Publications by authors named "Ryoko Higuchi"

16 Publications

  • Page 1 of 1

Potential Role of Artificial Intelligence for the Previous Study Using Traditional Analysis.

J Clin Med Res 2021 Jul 28;13(7):409-411. Epub 2021 Jul 28.

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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http://dx.doi.org/10.14740/jocmr4568DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336939PMC
July 2021

Fasting biochemical hypoglycemia and related-factors in non-diabetic population: Kanagawa Investigation of Total Check-up Data from National Database-8.

World J Diabetes 2021 Jul;12(7):1131-1140

School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka 238-8522, Japan.

Background: In healthy people, the lowest daily blood glucose concentration is usually observed in the early morning, after overnight fasting. However, the clinical relevance and the prevalence of fasting biochemical hypoglycemia (FBH) are poorly understood in people who do not have diabetes, although the clinical implications of such hypoglycemia have been extensively studied in patients with diabetes. FBH can be influenced by many factors, including age, sex, body mass, smoking, alcohol drinking, exercise levels, medications, and eating behaviors, such as breakfast skipping and late-night eating.

Aim: To determine the prevalence of FBH and investigated its association with potential risk factors in a population without diabetes.

Methods: Clinical parameters and lifestyle-related factors were assessed in a cross-sectional study of 695613 people aged 40-74 years who had undergone a health check-up (390282 men and 305331 women). FBH was defined as fasting plasma glucose < 70 mg/dL (3.9 mmol/L) after overnight fasting, regardless of any symptoms. The absence of diabetes was defined as HbA1c < 6.5%, fasting plasma glucose < 126 mg/dL (7.0 mmol/L), and no pharmacotherapy for diabetes. Multivariate logistic regression analysis, with adjustment for confounding factors, was used to identify associations.

Results: FBH was present in 1842 participants (0.26%). There were significantly more women in the FBH group (59.1%) than in the non-FBH group (43.9%). Values of most of the clinical parameters, but not age, were significantly lower in the FBH group than in the non-FBH group. Logistic regression analysis showed that a body mass index of ≤ 20.9 kg/m (reference: 21-22.9 kg/m) and current smoking were significantly associated with FBH, and this was not altered by adjustment for age, sex, and pharmacotherapy for hypertension or dyslipidemia. Female sex was associated with FBH. When the data were analyzed according to sex, men in their 60s or 70s appeared more likely to experience FBH compared with their 40s, whereas men in their 50s and women aged ≥ 50 years appeared less likely to experience FBH. The relationships of FBH with other factors including alcohol drinking and pharmacotherapies for hypertension and dyslipidemia also differed between men and women.

Conclusion: FBH occurs even in non-diabetic people, albeit at a very low frequency. FBH is robustly associated with low body mass and smoking, and its relationship with lifestyle factors varies according to sex.
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http://dx.doi.org/10.4239/wjd.v12.i7.1131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311474PMC
July 2021

The usefulness of postmortem computed tomography angiography for subdural hematoma caused by rupture of the cortical artery: A report of two autopsy cases and a literature review.

Leg Med (Tokyo) 2021 Jul 12;53:101941. Epub 2021 Jul 12.

Division of Legal Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Center of Cause of Death Investigation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Acute subdural hematoma (SDH) occurs following severe head trauma with brain contusion or rupture of bridging veins. Conversely, SDH caused by rupture of a cortical artery without trauma or with minor trauma is also possible. Although over 150 cases of the latter SDH have been reported, they were predominantly diagnosed only during surgery, and therefore, no adequate histological evaluation has been performed. Therefore, essential etiology of this SDH type has remained unclear. In addition, the scarcity of autopsy cases may be attributed to arterial rupture being missed if the macroscopic findings are too minimal to detect during autopsy. Here, we describe two autopsy cases of SDH of cortical artery origin. Extravasation on postmortem computed tomography angiography and arterial leakage on macroscopic observation during autopsy facilitated detection of the ruptured artery and allowed detailed histological evaluation of the ruptured artery and adjacent dura mater. The etiology of arterial rupture is briefly described on the basis of histopathological findings in this study and the available literature.
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http://dx.doi.org/10.1016/j.legalmed.2021.101941DOI Listing
July 2021

Association between extremely high high-density lipoprotein-cholesterol and hypertensive retinopathy: results of a cross-sectional study from Kanagawa Investigation of Total Checkup Data from the National Database-6 (KITCHEN-6).

