Impact of single nucleotide polymorphism on short stature and reduced tongue pressure among community-dwelling elderly Japanese participants: a cross-sectional study.

BACKGROUND: Asian-specific single nucleotide polymorphism (SNPs) (rs3782886) is reported to be associated with myocardial infarction; sarcopenia is reported to be associated with coronary subclinical atherosclerosis. On the other hand, short stature has been revealed as an independent risk factor for cardiovascular disease. However, no studies have reported on the association between sarcopenia and short stature nor on the impact of rs3782886 on this association. METHODS: Since reduced maximum voluntary tongue pressure against the palate (MTP) reflects one aspect of sarcopenia, we conducted a cross-sectional study of 537 community-dwelling elderly Japanese participants aged 60-89 years who had participated in a general health checkup in 2015. Short stature was defined as values at or under the 25th percentile, and reduced MTP was defined as the lowest tertile of the study population (<158.0 cm and <26.5 kPa for men, <145.0 cm and <24.1 kPa for women). RESULTS: Independent of classical cardiovascular risk factors, short stature was revealed to be positively associated with reduced MTP. The adjusted-odds ratio (OR) and 95% confidence interval (CI) of reduced MTP for short stature was 1.87 (1.19, 2.94). We also found that independent of known cardiovascular risk factors, with the non-minor homo of rs3782886 taken as the reference group, the adjusted OR and 95% CI for short stature and reduced MTP of the minor homo allele were 3.06 (1.23, 7.63) and 3.26 (1.33, 8.03), respectively. CONCLUSION: Short stature is independently associated with reduced MTP, with Asian-specific SNPs possibly playing an important role in this association.

Triglycerides and blood pressure in relation to circulating CD34-positive cell levels among community-dwelling elderly Japanese men: a cross-sectional study.

BACKGROUND: Triglycerides are reported to be positively associated with blood pressure (both systolic and diastolic). However, in a previous study, we reported a significant positive association between triglycerides and circulating CD34-positive cells (endothelial repair) among non-hypertensive, but not hypertensive, participants. Since hypertension and endothelial dysfunction have a bi-directional association (vicious cycle), the status of circulating CD34-positive cells may influence the association between triglycerides and hypertension. METHODS: Since antihypertensive medication use may influence results of the present study, we conducted a cross-sectional study of 327 community dwelling elderly (aged 60-69 years) Japanese participants who were not taking anti-hypertensive medication and who had participated in a general health check-up in 2013-2015. RESULTS: Participants were classified into two groups based on median values of circulating CD34-positive cells (0.93 cells/µL). For participants with lower circulating CD34-positive cells (n = 165), a significant positive association was seen between triglycerides and blood pressure, but not for participants with higher circulating CD34-positive cells (n = 162). The multivariable standardized parameter estimates (ß) and p values of systolic blood pressure and diastolic blood pressure were 0.23 (p = 0.007) and 0.18 (p = 0.036) for participants with lower circulating CD34-positive cells and 0.08 (p = 0.409) and 0.03 (p = 0.786) for those with higher circulating CD34-positive cells. CONCLUSION: A significant positive association between triglycerides and blood pressure exists among those with lower, but not higher, circulating CD34-positive cells. The level of circulating CD34-positive cells acts as a determinant factor for the association between triglycerides and blood pressure.

Multiple somatic symptoms and frailty: cross-sectional study in Japanese community-dwelling elderly people.

BACKGROUND: Physical frailty is relevant to adverse outcomes, but appropriate procedures for screening populations are lacking. We hypothesized that frailty is associated with multiple somatic symptoms because frail elderly people might have several somatic symptoms attributed to deterioration of multiple organs. OBJECTIVE: To examine the association between multiple somatic symptoms and frailty. METHODS: We conducted a cross-sectional study and enrolled 1818 participants aged ≥60 years from Japanese national medical check-up in 2015. Frailty status was categorized into frail, pre-frail or non-frail based on the definition of the Fried frailty phenotype model. Sixteen self-reported subjective somatic symptoms were recorded at the timing of medical check-up. Odds ratio (OR) and 95% confidence interval (CI) of frail or pre-frail were analyzed using number of somatic symptoms. RESULTS: Out of total of 1818 subjects, 44 (2.4%) frail subjects, 635 (34.9%) pre-frail subjects and 1139 (62.7%) non-frail subjects were detected. More than two somatic symptoms were significantly associated with the frail phenotype (OR 6.20, 95% CI 2.95, 13.03, P < 0.001) and were associated with the pre-frail phenotype (OR 2.06, 95% CI 1.69, 2.51, P < 0.001). Associations remained significant after multi-adjustment for age, sex, past medical cardiovascular diseases and depressive mood The number of somatic symptoms ≥2 was thought to be the optimal cut-off point to predict frail with a sensitivity of 79.6%, specificity of 61.5%. CONCLUSIONS: Our study shows that multiple somatic symptoms are independently associated with frailty. Using more than two multiple somatic symptoms as a prescreening tool for frailty may be appropriate.

