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Aims: We aimed to assess the cross-sectional association of heated tobacco product (HTP) use with prediabetes and diabetes. Methods: The present analysis included 8950 workers from 5 companies (Study I) and 31,341 workers from another large company (Study II), who participated in the Japan Epidemiology Collaboration on Occupational Health Study. The participants were divided into five groups: never smokers, past smokers, exclusive HTP users, dual users of cigarettes and HTPs, and exclusive cigarette smokers. Diabetes and prediabetes were defined according to the fasting blood glucose and HbA1c levels and self-reported diabetes treatment, using the American Diabetes Association criteria. We analyzed the data of Study I and II separately, and then pooled these estimates using the fixed-effect models, with adjustment for a wide range of covariates. Results: In this study that included 40,291 participants (mean age, 46.6 years; men, 84.3%), about half of the current tobacco-related product users reported using HTPs. Exclusive HTP users had higher odds of prediabetes (pooled odds ratio 1.36; 95% CI 1.25–1.47) and diabetes (1.68; 95% CI 1.45–1.94) than never smokers. Similarly, dual users also had increased odds of prediabetes (pooled odds ratio, 1.26; 95% CI 1.13–1.39) and diabetes (1.93; 95% CI 1.63–2.29). The strength of these associations was comparable to that of cigarette smokers. We observed significantly higher HbA1c and fasting blood glucose levels among both exclusive HTP users and dual users compared to never smokers. Conclusion: HTP use was associated with an increased likelihood of prediabetes and diabetes. Prospective studies are warranted to confirm the cross-sectional association. [ABSTRACT FROM AUTHOR]

Purpose: Brain-derived neurotrophic factor (BDNF) is a known essential mediator responsible for the beneficial effects of physical activity on brain health. Exercise-induced lactate is a potential endogenous factor that may increase BDNF expression, and the selection of cadence in exercise prescription is thought to influence lactate concentrations. The aim of this study was to examine the effect of pedaling cadence on circulating BDNF levels through lactate production in healthy adult men. Methods: Seventeen healthy adult men participated in three experimental sessions: a 40-min session of cycle-ergometry exercise with a pedaling cadence of 60 rpm at a workload of 40% peak oxygen uptake (Ex.60), a 40-min cycling exercise with a pedaling cadence of 100 rpm at the same workload as the Ex.60 (Ex.100), and a session of complete rest for 40 min (CON). Serum BDNF levels were measured before and after each session, and heart rate (HR) and lactate concentrations were evaluated after each session. Results: Ex.100 significantly increased serum BDNF and lactate levels (p < 0.05, respectively), while CON and Ex.60 induced no significant increases in these variables (all p > 0.05). The relative change in BDNF levels had a significant strong correlation with relative change in lactate (p < 0.05) but not with change in HR (p > 0.05). Conclusion: High-cadence aerobic exercise can increase peripheral BDNF levels through an increase in lactate concentrations, whereas the workload is low to moderate. This study indicates that exercise regimen considering pedaling cadence may have the possibility of inducing better brain health. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate patient–physician communication and patients' understanding of treatment goals in rheumatoid arthritis (RA). Methods: A cross-sectional online survey of patients with RA and physicians treating RA was conducted between 16 and 30 June 2021. Participants were asked to rate the importance of 17 goals on a 6-point Likert scale, and mean scores were compared between patients and physicians by the Wilcoxon rank sum test. Patients' satisfaction with physician communication and their understanding of treatment goals were also assessed. Results: The responses of 502 patients and 216 physicians were analyzed. The most common patient age group was 50–59 years (28.5%), and the mean disease duration was 10.3 years. Physicians had a mean of 19.2 years of treatment experience and were treating a mean of 44.3 patients. Among the 17 goals assessed, patients placed significantly more importance on drug tapering or discontinuation as short-term goals (3–6 months) and on performing basic activities of daily living, being able to engage in daily tasks, achieving and maintaining remission, maintaining better laboratory values, and drug tapering or discontinuation as long-term goals (5–10 years; all adjusted p < 0.05). Patient treatment satisfaction was significantly associated with disease activity, a feeling of treatment effectiveness, satisfaction with physician communication, and agreement with physician goals. Conclusion: Differences exist among patients with RA and physicians treating RA regarding the importance of short- and long-term treatment goals. Good patient–physician communication appears to be important for improving patient satisfaction. Trial registration: University Hospital Medical Information Network identifier: UMIN000044463. [ABSTRACT FROM AUTHOR]

We aimed to assess the association between heated tobacco product (HTP) use and high-density lipoprotein cholesterol (HDL-C) concentration. Our study included 12,268 workers from five companies (Study I) and 36,503 workers from another large company (Study II). Participants were categorized into five groups: never smokers, past smokers, exclusive HTP users, dual users of cigarettes and HTPs, and exclusive cigarette smokers. We analyzed the data of Studies I and II separately and then pooled these estimates using a fixed-effect model. Of the 48,771 participants, 9.3% were exclusive HTP users, and 6.0% were dual users. Exclusive HTP users had modestly but significantly lower concentrations of HDL-C than never smokers, with the pooled mean difference being − 1.1 (95% CI − 1.5 to − 0.6) mg/dL. Dual users showed a further reduction (mean difference − 3.7 (− 4.2 to − 3.2) mg/dL), which was comparable to that of exclusive cigarette smokers versus never smokers (mean difference − 4.3 (− 4.7 to − 3.9) mg/dL). The pooled odds ratios (95% CIs) of having low HDL-C (< 40 mg/dL for men and 50 mg/dL for women) were 1, 0.99 (0.90–1.11), 1.25 (1.09–1.43), 2.02 (1.76–2.32), and 2.09 (1.88–2.32) for never smokers, past smokers, exclusive HTP users, dual users, and exclusive cigarette smokers, respectively. In conclusion, exclusive HTP users had lower HDL-C concentrations than never smokers, although higher than exclusive cigarette smokers. Moreover, dual users had HDL-C concentrations similar to those in exclusive cigarette smokers. [ABSTRACT FROM AUTHOR]

Aims: Data are limited regarding how shift work is linked to the development of type 2 diabetes, especially among workers at high risk of diabetes. We examined the risk of diabetes according to shift-work conditions over several years among Japanese adults. Methods: This prospective study enrolled 17,515 workers (age 40–78 years). Shift work was self-reported at annual health examinations over time from 2004 to 2017 and categorized as shift workers or non-shift workers. Diabetes was defined as fasting plasma glucose, random glucose, HbA1c, and self-reported use of antidiabetic medications. The association of shift work and diabetes was quantified using Cox regression. Results: During a follow-up of 8.1 years in median, 2071 incident cases of diabetes were documented. Compared with non-shift work, shift work showed a significantly elevated hazard ratios of developing diabetes. Shift work showed a 19% (95% confidence intervals: 3–37%) higher hazard ratios for diabetes, after adjustment for demographic-, cardiometabolic-, and work-related factors. Further adjustment for lifestyle factors and body mass index did not materially change this association (a 16% increase; 95% confidence intervals, 1–34%). This relationship was replicated among workers with prediabetes. Conclusions: Engaging in shift work may increase the risk of developing diabetes independently of lifestyle factors and body mass index, even among prediabetic workers. [ABSTRACT FROM AUTHOR]