Faculty Profiles - FUJIHARA Kazuya

Papers - FUJIHARA Kazuya

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Effect of family-oriented diabetes programs on glycemic control: A meta-analysis. Reviewed International journal

Satoru Kodama, Sakiko Morikawa, Chika Horikawa, Dai Ishii, Kazuya Fujihara, Masahiko Yamamoto, Taeko Osawa, Masaru Kitazawa, Takaho Yamada, Kiminori Kato, Shiro Tanaka, Hirohito Sone

Family practice 36 ( 4 ) 387 - 394 2019.7

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Efficacy of programs for patients with diabetes mellitus (DM) that have promoted family members to help with patients' self-care activities has been largely inconsistent. This meta-analysis aims to assess the effect of family-oriented diabetes programs for glycemic control (GC). METHODS: Electronic literature searches were conducted for clinical trials with a parallel design wherein there were two groups according to whether family members were included (intervention group) or not included (control group) and changes in glycohemoglobin A1C (A1C) were assessed as a study outcome. Each effect size (i.e. difference in A1C change between the intervention and control group) was pooled with a random-effects model. RESULTS: There were 31 eligible trials consisting of 1466 and 1415 patients in the intervention and control groups, respectively. Pooled A1C change [95% confidence interval (CI)] was -0.45% (-0.64% to -0.26%). Limiting analyses to 21 trials targeted at patients with type 1 DM or 9 trials targeted at patients with type 2 DM, the pooled A1C changes (95% CI) were -0.35% (-0.55% to -0.14%) and -0.71% (-1.09% to -0.33%), respectively. CONCLUSION: This meta-analysis suggests that focusing on the family as well as the individual patient in self-management diabetes programs to improve the performance of self-care activities of patients with DM is effective in terms of proper GC.

DOI： 10.1093/fampra/cmy112

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Blake's pouch cystに伴う水頭症の治療により若年性認知症の改善を認めた糖尿病の1例 Reviewed

種村聡, 山本正彦, 石黒創, 岩永みどり, 松林泰弘, 山田貴穂, 藤原和哉, 渡邊賢一, 曽根博仁

糖尿病 62 ( 7 ) 441 - 441 2019.7

Overt Proteinuria, Moderately Reduced eGFR and Their Combination Are Predictive of Severe Diabetic Retinopathy or Diabetic Macular Edema in Diabetes. Reviewed International journal

Masahiko Yamamoto, Kazuya Fujihara, Masahiro Ishizawa, Taeko Osawa, Masanori Kaneko, Hajime Ishiguro, Yasuhiro Matsubayashi, Hiroyasu Seida, Nauta Yamanaka, Shiro Tanaka, Satoru Kodama, Hiruma Hasebe, Hirohito Sone

Investigative ophthalmology & visual science 60 ( 7 ) 2685 - 2689 2019.6

Language：English Publishing type：Research paper (scientific journal)

Purpose: Since the combined effects of proteinuria and a moderately decreased eGFR on incident severe eye complications in patients with diabetes are still largely unknown, these associations were determined in a large historical cohort of Japanese patients with diabetes mellitus. Methods: We evaluated the effects of overt proteinuria (OP) (dipstick 1+ and over) and/or moderately reduced estimated glomerular filtration rate (eGFR) (MG) (baseline eGFR 30.0-54.9 mL/min/1.73 m2) on the incidence of treatment-required diabetic eye diseases (TRDED). We divided 7709 patients into four groups according to the presence or absence of OP and MG: no OP without MG (NP[MG-]), OP without MG (OP[MG-]), no OP with MG (NP[MG+]), and OP with MG (OP[MG+]). Multivariate Cox analyses were performed to calculate hazard ratios (HRs) with 95% confidence intervals for combinations of the presence and/or absence of OP and MG on the risk of developing TRDED. Results: During the median follow-up period of 5.6 years, 168 patients developed TRDED. HRs for OP and MG for incident TRDED were 1.91 (95% confidence interval, 1.27-2.87) and 1.90 (1.11-3.23), respectively. HRs for incident TRDED were 1.73 (1.11-2.69) and 5.57 (2.40-12.94) for OP(MG-) and OP(MG+), respectively, in comparison with NP(MG-). Conclusions: In Japanese patients with diabetes, OP and MG were separately as well as additionally associated with higher risks of TRDED. Results indicate the necessity of the simultaneous assessment of proteinuria and eGFR for appropriate evaluation of risks of severe eye complications in patients with diabetes.

