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Background: Effects of endurance training on adipose insulin sensitivity in association with body composition, circulating adipokines, and markers of inflammation have been studied less in young Asian subjects.Methods: Adipose insulin sensitivity/resistance was compared between 170 female Japanese collegiate athletes and 311 nonathletes (18–24 years), who underwent measurements of serum adipokines, markers of insulin sensitivity, inflammation, and dual-energy X-ray absorptiometry. Two separate subsamples of two groups of women underwent either a 75-gram oral glucose tolerance test or a standardized meal test, but not both.Results: As compared with nonathletes, athletes, characterized by higher skeletal muscle mass and lower percentage of body fat (both P < 0.001), had lower adipose insulin resistance (IR) (a product of fasting insulin and nonesterified fatty acid (NEFA) and lower leptin/adiponectin ratio (both P < 0.001). Although athletes had lower postmeal/postglucose insulinemia (P = 0.009 and 0.01, respectively), the two groups did not differ in postmeal percentage NEFA suppression and postmeal/postglucose glycemia, suggesting increased insulin sensitivity in adipose tissue and skeletal muscle, respectively. Serum leptin (P < 0.001) and tumor necrosis factor-α (P = 0.01) were lower in athletes, whereas adiponectin and homeostasis model assessment IR did not differ.Conclusions: Endurance training was associated with increased insulin sensitivity in adipose tissue as well as skeletal muscle without changes in circulating adiponectin even in young, normal-weight Japanese women.

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BackgroundPostoperative delirium is common after extensive surgery, and is known to be associated with sleeping medications. In this study, we aimed to investigate the relationships between sleeping medications and postoperative delirium after pharyngolaryngectomy with esophagectomy.MethodsWe performed a retrospective analysis of 65 patients who underwent pharyngolaryngectomy with esophagectomy at Shizuoka Cancer Center Hospital between January 2012 and March 2016. All data were assessed by two psychiatrists, and univariate and multivariate analyses were performed.ResultsPostoperative delirium developed in 9 (13.8%) patients, with most cases (77.8%) occurring between postoperative day (POD) 1 and POD 3. Of the 24 patients taking a minor tranquilizer after surgery, 8 (33.3%) became delirious, but, of the remaining 41 patients taking ramelteon with or without suvorexant, only one (2.4%) became delirious after surgery. Moreover, of the 16 patients taking both ramelteon and suvorexant, no postoperative delirium was observed. Ramelteon with or without suvorexant was significantly associated with a decreased rate of postoperative delirium compared with minor tranquilizer use (p = 0.001). Multivariate analysis confirmed that the use of ramelteon with or without suvorexant was the only significant preventive factor of postoperative delirium (odds ratio 0.060, p = 0.013).ConclusionThe use of ramelteon with or without suvorexant was the only significant preventive factor of postoperative delirium after pharyngolaryngectomy with esophagectomy. However, using minor tranquilizers was associated with postoperative delirium. We recommend ramelteon with or without suvorexant for preventing postoperative delirium after pharyngolaryngectomy with esophagectomy.