The association of low muscle strength with cardio-metabolic risks remains controversial. The present study included 742 men aged 70 ± 9 years and 937 women aged 70 ± 8 years from a rural village. We examined the cross-sectional relationship between relative muscle strength defined by handgrip strength (HGS)/body weight (BW) ratio, and metabolic syndrome (MetS) based on the modified criteria of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP) III report and its components. Of these, 203 men (27.4%) and 448 women (47.8%) had MetS. In men, increasing quartile of HGS/BW ratio was significantly and independently associated with high waist circumference {odds ratio, 0.31; 95% confidence interval (CI), 0.24-0.41} and elevated triglyceridemia (0.71, 0.59-0.86). In women, it was also significantly and independently associated with high waist circumference (0.41; 0.36-0.48), high blood pressure (0.78; 0.66-0.92), Low HDL-cholesterolemia (0.84; 0.73-0.98) and elevated triglyceridemia (0.65; 0.53-0.79). In both genders, the prevalence of MetS significantly decreased in relation to increasing HGS/BW ratio. After adjustment for age, smoking status, drinking status, LDL-C, estimated glomerular filtration ratio (eGFR), and medication, the respective odds ratio (95% CI) for the quartile of HGS/BW ratio for MetS was 1.00, 0.54 (0.34-0.85), 0.32 (0.19-0.53), and 0.16 (0.09-0.29) in men, and 1.00, 0.76 (0.50-1.16), 0.33 (0.22-0.51), and 0.16 (0.10-0.25) in women. These results suggest that HGS/BW ratio was significantly and negatively associated with an increased risk of cardio-metabolic disorders in Japanese-community dwelling persons.

Objective Carotid intima-media thickness (IMT) is 1.37 (0.79-2.38), and 1.80 (1.03-3.15) in men, and 1.0, 1.04 (0.56-1.94), 2.35 (1.30-4.22), and 2.20 (1.16-4.20) in women. After adjusting for various known risk factors, the prevalence of carotid atherosclerosis (IMT 1.0 mm) was higher in subjects in the second, third and fourth quartiles of SUA concentration with odds ratios (95% CI) of 2.41 (1.08-5.37), 3.33 (1.49-7.42), and 2.73 (1.17-6.35

BackgroundThere are few studies to demonstrate the associations between newly addressed lipid profiles and metabolic syndrome (MetS)-associated variables.MethodsStudy participants without medications for hypertension, diabetes, or dyslipidemia {614 men aged 58 ± 14 (mean ± standard deviation; range, 20-89) years and 779 women aged 60 ± 12 (range, 21-88) years} were randomly recruited from a single community at the time of their annual health examination. The association between lipid profiles (total cholesterol (T-C), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, T-C/HDL-C, TG/HDL-C, LDL-C/HDL-C ratio and MetS, Insulin resistance by homeostasis model assessment of insulin resistance (HOMA-IR), and serum HMW adiponectin were analyzed.ResultsIn multiple linear regression analysis, TG/HDL-C and T-C/HDL-C ratios as well as TG showed significantly strong associations with all three MetS-associated variables in both men and women. In men, the ROC curve analyses showed that the best marker for these variables was TG/HDL-C ratio, with the AUC for presence of MetS (AUC, 0.82; 95% CI, 0.77-0.87), HOMA-IR (AUC, 0.75; 95% CI, 0.70-0.80), and serum HMW adiponectin (AUC, 0.67; 95% CI, 0.63-0.71), respectively. The T-C/HDL-C ratio, TG, HDL-C, LDL-C/HDL-C ratio, and non-HDL-C also discriminated these markers; however all their AUC estimates were lower than TG/HDL-C ratio. These results were similar in women.ConclusionIn Japanese community-dwelling adults, lipid ratios of TG/HDL-C, T-C/HDL-C, LDL-C/HDL-C as well as TG and HDL-C were consistently associated with MetS, insulin resistance and serum HMW adiponectin. Lipid ratios may be used as reliable markers.

