BACKGROUND: Increased triglycerides (TGs) and decreased high density lipoprotein cholesterol (HDL-C) levels are established as diabetic risks for nondiabetic subjects. The aim of this study was to investigate the relationship among TG, HDL-C, TG/HDL-C ratio, and early-phase insulin secretion in normoglycemic and prediabetic subjects. METHODS: We evaluated 663 Japanese subjects who underwent the 75-g oral glucose tolerance test. On the basis of these results, the subjects were divided into four groups: those with normal glucose tolerance (NGT; n=341), isolated impaired fasting glucose (i-IFG; n=211), isolated impaired glucose tolerance (i-IGT; n=71), and combined IFG and IGT (IFG+IGT; n=40). Insulin secretion was estimated by the insulinogenic index (IGI) (Deltainsulin/Deltaglucose [30 to 0 minutes]) and disposition index (DI) (IGI/homeostasis model assessment of insulin resistance). RESULTS: In prediabetic subjects (i-IFG, i-IGT, and IFG+IGT), linear regression analyses revealed that IGI and DI were positively correlated with HDL-C levels. Moreover, in subjects with i-IGT and (IFG+IGT), but not with i-IFG, the indices of insulin secretion were negatively correlated with the log-transformed TG and TG/HDL-C ratio. In both the subjects with i-IGT, multivariate linear regression analyses revealed that DI was positively correlated with HDL-C and negatively with log-transformed TG and TG/HDL-C ratio. On the other hand, in subjects with NGT, there was no association between insulin secretion and lipid profiles. CONCLUSION: These results revealed that serum TG and HDL-C levels have different impacts on early-phase insulin secretion on the basis of their glucose tolerance status.
Asian Continental Ancestry Group ; Cholesterol, HDL* ; Fasting ; Glucose ; Glucose Tolerance Test ; Hand ; Humans ; Insulin* ; Linear Models ; Triglycerides*

BACKGROUND: Structural characteristics of calcium phosphate cement (CPC) offer substantial mechanical integrity for fracture stabilization and fixation during the healing process, with particular applications in mechanically compromised osteoporotic bone.OBJECTIVE: To investigate the mechanism of the augmentation to fixation with CPC, comparing with screw fixation augmented by polymenthymethacrylate (PMMA) bone cement or with unaugmented screw fixation for femoral neck fractures in sheep by histological evaluation.DESIGN: Randomized controlled, duplicated observation and opening study.SETTING: Departments of Orthopeadics and General Surgery, the First Hospital of Jilin University; Department of Pathology, Basic Medical College of Jilin University; Department of Plastic Surgery, Aichi Medical University of Japan.MATERIALS: The experiment was completed in the Taonan Municipal Hospital of Jilin, Jilin University and Aichi Medical University of Japan from January 1999 to January 2004. A total of 45 adult sheep with mean age of 12.5 months were divided into three groups: unaugmentation group,CPC augmentation group and PMMA augmentation group with 15 in each group. Five sheep from each group were selected at 3, 6 and 12 weeks after operation. CPC was consisted of 75% α-tricalcium phosphate (α-TCP),18% tetracalcium phosphate (TeCP), 5% dicalcium phosphate dihydrate (DCPD) and 2% hydroxyapatite (HA). The solidify liquid was consisted of 5% sodium chondroitin sulphate, 12% sodium succinate and 83% water.The ratio between powder and water was 3:1. PMMA bone cement was combined with 97.4% methylmethacrylate, 2.6% N dimethyl-para-toluidine and hydroquinone.METHODS: ① Sheep from each group were anaesthetized by intravenous injection of pentobarbital sodium. The surgical steps were steotomy, drill,tap and fixation. An osteotomized bone at the base of right femoral neck of all groups was fixed by two cancellous bone screws of the diameter 4 mm through femoral neck at the site below great trochanter region. The cement material was filled into the screw hole before the screw insertion. ② CPC was injected into wells in CPC augmentation group, PMMA was injected into wells in PMMA augmentation group, but wells in unaugmentation group was not give any materials. ③After the maximum, compressive load was tested to detect intensity of healing bone, the specimens were fixed in 40%, 70%, 90% and 100% ethanol, dehydrated and stained, in the end embedded in PMMA resin. Serial histological specimens of 150-200 μm thickness were sliced along the long axis of the femoral neck with the microtom. The histological specimens also were taken for contact microradiography. The changes of the host bone and the new bone formation at the interface between cement and bone would be evaluated histologically until 3, 6 or 12 weeks after surgery.MAIN OUTCOME MEASURES: Changes of the host bone and the new bone formation in each group at various time points after operation.RESULTS: All 45 mature Chinese sheep were involved in the final analysis without any loss. Changes of the host bone and the new bone formation in each group at various time points after operation: ① Unaugmentation group: By 3 weeks after surgery, the thin fibrous tissue was found around the screw, and the host bone had micro-destruction. By 6 or 12 weeks after surgery, the micro-destruction of host bone was repaired. ② CPC augmentation group: By 3, 6 or 12 weeks after surgery, the most of gap between the screw and the host bone was occupied by this material, and the new bone connected directly to the material surface, and there was no intervening fibrous tissue between new bone and the material. Especially by 12weeks after surgery, a large quantity of the new bone was formed, and new bone was matured with many bone canals. ③ PMMA augmentation group:By 3 weeks after surgery, the thick fibrous tissue Between PMMA bone cement and the host bone, and the remarkable bone atrophy of host bone were found. By 6,12 weeks after surgery, the fibrous tissue and the bone atrophy were developed.CONCLUSION: CPC provide long-term beneficial augmentation of femoral neck fractures in sheep because of a good biocompatibility, good osteoconduction and capability of remodeling.

