Faculty Profiles - FUJIHARA Kazuya

Papers - FUJIHARA Kazuya

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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 Reviewed

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 2014.3

Language：English Publishing type：Research paper (scientific journal) Publisher：EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC

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 (I-2 [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. (c) 2014 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.amjcard.2013.12.005

Quantitative relationship between body weight gain in adulthood and incident type 2 diabetes: a meta-analysis. Reviewed International journal

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

Obesity review 15 ( 3 ) 202 - 214 2014.3

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

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 (≥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

Association of Helicobacter pylori Infection with Glycemic Control in Patients with Diabetes: A Meta-Analysis Reviewed

Chika Horikawa, Satoru Kodama, Kazuya Fujihara, Yoko Yachi, Shiro Tanaka, Akiko Suzuki, Osamu Hanyu, Hitoshi Shimano, Hirohito Sone

JOURNAL OF DIABETES RESEARCH 2014 250620 2014

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

Objective. To assess the association between Helicobacter pylori (HP) infection and glycemic control in patients with diabetes through a meta-analytic approach. Research Design and Methods. Electronic literature searches were conducted for cross-sectional studies that examined the hemoglobin A1c (A1C) level by whether patients with diabetes were or were not carriers of HP. Mean differences in A1C between groups with and without HP infection were pooled with a random-effects model. Results. Thirteen eligible studies were included in this meta-analysis. Overall, the HP carriers did not have significantly higher A1C levels compared with HP noncarriers (mean difference (95% CI), 0.19% (-0.18 to 0.46), P = 0.16). When the analysis was limited to studies targeting patients with type 1 diabetes, there was also no significant difference in A1C (0.69% (-0.31 to 1.68), P = 0.18). Conclusions. There was insufficient evidence that HP infection worsened glycemic control in patients with diabetes.

DOI： 10.1155/2014/250620

Utility of the Triglyceride Level for Predicting Incident Diabetes Mellitus According to the Fasting Status and Body Mass Index Category: The Ibaraki Prefectural Health Study Reviewed

Kazuya Fujihara, Ayumi Sugawara, Yoriko Heianza, Toshimi Sairenchi, Fujiko Irie, Hiroyasu Iso, Mikio Doi, Hitoshi Shimano, Hiroshi Watanabe, Hirohito Sone, Hitoshi Ota

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 21 ( 11 ) 1152 - 1169 2014

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

Aim: The levels of lipids, especially triglycerides (TG), and obesity are associated with diabetes mellitus (DM). Although typically measured in fasting individuals, non-fasting lipid measurements play an important role in predicting future DM. This study compared the predictive efficacy of lipid variables according to the fasting status and body mass index (BMI) category.
Methods: Data were collected for 39,196 nondiabetic men and 87,980 nondiabetic women 40-79 years of age who underwent health checkups in Ibaraki-Prefecture, Japan in 1993 and were followed through 2007. The hazard ratios (HRs) for DM in relation to sex, the fasting status and BMI were estimated using a Cox proportional hazards model.
Results: A total of 8,867 participants, 4,012 men and 4,855 women, developed DM during a mean follow-up of 5.5 years. TG was found to be an independent predictor of incident DM in both fasting and non-fasting men and non-fasting women. The multivariable-adjusted HR for DM according to the TG quartile (Q) 4 vs. Q1 was 1.18 (95% confidence interval (CI): 1.05, 1.34) in the non-fasting men with a normal BMI (18.5-24.9). This trend was also observed in the non-fasting women with a normal BMI. That is, the multivariable-adjusted HRs for DM for TG Q2, Q3 and Q4 compared with Q1 were 1.07 (95% CI: 0.94, 1.23), 1.17 (95% CI: 1.03, 1.34) and 1.48 (95% CI: 1.30, 1.69), respectively.
Conclusions: The fasting and non-fasting TG levels in men and non-fasting TG levels in women are predictive of future DM among those with a normal BMI. Clinicians must pay attention to those individuals at high risk for DM.

