Combined effect of body mass index and waist-height ratio on incident diabetes; a population based cohort study.

We investigated the impact of combined effect of body mass index and waist-to-height ratio on risk of diabetes. Overweight and abdominal obesity were defined as body mass index ≥23 kg/m2 and waist-to-height ratio ≥0.5, respectively. We divided participants into four groups according to presence of overweight and/or abdominal obesity. About 20% individuals with overweight did not complicated with an abdominal obesity. Among 3,737 participants, 286 participants had diabetes at baseline-examination. Adjusted odds ratios for prevalence of diabetes compared with non-overweight participants without abdominal obesity were as follow: 1.87 (95% confidence interval 1.09-3.14, p = 0.024) in non-overweight participants with abdominal obesity, 1.51 (0.87-2.55, p = 0.141) in overweight participants without abdominal obesity and 3.25 (2.37-4.52, p<0.001) in overweight participants with abdominal obesity. In the follow-up examination, 86 participants were diagnosed as diabetes among 2,263 participants. Adjusted odds ratios for incident diabetes were as follow: 2.59 (0.98-6.44, p = 0.056) in non-overweight participants with abdominal obesity, 1.65 (0.64-4.00, p = 0.288) in overweight participants without abdominal obesity and 2.77 (1.55-5.15, p<0.001) in overweight participants with abdominal obesity. Non-overweight individuals with abdominal obesity as well as overweight individuals with abdominal obesity was associated with diabetes compared with non-overweight individuals without abdominal obesity.

The novel association between red complex of oral microbe and body mass index in healthy Japanese: a population based cross-sectional study.

Microbiota has been thought to be one of important environmental factors for obesity or Type 2 diabetes mellitus. Among oral microbe, Porphyromonas gingivalis, Treponema denticola and Tannellera forsythia are known as risk factors, so called red complex, for periodontitis. Red complex could also be a risk factor for obesity. However, recent study indicated that obesity was not improved by periodontal therapy. Thus, we performed a cross sectional study to reveal the association of oral microbe with body mass index in a healthy population. Healthy individuals were randomly recruited. The infections of oral microbe were identified by Taqman polymerase chain reaction. The relationships between number of red complex and body mass index or waist circumference were analyzed. Two hundred and twenty-two apparently healthy Japanese were enrolled. BMI and waist circumference as well as age, periodontitis, number of brushing teeth were significantly associated with the number of red complex after adjusting covariance. The effect size of body mass index or waist circumference was 0.023 (p = 0.028) or 0.024 (p = 0.024), respectively. Body mass index and waist circumference were independently associated with the number of red complex among apparently healthy Japanese. The current observation implies the possibility that oral microbe was associated with obesity in healthy population.

Low urine pH Is a predictor of chronic kidney disease.

BACKGROUND/AIMS: A variety of risk factors for chronic kidney disease (CKD), including the metabolic syndrome, were recently reported. It has been suggested that a low urine pH is another characteristic of the metabolic syndrome. However, the relationship between urine pH and CKD remains to be elucidated. METHODS: A cohort study was performed on 1,811 subjects who underwent a health check-up, and we examined whether low urine pH could be a predictor of CKD. The following risk factors for CKD were evaluated: age, gender, history of alcohol intake and smoking, BMI, systolic blood pressure, fasting plasma glucose, total cholesterol, uric acid, total leukocyte count, CKD stage, fasting urine pH, and protein at baseline. RESULTS: We followed 1,811 subjects for a median period of 7.7 years. Three hundred and thirty-nine subjects developed stage 3 CKD defined as progression to estimated glomerular filtration rate < 60 ml/min/1.73 m(2). Multiple Cox regression analysis revealed that the adjusted HR (95% CI) for stage 3 CKD was 1.32 (1.06-1.65; p = 0.0129) in subjects with fasting urine pH 5.0-5.5 compared to subjects with pH 6.5-7.0. CONCLUSION: Our study suggests that low urine pH is an independent predictor of stage 3 CKD.

Classification and analysis of the natural corner curving motion of humans based on gait motion.

