Abstract Study question How can we find an ovarian stimulation method that does not cause hyper stimulation syndrome but can produce a high pregnancy rate at one cycle? Summary answer This newly developed method for PCOS has a higher accumulative clinical outcome for one trial and no OHSS. What is known already Almost all conventional treatments for PCOS have managed to avoid OHSS by reducing the number of growing follicles, which are associated with high Estradiol levels and stimulate the production of vessel endothelial growth hormone (VEGF), leading to increased vessel permeability. Low dose FSH administration, In vitro maturation (IVM), Ovarian Drilling and Coasting have been performed to achieve this. However, their actual clinical outcome is still unsatisfactory. Study design, size, duration Evaluation of the efficiency of this method was conducted retrospectively at St. Mother Clinic. The embryonic development and the clinical outcome were studied for 34 PCOS patients during the period between November 2018 and December 2019. Participants/materials, setting, methods We started injections of FSH (150iu/ml), then we did ultrasound follicle monitoring. GnRH antagonist shots were started when the leading follicle reached 18mm and continued until the largest follicle was 22–24mm and the E2 value was over 4000pg/ml. Letrozole (2.5mg) and leuprorelin acetate (1.88mg) was injected as trigger. Two tablets each of Letrozole, Cabergoline and GnRH antagonist were given for 5 consecutive days after the oocyte retrieval. All embryos were cryopreserved. Main results and the role of chance Number of patients and cycles were 34 and 59. Average number of cryopreserved blastocysts was 6.12 (1–16). The frequencies of OHSS (mild, moderate, severe) were 29.4% (10/34), 0% (0/34), 0% (0/34). Average days between oocyte collection and withdrawal hemorrhage was 5.44(5–7). Cryopreservation rate was 100.0% (34/34). Clinical pregnancy rate and miscarriage rate was 42.3% (25/59) and 16.0% (4/25). The cumulative pregnancy rate was 73.7% (25/34). The four remaining unsuccessful cases still have 10,6,3 and 7 frozen embryos. So, there is a high possibility that they become successful, that would bring the cumulative pregnancy rate up to 82.3% (28/34). Limitations, reasons for caution This COS for PCOS seems promising, however it is premature to conclude that this method is established. This method requires caution monitoring for hormone level, follicle size and number and coagulant function. It also accompanied with the risk of ovarian hemorrhage on aspiration of a great number of oocytes. Wider implications of the findings: This COS seems viable for PCOS cases. It could control the cohort of antral follicles with different doses of Letrozole to find the optimal COH method and it could become the first option for COS of PCOS. Trial registration number N/A

The desirable distribution of three major nutrients intake to prevent hypertension is not established. This study is to clarify the relationship between the prevalence of hypertension and the rate of intake of three major nutrients. This is a large-scale cross-sectional study. We analyzed Japanese subjects who had their annual medical examination at St Luke’s International Hospital, Tokyo from January 2004 to June 2010. The amount of three major nutrients and salt intake were checked by a questionnaire method, and this study clarified the relationship between the prevalence of hypertension and the rate of three major nutrients with adjustment for age, sex, body mass index (BMI), smoking, dyslipidemia, diabetes mellitus, hyperuricemia, and salt intake. We analyzed 89,851 subjects. Of those, the number of hypertensive subjects was 13,926 (15.5%). The hypertensive group had significantly higher rate of calories from protein (19.7% vs. 19.4%, P < 0.001) but lower rate of calories from fat (16.1% vs. 16.4%, P < 0.001) than that in the non-hypertensive group. The rate of calories from carbohydrate was almost the same between the two groups (64.2% vs. 64.2%). After multiple adjustments, high rate of calories from protein was associated with high prevalence of hypertension (odds ratio: 1.011, 95% confidence interval (CI), 1.005–1.017), as well as aging, male, high BMI, smoking habits, dyslipidemia, diabetes mellitus, and hyperuricemia. High rate of calories from protein could be associated with high risk of hypertension. Therefore, protein-restricted diet may have a favorable effect in preventing hypertension and cardiovascular diseases.

