Eicosapentaenoic acid/arachidonic acid ratio in Japanese junior high school students.

BACKGROUND: This epidemiological study investigated the eicosapentaenoic acid/arachidonic acid ratio (EAR) and docosahexaenoic acid/ arachidonic acid ratio (DAR) in ninth-graders in Japan. METHODS: A total of 175 ninth-grade children from Tsunan Town (115 boys and 60 girls) were enrolled in the study between 2015 and 2017. All participants were assessed during annual health checkups to determine their EAR and DAR. All data were compared between boys and girls using the Mann-Whitney test. Spearman's rank correlation coefficient was used to describe the strengths of correlations between the EAR, DAR, and relevant parameters. RESULTS: The median (minimum, maximum) EAR and DAR of all participants were 0.13 (0.05, 0.46) and 0.47 (0.25, 0.84), respectively. There was no significant difference in the EAR between boys and girls at 0.12 (0.05, 0.46) and 0.13 (0.06, 0.27) (P = 0.375), respectively. The DAR was not significantly different (P = 0.125). There was a significant positive correlation between EAR and triglyceride, body mass index, and homeostasis model assessment but a significantly negative correlation with HbA1c (r = -0.209, P = 0.006). In contrast, there was no significant correlation between DAR and any parameters. CONCLUSIONS: This is the first epidemiological study investigating the EAR using a population-based cohort of Japanese adolescents. The EAR in boys/girls in Japan is 0.12 (0.05, 0.46)/0.13 (0.06, 0.27). The study results suggest that children with a healthy diet may generally have a lower average blood glucose level.

Cause-specific mortality trends in a nationwide population-based cohort of childhood-onset type 1 diabetes in Japan during 35 years of follow-up: the DERI Mortality Study.

AIMS/HYPOTHESIS: The aim of this study was to investigate long-term, cause-specific mortality trends among patients with childhood-onset type 1 diabetes in Japan. METHODS: Individuals included in the study had received a diagnosis of type 1 diabetes at age <18 years between 1965 and 1979. All individuals were followed up for their survival status until 1 January 2005. The causes of death were divided into end-stage renal disease (ESRD), acute diabetic complications (ADC), accident/suicide, cardiovascular disease (CVD), infections, cancers, others (non-diabetic/diabetic) and unknown. The cause-specific mortality trends were expressed according to the follow-up period and year of diagnosis. RESULTS: A total of 1,385 patients were enrolled in the study, and the survival status of 1,324 was confirmed. Mortality rate at the 35 year follow-up (per 100,000 person-years) was 659.3, and the standardised mortality ratio (SMR) was 10.7. The SMR at the 25 year follow-up markedly declined from 19.3 in the 1965-1969 diagnosis group to 6.6 in the 1975-1979 diagnosis group. Approximately 40% died of ADC among those with <10 years of follow-up. A similar proportion of individuals died of ESRD among those with 10-19 years of follow-up. The longer the duration of follow-up, the lower the mortality from ADC and the greater the mortality from CVD. CONCLUSIONS/INTERPRETATION: In Japanese people with childhood-onset type 1 diabetes of more than 20 years of duration, CVD was the leading cause of death, as is the case among similar white people. The longer the duration of diabetes, the more attention should be paid to preventing CVD.

Changes in insulin resistance, body mass index and degree of obesity among junior high school students: A comparison before and after the outbreak of the COVID-19 pandemic.

This study aimed to investigate how the COVID-19 pandemic since 2020 has affected the homeostasis model assessment of insulin resistance (HOMA-IR), body mass index (BMI) and degree of obesity among Japanese children. HOMA-IR, BMI and degree of obesity were calculated for 378 children 14-15 years old (boys/girls, 208/170) who underwent checkups during 2015-2021. Changes in these parameters over time and correlations between parameters were assessed, and the proportions of participants with IR (HOMA-IR ≥2.5) were compared. HOMA-IR values increased significantly over the study period (p < 0.001), with a significantly large proportion of participants with IR in 2020-2021 (p < 0.001). Conversely, BMI and degree of obesity did not change significantly. HOMA-IR did not correlate with BMI or degree of obesity during 2020-2021. In conclusion, the COVID-19 pandemic may have had an impact on the increase in the proportion of children with IR, regardless of BMI or degree of obesity.

