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Niode NJ, Kepel BJ, Hessel SS, Kairupan TS, Tallei TE. Rhynchophorus ferrugineus larvae: A novel source for combating broad-spectrum bacterial and fungal infections. Vet World 2024; 17:156-170. [PMID: 38406375 PMCID: PMC10884581 DOI: 10.14202/vetworld.2024.156-170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/21/2023] [Indexed: 02/27/2024] Open
Abstract
Antimicrobial resistance is a growing concern due to the growth of antibiotic-resistant microorganisms, which makes it difficult to treat infection. Due to its broad-spectrum antimicrobial properties against a diverse array of bacteria, both Gram-positive and Gram-negative bacteria, and fungi, Rhynchophorus ferrugineus larval antimicrobial peptides (AMPs) have demonstrated potential as antimicrobial agents for the treatment of microbial infections and prevention of antibiotic resistance. This study emphasizes the unexplored mechanisms of action of R. ferrugineus larvae against microorganisms. Among the most widely discussed mechanisms is the effect of AMPs in larvae in response to a threat or infection. Modulation of immune-related genes in the intestine and phagocytic capacity of its hemocytes may also affect the antimicrobial activity of R. ferrugineus larvae, with an increase in phenoloxidase activity possibly correlated with microbial clearance and survival rates of larvae. The safety and toxicity of R. ferrugineus larvae extracts, as well as their long-term efficacy, are also addressed in this paper. The implications of future research are explored in this paper, and it is certain that R. ferrugineus larvae have the potential to be developed as a broad-spectrum antimicrobial agent with proper investigation.
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Affiliation(s)
- Nurdjannah Jane Niode
- Department of Dermatology and Venereology, Faculty of Medicine, Sam Ratulangi University, Prof. Dr. R. D. Kandou Hospital Manado, Manado 95115, North Sulawesi, Indonesia
| | - Billy Johnson Kepel
- Department of Chemistry, Faculty of Medicine, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia
| | - Sofia Safitri Hessel
- Department of Biotechnology, Indonesia Biodiversity and Biogeography Research Institute (INABIG), Bandung 40132, West Java, Indonesia
| | - Tara Sefanya Kairupan
- Department of Dermatology and Venereology, Faculty of Medicine, Sam Ratulangi University, Prof. Dr. R. D. Kandou Hospital Manado, Manado 95115, North Sulawesi, Indonesia
| | - Trina Ekawati Tallei
- Department of Biology, Faculty of Mathematics and Natural Sciences, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia
- Department of Biology, Faculty of Medicine, Sam Ratulangi University, Manado 95115, North Sulawesi, Indonesia
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Kairupan TS, Ibusuki R, Kheradmand M, Sagara Y, Mantjoro EM, Nindita Y, Niimura H, Kuwabara K, Ogawa S, Tsumematsu-Nakahata N, Nerome Y, Owaki T, Matsushita T, Maenohara S, Yamaguchi K, Takezaki T. Interactions between inflammatory gene polymorphisms and HTLV-I infection for total death, incidence of cancer, and atherosclerosis-related diseases among the Japanese population. J Epidemiol 2017; 27:420-427. [PMID: 28576445 PMCID: PMC5565753 DOI: 10.1016/j.je.2016.08.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 08/22/2016] [Indexed: 12/11/2022] Open
Abstract
Background An increased risk of total death owing to human T-lymphotropic virus type-I (HTLV-I) infection has been reported. However, its etiology and protective factors are unclear. Various studies reported fluctuations in immune-inflammatory status among HTLV-I carriers. We conducted a matched cohort study among the general population in an HTLV-I-endemic region of Japan to investigate the interaction between inflammatory gene polymorphisms and HTLV-I infection for total death, incidence of cancer, and atherosclerosis-related diseases. Method We selected 2180 sub-cohort subjects aged 35–69 years from the cohort population, after matching for age, sex, and region with HTLV-I seropositives. They were followed up for a maximum of 10 years. Inflammatory gene polymorphisms were selected from TNF-α, IL-10, and NF-κB1. A Cox proportional hazard model was used to estimate the hazard ratio (HR) and the interaction between gene polymorphisms and HTLV-I for risk of total death and incidence of cancer and atherosclerosis-related diseases. Results HTLV-I seropositivity rate was 6.4% in the cohort population. The interaction between TNF-α 1031T/C and HTLV-I for atherosclerosis-related disease incidence was statistically significant (p = 0.020). No significant interaction was observed between IL-10 819T/C or NF-κB1 94ATTG ins/del and HTLV-I. An increased HR for total death was observed in the Amami island region, after adjustment of various factors with gene polymorphisms (HR 3.03; 95% confidence interval, 1.18–7.77). Conclusion The present study found the interaction between TNF-α 1031T/C and HTLV-I to be a risk factor for atherosclerosis-related disease. Further follow-up is warranted to investigate protective factors against developing diseases among susceptible HTLV-I carriers. We observed death and incidence risk with HTLV-I and SNPs in a matched cohort study. An increased risk for total death with HTLV-I was observed in the island region. Inflammatory SNP interacted with HTLV-I for atherosclerosis-related disease risk.
