A survey of clinical physician's perceptions of stigma and advocacy in patients with type 2 diabetes in Kanagawa, Japan.

AIMS/INTRODUCTION: To investigate the recognition status of stigma/advocacy in patients with type 2 diabetes in clinical practice settings. METHOD: A questionnaire survey on stigma/advocacy of patients with diabetes was carried out for members of the Kanagawa Physicians Association in July 2021. RESULTS: The respondents consisted of 33 (16.6%) physicians specializing in diabetes (the D group) and 166 (83.4%) non-specialists (the ND group). 100% of the D group and 48.8% of the ND group knew that patients may be prejudiced or discriminated against because of diabetes. In the question of whether they know the terms 'stigma' and 'advocacy', 'know' was 97.0% and 94.0% in the D group, compared with 45.8% and 36.7% in the ND group, respectively. 97.0% of the D group and 19.9% of the ND group know the advocacy activities of the Japanese Diabetes Society (JDS) and the Japan Association for Diabetes Education (JADEC). The specific contents of the stigma were often unknown or never experienced in the ND group. A free description of the strategy for reducing or eliminating stigma was analyzed by text mining. 'Giving consideration to the patients' feelings', 'Commitment to the problem', and 'Dialogue' were frequent, and there was no significant difference between the two groups. CONCLUSIONS: The clinician's understanding of stigma/advocacy associated with having diabetes was insufficient, and activities that alert clinicians to stigma/advocacy, especially those in the ND group, was a theme to be addressed. More awareness-raising activities for stigma/advocacy will lead to better treatment and a better quality of life for patients with diabetes.

First Identification of a CMB Lensing Signal Produced by 1.5 Million Galaxies at z∼4: Constraints on Matter Density Fluctuations at High Redshift.

We report the first detection of the dark matter distribution around Lyman break galaxies (LBGs) at high redshift through the cosmic microwave background (CMB) lensing measurements with the public Planck PR3 κ map. The LBG sample consists of 1 473 106 objects with the median redshift of z∼4 that are identified in a total area of 305 deg^{2} observed by the Hyper Suprime-Cam Strategic Survey Program survey. After careful investigations of systematic uncertainties, such as contamination from foreground galaxies and cosmic infrared background, we obtain the significant detection of the CMB lensing signal at 5.1σ that is dominated by 2-halo term signals of the LBGs. Fitting a simple model consisting of the Navarro-Frenk-White profile and the linear-bias model, we obtain the typical halo mass of M_{h}=2.9_{-2.5}^{+9.5}×10^{11} h^{-1} M_{⊙}. Combining the CMB lensing and galaxy-galaxy clustering signals on the large scales, we demonstrate the first cosmological analysis at z∼4 that constrains (Ω_{m0},σ_{8}). We find that our constraint on σ_{8} is roughly consistent with the Planck cosmology, while this σ_{8} constraint is lower than the Planck cosmology over the 1σ level. This study opens up a new window for constraining cosmological parameters at high redshift by the combination of CMB and high-z galaxies, as well as studying the interplay between galaxy evolution and large-scale structure at such high redshift, by upcoming CMB and optical and near-infrared imaging surveys.

The Proportion of Long-term Response to Anti-N IgG Antibody after 12 Months for COVID-19 Subclinical Infections and a Longitudinal Survey for COVID-19 Subclinical Infections in 2021.

Objective To examine the continuation of antibody prevalence status after 12 months and background factors in antibody-positive subjects following asymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We initially determined the SARS-CoV-2 anti-nucleocapsid protein immunoglobulin G (anti-N IgG) antibody prevalence in 1,603 patients, doctors, and nurses at 65 medical institutions in Kanagawa Prefecture, Japan. We then obtained consent from 33 of the 39 subjects who tested positive and performed follow-up for 12 months. Results Follow-up for up to 12 months showed that a long-term response of the anti-N IgG antibody could be detected in 6 of the 33 participants (18.2%). The proportions with hypertension, using an angiotensin-receptor blocker, and without a drinking habit were higher among the participants with a long-term anti-N IgG antibody response for up to 12 months than among those without a long-term antibody response. Conclusions The proportion of individuals with subclinical COVID-19 who continuously had a positive result for the anti-N IgG antibody at 12 months was low.

A nasal double DNA adjuvant system induces atheroprotective IgM antibodies via dendritic cell-B-1a B cell interactions.

