Sedentary time, physical activity, and serum SPARC in a middle-aged population.

The influence of habitual physical activity (PA) on the circulating levels of secreted protein acidic and rich in cysteine (SPARC) remains unclear. The purpose of the current study was to clarify the effects of sedentary time, light-intensity PA (LPA), and moderate- to vigorous-intensity PA (MVPA) on the serum SPARC in a general middle-aged population. The current study is a cross-sectional study of 4,000 men and 6,040 women (40-69 years). Sedentary time, LPA, and MVPA were objectively measured by an accelerometer. The serum SPARC concentration was measured by enzyme-linked immunosorbent assay. Using an isotemporal substitution model, cross-sectional associations of replacing sedentary time with either LPA or MVPA on serum SPARC levels were analysed according to sex. Interactions with subject characteristics, such as the body mass index (BMI), smoking, and alcohol consumption, were also examined. In men, replacing 60 min of sedentary time with 60 min of MVPA was significantly associated with 23 ng/mL lower serum SPARC levels (confidence interval: -43, -2) after adjusting for confounders, including the BMI (P = 0.028). A significant interaction between replacing sedentary behaviour with LPA and the BMI on SPARC was detected in women (P = 0.029), although the stratified associations for each BMI level (<25 or ≥25 kg/m2) did not reach significance. The current study suggests that replacing sedentary time with MVPA is associated with reduced serum SPARC levels in middle-aged men, but not in women. In addition, a potential interaction between LPA and the BMI on SPARC was also found in women.Highlights An isotemporal substitution analysis showed that replacing sedentary behaviour with moderate- to vigorous-intensity physical activity (MVPA) is associated with decreased serum SPARC levels in men.Such an inverse association between replacing sedentary behaviour with MVPA and the SPARC levels was not observed in women.A potential interaction between replacing sedentary behaviour with light-intensity PA and the body mass index on the serum SPARC levels was also found in women.

Relationship between MRI findings and invasive breast cancer with podoplanin-positive cancer-associated fibroblasts.

OBJECTIVE: Purpose of our study is to assess the relationship between MRI findings and invasive breast cancer (IBC) with cancer-associated fibroblasts (CAFs) that are positive for podoplanin. METHODS: We retrospectively analyzed the consecutive 109 IBCs. The IBCs were dichotomized as with (+) or without (-) podoplanin-positive CAFs. In MRI analyses, the dichotomized IBCs were compared the lesion to muscle ratio (L/M ratio) in STIR images, the ADC value, the distribution of kinetic parameters, and morphological findings. RESULTS: Of the 109 IBCs, 28 (26%) IBCs had podoplanin(+) CAFs. Compared to the podoplanin(-) group, the podoplanin(+) group tended to have a more malignant pathological status. In the STIR images, the podoplanin(+) group had significantly higher L/M ratio (7.59 vs. 6.55, p = 0.040). In a dynamic study, the podoplanin(+) group had a significantly higher percentage of the washout pattern (42.21% vs. 29.43%, p = 0.045). There were 23 mass lesions and 5 non-mass enhancement (NME) lesions in the podoplanin(+) group, and 69 mass lesions and 12 NME lesions in the podoplanin(-) group. The mass lesions of the podoplanin(-) group had a significantly higher likelihood of showing an irregular shape (n = 47 vs. 8, p = 0.035). The podoplanin(+) group's lesions had a significantly higher likelihood of showing a circumscribed margin (n = 14 vs. 6, p < 0.001) and a rim enhancement (n = 10 vs. 13, p = 0.047). In multivariate analyses, only high nuclear grade was significant predictive value of podoplanin(+) CAFs. CONCLUSION: Although not significant in multivariate analyses, MRI findings may be used to determine the podoplanin-positive CAF status of invasive breast cancer.

Intensity-Specific and Modified Effects of Physical Activity on Serum Adiponectin in a Middle-Aged Population.

