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Aim: To determine the optimal cut-off value of serum total adiponectin for managing the risk of developing metabolic syndrome (MetS) in male Japanese workers. Methods: A total of 365 subjects without MetS aged 20–60 years were followed up prospectively for a mean of 3.1 years. The accelerated failure-time model was used to estimate time ratio (TR) and cut-off value for developing MetS. Results: During follow-up, 45 subjects developed MetS. Age-adjusted TR significantly declined with decreasing total adiponectin level (≤ 4.9, 5.0–6.6, 6.7–8.8 and ≥ 8.9 μg/ml, P for trend = 0.003). In multivariate analyses, TR of MetS was 0.12 (95% CI 0.02–0.78; P = 0.03) in subjects with total adiponectin level of 5.0–6.6 μg/ml, and 0.15 (95% CI 0.02–0.97; P = 0.047) in subjects with total adiponectin level ≤ 4.9 μg/ml compared with those with total adiponectin level ≥ 8.9 μg/ml. The accelerated failure-time model showed that the optimal cut-off value of total adiponectin for managing the risk of developing MetS was 6.2 μg/ml. In the multivariate-adjusted model, the mean time to the development of MetS was 78% shorter for total adiponectin level ≤ 6.2 μg/ml compared with > 6.2 μg/ml (TR 0.22, 95% CI: 0.08–0.64, P = 0.005). Conclusion: Our findings suggest that the cut-off value for managing the risk of developing MetS is 6.2 μg/ml in male Japanese workers. Subjects with total adiponectin level ≤ 6.2 μg/ml developed MetS more rapidly than did those with total adiponectin level > 6.2 μg/ml. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of nurse-led exercise interventions, in addition to standard rehabilitation, on patients suffering from hemiplegia soon after stroke onset. Methods: Interventions involved a series of hip bridges. Efficacy was evaluated by monitoring leg muscle mass. Participants were divided into control, intervention and terminated intervention groups. In addition to standard rehabilitation, the intervention group performed a series of hip bridges once a day. Leg muscle mass was evaluated using dual-energy X-ray absorptiometry (DXA). Measurements were taken 3-5 days after stroke onset, then again 7 days after initial measurement. Results: During the first week, the mean decrease in leg muscle mass on the paralyzed side was 417 g (7%) for the control group, 304 g (6%) for the terminated intervention group and 108 g (2%) for the intervention group. Only the difference between control and intervention groups was significant (P=0.008). Conclusions: Exercise interventions comprising a series of hip bridges soon after stroke onset, in addition to standard rehabilitation, can reduce leg muscle atrophy on the paralyzed side in stroke patients. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to evaluate the efficacy of a newly designed rehabilitation program for postoperative patients with breast cancer. This was achieved through examinations to clarify the range of motion (ROM) of the shoulder joint, postoperative pain and recovery of activities of daily living (ADL). The ROM of the shoulder joint was evaluated with respect to five items and determinations were carried out five times. Patients were orally questioned four times regarding their pain after surgery, movement-associated chest pain, pain at night and operative wound pain. Evaluation of the ADL after discharge was conducted using a three-level rating method at postoperative week 4 and week 12. A total of 72 patients were studied, comprising 39 who underwent pectoral muscle-conserving mastectomy and 33 who underwent breast-conserving surgery. The arm movement of forward raising showed the greatest decline, followed by lateral raising of the arm. Postoperative time-course changes in internal/external arm rotation, as well as backward arm raising were slight. Comparison of the operative procedures revealed differences only for lateral arm raising at postoperative week 4, while there were no differences in any of the shoulder joint movements. Lowering of the ROM of the shoulder joint was more marked at an earlier time (week 1 to week 2) after surgery, but it was not statistically significant. Pain at night and operative wound pain were prolonged over the period, and reported in postoperative week 1 to week 12 by 3–15% of patients. All ADL items became almost normal in approximately 90% of patients at postoperative week 4. The efficacy of the present rehabilitation program early after surgery was demonstrated in terms of recovery of ADL as well as the ROM of the arm on the affected side. [ABSTRACT FROM AUTHOR]

