Middle-aged Japanese Subjects Research Articles

Basal ganglia lesions may be a risk factor for characteristic features of a glaucomatous optic disc: population-based cohort study in Japan

BackgroundWe conducted a study to investigate the relationship between optic nerve vertical cup-to-disc ratio (VCDR), body and ocular parameters, and brain lesions in middle-aged and above Japanese subjects, because although...

PS-C06-12: HETEROGENEITY AND OVERLAP OF THE LONGITUDINAL ASSOCIATIONS AMONG INCREASED ARTERIAL STIFFNESS, HYPERTENSION AND DIABETES MELLITUS: A 16-YEAR PROSPECTIVE OBSERVATIONAL STUDY

Background: Hypertension and diabetes mellitus frequently coexist; however, differences in the bi-directional longitudinal relationships of arterial stiffness with hypertension and diabetes mellitus have not yet been clarified. Methods: In this 16-year prospective observational study, 3981 middle-aged Japanese subjects without hypertension/diabetes mellitus at the study baseline underwent annual measurements of the blood pressure, serum glycosylated hemoglobin A1c (HbA1c), and brachial-ankle pulse wave velocity (baPWV). Results: By the end of the study period, 664, 779, 154 and 406 subjects developed hypertension, prehypertension, diabetes mellitus and prediabetes, respectively. Increased baPWV at the baseline was associated with a significant odds ratio for new onset of prehypertension/hypertension without (beta = 5.0 x 10–3, P < 0.01) or with (beta = 4.0 x 10–3, P < 0.01) coexisting prediabetes/diabetes mellitus; no such association was found with new onset of prediabetes/diabetes mellitus alone. Furthermore, baPWV showed significant longitudinal associations with the development of all of the above conditions. Conversely, elevated mean blood pressure, even in the pre-hypertensive range, showed a significant longitudinal association with increase of the baPWV. Conclusions: In middle-aged Japanese subjects, a vicious cycle may be triggered between elevated blood pressure, even from the prehypertensive stage, and arterial stiffening and development of diabetes mellitus may be observed as a cross phenomenon of this vicious cycle with a collateral event. Arterial stiffness may be a key element in the development of hypertension, so that its contribution to cardiovascular risk may be greater in patients with hypertension than in those with diabetes mellitus.

PS-C04-2: LONGITUDINAL CONSTANCY OF VASCULAR AGEING PHENOTYPES AND FACTORS ASSOCIATED WITH THE PHENOTYPE CONSTANCY OVER TIME

Background: The concept of two phenotypes of vascular aging, healthy vascular aging (HVA) and early vascular aging (EVA) has been proposed. Objectives: To examine the: (1) constancy of these phenotypes over time; (2) validity of assuming that a constantly maintained phenotype reflects the rate of structural arterial stiffening; and (3) longitudinal associations between the vascular phenotypes and cardiovascular risk factors/heart rate (HR). Methods: The brachial-ankle pulse wave velocity (baPWV) was measured annually over a 16-year period in 4682 middle-aged Japanese subjects. The vascular phenotypes of 4682 middle-aged Japanese subjects were measured at the start and end of a 16-year study period, by measuring the arterial stiffness as a function of the age and blood pressure. Results: Of 4682 subjects, 158 (3.4%) showed constancy of the HVA phenotype, and 192 (4.1%) subjects showed constancy of the EVA phenotype throughout the study periods. The baPWV adjusted for the mean blood pressure differed significantly between the two groups. Elevated mean blood pressure, serum HbA1c levels and HR were significantly associated with constancy of the EVA phenotype, whereas only a low HR was significantly associated with constancy of the HVA phenotype. Conclusions: In middle-aged Japanese subjects with the HVA/EVA phenotype at the study baseline, while the phenotype changed during the study period in many subjects, phenotype constancy appeared to reflect the rate of structural arterial stiffening. Elevated blood pressure and abnormal glucose metabolism were associated with constancy of the EVA phenotype. On the other hand, HR was a robust marker of the presence/constancy of the HVA/EVA phenotype.

