Fatty Acid Accumulation and Resulting PPARα Activation in Fibroblasts due to Trifunctional Protein Deficiency

To examine fatty acid accumulation and its toxic effects in cells, we analyzed skin fibroblasts from six patients with mitochondrial trifunctional protein deficiency, who had abnormalities in the second through fourth reactions in fatty acid β-oxidation system. We found free fatty acid accumulation, enhanced three acyl-CoA dehydrogenases, catalyzing the first reaction in the β-oxidation system and being assumed to have normal activities in these patients, and PPARα activation that was confirmed in the experiments using MK886, a PPARα specific antagonist and fenofibrate, a PPARα specific agonist. These novel findings suggest that the fatty acid accumulation and the resulting PPARα activation are major causes of the increase in the β-oxidation ability as probable compensation for fatty acid metabolism in the patients' fibroblasts, and that enhanced cell proliferation and increased oxidative stress due to the PPARα activation relate to the development of specific clinical features such as hypertrophic cardiomyopathy, slight hepatomegaly, and skeletal myopathy. Additionally, significant suppression of the PPARα activation by means of MK886 treatment is assumed to provide a new method of treating this deficiency

摂食障害女性患者と栄養関連情報との関わり

Although eating disorder (ED) patients have a great interest in diet-related information, their method of seeking nutritional information appears to be imbalanced. In the present study, we assessed diet experience, enthusiasm for nutritional or health information, methods for gathering the information, and the reason for gathering information in patients with ED and without ED in a general hospital outpatient setting in Japan. 29 women with ED and 33 age-matched women without ED participated in the study. The assessment was based on a structured interview by a psychiatrist. Though the prevalence of dieting does not differ between two groups, the beginning of dieting was earlier in ED group (17.8 ± 3.2 y.o.) than in the control group (23.0 ± 7.5 y.o.). Compared to the control group, ED patients recognized themselves that their level of interest about nutrition is high and they were confident about their knowledge. However, ED patients preferred to gather nutritional information from the media based on convenience, not on reliability. We suggest that the efficiency-seeking behavior might be too strong in ED patients and that modification of information gathering behavior would contribute to nutritional counseling of ED patients

摂食障害の発症予防は可能か--やせ礼賛文化との共生を目指して

Eating disorders are medical psychiatric and social problem among adolescent girls and young adult women. The severe situation surrounding the eating disorders is recognized in Japan, because the prevalence of the patients is probably increasing, and the onset is getting younger. However, medical resources are limited in the current Japanese health care system. Thus, the effective prevention is also necessary for the eating disorders as well as other life-style diseases. Nutrition education may be contributable to prevent the disordered eating behaviors. In this review, we introduced the prevention trials developed and performed in western countries and Japan to date, and discussed the possibility of nutritional education for contributing to the prevention of the eating disorders

長野県内の小学生と中学生の摂食態度について

This study examined eating attitudes in early adolescents and pre-adolescents, using Eating Attitudes Test (EAT)-26 to search the characteristic tendency leading to eating disorders, and differences between sexes and grades among adolescents. The participants are 314 in 5th, 6th grades of an elementary school and 1,361 in two junior high schools in Nagano Prefecture. A total 1,287 subjects, excluding unavailable responses are analyzed. The average EAT-26 total score was higher in female students and increased by grades : 0.99 ± 2.42 (5th grade in elementary school) to 2.60 ± 4.34 (3rd grade in junior high school) in the male students and also, 0.97 ± 2.31 to 4.58 ± 4.91 in the female students. The numbers of the students whose scores were above cut-off point were observed 0.84% (girl) in 6th grade in elementary school, 0.94% (boys) and 1.80% (girls) in junior high school. The top 3 questions scored more than 2 point of EAT-26 among the female students both junior high and high school were following: “#11. Am occupied with a desire to be thinner”, “#1. Am terrified about being overweight” and “#14. Am preoccupied with the thought of having fat on my body”. Enhancement of thin ideal and food avoidance was observed in junior high school students. These results suggest the importance of preventive intervention through food and nutrition education in early school ages must be important

Peroxisome proliferator-activated receptor alpha mediates enhancement of gene expression of cerebroside sulfotransferase in several murine organs