Short stature is an inflammatory disadvantage among middle-aged Japanese men.

OBJECTIVES: A positive association between white blood cell count and carotid atherosclerosis has been reported. Our previous study also found an inverse association between height and carotid atherosclerosis in overweight but not non-overweight men. However, no studies have reported on the association between high white blood cell (WBC) count and height accounting for body mass index (BMI) status. METHODS: We conducted a hospital-based general population cross-sectional study of 3016 Japanese men aged 30-59 years undergoing general health check-ups between April 2013 and March 2014. High WBC count was defined as the highest tertiles of WBC count among total subjects. RESULTS: Independent of classical cardiovascular risk factors, height was found to be inversely associated with high WBC count, especially for subjects with a BMI ≥ 23 kg/m2. The classical cardiovascular risk factors adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) of high WBC count for an increment of one standard deviation (SD) in height (5.7 cm) were 0.91 (0.83-0.99) for total subjects, 1.00 (0.86-1.15) for subjects with a BMI < 23 kg/m2 and 0.86 (0.77-0.96) for subjects with a BMI ≥ 23 kg/m2. CONCLUSION: Independent of classical cardiovascular risk factors, height was found to be inversely associated with high WBC count, especially for those with a BMI ≥ 23 kg/m2. Compared to high stature, short stature appears to convey an inflammatory disadvantage among Japanese men, especially those with a BMI ≥ 23 kg/m2.

Serum triglyceride levels in relation to high-density lipoprotein cholesterol (TG-HDL) ratios as an efficient tool to estimate the risk of sleep apnea syndrome in non-overweight Japanese men.

OBJECTIVES: Several studies have reported the association between sleep apnea syndrome and insulin resistance. Being overweight is known risk factor both for sleep apnea syndrome and insulin resistance. However, no studies have reported on the association between serum triglyceride levels in relation to high-density lipoprotein cholesterol (TG-HDL) ratios (a marker of insulin resistance) and sleep apnea syndrome accounting for body mass index (BMI) status. METHODS: Subjects for the present cross-sectional study consisted of 1,528 men aged 30-69 years undergoing pulse oximetry at a sleep disorders clinic for sleep apnea syndrome. Sleep apnea syndrome was diagnosed as a 3 % oxygen desaturation index (ODI) of ≥15 events/h. RESULTS: Among study participants, 241 men were diagnosed with sleep apnea syndrome. Independent of classical cardiovascular risk factors, TG-HDL was significantly positively associated with sleep apnea syndrome in participants with a BMI <25 kg/m2, but not in participants with a BMI ≥25 kg/m2. The multivariable adjusted odds ratio (OR) and 95 % confidence interval (95 % CI) of sleep apnea syndrome per Log TG-HDL was 2.03 (95 % CI: 1.36-3.03) for a BMI <25 kg/m2 and 1.23 (95 % CI: 0.89-1.70) for a BMI ≥25 kg/m2. CONCLUSIONS: An independent positive association between TG-HDL levels and risk of sleep apnea syndrome was observed in participants with a BMI of <25 kg/m2, but not in participants with a BMI ≥25 kg/m2. TG-HDL levels could be an efficient tool to estimate the risk of sleep apnea syndrome in non-overweight Japanese men.

Height and drinking status in relation to risk of anemia in rural adult healthy Japanese men: the Nagasaki Islands study.