Association of adipocytokines and adipocytokine ratios with cardiovascular risk factors in Japanese preadolescents.

OBJECTIVES: Asians are particularly susceptible to obesity-associated disorders and rapid progression of obesity from childhood to adulthood. Data on the association between adipocytokine parameters, particularly adipocytokine ratios, and cardiovascular risk factors in childhood remain limited. Herein, we assessed the association of resistin, adiponectin, and leptin levels and leptin/adiponectin and resistin/adiponectin ratios with selected cardiovascular risk factors and the influence of unhealthy weight on such associations in children aged 9-10 years. METHODS: We included 380 children aged 9-10 years from three public elementary schools in Japan. RESULTS: The body mass index (BMI) was significantly higher in male preadolescents than in female adolescents (median 16.5 kg/m2 vs. 16.2 kg/m2, p=0.032). No differences in height, weight, waist circumference (WC), waist/height ratio (W/Hr), total cholesterol and high-density lipoprotein cholesterol levels, or atherosclerosis index (AI) were observed between the sexes. Of the adipocytokine levels and ratios analyzed, only the leptin level and leptin/adiponectin ratio (L/Ar) were strongly and significantly positively correlated with the cardiovascular risk factors WC, W/Hr, and BMI (all p<0.05). The AI was not strongly correlated with any adipocytokine levels or ratios. Apart from the strong positive correlation between the L/Ar and W/Hr, no other significant associations were observed between any of the adipocytokine levels or ratios and the selected cardiovascular risk factors. CONCLUSIONS: Our findings confirmed the value of adipocytokine ratios in risk assessment in pediatric populations, with leptin levels and leptin/adiponectin ratios strongly correlating with risk factors in children aged 9-10 years.

Changes in body mass index, leptin and adiponectin in Japanese children during a three-year follow-up period: a population-based cohort study.

OBJECTIVE: The study examined changes in and relationship between body mass index (BMI), leptin and adiponectin levels over a 3-year period in a pediatric population-based cohort. STUDY DESIGN: A 3-year prospective cohort study of 268 boys and 251 girls aged 9-10 in Ina, Saitama, Japan. RESULTS: Median body mass index (BMI) significantly increased from baseline (age 9-10) to follow up (age 12-13) in boys from 17.1 to 18.3 kg/m2 (P < 0.001) and in girls from 16.5 to 18.5 kg/m2 (P < 0.001), respectively. Adiponectin values significantly decreased from baseline to follow up in boys (13.5 to 8.9 microg/ml, respectively) (P < 0.001) and in girls (12.4 to 9.5 microg/ml, respectively) (P < 0.001). Leptin values at follow up significantly decreased from baseline in boys (4.9 to 2.3 ng/dl, respectively) (P < 0.001) and also in girls (5.3 to 5.1 ng/dl, respectively) (P = 0.049). A relatively strong correlation was seen in BMI (Spearman's correlation coefficient, r = 0.864, P < 0.001 in boys; r = 0.873, P < 0.001 in girls), adiponectin (r = 0.705, P < 0.001 in boys; r = 0.695, P < 0.001 in girls), and leptin (r = 0.449, P < 0.001 in boys; r = 0.610, P < 0.001 in girls) before and after the three-year period. The ratio of follow up to baseline BMI was negatively correlated with that for adiponectin (r = -0.224, P < 0.001 in boys; r = -0.165, P = 0.001 in girls) and positively correlated with that for leptin (r = 0.518, P < 0.001 in boys; r = 0.609, P < 0.001 in girls). CONCLUSION: This study demonstrated that baseline adiponectin, leptin and BMI values measured at ages 9-10 correlated with those measured three years later. However, adiponectin values decreased and leptin values increased in those subjects whose BMI increased during over this period.

Highly dispersed clay-polyolefin nanocomposites free of compatibilizers, via the in situ polymerization of alpha-olefins by clay-supported catalysts.

