2023/02/05 更新

写真a

ヤマダ マユコ
山田 万祐子
Mayuko Harada Yamada
所属
教育研究院 医歯学系 医学系列 助教
医歯学総合研究科 生体機能調節医学専攻 内部環境医学 助教
職名
助教
外部リンク

代表的な業績

学位

  • 博士(医学) ( 2020年3月   新潟大学 )

  • 学士(医学) ( 2012年3月   関西医科大学 )

研究キーワード

  • 糖尿病学

  • 医療ビッグデータ

  • 予防医学

研究分野

  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含まない

  • ライフサイエンス / 代謝、内分泌学

経歴(researchmap)

  • 新潟大学大学院医歯学総合研究科

    2020年4月 - 現在

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  • 淀川キリスト教病院

    2014年4月 - 2017年3月

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  • 神戸大学附属病院

    2012年4月 - 2014年3月

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経歴

  • 新潟大学   医歯学総合研究科 生体機能調節医学専攻 内部環境医学   助教

    2022年2月 - 現在

  • 新潟大学   教育研究院 医歯学系 医学系列   助教

    2022年2月 - 現在

学歴

  • 新潟大学大学院   医歯学総合研究科

    2017年4月 - 2020年3月

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  • 関西医科大学   医学部医学科

    2006年4月 - 2012年3月

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取得資格

  • 医師

 

論文

  • Impact of prior cerebrovascular disease and glucose status on incident cerebrovascular disease in Japanese 国際誌

    Momoko Oe, Kazuya Fujihara, Mayuko Harada-Yamada, Taeko Osawa, Masaru Kitazawa, Yasuhiro Matsubayashi, Takaaki Sato, Yuta Yaguchi, Midori Iwanaga, Hiroyasu Seida, Takaho Yamada, Hirohito Sone

    Cardiovascular Diabetology   20 ( 1 )   174 - 174   2021年12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:Springer Science and Business Media LLC  

    <title>Abstract</title><sec>
    <title>Background</title>
    Although both a history of cerebrovascular disease (CVD) and glucose abnormality are risk factors for CVD, few large studies have examined their association with subsequent CVD in the same cohort. Thus, we compared the impact of prior CVD, glucose status, and their combinations on subsequent CVD using real-world data.


    </sec><sec>
    <title>Methods</title>
    This is a retrospective cohort study including 363,627 men aged 18–72 years followed for ≥ 3 years between 2008 and 2016. Participants were classified as normoglycemia, borderline glycemia, or diabetes defined by fasting plasma glucose, HbA1c, and antidiabetic drug prescription. Prior and subsequent CVD (i.e. ischemic stroke, transient ischemic attack, and non-traumatic intracerebral hemorrhage) were identified according to claims using ICD-10 codes, medical procedures, and questionnaires.


    </sec><sec>
    <title>Results</title>
    Participants’ mean age was 46.1 ± 9.3, and median follow up was 5.2 (4.2, 6.7) years. Cox regression analysis showed that prior CVD + conferred excess risk for CVD regardless of glucose status (normoglycemia: hazard ratio (HR), 8.77; 95% CI 6.96–11.05; borderline glycemia: HR, 7.40, 95% CI 5.97–9.17; diabetes: HR, 5.73, 95% CI 4.52–7.25). Compared with normoglycemia, borderline glycemia did not influence risk of CVD, whereas diabetes affected subsequent CVD in those with CVD- (HR, 1.50, 95% CI 1.34–1.68). In CVD-/diabetes, age, current smoking, systolic blood pressure, high-density lipoprotein cholesterol, and HbA1c were associated with risk of CVD, but only systolic blood pressure was related to CVD risk in CVD + /diabetes.


    </sec><sec>
    <title>Conclusions</title>
    Prior CVD had a greater impact on the risk of CVD than glucose tolerance and glycemic control. In participants with diabetes and prior CVD, systolic blood pressure was a stronger risk factor than HbA1c. Individualized treatment strategies should consider glucose tolerance status and prior CVD.


    </sec>

    DOI: 10.1186/s12933-021-01367-7

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    その他リンク: https://link.springer.com/article/10.1186/s12933-021-01367-7/fulltext.html

  • Impact of Medication Adherence and Glycemic Control on the Risk of Micro- and Macrovascular Diseases in Patients with Diabetes. 国際誌

    Yuta Yaguchi, Kazuya Fujihara, Mayuko Harada Yamada, Yasuhiro Matsubayashi, Takaho Yamada, Midori Iwanaga, Masaru Kitazawa, Masahiko Yamamoto, Hiroyasu Seida, Satoru Kodama, Hirohito Sone

    The American journal of medicine   135 ( 4 )   461 - 470   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Our purpose in the research was to clarify the impact of medication adherence to oral hypoglycemic agents during a 1-year period and subsequent glycemic control on the risk of micro- and macrovascular diseases. METHODS: Examined was a nationwide claims database on 13,256 individuals with diabetic eye disease without requiring prior treatment, 7,862 without prior initiation of dialysis, 15,556 without prior coronary artery disease, 16,243 without prior cerebrovascular disease, and 19,386 without prior heart failure from 2008 to 2016 in Japan. Medication adherence was evaluated by the proportion of days covered. Patients were considered to have poor adherence if the proportion of days covered was <80%. Multivariate Cox regression model identified risks of micro- and macrovascular diseases. RESULTS: In each group, mean age was 53 to 54 years, HbA1c was 7.1% to 7.2%, and median follow-up period was 4.6 to 5.1 years, and the percentage of poor adherence was approximately 30%. During the study period, 532 treatment-requiring diabetic eye disease, 75 dialysis, 389 coronary artery disease, 316 cerebrovascular disease, and 144 heart failure events occurred. Multivariate Cox regression model revealed that the hazard ratio (95% confidence interval) of dialysis in the poor adherence group was 2.04 (1.27-3.30) compared with the good adherence group. The hazard ratios in the poor adherence/poor glycemic control group were 3.34 (2.63-4.24) for treatment-requiring diabetic eye disease, 4.23 (2.17-8.26) for dialysis, 1.69 (1.23-2.31) for coronary artery disease, and 2.08 (1.25-3.48) for heart failure compared with the good adherence/good glycemic control group. CONCLUSIONS: Poor medication adherence was an independent risk factor for the initiation of dialysis, suggesting that clinicians must pay close attention to these patients.

