Incidence of sodium-glucose cotransporter-2 inhibitor-associated perioperative ketoacidosis in surgical patients: a prospective cohort study

PURPOSE

Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are commonly prescribed anti-diabetic medications with various beneficial effects; however, they have also been associated with ketoacidosis. The aim of this study was to determine the incidence of SGLT2i-associated perioperative ketoacidosis (SAPKA) in surgical patients.

METHODS

We conducted a multicenter, prospective cohort study across 16 centers in Japan, enrolling surgical patients with diabetes who were prescribed SGLT2is between January 2021 and August 2022. Patients were monitored until the third postoperative day to screen for SAPKA, defined as urine ketone positivity with a blood pH of < 7.30 and HCO3 level ≤ 18.0 mEq/L, excluding cases of respiratory acidosis.

RESULTS

In total, 759 of the 762 evaluated patients were included in the final analysis. Among these, three patients (0.40%) had urine ketones with a blood pH of < 7.30; however, blood gas analysis revealed respiratory acidosis in all three, and none of them was considered to have SAPKA. The estimated incidence of SGLT2i-associated postoperative ketoacidosis was 0% (95% confidence interval, 0%-0.4%).

CONCLUSIONS

The observed incidence of SAPKA in our general surgical population was lower than expected. However, given that the study was observational in nature, interpretation of study results warrants careful considerations for biases.

A rad50 germline mutation induces tumorigenesis and ataxia-telangiectasia phenotype in a transparent medaka model

The MRE11A-RAD50-NBS1 complex activates the ataxia-telangiectasia mutated (ATM) pathway and plays a central role in genome homeostasis. The association of RAD50 mutations with disease remains unclear; hence, we adopted a medaka rad50 mutant to demonstrate the significance of RAD50 mutation in pathogenesis using the medaka as an experimental animal. A 2-base pair deletion in the rad50 gene was introduced into transparent STIII medaka using the CRISPR/Cas9 system. The mutant was analyzed histologically for tumorigenicity and hindbrain quality, as well as for swimming behavior, to compare with existing ATM-, MRE11A-, and NBS1-mutation-related pathology. Our results revealed that the medaka rad50 mutation concurrently reproduced tumorigenesis (8 out of 10 rad50Δ2/+ medaka), had a decrease in median survival time (65.7 ± 1.1 weeks in control vs. 54.2 ± 2.6 weeks in rad50Δ2/+ medaka, p = 0.001, Welch's t-test), exhibited semi-lethality in rad50Δ2/Δ2 medaka and most of the major ataxia-telangiectasia phenotypes, including ataxia (rheotaxis ability was lower in rad50Δ2/+ medaka than in the control, Mann-Whitney U test, p < 0.05), and telangiectasia (6 out of 10 rad50Δ2/+ medaka). The fish model may aid in further understanding the tumorigenesis and phenotype of ataxia-telangiectasia-related RAD50 germline mutations and in developing novel therapeutic strategies against RAD50 molecular disorders.

Excised human larynx in N-vinyl-2-pyrrolidone-embalmed cadavers can produce voiced sound by pliable vocal fold vibration

Tissue-hardening effect and health-hazard issue of formaldehyde (FA) have long been a great disadvantage of this conventional fixative in anatomical research. We recently developed a FA-free embalming method for cadavers which utilizes N-vinyl-2-pyrrolidone (NVP) and enables assessment of motion kinetics by maintaining the softness of embalmed tissue. By assessing the feasibility of NVP-embalmed tissue to mimic vocalization, this study aimed to prove the potential of embalmed cadavers, which have previously been used only for the understanding of anatomical morphology, for the assessment of precise motion physiology in the human body. Ten cadavers embalmed in NVP (n = 6) and FA (n = 4) were incorporated in this study. Excised larynges underwent experimental phonation to mimic vocalization with fast and pliable vibration of vocal folds. High-speed digital imaging was utilized for the assessment of vocal fold vibration. Furthermore, acoustic analysis of the voiced sound, and reproducibility examination were also performed. Regular vocal fold vibrations successfully produced voiced sounds during experimental phonation using NVP-embalmed larynges. The vibratory frequency, vibration amplitude, and stretch rate of the vocal folds were comparable to those of living humans. Six months after the first experiment, the vocal parameters were reproduced, to suggest the long-term preservation potential of our NVP-embalming technique. On the other hand, neither voiced sound nor vocal fold vibration were observed in FA-embalmed larynges. This novel embalming technique could pioneer the next era to utilize embalmed cadavers for the examination of motion physiology in the human body.

Multicentre prospective observational study of sodium-glucose cotransporter-2 inhibitor-associated postoperative ketoacidosis: the SAPKA study protocol

INTRODUCTION

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of antihyperglycaemic agents that promote urinary glucose excretion in the renal proximal tubule and have cardio-protective and renal-protective properties. However, there are several safety concerns related to increased risks of hypoglycaemic, urinary tract infections and ketoacidosis. Ketoacidosis is a potentially fatal complication that often presents as euglycaemic ketoacidosis during SGLT2 inhibitor treatment. Furthermore, invasive treatment and related surgical stress may increase the risk of ketogenesis. Therefore, this study aims to clarify the incidence of SGLT2 inhibitor-associated postoperative ketoacidosis (SAPKA) among patients who are receiving SGLT2 inhibitors and undergoing surgery under general anaesthesia.

METHODS AND ANALYSIS

This multicentre, prospective, observational study will recruit 750 adult Japanese patients with diabetes who are receiving SGLT2 inhibitors and undergoing surgery under general anaesthesia. Urine samples will be collected on postoperative days 0, 1, 2 and 3. Blood gas analysis will be performed when urine ketone positivity is detected. The incidence of postoperative ketoacidosis will be identified based on urine ketone positivity and a blood pH of ≤7.3. The study will also collect data to identify risk factors for SAPKA.

ETHICS AND DISSEMINATION

The study protocol has been approved by the ethics committee of Kyorin University (approval number: 785, 26 October 2020) and local ethical approval will be required at each participating centre. Study findings will be submitted to peer-reviewed journals and abstracts will be submitted to relevant national and international meetings.

TRIAL REGISTRATION NUMBER

UMIN000042795.

Polyethylene microbeads are more critically toxic to the eyes and reproduction than the kidneys or growth in medaka, Oryzias latipes

Many studies using experimental and wild animals have reported negative effects of microplastic beads (MPs) ingestion. However, data regarding the lowest observed adverse effect levels (LOAELs) of MPs remain limited. Our aim was to evaluate the adverse effect levels of polyethylene MPs (10-63 μm diameter) with respect to growth, reproduction, and the eyes and kidneys of medaka (Oryzias latipes) under breeding conditions to contribute to future research involving LOAEL determinations. Fish were exposed to 0.009 mg-MPs (approximately 1000 particles)/L to 0.32 mg-MPs (approximately 40,000 particles)/L for 12 weeks. The eyes and kidneys were evaluated by histopathologic analysis. Although histologic analyses indicated an absence of MPs in the tissues, the eyes and kidneys as well as reproduction were adversely affected by increasing MP concentrations. The number of spawned eggs decreased, and changes were noted in the eyes of fish exposed to ≥0.032 mg-MPs/L under breeding conditions. The eyes exhibited thinning of the optic nerve fiber layer and dilatation of retinal capillaries compared with medaka not treated with MPs. Changes in the kidneys were observed in fish exposed to ≥0.065 mg-MPs/L. The mesangial matrix in the glomerulus of the kidneys was expanded compared with non-treated medaka, suggesting a deterioration in renal function. Analyses of an oxidative stress marker in the tissues indicated that lesion progression was associated with increased oxidative stress. Furthermore, a comparison of adverse effect levels suggested that MPs were more toxic to the eyes and reproduction than the kidneys or growth. Our data should prove useful for determining the LOAELs of polyethylene beads on vertebrates and enhance understanding of the mechanism underlying the biological toxicity of polyethylene MPs.

