 %, change, 0.0±0.4, p=0.91). The relative abundance of the genus Sutterella was decreased by the use of probiotic BBG9-1 (from 0.011±0.009 to 0.008±0.006, change, -0.003±0.006, p=0.002). CONCLUSIONS: Type 2 diabetes mellitus patients treated with metformin showed significant improvement in all gastrointestinal symptom rating scores after using probiotic BBG9-1 without changing the glucose control. This study demonstrated the potential usefulness of probiotic BBG9-1 for improving gastrointestinal symptoms, including constipation and diarrhea, in type 2 diabetes mellitus patients treated with metformin.

4.
Nutrients ; 13(9)2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34578892

RESUMO

Salt intake is often estimated by the amount of sodium excreted in urine, and miso has been reported to increase it. This cross-sectional study investigated the relationship between obesity and high estimated salt intake with and without habitual miso consumption. Estimates of salt intake (g/day) were calculated using urinary sodium excretion, and a high estimated intake was defined as greater than the median amount of 9.5 g/day. Participants were divided into four groups based on estimated salt intake and miso consumption. Among 300 people, the proportions of obesity were 77.8% (n = 14/18), 40.2% (n = 53/132), 26.0% (n = 33/127), and 34.8% (n = 8/23) in the (+/-), (+/+), (-/+), and (-/-) groups of high estimated salt intake/habitual miso consumption, respectively. Compared with the (+/-) group, the adjusted odds ratios for obesity were 0.07 (95% confidence interval (CI): 0.02-0.26, p < 0.001), 0.16 (95% CI: 0.03-0.76, p = 0.022), and 0.14 (95% CI: 0.04-0.51, p = 0.003) in the (-/+), (-/-), and (+/+) groups, respectively. The presence of obesity was not much higher in people with high estimated salt intake with habitual miso consumption than that in people without. Clinicians should be aware that miso consumption promotes salt excretion, which may lead to an apparently higher estimated salt intake than actual.

5.
J Diabetes Investig ; 2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34561962

RESUMO

BACKGROUND AND AIMS: To clarify the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and chronic kidney disease (CKD). METHODS: The participants were divided into four groups by the presence or absence of fatty liver disease (FLD) and metabolic dysfunction (MD). MAFLD was defined as having both FLD and MD, whereas CKD was defined as having an estimated glomerular filtration rate of <60 mL/min/1.73 m2 and/or proteinuria. RESULTS: In this cross-sectional study of 27,371 participants, the proportions of those in the non-FLD without MD, non-FLD with MD, FLD without MD, and MAFLD groups were 48.7, 28.2, 2.3, and 20.8%, respectively. Compared with non-FLD without MD, MAFLD was associated with the risk of CKD (adjusted odds ratio 1.83 [1.66-2.01], P < 0.001), whereas FLD without MD was not (1.02 [0.79-1.33], P = 0.868). Moreover, compared with FLD without MD, MAFLD was associated with the risk of CKD (1.19 [1.09-1.31], P < 0.001). In this retrospective cohort study, 16,938 of 27,371 participants underwent a median 4.6 (2.0-8.1) years follow-up, and incident data of non-FLD without MD, non-FLD with MD, FLD without MD, and MAFLD were 21.0, 31.1, 26.1, and 31.1 cases per 1,000 person-years, respectively. Compared with the non-FLD without MD, MAFLD was associated with the risk of incident CKD (adjusted hazard ratio 1.24 [1.14-1.36], P < 0.001), whereas FLD without MD was not (1.11 [0.85-1.41], P = 0.433). CONCLUSIONS: MAFLD was associated with a risk of CKD, whereas FLD without MD was not a risk for CKD.

