研究者詳細 - 大西　浩文

論文 - 大西　浩文

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Comparison of the clinical features of Japanese patients with primary biliary cirrhosis in 1999 and 2004: Utilization of clinical data when patients applied to receive public financial aid

Fumio Sakauchi, Asae Oura, Hirofumi Ohnishi, Mitsuru Mori

Journal of Epidemiology 17 ( 6 ) 210 - 214 2007年12月 [査読有り]

Background: In Asia there are few reports considering time intervals in the examination of clinical features of primary biliary cirrhosis (PBC). Therefore, we tried to compare the characteristics of patients with PBC in two different years. Methods: In two fiscal years (1999 and 2004), 9,761 and 13,142 patients with symptomatic PBC were registered to receive public financial aid from the Ministry of Health, Labour and Welfare of Japan, respectively. For the present study, clinical data from 2,127 patients in 1999 and 6,423 ones in 2004 were available. We compared the data in the two different years, including sex, age, major symptoms, and laboratory data. Results: Male/female ratios were the same figure (0.13 for 1999 and 2004). The median age was significantly older in 2004 than in 1999 (59 years for 1999, 63 years for 2004, respectively, p< 0.01). Jaundice and esophageal varices were found significantly less frequent in 2004 than in 1999 (p< 0.01 for each item). Levels of total bilirubin, γ-glutamyl transpeptidase (γ-GTP), total cholesterol, and immunoglobulin M were significantly lower in 2004 than in 1999 (p< 0.02 for total bilirubin, and p< 0.01 for other each item). The positive rate of antimitochondrial antibodies was significantly higher in 1999 than in 2004 (87.0% for 1999, 83.5% for 2004, respectively, p< 0.01)). Complicated autoimmune diseases such as Sjögren's syndrome, rheumatoid arthritis, and chronic thyroiditis were found significantly more frequent in 2004 than in 1999 (p< 0.01 for each item). Conclusions: Among the patients with PBC in 2004, an increase in median age, and lower levels of laboratory data such as γ-GTP have been found compared to 1999. These results may show an accumulation of patients with better prognosis and the recent medical progress in controlling patients with PBC. Copyright © 2007 by the Japan Epidemiological Association.

DOI PubMed

慢性腎疾患とメタボリックシンドロームの関連の検討端野・壮瞥町研究

赤坂憲, 浦信行, 斎藤重幸, 大西浩文, 吉田英昭, 伊藤洋輔, 田中希尚, 三俣兼人, 島本和明

日本腎臓学会誌 ( (一社)日本腎臓学会 ) 49 ( 3 ) 282 - 282 2007年04月

加速度センサー装置での身体活動量測定と身体活動と関連する要因の検討

森満, 尚爾華, 和泉比佐子, 坂内文男, 大西浩文, 長多好恵, 岡野五郎, 小林幸太, 檜垣靖樹

北海道公衆衛生学雑誌 20 ( 2 ) 72 - 77 2007年03月

J-GLOBAL

Relationship between visceral fat and cardiovascular disease risk factors: The Tanno and Sobetsu study

Yu Chiba, Shigeyuki Saitoh, Satoru Takagi, Hirofumi Ohnishi, Nobuo Katoh, Junichi Ohata, Motoya Nakagawa, Kazuaki Shimamoto

HYPERTENSION RESEARCH ( JAPANESE SOC HYPERTENSION CENT ACADEMIC SOC, PUBL OFFICE ) 30 ( 3 ) 229 - 236 2007年03月 [査読有り]

