2024/07/13 更新

写真a

オハラ ノブマサ
小原 伸雅
OHARA Nobumasa
所属
医歯学総合病院 魚沼地域医療教育センター 特任助教
職名
特任助教
外部リンク

学位

  • 博士(医学) ( 2010年3月 )

経歴(researchmap)

  • 魚沼基幹病院   内分泌代謝内科   部長

    2015年4月 - 現在

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    国名:日本国

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経歴

  • 新潟大学   医歯学総合病院 魚沼地域医療教育センター   特任助教

    2015年4月 - 現在

  • 新潟大学   医歯学総合研究科   特任助教

    2014年7月 - 2015年3月

学歴

  • 新潟大学医歯学総合研究科   生体機能調節医学

    2006年4月 - 2010年3月

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    国名: 日本国

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  • 新潟大学   医学部

    1997年4月 - 2003年3月

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    国名: 日本国

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論文

  • Hypoglycemic Hemiplegia Associated with Reversible Narrowing of the Contralateral Middle Cerebral Artery in a Patient with Adrenal Insufficiency. 査読

    Yuhki Sakurai, Nobumasa Ohara, Yumi Fukai, Yasuhiro Seki, Katsuhiko Akiyama, Yuichiro Yoneoka, Toshinori Takada, Takashi Tani, Kenshi Terajima, Tetsutaro Ozawa, Hirohito Sone

    Internal medicine (Tokyo, Japan)   62 ( 5 )   751 - 756   2023年3月

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    担当区分:責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 56-year-old man with a 2.5-month history of anorexia developed sweating, weakness, and left hemiplegia and hemispatial neglect. Brain magnetic resonance imaging detected no abnormalities, but magnetic resonance angiography revealed narrowing of the right middle cerebral artery (MCA). The focal neurological signs and narrowing of the MCA resolved after detection and correction of hypoglycemia. Endocrinological examinations indicated adrenal insufficiency. Hemiplegia is a rare but important neurological manifestation of hypoglycemia, although the mechanisms involved remain unknown. Combined hypoglycemia and decreased MCA blood flow associated with vasospasm probably induced regionally severe neuroglycopenia with ischemia, which presented as focal neurological symptoms.

    DOI: 10.2169/internalmedicine.0038-22

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  • Primary Aldosteronism Presenting with Hypertension Five Days after Delivery: A Case Report and Literature Review 査読

    Nobumasa Ohara, Michi Kobayashi, Yuichiro Yoneoka, Go Hasegawa, Yayoi Aoki, Yasuhiro Nakamura, Yoshiki Kazama, Tsutomu Nishiyama

    Internal Medicine   61 ( 4 )   507 - 512   2022年2月

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    担当区分:筆頭著者, 責任著者   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society of Internal Medicine  

    DOI: 10.2169/internalmedicine.7778-21

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  • Isolated Adrenocorticotropic Hormone Deficiency Associated with Severe Hyperkalemia During Pembrolizumab Therapy in a Patient with Ureteral Cancer and an Ileal Conduit: A Case Report and Literature Review. 国際誌

    Yudai Hinata, Nobumasa Ohara, Yuhki Sakurai, Ryo Koda, Yuichiro Yoneoka, Toshinori Takada, Noboru Hara, Tsutomu Nishiyama

    The American journal of case reports   22   e931639   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND Immune checkpoint inhibitors (ICIs) are anticancer medications that enhance the antitumor immune response. The clinical benefit afforded by ICIs, however, can be accompanied by immune-related adverse events (IRAEs). One of the common endocrine IRAEs is hypophysitis, which often causes hypopituitarism with secondary adrenal insufficiency (AI). Secondary AI, including isolated adrenocorticotropic hormone (ACTH) deficiency (IAD), is often associated with hyponatremia. Here, we report an unusual case of ICI-related IAD associated with severe hyperkalemia. CASE REPORT A 78-year-old woman who had an ileal conduit, chronic kidney disease, type 2 diabetes mellitus, and hypertension and was taking an angiotensin II receptor blocker began treatment for advanced ureteral cancer with the anti-programmed cell death protein 1 inhibitor pembrolizumab. The therapy effectively controlled the cancer, but 4 1/2 months after starting it, the patient developed anorexia, general weakness, and muscle pain and was diagnosed with IAD associated with severe hyperkalemia and hyperchloremic metabolic acidosis. She recovered after prompt administration of corticosteroids and treatment with sodium bicarbonate, glucose/insulin, and cation exchange resins. CONCLUSIONS Hyperkalemia is a common symptom of primary AI but is less common in patients with central AI because a lack of ACTH does not cause aldosterone deficiency and mineralocorticoid action is preserved. The present case demonstrates the need for physicians to be aware of severe hyperkalemia as a life-threatening complication of secondary AI induced by ICIs, particularly in patients with predisposing factors, such as kidney dysfunction, diabetes mellitus, an ileal conduit, and renin-angiotensin-aldosterone system inhibitor use.

    DOI: 10.12659/AJCR.931639

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  • Central diabetes insipidus after syndrome of inappropriate antidiuretic hormone secretion with severe hyponatremia in a patient with Rathke's cleft cyst.

    Yudai Hinata, Nobumasa Ohara, Takeshi Komatsu, Yuki Sakurai, Yuichiro Yoneoka, Yasuhiro Seki, Katsuhiko Akiyama, Hirohito Sone

    Internal medicine (Tokyo, Japan)   61 ( 2 )   197 - 203   2021年7月

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    担当区分:責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 49-year-old man developed severe hyponatremia associated with transient headache and was diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Fluid restriction and sodium supplementation corrected the hyponatremia. However, several days later, the patient exhibited hypernatremia with thirst and polyuria. A detailed examination indicated central diabetes insipidus (CDI) with an intrasellar cystic lesion indicative of Rathke's cleft cyst (RCC). A case of RCC exhibiting headache, hyponatremia, and subsequent hypernatremia has been reported. Our case shows that CDI may appear after SIADH in patients with RCC, especially in those with serum sodium levels that unexpectedly increase rapidly beyond the reference range.

