Relationship of dietary intake between children aged 12-59 months and their mothers in rural Kenya: a cross-sectional study in two seasons

OBJECTIVE

The aim of the study was to investigate the quantitative association between the dietary intakes of children and their caregivers.

METHOD

In this cross-sectional study, a non-consecutive 2-day 24-h dietary recall was conducted in two seasons. Participants comprised 142 pairs of 12-59-month-old children and their female caregivers from rural areas of Kenya. Energy and micronutrient adequacy, food group intakes and food allocation were assessed. Differences and correlations between caregiver and child diets were examined, and multiple regression analysis was used to investigate the relationship between the children's and caregivers' dietary intakes.

RESULTS

The child's diet was significantly lower in energy and higher in micronutrient adequacy than was the caregiver's diet (p < 0.001). Specifically, the child's diet contained more fruits, dairy products, sugar and confectionaries per 4184 kj. Children were allocated relatively more dishes containing nutrient-rich foods than staple foods. The correlation coefficients between the dietary intake of caregivers and children were stronger among 24-59-month-old children. After controlling with covariates, caregiver energy intake was significantly associated with child energy intake (standardised beta [β] = 0.512, p < 0.001), and caregiver micronutrient adequacy was associated with child micronutrient adequacy (β = 0.679 and β = 0.262 after energy adjustment, p < 0.001).

CONCLUSIONS

The dietary intakes of caregivers and children were closely related. The children had a more nutrient-rich diet compared to that of their caregivers. Differences in food group intakes and food allocation may contribute to the higher nutrient adequacy of children. There is a need to improve the diet of caregivers, which would contribute to improving the diet of children.

Association between diet quality and risk of stunting among school-aged children in Schistosoma mansoni endemic area of western Kenya: a cross-sectional study

BACKGROUND

Healthy eating habits are essential for improving nutritional status and strengthening immunity against infectious diseases. This study examined the relationship between diet quality and stunting in school-aged children in an infectious disease-endemic area of western Kenya.

METHODS

This cross-sectional study included 260 school-aged children (age 9-17 years) enrolled in primary schools in Mbita Sub-county, western Kenya. The nutritional status was assessed using anthropometric measurements. Dietary intake was measured using food frequency questionnaires and evaluated using the Food Pyramid (FP) score, which indicates adherence to the Kenyan food-based dietary guideline. Information on the children's age, sex, maternal education, and household wealth index was collected using a household-based questionnaire. Infections with the predominant parasites, such as Schistosoma (S.) mansoni, were detected via microscopy. The trend associations of the FP score with food group intake were examined to characterize the dietary intake of this population. Logistic regression analysis was performed to investigate the relationship between stunting and FP score tertiles, adjusted for sociodemographic and economic indicators and parasitic infection status.

RESULTS

Among the studied schoolchildren, 15.0% exhibited stunting, while 76.2% were infected with S. mansoni. The mean FP score was 25.6 out of 50 points. A higher FP score was characterized by a high intake of roots and tubers, dairy products, pulses, and fruits and a low intake of cereals and animal-source foods. The analysis revealed a trend: a lower risk of stunting was evident in groups with elevated FP scores (p for trend = 0.065). However, these trend associations were observable among subjects with either negative or light S. mansoni infection (p for trend = 0.016).

CONCLUSIONS

A higher quality diet, as evaluated by FP scores, was associated with a low risk of stunting among school-aged children. Notably, this association seemed to weaken in the presence of a high burden of S. mansoni infection. It highlights the importance of enhancing dietary quality through the promotion of diverse nutrient-dense foods alongside effective S. mansoni infection control for improved growth. This study contributes fundamental knowledge for understanding the diet-malnutrition relationship in areas endemic for S. mansoni infection.

Interaction of Eating Status and Dietary Variety on Incident Functional Disability among Older Japanese Adults

OBJECTIVES

To examine whether eating status and dietary variety were associated with functional disability during a 5-year follow-up analysis of older adults living in a Japanese metropolitan area.

DESIGN

A 5-year follow-up study.

SETTING

Ota City, Tokyo, Japan.

PARTICIPANTS

A total of 10,308 community-dwelling non-disabled adults aged 65-84 years.

MEASUREMENTS

Eating status was assessed using a self-reported questionnaire. Dietary variety was assessed using the dietary variety score (DVS). Based on the responses, participants were classified according to eating alone or together and DVS categories (low: 0-3; high: 4-10). Functional disability incidence was prospectively identified using the long-term care insurance system's nationally unified database. Multilevel survival analyses calculated the adjusted hazard ratio (HR) and 95% confidence interval (CI) for incident functional disability.

RESULTS

During a 5-year follow-up, 1,991 (19.3%) individuals had functional disabilities. Eating status or DVS were not independently associated with incident functional disability. However, interaction terms between eating status and DVS were associated with functional disability; HR (95% CI) for eating together and low DVS was 1.00 (0.90-1.11), eating alone and high DVS was 0.95 (0.77-1.17), and eating alone and low DVS was 1.20 (1.02-1.42), compared to those with eating together and high DVS.

CONCLUSION

Older adults should avoid eating alone or increase dietary variety to prevent functional disability. This can be ensured by providing an environment of eating together or food provision services for eating a variety of foods in the community.

High Adherence to the Food Pyramid's Recommendations Avoids the Risk of Insufficient Nutrient Intake among Farmers in Peri-Urban Kenya

This study aimed to investigate whether the Kenyan Food Pyramid (FP) can evaluate excess or insufficient nutrient intake. Participants were farmers (56 men and 64 women, aged 18-60 years) in Wangige Village, Kiambu County-a peri-urban area of Kenya. Cross-sectional data were collected for demographic characteristics, physical measurements, and 2-day and 24-h dietary recalls. The average adherence level to the FP (hereafter, "FP score") was 25.0 out of 50.0, with a minimum and maximum of 14.1 and 41.5, respectively. Energy and protein % energy ratio were significantly higher (p for trend < 0.05) in the higher FP score group. A higher FP score was also associated with a higher energy-adjusted micronutrient intake, and it was more likely to meet nutrient requirements. However, the higher FP score group had a higher risk of excess sodium intake (p for trend < 0.001). The Kenyan FP could be a useful tool for avoiding the risk of insufficient nutrient intake, but not for avoiding high energy and sodium intake. It is necessary to include appropriate evaluations to limit energy, sugar, and salt. Food groups and recommendations of the FP should be optimised according to the dietary environment of the target population so as to promote their health.

Association between sugar and starch intakes and type 2 diabetes risk in middle-aged adults in a prospective cohort study

OBJECTIVES

We aimed to investigate the association between sugar or starch intake and the risk of type 2 diabetes (T2D) in middle-aged Japanese adults.

SUBJECTS/METHODS

Participants comprised 27,797 men and 36,880 women aged 45-75 years with no history of diabetes and critical illness before the second survey in the Japan Public Health Center-based Prospective Study. We calculated sugar (total sugar, total fructose, and sugar subtypes) and starch intakes (% energy/d) using a validated 147-item food frequency questionnaire, to estimate the average dietary intake over the previous year. T2D onset was defined by validated self-reports. ORs adjusted for potential confounders were estimated using multiple logistic regression with categorical and cubic spline models.

RESULTS

During the 5-year follow-up, 690 men and 500 women were identified with T2D. In women, the quartiles of total sugar or total fructose intakes were not significantly associated with T2D risk; however, the spline curves showed an increased risk at extremely high intake levels (ORs [95% CI]: 1.88 [1.07-3.31] at 30% energy/d for total sugar and 1.87 [1.10-3.16] at 14% energy/d for total fructose). Starch intake was positively associated with T2D risk among women in the categorical and spline models (ORs [95% CI]: 1.55 [1.13-2.12] at 50% energy/d). In men, sugar and starch intakes were not associated with T2D risk.

