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ABSTRACT: Recent studies suggested that home arterial stiffness index (HASI) may be a new measure of arterial stiffness. The aim of this study was to investigate whether HASI is more strongly associated with arterial stiffness than is pulse pressure (PP) and thus a more suitable tool than PP for evaluating arterial stiffness in patients with type 2 diabetes. We evaluated the relationship of HASI or PP with pulse wave velocity (PWV) as well as with major cardiovascular risk factors in 332 patients with type 2 diabetes. Furthermore, we compared the area under the receiver-operator characteristic curve (AUC) of HASI or PP for PWV. Morning PP was positively associated with PWV (r=0.303, P<0.0001), while morning HASI was not (r=-0.006, P=0.9063). Multiple regression analysis demonstrated that morning PP (β=0.179, P=0.0210), but not morning HASI (β=-0.040, P=0.5036), was independently associated with PWV. The AUCs (95% confidence interval (CI)) of morning HASI and morning PP for arterial stiffness were 0.510 (0.448-0.573) (P=0.745) and 0.638 (0.578-0.698) (P<0.0001), respectively. The AUC (95% CI) of morning HASI for arterial stiffness was significantly less than that of morning PP (P=0.0005). In conclusion, morning HASI is less correlated with PWV than is morning PP in patients with type 2 diabetes.Hypertension Research advance online publication, 14 February 2013; doi:10.1038/hr.2013.4.
Hypertension Research 02/2013; · 2.58 Impact Factor
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ABSTRACT: Recent studies have suggested that not only mean blood pressure but also variability in blood pressure might be related to cardiovascular disease. The aim of this study was to investigate the association between home blood pressure variability on one occasion and markers of arterial stiffness in patients with type 2 diabetes. We investigated the relationship between the s.d. of clinic- or home-measured systolic blood pressure on one occasion and pulse wave velocity (PWV) in 332 patients with type 2 diabetes, and we evaluated whether the SD of clinic- or home-measured systolic blood pressure on one occasion was an independent determinant of PWV by multivariate linear regression analysis, after adjustment for known risk factors for arterial stiffness, including sex, age, duration of diabetes, body mass index, hemoglobin A1c, serum total cholesterol, triglycerides, smoking status, drinking alcohol, presence of antihypertensive medication, average systolic blood pressure and heart rate. Age, average morning home-measured systolic blood pressure, heart rate and PWV (r=0.259, P<0.0001) were positively correlated with the s.d. of morning home blood pressure on one occasion. Multiple regression analysis demonstrated that age, average morning home-measured systolic blood pressure (P=0.0019), heart rate and the s.d. of morning home-measured systolic blood pressure on one occasion (P=0.0159) were independently associated with PWV. In conclusion, home blood pressure variability on one occasion was correlated with PWV, independent of other known risk factors, in Japanese patients with type 2 diabetes.Hypertension Research advance online publication, 25 October 2012; doi:10.1038/hr.2012.177.
Hypertension Research 10/2012; · 2.58 Impact Factor
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ABSTRACT: It is important to control blood pressure as well as to control blood glucose for the prevention of diabetic nephropathy. However, to our knowledge, there are no reports investigating which blood pressure, including morning, evening and clinic, is more closely associated with albuminuria and whether one measurement is sufficient or not in patients with Type 2 diabetes.
We measured morning, evening and clinic blood pressure and compared the area under the curve (AUC) of blood pressure for urinary albumin excretion equal to or more than 30 mg/g creatinine using receiver-operating characteristic curve analyses and odds ratio for albuminuria defined as urinary albumin excretion equal to or more than 30 mg/g creatinine in 858 patients with Type 2 diabetes.
Odds ratio (95% confidence interval (CI)) of morning, evening and clinic systolic blood pressure for albuminuria was 1.034 (1.024 - 1.044), 1.033 (1.023 - 1.043) and 1.013 (1.055 - 1.021), respectively (p < 0.001 in all), and AUC of morning, evening and clinic systolic blood pressure was 0.644 (0.628 - 0.700) (p < 0.001 vs. clinic), 0.660 (0.623 - 0.696) (p < 0.001 vs. clinic) and 0.597 (0.559 - 0.636), respectively. AUC of the second morning systolic blood pressure was greater than the first (p = 0.033).
The second measurement of morning systolic blood pressure is more closely associated with albuminuria than the first measurement of the morning in addition to clinic systolic blood pressure.
