All issues
Volume 39, Issue 4
Displaying 1-8 of 8 articles from this issue
- |<
- <
- 1
- >
- >|
-
Satoshi Tsukui, Setsuko Oshitani, Yukihito Fukumura, Susumu Toida, Mak ...1996 Volume 39 Issue 4 Pages 241-246
Published: April 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe associations between glycosylated hemoglobin (HbA1c), fructosamine (FRA), and 1, 5-anhydroglucitol (1, 5-AG) as screening tests for diabetes mellitus and risk factors for the disease were assessed. A 75 g oral glucose tolerance test based on WHO criteria was performed and Hb A1c, FRA, and 1, 5-AG were measured in 401 subjects. Multivariate logistic regression analysis was used to evaluate the effect of age and body mass index (BMI) on the probability of having diabetes for each test and to calculate the predicted values individually. Receiver operating characteristic (ROC) curves for the three tests and for three logistic models were constructed and the areas under ROC curves for the data obtained were calculated. Although the area under the ROC curve for each logistic model was slightly higher than that for the corresponding single test, statistical analysis did not show significance. However, the ROC curves indicated that the specificities of each logistic model were significantly higher than those of the corresponding single test, when screening levels were selected for sensitivities above 80%. These results suggest that age and BMI improve the diagnostic accuracy of HbA1c, FRA, and 1, 5-AG for diabetes screening.View full abstractDownload PDF (687K) -
(2) Risk Factors Related to the Prognosis of Diabetic PatientsAkira Sasaki, Masuko Uehara, Naruto Horiuchi, Kyoichi Hasegawa, Takao ...1996 Volume 39 Issue 4 Pages 247-253
Published: April 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSRisk factors related to the prognosis of diabetic patients were assessed in a follow-up study of 1, 939 NIDDM patients, with mean observation period of 15years, in our institute. The odds ratios of mortality computed in relation to baseline factors were significantly increased in male patients, patiens entering the study alter 45 years, of age fasting glucose level greater than 140mg/dl, hypertension, ischemic ECG changes, diabetic retinopathy, proteinuria, oral hypoglycemic agent treatment and insulin treatment. The baseline factors were compared between patients who were alive versus deceased at the end of follow-up. Older age at onset and at entry, higher values of fasting glucose, systolic and diastolic blood pressures, and an increase in male patients, patients with ischemic ECG changes, diabetic retinopathy, proteinuria, oral hypoglycemic agent treatment and insulin treatment were observed in the deceased patients. Furthermore, multiple logistic analysis indicated significant relations of age at entry, fasting glucose level, hypertension, retinopathy, proteinuria and therapeutic regimen to prognosis. Furthermore, it was found that the baseline factors predictive of the prognosis were different in each age group.View full abstractDownload PDF (946K) -
Yuichi Shiba1996 Volume 39 Issue 4 Pages 255-263
Published: April 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo develop a systematic method for the measurement of glucose turnover using stable isotope labeled glucose, fragmentation pathway of differential species of glucose labeled with 13C or 2H was analyzed by gas chromatography/mass spectrometry (GC/MS). Among the various methods for derivatizing glucose, trifluoroacetylation of glucose was demonstrated to be most suitable for the systemic tracer dilution study because of reasonable stability of isotopic peak ratios and strong ion peaks of high mass area. Under euglycemic hyperinsulinemic clamp conditions with four different insulin infusion rates, glucose turnovers were determined using [6, 6-2H2]-glucose as a tracer in normal conscious male Sprague-Dawley rats. The mean hepatic glucose production rate during the basal state was 7.2mg/kg. min. The maximal glucose uptake response of the peripheral tissues to insulin during the clamp was 42.1mg/kg. min and the arterial plasma insulin level at EC50 was 45μ/ml. HGP was almost completely suppressed at a plasma insulin level of 100μU/ml. These findings are corsistent with those of previous reports using radioisotopes as traceris. Thus, the stable isotope technique in which trifluoroacetylated glucose is analyzed on GC/MS may serve as a useful method for studying glucose metabolism in vivo.View full abstractDownload PDF (1353K) -
Yoshimasa Tasaka, Fumio Nakaya, Yasue Omori1996 Volume 39 Issue 4 Pages 265-269