Emerging evidence suggests that adiponectin secreted from adipocytes may have a preventive effect on the development of type 2 diabetes, attributable to an increase in insulin sensitivity and suppression of inflammation. However, when the East Asian population is considered, dysfunction of insulin secretion, besides insulin resistance and inflammation, has been assumed to play a significant role in the development of diabetes. Thus, the aim of the present study was to examine whether there is an association between a decrease in serum total adiponectin level and the incidence of diabetes in male Japanese, with consideration of insulin secretory function. We here report a prospective occupational-based cohort study, which was conducted during 2010-2019 in Japan. Briefly, 851 male workers without diabetes aged over 20 years were followed up prospectively. Diabetes was defined as either: 1) fasting plasma glucose ≥ 126 mg/dl, 2) HbA1c ≥ 6.5%, 3) medication for hyperglycemia or 4) postprandial plasma glucose ≥ 200 mg/dl during the follow-up period. Hazard ratios (HRs) with 95% confidence intervals (CIs) of serum total adiponectin level for the incidence of diabetes were estimated using a Cox proportional hazards model. In multivariate analysis after adjusting for age, BMI, smoking habit, alcohol intake, regular exercise, family history of diabetes, HDL-C, triglyceride, hypertension and HOMA-β, HR of developing diabetes was 8.61 [95%CI: 1.87 to 39.77, P=0.01] in the lowest quartile of serum total adiponectin, compared with the highest quartile. Furthermore, the risk of diabetes was 36% higher (P<0.01) per 1 µg/ml decrement of serum total adiponectin level in the multivariate-adjusted model. These results suggest that serum total adiponectin level could be a biomarker for the onset of diabetes in male Japanese, even with consideration of the ability of fasting insulin secretion and adjustment of its impact. Disclosure: A. Hata: None. M. Miyoshi: None. T. Nakao: None. T. Ichihara: None. A. Tamura: None. T. Minagawa: None. Y. Kuwamura: None. M. Funaki: Board Member; Self; Mechanogenic, Inc., Consultant; Self; Happy, Inc., Research Support; Self; Japan Tobacco Inc. [ABSTRACT FROM AUTHOR]

Serum 1,5-anhydroglucitol (1,5-AG) is a useful clinical indicator for short-term glycemic control status, which exhibits a rapid decrease if blood glucose levels are poorly controlled in diabetic patients. Interestingly, some cross-sectional studies have suggested that serum 1,5-AG level decreases even before the onset of type 2 diabetes. Thus, the aim of the present study was to examine whether there is an association between a decrease in serum 1,5-AG level and the incidence of abnormal glucose metabolism (AbGM) or metabolic syndrome (MetS) in Japanese in a prospective cohort study. We here report a prospective occupational-based cohort study, which was conducted during 2010-2017 in Japan. Briefly, 1) 837 male workers without AbGM and 2) 843 male workers without MetS aged over 20 years were followed up prospectively. AbGM was defined as either: 1) fasting plasma glucose ≥ 110 mg/dl, 2) HbA1c ≥ 6.0% or 3) medication for hyperglycemia. In multivariate analysis after adjusting for age, BMI, smoking habit, alcohol intake, regular exercise and estimated glomerular filtration rate, the HR of developing MetS was 1.81 [95%CI: 1.12 to 2.92, P=0.01] in the lowest quartile of baseline serum 1,5-AG, compared with the highest quartile. In addition, the incidence and multivariate-adjusted HR of AbGM or MetS also increased with decreasing quartile of serum 1,5-AG (P for trend for both <0.05). Our findings suggest that a decrease in serum 1,5-AG level is a predictive marker for the future onset of AbGM or MetS in male Japanese. Disclosure: A. Hata: None. N. Aki: None. T. Ichihara: None. A. Tamura: None. T. Minagawa: None. Y. Kuwamura: None. M. Funaki: None. Funding: Tokushima Prefecture [ABSTRACT FROM AUTHOR]

