Takuya Imatoh

Adiponectin levels associated with the development of hypertension: a prospective study.

Adiponectin is a recently discovered protein that seems to be exclusively secreted by adipocytes and is the most abundant adipose tissue–derived protein. While some recent studies have demonstrated an association between adiponectin levels and hypertension, these studies were cross-sectional in design, and the results have been inconsistent. Therefore we performed a prospective study to elucidate the role of adiponectin in the development of hypertension. The results of this study showed that serum adiponectin levels were significantly lower in hypertensive subjects than in normotensive subjects. Moreover, in logistic regression analysis, the subjects in the lowest quartile had a 3.72-fold higher risk than those in the highest quartile. Even after adjusting for potential confounding factors, this association was found to be significant. Low serum adiponectin levels were found to be independently associated with a higher risk for the development of hypertension. Our results therefore suggest that hypoadiponectinemia is a novel predictor of hypertension.

Evaluating measles surveillance: comparison of sentinel surveillance, mandatory notification, and data from health insurance claims

Inadequate notification is a recognized problem of measles surveillance systems in many countries, and it should be monitored using multiple data sources. We compared data from three different surveillance sources in 2007: (1) the sentinel surveillance system mandated by the Act on Prevention of Infectious Diseases and Medical Care for Patients Suffering Infectious Diseases, (2) the mandatory notification system run by the Aichi prefectural government, and (3) health insurance claims (HICs) submitted to corporate health insurance societies. For each dataset, we examined the number of measles cases by month, within multiple age groups, and in two categories of diagnostic test groups. We found that the sentinel surveillance system underestimated the number of adult measles cases. We also found that HIC data, rather than mandatory notification data, were more likely to come from individuals who had undergone laboratory tests to confirm their measles diagnosis. Thus, HIC data may provide a supplementary and readily available measles surveillance data source.

Is heat shock protein 60 associated with type 2 diabetes mellitus

AIMS HSP60 plays a protective role against heat, oxidative injury and ultraviolet. Recently, animal and clinical studies have suggested that HSP60 plays a role in various diseases. However, few epidemiological studies have demonstrated an association between HSP60 levels and type 2 diabetes mellitus. Therefore, an epidemiological study was conducted to examine the association of HSP60 with type 2 diabetes mellitus. METHODS This study included 83 type 2 diabetes mellitus patients and 161 controls that were recruited from male employees who received annual health check-ups between 2005 and 2007. The serum HSP60 levels were measured using the ELISA method. RESULTS Because the HSP60 levels were not detectable (<3.125 ng/mL) in 48.0% of the study subjects, HSP60 levels were divided into two categories (detectable or undetectable). A logistic regression analysis showed that the subjects in the undetectable had a 2.03 times higher risk of diabetes mellitus than those in the detectable after adjustment for age, BMI and rate of hypertension medication. CONCLUSIONS This study was the first epidemiological study to demonstrate an association between type 2 diabetes mellitus and HSP60, thus suggesting that HSP60 may play an important role in the type 2 diabetes mellitus pathology.

Does Elevated High-Sensitivity Serum C-Reactive Protein Associate with Hypertension in Non-Obese Japanese Males?

The object of this study is to assess whether elevated hsCRP levels are independently related to hypertension in non-obese Japanese males. This cross-sectional study comprised 86 hypertensive and 109 normotensive subjects. We defined hypertension as a systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg and/or taking antihypertensive therapy. Log-hsCRP levels were significantly higher in hypertensive than normotensive subjects. In logistic regression analysis, subjects in the highest tertile had a two-fold higher risk than those in the lowest tertile. The association between hypertension and hsCRP levels was marginally significant. In addition, there was a significant tendency for hypertension to increase with an increase in CRP level (p < .05). These findings suggest that elevated hsCRP level is an independent risk factor for hypertension in non-obese Japanese males.

Evaluation of the fatty liver index as a predictor for the development of diabetes among insurance beneficiaries with prediabetes.

Non‐alcoholic fatty liver disease (NAFLD) is the most common liver disease in developed countries, and it was required to monitor patients with prediabetes. However, there have been few reports establishing the risk for diabetes mellitus (DM) among patients with prediabetes. The purpose of the present study was to evaluate the effect of NAFLD on the progression of DM among insurance beneficiaries with prediabetes, using data from specific health check‐ups and the fatty liver index (FLI).

