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Objective: To identify the prevalence of risk factors for pulmonary non-tuberculous mycobacterial (NTM) disease in a Japanese population.Patients and Methods: We reviewed 337 consecutive Japanese patients (210 women) with pulmonary NTM disease, including 225 patients with Mycobacterium avium complex (MAC) disease (95.8%) at our hospital during 2006–2017. We calculated the prevalence of risk factors reported in Western countries among mycobacterial species.Results: Pulmonary MAC disease cases comprised 78.2% of pulmonary NTM patients in their 40s, increasing to 100% at age ≥80 years. Body mass index (BMI) was <18.5 in approximately 40% of patients, which was significantly higher than the prevalence of underweight in the Japanese population. The percentage of male heavy smokers (Brinkman index ≥600) was 58.2% of pulmonary NTM disease and was high for all mycobacterial species. In pulmonary MAC disease, systemic factors were observed in the order of malignant tumors (other than lung cancer), diabetes, rheumatoid arthritis, and tuberculosis. Local factors were observed in the order of bronchiectasis, chronic obstructive pulmonary disease, lung cancer, and bronchial asthma.Conclusion: The risk factors reported in Western countries were relatively highly prevalent among Japanese pulmonary NTM disease patients. This observation may help elucidate disease onset mechanisms.
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Objective: Pulmonary mycobacterium avium complex (MAC) disease is increasing significantly worldwide. Several studies have investigated the clinical features of pulmonary MAC disease in the setting of cancer. Here, we aimed to clarify the clinical characteristics of patients with cancer with recent onset of pulmonary MAC disease and the effect of cancer on the onset of this disease.Patients and Methods: Of the 323 consecutive Japanese patients newly diagnosed with pulmonary MAC disease at Jichi Medical University Hospital between and 2006–2017, we retrospectively reviewed 79 consecutive patients with cancer.Results: Seventeen patients had lung cancer (21.0%), while 62 had non-lung cancer. Of the 17 patients with lung cancer, 16 had adenocarcinoma of which 10 had stage I to III disease; 8 of the 10 patients had not received chemotherapy. Sixteen patients with lung cancer had a MAC infection in the ipsilateral lung. Notably, 9 of the 11 lung cancer patients who did not undergo surgery had a MAC infection in the affected lobe. Of the 39 patients with the most common types of non-lung cancer (14 had gastric cancer, 13 had colorectal cancer, and 12 had breast cancer), 22 had stage I to III disease, and 18 of these 22 had not received chemotherapy.Conclusion: Lung cancer may act as a local factor contributing to the onset of pulmonary MAC disease in the ipsilateral lung. However, the underlying mechanism by which a history of cancer might affect the onset of pulmonary MAC disease remains unclear. Further investigation into this mechanism is needed.
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Atherosclerotic risk factors contribute to carotid atherosclerosis. Carotid intima-media thickness (IMT), as assessed using a non-invasive high-resolution ultrasound, can predict cardiovascular disease (CVD). Whereas the control of CVD is crucial for the Mongolian people, the studies on carotid atherosclerosis are lacking. The present population-based survey was a cross-sectional investigation of the determinants of carotid IMT in the general Mongolian population. A total of 344 Mongolian volunteers, aged 18-69 years, without CVD and on no medication, were recruited from a health screening setting. The current smoking habits, body mass index, mean blood pressure (MBP), blood total cholesterol (TC), glucose, insulin and carotid IMT (maximum level) were measured. Mongolian males had a significantly higher prevalence of current smoking and a higher level of IMT than females (average=0.58 mm in males vs 0.46 in females). Both a single and multiple regression analysis adjusted for all the regression analysis adjusted for all the measures revealed that IMT was significantly and positively correlated with age, male sex, MBP, TC and glucose among all of the participants. IMT was significantly and positively correlated with age, followed by MBP, TC and glucose among males, while among females, IMT was significantly and positively correlated with age, followed by MBP and TC. Age was the strongest determinant of carotid atherosclerosis, and the increases in blood pressure and cholesterol levels were also important measures in both sexes as well as glucose levels in males in particularly, thus suggesting a preventive strategy necessary for CVD in the general Mongolian population.