6.
Nutrients ; 13(7)2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34371843

RESUMO

The aim of this prospective cohort study was to examine the relationships between the intakes of various vitamins and the loss of muscle mass in older people with type 2 diabetes (T2DM). The change in skeletal muscle mass index (SMI, kg/m2) (kg/m2/year) was defined as follows: (SMI at baseline (kg/m2) - SMI at follow-up (kg/m2))/follow-up period (year). The rate of SMI reduction (%) was calculated as follows (the change in SMI (kg/m2/year)/SMI at baseline (kg/m2)) × 100. The rate of SMI reduction ≥ 1.2% was considered as the loss of muscle mass. Among 197 people with T2DM, 47.2% of them experienced the loss of muscle mass at the 13.7 ± 5.2 month follow-up. Vitamin B1 (0.8 ± 0.3 vs. 0.8 ± 0.3 mg/day, p = 0.031), vitamin B12 (11.2 ± 8.3 vs. 13.4 ± 7.5 µg/day, p = 0.049), and vitamin D (16.5 ± 12.2 vs. 21.6 ± 13.0 µg/day, p = 0.004) intakes in people with the loss of muscle mass were significantly lower than those without. Vitamin D intake was related to the loss of muscle mass after adjusting for sex, age, exercise, alcohol, smoking, body mass index, SMI, glucagon-like peptide-1 agonist, sodium glucose cotransporter-2 inhibitor, insulin, HbA1c, creatinine, energy intake, and protein intake (adjusted odds ratio 0.93, 95% confidence interval: 0.88-0.97, p = 0.003). This study showed that vitamin D intake was related to the loss of muscle mass in older people with T2DM. Vitamin B12 intake tended to be related to the loss of muscle mass, although vitamin A, vitamin B2, vitamin B6, vitamin C, and vitamin E intake were not related.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Dieta/efeitos adversos , Estado Nutricional , Sarcopenia/epidemiologia , Vitaminas/análise , Idoso , Diabetes Mellitus Tipo 2/complicações , Dieta/estatística & dados numéricos , Inquéritos sobre Dietas , Ingestão de Energia/fisiologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Músculo Esquelético/fisiopatologia , Estudos Prospectivos , Sarcopenia/etiologia
7.
BMC Gastroenterol ; 21(1): 321, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372774

RESUMO

BACKGROUND: Hepatic steatosis has a pivotal role in the development of chronic liver diseases, even in alcohol-related liver disease. Alcoholic fatty liver disease is an important phenotype among alcohol-related liver diseases. While metabolic syndrome is a dominant risk factor of incident nonalcoholic fatty liver disease, the role of metabolic syndrome in alcoholic fatty liver disease has not been clarified yet. METHODS: A retrospective cohort study was performed at a health check-up center in Japan. Subjects consisted of male participants without fatty liver who consumed ethanol of 420 g/week or higher. Adjusted hazard ratios and 95% confidence intervals at the baseline examinations for incident alcoholic fatty liver disease were estimated using Cox model. RESULTS: A total of 640 participants were included in this study. During 3.91 years (IQR 1.63-7.09) of follow-up, 168 new cases of alcoholic fatty liver disease developed (49.1 cases per 1000 persons per year). After adjustment for age, smoking status, alcohol consumption, the hazard ratio for a 1 kg/m2 increase in body mass index was 1.2 (1.12-1.28). The hazard ratio of subjects with high triglyceride and low high-density lipoprotein-cholesterol levels were 1.56 (1.12-2.18) and 1.52 (1.03-2.25), respectively. CONCLUSIONS: Obesity, high triglyceridemia, and low high-density lipoprotein-cholesterolemia are independent risk factors of alcoholic fatty liver disease in Japanese men who consumed alcohol habitually. In people with these risks, triglyceride lowering and high-density lipoprotein-cholesterol raising by improving insulin resistance and weight maintenance in addition to abstinence from alcohol would be effective in preventing the development of alcoholic fatty liver disease.