We previously demonstrated that the dendritic cell (DC)-targeting nasal double DNA adjuvant system, which consists of a DNA plasmid expressing Flt3 ligand (pFL) and CpG oligodeoxynucleotide 1826 (CpG ODN), elicits specific immune responses to various antigens in the mucosal and systemic compartments. Here, we investigated, using phosphorylcholine (PC)-conjugated keyhole limpet hemocyanin (PC-KLH) as an antigen, whether the nasal double DNA adjuvant system induces protective immunity to atherosclerosis in apolipoprotein E-deficient (ApoE KO) mice. Further, we assessed the molecular and cellular mechanisms in the induction of anti-PC-specific immune responses. Nasal immunization with PC-KLH plus pFL and CpG ODN enhanced induction of PC-specific IgM in plasma, peritoneal fluids, and nasal washes when compared with mice administered PC-KLH alone. Of importance, these antibodies exhibited highly specific binding to the PC molecule, and dose-dependent binding to anti-T15 idiotype (AB1-2). Twelve weeks after the last immunization, the nasal double DNA adjuvant system with PC-KLH resulted in a reduction of atherogenesis in the aortic arch of ApoE KO mice. Therefore, we next assessed immunocytological mechanism to induce these antibodies. The nasal double DNA adjuvant system with PC-KLH resulted not only in significantly increased frequencies of CD11c+ DCs in the spleen, peritoneal cavity (PEC), and nasopharyngeal-associated lymphoid tissues (NALT), but also significantly increased expression of a proliferation-inducing ligand and B-cell-activating factor by CD11c+ DCs. In addition, the double DNA adjuvant system induced significantly increased numbers of B-1 B cells in the spleen, PEC, and NALT, and increased expression of transmembrane activator and calcium modulator and cyclophilin ligand interactor on CD5+ B220+ (B-1a) B cells. These findings demonstrated that the nasal double DNA adjuvant system with PC-KLH resulted in the induction of T15-like antibodies in the mucosal and systemic lymphoid tissues through interaction between DCs and B-1a B cells, and inhibited the progression of atherogenesis.

Study on Continuation of Antibody Prevalence Six Months after Detection of Subclinical Severe Acute Respiratory Syndrome Coronavirus 2 Infections.

Objective To examine the continuation of antibody prevalence and background factors in antibody-positive subjects after asymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods A study was carried out to investigate the SARS-CoV-2 antibody (IgG) prevalence. SARS-CoV-2 antibodies (IgG) were measured and analyzed with immunochromatographic tests. Patients Among 1,603 subjects, comprising patients, physicians, and nurses at 65 medical institutes in Kanagawa, Japan, 39 antibody-positive subjects received follow-up for 6 months. Results Of the 33 subjects who consented to the follow-up (23 patients and 10 medical professionals), continued positivity of IgG antibodies was confirmed in 11 of 32 cases (34.4%) after 2 months, 8 of 33 (24.2%) after 4 months, and 8 of 33 (24.2%) after 6 months. A significant difference was found in the sleeping time, drinking habits, hypertension, and use of angiotensin-receptor blockers on comparing subject background characteristics among three groups: patients with antibody production that continued for six months after the first detection of positivity, patients in whom antibody production stopped at four months, and patients in whom antibody production stopped at two months. Conclusion The continuation rate of IgG antibody prevalence was 24.2% at 6 months after the first detection of antibody positivity in cases with asymptomatic coronavirus disease 2019 (COVID-19) infections. This percentage is low compared with the antibody continuation rate in patients who have recovered from symptomatic COVID-19 infection.

Effect of jaw clenching on head acceleration during a predictable load impact.

BACKGROUND: Jaw clenching is considered to reduce head acceleration while receiving a strong impact on the body during sport activities. OBJECTIVE: The present study aimed to clarify the effect of jaw clenching on reduction of head acceleration during a predictable load impact to the body. METHODS: Seven healthy participants were exposed to a predictable load impact with and without jaw clenching. We recorded the electromyographic activity of the masseter (MA) and digastricus (DIG) muscles, occlusal pressure and head acceleration throughout the experiment. RESULTS: When participants were not instructed to clench their jaws, they naturally positioned their jaws without occlusal contact at the time of pendulum impact by co-contracting the jaw opener and closer muscles. When participants were instructed to clench their jaws, neither the activity of the jaw opener muscle nor the head acceleration differed at the time of pendulum impact when compared with when participants were not instructed to clench their jaws. CONCLUSIONS: A slightly distanced jaw position (co-contracting the jaw opener and closer muscles without occlusal contact) might serve inherently safety for reduction of head acceleration during predictable body impact, while jaw clenching does not contribute to reduction of head acceleration in response to pendulum impact more than the distanced jaw position does. Notably, DIG activation to minimise the head acceleration in response to pendulum impact was similar in clenching and no clenching positions. This suggests that DIG may play a crucial role in the reduction of head acceleration, regardless of MA muscle activity.

