Meguro, Shu

写真a

Affiliation

School of Medicine, Department of Internal Medicine (Nephrology, Endocrinology and Metabolism) (Shinanomachi)

Position

Assistant Professor/Senior Assistant Professor
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Career 【 Display / hide 】

  • 1993.04
    -
    1995.03

    慶應義塾大学病院　内科研修医

  • 1995.04
    -
    1997.03

    慶應義塾大学医学部内科学教室　助手

  • 1997.04
    -
    2001.06

    慶應義塾大学医学部　腎臓内分泌代謝内科　助手

  • 2001.07
    -
    2010.06

    東京都済生会中央病院

  • 2010.07
    -
    2012.03

    慶應義塾大学医学部　腎臓内分泌代謝内科　助教

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Academic Background 【 Display / hide 】

  • 1993.03

    Hokkaido University, Faculty of Medicine

    University, Graduated

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Academic Degrees 【 Display / hide 】

  • 医学博士, Keio University, Dissertation, 2003

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Licenses and Qualifications 【 Display / hide 】

  • fellow of the Japanese Society of Internal Medicine, 2006.12

  • 日本糖尿病学会　専門医, 2009.04

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Research Areas 【 Display / hide 】

  • Life Science / Metabolism and endocrinology (Metabolism Studies)

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Papers 【 Display / hide 】

  • Association of fish intake with all-cause mortality according to CRP levels or inflammation in older adults: a prospective cohort study

    Kurata H., Meguro S., Abe Y., Sasaki T., Arai Y., Hayashi K.

    BMC Public Health 24 ( 1 )  2024.12

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    Background: The relationship between inflammatory response, fish consumption, and mortality risk in older individuals is unclear. We investigated whether C-reactive protein (CRP) levels ≥ 0.1 mg/dL, fish intake, and inflammatory responses are associated with all-cause mortality risk in older adults. Methods: This prospective cohort study included older adults aged 85–89 years from the Kawasaki Aging and Wellbeing Project, who did not require daily care. Cohort was recruited from March 2017 to December 2018 (follow-up ended on December 31, 2021). Dietary assessment was conducted using the Brief Self-Administered Diet History Questionnaire. Multivariate Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for all-cause mortality in the CRP ≥ 0.1 mg/dL group; the CRP < 0.1 mg/dL group was used for reference. Within CRP ≥ 0.1 and < 0.1 mg/dL groups, participants were categorized into tertiles of fish intake. HRs and 95% CIs for all-cause mortality in the other groups were estimated using the lower tertile group as a reference. Results: The study included 996 participants (mean [standard deviation] age, 86.5 [1.37] years; 497 [49.9%] women) with a median CRP level of 0.08 (interquartile range [IQR] = 0.04–0.16). There were 162 deaths during 4,161 person-years of observation; the multivariable-adjusted HR for all-cause mortality in the CRP ≥ 0.1 mg/dL group was 1.86 (95% CI, 1.32–2.62); P < 0.001. In 577 individuals with median (IQR) fish intake of 39.3 g/1000 kcal (23.6–57.6) and CRP level of < 0.1 mg/dL, the multivariable-adjusted HR for all-cause mortality in the higher tertile group of fish intake was 1.15 (0.67–1.97); P = 0.59, non-linear P = 0.84. In 419 individuals with median (IQR) fish intake of 40.7 g/1000 kcal (25.0–60.1) and CRP level of ≥ 0.1 mg/dL, the multivariate-adjusted HR for all-cause mortality in the higher tertile group of fish intake was 0.49 (0.26–0.92); P = 0.026, non-linear P = 0.38, P-value for interaction = 0.040. Conclusions: A negative association between fish intake and all-cause mortality was seen in older adults with elevated CRP levels, which is a mortality risk factor. While the results may be limited owing to stringent methods ensuring impartiality, they offer valuable insights for future research. Trial registration: UMIN000026053. Registered February 24, 2017.

  • A sensor-augmented pump with a predictive low-glucose suspend system could lead to an optimal time in target range during pregnancy in Japanese women with type 1 diabetes

    Tamura R.K., Kodani N., Itoh A., Meguro S., Kajio H., Itoh H.

