著者

Kazuo Kitagawa Naohisa Hosomi Yoji Nagai Tatsuo Kagimura Toshiho Ohtsuki Hirofumi Maruyama Hideki Origasa Kazuo Minematsu Shinichiro Uchiyama Masakazu Nakamura Masayasu Matsumoto for the J-STARS collaborators

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

vol.26, no.5, pp.432-441, 2019-05-01 (Released:2019-05-01)

参考文献数

18

被引用文献数

17 24

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Aims: To investigate the relative contribution of on-treatment low-density lipoprotein (LDL) cholesterol and C-reactive protein (CRP) to the risk of recurrent stroke and transient ischemic attack (TIA) in patients with history of ischemic stroke.Methods: A total of 1095 patients with non-cardioembolic ischemic stroke were randomized into two groups: control and patients receiving 10 mg of pravastatin per day. After excluding 18 patients who did not have baseline CRP data, the effects of LDL cholesterol and CRP on recurrent stroke and TIA were prospectively assessed in 1077 patients.Results: During the follow-up of 4.9±1.4 years, there were 131 recurrent stroke or TIA cases. Patients with ontreatment LDL cholesterol <120 mg/dL showed 29% reduction in recurrent stroke and TIA than those with LDL cholesterol ≥ 120 mg/dL (event rate 2.20 vs. 3.11 per 100 person-years, hazard ratio [HR] 0.71, 95% confidence interval (CI) 0.50–0.99, p=0.048). Patients with CRP <1 mg/L had 32% reduction compared with that of patients with CRP ≥ 1 mg/L (event rate 2.26 vs. 3.40 per 100 person-years; HR 0.68, 95% CI 0.48–0.96, p=0.031). Although LDL cholesterol and CRP levels were not correlated in individual patients, those who achieved both LDL cholesterol <120 mg/dL and CRP <1 mg/L showed 51% reduction compared with that of patients with LDL cholesterol ≥ 120 mg/dL and CRP ≥ 1 mg/L (event rate 2.02 vs. 4.19 per 100 person-years; HR 0.49, 95% CI 0.31–0.79).Conclusions: The control of both LDL cholesterol and CRP levels appears to be effective for preventing recurrent stroke and TIA in patients with non-cardiogenic ischemic stroke.

著者

Atsuhito Saiki Yasuhiro Watanabe Takashi Yamaguchi Masahiro Ohira Daiji Nagayama Naoko Sato Mizuho Kanayama Mao Takahashi Kazuhiro Shimizu Masao Moroi Yoh Miyashita Kohji Shirai Ichiro Tatsuno

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

vol.28, no.10, pp.1083-1094, 2021-10-01 (Released:2021-10-01)

参考文献数

32

被引用文献数

8

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Aim: In the TOHO Lipid Intervention Trial Using Pitavastatin (TOHO-LIP), a multicenter randomized controlled trial, pitavastatin significantly reduced cardiovascular (CV) events compared to atorvastatin in patients with hypercholesterolemia. To investigate the mechanism by which pitavastatin preferentially prevents CV events, we investigated the relationship between CV events and cardio-ankle vascular index (CAVI) using the TOHO-LIP database. Methods: For the subgroup analysis, we selected patients from a single center, Toho University Sakura Medical Center. After excluding those who had CV events at baseline or during the first year, 254 patients were enrolled. The primary end point was the same as that of TOHO-LIP, and three-point major cardiac adverse events (3P-MACE) was added as secondary end point. Results: The cumulative 5-year incidence of 3P-MACE (pitavastatin 1.6%, atorvastatin 6.1%, P=0.038) was significantly lower in pitavastatin group (2 mg/day) than in atorvastatin group (10 mg/day). CAVI significantly decreased only in pitavastatin group during the first year (9.50–9.34, P=0.042), while the change in low-density lipoprotein cholesterol (LDL-C) did not differ between the two groups. The change in CAVI during the first year positively correlated with 3P-MACE and tended to be an independent predictor of 3P-MACE in Cox proportional hazards model (hazard ratio, 1.736; P=0.079). The annual change in CAVI throughout the observation period was significantly higher in subjects with CV events compared to those without. Conclusions: In this subgroup analysis, the reduction in CV events tended to be associated with the CAVI-lowering effect of pitavastatin, which was independent of the LDL-C-lowering effect.