The curving motion of the human body is more complex than gait motion for straight walking. In particular, when human can freely curve corners, the gait motion varies among and even within individuals. However, is it not possible to classify natural curving motion using a statistical method? This study investigates the natural curving motion, encompassing various walking paths selected by subjects, as opposed to previous studies that focused on specific stepping strategies or curving motion under precisely controlled conditions. As a result, the natural curving motions are statistically classified into five distinct groups based on certain motion indices. Each group represents a curving strategy and is mainly characterized by the inner inclination of the pelvis, outer rotation of hip joints at the time of heel contact of the inner leg, and inner and/or outer rotation of hip joints at the time of heel contact of the outer leg. Such strategies are speculated as typical motions within the large variation in natural curving motion. Another finding is that, unlike the joint pattern of lower limb joints in the sagittal plane, hip rotation and the abduction/adduction angle drastically change when curving. In particular, the large inner rotation and abduction angles of the hip joint of both legs, which reached approximately 30° and 10°, respectively, become important when considering the curving gait of a physical assistant robot. Our analysis and findings help specify the joint motion required for physical assistant robots.

Relationship between polymorphisms 804C/A and 252A/G of lymphotoxin-alpha gene and -308G/A of tumor necrosis factor alpha gene and diabetic retinopathy in Japanese patients with type 2 diabetes mellitus.

To clarify whether polymorphisms of the lymphotoxin-alpha (LTA) gene and tumor necrosis factor alpha (TNF-alpha) gene were related to diabetic retinopathy (DR), we performed a case-control study in 251 Japanese patients with type 2 diabetes mellitus participating in a multicenter research protocol. Genetic analyses were performed by using a fluorescent allele-specific DNA primer assay system. Diabetic retinopathy was diagnosed in a masked manner by an independent ophthalmologist using fundus photographs and was classified as nondiabetic retinopathy (NDR), nonproliferative retinopathy (NPDR), and proliferative retinopathy (PDR). The results showed that the genotype frequencies of 804C/A in exon 3 and 252A/G in intron 1 of the LTA gene were not significantly different among patients with NDR, NPDR, and PDR. A allelic frequency of the TNF-alpha gene (-302A/G in promoter) was also identical among NDR, NPDR, and PDR groups. Multivariate logistic regression analyses showed that significant associations with DR were glycosylated hemoglobin level and diabetes duration, but not polymorphisms of the LTA gene or TNF-alpha gene. In conclusion, the present study showed no association between polymorphisms 804C/A and 252A/G of the LTA gene and -302A/G of the TNF-alpha gene and DR in Japanese type 2 diabetic patients.

Angiotensinogen gene polymorphism (Met235Thr) influences visceral obesity and insulin resistance in obese Japanese women.

To investigate the relationship between angiotensinogen (AGT) Met235Thr polymorphism (M235T) and human obesity, because AGT is regarded as one of the cytokines produced from adipocytes and serum AGT concentrations are reported to be positively correlated with body mass index. One hundred and twenty obese Japanese women (age, 58.8+/-9.4 years; body mass index, 32.2+/-4.9 kg/m(2)) were enrolled. Angiotensinogen genotypes were determined with a fluorescent allele-specific DNA primer assay system. Subjects were divided into M/M, M/T, and T/T groups. Control subjects comprised 146 healthy age-matched women. Clinical characteristics and the effects of diet and exercise therapy for 6 months were compared among the 3 genotypes. The genotype frequencies of AGT M235T polymorphism were in accordance with the Hardy-Weinberg equation (obese: M/M, 6.7%; M/T, 27.5%; T/T, 65.8%; control: M/M, 6.8%; M/T, 21.2%; T/T, 71.9%). The frequency of the T allele did not differ between obese and control subjects (0.80 vs 0.83). As the number of obese women with M/M genotype was only 8, comparisons of the characteristics and outcomes of weight reduction therapy were performed only between subjects with M/T genotype and T/T genotype. In the T/T group, % body fat and waist circumference at baseline were significantly greater than in the M/T group (36.3%+/-4.8% vs 33.8%+/-4.7%, P=.0105; 107.9+/-10.9 vs 102.6+/-7.9 cm, P=.0428, respectively). Before the weight reduction therapy, significantly higher insulin and higher homeostasis model assessment (HOMA-R) were demonstrated in the T/T group than in the M/T group (9.1+/-5.5 microU/mL vs 5.9+/-4.4 microU/mL, P=.0056; 2.3+/-1.4 vs 1.6+/-1.3, P=.0252, respectively). Both systolic and diastolic blood pressure at baseline in the T/T group tended to be higher than those in the M/T group, but the differences were not significant. No genotype-dependent difference in energy expenditure or outcome of weight reduction therapy was observed with respect to AGT M235T polymorphism. After the diet and exercise therapy, the blood pressure in the T/T group tended to be higher than that in the M/T group, but the difference was not significant. We demonstrated that the T/T genotype of the AGT M235T gene polymorphism was positively related to visceral obesity and hyperinsulinemia in obese Japanese women. Blood pressure did not show genotype-specific differences before or after the treatment. Further studies of the association between obesity and this gene polymorphism should contribute to understanding and treating obesity-related diseases.