Sulfatides, 3-O-sulfogalactosylceramides, are known to have multifunctional properties. These molecules are distributed in various tissues of mammals, where they are synthesized from galactosylceramides by sulfation at C3 of the galactosyl residue. Although this reaction is specifically catalyzed by cerebroside sulfotransferase (CST), the mechanisms underlying the transcriptional regulation of this enzyme are not understood. With respect to this issue, we previously found potential sequences of peroxisome proliferator-activated receptor (PPAR) response element on upstream regions of the mouse CST gene and presumed the possible regulation by the nuclear receptor PPAR alpha. To confirm this hypothesis, we treated wild-type and Ppara-null mice with the specific PPAR alpha agonist fenofibrate and examined the amounts of sulfatides and CST gene expression in various tissues. Fenofibrate treatment increased sulfatides and CST mRNA levels in the kidney, heart, liver, and small intestine in a PPAR alpha-dependent manner. However, these effects of fenofibrate were absent in the brain or colon. Fenofibrate treatment did not affect the mRNA level of arylsulfatase A, which is the key enzyme for catalyzing desulfation of sulfatides, in any of these six tissues. Analyses of the DNA-binding activity and conventional gene expression targets of PPAR alpha has demonstrated that fenofibrate treatment activated PPAR alpha in the kidney, heart, liver, and small intestine but did not affect the brain or colon. These findings suggest that PPAR alpha activation induces CST gene expression and enhances sulfatide synthesis in mice, which suggests that PPAR alpha is a possible transcriptional regulator for the mouse CST gene.ArticleGLYCOCONJUGATE JOURNAL. 30(6):553-560 (2013)journal articl

Multiple roles of PPAR alpha in brown adipose tissue under constitutive and cold conditions

Peroxisome proliferator-activated receptor alpha (PPAR alpha) is a member of the nuclear receptor family, regulating fatty acid degradation in many organs. Two-dimensional SDS-PAGE of brown adipose tissue (BAT) from PPAR alpha-null mice produced a higher-density spot. Proteomic analysis indicated that the protein was pyruvate dehydrogenase beta (PDH beta). To observe PDH beta regulation in BAT, the organ was stimulated by long-term cold exposure, and the activities of associated enzymes were investigated. Histological and biochemical analyses of BAT showed a significant decrease in the triglyceride content in wild-type mice and some degree of decrease in PPAR alpha-null mice on cold exposure. Analyses of molecules related to glucose metabolism showed that the expression of PDH beta is under PPAR alpha-specific regulation, and that glucose degradation ability may decrease on cold exposure. In contrast, analyses of molecules related to fatty acid metabolism showed that numerous PPAR alpha/gamma target molecules are induced on cold exposure, and that fatty acid degradation ability in wild-type mice is markedly enhanced and also increases to same degree in PPAR alpha-null mice on cold exposure. Thus, this study proposes novel and multiple roles of PPAR alpha in BAT.ArticleGENES TO CELLS. 15(2):91-100 (2010)journal articl

摂食障害患者が主宰するウェブサイトの特徴について

We surveyed all the Japanese websites associated with eating disorders regis- tered to the major search engines in July - August, 2005. The total number surveyed is 195 sites. We could not access 69 sites at the starting of this research. Site authors(N = 126) are categorized as follows: Patients(female), 56 96; Patients(male), 6 96; Survivors(female), 27 96; Survivors(male) 2 96; Clinics/hospitals or related people, 8 96; Others, 1 96. Particularly, we focused on the sites offered by the patients and survivors. To estimate activities of the sites, we visited the same sites in a two-week interval. About 396 of the sites were closed or disappeared in the two weeks. Three authors were dead with their sites left. We found that the people who declare themselves as a survivor and/or who have been successfully cared, tended to offer the more creative and rich sites in their contents and provided useful information to other patients who are suffered from the problematic eating behavior and/or the self-harmed behavior. Those sites are active: many people visited and left their messages to the site authors; the authors themselves uploaded the contents such as their diaries and responded to those messages left by the visitors. In contrast, the patients who seem to be ill tended to provide poor contents and/or give up to upload in a comparatively short period after opening the sites. Less people visited the sites; the authors did not respond to them. Interestingly, topics between the authors and the visitors on the websites were more focused on their suffering in the sites offered by the patients than those by the survivors, although most of the visitors were patients