An outbreak of measles in Saitama City in 2007. What is the vaccination strategy to eliminate measles in Japan

In the present study, to elucidate an outbreak of measles in Saitama City, Japan, we analyzed the data for all notified subjects with measles. According to an active surveillance program, a total of 464 subjects were notified in 2007. The clinical criteria for the diagnosis of measles were defined as at least 3 days of a generalized maculopapular rash; a fever of 38.0°C or more; and cough, mucus, or pharyngitis. Two peaks according to age group were recognized: namely, children less than 2 years of age and adolescents from 15 to 19 years of age. The latter peak was associated with the period of time when the measles-mumps-rubella vaccine had become a social problem (40.9% of vaccinees and 41.6% of non-vaccinees in this group). Japan is said to be a developing country regarding its measles vaccination strategy. In addition, no national program against measles has yet been established. Continuous efforts to increase immunization coverage are needed to interrupt indigenous measles transmission. The Japanese Ministry of Health, Labor and Welfare should therefore plan and implement a nationwide program to eliminate measles in Japan.

Development of a novel algorithm for detecting glucocorticoid-induced diabetes mellitus using a medical information database.

Glucocorticoid‐induced diabetes mellitus (GIDM) increases the risk of diabetes mellitus (DM)‐related complications but is generally difficult to detect in clinical settings. The criteria for diagnosing GIDM have not been established. Recently, medical information databases (MIDs) have been used in post‐marketing surveillance (PMS) studies. We conducted a pharmacoepidemiological study to develop an algorithm for detecting GIDM using MID.

Moderate Oxidative Stress and High Antioxidative Activity Are Associated with Steatosis in Japanese Males

Steatosis is an increasingly common problem worldwide, accompanying increasing obesity. Recently, it has been suggested that oxidative stress plays an important role in development of fatty liver disease. We carried out an epidemiological study to clarify the role of oxidative stress and antioxidative activity in steatosis.

Effect of Infectious Diseases on the Pathogenesis of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions. Recent studies have revealed that the prevalence of SJS/TEN is associated with genetic backgrounds, such as polymorphisms in human leukocyte antigens (HLAs). However, non-genetic factors contributing to the etiology of SJS/TEN are largely unknown. This study aimed to assess the involvement of concurrent infection on the pathological states of SJS/TEN, examining the severity of cutaneous symptoms and ocular involvement as well as the time to onset in drug-induced SJS/TEN patients. We recruited 257 Japanese SJS/TEN patients from June 2006 to September 2013 through a nationwide case collection network and participating hospitals and reviewed the clinical information including patient backgrounds, primary disease and medication status. Association between infection and pathological states of SJS/TEN was assessed using univariate and multivariate analyses. The concurrent infectious group of SJS/TEN patients showed a significantly higher rate of exhibiting severer dermatological and ophthalmological phenotypes and an earlier onset of SJS/TEN than the non-infectious group. Our results suggest that the infection could be a risk factor to cause severer symptoms and earlier onset of SJS/TEN.

Effects of Eating Fast and Eating Before Bedtime on the Development of Nonalcoholic Fatty Liver Disease.

Few studies have evaluated the effects of lifestyle habits, such as eating behaviors, on the development of nonalcoholic fatty liver disease (NAFLD). It is known that NAFLD increases the risk of type 2 diabetes, prediabetes, cardiovascular disease, and chronic kidney disease. Therefore, a retrospective cohort study was conducted to evaluate the effect of eating behaviors and interactions between these behaviors on the development of NAFLD among health insurance beneficiaries without NAFLD. Study subjects were 2254 male and female insurance beneficiaries without NAFLD who had attended specific health checkups during fiscal years 2009 and 2012 among health insurance societies located in Fukuoka and Shizuoka Prefectures (Japan). The incidence of NAFLD was defined as Fatty Liver Index scores ≥60 or visiting medical organizations for fatty liver disease treatment according to claims data. Eating behaviors, including eating speed and eating before bedtime, were evaluated by a self-administered questionnaire. During the study period, 52 (2.3%) subjects progressed to NAFLD. Subjects who ate before bedtime but did not eat fast had a higher risk of NAFLD (adjusted odds ratio [AOR] = 2.15; 95% confidence interval [CI]: 1.03-4.46). Those with both negative eating habits had a significantly higher risk of NAFLD (AOR = 2.48; 95% CI: 1.09-5.63). Subjects who habitually ate before bedtime, and those who ate fast and before bedtime, tended to have an increased risk of NAFLD. Earlier intervention to modify these poor eating behaviors could be useful to prevent NAFLD. (Population Health Management 2016;19:279-283).