BMJ Open 2021 05 11;11(5):e043677. Epub 2021 May 11.

School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan.

Objectives: Doubt has been cast on the atheroprotective effect of very high high-density lipoprotein cholesterol (HDL-C). Hypertensive retinopathy (HR) is caused by persistent systemic hypertension. Therefore, we aimed to investigate the association between extremely high HDL-C (EH-HDL) and HR.

Design: A cross-sectional study.

Participants: A total of 4072 general Japanese population aged 40-74 years who underwent regular medical check-ups including fundus examinations.

Outcome Measures: HR and clinical parameters including serum HDL-C were investigated. HR was determined by the Keith-Wagener classification and the Scheie classifications for Hypertension and Atherosclerosis (n=4054 available). Serum HDL-C was divided into five categories: 30-49, 50-69, 70-89, 90-109 and ≥110 mg/dL.

Results: Overall, 828 (20.3%) subjects had Keith-Wagener-HR, 578 (14.3%) had hypertension-HR, and 628 (15.5%) had atherosclerosis-HR. Blood pressure decreased as HDL-C level increased, whereas the prevalences of HRs showed U-shaped curves against HDL-C with minimum values for HDL-C 90-109 mg/dL. In logistic regression analyses, EH-HDL ≥110 mg/dL was significantly associated with Keith-Wagener-HR and atherosclerosis-HR, compared with HDL-C 90-109 mg/dL after adjustments for age, sex and systolic blood pressure (OR 3.01, 95% CI 1.45 to 6.27 and OR 2.23, 95% CI 1.03 to 4.86). The hypertension-HR was not significantly associated with EH-HDL regardless of adjustment for the confounding factors (p=0.05-0.08). Although serum HDL-C as a continuous variable was inversely associated with three HRs, which disappeared after adjustment for the confounding factors.

Conclusion: EH-HDL may be associated with HR independently of blood pressure, suggesting that EH-HDL reflects a special atherosclerotic condition.
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http://dx.doi.org/10.1136/bmjopen-2020-043677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8118016PMC
May 2021

Unexpectedly High Prevalence of Breakfast Skipping in Low Body-Weight Middle-Aged Men: Results of the Kanagawa Investigation of Total Checkup Data from the National Data Base-7 (KITCHEN-7).

Nutrients 2020 Dec 30;13(1). Epub 2020 Dec 30.

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.

Breakfast skipping (BS) has been considered to be associated with obesity, particularly among younger generations. However, few studies have addressed this issue in a middle-aged population considering sex and the conditions prior to breakfast. Therefore, we investigated clinical parameters, self-reported BS, late-night dinner (LND) eating, and late-night snacking (LNS) in ten body mass index (BMI) categories in a cross-sectional study of 892,578 non-diabetic people aged 40-74 years old who underwent a checkup. BS and LND were more prevalent in men (20.7% and 40.5%, respectively) than women (10.9% and 17.4%), whereas LNS was more prevalent in women (15.0%) than men (12.2%; all < 0.0001). The overall prevalence of BS increased linearly with increasing BMI. However, when subjects were divided into men and women, the prevalence of BS showed a U-shaped relationship with BMI in men (n = 479,203). When male subjects were restricted to those in their 40s or those reporting LND, the prevalence of BS further increased, maintaining a U-shaped form. Logistic regression analysis also showed a U-shaped relationship in the adjusted odds ratios of BMI categories for BS in men and a J-shaped curve in women. In conclusion, our study revealed an unexpectedly high prevalence of BS in middle-aged low-body-weight men.
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http://dx.doi.org/10.3390/nu13010102DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823689PMC
December 2020

Trace Proteinuria and the Incidence of Overt Proteinuria After Five Years: Results of the Kanagawa Investigation of the Total Checkup Data From the National Database-5 (KITCHEN-5).

J Clin Med Res 2020 Sep 15;12(9):618-623. Epub 2020 Aug 15.

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.

Background: Trace proteinuria (TrP), which is usually defined as ± by dipstick urinalysis, is considered as normal and of limited clinical significance. However, the relationship between TrP and overt proteinuria (OP) (≥ +1) in the future is unknown. Therefore, we investigated the association between TrP and future incidence of OP in a community-based cohort study.