高齢者の胃瘻栄養法などの経管栄養に関する選択と意思表示について

The recent development of tube feeding enables a person who is unable to take anything by mouth because of aging and/or diseases to be alive longer. To present, a percutaneous endoscopic gastrostomy (PEG) has been frequently used because of its convenience and safety. However, the easy use of PEG has been criticized and reconsidered during the last decade. The problem associated with the decision making of the patient and his/her family is still remained. Sometimes the family faces to the decision making process with a conflict on behalf of their family member who is supposed to be fed by tube. Therefore, it would be convenient for us to utilize a “living will display card” similar to an “organ supply will display card” in order to show our living will. We examined the knowledge and the attitude toward tube feeding at the end-of-life nutrition among the people lived in the northern part of Nagano prefecture, and to obtain their evaluation about a “living will display card”, which we proposed. A questionnaire survey was preformed and the recovery rate was 92%. 　As results, the survey revealed a poor knowledge of the subjects about the tube feeding. Less than 40% of the subjects did not know the fact that the living will is not necessarily required for starting the tube feeding. The knowledge about the tube feeding based on their personal experiences seemed to contribute the refusal of persistent use of tube feeding. About a half of the subjects affirmatively answered to use “living will display card”. More than 70% of the subjects showed the respect toward their family member’s will in case the member would refuse the tube feeding in the end-of-life using the card. Not only the “living will display card” would let the family to respect their member’s will, it would also provide them a chance to discuss about nutrition at the end-of-life for their family member

Health Checkup and Telemedical Intervention Program for Preventive Medicine in Developing Countries: Verification Study

Background: The prevalence of non-communicable diseases is increasing throughout the world, including developing countries. / Objective: The intent was to conduct a study of a preventive medical service in a developing country, combining eHealth checkups and teleconsultation as well as assess stratification rules and the short-term effects of intervention. / Methods: We developed an eHealth system that comprises a set of sensor devices in an attaché case, a data transmission system linked to a mobile network, and a data management application. We provided eHealth checkups for the populations of five villages and the employees of five factories/offices in Bangladesh. Individual health condition was automatically categorized into four grades based on international diagnostic standards: green (healthy), yellow (caution), orange (affected), and red (emergent). We provided teleconsultation for orange- and red-grade subjects and we provided teleprescription for these subjects as required. / Results: The first checkup was provided to 16,741 subjects. After one year, 2361 subjects participated in the second checkup and the systolic blood pressure of these subjects was significantly decreased from an average of 121 mmHg to an average of 116 mmHg (P<.001). Based on these results, we propose a cost-effective method using a machine learning technique (random forest method) using the medical interview, subject profiles, and checkup results as predictor to avoid costly measurements of blood sugar, to ensure sustainability of the program in developing countries. / Conclusions: The results of this study demonstrate the benefits of an eHealth checkup and teleconsultation program as an effective health care system in developing countries

マンガに描かれる女性の体形と日本人若年女性のボディイメージ

日本のマンガの持つ内容の広さ、豊かさ、洗練性および画像表現の自由度は、読む者のボディイメージに強い影響を与える可能性がある。マンガにおける若年女性の体形の描かれ方に関して、ジャンル別(男性向け一女性向け、成人向け-子供向け)の体形の特徴、物語上の役割や人物の性格が体形に及ぼす影響、作者の性別と作品のジャンルの関係について検討した。描かれた身体像は、現代日本の若年女性の標準体形と比較して、若年女子短期大学生らの視点から評価した。男性向けのマンガではやや細いウェストと大きなヒップを持った若年女性が描かれているのに対して、女性向けのマンガではウェスト・ヒップ共に細い若年女性が描かれていた。作品中の若年女性の役割や性格と体形の関係では、女性誌において女性性や母性がいずれも細い身体像と結びつき、また依存性が太いウェストと結びついていた。男性向けのマンガを男性が画いている一方、女性向けのマンガは女性が画いていた。これらの結果から、マンガにおいては非現実的な「やせ理想像」が、女性読者を対象として、女性マンガ家により作られていることが示された