BACKGROUND: Several studies have reported that height is inversely associated with risk of cardiovascular disease but positively associated with cancer risk. On the other hand, evidence has been accumulating that anemia reflects poor health and increased vulnerability to poor outcomes in older persons. Moreover, alcohol consumption has also been reported to be associated with mortality. However, no studies have reported on a possible association between height and risk of anemia in relation to drinking status. METHODS: We conducted a cross-sectional study of 1287 men aged 40-89 years undergoing general health check-ups. RESULTS: Independent from classic cardiovascular risk factors, we found a significant inverse association between height and anemia for non-drinkers and a J-shaped association for drinkers. The multivariable odds ratio (ORs) of an increment of 1 SD (standard deviation) in height (6.68 cm) for anemia for non-drinkers was 0.59 (0.45-0.77). For drinkers, with the second quartile of height (Q2) as the reference group, the multivariable OR of anemia was 2.68(0.90-7.96) (p = 0.075) for the lowest height quartile (Q1), 2.73(0.92-8.08) for the third quartile (Q3) and 4.82(1.65-14.10) for the highest quartile (Q4) (p = 0.004). CONCLUSION: Height was found to be associated with anemia for rural Japanese men and drinking status is likely to affect those associations.

Free thyroxine (FT4) and anemia in relation to drinking status of Japanese men: the Nagasaki islands study.

It is well known that hypothyroidism is associated with anemia. It has also been reported that alcohol consumption may affect thyroid function. Furthermore, hemoglobin levels of drinkers are reportedly higher than those of non-drinkers. However, no published study has investigated the association between thyroid function evaluated with the free thyroxine (FT4) test and anemia while taking drinking status into account. We conducted a cross-sectional study of 843 men aged 30-89 years undergoing general health checks. While no significant associations were noted between FT4 and anemia for total subjects, when the analysis was limited to non-drinkers, a significant association was observed. After adjustment for classical cardiovascular risk factors and thyroid stimulating hormones (TSH), adjusted odds ratio (OR) and 95% confidence interval (CI) for an increment of 1SD (standard deviation) for FT4 (0.17 ng/dL) for anemia were 0.85 (0.67-1.09) for total subjects, 0.59 (0.41-0.85) for non-drinkers, and 1.23 (0.83-1.83) for drinkers. In conclusion, FT4 is inversely associated with anemia for non-drinking but not for drinking men. However, drinking may act as a confounding factor for this association.

Effects of smoking cessation on gastric emptying in smokers.

BACKGROUND: Smoking cessation can lead to changes in appetite and weight gain in some patients; thus, smoking cessation may alter gastrointestinal motility. Effects of smoking cessation on gastric emptying in smokers have not been established. AIM: This study sought to determine how smoking cessation affects gastric emptying in smokers. METHODS: Participant group comprised 53 habitual smokers and 12 healthy nonsmokers. Habitual smokers were treated for 2 months with transdermal nicotine patches. Gastric emptying was studied using C acetate breath tests at the beginning of the study, and at 1 week and 9 weeks after cessation of patch use. Maximal CO2 excretion time (Tmax), CO2 excretion half-life (T1/2), and parameters beta and kappa, representing initial and subsequent gastric-emptying phases, respectively, were determined using conventional formulae. RESULTS: Before smoking cessation, Tmax was reached significantly later in smokers (0.94+/-0.3 h, P=0.014) than in controls (0.89+/-0.1 h). At 1 week after the end of treatment, Tmax was significantly decreased (from 1.05+/-0.32 h to 0.72+/-0.64 h, P=0.003). T1/2 also tended to decrease, but not significantly. Although beta was decreased significantly (from 2.46+/-0.40 to 2.17+/-0.58, P=0.022), kappa was unchanged. However, by 9 weeks after the end of treatment, Tmax (1.28+/-0.69 h) had increased to levels seen before treatment. CONCLUSIONS: Smoking cessation temporarily accelerates gastric emptying, and decreases in beta suggest that initial-phase gastric emptying accelerates after smoking cessation. The temporary acceleration of gastric emptying after smoking cessation may be involved in the temporary increase in appetite and weight gain seen after smoking cessation.

White blood cell count and cardiovascular biomarkers of atherosclerosis.