DOI： 10.1167/iovs.19-26749

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Combined Effects of Energy Intake and Physical Activity on Obesity in Japanese Patients with Type 2 Diabetes (JDDM 50): A Cross-Sectional Study. Reviewed International journal

Mariko Hatta, Kazuya Fujihara, Sakiko Yoshizawa Morikawa, Yasutake Takeda, Dai Ishii, Chika Horikawa, Mitsutoshi Kato, Hiroki Yokoyama, Yoshio Kurihara, Koichi Iwasaki, Kazuhiro Miyazawa, Katsuya Yamazaki, Shiro Tanaka, Hiroshi Maegawa, Hirohito Sone

Diabetes therapy : research, treatment and education of diabetes and related disorders 10 ( 3 ) 1133 - 1138 2019.6

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: The combined effects of energy intake (EI) and physical activity (PA) on obesity have been poorly investigated. We have investigated the combined effects of EI and PA quantitatively in Japanese men and women with type 2 diabetes. METHODS: Data on 1395 patients with type 2 diabetes who attended 25 diabetes clinics located throughout Japan, obtained by questionnaire, were analyzed. A logistic regression model was used to calculate the odds ratio for obesity. RESULTS: Multi-adjusted odds ratios for the top versus the bottom tertile of EI and the bottom versus the top tertile of PA were 1.39 (95% confidence interval [CI] 1.02-1.89) and 1.64 (95% CI 1.22-2.22), respectively. The combination of EI (kcal/day) ≥ 1967 and PA (metabolic equivalents [METs] h/week) ≤ 9.9 for men and of EI ≥ 1815 and PA ≤ 8.3 for women were significantly associated with obesity. CONCLUSIONS: The existence of "allowable maximum EI" and "required minimum PA" that is significantly associated with "not being obese" is implied, suggesting the need for lifestyle education for Japanese patients with type 2 diabetes.

DOI： 10.1007/s13300-019-0610-x

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Pulse Pressure is a Stronger Predictor Than Systolic Blood Pressure for Severe Eye Diseases in Diabetes Mellitus. Reviewed International journal

Journal of the American Heart Association 8 ( 8 ) e010627 2019.4

Language：English Publishing type：Research paper (scientific journal)

Background Evidence of the role of systolic blood pressure ( SBP ) in development of severe diabetic retinopathy is not strong, although the adverse effect of low diastolic blood pressure has been a partial explanation. We assessed the predictive ability of incident severe diabetic retinopathy between pulse pressure ( PP ) which considers both SBP and diastolic blood pressure, compared with SBP . Methods and Results Eligible patients (12 242, 83% men) aged 19 to 72 years from a nationwide claims database were analyzed for a median observational 4.8-year period. Severe diabetic retinopathy was defined as vision-threatening treatment-required diabetic eye diseases. Multivariate Cox regression analysis revealed that hazard ratios (95% CI ) of treatment-required diabetic eye diseases for 1 increment of standard deviation and the top tertile compared with the bottom tertile were 1.39 (1.21-1.60) and 1.72 (1.17-2.51), respectively, for PP and 1.22 (1.05-1.41) and 1.43 (0.97-2.11), respectively, for SBP adjusted for age, sex, body mass index, hemoglobin A1c, fasting plasma glucose, lipids, and smoking status. In a model with SBP and PP simultaneously as covariates, the hazard ratios of only PP (hazard ratios [95% CI ], 1.57 [1.26-1.96]) but not SBP (0.85 [0.68-1.07]) were statistically significant. Delong test revealed a significant difference in the area under the receiver operating characteristic curve between PP and SBP (area under the receiver operating characteristic curve [95% CI ], 0.58 [0.54-0.63] versus 0.54 [0.50-0.59]; P=0.03). The strongest predictor remained as hemoglobin A1c (area under the receiver operating characteristic curve [95% CI ], 0.80 [0.77-0.84]). Conclusions After excluding the significant impact of glycemic control, PP in comparison with SBP is a better predictor of severe diabetic retinopathy, suggesting a role of diastolic blood pressure and arterial stiffness in pathology.

