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Ogiya A, Kimura K, Ueno T, Iwase T, Ohno S. Time trend of breast cancer-related lymphedema according to body mass index. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108350. [PMID: 38653160 DOI: 10.1016/j.ejso.2024.108350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/01/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE To clarify how body mass index (BMI) affects the development and temporal trend of breast cancer-related lymphedema (BCRL). METHODS This is a prospective study in which patients with operable breast cancer were registered in a single institute between November 2009 and July 2010. The incidence of lymphedema at 1, 3, and 5 years after surgery was assessed according to BMI, and the trend of newly developed BCRL was examined. Obesity was defined as BMI ≥25 in accordance with the Japan Society for the Study of Obesity. RESULTS A total of 368 patients were included in this study. The multivariate analysis of the whole population showed that high BMI, axillary dissection, and radiotherapy remained as risk factors for BCRL. Patients with high BMI showed a significantly higher incidence of new lymphedema than those with low BMI at 1 year (p < 00.001) regardless of axillary procedures (39.1 % vs 16.3 % for axillary dissection; 15.6 % vs 1.5 % for sentinel lymph node biopsy) but not at 3 and 5 years. Once BCRL developed, patients with high BMI showed slow recovery and 50.0 % of the patients retained edema at 5 years while patients with low BMI showed rapid recovery and 26.7 % retained after 3 years (p = 0.04). CONCLUSION The preoperative BMI affected the incidence and temporal trend of BCRL regardless of axillary procedures or radiotherapy. Patients with high BMI should be given appropriate information about BCRL before surgery with careful follow-up for BCRL after treatment.
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Affiliation(s)
- Akiko Ogiya
- Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 1358550, Japan.
| | | | - Takayuki Ueno
- Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 1358550, Japan.
| | - Takuji Iwase
- Department of Breast Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Aichi, 4538511, Japan
| | - Shinji Ohno
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 1358550, Japan
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Ishimoto R, Mutsuzaki H, Shimizu Y, Yoshikawa K, Koseki K, Takeuchi R, Matsumoto S, Hada Y. Association between Obesity and Short-Term Patient-Reported Outcomes following Total Knee Arthroplasty: A Retrospective Cohort Study in Japan. J Clin Med 2024; 13:1291. [PMID: 38592115 PMCID: PMC10932041 DOI: 10.3390/jcm13051291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
Background: This study investigated the association between obesity and short-term patient-reported outcomes after total knee arthroplasty (TKA). Methods: The primary outcomes were the Western Ontario and McMaster Universities Osteoarthritis Index's (WOMAC) pain and function scores. Data were collected preoperatively and 2 and 4 weeks after surgery. Patients were stratified into three groups based on body mass index (BMI): normal weight (BMI < 24.99 kg/m2), overweight (25 ≤ BMI < 29.99 kg/m2), and obese (BMI ≥ 30 kg/m2). The associations between BMI and the WOMAC pain and function scores were assessed using generalized linear mixed models. Results: Among the 102 patients (median age: 75.0, women [85.3%]), 29.4%, 48.0%, and 22.5% were normal weight, overweight, and obese, respectively. The mean pain and function scores at baseline were similar across the BMI-stratified groups (p = 0.727 and 0.277, respectively). The pain score significantly improved 2 weeks post-surgery (p = 0.001). The function score improved significantly 4 weeks post-surgery (p < 0.001). The group and group-by-time interaction effects lacked statistical significance. Conclusions: All patients statistically and clinically showed relevant pain reduction and functional improvement shortly after TKA, irrespective of their obesity status. These data may help healthcare professionals discuss the expectations of pain amelioration and functional improvement with TKA candidates.
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Affiliation(s)
- Ryu Ishimoto
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8575, Japan;
- Department of Rehabilitation Medicine, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Hirotaka Mutsuzaki
- Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Japan
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Kenichi Yoshikawa
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Kazunori Koseki
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Ryoko Takeuchi
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
| | - Shuji Matsumoto
- Department of Rehabilitation Medicine, Ibaraki Prefectural University of Health Sciences Hospital, Ami 300-0331, Japan
- Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
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Hayashi F, Shirai Y, Ohira T, Shirai K, Kondo N, Kondo K. Subjective Happiness, Frequency of Laughter, and Hypertension: A Cross-Sectional Study Based on the Japan Gerontological Evaluation Study (JAGES). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095713. [PMID: 37174231 PMCID: PMC10178400 DOI: 10.3390/ijerph20095713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
In recent years, positive psychological factors, such as subjective happiness and laughter, have been reported to be associated with cardiovascular disease. In this study, we examined the relationship of hypertension with subjective happiness and frequency of laughter using the data from the Japan Gerontological Evaluation Study (JAGES). Of the 138,294 respondents, 26,368 responded to a version of the self-administered questionnaire that included a question about the frequency of laughter in the JAGES 2013. In total, 22,503 (10,571 men and 11,932 women) were included in the analysis after excluding those with missing responses regarding a history of hypertension, frequency of laughter, and subjective happiness. The prevalence of hypertension in this study was 10,364 (46.1%). Multivariate logistic regression analysis showed that age, female sex, obesity, infrequent chewing, former and current drinker, seeing three to five friends, and the absence of hobbies were positively associated with hypertension. However, infrequent laughter/high level of subjective happiness, frequent laughter/high level of subjective happiness, being underweight, and current smoker were negatively associated with hypertension. As per the findings of this study, it was determined that subjective happiness was negatively associated with hypertension. Therefore, this study suggests that having more opportunities to feel happiness may be important in preventing hypertension.
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Affiliation(s)
- Fumikazu Hayashi
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Yuka Shirai
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Kokoro Shirai
- Department of Public Health, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Ohbu 474-8511, Japan
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Oda K, Anno T, Ogawa N, Kimura Y, Kawasaki F, Kaku K, Kaneto H, Takemasa M, Sasano M. Impact of nutritional guidance on various clinical parameters in patients with moderate obesity: A retrospective study. Front Nutr 2023; 10:1138685. [PMID: 37006919 PMCID: PMC10060631 DOI: 10.3389/fnut.2023.1138685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/09/2023] [Indexed: 03/18/2023] Open
Abstract
ContextThis study aims to investigate whether there is adequate provision of nutritional guidance through interventions by registered dietitians, especially for patients with moderate obesity. This is particularly important as such interventions may prove to be more effective for Japanese patients.MethodsIn Japan, since there is a system of nutritional guidance with a registered dietitian for patients with a BMI over 30 kg/m2, we recruited 636 patients with obesity who had a BMI over 30 kg/m2 admitted to the Kawasaki Medical School General Medical Center between April 2018 and March 2020 through a review of their medical records. Second, we recruited 153 patients who underwent a blood examination before receiving nutritional guidance and at least one time every 3 to 6 months thereafter after receiving it. We aimed to evaluate whether continued nutritional guidance and follow-up interventions for patients with obesity were effective. We compared the BMI and metabolic markers of the patients who received nutritional guidance from a registered dietitian against those who did not.ResultsA total of 636 patients with obesity who have a BMI over 30 kg/m2 were included in this study. A total of 164 patients with obesity received nutritional guidance from a registered dietitian at least one time, but 472 patients did not. Most interventions on nutritional guidance conducted by a registered dietitian were ordered from internal medicine (81.1%). However, internal medicine was the most common department that did not perform these interventions; however, less than half of the (49.2%) received them. In the second analysis, we compared two groups of patients with obesity. The first group (n = 70) who underwent blood examinations received nutritional guidance from a registered dietitian, while the second group (n = 54) did not receive such guidance. We found that there was no significant difference in body weight and BMI between the two groups of patients. We observed a significant decrease in dyslipidemia-associated metabolic markers among the patients who received nutritional guidance compared to those who did not [total cholesterol, −9.7 ± 29.3 vs. 2.3 ± 22.0 mg/dL (p = 0.0208); low-density lipoprotein cholesterol, −10.4 ± 30.5 vs. −2.0 ± 51.0 mg/dL (p = 0.0147), respectively]. Other metabolic markers also tended to decrease, although they did not reach statistical significance.ConclusionIt is rare for patients with only obesity to receive nutritional guidance. However, when nutritional guidance from a registered dietitian is provided, improvements in BMI and metabolic parameters can be expected.
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Affiliation(s)
- Kayoko Oda
- Department of Nutrition, Kawasaki Medical School General Medical Center, Okayama, Japan
- Department of Clinical Nutrition, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Takatoshi Anno
- Department of General Internal Medicine 1, Kawasaki Medical School, Okayama, Japan
| | - Nozomi Ogawa
- Department of Nutrition, Kawasaki Medical School General Medical Center, Okayama, Japan
- Department of Clinical Nutrition, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Yukiko Kimura
- Department of General Internal Medicine 1, Kawasaki Medical School, Okayama, Japan
| | - Fumiko Kawasaki
- Department of General Internal Medicine 1, Kawasaki Medical School, Okayama, Japan
| | - Kohei Kaku
- Department of General Internal Medicine 1, Kawasaki Medical School, Okayama, Japan
| | - Hideaki Kaneto
- Department of Diabetes, Metabolism and Endocrinology, Kawasaki Medical School, Kurashiki, Japan
| | - Mutsuko Takemasa
- Department of Clinical Nutrition, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Miyori Sasano
- Department of Nutrition, Kawasaki Medical School General Medical Center, Okayama, Japan
- Department of Clinical Nutrition, Kawasaki University of Medical Welfare, Kurashiki, Japan
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Prevalence of Sarcopenic Obesity and Factors Influencing Body Composition in Persons with Spinal Cord Injury in Japan. Nutrients 2023; 15:nu15020473. [PMID: 36678344 PMCID: PMC9863685 DOI: 10.3390/nu15020473] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 01/18/2023] Open
Abstract
This study aims to investigate the prevalence of sarcopenic obesity and factors influencing body composition in persons with spinal cord injury (SCI) in Japan. Adults with SCI aged ≥ 20 years who underwent whole-body dual-energy X-ray absorptiometry between 2016 and 2022 were retrospectively analyzed. Data from 97 patients were examined. The primary outcome was appendicular skeletal muscle mass (ASM). Multiple linear regression analysis was conducted to assess factors influencing the lean and adipose indices in persons with SCI. Sarcopenia, obesity, and sarcopenic obesity were prevalent in 76%, 85%, and 64% of patients, respectively. Multivariate linear regression analysis revealed that sex (β = 0.34, p < 0.001), lesion level (β = 0.25, p = 0.007), severity (β = 0.20, p = 0.043), and ability to walk (β = 0.29, p = 0.006) were independently associated with ASM. Sex (β = −0.63, p < 0.001) was independently associated with percent body fat. In conclusion, sarcopenia, obesity, and sarcopenic obesity were prevalent among patients with SCI in Japan. Female sex, tetraplegia, motor-complete injury, and inability to walk were risk factors for sarcopenia, whereas female sex was a risk factor for obesity in persons with SCI. A routine monitoring of body composition is necessary, especially among those with multiple risk factors, to identify individuals in need of preventive and therapeutic interventions.
