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Nakajima K.,Josai University | Nakajima K.,Social Insurance Omiya General Hospital | Hirose K.,Josai University | Ebata M.,Josai University | And 2 more authors.
British Journal of Nutrition | Year: 2010

Habitual coffee consumption is associated with the prevention of type 2 diabetes, which often accompanies diabetic nephropathy. However, the relationship between coffee consumption and kidney function is unclear. Therefore, we investigated the associations between habitual coffee consumption and kidney function and damage assessed by the estimated glomerular filtration rate (eGFR) and proteinuria using dipstick urinalysis, respectively, in a cross-sectional study of 342 apparently healthy adults. Habitual coffee consumption was defined as drinking one or more cups of coffee per d. eGFR in coffee consumers (n 182; 801 (sd 150) ml/min per 173m2) was significantly higher than that in non-coffee consumers (n 160; 769 (sd 126) ml/min per 173m2) (P<005). Multivariate logistic analysis showed that, compared with non-coffee consumption, coffee consumption was significantly associated with normal or increased eGFR (NIGFR) (90ml/min per 173m 2), but not proteinuria, which was not attenuated, even after adjustment for age, sex, smoking, tea consumption and other cardiovascular risks (OR 291; 95% CI 151, 561; P=0001). When we took into account eGFR measured 1 year before in a subgroup of the subjects (n 262), coffee consumption (n 142) had a significant relationship with eGFR, which was consistently higher with a difference of 40ml/min per 173m2 compared with non-coffee consumption (P=001; two-way repeated ANOVA). Similar associations were observed in both sexes when data were reanalysed according to sex. In conclusion, our findings suggest that habitual coffee consumption is associated with NIGFR independently of clinical confounders. Further studies are needed to confirm this association and to explore whether the effect of coffee consumption on eGFR is beneficial for the kidney. © 2009 The Authors.


Nakajima K.,Josai University | Nakajima K.,Social Insurance Omiya General Hospital | Nemoto T.,Josai University | Muneyuki T.,Jichi Medical University | And 3 more authors.
Cardiovascular Diabetology | Year: 2011

Background: Low serum amylase levels may reflect impaired exocrine-endocrine relationship in the pancreas. However, few clinical studies have addressed this issue. Therefore, in this epidemiological study, we investigated whether low serum amylase was associated with the pathogenesis of impaired insulin action: metabolic syndrome (MetS) and diabetes.Research Design and Methods: Serum amylase, cardiometabolic risk factors, MetS (Adult Treatment Panel III criteria), and diabetes were examined in 2,425 asymptomatic subjects aged 30-80 years who underwent medical checkups recently (April 2009-March 2010) and 5 years ago.Results: Clinical variables, except for age and estimated glomerular filtration rate (eGFR), shifted favorably with increasing serum amylase levels. Plasma glucose levels at 1- and 2-hr during OGTT increased significantly with decreasing serum amylase levels. Multiple logistic analyses showed that, compared with highest quartile of serum amylase, lowest quartile was associated with increased risk for MetS and diabetes after adjustment for confounding factors [odds ratio (95% CI), 2.07 (1.39-3.07) and 2.76 (1.49-5.11), respectively]. In subjects who underwent checkups 5 years ago (n = 571), lower amylase at the previous checkup were associated with larger numbers of metabolic abnormalities at the recent checkup. The fluctuation over time in serum amylase levels in subjects with low serum amylase at the previous checkup was slight and was unaffected by kidney dysfunction.Conclusions: Our results indicate that low serum amylase is associated with increased risk of metabolic abnormalities, MetS and diabetes. These results suggest a pancreatic exocrine-endocrine relationship in certain clinical conditions. © 2011 Nakajima et al; licensee BioMed Central Ltd.


Nakajima K.,Josai University | Nakajima K.,Social Insurance Omiya General Hospital | Oshida H.,Josai University | Muneyuki T.,Jichi Medical University | And 5 more authors.
BMJ Open | Year: 2013