ABSTRACT
Atherosclerotic risk factors contribute to carotid atherosclerosis. Carotid intima-media thickness (IMT), as assessed using a non-invasive high-resolution ultrasound, can predict cardiovascular disease (CVD). Whereas the control of CVD is crucial for the Mongolian people, the studies on carotid atherosclerosis are lacking. The present population-based survey was a cross-sectional investigation of the determinants of carotid IMT in the general Mongolian population.A total of 344 Mongolian volunteers, aged 18-69 years, without CVD and on no medication, were recruited from a health screening setting. The current smoking habits, body mass index, mean blood pressure (MBP), blood total cholesterol (TC), glucose, insulin and carotid IMT (maximum level) were measured.Mongolian males had a significantly higher prevalence of current smoking and a higher level of IMT than females (average=0.58 mm in males vs 0.46 in females). Both a single and multiple regression analysis adjusted for all the regression analysis adjusted for all the measures revealed that IMT was significantly and positively correlated with age, male sex, MBP, TC and glucose among all of the participants. IMT was significantly and positively correlated with age, followed by MBP, TC and glucose among males, while among females, IMT was significantly and positively correlated with age, followed by MBP and TC.Age was the strongest determinant of carotid atherosclerosis, and the increases in blood pressure and cholesterol levels were also important measures in both sexes as well as glucose levels in males in particularly, thus suggesting a preventive strategy necessary for CVD in the general Mongolian population.
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The present study investigated the association between the angiotensin II type 2 receptor [AT2R] gene adenine/cytosine [A/C]-3123 polymorphism and cardiometabolic variables in subjects with and without hypertension. Cardiometabolic variables, in addition to genotyping by an allele-specific DNA assay, were measured in 161 asymptomatic community-dwelling Japanese women [age range 30-83 years]. They were divided into hypertensive [n = 82, age 50-81 years] and nonhypertensive [n = 79, age 30-83 years] subjects. The A-allele carriers [n = 53] showed significantly lower high-density lipoprotein cholesterol [HDL-C] levels than the non-A-allele carriers [n = 26] among nonhypertensive subjects [1.45 +/- 0.38 vs. 1.66 +/- 0.33 mmol/l, p = 0.02]. Even when multiple-adjusted analyses were performed, the HDL-C levels continued to differ significantly and independently of other variables, including the body mass index and insulin resistance index, between A-allele and non-A-allele carriers. However, this association was not observed among hypertensive subjects. The present study demonstrated that A-allele carriers had significantly lower HDL-C levels than did non-A-allele carries among nonhypertensive women, while this association was not observed among hypertensive women. This indicates that the A/C3124 polymorphism may be a marker associated with HDL metabolism by hypertension. This was a small study, so further research is warranted to confirm the observed association
Subject(s)
Humans , Female , Cholesterol, HDL , Polymorphism, Single Nucleotide , Renin-Angiotensin System , Receptor, Angiotensin, Type 2/geneticsABSTRACT
Small dense low density lipoprotein [sdLDL] which has a small LDL particle size with greater susceptibility to oxidation is regarded as a risk marker for cardiovascular disease. The diacron reactive oxygen metabolites [d ROMs] test has recently been introduced as an oxidative stress related marker in the clinic. The aim of the present study was to investigate the correlation between the mean LDL particle size and the oxidative stress status as evaluated by the d ROMs in dyslipidemic patients. The study included 278 dyslipidemic patients [121 male and 157 female, mean age, 60 years]. Clinical data including the conventional atherosclerotic risk factors in addition to the mean LDL particle size measured with the gel electrophoresis and the d ROMs were collected. Male patients had a significantly smaller mean LDL particle size than females [262.2 +/- 7.5 [SD] vs. 264.3 +/- 6.7 A, P<0.05], while female patients had a significantly higher d ROMs level than males [318 +/- 68 vs. 350 +/- 72 U. Carr., P<0.01]. A multiple regression analysis revealed that there was an independent, significant, and inverse correlation between the mean LDL particle size and the d ROMs [beta=?0.19, P<0.05]. These findings of the co existence of both markers suggest that sdLDL and oxidative stress can be cooperative in atherogenesis, possibly leading to the incidence of CVD, in dyslipidemic patients