著者

Koichiro Fujisue Eiichiro Yamamoto Daisuke Sueta Yuichiro Arima Kyoko Hirakawa Noriaki Tabata Masanobu Ishii Miwa Ito Kenshi Yamanaga Shinsuke Hanatani Tadashi Hoshiyama Hisanori Kanazawa Seiji Takashio Satoshi Araki Hiroki Usuku Taishi Nakamura Hirofumi Soejima Koichi Kaikita Hiroaki Kawano Kenichi Matsushita Kenichi Tsujita

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.63044, (Released:2021-09-28)

参考文献数

37

被引用文献数

7

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Aims: Royal jelly, a creamy substance secreted by honeybees, has been reported to have beneficial effects against dyslipidemia and metabolic syndrome. However, the effects of royal jelly on atherogenesis remain unknown. Hence, we prospectively evaluated whether royal jelly augments vascular endothelial function, which can reflect early atherogenesis, in healthy volunteers. Methods: This was a single-center, double-blind, 1:1 randomized placebo-controlled study conducted from October 2018 to December 2019. A total of 100 healthy volunteers were randomly assigned to receive either royal jelly 690 mg or placebo daily for 4 weeks. The primary endpoint was augmentation in vascular endothelial function as assessed using the change in the reactive hyperemia peripheral arterial tonometry index (RH-PAT) index, and the secondary endpoints were the changes in liver function and lipid profiles between baseline and 4 weeks after enrollment. Results: The mean age of the participants was 35.0±9.3 years in the placebo group and 36.1±9.1 years in the royal jelly groups; 45% and 50% of the placebo and the royal jelly groups, respectively, were male. The percentage relative change in the RH-PAT index was significantly higher in the royal jelly group than in the placebo group (21.4%±53.1% vs. 0.05%±40.9%, P=0.037). The percentage relative changes in alanine aminotransferase and γ-glutamyl transpeptidase were significantly lower in the royal jelly group than in the placebo group (alanine aminotransferase: −6.06%±22.2% vs. 11.6%±46.5%, P=0.02; γ-glutamyl transpeptidase: −3.45%±17.8% vs. 4.62%±19.4%, P=0.045). Lipid profiles were not significantly different between the two groups. Conclusions: Royal jelly might have antiatherogenic property by improving vascular endothelial function. It also augmented liver functions in healthy volunteers.

著者

Chizuko Maruyama Yuri Shijo Noriko Kameyama Ariko Umezawa Aisa Sato Ai Nishitani Makoto Ayaori Katsunori Ikewaki Masako Waki Tamio Taramoto

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.60376, (Released:2021-01-17)

参考文献数

45

被引用文献数

10

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Aim: The Japan Diet (JD) recommended by the Japan Atherosclerosis Society based on the traditional Japanese diet is presumably favorable for preventing atherosclerotic cardiovascular diseases, but few high-quality controlled clinical trials have examined its benefits as compared with other diets. We studied effects of nutrition education for JD intake as compared with partial JD (PJD) intake on serum lipids and inflammatory parameters in subjects with dyslipidemia. Methods: A randomized parallel controlled clinical trial was conducted on outpatients with dyslipidemia. Participants were randomly divided into the JD or the PJD group. Face-to-face nutrition education based on each diet at baseline and at 3 months, as well as monthly counseling by mail during the intervening 3-month period, were provided and participants practiced up to 6 months. Both groups were advised to reduce consumptions of animal fat/ fatty meat/poultry, confections, and alcoholic drinks. Additionally, the JD group participants were recommended to consume more fish, soybean products especially natto, vegetables, and seaweed/mushrooms/konjak, and to switch from refined to unrefined cereals or barley. Results: Mean LDL-cholesterol was 125 +/- 29 mg/dL at baseline, and the JD group (n=49) showed a greater mean LDL-cholesterol decrease than the PJD group (n=49) [- 8 mg/dL in JD vs 1 mg/dL in PJD, difference, -9 mg/dL (95%CI, -17 to 0) p=0.043)], and triglyceride (p=0.023) and insulin (p=0.033) reductions were larger in the JD group than in the PJD group at 6 months. Conclusion: Nutrition education for JD intake was suggested to improve serum lipid and metabolic parameters in patients with dyslipidemia.

