Publications by authors named "Ako Oiwa"

Article Synopsis
  • A 56-year-old man diagnosed with hypertension was found to have primary aldosteronism and a 4-cm tumor on his left adrenal gland.
  • The removed adrenal gland tissue revealed both an aldosterone-producing adenoma and ectopic thyroid tissue.
  • This case marks the first documented instance of ectopic thyroid tissue in the adrenal gland coexisting with an aldosterone-producing adenoma, necessitating further studies to explore their relationship.
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There are few established easy-to-perform exercise protocols with evidence-based effects for individuals with type 2 diabetes (T2D). A unique exercise regimen, interval walking training (IWT), has been reported to be beneficial for improving metabolic function, physical fitness and muscle strength in adults of overall health. This pilot study aims to demonstrate descriptive statistics of IWT adherence and changes in various data before and after the intervention of IWT in adults with T2D, perform statistical hypothesis testing, and calculate effect sizes.

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Article Synopsis
  • Adding a low dose of spironolactone (12.5 mg/d) to treatment for adults with chronic kidney disease and type 2 diabetes can reduce levels of albumin in urine (albuminuria) without significantly increasing the risk of high potassium levels (hyperkalemia).
  • This study was conducted from July 2016 to November 2020 in three diabetes care centers in Japan, involving 130 adults with type 2 diabetes and specific kidney function criteria.
  • Results showed the spironolactone group had a significant reduction in urine albumin-to-creatinine ratio compared to a control group, and while potassium levels increased, none of the participants reached dangerously high levels of potassium.
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A 76-year-old woman was admitted to the emergency room of Nagano Municipal Hospital with the complain of severe back pain. Chest and abdominal enhanced computed tomography scans showed bilateral adrenal infarction and minute pulmonary nodules, but she had no respiratory symptoms. After admission, a family member of the patient was found to have been in close contact with a coronavirus disease 2019 (COVID-19) patient.

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Given that factors affecting renal function remain unknown, this study aimed to identify key predictors of estimated glomerular filtration rate (eGFR) deterioration, which is a representative of renal function decline in older adults with type 2 diabetes (T2DM). In an exploratory prospective observational study, we enrolled 268 Japanese people with T2DM aged ≥20 years who were followed up at Shinshu University Hospital. Among those, 112 eligible individuals aged ≥65 years were included in the present study.

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There is a great deal of research interest regarding the underlying causes of slightly elevated TSH values in patients with subclinical hypothyroidism (SH) without abnormal findings on ultrasonography or anti-thyroid antibodies. Twelve infertile women with thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb)-negative nongoitrous SH were referred to our department of endocrinology between September 2007 and September 2015. None had been diagnosed with autoimmune thyroid disease or had any possible causes of SH.

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In the therapeutic approach to elderly diabetic patients, it is necessary to consider that diabetes is one aspect of geriatric syndrome, and individualizing targets of treatments are needed based on the presence of frail, dementia, and activity of daily living. Because of decreased physiological functions along with aging, older patients are prone to cause hypoglycemia by drug therapy. Thus, proper using of drugs for older patients are important.

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Article Synopsis
  • Small heterodimer partner (SHP, NR0B2) is a nuclear receptor that represses various hormone receptors and exhibits a daily expression pattern in the liver.
  • The study found that the core circadian components CLOCK-BMAL1 bind to the mSHP promoter, boosting its activity significantly, while LRH-1 additionally enhances this activity.
  • SHP does not influence the promoter's activity directly but represses the combined action of CLOCK-BMAL1 and LRH-1, indicating a complex interaction that helps regulate circadian rhythms in liver functions.
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The expression of cholesterol 7alpha-hydroxylase (CYP7alpha), the rate-limiting enzyme in the catabolism of cholesterol to bile acid, is stimulated by oxysterol receptor, liver X receptor alpha (LXRalpha) and negatively regulated by a bile acid receptor, farnesoid X receptor. In the current study, we demonstrated that 1,25-(OH)(2)D3 blunted the LXRalpha-mediated induction of CYP7alpha mRNA in H4IIE rat hepatoma cells. In co-transfection experiments in HepG2 cells, VDR repressed the activity of rat CYP7alpha promoter in a ligand-dependent manner through inhibition of LXRalpha signaling.

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Peroxisome proliferator-activated receptors (PPARs) are nuclear fatty acid receptors that have been implicated to play an important role in lipid and glucose homeostasis. PPARalpha potentiates fatty acid catabolism in the liver and is activated by the lipid-lowering fibrates, whereas PPARgamma is essential for adipocyte differentiation. Here we report that nuclear vitamin D(3) receptor (VDR) represses the transcriptional activity of PPARalpha but not PPARgamma in a 1,25(OH)(2)D(3)-dependent manner.

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Two juvenile patients with multiple endocrine neoplasia type 1 (MEN1) who developed pituitary adenomas are reported. The first case, a 14-year-old girl, developed prolactinoma and manifested delayed puberty and growth arrest. The second case, a 16-year-old boy, was asymptomatic and a pituitary adenoma accompanied by mild elevation of PRL and GH was identified through family screening.

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