    DOI: 10.2169/internalmedicine.6608-20

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  • Non-insulin-dependent Diabetes Mellitus Induced by Immune Checkpoint Inhibitor Therapy in an Insulinoma-associated Antigen-2 Autoantibody-positive Patient with Advanced Gastric Cancer. 査読

    Nobumasa Ohara, Michi Kobayashi, Yohei Ikeda, Takahiro Hoshi, Shinichi Morita, Tsutomu Kanefuji, Kazuyoshi Yagi, Takeshi Suda, Toshinori Takada, Go Hasegawa, Yo Sato, Kenichiro Hirano, Shin-Ichi Kosugi

    Internal medicine (Tokyo, Japan)   59 ( 4 )   551 - 556   2020年2月

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 70-year-old man with insulinoma-associated antigen-2 autoantibodies developed diabetes mellitus (DM) without ketoacidosis after starting nivolumab to treat advanced gastric cancer. He subsequently exhibited preserved insulin-secretion capacity for over one year. Immune checkpoint inhibitors (ICIs) infrequently cause type 1 DM associated with the rapid loss of insulin secretion and ketoacidosis as an immune-related adverse event. ICIs may also cause non-insulin-dependent DM by inducing insulin resistance if there is islet autoantibody-related latent beta-cell dysfunction. The present case highlights the importance of testing blood glucose levels regularly to diagnose DM in patients treated with ICIs, even if they do not have diabetic ketoacidosis.

    DOI: 10.2169/internalmedicine.3208-19

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  • Isolated Adrenocorticotropic Hormone Deficiency Presenting with Severe Hyponatremia and Rhabdomyolysis: A Case Report and Literature Review 査読 国際誌

    Takeshi Komatsu, Nobumasa Ohara, Naoko Hirota, Yuichiro Yoneoka, Takashi Tani, Keishi Terajima, Tetsutaro Ozawa, Hirohito Sone

    American Journal of Case Reports   20   1857 - 1863   2019年12月

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    担当区分:責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:International Scientific Information, Inc.  

    BACKGROUND Isolated adrenocorticotropic hormone deficiency (IAD) is a rare disorder characterized by central adrenal insufficiency (AI) but normal secretion of pituitary hormones other than adrenocorticotropic hormone. IAD usually presents with unspecific symptoms of AI, such as anorexia and fatigue, but some patients present with a variety of atypical manifestations. Rhabdomyolysis is a potentially life-threatening clinical syndrome caused by skeletal muscle injury with the release of muscle cell contents into the circulation. A wide variety of disorders can cause rhabdomyolysis. Herein, we report an unusual case of IAD presenting with hyponatremia and rhabdomyolysis. CASE REPORT A 67-year-old Japanese woman with a 2-month history of anorexia and fatigue was diagnosed with severe hyponatremia (serum sodium, 118 mEq/L) and rhabdomyolysis (serum creatine phosphokinase, 6968 IU/L), after 2 days of vomiting and muscle weakness. Physical and laboratory findings did not show dehydration or peripheral edema. Her rhabdomyolysis resolved with normalization of serum sodium levels during administration of sodium chloride. However, her anorexia and fatigue remained unresolved. After reducing the amount of sodium chloride administered, the patient still had hyponatremia. Detailed endocrinological examinations indicated IAD; her hyponatremia was associated with inappropriately high plasma arginine vasopressin levels. The patient received corticosteroid replacement therapy, which resolved her anorexia, fatigue, excessive arginine vasopressin, and hyponatremia. CONCLUSIONS This case highlights the importance of considering the possibility of central AI in patients with hyponatremia and excessive arginine vasopressin levels. In addition, rhabdomyolysis associated with hyponatremia can be an important manifestation of IAD.

    DOI: 10.12659/ajcr.918427

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  • Glutamic Acid Decarboxylase Autoantibody-negative Slowly Progressive Type 1 Diabetes Mellitus: A Case Report and Literature Review 査読

    Michi Kobayashi, Nobumasa Ohara, Yohei Ikeda, Ouki Nagano, Toshinori Takada, Makoto Kodama, Hirohito Sone

    Internal Medicine   57 ( 24 )   3581 - 3587   2018年12月

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    担当区分:責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society of Internal Medicine  

    A 59-year-old non-obese Japanese woman developed diabetes mellitus with a negative glutamic acid decarboxylase autoantibody (GADA) test result. Her hyperglycemia was initially well controlled by oral hypoglycemic agents; however, despite continued treatment the hyperglycemia gradually worsened. As she had endogenous insulin deficiency and tested positive for insulin autoantibody (IAA), insulin therapy was initiated. Few studies have investigated GADA-negative patients with slowly progressive type 1 diabetes mellitus (SPT1D). Our IAA-positive SPT1D patient progressed from the clinical onset of diabetes mellitus to starting insulin therapy relatively quickly (1.5 years), similarly to other previously reported non-obese patients with GADA-positive SPT1D.

    DOI: 10.2169/internalmedicine.1008-18

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  • Quantitative Relationship Between Cumulative Risk Alleles Based on Genome-Wide Association Studies and Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

    Satoru Kodama, Kazuya Fujihara, Hajime Ishiguro, Chika Horikawa, Nobumasa Ohara, Yoko Yachi, Shiro Tanaka, Hitoshi Shimano, Kiminori Kato, Osamu Hanyu, Hirohito Sone

    Journal of Epidemiology   28 ( 1 )   3 - 18   2018年

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    掲載種別:研究論文(学術雑誌)  

    Many epidemiological studies have assessed the genetic risk of having undiagnosed or of developing type 2 diabetes mellitus (T2DM) using several single nucleotide polymorphisms (SNPs) based on findings of genome-wide association studies (GWAS). However, the quantitative association of cumulative risk alleles (RAs) of such SNPs with T2DM risk has been unclear. The aim of this meta-analysis is to review the strength of the association between cumulative RAs and T2DM risk. Systematic literature searches were conducted for cross-sectional or longitudinal studies that examined odds ratios (ORs) for T2DM in relation to genetic profiles. Logarithm of the estimated OR (log OR) of T2DM for 1 increment in RAs carried (1-ΔRA) in each study was pooled using a random-effects model. There were 46 eligible studies that included 74,880 cases among 249,365 participants. In 32 studies with a cross-sectional design, the pooled OR for T2DM morbidity for 1-ΔRA was 1.16 (95% confidence interval [CI], 1.13–1.19). In 15 studies that had a longitudinal design, the OR for incident T2DM was 1.10 (95% CI, 1.08–1.13). There was large heterogeneity in the magnitude of log OR (P < 0.001 for both cross-sectional studies and longitudinal studies). The top 10 commonly used genes significantly explained the variance in the log OR (P = 0.04 for cross-sectional studies; P = 0.006 for longitudinal studies). The current meta-analysis indicated that carrying 1-ΔRA in T2DM-associated SNPs was associated with a modest risk of prevalent or incident T2DM, although the heterogeneity in the used genes among studies requires us to interpret the results with caution.

