Faculty Profiles - FUJIHARA Kazuya

Papers - FUJIHARA Kazuya

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Utility of nonblood-based risk assessment for predicting type 2 diabetes mellitus: A meta-analysis Reviewed

Sakiko Yoshizawa, Satoru Kodama, Kazuya Fujihara, Hajime Ishiguro, Masahiro Ishizawa, Yasuhiro Matsubayashi, Satoshi Matsunaga, Takaho Yamada, Hitoshi Shimano, Kiminori Kato, Osamu Hanyu, Hirohito Sone

PREVENTIVE MEDICINE 91 180 - 187 2016.10

Language：English Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Objective. Nonblood-based risk assessment for type 2 diabetes mellitus (T2DM) that depends on data based on a questionnaire and anthropometry is expected to avoid unnecessary diagnostic testing and overdiagnosis due to blood testing. This meta-analysis aims to assess the predictive ability of nonblood-based risk assessment for future incident T2DM.
Methods. Electronic literature search was conducted using EMBASE and MEDLINE (from January 1, 1997 to October 1, 2014). Included studies had to use at least 3 predictors for T2DM risk assessment and allow reproduction of 2 x 2 contingency table data (i.e., true positive, true negative, false positive, false negative) to be pooled with a bivariate random-effects model and hierarchical summary receiver-operating characteristic model. Considering the importance of excluding individuals with a low likelihood of T2DM from diagnostic blood testing, we especially focused on specificity and LR-.
Results. Eighteen eligible studies consisting of 184,011 participants and 7038 cases were identified. The pooled estimates (95% confidence interval) were as follows: sensitivity = 0.73 (0.66-0.79), specificity = 0.66 (0.59-0.73), LR+ = 2.13 (1.81-2.50), and LR- = 0.41 (0.34-0.50).
Conclusions. Nonblood-based assessment of risk of T2DM could produce acceptable results although the feasibility of such a screener needs to be determined in future studies. (C) 2016 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ypmed.2016.07.026

Impact of individual components and their combinations within a family history of hypertension on the incidence of hypertension: Toranomon hospital health management center study 22 Reviewed

Risa Igarashi, Kazuya Fujihara, Yoriko Heianza, Masahiro Ishizawa, Satoru Kodama, Kazumi Saito, Shigeko Hara, Osamu Hanyu, Ritsuko Honda, Hiroshi Tsuji, Yasuji Arase, Hirohito Sone

MEDICINE 95 ( 38 ) e4564 2016.9

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Although a family history (FH) of hypertension is a risk factor for the development of hypertension, only a few studies have investigated in detail the impact of individual components of an FH on incident hypertension. We investigated the impact of individual components and their combinations on the presence or development of hypertension considering obesity, smoking habits, physical activity, and other metabolic parameters.Studied were 12,222 Japanese individuals without hypertension (n = 9,766) and with hypertension (n = 2,456) at the baseline examination. The presence or incidence of hypertension during 5 years after a baseline examination was assessed by the presence of systolic blood pressure 140 mmHg and/or diastolic blood pressure 90 mmHg or a self-reported history of clinician-diagnosed hypertension. In this prospective study, the odds ratio for incident hypertension was 1.39 (95% confidence interval [CI], 1.22, 1.59) for individuals with any FH of hypertension compared with those without such an FH. Individuals with an FH of hypertension in both parents and one or more grandparents had an odds ratio of 3.05 (95% CI 1.74, 5.36) for hypertension compared with those without an FH of hypertension. FH was associated with incident hypertension independently of other modifiable risk factors such as obesity, smoking, physical inactivity, hyperglycemia, hyperuricemia, and hypertriglyceridemia.A parental history of hypertension was an essential component within an FH for incident hypertension. FH of hypertension over two generations with both parents affected was the most important risk factor for incident hypertension. Although an FH is not a modifiable risk factor, modifying other risk factors could contribute to reducing the risk of hypertension even among individuals with a family history of hypertension.

