Objectives To compare the effects of baseline anthropometric parameters and their changes on incident hypertension. Design A retrospective 5-year follow-up study. Setting Annual general health screenings at a medical check-up center. Participants A general health screening population including 1,221 men and 815 women who were not with hypertension at baseline. Main outcome measures Hazard ratios (HRs) of incident hypertension for baseline body mass index (BMI), waist circumference (WC) and percent body fat (PBF) as well as changes in them after being adjusted for baseline blood pressure. Results The cumulative incidence of hypertension was 23.7% in men and 13.5% in women. The baseline BMI, WC and PBF were not significantly associated with incident hypertension adjusted for baseline blood pressure and other confounders, while the changes in BMI, WC and PBF during follow-up were significantly associated with incident hypertension in men. All the associations with incident hypertension were not significant except for those of each 1 kg/m2 change in BMI during follow-up and for the highest quartile of baseline BMI and PBF compared with the lowest quartile in women. Baseline BMI, WC and PBF were not significantly correlated with changes in blood pressure except for inverse correlations of BMI and PBF with blood pressure changes in men while changes in BMI, WC and PBF were significantly positively correlated with changes in blood pressure. Conclusions Changes in BMI, WC and PBF during follow-up rather than their baseline values were significantly associated with incident hypertension after being adjusted for baseline blood pressure in men.
Background Chest radiographic screening is a commonly used conventional method for the screening of lung and mediastinal tumors. However, majority of the lung cancer detected by chest radiography are those that have already progressed to the advanced stage. Recent studies have shown that low-dose spiral computed tomography (LDCT) is effective for the early stage detection of lung cancer. On the other hand, usability of early stage detection of mediastinal tumors on chest LDCT is still obscure because of the rarity of these tumors. The purpose of this study was to reappraise and to clarify the usefulness of LDCT in the early detection of lung and mediastinal tumors. Methods Among the individuals who underwent medical check-ups from April 2010 to March 2016 at our institution, 2,395 people who also underwent LDCT were enrolled in this study. The presence of lung and mediastinal tumors was investigated in these individuals. Results Ten cases of lung and mediastinal tumors were detected on LDCT. Seven of these 10 cases were detected on LDCT only, and no abnormal opacity was observed on chest radiography. Five cases were finally diagnosed as malignant (4 lung cancer and 1 mediastinal sarcoma). Among the 5 malignant cases, 4 were also detected on LDCT only, and were successfully resected, and no tumor recurrence has been observed. Conclusion These results suggest that screening with LDCT is more useful than screening with radiography. LDCT contributes to the early detection of lung and mediastinal tumors.
Objectives: This study determined the impact of self-perception of weight and lifestyle on the physical condition and health problems of male Japanese bus drivers. Subjects and Methods: The study participants included 532 male Japanese bus drivers (20-65 years old) working at a transportation company in Ishikawa Prefecture. We used a self-administered questionnaire to assess weight self-perceptions and 10 lifestyle characteristics during health examinations in the summer of 2014. The participants were grouped into three categories based on their self-perception of weight (overweight, normal weight, and underweight). Participants’ self-perception of weight was compared with actual BMI to assess overestimation, accurate estimation, and underestimation of body weight. We also examined the association between laboratory test results, 10 health-related behaviors, and perceived weight status within the three BMI categories. Results: The percentages of the total participants who perceived themselves as overweight, normal weight, and underweight were 64.3%, 23.1%, and 12.6%, respectively. In Total, 56.0% of total participant accurately perceived their body weight. In addition, the weight perception of many participants appeared to have been affected by actual body weight and laboratory test results. Only three health-related behaviors showed a significant difference among BMI classifications; however, other health-related behaviors, such as dietary habits, alcohol consumption, and smoking behaviors, were worse than national survey data for all groups. Conclusions: The results suggest the possibility that male bus drivers’ weight self-perception is associated with laboratory test results and that having a good self-perception of weight leads to better lifestyle habits.
