Usefulness of waist-to-height ratio in screening incident hypertension among Japanese community-dwelling middle-aged and elderly individuals

Kawamoto Ryuichi,Kikuchi Asuka,Akase Taichi,Ninomiya Daisuke,Kumagi Teru 대한고혈압학회 2020 Clinical Hypertension Vol.26 No.3

Background: The incidence of hypertension is increasing worldwide and obesity is one of the most significant risk factors. Obesity can be defined by various anthropometric indices such as body mass index (BMI), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR). This study examined a range of anthropometric indices and their relationships with hypertension. Methods: This study included 768 men aged 70 ± 10 years and 959 women aged 70 ± 8 years from a rural village. The relationship between anthropometric indices (BMI, WHpR, and WHtR) and hypertension was examined using cross-sectional (baseline, N = 1727) and cohort data (follow-up, N = 419). Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of obesity indices for hypertension in both genders. Logistic regression models were used to evaluate WHtR as a significant predictor of hypertension. Results: In the cross-sectional study, WHtR, BMI, and WHpR showed significant predictive abilities for hypertension in both genders, with WHtR showing the strongest predictive ability. Also, in the cohort study, WHtR showed a significant predictive ability for incident hypertension in both genders, and, for women, BMI as well as WHtR had also predictive ability. In the cross-sectional study, the optimal WHtR cutoff values were 0.53 (sensitivity, 44.3%; specificity, 80.2%) for men and 0.54 (sensitivity, 60.9%; specificity, 68.6%) for women. In the cohort study, the optimal WHtR values were 0.47 (sensitivity, 85.4%; specificity, 39.8%) for men and 0.51 (sensitivity, 66.7%; specificity, 58.2%) for women. Conclusions: The results suggest that WHtR is a useful screening tool for hypertension among Japanese middleaged and elderly community-dwelling individuals.

High serum uric acid within the normal range is a useful predictor of hypertension among Japanese community-dwelling elderly women

Kawamoto Ryuichi,Ninomiya Daisuke,Akase Taichi,Asuka Kikuchi,Kumagi Teru 대한고혈압학회 2021 Clinical Hypertension Vol.27 No.1

Background: The risk associated with serum uric acid (SUA) levels when within the normal range is unknown. This study aims to examine whether SUA within the normal range is a predictor of hypertension. Methods: The subjects comprised 704 men aged 71 ± 9 (mean ± standard deviation) years and 946 women aged 70 ± 8 years recruited for a survey at the community based annual medical check-up. The main outcome was the presence of hypertension (antihypertensive medication and/or having SBP ≥140 mmHg and/or DBP ≥90 mmHg). Results: At baseline, 467 (66.3%) men and 608 (64.3%) women had hypertension. Comparing to lowest quartile in women (SUA-1, uric acid <4.1 mg/dL), the unadjusted odds ratios (ORs) [95% confidence interval (CI)] for hypertension of SUA-2 (4.1 to 4.7 mg/dL), SUA-3 (4.8 to 5.4 mg/dL), and SUA-4 (≥5.5 mg/dL) were 1.11 (0.78-1.59), 1.75 (1.20-2.55), and 1.89 (1.30-2.77), respectively. These associations were apparent even after adjustments for age, but ORs were attenuated after adjusting for all confounding factors. During a follow-up of 3.0 years, there were 35 (24.0%) hypertension cases in men and 51 (20.8%) in women. In women only, a significant association between increased SUA categories and incidence of hypertension was observed, and the multivariate-ORs (95% (CI) for incident hypertension of SUA-3 (4.5- 5.2 mg/dL) and SUA-4 (≥5.3 mg/dL) were 2.23 (0.81-6.11) and 3.84 (1.36-10.8), respectively. Conclusions: These results suggest that baseline SUA within the normal range could be an important predictor for incidence of hypertension in Japanese community dwelling elderly women.

Serum uric acid to creatinine ratio is a useful predictor of all-cause mortality among hypertensive patients

Kawamoto Ryuichi,Kikuchi Asuka,Ninomiya Daisuke,Tokumoto Yoshio,Kumagi Teru 대한고혈압학회 2023 Clinical Hypertension Vol.29 No.-

Background Many of the existing research studies have shown that serum uric acid (SUA) is a predictor of renal disease progression. More recently, studies have suggested an association between renal function-normalized SUA and all-cause mortality in adults. This study aims to examine the association between the ratio of SUA to creatinine (SUA/ Cr) and all-cause mortality with a focus on hypertensive patients. Methods This study is based on 2,017 participants, of whom 916 were male (mean age, 67 ± 11 years) and 1,101 were female (mean age, 69 ± 9 years). All participants were part of the Nomura Cohort Study in 2002 (cohort 1) and 2014 (cohort 2), as well as the follow-up period (2002 follow-up rate, 94.8%; 2014 follow-up rate, 98.0%). We obtained adjusted relative risk estimates for all-cause mortality from a basic resident register. In addition, we employed a Cox proportional hazards model and adjusted it for possible confounders to determine the hazard ratio (HR) and 95% confidence interval (CI). Results Of the total participants, 639 (31.7%) were deceased; of these, 327 (35.7%) were male and 312 (28.3%) were female. We found an independent association between a higher ratio of SUA/Cr and a higher risk of all-cause mortality in female participants only (HR, 1.10; 95% CI, 1.02–1.18). The multivariable-adjusted HRs (95% CI) for all-cause mortality across quintiles of baseline SUA/Cr were 1.28 (0.91–1.80), 1.00, 1.38 (0.95–1.98), 1.37 (0.94–2.00), and 1.57 (1.03–2.40) for male participants, and 0.92 (0.64–1.33), 1.00, 1.04 (0.72–1.50), 1.56 (1.06–2.30), and 1.59 (1.06–2.38) for female participants. When the data were further stratified on the basis of age (< 65 or ≥ 65 years), body mass index (< 22.0 or ≥ 22.0 kg/m2), estimated glomerular filtration rate (< 60 or ≥ 60 mL/min/1.73 m2), and presence of SUAlowering medication, trends similar to those of the full population were found in all groups. Conclusion Baseline SUA/Cr is independently and significantly associated with future all-cause mortality among hypertensive patients.

