Gender difference of association between LDL cholesterol concentrations and mortality from coronary heart disease amongst Japanese: the Ibaraki Prefectural Health Study.

OBJECTIVE: The aim of this study was to examine whether LDL cholesterol raises the risk of coronary heart disease in a dose-response fashion in a population with low LDL-cholesterol levels. DESIGN: Population-based prospective cohort study in Japan. SUBJECTS AND MAIN OUTCOME MEASURES: A total of 30,802 men and 60,417 women, aged 40 to 79 years with no history of stroke or coronary heart disease, completed a baseline risk factor survey in 1993. Systematic mortality surveillance was performed through 2003 and 539 coronary heart disease deaths were identified. RESULTS: The mean values for LDL-cholesterol were 110.5 mg dL(-1) (2.86 mmol L(-1)) for men and 123.9 mg dL(-1) (3.20 mmol L(-1)) for women. Men with LDL-cholesterol > or =140 mg dL(-1) (> or =3.62 mmol L(-1)) had two-fold higher age-adjusted risk of mortality from coronary heart disease than did those with LDL-cholesterol <80 mg dL(-1) (<2.06 mmol L(-1)), whereas no such association for women was found. The multivariable hazard ratio for the highest versus lowest categories of LDL-cholesterol was 2.06 (95 percent confidence interval: 1.34 to 3.17) for men and 1.16 (0.64 to 2.12) for women. CONCLUSION: Higher concentrations of LDL-cholesterol were associated with an increased risk of mortality from coronary heart disease for men, but not for women, in a low cholesterol population.

Merosin-negative non-Fukuyama-type congenital muscular dystrophy: a case report.

We report a female infant with non-Fukuyama-type congenital muscular dystrophy with merosin deficiency. She manifested marked hypotonia and muscle weakness from the neonatal period, with an elevated creatine kinase concentration. Her motor developmental milestones were markedly delayed; however, her intellectual development was normal. Although cranial computed tomography (CT) at 3 months of age was normal, subsequent CT at 16 months of age demonstrated diffuse, abnormal white matter lucencies. Muscle biopsy findings at 16 months of age were compatible with those of congenital muscular dystrophy. In addition, no muscle fibers were immunostained by the merosin antibody. The patient died of pneumonia at 23 months of age. These clinical symptoms and CT findings are similar to those described in patients with merosin-negative congenital muscular dystrophy in European countries.