Height and drinking status in relation to risk of anemia in rural adult healthy Japanese men: the Nagasaki Islands study.

BACKGROUND: Several studies have reported that height is inversely associated with risk of cardiovascular disease but positively associated with cancer risk. On the other hand, evidence has been accumulating that anemia reflects poor health and increased vulnerability to poor outcomes in older persons. Moreover, alcohol consumption has also been reported to be associated with mortality. However, no studies have reported on a possible association between height and risk of anemia in relation to drinking status. METHODS: We conducted a cross-sectional study of 1287 men aged 40-89 years undergoing general health check-ups. RESULTS: Independent from classic cardiovascular risk factors, we found a significant inverse association between height and anemia for non-drinkers and a J-shaped association for drinkers. The multivariable odds ratio (ORs) of an increment of 1 SD (standard deviation) in height (6.68 cm) for anemia for non-drinkers was 0.59 (0.45-0.77). For drinkers, with the second quartile of height (Q2) as the reference group, the multivariable OR of anemia was 2.68(0.90-7.96) (p = 0.075) for the lowest height quartile (Q1), 2.73(0.92-8.08) for the third quartile (Q3) and 4.82(1.65-14.10) for the highest quartile (Q4) (p = 0.004). CONCLUSION: Height was found to be associated with anemia for rural Japanese men and drinking status is likely to affect those associations.

The A>T polymorphism of the tribbles homolog 1 gene is associated with serum triglyceride concentrations in Japanese community-dwelling women.

Recent genome-wide association studies have identified Tribbles homolog 1 (TRIB1) as one of the candidate genes associated with lipid profiles. TRIB1 is known to interact with MAP kinases, thereby regulating their activities. The single nucleotide polymorphism rs2954029 of TRIB1 is located within an intron and is associated with lipid profiles. The aim of the present study is to investigate the TRIB1 rs2954029 (A>T polymorphism) with conventional predictors of coronary artery diseases such as carotid intima-media thickness (CIMT) and cardio-ankle vascular index (CAVI), and with lipid profiles in general population. This study enrolled 2,581 Japanese adults, 942 men and 1,639 women with a median age of 68 years (range 29 to 94 years), who participated in a screening program for the general population living in Goto City, Nagasaki Prefecture, Japan from 2008 to 2010. For the determination of TRIB1 rs2954029 genotypes, the polymerase chain reaction method was used. The differences in each parameter among the TRIB1 rs2954029 genotypes were evaluated using analysis of covariance. Genotype frequencies of TRIB1 rs2954029 in all participants were 25.5% for AA, 50.4% for AT, and 24.0% for TT. In women, the AA genotype showed significantly higher log triglyceride (TG) concentrations than the AT genotype (P = 0.004) and the AT + TT genotypes (P = 0.004). On the other hand, there were no associations with CIMT and CAVI among the TRIB1 rs2954029 genotypes. In conclusion, the TRIB1 rs2954029 is associated with serum TG concentrations in Japanese community-dwelling women.

Association between hemoglobin and diabetes in relation to the triglycerides-to-high-density lipoprotein cholesterol (TG-HDL) ratio in Japanese individuals: the Nagasaki Islands Study.

OBJECTIVE: Our previous study reported that categorizing diabetes patients according to the serum triglycerides-to-high-density lipoprotein cholesterol (TG-HDL) ratio is useful for estimating the risk of atherosclerosis, as a high TG-HDL ratio in patients with diabetes constitutes risk factors for atherosclerosis. Another study showed that a high hemoglobin level is associated with the risk of atherosclerosis. However, no previous studies have examined the association between the hemoglobin level and diabetes categorized by the TG-HDL ratio. In order to investigate these associations, we conducted a cross-sectional study of 3,733 (1,299 men and 2,434 women) Japanese participants 30-89 years of age undergoing a general health checkup. METHODS: We investigated the association between the hemoglobin levels and the incidence of diabetes in all subjects, who were divided into tertiles according to the TG-HDL ratio. Diabetes was defined as an HbA1c (NGSP) level of ≥ 6.5% and/or the initiation of glucose-lowering or insulin therapy. RESULTS: Of the 265 diabetes patients identified in this study, 116 had a high TG-HDL ratio (high TG-HDL diabetes) and 71 had a low TG-HDL ratio (low TG-HDL diabetes). Independent from classical cardiovascular risk factors, the multivariate odds ratio of a 1 SD (standard deviation) increment in hemoglobin (1.30 g/dL for men, 1.16 g/dL for women) was 1.04 (95% confidence intervals (CI): 0.88-1.22) for all patients with diabetes, 1.44 (95%CI: 1.17-1.77) for the patients with high TG-HDL diabetes and 0.67 (95%CI: 0.54-0.83) for the patients with low TG-HDL diabetes. CONCLUSION: The hemoglobin level is positively associated with high TG-HDL diabetes and inversely associated with low TG-HDL diabetes. These findings suggest that measuring the hemoglobin level is clinically relevant for estimating the risk of atherosclerosis in patients with diabetes categorized according to the TG-HDL ratio.