Association of pulse wave velocity and pressure wave reflection with the ankle-brachial pressure index in Japanese men not suffering from peripheral artery disease

Background and aimsWe examined the cross-sectional and longitudinal association of arterial stiffness and pressure wave reflection with the ankle-brachial pressure index (ABI) in middle-aged Japanese subjects free of peripheral artery disease (PAD). MethodsABI, brachial-ankle pulse wave velocity (baPWV) and radial augmentation index (rAI) were measured annually during the 9-year observation period in 3066 men (42 ± 9 years old) with ABI ≥1.00 at baseline of the study period, and not taking any antihypertensive medication. ResultsIn the cross-sectional assessments, mediation analysis demonstrated that baPWV showed both direct and indirect (via the rAI) associations with ABI, and rAI showed both direct and indirect (via the heart-arm difference of systolic blood pressure) associations with the ankle-arm difference of systolic blood pressure, both at study baseline and end of study period. Mixed model linear regression analysis of the repeated-measurement data obtained over the 9-year observation period demonstrated that annual increase of baPWV (estimate = 0.73 × 10−4, p < 0.01) and rAI (estimate = 0.33 × 10−3, <0.01) was associated with ABI. When baPWV and rAI were entered into the same model, only baPWV showed a significant longitudinal association with ABI. ConclusionIn middle-aged Japanese men free of PAD, arterial stiffness may contribute to ABI directly and via pressure wave reflection. Pressure wave reflection may contribute to ABI directly and, at least in part, via attenuation of peripheral pulse pressure amplification.

Gender differences in patterns of relationship between body mass index and AF incidence

Abstract Background Obesity is reportedly associated with the new incidence of atrial fibrillation (AF). However, gender differences in patterns of relationship between body mass index (BMI) and the risk of AF are unknown. Methods We analyzed 21,382 middle-aged Japanese subjects (10923 men, 10459 women) without AF from a cohort of employees undergoing annual health examinations, with a follow-up period of 4.8±3.7 years. We examined the relationship between BMI at baseline to AF incidence in unadjusted and adjusted analyses. This relationship was also studied using linear and quadratic models. Results AF had developed in 137 subjects (119 men; mean age, 54.4±8.2 years; incidence, 2.19 and 0.38 per 1000 person-years in men and women, respectively). In multivariable Cox proportional-hazard models, increasing age (hazard ratio [HR], 2.72 per year; 95% CI, 2.22 to 3.33; P&amp;lt;0.001), male gender (HR, 3.28; 95% CI, 1.86 to 5.76; P&amp;lt;0.001) and BMI (HR, 1.08; 95% CI, 1.02 to 1.15; P=0.007) were associated with the new incidence of AF in all cohorts. The shape of the BMI-incident AF relationship showed a linear association in women and a J-shaped association in men. (Figure) In particular, a U-shaped relationship was observed in young men aged 40–49, with increased risk among those with higher BMI and with very low BMI. In analyses adjusted for comorbidities and risk factors for CV disease, the U-shaped AF incidence versus BMI curves were not attenuated, suggesting that other genetic or congenital factors may mediate this relationship. Conclusion Our results indicate that the shape of the BMI-incident AF relation differs by sex and in particular a U-shaped relationship was observed in young men. Patterns of relation among BMI and AF Funding Acknowledgement Type of funding source: None

Higher circulating orosomucoid, an acute-phase protein, and reduced glucose-induced insulin secretion in middle-aged Japanese people with prediabetes

IntroductionCirculating orosomucoid, an acute-phase protein, predicted type 2 diabetes mellitus risk in several Western countries. Here, we assessed serum orosomucoid (ORM) in relation to prediabetes in the Japanese.Research design and...

Combined effect of hemoglobin and mean corpuscular volume levels on incident metabolic syndrome: A population-based cohort study

Higher hemoglobin levels are associated with incident metabolic syndrome (MetS), and higher mean corpuscular volume (MCV) is associated with adverse outcomes. The objective of this study is to evaluate the combined effect of MCV and hemoglobin levels on incident MetS. In our cross-sectional study, we analyzed the prevalence of MetS in 20,162 middle-aged Japanese subjects without anemia and with normal MCV levels, as they underwent physical checkups. We subsequently analyzed incident MetS in 11,110 subjects. In order to evaluate the combined effect on incident MetS, the subjects were divided into four study groups according to cutoff values of hemoglobin and MCV for identifying the prevalence of MetS. In the cross-sectional study, hemoglobin (adjusted odds ratio [aOR], 1.02; P<0.0001 in men and OR, 1.04; P<0.0001 in women, per 1.0g/L) and MCV (aOR, 0.93; P<0.0001 in men and OR, 0.94; P=0.0005 in women, per 1.0fL) were independently associated with the prevalence of MetS. In the longitudinal cohort study, hemoglobin (adjusted hazards ratio [aHR, 1.12; P=0.0006, per 1.0g/L) and MCV (aHR, 0.96; P<0.0001, per 1.0fL) were independently associated with incident MetS in men but not in women. Then, the lower hemoglobin/higher MCV group showed decreased HRs for incidence of MetS compared with other groups of men but not of women. Among the subjects without anemia and with normal MCV levels, higher hemoglobin or lower MCV levels were associated with higher prevalence of MetS in men and women. In addition, lower hemoglobin with higher MCV showed a decreased risk of MetS in men. We suggested that the assessment of hemoglobin and MCV levels could be used as practical screening tool for MetS.

