Metabolic syndrome and depression: evidence from a cross-sectional study of real-world data in Japan.

BACKGROUND: Both metabolic syndrome (MetS) and depression are high priority health problems, especially for working age. Numerous studies have explored the link between metabolic syndrome and depression; however, not all of them have consistently demonstrated an association. The objective of this study was to determine whether there is an association between MetS and depression by analyzing extensive real-world data (RWD). METHODS: Our data was drawn from insurance claims and health checkups of local government officials across all prefectures in Japan except for Tokyo in the 2019 fiscal year. According to the number of months with diagnosis of depression and prescription of antidepressants, the study participants were classified into the following categories: Certainly not Depression (CN), Possibly not Depression (PN), Possible Depression (PD), and Certain Depression (CD). Associations between MetS and its components-visceral obesity, hypertension, hyperlipidemia, and diabetes- and these categories of depression were analyzed by logistic regression. RESULTS: The depression categories of the 130,059 participants were as follows: CN 85.2%; PN 6.9%; PD 3.9%; and CD 4.1%. For men, the adjusted odds ratio (AOR) for MetS were PN 0.94 (95% CI: 0.86-1.02), PD 1.31 (1.19-1.43), and CD 1.63 (1.50-1.76), with reference to CN. For women, AOR of MetS were PN 1.10 (0.91-1.32), PD 1.54 (1.24-1.91), and CD 2.24 (1.81-2.78). Among the MetS components, visceral obesity, hyperlipidemia, and diabetes were significantly associated with depression categories. CONCLUSIONS: In this study, we found a significant association between MetS and depression, this association being similar to that previously reported. Our findings provide robust evidence for linkage between MetS and depression, suggesting that analysis of RWD is useful for providing concrete evidence.

Sex-specific association of body mass index and fatty liver index with prevalence of renal hyperfiltration: a cross sectional study using Japanese health check-up data.

BACKGROUND: The relationship between obesity and nonalcoholic fatty liver disease and renal hyperfiltration is controversial. This study aimed to assess the correlations of body mass index and fatty liver index, respectively, with renal hyperfiltration in non-diabetic subjects, considering age, sex, and body surface area. METHODS: This cross-sectional study assessed the Japanese health check-up data (FY2018) of 62,379 non-diabetic individuals from a health insurance database. Renal hyperfiltration is the ≥ 95th percentile of estimated glomerular filtration rate (derived by Chronic Kidney Disease Epidemiology Collaboration formula) by gender and age in healthy subjects. After adjusting for potential confounders, multiple logistic regression models were applied to evaluate the correlation of renal hyperfiltration with body mass index categories and fatty liver index (10 equal parts). RESULTS: A negative and positive correlation, respectively, were noted when the body mass index was < 21 and ≥ 30 in women; however, a positive correlation was noted for BMI < 18.5 and ≥ 30 in men. Renal hyperfiltration prevalence increased when fatty liver index increased for both sexes; the cutoff value for fatty liver index was 14.7 for women and 30.4 for men. CONCLUSIONS: Body mass index and renal hyperfiltration correlated linearly in women; however, in men, the correlation was U-shaped; therefore, differing by sex. However, fatty liver index correlated linearly with renal hyperfiltration in both sexes. Non-alcoholic fatty liver disease might be associated with renal hyperfiltration; Fatty liver index is a simple marker that can be obtained from health check-ups. Since a high fatty liver index correlated with renal hyperfiltration, it may be beneficial to monitor the renal function in such a population.

Fatty liver index as a predictive marker for the development of diabetes: A retrospective cohort study using Japanese health check-up data.