Visceral Fat Area by Abdominal Bioelectrical Impedance Analysis as a Risk of Obstructive Sleep Apnea.

This is the first study to evaluate directly visceral fat area (VFA) using a visceral fat (VF) meter by the abdominal bioelectrical impedance analysis (A-BIA) method in obstructive sleep apnea (OSA) patients diagnosed with polysomnography (PSG). The purpose of this study is to clarify (1) whether VFA measurement using a VF meter by the A-BIA method is possible even in a private clinic without burdening patients and staff and (2) how much VFA affects OSA compared to body mass index (BMI). Even without a computed tomography scan, which is the gold standard for VFA measurement, a VF meter could analyze patients by the A-BIA method and easily measure VFA. Therefore, it could be used safely even in a private sleep clinic, with very little burden on the patients and the medical staff. We investigated the association between OSA and VFA in 133 OSA patients. Multiple regression analysis revealed that VFA (ß = 0.28; P = 0.020) was a stronger coexisting factor for OSA than age, male gender, or BMI (ß = 0.26; P = 0.032) in all OSA patients. In the OSA patients with VF accumulation, only VFA was a significant component of OSA severity (ß = 0.36; P = 0.006). The A-BIA method instrument could become a useful device for the evaluation of VF accumulation in OSA patients in private sleep clinics. VF accumulation should be recognized as an important risk factor as well as a known risk factor for OSA.

Complete Denture Fabrication Using Digitally Fabricated Copy Dentures for a Patient with Moderate Dementia.

A 91-year-old woman was referred to our hospital with a chief complaint of unsatisfactory fit and pain associated with her complete dentures. She had moderate dementia with difficulty in communication (Mini-Mental State Examination, 16; Barthel Index, 15). The closed impressions and jaw record were taken with the digitally fabricated copy dentures as follows. First, the tissue conditioner was used to correct the poor fit of the old dentures, following which minor occlusal alterations were made. Second, the copy dentures that copied the morphology of the corrected old dentures using three-dimensional (3D) scanner were fabricated with a 3D printer. The new dentures were then fabricated using conventional methods as follows. The impressions were cast and articulated, and the dentures were subsequently processed. This case report documented the following results. First, the acceptance of new dentures appeared to be easier since the new dentures copied the morphology of the familiar dentures digitally. Moreover, the 3D data of the dentures could be used for immediate denture fabrication in case of fracture or loss of the dentures. Second, only two visits were required for taking an impression and delivering the complete dentures. In addition, her old dentures were brought to our dental office by the patient's family after the patient's dinner; immediately after copying the dentures' morphology, the dentures were returned to the patient's family, thus avoiding any disturbance to the patient's eating routine. These reduced the burden on the patient and her family.

Severe gag reflex during dental treatment associated with hiatus hernia: A case report.

AIMS: This report presents a case wherein severe gagging during dental treatment was linked to hiatus hernia. METHODS AND RESULTS: A 22-year-old man with a severe gagging problem presented with a chief complaint of pain localized to the lower molars. Oral examination revealed inadequate plaque control, demineralization of the enamel surface on buccal-gingival margins of all teeth, and inflamed gingival tissue surrounding the coronal portion of both mandibular third molars; panoramic radiography revealed that they were horizontally impacted. As the patient reported experiencing vomiting and heartburn for the past two months, he was referred to the internal medicine department before scheduling surgical tooth extraction. Hiatus hernia and reflux esophagitis were diagnosed, and the severity of gagging was significantly reduced by modifying the patient's eating behavior and administering a proton pump inhibitor. Although intravenous sedation was still required for surgical extraction of the impacted third molars, preventive treatments, such as tooth cleaning and fluoride application, could be performed without the need for pharmacological intervention. CONCLUSION: While gagging is often attributed to conditioning responses and iatrogenic factors, interdisciplinary consultation for successful management may facilitate the elucidation of local anatomical and systemic causes.

Effect of jaw clenching on postural adjustments to a predictable external perturbation.

