Rei Otsuka

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.

The metabolic syndrome is associated with elevated circulating C-reactive protein in healthy reference range, a systemic low-grade inflammatory state.

OBJECTIVE: To elucidate the underlying mechanisms between C-reactive protein (CRP) and cardiovascular disease, we exa-mined the association of circulating CRP in healthy reference range (≤1.0 mg/dl) measured by high-sensitive CRP assay with the metabolic syndrome (MS).DESIGN: Cross-sectional study of circulating CRP in adult men.SUBJECTS: A total of 3692 Japanese men aged 34–69 y.MEASUREMENTS: Serum CRP, total cholesterol, triglycerides, LDL-cholesterol, fasting glucose, fasting insulin, uric acid, systolic blood pressure, diastolic blood pressure, and body mass index (BMI).RESULTS: There was a statistically significant positive correlation between CRP and BMI (r=0.25), total cholesterol (r=0.096), triglycerides (r=0.22), LDL-cholesterol (r=0.12), fasting glucose (r=0.088), fasting insulin (r=0.17), uric acid (r=0.13), systolic blood pressure (r=0.12), and diastolic blood pressure (r=0.11), and a significant negative correlation of CRP with HDL-cholesterol (r=0.24). After adjusting for age, smoking, and all other components of MS, obesity, hypertriglyceridemia, hyper-LDL-cholesterolemia, diabetes, hyperinsulinemia, and hyperuricemia were significantly associated with both mildly (≥0.06 mg/dl) and moderately (≥0.11 mg/dl) elevated CRP. Compared with men who had no such components of the MS, those who had one, two, three, four, and five or more components were, respectively, 1.48, 1.84, 1.92, 3.42, and 4.17 times more likely to have mildly elevated CRP levels (trend P<0.001). As for moderately elevated CRP, the same association was observed.CONCLUSIONS: These results indicate that a variety of components of the MS are associated with elevated CRP levels in a systemic low-grade inflammatory state.

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.

Perceived Psychological Stress and Serum Leptin Concentrations in Japanese Men

Objective: To examine epidemiologically whether subjects with higher stress perception levels have higher leptin concentrations.

Long-term body weight variability is associated with elevated C-reactive protein independent of current body mass index among Japanese men

OBJECTIVE: To elucidate the effect of long-term weight variability on C-reactive protein (CRP) levels.DESIGN: Cross-sectional study of the circulating CRP.SUBJECTS: A total of 637 Japanese men aged 40–49 y in1997.MEASUREMENTS: Serum CRP levels, body mass index in 1997 (current BMI), the slope of weight on age (weight-slope) representing an individuals weight trend of direction and magnitude, and the root mean square error around the slope of weight on age (weight-RMSE) representing the weight fluctuation magnitude, as calculated by a simple linear regression model in which each value of the subjects five actual weights (aged 20, 25, 30 y, five years ago, and current) was a dependent variable and the subjects ages independent variables.RESULTS: After adjustment for age and confounders, including smoking and health status, the odds ratios of elevated CRP (≥0.06 mg/dl) were 1.83 (95% CI: 1.25–2.69), 2.63 (1.69–4.11), and 10.31 (2.17–48.98) for upper normal-weight (BMI: 22–<25 kg/m2), overweight (25–<30), and obese (≥30) persons, respectively, compared with lower normal-weight persons (18.5–<22). Adjusting for age, confounders, and current BMI, weight-slope was positively associated with CRP level especially among subjects with BMI≥25 kg/m2 (trend P<0.01), and weight-RMSE was positively associated with CRP level particularly among subjects with BMI <25 kg/m2 (trend P<0.05).CONCLUSION: Our results suggest a state of low-grade systemic inflammation not only in overweight and obese persons, but also in normal-weight persons with large weight fluctuation, possibly explaining in part the positive association between weight fluctuation and CVD.

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.

Higher dietary intake of alpha-linolenic acid is associated with lower insulin resistance in middle-aged Japanese

OBJECTIVE To investigate the associations between dietary intake of n-3 polyunsaturated fatty acids (plant-derived alpha-linolenic acid: ALA, and marine-derived eicosapentaenoic and docosahexaenoic acid: EPA+DHA) and insulin resistance (IR) in a lean population with high n-3 PUFA intake. METHOD We cross-sectionally studied 3383 Japanese local government workers aged 35-66 in 2002. IR was defined as the highest quartile of homeostasis model assessment, and nutrient intake was estimated from a diet history questionnaire. The odds ratios (ORs) of IR taking the lowest quartile of ALA or EPA+DHA intake as the reference were calculated by logistic regression analysis. RESULTS Mean age, body mass index (BMI), and dietary ALA, and median of dietary EPA+DHA were 47.9 years, 22.9 kg/m(2), and 1.90 g/day (0.88%E) and 0.77 g/day (0.36%E), respectively. The ORs of IR decreased across the quartiles of ALA intake (multivariate-adjusted OR for Q4 versus Q1=0.74, P for trend=0.01) and the association was observed only in subjects with a BMI of <25 kg/m(2) (P for interaction=0.033). However EPA+DHA showed no such associations consistently. CONCLUSION Higher ALA intake was significantly associated with a lower prevalence of IR in normal weight individuals of middle-aged Japanese men and women.