Following the completion of human genome project, various genetic tests have been applied to diagnosis of hereditary diseases and to prediction of diseases including the common diseases. Since the most genetic tests for human diseases are home-brewed, these are not standardized. Although CDC proposed the ACCE model for the evaluation of genetic tests, there is no such system in Japan. Regarding the roles of genetic tests in health evaluation and promotion, genetic tests cannot predict the common diseases. Many genes are involved in the onset of common disease. Therefore, it is difficult to predict the diseases even with a combination of many tests. Genetic tests are not determined to be useful for prediction of common diseases and traits. However, Direct-to-consumer genetic tests are available via internet, which may cause serious problems. What is needed now is to study the clinical validity and utility by using the genetic tests whose analytical validity is assured. At present, genetic tests are not ready for health evaluation and promotion.
As the predicted life-time probability for having any cancer among Japanese are reported about 50% , it is urgent issue to establish an effective strategy for prevention and early detection of cancer. To this end, molecular epidemiological approach, genetic testing, can contribute to realize the reliable prediction system. This review summarizes the status quo and future perspectives and suggests a direction of the final goal of the research and practice of molecular genetics of cancer. First of all, the current practice on genetic testing of hereditary cancers is introduced, then recent progress in Parmacogenetics on drug response will be summarized. Genetic testing for predictive-incidence of sporadic cancers is still to be developed, but some leading data show promising predictive power such as in prostate cancer. Our preliminary data on comprehensive approach to establish a personal prediction system for many cancers in Japanese will be also shown. By analyzing about 4,000 specimens, we have found that 44 missense-SNP from 40 genes are significantly associated with at least one of 14 kinds of major cancers, which altogether cover～80% of total cancer patients in Japan. According to the stratification of the distribution of overlapping genotypes at risk on each individual for each cancer type, we have shown that about 60～80% of Japanese are relatively cancer-protective, 10～30% are intermediate, 5～20% are high-risk, and 0.5～2% are extremely high-risk on each type of cancer. Thus, our approach serves an efficient strategy to predict the susceptibility to specific cancers on each person. Once the strategy is established, we can make use them to prevent cancer by altering life-styles and to detect early cancers by periodic medical checking of the specified organs of the confined individuals at risk. Finally, scientific, ethical, and socio-economic aspects, as well as the limitation of genetic testing will be discussed.
The purpose of this study was to investigate the relationship between green and yellow vegetable intakes and high-density lipoprotein cholesterol (HDL-C). Subjects were 103 collegiate women, who neither drank nor smoked. The results of the multiple regression analysis showed that HDL-C and HDL2-C were significantly related with green and yellow vegetable intakes and body weight. When subjects were subdivided into 3 groups according to green and yellow vegetable intakes, the lowest category showed significantly lower HDL-C than the highest and middle categories after adjusting for body weight in the analysis of covariance. These results indicate that green and yellow vegetable intakes are related with HDL-C and HDL2-C, and HDL-C decreases with decreasing green and yellow vegetable intakes.
In April, 2008, Japanese government obliged health insurers to conduct the specific health checkup and instruction project focused on prevention of metabolic syndrome. Then, we constructed a health instruction support system as a tool for supporting the specific instruction by which a patient with metabolic syndrome can electronically record his daily-life information and physicians, health nurses or dietitians can the instruction. For the system construction, a management support system for patients with diabetes mellitus at home with a personal digital assistant (PDA) developed by us was improved. The health instruction support system has an easy menu selection method by button operation and a function of food model reference by which the standard of quantity of foods can be visually grasped. We added an automatic calculation function of a total amount of calorie intake to the system. It is necessary that we investigate whether the system is suitable for a health instruction support tool to prevent metabolic syndrome or not. Therefore, a questionnaire survey for evaluation of the system in which staffs of Department of Prevention Cardiology National Cardiovascular Center were chosen as the subjects was conducted in the present study. As a result, it was suggested that the function of food model reference is useful for elevating consciousness of food intake by comparing the quantity of foods as the visual information and an appropriate method for menu selection brings improvement of usability of the information input. This system has not been operated yet. However, from the hearing to specialists, it is expected that the developed system might be useful for the support of providing the health instruction services by physicians, health nurses or dietitians if the problems are solved.