Background: Different organs undergo different atherosclerotic changes due to aging. This study examined the effects of atherosclerotic risk factors on pulmonary and vascular age.

Methods: Our subjects were 531 persons whose pulmonary and vascular age was measured at our center. First, a correlation between pulmonary age and cardio-ankle vascular index (CAVI), an indicator of vascular age, was examined. Based on mean pulmonary age (60.8) and CAVI (8.53), subjects were divided into four groups (G I: CAVI ≤ 8.5 pulmonary age ≤ 60, G II: CAVI ≥ 8.6 pulmonary age ≤ 60, G III: CAVI ≤ 8.5 pulmonary age ≥ 61, G IV: CAVI ≥ 8.6 pulmonary age ≥ 61). Groups were compared in terms of chronological age, sex, affected atherosclerotic disease (high blood pressure (HBP), dyslipidemia, diabetes mellitus (DM)), blood pressure, low-density lipoprotein cholesterol, triglyceride, high-density lipoprotein cholesterol, fasting blood sugar, HbA1c, waist circumference, bone density, aortic calcification score and smoking score.

Results: A moderate, positive correlation was seen between pulmonary age and CAVI. Comparisons with atherosclerotic risk factors in the four groups revealed: i) HbA1c was associated with increased pulmonary age; ii) diastolic blood pressure and aortic calcification score were associated with increased CAVI; and iii) HBP, dyslipidemia, chronological age and systolic blood pressure were associated with increases in both pulmonary age and CAVI.

Conclusion: Although a correlation was seen between pulmonary and vascular age, it was not particularly high. The present study revealed that this was because atherosclerotic risk factors affect pulmonary and vascular age differently.

Objective: The purpose of this study was to perform a detailed statistical analysis on coffee’s effect on sleep in Japan from an epidemiological perspective.

Methods: Subjects were 9,839 men (mean age, 50.7 ± 9.2 years) and 7,148 women (mean age, 49.4 ± 8.9 years) who received a health check-up. Coffee intake, total sleep duration, and sleep satisfaction were investigated and evaluated using univariate and multivariate analyses.

Results: Our results are for: Coffee intake [<1 cup/day: n=5,430 (32.0%), 1 cup/day: n=2,540 (14.9%), 2 cups/day: n=3,647 (21.5%), and≥3 cups/day: n=5,370 (31.6%)], total sleep duration [average 6.1± 0.95 h/day; breakdown, <5 h/day: n=511 (3.0%), 5–7 h/day: n=10,842 (63.8%), 7–9 h/day: n=5,555 (32.7%), and ≥9 h/day: n=79 (0.5%)], sleep satisfaction [satisfaction: n=10,030 (59.0%), and dissatisfaction: n=6,957 (41.0%)]. Total sleep duration and sleep satisfaction increased with age, and were both poorer for women than men. Subjects satisfied with their sleep had a significantly longer sleep duration than those who did not (6.5 ± 0.85 h vs. 5.6 ± 0.82 h). Multivariate analyses showed that male gender, older age, smoking, drinking, and preferable dietary/fitness habits had a significantly positive association with both total sleep duration and sleep satisfaction.

Conclusions: Coffee had a weak but significant association with total sleep duration in subjects who drank ≥2 cups/day. On the other hand, no association was observed between coffee intake and sleep satisfaction.

Objective: While gallbladder adenomyomatosis (GA) is generally not considered to have malignant potential, there have been several reports of gallbladder cancer arising in areas of GA. However, an association remains undefined. On the other hand, some investigators have demonstrated a clear association of GA with gallstones. Additionally, recent studies have suggested that there is a relationship between metabolic risk factors and both gallstones and fatty liver, while no studies have investigated whether similar relationships exist with GA. The purpose of our study was to determine whether GA is associated with metabolic risk factors, fatty liver, and gallstones.

Methods: A total of 3,341 subjects (1,807 males and 1,534 females) undergoing comprehensive health check-ups with no history of cholecystectomy, hypertension, diabetes, dyslipidemia, and/or hyperuricemia underwent abdominal ultrasonography. Using univariate and multivariate analyses, parameters associated with GA as well as associations between GA, fatty liver, and gallstones were examined by sex.

Results: Subjects with GA (58 males and 28 females) exhibited significantly worse metabolic parameters compared to those without GA (1,749 males and 1,506 females) in univariate analyses. After adjustments for other factors, age, waist circumference, and smoking habit remained associated with GA in males, while in females, associations with age, body mass index, hemoglobin A1c levels, uric acid, and smoking habit became significant. Furthermore, fatty liver and gallstones remained associated with GA after adjusting for other risk factors.