Objectives: Low serum amylase (LSA) was reported to be associated with obesity, metabolic syndrome (MetS) and diabetes. However, it is unknown as to whether LSA is associated with non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of MetS and insulin resistance. Therefore, we performed a clinical epidemiological study to investigate this potential association. Design: A cross-sectional observational study with multivariate analysis. Setting: Subjects were recruited in a healthcare centre in Saitama, an eastern district of Japan, near Tokyo. Participants: A total of 1475 asymptomatic adults aged 30-79 years who underwent detailed medical check-ups and who regularly consumed small amounts of alcohol (<20 g/day). Outcome measures: Serum amylase, cardiometabolic risk factors, NAFLD determined by ultrasound, MetS determined by Adult Treatment Panel-III criteria and diabetes were assessed. Results: The prevalence of NAFLD increased significantly from 22.5% to 42.4% (all grades) and from 9.2% to 24.0% (moderate or severe grade) from the highest to the lowest quartile of serum amylase. Multiple logistic regression analysis showed that, compared with the highest quartile of serum amylase, the lowest quartile of serum amylase was significantly associated with any-grade NAFLD and with moderateto-severe NAFLD, even after adjusting for MetS or diabetes. The association between LSA and any-grade NAFLD disappeared after further adjustment for body mass index or waist circumference, whereas the association between LSA and moderate or severe NAFLD remained statistically significant (ORs (95%CI), 2.01 (1.07 to 3.78) and 2.06 (1.09 to 3.87), respectively, both p=0.01). Conclusions: Our results suggest that LSA may be associated with moderate or severe NAFLD in asymptomatic adults independent of MetS, diabetes and obesity. These results warrant confirmation in further studies.


Li Y.,Josai University | Saito M.,Josai University | Tobimatsu S.,Josai University | Oshida H.,Josai University | And 5 more authors.
Diabetes Research and Clinical Practice | Year: 2013

Diabetes and metabolic syndrome are associated with impaired lung function. However, it is unknown whether this is also true in prediabetes. In a cross-sectional study of 1237 asymptomatic adults, we found that diabetes and prediabetes were both significantly associated with low vital capacity, even after adjustment for relevant confounding factors. © 2013 Elsevier Ireland Ltd.


Muneyuki T.,Jichi Medical University | Nakajima K.,Josai University | Nakajima K.,Social Insurance Omiya General Hospital | Aoki A.,Jichi Medical University | And 8 more authors.
Cardiovascular Diabetology | Year: 2012

Background: Low serum amylase is likely to be associated with obesity and metabolic abnormalities, which are often accompanied by impaired insulin action. However, it is unclear whether low serum amylase is associated with impaired insulin action in clinical settings. Therefore, we investigated the associations of low serum amylase with plasma insulin levels, and obesity-related parameters, including leptin.Research design and methods: We measured serum amylase, plasma insulin, obesity-related parameters such as leptin, cardiometabolic risk factors, and anthropometric parameters in a cross-sectional study of 54 asymptomatic subjects (mean age 48.6 ± 7.6 years) who were not being treated for diabetes.Results: Body mass index (BMI) and plasma glucose at 120 min after a 75-g oral glucose tolerance test (OGTT) were significantly higher in subjects with low serum amylase (< 60 IU/l, n = 21) than in those with normal-to-high serum amylase (n = 33) (P = 0.04 and P = 0.004, respectively). In univariate correlation analysis, serum amylase was significantly correlated with BMI alone (r = -0.39, P = 0.004). By contrast, multivariate logistic analysis showed that each 1-SD increase in quantitative insulin sensitivity check index, and each 1-SD decrease in plasma insulin OGTT at 0 and 60 min, homeostasis model assessment of insulin resistance (HOMA)-R, and HOMA-β were significantly associated with low serum amylase, particularly after adjusting for BMI. When subjects were divided into three groups according to HOMA-R, serum amylase levels were significantly lower in subjects with HOMA-R > 2.5 (n = 23) compared with subjects with HOMA-R 1.6-2.5 (n = 10) (61.1 ± 13.6 U/ml versus 76.9 ± 20.5 U/ml, Bonferroni test, P = 0.02), but not compared with subjects with HOMA-R<1.6 (n = 21; 62.7 ± 17.6 U/ml). Similar trends were observed when subjects were divided according to plasma leptin and fasting plasma insulin levels.Conclusions: These results suggest that after adjusting for BMI, low serum amylase is associated with decreased basal insulin levels and insulin secretion, as well as high insulin resistance. The nature of these associations remains to be elucidated in further studies. © 2012 Muneyuki et al.