CONTEXT: The effects of intensity-specific physical activity (PA) and its interaction with other lifestyle factors on serum adiponectin are currently unclear. OBJECTIVE: To investigate the effects of replacing sedentary time with either light-intensity PA (LPA) or moderate- to vigorous-intensity PA (MVPA) on total and high-molecular-weight (HMW) adiponectin and to examine interactions with smoking, alcohol drinking, coffee consumption, and menopausal status in a general population. DESIGN/SETTING: Cross-sectional study of 4013 men and 6050 women (40 to 69 years of age). MAIN OUTCOME MEASURES: The associations of replacing sedentary time with LPA or MVPA on total and HMW adiponectin were analyzed using an isotemporal substitution model. RESULTS: In men, reallocating 60 minutes of sedentary time to 60 minutes of LPA was associated with 9% and 13% higher total and HMW adiponectin levels even after adjusting for confounders, although such associations were not observed for MVPA. A similar pattern of results was also seen in women. The effect of replacing sedentary time with LPA on adiponectin was clearer in middle/high coffee consumers than in low coffee consumers among women. Although increasing the effect of replacing sedentary time with MVPA on adiponectin was clearer in former/current smokers than in never smokers among men, the replacement effect for MVPA on total adiponectin was clearer in premenopausal women than in postmenopausal women. CONCLUSIONS: Replacing sedentary time with LPA resulted in increased levels of total and HMW adiponectin. The replacement effects for LPA or MVPA were found to be multiply modified by smoking, coffee consumption, and menopausal status.

Dietary patterns and serum gamma-glutamyl transferase in Japanese men and women.

BACKGROUND: Although specific foods and nutrients have been examined as potential determinants of serum gamma-glutamyl transferase (GGT) concentrations, the relationship between dietary patterns and GGT remains unknown. The present cross-sectional study aimed to determine relationships between dietary patterns and GGT concentrations, and the effects of lifestyle factors on GGT. METHODS: Relationships between dietary patterns and GGT were analyzed in 9803 Japanese individuals (3723 men and 6080 women age 40-69 years) without a history of liver diseases or elevated serum aminotransferase. We examined major dietary patterns by factor analysis of 46 items determined from a validated, short food frequency questionnaire. RESULTS: We defined dietary patterns as healthy, Western, seafood, bread, and dessert. The healthy pattern was inversely related to GGT in men (odds ratio [OR] for highest vs lowest quartile, 0.72; 95% confidence interval [CI], 0.57-0.92; P < 0.01 for trend) and women (OR 0.82; 95% CI, 0.66-1.0; P = 0.05 for trend), whereas the seafood pattern was positively related to GGT in men (OR 1.27; 95% CI, 1.01-1.61; P = 0.03 for trend) and women (OR 1.21; 95% CI, 0.98-1.49; P = 0.05 for trend). Male-specific inverse associations with GGT were found for bread and dessert patterns (OR 0.63; 95% CI, 0.50-0.80 and OR 0.53; 95% CI, 0.41-0.68, respectively; P < 0.01 for both trends). Seafood or bread patterns and alcohol consumption significantly interacted with GGT in men (P = 0.03 and <0.01 for interaction, respectively) and between the dessert pattern and body mass index or smoking habit in women (P = 0.03 and <0.01, respectively, for interaction). CONCLUSIONS: Dietary patterns may be important determinants of GGT, and their possible clinical implications warrant further investigation.

Perceived stress and coping strategies in relation to body mass index: cross-sectional study of 12,045 Japanese men and women.

BACKGROUND: Accumulated evidence suggests a weak positive relationship between psychosocial stress and body mass index (BMI), but little is known about stress coping strategies and BMI. OBJECTIVE: We aimed to examine if perceived stress and coping strategies are related to BMI, with any of their mutual interactions on BMI. METHODS: This cross-sectional study included 5,063 men and 6,982 women aged 40-69 years. A self-administered questionnaire ascertained perceived stress and 5 items of coping strategies (emotion expression, emotional support seeking, positive reappraisal, problem solving, and disengagement). Analyses were performed by gender with adjustment for age, socioeconomic status, and lifestyle factors. RESULTS: No significant associations were detected between perceived stress and BMI in either men (P(trend) = 0.09) or women (P(trend) = 0.58). In men, however, 'disengagement' showed an inverse association with BMI (P(trend) < 0.001), and 'positive reappraisal' and 'problem solving' revealed a positive association with BMI (P(trend) = 0.04 and 0.007, respectively) even after controlling for perceived stress. A possible interaction between perceived stress and 'disengagement' on BMI was found in men (P(interaction) = 0.027); the inverse association between 'disengagement' and BMI was more evident in higher levels of stress (ß = -0.13, P(trend) = 0.21 in low; ß = -0.22, P(trend) = 0.01 in medium; and ß = -0.24, P(trend) = 0.06 in high). In men, 'disengagement' was inversely associated with overweight/obesity (odds ratio 0.79, 95% confidential interval 0.67-0.95), and "positive reappraisal" was positively associated with it (1.25, 1.02-1.54). CONCLUSIONS: Coping strategies may have an important role in developing overweight/obesity, particularly in men.