DOI： 10.5551/jat.22913

Comparison of the Framingham Risk Score, UK Prospective Diabetes Study (UKPDS) Risk Engine, Japanese Atherosclerosis Longitudinal Study-Existing Cohorts Combine (JALS-ECC) and Maximum Carotid Intima-Media Thickness for Predicting Coronary Artery Stenosis in Patients with Asymptomatic Type 2 Diabetes Reviewed

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

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 21 ( 8 ) 799 - 815 2014

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

Aims: To compare the efficacy of Framingham Risk Score (FRS), UK Prospective Diabetes Study (UKPDS) risk engine, a risk score based on the Japanese Atherosclerosis Longitudinal Study-Existing Cohorts Combine (JALS-ECC), the maximum intima-media thickness (max-IMT) determined on coronary computed tomography angiography (CCTA) and their combination in asymptomatic patients with type 2 diabetes.
Methods: A total of 116 Japanese patients with type 2 diabetes underwent CCTA. The risk of coronary heart disease was calculated according to the FRS, UKPDS and JALS-ECC. We evaluated the reclassification of coronary artery stenosis (CAS) based on the risk score categories after adding each IMT related variable.
Results: Sixty-eight patients had CAS. The areas under the curves (AUCs) in the receiver operating characteristic curve analyses of FRS, UKPDS and JALS-ECC were 0.763 (95% confidence interval [CI]: 0.674-0.853), 0.785 (95% CI: 0.703-0.868) and 0.767 (95% CI: 0.681-0.853), respectively. The AUCs for FRS, UKPDS and JALS-ECC combined with the max-IMT were 0.788 (95% CI: 0.705-0.872), 0.800 (95% CI: 0.720-0.879) and 0.786 (95% CI: 0.703-0.869), respectively. Combining the max-IMT with the risk scores improved the identification of subjects with stenotic lesions, in particular, those in the first, second and third tertiles of the FRS, first and second tertiles of the UKPDS and first and second tertiles of the JALS-ECC (P=0.054, P=0.056, P=0.015, P=0.082, P=0.060, P=0.007, and P=0.080, respectively). The net reclassification improvement increased following the addition of a max-IMT of >= 1.9 mm (32.4% in FRS, 19.9% in UKPDS and 51.7% in JALS-ECC).
Conclusions: These data suggest that combining a risk score with the max-IMT improves the prediction of CAS in comparison with the risk score alone.

DOI： 10.5551/jat.20487

Use of high-normal levels of haemoglobin A(1C) and fasting plasma glucose for diabetes screening and for prediction: a meta-analysis. Reviewed International journal

Satoru Kodama, Chika Horikawa, Kazuya Fujihara, Reiko Hirasawa, Yoko Yachi, Sakiko Yoshizawa, Shiro Tanaka, Yasuko Sone, Hitoshi Shimano, Kaoruko Tada Iida, Kazumi Saito, Hirohito Sone

Diabetes/metabolism research and reviews 29 ( 8 ) 680 - 92 2013.11

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

BACKGROUND: Using high-normal levels of haemoglobin A1C (Abnormal-A1C ) or fasting plasma glucose (FPG) (Abnormal-FPG) for diabetes screening are expected to improve the ability to detect persons with or at high risk of diabetes. We assessed the diagnostic and predictive capacity for diabetes of Abnormal-A1C and Abnormal-FPG. We compared these to the combined use of the two measures to the single use of either measurement. METHODS: We analysed 31 eligible cross-sectional or cohort studies that assessed diagnostic or predictive ability, respectively, by using lower A1C and FPG cutoff values than recommended by current diabetes criteria. Positive and negative likelihood ratios (LR+ and LR-) were calculated to assess the ability to confirm or exclude diabetes, respectively, on the basis of a bivariate random-effects model. RESULTS: With both Abnormal-A1C and Abnormal-FPG, the pooled LR+ was above 4 for diagnosing diabetes and above 3 for predicting diabetes. However, the pooled LR- for predicting diabetes was higher with Abnormal-A1C (0.48) and Abnormal-FPG (0.49) in comparison with that for diagnosing diabetes (0.27, Abnormal-A1C ; 0.28, Abnormal-FPG). In eight studies that assessed the predictive ability of the combination of A1C and FPG, using either Abnormal-A1C or Abnormal-FPG could lower LR- to 0.17 from 0.43 for only Abnormal-A1C and from 0.38 for only Abnormal-FPG. Accordingly, LR+ was also lowered to 2.37 from 3.36 for only Abnormal-A1C and from 3.84 for only-Abnormal-FPG. CONCLUSION: The use of the two blood glucose tests had insufficient capacity to identify subjects at high risk for diabetes but had considerable capacity to identify undiagnosed diabetes.

