Light-to-moderate alcohol drinking has been shown to reduce the risk of type 2 diabetes, for which obesity is a primary risk factor. The aim of this study was to determine whether drinking alcohol influences the relationship between obesity and hyperglycemia.The relationships of adiposity indices with hyperglycemia were compared among middle-aged Japanese men (N = 12,627) who were non-, light-to-moderate (<22 g ethanol/day), heavy (≥22 and <44 g ethanol/day), and very heavy (≥44 g ethanol/day) drinkers.There were significant positive correlations of hemoglobin A1c with body mass index (BMI) and waist-to-height ratio (WHtR), which were significantly weaker in light-to-moderate and heavy drinkers than in nondrinkers but were not significantly different in very heavy drinkers compared with nondrinkers. Odds ratios (ORs) for hyperglycemia in subjects with versus those without high BMI or WHtR were significantly higher than reference level of 1.00 in all the drinker groups and significantly lower in light-to-moderate and heavy drinkers compared with nondrinkers; however they were not significantly different in very heavy drinkers compared with nondrinkers. ORs of the interaction term consisting of alcohol drinking and high adiposity index were significantly lower than the reference level in the light-to-moderate and heavy drinkers (OR with 95% confidence interval: high BMI, 0.61 [0.41, 0.91] in light-to-moderate drinkers and 0.64 [0.48, 0.85] in heavy drinkers; high WHtR, 0.57 [0.38, 0.85] in light-to-moderate drinkers and 0.66 [0.50, 0.88] in heavy drinkers) but were not significantly different from the reference level in very heavy drinkers (high BMI, 0.90 [0.65, 1.25]; high WHtR, 1.04 [0.74, 1.46]).The associations between obesity and hyperglycemia were weaker in light-to-moderate drinkers than in nondrinkers. Thus, light-to-moderate drinking may reduce the impact of obesity on the risk for diabetes.
Serum sialic acid is related to mortality from cardiovascular disease and is increased in patients with diabetic microangiopathies. The purpose of this study was to examine whether serum sialic acid is associated with ischemic disease of the lower extremities, using the ankle versus brachial arterial-pressure ratio. The subjects were NIDDM patients attending diabetic clinics. They received a questionnaire on smoking and duration of diabetes, and physical examinations including measurement of blood pressure of upper and lower extremities. Fasting blood was taken for measurement of sialic acid, total and HDL cholesterol, and HbA1c. Serum sialic acid was significantly correlated with ankle versus brachial arterial-pressure ratio (r = -0.32) and HbA1c (r=0.45). The correlation with ankle versus brachial arterial-pressure ratio was evident in the patients with low ankle versus brachial arterial-pressure ratios (r = -0.66), but was not significant in those with normal ankle versus brachial arterial-pressure ratios (r=0.16). The correlation with HbA1c was significant independently of ankle versus brachial arterial-pressure ratios. Mean serum sialic acid was higher in patients with very low ankle versus brachial arterial-pressure ratios (< 0.9) than in those with normal ankle versus brachial arterial-pressure ratios (> or = 1.0) or slightly low ankle versus brachial arterial-pressure ratios (0.9 approximately 1.0). These results suggest that serum sialic acid reflects the status of blood glucose control and the progression of ischemic disease of the lower extremities in NIDDM patients.
Platelets are a major source of microRNAs (miRNAs) in blood. Relationships between circulating platelet-derived miRNAs were investigated to elucidate their significance as biomarkers. Total miRNAs in serum were analyzed using the 3D-Gene miRNA Oligo chip. Among 22 miRNAs that are included in platelets and play functional roles, sufficient miRNA levels for comparison were detected for 11 miRNAs (let-7b-5p, miR-16-5p, miR-17-5p, miR-24-3p, miR-107, miR-126-3p, miR-150-3p, miR-191-5p, miR-197-3p, miR-223-3p, and miR-326). Among 55 pairs prepared by these miRNAs, relatively strong correlations (Spearman's correlation coefficient >0.8) were shown between miRNAs of 7 pairs including let-7b-5p and miR-16-5p, let-7b-5p and miR-17-5p, let-7b-5p and miR-107, miR-16-5p and miR-17-5p, miR-16-5p and miR-107, miR-17-5p and miR-107, and miR-107 and miR-126-3p. In principal component analysis, the first principal component consisted of let-7b-5p, miR-16-5p, miR-17-5p, miR-107, miR-126-3p, and miR-191-5p. These six miRNAs may be useful biomarkers that reflect platelet condition and function.
The number of bedridden patients in our super-aging society is increasing. We previously studied fractures occurring in bedridden patients during daily activities with caregiver assistance (dry baths, range of motion exercises, transfer to wheelchair, changing diapers, and so forth) and non-traumatic fractures detected by pain, swelling, subcutaneous bleeding, deformity, and so on. These minimal trauma or spontaneous fractures were defined as "spontaneus fractures in the bedridden patients unintentionally caused by caregivers". Despite efforts to draw attention to preventing these injuries, the incidence of such fractures has been increasing. Spontaneus fractures caused by caregivers are characterized by the presence of untreated osteoporosis, contracture or spasticity near the lesion, institutionalization or hospitalization, repeated fractures, femur fracture, and other unknown causes.
Objectives
Spontaneus fractures caused by caregivers frequently occur without any noticeable trauma and at present, predicting the risk of occurrence is difficult. This study aimed to explore the usefulness of bone metabolism markers in predicting the risk for spontaneus fractures caused by caregivers.