1525-P: Serum Uric Acid Level Is an Independent Risk Factor for Glomerular Filtration Rate Decline in Patients with Untreated Type 2 Diabetes

Decline in kidney function is a major concern for patients with type 2 diabetes. The importance of serum uric acid level as the risk factor for chronic kidney disease (CKD) remains unconfirmed. We therefore evaluated the relationship between baseline serum uric acid level and the risk of incident CKD among men with untreated type 2 diabetes at baseline examination in a 10-11 years prospective cohort study. We included 717 middle-aged Japanese subjects with fasting plasma glucose level ≥126 mg/dL or HbA1c ≥6.5% at baseline who were not taking hypoglycemic medications nor insulin, who had an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2, who did not have proteinuria nor malignant tumors, and who were not taking anti-hypertensive medications nor urate-lowering medications at baseline. CKD was defined as eGFR &amp;lt;60 ml/min/1.73 m2. Cox proportional hazards models were used in the multivariate analysis. During the 5961 person-years follow-up period, 87 subjects developed CKD. Higher serum uric acid level was associated with an increased risk of CKD after adjustment for age, body mass index, systolic blood pressure, diastolic blood pressure, HbA1c, smoking habits (nonsmokers, past smokers, and current smokers), regular leisure-time physical activity (yes/no), daily alcohol consumption (g ethanol/day), and eGFR at baseline. Multiple-adjusted hazard ratios of CKD for quintile 4 (6.2-6.9 mg/dL) and quintile 5 (≥7.0 mg/dL) of serum uric acid levels were 1.30 (95% CI, 0.73-2.30) and 1.80 (95% CI, 1.04-3.11), respectively, compared with quintile 1 to 3 (0.7-6.1 mg/dL). Moreover, when we modeled serum uric acid level as a continuous variable, serum uric acid level per 1.0 mg/dL increase was significantly associated with a 25% increased risk of incident CKD. In conclusion, higher serum uric acid level is independently and significantly associated with an increased risk of CKD in patients with untreated type 2 diabetes. Disclosure Y. Okada: None. K.K. Sato: None. M. Shibata: None. S. Uehara: None. H. Koh: None. K. Oue: None. H. Kambe: None. M. Morimoto: None. T. Hayashi: None.

Relationship between nonalcoholic fatty liver disease and muscle quality as well as quantity evaluated by computed tomography.

Sarcopenia is reported to be associated with nonalcoholic fatty liver disease (NAFLD). Evaluation of skeletal muscle attenuation and area by computed tomography (CT) may represent a promising approach for evaluation of the risk of NAFLD. We examined the association between skeletal muscle characteristics and NAFLD and investigated the combined effect of these parameters on the prevalence of NAFLD. In this cross-sectional study, we analysed data from 632 middle-aged Japanese subjects without daily alcohol intake (353 men and 279 women) from a cohort of employees undergoing annual health examinations. The cross-sectional skeletal muscle area was evaluated on the basis of CT data at the level of the third lumbar vertebrae, and the skeletal muscle index (SMI) and density (SMD) were calculated. The subjects were divided into four study groups according to their SMI and SMD relative to median values. One hundred forty men and forty-three women had NAFLD. Total SMI (odds ratio [OR] per 1.0cm2 /kg/m2 increase 0.43, 95% confidence interval [CI] 0.29-0.64 in men and OR 0.21, 95% CI 0.10-0.42 in women) and total SMD (OR, per 1.0 Hounsfield Unit increase 0.88, 95% CI 0.83-0.93 in men and 0.88, 0.82-0.95 in women) were significantly associated with the prevalence of NAFLD after adjusting for covariates. The subgroup with simultaneous presence of low SMI and low SMD was associated with a significantly higher prevalence of NAFLD compared with other groups. Both SMI and SMD are independently associated with the prevalence of NAFLD.