    DOI: 10.2188/jea.JE20160151

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  • Isolated adrenocorticotropin deficiency due to nivolumab-induced hypophysitis in a patient with advanced lung adenocarcinoma: A case report and literature review 査読

    Nobumasa Ohara, Kazumasa Ohashi, Toshiya Fujisaki, Chiyumi Oda, Yohei Ikeda, Yuichiro Yoneoka, Takehisa Hashimoto, Go Hasegawa, Kazuo Suzuki, Toshinori Takada

    Internal Medicine   57 ( 4 )   527 - 535   2018年

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society of Internal Medicine  

    A 63-year-old Japanese woman with advanced lung adenocarcinoma developed isolated adrenocorticotropin deficiency caused by immune checkpoint inhibitor (ICI)-related hypophysitis following 8 months of nivolumab therapy. Prompt corticosteroid replacement therapy effectively relieved her secondary adrenal insufficiency symptoms and allowed her to pursue nivolumab therapy, which had been effective for the control of lung adenocarcinoma. Human leukocyte antigen (HLA) typing revealed the presence of the DRB1*04:05-DQA1*03:03-DQB1*04:01 haplotype, which is associated with susceptibility to autoimmune polyglandular syndrome with pituitary disorder in the Japanese population. This case suggests that genetic factors, such as HLA, contribute to the development of endocrinopathies induced by ICIs.

    DOI: 10.2169/internalmedicine.9074-17

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  • Acute hypopituitarism associated with periorbital swelling and cardiac dysfunction in a patient with pituitary tumor apoplexy: A case report 査読

    Nobumasa Ohara, Yuichiro Yoneoka, Yasuhiro Seki, Katsuhiko Akiyama, Masataka Arita, Kazumasa Ohashi, Kazuo Suzuki, Toshinori Takada

    Journal of Medical Case Reports   11 ( 1 )   235   2017年8月

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BioMed Central Ltd.  

    Background: Pituitary tumor apoplexy is a rare clinical syndrome caused by acute hemorrhage or infarction in a preexisting pituitary adenoma. It typically manifests as an acute episode of headache, visual disturbance, mental status changes, cranial nerve palsy, and endocrine pituitary dysfunction. However, not all patients present with classical symptoms, so it is pertinent to appreciate the clinical spectrum of pituitary tumor apoplexy presentation. We report an unusual case of a patient with pituitary tumor apoplexy who presented with periorbital edema associated with hypopituitarism. Case presentation: An 83-year-old Japanese man developed acute anterior hypopituitarism
    he showed anorexia, fatigue, lethargy, severe bilateral periorbital edema, and mild cardiac dysfunction in the absence of headache, visual disturbance, altered mental status, and cranial nerve palsy. Magnetic resonance imaging showed a 2.5-cm pituitary tumor containing a mixed pattern of solid and liquid components indicating pituitary tumor apoplexy due to hemorrhage in a preexisting pituitary adenoma. Replacement therapy with oral hydrocortisone and levothyroxine relieved his symptoms of central adrenal insufficiency, central hypothyroidism, periorbital edema, and cardiac dysfunction. Conclusions: Common causes of periorbital edema include infections, inflammation, trauma, allergy, kidney or cardiac dysfunction, and endocrine disorders such as primary hypothyroidism. In the present case, the patient's acute central hypothyroidism was probably involved in the development of both periorbital edema and cardiac dysfunction. The present case highlights the need for physicians to consider periorbital edema as an unusual predominant manifestation of pituitary tumor apoplexy.

    DOI: 10.1186/s13256-017-1371-7

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  • Unstable bodyweight and incident type 2 diabetes mellitus: A meta-analysis

    Satoru Kodama, Kazuya Fujihara, Hajime Ishiguro, Chika Horikawa, Nobumasa Ohara, Yoko Yachi, Shiro Tanaka, Hitoshi Shimano, Kiminori Kato, Osamu Hanyu, Hirohito Sone

    Journal of Diabetes Investigation   8 ( 4 )   501 - 509   2017年7月

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    掲載種別:研究論文(学術雑誌)  

    Aims/Introduction: The present meta-analysis aimed to clarify the association of unstable bodyweight with the risk of type 2 diabetes mellitus, an association that has been controversial among longitudinal studies. Materials and Methods: An electronic literature search using EMBASE and MEDLINE was followed up to 31 August 2016. The relative risks (RRs) of type 2 diabetes mellitus in individuals with unstable bodyweight were pooled using the inverse variance method. Results: Eight studies were eligible for the meta-analysis. The median duration of measurements of weight change and follow-up years for ascertaining type 2 diabetes mellitus were 13.5 and 9.4 years, respectively. The pooled RR for the least vs most stable category was 1.33 (95% confidence interval 1.12–1.57). Between-study heterogeneity was statistically significant (P = 0.048). Whether type 2 diabetes mellitus was ascertained by blood testing explained 66.0% of the variance in the logarithm of RR (P = 0.02). In three studies in which blood testing was carried out, type 2 diabetes mellitus risk was not significant (RR 1.06, 95% confidence interval 0.91–1.25). Furthermore, publication bias that inflated type 2 diabetes mellitus risk was statistically detected by Egger's test (P = 0.09). Conclusions: Unstable bodyweight might be modestly associated with the elevated risk of type 2 diabetes mellitus; although serious biases, such as diagnostic suspicion bias and publication bias, made it difficult to assess this association.

