Kaichiro Sugiura

Validity of self-reported height and weight in a Japanese workplace population.

OBJECTIVE:To assess the validity of self-reported height and weight in a Japanese workplace population, and to examine factors associated with the validity of self-reported weight.DESIGN:Comparison of self-reported height and weight with independent measurement.SUBJECTS:In total, 4253 men and 1148 women aged 35–64 y (mean measured body mass index (BMI): 23.3 kg/m2 in men, 21.9 kg/m2 in women) were included in the study.MEASUREMENTS:Self-reported height and weight were obtained by a self-administered questionnaire. Measured height and weight were based on annual health checkups. Sex, age, measured BMI, and the presence of hypertension, diabetes, and hyperlipidemia were examined as potential factors associated with the accuracy of self-reported weight.RESULTS:Self-reported height and weight were highly correlated with measured height and weight for men and women (Pearson’s r for men and women: 0.979 and 0.988 in height, 0.961 and 0.959 in weight, 0.943 and 0.950 in BMI, respectively). For men, mean differences±2 s.d. of height and weight were 0.078±2.324 cm and −0.034±5.012 kg, respectively, and for women 0.029±1.652 cm and 0.024±4.192 kg, respectively. The prevalence of obesity with BMI ≥25 kg/m2 based on self-reported data (23.6 and 11.5% for men and women, respectively) was slightly smaller than that based on measured data (24.9 and 12.4%, respectively). Specificity and sensitivity, however, were quite high for both men and women (sensitivity was 85.8 and 85.2%, and specificity was 97.0 and 98.9%, respectively). The subjects with higher measured BMI significantly underestimated their weight compared with those with smaller BMI after adjustments for age in men and women. Furthermore, the presence of diabetes in men and age in women affected self-reported weight. Neither the presence of hypertension nor hyperlipidemia was associated with reporting bias.CONCLUSION:The self-reported height and weight were generally reliable in the middle-aged employed Japanese men and women. However, it should be remembered that self-reported weight was biased by actual BMI and affected by age and the presence of diabetes.

Eating fast leads to obesity: findings based on self-administered questionnaires among middle-aged Japanese men and women.

BACKGROUND Few epidemiologic studies have examined the association between the rate of eating and obesity. In this study, we cross-sectionally examined the association of the self-reported rate of eating with current Body Mass Index (BMI), and BMI-change from 20 years of age to the current age. METHODS Subjects were 3737 male (mean age ± standard deviation and mean BMI ± standard deviation: 48.2 ± 7.1 years and 23.3 ± 2.7 kg/m2) and 1005 female (46.3 ± 7.0 years and 21.8 ± 2.8 kg/m2) Japanese civil servants. We measured self-reported categorical rate of eating, current BMI, BMI at age 20, and BMI-change from age 20. Energy intake was assessed over a 1-month period with a brief-type diet history questionnaire. RESULTS The multiple regression analysis in which the current BMI was regressed by categorical rate of eating, energy intake, age, and lifestyle factors showed that current BMI steadily increased by -0.99, -0.67, 0.81, and 1.47 kg/m2 along with the progress of categorical rate of eating from the ‘medium’ group to ‘very slow’, ‘relatively slow’, ‘relatively fast’, and ‘very fast’ groups, respectively, in men. In women, the corresponding values were -1.06, -0.35, 0.50, and 1.34 kg/m2. When the BMI increment from age 20 to current age was regressed in the same manner, the increment was -0.63, -0.34, 0.57, and 1.05 kg/m2 in men and -0.71, -0.32, 0.34, and 1.14 kg/m2 in women, respectively. Additionally, both BMI at age 20 and current height were positively associated with rate of eating. CONCLUSIONS Our results among middle-aged men and women suggest that eating fast would lead to obesity.

Comparison of Circulating Adiponectin and Proinflammatory Markers Regarding Their Association With Metabolic Syndrome in Japanese Men

