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H Shimokata

Publications and source records attributed to H Shimokata.

At least 19 recordsLinked to original sources
PubMed2006

Can you diagnose for vertebral fracture correctly by plain X-ray?

INTRODUCTION: A wrong diagnosis of latent vertebral fracture is often made when it is based on plain X-ray imaging. Magnetic resonance imaging (MRI) has a high degree of accuracy for the definite diagnosis. This study was designed to identify ways to support improvements in the diagnostic accuracy of plain X-ray (X-P). METHODS: We studied X-P and MRI images of 120 women and men (age range: 50-96 years). Five orthopedists and two radiologists interpreted front and lateral thoracolumbar X-Ps and MRI images. The correct diagnosis rate for the presence and location of incident vertebral fractures and the correct diagnosis rate according to morphological classifications were analyzed. RESULTS: A correct diagnosis of incident fractures was made in 51.5% of cases overall. Diagnoses of non-incident fracture based on X-P in those cases with incident fracture based on MRI (false positive) occurred in 24.8% of the patients, while diagnoses of incident fracture based on X-P in those cases without incident fracture based on MRI (false negative) occurred in 6.5% of the patients. The application of morphological classifications (the primary osteoporosis diagnostic criteria and Yoshida's classification) resulted in the correct diagnosis rate being significantly higher in the group without prevalent fracture even when there were morphological changes (wedge, indented, protruding type) in the anterior bone cortex. Odds ratios were investigated for factors that would affect the correct diagnosis rate, including age, body weight, lumbar vertebrae bone mineral density, and examiner ability. In an overall investigation, age (OR=0.660), body weight (OR=2.082), and examiner ability (p=0.0205) affected the correct diagnosis rate. CONCLUSION: The correct diagnosis rate for incident vertebral fractures with X-Ps was low (24.8%) and in cases with prevalent fractures, the rate was even lower (16.8%), but the number of prevalent fractures and BMD did not exert an effect. One key improving the correct diagnosis rate may be to pay attention to morphological changes in the anterior bone cortex.

Aged↗
PubMed2006

Preproghrelin Leu72Met variant contributes to overweight in middle-aged men of a Japanese large cohort.

OBJECTIVE: To investigate whether Leu72Met polymorphism of the preproghrelin gene is associated with overweight/obesity in middle-aged and older Japanese. DESIGN: Cross-sectional analysis. SUBJECTS: A total of 2238 community-dwelling middle-aged and older Japanese people (age: 40-79 years) who participated in the first wave of examinations in the National Institute for Longevity Sciences - Longitudinal Study of Aging from April 1998 to March 2000. MEASUREMENTS: The Leu72Met polymorphism of prepoghrelin gene, anthropometric variables including body weight, body mass index (BMI), waist circumference, waist-to-hip ratio and whole-fat mass and biochemical variables including serum lipid levels, fasting plasma glucose, insulin and homeostasis model assessment for insulin resistance. RESULTS: The frequencies of the Leu72Leu, Leu72Met and Met72Met alleles were 63.4, 32.7 and 4.0%, respectively. No differences in the genotype distributions of the Leu72Met polymorphism were found between genders or age groups, and no significant associations were observed between polymorphism and anthropometric variables in women and older men. However, middle-aged men who were 72Met allele carriers showed a higher body weight change from body weight at 18 years of age, as well as a higher waist circumference and a tendency to a higher waist-hip-ratio than noncarriers. Although there were no significant differences in the genotype distribution according to BMI in women and older men, a significantly higher frequency of the 72Met allele was found in the higher BMI group (BMI> or =25 kg/m(2)) of middle-aged men than in the normal-weight group. No significant associations were observed between polymorphism and serum lipid, glucose or insulin levels. CONCLUSIONS: These results suggest that the 72Met allele of the preproghrelin gene is a contributing factor for midlife weight change in men.

Adult↗
PubMed2005

Differences in the relationship between lipid CHD risk factors and body composition in Caucasians and Japanese.

