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Objectives:To examine the demographic and lifestyle characteristics related to the dietary inflammatory index (DII™) score and to evaluate the association between DII score and disability among older people in Japan.Design:Cross-sectional design. The DII score was calculated from nutrient intake information obtained from a FFQ. Disability was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence questionnaire. Overall disability and disability in each component of everyday competence, that is, instrumental activities of daily living (IADL), intellectual activities and social participation, were assessed. Those with a deficit in one or more activities were defined as disabled.Setting:Five non-urban areas in Japan.Participants:A total of 1642 Japanese older people aged 65 years or older.Results:Women, residents of Oga-shi, and those with a higher education and greater frequency of shopping followed a more anti-inflammatory diet, while those living alone and residents of Minamiawaji-shi had higher dietary inflammation. A pro-inflammatory diet was associated with higher odds of overall disability and disability in each component of competence: overall disability, OR (95 % CI) = 1·26 (1·16, 1·36); IADL disability, OR (95 % CI) = 1·16 (1·07, 1·26); disability in intellectual activities, OR (95 % CI): 1·30 (1·20, 1·40); and disability in social participation, OR (95 % CI) = 1·20 (1·11, 1·29).Conclusions:Sex, living alone, education, frequency of shopping and area of residence were shown to be determinants of DII score in Japanese older people. DII score was positively associated with disability.

Background Homo sapiens have experienced admixture many times in the last few thousand years. To examine how admixture affects local adaptation, we investigated genomes of modern Polynesians, who are shaped through admixture between Austronesian-speaking people from Southeast Asia (Asian-related ancestors) and indigenous people in Near Oceania (Papuan-related ancestors). Methods In this study local ancestry was estimated across the genome in Polynesians (23 Tongan subjects) to find the candidate regions of admixture-enabled selection contributed by Papuan-related ancestors. Results The mean proportion of Papuan-related ancestry across the Polynesian genome was estimated as 24.6% (SD = 8.63%), and two genomic regions, the extended major histocompatibility complex (xMHC) region on chromosome 6 and the ATP-binding cassette transporter sub-family C member 11 (ABCC11) gene on chromosome 16, showed proportions of Papuan-related ancestry more than 5 SD greater than the mean (> 67.8%). The coalescent simulation under the assumption of selective neutrality suggested that such signals of Papuan-related ancestry enrichment were caused by positive selection after admixture (false discovery rate = 0.045). The ABCC11 harbors a nonsynonymous SNP, rs17822931, which affects apocrine secretory cell function. The approximate Bayesian computation indicated that, in Polynesian ancestors, a strong positive selection (s = 0.0217) acted on the ancestral allele of rs17822931 derived from Papuan-related ancestors. Conclusions Our results suggest that admixture with Papuan-related ancestors contributed to the rapid local adaptation of Polynesian ancestors. Considering frequent admixture events in human evolution history, the acceleration of local adaptation through admixture should be a common event in humans.

A common single nucleotide polymorphism (SNP) located in intron 4 of the EFEMP1 gene, rs3791675, has been reported to be associated with human height in European and Asian populations. The objective of this study is to examine the possible association of rs3791675-G with taller height in Oceanian populations. The rs3791675 SNP was genotyped for 636 adult subjects living in Tonga (Tonga population) and Solomon Islands (Munda, Kusaghe, and Rawaki populations). The allele frequency of rs3791675-G ranged from 0.29 to 0.66. A multiple regression analysis adjusted for age and sex was performed to test the association of rs3791675 with height in each population. The results revealed that a single copy of the rs3791675-G allele significantly increased height by 1.2 cm in Tonga population (P-value = 0.031), while no significant association was detected in Munda, Kusaghe, and Rawaki populations. Since the partial regression coefficients of rs3791675-G estimated in regression models were positive in all the populations, the lack of association in the Solomon Islanders may have come from small effect size of rs3791675-G in them as well as small sample size. To confirm the present finding, replication studies in other Oceanian populations are required.