Methods: TrP detected during the initial 2 years, which was classified into transient TrP (once/2 years) (T-TrP) and recurrent TrP (twice/2 years) (R-TrP); and the incidence of OP after 5 years were investigated in 292,257 general Japanese people aged 40 - 68 years who attended checkups. To determine TrP and OP, dipstick urinalysis was conducted with visual reading (VR) by medical staff or automated reading (AR) using a machine reader.

Results: Overall, T-TrP and R-TrP were observed in 24,782 (8.5%) and 3,767 (1.3%) subjects, respectively. Both types of TrP were prevalent in the detection with AR than VR. The prevalences of T-TrP and R-TrP showed J-shaped relationships against baseline body mass index (BMI), regardless of sex and BMI categories. The incident of OP after 5 years was larger (around 10%) in R-TrP than T-TrP (around 5%): approximately two times. Logistic regression analysis showed that T-TrP and R-TrP were significantly associated with OP, even after adjustment for relevant confounding factors including age, sex, and BMI (odds ratios (95% confidence intervals (CIs)): 2.77 (2.60 - 2.95) and 4.85 (4.34 - 5.43)), which were not largely altered when sub-analysis was conducted according to men and women, non-obesity and obesity, or AR and VR. In all analysis above, the odds ratios (95% CIs) of R-TrP for OP were higher than T-TrP.

Conclusions: Our findings suggest that TrP, particularly R-TrP, is substantially associated with the future incidence of OP, which may be independent of confounding factors and the methods detecting TrP.
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http://dx.doi.org/10.14740/jocmr4274DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430916PMC
September 2020

The association of low serum salivary and pancreatic amylases with the increased use of lipids as an energy source in non-obese healthy women.

BMC Res Notes 2020 May 6;13(1):237. Epub 2020 May 6.

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.

Objective: It is unknown whether low serum levels of salivary and pancreatic amylases are associated with the high combustion of carbohydrates or lipids for energy. Elevated blood ketones and a low respiratory quotient (RQ) can reflect the preferential combustion of lipids relative to carbohydrates. Therefore, using the data from our previous study, we investigated if low levels of serum amylases were associated with a high serum ketone level and low RQ in 60 healthy non-obese young women aged 20-39 years old.

Results: Serum ketones [3-hydroxybutyric acid (3-HBA) and acetoacetic acid (AA)] were inversely correlated with RQs, but not body mass index (BMI) or glycated haemoglobin (HbA1c) levels. Logistic regression analysis showed that high levels of serum ketones (3-HBA ≥ 24 μmol/L and AA ≥ 17 μmol/L) and a low RQ (< 0.766) were significantly associated with low serum salivary (< 60 U/L) and pancreatic (< 29 U/L) amylase levels, respectively. These associations were not altered by further adjustments for age, BMI, HbA1c, and estimated glomerular filtration rate. These results confirm the high combustion of lipids for energy in individuals with low serum amylase levels, suggesting a close relationship between circulating amylases and internal energy production.
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http://dx.doi.org/10.1186/s13104-020-05078-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201991PMC
May 2020

Copy Number Variation of the Salivary Amylase Gene and Glucose Metabolism in Healthy Young Japanese Women.

J Clin Med Res 2020 Mar 2;12(3):184-189. Epub 2020 Mar 2.

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.

Background: Many studies have shown that low copy number variation (CNV) of the salivary amylase gene () and low serum amylase concentration are associated with impaired glucose metabolism and obesity. We aimed to clarify the conflicting results of previous studies by examining expression and metabolic indices in a homogenous group of healthy participants.

Methods: Sixty healthy non-obese young Japanese women aged 20 - 39 years were examined for CNV, salivary amylase, body mass index (BMI) and serum parameters including glycated hemoglobin (HbA1c), ketones, and total, salivary and pancreatic amylase. Respiratory quotient at rest and changes in blood glucose after starch loading were also examined.