Ingestion of polyethylene microbeads affects the growth and reproduction of medaka, Oryzias latipes

Research using various species of wild and cultured fish has identified negative effects of short-term exposure to microbeads. Although wild animals might be contaminated with microbeads and/or other pharmaceuticals, data regarding the long-term effects remain limited. To clearly elucidate the effects of microbeads, studies of long-term exposure using animal models are necessary. Our aim was to elucidate the effects of microbeads alone on the growth and fecundity of medaka following long-term exposure (12 weeks). In experiment 1, fish groups (except controls) were temporarily exposed to polyethylene microbeads (10-63 μm diameter) a low dose of 0.065 microbeads-mg/L and high dose of 0.65 microbeads-mg/L. In experiment 2, see-through medaka and fluorescent polyethylene microbeads (10-45 μm diameter) were used to estimate the retention time of ingested microbeads in the digestive tract, which was 4-9 days. The low dose of microbeads did not affect growth but did decrease the number of eggs and the hatching rate. The high dose decreased growth, the number of eggs, and hatching rate. Growth differences were recognized for the first time at 7 weeks, and differences in the number of eggs at 12 weeks. Thus, long-term tests using medaka indicated that microbeads per se exhibit growth inhibition and reproductive toxicity. These effects could be associated with nutritional factors resulting from the long retention time of microbeads in the digestive tract. We also determined the dose that affects only fecundity. This suggests that normal growth of medaka in the wild does not mean the environment is free from microbead contamination. We are thus attempting to identify new biological indexes for monitoring the status of microbead contamination using our system.

Longevity-associated mitochondrial DNA 5178 C/A polymorphism modifies effect of aging on renal function in male Japanese health checkup examinees: an exploratory cross-sectional study

Background

Mitochondrial DNA 5178 (Mt5178) C/A polymorphism is reportedly associated with longevity in the Japanese population. The objective of this study was to investigate whether Mt5178 C/A polymorphism influences the effect of physiological aging on renal function in male Japanese health checkup examinees.

Methods

A total of 404 male subjects (mean age ± SD, 53.9 ± 7.8 years; range, 29–76 years) were selected from among individuals visiting the hospital for regular medical checkups. After Mt5178 C/A genotyping, a cross-sectional study assessing the joint effects of Mt5178 C/A polymorphism and aging on renal function was then conducted. Renal function was evaluated by estimated glomerular filtration rate (eGFR). Subjects were divided into three age groups (< 50, 50–59, ≥ 60 years).

Results

In simple linear regression analysis, a significant negative association between aging and eGFR was observed in both Mt5178C and Mt5178A genotypic men (P < 0.001 and P = 0.003, respectively). However, in multiple linear regression analysis, a significant effect of aging on reduced eGFR was observed only in Mt5178C genotypic men (P < 0.001). Logistic regression analysis showed that, in the case of reduced eGFR defined as < 75 mL/min/1.73 m², reduced eGFR was dependent on aging in both Mt5178C and Mt5178A genotypic men (P for trend < 0.001 and P for trend = 0.002, respectively). After adjusting for smoking status and alcohol consumption, reduced eGFR was also dependent on aging in both Mt5178C and Mt5178A genotypic men (P for trend < 0.001 and P for trend = 0.014, respectively). However, in reduced eGFR defined as < 90 mL/min/1.73 m², reduced eGFR was dependent on aging only in Mt5178C genotypic men (P for trend < 0.001).

Conclusions

This cross-sectional study suggests that Mt5178 C/A polymorphism modulates the effects of physiological aging on kidney function in Japanese men.

For making a declaration of countermeasures against the falling birth rate from the Japanese Society for Hygiene: summary of discussion in the working group on academic research strategy against an aging society with low birth rate

In 1952, the Japanese Society for Hygiene had once passed a resolution at its 22nd symposium on population control, recommending the suppression of population growth based on the idea of cultivating a healthier population in the area of eugenics. Over half a century has now passed since this recommendation; Japan is witnessing an aging of the population (it is estimated that over 65-year-olds made up 27.7% of the population in 2017) and a decline in the birth rate (total fertility rate 1.43 births per woman in 2017) at a rate that is unparalleled in the world; Japan is faced with a "super-aging" society with low birth rate. In 2017, the Society passed a resolution to encourage all scientists to engage in academic researches to address the issue of the declining birth rate that Japan is currently facing. In this commentary, the Society hereby declares that the entire text of the 1952 proposal is revoked and the ideas relating to eugenics is rejected. Since the Society has set up a working group on the issue in 2016, there have been three symposiums, and working group committee members began publishing a series of articles in the Society's Japanese language journal. This commentary primarily provides an overview of the findings from the published articles, which will form the scientific basis for the Society's declaration. The areas we covered here included the following: (1) improving the social and work environment to balance between the personal and professional life; (2) proactive education on reproductive health; (3) children's health begins with nutritional management in women of reproductive age; (4) workplace environment and occupational health; (5) workplace measures to counter the declining birth rate; (6) research into the effect of environmental chemicals on sexual maturity, reproductive function, and the children of next generation; and (7) comprehensive research into the relationship among contemporary society, parental stress, and healthy child-rearing. Based on the seven topics, we will set out a declaration to address Japan's aging society with low birth rate.

[Political Measures against Declining Birthrate-Implication of Good Family Policies and Practice in Sweden or France]

Although the birthrate greatly declined from the 1960s to the mid-1970s amongst many developed countries, the downturn has steadily been reversed by promoting women's rights and reviewing family policies in some European countries such as Sweden and France. The current total fertility rate in Sweden or France is approximately around 1.9 children per woman. The favorable state can be partly explained by the active family policies of these countries. The government of Sweden has implemented a wide range of measures including tax allowances, childcare services, and other subsidies, as well as an18 month parental leave to be shared between mothers and fathers. The government of France has expanded childcare and provided incentives by increasing childcare/family benefits with each subsequent child.In Japan, the fertility rate has changed from a downward trend to an upward trend, but only very slightly over the last decade. The legislative systems and enforcement remain totally inadequate to maintain stable a fertility rate. The Japanese government should try to change the social security/labor policies into more active and generous ones, with enhancement of economic support and promotion of work-life balance. Other attempts including removing barriers to encourage the youth to start a family are needed to overcome declining birth rates in Japan.

NADH Dehydrogenase Subunit-2 237 Leu/Met Polymorphism Influences the Association of Coffee Consumption with Serum Chloride Levels in Male Japanese Health Checkup Examinees: An Exploratory Cross-Sectional Analysis

Background: Nicotinamide adenine dinucleotide (NADH) dehydrogenase subunit-2 237 leucine/methionine (ND2-237 Leu/Met) polymorphism has been shown to modify the association of coffee consumption with the risk of hypertension, dyslipidemia, and abnormal glucose tolerance, and low serum chloride levels have been shown to be associated with all-cause and cardiovascular disease mortality. Therefore, the purpose of the present study was to investigate whether ND2-237 Leu/Met polymorphism influences the association of coffee consumption with serum chloride levels in male Japanese health checkup examinees. Methods: From among individuals visiting the hospital for a regular medical checkup, 402 men (mean age ± standard deviation, 53.9 ± 7.8 years) were selected for inclusion in the study. After ND2-237 Leu/Met genotyping, we conducted an exploratory cross-sectional study to examine the combined association of ND2-237 Leu/Met polymorphism and coffee consumption with serum electrolyte levels. Results: After adjusting for age, body mass index, habitual smoking, alcohol consumption, green tea consumption, and antihypertensive medication, coffee consumption significantly increased serum chloride levels (p for trend = 0.001) in men with the ND2-237Leu genotype. After these adjustments, the odds ratios (ORs) for low levels of serum chloride, defined as <100 mEq/L, were found to be dependent on coffee consumption (p for trend = 0.001). In addition, the OR for low levels of serum chloride was significantly lower in men with the ND2-237Leu genotype who consumed ≥4 compared with <1 cup of coffee per day (OR = 0.096, 95% confidence interval = 0.010–0.934; p = 0.044). However, neither serum chloride levels nor risk of low levels of serum chloride appeared to be dependent on coffee consumption. Conclusions: The results suggest that ND2-237 Leu/Met polymorphism modifies the association of coffee consumption with serum chloride levels in middle-aged Japanese men.