著者

Daiju Fukuda Phuong Tran Pham Masataka Sata

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.RV17059, (Released:2021-07-12)

参考文献数

82

被引用文献数

4

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Sterile chronic inflammation causes cardiometabolic disorders; however, the mechanisms are not fully understood. Previous studies have demonstrated the degradation of cells/tissues in the vasculature and metabolic organs in lifestyle-associated diseases, such as diabetes and hyperlipidemia, suggesting the release and/or accumulation of nucleic acids from damaged cells. DNA is indispensable for life; however, DNA fragments, especially those from pathogens, strongly induce inflammation by the activation of DNA sensors. Growing evidence suggests that DNA-sensing mechanisms, which are normally involved in self-defense against pathogens as the innate immune system, are associated with the progression of inflammatory diseases in response to endogenous DNA fragments. There are several types of DNA sensors in our bodies. Toll-like receptor 9 (TLR9)—one of the most studied DNA sensors—recognizes DNA fragments in endosome. In addition, stimulator of interferon genes (STING), which has recently been extensively investigated, recognizes cyclic GMP-AMP (cGAMP) generated from DNA fragments in the cytosol. Both TLR9 and STING are known to play pivotal roles in host defense as the innate immune system. However, recent studies have indicated that the activation of these DNA sensors in immune cells, such as macrophages, promotes inflammation leading to the development of vascular and metabolic diseases associated with lifestyle. In this review, we discuss recent advances in determining the roles of DNA sensors in these disease contexts. Revealing a novel mechanism of sterile chronic inflammation regulated by DNA sensors might facilitate clinical interventions for these health conditions.

著者

Shinji Koba Yuuya Yokota Tsutomu Hirano Yasuki Ito Yoshihisa Ban Fumiyoshi Tsunoda Takatoshi Sato Makoto Shoji Hiroshi Suzuki Eiichi Geshi Youichi Kobayashi Takashi Katagiri

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

vol.15, no.5, pp.250-260, 2008 (Released:2008-11-01)

参考文献数

35

被引用文献数

63 74

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Aim: Recent evidence suggests that small dense low-density lipoprotein (sd-LDL) particles are more atherogenic than large-LDL in spite of their lower cholesterol content. This study aimed to determine whether sd-LDL-cholesterol (sd-LDL-C) is superior to LDL-C as a biomarker of coronary heart disease (CHD).Methods: LDL particle size determined by gradient gel electrophoresis and sd-LDL-C concentrations quantified by heparin-magnesium precipitation were compared between 482 stable CHD patients and 389 non-diabetic subjects without CHD who were not receiving any lipid-lowering drugs.Results: Both male and female CHD patients had significantly smaller LDL particles and lower large-LDL-C concentrations (estimated by subtracting the sd-LDL-C concentration from the LDL-C concentration), and significantly higher sd-LDL-C concentrations than the control subjects. LDL-C concentrations were modestly higher and sd-LDL-C concentrations were significantly higher in 258 patients with angiographically documented severe CHD than in the patients with mild CHD irrespective of treatment by LDL-lowering drugs and history of myocardial infarction and/or coronary revascularization. Large-LDL-C concentrations, in contrast, were similar between the two groups. Multivariate logistic regression analysis revealed that sd-LDL-C levels were significantly associated with severe CHD independently of LDL-C.Conclusion: sd-LDL-C levels are more powerful than LDL-C levels for the determination of severe stable CHD.

著者

Aya Higashiyama Ichiro Wakabayashi Tomonori Okamura Yoshihiro Kokubo Makoto Watanabe Misa Takegami Kyoko Honda-Kohmo Akira Okayama Yoshihiro Miyamoto

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.62730, (Released:2021-05-28)

参考文献数

29

被引用文献数

18

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Aim: A prospective cohort study in a Japanese urban general population was performed to investigate whether triglyceride (TG) and its related indices were associated with the risk for the incidence of ischemic cardiovascular disease (CVD) after the adjustment for low-density lipoprotein cholesterol (LDL-C) in Asian community dwellers. Methods: A 15.1-year prospective cohort study was performed in 6,684 Japanese community dwellers aged 30–79 years without a history of CVD and whose fasting TG levels were <400 mg/dL. After adjusting for covariates, including LDL-C, the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of the deciles (D) of TG and those of 1-standard deviation (SD) increment of log-transformed TG (1-SD of TG) according to LDL-C level (≥ 140 and <140 mg/dL) for ischemic CVD incidence were estimated. The multivariable-adjusted HRs and 95%CIs of the quintiles (Q) of TG, TG/HDL-C, and the cardiometabolic index (CMI) for ischemic CVD were also estimated. Results: In 101,230 person-years, 464 ischemic CVD cases occurred. For D10 of TG, the HR (95%CI) was 1.56 (1.05–2.32), and for 1-SD of TG, it was 1.30 (1.00–1.70) in participants with LDL-C <140 mg/dL and 1.07 (0.77–1.50) in those with LDL-C ≥ 140 mg/dL. For Q5 of the CMI, the multivariable-adjusted HR was higher than those of TG and TG/HDL-C. Conclusions: Fasting TG was an independent predictor for ischemic CVD incidence after adjusting for LDL-C in Japanese community dwellers with TG <400 mg/dL. Among TG, TG/HDL-C, and the CMI, the CMI could be the most powerful predictor for ischemic CVD.

