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Ōsaka, Japan

Koga M.,Kinki Central Hospital | Kasayama S.,Nissay Hospital
Endocrine Journal | Year: 2010

It is known that glycation among various proteins is increased in diabetic patients compared with non-diabetic subjects. Currently, among these glycated proteins, glycated hemoglobin (HbA 1C) is used as the gold standard index of glycemic control in clinical practice for diabetes treatment. However, HbA 1C does not accurately reflect the actual status of glycemic control in some conditions where plasma glucose changes during short term, and in patients who have diseases such as anemia and variant hemoglobin. In comparison, another index of glycemic control, glycated albumin (GA), more accurately reflects changes in plasma glucose during short term and also postprandial plasma glucose. Although GA is not influenced by disorders of hemoglobin metabolism, it is affected by disorders of albumin metabolism. This review summarizes diseases and pathological conditions where GA measurement is useful. These include the status of glycemic control changes during short term, diseases which cause postprandial hyperglycemia, iron deficiency anemia, pregnancy, chronic liver disease (liver cirrhosis), chronic renal failure (diabetic nephropathy), and variant hemoglobin. © The Japan Endocrine Society. Source

Koga M.,Kawanishi City Hospital | Hirata T.,Foundation for Biomedical Research and Innovation | Kasayama S.,Nissay Hospital | Ishizaka Y.,Center for Multiphasic Health Testing and Services | Yamakado M.,Center for Multiphasic Health Testing and Services
Clinica Chimica Acta | Year: 2015

Background: Glycated albumin (GA) is known to be negatively regulated by body mass index (BMI) in non-diabetic subjects and patients with type 2 diabetes mellitus (T2DM). In non-diabetic subjects, a mechanism has been proposed in which chronic inflammation associated with obesity increases albumin metabolism and negatively regulates GA levels. However, whether this same mechanism exists in T2DM is unclear. We investigated the factor(s) which influence GA levels in T2DM patients. Methods: This study included 179 T2DM patients from among people undergoing complete medical examinations. Correlations between GA and the following variables were examined among fasting samples for T2DM patients: BMI, C-reactive protein (CRP), homeostasis model assessment for β-cell function (HOMA-β) and homeostasis model assessment for insulin resistance (HOMA-R). Results: BMI was significantly positively correlated with CRP, but CRP was not significantly correlated with GA. HOMA-β was significantly positively correlated with BMI and significantly negatively correlated with GA. Multivariate analysis showed that HOMA-β was a significant explanatory variable for GA, but not CRP and HOMA-R. Conclusions: Our findings suggest that insulin secretion plays a greater role than chronic inflammation in the mechanism by which BMI negatively regulates GA in T2DM patients. © 2014 Elsevier B.V. Source

Miyazaki A.,Osaka Medical College | Kohzuma T.,Asahi Kasei Corporation | Kasayama S.,Nissay Hospital | Koga M.,Kinki Central Hospital
Annals of Clinical Biochemistry | Year: 2012

Background: Asymptomatic variant haemoglobin is increasingly being found in the measurement of glycated haemoglobin (HbA1c) for the management of diabetes mellitus. We compared the Hb1c concentrations measured by high-performance liquid chromatography (HPLC) and immunoassay and glycated albumin (GA) concentrations and calculated the respective ratios in order to classify the variant haemoglobin. Methods: Twenty different haemoglobin variants from 43 subjects were identified by mass spectrometry and DNA analysis. Since GA accurately reflects glycaemic control in patients with variant haemoglobin, we calculated respective ratios of Hb1c and GA. Haemoglobin variants causing a low ratio of Hb1c measured by HPLC (HPLC-Hb1c) to GA with a normal ratio of Hb1c measured by immunoassay (IA-Hb1c) to GA were classified as C1. A further classification of α and β was used with abnormalities of the α chain or β chain in the haemoglobin gene. Other haemoglobin variants were classified as non- C1. Eight diabetic patients with stable glycaemic control were used as controls. Results: Twenty forms of variant haemoglobins were classified as C1α(2 variants; I-Interlaken and Hb J-Meerut), C1β (15 variants) and non-C1 (3 variants; Hb Himeji, Hb Woolwich, Hb Peterborough). Positive correlations between GA and HPLCHb1c or IA-Hb1c were seen in the C1β patients with diabetes mellitus. The regression line between GA and HPLC-Hb1c, but not that betweenGAand IA-Hb1c, showed a downward shift in comparison with the data obtained fromthe diabetic controls. Conclusions: Variant haemoglobin could be classified by calculating the ratios of HPLC-Hb1c, IA-Hb1c and GA. Source

Koga M.,Kinki Central Hospital | Murai J.,Kinki Central Hospital | Saito H.,Kinki Central Hospital | Kasayama S.,Nissay Hospital
Diabetes Care | Year: 2010

OBJECTIVE- Glycated albumin (GA) relative to A1C is a useful marker of short-term glycemic control. We investigated whether endogenous insulin secretion in type 2 diabetes has different effects on GA and A1C levels. RESEARCH DESIGN AND METHODS- A1C, GA, and GA-to-A1C ratio were compared in 202 type 2 diabetic patients by type of treatment. Effect of β-cell function determined by homeostasis model assessment (HOMA-%β) on GA-to-A1C ratio was examined. In addition, GA-to-A1C ratio was compared between type 2 diabetic patients and 16 patients with type 1 diabetes. RESULTS- In type 2 diabetic patients, GA-to-A1C ratio was significantly higher in those treated with insulin than in those treated with diet or oral hypoglycemic agents. HOMA-%β showed a significant inverse correlation with GA-to-A1C ratio. This ratio was higher in type 1 diabetic patients than in type 2 diabetic patients. CONCLUSIONS- In diabetic patients with decreased insulin secretion, serum GA levels are higher relative to A1C. © 2010 by the American Diabetes Association. Source

Kawada N.,Nissay Hospital | Tanaka S.,Japan National Cardiovascular Center Research Institute
World Journal of Gastroenterology | Year: 2016

Elastography for the pancreas can be performed by either ultrasound or endoscopic ultrasound (EUS). There are two types of pancreatic elastographies based on different principles, which are strain elastography and shear wave elastography. The stiffness of tissue is estimated by measuring the grade of strain generated by external pressure in the former, whereas it is estimated by measuring propagation speed of shear wave, the transverse wave, generated by acoustic radiation impulse (ARFI) in the latter. Strain elastography is difficult to perform when the probe, the pancreas and the aorta are not located in line. Accordingly, a fine elastogram can be easily obtained in the pancreatic body but not in the pancreatic head and tail. In contrast, shear wave elastography can be easily performed in the entire pancreas because ARFI can be emitted to wherever desired. However, shear wave elastography cannot be performed by EUS to date. Recently, clinical guidelines for elastography specialized in the pancreas were published from Japanese Society of Medical Ultrasonics. The guidelines show us technical knacks of performing elastography for the pancreas. © The Author(s) 2016. Source

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