CONCLUSIONS

In this large-scale population-based cohort study, starch intake was associated with an increased T2D risk in Japanese women. An increased risk with extremely high intake of total sugar or total fructose among women cannot be disregarded.

[The effects of the "Tabepo Check Sheet," which lists 10 food groups, on the dietary variety of older adults in a metropolitan area]

Objectives　This study examined the effects of checking the "Tabepo Check Sheet," which has 10 food groups, on changes in dietary variety among older adults living in Japanese metropolitan areas.Methods　We used baseline and two-year follow-up data from a community-wide intervention to prevent frailty in Ota City, Tokyo. A total of 8,635 non-disabled residents (4,145 men and 4,490 women) aged 65-84 years who responded to the self-administered questionnaire surveys in 2016 and 2018, were included in the two analyses. In 2018, we asked about their experience with the "Tabepo Check Sheet," which had been distributed among participating communities from three districts in Ota City since July 2017. The "checked group" consists of those who answered "habitually check" or "have checked." Dietary variety was assessed using the Dietary Variety Score (DVS). We performed propensity score matching with a 1:1 ratio (checked group vs. non-checked group) for the following variables: demographic, socioeconomic, physical, medical, and lifestyle variables, and DVS. After propensity score matching, 876 participants from the checked and non-checked groups were selected. We used a two-way ANOVA to examine the changes in DVS over two years. We also compared the rates of DVS ≤3 and ≥7 points in 2018 using multivariate adjusted logistic regression analysis.Results　In 2018, 11.9% of the respondents had checked the "Tabepo Check Sheet." The DVS mean±standard deviation in the checked and non-checked groups were 3.9±2.2 points and 3.9±2.3 points in 2016, respectively, and 4.5±2.4 points and 4.1±2.4 points in 2018, respectively. The DVS showed a significant interaction between checking experience and time (p<0.001). The rates of DVS ≤3 points in 2018 were 35.2% and 43.8% among the checked and non-checked groups, respectively. The multivariate adjusted odds ratio (OR) of DVS ≤3 points was 0.68 (95% confidence interval [95% CI] 0.56-0.83) in the checked group versus the non-checked group. The rates of DVS ≥7 points in 2018 were 21.7% and 16.8% among the checked and non-checked groups, respectively. The multivariate adjusted OR (95% CI) of DVS ≥7 points was 1.40 (1.10-1.78) in the checked versus the non-checked group.Conclusions　These results suggest that checking the "Tabepo Check Sheet" may improve dietary variety. However, the effects of dietary variety improvement may be weakened by the incidence of skipped meals, social isolation, frailty, and lack of social participation.

Breakfast before resistance exercise lessens urinary markers of muscle protein breakdown in young men: A crossover trial

OBJECTIVES

Skipping breakfast prolongs the fasting state initiated after the last meal consumed the previous day and can have negative effects on muscle protein balance. The aim of this crossover trial was to examine the effects of skipping breakfast before a single bout of resistance exercise (RE) on muscle protein breakdown (MPB), as assessed using the urinary 3-methylhistidine/creatinine ratio (3-MH/Cr).

METHODS

Thirteen healthy young men, who habitually consumed breakfast (21.8 ± 1.1 y of age), were assigned to eating breakfast (EB) and skipping breakfast (SB) conditions. Participants consumed meat-free diets throughout the 5-d experiment. On day 5, individuals in the EB group consumed breakfast (497 kcal) 2.5 h before RE (75% repetition maximum), whereas those in the SB group consumed the same meal after dinner.

RESULTS

In the two-way analysis of variance, significant interactions were observed with blood insulin and free fatty acid levels, and the 3-MH/Cr ratio (P < 0.05). We confirmed a significantly greater decrease in the insulin level pre-RE (P < 0.001; d = 3.281), and increases in the free fatty acid level pre-RE (P < 0.001; d = 1.437) and post-RE (P = 0.013; d = 0.811) and the 3-MH/Cr ratio 6 (P < 0.001; d = 0.878) and 8 h (P < 0.001; d = 0.634) post-RE in the SB condition than in the EB condition.

CONCLUSION

Eating breakfast before RE can be beneficial for MPB suppression. The importance of breakfast consumption in terms of positive muscle protein balance is emphasized on sports fields.

Time-of-Day of Energy Intake Is Associated with Body Fat Percentage in Japanese Female University Rhythmic Gymnasts and Non-Athlete Students

This study investigated whether body fat percentage (BF%) in Japanese female university rhythmic gymnasts (RG) and non-athletes (control) was associated with the time-of-day of energy intake. A total of 57 females (RG group, n=34; control group, n=23) completed 24-h dietary recall surveys on 3 non-consecutive days. BF% was measured using a bioelectrical impedance analyzer after overnight fasting. Energy intake was stratified by time-of-day: morning (3:00 to 11:00), midday (11:00 to 17:00), evening (17:00 to 21:00), and nighttime (21:00 to 3:00). There was no significant difference between the groups in total energy intake, body weight, or body mass index. The RG group had significantly higher energy expenditure, a larger negative energy balance and lower BF% than the control group. The energy intake ratios (ER%) in the evening and at nighttime in the RG group were significantly lower and higher than in the control group, respectively. Total energy intake and energy balance did not show any significant association with BF% in either group. Multivariate linear regression with substitution model indicated that a substitution of ER% in the morning for ER% at nighttime was negatively associated with BF% after adjusting for confounding factors (β=-0.240; 95% confidence interval (CI): -0.455, -0.025) in the control group. In the RG group, a substitution of ER% in the evening for ER% at nighttime was negatively associated with BF% (β=-0.117; 95%CI: -0.214, -0.019). These results suggest that the timing of energy intake throughout the day is associated with BF% in Japanese university RG and non-athlete female students.

Nutrition and Exercise in Sarcopenia

Sarcopenia is a debilitating condition that involves loss of muscle mass and function, which affects virtually everyone as they age, and can lead to frailty and ultimately disability. In growing recognition of the importance of both muscle strength and muscle mass relative to body size in contributing to functional decline, recent definitions have now incorporated grip strength and a correction for body mass as part of the key criteria that define sarcopenia. With this new definition, a much larger population of older adults are now at risk of sarcopenia. In the present article, we reviewed the literature for studies which tested the effects of diet or exercise interventions on changes in lean mass and/or functional outcomes in individuals with either sarcopenia and/or frailty and identified 19 clinical trials. There were a few key findings. First, dietary interventions involving protein supplementation improved functional and/or strength outcomes in a few trials; however, other dietary approaches were less effective. Exercise interventions and combined diet and exercise interventions produced consistent improvements in lower body muscle strength but had less consistent effects on walking speed and grip strength. Lifestyle interventions not involving calorie restriction generally did not induce significant changes in body composition. There were a limited number of trials in which participants with sarcopenia were specifically targeted, and thus there is an important need for more research to determine the appropriate types of intervention approaches for the high risk population of sarcopenic older adults.

The Impact of Menstrual Cycle Phases on Cardiac Autonomic Nervous System Activity: An Observational Study Considering Lifestyle (Diet, Physical Activity, and Sleep) among Female College Students

Studies examining the impact of menstrual cycle phases on the cardiac autonomic nervous system have produced inconsistent results. This study aimed to investigate this relationship, controlling for the confounding effects of diet, physical activity, and sleep, which can be affected by the menstrual cycle. Fifteen female college students with regular menses were enrolled. Data regarding 24-h heart rate variability (HRV), dietary intake, eating behavior, menstrual distress, and sleep and activity parameters were obtained during the follicular and luteal phases. Power spectral analysis of HRV was used to calculate low-frequency (0.04-0.15 Hz, LF), high-frequency (>0.15 Hz, HF), and total spectral power (TP). Cardiac sympathetic and parasympathetic nervous system activity indicators were evaluated as LF/HF and HF/TP, respectively. Intake of protein and fat, as well as total sleep time and number of awakenings, were higher in the luteal phase than in the follicular phase (p<0.05). Tendencies for increased mean activity counts, emotional eating scores, and behavioral change scores in the Menstrual Distress Questionnaire were observed in the luteal phase (p<0.10). Although LF/HF was higher in the luteal phase (p=0.036), the relationship was weakened after controlling for diet, physical activity, and sleep (p=0.113). Our findings suggest that altering sympathetic nervous system activity during the menstrual cycle was not independent from major lifestyle factors (diet, physical activity, and sleep). Menstrual cycle phase and changes of these parameters should be considered when assessing the cardiac autonomic function among menstruating woman.