Assuntos
Fígado Gorduroso Alcoólico , Síndrome Metabólica , Hepatopatia Gordurosa não Alcoólica , Fígado Gorduroso Alcoólico/epidemiologia , Humanos , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Estudos Retrospectivos , Fatores de Risco
8.
Front Immunol ; 12: 669629, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34305899

RESUMO

Background and aims: Group 2 innate lymphoid cells (ILC2s) have been implicated in the regulation of metabolic homeostasis in mice. Methods: In this study, the role of ILC2s in white adipose tissue (WAT) was investigated using ST2, an IL-33 receptor that is expressed on ILC2 knockout mice. Results: The deficiency of ST2 decreased ILC2s in WAT, whereas ex-ILC2, which acquired group 1 innate lymphoid cell (ILC1)-like traits, was increased. This led to significant metabolic disorders such as visceral fat obesity, decreased browning in WAT, reduction of energy metabolism, and impaired glucose tolerance, compared to wild type (WT) mice. Those metabolic abnormalities of ST2-knockout (ST2KO) mice were not ameliorated by IL-33 administration, but impaired glucose tolerance and visceral fat obesity were significantly improved by transplantation of ILCs from the bone marrow of WT mice. The relative expression of Cd36 in WAT increased due to the deficiency of ST2, and the storage of saturated fatty acids in WAT of ST2KO mice was significantly higher than that of WT mice. Moreover, saturated fatty acids aggravated the chronic inflammation in adipocytes, promoted the differentiation of M1-like macrophages, and inhibited that of M2-like macrophages. Conclusions: Our results indicated that ILC2 regulates diet-induced obesity and chronic inflammation through the regulation of saturated fatty acid absorption in visceral adipose tissue.

9.
Artigo em Inglês | MEDLINE | ID: mdl-34203155

RESUMO

Objectives: We verified the clinical usefulness of an approach method in which a physician gives simple salt reduction instructions during outpatient visits to patients with type 2 diabetes. Methods: This study was an open-blind, randomized controlled trial. Subjects were outpatients with type 2 diabetes whose estimated salt intake using spot morning urine sample exceeded the target of salt intake. The control group (CG) was notified only of the current salt intake, whereas the intervention group (IG) was given the brief salt reduction instruction by a physician in addition to the information regarding their current salt intake. Results: The change in estimated salt intake was -0.6 g (from 10.1 to 9.5 g, p = 0.029) in the CG after 8 weeks, and -0.9 g (from 10.1 to 9.2 g, p = 0.001) in the IG, although there were no significant differences between them (p = 0.47). After 24 weeks, both groups no longer differed significantly from the baseline. In addition, multivariate linear regression analyses indicated that high salt intake and low estimated glomerular filtration rate at baseline were significantly associated with salt reduction after 8 weeks. Conclusions: Salt-reducing effects were observed after 8 weeks in both the IG and CG, but no significant difference was observed. Moreover, patients with high salt intake and renal disfunction may be more effective in accepting salt reduction instructions. Making patients aware of the importance of salt reduction through a physician is effective for continuous salt reduction, and it is important to continue regular and repetitive guidance.


Assuntos
Diabetes Mellitus Tipo 2 , Hipertensão , Médicos , Diabetes Mellitus Tipo 2/prevenção & controle , Comportamento Alimentar , Taxa de Filtração Glomerular , Humanos , Cloreto de Sódio na Dieta
10.
Nutrients ; 13(6)2021 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-34205413

