Koichiro Kadota

Thyroid function is associated with carotid intima-media thickness in euthyroid subjects.

To investigate the relationship between thyroid function and carotid intima-media thickness (CIMT) in a relatively large general population with euthyroid status we initially enrolled 1772 Japanese adults (421 men and 1351 women) who participated in a medical screening program for the general population over 40 years old. To evaluate only euthyroid subjects without vascular diseases and/or its major risk factors, 1129 were excluded and 643 participants (175 men and 468 women) were included for further analysis. Simple and multivariate linear regression analyses were performed to evaluate free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels and other existing parameters, including carotid intima-media thickness. By multivariate linear regression analysis adjusted for age and sex, free thyroxine was significantly correlated with triglycerides (beta=0.07, p=0.015), carotid intima-media thickness (beta=-0.091, p=0.049), and thyroid-stimulating hormone (beta=-0.091, p=0.003). Thyroid-stimulating hormone was significantly correlated with high-density lipoprotein cholesterol (HDL-C) (beta=-0.001, p=0.015), HbA(1c) (beta=0.038, p=0.045), carotid intima-media thickness (beta=0.27, p=0.001), and free thyroxine (beta=-0.15, p=0.003). When adjusted for confounding factors, free thyroxine was significantly correlated only with carotid intima-media thickness (beta=-0.13, p=0.043) and thyroid-stimulating hormone was significantly correlated with HDL-C (beta=-0.001, p<0.001), HbA(1c) (beta=0.04, p=0.021), and carotid intima-media thickness (beta=0.29, p=0.001). We have demonstrated that carotid intima-media thickness is independently associated with thyroid function within the normal reference range, which suggests an increased cardiovascular risk in subjects with low normal thyroid function.

White blood cell count and cardiovascular biomarkers of atherosclerosis.

Objective: To investigate the association with white blood cells (WBC) and atherosclerotic parameters including cardio-ankle vascular index (CAVI) and carotid intima–media thickness (CIMT) in the general population. Methods: We investigated the relationship between WBC count and metabolic syndrome components, CAVI and CIMT in 3738 Japanese study participants. Results: WBC count weakly correlated with CAVI in men (β = 0.61, p = 0.043), but not in women (β = 0.35, p = 0.17). On the other hand, WBC did not correlate with CIMT in either men or women (p = 0.41 and p = 0.71, respectively). Conclusion: WBC count was associated with lipids, blood pressure and body mass index, although the correlations with CAVI and CIMT were weak or absent.

Leptin to high-molecular-weight adiponectin ratio is independently correlated with carotid intima-media thickness in men, but not in women.

Background: The leptin:adiponectin ratio (L:A ratio) is an independent predictor of carotid intima-media thickness (CIMT). Objective: To evaluate whether the leptin:high-molecular-weight adiponectin ratio (L:HA ratio) is associated with CIMT in the general population. Methods: We investigated the relationship between the L:HA ratio and CIMT in 233 Japanese study participants (106 men and 127 women). Results: After adjustment for confounding factors, CIMT was significantly correlated with the log L:HA ratio (β = 0.11, p = 0.014) in men, whereas no correlation was observed in women (β = 0.01, p = 0.50). Conclusion: The L:HA ratio is closely correlated with CIMT in men, but not in women.

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

To investigate associations between hemoglobin levels and arterial stiffness accounting for body mass index (BMI) in a large‐scale cross‐sectional study.

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

BackgroundAlthough 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.MethodsWe 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.ResultsOf 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.ConclusionALP 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.

Circulating CD34-positive cells, glomerular filtration rate and triglycerides in relation to hypertension

OBJECTIVE Serum triglycerides have been reported to be independently associated with the development of chronic kidney disease (CKD), which is known to play a role in vascular disturbance. On the other hand, circulating CD34-positve cells, including endothelial progenitor cells, are reported to contribute to vascular repair. However, no studies have reported on the correlation between triglycerides and the number of CD34-positive cells. Since hypertension is well known factor for vascular impairment, the degree of correlation between serum triglycerides and circulating CD34-positve cells should account for hypertension status. METHODS We conducted a cross-sectional study of 274 elderly Japanese men aged ≥ 60 years (range 60-79 years) undergoing general health checkups. RESULTS Multiple linear regression analysis of non-hypertensive subjects adjusting for classical cardiovascular risk factors showed that although triglyceride levels (1SD increments; 64 mg/dL) did not significantly correlate with glomerular filtration rate (GFR) (β = -2.06, p = 0.163), a significant positive correlation was seen between triglycerides and the number of circulating CD34-positive cells (β = 0.50, p = 0.004). In hypertensive subjects, a significant inverse correlation between triglycerides and GFR was observed (β = -2.66, p = 0.035), whereas no significant correlation between triglycerides and the number of circulating CD34-positive cells was noted (β = -0.004, p = 0.974). CONCLUSION Since endothelial progenitor cells (CD34-positive cells) have been reported to contribute to vascular repair, our results indicate that in non-hypertensive subjects, triglycerides may stimulate an increase in circulating CD34-positive cells (vascular repair) by inducing vascular disturbance.

