Fatherhood and distal adenomas of the large bowel: a study of male self-defense officials in Japan.

Parity has been studied extensively as a risk factor for colorectal cancer but has not been definitively shown to be associated with altered risk. In a few studies, risk of colorectal cancer in childless men has been compared to risk in men with children, but results have not been consistent. We analyzed the association of fatherhood with risk of colorectal adenomas in male self-defense officials (ages 49-55) in Japan. The study participants received a preretirement health examination including flexible sigmoidoscopy at Self-Defense Forces hospitals in Japan from January 1991 through December 1992. The examinations identified 265 cases with rectal or sigmoid adenomas and 1480 controls with normal examinations up to 60 cm from the anus. Data on marital status, number of children, long-term work assignment away from wife and children, and other lifestyle variables were obtained by means of a self-administered questionnaire prior to physical examination. Multiple logistic regression analysis assessed the risk of adenomas in relation to number of children, marital status, long-term work assignment away from family, and military rank, with adjustment for cigarette smoking, alcohol intake, dietary variables, body mass index, and recreational physical activity. In this relatively homogeneous group, more than 98% of both cases and controls were currently married, and more than 93% had children. The adjusted odds ratio for the association of adenomas with fatherhood was 0.4 (95% confidence interval, 0.2-0.8). Marital status and work assignment away from the family were not associated with adenoma risk. These findings suggest that colorectal adenomas and perhaps cancer risk may be associated with childlessness in men.

Behavioral correlates of plasma sex hormones and their relationships with plasma lipids and lipoproteins in Japanese men.

In contrast to the hypothesis that endogenous testosterone decreases plasma high-density lipoprotein (HDL) cholesterol levels, many, but not all, studies have reported a positive correlation between plasma total testosterone and HDL cholesterol. We examined behavioral correlates of plasma testosterone and estradiol and the relationships between these sex hormones and plasma lipoproteins, in middle-aged Japanese men. Plasma, lipids, including HDL subfractions, total and free testosterone, and total estradiol were determined with 313 men aged 50-54 years who received a preretirement health examination at the Self-Defence Forces Fukuoka Hospital from January to June in 1992. Body mass index and waist-hip ratio were also measured. Smoking habit, alcohol use, and physical activity were ascertained by a self-administered questionnaire. Obesity, especially waist-hip ratio, was a strong correlate of both total and free testosterone, but not of estradiol. Smoking was associated with elevated levels of testosterone without a dose-effect relation. Neither alcohol use nor physical activity was associated with total or free testosterone, but plasma estradiol levels were higher among current alcohol drinkers. HDL and HDL2 cholesterol were unrelated to either total or free testosterone in the univariate analysis, but negatively associated with free, not total, testosterone after adjustment for obesity. HDL and HDL2 cholesterol also were positively associated with estradiol regardless of adjustment for obesity and other covariates. These findings add to evidence for a hypothesis that high levels of endogenous testosterone and low estradiol levels may cause a decrease in plasma HDL cholesterol, thereby being linked with atherosclerosis in middle aged men.

Lifestyle and glucose tolerance: a cross-sectional study of Japanese men.

The relationship of smoking, alcohol use, body mass index, and physical activity to glucose tolerance was studied in 2407 male self-defense officials aged 49-56 years who received a health examination before retirement at the Self-Defense Forces Fukuoka Hospital from October 1986 to December 1990. Body mass index (BMI) was significantly, positively related to impaired glucose tolerance (IGT) and noninsulin-dependent diabetes mellitus (NIDDM); after adjustment for rank of the Self-Defense Forces, smoking, alcohol use, prior diagnosis of diabetes mellitus, and parental history of the disease, odds ratios (ORs) of IGT and NIDDM for the highest (> or = 25.5 kg/m2) versus lowest (< 21.6 kg/m2) quintile of BMI were 4.2 [95% confidence interval (CI) 2.6-6.8] and 4.6 (95% CI 2.3-9.3), respectively. Cigarette smoking was weakly, positively associated with IGT and strongly so with NIDDM; adjusted ORs of IGT and NIDDM for 800 cigarette-years or more versus never smoking were 1.6 (95% CI 1.1-2.5) and 4.1 (95% CI 1.8-9.3), respectively. The prevalence of IGT and NIDDM tended to be decreased among men with high physical activity as measured by the time spent for vigorous exercise in leisure time. There was virtually no association between alcohol consumption and either IGT or NIDDM. The findings suggest that obesity and cigarette smoking are important factors in the development of glucose intolerance in middle-aged Japanese men.