RESUMO

The aim of this research was to reveal the characteristics of gut microbiome altered by acarbose intervention in Japanese patients with type 2 diabetes (T2D) and its possible association with habitual dietary intake. Eighteen patients with T2D were administered acarbose for four weeks. The abundances of two major phyla, namely Actinobacteria and Bacteroidetes, were reciprocally changed accompanied by the acarbose intervention. There were also significant changes in the abundances of ten genera, including the greater abundance of Bifidobacterium, Eubacterium, and Lactobacillus and the lower abundance of Bacteroides in the group after the intervention than that before the intervention. Hierarchical clustering of habitual dietary intake was performed based on the pattern of changes in the gut microbiota and were classified into distinct three clusters. Cluster I consisted of sucrose, cluster II mainly included fat intake, and cluster III mainly included carbohydrate intake. Moreover, the amount of change in Faecalibacterium was positively correlated with the intake of rice, but negatively correlated with the intake of bread. The intake of potato was negatively correlated with the amount of change in Akkermansia and Subdoligranulum. Acarbose altered the composition of gut microbiome in Japanese patients with T2D, which might be linked to the habitual dietary intake.


Assuntos
Acarbose/administração & dosagem , Diabetes Mellitus Tipo 2/microbiologia , Dieta , Comportamento Alimentar/fisiologia , Microbioma Gastrointestinal/efeitos dos fármacos , Microbioma Gastrointestinal/fisiologia , Idoso , Bactérias/classificação , Bactérias/efeitos dos fármacos , Bactérias/genética , DNA Bacteriano/análise , Diabetes Mellitus Tipo 2/tratamento farmacológico , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Sacarose na Dieta/administração & dosagem , Fezes/microbiologia , Feminino , Inibidores de Glicosídeo Hidrolases , Humanos , Japão , Masculino , Pessoa de Meia-Idade
11.
Int J Mol Sci ; 22(11)2021 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-34074061

RESUMO

BACKGROUND: Erythritol, a sugar alcohol, is widely used as a substitute for sugar in diets for patients with diabetes or obesity. METHODS: In this study, we aimed to investigate the effects of erythritol on metabolic disorders induced by a high-fat diet in C57BL/6J mice, while focusing on changes in innate immunity. RESULTS: Mice that were fed a high-fat diet and administered water containing 5% erythritol (Ery group) had markedly lower body weight, improved glucose tolerance, and markedly higher energy expenditure than the control mice (Ctrl group) (n = 6). Furthermore, compared with the Ctrl group, the Ery group had lesser fat deposition in the liver, smaller adipocytes, and significantly better inflammatory findings in the small intestine. The concentrations of short-chain fatty acids (SCFAs), such as acetic acid, propanoic acid, and butanoic acid, in the serum, feces, and white adipose tissue of the Ery group were markedly higher than those in the Ctrl group. In flow cytometry experiments, group 3 innate lymphoid cell (ILC3) counts in the lamina propria of the small intestine and ILC2 counts in the white adipose tissue of the Ery group were markedly higher than those in the Ctrl group. Quantitative real-time reverse transcription polymerase chain reaction analyses showed that the Il-22 expression in the small intestine of the Ery group was markedly higher than that in the Ctrl group. CONCLUSIONS: Erythritol markedly decreased metabolic disorders such as diet-induced obesity, glucose intolerance, dyslipidemia, and fat accumulation in the mouse liver by increasing SCFAs and modulating innate immunity.


Assuntos
Dieta Hiperlipídica/efeitos adversos , Eritritol/farmacologia , Intolerância à Glucose/dietoterapia , Imunidade Inata/efeitos dos fármacos , Intestino Delgado/efeitos dos fármacos , Obesidade/tratamento farmacológico , Adipócitos/citologia , Adipócitos/efeitos dos fármacos , Tecido Adiposo/metabolismo , Tecido Adiposo Branco/metabolismo , Animais , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Metabolismo Energético/efeitos dos fármacos , Eritritol/administração & dosagem , Ácidos Graxos Voláteis/sangue , Ácidos Graxos Voláteis/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/genética , Intolerância à Glucose/metabolismo , Imunidade Inata/genética , Inflamação/dietoterapia , Inflamação/genética , Inflamação/metabolismo , Interleucinas/genética , Interleucinas/metabolismo , Intestino Delgado/imunologia , Intestino Delgado/metabolismo , Fígado/efeitos dos fármacos , Fígado/enzimologia , Fígado/metabolismo , Fígado/patologia , Linfócitos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Membrana Mucosa/efeitos dos fármacos , Membrana Mucosa/metabolismo , Obesidade/genética , Obesidade/metabolismo
12.
J Clin Med ; 10(9)2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-34064337