    DOI: 10.1111/jdi.12623

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  • Generalized Status Epilepticus in a Patient with Acute-onset Type 1 Diabetes Mellitus Associated with Severe Kidney Dysfunction: A Case Report and Literature Review 査読

    Nobumasa Ohara, Ryo Koda, Hirofumi Watanabe, Noriaki Iino, Kazumasa Ohashi, Kenshi Terajima, Tetsutaro Ozawa, Yohei Ikeda, Hiroshi Sekiguchi, Hitomi Ohashi, Seigo Yamaguchi

    Internal Medicine   56 ( 15 )   1993 - 1999   2017年

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society of Internal Medicine  

    DOI: 10.2169/internalmedicine.56.8304

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  • Lung adenocarcinoma and adrenocortical carcinoma in a patient with multiple endocrine neoplasia type 1 査読

    Nobumasa Ohara, Masanori Kaneko, Masahiro Ikeda, Fumio Ishizaki, Kazuya Suzuki, Ryo Maruyama, Takeshi Komeyama, Kazuhiro Sato, Kenichi Togashi, Hiroyuki Usuda, Yuto Yamazaki, Hironobu Sasano, Kenzo Kaneko, Kyuzi Kamoi

    Respiratory Medicine Case Reports   20   77 - 81   2017年

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W.B. Saunders Ltd  

    Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant disorder caused by heterozygous germline mutations in the tumor suppressor gene MEN1, which encodes a nuclear protein, menin. MEN1 is characterized by the combined occurrence of tumors involving the pituitary gland, pancreatic islets, and parathyroid glands. Additionally, patients with MEN1 often exhibit adrenal tumors. Although most MEN1-associated tumors are benign, malignant lesions arising in these endocrine organs have been reported. Additionally, malignant diseases of non-endocrine organs concomitant with MEN1 have also been reported. Here, we report a rare case of a MEN1 patient who exhibited adrenocortical carcinoma (ACC) and lung adenocarcinoma (LAC). A 53-year-old Japanese woman was diagnosed with genetically proven MEN1 that initially manifested as parathyroid, pancreatic, and adrenal tumors. During the course of the disease, she developed LAC harboring the epidermal growth factor receptor gene mutations and cortisol-secreting ACC. Both tumors were surgically resected. The tumor cells were immunohistochemically negative for menin. Studies have suggested a causative link between MEN1 gene mutations and ACC, and menin expression may decrease in MEN1-related ACCs. In contrast, there are few reports suggesting a specific role of MEN1 gene mutations in LAC. Menin is often inactivated in the LACs of patients without MEN1. Thus, our patient's ACC probably occurred as part of MEN1, whereas the latter had no evident etiological association with her LAC. This case demonstrates the need for physicians to consider the potential development of malignant diseases originating from both endocrine and non-endocrine organs in MEN1 patients.

    DOI: 10.1016/j.rmcr.2016.12.002

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  • Quantitative assessment of genetic testing for type 2 diabetes mellitus based on findings of genome-wide association studies

    Satoru Kodama, Kazuya Fujihara, Hajime Ishiguro, Chika Horikawa, Nobumasa Ohara, Yoko Yachi, Shiro Tanaka, Hitoshi Shimano, Kiminori Kato, Osamu Hanyu, Hirohito Sone

    Annals of Epidemiology   26 ( 11 )   816 - 818.e6   2016年11月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.annepidem.2016.09.004

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  • Histopathological analysis of spontaneous large necrosis of adrenal pheochromocytoma manifested as acute attacks of alternating hypertension and hypotension: a case report 査読

    Nobumasa Ohara, Yasuyuki Uemura, Naomi Mezaki, Keita Kimura, Masanori Kaneko, Hirohiko Kuwano, Katsuya Ebe, Toshio Fujita, Takeshi Komeyama, Hiroyuki Usuda, Yuto Yamazaki, Takashi Maekawa, Hironobu Sasano, Kenzo Kaneko, Kyuzi Kamoi

    Journal of Medical Case Reports   10 ( 1 )   1 - 6   2016年10月

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BioMed Central Ltd.  

    Background: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. Hypertension secondary to pheochromocytoma is often paroxysmal, and patients occasionally present with sudden attacks of alternating hypertension and hypotension. Spontaneous, extensive necrosis within the tumor that is associated with catecholamine crisis is an infrequent complication of adrenal pheochromocytoma, but its pathogenesis remains unclear. Case presentation: A 69-year-old Japanese man developed acute-onset episodic headaches, palpitations, and chest pains. During the episodes, both marked fluctuations in blood pressure (ranging from 40/25 to 300/160 mmHg) and high plasma levels of catecholamines were found simultaneously. Radiological findings indicated a 4-cm left adrenal pheochromocytoma. These episodic symptoms disappeared within 2 weeks with normalization of plasma catecholamine levels. Two months later, the patient underwent adrenalectomy. Microscopic examinations revealed pheocromocytoma with a large central area of coagulative necrosis. The necrotic material was immunohistochemically positive for chromogranin A. Granulation tissue was adjacent to the necrotic area, accompanied by numerous hemosiderin-laden macrophages and histiocytes with vascular proliferation. Viable tumor cells, detected along the periphery of the tumor, demonstrated pyknosis, and the Ki-67 labeling index was 2 % in the hot spot. No embolus or thrombus formation was found in the resected specimen harboring the whole tumor. The Pheochromocytoma of the Adrenal gland Scaled Score was 2 out of 20. The patient's postoperative course was unremarkable for &gt
    7 years. Conclusions: Presumed causal factors for the extensive necrosis of adrenal pheochromocytoma in previously reported cases include hemorrhage into the tumor, hypotension induced by a phentolamine administration, embolic infarction, high intracapsular pressure due to malignant growth of the tumor, and catecholamine-induced vasoconstriction. In the present case, histopathological and clinical findings suggest that under conditions of chronic ischemia due to catecholamine-induced vasoconstriction, an acute infarction occurred after sudden attacks of alternating hypertension and hypotension. Over the subsequent 2 weeks, repetitive massive release of catecholamines from the infarcts into circulation likely accelerated infarction progression by causing repeated attacks of alternating hypertension and hypotension and resulted in the large necrosis. This case highlights the need for physicians to consider acute spontaneous tumor infarction accompanying episodic catecholamine crisis as a rare but severe complication of pheochromocytoma.

