Beverage-specific effects of ethanol consumption on its biological markers.

BACKGROUND: Serum gamma-glutamyltransferase (GGT) and erythrocyte mean corpuscular volume (MCV) are well-known biological markers of excessive ethanol consumption. METHODS: The beverage-specific effects of ethanol consumption on GGT level and MCV value were analyzed cross-sectionally and retrospectively among middle-aged Japanese men who underwent a retirement health checkup (n = 974). RESULTS: Both the consumption of distilled alcohol and that of fermented alcohol positively correlated with the logarithm of GGT [standard regression coefficient (beta) 0.261 and 0.174, respectively]. The prevalence rate of elevated GGT levels > or = 70 IU/L) was higher among heavy drinkers of distilled alcohol than among heavy drinkers of fermented alcohol (38.8% vs. 27.6%, p = 0.013). The MCV value correlated with distilled alcohol consumption (beta: 0.212, p < 0.0001) but not with fermented alcohol consumption (beta: 0.043, not significant). The prevalence rate of an elevated MCV (> or = 97 fL) was higher among heavy drinkers of distilled alcohol than among heavy drinkers of fermented alcohol (35.3% vs. 16.8%, p < 0.001). CONCLUSIONS: These results suggest that MCV is less sensitive for detecting heavy consumption of fermented alcohol than for detecting that of distilled alcohol in apparently healthy middle-aged men.

Serum gamma-glutamyl transferase is associated with plasma total homocysteine in Japanese patients with type 2 diabetes.

Serum gamma-glutamyl transferase (gamma-GT), a marker of oxidative stress, predicts morbidity and mortality from cardiovascular disease. Plasma total homocysteine (tHcy), a pro-oxidant and also an independent risk factor for cardiovascular disease, correlates with gamma-GT among some populations. It is not known whether tHcy correlates with gamma-GT among type 2 diabetic patients in whom oxidative stress is increased and implicated for the development of diabetic complications. In the present study, we analyzed the association between gamma-GT, tHcy and related vitamins cross-sectionally among patients with type 2 diabetes without overt nephropathy (age range 17-76 years; n = 110). In a univariate regression analysis model, gamma-GT (logarithm) was positively associated with tHcy (beta = 0.288, P = 0.002) but not with folate or vitamin B(12). The association between tHcy and gamma-GT (logarithm) remained significant in a multivariate analysis model including age, lifestyle factors, folate, vitamin B(12), creatinine, HbA(1c) and medical history (beta = 0.219, P = 0.027). These results suggest that tHcy generates oxidative stress among type 2 diabetic patients and may partly explain the reported association between gamma-GT and cardiovascular disease.

Beer ethanol consumption and plasma homocysteine among patients with type 2 diabetes.

We analyzed the association between beer and other type of ethanol consumption and tHcy levels among type 2 diabetic patients. Male type 2 diabetic patients without overt nephropathy were studied (n=242). Ethanol consumptions of the patients were 35.1+/-37.8mL/day for total ethanol, 13.9+/-15.2mL/day for beer ethanol and 21.2+/-32.1mL/day for non-beer ethanol. Both, total and non-beer ethanol consumption correlated with tHcy, whereas beer ethanol consumption showed a trend to inverse association with tHcy (standard regression coefficient, 0.184, 0.283 and -0.110, respectively). Each intake of 30mL/day ethanol consumption was associated with an increase of tHcy of 0.6micromol/L for total ethanol and 1.1micromol/L for non-beer ethanol and a decrease of tHcy of 0.7micromol/L for beer ethanol. Similar trend was observed in the analysis model which included only drinkers, and also in an adjusted analysis model. Plasma tHcy of beer only drinkers was lower than that of non-beer alcohol only drinkers (8.9+/-1.9micromol/L versus 11.5+/-5.5micromol/L, P=0.003). Non-beer ethanol consumption might be less healthy compared with beer ethanol consumption among type 2 diabetic patients in terms of the effects on tHcy.

Type 2 diabetes and hearing loss in personnel of the Self-Defense Forces.