Sodium-chloride Difference and Metabolic Syndrome: A Population-based Large-scale Cohort Study.

Objective Metabolic syndrome (MetS) is associated with cardiovascular disease, which is the leading cause of mortality and morbidity. Hypernatremia and hypochloremia are also associated with an increased mortality. Thus, the aim of this study was to evaluate the association between the sodium-chloride difference (Na+-Cl-) and MetS. Methods In this cross-sectional and retrospective cohort study, we enrolled 3,875 subjects and evaluated the relationship between Na+-Cl- and MetS using logistic regression analyses. MetS was diagnosed according to the joint interim statement when a subject had three or more of the following criteria: hypertension; hyperglycemia; hypertriglyceridemia; low high-density lipoprotein (HDL) cholesterol; and abdominal obesity. Results There were 3,354 subjects without MetS and 521 subjects with MetS at baseline. The highest Na+-Cl- quartile (≥43 mmol/L) was associated with an increased risk of the presence of MetS compared to the lowest Na+-Cl- quartile (≤38 mmol/L) after adjusting for covariates, including age, sex, the body mass index, systolic blood pressure, fasting plasma glucose, triglycerides, HDL cholesterol, creatinine, uric acid and lifestyle factors [multivariate odds ratio (OR) 1.81, 95% confidence interval (CI) 1.17-2.84, p=0.0078]. After an 8-year follow-up, 658 out of 3,352 subjects were newly diagnosed with MetS. The highest Na+-Cl- quartile (≥43 mmol/L) was associated with an increased risk of the development of MetS compared to the lowest Na+-Cl- quartiles (≤38 mmol/L) after adjusting for covariates (multivariate OR 1.76, 95% CI 1.27-2.45, p=0.0007). Conclusion The sodium and chloride difference is associated with MetS.

Noninvasive evaluation of coronary reperfusion by transthoracic Doppler echocardiography in patients with anterior acute myocardial infarction before coronary intervention.

BACKGROUND: Transthoracic Doppler echocardiography (TTDE) enables evaluation of distal left anterior descending coronary artery (LAD) flow. The purpose of this study was to test whether TTDE can differentiate coronary reperfusion with Thrombolysis in Myocardial Infarction (TIMI) grade 3 from TIMI grade < or =2 in patients with anterior acute myocardial infarction (AMI). METHODS AND RESULTS: In 46 consecutive patients with a first anterior AMI in the acute phase before emergent coronary intervention, the presence of antegrade distal LAD flow and its diastolic peak velocity were evaluated by color and pulsed TTDE and compared with TIMI grades by subsequent coronary angiography performed 29+/-12 minutes later. Nineteen patients had TIMI 0 reperfusion, 4 had TIMI 1, 10 had TIMI 2, and 13 had TIMI 3. Visual antegrade distal LAD flow was present in 22 of the 46 patients. TIMI 2 and 3 reperfusions were both generally visualized by color TTDE. However, peak distal LAD flow velocity by pulsed TTDE was significantly greater in patients with TIMI 3 compared with those with TIMI 2 (40+/-10 vs 20+/-6 cm/s, P<0.0001). The diagnosis of TIMI 3 based on diastolic peak distal LAD flow velocity > or =25 cm/s by TTDE had a sensitivity, specificity, and accuracy of 77%, 94%, and 89%, respectively. CONCLUSIONS: TTDE enables noninvasive differentiation of TIMI 3 from TIMI < or =2 coronary reperfusion in patients with AMI in the acute phase before emergent coronary intervention.