著者

Masayuki Kuroda Hideaki Bujo Koutaro Yokote Takeyoshi Murano Takashi Yamaguchi Masatsune Ogura Katsunori Ikewaki Masahiro Koseki Yasuo Takeuchi Atsuko Nakatsuka Mika Hori Kota Matsuki Takashi Miida Shinji Yokoyama Jun Wada Mariko Harada-Shiba on behalf of the Committee on Primary Dyslipidemia under the Research Program on Rare and Intractable Disease of the Ministry of Health Labour and Welfare of Japan

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.RV17051, (Released:2021-04-18)

参考文献数

68

被引用文献数

7

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Lecithin cholesterol acyltransferase (LCAT) is a lipid-modification enzyme that catalyzes the transfer of the acyl chain from the second position of lecithin to the hydroxyl group of cholesterol (FC) on plasma lipoproteins to form cholesteryl acylester and lysolecithin. Familial LCAT deficiency is an intractable autosomal recessive disorder caused by inherited dysfunction of the LCAT enzyme. The disease appears in two different phenotypes depending on the position of the gene mutation: familial LCAT deficiency (FLD, OMIM 245900) that lacks esterification activity on both HDL and ApoB-containing lipoproteins, and fish-eye disease (FED, OMIM 136120) that lacks activity only on HDL. Impaired metabolism of cholesterol and phospholipids due to LCAT dysfunction results in abnormal concentrations, composition and morphology of plasma lipoproteins and further causes ectopic lipid accumulation and/or abnormal lipid composition in certain tissues/cells, and serious dysfunction and complications in certain organs. Marked reduction of plasma HDL-cholesterol (HDL-C) and corneal opacity are common clinical manifestations of FLD and FED. FLD is also accompanied by anemia, proteinuria and progressive renal failure that eventually requires hemodialysis. Replacement therapy with the LCAT enzyme should prevent progression of serious complications, particularly renal dysfunction and corneal opacity. A clinical research project aiming at gene/cell therapy is currently underway.

著者

Hidenori Arai Hideaki Bujo Daisaku Masuda Toshiyuki Ishibashi Satoshi Nakagawa Kenichiro Tanabe Tatsuo Kagimura Hyun-Jae Kang Moo Hyun Kim Jidong Sung Sang-Hyun Kim Cheol-Ho Kim Jeong Euy Park Junbo Ge Byung-Hee Oh Toru Kita Yasushi Saito Masanori Fukushima Yuji Matsuzawa Shizuya Yamashita

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.62821, (Released:2021-04-18)

参考文献数

45

被引用文献数

6

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Aims: In this study, we integrated two randomized control trials, PROSPECTIVE and IMPACT, to address the effect of probucol on cerebrocardiovascular events and carotid intima-media thickness (IMT) in Japanese, Korean, and Chinese patients with coronary artery disease (CAD). Methods: A total of 1,025 patients from the PROSPECTIVE and IMPACT studies were enrolled. The time to the first major adverse cerebrocardiovascular event, in addition to carotid IMT and lipid levels, was compared between the control and probucol groups. Results: In the integrated analysis, the adjusted hazard ratio (HR) and 95% confidence interval (CI) were 0.67 and 0.44–1.03, respectively, indicating a tendency to show the effect of probucol on cerebrocardiovascular events in secondary prevention. We also found no significant differences between the control and probucol groups in the mean IMT of the carotid arteries and its changes. However, we found a significant decrease in cerebrocardiovascular events in patients with reduced levels of HDL cholesterol (HDL-C) (≥ 6.25 mg/dL) compared with those with levels <6.25 mg/dL (p=0.024), without any increase in adverse events such as severe ventricular arrhythmias. Conclusion: We demonstrated a marginal effect of probucol on cerebrocardiovascular events in Asian patients with CAD, with reasonable safety profiles. A larger study may be needed to support the effect of probucol for cardiovascular prevention.