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Abstract
Asthma is chronic eosinophilic bronchitis with the dominancy of T helper 2 (Th2) inflammation. However, patients with asthma and metabolic dysfunction have pathogenic and pathological differences from those with Th2 inflammation. Metabolic dysfunction, typically presented as metabolic syndrome, has several important clinical components including central obesity, insulin resistance or glucose intolerance, dyslipidemia, and vitamin D deficiency. Data from large epidemiological studies support the significance of these components in the control of asthma and their contribution to airway remodeling, suggesting the presence of an asthma phenotype with metabolic dysfunction. These components are quite interactive with each other, so it is difficult to reveal the individual role of each. It is well known that asthma is difficult to treat in patients with obesity, due in part to inadequate response to inhaled corticosteroids. Additionally, vitamin D deficiency and insulin resistance have been regarded as aggravating factors of asthma control and airway remodeling. Recent clinical and in vivo studies have revealed the specific mechanisms of these components, which may aggravate asthma control and airway remodeling. In this review article, I summarize the recent studies and unmet needs for patients with asthma and metabolic dysfunction.
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Affiliation(s)
- Jung-Won Park
- Institute for Allergy & Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Hayashi F, Ohira T, Okazaki K, Nakano H, Sakai A, Hosoya M, Shimabukuro M, Takahashi A, Kazama J, Yasumura S, Hashimoto S, Kawasaki Y, Kobashi G, Ohto H, Kamiya K, for the Fukushima Health Management Survey. Relationship between physical activity/exercise habits and the frequency of new onset of lifestyle-related diseases after the Great East Japan Earthquake among residents in Fukushima: the Fukushima Health Management Survey. JOURNAL OF RADIATION RESEARCH 2021; 62:i129-i139. [PMID: 33978173 PMCID: PMC8114221 DOI: 10.1093/jrr/rraa134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/30/2020] [Indexed: 06/12/2023]
Abstract
The effect of exercise habits on the increased incidence of lifestyle-related diseases among residents of the evacuation area in Fukushima Prefecture after the Great East Japan Earthquake is not well characterized. This study examined the influence of exercise habits on the frequency of new onset of lifestyle-related diseases in the aftermath of the earthquake using data from the Fukushima Health Management Survey (FHMS). Of the 32 289 individuals (14 004 men and 18 285 women) aged 40-90 years who underwent one or more health examinations in both 2011-12 and 2014-15, those who knew whether they had any lifestyle diseases and who responded to a questionnaire about their exercise and physical activity habits were included (dyslipidemia, 8017; hypertension, 7173; and diabetes mellitus, 13140 individuals). The association between the frequency of new onset of lifestyle-related diseases in 2014-15 and the presence or absence of persistent exercise and physical activity habits (active lifestyle) was examined using the FHMS data. The frequency of new onset of dyslipidemia was significantly lower in the active lifestyle group than in the sedentary lifestyle group (P = 0.008). On univariate and multivariate logistic regression analyses, the presence of active lifestyle, obesity and the experience of evacuation showed a significant association with new onset of dyslipidemia, independent of age, sex or follow-up period. Thus maintaining physical activity and exercise habits may help prevent the new onset of dyslipidemia among residents of the evacuation area in the Fukushima Prefecture after the earthquake.
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Affiliation(s)
- Fumikazu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Radiation Life Sciences, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Junichiro Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Nephrology and Hypertension, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Shigeatsu Hashimoto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Metabolism, Diabetes and Nephrology, Fukushima Medical University Aizu Medical Center, Fukushima-city, Fukushima, Japan
| | - Yukihiko Kawasaki
- Department of Pediatrics, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Gen Kobashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Public Health, School of Medicine, Dokkyo Medical University, Tochigi, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
- Department of Blood Transfusion and Transplantation Immunology, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, Japan
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Ogihara S, Yamazaki T, Shiibashi M, Chikuda H, Maruyama T, Miyoshi K, Inanami H, Oshima Y, Azuma S, Kawamura N, Yamakawa K, Hara N, Morii J, Okazaki R, Takeshita Y, Tanaka S, Saita K. Risk factors for deep surgical site infection following posterior instrumented fusion for degenerative diseases in the thoracic and/or lumbar spine: a multicenter, observational cohort study of 2913 consecutive cases. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:1756-1764. [PMID: 33512588 DOI: 10.1007/s00586-020-06609-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/31/2020] [Accepted: 09/20/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Surgical site infection (SSI) is one of the most devastating complications following spinal instrumented fusion surgeries because it may lead to a significant increase in morbidity, mortality, and poor clinical outcomes. Identifying the risk factors for SSI can help in developing strategies to reduce its occurrence. However, data on the risk factors for SSI in degenerative diseases are limited. This study aimed to identify risk factors for deep SSI following posterior instrumented fusion for degenerative diseases in the thoracic and/or lumbar spine in adult patients. METHODS This was a multicenter, observational cohort study conducted at 10 study hospitals between July 2010 and June 2015. The subjects were consecutive adult patients who underwent posterior instrumented fusion surgery for degenerative diseases in the thoracic and/or lumbar spine and developed SSI. Detailed patient-specific and procedure-specific potential risk variables were prospectively recorded using a standardized data collection chart and retrospectively reviewed. RESULTS Of the 2913 enrolled patients, 35 developed postoperative deep SSI (1.2%). Multivariable regression analysis identified three independent risk factors: male sex (P = 0.002) and American Society of Anesthesiologists (ASA) score of ≥ 3 (P = 0.003) as patient-specific risk factors, and operation including the thoracic spine (P = 0.018) as a procedure-specific risk factor. CONCLUSION Thoracic spinal surgery, an ASA score of ≥ 3, and male sex were risk factors for deep SSI after routine thoracolumbar instrumented fusion surgeries for degenerative diseases. Awareness of these risk factors can enable surgeons to develop a more appropriate management plan and provide better patient counseling.
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Affiliation(s)
- Satoshi Ogihara
- Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
| | - Takashi Yamazaki
- Department of Orthopaedic Surgery, Musashino Red Cross Hospital, 1-26-1 Kyonancho, Musashino, Tokyo, 180-8610, Japan
| | - Michio Shiibashi
- Information Technology Center, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan
| | - Toru Maruyama
- Department of Orthopaedic Surgery, Saitama Rehabilitation Center, 148-1 Nishikaizuka, Ageo, Saitama, 362-0057, Japan
| | - Kota Miyoshi
- Department of Orthopaedic Surgery, Yokohama Rosai Hospital, 3211 Kozukuecho, Kouhoku-ku, Yokohama, Kanagawa, 222-0036, Japan
| | - Hirohiko Inanami
- Department of Orthopaedic Surgery, Iwai Orthopaedic Medical Hospital, 8-17-2 Minamikoiwa, Edogawa-ku, Tokyo, 133-0056, Japan
| | - Yasushi Oshima
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Seiichi Azuma
- Department of Orthopaedic Surgery, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - Naohiro Kawamura
- Department of Spine and Orthopaedic Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan
| | - Kiyofumi Yamakawa
- Department of Orthopaedic Surgery and Musculoskeletal Oncology, Tokyo Metropolitan Komagome Hospital, 3-18 Honkomagome, Bunkyo-ku, Tokyo, 113-0021, Japan
| | - Nobuhiro Hara
- Department of Orthopaedic Surgery, Musashino Red Cross Hospital, 1-26-1 Kyonancho, Musashino, Tokyo, 180-8610, Japan
| | - Jiro Morii
- Department of Orthopaedic Surgery, Sanraku Hospital, 2-5 Surugadai, Kanda, Chiyoda-ku, Tokyo, 101-8326, Japan
| | - Rentaro Okazaki
- Department of Orthopaedic Surgery, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama, 330-8553, Japan
| | - Yujiro Takeshita
- Department of Orthopaedic Surgery, Yokohama Rosai Hospital, 3211 Kozukuecho, Kouhoku-ku, Yokohama, Kanagawa, 222-0036, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kazuo Saita
- Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
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Sugiura K, Kobayashi T, Ojima T. The epidemiological characteristics of thromboembolism related to oral contraceptives in Japan: Results of a national survey. J Obstet Gynaecol Res 2020; 47:198-207. [PMID: 32885566 DOI: 10.1111/jog.14452] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/03/2020] [Accepted: 08/08/2020] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to reveal the epidemiological characteristics of thromboembolism related to combined oral contraceptives (COCs) in Japan. METHODS A survey of confirmed thromboembolism patients among Japanese COC users was conducted at randomly selected hospitals from across Japan. The survey examined six types of venous thromboembolism (VTE) and arterial thromboembolism (ATE) in all COC users: pulmonary embolism, deep vein thrombosis, other venous thrombosis, cerebral infarction, myocardial infarction, and other arterial thrombosis. The survey covered 5 years from 2009 to 2013. This study was approved in an ethical review by Hamamatsu University School of Medicine. RESULTS Four hundred and twenty-five cases clearly related to COCs were analyzed. The annual estimated incidence rates per 10 000 person-years of VTE, ATE and all thromboembolisms in all COC users were 1.17, 0.33 and 1.50, respectively. The incidence of thromboembolism was 35.2% within 30 days from the start of COCs, 53.8% within 90 days, 66.9% within 180 days and 78.2% within 360 days regardless of progestin type. Age adjusted odds ratios in the obese and underweight groups were 2.33 and 0.98 for overall thromboembolism, 2.59 and 0.77 for VTE, and 1.11 and 1.28 for ATE compared with the standard group, respectively. Odds ratios for thromboembolism in non-O blood groups were 1.89 for overall thromboembolism, 2.16 for VTE, and 1.35 for ATE, when compared with the O blood group. CONCLUSION The epidemiological characteristics of COC-related thromboembolisms were revealed in this national survey covering the years from 2009 to 2013.
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Affiliation(s)
- Kazuko Sugiura
- Department of Reproductive Health Nursing/Midwifery, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Takao Kobayashi
- Department of Obstetrics and Gynecology, Hamamatsu Medical Center, Hamamatsu, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Hamaguchi M, Obora A, Okamura T, Hashimoto Y, Kojima T, Fukui M. Changes in metabolic complications in patients with alcoholic fatty liver disease monitored over two decades: NAGALA study. BMJ Open Gastroenterol 2020; 7:e000359. [PMID: 32337056 PMCID: PMC7170409 DOI: 10.1136/bmjgast-2019-000359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/05/2020] [Accepted: 03/12/2020] [Indexed: 12/17/2022] Open
Abstract
Objective The social conditions are changing in the world, which may contribute to the change in lifestyle, including alcohol consumption and dietary intake; however, changes in metabolic complications in patients with alcoholic fatty liver disease (AFLD) have never been reported. Therefore, here we compare the metabolic complications in current AFLD with those of two decades ago. Methods We performed this cross-sectional study in a Japanese health check-up centre. Consecutive participants who visited the facilities between June 1994 and December 1997 or between January 2014 and December 2017 were enrolled. A total of 7499 participants (4804 men, 2695 women) in the past cohort and 20 029 participants (11 676 men, 8353 women) in the current cohort were entered to this study. Results The prevalence of drinkers in the current cohort was significantly lower (4.7%) than that in the past cohort in men (5.9%, p<0.001) but significantly higher in women (1.9% in the current vs 1.1% in the past, p<0.001). The prevalence of fatty liver in drinkers has increased in men (22.3% in the past cohort, 36.6% in the current cohort; p<0.001) but not in women (13.3% in the past cohort, 14.7% in the current cohort; p=1.0), while the prevalence of all fatty liver has increased in men and women (men: 24.0% in the past cohort, 36.2% in the current cohort, p<0.001; women: 9.3% in the past cohort, 12.8% in the current cohort, p<0.001). Regarding metabolic abnormalities, the prevalence of hyperglycaemia increased from 25.4% to 43.0% in men with AFLD (p<0.001) and from 25.1% to 39.1% in women with AFLD (p=1.0). Conclusions AFLD currently tends to be accompanied by hyperglycaemia. The prevalence of fatty liver in drinkers increased in men, although alcoholic consumptions did not increase. We should pay attention to fatty liver combined with hyperglycaemia for individuals who consume alcohol today.
