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Nakajima K.,Josai University | Suwa K.,Saitama Health Promotion Corporation
Journal of Diabetes and Metabolic Disorders | Year: 2015

The unhealthy habit of late-night-dinner eating (LNDE) is often observed in adults. Since LNDE can lead to breakfast skipping (BS) the next morning, we examined the associations of LNDE and BS with hyperglycemia (HbA1c ≥ 5.7% and/or pharmacotherapy for diabetes), separately and in combination, in 61,364 apparently healthy Japanese adults aged 30-70 years. Although LNDE alone was significantly associated with hyperglycemia, even after adjustment for body mass index, BS alone was not. Our results indicate that hyperglycemia in the general Japanese population is associated with LNDE alone, but not BS alone. © 2015 Nakajima and Suwa.


Muneyuki T.,Josai University | Muneyuki T.,Jichi Medical University | Sugawara H.,Jichi Medical University | Suwa K.,Saitama Health Promotion Corporation | And 8 more authors.
Kidney International | Year: 2013

Although proteinuria is highly prevalent in obese individuals, the association between proteinuria and low body weight is equivocal. In this study we determine whether low body weight is more strongly associated with proteinuria compared with normal weight. The association between body mass index (BMI) and proteinuria was examined in a cross-sectional study of 62,582 asymptomatic individuals aged 20-70 years without known kidney diseases recruited, based on the results of medical checkups in 1999. We also examined the incidence of recurrent or nonrecurrent proteinuria in an 8-year longitudinal analysis of 12,493 individuals without proteinuria at baseline. The prevalence of proteinuria showed a J-shaped relationship with BMI. Multivariate regression analysis showed that BMI of 27.0 kg/m 2 and above or 18.9 kg/m 2 and less was significantly associated with proteinuria relative to BMI 21.0-22.9 kg/m 2, even after adjusting for relevant cardiometabolic risk factors. In the longitudinal study, similar J-shaped relationships between the incident rates of proteinuria and baseline BMI groups were observed at post-baseline checkups. Baseline BMI 27.0 kg/m 2 and above was associated with significantly greater risk for recurrent and nonrecurrent proteinuria, whereas BMI 18.9 kg/m 2 and less was only associated with nonrecurrent proteinuria. Thus, obesity and low body weight may be associated with different types of proteinuria independent of cardiometabolic risk factors.© 2013 International Society of Nephrology.


Kanda E.,Tokyo Kyosai Hospital | Kanda E.,Tokyo Medical and Dental University | Muneyuki T.,Funabashi City Rehabilitation Hospital | Suwa K.,Saitama Health Promotion Corporation | Nakajima K.,Kuki General Hospital
PLoS ONE | Year: 2015

Background: Obesity is associated with diabetes mellitus and cardiovascular diseases. However, it has been reported that weight loss is associated with incident chronic kidney disease (CKD) in healthy males. The purpose of this prospective cohort study is to investigate the effects of weight loss on kidney function in healthy people in terms of body mass index (BMI) and gender. Methods: A total of 8447 nondiabetic healthy people were enrolled in the Saitama Cardiometabolic Disease and Organ Impairment Study, Japan. Relationships between estimated glomerular filtration rate (eGFR) change, BMI, and BMI change were evaluated using 3D-scatter plots with spline and generalized additive models (GAMs) adjusted for baseline characteristics. Results: The subjects were stratified into four groups according to BMI. The mean±standard deviations for males and females were, respectively, 40.11 ±9.49, and 40.3±9.71 years for age and 76.39±17.72 and 71.49±18.4 ml/min/1.73m2 for eGFR. GAMs showed that a decreasing BMI change (<-1 kg/m2/year) was associated with a decreasing eGFR change in males with high normal BMIs (22 kg/m2


Nakajima K.,Josai University | Suwa K.,Saitama Health Promotion Corporation
Endocrine Research | Year: 2015