Association between the hemoglobin levels and hypertension in relation to the BMI status in a rural Japanese population: the Nagasaki Islands Study.

OBJECTIVE: The hemoglobin levels and blood pressure has been reported in a few studies, and a positive association between the hemoglobin levels and the body mass index (BMI) status has also been documented. A higher BMI may therefore affect the association between the hemoglobin levels and hypertension. However, no published studies have examined this association in relation to the BMI status. The primary purpose of this study was to assess the association between the hemoglobin levels and hypertension in relation to the BMI status. METHODS: A cross-sectional study of 3,203 non-anemic subjects (1,191 men and 2,012 women, 30-79 years old) who were undergoing general health checkups was conducted. RESULTS: A positive association between the hemoglobin levels and hypertension was established for both men and women. For a one SD (standard deviation) increment in hemoglobin, the multivariable odds ratio (ORs) and 95% confidence interval (CIs) for hypertension were 1.21 (95%CI: 1.05-1.40) for men and 1.25 (95%CI: 1.13-1.39) for women. We also found that a significant association was confined to the participants with a BMI of <25 kg/m(2). Among the participants with a BMI of <25 kg/m(2), the multivariable ORs and 95% CIs for hypertension of a one SD increment in hemoglobin were 1.34 (95%CI: 1.12-1.60) for men and 1.31 (95%CI: 1.16-1.47) for women. Meanwhile, among those with a BMI of ≥25 kg/m(2), the corresponding values were 1.01 (95%CI: 0.79-1.30) and 1.09 (95%CI: 0.87-1.37). CONCLUSION: An independent positive association between the hemoglobin levels and the risk of hypertension was observed for both non-anemic Japanese men and women, confined to participants with a BMI of <25 kg/m(2).

Association between hemoglobin levels and arterial stiffness for general Japanese population in relation to body mass index status: The Nagasaki Islands study.

AIM: To investigate associations between hemoglobin levels and arterial stiffness accounting for body mass index (BMI) in a large-scale cross-sectional study. METHODS: We investigated the association between hemoglobin levels and atherosclerosis evaluated by cardio-ankle vascular index (CAVI), which can assess arterial stiffness independently from blood pressure, while taking BMI status into account. Separate models were constructed for participants with or without anemia. In our main investigation for the association between hemoglobin levels and increased arterial stiffness, only participants without anemia (1064 men and 1886 women) were included to avoid the influence of chronic disease. RESULTS: We found significantly positive associations between increased arterial stiffness and hemoglobin levels for both men and women, and that such associations were limited to subjects with BMI <25 kg/m(2) . The multivariable-adjusted odds ratios (OR) and 95% coincidence intervals (CI) of 1-standard deviation increments in hemoglobin levels for increased arterial stiffness were 1.17 (95% CI 1.00-1.38) for men and 1.17 (95% CI1.02-1.34) for women. For participants with BMI <25 kg/m(2) , the corresponding values were 1.40 (95% CI 1.14-1.73) and 1.19 (95% CI 1.02-1.40), and for those with BMI ≥25 kg/m(2) , they were 0.88 (95% CI 0.67-1.15) and 1.12 (95% CI 0.86-1.46). CONCLUSIONS: Independent positive associations between hemoglobin levels and increased arterial stiffness were observed both for Japanese men and women, and those associations were limited to participants with BMI <25 kg/m(2) .

Relationship between adult height and body weight and risk of carotid atherosclerosis assessed in terms of carotid intima-media thickness: the Nagasaki Islands study.