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To investigate the influence of ezetimibe monotherapy on remnant-like particle cholesterol [RLP-C] in subjects with metabolic syndrome [MetS]. Ezetimibe [10 mg/daily] was prescribed over a 12-week period for hypercholesterolemic subjects divided into groups with MetS [n = 28; male/female = 13/15; mean age 67 years] and without MetS [n = 22; male/female = 9/13; mean age 66 years]. In the pre- and post-treatment phases, BMI, blood pressure and fasting blood levels of glucose, lipid panels and RLP-C were measured. The group with MetS showed significantly higher RLP-C levels than the group without MetS [median level: 0.18 vs. 0.12 mmol/l [7.1 vs. 4.4 mg/dl], p < 0.01] in the pre-treatment phase. In the post-treatment phase, the low-density lipoprotein cholesterol levels were significantly reduced in both groups to a similar level [p < 0.001 in both], while there was a significantly greater reduction in RLP-C in the group with MetS than the group without MetS [median level: 0.12 vs. 0.11 mmol/l [4.8 vs. 4.1 mg/dl], p < 0.05]. This difference in RLP-C remained significant after adjusting for confounding factors. Ezetimibe monotherapy may be associated with a greater reduction in RLP-C levels in subjects with MetS than in those without MetS
Subject(s)
Humans , Male , Female , Azetidines/analogs & derivatives , CholesterolABSTRACT
The aim of this study was to Investigate the relationship between metabolic risk factors and oxidative stress using urinary 8-hydroxydeoxyguanosine [8-OHdG], a recently utilized biological marker, in asymptomatic subjects. Ninety subjects [males/females = 30/60; mean age = 52 years], who were nonsmoking, nondiabetic and not on any medicine, were enrolled in the study. The body mass index, blood pressure, total cholesterol, triglyceride [TG], high-density lipoprotein cholesterol [HDL-C] and glucose as well as urinary 8-OHdG and creatinine were measured. The median level of 8-OHdG was 9.3 ng/mg creatinine [nterquartile range: 5.8-23.2]. TG [Pearson's correlation: r = 0.262, p - 0.013] and HDL-C [r - -0.259, p - 0.014] showed a significant correlation with 8-OHdG. A multiple linear regression analysis adjusted for all the variables revealed that only TG had an independently significant and positive correlation with 8-OHdG [p = 0.231, p = 0.046]. The data in this population suggest that, among metabolic risk factors, hypertriglyceridemia may be weakly but significantly associated with hyperoxidative stress as assessed by 8-OHdG
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It was the aim of this study to investigate whether there is any relationship between oxidative stress, as assessed by the diacron reactive oxygen metabolite [d-ROM] test, and carotid atherosclerosis among hypercholesterolemic patients. A well-defined group of patients with type II hypercholesterolemia [n = 81, mean age 59 years] was studied to observe the correlation between the levels of serum d-ROMs and carotid artery intima-media thickness [IMT] using B-mode ultrasound, in relation to the traditional atherosclerotic risk factors [age, sex, smoking, body mass index, blood pressure, glucose and lipid panels]. The mean level in low-density lipoprotein cholesterol [LDL-C] in this population was 4.45 mmol/l, d-ROMs were 323.2 Carr U, and IMT was 0.91 mm. A multiple regression analysis revealed a positive and significant correlation between IMT and d-ROMs [beta = 0.27, p < 0.05], along with age and LDL-C. These results indicate that the increased oxidative stress levels using the d-ROM test, independent of aging and increased LDL-C levels, may be associated with carotid atherosclerosis even in hypercholesterolemic patients
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To assess the influence of smoking on glycated albumin [GA] to hemoglobin A1c [HbA1c] ratio among type 1 diabetes mellitus [T1DM] patients. Eighty-one T1DM patients [49 females, 32 males, mean age 48 +/- 18 years] were recruited, and data concerning GA/HbA1c ratio and smoking were collected. The median levels of GA and HbA1c were 23.3 and 7.4%, respectively. Independent of age, sex and/or body mass index, the GA/HbA1c ratio in smokers was significantly lower than that in nonsmokers [3.0 vs. 3.3, p < 0.05]. The data suggest that smoking might affect the GA/HbA1c ratio among T1DM patients