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The gut microbiota and coronary artery calcification in Japanese men
Get PDFBackground:
The gut microbiota differs between patients with coronary artery disease (CAD) and healthy controls; however, it currently remains unclear whether these differences exist prior to the onset of CAD. We herein investigated the gut microbiota associated with subclinical coronary artery calcification (CAC) in a Japanese population.
Methods:
A total of 663 Japanese men were enrolled in this cross-sectional study. Computed tomography and gut microbiology tests were performed, and CAC scores were calculated using the Agatston method. Participants were categorized into 4 groups based on their CAC scores: CAC = 0, 0 <CAC ≤100, 100 <CAC, and with a CAD history. The bacterial 16S ribosomal RNA gene was amplified, and DNA sequencing was conducted on a MiSeq System. QIIME2 and LEfSe were used to analyze the gut microbiota, and the results obtained were compared among the 4 CAC categories.
Results:
The mean age of participants was 68.4 years (46-83 years). The numbers of participants in CAC = 0, 0 <CAC ≤100, 100 <CAC, and with a CAD history were 219, 200, 193, and 51, respectively. The medians of the Firmicutes to Bacteroidota ratio were 1.50, 1.52, 1.67, and 1.80 for each CAC category (P = .020). One standard deviation higher phylum Firmicutes, class Bacilli, and order Lactobacillales were associated with a 1.3- to 1.4-fold higher risk of CAD. These taxa were also associated with a higher CAC score category. The family Streptococcaceae and genus Streptococcus showed a higher risk of CAD. The order Enterobacterales and family Enterobacteriaceae correlated with CAC scores. The genus Blautia showed a preventive direction for CAD but did not correlate with CAC scores.
Conclusions:
The gut microbiota significantly differed from the phylum to genus level in a manner that was dependent on CAC scores, even before the onset of CAD.journal articl
Relationships of Proton Pump Inhibitor-Induced Renal Injury with CYP2C19 Polymorphism: A Retrospective Cohort Study
Get PDFProton pump inhibitors (PPIs) have recently been reported to be linked with nephrotoxicity. PPIs are metabolized mainly or partly by cytochrome P450 2C19 (CYP2C19). However, the relationship between CYP2C19 genetic polymorphism and PPI-induced nephrotoxicity is unclear. In this study, we aimed to analyze the association between the time of occurrence of renal injury by PPIs, including lansoprazole, esomeprazole, rabeprazole, and vonoprazan, and CYP2C19 metabolizer status classified by CYP2C19 genotypes. Patients prescribed PPIs were reviewed in this retrospective cohort study. The primary outcome was the time to a 30% decrease in estimated glomerular filtration rate (eGFR) from baseline. In patients treated with lansoprazole, the time to a 30% decrease in eGFR for the CYP2C19 poor metabolizer (PM) group was significantly shorter than that for the non-PM group (hazard ratio for PM vs. non-PM, 2.43, 95% confidence interval, 1.21 to 4.87, P = 0.012). In contrast, in patients that received esomeprazole, rabeprazole, or vonoprazan, no significant differences were found in the time to a 30% decrease in eGFR between non-PM and PM groups. The adjusted hazard ratios for the time to a 30% eGFR decrease in patients treated with lansoprazole were significantly higher for CYP2C19 PM, hypertension, and a history of myocardial infarction. In conclusion, this retrospective study showed that CYP2C19 metabolizer status was associated with the time to a 30% eGFR decrease in patients treated with lansoprazole, but not with esomeprazole, rabeprazole, or vonoprazan.journal articl
Heart Rate Fragmentation, Ambulatory Blood Pressure, and Coronary Artery Calcification: A Population-Based Study
Get PDFBackground:
Little is known regarding whether ultra-rapid patterns of heart rate variability (eg, heart rate fragmentation [HRF]) are associated with coronary artery calcification (CAC) in a general population.
Objectives:
This study aimed to assess the association between HRF and CAC, and whether these associations are independent of systolic blood pressure (SBP) levels.
Methods:
From SESSA (the Shiga Epidemiological Study of Subclinical Atherosclerosis), we used data from 24-hour ambulatory blood pressure monitoring to identify awake and asleep SBP levels, and data from concurrent 24-hour Holter monitoring to quantify HRF using the awake and asleep percentage of inflection points (PIP). CAC on computed tomography scanning was quantified using an Agatston score. We used multivariable binomial logistic regression to assess the associations of PIP and ambulatory SBP with the presence of CAC, as defined by Agatston score >0.