DOI： 10.1161/JAHA.118.010627

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耐糖能状態と心血管疾患既往の有無別に見たその後の心血管疾患発症リスク Reviewed

北澤勝, 藤原和哉, 原田万祐子, 大澤妙子, 山本正彦, 矢口雄大, 金子正儀, 松林泰弘, 山田貴穂, 清田浩康, 曽根博仁

糖尿病 62 ( Suppl.1 ) S - 190 2019.4

Physical Fitness Tests and Type 2 Diabetes Among Japanese: A Longitudinal Study From the Niigata Wellness Study. Reviewed

Momma H, Sawada SS, Kato K, Gando Y, Kawakami R, Miyachi M, Huang C, Nagatomi R, Tashiro M, Ishizawa M, Kodama S, Iwanaga M, Fujihara K, Sone H

Journal of epidemiology 29 ( 4 ) 139 - 146 2019.4

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Simple physical fitness test can be a useful potential predictor of type 2 diabetes (T2DM). We examined the association between performances on simple physical fitness tests and the incidence of T2DM. METHODS: This longitudinal study was conducted in 21,802 nondiabetic Japanese (6,649 women) aged 20 to 92 years, who underwent all physical fitness tests at baseline (April 2001 to March 2002). From April 2001 to March 2008, physical fitness tests, including grip strength, vertical jump, single-leg balance with eyes closed, forward bending, whole-body reaction time, and supine legs-up, were performed every year. Participants had physical fitness tests at least two times during the period. T2DM was also annually determined based on fasting blood glucose, glycated hemoglobin, and self-reported diabetes during the period. Discrete-time logit models were used to examine the influence of the serial level of each physical fitness test on the incidence of T2DM. RESULTS: During the entire study period, 972 participants developed diabetes. Lower relative grip strength (grip strength/body weight) and single-leg balance performance were associated with a higher incidence of T2DM. For relative grip strength, as compared with the fourth quartile group, the odds ratios for other groups ranged from 1.16 to 1.56 (P for trend < 0.001). For single-leg balance, the odds ratios ranged from 1.03 to 1.49 (P for trend < 0.001). CONCLUSION: The performance of a simple single-leg balance test as well as that of a grip strength test were negatively associated with the risk of T2DM among Japanese.

DOI： 10.2188/jea.JE20170280

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2型糖尿病患者における食事エネルギー密度と食事パターンとの関連 Reviewed

武田安永, 藤原和哉, 治田麻理子, 森川咲子, 堀川千嘉, 石井大, 根立梨奈, 加藤光敏, 横山宏樹, 栗原義夫, 宮澤一裕, 岩崎晧一, 川井紘一, 朝長修, 屋宜宣治, 前川聡, 曽根博仁