Purpose/aim: Obese individuals with normal HbA1c levels and low-body-weight individuals with high-normal HbA1c levels are frequently encountered in clinical settings, but the effects of these phenotypes on the onset of diabetes are poorly understood. Therefore, we addressed this issue in a longitudinal study. Materials and methods: We analyzed clinical parameters, including body mass index (BMI) and HbA1c levels, in 5325 non-diabetic Japanese people aged 20-75 years who underwent four medical checkups between 1999 (baseline) and 2007. The subjects were then classified into six baseline BMI categories, each of which was divided into two HbA1c groups, resulting in a total of 12 groups. Results: In 405 obese subjects with a normal baseline HbA1c (BMI ≥27.0kg/m2, HbA1c 5.2-5.6%), the mean HbA1c level increased during the study period, and 50.9% developed prediabetes/diabetes. In contrast, in 77 low-body-weight subjects with a high-normal baseline HbA1c (BMI 18.9kg/m2, HbA1c 5.7-6.4%), the mean HbA1c level remained constant. Similar changes occurred in the other groups during the study, resulting in a linear increase in HbA1c levels with increasing BMI. Conclusion: Our results suggest that approximately half of the obese individuals with HbA1c in the normal range develop prediabetes or diabetes within 8 years, whereas low-body-weight individuals with high-normal HbA1c are less likely to exhibit worsening in glycemia. Thus, excess body weight may be the primary therapeutic target to prevent the early onset of diabetes, regardless of the individual's HbA1c. © 2015 Informa Healthcare USA, Inc.


Kutsuma A.,Josai University | Oshida H.,Josai University | Suwa K.,Saitama Health Promotion Corporation | Nakajima K.,Josai University
Clinical Biochemistry | Year: 2014

Background: It is unknown whether low serum pepsinogen I and pepsinogen I/II ratio (PGI-PGI/II), a marker for chronic atrophic gastritis, is associated with low or high body weight. Methods: We investigated the association between low PGI-PGI/II and both ends of the spectrum of body mass index (BMI) in 819 apparently healthy Japanese men aged 20-75. years who received a medical check-up in 2008. Results: In univariate analysis, serum pepsinogen I, but not pepsinogen II or pepsinogen I/II, was significantly reduced across the increasing BMI categories. Multivariate regression analysis showed that, compared with BMI 21.0-22.9kg/m2, BMI of 20.9kg/m2 and less or 25.0kg/m2 and above was significantly associated with low PGI-PGI/II (pepsinogen I<50ng/ml combined with PG I/II<3.0), even after adjustment for relevant confounders. These associations showed a J-shaped curve against BMI. Conclusion: Low PGI-PGI/II may be independently associated with both low body weight and obesity in Japanese men. © 2013 The Canadian Society of Clinical Chemists.


PubMed | Saitama Health Promotion Corporation, Tokyo Medical and Dental University, Funabashi City Rehabilitation Hospital and Josai University
Type: Journal Article | Journal: PloS one | Year: 2015

Although lifestyle is associated with metabolic syndrome and cardiovascular diseases, there has been no sufficient evidence of lifestyles on incident chronic kidney disease (CKD). The purpose of this prospective cohort study is to investigate the effects of lifestyles on kidney function in healthy people.A total of 7473 healthy people were enrolled in this Saitama Cardiometabolic Disease and Organ Impairment Study, Japan. Data on alcohol consumption, exercise frequency, and sleep duration were collected. The outcome event was incident CKD or decrease in estimated glomerular filtration rate (eGFR) by >25% in 3 years.Subjects were classified into four groups according to body mass index and gender. Mean standard deviation of age was 38.810.5 years; eGFR, 78.115.2 ml/min/1.73 m2. In the male groups, multivariate logistic regression models showed that the outcome events were associated with a small amount of alcohol consumed (20 to 140 g of alcohol/week) (ref. more than 140 g of alcohol/week); non-obese male, adjusted odds ratio 1.366 (95% confidence interval, 1.086, 1.718); obese male (body mass index 25), 1.634 (1.160, 2.302); and with frequent exercise (twice a week or more) (ref. no exercise); non-obese male, 1.417 (1.144, 1.754); obese male, 1.842 (1.317, 2.577). Sleep duration was not associated with the outcome events.These findings suggest that, regardless of obesity, a small amount of alcohol consumed and high exercise frequency were associated with the increased risk of loss of kidney function in the male groups.


PubMed | Kanagawa University of Human Services and Saitama Health Promotion Corporation
Type: Journal Article | Journal: Clinical biochemistry | Year: 2016

Numerous etiologies are implicated in the complications of diabetes. A link between diabetes and the predisposition to certain cancers, including colon cancer, has been established during the last decade. However, the relationship between fecal occult blood test (FOBT), a screening method used principally for detection of colon cancer, and diabetes has not been explored.We investigated the association of positive FOBT with HbA1c of 5.70-6.49% (prediabetes) and HbA1c of 6.5% (diabetes) during health screening of 12,836 Japanese people aged 30-79years (9258 men and 3578 women).Mean age and HbA1c were significantly higher in the positive (n=1502) than the negative FOBT groups (n=11,334). There were fewer men and current smokers in the positive FOBT group. Multivariate logistic regression analysis showed that, compared with HbA1c of 5.69%, HbA1c of 6.5% was significantly associated with positive FOBT, independently of relevant confounders including age, sex, and past history of gastric/duodenal ulcers and colon cancer or polyp.Current results support a predisposition towards gastrointestinal cancer in diabetics, or may imply the development of diabetes-related gut microangiopathy, which deserves further study including FOBT and clinical diagnosis of the gut.