DOI： 10.1097/MD.0000000000004564

Association of eating three meals irregularly with changes in BMI and weight among young Japanese men and women: A 2-year follow-up Reviewed

Yoko Ibe, Happei Miyakawa, Yasuko Fuse-Nagase, Ayumi Sugawara Hirose, Reiko Hirasawa, Yoko Yachi, Kazuya Fujihara, Kazuto Kobayashi, Hitoshi Shimano, Hirohito Sone

PHYSIOLOGY & BEHAVIOR 163 81 - 87 2016.9

Language：English Publishing type：Research paper (scientific journal) Publisher：PERGAMON-ELSEVIER SCIENCE LTD

Objective: Epidemiological longitudinal investigations of the association between not eating three meals regularly and changes in BMI and weight are scarce. The aim of this study was to investigate whether or not regularly eating three meals was associated with changes in BMI and weight in young Japanese men and women.
Methods: Study participants were 1241 men and 897 women aged 19.0 +/- 12 and 18.8 +/- 0.8 years, respectively, who underwent health checkups at a university in Japan in 2001 as the baseline and subsequently in 2003. Weight and height were measured at baseline and 2 years later. Whether an individual ate three meals regularly was determined by a self-report questionnaire in 2001.
Results: During the 2-year follow-up, the BMI gain was 0.347 for men and 0.067 for women. In the logistic regression analysis, for men, eating three meals irregularly was significantly associated with a 4% BMI gain (OR 1.60, CI 1.11-230), 6% BMI gain (OR 1.72, CI 1.12-2.63), 4 kg weight gain (OR 2.01, CI 1.29-3.13), 6 kg weight gain (OR 1.86, CI 1.02-337), and incidence of obesity (BMI >= 25)(OR 2.96, CI 122-7.17). For women, eating three meals irregularly was significantly associated with a 4% BMI loss (OR 1.99, CI 1.01-3.94), 6% BMI loss (OR 2.79, CI 129-6.03), 4 kg weight loss (OR 3.85, CI 1.62-9.12), 6 kg weight loss (OR 7.65, CI 2.06-28.46), and the incidence of underweight (OR 3.95, CI 132-11.89).
Conclusions: The current results suggested that eating three meals irregularly was associated with subsequent BMI and weight gains for men and subsequent BMI and weight losses for women; both groups were around 20 years of age. Self-reported eating behavior in this study might be used to screen and evaluate young Japanese men and women at high risk for changes in BMI and weight in a practical clinical setting. (C) 2016 Elsevier Inc All rights reserved.

DOI： 10.1016/j.physbeh.2016.04.045

Serum malondialdehyde-modified LDL levels are increased in type 2 diabetic patients with nephropathy

Suzuki, H, Furukawa, S, Fujihara, K, Kobayashi, K, Iwasaki, H, Yatoh, S, Sugano, Y, Sekiya, M, Yahagi, N, Yagyu, H, Shimano, H

DIABETOLOGIA 59 ( 1 ) S538 - S538 2016.8

血糖治療自己中断後に、中耳炎からBezold膿瘍に至った2型糖尿病の1例

北原多佳子, 古川祥子, 熊谷亮, 五十野桃子, 城川泰司郎, 小林裕幸, 青柳安典, 秋月浩光, 矢野晴美, 藤原和哉, 野牛宏晃

糖尿病 59 ( 8 ) 600 - 600 2016.8

Body Mass Index (BMI), Waist Circumference (WC) and Waist Height Ratio (WHtR) Cutoff Values, and the Impact of Their Combinations on Future Diabetes among Japanese Individuals Reviewed

Risa Igarashi, Kazuya Fujihara, Yoriko Heianza, Masahiro Ishizawa, Megumi Tsuruta, Mariko Hatta, Sakiko Yoshizawa, Chika Hirikawa, Satoshi Matsunaga, Osamu Hanyu, Satoru Kodama, Koji Sato, Kiminori Kato, Hirohito Sone

DIABETES 65 A519 - A520 2016.6

Comparison of clinical characteristics in patients with type2 diabetes among whom different antihyperglycemic agents were prescribed as monotherapy or combination therapy by diabetes specialists Reviewed

Kazuya Fujihara, Osamu Hanyu, Yoriko Heianza, Akiko Suzuki, Takaho Yamada, Hiroki Yokoyama, Shiro Tanaka, Hiroaki Yagyu, Hitoshi Shimano, Atsunori Kashiwagi, Katuya Yamazaki, Koichi Kawai, Hirohito Sone

