Hiroki Satoh

Background: Coronary artery disease (CAD) is a major problem worldwide. Atherosclerosis and thrombosis underlying CAD involve multiple cell types. New and useful diagnostic markers are required. MicroRNAs (miRNAs) are a class of noncoding RNAs that posttranscriptionally regulate the gene expressions involved in various cellular processes. Endothelial dysfunction is implicated in early processes of athero-thrombosis. Thus, it was hypothesized that the level of vascular endothelium-enriched miRNAs would be altered in plasma samples of CAD patients. Methods: Vascular endothelium-enriched miRNA (miR-126) level was analyzed in plasma from 31 patients with CAD and 36 patients without CAD (qRT-PCR analysis). Results: MiR-126 was not significantly down-regulated or up-regulated in CAD patients. Interestingly, the level of miR-126 was significantly decreased in patients with CAD and high low-density lipoprotein (LDL) cholesterol level. In contrast, the level of miR-126 was significantly increased when LDL cholesterol was high in patients who had risk factors for CAD but did not have angiographically significant CAD. Conclusion: MiR-126 was not significantly down-regulated or up-regulated in CAD patients and was not suitable for discriminating CAD patients from patients without CAD. The oppositely-directed relationship between miR-126 and LDL cholesterol in patients with or without CAD may have significant implications for identifying a potential role of miR-126 in cholesterol metabolism.

Objective: This study aimed to determine the effect of a home visit program using a Functioning Improvement Tool (FIT) compared with a home visit using conversation alone. Methods: Twenty-eight participants (mean age, 78.6±7.5 years) were randomly assigned to an intervention (n = 13) or control (n = 15) group for 3 months. The intervention group received a 60-minute FIT home visit program; the control group received a 30-minute home visit using common conversational techniques. Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and Geriatric Depression Scale (GDS) scores were evaluated. Results: The FAB score was significantly improved in the intervention group compared with the control group (2.5 vs -0.5, P = 0.02). Conclusions: Our FIT home visit program may help prevent dementia. Further studies with larger samples and longer follow-up periods are needed to assess the long-term effectiveness of an FIT home visit program on dementia prevention (UMIN-CTR number, UMIN000004767.

Cardiovascular morbidity and mortality are closely associated with hypertension, however, predictors of incident hypertension have not been fully established. We have conducted a study aimed at evaluating whether brachial-ankle pulse wave velocity (baPWV) is a predictor of incident hypertension. The relation between baPWV, a noninvasive index of aortic stiffness, and incident hypertension was evaluated in a cohort of 2,278 Japanese normotensive male subjects with a follow-up of 3 years. Of the 2, 278 study participants, 151 (6.6%) had incident hypertension during the follow-up. After adjustment for variables, including age, gender, body mass index (BMI), smoking habit, alcohol consumption, diabetes mellitus, hyperlipidemia, family history of hypertension, heart rate, systolic blood pressure, low-density lipoprotein cholesterol, triglyceride, and fasting plasma glucose, multiple logistic regression analysis revealed that baPWV was a significant and independent predictor of incident hypertension with an adjusted odds ratio 1.45 (95% confidence interval 1.17–1.79, P < 0.01). In addition, baPWV values >1,380 cm/s indicated a high risk for incident hypertension. Among the Japanese normotensive male subjects participating in this study, BaPWV was a significant and independent predictor of incident hypertension. This result suggests that BaPWV could be a useful screening method to identify normotensive individuals who should be targeted for interventions aimed at preventing the incident hypertension.

Objective Adiposity is closely associated with the clustering of metabolic risk factors such as high blood pressure, dyslipidemia, and glucose intolerance. Waist circumference and body mass index (BMI) are the established markers of abdominal adiposity and general adiposity, respectively. However, it has not been examined whether these two markers can detect the clustering of metabolic risk factors in Japanese subjects. Methods and Results We studied 5,796 Japanese middle-aged subjects aged 40-60 years (4,344 males and 1,452 females). Metabolic risk factors including high blood pressure, dyslipidemia, and glucose intolerance were identified according to the diagnostic criteria for metabolic syndrome in Japan. The number of metabolic risk factors was significantly associated with the BMI values in both male and female subjects. The prevalence of subjects with multiple (two or more) metabolic risk factors was 29.4% and 7.6% in males and females, respectively. According to receiver operating characteristic (ROC) analysis, the area under curve values of BMI and waist circumference did not differ in male (0.658 vs. 0.671, p=n.s.) and female (0.776 vs. 0.790, p=n.s.) subjects, indicating that the waist circumference as well as the BMI could be useful in detecting the occurrence of multiple metabolic risk factors. The appropriate cut-off values of BMI to predict the presence of multiple metabolic risk factors were 24.7 and 23.4 kg/m2 in males and females, respectively. The sensitivity and specificity using these cut-off values were 58 and 65% in males and 65 and 77% in females, respectively. Conclusion The BMI values can similarly predict the presence of multiple metabolic risk factors just as the waist circumference in Japanese middle-aged subjects.

