Association between hemoglobin A1c and carotid atherosclerosis in rural community-dwelling elderly Japanese men

Background

Recent studies have reported an association between both higher and lower levels of hemoglobin A1c (HbA1c) and higher mortality of diabetes patients. Like diabetes, carotid atherosclerosis is a well known lifestyle-related disease. However, no studies have yet reported an association between HbA1c levels and carotid atherosclerosis.

Methods

We conducted a cross-sectional study of 1,150 Japanese elderly men aged ≥60 years who were undergoing general health checkups. Carotid atherosclerosis was defined as a carotid intima-media thickness (CIMT) ≥1.1 mm. Since body mass index (BMI) is regarded as a cardiovascular risk factor that exerts a strong influence on both HbA1c levels and carotid atherosclerosis, we performed a stratified analysis of this risk based on BMI.

Results

Using the intermediate HbA1c quintile as a reference group, the groups in the lowest HbA1c quintiles showed a significantly higher risk of carotid atherosclerosis in patients with low BMI (≤23 kg/m²) vs. no increased risk in those with high BMI (>23 kg/m²). The association of HbA1c with carotid atherosclerosis became slightly stronger when these analyses were limited to subjects who were not taking glucose-lowering medications or medications for hyperlipidemia and cardiovascular disease. After adjusting for classical cardiovascular risk factors, adjusted odds ratios (ORs) for carotid atherosclerosis were 1.36 (0.84 to 2.20) for total subjects, 2.29 (1.12 to 4.66) for low-BMI groups, and 0.68 (0.33 to 1.41) for high-BMI groups.

Conclusions

Lower HbA1c level is a significant risk factor for carotid atherosclerosis in rural community-dwelling elderly Japanese men with low, but not high BMI, particularly in those not taking glucose-lowering medication.     

The ALDH2 genotype, alcohol intake, and liver-function biomarkers among Japanese male workers

A highly prevalent, atypical genotype in low Km aldehyde dehydrogenase (ALDH2) may influence alcohol-induced liver injury because of higher production of acetaldehyde in the liver. In the present study, we examined relationships between the ALDH2 genotype, alcohol intake, and liver-function biomarkers among Japanese male workers. Study subjects were 385 male workers in a metal plant in Japan, who were free from hepatic viruses and did not have higher aminotransferase activities (<100). The subjects completed a questionnaire on alcohol drinking habits and other lifestyles. The ALDH2 genotype was determined by the PCR method followed by restriction-enzyme digestion. In the moderately and heavily drinking groups, those with ALDH2*1/*2 exhibited significantly lower levels than those with ALDH2*1/*1 for all three parameters of liver function, whereas no such differences were observed in the least-drinking group. Multiple linear-regression analysis, adjusting for age, obesity, and smoking habits, revealed that aspartate aminotransferase activity was positively associated with alcohol intake only in those with ALDH2*1/*1. On the other hand, alanine transferase activity was negatively associated with alcohol intake only in those with ALDH2*1/*2. The present study indicates that effects of alcohol intake on liver-function biomarkers are likely to be modified by the ALDH2 genotype in adult males.     

Factors that mitigate war-induced anxiety and mental distress

The effects of war-induced anxiety and mental distress on individuals and groups can either be mitigated or exacerbated by 'humanitarian action'. This paper focuses on two key factors that protect the mental well-being of war-affected populations: organized displacement or assisted relocation; and coordinated humanitarian aid operations that are responsive to local needs. Qualitative data from two internally displaced person (IDP) camps in Eritrea are presented. Analysis of these data serves to substantiate and refine a working hypothesis: that social support of the right type, provided at the right time and level, can mitigate the worst effects of war and displacement on victims/survivors. An integrated model of psychosocial transition is suggested. The implications of this approach for humanitarian policy and practice are discussed in the wider context of current debates and lamentations of the 'humanitarian idea'.     

Association of polymorphisms in CYP17A1, MTP, and VLDLR with bone mineral density in community-dwelling Japanese women and men

We examined whether a -34T --> C polymorphism of the gene for cytochrome P450, family 17, subfamily A, polypeptide 1 (CYP17A1), a -493G --> T polymorphism of the microsomal triglyceride transfer protein gene (MTP), and a CGG repeat polymorphism of the very low density lipoprotein receptor gene (VLDLR) were associated with bone mineral density (BMD) in community-dwelling Japanese women and men. The -34T --> C polymorphism of CYP17A1 was associated with BMD in postmenopausal women, with the CC genotype being related to increased BMD. The -493G --> T polymorphism of MTP was associated with BMD in premenopausal women, with the TT genotype being related to increased BMD. The CGG repeat polymorphism of VLDLR was associated with BMD in men, with two (CGG)(n > or= 8) alleles being related to increased BMD. These results suggest that CYP17A1 and MTP are susceptibility loci for increased BMD in postmenopausal and premenopausal Japanese women, respectively, and that VLDLR constitutes such a locus in Japanese men.     

