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Ōsaka, Japan

Funahashi T.,Osaka University | Matsuzawa Y.,Sumitomo Hospital
Best Practice and Research: Clinical Endocrinology and Metabolism | Year: 2014

Adiponectin is an adipocyte-derived plasma protein with cardio-vasculo-protective and anti-diabetic properties. Plasma adiponectin levels are low in patients with the cardiometabolic syndrome (a cluster of multiple risk factors based on visceral fat accumulation). Routine measurement of plasma adiponectin may be useful to encourage life-style changes. © 2013 Elsevier Ltd. All rights reserved. Source


Matsuzawa Y.,Sumitomo Hospital | Matsuzawa Y.,Osaka University
Proceedings of the Japan Academy Series B: Physical and Biological Sciences | Year: 2010

Although obesity is a major background of life style-related diseases such as diabetes mellitus, lipid disorder, hypertension and cardiovascular disease, the extent of whole body fat accumulation does not necessarily the determinant for the occurrence of these diseases. We developed the method for body fat analysis using CT scan and established the concept of visceral fat obesity, in other word metabolic syndrome in which intra-abdominal visceral fat accumulation has an important role in the development of diabetes, lipid disorder, hypertension and atherosclerosis. In order to clarify the mechanism that visceral fat accumulation causes metabolic and cardiovascular diseases, we have analyzed gene expression profile in subcutaneous adipose tissue and visceral adipose tissue. From the analysis, we found that adipose tissue, especially visceral adipose tissue expressed abundantly the genes encoding bioactive substances such as cytokines, growth factors and complements. In addition to known bioactive substances, we found a novel collagen-like protein which we named adiponectin. Adiponectin is present in plasma at a very high concentration and is inversely associated with visceral fat accumulation. Adiponectin has anti-diabetic, antihypertensive and anti-atherogenic properties and recent studies revealed that this protein has an anti-inflammatory and anti-oncogenic function. Therefore hypoadiponectinemia induced by visceral fat accumulation should become a strong risk factor for metabolic and cardiovascular diseases and also some kinds of cancers. In this review article, I would like to discuss the mechanism of life style-related diseases by focusing on the dysregulation of adiponectin related to obesity, especially visceral obesity. © 2010 The Japan Academy. Source


Kihara S.,Osaka University | Matsuzawa Y.,Sumitomo Hospital
Current Cardiovascular Risk Reports | Year: 2015

The increase in obesity and cardiovascular disease (CVD) is a major problem in developed countries. As a consequence, metabolic syndrome, a disorder that links obesity and CVD, is becoming an important health concern. The underlying mechanisms of metabolic syndrome are considered to be excess visceral fat accumulation and insulin resistance. Visceral adipose tissue essentially takes up and stores excess energy and buffers against hyperglycemia and hyperlipidemia. However, excess visceral fat accumulation causes dysregulation of various adipocyte-derived bioactive molecules (adipocytokines), which leads to chronic systemic low-grade inflammation and CVD. The reduction of visceral fat through lifestyle modification is a potentially useful strategy for the prevention of CVD. Waist circumference is a good surrogate marker of visceral fat accumulation and is useful for monitoring the results of lifestyle changes. Moreover, adipocytokines are useful biomarkers and therapeutic targets for obesity-induced CVD. © 2015, Springer Science+Business Media New York. Source


Kishida K.,Osaka University | Funahashi T.,Osaka University | Matsuzawa Y.,Sumitomo Hospital | Shimomura I.,Osaka University
Annals of Medicine | Year: 2012

Atherosclerosis, the underlying cause of atherosclerotic cardiovascular disease (ACVD), develops due not only to a single cardiovascular risk factor but to a variety of complex factors. The concept of the multiple cardiometabolic risk factor clustering syndrome has been proposed as a highly atherogenic state, independent of hypercholesterolemia and smoking. Body fat distribution, especially visceral fat accumulation, is a major correlate of a cluster of diabetogenic, atherogenic, prothrombotic, and proinflammatory metabolic abnormalities referred to as the metabolic syndrome, with dysfunctional adipocytes and dysregulated production of adipocytokines (hypoadiponectinemia). Medical research has focused on visceral adiposity as an important component of the syndrome in Japanese subjects with a mild degree of adiposity compared with Western subjects. For the prevention of ACVD at least in Japan, it might be practical to stratify subjects with multiple risk factors for atherosclerotic cardiovascular disease based on visceral fat accumulation. Visceral fat reduction through health promotion programs using risk factor-oriented approaches may be effective in reducing ACVD events, as well as producing improvement in risks and hypoadiponectinemia. This review article discusses visceral adiposity as a key player in the syndrome. Visceral fat reduction with life-style modification is a potentially useful strategy in the prevention of ACVD in patients with the metabolic syndrome. © 2012 Informa UK, Ltd. Source


Misaki S.,Sumitomo Hospital
[Rinshō ketsueki] The Japanese journal of clinical hematology | Year: 2012

An 81-year-old male had been diagnosed with Waldenström macroglobulinemia (WM) eight years previously and had thus been administered appropriate treatment. Left chylothorax later developed at 3 years and 8 months after the initial diagnosis. He was hospitalized with severe anemia, general fatigue, and appetite loss one year prior to this presentation and died due to a severe fungal infection. Autopsy revealed the presence of 1,300 ml chylothorax and infiltration of lymphoplasmacytic lymphoma (LPL) cells throughout his entire body. LPL cells were found to have invaded the excitation conducting system in the heart. In an evaluation of a resected lung tissue specimen of pneumothorax, subpleural infiltrated lymphoid cells were observed to show immunohistochemical positivity for IgM and bcl-2. Although these lymphoid cells were initially considered to be non-neoplastic lymphocytes, they were later determined to be LPL cells, which thus induced dilatation and proliferation of the lymph vessels. Chylothorax complications in patients with WM are rare events and only six such cases have so far been reported. The present case is considered to be an instructive one in which autopsy suggested the invasion of LPL cells to be involved in the development of arrhythmia, pneumothorax, and chylothorax before death. Source

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