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Aims: To compare high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) as a predictor of incident diabetes in a population where obesity is not prevalent., Methods: This is a retrospective 6-year follow-up study in a Japanese health screening population including 1874 men and 1094 women. Using Cox regression methods, hazard ratios (HRs) of incident diabetes for hs-CRP and WBC adjusting for fasting plasma glucose (FPG), hemoglobin A1c (HbA1c) and other confounders were calculated, and using areas under receiver operating characteristic curve (AUCs), diabetes-predicting abilities of hs-CRP and WBC were compared. Diabetes was defined as FPG ≥ 126 mg/dL and HbA1c ≥ 6.5 % or use of antidiabetic medication., Results: During the 6-year follow-up period (mean ± SD, 4.8 ± 1.7 years), 71 men (3.8 %) and 19 women (1.7 %) developed incident diabetes. The fully adjusted HRs [95 % confidence intervals (CIs)] of incident diabetes for each 1 SD increase in log hs-CRP and WBC were 1.20 (0.92-1.56) (p = 0.174) and 1.01 (0.78-1.30) (p = 0.946), respectively. The fully adjusted HRs (95 % CIs) of incident diabetes for the highest tertile of hs-CRP and WBC compared with the lowest tertile were 2.57 (1.05-6.27) (p = 0.039) and 1.20 (0.53-2.70) (p = 0.665), respectively. The AUCs (95 % CIs) of hs-CRP and WBC for the discrimination of incident diabetes were 0.73 (0.68-0.77) and 0.67 (0.62-0.72), respectively., Conclusions: Hs-CRP, but not WBC, was independently associated with incident diabetes in a Japanese health screening population where obesity is not prevalent.

Objectives: To investigate longitudinal relationships between obesity/inflammation and kidney stone formation in a population where obesity is not prevalent., Methods: Using Cox regression models, associations between kidney stone formation and body mass index, waist circumference, high-sensitivity C-reactive protein and other possible risk factors were retrospectively examined in a health screening Japanese population including 1726 men and 992 women., Results: During 4 years of follow up (mean 3.2 years), kidney stones were formed in 238 men (34.5 per 1000 person-years) and 82 women (20.7 per 1000 person-years). In men, when the possible risk factors were separately examined as continuous parameters, body mass index (P = 0.030) and waist circumference (P = 0.025) were significantly, and log C-reactive protein (P = 0.092) were marginally, associated with kidney stone formation. However, none of these parameters was independently associated with kidney stone formation after fully adjusted. In women, none of the aforementioned three parameters was associated with kidney stone formation. As a categorical parameter, the higher two quintiles of C-reactive protein were significantly associated with kidney stone formation compared with the lower two quintiles in men (P = 0.026)., Conclusions: Overweight and C-reactive protein are weakly associated with kidney stone formation in Japanese men. Inflammation might be an underlying mechanism of the association between obesity and kidney stone formation., (© 2014 The Japanese Urological Association.)

To compare high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) as a predictor of metabolic syndrome (MetS). Hazard ratios (HRs) adjusted for age, smoking, and other confounding covariates and areas under receiver operating characteristic curve (AUCs) of hs-CRP and WBC for developing MetS were calculated in 1,463 men and 920 women from a Japanese health screening population who were free from MetS, diabetes, histories of coronary heart disease, and stroke at baseline and followed through 3 years. The adjusted HRs (95% confidence interval-CI; p value) of MetS for each 1 SD increases in log hs-CRP, and log WBC were 1.345 (1.166-1.553; <0.001) and 1.406 (1.188-1.664; <0.001), respectively, in men and 1.388 (1.110-1.736; 0.004) and 1.358 (1.072-1.721; 0.011), respectively, in women. However, the HRs became nonsignificant after further adjusted for the components of MetS. The AUCs (95% CI; p value) of hs-CRP and WBC for predicting MetS were 0.616 (0.573-0.660; <0.001) and 0.613 (0.566-0.659; <0.001), respectively, in men and 0.636 (0.573-0.698; <0.001) and 0.606 (0.538-0.673; 0.003), respectively, in women. Hs-CRP and WBC equally predict development of MetS, but both are poor predictors of MetS in a Japanese health screening population where obesity is not prevailing.

The aim of this study was to investigate the association between leukocyte subtype counts and hyper-LDL cholesterolemia, hypertriglyceridemia, and hypo-HDL cholesterolemia. Logistic regressions using hyper-LDL cholesterolemia, hypertriglyceridemia, and hypo-HDL cholesterolemia as a dependent variable and total leukocyte, basophil, eosinophil, neutrophil, lymphocyte, and monocyte counts as an independent variable were calculated adjusting for age, body mass index (BMI), high-sensitivity C-reactive protein (hs-CRP), smoking, drinking, and physical activity in apparently healthy Japanese men (1,803) and women (1,150). The odds ratio (OR) of hyper-LDL cholesterolemia for total leukocyte, eosinophil, and lymphocyte counts, the OR of hypertriglyceridemia for total leukocyte, eosinophil, neutrophil, and lymphocyte counts, and the OR of hypo-HDL cholesterolemia for total leukocyte, neutrophil, and lymphocyte counts were significant in men, and the OR of hyper-LDL cholesterolemia, for lymphocyte count, and the OR of hypo-HDL cholesterolemia for eosinophil count were significant in women. Lymphocyte count was significantly associated with hyper-LDL cholesterolemia independently of hs-CRP in apparently healthy Japanese.

