Purpose: This study aimed to evaluate the clinical validity of three different obesity criteria and to access the cut-off values of body mass index (BMI) and waist circumference (WC) to diagnose glucose intolerance.
Methods: We analyzed 11,579 participants (6,678 men, 4,901 women) from 15,278 individuals who had undergone a worksite annual health check-up in 2013, excluding those with missing values, on diabetes medication, and aged <20 years or ≥60 years. The diagnostic validity of three cut-off values as criteria was evaluated: a BMI ≥25, a WC ≥85 cm (men) and ≥90 cm (women) using the Japan Society for the Study of Obesity (JASSO) criterion, and a WC ≥90 cm (men) and ≥80 cm (women) (WHO criterion). For each age and sex strata, we compared the ratio of obese and non-obese participants with glucose intolerance, and determined the BMI and WC cut-off values using receiver operating characteristic (ROC) curves corresponding to 126 mg/dL, 110 mg/dL, and 100 mg/dL FBS levels, and 6.5%, 6.0%, and 5.6% HbA1c levels, respectively.
Results: In men, the prevalence and odds ratios of glucose intolerance were similar for BMI and WHO WC criteria, but in women, those values were inconsistent for all three. In ROC analysis, BMI cut-off values corresponding to each of the three FBS and HbA1c levels were 24.5–25.7 (area under the curve [AUC] 0.63–0.71), and 21.3–25.0 (AUC 0.62–0.86) in men and women. WC cut-off values were 80.9–89.2 (AUC 0.66–0.74), and 76.9–85.0 (AUC 0.63–0.88) in men and women. BMI and WC cut-off values tended to reduce as glucose levels reduced, but only the BMI in men settled to a value of approximately 25.
Conclusion: In this population, the cut-off values in women were lower than the present JASSO WC criterion, necessitating further investigation of this criterion.
[Objective] To develop a formula to estimate the skeletal muscle mass index (SMI) of young women using simple measurable items.
[Methods] The study included 117 female students (18.8 ± 0.8 years old) who signed the consent in advance and were able to undergo the following measurements: height, weight, body fat percentage, body fat mass, appendicular muscle mass, grip strength, and calf circumference. Height was measured with a stadiometer, whereas weight and composition were measured using bioelectrical impedance analysis. To generate a more precise SMI estimation formula, the calf circumference index (CCI) [body fat mass (kg)/(calf circumference [m])2 ]was invented, and multiple regression analysis was performed using variables selected by a stepwise method. SMIs were used as response variables and explanatory variables were selected from body mass index (BMI), body fat mass, grip strength, calf circumference, and CCI.
[Results] The mean SMI was 7.2 ± 0.6 kg. Although a significant correlation was observed in terms of all variables, CCI (p < 0.001) had the highest correlation coefficient. A highly precise SMI estimation formula based on BMI and CCI was developed using the following regression model formula (R2 = 0.89):
SMI = 3.003 + 0.297BMI -0.020CCI
[Conclusion] The SMI estimation formula developed herein can be calculated using a simple measurement method, facilitating self-evaluation of skeletal muscle mass. This information is expected to allow prevention of sarcopenia in young women at an early stage.
The aim of health check-ups is to determine the necessity of medical care. Thus, the determination ability can be regarded as the quality of health check-ups. The thoughts about this determination in health check-ups are similar to those about sensitivity and specificity in statistics. Thus, the instruction rate and response rate to detailed examination, detection rate, etc., which allow the calculation of sensitivity and specificity, can be used as quality indices of health check-ups. Therefore, a full follow-up survey of participants in health check-ups is required. In addition, to more accurately judge health checkup results, we should not judge the results based on uniform standards. Instead, we should establish a standard range for each health checkup item based on individual's physiological changes and use it for the judgment of health checkup results. We should also take aging phenomena into consideration when making judgment. Therefore, we need to accumulate longitudinally comparable results obtained from examinations to always maintain a certain level of precision. Considering that the results may be carried to various institutions, we must provide results that allow longitudinal comparison with those from other health checkup facilities. At the same time, to increase the precision of the judgment of health checkup results, we should educate participants in health check-ups about the importance of their providing feedback of their subsequent health conditions to their health checkup facilities.
Because scuba diving is special activity to be carried out under the high pressure environment of undersea, a health appropriate standard becomes special. In Japan, there is a medical check/guideline prepared by Japanese Society of Hyperbaric and Undersea Medicine based on the Recreational Scuba Training Council which is the global diving standard for divers. Diver examination items are individually determined depending on whether these guidelines are met. First, the diver fills in a health questionnaire, and if there is no corresponding item, it will be only a general checkup, but if there is, it will decide additional examination items with reference to the guideline. In this thesis explain only diseases and pathological conditions that are not a problem in health conditions in general sports bring about serious obstacles in submergence activities, and that clinicians are likely to mislead excerpts and explains. In nervous system diseases, pathologies that can cause consciousness disturbances and fainting attacks are submission contraindications. Epilepsy is especially dangerous in fatal accidents. In the cardiovascular system, 9 METS exercise capacity is required, no cardiac shunt, high blood pressure is well controlled only with designated drugs. In the digestive system, diseases that can potentially because vomiting are drinking contraindications. In the respiratory system, there is no lung cavitary lesion, control of asthma is controlled by meeting the guidelines, and no history of pneumothorax. With blood disorders, diving cannot be performed in bleeding tendencies and pathological conditions with high blood cohesion. In the endocrine system, diabetes is impossible to dive in a condition requiring medication.
In addition, knowing the decompression illness, which is a specific disease under the high-pressure environment, helps divers to check and diagnose. This includes a decompression sickness and an arterial gas embolism, which is a special disease that develops during depressurization during levitation.
Hirosaki University has run a project named "Iwaki Health Promoting Project" since 2005, of which advantage is the Health Big-Data containing super multi-item data of healthy people, over 2,000 items per person and a total of over 20,000 people including school students. This Big-Data has a comprehensive structure including total contents of whole-body health/function ranged from a genome, physiological and biochemical data to personal activities data and social economic environmental data.
This project was adopted as a "Center of Innovation (COI)" of MEXT in 2013. Over 40 major health-care companies and some 50 institutions like universities have participated, we all members built a large consortium to strategically develop specifying and predicting diseases like life-style-related disease and dementia.
Here I should introduce the result of "health Big-Data" analysis, our prospects and strategies aiming to "a society of health and longevity", and our strategic project for social implementation.
We put high importance on constructing of our social environment to promote the regional residence health by co-operation among industrial, academic, public and private sectors. We provide our educational activities to main fields like schools, region and working rages.
Among all strategies, we are presently developing a new behavior modifying program (an enlightening medical checkup) of which checkup items are focused on the 4 major fields, that is, "metabolic syndrome", "locomotive syndrome", "oral health" and "depression and dementia".
We complete checkup, result explanation and health education within 2-3 hours, so this can be called as a compact type program package. The result of demonstration experiments so far indicates the significant decline of HbA1c and visceral fat, and other effect like improvement in health literacy of regional residence.
Our social innovative strategy gradually leads to improve health literacy in Aomori Pref., the shortest average life span prefecture in Japan. By organizing our knowledge and achievement, and by expanding not only in Japan but also in Asian countries and to the world, we would like to make contrition to world human health (SDGs) in the future.