OBJECTIVE: To investigate the association with white blood cells (WBC) and atherosclerotic parameters including cardio-ankle vascular index (CAVI) and carotid intima-media thickness (CIMT) in the general population. METHODS: We investigated the relationship between WBC count and metabolic syndrome components, CAVI and CIMT in 3738 Japanese study participants. RESULTS: WBC count weakly correlated with CAVI in men (beta = 0.61, p = 0.043), but not in women (beta = 0.35, p = 0.17). On the other hand, WBC did not correlate with CIMT in either men or women (p = 0.41 and p = 0.71, respectively). CONCLUSION: WBC count was associated with lipids, blood pressure and body mass index, although the correlations with CAVI and CIMT were weak or absent.

Leptin to high-molecular-weight adiponectin ratio is independently correlated with carotid intima-media thickness in men, but not in women.

BACKGROUND: The leptin:adiponectin ratio (L:A ratio) is an independent predictor of carotid intima-media thickness (CIMT). OBJECTIVE: To evaluate whether the leptin:high-molecular-weight adiponectin ratio (L:HA ratio) is associated with CIMT in the general population. METHODS: We investigated the relationship between the L:HA ratio and CIMT in 233 Japanese study participants (106 men and 127 women). RESULTS: After adjustment for confounding factors, CIMT was significantly correlated with the log L:HA ratio (beta = 0.11, p = 0.014) in men, whereas no correlation was observed in women (beta = 0.01, p = 0.50). CONCLUSION: The L:HA ratio is closely correlated with CIMT in men, but not in women.

Possible mechanism underlying the association between height and vascular remodeling in elderly Japanese men.

Height is reported to be inversely associated with cardiovascular disease. And platelets play an important role in vascular remodeling by supporting CD34-positive cells. To clarify the association between height and platelet, we conducted a cross-sectional study of 219 elderly Japanese men. Since hemoglobin concentration is influenced by vascular remodeling activity, an analysis stratified by hemoglobin level was performed. An inverse association was seen between height and platelet count in subjects with a high hemoglobin concentration (≥ 14.5 g/dL), but not in subjects with a low hemoglobin concentration (< 14.5 g/dL). The standardized parameter estimates (ß) were ß = -0.22, p = 0.019 for subjects with high hemoglobin, and ß = -0.01, p = 0.931 for subjects with low hemoglobin. We also found a positive association between platelets and carotid intima media thickness (CIMT) and circulating CD34-positive cells in subjects with high hemoglobin (partial correlation coefficient (r) = 0.21, p = 0.037 and r = 0.40, p =< 0.001), but not in subjects with low hemoglobin (r = 0.04, p = 0.710 and r = 0.06, p = 0.544). In subjects with a high hemoglobin concentration, platelets were inversely associated with height, and positively associated with CIMT and circulating CD34-positive cells. These results indicate that subjects with a short stature activate vascular remodeling to a much greater extent than subjects with a tall stature.

Serum sodium level within the normal range is associated with maximum voluntary tongue pressure against the palate among community-dwelling older Japanese men.

AIM: Recent geriatric studies have focused on maximum voluntary tongue pressure against the palate (MTP) as a diagnostic value for dysphagia, as dysphagia causes aspiration pneumonia. Dysphagia can also cause water intake difficulties, resulting in hypernatremia by indicating the presence of hyperosmotic dehydration. However, no studies have reported on a possible association between reduced MTP and serum sodium levels. METHODS: To evaluate hyperosmotic dehydration within the normal range as an indicator of reduced MTP, we carried out a cross-sectional study of 655 older Japanese community-dwelling men (age ≥60 years) who undertook a general health check-up from 2015 to 2016. As a high concentration of glucose influences serum osmolarity, which might act as a strong confounding factor on this association, the additional analysis was limited to individuals without diabetes. Reduced MTP is defined as a tongue pressure at or under the 20th percentile of the study population (≤24.0 kPa). RESULTS: Independent of classical cardiovascular risk factors, the adjusted odds ratio of reduced MTP for a 1-standard deviation increment of serum sodium (2.21 mEq/L) was 1.29 (95% confidence interval 1.10-1.52). When the analysis was limited to individuals without diabetes, the association became slightly stronger, with an adjusted corresponding value of 1.59 (95% confidence interval 1.21-2.10). CONCLUSIONS: Serum sodium level within the normal range is independently associated with reduced MTP in older Japanese men. This finding suggests that measuring the MTP is clinically relevant for estimating the pathophysiological values (such as dysphagia risks and aspiration pneumonia risks) in daily clinical practice. Geriatr Gerontol Int 2018; 18: 183-186.

