Objective: It is difficult to clearly detect the anterior wall of the stomach over a wide range by double contrast gastro-fluoroscopy in the prone position and this technique tends to increase the mental and physical stress of examinees. We made our own special pillow to resolve these problems and studied its effectiveness.
Methods: We studied the effectiveness of the pillow in 500 examinees (335 males, 165 females) who visited our health care center between February, 2009 and June, 2009 by evaluating the extent to which the anterior wall could be clearly detected in double contrast gastro-fluoroscopy with and without the homemade pillow. We also evaluated the effectiveness of the homemade pillow for each stomach type (long stomach, normal stomach, short stomach). Double contrast fluoroscopy of the gastric anterior wall was performed within 10 degrees of the head-down position in order to decrease mental and physical stress in the examinees.
Results: The extent that the anterior wall could be clearly detected by double contrast fluoroscopy was significantly increased with the pillow compared to without it, and this was so for all stomach types. We also found that the use of the pillow reduced mental and physical stress in examinees.
Conclusions: These results suggest that our homemade pillow is useful as regards detection of the anterior wall of the stomach and decreasing mental and physical stress in examinees undergoing double contrast fluoroscopy of the gastric anterior wall.

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Objective: We have been conducting the lifestyle intervention program "Diet Support Plan Group Challenge" (DSP-G) since 2006. In this study, we aimed to clarify whether program participants could maintain improvements in various biochemical data and weight loss after finishing the program.
Methods: Participants were a total of 60 Japanese male office workers who underwent health check-ups in 2006 and had one or more of the following objective findings: body mass index (BMI, kg/m²) 25≦, hypertension, hyperglycemia, dyslipidemia, hyperuric academia or liver dysfunction. They started the DSP-G between November and December 2006 and finished it between February and March 2007. Biochemical data obtained in health check-ups in 2006, on finishing the DSP-G program and in follow-up health check-ups performed between May 2007 and January 2008 were compared.
Results: Forty-three participants completed the program and underwent health check-ups in 2007. Body weight was significantly decreased after finishing the DSP-G program (77.2± 8.6 to 73.4± 8.9kg, p<0.0001) and this improvement was maintained until the follow-up health check-ups in 2007 (73.2±10.2 kg). Similar tendencies were observed for biochemical data.
Conclusion: Our results suggest that the lifestyle improvements achieved by the DSP-G program were maintained by the participants for at least 1 year.

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Objective: It is very important for healthful longevity to maintain a good body mass index (BMI). The purpose of this study was to determine the lifestyle habits that are most related to BMI.
Methods: Questionnaire data on lifestyles and BMI measurements from 6,826 adults who underwent health check-ups at our center were analyzed statistically.
Results: The BMI of middle-aged males (30s to 50s) was high while that of young females (20s to 30s) was low. Men and women who ate rapidly or took meals late at night had a high BMI. Physical exercise and sleep satisfaction, however, were not related to BMI. Further, men who had an extra meal after supper or consumed a large amount of alcohol had a high BMI, and those who smoked, engaged in physical activity, walked rapidly, or drank every day had a low BMI. The women who did not take breakfast had a high BMI.
Conclusions: To maintain a good BMI, health guidance in which people are told to eat slowly and not to take meals late at night is even more important than that telling them to stop smoking, do physical exercise or take a good amount of alcohol.

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Objective: We set reference central blood pressure levels in consideration of presence or absence of atherosclerosis findings and examined their significance in health check-ups as well as target levels for health guidance.
Methods: We measured central blood pressures in 316 health check-up examinees with normal brachial blood pressures (systolic pressure<130 mmHg, diastolic pressure<85 mmHg; not under treatment) by tonometry and derived reference levels through ROC analysis of atherosclerosis findings in chest X-ray, ECG, ocular fundus, carotid artery, and brain MRI/MRA examinations. We also considered appropriate values for health guidance.
Results: From the maximum likelihood ratio point on the ROC curve, the reference central blood pressure was 125 mmHg. Also for systolic pressures of 120 mmHg and above and diastolic pressures of 75 mmHg and above, there was a marked increase in the number of subjects with high central blood pressures.
Conclusion: A large number of subjects had high central blood pressures despite being in the normal brachial blood pressure range so it would be possible to discover latent cases of atherosclerosis through central blood pressure measurements. Also, for health guidance purposes, it would be desirable to have target systolic and diastolic blood pressures of less than 120 mmHg and less than 75 mmHg, respectively.

