Kenji Kamiuchi

Interleukin-6 polymorphism (-634C/G) in the promotor region and the progression of diabetic nephropathy in type 2 diabetes.

Aims Interleukin‐6 (IL‐6) is a multifunctional cytokine produced by many different cell types, including glomerular mesangial cells. Recently, a novel C/G polymorphism at position −634 in the promotor region of the IL‐6 gene has been reported. The aim of this study was to investigate whether the −634C/G polymorphism is associated with an increased risk for progression to diabetic nephropathy as well as elevated levels of IL‐6 secretion by peripheral blood mononuclear cells.

Intercellular adhesion molecule-1 (ICAM-1) polymorphism is associated with diabetic retinopathy in Type 2 diabetes mellitus.

Aims Leucocyte adhesion to the diabetic retinal vasculature has been implicated in the pathogenesis of diabetic retinopathy. We evaluated the relationship between genetic polymorphisms in leucocyte and endothelial cell adhesion molecules and diabetic retinopathy in Type 2 diabetes mellitus.

Augmentation of central arterial pressure as a marker of atherosclerosis in patients with type 2 diabetes.

Macrovascular disease is the most common cause of morbidity and mortality in diabetic patients. With the increasing numbers of patients with type 2 diabetes, a simple, noninvasive method is needed to detect atherosclerosis. Augmentation represents the difference between the second and first peaks of the central arterial pressure waveform in systole and is a measure of systemic arterial stiffness, which causes the pressure wave to rebound. We investigated whether augmentation could serve as a marker of atherosclerosis in patients with type 2 diabetes. Central arterial pressure and degree of its augmentation by pulse wave rebound were measured sphygmographically in 208 consecutive patients with type 2 diabetes and 117 healthy control subjects. The relationship between augmentation and carotid atherosclerosis detected by carotid ultrasonography was investigated in a subgroup of 81 diabetic patients. Augmentation was greater in diabetic patients than control subjects (13.2+/-6.9 vs. 9.4+/-5.7 mm Hg, P<0.0001). The positive correlation between augmentation and intima-media thickness (r=0.309, P=0.0051) and between augmentation and plaque score (r=0.304, P=0.0059) were found in patients with type 2 diabetes. Augmentation was greater in diabetic patients with cardiovascular disease (n=47) than without (n=161; 15.1+/-8.4 vs. 12.6+/-6.3 mm Hg, P=0.031). Augmentation of central arterial pressure is a reliable marker for atherosclerosis in patients with type 2 diabetes. This simple, noninvasive determination would permit large-scale, early screening for atherosclerosis in patients with type 2 diabetes, who are at increased risk for cardiovascular disease.

Leukocyte-endothelial cell adhesion molecule 1 (LECAM-1) polymorphism is associated with diabetic nephropathy in type 2 diabetes mellitus

BACKGROUND/AIMS Glomerular infiltration with monocytes/macrophages has been implicated in the pathogenesis of diabetic nephropathy. In this study, we evaluated the relationship between the genetic polymorphism in leukocyte-endothelial adhesion molecule-1 (LECAM-1) and diabetic nephropathy in patients with type 2 diabetes mellitus. METHODS We determined the frequency of the LECAM-1 P213S genotype in 102 diabetic patients with diabetic nephropathy, 90 diabetic patients with no evidence of diabetic nephropathy, and 200 healthy control individuals. RESULTS The frequency of the LECAM-1 213PP genotype and P allele in patients with diabetic nephropathy was significantly higher than that in patients without nephropathy (genotype 68% vs. 53%, chi(2)=6.78, P=.034; allele 83% vs. 72%, chi(2)=6.26, P=.012). The LECAM-1 P213 genotype was associated with a 1.86-fold increased risk for nephropathy independently of other risk factors. CONCLUSION The data suggest that the LECAM-1 213PP genotype is a genetic risk factor for the development of nephropathy in type 2 diabetes mellitus.

Metabolic syndrome is not associated with markers of subclinical atherosclerosis, serum adiponectin and endogenous androgen concentrations in Japanese men with Type 2 diabetes

Aims  Metabolic syndrome is characterized by its association with certain cardiovascular disease risk factors. The aim of this study was to investigate the relationships between metabolic syndrome and markers of subclinical atherosclerosis, serum adiponectin and endogenous androgen concentrations in Japanese men with Type 2 diabetes.

Replacement of neutral protamine Hagedorn insulin with the long-acting insulin analogue, detemir, improves glycemic control without weight gain in basal-bolus insulin therapy in Japanese patients with type 1 diabetes.

Aims/Introduction:  The aim of the present study was to evaluate the efficacy of replacing neutral protamine Hagedorn insulin (NPH) with the long‐acting insulin analogue, detemir, in clinical practice.