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Affiliation(s)
- Masahide Hamaguchi
- Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Akihiro Obora
- Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Takuro Okamura
- Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshitaka Hashimoto
- Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takao Kojima
- Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Michiaki Fukui
- Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Shibata M, Nakajima K, Higuchi R, Iwane T, Sugiyama M, Nakamura T. High Concentration of Serum Aspartate Aminotransferase in Older Underweight People: Results of the Kanagawa Investigation of the Total Check-Up Data from the National Database-2 (KITCHEN-2). J Clin Med 2019; 8:1282. [PMID: 31443545 PMCID: PMC6780907 DOI: 10.3390/jcm8091282] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/13/2019] [Accepted: 08/16/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Aspartate aminotransferase (AST) is pivotal in amino acid metabolism. However, the serum activity of AST, which leaks from multiple organs, including liver and skeletal muscle, is unknown in older underweight people, who are at high risk of skeletal muscle mass loss. Therefore, we measured the serum activities of AST and alanine aminotransferase (ALT), a liver-specific transaminase, in a large, community-based cross-sectional study. METHODS Clinical parameters and lifestyles were characterized in 892,692 Japanese people with a wide range of body mass indexes (BMIs; 13-39.9 kg/m2), aged 40-74 years old, who were undergoing a medical checkup. A general linear model was used to calculate the estimated mean of serum AST (EM-AST) in each BMI category after adjustment for confounding factors, including past history of cardiovascular disease and waist circumference. RESULTS Severe underweight (BMI 13-14.9 kg/m2) was present in 910 subjects (0.1%). Raw serum AST showed a J-shaped relationship with BMI, which was blunted in older subjects (60-74 years), and similar, but less curved relationships were identified for raw serum ALT and gamma-glutamyl transferase. These J-shaped relationships in serum AST were not altered when subjects were classified by sex, past history of cardiovascular and cerebrovascular diseases, and habitual exercise. EM-AST showed a U-shaped relationship, with a minimum at BMI 21-22.9 kg/m2, regardless of age and waist circumference. CONCLUSIONS High serum AST but normal serum ALT is highly prevalent in older underweight people and might reflect skeletal muscle pathology.
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Affiliation(s)
- Michi Shibata
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan
- Department of Nutrition, School of Medicine, St. Marianna University, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan
| | - Kei Nakajima
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan.
- Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
| | - Ryoko Higuchi
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan
| | - Taizo Iwane
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan
| | - Michiko Sugiyama
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan
| | - Teiji Nakamura
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan
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Kim YY, Seo E, Baek J, Ha S, Kang HS. Effects of the Relative Distribution of Body Mass Index on the Incidence of Hypertension and Diabetes Mellitus, Using the Korean Obesity Index. Metab Syndr Relat Disord 2018; 17:108-114. [PMID: 30543477 DOI: 10.1089/met.2018.0104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Korean Obesity Index, which contains standard reference data (SRD) of obesity, was established in 2016 and revised in 2017 based on national health screening data to provide the distribution of the body mass index (BMI) of the whole population of Korea as a reference. This study aimed to investigate the effect of the SRD of obesity on the incidence of hypertension (HTN) and diabetes mellitus (DM). METHODS The percentile of BMI was calculated for each of the 864 subgroups by defined by gender, region, and age group according to the groupings in the SRD. Incident cases were defined as the presence of HTN and DM and medication prescription in the health care utilization database for a given individual in 2017, but not in 2015-2016. Logistic regression for the incidence of HTN and DM according to the relative distribution of BMI was performed. Gender, age, insurance type, insurance contribution, smoking, drinking, physical activity, blood pressure, waist circumference, fasting glucose, triglycerides, high-density lipoprotein cholesterol, the Charlson comorbidity index (2012-2014), and diagnosis and medication for HTN and DM (2015-2017) were adjusted in the analysis. RESULTS The C-statistics of the fully adjusted model for HTN and DM were 0.799 and 0.852, respectively. The risks of HTN and DM increased by 1.007 and 1.011 times, respectively, for each 1-percentile increase in BMI. CONCLUSION The results showed that BMI was associated with the incidence of HTN and DM according to the SRD. The relative distribution of BMI can be used to motivate self-care through providing more detailed information to individuals.
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Affiliation(s)
- Yeon-Yong Kim
- Big Data Steering Department, National Health Insurance Service, Wonju, Korea
| | - Eunjung Seo
- Big Data Steering Department, National Health Insurance Service, Wonju, Korea
| | - Jiyeon Baek
- Big Data Steering Department, National Health Insurance Service, Wonju, Korea
| | - Seongjun Ha
- Big Data Steering Department, National Health Insurance Service, Wonju, Korea
| | - Hyung-Soo Kang
- Big Data Steering Department, National Health Insurance Service, Wonju, Korea
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Wakamatsu K, Seki Y, Kasama K, Uno K, Hashimoto K, Seto Y, Kurokawa Y. Prevalence of Chronic Kidney Disease in Morbidly Obese Japanese and the Impact of Bariatric Surgery on Disease Progression. Obes Surg 2018; 28:489-496. [PMID: 28785976 DOI: 10.1007/s11695-017-2863-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The prevalence of chronic kidney disease (CKD) among Japanese morbidly obese patients undergoing bariatric surgery and the impact of bariatric surgery on their renal function has not previously been investigated. OBJECTIVES The aims were to assess the prevalence of CKD patients who underwent bariatric surgery in our institution and to elucidate the impact of bariatric surgery on their kidney function as measured by the estimated glomerular filtration rate by Cystatin-C (eGFRcys). SETTING The setting of the study was in a single private hospital. METHODS Two hundred fifty-four consecutive Japanese patients who underwent bariatric surgery were retrospectively analyzed to elucidate the prevalence of CKD. The eGFRcys was calculated to assess the change in the kidney function for 1 year after surgery. RESULTS The preoperative prevalence of CKD was as follows: G1, 45.3%; G2, 47.2%; G3, 6.5%; and G4, 0.9%. The eGFRcys values before and after surgery were compared; the G1 and G2 patients showed significantly improved eGFRcys values after surgery (G1 101 [94-108] vs 114 [103-127]; G2 79 [74-84] vs 97 [87-104] ml/min/1.73 m2; p < 0.01) with significant weight loss (G1 38.1 ± 6.2 vs 26.5 ± 3.4; G2 38.5 ± 6.9 vs 26.7 ± 3.6 kg/m2; p < 0.01). Although the renal function of G3 patients was not improved after surgery (44 [42-47] vs 45 [43-63] ml/min/1.73 m2; p = 0.08), successful weight loss was achieved (36.1 ± 6.3 vs 26.6 ± 3.6 kg/m2; p < 0.01). In multivariate analysis, postoperative eGFRcys correlated negatively with proteinuria (p < 0.01), age (p < 0.01), and body mass index (p < 0.01) and positively with persistence of antihypertensive drugs. CONCLUSION Bariatric surgery resulted in the significant improvement in the eGFRcys values of Japanese patients with morbid obesity, particularly those with pre-CKD (eGFRcys ≥ 60 ml/min/1.73 m2), while the eGFRcys values of CKD patients (< 60 ml/min/1.73 m2) were not ameliorated by surgery.
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Affiliation(s)
- Kotaro Wakamatsu
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan.,Department of Gastrointestinal Surgery, University of Tokyo, Bunkyo, Tokyo, Japan
| | - Yosuke Seki
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan.
| | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan
| | - Kohei Uno
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan
| | - Kenkichi Hashimoto
- Department of Gastroenterological Surgery, National Kyushu Medical Center, Chuo Ward, Fukuoka, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, University of Tokyo, Bunkyo, Tokyo, Japan
| | - Yoshimochi Kurokawa
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan
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Iwasaki T, Fukuda H, Kitamura M, Kawashita Y, Hayashida H, Furugen R, Koyama Z, Ando Y, Saito T. Association between number of pairs of opposing posterior teeth, metabolic syndrome, and obesity. Odontology 2018; 107:111-117. [DOI: 10.1007/s10266-018-0386-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 06/02/2018] [Indexed: 01/22/2023]
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Ikemura S, Mawatari T, Matsui G, Iguchi T, Mitsuyasu H. The depth of the low-intensity band on the T1-weighted MR image is useful for distinguishing subchondral insufficiency fracture from osteonecrosis of the collapsed femoral head. Arch Orthop Trauma Surg 2018; 138:1053-1058. [PMID: 29728832 DOI: 10.1007/s00402-018-2948-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Indexed: 10/17/2022]
Abstract
PURPOSE To verify the hypothesis that depth of the low-intensity band on T1-weighted MR image is useful for distinguishing subchondral insufficiency fracture (SIF) from osteonecrosis of the collapsed femoral head (ON). PATIENTS AND METHODS We reviewed 35 consecutive hips in 35 patients with radiological evidence of subchondral collapse of the femoral head and available MR images and histology between May 2013 and January 2016. Both clinical and radiological appearances were investigated. The ratios of distance from articular surface of the femoral head to the T1 low-intensity band to femoral head diameter (band depth ratio: BDR) on (1) mid-coronal slice of MR images and that on (2) coronal slice of MR images in which the highest BDR was observed, were calculated. RESULTS The mean age in SIF group was significantly higher than that in ON group (SIF: 68 years, ON: 49 years, P = 0.0017). The rates of history of steroid intake or alcohol consumption in SIF group were significantly lower than those in ON group (P = 0.0022 and P = 0.0408, respectively). The mean BDRs in SIF group were (1) 0.16 and (2) 0.23, which were significantly lower than those in ON group [(1) 0.42 and (2) 0.59] (P < 0.0001 for both). The cut-off BDR values to differentiate SIF from ON were (1) 0.22 and (2) 0.38, respectively. CONCLUSION The results of the study suggest that depth of the low-intensity band on T1-weighted MR image is useful for distinguishing SIF from ON in cases with collapsed femoral heads.