RESUMO

BACKGROUND: Various factors other than fibrosis could affect liver stiffness (LS), measured by two-dimensional shear wave elastography (2D-SWE). We aimed to clarify the factors affecting LS in local citizens. METHODS: We performed a cross-sectional study among local citizens of a health checkup program. Abdominal obesity was defined as waist circumference ≥85 cm for men and ≥90 cm for women. We evaluated the correlation between LS by 2D-SWE (Aplio 500) and waist circumference with linear regression analyses. We selected the following items as variables in the multivariate analysis: waist circumference, sex, hypertension, diabetes, diagnostic components of metabolic syndrome, γ-glutamyl transpeptidase, total bilirubin, NAFLD fibrosis score, and an indicator of a fatty liver, evaluated ultrasonographically. RESULTS: Overall, 345 individuals were included; 318 (181 men and 137 women; age, 63.4 years; waist circumference, 84.0 cm; LS, 5.79 kPa) were analyzed, 128 of whom had abdominal obesity and significantly higher LS than non-abdominally obese individuals. In the multivariate analysis, waist circumference was positively, independently, and significantly correlated with LS only in abdominally obese individuals. CONCLUSIONS: Liver stiffness by 2D-SWE could increase with increases in waist circumference in local citizens with abdominal obesity. Physicians should pay attention when assessing the LS of abdominally obese individuals.

13.
Front Immunol ; 12: 669672, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33995404

RESUMO

Background and Aims: Many nutritional and epidemiological studies have shown that high consumption of trans fatty acids can cause several adverse effects on human health, including cardiovascular disease, diabetes, and cancer. In the present study, we investigated the effect of trans fatty acids on innate immunity in the gut by observing mice fed with a diet high in trans fatty acids, which have been reported to cause dysbiosis. Methods: We used C57BL6/J mice and fed them with normal diet (ND) or high-fat, high-sucrose diet (HFHSD) or high-trans fatty acid, high-sucrose diet (HTHSD) for 12 weeks. 16S rRNA gene sequencing was performed on the mice stool samples, in addition to flow cytometry, real-time PCR, and lipidomics analysis of the mice serum and liver samples. RAW264.7 cells were used for the in vitro studies. Results: Mice fed with HTHSD displayed significantly higher blood glucose levels and advanced fatty liver and intestinal inflammation, as compared to mice fed with HFHSD. Furthermore, compared to mice fed with HFHSD, mice fed with HTHSD displayed a significant elevation in the expression of CD36 in the small intestine, along with a reduction in the expression of IL-22. Furthermore, there was a significant increase in the populations of ILC1s and T-bet-positive ILC3s in the lamina propria in mice fed with HTHSD. Finally, the relative abundance of the family Desulfovibrionaceae, which belongs to the phylum Proteobacteria, was significantly higher in mice fed with HFHSD or HTHSD, than in mice fed with ND; between the HFHSD and HTHSD groups, the abundance was slightly higher in the HTHSD group. Conclusions: This study revealed that compared to saturated fatty acid intake, trans fatty acid intake significantly exacerbated metabolic diseases such as diabetes and fatty liver.