We assessed the amount of visceral fat using ultrasonography (US) and studied its relationship to cardiovascular disease risk factors, particularly blood pressure. The subjects in the first study were 45 male and 61 female outpatients. We measured the visceral fat area (VFA) of each subject using abdominal CT and waist circumference (WC), and visceral fat distance (VFD) using US. The subjects in the second study were 353 male and 457 female inhabitants of a rural community, for whom VFD and WC were measured. We divided subjects into tertiles based on VFD and WC, and studied the relationship between each group and individual risk factors. In an analysis of outpatient subjects, the correlation coefficient between VFA and VFD was satisfactory: r=0.660 for men and r=0.643 for women. In the analysis of the rural subjects, the high VFD group had a significantly higher odds ratio than the low VFD group in high blood pressure (HBP) and hypertriglyceridemia (HTG) for men and in HBP, HTG and low high-density lipoprotein cholesterolemia (LHDL) for women. Moreover, adjusting VFD for body mass index revealed that, in comparison to WC, VFD was significantly related to risk factors. VFD was used as an independent variable in multiple regression analysis with blood pressure level as a dependent variable; no significant association between WC and blood pressure was obtained. Visceral fat assessment by US may be useful for epidemiological study and for clinics with no abdominal CT equipment for identifying high-risk individuals, such as those with metabolic syndrome.

Impact of abnormal glucose tolerance, hypertension and other risk factors on coronary artery disease

Yosuke Nakamura, Shigeyuki Saitoh, Satoru Takagi, Hirofumi Ohnishi, Yu Chiba, Nobuo Kato, Hiroshi Akasaka, Tetsuji Miura, Kazufumi Tsuchihashi, Kazuaki Shimamoto

Circulation Journal ( 1 ) 71 ( 1 ) 20 - 25 2007年 [査読有り]

Background: The degree to which abnormal glucose tolerance contributes to the development of coronary artery disease (CAD) has not been clarified in Japanese. The relationship between abnormal glucose tolerance and severity of coronary artery stenosis, as well as the contributions of hypertension, diabetes and other risk factors for CAD to recurrence of the disease, were investigated in the present study. Methods and Results: The subjects were 474 consecutive patients (mean age: 63.8±11.3 years) with suspected CAD who were admitted to Sapporo Medical University Hospital during April 1, 1997 to March 31, 2004. The coronary index and stenosis score were higher in subjects with diabetes mellitus (DM) and in subjects with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) than in subjects with normal glucose tolerance (NGT). Ischemic episodes recurred during the observation period (mean 2.5 years) in 61 of 341 patients diagnosed as having CAD. In the follow-up subjects, systolic blood pressure (SBP) was significantly higher in the recurrence group than in the non-recurrence group, and SBP was a significant variable in logistic regression analysis after adjustment for age, gender, hemoglobin A1c, total cholesterol, body mass index, smoking history, family history and stenosis score. The relative risk of recurrence became 1.7-fold higher with a rise in SBP of 10 mmHg (95% confidence interval: 1.252-2.250). Analysis of the relationship between glucose tolerance and recurrence showed that the rate of recurrence was higher in patients with IFG+IGT+DM than in those with NGT. Conclusions: CAD progresses not only in patients with DM but also in those with IGT. The rate of recurrence of ischemic episodes increases in individuals with IGT or DM, and suggesting that hypertension is a risk factor for recurrence of ischemic episodes. Management of glucose tolerance and blood pressure is therefore important for prevention of CAD in Japanese.

DOI PubMed

Effects of angiotensin II type 1 receptor gene polymorphisms on insulin resistance in a Japanese general population: the Tanno-Sobetsu study.

Hiroshi Akasaka, Tomohiro Katsuya, Shigeyuki Saitoh, Ken Sugimoto, Yuxiao Fu, Satoru Takagi, Hirofumi Ohnishi, Hiromi Rakugi, Nobuyuki Ura, Kazuaki Shimamoto, Toshio Ogihara

Hypertension research : official journal of the Japanese Society of Hypertension ( 12 ) 29 ( 12 ) 961 - 7 2006年12月 [査読有り] [国際誌]