PubMed | Saitama Health Promotion Corporation and Josai University
Type: | Journal: Journal of diabetes and metabolic disorders | Year: 2015

The unhealthy habit of late-night-dinner eating (LNDE) is often observed in adults. Since LNDE can lead to breakfast skipping (BS) the next morning, we examined the associations of LNDE and BS with hyperglycemia (HbA1c5.7% and/or pharmacotherapy for diabetes), separately and in combination, in 61,364 apparently healthy Japanese adults aged 30-70 years. Although LNDE alone was significantly associated with hyperglycemia, even after adjustment for body mass index, BS alone was not. Our results indicate that hyperglycemia in the general Japanese population is associated with LNDE alone, but not BS alone.


PubMed | Saitama Health Promotion Corporation, Kuki General Hospital, Tokyo Kyosai Hospital and Funabashi City Rehabilitation Hospital
Type: Journal Article | Journal: PloS one | Year: 2015

Obesity is associated with diabetes mellitus and cardiovascular diseases. However, it has been reported that weight loss is associated with incident chronic kidney disease (CKD) in healthy males. The purpose of this prospective cohort study is to investigate the effects of weight loss on kidney function in healthy people in terms of body mass index (BMI) and gender.A total of 8447 nondiabetic healthy people were enrolled in the Saitama Cardiometabolic Disease and Organ Impairment Study, Japan. Relationships between estimated glomerular filtration rate (eGFR) change, BMI, and BMI change were evaluated using 3D-scatter plots with spline and generalized additive models (GAMs) adjusted for baseline characteristics.The subjects were stratified into four groups according to BMI. The meanstandard deviations for males and females were, respectively, 40.119.49, and 40.39.71 years for age and 76.3917.72 and 71.4918.4 ml/min/1.73m2 for eGFR. GAMs showed that a decreasing BMI change (<-1 kg/m2/year) was associated with a decreasing eGFR change in males with high normal BMIs (22 kg/m2BMI<25 kg/m2). A decreasing BMI change (<-2 kg/m2/year) was associated with an increasing eGFR change in overweight males (25 kg/m2BMI). Among underweight females (BMI<18.5 kg/m2), decreasing BMI was observed with decreasing eGFR.These findings suggest that the benefit and risk of weight loss in relation to kidney function differs depending on BMI and weight loss speed, especially in males.


PubMed | Saitama Health Promotion Corporation, Tokyo Medical and Dental University, Saitama Citizens Medical Center, Tokyo Medical University and Josai University
Type: Journal Article | Journal: PloS one | Year: 2015

The relationship between hyperuricemia and chronic kidney disease (CKD) has been found in various observational studies. Although hypouricemia is associated with cardiovascular events, it has not been established as a risk factor for CKD. We investigated the relationship between serum uric acid level and the loss of kidney function and incident CKD in healthy people.Healthy people were enrolled in this community-based prospective cohort study, the Saitama Cardiometabolic Disease and Organ Impairment Study, Japan. The analysis was conducted on 4188 subjects followed up for at least 3 years, 3102 for 6 years and 1052 for 9 years. Their data including glomerular filtration rate (eGFR) decline were examined every three years. The outcome event was incident CKD or the decrease in eGFR by more than 25% in three years. Multivariate statistical models were adjusted for the baseline characteristics.The following data was obtained: mean SD age, male, 39.6 10.4 years, female 38.4 10.8 years; eGFR, male, 81.9 16.4 ml/min/1.73 m2, female, 82.1 17.5 ml/min/1.73 m2; serum uric acid level, male, 5.8 1.2 mg/dl, female, 4.1 0.9 mg/dl. Both low and high serum uric acid levels were associated with the outcome and eGFR decline in males (multivariate logistic additional additive models, linear p = 0.0001, spline p = 0.043; generalized additive models, linear p = 0.0001, spline p = 0.012). In subjects with low serum uric acid levels (male, <5 mg/dl; female, <3.6 mg/dl), multivariate linear mixed models showed that low serum uric acid levels were associated with eGFR decline in a time-dependent manner (male, p = 0.0001; female, p = 0.045).This study showed that low as well as high levels of uric acid are associated with the loss of kidney function. Hypouricemia is a candidate predictor of kidney function decline in healthy people.

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