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Objective To date, no previous study has examined the independent association between nausea, vomiting, and social support and health-related quality of life among early pregnant women. Methods To fill this gap, we investigated these associations within this group using repeated-measurement data. Methods A prospective cohort design was conducted from August 2018 to February 2019 with perinatal outpatients in a general hospital. Participants were 153 pregnant women aged 20 years or older and under 20 weeks of gestation at their first prenatal visit. Along with reporting their sociodemographic data, participants completed the Index of Nausea, Vomiting, and Retching (INVR), the 12-item Short Form Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support (MSPSS) and re-completed INVR, and SF-12 at follow-up checkups a maximum of three times. Results After controlling for internal correlations and confounding factors, INVR was found to be significantly negatively associated with the physical component summary scale score of SF-12; however, MSPSS showed no association with the physical component summary scale score. Conversely, the scores for both INVR and MSPSS were negatively and positively, respectively, significantly associated with the mental component summary scale score of SF-12. Conclusion The severity of nausea and vomiting significantly impacts physical quality of life during early pregnancy. Both nausea and vomiting and social support significantly and independently affect mental quality of life. Health professionals should recognize these impacts and be aware that social support contributes to improving mental quality of life.

Objective To investigate differences in the association of parental history of diabetes with the risk of type 2 diabetes mellitus (T2DM) in the offspring according to the sex of the parent and the offspring's body weight. Methods A prospective cohort study of 4446 middle-aged non-diabetic Japanese men and women were followed in Aichi Prefecture, central Japan, from 2002 to 2011. Subjects were categorized by their self-reported parental history of diabetes (“no parental history,” “father only,” “mother only,” and “both”). The association of parental history of diabetes and incidence in the offspring was examined according to overweight status adjusted for age, sex, birth weight, smoking, alcohol consumption, physical activity, total energy intake, body mass index, and number of metabolic syndrome components. Results During follow-up (median 8.9 years), 277 subjects developed T2DM. Parental history of diabetes was positively associated with T2DM incidence. However, stratified analysis by overweight status revealed that only maternal history was associated with increased T2DM incidence in non-overweight subjects (hazard ratio = 2.35, 95% confidence interval: 1.41–3.91). While in overweight subjects, paternal history was significantly associated with higher T2DM incidence (hazard ratio = 1.98, 95% confidence interval: 1.19–3.28). Conclusions Our results suggest that parental history of diabetes mellitus is associated with the incidence of T2DM in offspring differently according to the sex of the affected parent and the offspring's body weight.

Summary Background To examine the association of intrahepatic fat with homeostasis model assessment-insulin resistance (HOMA-IR), a marker of insulin resistance, in Japanese adults, and whether intrahepatic fat is associated with insulin resistance independent of waist circumference and other measures of obesity. Methods Fifty-three individuals aged 37–69 were studied. Spectrum obtained using a 3-T magnetic resonance imager was analysed with LCModel to quantify intrahepatic fat. Blood levels of insulin, glucose and other biochemical markers were obtained after 8 h or more fasting. Percent body fat was estimated by a bioelectrical impedance analyzer. HOMA-IR and intrahepatic fat content were log-transformed in the analysis. Results We found a positive correlation between intrahepatic fat and HOMA-IR, which was independent of the anthropometric measures of obesity. In contrast, significant and positive correlations of body mass index, percent body fat, and waist circumference with HOMA-IR were largely explained by their associations with intrahepatic fat. Intrahepatic fat was positively associated with alanine transaminase and triglycerides even after adjustment for HOMA-IR. Conclusion Intrahepatic fat was associated with insulin resistance independent of age, sex, and measures of obesity in Japanese adults. Hypertriglyceridemia and liver injury may directly occur subsequent to intrahepatic fat accumulation.

