Ningen Dock is a comprehensive medical examination of the general body condition, health guidance is provided for abnormal findings, and more precise examinations and treatment are recommended as necessary.
Evaluations are made from the viewpoints of weight and waist circumference reduction in the Specific Health Examination focused on metabolic syndrome and reducing mortality rates from cancers of specific organs in specific cancer screening. However, the utility of Ningen Dock, a system of general heath examination and evaluation, is unclear because of the wide ranging targets of examination and testing. Therefore, we carried out a study to assess the significance and utility of Ningen Dock from several viewpoints, especially subjective health feeling, which has attracted attention as an indicator of health evaluation in recent years. Subjective health feeling is correlated with mortality rate and healthy life span. Characteristically, the subjective health feeling of subjects who undergo Ningen Dock is very good even in old age, significantly different from that in the statistical results produced by the National Basic Health Survey. In addition, it is noteworthy that a good subjective health feeling is maintained by continuously undergoing Ningen Dock over the long-term.
Objective: To evaluate the long-term effectiveness of Specific Health Guidance, we investigated its improving effect on lab test values up to 6 years later.
Methods: In the period 2008 – 2010, 2,152 people receiving active support were designated as an intervention group, and 6,523 people not receiving active support as a control group. Covariate adjustment by propensity score matching was carried out, matching 1 person in the intervention group with 2 in the control group, and the improving effect on lab test values for persons receiving active support was examined. The effect of weight change after 1 year was verified, stratifying the intervention group into to 6 subgroups by weight change: 1% or more increase, ± 1% or less, 1 – 2% decrease, 3 – 4% decrease, 5 – 6% decrease, 7% or greater decrease.
Results: Significant improvements in body weight, abdominal circumference, blood pressure, FPG, HbA1c and triglyceride were maintained over 6 years. Also, a significant improvement in HDL-C was maintained over 5 years, in ALT over 4 years, in γ-GTP over 3 years, in AST over 2 years and in LDL-C after 1 year. Regarding weight loss after 1 year, in a subgroup with a 3 – 4% decrease in weight, a significant improvement in lab test values was achieved and continued until 1-2 years later. A subgroup with a 5 – 6% decrease achieved a significant improvement in lab test values lasting 3 – 4 years and one with a 7% or greater decrease a significant improvement lasting 5 – 6 years.
Conclusion:The duration of the improving effect differed depending on the lab test parameter and it was found that with a greater weight loss, the duration of the improving effect was longer.
Objective: We examined an association between Helicobacter pylori (H. pylori) infection and colorectal adenoma (CA), including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and lifestyle factors as covariates.
Methods: A total of 44,254 Japanese males underwent a comprehensive health check-up at our facility between April 2013 and March 2017. Among 2,662 subjects positive for the fecal occult-blood test, 1,450 underwent total colonoscopy. Subjects aged less than 40 years, those who did not undergo esophagogastroduodenoscopy screening or VAT/SAT measurement or who were diagnosed with colorectal cancer or inflammatory bowel diseases were excluded. The final number of subjects enrolled for this cross-sectional study was 990 (mean age: 55.3 years). The association of H. pylori antibody serostatus and endoscopic gastritis with CA was investigated using multiple logistic regression analysis.
Results: Rates of H. pylori antibody seropositivity and chronic gastritis were higher in those with CA compared to those without (20.4% and 54.2% vs 13.0% and 34.7%, p<0.01 and <0.01, respectively). There was a significant, independent association between H. pylori antibody seropositivity and CA (OR=1.595, 95%CI=1.093-2.327, p=0.015) in Model 1. Similarly, there was a significant, independent association between chronic gastritis and CA (OR=1.97, 95%CI=1.46-2.65, p<0.01) in Model 2. Age and VAT were predictors of CA in both Models. Alcohol and smoking habit increased the prevalence of CA in both Models, and exercise reduced it.
Conclusions: The prevalence of CA was significantly and independently increased by H. pylori infection in a Japanese male population, after adjusting for metabolic parameters and lifestyle factors.
Objective: To effectively implement health guidance for prevention of chronic kidney disease (CKD) onset and progression, we examined changes in albumin in urine over a period of 5 years in subjects who underwent and had normal baseline urinary albumin level (<30 mg/g・Cr). Factors related to changes in level were examined.
Methods: Of 9,694 individuals who underwent a medical examination in 2009 and then 5 years later in 2014, we enrolled 8,386 (males 4,322, females 4,064; average age 50.9 ± 9.6 years) with normoalbuminuria in 2009, after excluding subjects with diabetes mellitus or nephritis. In 2014, we examined changes in urinary albumin level relative to the baseline level as well as related factors.
Results: We found that 5.04% of the subjects with normoalbuminuria in 2009 shifted microalbuminuria or macroalbuminuria in 2014, of whom 86.3% had urinary albumin levels lower than 100 mg/g・Cr. Factors associated with the at shift were aging as well as higher urinary albumin level, greater waist circumference, hypertension, low HDL-C, hypoalbuminemia, greater BMI in 2009. As for lifestyle factors, smoking, and consumption of protein-rich foods were associated with the change.
Discussion: Among factors shown to be related to the transition to microalbuminuria or macroalbuminuria, we consider that those of metabolic syndrome other than age can be addressed by interventions to improve blood pressure, obesity and dyslipidemia as well as smoking cessation and improved dietary habits. For patients with such associated factors, health guidance with emphasis on the possibility of progression to CKD is important.
Objective: To clarify the reason for the low Helicobacter pylori (HP) eradication therapy performance rate following gastro-fluoroscopy in HP infection-induced gastritis, we compared the diagnostic accuracies of X-ray and endoscopic examinations as well the situations of performing HP eradication.
Methods: 7,328 subjects who received gastric cancer screening in 2015 were enrolled in this study. In interviews, we asked all subjects if their HP serum antibody titers had been measured and if they had undergone HP eradication therapy or not. In addition, the diagnostic accuracy for HP infection-induced gastritis was compared between the examinations.
Results: The positive predictive value for HP infection-induced gastritis by X-ray examination was 69.6%, whereas it was 62.0% for endoscopic examination. In contrast, the eradication performance rates were 20% and 80%, respectively, for each method.
Conclusions: The reason for the low eradication therapy performance rate for HP infection-induced gastritis diagnosed in X-ray examinations was considered not to be due examination accuracy but the requirements of the Japanese medical insurance system.