Association study of G1704T and G82S polymorphisms of RAGE gene for microalbuminuria in Japanese type 2 diabetic patients.

To clarify whether polymorphisms G1704T and G82S of the RAGE gene were related to microalbuminuria, we performed a case-control study in Japanese type 2 diabetic patients. Polymorphisms G1704T and G82S of the RAGE gene were examined with genomic DNA obtained from 116 type 2 diabetic patients with microalbuminuria (urinary albumin/creatinine ratio between 30 and 300 mg/g of creatinine) (microalbuminuria group), and 232 patients with normoalbuminuria (urinary albumin/creatinine ratio <30 mg/g of creatinine) (normoalbuminuria group). The genotype distribution and T allele frequency of G1704T (9.9%) and S allele frequency of G82S (14.2%) in the microalbuminuria group did not significantly differ from those (T allele frequency, 8.4%; S allele frequency, 12.3%) in the normoalbuminuria group. There were no differences among the genotypes of G1704T and G82S of the RAGE gene regarding age, duration of diabetes, body mass index, glycosylated hemoglobin (HbA1c), blood pressure, and serum lipid levels. These data suggest that G1704T and G82S polymorphisms of the RAGE gene are not related to microalbuminuria in Japanese type 2 diabetic patients.

Noninvasive prediction of complications with anteroseptal acute myocardial infarction by left ventricular Tei index.

BACKGROUND: Tei index has been proposed as a noninvasive and simple index that enables the evaluation of global left ventricular (LV) function and prediction of patient prognosis. However, its use to predict complications with acute myocardial infarction (AMI) is not fully investigated. Therefore, the purpose of this study was to investigate whether or not LV Tei index allows noninvasive prediction of complications with AMI. METHODS: In all, 80 consecutive patients with anteroseptal AMI were enrolled. LV Tei index was measured at the time of admission as (a - b)/ b , where a is the interval between cessation and onset of mitral filling flow and interval b is the aortic flow ejection time. Subsequent complications including cardiac death, shock, congestive heart failure, ventricular tachycardia/fibrillation, paroxysmal atrial fibrillation/flutter, advanced atrioventricular block requiring pacing, pericardial effusion, and LV aneurysm during the 30 days after the onset of AMI were prospectively evaluated and compared with the initial Tei index at admission. RESULTS: Complications developed in 31 of 80 (39%) patients with AMI. The Tei index was significantly increased for patients with complications compared with those without them (0.69 +/- 0.16 vs 0.50 +/- 0.11, P < .0001). When Tei index > or = 0.59 was used for the criteria, the sensitivity, specificity, and overall accuracy to predict subsequent complications were 77%, 86%, and 85%, respectively. CONCLUSION: In patients with anteroseptal AMI, LV Tei index at arrival to the hospital in the acute phase allows noninvasive prediction of subsequent complications.

Thr54 allele of the FABP2 gene affects resting metabolic rate and visceral obesity.

We investigated the relationship between Ala54Thr variant allele of the fatty acid-binding protein 2 (FABP2) gene (Ala54Thr) and development of obesity in Japanese obese women. FABP2 genotypes were determined with a fluorescent allele-specific DNA primer assay system. Body weight, waist and hip circumference, amounts of visceral and subcutaneous white adipose tissue measured by computed tomography (CT) were compared between subjects with Thr allele and without Thr allele before and after the diet and exercise therapy in 80 Japanese obese women. The frequency of the Thr54 allele did not differ between obese and control subjects (0.388 versus 0.329, respectively). In subjects with Ala/Thr and Thr/Thr genotype, adjusted resting metabolic rate (RMR) was significantly lower than the subjects with Ala/Ala genotype. Subjects with the Thr54 allele showed significantly greater waist circumference after diet and exercise therapy than subjects with Ala/Ala genotype. They also demonstrated greater body weight at 20 years of age compared to subjects with Ala/Ala genotype. In conclusion, Thr54 allele of FABP2 has associations with lower adjusted resting metabolic rate, resistance in reducing visceral white adipose tissue (WAT) and early onset of obesity in Japanese obese women.