Stool samples were collected from 148 healthy adults living a traditional subsistence lifestyle in Papua New Guinea and screened for enteric pathogens using real-time RT-PCR/PCR assays. Enteric pathogens were detected in a high proportion (41%) of individuals. Clear differences were observed in the detection of pathogens between highland and lowland communities. In particular, there was a marked difference in detection rates of norovirus GII (20% and 0%, respectively) and Shigella sp. (15% and 0%, respectively). Analysis of the relationship between enteric pathogen carriage and microbial community composition of participants, using box plots to compare specific normal flora population numbers, did not suggest that gut microbial composition was directly associated with pathogen carriage. This study suggests that enteric pathogens are common in healthy individuals in Papua New Guinean highland communities, presumably acting as a reservoir of infection and thus contributing to a high burden of gastrointestinal illnesses.

秋田県内3地域(秋田市、横手市、湯沢市)に居住する一般市民のがん医療に対する安心感の実態と、安心感に影響を与える居住地域の特徴について明らかにすることを目的に、1200名に対して質問紙調査を行った。437名(有効回答率36.6% )から回答を得た。その結果、居住地域でのがん医療に対して、59.2%の回答者は安心して治療や介護を受けられるとは思っていなかった。特に自宅療養に関する安心感は低く、「地域で安心して自宅療養できる」と思っていた回答者は20.4%であった。また、7割以上の回答者が「冬を乗り切ることは『安心感』を考える上で大切である」「地域での療養は『安心感』を考える上で大切である」と思っていた。地域別の特徴では、がん拠点病院や緩和ケア施設をもたず、特別豪雪地域である湯沢市の安心感が低く、医療圏での差が生じていた。がん医療に対する安心感を高める居住地域の特徴は「近くにすぐかかれる医療機関があって安心であること」「冬季にも自宅療養することが可能であること」「地域の在宅療養の体制を知ること」であった。本研究の結果、一般市民のがん医療に対する安心感を高めるには、身近な医療機関の充実やがん医療に関する情報支援システムなどの対策の必要性が示されたと言える。また、冬季での自宅療養を可能にするために、除雪サービス等の具体的な福祉や生活支援の検討も必要である。, Questionnaire concerning feelings of support and security regarding cancer care were administered to 1200 residents from three regions in Akita prefecture (Akita, Yokote, and Yuzawa cities), to elucidate the characteristics of these residential areas as it aff ects their sense of security. We received 437 responses (response rate: 36.6% ). The results of the survey revealed that 59.2% of the respondents did not believe that they could receive cancer treatment or nursing care without anxiety in their residential areas. A sense of security concerning home care services was especially low: only 20.4% of the respondents thought that they "can receive home care services in their local area without anxiety." Moreover, 70% or more of the respondents thought that "to get through the winter" or "to receive eff ective treatment in the local community" were important with reference to their own sense of security. The characteristics analyzed by each region revealed diff erences between the healthcare zones in which the areas were located. Thus a sense of security among residents of Yuzawa city was low, possibly because the city has no core hospitals or palliative care facilities being in an area that receives particularly heavy snowfall. The characteristics of these residential areas that increase a sense of security concerning cancer care were as follows: "there is a medicalinstitution nearby that can be immediately consulted when necessary," "residents can receive medical care at home even during winter," and "residents know about the system for home medical care in the local community." These results show that in order to increase a sense of security for ordinary citizens with reference to cancer care, it is necessary to examine strategies to enhance local medical institutions and information support systems concerning cancer care. Also to develop specific welfare and livelihood support such as snow-removal services are needed to enable home medical treatment during winter., 5, KJ00010273139, 原著論文, Original articles