Results: CNV (range, 4 - 14) and the level of serum salivary amylase were correlated inversely with HbA1c (r = -0.36, P = 0.003 and r = -0.30, P = 0.02, respectively), whereas the percentage of serum salivary amylase in total serum amylase was positively correlated with blood glucose at 30 and 45 min after starch loading (r = 0.38, P = 0.004 and r = 0.27, P = 0.04, respectively). The level of serum total amylase, but not CNV, was correlated inversely with BMI (r = -0.29, P = 0.02). Logistic regression analysis showed that low CNV (4 - 7) was significantly associated with an HbA1c of ≥ 5.4% (34 mmol/mol) even after adjustment for age, BMI and energy consumption, compared with high CNV (8 - 14).

Conclusions: Although a higher percentage of serum salivary amylase was associated with higher levels of blood glucose at the early stage after starch loading, low CNV was associated with chronic unfavorable glucose metabolism in healthy non-obese young women in Japan.
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http://dx.doi.org/10.14740/jocmr4082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092761PMC
March 2020

Impaired Glucose Metabolism in People with Extremely Elevated High-Density Lipoprotein Cholesterol and Low Alcohol Consumption: Results of the Kanagawa Investigation of Total Checkup Data from the National Database-3 (KITCHEN-3).

J Clin Med 2019 Nov 1;8(11). Epub 2019 Nov 1.

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.

Background: Recently, we have shown that extremely high high-density lipoprotein cholesterol (HDL-C), which was observed mostly in heavy drinkers, was associated with the incidence of diabetes. However, the observed association was influenced by the consumption of alcohol. Furthermore, it is unknown whether impaired glucose metabolism exists in people with extremely high HDL-C, regardless of their alcohol consumption. Therefore, we addressed this issue in people who did not have a habit of drinking alcohol.

Methods: In this community-based cross-sectional study, we included 177,034 participants (40-74 years old) who reported being nondrinkers. We investigated levels of HbA, fasting plasma glucose (FPG), HDL-C, and clinical parameters according to 11 levels of HDL-C concentration from 20 to 120 mg/dL or over.

Results: A total of 6112 participants with HDL-C ≥ 100 mg/dL (3.5%) showed a better lipid profile, higher prevalence amongst women, more habitual exercise, a lower prevalence of smoking, and lower body mass index (BMI). Compared with an HDL-C of 70-79 mg/dL, HDL-C ≤ 69 mg/dL (except an HDL-C of 20-29 mg/dL) and HDL-C ≥ 90 mg/dL were significantly associated with a high HbA of ≥6.0%, independently of confounding factors. This finding was distinctly demonstrated in women. Similar trends were observed when high HbA was replaced with high FPG (≥110 mg/dL).

Conclusions: Our study demonstrated that impaired glucose metabolism may exist in people with extremely high HDL-C and who hardly drink alcohol.
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http://dx.doi.org/10.3390/jcm8111825DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912278PMC
November 2019

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 Aug 22;8(9). Epub 2019 Aug 22.

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.

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/m), 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/m) 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/m, 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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http://dx.doi.org/10.3390/jcm8091282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780907PMC
August 2019

An autopsy case of peliosis hepatis with X-linked myotubular myopathy.

Leg Med (Tokyo) 2019 May 18;38:77-82. Epub 2019 Apr 18.

Division of Legal Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan; Center of Cause of Death Investigation, Faculty of Medicine, Niigata University, Niigata, Japan. Electronic address:

This report describes the autopsy case of a 4-year-old boy who died from hepatic hemorrhage and rupture caused by peliosis hepatis with X-linked myotubular myopathy. Peliosis hepatis is characterized by multiple blood-filled cavities of various sizes in the liver, which occurs in chronic wasting disease or with the use of specific drugs. X-linked myotubular myopathy is one of the most serious types of congenital myopathies, in which an affected male infant typically presents with severe hypotonia and respiratory distress immediately after birth. Although each disorder is rare, 12 cases of pediatric peliosis hepatis associated with X-linked myotubular myopathy have been reported, including our case. Peliosis hepatis should be considered as a cause of hepatic hemorrhage despite its low incidence, and it requires adequate gross and histological investigation for correct diagnosis.
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http://dx.doi.org/10.1016/j.legalmed.2019.04.005DOI Listing
May 2019

High Incidence of Diabetes in People with Extremely High High-Density Lipoprotein Cholesterol: Results of the Kanagawa Investigation of Total Checkup Data from the National Database-1 (KITCHEN-1).

