[Is whole body bone mineral density measured by the dual energy X-ray absorptiometry applied to evaluate risk of osteoporosis among Japanese adult females?].

To measure whole body fat accurately, the dual energy X-ray absorptiometry (DXA) is widely utilized. Simultaneously, bone mineral density (BMD) of the whole body can also be measured. BMD is one of important information to diagnose osteoporosis. However, it is not established to use whole body BMD for this diagnosis. It is recommended that lumbar and/or hip BMD should be used for diagnosing osteoporosis by the guideline for prevention and treatment of osteoporosis. Although it is possible to measure whole body BMD and lumbar and/or hip BMD separately at the same visit, it is inevitable to expose patients to more X-ray. Therefore, an aim of this study is to elucidate the relationship between whole body BMD and lumbar BMD to find the cut off point of whole body BMD for screening of osteoporosis. Two hundred and thirty six Japanese adult females were ascertained to this study. Whole body BMD and lumbar BMD of each subject were measured with the use of Delphi W (Hologic, USA). One hundred and sixty five subjects were judged as possible osteoporosis (less than 80% of young adult mean (YAM) of lumbar BMD and/or definite fracture of lumbar vertebras). The cut off point of whole body BMD for screening possible osteoporosis was estimated by receiver operated characteristic (ROS) analysis. The cut off point of whole body BMD was 84% of YAM, equivalent to 80% of YAM of lumbar BMD, with the following sensitivity and specificity (0.84 and 0.79, respectively), indicating that whole body BMD could be used for screening osteoporosis.

Relationship between obesity and physical fitness and periodontitis.

BACKGROUND: Obesity and exercise are important elements associated with lifestyle-related diseases, and studies suggested that these factors may also be related to periodontitis. This study investigates the relationship between obesity and physical fitness and periodontitis. METHODS: One thousand, one hundred and sixty Japanese subjects, aged 20 to 77 years, who participated in health examinations at Fukuoka Health Promotion Center were analyzed. Periodontal conditions were evaluated using the Community Periodontal Index (CPI), and subjects with > or =3 sextants of CPI code 3 or 4 were defined as having severe periodontitis. We used the body mass index (BMI) and percentage of body fat as indicators of obesity and estimated the maximal oxygen consumption (VO(2max)) during exercise as an indicator of physical fitness. We divided these variables into quintiles. We examined the single effect and interactions of the obesity index and VO(2max) on severe periodontitis. RESULTS: The lowest quintile in BMI and the highest quintile in VO(2max) were inversely associated with severe periodontitis, singly, in multivariate logistic regression analyses. Subjects with the combined lowest quintile in BMI and the highest quintile in VO(2max) had a significantly lower risk of severe periodontitis compared to subjects with other combined quintiles in BMI and in VO(2max) (odds ratio: 0.17; 95% confidence interval: 0.05 to 0.55). CONCLUSION: This study suggests that obesity and physical fitness may have some interactive effect on periodontal health status.

Waist circumference is the main determinant of elevated C-reactive protein in metabolic syndrome.

BACKGROUND: Metabolic syndrome (MetS) is known to increase the risk of cardiovascular disease. C-reactive protein (CRP) has been reported to be elevated in subjects with MetS. However, which component of MetS contributes mostly to the elevation has not been studied in detail. METHODS: We studied 628 apparently healthy Japanese subjects (men 262, women 366, age 19-85 years). Body mass index, waist circumference (WC), blood pressure, lipids, glucose, insulin and CRP were measured. MetS was defined according to the National Cholesterol Education Program's Adult Treatment Panel III report. RESULTS: In partial correlation analysis, WC showed the strongest correlation with CRP among the variables related to MetS. CRP increased as the number of MetS components increased. The mean CRP value adjusted for demographic variables was higher in subjects with MetS than those without MetS, and further adjustments with variables related to MetS revealed that the significant difference between the two groups disappeared only when further adjustment was made for WC. In multiple linear regression analysis, the independent variable that most strongly explained the CRP level was WC, which was followed by HDL-cholesterol. Finally, comparison of the CRP levels in groups stratified by abdominal obesity and the number of MetS components revealed that those with abdominal obesity tended to show higher CRP levels compared with those without abdominal obesity regardless of the number of MetS components other than WC. CONCLUSIONS: Subjects with MetS showed higher levels of CRP and the main determinant of the CRP elevation was WC.

