Menstrual Status and Pregnancy in Former Elite Long-Distance Runners With Menstrual Disorders.

OBJECTIVE: To estimate the ratio of menstrual abnormalities, infertility, and other problems related to pregnancy and childbirth in former long-distance runners. We hypothesized that the female athlete triad during an athletic career affects future fertility and childbearing in former athletes. DESIGN: Cross-sectional study. SETTING: Participants of the All Japan University Women's Ekiden. PARTICIPANTS: Female former athletes who competed at national level were asked to complete the questionnaire; 137 valid responses were obtained. INDEPENDENT VARIABLES: Age at menarche and at the onset of pregnancy, history of amenorrhea and gynecological disorders, and lowest body mass index (BMI) during their athletic career. MAIN OUTCOME MEASURES: Menstrual status, history of pregnancy and childbirth, any related infertility treatment and problems, and history of stress fractures. RESULTS: The mean age at menarche was 13.3 ± 2.2 (range, 10-25) years. Five athletes (3.6%) had primary amenorrhea. Eleven of the 137 participants (8.0%) required treatment for infertility. Sixty participants had 121 pregnancies, of which 5 were yet to deliver during the survey. Fifteen of 116 pregnancies (12.9%) ended in miscarriage, induced abortion, or stillbirth. Logistic regression analysis showed that the factors related to "infertility treatment" were age at the onset of pregnancy ( P = 0.047) and higher BMI during their athletic career ( P = 0.032; odds ratio, 2.19). CONCLUSIONS: The main factor influencing infertility was an older age at the time of pregnancy, similar to that observed in the general population. Amenorrhea or being underweight during their athletic career was not associated with problems related to conception and childbirth.

Usefulness of diurnal variation of fractional exhaled nitric oxide for predicting early therapeutic response to asthma treatment.

OBJECTIVE: Fractional exhaled nitric oxide (FeNO) is considered to be an adjunct for asthma management, although its usefulness remains controversial. Therefore, it may be necessary for new approaches to use FeNO for asthma management. We evaluated whether diurnal variations of FeNO can predict response to asthma treatment. METHODS: This pilot study consisted of 22 uncontrolled asthmatics and 16 healthy subjects. FeNO and peak expiratory flow (PEF) were measured by themselves twice daily at home for three weeks (asthmatics) or two weeks (healthy subjects), and daily mean and diurnal variations of FeNO and PEF levels were calculated. In uncontrolled asthmatics, treatment was intensified a week after study entry, and then control status was reevaluated after three to four weeks. Asthmatics were then divided into two groups; good or poor responders. RESULTS: Diurnal variations of FeNO levels, as well as daily mean FeNO and PEF levels, in uncontrolled asthmatics before intensive treatment were significantly higher than those in healthy subjects, regardless of treatment response (p < 0.01). Furthermore, in the good responders, diurnal variations of FeNO levels were significantly decreased in the 1st week (p < 0.05) of intensive treatment, whereas the daily mean FeNO levels significantly dropped in the 2nd week (p < 0.05). In the poor responders, no such changes were observed in FeNO levels. In terms of PEF, only the daily mean levels were significantly elevated after the initiation of intensive treatment, regardless of treatment response. CONCLUSIONS: Diurnal variations of FeNO may contribute to predicting early therapeutic response to asthma treatment.

Real-world clinical outcomes of treatment with casirivimab-imdevimab among patients with mild-to-moderate coronavirus disease 2019 during the Delta variant pandemic.