[Dilemma of Environmental Health Research]

This article presents not only a brief overview of birth cohort studies focusing on environmental health in which the associations between health and environment were examined, but also a tentative plan to apply epidemiological data to benchmark dose calculation. According to the preceding studies, the checkpoints to be scrutinized when a result is not consistent with those of other researchers are as follows: (1) whether the study included all crucial confounders, (2) whether it included any exposure marker or confounder with a U-shaped dose-response curve, (3) whether the outcome measure was conducted by two or more examiners that might lead to measurement bias, (4) whether such examiners picked up information about exposure levels of the subjects before measuring the endpoints, and (5) whether subjects with different genetic factors were included in the analysis. In addition, (6) researchers conducting a children's study on developmental effects due to toxic substances must keep in mind that the impact of prenatal methylmercury exposure, independent of postnatal exposure, may continue for at least seven years. (7) When an environmental health research emphasizes to be population-based study, the levels of exposure to environmental chemical substances in developed countries with strict environmental regulations may be too low to examine a dose-response relationship for critical dose estimation. Such risk assessment should be carried out among the subjects with a wide range of exposure levels.

Mitochondrial DNA 5178 C/A polymorphism modulates the effects of coffee consumption on elevated levels of serum liver enzymes in male Japanese health check-up examinees: an exploratory cross-sectional study

Background

Longevity-associated mitochondrial DNA 5178 cytosine/adenine (Mt5178 C/A) polymorphism modulates the effects of coffee consumption on the risk of hypertension, dyslipidemia, and abnormal glucose tolerance. The objective of this study was to investigate whether Mt5178 C/A polymorphism modifies the effects of coffee consumption on abnormally elevated levels of serum liver enzymes in male Japanese health check-up examinees.

Methods

A total of 421 male subjects (mean age ± SD, 54.1 ± 7.7 years) were selected from among individuals visiting the hospital for regular medical check-ups. After Mt5178 C/A genotyping, a cross-sectional study assessing the joint effects of Mt5178 C/A polymorphism and coffee consumption on elevated levels of serum aspartate aminotransferase (AST), serum alanine aminotransferase (ALT), and serum gamma-glutamyl transpeptidase (GGT) was then conducted.

Results

For men with Mt5178C, after adjustment for age, body mass index, alcohol consumption, habitual smoking, green tea consumption, antihypertensive treatment, and antidiabetic treatment, elevated levels of serum AST, as defined as ≥30 U/L; those of serum ALT, as defined as ≥25 U/L; or those of serum GGT, as defined as ≥60 or >51 U/L, may depend on coffee consumption (P for trend = 0.013, P for trend <0.001, P for trend = 0.002, and P for trend <0.001, respectively). On the other hand, no significant joint effects of Mt5178A genotype and coffee consumption on elevated levels of serum liver enzymes were observed.

Conclusions

The present results suggest that Mt5178 C/A polymorphism modifies the effects of coffee consumption on abnormally elevated levels of serum liver enzymes in male Japanese health check-up examinees.

[Recent Epidemiological Studies on Methylmercury, Mercury and Selenium]

More than sixty years has passed since the outbreak of Minamata disease, and high-level methylmercury contaminations now seem nonexistent in Japan. However, mercury has been continuously discharged from natural sources and industrial activities, and the health effects on children susceptible to methylmercury exposure at low levels, in addition to mercury contamination from mercury or gold mining areas in developing countries, become a worldwide concern. In this article, we provide a recent overview of epidemiological studies regarding methylmercury and mercury. The following findings were obtained. (1) Many papers on exposure assessment of methylmercury/mercury have been published since the Minamata Convention on Mercury was adopted in 2013. (2) The most crucial problem is child developmental neurotoxicity resulting from prenatal exposure to methylmercury, but its precise assessment seems to be difficult because most of such effects are neither severe nor specific. (3) Several problems raised in birth cohort studies (e.g., whether IQ deficits due to prenatal methylmercury exposure remain when the children become adults, or whether the postnatal exposure at low levels also causes such adverse effects in children) remain unsolved. (4) Concurrent exposure models of methylmercury, lead, polychlorinated biphenyls, aresenic, and organochlorine pesticides, as well as possible antagonists such as polyunsaturated fatty acids and selenium, should be considered in the study design because the exposure levels of methylmercury are extremely low in developed countries. (5) Further animal experiments and molecular biological studies, in addition to human studies, are required to clarify the mechanism of methylmercury toxicity.

Longevity-associated mitochondrial DNA 5178 C/A polymorphism modulates the effects of coffee consumption on erythrocytic parameters in Japanese men: an exploratory cross-sectional analysis

Background

Mitochondrial DNA 5178 cytosine/adenine (Mt5178 C/A) polymorphism reportedly modulates the effects of coffee consumption on the risk of hypertension, dyslipidemia and abnormal glucose tolerance. The objective of this analysis was to investigate whether Mt5178 C/A polymorphism modifies the effects of coffee consumption on erythrocytic parameters in male Japanese health check-up examinees.

Methods

A total of 436 men (mean age ± standard deviation, 54.1 ± 7.8 years) were selected from among individuals visiting the hospital for regular medical check-ups. After Mt5178 C/A genotyping, an exploratory cross-sectional analysis assessing the joint effects of Mt5178 C/A polymorphism and coffee consumption on red blood cell counts, hematocrit and hemoglobin was conducted.

Results

For Mt5178C genotypic men, after adjustment for age, body mass index, alcohol consumption, habitual smoking and green tea consumption, coffee consumption significantly decreased red blood cell counts (P for trend = 0.022) and hemoglobin (P for trend = 0.035). The risk of anemia, defined as hemoglobin of <14 g/dL, after the aforementioned adjustment, appeared to depend on coffee consumption (P for trend = 0.078), and the adjusted odds ratio for anemia was significantly higher in men who consumed ≥4 cups of coffee per day than in those who consumed <1 cup per day (odds ratio = 3.771, 95% confidence interval: 1.088 to 13.06, P = 0.036). For Mt5178A genotypic men, coffee consumption possibly reduced the risk of anemia (P for trend = 0.049). However, after the aforementioned adjustment, the statistical significance disappeared (P for trend = 0.137).

Conclusions

This exploratory cross-sectional analysis suggests that Mt5178 C/A polymorphism modulates the effects of coffee consumption on erythrocytic parameters and the risk of anemia in male Japanese health check-up examinees.

Association of blood pressure and body mass index with intraocular pressure in middle-aged and older Japanese residents: a cross-sectional and longitudinal study

To clarify whether high blood pressure (BP) and high body mass index (BMI) are associated with elevated intraocular pressure (IOP), a cross-sectional and longitudinal study was conducted. This epidemiological study analyzed health examination data obtained between 2001 and 2005 from 896 Japanese individuals (aged 32-79 years) who had not undergone any ocular surgery or medical treatment for hypertension, ocular hypertension, or glaucoma. Multiple-regression analysis of our cross-sectional data showed that systolic and diastolic BP (SBP and DBP) and BMI had significant and near-significant positive associations with IOP in men (p＜0.05) and women (p＜0.1). Our longitudinal study from analyses of covariance found that the adjusted mean level of changes in IOP tended to increase with increased levels of SBP, DBP, and BMI in men (p＜0.1). In women also, changes in SBP and BMI tended to be positively related with that of IOP (p＜0.1). The results of this study suggested that BP and BMI were positively associated with IOP in middle-aged and older Japanese. Therefore, management of BP and improvement of obesity might be especially important to Japanese patients with open-angle glaucoma or ocular hypertension as they have a higher incidence of normal-tension glaucoma than Europeans and Americans.

