Seasonal variation in serum lipid levels in the Japanese population remains unclear. The aim of this study was to determine whether a variation in lipid levels exists in Japanese workers.We investigated 1,331 employees in our institution (1,192 men, 44+/-10 years; 139 women, 38+/-11 years) who underwent health checkups in both June (summer) and December (winter), 2008.Serum levels of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, and triglyceride were significantly higher in winter than in summer (129.1+/-31.2 mg/dL versus 125.2+/-30.2 mg/dL, p<0.0001; 65.9+/-16.8 mg/dL versus 63.5+/-16.1 mg/dL, p<0.0001; 110.4+/-67.5 mg/dL versus 107.5+/-70.4 mg/dL, p<0.05; respectively), although the ratio of LDL to HDL cholesterol was comparable (2.11+/-0.81 in summer versus 2.12+/-0.81 in winter). The frequency of study subjects diagnosed with hypercholesterolemia, defined as LDL cholesterol > or = 140 mg/dL, was significantly higher in winter than in summer (34.5 % versus 30.9 %, p<0.0001).In Japanese workers, we demonstrated that there is a seasonal variation in serum lipid levels and the prevalence of hypercholesterolemia. This result indicates that we have to give careful consideration to the season of blood sampling in the clinical diagnosis of and management decisions for hypercholesterolemia.
Objective The aim of this study was to determine whether elevated depressive symptoms are associated with metabolic syndrome and its components in the Japanese population. Methods Out of 1,386 male workers who underwent measurements of variables of metabolic syndrome components in their health checkup, 1,186 subjects (44.5 ± 9.6 years) completed the Zung self-rating depression scale (ZSDS) (response rate 85.6%). In this study, metabolic syndrome was defined according to the joint scientific statement proposed by 6 major organizations, including the International Diabetes Federation. Results The overall frequency of elevated depressive symptoms (ZSDS scores ≥40) was 42.1% (n=499). The incidence of metabolic syndrome was significantly higher in subjects with elevated depressive symptoms than in those without (13.2% vs. 8.9%, p<0.05). Of all the metabolic syndrome components, mean triglyceride levels were significantly higher in subjects with elevated depressive symptoms than in those without [124.7 (95% confidence interval (CI): 117.8-131.7) mg/dL vs. 111.5 (95% CI: 107.2-115.9) mg/dL, p<0.05]. Consequently, hypertriglyceridemia (28.9% vs. 21.0%, p<0.01) was the main component correlated with the between-group difference of metabolic syndrome incidence. In the logistic regression analysis after adjustment for potential confounders, the odds ratio of the total ZSDS scores for the diagnosis of hypertriglyceridemia was 1.52 (95% CI: 1.13-2.04; p<0.01), and the major depressive symptom was psychomotor agitation (odds ratio: 1.47; 95% CI: 1.10-1.94; p<0.01). Conclusion This study showed that elevated depressive symptoms were associated with hypertriglyceridemia in Japanese male workers, which affected the clinical diagnosis of metabolic syndrome.
The Japanese Guidelines for management of acute cholangitis and cholecystitis were published in 2005 as the first practical guidelines presenting diagnostic and severity assessment criteria for these diseases. After the Japanese version, the Tokyo Guidelines (TG07) were reported in 2007 as the first international practical guidelines. There were some differences between the two guidelines, and some weak points in TG07 were pointed out, such as low sensitivity for diagnosis and the presence of divergence between severity assessment and clinical judgment for acute cholangitis. Therefore, revisions were started to not only make them up to date but also concurrent with the same diagnostic and severity assessment criteria. The Revision Committee for the revision of TG07 (TGRC) performed validation studies of TG07 and new diagnostic and severity assessment criteria of acute cholangitis and cholecystitis. These were retrospective multi-institutional studies that collected cases of acute cholangitis, cholecystitis, and non-inflammatory biliary disease. TGRC held 35 meetings as well as international email exchanges with co-authors abroad and held three International Meetings. Through these efforts, TG13 improved the diagnostic sensitivity for acute cholangitis and cholecystitis, and presented criteria with extremely low false positive rates. Furthermore, severity assessment criteria adapted for clinical use, flowcharts, and many new diagnostic and therapeutic modalities were presented. The world's first management bundles of acute cholangitis and cholecystitis were also presented. The revised Japanese version was published with the same content as TG13. An electronic application of TG13 that can help to diagnose and assess the severity of these diseases using the criteria of TG13 was made for free download.