JOURNAL OF DIABETES INVESTIGATION 7 ( 2 ) 260 - 269 2016.3

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Aims/IntroductionWe compared clinical characteristics in patients with type2 diabetes for whom different antihyperglycemic agents were prescribed as monotherapy or combination therapy by diabetes specialists in Japan.
Materials and MethodsPrescription data for 2005, 2008 and 2011 from diabetes specialists' patient registries identified variables related to prescription of different antihyperglycemic agents.
ResultsA total of 33,251 prescriptions in 2005, 25,119 in 2008 and 20,631 in 2011 were analyzed. Prescribing insulin was related to younger age, long duration of diabetes and glycated hemoglobin (HbA1c) 8.0%, but was negatively associated with obesity. Prescribing sulfonylureas was related to older age and long duration of diabetes, but not to obesity. Use of biguanides was related to younger age, short duration of diabetes and obesity, but was negatively associated with HbA1c 8.0%. A short duration of diabetes and HbA1c 8.0% were associated with use of a DPP-4 inhibitor, but not with obesity. Prescribing GLP-1 receptor agonists was related to younger age, obesity and HbA1c 8.0%. Odds ratios for each antihyperglycemic combination therapy were determined based on the characteristics of each included antihyperglycemic agent.
ConclusionsThese results could be expected to reflect in part the consensus of diabetes specialists, and might provide guidance regarding pharmacotherapy in the clinical setting.

DOI： 10.1111/jdi.12387

Meta-analytic research on the relationship between cumulative risk alleles and risk of type 2 diabetes mellitus Reviewed

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 - 186 2016.2

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

BackgroundOur 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.
MethodsElectronic 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 (RA(total)) 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 RA(total) (RA(total)) and the natural logarithms of ORs (log OR) for T2DM.
ResultsSixty-five eligible studies that included 68267 cases among 182603 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 RA(total) 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 RA(total) were almost identical.
ConclusionUsing 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 (c) 2015 John Wiley & Sons, Ltd.

DOI： 10.1002/dmrr.2680

Meta-analytic research on the relationship between cumulative risk alleles and risk of type 2 diabetes mellitus. Reviewed International journal

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 2016.2

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

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

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 Reviewed

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 2016.1

Language：English Publisher：ADIS INT LTD

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 HbA(1c) [>= 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/m(2); P = 0.03). Linear regression analyses predicted that each increment of 1 % in the baseline HbA(1c) would enlarge the effect size by 0.036 %, while each increment of 1 kg/m(2) in the baseline BMI decreased it by 0.070 % in the range between 22.3 and 38.8 kg/m(2).
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

Pioglitazone-induced Pulmonary Injury in a Very Elderly Patient Reviewed

Kohta Katayama, Ryo Kumagai, Momoko Isono, Kazuya Fujihara, Hiroaki Yagyu, Gen Ohara, Katsunori Kagohashi, Hiroaki Satoh

INTERNAL MEDICINE 55 ( 13 ) 1779 - 1782 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN SOC INTERNAL MEDICINE

An 85-year-old woman with diabetes mellitus was admitted to our hospital due to progressive dyspnea. Two months previously, pioglitazone had been newly prescribed for diabetes management. Bilateral ground-glass opacities and progressive respiratory deterioration suggested respiratory failure due to a drug-induced lung injury. With discontinuation of pioglitazone and the administration of a corticosteroid, an improvement in her respiratory condition was achieved, although sequelae remained in some areas of the lungs. Results of drug-induced lymphocyte stimulation tests were positive for pioglitazone. Resumption of other drugs did not reinduce the lung injury. Therefore, a diagnosis of pioglitazone-induced lung injury was made. Although pioglitazone-induced lung injury is very rare, clinicians should keep it in mind when pioglitazone is used.

DOI： 10.2169/internalmedicine.55.6330

Fulminant Type 1 Diabetes Mellitus Presenting 11 Days after Delivery in a Patient of Mixed Genetic Background Reviewed

Shoko Furukawa, Kazuya Fujihara, Ryo Kumagai, Momoko Isono, Hiroaki Yagyu

INTERNAL MEDICINE 55 ( 14 ) 1881 - 1885 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN SOC INTERNAL MEDICINE

The patient was a 25-year-old woman whose paternal family was Japanese, maternal grandfather was Filipino, and maternal grandmother was Chinese. Eleven days after delivery, she presented with excessive thirst and disturbed consciousness due to diabetic ketoacidosis. She was diagnosed as having fulminant type 1 diabetes associated with pregnancy (PF). The antibody concentration against glutamic acid decarboxylase was 1.2 (<1.5) U/mL, and human leukocyte antigen (HLA) class II haplotypes were DRB1*04:10-DQB1*03: 02 and DRB1*15: 02-DQB1*05:01. The present case had unique HLA class II haplotypes that have not been previously reported in association with PF.

