The number of elderly patients with insulin-dependent diabetes mellitus (IDDM) is increasing because of the prolongation of life due to the improvement of diabetic control. For better management of elderly patients with IDDM, we investigated the clinical and genetic characteristic of older patients with IDDM in comparison with younger patients. The subjects studied consisted of 19 patients with IDDM treated at the Department of Geriatric Medicine, Osaka University Hospital. Among the 19 subjects, 7 patients (37%) were more than 50 years old, including 3 patients (16%) more than 65 years old. The clinical and genetic characteristics of these 7 patients (older patients group) were compared with those of 12 patients (younger patient group) whose age was less than 50 years old. The age at onset of IDDM was significantly higher in older patient group (46 +/- 13 years old; mean +/- SD) than in younger patient group (34 +/- 6 years old). There was no significant difference in the duration of IDDM between older and younger patients (13 +/- 6 and 12 +/- 8 years, respectively). There were no significant differences in daily insulin dose, glycemic control (fasting plasma glucose and HbA1c levels) and glycemic stability as measured by the standard deviation of 10 measured fasting plasma glucose levels between the two groups. The frequency of diabetic retinopathy and neuropathy in the older patients was slightly, but not significantly, higher than that in younger patients. The frequency of diabetic nephropathy was similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

10.3143/geriatrics.29.931

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Tissue-Specific and Glucose-Dependent Expression of Receptor Genes for Glucagon and Glucagon-Like Peptide-1 (GLP-1)

Hormone and Metabolic Research (1997)

Eiji Yamato H Ikegami Kazunori Takekawa T. Fujisawa Yusuke Nakagawa

Both glucagon and glucagon-like peptide-1 (GLP-1) play an important role in the regulation of nutrient homeostasis. In this study, the tissue distributions of the expression of receptor genes for glucagon and GLP-1 were examined. Expression of glucagon receptor gene was detected in liver, kidney, ileum and pancreatic islets but not in brain. In contrast, expression of GLP-1 receptor gene was detected in brain, pancreas and pancreatic islets but not in liver, kidney, or ileum. To investigate the existence and characteristics of glucagon and GLP-1 receptors on pancreatic β cells, expression of the receptor genes and translational regulation of the expression of the receptor genes by glucose were analyzed in a mouse pancreatic β cell line, MIN6 cells. In the cDNA pool of MIN6 cells, both glucagon and GLP-1 receptor genes were identified and showed higher expression level in MIN6 cells cultured under high glucose condition than in those cultured under low glucose condition. These results suggest that glucagon and GLP-1 receptor genes are expressed in pancreatic β cells and their expression is upregulated by glucose.

Glucagon receptor

Pancreatic Islets

Receptor expression

10.1055/s-2007-978985

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Citations (51)

Paternal-maternal effects on phenotypic characteristics in spontaneously diabetic Nagoya-Shibata-Yasuda mice

Metabolism (2000)

Hironori Ueda Hiroshi Ikegami Yoshihiko Kawaguchi T. Fujisawa Koji Nojima

Inbred strain

Inheritance

Strain (injury)

10.1016/s0026-0495(00)80043-8

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Bone mineral density in a rat model of non-insulin dependent diabetes mellitus

Diabetes, Nutrition & Metabolism (1997)

Tomomi Fujisawa H. Ikegami Eiji Yamato Y. Kawaguchi Yoichi Hamada

Source

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Cytokine Gene Therapy for Myocarditis byIn VivoElectroporation

Human Gene Therapy (2001)