Although gene polymorphisms in the renin-angiotensin system (RAS) are predisposing factors for cardiovascular diseases, the precise mechanisms and interactions among confounding factors have not been clarified. We investigated whether genetic variants of RAS are involved in insulin sensitivity in a Japanese general population. During a medical checkup in 2001, participants (n=550) were recruited from among the residents of the towns of Tanno and Sobetsu, and written informed consent was obtained to participate in the genetic analysis and the epidemiological study. The insertion/deletion (lID) polymorphism of the angiotensin-converting enzyme gene (ACE), the Met235Thr polymorphism of the angiotensinogen gene (AGT), and the A1166C polymorphism of the angiotensin II type 1 receptor gene (AGTR1) were determined by gel electrophoresis or the TaqMan PCR method. We assessed insulin sensitivity using the homeostasis model assessment insulin resistance (HOMA-IR). The RAS gene polymorphisms were not associated with log-transformed values of HOMA-IR, whereas borderline association (p=0.02) was found between the A1166C polymorphism and dichotomous categorization of insulin resistance (defined as HOMA-IR > or =1.73). Our results suggested that the A1166C polymorphism of AGTR1 might affect insulin resistance by altering the responsiveness to angiotensin II signaling, though this mechanism is as yet inconclusive. Further study is required to confirm these findings in a larger, multi-ethnic population.

DOI PubMed

Relationship between hepatocellular carcinoma and impaired glucose tolerance among Japanese

M. M.H. Khan, Shigeyuki Saito, Satoru Takagi, Hirofumi Ohnishi, Hisako Izumi, Fumio Sakauchi, Masakazu Washio, Tomoko Sonoda, Yoshie Nagata, Sumiyo Asakura, Kota Kobayashi, Mitsuru Mori, Kazuaki Shimamoto

Hepato-Gastroenterology 53 ( 71 ) 742 - 746 2006年09月 [査読有り]

Background/Aims: Both the incidence of diabetes mellitus (DM) and mortality from Hepatoceuular carcinoma (HCC) are increasing in Japan. As the association of overall cancer and HCC with impaired glucose tolerance (IGT) has been studied rarely in the world including Japan, this study assessed their associations using cohort data of Hokkaido, Japan. Methodology: After getting ethical consent, this study included 908 men and 1,081 women aged 30-77 years during 1977-78 and collected detailed information using the baseline survey. The subjects were followed until 2002 and deaths were recorded using ICD-9. Classifying them into three groups of diabetes status namely DM, IGT, and normal, the relative risk (RR) of mortality was estimated by diabetes status using multivariate Cox model. Results: This study revealed no association between overall cancer and diabetes status. However, the RR of mortality from HCC was about 11 times (HR=10.8,95%CI: 1.3-92.5) higher in IGT compared with normal group. DM group also showed higher risk of mortality than normal group. Conclusions: HCC mortality was significantly high among IGT group. However, as the results of the study were based on small data, further studies with large cohort are needed to address the association of IGT with overall cancer and HCC mortality in Japan. © H.G.E. Update Medical Publishing S.A.

PubMed

Chronic kidney disease is a risk factor for cardiovascular death in a community-based population in Japan NIPPON DATA90

Koshi Nakamura, Tomonori Okamura, Takehito Hayakawa, Takashi Kadowaki, Yoshikuni Kita, Hirofumi Ohnishi, Shigeyuki Saitoh, Kiyomi Sakata, Akira Okayama, Hirotsugu Ueshima

CIRCULATION JOURNAL ( JAPANESE CIRCULATION SOCIETY ) 70 ( 8 ) 954 - 959 2006年08月 [査読有り]