DOI： 10.2169/internalmedicine.55.6052

Simple self-reported behavioral or psychological characteristics as risk factors for future type 2 diabetes in Japanese individuals: Toranomon Hospital Health Management Center Study 14 Reviewed

Yoriko Heianza, Yasuji Arase, Satoru Kodama, Hiroshi Tsuji, Kazuya Fujihara, Kazumi Saito, Shigeko Hara, Hirohito Sone

JOURNAL OF DIABETES INVESTIGATION 6 ( 2 ) 236 - 241 2015.3

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Aims/IntroductionDepression, anger, sleep disorders and cognitive impairment are regarded as presenting a high risk for diabetes. We investigated whether responses to single statements on a self-report questionnaire on the presence of each of these four factors were associated with the development of type 2 diabetes.
Materials and MethodsWe investigated 3,211 Japanese individuals without diabetes. Cumulative incidence rate and hazard ratios (HRs) for future type 2 diabetes over 7-13years were evaluated according to the presence of lack of perseverance, anger, memory loss or sleep disorders.
ResultsResults of Cox regression analysis showed that lack of perseverance (age- and sex-adjusted HR 1.41, 95% confidence interval 1.07-1.84), anger, (HR 1.51, 95% confidence interval 1.07-2.12) or memory loss (HR 1.47, 95% confidence interval 1.14-1.90) was predictive of the development of diabetes. Even after adjustment for metabolic factors including glycemic measurements, anger was significantly associated with an increased risk of future diabetes. Individuals with both anger and memory loss had a 1.94-fold (95% confidence interval 1.19-3.15) increased risk of type2 diabetes than those without those two symptoms.
ConclusionsResponses to a simple self-report questionnaire as to whether individuals were aware of anger or memory loss were associated with the development of type2 diabetes independent of traditional risk factors for diabetes in this cohort of Japanese individuals.

DOI： 10.1111/jdi.12274

Circulating Malondialdehyde-Modified LDL-Related Variables and Coronary Artery Stenosis in Asymptomatic Patients with Type 2 Diabetes Reviewed

Kazuya Fujihara, Hiroaki Suzuki, Akira Sato, Satoru Kodama, Yoriko Heianza, Kazumi Saito, Hitoshi Iwasaki, Kazuto Kobayashi, Shigeru Yatoh, Akimitsu Takahashi, Naoya Yahagi, Hiroaki Yagyu, Hirohito Sone, Hitoshi Shimano

JOURNAL OF DIABETES RESEARCH 2015 507245 2015

Language：English Publishing type：Research paper (scientific journal) Publisher：HINDAWI PUBLISHING CORPORATION

Aims. To elucidate the levels of malondialdehyde-modified LDL (MDA-LDL)-related variables for predicting coronary artery stenosis (CAS) by coronary CT angiography (CCTA) in asymptomatic patients with type 2 diabetes (T2DM). Methods. Enrolled were 36 Japanese patients with T2DM who underwent CCTA and in whom MDA-LDL levels were measured. Definition of CAS was luminal narrowing of >= 50%. Trends through tertiles of each MDA-LDL-related variable were analyzed with a general linear model. The ability of each MDA-LDL-related variable to predict CAS was compared to areas under the curve (AUCs) in receiver operating characteristic curve (ROC) analysis. Results. Seventeen patients had CAS. Each MDA-IDL-related variable was an independent predictor of CAS (P = 0.039 for MDALDL, P = 0.013 for MDA-LDL/LDL-C, P = 0.047 for MDA-LDL/HDL-C, and P = 0.013 for (MDA-LDULDL-C)/HDL-C). AUCs of MDA-LDL, MDA-LDL/LDL-C, MDA-LDL/HDL-C, and (MDA-LDULDLC)/HDL-C were 0.675 (95% CI 0.496-0.854), 0.765 (0.602-0.927), 0.752 (0.592-0.913), and 0.799 (0.643-0.955), respectively, for predicting CAS. Trends throughout the tertiles showed significant associations between N4DA-LDL/LDL-C, N4DA-LDL/41DL-C, or (MDALDL/LDL-C)/41DL-C and CAS (P 0.003 for MDA-LDL/LDL-C, P=0.042 for MDA-LDULIDL-C, and P 0.001 for (MDA-LDULDL-C)/HDL-C). Conclusions. Data suggest that measurements of MDA-LDL/LDL-C, MDA-LDL/HDLC, and (MakLDULDL-C)/HDL-C are useful for predicting CAS.