Validity of maximum isometric tongue pressure as a screening test for physical frailty: Cross-sectional study of Japanese community-dwelling older adults.

AIM: Maximum isometric tongue pressure (MIP) seems to have a diagnostic value for oral phase dysphagia. The present study aimed to examine the association between MIP and frailty, and to assess the screening validity of MIP for physical frailty. METHODS: We carried out a cross-sectional study, and enrolled participants aged ≥60 years from Japanese national medical check-ups in 2015 and 2016. The Fried frailty phenotype model was used. We analyzed odds ratios (OR) and 95% confidence intervals (CI) of physical frailty using one standard deviation increments of tongue pressure. Receiver operating characteristic curves were obtained to predict physical frailty using MIP values. RESULTS: Out of 1603 participants, 968 were categorized as non-frail, 605 as pre-frail and 30 as frail. In logistic regression analysis, one standard deviation increment of MIP significantly differentiated frail and pre-frail: the OR for frail with one standard deviation increment in MIP was 0.37 (95% CI 0.26-0.54, P < 0.001), and the OR for pre-frail was 0.63 (95% CI 0.57-0.70, P < 0.001). The area under the receiver operating characteristic curve for predicting frailty with MIP score was as high as 0.776 (95% CI 0.689-0.862). A point of MIP 35 kPa had a sensitivity of 90.0%, specificity of 40.4%, a positive likelihood ratio of 1.5 and a negative likelihood ratio of 0.2 for predicting frailty. CONCLUSIONS: MIP performance is independently associated with frailty. MIP also can be used as a simple screening tool for frailty. Geriatr Gerontol Int 2018; 18: 240-249.

Possible mechanism underlying the association between higher hemoglobin level and hypertension in older Japanese men.

AIM: Hemoglobin is reported to be positively associated with hypertension. However, the underlying mechanism of this association is unknown. Recently, bone marrow-derived CD34-positive cells have been reported to play an important role in endothelial repair in conjunction with platelets. As the association between hypertension and endothelial dysfunction is bidirectional, the influence of endothelial repair also might strongly influence the association between hemoglobin and hypertension. METHODS: To clarify the clinical importance of the hematological parameter on endothelial maintenance in older men, we carried out a cross-sectional study of 222 Japanese men aged 60-69 years undergoing a general health checkup. RESULTS: For participants with a lower platelet count (≤21.0/µL), hemoglobin was significantly positively associated with hypertension, but not for participants with a higher platelet count (>21.0/µL). The classical cardiovascular risk factor adjusted odds ratio of hypertension for 1-standard deviation increment of hemoglobin (1.0 g/dL) was 2.09 (95% CI: 1.26, 3.48) for participants with a lower platelet count, and 1.07 (95% CI: 0.68, 1.67) for participants with a higher platelet count. We also found that although there was no significant correlation between hemoglobin and circulating CD34-positive cells for participants with a lower platelet count (ß = -0.06, P = 0.603), a significant positive correlation was seen for participants with a higher platelet count (ß = 0.29, P = 0.004). CONCLUSIONS: The positive association between hemoglobin and hypertension was limited to participants with a lower platelet count as a result of insufficient endothelial repair. These results represent an efficient tool for clarifying the mechanism of endothelial maintenance that correlates with hypertension. Geriatr Gerontol Int 2017; 17: 2586-2592.

Height is an indicator of vascular maintenance capacity in older men.

