Sitagliptin reduces the ACR through decreasing both blood pressure and eGFR, with no correlation with a decrease in HbA1c over a 3-month period. These results may reflect the direct action of sitagliptin on the kidneys.

Cholesteryl ester transfer protein (CETP) is a key regulating factor of lipid metabolism, and the polymorphism of its gene may therefore be a candidate for modulating the lipid parameters, altering the susceptibility to atherosclerosis in type 2 diabetic subjects. In a group of 443 unrelated Japanese patients with type 2 diabetes, we studied the B1B2 polymorphism at the CETP locus, which is detectable with the restriction enzyme TaqI. Patients were separated into three groups according to genotype and compared based on their clinical characteristics, lipid parameters, and macrovascular complications. The B2 allele was associated in a dose-dependent fashion with higher HDL cholesterol and apolipoprotein AI levels, together with lower CETP concentrations. Furthermore, the prevalence of macrovascular complications, such as coronary heart disease, arteriosclerosis obliterans, and cerebral vascular disease, was significantly higher in subjects with the B1B1 genotype. Multiple logistic regression analysis also showed that the B1 allele of CETP genotype was associated with the incidence of these three complications independently of other risk factors. Thus, in type 2 diabetic patients, the B1B2 polymorphism of CETP gene is likely to be a strong genetic predictor of macrovascular complications. Diabetes 51:871-874, 2002 T ype 2 diabetic patients are at high risk of atherosclerotic diseases, such as coronary heart disease (CHD), cerebral vascular disease (CVD), or arteriosclerosis obliterans (ASO) (1). This increased risk can be partly accounted for by the lipoprotein disorders linked to insulin resistance: elevated VLDL, triglycerides, and cholesterol, together with low HDL cholesterol (2). The inverse relationship between the level of HDL cholesterol and the risk of cardiovascular disease is commonly explained by the crucial role of HDL in reverse cholesterol transport (3-5). By this process, cholesterol from peripheral cells is taken up by HDL and transported to the liver, where it is metabolized and excreted in the bile. Cholesteryl ester transfer protein (CETP) has a central role in the metabolism of HDL lipoprotein and may therefore alter the susceptibility to atherosclerotic vascular disease (3). In a normolipidemic population, the plasma CETP concentration varies mostly over a threefold range and is influenced by environmental factors (6). Plasma CETP has been shown to be elevated in smokers and to be decreased by heavy alcohol drinking and physical training (7-9).Recently, the B1B2 polymorphism of intron 1 of the CETP gene (presence or absence of a TaqIB restriction site) was shown to be a determinant of HDL cholesterol (10). It has been reported that both healthy and type 2 diabetic subjects with the B2B2 genotype of TaqIB polymorphism have significantly higher HDL cholesterol levels than those with the B1B1 or B1B2 genotype (11,12). Furthermore, in subjects with the B2B2 genotype, the progression of coronary atherosclerosis is more greatly suppressed by pravastatin than in those with the B1B1 or B1B2 genotype,...

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We encountered a case of epithelioid inflammatory myofibroblastic sarcoma (EIMS) originating from an abdominal organ that rapidly regrew twice. The patient underwent two surgeries. Large tumors grew within three months after the second surgery. The patient subsequently received chemotherapy with an anaplastic lymphoma kinase (ALK) inhibitor. Although EIMS has a poor prognosis, the patient continues to be alive with disease 14 months after surgical treatment and the administration of the ALK inhibitor.

The combination of glomerulonephritis and diabetes nephropathy has been reported to occur in 1.8–22% of biopsy-proven diabetic nephropathy cases [1–6]. In these reports, however, the onset of glomerulonephritis during the course of diabetic nephropathy was not described in detail, and how the superimposition of glomerulonephritis affected renal function, particularly at the advanced stage of diabetic nephropathy. We recently encountered a patient, in whom the onset of IgA glomerulonephritis was detected clinically during the advanced stage of overt diabetic nephropathy. In this case, the onset of glomerulonephritis significantly increased the progressive deterioration of renal function.