Ryugaku Jinja · Professor Archive
Public Professor Archive
Tsugumi Uema上間 次己
University of the Ryukyus · Faculty of Medicine
- Publications
- 4
- Projects
- 2
- Keywords
- 7
留学
神社University of the Ryukyus · Faculty of Medicine
Research keywordsgut microbiota・glucose intolerance prediction・primary aldosteronism・cardiometabolic health・digital health intervention・mucosal immunity・pediatric urine biomarkers
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- A Rare Case of Autoimmune-Mediated Lecithin:Cholesterol Acyltransferase Insufficiency Manifesting as the Acute Onset of Extremely Hypo-High-Density Lipoprotein-Cholesterolemia and Spontaneous Improvement: A Case Report with a Review of the Literature2025 · <p>A 59-year-old Japanese woman was referred for an extremely low level of circulating high-density lipoprotein cholesterol (HDL-C). The serum HDL-C level had long been within the normal range but suddenly decreased asymptomatically to 7 mg/dL. She had no typical symptoms associated with familial lecithin, cholesterol acyltransferase deficiency (FLD), including proteinuria, anemia, and corneal opacity. The circulating level of ApoA-1 was also markedly decreased at 48 mg/dL, and the proportion of esterified cholesterol to free cholesterol was irregularly low at 26%. Whole-genome sequencing revealed no apparent pathological mutations in the <i>LCAT</i> gene. Notably, anti-LCAT antibodies were detected in the serum at 146±1.7 ng/mL, resulting in her being diagnosed with acquired LCAT insufficiency (ALCATI) caused by anti-LCAT antibodies. Five years after her HDL-C levels spontaneously decreased, they increased without any identifiable cause. To our knowledge, only six cases of ALCATI caused by anti-LCAT antibodies have been reported to date. In contrast to the present case, previously reported cases of ALCATI manifested proteinuria that improved with steroid therapy. The unique clinical course in the present case highlights the heterogeneity of ALCATI, warranting further research to clarify the molecular pathophysiology of FLD and ALCATI.</p>
- A Rare Case of Autoimmune-Mediated Lecithin: Cholesterol Acyltransferase Insufficiency Manifesting as the Acute Onset of Extremely Hypo-High-Density Lipoprotein-Cholesterolemia and Spontaneous Improvement: A Case Report with a Review of the Literature(タイトル和訳中)2025 · Tamaki Atsuko, Kuroda Masayuki, Yonaha Ken, Ishiki Yohei, Uehara Moriyuki, Nakayama Yoshiro, Honma Ken-ichiro, Chinen Rei, Uema Tsugumi, Okamoto Shiki, Miyoshi Junko, Kirinashizawa Mika, Sato Kazuki, Aohara Tsutomu, Yamamoto Misato, Maezawa Yoshiro, Yokote Koutaro, Masuzaki Hiroaki
- Gut microbiota-based prediction for the transition from normal glucose tolerance (NGT) to impaired glucose tolerance (IGT) in a remote island cohort study2024 · Aim: The present cohort study explored whether specific gut microbiota (GM) profile would predict the development of impaired glucose tolerance (IGT) in individuals with normal glucose tolerance (NGT). Methods: A total of 114 study subjects with NGT in Kumejima island, Japan participated in the present study and underwent 75 g oral glucose tolerance tests at baseline and one year later. We compared the profile of GM at baseline between individuals who consistently maintained NGT (NRN, n = 108) and those who transitioned from NGT to IGT (NTI, n = 6). Results: Within-individual bacterial richness and evenness as well as inter-individual bacterial composition showed no significant differences between NRN and NTI. Of note, however, partial least squares discriminant analyses revealed distinct compositions of GM between groups, with no overlap in their 95 % confidence interval ellipses. Multi-factor analyses at the genus level demonstrated that the proportions of CF231, Corynebacterium, Succinivibrio, and Geobacillus were significantly elevated in NTI compared to NRN (p < 0.005, FDR < 0.1, respectively) after adjusting for age, sex, HbA1c level, and BMI. Conclusions: Our data suggest that increased proportion of specific GM is linked to the future deterioration of glucose tolerance, thereby serving as a promising predictive marker for type 2 diabetes mellitus.
- 急性外傷性脊髄損傷と高所からの転落後直ちに出現した外傷後下垂体茎離断症候群(PSTS) 稀な1症例報告と文献レビュー(Post-traumatic pituitary stalk transection syndrome(PSTS) expeditiously manifested after a fall from a height combined with acute traumatic spinal cord injury: a rare case report with review of literature)2024 · 症例は34歳女性で、建物の4階から飛び降り、その2日後に当院に搬送された。不全四肢麻痺がみられ、MRIでC7椎体の脱臼骨折とT1の軽度後方転位が明らかになった。明白な内臓損傷は観察されなかった。外傷後5日目に待機的後方脊椎固定術(C3~T4)を施行した。入院後7日目に血液検査は高カリウム血症(カリウム6.7mEq/L)と低ナトリウム血症(ナトリウム133mEq/L)を示した。好酸球増加症、貧血、肝酵素とプロラクチンの血清レベルの上昇、性腺機能低下症、甲状腺機能低下症、続発性副腎機能不全、低ソマトメジンCレベルが明らかになった。アルギニンバソプレシンの血漿レベルは測定可能範囲未満であった。飛び降りた日から6週間後のMRI所見は下垂体茎離断症候群の特徴と一致した。患者はヒドロコルチゾンとレボチロキシンナトリウム水和物による治療を開始した。月経は転落後に初めて止まり、200日後も再開しなかった。
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