Interrelationship among blood pressure, intraocular pressure, and life-style in middle-aged and older Japanese residents

To clarify the interrelationship among blood pressure (BP), intraocular pressure (IOP), and life-style related factors, a cross-sectional study was conducted. This epidemiological study analyzed health examination data obtained between 2001 and 2004 from 1113 Japanese individuals, ranging in age 28 to 79 years, who had not undergone any ocular surgery or medical treatment for hypertension, ocular hypertension, and glaucoma. The association of systolic and diastolic BP (SBP and DBP), and life-style related factors such as body mass index (BMI), drinking, smoking, and exercise habits with IOP were evaluated by multiple regression analyses and analyses of covariance. The results of this study showed that SBP, DBP, and BMI had a significantly positive association with IOP in both sexes. In men, the number of cigarette smoking per day was also positively related to IOP

Non-alcoholic fatty liver disease: What has changed in the treatment since the beginning?

Non-alcoholic fatty liver disease(NAFLD) is an umbrella term to describe the entire spectrum of this common liver disease. In patients with NAFLD, especially those with non-alcoholic steatohepatitis(NASH), most often have one or more components of the metabolic syndrome, but this is not universal. Although most patients with NAFLD share many clinical features, only a subset of patients develops significant liver inflammation and progressive fibrosis. On the other hand, not all patients with NASH exhibit insulin resistance. NASH can be seen in patients who are lean and have no identifiable risk factors. Many clinical studies have tried numerous drugs and alternative medicine, however, investigators have failed to identify a safe and effective therapy for patients with NASH. As summarized, the heterogeneity of pathogenic pathways in individual patients with NASH may warrant the development of an individualized treatment according to the underlying pathogenic pathway. The differentiation of pathogenetic targets may require the development of diagnostic and prognostic biomarkers, and the identification of genetic susceptibilities. At present, evidence-based medicine provides only a few options including life-style modifications targeting weight loss, pioglitazone and vitamin E in non-diabetic patients with biopsy-proven NASH.

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

AIM To determine the clinical effectiveness of nutritional counseling on reduction of non-alcoholic fatty liver disease(NAFLD) severity, weight loss, metabolic and anthropometric indexes and liver enzymes.METHODS Forty-six adults with NAFLD received a 6-mo clinical and a dietary intervention(based on Mediterranean diet) carried out respectively by a gastroenterologist and a nutritionist with counseling license. The counseling process consisted of monthly meeting(about 45 min each). The effect of the treatment was evaluated monitoring liver enzymes, metabolic parameters, cardiovascular risk indexes, NAFLD severity [assessed by ultrasound(US)] and related indexes. All parameters were assessed at baseline. Biochemistry was also assessed at mid-and end-interventions and US was repeated at end-intervention.RESULTS The percentage of patients with steatosis grade equal or higher than 2 was reduced from 93% to 48% and steatosis regressed in 9 patients(20%). At the end of the treatment the end-point concerning the weight(i.e., a 7% weight reduction or achievement/maintenance of normal weight) was accomplished by 25 out of 46 patients(i.e., 54.3%). As far as the liver enzymes is concerned, all three liver enzymes significantly decrease during the treatment the normalization was particularly evident for the ALT enzyme(altered values reduced from 67% down to 11%). Several parameters, i.e., BMI, waist circumference, waist-to-hip ratio, AST, ALT, GGT, HDL, serum glucose, Tot-Chol/HDL, LDL/HDL, TG/HDL, AIP, HOMA, FLI, Kotronen index, VAI, NAFLD liver fat score and LAP, showed a significant improvement(P < 0.01) between baseline and end-treatment.CONCLUSION Outcomes of this study further strengthen the hypothesis that Med Diet and more active lifestyle can be considered a safe therapeutic approach for reducing risk and severity of NAFLD and related disease states. The proposed approach may be proposed as a valid and recommended approach for improving the clinical profile of NAFLD patients.

Self-assessed health and its aspects in the case of Mongolia

Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects should be included in health self assessment, especially in developed world. In the developing world, however, very few studies have examined self health assessment. The aim of this study was to identify particular aspects and associations in self health assessment and differences between subgroups in Ulaanbaatar, Mongolia. The area sampling approach and Kish tables were used for selecting respondents. Total 500 respondents were surveyed by paper-based questionnaires. Spearman’s analysis and multiple logistic regression analysis were used to show relations between variables. Sociodemographic status, such as age and gender, proved to be important in self health assessment. Other factors affecting self health assessment included the number of family members, daily life and lifestyles, social environment, community motivation, and utilization of health services. Women, the elderly, or people with less-than- normal access to information suffer from poor self-assessed health. People who are socially inactive and who have poor living conditions are less likely to use health care services and are likely to assess their health as “poor.” In order to reduce the poor self-assessed health status it is important to address disparities in socioeconomic factors, such as age, gender, employment, and residential area. In addition, more attention should be paid to community and health services, as well as to health promotion and empowerment activities, including income-generation activities. Further research is also needed, however, for better understanding of about the local people and their health-related issues.