In situ polymerization by certain transition metal catalysts supported on and activated by acid-treated montmorillonite produces well-dispersed clay-polyolefin nanocomposites, without requiring either organic surfactants to be present in the clay phase or modification of the polyolefin structure.

[Current evidence-based medicine for early intervention in diabetes].

The management of diabetes has changed recently with the early intervention, including diet, exercise, various pharmacological agents and education. In this review, we have provided current evidences of early intervention in various treatments. For example, sulfonylureas, metformin, alpha-glucosidase inhibitors, pioglitazone and glinides appear to be some of the drugs of choice to start with early pharmacological treatment when type 2 diabetic patients continue to have hyperglycemia despite diet and exercise. Clinical studies have shown that insulin therapy should be started sooner at an early stage in the natural progression of the diabetes. Moreover, recent data have demonstrated that treatment with early intervention of lifestyle adjustments as well as some pharmacological agents resulted in greater improvement of glycemic control. Further studies are expected to show the best point of intervention during diabetic course in preventing from progression of diabetic stage and diabetic complications.

Ratio of high-, medium-, and low-molecular weight serum adiponectin to the total adiponectin value in children.

In 760 children age 9 to 10 years, the serum adiponectin composition (high molecular weight [HMW], hexameric medium molecular weight [MMW], and trimeric low molecular weight [LMW]) was found to vary markedly depending on whether the total adiponectin value was high or low. A lower total adiponectin value was associated with a lower ratio of HMW adiponectin.

Glycated albumin is low in obese, type 2 diabetic patients.

This study is to clarify whether obesity status affects glycated albumin (GA) and HbA1c levels in adults with type 2 diabetes. One hundred and seven individuals with type 2 diabetes without advanced complications participated in this study. The relationship between HbA1c, GA, hemoglobin (Hb), albumin (ALB), absolute value of GA (aGA) and Body Mass Index (BMI) were examined using Pearson's correlation coefficient. The comparison of each parameter was conducted using unpaired t-test between the obese (BMI> or =25) and the non-obese (BMI<25) group. Additionally the multiple regression analyses to find factors related with GA (i.e. BMI, HbA1c, age, ALB and the insulin therapy) were performed. HbA1c level and BMI showed very weak correlation (r=-0.04; p=0.65). However, GA, aGA and BMI showed a significant negative correlation (r=-0.28; p=0.004, r=-0.22; p=0.024). The GA and aGA values of the obese group were significant lower than those in the non-obese group. In multiple regression analysis, BMI (beta=-0.24; p=0.001) was negatively, and HbA1c (beta=3.65; p<0.001) was positively correlated with GA. In conclusion, the current analysis demonstrated a need of careful evaluation of GA values in obese diabetic patients in daily practice. Further researches are required to elucidate the underlying mechanisms.

Childhood obesity and its relation to serum adiponectin and leptin: a report from a population-based study.

This study examined the relationships between serum adiponectin (AD) and leptin (LP) levels, and obesity using a population-based cohort consisted of 315 (9-10 year olds: G1) and 308 (12-13 year olds: G2) school children. Serum AD, LP and other markers were compared according to the presence of obesity. The prevalence rates of obesity were 14.9% in G1 and 9.4% in G2. The medians of serum AD (microg/dl: non-obese/obese) were statistically lower in obese children (9.6/8.3 in G1, p<0.05; 8.9/6.6 in G2, p<0.05), and the medians of serum LP (ng/dl) were statistically higher in obese children (3.7/12.5 in G1, p<0.05; 2.9/8.4 in G2, p<0.05). The serum LP levels were significantly positively correlated with percent overweight (POW) irrespective of age and sex, and the serum AD levels were significantly negatively correlated with POW except for boys in G1. Multivariate regression analyses revealed that LP, LDL-cholesterol and gender in G1, and LP, AD, blood pressure and gender in G2 were significantly correlated with POW. A large-scale, population-based study revealed that AD was lower and LP higher in obese children, and that the obese status in G2 was related to a worse metabolic profile than the case in G1.

