The purpose of this study was to establish by way of trial reference interval of serum lipids (TC, HDL-C, TG and LDL-C) for old people aged 65 or over based on the document published by America's National Committee for Clinical Laboratory Standards. For this purpose, we used the results of the mass health screening tests run on a total of 14, 738 residents in Shimane Prefecture. We selected reference sample groups by excluding those examinees who had been undergoing medical treatment, those who had taken their meal less than 12 hours before, habitual drinkers and smokers, and those whose systolic blood pressure was more than 160mmHg, diastolic blood pressure upwards of 95mmHg, obesity level downwards -20% or upwards of +20%.
T-C values peaked in the age group of 50s for men, while for women in the age group of 60s. Regarding HDL-C values, women were generally high compared withmen, but mean values for women in their 60s were significantly low (p<0.01) compared with those for women in their 50s. TG values were higher in men than in women. LDLC levels showed the same tendency as T-C levels.
We compared the mean values of adults aged 64 or below and elders aged 65 or above. In the elders, the mean values for T-C, TG and LDL-C were significantly higher (p<0.01) than in the adults, and the mean HDL-C values were significantly lower (p<0.01) than in the adults.
These results indicated that the reference interval of elders of T-C, HDL-C, TG and LDL-C could be from 147 to 289mg/dl, from 37 to 99mg/dl, from 40 to 209mg/dl and from 70 to 200mg/dl, respectively.

　　Chronic kidney disease (CKD) has recently been reported to be an independent risk factor for stroke. However, a detailed analysis was yet to be conducted according to stroke subtype. We attempted to determine the risk factors for stroke using data from the “specific health checkup” for metabolic syndrome conducted by the 9 hospitals affiliated with the Akita Prefectural Federation of Agricultural Cooperatives, and evaluate and determine the risk factors for stroke. There were 401 patients who had undergone metabolic syndrome checkups from 2007 and 2010 and suffered from stroke afterwards within 3 years after the screening. The controls were all 69,407 subjects who were screened during the same period. The predictors examined were sex, age, blood pressure, BMI, cholesterol values (HDL・LDL), history of diabetes mellitus, presence of atrial fibrillation, CKD, and drinking and smoking habits. Analysis was conducted using logistic regression. The risk factors for stroke as a whole were male sex, age, blood pressure, diabetes, atrial fibrillation, CKD, and smoking history. For cerebral infarction, the risk factors were male sex, age, blood pressure, diabetes, atrial fibrillation, CKD, and smoking habit. The risk factors for cerebral hemorrhage were age, blood pressure, and CKD. For subarachnoid hemorrhage, the risk factors were female sex, age, blood pressure, low HDLemia, and CKD. In conclusion, CKD is an independent risk factor for the 3 subtypes of stroke, and in particular plays an important role as a higher risk factor for cerebral hemorrhage. Smoking cessation and controls of blood pressure, diabetes and atrial fibrillation are the important measures for stroke prevention. In addition, the further intervention should also be targeted to those with the result of CKD revealed by specific health checkups.

This study sought to demonstrate the benefits of conducting cervical cytology and human papillomavirus (HPV) testing in our cervical cancer screening program and was conducted between April 2012 and March 2017 in the Yuri-Honjo district of Akita Prefecture. A total of 3581 women aged 20-49 years underwent this combined screening for 5 years. Of these, 10.3% (369/3581) tested positive for HPV, and 433 women were initially diagnosed as positive for atypical squamous cells of undetermined significance and/or positive for HPV. Of those, 342 women (79.0%) underwent cervical biopsy, among whom 62 (18.1%) were diagnosed as positive for cervical intraepithelial neoplasia (CIN)2+. Of 204 women who were positive for HPV but showed no abnormalities in cytology, 24 women (11.8%) were positive for CIN2+ and 6 women were positive for CIN3+. Conventional cytology (Pap test) detected only 0.58% of the examinees positive for CIN2+ in Akita Prefecture, whereas our combined screening involving a Pap test and HPV testing detected 1.73% of the examinees (P<0.0001). We recommend HPV testing be used in combination with the Pap test to improve cervical cancer screening and accurately identify CIN2/3 disease.