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Affiliation(s)
- Satoshi Ikemura
- Department of Orthopaedic Surgery, Hamanomachi Hospital, 3-3-1 Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan.
| | - Taro Mawatari
- Department of Orthopaedic Surgery, Hamanomachi Hospital, 3-3-1 Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Gen Matsui
- Department of Orthopaedic Surgery, Hamanomachi Hospital, 3-3-1 Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Takahiro Iguchi
- Department of Orthopaedic Surgery, Hamanomachi Hospital, 3-3-1 Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Hiroaki Mitsuyasu
- Department of Orthopaedic Surgery, Hamanomachi Hospital, 3-3-1 Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
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Gregori M, Miccini M, Biacchi D, de Schoutheete JC, Bonomo L, Manzelli A. Day case laparoscopic cholecystectomy: Safety and feasibility in obese patients. Int J Surg 2018; 49:22-26. [DOI: 10.1016/j.ijsu.2017.11.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/27/2017] [Accepted: 11/30/2017] [Indexed: 12/20/2022]
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Tomita M, Ayabe T, Nakamura K. Low Body Mass Index Is an Independent Predictive Factor after Surgical Resection in Patients with Non-Small Cell Lung Cancer. Asian Pac J Cancer Prev 2017; 18:3353-3356. [PMID: 29286350 PMCID: PMC5980894 DOI: 10.22034/apjcp.2017.18.12.3353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: The effect of body mass index (BMI) on postoperative survival in non-small cell lung cancer (NSCLC) has been controversial. We retrospectively analysed the effect of preoperative BMI on postoperative outcomes of NSCLC surgery. Methods: Consecutive 384 NSCLC patients were enrolled. Patients were subdivided into 3 groups: low BMI group (BMI<18.5 kg/m2), normal BMI group (BMI=18.5-24.0 kg/m2) and high BMI group (BMI>24.0 kg/m2). The prognostic significance of BMI was examined retrospectively. Results: The 5-year survival of patients with low, normal and high BMI groups were 46.3%, 74.3% and 84.3%, respectively. The low BMI group had a poorer prognosis than the other groups (p<0.001). The survival of high BMI group had a more favorable trend than that of normal BMI group, but this did not reach statistical significance (p=0.057). On multivariate analysis, significant risk factors for cancer-specific survival were male gender (p=0.0061), non-adenocarcinoma histology (p=0.0003), pN1-2 status (p=0.0007), high serum CEA level (p<0.0001) and low BMI (low vs. others: p <0.0001). Conclusions: Preoperative BMI is an independent prognostic factor for NSCLC patients after surgical resection, with low BMI patients having an unfavorable prognosis.
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Affiliation(s)
- Masaki Tomita
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake, Miyazaki, Japan.
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Haruta H, Kasama K, Ohta M, Sasaki A, Yamamoto H, Miyazaki Y, Oshiro T, Naitoh T, Hosoya Y, Togawa T, Seki Y, Lefor AK, Tani T. Long-Term Outcomes of Bariatric and Metabolic Surgery in Japan: Results of a Multi-Institutional Survey. Obes Surg 2017; 27:754-762. [PMID: 27631329 DOI: 10.1007/s11695-016-2361-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The number of bariatric procedures performed in Japan is increasing. There are isolated reports of bariatric surgery, but there have been no nationwide surveys including long-term data. METHODS We retrospectively reviewed data for patients who underwent bariatric and metabolic surgery throughout Japan and reviewed outcomes. Surveys were sent to ten institutions for number of procedures, preoperative patient weight and preoperative obesity-related comorbidities, and data at 1, 3, and 5 years postoperatively. Improvement of type 2 diabetes mellitus at 3 years after surgery was stratified by baseline ABCD score, based on age, body mass index, C-peptide level, and duration of diabetes. RESULTS Replies were received from nine of the ten institutions. From August 2005 to June 2015, 831 patients, including 366 males and 465 females, underwent bariatric procedures. The mean age was 41 years, and mean BMI was 42 kg/m2. The most common procedure was laparoscopic sleeve gastrectomy (n = 501, 60 %) followed by laparoscopic sleeve gastrectomy with duodenojejunal bypass (n = 149, 18 %). Laparoscopic Roux-en-Y gastric bypass was performed in 100 patients (12 %), and laparoscopic adjustable gastric banding was performed in 81 (10 %). At 3 years postoperatively, the remission rate of obesity-related comorbidities was 78 % for diabetes, 60 % for hypertension, and 65 % for dyslipidemia. Patients with complete remission of diabetes at 3 years postoperatively had a higher ABCD score than those without (6.4 ± 1.6 vs 4.2 ± 2.0, P < 0.05). CONCLUSIONS Bariatric and metabolic surgery for Japanese morbidly obese patients is safe and effective. These results are comparable with the results of previous studies.
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Affiliation(s)
- Hidenori Haruta
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, 102-0084, Japan. .,Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University, 3311-1 Yakushiji, Shimotsukeshi, Tochigi, 329-0498, Japan.
| | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, 102-0084, Japan
| | - Masayuki Ohta
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, 879-5593, Japan
| | - Akira Sasaki
- Department of Surgery, Iwate Medical University, Iwate, 020-8505, Japan
| | - Hiroshi Yamamoto
- Department of Surgery, Shiga University of Medical Science, Shiga, 520-2192, Japan
| | - Yasuhiro Miyazaki
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
| | - Takashi Oshiro
- Department of Surgery, Toho University Medical Center, Sakura Hospital, Chiba, 285-8741, Japan
| | - Takeshi Naitoh
- Department of Surgery, Tohoku University Graduate School of Medicine, Miyagi, 980-8574, Japan
| | - Yoshinori Hosoya
- Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University, 3311-1 Yakushiji, Shimotsukeshi, Tochigi, 329-0498, Japan
| | - Takeshi Togawa
- Department of Diabetes and Endocrinology, Kusatsu General Hospital, Shiga, 525-8585, Japan
| | - Yosuke Seki
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, 102-0084, Japan
| | - Alan Kawarai Lefor
- Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University, 3311-1 Yakushiji, Shimotsukeshi, Tochigi, 329-0498, Japan
| | - Toru Tani
- Department of Surgery, Shiga University of Medical Science, Shiga, 520-2192, Japan
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Tomita M, Ayabe T, Nakamura K. Does Obesity-Related Hemodilution of Carcinoembryonic Antigen Exist in Non-Small Cell Lung Cancer Patients? World J Oncol 2017; 8:41-44. [PMID: 29147433 PMCID: PMC5649995 DOI: 10.14740/wjon1026w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/15/2022] Open
Abstract
Background Previous investigations reported inverse relationship between prostate-specific antigen concentration and body mass index (BMI). These results have been explained by a hemodilution effect among obese men. However, the hemodilution of serum carcinoembryonic antigen (CEA) concentration in obese patients with non-small cell lung cancer (NSCLC) has not been ever reported. Methods Consecutive 381 NSCLC patients were enrolled. A body surface area (BSA)-based and a hematocrit (HCT)-based equations were applied for plasma volume (PV) estimation. The relationship between BMI and PV, serum CEA concentration and CEA amount, representing the total amount of CEA protein within the circulation, were examined. Results Higher BMI was significantly associated with higher PV (P < 0.001). However, serum CEA concentration was not significantly associated with increasing BMI. Furthermore, there was no significant association between BMI and CEA amount. The 5-year survival rate of patients with a high serum CEA concentration was significantly lower than that of patients with a normal CEA. There was no difference in the prognostic significance of serum CEA concentration and CEA amount. Conclusions We failed to find the association between BMI and CEA, suggesting no or small hemodilution effect of CEA in NSCLC patients. Furthermore, the measurement of the CEA amount could not provide any additional information.
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Affiliation(s)
- Masaki Tomita
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake, Miyazaki 889-1692, Japan
| | - Takanori Ayabe
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake, Miyazaki 889-1692, Japan
| | - Kunihide Nakamura
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake, Miyazaki 889-1692, Japan
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Suto M, Tanaka H, Mochizuki Y, Mukai J, Takada H, Soga F, Dokuni K, Hatani Y, Hatazawa K, Matsuzoe H, Sano H, Shimoura H, Ooka J, Matsumoto K, Hirota Y, Ogawa W, Hirata KI. Impact of overweight on left ventricular function in type 2 diabetes mellitus. Cardiovasc Diabetol 2017; 16:145. [PMID: 29121924 PMCID: PMC5679500 DOI: 10.1186/s12933-017-0632-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/02/2017] [Indexed: 01/07/2023] Open
Abstract
Background Coexistence of left ventricular (LV) longitudinal myocardial systolic dysfunction with LV diastolic dysfunction could lead to heart failure with preserved ejection fraction (HFpEF). Diabetes mellitus (DM) is known as a significant factor associated with HFpEF. Although the mechanisms of DM-related LV myocardial injury are complex, it has been postulated that overweight contributes to the development of LV myocardial injury in type 2 diabetes mellitus (T2DM) patients. However, the precise impact of overweight on LV longitudinal myocardial systolic function in T2DM patients remains unclear. Methods We studied 145 asymptomatic T2DM patients with preserved LV ejection fraction (LVEF) without coronary artery disease. LV longitudinal myocardial systolic function was assessed by global longitudinal strain (GLS), which was defined as the average peak strain of 18-segments obtained from standard apical views. Overweight was defined as body mass index (BMI) ≥ 25 kg/m2. Ninety age-, gender- and LVEF-matched healthy volunteers served as controls. Results GLS of overweight T2DM patients was significantly lower than that of non-overweight patients (17.9 ± 2.4% vs. 18.9 ± 2.6%, p < 0.05), whereas GLS of both overweight and non-overweight controls was similar (19.8 ± 1.3% vs. 20.4 ± 2.1%, p = 0.38). Furthermore, multiple regression analysis revealed that for T2DM patients, BMI was the independent determinant parameters for GLS as well as LV mass index. Conclusions Overweight has a greater effect on LV longitudinal myocardial systolic function in T2DM patients than on that in non-DM healthy subjects. Our finding further suggests that the strict control of overweight in T2DM patients may be associated with prevention of the development of HFpEF.
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Affiliation(s)
- Makiko Suto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Yasuhide Mochizuki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Jun Mukai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroki Takada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Fumitaka Soga
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kumiko Dokuni
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yutaka Hatani
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Keiko Hatazawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroki Matsuzoe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroyuki Sano
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroyuki Shimoura
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Junichi Ooka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kensuke Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yushi Hirota
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Kobayashi T, Sugiura K, Ojima T. Risks of thromboembolism associated with hormone contraceptives in Japanese compared with Western women. J Obstet Gynaecol Res 2017; 43:789-797. [PMID: 28422361 DOI: 10.1111/jog.13304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 01/09/2017] [Indexed: 11/27/2022]
Abstract
We extracted 581 thromboembolic events associated with combined oral contraceptives (COC) that occurred between 2004 and 2013 in Japan, from the Pharmaceuticals and Medical Devices Agency database. The most common thromboembolic events associated with COC were deep vein thrombosis, pulmonary embolism and their combination. The reported thromboembolic events increased year by year, in association with an increase in the quantity of prescribed low-dose estrogen progestin after approval for health insurance coverage for dysmenorrhea in 2008 in Japan. The incidence of venous thromboembolism (VTE) in Japanese COC users is estimated to be lower compared with their Western counterparts. In contrast, the frequency of all thromboembolic events peaked at 90 days from the start of COC, as in Western studies. The risk of VTE in the overweight group (body mass index ≥ 25 kg/m2 ) was more than twofold higher than in the standard group, and age-specific incidence rate rose sharply after the age of 40. There were different VTE risks according to progestin type in Japan as in Western countries, but a definite conclusion about risk according to progestin type was not able to be reached at present. As for the risk of arterial embolism and thrombosis, the difference by progestin type was small, but it became higher at ≥50 years of age. Last, mortality rate caused by thromboembolism is extremely low among COC users.