This study investigated the effect of jaw clenching on anticipatory postural adjustments (APAs) and reactive postural adjustments (RPAs). Eight healthy adults were exposed to predictable external perturbations with and without submaximal jaw clenching. We recorded the three-dimensional body kinematics, ground reaction forces, and electromyography (EMG) of 12 muscles. EMG onset, integrated EMG, and positions of the center-of-mass (COM) and center-of-pressure (COP) during the anticipatory and reactive phases of postural adjustments were computed and compared for the jaw clenching and control conditions. Jaw clenching resulted in an earlier onset of APAs and a greater amplitude of trunk and lower limb EMG activities in the APAs and RPAs. There were no differences in the COM and COP displacements after the perturbation. Jaw clenching is effective for enhancing APAs and RPAs, although it may not increase postural stability following predictable external perturbation in healthy adults.

Occlusal support and postural stability in children: An observational study.

BACKGROUND: The relationship between uneven occlusal contact and fall risk has been described in elderly participants; however, multiple confounding factors, such as systemic disease or deterioration in vestibular function, have not been well considered. This study aimed to investigate this relationship in pediatric participants at the age of approximately 9-12, where these confounding factors are absent and the replacement of primary molars by permanent ones generally occurs and transiently results in uneven occlusal contact. METHODS: Sixty-five children (36 boys and 29 girls, mean age: 9.5 ± 1.5 years) were enrolled in this study. Participants were asked whether they had experienced at least two falls within the past 1 year. The occlusal contact area ratio was calculated by dividing the greater half (right or left dental arch) by the smaller half (the other half) with U-shaped pressure sensor sheet. The total length and rectangular area of the center of pressure while standing upright for 10 s were measured with a stabilometer and used as postural sway parameters. RESULTS: The occlusal contact area ratio significantly correlated with the postural sway parameters. Comparison between those who had experienced the fall incidences and those who had not after propensity score matching that adjusts their overall physical function revealed that there were no significant differences in the postural sway parameters and occlusal contact area ratio regardless of the history of fall incidence. CONCLUSIONS: Uneven occlusal contact leads to an increase in postural sway in children; however, this may not be associated with fall incidence.

The effect of occlusal splints on the mechanical stress on teeth as measured by intraoral sensors.

PURPOSE: Whether it is possible to prevent mechanical stress on teeth via an occlusal splint remains to be clarified. This study aimed to assess the same by simultaneously recording the occlusal pressure and strain on the teeth in humans. METHODS: Eleven participants (five women and six men; mean age 25.7 years) were enrolled in this study. Hard and soft oral appliances were fabricated for the maxillary arch of each participant. The strain on the four target teeth (right maxillary and mandibular first premolars, and first molars) and occlusal pressure were concurrently measured, while the participants performed maximum voluntary teeth clenching under each condition (hard, soft, or no occlusal splint). RESULTS: Compared to the absence of an occlusal splint, hard occlusal splints generated less strain on molar teeth but more strain on premolar teeth, while soft occlusal splints did not lower the strain on all target teeth significantly. CONCLUSION: Considering the limitations of this study, hard occlusal splints should be used for the protection of molar teeth but for premolar teeth caution is required and depends on the case. On the other hand, soft occlusal splints may not have any benefit for the protection of either type of teeth for patients exhibiting excessive occlusal pressure.

Survey of the current status of subclinical coronavirus disease 2019 (COVID-19).

OBJECTIVES: We investigated relationships between subclinical COVID-19 (coronavirus disease 2019) and background factors. METHODS: We determined SARS-CoV-2 antibody (IgG) prevalence in 1603 patients, doctors, and nurses in 65 medical institutions in Kanagawa Prefecture, Japan and investigated their background factors. Antibodies (IgG) against SARS-CoV-2 were analyzed by Immunochromatographic test. RESULTS: The 39 subjects (2.4%) were found to be IgG antibody-positive: 29 in the patient group (2.9%), 10 in the doctor/nurse group (2.0%), and 0 in the control group. After adjustment for age, sex, and the antibody prevalence in the control group, antibody prevalence was 2.7% in the patient group and 2.1% in the doctor/nurse group. There was no significant difference between the antibody-positive subjects and the antibody-negative subjects in any background factors investigated including overseas travel, contact with overseas travelers, presence/absence of infected individuals in the living area, use of trains 5 times a week or more, BCG vaccination, and use of ACE inhibitor and ARB. CONCLUSIONS: Antibody prevalence in the present survey at medical institution is higher than that in Tokyo and in Osaka measured by the government suggesting that subclinical infections are occurring more frequently than expected. No background factor that influenced antibody-positive status due to subclinical infection was identified.

