The incidence of decreased HDL-Cholesterol (HDL-C) level was examined in 13, 936 persons who had received general health check-ups at our Hokkaido Health Care and Research Center from April 2001 to March 2002.
Subjects were divided into three groups ; group-A (46-55 yrs), 4, 937 men/2, 543 women ; group-B (56-65 yrs), 3, 582 men/1, 318 women ; group-C (66-75 yrs), 1, 289 men/267 women. Low HDL-C level was defined as<40 mg/dl.
1) Age and gender differences were examined in subjects with low HDL-C level.
2) Each appearance rate of obesity, diabetes mellitus, hypertension and hyperlipidemia, was analyzed in the subjects with document-ed low HDL-C level.
[Results] (1) Decreased HDL-C levels were observed in men (%) /women (%) of three groups as follows ; group-A, 969 (19.6%) / 99 (3.9%) ; group-B, 638 (17.8%) /58 (4.4%) ; and group-C, 177 (13.7%) /10 (3.7%), respectively. Low HDL-C level appeared more frequent in men than women, regardless of age. (2) Low HDL-C level was frequently observed in both men and women with obesity, DM and hyperlipidemia, especially in groups A and B, except hypertension.
[Conclusion] High prevalence of low HDL-C level in upper-middle aged subjects is a clue for the prevention of life style-related diseases.

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To inquire the assessment of our checkup services by our customers, we performed questionnaire surveys. The first survey was performed one year after our move to a new building. The main aim of the first survey was how our new services were accepted to our customers. After one year, customers of checkup service were increased to 1.7 times. To assess the effect of the increase in customers, we surveyed the same questionnaire. Customers were asked to fill out a sheet of questionnaire after completion of checkup services. The points of the manner were high in all departments from reception to medical examinations (the sum of‘excellent’ and‘good’ amounted 87-99%), although the ‘excellent’ points were reduced by 12% in general in the second survey as compared with the first one. The assessment of ‘waiting time during checkup service’ worsened in the second survey ; the sum of ‘short’ and ‘appropriate’ accounted 78% in the first survey and 67% in the second survey. The strong preference to our checkup center for next visit was decreased from 61 to 55%. We analyzed what factors were related to the preference to our center. All variables except ‘an introducer to our checkup center’ and ‘uneasiness for examinations’ were related to the preference. Repeated visitors, male, older age, and the one who reserved by himself were positive effecters. As for variables of checkup center, better manner and shorter waiting time affected positively. On the multivariate analysis, the main effecters on the preference to our center were ‘number of visit’ and‘waiting time during checkup’. As for women, examination manner of surgeon was the strongest effecter.

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Purpose : In order to determine the specific risk factors of acute myocardial infarction in male under 45 years of age, we studied 44 patients, comparing with 88 healthy men as age matched.
Methods : The subjects in the study were 44 male patients with acute myocardial infarction (mean age 40.3 y.o) who were admitted to the Jikei University Hospital and 88 healthy men (mean age 40.5y.o) who visited our health science center for general medical check up. We analyzed the clinical data, such as body mass index (BMI), BMI at 20 years of age, blood pressure, serum lipids, glucose metabolism, uric acid, and smoking habit. Information on smoking habit was obtained by a questionnaire.
Results : Compared with healthy group, BMI, BMI at 20 years of age, serum triglyceride (TG), serum total cholesterol (TC), fasting plasma glucose (FPG), and hemoglobin A_1c (HbA_1c) were significantly higher and high density lipoprotein cholesterol (HDL-C) was significantly lower in the patient group. BMI (26.1±0.6 versus 22.7±0.3 kg/m²), BMI at 20 (22.7±0.5 versus 20.6±0.3 kg/m²), TG (160.5±13.7 versus 107.8±6.0 mg/dl), TC (224.9±11.9 versus 202.4±3.1 mg/dl), FPG (129.5±16.3 versus 94.1±1.0 mg/dl), HbAlc (6.2±0.4 versus 5.1±0.04%), HDL-C (44.4±3.8 versus 53.4±1.4 mg/dl) . However there was no significant difference in blood pressure and uric acid between both groups. The increase in BMI since age of 20 was also significantly higher in the patient group (3.5±0.4 versus 2.0±0.2 kg/m²) . In the patient group, the ratio of smokers was 77% and mean smoking consumptions per day were 37 cigarettes. These were significantly higher than data in the healthy group (59%, 20.3±1.4 cigarettes) . 69% of the patients had single vessel disease according to the angiographic findings.
Conclusion : The specific risk factors with myocardial infarction in male under 45 years of age was not blood pressure, but were BMI, especially the increase in BMI over age of 20, lipid, glucose metabolism and smoking.