介護保険制度の短期宿泊サービスであるショートステイは施設形態、運営する法人が多様である。また30日を超えてショートステイを利用する長期利用者が存在する。本研究の目的は、ショートステイの施設特性の実態と長期利用率「長期利用者数/(長期利用者数+短期利用者数)」に関連する要因を明らかにし、今後地域包括ケアシステムの中で担うべき機能について探ることである。秋田県内全域の280事業所のショートステイ管理者を対象とした質問紙調査を行い、108事業所より回答を得た。施設形態は単独型で小規模であり営利法人の運営が多かった。平均の「長期利用率」は単独型、営利法人で割合が高かった。サービス提供状況では職員配置が充実しているショートステイでは、サービスの質の向上に関わる加算が算定される傾向があった。また、全体の傾向として常時医療職の関与が必要な医療ニーズの高い利用者を断っており、個別の機能訓練を実施している割合は低かった。秋田県は高齢化でショートステイの利用需要が高まり、営利法人が単独型ショートステイの運営へ参画している。今後医療機関から在宅へ戻る際に重要な役割を果たすショートステイは機能訓練や医療ニーズへの対応が機能として求められる。しかし単独型ショートステイでは経営面からサービスの質向上よりも利用者確保が優先されやすい。単独型ショートステイでも経営が安定するような介護報酬請求の仕組みが必要である。, A short-stay, a short-term stay service of the nursing-care insurance system, is characterized by diverse facility forms and the managing corporate bodies. In addition, there are long-term facility users who remain consecutively in a short-stay service for 30 days or longer. The objective of this study was to clarify the relationship between the realities of short-stay facility characteristics and the long-term usage rate (the number of long-term facility users)/ (the number of long-term facility users + the number of short-term facility users) and to explore the functions that such facilities should bear in the future as part of a regional comprehensive care system. A questionnaire was conducted with the managers of 280 short-stay operations within Akita prefecture, with 108 of these operations responding. The most common facility format was a single-operation type, small in size, and run by a for-profit corporation. The average long-term usage rate was higher in the single-operation type, for-profit corporations. Regarding the state of service provision, short stay operations with sufficient personnel allocation, showed a tendency for an additional charge connected with an improvement in service quality to be included. Furthermore, as an overall trend, facilities rejected facility users with high medical needs that constantly required involvement of health care professionals. Furthermore, the percentage of facilities that conduct functional training for individuals was low. The demand for short-stay services has increased in Akita prefecture due to the aging of the population. Thus, profit-making corporations are participating in the management of single-operation type shortstay facilities. In the future, short-stay facilities will be required to provide functions such as provision of functional training for those who can address medical needs since such facilities play an important role for elderly patients when returning to their respective homes after being discharged from medical facilities. However, single-operation short stay facilities tend to prioritize the securing of facility users rather than improving the overall service quality due to managerial reasons. A claim system for nursing-care benefits that will help stabilize management even for singleoperation type short-stay facilities is required., 4, KJ00010273119, 原著論文, Original articles

People in the Solomon Islands today are considered to have derived from Asian- and Papuan-related ancestors. Papuan-related ancestors colonized Near Oceania about 47,000 years ago, and Asian-related ancestors were Austronesian (AN)-speaking population, called Lapita, who migrated from Southeast Asia about 3,500 years ago. These two ancestral populations admixed in Near Oceania before the expansion of Lapita people into Remote Oceania. To understand the impact of the admixture on the adaptation of AN-speaking Melanesians in Near Oceania, we performed the genome-wide single nucleotide polymorphism (SNP) analysis of 21 individuals from Munda, the main town of the New Georgia Islands in the western Solomon Islands. Population samples from Munda were genetically similar to other Solomon Island population samples. The analysis of genetic contribution from the two different ancestries to the Munda genome revealed significantly higher proportions of Asian- and Papuan-related ancestries in the region containing the annexin A1 (ANXA1) gene (Asian component > 82.6%) and in the human leukocyte antigen (HLA) class II region (Papuan component > 85.4%), respectively. These regions were suspected to have undergone natural selection since the time of admixture. Our results suggest that admixture had affected adaptation of AN-speaking Melanesians in the Solomon Islands., 論文

Modern Austronesian (AN)-speaking Melanesians are considered to be derived from the admixture of indigenous non-Austronesian (NAN)-speaking people and AN-speaking people from Southeast Asia. In this study, we analyzed mitochondrial DNA (mtDNA) variations in the D-loop region for two AN-speaking Melanesian populations (Munda and Kusaghe) and an AN-speaking Micronesian population (Rawaki) in the New Georgia Islands, the Western Province of the Solomon Islands to examine their genetic similarities to AN-speaking Polynesians in Tonga and NAN-speaking Melanesians, Gidra, in Papua New Guinea. The ‘Polynesian motif’, which is well-characterized mtDNA marker for Polynesians, was frequently observed in Munda and Kusaghe. Of particular interest, haplogroup E1a2 + 16261, which has been rarely observed in the Solomon Islands, accounted for 12.8% in Kusaghe. It has been reported that the haplogroup E1a2 arose in Island Southeast Asia (ISEA) 9400 ± 2850 years ago. Phylogenetic and principle component analyses for 24 Oceanian populations revealed that Munda and Kusaghe populations were genetically close to Tongan population, but not to Gidra. Rawaki population showed no apparent genetic similarities to populations of Tonga and Gidra. Our results suggest that considerable gene flow from AN-speaking populations originated from Southeast Asia to indigenous Melanesians occurred in the New Georgia Islands.