    DOI: 10.1186/s13256-016-1068-3

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  • Meta-analytic research on the relationship between cumulative risk alleles and risk of type 2 diabetes mellitus. 国際誌

    Satoru Kodama, Kazuya Fujihara, Hajime Ishiguro, Chika Horikawa, Nobumasa Ohara, Yoko Yachi, Shiro Tanaka, Hitoshi Shimano, Kiminori Kato, Osamu Hanyu, Hirohito Sone

    Diabetes/metabolism research and reviews   32 ( 2 )   178 - 86   2016年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Our aim is to examine the dose-response association between cumulative genetic risk and actual risk of type 2 diabetes mellitus (T2DM) and the influence of adjustment for covariates on T2DM risk through a comprehensive meta-analysis of observational studies. METHODS: Electronic literature search using EMBASE and MEDLINE (from 2003 to 2014) was conducted for cross-sectional or longitudinal studies that presented the odds ratio (OR) for T2DM in each group with categories based on the total number of risk alleles (RAs) carried (RAtotal ) using at least two single-nucleotide polymorphisms. Spline regression model was used to determine the shape of the relationship between the difference from the referent group of each study in RAtotal (ΔRAtotal ) and the natural logarithms of ORs (log OR) for T2DM. RESULTS: Sixty-five eligible studies that included 68 267 cases among 182 603 participants were analysed. In both crude and adjusted ORs, defined by adjusting the risk for at least two confounders among age, gender and body mass index, the slope of the log OR for T2DM became less steep as the ΔRAtotal increased. In the analysis limited to 14 cross-sectional and four longitudinal studies presenting both crude and adjusted ORs, regression curves of both ORs in relation to ΔRAtotal were almost identical. CONCLUSION: Using only single-nucleotide polymorphisms for T2DM screening was of limited value. However, when genotypic T2DM risk was considered independently from risk in relation to covariates, it was suggested that genetic profiles might have a supplementary role related to conventional T2DM risk factors in identifying individuals at high risk of T2DM. Copyright © 2015 John Wiley & Sons, Ltd.

    DOI: 10.1002/dmrr.2680

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  • Acute Exacerbation of Idiopathic Pulmonary Fibrosis Following Treatment for Cushing's Syndrome 査読

    Nobumasa Ohara, Masanori Kaneko, Kazuhiro Sato, Hiroyuki Usuda, Junta Tanaka, Takashi Maekawa, Hironobu Sasano, Hideki Katakami, Kenzo Kaneko, Kyuzi Kamoi

    INTERNAL MEDICINE   55 ( 4 )   389 - 394   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    A 64-year-old Japanese man with mild reticular shadows in both lungs developed a lung tumor causing ectopic Cushing's syndrome. He was prescribed an adrenal inhibitor, which controlled his hypercortisolemia. However, he developed acute exacerbation of idiopathic pulmonary fibrosis (IPF) and died within weeks. Previous studies have suggested a dosage reduction of corticosteroids for IPF as a triggering event for acute exacerbation. The present case suggests that IPF coexisting with Cushing's syndrome may have been exacerbated after the correction of hypercortisolemia. Therefore, close monitoring of cortisol levels along with the clinical course of IPF is required in similar cases that require the correction of hypercortisolemia.

    DOI: 10.2169/internalmedicine.55.5566

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  • Isolated Adrenocorticotropin Deficiency Concomitant with Graves' Disease: A Case Report and Literature Review

    Nobumasa Ohara, Masanori Kaneko, Hideyuki Kuriyama, Kazuhiro Sato, Hideki Katakami, Yutaka Oki, Kenzo Kaneko, Kyuzi Kamoi

    INTERNAL MEDICINE   55 ( 18 )   2649 - 2658   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    A 73-year-old Japanese woman with untreated Graves' hyperthyroidism developed glucocorticoid-induced adrenal insufficiency (AI) after a supraphysiological dose of prednisolone therapy for bronchial asthma. Days later, she had high plasma adrenocorticotropic hormone (ACTH) levels and was expected to recover from glucocorticoid-induced AI. Her plasma ACTH levels remained high over 3 months during a physiological dose of hydrocortisone replacement. However, she suffered a further decrease in her serum cortisol level and was diagnosed with isolated adrenocorticotropin deficiency (IAD), in which bioinactive ACTH likely caused the high ACTH value. IAD should be considered as an unusual disorder associated with Graves' disease, especially in older patients.

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  • Fulminant Type 1 Diabetes Mellitus Associated with Coxsackie Virus Type A2 Infection: A Case Report and Literature Review

    Ohara Nobumasa, Kaneko Masanori, Nishibori Takeaki, Sato Kazuhiro, Furukawa Tatsuo, Koike Tadashi, Sone Hirohito, Kaneko Kenzo, Kamoi Kyuzi

    Internal Medicine   55 ( 6 )   643 - 646   2016年

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    記述言語:英語   出版者・発行元:一般社団法人 日本内科学会  

    A 65-year-old Japanese man presented to our hospital in June 2013 with a 6-day history of fever and fatigue, a 24-h history of thirst, and polyuria. His temperature was 37.8°C and he was alert. However, laboratory tests revealed severe hyperglycemia, undetectable C-peptide levels, and diabetic ketoacidosis. Serum antibody testing confirmed a Coxsackie virus A2 infection. A variety of viral infections are reported to be involved in the development of fulminant type 1 diabetes mellitus (FT1D). Our patient is the first reported case of FT1D associated with Coxsackie virus A2 infection and supports the etiological role of common viral infections in FT1D.

    DOI: 10.2169/internalmedicine.55.5292

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    その他リンク: http://search.jamas.or.jp/link/ui/2017010131

  • Rapid Normalization of High Glutamic Acid Decarboxylase Autoantibody Titers and Preserved Endogenous Insulin Secretion in a Patient with Diabetes Mellitus: A Case Report and Literature Review

    Ohara Nobumasa, Kaneko Masanori, Furukawa Tatsuo, Koike Tadashi, Sone Hirohito, Tanaka Shoichiro, Kaneko Kenzo, Kamoi Kyuzi

    Internal Medicine   55 ( 5 )   485 - 489   2016年

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    記述言語:英語   出版者・発行元:一般社団法人 日本内科学会  

    A 59-year-old Japanese woman developed diabetes mellitus without ketoacidosis in the presence of glutamic acid decarboxylase autoantibody (GADA) (24.7 U/mL). After the amelioration of her hyperglycemia, the patient had a relatively preserved serum C-peptide level. Her endogenous insulin secretion capacity remained almost unchanged during 5 years of insulin therapy. The patient's GADA titers normalized within 15 months. The islet-related autoantibodies, including GADA, are believed to be produced following the autoimmune destruction of pancreatic beta cells and are predictive markers of type 1 diabetes mellitus. Therefore, the transient appearance of GADA in our patient may have reflected pancreatic autoimmune processes that terminated without progression to insulin deficiency.

