Objectives: To clarify the involvement of obesity, atherosclerotic risk factors, and metabolic syndrome in vascular aging in the elderly population and examine the significance of atherosclerotic risk factor treatment.

 Design: A retrospective study.

 Setting: Hospital.

 Participants: Two hundred and sixteen examinees (146 men and 70 women) aged ≥65 years.

 Main outcome measures: We examined whether there were sex differences in aortic calcification, cardio-ankle vascular index (CAVI), age, body mass index (BMI), atherosclerosis risk factors, and metabolic syndrome degree. We also examined whether aortic calcification and CAVI correlated with age, BMI, atherosclerosis risk factors, and degree of metabolic syndrome. Aortic calcification, CAVI, age, BMI, atherosclerotic risk factors, and metabolic syndrome degree were compared between the treatment and non-treatment groups for risk factors (hypertension, dyslipidemia, and diabetes).

 Results: Men had higher values than women for several parameters, except cholesterol. Aortic calcification was associated with age and atherosclerotic risk factors in men and with age and dyslipidemia treatment in women. The CAVI was associated with age and blood pressure only in men. Among men, the CAVI was higher in dyslipidemia and diabetes treatment groups than in the non-treatment group but not significantly different between the hypertension and non-treatment groups. In women, the CAVI was significantly higher in the hypertension treatment than in the non-treatment group but not significantly different between dyslipidemia and diabetes treatment and non-treatment groups.

 Conclusions: Although there are differences between men and women, therapeutic reductions of atherosclerotic risks may inhibit the progression of vascular aging.

 Objective Postprandial hyperlipidemia has been considered as one of the residual risk factors for cardiovascular disease after a decrease in low-density lipoprotein cholesterol (LDL-C) levels. Although low-fat meal ingestion may be the first step in the prevention and amelioration of postprandial hyperlipidemia, there is limited information on how lipid levels change after low-fat meal ingestion in the Japanese population.

 Methods We recruited 28 Japanese subjects (20 men and 8 women) who underwent an annual health examination in our hospital in 2020 and were not using any medications. The determinants of 2 h and 3h postprandial triglyceride (TG) and remnant-like particle cholesterol (RLP-C) levels were determined using multiple regression analyses. Postprandial TG and RLP-C levels were compared in subjects classified according to fasting TG and homeostasis model assessment-insulin resistance (HOMA-IR).

 Results Fasting immunoreactive insulin (FIRI) and apolipoprotein (apo) B were positively correlated with 2 h and 3 h postprandial TG and remnant RLP-C levels. Multiple linear regression analysis revealed that FIRI and apo B levels were positively associated with postprandial TG levels, whereas age was negatively associated with these levels. Additionally, FIRI and apo B levels were positively associated with postprandial RLP-C levels. Postprandial 2 h and 3 h TG and RLP-C levels increased as HOMA-IR and/or apo B level increased.

 Conclusion Postprandial 2 h and 3 h TG and RLP-C levels mainly depend on HOMA-IR and apo B levels after low-fat meal ingestion in Japanese subjects. In addition to low-fat meals, amelioration of insulin resistance may be necessary to improve postprandial hyperlipidemia.

 Objective: The present study aimed to examine the relationship among homocysteine (Hcy), inflammation, and muscle strength.

 Design, Setting and Participants: A total of 420 subjects (male, n=218; female, n=202) who underwent the Advanced course anti-aging health checks at Tokai University Tokyo Hospital were enrolled in this cross-sectional study.

 Measurements: Hcy and Hcy-related vitamin concentrations, muscle strength (grip strength and back strength), body composition, and inflammatory marker levels (C-reactive protein, IL-6) were analyzed.

 Results: The median age of the male and female subjects was 66.0 years and 63.0 years, respectively. The prevalence of sarcopenia, according to the definition of the Asian Working Group for Sarcopenia, was 2.1% in men and 7.0% in women. IL-6 was found to be a positive determinant of Hcy in women. Muscle strength showed a significant positive association with the appendicular lean mass in men and women, and a negative association with Hcy in women. Furthermore, in women, low grip strength was associated with elevated Hcy levels and high IL-6 levels.

 Conclusion: Hcy is associated with lower muscle strength and inflammation may mediate this association in women.

 The principle of medical ethics is to protect human dignity and respect human rights. Every healthcare worker, who is involved in human healthcare and research targeting humans, is desired to behave with high ethical standards. From this point of view, most medical institutions carry out daily practices according to determined basic principles and action goals. However, it is practicing only with the principle is insufficient. Every institution should be required to formulate a written code of ethics and establish a deliberating system to evaluate whether ethical consideration is performed.

 Our clinic was pointed out deficiencies in the written ethical code and the concrete behavioral goal through onsite examination of the excellent facility update approval committee of the Japan Society of Health Evaluation and Promotion. They also requested to submit an improvement report on these deficiencies. According to this deliberative examination, we immediately acted to formulate an institutional ethical code and to set up an ethical committee as the clinic attached to the health check division.

 In this article, we introduce how to proceed with the establishment of these ethical activities and emphasize the importance of third-party examinations of healthcare facilities with the aim of obtaining an excellent evaluation.