Relationship between metabolic syndrome and trunk muscle quality as well as quantity evaluated by computed tomography

Metabolic syndrome is a cluster of metabolic abnormalities. Skeletal muscle attenuation and area evaluated by computer tomography (CT) may provide valuable information about patients with metabolic disorder. Therefore, we examined the association between skeletal muscle characteristics and metabolic syndrome, and investigated the combined effect of quantitative and qualitative muscle parameters. In this cross-sectional study, we analyzed 808 middle-aged Japanese subjects. The cross-sectional area of skeletal muscle was evaluated based on CT at the third lumbar vertebrae. The subjects were divided into four groups according to the median levels of skeletal muscle index (SMI) and density (SMD). Eighty-five men and twenty-two women had metabolic syndrome. In the adjusted model, SMI and SMD had an interaction effect on the number of metabolic syndrome components (p=0.0398 in men and p=0.0306 in women). When SMI and SMD were considered as independent variables for multiple regression analysis, SMI (β=-0.155, p=0.0019 in men and β=-0.295, p<0.0001 in women) and SMD (β=-0.355, p<0.0001 in men and β=-0.324, p<0.0001 in women) were both independently associated with the number of metabolic syndrome components. The subgroup with presence of low SMI and low SMD levels had a significantly higher prevalence of metabolic syndrome than that observed in other groups. Therefore, we suggest that not only muscle quantity but also quality is independently associated with metabolic syndrome.

Potential impact of the joint association of total bilirubin and gamma-glutamyltransferase with metabolic syndrome

BackgroundMetabolic syndrome is characterized by the clustering of different metabolic abnormalities. Total bilirubin and gamma-glutamyltransferase (GGT) levels have been reported to be associated with this condition. However, the extent to which the interaction between these parameters affects metabolic syndrome is unknown. Therefore, we examined the association of total bilirubin and GGT levels with metabolic syndrome, and investigated the combined effect of the two parameters.MethodsIn this retrospective cohort study, we analyzed 8992 middle-aged Japanese subjects (4586 men, 4406 women; mean age, 44.8 ± 9.3 years) without metabolic syndrome from a cohort of employees undergoing annual health examinations. They were divided into four groups according to median total bilirubin and GGT levels: both-low, GGT-high, total bilirubin-high, and both-high. The incident of metabolic syndrome was evaluated during a follow-up of 2.8 ± 1.2 years.ResultsThe incident rate of metabolic syndrome during the follow-up was 4.6% in the both-low group, 12.1% in the GGT-high group, 2.7% in the total bilirubin-high group, and 10.6% in the both-high group. Total bilirubin and GGT have an interaction effect on the risk of incident metabolic syndrome (p = 0.0222). The both-low [hazard ratio (HR), 1.37; 95% confidence interval (CI) 1.002–1.89], GGT-high (HR, 1.88; 95% CI 1.42–2.52), and both-high (HR, 2.07; 95% CI 1.56–2.80) groups showed an increased adjusted HR for incident metabolic syndrome after adjusting for covariates compared with the total bilirubin-high group.ConclusionsThe simultaneous presence of high total bilirubin and low GGT levels may be associated with a lower incidence of metabolic syndrome.

Abstract TP222: Silent Brain Infarct (SBI) on MRI, Not White Matter Lesions, is Related to 10-year Stroke Risk Prediction in Middle-aged Healthy Japanese Individuals

