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Background This epidemiological study investigated the eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio (EAR) and docosahexaenoic acid (DHA)/AA ratio (DAR) in ninth-graders in Japan. Methods A total of 175 ninth-grade children from Tsunan Town (boys/girls, 115/60) were enrolled in the study between 2015 and 2017. All participants were assessed during annual health check-ups to determine their EAR and DAR. All data were compared between boys and girls using the Mann-Whitney test. Spearman's rank correlation coefficient was used to describe the strengths of correlation between the EAR, DAR, and relevant parameters. Results The median (minimum, maximum) EAR and DAR of all participants were 0.13 (0.05, 0.46) and 0.47 (0.25, 0.84), respectively. There was no significant difference in the EAR between boys and girls at 0.12 (0.05, 0.46) and 0.13 (0.06, 0.27) (P = 0.375), respectively. In addition, the DAR was not significantly different (P = 0.125). There was a significant positive correlation between EAR and triglyceride, BMI, and homeostasis model assessment (HOMA)-IR but a significantly negative correlation with HbA1c (r = -0.209, P = 0.006). In contrast, there was no significant correlation between DAR and any parameters. Conclusions This is the first epidemiological study investigating the EAR using a population-based cohort of Japanese adolescents. The EAR in boys/girls in Japan is 0.12 (0.05, 0.46)/0.13 (0.06, 0.27). The study results suggest that children with a healthy diet may generally have a lower average blood glucose level.

Aims/Introduction Little information is available regarding the status of insulin resistance (IR) and insulin deficiency (ID), as well as their relationship with obesity in children using the homeostasis model assessment (HOMA) in a population-based setting. Materials and Methods The study included a total of 445 ninth-grade children participating in health check-up programs implemented in Tsunan Town, Niigata, Japan (boys/girls, 252/193 [participation rates: 98.1/95.5%]). HOMA of insulin resistance ≥2.5 was defined as IR, and HOMA of β-cell function

Background It is not clear whether resistin, adiponectin and leptin are as closely associated with cardiovascular disease risk in childhood as in adulthood. Methods A survey was performed on elementary school 4 th graders aged 9 to 10 years in Ina-machi, Saitama, Japan to investigate whether resistin, adiponectin and leptin in these children might be associated with cardiovascular risk factors (atherosclerosis index: AI, waist-to-height ratio: W/H ratio, body mass index: BMI), and how the presence of obesity might affect their association. Results A total of 204 boys and 176 girls participated in the survey. Leptin and the leptin-to-adiponectin ratio (L/A ratio) were significantly correlated with the cardiovascular risk factors except AI, and adiponectin was shown to be negatively correlated with all the cardiovascular risk factors examined in the entire study population. While the serum resistin concentration was not found to be significantly different among the boys and girls with or without obesity, the resistin-to-adiponectin ratio (R/A ratio) was found to be significantly different between the obese and non-obese boys but not between the obese and non-obese girls. Among the obese boys, there was a significant correlation between resistin and AI and between the R/A ratio and the cardiovascular risk factors, neither of which was noted among the entire boy population or the non-obese boys. Whereas the R/A ratio was significantly correlated with all the cardiovascular risk factors only in the obese boys. (AI: 0.426, p

To investigate the causes of death and how they changed over time in patients with childhood-onset type 1 diabetes who were receiving dialysis.Of the 1384 patients who were diagnosed with type 1 diabetes at18 years of age between 1965 and 1979, 113 who were subsequently confirmed as having received dialysis and having died as of January 1, 2008 were found eligible for the study. The cause of death trends were expressed according to the duration of dialysis.The leading causes of death were end-stage renal disease (ESRD) (36.3%), cardiovascular disease (CVD) (31.9%), and infections (20.3%). Among CVD, cerebral hemorrhage was the most frequent (38.9%) and showed a significant trend for an increase in the duration of dialysis (P=0.01, the Cochran-Armitage trend test). The mortality from ESRD concentrated within 5 years of dialysis and that from CVD increased after 10 years of dialysis, while the mortality from infections peaked during 5 to 10 years from initiation of dialysis.The leading causes of death in dialysis patients with type 1 diabetes were ESRD, CVD, and infections. As the duration of dialysis increased, however, CVD contributed more to mortality. Special attention should be paid to CVD, particularly cerebral hemorrhage, to improve the long-term prognosis of patients.

