Nobukiyo Koide

Circulating angiotensin II is associated with body fat accumulation and insulin resistance in obese subjects with type 2 diabetes mellitus

Adipocytes express all components of the renin-angiotensin system, and the renin-angiotensin system is involved in obesity and insulin resistance. Circulating angiotensin II (Ang II) is detectable in blood, but its significance in human obesity remains unknown. The aim of this study was to investigate plasma Ang II in obese patients with type 2 diabetes mellitus (T2D) and the change during weight loss. Fifty Japanese obese subjects with T2D (body weight, 75.0 +/- 14.1 kg; body mass index, 29.1 +/- 3.7 kg/m(2); visceral fat area [VFA], 169.3 +/- 54.3 cm(2); hemoglobin A(1c), 7.6% +/- 1.5%) were enrolled. The subjects were prescribed a diet of daily caloric intake of 20 kcal/kg for 24 weeks. Plasma Ang II was measured by radioimmunoassay. Leptin, adiponectin, and lipoprotein lipase mass in preheparin serum were also measured as adipocyte-derived factors. After 24 weeks of weight reduction diet, the mean body weight, VFA, and hemoglobin A(1c) decreased significantly by 2.3%, 7.0%, and 8.3%, respectively. The mean plasma Ang II decreased by 24% (P < .0001) and correlated with body weight both at baseline (r = 0.425, P = .0018) and at 24 weeks (r = 0.332, P = .0181). The change in Ang II correlated with changes in body weight (r = 0.335, P = .0167) and VFA (r = 0.329, P = .0191). The change in Ang II also correlated positively with change in leptin (r = 0.348, P = .0127) and tended to correlate negatively with change in lipoprotein lipase mass in preheparin serum (r = -0.260, P = .0683), which is a marker of insulin sensitivity. Plasma Ang II is associated with body weight, decreases during weight loss, and is associated with markers of insulin resistance in obese subjects with T2D.

Determination of serum 7-ketocholesterol concentrations and their relationships with coronary multiple risks in diabetes mellitus

Oxysterols have cytotoxic effects and contribute to the development of atherosclerosis. To examine association between 7-ketocholesterol and diabetes mellitus, and other coronary risk factors, we developed a reliable quantitative method to measure serum 7-ketocholesterol (s-7KCHO) and studied s-7KCHO in patients with type 2 diabetes mellitus (T2DM). The s-7KCHO was detected by gas chromatography-mass spectrometry assay. The s-7KCHO was significantly higher in patients with T2DM (n=137, 33.8 ng/ml) compared to non-diabetic healthy subjects (n=89, 16.1 ng/ml). Patients with T2DM were divided into two groups with two or more than two risk factors (defined as multiple risk factors group) and with zero or one risk factor (non-multiple risk factors group). The s-7KCHO was significantly higher in multiple risk factors group (39.5 ng/ml) compared to non-multiple risk factors (30.1 ng/ml). Among patients with multiple risk factors group, s-7KCHO was significantly higher in patients with high low-density lipoprotein cholesterol (LDL-C) levels (45.1+/-5.9 ng/ml) compared to those with normal LDL-C levels (35.3+/-7.0 ng/ml). Furthermore, s-7KCHO increased according to the number of concurrent coronary risk factors. These results suggest that serum 7-ketocholesterol levels may depend on the multiple risk factors and serum LDL-C levels.

Suppression of lipoprotein lipase expression in 3T3-L1 cells by inhibition of adipogenic differentiation through activation of the renin-angiotensin system

The renin-angiotensin system (RAS) may inhibit adipogenic differentiation by down-regulating peroxisome proliferator-activated receptor gamma gene expression in adipocytes, and adipocytes express all components of the RAS, including angiotensinogen. Expression of lipoprotein lipase (LPL), which is expressed mainly in adipocytes, is considered to be affected by adipogenic differentiation. We studied whether LPL expression in mouse 3T3-L1 cells is suppressed by inhibition of adipogenic differentiation through activation of RAS by the cells. The mean 3T3-L1 cell size increased and peroxisome proliferator-activated receptor gamma messenger RNA (mRNA) expression in the cells measured by reverse transcriptase polymerase chain reaction (RT-PCR) was enhanced with increase in incubation time. The LPL activity, LPL protein expression (Western blot), and mRNA expression (RT-PCR) in 3T3-L1 cells increased transiently followed by a decline during long-term incubation. Angiotensin II suppressed adipogenic differentiation, LPL activity, protein expression, and mRNA expression in 3T3-L1 cells. On the other hand, the selective angiotensin type 1 receptor blocker valsartan enhanced adipogenic differentiation and LPL activity in 3T3-L1 cells. Angiotensinogen mRNA expression in 3T3-L1 cells measured by RT-PCR was enhanced with increase in incubation time. These results suggest that LPL expression may be suppressed by inhibition of adipogenic differentiation through activation of endogenous RAS in 3T3-L1 cells angiotensin type 1 receptor.

Aseptic meningitis as the sole manifestation of Behçet's disease.

We report a 33-year-old woman who had aseptic meningitis alone, without any other systemic manifestations, due to Behçet’s disease. Behçet’s disease should be listed as a differential diagnosis of acute aseptic meningitis because, in acute aseptic meningitis caused by Behçet’s disease, early treatment with corticosteroids could ameliorate this disorder.