DOI： 10.1155/2015/507245

Impact on short-term glycaemic control of initiating diabetes care versus leaving diabetes untreated among individuals with newly screening-detected diabetes in Japan Reviewed

Yoriko Heianza, Akiko Suzuki, Kazuya Fujihara, Shiro Tanaka, Satoru Kodama, Osamu Hanyu, Hirohito Sone

JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH 68 ( 12 ) 1189 - 1195 2014.12

Language：English Publishing type：Research paper (scientific journal) Publisher：BMJ PUBLISHING GROUP

Background The impact of early initiation of diabetes care soon after the identification of hyperglycaemia rather than leaving diabetes untreated on changes in glycaemic control has not been fully clarified. We aimed to quantify the effect of initiating and continuing diabetes care compared with not starting management of diabetes on short-term changes in glycaemic control among the Japanese with newly screening-detected diabetes.
Methods We retrospectively reviewed data from a nationwide claims database to assess histories of physician-diagnosed diabetes or hyperglycaemia, as well as the use of antidiabetic agents, blood testing for hyperglycaemia or dietary advice among individuals without a history of diabetes care. Changes in glycated haemoglobin (HbA1c) concentrations were evaluated using baseline data and data from a health examination during the following year.
Results Among 1393 individuals with newly screening-detected diabetes, 62% (n=864) did not initiate diabetes management during the follow-up period; 49.2% (n=425) of the untreated group had poor glycaemic control (HbA1c =7%) at the baseline examination. Only 38% (n=529) began diabetes management in medical settings. Individuals who remained untreated had a 1.87 (95% CI 1.38 to 2.52) or 1.63 (1.10 to 2.41) times higher risk of absolute increases in HbA1c >= 0.5% or >= 1%, respectively, compared with the treated patients, a difference that was significant. Making more frequent clinic visits especially after the first visit was dose-dependently associated with improved HbA1c levels compared with no diabetes management.
Conclusions In comparison with a lack of management of diabetes, immediately initiating and continuing diabetes care after identification of hyperglycaemia in a screening setting would contribute to clinically meaningful, improved glycaemic control in the Japanese.

DOI： 10.1136/jech-2014-204054

High cholesterol intake is associated with elevated risk of type 2 diabetes mellitus - A meta-analysis(1-4) Reviewed

Ryoko Tajima, Satoru Kodama, Miho Hirata, Chika Horikawa, Kazuya Fujihara, Yoko Yachi, Sakiko Yoshizawa, Kaoruko Tada Iida, Hirohito Sone

CLINICAL NUTRITION 33 ( 6 ) 946 - 950 2014.12

Language：English Publishing type：Research paper (scientific journal) Publisher：CHURCHILL LIVINGSTONE

Background & aims: Some foods rich in cholesterol are associated with high risk of type 2 diabetes (T2D). To confirm the association between dietary cholesterol intake and T2D risk, we performed a meta-analysis of observational studies.
Methods: We searched for longitudinal studies that provided data on the relative risk (RR) for T2D in relation to the cholesterol intake level using MEDLINE (from 1950 for July 10, 2013) and EMBASE (from 1974 to July 10, 2013). The RR for the highest vs. lowest cholesterol intake category or for an increment of 100 mg/day in cholesterol consumption was pooled with an inverse-variance method.
Results: Five studies met the inclusion criteria. Compared with the lowest category, the highest category had a significantly higher association with T2D risk (RR [95% confidence interval (CI)], 1.25 [1.16-1.36]). The pooled RR for a 100-mg/day increment was also significant (RR [95% CI], 1.11 [1.06-1.15]).
Conclusion: Current meta-analysis suggested that high intake of cholesterol was positively associated with future T2D risk. (C) 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

DOI： 10.1016/j.clnu.2014.03.001

Role of sleep duration as a risk factor for Type 2 diabetes among adults of different ages in Japan: the Niigata Wellness Study. Reviewed

Y.Heianza, K.Kato, K.Fujihara, S.Tanaka, S.Kodama, O.Hanyu, K.Sato, H.Sone

Diabet Med 31 ( 11 ) 1363 - 1367 2014.11

High risk of failing eradication of Helicobacter pylori in patients with diabetes: A meta-analysis Reviewed

Chika Horikawa, Saroru Kodama, Kazuya Fujihara, Reiko Hirasawa, Yoko Yachi, Akiko Suzuki, Osamu Hanyu, Hitoshi Shimano, Hirohito Sone

