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Ketosis Proneness and Insulin Dependency in Diabetes Mellitus

Research Project

Project/Area Number 62480250
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field 内分泌・代謝学
Research InstitutionShiga University of Medical Science

Principal Investigator

HIDAKA Hideki  Shiga Univ. Med. Sci., Dep. of Med., Instructor, 医学部, 助手 (80156603)

Co-Investigator(Kenkyū-buntansha) KOSUGI Keisuke  Shiga Univ. Med. Sci., Dep of Med., Instructor, 医学部, 助手 (00153544)
HARANO Yutaka  Nat, Cardiovas. Center, Dep of Med Chief, Div. of Metab., 動脈硬化・代謝部門, 部長 (10028615)
Project Period (FY) 1987 – 1989
Project Status Completed (Fiscal Year 1989)
Budget Amount *help
¥6,500,000 (Direct Cost: ¥6,500,000)
Fiscal Year 1989: ¥1,500,000 (Direct Cost: ¥1,500,000)
Fiscal Year 1988: ¥2,200,000 (Direct Cost: ¥2,200,000)
Fiscal Year 1987: ¥2,800,000 (Direct Cost: ¥2,800,000)
KeywordsBlood Ketone body / Diabetes mellitus / Hormonal action / Isolated hepatocytes / FFA oxidation / Self-monitoring of ketone body / ケトン体 / 肝細胞 / 脂肪酸酸化 / バソプレッシン
Research Abstract

Fasting serum levels of ketone bodies were determind using a method reported by us(Harano et al, Clin. Chim. Acta 22:327, 1983) in more than 300 subjects with insulin-dependent diabetes mellitus(IDDM) as well as non-insulin-dependent diabetes mellitus(NIDDM). The levels were higher in subjects with IDDM than in those with NIDDM, and the discriminant equation between IDDM and NIDDM has been developed. The concentrations were also higher in NIDDM patients who required insulin therapy than in the patients who did not require the insulin therapy even though markers for the control of blood glucose levels were similar in both groups, indicating that the serum ketone levels may be used as a marker for the indication of insulin therapy(insulin dependency) in NIDDM patients. The mechanisms of the elevated blood ketone body levels were studied in hepatocytes isolated from NIDDM model rats which were made diabetic by inpraperitoneal injection of streptozotocin at neonatal periods. Ketone body pr … More oduction rates in the hepatocytes from NIDI)M rats were regulated by hormones, and were significantly increased than in those from normal rats, but lower than in those from ketotic rats. These data indicate that the kotogenesis of the liver in non-obese NIDDM is elevated due to insulin deficiency, and that the elevation of plasma levels of insulin antagonists and substrate(free fatty acids) also contributes to the increased concentrations of ketone bodies.
Diabetic coma is classified into two types; diabetic ketoacidosis and non-ketotic hyperosmolar coma. However, the pathophysiological mechanisms of these two states have not been clearly known. We have observed that intravenous infusion of anti-ditiretic hormone(ADH) decreased the plasma ketone body levels without changing the plasma concentrations of free fatty acids. Since plasma ADH levels are elevated in non-ketotic hyperosmolar coma, the hormone may play a role in the disease states through depressing the ketogenesis of the liver. A study of the ADH actions in isolated rat hepatocytes revealed that protein kinase C plays a role in ketogenesis. We have also found that the phosphorylation of carnitine-palmitoyl transferase; the rate limiting enzyme of fatty acid oxidation has taken place when the enzyme is activated by hormones. A new carnitine analogue; emeriamine was shown to reverse diabetic ketoacidosis and to have organ specificty; less effective in heart and other organs than in the liver.
A new system for the rapid determination of a major plasma ketone body; 3-hydroxybutyrate(3-OHBA) has been developed and applied to a clinical use. The system consists with a film, containing 3-OHBA dehydrogenase and dye, and a reflectance meter. The blood ketone body levels can be measured within 3 minutes accurately even by children with IDDM. Monitoring of the levels at home revealed that the con centrations were increased on sick days as well as during exercise even though the blood glucose levels were not changed in a considerable magnitude. We believe that the self-monitoring of blood glucose and ketone body levels will decrease the incidence of ketoacidosis and will improve the diabetic control not only over glucose but also fatty acid metabolism. Less

Report

(4 results)
  • 1989 Annual Research Report   Final Research Report Summary
  • 1988 Annual Research Report
  • 1987 Annual Research Report
  • Research Products

    (70 results)

All Other

All Publications (70 results)