Background: Mutations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may reduce the efficacy of neutralizing monoclonal antibody therapy against coronavirus disease 2019 (COVID-19). We here evaluated the efficacy of casirivimab-imdevimab in patients with mild-to-moderate COVID-19 during the Delta variant surge in Fukushima Prefecture, Japan. Methods: We enrolled 949 patients with mild-to-moderate COVID-19 who were admitted to hospital between July 24, 2021 and September 30, 2021. Clinical deterioration after admission was compared between casirivimab-imdevimab users (n = 314) and non-users (n = 635). Results: The casirivimab-imdevimab users were older (P < 0.0001), had higher body temperature (≥ 38°C) (P < 0.0001) and greater rates of history of cigarette smoking (P = 0.0068), hypertension (P = 0.0004), obesity (P < 0.0001), and dyslipidemia (P < 0.0001) than the non-users. Multivariate logistic regression analysis demonstrated that receiving casirivimab-imdevimab was an independent factor for preventing deterioration (odds ratio 0.448; 95% confidence interval 0.263-0.763; P = 0.0023). Furthermore, in 222 patients who were selected from each group after matching on the propensity score, deterioration was significantly lower among those receiving casirivimab-imdevimab compared to those not receiving casirivimab-imdevimab (7.66% vs 14.0%; p = 0.021). Conclusion: This real-world study demonstrates that casirivimab-imdevimab contributes to the prevention of deterioration in COVID-19 patients after hospitalization during a Delta variant surge.

Structural basis of the divergent oxygenation reactions catalyzed by the rieske nonheme iron oxygenase carbazole 1,9a-dioxygenase.

Carbazole 1,9a-dioxygenase (CARDO), a Rieske nonheme iron oxygenase (RO), is a three-component system composed of a terminal oxygenase (Oxy), ferredoxin, and a ferredoxin reductase. Oxy has angular dioxygenation activity against carbazole. Previously, site-directed mutagenesis of the Oxy-encoding gene from Janthinobacterium sp. strain J3 generated the I262V, F275W, Q282N, and Q282Y Oxy derivatives, which showed oxygenation capabilities different from those of the wild-type enzyme. To understand the structural features resulting in the different oxidation reactions, we determined the crystal structures of the derivatives, both free and complexed with substrates. The I262V, F275W, and Q282Y derivatives catalyze the lateral dioxygenation of carbazole with higher yields than the wild type. A previous study determined the crystal structure of Oxy complexed with carbazole and revealed that the carbonyl oxygen of Gly178 hydrogen bonds with the imino nitrogen of carbazole. In these derivatives, the carbazole was rotated approximately 15, 25, and 25°, respectively, compared to the wild type, creating space for a water molecule, which hydrogen bonds with the carbonyl oxygen of Gly178 and the imino nitrogen of carbazole. In the crystal structure of the F275W derivative complexed with fluorene, C-9 of fluorene, which corresponds to the imino nitrogen of carbazole, was oriented close to the mutated residue Trp275, which is on the opposite side of the binding pocket from the carbonyl oxygen of Gly178. Our structural analyses demonstrate that the fine-tuning of hydrophobic residues on the surface of the substrate-binding pocket in ROs causes a slight shift in the substrate-binding position that, in turn, favors specific oxygenation reactions toward various substrates.

Relationship between self-reported sleep quality and metabolic syndrome in general population.

BACKGROUND: To examine an association between self-reported sleep quality determined by Pittsburgh sleep quality index (PSQI) and metabolic syndrome. METHODS: This study was designed as cross-sectional study. Participants were 1481 adults aged 20 years and above from general population (549 males and 932 females). We assessed the global sleep quality by PSQI. PSQI consists of 7 elements, i.e. subjective sleep quality, sleep latency (prolonged sleep onset time), sleep duration, habitual sleep efficiency (proportion of hours slept to hours spent in bed), sleep disturbance (interruption of sleep), use of sleep medication and daytime dysfunction (trouble staying awake while engaging in social activity). Any participants with score of 6 or more are diagnosed to have sleep disorder. We also assessed the above 7 elements, which consisted of a four-grade system (i.e. 0, 1, 2, 3). Metabolic syndrome consisted of abdominal obesity, hypertension, impaired glucose tolerance and dyslipidemia. Diagnosis of metabolic syndrome was done when the participants have abdominal obesity and meet two or more other components. All analyses were adjusted by age, drinking habit, smoking habit, working hours, exercise habit and depression. RESULTS: Fifty-two male participants (9.5%) and 133 female (14.3%) scored 6 or more points in global PSQI score. The global PSQI score, sleep latency score and sleep disturbance score of participants with metabolic syndrome were higher level than those without the condition (p < 0.001, p = 0.009, p = 0.025 for male and p < 0.001, p < 0.001, p = 0.002 for females, respectively). The odds ratio of metabolic syndrome among participants with PSQI score of 6 or more points were 2.37 (95% confidence interval: 1.23-4.58) for males and 2.71 (1.45-5.07) for females in contrast to those with 5 or less points. The odds ratio of metabolic syndrome with sleep latency score of 2 was 2.65 (1.14-6.15) for male and 3.82 (1.81-8.09) for females in contrast with those of 0. The odds ratio of metabolic syndrome with sleep disturbance score of 1 was 1.76 (1.09-2.86) for males and 2.43 (1.26-4.69) for females in contrast with those of 0. CONCLUSIONS: Global PSQI score and its components (especially, sleep latency and sleep disturbance) were associated with metabolic syndrome.

