Differences in glucose intolerance within various occupational groups , i.e. laborers, clerks, and managers, and the related environmental factors were studied in ca. 9000 male workers of a certain factory. Age-and weight-adjusted prevalence rates of glucose intolerance were 3.2% in the laborers, 5.8% in the clerks, and 9.3% in the managers. In the managers, the total intake of calories was excessive for the amount of exercise expended ; food intake was relatively low in complex carbohy drates and high in animal fats. The clerks were characterized by a high sugar intake. The low prevalence of glucose intolerance in the laborers was ascribed to the greater amount of exercise. Assigned work hours, however, probably affected the prevalence of diabetes in the laborers, which was 2.1% in subjects who worked all three shifts, but 0.9% in subjects working only day shifts. Thirty laborers from all 3 shifts consented to give urine specimens during their working time (8 hr), after the same amount of food and exercise in all of them. Urinary excretionn of HGH and VMA during the midnight shift was significantly higher (p <0.05) than that during the day shift although urinary 170HCS was significantly low (p <0.01) at midnight. There were no significant changes in urinary CPR excretion between day and night shifts. These data indicate the importance of environmental factors, such as exercise, nutrition and stress, in glucose intolerance. occupation ; diabtes mellitus ; shift workers ; stress ; urinary human growth hormone

Objective The measurement of C-peptide immunoreactivity (CPR) is essential for evaluating the pancreatic β-cell function and selecting appropriate therapeutic agents in patients with diabetes mellitus. The meal tolerance test (MTT) is simple to administer physiological insulin-stimulating test. Previous studies have reported that several CPR-related indices are useful markers for predicting insulin requirement in type 2 diabetes. In the present study, we investigated the serum CPR response during the MTT in hospitalized patients with type 2 diabetes mellitus in order to clarify the clinical utility of the MTT. Methods We performed the MTT using a test meal with timed measurements of the serum CPR level based on the oral glucose tolerance test over 180 minutes and tested the correlation of various CPR-related indices and clinical factors in patients with type 2 diabetes mellitus. Patients The subjects were patients with type 2 diabetes mellitus who had been admitted to our hospital for diabetes management and education. The final study population consisted of 68 patients. Results The fasting CPR level was correlated with the 24-hour urinary CPR excretion and body mass index. The serum CPR level at 120 minutes in the MTT was strongly correlated with the area under the curve of CPR during the MTT. The patients who needed insulin therapy at 6 months after hospitalization showed a significant lower incremental CPR value from 0 to 120 minutes in the MTT than those who did not need insulin therapy. Conclusion The plasma C-peptide levels at 0 and 120 minutes in the MTT provide essential information for the clinical management of patients with type 2 diabetes mellitus.

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Liver-related mortality rates in patients with non-alcoholic steatohepatitis (NASH) increase with advancing liver fibrosis stage. The present study aimed to elucidate whether adding non-invasive liver fibrosis tests to a comprehensive health checkup system is useful for NASH screening. Both serum Mac-2-binding protein glycosylation isomer (M2BPGi) and point shear wave elastography (pSWE) using ultrasonography were performed for 483 health checkup subjects who consented to participate in this prospective study. Outcomes in positive subjects were surveyed 1 year later. Eighty-eight subjects (18%) showed positive results for at least one liver fibrosis test, with 63 subjects positive for pSWE, 33 subjects positive for M2BPGi, and 72 subjects showing no significant elevation of liver enzymes. The secondary consultation rate for positive subjects was 52% (46/88). However, as 15 of those 46 subjects visited a non-liver-specialist and could not undergo detailed examination, the secondary examination rate was only 35% (31/88). For the 31 subjects who received secondary examination, NASH was diagnosed in 14 subjects, other chronic liver disease (CLD) in 6 subjects, and no CLD in 11 subjects. Additional liver fibrosis tests using M2BPGi and pSWE appear useful in health checkups when screening for CLD, especially for NASH.

T2DM is a common disease progressed over the long duration of life. Because of lacking apparent symptoms and signs in many cases, interrelationship between patient and doctor becomes complicated.