Ichiro Iwamoto

Relationships between serum leptin level and regional bone mineral density, bone metabolic markers in healthy women.

Background. Leptin might affect bone metabolism. This study was performed to investigate the relationship of leptin to bone metabolism in detail in premenopausal and postmenopausal healthy women.

A longitudinal study of the effect of vitamin K2 on bone mineral density in postmenopausal women a comparative study with vitamin D3 and estrogen-progestin therapy.

OBJECTIVES To investigate the effect of vitamin K2 treatment for a year on spinal bone mineral density (BMD) in postmenopausal women, comparing with vitamin D3 hormone replacement therapy and to determine the factors which affect the efficacy of vitamin K2 therapy. SUBJECTS AND METHODS Seventy-two postmenopausal women were randomized into four groups and treated with respective agents. Before the therapy, 6 and 12 months after the treatment, their lumbar spine BMD were measured by dual energy X-ray absorptiometry. The rates of change in BMD (delta BMD) were calculated. Correlations of BMD with age, year since menopause and the initial BMD were determined. RESULTS Vitamin K2 suppressed the decrease in spinal BMD as compared with no treatment group. BMD in women treated with vitamin K2 was inversely correlated with their age (r = -0.54; P < 0.05). CONCLUSIONS Vitamin K2 therapy may be a useful method for preventing postmenopausal spinal bone mineral loss. In addition, the therapy should be started early in postmenopausal period.

Precedence of the shift of body‐fat distribution over the change in body composition after menopause

Aim:  This study investigated the sequence of certain phenomena after menopause: decrease in bone mineral density (BMD), change in body composition (lean and fat components), and the shift toward upper body fat distribution.

Preoperative plasma osteopontin level as a biomarker complementary to carbohydrate antigen 125 in predicting ovarian cancer

Aim:  New biomarkers other than carbohydrate antigen (CA) 125 are needed for the detection of ovarian cancer. Osteopontin (OPN) is one of the candidates identified by high‐throughput complementary DNA microarray techniques. We evaluated the preoperative plasma OPN level as a diagnostic biomarker for ovarian cancer in comparison with CA125.

The leptin receptor in human osteoblasts and the direct effect of leptin on bone metabolism.

It is important to elucidate whether the leptin receptor, especially the long signal-transducing form of the leptin receptor (OB-Rb) is expressed in human osteoblasts. We detected the expression of human OB-Rb in cultured commercially available human osteoblasts (NHOst cells) using real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR). After confirming the expression of OB-Rb, we investigated the effect of leptin on NHOst cells. Leptin enhanced cell proliferation of the cells shown by the MTT assay. Furthermore, leptin changed the copy numbers of Bax and Bcl-2 mRNAs in the cultured cells as shown by real-time quantitative RT-PCR, although the effect was not consistent. Leptin did not change the production of osteocalcin and osteopontin by the cells. Leptin did not change the expression of OB-Rb mRNA in the cells. In conclusion, OB-Rb mRNA is expressed in cultured commercially available human osteoblasts. Leptin may have some effects on bone metabolism by directly modulating cell proliferation and apoptosis of osteoblasts in humans.

Association of estrogen receptor α and β3-adrenergic receptor polymorphisms with endometrial cancer

OBJECTIVE To investigate the association of estrogen receptor α and β3-adrenergic receptor polymorphisms with endometrial cancer risk in Kagoshima, Japan. METHODS Ninety-two patients with endometrial cancer and 65 healthy women were enrolled in this study. Blood samples were collected, and deoxyribonucleic acid (DNA) was extracted. Estrogen receptor α and β3-adrenergic receptor gene variants were analyzed by restriction fragment length polymorphisms using the restriction enzymes, Pvu II, Xba I for estrogen receptor α, and Mva I for β3-adrenergic receptor. Multivariable logistic regression analysis was performed, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. RESULTS The Pvu II PP genotype was associated with a decreased risk of endometrial cancer (multivariable OR 0.23; 95% CI 0.07, 0.82) compared with the pp genotype. The Xba I XX genotype was associated with a decreased risk for endometrial cancer (multivariable OR 0.26; 95% CI 0.09, 0.79) compared with the xx genotype. The Mva I variants were not associated with endometrial cancer risk (multivariable OR 0.55; 95% CI 0.20, 1.51). CONCLUSION Estrogen receptor α polymorphisms, but not β3-adrenergic receptor gene, may be associated with a risk of endometrial cancer.