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Affiliation(s)
- Tara Sefanya Kairupan
- Department of International Islands and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia
| | - Rie Ibusuki
- Department of International Islands and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | | | - Yasuko Sagara
- Japanese Red Cross Kyushu Block Blood Center, Fukuoka, Japan
| | | | - Yora Nindita
- Department of International Islands and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | | | - Kazuyo Kuwabara
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Shin Ogawa
- National Health Insurance Yamato Clinic, Yamato, Japan
| | | | - Yasuhito Nerome
- Education Center for Doctors in Remote Islands and Rural Areas, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tetsuhiro Owaki
- Education Center for Doctors in Remote Islands and Rural Areas, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | | | | | | | - Toshiro Takezaki
- Department of International Islands and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
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Okada R, Naito M, Hattori Y, Seiki T, Wakai K, Nanri H, Watanabe M, Suzuki S, Kairupan TS, Takashima N, Mikami H, Ohnaka K, Watanabe Y, Katsuura-Kamano S, Kubo M, Hamajima N, Tanaka H. Matrix metalloproteinase 9 gene polymorphisms are associated with a multiple family history of gastric cancer. Gastric Cancer 2017; 20:246-253. [PMID: 27053167 DOI: 10.1007/s10120-016-0608-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/30/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND A family history of gastric cancer (GC) is a well-known risk factor of GC. Genetic variations in genes of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) have been related to the risk of GC, but their association with familial background is not clear. We investigated whether individuals with a multiple family history of GC have more risk genotypes of MMP/TIMP genes. METHODS We genotyped ten common functional polymorphisms of MMP/TIMP genes in 4427 individuals aged 35-69 years without a history of GC who were enrolled in the Japan Multi-institutional Collaborative Cohort Study. Individuals who have two or more first-degree relatives (parents and siblings) with GC were categorized as having a multiple family history. Odds ratios (ORs) for multiple family history compared with no family history were calculated. RESULTS MMP9 279QQ (rs17576) was more frequently observed in individuals whose both parents had a history of GC (n = 23) and in individuals for whom one parent and their sibling(s) had a history of GC (n = 36) compared with those with no family history (n = 3816) [30.4 % vs 11.6 %, OR 4.34, 95 % confidence interval (CI) 1.45-13.03 and 16.7 % vs 11.6 %, OR 2.26, 95 % CI 0.81-6.27 after adjustment for age, sex, and current smoking]. The population attributable fraction was 38.1 %. The haplotype MMP9-1562C/279Q/668Q was more frequently observed in individuals whose both parents had a history of GC and in individuals for whom one parent and their sibling(s) had a history of GC compared with those with no family history (OR 3.35, 95 % CI 0.75-14.96 and OR 3.51, 95 % CI 1.35-9.15 respectively). CONCLUSIONS MMP9 polymorphisms were associated with a multiple family history of GC. Screening for these genotypes together with familial background may help us to identify individuals at an increased risk of GC.
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Affiliation(s)
- Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 4668550, Japan.
