税所 芳史 (サイショ ヨシフミ)

Saisho, Yoshifumi

写真a

所属(所属キャンパス)

医学部 内科学教室(腎臓・内分泌・代謝) (信濃町)

職名

専任講師(有期)

メールアドレス

メールアドレス

経歴 【 表示 / 非表示

  • 1998年04月
    -
    2000年03月

    慶應義塾大学医学部内科学教室

  • 2000年04月
    -
    2001年03月

    静岡市立清水病院, 内科

  • 2001年04月
    -
    2002年04月

    平塚市民病院, 内科

  • 2002年05月
    -
    2006年03月

    慶應義塾大学医学部腎臓内分泌代謝内科

  • 2006年04月
    -
    2009年03月

    米国UCLA Larry Hillblom Islet Research Center (Prof. Peter Butler)

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学歴 【 表示 / 非表示

  •  

    慶應義塾大学医学部

学位 【 表示 / 非表示

  • 医学博士, 慶應義塾大学, 2009年

免許・資格 【 表示 / 非表示

  • 医師免許, 1998年

 

研究分野 【 表示 / 非表示

  • 代謝学

  • 内分泌学

研究キーワード 【 表示 / 非表示

  • 糖尿病全般、特に2型糖尿病におけるβ細胞障害

共同研究希望テーマ 【 表示 / 非表示

  • 糖尿病

 

著書 【 表示 / 非表示

  • いま知っておきたい 2型糖尿病の注射療法の疑問67

    税所 芳史, 南江堂, 2016年12月

    担当範囲: Q48 注射する場所は? Q49 注射の手順は? Q50 注射薬はどのくらい予備をもっているべき?

  • 【糖尿病の臨床検査-その限界に挑戦する】 糖尿病の臨床検査(各論) 糖尿病の治療に関連した検査 Cペプチドインデックス(Cpi)

    税所, 芳史, 2015年

     概要を見る

    <Point>cペプチドインデックス(cpi)はcペプチドを血糖値で補正した指標である.cpiはβ細胞機能を反映する.cpiはインスリン療法の必要性を予測し,治療法の選択に有用である.(著者抄録)

  • 【糖尿病治療の経口薬up to date】 これらの薬剤のみで不十分な際に、相乗効果を期待して加える薬剤は、その理由は? メトホルミン

    税所, 芳史 and 島田, 朗, 2015年

  • 産科診療Q&A 一つ上を行く診療の実践 Q42.カーボカウントやCSIIなど新しい血糖管理を行っている糖尿病合併妊娠での注意点を教えて下さい

    税所 芳史宮越 敬(/)-#HR田中 守, 中外医学社, 2015年

  • Case Study 高齢者に対するインスリン分泌系薬剤の使用経験

    税所, 芳史, 2014年

     概要を見る

    症例1(62歳女性)。症例2(73歳女性)。両症例とも24年来、10年来の2型糖尿病で、治療薬としてSU薬を使用していた。

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論文 【 表示 / 非表示

  • Associations of birthweight and history of childhood obesity with beta cell mass in Japanese adults

    Sasaki H., Saisho Y., Inaishi J., Watanabe Y., Tsuchiya T., Makio M., Sato M., Kitago M., Yamada T., Itoh H.

    Diabetologia (Diabetologia)  63 ( 6 ) 1199 - 1210 2020年06月

    ISSN  0012186X

     概要を見る

    © 2020, The Author(s). Aims/hypothesis: Low birthweight is associated with a high risk of diabetes, but there are no reports discussing birthweight and pancreatic tissues in humans. The purpose of this study was to examine the correlation between birthweight and beta and alpha cell mass in humans. Methods: Sixty-four Japanese adults with and without diabetes who underwent pancreatectomy and were able to recall their weight history including birthweight were included. Pancreatic tissues were stained for insulin and glucagon, and fractional beta cell area (BCA) and alpha cell area (ACA) were quantified. Islet size and density and beta cell replication were also quantified and their associations with birthweight were evaluated. Results: In participants without diabetes, there was a weak positive correlation between birthweight and BCA (R = 0.34, p = 0.03). The group with a history of childhood obesity, but not the group with a history of obesity in adulthood only, showed higher BCA compared with those without a history of obesity (1.78 ± 0.74% vs 0.99 ± 0.53%, p = 0.01), and the correlation coefficient between birthweight and BCA increased after excluding those with a history of childhood obesity (R = 0.51, p < 0.01). In those with diabetes, there was no correlation between birthweight and BCA. No correlation was found between birthweight and ACA in either those with or without diabetes. Conclusions/interpretation: Birthweight and beta, but not alpha, cell mass are positively correlated in non-diabetic adults, and a history of childhood obesity may affect beta cell mass. [Figure not available: see fulltext.].