BACKGROUND: Previous studies have reported an inverse association between height and risk of cardiovascular disease. However, evidence is limited for the association between risk of atherosclerosis and height. Further, although the association between atherosclerosis and body mass index (BMI) is reportedly positive, there have been no reports of studies on associations between height and atherosclerosis in relation to BMI. METHODS: We conducted a cross-sectional study of Japanese men aged 30 to 89 years undergoing general health check-ups. RESULTS: Of the 1,337 men, 312 were diagnosed with carotid atherosclerosis (carotid intima-media thickness (CIMT) ≥ 1.1 mm), but no significant association was found between height and carotid atherosclerosis for the entire study group. Stratification by BMI status of those analytical findings disclosed a significant inverse association between height and carotid atherosclerosis among overweight (BMI ≥ 25 kg/m(2)) but not among non-overweight (BMI < 25 kg/m(2)) men. The classical cardiovascular risk factors-adjusted odds ratio (OR) and 95% confidence interval (CI) of carotid atherosclerosis for an increment of one SD (standard deviation) in height (6.70 cm) were 0.71 (0.54 to 0.94) for overweight (BMI ≥ 25 kg/m(2)) and 1.05 (0.87 to 1.27) for non-overweight (BMI < 25 kg/m(2)) men. CONCLUSION: Independent from classical cardiovascular risk factors, height was found to be inversely associated with carotid atherosclerosis for overweight but not for non-overweight men.

Association between alkaline phosphatase and hypertension in a rural Japanese population: the Nagasaki Islands study.

BACKGROUND: Although serum alkaline phosphatase (ALP) levels have been associated with hypertension, and ALP is known as an enzyme affected by alcohol consumption, no study has been published on the associations between ALP and the risk of hypertension in relation to drinking status. METHODS: We conducted a cross-sectional study of 2,681 participants (837 men and 1,846 women) aged 30 to 89 years undergoing a general health check-up to investigate the associations between ALP and hypertension in relation to drinking status. RESULTS: Of the 2,681 participants, 1,549 (514 men and 1,035 women) were diagnosed with hypertension. A sex difference was observed for the relationship between ALP and hypertension. While no significant association was observed for men, the association was significantly positive for women. The multivariable adjusted odds ratio and 95% coincidence interval (CI) of hypertension per increment of 1-log ALP were 0.95 (95% CI: 0.56 to 1.59) for men and 1.57 (95% CI: 1.07 to 2.33) for women. When this analysis was restricted to nondrinkers, a significantly elevated risk of hypertension was observed for men and remained significant for women; that is, 3.32 (95% CI: 1.38 to 8.02) for men and 1.68 (95% CI: 1.11 to 2.55) for women. CONCLUSION: ALP is associated with hypertension for both male and female nondrinkers, but not for drinkers. For analyses of associations between ALP and blood pressure, alcohol consumption should thus be considered a potential confounder.

Association of periodontitis with carotid artery intima-media thickness and arterial stiffness in community-dwelling people in Japan: the Nagasaki Islands study.

OBJECTIVE: Recent studies have suggested an association between periodontitis and atherosclerosis; however, the relationship between periodontal status and arterial alterations should be clarified. The purpose of this study was to examine associations between periodontal status and carotid intima-media thickness (cIMT) and arterial stiffness using the cardio-ankle vascular index (CAVI) in community dwellers. METHODS: A community-based cross-sectional study of 1053 subjects ≥40 years with 10 teeth or more was conducted in Goto, Japan from 2008 to 2010. RESULTS: In a multiple linear regression analysis adjusted for age, sex, number of present teeth, and other confounders, each 1-mm increase in mean periodontal pocket depth corresponded to a 0.02-mm increase in maximal cIMT (ß = 0.018; P = 0.049) and also to a 0.1 increase in mean CAVI (ß = 0.133; P = 0.040). In addition, each 1-mm increase in the mean periodontal attachment loss corresponded to a 0.01-mm increase in maximal cIMT (ß = 0.013; P = 0.040). A multiple logistic regression analysis revealed that each 1-mm increase in mean periodontal pocket depth was associated with an increased risk of a maximal cIMT >1 mm (adjusted odds ratio [OR], 1.430; 95% confidence interval [CI], 1.067-1.918; P = 0.017) and mean CAVI of ≥8 (OR, 1.323; 95% CI, 1.003-1.743; P = 0.047). Furthermore, each 1-mm increase in mean periodontal attachment loss was associated with an increased risk of a maximal cIMT >1 mm (OR, 1.251; 95% CI, 1.032-1.516; P = 0.022). CONCLUSION: A linear, dose-dependent relationship was found between periodontal pocket depth, cIMT, and arterial stiffness.

