Kanae Mure

Effect of the Hanshin-Awaji earthquake on posttraumatic stress, lifestyle changes, and cortisol levels of victims

Abstract In 1995, the Hanshin-Awaji area in Japan was damaged severely by a major earthquake. In this study, the authors administered questionnaires and obtained blood samples to analyze the relationships among lifestyle, psychological stress, and plasma cortisol levels of victims. The authors questioned 107 male inhabitants of Awaji Island about their lifestyles before and after the earthquake, presence of any symptoms of posttraumatic stress disorder, and demographic variables. Plasma cortisol levels were determined with enzyme immunoassay. Cortisol level was correlated strongly with change in lifestyle. The highest cortisol levels were found in the group characterized by a high posttraumatic stress disorder score and by a very profound lifestyle change. This group also contained the highest percentage of subjects who had poor health. In summary, the psychological stress induced by the Hanshin-Awaji earthquake was associated with mean cortisol level; however, this relationship was affected by adjustment of lifestyle.

Chromosome alterations in peripheral lymphocytes as indices of lifestyle and genotoxicity

SummaryShort-term cultures of human lymphocytes were used to investigate the in vitro metabolism of benzene and its genotoxicity, and to monitor genetic health effects of lifestyles. Metabolic (S9) activation of benzene and its metabolites, catechol, hydroquinone, and phenol, caused an increase in sister-chromatid exchanges (SCEs) with different optimal concentrations of S9 mix for converting each compound into further reactive forms. The data indicate that catechol and hydroquinone can be optimally metabolized to produce reactive species, presumably benzo(semi)quinones, under conditions of lower metabolic activity than those necessary for phenol and benzene. We have further investigated the correlations between chromosome alterations (SCEs, structural aberrations and micronuclei) in peripheral lymphocytes and individual lifestyles. Healthy lifestyles, or “good health practices” examined were 1) not smoking, 2) not drinking too much alcohol, 3) doing physical exercise regularly, 4) sleeping more than 6 h per night, 5) keeping nutritional balance in meals, 6) not snacking, 7) having breakfast everyday, and 8) not having too much perceived stress. The persons were categorized into 3 groups having good, moderate and poor lifestyles by the number of good health practices they do. Mean frequencies of chromosome alterations in lymphocytes from men with poor lifestyles have been shown to be significantly higher than those in cells from men having good lifestyles. Further experiments have been done to examine whether lymphocytes from men having unhealthy lifestyles might show a higher susceptibility 1) to the SCE production by treatment with hydroquinone, a major metabolite of benzene, and 2) to the chemicals inhibitory effect of repair of radiation-induced chromosome breakage, because our living and working environments contain possible repair inhibitors such as benzene, lead and chromium. The results showed that unhealthy lifestyles could make the cells to be more sensitive to the production of these chromosome alterations by the environmental and occupational agents.

Association of serum uric acid with subsequent arterial stiffness and renal function in normotensive subjects

Serum uric acid (SUA) is correlated with an increased risk of not only gout but also cardiovascular diseases. The present study aimed to longitudinally evaluate the effects of SUA level on renal function and arterial stiffness in a population-based sample of normotensive subjects. The subjects completed a health checkup in 2002 at baseline and in 2011 or 2012 at the end of the follow-up period. A total of 407 normotensive subjects (171 men and 236 women) aged 26–66 years were enrolled in this study. We measured blood pressure (BP), brachial-ankle pulse wave velocity (baPWV), central BP, intima–media thickness, SUA level and estimated glomerular filtration rate (eGFR). We divided the subjects into four subgroups according to the SUA quartile at baseline and compared renal function and arterial stiffness after the follow-up. The cutoff values were 3.6, 4.4, 5.6 and 9.6 mg dl−1. The SUA levels associated with baPWV (Q1, 1324; Q2, 1457; Q3, 1442; Q4, 1489 cm s−1), systolic BP (SBP) (Q1, 110.9; Q2, 110.1; Q3, 112.8; Q4. 116.1 mm Hg) and eGFR (P for trend <0.001). There was a significant difference in the incidence of arterial stiffness in women. Multivariate regression analyses showed that after adjusting for potential confounders, including age, sex, body mass index, SBP and lipids, SUA was a significant determinant of baPWV (β=0.117; P<0.05) and eGFR (β=−0.335, P<0.001). The results of this study suggest that elevated SUA levels may be associated with a higher risk of increased arterial stiffness and reduced renal function in normotensive subjects.