Association between roentgenographic findings of the cervical spine and neck symptoms in a Japanese community population.

BACKGROUND: Radiographic findings may provide clues to the underlying cause of neck symptoms. However, these associations remain controversial. This study investigates the association between roentgenographic findings of the cervical spine and neck symptoms in a Japanese community population. METHODS: A total of 762 volunteers participated in this study. Sagittal radiographs of the cervical spine were taken and a questionnaire about the presence of and visual analog scale (VAS) for neck pain or stiff shoulder was completed. The sagittal alignment of the cervical spine (C2-C7) and the degenerative index were measured from lateral aspect radiographs. Three groups based on the sagittal alignment of C2-C7 were defined: straight-spine, lordotic-spine, and kyphotic-spine. The roentgenographic findings were examined in relation to symptoms. RESULTS: The prevalence rate of stiff shoulder on the day of examination was significantly higher in females than males. Although the VAS for neck pain and stiff shoulder on the examination day and for stiff shoulder in the preceding 12 months were not significantly different between females and males, that for neck pain in the preceding 12 months was significantly higher in females than males. Although there was no association between the sagittal alignment of C2-C7 and neck symptoms in males or females, a significant correlation between the degenerative index and VAS for neck pain on the examination day and in the preceding 12 months was seen in females after adjusting for age. The prevalence of and VAS for neck pain and stiff shoulder were not significantly different among the three C2-C7 sagittal alignment groups. CONCLUSION: Although the sagittal alignment of the cervical spine was not associated with neck symptoms, degenerative changes were associated with the severity of neck pain in females.

Prevalence and symptom of ossification of posterior longitudinal ligaments in the Japanese general population.

BACKGROUND: Ossification of the posterior longitudinal ligaments (OPLL) causes myelopathy with progression or trauma. Most OPLL patients visit the hospital after severe symptoms occur, and surgery did not supply complete relief in severe symptoms related to OPLL. While it is necessary to diagnose OPLL early and observe carefully, the nature of symptoms and asymptomatic OPLL have been unclear. The purposes of this study were to investigate the prevalence and symptoms of ossification of the posterior longitudinal ligaments (OPLL) of the cervical spine in the general population. METHODS: The subjects were 1291 Japanese general residents. Radiographic OPLL was detected by lateral view of the cervical spine, and subjects were classified into OPLL and non-OPLL groups. Visual analog scales of neck stiffness, neck pain, arm pain, and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire were examined. Neck and arm symptoms were compared among the presence of OPLL, and among subtypes (continuous, segmental, and mixed types) statistically. RESULTS: Prevalence of OPLL was 3.7 % in overall participants, 3.9 % in symptomatic participants, and 2.2 % in asymptomatic participants. While 86.7 % of participants with OPLL had symptoms, the consultation rate was only 6.7 %. The female OPLL group had higher neck pain than the non-OPLL group, and neck function of JOACMEQ in the continuous type of OPLL was significantly restricted compared to those without OPLL and with the mixed type of OPLL. CONCLUSIONS: Prevalence of OPLL was 3.7 %, and most of them had neck and arm symptoms; however, they did not visit hospitals. Asymptomatic OPLL had the potential risk for spinal cord injury and myelopathy. Early detection and careful observation would prevent the severe symptoms induced by OPLL.