The success of IVF treatment in poor responder (POR) patients is low due to decreases in the number of retrieved oocytes. A recent study demonstrated that suppression of Hippo signaling in somatic cells of ovarian follicles induced secondary follicle growth, resulting in successful follicle growth in patients with primary ovarian insufficiency though in vitro activation (IVA). The aim of this study is to improve clinical outcome of IVF treatment in POR patients through induction of secondary follicle growth leading to increases in number of viable embryos by Drug-free IVA.. Prospective cohort study to improve clinical outcome of IVF treatment in POR patients. Under ethical approval for clinical study of Drug-free IVA, 79 patients who received written informed consent and met the Bologna criteria were enrolled from February 2016 to December 2017.. For Drug-free IVA, we excised partial ovarian tissues from one side of ovary under laparoscopic surgery. The ovarian cortex was dissected into 1-2 mm squares and cultured them overnight to suppress Hippo signaling pathway. After culture, these cubes were auto-transplanted beneath the serosa of Fallopian tubes and ovaries. Simultaneously, we made 7-9 linear cuts on the surface of contralateral side of ovary. After the surgery, patients received ovarian stimulation under short protocol with maintaining normal LH levels (<10 mIU/ml) for oocyte retrieval. The effects of Drug-free IVA were evaluated by counting the number of follicles at oocyte retrieval under trans-vaginal ultrasound monitoring and the number of retrieved oocytes, fertilization rate, cleavage rate, cryopreservation rate, clinical pregnancy rate, and miscarriage rate. The oocytes were allowed to fertilize either cIVF or ICSI and all embryo transfers were preformed using freeze-thawed embryos under hormone replacement protocol. The median age of enrolled patients was 43.6 [38-48].Clinical outcome with this procedure was listed in Table 1.Tabled 1Table 1Clinical outcome following laparoscopically modified in vitro activationPatients (n=79)Average number of follicles at oocyte retrievalAverage number of retrieved oocytesFertilization rate (%)Cleavage rate (%)Cryopreservation rate (%)Clinical pregnancy rate (%)Miscarriage rate (%)pre-op (240 cycles)1.45a1.3958.3% (130/223)57.0% (127/223)19.7% (25/127)3.7% (1/27)100.0%(1/1)post-op (226 cycles)1.79a'1.5464.7% (161/249)63.9% (159/249)13.8% (22/159)18.4% (7/38)Ongoing:3Birth:1(twins)42.9% (3/7)(a-a': p<0.05, t-test) Open table in a new tab (a-a': p<0.05, t-test) The Drug-free IVA increased the number of mature follicles and also tend to increase the quality of oocytes. These data suggest a potential of Drug-free IVA to improve clinical outcome of IVF treatment in POR patients.

Objective: This study was conducted to identify whether higher fasting blood glucose levels is predictive of hypertension by a large-scale longitudinal design. Methods: We conducted a retrospective 5-year cohort study using the data from 13 201 Japanese individuals who underwent annual medical examinations in 2004 and were reevaluated 5 years later. This study included individuals without diabetes or hypertension between ages 30 and 85 years in 2004. The cumulative incidences of hypertension over 5 years in each 10 mg/dl of fasting blood glucose levels were calculated. Moreover, we examined risk factors and calculated odds ratios (ORs) for developing hypertension after adjustments for age, sex, BMI, smoking and drinking habits, dyslipidemia, chronic kidney disease, serum uric acid, and fasting blood glucose levels by logistic regression analyses. Results: We analyzed 10 157 participants (age: 48.9 ± 10.7 years; 43.4% men) without diabetes or hypertension in 2004. After multiple adjustments, higher baseline blood glucose level is an independent risk for hypertension (OR: 1.176; 95% CI 1.086–1.275), as well as aging, women, higher BMI, drinking habits, and higher serum uric acid. After stratifying by sex, higher baseline blood glucose level is an independent risk for hypertension both in women (OR: 1.295; 95% CI 1.135–1.478) and men (OR: 1.108; 95% CI 1.001–1.227). When we conducted the same analysis using glycated hemoglobin instead of blood glucose, glycated hemoglobin was not a risk for hypertension. Conclusion: Higher fasting blood glucose is an independent risk for developing hypertension. Further studies are needed to determine if treatment for elevated blood glucose can prevent developing hypertension.