Higher energy intake at dinner decreases parasympathetic activity during nighttime sleep in menstruating women: A randomized controlled trial

BACKGROUND

Previous studies have found more frequent increases in dietary intake and nonrestorative nocturnal sleep during the luteal phase than in the follicular phase, but few studies have investigated how increased energy intake at dinner influences sleep by considering the correlation between female hormone and cardiac autonomic nervous system (ANS) activity. This study examined the effects of energy intake at dinner on ANS activity during nighttime sleep in order to evaluate restorative sleep in healthy women. We also examined whether ANS activity is associated with female hormone dynamics.

METHODS

Twenty-four healthy collegiate women participated in this randomized crossover trial. Each was assigned to receive a High Energy Dinner (HED) or Low Energy Dinner (LED) treatment. Energy ratios of each test meal (breakfast, lunch, and dinner) to total energy intake were 1:1:2 and 1:2:1 for HED and LED treatments, respectively. Each participant wore an ECG recorder before dinner and removed it upon waking the next morning. Power spectral analysis of heart rate variability was used to calculate low frequency (LF), high frequency (HF), and total spectral power (TP). Cardiac sympathetic (SNS) and parasympathetic (PNS) nervous system activity were evaluated as LF/HF and HF/TP, respectively.

RESULTS

Mean HF/TP for the entire sleeping period was lower with HED treatment compared to LED treatment (41.7 ± 11.4 vs. 45.0 ± 12.13, P = .034). Intergroup comparisons of the initial 3-h sleeping period revealed that LF/HF (0.87 ± 0.82 vs. 0.66 ± 0.82, P = .013) and HF/TP (45.6 ± 13.9 vs. 51.5 ± 11.8, P = .002) were higher and lower, respectively, with HED treatment compared to LED treatment. Progesterone levels were positively correlated with LF/HF with LED treatment, and negatively correlated with HF/TP with both HED and LED treatments.

CONCLUSION

Higher energy intake at dinner increases and decreases SNS and PNS activities, respectively, resulting in nonrestorative nocturnal sleep. In addition, a negative correlation was observed between progesterone and PNS activity, highlighting the difficulty of increasing PNS activity during sleep in the luteal phase compared to the follicular phase.

Evaluation of circadian phenotypes utilizing fibroblasts from patients with circadian rhythm sleep disorders

We evaluated the circadian phenotypes of patients with delayed sleep-wake phase disorder (DSWPD) and non-24-hour sleep-wake rhythm disorder (N24SWD), two different circadian rhythm sleep disorders (CRSDs) by measuring clock gene expression rhythms in fibroblast cells derived from individual patients. Bmal1-luciferase (Bmal1-luc) expression rhythms were measured in the primary fibroblast cells derived from skin biopsy samples of patients with DSWPD and N24SWD, as well as control subjects. The period length of the Bmal1-luc rhythm (in vitro period) was distributed normally and was 22.80±0.47 (mean±s.d.) h in control-derived fibroblasts. The in vitro periods in DSWPD-derived fibroblasts and N24SWD-derived fibroblasts were 22.67±0.67 h and 23.18±0.70 h, respectively. The N24SWD group showed a significantly longer in vitro period than did the control or DSWPD group. Furthermore, in vitro period was associated with response to chronotherapy in the N24SWD group. Longer in vitro periods were observed in the non-responders (mean±s.d.: 23.59±0.89 h) compared with the responders (mean±s.d.: 22.97±0.47 h) in the N24SWD group. Our results indicate that prolonged circadian periods contribute to the onset and poor treatment outcome of N24SWD. In vitro rhythm assays could be useful for predicting circadian phenotypes and clinical prognosis in patients with CRSDs.

Association of eating behaviours with diurnal preference and rotating shift work in Japanese female nurses: a cross-sectional study

OBJECTIVES

Our study examines differences in eating behaviour between day workers and rotating shift workers, and considers whether diurnal preference could explain the differences.

METHODS

Japanese female nurses were studied (39 day workers and 123 rotating shift workers, aged 21-63 years) using self-administered questionnaires. The questionnaires assessed eating behaviours, diurnal preference and demographic characteristics. The questionnaire in the Guidelines for the management of obesity disease issued by the Japan Society for the Study of Obesity was used to obtain scores for the levels of obesity-related eating behaviours, including cognition of constitution, motivation for eating, eating as a diversion, feeling of satiety, eating style, meal contents and temporal eating patterns. The Japanese version of the Morningness-Eveningness (ME) questionnaire was used to measure self-rated preference for the degree to which people prefer to be active in the morning or the evening (ME).

RESULTS

The scores for meal contents and temporal eating patterns in rotating shift workers were significantly higher than those in day workers. The ME score of rotating shift workers was significantly lower, indicating greater eveningness/less morningness among rotating shift workers. Multivariate linear regression revealed that the ME score was significantly negatively associated with temporal eating patterns and showed a negative association with the score for meal contents at a trend level, while current work shift was not significantly correlated with the scores.

CONCLUSIONS

These results suggest that eating behaviours for rotating shift workers are associated with a more unbalanced diet and abnormal temporal eating patterns and that the associations may be explained by diurnal preference rather than by rotating shift work.

Habitual dietary protein intake affects body iron status in Japanese female college rhythmic gymnasts: a follow-up study

Background

Many rhythmic gymnasts stay lean by reducing their body weight (BW); however, this may result in iron deficiency (ID). Our previous cross-sectional study reported an association between ID incidence and protein intake in gymnasts during the pre-season. The present study aimed to examine the association between dietary protein intake and ID incidence in a 2-year follow-up study.

Methods

Elite Japanese female college rhythmic gymnasts [mean age ± standard deviation (SD): 18.4 ± 0.5 years] were recruited on a voluntary basis every August for 9 years. Anthropometric, dietary intake, and hematological parameters were measured at baseline and 2 years later. A total of 20 participants without ID at baseline were divided into either a lower (L, n = 11) or higher (H, n = 9) protein group based on median protein intake (1.3 g protein/kg BW).

Results

Participants consumed 1.08 ± 0.16 and 1.55 ± 0.14 g/kg BW of protein in the L and H groups, respectively. No significant changes in the intake of protein and other nutrients were observed between baseline and 2-year follow-up in both groups. ID was observed in a total of eight (72.8 %) participants in the L group and one (11.2 %) in the H group at follow-up. The incidence of ID was significantly lower in the H group than the L group (Fisher’s exact test, odds ratio, 0.043; 95 % CI 0.004–0.552; p = 0.010).

Conclusions

During the pre-season weight loss period, habitually higher protein intake may reduce ID incidence among elite college female rhythmic gymnasts.