Crystallization and preliminary X-ray diffraction studies of the reduced form of the terminal oxygenase component of the Rieske nonhaem iron oxygenase system carbazole 1,9a-dioxygenase.

The initial reaction of bacterial carbazole degradation is catalysed by carbazole 1,9a-dioxygenase, which consists of terminal oxygenase, ferredoxin and ferredoxin reductase components. The reduced form of the terminal oxygenase component was crystallized at 293 K by the hanging-drop vapour-diffusion method using PEG MME 550 as the precipitant under anaerobic conditions. The crystals diffracted to a resolution of 1.74 Šand belonged to space group P6(5), with unit-cell parameters a = b = 92.0, c = 243.6 Å. The asymmetric unit contained a trimer of terminal oxygenase molecules.

Changes in immune functions during a peaking period in male university soccer players.

The concept of peaking ensures that athletes have trained to attain their absolute peak performance levels prior to a competition. This study investigates the effects of peaking on the functions of neutrophils and lymphocytes in university soccer players during a five-day soccer training camp followed by two weeks of tapering. The study subjects were 22 soccer players who were members of a university soccer club. We carried out our investigation during a five-day training camp and two weeks after the training camp (i.e. the tapering period). We measured body composition, immune-related parameters (leukocyte count, neutrophil count, lymphocyte count, immunoglobulins and complements), myogenic enzymes, superoxide dismutase activity (SOD) and neutrophil functions [reactive oxygen species (ROS) production, phagocytic activity, serum opsonic activity and lymphocyte subtypes]. Leukocyte and neutrophil counts tend to increase after the training camp compared with values before the training camp, and recovered during the conditioning period, although the final values were still lower than those before the training camp. The amount of ROS production per neutrophil and level of SOD decreased significantly during the conditioning period compared with before the training camp (p < 0.05, p < 0.01, respectively). Levels of Th1 cells decreased significantly during the conditioning period compared with the training camp (p < 0.05). In conclusion, the period of two weeks for the tapering period was considered insufficient to allow the athletes' immune function to recover completely after an intensive training camp.

The influence of blood glucose on neutrophil function in individuals without diabetes.

We assessed the association of neutrophil function with glycated hemoglobin (HbA1c) levels in a Japanese general population. Participants were 809 males and females who were over 20 years old living in the Iwaki region in Aomori Prefecture located in northern Japan. Lifestyle parameters (smoking, alcohol consumption, and exercise habits), HbA1c and neutrophil function such as reactive oxygen species (ROS) production capability and phagocytic activity (PA) were measured. ROS production capability was measured before and after phagocytic stimulus to obtain basal ROS production and stimulated ROS production. Level of HbA1c had a positive correlation with basal ROS production (p=0.053), a negative correlation with stimulated ROS production (p=0.072) and PA (p=0.059) only in post-menopausal groups, and not in pre-menopausal groups. However, there were no correlations between levels of HbA1c and neutrophil functions in male. In conclusion, in the present study, despite the presence of diabetes, chronic hyperglycemia was found to cause an increase in daily basal ROS production of neutrophils, and increased susceptibility to infection caused by reduced neutrophilic reaction in females in their menopause. Therefore, from the oxidative point of view, strict glycemic control is necessary to prevent post-menopausal females from developing diabetic complications in spite of the presence of diabetes.

Influence of a 3-month training program on muscular damage and neutrophil function in male university freshman judoists.