DOI： 10.1002/dmrr.2445

Body Weight Change and Type 2 Diabetes Reviewed

Satoru Kodama, Chika Horikawa, Sakiko Yoshizawa, Kazuya Fujihara, Yoko Yachi, Shiro Tanaka, Akiko Suzuki, Osamu Hanyu, Hiroaki Yagyu, Hirohito Sone

EPIDEMIOLOGY 24 ( 5 ) 778 - 779 2013.9

Role of alcohol drinking pattern in type 2 diabetes in Japanese men: the Toranomon Hospital Health Management Center Study 11 (TOPICS 11) Reviewed

Yoriko Heianza, Yasuji Arase, Kazumi Saito, Hiroshi Tsuji, Kazuya Fujihara, Shiun Dong Hsieh, Satoru Kodama, Hitoshi Shimano, Nobuhiro Yamada, Shigeko Hara, Hirohito Sone

AMERICAN JOURNAL OF CLINICAL NUTRITION 97 ( 3 ) 561 - 568 2013.3

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER SOC NUTRITION-ASN

Background: Findings of past studies on the effect of drinking patterns on diabetes risk have been inconsistent.
Objective: We aimed to investigate the role of drinking frequency and usual quantity consumed in the development of type 2 diabetes.
Design: Enrolled were 1650 Japanese men without diabetes (diabetes: fasting plasma glucose >= 7.0 mmol/L, glycated hemoglobin >= 6.5%, or self-reported clinician-diagnosed diabetes). Average alcohol consumption and 12 combinations of frequency and usual quantity per drinking occasion were assessed at the baseline examination. The absolute risk and HR for the development of diabetes were calculated.
Results: During a mean follow-up period of 10.2 y, 216 individuals developed diabetes. Lifetime abstainers (n = 153) had a relatively low incidence of diabetes (9.1/1000 person-years), similar to moderate consumers (99-160 g ethanol/wk; 9.0/1000 person-years). Increasingly higher quantities of alcohol usually consumed per occasion increased the risk of diabetes regardless of drinking frequency. The lowest incidence rate of diabetes (8.5/1000 person-years) was associated with the consumption of <1 drink (<23 g ethanol) per occasion over >= 6 times/wk. Binge drinking (>= 3 drinks per occasion) significantly increased the risk of future diabetes regardless of frequency (HR: 1.79; 95% CI: 1.17, 2.74) compared with <1 drink per occasion.
Conclusions: Among current drinkers, a drinking pattern of <1 drink per occasion regularly over 6 times within a week was associated with the lowest risk of developing diabetes. Usual quantity per drinking occasion was a more important determinant than was weekly drinking frequency in the association between alcohol consumption and risk of diabetes in Japanese men. Am J Clin Nutr 2013;97:561-8.

DOI： 10.3945/ajcn.112.043364

Association Between Physical Activity and Risk of All-Cause Mortality and Cardiovascular Disease in Patients With Diabetes A meta-analysis Reviewed

Satoru Kodama, Shiro Tanaka, Yoriko Heianza, Kazuya Fujihara, Chika Horikawa, Hitoshi Shimano, Kazumi Saito, Nobuhiro Yamada, Yasuo Ohashi, Hirohito Sone

