Objective
Oral fungal infection is generally associated with dysbiosis related to antibiotic use, immunodeficiency, or frailty. However, fungal colonization in a typical population without apparent ...symptoms and its associated conditions are poorly understood. In this study, oral fungal colonization in community‐dwelling and independently living elderly populations was evaluated and factors affecting fungal colonization were analyzed.
Subjects and Methods
The subjects (410; 181 males and 229 females) were 75–99 years of age; those under prior antibiotic use were excluded. Fungal populations in the saliva were evaluated by PCR‐based molecular techniques. Body mass index (BMI), smoking habits, and oral health conditions were examined.
Results
Salivary fungal amounts exceeded 104 CFU/ml in 63 (15.4%) of 410 subjects. Candida albicans was most frequently detected (98.4%), followed by Candida glabrata (54.0%), and Candida dubliniensis (38.1%) in those subjects with fungi at 104 CFU/ml or over. Fungi at 104 CFU/ml or over in the presence of C. glabrata or C. dubliniensis was significantly associated with low BMI.
Conclusions
Candida albicans, C. glabrata, and C. dubliniensis dominated the oral mycobiome in Japanese community‐dwelling elderly. Lower BMI might signify compromised health status and thus could result in susceptibility to specific candidiasis by C. glabrata and C. dubliniensis.
Background The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. The elevated visceral fat accumulation (VFA) has been reported to be closely ...related to the development of atherosclerosis. This preliminary study was therefore designed to test the hypothesis that the presence of WML correlates with VFA and insulin resistance in type 2 diabetic patients not receiving insulin treatment.
Material and methods Based on brain magnetic resonance imaging (MRI), 95 type 2 diabetic patients were divided into two groups: WML‐positive group (aged 59 ± 7 years, mean ± SD n = 37) and WML‐negative group (aged 58 ± 5, years, n = 58). The level of blood glucose was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin, homeostasis model assessment (HOMA) index, and haemoglobin A1c. The fat distribution was evaluated by measuring the visceral fat accumulation by abdominal computerized tomography at the umbilical level.
Results The body mass index was higher in the WML‐positive group than in the WML‐negative group (P < 0·005). Plasma levels of triglycerides were higher while high‐density lipoprotein cholesterol was lower in the WML‐positive group than in the WML‐negative group (P < 0·05 and P < 0·01, respectively). FPG (P < 0·01), insulin concentrations (P < 0·0001), HOMA index (P < 0·0001) and VFA (<0·0001) levels were higher in the WML‐positive group than in the WML‐negative group. Multivariate logistic analysis revealed that WML was independently predicted by the high VFA and insulin resistance (P < 0·001, P < 0·0001, respectively).
Conclusions The results of this preliminary study indicate that the presence of WML was associated with the high VFA and insulin resistance in Japanese patients with type 2 diabetes mellitus. Further larger cohort studies are warranted to confirm these findings.
Background Insulin resistance significantly correlated with a non‐dipper type of essential hypertension. Thiazolidinediones (TZD), oral hypoglycaemic agents that act as insulin sensitizers, have ...been demonstrated in multiple in vivo and in vitro studies to possess antihypertensive properties. This study examined the efficacy of TZD therapy with pioglitazone at transforming the circadian rhythms of blood pressure from a non‐dipper to a dipper type.
Materials We examined 31 patients with type 2 diabetes mellitus during both a baseline period and a period of treatment with pioglitazone. Patients received 15 mg day−1 pioglitazone for four weeks and 30 mg day−1 for 12 weeks. Twenty‐four hour ambulatory blood pressure monitoring (ABPM) and laboratory data (blood tests for cardiovascular risk factors) were obtained at the beginning and end of the study.
Results In non‐dippers (n = 16), but not dippers (n = 15), we observed a significant interaction between pioglitazone therapy and nocturnal falls in systolic and diastolic blood pressure. This examination indicated that the magnitude of the nocturnal blood pressure fall was affected by pioglitazone therapy. In non‐dippers, but not dippers, a significant correlation was observed between the percent decrease in nocturnal BP and the homeostasis model assessment (HOMA) index (r = 0·774, P = 0·0007).