BACKGROUND & AIMS: Fatty liver is associated with incident diabetes, and the fatty liver index (FLI) is a surrogate marker for non-alcoholic fatty liver disease (NAFLD). We aimed to determine whether or not FLI was associated with incident diabetes in relation to obesity and prediabetic levels in the general Japanese population. METHODS: This was a retrospective study using the Japanese health check-up database of one health insurance from FY2015 to FY2018. This study included 28,991 individuals with prediabetes. First, we stratified all participants into two groups: "high-risk," comprising patients with HbA1c >6.0%, and "standard," comprising the rest. Subsequently, we divided them into four groups according to FLI (<30 or not) and obesity (BMI <25 kg/m2 or not). Subsequently, the incidence rate of diabetes was compared among the groups after 3 years of follow-up using multiple logistic regression models after adjusting for potential confounders. RESULTS: After 3 years of follow-up, 1,547 new cases of diabetes were found, and the cumulative incidence was 2.96% for the standard group and 26.1% for the high-risk group. In non-obese individuals, odds ratios (95% confidence interval) for FLI ≥30 versus FLI <30 were: 1.44 (1.09-1.92) for the standard group and 1.42 (0.99-2.03) for the high-risk group. In the high-risk group, obesity (BMI ≥25 kg/m2) but FLI <30 was not a risk factor for developing diabetes. CONCLUSION: Although high FLI is generally considered to be a risk factor for developing diabetes, obesity might have been a confounding factor. However, the present study showed that high FLI is a risk factor for the development of diabetes, even in non-obese individuals. Our results include suggestion to develop a screening tool to effectively identify people at high risk of developing diabetes from the population (especially non-obese prediabetes) who are apparently at low health risk and are unlikely to be targeted for health guidance.

Identification of most influential co-occurring gene suites for gastrointestinal cancer using biomedical literature mining and graph-based influence maximization.

BACKGROUND: Gastrointestinal (GI) cancer including colorectal cancer, gastric cancer, pancreatic cancer, etc., are among the most frequent malignancies diagnosed annually and represent a major public health problem worldwide. METHODS: This paper reports an aided curation pipeline to identify potential influential genes for gastrointestinal cancer. The curation pipeline integrates biomedical literature to identify named entities by Bi-LSTM-CNN-CRF methods. The entities and their associations can be used to construct a graph, and from which we can compute the sets of co-occurring genes that are the most influential based on an influence maximization algorithm. RESULTS: The sets of co-occurring genes that are the most influential that we discover include RARA - CRBP1, CASP3 - BCL2, BCL2 - CASP3 - CRBP1, RARA - CASP3 - CRBP1, FOXJ1 - RASSF3 - ESR1, FOXJ1 - RASSF1A - ESR1, FOXJ1 - RASSF1A - TNFAIP8 - ESR1. With TCGA and functional and pathway enrichment analysis, we prove the proposed approach works well in the context of gastrointestinal cancer. CONCLUSIONS: Our pipeline that uses text mining to identify objects and relationships to construct a graph and uses graph-based influence maximization to discover the most influential co-occurring genes presents a viable direction to assist knowledge discovery for clinical applications.

Querying large graphs in biomedicine with colored graphs and decomposition.

In graph networks, graph structural analytics such as betweenness centrality has played an important role in finding the most central vertices in graph data. Hence, betweenness centrality has been heavily applied to discover the most important genes with respect to multiple diseases in biomedicine research. Considering color as a property of graph data to represent different categories for the nodes and edges in the graph, we may investigate the betweenness centrality of each colored subgraph composed of a specific color. However, as investigators may be interested in querying betweenness centrality on multiple combinations of the colored subgraphs, the total execution time on all the subgraphs may be excessively long, considering all the possible combinations. In addition, the performance could be worse when the size of the graph grows larger. In this research, we propose an approach to computing betweenness centrality by incorporating node colors and edge colors. We propose that the node with the highest betweenness centrality can be computed for a very large and colored graph by decomposing the graph into colored subgraphs and merging the result from the base cases. Furthermore, we compare our approach with the conventional approaches in the experiments, and we demonstrate that our scalable approach is more efficient when finding the global backbone node with the highest betweenness centrality.

An IgA1-lambda-type monoclonal immunoglobulin deposition disease associated with membranous features in a patient with IgG4-related kidney disease: a case report.