著者

Akihiro Yoshida Masaaki Kouwaki Yasuko Matsutani Yoshiko Fukuchi Michitaka Naito

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

vol.11, no.4, pp.215-219, 2004 (Released:2004-09-09)

参考文献数

13

被引用文献数

20 24

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Objective: We examined the usefulness of the serum total cholesterol (TC)/triglyceride (TG) and LDL-cholesterol (LDL-C)/TG ratios for predicting the presence of small, dense LDL, by comparing them with the established indicators of small, dense LDL, such as the LDL-migration index (LDL-MI) and LDL-C/Apolipoprotein B (ApoB) ratio.Materials and methods: Fasting serum lipid was analyzed in 99 Japanese hyperlipidemic and normolipidemic subjects (34 males and 65 females, 59.4 ± 11.9 years old).Results: A good negative correlation was observed between LDL-MI and log (TC/TG) (R2 = 0.473, p < 0.0001). There was a strong positive correlation between LDL-C/ApoB and log (TC/TG) (R2 = 0.665, p < 0.0001). Similar results were obtained using LDL-C instead of TC. Using LDL-MI > 0.4 as an indicator of small, dense LDL, the upper limit of TG was estimated to be 140−142 mg/dl.Conclusion: TC/TG and LDL-C/TG may offer a convenient and simple clinical tool for predicting the presence of small, dense LDL. Particularly, TC/TG could be an easy-to-use indicator of small, dense LDL for general practitioners.

著者

Takanori Honda Yuki Ishida Masaaki Oda Kenichi Noguchi Sanmei Chen Satoko Sakata Emi Oishi Yoshihiko Furuta Daigo Yoshida Yoichiro Hirakawa Jun Hata Takanari Kitazono Toshiharu Ninomiya

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.59394, (Released:2021-01-17)

参考文献数

42

被引用文献数

6

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Aim: We investigated the influence of weight change on concurrent changes in predicted cardiovascular disease (CVD) risk and individual CVD risk factors over time. Methods: A total of 2,140 community-dwellers aged 40–74 years participated in both 2002 and 2007 health examinations. Obesity was defined as body mass index ≥ 25 kg/m2. Weight trajectories were classified as: “stable obese” (obese at both examinations), “obese to nonobese” (obese in 2002 but nonobese in 2007), “nonobese to obese” (nonobese in 2002 but obese in 2007), or “stable nonobese” (nonobese at both examinations). We compared changes in the model-predicted risk for CVD and individual CVD risk factors across weight-change categories. Results: The predicted risk for CVD increased during 5 years in all groups; the increment in the predicted risk for CVD was smallest in the obese to nonobese participants and steepest in the nonobese to obese subjects. Compared with the stable obese participants, the obese to nonobese participants had greater favorable changes in waist circumferences, blood pressure, fasting plasma glucose, serum high-density lipoprotein cholesterol, serum triglycerides, and liver enzymes. For all these parameters, opposite trends were observed when comparing the nonobese to obese participants with the stable nonobese group. Conclusions: We demonstrated the favorable association of losing weight in obese people and avoiding excessive weight gain in nonobese people with global risk of future CVD and individual CVD risk factors in a real-world setting. The findings could improve behavioral lifestyle interventions that provide information on the health consequences of weight change at health checkups.

著者

Kazutoshi Fujibayashi Hiroshi Fukuda Hirohide Yokokawa Tomomi Haniu Fukuko Oka Miki Ooike Toshiaki Gunji Noriko Sasabe Mitsue Okumura Kimiko Iijima Teruhiko Hisaoka Hiroshi Isonuma

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

vol.19, no.10, pp.932-940, 2012 (Released:2012-10-29)

参考文献数

42

被引用文献数

22 28

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Aim: The aim was to investigate the respective associations between lifestyle and proteinuria and the estimated glomerular filtration rate (eGFR).Methods: The lifestyle habits of 25,493 middle-aged participants were investigated in a cross-sectional study to find habits that are associated with a low eGFR (<60 mL/min/1.73 m2) and/or the presence of proteinuria. The lifestyle habits of the participants were evaluated using a questionnaire. Unhealthy lifestyle habits were defined as follows: 1. obesity, 2. being a current/former smoker, 3. eating irregular meals, 4. having less than 5 hours sleep, 5. exercising less than once a week, and 6. drinking more than once a week. The associations among unhealthy habits, eGFR, and proteinuria were evaluated using multivariate analysis.Results: The following lifestyle factors were significantly and independently associated with proteinuria: obesity (odds ratio (OR): 1.18, 95%C.I: 1.04-1.34), being a current/former smoker (OR: 1.26, 95%C.I: 1.11-1.42), eating irregular meals (OR: 1.40, 95%C.I: 1.22-1.61), sleeping less than 5 hours (OR: 1.38, 95%C.I: 1.15-1.65), and exercising less than once a week (OR: 1.18, 95%C.I: 1.05-1.33). In contrast, the following unhealthy lifestyle factors were not clearly associated with a low eGFR: obesity (OR: 1.05, 95%C.I: 0.95-1.17), being a current/former smoker (OR: 0.76, 95%C.I: 0.69-0.84), eating irregular meals (OR: 0.91, 95%C.I: 0.79-1.04), sleeping less than 5 hours (OR: 1.02, 95%C.I: 0.85-1.22), and exercising less than once a week (OR: 0.91, 95%C.I: 0.83-0.99).Conclusion: Associations between proteinuria and unhealthy lifestyle habits were observed in our cross-sectional study. Unhealthy lifestyles should be monitored during the management of CKD patients with proteinuria.