Initial Report for the Radiation Effects Research Foundation F1 Mail Survey

To study the full health effects of parental radiation exposure on the children of the atomic bomb survivors, the Radiation Effects Research Foundation developed a cohort of 76,814 children born to atomic bomb survivors (F1 generation) to assess cancer incidence and mortality from common adult diseases. In analyzing radiationassociated health information, it is important to be able to adjust for sociodemographic and lifestyle variations that may affect health. In order to gain this and other background information on the F1 cohort and to determine willingness to participate in a related clinical study, the F1 Mail Survey Questionnaire was designed with questions corresponding to relevant health, sociodemographic, and lifestyle indicators. Between the years 2000 and 2006, the survey was sent to a subset of the F1 Mortality Cohort. A total of 16,183 surveys were completed and returned: 10,980 surveys from Hiroshima residents and 5,203 from Nagasaki residents. The response rate was 65.6%, varying somewhat across parental exposure category, city, gender, and year of birth. Differences in health and lifestyle were noted in several variables on comparison across city and gender. No major differences in health, lifestyle, sociodemographics, or disease were seen across parental exposure categories, though statistically significant tests for heterogeneity and linear trend revealed some possible changes with dose. The data described herein provide a foundation for studies in the future.

Validity of a Semi-Quantitative Food Frequency Questionnaire for Collegiate Athletes

Background

Food frequency questionnaires (FFQs) have been developed and validated for various populations. To our knowledge, however, no FFQ has been validated for young athletes. Here, we investigated whether an FFQ that was developed and validated to estimate dietary intake in middle-aged persons was also valid for estimating that in young athletes.

Methods

We applied an FFQ that had been developed for the Japan Public Health Center-based Prospective Cohort Study with modification to the duration of recollection. A total of 156 participants (92 males) completed the FFQ and a 3-day non-consecutive 24-hour dietary recall (24hDR). Validity of the mean estimates was evaluated by calculating the percentage differences between the 24hDR and FFQ. Ranking estimation was validated using Spearman’s correlation coefficient (CC), and the degree of miscategorization was determined by joint classification.

Results

The FFQ underestimated energy intake by approximately 10% for both males and females. For 35 nutrients, the median (range) deattenuated CC was 0.30 (0.10 to 0.57) for males and 0.32 (−0.08 to 0.62) for females. For 19 food groups, the median (range) deattenuated CC was 0.32 (0.17 to 0.72) for males and 0.34 (−0.11 to 0.58) for females. For both nutrient and food group intakes, cross-classification analysis indicated extreme miscategorization rates of 3% to 5%.

Conclusions

An FFQ developed and validated for middle-aged persons had comparable validity among young athletes. This FFQ might be useful for assessing habitual dietary intake in collegiate athletes, especially for calcium, vitamin C, vegetables, fruits, and milk and dairy products.

Steroid hormone measurements from different types of assays in relation to body mass index and breast cancer risk in postmenopausal women: Reanalysis of eighteen prospective studies

Epidemiological studies have examined breast cancer risk in relation to sex hormone concentrations measured by different methods: "extraction" immunoassays (with prior purification by organic solvent extraction, with or without column chromatography), "direct" immunoassays (no prior extraction or column chromatography), and more recently with mass spectrometry-based assays. We describe the associations of estradiol, estrone and testosterone with both body mass index and breast cancer risk in postmenopausal women according to assay method, using data from a collaborative pooled analysis of 18 prospective studies. In general, hormone concentrations were highest in studies that used direct assays and lowest in studies that used mass spectrometry-based assays. Estradiol and estrone were strongly positively associated with body mass index, regardless of the assay method; testosterone was positively associated with body mass index for direct assays, but less clearly for extraction assays, and there were few data for mass spectrometry assays. The correlations of estradiol with body mass index, estrone and testosterone were lower for direct assays than for extraction and mass spectrometry assays, suggesting that the estimates from the direct assays were less precise. For breast cancer risk, all three hormones were strongly positively associated with risk regardless of assay method (except for testosterone by mass spectrometry where there were few data), with no statistically significant differences in the trends, but differences may emerge as new data accumulate. Future epidemiological and clinical research studies should continue to use the most accurate assays that are feasible within the design characteristics of each study.

Association of body mass index with lifestyle and rotating shift work in Japanese female nurses

OBJECTIVE

Higher body mass index (BMI) values have been reported in rotating shift workers compared with regular daytime workers. This study examines the relationship between work schedule and BMI, and considers whether lifestyle habits could explain the relationship.

METHODS

Japanese female nurses (1179 day workers and 1579 rotating shift workers, aged 20-59) were studied using self-administered questionnaires. The questionnaires assessed height, weight, and dietary intake, physical activity, and sleep (lifestyle) habits.

RESULTS

The BMI of shift workers was significantly higher than that of day workers. Shift workers consumed significantly higher amounts of sugar-sweetened beverages and slept for significantly shorter durations on nights between days on the day shift compared with day workers-factors which were also independently associated with higher BMI. In addition, multivariable linear regression coefficients for BMI showed a significant correlation with rotating shift work (β = 0.051), after controlling for lifestyle habits.

CONCLUSIONS

Higher consumption of sugar-sweetened beverages and shorter sleep duration were associated with rotating shift work and higher BMI. This should be taken into consideration in preventing obesity in real-life shift work situations. Other shift work-related factors, such as abnormal timing of meals and/or sleep, should also be identified.

Atypical mycobacteriosis in two patients with rheumatoid arthritis

Abstract We report two cases of rheumatoid arthritis (RA) with atypical mycobacteriosis. Opportunistic infections are critical complications for rheumatic diseases. The use of steroids or immunosuppressants may increase the risk of opportunistic infections. However, these reports are rare in that they demonstrate atypical mycobacterial infections as complications of RA, even though no immunosuppressive agents were used. We discuss the characteristics of atypical mycobacterial infections of the lung in RA.

Effects of feeding schedule changes on the circadian phase of the cardiac autonomic nervous system and serum lipid levels

PURPOSE

The purpose of this study was to investigate whether scheduling meals earlier in the day affects the circadian phase of the cardiac autonomic nervous system as assessed by heart rate variability (HRV) and serum lipid levels.

METHODS

Healthy men aged 21.4 ± 0.5 years (n = 14) with a habit of regularly skipping breakfast participated in this parallel trial involving altered feeding schedules. Participants in the early mealtime group (EM group, n = 8) were asked to eat three meals at 8:00, 13:00, and 18:00, and the control group (n = 6) ate at 13:00, 18:00, and 23:00 for 2 weeks. On the measurement day before and after intervention, fasting blood samples and 24-h electrocardiograph recordings were collected. Spectral analysis was used for approximate 10-min HRV segments. Low frequency (LF) power, high frequency (HF) power, and the ratio of HF to total power (%HF) were calculated to assess sympathovagal balance. Acrophases of the circadian rhythm of HRV variables were obtained by nonlinear least squares regression.

RESULTS

Triglyceride and total and LDL cholesterol levels were significantly decreased in the EM group when compared with the control group (p = 0.035, 0.008, and 0.004, respectively). Acrophases for HRV variables were advanced in the EM group and their difference between before and after the intervention in LF power (-3.2 ± 1.2 h) and %HF (-1.2 ± 0.5 h) reached significant level, respectively (p < 0.05).

CONCLUSIONS

Timing of meals was a key factor in regulating circadian phases of the cardiac autonomic nervous system and lipid metabolism.

Diurnal 24-Hour Rhythm in Ambulatory Heart Rate Variability during the Day Shift in Rotating Shift Workers

Circadian variation in cardiac autonomic nervous system activity and behavior during the day shifts of shift workers has not hitherto been clarified. This study examined diurnal 24-h variation in heart rate variability (HRV), sleep-wake cycle, physical activity, and food intake during the day shift in rotating shift workers. The subjects were female nurses and caregivers working at a health care facility (14 day workers and 13 rotating shift workers). Each subject was asked to undergo 24-h electrocardiograph and step count recordings. Coarse graining spectral analysis was used for approximately 10-min segments of HRV (600 beats) to derive the total power (TOT: >0.04 Hz), integrated power in the low-frequency (LF: 0.04-0.15 Hz) and high-frequency (HF: >0.15 Hz) ranges, the ratio of HF power to TOT (HF nu), and the ratio of LF power to HF power (LF/HF). Double cosinor analysis was used to obtain 24-h and 12-h period variations in variables of HRV and physical activity. While no difference was found in the acrophases of either period for step counts or in the 12-h period of HRV variables between the groups, the acrophases of the 24-h period for HRV variables were delayed by 1.3 to 5.5 h in rotating shift workers, and their differences in HF power, HF nu, and LF/HF reached a significant level ( p < 0.05). On the days of the experiment, retiring time, waking up time, total time in bed, sleep efficiency, and mealtimes and energy intake for each diet did not differ between the groups. These results suggest that there is a possibility of an abnormal phase angle between circadian variation in cardiac autonomic nervous system activity and the sleep-wake cycle during the day shift in shift workers.