Serum lipids and gallstone disease. A study of self-defense officials in Japan.

Based on screening ultrasonography of the gallbladder in 2756 men who received a retirement health examination at the Self-Defense Forces Fukuoka Hospital, Japan, during the period of 1986 to 1990, we compared serum lipid levels among 61 men with gallstones, 38 who had the gallbladder removed previously, and 2494 with a normal gallbladder. In univariate analysis, men having gallstones and those who had had a cholecystectomy had lower concentrations of total and low-density-lipoprotein (LDL) cholesterol than did control subjects, although the differences were not statistically significant. After adjustment for body mass index, smoking, alcohol use, and glucose tolerance, inverse associations of cholecystectomy with total and LDL cholesterol levels were more pronounced and statistically significant. There was no appreciable difference in high-density-lipoprotein (HDL) cholesterol and triglycerides between control subjects and men either with gallstones or after cholecystectomy. The present study did not support a positive relation between gallstones and serum triglyceride levels and an inverse one to HDL cholesterol, which have been reported elsewhere. The findings on total and LDL cholesterol are consistent with some, but not all recent studies.

Relationship of cigarette smoking, alcohol use, and dietary habits with sigmoid colon adenomas.

The relationship between cigarette smoking, alcohol use, and dietary factors and the risk of adenomas of the sigmoid colon was examined in male self-defense officials who received a preretirement health examination at three Self-Defense Forces hospitals in Japan. In the comparison between 228 patients with sigmoid adenomas and 1484 control subjects with normal colonoscopy findings (> or = 60 cm from the anus), a clear dose-response relationship was observed between cigarette smoking and risk of adenoma. After adjustment for rank, body mass index, alcohol use, and physical activity as well as for hospital and survey season, the odds ratios (and 95% confidence intervals (CIs)) for the categories of 0, 1 to 399, 400 to 799, and 800 or more cigarette-years were 1.0, 2.1 (1.2 to 3.5), 2.8 (1.8 to 4.3), and 3.5 (2.1 to 5.8), respectively. Current alcohol drinkers tended to have an increased risk, but without a dose-response relation. Among four types of alcoholic beverages (shochu, sake, beer, and whiskey), only whiskey showed a weak association with risk of adenoma. None of the 13 dietary items studied (including meat and rice consumption) was measurably associated with adenoma risk. The present findings provide additional evidence that cigarette smoking is a risk factor for colon adenomas. It is inconclusive regarding alcohol intake's association with adenoma risk.

Coffee drinking and serum gamma-glutamyltransferase: an extended study of Self-Defense Officials of Japan.