BACKGROUND: IgG4-related disease (IgG4-RD) is a newly recognized fibroinflammatory condition. The kidney is one of the organs commonly affected by IgG4-RD. Tubulointerstitial nephritis (TIN) is the main feature, and membranous nephropathy (MN) has also been described frequently. In MN, polyclonal immunoglobulins and complements are deposited in granular form along the glomerular basement membranes (GBMs). Unusual cases of monoclonal immunoglobulin deposition disease (MIDD) associated with membranous features have been reported. MIDD is morphologically similar to MN but contains immunoglobulins considered to be derived from single B-cell clone. CASE PRESENTATION: We describe a 65-year-old man who was referred to our hospital because of hyperproteinaemia, eosinophilia, anaemia, and proteinuria. A renal biopsy demonstrated infiltration of plasma cells and eosinophils in the interstitium, and the ratio of IgG4-positive plasma cells to IgG-positive plasma cells was 55%. The patient was diagnosed as having IgG4-related TIN. Periodic acid methenamine silver staining under light microscopy revealed a bubbling appearance and spike formation in the GBM. On immunofluorescence, the expression of IgG and complements was negative; however, IgA was positively expressed in a granular pattern along the GBM. An IgA subclass analysis revealed a significant deposition of IgA1-lambda (IgA1-λ). Electron microscopy revealed irregular and small non-organized and non-Randall-type granular electron-dense deposits in the GBM that were shaped like snow leopard spots. CONCLUSIONS: After corticosteroid therapy was initiated, the patient's eosinophilia remarkably improved and his serum creatinine, IgG, and IgG4 levels decreased to within the normal ranges. However, massive proteinuria persisted. To our knowledge, this is the first reported case of IgG4-related TIN associated with IgA1-λ-type MIDD with membranous features.

Acquired Factor V Inhibitors in a Patient with End-stage Renal Disease.

We report a case of acquired factor V inhibitors (AFVIs) in a patient with end-stage renal disease receiving warfarin therapy for atrial fibrillation. A 72-year-old Japanese man was admitted to our hospital complaining of tarry stools and abdominal pain. The laboratory findings revealed eosinophilia (52.1%), prolonged activated partial thromboplastin time (APTT) (98 s), PT (84 s), a factor V (FV) activity of <3%, and an FV inhibitor level of 6 Bethesda units/mL. After administration of prednisolone was started, his coagulation findings improved. However, his renal failure progressed, and he ultimately required chronic hemodialysis. This is the first case of AFVIs in a patient starting hemodialysis for end-stage renal disease.

Myeloperoxidase Antineutrophil Cytoplasmic Antibody (MPO-ANCA) Associated Crescentic and Necrotizing Glomerulonephritis (GN) with Membranoproliferative GN Features.

A 77-year-old man presented with a fever, non-productive cough, and edema formation. A laboratory analysis showed an elevated creatinine level (2.5 mg/dL), a high titer of myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA) (99 U/mL), positive reaction for antinuclear antibody (×320), hematuria, and massive proteinuria (3.33 g/day). A renal biopsy revealed crescentic and necrotizing glomerulonephritis (GN) with membranoproliferative GN features [double contour appearance of the glomerular basement membrane, granular deposition of immunoglobulin (Ig) G, IgM, and C3 along the capillary wall, subendothelial and subepithelial deposits with mesangial interposition]. A potential relationship between MPO-ANCA associated GN and membranoproliferative GN is discussed.

Three-dimensional imaging navigation during a lung segmentectomy using an iPad.

OBJECTIVES: The requirement for anatomical lung segmentectomies has increased in recent years but this surgical procedure is relatively difficult. We herein present the benefits of using three-dimensional (3D) imaging navigation during a lung segmentectomy via the intra-operative use of an iPad. METHODS: Fourteen patients who had undergone an anatomic segmentectomy for a primary lung cancer or a metastatic lung tumour between 1 October 2010 and 30 April 2011 were included in this study. Contrast-enhanced scanning was performed twice on each patient, and 3D images were constructed using a workstation. These images were then transferred to an iPad and analysed during the operation using DICOM image viewer software. RESULTS: The study group included 3 men (21%) and 11 women (79%) ranging in age from 57 to 83 (mean 69 ± 7.8 years). The operative procedure involved a resection in one case each of the right S1, the right S2, the right S2 + S6a, the right S3, the right S6, the left S8 and the left S8 + 9. The left S1 + 2 and the left basal segment were resected in two cases. The left upper division was resected in three cases. All segmentectomies were successful and no major post-operative complications developed in any patient during or after their procedures. No positive margins were detected pathologically. CONCLUSIONS: A 3D computed tomography navigation using an iPad enhances the ability to perform a safe and secure segmentectomy.

Temporal trends and relationships of particulate chlorinated polycyclic aromatic hydrocarbons and their parent compounds in urban air.