J Clin Med 2019 Mar 19;8(3). Epub 2019 Mar 19.

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.

Background: It is unknown whether extremely high high-density lipoprotein cholesterol (HDL-C) has a protective effect against diabetes, which plays a key role in cardiovascular disease.

Methods: In a community-based cohort study of 387,642 subjects (40⁻68 years old) without diabetes, the incidence of diabetes 6 years later was determined according to baseline HDL-C (≤39, 40⁻49, 50⁻59, 60⁻69, 70⁻79, 80⁻89, 90⁻99, 100⁻109, or ≥110 mg/dL).

Results: At baseline, HDL-C ≥100 mg/dL was present in 12,908 subjects (3.3%), who had a better lipid profile and a high prevalence of heavy alcohol consumption and habitual exercise. The incidences of diabetes according to baseline HDL-C were 14.7, 11.2, 7.7, 5.3, 3.8, 2.8, 2.7, 2.5, and 3.5 per 1000 person-years, respectively. The adjusted relative risks (ARRs) for diabetes showed concave relationships with HDL-C, with minima at 80⁻89 mg/dL. The ARR (95% CI) of the lowest HDL-C category was 1.56 (1.40⁻1.74) and of the highest HDL-C category was 1.46 (1.18⁻1.81) (both < 0.001), regardless of alcohol consumption. The latter ARR was higher in men ( = 219,047) (2.45 (1.70⁻3.53), < 0.0001) after adjustment for baseline glycemic index.

Conclusion: Both extremely high and low HDL-C represent risks for diabetes, which deserves further study.
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http://dx.doi.org/10.3390/jcm8030381DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463166PMC
March 2019

Kanagawa Investigation of the Total Check-up Data from the National database (KITCHEN): protocol for data-driven population-based repeated cross-sectional and 6-year cohort studies.

BMJ Open 2019 02 21;9(2):e023323. Epub 2019 Feb 21.

School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Japan.

Introduction: The unmitigated incidence of cardiometabolic diseases, such as type 2 diabetes and metabolic syndrome, has gained attention in Japan. 'Big data' can be useful to clarify conflicting observations obtained from studies with small samples and about rare conditions that are often neglected. We epidemiologically address these issues using data from health check-ups conducted in Kanagawa Prefecture, the prefecture with the second largest population in Japan, in the Kanagawa Investigation of the Total Check-up Data from the National Database (KITCHEN).

Methods And Analysis: This research consists of a series of population-based cross-sectional studies repeated from 2008-2014 and 6-year cohort studies. Since 2017, we have reviewed the data of people living in Kanagawa Prefecture who underwent a health check-up mainly for general health and the prevention of metabolic syndrome. The sample size ranges from 1.2 million to 1.8 million people in the cross-sectional studies and from 370 000 to 590 000 people in the cohort studies. These are people aged 40-74 years, whose clinical parameters were measured and who responded individually to a questionnaire. We investigate potential associations and causalities of various aetiologies, including diabetes and metabolic syndrome, using clinical data and lifestyle information. With multidisciplinary analysis, including data-driven analysis, we expect to obtain a wide range of novel findings, to confirm indeterminate previous findings, especially in terms of cardiometabolic disease, and to provide new perspectives for human health promotion and disease prevention.

Ethics And Dissemination: Ethical approval was received from the Ethics Committee of Kanagawa University of Human Services (10-43). The protocol was approved in December 2016 by the Japanese Ministry of Health, Labour and Welfare (No. 121). The study results will be disseminated through open platforms including journal articles, relevant conferences and seminar presentations.
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http://dx.doi.org/10.1136/bmjopen-2018-023323DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398776PMC
February 2019

Adjustment for Waist Circumference Reveals a U-Shaped Association Between Glycated Hemoglobin Levels and Body Mass Index in Young Adults.

Can J Diabetes 2019 Apr 21;43(3):201-206. Epub 2018 Sep 21.

School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan; Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan. Electronic address:

Objectives: Body mass index (BMI) is used to assess adiposity worldwide. However, additional adjustment for waist circumference (WC), a surrogate marker of abdominal fat, may be capable of revealing a latent relationship between low body weight and glycated hemoglobin (A1C) concentration. Here, we investigated the relationship between A1C and BMI in young adults, adjusting for WC.