Intratumoral heterogeneity of the distribution of kinetic parameters in breast cancer: comparison based on the molecular subtypes of invasive breast cancer.

PURPOSE: To evaluate the distribution pattern of kinetic parameters in breast cancers with various molecular subtypes. MATERIALS AND METHODS: This study was approved by institutional review board and was compliant with HIPAA. We classified 192 invasive breast cancers of 186 patients into four molecular subtypes using hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) results and evaluated the distribution pattern of kinetic parameters (percent volume of kinetic types relative to the tumor volume) in the molecular subtypes. RESULTS: In the delayed phase, all three types of kinetic parameter (persistent, plateau, and washout pattern) were observed in each molecular subtype without any dominant type of kinetic parameter. The percentages of washout pattern in the HR+ and HER2- type and triple negative (TN) cancers tended to be lower than those in the other molecular subtype cancers. CONCLUSION: Each molecular subtype of invasive breast cancer showed a heterogeneous kinetic pattern in dynamic-contrast magnetic resonance imaging (MRI). The HR+/HER2- cancers and the TN cancers had relatively lower percentages of washout pattern. When a manual assessment of the kinetic parameters is performed, close attention should be paid in order to identify the malignant washout kinetic pattern, particularly in HR+/HER2- cancer and TN cancer.

Objectively measured physical activity and inflammatory cytokine levels in middle-aged Japanese people.

OBJECTIVE: Studies using self-reported physical activity (PA) showed that higher PA is associated with lower circulating levels of C-reactive protein; in contrast, studies investigating associations of objective PA and other inflammatory markers are limited. We investigated cross-sectional associations of accelerometer-determined PA with circulating levels of myokine-type inflammatory cytokines in a middle-aged Japanese population. METHOD: A total of 1838 individuals (737 men and 1101 women) aged 40 to 69 years participated in the baseline survey of a population-based cohort study in Saga, Japan (2005-2007). Habitual PA was assessed by a single-axis accelerometer. Serum interleukin (IL)-4, IL-6, IL-8, IL-15, and tumor necrosis factor (TNF)-α were measured by a multiplex enzyme-linked immunosorbent assay. Associations between PA and cytokine levels were assessed by multiple regression analysis and analysis of covariance, with adjustment for potential confounders. RESULTS: Step count and PA level (PAL) were inversely associated with TNF-α and IL-15 even after adjusting for BMI. Similarly, greater PA indices were also independently associated with a lower level of inflammatory cytokine z score as an index of overall inflammation. CONCLUSION: The current results suggest that greater engagement in daily PA may be linked with reduced levels of myokine-type cytokines including IL-15, irrespective of body weight in middle-aged Japanese people.

Gender-specific associations of perceived stress and coping strategies with C-reactive protein in middle-aged and older men and women.

BACKGROUND: Perceived stress and coping strategies may influence the risk of cardiovascular disease through their possible association with inflammation, but data remain controversial for perceived stress or scanty for coping strategies. PURPOSE: We examined the associations of perceived stress and coping strategies with serum high-sensitivity C-reactive protein (CRP) in a Japanese general population. METHODS: This cross-sectional study included 2,971 men and 4,902 women aged 40-69 years who were enrolled between 2005 and 2007. Subjects with possible inflammation-related disease, CRP levels ≥3,000 ng/mL, or currently used analgesics or lipid-lowering drugs were excluded. Analyses were performed by gender with adjustment for lifestyle, socioeconomic, and psychosocial factors. RESULTS: Unexpectedly, elevated perceived stress was significantly associated with lower CRP levels in men (P trend < 0.001) but not in women (P trend = 0.90) after adjustment for age and covariates. Among five items of coping strategies evaluated, "disengagement" showed a significant inverse association with CRP in men only (P trend = 0.027). In addition, a possible interaction between "emotional support seeking" and perceived stress on CRP was detected in men (P interaction = 0.021); "emotional support seeking" was associated with lower CRP at the high stress level only (P trend = 0.028). CONCLUSIONS: Both perceived stress and coping strategies may be associated with systemic inflammation in Japanese men, yet caution must be exercised before accepting the stress-inflammation-disease pathway.

