Objective: Smoking and obesity are leading lifestyle factors that affect hematological parameters. Studies with large cohorts are rare. This study aimed to examine the association between smoking and obesity and hematological parameters.

Methods: This study included 3,969 men and 3,722 nongravid women who visited the Takaoka Health Care Center from 2019 to 2020. Pregnant women and individuals with myeloproliferative disease were excluded from the study. We determined the leukocyte, erythrocyte, and platelet counts, mean corpuscular volume (MCV), body mass index (BMI), C-reactive protein, smoking habits, age, and sex of all the study participants.

Results: We used a stepwise linear regression analysis and demonstrated that smoking significantly increased the platelet and leukocyte counts, hemoglobin (Hb) levels, and MCV in men (p<0.001) and the leukocyte and platelet counts in women (p<0.001). Obesity, significantly increased leukocyte and erythrocyte counts and Hb levels in men (p<0.001) and also increased leukocyte, erythrocyte, and platelet counts and Hb levels in women (p<0.001). Obesity significantly decreased MCV (p<0.001). Smoking affected leukocytes to a greater extent than obesity, whereas obesity had a stronger effect on Hb than smoking. It is considered that 20 cigarettes/day increases leukocyte counts by 1,582/μL in men and by 2,468/μL in women. Male smokers had an increase in Hb levels by 0.2 g/dL. An increase in leukocyte counts by 444/μL and 620/μL and an increase in Hb levels by 0.8 g/dL and 0.5 g/dL were observed in men and women with a BMI of 10 kg/m², respectively.

Conclusion: Both smoking and obesity affect hematological parameters. The study finds that smoking affects leukocyte counts considerably, whereas obesity considerably affects Hb levels.

Objective: We investigated the relationship between the respiratory event index (REI) of the screening polysomnography (PSG) test and physical findings in our hospital’s Comprehensive Health Checkup System.

Methods: From May 2016 to March 2020, 46,171 employees (41,418 males and 4,753 females) from NTT Group companies took the Comprehensive Health Checkup System examination. Among them, we targeted 977 (899 males and 78 females) employees who requested the screening PSG test as an optional test for this study. The results of the screening PSG test were classified into 4 stages, from normal to severe sleep apnea syndrome (SAS) by the REI, and moderate, severe, and mild SAS with a Japanese Epworth Sleepiness Scale (JESS) of 11 or more points were included in the detailed examination. We examined the relationship between the REI and age, weight, body mass index (BMI), systolic blood pressure, and JESS.

Results: Of the 977 examinees, 871 (89.2%) had sleep apnea disorder of mild SAS or higher, and 625 (71.8%) required a detailed examination. The correlation coefficients between the REI and physical findings were 0.440 for BMI, 0.392 for body weight, 0.251 for systolic blood pressure, 0.198 for age, and 0.047 for JESS.

Conclusion: In this study, the REI and BMI were positively correlated. There was also a weak positive correlation between the REI and body weight, systolic blood pressure, and age, suggesting a link between obesity and SAS, as in previous studies.

Objectives: Prevention of the onset and exacerbation of diabetes is an urgent issue for central and local governments in Japan. In 2018, we started an attempt as part of Nitona Diabetes Control Study to encourage people diagnosed with hyperglycemia at a health checkup to consult with a medical professional through collaboration between checkup institutions and medical institutions which specialize in diabetes. Our aim was to prevent the onset and exacerbation of diabetes by providing specialized medical care, including initial education. Here, we analyzed the effects of active intervention by public health nurses during a checkup visit in people with untreated hyperglycemia.

Methods: Subjects were selected from individuals who had presented with untreated hyperglycemia requiring consultation in the previous year’s checkup. They underwent immediate blood glucose measurement at checkup. Those who still had untreated hyperglycemia requiring consultation received health guidance from public health nurses, in which they received detailed information on diabetes mellitus. They also received on-site active intervention that encouraged them to consult with a medical professional and make an outpatient appointment. The effects of intervention on their medical care-seeking behavior and blood sugar level were analyzed.

Results: In 2017, a total of 32,441 people received a checkup, of whom 938 had hyperglycemia requiring consultation. In 2018, 488 of the 938 people received a checkup and underwent immediate blood glucose measurement, which showed that 250 of the 488 people still had untreated hyperglycemia requiring consultation. Follow up of these 250 people during the next year’s checkup showed that the percentage of people who received medical care was significantly higher in those who had received active intervention from public health nurses in the previous year than in those who had not (p < 0.00005).

Conclusion: Active intervention by public health nurses during a checkup visit was effective in encouraging people with untreated hyperglycemia requiring consultation to consult with a medical professional.

