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Hideyo Yoshida

Publications and source records attributed to Hideyo Yoshida.

26 records · Page 2Linked to original sources

Association of molecular variants, haplotypes, and linkage disequilibrium within the human vitamin D-binding protein (DBP) gene with postmenopausal bone mineral density.

UNLABELLED: Possible contribution of vitamin D-binding protein (DBP) gene for determination of BMD was tested by characterizing 13 SNPs in 384 adult Japanese women. When the effect of a specific single SNP was tested, five SNPs (-39C>T, IVS1+827C>T, IVS1+1916C>T, IVS1-1154A>G, and IVS11+1097G>C) correlated with BMD significantly at various levels. The chromosomal dosage of one haplotype (T-C-C-G-T-C in -39C>T, IVS1+827C>T, IVS1+1916C>T, IVS1-1154A>G, D432E, and IVS11+1097G>C) displayed significant correlation with adjusted radial BMD (r = 0.15, p = 0.008; n = 331). Multiple regression analyses revealed a most significant correlation with the combination of IVS1+827C>T and D432E (r2 = 0.029, p = 0.005). These results indicate a complex combined effect of several SNPs within the DBP gene that might underlie susceptibility to low radial BMD and osteoporosis. INTRODUCTION: Osteoporosis results from the interplay of multiple environmental and genetic determinants. The gene encoding vitamin D-binding protein (DBP), a key factor for regulating calcium homeostasis through the vitamin D endocrine system, is a probable candidate for conferring susceptibility to osteoporosis. METHODS: To test a possible contribution of the DBP gene for determination of bone mineral density (BMD) of adult women, we have characterized 13 single nucleotide polymorphisms (SNPs) within the DBP gene in DNA from 384 adult Japanese women and attempted to correlate specific SNPs with BMD. RESULTS AND CONCLUSIONS: Sixteen major haplotypes accounted for 80% of the variations, indicating allelic complexity in this genomic region. Pairwise linkage disequilibrium (LD), measured by the D' and r2 statistics, demonstrated a general pattern of decline with increasing distance, but individual LD values within small genomic segments were diverse. Regression analysis for adjusted BMD revealed significant correlation with respect to five of them (-39C>T, IVS1+827C>T, IVS1+1916C>T, IVS1-1154A>G, and IVS11+1097G>C) at various levels. An intronic SNP (IVS11+1097G>C) with the highest significance of association (p = 0.006) showed significant LD with four SNPs located around the first exon (r2 values > 0.18, D' > 0.5). A non-synonymous coding SNP, D432E, showed a comparable level of correlation, but it was in a moderate LD only with IVS11+1097G>C. The chromosomal dosage of one haplotype (T-C-C-G-T-C in -39C>T, IVS1+827C>T, IVS1+1916C>T, IVS1-1154A>G, D432E and IVS11+1097G>C) estimated in each subject displayed significant correlation with adjusted radial BMD (r = 0.15, p = 0.008; n = 331). Furthermore, multiple regression analyses revealed that the most significant correlation was achieved for the combination of IVS1+827C>T and D432E (r2 = 0.029, p = 0.005). These results indicate a complex combined effect of several SNPs within the DBP gene that might underlie susceptibility to low radial BMD and osteoporosis.

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[Comprehensive health examination ("Otasha-Kenshin") for the prevention of geriatric syndromes and a bed-ridden state in the community elderly. 1. Differences in characteristics between participants and non-participants].

PURPOSE: We conducted a comprehensive mass health examination for elderly subjects aged 70 or above, living in the community, to assess early deterioration to long-term care conditions and promote healthy and successful aging ("Otasha-Kenshin"). In this study, we clarified characteristic differences between participants and non-participants. SUBJECTS & METHODS: A mass health examination was offered in October 2001 to 863 community elderly, including individuals suffering from falls (and fractures), incontinence, malnutrition, depression, mild cognitive impairment and less of functional capacity. Among the total, 438 (50.8%) opted for the "Otasha-Kenshin" examination. Differences in characteristics between the participants and non-participants were examined, parameters including sex and age distribution, self-rated health, functional capacity by the TMIG Index of Competence, depressed status by the General Health Questionnaire (GHQ), subjective well-being by the Philadelphia Geriatric Center Morale Scale: A revision (PGC-MS), frequency of falls, and prevalence of chronic diseases. The comparison was based on the results of measurements from the final survey conducted in 2000. RESULTS: 1) The participation rate in the "Otasha-Kenshin" was 49.0% in males and 51.0% in females. The average age was 75.3 year olds in participants and 76.4 in non-participants, the difference being significant (t = 3.97, P < 0.0001). 2) Non-participants had a significantly lower level of self-rated health than participants. 3) There was no significant difference in hand grip strength between participants and non-participants. 4) Non-participants showed significantly lower level of functional capacity and subjective well-being, and they were more likely to be in a depressed state than participants. 5) There was no significant difference in fall rate between participants and non-participants. 6) The prevalence of hypertension and diabetes (found in more than 5% among the subjects surveyed in 2000) was not significantly different between participants and non-participants. CONCLUSION: With aging of society, new and specialized health maintenance systems for the elderly are essential, both for the prevention of deterioration to a long-term care condition (a bed-ridden status) and for the promotion of successful aging with autonomy. Participants in "Otasha-Kenshin" appear to be healthier and more independent than non-participants who were more frail and at higher risk group of a long-term care condition and a bed-ridden status. The major reason for non-participation in the health examination found in this study was subjective or mental deterioration rather than the presence of chronic illness or any geriatric syndrome per se. Frail elderly people like the non-participants in this study should be encouraged and mentally supported to avoid aggravation of their health status through intensive or specialized health surveillance system such as home-visit nursing.