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Objective: A relationship between visceral fat accumulation and lifestyle-related diseases such as hypertension, diabetes mellitus and dyslipidemia has become more widely recognized with the spread of the metabolic syndrome concept. The present study was conducted to determine if changes in various lifestyle-related disease parameters and changes in visceral fat area are correlated.
Methods: The subjects were 372 adults whose visceral fat area was measured by CT scan at least twice, and we investigated a correlation between changes in various lifestyle-related disease factors and changes in visceral fat area measurements.
Results: There was a significant correlation between changes in visceral fat area and changes in blood pressure, lipids, fasting plasma glucose, plasma glucose at 120 minutes in oral glucose tolerance test, and fasting insulin concentration. Atherosclerosis risk factors also changed with changes in visceral fat. In addition, there was a highly significant correlation between changes in visceral fat area and changes in obesity related parameters. Further, change in visceral fat area was more strongly correlated with change in body mass index than it was with change in waist circumference.
Conclusions: These results suggested that measuring visceral fat area is useful. However, a cost-benefit study of visceral fat area measurements by CT scan is also needed.

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Objective: We measured the cholesterol levels in low density lipoprotein (LDL) subclasses and LDL particle sizes by gel permeation HPLC in healthy subjects in an annual health check-up, and investigated a relationship between lipoprotein cholesterol profiles and metabolic syndrome (MS) risk items.
Methods: For 538 men (aged 21-69 years) who underwent an annual health check-up focused on MS, cholesterol levels in lipoprotein subclasses were measured by an analytical HPLC service (^®LipoSEARCH) of Skylight Biotech Inc. (Akita, Japan). We investigated how LDL subclass cholesterol levels and LDL particle size were related to total numbers of MS risk items (MS score): obesity, high blood pressure, high serum triglyceride (TG) and/or low high density lipoprotein (HDL-C) and high HbA1c.
Results: All the MS risk items and MS scores were significantly (p<0.001) positively correlated with small LDL-C, and negatively correlated with LDL particle size, but not correlated with large LDL-C. In a subgroup with age over 45 and LDL-C less than 140 mg/dl (n=224), large LDL-C was significantly (p<0.05) negatively correlated with BMI, systolic blood pressure, HbA1c and MS score.
Conclusion: In a large number of healthy men, we confirmed the existence of a unique LDL subclass that was negatively correlated with MS risk items by gel permeation HPLC. The measurement of large LDL-C as well as small LDL-C by gel permeation HPLC may be very useful in evaluating MS risk in a healthy population.

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Objective: We compared non-smoking subjects and those with different smoking habits to determine whether the prevalence of allergic rhinitis (rhinitis) differed among them.
Methods: Our subjects were 9,733 men and 3,071 women who had undergone an annual health check-up. Information regarding lifestyle habits, medicines taken regularly, and past and present illnesses was obtained using a self-reported questionnaire.
Results: The prevalence of rhinitis was 10.5, 14.5, 10.6, 9.7, 5.8, and 3.7% in the subjects overall, non-smokers, past smokers, and smokers who smoked 1-19, 20-39, and 40 or more cigarettes per day, respectively. Multiple regression analysis revealed that rhinitis was associated with smoking and age, but not with body-mass index, alcohol consumption, and exercise frequency. After being adjusted for age, the odds ratios of the prevalence of rhinitis in past smokers, and smokers who smoked 1-19, 20-39, and 40 or more cigarettes per day were 0.76, 0.64, 0.38, and 0.25, respectively. All of these odds ratios were significantly lower than for non-smokers. The prevalence of rhinitis in women was 14.7%, which was significantly higher than that in men. However, there was no difference between men and women when only non-smokers were analyzed.
Conclusion: The prevalence of rhinitis was negatively associated with the level of smoking. The difference in prevalence between men and women could be a result of variation in the amount of smoking.