Central obesity and health-related factors among middle-aged men: a comparison among native Japanese and Japanese-Brazilians residing in Brazil and Japan

The objective of this study was to investigate the influence of different cultural environments on the development of obesity by examining the association of central obesity, lifestyle, and selected coronary risk factors among people with identical Japanese genetic backgrounds living in Japan and Brazil. One hundred and four native Japanese and 286 Japanese-Brazilians residing in Brazil and Japan aged 35 years or over were studied. Obesity, metabolic risk factors for coronary disease, and history of regular sports activity, daily physical activity, and eating habits were assessed. The results showed Japanese-Brazilians residing in Brazil with significantly higher waist circumference values, and greater prevalence of central obesity compared to native Japanese and Japanese-Brazilians residing in Japan. The risk of developing central obesity was found to be 2.8 times higher among Japanese-Brazilians residing in Brazil. However, this association was no longer found to be significant after adjusting for lifestyle factors in the logistic model. Additionally, waist circumference was found to be significantly associated with metabolic risk factors for coronary disease. These findings suggest substantial variation in measures of central obesity among the three groups of Japanese ancestry, and underscore the heterogeneity of risk factors among communities of Japanese ancestry living in different cultural environments. The results also suggest that immigrant men exposed to the Brazilian cultural environment are more susceptible to the development of central obesity, and it seems to be associated with various lifestyle items and metabolic risk factors for coronary disease.     

Follow up study of moderate alcohol intake and mortality among middle aged men in Shanghai,China.

OBJECTIVE: To assess the risk of death associated with various patterns of alcohol intake. DESIGN: Prospective study of mortality in relation to alcohol consumption at recruitment, with active annual follow up. SETTING: Four small, geographically defined communities in Shanghai, China. SUBJECTS: 18,244 men aged 45-64 years enrolled in a prospective study of diet and cancer during January 1986 to September 1989. MAIN OUTCOME MEASURE: All cause mortality. RESULTS: By 28 February 1995, 1198 deaths (including 498 from cancer, 269 from stroke, and 104 from ischaemic heart disease) had been identified. Compared with lifelong non-drinkers, those who consumed 1-14 drinks a week had a 19% reduction in overall mortality (relative risk 0.81; 95% confidence interval 0.70 to 0.94) after age, level of education, and cigarette smoking were adjusted for. This protective effect was not restricted to any specific type of alcoholic drink. Although light to moderate drinking (28 or fewer drinks per week) was associated with a 36% reduction in death from ischaemic heart disease (0.64; 0.41 to 0.998), it had no effect on death from stroke, which is the leading cause of death in this population. As expected, heavy drinking (29 or more drinks per week) was significantly associated with increased risks of death from cancer of the upper aerodigestive tract, hepatic cirrhosis, and stroke. CONCLUSIONS: Regular consumption of small amounts of alcohol is associated with lower overall mortality including death from ischaemic heart disease in middle aged Chinese men. The type of alcoholic drink does not affect this association.     

The association between renal function and tooth loss in Japanese community-dwelling postmenopausal women

doi: 10.1111/j.1741‐2358.2011.00481.x
The association between renal function and tooth loss in Japanese community‐dwelling postmenopausal women Objectives: This study examined whether low renal function is associated with the number of remaining teeth among community‐dwelling elderly Japanese. Background data: Many elderly individuals display both low renal function and tooth loss. Materials and Methods: Subjects comprised 405 randomly selected women (55–74 years old). Serum cystatin C level was used to assess renal dysfunction. Multiple linear regression analysis was used to evaluate the relationship between number of remaining teeth and serum cystatin C level, with number of remaining teeth as the dependent variable. Six variables were selected as independent variables in the final model: serum cystatin C; age; mean clinical attachment level; serum cross‐linked N‐telopeptide of type I collagen level; body mass index and smoking habits. Results: Multiple linear regression analysis revealed a significant relationship between number of remaining teeth and serum cystatin C level. The beta value for serum cystatin C level for the number of remaining teeth was ?0.11 (p = 0.018). Conclusion: This study indicates a relationship between serum cystatin C level and number of remaining teeth, suggesting that low renal function could be associated with tooth loss.     

