Importance of physical evaluation using skeletal muscle mass index and body fat percentage to prevent sarcopenia in elderly Japanese diabetes patients

Aims/Introduction To investigate the prevalence of sarcopenia, its related factors and indicators of physical evaluation in elderly diabetes patients. Materials and Methods This was a cross-sectional observation study. A total of 267 diabetes patients (159 men, 108 women) aged >65 years were recruited in the present study. Skeletal muscle mass index, grip strength and usual gait speed were measured to diagnose sarcopenia according to the Asian Working Group for Sarcopenia. Body composition was measured using bioelectrical impedance analysis. Body mass index (BMI) and body fat percentage were evaluated in quartiles to investigate the relationship with sarcopenia. A multiple logistic regression analysis examined sarcopenia-related factors. Results The prevalence of sarcopenia in all participants was 18.7% and increased with age. Sarcopenia decreased as BMI increased (P < 0.01, Cochran-Armitage test). In contrast, the third quartile body fat percentage group showed the lowest prevalence of sarcopenia. A strong positive correlation was observed between body mass and skeletal muscle mass indices (R = 0.702-0.682). Multiple logistic regression analysis showed that sarcopenia was associated with lower BMI, non-use of metformin and lower bone mineral content in men (P < 0.05), and lower bone mineral content, lower serum levels of albumin and older age in women (P < 0.05). Conclusions The present study suggests that diabetes patients with a high body fat percentage in addition to low BMI might develop sarcopenia. It is suggested that physical management in elderly diabetes patients should be carried out based on the evaluation of BMI and body fat percentage to prevent sarcopenia

Reduction of Superoxide Dismutase 1 Delays Regeneration of Cardiotoxin-Injured Skeletal Muscle in KK/Ta-Ins2Akita Mice with Progressive Diabetic Nephropathy

Superoxide dismutase (SOD) is a major antioxidant enzyme for superoxide removal, and cytoplasmic SOD (SOD1) is expressed as a predominant isoform in all cells. We previously reported that renal SOD1 deficiency accelerates the progression of diabetic nephropathy (DN) via increasing renal oxidative stress. To evaluate whether the degree of SOD1 expression determines regeneration capacity and sarcopenic phenotypes of skeletal muscles under incipient and advanced DN conditions, we investigated the alterations of SOD1 expression, oxidative stress marker, inflammation, fibrosis, and regeneration capacity in cardiotoxin (CTX)-injured tibialis anterior (TA) muscles of two Akita diabetic mouse models with different susceptibility to DN, DN-resistant C57BL/6-Ins2Akita and DNprone KK/Ta-Ins2Akita mice. Here, we report that KK/Ta-Ins2Akita mice, but not C57BL/6-Ins2Akita mice, exhibit delayed muscle regeneration after CTX injection, as demonstrated by the finding indicating significantly smaller average cross-sectional areas of regenerating TA muscle myofibers relative to KK/Ta-wild-type mice. Furthermore, we observed markedly reduced SOD1 expression in CTX-injected TA muscles of KK/Ta-Ins2Akita mice, but not C57BL/6-Ins2Akita mice, along with increased inflammatory cell infiltration, prominent fibrosis and superoxide overproduction. Our study provides the first evidence that SOD1 reduction and the following superoxide overproduction delay skeletal muscle regeneration through induction of overt inflammation and fibrosis in a mouse model of progressive DN