Background Chronic kidney disease (CKD) has been identified as a risk factor for cardiovascular disease (CVD). Methods and Results The risk of cardiovascular death was evaluated in a large cohort of participants selected randomly from the overall Japanese population. Participants (mean age, 52.4 years) free of previous CVD were followed up for 10 years. Glomerular filtration rate (GFR) was estimated using the abbreviated equation developed at the Cleveland Clinic laboratory for the Modification of Diet in Renal Disease study. Of the 7,316 participants, 6.7% had CKD with a GFR < 60 at baseline. Even after adjustment for other risk factors, the presence of CKD conferred an increased risk of cardiovascular death with a hazard ratio of 1.20 (95% confidence interval, 0.82-1.76). Furthermore, a negative, graded correlation between GFR and risk of cardiovascular death was observed: 1.09 (0.72-1.64) for a 60 <= GFR < 90, 1.15 (0.67-1.99) for a 45 <= GFR < 60, 1.23 (0.49-3.09) for a 30 <= GFR < 45, 5.52 (1.62-18.75) for a 15 <= GFR < 30, 9.12 (2.12-39.29) for a GFR < 15, as compared with normal kidney function (GFR 90). The proportion of excess cardiovascular death due to CKD was 1.3%. Conclusion CKD was an independent risk factor for cardiovascular death in a community-dwelling Japanese population.

DOI PubMed

Incidence of type 2 diabetes in individuals with central obesity in a rural Japanese population - The Tanno and Sobetsu Study

H Ohnishi, S Saitoh, S Takagi, N Katoh, Y Chiba, H Akasaka, Y Nakamura, K Shimamoto

DIABETES CARE ( AMER DIABETES ASSOC ) 29 ( 5 ) 1128 - 1129 2006年05月 [査読有り]

DOI PubMed

Incidence of type 2 diabetes in individuals with central obesity in a rural japanese population: The Tanno and Sobetssu study: Response to Oda [13]

Hirofumi Ohnishi, Shigeyuki Saitohi, Satoru Takagii, Nobuo Katohi, Yu Chibai, Hiroshi Akasakai, Yosuke Nakamurai, Kazuaki Shimamotoi

Diabetes Care ( 8 ) 29 ( 8 ) 1989 2006年 [査読有り]

DOI PubMed

Metabolic syndrome and cardiac disease in Japanese men: Applicability of the concept of metabolic syndrome defined by the National Cholesterol Education Program-Adult Treatment panel III to Japanese men - The Tanno and Sobetsu study

H Takeuchi, S Saitoh, S Takagi, H Ohnishi, J Ohhata, T Isobe, K Shimamoto

HYPERTENSION RESEARCH ( JAPANESE SOC HYPERTENSION CENT ACADEMIC SOC, PUBL OFFICE ) 28 ( 3 ) 203 - 208 2005年03月 [査読有り]

Results of a 6-year follow-up study were used to determine whether the concept of and the criteria for metabolic syndrome as defined by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) can be applied to Japanese men for prediction of the occurrence of cardiac disease. The subjects were 808 men who underwent mass health check-ups in 1993 and who were not on medication for hypertension, diabetes or hyperlipidemia. Individuals who had hypertriglyceridemia, hypo-high density lipoprotein (HDL) cholesterolemia, high blood pressure, and/or high fasting plasma glucose levels were identified on the basis of the NCEP-ATP III criteria. Not in conformity with the NCEP-ATP III, however, a cut-off value of 85 cm was used for waist girth as an indicator of abdominal obesity. The subjects who had 3 or more risk factors were judged as having metabolic syndrome. The proportion of subjects having metabolic syndrome was 25.3%. In the 6-year follow-up study, cardiac disease occurred in 11.7% of the subjects in the metabolic syndrome group and in 6.7% of the subjects in the non-metabolic syndrome group. Results of regression analysis using Cox's proportional hazards model showed that subjects in the metabolic syndrome group had a 2.2-times greater risk of developing cardiac disease than did subjects in the non-metabolic syndrome group. The concept of metabolic syndrome as defined in the NCEP-ATP III was therefore considered to be useful for predicting the occurrence of cardiac disease in Japanese men.

