自己組織化を基礎とする研究は、近年、世界中で急速な発展が見られる。この応用である自己組織化マップ（Self-Organizing Map: SOM）解析法については複雑系の事象データの分析に対して、非線形回帰法として分布型の如何に影響されないというメリットを有している。さらにSOMでは相互の類似関係を保持したまま全体を要約することができるという特長がある。

We propose to simultaneously display the front and back sides of the spherical SOM so that cluster locations can be expressed in terms of phase relations even if they are on opposite sides of the spherical SOM. The technique is showcased on the medical health care-data. Furthermore, the component map was converted numerically (DIM (Dimensional Interaction Map) mode) for the medical data case and the result compared with that obtained with the front and back sides of the map.

1973年に創設された当時の本学会名称はMultiphasic Health Testing and Services（MHTS）と英訳されていた。このことからも明らかなように、総合健診業務はMultiphasic（多相な）サービスの一つであり、生活者の様々な健康レベルを多角的・総合的に捉え、各個人への効果的な健康増進支援を実現するチーム医療の必然性が当初から認識されていた。本学会の樫田良精初代会長が臨床検査の精度管理調査を総合健診の継続的な事業の柱として位置づけられたこともその意図があったためと思われる。時が経過し、45年を経過した今日では人々の生活習慣は益々多様化し、社会構造や働く環境がグローバル化して変化の激しい時代となった。この中において、健康を阻害するリスク要因も多岐にわたり複雑化してきている。これらの多様なリスク増大時代を克服するためには、医師の専門的治療行為だけでは総合健診は遂行できず、医師以外の専門職種も加えた有機的な相互の信頼と協働のシステムが稼働する必要がある。その中で各職種の必要かつ効果的な業務拡大と連携のあり方が模索されている。 総合健診における臨床検査技師の役割と課題について、筆者は、臨床検査データの有効活用をさらに積極的に提示して、健診を利用する側である事業所や地域社会の生活者の健康増進の質（QOL）の向上に寄与し得る行動変容へ結びつける努力が最も重要であると考えている。従来の二次予防型健診から一次予防重視型健診へと総合健診の重点とその役割が移行しつつある現代においては、総合健診の新しいステージを迎え入れるために、「治未病（病気を治すのではなく、未病状態を治すこと）」の概念を意識した臨床検査の活用を図る検討がさらに望まれる。本学会の特色である「総合健診指導士」および「業務管理士」認定制度を活かし、新たなる臨床検査技師の使命とチャレンジをもって、現代予防医学に寄与できる面が多々あると考えられる。臨床検査のプロだからこそできる、検査の特性と精度および意義を踏まえた価値のある検査医学支援を基軸として、新しいバイオマーカーやゲノム情報等のエビデンスを蓄積して、発症前の予測にも寄与し得る検査知識・技能そして人格を有する専門職種の育成を今後に期待したい。

Background/Aims: It is possible that carnosinase (CNDP1) and cellular nonspecific dipeptidase (CNDP2) have important roles in protecting cells and tissues against the damage of oxidative stress. Oxidative stress and subsequent inflammation are key factors in the development of common chronic metabolic diseases, such as obesity. We aimed to investigate the combined effects of genetic variations in CNDP1 and CNDP2 and dietary carbohydrate and carotene intake on obesity risk. Methods: A total of 1,059 Japanese men were randomly selected from participants who visited a medical center for routine medical checkups. We analyzed the relationships between the genotypes of 4 single-nucleotide polymorphisms (SNPs) (rs12605520, rs7244647, rs4891558, and rs17089368) in the CNDP1/CNDP2 locus and body mass index or prevalence of obesity/overweight taking into account dietary carbohydrate and carotene intake. Results: We found that 2 SNPs (rs7244647 in CNDP1 and rs4891558 in CNDP2) were associated with obesity risk. In addition, these associations were observed only in the group with high carbohydrate and low carotene intake but not in the group with low carbohydrate and high carotene intake. Conclusions: Our findings indicate that the combination of genetic variations in CNDP1 and CNDP2 and dietary carbohydrate/carotene intake modulate obesity risk.