  • Efficacy and safety of once-weekly exenatide after switching from twice-daily exenatide in patients with type 2 diabetes

    Watanabe Y., Saisho Y., Inaishi J., Kou K., Yamauchi A., Kanazawa Y., Okubo Y., Tokui M., Imai T., Murakami R., Tsuchiya T., Sasaki H., Masaoka T., Irie J., Meguro S., Itoh H.

    Journal of Diabetes Investigation (Journal of Diabetes Investigation)  11 ( 2 ) 382 - 388 2020年03月

    ISSN  20401116

     概要を見る

    © 2019 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd Aims/Introduction: To evaluate the efficacy and safety of once-weekly (q.w.) extended-release exenatide after switching from twice-daily (b.i.d.) exenatide in patients with type 2 diabetes. Materials and Methods: This was an investigator-initiated, prospective, single-arm, multicenter study. Individuals with type 2 diabetes who had been treated with exenatide b.i.d. for at least 3 months were enrolled and switched to exenatide q.w. for 24 weeks. The primary end-point was change in HbA1c at week 24 to test the glucose-lowering effect of exenatide q.w. versus exenatide b.i.d. Results: A total of 58 Japanese individuals with type 2 diabetes completed the study. Glycated hemoglobin was reduced by 0.2% at week 24 (7.2 ± 1.2% vs 7.0 ± 1.2% [56 ± 13 vs 53 ± 13 mmol/mol], 95% confidence interval −0.4 to −0.03%, P < 0.005 for non-inferiority, P = 0.01 for superiority). Fasting plasma glucose was reduced by 12 mg/dL at week 24 (154 ± 46 vs 142 ± 46 mg/dL, P = 0.02). β-Cell function assessed by homeostasis model assessment of β-cell function and C-peptide index was significantly improved at week 24. The incidence of self-reported hypoglycemia was reduced, and treatment satisfaction assessed by the Diabetes Treatment Satisfaction Questionnaire and Diabetes Medication Satisfaction Questionnaire was improved at week 24, with no change in body weight. There was no serious adverse event related to the study drug. Conclusions: Switching from exenatide b.i.d. to exenatide q.w. resulted in a reduction in glycated hemoglobin, fasting plasma glucose and the incidence of hypoglycemia, and improvement in β-cell function and treatment satisfaction in patients with type 2 diabetes. These findings will be useful for selecting optimal treatment in individuals with type 2 diabetes.

  • Longitudinal association of fatty pancreas with the incidence of type-2 diabetes in lean individuals: a 6-year computed tomography-based cohort study

    Yamazaki H., Tauchi S., Wang J., Dohke M., Hanawa N., Kodama Y., Katanuma A., Saisho Y., Kamitani T., Fukuhara S., Yamamoto Y.

    Journal of Gastroenterology (Journal of Gastroenterology)  2020年

    ISSN  09441174

     概要を見る

    © 2020, Japanese Society of Gastroenterology. Background: Only a few studies have longitudinally evaluated whether fatty pancreas increases the risk of type-2 diabetes (T2D), and their results were inconsistent. Fatty pancreas is closely linked to overweight and obesity, but previous studies did not exclude overweight or obese individuals. Therefore, in this cohort study, we investigated the association between fatty pancreas and T2D incidence in lean individuals. Methods: Between 2008 and 2013, 1478 nondiabetic lean individuals (i.e. body-mass index < 25 kg/m2) underwent health examinations including computed tomography (CT) and were followed for a median of 6.19 years. Fatty pancreas was evaluated by a histologically-validated method using pancreas attenuation (Hounsfield units [HU]) on CT at baseline; lower pancreas attenuation indicates more pancreatic fat. To detect incident T2D, we used fasting plasma glucose, HbA1c, and self-reports of prescribed anti-diabetes medications. Odds ratios (OR) for the association between pancreas attenuation and incident T2D were estimated using logistic regression models adjusted for likely confounders. Results: T2D occurred in 61 participants (4.13%) during the follow-up period. Lower pancreas attenuation (i.e. more pancreatic fat) at baseline was associated with incident T2D (unadjusted OR per 10 HU lower attenuation: 1.56 [95% CI 1.28–1.91], p < 0.001). The multivariable-adjusted analysis revealed a similar association (adjusted OR per 10 HU lower attenuation: 1.32 [95% CI 1.06–1.63], p = 0.012). Conclusions: T2D was likely to develop in lean individuals with the fatty pancreas. Among people who are neither obese nor overweight, the fatty pancreas can be used to define a group at high risk for T2D.