Background—Anti-inflammatory and proinflammatory molecules purportedly play an important role in developing metabolic syndrome (MetS). However, little is known as to the relative importance of these molecules in the association with MetS. Methods and Results—We studied 624 middle-aged Japanese men without medical history of cardiovascular disease or cancer and investigated the associations of circulating tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), and adiponectin with MetS. We used the respective definitions proposed by the National Cholesterol Education Program Adult Treatment Panel III (ATP-III), the International Diabetes Federation, and the Japanese Society of Internal Medicine. Decreased serum adiponectin was observed in those with any of the ATP-III–MetS components, whereas this was not the case with increased TNF-α, IL-6, or CRP. Adiponectin and CRP levels linearly deteriorated with an increasing number of ATP-III–MetS components (trend P<0.001, respectively). Significantly higher CRP and lower adiponectin levels were observed in those who met any MetS criteria, whereas increased TNF-α was observed in only those with ATP-III–MetS. Finally, odds ratios (ORs) for MetS prevalence of a 1-SD increase/decrease in log-transformed 4 markers were calculated with multivariate logistic regression analyses. Consequently, decreased adiponectin was associated most strongly with ATP-III–MetS (adiponectin: OR, 1.90 [95% CI, 1.44 to 2.51]; P<0.001; CRP: OR, 1.33 [95% CI, 1.01 to 1.74]; P=0.03; TNF-α: OR, 1.25 [95% CI, 0.94 to 1.67]; P=0.12; and IL-6: OR, 0.87 [95% CI, 0.63 to 1.19]; P=0.37). This result was not altered by using the other 2 criteria. Conclusions—The present results raise the possibility that decreased serum adiponectin might be fundamentally involved in the development of MetS.

Adiponectin Level and Left Ventricular Hypertrophy in Japanese Men

A recent study has demonstrated that adiponectin inhibited hypertrophic signaling in the myocardium of mice, implying that a decrease in the blood adiponectin level could cause cardiac muscle hypertrophy. We hypothesized that a relationship might exist between the serum adiponectin level and electrocardiographically diagnosed left ventricular hypertrophy (ECG-LVH), and we examined this hypothesis by epidemiological study of 2839 Japanese male workers who were not taking medications for hypertension. ECG-LVH was defined as meeting Sokolow–Lyon voltage criteria and/or Cornell voltage-duration product. The subjects were categorized by tertiles of serum adiponectin level, and a multivariate logistic regression analysis was conducted relating left ventricular hypertrophy to adiponectin tertiles adjusting for potential confounding factors. Prevalence of ECG-LVH in the studied sample was 16.7%. Adiponectin ranged from 1.0 to 5.0 &mgr;g/mL in the lowest category and from 7.4 to 30.6 &mgr;g/mL in the highest. Compared with subjects in the highest adiponectin category, those in the lowest one had a significantly higher prevalence of ECG-LVH independent of age, body mass index, and systolic blood pressure with an odds ratio of 1.50 and a 95% CI of 1.16 to 1.94. Further adjustment for high-density lipoprotein cholesterol, triglyceride, and insulin resistance did not change the association (odds ratio: 1.68; 95% CI: 1.28 to 2.21; P<0.001). Similar results were obtained when different criteria for ECG-LVH were used or when subjects were stratified by blood pressure or body mass index. Adiponectin concentration was inversely and independently associated with ECG-LVH in Japanese men.

Self-reported medical history was generally accurate among Japanese workplace population

OBJECTIVE To assess the validity of self-reported medical history of several diseases among the Japanese population, and to clarify to what extent the self-reported year of diagnosis for chronic diseases is different from the physicians reports. STUDY DESIGN AND SETTING Subjects were 8,947 persons who responded to questions about medical history in a self-administered questionnaire. Of them, 854 subjects reported one or more medical histories and gave permission to contact their physician. The physicians were then requested to provide information on 809 subjects. Valid responses of 714 subjects were collected. We compared the self-reported medical histories with those reported by the physician. RESULTS Of 15 persons who reported myocardial infarction, 13 (87%) were confirmed. Angina pectoris was verified in eight out of the 11 (73%). The confirmation proportions of hypertension, diabetes, hyperlipidemia, and hyperuricemia were 97%, 96%, 95%, and 95%, respectively. The self-reported year of diagnosis was 1.70-2.49 years earlier than the physician-reported year for chronic diseases. Agreement between the self-reported and the physician-reported years was higher, the more recent the self-reported year was. CONCLUSION Self-reported medical histories were generally accurate, especially for diseases with clear diagnostic criteria. However, investigators should be aware of the errors in reporting the year of diagnosis.

The transition to menopause reinforces adiponectin production and its contribution to improvement of insulin‐resistant state

Objective  To evaluate the influence of menopausal status on the serum adiponectin concentration and investigate whether the contribution of adiponectin to insulin resistance is modified by menopausal status.

