Mitsuhiro Nakae

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.

Relationship of androgens to muscle size and bone mineral density in women with polycystic ovary syndrome.

OBJECTIVE To investigate the relationship of androgens to regional muscle size and bone mineral density (BMD) in women with polycystic ovary syndrome (PCOS). METHODS Seventy‐one amenorrheic and right‐side dominant women with PCOS (mean age ± standard deviation 28.1 ± 6.7 years) were enrolled. Baseline characteristics included age, height, weight, and body mass index (BMI). Regional BMD and lean mass were measured by whole‐body scanning with dual‐energy x‐ray absorptiometry. Serum levels of testosterone, dehydroepiandrosterone sulfate (DHEAS), and androstenedione were measured by radioimmunoassay. Correlations between regional BMD and variables were investigated using a Pearson correlation test and multiple regression analysis. RESULTS Serum testosterone levels correlated significantly with lean mass of the left arm, right arm, trunk, left leg, and right leg (r = .34, P < .05 to r = .50, P < .01). Regional lean mass correlated significantly with respective regional BMD (r = .30, P < .05 to r = .68, P < .001). These relationships remained significant after adjusting for age, height, and weight. Serum testosterone levels were not correlated with BMD of the bilateral arms and lumbar spine. Although serum testosterone levels correlated with leg BMD (r = .34, P < .05 to r = .45, P < .01), significance did not persist after adjusting for respective regional lean mass. CONCLUSION Testosterone influences regional BMD through increasing regional muscle mass in women with polycystic ovary syndrome.

Waist to Hip Circumference Ratio as a Significant Predictor of Preeclampsia, Irrespective of Overall Adiposity

Objective: To investigate whether abnormal body fat distribution is a significant predictor of the development of preeclampsia, irrespective of overall adiposity.

Precedence of bone loss over changes in body composition and body fat distribution within a few years after menopause

OBJECTIVE The present study investigated the sequence of certain phenomena with a few years after menopause: bone mineral loss, decrease in lean body mass, increase in body fat mass, or the shift toward upper body fat distribution. METHODS Subjects were 64 postmenopausal women aged 50-53 years with right side dominance (mean age+/-S.D., 51.4+/-1.1 years), and 59 age-matched regularly menstruating premenopausal women (51.7+/-1.2 years) serving as controls. Height, weight, body mass index (BMI, wt./ht.(2)), age at menopause (in postmenopausal women), and years since menopause (YSM) were recorded. Anthropometries, bone mineral density (BMD), and body fat distribution were assessed by dual-energy X-ray absorptiometry. RESULTS Age at menopause and YSM in postmenopausal women were 51.7+/-1.2 and 2.3+/-1.7 years, respectively. Age, height, weight, BMI did not differ between the two groups. BMD of the bilateral arm, lumbar spine (L2-4), pelvis, and total body were significantly lower in postmenopausal women. However, leg BMD, trunk-leg fat ratio, body fat mass, and the lean body mass did not differ between the two groups. CONCLUSION Within a few years after menopause, bone mineral loss precedes lean mass loss, increase in body fat mass, and a shift toward upper body fat distribution. We can say that bone tissue is more sensitive to hypogonadism than lean and fat tissues are.

Lean mass as a significant determinant of regional and total body bone mineral density in premenopausal women

Abstract: We investigated the relations of body composition to regional and total body bone mineral density (BMD) in 275 healthy Japanese premenopausal women (mean age, 37.1 ± 9.2 years; range, 16–55 years). In all subjects, the right side was dominant. BMD of the head, bilateral arms, lumbar spine (L2–L4), bilateral legs, and total body were measured using whole-body scanning by dual-energy X-ray absorptiometry (DXA). Total fat mass, total lean mass, regional lean mass, and regional fat mass were measured by DXA. Baseline characteristics including age, height, body weight, and body mass index were recorded for each subject. Possible correlations between regional or total body BMD with variables were determined on univariate and stepwise multiple regression analysis. BMD, lean mass, and fat mass were compared between the bilateral extremities. Total lean mass for the right arm, regional lean mass for the left arm, total lean mass for the lumbar spine, body weight for the bilateral legs, and total lean mass for the whole body were the most significant determinants of BMD on stepwise multiple regression analysis. Right-arm BMD was significantly higher than left-arm BMD. However, no significant difference was observed between BMD in the right and left legs. We concluded that lean mass is a more significant determinant of regional and total body BMD than fat mass in premenopausal women.

Body fat patterning in polycystic ovary syndrome women as a predictor of the response to clomiphene

Background.  To investigate the difference in the response to clomiphene citrate (CC) based on body fat distribution in women with polycystic ovary syndrome (PCOS).