Results:
Of the 508 participants in this study (mean age: 66.5 ± 7.3 years), 325 (64%) had CAC and 183 (36%) did not. In fully adjusted models of prevalent CAC that also included office SBP, the ORs with 95% CIs for awake PIP, awake SBP, asleep PIP, and asleep SBP were 1.23 (95% CI: 0.99-1.54), 1.40 (95% CI: 1.11-1.77), 1.31 (95% CI: 1.05-1.62), and 1.28 (95% CI: 1.02-1.60), respectively. There was no evidence of interaction between PIP and ambulatory SBP in association with CAC. Results were similar when other HRF indices instead of PIP were used.
Conclusions:
Higher HRF and SBP levels during sleep are each associated with the presence of CAC in a general male population.journal articl
Fructose overconsumption accelerates renal dysfunction with aberrant glomerular endothelial-mesangial cell interactions in db/db mice
Get PDF滋賀医科大学博士（医学）Biochimica et biophysica acta. Molecular basis of disease. 2024 Apr;1870(4):167074.令和6年度thesi
Relationship Between Hemoglobin Concentration and Cardiovascular Disease Mortality in a 25-Year Follow-up Study of a Japanese General Population - NIPPON DATA90
Get PDF滋賀医科大学博士（医学）Background:
Deviations of hemoglobin from normal levels may be a factor in cardiovascular disease (CVD) risk; however, conclusive evidence is lacking. In addition, preclinical conditions may influence hemoglobin concentrations, but studies focusing on reverse causation are limited. Thus, we examined the relationship between hemoglobin concentrations and CVD mortality risk, considering reverse causation.
Methods and results:
In a prospective cohort representative of the general Japanese population (1990-2015), we studied 7,217 individuals (mean age 52.3 years; 4,219 women) without clinical CVD at baseline. Participants were categorized into sex-specific hemoglobin quintiles (Q1-Q5) and data were analyzed using the Cox proportional hazards model adjusted for possible confounders. During a 25-year follow-up, 272 men and 334 women died from CVD. Adjusted hazard ratios for CVD mortality across sex-specific quintiles, using Q3 as the reference, were significantly higher for Q1 (1.40; 95% confidence interval [CI] 1.08-1.82) and Q5 (1.49; 95% CI 1.14-1.96), and remained significant after excluding deaths within the first 5 years of follow-up to consider reverse causation (1.35 [95% CI 1.02-1.79] and 1.45 [95% CI 1.09-1.94], respectively). A similar U-shaped association was seen between transferrin saturation levels and CVD mortality, but after excluding deaths within the first 5 years the association was significant only for Q1.
Conclusions:
Low and high hemoglobin concentrations were associated with an increased risk of CVD mortality.令和6年度doctoral thesi
Acetate derived from the intestinal tract has a critical role in maintaining skeletal muscle mass and strength in mice
Get PDF滋賀医科大学博士（医学）Physiological reports. 2024 Jun;12(11):e16047.令和6年度thesi
シガ イカ ダイガク ニ オケル キョウガク マネジメント カイカク : ミッツ ノ ホウシン ノ カイカク ト キョウイク カテイ カイヘン
Get PDF本稿の目的は，滋賀医科大学における教学マネジメント改革の実践事例を広く共有すること，及び滋賀医科大学の全構成員に自大学の三つの方針の改訂や教育課程編成に関する背景や概要を共有し，すべての教員・職員・学生へ教育改善のオーナーシップを共有することである．今般の改革は，「医学教育モデル・コア・カリキュラム」の改訂と「学修者本位の教育」への転換を主な背景として実施した．教育改善に関する主な実践内容は，「三つの方針及びアウトカムの改訂」と「教育課程の改編」である．「三つの方針等の改訂」については，「改訂版医学教育モデル・コア・カリキュラムとの整合性の確保」，「ディプロマ・ポリシーとアウトカムの関係性の整理」及び「ディプロマ・ポリシーとカリキュラム・ポリシーの一貫性の確保」の３点について，「教育課程の改編」については，「科目区分の整理と単位制の導入」，「教養科目のあり方の検討」及び「体系的かつ組織的な教育課程の基盤整備」の３点についてそれぞれ言及した．また，本実践においては，審議や作業に充てることができる時間が限られていたため，更なる検討を要する事項や引き続き取り組んでいくべき課題を多く残していることを示したうえで，今後の教育改善の課題と方針として，「マイルストーンの設定」，「アウトカムの精査」，「教学IRの基盤整備」，「教学マネジメント体制の周知」の４つの事項を挙げた．departmental bulletin pape
