研究者業績
基本情報
研究分野
1受賞
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2019年6月
論文
51-
Scientific reports 12(1) 20012-20012 2022年11月21日Chronic kidney disease (CKD) and heart failure (HF) are the first and most frequent comorbidities associated with mortality risks in early-stage type 2 diabetes mellitus (T2DM). However, efficient screening and risk assessment strategies for identifying T2DM patients at high risk of developing CKD and/or HF (CKD/HF) remains to be established. This study aimed to generate a novel machine learning (ML) model to predict the risk of developing CKD/HF in early-stage T2DM patients. The models were derived from a retrospective cohort of 217,054 T2DM patients without a history of cardiovascular and renal diseases extracted from a Japanese claims database. Among algorithms used for the ML, extreme gradient boosting exhibited the best performance for CKD/HF diagnosis and hospitalization after internal validation and was further validated using another dataset including 16,822 patients. In the external validation, 5-years prediction area under the receiver operating characteristic curves for CKD/HF diagnosis and hospitalization were 0.718 and 0.837, respectively. In Kaplan-Meier curves analysis, patients predicted to be at high risk showed significant increase in CKD/HF diagnosis and hospitalization compared with those at low risk. Thus, the developed model predicted the risk of developing CKD/HF in T2DM patients with reasonable probability in the external validation cohort. Clinical approach identifying T2DM at high risk of developing CKD/HF using ML models may contribute to improved prognosis by promoting early diagnosis and intervention.
MISC
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Thyroid : official journal of the American Thyroid Association 22(5) 516-21 2012年5月 査読有りBACKGROUND: Interactions between CD40 and its ligand (CD40L) have important roles in T-cell-dependent activation of B cells, which may be related to the thyrotoxic activity of Graves' disease (GD). Soluble forms of CD40 ligand (sCD40L) are released from activated T cells and platelets, and several types of inflammatory cytokines are increased in patients with hyperthyroid GD. The aim of this study was to assess sCD40L and other cytokines as clinical indicators of disease activity or as possible markers of remission in GD. METHODS: Serum levels of sCD40L, interleukin 18 (IL-18), tumor necrosis factor-alpha (TNFα), and TNFα receptors 1 and 2 (TNFR1 and TNFR2) were investigated in patients with active GD (GD-A), intractable GD (GD-IT), inactive GD (GD-IA), GD in remission (GD-R), and Hashimoto's thyroiditis (HT), and in control subjects (CON). RESULTS: Serum concentrations of sCD40L were higher in the GD-A and GD-IT groups than in the HT and CON groups. Similarly, serum concentrations of IL-18, which induces Th1 cytokines, such as interferon-γ, were higher in the GD-A and GD-IT groups than in all other groups. Serum levels of TNFR1 and TNFR2 were also significantly higher in the GD-A than in all other groups. The mean serum concentration of TNFα was higher in the GD-R compared with the GD-A and GD-IT groups, although the difference was not significant. Serum sCD40L concentrations in the GD-R group were lower than in the GD-A and GD-IT groups. Finally, the ratio of serum TNFα to sCD40L was higher in the GD-R group than in the GD-A and GD-IT groups. This is the first report that serum sCD40L is increased in active GD, and that the serum TNFα:sCD40L ratio is a marker for remission in GD. CONCLUSIONS: Our results suggest that not only thyrotoxicosis, but also the activity of the immunoreaction presenting as anti-thyrotropin receptor antibodies (TRAb) titer in GD, affects inflammatory cytokine serum profiles. Serum profiles of cytokines vary in patients with GD depending on disease activity. An elevated serum TNFα:sCD40L ratio indicates declining disease activity and reflects a shift from Th2 to Th1 dominance, suggesting that suppression of sCD40L or increased production of TNFα is required to initiate or maintain remission of GD.
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Osteoporosis Japan 19(Suppl.1) 296-296 2011年11月
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糖尿病 53(2) 90-95 2010年2月糖尿病に伴う血管障害は,動脈硬化性疾患の発症・進展に深く関わることが知られている.我々は,2型糖尿病患者69名を対象に心臓・足首血管指標(CAVI)とヒ卜脳性ナトリウム利尿ペプチド前駆体N端フラグメント(NT-proBNP)との関連,糖尿病性網膜症とメタボリックシンドロームの危険指標との関連についての検討を行った.対象者における糖尿病網膜症の有無の確認を行い,正常群,単純性網膜症群,増殖性網膜症群の各病期に分類して検討した.動脈壁の固さ(Stiffness)の指標CAVIと心不全の指標NT-proBNPは,ともに網膜症の進展に伴って高値を示し,NT-proBNPとR-CAVI(r=0.401,p=0.0006),L-CAVI(r=0.450,p<0.0001)との間に有意な相関を認めた.以上より,CAVIとNT-proBNPの上昇は,糖尿病に伴う動脈硬化や心血管機能有用な指標となると考えられた.(著者抄録)