Few prospective cohort studies have examined the association between serum fatty acid (FA) proportions and type 2 diabetes (T2D). In addition, the involvement of serum FAs in the development of early stage abnormality of glucose homeostasis remains unclear. The present study investigated the association between serum FA proportions or FA ratios, which reflect desaturase activity, and the incidence of early stage abnormal glucose metabolism before the actual onset of T2D. We here report a prospective occupational-based cohort study, which has been conducted since 2008 in Japan. A total of 396 male workers without abnormal glucose metabolism aged 20 to 60 years were followed-up prospectively (mean follow-up period: 5.9 years). Abnormal glucose metabolism was defined as either: 1) fasting plasma glucose ≥ 110 mg/dl, 2) HbA1c ≥ 6.0% or 3) medication for hyperglycemia. We evaluated serum FA proportions and the activities of ⊿5desaturase, ⊿6desaturase and ⊿9desaturase, which reflect desaturation of FAs estimated from the FA product-to-precursor ratios. In multivariate analysis after adjusting for age, BMI, smoking habit, alcohol intake, regular exercise, HDL cholesterol, triglycerides, family history of diabetes, and hypertension, the HR of developing abnormal glucose metabolism was 4.42 [95% CI: 1.81 to 10.76, P=0.001] in the highest quartile of baseline serum dihomo-γ-linolenic acid proportion, compared with the lowest quartile. In addition, the age-adjusted incidence and multivariate-adjusted HR of abnormal glucose metabolism also increased with increasing quartile of ⊿6desaturase (P for trend for both <0.01). Our findings suggest that increased serum dihomo-γ-linolenic acid proportion and enhanced activity of ⊿6desaturase are predictive markers for the development of early stage abnormal glucose metabolism in male Japanese. These results imply that altered FA metabolism may associate with early stage disorders of glucose metabolism. Disclosure: A. Hata: None. N. Aki: None. T. Ichihara: None. A. Tamura: None. T. Minagawa: None. Y. Kuwamura: None. M. Funaki: Consultant; Self; Happy, Inc. Research Support; Self; Otsuka Holdings Co., Ltd. Funding: Japan Ministry of Education, Culture, Sports, Science and Technology [ABSTRACT FROM AUTHOR]

The aim of this study was to clarify the characteristics of lifestyle and health awareness according to dietary diversity in a Japanese worksite population. The participants were 1,312 men and women aged 20 to 63 years who were living in Tokushima Prefecture, Japan during the period 2012-2013. We obtained anthropometric data and information on lifestyle characteristics using a self-administered questionnaire. Dietary intake was assessed using a food frequency questionnaire, and dietary diversity was determined using the Quantitative Index for Dietary Diversity (QUANTIDD). The characteristics of lifestyle and health awareness according to quartiles of the QUANTIDD score were assessed using the chi-square test and a general linear model. The higher the QUANTIDD score was, the larger were the proportions of participants who knew the appropriate amount of dietary intake and participants who referred to nutritional component information when choosing and / or buying food. Among participants with higher QUANTIDD scores, the proportion of participants who considered their current diet was good was high in women, whereas the proportion of participants who wanted to improve their diet in the future was high in men. Those results indicate that higher dietary diversity was related to better characteristics of lifestyle and awareness of health. J. Med. Invest. 67 : 255-264, August, 2020.

Epidemiological investigations have shown that consumption of soybeans or soy foods reduces the risk of the development of cardiovascular disease, cancer and osteoporosis. The aim of this study was to determine the associations between different soy foods and inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, and IL-18, in Japanese workers. The cross-sectional study included 1,426 Japanese workers (1,053 men and 373 women) aged 20 to 64 years. Intake of 12 soy foods was estimated by a validated food frequency questionnaire. Associations of total soy foods, fermented soy food, non-fermented soy food, soy isoflavone with hs-CRP, IL-6, and IL-18 levels were examined by general linear model regression analysis. We found that total fermented soy food intake was inversely associated with multivariable-adjusted geometric concentration of IL-6 in men (Q1:1.03 pg/mL, Q5:0.94 pg /mL;P for trend = 0.031). Furthermore, it was shown that IL-6 concentrations were inversely associated with miso intake (β = -0.068;p = 0.034) and soy sauce intake in men (β = -0.074;p = 0.018). This study suggests that intake of total fermented soy food, miso and soy sauce be associated with IL-6 concentrations in Japanese men. J. Med. Invest. 65:74-80, February, 2018.

Purpose: The aim of this study was to clarify the changes in medication-taking behavior and related factors over time in patients with initial mild cerebral infarction up to 12 months after onset., Methods: Thirty-one patients with initial mild cerebral infarction were surveyed a total of four times: on admission to hospital, 3 months after onset, 6 months after onset, and 12 months after onset. Patients were surveyed regarding medication compliance, awareness of taking medication, perceived behavioral control, lifestyle risk factors, and subjective norms., Results: Medication compliance improved over time from the time of admission, but no changes were seen in awareness of taking medication. A cluster analysis based on changes in medication compliance over time revealed a "Persistently high compliance group" and a "Persistently low compliance group" for medication compliance. The health locus of control in the "Persistently high compliance group" was perceived as the result of chance and fate., Conclusions: Assessing the current state of medication compliance and the health locus of control during hospitalization permitted an understanding of patient characteristics, and indicated a need for recurrence prevention education and medication guidance tailored to each patient's cognitive and behavioral characteristics. J. Med. Invest. 64: 85-95, February, 2017.