Relation between polymorphisms G1704T and G82S of rage gene and diabetic retinopathy in Japanese type 2 diabetic patients.

OBJECTIVE: To clarify whether polymorphisms G1704T and G82S of the rage gene were related to diabetic retinopathy, we performed a case-control study in Japanese type 2 diabetic patients. PATIENTS AND METHODS: Two hundred and sixty-eight patients with type 2 diabetes were examined for polymorphisms G1704T and G82S of the RAGE gene. The genotypes of G1704T and G82S of the RAGE gene were determined with a fluorescent allele-specific DNA primer assay system. Diabetic retinopathy (DR) was diagnosed in a masked manner by independent ophthalmologists using fundus photographs and was classified as non-diabetic retinopathy (NDR), non-proliferative retinopathy (NPDR), and proliferative retinopathy (PDR). RESULTS: The T allele frequency of G1704T and S allele frequency of G82S in patients with DR did not significantly differ from those without retinopathy. There were no differences among the genotypes of G1704T and G82S of the RAGE gene regarding age, duration of diabetes, BMI, HbA(1c), blood pressure, and lipids levels. CONCLUSION: These data suggest that polymorphisms G1704T and G82S of the RAGE gene are not related to DR in Japanese type 2 diabetic patients.

Hemoglobin concentration and incident metabolic syndrome: a population-based large-scale cohort study.

Previous cross-sectional studies revealed an association between hemoglobin concentration and a prevalence of metabolic syndrome (MetS). However, the association between hemoglobin concentration and incident MetS remains to be elucidated. Thus, the aim of this study was to investigate the association between hemoglobin concentration and incident MetS. We enrolled 2695 subjects (1454 men and 1241 women) and performed 8-year follow-up cohort study. MetS was diagnosed, according to the joint interim statement, when a subject had three or more of the following components: hypertension; hyperglycemia; hypertriglyceridemia; low high-density lipoprotein cholesterol; and abdominal obesity. Logistic regression analyses were performed to assess the impact of hemoglobin concentration on incident MetS by adjusting for age, body mass index, lifestyle factors, including smoking status, habit of alcohol and habit of exercise, systolic blood pressure, fasting plasma glucose, triglycerides, high-density lipoprotein cholesterol, creatinine, and uric acid. The highest (≥157 g/L) and third (151-156 g/L) hemoglobin concentration quartiles were associated with the increased risk of incident MetS compared to the lowest (<145 g/L) hemoglobin concentration quartile after adjusting for covariates in men (multivariate odds ratio (OR) 2.24, 95% CI 1.34-3.85, P = 0.0021 and multivariate OR 2.03, 95% CI 1.21-3.45, P = 0.0070). On the other hand, there was no association between hemoglobin concentration and incident MetS in women. Hemoglobin concentration was a novel risk marker for incident MetS in men.

Metabolically healthy obesity and risk of incident CKD.

BACKGROUND AND OBJECTIVES: Metabolically healthy obesity (MHO) is a unique obesity phenotype that apparently protects people from the metabolic complications of obesity. The association between MHO phenotype and incident CKD is unclear. Thus, this study investigated the association between MHO phenotype and incident CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A total of 3136 Japanese participants were enrolled in an 8-year follow-up cohort study in 2001. Metabolically healthy status was assessed by common clinical markers: BP, triglycerides, HDL cholesterol, and fasting plasma glucose concentrations. Body mass index ≥25.0 kg/m(2) was defined as obesity. CKD was defined by proteinuria or eGFR of <60 ml/min per 1.73 m(2). To calculate the odds ratio for incident CKD, logistic regression analyses were performed. RESULTS: The crude incidence proportions of CKD were 2.6% (56 of 2122 participants) in participants with the metabolically healthy nonobesity phenotype, 2.6% (8 of 302) in those with the MHO phenotype, 6.7% (30 of 445) in those with the metabolically abnormal nonobesity phenotype, and 10.9% (29 of 267) in those with the metabolically abnormal obesity phenotype. Compared with metabolically healthy nonobesity phenotype, the odds ratios for incident CKD were 0.83 (95% confidence interval [95% CI], 0.36 to 1.72; P=0.64) for MHO, 1.44 (95% CI, 0.80 to 2.57; P=0.22) for metabolically abnormal nonobesity, and 2.80 (95% CI, 1.45 to 5.35; P=0.02) for metabolically abnormal obesity phenotype after adjustment for confounders, including age, sex, smoking statues, alcohol use, creatinine, uric acid, systolic BP, HDL cholesterol, and impaired fasting glucose or diabetes. CONCLUSION: MHO phenotype was not associated with higher risk of incident CKD.