14.
BMC Gastroenterol ; 21(1): 223, 2021 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-34001028

RESUMO

BACKGROUND: In this study, to clarify the evolving background of people with non-alcoholic fatty liver disease (NAFLD), we compared the current prevalence of NAFLD with that of 2 decades ago. METHODS: We included two cohorts. The past cohort was from 1994 to 1997 and included 4279 men and 2502 women. The current cohort was from 2014 to 2017 and included 8918 men and 7361 women. NAFLD was diagnosed by abdominal ultrasonography. RESULTS: The prevalence of NAFLD increased in both genders throughout these 2 decades (18.5% in the past cohort and 27.1% in the current cohort for men; and 8.0% in the past cohort and 9.4% in the current cohort for women). The prevalence of hyperglycemia increased, whereas the prevalence of low high-density lipoprotein cholesterol levels and hypertriglyceridemia significantly decreased. There was no significant difference in the mean body mass index. Multivariate analysis revealed that the prevalence of obesity and body mass index were significantly associated with the prevalence of NAFLD in both the past and current cohorts. CONCLUSIONS: The incidence of NAFLD significantly increased throughout these 2 decades, and obesity is the most prevalent factor. Thus, body weight management is an essential treatment option for NAFLD.


Assuntos
Hiperglicemia , Hepatopatia Gordurosa não Alcoólica , Índice de Massa Corporal , Feminino , Humanos , Masculino , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Prevalência , Fatores de Risco , Ultrassonografia
15.
Front Immunol ; 12: 648754, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33790913

RESUMO

Background and Aims: Emerging evidence has revealed that innate lymphoid cells (ILCs) play a key role in regulating metabolic disorders. Here, we investigated the role of group 3 ILCs (ILC3s) in the modulation of Non-alcoholic fatty liver disease (NAFLD). Methods: RORγ gfp/gfp (RORgt KI/KI) and Rag2-/- mice with the administration of A213, RORgt antagonist, fed with a high-fat-diet (HFD) for 12 weeks, were used. We performed flow cytometry, real time PCR, and lipidomics analysis of serum and liver, and used RAW264.7 cells and murine primary hepatocytes in vitro. Results: HFD increased ILC3s and M1 macrophages in the liver, and RORgt KI/KI mice deficient in ILC3 showed significant fatty liver, liver fibrosis and significantly increased palmitic acid levels in serum and liver. In addition, administration of A213 to Rag2-/- mice caused significant fatty liver, liver fibrosis, and a significant increase in serum and liver palmitate concentrations, as in RORgt KI/KI mice. Addition of palmitc acid stimulated IL-23 production in cell experiments using RAW264.7. IL-22 produced by ILC3s inhibited the palmitate-induced apoptosis of primary hepatocytes. Conclusions: HFD stimulates IL-23 production by M1 macrophages, thus promoting ILC3 proliferation, whereas IL-22 secreted by ILC3s contributes to the upregulation of hepatic lipid metabolism and has anti-apoptosis activity.


Assuntos
Fígado Gorduroso/imunologia , Imunidade Inata/imunologia , Fígado/imunologia , Linfócitos/imunologia , Macrófagos/imunologia , Animais , Apoptose/imunologia , Células Cultivadas , Dieta Hiperlipídica/efeitos adversos , Fígado Gorduroso/etiologia , Fígado Gorduroso/metabolismo , Hepatócitos/citologia , Hepatócitos/imunologia , Fígado/metabolismo , Fígado/patologia , Linfócitos/metabolismo , Macrófagos/classificação , Macrófagos/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Camundongos Transgênicos , Ácido Palmítico/sangue , Ácido Palmítico/imunologia , Ácido Palmítico/metabolismo , Substâncias Protetoras/metabolismo , Células RAW 264.7
16.
Artigo em Inglês | MEDLINE | ID: mdl-33832915