Difference in concentration trends of airborne particulate matter during rush hour on weekdays and Sundays in Tokyo, Japan

Suspended particulate matter (SPM) and fine particulate matter (less than or equal to 2.5 microm: PM2.5) have generally been decreasing for the last decade in Tokyo, Japan. To elucidate the major cause of this decrease, the authors investigated the different trends of airborne particulates (both SPM and PM2.5 concentrations) by evaluating comparisons based on the location of the monitoring stations (roadside vs. ambient), days of the week (weekdays vs. Sundays), and daily fluctuation patterns (2002 vs. 2010). Hourly mean SPM and PM2.5 concentrations were obtained at four monitoring stations (two roadside stations, two ambient stations) in Tokyo, Japan. Annual mean concentrations of each day of the week and of each hour of the day from 2002 to 2010 were calculated. The results showed that (1) the daily differences in annual mean concentration decreased only at the two roadside monitoring stations; (2) the high hourly mean concentrations observed on weekdays during the daily rush hour at the two roadside monitoring stations observed in 2002 diminished in 2010; (3) the SPM concentration that decreased the most since 2002 was the PM2.5 concentration; and (4) the fluctuation of hourly concentrations during weekdays at the two roadside monitoring stations decreased. A decreasing trend of airborne particulates during the daily rush hour in Tokyo, Japan, was observed at the roadside monitoring stations on weekdays since 2002. The decreasing PM2.5 concentration resulted in this decreasing trend of airborne particulate concentrations during the daily rush hours on weekdays, which indicates fewer emissions were produced by diesel vehicles. Implications: The authors compared the trends of SPM and PM2.5 in Tokyo by location (roadside vs. ambient), days of the week (weekdays vs. Sundays), and daily fluctuation patterns (2002 vs. 2010). The high hourly mean concentrations observed at the roadside location during rush hour on weekdays in 2002 diminished in 2010. The SPM concentration that decreased during rush hour the most was the PM2.5 concentration. This significant decrease in the PM2.5 concentration resulted in the general decreasing trend of SPM concentrations during the rush hours on weekdays, which indicates fewer emissions were produced from diesel vehicles.

NADH dehydrogenase subunit-2 237 Leu/Met polymorphism modifies effects of cigarette smoking on risk of elevated levels of serum liver enzyme in male Japanese health check-up examinees: a cross-sectional study

Background

NADH dehydrogenase subunit-2 237 leucine/methionine (ND2-237 Leu/Met) polymorphism reportedly influences the effects of cigarette smoking on respiratory function, risk of dyslipidemia, serum non-high-density lipoprotein cholesterol levels, hematological parameters and intraocular pressure. The objective of this study was to investigate whether ND2-237 Leu/Met polymorphism modifies the effects of cigarette smoking on serum liver enzyme levels in male Japanese health check-up examinees.

Methods

A total of 421 male subjects (mean age ± SD, 54.1 ± 7.7 years) were selected from among individuals visiting the hospital for regular medical check-ups. After ND2-237 Leu/Met genotyping, a cross-sectional study assessing the combined effects of ND2-237 Leu/Met polymorphism and cigarette smoking on serum aspartate aminotransferase levels, serum alanine aminotransferase (ALT) levels and serum gamma-glutamyltransferase (GGT) levels was then conducted.

Results

No statistically significant differences in serum liver enzyme levels among the three smoking status groups (never- or ex-smokers, 1–20 cigarettes smoked per day and >20 cigarettes smoked per day) by ND2-237 Leu/Met genotype were observed. However, for men with ND2-237Met, cigarette smoking significantly increased the risk of elevated levels of serum ALT (>30 U/L) or serum GGT (≥60 U/L or >51 U/L) (P for trend = 0.031, P for trend = 0.007 and P for trend = 0.004, respectively). After adjustment for age, body mass index, alcohol consumption, coffee consumption, antihypertensive treatment and antidiabetic treatment, a significant association between cigarette smoking and risk of elevated levels of serum ALT (>30 U/L) or serum GGT (≥60 U/L or >51 U/L) was also observed (P for trend = 0.032, P for trend = 0.019 and P for trend = 0.009, respectively). Surprisingly, for men with ND2-237Leu, cigarette smoking significantly decreased the risk of elevated levels of serum ALT (>30 U/L or ≥25 U/L) (P for trend = 0.026 and P for trend = 0.003, respectively).

Conclusions

Cigarette smoking appears to increase the risk of elevated levels of serum ALT or serum GGT in ND2-237Met genotypic men, but to decrease the risk of elevated levels of serum ALT in ND2-237Leu genotypic men.

Joint effects of mitochondrial DNA 5178 C/A polymorphism and coffee consumption or alcohol consumption on clustering of cardiovascular risk factors in middle-aged Japanese men: a cross-sectional study

Background

Longevity-associated mitochondrial DNA 5178 (Mt5178) C/A reportedly modulates the effects of coffee consumption on the risk of hypertension, dyslipidemia and abnormal glucose tolerance, and those of alcohol consumption on the risk of hypertension, dyslipidemia and hyperuricemia in middle-aged Japanese men. However, there has been no research examining whether Mt5178 C/A polymorphism influences the effects of coffee consumption or alcohol consumption on the clustering of cardiovascular risk factors (CRFs).

Methods

A total of 332 male subjects (mean age ± SD, 52.8 ± 7.8 years) were selected from among individuals visiting the hospital for regular medical check-ups. After Mt5178 C/A genotyping, a cross-sectional study assessing the joint effects of Mt5178 C/A polymorphism and coffee consumption or alcohol consumption on the clustering of CRFs, namely hypertension, abnormal glucose tolerance, hyper-low-density lipoprotein cholesterolemia, hypo-high density lipoprotein cholesterolemia, hypertriglyceridemia and hyperuricemia, was then conducted.

Results

After adjustment for confounding factors, significant and negative associations were observed between coffee consumption and clustering of ≥2 CRFs in subjects with Mt5178C. The adjusted odds ratio (OR) for the clustering of ≥2 or ≥3 CRFs was significantly lower in subjects who consumed 1–3 cups of coffee per day than in those who consumed <1 cup of coffee per day (OR = 0.496, 95% confidence interval (CI): 0.249–0.989, and OR = 0.369, 95% CI: 0.165–0.826, respectively). On the other hand, after adjustment, positive associations between coffee consumption and clustering of ≥2 CRFs were observed in subjects with Mt5178A. However, these associations did not reach a significant level. For Mt5178C genotypic men, the adjusted OR for the clustering of ≥2 or ≥3 CRFs was significantly higher in daily drinkers than in occasional drinkers (OR = 2.737, 95% CI: 1.361–5.502, and OR = 3.024, 95% CI: 1.269–7.210, respectively). On the other hand, the association between Mt5178A genotype and the clustering of ≥2 or ≥3 CRFs did not appear to depend on alcohol consumption.

Conclusions

The present results suggest that Mt5178 C/A polymorphism modifies the effects of coffee consumption or alcohol consumption on the clustering of CRFs in middle-aged Japanese men.