Relationship between periodontal status and intellectual function among community-dwelling elderly persons

doi: 10.1111/j.1741‐2358.2011.00483.x
Relationship between periodontal status and intellectual function among community‐dwelling elderly persons Objective: The aim of this study was to indicate the relationship between periodontal status and intellectual function in the elderly. Background: Periodontal status has been shown to be related to demographic, socioeconomic, and psychological status. Intellectual function is a significant indicator of health status. Nevertheless, the relationship between periodontal status and intellectual function has not been elucidated in detail among the elderly. Materials and Methods: A total of 152 community‐dwelling elderly persons, aged 70–74 years, were enrolled in the study. Periodontal status was evaluated using the WHO Community Periodontal Index of Treatment Needs (CPITN). Intellectual function was assessed by four neuropsychological tests: Raven’s Coloured Progressive Matrices (RCPM) test, the Verbal Paired Associates 1 (VerPA) task and the Visual Paired Associates 1 (VirPA) task, extracted from the Wechsler Memory Scale Revised Edition, and the Block Design subtest, extracted from the Wechsler Adult Intelligence Scales, Third Edition. Correlations between CPITN and each test were examined using Spearman rank correlation coefficients. The ordinal regression model was constructed with CPITN as the dependent variable and neuropsychological test as the principal independent variable to adjust for demographic factors, general health, lifestyle and oral health behaviour. Results: Significant correlations were found between the RCPM test, the VerPA task, the Visual Paired Associates 1 and CPITN. In the ordinal regression model, CPITN was significantly related to measures of RCPM after adjusting for demographic factors, general health status, lifestyle and oral health behaviour. Conclusion: Intellectual function is considered a significant indicator of periodontal status among community‐dwelling elderly persons.     

Effects of an oral androgen on muscle and metabolism in older,community-dwelling men

To determine whether oxymetholone increases lean body mass (LBM) and skeletal muscle strength in older persons, 31 men 65-80 yr of age were randomized to placebo (group 1) or 50 mg (group 2) or 100 mg (group 3) daily for 12 wk. For the three groups, total LBM increased by 0.0 +/- 0.6, 3.3 +/- 1.2 (P < 0.001), and 4.2 +/- 2.4 kg (P < 0.001), respectively. Trunk fat decreased by 0.2 +/- 0.4, 1.7 +/- 1.0 (P = 0.018), and 2.2 +/- 0.9 kg (P = 0.005) in groups 1, 2, and 3, respectively. Relative increases in 1-repetition maximum (1-RM) strength for biaxial chest press of 8.2 +/- 9.2 and 13.9 +/- 8.1% in the two active treatment groups were significantly different from the change (-0.8 +/- 4.3%) for the placebo group (P < 0.03). For lat pull-down, 1-RM changed by -0.6 +/- 8.3, 8.8 +/- 15.1, and 18.4 +/- 21.0% for the groups, respectively (1-way ANOVA, P = 0.019). The pattern of changes among the groups for LBM and upper-body strength suggested that changes might be related to dose. Alanine aminotransferase increased by 72 +/- 67 U/l in group 3 (P < 0.001), and HDL-cholesterol decreased by -19 +/- 9 and -23 +/- 18 mg/dl in groups 2 and 3, respectively (P = 0.04 and P = 0.008). Thus oxymetholone improved LBM and maximal voluntary muscle strength and decreased fat mass in older men.     

Low salivary cortisol and elevated depressive affect among rural men in Botswana: reliability and validity of laboratory results

Most research on hypothalamic-pituitary-adrenal axis function under aversive conditions has focused on relatively increased acute episodic, or chronic secretions as an operationalization of "stress." Severe or recurrent stress, perhaps in interaction with individual characteristics, results in chronically decreased HPA function among some persons suffering from posttraumatic stress disorder. Little evidence exists to assess the population distribution of chronic low cortisol in different free-ranging human populations, as a manifestation of past trauma or stress. This study reports findings of chronically depressed ambulatory salivary cortisol among rural-dwelling Batswana men (n=30) compared with men living in Gaborone (n=34), the capital of Botswana, based on repeated ambulatory sampling. Out of 914 saliva samples analyzed by radioimmunoassay, 268 (29.3%) samples (41 urban, 227 rural) were below the minimum detectable dose (相似文献   

Obesity and cardiovascular risk factors among men and women aged 40 years and older in a rural area of Japan