Atsushi Nakano Akira Matsumori Shunsuke Kawamoto Hideaki Tahara Eiji Yamato

Cytokines are important pathophysiologic and pathogenic factors in cardiovascular disorders, including viral myocarditis. We attempted to treat viral myocarditis with cytokine gene therapy by transferring an inhibitory cytokine, IL-1 receptor antagonist (IL-1ra) or viral IL-10 (vIL-10), by in vivo electroporation, a new method for gene transfer into muscle. Four-week-old male DBA/2 mice were inoculated intraperitoneally with 10 PFU of encephalomyocarditis virus. Immediately after virus inoculation, an expression plasmid carrying IL-1ra or vIL-10 was injected into tibialis anterior muscles followed by electroporation. Serum levels of IL1ra and vIL-10 reached 10.5 and 2.3 ng/ml, respectively, on day 5, when gene expression reached its peak. Histopathological examination showed that myocardial cellular infiltration was improved in mice treated with IL-1ra or vIL-10 compared with the control group. On day 14 after the onset of myocarditis, transfer of IL1ra or vIL-10 expression plasmid had significantly improved the survival rates of the animals. The expression of TNF-alpha was decreased to 0.60-fold (p < 0.005) and inducible nitric oxide synthase (iNOS) 0.43-fold (p < 0.005) by IL-1ra treatment, and the expression of IFN-gamma in the heart was decreased to 0.35-fold (p < 0.05), and iNOS 0.21-fold (p < 0.005), by vIL-10 relative to the controls. These results show that gene therapy with IL-1ra or vIL-10 expression plasmid was effective in the treatment of viral myocarditis, and in vivo electroporation may be a useful method by which to deliver cytokine therapy in cardiovascular diseases.

Viral Myocarditis

10.1089/104303401750270940

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Trp64Arg Mutation of ?-Adrenergic Receptor in Essential Hypertension Insulin Resistance and the Adrenergic System

American Journal of Hypertension (1997)

T. Fujisawa Hiroshi Ikegami Eiji Yamato Yoichi Hamada Kei Kamide

A putative pathogenic mutation in the β3-adrenergic receptor gene (Trp64Arg) has been reported to be associated with higher diastolic blood pressure as well as clinical features of the insulin resistance syndrome and an earlier onset of non-insulin-dependent diabetes mellitus (NIDDM) in Pima Indians and Finns. Because essential hypertension is reported to be associated with insulin resistance, we studied the mutation in Japanese patients with essential hypertension to clarify associations of this mutation with hypertension, insulin resistance, and basal adrenergic state in hypertensive subjects. The allele frequency of the mutation (Arg) in patients with essential hypertension was similar to that in control subjects (35 of 202 alleles [17.3%] v 27 of 146 [18.5%], respectively, P > .7). Insulin sensitivity measured by hyperinsulinemic euglycemic glucose clamp and plasma norepinephrine and epinephrine levels were also similar in hypertensive subjects with and without the mutation. These data suggest that Trp64Arg mutation in the β3-adrenergic receptor gene does not play a major role in susceptibility to essential hypertension or in insulin resistance and basal adrenergic state in hypertension. © 1997 American Journal of Hypertension, Ltd. Am J Hypertens 1997;10:101–105

Essential hypertension

Basal (medicine)

10.1016/s0895-7061(96)00297-x

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Citations (37)

Remarked hyperaldosteronemia in long-term hemodialysis patients who were recipients of renal transplantation

Journal of Japanese Society for Dialysis Therapy (1988)

Yoshiharu Tsubakihara Isao Nakanishi Eiji Yamato Kenji Yokoyama Hisashi Bandai

長期血液透析患者の中に高レニン (5ng/ml/hr以上) を伴う著明な高アルドステロン血症 (160ng/dl以上) を呈する症例が約20%に存在し, 低血圧症例が多い. このような病態を解明するために生体腎移植前後の血漿レニン活性 (PRA), 血漿アルドステロン値 (PAC) と体液バランスの変動について検討した.19例の生体腎移植成功例 (自己腎は残存) のうち, 移植前にPRAまたはPACが測定されていたのは11例であった. 11例中透析前PRA, PACが高値を呈する例は7例 (64%) におよび, うち6例が透析中に低血圧発作を呈していた. 透析前後の各電解質濃度や透析間の体重増加率は他の症例と差はなく, 移植後の腎機能の回復は共に順調で両群に差はなかった.状態が安定する術後15日目における体重増加率 (透析療法期の目標体重との比率) を比較すると, PRA, PACが高値でない症例 (N=4) では0.2±1.0%であったのに対し, PRA, PAC高値群 (N=7) では11.1±1.4%と有意の増加を呈した. また高値を呈したPRA, PACはともに移植後3-5日で正常範囲内に低下した.以上より長期透析患者に見られる高レニンを伴う著明な高アルドステロン症の主因は, 透析の目標体重が, 腎機能が正常である場合に仮定される真のbody weightを下回り, 慢性的な脱水症状にあるためによると推測され, PRA, PACの測定が血液透析療法における目標体重設定の一指標となり得ると考えられる.

10.4009/jsdt1985.21.173

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