Difference in effects of cigarette smoking or alcohol consumption on serum non-high-density lipoprotein cholesterol levels is related to mitochondrial DNA 5178 C/A polymorphism in middle-aged Japanese men: a cross-sectional study

BACKGROUND

Mitochondrial DNA 5178 cytosine/adenosine (Mt5178 C/A) polymorphism is associated with longevity in the Japanese. The purpose of this study is to investigate whether Mt5178 C/A polymorphism modifies the effects of habitual smoking or habitual drinking on serum non-high-density lipoprotein (non-HDL) cholesterol levels in middle-aged Japanese men.

METHODS

A total of 394 male subjects (age 53.9 ± 7.9 years; mean ± SD) were selected from among individuals visiting the hospital for regular medical check-ups. After Mt5178 C/A genotyping, a cross-sectional study assessing the joint effects of Mt5178 C/A polymorphism and cigarette smoking or alcohol drinking on serum non-HDL cholesterol levels was conducted. High levels of serum non-HDL cholesterol were defined as serum non-HDL cholesterol levels ≥160 mg/dl or ≥190 mg/dl.

RESULTS

For men with Mt5178A, cigarette smoking may increase serum non-HDL cholesterol levels (P for trend < 0.001), as well as the risk of high levels of non-HDL cholesterol (serum non-HDL cholesterol levels ≥160 mg/dl, P for trend < 0.001; serum non-HDL cholesterol levels ≥190 mg/dl, P for trend = 0.004). On the other hand, for men with Mt5178C, after adjusting for age and body mass index, alcohol consumption may decrease serum non-HDL cholesterol levels (P for trend = 0.043) and the risk of high levels of non-HDL cholesterol (serum non-HDL cholesterol level ≥160 mg/dl, P for trend = 0.005).

CONCLUSIONS

These gene-environment interactions on serum non-HDL cholesterol levels may contribute to the establishment of individualized prevention of the risk of high levels of serum non-HDL cholesterol.

Unexpected combined effects of NADH dehydrogenase subunit-2 237 Leu/Met polymorphism and green tea consumption on renal function in male Japanese health check-up examinees: a cross-sectional study

Background

NADH dehydrogenase subunit-2 237 leucine/methionine (ND2-237 Leu/Met) polymorphism is associated with longevity in Japanese. A previous study has shown that ND2-237 Leu/Met polymorphism modulates the effects of green tea consumption on risk of hypertension. For men with ND2-237Leu, habitual green tea consumption may reduce the risk of hypertension. Moreover, there is a combined effect of ND2-237 Leu/Met polymorphism and alcohol consumption on risk of mildly decreased estimated glomerular filtration rate (eGFR) (<90 ml/min/1.73 m²). Several beneficial effects of green tea on the kidney have been reported. The objective of this study was to investigate whether ND2-237 Leu/Met polymorphism modifies the effects of green tea consumption on risk of mildly decreased eGFR in male Japanese health check-up examinees.

Results

For ND2-237Leu genotypic men, after adjustment for confounding factors, green tea consumption may increase the risk of mildly decreased eGFR (P for trend = 0.016). The adjusted odds ratio (OR) for mildly decreased eGFR was significantly higher in subjects with ND2-237Leu who consume ≥6 cups of green tea per day than those who consume ≤1 cup of green tea per day (adjusted OR = 5.647, 95% confidence interval: 1.528-20.88, P = 0.009). On the other hand, for ND2-237Met genotypic men, green tea consumption does not appear to determine the risk of mildly decreased eGFR.

Conclusion

The present results suggest that ND2-237 Leu/Met polymorphism unexpectedly modifies the effects of green tea consumption on eGFR and the risk of mildly decreased eGFR in male Japanese subjects.

Factors associated with dietary habits and mood states affecting taste sensitivity in Japanese college women

We conducted a cross-sectional survey to evaluate the factors associated with dietary habits and mood states affecting taste sensitivity in 127 Japanese college women with a mean age of 19.2 y. Differential thresholds for the four basic tastes on the tongue were determined by the filter paper disc method, while dietary intake was assessed using a food frequency questionnaire. Psychological mood states were evaluated by the Profile of Mood State (POMS) questionnaire. Differential thresholds for saltiness and bitterness in alcohol drinkers were higher than those in alcohol non drinkers, whereas differential thresholds for the other tastes did not differ significantly between any of the stratified groups. Canonical correlation analysis revealed that among the five POMS mood states, POMS fatigue scores showed relatively stronger association with combined variables of taste thresholds. Logistic regression analysis revealed significant involvement of zinc and iron intake, and that POMS fatigue and anger scores affected the differential threshold for sourness. Specific mood and dietary factors were shown to be associated with sensitivity to sourness and bitterness. Among the five POMS mood states, high POMS fatigue scores and low POMS anger scores appeared to be associated with decreased taste sensitivity.

Decreasing trends of suspended particulate matter and PM2.5 concentrations in Tokyo, 1990-2010

In Tokyo, the annual average suspended particulate matter (SPM) and PM2.5 concentrations have decreased in the past two decades. The present study quantitatively evaluated these decreasing trends using data from air-pollution monitoring stations. Annual SPM and PM2.5 levels at 83 monitoring stations and hourly SPM and PM2.5 levels at four monitoring stations in Tokyo, operated by the Tokyo Metropolitan Government, were used for analysis, together with levels of co-pollutants and meteorological conditions. Traffic volume in Tokyo was calculated from the total traveling distance of vehicles as reported by the Ministry of Land, Infrastructure, Transport, and Tourism. High positive correlations between SPM levels and nitrogen oxide levels, sulfur dioxide levels, and traffic volume were determined. The annual average SPM concentration declined by 62.6%from 59.4 microg/m3 in 1994 to 22.2 microg/m3 in 2010, and PM2.5 concentration also declined by 49.8% from 29.3 microg/m3 in 2001 to 14.7 microg/m3 in 2010. Likewise, the frequencies of hourly average SPM and PM2.5 concentrations exceeding the daily guideline values have significantly decreased since 2001 and the hourly average SPM or PM2.5 concentrations per traffic volume for each time period have also significantly decreased since 2001. However SPM and PM2.5 concentrations increased at some monitoring stations between 2004 and 2006 and from 2009 despite strengthened environmental regulations and improvements in vehicle engine performance. The annual average SPM and PM2.5 concentrations were positively correlated with traffic volumes and in particular with the volume of diesel trucks. These results suggest that the decreasing levels of SPM and PM2.5 in Tokyo may be attributable to decreased traffic volumes, along with the effects of stricter governmental regulation and improvements to vehicle engine performance, including the fitting of devices for exhaust emission reduction.

Combined effect of mitochondrial DNA 5178 C/A polymorphism and alcohol consumption on estimated glomerular filtration rate in male Japanese health check-up examinees: a cross-sectional study

Background

Prevention of chronic kidney disease (CKD) is a major public health issue. Although several studies have been performed on the association between alcohol consumption and CKD or renal function, it remains controversial. Numerous genetic polymorphisms have been reported to be associated with CKD and kidney function. Mitochondrial DNA cytosine/adenine (Mt5178 C/A) polymorphism is associated with longevity in Japanese. This polymorphism modifies the effects of alcohol consumption on blood pressure, risk of hypertension, serum triglyceride levels, risk of hyper-LDL cholesterolemia and serum uric acid levels. The objective of this study was to investigate whether Mt5178 C/A polymorphism modifies the effects of alcohol consumption on renal function in male Japanese health check-up examinees.

Methods

A total of 394 male subjects aged 29–76 years were selected from among individuals visiting the hospital for regular medical check-ups. After Mt5178 C/A genotyping, a cross-sectional study assessing the combined effects of Mt5178 C/A polymorphism and habitual drinking on the risk of mildly decreased estimated glomerular filtration rate (eGFR) (<90 ml/min/1.73 m²) was conducted.