It has been suggested that a ‘thrifty’ genotype hypothesis can account for high prevalence of obesity in the island populations of Oceania. A recent genome-wide association study revealed that a missense variant, rs373863828-A (p.Arg457Gln), of the CREBRF gene (encoding CREB3 regulatory factor) was associated with an excessive increase in body mass index (BMI) in Samoans. In the present study, the association of rs373863828-A with an increase in BMI was examined in four Austronesian (AN)-speaking populations in Oceania. We found that rs373863828-A was frequently observed (frequency of 0.15) in Tongans (Polynesians), and was strongly associated with higher BMI (P=6.1 × 10−4). A single copy of the rs373863828-A allele increased BMI by 3.09 kg m−2 after adjustment of age and sex. No significant association was detected in the other three AN-speaking populations (Melanesians and Micronesians) living in Solomon Islands. This was probably due to the low allele frequency (0.02–0.06) of rs373863828-A as well as small sample size. The rs373863828-A allele was not found in both AN-speaking and non-AN-speaking Melanesians living in Papua New Guinea. Our results suggest that rs373863828-A of CREBRF, a promising thrifty variant, arose in recent ancestors of AN-speaking Polynesians.

Human essential hypertension is partly caused by genetic factors. Angiotensinogen (AGT), G-protein β3-subunit (GNB3) and cytochrome P450 3A5 (CYP3A5) are candidate hypertension susceptibility genes and risk alleles at these loci have been thought to arise owing to human adaptation to climatic changes following the migration out-of-Africa. This study aimed to reveal the frequencies of hypertension-susceptibility genotypes in Pacific Island populations and associations of these single-nucleotide polymorphisms (SNPs) to hypertension. Genotyping was conducted for 804 individuals from Melanesian, Micronesian and Polynesian populations at SNPs in the genes encoding AGT (rs699, rs5049 and rs5051), GNB3 (rs5443) and CYP3A5*1/*3 (rs776746). Associations between these SNPs and hypertension were tested for 383 Melanesian Solomon Islanders. We found that the A/A genotype at rs5049 was a risk factor for hypertension (P=0.025) in the Melanesian Solomon Islanders; three SNPs for AGT were in linkage disequilibrium. The ancestral alleles of rs699, rs5051 and rs776746, and the derived allele of rs5443 were as frequent in the populations surveyed here as in other equatorial populations. Although other polymorphisms associated with hypertension and additional populations remain to be studied, these findings suggest that the Pacific Islanders' susceptibility to hypertension arose because of human migration and adaptation.

It has been hypothesized that nitrogen fixation occurs in the human gut. However, whether the gut microbiota truly has this potential remains unclear. We investigated the nitrogen-fixing activity and diversity of the nitrogenase reductase (NifH) genes in the faecal microbiota of humans, focusing on Papua New Guinean and Japanese individuals with low to high habitual nitrogen intake. A 15N2 incorporation assay showed significant enrichment of 15N in all faecal samples, irrespective of the host nitrogen intake, which was also supported by an acetylene reduction assay. The fixed nitrogen corresponded to 0.01% of the standard nitrogen requirement for humans, although our data implied that the contribution in the gut in vivo might be higher than this value. The nifH genes recovered in cloning and metagenomic analyses were classified in two clusters: one comprising sequences almost identical to Klebsiella sequences and the other related to sequences of Clostridiales members. These results are consistent with an analysis of databases of faecal metagenomes from other human populations. Collectively, the human gut microbiota has a potential for nitrogen fixation, which may be attributable to Klebsiella and Clostridiales strains, although no evidence was found that the nitrogen-fixing activity substantially contributes to the host nitrogen balance.