This study examined the relationships between serum adiponectin (AD) and leptin (LP) levels, and obesity using a populationbased cohort consisted of 315 (9–10 year olds: G1) and 308 (12–13 year olds: G2) school children. Serum AD, LP and other markers were compared according to the presence of obesity. The prevalence rates of obesity were 14.9% in G1 and 9.4% in G2. The medians of serum AD (mg/dl: non-obese/obese) were statistically lower in obese children (9.6/8.3 in G1, p < 0.05; 8.9/6.6 in G2, p < 0.05), and the medians of serum LP (ng/dl) were statistically higher in obese children (3.7/12.5 in G1, p < 0.05; 2.9/8.4 in G2, p < 0.05). The serum LP levels were significantly positively correlated with percent overweight (POW) irrespective of age and sex, and the serum AD levels were significantly negatively correlated with POW except for boys in G1. Multivariate regression analyses revealed that LP, LDL-cholesterol and gender in G1, and LP, AD, blood pressure and gender in G2 were significantly correlated with POW. A large-scale, population-based study revealed that AD was lower and LP higher in obese children, and that the obese status in G2 was related to a worse metabolic profile than the case in G1. # 2006 Elsevier Ireland Ltd. All rights reserved.

The current study evaluates the indices of glucose control for diabetics (i.e., glycated albumin (GA), hemoglobin A1c (HbA1c), plasma glucose (PG) and immuno-reactive insulin (IRI)) in non-diabetic children from a population-based cohort, and compares those values according to the presence of obesity to examine any differences in these indices. GA, HbA1c, casual PG and casual IRI in obese children (n = 209) were compared to those of non-obese children (n = 1060) in Ina town, Saitama Prefecture, in 2002-2003. In obese children, the levels of HbA1c, PG and IRI were statistically higher when compared to those of non-obese children. In contrast, the median and intra-quartile range (IQR) of GA of obese children (13.6%: 12.6-14.7) was statistically lower when compared to that of non-obese children (14.3%: 13.5-15.4, p < 0.001). The low GA (%) in obese children is mainly due to the low absolute value of GA (g/dl) rather than a higher albumin value (g/dl). This is the first report to reveal that GA levels are low in obese, non-diabetic children. Additional data collection and an experimental approach are necessary to reveal the reasons behind lower GA levels in obese children.

The purpose of the present study was to examine whether gender differences exist in the relationship between percent body fat (%BF) and body mass index (BMI) in Japanese children using a population-based cohort. Subjects are comprised of 187 boys and 163 girls aged 9-10, and 137 boys and 155 girls aged 12-13. Percent BF was measured using a bipedal biometrical impedance analysis (BIA) device. The relationship between %BF and BMI was investigated as a function of age and gender with Pearson's correlation coefficient. Strong linear relationships existed between %BF and BMI, especially in girls (9-10-year-old boys: r=0.779, P0.0001; 9-10-year-old girls: r=0.975, P0.0001; 12-13-year-old boys: r=0.786, P0.0001; 12-13-year-old girls: r=0.975, P0.000l). These results indicate that %BF can be predicted from BMI in Japanese children aged 9-10 and 12-13 years. The correlations in boys were not as strong as those observed in girls, that is, less variability was explained for girls than for boys. Further study will be necessary to ascertain whether the strong correlation seen among girls will be observed in different age or ethnic groups, and to ascertain the mechanism that produces this gender difference.