    DOI: 10.2169/internalmedicine.55.5398

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    その他リンク: http://search.jamas.or.jp/link/ui/2017035397

  • Fibromyalgia in a Patient with Cushing's Disease Accompanied by Central Hypothyroidism 査読

    Nobumasa Ohara, Shinichi Katada, Takaho Yamada, Naomi Mezaki, Hiroshi Suzuki, Akiko Suzuki, Osamu Hanyu, Yuichiro Yoneoka, Izumi Kawachi, Takayoshi Shimohata, Akiyoshi Kakita, Masatoyo Nishizawa, Hirohito Sone

    INTERNAL MEDICINE   55 ( 21 )   3185 - 3190   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    A 39-year-old woman with a 3-year history of a rounded face developed widespread myalgia. Detailed examinations revealed no disorders that could explain the pain other than concomitant Cushing's disease and central hypothyroidism. Both the hypercortisolemia and hypothyroidism completely resolved after the patient underwent surgery to treat Cushing's disease, but she continued to experience unresolved myalgia and met the diagnostic criteria for fibromyalgia. Few studies have so far investigated patients with fibromyalgia associated with Cushing's syndrome. In our case, the hypothyroidism caused by Cushing's disease probably played an important role in triggering and exacerbating fibromyalgia. This highlights the need to examine the endocrine function in patients with muscle pain.

    DOI: 10.2169/internalmedicine.55.5926

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  • Type 1 Diabetes Mellitus and Isolated Adrenocorticotropin Deficiency Manifested by Parkinsonism: A Case Report and Literature Review

    Ohara Nobumasa, Kojima Naoyuki, Sato Takashi, Ikarashi Tomoo, Sone Hirohito, Oki Yutaka, Kamoi Kyuzi, Hara Masao, Sasaki Hideo

    Internal Medicine   54 ( 20 )   2629 - 2635   2015年

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    記述言語:英語   出版者・発行元:The Japanese Society of Internal Medicine  

    A 67-year-old woman developed isolated adrenocorticotropin deficiency (IAD), which manifested as lethargy, a 20-kg body weight loss, hypoglycemia, and parkinsonism, and began corticosteroid replacement. Her symptoms resolved rapidly, and her weight returned to normal within six months. However, she then developed slowly progressive type 1 diabetes mellitus (T1D) with co-existing Hashimoto thyroiditis, and commenced insulin therapy. To our knowledge, this is the first reported case of parkinsonism associated with IAD. In addition, because diabetes mellitus, including T1D, could be latent in patients with untreated IAD, careful assessment of glucose metabolism is needed after commencing corticosteroid replacement until weight regain is achieved.<br>

    DOI: 10.2169/internalmedicine.54.5022

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  • Reversible brain atrophy and cognitive impairment in an adolescent Japanese patient with primary adrenal Cushing’s syndrome

    Nobumasa Ohara, Hiroshi Suzuki, Akiko Suzuki, Masanori Kaneko, Masahiro Ishizawa, Kazuo Furukawa, Takahiro Abe, Yasuhiro Matsubayashi, Takaho Yamada, Osamu Hanyu, Takayoshi Shimohata, Hirohito Sone

    Neuropsychiatric Disease and Treatment   10   1763 - 1767   2014年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Dove Medical Press Ltd.  

    Endogenous Cushing’s syndrome is an endocrine disease resulting from chronic exposure to excessive glucocorticoids produced in the adrenal cortex. Although the ultimate outcome remains uncertain, functional and morphological brain changes are not uncommon in patients with this syndrome, and generally persist even after resolution of hypercortisolemia. We present an adolescent patient with Cushing’s syndrome who exhibited cognitive impairment with brain atrophy. A 19-year-old Japanese male visited a local hospital following 5 days of behavioral abnormalities, such as money wasting or nighttime wandering. He had hypertension and a 1-year history of a rounded face. Magnetic resonance imaging (MRI) revealed apparently diffuse brain atrophy. Because of high random plasma cortisol levels (28.7 µg/dL) at 10 AM, he was referred to our hospital in August 2011. Endocrinological testing showed adrenocorticotropic hormone-independent hypercortisolemia, and abdominal computed tomography demonstrated a 2.7 cm tumor in the left adrenal gland. The patient underwent left adrenalectomy in September 2011, and the diagnosis of cortisol-secreting adenoma was confirmed histologically. His hypertension and Cushingoid features regressed. Behavioral abnormalities were no longer observed, and he was classified as cured of his cognitive disturbance caused by Cushing’s syndrome in February 2012. MRI performed 8 months after surgery revealed reversal of brain atrophy, and his subsequent course has been uneventful. In summary, the young age at onset and the short duration of Cushing’s syndrome probably contributed to the rapid recovery of both cognitive dysfunction and brain atrophy in our patient. Cushing’s syndrome should be considered as a possible etiological factor in patients with cognitive impairment and brain atrophy that is atypical for their age.

    DOI: 10.2147/NDT.S70611

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  • Meta-analysis of the quantitative relation between pulse pressure and mean arterial pressure and cardiovascular risk in patients with diabetes mellitus

    Satoru Kodama, Chika Horikawa, Kazuya Fujihara, Sakiko Yoshizawa, Yoko Yachi, Shiro Tanaka, Nobumasa Ohara, Satoshi Matsunaga, Takaho Yamada, Osamu Hanyu, Hirohito Sone

    American Journal of Cardiology   113 ( 6 )   1058 - 1065   2014年3月

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    掲載種別:研究論文(学術雑誌)  