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assessment of the carotid artery is a useful method for evaluation of atherosclerosis. Recently, this method is applied on physical check-up. We studied the relationship between carotid intima-media thickness (IMT) and plaques by ultrasound and atherosclerotic risk factors, including funduscopy and electrocardiography.
Subjects and methods : Eighty healthy subjects (age 30-70, all men) were examined. IMT was measured as far walls of carotid arteries at a central site 10-15 mm from a bifurcation without plaques. We defined the max IMT which was the thicker IMT in the common carotid arteries. The local lesion (≥1.1 mm) was evaluated as plaques.
Results : Age and HbAlc were associated with max IMT. Plaque occurrence was associated with age, systolic blood pressure, diastolic blood pressure, and serum LDL cholesterol. The results of funduscopy and electrocardiography were not related to max IMT or plaque.
Conclusion : The present study indicates that carotid plaque is relevant to atherosclerotic risk factors, compared with IMT. Atherosclerosis should be evaluated using combination between carotid ultrasound and funduscopy.

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The on-line mental health questionnaire which NTT-IT had created was used. The evaluation for the NTT Hokuriku area personnel was performed and the direct individual interview was performed for all the members at the time of a periodic medical examination and human dry dock and then the mental situation has been grasped. The sensitivity and the specificity of an on-line mental health questionnaire were high, and most consulted persons had looked at and satisfied the replies of their on-line mental health votes. An e-mail, counseling by mobile type TV phone and the consultation to psychosomatic medicine clinic were recommended to the person considered to be a depressed state and depression by direct interview. Eight persons were treated by professional doctors of psychosomatic medicine during the period.

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Changes of serum lipids and blood sugar for 7 years from 1992 to 1999 were studied statistically. The subjects were 2, 719 men (age 30 's to 50 's), who were working in the service industry. They were divided into three groups by the degree of obesity ; low, standard, and high BMI groups.
The degree of obesity, HDL-C, blood sugar and HbAlc increased in all groups. While the increase of degree of obesity was prominent in the low BMI group, the increase of HDL-C, blood sugar and HbAlc were prominent in the high BMI group. Serum lipids except HDL-C increased most remarkably in the low BMI group.
To investigate the effect of aging more precisely, each group was separated into two groups by the degree of weight gain, one without weight gain (aging effect), the other with weight gain (aging plus obesity effect) . While serum lipid level of the latter increased significantly compared to the former, of which serum lipids were improved in 7 years, blood sugar level increased equally in both groups. Both of serum lipid and blood sugar changes were more remarkable in the high BMI group than in the low BMI group. These changes of serum lipids and blood sugar in different BMI groups were considered to be due to such factors as aging and weight gain, since alcohol intake, the number of cigarettes smoked and physical activity among these groups were not statistically significant.
These data showed that changes of the degree of obesity, serum lipid and blood sugar levels in 7 years were different according to BMI. The improvement of serum lipids by aging, the increase of blood sugar depending on the degree of obesity by aging and the increase both of serum lipids and blood sugar by aging plus obesity indicated the importance of body weight control in middle-aged men.

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A close correspondence between aortic, coronary artery calcium deposits and atherosclerosis has been shown by pathologic studies. The purpose of this study is to evaluate the relationship between extracranial carotid atherosclerosis and aortic calcification, coronary calcification and ischemic cerebrovascular lesions.
Between April 2000 and March 2001, total 719 participants (men 487, women 232, mean age 58.6±9.9 years) received carotid ultrasonography, chest helical CT scan and brain MRI.
Aortic calcification, coronary calcification and ischemic cerebrovascular lesions were more frequent in the group with carotid atherosclerosis than in the group without carotid atherosclerosis.
A significant relation was seen between carotid atherosclerosis and age, male sex, cigarette smoking, hypertension, glucose intolerance and hyperuricemia.
These results suggested that carotid atherosclerosis is correlated with aortic, coronary artery and cerebrovascular atherosclerosis.

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We performed screening of sleep apnea syndrome (SAS) using pulse oximetry in human dry dock. Ninety-four middle-aged men who had any objective symptoms of sleep disorder, such as apnea and loud snoring, underwent pulse oximetry with a finger transducer during one night of sleep. Pulse oximetry data were analyzed by personal computer to calculate oxygen desaturation index (ODI : number of desaturation episodes per hour of examination) . We determined ODI 3% or ODI 4% > =15 as suggesting SAS. Twenty-one men (22.3% of the subjects) were suspected of SAS. A significantly higher percentage of subjects with obesity (p=0.01) or subjective symptoms during sleeping such as sleep disturbance (p=0.02) were suspected of SAS than that of subjects without obesity or subjective symptoms. Six subjects suspected of SAS did not have any subjective symptoms. Blood levels of fasting glucose and HbAlc were also significantly higher in the subjects suspected of SAS than those in subjects not suspected of SAS (p=0.01 and p= 0 respectively) . Multiple logistic regression analysis showed that suspicion of SAS was positively associated with age (p=0.02), body mass index (BMI) (p=0.01), smoking (p=0.03), drinking everyday (p=0.04) and subjective symptoms during sleeping (p=0.01) . In conclusion, using pulse oximetry during sleeping may be a useful and easy-to-use method of screening for SAS in human dry dock. We also found that some lifestyle-related diseases may be associated with SAS. There may be a suspicion of SAS not only in those who have subjective symptoms but also in those who have objective symptoms.

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