    DOI: 10.1016/j.amjmed.2021.10.018

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  • 日本人男性における耐糖能別にみた脳卒中既往がその後の脳卒中発症に与える影響

    山田 万祐子, 藤原 和哉, 大江 桃子, 大澤 妙子, 北澤 勝, 松林 泰弘, 佐藤 隆明, 矢口 雄大, 岩永 みどり, 山田 貴穂, 曽根 博仁

    糖尿病合併症   35 ( Suppl. )   174 - 174   2021年9月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病合併症学会  

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  • 経口血糖降下薬(OHA)の服薬アドヒアランスおよび血糖コントロールと細小/大血管合併症発症の関連の検討

    矢口 雄大, 藤原 和哉, 山田 万祐子, 北澤 勝, 山本 正彦, 岩永 みどり, 山田 貴穂, 清田 浩康, 松林 泰弘, 児玉 暁, 曽根 博仁

    糖尿病合併症   35 ( Suppl. )   173 - 173   2021年9月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病合併症学会  

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  • 血清尿酸値と重症糖尿病網膜症との関係

    山本 正彦, 藤原 和哉, 矢口 雄大, 大澤 妙子, 山田 万祐子, 松林 泰弘, 長谷部 日, 山田 貴穂, 児玉 暁, 曽根 博仁

    糖尿病合併症   35 ( Suppl. )   268 - 268   2021年9月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病合併症学会  

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  • Associations of Systolic Blood Pressure and Diastolic Blood Pressure With the Incidence of Coronary Artery Disease or Cerebrovascular Disease According to Glucose Status 国際誌

    Mayuko Harada Yamada, Kazuya Fujihara, Satoru Kodama, Takaaki Sato, Taeko Osawa, Yuta Yaguchi, Masahiko Yamamoto, Masaru Kitazawa, Yasuhiro Matsubayashi, Takaho Yamada, Hiroyasu Seida, Wataru Ogawa, Hirohito Sone

    Diabetes Care   44 ( 9 )   dc202252 - dc202252   2021年5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:American Diabetes Association  

    OBJECTIVE: To determine associations of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with new-onset coronary artery disease (CAD) or cerebrovascular disease (CVD) according to glucose status. RESEARCH DESIGN AND METHODS: Examined was a nationwide claims database from 2008 to 2016 on 593,196 individuals. A Cox proportional hazards model identified risks of CAD and CVD events among five levels of SBP and DBP. RESULTS: During the study period 2,240 CAD and 3,207 CVD events occurred. Compared with SBP ≤119 mmHg, which was the lowest quintile of SBP, hazard ratios (95% CI) for CAD/CVD in the 4 higher quintiles (120-129, 130-139, 140-149, ≥150 mmHg) gradually increased from 2.10 (1.73-2.56)/1.46 (1.27-1.68) in quintile 2 to 3.21 (2.37-4.34)/4.76 (3.94-5.75) in quintile 5 for normoglycemia, from 1.39 (1.14-1.69)/1.70 (1.44-2.01) in quintile 2 to 2.52 (1.95-3.26)/4.12 (3.38-5.02) in quintile 5 for borderline glycemia, and from 1.50 (1.19-1.90)/1.72 (1.31-2.26) in quintile 2 to 2.52 (1.95-3.26)/3.54 (2.66-4.70) in quintile 5 for diabetes. A similar trend was observed for DBP across 4 quintiles (75-79, 80-84, 85-89, and ≥90 mmHg) compared with ≥74 mmHg, which was the lowest quintile. CONCLUSIONS: Results indicated that cardiovascular risks gradually increased with increases in SBP and DBP regardless of the presence of and degree of a glucose abnormality. Further interventional trials are required to apply findings from this cohort study to clinical practice.

    DOI: 10.2337/dc20-2252

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  • Accuracy of Japanese claims data in identifying diabetes-related complications. 国際誌

    Kazuya Fujihara, Mayuko Yamada-Harada, Yasuhiro Matsubayashi, Masaru Kitazawa, Masahiko Yamamoto, Yuta Yaguchi, Hiroyasu Seida, Satoru Kodama, Kohei Akazawa, Hirohito Sone

    Pharmacoepidemiology and drug safety   30 ( 5 )   594 - 601   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To evaluate the accuracy of various claims-based definitions of diabetes-related complications (coronary artery disease [CAD], heart failure, cerebrovascular disease and dialysis). METHODS: We evaluated data on 1379 inpatients who received care at the Niigata University Medical & Dental Hospital in September 2018. Manual electronic medical chart reviews were conducted for all patients with regard to diabetes-related complications and were used as the gold standard. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of each claims-based definition associated with diabetes-related complications based on Diagnosis Procedure Combination (DPC), International Classification of Diseases, Tenth Revision (ICD-10) codes, procedure codes and medication codes were calculated. RESULTS: DPC-based definitions had higher sensitivity, specificity, and PPV than ICD-10 code definitions for CAD and cerebrovascular disease, with sensitivity of 0.963-1.000 and 0.905-0.952, specificity of 1.000 and 1.000, and PPV of 1.000 and 1.000, respectively. Sensitivity, specificity, and PPV were high using procedure codes for CAD and dialysis, with sensitivity of 0.963 and 1.000, specificity of 1.000 and 1.000, and PPV of 1.000 and 1.000, respectively. DPC and/or ICD-10 codes + medication were better for heart failure than the ICD-10 code definition, with sensitivity of 0.933, specificity of 1.000, and PPV of 1.000. The PPVs were lower than 60% for all diabetes-related complications using ICD-10 codes only. CONCLUSION: The DPC-based definitions for CAD and cerebrovascular disease, procedure codes for CAD and dialysis, and DPC or ICD-10 codes with medication codes for heart failure could accurately identify these diabetes-related complications from claims databases.