OBJECTIVES: To examine differences in the relationship between fat distribution and lipid coronary risk factors in Caucasian and Japanese population and further to determine whether the cut-points for body mass index (BMI) and waist circumference (WC) proposed by WHO and NHLBI are applicable to Japanese population as a predictor of a lipid risk factor abnormality or not. RESEARCH METHODS AND PROCEDURES: Subjects were 895 participants of the Baltimore Longitudinal Study of Aging in the US (BLSA) and 1705 participants of the Longitudinal Study of Aging by the National Institutes for Longevity Science in Japan (NILS-LSA). Subjects were divided into four demographic groups as younger (age<65 y) men and women, and older (age> or =65 y) men and women. Blood total cholesterol, triglycerides, LDL- and HDL-cholesterol and anthropometry were measured. Regression coefficients of BMI and WC on risk factors, sensitivity and specificity of the BMI and WC cut-points for blood lipid abnormality, and mean values of blood lipids at BMI or WC cut-points were computed in both populations. RESULTS: Height, weight, WC and BMI were significantly greater in the BLSA than those in the NILS-LSA subjects. Total cholesterol, HDL- and LDL-cholesterol were significantly greater in the NILS-LSA than in the BLSA subjects. Sensitivities of BMI and WC cut-points were much lower in the NILS-LSA than in the BLSA subjects. Specificities of BMI and WC cut-points were higher in the NILS-LSA than in the BLSA subjects. Mean values of triglycerides, total cholesterol, HDL- and LDL-cholesterol at BMI=25 were significantly greater in the NILS-LSA than in the BLSA subjects. At the WC cut-point (94 cm for men, 80 cm for women), mean values of all lipids were significantly greater in the NILS-LSA than in the BLSA subjects with the exception of triglycerides in younger women. CONCLUSIONS: The Japanese subjects have smaller BMI and WC, worse total and LDL-cholesterol levels and better HDL-cholesterol levels compared to Caucasians. Sensitivities of BMI and WC for predicting lipid risk factor abnormality are much lower in Japanese. The cut-points for BMI and WC proposed by WHO and NHLBI may be too high for predicting an abnormality in triglycerides, total and LDL-cholesterol in Japanese. For detecting an abnormal HDL-cholesterol level, the BMI and WC cut-points may not be as beneficial for the Japanese population as for Caucasians.

Adult↗
PubMed2004

Alcohol dehydrogenase 2 variant is associated with cerebral infarction and lacunae.

The authors examined the association of the alcohol dehydrogenase 2 (ADH2) genotype with vascular events in community-dwelling Japanese (1,102 men/1,093 women). The allele ADH2*2 encodes an isozyme with a higher level of activity than ADH2*1. Here, the authors show that the ADH2*1 carriage is associated with high prevalence of cerebral infarction and lacunae in men. Multiple regression analyses confirmed that the risk of lacunae and cerebral infarction was increased by the ADH2*1 allele.

Adult↗
PubMed2003

Association of polymorphisms in the estrogen receptor alpha gene with body fat distribution.

OBJECTIVE: To examine whether polymorphisms of the estrogen receptor (ER) alpha gene are associated with body fat distribution. DESIGN: Cross-sectional, epidemiological study of two single-nucleotide polymorphisms, a T --> C (PvuII) and an A --> G (XbaI), in the first intron of the ERalpha gene. SUBJECTS: A total of 2238 community-dwelling middle-aged and elderly Japanese population (age: 40-79 y). MEASUREMENTS: The ERalpha genotypes (by automated fluorescent allele-specific DNA primer assay system), anthropometric variables, fat mass (FM) and percentage FM (%FM) (by dual-energy X-ray absorptiometry). RESULTS: FM and waist were inversely associated with age (r=-0.630 and -0.504, respectively) in women with the GG genotype. On the other hand, waist circumference of the AA genotype was positively correlated with age (r=0.231). Thus, for middle-aged women (40-59 y) with the AG or GG genotype body mass index (BMI), %FM, FM, waist, hip and waist-to-hip ratio (WHR) were larger than those with the AA genotype. In particular, FM and waist were greater by 20% and 9%, respectively, for the GG genotype, compared to the AA genotype. Alternatively, FM and waist were smaller by 18% and 6%, respectively, in older women with the GG genotype, compared to the AA genotype. No effect was found among the A --> G polymorphisms for men. For both genders, no difference was found in any variables among the TT, TC and CC genotypes with the exception of BMI of older men (60-79 y). CONCLUSION: No association was found between the ERalpha gene polymorphisms and body fat distribution in men. For women, the A --> G polymorphism, in particular the GG genotype, may contribute to the development of upper-body obesity in middle-aged individuals, but may serve to decrease the whole-body and abdominal fat tissue of older individuals.

