Future directions of welfare care of the elderly : from the society with long life for realization of the protracted-life society

総説departmental bulletin pape

インクルーシブ概念のデザイン経営実践への適用可能性の検討

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Excessive daytime napping independently associated with decreased insulin sensitivity in cross-sectional study – Hyogo Sleep Cardio-Autonomic Atherosclerosis cohort study

BackgroundAlthough excessive daytime napping has been shown to be involved in diabetes occurrence, its impact on insulin secretion and sensitivity has not been elucidated. It is speculated that excessive napping disrupts the sleep-wake rhythm and increases sympathetic nerve activity during the day, resulting in decreased insulin sensitivity, which may be a mechanism leading to development of diabetes. We previously conducted a cross-sectional study that showed an association of autonomic dysfunction with decreased insulin sensitivity, though involvement of autonomic function in the association between napping and insulin sensitivity remained unclear. Furthermore, the effects of napping used to supplement to short nighttime sleep on insulin secretion and sensitivity are also unknown. In the present cross-sectional study, we examined the relationships of daytime nap duration and autonomic function with insulin secretion and sensitivity in 436 subjects enrolled in the Hyogo Sleep Cardio-Autonomic Atherosclerosis (HSCAA) Cohort Study who underwent a 75-g oral glucose tolerance test (75-g OGTT), after excluding those already diagnosed with diabetes.MethodsDaytime nap duration was objectively measured using actigraphy, with the subjects divided into the short (≤1 hour) and long (>1 hour) nap groups. Insulin secretion and sensitivity were determined using 75-g OGTT findings. Standard deviation of normal to normal R-R interval (SDNN), a measure of autonomic function, was also determined based on heart rate variability. Subgroup analysis was performed for the associations of napping with insulin secretion and sensitivity, with the results stratified by nighttime sleep duration of less or greater than six hours.ResultsSubjects in the long nap group exhibited lower insulin sensitivity parameters (QUICKI: β=-0.135, p<0.01; Matsuda index: β=-0.119, p<0.05) independent of other clinical factors. In contrast, no associations with insulin secretion were found in either group. Furthermore, the association of long nap duration with insulin sensitivity was not confounded by SDNN. Specific subgroup analyses revealed more prominent associations of long nap habit with lower insulin sensitivity in subjects with a short nighttime sleep time (β=-0.137, p<0.05).ConclusionLong daytime nap duration may be a potential risk factor for decreased insulin sensitivity

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活動報告departmental bulletin pape

Position and rate of intestinal fermentation in adult ostrich evaluated by volatile fatty acid

application/pdfThe study was conducted in Obihiro, Japan to examine the position and rate of intestinal fermentation in three adult ostriches (Struthio camelus) with mean liveweight of 103±4.7 kg. The ostriches were fed fresh leaves of orchardgrass (Dactylis glomerata). At twenty five hours before the slaughter, they ingested 100 g fresh leaves mixed with 20 g oblong strips (2mm wide and 30 mm long) of a filter paper, in which chromium oxide was absorbed at a rate of 40 %. After the slaughter, small intestine, cecum and large intestine were cut into 3, 2 and 7 pieces, respectively, with the same length in each organ. Crude ash content in digesta samples was the highest in muscular stomach (90.1±1.17 %), compared with 27-51 % in other organs of glandular stomach, small intestine and cecum. The percentages of both dry matter and organic matter were significantly higher in colon. The peak of chromium content was observed at the final position of large intestine, suggesting passage rate of grass leaves through all digestive organs being about 24 hours. A small peak of total content of volatile fatty acids was observed at middle part of small intestine, suggesting the commencement of volatile fatty acid forming in small intestine. The peaks of both total content of volatile fatty acids and acetic acid content were observed in colon, being 24.5±7.25 % and 15.5±5.75 %, respectively. Acetic acid content rapidly decreased at the following sites of large intestine, suggesting active absorption of acetic acid in colon.植物資源の利用を改善するために、平均生体重が103±4.7kgの3羽のダチョウ成鳥(Struthio camelus)における腸管内醗酵の場所と速度を調査した。ダチョウにオーチャードグラス(Dactylis glomerata)の葉身を給与し、屠殺の25時間前に100gの葉身と20gの長方形のロ紙(幅2mm、長さ30mm)を採食させた。ロ紙には40%の酸化クロム水溶液を吸着させておいた。屠殺後、小腸、盲腸、大腸を同じ長さになるようにそれぞれ3、2、7個に分割した。 消化管内容物中の粗灰分の割合は筋胃で最も高く(90.1±1.17 %)、腺胃、小腸、盲腸では27-51%であった。乾物と有機物の割合は盲腸で最も高かった。クロム濃度のピークは大腸の最後の部分で認められ、ダチョウ成鳥のすべての消化管を通過する時間は約24 時間と推察された。揮発性脂肪酸の総量の小さなピークが小腸の中間部で認められ、ここですでに醗酵が開始されていることを示唆していた。揮発性脂肪酸の総量と酢酸濃度の両方のピークが結腸で認められ、平均値はそれぞれ24.5±7.25 mmol/100ml と15.5±5.75 mmol/100ml であった。酢酸濃度は大腸を下行するにつれて急速に低下しており、酢酸は結腸において活発に吸収されていることが示唆された。departmental bulletin pape

Total and High Molecular Weight Adiponectin and Hepatocellular Carcinoma with HCV Infection

Adiponectin is shown to be inversely associated with development and progression of various cancers. We evaluated whether adiponectin level was associated with the prevalence and histological grade of hepatocellular carcinoma (HCC), and liver fibrosis in patients with hepatitis C virus (HCV) infection.A case-control study was conducted on 97 HCC patients (cases) and 97 patients (controls) matched for sex, Child-Pugh grade and platelet count in patients with HCV infection. The serum total and high molecular weight (HMW) adiponectin levels were measured by enzyme-linked immunosorbent assays and examined in their association with the prevalence of HCC. In addition, the relationship between these adiponectin levels and body mass index (BMI), progression of liver fibrosis, and histological grade of HCC was also evaluated. Liver fibrosis was assessed using the aspartate aminotransferase to platelet ratio index (APRI).There were no significant differences in the serum total and HMW adiponectin levels between cases and controls. Moreover, there were no inverse associations between serum total and HMW adiponectin levels and BMI in both cases and controls. On the other hand, serum total and HMW adiponectin levels are positively correlated with APRI in both cases (r = 0.491, P<0.001 and r = 0.485, P<0.001, respectively) and controls (r = 0.482, P<0.001 and r = 0.476, P<0.001, respectively). Interestingly, lower serum total (OR 11.76, 95% CI: 2.97–46.66 [P<0.001]) and HMW (OR 10.24, CI: 2.80–37.40 [P<0.001] adiponectin levels were independent risk factors of worse histological grade of HCC.Our results suggested that serum total and HMW adiponectin levels were predictors of liver fibrosis, but not prevalence of HCC in patients with HCV infection. Moreover, low these adiponectin levels were significantly associated with worse histological grades