Yukiyoshi Okauchi

Changes in Serum Adiponectin Concentrations Correlate With Changes in BMI, Waist Circumference, and Estimated Visceral Fat Area in Middle-Aged General Population

Adiponectin was identified as an adipocytokine in the human adipose tissue cDNA library. It has antiatherosclerotic and antidiabetic properties in experimental studies, and its blood levels are low in obesity, diabetes, cardiovascular diseases, and metabolic syndrome. Several studies have reported that weight reduction in massively obese subjects is associated with a rise in serum adiponectin (APN) concentration (1–3). However, the relationship between changes in APN and BMI, waist circumference (WC), and visceral fat accumulation (VFA) in general population has not been reported. The present study investigated 1-year change in APN (ΔAPN) in relation to changes in BMI (ΔBMI), WC …

Liraglutide is effective in type 2 diabetic patients with sustained endogenous insulin‐secreting capacity

Aims/Introduction:  Recently, glucagon‐like peptide‐1 (GLP‐1) receptor agonists of liraglutide have become available in Japan. It has not yet been clarified what clinical parameters could discriminate liraglutide‐effective patients from liraglutide‐ineffective patients.

Relationship between visceral fat accumulation and urinary albumin-creatinine ratio in middle-aged Japanese men

OBJECTIVE Chronic kidney disease including microalbuminuria relates to cardiovascular disease (CVD). Microalbuminuria is also known to be a marker of generalized endothelial dysfunction. The metabolic syndrome which encompasses visceral fat accumulation and various metabolic disorders, has also an increase in albuminuria and relates to CVD. However, the relationship between visceral fat accumulation and albuminuria remains to be defined. The present study investigated the relationship between visceral fat accumulation and urinary albumin-creatinine ratio (UACR) in Japanese men. METHODS This study group comprised 1990 Japanese male subjects, who were employees of a city office, had undergone annual health check-up. Urinary albumin was collected from a single spot urine specimen collected anytime between morning and afternoon. Visceral fat area was estimated (eVFA) by the bioelectrical impedance analysis method. RESULTS Log-UACR correlated with age, log-body mass index (BMI), log-waist circumference (WC), log-eVFA, log-adiponectin, blood pressure, serum lipids and hemoglobin A1c (HbA1c). Stepwise multiple regression analysis identified log-eVFA, as well as HbA1c, blood pressure, log-TG, and age, as a significant determinant of log-UACR. Moreover, subjects with eVFA > or = 100 cm(2) had significantly higher UACR than those with eVFA <100 cm(2), irrespective of BMI. UACR was significantly worse in subjects with high numbers of metabolic risk factors, and moreover in subjects with eVFA > or = 100 cm(2) than in those with eVFA <100 cm(2). CONCLUSION These results suggested that visceral fat accumulation is associated with an increase in UACR. Evaluation of both visceral fat accumulation and urinary albumin may be important for preventing atherosclerotic diseases.

Visceral Obesity and Hypoadiponectinemia are Significant Determinants of Hepatic Dysfunction: An Epidemiologic Study of 3827 Japanese Subjects

Background and Aim Adiponectin is an anti-inflammatory and insulin-sensitizing adipocytokine, and its serum concentrations are reduced in obesity with visceral fat accumulation. Visceral fat accumulation is an independent determinant of elevated serum liver enzymes. Hypoadiponectinemia plays important roles in the clinical progression of nonalcoholic steatohepatitis. The aim of this study was to evaluate the relation between visceral fat area (VFA), serum adiponectin concentration, and biochemical liver tests, such as aspartate aminotransferase, alanine aminotransferase (ALT), and γ-glutamyltransferase (GGT) in normal subjects. Methods The study group comprised 3827 Japanese subjects [mean age±SD; 47.6±10.7 y: 2854 males (48.4±10.7 y), 973 females (45.3±10.1 y)], who underwent annual health checkup in 2004. In addition to parameters measured in the annual health checkup, VFA and serum adiponectin concentration were measured by the bioelectrical impedance analysis method and a latex particle-enhanced turbidimetric assay system, respectively. Results Pearsons correlation analysis showed a significant correlation between VFA and the levels of the above 3 liver enzymes in both sexes, and a significant negative correlation between adiponectin and all biochemical liver tests in men and with ALT and GGT in women. Stepwise multiple regression analysis showed that VFA was a significant determinant of serum liver tests in both sexes. Moreover, serum adiponectin concentration significantly and negatively influenced male ALT and GGT and female GGT. Conclusions Both visceral obesity and hypoadiponectinemia are significant determinants of subtle and asymptomatic hepatic dysfunction in normal Japanese subjects.

Insulin-secretion capacity in normal glucose tolerance, impaired glucose tolerance, and diabetes in obese and non-obese Japanese patients.