Conclusion: Our analyses suggest that fatty liver, gallstones, and GA are strongly associated with metabolic risk factors, while GA, is closely related with smoking habit, fatty liver, and gallstones.

Objective: The aim of this study was to assess daily salt intake and associated factors in patients with lifestyle-related diseases.

Methods: The participants were 132 men and 123 women who regularly visited our center for treatment of lifestyle-related diseases. Salt intake was estimated using 24-h urine collections without adjustment for non-urinary losses.

Results: Men and women consumed an average of 13.1 and 10.2 g/day of salt per day (p<0.001), respectively. Calculation of salt intake per kg of body weight (BW) revealed that there was no difference between men and women. The correlation coefficient between salt intake and BW was higher than that between it and body mass index, body height, and standard BW. Multiple regression analyses revealed that salt intake was most closely associated with BW, followed by frequency of drinking and age. When adjusted for frequency of drinking and age, the salt intake of participants with BWs in the highest quartile was approximately 1.5 times greater than those with BWs in the lowest quartile.

Conclusion: These results suggest that restricting daily salt intake is more difficult for individuals who require a higher amount of total energy than those with lower total energy requirements.

Background and Aims: Hypercholesterolemia has been suggested to be a risk factor of hearing loss. However, most of the epidemiological studies showing this were cross-sectional and controversial. The aim of this longitudinal study was to find independent risk factors of incident hearing loss.

Methods: This was an 8-year follow-up study to find risk factors of high-frequency hearing loss (HFHL) and low-frequency hearing loss (LFHL) in 2,628 and 2,775 participants, respectively. The threshold levels of HFHL and LFHL were defined at the 40 dB (4,000 Hz) and the 30 dB (1,000 Hz) for a better ear, respectively. Age and sex adjusted hazard ratios (HRs) of incident hearing loss were calculated for candidate risk factors. Then, stepwise Cox regressions were performed. Similar calculations were made excluding subjects older than 60 years.

Results: HFHL and LFHL developed in 18.4% of men and 6.5% of women and 8.7% of men and 9.5% of women, respectively. The incidence of hearing loss was markedly higher in participants older than 60 years: 53.4% in men and 20.6% in women and 28.4% in men and 26.9% in women, respectively, for HFHL and LFHL. Smoking and daily alcohol drinking were independent risk factors of HFHL while hypercholesterolemia was an independent risk factor of LFHL for all participants. Hypercholesterolemia and smoking were independent risk factors of HFHL while hypercholesterolemia and anemia were independent risk factors of LFHL after excluding subjects older than 60 years.

Conclusions: Our results suggested that hypercholesterolemia was an independent risk factor of both HFHL and LFHL after excluding subjects older than 60 years. Individuals with hypercholesterolemia should be recommended to undergo audiometry and avoid risk factors of hearing loss.

Objective: In Japan, to achieve sensitivity in mammography, a current approach is to use ultrasonography together with mammography for dense breasts. Although more objective and reproducible determination of dense breasts is necessary, few studies have shown correlations between radiologists’ assessments and fully automated volumetric measurements. This study was undertaken to assess the level of agreement between the two evaluation methods and to identify factors associated with disagreement between them.

Methods: Between April and June 2017, 1,456 women were included in the study. Agreement in breast density assessments between two radiologists and automated software was evaluated using kappa (κ) values. We also evaluated factors that could have contributed to any differences using univariate and multivariate analysis.

Results: Inter-observer agreement was good (κ=0.701). Breast density assessments made by radiologists versus software exhibited fair agreement (κ=0.224). Age, menopausal stage, difference in bilateral breast density, fibroglandular tissue volume, breast tissue volume and volumetric breast density (VBD) were significantly different between the two methods in univariate analysis. In multivariate analysis, VBD was an independent correlative factor for greater possibility of significant disagreement (Odds ratio for agreement = 0.755; 95% CI, 0.730–0.782).

Conclusions: Automated volumetric breast density measurements showed fair agreement with radiologists’ visual assessments. Low VBD was a contributing factor in disagreement. Although the automated method may have value, further research is necessary in Japan before it is put into widespread use.

Background and Aim: No longitudinal study has been conducted on risk factors of incident ocular hypertension (OH). The aim of this study was to find risk factors of OH defined as intraocular pressure (IOP) of ≥ 21 mmHg for one or both eyes in a health screening population.

Methods: This was a retrospective 8-year follow-up study of 1,950 men and 1,109 women whose IOPs were < 21 mmHg at baseline. Hazard ratios (HRs) of incident OH for candidate numerical and candidate categorical risk factors were calculated with Cox regressions.