Published: April 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe effects of calcium on fasting serum insulin (IRI) and glucose levels were compared in 3 patients with insulinoma and 4 control non-insulinoma subjects (reactive hypoglycemia). Calcium was administered intravenously as a rapid calcium infusion test (RCI; Ca 2mg/kg body weight in 1 minute). In control subjects, the RCI test produced a rise in mean serum IRI from a basal 9.7±1.8μU/ml to a peak of 14.4±4.4μU/ml. In the patients with insulinoma, the RCI test resulted in a rapid increase in mean serum IRI from 12.9±1.7μU/ml. to a peak level of 47.7±8.8μU/ml. Serum ΣΔIRI (30')(net cumulative IRI value from 0 to 30 min) values in the 2 groups were compared. Significantly high levels were found in patients with insulinoma (91.1±26.0 vs 7.3±3.8μU/ml; p<0.01). These data show that the RCI test is a useful diagnastic test for insulinoma.View full abstractDownload PDF (824K) -
Hirosi Matuba1996 Volume 39 Issue 4 Pages 271-281
Published: April 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo elucidate the role of insulin receptor abnormality on the pathogenesis of non-insulin dependent diabetes mellitus (NIDDM), the autophosphorylative activity of erythrocyte insulin receptors was measured by a newly developed sandwich assay. Of 124 subjects who had a basal immunoreactive insulin level above 15μU/ml, five families were identified as insulin receptor kinase deficient. Two of these families were extensively studied by using a 75-g oral glucose tolerance test (OGTT). In these two families, the insulin receptor abnonmality was almost identical among family members, but family members exhibited different patterns of glucose levels in the OGTT. The subjects who showed a diabetic pattern in the OGTT were chanacterized by a deficiency of initial insulin secretion (ΔIRI/ΔBS at 30min less than 0.2). These results suggest that the incidence of a genetic insulin receptor abnormality in the NIDDM patients with basal hyperinsulinemia is around 5%. Moneover, simple insulin resistance may not be sufficient to cause clinically overt diabetes mellitus.View full abstractDownload PDF (1634K) -
Masahiko Kato, Yuri Ono, Hideki Hozen, Satoru Kadota1996 Volume 39 Issue 4 Pages 283-288
Published: April 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report herein the first observation of biopsy-proved rhabdomyolysis associated with macro-creatine kinase (macroCK) type 1 in a patient with diabetic nephrotic syndrome. A 42-year-old man with advanced chmonic complications of diabetes was admitted to the hospital with an episode of severe systemic edema caused by diabetic nephrotic syndrome. The patient was found to have elevated serum CK (2499IU/l, MM 89%), aldolase (25.1IU/l) and myoglobin (≥500ng/ml) levels. None of the known predisposing factors for rhabdomyolysis were present in this patient. Muscle biopsy showed rhabdomyolysis and muscle changes. The latter included both neurogenic and myogenic changes. Therapy for the nephrotic syndmome had not only decreased his body weight and edema but also serum enzyme levels. We speculate that subclinical muscle changes caused by diabetic neuromyopathy and general arteriosclerosis with excess interstitial edema caused rhabdomyolysis. Furthermore, macroCK was detected by gel electrophoresis as an atypical band between CK-MM and CK-MB and identified by immunofixation electrophoresis as containing CK isoenzymes MM and immunoglobulin A (λ).View full abstractDownload PDF (3062K) -
Hiroaki Seino, Akihiko Hirata, Hirosi Yamaguchi, Tosio Yamazaki, Hiroa ...1996 Volume 39 Issue 4 Pages 289-293
Published: April 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 69-year old male was first admitted to our hospital at age 49 years, in May 1976, complaining of positive urinary glucose. The first examination in our hospital demonstrated a fasting plasma glucose level of 139mg/dl while urinary ketones were negative. After discharge, the patient maintained good glycemic control with a diet of 1760 kcal/day and oral glybuzole (125mg/day). Good plasma glucose was maintained up to January of 1977.
In February of the same year, glycemic control deteriorated and insulin treatment was started with eight units of lente insulin every morning. The highest plasma CPR value was 1.1ng/ml in response to a 75g oral glucose tolerance test conducted in 1981. Five years after the diagnosis of diabetes mellitus, endogenous insulin secretion capacity had significantly decreased. ICA were negative while anti-GAD Abs were positive with a value of 63au/ml (normal value: less than 35au/ml) in 1995.
Considering the progression of β cell dysfunction during observation, the clinical characteristics of this patient appear to be compatible with slowly progressive IDDM. It is noteworthy that anti-GAD antibody was still positive 20 years after the diagnosis of diabetes.View full abstractDownload PDF (655K) -
1996 Volume 39 Issue 4 Pages 295-315
Published: April 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (5309K)
- |<
- <
- 1
- >
- >|