Gender differences in the relationship between percent body fat (%BF) and body mass index (BMI) in Japanese children.

The purpose of the present study was to examine whether gender differences exist in the relationship between percent body fat (%BF) and body mass index (BMI) in Japanese children using a population-based cohort. Subjects are comprised of 187 boys and 163 girls aged 9-10, and 137 boys and 155 girls aged 12-13. Percent BF was measured using a bipedal biometrical impedance analysis (BIA) device. The relationship between %BF and BMI was investigated as a function of age and gender with Pearson's correlation coefficient. Strong linear relationships existed between %BF and BMI, especially in girls (9-10-year-old boys: r=0.779, P<0.0001; 9-10-year-old girls: r=0.975, P<0.0001; 12-13-year-old boys: r=0.786, P<0.0001; 12-13-year-old girls: r=0.975, P<0.000l). These results indicate that %BF can be predicted from BMI in Japanese children aged 9-10 and 12-13 years. The correlations in boys were not as strong as those observed in girls, that is, less variability was explained for girls than for boys. Further study will be necessary to ascertain whether the strong correlation seen among girls will be observed in different age or ethnic groups, and to ascertain the mechanism that produces this gender difference.

Waist circumference estimation from BMI in Japanese children.

Waist circumference, not BMI, is one of the factors in the definition of metabolic syndrome in adults. In children, waist circumference is also a well known predictor of metabolic syndrome. However, waist circumference measurement is not as commonly recorded as weight and height measurements in physical examinations in schools. This means BMI data is available for every child, but waist circumference is not. Therefore, we investigated whether there is an alternative way to estimate waist circumference even in those children whose waist circumference measurement has not been taken. We evaluated the relationship between BMI and the waist circumference of schoolchildren using a relatively large-scale population-based cohort in Japan. There was a significant linear relationship between BMI and waist circumference noted in each age- and sex-divided group [9-10-year-old boys: waist=13.99+2.63BMI (r=0.940, p<0.001), 9-10-year-old girls: waist=15.09+2.61BMI (r=0.933, p<0.001), 12-13-year-old boys: waist=23.67+2.22BMI (r=0.880, p<0.001), 12-13-year-old girls: waist=23.83+2.15BMI (r=0.859, p<0.001)]. This means it is possible to estimate waist circumference from height and weight, at least among those age groups of children in Japan. This estimation could be an alternative way and useful in detecting childhood metabolic syndrome or obesity disease in which a waist circumference figure is necessary.

Three-Dimensional-Moldable Nanofiber-Reinforced Transparent Composites with a Hierarchically Self-Assembled "Reverse" Nacre-like Architecture.

Achieving a structural hierarchy and a uniform nanofiller dispersion simultaneously remains highly challenging for obtaining a robust polymer nanocomposite of immiscible components. In this study, a remarkably facile Pickering emulsification approach is developed to fabricate hierarchical composites of immiscible acrylic polymer and native cellulose nanofibers by taking advantage of the dual role of the nanofibers as both emulsion stabilizer and polymer reinforcement. The composites feature a unique "reverse" nacre-like microstructure reinforced with a well-dispersed two-tier hierarchical nanofiber network, leading to a synergistic high strength, modulus, and toughness (20, 50, and 53 times that of neat polymer, respectively), high optical transparency (89%), high flexibility, and a drastically low thermal expansion (13 ppm K-1, 1/15th of the neat polymer). The nanocomposites have a three-dimensional-shape moldability, also their surface can be patterned with micro/nanoscale features with high fidelity by in situ compression molding, making them attractive as the substrate for flexible displays, smart contact lens devices, and photovoltaics. The Pickering emulsification approach should be broadly applicable for the fabrication of novel functional materials of various immiscible components.

Population-based cross-sectional study on insulin resistance and insulin-secretory capacity in Japanese school children.