    DOI: 10.1002/pds.5213

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  • 日本人男性における耐糖能と脳卒中既往がその後の脳卒中発症に与える影響 リアルワールドデータによる検討

    山田 万祐子, 藤原 和哉, 大江 桃子, 大澤 妙子, 北澤 勝, 松林 泰弘, 佐藤 隆明, 矢口 雄大, 岩永 みどり, 清田 浩康, 山田 貴穂, 曽根 博仁

    糖尿病   64 ( Suppl.1 )   III - 2   2021年5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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  • 機械学習による糖尿病専門医のインスリン選択の予測能の検討及び一般医との比較検討

    藤原 和哉, 松林 泰弘, 山田 万祐子, 山本 正彦, 飯塚 敏浩, 宮村 幸祐, 長谷川 好範, 山本 寛悟, 前川 聡, 山崎 達也, 曽根 博仁

    糖尿病   64 ( Suppl.1 )   III - 3   2021年5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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  • 健診の体力テスト結果を用いた総合体力指標の算出と生活習慣病との関連の検討

    佐藤 隆明, 藤原 和哉, 矢口 雄大, 山田 万祐子, 北澤 勝, 山本 正彦, 松林 泰弘, 岩永 みどり, 山田 貴穂, 加藤 公則, 曽根 博仁

    糖尿病   64 ( Suppl.1 )   III - 1   2021年5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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  • 経口血糖降下薬(OHA)の服薬アドヒアランス(Ad)と生活習慣因子の関連

    矢口 雄大, 藤原 和哉, 山田 万祐子, 北澤 勝, 金子 正儀, 清田 浩康, 松林 泰弘, 曽根 博仁

    糖尿病   64 ( Suppl.1 )   III - 1   2021年5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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  • 服薬アドヒアランスと下肢切断のリスクに関する縦断的検討(第2報)

    金子 正儀, 藤原 和哉, 山田 万祐子, 北澤 勝, 矢口 雄大, 松林 泰弘, 山田 貴穂, 清田 浩康, 曽根 博仁

    糖尿病   64 ( Suppl.1 )   P - 4   2021年5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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  • メトホルミン内服中の2型糖尿病患者に対するDPP4阻害薬またはSGLT2阻害薬の追加併用効果の多施設共同無作為化比較試験

    北澤 勝, 片桐 尚, 鈴木 裕美, 松永 佐澄志, 山田 万祐子, 五十嵐 智雄, 山本 正彦, 古川 和郎, 岩永 みどり, 治田 麻理子, 藤原 和哉, 山田 貴穂, 田中 司郎, 曽根 博仁, NISM研究グループ

    糖尿病   64 ( Suppl.1 )   I - 6   2021年5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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  • 糖尿病(DM)の有無別にみたeGFRと尿蛋白が透析開始に及ぼす影響

    大澤 妙子, 藤原 和哉, 山田 万祐子, 山本 正彦, 矢口 雄大, 北澤 勝, 松林 泰弘, 山田 貴穂, 曽根 博仁

    糖尿病   64 ( Suppl.1 )   I - 8   2021年5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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  • Rates and risk factors for amputation in people with diabetes in Japan: a historical cohort study using a nationwide claims database. 国際誌

    Masanori Kaneko, Kazuya Fujihara, Mayuko Yamada Harada, Taeko Osawa, Masahiko Yamamoto, Masaru Kitazawa, Yasuhiro Matsubayashi, Takaho Yamada, Hiroyasu Seida, Satoru Kodama, Hirohito Sone

    Journal of foot and ankle research   14 ( 1 )   29 - 29   2021年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The prevalence of diabetes is rising, and diabetes develops at a younger age in East Asia. Although lower limb amputation negatively affects quality of life and increases the risk of cardiovascular events, little is known about the rates and predictors of amputation among persons with diabetes from young adults to those in the "young-old" category (50-72 y). METHODS: We analyzed data from a nationwide claims database in Japan accumulated from 2008 to 2016 involving 17,288 people with diabetes aged 18-72 y (mean age 50.2 y, HbA1c 7.2%). Amputation occurrence was determined according to information from the claims database. Cox regression model identified variables related to lower limb amputation. RESULTS: The mean follow-up time was 5.3 years, during which time 16 amputations occurred (0.17/1000 person-years). Multivariate Cox regression analysis showed that age (hazard ratio [HR] 1.09 [95% confidence intervals] 1.02-1.16, p = 0.01) and HbA1c (HR 1.46 [1.17-1.81], p < 0.01) were independently associated with amputations. Compared with those aged < 60 years with HbA1c < 8.0%, the HR for amputation was 27.81 (6.54-118.23) in those aged ≥60 years and HbA1c ≥8.0%. CONCLUSIONS: Age and HbA1c were associated with amputations among diabetic individuals, and the rates of amputation were significantly greater in those ≥60 years old and with HbA1c ≥8.0%.

    DOI: 10.1186/s13047-021-00474-8

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  • 心血管疾患既往の有無と耐糖能状態別に見たその後の心血管疾患発症リスク

    北澤 勝, 藤原 和哉, 山田 万祐子, 大澤 妙子, 矢口 雄大, 山本 正彦, 金子 正儀, 松林 泰弘, 山田 貴穂, 清田 浩康, 曽根 博仁

    日本内分泌学会雑誌   97 ( 1 )   274 - 274   2021年4月

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    記述言語:日本語   出版者・発行元:(一社)日本内分泌学会  

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  • 心血管疾患既往の有無と耐糖能状態別に見たその後の心血管疾患発症リスク

    北澤 勝, 藤原 和哉, 山田 万祐子, 大澤 妙子, 矢口 雄大, 山本 正彦, 金子 正儀, 松林 泰弘, 山田 貴穂, 清田 浩康, 曽根 博仁

    日本内分泌学会雑誌   97 ( 1 )   274 - 274   2021年4月

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    記述言語:日本語   出版者・発行元:(一社)日本内分泌学会  

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  • A 52-week randomized controlled trial of ipragliflozin or sitagliptin in type 2 diabetes combined with metformin: The N-ISM study. 国際誌