Objective: Body weight gain is often observed after smoking cessation. This study aimed to clarify the relationship between changes in body weight over time after smoking cessation versus the number of cigarettes smoked before the cessation and eating behavior, and utilize the results in smoking cessation guidance.

Methods: Of 1,923 men who received a specific medical checkup every year at our hospital from 2015 to 2019, the annual change in body weight of those who stopped smoking was examined. Subjects were classified into the following four groups: those whose body weight during the first year was unchanged or reduced, and those who gained <3 kg, 3–5 kg, and >5 kg respectively, during the first year. Smoking status pre-cessation (≤19 cigarettes per day or ≥20 cigarettes per day), and responses to a standard questionnaire on eating behavior pre- and post-cessation were compared between groups.

Results: Mean body weight changes with respect to years of continued smoking cessation were as follows: first year, +2.20 kg; second year, +0.55 kg; third year, –0.04 kg; and fourth year, –0.44 kg. Distribution of the four weight groups during the first year of cessation among those who smoked ≤19 cigarettes per day pre-cessation was as follows: unchanged or reduced body weight, 24.4%; <3 kg gain, 56.1%; 3–5 kg gain, 14.6%; and ≥5 kg gain, 4.9%. Distribution of groups among those who smoked ≥20 cigarettes was as follows: unchanged or reduced body weight, 10.9%; <3 kg gain, 35.9%; 3–5 kg gain, 37.5%; and ≥5 kg gain, 15.6%. Body weight gain rates of the ≥20 cigarettes per day group were significantly higher than those in the ≤19 cigarettes per day group. When the eating behaviors of the ≥20 cigarettes and ≤ 19 cigarettes per day groups were compared, the proportion of “persons who eat faster than others” was significantly higher in the former group than in the latter group.

Conclusion: After one year of smoking cessation, 80% of those who stopped smoking gained approximately 2 kg of body weight on average. However, body weight gain was not observed in and after the third year. Because those who smoked ≥20 cigarettes per day before smoking cessation were likely to gain substantial body weight, it is necessary to instruct them to pay attention to eating speed.

Objective: Premature ventricular contraction (PVC) has been thought to be benign in the absence of structural heart disease. However, there has been an emerging concept that frequent PVCs can suppress cardiac function and lead to congestive heart failure in some cases. This study aimed to investigate the characteristics of patients with PVC found in medical check-ups.

Methods: Of 588 patients with multiple PVCs detected by 12-lead electrocardiogram, 100 patients undergoing 24-h ambulatory monitoring were analyzed. Patients were divided into two groups according to the number of PVCs <5,000 (Group 1, n=63) and ≥5,000 (Group 2, n=37).

Results: The total number of PVCs during 24-h ambulatory monitoring was 1,245±1,507（1–4,733）and 11,931±5,842（5,099–30,671）in Groups 1 and 2, respectively. Couplets and runs of PVCs were more frequently observed in Group 2 (1.3±3.6 vs 62.0±145.8, p=0.02, and 0.05±0.21 vs 0.49±1.28, p=0.04). In baseline characteristics, both low-density lipoprotein (LDL) cholesterol and triglyceride were significantly higher in Group 2 (110.7±25.7 vs 121.9±26.7 mg/dL, p=0.04, 81.7±44.2 vs 105.0±59.7 mg/dL, p=0.04).

Conclusion: Frequent PVCs were observed in 40% of the patients undergoing 24-h ambulatory monitoring. Regular follow-up is recommended for patients with multiple PVCs, especially those with higher LDL cholesterol and triglyceride.

Objective: To understand the implementation status and evaluate its effect on explaining results and health guidance on the current day, we compared inspection data related to lifestyle diseases after one year.

Methods: A total of 554 participants were included depending on whether they were inferred to require treatment in 2018. However, those treated with medication in 2019 were excluded. Participants were divided into a health guidance (n=430) and a non-health guidance (n=124) group. Further, seven inspection data items from 2018 (diastolic blood pressure: n=45, systolic blood pressure: n=52, LDL-C: n=264, HDL-C: n=17, triglyceride: n=30, HbA1c: n = 89 and body weight: n=277) were compared to those of 2019.

Results: The health guidance implementation rate was 77.6%. Most participants (59.6%) were men in their 40s–60s. Diastolic and systolic blood pressure, LDL-C, HDL-C, and triglyceride were significantly improved in the health guidance group (p < 0.05). Only LDL-C was enhanced significantly in the non-health guidance group. HbA1c was not significantly improved in either the health guidance or the non-health guidance group.