  • [Publications] 小島秀人: "肝細胞における脂肪酸化とケトン体産生に対するホルモン作用とProtein Kinaseの役割" 糖尿病. 30. 419-427 (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 田中逸他: "実験的糖尿病生ケトアシド-シスにおける新しいカルニチンアナログ(Emeriamine)のケト-シス是正効果" 糖尿病. 30. 909-914 (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 青木孝彦他: "血中ケトン体自己測定の臨床応用" 糖尿病. 31. 591-595 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 原納優他: "New approach for the pathophysiology of ketotic and non-ketotic diabetic coma." 第4回糖尿病脂質代謝研究会記録集. 54-62 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 日比晶: "実験的糖尿病ラットにおけるVasopressinのケト-シス抑制作用" 糖尿病. 32. 585-591 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 小杉圭右他: "血中ケトン体の家庭内自己測定" 糖尿病. 32. 801-805 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 青木孝彦: "NIDDMモデルラット肝細胞におけるケトン体産生能" 糖尿病. 33. 205-211 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 青木孝彦他: "軽症糖尿病モデルラット肝細胞におけるグルカゴン作用" 第18回グルカゴン研究会記録(印刷中).

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 原納優他: "病態を知る上で役立つ新しい検査法とその診断的意義 血中ケトン体測定" 治療. 70. 66-70 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 原納優他: "血中ケトン体" 内科. 61. 1113-1114 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 原納優: "ケトン体・インスリン感受性測定の診断的意義とインスリン・SV剤併用療法" 循環器病研究の進歩. 9. 108-115 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 小島秀人: "糖尿病性ケトアシド-シスの一例" 新薬と治療. 39. 11-12 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 原納優他: "尿中および血中ケトン体-コントロ-ル指標としての活用-" プラクティス. 6. 274-277 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 小島秀人他: "糖尿病患者におけるプラゾシンの糖・脂質代謝改善作用に関する研究" 臨牀と研究. 66. 283-288 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Harano,Y.他: "Development of stable film test for the rapid estimation of blood or plasma 3-hydroxybutyrate.-Rapid film test for 3-hydroxybutyrate-" Diabetes Care(in press).

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] T.Aoki,他: "INSULIN SENSITIVITY AND ITS IMPROVEMENT BY VERY LOW CALORIE DIET IN JAPANESE" 4 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Y.Harano,他: "Clinical feature of diabetic caoma and its pathophysiology" 4 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Y.Harano,他: "A new carnitine analogus for the correction of metabolic derangements in diabetes." 5 (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Y.Harano,他: "Role of vasopressin in the pathophysiology of non-ketotic hyper osmolar diabetic coma" 7 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 原納優他: "糖尿病性昏睡(印刷中)" (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Kojima, H.: "Hormonal regulation and the roles of three protein kinases in hepatic fatty acid oxidation and ketogenesis." J.Japan Diab.Soc. 30:419-427, 1987.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Tanaka, T. et al.: "The effect of a new carnitine analogue(Emeriamine) on diabetic ketoacidosis induced by streptozotocin." J.Japan.Diab.Soc. 30:909-914, 1987.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Aoki, T. et al.: "Insulin sensitivity and its improvement by very low calorie diet in Japanese NIDDM subjects." Diabetes mellitus in East Asia. G. Mimura et al edts. p349-352, 1988.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Harano, Y. et al.: "Clinical feature of diabetic coma and its pathophysiology." Diabetes Mellitus in East Asia. G.Mimura et al edts p349-352, 1988.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Aoki, T. et al.: "Clinical application of the self-monitoring of blood 3-hydroxybutyrate levels." J.Japan.Diab.Soc. 31:591-595, 1988.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Harano, Y. et al.: "New approach for the pathophysiology of ketotic and non-ketotic coma." The proceedings of 4th meeting on lipid metab in DM. p54-62, 1988.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Hibi, A.: "Anti-ketogenic effects of vasopressin in diabetic rats." J.Japan Diab.Soc. 32:585 591, 1989.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Kosugi, K. et al.: "Self-measurement of blood 3-hydroxybutyrate levels at home." J.Japan Diab.Soc. 32:801-805, 1989.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Aoki, T.: "Ketogenesis in the hepatocytes from NIDDM model rats." J.Japan Diab.Soc. 33:205-211, 1990.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Aoki, T. et al.: "Effects of glucagon in NIDDM model rats." Proceedings of 18th glucagon symp.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Harano, Y. et al.: "A new carnitine analogue for the correction of metabolic" Recent Trend in Management of DM. p567-571, 1987.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Harano, Y. et al.: "Role of vasopressin in the pathophysiology of nonketotic hyperosmolar diabetic coma." Recent Prog. in Post. Pituitary. p395-401, 1988.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Harano, Y.: "Clinical significance of determination of plasma ketone bodies and insulin sensitivity -Relation to combined therapy with insulin and SU." Prog. in Circulation Res. 9:108-115, 1988.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Harano, Y. et al.: "Diabetic coma." Diabetology. S.Tarui et al edts.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Kosugi K. et al.: "Analysis of serum ketone levels in relation to insulin deficiency in diabetes mellitus." Current Status of Prev. & Treatment in DM. Sakamoto edt. p342-246, 1990.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] Harano, Y. et al.: "Development of stable film test for the rapid estimation of blood or plasma 3-hydroxybutyrate. -Rapid film test for 3-hydroxybutyrate." Diabetes Care.