    Diabetology International 15 ( 3 ) 447 - 455 2024.07

    ISSN  21901678

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    Introduction: It is challenging for pregnant women with type 1 diabetes to maintain optimum glucose level to attain good neonatal outcomes. This study evaluated the efficacy of sensor-augmented insulin pump (SAP) with a predictive low-glucose suspend (PLGS) system in pregnant Japanese women with type 1 diabetes. Materials and methods: SAP with PLGS was used in 11 of the 22 women with type 1 diabetes who delivered between 2011 and 2021 at the two medical institutions in Japan. Glucose management, insulin delivery suspension time (IST) and neonatal outcomes were retrospectively studied. Results: In SAP with PLGS cases (n = 11), average glycated hemoglobin levels were < 6.5% throughout the pregnancy, and the time in range (TIR, 63–140 mg/dl) was > 70% in the second and third trimesters. PLGS was safely used without inducing ketoacidosis. Positive correlation was observed between IST and TIR (r = 0.62, p < 0.01). Negative correlation was observed between IST and time below range (TBR) (r = − 0.40, p = 0.02), and IST and time above range (TAR) (r = − 0.45, p = 0.01). Total daily insulin dose was adequately increased without increasing hypoglycemia. There was only one heavy-for-date HFD) infant among the 11 newborns in SAP with PLGS cases. In cases without SAP (n = 11), target glycemic levels were difficult to achieve and there were 5 HFD infants among the 11 newborns. Conclusion: SAP with PLGS was safely and effectively used in pregnant women with type 1 diabetes to achieve target glucose levels without increasing the risk of hypoglycemia, which may have led to good neonatal outcomes.

  • Predictors of the effectiveness of isCGM usage in adults with type 1 diabetes mellitus: post-hoc analysis of the ISCHIA study

    Fukunaga M., Kouyama K., Tanaka T., Tenta M., Matsushita Y., Takeda M., Iseda I., Hida K., Nagao T., Taniguchi R., Tanaka N., Abe K., Hitaka Y., Matoba Y., Katsuno T., Kusunoki Y., Fukuda T., Shimizu I., Kodani N., Tsuchiya T., Yagi K., Sugiyama K., Itoh A., Yamaguchi S., Kinouchi K., Inaishi J., Nakajima Y., Mitsuishi M., Tanaka M., Irie J., Saisho Y., Itoh H., Meguro S., Kawashima S., Haisa A., Satomura A., Oikawa Y., Shimada A., Saito N., Kimura M., Tsuchida Y., Shimura K., Hoshina S., Takagi S., Kobayashi H., Shen Z., Suganuma A., Watanabe T., Ito Y., Suzuki S., Kasama S., Kasahara M., Tone A., Miura J., Kouyama R., Kato K., Kuroda A., Matsuhisa M., Hirota Y., Toyoda M., Satoh-Asahara N., Sakane N., Murata T., Miyamoto Y., Nishimura K., Hosoda K.

    Diabetology International 15 ( 3 ) 400 - 405 2024.07

    ISSN  21901678

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    Aim: The Effect of Intermittent-Scanning Continuous Glucose Monitoring to Glycemic Control Including Hypoglycemia and Quality of Life of Patients with Type 1 Diabetes Mellitus (ISCHIA) study was a randomized, crossover trial that reported the decrease in time below range (TBR) by the use of intermittent-scanning continuous glucose monitoring (isCGM) combined with structured education in adults with type 1 diabetes (T1D) treated by multiple daily injections. The participants were instructed to perform frequent scanning of the isCGM sensor (10 times a day or more) and ingest sugar when impending hypoglycemia is suspected by tracking the sensor glucose levels and the trend arrow. We conducted post-hoc analysis to identify factors affecting difference in TBR (∆TBR), in time in range (∆TIR), and in time above range (∆TAR). Participants and methods: Data from 93 participants who completed the ISCHIA study were used. Multiple regression analyses were performed to identify factors affecting CGM metrics. Results: Pearson’s correlation analysis showed the negative association between log-transformed scan frequency and with ∆TBR (r = − 0.255, P = 0.015), while there was no significant association of log-transformed scan frequency with ∆TIR (r = 0.172, P = 0.102) and ∆TAR (r = 0.032, P = 0.761), respectively. The log-transformed scan frequency was an independent predictor of ∆TBR (Beta = − 7.712, P = 0.022), but not of ∆TIR(Beta = 7.203, P = 0.091) and of ∆TAR (Beta = 0.514, P = 0.925). Conclusions: Our findings suggest that more frequent scanning of isCGM may be beneficial to reduce TBR in T1D adults.

  • Effects of weight loss from oral semaglutide administration on cardiometabolic risk factors in Japanese patients with type 2 diabetes: a retrospective analysis using propensity score matching

    Aoyama K., Nakajima Y., Meguro S., Hayashi K.

    Diabetology International  2024

    ISSN  21901678

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    Background: Obesity is increasingly being recognized as a chronic disease that exacerbates type 2 diabetes and its related complications. Oral semaglutide, a novel glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated efficacy in weight loss and diabetes control in Western populations. However, in real-world clinical practice, its effectiveness in Japanese patients, who typically exhibit a leaner phenotype and unique genetic susceptibilities affecting insulin secretion, remains unclear. Methods: We retrospectively evaluated the electronic medical records of 313 patients treated with oral semaglutide and 11,239 untreated controls at the Keio University School of Medicine. We performed propensity score matching to adjust for covariates, including age, sex, height, weight, blood pressure, blood test data, medications, and compared the cardiometabolic risk factors, including HbA1c, blood pressure, lipids, and liver function 180 days post-treatment, of both patient groups. We conducted a subgroup analysis for patients who achieved ≥ 3% weight loss. Results: After propensity score matching, the semaglutide group demonstrated significantly better outcomes for HbA1c reduction and weight loss and improvements in systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and liver function than the control group. Subgroup analysis of patients with ≥ 3% weight loss revealed superior HbA1c improvements in the semaglutide group; however, no significant differences in other metabolic parameters, such as SBP, LDL-C, and liver function, were observed. Conclusion: Oral semaglutide effectively improved metabolic markers in Japanese patients with type 2 diabetes, similar to that in Western populations. Weight loss itself was suggested to significantly contribute to blood pressure, lipid levels, and liver function changes.