AIM: Bone-derived circulating CD34-positive cells are reported to play an important role in vascular maintenance. Additionally, height might influence age-related hematopoietic bone marrow decline, as it positively correlates with total bone marrow volume. As hypertension should mask the beneficial effects of circulating CD34-positive cells, hypertension status should account for this correlation. The present study aimed to clarify the clinical importance of height on vascular maintenance in older Japanese men. METHODS: We carried out a cross-sectional study of 343 older men aged 65-69 years who underwent a general health checkup from 2013 to 2015. RESULTS: Independent of known cardiovascular risk factors, height was found to be slightly, but significantly, positively correlated with the log number of circulating CD34-positive cells in systolic, but not non-systolic, hypertensive men. Multilinear regression analysis showed a parameter estimate (B) and standardized parameter estimate (ß) of 3.23 × 10-2 , 0.28 (P = 0.003) for systolic hypertensive men and -0.49 × 10-2 , -0.04 (P = 0.495) for non-systolic hypertensive men. CONCLUSIONS: Height positively correlates with circulating CD34-positive cells in systolic, but not non-systolic, hypertensive men. As the beneficial effects of circulating CD34-positive cells on endothelial repair might be masked by hypertension where the production of CD34-positive cells is stimulated by hypertension-induced vascular damage, among individuals with systolic hypertension, circulating CD34-positive cells should indicate the limits of endothelial repair. Therefore, height might indicate the capacity for adequate vascular maintenance in older men. Geriatr Gerontol Int 2017; 17: 1729-1736.

Association between high-density lipoprotein-cholesterol and hypertension in relation to circulating CD34-positive cell levels.

BACKGROUND: Although high-density lipoprotein-cholesterol (HDL) level is inversely correlated with cardiovascular events, HDL is also reported to be positively associated with hypertension, which is a known endothelial impairment factor. Since HDL mediates important protective actions on the vascular endothelium by increasing the number of circulating endothelial progenitor cells (CD34-positive cells), the level of circulating CD34-positive cells should influence the association between HDL and hypertension. METHODS: To investigate the association between HDL and hypertension in relation to the level of circulating CD34-positive cells, we conducted a cross-sectional study of 477 elderly men aged 60-69 years who participated in general health checkup. RESULTS: HDL was found to be significantly positively associated with hypertension in subjects with a high level of circulating CD34-positive cells, while no significant association was observed for subjects with low circulating CD34-positive cells. Known cardiovascular risk factors adjusted odds (ORs) and 95% confidence intervals (CIs) of hypertension for increments of one standard deviation (SD) in HDL (13.8 mg/dL) were 1.44 (1.06, 1.96) for subjects with a high level of circulating CD34-positive cells and 0.87 (0.63, 1.19) for subjects with low circulating CD34-positive cells. We also revealed a significant association between HDL level and CD34-positive cell level on hypertension, with fully adjusted p values for the effect of this interaction on hypertension at 0.022. CONCLUSIONS: Independent of known cardiovascular risk factors, HDL was found to be positively associated with hypertension in subjects with a high level of circulating CD34-positive cells but not for subjects with low circulating CD34-positive cells.

Platelets and circulating CD34-positive cells as an indicator of the activity of the vicious cycle between hypertension and endothelial dysfunction in elderly Japanese men.

BACKGROUND AND AIMS: The bi-directional association between hypertension and endothelial dysfunction (vicious cycle) is crucial for the development of cardiovascular disease. Since platelets and circulating CD34-positive cells have been reported to contribute to vascular repair (endothelial repair and the development of atherosclerosis), these two factors could act as an indicator for the activity of this vicious cycle. METHODS: We conducted a cross-sectional study of 580 Japanese men aged 60-69 years who underwent an annual health check-up. Since aggressive endothelial repair might cause consumptive reduction of circulating CD34-positive cells, subjects were stratified by circulating CD34-positive count (<1.01 cells/µL or ≥ 1.01 cells/µL). RESULTS: Platelet count is positively associated with hypertension among participants with a low CD34-positive cell count (multivariable-OR (odds ratio) for hypertension of 1 standard deviation (SD) increments in platelets (5.24 × 104/µL) = 1.47 (1.12, 1.91)), but not among participants with a high CD34-positive cell count (multivariable-OR = 0.91 (0.71, 1.18)). We also found that platelet count is positively associated with carotid intima-media thickness related to endothelial dysfunction among hypertensive participants with a low CD34-positive cell count (standardized parameter estimate (ß) = 0.26, p = 0.008), but not with a high CD34-positive cell count (ß = 0.11, p = 0.234). CONCLUSIONS: Our results indicate that the number of platelets and circulating CD34-positive cells acts as an indicator of the activity of the vicious cycle that exists between hypertension and endothelial dysfunction in elderly Japanese men.