| | - Mariko Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 4668550, Japan
| | - Yuta Hattori
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 4668550, Japan
| | - Toshio Seiki
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 4668550, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 4668550, Japan
| | - Hinako Nanri
- Department of Public Health, Showa University School of Medicine, Tokyo, Japan
| | - Miki Watanabe
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.,Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tara Sefanya Kairupan
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoyuki Takashima
- Department of Health Science, Shiga University of Medical Science, Otsu, Japan
| | - Haruo Mikami
- Division of Cancer Prevention and Epidemiology, Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Keizo Ohnaka
- Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshiyuki Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideo Tanaka
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.,Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Mantjoro EM, Toyota K, Kanouchi H, Kheradmand M, Niimura H, Kuwabara K, Nakahata N, Ogawa S, Shimatani K, Kairupan TS, Nindita Y, Ibusuki R, Nerome Y, Owaki T, Maenohara S, Takezaki T. Positive Association of Plasma Homocysteine Levels with Cardio-Ankle Vascular Index in a Prospective Study of Japanese Men from the General Population. J Atheroscler Thromb 2016; 23:681-91. [PMID: 26797265 DOI: 10.5551/jat.32243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Observational studies have reported that elevated homocysteine (Hcy) levels are associated with the risk of cardiovascular disease (CVD). However, interventions that lower Hcy do not provide a corresponding risk reduction. Therefore, the causal role of Hcy in CVD remains unclear. This 5-year prospective study investigated the associations of Hcy levels, folate intake, and host factors with arterial stiffness among the general Japanese population. METHODS We prospectively recruited 658 participants (40-69 years old) from the general population during regular health checkup examinations. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI) at baseline and the 5-year follow-up. Folate intake was estimated using a structured questionnaire. Genotyping was used to evaluate the MTHFR C677T and MS A2756G gene polymorphisms. Ultrafast liquid chromatography was used to measure total plasma Hcy levels. Association between these variables and CAVI values was evaluated using general linear regression and logistic regression models that were adjusted for atherosclerosis-related factors. RESULTS Men had higher Hcy levels and CAVI values and lower folate intake than women (all, p<0.001). At baseline, Hcy, folate intake, and the two genotypes were not associated with CAVI values for both sexes. Among men, Hcy levels were positively associated with CAVI values at the 5-year follow-up (p=0.033). Folate intake and the two genotypes were not associated with the 5-year CAVI values. CONCLUSION Plasma Hcy may be involved in arterial stiffness progression, as monitored using CAVI, among men.
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Affiliation(s)
- Eva Mariane Mantjoro
- Department of International Islands and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
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Hishida A, Wakai K, Naito M, Suma S, Sasakabe T, Hamajima N, Hosono S, Horita M, Turin TC, Suzuki S, Kairupan TS, Mikami H, Ohnaka K, Watanabe I, Uemura H, Kubo M, Tanaka H. Polymorphisms of genes involved in lipid metabolism and risk of chronic kidney disease in Japanese - cross-sectional data from the J-MICC study. Lipids Health Dis 2014; 13:162. [PMID: 25311932 PMCID: PMC4210508 DOI: 10.1186/1476-511x-13-162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 10/07/2014] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is known to be one of the causes of cardiovascular disease and end-stage renal disease. Among the several treatable risk factors of CKD, that of dyslipidemia is relatively controversial. To clarify the association of polymorphisms in genes involved in lipid metabolism with the risk of CKD in the Japanese population, we used cross-sectional data from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study. METHODS A total of 3,268 men and women, aged 35-69 years, were selected from J-MICC Study participants for inclusion in this study. Twenty-eight candidate single nucleotide polymorphisms (SNPs) were selected in 17 genes associated with the risk of lipid metabolism disorders, and genotyping of the subjects was conducted using the multiplex PCR-based invader assay. The prevalence of CKD was determined for stages 3-5 (defined as estimated glomerular filtration rate <60 ml/min/1.73 m2). RESULTS Logistic regression analysis revealed that SNPs APOA5 T - 1131C (rs662799), APOA5 T1259C (rs2266788), TOMM40 A/G (rs157580), and CETP TaqIB (rs708272) were significantly associated with CKD risk in those individuals genotyped, with age- and sex-adjusted odds ratios (ORs) per minor allele (and 95% confidence intervals (CIs)) of OR 1.22 (95% CI: 1.06-1.39), 1.19 (1.03-1.37), 1.27 (1.12-1.45), and 0.81 (0.71-0.92), respectively. Analysis of the gene-environment interaction revealed that body mass index (BMI) was a significant effect modifier for APOA5 T - 1131C (rs662799) and a marginally significant effect modifier for APOA5 T/C (rs2266788), with the interaction between BMI ≥30 and individuals with at least one minor allele of each genotype of OR 10.43 (95% CI: 1.29-84.19) and 3.36 (0.87-13.01), respectively. CONCLUSIONS Four polymorphisms in APOA5, TOMM40, and CETP were shown to be significantly associated with CKD risk, and a significant interaction between the two APOA5 SNPs and BMI on CKD risk was also demonstrated. This suggests the future possibility of personalized risk estimation for this life-limiting disease.