    Masaru Kitazawa, Takashi Katagiri, Hiromi Suzuki, Satoshi Matsunaga, Mayuko H Yamada, Tomoo Ikarashi, Masahiko Yamamoto, Kazuo Furukawa, Midori Iwanaga, Mariko Hatta, Kazuya Fujihara, Takaho Yamada, Shiro Tanaka, Hirohito Sone

    Diabetes, obesity & metabolism   23 ( 3 )   811 - 821   2021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)  

    AIM: To compare the long-term efficacy of sodium-glucose co-transporter-2 inhibitors and dipeptidyl peptidase-4 inhibitors as second-line drugs after metformin for patients not at high risk of atherosclerotic cardiovascular disease (ASCVD). MATERIALS AND METHODS: In a 52-week randomized open-label trial, we compared ipragliflozin and sitagliptin in Japanese patients diagnosed with type 2 diabetes, without prior ASCVD and treated with metformin. The primary endpoint was a glycated haemoglobin (HbA1c) reduction of ≥0.5% (5.5 mmol/mol) without weight gain at 52 weeks. RESULTS: Of a total of 111 patients (mean age 59.2 years, mean body mass index [BMI] 26.6 kg/m2 , 61.3% men), 54 patients received ipragliflozin and 57 received sitagliptin. After 52 weeks, achievement of the primary endpoint was not significantly different (37.0% and 40.3%; P = 0.72). HbA1c reduction rate at 24 weeks was greater for sitagliptin (56.1%) than for ipragliflozin (31.5%; P = 0.01). From 24 to 52 weeks, the HbA1c reduction with sitagliptin was attenuated, with no significant difference in HbA1c reduction after 52 weeks between sitagliptin (54.4%) and ipragliflozin (38.9%; P = 0.10). Improvements in BMI, C-peptide and high-density lipoprotein cholesterol were greater with ipragliflozin than with sitagliptin. Adverse events occurred in 17 patients with ipragliflozin and in 10 patients with sitagliptin (P = 0.11). CONCLUSION: The HbA1c-lowering effect at 24 weeks was greater with sitagliptin than with ipragliflozin, but with no difference in efficacy related to HbA1c and body weight at 52 weeks. However, some ASCVD risk factors improved with ipragliflozin.

    DOI: 10.1111/dom.14288

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  • Severity of hypertension as a predictor of initiation of dialysis among study participants with and without diabetes mellitus. 国際誌

    Taeko Osawa, Kazuya Fujihara, Mayuko Harada Yamada, Masahiko Yamamoto, Masaru Kitazawa, Yasuhiro Matsubayashi, Midori Iwanaga, Takaho Yamada, Hiroyasu Seida, Satoru Kodama, Yoshimi Nakagawa, Hitoshi Shimano, Hirohito Sone

    Journal of investigative medicine : the official publication of the American Federation for Clinical Research   69 ( 3 )   724 - 729   2021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)  

    To determine associations between severity of hypertension and risk of starting dialysis in the presence or absence of diabetes mellitus (DM). A nationwide database with claims data on 258 874 people with and without DM aged 19-72 years in Japan was used to elucidate the impact of severity of hypertension on starting dialysis. Initiation of dialysis was determined from claims using International Classification of Diseases-10 codes and medical procedures. Using multivariate Cox modeling, we investigated the severity of hypertension to predict the initiation of dialysis with and without DM. Hypertension was significantly associated with the initiation of dialysis regardless of DM. The incidence of starting dialysis in those with systolic blood pressure (SBP) ≤119 mm Hg and DM (DM+) was almost the same as in those with SBP ≥150 mm Hg and absence of DM (DM-). In comparison with SBP ≤119 mm Hg, SBP ≥150 mm Hg significantly increased the risk of the initiation of dialysis about 2.5 times regardless of DM+ or DM-. Compared with DM- and SBP ≤119 mm Hg, the HR for DM+ and SBP ≥150 mm Hg was 6.88 (95% CI 3.66 to 12.9). Although the risks of hypertension differed only slightly regardless of the presence or absence of DM, risks for starting dialysis with DM+ and SBP ≤119 mm Hg were equivalent to DM- and SBP ≥150 mm Hg, indicating more strict blood pressure interventions in DM+ are needed to avoid dialysis. Future studies are required to clarify the cut-off SBP level to avoid initiation of dialysis considering the risks of strict control of blood pressure.

    DOI: 10.1136/jim-2020-001489

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  • Ability of Current Machine Learning Algorithms to Predict and Detect Hypoglycemia in Patients With Diabetes Mellitus: Meta-analysis. 国際誌

    Satoru Kodama, Kazuya Fujihara, Haruka Shiozaki, Chika Horikawa, Mayuko Harada Yamada, Takaaki Sato, Yuta Yaguchi, Masahiko Yamamoto, Masaru Kitazawa, Midori Iwanaga, Yasuhiro Matsubayashi, Hirohito Sone

    JMIR diabetes   6 ( 1 )   e22458   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Machine learning (ML) algorithms have been widely introduced to diabetes research including those for the identification of hypoglycemia. OBJECTIVE: The objective of this meta-analysis is to assess the current ability of ML algorithms to detect hypoglycemia (ie, alert to hypoglycemia coinciding with its symptoms) or predict hypoglycemia (ie, alert to hypoglycemia before its symptoms have occurred). METHODS: Electronic literature searches (from January 1, 1950, to September 14, 2020) were conducted using the Dialog platform that covers 96 databases of peer-reviewed literature. Included studies had to train the ML algorithm in order to build a model to detect or predict hypoglycemia and test its performance. The set of 2 × 2 data (ie, number of true positives, false positives, true negatives, and false negatives) was pooled with a hierarchical summary receiver operating characteristic model. RESULTS: A total of 33 studies (14 studies for detecting hypoglycemia and 19 studies for predicting hypoglycemia) were eligible. For detection of hypoglycemia, pooled estimates (95% CI) of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were 0.79 (0.75-0.83), 0.80 (0.64-0.91), 8.05 (4.79-13.51), and 0.18 (0.12-0.27), respectively. For prediction of hypoglycemia, pooled estimates (95% CI) were 0.80 (0.72-0.86) for sensitivity, 0.92 (0.87-0.96) for specificity, 10.42 (5.82-18.65) for PLR, and 0.22 (0.15-0.31) for NLR. CONCLUSIONS: Current ML algorithms have insufficient ability to detect ongoing hypoglycemia and considerate ability to predict impeding hypoglycemia in patients with diabetes mellitus using hypoglycemic drugs with regard to diagnostic tests in accordance with the Users' Guide to Medical Literature (PLR should be ≥5 and NLR should be ≤0.2 for moderate reliability). However, it should be emphasized that the clinical applicability of these ML algorithms should be evaluated according to patients' risk profiles such as for hypoglycemia and its associated complications (eg, arrhythmia, neuroglycopenia) as well as the average ability of the ML algorithms. Continued research is required to develop more accurate ML algorithms than those that currently exist and to enhance the feasibility of applying ML in clinical settings. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020163682; http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42020163682.