Social networks, leisure activities and maximum tongue pressure: cross-sectional associations in the Nagasaki Islands Study.

OBJECTIVES: Social environment is often associated with health outcomes, but epidemiological evidence for its effect on oral frailty, a potential risk factor for aspiration, is sparse. This study aimed to assess the association between social environment and tongue pressure, as an important measure of oral function. The study focused on family structure, social networks both with and beyond neighbours, and participation in leisure activities. DESIGN: A population-based cross-sectional study. SETTING: Annual health check-ups in a rural community in Japan. PARTICIPANTS: A total of 1982 participants, all over 40 years old. Anyone with missing data for the main outcome (n=14) was excluded. OUTCOME MEASURES: Tongue pressure was measured three times, and the maximum tongue pressure was used for analysis. A multivariable adjusted regression model was used to calculate parameter estimates (B) for tongue pressure. RESULTS: Having a social network involving neighbours (B=2.43, P=0.0001) and taking part in leisure activities (B=1.58, P=0.005) were independently associated with higher tongue pressure, but there was no link with social networks beyond neighbours (B=0.23, P=0.77). Sex-specific analyses showed that for men, having a partner was associated with higher tongue pressure, independent of the number of people in the household (B=2.26, P=0.01), but there was no association among women (B=-0.24, P=0.72; P-interaction=0.059). CONCLUSIONS: Having a social network involving neighbours and taking part in leisure activities were independently associated with higher tongue pressure. Marital status may be an important factor in higher tongue pressure in men.

Handgrip strength and subclinical carotid atherosclerosis in relation to platelet levels among hypertensive elderly Japanese.

Age-related disruption of microvascular endothelium exacerbates hypertension and sarcopenia; and atherosclerosis is a well-known biological response to vascular endothelial injury. Therefore, prevalence of atherosclerosis among hypertensive elderly subjects may partly indicate the presence of an appropriate response to endothelial injury. We conducted a cross-sectional study of 795 elderly hypertensive Japanese subjects aged 60-89 years. Since platelet level is an indicator of vascular repair activity, subjects were stratified by platelet counts. No significant association between handgrip strength and subclinical carotid atherosclerosis (carotid intima-media thickness (CIMT) ≥1.1mm) was observed for subjects with lower platelet counts, while a significant positive association was observed for subjects with higher platelets. Adjusted odds and 95% confidence intervals of subclinical carotid atherosclerosis for 1 standard deviation increments in handgrip strength were 0.86 (0.61, 1.22) for subjects with lower platelets and 1.82 (1.26, 2.64) for subjects with higher platelets. A positive association between handgrip strength and subclinical carotid atherosclerosis exists in hypertensive elderly subjects with higher, but not lower, platelet counts. These results lead us to speculate that subjects with a beneficial influence on prevention of sarcopenia (maintenance of handgrip strength) may possess the capacity of active endothelial repair that causes atherosclerosis.

Platelets as an indicator of vascular repair in elderly Japanese men.

Platelets and circulating CD34-positive cells have been reported to contribute to vascular repair (endothelial repair and developing atherosclerosis). And because hypertension is known to be a strong vascular impairment factors, it should also influence the respective numbers of these factors. To clarify the clinical importance of platelets on vascular repair, we conducted a cross-sectional study of 567 Japanese men aged 60-69 who underwent an annual health check-up between 2013 and 2015. Multiple linear regression analysis of non-hypertensive subjects adjusting for classical cardiovascular risk factors showed that although platelet count did not significantly correlate with carotid intima media thickness (ß = -0.05, p = 0.356), it did positively correlate significantly with the natural log of the number of circulating CD34-positive cells (ß = 0.26, p < 0.001). In hypertensive subjects, a significant positive correlation was seen between platelets and intima media thickness (ß = 0.19, p = 0.008), whereas no significant correlation was seen between platelet count and the natural log of the number of circulating CD34-positive cells (ß = 0.11, p = 0.119). Our results indicate that platelet count is an indicator of vascular repair activity (endothelial repair and developing atherosclerosis). Additionally, hypertension might mask the beneficial effects of circulating CD34-positive cells.