Prehypertension frequently progresses to hypertension, a condition associated with high morbidity and mortality from cardiovascular diseases and stroke. However, the risk factors for developing hypertension from prehypertension remain poorly understood. We conducted a retrospective cohort study using the data from 3584 prehypertensive Japanese adults (52.1±11.0 years, 2081 men) found to be prehypertensive in 2004 and reexamined in 2009. We calculated the cumulative incidences of hypertension over 5 years, examined risk factors, and calculated odds ratios (ORs) for developing hypertension after adjustments for age, sex, body mass index, smoking and drinking habits, baseline systolic and diastolic blood pressure, pulse rate, diabetes mellitus, dyslipidemia, chronic kidney disease, and serum uric acid levels. The additional analysis evaluated whether serum uric acid (hyperuricemia) constituted an independent risk factor for developing hypertension. The cumulative incidence of hypertension from prehypertension over 5 years was 25.3%. There were no significant differences between women and men (24.4% versus 26.0%; P=0.28). The cumulative incidence of hypertension in subjects with hyperuricemia (n=726) was significantly higher than those without hyperuricemia (n=2858; 30.7% versus 24.0%; P<0.001). After multivariable adjustments, the risk factors for developing hypertension from prehypertension were age (OR, 1.023; P<0.001), female sex (OR, 1.595; P<0.001), higher body mass index (OR, 1.051; P<0.001), higher baseline systolic (OR, 1.072; P<0.001) and diastolic blood pressure (OR, 1.085; P<0.001), and higher serum uric acid (OR, 1.149; P<0.001). Increased serum uric acid is a strong risk marker for developing hypertension from prehypertension. Further studies are needed to determine whether treatment of hyperuricemia in prehypertensive subjects could impede the onset of hypertension.

Obesity is a risk factor for hypertension, diabetes mellitus (DM), dyslipidemia, and hyperuricemia. Here, we evaluated whether the same body mass index (BMI) for the U.S. population conferred similar metabolic risk in Japan. This was a cross-sectional analysis involving 90,047 Japanese adults (18–85 years) from St. Luke’s International Hospital, Tokyo, Japan and 14,734 adults from National Health and Nutrition Examination Survey (NHANES) collected in the U.S. We compared the prevalence of hypertension, DM, dyslipidemia, and hyperuricemia according to BMI in Japan and the U.S. The prevalence of hypertension, DM, and dyslipidemia were significantly higher in the U.S. than Japan, whereas the prevalence of hyperuricemia did not differ between countries. Higher BMI was an independent risk factor for hypertension, DM, dyslipidemia, and hyperuricemia both in Japan and in the U.S. after adjusting for age, sex, smoking and drinking habits, chronic kidney disease, and other cardiovascular risk factors. The BMI cut-off above which the prevalence of these cardio-metabolic risk factors increased was significantly higher in the U.S. than in Japan (27 vs. 23 kg/m2 for hypertension, 29 vs. 23 kg/m2 for DM, 26 vs. 22 kg/m2 for dyslipidemia, and 27 vs. 23 kg/m2 for hyperuricemia). Higher BMI is associated with an increased prevalence of hypertension, DM, dyslipidemia, and hyperuricemia both in Japan and U.S. The BMI cut-off above which the prevalence of cardio-metabolic risk factors increases is significantly lower in Japan than the U.S., suggesting that the same definition of overweight/obesity may not be similarly applicable in both countries.