Free thyroxine (FT4) and anemia in relation to drinking status of Japanese men: the Nagasaki islands study.

It is well known that hypothyroidism is associated with anemia. It has also been reported that alcohol consumption may affect thyroid function. Furthermore, hemoglobin levels of drinkers are reportedly higher than those of non-drinkers. However, no published study has investigated the association between thyroid function evaluated with the free thyroxine (FT4) test and anemia while taking drinking status into account. We conducted a cross-sectional study of 843 men aged 30-89 years undergoing general health checks. While no significant associations were noted between FT4 and anemia for total subjects, when the analysis was limited to non-drinkers, a significant association was observed. After adjustment for classical cardiovascular risk factors and thyroid stimulating hormones (TSH), adjusted odds ratio (OR) and 95% confidence interval (CI) for an increment of 1SD (standard deviation) for FT4 (0.17 ng/dL) for anemia were 0.85 (0.67-1.09) for total subjects, 0.59 (0.41-0.85) for non-drinkers, and 1.23 (0.83-1.83) for drinkers. In conclusion, FT4 is inversely associated with anemia for non-drinking but not for drinking men. However, drinking may act as a confounding factor for this association.

Association of arterial stiffness and diabetes with triglycerides-to-HDL cholesterol ratio for Japanese men: the Nagasaki Islands Study.

OBJECTIVE: Although many studies have reported that elevated serum triglycerides to high-density lipoprotein cholesterol (TG-HDL) ratios constitute a risk for insulin resistance and increased arterial stiffness, no study has clarified as yet the association, in terms of the TG-HDL ratio, between diabetes and increased arterial stiffness evaluated by means of carotid intima-media thickness (CIMT) and cardio-ankle vascular index (CAVI). To investigate this association, we conducted a cross-sectional study of 1344 Japanese men aged 36-79 years undergoing a general health check. METHODS: We investigated the associations between atherosclerosis/arterial stiffness, evaluated by means of CIMT and CAVI, and diabetes for all subjects, who were divided into tertiles according to TG-HDL levels. Diabetes was defined as HbA1c (NGSP) ≥6.5%, and/or initiation of glucose-lowering medication or insulin therapy. RESULTS: Of the 130 diabetes patients identified in the cohort, 56 patients had high TG-HDL (high TG-HDL diabetes) and 43 had low TG-HDL (low TG-HDL diabetes). We found that only diabetic patients with high TG-HDL were at a significant risk for atherosclerosis (diagnosed as CIMT ≥ 1.1 mm) and increased arterial stiffness (diagnosed as CAVI ≥ 8.0). The multivariable-adjusted odds ratios and 95% confidence intervals of atherosclerosis and increased arterial stiffness for diabetes were 2.67 (95%CI: 1.35-5.28) and 2.36 (95%CI: 1.01-5.50), for total TG-HDL diabetes 2.57 (95%CI: 1.32-5.02) and 3.56 (95%CI: 1.50-8.46) for high TG-HDL diabetes, and 1.17 (95%CI: 0.52-2.63) and 0.80 (95%CI: 0.33-1.90) for low TG-HDL diabetes, respectively. CONCLUSION: Diabetes, especially high TG-HDL diabetes, constitutes a significant risk for increased arterial stiffness and atherosclerosis.

[A case of mycoplasmal pneumonia with bronchiolitis treated with steroids].

A 37-year-old woman admitted elsewhere for a high fever, dry cough, stridor, and dyspnea was found in chest radiography and computed tomography on admission to have a thickened bronchial wall with centrilobular nodules in both lower lobes and skipped consolidations in the lower and middle lobe of the right lung. She had been diagnosed with mycoplasmal pneumonia because of high Mycoplasma pneumoniae antibody titer, so clarithromycin (CAM) was administrated. She was referred to us due to hypoxia with obstructive impairment in the pulmonary function test. Ventilation/perfusion radioisotope in the lung scan indicated heterogeneous distribution without mismatch, suggesting bronchiolitis obliterans due to M. pneumoniae pneumonia, so steroids were started. Five weeks of steroid administration ameliorated clinical symptoms, hypoxia, and abnormal shadows, but obstructive impairment diod not disappear completely. Early administration of steroid with antibiotics is required for bronchiolitis obliterans caused by M. pneumoniae. We review cases of mycoplasmal bronchiolitis reported in Japan.