We studied the effects of a high intensity and high frequency 3-month training program on muscle damage and neutrophil function in male judoists. The study included 15 male judoists who started intensive judo training program after a 6-month break. Creatine kinase (CK), neutrophil counts and reactive oxygen species (ROS) production capability as well as phagocytic activity (PA) of neutrophils were measured at 2 stages; entering university (pre-training) and after 3-month training (post-training). At both points, we investigated parameters three times: just before, immediately after and 24 h after a 2-h practice session. Practice-mediated change in CK was lower at post-training than at pre-training. Neutrophil count significantly increased after 2-h practice but recovered 24 h later whereas it showed no subsequent and further increased at 24 h post-practice. Although neutrophil ROS production capability and PA both decreased (breakdown) after practice session, ROS production capability increased and PA decreased (well-adapted) at the post-training. Long-term training strengthened muscular function and improved neutrophil reaction against practice-mediated stress.

Effects of soccer matches on neutrophil and lymphocyte functions in female university soccer players.

In this study, changes in physical fatigue and biological functions of Japanese female soccer players were investigated by determining changes in neutrophil and lymphocyte functions. Study subjects included 18 female soccer players. Body composition, serum myogenic enzymes, neutrophil function, including reactive oxygen species (ROS) production capability, phagocytic activity (PA) and serum opsonic activity, as well as lymphocyte subpopulation were measured before and after a soccer match. Levels of myogenic enzymes (AST, ALT, CK and LDH) and immunoglobulins (IgG and IgA) and complements (C3) increased significantly after the match. In addition, leukocyte, neutrophils and lymphocyte counts increased whereas total PA decreased significantly. The number of T and Th1 cells (subsets of T helper cells) decreased whereas Th2 increased significantly. In addition, the number of B cells increased and NK cells decreased significantly after the match. The match was found to result in degenerative changes in and damage to athlete muscle tissues together with damage- and change-mediated stress. These data also suggest a post-match accelerated inflammatory reaction and potential immunosuppression as indicated by reductions in neutrophil PA and lymphocyte functions.

Effect of glutamine supplementation on neutrophil function in male judoists.

Glutamine is an important amino acid for immune function. Though high intensity and prolonged exercise decreases plasma glutamine concentration and causes immune suppression, the relationship between neutrophil functions and glutamine has not yet been found. The purpose of this study was to investigate the impacts of glutamine supplementation on neutrophil function. Twenty-six male university judoists were recruited. Subjects were classified into glutamine and control groups. The glutamine group ingested 3000 mg of glutamine per day and the control group ingested placebo for 2 weeks. Examinations were performed at the start of preunified loading exercise (pre-ULE), then 1 and 2 weeks after ULE (post-ULE). Reactive oxygen species (ROS) production, phagocytic activity, serum opsonic activity and serum myogenic enzymes were measured. Differences between the levels obtained in pre-ULE and post-ULE for the two groups were compared. In the glutamine group, ROS production activity increased 1 week after ULE, whereas it was not observed in the control group (P < 0.001). Though myogenic enzymes increased significantly after ULE (P < 0.001), the glutamine group remained unchanged by supplementation during ULE. Glutamine supplementation has prevented excessive muscle damage and suppression of neutrophil function, especially in ROS production activity, even during an intensive training period.

Effects of dehydration on immune functions after a judo practice session.

We investigated the effects of dehydration after a judo practice session on player muscle and immune functions. Subjects included 25 female university judoists. Investigations were performed before and after 2.5 h of regular judo practice. Body composition, serum enzymes (myogenic enzymes, immunoglobulins and complements), neutrophils counts, reactive oxygen species (ROS) production capability, and phagocytic activity (PA) were measured. Subjects were divided into two groups according to level of dehydration after practice (mild dehydration and severe dehydration groups) and results were compared. Creatine kinase was found to increase significantly after practice. In addition, neutrophil count also increased significantly after practice in both groups. The changing ratios of IgA, IgG and C3 observed in the mild dehydration group were significantly higher than those in the severe dehydration group. In the severe dehydration group, post-practice PA/neutrophil had decreased significantly. Significant positive correlations were found between severity of dehydration and changing ratios of IgA, IgG, IgM, C3, C4 and ROS production capabilities, whereas no significant association was seen with PA and/or serum SOD activity. These results suggest that dehydration resulted in immunosuppression, including decreased neutrophil function.

Changes in neutrophil functions during a 10-month soccer season and their effects on the physical condition of professional Japanese soccer players.