Objective To evaluate the effect of baseline combination of 6 lifestyle factors on all-cause mortality. Methods A total of 62,106 Japanese men and women aged 40–79 years were followed for 12.5 years on average. Hazard ratios and 95% confidence intervals (CIs) of all-cause mortality in relation to healthy lifestyle factors (not currently smoking, not heavily drinking, walking 1 h or more per day, sleeping 6.5 to 7.4 h per day, eating green-leafy vegetables almost daily and BMI between 18.5 and 24.9) were calculated from proportional-hazards regression models. We also estimated population-attributable fractions of death to address the impact of potential lifestyle modifications on mortality. Results Until 2003, 8497 deaths were observed. Age-adjusted HR of all-cause mortality for the group with 6 healthy lifestyle factors was 0.42 (95% CI: 0.32–0.56) among men and 0.49 (0.39–0.60) among women, respectively, compared with the group with 0–2 healthy lifestyle factors. Even at ages 60–79 years, a healthy lifestyle has a major impact on mortality. Had the subjects achieved even a 1-point increment in their lifestyle scores, death rates of 24.7% among men and 18.5% among women could have been reduced. Conclusion We found an inverse association between baseline combination of 6 healthy lifestyle factors and all-cause mortality as well as its impact on preventable fraction of death. Our results also demonstrated that healthy lifestyle behaviors are important even in old age.

Objective To assess the validity of self-reported medical history of several diseases among the Japanese population, and to clarify to what extent the self-reported year of diagnosis for chronic diseases is different from the physician's reports. Study Design and Setting Subjects were 8,947 persons who responded to questions about medical history in a self-administered questionnaire. Of them, 854 subjects reported one or more medical histories and gave permission to contact their physician. The physicians were then requested to provide information on 809 subjects. Valid responses of 714 subjects were collected. We compared the self-reported medical histories with those reported by the physician. Results Of 15 persons who reported myocardial infarction, 13 (87%) were confirmed. Angina pectoris was verified in eight out of the 11 (73%). The confirmation proportions of hypertension, diabetes, hyperlipidemia, and hyperuricemia were 97%, 96%, 95%, and 95%, respectively. The self-reported year of diagnosis was 1.70–2.49 years earlier than the physician-reported year for chronic diseases. Agreement between the self-reported and the physician-reported years was higher, the more recent the self-reported year was. Conclusion Self-reported medical histories were generally accurate, especially for diseases with clear diagnostic criteria. However, investigators should be aware of the errors in reporting the year of diagnosis.

To examine relationships between speed of eating and insulin resistance.Cross-sectional study of 2704 male (mean age and BMI: 48.2 y and 23.3 kg/m(2)) and 761 female (46.3 y and 21.8 kg/m(2)) non-diabetic Japanese civil servants, 75% clerical, and 25% manual laborers, using a two-part questionnaire on life-style factors and diet history with self-assessment of categorical speed of eating and energy intake over a 1-month period. We measured BMI, blood glucose and insulin concentrations and calculated insulin resistance using the homeostasis model assessment of insulin resistance: (HOMA-IR).BMI correlated with eating rate in both sexes, and with daily energy intake in men. Multiple regression analysis of log HOMA-IR by categorical speed of eating, adjusting for age, energy intake and lifestyle factors showed a statistically significant gradual increase in HOMA-IR with increases in relative eating rate in men (p0.001, for trend) and in women (p0.01). Adjusting for BMI, this positive relationship appeared only in men (p=0.03).Our results suggest that eating fast is independently associated with insulin resistance in middle-aged Japanese men and women.