Waist circumference, not BMI, is one of the factors in the definition of metabolic syndrome in adults. In children, waist circumference is also a well known predictor of metabolic syndrome. However, waist circumference measurement is not as commonly recorded as weight and height measurements in physical examinations in schools. This means BMI data is available for every child, but waist circumference is not. Therefore, we investigated whether there is an alternative way to estimate waist circumference even in those children whose waist circumference measurement has not been taken. We evaluated the relationship between BMI and the waist circumference of schoolchildren using a relatively large-scale population-based cohort in Japan. There was a significant linear relationship between BMI and waist circumference noted in each age- and sex-divided group [9-10-year-old boys: waist=13.99+2.63BMI (r=0.940, p0.001), 9-10-year-old girls: waist=15.09+2.61BMI (r=0.933, p0.001), 12-13-year-old boys: waist=23.67+2.22BMI (r=0.880, p0.001), 12-13-year-old girls: waist=23.83+2.15BMI (r=0.859, p0.001)]. This means it is possible to estimate waist circumference from height and weight, at least among those age groups of children in Japan. This estimation could be an alternative way and useful in detecting childhood metabolic syndrome or obesity disease in which a waist circumference figure is necessary.

The aim of this study was to investigate long-term, cause-specific mortality trends among patients with childhood-onset type 1 diabetes in Japan.Individuals included in the study had received a diagnosis of type 1 diabetes at age18 years between 1965 and 1979. All individuals were followed up for their survival status until 1 January 2005. The causes of death were divided into end-stage renal disease (ESRD), acute diabetic complications (ADC), accident/suicide, cardiovascular disease (CVD), infections, cancers, others (non-diabetic/diabetic) and unknown. The cause-specific mortality trends were expressed according to the follow-up period and year of diagnosis.A total of 1,385 patients were enrolled in the study, and the survival status of 1,324 was confirmed. Mortality rate at the 35 year follow-up (per 100,000 person-years) was 659.3, and the standardised mortality ratio (SMR) was 10.7. The SMR at the 25 year follow-up markedly declined from 19.3 in the 1965-1969 diagnosis group to 6.6 in the 1975-1979 diagnosis group. Approximately 40% died of ADC among those with10 years of follow-up. A similar proportion of individuals died of ESRD among those with 10-19 years of follow-up. The longer the duration of follow-up, the lower the mortality from ADC and the greater the mortality from CVD.In Japanese people with childhood-onset type 1 diabetes of more than 20 years of duration, CVD was the leading cause of death, as is the case among similar white people. The longer the duration of diabetes, the more attention should be paid to preventing CVD.

The aim of the study was to investigate trends in the incidence of blindness and the association with laser photocoagulation in patients with type 1 diabetes in Japan.Patients diagnosed between 1965 and 1979 aged under 18 years old were studied. The status of blindness and laser photocoagulation was identified as of 1 January 1995. To examine the time trend, we divided the cohort into two groups: 285 patients diagnosed between 1965 and 1969 (65-69 cohort) and 769 patients diagnosed between 1975 and 1979 (75-79 cohort). Survival analysis was performed using the Kaplan-Meier method. Cox proportional hazard models were used to assess the demographic characteristics.Blindness developed in 60 subjects in the 65-69 cohort and 15 subjects in the 75-79 cohort. The incidence of blindness in the 75-79 cohort was significantly lower than that in the 65-69 cohort (p0.0001). In spite of no change in the use of laser photocoagulation in the 75-79 cohort compared with the 65-69 cohort, the hazard ratio for the blindness in those who received laser photocoagulation in the 75-79 cohort decreased significantly to 0.55 (p0.01) compared with those in the 65-69 cohort when adjusted for the age of onset, sex, and time of diagnosis.The incidence of blindness decreased significantly for the subjects diagnosed more recently. The change in quality and the earlier introduction of laser photocoagulation might have contributed to the decreased incidence of blindness observed over time.