    DOI: 10.2196/22458

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  • Machine Learning Approach to Decision Making for Insulin Initiation in Japanese Patients With Type 2 Diabetes (JDDM 58): Model Development and Validation Study. 国際誌

    Kazuya Fujihara, Yasuhiro Matsubayashi, Mayuko Harada Yamada, Masahiko Yamamoto, Toshihiro Iizuka, Kosuke Miyamura, Yoshinori Hasegawa, Hiroshi Maegawa, Satoru Kodama, Tatsuya Yamazaki, Hirohito Sone

    JMIR medical informatics   9 ( 1 )   e22148   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Applications of machine learning for the early detection of diseases for which a clear-cut diagnostic gold standard exists have been evaluated. However, little is known about the usefulness of machine learning approaches in the decision-making process for decisions such as insulin initiation by diabetes specialists for which no absolute standards exist in clinical settings. OBJECTIVE: The objectives of this study were to examine the ability of machine learning models to predict insulin initiation by specialists and whether the machine learning approach could support decision making by general physicians for insulin initiation in patients with type 2 diabetes. METHODS: Data from patients prescribed hypoglycemic agents from December 2009 to March 2015 were extracted from diabetes specialists' registries, resulting in a sample size of 4860 patients who had received initial monotherapy with either insulin (n=293) or noninsulin (n=4567). Neural network output was insulin initiation ranging from 0 to 1 with a cutoff of >0.5 for the dichotomous classification. Accuracy, recall, and area under the receiver operating characteristic curve (AUC) were calculated to compare the ability of machine learning models to make decisions regarding insulin initiation to the decision-making ability of logistic regression and general physicians. By comparing the decision-making ability of machine learning and logistic regression to that of general physicians, 7 cases were chosen based on patient information as the gold standard based on the agreement of 8 of the 9 specialists. RESULTS: The AUCs, accuracy, and recall of logistic regression were higher than those of machine learning (AUCs of 0.89-0.90 for logistic regression versus 0.67-0.74 for machine learning). When the examination was limited to cases receiving insulin, discrimination by machine learning was similar to that of logistic regression analysis (recall of 0.05-0.68 for logistic regression versus 0.11-0.52 for machine learning). Accuracies of logistic regression, a machine learning model (downsampling ratio of 1:8), and general physicians were 0.80, 0.70, and 0.66, respectively, for 43 randomly selected cases. For the 7 gold standard cases, the accuracies of logistic regression and the machine learning model were 1.00 and 0.86, respectively, with a downsampling ratio of 1:8, which were higher than the accuracy of general physicians (ie, 0.43). CONCLUSIONS: Although we found no superior performance of machine learning over logistic regression, machine learning had higher accuracy in prediction of insulin initiation than general physicians, defined by diabetes specialists' choice of the gold standard. Further study is needed before the use of machine learning-based decision support systems for insulin initiation can be incorporated into clinical practice.

    DOI: 10.2196/22148

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  • 糖尿病と定期的な運動習慣が要介護発症へ及ぼす影響の検討

    藤原 和哉, 山田 万祐子, 北澤 勝, 松林 泰弘, 八尋 拓也, 筒井 歩, 加藤 公則, 曽根 博仁

    Journal of Epidemiology   31 ( Suppl. )   102 - 102   2021年1月

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    記述言語:日本語   出版者・発行元:(一社)日本疫学会  

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  • Skipping breakfast, late-night eating and current smoking are associated with medication adherence in Japanese patients with diabetes. 国際誌

    Yuta Yaguchi, Kazuya Fujihara, Mayuko Harada Yamada, Yasuhiro Matsubayashi, Masaru Kitazawa, Taeko Osawa, Masahiko Yamamoto, Masanori Kaneko, Nauta Yamanaka, Hiroyasu Seida, Satoru Kodama, Hirohito Sone

    Primary care diabetes   14 ( 6 )   753 - 759   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIMS: Little is known about the relationship between medication adherence for oral hypoglycemic agents (OHAs) and glycemic control after adjusting healthy adherer effect in large scale study. Thus, adjusting for health-related behaviors, we investigated the clinical variables associated with medication adherence and the relationship between medication adherence and glycemic control using a large claims database. METHODS: Analyzed were 8805 patients with diabetes whose medication records for OHA were available for at least 1year. Medication adherence was evaluated by the proportion of days covered (PDC). Multivariate logistic regression model was used to identify clinical variables significantly associated with non-adherence. Multiple regression analysis evaluated the relationship between PDC and HbA1c after adjusting for health-related behaviors. RESULTS: Mean PDC was 80.1% and 32.8% of patients were non-adherence. Logistic analysis indicated that older age and taking concomitant medications were significantly associated with adherence while skipping breakfast (odds ratio 0.66 [95% CI 0.57-0.76]), late-night eating (0.86 [0.75-0.98]), and current smoking (0.89 [0.80-0.99]) were significantly associated with non-adherence. CONCLUSIONS: Skipping breakfast, late-night eating and current smoking were significantly associated with medication adherence, suggesting that clinicians pay attention to those health-related behaviors to achieve good medication adherence.