DIABETES CARE 36 ( 2 ) 471 - 479 2013.2

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER DIABETES ASSOC

OBJECTIVE-The association between habitual physical activity (PA) and lowered risk of all-cause mortality (ACM) and cardiovascular disease (CVD) has been suggested in patients with diabetes. This meta-analysis summarizes the risk reduction in relation to PA, focusing on clarifying dose-response associations.
RESEARCH DESIGN AND METHODS-Electronic literature searches were conducted for cohort studies that examined relative risk (RR) of ACM or CVD in relation to PA in patients with diabetes. For the qualitative assessment, RR for the highest versus the lowest PA category in each study was pooled with a random-effects model. We added linear and spline regression analyses to assess the quantitative relationship between increases in PA and ACM and CVD risk.
RESULTS-There were 17 eligible studies. Qualitatively, the highest PA category had a lower RR [95% CI] for ACM (0.61 [0.52-0.70]) and CVD (0.71 [0.60-0.84]) than the lowest PA category. The linear regression model indicated a high goodness of fit for the risk of ACM (adjusted R-2 = 0.44, P = 0.001) and CVD (adjusted R-2 = 0.51, P = 0.001), with the result that a 1 MET-h/day incrementally higher PA was associated with 9.5% (5.0-13.8%) and 7.9% (4.3-11.4%) reductions in ACM and CVD risk, respectively. The spline regression model was not significantly different from the linear model in goodness of fit (P = 0.14 for ACM risk; P = 0.60 for CVD risk).
CONCLUSIONS-More PA was associated with a larger reduction in future ACM and CVD risk in patients with diabetes. Nevertheless, any amount of habitual PA was better than inactivity. Diabetes Care 36:471-479, 2013

DOI： 10.2337/dc12-0783

Diabetes and Risk of Hearing Impairment in Adults: A Meta-Analysis Reviewed

Chika Horikawa, Satoru Kodama, Shiro Tanaka, Kazuya Fujihara, Reiko Hirasawa, Yoko Yachi, Hitoshi Shimano, Nobuhiro Yamada, Kazumi Saito, Hirohito Sone

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 98 ( 1 ) 51 - 58 2013.1

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

Context: Recently, several studies have investigated the relationship between diabetes and hearing impairment, but results were inconsistent.
Objective: Our objective was to compare the prevalence of hearing impairment between diabetic and nondiabetic adults. Data Sources : We performed a systematic literature search using MEDLINE (1950 to May 30, 2011) and EMBASE (1974 to May 30, 2011).
Study Selection: Cross-sectional studies were included if data on numbers of hearing-impaired and non-hearing-impaired cases with diabetes were presented. Hearing impairment was limited to that assessed by pure-tone audiometry that included at least 2 kHz of frequency range and was defined as progressive, chronic, sensorineural, or without specified cause.
Data Extraction: Two authors independently extracted relevant data. Odd ratios (ORs) of hearing impairment related to diabetes calculated in each study were pooled with the random-effects model.
Data Synthesis: Data were obtained from 13 eligible studies (20,194 participants and 7,377 cases). Overall pooled OR (95% confidence interval) of hearing impairment for diabetic participants compared with nondiabetic participants was 2.15 (1.72-2.68). OR was higher in younger participants (mean age, <= 60 yr) than in those over 60 yr among which the OR remained significant (2.61 and 1.58, P = 0.008). The strength of the association between diabetes and prevalence of hearing impairment was not significantly influenced by whether participants were matched for age and gender (P = 0.68) or whether participants chronically exposed to noisy environments were excluded (P = 0.19).
Conclusions: Current meta-analysis suggests that the higher prevalence of hearing impairment in diabetic patients compared with nondiabetic patients was consistent regardless of age. (J Clin Endocrinol Metab 98: 51-58, 2013)

DOI： 10.1210/jc.2012-2119

Carotid artery plaque and LDL-to-HDL cholesterol ratio predict atherosclerotic status in coronary arteries in asymptomatic patients with type 2 diabetes mellitus Reviewed