  • Diurnal variation in the association between the scan frequency of isCGM and CGM metrics: post hoc analysis of the ISCHIA study

    Meguro S., Sakane N., Hosoda K., Hirota Y., Itoh A., Kato K., Kodani N., Kuroda A., Matsuhisa M., Miura J., Shimada A., Tone A., Toyoda M., Murata T., Nishimura K., Miyamoto Y., Satoh-Asahara N., Kouyama R., Kasahara M., Kasama S., Suzuki S., Ito Y., Watanabe T., Suganuma A., Shen Z., Kobayashi H., Takagi S., Hoshina S., Shimura K., Tsuchida Y., Kimura M., Saito N., Oikawa Y., Satomura A., Haisa A., Kawashima S., Itoh H., Saisho Y., Irie J., Tanaka M., Mitsuishi M., Nakajima Y., Inaishi J., Kinouchi K., Yamaguchi S., Sugiyama K., Yagi K., Tsuchiya T., Shimizu I., Fukuda T., Kusunoki Y., Katsuno T., Matoba Y., Hitaka Y., Abe K., Tanaka N., Taniguchi R., Nagao T., Hida K., Iseda I., Takeda M., Matsushita Y., Tenta M., Tanaka T., Kouyama K., Fukunaga M.

    Diabetology International  2024

    ISSN  21901678

    　View Summary

    Background and aims: To investigate the association between the frequency of intermittent-scanning continuous glucose monitoring (isCGM) and diurnal variation of time in range (TIR), time above range (TAR), and time below range (TBR), we performed a post hoc analysis of the ISCHIA study, a multicenter, prospective, open-label, randomized crossover study of patients with type 1 diabetes mellitus. Method: Data of 93 people who completed the ISCHIA study were used. We calculated scan frequency, TAR, TIR, and TBR of four approximately 6-h intervals: 6:00–11:59 (morning), 12:00–17:59 (afternoon), 18:00–23:59 (evening), and 0:00–5:59 (night). The correlation between scan frequency and diurnal variation of CGM metrics was analyzed using nonparametric Spearman correlation analysis. Results: More frequent scanning was associated with higher TIR in the afternoon (rho = 0.343, P < 0.001), evening (rho = 0.243, P = 0.019), and night (rho = 0.218, P = 0.036); furthermore, it was associated with lower TAR in the afternoon (rho = -0.275, P = 0.008) and TBR in the evening (rho = -0.235, P = 0.024). Concern about the effect of blood glucose fluctuation on social communication affected the number of scans during the day. Concerns about loneliness and hypoglycemia when alone also influenced the number of nighttime scans. Conclusion: Scan frequency is influenced by psychological factors. Afternoon scans were associated with the highest increase in TIR and decrease in TAR. Evening scans were linked to a reduction in TBR.

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Papers, etc., Registered in KOARA 【 Display / hide 】

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Reviews, Commentaries, etc. 【 Display / hide 】

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Courses Taught 【 Display / hide 】

  • PATHOPHYSIOLOGICAL ISSUES IN CHRONIC CARE

    2025

  • LECTURE SERIES, INTERNAL MEDICINE (NEPHROLOGY, ENDOCRINOLOGY, AND METABOLISM)

    2025

  • LECTURE SERIES, INTERNAL MEDICINE (NEPHROLOGY, ENDOCRINOLOGY, AND METABOLISM)

    2024

  • PATHOPHYSIOLOGICAL ISSUES IN CHRONIC CARE

    2024

  • PATHOPHYSIOLOGICAL ISSUES IN CHRONIC CARE

    2023

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Courses Previously Taught 【 Display / hide 】

  • Internal medicine

    Keio University

    2017.04
    -
    2018.03
    , 

    Full academic year, Lecture

  • 内科学「腎臓・内分泌・代謝」　糖尿病（薬物療法（インクレチン、インスリン含む）

    Keio University

    2015.04
    -
    2016.03
    , 

    Spring Semester, Lecture, Within own ｆaculty

  • 内科学臨床実習アドバンスト　腎臓内分泌代謝

    Keio University

    2015.04
    -
    2016.03
    , 

    Spring Semester, Laboratory work/practical work/exercise

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Memberships in Academic Societies 【 Display / hide 】

  • Japanese Society of Internal Medicine

    　

  • Japan Diabetes Society

    　

  • Japan Endocrine Society

    　
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