Aim: Helicobacter Pylori infection was associated with the risk of cardiovascular disease; however, the relation between Helicobacter Pylori infection and the lipid profile has not been fully established. Methods: We measured anti-Helicobacter Pylori antibody concentration and lipid profiles in 6,289 Japanese subjects aged 21-64 years (5,077 male and 1,212 female). Results: The prevalence of Helicobacter Pylori-seropositive subjects was 46.8% and 39.6% in men and women, respectively. Adjusted mean values of low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol in men were significantly higher and lower in Helicobacter Pylori-seropositive than-negative subjects, respectively, (LDL-cholesterol: 129.0±0.8 vs. 125.3±0.7 mg/dL, p< 0.001, HDL-cholesterol: 54.6±0.3 vs. 56.6±0.3 mg/dL, p< 0.01), whereas these associations were not significant in female subjects. Moreover, the odds ratio of Helicobacter Pylori infection for high LDL-cholesteremia and low HDL-cholesteremia in male subjects was 1.23 (95% CI (confidence interval): 1.08-1.40, p< 0.05) and 1.29 (95% CI: 1.03-1.59, p< 0.05), respectively. Female subjects did not have such associations. Conclusions: The present study demonstrates that Helicobacter Pylori infection is significantly associ-ated with high LDL-cholesteremia and low HDL-cholesteremia in Japanese male subjects.

Metabolic syndrome (MetS) has been recognized as a risk factor for cardiovascular disease; however, the impact of MetS on arterial stiffness has not been fully established in the general Japanese population. We analyzed the relationship between MetS and the severity of arterial stiffness using brachial-ankle pulse wave velocity (baPWV) in 2744 male and 358 female subjects aged 38–62 years, adjusted for conventional risk factors and C-reactive protein. The prevalence rates of MetS identified by Japanese criteria were 22.7% (n=624) and 7.8% (n=28) in male and female subjects, respectively. The subjects with MetS had significantly greater mean values of baPWV than those without MetS among both male and female subjects (1444±209 vs. 1294±165 cm/s in male subjects, Pvs. 1220±171 cm/s in female subjects, PPP<0.001). In conclusion, MetS was identified as a significant and independent risk factor for increased arterial stiffness in both the male and female general population in Japan.

Lower levels of high-density lipoprotein cholesterol (HDL-C) have been recognized as a risk factor for coronary artery disease (CAD), but the relationship between HDL-C values and the occurrence of CAD has not been fully established in the Japanese general population. A cohort study of 5,371 Japanese men with 12 years of follow-up was conducted to identify risk factors for the occurrence of CAD. One hundred and twelve subjects had CAD (acute myocardial infarction in 67 patients and angina in 45 patients) during the follow-up period. Adjustment for variables including age, body mass index, smoking habit, alcohol intake, systolic blood pressure, low-density lipoprotein cholesterol, triglyceride, fasting plasma glucose, hypertension, diabetes mellitus and hyperlipidemia, adjusted hazard ratio (HR) of lower levels of HDL-C for the occurrence of CAD was 1.21 (95% confidence interval (CI): 1.11-1.33, p<0.001). Serum HDL-C concentration less than 51 mg/dL was a significant risk for CAD. Low HDL-C was identified as a significant and independent risk for CAD in Japanese men using long-term follow-up data.

Background It has been well established that dyslipidemia is a significant risk factor for coronary artery disease (CAD), however, the association between fasting triglyceride (TG) and the occurrence of CAD is controversial. The objective of this study was to elucidate the relationship between fasting TG and CAD in middle-aged Japanese men. Methods and Results A cohort study of 6,966 middle-aged Japanese men (mean ± SD: 46.6±5.2 years) with a 10-year follow-up period was conducted to identify risk factors for the occurrence of CAD. One hundred and eleven cases of CAD were identified during the follow up. The Cox proportional hazard model was used to identify the independent risk factors for CAD. Adjustment was made for variables including age, body mass index, smoking habit, alcohol intake, duration of sleeping, systolic blood pressure, uric acid, total cholesterol, high-density lipoprotein cholesterol, fasting plasma glucose, and TG. Fasting TG was identified as an independent risk factor for CAD. The adjusted hazard ratio of TG for CAD was 3.07 (95% confidence interval: 1.01-9.35, p<0.05). Additionally, a serum TG concentration level greater than 78 mg/dl was a significant risk for CAD. Conclusions By using the long term follow-up data of the study of middle-aged Japanese men, fasting TG was identified to be a significant risk factor for CAD. (Circ J 2006; 70: 227 - 231)