Obesity is one of the most common health problems, and is recognized worldwide as an "escalating epidemic." For the establishment of an obesity-prevention strategy in Japan, it is important to assess the association between obesity and cardiovascular risk factors. Therefore, we conducted anthropometric measures of obesity and investigated the association of obesity with cardiovascular risk factors such as hypertension, diabetes, and dyslipidemia among community-dwelling men (N=85) and women (N=173) aged 40 years and older. Height, weight, and waist circumference (WC) were measured, and body mass index (BMI) was calculated. Subjects with a BMI> or =25 kg/m(2) were considered obese (BMI obesity), while men with a WC> or =85 cm and women with a WC> or =90 cm were classified as obese (WC obesity). In the present study, we defined 'obesity' as a BMI> or =25 kg/m(2) or a WC> or =85 cm for men, and a BMI> or =25 kg/m(2) or a WC> or =90 cm for women. The results of an age- and sex-adjusted logistic regression analysis indicated that BMI obesity was associated with dyslipidemia (p=0.04), WC obesity was associated with dyslipidemia (p=0.07), and 'obesity' was associated with diabetes (p=0.06) and dyslipidemia (p=0.01). These results emphasize the importance of preventing obesity in Japan. Therefore, healthcare professionals should measure BMI and WC in order to enhance their assessment of cardiovascular risk.     

Testosterone levels and mental rotation performance in Chinese men

Males achieve markedly higher scores than females on mental rotation tests (MRTs). Therefore, it might be hypothesized that, within groups of males, testosterone levels modulate MRT performance. However, studies of this relationship have yielded inconsistent results. Notably, a recent study of 28 American men, using the computerized Shepard and Metzler MRT (SM), found significant associations between salivary testosterone levels and the intercepts of the functions relating response time and error rate to the angular disparity between comparison objects. Conversely, a study of 35 British men, using the same methodology, found no such associations. We attempted a cross-cultural replication of these studies, in which we obtained salivary testosterone levels, together with performance measures on the SM, from 92 heterosexual right-handed men, aged 21-38, in Beijing, China. We hypothesized that Chinese men might perform more slowly and carefully than Western men on this test (which imposes no time limitations), but that associations of testosterone levels with performance, if real, should nevertheless be detectable across cultures. We found that the Chinese men indeed displayed significantly longer response times than the American men, although the Chinese men were equally accurate. Interestingly, testosterone was significantly associated with the slope of the response time function in Chinese men, whereas the earlier American study had found that testosterone was associated with the intercept, but not the slope, of this function. These observations suggest that differing cultural values regarding speed and accuracy may influence MRT performance--and that these values must be considered in future studies of testosterone and MRT measures.     

Salt intake and intestinal dopaminergic activity in adult and old Fischer 344 rats

We have earlier shown that the renal dopaminergic system failed to respond to high salt (HS) intake in old (24-month-old) Fisher 344 rats (Hypertension 1999;34:666-672). In the present study, intestinal Na+,K+-ATPase activity and intestinal dopaminergic tonus were evaluated in adult and old Fischer 344 rats during normal salt (NS) and HS intake. Basal intestinal Na+,K+-ATPase activity (nmol Pi/mg protein/min) in adult rats (142+/-6) was higher than in old Fischer 344 rats (105+/-7). HS intake reduced intestinal Na+,K+-ATPase activity by 20% (P<0.05) in adult, but not in old rats. Dopamine (1 microM) failed to inhibit intestinal Na+,K+-ATPase activity in both adult and old Fischer 344 rats (NS and HS diets). In adult animals, co-incubation of pertussis toxin with dopamine (1 microM) produced a significant inhibitory effect in the intestinal Na+,K+-ATPase activity. L-DOPA and dopamine tissue levels in the intestinal mucosa of adult rats were higher (45+/-9 and 38+/-4 pmol/g) than those in old rats (27+/-9 and 14+/-1 pmol/g). HS diet did not change L-DOPA and DA levels in both adult and old rats. DA/L-DOPA tissue ratios, an indirect measure of dopamine synthesis, were higher in old (1.1+/-0.2) than in adult rats (0.6+/-0.1). Aromatic L-amino acid decarboxylase (AADC) activity in the intestinal mucosa of old rats was higher than in adult rats. HS diet increased the AADC activity in adult rats, but not in old rats. It is concluded that intestinal dopaminergic tonus in old Fisher 344 rats is higher than in adult rats and is accompanied by lower basal intestinal Na+,K+-ATPase activity. In old rats, HS diet failed to alter the intestinal dopaminergic tonus or Na+,K+-ATPase activity, whereas in adult rats increases in AADC activity were accompanied by decreases in Na+,K+-ATPase activity. The association between salt intake, increased dopamine formation and inhibition of Na+,K+-ATPase at the intestinal level was not as straightforward as that described in renal tissues.     