Decision making for breast lesions initially detected at contrast-enhanced breast MRI.

OBJECTIVE: The purpose of this study was to assess the clinical significance of breast lesions initially detected at contrast-enhanced breast MRI and to consider how to manage those lesions in accordance with the imaging findings and the indication for MRI. MATERIALS AND METHODS: A retrospective study of 4260 consecutive breast MRI examinations was performed to identify MRI-detected enhancing lesions. In 4260 studies, 554 MRI-detected lesions were found in 417 patients, and 134 (24%) of the lesions were malignant. Pathologic confirmation was obtained for 319 (58%) lesions. Results of the subsequent imaging workup, biopsy, surgery, and imaging follow-up were reviewed. RESULTS: The median size of the lesions was 89 mm (malignant, 15.45 mm; benign, 7.48 mm). Irregular shape, irregular or spiculated margins, and heterogeneous or rim enhancement were seen significantly more often in malignant mass lesions (p < 0.001). Malignant lesions were more likely to exhibit rapid enhancement (p < 0.001). Benign lesions were more likely to have persistent kinetics (p < 0.001). There was a statistically significant difference (p < 0.001) between malignant (58/87, 67%) and benign lesions (128/287, 45%) with respect to sonographic detection at second-look ultrasound examinations. Malignant lesions were most often detected in patients with metastatic axillary lymph nodes with an unknown primary tumor (8/8, 100%), followed by patients with positive or close margins in recent breast cancer surgery (45/76, 59%), and patients with newly diagnosed breast cancer (44/115, 38%). CONCLUSION: Management of MRI-detected lesions should be based on both MRI findings and the patient's indication for MRI.

Polymorphisms in PPAR Genes (PPARD, PPARG, and PPARGC1A) and the Risk of Chronic Kidney Disease in Japanese: Cross-Sectional Data from the J-MICC Study.

Chronic kidney disease (CKD) is well known as a strong risk factor for both end stage renal disease and cardiovascular disease. To clarify the association of polymorphisms in the PPAR genes (PPARD, PPARG, and PPARGC1A) with the risk of CKD in Japanese, we examined this association among the Japanese subjects using the cross-sectional data of J-MICC (Japan Multi-Institutional Collaborative Cohort) Study. The subjects for this analysis were 3,285 men and women, aged 35-69 years, selected from J-MICC Study participants; genotyping was conducted by multiplex polymerase chain reaction-based Invader assay. The prevalence of CKD was determined for CKD stages 3-5 (defined as eGFR < 60 ml/min/1.73 m(2)). Participants with CKD accounted for 17.3% of the study population. When those with PPARD T-842C T/T were defined as reference, those with PPARD T-842C T/C and C/C demonstrated the OR for CKD of 1.26 (95%CI 1.04-1.53) and 1.31 (95%CI 0.83-2.06), respectively. There were no significant associations between the polymorphisms in other PPAR genes and the risk of CKD. The present study found a significantly increased risk of CKD in those with the C allele of PPARD T-842C, which may suggest the possibility of personalized risk estimation of this life-limiting disease in the near future.

Differential distribution of lymphatic clearance between upper and lower regions of the lung.

BACKGROUND AND OBJECTIVE: Many lung diseases arise as the consequence of inhalational injury. When pathogenic materials are inhaled, it is possible that their clearance routes become the main focus of injury in the lung. Lymphatic clearance is important in the removal from the lung of small inhaled particles. The leak of toxic agents from the lymphatic flow potentially explains the topographic distribution of diffuse lung diseases triggered by inhaled materials, for example asbestosis. The aim of this study was to evaluate the differences in lymphatic distribution across various craniocaudal levels of the lung by using carbon dust deposition (CDD) as a tracing marker. METHODS: We evaluated 61 HE-stained slides of the normal lung area from 61 lobectomy specimens. The intensity of CDD was scored into five degrees (0-4) in bronchiolovascular (BV) areas and subpleural/septal (SP) areas per slide. The distribution was highlighted by subtraction scores of SP areas from those of bronchiolovascular areas. RESULTS: The subtraction scores of the upper lung area were significantly greater than those in the lower area, whereas there was no significant difference in scores by pulmonary lobes. CONCLUSIONS: Our results indicated that the main lymphatic clearance routes vary according to the craniocaudal levels, and are predominant in BV areas of the upper areas and in SP areas of the lower areas of the lung. This may explain the histological variations in anatomical distribution observed in the biopsy specimens of some diffuse lung diseases.

eNOS genotype modifies the effect of leisure-time physical activity on serum triglyceride levels in a Japanese population.