PURPOSE: To examine the effect of coffee drinking on serum gamma-glutamyltransferase (GGT) level in relation to alcohol drinking, smoking, and degree of obesity in middle-aged Japanese men. METHODS: From 1986 to 1994, a total of 7,637 male officials of the Self-Defense Forces of Japan aged 48-59 years received a preretirement health examination. Coffee drinking was ascertained by a self-administered questionnaire, and serum GGT level was measured. After excluding 1,360 men with a possible pathologic condition influencing liver enzyme levels and 182 former alcohol drinkers, effect of coffee drinking on serum GGT was examined by a multiple linear regression model and analysis of variance adjusting for alcohol drinking, smoking, and body mass index (BMI). RESULTS: The adjusted percentage of difference in serum GGT was -4.3 (95% CI = -5.0; -3.5) per cup of coffee. The inverse coffee-GGT relation was most prominent among men drinking > or = 30 ml of ethanol and smoking > or = 15 cigarettes daily; and positive associations of alcohol and smoking with GGT were attenuated by coffee drinking, more clearly among men with BMI > or = 25.00 kg/m2. Adjusted percentages of difference in serum GGT were -2.6% (p = 0.0003) per cup of brewed coffee, and -5.1% (p = 0.0001) per cup of instant coffee, independently of each other. CONCLUSIONS: The present study suggests that coffee consumption may weaken GGT-induction by alcohol, and possibly by smoking. These effect modifications by coffee may differ according to the degree of obesity.

Physical activity, dietary habits and adenomatous polyps of the sigmoid colon: a study of self-defense officials in Japan.

Physical activity and dietary habits were compared between 80 men with adenomatous polyps of the sigmoid colon and 1148 men with normal colonoscopy among male retiring self-defense officials. Physical activity as expressed in terms of time spent doing strenuous activities during leisure time was inversely related to the risk of adenomatous polyps. Controlling for rank, smoking, alcohol and body mass index (BMI), odds ratios for the categories of 0, 1-59, 60-119 and greater than or equal to 120 minutes per week were 1.0, 0.88, 0.70 and 0.44, respectively (trend p = 0.015). Among a limited range of foods and beverages, the consumption of rice, green tea and instant coffee tended to be associated with a decreased risk of adenomatous polyps. Although the associations observed with dietary habits still need to be substantiated, the findings on physical activity lend further evidence to the hypothesis that physical activity may be protective in the development of colon cancer.

Coffee consumption and serum aminotransferases in middle-aged Japanese men.

We investigated the relation between coffee drinking and serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations among 7313 Japanese men receiving a health examination, excluding former alcohol drinkers and men with a history of chronic liver disease. Serum AST > 40 and/or ALT > 40 U/L was defined as liver inflammation. Adjustment was made for alcohol use, smoking, body mass index, serum marker for hepatitis virus infection, and other possible confounders. Adjusted odds ratios of liver inflammation were 1.00 (reference), 0.80, 0.69, and 0.61 for men drinking < 1, 1-2, 3-4, and > or = 5 cups of coffee daily, respectively. Among 6898 men without liver inflammation, serum AST and ALT were inversely associated with coffee consumption, and alcohol-related rise in AST was attenuated with coffee drinking. These findings suggest coffee may have an effect of suppressing the rise of serum aminotransferase, partly by inhibiting the alcohol-related elevation. Studies regarding biological mechanism are warranted.

Alcohol consumption and blood pressure: an extended study of self-defence officials in Japan.

BACKGROUND: It remains controversial whether the relation between alcohol intake and blood pressure is linear or non-linear. METHODS: The relation between alcohol intake and blood pressure was investigated in 2341 male self-defence officials who received a preretirement health examination at the Self-Defense Forces Fukuoka Hospital between October 1986 and December 1990. Average alcohol intake in the past year was ascertained by a self-administered questionnaire. The study excluded past drinkers, and allowed for smoking, body mass index and glucose tolerance. RESULTS: Blood pressure was higher at higher levels of alcohol intake across the range from 0 to 40-59 ml of alcohol per day, but was not progressively higher in men consuming > or = 60 ml per day. Blood pressure was significantly higher even among light drinkers (< 20 ml per day) compared to non-drinkers; adjusted mean differences were 3.1 mmHg (95% confidence interval (CI): 1.1-5.2) in systolic pressure and 2.1 mmHg (95% CI: 0.7-3.5) in diastolic pressure. CONCLUSIONS: Our findings do not support the existence of a threshold in the relation between alcohol and blood pressure.

Behavioural and biological correlates of serum uric acid: a study of self-defence officials in Japan.