Nakajima K.,Josai University | Nakajima K.,Social Insurance Omiya General Hospital | Li Y.,Josai University | Fuchigami H.,Social Insurance Omiya General Hospital | Munakata H.,Social Insurance Omiya General Hospital
Pulmonary Medicine | Year: 2012

Studies have shown that low forced vital capacity (LFVC) is associated with atherosclerosis. However, it is unclear whether LFVC is associated with resting electrocardiographic ST-T abnormalities, a common finding that is prognostic for cardiovascular events. Therefore, pulmonary functions, ST-T abnormalities defined with Minnesota Code, and cardiometabolic risk factors were examined in a cross-sectional study of 1,653 asymptomatic adults without past history of coronary heart diseases. The prevalence of diabetes, metabolic syndrome, and ST-T abnormalities significantly increased with decreasing percent of predicted forced vital capacity (%PFVC). ST-T abnormalities were observed in 73 subjects (4.4% in total). Multiple logistic regression analysis showed that, compared with the highest quartile of %PFVC (≥99.7%), the lowest quartile of %PFVC (≤84.2%) was persistently associated with ST-T abnormalities even after further adjustment for diabetes or metabolic syndrome (odds ratio (95%CI): 2.44 (1.16-5.14) and 2.42 (1.15-5.10), resp.). Similar trends were observed when subjects were divided into quartiles according to percent of predicted forced expiratory volume in 1 second (FEV1), but not the ratio of FEV1/FVC. In conclusion, LFVC may be associated with ST-T abnormalities independent of metabolic abnormalities in asymptomatic adults, suggesting a plausible link between impaired pulmonary defects and cardiovascular diseases. Copyright © 2012 Kei Nakajima et al.


Nakajima K.,Josai University | Nakajima K.,Social Insurance Omiya General Hospital | Muneyuki T.,Jichi Medical University | Munakata H.,Social Insurance Omiya General Hospital | Kakei M.,Jichi Medical University
BMC Research Notes | Year: 2011

Background: The pancreas has dual functions as a digestive organ and as an endocrine organ, by secreting digestive enzymes and endocrine hormones. Some early studies have revealed that serum amylase levels are lower in individuals with chronic pancreatitis, severe long-term type 2 diabetes or type 1 diabetes. Regarding this issue, we recently reported that low serum amylase levels were associated with metabolic syndrome and diabetes in asymptomatic adults. In the light of this, we further investigated the fundamental relationship between serum amylase and cardiometabolic aspects by reanalyzing previous data which comprised subjects without diabetes treatment with oral hypoglycemic drugs or insulin (n = 2,344). Findings. Serum amylase was inversely correlated with body mass index independently of age. Higher serum amylase levels were noted in older subjects aged 55 years old or more (n = 1,114) than in younger subjects (P < 0.0001, ANOVA), probably due to lower kidney function. It was likely that serum amylase may act similarly to other cardiometabolic protective factors such as high-density lipoprotein cholesterol. However, serum amylase levels were significantly lower in drinkers, particularly daily drinkers (n = 746, P < 0.0001, ANOVA). Meanwhile, despite of consistent inverse relationship between serum amylase and fasting plasma glucose, the relationship between serum amylase and HbA1c may be rather complicated in individuals with normal or mildly impaired glucose metabolism (up to HbA1c 6.0% (NGSP)). Conclusions: Revisiting the cardiometabolic relevance of serum amylase may yield novel insight not only into glucose homeostasis and metabolic abnormalities related to obesity, but also possibly carbohydrate absorption in the gut. © 2011 Nakajima et al; licensee BioMed Central Ltd.


Nakamura A.,Teikyo University | Nakamura A.,Social Insurance Omiya General Hospital
Pediatrics International | Year: 2015

Background Angiotensinogen (AGT) and angiotensin-converting enzyme (ACE) are recognized as important regulators of body mass index (BMI) and systemic blood pressure (BP). An association between these single nucleotide polymorphisms (SNP) of AGT and ACE genes and obesity or hypertension has been established. This study examined relationships between the molecular variants of the AGT and ACE genes and bodyweight or BP in children treated with glucocorticoids for nephrotic syndrome. Methods Twenty Japanese children (male, n = 14; female, n = 6; age, 2-13 years) were genotyped for AGT polymorphisms (M235T and A-6G) and the ACE polymorphisms (insertion/deletion: I/D and rs4341). All of the children studied were treated with daily prednisolone 2 mg/kg for 4 weeks and thereafter alternate-day prednisolone for 8 weeks. BMI, BMI z-scores, blood lipids, renal function and BP in each group were evaluated during the study period. Results BMI and BMI z-scores during the glucocorticoid therapy were significantly higher in the TT genotype of the AGT M235T polymorphisms and the AA genotype of the AGT A-6G polymorphisms compared to other genotypes (P < 0.05). In contrast, the molecular variant of ACE I/D and rs4341 genotypes did not change bodyweight during the glucocorticoid exposure. It was evident, however, that the BP and blood lipids and renal function were not significantly influenced by the AGT and ACE polymorphisms. Conclusions The TT genotype of the AGT M235T and the AA genotype of the A-6G polymorphisms may predispose children to bodyweight gain when initially treated with glucocorticoids for nephrotic syndrome. © 2014 Japan Pediatric Society.

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