The PR interval and QRS duration could be predictors of renal function decline.

OBJECTIVE: Previous studies have implicated PR interval (iPR) and QRS duration (dQRS) obtained by electrocardiography in independent predictors of cardiovascular disease, which often precedes renal dysfunction. The aim of this study was to examine whether iPR or dQRS could be a predictor of renal function decline in a community-based cohort. METHODS: We enrolled 1149 healthy subjects, and retrospectively evaluated the relationships between iPR or dQRS and renal function decline, observation period of which was 3 years, and assessed whether iPR or dQRS could predict renal function decline. RESULTS: The iPR (r=-0.102, p=0.0006) or dQRS (r=-0.097, p=0.0010) was negatively associated with a rate of decline in estimated glomerular filtration rate (eGFR). Multiple regression analyses revealed that iPR (ß=-0.095, p=0.0023) or dQRS (ß=-0.069, p=0.0351) was an independent determinant of the rate of decline in eGFR after adjustment for covariates. Logistic regression analyses demonstrated that the longest iPR (odds ratios (OR), 2.03; 95% confidence intervals (CI), 1.49 to 2.76; p<0.0001) or dQRS (OR, 1.62; 95% CI, 1.16 to 2.25; p=0.0043) tertile showed an increased OR for prevalence of the rate of decline in eGFR≤1 ml/min/1.73 m2/year compared to the shortest iPR or dQRS tertile after adjustment for covariates. CONCLUSION: The iPR and dQRS could be independent predictors of renal function decline in healthy subjects.

Adiponectin gene polymorphism (G276T) is not associated with incipient diabetic nephropathy in Japanese type 2 diabetic patients.

A single-nucleotide polymorphism (SNP) G276T in the adiponectin gene has been associated with lower plasma adiponectin levels and insulin resistance, which are related to the prevalence of type 2 diabetes or diabetic complications of macroangiopathy. We performed a case-control study to examine whether the SNP276 of the adiponectin gene was also related to early diabetic nephropathy. SNP276 was examined with genomic DNA obtained from 108 type 2 diabetic patients with microalbuminuria (urinary albumin creatinine ratio [ACR] between 30 mg/g x Cr and 300 mg/g x Cr; case subjects), and 208 patients with normoalbuminuria (ACR < 30 mg/g x Cr; control subjects). The genotype distribution and G allele frequency of SNP276 in the case subjects (0.71) did not significantly differ from the control subjects (0.69). There were no differences among the genotypes of the adiponectin gene regarding age, duration of diabetes, body mass index (BMI), hemoglobin A(1c) (HbA(1c)), serum lipids, serum creatinine, and plasma adiponectin levels. These data suggest that SNP276 of the adiponectin gene is not an independent risk factor for incipient diabetic nephropathy in Japanese type 2 diabetic patients.

Homocysteine and hemostatic disorder as a risk factor for myocardial infarction at a young age.

INTRODUCTION: Hyperhomocysteinemia is a coronary risk factor, but its pathophysiologic mechanism remains unclear. MATERIALS AND METHODS: The importance of hyperhomocysteinemia in the pathogenesis of early myocardial infarction, was determined in case-control study of 127 men with a first early myocardial infarction

Low serum bilirubin concentration is a predictor of chronic kidney disease.