Background: Cutoff points for high-sensitivity C-reactive protein (hs-CRP) as a component of metabolic syndrome (MetS) in Japanese have been proposed as 0.40-0.45 mg/L for men and 0.25-0.35 mg/L for women. However, there are some concerns about the reproducibility of hs-CRP., Methods and Results: Reproducibility of hs-CRP as a component of MetS was examined using receiver-operating characteristic (ROC) curves for diagnosing MetS in 1,274 men and 673 women whose serum levels of hs-CRP were measured twice at annual health screening tests. The Spearman's correlation coefficient between baseline hs-CRP and hs-CRP at the next year's test was 0.68 in men and 0.71 in women. The area under the ROC curves of baseline hs-CRP, hs-CRP at the next year's test, and the mean of the 2 hs-CRP tests for diagnosing baseline MetS were 0.71, 0.71, and 0.72, respectively, in men and 0.75, 0.74, and 0.74, respectively, in women. Optimal cutoff points of baseline hs-CRP, hs-CRP at the next year's test, and the mean of 2 tests for diagnosing baseline MetS were all 0.40 mg/L in men and 0.35 mg/L in women., Conclusions: The serum level of hs-CRP was stable enough for use as a measure of the inflammatory component of MetS, and the optimal cutoff point of hs-CRP was 0.40 mg/L for men and 0.35 mg/L for women in a Japanese health-screening population.

Objective: To compare two systemic inflammatory markers, high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC), as a component of metabolic syndrome (MetS)., Methods: Data of hs-CRP and WBC from 2,185 Japanese men and 1,383 Japanese women were examined using receiver operating characteristic (ROC) curve for diagnosing MetS and Spearman's correlation coefficients., Results: The area under ROC curve (AUC) of hs-CRP was 0.71 in men and 0.74 in women. The AUC of WBC was 0.65 in men and 0.69 in women. The optimal cutoff point (sensitivity; specificity) of hs-CRP was 0.40 mg/L (0.69; 0.65) in men and 0.35 mg/L (0.67; 0.72) in women. The optimal cutoff point (sensitivity; specificity) of WBC was 5,600/L(-6) (0.61; 0.61) in men and 5,000/L(-6) (0.65; 0.63) in women. Correlations between obesity parameters, blood pressure, and liver function tests were stronger with hs-CRP than with WBC. But, no correlation between MetS-related risk factors was stronger with WBC than with hs-CRP., Conclusion: Hs-CRP is superior to WBC as an inflammatory component of MetS in Japanese. However, WBC may be useful when hs-CRP is not available because WBC is routinely measured in clinical practice.

Background: High-sensitivity C-reactive protein (hs-CRP) is an independent risk factor of diabetes and cardiovascular disease, and is proposed as a component of metabolic syndrome (MetS). An optimal cut point of hs-CRP as a component of MetS was previously reported as 0.65 mg/L based on data from a small-sized study., Methods and Results: Medical check-up data of 1,062 men and 647 women whose plasma levels of hs-CRP were <10 mg/L were examined using a receiver-operating characteristic (ROC) curve for diagnosing MetS, which was defined by revised NCEP criteria for Japanese. An optimal cut point was defined as the point on a ROC curve nearest to the point where both sensitivity and specificity were 1. The area under the ROC curve of hs-CRP was 0.74 (95% confidence interval (CI) 0.70-0.79) in men and 0.73 (95%CI 0.66-0.79) in women. The optimal cut point of hs-CRP and its sensitivity-specificity were, respectively, 0.45 mg/L and 0.67-0.72 in men and 0.25 mg/L and 0.71-0.62 in women., Conclusions: Among Japanese patients, a tentative cut point of hs-CRP as a component of MetS may be 0.45 mg/L in men and 0.25 mg/L in women. However, standardization of the measurement of hs-CRP is required.

Background: High-sensitivity C-reactive protein (hs-CRP) is an independent risk factor of diabetes and cardiovascular disease and it is proposed as a component of metabolic syndrome. Blood levels of hs-CRP are reported to be much lower in Japanese than in Westerners and bimodally distributed in Japanese., Methods: Very low levels of hs-CRP were examined using medical check-up data of 1,360 Japanese men and 821 women whose plasma levels of high-sensitivity C-reactive protein (hs-CRP) were below 10 mg/L., Results: The distribution of hs-CRP levels were skewed but not bimodal in both men and women and very low levels of hs-CRP were significantly related to waist circumference, systolic blood pressure, diastolic blood pressure, fasting glucose, triglycerides, and low-density lipoprotein cholesterol in both men and women. The area under receiver operating characteristic curve of hs-CRP for diagnosing metabolic syndrome and Spearman's correlation coefficients between hs-CRP and components of metabolic syndrome were comparable to those of components of metabolic syndrome in both men and women., Conclusion: Very low levels of hs-CRP were not bimodally distributed but were significantly related to metabolic risk factors in Japanese.

Background: C-reactive protein (CRP) independently predicts cardiovascular disease (CVD) and is considered to be part of metabolic syndrome (MS). The concentration of CRP are proposed to be <1.0 mg/L as low risk, 1.0 to 3.0 mg/L as intermediate risk, and >3.0 mg/L as high risk for CVD in Western society., Methods and Results: Apparently healthy 179 men and 166 women were categorized with modified National Cholesterol Education Program Adult Treatment Panel III criteria (body mass index > or = 25 in place of abdominal obesity) for defining MS. The cut-off points of CRP were evaluated for both MS defined by impaired fasting glucose criteria of > or = 110 mg/dl (MS110) and > or = 100 mg/dl (MS100), separately by sex. The optimal cut-off point of CRP was 0.65 mg/L in all subgroups. The sensitivity and specificity of this CRP value for male MS100, female MS100, male MS110, and female MS110 were 0.650 and 0.626, 1.000 and 0.771, 0.739 and 0.609, and 1.000 and 0.756, respectively., Conclusions: The optimal cut-off point of CRP for MS might be 0.65 mg/L in Japan and this value can be useful in routine clinical practice and studies on MS.