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1989 Final Research Report Summary
  • [Publications] 日比晶: "実験的糖尿病ラットにおけるVasopressinのケト-シス抑制作用" 糖尿病. 32. 585-591 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] 小杉圭右他: "血中ケトン体の家庭内自己測定" 糖尿病. 32. 801-805 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] 青木孝彦: "NIDDMモデルラット肝細胞におけるケトン体産生能" 糖尿病. 33. 205-211 (1990)

    • Related Report
      1989 Annual Research Report
  • [Publications] 青木孝彦他: "軽症糖尿病モデルラット肝細胞におけるグルカゴン作用" 第18回グルカゴン研究会記録.

    • Related Report
      1989 Annual Research Report
  • [Publications] 小島秀人: "糖尿病性ケトアシド-シスの一例" 新薬と治療. 39. 11-12 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] 原納優他: "尿中および血中ケトン体-コントロ-ル指標としての活用-" プラクティス. 6. 274-277 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] 小島秀人他: "糖尿病患者におけるプラゾシンの糖・脂質代謝改善作用に関する研究" 臨牀と研究. 66. 283-288 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] Harano,Y.他: "Development of stable film test for the rapid estimation of blood or plasma 3-hydroxybutyrate.-Rapid film test for 3-hydroxybutyrate-" Diabetes Care.

    • Related Report
      1989 Annual Research Report
  • [Publications] 原納優他: "糖尿病性昏睡" (1990)

    • Related Report
      1989 Annual Research Report
  • [Publications] 青木孝彦 他: 糖尿病. 31. 591-595 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] 原納優 他: 治療. 70. 66-70 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] 原納優 他: 内科. 61. 1113-1114 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] 小杉圭右 他: 糖尿病. 31(suppl1). 243 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] 日比晶: 糖尿病. (1989)

    • Related Report
      1988 Annual Research Report
  • [Publications] 小島秀人 他: 日本内分泌学会雑誌. (1989)

    • Related Report
      1988 Annual Research Report
  • [Publications] 小杉圭右 他: 糖尿病. (1989)

    • Related Report
      1988 Annual Research Report
  • [Publications] 青木孝彦 他: 糖尿病. (1989)

    • Related Report
      1988 Annual Research Report
  • [Publications] 川瑞敏裕 他: 糖尿病. (1989)

    • Related Report
      1988 Annual Research Report
  • [Publications] 青木孝彦 他: 糖尿病. (1989)

    • Related Report
      1988 Annual Research Report
  • [Publications] KoJima H.;et al: Biomedical Res.(1989)

    • Related Report
      1988 Annual Research Report
  • [Publications] Harano Y.;et al: "Recent Pvagness in PoSterior Pituitary Hormones" Elsevier Science Publishers, 7 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] Kosugi K.;et al: "Curreit status of Prevention and treatment of diabetic complications" Excerpta Medica, (1989)

    • Related Report
      1988 Annual Research Report
  • [Publications] 小島秀人他: 日本内分泌学会雑誌. 63. 577 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 日比晶他: 日本内分泌学会雑誌. 63. 1156 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 中島譲他: 糖尿病. 30supple 1. 397 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 小島秀人他: 糖尿病. 30supple. 506 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 小島秀人他: グルカゴン研究会報. (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 青木孝彦他: 糖尿病. (1988)

    • Related Report
      1987 Annual Research Report
  • [Publications] 鈴木正昭他: 糖尿病. 31. (1988)

    • Related Report
      1987 Annual Research Report
  • [Publications] Kosugi K.et al: Diabetes Research and Clinical Practice. 3supple 1. S59 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 原納優他: 治療. 70. 66-70 (1988)

    • Related Report
      1987 Annual Research Report
  • [Publications] 青木孝彦他: 糖尿病.

    • Related Report
      1987 Annual Research Report
  • [Publications] Yukio Shigeta: "Best Approach to the ideal therapy pf diabetes mellitus "Method for the evaluation of ketonemia and its clinical significance in deabetes mellitus."" Elsevier Science Publishers, 6 (1987)

    • Related Report
      1987 Annual Research Report
  • [Publications] 原納優;小島秀人;垂井清一郎;葛谷健: "糖尿病学"糖尿病性昏睡"" 朝倉書店, 35 (1988)

    • Related Report
      1987 Annual Research Report

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Published: 1987-04-01   Modified: 2016-04-21  

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