Concentrations of 12 chlorinated polycyclic aromatic hydrocarbons (CIPAHs) and the corresponding 5 parent PAHs associated with particulates in urban air in Shizuoka, Japan, were investigated from 1992 to 2002. Among the seven target CIPAHs that were detected in the air samples, 6-chlorobenzo[a]pyrene (6-ClBaP) had the highest mean concentration (15 pg m(-3)), followed by 1-chloropyrene (5.2 pg m(-3)) and 7-chlorobenz[a]anthracene (3.1 pg m(-3)). The concentrations of all the ClPAHs and PAHs, except 6-ClBaP, were higher in winter than in summer. Over the study period, the concentrations of the CIPAHs, except 6-ClBaP, remained almost constant, whereas the parent PAH concentrations declined moderately. There was significant correlation between the concentrations of the ClPAHs (except 3,9- and 9,10-dichlorophenanthrene) and the concentrations of the corresponding parent PAHs. Compositional analysis showed that the proportions of the detected PAHs generally did not vary over the period, whereas the proportion of 6-ClBaP relative to the total ClPAH concentration decreased over time. Comparison of the concentration profile of certain ClPAHs normalized to the concentration of 3-chlorofluoranthene, which is relatively photostable, with the profile for a traffic air sample reported previously revealed that there was no similarity between the two profiles. Factor analysis indicated that the atmospheric behavior of the ClPAHs, except for 6-ClBaP, may be similar to that of the parent PAHs, and that the atmospheric behavior of 6-ClBaP may differ from that of the other ClPAHs. The factor analysis also suggested that the emission sources for the ClPAHs (except for 6-CIBaP) may be similar to the sources of the parent PAHs.

Occurrence, profiles, and photostabilities of chlorinated polycyclic aromatic hydrocarbons associated with particulates in urban air.

The atmospheric levels of 12 chlorinated polycyclic aromatic hydrocarbons (ClPAHs) associated with particulates at an urban site in Japan were investigated. Only 7 of the 12 species studied were detected in air samples collected monthly during 2002. 1-Chloropyrene (1-ClPy) was detected at the highest concentration (7.5 pg m(-3) (annual mean)), followed by 6-chlorobenzo[a]pyrene (6-ClBaP; 5.6 pg m(-3)) and 9,10-dichlorophenanthrene (5.1 pg m(-3)). The concentrations of the ClPAHs tended to be higher in winter than in summer, with the exception of the 6-ClBaP concentration, which was high in both summer and winter. Correlation analysis also indicated that the behavior of 6-CIBaP differed significantly from that of the other ClPAHs. Comparison of the atmospheric ClPAH concentration profile normalized to 1-CIPy concentration with that for a traffic air sample revealed significant differences between the profiles. The behavior of the atmospheric ClPAHs was also influenced by the origin of the associated particulates, which varied according to season. The positions of chlorination in the detected ClPAHs were consistent with those where the frontier electron density was high. This means that the atmospheric ClPAHs were formed by secondary reactions with chlorine atoms. The photostabilities of the ClPAHs were also investigated in laboratory experiments using a chemical model system. The ClPAHs decayed according to first-order reaction rate kinetics, with photostabilities increasing in the order 6-ClBaP < 1-ClPy < 7-ClBaA < ClPhe < ClFluor, consistent with the trend for the parent PAHs. The photolyses of chlorophenanthrenes and 7-chlorobenz[a]anthracene were confirmed to proceed by initial abstraction of chlorine, followed by oxidative degradation.

Seasonal variability of 1-chloropyrene on atmospheric particles and photostability in toluene.

The occurrence of a mutagenic compound, 1-chloropyrene (Cl-Py), in extracts of ambient particulate matter at an urban site in Japan has been investigated. Samples were collected with a high-volume air sampler for 24 h periods over the course of 1 week in winter (February), spring (May), summer (August), and autumn (November) 2002. The Cl-Py levels showed seasonal variation, ranging from 2.4 pg/m(3) (summer) to 18.9 pg/m(3) (winter). This variation would indicate that the lower temperatures in winter results in an increased distribution of Cl-Py from vapor phase to the particle phase. In addition, there is also the possibility that ambient Cl-Py is emitted from seasonal sources or is susceptible to photodegradation by sunlight, or both. The photodegradation of Cl-Py in a laboratory experiment was conducted to simulate the compound's fate on airborne particle surfaces. The degradation of Cl-Py proceeded by a first-order reaction with a rate constant of 0.72 h(-1). In the presence of a radical sensitizer, 9,10-anthraquinone (AQ), the photodegradation rate of Cl-Py was elevated in comparison with the rate in the absence of AQ. In addition, the dechlorination of Cl-Py (i.e., the formation of Py) occurred in the presence of AQ.