We examined changes in neutrophil function of soccer players over a 10-month period and determined its effectiveness as an index for athlete physical condition. Subjects included 21 male professional Japanese soccer players. Data on body composition, myogenic enzymes and neutrophil function were obtained before and after 2 h of training at 3 investigation points: one week before opening season, at season mid-point, and one week before the last game of the season. As a result, change ratios of myogenic enzyme levels before and after the 2-hr training session at the third investigation point were significantly higher compared to the two other points. Reactive oxygen species production and phagocytic activity significantly increased after 2-hr training session at point 1, although the extent of the increase became smaller over time and ROS production capability decreased significantly by point 3 assessment. Fatigue, especially muscle fatigue, chronically accumulated along with a gradual decrease in neutrophil immune function over the 10-month season. Therefore, determination of neutrophil function can be used as a useful index to assess and understand an athlete's physical condition.

Evaluation of locomotive disability using loco-check: a cross-sectional study in the Japanese general population.

BACKGROUND: The purposes of this study were to reveal the prevalence of locomotive syndrome (LS) evaluated by loco-check in the Japanese general population and to analyze the relationship between radiographic knee osteoarthritis (OA) and lumbar spondylosis, metabolic syndrome and LS. Furthermore, we evaluated LS according to functional examinations. METHODS: Seven hundred twenty-two volunteers aged 56.6 ± 13.6 years participated in the Iwaki Health Promotion Project in 2010 and were classified into two groups: LS (one or more disabilities) or non-LS (no disability) according to the criteria of LS proposed by the Japanese Orthopaedic Association. Radiographic knee OA and lumbar spondylosis were defined according to the Kellgren-Lawrence grade. Metabolic syndrome was defined as the presence of two or more risk factors in addition to visceral obesity. The prevalence of LS associated with knee OA, lumbar spondylosis and metabolic syndrome was compared statistically. Also, data of six functional examinations were compared between the non-LS and LS groups. RESULTS: The prevalence of LS was 21.2 % in males and 35.6 % in females and increased with aging regardless of gender. The prevalence of LS with knee OA was 48.7 %, with lumbar spondylosis was 33.8 %, and with metabolic syndrome was 43.4 %. The non-LS group had significantly better performance in the functional reach and sit and reach tests than the LS group in males and females by age-adjusted comparison. CONCLUSION: The prevalence of LS in the general population was higher in females than in males. A strong risk factor for LS was radiographic knee OA. Also, those with LS had loss of skeletal muscle mass, balancing and flexibility. This study showed that evaluation by loco-check was an acceptable tool to detect the early stage of locomotive disability for LS, and interventional prevention for strength, balancing and flexibility would be helpful for those with LS.

Change with increasing age in control of the lower limbs during jump-landing in adolescents: a 5-year prospective study.

BACKGROUND: A discrepancy in the incidence of anterior cruciate ligament injury in males and females appears after puberty; however, little is known about changes that occur in control of the lower limbs during jump-landing in adolescents. METHODS: Twenty-five male and 29 female 5th grade students (age 10-11 years) participated at the beginning of study and were followed for 5 consecutive years. Control of the lower limbs during jump-landing was evaluated by use of a drop-jump test and 2-dimensional video analysis. The K/H ratio, which was determined by dividing the knee-separation distance by the hip-separation distance, was calculated for initial contact (IC) and for maximum knee flexion (MKF). RESULTS: In all grades female subjects had a significantly lower K/H ratio at both IC and MKF than male subjects. Although no statistically significant difference in K/H ratio between age categories was shown at either IC or MKF for male subjects, K/H ratio at IC and MKF decreased significantly between 5th grade and 9th grade for female subjects. CONCLUSION: This study suggests that adolescent females have a lower K/H ratio during jump-landing than male subjects of the same age, and that K/H ratio for females decreases with increasing age.

Serum hyaluronan levels increase with the total number of osteoarthritic joints and are strongly associated with the presence of knee and finger osteoarthritis.