    Results of epidemiologic studies that investigated the significance of pulse pressure (PP) and mean arterial pressure (MAP) in terms of risk of cardiovascular disease (CVD) in patients with diabetes mellitus are inconsistent. We performed a quantitative meta-analysis to estimate CVD risk in relation to PP or MAP. Electronic literature search was conducted for prospective studies providing data on CVD risk for an increment in baseline MAP or PP in patients with diabetes mellitus. The pooled CVD risk for a 10-mm Hg increase in each blood pressure (BP) index was estimated with a random-effects model. There were 17 eligible studies consisting of 52,647 patients and 5,112 CVD cases. The pooled relative risk (95% confidence interval) of CVD for an increment of 10 mm Hg was 1.10 (1.04 to 1.16) for PP and 1.09 (0.98 to 1.21) for MAP. Significant between-study heterogeneity was observed (I2 [p value]; 76.5% [p <0.001] for PP, 67.8% [p = 0.005] for MAP). In studies concurrently investigating CVD risk for the 4 indexes (i.e., PP, MAP, systolic BP, and diastolic BP), the pooled relative risk (95% confidence interval) was 1.17 (1.09 to 1.26) for PP, 1.11 (1.06 to 1.15) for MAP, 1.14 (1.06 to 1.22) for systolic BP, and 1.06 (0.94 to 1.19) for diastolic BP. In conclusion, the current meta-analysis suggested that PP was the strongest indicator among the 4 commonly used BP indexes. However, the large heterogeneity urged cautious interpretation of the study results. © 2014 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.amjcard.2013.12.005

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  • Quantitative relationship between body weight gain in adulthood and incident type 2 diabetes: a meta-analysis 査読

    S. Kodama, C. Horikawa, K. Fujihara, S. Yoshizawa, Y. Yachi, S. Tanaka, N. Ohara, S. Matsunaga, T. Yamada, O. Hanyu, H. Sone

    OBESITY REVIEWS   15 ( 3 )   202 - 214   2014年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    This meta-analysis quantified the risk of type 2 diabetes mellitus (T2DM) preceded by body weight (BW) gain in the general population. Systematic literature searches retrieved 15 eligible studies. The BW gain was divided into early weight-gain, which was defined as BW gain from early adulthood (18-24 years of age) to cohort entry (&gt;= 25 years of age), and late weight-gain, which was defined as BW gain from cohort entry. The pooled relative risk (RR; 95% confidence interval [CI]) of T2DM for an increment of BW gain standardized into a 5-kg m(-2) increment in the body mass index (BMI) was 3.07 (2.49-2.79) for early weight-gain and 2.12 (1.74-2.58) for late weight-gain. When limiting analysis to studies that concurrently examined T2DM risk for current BMI (defined in both groups as BMI at cohort entry), a larger magnitude of T2DM risk was revealed for early weight-gain compared with current BMI (RR [95% CI], 3.38 [2.20-5.18] vs. 2.39 [1.58-3.62]), while there was little difference between late weight-gain (RR [95% CI], 2.21 [1.91-2.56]) and current BMI (RR [95% CI], 2.47 [1.97-3.30]). The meta-analysis suggested that BW gain was a quantifiable predictor of T2DM, as well as current obesity in adults. Particularly, BW gain in early rather than middle-to-late adulthood played an important role in developing T2DM.

    DOI: 10.1111/obr.12129

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  • Hypertension increases urinary excretion of immunoglobulin G, ceruloplasmin and transferrin in normoalbuminuric patients with type 2 diabetes mellitus 査読

    Nobumasa Ohara, Osamu Hanyu, Satoshi Hirayama, Osamu Nakagawa, Yoshifusa Aizawa, Seiki Ito, Hirohito Sone

    Journal of Hypertension   32 ( 2 )   432 - 438   2014年2月

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    担当区分:筆頭著者, 責任著者   掲載種別:研究論文(学術雑誌)   出版者・発行元:Ovid Technologies (Wolters Kluwer Health)  

    DOI: 10.1097/hjh.0000000000000019

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  • In Search of the Ideal Resistance Training Program to Improve Glycemic Control and its Indication for Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

    Hajime Ishiguro, Satoru Kodama, Chika Horikawa, Kazuya Fujihara, Ayumi Sugawara Hirose, Reiko Hirasawa, Yoko Yachi, Nobumasa Ohara, Hitoshi Shimano, Osamu Hanyu, Hirohito Sone

    Sports Medicine   46 ( 1 )   67 - 77   2016年1月

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    掲載種別:書評論文,書評,文献紹介等  

    Background: Resistance training (RT) is effective for glycemic control in type 2 diabetes mellitus (T2DM) patients. However, the characteristics of an RT program that will maximize its effect and those of patients that will especially benefit from RT are unknown. Objective: The objectives of this systematic review were to identify via a comprehensive meta-analysis the characteristics of an RT program for patients with T2DM that might increase the patients’ improvement in glycemic control and the characteristics of patients that will benefit from RT. Data Sources: Electronic-based literature searches of MEDLINE and EMBASE entries from 1 January 1966 to 25 August 2014 were conducted to identify clinical trials examining the effect of RT on glycemic control among patients with T2DM. Study keywords were text words and thesaurus terms related to RT and T2DM. Study Selection: Studies were included if they (1) were clinical trials consisting of two groups with and without RT exercise intervention; (2) had an intervention period of at least 5 weeks; (3) clarified that all patients had T2DM; and (4) reported or made it possible to estimate the effect size [i.e., change in glycosylated hemoglobin (HbA1c) in the RT group minus that in the control group] and its corresponding standard error. Study Appraisal and Synthesis Methods: The effect size in each study was pooled with a random-effects model. Analyses were stratified by several key characteristics of the patients and RT exercise programs; meta-regression analysis was then used to detect a difference in the effect size among strata within each factor. Linear regression analyses were added by entering each of the following profiles: patients’ baseline characteristics [mean baseline age, body mass index (BMI), and HbA1c levels] and exercise characteristics (total sets per week, total sets per bout of exercise, frequency, and intensity). Results: There were 23 eligible studies comprising 954 patients with T2DM. The pooled effect size (95 % confidence interval) was −0.34 % (−0.53 to −0.16). A program with multiple sets (≥21 vs. <21) per one RT bout was associated with a large effect size (P = 0.03); however, the linear correlation between the number of sets and effect size was not significant (P = 0.56). A larger effect size was observed in studies with participants with diabetes of a relatively short duration (<6 vs. ≥6 years; P = 0.04) or a high baseline HbA1c [≥7.5 % (58 mmol/mol) vs. <7.5 %; P = 0.01] while a smaller effect size was observed in studies with a particularly high mean baseline BMI value (≥32 vs. <32 kg/m2; P = 0.03). Linear regression analyses predicted that each increment of 1 % in the baseline HbA1c would enlarge the effect size by 0.036 %, while each increment of 1 kg/m2 in the baseline BMI decreased it by 0.070 % in the range between 22.3 and 38.8 kg/m2. Conclusion: In terms of glycemic control, RT could be recommended in the early stage of T2DM, especially for patients with relatively poor glycemic control. More benefit would be elicited in less obese patients within a limited range of the BMI. A substantial amount of exercise might be required to stimulate post-exercise glucose uptake, although the dose-dependency was not specifically clarified.