OBJECTIVE:Obesity is a growing health concern in the Oceanic populations. To investigate the genetic factors associated with adult obesity in the Oceanic populations, the association of single nucleotide polymorphisms (SNPs) of the beta-2 adrenergic receptor (ADRB2) gene with obesity was examined in 694 adults living in Tonga and Solomon Islands.\nRESULTS:A screening for variation in 16 Oceanic subjects detected 17 SNPs in the entire region of ADRB2, of which nine SNPs including two non-synonymous ones, rs1042713 (Arg16Gly) and rs1042714 (Gln27Glu), were further genotyped for all subjects. The rs34623097-A allele, at a SNP located upstream of ADRB2, showed the strongest association with risk for obesity in a logistic regression analysis adjusted for age, sex, and population (P=5.6 × 10^, odds ratio [OR]=2.5, 95% confidence interval [CI]=1.5–4.2). The 27Glu was also significantly associated with obesity in the single-point association analysis (P=0.013, OR=2.0, 95%CI=1.2–3.4); however, this association was no longer significant after adjustment for rs34623097 since these SNPs were in linkage disequilibrium with each other. A copy of the obesity-risk allele, rs34623097-A, led to a 1.6 kg/m^2 increase in body mass index (BMI; defined as weight in kilograms divided by height in meters squared) (P=0.0019). A luciferase reporter assay indicated that rs34623097-A reduced the transcriptional activity of the luciferase reporter gene by approximately 10% compared with rs34623097-G. An electrophoretic mobility shift assay demonstrated that rs34623097 modulated the binding affinity with nuclear factors. An evolutionary analysis implies that a G>A mutation at rs34623097 occurred in the Neandertal genome and then the rs34623097-A allele flowed into the ancestors of present-day humans.\nCONCLUSION:The present results suggest that rs34623097-A, which would lead to lower expression of ADRB2, contributes to the onset of obesity in the Oceanic populations., 論文

Various Pacific Island populations have experienced a marked increase in the prevalence of obesity in past decades. This study examined the association of a promoter polymorphism of the leptin gene (LEP), G-2548A (rs7799039), and two non-synonymous single nucleotide polymorphisms of the leptin receptor gene (LEPR), K109R (rs1137100) and Q223R (rs1137101), with body weight, body mass index (BMI) and obesity (BMIor = 30) in Pacific Islanders. A total of 745 Austronesian (AN)-speaking participants were analyzed after adjusting for age, gender, and population differences. The results revealed that carriers of the 223Q alleles of LEPR had significantly higher body weight (P = 0.0009) and BMI (P = 0.0022) than non-carriers (i.e., 223R homozygotes); furthermore, the 223Q carriers also had a signiWcantly higher risk of obesity in comparison to non-carriers (P = 0.0222). The other two polymorphisms, G-2548A and K109R, were associated with neither body weight, BMI, nor obesity. The 223Q allele was widely found among the AN-speaking study subjects, thus suggesting that the LEPR Q223R polymorphism is one of the factors contributing to the high prevalence of obesity in the Pacific Island populations.

It has been suggested that Neel's "thrifty genotype" model may account for high body weights in some Oceanic populations, which presumably arose in modern times. In European populations, common variants (rs1421085-C, rs17817449-G, and rs9939609-A) in the fat mass and obesity (FTO associated) were recently found to be associated with body mass index (BMI) or obesity. In this study, we investigated the population frequencies of these variants in six Oceanic populations (Melanesians, Micronesians, and Polynesians) and tested for an association with BMI. Unlike European populations, the Oceanic populations displayed no significant association between the FTO polymorphisms and BMI. These variants were in strong linkage disequilibrium. The population frequencies ranged between 4.2 and 30.3% in the six Oceanic populations, and were similar to those in southeast and east Asian populations. Our study of the FTO polymorphisms has generated no evidence to support the thrifty genotype hypothesis for Oceanic populations.