OBJECTIVE: Chronic kidney disease (CKD) is a worldwide public health problem. It is very important to identify the factors that affect CKD. Previous studies have reported that serum bilirubin concentration was positively correlated with renal function in a cross-sectional study. The aim of this study was to investigate the relationship between serum bilirubin concentration and the progression of CKD. METHODS: A cohort study was performed on a consecutive series of 2784 subjects without CKD, defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m(2), at baseline. We analyzed the relationship between serum total bilirubin concentration at baseline and new-onset CKD in the general population. RESULTS: We followed the subjects for a median period of 7.7 years. There were 1157 females and 1627 males, and 231 females and 370 males developed CKD during this period. Multiple Cox regression analyses revealed that serum total bilirubin concentration (hazard ratio (HR) per 1.0 µmol/L increase 0.97 (95% CI 0.95-0.99), P = 0.0084) in addition to age, gamma-glutamyl transpeptidase (GGT), uric acid (UA), creatinine and medication for hypertension in men and serum total bilirubin concentration (HR per 1.0 µmol/L increase 0.96 (95% CI 0.93-1.00), P = 0.0309) in addition to age, GGT, alanine aminotransferase, UA, creatinine and medication for dyslipidemia in women were independent predictors of new-onset CKD, after adjusting for confounders. CONCLUSION: Our study demonstrated that serum total bilirubin concentration could be a novel risk factor for the progression of CKD, defined as eGFR <60 ml/min/1.73 m(2), in the general population.

Atrophic gastritis is associated with coronary artery disease.

Atrophic gastritis is characterized by chronic inflammation of gastric mucosa by Helicobacter pylori infection and other factors. Helicobacter pylori infection has been linked to coronary artery disease. To our knowledge, however, no reports are available on the relationship between atrophic gastritis and coronary artery disease. In this study, we investigated the relationship between atrophic gastritis, which is diagnosed based on serum pepsinogen levels (pepsinogen I ≤ 70 ng/mL and pepsinogen I/II ratio ≤ 3.0), and the prevalence of coronary artery disease in general Japanese population. Among 2,633 study subjects, 531 subjects (20.2%) were diagnosed as atrophic gastritis. The prevalence of coronary artery disease was higher in the atrophic gastritis-positive group than that in the atrophic gastritis-negative group (5.8% vs 2.8%, p = 0.0005). Multiple logistic regression analysis demonstrated that atrophic gastritis was independently associated with coronary artery disease (odds ratio, 1.67; 95% confidence interval, 1.03-2.72), after adjustment for age, sex, obesity, hypertension, diabetes mellitus, dyslipidemia, hyperuricemia, and habits of smoking and drinking. These results suggest that atrophic gastritis is an independent risk factor for coronary artery disease. Chronic inflammation of gastric mucosa may be associated with the prevalence of coronary artery disease.

The serum concentration of allograft inflammatory factor-1 is correlated with metabolic parameters in healthy subjects.

Obesity is associated with low-grade chronic inflammation characterized by inflamed adipose tissue with increased infiltration of macrophages. The aim of this study was to investigate the correlations between the serum concentration of allograft inflammatory factor-1 (AIF-1), which is a marker of activated macrophages, and metabolic parameters. The serum AIF-1 concentrations were measured in 303 healthy subjects (163 men and 140 women). We then evaluated the relationships between the serum AIF-1 concentrations and metabolic parameters, including fasting plasma glucose levels, serum lipid concentration, uric acid concentration, and waist circumference. The serum AIF-1 concentrations positively correlated with levels of fasting plasma glucose (r = 0.159, P =.0056), hemoglobin A(1c) (r = 0.169, P = .0032), triglycerides (r = 0.137, P = .0172), and uric acid (r = 0.146, P = .0108) and with waist circumference (r = 0.221, P = .0001) and body mass index (r = 0.185, P = .0012), whereas the serum AIF-1 concentrations inversely correlated with high-density lipoprotein cholesterol level (r = -0.178, P = .0019). Stepwise multiple regression analysis demonstrated that hemoglobin A(1c) level (ß = .133, F = 5.490, P < .05) and waist circumference (ß = .197, F = 11.954, P < .05) were independent predictors of the serum AIF-1 concentrations. The serum AIF-1 concentrations correlated with clinical and biochemical metabolic parameters. Allograft inflammatory factor-1 may be a significant predictor of activated macrophages as well as cardiovascular disease in humans.