Objectives: Locomotive syndrome stage 3 (LS3), which has been established recently, may imply a greater need for care than LS stage 0 (LS0), LS stage 1 (LS1), and LS stage 2 (LS2). The relationship between LS3 and long-term care in Japan is unclear. Therefore, this study aimed to examine this relationship. Methods: A total of 531 patients (314 women and 217 men; mean age, 75 years) who were not classified as requiring long-term care and underwent musculoskeletal examinations in 2012 were grouped according to their LS stage. Group L comprised patients with LS3 and Group N comprised those with LS0, LS1, and LS2. We compared these groups according to their epidemiology results and long-term care requirements from 2013 to 2018. Results: Fifty-nine patients (11.1%) were diagnosed with LS3. Group L comprised more patients (50.8%) who required long-term care than Group N (17.8%) (P < 0.001). Group L also comprised more patients with vertebral fractures and knee osteoarthritis than Group N (33.9% vs 19.5% [P = 0.011] and 78% vs 56.4% [P < 0.001], respectively). A Cox proportional hazards model and Kaplan–Meier analysis revealed a significant difference in the need for nursing care between Groups L and N (log-rank test, P < 0.001; hazard ratio, 2.236; 95% confidence interval, 1.451–3.447). Conclusions Between 2012 and 2018, 50% of patients with LS3 required nursing care. Therefore, LS3 is a highrisk condition that necessitates interventions. Approaches to vertebral fractures and osteoarthritis of the knee could be key.

Methods: The subjects were 473 volunteers. They were divided into two groups (activity and non-activity) according to participation or non-participation in sporting activities using a self-filled questionnaire. The evaluation items were height, weight, grip strength, bone density, Hospital Anxiety and Depression Scale (HADS) score, standing radiographic parameters, PRO (evaluated by EuroQol-5 dimension [EQ-5D], Oswestry Disability Index [ODI]), and NDI. Results: There were 101 males in the non-activity group and 69 in the activity group and 178 females in the non-activity group and 125 in the activity group. For the males, the evaluation items with significant influence were cervical lordosis (non-activity group:activity group, 17°:22°) and T1 slope minus cervical lordosis (10°:6°, p <0.05). For the females, the evaluation items with significant influence were sagittal vertical axis (28:14 mm), HADS (10.4:8.4), EQ-5D (0.79:0.86), ODI (17:12), and NDI (12:9, p <0.01). HADS and PRO in the females were significantly correlated with the EQ-5D (−0.40), ODI (0.43), and NDI (0.55). Conclusions Males who participated in sporting activities had better cervical spine alignment but no effect on PRO. Females with sporting activities had better spinal global alignment and less mental stress. It is suggested that sporting activity in females might be associated with PRO because HADS highly correlates with PRO.