    DOI: 10.1016/j.pcd.2020.05.002

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  • 眼科処置を要する糖尿病重症眼疾患発生と飲酒についての検討

    山本 正彦, 藤原 和哉, 矢口 雄大, 大澤 妙子, 山田 万祐子, 松林 泰弘, 長谷部 日, 曽根 博仁

    糖尿病合併症   34 ( Suppl.1 )   269 - 269   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病合併症学会  

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  • 心血管・動脈硬化 耐糖能別にみた収縮期血圧と冠動脈疾患、脳血管疾患発症との関連

    山田 万祐子, 藤原 和哉, 大澤 妙子, 矢口 雄大, 北澤 勝, 松林 泰弘, 岩永 みどり, 清田 浩康, 山中 菜詩, 山田 貴穂, 曽根 博仁

    糖尿病合併症   34 ( Suppl.1 )   219 - 219   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病合併症学会  

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  • 眼科処置を要する糖尿病重症眼疾患発生と飲酒についての検討

    山本 正彦, 藤原 和哉, 矢口 雄大, 大澤 妙子, 山田 万祐子, 松林 泰弘, 長谷部 日, 曽根 博仁

    糖尿病合併症   34 ( Suppl.1 )   269 - 269   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病合併症学会  

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  • 心血管・動脈硬化 耐糖能別にみた収縮期血圧と冠動脈疾患、脳血管疾患発症との関連

    山田 万祐子, 藤原 和哉, 大澤 妙子, 矢口 雄大, 北澤 勝, 松林 泰弘, 岩永 みどり, 清田 浩康, 山中 菜詩, 山田 貴穂, 曽根 博仁

    糖尿病合併症   34 ( Suppl.1 )   219 - 219   2020年11月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病合併症学会  

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  • Network Meta-Analysis of Drug Therapies for Lowering Uric Acid and Mortality Risk in Patients with Heart Failure. 国際誌

    Satoru Kodama, Kazuya Fujihara, Chika Horikawa, Mayuko Yamada, Takaaki Sato, Yuta Yaguchi, Masahiko Yamamoto, Masaru Kitazawa, Yasuhiro Matsubayashi, Takaho Yamada, Kenichi Watanabe, Hirohito Sone

    Cardiovascular drugs and therapy   35 ( 6 )   1217 - 1225   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: This network meta-analysis aimed to assess the current efficacy of decreasing the uric acid (UA) level with drugs to reduce mortality in patients with heart failure (HF). METHODS: Electronic literature searches using EMBASE and MEDLINE of studies published from 1 Jan 1950 to 26 Dec 2019 were conducted for randomized controlled trials or non-randomized cohort studies that included at least one group of patients who took UA-lowering drugs and with a study outcome of all-cause mortality. A random-effects network meta-analysis was performed within a frequentist framework. Hierarchy of treatments was expressed as the surface under the cumulative ranking curve (SUCRA) value, which is in proportion to mean rank (best is 100%). RESULTS: Nine studies, which included seven different types of groups, were eligible for analysis. The "untreated uricemia" group in which patients had hyperuricemia but without treatment had a significantly higher risk of mortality than the "no uricemia" group in which patients had no hyperuricemia (relative risk (RR)(95% confidence interval (CI), 1.43 (1.08-1.89)). The "start-allo" group wherein patients started to take allopurinol did not have a significantly lower risk of mortality than the "untreated uricemia" group (RR (95% CI), 0.68 (0.45-1.01)). However, in the "start-allo" group the SUCRA value was comparable to that in the "no uricemia" group (SUCRA: 65.4% for "start-allo"; 64.1% for "no uricemia"). CONCLUSIONS: Results suggested that allopurinol therapy was not associated with a significantly improved prognosis in terms of mortality but could potentially counteract the adverse effects associated with longstanding hyperuricemia in HF patients.

    DOI: 10.1007/s10557-020-07097-4

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  • Association of treatment-achieved HbA1c with incidence of coronary artery disease and severe eye disease in diabetes patients. 国際誌

    M Harada, K Fujihara, T Osawa, M Yamamoto, M Kaneko, M Ishizawa, Y Matsubayashi, T Yamada, N Yamanaka, H Seida, S Kodama, W Ogawa, H Sone

    Diabetes & metabolism   46 ( 4 )   331 - 334   2020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)  

    AIM: To examine the association between treatment-achieved HbA1c values and incidence of both coronary artery disease (CAD) and severe eye disease with different diabetes treatments. METHODS: Associations of treatment-achieved HbA1c were investigated in various treatment groups [diet only; insulin; sulphonylurea (SU) alone; SU with glinides; and antihyperglycaemic agents other than glinides, SU or insulin] taken from a nationwide claims database of 14,633 Japanese diabetes patients. Cox's regression analysis examined risks over a 5.1-year follow-up. RESULTS: A significant linear trend was associated with HbA1c levels and CAD events in the diet-only group, and CAD risks were significantly higher in insulin and SU groups with HbA1c ≤ 7.0% and > 8.0% than in the diet-only group with HbA1c ≤ 7.0%. In contrast to CAD, a linear association was observed regardless of treatment modality between achieved HbA1c levels and risk of severe diabetic eye disease, but with no significant difference in eye disease risk between groups with HbA1c ≤ 7.0% and 7.1-8.0% in those treated with either SU alone, SU with glinides, or insulin. CONCLUSION: These findings suggest that the relationship between treatment-achieved HbA1c and incidence of both CAD and severe diabetic eye disease differed according to treatment, based on a large-scale real-life database. More research is now needed to confirm these findings and to further investigate the underlying mechanisms.