Relationships between Lifestyle, Living Environments, and Incidence of Hypertension in Japan (in Men): Based on Participant's Data from the Nationwide Medical Check-Up.

This study aims to investigate factors that contribute to the differences in incidence of hypertension between different regions in Japan, by accounting for not only individual lifestyles, but also their living environments. The target participants of this survey were individuals who received medical treatment for hypertension, as well as hypertension patients who have not received any treatment. The objective variable for analysis was the incidence of hypertension as data aggregated per prefecture. We used data (in men) including obesity, salt intake, vegetable intake, habitual alcohol consumption, habitual smoking, and number of steps walked per day. The variables within living environment included number of rail stations, standard/light vehicle usage, and slope of habitable land. In addition, we analyzed data for the variables related to medical environment including, participation rate in medical check-ups and number of hospitals. We performed multiple stepwise regression analyses to elucidate the correlation of these variables by using hypertension incidence as the objective variable. Hypertension incidence showed a significant negative correlation with walking and medical check-ups, and a significant positive correlation with light-vehicle usage and slope. Between the number of steps and variables related to the living environment, number of rail stations showed a significant positive correlation, while, standard- and light-vehicle usage showed significant negative correlation. Moreover, with stepwise multiple regression analysis, walking showed the strongest effect. The differences in daily walking based on living environment were associated with the disparities in the hypertension incidence in Japan.

Mps 10-04 The Combination Of Obesity And Sarcopena Is Associated With Cognitive Decline In Elderly Hypertensive Individuals

Objective: The combination of obesity and sarcopenia, defined as sarcopenic obesity, may contribute to cognitive decline more than the two conditions exist solely. This study aimed to investigate the risk of cognitive impairment associated with the sarcopenia, obesity, and its combination among elderly hypertensive individuals. Design and Method: A total of 348 elderly hypertensive subjects (175 men and 173 women, 69.5 ± 2.9 years of age), was enrolled in this study. We evaluated the cognitive functioning of individuals based on the 12-signs version of the Observations List for early signs of Dementia (OLD). Bioelectrical impedance analysis was performed to estimate appendicular skeletal muscle mass (ASM). A value of ASM was normalized for height and conversed to an ASM index. Results: Subject with an ASM index of less than the gender-specific lowest quartiles was classified as sarcopenic. Obesity was defined as waist circumference greater than 85 cm for men and 90 cm for women. Based on the cutoffs, four categorical groups were created as solely sarcopenic (sarcopenic non-obese), solely obese (non-sarcopenic obese), sarcopenic obese, and normal. The OLD score was highest (namely, cognitive functioning was lowest) among the sarcopenic obese group (5.3 ± 0.7 points), followed by non-sarcopenic obese group (3.3 ± 0.2 points), the sarcopenic non-obese group (3.4 ± 0.3 points), and normal group (2.8 ± 0.2 points) after adjusting for confounding factors (p for trend <.001). When a cognitive decline was defined as the OLD score of 5 points or above, 25.9% of the subjects met the criteria. Multiple logistic regression analysis revealed that the sarcopenic obese condition was significantly associated with the increased risk for cognitive decline (odds ratio, 4.0; 95% CI, 1.3–12.0; P<.05), independent of age, gender, education level, and use of anti-hypertensive agents. Conclusions: In elderly hypertensive individuals, the combination of obesity and sarcopenia may contribute to the acceleration of cognitive decline relative to the condition that they exist solely.

