Tailored nutritional guidance by a registered dietitian is necessary for feasible, practical application of nutrition therapy. In order to reduce the requirement for estimation by a dietitian and to increase the time available for practical advice, we developed and validated computer software for estimating dietary intake among patients with type 2 diabetes. The study enrolled 46 patients with type 2 diabetes, recruited from an outpatient clinic in 2015. We used the computer software "Syokuseikatsu Shindan System" (SSS; Nissha, Kyoto, Japan). SSS allows the user to choose pictures of dishes and the portions he/she has consumed for each meal. The one-day dietary intake estimations for SSS were validated against a reference estimation of 24-h dietary recall by a registered dietitian. The mean carbohydrate intake as assessed by SSS and 24-h recall was 210.6 ± 55.1 and 215.5 ± 52.9 g/day, with a positive correlation (r = 0.53, p<0.001). Bland–Altman analysis showed that limits of agreement in carbohydrates between the methods were –107.4 to 97.5 g/day. Even though the limits of agreement were wide and non-negligible at the individual level for clinical use, SSS appears to have potential as a dietary estimation tool under registered dietitian supervision.
Aims The aim of this study was to examine whether low serum potassium concentration could be a predictor of chronic kidney disease (CKD) in a community-based cohort. Materials and methods We enrolled 1001 subjects, median period of 5.7 years, and evaluated the risk factors for CKD, defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, and assessed whether low serum potassium concentration could predict CKD. Results Compared with the subjects without development of CKD, age, body mass index, fasting plasma glucose, uric acid (UA), creatinine and serum sodium concentration were higher, and serum potassium concentration was lower in subjects with development of CKD. Univariate Cox regression analyses demonstrated that age, body mass index, fasting plasma glucose, UA, creatinine, serum sodium concentration and serum potassium concentration were associated with progression of CKD. Multiple Cox regression analysis revealed that age, gender, creatinine and serum potassium concentration were independent predictors of CKD after adjustment for covariates. When serum potassium concentration was below 4.0 mmol/l at baseline, hazard ratio (95% confidence interval) of developing CKD was 2.65 (2.04–3.44; p < 0.0001). Conclusions Serum potassium concentration could be a clinically relevant risk factor for the progression of CKD, defined as eGFR < 60 ml/min/1.73 m2, in healthy subjects.
Background Multislice computed tomography (MSCT) permits direct visualization of not only coronary artery stenosis but also the characteristics of plaques in patients with coronary artery disease (CAD). Also, because of its potential to be a novel risk factor for cardiovascular disease, interest in non-alcoholic fatty liver disease (NAFLD) is increasing. Methods and Results Participants comprised 298 consecutive patients who received MSCT to diagnose CAD. Patients with an alcohol intake exceeding 20 g/day or with a history of known liver disease were excluded from the study. Liver steatosis and 4 coronary artery findings, including remodeling lesions, lipid core plaques, calcified plaques and narrowing of lumen, were assessed. Liver steatosis was evaluated by computed tomography density of the liver and spleen. In the study, NAFLD was defined as having a liver and spleen (L:S) ratio of <1.1. The L:S ratios of patients with remodeling lesions or lipid core plaques were significantly lower than those without. NAFLD was related significantly to those findings, but there was no correlation between calcified plaques, narrowing of lumen and L:S ratios. Adjusted odds ratio of NAFLD for remodeling lesions was 2.41 (95% confidence interval (CI), 1.24-4.67; p=0.009), and those for lipid core lesions was 2.29 (95% CI, 1.15-4.56; p=0.018). Conclusion NAFLD is a novel risk factor for vulnerable plaques. (Circ J 2008; 72: 618 - 625)
Background Cardiovascular disease (CVD) is the primary cause of mortality and morbidity in patients with type 2 diabetes. N-terminal pro-brain natriuretic peptide (NT-proBNP), which is a useful biomarker of chronic heart failure, has been shown to be a strong predictor of cardiovascular mortality. Furthermore, alterations in vascular structure and function are also recognized increasingly as significant independent predictors of adverse cardiovascularoutcomes. In this study, we investigated the relationships between NT-proBNP and markers of subclinical atherosclerosis in patients with type 2 diabetes. Methods Relationships of NT-proBNP to pulse wave velocity (PWV) or ankle-brachial index (ABI) as wellas to major metabolic risk parameters, including body mass index, blood pressure, serum lipid concentration, serum uric acid concentration,and glycemic control (hemoglobinA1c), age, hemoglobin, serum creatinine concentration, severity of diabetic nephropathy orretinopathy, current treatment of diabetes, smoking status, and presence of CVD were investigated in 323 consecutive patients with type 2 diabetes. Results Log (NT-proBNP) correlated positively with PWV (r = 0.283, p < 0.0001) and correlated negatively with ABI (r = −0.144, p = 0.0094). Multiple regression analysis demonstrated that age (β = 0.267, p < 0.0001), systolic blood pressure (β = 0.249, p < 0.0001), uric acid (β = 0.121, p = 0.0383), creatinine (β = −0.139, p = 0.0239) and log (NT-proBNP) (β = 0.173, p = 0.0043) were independent determinants of PWV and that log triglyceride (β = −0.130, p = 0.0390) andlog (NT-proBNP) (β = −0.153 p = 0.0256) were independent determinants of ABI. Conclusions NT-proBNP was associated with PWV and ABI in patients with type 2 diabetes. NT-proBNP could be a marker of subclinical atherosclerosis in patients with type 2 diabetes.