BACKGROUND: In Japan epidemiological data on correlates of serum uric acid are sparse. METHODS: Behavioural and biological correlates of serum uric acid were investigated in 2487 men who received a retirement health examination at the Self-Defence Forces Fukuoka Hospital from October 1986 through 1990, excluding those under medication for hyperuricaemia, hypertension or hyperlipidaemia. RESULTS: Multiple regression analysis demonstrated that serum creatinine was the strongest correlate followed by serum triglycerides, body mass index and diastolic blood pressure; these four variables accounted for 16% of the overall variation in serum uric acid. Serum total cholesterol, alcohol intake and past smoking were positively associated with serum uric acid levels while diabetes mellitus and serum high density lipoprotein (HDL) cholesterol were negatively related to serum uric acid; these five variables additionally explained 2% of the variation. Although an independent impact was minimal, beer consumption was significantly associated with an elevated level of serum uric acid after allowing for the previously mentioned correlates. CONCLUSIONS: Serum creatinine and triglycerides are major correlates of serum uric acid in Japanese men. Our data add to the body of evidence suggesting that weight control, avoiding excessive drinking and adequate control of hypertension are beneficial in the prevention of hyperuricaemia.

Alcoholic beverages and adenomatous polyps of the sigmoid colon: a study of male self-defence officials in Japan.

The drinking habits of 86 men with adenomatous polyps of the sigmoid colon were compared to those of 1184 men with normal colonoscopy among middle-aged male self-defence officials. After adjustment for rank, smoking history and rice consumption, total ethanol intake was positively associated with the risk of adenomatous polyps. The odds ratio (OR) was 2.4 (95% confidence interval (CI) 1.0-5.5) for men consuming at least 60 ml of ethanol per day. Among five alcoholic beverages (shochu, beer, sake, whiskey and wine), both sake and beer showed a dose-response relationship with the risk of adenomatous polyps although the association with beer was less striking. Shochu was the largest source of ethanol intake in the study population, but there was virtually no association between shochu consumption and adenomatous polyps. Men drinking wine had a significantly increased risk, but these men were too few to examine the relation in detail. The findings suggest that the consumption of specific alcoholic beverages rather than ethanol itself is associated with an increased risk of adenomatous polyps of the sigmoid colon.

Relationship of alcohol consumption and smoking to plasma cortisol and blood pressure.

The role of plasma cortisol in the relationship of alcohol consumption and smoking with BP was investigated in a study of 297 Japanese men, aged 50-54 years, who were not receiving antihypertensive agents. They were admitted to the Self-Defense Forces Fukuoka Hospital between January and June 1992 for a detailed pre-retirement health examination. A history of alcohol consumption and cigarette smoking were determined from a self-administered questionnaire. The plasma level of cortisol and BP were determined in the morning of the first admission day. While the plasma level of cortisol was positively related to systolic and diastolic BP, cortisol levels did not vary substantially with alcohol consumption. Both BP and plasma cortisol levels were lower among current smokers than nonsmokers. The lower BP observed among current smokers was ascribed in part (about 20-30%) to the plasma cortisol levels. While the cortisol levels may contribute the lower BP among current smokers, the data did not support its role in mediating the alcohol-BP relationship.

Lifestyles, glucose tolerance and blood pressure in male self-defence officials in northern Kyushu, Japan.

Evidence on determinants of BP is mostly derived from studies in western populations. The relationship of BP with lifestyle variables and glucose tolerance was studied in 1,302 male self-defence officials aged 49-56 years who received a health examination before retirement at the Self-Defense Forces Fukuoka Hospital from October 1986 to December 1988. Those with treated hypertension or diabetes mellitus and those with conditions affecting BP levels were excluded from the study. In multiple regression analysis, alcohol use, body mass index and glucose intolerance were strongly associated with elevated BP while there was an inverse relation between cigarette smoking and BP. Physical activity expressed as the time spent in vigorous exercise was not associated with either systolic or diastolic BP. These findings indicate that alcohol use, obesity and glucose intolerance are also important determinants of BP in male Japanese, and that cigarette smoking is a potential covariate in the study of BP.