Results

For Mt5178A genotypic men, habitual drinking may increase eGFR (P for trend = 0.003) or reduce the risk of mildly decreased eGFR (P for trend = 0.003). Daily drinkers had a significantly higher eGFR than non-drinkers (P = 0.005). The crude odds ratio for decreased eGFR was significantly lower in daily drinkers than in non-drinkers (odds ratio = 0.092, 95% confidence interval: 0.012-0.727, P = 0.024). On the other hand, for Mt5178C genotypic men, habitual drinking does not appear to affect eGFR.

Conclusion

The present results suggest a joint effect of Mt5178 C/A polymorphism and alcohol consumption on eGFR and the risk of mildly decreased eGFR in male Japanese subjects.

Mitochondrial DNA 5178 C/A polymorphism influences the effects of habitual smoking on the risk of dyslipidemia in middle-aged Japanese men

Background

Several genetic polymorphisms have been reported to modify the effects of smoking on serum lipid levels. The objective of this study was to investigate whether longevity-associated mitochondrial DNA 5178 (Mt5178) C/A polymorphism modifies the effects of habitual smoking on the risk of dyslipidemia in middle-aged Japanese subjects.

Methods

A total of 394 male subjects (age, 53.9 ± 7.9 years; mean ± SD) were selected from among individuals visiting the hospital for regular medical check-ups. After Mt5178 C/A genotyping, a cross-sectional study assessing the joint effect of Mt5178 C/A polymorphism and cigarette smoking on the risk of hypo-high-density lipoprotein (HDL) cholesterolemia, hyper-low-density lipoprotein (LDL) cholesterolemia or hypertriglyceridemia was conducted.

Results

For subjects with Mt5178C, the risk of hypo-HDL cholesterolemia increased with the number of cigarettes smoked daily (P for trend = 0.001). On the other hand, the association between Mt5178A genotype and the risk of hypo-HDL cholesterolemia did not appear to depend on the number of cigarettes smoked daily. For those with Mt5178A, the risk of hyper-LDL cholesterolemia or hypertriglyceridemia increased with cigarettes smoked daily (P for trend = 0.017 and P for trend = 0.002, respectively). However, the association between Mt5178C genotype and the risk of hyper-LDL cholesterolemia or hypertriglyceridemia did not depend on the number of cigarettes smoked daily.

Conclusions

The present results suggest that Mt5178 C/A polymorphism modulates the effects of habitual smoking on the risk of dyslipidemia in middle-aged Japanese men.

Influence of mitochondrial DNA 5178 C/A polymorphism on serum cholesterol changes: a short-term follow-up in middle-aged Japanese men

OBJECTIVE

The mitochondrial DNA 5178 cytosine/adenine (Mt5178 C/A) polymorphism is reportedly associated with longevity in the Japanese population, and the Mt5178A genotype may exert anti-atherogenic effects. The aim of this study was to determine whether there were longitudinal differences in serum lipid levels between carriers of the Mt5178C genotype and those of the Mt5178A genotype and to assess the impact of these genotypes on serum cholesterol levels.

METHODS

The serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), and low-density lipoprotein cholesterol (LDLC) were measured and the Mt5178 C/A genotypes determined in 110 Japanese men aged 41-66 (mean 52.3) years who had received medical checkups twice in the period 1999-2005. The longitudinal changes of TC, HDLC, and LDLC were calculated according to genotype.

RESULTS

The serum levels of TC at baseline and follow-up were significantly different, whereas those of HDLC and LDLC were not. The changes in HDLC differed significantly between the two Mt5178 C/A genotype groups, with the changes in HDLC level being significantly greater in the Mt5178A genotype group than in the Mt5178C group (p = 0.015).

CONCLUSIONS

The Mt5178 C/A genotype may modify longitudinal changes in serum TC and HDLC levels in middle-aged Japanese men.

Driver exposure to particulate matter in Bangkok

The aims of this study were to determine the particulate matter with aerodynamic diameters > or = 2.5 microm (PM2.5) and 2.5-10 microm (PM10-2.5) exposure levels of drivers and to analyze the proportion of elemental carbon (EC) and organic carbon (OC) in PM2.5 in Bangkok, Thailand. Four bus routes were selected. Measurements were conducted over 10 days in August (rainy season) 2008 and 8 days in January (dry season) 2009. The mean PM2.5 exposure level of the Tuk-tuk drivers was 86 microg/m3 in August and 198 microg/m3 in January. The mean for the non-air-conditioned bus drivers was 63 microg/m3 in August and 125 microg/m3 in January. The PM2.5 and PM10-2.5 exposure levels of the drivers in January were approximately twice as high as those in August. The proportion of total carbon (TC) in PM2.5 to the PM2.5 level in August (0.97 +/- 0.28 microg/m3) was higher than in January (0.65 +/- 0.13 microg/m3). The proportion of OC in the TC of the PM2.5 in August (0.51 +/- 0.08 microg/m3) was similar to that in January (0.65 +/- 0.07 microg/m3). The TC exposure by PM25 in January (81 +/- 30 microg/m3) remained higher than in August (56-21 microg/m3). The mean level of OC in the PM2.5 was 29 +/- 13 microg/m3 in August and 50 +/- 24 microg/m3 in January. In conclusion, the PM exposure level in Bangkok drivers was higher than that in the general environment, which was already high, and it varied with the seasons and vehicle type. This study also demonstrated that the major component of the PM was carbon, likely derived from vehicles.

Recent evidence from epidemiological studies on methylmercury toxicity

More than fifty years have passed since the outbreak of Minamata disease, and large-scale methylmercury poisoning due to industrial effluents or methylmercury-containing fungicide intoxication has scarcely happened in developed countries. On the other hand, widespread environmental mercury contamination has occurred in gold and mercury mining areas of developing countries. In this article, we provided an overview of recent studies addressing human health effects of methylmercury, which we searched using the PubMed of the US National Library of Medicine. The following suggestions were obtained for low-level methylmercury exposure: (1) In recent years, the proportion of human studies addressing methylmercury has tended to decrease. (2) Prenatal exposure to methylmercury through fish intake, even at low levels, adversely affects child development after adjusting for polychlorinated biphenyls and maternal fish intake during pregnancy, whereas maternal seafood intake has some benefits. (3) Long-term methylmercury exposure through consumption of fish such as bigeye tuna and swordfish may pose a potential risk of cardiac events involving sympathovagal imbalance. (4) In measuring methylmercury levels in preserved umbilical cord collected from inhabitants born in Minamata areas between 1945 and 1989, the elevated concentrations (≥1 mg/g) were observed mainly in inhabitants born between 1947 and 1968, and the peak coincided with the peak of acetaldehyde production in Minamata. (5) Since some developing countries appear to be in similar situations to Japan in the past, attention should be directed toward early recognition of a risky agent and precautions should be taken against it.

Joint effect of longevity-associated mitochondrial DNA 5178 C/A polymorphism and alcohol consumption on risk of hyper-LDL cholesterolemia in middle-aged Japanese men

BACKGROUND

Combined effects between mitochondrial DNA 5178 (Mt5178) C/A polymorphism and alcohol consumption on the risk of hypertension or hyperuricemia have been reported. The objective of this study was to investigate whether Mt5178 C/A polymorphism modulates the effects of alcohol consumption on the risk of dyslipidemia.

METHODS

A total of 394 male subjects were selected from among individuals visiting the hospital for regular medical check-ups. After Mt5178 C/A genotyping, a cross-sectional study assessing the combined effect of Mt5178 polymorphism and alcohol consumption on the risk of dyslipidemia was conducted.