Leptin production in pre- and postmenopausal women.

OBJECTIVES To investigate the differences in leptin production between pre- and postmenopausal women. METHODS Subjects were 75 pre- and 75 postmenopausal women. Age, height, weight, and body mass index (BMI, wt/ht(2)) were recorded. Serum leptin levels were measured by RIA. Total body fat mass and percentage of body fat mass were measured by whole-body scanning with dual-energy X-ray absorptiometry. Serum leptin levels, the ratio of serum leptin levels to total body fat mass (leptin-fat mass ratio), baseline characteristics, and anthropometric variables were compared between the two groups. In all subjects (n=150), relationship of serum leptin levels with menopausal status (pre- and postmenopause) was investigated by univariate and multiple regression analysis. RESULTS Serum leptin levels in premenopausal women 8.4+/-4.8 ng/ml, which did not differ from that in postmenopausal women (9.2+/-7.1 ng/ml). Total body fat mass, percentage of body fat mass, and BMI did not differ between the two groups. Leptin-fat mass ratio in premenopausal women was 0.43+/-0.17 ng/ml/kg, which did not differ from that in postmenopausal women (0.44+/-0.24 ng/ml/kg). On both univariate and multiple regression analysis, serum leptin levels were not correlated with menopausal status. CONCLUSIONS Menopausal status does not have a significant impact on leptin production.

Isolated adenomyotic cyst associated with severe dysmenorrhea.

A case of a 23‐year‐old, nulliparous female with a very rare isolated adenomyotic cyst inducing severe dysmenorrhea was seen. Transvaginal ultrasonographic tomography and magnetic resonance imaging (MRI) showed a 3 × 3‐cm cystic mass within the left anterior wall of the uterine corpus. The cystic space was filled with hyperintense fluid on T1‐weighted images, which was surrounded by hypointense tissue beside the right uterine corpus on T2‐weighted images. The case was preliminarily diagnosed using MRI as having cavitated rudimentary uterine horn. However, hysterosalpingography excluded the possibility of uterine anomaly. A hemorrhagic adenomyotic cyst measuring 3 cm within the left anterior wall of the uterine corpus was surgically removed. There was no evidence of diffuse adenomyosis uteri. Dysmenorrhea completely disappeared postoperatively.

Non-weight-bearing effect of trunk and peripheral fat mass on bone mineral density in pre- and post-menopausal women

OBJECTIVE To investigate the non-weight-bearing effect of trunk fat mass (composed of visceral and subcutaneous fat mass) and peripheral fat mass (subcutaneous fat mass alone) on bone mineral density (BMD) in pre- and post-menopausal women. METHODS The subjects were 412 pre-menopausal women, 20-50 years of age and 228 post-menopausal women, 50-75 years of age. Age, years since menopause (YSM), height, body weight, and body mass index were recorded. Trunk, peripheral (extremities), left arm (non-weight-bearing site), lean mass, and BMD were measured by dual-energy X-ray absorptiometry. RESULTS In pre-menopausal women, the amount of trunk fat mass was 6.8+/-4.1 kg, which was significantly lower than the amount of peripheral fat mass (11.6+/-3.8 kg, p < 0.001). Although trunk fat mass was positively correlated with arm BMD on Pearsons correlation test, arm lean mass was the only significant predictor of BMD on multiple regression analysis. In post-menopausal women, the amount of trunk fat mass (8.7+/-3.6 kg) was also significantly lower than the peripheral fat mass (10.3+/-3.4 kg, p < 0.001). On multiple regression analysis, however, trunk fat mass, but not arm lean mass, was the significant predictor of BMD. In both groups, peripheral fat mass was not correlated with left arm BMD. CONCLUSION The effect of adipocyte-derived biochemical factors on BMD may differ with menopausal status and the sites of adipocyte deposition.

Severe leg compartment syndrome associated with dorsal lithotomy position during radical hysterectomy

We encountered a female patient with left‐leg compartment syndrome; a devastating complication, probably associated with prolonged dorsal lithotomy position during radical hysterectomy using intermittent pneumatic compression. This patient was intensively treated and fortunately recovered. However, leg compartment syndrome is poorly understood by gynecologists. We must always consider the potential risk of this life‐threatening complication when patients are placed in the dorsal lithotomy position for a prolonged period during extended surgery using intermittent external compression.