Background: High serumuric acid (SUA) is associated with the dyslipidemia, but whether hyperuricemia predicts an increase in serumlow-density lipoprotein (LDL) cholesterol is unknown. This study is to evaluate whether an elevated SUA predicts the development of high LDL cholesterol as well as hypertriglyceridemia. Methods: This is a retrospective 5-year cohort study of 6476 healthy Japanese adults (age, 45.7 +/- 10.1 years; 2.243 men) who underwent health examinations at 2004 and were reevaluated in 2009 at St. Luke's International Hospital, Tokyo, Japan. Subjects were included if at their baseline examination they did not have hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, or if they were on medication for hyperuricemia and/or gout. The analysis was adjusted for age, body mass index (BMI), smoking and drinking habits, baseline estimated glomerular filtration rate (eGFR), baseline SUA and SUA change over the 5 years. Results: High baseline SUA was an independent risk for developing high LDL cholesterol both in men (OR: 1.159 per 1 mg/dL increase, 95% CI: 1.009-1.331) and women (OR: 1.215, 95% CI: 1.061-1.390). Other risk factors included a higher baseline LDL cholesterol, higher BMI, and higher baseline eGFR (the latter two in women only). Increased SUA over 5 years were also independent risks for developing high LDL cholesterol and hypertriglyceridemia, but not for low high-density lipoprotein (HDL) cholesterol. Conclusions: This is the first study to report that an elevated SUA increases the risk for developing high LDL cholesterol, as well as hypertriglyceridemia. This may shed light into the role of SUA in cardiovascular disease. (C) 2018 Elsevier B.V. All rights reserved.

The prevalence of fatty liver disease (FLD) is increasing. To clarify risk factors for developing FLD, we analyzed a database from healthy Japanese adults who had annual medical check-ups in 2004 and reexamined in 2009. We used the fatty liver index (FLI) to classify participants as FLD (FLI ≥60), borderline FLD (30≤ FLI <60), and normal liver (FLI <30). Subjects with hepatitis B or C virus infection and subjects with FLD at the baseline were excluded. The cumulative incidence of FLD from normal liver and from borderline FLD over five years were 0.65% (52/8,025) and 12.9% (244/1,888), respectively. After multiple adjustments, higher serum uric acid (SUA) (OR:1.92; 95% CI:1.40–2.63) and increased SUA change (OR:3.734; 95% CI:2.57–5.42) became risk factors for developing FLD from normal liver, as well as younger age and higher body mass index. The risk factors for developing FLD from borderline FLD were similar. Not only higher baseline SUA but also increased SUA change became independent risks for developing FLD.

Detecting and stratifying hypertension 961at all scheduled visits, and antihypertensive treatment will be adjusted whenever ABP exceeds normal values (Figure).Results: MASTER will evaluate whether an ABPM based strategy is superior to an OBPM based strategy in changing LVmass and microalbuminuria (intermediate coprimary outcome) and in preventing CV events (secondary outcome).Conclusions: Although the superiority of ABPM over OBPM has been repeatedly shown by observational studies, key evidence from randomized intervention trials on the actual clinical value of ABPM is still missing.The results of the MASTER study will help to clarify whether an ABPM guided treatment strategy provides a greater benefit in terms of prevention/regression of organ damage and reduction in CV events than a strategy based on conventional OBP measurements.