DIABETES RESEARCH AND CLINICAL PRACTICE 106 ( 1 ) 81 - 87 2014.10

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER IRELAND LTD

Aims: Eradication of Helicobacter pylori (HP) is an effective approach to improve intestinal symptoms and prevent gastric cancer. However, there has been concern that the presence of diabetes reduces the effectiveness of antibiotics. We performed this meta-analysis to investigate the effect of diabetes on the risk of failing eradication in patients with diabetes.
Methods: An electronic literature search was conducted using Biosis, MEDLINE, Embase, PASCAL, and SciSearch through November 30, 2012. Selected studies had to provide data on the number of individuals who received treatment for HP infection and on the failure of HP eradication in groups with and without diabetes. Two authors independently extracted relevant data.
Results: Data were obtained from 8 eligible studies (693 total participants including 273 participants with diabetes). Overall, the pooled risk ratio (RR) of failing HP eradication for diabetic patients compared with non-diabetic participants was 2.19 [95% CI, 1.65-2.90] (P < 0.001). Excluding the 2 studies that used a non-standard protocol for HP eradication, individuals with diabetes had a higher risk of failure of eradication compared to those without diabetes (RR = 2.31 [95% CI, 1.72-3.11]).
Conclusions: Current meta-analysis confirmed the higher risk of HP eradication failure in individuals with diabetes compared with those without diabetes, suggesting the necessity of prolonging treatment or developing a new regimen for HP eradication in patients with diabetes. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.diabres.2014.07.009

Second trimester postload glucose level as an important predictor of low birth weight infants: Tanaka Women's Clinic Study Reviewed

Yoko Yachi, Yasuhiro Tanaka, Izumi Nishibata, Sakiko Yoshizawa, Kazuya Fujihara, Satoru Kodama, Akiko Suzuki, Osamu Hanyu, Hirohito Sone

DIABETES RESEARCH AND CLINICAL PRACTICE 105 ( 3 ) E16 - E19 2014.9

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER IRELAND LTD

Although it is well known that the maternal prepregnancy BMI is a strong contributor to fetal growth, our results showed that a low postload glucose level, although within normal range, independent of maternal BMI was strongly associated with an increased risk of low birth weight births among Japanese mothers. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.diabres.2014.02.006

Metabolically Healthy Obesity, Presence or Absence of Fatty Liver, and Risk of Type 2 Diabetes in Japanese Individuals: Toranomon Hospital Health Management Center Study 20 (TOPICS 20) Reviewed

Yoriko Heianza, Yasuji Arase, Hiroshi Tsuji, Kazuya Fujihara, Kazumi Saito, Shiun Dong Hsieh, Shiro Tanaka, Satoru Kodama, Shigeko Hara, Hirohito Sone

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 99 ( 8 ) 2952 - 2960 2014.8

Language：English Publishing type：Research paper (scientific journal) Publisher：ENDOCRINE SOC

Objective: We investigated whether the metabolically healthy obese (MHO) phenotype was associated with an increased risk of the development of diabetes. If so, we aimed to determine what factors could explain this finding.
Design, Setting, and Participants: Studied were 8090 Japanese individuals without diabetes. Metabolic health status was assessed by common clinical markers: blood pressure, triglycerides, high-density lipoprotein-cholesterol, and fasting glucose concentrations. The cutoff value for obesity or normal weight (NW) was a body mass index of 25.0 kg/m(2).
Results: The 5-year incidence rate of diabetes was 1.2% (n = 58 of 4749) in metabolically healthy NW (MHNW) individuals, 2.8% (n = 20 of 719) in MHO individuals, 6.0% (n = 102 of 1709) in metabolically abnormalNWindividuals, and 10.3%(n = 94 of 913) in metabolically abnormal obese individuals. Although MHO individuals had no or one metabolic factor, 47.8% had ultrasonographic fatty liver (FL). The MHO group had a significantly increased risk of diabetes compared with the MHNW group [multivariate adjusted odds ratio (OR) 2.23 (95% confidence interval [CI] 1.33, 3.75)], but this risk was attenuated after adjustment for FL. Compared with the MHNW/non-FL group, the risk of diabetes in the MHO/non-FL group was not significantly elevated [OR 1.01 (95% CI 0.35, 2.88)]. However, the MHO/FL and MHNW/FL groups had similarly elevated risks of diabetes [OR 4.09 (95% CI 2.20, 7.60) and 3.16 (1.78, 5.62), respectively].
Conclusions: Almost half of the MHO participants had FL, which partially explained the increased risk of diabetes among the obese phenotypes. The presence of FL should be evaluated to assess whether an individual was actually in a metabolically benign state for the prediction of diabetes.

DOI： 10.1210/jc.2013-4427

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