Association between Sports-Related Concussion and Mouthguard Use among College Sports Players: A Case-Control Study Based on Propensity Score Matching.

Sports-related concussion (SRC) is a major public health concern. This study aimed to assess the association between mouthguard use and the incidence of SRC in college students through a case-control study using propensity score matching. In total, 195 of 2185 potential participants volunteered to participate in this study. We used Google Forms online to capture participants' information, including: age; gender; height; weight; sports contact level; level of play; exposure time; frequency of mouthguard use; mouthguard type; and SRC experience. Data for 115 participants who played collision and contact sports were used for the analysis. The difference in the frequency of mouthguard use was assessed between matched pairs and the overall association between SRC and mouthguard use was evaluated. In the matched groups, those who had not experienced SRC wore a mouthguard more frequently than those who had experienced SRC (7/28 vs. 1/28; p = 0.051). Logistic regression analysis showed there was a significant negative association between the frequency of mouthguard use and the incidence of SRC (odds ratio 0.101; p = 0.041). Within the limitations of this study, these results suggest that mouthguard use may offer some benefit in preventing SRC.

Suppression of advanced glycation and lipoxidation end products by angiotensin II type-1 receptor blocker candesartan in type 2 diabetic patients with essential hypertension.

OBJECTIVE: This study investigated whether the angiotensin II type-1 receptor blocker (ARB) candesartan affects markers of oxidative stress in type 2 diabetes mellitus (DM) patients with essential hypertension (EH). METHODS: Urinary excretion of pyrraline (PR), pentosidine (PT), acrolein (AC), and 8-hydroxy-2'-deoxyguanosine (8-OH-dG) and microalbuminuria were assessed in patients with DM complicated by EH who were treated with candesartan 4 mg/day for 3 months. RESULTS: In a total of 25 patients urinary excretion of PR (nmol/g · cr), PT (pmol/g · cr), and 8-OH-dG (ng/mg · cr) was significantly (all P < 0.05) decreased from (mean ± SEM) 11.9 ± 1.9, 30.6 ± 2.4, and 7.9 ± 0.6, respectively, at baseline to 8.4 ± 1.4, 27.1 ± 2.0, and 6.9 ± 0.6, respectively, at 3 months. Meanwhile, excretion of AC was unaltered from 209.6 ± 40.0 to 189 ± 24.8 nmol/mgcr (P = NS). Urinary albumin excretion was significantly (P < 0.05) reduced from 27.7 ± 4.6 to 14.1 ± 1.1 mg/g · cr. There were weak but statistically significant positive correlations between the change of urinary 8-OH-dG excretion and that of albumin (r = 0.414; P < 0.05) and change of hemoglobin (Hb) A1c (r = 0.45; P < 0.05). CONCLUSION: Candesartan exerts protective effect(s) on the cardiovascular system by suppression of oxidative stress--mainly through inhibiting production of advanced glycation end products (AGEs) rather than of advanced lipoxidation end products (ALEs)--in type 2 DM patients with EH.

The effect of chewing exercise in preschool children on maximum bite force and masticatory performance.

BACKGROUND: Mastication is a developing function affected by various factors. There is a need for further research on methods of promoting masticatory function in young children. AIM: The aim of this study was to evaluate the effects of gum chewing exercise on the maximum bite force (MBF) and the masticatory performance of preschool children. DESIGN: The study population included 98 preschool children age 4-6years. MBF was measured by Occlusal Force-Meter(®) , and masticatory performance values were evaluated by using the colour-changeable chewing gum. The examinations were performed four times with an interval of 4weeks. An exercise group of 70 subjects was instructed to chew the exercise gum twice daily for 5min during a 4-week period. The chewing gum used for this study was specially developed with the physical property of maintaining hardness during chewing. A control group of 28 subjects was instructed not to chew any gum during the study period. RESULTS: No significant differences were found between the exercise group and the control group in MBF and a* values at the start of the study. After 4weeks of chewing exercise, MBF and a* values were significantly increased in the exercise group compared with those of the control group. These increases were maintained for 4weeks after exercise had finished. CONCLUSIONS: Gum chewing exercise is effective to increase MBF and a* values of preschool children and the effects are maintained after exercise completion.

Fluvastatin increases bone mineral density in postmenopausal women.