Height is an indicator of vascular maintenance capacity in older men.

Bone‐derived circulating CD34‐positive cells are reported to play an important role in vascular maintenance. Additionally, height might influence age‐related hematopoietic bone marrow decline, as it positively correlates with total bone marrow volume. As hypertension should mask the beneficial effects of circulating CD34‐positive cells, hypertension status should account for this correlation. The present study aimed to clarify the clinical importance of height on vascular maintenance in older Japanese men.

Multiple somatic symptoms and frailty: cross-sectional study in Japanese community-dwelling elderly people

BACKGROUND Physical frailty is relevant to adverse outcomes, but appropriate procedures for screening populations are lacking. We hypothesized that frailty is associated with multiple somatic symptoms because frail elderly people might have several somatic symptoms attributed to deterioration of multiple organs. OBJECTIVE To examine the association between multiple somatic symptoms and frailty. METHODS We conducted a cross-sectional study and enrolled 1818 participants aged ≥60 years from Japanese national medical check-up in 2015. Frailty status was categorized into frail, pre-frail or non-frail based on the definition of the Fried frailty phenotype model. Sixteen self-reported subjective somatic symptoms were recorded at the timing of medical check-up. Odds ratio (OR) and 95% confidence interval (CI) of frail or pre-frail were analyzed using number of somatic symptoms. RESULTS Out of total of 1818 subjects, 44 (2.4%) frail subjects, 635 (34.9%) pre-frail subjects and 1139 (62.7%) non-frail subjects were detected. More than two somatic symptoms were significantly associated with the frail phenotype (OR 6.20, 95% CI 2.95, 13.03, P < 0.001) and were associated with the pre-frail phenotype (OR 2.06, 95% CI 1.69, 2.51, P < 0.001). Associations remained significant after multi-adjustment for age, sex, past medical cardiovascular diseases and depressive mood The number of somatic symptoms ≥2 was thought to be the optimal cut-off point to predict frail with a sensitivity of 79.6%, specificity of 61.5%. CONCLUSIONS Our study shows that multiple somatic symptoms are independently associated with frailty. Using more than two multiple somatic symptoms as a prescreening tool for frailty may be appropriate.

Effects of smoking cessation on gastric emptying in smokers.

Background Smoking cessation can lead to changes in appetite and weight gain in some patients; thus, smoking cessation may alter gastrointestinal motility. Effects of smoking cessation on gastric emptying in smokers have not been established. Aim This study sought to determine how smoking cessation affects gastric emptying in smokers. Methods Participant group comprised 53 habitual smokers and 12 healthy nonsmokers. Habitual smokers were treated for 2 months with transdermal nicotine patches. Gastric emptying was studied using 13C acetate breath tests at the beginning of the study, and at 1 week and 9 weeks after cessation of patch use. Maximal 13CO2 excretion time (Tmax), 13CO2 excretion half-life (T1/2), and parameters β and κ, representing initial and subsequent gastric-emptying phases, respectively, were determined using conventional formulae. Results Before smoking cessation, Tmax was reached significantly later in smokers (0.94±0.3 h, P=0.014) than in controls (0.89±0.1 h). At 1 week after the end of treatment, Tmax was significantly decreased (from 1.05±0.32 h to 0.72±0.64 h, P=0.003). T1/2 also tended to decrease, but not significantly. Although β was decreased significantly (from 2.46±0.40 to 2.17±0.58, P=0.022), κ was unchanged. However, by 9 weeks after the end of treatment, Tmax (1.28±0.69 h) had increased to levels seen before treatment. Conclusions Smoking cessation temporarily accelerates gastric emptying, and decreases in β suggest that initial-phase gastric emptying accelerates after smoking cessation. The temporary acceleration of gastric emptying after smoking cessation may be involved in the temporary increase in appetite and weight gain seen after smoking cessation.

Height indicates hematopoietic capacity in elderly Japanese men.

Previously, we reported that height is an indicator of the capacity of vascular repair in elderly men, especially hypertensive men. On the other hand, hemoglobin could act as a possible biochemical index of hypertension-induced vascular damage. However, no studies have clarified the correlation between height and hematopoietic activity. We conducted a cross-sectional study of 249 men aged 65-69 undergoing a general health check-up. Reticulocyte was used to evaluate hematopoietic activity. Because hemoglobin concentration should influence hematopoietic activity, analyses stratified by hemoglobin level were performed. Independent of known cardiovascular risk factors and other hematological parameters (white blood cell count), a significant positive correlation was seen between height and reticulocytes for total subjects and subjects with a high hemoglobin concentration (≥14.5 g/dL), but not in subjects with a low hemoglobin concentration (<14.5 g/dL). The standardized parameter estimates (β) were β=0.18, p=0.003 for total subjects, β=0.28, p=0.001 for subjects with a high hemoglobin concentration, and β=0.03, p=0.717 for subjects with low hemoglobin. Independently, height is significantly positively correlated with reticulocyte in elderly Japanese men, particularly in men with a high hemoglobin concentration. These results indicate that subjects with a short stature might have lower hematopoietic capacity than those with a high stature.