    DOI: 10.1007/s40279-015-0379-7

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  • Isolated adrenocorticotropin deficiency concomitant with Graves’ disease: A case report and literature review

    Nobumasa Ohara, Masanori Kaneko, Hideyuki Kuriyama, Kazuhiro Sato, Hideki Katakami, Yutaka Oki, Kenzo Kaneko, Kyuzi Kamoi

    Internal Medicine   55 ( 18 )   2649 - 2658   2016年

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    掲載種別:書評論文,書評,文献紹介等  

    A 73-year-old Japanese woman with untreated Graves’ hyperthyroidism developed glucocorticoid-induced adrenal insufficiency (AI) after a supraphysiological dose of prednisolone therapy for bronchial asthma. Days later, she had high plasma adrenocorticotropic hormone (ACTH) levels and was expected to recover from glucocorticoid-induced AI. Her plasma ACTH levels remained high over 3 months during a physiological dose of hydrocortisone replacement. However, she suffered a further decrease in her serum cortisol level and was diagnosed with isolated adrenocorticotropin deficiency (IAD), in which bioinactive ACTH likely caused the high ACTH value. IAD should be considered as an unusual disorder associated with Graves’ disease, especially in older patients.

    DOI: 10.2169/internalmedicine.55.6599

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  • Project 8(全ての人がHbA1c 8%以下に)と新潟県職域健診の推移

    加藤 公則, 上村 伯人, 布施 克也, 平安座 依子, 小原 伸雅, 児玉 暁, 田代 稔, 小林 篤子, 小林 隆司, 佐藤 幸示, 曽根 博仁

    糖尿病   58 ( Suppl.1 )   S - 154   2015年4月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病学会  

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  • 体幹の柔軟性と高血圧罹患の関係 人間ドック受診者を対象としたコホート研究(the Niigata Wellness Study)

    加藤 公則, 丸藤 祐子, 澤田 亨, 田代 稔, 平安座 依子, 小原 伸雅, 児玉 暁, 鈴木 亜希子, 羽入 修, 曽根 博仁

    日本内科学会雑誌   104 ( Suppl. )   154 - 154   2015年2月

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    記述言語:日本語   出版者・発行元:(一社)日本内科学会  

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  • ゲノムワイド関連解析(GWAS)で検出された一塩基多型(SNP)を用いた2型糖尿病のスクリーニング・予測能の定量メタ分析

    児玉 暁, 藤原 和哉, 小原 伸雅, 加藤 公則, 羽入 修, 曽根 博仁

    日本内科学会雑誌   104 ( Suppl. )   209 - 209   2015年2月

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    記述言語:日本語   出版者・発行元:(一社)日本内科学会  

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  • 体格的肥満・腹部肥満と代謝異常の程度の組み合わせが2型糖尿病発症リスクに与える影響

    平安座 依子, 加藤 公則, 児玉 暁, 田代 稔, 五十嵐 理沙, 由澤 咲子, 小原 伸雅, 羽入 修, 佐藤 幸示, 曽根 博仁

    日本病態栄養学会誌   18 ( Suppl. )   S - 86   2014年12月

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    記述言語:日本語   出版者・発行元:(一社)日本病態栄養学会  

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  • Combination effect of hypertension and diabetes mellitus on urinary protein excretion Reply

    Nobumasa Ohara, Osamu Hanyu, Hirohito Sone

    JOURNAL OF HYPERTENSION   32 ( 11 )   2278 - 2278   2014年11月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1097/HJH.0000000000000353

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  • Diabetes Risk Related to Carrying 1 Risk Allele of a Diabetes-Susceptible Gene Is Comparable to That Related to 1 Unit of Increased Body Mass Index: A Meta-analysis

    Chika Horikawa, Satoru Kodama, Satoshi Matsunaga, Sakiko Yoshizawa, Yoriko Heianza, Yoko Yachi, Nobumasa Ohara, Akiko Suzuki, Osamu Hanyu, Hirohito Sone

    DIABETES   63   A360 - A360   2014年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:AMER DIABETES ASSOC  

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  • 【最新肥満症学-基礎・臨床研究の最前線-】 Metabolically obese normal-weight(MONW)とmetabolically healthy obese(MHO)の概念と臨床的意義

    小原 伸雅, 平安座 依子, 曽根 博仁

    日本臨床   72 ( 増刊4 最新肥満症学 )   697 - 702   2014年5月

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    記述言語:日本語   出版者・発行元:(株)日本臨床社  

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  • 【糖尿病と脳卒中】 DPP-4阻害薬による脳卒中予防効果

    小原 伸雅, 曽根 博仁

    分子脳血管病   13 ( 1 )   27 - 32   2014年1月

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    記述言語:日本語   出版者・発行元:(株)先端医学社  

    新しい経口2型糖尿病治療薬であるdipeptidyl peptidase-4(DPP-4)阻害薬は、おもに食後高血糖の改善効果に優れ、体重増加や低血糖を起こしにくいことを特徴とする。糖尿病患者に対する血糖管理の脳卒中(脳梗塞)を予防する効果が今まで必ずしも明確となっていないなかで、欧米人においてDPP-4阻害薬を用いた血糖管理による脳梗塞発症予防効果が示されている。日本人2型糖尿病患者と欧米患者とのあいだでは、肥満度の明らかな違いに加えてDPP-4阻害薬の効果にも差がある可能性が示唆されており、DPP-4阻害薬による脳梗塞予防効果について日本人患者での検討も必要である。(著者抄録)

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  • 発症8年後に悪性貧血を併発した特発性1型糖尿病の1例

    小原 伸雅, 金子 正儀, 皆川 真一, 矢野 敏雄, 佐藤 直子, 曽根 博仁, 鴨井 久司, 金子 兼三

    糖尿病   56 ( 7 )   451 - 451   2013年7月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病学会  

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