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Affiliation(s)
- Takao Kobayashi
- Department of Obstetrics and Gynecology, Hamamatsu Medical Center, Hamamatsu, Japan
| | - Kazuko Sugiura
- Department of Reproductive Health Nursing/Midwifery, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Saito Y, Takahashi O, Arioka H, Kobayashi D. Associations between body fat variability and later onset of cardiovascular disease risk factors. PLoS One 2017; 12:e0175057. [PMID: 28369119 PMCID: PMC5378370 DOI: 10.1371/journal.pone.0175057] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 03/20/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE There is current debate regarding whether body weight variability is associated with cardiovascular events. Recently, high body fat percentage (BF%) has been shown to be a cardiovascular risk factor. We therefore hypothesized that BF% variability would present a stronger cardiovascular risk than body weight variability. METHODS A single-center retrospective cohort study of medical check-up examinees aged 20 years or older at baseline (2005) was performed. Examinees were followed in 2007, 2009, and 2013-2014. BF% variability in 2005, 2007 and 2009 was calculated as the root-mean square error (RMSE) using a simple linear regression model. Multiple logistic regression models estimated the association between BF%-RMSE and new diagnoses of cardiovascular risk factors occurring between the 2009 and 2013-2014 visits. RESULTS In total, 11,281 participants (mean age: 51.3 years old, 48.8% were male) were included in this study. The average BF%-RMSE of our subjects was 0.63, and the average BMI-RMSE was 0.24. The high BF%-RMSE group (76-100th percentile) had a higher incidence of hypertension and a lower incidence of diabetes mellitus than the low BF%-RMSE group (1-25th percentile). This tendency was particularly evident in male participants. BMI-RMSE was not associated with any cardiovascular risks in our study. CONCLUSIONS This study indicates that body fat variability has contrasting effects on cardiovascular risk factors, while body weight variability has no significant effects.
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Affiliation(s)
- Yuki Saito
- Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, Tokyo, Japan
- * E-mail:
| | - Osamu Takahashi
- Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, Tokyo, Japan
- Center for Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan
| | - Hiroko Arioka
- Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, Tokyo, Japan
| | - Daiki Kobayashi
- Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, Tokyo, Japan
- Center for Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan
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Chen B, Zhang Y, Zhao S, Yang T, Wu Q, Jin C, He Y, Wang Z. The impact of general/visceral obesity on completion of mesorectum and perioperative outcomes of laparoscopic TME for rectal cancer: A STARD-compliant article. Medicine (Baltimore) 2016; 95:e4462. [PMID: 27603340 PMCID: PMC5023862 DOI: 10.1097/md.0000000000004462] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
To evaluate the impact of visceral obesity on laparoscopic total mesorectal excision (TME) and decide the best index to reflect completion of mesorectum and perioperative outcomes.Patients with rectal cancer who underwent laparoscopic TME were enrolled. The data including body mass index (BMI), visceral fat area (VFA), visceral fat area/body surface area (VFA/BSA), mesorectum fat ratio (MFR), pelvic fat area (PFA), pelvic fat ratio (PFR), completion of mesorectum, and other perioperative outcomes were collected. Data were analyzed.A total of 322 patients were enrolled between 2011 and 2014. There was no significantly difference between the BMI groups on completion of mesorectum and other outcomes (P ≥ 0.05). However, in VFA groups, completion of mesorectum (P = 0.002), operative time (P = 0.02), and incision length (P = 0.02) were significantly different. In VFA/BSA groups, completion of mesorectum (P = 0.002) and incision length (P = 0.009) were significantly different. When MFR was equal to 0.48, completion of mesorectum (P = 0.002), operative time (P = 0.001), incision length (P = 0.03), and blood loss (P = 0.04) were significantly different between the 2 groups. In PFA and PFR groups, there was no significantly difference (P ≥ 0.05). After the analysis of logistic regression, only VFA was the risk factor of incomplete mesorectum excision.BMI does not reflect the impact of obesity on laparoscopic rectal surgery. VFA is a better index in predicting the influence of visceral obesity on surgical quality and difficulty of laparoscopic rectal surgery than VFA/BSA and MFR.
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Affiliation(s)
- Bingchen Chen
- The Surgical Department of Coloproctology, Zhejiang Provincial People's Hospital
| | - Yuanchuan Zhang
- Department of General Surgery, The Third People's Hospital of Chengdu
| | - Shuang Zhao
- Department of Gastrointestinal Surgery, West China Hospital
| | - Tinghan Yang
- Department of Gastrointestinal Surgery, West China Hospital
| | - Qingbin Wu
- Department of Gastrointestinal Surgery, West China Hospital
| | - Chengwu Jin
- Department of Gastrointestinal Surgery, West China Hospital
| | - Yazhou He
- Department of Gastrointestinal Surgery, West China Hospital
| | - Ziqiang Wang
- Department of Gastrointestinal Surgery, West China Hospital
- Correspondence: Ziqiang Wang, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Guo Xue Xiang No. 37, Chengdu 610041, Sichuan Province, China (e-mail: )
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Ikemura S, Mawatari T, Matsui G, Iguchi T, Mitsuyasu H. Clinical outcomes in relation to locations of bone marrow edema lesions in patients with a subchondral insufficiency fracture of the hip: a review of fifteen cases. Br J Radiol 2016; 89:20150750. [PMID: 27537078 DOI: 10.1259/bjr.20150750] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The prognosis of patients with a subchondral insufficiency fracture remains unclear. The purpose of this study was to investigate the correlation between locations of bone marrow edema (BME) lesions and clinical outcome in patients with a subchondral insufficiency fracture of the hip. METHODS We retrospectively reviewed 15 consecutive hips in 14 patients who were diagnosed with subchondral insufficiency fracture of the hip at our institution between April 2013 and September 2014. This study included five males (six hips) and nine females (nine hips), ranging from 36 to 83 years of age (mean age: 66 years). The mean duration from the onset of hip pain to MRI examination was 1.8 months (range 0.5-5 months). Both clinical and imaging findings were investigated. RESULTS Based on the findings of MR images, BME lesion in the femoral head alone was observed in six patients (six hips), BME lesion in the acetabulum alone was observed in one patient (two hips) and BME lesions in both the femoral head and acetabulum were observed in seven patients (seven hips). 3 of 15 hips resulted in rapidly destructive arthrosis and their BME lesions were observed in both the femoral head and acetabulum. 8 of 15 hips successfully healed by conservative treatment and BME lesions in 7 of these 8 hips were observed in only the femoral head or acetabulum. CONCLUSION The results of this study indicate that the locations of BME lesions (femoral side alone, acetabular side alone or both) may be related to the clinical outcome in patients with a subchondral insufficiency fracture of the hip. ADVANCES IN KNOWLEDGE Patients with subchondral insufficiency fracture of the hip in whom BME lesions were observed in both the femoral head and acetabulum may have a higher risk to need to undergo total hip arthroplasty.
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Affiliation(s)
- Satoshi Ikemura
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan
| | - Taro Mawatari
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan
| | - Gen Matsui
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan
| | - Takahiro Iguchi
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan
| | - Hiroaki Mitsuyasu
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan
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Seki Y, Kakizaki S, Horiguchi N, Hashizume H, Tojima H, Yamazaki Y, Sato K, Kusano M, Yamada M, Kasama K. Prevalence of nonalcoholic steatohepatitis in Japanese patients with morbid obesity undergoing bariatric surgery. J Gastroenterol 2016; 51:281-289. [PMID: 26314837 DOI: 10.1007/s00535-015-1114-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/03/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Patients with morbid obesity selected for bariatric surgery have a high prevalence of nonalcoholic steatohepatitis (NASH); however, the incidence is varied and depends on race. The prevalence of NASH in obese Japanese patients is unknown. We evaluated the prevalence of NASH in a prospective cohort of Japanese patients with morbid obesity. METHODS From October 2009 to July 2011, consecutive patients requiring bariatric surgery underwent a liver biopsy during the operation. The indications for bariatric surgery followed the guidelines of the Asia-Pacific Metabolic and Bariatric Surgery Society. RESULTS One hundred two patients (55 males and 47 females, age 42.7 ± 10.7 years) were analyzed. The mean body mass index was 42.1 ± 8.2 kg/m(2). Among the 102 patients, 84 patients (82.4%) had nonalcoholic fatty liver disease and 79 patients (77.5%) had NASH. The grading and staging of NASH by Brunt's classification were as follows: grade 0 steatosis, one patient; grade 1 steatosis, 35 patients; grade 2 steatosis, 32 patients; grade 3 steatosis, 11 patients; stage 1 fibrosis, 25 patients; stage 2 fibrosis, 38 patients; stage 3 fibrosis, 16 patients, stage 4 fibrosis, no patients. The body weight, waist-hip ratio, visceral fat area, and aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transpeptidase, fasting plasma glucose, fasting plasma insulin, C peptide, hemoglobin A1c, and homeostasis model assessment insulin resistance levels were significantly elevated in the NASH group in comparison with the non-NASH group. The platelet count was significantly decreased in the NASH group. The waist-hip ratio and the alanine aminotransferase, fasting plasma glucose, and homeostasis model assessment insulin resistance levels were found to be independent predictors of NASH in a multivariate analysis. CONCLUSION The prevalence of NASH was 77.5% in this prospective Japanese cohort. The prevalence of NASH in Japanese morbidly obese patients was extremely high, and early intervention should be undertaken.
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Affiliation(s)
- Yosuke Seki
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Satoru Kakizaki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
| | - Norio Horiguchi
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Hiroaki Hashizume
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Hiroki Tojima
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Yuichi Yamazaki
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Ken Sato
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Motoyasu Kusano
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Masanobu Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
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Ikeda N. Secondary Data Analysis of National Surveys in Japan Toward Improving Population Health. J Epidemiol 2016; 26:106-14. [PMID: 26902170 PMCID: PMC4773486 DOI: 10.2188/jea.je20150319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Secondary data analysis of national health surveys of the general population is a standard methodology for health metrics and evaluation; it is used to monitor trends in population health over time and benchmark the performance of health systems. In Japan, the government has established electronic databases of individual records from national surveys of the population’s health. However, the number of publications based on these datasets is small considering the scale and coverage of the surveys. There appear to be two major obstacles to the secondary use of Japanese national health survey data: strict data access control under the Statistics Act and an inadequate interdisciplinary research environment for resolving methodological difficulties encountered when dealing with secondary data. The usefulness of secondary analysis of survey data is evident with examples from the author’s previous studies based on vital records and the National Health and Nutrition Surveys, which showed that (i) tobacco smoking and high blood pressure are the major risk factors for adult mortality from non-communicable diseases in Japan; (ii) the decrease in mean blood pressure in Japan from the late 1980s to the early 2000s was partly attributable to the increased use of antihypertensive medication and reduced dietary salt intake; and (iii) progress in treatment coverage and control of high blood pressure is slower in Japan than in the United States and Britain. National health surveys in Japan are an invaluable asset, and findings from secondary analyses of these surveys would provide important suggestions for improving health in people around the world.