The relationship between drinking frequency and amount of alcohol consumption (i.e., drinking habits) and the risk of chronic kidney disease (CKD) remains unclear. We aimed to clarify either a linear or J-shaped dose-response relationship between drinking habits and estimated glomerular filtration rate (eGFR) as a biomarker for identifying individuals at high risk of CKD. In a large-scale cross-sectional study, 403 men and 121 women with an eGFR of 30-60 mL/min per 1.73 m(2) were defined as cases, and 1209 men and 363 women with >= 60 mL/min/1.73 m(2) were randomly extracted as controls (one case subject was matched with three control subjects, matched according to age and season of data collection). We calculated multivariate-adjusted CKD risk and the corresponding mean eGFR according to drinking habits. In men, negative and positive linear relationships with drinking habits were found for CKD risk and mean eGFR (p < 0.001 for all linear terms), respectively, but there were no corresponding J-shaped relationships (not significant for all quadratic terms). In regard to the mean eGFR, however, positive linear relationships were only shown in men in the highest eGFR quartile (p < 0.05 and p < 0.01 for drinking frequency and amount of alcohol consumption, respectively). In women, no association was found. Regarding each drinking habit, we found a positive linear dose-response relationship to eGFR in middle-aged men with an eGFR >= 30 mL/min/1.73 m(2). (C) 2016 Elsevier Inc. All rights reserved.

BACKGROUND:Modifying lifestyle factors such as diet and exercise can reduce the risk of cancer. Psychological stress (PS) might be indirectly associated with cancer because it alters lifestyle factors. However, the relationship among these variables has not been fully investigated. Thus, we examined interactions between self-reported PS (SRPS) and habitual exercise on diet. MATERIALS AND METHODS:In all, 5,587 men and 2,718 women were divided into "exerciser" and "non-exerciser" groups, based on whether they exercised regularly, and classified into three SRPS levels: low, moderate and high. Diet was estimated using a validated food frequency questionnaire. Using a general linear model, food and nutrient consumption was estimated for each SRPS level in the 2 exercise groups, and the interactions between SRPS levels and exercise were calculated. RESULTS:In women, the intake of pork and beef, low fat milk and yogurt, natto (fermented soybean), carrots and squash, other root vegetables, mushrooms, seaweeds, and wine, along with the nutrients vegetable protein, soluble, insoluble and total dietary fiber, daidzein, genistein, carotene, retinol equivalents, vitamin B2, pantothenic acid, potassium, calcium, magnesium, phosphorus and iron demonstrated significant interaction with SRPS and habitual exercise (p for interaction <0.05). In men, raw and green leafy vegetables and fruit and vegetable juice significantly interacted with SRPS and habitual exercise (p for interaction <0.05). CONCLUSIONS:We suggest that certain foods and nutrients, which are thought to have a protective effect against cancer, interact with SRPS and habitual exercise, especially in women. This information is valuable for understanding and improving interventions for cancer prevention.

At present, the Metabolic Syndrome (MS) is judged by checking whether a number of reference values are exceeded. It is regarded as non-metabolic if those values are not exceeded. Using our previously established non-ill area for these values, we evaluate their applicability in medical practice. We startwith a clinical survey of medical checkup data and apply our methodology to six items of the checkup sheet: glucose metabolism, liver, diabetes, kidney, blood-general and inflamed-immunity. We outline our methodology, called Dr. Ningendock, and evaluate it on the results of the liver function.

Recent genome-wide association studies (GWAS) have identified many SNPs associated with type 2 diabetes mellitus (T2DM). However, the functional roles for most of the SNPs have not been elucidated. MicroRNAs (miRNAs) are key regulators of gene expression involved in the development and progression of various diseases including T2DM. In this study, we investigated whether commonly occurring SNPs modulate miRNA-directed regulation of gene expression, and whether such SNPs in miRNA-binding sites are associated with the susceptibility for T2DM.

BACKGROUND:In Japan, in comparison with the rest of the world the death rate of lung cancer is low although the smoking rate is relatively high. This is the so-called "Japanese smoking paradox". A healthy diet is proposed to attenuate the risk without quitting smoking. We here examined the relationships between smoking status (SS) and the consumption of food and nutrient in Japan.MATERIALS AND METHODS:Totals of 5,587 men and 2,718 women were divided into three (non-smokers, smokers and heavy smokers) and two (non-smokers and smokers) groups, respectively, according to pack-year, which represents the amount of smoking over a long period. Food and nutrient consumption was estimated with a validated food frequency questionnaire. Using general linear models, food and nutrient consumption was estimated for each group in men and women, separately.RESULTS:In men, SS was positively related to consumption of rice, 3 alcoholic beverages, carbohydrate, alcohol and other 8 foods/nutrients (p<0.05 for all) and negatively to those of protein animal, fat, fatty acids, dietary fiber, isoflavones and 36 other foods/nutrients (p<0.05 for all). In women, SS was positively associated with intake of 13 foods/nutrients, while being negatively associated with those of rice, energy, dietary fiber, and 14 other foods/nutrients (p<0.05 for all).CONCLUSIONS:Our results support lower intake of vegetables and fruits rich in antioxidants, which are thought as preventive factors for many diseases, in smokers.