Clinical nephrology 08/2012; 78(2):129-34. · 1.17 Impact Factor
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Emi Ushigome,
Michiaki Fukui,
Kazumi Sakabe,
Muhei Tanaka,
Shinobu Inada,
Atsushi Omoto, Toru Tanaka,
Wataru Fukuda,
Haruhiko Atsuta,
Masayoshi Ohnishi,
Shin-Ichi Mogami,
Yoshihiro Kitagawa,
Yohei Oda,
Masahiro Yamazaki,
Goji Hasegawa,
Naoto Nakamura
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ABSTRACT: The purposes of this study were to investigate the state of blood pressure control level and to investigate the relationship between blood pressure control level and nephropathy in Japanese type 2 diabetes. We measured clinic and home blood pressure in 923 type 2 diabetic patients. According to the criteria for hypertension in the Japanese Society of Hypertension Guidelines 2009, patients were classified into four groups by clinic systolic blood pressure (130 mmHg) and morning systolic blood pressure (125 mmHg), as follows: controlled hypertension (CH), white-coat hypertension (WCH), masked hypertension (MH), and sustained hypertension (SH). Of all patients, 13.9, 12.6, 13.3, and 60.2% were identified as having CH, WCH, MH, and SH, respectively. The average number of drugs prescribed was 1.8. We assessed the association between blood pressure control level and nephropathy in diabetic patients. The degree of urinary albumin excretion and the prevalence of nephropathy in diabetic patients were higher in MH and SH groups than those in the CH group. The majority of patients had poor blood pressure control, regardless of ongoing conventional antihypertensive therapy, and diabetic patients with MH and SH were associated with nephropathy. It is suggested that more aggressive antihypertensive treatment is recommended to prevent nephropathy in diabetic patients.
Heart and Vessels 01/2011; 26(6):609-15. · 2.05 Impact Factor
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ABSTRACT: This cross-sectional study was done to show how nutritional indices influence each other and the contributions made by inflammation to the development of rheumatoid cachexia. We studied 295 female patients with rheumatoid arthritis (RA). We chose five nutritional indices: body mass index (BMI), arm muscle area (AMA), triceps skinfold thickness (TSF), which were obtained via anthropometric measurements, and serum albumin and cholesterol. Clinical indicators of RA included disease duration, C-reactive protein (CRP) and Disease Activity Score 28 (DAS28). We performed a bivariate correlation test between the nutritional indices and multiple regression analysis for each nutritional index. Mean AMA was low, 87.3% of the normal value, whereas TSF was not different. Muscle protein expressed by AMA decreased according to RA duration, whereas visceral protein indicated by serum albumin decreased with an increase in RA activity. The continuation of inflammation appears to be essential for a decrease in muscle protein in rheumatoid cachexia. DAS28 showed a positive contribution to BMI in the regression model, and the increase in RA disease activity causes an increase in BMI via an accumulation of tissue fat.
Modern Rheumatology 10/2010; 20(5):439-43. · 1.58 Impact Factor
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Goji Hasegawa,
Shizuo Kajiyama, Toru Tanaka,
Saeko Imai,
Hana Kozai,
Aya Fujinami,
Mitsuhiro Ohta,
Hiroshi Obayashi,
Hyohun Park,
Koji Nakano,
Muhei Tanaka,
Emi Shiraishi,
Michiaki Fukui,
Toshikazu Yoshikawa,
Naoto Nakamura
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ABSTRACT: Several epidemiological studies have shown that postprandial hyperglycemia is associated with an increased risk of cardiovascular disease (CVD). The present study was conducted in order to compare the effects of acarbose and glimepiride treatment on serum lipoprotein profiles in patients with type 2 diabetes.
A total of 37 patients with newly diagnosed type 2 diabetes were studied. The patients were assigned randomly to treatment for 12 weeks with either acarbose (n=13, 100 mg x 3/day, group A), glimepiride (n=13, 2 mg/day, group G) or diet only (n=11, group D). Lipid and lipoprotein profiles before and after each treatment were evaluated.
A significant reduction in the net electronegative charge of low-density lipoprotein (emLDL) was observed in group A (-1.8, P<0.01), whereas no significant change in emLDL was observed in groups G and D. In group A, small VLDL and very small LDL levels were also decreased significantly (P<0.05). The change in emLDL levels correlated significantly with changes in very small LDL (r=0.751, P<0.01) and oxidized LDL levels (r=0.623, P<0.05).
These results suggest that measurement of serum emLDL may be a sensitive and clinically useful marker for determining qualitative lipoprotein abnormalities in diabetes, and that acarbose treatment lowers CVD risk by decreasing production of emLDL.
Clinica Chimica Acta 05/2008; 390(1-2):110-4. · 2.54 Impact Factor