Bioavailability of rumen bacterial selenium in mice using tissue uptake technique.

A tissue uptake experiment was conducted to determine the bioavailability of rumen bacterial Selenium (Se) in mice. The donor animal was wether fed a diet containing 0.2 mg Se/kg dietary dry matter (DM). Ruminal fluid was collected 2 h postprandially. Bacterial-rich precipitate was obtained by differential centrifugation of the ruminal fluids. This was later freeze-dried and mixed in the diet to be used in feeding the mice experiment. Thirty growing female mice with a body wt (mean +/- SD) of 21.4 +/- 0.74 g were housed in plastic cages (5 mice/cage) and allotted equally to three dietary treatments. Diet 1 and Diet 2 were formulated based on AIN-76, except that no Se supplementation in the form of selenite was made in the former. In Diet 3, rumen bacterial matter was 20% of the diet, which gave an equivalent of 0.1 mg Se/kg dietary DM. The other two diets, Diet 1 and Diet 2, had an Se content of 0.025 and 0.1 mg/kg dietary DM, respectively. A 7-d feeding commenced after 7 d of acclimatization of the semipurified diet. Results showed that those mice fed an Se- (selenite) supplemented diet (Diet 2) had higher (P < 0.05) tissue Se concentrations than those mice fed the other two diets. No statistical differences were observed on various tissue Se concentrations between Diet 1 and Diet 3, although the latter diet had higher values. Kidney and liver had the highest Se concentrations compared to the other tissues. This study concludes that bacterial Se collected from the rumen of wether is not fully available for absorption in the intestine of the mice.

Relationship of diet to small and large adenomas of the sigmoid colon.

The relation of dietary factors to the risk of adenomas of the sigmoid colon was examined in men receiving a retirement health examination at the Self-Defense Forces Fukuoka Hospital between October 1986 and 1990. A total of 187 adenoma cases and 1557 controls with normal colonoscopy were identified in the series. Cases were further classified into small-adenoma (< 5 mm, n = 78) and large-adenoma (> or = 5 mm, n = 67) groups. The consumptions of selected foods and beverages were ascertained before colonoscopy by means of a self-administered questionnaire. After adjustment for smoking, alcohol use, rank and body mass index, low rice consumption and high meat intake were independently associated with an increased risk of large adenomas. The risk of small adenomas was not related to either rice consumption or meat intake. Adjusted odds ratios of large adenomas for the low, intermediate and high consumption levels of rice were estimated to be 1.0 (referent), 0.83 and 0.43, respectively (trend P = 0.08), and the corresponding figures for meat consumption were 1.0 (referent), 1.58 and 2.38, respectively (trend P = 0.02). The findings suggest that low rice consumption and high meat intake may promote the growth of colon adenomas, thereby increasing the risk of colon cancer.

Serum lipids and left-sided adenomas of the large bowel: an extended study of self-defense officials in Japan.

In the on-going study of men retiring from the Self-Defense Forces in Japan, we previously reported that serum total cholesterol was not related to colorectal adenomas but that men with low levels of serum high-density lipoprotein (HDL) cholesterol had an elevated adenoma risk. We examined whether the previous observation was reproducible in a different set of data accrued subsequently in the study. Serum total cholesterol, HDL-cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides were compared between 138 cases of colorectal adenomas at the depth of 60 cm or less from the anus and 909 controls with normal sigmoidoscopy in the period from October 1988 to December 1990. There was virtually no relation between adenoma risk and any of the serum lipids studied with or without adjustment for smoking, alcohol use, and body mass index. In the analysis combining the earlier and present data, however, men with large adenomas (> or = 10 mm, n = 25) tended to have lower levels of total cholesterol and LDL-cholesterol compared with controls (n = 1,612); adjusted mean differences were -0.21 mmol/l (P = 0.24) and -0.26 mmol/l (P = 0.13), respectively. These findings are inconclusive, but hypocholesterolemia may be associated with the growth of colorectal adenoma.