Methods: We reviewed A1C, BMI, WC and other clinical data in a cross-sectional study of 26,475 apparently healthy Japanese people 20 to 39 years of age who were undergoing health check-ups.

Results: Although the values of most serum parameters were high in subjects with a high BMI in both younger (20 to 29 years of age, n=10,810) and older subjects (30 to 39 years of age, n=15,665), A1C had a J-shaped relationship with BMI category in younger subjects, regardless of sex. A traditional linear model via a generalized linear model showed that in younger subjects, an inverse association of A1C level with BMI category (19 to 26.9 kg/m vs. ≤18.9 kg/m) was identified after adjustment for WC. This indicates positive associations between A1C and BMI categories of ≤18.9 (beta=0.06; p<0.0001), 19.0 to 20.9 (beta=0.03; p<0.01) and ≥27.0 kg/m (beta=0.08; p<0.0001), in contrast to individuals with BMIs of 23.0 to 24.9 kg/m. Similarly, in older subjects, BMIs ≤18.9 kg/m were associated with A1C levels but to a lesser extent (beta=0.04; p<0.05) than in younger subjects.

Conclusions: Additional adjustment of BMI for WC revealed a latent U-shaped association between A1C concentration and BMI, particularly in young adults; this deserves further investigation.
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http://dx.doi.org/10.1016/j.jcjd.2018.09.007DOI Listing
April 2019

Potential common factors associated with predisposition to common cold in middle-aged and elderly Japanese: A community-based cross-sectional study.

Medicine (Baltimore) 2018 May;97(20):e10729

School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services Department of Nutrition, St. Marianna University School of Medicine Hospital, Kawasaki, Kanagawa Saitama Health Promotion Corporation, Yoshimimachi, Hikigun Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.

People worldwide frequently catch a common cold, which occasionally develops into secondary severe conditions such as pneumonia. However, it is unclear whether predisposition to the common cold is associated with the individual's characteristics including age, body weight, lifestyles, diets, and intestinal functions, besides exposure to a responsible pathogen. We addressed this issue epidemiologically considering many relevant clinical factors.We reviewed data from a cross-sectional study consisting of 39,524 apparently healthy Japanese aged 40 to 79 years (26,975 men and 12,549 women) who underwent a checkup in 2007. Self-reported predisposition to common cold (SPCC) and relevant clinical conditions and parameters were considered.We observed no significant difference in most clinical parameters including age, body mass index (BMI), glycated hemoglobin (HbA1c), and prevalence of men and current smokers between subjects with and without SPCC. In univariate analysis, circulating white blood cell (WBC) count and serum alanine-aminotransferase (ALT) were significantly higher in subjects with SPCC than in those without, whereas serum high-density lipoprotein cholesterol (HDL-C) and duration of sleep were lower. In logistic regression analysis after full adjustment for relevant confounding factors, BMI categories except BMI of ≥27.0 kg/m were significantly associated with SPCC compared with BMI of 23.0 to 24.9 kg/m. Short duration of sleep (≤5 hours), occasional alcohol drinking, and no-exercise were significantly associated with SPCC compared with 7 hours sleep duration, no-drinking alcohol, and low frequent exercise (twice per month), respectively. All gastrointestinal disorders (gastric complaints, constipation, and diarrhea) were independently associated with SPCC. Imbalanced diet and taking a snack were also associated with SPCC in a degree dependent manner. Furthermore, WBC count, serum ALT, and HDL-C (as continuous variables) were associated with SPCC (HDL-C was inversely), whereas no significant association was observed between SPCC and age, smoking, HbA1c, and pharmacotherapy for diabetes, hypertension, and dyslipidemia.Our results demonstrated that multifactorial conditions and parameters might be simultaneously associated with the predisposition to common cold. Prospective studies including detailed common cold questionnaire and measurements are needed to confirm currently suspected causative and protective factors.
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http://dx.doi.org/10.1097/MD.0000000000010729DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976333PMC
May 2018

The timing of ingestion may influence the effect of nonnutritive sweeteners on cardiometabolic health: a potentially overlooked factor.

CMAJ 2017 11;189(46):E1427

Assistant Professor, School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan.

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http://dx.doi.org/10.1503/cmaj.733416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5698035PMC
November 2017
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