A woman with isolated prolactin deficiency

It is well established that hyperprolactinemia due to either pituitary prolactinoma or hypothalamic derangement interferes with normal cyclic feed back mechanism. However, there are reports that prolactin (PRL) oversuppression to below normal levels causes the impairment of progesterone synthesis in normal cycling women (1, 2). It appears that a certain plasma level of PRL is required for progesterone synthesis to proceed normally. However, this concept is based on circumstances where PRL deficiency was surgically or medically induced. Thus, the clinical significance of hypoprolactinemia remains to be elucidated. We report a very rare case of isolated PRL deficiency, and discuss the relationship between hypoprolactinemia and reproductive function such as lactogenesis and ovarian function.

Relationship of upper body fat distribution to higher regional lean mass and bone mineral density

Abstract. We investigated the relationship of upper body fat distribution to regional bone mineral density (BMD). Subjects were 361 regularly menstruating premenopausal women with right-side dominance. Age, height, and weight were recorded. Regional (arms, L2–L4 of the lumbar spine, and legs) BMD, regional (arms, trunk, and legs) lean mass, and the ratio of trunk fat mass to leg fat mass amount (trunk–leg fat ratio) were measured by dual-energy X-ray absorptiometry. Body fat distribution was assessed by trunk–leg fat ratio. Trunk–leg fat ratio was positively correlated with regional BMD (r = 0.120–0.216; P < 0.05–P < 0.001) and regional lean mass (r = 0.162–0.229; P < 0.01–P < 0.001). Regional lean mass was more positively correlated with regional BMD (r = 0.319–0.475; P < 0.001). These relationships remained significant after adjusting for age and height. However, correlation of trunk–leg fat ratio with regional BMD disappeared after additionally adjusting for regional lean mass. In premenopausal women, upper body fat distribution is associated with higher regional BMD via greater regional lean mass irrespective of age and height.

Inverse relationship between the changes in trunk lean and fat mass during gonadotropin-releasing hormone agonist therapy

OBJECTIVE The aim of the present study was to investigate the relationship between the changes in lean and fat mass during gonadotropin-releasing hormone agonist (GnRH agonist) therapy. METHODS Subjects were 24 premenopausal women (mean age, 39.5+/-9.4 years; range, 32-52 years) with uterine leiomyomas. They were given GnRH agonist (leuprorelin acetate, 3.75 mg) monthly for 4 months. Age and height were recorded. Body weight, regional and total body composition, and the ratio of trunk fat mass to leg fat mass (trunk-leg fat ratio) were assessed by whole body scanning with dual-energy X-ray absorptiometry. Changes in these variables were investigated. Relationships between the changes in regional lean and fat mass were investigated using Pearsons correlation test. RESULTS Trunk fat mass significantly increased from 8616+/-3538 to 9265+/-3526 g (P<0.01) and trunk-leg fat ratio significantly increased (1.02+/-0.39 to 1.07+/-0.39, P<0.05). Trunk lean mass significantly decreased from 18,509+/-2602 to 17,916+/-2402 g (P<0.01). However, body weight, and lean and fat mass component in the extremities did not change. Change in trunk fat mass was inversely correlated with change in trunk lean mass (r=-0.439, P<0.05), but such relationships were not observed in arm and leg regions. CONCLUSION Inverse relationship between the changes in trunk lean and fat mass is observed during GnRH agonist therapy.

Age-related change in the strength of correlation of lumbar spine bone mineral density with other regions

OBJECTIVES To investigate whether the strength of correlation of lumbar spine bone mineral density (BMD) with other regions differs with age. METHODS Subjects were 336 premenopausal women aged 20-49 years and 218 postmenopausal women aged 50-69 years with right-side dominance. Age, height, weight, and years since menopause (YSM) were recorded. Subjects were classified into five subgroups at 10-year increments. BMD of the arms, lumbar spine (L2-4), pelvis, legs, and total body were measured by dual-energy X-ray absorptiometry (DEXA). RESULTS Regional and total body BMD did not differ among women aged in their 20s, 30s, and 40s. However, in women aged over 50, regional and total body BMD gradually decreased with age. The strength of correlation of lumbar spine BMD with the left arm, right arm, left leg, right leg, and total body BMD gradually increased with advancing age (r=0.422-0.715, 0.376-0.714, 0.476-0.721, 0.491-0.734, and 0.642-0.800, respectively). However, the strength of correlation of lumbar spine BMD with pelvis BMD remained unchanged (r=0.512-0.622). CONCLUSIONS Correlation of lumbar spine BMD with extremities BMD gradually strengthens with advancing age, while higher correlation of lumbar spine BMD with pelvis BMD remains unchanged. When lumbar spine BMD is predicted using values at sites such as forearm BMD, we should consider the patients age.