  • Association of glucose tolerance status with pancreatic β- and α-cell mass in community-based autopsy samples of Japanese individuals: The Hisayama Study

    Inaishi J., Saisho Y., Hirakawa Y., Yoshida D., Hata J., Mukai N., Watanabe Y., Oda Y., Itoh H., Ninomiya T.

    Journal of Diabetes Investigation (Journal of Diabetes Investigation)  2020年

    ISSN  20401116

     概要を見る

    © 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd Aims/Introduction: Changes in histologically quantified β- and α-cell mass during the development of glucose intolerance have not been fully elucidated. The aim of the present study was to explore differences in β- and α-cell mass according to the glucose tolerance status. Materials and Methods: Autopsy samples from a total of 103 individuals (40 with normal glucose tolerance, 31 with prediabetes and 32 with type 2 diabetes mellitus) who underwent a 75-g oral glucose tolerance test within 5 years before death were selected from 643 community-based autopsy samples collected from 2002 to 2016. Fractional β-cell area (BCA) and α-cell area were quantified with Image Pro Plus software. Associations of BCA and α-cell area with glucose tolerance status were assessed using a linear regression analysis, and Spearman’s correlation coefficients between glycemic markers and β-cell function were estimated. Results: The mean values of BCA decreased significantly with worsening glucose tolerance status (mean ± standard error 1.85 ± 0.10% in normal glucose tolerance, 1.59 ± 0.11% in prediabetes and 1.17 ± 0.11% in type 2 diabetes mellitus, P for trend < 0.001), whereas there was no significant association between α-cell area and glucose tolerance status. BCA was inversely correlated with fasting and 2-h plasma glucose levels during oral glucose tolerance test and glycated hemoglobin measurement, and positively correlated with disposition index (all P < 0.01). Conclusions: β-Cell mass decreased significantly with worsening glucose tolerance, from the stage of prediabetes, in the Japanese population. Prevention of declining β-cell mass before the onset of glucose intolerance is important to reduce the burden of type 2 diabetes mellitus.

  • Pancreatic alpha-cell mass across adult human lifespan

    Moin A.S.M., Cory M., Gurlo T., Saisho Y., Rizza R.A., Butler P.C., Butler A.E.

    European Journal of Endocrinology (European Journal of Endocrinology)  182 ( 2 ) 219 - 231 2020年

    ISSN  08044643

     概要を見る

    © 2020 European Society of Endocrinology Printed in Great Britain. Aim: To establish pancreatic alpha-cell mass in lean, non-diabetic humans over the adult lifespan, performed as a follow-up study to beta-cell mass across the adult human lifespan. Methods: We examined human pancreatic autopsy tissue from 66 lean, non-diabetic individuals aged from 30 to 102 years, grouped into deciles: 3rd (30–39 years), 4th (40–49 years), 5th (50–59 years), 6th (60–69 years), 7th (70–79 years), 8th (80–89 years) and 9th deciles (90+ years). Sections of pancreas were immunostained for glucagon and analyzed for fractional alpha-cell area. Population-based pancreatic volume data were used to calculate alpha-cell mass. Results: With advanced age, the exocrine pancreas undergoes atrophy demonstrated by increased fat area (as % exocrine area) (0.05 ± 0.01 vs 1.6 ± 0.7% fat area of total exocrine pancreas, 3rd vs 9th decile, P < 0.05). Consequently, islet density increases with age (2.7 ± 0.4 vs 10.5 ± 3.3 islets/mm2, 3rd vs 9th decile, P < 0.05). Alpha-cell fractional area increases with advanced age (0.34 ± 0.05% vs 0.73 ± 0.26%, 3rd vs 9th decile, P < 0.05). However, alpha-cell mass remains constant at ~190 mg throughout the adult lifespan in lean, non-diabetic humans. Within islets, alpha-cell distribution between mantle and core is unchanged across deciles (1862 ± 220 vs 1945 ± 200 vs 1948 ± 139 alpha cells in islet mantle/mm2, 3rd vs 6th vs 9th decile, P = 0.93 and 1912 ± 442 vs 1449 ± 123 vs 1514 ± 168 alpha cells in islet core/mm2, 3rd vs 6th vs 9th decile, P = 0.47), suggesting that human islets retain their structural organization in the setting of age-related exocrine atrophy. Conclusions: Consistent with our previous findings for beta-cell mass, alpha-cell mass remains constant in humans, even with advanced age. Pancreatic endocrine cells are much more robustly preserved than exocrine cells in aged humans, and islets maintain their structural integrity throughout life.