著者

Meng-Huan Lei Yu-Lin Wu Sheng-Liang Chung Chao-Chin Chen Wei-Cheng Chen Yu-Chen Hsu

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.59386, (Released:2020-11-07)

参考文献数

43

被引用文献数

10

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Aims: Type 2 diabetes mellitus (T2DM) is no longer regarded as a coronary risk equivalent, and heterogeneity of cardiovascular risk exists, suggesting that further risk stratification should be mandatory. This study aimed to determine the prevalence and clinical predictors of coronary artery calcium (CAC) score, and evaluate the CAC score as a predictor of cardiovascular outcome in a large asymptomatic T2DM cohort. Methods: A total of 2,162 T2DM patients were recruited from a Diabetes Shared Care Network and the CAC score was measured. Cardiovascular outcomes were obtained for 1,928 patients after a follow-up of 8.4 years. Multiple regression analysis and Cox proportional hazard regression were applied to identify clinical predictors of CAC and calculate the incidence and hazard ratios (HRs) for all-cause mortality and cardiovascular events by CAC category. Results: Of the recruited patients, 96.8% had one or more risk factors. The distribution of CAC scores was as follows: CAC=0 in 24.2% of the patients, 0 <CAC ≤ 100 in 41.5%, 100 <CAC ≤ 400 in 20.3%, CAC >400 in 14.7%. The multivariable predictor of increased CAC included age (years) (odds ratio, 1.07; 95% confidence interval, 1.06–1.08), male sex (1.82; 1.54–2.17), duration (years) of T2DM (1.07; 1.05–1.09), and multiple risk factors (1.94; 1.28–2.95). Increasing severity of CAC was associated with higher all-cause or cardiac mortality and higher incident cardiovascular events. The HRs for cardiac death or major cardiac events in CAC >400 vs CAC=0 were 8.67 and 10.52, respectively (p<0.001) Conclusion: CAC scoring provides better prognostication of cardiovascular outcome than traditional risk factors in asymptomatic T2DM patients, and may allow identifying a high-risk subset for enhancing primary prevention.

著者

Yuanying Li Hiroshi Yatsuya Sachiko Tanaka Hiroyasu Iso Akira Okayama Ichiro Tsuji Kiyomi Sakata Yoshihiro Miyamoto Hirotsugu Ueshima Katsuyuki Miura Yoshitaka Murakami Tomonori Okamura EPOCH-JAPAN Research Group

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.58958, (Released:2020-10-10)

参考文献数

44

被引用文献数

9

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Aims: We aimed to develop and validate risk prediction models to estimate the absolute 10-year risk of death from coronary heart disease (CHD), stroke, and cardiovascular disease (CVD). Methods: We evaluated a total of 44,869 individuals aged 40–79 years from eight Japanese prospective cohorts to derive coefficients of risk equations using cohort-stratified Cox proportional hazard regression models. Discrimination (C-index) of the equation was examined in each cohort and summarised using random-effect meta-analyses. Calibration of the equation was assessed using Hosmer-Lemeshow chi-squared statistic. Results: Within a median follow-up of 12.7 years, we observed 765 deaths due to CVD (276 CHDs and 489 strokes). After backward selection, age, sex, current smoking, systolic blood pressure (SBP), proteinuria, prevalent diabetes mellitus, the ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDLC), interaction terms of age by SBP, and age by current smoking were retained as predictors for CHD. Sex was excluded in the stroke equation. We did not consider TC/HDLC as a risk factor for the stroke and CVD equations. The pooled C-indices for CHD, stroke, and CVD were 0.83, 0.80, and 0.81, respectively, and the corresponding p-values of the Hosmer-Lemeshow tests were 0.18, 0.003, and 0.25, respectively. Conclusions: Risk equations in the present study can adequately estimate the absolute 10-year risk of death from CHD, stroke, and CVD. Future work will evaluate the system as an education and risk communication tool for primary prevention of CHD and stroke.

