Metabolic syndrome (MetS) may be the systemic manifestation of adipose tissue disease induced by chronic energy overload and defined as an increased aggregation of activated macrophages into adipose tissue characterized by crown-like structure. The predominant underlying mechanisms of MetS appear to be insulin resistance, leptin resistance, abdominal obesity, autonomic dysfunction, endothelial dysfunction, and inflammation. Established components of MetS are increased waist circumference, high BP, increased serum TG levels, decreased serum HDL cholesterol levels, and impaired fasting glucose. Increased serum levels of hs-CRP, fatty liver, increased serum gamma glutamyltransferase and/or ALT levels, increased serum LDL cholesterol levels, increased urinary excretion of albumin, increased resting heart rate, and decreased vital capacity are reported as associated components of MetS. Thus, the author proposes an extended concept of MetS as a systemic pre-disease state developing through adipose tissue disease. (Ningen Dock 2010; 24: 1-6)

抄録全体を表示

Background We examined the association between WBC count and lifestyle factors, and the effects of habitual exercise on WBC count.
Methods We conducted a questionnaire survey on 112 subjects undergoing a complete medical check-up at our hospital using computer-graded answer sheets to determine whether or not they (1) are currently suffering from mental stress; (2) smoke 20 or more cigarettes each day and; (3) exercise at least once a week. We also measured BMI to investigate the association between these factors and the WBC count. Furthermore, we analyzed abnormal WBC counts using logistic regression.
Results WBC count significantly increased in the subjects who were current smokers and those with a BMI≧25 kg/m². Among the subjects who exercised regularly, we observed a significant decrease in WBC count of those with mental stress, and a predisposition towards decreased WBC count in those who were currently smokers; however, there was no significant difference in BMI. Moreover, current smoker status was an independent risk factor for abnormal WBC count.
Conclusion WBC count increased in the current smokers and overweight subjects with a BMI of 25 kg/m² or above. The results, however, suggest that although habitual exercise at least once a week can prevent an increase in WBC count caused by smoking, it does not have any effect on the increase in WBC count caused by being overweight. (Ningen Dock 2010; 24: 7-11)

抄録全体を表示

Background The associations between hs-CRP and metabolic risk factors, metabolic syndrome (MS), diabetes, and chronic kidney disease (CKD) were poorly studied in Japanese.
Methods MS-related risk factors, MS defined by revised National Cholesterol Education Program (NCEP) criteria for Japanese, Japanese metabolic syndrome (JMS), diabetes, and CKD were compared between subjects with the highest quartile of hs-CRP (Q4) and those with the lowest quartile of hs-CRP (Q1) using medical check-up data from 1880 men and 1079 women. Diabetes was defined as fasting glucose ≥126 mg/dl and/or antidiabetic medication. CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² and/or proteinuria.
Results BMI, body fat %, waist circumference, systolic and diastolic BP, fasting glucose, TG, hs-CRP, gamma glutamyltransferase, ALT, LDL cholesterol, uric acid, WBC count, and heart rate were significantly higher and HDL cholesterol and eGFR were significantly lower in MS subjects than in non-MS subjects in both men and women. % vital capacity was significantly lower in MS subjects than in non-MS subjects in men. The prevalence of MS, JMS, and CKD was significantly higher in Q4 than in Q1 in both men and women and the prevalence of diabetes was significantly higher in Q4 than in Q1 in men, but not in women.
Conclusion The prevalence of MS, JMS, and CKD was significantly higher in Q4 than in Q1 in both men and women and the prevalence of diabetes was significantly higher in Q4 than in Q1 in men. (Ningen Dock 2010; 24: 13-20)

抄録全体を表示

Background The prognosis of hematological malignancies is still unsatisfactory despite recent advances in therapeutic modalities. However, the effectiveness of their early detection has not been evaluated. We report on asymptomatic patients with acute leukemias or malignant lymphomas detected in ningen dock and compare their clinical courses with symptomatically diagnosed patients.
Methods Among 222 patients with acute leukemias or malignant lymphomas that we diagnosed between 1998 and 2008, 5 asymptomatic patients were referred by ningen dock centers. Their diseases were acute promyelocytic leukemia, acute lymphoblastic leukemia, follicular lymphoma, diffuse large B cell lymphoma, and small lymphocytic lymphoma, respectively. Their survival time following completion of chemotherapy was analyzed in comparison with symptomatically diagnosed patients.
Results All of the 5 patients remained alive during observation periods ranging from 25 to 131 months (median 58) with no particular events. However, event-free survival rates at 5 and 10 years for the 217 symptomatic patients were 29.9% and 14.8%, respectively.
Conclusion Although more precise analyses are required, we postulate that the widely practiced ningen dock and population-based screening could improve the prognosis for hematological tumors by detecting them at an earlier stage. Therefore, closer relationships between ningen dock centers and institutes where detailed hematological examinations are carried out should be established. (Ningen Dock 2010; 24: 21-24)