[PP.09.33] THE EFFECTS OF SMOKING ON CENTRAL BLOOD PRESSURE IN MIDDLE-AGED AND ELDERLY JAPANESE INDIVIDUALS

Objective: The aim of this study was to investigate the effect of smoking habits on central blood pressure in a population-based sample of middle-aged and elderly individuals. Design and method: A total of 406 normotensive and untreated hypertensive (stage-1) individuals (mean age; 59 ± 10 years) without a history of cardiovascular disease, renal disease and arteriosclerosis obliterans was recruited for this study. When the subject was in a comfortable seated position the peripheral brachial pressures were measured, and then the brachial waveform was captured by a standard brachial cuff (SphygmoCor XCEL) and the central aortic pressures were estimated using a generalized transfer function. Smoking status was determined by questionnaire. Current smokers and former smokers were asked how many cigarettes they smoked per day and the number of years spent smoking. Brinkman Index (BI) values were calculated as the number of cigarettes smoked per day multiplied by the number of years of smoking. Results: The subjects were divided into subgroups according to cumulative number of cigarettes smoked; never-smokers (N = 292), mild-to-moderate smokers (BI of < 800 per lifetime, N = 64), and heavy smokers (BI of > = 800 per lifetime, N = 50). Central systolic pressure was higher in both heavy smokers (123mmHg, P < .001) and mild-to-moderate smokers (117mmHg, P = .070) than those in never-smokers (112 ± 14mmHg) after adjustment for sex, age, and body mass index (p for trend<.001). This dose-response increase by smoking status was not clearly demonstrated in brachial systolic pressure. A stepwise multiple regression analysis revealed that the heavy smoking (&bgr; = .192, P < .001), age (&bgr; = .231, P < .001), body mass index (&bgr; = .278, P < .001), and LDL cholesterol (&bgr; = .099, P = .028) were selected as significant determinants of central systolic pressure independent of sex. Conclusions: These results suggest that smoking habits may have greater impact on central aortic pressure than peripheral brachial pressure and hence could be identified by abnormal increases in central systolic pressure and wave reflection even before clinical manifestation of hypertension.

[OP.6A.07] EFFECTS OF A HOME BLOOD PRESSURE MONITORING BY MOBILE PHONE-BASED SELF-MANAGEMENT SUPPORT SYSTEM IN MILD HYPERTENSION: THE KATSURAGI STUDY

Objective: Hypertension is a significant risk factor for heart disease and stroke worldwide. Effective treatment regimens exist; however, treatment adherence rates are poor (30%-50%). Improving self-management may be a way to increase adherence to treatment. To evaluate the efficacy of a new strategy to control blood pressure by interactive mobile phone support in mild hypertension. Design and method: Study subjects were 657 general individuals who participated in a specific health check-up. In 389 hypertensive subjects,90 patients (Grade 1)who agreed with this study were randomly selected and distributed in three groups:A total of 83 patients completed the study, (1) control group (n = 29:C);(2) salt restriction group (n = 28:S); (3)exercise group (n = 26:E). All patients were measured by a mobile phone-based self-management support system (OMRON, HEM-7251G) for 3 months. 50 subjects among 90 mild hypertension were performed follow-up study one year later by usual BP measurement. We measured urinary Na/K at 6 times in this study-periods. Results: After 3 months intervention, mean home blood pressure for 7 days significantly reduced in three groups (C: 143 ± 19/85 ± 11;136 ± 19/82 ± 13 mmHg, S:144 ± 21/85 ± 12;139 ± 19/82 ± 12 mmHg, E:141 ± 19/83 ± 12;130 ± 17/77 ± 10 mmHg, p = 0.0001).There were no differences of home blood pressure-reduction between three groups. After one year, arterial blood pressure at health check-up significantly reduced only in S group (141 ± 12/82 ± 8 mmHg vs 133 ± 16/77 ± 10 mmHg, SBP, p = 0.002, DBP, p = 0.014), but no significant changes were observed in other 2 group. Urinary Na/K significantly decreased in S (4.0 to 2.7, p = 0.008)), but there are no significant changes in E and C. Conclusions: A home blood pressure monitoring by mobile phone-based self-management support system is effective in mild hypertension. Long term intervention revealed that salt restriction is effective in reducing blood pressure and urinary Na/K.