AIMS/INTRODUCTION: Little information is available regarding the status of insulin resistance (IR) and insulin deficiency (ID), as well as their relationship with obesity in children using the homeostasis model assessment (HOMA) in a population-based setting. MATERIALS AND METHODS: The study included a total of 445 ninth-grade children participating in health check-up programs implemented in Tsunan Town, Niigata, Japan (boys/girls, 252/193 [participation rates: 98.1/95.5%]). HOMA of insulin resistance ≥2.5 was defined as IR, and HOMA of ß-cell function <40 defined as ID. RESULTS: The medians (25-75th percentiles) of HOMA of insulin resistance, HOMA of ß-cell function, Disposition Index and body mass index in boys were 1.2 (0.8-1.7), 64 (44-93), 52 (43-64) and 19.2 (18.0-20.7) kg/m2 , respectively, vs 1.5 (1.0-2.0), 86 (63-120), 60 (50-74) and 20.4 (18.9-22.0) kg/m2 , respectively, in girls. The HOMA of insulin resistance, HOMA of ß-cell function and Disposition Index values were significantly higher in the girls (P = 0.002, P < 0.001 and P < 0.001, respectively). Those with IR accounted for a significantly higher proportion of girls than boys (15.5/8.7%; P = 0.027); those with obesity accounted for 9.9/10.7% (boys/girls); and those with IR and obesity accounted for 2.4/4.7%. Those with ID accounted for a significantly higher proportion of boys than girls (20.6/8.8%; P = 0.001), whereas those with ID and obesity accounted for a very small proportion of either group (0.4/0.5%). CONCLUSIONS: The presence of IR was higher among the girls. In contrast, ID was more frequent among the boys. The infrequent presence of ID among children might support the presence of non-obese type 2 diabetes adults in Japan.

Glycated albumin is low in obese, non-diabetic children.

The current study evaluates the indices of glucose control for diabetics (i.e., glycated albumin (GA), hemoglobin A1c (HbA1c), plasma glucose (PG) and immuno-reactive insulin (IRI)) in non-diabetic children from a population-based cohort, and compares those values according to the presence of obesity to examine any differences in these indices. GA, HbA1c, casual PG and casual IRI in obese children (n = 209) were compared to those of non-obese children (n = 1060) in Ina town, Saitama Prefecture, in 2002-2003. In obese children, the levels of HbA1c, PG and IRI were statistically higher when compared to those of non-obese children. In contrast, the median and intra-quartile range (IQR) of GA of obese children (13.6%: 12.6-14.7) was statistically lower when compared to that of non-obese children (14.3%: 13.5-15.4, p < 0.001). The low GA (%) in obese children is mainly due to the low absolute value of GA (g/dl) rather than a higher albumin value (g/dl). This is the first report to reveal that GA levels are low in obese, non-diabetic children. Additional data collection and an experimental approach are necessary to reveal the reasons behind lower GA levels in obese children.

High-shear effects on the nano-dispersed structure of the PVDF/PA11 blends.

The fabrication of miscible or nanostructured polymer blends or alloys raises much hope, but poses significant scientific and industrial challenges over the past several decades. Here, we propose a novel strategy using high-shear processing and demonstrate the high-shear effects on the nanodispersed structure formed in the poly(vinylidene fluoride) (PVDF)/polyamide 11 (PAll) blends, in which PA11 domains with a size of several tens of nanometers are dispersed in the PVDF phase. For the blend of PVDF/PA11 = 65/35, the TEM image shows that many nanometer-sized PAl1 particles are dispersed in the PVDF domain to form a special type of domain-in-domain morphology. In contrast, no PVDF nano-dispersion was observed in the PA11 phase. The effects of both the screw rotation speed and the mixing time on the blend structure were systematically studied. It shows that the extruder screw rotation speed and the mixing time are two critical factors to prepare the nanostructured blends. In addition, the investigations on the thermal behavior of the obtained blends indicate the improved miscibility between PVDF and PAl1 by the high shear processing.

Age at Transition from Pediatric to Adult Care Has No Relationship with Mortality for Childhood-Onset Type 1 Diabetes in Japan: Diabetes Epidemiology Research International (DERI) Mortality Study.