We wished to examine potential associations among blood concentrations of fatty acid-binding protein (FABP) 4 and parameters in health check-ups such as abdominal fat area (AFA) and blood pressure (BP) in middle-aged Japanese males. We conducted a cross-sectional study of males who participated in health check-ups in Japan. We excluded participants diagnosed with metabolic diseases by the time of their check-up. A total of 305 subjects (30-64 [mean±standard deviation, 47.3±8.5] y) were recruited. Areas of total-abdominal, visceral and subcutaneous fat were measured using computed tomography. We compared the association of serum concentrations of FABP4 with various clinical parameters by Pearson product-moment correlation coefficient (PPMCC) analyses, and by step-wise multivariate linear regression analyses (MLRA). PPMCC analyses showed that blood concentrations of FABP4 were positively associated with: body mass index; areas of fat (total abdominal, visceral, subcutaneous); systolic BP; diastolic BP; total cholesterol; low-density lipoprotein-cholesterol; triacylglycerol; activities of γ-glutamyl transpeptidase, aspartate aminotransferase and alanine aminotransferase; white blood cell count; and levels of creatinine. Step-wise MLRA showed that AFAs (visceral and subcutaneous) and diastolic BP were positively and independently associated with serum concentrations of FABP4 among the parameters tested. These data suggest that serum concentrations of FABP4 are independently and positively associated with BP and AFA among parameters measured in health check-ups in middle-aged Japanese males.

The aim of this study was to investigate the interaction between psychological stress (PS) and drinking status in relation to diet among middle-aged Japanese men and women in a large-scale cross-sectional study. The study population included 5,587 middle-aged Japanese men and 2,718 middle-aged Japanese women who underwent annual health checkups. The subjects were divided into 2 groups (non-drinkers and drinkers) and classified as having low, moderate, or high self-reported PS levels. Energy-adjusted food and nutrient consumption was assessed with a validated food frequency questionnaire. Using a general linear model, food and nutrient consumption was estimated for each self-reported PS level in the 2 groups (non-drinkers and drinkers) and the interactions between self-reported PS levels and drinking status were calculated. In men, pork and beef; squid. octopus, shrimp, and clams; eggs; mushrooms; Japanese-style sweets; ice cream; bread; Chinese noodles; coffee; and soda as foods and protein, animal protein, fat, animal fat, carbohydrate, monounsaturated fatty acid, polyunsaturated fatty acid (PUFA), n-3 PUFA, n-6 PUFA, cholesterol, vitamin D, vitamin B-2, vitamin B-6, vitamin B-12, niacin, pantothenic acid, magnesium, phosphorus, and zinc as nutrients significantly interacted with self-reported PS levels and drinking status (p for interaction <0.05 for all). No specific interactions were found in women. These findings suggest interactions between PS levels and drinking status with consumption of some foods and nutrients, especially macronutrient intake, in men but not in women.

Inflammation has been suggested to play an important role in age-related chronic diseases and disability, and it is associated with nutritional status including obesity and malnutrition. While numerous studies have examined the validity of inflammatory markers in the population studies in Caucasian elderly people, very little information is available for the factors affecting inflammatory markers in Asian elderly people. Among inflammatory markers frequently used for the studies of aging, tumor necrosis factor α (TNF-α) is produced mainly by macrophages, and contributes to production of interleukin-6 (IL-6) and C-reactive protein (CRP), thus directing a chronic inflammatory process in the body. In the present study, we examined the associations between plasma TNF-α level and several factors related to nutrition status, including BMI, albumin, and energy intake in community-dwelling Japanese elderly. We conducted a cross-sectional study of 390 men and women aged 70-86 y (average 73.5 y), who participated in health check-ups. Associations between plasma TNF-α levels, other clinical parameters, and lifestyle factors were analyzed using Spearman's rank correlation coefficient analysis and multiple linear regression analysis. In elderly men, plasma TNF-α level was positively associated with age, white blood cell count, monocyte count, plasma CRP level, serum creatinine, ureic acid, and triacylglycerol levels, and negatively associated with albumin/globulin ratio, eGFR, and serum HDL-cholesterol level. In elderly women, plasma TNF-α level was positively associated with age, plasma CRP level, and serum triacylglycerol level, and negatively associated with serum albumin and HDL-cholesterol levels. The results of this study suggest that plasma TNF-α is associated with inflammation and insulin resistance in both Japanese elderly men and women, and a prominent association of TNF-α with malnutrition status was observed in elderly women.