RESULTS

For men with Mt5178C, alcohol consumption was significantly and negatively associated with the risk of hyper-low-density lipoprotein (LDL) cholesterolemia (serum LDL cholesterol ≥ 140 mg/dl) (P for trend = 0.015). After adjustment for age, body mass index (BMI), habitual smoking, coffee consumption and use of antihypertensive medicine, the odds ratio (OR) for hyper-LDL cholesterolemia was significantly lower in daily drinkers with Mt5178C than non-drinkers with Mt5178C (OR = 0.360, 95% confidence intervals: 0.153-0.847). A significant and negative association between alcohol consumption and serum LDL cholesterol levels was also observed in Mt5178C genotypic men (P for trend < 0.01). On the other hand, the association between Mt5178A genotype and risk of hyper-LDL cholesterolemia does not appear to depend on alcohol consumption.

CONCLUSIONS

For Mt5178C genotypic men, alcohol consumption may reduce the risk of hyper-LDL cholesterolemia.

[Application of the benchmark dose approach to epidemiological endpoints with clinical standards]

OBJECTIVE

By publishing the scientific opinion entitled "Use of the benchmark dose (BMD) approach in risk assessment: Guidance of the Scientific Committee," the European Food Safety Authority (EFSA) recommended that the BMD approach, as an alternative to the traditionally used no-observed-adverse-effect level approach, be used as the method of choice for the determination of the reference point for deriving health-based guidance values and margins of exposure, and described the BMD approach as being extensively applicable to all chemicals, even to dose-effect assessment of epidemiological data. When the BMD approach was first proposed, the approach was expected to estimate the dose causing a low but measurable target organ effect. We examined whether the BMD approach can be applied to epidemiological endpoints with clinical standards.

METHODS

Comparisons between the BMD approach recommended by the EFSA and classical BMD approach (hybrid method) were conducted using epidemiological data with clinical standards.

RESULTS

The 95% lower confidence limit of the EFSA-based BMD tended to be considerably lower than that of the hybrid method. The former approach is easily applicable to dose-response data in published papers, though it is difficult to adjust for possible confounders. The cutoff values, calculated by the hybrid method, of epidemiological endpoints are nearly concordant with the clinical standards.

CONCLUSIONS

By using the BMD approach recommended by the EFSA, human health safety may be better guaranteed because of the lower reference points for hazardous substances. However, its application to epidemiological data does not always reflect toxicological implications in light of the clinical standard.

Combined effect of longevity-associated mitochondrial DNA 5178 C/A polymorphism and coffee consumption on the risk of hyper-LDL cholesterolemia in middle-aged Japanese men

The objective of this study was to investigate whether the mitochondrial DNA 5178 cytosine/adenine (Mt5178 C/A) polymorphism modifies the effects of coffee consumption on serum lipid levels and the risk of dyslipidemia in middle-aged Japanese men. A total of 397 male subjects (age, 53.9±7.8 years; mean±s.d.) were selected from among individuals visiting the hospital for regular medical check-ups. After adjustment for age, body mass index, habitual alcohol consumption, habitual smoking and use of antihypertensive medication, among subjects who consumed <1 cup of coffee per day, the odds ratio (OR) for hyper-low-density lipoprotein (LDL) cholesterolemia (serum LDL cholesterol > or =140 mg per 100 ml) was significantly lower in those with Mt5178A than in those with Mt5178C (OR=0.378, 95% confidence interval: 0.153-0.919). After adjustment, the association between the Mt5178A genotype and hyper-LDL cholesterolemia depended on coffee consumption (P for trend=0.018). Coffee consumption was positively associated with serum LDL cholesterol levels only in subjects with Mt5178A. However, in subjects with Mt5178C, serum LDL cholesterol level or risk of hyper-LDL cholesterolemia did not seem to depend on coffee consumption. These results suggest that for men with Mt5178A, coffee consumption negates the genetic benefit of lower risk for hyper-LDL cholesterolemia.

Longevity-associated NADH dehydrogenase subunit-2 237 Leu/Met polymorphism modulates the effects of daily alcohol drinking on yearly changes in serum total and LDL cholesterol in Japanese men

Reduced nicotinamide adenine dinucleotide (NADH) dehydrogenase subunit 2 237 leucine/methionine (ND2-237 Leu/Met) polymorphism, is reportedly associated with longevity in the Japanese population. The ND2-237Met genotype may exert resistance to atherogenic diseases, such as myocardial infarction or cerebrovascular disorders. To investigate whether ND2-237 Leu/Met polymorphism is associated with yearly changes in serum lipid levels, we conducted a longitudinal study of 107 healthy Japanese male subjects. Analysis of covariance revealed that the interaction between the ND2-237 Leu/Met genotypes and habitual drinking was significantly associated with yearly changes in serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDLC) levels (p=0.036 and p=0.006, respectively). In multiple regression analysis, daily drinking was significantly and positively associated with yearly changes in serum LDLC levels in men with ND2-237Met (p=0.026). After adjusting for covariates, yearly changes in serum LDLC levels were significantly lower in non-daily drinkers with ND2-237Met than in those with ND2-237Leu (p=0.047). These results suggest that ND2-237Met has a beneficial impact on yearly changes in serum LDLC in non-daily drinkers but not in daily drinkers.

NADH dehydrogenase subunit-2 237 Leu/Met polymorphism modulates the effects of coffee consumption on the risk of hypertension in middle-aged Japanese men

Background

Habitual coffee consumption has been reported to lower blood pressure in the Japanese population. The NADH dehydrogenase subunit-2 237 leucine/methionine (ND2-237 Leu/Met) polymorphism is associated with longevity and modifies the effects of alcohol consumption on blood pressure in the Japanese population. The objective of this study was to determine whether this polymorphism also modifies the effects of coffee consumption on blood pressure or the risk of hypertension in middle-aged Japanese men.

Methods

A total of 398 men (mean age ± standard deviation, 53.8 ± 7.8 years) were selected from among individuals visiting the hospital for regular medical check-ups. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or antihypertensive drug treatment. Polymerase chain reaction-restriction fragment length polymorphism using the restriction enzyme AluI was performed to determine ND2-237 Leu/Met genotype.

Results

In subjects with ND2-237Leu, coffee consumption was significantly and negatively associated with diastolic blood pressure (P = 0.007). The odds ratio (OR) for hypertension was significantly lower in subjects with ND2-237Leu who consumed 2 or 3 cups of coffee per day than in those who consumed less than 1 cup of coffee per day (OR, 0.517; 95% confidence interval [CI], 0.276 to 0.968; P = 0.039). After adjustment, the OR remained significant (OR = 0.399; 95% CI, 0.184 to 0.869; P = 0.020). Moreover, after adjustment, the OR was significantly lower in subjects with ND2-237Leu who consumed more than 4 cups of coffee per day than in those who consumed less than 1 cup of coffee per day (OR, 0.246; 95% CI, 0.062 to 0.975; P = 0.046). However, the association between ND2-237Met genotype and hypertension did not depend on coffee consumption.

Conclusions

The present results suggest that the ND2-237 Leu/Met polymorphism modulates the effects of coffee consumption on hypertension risk in middle-aged Japanese men.

Association between PM10 and O3 levels and hospital visits for cardiovascular diseases in Bangkok, Thailand

Background

The association between air pollution and cardiovascular diseases is well known, but previous studies only assessed mortality and hospital admissions in North America, Europe, and Northeast Asia. Few studies have been conducted in less-developed countries in regions with a tropical climate. This study evaluated whether short-term exposures to fine particulate matter (PM₁₀) and ozone (O₃) were associated with hospital visits for cardiovascular diseases (CVD; ICD-10th, I00–I99) in central Bangkok, Thailand.

Methods

Data from hospital records were obtained from 3 major government hospitals. All hospital visits were stratified by age group and category of CVD. Daily PM₁₀ and O₃ levels reported by the Pollution Control Department from April 2002 to December 2006 (1736 days) were used in a time-series analysis with a generalized additive model procedure.

Results

Exposure on the previous day to PM₁₀ and O₃ had a positive association with hospital visits for CVD among elderly (≥65 years) individuals. The increase in CVD hospital visits in this age group was 0.10% (95% CI, 0.03–0.19) with a 10 µg/m³ increase in PM₁₀, and 0.50% (95% CI, 0.19–0.81) with an increase in O₃.