Absorptiometry, Photon↗
PubMed2002

Mechanism of the development of gastric ulcer after percutaneous endoscopic gastrostomy.

BACKGROUND AND STUDY AIMS: The present study was carried out in order to elucidate the mechanism of the development of gastric ulcer, one of the serious complications of PEG tube placement. PATIENTS AND METHODS: This retrospective study included 92 patients who underwent gastric endoscopy after PEG tube placement. Gastric ulcers detected at gastroscopy were examined in relation to the length of the protrusion from the PEG tubes intragastric bumper and the use of histamine H 2 -receptor antagonists. RESULTS: Gastric ulcers were found in nine of the 92 patients, and in all nine the ulcer was found on the posterior wall of the gastric body, where the tip of the PEG tube was attached. Seven of the 21 patients (33.3 %) who had a PEG tube with a long protrusion from the intragastric bumper developed gastric ulcer. By contrast, only two of the 71 patients (2.8 %) who had a PEG tube with a short protrusion developed gastric ulcer. The use of H 2 -blockers had no significant impact on the development of gastric ulcer. CONCLUSIONS: The occurrence of gastric ulcer after PEG placement was attributable to the shape of the PEG tube within the intragastric space, and not to the use of H 2 -blockers, suggesting that appropriate placement of the PEG tube is an important factor in preventing gastric ulcer.

Adult↗
PubMed2001

Effects of high versus low-intensity resistance training on bone mineral density in young males.

The purpose of this study was to investigate the effect of high-intensity and low-intensity resistance training upon bone mineral density (BMD) by comparing the BMD of young male powerlifters (n = 5), recreational trainees (n = 5), and controls (n = 5). Lumbar spine (L2-L4), proximal femur, and whole body BMDs were measured using dual-energy X-ray absorptiometry (DXA). The high-intensity group showed a significantly greater BMD when the whole body and trochanter regions were measured than the low-intensity and control group. The BMD of the lumbar spine, femoral neck, and Ward's triangle was greater in the high-intensity group compared with the control group. There was no significant BMD difference between the low-intensity and control group except at the trochanter region. These results suggest that high-intensity resistance training is effective for increasing BMD, but low-intensity resistance training is not.

Absorptiometry, Photon↗
PubMed2001

The effect of public long-term care insurance plan on care management and care planning in Japanese geriatric hospitals.

Japan, a society facing demographic aging at an incomparable speed, decided to introduce a new public long-term care insurance system to meet the expected need for elders to be cared for in the near future. The purpose of this study was to examine the change in knowledgeability on the side of managers of Japanese geriatric hospitals regarding (1) the concept of care-management as the methodology to supply care services to the elderly smoothly, and (2) comprehensive assessment for the elders as the technical skill in the process of materializing care management. Subjects were interviewed and questioned over the telephone according to a structural questionnaire. Managers (directors and office managers) of geriatric hospitals in 1996 and 1999. In 1996, the rate of knowledgeability for care management on the side of managers of geriatric hospitals was 70.0% (28/40) as a whole, increasing to 97.3% (71/73) in 1999. With regard to MDS-RAPs, the knowledgeability rate increased from 57.5% (23/40) in 1996 to 95.9% (70/73) in 1999. However, regarding care planning, almost all of the hospitals that performed care planning were those in the category required to submit care plans to the municipal government. Geriatric hospitals that were not required to submit such plans did not perform such planning either in 1996 or in 1999. It can be concluded that the decision to introduce a long-term care insurance system in Japan has led to a deeper understanding of the methodology of care management and a comprehensive assessment on the side of managers of geriatric hospitals.

Journal Article↗
PubMed2001

Does waist circumference add to the predictive power of the body mass index for coronary risk?

