Mariko Sudo

Association of serum apolipoprotein B48 level with the presence of carotid plaque in type 2 diabetes mellitus

AIMS The atherogenicity of chylomicron remnants has been discussed. We examined whether serum apoB48 level is associated with the presence of carotid plaque in type 2 diabetic patients. METHOD Forty type 2 diabetic patients (21 males and 19 females, 52.8+/-11.8 years old; mean+/-S.D.) were divided into two groups by the presence or absence of carotid plaque. The diurnal change of serum apoB48 level was measured by enzyme-linked immunosorbent assay. RESULTS Fasting serum apoB48 level was higher in the subjects with carotid plaque than those without (6.5+/-3.8vs. 4.1+/-1.9 microg/ml, p=0.01). Age- and gender-adjusted analysis showed that the presence of carotid plaque was associated with fasting apoB48 (OR 1.43; 95% CI, 1.07-2.09, p=0.04) and triglyceride (OR 1.14; 95% CI, 1.02-1.32, p=0.04) levels. In normal LDL-cholesterol (<140 mg/dl) subjects, the presence of carotid plaque was associated with fasting apoB48 level (OR 2.16; 95% CI, 1.22-5.32, p=0.04), but not associated with fasting triglyceride level (OR 1.11; 95% CI, 0.99-1.30, p=0.13). CONCLUSIONS Serum apoB48 level was strongly associated with the presence of carotid plaque in type 2 diabetic patients.

Selective breeding of mice for different susceptibilities to high fat diet-induced glucose intolerance : Development of two novel mouse lines, Selectively bred Diet-induced Glucose intolerance-Prone and -Resistant

Aims/Introduction:  The development of type 2 diabetes is primarily due to lifestyle and environmental factors, as well as genetics, as shown by familial clustering. To establish mouse lines for evaluating heritable factors determining susceptibility to diet‐induced diabetes, we performed selective breeding for differences in high fat diet (HFD)‐induced glucose intolerance.

Comparison of pituitary-adrenal responsiveness between insulin tolerance test and growth hormone-releasing peptide-2 test: a pilot study.

Insulin tolerance test (ITT) is the gold standard for assessing the hypothalamic-pituitary-adrenal (HPA) function. GH-releasing peptide (GHRP)-2, which has a strong GH-stimulating activity, is useful for diagnosing GH deficiency as well as ITT. Additionally, GHRP-2 is also known to activate HPA axis. There have been no comparative studies of pituitary-adrenal responsiveness between GHRP-2 test and ITT in patients with hypothalamic/pituitary disease. To assess whether GHRP-2 test could be an alternative to ITT for diagnosing HPA axis failure, both ITT and GHRP-2 test were performed in 15 patients suspected of hypopituitarism. A 100mug dose of GHRP-2 was administered intravenously and plasma ACTH and serum cortisol concentrations were measured. In ITT, a peak cortisol value over 18mug/dl is considered normal. Nine patients were diagnosed as HPA axis failure by ITT. Their median peak cortisol in GHRP-2 test was 11.4mug/ml. In 6 patients diagnosed as normal HPA axis status by ITT, their median peak cortisol in response to GHRP-2 test was 21.4mug/dl, significantly higher (p=0.0032) than seen in patients diagnosed as HPA axis failure. There was a strong correlation between the peak cortisol in GHRP-2 test and ITT (r=0.817; p<0.0001). When the cut-off value for the peak cortisol in GHRP-2 test was set to 13-14mug/dl for diagnosing HPA axis failure, the specificity and sensitivity were 100% and 88.9%, respectively. Although further studies that include normal subjects are needed, these preliminary results suggest the possibility that GHRP-2 test may be an alternative to ITT for assessing HPA axis function.

Association of glycated albumin with the presence of carotid plaque in patients with type 2 diabetes.

Postprandial hyperglycemia is a potent risk factor for cardiovascular disease. Serum glycated albumin (GA) has been reported to reflect postprandial blood glucose fluctuations. In the present study, we assessed the possible correlation of GA with the presence of carotid plaque to evaluate the potential clinical usefulness of GA for predicting atherosclerotic cardiovascular complications in patients with type 2 diabetes.

Frequency of Achilles Tendon Xanthoma in Patients with Acute Coronary Syndrome

Aim: We studied the frequency of Achilles tendon xanthoma (ATX) in patients with acute coronary syndrome (ACS). Furthermore, we investigated the differences in clinical findings between ACS patients with and without ATX. Methods: Patients with ACS (n = 335) were admitted to the coronary care unit of Nippon Medical School between July 2011 and December 2014. Informed consent for the measurement of Achilles tendon thickness (ATT) on a radiograph was obtained from 228 patients without tendon rupture. ATT of each side was measured on the radiograph in patients with ACS and in those with acromegaly (n = 18), non-familial hypercholesterolemia (non-FH; n = 96), and familial hypercholesterolemia (FH; n = 31). Results: ATT of the right and left side in ACS patients were 6.9 ± 1.3 and 7.0 ± 1.6 (mm; mean ± SD). In acromegaly, non-FH, and FH patients, ATT of the right/left side were 6.6 ± 1.1/6.7 ± 1.1, 6.2 ± 0.9/6.6 ± 1.0, and 9.4 ± 3.3/10.0 ± 3.1, respectively. ATX (ATT ≥ 9 mm) was found in 26 (11.4%) patients with ACS. Patients with acromegaly and non-FH had no ATX, whereas all patients with FH had ATX. No differences in age and serum lipid profiles were observed between ACS patients with and without ATX. The levels of body mass index and glycated hemoglobin of ACS patients with ATX were significantly greater than those in ACS patients without ATX (26.8 ± 4.0 vs. 23.9 ± 3.3, p < 0.05, and 6.9 ± 1.4% 6.3 ± 1.3%, p < 0.05, respectively). Conclusion: This is the first report in which the frequency of ACS patients with ATX was 11.4%. The serum lipid profiles of ACS patients with ATX were similar to those without ATX. In the future, ACS patients with ATX will be diagnosed as having FH.