Combination of leucine-rich alpha-2 glycoprotein and fecal markers detect Crohn’s disease activity confirmed by balloon-assisted enteroscopy

Ami Kawamoto,Kento Takenaka,Shuji Hibiya,Yoshio Kitazume,Hiromichi Shimizu,Toshimitsu Fujii,Eiko Saito,Kazuo Ohtsuka,Ryuichi Okamoto 대한장연구학회 2024 Intestinal Research Vol.22 No.1

Background/Aims: Endoscopic activity confirmed by enteroscopy is associated with poor clinical outcome in Crohn’s disease (CD). We investigated which of the existing biomarkers best reflects endoscopic activity in CD patients including the small bowel, and whether their combined use can improve accuracy.Methods: One hundred and four consecutive patients with ileal and ileocolonic type CD who underwent balloon-assisted enteroscopy (BAE) from October 2021 to August 2022 were enrolled, with clinical and laboratory data prospectively collected and analyzed.Results: Hemoglobin, platelet count, C-reactive protein, leucine-rich alpha-2 glycoprotein (LRG), fecal calprotectin, and fecal hemoglobin all showed significant difference in those with ulcers found on BAE. LRG and fecal calprotectin showed the highest areas under the curve (0.841 and 0.853) for detecting ulcers. LRG showed a sensitivity of 78% and specificity of 80% at a cutoff value of 13 μg/mL, whereas fecal calprotectin showed a sensitivity of 91% and specificity of 67% at a cutoff value of 151 μg/g. Dual positivity for LRG and fecal calprotectin, as well as LRG and fecal hemoglobin, both predicted ulcers with an improved specificity of 92% and 100%. A positive LRG or fecal calprotectin/hemoglobin showed an improved sensitivity of 96% and 91%. Positivity for LRG and either of the fecal biomarkers was associated with increased risk of hospitalization, surgery, and relapse.Conclusions: The biomarkers LRG, fecal calprotectin, and fecal hemoglobin can serve as noninvasive and accurate tools for assessing activity in CD patients confirmed by BAE, especially when used in combination.

First Two Cases of Infected Aortic Aneurysm Caused by Non-Vaccine Streptococcus pneumoniae Serotype 23A

Risako Kakuta,Ryuichi Nakano,Hisakazu Yano,Daiki Ozawa,Nobuo Ohta,Takayuki Matsuoka,Naotaka Motoyoshi,Shunsuke Kawamoto,Yoshikatsu Saiki,Yukio Katori,Mitsuo Kaku 대한진단검사의학회 2020 Annals of Laboratory Medicine Vol.40 No.3

Dear Editor, Infected aortic aneurysm (IAA) is an uncommon, but life-threatening condition. Identification of the causative pathogen is essential for accurate diagnosis and effective treatment. However, 14–40% of IAA cases are culture-negative [1]. IAA due to Streptococcus pneumoniae is rare, and reports of the involvement of S. pneumoniae capsular serotypes and sequence types (STs) in IAA are even rarer [2-5]. We identified S. pneumoniae from culture-negative IAA by genetic analysis. To the best of our knowledge, as of 2019, only 59 cases of pneumococcal IAA have been reported in France, the United Kingdom (UK), the Netherlands, Germany, Switzerland, Belgium, Denmark, the United States (USA), Canada, Chile, Japan, Hong Kong, Korea, and Austria since 1977 [2-5]. In the previous cases of IAA due to S. pneumoniae, capsular serotype analysis was reported only for seven: 10A and 23F in the UK, 4 and 8 in Denmark, 19F in Hong Kong, 4 in Belgium, and 23 in USA [2-5]. We report the first two cases of culture-negative IAA due to non-vaccine S. pneumoniae serotype 23A, ST338. The study protocol was approved by the Institutional Ethics Committees of Tohoku University, Sendai, Japan (No. 2018-1-456).

Artificial intelligence for endoscopy in inflammatory bowel disease

( Kento Takenaka ),( Ami Kawamoto ),( Ryuichi Okamoto ),( Mamoru Watanabe ),( Kazuo Ohtsuka ) 대한장연구학회 2022 Intestinal Research Vol.20 No.2

Inflammatory bowel disease (IBD), with its 2 subtypes, Crohn’s disease and ulcerative colitis, is a complex chronic condition. A precise definition of disease activity and appropriate drug management greatly improve the clinical course while minimizing the risk or cost. Artificial intelligence (AI) has been used in several medical diseases or situations. Herein, we provide an overview of AI for endoscopy in IBD. We discuss how AI can improve clinical practice and how some components have already begun to shape our knowledge. There may be a time when we can use AI in clinical practice. As AI systems contribute to the exact diagnosis and treatment of human disease, we should continue to learn best practices in health care in the field of IBD. (Intest Res 2022;20:165-170)