Influence of dietary behavior on the circadian rhythm of the autonomic nervous system as assessed by heart rate variability

BACKGROUND

Misalignment of circadian systems is detrimental to human health. However, only a few studies have examined the influence of late meals on the human circadian system. The purpose of this study was to investigate whether delayed meals affect circadian rhythm as assessed by heart rate variability (HRV).

METHODS

Seven healthy men (aged 22.4±0.4years) participated in this study, which involved delaying mealtimes by 5h for two weeks. Prior to this study, the regular mealtimes of participants were at 08:00, 13:00, and 18:00 (Baseline). During the intervention, each meal was provided at 13:00, 18:00 and 23:00 (Late mealtimes). Circadian variation was assessed by HRV based on R-R intervals calculated from a pulse at the rising phase of each spike in the QRS complex in a 24-h electrocardiograph record. The ratio of low frequency (LF) to high frequency (HF) power (LF/HF) and the ratio of HF power to total power (%HF) were calculated using spectral analysis. The phase and amplitude of HRV variables in a 24-h period were mathematically obtained with double cosinor analysis.

RESULTS

The acrophase and amplitude for LF power, HF power and %HF in a 24-h period were not significantly different between Baseline and Late mealtimes. On the other hand, the acrophase significantly differed between Baseline and Late mealtimes for heart rate (95%CI, 1.1-3.8h), standard deviation of R-R intervals (95%CI, 2.5-4.4h) and LF/HF (95%CI, 1.1-2.3h).

CONCLUSIONS

Our findings suggest that delayed mealtimes shift the phase of circadian rhythm of the autonomic nervous system.

Effects of egg white protein supplementation on muscle strength and serum free amino acid concentrations

The aim of this study was to evaluate the effects of egg white protein compared to carbohydrate intake prior to exercise on fat free mass (FFM), one repetition maximum (1RM) muscle strength and blood biochemistry in female athletes. Thirty healthy female collegiate athletes were recruited for this study and matched by sport type, body fat percentage and 1RM leg curl muscle strength. Participants were randomly divided into two groups: protein group (15.0 g egg white protein; 75 kcal) and carbohydrate group (17.5 g maltodextrin, 78 kcal). Supplements were administered daily at the same time in a double-blind manner prior to training during an 8-week period. Measurements were performed before and after the 8-week regimen. The mean dietary energy intake did not change throughout the study period. FFM and 1RM assessments (i.e., leg curl, leg extension, squat, and bench press) increased in both groups. Furthermore, serum urea and serum citrulline levels after the 8-week regimen increased significantly only in the protein group. Our findings indicated that compared to the carbohydrate supplement, the protein supplement was associated with some changes in protein metabolites but not with changes in body composition or muscle strength.

Lipid infiltration in the parotid glands: a clinical manifestation of metabolic syndrome

BACKGROUND

The clinical features of lipid infiltration in the parotid glands (LIPG) have not been studied. Monitoring of atomic-bomb survivors for late effects of radiation exposure has provided the opportunity to review the clinical findings of LIPG.

METHODS

A total of 992 atomic-bomb survivors in Nagasaki, Japan underwent lachrymal and salivary secretion tests and anthropometric, biochemical, and abdominal ultrasonographic examinations between 2002 and 2004. Among 465 subjects who had reduced tear and/or salivary excretion, 176 subjects took a salivary magnetic resonance imaging (MRI) examination.

RESULTS

LIPG was detected in 53 of the 176 subjects who had salivary MRI. LIPG cases showed a preponderance of females and fatty liver compared with the subjects without LIPG. Age-and-sex-adjusted regression analysis revealed that body mass index (BMI), low-density lipoprotein cholesterol, triglycerides, hemoglobin A1c, and C-reactive protein were higher, whereas high-density lipoprotein cholesterol and adiponectin were lower, in the subjects with LIPG. Multivariate logistic regression analysis showed that BMI and fatty liver were mutually associated with LIPG independently from radiation dose.

CONCLUSIONS

LIPG associated with BMI, fatty liver, and coronary risk factors was a clinical manifestation of metabolic syndrome.

Relationship of dietary intake and lifestyle factors to health-related quality of life in the community-dwelling elderly

Quality of life (QOL) encompasses a broad notion of health and is increasingly used to evaluate the effectiveness of health care services. The purpose of this cross-sectional study was to assess health-related quality of life (HR-QOL) in the community-dwelling elderly (mean age, 72.7±0.3 y; female 46.4%, n=179) in Japan and to explore diminished factors. We assessed HR-QOL by the 36-Item Short-Form Health Survey (SF-36), maximum walking speed, step counts, Tokyo Metropolitan Institute of Gerontology (TMIG) index, dietary intake and blood biochemistry. Two summary scores of the SF-36 were calculated (physical component score: PCS, mental component score: MCS). We divided participants into two groups based on the standard values of PCS and MCS classified by age (high and low group), which was further stratified into a high PCS and high MCS (BH) group and a low PCS and low MCS (BL) group. Mean maximum walking speed and daily step counts were 207.7±2.8 cm/s and 7,008±289. Eighty-one percent of the participants had full scores in the TMIG index. Daily intake of energy and protein were 2,081±33 kcal and 74.5±0.9 g. The maximum walking speed, TMIG index, alcohol consumption and chewing ability were significantly higher in the BH group than those in the BL group, but not dietary intake. Stepwise logistic regression analysis indicated that maintaining maximum walking speed might be associated with sustaining HR-QOL in the healthy elderly.

Cataract in atomic bomb survivors

PURPOSE

Ophthalmologic examinations were conducted on atomic bomb (A-bomb) survivors 55 years after exposure.

MATERIALS AND METHODS

A-bomb survivors who had been exposed before 13 years of age at the time of the bombings in 1945 or who had been examined in a previous study between 1978 and 1980. The examinations, conducted between June 2000 and September 2002, included slit-lamp examination, digital photography and a cataract grading system for three parts of the lens (nucleus, cortex and posterior subcapsule) as an outcome variable. Proportional odds logistic regression analysis was conducted using the lowest grading class as a reference and included explanatory variables such as age, sex, city, dose and various cataract-related risk factors. When the grades in an individual differed, the worst grade was used.

RESULTS

Results indicate that odds ratios (ORs) at 1 Sv were 1.07 (95% confidence intervals [CI] 0.90, 1.27) in nuclear colour, 1.12 (95% CI 0.94, 1.30) in nuclear cataract, 1.29 (95% CI 1.12, 1.49) in cortical cataract and 1.41 (95% CI 1.21, 1.64) in posterior subcapsular cataract. The same was true after excluding 13 people whose posterior subcapsular cataracts had been previously detected.

CONCLUSION

Significant radiation effects were observed in two types of cataracts in A-bomb survivors.