抄録全体を表示

Background The basic clinical condition of metabolic syndrome (Met.S) is obesity. The quantified effect of daily physical activity without intervention is unclear. The aim of this study was to examine the relationship between Met.S and daily physical activity as evaluated with an accelerometer.
Methods We quantified the amount of daily physical activity using motion-measuring equipment incorporating an accelerometer (Lifecorder^® EX). We also asked subjects about their lifestyles through interviews, in order to evaluate the activity status of each of three groups. The subjects were 241 men whose ages ranged from 40 to 70. They were assigned to the control group (waist circumference (WC)<85 cm), the Met.S risk group (only WC≥85 cm or WC≥85 cm and 1 risk factor), and the Met.S group (WC≥85 cm and at least 2 risk factors), based on Japanese Met.S diagnostic criteria.
Results Compared to the other 2 groups, the Met.S group showed significant obesity (p<0.05). In the Met.S group, the amount of daily physical activity was lower in terms of exercise calorie rate (p=0.03), effective exercise time rate (p=0.22), and average steps (p<0.0001). The Met.S group was also characterized by a higher BP and lower concentrations of HDL cholesterol and adiponectin than the other groups.
Conclusion Japanese obese adult males tend to do engage in less daily physical activity. This may adversely affect BP, glucose tolerance, lipid profiles, and adiponectin concentrations, causing Met.S and other undesirable conditions. For this reason, it is useful to evaluate daily physical activity using an accelerometer. (Ningen Dock 2010; 24: 25-29)

抄録全体を表示

Background Subjects with minor abnormal ECG findings, such as counterclockwise rotation, clockwise rotation, axis deviation, low voltage, incomplete right bundle branch block, and RsR’ pattern, are considered to require follow-up. We examined changes in the ECGs of these subjects after 10 years to evaluate whether follow-up is necessary.
Methods Subjects who visited our hospital for health check-up in 1993 or 1994 were designated as having minor abnormal ECG findings (M, n=1539) or as having normal ECGs (N, n=1309), and the ECGs of these 2 groups were compared in 2003 or 2004, respectively. Serum lipids, plasma glucose, BP, and BMI for subjects with newly detected ischemic ECG findings (IC group) were compared with those for subjects with ECG findings that were relatively unchanged (S group).
Results About 50% of the subjects showed similar ECG findings 10 years later. The percentage of newly detected ischemic findings in M was comparable to that in N. In the men in the IC group, serum lipids, BP, and BMI were higher than in the S group both in 1993 and 1994, and after 10 years. In the women in the IC group, BP was higher in 1993 and 1994, and had increased 10 years later.
Conclusion Subjects with minor ECG abnormalities can be dealt with similarly to those with a normal ECG. However, annual ECG follow-up is important in cases of dyslipidemia, hypertension, or obesity. (Ningen Dock 2010; 24: 31-38)

抄録全体を表示

Objective To examine the relationship between the serum level of iron and that of CRP within its normal range of 0-5 mg/l.
Methods A cross-sectional study involving 7250 male employees who underwent an annual health checkup was conducted. Information regarding current medications and lifestyle habits was obtained using a self-reported questionnaire.
Results The subjects were divided into 6 groups based on the serum level of CRP in the range 0 to 5 mg/l and the mean values were compared among the groups. The mean level of iron decreased from 21.8 mmol/l to 17.2 mmol/l as the CRP level increased from 0 mg/l to 5 mg/l. However, there was no change in the level of Hb or the erythrocyte mean cell volume. Similar results were obtained when values were adjusted for the age, BMI, smoking, alcohol consumption, and physical activity.
Conclusion These results indicated a negative association between the serum level of iron and that of CRP within its normal range. (Ningen Dock 2010; 24: 39-41)

抄録全体を表示

Background Up till now, there has been no detailed study on an association between impaired fasting glucose (IFG) and metabolic risk factors by age and gender in Japanese.
Methods Stepwise logistic regressions using IFG as a dependent variable and BMI, metabolic risk factors, age, drinking status, and smoking status as independent variables were performed by age and gender in non-diabetic Japanese without antihypertensive and/or antihyperlipidemic medication, or any history of cardiovascular disease.
Results Correlations between fasting plasma glucose and obesity indices were stronger in women ≤50 years than in men ≤50 years, but were weaker in women >50 years than in men >50 years. Age, BMI, HDL cholesterol, gamma glutamyltransferase (GGT), and LDL cholesterol in men ≤50 years, BMI, TG, ALT, and drinking status in men >50 years, heart rate and BMI in women ≤50 years, and uric acid and drinking status in women >50 years were independently associated with IFG.
Conclusion Uric acid was the only metabolic risk factor to be independently associated with IFG in apparently healthy non-diabetic Japanese women >50 years. (Ningen Dock 2010; 24: 43-47)

抄録全体を表示