Conclusion: It was evaluated that explaining the results and health guidance on the same day effectively improved the inspection data. Since no improvement in the inspection data was observed for HbA1c, verifying the cause and review of the guidance content and method were problematic.

Objective: To determine the characteristics of solid mass lesions identified on thyroid gland mass screening.

Subjects and Methods: Ultrasonography was performed for 5,714 individuals who did not undergo treatment and who were aged 51.3 ± 10.5 years, including 3,971 women and 1,743 men, from April 1, 2018. The maximum diameter and characteristics of the solid masses with and without diffuse abnormalities, such as swelling, inhomogeneity, and/or coarseness, were evaluated.

Results: Abnormal findings were identified in 2,333 individuals (40.8%), including solid masses in 1,551 (27.1%), cystic lesions in 1,002 (17.5%), and diffuse abnormalities in 467 (8.2%). Further check-ups were recommended in 136 cases, resulting in diagnosis of papillary carcinoma in 9 cases (0.2%). The diameters of the solid masses showed a log-normal distribution (p<0.0001) and averaged 6.8 (3.2–14.6) mm (mean ± 2SD). The masses were single in 1,054 individuals (68.0%) and multiple in 497 (32.0%). Cystic degeneration and swelling more frequently occurred when the masses were multiple or > 20 mm in size. The incidence and number of solid masses increased accordingly with age without a significant increase in size.

Conclusions: Mass screening with ultrasonography identified a high prevalence of solid mass lesions in the thyroid gland. The log-normal distribution of their sizes without significant increases with age, despite the increase in number, suggests that the small mass lesions were benign, provided they had no characteristics suggestive of papillary carcinoma. A small proportion of these solid masses may develop into adenomatous goiter or follicular neoplasia.

Objectives: One year has passed since the introduction of liquid-based cytology (LBC) for cervical cancer screening in April 2020. We report on our experience with using LBC at our institution by comparison with the traditional method.

Subjects and Methods: We compared cases with the traditional method in FY 2019 (21,502 cases) and those with LBC in FY 2020 (17,706 cases) by dividing them into mass screening and individual screening.

Results: Inadequate specimen rates with the traditional method and LBC were 0.6% and 0.2%, respectively, in mass screening and 1.3% and 0.02%, respectively, in individual screening. The percentages of ASC-US with the traditional method and LBC were 1.6% and 1.4% in mass screening and 2.3% and 2.2% in individual screening. The percentages of NILM with the traditional method and LBC were 97.2% and 97.9% in mass screening and 94.9% and 96.9% in individual screening. The percentages of ASC-H with the traditional method and LBC were 0.1% and 0.1% in mass screening and 0.3% and 0.1% in individual screening. The percentages of LSIL with the traditional method and LBC were 0.1% and 0.2% in mass screening and 0.4% and 0.5% in individual screening. The percentages of HSIL with the traditional method and LBC were 0.3% and 0.1% in mass screening and 0.5% and 0.2% in individual screening. The percentages of cases requiring close examination with the traditional method and LBC were 2.2% and 1.9% in mass screening and 3.8% and 3.1% in individual screening. LBC significantly reduced inadequate specimen rates compared with the traditional method, contributing to reduced workload in specimen handling and microscopic examination.

Conclusions: The introduction of LBC reduced inadequate specimens and the workload of cytotechnologists. It contributed to improving the quality of cytology and was considered to be useful during the COVID-19 pandemic.

Objective: After esophagogastroduodenoscopy (EGD), doctors advised patients to visit a medical institution and explained its necessity, for treatment on the basis of suspected Helicobacter pylori infection; however, due to the absence of anti-H. pylori antibody titers in the health check-up sheet, patients died without receiving eradication treatment. Therefore, we introduced changes by including doctor’s comments on the final endoscopy report sheets. Subsequently, we conducted a telephonic survey to find out whether the patients visited a medical institution for eradication treatment.

Methods: During the 5-month period, 35 patients undergoing endoscopy and H. pylori antibody testing were advised to visit a medical institution for eradication treatment were included in the analysis.

Results: Thirty-one patients responded while four did not. Out of these patients, 21 received the eradication treatment, one did not start the prescribed medicine, two were on-course of H. pylori antibody titer that eradicated in the past, and one was diagnosed as having no H. pylori infection, and six did not visit a medical institution. One patient visited the medical institution and received treatment after the survey.

Conclusion: Revised endoscopic result sheets provide significantly improved results; several patients were able to visit medical institutions for treatment. However, to achieve more effective results, it is necessary to include information about H. pylori infection and available eradication treatments in the endoscopy result sheets.