BACKGROUND: Nitric oxide is a key molecule not only in the cardiovascular system, but also in the metabolic-endocrine system. The purpose of this study was to examine possible associations of the NOS3 T-786C polymorphism (rs2070744) with serum lipid levels on the basis of lifestyle factors for tailoring prevention of dyslipidemia. METHODS: For this cross-sectional study, a total of 2226 subjects aged 35 to 69 years (1084 men and 1142 women) were selected from Japanese participants in the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study. They were recruited in eight areas throughout Japan between February 2004 and November 2008. RESULTS: In a stratified analysis by leisure-time physical activity, the likelihood of hypertriglyceridemia (serum triglyceride levels ≥ 150 mg/dL) among subjects with the C allele was significantly lower than those without it in the active group (OR = 0.43, 95% CI = 0.22-0.84 in the fasting group), but not in the sedentary group. A gene-environment interaction between the T-786C polymorphism and leisure-time physical activity for hypertriglyceridemia was significant (P = 0.007 in the fasting group). Additionally, serum triglyceride levels (mean ± SD) across leisure-time physical activity classes decreased significantly only in the TC + CC genotype group (111 ± 60 mg/dL for sedentary, 95 ± 48 mg/dL for moderately active, 88 ± 44 mg/dL for very active, P for trend = 0.008 in the fasting group), but not in the TT genotype group. Total cholesterol, high-density lipoprotein (HDL) cholesterol, and non-HDL cholesterol levels had no significant association with the polymorphism. CONCLUSIONS: This study suggests that the NOS3 T-786C polymorphism modifies the effect of leisure-time physical activity on serum triglyceride levels.

Impact of carbon ion radiotherapy for unresectable osteosarcoma of the trunk.

BACKGROUND: The authors summarized the outcomes of patients with unresectable osteosarcoma of the trunk who received carbon ion radiotherapy (CIRT). METHODS: The authors performed a retrospective analysis of 78 patients who had medically inoperable osteosarcoma of the trunk and received treatment with CIRT between 1996 and 2009. Tumor sites included the pelvis in 61 patients, the spine and paraspinal region in 15 patients, and other sites in 2 patients. The median applied CIRT dose was 70.4 Gray equivalent (GyE) in a total of 16 fixed fractions over 4 weeks. RESULTS: The minimum duration of follow-up for survivors was 14 months. Forty-eight patients remained alive. The 5-year overall survival rate was 33%, and the local control rate was 62%. Thirty-eight patients who had a clinical target volume <500 cm(3) had a 5-year overall survival rate of 46% and a 5-year local control rate of 88%. Except for 3 patients who experienced severe skin/soft tissue complications requiring skin grafts, no other severe toxicities were observed. Of 9 patients who were continuously disease free for >5 years, 8 were able to walk with or without the help of a cane, and 6 were free from pain killers. CONCLUSIONS: CIRT appeared to be a safe and effective modality for the management of unresectable osteosarcoma of the trunk, providing good local control and offering a survival advantage and good long-term functional results without unacceptable morbidity.

Retrospective analysis of contrast-enhanced computed tomographic findings related to obstructive shock due to ascending aortic dissection.

OBJECTIVE: The objective of this study was to evaluate contrastenhanced computed tomography findings related to obstructive shock due to ascending aortic dissection (AAD). METHODS: The computed tomography findings in 9 AAD patients with shock, 11 AAD patients without shock, and 18 control subjects were evaluated for (1) pericardial effusion, (2) diameter of the inferior vena cava, (3) periportal hypodensity, (4) retrograde reflux of contrast material, (5) aortic and visceral enhancement, and (6) other factors (peripancreatic edema, bowel thickening/dilatation). RESULTS: Patients with shock showed the highest ratio of pericardial effusion, periportal hypodensity, and retrograde reflux of contrast material; largest inferior vena cava diameter; stronger aortic enhancement in both the arterial and portal phases; lowered splenic and pancreatic enhancement in the arterial phase; and stronger visceral (especially adrenal) enhancement, except for the renal medulla in the portal phase. CONCLUSIONS: Computed tomography findings related to obstructive shock due to AAD reflected impaired diastolic filling, decreased cardiac output, and flow redistribution in visceral organs.