Results: OH developed in 36 men (1.9%) and 12 women (1.1%) during the mean follow-up period of 6.1 years. Among numerical variables, an increase in systolic and diastolic blood pressures (BPs) and a decrease in HDL cholesterol were significant risk factors of OH in all participants. When calculated separately by gender, increases in systolic and diastolic BPs were significant risk factors of incident OH in men while an increase in diastolic BP was a significant risk factor of incident OH in women. Among categorical variables, hypertension and hypo-HDL cholesterolemia were significant risk factors of incident OH in all participants. When calculated separately by gender, hypertension and absence of daily alcohol drinking were significant risk factors of incident OH in men while no significant risk factor was found in women.

Conclusion: High BP was a significant risk factor of incident OH.

Objective: Helicobacter pylori (Hp) infection plays a critical role in gastric neoplasm pathology. Detecting Hp and Hp-related gastric diseases is important for gastric cancer prevention. Recent studies showed that Hp infection was missed to be diagnosed in some patients with atrophic gastritis when serum anti-Hp antibody enzyme immunoassay detection tests (Hp tests) were used. Here, we review the results of Hp testing over a 5-year period in patients with Hp-related gastritis.

Methods: We included 4,319 subjects who underwent optional Hp testing at our institute during Ningen Dock from 2012 to 2016. We investigated the prevalence of Hp positivity in spite of technically negative antibody titers of 3-9 (high negative) in Hp tests in Hp-related gastritis. Single and multiple logistic regression analyses were performed to identify factors associated with Hp infection among a total of 26 potential factors.

Results: The prevalence rates of positive and high negative Hp results were 31.6% and 11.4%, respectively, with no differences between the sexes. In patients with Hp-related gastritis, the prevalence rates of positive and high negative Hp results were 62.5% and 14.2%, respectively. Age, anemia, increased white blood cell count, and higher aspartate aminotransferase (AST) levels were associated with Hp infection (p <0.05).

Conclusions: We identified possible Hp infection in patients with Hp-related gastritis who tested negative for serum anti-Hp antibodies. Anemia was a factor associated with Hp infection, which is consistent with previous studies. We also found that elevated AST levels were associated with Hp infection, a novel finding. Further studies are needed to clarify the pathology.

Objective : Allergies might be associated with a low risk of developing malignant diseases. When an allergy is present, it is thought that the immune surveillance mechanism may inhibit carcinogenesis because the immune system is in a state of hyperreactivity. Usually, eosinophils increase in this state. Therefore, we investigated an association between the number of eosinophils and cancer incidence.

Methods: This cross-sectional study included 31,350 Japanese individuals, and was conducted at the Center for Preventive medicine, NTT Medical Center Tokyo, from 2006 to 2011. Associations of the number of eosinophils with cancer were assessed based on cancer-related information from self-reported medical histories in questionnaires. Absolute eosinophil counts were calculated by multiplying the relative count by the total WBC count.

Results: Among all 31,350 subjects, the mean absolute eosinophil count was 145.8/μL, 21% had allergies and 4.9% had cancer. The incidence of cancers was significantly lower in a group with eosinophil counts >350/μL than in those with eosinophil counts≤350/μL (3.75% vs 4.95%, p=0.03). Multivariate analysis revealed that allergies and eosinophils >350/μL were independent negative factors for cancer (p<0.0001, p=0.012, respectively).

Conclusions: An increased number of eosinophils was significantly associated with low incidence of cancers. In addition, our results suggested that high eosinophil counts may be inversely associated with cancer risk, regardless of whether allergies are present or not.

Objective: Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease. Approximately 50% of the affected patients suffer end-stage renal failure, requiring dialysis. In recent years, ADPKD has gained substantial attention due to advances in its treatment and its coverage by the financial aid system for treatment of intractable diseases in Japan. In this study, we evaluated the current status of patients with ADPKD undergoing health check-up at our facilities and examined the validity of the screening method.

Methods: In total, 47,383 individuals who underwent health check-up at our facilities between April 2017 and March 2018 were screened using abdominal ultrasonography focusing on the number of renal cysts. Individuals in whom ADPKD was suspected were interviewed further and advised to undergo close examination, the results of which were analyzed.

Results: Among the study subjects, the prevalence rate of ADPKD was 68–137 per 100,000 population, and the positive predictive value of our screening method was 36.2%. Among the newly diagnosed ADPKD patients, only 11.8% had renal ultrasonographic findings that required close examination according to the current Abdominal Ultrasonographic Screening Manual, which does not include number of renal cysts as a standard criterion.

Conclusions: The prevalence rate of ADPKD was considerably higher than that previously reported in Japan (≈25 per 100,000 population), suggesting a high number of undiagnosed cases. ADPKD may be detected and treated at early stages by screening based on the number of renal cysts.