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KOARA(リポジトリ)収録論文等 【 表示 / 非表示

総説・解説等 【 表示 / 非表示

  • Glycemic and metabolic features in gestational diabetes: Singleton versus twin pregnancies

    Akiba Y., Miyakoshi K., Ikenoue S., Saisho Y., Kasuga Y., Ochiai D., Matsumoto T., Tanaka M.

    Endocrine Journal (Endocrine Journal)  66 ( 7 ) 647 - 651 2019年

    ISSN  09188959

     概要を見る

    © The Japan Endocrine Society. A number of data on gestational diabetes mellitus (GDM) in singleton pregnancy is available, however, little is known about the glycemic characteristics of twin pregnancy with GDM. The aim of this study was to compare the severity of dysglycemia between twin and singleton pregnancies with GDM (T-GDM and S-GDM). We retrospectively analyzed pregnancies with GDM defined by the Japan Diabetes Society criteria (T-GDM, n = 20; S-GDM, n = 451) in our hospital. During the study period, women with GDM underwent self-monitoring of blood glucose measurements as well as dietary management. Insulin treatment was initiated when dietary treatment did not achieve the glycemic goal. The glycemic and metabolic characteristics were compared between T-GDM and S-GDM, as follows: gestational week at the diagnosis of GDM, 75 g oral glucose tolerance test (OGTT) results, HbA1c, insulin secretion (i.e. insulinogenic index [IGI] and Insulin SecretionSensitivity Index-2 [ISSI-2]), and insulin requirement before delivery. The rate of one abnormal OGTT value in T-GDM was similar to that in S-GDM (60% vs. 71%). There were no significant differences in gestational week and levels of HbA1c at diagnosis, levels of IGI and ISSI-2 between T-GDM and S-GDM (median, 20 weeks vs. 17 weeks, 5.0% vs. 5.2%, 0.58 vs. 0.71, 1.7 vs. 1.8, respectively). The rate of insulin treatment and a median dosage of insulin needed before delivery was comparable between the two groups (T-GDM vs. S-GDM: 45% vs. 32% and 14 vs. 13 unit/day). Our data suggested that the severity of dysglycemia in T-GDM was similar to that in S-GDM during pregnancy.

  • Association between severity of obstructive sleep apnea and glycated hemoglobin level in japanese individuals with and without diabetes

    Kurosawa H., Saisho Y., Fukunaga K., Haraguchi M., Yamasawa W., Kurihara I., Betsuyaku T., Itoh H.

    Endocrine Journal (Endocrine Journal)  65 ( 1 ) 121 - 127 2018年

    ISSN  09188959

     概要を見る

    © The Japan Endocrine Society. Aim of this study was to examine the association between the severity of obstructive sleep apnea (OSA) and dysglycemia in Japanese individuals with and without type 2 diabetes (T2DM). We enrolled 115 individuals diagnosed with OSA with an apnea hypopnea-index (AHI) ≥ 20 in whom continuous positive airway pressure (CPAP) therapy was introduced (N = 115, 44 with T2DM, age 62 ± 11 years, BMI 27.0 ± 4.4 kg/m2 and AHI median 36.1; interquartile range 27.2–48.1). During admission, the severity of OSA was evaluated by polysomnography, and its association with glycated hemoglobin (HbA1c) level was examined. Continuous glucose monitoring (CGM) was also conducted during the admission in 94 individuals. Apnea-hypopnea index (AHI), non-rapid eye movement (REM) AHI, minimum peripheral capillary oxygen saturation (SpO2) and percentage of sleep time (%TST) with SpO2 < 90% were significantly associated with HbA1c level in total and non-diabetic individuals (all p < 0.05) but not in those with T2DM, the majority of whom were treated with anti-diabetic medications. The associations of the non-REM AHI and %TST with SpO2 < 90% with HbA1c level remained significant after adjustment for age, sex and BMI in non-diabetic and T2DM subjects treated with dietary therapy only. Mean glucose level, but not SD or coefficient of variation of glucose, assessed by CGM was significantly associated with AHI and non-REM AHI in non-diabetic subjects after adjustment for age, sex and BMI. In conclusion, the severity of OSA was associated with increased HbA1c level independently of BMI in Japanese individuals, especially in those without diabetes.