Although several studies have reported a lower risk of osteoporotic fracture in hypercholesterolemic patients (WHO IIa) treated with statin, longitudinal studies on the effects of statins on bone are lacking. The aim of the present study was to evaluate bone mineral density (BMD) and bone turnover changes induced by 3-year fluvastatin treatment in postmenopausal women. Twenty-eight consecutive postmenopausal non-diabetic, normotensive hypercholesterolemic women (64.0±3.6 years) were treated for 36 months with 30 mg/day fluvastatin and 28 non-diabetic, normotensive normocholesterolemic age- and body mass index-matched postmenopausal women served as the control subjects. The result revealed a significant increase of the BMD as compared with the level at the base line (p< 0.001) in the fluvastairn-treated group, from 6 months on ward after the start treatment. Significant differences of the BMD were found between the controls and fluvastatin-treated group (p< 0.001) were at 6, 12, 24 and 36 months after the start of the study. In conclusion our results, although obtained small sample of postmenopausal hypercholesterolemic women, suggest a probable favorable effect of fluvastatin on bone formation and BMD.

Influence of the location of the parotid duct orifice on oral clearance.

OBJECTIVES: To determine the location of the parotid duct orifice in relation to the maxillary molars and its influence on oral clearance on the buccal surfaces of the maxillary molars. METHODS: A 2-mm hole was made at the centre of an adhesive therapeutic agent for aphthous stomatitis and the agent was placed on the mucosa so that the hole matched the parotid duct orifice. To locate the orifice, an impression of the buccal tooth surfaces and mucosa around the agent was taken with the teeth in centric occlusion. To evaluate the oral clearance rate, 12 subjects who displayed the parotid duct orifice within 1S.D. of the mean values obtained from the original 35 subjects were selected. 1% agar containing 1 mol/l potassium chloride was placed into three cylinders positioned horizontally, 6mm apart, in an acrylic holder centred over the mean duct location. The diffusion chambers were taken from the mouth at selected time intervals and the gel transferred quantitatively to flasks containing 300 ml of 100 ppm NaCl, which was assayed for potassium by atomic absorption spectrophotometry. Half-times for clearance were calculated. RESULTS: The mean location of the parotid duct orifice was -0.4 mm (range -7.5 to +6.1 mm) mesial to the contact surface between the maxillary first and second molars (where negative values indicate mesial and positive values distal) and 7.2 mm (range +3.8 to +10.4 mm) above a line touching the buccal cusps of the upper molars. The clearance half-time values were shortest for the central cylinder whether salivary flow was unstimulated or stimulated and when flow was unstimulated the clearance half-time was shorter for the mesial than the distal cylinder. CONCLUSION: The degree of individual variation in the location of the parotid duct orifice is great and its exact location will markedly affect oral clearance at different positions on the buccal surfaces of the upper molars.

High blood pressure, bone-mineral loss and insulin resistance in women.

Increasing evidence indicates that high blood pressure is associated with abnormalities in calcium metabolism. Sustained calcium loss may lead to increased bone-mineral loss in subjects with elevated blood pressure. Furthermore, recent findings indicate a possible linkage between abnormal calcium metabolism and insulin resistance. In the present study, we investigated the relationship(s) among bone-mineral density (BMD), blood pressure, calcium-related and bone metabolic parameters (plasma intact parathyroid hormone (I-PTH), 1,25-dihydroxyvitamin D [1,25(OH)2D], osteocalcin, and urinary deoxypyridinoline), and insulin resistance, as assessed by a conventional homeostasis model (HOMA-R). We compared non-diabetic women with essential hypertension (WHT, n=34) with age-, body mass index- and menopause (yes or no)-matched normotensive, non-diabetic women (WNT, n=34). The BMD for WHT was significantly lower than that for WNT (0.596+/-0.019 vs. 0.666+/-0.024 g/cm2, p<0.05). The BMD was correlated inversely with systolic blood pressure in all subjects examined (r=-0.385, p<0.05). The 24-h urinary calcium/sodium excretion ratio (Ux-Ca/Na) was significantly greater in WHT compared with WNT (p<0.01). In addition, a negative relationship was apparent between Ux-Ca/Na and BMD (r=-0.58, p<0.05). The plasma levels of PTH and 1,25(OH)2D, and HOMA-R were significantly higher in WHT compared with WNT (p<0.01, p<0.05, and p<0.05, respectively), whereas the serum ionized calcium was lower in WHT compared with WNT (p<0.05). There were no significant differences in serum total calcium, inorganic phosphorus, osteocalcin, or urinary deoxypyridinoline between the two groups. These results indicate that high blood pressure is associated with abnormalities in calcium metabolism and insulin resistance in WHT.