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大岩 亜子  オオイワ アコ

教員組織学術研究院(医学系(附属病院))電話番号
教育組織医学部附属病院 糖尿病・内分泌代謝内科FAX番号
職名講師メールアドレス
住所〒390-8621 長野県松本市旭3-1-1ホームページURL

プロフィール

学歴
取得学位
信州大学大学院医学研究科加齢適応医科学系専攻 医学博士 , 信州大学

研究活動業績

研究業績(著書・
発表論文等)
書籍等出版物
日本糖尿病学会による新たな食事療法指針について考えるー量から質の時代へー, 3
糖尿病プラクティス・医歯薬出版株式会社 2022
Author:大岩亜子
Abstract:2019年に改訂された日本糖尿病学会による糖尿病食事療法の指針の再確認と、海外の食事療法を概説した。


新たな食事療法指針の実施状況〜長野県の糖尿病専門医へのアンケート調査結果より, 3
糖尿病プラクティス・医歯薬出版株式会社 2022
Author:大岩亜子
Abstract:2019年に改訂された糖尿病学会による食事療法指針について、長野県内の糖尿病専門医へアンケートを行った結果を概説した。


知っておきたい「日本食品標準成分表2020年版(八訂)」の改定ポイント
糖尿病プラクティス・医歯薬出版株式会社 2022
Author:大岩亜子


糖尿病ではなぜ食事療法が重要なのか?新たな展開とその展望, Vol.20, No.8 800-803
Visual Dermatology・秀潤社 2021
Author:大岩亜子


糖尿病患者における食事療法の新たな展開〜高齢者に食事療法はナンセンス!?, 217-219
信州医学雑誌 2020
Author:大岩亜子
Abstract:糖尿病患者の食事療法の新たな指針について概説した。


高齢者糖尿病, 日本臨床 第73巻 第12号, 2027-2031
株式会社 日本臨床社 2015
Author:大岩亜子、駒津光久
Keywords:diabetes in older adults, frailty, geriatric syndrome


論文
Efficacy and Safety of Low-dose Spironolactone for Chronic Kidney Disease in Type 2 Diabetes
The Journal of Clinical Endocrinology & Metabolism,Advance access publication 14 March 2023 2023
Author:Ako Oiwa, Dai Hiwatashi, Teiji Takeda, Takahide Miyamoto, Iori Kawata, Masayoshi Koinuma, Masanori Yamazaki, and Mitsuhisa Komatsu
Abstract:Context: Although adding spironolactone to renin-angiotensin system blockers reduces albuminuria in adults with chronic kidney disease and type 2 diabetes, it increases the risk of hyperkalemia. Objective: To assess whether a lower dose of spironolactone (12.5 mg/d) reduces the risk of hyperkalemia while maintaining its effect on reducing albuminemia. Design: Multicenter, open-label, randomized controlled trial. Setting: This study was conducted from July 2016 to November 2020 in ambulatory care at 3 diabetes medical institutions in Japan. Patients: We enrolled 130 Japanese adults with type 2 diabetes and albuminuria (≥30 mg/gCre), estimated glomerular filtration rate ≥30 mL/ min/1.73 m2, and serum potassium level <5.0 mEq/L. Interventions: The participants were randomly assigned to the spironolactone-administered and control groups. Main outcome measures: Changes in urine albumin-to-creatinine ratio (UACR) from baseline over the 24-week interventional period. Results: The spironolactone group showed a significant reduction in UACR from baseline (mean decrease, 103.47 ± 340.80 mg/gCre) compared with the control group, which showed an increased UACR (mean increase, 63.93 ± 310.14 mg/gCre; P = .0007, Wilcoxon rank-sum test and t test). Although the spironolactone group had a statistically significant increase in serum potassium levels, none of the participants had a potassium level ≥5.5 mEq/L at 24 weeks. Further, participants with a higher initial serum potassium level tended to have a smaller increase (estimate, −0.37, analysis of covariance). Conclusions: Low-dose spironolactone administration reduced albuminuria without causing hyperkalemia. Spironolactone administration, the oldest known and most cost-effective mineralocorticoid receptor antagonist, at lower doses should be reconsidered.


Interval walking training in type 2 diabetes: A pilot study to evaluate the applicability as exercise therapy
PLOS ONE,PLoS ONE 18(5): e0285762. 2023
Author:Kouhei Kitajima, Ako Oiwa, Takahiro Miyakoshi, Manami Hosokawa, Mayuka Furihata, Masaaki Takahashi, Shizue Masuki, Hiroshi Nose, Yosuke Okubo, Ai Sato, Masanori Yamazaki, Mitsuhisa Komatsu
Abstract:There are few established easy-to-perform exercise protocols with evidence-based effects for individuals with type 2 diabetes (T2D). A unique exercise regimen, interval walking training (IWT), has been reported to be beneficial for improving metabolic function, physical fitness and muscle strength in adults of overall health. This pilot study aims to demonstrate descriptive statistics of IWT adherence and changes in various data before and after the intervention of IWT in adults with T2D, perform statistical hypothesis testing, and calculate effect sizes. We performed a single-arm interventional pilot study with IWT for 20 weeks. We enrolled 51 participants with T2D aged 20–80 years with glycohemoglobin (HbA1c) levels of 6.5–10.0% (48–86 mmol/mol) and a body mass index of 20–34 kg/m2, respectively. The target was 60 min/week of fast walking for 20 weeks. The participants visited the hospital and were examined at 4-week intervals during this period. Between the start of IWT and after 20 weeks, we measured and evaluated changes in glucose and lipid metabolism data, body composition, physical fitness, muscle strength, dietary calorie intake, and daily exercise calories. All included participants completed IWT, with 39% of them reaching the target length of fast walking over 1,200 minutes in 20 weeks. In the primary outcome, HbA1c levels, and in the secondary, lipid metabolism and body composition, no significant changes were observed except for high-density lipoprotein cholesterol (HDL-C) (from 1.4 mmol/L to 1.5 mmol/L, p = 0.0093, t-test). However, in the target achievement group, a significant increase in VO2 peak by 10% (from 1,682 mL/min to 1,827 mL/min, p = 0.037, t-test) was observed. Effect sizes were Cohen’s d = 0.25 of HDL-C, -0.55 of triglyceride, and 0.24 of VO2 peak in the target achievement group, which were considered to be of small to medium clinical significance. These results could be solely attributed to IWT since there were no significant differences in dietary intake and daily life energy consumption before and after the study. IWT could be highly versatile and was suggested to have a positive effect on lipid metabolism and physical fitness. In future randomized controlled trial (RCT) studies, the detailed effects of IWT, focusing on these parameters, will be examined.