糖尿病 62 ( Suppl.1 ) S - 116 2019.4

糖尿病の有無別にみた血糖・血圧・脂質・喫煙の各管理目標達成状況が冠動脈疾患発症に及ぼす影響 Reviewed

原田万祐子, 藤原和哉, 大澤妙子, 石澤正博, 山本正彦, 金子正儀, 松林泰弘, 清田浩康, 山田貴穂, 小川渉, 曽根博仁

糖尿病 62 ( Suppl.1 ) S - 285 2019.4

糖尿病(DM)・冠動脈疾患(CAD)・脳血管疾患(CVD)の既往及び組み合わせがその後のリスクへ及ぼす影響の検討 Reviewed

藤原和哉, 松林泰弘, 原田万祐子, 大澤妙子, 金子正儀, 山本正彦, 山田高穂, 清田浩康, 加藤公則, 曽根博仁

糖尿病 62 ( Suppl.1 ) S - 254 2019.4

糖尿病の有無別にみた高血圧が透析導入に及ぼす影響の検討 Reviewed

大澤妙子, 藤原和哉, 山本正彦, 原田万祐子, 北澤勝, 金子正儀, 石黒創, 石澤正博, 松林泰弘, 清田浩康, 山中菜詩, 山田貴穂, 曽根博仁

糖尿病 62 ( Suppl.1 ) S - 219 2019.4

医療ビッグデータを用いた糖尿病患者の下肢切断に関するリスク因子の検討 Reviewed

金子正儀, 藤原和哉, 原田万祐子, 山本正彦, 松林泰弘, 北澤勝, 石井大, 清田浩康, 曽根博仁

糖尿病 62 ( Suppl.1 ) S - 195 2019.4

血清アミラーゼ値およびその経時変化が2型糖尿病発症に及ぼす影響の定量的検討

石井大, 藤原和哉, 根立梨奈, 原田万佑子, 松林泰弘, 斎藤和美, 児玉暁, 森保道, 本田律子, 荒瀬康司, 曽根博仁

糖尿病 62 ( Suppl.1 ) S - 219 2019.4

(わが国における)経口血糖降下薬の服薬アドヒアランスの現況とその関連因子

矢口雄大, 藤原和哉, 原田万祐子, 金子正儀, 松林泰弘, 北澤勝, 清田浩康, 曽根博仁

糖尿病 62 ( Suppl.1 ) S - 263 2019.4

脂肪細胞インスリン抵抗性からみたSGLT2阻害薬投与によるケトン体上昇予測因子の検討

松林泰弘, 吉田明弘, 野島俊秋, 菅波秀規, 石黒創, 岩永みどり, 山田貴穂, 藤原和哉, 加来浩平, 曽根博仁

糖尿病 62 ( Suppl.1 ) S - 126 2019.4

Higher pulse pressure predicts initiation of dialysis in Japanese patients with diabetes. Reviewed International journal

Taeko Osawa, Kazuya Fujihara, Mayuko Harada, Masahiko Yamamoto, Masahiro Ishizawa, Hiroshi Suzuki, Hajime Ishiguro, Yasuhiro Matsubayashi, Hiroyasu Seida, Nauta Yamanaka, Shiro Tanaka, Hitoshi Shimano, Satoru Kodama, Hirohito Sone

Diabetes/metabolism research and reviews 35 ( 3 ) e3120 2019.3

Language：English Publishing type：Research paper (scientific journal)

AIMS: To determine incidence and predictors of starting dialysis in patients with diabetes emphasizing blood pressure variables. METHODS: A nationwide database with claim data on 18 935 people (15 789 men and 3146 women) with diabetes mellitus aged 19 to 72 years in Japan was used to elucidate predictors for starting dialysis. Initiation of dialysis was determined from claims using ICD-10 codes and medical procedures. Using multivariate Cox modelling, interactions between glycaemic and blood pressure values were determined. RESULTS: During a median follow-up of 5.3 years, incidence of dialysis was 0.81 per 1000 person-years. Multivariate analysis of a model involving systolic and diastolic blood pressure (SBP and DBP) simultaneously as covariates showed that hazard ratios (HRs) for starting dialysis for each 1-SD elevation in SBP and DBP were 2.05 (95% confidence interval 1.58-2.64) and 0.66 (0.50-0.88), respectively, implying that pulse pressure (PP) was a promising predictor. For confirmation, a model involving SBP and PP simultaneously as covariates demonstrated that HRs for each 1-SD elevation in SBP and PP were 1.09 (0.81-1.48) and 1.54 (1.14-2.08), respectively, with PP the more potent predictor. Compared with HbA1c <8% and PP <60 mmHg, the HR for those with HbA1c ≥8% and PP ≥60 mmHg was 6.32 (3.42-11.7). CONCLUSIONS: In our historical cohort analysis, SBP and PP were independent predictors for starting dialysis. PP was the more potent, suggesting the contribution of increased arterial stiffness to the incidence of dialysis. Future studies are needed to conclude the independent influence of PP and HbA1c on dialysis considering other risk factors.