IntroductionThe increasing prevalence of chronic kidney disease (CKD), with its associated high annual rates of mortality and cardiovascular complications ( 1 -3 ), is a major public health problem. In Japan, clinical practice guidelines established by the Japanese Society of Nephrology estimate that 18.7% of adults have CKD, which is defined as kidney damage or glomerular filtration rate (GFR) < 60 mL/min/1.73 m 2 for 3 months or more regardless of cause ( 4 ), and 4.1% have moderate or severe CKD ( 5 ). Identifying risk factors for CKD is critical in order to devise effective, population-based preventive strategies. Obesity is also a major worldwide public health problem. Obesity increases the risk of cardiovascular disease, diabetes, hypertension, and dyslipidemia (6, 7). However, few studies have examined the relationship between excess weight and CKD risk. Obese patients are at a higher risk for focal segmental glomerulosclerosis and glomerulomegaly (8) Vol. 31, No. 8 (2008) (9). In Western countries, many patients have an estimated GFR (eGFR) of less than 60 mL/min/1.73 m 2 or a body mass index (BMI) of 30 kg/m 2 or more. However, the risk of slightly elevated weight (BMI, 22.0 to 24.9 kg/m 2 ) in a Japanese population for mildly reduced renal function (eGFR, 60 to 90 mL/min/1.73 m 2 ) is not clear. We evaluated the relationship of BMI to potential risk factors such as hypertension, hyperglycemia, and lipids, as well as to renal function, using cross-sectional data from community-dwelling participants. Methods SubjectsParticipants were recruited at the time of their annual health examination in a rural town that has a total population of 11,136 (as of April 2002) and located in Ehime Prefecture, Japan, in 2002. Among the 9,133 adults aged 19 to 90 years in this population, 3,164 (34.6%) subjects met the eligibility requirements to participate in the study. Information on medical history, present conditions, and drugs was obtained by interview. Subjects with a clinical history of stroke, transient ischemic attack, myocardial infarction, or angina were excluded. Subjects taking medications for hypertension, diabetes, or dyslipidemia were also excluded from the study. However, participants that met the eligibility requirements with BMI> 30 kg/m 2 were included (37 subjects). The final study sample included 1,716 eligible persons. All procedures were approved by the Ethics Committee of Ehime University School of Medicine. Evaluation of Risk FactorsWe measured blood pressure in the right upper arm of participants in a seated position using an automatic oscillometric blood pressure recorder. Cigarette smoking was quantified based on daily consumption and on duration of smoking. Fasting total cholesterol (T-C), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), creatinine (enzymatic method), and uric acid were measured during fasting. Low-density lipoprotein cholesterol (LDL-C) levels were calculated using the Friedewald formula (10). Participants with TG levels ≥ 4...

BackgroundIn Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students.MethodsA total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18–34) years and 227 men aged 22 ± 4 (range, 18–44) years. Binary Logistic regression analysis was performed using specialty preferences as the criterion variable and the factors in brackets as six motivational variables (e.g., Factor 1: educational experience; Factor 2: job security; Factor 3: advice from others; Factor 4: work-life balance; Factor 5: technical and research specialty; and Factor 6: personal reasons).ResultsWomen significantly preferred pediatrics, obstetrics & gynecology, and psychology than the men. Men significantly preferred surgery and orthopedics than the women. For both genders, a high odds ratio (OR) of “technical & research specialty” and a low OR for “personal reasons” were associated with preference for surgery. “Technical & research specialty” was positively associated with preference for special internal medicine and negatively for pediatrics. “Work-life balance” was positively associated with preference for psychology and negatively for emergency medicine. Among the women only, “technical & research specialty” was negatively associated with preference for general medicine/family medicine and obstetrics & gynecology, and “job security” was positively associated for general medicine/family medicine and negatively for psychology. Among men only, “educational experience” and “personal reasons” were positively, and “job security” was negatively associated with preference for pediatrics. For both genders, “work-life balance” was positively associated with preference for controllable lifestyle specialties.ConclusionWe must acknowledge that Japanese medical students have dichotomized some motivations for their specialty preference based on gender. Systematic improvements in the working environment are necessary to solve these issues.