Prevalence of adult-onset multifactorial disease among offspring of atomic bomb survivors

The first study to examine whether parental radiation exposure leads to increased heritable risk of common adult-onset multifactorial diseases (i.e., hypertension, diabetes mellitus, hypercholesterolemia, ischemic heart disease, and stroke) was conducted among 11,951 participants in the clinical examination program out of a potential of 24,673 mail survey subjects who were offspring of survivors born from May 1946 through December 1984. Logistic regression analyses demonstrated no evidence of an association between the prevalence of multifactorial diseases in the offspring and parental radiation exposure, after adjusting for age, city, gender and various risk factors. The odds ratio (OR) for a paternal dose of 1 Gy was 0.91 [95% confidence interval (CI) 0.81-1.01, P = 0.08], and that for a maternal dose of 1 Gy was 0.98 (95% CI 0.86-1.10, P = 0.71). There was no apparent effect of parental age at exposure or of elapsed time between parental exposure and birth, but male offspring had a low odds ratio (OR = 0.76 at 1 Gy) for paternal exposure, but cautious interpretation is needed for this finding. The clinical assessment of nearly 12,000 offspring of A-bomb survivors who have reached a median age of about 50 years provided no evidence for an increased prevalence of adult-onset multifactorial diseases in relation to parental radiation exposure.

Prevalence of Sjogren syndrome among Nagasaki atomic bomb survivors

OBJECTIVES

Through a comprehensive epidemiological study, we determined Sjögren syndrome (SS) prevalence and examined the association between SS and ionising radiation dose.

METHODS

A total of 1008 atomic bomb survivors in Nagasaki agreed to undergo the tests comprising a questionnaire for xerophthalmia and xerostomia, Schirmer-I test, Saxon test, and tests of anti-SS-A/Ro and anti-SS-B/La antibodies, and, if necessary, Rose Bengal stain test, salivary ultrasonographic and MRI examination from November 2002 through October 2004. Diagnosis of SS was based on the American-European Consensus Group criteria, or a modified version thereof.

RESULTS

Among the 1008 participants (male 398, female 610, average age 71.6 years), 154 participants (15.3%) complained of xerophthalmia, and 264 (26.2%) of xerostomia. Reduced tear flow as assessed by the Schirmer-I test was detected in 371 of 992 participants (37.4%) and reduced saliva flow as assessed by the Saxon test in 203 of 993 participants (20.4%). Among all participants, 38 (3.8%) and 10 (1.0%) participants tested positive for anti-SS-A/Ro and anti-SS-B/La antibodies, respectively. Taking into consideration all the results, 23 participants were diagnosed with SS (primary 20, secondary 3), yielding a prevalence of 2.3%. Although the association between SS and radiation dose was not significant, radiation dose was significantly associated with hyposalivation.

CONCLUSIONS

The present comprehensive epidemiological study reveals that the prevalence of SS was 2.3% among Nagasaki atomic bomb survivors and was not associated with radiation dose. The association between radiation dose and hyposalivation supported the possibility that radiation exposure damaged salivary gland function.

Constitutive expression of aryl hydrocarbon receptor in keratinocytes causes inflammatory skin lesions

Occupational and environmental exposure to polycyclic aromatic hydrocarbons (PAHs) has been suggested to provoke inflammatory and/or allergic disorders, including asthma, rhinitis, and dermatitis. The molecular mechanisms of this PAH-mediated inflammation remain to be clarified. Previous studies implied the involvement of PAHs as irritants and allergens, with the reactive oxygen species generated from the oxygenated PAHs believed to be an exacerbating factor. It is also possible that PAHs contribute to the pathogenesis through activation of aryl-hydrocarbon receptor (AhR)-mediated transcription, since PAHs are potent inducers of the AhR. To address this point, we generated transgenic mouse lines expressing the constitutive active form of the AhR in keratinocytes. In these lines of mice, the AhR activity was constitutively enhanced in the absence of ligands, so that any other direct effects of PAHs and their metabolites could be ignored. At birth, these transgenic mice were normal, but severe skin lesions with itching developed postnatally. The skin lesions were accompanied by inflammation and immunological imbalance and resembled typical atopic dermatitis. We demonstrate that constitutive activation of the AhR pathway causes inflammatory skin lesions and suggests a new mechanism for the exacerbation of inflammatory diseases after exposure to occupational and environmental xenobiotics.

Detection of apoptosis-specific autoantibodies directed against granzyme B-induced cleavage fragments of the SS-B (La) autoantigen in sera from patients with primary Sjögren's syndrome

The objective of this study was to detect autoantibodies against granzyme B cleavage products in sera from patients with primary Sjögren's syndrome (SS). Cell lysates derived from human salivary gland (HSG) cell lines were incubated with granzyme B. The susceptibility to the generation of cleavage fragments of SS autoantigens was assayed by immunoblotting using sera from 57 primary SS patients, 17 primary SS patients with malignant lymphoma (ML), 28 systemic lupus erythematosus (SLE) patients, and 20 healthy controls. A 27 kD protein was recognized by serum autoantibodies in 8 (14.0%) of 57 primary SS patients, 5 (29.4%) of 17 SS patients with ML, 2 (7.1%) of 28 SLE patients, but not in 20 normal subjects. This protein was recognized by anti-SSB (La) monoclonal antibodies. Granzyme B-treated recombinant La protein was also shown to migrate as a discrete 27 kD protein by SDS PAGE. Blocking studies demonstrated the existence of an apoptosis-specific B cell epitope present in sera from 2 of 8 primary SS patients and in 2 of 5 primary SS patients with ML which recognized the 27 kD protein. Granzyme B-induced La fragments are generated during cytotoxicity in vitro. This is the first report describing autoantibodies in sera from primary SS patients that specifically recognize fragments of the La protein that are produced by the granzyme B protease.

Constitutively Active Aryl Hydrocarbon Receptor Expressed Specifically in T-Lineage Cells Causes Thymus Involution and Suppresses the Immunization-Induced Increase in Splenocytes

The aryl hydrocarbon receptor (AhR) is a transcription factor belonging to the basic helix-loop-helix-PER-ARNT-SIM superfamily. Xenobiotics, such as 2,3,7,8-tetrachlorodibenzo-p-dioxin, bind the receptor and trigger diverse biological reactions. Thymocyte development and T cell-dependent immune reactions are sensitive targets of AhR-dependent 2,3,7,8-tetrachlorodibenzo-p-dioxin toxicity. However, the exact role of the AhR in T cells in animals exposed to exogenous ligands has not been clarified because indirect effects of activated AhR in other cell types cannot be excluded. In this study, we generated transgenic (Tg) mice expressing a constitutively active mutant of AhR under the regulation of a T cell-specific CD2 promoter to examine AhR function in T cells. The mRNAs of the constitutively active mutant of AhR and an AhR-induced gene, CYP1A1, were expressed in the thymus and spleen of the Tg mice. The transgene expression was clearly detected in the thymocytes, CD4, and CD8 T cells, but not in the B cells or thymus stromal cells. These Tg mice had a decreased number of thymocytes and an increased percentage of CD8 single-positive thymocytes, but their splenocytes were much less affected. By contrast, the increase in number of T cells and B cells taking place in the spleen after immunization was significantly suppressed in the Tg mice. These results clearly show that AhR activation in the T-lineage cells is directly involved in thymocyte loss and skewed differentiation. They also indicate that AhR activation in T cells and not in B cells suppresses the immunization-induced increase in both T cells and B cells.

Anti-apoptogenic function of TGFbeta1 for human synovial cells: TGFbeta1 protects cultured synovial cells from mitochondrial perturbation induced by several apoptogenic stimuli

OBJECTIVE

To investigate anti-apoptogenic mechanism of transforming growth factor beta1 (TGFbeta1) towards synovial cells.

METHODS

Isolated synovial cells, treated or not with TGFbeta1, were cultured in the presence or absence of anti-Fas IgM, proteasome inhibitor Z-Leu-Leu-Leu-aldehyde (LLL-CHO), etoposide, or C2-ceramide. After cultivation, apoptosis of synovial cells was examined by the presence of hypodiploid DNA(+) cells, the presence of terminal deoxy (d)-UTP nick end labelling(+) cells (TUNEL(+) cells), activation of caspases, and disruption of mitochondrial transmembrane potential (DeltaPsim).