To examine genetic affinity among Oceanian populations, polymorphisms of exons six and seven of the ABO blood group gene (ABO) were investigated in three populations--Munda town, Paradise village, and Rawaki village--in the New Georgia group of the Solomon Islands. The Munda and Paradise populations consist of Austronesian (AN)-speaking Melanesians; the Rawaki population consists of AN-speaking Micronesians who migrated from the Gilbert Islands to the New Georgia Islands approximately 30 years ago. We recently described the polymorphisms of ABO in three other Oceanian populations--Balopa Islanders (AN-speaking Melanesians), Gidra (non-AN-speaking Melanesians), and Tongans (AN-speaking Polynesians). The results from these six Oceanian populations suggest: (1) the main alleles in Oceanian populations are ABO*A101, ABO*A102, ABO*B101, ABO*O01, and ABO*O02, among which the most predominant is ABO*O01, and (2) there are marked differences in the ABO allele frequency spectrum among Oceanian populations. The different geographical distribution of ABO alleles provides insight into the migration history of AN-speaking populations in Oceania.

In order to assess overweight in urban schoolchildren (298 boys and 298 girls) aged 9-16 years in Dalian, China, their body height, weight, skinfolds at triceps, biceps, subscapular and suprailiac, and body circumferences of mid-upper arm, waist and hip were measured. The results showed that the prevalence of overweight, based on the United States Centers for Disease Control 2000 reference values using body mass index (BMI), was 22.9% in boys and 10.4% in girls, which was higher than that of indicated in Chinese national surveys of recent decades. More boys were overweight than girls due to excessive increase in body fat, although the prevalence of overweight in girls prevalence increased from 13 years. Discussion here focuses on the effects of behavioral patterns on overweight in Dalian schoolchildren, paying attention to gender difference.

The people of the Solomon Islands represent an Austronesian (AN)-speaking population’s adaptation to a humid tropical environment and subsistence of tuberous crops. Genome-wide association studies (GWASs) of other populations (e.g. the Human Genome Diversity Project [HGDP]) have suggested the existence of genotypes adaptive to ecoregion, diet, and subsistence, and that those genotypes are also associated with metabolic and cardiovascular diseases. Recently, the incidence of non-communicable diseases has been increasing in the Solomon Islands. In the present study, we explored the association of genotypes adaptive to a tropical environment and tuberous crop diet with metabolic and cardiovascular conditions in rural and urban AN-speaking Melanesian and Micronesian populations of the Solomon Islands. A total of 561 participants were genotyped for single nucleotide polymorphisms (SNPs) potentially associated with a tropical environment (rs174570 and rs2237892) and a tuberous crop diet (rs162036, rs185819, and rs2722425). The results showed that the allele frequencies of the Solomon Islands populations adopted patterns similar to those in populations from other hot, tropical areas with a tuberous crop diet in previous studies. Furthermore, rs162036, rs185819, rs2237892, and rs2722425 were all strongly associated with one or more metabolic and cardiovascular conditions. The derived allele of rs2722425 (i.e. rs2722425-G) was significantly associated with an elevated LDL level (P = 0.000264) even after the significance level was adjusted for multiple testing (i.e., α = 0.0005). Our results suggest that the inhabitants of the Solomon Islands exhibit the effects of the tropical environment and tuberous crop diet on their allele frequencies, and that their susceptibility to metabolic and cardiovascular diseases is therefore considered to be associated with their environment and diet., 論文

Physical activity in childhood is important as it may establish adult behavior. However, few studies on physical activity in children have been conducted, especially in Asian children. We performed anthropometric measurements of 159 school children in two grades (grade 5: 10-11 years old and grade 8: 13-14 years old) from urban areas of Korea (n=79) and China (n=80). The total daily energy expenditure (TEE) was estimated for 7 consecutive days using an accelerometer. The mean height, weight, and body mass index (BMI) for boys and girls in both countries exceeded the US national reference median (CDC, 2000). Physical activity levels (PALs) were significantly higher in the grade 5 group (10-11 years old) and in girls than in boys for both grades. No significant difference in PALs or daily step-counts (STPs) was observed between 'normal' and 'overweight' subgroups based on BMI, although negative correlations were found between weight, BMI, or %body fat vs. PAL or STP among Korean girls and Chinese boys (r=0.32-0.38, all p