Background: Periventricular hyperintensity (PVH), deep and subcortical white matter hyperintensity (DSWMH), and silent brain infarct (SBI) have been proposed as subclinical risk markers for future symptomatic stroke onset. However, the differences between PVH, DSWMH, and SBI as markers for eventual development of symptomatic stroke in middle-aged healthy Japanese individuals has not been adequately explored. Methods: We examined 280 Japanese adults (92 female, mean age, 52.9±5 years) with no history of cardio-cerebrovascular disease. PVH, DSWMH, SBI and various vascular risk factors for each subject were assessed, and 10-year stroke risk was predicted using the point-based prediction model provided by the Japan Public Health Center (JPHC) study, which consists of six risk factors that are used to calculated predicted stroke risk, including age, sex, smoking status, body mass index (BMI), blood pressure (BP), and diabetes status. Results: The subjects were divided into four groups based on predicted stroke risk: low, &lt;1%; low-medium, 1- &lt;5%; medium-high, 5-&lt;10%; high, ≥10%. According to the JPHC study risk-prediction algorithm, a PVH grading ≥ 2, a DSWMH grading ≥2, and a SBI number ≥1 were positively correlated with an increase in predicted stroke risk. Age, systolic BP, HbA1c levels, eGFR, hypertension, diabetes mellitus, and family history of cardio-cerebrovascular disease (CCVD) were found to be significantly associated with SBI. The odds ratio (OR) for high predicted stroke risk (10-year risk ≥10%) showed significance for SBI ≥1, even after adjusting for potential confounding factors (OR, 12.45: 95% CI, 3.09-50.84), whereas the ORs for PVH and DSWMH were not significant. Conclusion: The presence of an SBI, not white matter lesions, was significantly correlated with an increased 10-year stroke risk, suggesting that detection of SBI by MRI may be practical for identifying a high risk of stroke for middle-aged Japanese subjects.

Plasma tea catechins and risk of cardiovascular disease in middle-aged Japanese subjects: The JPHC study

Background and aimsAlthough a potential benefit of drinking green tea has been suggested to reduce the development of cardiovascular disease, no study has investigated the relationship between plasma tea catechin and risk of cardiovascular disease. MethodsA prospective, nested case-control study was conducted to examine the association between plasma tea catechin and risk of stroke and coronary heart disease (CHD) in a cohort of 29,876 men and women aged 40–69 years without history of heart disease, stroke or cancer. Participants completed a survey and donated blood samples between 1990 and 1994, and were followed-up through 2008. A total of 1132 stroke cases and 209 CHD cases, matched 1:1 to controls (n = 1132) for stroke and 1:2 to controls (n = 418) for CHD, were included in the analysis. ResultsWe found no significant association between plasma tea catechin and the incidence of stroke or CHD in either men or women. However, we found that high plasma levels of epigallocatechin gallate (EGCG) were associated with reduced risk of stroke in non-smoking men; the adjusted odds ratio (95% CI) for the highest vs. non-detectable levels was 0.53 (0.29–0.98). The respective OR in male smokers was 1.23 (0.75–2.16). A significant interaction by smoking status was found for the highest vs. non-detected plasma EGCG in relation to stroke (p-for-interaction: p = 0.09). ConclusionsPlasma tea catechin was not associated with reduced risks of either stroke or CHD, while a protective effect of certain tea catechin on stroke risk is suggested for male non-smokers.

Abstract 14004: Role of Inflammation in the Pathogenesis of Hypertension a 9-year Repeated-measures Data Analysis in a Prospective Cohort Study

Introduction: The underlying mechanisms of the association of inflammation with the development of hypertension has not been clarified. Hypothesis: Inflammation affect the development of hypertension via vascular and/or renal abnormalities. Methods: The association of inflammation with vascular and/or renal abnormalities, and the association of such abnormalities with elevation of the blood pressure were examined by analyzing longitudinal repeated-measures data using a linear mixed model (LMM) approach in a 9-year prospective observational study. 3908 middle-aged Japanese employees of the construction company (aged 41 ± 9 years old) without hypertension at the study baseline. The blood pressure, brachial-ankle pulse wave velocity (baPWV), radial augmentation index (rAI), estimated glomerular filtration rate (eGFR; based on the serum creatinine) and serum C-reactive protein (CRP) levels were measured annually in the subjects from year 2007 to year 2015. Results: During this study period, 520 subjects (13%) developed hypertension. LMM analysis of the obtained repeated-measures data after adjustments for covariates revealed the following: 1) At each annual measurement, higher annual values of the log-transformed CRP were associated with a higher annual increase of the baPWV (beta = 62.647 ± 26.017, p &lt; 0.001), but not the annual increase of the rAI or annual decrease of the eGFR; 2) higher annual values of the baPWV were associated with a higher annual elevation of the blood pressure (beta = 0.032 ± 0.001, p &lt; 0.001). Conclusions: In middle-aged Japanese subjects without hypertension at the study baseline, the presence of inflammation, as reflected by serum CRP levels, appears to be associated with the longitudinal increase of the arterial stiffness, but not with abnormal progression of the central hemodynamics or decline of the glomerular filtration rate. In turn, this longitudinal increase in the arterial stiffness appears to be associated with the longitudinal elevation of the blood pressure to hypertensive range. Thus, inflammation may play a role in the pathogenesis of hypertension via the accelerated progression of arterial stiffness.

