Objective: Cardiovascular disease and osteoporosis are major public health problems that share common pathophysiological mechanisms besides aging. This study aimed to investigate the possible association between bone mineral density (BMD) and arterial stiffness measured by cardio-ankle vascular index (CAVI) in the Japanese general population without overt cardiac disease.

Methods: The study population was 1,242 consecutive participants who underwent cardiovascular health check-ups at the University of Tokyo Hospital. After excluding participants with coronary artery disease, peripheral arterial disease, atrial fibrillation/atrial flutter, decreased left ventricular systolic function, and pacemaker implantation, 1,169 men and women were analyzed. The calcaneus BMD was assessed by quantitative ultrasound methods. Cardiovascular functions were evaluated with CAVI, left ventricular global longitudinal strain (LVGLS), peak early diastolic transmitral velocity (E)/peak early diastolic mitral annular velocity(e′) (E/e′), and carotid intima-media thickness (IMT) measurements.

Results: In univariate analysis, BMD was associated with CAVI, E/e′ and IMT along with other cardiovascular risk factors except for diabetes (r=−0.162, p<0.001, r=−0.203, p<0.001, r=−0.113, p<0.001, respectively), whereas no association was identified between BMD and LVGLS. In multivariate analysis, after adjustment for pertinent confounding variables, only CAVI remained associated with low BMD (estimated coefficient=0.0050, p=0.004), but the direction of association was opposite and smaller in size compared to univariate analysis.

Conclusions: This study is the first to examine the relationship between BMD and multiple cardiovascular measurements in the Japanese general population without overt cardiovascular disease and has demonstrated the partial relationship of osteoporotic state and enhanced arterial stiffness, as evaluated by CAVI.

  An asymptomatic 69-year-old woman exhibited slight ST-segment depression in the inferior leads on an electrocardiogram during a health check-up. Echocardiography revealed a small mobile tumor originating from the anterolateral papillary muscle of the left ventricle. As brain computed tomography revealed a cerebral infarction, urgent surgery was performed. The resected tumor was histologically diagnosed as a papillary fibroelastoma (PFE). The postoperative course was uneventful with no tumor recurrence two years post-surgery. It is extremely rare to find PFE during a health check-up. We emphasize that even minor abnormal findings during health check-ups should be monitored vigilantly.

Objective: It has been nearly 30 years since Helicobacter pylori (Hp) was identified as a class I carcinogen for gastric cancer (GC). However, only a small percentage of Hp-infected patients develop cancer. Although eradication therapy is considered the most effective for preventing GC, various cases of GC have been observed after eradication. This study aimed to analyze the factors preventing GC based on health examination data.

Methods: A total of 19,278 health checkup subjects (12,916 males and 6,362 females; mean age, 51.9±11.3 years) who underwent physical examinations at our health checkup center from 2012 to 2018 were included. Patients with a history of GC were excluded. Multiple logistic regression analysis was used to analyze the association between GC and background factors (age, sex, smoking history, alcohol consumption history, and family history of GC), lifestyle factors (dietary preferences, exercise, and sleep), and lifestyle-related disease factors (body-mass index, metabolic syndrome, abdominal circumference, visceral fat, body fat, lipids, glucose tolerance, liver function, and fatty liver). We also compared GC incidence between Hp-infected and post-Hp eradication patients.

Results: Age and salt intake were significantly associated with GC (p=0.001 and 0.003, respectively). GC incidence was 1.53% among Hp-infected patients and 0.52% among post-Hp eradication patients, approximately one-third of that in those who did not undergo eradication.

Conclusion: Aging and a high salt intake may be associated with GC, suggesting that a low-sodium diet can prevent GC, especially among the elderly. The results of this study also suggest that Hp eradication therapy is effective in preventing GC.

Objective: This study aimed to identify predictive factors for diabetes development in Ningen Dock examinees with very mild glucose intolerance.

Methods: We retrospectively analyzed medical records, interview responses, and Ningen Dock results of 11,313 examinees from April 2015 to March 2016 and followed them until March 2021.

Results: Over five years, 2.6% of examinees were newly diagnosed with diabetes. Those who developed diabetes had statistically significantly higher median age, body weight, and BMI compared to those who did not develop diabetes (p<0.001). Almost all laboratory values, including FPG and HbA1c, were worse in the former group. When their FPG and HbA1c levels were not high (Ningen Dock category A or B), their incidence rate of developing diabetes over the next five years was extremely low (0.09–0.7%). We conducted multivariate analysis regarding predictive factors for the development of diabetes among examinees in Ningen Dock category B, which identified BMI ≥25 kg/m² (OR 5.356, p<0.001), LDL-C ≥140 mg/dL (OR 2.415, p=0.023), smoking (OR 2.320, p=0.042), and family history of diabetes (OR 2.510, p=0.016) as significant predictive factors. The incidence rate of developing diabetes over the next five years increased from 0.7% to 12.5% when these predictive factors were present.

Conclusions: FPG and HbA1c levels are the most important variables in predicting the development of diabetes. However, individuals with multiple risk factors should be carefully monitored for the development of diabetes, even if their FPG and HbA1c levels are not high.

Objective: Urinary sediment is examined in Ningen Dock. We sought to evaluate the costs and diagnostic value associated with abnormal urinary sediment findings, in addition to estimated glomerular filtration rate (eGFR), urinary protein, and occult blood measurement, in Ningen Dock after 4 years.

Methods: In the patients who underwent Ningen Dock in 2015, urinalysis was performed using a fully-automated urinalysis system at the central laboratory of each hospital. Urine sediment was microscopically examined by laboratory technicians. Granular casts, epithelial casts, and tubular epithelium were defined as pathological findings. Seventy-six patients who showed these findings in 2015 and were re-examined in 2019. The eGFR, urinary protein, and occult blood were statistically analyzed.

Results: Pathological urinary sediment findings detected in 2015 spontaneously disappeared after 4 years in 91% of the patients. No significant change was observed in eGFR, urinary protein or occult blood in the patients who continued to have pathological findings after 4 years. At least \157 was spent per sample in supplies and personnel.

Conclusions: Almost the pathological urine sediment was disappeared after four years. The benefit of urine sediment examinations was small for the cost. The eGFR, urine protein and occult blood test are sufficient in the kidney function examinations in Ningen Dock.