    DOI: 10.1016/j.diabet.2018.08.009

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  • 指先穿刺による血糖およびHbA1c迅速測定をもちいた糖尿病啓発の取り組み(第2報)

    山田 貴穂, 武田 安永, 池田 和泉, 竹内 瑞希, 國米 純也, 中湊 大成, 滝澤 祥子, 村井 幸四郎, 竹内 亮, 今西 明, 安楽 匠, 岸 裕太郎, 小松 健, 佐藤 隆明, 矢口 雄大, 山田 万祐子, 川田 亮, 金子 正儀, 鈴木 浩史, 松林 泰弘, 藤原 和哉, 岩永 みどり, 鈴木 亜希子, 羽入 修, 曽根 博仁, 新潟県糖尿病協会

    糖尿病   63 ( Suppl.1 )   S - 349   2020年8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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  • 耐糖能別にみた収縮期血圧が冠動脈/脳血管疾患に及ぼす影響の検討

    山田 万祐子, 藤原 和哉, 大澤 妙子, 北澤 勝, 松林 泰弘, 矢口 雄大, 岩永 みどり, 山中 菜詩, 清田 浩康, 山田 貴穂, 小川 渉, 曽根 博仁

    糖尿病   63 ( Suppl.1 )   S - 206   2020年8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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  • 糖尿病の有無別にみた収縮期血圧が透析開始に及ぼす影響

    大澤 妙子, 藤原 和哉, 山田 万祐子, 山本 正彦, 北澤 勝, 松林 泰弘, 岩永 みどり, 清田 浩康, 山田 貴穂, 曽根 博仁

    糖尿病   63 ( Suppl.1 )   S - 172   2020年8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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  • 糖尿病と定期的な運動習慣が要介護発症へ及ぼす影響の検討

    藤原 和哉, 山田 万祐子, 北澤 勝, 松林 泰弘, 矢口 雄大, 八尋 拓也, 筒井 歩, 山田 貴穂, 加藤 公則, 曽根 博仁

    糖尿病   63 ( Suppl.1 )   S - 148   2020年8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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  • 総合体力尺度から作成した体力年齢とメタボリックシンドローム(MetS)との関連

    佐藤 隆明, 藤原 和哉, 山田 万祐子, 矢口 雄大, 北澤 勝, 松林 泰弘, 岩永 みどり, 山田 貴穂, 加藤 公則, 曽根 博仁

    糖尿病   63 ( Suppl.1 )   S - 133   2020年8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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  • スマートフォンを含むスクリーンタイムと小児の生活習慣、食品群別摂取量および肥満との関連

    池田 和泉, 藤原 和哉, 根立 梨奈, 森川 咲子, 石黒 創, 山田 万祐子, 松林 泰弘, 山田 貴穂, 曽根 博仁

    糖尿病   63 ( Suppl.1 )   S - 275   2020年8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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  • 糖尿病の有無別にみた日本人男性におけるBMI・腹囲と冠動脈疾患発症との関連

    上村 和樹, 藤原 和哉, 山田 万祐子, 北澤 勝, 矢口 雄大, 清田 浩康, 山中 菜詩, 松林 泰弘, 山田 貴穂, 児玉 暁, 曽根 博仁

    糖尿病   63 ( Suppl.1 )   S - 229   2020年8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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  • 経口血糖降下薬(OHA)の服薬アドヒアランス(Ad)と血糖コントロールとの関係

    矢口 雄大, 藤原 和哉, 山田 万祐子, 北澤 勝, 金子 正儀, 清田 浩康, 山中 菜詩, 松林 泰弘, 曽根 博仁

    糖尿病   63 ( Suppl.1 )   S - 222   2020年8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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  • 服薬アドヒアランスと下肢切断のリスクとの関連に関する縦断的検討

    金子 正儀, 藤原 和哉, 山田 万祐子, 北澤 勝, 矢口 雄大, 清田 浩康, 山中 菜詩, 松林 泰弘, 曽根 博仁

    糖尿病   63 ( Suppl.1 )   S - 207   2020年8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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  • Combination of diabetes mellitus and lack of habitual physical activity is a risk factor for functional disability in Japanese. 国際誌

    Kazuya Fujihara, Yasuhiro Matsubayashi, Mayuko Harada Yamada, Masaru Kitazawa, Masahiko Yamamoto, Masanori Kaneko, Satoru Kodama, Takuya Yahiro, Ayumu Tsutsui, Kiminori Kato, Hirohito Sone

    BMJ open diabetes research & care   8 ( 1 )   2020年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Declining healthy life expectancy due to functional disability is relevant and urgent because of its association with decreased quality of life and also for its enormous socioeconomic impact. The aim of this study is to examine the impact of diabetes, hypertension, dyslipidemia and physical activity habits on functional disability among community-dwelling Japanese adults. RESEARCH DESIGN AND METHODS: This is a population-based retrospective cohort study including 9673 people aged 39-98 years in Japan (4420, men). Functional disability was defined as a condition meeting Japan's new long-term care insurance certification requirements for the need of assistance in the activities of daily living whether by caregivers or assistive devices. Cox proportional-hazards regression model identified variables related to functional disability. RESULTS: Median follow-up was 3.7 years. During the study period, 165 disabilities occurred in the overall study population. Multivariate analysis showed that diabetes (HR 1.74 (95% CI 1.12 to 2.68)) and no physical activity habit (HR 1.83 (1.27 to 2.65)) presented increased risks for disability. HR for disability increased with the number of risk factors (HR of individuals with four conditions, 3.96 (1.59 to 9.99) vs individuals with none of those conditions as a reference). HR for disability among patients with diabetes with and without a physical activity habit was 1.68 (0.70 to 4.04) and 3.19 (1.79 to 5.70), respectively, compared with individuals without diabetes with a physical activity habit. CONCLUSIONS: The combination of diabetes and lack of habitual physical activity is predictive of functional disability in Japanese. Habitual physical activity attenuates the risk of functional disability in patients with diabetes.