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Objective: To study associations between changes in body weight (dBW), body mass index (dBMI), and waist circumference (dWC) and changes in systolic blood pressure (SBP) (dSBP), diastolic blood pressure (DBP) (dDBP), fasting plasma glucose (FPG) (dFPG), triglycerides (dTG), HDL cholesterol (dHDL), LDL cholesterol (dLDL), and high-sensitivity C-reactive protein (hsCRP) (dCRP) over 1 year.
Methods: Our subjects were 1,557 men and 817 women with each cardiovascular risk factor (SBP >= 130mmHg, DBP >= 85mmHg, FPG >= 100mg/dL, triglycerides >= 150mg/dL, HDL < 40mg/dL in men and < 50mg/dL in women, LDL cholesterol >= 140mg/dL, or hsCRP >= 0.4mg/L in men and >= 0.35mg/L in women). Those who ceased taking relevant drugs or were newly prescribed with such drugs during the follow-up period were excluded. Multivariate linear regressions were individually calculated between changes in the risk factors as dependent variables and dBW, dBMI, and dWC as independent variables.
Results: The standardized regression coefficients of dBW, dBMI, and dWC, for dSBP, dFPG, dTG, dHDL, and dLDL were 0.124 (p=0.005), 0.132 (p=0.003), and 0.115 (p=0.009), 0.204 (p<0.0001), 0.189 (p=0.0001), and 0.167 (p=0.001), 0.067 (p=0.183), 0.145 (p=0.004), and 0.131(p=0.008), -0.263 (p=0.006), -0.271 (p=0.004), and -0.224 (p=0.024), and 0.280 (p<0.0001), 0.227 (p<0.0001), and 0.150 (p=0.005), respectively, in men. There were no significant associations between dBW or dWC and changes in risk factors in women.
Conclusions: In men, the associations of dBW with dFPG, dHDL, and dLDL tended to be stronger than those of dWC, while dWC and dBMI, but not dBW, were significantly associated with dTG.

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Objective: We clarified the characteristics of lung ages calculated on the basis of 1-second forced expiratory volume and examined problems with using them.
Methods: We divided 9,123 people who underwent respiratory function testing in ningen dock in fiscal 2008 into a smokers group, a past smokers group and a non-smokers group. They were compared for respiratory function, lung age and lung age difference (lung age - actual age) and inflammation findings and we examined optimal lung age difference cut-off points for suspected COPD. For heavy smokers, differences between a lung age (+) group and a lung age (-) group were also examined.
Results: COPD was suspected in 7.5% of smokers and past smokers and 2.0% of non-smokers. At 0.099±0.206 mg/dL and 0.094±0.199 mg/dL, respectively, the high-sensitivity CRP level in the smokers and past smokers groups was significantly higher than that in the non-smokers, of 0.075±0.167 mg/dL (p<0.001) but the difference between smokers and past smokers was not significant. The optimal lung age difference cut-off point for suspected COPD was 16.6 years. Around 17.5% of the heavy smokers came under the lung age (-) group and in these subjects, pulmonary capacity was higher and evidence of inflammation slight.
Conclusions: As lung age is connected with smoking history it can play an important role in smoking cessation counseling. However, it is necessary to keep in mind that in spite of smoking a large number of cigarettes, there are individuals with a lung age younger than their actual age who have a high pulmonary capacity and show only a slight inflammatory reaction. In addition, our findings suggest that inflammation due to smoking persists in past smokers.

