Because this study was conducted along with annual health examinations, a rapid and simple measurement was prerequisite. The intra- and inter-assay coefficients of variation for the OSI were 1.1–0.8%, respectively. Assessment of other variables Blood samples were drawn from the antecubital vein, with minimal tourniquet use, while the subjects were seated. Specimens were collected in siliconized vacuum glass tubes containing sodium fluoride for
fasting blood Nutlin-3a datasheet glucose and no additives for lipid analyses. Fasting blood glucose concentration was measured by enzymatic methods this website (Eerotec, Tokyo, Japan). The triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) concentrations were measured by enzymatic methods using appropriate kits (Sekisui Medical, Tokyo, Japan). Depressive symptoms were assessed according to the Japanese version  AZD0156 mouse of the Self-Rating Depression Scale (SDS). Participants were considered as depressive when the SDS score was 45 or more . Blood pressure (BP) in the left
upper arm was measured twice using an automatic device (YAMASU605P; Kenzmedico Co. Ltd., Saitama, Japan) following a 5-min rest in a seated position. The mean value was used as the BP value. Anthropometric parameters (height and body weight) were recorded using a standard protocol. Body mass index (BMI) was calculated as weight (kilogram) divided by height in meters squared. Sociodemographic variables, including
age and educational level, were also assessed. Educational level was assessed by determining the final grade level and was divided into two categories: lower than college level and college level and above. History of physical illness and current medication use were evaluated on the basis of “yes” or “no” responses to questions. History of fractures was obtained from a questionnaire owing to the unavailability of clinical data and was divided into two categories: those who had a history of lower extremity fractures and those who did not. Information on smoking status (never, former, or currently smoking and Brinkman index), alcohol-drinking status (never, ≥1 day/week, or 7 days/week), and occupation (desk based or not), was obtained from a questionnaire survey. Levels of daily physical activity click here (PA) were estimated using the International Physical Activity Questionnaire (Japanese version) , and categorized into tertiles (low, middle, and high). Calcium, vitamin D, and alcohol intake were estimated using a brief self-administered dietary history questionnaire . A diagnosis of metabolic syndrome (MS) was defined according to the modified Japanese criteria (defined by the Japanese Society for the Study of Obesity) . Statistical analysis All statistical analyses were performed using SPSS 17.0 for Windows (SPSS, Inc., Chicago, IL, USA).