研究発表 【 表示 / 非表示

  • 著明な高血糖に人工膵臓を用いて血糖コントロールを行った1例

    野島, 淳, 目黒, 周, 入江, 潤一郎, 田中, 正巳, 税所, 芳史, 河合, 俊英 and 伊藤, 裕

    日本内分泌学会雑誌, 2015年, 口頭(一般)

  • 膵摘出症例におけるβ細胞量と糖代謝指標の関連についての検討

    稲石, 淳, 税所, 芳史, 村上, 理恵, 佐藤, 誠治, 侯, 金成, 北郷, 実, 北川, 雄光, 山田, 健人 and 伊藤, 裕

    日本内分泌学会雑誌, 2015年, 口頭(一般)

  • 外来通院糖尿病患者における血糖変動に関する検討

    金子, 賢司, 税所, 芳史, 村上, 理恵, 稲石, 淳 and 伊藤, 裕

    日本内分泌学会雑誌, 2015年, ポスター(一般)

  • Foxo1 CoRepressor(FCoR)は、膵β細胞からα細胞への変換を抑制する

    小谷, 紀子, 中江, 淳, 川野, 義長, 大平, 理沙, 菊地, 徹洋, 松崎, 素子, 後藤, 伸子, 茂田, 文子, 八木, 一騎, 税所, 芳史, 北村, 忠弘 and アチリ・ドミニコ

    日本内分泌学会雑誌, 2015年, 口頭(一般)

  • 2型糖尿病症例におけるアログリプチン長期投与の有効性と安全性

    西村, 健志, 田中, 正巳, 関岡, 理沙, 河合, 俊英, 目黒, 周, 入江, 潤一郎, 税所, 芳史 and 伊藤, 裕

    日本内分泌学会雑誌, 2015年, ポスター(一般)

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競争的資金等の研究課題 【 表示 / 非表示

  • ヒト膵β細胞量の調節機構および糖代謝との関連についての包括的検討

    2018年04月
    -
    2021年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 税所 芳史, 基盤研究(C), 補助金,  代表

  • ヒト膵β細胞量調節機構に関する包括的検討

    2015年04月
    -
    2017年03月

    科学研究費補助金(文部科学省・日本学術振興会), 補助金,  代表

受賞 【 表示 / 非表示

  • Publons Peer Review Awards

    2017年

  • Marquis Who's Who in the World 2015

    2015年

  • Marquis Who's Who in the World 2015

    2014年

  • 日本糖尿病財団・ノバルティスファーマ研究助成

    2012年

  • International Diabetes Center Etzwiler International Scholarship

    2012年

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担当授業科目 【 表示 / 非表示

  • 慢性期病態学各論

    2020年度

  • 内科学(腎臓・内分泌・代謝)講義

    2020年度

  • 内科学講義

    2020年度

  • 臨床実習入門

    2020年度

  • 診断学実習

    2020年度

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担当経験のある授業科目 【 表示 / 非表示

  • 糖尿病

    慶應義塾大学医学部、慶應義塾大学看護医療学部など, 2018年度

  • 甲状腺疾患

    慶應義塾大学医学部、慶應義塾大学看護医療学部など, 2018年度

  • 脂質異常症

    慶應義塾大学医学部、慶應義塾大学看護医療学部など, 2018年度

  • 慶應義塾大学医学部診断学実習

    慶應義塾, 2017年度, 秋学期, 専門科目, 実習・実験

  • 慶應義塾大学看護医療学部講義

    慶應義塾, 2017年度, 春学期, 専門科目, 講義

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教育活動及び特記事項 【 表示 / 非表示

  • 慶應義塾大学病院 看護専門領域研修会

    2010年
    -
    2015年

    , その他特記事項

 

所属学協会 【 表示 / 非表示

  • 日本内科学会(総合内科専門医、指導医)

     
  • 日本糖尿病学会(専門医、指導医)

     
  • 日本内分泌学会

     
  • 日本動脈硬化学会

     
  • 日本高血圧学会

     

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委員歴 【 表示 / 非表示

  • 2017年10月
    -
    継続中

    資格認定試験問題作成者, 日本内科学会

  • 2016年04月
    -
    継続中

    OSCE委員, 慶應義塾大学医学部

  • 2016年04月
    -
    継続中

    学事委員, 慶應義塾大学医学部

  • 2016年04月
    -
    継続中

    クリニカルパス委員, 慶應義塾大学医学部内科学教室

  • 2016年
    -
    継続中

    認定委員会, 日本糖尿病療養指導士認定機構

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