Methods
Study subjects were selected from a pool of 28 patients (3 men; 25 women) with 33 spontaneus fractures caused by caregivers who were treated in our hospital between April 2006 and July 2016. Patients were selected based on the following inclusion criteria: no renal dysfunction (eGFR ≥60) and those who had undergone measurement of bone metabolism markers. Finally, 12 women with a mean age at onset of 90.6 (76–100) years were enrolled in the study. The following markers were evaluated: the bone formation markers bone type alkaline phosphatase and intact procollagen type 1 amino-terminal propeptide; the bone resorption markers tartrate-resistant acid phosphatase (TRACP)-5b, urinary deoxypyridinoline (DPD), and serum N-telopeptide; and the bone quality markers undercarboxylated osteocalcin (ucOC), urinary pentosidine (Pen), and homocysteine (Hcy).
Results
Low levels of bone metabolism markers were not observed in these subjects. However, TRACP-5b levels were high in six subjects while urinary DPD levels were abnormally high in all subjects with a mean value of 23.3 (9.2–41.4) nmol/mmol creatinine (Cr). With regards to bone quality markers, levels of Hcy and ucOC were high in two and three subjects, respectively; while Pen levels were abnormally high in ten subjects with a mean value of 0.183 (0.0774–0.3115) μg/mg Cr.
Conclusions
The majority of subjects with spontaneus fractures caused by caregivers had untreated osteoporosis and some had repeated fractures, indicating that early treatment of osteoporosis is important. Assessing osteoporosis in bedridden patients is challenging as measurement of bone density is often difficult due to spinal deformity and contracture. Our results suggest that among the bone metabolism markers, DPD and Pen may be useful predictors for the risk of spontaneus fractures caused by caregivers.
References
T Kashiwagura et al. Clinical results of spontaneous fractures in the bedridden patients unintentionally caused by caregivers. Orthop Surg Traumatol 56:189–193, 2013.
Acknowledgements
The authors would like to thank Y. Sasaki for technical assistance.
Aim: High-sensitivity C-reactive protein (hs-CRP) identifies individuals at risk for cardiovascular disease (CVD) without an increased level of low-density lipoprotein cholesterol (LDL-C). The present study was performed to compare hs-CRP and LDL-C in association with the cardio-ankle vascular index (CAVI) in Japanese community dwellers considered to be at low risk for atherosclerosis from their level of traditional CVD risk factors.Methods: A community-based study involving 386 healthy Japanese (261 men and 125 women) without a history of CVD and medications for hypertension, diabetes, and dyslipidemia was performed. Multiple adjustments were performed with linear regression models to estimate the association between CAVI and hs-CRP or LDL-C levels. The participants were divided into four groups on the basis of whether they were above or below the median hs-CRP and LDL-C values, and CAVI was compared among the four groups by analysis of covariance after adjusting for confounders.Results: In multiple linear regression models, hs-CRP showed a significant positive association with CAVI; however, no clear association was observed between CAVI and LDL-C. These results were similar in the analyses among the participants with LDL-C <140 mg/dL or hs-CRP <1.0 mg/L. CAVI was higher in the groups with high hs-CRP than in those with low hs-CRP, irrespective of LDL-C; however, CAVI was highest in the group with high LDL-C and high hs-CRP.Conclusions: The present study suggests that hs-CRP could be a better risk factor assessor for atherosclerosis than LDL-C in individuals considered to be at low risk for atherosclerosis assessed by their traditional CVD risk factors.
Indoxyl sulfate is a metabolite of tryptophan and its urinary level reflects the status of bacterial flora in the intestine. Indoxyl sulfate possesses prooxidant properties and is implicated in various diseases including chronic kidney disease and cardiovascular diseases. However, the relation of urinary indoxyl sulfate to oxidative stress is not known.
Radiographic upper gastrointestinal barium examination is commonly used to diagnose peptic ulcer. However, little attention has been paid to its thickening, except in Ménétrier disease and gastric carcinoma of Borrman type IV. The present study was undertaken to investigate the relation of age to roentgenometrical gastric fold width and history of peptic ulcer. The subjects were 724 men (35-64 years old) who participated in a periodic medical health examination and underwent radiographic upper gastrointestinal barium examination. The gastric fold width of the anterior wall in the body was evaluated by air-contrast examination and expressed in millimeters. In the group with a history of peptic ulcer, the roentgenometrical gastric fold was significantly thicker than that in the group without it. The fold width was significantly greater in the elderly group (55-64 years old) than in the young (35-44 years old) and middle-aged (45-54 years old) groups. The fold width tended to increase with age in persons with peptic ulcer history, but not in those without it. When the subjects were divided into three groups by gastric fold width, the incidence of peptic ulcer was significantly higher in the upper third group compared with the lower third group. This relationship between the gastric fold width and the incidence of peptic ulcer tends to become stronger with aging. In the heavy smoker group (> or = 10 of cigarettes per day), the gastric fold width was significantly thicker than that of non-smokers or those who smoked less. This relationship also tended to grow stronger with aging. The mean incidence of peptic ulcers was significantly higher among the heavy smokers. However, daily alcohol drinkers did not show any significant difference in gastric fold width from the other subjects. The gastric fold seems to be thicker in persons with peptic ulcer history, and the incidence of peptic ulcer is higher in persons with thicker gastric fold. These relationships tend to grow stronger with aging.a