OBJECTIVE: To follow up Japanese patients with type 1 diabetes for a maximum of 40 years to examine when they transitioned from pediatric care to adult care and to explore whether the attending physician, i.e., pediatrician or internist, was associated with prognosis. METHODS: Participants consisted of 1,299 patients who had been diagnosed as having type 1 diabetes at less than 15 years old between 1965 and 1979 identified through two nationwide surveys. Patients were classified as having received either pediatric care or adult care at the age of 15 and 30, and were compared for differences in mortality associated with the attending physician. RESULTS: The attending physicians were confirmed for a total of 1,093 patients at the age of 15. Of these patients, 43.8% and 40.3% received pediatric care and adult care, respectively. Of the 569 patients receiving pediatric care, 74.2%, 56.6%, 53.4%, and 51.3% continued with pediatric care at 20, 30, 40, and 50 years old, respectively. The attending physicians (pediatrician or internist) at the age of 15 and 30 had no significant impact on their survival (P = 0. 892, 0.411, respectively). CONCLUSIONS: More than half of the patients who had received pediatric care at the age of 15 continued to receive pediatric care even after the age of 30, suggesting that their transition was far from smooth, while the attending physician at the age of both 15 and 30 was not a prognostic factor for mortality. Thus, the timing for transition to adult care in these patients has no relationship with mortality in Japan.

Changes in the Composition of Adiponectin Fractions over a 3-Year Period in Children: A Population-Based Cohort Study.

BACKGROUND: Little information is available regarding changes in adiponectin fractions. The objective of this study was to examine changes in the composition of differing adiponectin fractions using a population-based, prospective pediatric cohort. METHODS: A total of 358 fourth graders (9-10 years old) from Ina town in Saitama, Japan, were followed up for 3 years. BMI and total adiponectin (TAD), high-molecular weight adiponectin (HAD), medium-molecular weight adiponectin, and low-molecular weight adiponectin levels were measured in these subjects at baseline and at the end of the follow-up. RESULTS: Of the fourth graders participating in the study, 326 (172 boys and 154 girls; follow-up rate, 91.1%) became available for follow-up. No significant changes were observed in TAD values after 3 years. HAD values were significantly decreased in both the boys (2.4 to 2.2 µg/mL: p < 0.001) and girls (3.1 to 2.7 µg/mL: p = 0.005). All values in the parameters examined at baseline and after 3 years were significantly correlated. A negative correlation was found between the ratios of follow-up compared to baseline values for BMI and those for TAD (boys, r = -0.322, p < 0.001; girls, r = -0.433, p < 0.001) as well as those for HAD (boys, r = -0.353, p < 0.001; girls, r = -0.351, p < 0.001). CONCLUSIONS: HAD had the most robust correlation between its values at baseline and those after 3 years in both boys and girls. The changes in HAD also had the most robust correlation between the changes in BMI in 3 years.

Causes of death in patients with childhood-onset type 1 diabetes receiving dialysis in Japan: Diabetes Epidemiology Research International (DERI) Mortality Study.

AIMS: To investigate the causes of death and how they changed over time in patients with childhood-onset type 1 diabetes who were receiving dialysis. METHODS: Of the 1384 patients who were diagnosed with type 1 diabetes at<18 years of age between 1965 and 1979, 113 who were subsequently confirmed as having received dialysis and having died as of January 1, 2008 were found eligible for the study. The cause of death trends were expressed according to the duration of dialysis. RESULTS: The leading causes of death were end-stage renal disease (ESRD) (36.3%), cardiovascular disease (CVD) (31.9%), and infections (20.3%). Among CVD, cerebral hemorrhage was the most frequent (38.9%) and showed a significant trend for an increase in the duration of dialysis (P=0.01, the Cochran-Armitage trend test). The mortality from ESRD concentrated within 5 years of dialysis and that from CVD increased after 10 years of dialysis, while the mortality from infections peaked during 5 to 10 years from initiation of dialysis. CONCLUSIONS: The leading causes of death in dialysis patients with type 1 diabetes were ESRD, CVD, and infections. As the duration of dialysis increased, however, CVD contributed more to mortality. Special attention should be paid to CVD, particularly cerebral hemorrhage, to improve the long-term prognosis of patients.