PURPOSE: Although serum hyaluronan (HA) levels increase in patients with osteoarthritis (OA), the association between OA severity and elevation of serum HA levels is not clear. Our purpose was to investigate the relationship between serum HA levels and OA in various anatomical sites and to detect which joints are strongly correlated with elevated serum HA levels. METHODS: Seven hundred and ten individuals from the general population who participated in the Iwaki Health Promotion Project in 2008 were involved. Kellgren-Lawrence grade 2 or higher in the knee, hip, lumbar spine, finger and wrist was defined as OA. Serum HA levels were determined on the same day. Spearman's correlation coefficients between serum HA levels and total number of joints affected by OA were calculated. Linear regression was analysed with serum HA levels as the independent variable; age, gender, presence of OA and intake of supplements were used as dependent variables. RESULTS: Prevalence of knee OA was 30.7 %, hip 16.8 %, lumbar spine 65.1 %, wrist 9.0 % and finger 22.0 %. Serum HA levels had a positive correlation with the number of involved joints, and the correlation coefficient was 0.410 (p < 0.001). Serum HA was significantly affected by age (ß = 0.382), knee OA (ß = 0.163) and finger OA (ß = 0.164). CONCLUSION: Although this biomarker reflects a systemic condition, higher serum HA levels were associated with total number of OA joints. Knee and finger OA were key joints related to increased serum HA levels. These results are valuable in understanding characteristics of serum HA levels as a biomarker for osteoarthritis.

Effect of age and disease on bone mass in Japanese patients with schizophrenia.

BACKGROUND: There have been a limited number of studies comparing bone mass between patients with schizophrenia and the general population. The aim of this study was to compare the bone mass of schizophrenia patients with that of healthy subjects in Japan. METHODS: We recruited patients (n = 362), aged 48.8 ± 15.4 (mean ± SD) years who were diagnosed with schizophrenia or schizoaffective disorder based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Bone mass was measured using quantitative ultrasound densitometry of the calcaneus. The osteosono-assessment index (OSI) was calculated as a function of the speed of sound and the transmission index. For comparative analysis, OSI data from 832 adults who participated in the Iwaki Health Promotion Project 2009 was used as representative of the general community. RESULTS: Mean OSI values among male schizophrenic patients were lower than those in the general population in the case of individuals aged 40 and older. In females, mean OSI values among schizophrenic patients were lower than those in the general community in those aged 60 and older. In an analysis using the general linear model, a significant interaction was observed between subject groups and age in males. CONCLUSIONS: Older schizophrenic patients exhibit lower bone mass than that observed in the general population. Our data also demonstrate gender and group differences among schizophrenic patients and controls with regard to changes in bone mass associated with aging. These results indicate that intervention programs designed to delay or prevent decreased bone mass in schizophrenic patients might be tailored according to gender.

Ankle brachial pressure index as a marker of apathy in a community-dwelling population.

BACKGROUND: Apathy is defined as a lack of interest or emotion. Several studies have shown the relationship between apathy and atherosclerotic change in poststroke patients. Although apathy is confused with depression, it might be a specific neuropsychiatric syndrome separate from depression. OBJECTIVE: To clarify the relationship between atherosclerotic change and apathy in a community-dwelling population, which does not include the psychologic factors associated with stroke events. METHODS: The ankle brachial pressure index (ABI) was measured using a volume-plethymographic apparatus in 860 volunteers (315 males and 545 females) who participated in the Iwaki Health Promotion Project 2008. Starkstein's apathy score and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess the psychologic status. The association between the ABI and apathy was assessed by a multiple linear regression analysis. RESULTS: Gender and low-density lipoprotein (LDL)-cholesterol were independently and significantly associated with the CES-D score. We did not find any association between CES-D score and the ABI. In addition, the extent of education and the ABI were independently and significantly associated with the apathy scale (AS). CONCLUSION: In a community-dwelling population, a lower ABI score was an independent risk factor for a higher AS score, but not for a higher CES-D score. Apathy and depression may have different etiologies in vascular factors.