Aims/Introduction:  Pronounced reduction of insulin secretion in response to a rise in glucose level has been reported in Japanese patients compared with Caucasian patients, but the mean body mass index (BMI) is also lower in Japanese patients. As BMI is a determinant of insulin secretion, we examined insulin‐secretion capacity in obese and non‐obese Japanese patients.

Cross-sectional and longitudinal study of association between circulating thiobarbituric acid-reacting substance levels and clinicobiochemical parameters in 1,178 middle-aged Japanese men - the Amagasaki Visceral Fat Study.

BackgroundCirculating thiobarbituric acid-reacting substance (TBARS) levels, a marker of systemic oxidative stress, are predictive of cardiovascular events. However, they has not been evaluated in Japanese, especially with regard to the factors that contribute to the changes in circulating TBARS levels. We investigated the cross-sectional and longitudinal relationships between circulating TBARS levels and various clinicobiochemical parameters in middle-aged men.MethodsIn this population-based study (The Amagasaki Visceral Fat Study), 1,178 Japanese male urban workers who had undergone health check-ups in 2006, 2007 and 2008 and were not on medications for metabolic disorders during the follow-up period, were enrolled. Serum TBARS levels were measured by the method of Yagi. The estimated visceral fat area (eVFA) by bioelectrical impedance was measured annually. After health check-ups, subjects received health education with lifestyle modification by medical personnel.ResultsThe number of cardiovascular risk factors (hypertension, hyperglycemia, low HDL-C, hypertriglyceridemia, hyperuricemia, hyper-LDL-C and impaired renal function) augmented with the increases in log-eVFA (p < 0.0001) and log-TBARS (p < 0.0001). The combination of TBARS and eVFA had a multiplicative effect on risk factor accumulation (F value = 79.1, p = 0.0065). Stepwise multiple regression analysis identified log-eVFA, as well as age, log-body mass index (BMI), LDL-C, log-adiponectin, γ-glutamyl transpeptidase (γ-GTP) and uric acid as significant determinants of log-TBARS. Stepwise multiple regression analysis identified one-year changes in eVFA as well as BMI, γ-GTP and estimated glomerular filtration rate (eGFR) as significant determinants of one-year change in TBARS, and biennial changes in eVFA as well as BMI and γ-GTP, eGFR as significant determinants of biennial change in TBARS.ConclusionsThe present study showed a significant cross-sectional and longitudinal correlation between TBARS and eVFA, as well as BMI and γ- GTP, eGFR. Visceral fat reduction may independently associate with the improvement in systemic ROS in middle-aged Japanese men.Trial RegistrationThe Amagasaki Visceral Fat Study UMIN000002391.

One-Year Reductions in Body Weight and Blood Pressure, but Not in Visceral Fat Accumulation and Adiponectin, Improve Urinary Albumin-to-Creatinine Ratio in Middle-Aged Japanese Men

Microalbuminuria has been recognized recently as a risk factor for cardiovascular diseases as well as renal failure and is often found in subjects with metabolic syndrome. The relationship between visceral fat accumulation and microalbuminuria, urinary albumin-to-creatinine ratio (UACR), has not been fully clarified. Our cross-sectional study demonstrated that visceral fat accumulation is associated with increases in UACR. However, the accompanying obesity-related risk factors, especially hemoglobin A1c (HbA1c) and elevated blood pressure, strongly increased the risk of UACR (1). We have reported that reductions in both body weight and estimated visceral fat area (eVFA) measured by the bioelectrical impedance analysis method (2) were accompanied by reductions in the number of obesity-related cardiovascular risk factors (3) and increases in serum levels of adiponectin (4) in our longitudinal Amagasaki Visceral Fat Study, in which intensive risk factor–oriented health promotion programs were …

Weight reduction is associated with improvement of glycemic control in Japanese men, whose hemoglobin A1C is 5.6–6.4%, with visceral fat accumulation, but not without visceral fat accumulation

The aim of the present study was to determine whether weight reduction is associated with improvement of glycemic control in non‐obese and obese subjects with or without visceral fat accumulation, whose hemoglobin A1c (A1C) is 5.6–6.4%.

Extent of weight reduction necessary for minimization of diabetes risk in Japanese men with visceral fat accumulation and glycated hemoglobin of 5.6-6.4.

Weight reduction improves glycemic control in obese men with glycated hemoglobin (HbA1c) of 5.6–6.4%, suggesting that it can prevent the development of diabetes in these patients. The aim of the present study was to quantify the amount of weight reduction necessary for minimization of diabetes risk in Japanese men with visceral fat accumulation.

Carotid intima-media thickness, but not visceral fat area or adiponectin, correlates with intracoronary stenosis detected by multislice computed tomography in people with type 2 diabetes and hypertension

We investigated the relationship between intracoronary stenosis detected by multislice computed tomography and various clinical parameters in type 2 diabetic patients with hypertension treated with candesartan (n=42). The results showed that carotid intima-media thickness, but not visceral fat area or adiponectin, correlated significantly with intracoronary stenosis (p<0.05).