東シナ海の流れ藻に蝟集する稚魚の摂餌生態と海洋環境

Many commercially important fishes associate with drifting seaweeds in their juvenile stage, however, the ecological significance of drifting seaweeds for juvenile fishes is still unclear. We postulated that the following two hypotheses may be applicable for juvenile fishes associate with drifting seaweeds, the “concentration of food supply” hypothesis: juvenile fishes are attracted by phytal animals on the drifting seaweeds and the “indicator-log” hypothesis: fish use accumulations of drifting seaweed as an indicator of productive areas (e.g. frontal areas) for food. We investigated the frontal areas, zooplankton abundance around the drifting seaweed, and the food availability of fish juveniles associated with drifting seaweed accumulations in the East China Sea in 2012 and 2013. A total of 14 drifting seaweed mass and 22 species (n = 408) of fish juveniles were collected. We found that 49.7 - 99.7 % of the individual fed on planktonic food and the feeding incidence on phytal animals was less than 50 %. Although drifting seaweeds were aggregated around the frontal areas of surface currents, the zooplankton abundance was not significantly different between these frontal areas and other areas. Our findings indicate that ecological significance of drifting seaweeds as feeding habit is relatively low for juvenile fishes associated with drifting seaweeds.流れ藻には多くの水産上重要種の稚魚が付随するが，流れ藻の稚魚にとっての生態学的意義は明らかにされていない。筆者らは次の2仮説のいずれかが流れ藻付随稚魚に当てはまると考え，“concentration of food supply hypothesis”（流れ藻葉上生物を摂餌するため）と“indicator log hypothesis”（流れ藻をフロント域のような餌豊度の高い海域の目印とするため）を検証するため，2012年と2013年に東シナ海の流れ藻周辺の海洋環境，フロント域，動物プランクトン豊度，流れ藻付随稚魚の摂餌個体率を調べた。流れ藻は表層流の収束帯に集積されていたが，収束帯のプランクトン豊度は高くなかった。合計14個の流れ藻を採集し，合計22種（408尾）の稚魚の胃内容物を調査した結果，稚魚の49.7 - 99.7 %の個体はプランクトンを選択的に摂餌していたが，葉上生物の摂餌個体率は高くなかった（50 %未満）。以上の結果から流れ藻の稚魚にとっての生態学的意義は摂餌場でないことが示唆された

Magnitude of slowing gastric emptying by glucagon‐like peptide‐1 receptor agonists determines the amelioration of postprandial glucose excursion in Japanese patients with type 2 diabetes

Aims/Introduction: Pharmacological levels of glucagon‐like peptide‐1 (GLP‐1) can decelerate gastric emptying (GE) and reduce postprandial glucose levels. Most previous studies have used liquid meals to evaluate GE. We evaluated the effects of GLP‐1 receptor agonists (GLP‐1 RAs) on GE and postprandial glucose excursion in Japanese type 2 diabetes mellitus patients using a combination of solid and liquid meals. Materials and Methods: In this single‐center, prospective, open‐label study, nine healthy individuals and 17 patients with type 2 diabetes mellitus consumed a 460‐kcal combination of a solid and liquid meal labeled with 13C‐acetic acid. GE was measured from t = 0 to 150 min in a continuous 13C breath test. Eight participants with type 2 diabetes mellitus were administered GLP‐1 RAs, and we examined the relationship between GE and blood glucose excursion. Results: There were no differences in the average GE coefficient (GEC) and lag time between the healthy and type 2 diabetes mellitus groups. However, the type 2 diabetes mellitus group showed larger GEC variations (P < 0.05). The coefficient of variation of R‐R intervals was a significant predictor of GEC in type 2 diabetes mellitus patients (P < 0.01). The short‐acting GLP‐1 RA reduced the GEC at 1 month (P = 0.012), whereas the long‐acting GLP‐1 RA did not significantly change the GEC after treatment. A positive relationship was observed between postprandial glucose excursion from T0 min to T60 min and the GEC (r2 = 0.75; P < 0.01). Conclusions: The reduction in GE rate by the administration of GLP‐1 RAs can predict the improvement in postprandial glucose excursion in type 2 diabetes mellitus patients

Defined TLR3-specific adjuvant that induces NK and CTL activation without significant cytokine production in vivo

Ligand stimulation of the Toll-like receptors (TLRs) triggers innate immune response, cytokine production and cellular immune activation in dendritic cells. However, most TLR ligands are microbial constituents, which cause inflammation and toxicity. Toxic response could be reduced for secure immunotherapy through the use of chemically synthesized ligands with defined functions. Here we create an RNA ligand for TLR3 with no ability to activate the RIG-I/MDA5 pathway. This TLR3 ligand is a chimeric molecule consisting of phosphorothioate ODN-guided dsRNA (sODN-dsRNA), which elicits far less cytokine production than poly(I:C) in vitro and in vivo. The activation of TLR3/TICAM-1 pathway by sODN-dsRNA effectively induces natural killer and cytotoxic T cells in tumour-loaded mice, thereby establishing antitumour immunity. Systemic cytokinemia does not occur following subcutaneous or even intraperitoneal administration of sODN-dsRNA, indicating that TICAM-1 signalling with minute local cytokines sufficiently activate dendritic cells to prime tumoricidal effectors in vivo