Objective. We assessed the relationship between sarcopenic obesity (SO) and metabolic syndrome (MetS) in Japanese elderly. Design. Cross-sectional observational study. Setting. Comprehensive health checkup center. Participants. A total of 235 individuals (95 men and 140 women; mean age, 73.2 ± 6.0 years) underwent comprehensive health checkups and examination of whole-body composition using dual-energy X-ray absorptiometry. Sarcopenia was defined by height-adjusted skeletal muscle mass, cutoff points of <7.0 kg/m2 for men and <5.4 kg/m2 for women. Obesity was defined by total-body fat percentage, cutoff points of ≥25% for men and ≥30% for women. The diagnostic criteria of MetS defined by the Japanese Society of Internal Medicine were used. Main outcome measures. Multivariate logistic regression analyses were performed to identify the risk for MetS associated with SO. Results. The prevalences of sarcopenia, obesity, and SO were 20%, 31%, and 18%, respectively. The prevalence of MetS at-risk was 31%, which was significantly higher in men than in women (42% vs. 24%, respectively; p < 0.05). Multivariate logistic regression analyses revealed that obesity and SO were associated with increased risk for MetS at-risk in the age- and sex-adjusted model (odds ratio [OR] and 95% confidence interval [CI] for obesity: OR, 9.69; 95% CI, 4.13-22.75; for SO: OR, 3.12; 95% CI, 1.23-7.94). After additive adjustments with body mass index (BMI), smoking, drinking, and physical activity, only SO showed a marginally positive association with the risk for MetS at-risk (OR, 3.02; 95% CI, 0.99-9.22). Conclusions. SO showed a greater association with the risk for MetS than obesity alone, independent of BMI and other confounders.
Objective Excessive caloric intake and a sedentary lifestyle are well-known risk factors for incident diabetes. The aim of this study was to determine if body composition, nutrient intake and daily energy expenditure values had any impact on glucose regulation. Methods A total of 81 subjects (49 men and 32 women) who underwent anti-aging health checks at Tokai University Tokyo Hospital were enrolled in this study. Body composition was evaluated using whole-body dual-energy X-ray absorptiometry. A food frequency questionnaire (FFQg) was used to estimate nutrient intake and energy expenditure values. Results The subjects were not obese on average in BMI. Percentage of body fat showed a significantly positive correlation with fasting glucose in both men and women. The relationship between energy intake and fasting glucose remained inconclusive in this study. There was a significantly negative correlation between fasting glucose and daily energy expenditure in men, and resting energy expenditure in women, but not energy expenditure of exercise in both men and women. Conclusion The present study shows that subclinical glucose dysregulation was associated with decreased energy expenditure other than exercise and increased percentage of body fat, rather than excessive energy intake and/or decreased physical activity in the anti-aging checkup examinees. We strongly emphasize the importance of evaluating body composition to detect early signs of metabolic changes, because subjects with sarcopenic obesity are at high risk of developing lifestyle-related diseases including type 2 diabetes.
In anti-aging medical check-ups, aging is evaluated by functional ages (muscle age, vasucular age, neural age, hormone age, and bone age) and risk factors of aging (immune stress, oxidative stress, physical and mental stress, glycative stress, and lifestles) separately. Based on each measurement result, a medical treatment plan is implemented targeting the improvement of lifestyle habits including education about proper diet, nutrition, and physical exercise. In order to attain balance, we start with rectifying risk factors in descending order of seriousness by focusing on the most deteriorated parts of the body in terms of functionality. It enables the patient to prolong their years of healthy lifespan and to increase their average lifespan. We will show a practice example of the anti-aging medical check-up in occupational health care as well as elderly care. Among the college personnel, there are many who suffer from aging of their musculoskeletal system. Among those with metabolic syndrome, there are many who are weak in terms of the blood vessel systems. It is shown that executives of big enterprises have a 15% younger bone age and IGF-I hormone compared to other males in the same generation. It is recommended that in the analysis of five months’ intervention study on elderly patients, we should treat functional age adding 0.42 years which is equivalent to five months. In the anti-aging check-up, it is possible to attain information which cannot be recognized during an ordinary check-up.