Aims/IntroductionElevation of the branched-chain amino acids (BCAAs), valine, leucine and isoleucine; and the aromatic amino acids, tyrosine and phenylalanine, has been observed in obesity-related insulin resistance. However, there have been few studies on Asians, who are generally less obese and less insulin-resistant than Caucasian or African-Americans. In the present study, we investigated the relationship between homeostasis model assessment of insulin resistance (HOMA-IR) and plasma amino acid concentration in non-diabetic Japanese participants.Materials and MethodsA total of 94 healthy men and women were enrolled, and plasma amino acid concentration was measured by liquid chromatography/mass spectrometry after overnight fasting. The associations between HOMA-IR and 20 amino acid concentrations, and anthropometric and clinical parameters of lifestyle-related diseases were evaluated.ResultsThe mean age and body mass index were 40.1 ± 9.6 years and 22.7 ± 3.9, respectively. Significantly positive correlations were observed between HOMA-IR and valine, isoleucine, leucine, tyrosine, phenylalanine and total BCAA concentration. Compared with the HOMA-IR ≤ 1.6 group, the HOMA-IR > 1.6 group showed significantly exacerbated anthropometric and clinical parameters, and significantly elevated levels of valine, isoleucine, leucine, tyrosine, phenylalanine and BCAA.ConclusionsThe present study shows that the insulin resistance-related change in amino acid profile is also observed in non-diabetic Japanese subjects. These amino acids include BCAAs (valine, isoleucine and leucine) and aromatic amino acids (tyrosine and phenylalanine), in agreement with previous studies carried out using different ethnic groups with different degrees of obesity and insulin resistance.
Recurrent anterior and interal rotatory subluxation of the tibial plateau is a disabling symptom in patients with insufficiency of the anterior cruciate ligament. Since 1970 we have used the N-test, a special jolt test to detect the characteristic instability. One hundred eighteen cases with anterior-internal rotatory instability of the knee seen at the Kanto Rosai Hospital and the University of Tokyo Hospital and diagnosed by arthroscopy and arthrotomy from 1973 to 1978 were reviewed. Most of the patients were athletes or sportsmen and the injuries commonly occurred in deceleration-injury mechanism and 81% of the cases were associated with meniscal tear. Thirty-two cases were reconstructed by iliotibial tract transfer, twenty of whom had been evaluated from 1-5 years after operation. Postoperatively, giving-way incidents disappeared in eleven, markedly decreased in five, and were unchanged in four patients. The anterior and internal rotatory subluxation of the tibial plateau disappeared or decreased in seventeen and was unchanged in two cases. Some type of defective anterior cruciate ligament was recognized in all our 118 cases and the capsular lesions were considered to play only a secondary role in exhibiting the instability.
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