Importance of physical evaluation using skeletal muscle mass index and body fat percentage to prevent sarcopenia in elderly Japanese diabetes patients

Abstract Aims/Introduction To investigate the prevalence of sarcopenia, its related factors and indicators of physical evaluation in elderly diabetes patients. Materials and Methods This was a cross‐sectional observation study. A total of 267 diabetes patients (159 men, 108 women) aged >65 years were recruited in the present study. Skeletal muscle mass index, grip strength and usual gait speed were measured to diagnose sarcopenia according to the Asian Working Group for Sarcopenia. Body composition was measured using bioelectrical impedance analysis. Body mass index (BMI) and body fat percentage were evaluated in quartiles to investigate the relationship with sarcopenia. A multiple logistic regression analysis examined sarcopenia‐related factors. Results The prevalence of sarcopenia in all participants was 18.7% and increased with age. Sarcopenia decreased as BMI increased (P < 0.01, Cochran–Armitage test). In contrast, the third quartile body fat percentage group showed the lowest prevalence of sarcopenia. A strong positive correlation was observed between body mass and skeletal muscle mass indices (R = 0.702–0.682). Multiple logistic regression analysis showed that sarcopenia was associated with lower BMI, non‐use of metformin and lower bone mineral content in men (P < 0.05), and lower bone mineral content, lower serum levels of albumin and older age in women (P < 0.05). Conclusions The present study suggests that diabetes patients with a high body fat percentage in addition to low BMI might develop sarcopenia. It is suggested that physical management in elderly diabetes patients should be carried out based on the evaluation of BMI and body fat percentage to prevent sarcopenia

Inflammatory pseudotumor of the liver and spleen diagnosed by percutaneous needle biopsy

An inflammatory pseudotumor (IPT) is a relatively rare lesion characterized by chronic infiltration of inflammatory cells and areas of fibrosis. IPTs are difficult to diagnose because of the absence of specific symptoms or of characteristic hematological or radiological findings. In this study, a case of a woman aged over 70 years was reported, who presented with a general malaise lasting more than two months. A computed tomography scan demonstrated a diffusely spread lesion of the liver with a portal vein occlusion and a splenic lesion surrounded by a soft density layer. Since the percutaneous liver biopsy showed findings that suggested an IPT, although the radiological findings did not exclude the possibility of a malignancy, we performed a percutaneous spleen biopsy to enable a more definitive diagnosis. The microscopic findings from the spleen specimen lead us to a diagnosis of IPT involving the liver and spleen. Subsequent steroid pulse therapy was effective, and rapid resolution of the disease was observed

Reduction of Superoxide Dismutase 1 Delays Regeneration of Cardiotoxin-Injured Skeletal Muscle in KK/Ta-Ins2Akita Mice with Progressive Diabetic Nephropathy

Superoxide dismutase (SOD) is a major antioxidant enzyme for superoxide removal, and cytoplasmic SOD (SOD1) is expressed as a predominant isoform in all cells. We previously reported that renal SOD1 deficiency accelerates the progression of diabetic nephropathy (DN) via increasing renal oxidative stress. To evaluate whether the degree of SOD1 expression determines regeneration capacity and sarcopenic phenotypes of skeletal muscles under incipient and advanced DN conditions, we investigated the alterations of SOD1 expression, oxidative stress marker, inflammation, fibrosis, and regeneration capacity in cardiotoxin (CTX)-injured tibialis anterior (TA) muscles of two Akita diabetic mouse models with different susceptibility to DN, DN-resistant C57BL/6-Ins2(Akita) and DN-prone KK/Ta-Ins2(Akita) mice. Here, we report that KK/Ta-Ins2(Akita) mice, but not C57BL/6-Ins2(Akita) mice, exhibit delayed muscle regeneration after CTX injection, as demonstrated by the finding indicating significantly smaller average cross-sectional areas of regenerating TA muscle myofibers relative to KK/Ta-wild-type mice. Furthermore, we observed markedly reduced SOD1 expression in CTX-injected TA muscles of KK/Ta-Ins2(Akita) mice, but not C57BL/6-Ins2(Akita) mice, along with increased inflammatory cell infiltration, prominent fibrosis and superoxide overproduction. Our study provides the first evidence that SOD1 reduction and the following superoxide overproduction delay skeletal muscle regeneration through induction of overt inflammation and fibrosis in a mouse model of progressive DN