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家庭血圧の季節間の差と臓器障害および心血管リスクとの関連－家庭血圧についての全国規模観察研究−J-HOP (Japan Morning Surge-Home Blood Pressure)研究−
Get PDF自治医科大学博士（医学）令和2年度doctoral thesi
Gender differences in the association of high-sensitivity C-reactive protein with metabolic syndrome and diabetes mellitus in a Japanese population: Jichi Medical School Cohort Study II
Get PDFBackground
Recently, some studies showed that metabolic syndrome (MetS) is associated with inflammation, indicated by high-sensitivity C-reactive protein (hsCRP), but there have been few population-based studies, especially in Japan. Herein, gender-specific relationships between MetS, diabetes mellitus (DM) and hsCRP in a general Japanese population were examined.
Methods
This cross-sectional study included 6436 males and females examined between 2010 and 2017 as part of the Jichi Medical School Cohort Study Ⅱ. Total subjects were divided into tertiles according to hsCRP values and the odds ratios (ORs) in MetS and DM were compared by gender.
Results
There exists a dose–response relationship between hsCRP levels and prevalence of MetS in both males and females. The conditional (adjusted) ORs of DM for given MetS status were not statistically significant, on the other hand, all the conditional ORs of MetS for given DM status were statistically significant (p<0.01) for both males and females (males: ORs for the second and third tertiles, DM- 1.7[95% confidence interval, 1.2-2.4], 2.4[1.8-3.4], DM+ 2.8[1.8-4.2], 3.1[2.1-4.5]; females: DM- 3.2[1.9-5.4], 5.4[3.2-9.9], DM+ 2.9[1.6-5.4], 4.2[2.3-7.5]). Furthermore, it was statistically shown that the conditional ORs of females are greater than those of males (female-to-male ratios of ORs for the second and third tertiles, 1.9, p=0.023; 2.2, p=0.005).
Conclusion
Inflammation, as measured by hsCRP, was elevated in both males and females with MetS in this Japanese population; however, hsCRP was elevated in patients with DM, probably because of high prevalence of MetS in patients with DM. hsCRP is a more suitable predictor of MetS for females than males.departmental bulletin pape
Hyperosmolar Hyperglycemic State in a Patient Receiving Corticosteroids in Palliative Care: A Case Report
Get PDFCorticosteroids are commonly used in palliative care to relieve symptoms but have been associated with adverse effects such as hyperglycemia. Here, we report a patient with end-stage cancer who developed a hyperosmolar hyperglycemic state during administration of corticosteroids. Insulin therapy and fluid replacement ameliorated his symptoms. The course of this patient suggests that a hyperosmolar hyperglycemic state should be considered as a differential diagnosis when a patient with a history of diabetes mellitus showed lethargy during a course of corticosteroids.departmental bulletin pape