A patient with mild respiratory COVID-19 infection who developed bilateral non-hemorrhagic adrenal infarction.
Nagoya Journal of Medical Science,83巻(4号):883-891 2021
Author:5. Asano Y, Koshi T, Sano A, Maruno T, Kosaka M, Yamazaki Y, Oiwa A, Nishii Y.
Abstract:上気道症状はほとんど認めなかったにも関わらず、副腎梗塞を併発したCOVID-19患者の症例報告。


Changes in serum uric acid levels as a predictor of future decline in renal function in older adults with type 2 diabetes.
Medicine,8(100):e27420 2021
Author:4. Shibata Y, Yamazaki M, Kitahara J, Okubo Y, Oiwa A, Sato A, Komatsu M.


Aldosterone to Potassium Ratio after Adrenocorticotropin Stimulation in Unilateral Primary Aldosteronism Diagnosis
信州医学雑誌,68(3):159-168 2020(Jun. 10)
Author:Kitahara, Junichiro; Ohkubo, Yousuke; Kitajima, Kouhei; Nishio, Shin-ichi; Oiwa, Ako; Sato, Ai; Yamazaki, Masanori; Sakuma, Takahiro; Sano, Asami; Nishii, Yutaka; Komatsu, Mitsuhisa


Implications of thyroid autoimmunity in infertile women with subclinical hypothyroidism in the absence of both goiter and anti-thyroid antibodies: lessons from three cases
Endocrine Journal,66巻(2号):193-198 2018(Dec. 18)
Author:Ako Oiwa, Kesami Minemura, Shin-ichi Nishio, Masanori Yamazaki, Mitsuhisa Komatsu


Long-term Effects of Ipragliflozin on Adipose Tissue in Japanese Patients with Obese Type 2 Diabetes
信州医学雑誌,66(1):29-37 2018(Feb. 10)
Author:Nishio Shin-ichi, Sekido Takash, Ohkubo Yohsuke, Oiwa Ako, Komatsu Mitsuhisa


講演・口頭発表等
新たな食事療法指針の実施状況〜長野県糖尿病専門医へのアンケート調査結果より
第60回糖尿病学会関東甲信越地方会 2023
Presenter:大岩亜子、北島浩平、宮腰隆弘、大久保洋輔、佐藤亜位、山崎雅則、駒津光久


日本における糖尿病食事療法指針の変遷 〜他国との比較を通して再考する
第57回糖尿病学の進歩 2023
Presenter:大岩亜子


信州大学発インターバル速歩は2型糖尿病患者の体力向上に有効な運動療法である
第119回日本内科学会総会 2022
Presenter:大岩亜子、北島浩平、宮腰隆弘、大久保洋輔、佐藤亜位、山崎雅則、駒津光久


糖尿病性腎症患者に対する少量スピロノラクトンの尿中アルブミン量減少効果と安全性に関する多施設ランダム化比較試験
第64回日本糖尿病学会年次学術集会 2021
Presenter: 大岩 亜子, 樋渡 大, 武田 貞二, 宮本 高秀, 川田 伊織, 濃沼 政美, 山崎 雅則, 駒津 光久


摂食障害との鑑別困難なadult-onset ゴナドトロピン単独欠損症が強く疑われる一例
日本内分泌学会学術総会 2019(May 09)
Presenter:成澤望、大岩亜子、久保田諭史、河合裕子、北原順一郎、佐藤吉彦、駒津光久


BMI低値群では高値群に比べて透析予防外来の指導効果が表れやすい
2018(May)
Presenter:大岩亜子、高橋良恵、草間恵里、遠藤美弥子、丸山陽子、座光寺智恵子、駒津光久


巨大甲状腺腫および重症甲状腺眼症を併発したT3優位型バセドウ病の2症例
2018(Apr.)
Presenter:大岩亜子、西尾真一、山崎雅則、佐藤吉彦、駒津光久


ピオグリタゾン中止とSGLT-2阻害薬の使用により、1年で約30kgの体重減少を認めた高度肥満症合併2型糖尿病の一例
日本内分泌学会北海道支部学術集会 2016
Presenter:大岩亜子、柴田有亮、加藤晃佑、西尾真一、山崎雅則、峯村今朝美、駒津光久


不妊女性における、原因不明の高TSH血症と原因不明の高プロラクチン血症の併存について
日本内分泌学会総会 2016
Presenter:大岩亜子、峯村今朝美、西尾真一、駒津光久


潜在性甲状腺機能低下症合併不妊女性において、甲状腺自己抗体陰性でも自己免疫性甲状腺疾患の可能性がある
日本内分泌学会総会 2015
Presenter:大岩亜子、樋渡大、峯村今朝美、片倉正文、駒津光久