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[Functional status of community-dwelling frail elderly in the Japanese long-term care insurance system].

OBJECTIVE: To clarify exercise habits, self-rated functional fitness, activities of daily living (ADL) and fear of falling in community-dwelling elderly who are classified as frail by the eligibility decision process of the Japanese long-term care insurance system. METHODS: Subjects aged 75 years and older were classified into a frail elderly group (n = 126; male = 29, female = 97) and a healthy elderly group (n = 262; male = 114, female = 148). We had carried out an interview survey using questionnaire asking about exercise habits, self-rated functional fitness, ADL, fear of falling and activity curtailment. The survey was carried out by door-to-door method and data were collected from November to December 2000. RESULTS: Respondents who answered no practice of exercise were more likely to be in the frail elderly group. Among the self-rated functional fitness items, endurance, muscular strength and flexibility were comparatively low in the frail elderly group. The rates of basic ADL dependence were higher for bathing (males = 34.5%, females = 15.5%) and walking (males = 27.6%, females = 20.6%), for both sexes of the frail elderly group. Also, the rate of instrumental ADL dependence was much higher in the frail elderly group than in the healthy elderly group. Among frail elderly, 93.1% of males and 93.8% of females had fear of falling. Of those who were afraid, 66.7% of males and 60.4% of females curtailed going out due to this fear. CONCLUSIONS: Our findings suggest that intervention programs are needed to improve bathing and walking ability as well as to provide social support for the frail elderly. Self-rated fear of falling is significantly associated with activity curtailment in this population.

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[Cognitive function as the factor determining higher-level competence in community-dwelling elderly: comprehensive health examination for the community elderly for the prevention of the geriatric syndrome and a bed-ridden state ("otasha-kenshin")].

PURPOSE: This study was conducted to examine age-related differences in cognitive function, and their relation to higher-level competence of elderly living in an urban community. METHOD: Participants were 438 individuals (males 168, females 270) aged 70 to 84 years living in an urban community in Tokyo. Three cognitive performance tests, the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Digit Symbol, Word Fluency Test, and the WAIS-R Digit Span, were employed for estimating cognitive function, and the TMIG Index of Competence for measuring higher-level competence. In the Index, three constructions: "Instrumental Self-Maintenance", "Intellectual Activity", and "Social Role" were involved. RESULTS AND CONCLUSIONS: Age-related differences in the cognitive tests were analyzed using ANCOVA controlling for educational year. Age-related differences between younger elderly (70-79 years old) and older elderly (80-84 years old) were observed with the WAIS-R Digit Symbol, Word Fluency Test and the WAIS-R Digit Span. The results indicate that information processing speed, executive function and primary memory in community-dwelling elderly continue to decline in old age, and this trend is salient in the old-old. We carried out partial correlation analysis and multiple regression analysis for exploring the relationships between cognitive function and the sub-scales in the TMIG Index of Competence, controlling for age and educational year. Cognitive function was significantly and positively related with the sub-scales in the Index, this being especially robust for "Intellectual Activity". The results suggest that higher-level competence can be modestly determined with reference to cognitive function, and "Intellectual Activity" may have a stronger relation with cognitive function than the other two sub-scales in the Index.

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[Effects of dietary variety on declines in high-level functional capacity in elderly people living in a community].

OBJECTIVE: The purpose of the investigation was to assess effects of dietary variety on declines in high-level functional capacity in community dwelling elderly, based on a 5-year longitudinal study (from 1992 to 1997). SUBJECTS AND METHOD: Subjects were a representative sample comprising 235 men (mean age 70.8 years) and 373 women (71.7 years) aged 65 years and above, living in Nangai village in Akita prefecture. Baseline and follow-up surveys were undertaken by the interview method. For assessing dietary variety, we introduced the dietary variety score (DVS), counting the number of 10 food-groups consumed daily from food frequency questionnaires: meat, fish and shellfish, eggs, milk, soybean products, potatoes, green yellow vegetables, fruits, seaweed, and fat and oil. The DVS ranged from 0 to 10 with higher score indicating a higher dietary variety. We also evaluated higher-level functional capacity using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG Index of Competence). Effects of dietary variety on declines in TMIG Index of Competence were analyzed by multiple logistic regression analysis. RESULTS: The average TMIG Index of Competence score for men and women were 12.1 and 10.8 at baseline, respectively. The mean baseline DVS was 6.3 for men, and 6.2 for women. Relative to the reference groups with DVS in 1-3, the groups with 4-8 and 9-10 scores had lower risks for decrease in TMIG Index of Competence scores over the study period. Relative risks (95% confidence interval) of the groups with a DVS of 4-8 and 9-10 were 0.92 (0.50-1.67) and 0.71 (0.34-1.48) regarding instrumental self maintenance, 0.50 (0.29-0.86) and 0.40 (0.20-0.77) for intellectual activities, and 0.44 (0.26-0.75) and 0.43 (0.20-0.82) for social roles of sub-scales of TMIG Index of Competence, adjusting for age, sex, educational attainment, and the baseline TMIG Index of Competence scores. CONCLUSION: Higher dietary variety is associated with a reduced risk of higher-level functional decline in community dwelling elderly.