PS 12-22 ASSOCIATION OF Lp-PLA2 (PLA2G7) V279F GENOTYPES WITH ATHEROSCLEROTIC MARKERS IN THE GENERAL JAPANESE POPULATION

Objective: Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been reported as a sensitive biomarker for cardiovascular disease. However, the association of La-PLA2 and atherosclerotic markers are now always warranted. The V279F loss-of-function variant of PLA2G7 gene encoding Lp-PLA2 is commonly seen in East Asians. To clarify the association of Lp-PLA2 and atherosclerotic markers, the PLA2G7 V279F genotypes in the general Japanese populations were investigated. Design and Method: Serum triglyceride, high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure (SBP and DBP), and atherosclerosis indices such as brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and carotid intima-media thickness (CIMT) were assessed in 792 participants (385 men, 64.1 ± 9.0 years; 407 women, 62.6 ± 9.5 years). Rs 76863441 polymorphism (exon 9, G994T) was screened using a TaqMan allelic discrimination assay. Multivariate regression analyses and analyses of covariance adjusted for age, BMI, medication, alcohol consumption, smoking and walking status were carried. Results: Significant association of V279F genotype with triglyceride (&bgr;=0.15, P = 0.005) and with ABI (&bgr; = 0.12, P = 0.036) were seen in men. It also showed trend of being associated with HDL-C in men (&bgr; =− 0.09, P = 0.080) and with baPWV in women (&bgr; = 0.08, P = 0.080). Men with rare T allele showed significantly higher triglyceride (P = 0.004) compared to those in men with GG wild type, and women with T allele showed significantly higher baPWV (P = 0.011) compared with those in women with GG wild type. Conclusions: Lp-PLA2 V279F polymorphisms were significantly associated with atherosclerotic markers in the general Japanese population with gender differences.

Depression, Alcoholism, and Genetic Alcohol Sensitivity Regulated by ALDH2 and ADH1B Polymorphisms among Japanese Community-Dwelling Adults

Background: Although strong association between drinking and depression as well as alcohol-related disorders (ARD) has been reported, the relationship between potential ability to drink (genetic alcohol sensitivity) and depression or ARD is unclear. Genetic alcohol sensitivity is regulated by two alcohol metabolic enzyme genes, ADH1B and ALDH2 polymorphisms. We have already evaluated the association between depression and these polymorphisms in Japanese white-collar workers. Current study expanded this issue on community-dwelling relatively older adults.

Categorization of micronuclei by size and measurement of each ratio in cytokinesis-block and conventional cultures of human lymphocytes exposed to mitomycin C and colchicine.

Micronuclei (MN) assays are very useful tests for monitoring human exposure to mutagens and carcinogens. We investigated the effects of the culture method (either conventional or cytokinesis-block) and exposure time (48 or 72hr) on the frequency and size distribution of MN in human peripheral lymphocytes exposed to mitomycin C (MMC) or colchicine. To quantitatively analyze the effects of the agents, methods and exposure times, we categorized MN by size into small (MN-1), medium (MN-2), and large (MN-3). MN-1 were less than one fifth, MN-2 one fifth to one third, and MN-3 larger than one third of the diameter of the main nucleus.Both MMC and colchicine induced dose-related increases in the frequency of MN. The number and distribution of the size-categorized MN were influenced by the agent, method and exposure time. The conventional culture method was useful for detecting the induction of MN-1 by MMC, whereas the cytokinesis-block method was useful for detecting the induction of MN-1 by colchicine. The ratios of MN in the various size categories reflect the different mechanisms of MN induction by MMC and colchicine.These findings suggest that categorization of MN by size can allow one to differentiate between a clastogen and an aneuploidogen, and that the ratios of MN in the three size categories may provide a good index for estimating the type of MN induction for human monitoring.