OBJECTIVES: To examine the power of the combined measurements of body mass index (BMI) and waist circumference (WC) for the prediction of abnormality in coronary heart disease risk factors and to determine whether the additional measurement of WC is predictive in older men and women. RESEARCH METHODS AND PROCEDURES: 1190 men and 751 women of the Baltimore Longitudinal Study of Aging were dichotomized into younger (<65 years) and older (65+ years) age groups. Coronary risk factors in the realms of glucose/insulin metabolism, blood pressure, and plasma lipids were assessed. The relationship of BMI and WC, singly and combined, to 10 risk factors for coronary heart disease was examined. RESULTS: In younger and older men and women, BMI and WC are highly correlated (0.84 to 0.88). BMI and WC are also significantly correlated to all 10 coronary risk factors in younger men and women and to 8 of the 10 in the older men and women. Both partial correlation and logistic regression analyses revealed a modest but significant improvement in the prediction of coronary risk in younger men and women by WC after controlling for the level of BMI. There was no improvement in the older subjects. DISCUSSION: WC adds only modestly to the prediction of coronary risk in younger subjects once BMI is known, and adds nothing to the production of risk in older subjects.

Adolescent↗
PubMed2001

[Physiological requirements for longevity].

Genetic background is an important factor for longevity. Life-style and environmental factors, such as nutrition, physical activity, smoking and alcohol, are also important. For example, obesity is negatively associated with health and longevity. It is known that dietary restriction is the most consistent method of extending life span in rats. In human, however, under nutrition as well as over nutrition is a risk factor for a short life. Losing weight is often dangerous in the elderly, in whom reserved physiological functions are limited. Smoking, diabetes mellitus and hypertension accelerate human aging, while physical activity and a moderate amount of alcohol is good to live long. Preventive medicine and health support are also important to promote longevity. Good results of new strategies such as custom-made health support and preventive treatment are anticipated in the near future. Accumulation of basic data in human aging and health are essential to the practice of preventive medicine and health support. A new comprehensive longitudinal study was started at the National Institute of Longevity Sciences (NILS) in 1997 (NILS-Longitudinal Study of Aging, NILS-LSA). The results of this study should be helpful for the practice of preventive medicine and health support.

Aged↗
PubMed2001

Outcomes of written living wills in Japan--a survey of the deceased ones' families.

A study was recently done to investigate the outcomes of written living wills in Japan, which, unlike the United States, does not legally recognize advance directives. This study collected demographic information and predictors of living will use among families and guardians who used the living will form provided by the Japan Society for Dying with Dignity. According to the results of the study, affliction with cancer and death in a hospital was the best predictor of written living will use. Research on physicians' treatment limitation and withdrawal behaviors in the clinical setting is needed to better understand the actual impact of living wills. Such research can provide better understanding of where boundaries of self-determination are drawn and how to respect autonomy in Japan.

Advance Directive Adherence↗
PubMed2000

Gene structure of human cholecystokinin (CCK) type-A receptor: body fat content is related to CCK type-A receptor gene promoter polymorphism.

The transcriptional start site of the human cholecystokinin (CCK)-A receptor gene was determined by the Capsite Hunting method. Two sequence changes were detected, a G to T change in nucleotide -128, and an A to G change in nucleotide -81. The homozygote (T/T, G/G) was detected in 25 of 1296 individuals (1.9%) in the cohort study. This polymorphism showed a significantly higher percent body fat and higher levels of serum insulin and leptin, compared with wild type and heterozygotes. Our study provided the possibility that polymorphism in the promoter region of the CCK-A receptor gene may be one of genetic factors affecting fat deposition.

Adipose Tissue↗
PubMed2000

A test of recently proposed BMI standards with respect to old age.

The purpose of this study was to investigate the effects of age on the relationship between BMI and multiple coronary risk factors, and to determine whether the BMI classification by NHLBI and WHO is applicable as a predictor of coronary risk factors in older (>65 years) as well as in younger (<65 years) men and women. Effects of age on ten coronary risk factors were examined. Sex differences in the slopes of BMI on risk factors were compared between younger and older subjects in order to examine the effects of age on these relationships. The frequency of risk factor abnormality in individual BMI groups (18.5-24.9, 25.0-29.9, 30.0+) was examined for four age-sex groups. The significance of an age group-BMI interaction term was tested by the logistic regression model to see whether there is a significant difference in the relationship between BMI and the individual risk factor abnormalities between younger and older subjects. Older subjects had significantly higher values for most risk factors than younger subjects. The slopes of BMI on risk factors were different between younger and older subjects for fasting glucose, total, HDL- and LDL-cholesterol in men, and for diastolic blood pressure, total and LDL-cholesterol in women. The proportion of subjects with abnormal risk factor levels in each of the three BMI groups was higher in older than in younger subjects for most risk factors. There was generally a progressive worsening of the risk factor levels with increasing BMI in both age groups. There was no consistent age difference in the relationship between BMI groups and the frequency of risk factor abnormality. We conclude that, although age increases the frequency of most cardiovascular risk factor abnormalities, in general, it does not affect the trend of the relationship between the risk factors and the normal, overweight and obese BMI groups defined by NHLBI and WHO. Therefore, these BMI categories are applicable as predictors of risk factor levels in older as well as in younger men and women.