RESULTS

Activation of caspase-9 and DeltaPsim was found in anti-Fas IgM treated synovial cells. The increment of both hypodiploid DNA(+) cells and TUNEL(+) cells accompanied by the activation of caspase-8 and caspase-3 was also determined in anti-Fas IgM treated synovial cells. These hallmarks for apoptosis induced by anti-Fas IgM were significantly suppressed in TGFbeta1 treated synovial cells. LLL-CHO, etoposide, and C2-ceramide also caused DeltaPsim, the increment of both hypodiploid DNA(+) cells and TUNEL(+) cells, and the activation of both Leu-Glu-His-Asp ase (LEHDase; caspase-9 like activity) and Asp-Glu-Val-Asp ase (DEVDase; caspase-3 like activity) in synovial cells. As determined in anti-Fas IgM treatment, TGFbeta1 significantly reduced apoptotic cell death of synovial cells induced by the above chemicals.

CONCLUSIONS

The protective effect of TGFbeta1 for mitochondrial homoeostasis may be important in the anti-apoptogenic function of TGFbeta1 for synovial cells.

Gene expression of detoxifying enzymes in AhR and Nrf2 compound null mutant mouse

The arylhydrocarbon receptor (AhR) regulates the expression of cytochrome P450 (CYP)-1 gene family members which catalyze xenobiotic Phase I metabolism, while Nrf2 exerts the concerted regulation of Phase II enzyme genes. We generated AhR and Nrf2 compound null mutant mice to examine the integrated function of AhR- and Nrf2-regulated enzymes in detoxification. Furthermore, we used this mouse model, by administering three different classes of chemical inducers, to examine how xenobiotic metabolism may be influenced in the absence of signals transduced by AhR or Nrf2. The compound mutant mice responded only weakly to AhR ligand or Phase II inducer, while they displayed a clear response to phenobarbital, an inducer of the CYP2B family through another, unrelated transcription factor. Here, we report an initial characterization of the AhR-Nrf2 double mutant mice, which may serve as a simplified bioassay system to evaluate xenobiotic toxicity and metabolic biotransformation of various drugs and environmental chemicals.

The role of peroxynitrite in cyclooxygenase-2 expression of rheumatoid synovium

OBJECTIVE

Reactive oxygen intermediates play an important role in the inflammatory processes of rheumatoid arthritis. Cyclooxygenase-2 is an inducible form of an enzyme involved in prostanoid biosynthesis. This study linked peroxynitrite (ONOO-) to the signaling pathways that induce COX-2.

RESULTS

Exposure of rheumatoid synovial cells to peroxynitrite resulted in COX-2 protein expression in a dose-dependent manner. RT-PCR analysis also demonstrated that COX-2 mRNA was induced in peroxynitrite-treated rheumatoid synovial cells. Dexamethasone markedly inhibited this peroxynitrite-mediated COX-2 expression at therapeutic concentrations.

CONCLUSION

This study demonstrates that oxidant stress is an important inducer of COX-2 in rheumatoid synovium. This induction may contribute to the amplification of prostanoids in the rheumatoid inflammatory process.

Expression of membrane-type 1 matrix metalloproteinase in rheumatoid synovial cells

Membrane-type 1 matrix metalloproteinase (MT1-MMP) is thought to be a putative regulator of pro-gelatinase A (MMP-2) in the rheumatoid synovium. In this study, we examined the effects of IL-1beta, one of the inflammatory cytokines, on the expression of MT1-MMP and the activation of pro-MMP-2 using rheumatoid synovial cells. We also studied the effects of KE-298 (2-acetylthiomethyl-4-(4-methylphenyl)-4-oxobutanoic acid), a new disease-modifying anti-rheumatic drug (DMARD), on MT1-MMP expression of rheumatoid synovial cells. Type B synovial cells (fibroblast-like synovial cells) were cultured with KE-298 (25-100 microg/ml) in the presence of IL-1beta for 48 h. Activation of pro-MMP-2 secreted from synovial cells was analysed by gelatin zymography. Reverse transcription-polymerase chain reaction (RT-PCR) methods were used to detect MT1-MMP mRNA. MT1-MMP protein expression on synovial cells was examined by anti-MT1-MMP immunoblot. An active form of MMP-2 was demonstrated in the culture media conditioned by IL-1beta-stimulated synovial cells. In addition, MT1-MMP mRNA and protein expression of rheumatoid synovial cells were increased by IL-1beta treatment. KE-298 blocked this IL-1beta-induced pro-MMP-2 activation and MT1-MMP expression, but did not affect IL-1beta-induced tissue inhibitor of metalloproteinase-2 (TIMP-2) secretion from rheumatoid synovial cells. These findings indicate that activation of rheumatoid synovial cells by IL-1beta results in the induction of MT1-MMP expression. Given that MT1-MMP promotes matrix degradation by activating pro-MMP-2, these results suggest a novel mechanism whereby cytokine may contribute to articular destruction in rheumatoid arthritis (RA). KE-298 may prevent this process by down-regulating MT1-MMP expression.

New disease-modifying antirheumatic drug 2 acetylthiomethyl-4-(4-methylphenyl)-4-oxobutanoic acid (KE-298) selectively augments activation-induced T cell death

We examined in this study whether the newly developed disease-modifying antirheumatic drug (DMARD) 2-acetylthiomethyl-4-(4-methylphenyl)-4-oxobutanoic acid (KE-298) augments activation-induced T cell death. Peripheral blood (PB) T cells, isolated from healthy donors, were activated by incubation with interleukin-2 (IL-2) followed by further culture with 12-0-tetradecanoyl phorbol 13-acetate (PMA) and ionomycin in the presence or absence of KE-298. The apoptosis of activated T cells was examined by flow cytometric determination of hypodiploid DNA. Fas expression and caspase-3 activity in activated T cells were also examined by flow cytometry, and expression of Fas ligand (FasL), Bcl-2-related proteins, and X chromosome-linked inhibitor of apoptosis protein (XIAP) was determined by Western blot analysis. Apoptosis was not obvious in resting T cells and was not augmented by KE-298. In contrast, apoptosis was clearly detected in activated T cells (activation-induced T cell death) with the increment of caspase-3 activity, and incubation of these cells with KE-298 further enhanced apoptosis. Treatment of activated T cells with KE-298 increased Bax expression but decreased XIAP expression without affecting the expression of Fas/FasL. Thus caspase-3 activity in activated T cells appeared to be increased by KE-298. Our results suggest that the newly developed DMARD, KE-298, selectively augmented activation-induced T cell death. This finding may contribute to the therapeutic efficacy of KE-298 in rheumatoid arthritis (RA) patients and provide new insight into the pharmacologic action of DMARDs.

Importance of NF-kappaB in rheumatoid synovial tissues: in situ NF-kappaB expression and in vitro study using cultured synovial cells

OBJECTIVES

To examine whether inhibition of NF-kappaB induces apoptosis of human synovial cells stimulated by tumour necrosis factor alpha (TNFalpha), interleukin 1beta (IL1beta), and anti-Fas monoclonal antibody (mAb).

METHODS

The expression of proliferating cell nuclear antigen (PCNA), NF-kappaB, and the presence of apoptotic synovial cells were determined in synovial tissues. Apoptosis of cultured synovial cells was induced by inhibition of NF-kappaB nuclear translocation by Z-Leu-Leu-Leu-aldehyde (LLL-CHO). The activation of caspase-3 and expression of XIAP and cIAP2 in synovial cells in LLL-CHO induced apoptosis was also examined.