RESUMO

INTRODUCTION: Trigger finger is one of the complications affecting the upper extremity in patients with diabetes. Diabetes is also a well-known risk factor that predisposes individuals to cardiovascular diseases (CVDs). This retrospective cohort study aimed to establish the association between trigger finger and the patients with incident CVD with type 2 diabetes. MATERIALS AND METHODS: Trigger finger was diagnosed by palpating a thickened tendon during flexion or on the manifestation of a locking phenomenon during extension or flexion of either finger. The relationship between trigger finger and other clinical parameters or complications of diabetes was examined by a comparative analysis. Cox regression analysis was used to evaluate the association between trigger finger and incidence of CVD. We calculated the propensity scores using sex, body mass index, age, smoking status, duration of diabetes, estimated glomerular filtration rate, hypertension, dyslipidemia, and hemoglobin A1c as the number of patients with incident CVD during the follow-up period was low. RESULTS: Among the 399 patients with type 2 diabetes, 54 patients had trigger finger. Patients with trigger finger were significantly older in age and had been suffering from diabetes for a longer duration. They also displayed worse renal function and glycemic control, along with a higher incidence of hypertension, neuropathy and nephropathy. During the average 5.66±1.12 years of follow-up, a total of 18 incidents occurred. According to the Cox regression analysis, trigger finger was shown to be associated with enhanced risk of the incidence of CVD after adjustment for the covariates (adjusted HR=3.33 (95% CI 1.25 to 8.66), p=0.017). CONCLUSIONS: Trigger finger is associated with the risk of incident CVD in patients with type 2 diabetes. Thus, clinicians must consider these factors at the time of diagnosis of such patients.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Dedo em Gatilho , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobina A Glicada , Humanos , Estudos Retrospectivos , Dedo em Gatilho/epidemiologia
17.
Case Rep Med ; 2021: 5568978, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33883999

RESUMO

The spontaneous rupture of a pheochromocytoma is rare and can be potentially fatal. We report a case of a tumor size reduction of a ruptured pheochromocytoma after transcatheter arterial embolization (TAE). A 60-year-old Japanese woman was referred to the emergency department of another hospital with a sudden onset of left lateral pain. Computed tomography of the abdomen revealed adrenal hemorrhage with a 5.7 cm adrenal mass, and she was transferred to our hospital for treatment. Considering that she had marked hypertension (193/115 mmHg), we made a provisional diagnosis of left lateral pain due to a ruptured pheochromocytoma. She underwent TAE, and the hemorrhage was successfully controlled. She was started on oral doxazosin for hypertension. The dose of doxazosin was increased to the extent that orthostatic hypotension did not develop, and blood pressure was well controlled. After discharge, the tumor size gradually decreased to approximately 1.0 cm within six months. Six months after TAE, elective laparoscopic surgery was performed, and the diagnosis was confirmed by histopathology. We observed a decrease in the size of the ruptured pheochromocytoma after TAE. To reduce the risk of laparoscopic adrenal surgery, it may be useful to monitor the size of a ruptured pheochromocytoma after TAE before deciding the surgery time.

18.
Nutrients ; 13(5)2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33924846

RESUMO

Glycemic control, including glycemic variability, is important for the prevention of diabetic vascular complications in patients with type 2 diabetes mellitus (T2DM). There was an association between miso soup intake and insulin resistance. However, the relationship between habitual miso consumption and glycemic control, including glycemic variability, in patients with T2DM remains unknown. We defined people without habitual miso consumption if they did not consume miso soup at all in a day. The average, standard deviation (SD), and coefficient of variation (CV), calculated as CV = (SD/average HbA1c) × 100 (%), of hemoglobin (Hb) A1c levels were evaluated. The proportions of habitual miso consumption of male and female were 88.1% and 82.3%, respectively. The average (7.0 [6.4-7.5] vs. 7.3 [6.8-8.4] %, p = 0.009), SD (0.21 [0.12-0.32] vs. 0.37 [0.20-0.72], p = 0.004), and CV (0.03 [0.02-0.04] vs. 0.05 [0.03-0.09], p = 0.005) of HbA1c levels in female with habitual miso consumption were lower than those of female without. Moreover, habitual miso consumption correlated with average (ß = -0.251, p = 0.009), SD (ß = -0.175, p = 0.016), and CV (ß = -0.185, p = 0.022) of HbA1c levels after adjusting for covariates. However, no association between habitual miso consumption and any glycemic parameters was shown among male. This study clarified the association between habitual miso consumption and good glycemic control, including glycemic variability, in female, but not in male.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Dieta/métodos , Alimentos e Bebidas Fermentados , Controle Glicêmico/métodos , Alimentos de Soja , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores Sexuais
19.
Diabetol Int ; : 1-6, 2021 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-33898153