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[The importance and application of osteoporosis screening].

Osteoporosis screening is important from the viewpoint of not only early diagnosis of osteoporosis by bone mineral density measurements but also health promotion education for the prevention of osteoporosis. The perspective of prevention of osteoporosis is a consistent theme from childhood to the elderly. Measures to prevent bone loss throughout life is linked to an improved lifestyle such as paying attention to eating habit and exercise, and is expected to prevent other lifestyle-related diseases.

English Abstract↗

Markers of insulin resistance in day and shift workers aged 30-59 years.

OBJECTIVES: To examine relationships between shift work and markers (metabolic abnormalities) of insulin resistance (IR). METHODS: A cross-sectional study of 2,824 day and 826 shift workers. All the subjects were male blue-collar workers aged 30-59 years. Four IR markers [(1) hypertension (systolic blood pressure >or=140 mmHg or diastolic blood pressure >or=90 mmHg or under treatment for hypertension); (2) hyperglycemia (fasting serum glucose >or=7.00 mmol/l or under treatment for diabetes); (3) hypertriglyceridemia (fasting serum triglyceride >or=1.70 mmol/l or under treatment for hyperlipidemia); (4) hypo-HDL-cholesterolemia (fasting serum HDL-cholesterol <1.04 mmol/l)] were checked. Subsequently, IR syndrome, a cluster of IR markers, was expediently diagnosed by the number (N) of IR markers found in each worker. N>or=1, N>or=2 or N>or=3 was used as a cutpoint for the diagnosis. The prevalence of each IR marker and IR syndrome was compared between the two worker groups. Age, body mass index (kg/m(2)), job, drinking, smoking, and exercise were used as confounding factors. Job, work schedule and lifestyles were based on self-administered questionnaires. RESULTS: Hypertriglyceridemia (28.7% in day workers, 31.2% in shift workers) was most prevalent (4.6%), and hyperglycemia (5.4%) was least, in the four IR markers in both worker groups. Approximately half of the subjects had at least one IR marker in both groups (N>or=1; 46.0% and 46.6%, respectively). However, a full cluster of IR markers was rare in both groups (N=4; 0.2% and 0.1%, respectively). Prevalence of IR syndrome by any cutpoints increased with age in day workers, but shift workers aged 50 years or older had lower prevalence than shift workers younger than 50 years. In subjects younger than 50 years, all IR markers (except for hypo-HDL-cholesterolemia) and IR syndrome by any cutpoints were more prevalent in shift workers than in day workers. Contrariwise, in subjects aged 50 years or older, lower prevalence of all IR markers and IR syndrome in shift workers than in day workers was found. These results were not influenced by statistical adjustments for the confounding factors by multiple logistic regression analysis. CONCLUSIONS: Shift work may be associated with IR syndrome in workers younger than 50 years. These relations may be underestimated mainly by broad definition of shift work and healthy-worker effects.

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Longitudinal changes in higher-level functional capacity of an older population living in a Japanese urban community.

This study examined the present state and longitudinal changes in higher-level functional capacity in a Japanese urban community. Persons aged 65-84 years living in a suburb of central Tokyo participated in a baseline survey held in 1991 (n = 814) and followed-up for 8 years. Outcome measures were disabilities in: instrumental self-maintenance (IADL), the intellectual activity scale (intellectual activity) and the social role scale (social role), as measured by subscales of the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-index of competence). At baseline among the three subscales, both older men and women had the highest prevalence of disability in social role, followed in turn by intellectual activity and IADL disability. The 8-year longitudinal survey on subjects who had no initial disability (229 men and 235 women) in all three subscales of TMIG-index of competence demonstrated that they were most likely to lose social role function with advancing age, followed in turn by intellectual activity and IADL. The Cox proportional hazard model analysis for all 814 participants revealed that baseline level of social role and intellectual activity significantly predicted the new onset of IADL disability during the 8-year follow-up period even after controlling for gender, age, and chronic medical conditions. In summary, disability in social role and intellectual activity do not only likely precede IADL disability, but also predict significantly the future onset of IADL disability in a Japanese urban community older population.

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