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

Journal of Atherosclerosis and Thrombosis 20 ( 5 ) 452 - 464 2013

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

Aims: To investigate the clinical predictors of coronary atherosclerosis and to assess the utility of maximum-IMT for predicting coronary atherosclerosis in asymptomatic type 2 diabetic patients. Methods: One hundred one Japanese patients with type 2 diabetes underwent computed tomography coronary angiography. Definitions of coronary artery stenosis and vulnerable coronary plaque were luminal narrowing of ≥50% and any coronary plaque with positive vessel remodeling and low attenuation, respectively. Carotid intima-media thickness (IMT) was assessed using B-mode ultrasound. Results: Of the 101 patients, 40 had coronary artery stenosis without vulnerable coronary plaque, 7 had vulnerable coronary plaque without coronary artery stenosis, and 23 had coronary artery stenosis with vulnerable coronary plaque. Male sex (p= 0.031), duration of diabetes (p= 0.024), systolic blood pressure (SBP) (p=0.039), and the LDL/HDL ratio (LDL/HDL) (p=0.013) were independent predictors of coronary artery stenosis and the LDL/HDL (p=0.042) independently predicted vulnerable coronary plaque by logistic regression analyses. Areas under the curves in receiver operating characteristic curve analysis of the maximum-IMT, LDL/HDL, and these two parameters combined were 0.711 (95% CI 0.601-0.820), 0.618 (0.508-0.728), and 0.732 (0.632-0.831), respectively, for predicting coronary artery stenosis and 0.655 (0.537-0.773), 0.629 (0.504-0.754), and 0.710 (0.601- 0.818), respectively, for predicting vulnerable coronary plaque. Conclusions: Male sex, duration of diabetes, elevated SBP, and LDL/HDL were independent predictors of coronary artery stenosis. LDL/HDL was an independent predictor of vulnerable coronary plaque. Maximum-IMT predicted both coronary stenosis and vulnerable coronary plaque. Adding LDL/HDL improved the prediction of coronary artery stenosis and vulnerable coronary plaque.

DOI： 10.5551/jat.14977

The Relationship between Diabetic Neuropathy and Sleep Apnea Syndrome: A Meta-Analysis. Reviewed International journal

Kazuya Fujihara, Satoru Kodama, Chika Horikawa, Sakiko Yoshizawa, Ayumi Sugawara, Reiko Hirasawa, Hitoshi Shimano, Yoko Yachi, Akiko Suzuki, Osamu Hanyu, Hirohito Sone

Sleep disorders 2013 150371 - 150371 2013

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

Aims. High prevalence of sleep apnea syndrome (SAS) has been reported in patients with diabetes. However, whether diabetic neuropathy (DN) contributes to this high prevalence is controversial. Our aim of this study is to compare the prevalence of SAS between patients with and without DN. Methods. Systematic literature searches were conducted for cross-sectional studies that reported the number of patients with DN and SAS using MEDLINE (from 1966 to Nov 5, 2012) and EMBASE (from 1974 to Nov 5, 2012). Odds ratios (ORs) of SAS related to DN were pooled with the Mantel-Haenszel method. Results. Data were obtained from 5 eligible studies (including 6 data sets, 880 participants, and 429 cases). Overall, the pooled OR of SAS in patients with DN compared with that in non-DN patients was significant (OR (95% CI), -1.95 (1.03-3.70)). The pooled OR of SAS was 1.90 (0.97-3.71) in patients with type 2 diabetes. Excluding data on patients with type 1 diabetes, a higher OR was observed in younger patients (mean age <60 years) than in those ≥60 years among whom the OR remained significant (3.82; 95% CI, 2.24-6.51 and 1.17; 95% CI, 0.81-1.68). Conclusions. Current meta-analysis suggested the association of some elements of neuropathy with SAS in type 2 diabetes. Further investigations are needed to clarify whether the association is also true for patients with type 1 diabetes.

DOI： 10.1155/2013/150371

Comparisons of the Strength of Associations With Future Type 2 Diabetes Risk Among Anthropometric Obesity Indicators, Including Waist-to-Height Ratio: A Meta-Analysis Reviewed

Satoru Kodama, Chika Horikawa, Kazuya Fujihara, Yoriko Heianza, Reiko Hirasawa, Yoko Yachi, Ayumi Sugawara, Shiro Tanaka, Hitoshi Shimano, Kaoruko Tada Iida, Kazumi Saito, Hirohito Sone

AMERICAN JOURNAL OF EPIDEMIOLOGY 176 ( 11 ) 959 - 969 2012.12

Language：English Publisher：OXFORD UNIV PRESS INC

The aim of this meta-analysis was to compare the association of waist-to-height ratio (WHtR) with risk of incident diabetes with the associations of 3 other conventional obesity indicators (body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR)) with risk of incident diabetes. Literature searches in MEDLINE (January 1950 to April 27, 2011) and EMBASE (January 1974 to April 27, 2011) were conducted for prospective studies that made it possible to estimate the relative risk of diabetes per 1-standard deviation increase in WHtR, in addition to the RR of BMI, WC, or WHR. Strength of the estimated pooled relative risk for a 1-standard deviation increase of each indicator (expressed as RRWHtR, RRBMI, RRWC, and RRWHR) was compared with a bivariate random-effects model. Pooled relative risks of the 15 eligible studies with 6,472 diabetes cases were 1.62 (95 CI: 1.48, 1.78) for RRWHtR, 1.55 (95 CI: 1.43, 1.69) for RRBMI, 1.63 (95 CI: 1.49, 1.79) for RRWC, and 1.52 (95 CI: 1.40, 1.66) for RRWHR. WHtR had an association stronger than that of BMI (P0.001) or WHR (P0.001). The present meta-analysis showed that WHtR has a modestly but statistically greater importance than BMI and WHR in prediction of diabetes. Nevertheless, measuring height in addition to WC appeared to have no additional benefit.