Conclusions The present study demonstrated that pioglitazone can restore the nocturnal BP declines in parallel to reductions in the HOMA index, suggesting that insulin resistance may play an important role in the genesis of circadian BP rhythms. TZD‐based treatment may thus have the additional therapeutic advantage of reducing the risk of cardiovascular complications by transforming the circadian rhythm of BP.
Background: In patients with chronic renal failure undergoing hemodialysis (HD), silent cerebral infarctions (SCI) are associated with high mortality. Levels of interleukin‐6 (IL‐6) increase with ...renal dysfunction and may be a novel predictor for cerebrovascular events. We tested the hypothesis that increased IL‐6 levels correlate with the occurrence of SCI in HD patients.
Methods: Using cranial magnetic resonance imaging findings, we divided 50 Japanese patients undergoing HD into two groups: with SCI (60 ± 7 years, mean ± SD, n = 27) and without SCI (60 ± 6 years, n = 23). We compared the gender, body mass index, metabolic profiles, IL‐6 levels, and smoking habits between the two groups.
Results: We made the following observations: (i) The prevalence of diabetes or hypertension did not differ between the two groups, (ii) the level of IL‐6 was higher in the with‐SCI group than in the without‐SCI group (P < 0.0001), (iii) the proportion of smokers was higher in the with‐SCI group (P < 0.05), (iv) plasma level of high‐density lipoprotein cholesterol was lower, whilst uric acid level was higher, in the with‐SCI group (P < 0.05 and P < 0.05, respectively), and (v) multiple logistic regression analysis identified IL‐6 levels as being significantly associated with the presence of SCI (odds ratio 3.13, 95% CI = 1.42–7.89, P < 0.0001).
Conclusions: This study indicates that patients with chronic renal failure who are maintained on HD exhibit an increased prevalence of SCI and that IL‐6 is significantly associated with the presence of SCI in HD patients.
Background: In patients with chronic renal failure undergoing haemodialysis (HD), silent cerebral infarctions (SCI) are associated with high mortality. Levels of monocyte chemoattractant protein‐1 ...(MCP‐1) increase with renal dysfunction and may be a novel predictor for cerebrovascular events. We tested the hypothesis that increased MCP‐1 concentration correlate with the occurrence of SCI in HD patients.
Methods: Using cranial magnetic resonance imaging (MRI) findings, 52 Japanese patients undergoing HD were divided into two groups: with SCI (61 ± 7 years, mean ± SD, n= 28) and without SCI (60 ± 6 years, n= 24). The gender, metabolic profiles and MCP‐1 concentration were compared between the two groups.
Results: The level of MCP‐1 was higher in the with‐SCI group than in the without‐SCI group (P < 0.0001). The proportion of smokers was higher in the with‐SCI group (P < 0.05) than in the without‐SCI group. Plasma level of high‐density lipoprotein cholesterol was lower, while uric acid level was higher, in the with‐SCI group (P < 0.05 and P < 0.05 respectively) compared to the without‐SCI group. Multiple logistic regression analysis identified MCP‐1 level as being significantly associated with the presence of SCI (odds ratio 1.48, 95% confidence interval = 1.10–5.75, P < 0.0001).
Conclusions: This study indicates that patients with chronic renal failure who are maintained on HD exhibit an increased prevalence of SCI, and that MCP‐1 is significantly associated with the presence of SCI in HD patients.
The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. Plasma total homocysteine (tHcy), which increases with diabetes, has been flagged as a ...novel predictor for cerebrovascular events. We tested the hypothesis that the presence of WML correlates with tHcy and insulin resistance in type 2 diabetic patients not receiving insulin treatment. Based on brain magnetic resonance imaging findings, 81 type 2 diabetic patients were divided into two groups, with‐WML group (57 ± 8 years, mean ± standard deviation, n = 31) and without‐WML group (57 ± 6 years, n = 50). The blood glucose level was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin, Homeostasis Model Assessment (HOMA) Index and hemoglobin A1c. The body mass index was higher in the with‐WML group than in the without‐WML group (P < 0.05). Plasma levels of triglyceride were higher whilst high‐density lipoprotein cholesterol was lower in the with‐WML group than in the without‐WML group (P < 0.05 and P < 0.0001 respectively). FPG (P < 0.005), insulin concentrations (P < 0.0001), HOMA Index (P < 0.0001) and tHcy (<0.0001) levels were higher in the with‐WML group than in the without‐WML group. Multivariate logistic analysis revealed that WML was independently predicted by the high tHcy and insulin resistance. Our findings indicate that the presence of WML was associated with the high tHcy and insulin resistance in these Japanese patients with type 2 diabetes mellitus.