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Affiliation(s)
- Nayu Ikeda
- Center for International Collaboration and Partnership, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition
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27
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Risks of thromboembolism associated with hormonal contraceptives related to body mass index and aging in Japanese women. Thromb Res 2016; 137:11-16. [DOI: 10.1016/j.thromres.2015.11.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 11/18/2015] [Accepted: 11/27/2015] [Indexed: 11/19/2022]
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Christiani Y, Byles JE, Tavener M, Dugdale P. Do women in major cities experience better health? A comparison of chronic conditions and their risk factors between women living in major cities and other cities in Indonesia. Glob Health Action 2015; 8:28540. [PMID: 26689455 PMCID: PMC4685294 DOI: 10.3402/gha.v8.28540] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 11/26/2015] [Accepted: 11/27/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Inhabitants of rural areas can be tempted to migrate to urban areas for the type and range of facilities available. Although urban inhabitants may benefit from greater access to human and social services, living in a big city can also bring disadvantages to some residents due to changes in social and physical environments. DESIGN We analysed data from 4,208 women aged >15 years old participating in the fourth wave of the Indonesia Family Life Survey. Chronic condition risk factors - systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), and tobacco use - among women in four major cities in Indonesia (Jakarta, Surabaya, Medan, and Bandung) were compared against other cities. Fractional polynomial regression models were applied to examine the association between living in the major cities and SBP, DBP, BMI, and tobacco use. The models were also adjusted for age, education, employment status, migration status, ethnic groups, and religion. The patterns of SBP, DBP, and BMI were plotted and contrasted between groups of cities. RESULTS Chronic condition prevalence was higher for women in major cities than in contrasting cities (p<0.005). Living in major cities increased the risk of having higher SBP, DBP, BMI and being a current smoker. Chronic disease risk factors in major cities were evident from younger ages. CONCLUSIONS Women residing in Indonesia's major cities have a higher risk of developing chronic conditions, starting at younger ages. The findings highlight the challenges inherent in providing long-term healthcare with its associated cost within major Indonesian cities and the importance of chronic disease prevention programmes targeting women at an early age.
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Affiliation(s)
- Yodi Christiani
- Research Centre for Generational Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Newcastle, Australia;
| | - Julie E Byles
- Research Centre for Generational Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Newcastle, Australia
| | - Meredith Tavener
- Research Centre for Generational Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Newcastle, Australia
| | - Paul Dugdale
- Centre for Health Stewardship, Australian National University, Canberra, Australia
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Takeuchi M, Tsuboi A, Kurata M, Fukuo K, Kazumi T. Association of Metabolic Syndrome with Serum Adipokines in Community-Living Elderly Japanese Women: Independent Association with Plasminogen Activator-Inhibitor-1. Metab Syndr Relat Disord 2015; 13:415-21. [DOI: 10.1089/met.2015.0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Mika Takeuchi
- Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Ayaka Tsuboi
- Postgraduate School of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Miki Kurata
- Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Research Institutes for Nutrition Sciences, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Keisuke Fukuo
- Department of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Postgraduate School of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Research Institutes for Nutrition Sciences, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
| | - Tsutomu Kazumi
- Postgraduate School of Food Sciences and Nutrition, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, Hyogo, Japan
- Diabetes Division, Sadamitsu Hospital, Kakogawa, Hyogo, Japan
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A Risk Score with Additional Four Independent Factors to Predict the Incidence and Recovery from Metabolic Syndrome: Development and Validation in Large Japanese Cohorts. PLoS One 2015; 10:e0133884. [PMID: 26230621 PMCID: PMC4521863 DOI: 10.1371/journal.pone.0133884] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 07/03/2015] [Indexed: 11/19/2022] Open
Abstract
Background Although many risk factors for Metabolic syndrome (MetS) have been reported, there is no clinical score that predicts its incidence. The purposes of this study were to create and validate a risk score for predicting both incidence and recovery from MetS in a large cohort. Methods Subjects without MetS at enrollment (n = 13,634) were randomly divided into 2 groups and followed to record incidence of MetS. We also examined recovery from it in rest 2,743 individuals with prevalent MetS. Results During median follow-up of 3.0 years, 878 subjects in the derivation and 757 in validation cohorts developed MetS. Multiple logistic regression analysis identified 12 independent variables from the derivation cohort and initial score for subsequent MetS was created, which showed good discrimination both in the derivation (c-statistics 0.82) and validation cohorts (0.83). The predictability of the initial score for recovery from MetS was tested in the 2,743 MetS population (906 subjects recovered from MetS), where nine variables (including age, sex, γ-glutamyl transpeptidase, uric acid and five MetS diagnostic criteria constituents.) remained significant. Then, the final score was created using the nine variables. This score significantly predicted both the recovery from MetS (c-statistics 0.70, p<0.001, 78% sensitivity and 54% specificity) and incident MetS (c-statistics 0.80) with an incremental discriminative ability over the model derived from five factors used in the diagnosis of MetS (continuous net reclassification improvement: 0.35, p < 0.001 and integrated discrimination improvement: 0.01, p<0.001). Conclusions We identified four additional independent risk factors associated with subsequent MetS, developed and validated a risk score to predict both incident and recovery from MetS.
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Secular trends of the impact of overweight and obesity on hypertension in Japan, 1980–2010. Hypertens Res 2015; 38:790-5. [PMID: 26178153 DOI: 10.1038/hr.2015.81] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 04/23/2015] [Accepted: 05/27/2015] [Indexed: 11/08/2022]
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Krzysztoszek J, Wierzejska E, Zielińska A. Obesity. An analysis of epidemiological and prognostic research. Arch Med Sci 2015; 11:24-33. [PMID: 25861287 PMCID: PMC4379361 DOI: 10.5114/aoms.2013.37343] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 07/27/2012] [Accepted: 11/21/2012] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Apart from its medical dimension, the current problem with obesity has acquired social urgency. This serious lifestyle disease has a negative impact on a number of life processes in the body, causing distortions and damaging different structures. It also contributes to clinical complications, lowers the quality of life and reduces life expectancy. Apart from health-related consequences, it can bring such unfavourable results as social, mental and emotional disorders. MATERIAL AND METHODS A systematic review of relevant epidemiological studies on obesity in Poland relative to selected countries in Europe and the world over the past 15 years was conducted. Also an attempt was made at forecasting the development of the obesity problem. RESULTS The analysed results demonstrated that the percentage of obese people among the adult population of Poland was on the rise in the period under investigation. Taking into account the estimated growth rate, we can assume that the percentage of obese people in Poland right now might total 23.7% for men and 23.3% for women. If no changes are introduced in this respect, in 2020 we can expect a rise to, respectively, 30.3% and 27.3%, and in 2030 to 37% for men and 31.4% for women. CONCLUSIONS The increase in the percentage of obese people among the adult population in Poland is most likely connected with a positive energy balance. In comparison to other European countries Poland has the highest percentage of obese men and women.
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Affiliation(s)
- Jana Krzysztoszek
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewelina Wierzejska
- Laboratory of International Health, Department of Preventive Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Alicja Zielińska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
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Kaneko G, Miyajima A, Yuge K, Yazawa S, Mizuno R, Kikuchi E, Jinzaki M, Oya M. Visceral obesity is associated with better recurrence-free survival after curative surgery for Japanese patients with localized clear cell renal cell carcinoma. Jpn J Clin Oncol 2015; 45:210-216. [DOI: 10.1093/jjco/hyu193] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Prospective multicenter surveillance and risk factor analysis of deep surgical site infection after posterior thoracic and/or lumbar spinal surgery in adults. J Orthop Sci 2015; 20:71-7. [PMID: 25366698 DOI: 10.1007/s00776-014-0669-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 10/16/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Surgical site infection is a serious and significant complication after spinal surgery and is associated with high morbidity rates, high healthcare costs and poor patient outcomes. Accurate identification of risk factors is essential for developing strategies to prevent devastating infections. The purpose of this study was to identify independent risk factors for surgical site infection among posterior thoracic and/or lumbar spinal surgery in adult patients using a prospective multicenter surveillance research method. METHODS From July 2010 to June 2012, we performed a prospective surveillance study in adult patients who had developed surgical site infection after undergoing thoracic and/or lumbar posterior spinal surgery at 11 participating hospitals. Detailed preoperative and operative patient characteristics were prospectively recorded using a standardized data collection format. Surgical site infection was based on the definition established by the Centers for Disease Control and Prevention. RESULTS A total of 2,736 consecutive adult patients were enrolled, of which 24 (0.9%) developed postoperative deep surgical site infection. Multivariate regression analysis indicated four independent risk factors. Preoperative steroid therapy (P = 0.001), spinal trauma (P = 0.048) and gender (male) (P = 0.02) were statistically significant independent patient-related risk factors, whereas an operating time ≥3 h (P < 0.001) was a surgery-related independent risk factor. CONCLUSION Preoperative steroid therapy, spinal trauma, male gender and an operating time ≥3 h were independent risk factors for deep surgical site infection after thoracic and/or lumbar spinal surgery in adult patients. Identification of these risk factors can be used to develop protocols aimed at decreasing the risk of surgical site infection.
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Increased epicardial adipose tissue volume predicts insulin resistance and coronary artery disease in non-obese subjects without metabolic syndrome. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.ijcme.2014.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fukui K, Kaneuji A, Fukushima M, Matsumoto T. Imaging and histopathological evaluation of a cystlike formation in subchondral insufficiency fracture of the femoral head: A case report and literature review. Int J Surg Case Rep 2014; 5:324-9. [PMID: 24794026 PMCID: PMC4066577 DOI: 10.1016/j.ijscr.2014.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 01/20/2014] [Accepted: 03/25/2014] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION In the majority of subchondral insufficiency fractures (SIFs) of the femoral head, T1-weighted magnetic resonance imaging shows an irregular, serpiginous, low-intensity band that is convex to the articular surface. We report a case of a cystlike formation in SIF of the femoral head in an elderly woman. PRESENTATION OF CASE A 71-year-old woman reported right hip pain without any history of antecedent trauma. The initial radiograph showed a slight narrowing of the joint space in the right hip. The patient was treated with conservative therapy for 2 months. Radiographs obtained 3 months after the onset of pain showed non-progressive joint-space narrowing. T1-weighted magnetic resonance images obtained 2 months after pain onset revealed a round, cystlike, low-intensity area just beneath the articular cartilage. The patient underwent total hip arthroplasty. Histopathological examination showed fracture callus and granulation tissue in the subchondral area, surrounded by vascular-rich granulation tissue and fibrous tissue, which corresponded to the round, low-intensity band observed on the T1-weighted image. DISCUSSION This case was a rare SIF of the femoral head which had a cystlike formation with a low signal intensity on T1-weighted images and a very high signal intensity on STIR sequences in the superolateral portion of the femoral head, surrounded by a pattern of edema in the bone marrow. To our knowledge, no similar cases were cited in the literature. CONCLUSION It is important for surgeons to keep in mind that sometimes SIFs of the femoral head can appear as a round cystlike formation.