Objectives: Prehypertension frequently progresses to hypertension and is associated with cardiovascular diseases, stroke, excess morbidity and mortality. However, the identical risk factors for developing hypertension from prehypertension are not clarified. This study is conducted to clarify the risks. Methods: We conducted a retrospective 5-year cohort study using the data from 3,584 prehypertensive Japanese adults (52.1±11.0 years, 2,081 men) in 2004 and reevaluated it 5 years later. We calculated the cumulative incidences of hypertension over 5 years, then, we detected the risk factors and calculated odds ratios (ORs) for developing hypertension by crude analysis and after adjustments for age, sex, body mass index, smoking and drinking habits, baseline systolic and diastolic blood pressure, pulse rate, diabetes mellitus, dyslipidemia, chronic kidney disease, and serum uric acid. We also evaluated whether serum uric acid (hyperuricemia) provided an independent risk for developing hypertension. Results: The cumulative incidence of hypertension from prehypertension over 5 years was 25.3%, but there were no significant differences between women and men (24.4% vs 26.0%, p=0.28). The cumulative incidence of hypertension in subjects with hyperuricemia (n=726) was significantly higher than those without hyperuricemia (n=2,858) (30.7% vs 24.0%, p<0.001). After multivariable adjustments, the risk factors for developing hypertension from prehypertension were age (OR per 1 year increased: 1.023; 95% CI, 1.015-1.032), women (OR versus men: 1.595; 95% CI, 1.269-2.005), higher body mass index (OR per 1 kg/m 2 increased: 1.051; 95% CI 1.021-1.081), higher baseline systolic blood pressure (OR per 1 mmHg increased: 1.072; 95% CI, 1.055-1.089) and diastolic blood pressure (OR per 1 mmHg increased: 1.085; 95% CI, 1.065-1.106), and higher serum uric acid (OR pre 1 mg/dL increased: 1.149; 95% CI, 1.066-1.238), but not smoking and drinking habits, diabetes mellitus, dyslipidemia, and chronic kidney diseases. Conclusions: Increased serum uric acid is an independent risk factor for developing hypertension from prehypertension. Intervention studies are needed to clarify whether the treatments for hyperuricemia in prehypertensive subjects are useful.

BACKGROUND:While elevated serum uric acid level (SUA) is a recognized risk factor for chronic kidney disease, it remains unclear whether change in SUA is independently associated with change in estimated glomerular filtration rate (eGFR) over time. Accordingly, we examined the longitudinal associations between change in SUA and change in eGFR over 5 years in a general Japanese population.METHODS:This was a large, single-center, retrospective 5-year cohort study at St. Luke's International Hospital, Tokyo, Japan, between 2004 and 2009. We included 13,070 subjects (30-85 years) in our analyses whose data were available between 2004 and 2009. Of those, we excluded 492 subjects with eGFR <60 mL/min/1.73 m2 at baseline. In addition to examining the entire cohort (n = 12,578), we stratified our analyses by baseline eGFR groups: 60-90, 90-120, and ≥120 mL/min/1.73 m2. Linear and logistic regressions models were applied to examine the relationships between baseline and change in SUA, change in eGFR, and rapid eGFR decline (defined as the highest quartile of change in eGFR), adjusted for age, gender, body mass index, abdominal circumference, hypertension, dyslipidemia, and diabetes mellitus.RESULTS:After multivariable adjustments including baseline eGFR, 1 mg/dL increase in baseline SUA was associated with greater odds of developing rapid eGFR decline (OR 1.27, 95% CI 1.17-1.38), and 1 mg/dL increase in SUA over 5 years was associated with 3.77-fold greater odds of rapid eGFR decline (OR 3.77, 95% CI 3.35-4.26).CONCLUSIONS:Elevated baseline SUA and increasing SUA over time were independent risk factors for rapid eGFR decline over 5 years.

ObjectiveWhether obesity without metabolic syndrome (i.e., “metabolically healthy” obesity) confers similar or less metabolic risk remains controversial.MethodsA retrospective 5‐year cohort study of 9,721 Japanese subjects (48.5 ± 10.5 years, 4,160 men) was conducted in 2004 and reevaluated 5 years later. Subjects were excluded if they were hypertensive or diabetic or were receiving medications for dyslipidemia and/or gout or hyperuricemia in 2004. Study subjects were categorized according to baseline BMI ≥ 25 kg/m2 (overweight/obesity) and < 25 kg/m2 (lean/normal weight) and also whether they had metabolic syndrome. The cumulative incidence of hypertension and diabetes over 5 years between groups was assessed. A second analysis evaluated whether baseline hyperuricemia provided additional risk.ResultsSubjects with overweight/obesity but without metabolic syndrome carried increased cumulative incidence of hypertension (14.6% vs. 7.2%, P < 0.001) and diabetes (2.6% vs. 1.1%, P = 0.004) over 5 years compared to lean/normal subjects without metabolic syndrome. Overweight/obesity conferred an increased risk for diabetes even in individuals with normal fasting blood glucose. Hyperuricemia became an independent risk factor for developing hypertension over 5 years in lean/normal subjects without metabolic syndrome. A 1 mg/dL increase in serum uric acid carried increased risk for hypertension (19%) and diabetes (27%).ConclusionsMetabolically healthy obesity and hyperuricemia confer increased risk for hypertension and diabetes.