著者

後藤 由夫 阿部 隆三 及川 真一 佐野 隆一 藤井 豊

出版者

Japan Atherosclerosis Society

雑誌

動脈硬化 (ISSN:03862682)

巻号頁・発行日

vol.12, no.6, pp.1351-1357, 1985

著者

阿部 隆三 及川 真一 佐野 隆一 藤井 豊 義江 和子 後藤 由夫

出版者

Japan Atherosclerosis Society

雑誌

動脈硬化 (ISSN:03862682)

巻号頁・発行日

vol.12, no.4, pp.951-956, 1984

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In the present study, effect of probucol (500mg×2, daily) on serum lipids and lipoproteins in S. F. family who showed typical familial hyper-cholesterolemia (FH) were investigated. The results were as follows:<br>1) The values of serum cholesterol (TC) before and after treatment of probucol were 348±14mg/dl and 220±12mg/dl, respectively. These data shows significant reduction of serum cholesterol after treatment of probucol. The percent of reduction of serum cholesterol was 36.4%. This value was significantly higher than the value (17%) in the other FH.<br>2) Though levels of LDL- and HDL-C were decreased after treatment of probucol, LDL-C level was markedly decrease in S. F family as compared with other FH. Reduction of HDL-C after treatment of probucol was not significant difference between in S. F family and other FH.<br>3) Total biliary lipids after treatment of probucol increased from 68.8μmol/ml to 141.9μmol/ml in a patient of S. F family. Level of bile acid increased after treatment of probucol, especially, in this case. On the other hand, the change of biliary lipids after treatment of probucol was not seen in other FH.<br>From these data, though mechanism of marked reduction of LDL-C in S. F family after treatment of probucol was still unclear, metabolism of cholesterol to synthesis of bile acid might have especially involved to marked reduction of serum LDL-C in S. F family.

著者

小竹 英俊 及川 眞一 生井 一之 佐久間 恵理子 義江 和子 豊田 隆謙

出版者

Japan Atherosclerosis Society

雑誌

動脈硬化 (ISSN:03862682)

巻号頁・発行日

vol.17, no.3, pp.453-456, 1989

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It has been established previously that low density lipoprotein (LDL) incubated with cultured endothelial cells, smooth muscle cells, or macrophages undergo a free radical-catalyzed oxidative modification. This modification involves lipid peroxides and extensive structural changes in the LDL molecule. The oxidatively modified LDL inhibits the motility of the mouse resident peritoneal macrophages, yet lysophosphatidylcholine in oxidized LDL acts as a chemotactic factor for circulating human monocytes. The present study demonstrated that the stimulation of human mononuclear cells with phorbol myristate acetate (PMA) results in an increase of oxidized LDL, which was assayed by LPO-KIT (obtained from Kyowa Hakko Inc.) in the culture medium. The medium containing oxidized LDL did not exhibit a chemotactic for human monocytes, but inhibited the chemotactic responses of monocytes to the N-formyl peptide and aortic extract.<br>These findings suggest that circulating monocytes may play a role in the subendothelial space by some chemotactic factors and become trapped in the splace due to the inhibitory effects of oxidatively modified LDL.

著者

及川 眞一 堀 三郎

出版者

Japan Atherosclerosis Society

雑誌

動脈硬化 (ISSN:03862682)

巻号頁・発行日

vol.14, no.1, pp.25-29, 1986

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It would be important to study the characteristics and the action of "dentured" or "modified" LDL in atherogenesity. We investigated whether modified LDL was formed in normal human and what effect this LDL had on human arterial smooth muscle cells in culture.<br>Incubation of plasma prepared from normal human was performed at 37°C for 6 hours. Thrombin was added to both of incubated plasma and also non-incubated plasma obtained from each subject in order to remove fibrin. Lipoproteins (VLDL, IDL, LDL and HDL) were ultracentrifugally isolated from each serum.<br>LDL obtained from incubated plasma had faster mobility than that from non-incubated plasma on agarose-gel electrophoresis. Lipids-composition (TC, TG, PL and Ch-ester) was altered in LDL after incubation. These alterations of LDL might be induced by lipid transfer protein. In this way, LDL obtained from normal human was modified.<br>DNA synthesis of human arterial smooth muscle cells (SMC) increased in the culture with LDL addition. This action of LDL was dose-dependent manner. DNA synthesis increased in the culture with modified LDL more than that with native LDL.<br>These data indicated that LDL obtained from normal human was easily modified and modified LDL influenced DNA synthesis of cultured arterial SMC.