Profile of participants and genotype distributions of 108 polymorphisms in a cross-sectional study of associations of genotypes with lifestyle and clinical factors: a project in the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study.

BACKGROUND: Most diseases are thought to arise from interactions between environmental factors and the host genotype. To detect gene-environment interactions in the development of lifestyle-related diseases, and especially cancer, the Japan Multi-institutional Collaborative Cohort (J-MICC) Study was launched in 2005. METHODS: We initiated a cross-sectional study to examine associations of genotypes with lifestyle and clinical factors, as assessed by questionnaires and medical examinations. The 4519 subjects were selected from among participants in the J-MICC Study in 10 areas throughout Japan. In total, 108 polymorphisms were chosen and genotyped using the Invader assay. RESULTS: The study group comprised 2124 men and 2395 women with a mean age of 55.8 ± 8.9 years (range, 35-69 years) at baseline. Among the 108 polymorphisms examined, 4 were not polymorphic in our study population. Among the remaining 104 polymorphisms, most variations were common (minor allele frequency ≥0.05 for 96 polymorphisms). The allele frequencies in this population were comparable with those in the HapMap-JPT data set for 45 Japanese from Tokyo. Only 5 of 88 polymorphisms showed allele-frequency differences greater than 0.1. Of the 108 polymorphisms, 32 showed a highly significant difference in minor allele frequency among the study areas (P < 0.001). CONCLUSIONS: This comprehensive data collection on lifestyle and clinical factors will be useful for elucidating gene-environment interactions. In addition, it is likely to be an informative reference tool, as free access to genotype data for a large Japanese population is not readily available.

Optimal cutoff values of waist circumference and the discriminatory performance of other anthropometric indices to detect the clustering of cardiovascular risk factors for metabolic syndrome in Japanese men and women.

OBJECTIVE: To evaluate the pertinent cutoffs of waist circumference (WC) and the discriminatory performance of other anthropometric indices to detect clustering cardiovascular risk factors for metabolic syndrome (MetS) in Japan, where the current WC cutoffs for MetS (85 cm for men and 90 cm for women) remain controversial. METHODS: We analyzed the baseline data from 844 subjects (330 men and 514 women) aged 40-69 years who participated in a cohort study in Saga city, Japan, between November 2005 and December 2007. Receiver operating characteristic (ROC) analyses were performed to find an appropriate cutoff (defined as the point nearest to the upper left corner of the ROC curve) of each anthropometric index for the presence of multiple risk factors among dyslipidemia, hypertension, and hyperglycemia [which was defined as hemoglobin A1c (HbA1c) levels at and above 5.2, 5.5, or 5.8%, values approximately corresponding to fasting plasma glucose levels of 100, 110, and 120 mg/dL, respectively]. RESULTS: The optimal WC cutoff was 88 cm (sensitivity 60%, specificity 70%) for men and 82 cm (sensitivity 78%, specificity 62%) for women; changing the HbA1c cutoff affected the results in women only (~85 cm). For the currently defined WC cutoffs in Japan, specificity was low (53-57%) in men, whereas sensitivity was very low (32-42%) in women. Body mass index, proportion of body fat, waist-to-height ratio, and waist-to-hip ratio showed area under the curve values similar to that of WC. CONCLUSION: The current Japanese criteria of WC for MetS may be low for men and too high and insensitive for women in our study population. Other anthropometric indices such as waist-to-height ratio did not confer an improved discriminatory performance compared with WC.

Association between dietary pattern and serum C-reactive protein in Japanese men and women.