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Affiliation(s)
- Asahi Hishida
- />Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, 466-8550 Japan
| | - Kenji Wakai
- />Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, 466-8550 Japan
| | - Mariko Naito
- />Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, 466-8550 Japan
| | - Shino Suma
- />Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, 466-8550 Japan
| | - Tae Sasakabe
- />Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, 466-8550 Japan
| | - Nobuyuki Hamajima
- />Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, 466-8550 Japan
| | - Satoyo Hosono
- />Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, 464-8681 Japan
| | - Mikako Horita
- />Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, 849-8501 Japan
| | - Tanvir Chowdhury Turin
- />Department of Health Science, Shiga University of Medical Science, Otsu, 520-2192 Japan
- />Department of Family Medicine, University of Calgary, Calgary, AB T2N 1N4 Canada
| | - Sadao Suzuki
- />Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601 Japan
| | - Tara Sefanya Kairupan
- />Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-8544 Japan
- />Department of Community Medicine, Faculty of Medicine, Sam Ratulangi University, Manado, 95115 Indonesia
| | - Haruo Mikami
- />Division of Epidemiology, Chiba Cancer Center Research Institute, Chiba, 260-8717 Japan
| | - Keizo Ohnaka
- />Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582 Japan
| | - Isao Watanabe
- />Department of Social Medicine and Cultural Sciences, Kyoto Prefectural University of Medicine, Kyoto, 602-8566 Japan
| | - Hirokazu Uemura
- />Department of Preventive Medicine, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, 770-8503 Japan
| | - Michiaki Kubo
- />Core for Genomic Medicine, Center for Integrative Medical Sciences, RIKEN, Yokohama, 230-0045 Japan
| | - Hideo Tanaka
- />Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, 464-8681 Japan
| | - for the J-MICC Study Group
- />Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, 466-8550 Japan
- />Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, 466-8550 Japan
- />Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, 464-8681 Japan
- />Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, 849-8501 Japan
- />Department of Health Science, Shiga University of Medical Science, Otsu, 520-2192 Japan
- />Department of Family Medicine, University of Calgary, Calgary, AB T2N 1N4 Canada
- />Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601 Japan
- />Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-8544 Japan
- />Department of Community Medicine, Faculty of Medicine, Sam Ratulangi University, Manado, 95115 Indonesia
- />Division of Epidemiology, Chiba Cancer Center Research Institute, Chiba, 260-8717 Japan
- />Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582 Japan
- />Department of Social Medicine and Cultural Sciences, Kyoto Prefectural University of Medicine, Kyoto, 602-8566 Japan
- />Department of Preventive Medicine, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, 770-8503 Japan
- />Core for Genomic Medicine, Center for Integrative Medical Sciences, RIKEN, Yokohama, 230-0045 Japan
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Katsuura-Kamano S, Uemura H, Arisawa K, Yamaguchi M, Hamajima N, Wakai K, Okada R, Suzuki S, Taguchi N, Kita Y, Ohnaka K, Kairupan TS, Matsui D, Oze I, Mikami H, Kubo M, Tanaka H. A polymorphism near MC4R gene (rs17782313) is associated with serum triglyceride levels in the general Japanese population: the J-MICC Study. Endocrine 2014; 47:81-9. [PMID: 24880622 DOI: 10.1007/s12020-014-0306-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 05/15/2014] [Indexed: 01/22/2023]
Abstract
Previously reported associations of a common polymorphism near melanocortin-4 receptor (MC4R) gene (rs17782313) with BMI/obesity were inconsistent, especially in East Asia, and the associations of the polymorphism with serum lipid levels have not been fully elucidated. This study evaluated the association between rs17782313 and obesity-related traits and serum lipid levels in the general Japanese population. A total of 2,035 subjects (aged 35-69 years, 1,024 males and 1,011 females) enrolled in the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study. We examined the associations between near MC4R polymorphism (rs17782313) and obesity-related traits [height, weight, body mass index (BMI), weight change from 20 years old], serum lipid levels (triglycerides, total and HDL-cholesterol), and intake of nutrients (total energy and macronutrients). Polymorphism of rs17782313 (minor C allele) was positively associated with serum triglyceride levels (P for trend = 0.020) adjusted for age and sex. Analysis using a general linear model revealed that the number of minor C alleles was positively associated with serum triglyceride levels after adjustment for age, sex, and potential confounders (P for trend = 0.004). Statistical significance did not change after further adjustment for total energy intake and BMI. There was no significant association between rs17782313 and obesity-related traits including BMI. Interactions between rs17782313 and sex, BMI, or total energy intake for triglyceride levels were not significant. To our knowledge, this study demonstrated for the first time that rs17782313 was associated with serum triglyceride levels in Asian population. Further studies are needed to confirm this result.
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Affiliation(s)
- Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15, Kuramoto-cho, Tokushima, Japan,
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