DOI： 10.1093/aje/kws172

High normal HbA1c levels were associated with impaired insulin secretion without escalating insulin resistance in Japanese individuals: The Toranomon Hospital Health Management Center Study 8 (TOPICS 8) Reviewed

Y. Heianza, Y. Arase, K. Fujihara, H. Tsuji, K. Saito, S. D. Hsieh, S. Kodama, H. Shimano, N. Yamada, S. Hara, H. Sone

Diabetic Medicine 29 ( 10 ) 1285 - 1290 2012.10

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

Aims We aimed to characterize the association of insulin resistance, impaired insulin secretion and β-cell dysfunction in relation to HbA1c levels in a non-diabetic range in Japanese individuals without clinically diagnosed diabetes. Methods This cross-sectional study included 1444 individuals without a history of outpatient treatment of diabetes or use of insulin or oral hypoglycaemic agents. The homeostasis model assessment of insulin resistance and beta-cell function, insulinogenic index, Matsuda index and disposition index were calculated using data from 75-g oral glucose tolerance tests and compared across quintile (Q) categories of HbA1c levels. Results Fasting plasma glucose and 30-min and 60-min plasma glucose (PG) levels were significantly higher when HbA1c exceeded 36mmol/mol (5.4%). A HbA1c concentration of 36-37mmol/mol (5.4-5.5%) (Q3) was significantly associated with a 15% lower homeostasis model assessment of β-cell function value and 31% lower insulinogenic index value compared with HbA1c≤32mmol/mol (≤5.1%) (Q1) (P&lt
0.01). Further, a HbA1c concentration of 38-40mmol/mol (5.6-5.8%) (Q4) was associated with 17% (P&lt
0.01) and 24% (P&lt
0.05) reductions in those indexes, respectively. However, the homeostasis model assessment of insulin resistance was not significantly elevated and the Matsuda index was not significantly lower unless HbA1c exceeded 41mmol/mol (5.9%). Individuals with HbA1c≥41mmol/mol (≥5.9%) (Q5) had a 69% lower disposition index than those with a HbA1c concentration of ≤32mmol/mol (≤5.1%) (Q1). Conclusions Elevated HbA1c levels ≥41mmol/mol (≥5.9%) were associated with substantial reductions in insulin secretion, insulin sensitivity and β-cell dysfunction in Japanese individuals not treated for diabetes. High normal HbA1c levels of 36-40mmol/mol (5.4-5.8%) were also associated with impaired insulin secretion without marked insulin resistance in Japanese individuals. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

DOI： 10.1111/j.1464-5491.2012.03667.x

Screening for pre-diabetes to predict future diabetes using various cut-off points for HbA1c and impaired fasting glucose: the Toranomon Hospital Health Management Center Study 4 (TOPICS 4)

Heianza, Y, Arase, Y, Fujihara, K, Tsuji, H, Saito, K, Hsieh, S. D, Kodama, S, Shimano, H, Yamada, N, Hara, S, Sone, H

DIABETIC MEDICINE 29 ( 9 ) E279 - E285 2012.9

Longitudinal Trajectories of HbA(1c) and Fasting Plasma Glucose Levels During the Development of Type 2 Diabetes The Toranomon Hospital Health Management Center Study 7 (TOPICS 7) Reviewed

Yoriko Heianza, Yasuji Arase, Kazuya Fujhara, Shiun Dung Hsieh, Kazumi Saito, Hiroshi Tsuji, Satoru Kodama, Naoya Yahagi, Hitosh Shimano, Nobuhiro Yamada, Shigeko Hara, Hirohito Sone