著者

佐野 隆一 阿部 隆三 平川 秀紀 金沢 義彦 小泉 勝 豊田 隆謙 後藤 由夫 及川 真一

出版者

Japan Atherosclerosis Society

雑誌

動脈硬化 (ISSN:03862682)

巻号頁・発行日

vol.11, no.3, pp.671-676, 1983

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In the present study, the effect of probucol (500mg×2, daily) on serum lipids and lipoproteirs level were studied in 9 patients with familial hypercholesterolemia (FH) during 3-4 months. The diagnosis of FH was established according to the criteria both of Fredrickson et al and of Makuchi et al. Thickness of Achilles tendon was over 9mm in all patients and the xanthomas were observed in 4 of 9 patients.<br>Before and 3-4 months after treatment of probucol the measurement of serum triglyceride (TG), total cholesterol (TC) and apolipoprotein (Apo) A-I and A-II were made. At the same time, serum VLDL, LDL, HDL₂ and HDL₃ were separated by successive ultracentrifugation. Thereafter, TG, TC and protein of each lipoprotein fraction were measured.<br>TG and TC were determined by enzymatic method, Apo A-I and A-II were done by single immunodiffusion assay, and protein was done by dye-binding method.<br>All data were expressed as mean ±S.E. and statistically analized by Student's t-test.<br>The results were as follows:<br>1) VLDL-TG levels were slightly increased, although no significance was found between VLDL-TG level before and after treatment.<br>2) The levels of serum TC were 388±37mg/dl and 308±28mg/dl (-21%, p<0.05) before and after probucol administration, respectively. LDL-cholesterol (LDL-C) levels decreased from 325±37mg/dl before treatment to 262±32mg/dl (-19%, p<0.05) after treatment. HDL-C values significantly decreased from 42±5mg/dl to 26±4mg/dl (-38%, p<0.01), and especially HDL₂-C showed significant fall (-48%, p<0.01).<br>3) Serum Lecithin: Cholesterol Acyltransferase (LCAT) activities were not changed.<br>4) The concentrations of Apo LDL decreased from 139±18mg/dl to 106±17mg/dl (-29%), but it was not significant statistically. Apo A-I levels decreased significantly from 92±10mg/dl to 66±10mg/dl (-28%, p<0.01). On the other hand, Apo A-II levels were unchanged.<br>These observations suggested that probucol would be a useful drug to improve serum and LDL cholesterol levels in FH. However, we should take care to use this drug because of its effect on HDL metabolism.

著者

山田 憲一 阿部 隆三 鈴木 進 及川 真一 後藤 由夫

出版者

Japan Atherosclerosis Society

雑誌

動脈硬化 (ISSN:03862682)

巻号頁・発行日

vol.10, no.3, pp.489-495, 1982

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Diabetic autopsy cases were collected from the Annual Report of Pathological Autopsy Cases published by Japanese of Pathology for the year 1976-1978. 2089 primary diabetic cases were collected and the cause of death and pathoanatomical findings in various organs were analysed in these primary diabetic cases, and following results were obtained.<br>1) The main causes of death were cardiovascular diseases (43.1%), malignant neoplasma (22.6%), infections (16.2%), diabetic coma (1.9%) and hypoglycemia (0.3%).<br>2) In cardiovascular diseases, the leading cause was diabetic nephropathy (15.6%), followed by cerebral (14.6%) and coronary (10.5%) artery disease.<br>3) The frequency of arteriosclerotic cardiovascular diseases and malignant neoplasmas as cause of death increased with age. Diabetic nephropathy appeared as a cause of death in 3rd decade and the leading cause of death was diabetic nephropathy in 3rd decade (52%) and 4th decade (32%), and over 5th decade decreased with age. Cerebral vascular and coronary artery diseases increased with age and cerebral vascular disease was the leading cause of death over 6th decade.<br>4) In pathoanatomical findings, the frequencies of glomerulosclerosis, myocardial infarction, cerebral infarction and homorrhage were 40.9%. 17.2%, 15.6% and 7.0%, respectively. Myocrdial infarction and cerebral infarction were found in 4th decade and increased with age, while cerebral hemorrhage decreased over 6th decade with age. Diabetic glomerulosclerosis was found in the cases of 2nd decade and high frequencies of glomerulosclerosis were found in all decade and it was higher than those of other vascular lesions.<br>These results showed the characteristics in the causes of death of diabetics in Japan are a lower incidence of coronary artery disease and a high incidence of diabetic nephropathy.