Impaired fasting glucose as an independent risk factor for hypertension among healthy middle-aged Japanese subjects with optimal blood pressure: the Yuport Medical Checkup Centre retrospective cohort study

BackgroundThis study aimed at investigating whether impaired fasting glucose (IFG) is an independent risk factor for incident hypertension among middle-aged Japanese subjects with optimal blood pressure (OBP).FindingsThis retrospective cohort study was conducted in 2943 non-diabetic and non-hypertensive subjects aged 40–64 years, who participated in a voluntary health check-up program during the baseline (1998–2002) and follow-up periods (2002–2006). A multiple logistic regression model was utilized to calculate the odds ratio (OR) of incident hypertension among men and women with IFG and OBP. OBP was defined as systolic blood pressure (SBP) <120 mmHg and diastolic blood pressure (DBP) <80 mmHg, with no known history of hypertension. In this study, hypertension was defined as SBP ≥140 mmHg and DBP ≥90 mmHg or by a self-reported clinical diagnosis of hypertension. After the mean follow-up period of 5.6 years, the incidence of hypertension in men and women was 5.7% (73/1270) and 3.8% (62/1673), respectively. The age-adjusted ORs for incident hypertension in men and women with IFG were 1.95 (95% CI, 1.21–3.15) and 3.54 (95% CI, 2.00–6.27), respectively. After adjusting for age, systolic blood pressure, body mass index, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and uric acid, the ORs for hypertension were 1.66 (95% CI; 1.02–2.70) for men and 2.62 (95% CI, 1.45–4.73) for women.ConclusionThe study results show that IFG may act as an independent risk factor for developing hypertension in individuals with OBP.

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

BackgroundSeveral genetic polymorphisms have been reported to modify the effects of smoking on serum lipid levels. The objective of this study was to investigate whether longevity-associated mitochondrial DNA 5178 (Mt5178) C/A polymorphism modifies the effects of habitual smoking on the risk of dyslipidemia in middle-aged Japanese subjects.MethodsA total of 394 male subjects (age, 53.9 ± 7.9 years; mean ± SD) were selected from among individuals visiting the hospital for regular medical check-ups. After Mt5178 C/A genotyping, a cross-sectional study assessing the joint effect of Mt5178 C/A polymorphism and cigarette smoking on the risk of hypo-high-density lipoprotein (HDL) cholesterolemia, hyper-low-density lipoprotein (LDL) cholesterolemia or hypertriglyceridemia was conducted.ResultsFor subjects with Mt5178C, the risk of hypo-HDL cholesterolemia increased with the number of cigarettes smoked daily (P for trend = 0.001). On the other hand, the association between Mt5178A genotype and the risk of hypo-HDL cholesterolemia did not appear to depend on the number of cigarettes smoked daily. For those with Mt5178A, the risk of hyper-LDL cholesterolemia or hypertriglyceridemia increased with cigarettes smoked daily (P for trend = 0.017 and P for trend = 0.002, respectively). However, the association between Mt5178C genotype and the risk of hyper-LDL cholesterolemia or hypertriglyceridemia did not depend on the number of cigarettes smoked daily.ConclusionsThe present results suggest that Mt5178 C/A polymorphism modulates the effects of habitual smoking on the risk of dyslipidemia in middle-aged Japanese men.

Decreased Salt Intake in Japanese Men Aged 40 to 70 Years and Women Aged 70 to 79 Years: An 8-Year Longitudinal Study