Background. Recent studies promisingly indicate that adiponectin plays an important and fundamental role in the development and progression of metabolic and atherosclerosis disorders. Smoking is known as one of the most important risk factors of atherosclerosis, and its relation with metabolic disorders has also been reported. We therefore investigated the association between cigarette smoking and adiponectin concentration in a large sample of Japanese men and women. Method. The cross-sectional study was carried out in 2002. The subjects were 3260 men and 953 women local government workers aged 35 to 59 in Japan. Lifestyle-related variables including detailed smoking history were inquired in a self-administered questionnaire. Results. Significant differences in adiponectin levels related to smoking status were observed in both men and women (p = 0.001). A dose-dependent association was found between the intensity of smoking and adiponectin levels in current smokers, and was statistically significant in men (p for trend = 0.006 in the multivariate-adjusted model). Men who quit smoking for more than 20 years and women for more than 10 years had an adiponectin concentration similar to that observed in non-smokers. Conclusion. We not only revealed that current smoking habit was associated with low adiponectin level but also found a dose-dependent association between smoking intensity and adiponectin level in current smokers. The present finding may provide further evidence of the importance of a causal relationship between smoking status and adiponectin concentrations.

The purpose of this study was to investigate factors related to self-rated health and to mortality among 2490 community-living elderly. Respondents were followed for 7.3 years for all-cause mortality. To compare the relative impact of each variable, we employed logistic regression analysis for self-rated health and Cox hazard analysis for mortality. Cox analysis stratified by gender, follow-up periods, age group, and functional status was also employed. Series of analysis found that factors associated with self-rated health and with mortality were not identical. Psychological factors such as perceived isolation at home or 'ikigai (one aspect of psychological well-being)' were associated with self-rated health only. Age, functional status, and social relations were associated both with self-rated health and mortality after controlling for possible confounders. Illnesses and functional status accounted for 35-40% of variances in the fair/poor self-rated health. Differences by gender and functional status were observed in the factors related to self-rated health. Overall, self-rated health effect on mortality was stronger for people with no functional impairment, for shorter follow-up period, and for young-old age group. Although, illnesses and functional status were major determinants of self-rated health, economical, psychological, and social factors were also related to self-rated health.

Purpose Low birth weight has been associated with metabolic and vascular diseases, but the precise mechanism is debated. Adiponectin is one of the key molecules in metabolic disease, and a decrease in level precedes the onset of type 2 diabetes and development of atherosclerosis. Our aim is to examine whether low birth weight is associated with adiponectin concentration in adult. Methods We conducted a population-based cross-sectional study of 2277 subjects (1661 men and 616 women) aged 35 to 66 years who had their self-reported birth weights and adiponectin concentrations measured as adults. Results After adjusting for potential confounders, including age, sex, current body mass index (BMI), smoking status, alcohol consumption, and exercise, geometric mean adiponectin levels were 6.63, 6.45, 6.86, 7.05, 6.75, and 7.22 μg/mL for subjects with birth weights less than 2500, 2500 to less than 2800, 2800 to less than 3000, 3000 to less than 3200, 3200 to less than 3500, and greater than 3500 g, respectively. A positive association was found between birth weight and adiponectin concentration (trend p = 0.002). Stratified by current BMI of 25 kg/m 2 , a positive association was not observed for subjects with a BMI less than 25 kg/m 2 , but was pronounced in those with a BMI of 25 kg/m 2 or greater. Conclusion This study indicates that low birth weight contributes to decreased adiponectin concentrations in adult life independently of current BMI, especially for obese subjects.

Objective. The purpose of this study was to explore epidemiological features of malignant ovarian neoplasm in Japan. Methods. The number of deaths from malignant ovarian neoplasm was obtained from the national vital statistics. Estimated incidence rates, based on several cancer registries, were also used for analyses. We divided the subjects into two age groups (0–29 and 30+ years) and examined secular trends in mortality (1950–1997) and incidence (1975–1993) by age, time, and birth cohort. Results. The age-adjusted mortality rate has increased approximately 4-fold (from 0.9 to 3.6 per 100,000 women) from 1950 to 1997. Age-specific mortality rates showed a rising pattern in the elderly, whereas mortality in the younger people tended to increase in the 1950s and 1960s, but then decreased in the 1970s and afterward. In analyses using a mathematical model, the time effect in the population aged 0–29 years increased with advancing period up to 1970, and then decreased. The cohort effects had positive values, which indicate higher than additive influence from age/time effect, for birth cohorts from 1900 to 1935. The age-adjusted incidence rate increased approximately 1.5-fold (from 3.6 to 5.7) from 1975 to 1993. The rate increased in the early 1980s, but has remained stable since the late 1980s. Age-specific incidence rates in older age groups increased steadily up to 1985, and have remained stable since, while the rates in younger women have remained almost unchanged. Conclusion. The major effects on malignant ovarian neoplasm in Japan are supposed to be due to declining parity and therapeutic improvements.