Faster eating is positively associated with body mass index in apparently healthy Japanese populations. In the present study, we examined the associations between self-reported rate of eating and visceral and subcutaneous fat areas in apparently healthy middle-aged Japanese men.

Increased levels of circulating soluble type of E-selectin (sE-selectin), neutrophil counts and blood pressure are associated with the development of cardiovascular diseases (CVD). In this study, we conducted a cross-sectional study of men who participated in health check-ups, and selected those who were not diagnosed with or being treated for metabolic diseases such as diabetes, hypertension and lipid abnormality according to the health check-ups. We measured their basic clinical parameters including blood pressure and neutrophil count, plasma sE-selectin concentration and lifestyle factors, and assessed their interrelations by multivariate linear regression (MLR) analysis. A total of 351 subjects aged 47.5±8.41 (range, 30-64) y were recruited. Significantly correlated with sE-selectin concentration were neutrophil count, diastolic blood pressure (DBP), and systolic blood pressure (SBP) (Pearson's correlation coefficient, 0.194, 0.220 and 0.175, respectively). MLR analysis showed that sE-selectin concentration was independently positively related with DBP and neutrophil count, whereas neutrophil count was positively associated with sE-selectin concentration but not DBP. DBP, but not SBP, was independently positively correlated with sE-selectin concentration but not neutrophil count. These results indicate that circulating sE-selectin concentration may be a biomarker for indicating subsequent development of metabolic diseases, in particular CVD, from a healthy state.

Background Dyslipidemia due to high total cholesterol, LDL-cholesterol, triglycerides, or low HDL-cholesterol is an important risk factor for coronary heart disease (CHD). Both SIRT1 and PUFAs can influence the expression of genes for nuclear receptors and transcription factors related to lipid metabolism such as LXRα, LXRβ, PPARα, SREBP-1c. Methods A total of 707 Japanese males and 723 females were randomly selected from the participants who visited a medical center for routine medical check-ups. We analyzed the combined effects of the genotype/haplotype of the SIRT1 gene and dietary n-6/n-3 PUFA intake ratio on the determination of serum lipid levels. Results We found that the SIRT1 gene marked with haplotype 2 was associated with decreased serum LDL-cholesterol and increased HDL-cholesterol levels. In addition, the associations between the SIRT1 haplotype 2 and decreased LDL-C and increased HDL-C levels were only observed in the low n-6/n-3 PUFA intake ratio group, but not in the high n-6/n-3 PUFA intake ratio group. Conclusions Our findings indicate that the combination of genetic variation in the SIRT1 gene and dietary n-6 and/or n-3 PUFA intake influence the determination of inter-individual variations of serum levels of LDL-C and HDL-C.

Elevated circulating activities of alanine aminotransferase (ALT), a marker for liver injury, and the lifestyle of a higher rate of eating in healthy and preclinical subjects are associated with increased risk of obesity and diabetes. In this study, we examined the associations between self-reported rate of eating and circulating ALT activity in middle-aged apparently healthy Japanese men.

Obesity is a complex multifactorial disorder resulting from the action and interaction of many genetic factors and environmental factors. Recently, it has become clear that inflammation is a key feature of obesity. Long-chain ω-3 polyunsaturated fatty acids (PUFA) have anti-inflammatory effects, and the G protein-coupled receptor GPR120 was reported to mediate the anti-inflammatory effects of ω-3 PUFAs. In addition, it was reported that GPR120 is involved in the development of obesity in mice and humans. In this study, we investigated whether common genetic variants of the GPR120 gene could influence the risk of obesity in a Japanese population. Our data suggest that the combination of common genetic variations in the GPR120 gene and dietary fat intake is a possible determinant of body mass index.