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Affiliation(s)
- Kiyokazu Fukui
- Department of Orthopaedic Surgery, Kanazawa Medical University, Kahokugun, Japan.
| | - Ayumi Kaneuji
- Department of Orthopaedic Surgery, Kanazawa Medical University, Kahokugun, Japan
| | - Mana Fukushima
- Department of Pathology and Medical Laboratory, Kanazawa Medical University, Kahokugun, Japan
| | - Tadami Matsumoto
- Department of Orthopaedic Surgery, Kanazawa Medical University, Kahokugun, Japan
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Kobayashi T, Suzuki E, Oksanen T, Kawachi I, Takao S. The bright side and dark side of workplace social capital: opposing effects of gender on overweight among Japanese employees. PLoS One 2014; 9:e88084. [PMID: 24498248 PMCID: PMC3909277 DOI: 10.1371/journal.pone.0088084] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 01/05/2014] [Indexed: 11/30/2022] Open
Abstract
Background A growing number of studies have sought to examine the health associations of workplace social capital; however, evidence of associations with overweight is sparse. We examined the association between individual perceptions of workplace social capital and overweight among Japanese male and female employees. Methodology/Principal Findings We conducted a cross-sectional survey among full-time employees at a company in Osaka prefecture in February 2012. We used an 8-item measure to assess overall and sub-dimensions of workplace social capital, divided into tertiles. Of 1050 employees, 849 responded, and 750 (624 men and 126 women) could be linked to annual health check-up data in the analysis. Binomial logistic regression models were used to calculate odds ratios and 95% confidence intervals for overweight (body mass index: ≥25 kg/m2, calculated from measured weight and height) separately for men and women. The prevalence of overweight was 24.5% among men and 14.3% among women. Among men, low levels of bonding and linking social capital in the workplace were associated with a nearly 2-fold risk of overweight compared to high corresponding dimensions of social capital when adjusted for age, sleep hours, physiological distress, and lifestyle. In contrast, among women we found lower overall and linking social capital to be associated with lower odds for overweight even after covariate adjustment. Subsequently, we used multinomial logistic regression analyses to assess the relationships between a 1 standard deviation (SD) decrease in mean social capital and odds of underweight/overweight relative to normal weight. Among men, a 1-SD decrease in overall, bonding, and linking social capital was significantly associated with higher odds of overweight, but not with underweight. Among women, no significant associations were found for either overweight or underweight. Conclusions/Significance We found opposite gender relationships between perceived low linking workplace social capital and overweight among Japanese employees.
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Affiliation(s)
- Tomoko Kobayashi
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Etsuji Suzuki
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Tuula Oksanen
- Centre of Expertise for Development of Work and Organizations, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Soshi Takao
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- * E-mail:
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Periprostatic Fat Area Is an Independent Factor That Prolonged Operative Time in Laparoscopic Radical Prostatectomy. Urology 2013; 82:1304-9. [DOI: 10.1016/j.urology.2013.04.077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 04/20/2013] [Accepted: 04/29/2013] [Indexed: 11/22/2022]
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Ikemura S, Yamamoto T, Motomura G, Nakashima Y, Mawatari T, Iwamoto Y. The utility of clinical features for distinguishing subchondral insufficiency fracture from osteonecrosis of the femoral head. Arch Orthop Trauma Surg 2013; 133:1623-7. [PMID: 23995552 DOI: 10.1007/s00402-013-1847-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Subchondral insufficiency fractures of the femoral head (SIF) need to be differentiated from osteonecrosis of the femoral head (ON), since these two conditions have several overlapping characteristics especially in their radiological findings. The purpose of this study was to determine the useful clinical features for differentiating SIF from ON. METHODS This study reviewed 44 consecutive patients, aged 60 years or older with a radiological evidence of subchondral collapse of the femoral head. According to the histopathological diagnosis, 22 patients were grouped as SIF and 22 patients as ON. A 2 × 2 contingency table analysis was used to obtain the odd ratios (ORs) for SIF compared to ON. RESULTS The age, proportion of females, the rate of a history of neither corticosteroid intake nor alcohol abuse, and the presence of vertebral compression fracture in subchondral insufficiency fracture were significantly higher than those with osteonecrosis (p = 0.0001, 0.0212, 0.0001, and 0.0040, respectively). ORs for SIF were 12.01 [95 % confidence intervals (CI) 1.35-106.80] and 7.29 (95 % CI 1.91-27.86), if the patient were female and 70 years of age or older, respectively. In addition, OR for SIF was extremely high (OR 56.01, 95 % CI 6.12-512.87) compared to ON, if the patients have a history of neither corticosteroid intake nor alcohol abuse [corrected]. CONCLUSION The results of this study indicate that osteoporotic elderly women without any history of corticosteroid intake or alcohol abuse need to first be considered to have subchondral insufficiency fracture when radiographs show a collapse of the femoral head.
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Affiliation(s)
- Satoshi Ikemura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Kawakami T, Nishiyama K, Kadota Y, Sato M, Inoue M, Suzuki S. Cadmium modulates adipocyte functions in metallothionein-null mice. Toxicol Appl Pharmacol 2013; 272:625-36. [PMID: 23921151 DOI: 10.1016/j.taap.2013.07.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 07/22/2013] [Accepted: 07/24/2013] [Indexed: 01/01/2023]
Abstract
Our previous study has demonstrated that exposure to cadmium (Cd), a toxic heavy metal, causes a reduction of adipocyte size and the modulation of adipokine expression. To further investigate the significance of the Cd action, we studied the effect of Cd on the white adipose tissue (WAT) of metallothionein null (MT(-/-)) mice, which cannot form atoxic Cd-MT complexes and are used for evaluating Cd as free ions, and wild type (MT(+/+)) mice. Cd administration more significantly reduced the adipocyte size of MT(-/-) mice than that of MT(+/+) mice. Cd exposure also induced macrophage recruitment to WAT with an increase in the expression level of Ccl2 (MCP-1) in the MT(-/-) mice. The in vitro exposure of Cd to adipocytes induce triglyceride release into culture medium, decrease in the expression levels of genes involved in fatty acid synthesis and lipid hydrolysis at 24 h, and at 48 h increase in phosphorylation of the lipid-droplet-associated protein perilipin, which facilitates the degradation of stored lipids in adipocytes. Therefore, the reduction in adipocyte size by Cd may arise from an imbalance between lipid synthesis and lipolysis. In addition, the expression levels of leptin, adiponectin and resistin decreased in adipocytes. Taken together, exposure to Cd may induce unusually small adipocytes and modulate the expression of adipokines differently from the case of physiologically small adipocytes, and may accelerate the risk of developing insulin resistance and type 2 diabetes.
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Affiliation(s)
- Takashige Kawakami
- Faculty of Pharmaceutical Science, Tokushima Bunri University, 180 Yamashiro-cho, Tokushima 770-8514, Japan
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Radiologic Measurements Associated With the Prognosis and Need for Surgery in Patients With Subchondral Insufficiency Fractures of the Femoral Head. AJR Am J Roentgenol 2013; 201:W97-103. [DOI: 10.2214/ajr.12.9615] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Nagai M, Tomata Y, Watanabe T, Kakizaki M, Tsuji I. Association between sleep duration, weight gain, and obesity for long period. Sleep Med 2012; 14:206-10. [PMID: 23218534 DOI: 10.1016/j.sleep.2012.09.024] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 09/13/2012] [Accepted: 09/14/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although previous studies showed the long-term effects of sleep duration on risk of weight gain, Western tends to gain weight irrespective of sleep duration over a long period. Conversely, it is showed that body mass index (BMI) decreases during a long period in Japanese and thus, the long-term effect of sleep duration on weight gain and obesity is still unclear in Asia. METHODS We followed up 13,629 participants aged 40-79years and prospectively collected data from 1995 to 2006. We divided the participants into five groups according to their self-reported sleep duration: ⩽5h (short sleep), 6h, 7h (reference), 8h, and ⩾9h (long sleep). The main outcome was ⩾5kg weight gain or BMI⩾25kg/m(2) (obesity). We used logistic regression analyses to derive odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for several confounding factors. RESULTS We observed no association between sleep duration and risk of ⩾5kg weight gain and obesity. After stratification by BMI, long sleepers had a significantly increased risk of ⩾5kg weight gain (OR: 1.36, 95%CI: 1.09-1.70) in obese participants. CONCLUSIONS Among community-dwelling Japanese, only obese long sleepers have a significantly increased long-term risk of ⩾5kg weight gain.
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Affiliation(s)
- Masato Nagai
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Miyashita M, Ito T, Sakaki M, Kajiwara A, Nozawa H, Hiroishi K, Kobayashi M, Kumada H, Imawari M. Genetic polymorphism in cyclooxygenase-2 promoter affects hepatic inflammation and fibrosis in patients with chronic hepatitis C. J Viral Hepat 2012; 19:608-14. [PMID: 22863264 DOI: 10.1111/j.1365-2893.2011.01580.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cyclooxygenase (COX)-2 is involved in inflammation, anti-apoptosis and carcinogenesis. The -1195GG genotype of single nucleotide polymorphism (SNP) in COX-2 promoter was associated with low platelet counts in patients with chronic hepatitis C. Polymorphism of patatin-like phospholipase domain-containing protein 3 (PNPLA3) gene (rs738409 C>G) have been reported to be associated with cirrhosis, and the major genotype of SNPs near interleukin (IL)28B are related to viral clearance. The present study was designed to assess the contribution of these SNPs to disease progression in patients with chronic hepatitis C. The study enrolled 220 Japanese patients with chronic hepatitis C. Three SNPs, -1195 COX-2, PNPLA3 and IL28B (rs8099917), were genotyped in order to analyze their association with hepatic fibrosis and inflammation. The -1195GG genotype in COX-2 was associated with advanced fibrosis and higher levels of inflammation in the liver tissues. The major genotype of IL28B was also associated with advanced fibrosis, but the polymorphism of PNPLA3 was neither associated with fibrosis nor inflammation. Multivariate analysis showed that -1195GG in COX-2 is an independent factor associated with advanced fibrosis, while the major genotype of IL28B and HCV genotype 2 were other independent factors. In conclusion, the -1195GG genotype in COX-2 is a genetic marker for liver disease progression, while the PNPLA3 genotypes are not associated with disease progression in Japanese patients with chronic hepatitis C.
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Affiliation(s)
- Miyuki Miyashita
- Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
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Morita S, Shimajiri Y, Sakagashira S, Furuta M, Sanke T. Effect of exposure to non-esterified fatty acid on progressive deterioration of insulin secretion in patients with Type 2 diabetes: a long-term follow-up study. Diabet Med 2012; 29:980-5. [PMID: 22221293 DOI: 10.1111/j.1464-5491.2011.03566.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of the study was to determine whether fasting serum non-esterified fatty acid (NEFA) could be associated with long-term progressive deterioration of insulin secretion in patients with Type 2 diabetes. METHODS Seventy-seven Japanese patients with Type 2 diabetes (mean BMI 23.3 kg/m(2) ) were followed for 10 years. We measured fasting C-peptide level every 1-2 years. By using the slope of regression line between fasting C-peptide level and duration, we calculated its individual annual decline as an index of insulin secretion. During the follow-up periods of C-peptide, the patients were evaluated for fasting serum non-esterified fatty acid, LDL cholesterol, HDL cholesterol and HbA(1c) levels for the last 8 years. We excluded patients who had renal dysfunction or anti-insulin antibodies from among the insulin-treated patients. Association between the individual annual decline of fasting C-peptide level and related factors were evaluated. RESULTS The mean individual annual decline of fasting serum C-peptide level was -0.013 ± 0.027 nmol/l/year. Fasting serum non-esterified fatty acid level had no significant difference between the first and the last 2 years of the 8-year observation period of non-esterified fatty acid. Using multiple regression analysis, mean fasting serum non-esterified fatty acid level was associated with the individual annual decline of fasting serum C-peptide level (standardized regression coefficient -0.358, P=0.0056), although other related factors, including HbA(1c) level, were not associated. CONCLUSIONS Mean fasting serum non-esterified fatty acid level during an 8-year observation was independently associated with long-term progressive deterioration of insulin secretion in Japanese patients with Type 2 diabetes.