It has been reported that the incidence of sperms with disomic XY is higher in the testis tissue smear of KS patients and these sperms are the cause of KS. However some papers report the maternal origin. So we performed this study to investigate the origin of extra X in Klinefelter Syndrome (KS). Cytogenetic analysis in KS patients and their parents. Blood samples from 12 KS patients were used for X-chromosome short tandem repeats (STR) analysis. The STR analysis also included data of the parents of the KS patients (8: both parents, 4: mother only, 0: father only) from January 2015 to December 2016. This study was conducted with the informed consent of all participating patients and approved by The Institutional Review Boards of the Saint Mother Obstetrics and Gynecology Clinic and adhered to JCMJER criteria UMIN Clinical Trial Registry was UMIN000024542. Blood samples of 12 KS patients and one or both of their parents were used to determine the origin of the extra X chromosome using X-chromosome haplotype markers (short tandem repeats of 12 loci), according to the method by Shrivastava et al. With DNA extracted from the samples, multiplexed PCR amplifications of the 12 X-STR loci and AMELOGENIN were conducted using an Investigator Argus X-12 QS Kit (Quigen, Germany). The data obtained was analyzed with GeneMapper ID software. X-chromosomal STR DNA profiles were compared among KS patient and their parents. In 7 of the 12 KS patients, both two X chromosomes were maternal origin, showing that an extra X chromosome was left in an oocyte as a result of chromosomal non-disjunction at the 1st (4/7) or 2nd (3/7) meiotic division. In 5 patients, X-chromosomes were inherited from parents, suggesting that fertilization of XY-sperm is the cause of KS.Tabled 1Patient no. 09KYMarkerDXS10148DXS10135DXS8378DXS10079DXS10074DXS7132Father20221018, 211716Mother20, 22.121, 221017, 18, 2016, 1814, 15Patient22.1221018, 201814MarkerHPRTBDXS10101DXS10103DXS10134DXS10146DXS7423Father1231.2183524, 40.214Mother13, 1429, 31.217, 1936, 37.326, 3215, 16Patient1429, 31.217, 1936, 37.326, 3215, 16 Open table in a new tab Although the sample number applied for X-chromosomal STR DNA profiling is not enough, the present data may indicate that contribution of XX oocyte to the production of XXY embryos is greater than XY sperm. Namely, a XX oocyte penetration by a Y sperm is the main cause of KS. Cytogenetic analysis with smear of testicular cell mixture that was used in the studies may overestimate chromosomal abnormality.

[This corrects the article DOI: 10.1371/journal.pone.0169137.].