DOI PubMed

Establishment and assessment of wide area medical information network system in Hokkaido

H Akashi, H Tokura, H Ohnishi, K Nishikage, T Yamaguchi, K Saijo, T Shinmi, M Nakamura, M Nakayama, H Tatsumi

WEB AND COMMUNICATION TECHNOLOGIES AND INTERNET -RELATED SOCIAL ISSUES - HSI 2005 ( SPRINGER-VERLAG BERLIN ) 3597 179 - 189 2005年 [査読有り]

To support regional medicine in rural area of Hokkaido, we have tried to establish advanced medical information network system. At first we connected two rural town hospitals with SMU (Sapporo Medical University) and performed medical data transmission via the Internet. We used IPsec and regional Internet exchange (IX) for ensuring security and stability. As a second stage, we established a Metropolitan Area Network (MAN), a gigabit network with a 120 km radius in order to connect three medical schools (Hokkaido University, Asahikawa Medical College and SMU) with 10 hospitals. These experiments were performed with Internet technology such as VoIP (voice over IP), VPN, IPsec. As a third stage, we have coined VGN (Virtual Global Network) a concept, which includes IPv6 Topological Addressing Policy. According to the policy we established the IPv6 network to connect SMU with Obihiro area hospitals and a preschool for disabled children. Here, we described details of these experiments in terms of applications and network technologies.

DOI

Prevalence of asymptomatic arteriosclerosis obliterans and its relationship with risk factors in inhabitants of rural communities in Japan: Tanno-Sobetsu study

T Fujiwara, S Saitoh, S Takagi, H Ohnishi, J Ohata, H Takeuchi, T Isobe, Y Chiba, N Katoh, H Akasaka, K Shimamoto

ATHEROSCLEROSIS ( ELSEVIER SCI IRELAND LTD ) 177 ( 1 ) 83 - 88 2004年11月 [査読有り]

Objectives: Since arteriosclerosis obliterance in the legs (ASO) causes deterioration of the prognosis of the elderly, prevention of ASO is important for maintenance of their quality of lives. We studied the prevalences of ASO in rural communities in Japan. Methods and results: We measured the ratio of systolic blood pressure in the leg to that in the arm (ABI) using a new device, Form PWV/ABI, in 1398 subjects of both sexes. Subjects with ABI values below 0.9 were considered to have ASO. The prevalence of ASO was 2.7% in all of the subjects, 1.0% in subjects under the age of 60 years, and 3.4% in subjects aged 65 years or more. Multiple regression analysis showed that ABI was correlated with plasma level of total cholesterol in men. There were no significant differences of the mean age, mean fasting plasma glucose level and percentage of patients who smoked between the ASO group and non-ASO group in each sex. Mean cholesterol level in our subjects is lower than the reported levels in Europeans and Americans. The prevalence of ASO increased with increase in the number of risk factors in individual subjects. Conclusions: Among the atherosclerotic risk factors, age and total cholesterol seem to be more important risk factors of ASO than others. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

DOI PubMed

[Adiponectin levels and coronary risk factors in the elderly].

Isobe T, Saitoh S, Takagi S, Ohnishi H, Ohhata J, Takeuchi H, Fujiwara T, Higashiura K, Ura N, Shimamoto K

Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics ( 3 ) 41 ( 3 ) 328 - 333 2004年05月 [査読有り]

DOI PubMed CiNii

Pulse wave velocity as an indicator of atherosclerosis in impaired fasting glucose - The Tanno and Sobetsu study

H Ohnishi, S Saitoh, S Takagi, J Ohata, T Isobe, Y Kikuchi, H Takeuchi, K Shimamoto

DIABETES CARE ( AMER DIABETES ASSOC ) 26 ( 2 ) 437 - 440 2003年02月 [査読有り]