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Affiliation(s)
- S Morita
- Department of Clinical Laboratory Medicine, Wakayama Medical University, Wakayama, Japan.
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Rondonotti E, Sunada K, Yano T, Paggi S, Yamamoto H. Double-balloon endoscopy in clinical practice: where are we now? Dig Endosc 2012; 24:209-19. [PMID: 22725104 DOI: 10.1111/j.1443-1661.2012.01240.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Double-balloon endoscopy (DBE) was developed in 2000 for the diagnosis and treatment of small bowel diseases. Although use rates still differ between Eastern and Western countries, DBE quickly reached a broad global diffusion. Together with capsule endoscopy (CE), DBE represented 'a revolution' for the management of small bowel diseases because of its therapeutic capabilities. At present, the main indications for DBE in clinical practice are obscure gastrointestinal bleeding, Crohn's disease and familial polyposis. In the setting of obscure gastrointestinal bleeding, DBE seems to have similar diagnostic performances as capsule endoscopy, but it allows for a more definitive diagnosis and the treatment of identified lesions. The main contribution of DBE in the management of Crohn's disease patients is its therapeutic capabilities. Indeed, several recently published studies have suggested that endoscopic dilation of small bowel strictures can delay or, in the near future, could even replace surgical interventions. Also, for patients with familial polyposis syndromes, DBE can represent a viable alternative to small bowel surgery. The complication rate of DBE appears to be low; major complications, such as pancreatitis, bleeding and perforation, have been reported in approximately 1% of all diagnostic DBE whereas the complication rate for therapeutic procedures is about 5%.
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Kang J, Baek SE, Kim T, Hur H, Min BS, Lim JS, Kim NK, Lee KY. Impact of fat obesity on laparoscopic total mesorectal excision: more reliable indicator than body mass index. Int J Colorectal Dis 2012; 27:497-505. [PMID: 22065107 DOI: 10.1007/s00384-011-1333-2] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the impact of visceral fat obesity (VFO) on early surgical and oncologic outcomes of laparoscopic total mesorectal excision (LTME) for rectal cancer. PATIENTS AND METHODS Between June 2003 and June 2009, a total of 142 patients who had undergone LTME were included. Patients were divided into the obese group (OG) and the non-obese group (NOG) according to BMI and visceral fat area (VFA). Obesity was defined by BMI ≥25 kg/m² or VFA ≥130 cm². RESULTS There were 37 (26.0%) and 29 (20.4%) obese patients according to BMI and VFA, respectively. The OG, defined by both VFA and BMI, had a significantly longer operative time. The VFO group experienced more frequent conversion to laparotomy (17.2% vs. 5.0%; P = 0.047) and significantly higher blood loss during surgery (205.8 ± 257.0 mL vs. 102.5 ± 219.9 mL; P = 0.031), whereas there was no significant difference when defined by BMI. Time to first flatus was significantly longer in the VFO group compared with the NOG (mean 3.5 days vs. 2.7 days; P = 0.046), whereas it was not significantly different when classified by BMI. Regarding oncologic parameters, the VFO group had a significantly higher number of patients from whom less than 12 total lymph nodes were retrieved (65.5% vs. 34.5%; P = 0.002); however, there was no difference between the two groups defined by BMI. CONCLUSION VFO is proven to be a more reliable predictive factor than BMI in estimating early surgical outcomes for patients who underwent LTME. VFO is associated with fewer numbers of retrieved lymph nodes.
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Affiliation(s)
- Jeonghyun Kang
- Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, Korea, 120-752
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Effect of body mass index on short-term outcomes of patients undergoing laparoscopic resection for colorectal cancer: a single institution experience in Japan. Surg Laparosc Endosc Percutan Tech 2012; 21:409-14. [PMID: 22146162 DOI: 10.1097/sle.0b013e31822e5fdc] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The impact of body mass index (BMI) on laparoscopic surgery for colorectal cancer in Asian countries is unclear, partly because obesity is less common in Asia than in western countries. The purpose of this study was to evaluate the association between BMI and short-term outcomes after laparoscopic resection for colorectal cancer in Japanese patients. METHODS A cohort of 1194 patients who underwent laparoscopic resection for colorectal cancer at Cancer Institute Hospital between July 2005 and February 2010 were enrolled in this prospective study. Outcomes were analyzed according to BMI category: nonobese (BMI<25), obese I (25 ≤ BMI < 30), and obese II (BMI ≥ 30). RESULTS A total of 926 patients (78%) were classified as nonobese, 243 (20%) were obese I, and 25 (2%) were obese II. Mean operating time (214 min vs. 244 min vs. 293 min) and mean estimated blood loss (23 mL vs. 42 mL vs. 88 mL) increased significantly with increasing BMI (P<0.0001, respectively). The rate of postoperative complications was significantly higher in obese II patients than in nonobese and obese I patients (24% vs. 9.2% vs. 9.1%, P=0.0428). Multivariate analysis showed that a BMI in the obese II range was an independent predictive factor for developing anastomotic leakage (odds ratio: 10.27, 95% confidence interval, 1.98-53.44). CONCLUSIONS Laparoscopic surgery for colorectal cancer is technically more demanding in Japanese obese II patients than in nonobese or obese I patients. Special care is required because of the increased risk of developing postoperative complications.
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The association between decline in physical functioning and atrophy of medial temporal areas in community-dwelling older adults with amnestic and nonamnestic mild cognitive impairment. Arch Phys Med Rehabil 2012; 92:1992-9. [PMID: 22133247 DOI: 10.1016/j.apmr.2011.07.195] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 07/20/2011] [Accepted: 07/24/2011] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine whether declining performance in aspects of physical functioning, including lower extremity muscle strength, 1-legged balance, walking speed, and exercise capacity, is associated with atrophy of medial temporal areas in community-dwelling older adults with mild cognitive impairment (MCI). DESIGN Cross-sectional study. SETTING General community in Japan. PARTICIPANTS Community-dwelling older adults 65 years and older with a Clinical Dementia Rating of 0.5 or memory complaints were enrolled in this study. This study examined 34 participants with amnestic MCI (aMCI) and 58 nonamnestic MCI (non-aMCI) participants. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The following physical performance tests were conducted: muscle strength of knee extension, 1-legged standing time, 5-m walking test, and 6-minute walk test (6MWT). The z scores of the voxel-based specific regional analysis system for Alzheimer's disease were determined to assess the degree of atrophy in the bilateral medial temporal areas including the entorhinal cortex (MTA-ERC). RESULTS In the aMCI group, 6MWT performance was associated with MTA-ERC atrophy (β=-.462, P=.014) after controlling for age. In the stepwise multiple regression analyses, 6MWT and body mass index were found to be significant determinants of MTA-ERC atrophy in all participants (R(2)=.275), as well as the aMCI and non-aMCI groups when analyzed separately (R(2)=.418 and R(2)=.216, respectively). CONCLUSIONS A decline in exercise capacity was found to be more closely associated with atrophy of the MTA-ERC compared with other aspects of physical functioning in older adults with MCI, especially the amnestic type. These findings suggest that it is important for future studies to investigate the effects of increased aerobic activity and improved fitness on brain volume in older adults at risk of developing dementia.
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Nagai M, Kuriyama S, Kakizaki M, Ohmori-Matsuda K, Sone T, Hozawa A, Kawado M, Hashimoto S, Tsuji I. Impact of obesity, overweight and underweight on life expectancy and lifetime medical expenditures: the Ohsaki Cohort Study. BMJ Open 2012; 2:bmjopen-2012-000940. [PMID: 22581797 PMCID: PMC3353127 DOI: 10.1136/bmjopen-2012-000940] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES People who are obese have higher demands for medical care than those of the normal weight people. However, in view of their shorter life expectancy, it is unclear whether obese people have higher lifetime medical expenditure. We examined the association between body mass index, life expectancy and lifetime medical expenditure. DESIGN Prospective cohort study using individual data from the Ohsaki Cohort Study. SETTING Miyagi Prefecture, northeastern Japan. PARTICIPANTS The 41 965 participants aged 40-79 years. PRIMARY AND SECONDARY OUTCOME MEASURES The life expectancy and lifetime medical expenditure aged from 40 years. RESULTS In spite of their shorter life expectancy, obese participants might require higher medical expenditure than normal weight participants. In men aged 40 years, multiadjusted life expectancy for those who were obese participants was 41.4 years (95% CI 38.28 to 44.70), which was 1.7 years non-significantly shorter than that for normal weight participants (p=0.3184). Multiadjusted lifetime medical expenditure for obese participants was £112 858.9 (94 954.1-131 840.9), being 14.7% non-significantly higher than that for normal weight participants (p=0.1141). In women aged 40 years, multiadjusted life expectancy for those who were obese participants was 49.2 years (46.14-52.59), which was 3.1 years non-significantly shorter than for normal weight participants (p=0.0724), and multiadjusted lifetime medical expenditure was £137 765.9 (123 672.9-152 970.2), being 21.6% significantly higher (p=0.0005). CONCLUSIONS According to the point estimate, lifetime medical expenditure might appear to be higher for obese participants, despite their short life expectancy. With weight control, more people would enjoy their longevity with lower demands for medical care.
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Affiliation(s)
- Masato Nagai
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shinichi Kuriyama
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Molecular Epidemiology, Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masako Kakizaki
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kaori Ohmori-Matsuda
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Toshimasa Sone
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Atsushi Hozawa
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Public Health, Yamagata University Graduate School of Medical Science, Yamagata, Japan
| | - Miyuki Kawado
- Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan
| | - Shuji Hashimoto
- Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Relationship between health-related quality of life and clustering of metabolic syndrome diagnostic components. Qual Life Res 2011; 21:1165-70. [PMID: 21984466 DOI: 10.1007/s11136-011-0029-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE To examine the association of the number of metabolic syndrome diagnostic components (MetS-DC) with health-related quality of life (HR-QOL). METHODS We examined the baseline data from 4,480 healthy workers in Japan (3,668 men and 812 women) aged 19-69 years. We assessed HR-QOL based on scores for five scales of the SF-36. We defined four components for MetS in this study as follows: (1) high blood pressure (BP); (2) dyslipidemia; (3) impaired glucose tolerance; and (4) overweight: a body mass index ≥25 kg/m(2). Logistic regression analysis adjusted for lifestyle factors was used to examine the association of the number of MetS-DC with the HR-QOL sub-scales. RESULTS Those who had 0-4 MetS-DC accounted for 2,287, 1,135, 722, 282, and 54 participants. The number of MetS-DC inversely contributed significantly to General Health (norm-based scoring >50) (odd ratios [OR] 0.59-0.82, P < 0.05) and positively associated with Mental Health (OR 1.37, P < 0.05). CONCLUSION When adjusted for lifestyle factors, the number of MetS-DC was inversely associated with General Health and positively with Mental Health in men and women.
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