DOI： 10.1002/dmrr.3120

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Meat intake and incidence of cardiovascular disease in Japanese patients with type 2 diabetes: analysis of the Japan Diabetes Complications Study (JDCS). Reviewed International journal

Chika Horikawa, Chiemi Kamada, Shiro Tanaka, Sachiko Tanaka, Atsushi Araki, Hideki Ito, Satoshi Matsunaga, Kazuya Fujihara, Yukio Yoshimura, Yasuo Ohashi, Yasuo Akanuma, Hirohito Sone

European journal of nutrition 58 ( 1 ) 281 - 290 2019.2

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Excessive meat intake has been researched as a major cause of cardiovascular disease (CVD) among healthy adults, but data on this topic in Asian patients with diabetes are sparse. The quantity and variety of available meats vary widely between Asian and Western countries. As part of a nationwide cohort study we investigated the relationship between meat intake and incidence of CVD in Japanese patients with type 2 diabetes aged 40-70 years with HbA1c ≥ 6.5%. METHODS: Analyzed were 1353 responders to a baseline dietary survey assessed by the Food Frequency Questionnaire based on food groups. Primary outcome was the 8-year risk of a CVD event, including coronary heart disease (CHD) and stroke. Cox regression analyses estimated hazard ratios (HRs) for dietary intake adjusted for age, gender, body mass index, HbA1c, smoking, energy intake, and other confounders. RESULTS: Mean meat intake in quartiles ranged from 9.9 to 97.7 g/day. After adjusting for confounders, HRs of CHD in the 2nd, 3rd, and 4th quartiles for meat intake compared with the 1st quartile were 2.84 (95% confidence interval 1.29-6.24, p = 0.01), 3.02 (1.36-6.70, p < 0.01), and 2.99 (1.35-6.65, p = 0.01), respectively. In two groups according to meat intake, patients consuming ≥ 20 g/day of meat had a 2.94-fold higher risk of CHD than those consuming < 20 g/day (p < 0.01). There was no significant association of stroke with meat intake. CONCLUSIONS: An elevated incidence of CHD in Japanese patients with type 2 diabetes was associated with high meat intake.

DOI： 10.1007/s00394-017-1592-y

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Physical Fitness Tests and Type 2 Diabetes Among Japanese: A Longitudinal Study From the Niigata Wellness Study. Reviewed

Momma H, Sawada SS, Kato K, Gando Y, Kawakami R, Miyachi M, Huang C, Nagatomi R, Tashiro M, Ishizawa M, Kodama S, Iwanaga M, Fujihara K, Sone H

J Epidemiol 29 ( 4 ) 139 - 146 2019

当科で経験した下垂体茎断裂症候群の1例 Reviewed

佐藤隆明, 金子正儀, 福武嶺一, 安楽匠, 種村聡, 今西明, 矢口雄大, 山本正彦, 鈴木達郎, 石黒創, 松林泰弘, 山田貴穂, 岩永みどり, 藤原和哉, 曽根博仁

新潟医学会雑誌 132 ( 11-12 ) 399 - 399 2018.12

当科で経験した下垂体茎断裂症候群の1例 Reviewed

佐藤隆明, 金子正儀, 福武嶺一, 安楽匠, 種村聡, 今西明, 矢口雄大, 山本正彦, 鈴木達郎, 石黒創, 松林泰弘, 山田貴穂, 岩永みどり, 藤原和哉, 曽根博仁

新潟医学会雑誌 132 ( 11-12 ) 399 - 399 2018.12

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Papers - FUJIHARA Kazuya