OBJECTIVE - Brachial-ankle pulse wave velocity (baPWV), as an indicator of atherosclerosis in impaired fasting glucose (IFG), was studied in 232 subjects randomly selected from inhabitants of two rural communities in Japan. RESEARCH DESIGN AND METHODS - BMI, systolic blood pressure (SBP), fasting blood glucose (FBS), lipid parameters, ankle brachial pressure index (ABI), and baPWV were measured in each subject. ABI and baPWV were measured using the recently developed device, form ABI/PWV. The subjects were divided into three groups according FBS level: a normal group consisting of subjects with FBS <110 mg/dl, an IFG group consisting of subjects with FBS 110-125 mg/dl, and a diabetic group consisting of subjects with FBS greater than or equal to126 mg/dl and subjects taking hypoglycemic agents. The parameters in the three groups were compared. RESULTS - it was found that the baPWV value increased with increasing plasma glucose level. Significant differences were found between the baPWV values in the normal and IFG groups (1,518 vs. 1,673 cm/s, P = 0.01) and in the normal and diabetic groups (1,518 vs. 1,771 cm/s, P < 0,0001). The results of multiple regression analysis showed that FBS was closely related to baPWV as well as to age and SBP. CONCLUSIONS - The relationship between IFG and atherosclerosis remains controversial. Further studies are needed to evaluate whether strict control of blood glucose level in patients with IFG will result in the prevention of atherosclerosis progression.

DOI PubMed

Relation of hypertension and glucose tolerance impairment in elderly people to the development of arteriosclerosis-investigation using pulse wave velocity

Takeshi Isobe, Shigeyuki Saitoh, Satoru Takagi, Hirofumi Ohnishi, Junichi Ohhata, Hiroshi Takeuti, Tadashi Fujiwara, Hirosi Akasaka, Kazuaki Shimamoto

Japanese Journal of Geriatrics ( 6 ) 40 ( 6 ) 610 - 614 2003年 [査読有り]

Hypertension and diabetes are risk factors for arteriosclerosis and have a synergistic effect on the progression of arteriosclerosis. The aim of this study was to determine the correlation between complications of hypertension and diabetes and arteriosclerosis as assessed by pulse wave velocity (PWV) in elderly subjects. The subjects of this study were 186 people aged 60 years or older (mean age: 68.8 ± 5.8 years) who were scheduled to undergo health examinations. PWV, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), fasting blood sugar (FBS), total cholesterol (TC), triglyceride (TG) and HDL cholesterol (HDL) were measured in each subject. The patients were divided according to the American Diabetes Association (ADA) diagnostic criteria for diabetes based on fasting blood sugar level into the following three groups: a normal (NGT) group (FBS< 110mg/dl), an impaired fasting glucose (IFG) group (110≤FBS< 126mg/dl) and a diabetes mellitus (DM) group (FBS≥126mg/dl or receiving treatment for diabetes). Based on the JNC-VI and WHO/ISH diagnostic criteria, subjects who had a SBP of 140mmHg or higher or a DBP of 90mmHg or higher or who had been taking hypotensive drugs were assigned to the hypertension (HT) group, and the other subjects were assigned to the normotenskm (NT) group. PWV showed significant positive correlations with SBP and FBS (r = 0.499 and r = 0.300, respectively). The effects of hypertension on PWV were significantly higher in subjects with HT than in subjects with NT in all of the glucose tolerance groups (all p< 0.01). Moreover, in the subjects with HT, PWV started to increase from the IFG stage, and PWV was significantly higher in the DM groups than in the NGT group (p< 0.01). In multiple regression analysis using PWV as an objective variable, SBP and FBS were selected as significant explanatory variables. The results of this study indicate the need for stricter management of elderly people with slight glucose tolerance impairment and hypertension in order to prevent the occurrence of arteriosclerosis.