    DOI: 10.1136/bmjdrc-2019-000901

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  • Risk of coronary artery disease according to glucose abnormality status and prior coronary artery disease in Japanese men. 国際誌

    Masaru Kitazawa, Kazuya Fujihara, Taeko Osawa, Masahiko Yamamoto, Mayuko Harada Yamada, Masanori Kaneko, Yasuhiro Matsubayashi, Takaho Yamada, Nauta Yamanaka, Hiroyasu Seida, Hirohito Sone

    Metabolism: clinical and experimental   101   153991 - 153991   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Although glucose abnormality status (GAS), prior coronary artery disease (CAD), and other traditional risk factors affect the incidence of subsequent CAD, their impact in the same cohort has been scantly studied. RESEARCH DESIGN AND METHODS: We analyzed data from a nationwide claims database in Japan that was accumulated during 2008-2016 involving 138,162 men aged 18-72 years. Participants were classified as having normoglycemia, borderline glycemia, or diabetes mellitus (DM) with prior CAD (CAD+) or without prior CAD (CAD-). Cox regression model identified variables related to the incidence of CAD. RESULTS: Among CAD-, management of traditional risks differed from those with and without subsequent CAD events. On the other hand, such differences were weaker in borderline glycemia and DM CAD+, and the influence of traditional risk factors on subsequent CAD was not observed. Cox regression model showed that borderline glycemia and DM confer approximately 1.2- and 2.8-fold excess risks of CAD, respectively, compared with CAD- with normoglycemia. CAD+ confers approximately a 5- to 8-fold increased risk. The impacts of DM and prior CAD additively reached a hazard ratio (HR) of 15.74 (95% confidence interval [CI]: 11.82-21.00). However, the HR in those with borderline glycemia and CAD+ was 7.20 (95% CI: 5.01-10.34), which was not different from those with normoglycemia and CAD+. CONCLUSION: Control status of traditional risk factors and impact on subsequent CAD differ among categories of glycemic status with and without prior CAD. Individualizing treatment strategies is needed in consideration of risk factors, such as GAS and CAD+.

    DOI: 10.1016/j.metabol.2019.153991

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  • Relationship Between Number of Multiple Risk Factors and Coronary Artery Disease Risk With and Without Diabetes Mellitus. 国際誌

    Mayuko Yamada-Harada, Kazuya Fujihara, Taeko Osawa, Masahiko Yamamoto, Masanori Kaneko, Masaru Kitazawa, Yasuhiro Matsubayashi, Takaho Yamada, Nauta Yamanaka, Hiroyasu Seida, Wataru Ogawa, Hirohito Sone

    The Journal of clinical endocrinology and metabolism   104 ( 11 )   5084 - 5090   2019年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To determine the degree of control of multiple risk factors under real-world conditions for coronary artery disease (CAD) according to the presence or absence of diabetes mellitus (DM) and to determine whether reaching multifactorial targets for blood pressure (BP), low-density lipoprotein-cholesterol (LDL-C), HbA1c, and current smoking is associated with lower risks for CAD. METHODS: We investigated the effects on subsequent CAD of the number of controlled risk factors among BP, LDL-C, HbA1c, and current smoking in a prospective cohort study using a nationwide claims database of 220,894 individuals in Japan. Cox regression examined risks over a 4.8-year follow-up. RESULTS: The largest percentage of participants had two risk factors at target in patients with DM (39.6%) and subjects without DM (36.4%). Compared with those who had two targets achieved, the risks of CAD among those who had any one and no target achieved were two and four times greater, respectively, regardless of the presence of DM. The effect of composite control was sufficient to bring CAD risk in patients with DM below that for subjects without DM with any two targets achieved, whereas the risk of CAD in the DM group with all four risk factors uncontrolled was 9.4 times more than in the non-DM group who had achieved two targets. CONCLUSIONS: These findings show that composite control of modifiable risk factors has a large effect in patients with and without DM. The effect was sufficient to bring CAD risk in patients with DM below that in the non-DM group who had two targets achieved.

    DOI: 10.1210/jc.2019-00168

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  • 大血管障害 糖尿病、非糖尿患者における血糖・血圧・脂質・喫煙の管理目標の達成状況と冠動脈疾患発症の関連

    山田 万祐子, 藤原 和哉, 大澤 妙子, 山本 正彦, 石澤 正博, 金子 正儀, 松林 泰弘, 清田 浩康, 山田 貴穂, 曽根 博仁

    糖尿病合併症   33 ( Suppl.1 )   241 - 241   2019年9月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病合併症学会  

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  • 眼科処置を要する重症糖尿病性眼疾患発生リスクと血液学的因子の関係についての検討

    山本 正彦, 藤原 和哉, 大澤 妙子, 山田 万祐子, 石澤 正博, 石黒 創, 鈴木 浩史, 松林 泰弘, 児玉 暁, 長谷部 日, 曽根 博仁

    糖尿病合併症   33 ( Suppl.1 )   263 - 263   2019年9月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病合併症学会  

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  • 大血管障害 耐糖能状態及び心血管疾患既往の有無で層別化した、心血管疾患発症リスクの検討

    北澤 勝, 藤原 和哉, 山田 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

    糖尿病合併症   33 ( Suppl.1 )   242 - 242   2019年9月

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    記述言語:日本語   出版者・発行元:(一社)日本糖尿病合併症学会  

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  • Higher pulse pressure predicts initiation of dialysis in Japanese patients with diabetes. 国際誌

    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)  

    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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  • The Combination of Canagliflozin with a Half-Dose of Glimepiride Improves Glycemic Control and Blood Glucose Perturbation without Increasing the Risk of Hypoglycemia and Ketosis

    Mayuko Harada, Yasuhisa Abe, Yuki Maeda, Michiko Kajikawa, Mitsuru Hashiramoto

    International Journal of Diabetes and Clinical Research   3 ( 3 )   2016年12月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:ClinMed International Library  

    DOI: 10.23937/2377-3634/1410065

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MISC

  • 経口血糖降下薬(OHA)の服薬アドヒアランスに関連する因子および血糖コントロールとの関連

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

    日本内分泌学会雑誌   97 ( 1 )   2021年

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  • 糖尿病,非糖尿患者における血糖・血圧・脂質・喫煙の管理目標の達成状況と冠動脈疾患発症の検討

    藤原和哉, 山田万祐子, 石澤正博, 山本正彦, 清田浩康, 山中菜詩, 児玉暁, 曽根博仁

    日本疫学会学術総会講演集(Web)   30th   2020年

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受賞

  • 令和2年 新潟大学学生表彰

    2020年3月  

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  • 令和元年度新潟大学国際会議研究発表支援事業

    2019年6月  

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  • 平成30年度長寿科学関連国際学会派遣事業

    2018年10月  

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  • 平成30年度新潟大学国際会議研究発表支援事業

    2018年6月  

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