2021 Fiscal Year Final Research Report
Construction and application of a prediction model for the development of diabetic complications based on the effects of accumulation and variation of blood glucose, blood pressure, and lipids.
| Project/Area Number |
19K07166
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 47060:Clinical pharmacy-related
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| Research Institution | Kumamoto University |
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Principal Investigator |
Oniki Kentaro 熊本大学, 大学院生命科学研究部(薬), 准教授 (00613407)
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| Co-Investigator(Kenkyū-buntansha) |
猿渡 淳二 熊本大学, 大学院生命科学研究部(薬), 教授 (30543409)
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| Project Period (FY) |
2019-04-01 – 2022-03-31
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| Keywords | メタボリックメモリー / modeling / simulation / HbA1c / 糖尿病性腎臓病 / 微量アルブミン尿 |
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| Outline of Final Research Achievements |
In this study, we examined the factors involved in the development of diabetic complications from the perspective of metabolic memory and obtained the following findings.
1). By expressing persistent hyperglycemia as the area under the HbA1c curve and clarifying that its increase is related to renal function decline, we showed the importance of the degree and duration of hyperglycemia exposed in type 2 diabetes patients.2). We newly devised "area under the HbA1c-time curve (HbA1c-AUC)" as an index of HbA1c variability and showed that HbA1c-AUC is related to the development of microalbuminuria in type 2 diabetes patients independently of mean HbA1c values. In addition, serum albumin oxidation level was higher in patients with higher HbA1c variability, suggesting that oxidative stress status is involved the association between HbA1c variability and microalbuminuria.
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| Free Research Field |
臨床薬理学
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| Academic Significance and Societal Importance of the Research Achievements |
本検討では、血糖値の築盛効果と変動効果の両方について検討し、メタボリックメモリーの定量的評価を腎機能低下との関連性の観点から証明した。本研究結果から、曝露された高血糖の程度や期間並びに変動の重要性が示され、合併症発症・進行における詳細な病態生理機序の解明や、合併症予防のための個別化治療目標の設定等に繋がることが期待される。また、HbA1cの変動については、生活習慣の乱れやアドヒアランス不良、HbA1cの季節変動、治療薬の変更に起因すると考えられる。今後、変動が大きい患者に積極的介入を行うことで、糖尿病性腎臓病発症予防につながることが期待される。
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