Usefulness of health checkup-based indices in identifying metabolic dysfunction-associated steatotic liver disease.

Aims: The application of indices in the context of metabolic dysfunction-associated steatotic liver disease (MASLD) remains unexplored. We aimed to validate the ability of alanine aminotransferase (ALT), fatty liver index (FLI), and hepatic steatosis index (HSI) to identify MASLD during health checkups. Methods: We recruited 627 participants and utilized their health checkup data and ultrasound to assess the potential of using ALT, FLI, and HSI as indices for MASLD; this was indicated by the area under the curve (AUC) and restricted cubic spline (RCS) model. The optimal, rule-out (sensitivity ≥90%), and rule-in (specificity ≥90%) cutoff values of each index for identifying MASLD were reported. Results: Among participants with a median age of 46 years, the prevalence of MASLD was 28% in total (38% in males and 18% in females). RCS models confirmed a linear association between indices and MASLD. ROC analyses indicated that the AUC of ALT in identifying MASLD was 0.79 for the total cohort, 0.81 for males, and 0.69 for females. The optimal, rule-out, and rule-in cutoff values for ALT were 21, 13, and 29, respectively. Similarly, the AUC of FLI/HSI in identifying MASLD was 0.90/0.88 for the total cohort, 0.86/0.85 for males, and 0.93/0.90 for females. Considering the reference cutoff values, distinct cutoff values were observed between the sexes for FLI, while HSI had similar cutoff values. Conclusion: This study demonstrated that ALT > 30 IU/L is a reasonable cutoff value to rule-in MASLD. ALT, FLI, and HSI are reliable indices for identifying MASLD during health checkups.

Changes in Mental Health among Japanese University Students during the COVID-19 Era: Differences by College Department, Graduate Level, Sex, and Academic Year.

This study compared the effects of academic year, college department, and undergraduate or graduate status on Japanese students' mental health during the COVID-19 pandemic. From 2021-2023, an online survey was conducted using the Counseling Center Assessment of Psychological Systems-Japanese (CCAPS-Japanese) to evaluate students' mental health; 9395 undergraduate students (4623 female, 4772 male) and 1169 graduate students (380 female, 789 male) responded. Undergraduate students in medicine had lower levels of depression, generalized anxiety, and social anxiety than those in other departments. Engineering students exhibited the highest level of academic distress. First-year students had the highest levels of generalized and social anxiety but the lowest level of academic distress. Second-year students had the lowest level of depression, and third-year students had the highest level of academic distress. Among graduate students, first-year students had higher levels of depression, generalized anxiety, social anxiety, academic distress, and hostility than second-year students. Undergraduates had poorer mental health than graduate students. Females had higher levels of eating concerns than males among undergraduate students. This study revealed that the mental health of university students was affected by various factors. These findings demonstrate the characteristics of university students requiring early support.

Prevalence of Steatotic Liver Disease Based on a New Nomenclature in the Japanese Population: A Health Checkup-Based Cross-Sectional Study.

This cross-sectional study examined the prevalence and characteristics of steatotic liver disease (SLD) based on a recently introduced nomenclature in the Japanese health checkup population. SLD was evaluated using liver ultrasonography, and participants were categorized into metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol associated steatotic liver disease (MetALD), alcohol-associated/related liver disease (ALD), and cryptogenic SLD groups. The prevalence and characteristics of the SLD subclasses were assessed, and subgroup analyses were conducted for the non-obese (body mass index [BMI] ≤ 25 kg/m2) and lean (BMI ≤ 23 kg/m2) populations. Among the 694 participants, with a median age of 47 years and comprising 54% males, the prevalence of MASLD, MetALD, ALD, and cryptogenic SLD was 26%, 2%, 1%, and 2%, respectively. A remarkable difference was observed in the prevalence of SLD subclasses according to age, sex, and BMI. Subgroup analyses revealed heterogeneous demographic, clinical, and biochemical parameters between the SLD categories. Individuals with MetALD had higher gamma-glutamyl transferase levels, lower platelet counts, and higher fibrosis-4 index than did those with MASLD. Furthermore, the prevalence of non-obese and lean MASLD was 13% and 6%, respectively. This study provides preliminary information on the prevalence of SLD based on a new nomenclature in the Japanese population.

Usefulness of a questionnaire for assessing the relationship between eating behavior and steatotic liver disease among Japanese male young adults.