To investigate the relation between matrix metalloproteinases (MMP) and tissue inhibitors of metalloproteinases (TIMP) in malignant ovarian tumor, MMP and TIMP activities in conditioned media of 16 malignant ovarian tumor tissues and six normal ovaries were detected by zymography and reverse zymography, respectively and were quantitated with a densitometer. TIMP-1 and TIMP-2 were detected in all normal and malignant ovarian tumor tissues by reverse zymography. In normal ovaries, the intensity of TIMP-2 bands was stronger than TIMP-1, but in malignant tumor tissues those of TIMP-1 were stronger. The ratios of TIMP-1 to TIMP-2 and MMP-9 to MMP-2 were significantly higher in malignant tumor tissues than in normal ovaries (P0.001). TIMP activity consisting of TIMP-1 and TIMP-2 correlated significantly to MMP activity of MMP-2 and MMP-9 (r = 0.67, P0.005). There was a significant correlation between TIMP-1 activity and MMP activity (r = 0.72, P0.001), but no correlation was observed between TIMP-2 activity and MMP activity. The high level of TIMP-1 appeared to be related to malignant phenotype in ovaries as well as the high level of MMP-9.

Our purpose was to evaluate type IV collagenase in ovarian and endometrial cancer tissues.Tissue specimens were obtained from patients with ovarian and endometrial cancer and uterine myoma. Gelatinase activity was detected by zymography and quantitated by densitometer.Four dominant gelatinases were detected in ovarian and endometrial cancer tissues: 200, 130, 92, and 72 kd gelatinase. Other forms observed were 83 kd gelatinase, which is an active form of 92 kd gelatinase, and 66 kd gelatinase, which is an active form of 72 kd gelatinase. Densitometric analysis showed that the 92 kd/72 kd ratio in ovarian cancer tissues was significantly higher than in normal ovarian tissues (p0.05) and that the 66 kd/72 kd ratio was higher in ovarian cancer tissues (p = 0.07). Both ratios in endometrial cancer tissues were significantly higher than in normal endometrial tissues (p0.05).Gelatinase activity was remarkably higher in ovarian and endometrial cancer tissues. Especially, 92, 83, and 66 kd gelatinases were clearly detected in cancer tissues, suggesting that these gelatinases were related to the malignant phenotype, because degradation of the components of the basement membrane such as type IV collagen is necessary for cancer cells to metastasize.

To investigate the clinical significance of transvaginal color-pulse Doppler sonography in ovarian tumors, 109 patients were examined at Nagoya University Hospital. Ultrasonographic patterns were classified and the levels of three circulating tumor markers, CA125, CA72-4, and CA19-9, were simultaneously evaluated. In differentiating benign and malignant ovarian tumors, transvaginal color-pulse Doppler and ultrasonographic pattern classification were superior to the tumor markers. Of 49 cases with benign pattern, 45 were benign (91.8%). Of 60 cases with malignant pattern, 24 (40%) were benign and 36 (60%) were malignant or borderline malignant. In this group color-pulse Doppler sonography was the most useful procedure, and sensitivity, specificity, and accuracy were 75.0, 79.2, and 76.7%, respectively. Menopausal status and site of the arterial wave form in the tumor were also important. Transvaginal color-pulse Doppler sonography was a reliable diagnostic method for differentiating ovarian tumors.