DOI PubMed

Relationship between insulin-resistance and remnant-like particle cholesterol

H Ohnishi, S Saitoh, S Takagi, J Ohata, T Isobe, Y Kikuchi, H Takeuchi, K Shimamoto

ATHEROSCLEROSIS ( ELSEVIER SCI IRELAND LTD ) 164 ( 1 ) 167 - 170 2002年09月 [査読有り]

We investigated the relationship between insulin-resistance (IR) and remnant-like particle cholesterol (RLP-C) using 472 subjects (174 men and 298 women) randomly selected from inhabitants of two rural communities in Japan, Tanno and Sobetsu. The level of fasting immunoreactive insulin (FIRI), fasting blood glucose (FBS), total cholesterol (TC), triglyceride (TG), HDL cholesterol, LDL cholesterol, and RLP-C were measured in each subject. Homeostasis model assessment (HOMA-R) was used as an indicator of IR. The subjects were divided into two groups according to the value of HOMA-R: an IR group of subjects with HOMA-R greater than or equal to 1.73 and a normal (NR) group of subjects with HOMA-R < 1.73. There was a significant positive correlation between HOMA-R and RLP-C. The value of RLP-C was higher in the IR group than in the NR group (7.1 vs. 3.9 mg/dl in men and 5.3 vs. 3.6 mg/dl in women). The frequency of hyper RLP cholesterolemia (RLP-C &GE; 7.5 mg/dl) was higher in the IR than in the NR group (23.7 vs. 6.6% in men and 20.3 vs. 6.6% in women). The results of multiple regression analysis showed that HOMA-R was closely related to RLP-C. The results of this study suggest that RLP-C is closely associated with IR syndrome. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

PubMed

Detection of cardiac calcinosis in hemodialysis patients by whole-body scintigraphy with 99m-technetium methylene diphosphonate

Mariko Eguchi, Kazufumi Tsuchihashi, Hideki Takizawa, Narifumi Nakahara, Makoto Hagiwara, Hirofumi Ohnishi, Taka-Aki Torii, Akiyoshi Hashimoto, Shigeru Marusaki, Tomoaki Nakata, Nobuyuki Ura, Kazuaki Shimamoto

American Journal of Nephrology ( S. Karger AG ) 20 ( 4 ) 278 - 282 2000年 [査読有り]

A noninvasive method for the diagnosis of cardiac calcinosis, a life- threatening complication in hemodialysis patients with end-stage renal disease (ESRD), has not, as yet, been firmly established. We tested whether whole body scanning with 99m-technetium methylene diphosphonate (MDP) might visualize cardiac calcinosis. In 19 consecutive chronic hemodialysis ESRD patients (13 males and 6 females, aged 40-81, mean 63 ± 8 years) with cardiovascular disease [mitral annular calcinosis and/or calcified aortic valve (n = 4), hemodialysis cardiomyopathy (n = 1), coronary artery disease (n = 9) and peripheral artery atherosclerotic disease (n = 6)], MDP uptake in the heart was compared to that in 7 non-ESRD controls with hyperparathyroidism due to adenoma. Cardiac and lung field MDP uptake was confirmed in only 3 (16%) and 5 (26%) of the 19 ESRD subjects, respectively, but was absent in controls. Positive cardiac uptake was related to cardiac calcified complications (mobile intracardiac calcinosis, myocardial calcinosis and mitral annular calcification) and the duration of hemodialysis (p = 0.015). While it was statistically insignificant, subjects showing MDP uptake were elder and had higher serum Ca or Ca x P product and lower intact parathyroid hormone levels. These results suggest that cardiac calcinosis in ESRD patients can be detected noninvasively by myocardial scintigraphy with 99m-technetium MDP. Copyright (C) 2000 S. Karger AG, Basel.

DOI PubMed

A Review of Cohort Studies on the Association Between History of Diabetes Mellitus and Occurrence of Cancer.

Mori M, Saitoh S, Takagi S, Obara F, Ohnishi H, Akasaka H, Izumi H, Sakauchi F, Sonoda T, Nagata Y, Shimamoto K

Asian Pacific journal of cancer prevention : APJCP ( 4 ) 1 269 - 276 2000年 [査読有り]

PubMed

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