Background Smoking and cardiovascular autonomic dysfunction are associated with high mortality in type 2 diabetic patients. This study tested the hypothesis that smoking is associated with insulin ...resistance/hyperinsulinaemia and cardiovascular autonomic dysfunction in type 2 diabetic patients who are not treated with insulin.
Materials and methods The study patients were 22 current smokers with type 2 diabetes mellitus (age: 57 ± 5 years, mean ± SD) and 30 age‐matched never‐smoked patients with type 2 diabetes mellitus (control group, 57 ± 8 years). The quality of blood glucose was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin (F‐IRI), homeostasis model assessment (HOMA) index and haemoglobin A1c (HbA1c). The severity of smoking status was expressed by the Brinkman index, which is calculated as number of cigarettes per day multiplied by years of smoking. Cardiovascular autonomic function was assessed by baroreflex sensitivity (BRS), heart‐rate variability, plasma norepinephrine concentration and cardiac 123I‐metaiodobenzylguanidine (MIBG) scintigraphic findings.
Results Baroreflex sensitivity was lower in the current smokers group than in the never‐smoked group (P < 0·05). Early and delayed 123I‐MIBG myocardial uptake values were lower (P < 0·05, and P < 0·01, respectively) and the percentage washout‐rate of 123I‐MIBG was higher (P < 0·0001) in the current smokers group than in the never‐smoked group. Fasting immunoreactive insulin (F‐IRI) concentration (P < 0·0001) and the homeostasis model assessment (HOMA) index (P < 0·0001) were higher in the current smokers group than the never‐smoked group. Multiple logistic regression analysis revealed that smoking was independently predicted by F‐IRI and the percentage washout‐rate of 123I‐MIBG.
Conclusions The results of the study suggested that smoking was associated with cardiovascular autonomic dysfunction and hyperinsulinaemia and that F‐IRI and the percentage washout‐rate of 123I‐MIBG were independent predictors of smoking in these Japanese patients with type 2 diabetes mellitus.
Human T‐cell Leukaemia Virus Type 1 (HTLV‐I) is a retrovirus that causes Adult T‐cell Leukaemia (ATL). The transmission routes of HTLV‐I are (i) from infected mothers to their newborn babies, (ii) ...from infected males (husbands) to females (their wives) by long‐term sexual intercourse, and (iii) from infected females (wives) to males (their husbands). Eshima et al. (2001) analysed a continuous‐time HTLV‐I model with no age structure in the population. In this paper, we consider the population dynamics of HTLV‐I infection in a discrete‐time mathematical model incorporating an age structure. The necessary and sufficient condition for the extinction of HTLV‐I is derived from the mathematical model. A simulation of the HTLV‐I infection based on the model demonstrates a rapid reduction of the HTLV‐I infection proportion in Japan.
Abstract Background The seroprevalence of Human T-cell Leukemia Virus Type 1 (HTLV-1) is female predominant despite the higher incidence of Adult T-cell Leukemia (ATL) in males. If the ...mother-to-child transmission of HTLV-1 is more common for male infants than in female infants, longer exposure to the virus for males may explain the paradoxically higher incidence of ATL. Objectives To test the hypothesis that the seroprevalence of HTLV-1 is male predominant during adolescence. Study design The presence of HTLV-1 antibody in 272,043 blood samples donated to a regional blood bank in an HTLV-1 high-endemic region was assessed. Results The entire population of female donors had a significantly higher seroprevalence compared to males (2.05% and 1.80%, respectively, p < 0.0001). However, compared with male donors, the carrier rate for female donors was lower for the youngest subgroup (16–19 years, p = 0.0011); was similar for the next two age subgroups (20–29 years and 30–39 years); and was significantly higher for the last two age subgroups (40–49 years and over 50–64 years, both p < 0.0001). In general, older age subgroups led to higher seroprevalence in both genders. Conclusions HTLV-1 infection is more common for males until after age 20, when male to female sexual transmission becomes likely. This suggests that mother-to-child transmission is more common for males.
