{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:04:08Z","timestamp":1789790648833,"version":"4.0.1"},"reference-count":26,"publisher":"Japanese Society of Internal Medicine","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intern. Med."],"published-print":{"date-parts":[[2026]]},"DOI":"10.2169\/internalmedicine.7438-26","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:11:38Z","timestamp":1789423898000},"source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Clinical Impact of Abnormal Glucose Metabolism in Immunotherapy-na\u00efve Myasthenia Gravis"],"prefix":"10.2169","author":[{"given":"Manato","family":"Yasuda","sequence":"first","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyuki","family":"Uzawa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Japan"},{"name":"Department of Neurology, NHO Chiba Medical Center, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Akamine","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Japan"},{"name":"Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuko","family":"Ogaya","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Handa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Ozawa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Japan"},{"name":"Department of Neurology, Japanese Red Cross Narita Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kuwabara","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Japan"},{"name":"Research Institute of Disaster Medicine, Chiba University, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"962","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"1. Punga AR, Maddison P, Heckmann JM, Guptill JT, Evoli A. Epidemiology, diagnostics, and biomarkers of autoimmune neuromuscular junction disorders. Lancet Neurol 21: 176-188, 2022.","DOI":"10.1016\/S1474-4422(21)00297-0"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Zivkovi\u0107 SA, Clemens PR, Lacomis D. Characteristics of late-onset myasthenia gravis. J Neurol 259: 2167-2171, 2012.","DOI":"10.1007\/s00415-012-6478-6"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3. Yeh JH, Chen HJ, Lin CC, Chen YK, Chiu HC, Kao CH. Risk of diabetes mellitus among patients with myasthenia gravis. Acta Neurol Scand 132: 132-138, 2015.","DOI":"10.1111\/ane.12374"},{"key":"4","unstructured":"4. Sudulagunta SR, Sepehrar M, Sodalagunta MB, et al. Refractory myasthenia gravis - clinical profile, comorbidities and response to rituximab. Ger Med Sci 14: Doc12, 2016."},{"key":"5","doi-asserted-by":"crossref","unstructured":"5. Ozdemir HN, Karasoy H, Yuceyar AN, Ekmekci O. Effects of comorbid diseases on clinical outcomes in patients with myasthenia gravis. Neurol Sci 44: 2923-2931, 2023.","DOI":"10.1007\/s10072-023-06750-8"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Zhang P, Yang CL, Du T, et al. Diabetes mellitus exacerbates experimental autoimmune myasthenia gravis via modulating both adaptive and innate immunity. J Neuroinflammation 18: 244, 2021.","DOI":"10.1186\/s12974-021-02298-6"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7. Dong J, Shi X, Gu XD, et al. Diabetes exacerbates myasthenia gravis by enhancing pathological thymic output via the GPR183-7\u03b1,25-OHC axis. J Neuroinflammation 22: 250, 2025.","DOI":"10.1186\/s12974-025-03571-8"},{"key":"8","doi-asserted-by":"crossref","unstructured":"8. Li T, Yang CL, Du T, et al. Diabetes mellitus aggravates humoral immune response in myasthenia gravis by promoting differentiation and activation of circulating Tfh cells. Clin Immunol 245: 109141, 2022.","DOI":"10.1016\/j.clim.2022.109141"},{"key":"9","doi-asserted-by":"crossref","unstructured":"9. Liu YD, Tang F, Li XL, et al. Type 2 diabetes mellitus as a possible risk factor for myasthenia gravis: a case-control study. Front Neurol 14: 1125842, 2023.","DOI":"10.3389\/fneur.2023.1125842"},{"key":"10","doi-asserted-by":"crossref","unstructured":"10. Uehara A, Kurotani K, Kochi T, et al. Prevalence of diabetes and pre-diabetes among workers: Japan Epidemiology Collaboration on Occupational Health Study. Diabetes Res Clin Pract 106: 118-127, 2014.","DOI":"10.1016\/j.diabres.2014.07.013"},{"key":"11","doi-asserted-by":"crossref","unstructured":"11. American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2024. Diabetes Care 47 (Suppl 1): S20-S42, 2024.","DOI":"10.2337\/dc24-S002"},{"key":"12","unstructured":"12. Ministry of Health, Labour and Welfare. National health and nutrition survey 2019 [Internet]. [cited 2026 Mar 2]. Available from: https:\/\/www.mhlw.go.jp\/stf\/seisakunitsuite\/bunya\/kenkou_iryou\/kenkou\/eiyou\/r1-houkoku_00002.html (in Japanese)"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13. Andersen JB, Gilhus NE, Sanders DB. Factors affecting outcome in myasthenia gravis. Muscle Nerve 54: 1041-1049, 2016.","DOI":"10.1002\/mus.25205"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14. Uzawa A, Suzuki S, Kuwabara S, et al. Effectiveness of early cycles of fast-acting treatment in generalised myasthenia gravis. J Neurol Neurosurg Psychiatry 94: 467-473, 2023.","DOI":"10.1136\/jnnp-2022-330519"},{"key":"15","doi-asserted-by":"crossref","unstructured":"15. Wolfe GI, Herbelin L, Nations SP, Foster B, Bryan WW, Barohn RJ. Myasthenia gravis activities of daily living profile. Neurology 52: 1487-1489, 1999.","DOI":"10.1212\/WNL.52.7.1487"},{"key":"16","doi-asserted-by":"crossref","unstructured":"16. Jaretzki A 3rd, Barohn RJ, Ernstoff RM, et al. Myasthenia gravis: recommendations for clinical research standards. Task force of the medical scientific advisory board of the Myasthenia Gravis Foundation of America. Neurology 55: 16-23, 2000.","DOI":"10.1212\/WNL.55.1.16"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Ashida S, Ochi H, Hamatani M, et al. Immune skew of circulating follicular helper T cells associates with myasthenia gravis severity. Neurol Neuroimmunol Neuroinflamm 8: e945, 2021.","DOI":"10.1212\/NXI.0000000000000945"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18. Morita R, Schmitt N, Bentebibel SE, et al. Human blood CXCR5(+)CD4(+) T cells are counterparts of T follicular cells and contain specific subsets that differentially support antibody secretion. Immunity 34: 108-121, 2011.","DOI":"10.1016\/j.immuni.2010.12.012"},{"key":"19","doi-asserted-by":"crossref","unstructured":"19. Manigrasso MB, Juranek J, Ramasamy R, Schmidt AM. Unlocking the biology of RAGE in diabetic microvascular complications. Trends Endocrinol Metab 25: 15-22, 2014.","DOI":"10.1016\/j.tem.2013.08.002"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20. Dong H, Zhang Y, Huang Y, Deng H. Pathophysiology of RAGE in inflammatory diseases. Front Immunol 13: 931473, 2022.","DOI":"10.3389\/fimmu.2022.931473"},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Mu L, Zhang Y, Sun B, et al. Activation of the receptor for advanced glycation end products (RAGE) exacerbates experimental autoimmune myasthenia gravis symptoms. Clin Immunol 141: 36-48, 2011.","DOI":"10.1016\/j.clim.2011.04.013"},{"key":"22","doi-asserted-by":"crossref","unstructured":"22. Moser B, Bekos C, Zimprich F, Nickl S, Klepetko W, Ankersmit J. The receptor for advanced glycation endproducts and its ligands in patients with myasthenia gravis. Biochem Biophys Res Commun 420: 96-101, 2012.","DOI":"10.1016\/j.bbrc.2012.02.121"},{"key":"23","doi-asserted-by":"crossref","unstructured":"23. Uzawa A, Kawaguchi N, Kanai T, Himuro K, Kuwabara S. Serum high mobility group box 1 is upregulated in myasthenia gravis. J Neurol Neurosurg Psychiatry 86: 695-697, 2015.","DOI":"10.1136\/jnnp-2014-309232"},{"key":"24","doi-asserted-by":"crossref","unstructured":"24. Maimaitiming B, Uzawa A, Ozawa Y, et al. High mobility group box 1 is involved in the pathogenesis of passive transfer myasthenia gravis model. NeuroReport 32: 803-807, 2021.","DOI":"10.1097\/WNR.0000000000001665"},{"key":"25","doi-asserted-by":"crossref","unstructured":"25. Prasad M, Chen EW, Toh SA, Gascoigne NRJ. Autoimmune responses and inflammation in type 2 diabetes. J Leukoc Biol 107: 739-748, 2020.","DOI":"10.1002\/JLB.3MR0220-243R"},{"key":"26","doi-asserted-by":"crossref","unstructured":"26. Petersson M, Feresiadou A, Jons D, et al. Patient-reported symptom severity in a nationwide myasthenia gravis cohort: cross-sectional analysis of the Swedish GEMG Study. Neurology 97: e1382-e1391, 2021.","DOI":"10.1212\/WNL.0000000000012604"}],"container-title":["Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/internalmedicine\/advpub\/0\/advpub_7438-26\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:30:47Z","timestamp":1789788647000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/internalmedicine\/advpub\/0\/advpub_7438-26\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":26,"URL":"https:\/\/doi.org\/10.2169\/internalmedicine.7438-26","relation":{},"ISSN":["0918-2918","1349-7235"],"issn-type":[{"value":"0918-2918","type":"print"},{"value":"1349-7235","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"7438-26"}}