RESULTS

Abundant PCNA+ synovial cells were found in rheumatoid arthritis (RA) synovial tissue, though a few apoptotic synovial cells were also detected in the RA synovial tissues. Nuclear NF-kappaB was expressed in RA synovial cells. Electrophoretic mobility shift assay showed that treatment of cells with TNFalpha or IL1beta significantly stimulated nuclear NF-kappaB activity. A small number of apoptotic synovial cells expressing intracellular active caspase-3 were found after treatment of cells with LLL-CHO. Although treatment of RA synovial cells with TNFalpha or IL1beta alone did not induce apoptosis, apoptosis induced by LLL-CHO and caspase-3 activation were clearly enhanced in TNFalpha or IL1beta stimulated synovial cells compared with unstimulated synovial cells. Furthermore, induction of apoptosis of synovial cells with caspase-3 activation by anti-Fas mAb was clearly increased by LLL-CHO. The expression of cIAP2 and XIAP in synovial cells may not directly influence the sensitivity of synovial cells to apoptosis induced by LLL-CHO.

CONCLUSION

The results suggest that NF-kappaB inhibition may be a potentially important therapeutic approach for RA by correcting the imbalance between apoptosis and proliferation of synovial cells in RA synovial tissue.

Y chromosome compound haplotypes with the microsatellite markers DXYS265, DXYS266, and DXYS241

Two newly developed microsatellite markers on Yp11 (DXYS265) and Yq11.21 (DXYS266) and our previously reported marker, on Yp11 (DXYS241), were typed by triplex polymerase chain reaction (PCR) in 102 Japanese, 18 white American, and 17 black American males. The DXYS265 locus revealed three alleles, the DXYS266 locus showed two alleles, while the DXYS241 locus showed five alleles. Nine different compound haplotypes were observed among the males. Of these, two haplotypes were common to all groups, while four were limited to Japanese. Pedigree analysis of 61 Japanese families revealed no mutations of these loci. The triplex PCR developed in this study, as well as the new loci, are useful for tracing paternal lineages in human migration studies and population analysis, in addition to Y chromosome evolutionary studies.

Novel acyl-CoA synthetase in adrenoleukodystrophy target tissues

X-linked adrenoleukodystrophy (X-ALD) is a neurodegenerative disorder characterized by demyelination of white matter. The X-ALD gene product adrenoleukodystrophy protein (ALDP) is expressed broadly among various tissues. However, deficiency of functional ALDP exclusively impairs brain, adrenal gland, and testis. Thus, loss of ALDP function is assumed to involve inactivation of a putative mediating factor that functions in a tissue-specific manner. Here we cloned a mouse cDNA encoding a novel protein, Lipidosin, that possesses long-chain acyl-CoA synthetase (LCAS) activity. Lipidosin is expressed exclusively in mouse brain, adrenal gland, and testis, which are affected by X-ALD. LCAS activity of Lipidosin was diminished by mutation of conserved amino acids within the AMP-binding domain. Mutation of the Drosophila homologue of Lipidosin has been reported to cause neuronal degeneration. Thus, Lipidosin may mediate the link between ALDP dysfunction and the impairment of fatty acid metabolism in X-ALD.

Regulation of cyclooxygenase-2 expression in human osteoblastic cells by N-acetylcysteine

Cyclooxygenase (COX) plays a pivotal role in the inflammatory process of inflammatory arthropathies. Inflammatory cytokines induce COX-2 expression in osteoblasts of inflamed joints, followed by osteoclast activation. The inhibition of COX-2 expression could help prevent prostaglandin E2 secretion, followed by osteoclast activation for bone destruction and resorption. We examined whether the antioxidant N-acetylcysteine (NAC) inhibited COX-2 expression induced in the human osteoblastic cell line MG63 by interleukin-1beta (IL-1beta). According to Western blot and reverse transcription-polymerase chain reaction (RT-PCR) test results, NAC inhibited IL-1beta-induced COX-2 expression in protein and messenger RNA. We also demonstrated immunohistochemically that NAC inhibited NFkappaB nuclear translocation. These results suggested that NAC inhibited both COX-2 expression and NFkappaB nuclear translocation in MG63, which in turn indicated that NAC could inhibit the inflammatory process involved in bone resorption by regulating COX-2 expression at the level of transcription.

MR imaging of the salivary glands in sicca syndrome: comparison of lipid profiles and imaging in patients with hyperlipidemia and patients with Sjögren's syndrome

OBJECTIVE

We correlated abnormalities on MR imaging with the plasma lipid profiles of patients with hyperlipidemia and symptoms of sicca syndrome.

SUBJECTS AND METHODS

MR imaging features of the salivary glands, salivary function, immunologic abnormalities, and plasma lipid profiles were analyzed in 24 patients with hyperlipidemia and symptoms of sicca syndrome and compared with those of 50 patients with Sjögren's syndrome.

RESULTS

Swelling of the parotid gland, impaired salivary flow, or both were observed in 20 (83%) of 24 patients with hyperlipidemia and symptoms of sicca syndrome. MR imaging findings included an enlarged parotid gland replaced with extensive lipid infiltration, whereas sialography of the parotid gland revealed normal findings. Immunologic studies and analyses of the labial glands of the mouth revealed distinctive features in patients with Sjögren's syndrome. Importantly, elevated levels of plasma triglyceride correlated with parotid gland swelling, and increased cholesterol levels significantly affected salivary flow.

CONCLUSION

Our findings suggest a distinct entity of sicca syndrome in patients with hyperlipidemia compared with patients with Sjögren's syndrome. Characteristic MR imaging findings of salivary glands in patients with hyperlipidemia included extensive lipid infiltration and gland enlargement.

Effect of vitamin K2 on osteoblast apoptosis: vitamin K2 inhibits apoptotic cell death of human osteoblasts induced by Fas, proteasome inhibitor, etoposide, and staurosporine

Vitamin K2 is used for the treatment of osteoporosis, but the precise mode of action is still not clear. We investigated the effects of vitamin K2 on apoptosis of human osteoblasts. Human osteoblastic cell line MG63 cells and human primary osteoblast-like cells obtained from bone fragments in corrective surgery were used as human osteoblasts. Cells were cultured with or without various concentrations of vitamin K2 and tumor necrosis factor-alpha (TNF-alpha). We then determined the proliferative response, expression of Fas and Bcl-2-related proteins, and Fas-mediated apoptosis of these cells induced by anti-Fas immunoglobulin M (IgM). In addition, the effect of vitamin K2 in osteoblast apoptosis induced by Z-Leu-Leu-Leu-aldehyde (LLL-CHO), etoposide, or staurosporine was also examined. Human osteoblasts did not show spontaneous apoptosis in culture, even in the presence of vitamin K2 or TNF-alpha. Furthermore, proliferation of the cells was not influenced by vitamin K2 or TNF-alpha. Fas was functionally expressed on human osteoblasts, and the treatment with TNF-alpha significantly enhanced both Fas expression and Fas-mediated apoptosis of osteoblasts. The addition of vitamin K2 to the culture resulted in a dose-dependent inhibition of functional Fas expression on osteoblasts, in the presence or absence of TNF-alpha. Treatment of human osteoblasts with vitamin K2 clearly suppressed Bax expression of the cells, although the expression of Bcl-2 was not influenced by vitamin K2. Fas ligand (FasL) cDNA transformants were cytotoxic against osteoblasts, and the cytotoxicity was increased when osteoblasts were treated with TNF-alpha. The addition of vitamin K2 to osteoblasts significantly decreased the cytotoxic effects of FasL cDNA transformants. Furthermore, apoptosis of human osteoblasts induced by LLL-CHO, etoposide, or staurosporine was also clearly suppressed in vitamin K2-treated osteoblasts. Our results suggest that vitamin K2 inhibits apoptotic cell death of osteoblasts and maintains the number of osteoblasts. These actions may explain the therapeutic efficacy of vitamin K2 in osteoporosis.