Conclusions

In central Bangkok, a short-term association was observed between increases in daily levels of PM₁₀ and O₃ and the number of daily emergency hospital visits for CVD, particularly among individuals aged ≥65 years.

Changes in body mass index by birth cohort in Japanese adults: results from the National Nutrition Survey of Japan 1956-2005

Background The National Nutrition Survey, Japan (NNS-J) provides annual anthropometric information for a whole nation over 50 years. Based on this survey, the mean body mass index (BMI) of Japanese men and elderly women has increased in recent decades, but that of young women has decreased. We examined the effect of birth cohort on this phenomenon.

Methods We analysed data from the NNS-J for subjects aged 20–69 years. BMI during 1956–2005 and the prevalence of overweight and obesity (BMI ≥ 25 kg/m²) during 1976–2005 were estimated.

Results The BMI increased with age in every birth cohort, with similar increments, and did not peak until 60–69 years of age. However, with cross-sectional age, the BMI usually peaked before 60–69 years of age. The differences among cohorts already existed at 20–29 years of age, and slightly increased in men between 20–29 and 30–39 years of age. The BMI in all male age groups increased from the 1891–1900 through 1971–80 cohorts. However, in women, the figure increased until the 1931–40 cohorts, but later decreased. Changes in prevalence were generally consistent with changes in BMI. The recent increase (decrease in young women) in the mean BMI is attributable to birth cohort, indicating that thinner (fatter) and less recent birth cohorts have been replaced by fatter (thinner) ones.

Conclusions A cohort effect was quantitatively demonstrated based on a repeated annual survey. In Japan, the differences in BMI among cohorts were already established by young adulthood.

Validity of a self-administered food frequency questionnaire used in the 5-year follow-up survey of the JPHC Study to assess selenium intake: comparison with dietary records and blood levels

Selenium (Se) levels in serum and erythrocytes were measured in 215 adults to assess the relative validity of Se intake estimated from 28-day dietary records (DR) and the food frequency questionnaire (FFQ) used in the 5-year follow-up survey of the JPHC study. Se intake estimated from DR was correlated with that from the FFQ both in males and females (r=0.36 and r=0.32, respectively). Se levels in erythrocytes were weakly correlated with Se intake by DR for men (r=0.21) after adjustments for the total energy intake, though no significant correlation was found for women nor in crude values for either sex. Although Se intake estimated from our FFQ was correlated with that from the DR, no correlation was observed between the Se level in serum and estimated Se intake. In this population, the serum Se level was not a good biomarker for estimated Se intake.

Gastric electrical activity and cardiovascular risk factors in relation to autonomic nervous function, hormonal responses, and health-related lifestyles in young men

BACKGROUND

Electrogastrography (EGG) is the noninvasive recording of gastric myoelectrical activity. The purpose of the present study was to assess associations of EGG with risk factors for cardiovascular disease (CVD), autonomic nervous function, hormonal responses, and health-related lifestyles.

METHODS

EGG was measured in 435 Japanese men, aged 24-39 years, who worked at the same company. In addition to anthropometric measurements and blood examinations, power spectral analysis of heart rate variability in low-frequency (LF; 0.04-0.15 Hz) and high-frequency (HF; 0.15-0.40 Hz) bands was conducted. LF/HF and HF were used as the indicators of sympathetic and parasympathetic nervous activity, respectively. Serum cortisol and catecholamine levels were measured as well.

RESULTS

In univariate analyses, the EGG frequency was associated positively with the serum high-density lipoprotein (HDL) and cholesterol level (both-P < 0.0001) and negatively with age, body mass index (BMI), serum triglyceride level, fasting blood sugar, and diastolic blood pressure (all P < 0.05). The EGG frequency tended to increase with increases in the HF band (P = 0.10) and was not significantly associated with the LF/HF ratio (P = 0.45). Neither hormonal responses nor health-related lifestyle factors such as smoking and alcohol were significant (all P > 0.05). A multivariate analysis indicated that both the HDL cholesterol level and BMI were independent predictors of EGG frequency (both P < 0.05), after adjusting for the significant effects of age, HF, and other CVD factors.

CONCLUSIONS

Slowed EGG frequency appeared to be linked with various CVD risk factors, including obesity and low HDL cholesterol levels, in young men.

Respiratory symptoms and lung function in Bangkok school children

BACKGROUND

Previous epidemiological studies have shown acute effects of ambient air pollutants in children with respiratory disorders.

METHODS

The chronic effects of air pollution in Bangkok children were investigated. Children aged 10-15 years were examined for lung functions using spirometry tests and for respiratory symptoms by the American Thoracic Society's Division of Lung Diseases (ATS-DLD-78-C) questionnaire during May-August 2004. Effects of residential area were estimated by multiple logistic regression analysis. Of the 878 children, 722 (82%) had completed lung function test and ATS-DLD questionnaire.

RESULTS

In children, who live in roadside (R) and general (G) areas with high (H) pollution, the prevalence of respiratory symptoms increased significantly [odds ratios (95% confidence interval) in HR and HG are 2.44 (1.21-4.93) and 2.60 (1.38-4.91), respectively]. Children with normal lung function were less observed in H- and M-polluted roadside and general area [HR, OR = 1.41 (95% CI 0.89-2.22); HG, 1.08 (0.71-1.64); and MR, 0.99 (0.63-1.57)]. Residential locations and family members were associated with the prevalence of respiratory symptoms, whereas factors such as the responder of ATS-DLD, gender, age, residential years, home size, parental smoking habits, use of air conditioners, and domestic pets were not associated. Age was associated with the impaired lung function, whereas others factors were not associated.

CONCLUSION

The prevalence of respiratory symptoms and impaired lung function were higher among children living in areas with high pollution than those in areas with low pollution.

Expression of transforming growth factor beta1, beta2, and beta3 in chronic, cancer-associated, obstructive pancreatitis

CONTEXT

Myofibroblasts are considered to play central roles in pancreatic fibrosis. The potent fibrogenic capacities of transforming growth factor betas (TGF-betas) have been emphasized in vitro and in animal studies. However, the roles of TGF-betas in human chronic pancreatitis have not been fully clarified.

OBJECTIVE

To investigate whether expressions of TGF-betas are related to myofibroblast distribution in chronic, cancer-associated, obstructive pancreatitis (COP).

DESIGN

Histopathologic studies using hematoxylin-eosin and Elastica-Masson trichrome and immunohistochemical studies using antibodies against alpha-smooth muscle actin (SMA); CD68; TGF-beta1, -beta2, and -beta3; and TGF-beta soluble receptor type II were performed in 19 COP cases and 6 controls. By classifying COP tissues into 3 fibrosis phases by the amount of collagen deposits, immunoreactivities for TGF-betas, histopathologic changes, and myofibroblast distribution were examined for each fibrosis phase.

RESULTS

Six cases were categorized in the early stage of fibrosis, 8 in the intermediate stage, and 5 in the advanced stage. Immunoreactivities for all 3 isoforms of TGF-beta were observed in occasional myofibroblasts. In the early and intermediate stages, TGF-beta1-expressing macrophages and neutrophils were distributed in the midst of myofibroblasts. TGF-beta2 and TGF-beta3 expressions were observed in ductal structures, sometimes even in sites where no or few myofibroblasts were seen. TGF-beta soluble receptor type II was immunoreactive for myofibroblasts, endothelium, and ductal structures.

CONCLUSIONS

All 3 isoforms of TGF-betas may contribute to fibrosis in COP. Macrophages and neutrophils may be sources of fibrogenic TGF-beta1. Infiltration of these cells appears to play an important role in the progression of COP fibrosis.