The association of type 2 diabetes with hearing loss was evaluated in middle-aged male personnel of the Self-Defense Forces (SDFs). Hearing loss was defined as the pure-tone average (PTA) of the thresholds frequency at 0.5, 1, 2, and 4 kHz greater than 25 dB hearing levels (HL) in the worse ear. Diabetes status was determined by self-report of physician-diagnosed diabetes or by oral glucose tolerance test (OGTT). Of 699 subjects studied (age 52.9+/-1.0 years), 103 subjects were classified as having type 2 diabetes. Fasting plasma glucose of diabetic subjects was 120+/-19 mg/dl. Hearing loss levels were (worse) higher among diabetic subjects compared with subjects with normal glucose tolerance (NGT) (30.7+/-13.0 dB versus 27.4+/-12.3 dB, P=0.014). Hearing loss was more prevalent among diabetic subjects than among subjects with normal glucose tolerance (60.2% versus 45.2%, P=0.006). The odds ratio (OR) of type 2 diabetes for the presence of hearing loss was 1.87 (95% confidence interval 1.20-2.91, P=0.006) in a logistic regression analysis adjusted for age, rank, cigarette smoking and ethanol consumption. These results suggest that type 2 diabetes is associated with hearing loss independently of lifestyle factors in middle-aged men.

Vital capacity and selected metabolic diseases in middle-aged Japanese men.

OBJECTIVE: To elucidate the association between vital capacity and the presence of selected metabolic diseases in middle-aged Japanese men. METHODS: A cross-sectional analysis of the associations among forced vital capacity (FVC), static vital capacity as a percentage of that predicted (%VC) and the presence of metabolic diseases was performed. RESULTS: In a univariate linear regression analysis, FVC and %VC were inversely associated with poor vegetable intake, cigarette smoking and body mass index, but not with physical activity or ethanol consumption. In a logistic regression analysis adjusted for lifestyle factors, body mass index and age, the odds ratios for the presence of metabolic disease per 0.54 L (1 SD) decrease in FVC were 1.24 (95% CI 1.03 to 1.50) for type II diabetes, 1.21 (95% CI 1.02 to 1.42) for hypertension, 1.34 (95% CI 1.11 to 1.63) for hypertriglyceridemia, 1.23 (95% CI 1.03 to 1.46) for high gamma-glutamyl transferase levels and 1.63 (95% CI 1.10 to 2.41) for an episode of cardiovascular disease. FVC did not correlate with hyperhomocysteinemia, hypercholesterolemia or high white blood cell count. Similar results were also obtained for the association between %VC and metabolic diseases. CONCLUSIONS: A decrease in FVC or %VC was associated with the presence of some metabolic diseases. The association may partly explain the reported association between low FVC and cardiovascular disease.

Gamma-glutamyl transferase and airflow obstruction in middle-aged men.

BACKGROUND: A relationship between pulmonary dysfunction and cardiovascular mortality has been described. The mechanism responsible for the relationship remains largely unknown. METHODS: The association between airflow obstruction and selected cardiovascular risk factors including gamma-glutamyl transferase (gamma-GT) and total homocysteine was analyzed cross-sectionally in 954 middle-aged men. Airflow obstruction was assessed with %FEV(1) (FEV(1)/FVC). RESULTS: Serum gamma-GT and white blood cell (WBC) count were higher in subjects with airflow obstruction (%FEV(1)<70%) than in those without it (76.9+/-164.3 IU/L vs. 55.9+/-67.9 IU/L, P=0.030; 6290+/-1590/microL vs. 5590+/-1410/microL, P<0.001). Airflow obstruction was not associated with body mass index, total cholesterol, triglycerides, fasting glucose, or systolic blood pressure, but there was a marginal association with total homocysteine. In a logistic regression analysis adjusted for smoking status and alcohol consumption, the odds ratios (95% confidence interval) of Delta100 IU/L increase in gamma-GT and Delta1000/microL increase in WBC count for the presence of airflow obstruction were 1.20 (0.97-1.48, P=0.090) and 1.21 (1.02-1.44, P=0.036), respectively. CONCLUSIONS: Airflow obstruction was associated with gamma-GT. The association was independent of alcohol consumption category, but was attenuated by the addition of cigarette smoking status.

Gamma-glutamyl transferase and metabolic risk factors for cardiovascular disease.

OBJECTIVE: To elucidate the mechanism of the reported association between serum gamma-glutamyl transferase (GGT) activity and cardiovascular mortality. METHODS: Cross-sectional analysis of the relationship between serum GGT activity and the risk factors for cardiovascular disease was performed. PATIENTS AND MATERIALS: Middle-aged Japanese male personnel of the Self-Defense Forces who underwent retirement check-up. RESULTS: Serum GGT activity was associated with total cholesterol, triglyceride, fasting plasma glucose, total homocysteine and systolic blood pressure. The association remained in the analysis adjusted for possible confounders including cigarette smoking, ethanol consumption and body mass index. CONCLUSION: The observed association between serum GGT and cardiovascular risk factors may partly explain the reported relationship between serum GGT activity and cardiovascular disease. Serum GGT activity may be regarded as a marker of cardiovascular risk factors or oxidative stress rather than a mere indicator of excessive ethanol consumption or obesity.