DIABETES CARE 35 ( 5 ) 1050 - 1052 2012.5

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER DIABETES ASSOC

OBJECTIVE-To describe the trajectory of HbA(1c), and glucose concentrations before the diagnosis of diabetes.
RESEARCH DESIGN AND METHODS-The study comprised 1,722 nondiabetic Japanese individuals aged 26-80 years. Fasting plasma glucose (FPG) and HbA(1c) were measured annually for a mean of 9.5 (SD 1.8) years.
RESULTS-Diabetes occurred in 193 individuals (FPG >= 7.0 mmol/L, self-reported clinician-diagnosed diabetes, or HbA(1c) >= 6.5%). Mean HbA(1c) values were >5.6% each year before diagnosis in diabetes cases. Mean HbA(1c) (5.69% [95% CI 5.50-5.88]) was higher in the 21 individuals who developed diabetes 10 years after the baseline examination than in nondiabetic individuals after 10 years (5.27% [5.25-5.28]). From 3 years to 1 year prediagriosis, HbA(1c) increased 0.09% (SE 0.01)/year, reaching 5.90% (5.84-5.96) 1 year prediagnosis. In the entire group, marked increases in HbA(1c) of 0.3% (SE 0.05%)/year and FPG of 0.63 (0.07) mmol/L/year predicted diabetes.
CONCLUSIONS HbA(1c) trajectory increased sharply after gradual long-term increases in diabetic individuals.

DOI： 10.2337/dc11-1793

[New vision of secondary and tertiary prevention in diabetic complication]. Reviewed

Fujihara K, Sone H

Nihon rinsho. Japanese journal of clinical medicine 70 Suppl 3 561 - 569 2012.5

Impact of psychological stress caused by the Great East Japan Earthquake on glycemic control in patients with diabetes Reviewed

K. Fujihara, A. Saito, Y. Heianza, H. Gibo, H. Suzuki, H. Shimano, K. Saito, S. Kodama, N. Yamada, H. Sone

Experimental and Clinical Endocrinology and Diabetes 120 ( 9 ) 560 - 563 2012

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

We examined the relationship between psychological stress and the worsening of glycemic control in diabetic patients at the time of the Great East Japan Earthquake. HbA1c levels in diabetic patients before and after the disaster were evaluated with the General Health Questionnaire (GHQ) and other questions including those on changes in diet, exercise, psychological stress and drug intake in 320 consecutive diabetic patients who had been followed in a diabetes clinic. Logistic regression analysis revealed that the total GHQ scores (odds ratio [OR] 1.03 [95% confidence interval 1.01-1.06]
p&lt
0.01) and interruption of drug intake (OR 4.48 [1.57-12.7]
p=0.01) were independently associated with worsening of glycemic control defined as an increase in the HbA1c level equal to or greater than 0.5%. Among the scores on the GHQ, those for somatic symptoms (OR 1.18 [1.01-1.38]
p=0.03) and sleep disturbances or anxiety (OR 1.26 [1.08-1.46]
p&lt
0.01) were independently associated with glycemic control. These results suggest that psychological stress during a disaster has independent effects on worsening of glycemic control. © Georg Thieme Verlag KG Stuttgart · New York.

DOI： 10.1055/s-0032-1314873

Weight History as a Screening Tool for Identifying Undiagnosed Diabetes and Pre-Diabetes in Japanese Men: The Toranomon Hospital Health Management Center Study (TOPICS) Reviewed

Sakiko Yoshizawa, Yoriko Heianza, Kazuya Fujiwara, Shigeko Hara, Kazumi Saito, Hiroshi Tsuji, Satoru Kodama, Yasuji Arase, Nobuhiro Yamada, Kinori Kosaka, Hirohito Sone

DIABETES 60 A235 - A235 2011.7

Weight History as a Screening Tool for Identifying Undiagnosed Diabetes and Pre-Diabetes in Japanese Men: The Toranomon Hospital Health Management Center Study (TOPICS) Reviewed

Sakiko Yoshizawa, Yoriko Heianza, Kazuya Fujiwara, Shigeko Hara, Kazumi Saito, Hiroshi Tsuji, Satoru Kodama, Yasuji Arase, Nobuhiro Yamada, Kinori Kosaka, Hirohito Sone

DIABETES 60 A235 - A235 2011.7

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