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Objective: We examined the effects of exercise frequency on clinical laboratory data.
Methods: Our subjects were 1,963 men who had undergone an annual health check-up. Information regarding lifestyle habits was obtained using a self-reported questionnaire. For the question regarding exercise, subjects chose 1 of the following 4 responses: almost no exercise, once or twice per month, once or twice per week, and 3 times or more per week.
Results: When values were adjusted for age, body-mass index, amount of smoking, and alcohol consumption, significant partial correlations were obtained between exercise frequency and IRI, creatinine, HDL cholesterol, ALT, cholinesterase, triglycerides, and total cholesterol, in order of correlation intensity. The adjusted average values of IRI were 4.95, 4.48, 4.42, and 4.09 μU/L in subjects doing almost no exercise, those exercising once or twice per month, once or twice per week, and 3 times or more per week, respectively. Compared with the group performing almost no exercise, the IRI values in the other 3 groups were significantly lower.
Conclusion: These results suggest that IRI is the laboratory study parameter that is most sensitive to variation in exercise frequency, and insulin resistance is improved even by exercise only at a frequency of once or twice per month.

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Objective: Lung age, which is calculated from height, sex and 1-second forced expiratory volume, is an index of respiratory function.
When the lung ages are higher than actual ages, the question is whether they deviate from reference intervals or not. However, as yet no reference intervals have been established.With this in mind, we investigated the basic statistical ranges of lung age in non-smokers.
Methods: Our subjects were 2,707 non-smokers (30-79 years old) without respiratory diseases taken from among 7,935 persons who underwent ningen dock at the Shimbashi Medical Checkup Office of Jikei University Hospital. They comprised 1,134 males and 1,573 females.We calculated lung ages according to age group, and considered lung age reference intervals based on respiratory function.
Results: The average lung ages of the non-smokers with normal lung function (Average age: males 49.7±10.5 yrs, females 50.3±11.1 yrs) were 52.3±15.6 yrs for males, and 45.6±15.7yrs for females and the differences with actual ages were 2.6±12.3 yrs for males, and -4.7±12.4 yrs for females. When lung age was more than the actual age, the reference intervals were 24.1 yrs in males, and 24.3yrs in female. These figures were obtained by multiplying the standard deviations by 1.96.
Conclusions: There would be limitations on using lung age in educating people regarding prevention of chronic obstructive pulmonary disease because at more than 24 years, the standard deviation in normal subjects was very broad.

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Objective: To assess the potential of urinary myoinositol measurement after a meal to be used in place of that after glucose loading (2).
Methods: Fifty-two volunteers who underwent 75-g oral glucose tolerance testing (75gOGTT) were classified according to 1998 WHO criteria. Normal glucose tolerance subjects with a 1 h plasma glucose ≥180 mg/dL were defined as pre-borderline type. On a different day, they underwent a regulated meal load test (MT). Urinary myoinositol was measured before and 2 hours after both OGTT and MT and incremental urinary myoinositol (ΔUMI: myoinositol/creatinine ratio 2 hours after loading - myoinositol/creatinine ratio before loading) was compared between the tests.
Results: A good correlation was observed between ΔUMI in OGTT and that in MT (r = 0.796). Lower glucose tolerance was associated with a greater ΔUMI. Setting 10 mg/gCr as a tentative cut-off value in MT for detecting glucose intolerance, ΔUMI was positive in 100% of subjects (8/8) with diabetes mellitus (DM) and 86% (6/7) of those with impaired glucose tolerance (IGT). In OGTT, ΔUMI was positive in 100% of subjects (8/8) with DM and 86% of subjects (6/7) with IGT. Therefore, the positive rates for ΔUMI in OGTT and MT were equivalent.
Conclusion: These results indicate that as a non-invasive and sensitive marker of glucose intolerance, ΔUMI in MT is comparable to that in OGTT.

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