Adiponectin levels and cardiovascular risk factors in Japanese men with type 2 diabetes.

Several cardiovascular risk factors correlate with adiponectin levels. It is not known whether total homocysteine, folate and gamma-glutamyl transferase levels correlate with adiponectin. We cross-sectionally analyzed the association between adiponectin and these cardiovascular risk factors in diabetic patients. One hundred and two male inpatients with type 2 diabetes without overt nephropathy or insulin use were studied. In a regression analysis of the quartiles of adiponectin, plasma levels of adiponectin were associated positively with HDL-cholesterol and age, and inversely with body mass index and HbA1c, but not with total homocysteine, folate or gamma-glutamyl transferase. Non-traditional cardiovascular risk factors such as homocysteine and folate levels were not associated with adiponectin levels in male type 2 diabetic patients who are not subject to insulin therapy.

Plasma folate levels in men with type 2 diabetes.

Limited data suggest that folate levels are higher in patients with type 2 diabetes than in subjects with normal glucose tolerance (NGT). We compared the fasting plasma folate, glucose (FPG), body mass index (BMI), and supplementary vitamin use among male subjects with NGT, those with impaired glucose tolerance (IGT), those with newly diagnosed type 2 diabetes, and those with previously diagnosed type 2 diabetes. Plasma folate of patients with newly diagnosed diabetes and that of patients with previously diagnosed diabetes was significantly higher than that of NGT subjects (p < 0.001). Prevalence of vitamin use was lower in newly diagnosed or previously diagnosed diabetic patients compared with non-diabetic subjects. Self-rated vegetable intake was similar among the four groups. FPG, BMI, triglycerides, and systolic blood pressure correlated with plasma folate levels independently of lifestyle factors studied. These results suggest that plasma folate levels are elevated in male diabetic patients independently of health-conscious behavior that is recommended for diabetic people.

Newly identified steroid hormone in urine of patients with Cushing's syndrome: 3alpha,11 beta-dihydroxy-4-androsten-17-one.

We have previously reported that the urine of patients with Cushing's syndrome, including pituitary adenoma cases and adrenal adenoma cases, consistently show a conspicuous peak in the chromatographical analysis of 17-ketosteroid fraction but not in the urine of control subjects. The substance emerges just before 11beta-hydroxy-androsterone (11beta-OH-A) in capillary gas chromatography. In the present study, we have identified an "unknown peak substance" observed in the urine of Cushing's syndrome patients using gas chromatography-mass spectrometry (GC/MS). Trimethylsilylether (TMS)-derivative of the substance was found to have a molecular weight (MW) of 448, which is similar to that of 11-OH-A (MW: 450). From these findings, we hypothesized that the substance had the structure of a C-19 steroid with two hydroxyl groups at positions C-3 and C-11, one keto-group at C-17 and a double bond between C-4 and C-5 of the A ring. We hypothesized that the unknown peak substance was 3alpha,11beta-dihydroxy-4-androsten-17-one (3alpha,11beta-DH-A). To confirm this speculation we synthesized 3alpha,11beta-DH-A and compared the elution pattern of it with that of the "unknown peak substance" using GC and GC/MS. We found that both substances were indistinguishable by GC and GC/MS analysis. These results suggest that the unknown substance observed in the urine of patients with Cushing's syndrome is 3alpha,11beta-DH-A.

Antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis with intrarenal aneurysms and renal arteriovenous fistulaes.

A 78-year-old Japanese man was admitted with a complaint of slight fever and weight loss. At admission, he tested positive for myeloperoxidase (MPO)-ANCA and had renal failure. An abdominal angiography revealed atrophy of the right kidney, two or more arteriovenous fistulae (AVF) in the right renal interlobular arteries, and multiple aneurysms in both kidneys. A renal biopsy specimen showed diffuse crescentic glomerulonephritis accompanied by tubulo-interstitial changes. This case suggests the possibility of some relationship between ANCA-associated vasculitides and the formation of aneurysms and AVFs.