Comparison of body composition measurements obtained by two fan-beam DXA instruments.

Although dual-energy X-ray absorptiometry (DXA) has been widely used for measuring body composition, discrepancies have been reported to exist among results obtained from different instruments. In the course of longitudinal studies lasting for many years, old instruments may be required to be replaced with new ones, necessitating comparison and validation between the values obtained by the old and new instruments. We compared the data obtained by the two fan-beam DXA instruments, QDR-2000 (Hologic, Waltham, MA) and Delphi (Hologic). Body composition was first measured by the Hologic QDR-2000 and next by the Delphi W within 30 days in 99 healthy subjects. Whole-body fat mass (FM), percentage of FM, arm FM, and leg FM measured by the Hologic QDR-2000 were significantly larger than those measured by the Delphi W. Lean tissue mass (LTM), bone mineral content, and bone mineral density of the whole body, trunk FM, arm LTM, and leg LTM measured by the QDR-2000 were significantly smaller than those measured by the Delphi W. After converting the QDR-2000 values by equations developed by multiple regression analysis, they were not significantly different from the corresponding Delphi values. Measurements by the QDR-2000 and the Delphi W were not interchangeable and the conversion equations reduced the discrepancy to a level that enabled direct comparison of the data obtained by the two instruments. However, cautious interpretation is necessary when the conversion equations are applied to other instruments even of the same type or when evaluating data of individual subjects.

[Factors related to functional capacity in community dwelling elderly people].

PURPOSE: To clarify the content of support for healthy aging, we analyzed age-related changes in functional capacity and factors affecting the maintenance based on a health status survey in elderly people, and also evaluated the results of a survey on functional capacity, living habits, and health in leaders in elderly people's clubs. METHODS: A questionnaire survey was carried out with (1) 1,000 randomly selected elderly subjects aged > or = 65 years and (2) 122 leaders in elderly people's clubs to evaluate functional capacity according to The Tokyo Metropolitan Institute of Gerontology Index of Competence, feeling of happiness according to the morale scale established by Lawton, living habits, and health. Factors affecting functional capacity were identified by stepwise multiple longistic regression analysis. In addition, the elderly people's club leader group and an age- and sex-matched control group were compared. RESULTS: 1) Functional capacity decreased with age, this being more marked in the females than in the males. In particular, Instrumental Activities of Daily Living markedly decreased in the females at late ages. 2) Stepwise multiple logistic regression analysis revealed the following positive and negative factors associated with the maintenance of a high functional capacity (functional capacity score > or = 12). The positive factors were: 1. hobbies, 2. living with the spouse, 3. habitual exercise, 4. positive acceptance of aging, 5. psychological stability, 6. diets with consideration of nutritional balance, 7. busy life, and 8. talking with friends and acquaintances once a week or more. The negative factors were: 1. belonging to a higher age groups, 2. living alone, and 3. smoking. 3) In the elderly people's club leader group, the age-related decline was gradual, and functional capacity was maintained at later ages. The group leaders typically 1. had hobbies, 2. went out almost everyday, 3. exercised almost every day, 4. talked with friends and relatives almost every day, 5. had active roles, 6. were busy, and 7. considered themselves to be healthy more frequently than the control group. The leader group also showed 8. a higher total morale scale score and 9. a higher score for positive acceptance of aging as a subscale than the control group. CONCLUSIONS: Our results suggest that nutrition balance, habitual exercise, hobbies, social roles, frequent contacts with others, positive acceptance of aging, and psychological stability are important for maintaining functional capacity in the maintenance of functional capacity. Early preventive measures are necessary to combat decline in functional capacity, particularly regarding Instrumental Activities of Daily Living, in females at later ages.