Published papers

© 2019 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objective Assessment of total energy expenditure (TEE) is essential for appropriate recommendations regarding dietary intake and physical activity in patients with and without diabetes mellitus (DM). However, few reports have focused on TEE in patients with DM, particularly in Asian countries. Therefore, we evaluated TEE in Japanese patients with DM using the doubly labeled water (DLW) method and physical activity level (PAL). Research design and methods In this cross-sectional observational study, we evaluated 52 patients with type 2 DM and 15 patients without DM. Free-living TEE was measured over 12-16 days by the DLW method, and PAL was calculated as TEE divided by the basal metabolic rate (BMR) as assessed by indirect calorimetry. The equivalence margin was defined as 5 kcal/kg/day. Results The numbers of patients with DM treated with insulin, oral antidiabetic drugs, and diet were 18 (34.6%), 20 (38.5%), and 14 (26.9%), respectively. The mean±SD level of glycated hemoglobin was 6.9%±0.8% and 5.5%±0.3% in the DM and non-DM group, respectively (p<0.001). The mean body mass index was 23.3±3.0 and 22.7±2.1 kg/m 2 in the DM and non-DM group, respectively. The mean TEE per kilogram body weight adjusted for sex and age was 36.5 kcal/kg/day and 37.5 kcal/kg/day in the DM and non-DM group, respectively, with no significant difference (mean difference,-1.0 kcal/kg/day; 95% CI-4.2 to 2.3 kcal/kg/day). The BMR tended to be higher in the DM than in the non-DM group (mean difference, 33 kcal/day; 95% CI,-15 to 80 kcal/day). The mean PAL adjusted for sex and age was 1.71 and 1.81 in the DM and non-DM group, respectively, without a significant difference (mean difference,-0.10; 95% CI-0.21 to 0.01). Conclusion TEE was comparable between Japanese patients with and without DM. Trial registration number UMIN000023051.

粉末油脂とは、平均粒子径約1μmの微細な油脂が糖質やタンパク質などでカプセル化された油脂製品であり、食品に使用することにより調理性や風味の付与、食感改良など様々な機能を発揮することが知られている。これまでに、脂質の消化・吸収について、粒子径の大きさが影響を与えることが示唆されているが、粉末油脂の消化・吸収についての検証は十分とは言えない。本研究では、健常若年成人男性を対象に、粉末油脂と液状油を摂取させ、血中中性脂肪(TG)値の推移を比較した。対象者24名でそれぞれ粉末油脂および液状油を摂取させ、0時間から6時間後まで1時間おきに計7回採血を行い、血中TGを測定した。その結果、粉末油脂と液状油ともに血中TG値は摂取後3時間でピークとなった。摂取後0時間から3時間において、血中TG値の推移は油脂の種類と時間で有意な交互作用が認められ、液状油摂取時に比べ粉末油脂摂取時で血中TG変化量の曲線下面積が有意に大きかった。以上より、液状油と比べ粉末油脂の一定時間における吸収量が多い可能性が示唆された。(著者抄録)

　The purpose of this study is to examine the validity of two obesity indices, BMI and waist circumference （WC）, regarding the diagnosis of dyslipidemia among a worksite population. Worksite annual health check-up data in 2013 involving 15,289 subjects were utilized for this study. After subjects with missing values, on lipid-lowering medication, with TG values of ≥ 600 mg/dl, under 20 years or over 60 years of age, and smokers were excluded, we eventually analyzed 8,189 subjects （3,990 men, 4,199 women）. In this population, the diagnostic validity of the following three cut-off values was evaluated: 1） BMI ≥ 25 （BMI criteria）, 2） WC ≥ 85 cm （men） and ≥ 90 cm （women） （JASSO WC criteria）, and 3） WC ≥ 90 cm （men） and ≥ 80 cm （women） （WHO WC criteria）. Among each age and sex strata, relatively high odds ratios were observed for high triglyceridemia （TG ≥ 150 mg/dl） and low HDL-cholesterolemia （HDL-C＜40 mg/dl）, especially when both the JASSO and WHO WC criteria were used. The ROC curve analysis showed moderately high diagnostic abilities of both BMI and WC for high TG and low HDL-cholesterol values with the AUC range of 0.70 to 0.79 and that the appropriate BMI and WC cut-off values were 23 and 80 cm for both the men and women, respectively.　In this population, both BMI and WC were related to high triglyceridemia and low HDL-cholesterolemia, and the appropriate cut-off values for both of these conditions were BMI of 23 and WC of 80 cm for both the men and women.