Relationship of cigarette smoking, alcohol use, and dietary habits with Helicobacter pylori infection in Japanese men.

BACKGROUND: Little is known of factors determining infection with Helicobacter pylori. METHODS: In a cross-sectional study of 566 men aged 50-55 years, who received a preretirement health examination at the Self Defense Forces Fukuoka Hospital between January 1993 and December 1994, we examined the association of smoking, alcohol use, and dietary habits with H. pylori infection. RESULTS: The overall seropositivity as determined with IgG antibody was 79.3% (449 of 566). The rank was inversely associated with the infection (trend, P = 0.048). Neither smoking nor alcohol drinking was related to the infection. The prevalence adjusted for rank tended to be lower in men consuming raw vegetables (trend, P = 0.12) daily than those with less consumption. Unexpectedly, the consumption of tofu (soybean curd) was significantly, negatively related to the infection (trend, P = 0.013). The seropositivity was unrelated to the consumption of pickled vegetables, soy paste soup, green tea, or garlic. CONCLUSION: The findings suggest that fresh vegetables may be protective against H. pylori infection. The study does not support either an increased risk of the infection associated with salty foods or a protective effect of green tea or garlic.

Coffee and serum gamma-glutamyltransferase: a study of self-defense officials in Japan.

The relation of coffee drinking and other behavioral factors to serum gamma-glutamyltransferase (GGT) was examined in 2,494 male self-defense officials aged 48-56 years, who received a retirement health examination at the Self-Defense Forces Fukuoka Hospital between October 1986 and December 1990. Coffee, but not green tea, consumption was inversely related to serum GGT independently of body mass index, alcohol use, and smoking. All of the latter variables were also independently and positively associated with serum GGT. Lower levels of serum GGT associated with coffee drinking were more evident among heavier alcohol drinkers and also among heavier smokers. The findings suggest that coffee may inhibit the inducing effects of alcohol and possibly of smoking upon GGT in the liver.

Epidemiology of gallbladder polyps: an ultrasonographic study of male self-defense officials in Japan.

The prevalence and risk factors of gallbladder polyps diagnosed by ultrasonography were investigated in 2739 male self-defense officials who received a retirement health examination at the Self-Defense Forces Fukuoka Hospital, Japan, between October 1986 and December 1990. Excluding 38 men whose gallbladder had been removed previously, 143 men were found to have gallbladder polyps. The overall prevalence of gallbladder polyps was 5.3%. The relation between gallbladder polyps and smoking, alcohol use, body mass index, glucose tolerance, and serum lipids was examined in 137 men with stoneless polyps and 2495 normal subjects. Whereas smoking tended to be inversely associated with gallbladder polyps, none of the other lifestyle and clinical variables were related to this condition. Thus the reported risk factors of gallstones had no relation to gallbladder polyps.

Risk of gallstones following gastrectomy in Japanese men.

The risk of gallstones developing after gastrectomy in middle-aged Japanese men was investigated in a study of 2,738 men aged between 48 and 56 years who underwent both gallbladder ultrasonography (US) and a barium study of the upper digestive tract. It was revealed that 61 men had gallstones, 37 had had their gallbladder removed previously, and 55 had a history of gastrectomy. The prevalence of gallstones was 3.5 times higher in the men who had previously undergone gastrectomy (7.7%) than in those who had not (2.2%) (P = 0.03). Moreover, gallstones tended to be more prevalent in those who had undergone Billroth II gastrectomy (12.5%) compared with those who had undergone Billroth I gastrectomy (5.6%); however, the difference was not significant. These results indicate that gastrectomy using either Billroth I or Billroth II reconstruction predisposes to gallstone formation. Nevertheless, it was estimated that prior gastrectomy was responsible for no more than 5% of gallstones in the study population.