Background It is not known whether salt intake decreases over time in the same population. This study attempts to describe salt intake for 8 years according to age groups, and examines whether salt intake changes over time in community-dwelling middle-aged and elderly Japanese subjects. Methods Data were collected as part of the National Institute for Longevity Sciences Longitudinal Study of Aging. Participants included 544 men and 512 women who participated in and completed all nutrition surveys from the first (1997-2000) to fifth (2006-2008) study waves. Each study wave was conducted for 2 years; in individuals, the entire follow-up period was 8 years. Salt and energy intake were calculated from 3-day diet records with photographs. The mixed-effects regression model was used for analysis of repeated measures of salt intake. Results Mean age and salt intake for study participants at first participation in the survey were 56.5±9.3 years and 12.8±3.3 g/day in men and 55.8±9.4 years and 10.6±2.5 g/day in women, respectively. Mean energy intake decreased in men and women in all age groups from the first to fifth study waves. Eight-year longitudinal data showed that salt intake decreased in men. In stratified analyses by age, mean salt intake in men decreased 0.08 g/year among 40- to 49-year-olds, 0.09 g/year among 50- to 59-year-olds, 0.16 g/year among 60- to 69-year-olds, and 0.14 g/year among 70- to 79-year-olds. For women, mean salt intake decreased 0.08 g/year among 70- to 79-year-olds ( P=0.098). After adjusting for energy intake, salt intake was decreased among 60- to 69-year-old men ( P=0.049) and increased among 50- to 59-year-old women ( P=0.015). Conclusions Absolute salt intake was decreased among all age groups from 40 to 70 years in men and from 70 to 79 years in women. An increased focus on reducing energy intake resulted in only a modest decrease in salt intake. Although we observed a decline, salt intake still exceeded recommended levels. Efforts that focus on salt reduction are needed to address this important public health problem.

Increased reactive oxygen metabolites is associated with cardiovascular risk factors and vascular endothelial damage in middle-aged Japanese subjects

BackgroundVascular endothelium, a provider of nitric oxide, is essential for the maintenance of homeostasis in healthy vascular systems. Increased oxidative stress promotes vascular inflammation and is a common pathway involved in endothelial damage. The present study sought to investigate the usefulness of derivative reactive oxygen metabolites (d-ROM) as an oxidative stress marker for detecting endothelial damage in the clinical setting in subjects with early-stage atherosclerosis.MethodsStudy 1 investigated the relationship between serum d-ROM levels and cardiovascular risk factors in apparently healthy middle-aged subjects (n = 1992, 49 ± 8 years) who participated in our health checkup program. Study 2 analyzed the association between d-ROM levels and endothelial function assessed by flow-mediated dilation and that between d-ROM levels and high-sensitivity C reactive protein (hs-CRP) levels in middle-aged outpatients with mild-to-moderate cardiovascular risk (n = 43, 40 ± 5 years).ResultsIn study 1, the d-ROM level was independently correlated with age, systolic blood pressure, fasting plasma glucose, low-density lipoprotein cholesterol, and brain natriuretic peptide in univariate and multivariate regression analysis. In study 2, the d-ROM level was correlated positively with the hs-CRP level and inversely with the flow-mediated dilation value. Patients in the highest tertile of d-ROM had significantly lower flow-mediated dilation values compared with patients in the other tertiles. Moreover, after subdivision of patients into four groups according to d-ROM and hs-CRP levels, patients with high levels of both d-ROM and hs-CRP showed significantly reduced flow-mediated dilation as compared with those with low levels of both indices.ConclusionThe close relationship of d-ROM with cardiovascular risk factors, brain natriuretic peptide, inflammatory markers (hs-CRP), and endothelial function (flow-mediated dilation) suggest that d-ROM is a useful oxidative stress marker for detection of endothelial damage in the clinical setting. Assessment of d-ROM, especially combined with hs-CRP, may be a possible predictor of cardiovascular disease.

Erythrocytes Carotenoids after Astaxanthin Supplementation in Middle-Aged and Senior Japanese Subjects

A randomized, double-blind human trial was conducted to assess the effect of 4- or 12-week astaxanthin supplementation (1 or 3 mg/day) on the carotenoid compositions of erythrocytes in Japanese middle-aged and senior subjects. Erythrocyte astaxanthin concentrations after 4- or 12-weeks of supplementation (3 mg/day) was significantly higher than after placebo or 1 mg astaxanthin supplementations. No differences were observed in either the carotenoid compositions or the phospholipid hydroperoxide concentrations in erythrocytes after astaxanthin intake in both the 1 and 3 mg/day groups.

Nocturnal intermittent hypoxia and C reactive protein among middle-aged community residents: a cross-sectional survey

BackgroundThere are conflicting results for the association between obstructive sleep apnoea and raised C reactive protein (CRP) levels. A study was undertaken to investigate whether nocturnal intermittent hypoxia, a surrogate...