Adult↗
PubMed2000

Relationship between intraocular pressure and obesity in Japan.

BACKGROUND: Some cross-sectional studies have suggested that age, systolic blood pressure and obesity are positively related to intraocular pressure (IOP), but few longitudinal studies have examined this relationship. This study was carried out to evaluate the association between intraocular pressure and obesity by cross-sectional and longitudinal analyses in a large Japanese population. METHODS: Data were collected from annual health examinations between 1989 and 1997 and reviewed retrospectively. Subjects of the cross-sectional analysis were 70 139 males and females aged 14-94 years. Among these subjects, 25 216 males and females who had undergone IOP measurements more than three times were analysed longitudinally. The association between IOP and obesity was examined cross-sectionally and longitudinally. RESULTS: Cross-sectional analysis: The mean IOP at the last visit was 11.6 mmHg. The IOP decreased gradually with age and was significantly higher in males than in females in almost all age groups. Body mass index (BMI) significantly correlated with IOP after controlling for age, gender and blood pressure. Longitudinal analysis: There was a significant association between longitudinal change in IOP and change in weight. This relationship remained significant after controlling for initial BMI, initial blood pressure, change in blood pressure, gender and age. CONCLUSION: This study showed a significant association between IOP and obesity in both cross-sectional and longitudinal analysis. These findings suggest that obesity is an independent risk factor for increase in IOP.

Adolescent↗
PubMed2000

Effect of aging on the relationship between multiple risk factors and waist circumference.

OBJECTIVE: To examine the relationship between various coronary risk factors and the different levels of fat distribution in younger (<65 years) and older (> or = 65 years) men and women, using the classifications proposed by the National Heart, Lung and Blood Institute (NHLBI) and the World Health Organization (WHO). DESIGN: Cross-sectional study of subjects enrolled in the Baltimore Longitudinal Study of Aging. MEASUREMENTS: Systolic blood pressure, diastolic blood pressure, fasting glucose, 2-hour glucose, fasting insulin, homeostasis model assessment insulin resistance (HOMAIR), triglyceride, total cholesterol, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol were measured as risk factors. The proportion of subjects with abnormal risk factor levels by waist circumference classifications was determined in the age and gender subgroups. RESULTS: There were significant adverse effects of age per se on all risk factors with the exception of fasting insulin and HOMAIR in both men and women, total cholesterol in men, and diastolic blood pressure in women. HDL-cholesterol was higher in older subjects. There were significant correlations between waist circumference and all of the risk factors in the younger group. Waist circumference did not have a significant correlation with total cholesterol in older men, or with total cholesterol and LDL-cholesterol in older women. The proportion of subjects with an abnormal risk factor level increased with increasing waist circumference for most risk factors in both younger and older subjects, but proportions of subjects in each individual waist group were higher in older than in younger groups for systolic blood pressure, diastolic blood pressure, fasting glucose, and 2-hour glucose in men, and for systolic blood pressure, fasting glucose, 2-hour glucose, total and LDL-cholesterol, and triglyceride in women. CONCLUSIONS: Our data indicate that the waist circumference cutpoints proposed by NHLBI and WHO standards are useful for the prediction of cardiovascular disease risk factors in older as well as in younger men and women.

Adolescent↗
PubMed2000

A new comprehensive study on aging--the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA).

A new comprehensive longitudinal study of aging, the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA) started in November 1997. The participants of this study will be 2,400 residents aged 40 to 79 years who were age- and gender-stratified random samples selected from the NILS area. All participants provided written informed consent after a detailed explanation of the study. They will be examined at the NILS-LSA Examination Center every two years. Their first wave examinations will be finished by the end of March 2000. The examined variables number over 1,000, including clinical evaluations, medical examinations, anthropometry, body composition, physical functions, physical activities, psychological assessments, nutritional analysis and molecular epidemiology. By the end of September 1999, 1,643 men and women had completed their first wave examinations.

Adult↗