We previously reported that mortality is worse for pubertal-onset type 1 diabetes than for the prepubertal-onset variety (1). Other studies have disparately reported that the risk for incipient microangiopathy in type 1 diabetic patients is higher during puberty than before puberty (2–4) or that the risk is similar (5,6). However, evidence regarding the relationship between puberty and advanced microangiopathy is limited (7). We therefore investigated the incidence of blindness and renal replacement therapy (RRT) by pubertal status at diagnosis. A total of 1,408 type 1 diabetic patients diagnosed at

In 760 children age 9 to 10 years, the serum adiponectin composition (high molecular weight [HMW], hexameric medium molecular weight [MMW], and trimeric low molecular weight [LMW]) was found to vary markedly depending on whether the total adiponectin value was high or low. A lower total adiponectin value was associated with a lower ratio of HMW adiponectin.

This study is to clarify whether obesity status affects glycated albumin (GA) and HbA1c levels in adults with type 2 diabetes. One hundred and seven individuals with type 2 diabetes without advanced complications participated in this study. The relationship between HbA1c, GA, hemoglobin (Hb), albumin (ALB), absolute value of GA (aGA) and Body Mass Index (BMI) were examined using Pearson's correlation coefficient. The comparison of each parameter was conducted using unpaired t-test between the obese (BMI> or =25) and the non-obese (BMI

A 51-year-old type 2 diabetic patient with a scrotal subcutaneous abscess is reported. He was diagnosed as having diabetes mellitus five years earlier. He had left scrotal swelling and pain with granulocytosis, elevated C-reactive protein and hyperglycemia. He was successfully treated with incision and drainage (Streptococcus agalactiae was identified in the pus), debridement, antibiotics, immunoglobulin and insulin. This case resembled Fournier's gangrene, an infective necrotizing fasciitis of the perineal, genital or perianal regions. Diabetes mellitus is a basic disorder often associated with Fournier's gangrene. Scrotal subcutaneous abscess should be prevented from progressing to Fournier's gangrene with early and appropriate treatment.

Objective The study examined changes in and relationship between body mass index (BMI), leptin and adiponectin levels over a 3-year period in a pediatric population-based cohort. Study design A 3-year prospective cohort study of 268 boys and 251 girls aged 9–10 in Ina, Saitama, Japan. Results Median body mass index (BMI) significantly increased from baseline (age 9–10) to follow up (age 12–13) in boys from 17.1 to 18.3 kg/m2 (P < 0.001) and in girls from 16.5 to 18.5 kg/m2 (P < 0.001), respectively. Adiponectin values significantly decreased from baseline to follow up in boys (13.5 to 8.9 μg/ml, respectively) (P < 0.001) and in girls (12.4 to 9.5 μg/ml, respectively) (P < 0.001). Leptin values at follow up significantly decreased from baseline in boys (4.9 to 2.3 ng/dl, respectively) (P < 0.001) and also in girls (5.3 to 5.1 ng/dl, respectively) (P = 0.049). A relatively strong correlation was seen in BMI (Spearman's correlation coefficient, r = 0.864, P < 0.001 in boys; r = 0.873, P < 0.001 in girls), adiponectin (r = 0.705, P < 0.001 in boys; r = 0.695, P < 0.001 in girls), and leptin (r = 0.449, P < 0.001 in boys; r = 0.610, P < 0.001 in girls) before and after the three-year period. The ratio of follow up to baseline BMI was negatively correlated with that for adiponectin (r = -0.224, P < 0.001 in boys; r = -0.165, P = 0.001 in girls) and positively correlated with that for leptin (r = 0.518, P < 0.001 in boys; r = 0.609, P < 0.001 in girls). Conclusion This study demonstrated that baseline adiponectin, leptin and BMI values measured at ages 9–10 correlated with those measured three years later. However, adiponectin values decreased and leptin values increased in those subjects whose BMI increased during over this period.