BACKGROUND: Dietary pattern may influence the risks of cardiovascular disease, atherosclerosis, type 2 diabetes, and metabolic syndrome through its effects on inflammation. We evaluated the association between dietary pattern and serum high-sensitivity C-reactive protein (hs-CRP) in a Japanese population. METHODS: In this cross-sectional analysis, we used baseline data from 3905 men and 5640 women (age 40-69 years) who participated in a population-based cohort study between November 2005 and December 2007. Participants with possible inflammation-related diseases, current analgesic use, high hs-CRP levels (≥3000 ng/mL) or extreme dietary energy intake were excluded. We used 46 items from a validated short food frequency questionnaire and examined major dietary patterns by factor analysis. RESULTS: We identified 5 dietary patterns: healthy (high in vegetables and fruit), Western (high in meat and fried foods), seafood (high in shellfish, squid, fish, etc.), bread (high in bread and low in rice), and dessert (high in confections and fruit). After adjustment for age, alcohol use, smoking, physical activity, and body mass index, hs-CRP levels in men were inversely associated with the healthy, bread, and dessert patterns (P-trend: 0.01, 0.06, and <0.01, respectively) and positively associated with the seafood pattern (P-trend = 0.02). In women, hs-CRP levels were inversely associated with the healthy pattern (P-trend = 0.06) and positively associated with the Western pattern (P-trend = 0.06). CONCLUSIONS: The healthy dietary pattern may be associated with suppressed inflammation in Japanese men and women, independently of body mass index and other factors. The sex-specific associations of hs-CRP with other dietary patterns (eg, the seafood pattern) require further study.

Factors influencing participation rate in a baseline survey of a genetic cohort in Japan.

BACKGROUND: Although many studies have examined factors that influence the response to postal questionnaires, few have addressed baseline recruitment for cohort studies involving genetic analyses. The aim of this study was to describe the method used for a baseline survey, the Japan Multi-institutional Collaborative Cohort Study (J-MICC Study), in Saga Prefecture, and to examine the factors that might influence the recruitment of participants in such studies. METHODS: The Saga J-MICC Study is an ongoing population-based prospective cohort study of the genetic and environmental interactions associated with lifestyle-related disease. From 2005 through 2007, a total of 61 447 residents between the ages of 40 and 69 were invited by mail to participate in this study. The survey date and time were arranged by telephone. RESULTS: Among that population, 31 002 (50.5%) responded and 12 078 (19.7%) agreed to participate. A completed questionnaire and blood pressure and anthropometric data were collected from all participants; blood, DNA specimens, and accelerometer measures were obtained from the great majority of them. Female sex and older age were associated with a higher participation rate. In addition, the convenience of the survey location and the sending of a reminder significantly improved the participation rate (odds ratio, 1.3). CONCLUSIONS: Our findings suggest that making the survey location as convenient as possible and sending a reminder can both substantially improve participation rate in population-based studies.

Interaction between cytochrome P450 1A2 genetic polymorphism and cigarette smoking on the risk of hepatocellular carcinoma in a Japanese population.

Limited epidemiological evidence suggests that genetic polymorphisms of drug-metabolizing enzymes such as cytochrome P450 (CYP), glutathione S-transferase (GST) and N-acetyltransferase (NAT) may be involved in tobacco-related hepatocarcinogenesis. We conducted a case-control study, including 209 incident cases with hepatocellular carcinoma (HCC) and two different control groups [275 hospital controls and 381 patients with chronic liver disease (CLD) without HCC], to investigate whether CYP1A1, CYP1A2, CYP2A6, CYP2E1, GSTM1 and NAT2 polymorphisms are related to the risk of HCC with any interaction with cigarette smoking. Overall, no significant associations with HCC were observed for any genotypes against either control group. However, we found a significant interaction (P = 0.0045) between CYP1A2 -3860G>A polymorphism and current smoking on HCC risk when we compared HCC cases with CLD patients; adjusted odds ratios [ORs; and 95% confidence intervals (CIs)] for G/A and A/A genotypes relative to G/G genotype were 0.28 (0.12-0.66) and 0.18 (0.04-0.94), respectively, among current smokers (P trend = 0.002), as compared with 1.28 (0.80-2.06) and 0.76 (0.34-1.71), respectively, among never/former smokers (P trend = 0.96). Similarly, in CYP1A2 G/G genotype, significant risk increase was observed for current smoking (OR = 4.08, 95% CI = 2.02-8.25) or more recent cigarette use (e.g. pack-years during last 5 years, P trend = 0.0003) but not in G/A and A/A genotypes combined (OR for current smoking = 1.39, 95% CI = 0.63-3.03; P trend for pack-years during last 5 years = 0.40). These results suggest that the CYP1A2 -3860G>A polymorphism modifies the smoking-related HCC risk among CLD patients.