Whether asymptomatic hyperuricemia in the absence of comorbidities increases the risk for cardiometabolic disorders and chronic kidney disease remains controversial. This study was conducted to clarify the association between asymptomatic hyperuricemia and cardiometabolic conditions. Subjects consisting of Japanese adults between 30 and 85 years of age were enrolled in the study at Center for Preventive Medicine, St Luke’s International Hospital, Tokyo, and were available at enrollment (2004) and at 5-year follow-up (2009). Subjects were excluded if they were overweight or obese, hypertensive, diabetic, and dyslipidemic, had a history of gout or hyperuricemia on medications, or had chronic kidney disease as estimated glomerular filtration rate <60 mL/min per 1.73 m2. Linear and logistic regression analyses were used to examine the relationship between hyperuricemia and development of hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, and overweight/obesity (unadjusted and adjusted for age, sex, smoking, drinking habits, baseline estimated glomerular filtration rate, and body mass index). Five thousand eight hundred and ninety-nine subjects without comorbidities (mean age of 47±10 years, 1864 men) were followed for 5 years. Hyperuricemia (defined as >7 mg/dL in men and ≥6 mg/dL in women) was associated with increased cumulative incidence of hypertension (14.9% versus 6.1%; P<0.001), dyslipidemia (23.1% versus 15.5%; P<0.001), chronic kidney disease (19.0% versus 10.7%; P<0.001), and overweight/obesity (8.9% versus 3.0%; P<0.001), while diabetes mellitus (1.7% versus 0.9%; P=0.087) showed a trend but did not reach statistical significance. In conclusion, asymptomatic hyperuricemia carries a significant risk for developing cardiometabolic conditions in Japanese individual without comorbidities.

Abstract Background: The discovery and development of novel biomarkers that could facilitate early diagnosis and thus prevent the progression of atherosclerosis-related diabetes mellitus (DM), cerebral infarction (CI), and cardiovascular disease (CVD) has garnered much research interest. Notably, recent reports have described a number of highly sensitive antibody markers. In this study, we aimed to identify additional antibody markers that would facilitate screening. Methods: The amplified luminescent proximity homogeneous assay (AlphaLISA) method, which incorporates glutathione- or streptavidin-donor beads and anti-human-IgG-acceptor beads, was used to evaluate serum antibody levels in serum samples. The protein array method was used for the initial screening, and peptide arrays were used to identify epitope sites. Results: The protein array identified SH3 domain-binding protein 5 (SH3BP5) as a target antigen of serum IgG antibodies in the sera of patients with atherosclerosis. We prepared recombinant glutathione S-transferase (GST)- fused SH3BP5 protein. Peptide arrays revealed that the epitope site recognized by serum antibodies is located within amino acids 161–174 of SH3BP5. AlphaLISA revealed significantly higher serum antibody levels against both the SH3BP5 protein and peptide in patients with DM, acute-phase CI, transient ischemic attack, CVD or chronic kidney disease (CKD), than in healthy donors. Furthermore, areas under the receiver operating characteristic curves of these antibodies were higher in patients with CKD and DM than in other patients. Spearman correlation analysis revealed associations between the serum antibody levels against SH3BP5 peptide and artery stenosis, hypertension, and smoking. Conclusions: The serum anti-SH3BP5 antibody marker appears to be useful for estimating the progress of atherosclerosis and may discriminate atherosclerosis associated with hypertension and/or habitual smoking.

Introduction: Decongestion is related to improved clinical outcomes in patients with heart failure (HF). Worsening of renal function (WRF) is sometimes accompanied by the treatment for decongestion. Methods: 154 consecutive patients admitted with their first presentation of acute decompensated HF were enrolled. We investigated the prognostic impact of markers for decongestion, including a decrease in body weight and a hemoconcentration defined as an increase in hemoglobin, as well as the presence of WRF, during the initial 3 days after admission. Results: When divided by the median of the decrease in body weight (1.8 kg per 3 days), the difference in 1-year mortality did not reach statistical significance, but the duration of hospitalization was shorter in the aggressive decongestion group (20.8 and 30.7 days, P = .034). Patients who had WRF without hemoconcentration had worse prognosis in the aggressive decongestion group (P = .009); whereas neither WRF nor hemoconcentration was associated with 1-year mortality in the other group (P = .913). If we exclude patients who had WRF without hemoconcentration, the difference in 1-year mortality between the two groups became significant (P = .026). Conclusions: WRF due to aggressive decongestion did not have worse effect if accompanied by hemoconcentration. Accomplishment of decongestion in the initial 3 days can be a simple and potent marker for improved outcome of HF.