Comparison of temporal changes in psychological distress after hematopoietic stem cell transplantation among the underlying diseases of Japanese adult patients

Background  

The onset and course of irritable bowel syndrome (IBS) are strongly influenced by psychological factors, and treatment often includes cognitive-behavioral therapy. We conducted a study of the relationships between cognitive appraisal of IBS symptoms and negative mood for the subtypes of IBS.     

Plasma free fatty acid composition in Ainu and Japanese men

The ratio of oleic acid in the plasma FFA fraction was higher in the Japanese than in the Ainu. When glucose was administered, the proportion of oleic acid was reduced, while that of stearic acid increased in both groups. In the Japanese, moreover, a decrease in linoleic acid and increases in palmitic and myristic acids were also observed. As the plasma FFA level rose after injection of norepinephrine, the proportion of oleic acid increased and that of palmitic, stearic, myristic and lauric acids decreased, and the composition approached the pattern of depot fat. It was inferred that the difference observed in the plasma FFA composition between the Ainu and Japanese was attributable to the difference in the plasma levels of FFA which was significantly lower in the Ainu.

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Zusammenfassung Das Verhältnis von Oelsäure in der freien Fettsäurenfraktion (FFA) im Plasma war bei Japanern (n=9) höher als bei Ainus (n=5). Nach Glukose war das Oelsäure-Verhältnis vermindert, während in beiden Gruppen Stearinsäure anstieg. Bei den Japanern ergaben sich ausserdem ein Abfall der Linolensäure und Austiege der Palmitin- und Myristinsäure. Wenn der Plasma FFA-Spiegel nach Noradrenalin-Injektion anstieg, stieg der Oelsäureanteil und fielen die Palmitin-, Myristin- und Laurinsäureanteile und die Zusammensetzung war wie die von Depotfett. Es wird angenommen, dass die Unterschiede in der Zusammensetzung der Plasma FFA bei Japanern und Ainus Folge der unterschiedlichen FFA-Spiegel waren, die bei den Ainu signifikant tiefer lagen.

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Resume La proportion d'acide oleique dans l'ensemble des acides gras libres (FFA) du plasma sanguin est plus marquée chez les Japonais (n=9) que chez les Aïnous (n=5). La proportion d'acide oleique a diminuê après l'administration de glucose, car, dans les deux groupes, la teneur en acide stéarique s'est renforcée. On constante en outre une diminution de l'acide linoleique et une augmentation des acides palmitique et myristique. Lorsque, après injection de noradrénaline, le taux de FFA du plasma se relève, on constate une augmentation des quantités relatives de l'acide oleique au détriment de la part prise par les acides palmitique, myristique et laurique et leur composition est semblable aux dépots adipeux. On peut ainsi admettre que les différences de composition du FFA plasmatique découlent du taux dissemblable du FFA entre Aïnous et Japonais. Ce taux est significativement inférieur chez les premiers.

     

Gene-nutrient and gene-gene interactions of controlled folate intake by Japanese women

Elevated serum total homocysteine (tHcy) levels are associated with increased risk for cardiovascular disease and dementia. The prevalence rates of homozygous mutants among Japanese women (n = 300) were 17.3%, 1.3%, 18.6%, and 5.3% for methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, reduced folate carrier (RFC-1) A80G, and methionine synthase (MS) A2756G, respectively. The tHcy value was significantly lower (p < 0.001) in young women with CC or CT of MTHFR than with TT (10.9+/-4.7 micromol/L) (n =250). Diversities of serum folate and tHcy in women with 23 combinations of different alleles at low folate intake converged to the highest (34.0+/-8.6 nmol/L) and lowest (7.6+/-1.5 micromol/L) levels, respectively, after folic acid (400 microg/day) supplementation. In the regression equation ( y= ax + b) of serum folate ( y nmol/L) plotted against mean folate intake ( x microg/day), the values of "a" were 0.032, 0.037, and 0.045 for individuals with CC, CT, and TT alleles, respectively, of MTHFR.     

Phytochemical intake and relationship to past health history in Japanese women

We calculated functional food factor (FFF) intakes using a new database and examined their relationship to health conditions commonly affecting Japanese women in midlife. One-day DRs were collected weekly for 6 months from 67 Japanese women, aged 45-55 yr, living in Kyoto prefecture, Japan. Macro- and micronutrient and FFF intake were calculated from the resulting 1528 DRs. Factor analysis and logistic regression were performed to identify relationships between FFFs and past health history. Fourteen of 17 FFF factors, as well as age, BMI and menopausal status, exhibited both positive and negative correlations with past history of hypertension, diabetes, allergy, migraine, and menopausal syndrome.