This study aimed to reveal the relationship between eating behavior and nonalcoholic fatty liver disease (NAFLD)/metabolic dysfunction-associated steatotic liver disease (MASLD) in young adults and suggest a questionnaire for eating behavior assessment. We included 322 male graduate students at Gifu University. Diagnoses of NAFLD and MASLD were based on the presence of hepatic steatosis on ultrasonography. Eating behavior was assessed using the eating behavior questionnaire (EBQ) recommended by the Japan Society for the Study of Obesity. We assessed the eating behaviors associated with NAFLD and MASLD using logistic regression, decision tree, and random forest analyses. The median age of the participants was 22 years, and 16% and 11% had NAFLD and MASLD, respectively. The EBQ total score was significantly higher in participants with MASLD than in those without MASLD (102 vs. 90 points, P = 0.006) and in those with NAFLD than in those without NAFLD (97 vs. 90 points, P = 0.007). Among eating behavior categories, the decision tree and random forest analyses revealed that "perception of constitution and weight" was the strongest contributor for NAFLD/MASLD. Our study revealed that eating behavior assessed with the EBQ is robustly associated with NAFLD and MASLD in young male adults.

Gray matter volume differences between transgender men and cisgender women: A voxel-based morphometry study.

OBJECTIVE: Gender dysphoria (GD) is characterized by distress due to inconsistency between gender identity and biological sex. Individuals with GD often desire to be the other gender, which is called transgender. Although altered brain volumes in transgender people, particularly transgender women, have been reported, the particular brain regions have been inconsistent among studies. This study aimed to investigate neuroanatomical differences in transgender men without physical interventions. METHOD: T1-weighted magnetic resonance images (MRIs) were acquired in 21 transgender men and 21 cisgender women matched for biological sex and age. Whole-brain comparisons using voxel-based morphometry (VBM) were performed to identify gray matter volume (GMV) differences between transgender men and cisgender women. RESULTS: Transgender men showed greater GMV in the right posterior cingulate gyrus (PFWE-corr = 3.06×10-6) and the left occipital pole (PFWE-corr = 0.017) and lower GMV in the left middle temporal gyrus (PFWE-corr = 0.017) than cisgender women. Even after including serum sex hormone levels as covariates, the posterior cingulate gyrus was still significant (PFWE-corr < 0.05). In contrast, the occipital pole and the middle temporal gyrus were not significant after controlling for the sex hormone levels (PFWE-corr > 0.05), especially affected by testosterone but not estradiol. CONCLUSION: These findings suggest that transgender men have altered brain structure. We suggest that larger posterior midline structures may contribute to sensitivity to self-referential processing through altered visual perception in transgender people.

Pharmacogenomic Study of Clozapine-Induced Agranulocytosis/Granulocytopenia in a Japanese Population.

BACKGROUND: Clozapine-induced agranulocytosis (CIA)/clozapine-induced granulocytopenia (CIG) (CIAG) is a life-threatening event for schizophrenic subjects treated with clozapine. METHODS: To examine the genetic factor for CIAG, a genome-wide pharmacogenomic analysis was conducted using 50 subjects with CIAG and 2905 control subjects. RESULTS: We identified a significant association in the human leukocyte antigen (HLA) region (rs1800625, p = 3.46 × 10(-9), odds ratio [OR] = 3.8); therefore, subsequent HLA typing was performed. We detected a significant association of HLA-B*59:01 with CIAG (p = 3.81 × 10(-8), OR = 10.7) and confirmed this association by comparing with an independent clozapine-tolerant control group (n = 380, p = 2.97 × 10(-5), OR = 6.3). As we observed that the OR of CIA (OR: 9.3~15.8) was approximately double that in CIG (OR: 4.4~7.4), we hypothesized that the CIG subjects were a mixed population of those who potentially would develop CIA and those who would not develop CIA (non-CIA). This hypothesis allowed the proportion of the CIG who were non-CIA to be calculated, enabling us to estimate the positive predictive value of the nonrisk allele on non-CIA in CIG subjects. Assuming this model, we estimated that 1) ~50% of CIG subjects would be non-CIA; and 2) ~60% of the CIG subjects without the risk allele would be non-CIA and therefore not expected to develop CIA. CONCLUSIONS: Our results suggest that HLA-B*59:01 is a risk factor for CIAG in the Japanese population. Furthermore, if our model is true, the results suggest that rechallenging certain CIG subjects with clozapine may not be always contraindicated.