Contribution of adipocytokines to low-grade inflammatory state as expressed by circulating C-reactive protein in Japanese men: Comparison of leptin and adiponectin

BACKGROUND Circulating C-reactive protein (CRP) is a marker of inflammation and is associated with the incidence of cardiovascular events. Although it has been known that adiponectin protects, whereas leptin accelerates, the development of atherosclerotic diseases, the comparative strength of their reciprocal effects on circulating CRP remains unclear. METHODS We studied a population of 2049 Japanese men aged 35 to 66. For all subjects, multiple regression analysis performed with log-transformed CRP concentration as the dependent variable, and with log-transformed leptin, log-transformed adiponectin, age, BMI, smoking status, and components of metabolic syndrome as independent variables. RESULTS Both leptin (positively) and adiponectin (negatively) were significantly and independently associated with CRP concentration. The absolute value of the standardized regression coefficient (st-beta) of leptin (st-beta=0.201) was higher than that of adiponectin (st-beta=-0.082). After subjects were stratified by current BMI level, both of the adipocytokines were significantly associated with CRP concentration among subjects with BMI <25 kg/m(2), whereas only leptin was significantly associated with CRP concentration among subjects with BMI >=25 kg/m(2). CONCLUSIONS Both leptin and adiponectin were independently associated with CRP concentration. Leptin was more strongly related to CRP levels than adiponectin was, especially among obese subjects.

Use of landiolol hydrochloride, a new β-blocker, in coronary computed tomography angiography

We investigated the usefulness of landiolol hydrochloride, an ultrashort-acting beta(1)-selective agent, for coronary computed tomography angiography (CTA). Intravenous landiolol was administered to 133 patients before coronary CTA. Hemodynamic changes, adverse effects, image quality, and diagnostic accuracy for detection of coronary stenoses were evaluated. HR was significantly reduced during injection, but quickly recovered after cessation of landiolol. Neither significant changes in BP nor adverse effects were seen. The sensitivity, specificity, and positive and negative predictive values of coronary CTA for detection of significant stenoses were excellent, compared with invasive angiography. Therefore, our results show that intravenous landiolol administration gives a favorable image quality and facilitates diagnostic accuracy without causing adverse effects, indicating that landiolol is a useful premedication for coronary CTA.

Optimal Starting Time of Acquisition and Feasibility of Complementary Administration of Nitroglycerin With Intravenous β-Blocker in Multislice Computed Tomography

Objectives: We determined the optimal starting time of acquisition after sublingual nitroglycerin (NTG) administration and evaluated the effects on multislice computed tomographic (MSCT) images of a complementary administration of sublingual NTG with &bgr;-blocker. Methods: Sixty patients who underwent MSCT coronary angiography (CA) were randomly divided into 2 groups as follows: 30 patients given an intravenous administration of &bgr;-blocker (landiolol hydrochloride, mean dose of 0.032 mg/kg per minute; group B); and 30 patients given a coadministration of intravenous &bgr;-blocker and sublingual NTG (0.3 mg; group N). Blood pressure and heart rate were recorded every 1 minute after NTG administration. In addition, the maximum diameters of the proximal and distal lesions in each coronary artery were measured, and the number of assessable segments was calculated. Results: Blood pressure significantly decreased and heart rate significantly increased 4 minutes after NTG administration. The number of assessable segments was significantly greater in group N than in group B. The maximum diameters of the distal lesions of the left anterior descending and left circumflex arteries and both proximal and distal lesions of the right coronary artery were significantly larger in group N than in group B. Conclusions: It is advisable to obtain MSCT images after sublingual NTG administration because nitrates are always given during conventional CA and may prevent &bgr;-blocker-induced coronary spasm. The optimal starting time for MSCT CA is approximately 3 minutes after sublingual NTG administration.

The number and function of circulating CD34+CD133+ progenitor cells decreased in stable coronary artery disease but not in acute myocardial infarction

Objective Circulating CD34+CD133+ cells are one of the main sources of circulating endothelial progenitor cells (EPCs). Age is inversely related to the number and function of CD34+CD133+ progenitor cells in stable coronary artery disease (CAD), but the relationship remains unclear in acute myocardial infarction (AMI). The authors aimed to clarify how ageing affects the number and function of mobilised CD34+CD133+ progenitor cells in AMI. Design and results Circulating CD34+CD133+ progenitor cells were measured by flow cytometry. Measurements were made at admission for CAD, or on day 7 after the onset of AMI. In stable CAD (n=131), circulating CD34+CD133+ cells decreased with age (r=−0.344, p<0.0001). In AMI, circulating CD34+CD133+ cells did not correlate with age (n=50), and multivariate analysis revealed that the decreased number of circulating CD34+CD133+ cells was associated with male sex and higher peak creatinine kinase. The ability to give rise to functional EPCs, which show good migratory and tube-forming capabilities, deteriorated among stable CAD subjects (n=10) compared with AMI subjects (N=6). Conclusions In stable CAD, the number and function of circulating CD34+CD133+ progenitor cells decreased with age, whereas those mobilised and circulating in AMI did not.