RESUMO

Background: To investigate the acute effects of coronavirus disease (COVID-19) on lifestyle and metabolic parameters in patients with type 1 diabetes (T1D). Methods: This retrospective cohort study included 34 patients who were admitted to our hospital from April 16 to May 1, 2020. Data on stress levels, sleep duration, exercise, total diet, snacks, and prepared food intake were obtained from the questionnaires. Changes in the values of hemoglobin A1c (HbA1c) and body weight from 3 months before the administration of the questionnaire to the time the study questionnaire was administered (pandemic year), and those from 15 months before to 12 months before the administration of the questionnaire (pre-pandemic year) were evaluated. Results: Increased stress levels and decreased exercise volumes were observed in approximately 60% and 50% of participants during the COVID-19 pandemic, respectively. Decreased sleep duration was associated with changes in the body weight for 3 months during pandemic year (r = - 0.40, p = 0.043). Furthermore, compared with changes in HbA1c for 3 months during pre-pandemic year, changes in HbA1c during the pandemic year were worse (0.12% [0.33] % during pandemic year vs. - 0.09 [0.39] % during pre-pandemic year, p = 0.027). Conclusions: Many patients experienced stress and exercised less due to the COVID-19 pandemic. Glycemic control in patients with T1D was worse than that in the previous year. Since the pandemic is currently ongoing, more attention should be paid to stress and lifestyle factor management in patients with T1D. Supplementary Information: The online version contains supplementary material available at 10.1007/s13340-021-00507-4.

20.
Artigo em Inglês | MEDLINE | ID: mdl-33920957

RESUMO

Background: The aim of this study was to investigate the effect of the coronavirus disease (COVID-19) pandemic restrictions on the change in muscle mass in older patients with type 2 diabetes (T2D), who were not infected with COVID-19. Methods: In this retrospective cohort study, data were obtained from outpatients who underwent bioelectrical impedance analysis at least twice before April 2020 and at least once thereafter. Skeletal muscle mass index (SMI, kg/m2) was calculated as appendicular muscle mass (kg) divided by height squared (m2). Change in SMI (kg/m2/year) was calculated as (follow-up SMI-baseline SMI/follow-up period). The differences between the changes in SMI before and after the start of the COVID-19 pandemic were evaluated using paired t test. Results: This study recruited 56 patients, with a mean (SD) age of 75.2 (7.1) years. SMI changed from 6.7 (0.9) to 6.8 (0.9) kg/m2 before the COVID-19 pandemic, whereas SMI changed from 6.8 (0.9) to 6.6 (0.9) kg/m2 after the start of the COVID-19 pandemic. SMI decreased after the start of the COVID-19 pandemic compared with before the pandemic (-0.117 (0.240) vs. 0.005 (0.289) kg/m2/year, p = 0.049). This decrease was observed in men (-0.159 (0.257) vs. 0.031 (0.325) kg/m2/year, p = 0.038), patients with poor glycemic control (-0.170 (0.264) vs. 0.031 (0.285) kg/m2/year, p = 0.042), and those with a long diabetes duration (-0.153 (0.229) vs. 0.082 (0.291) kg/m2, p = 0.049). Conclusions: The COVID-19 pandemic restrictions caused muscle mass loss in older patents with T2D. Actions, including recommendation of exercise and adequate diet intake, are needed to prevent loss of muscle mass.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 2 , Sarcopenia , Idoso , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/patologia , Humanos , Masculino , Músculo Esquelético , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Sarcopenia/epidemiologia
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