{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T11:13:57Z","timestamp":1772709237512,"version":"3.50.1"},"reference-count":30,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,11,15]]},"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined the associations of body flexibility with carotid arterial remodelling, including intima\u2013media thickness (IMT) and plaque formation in middle-aged men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The subjects of this cross-sectional study included 1354 Japanese men aged 35\u201359 years without histories of stroke or cardiac diseases. The arm extensibility test, which can estimate flexibility of the upper extremity (composed of shoulder external rotation and forearm supination), and the sit-and-reach test were performed. Common carotid IMT and plaque formation (\u22651.1\u2009mm) were estimated by ultrasound.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The proportion of subjects who fully completed the arm extensibility test was 55.0%, and who had plaques in the common carotid artery was 37.8%. IMT was associated with poor arm extensibility (\u03b2=\u20130.073, 95% CI \u20130.02224 to\n                      <jats:underline>\u2013<\/jats:underline>\n                      0.00041, P=0.004), while plaque formation was associated with poor sit-and-reach (OR 0.98579, 95% CI 0.97257 to 0.99919, P=0.038) after adjustment by all covariates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrated that poor upper extremity and trunk flexibility were associated with characteristics of early onset of atherosclerosis. Furthermore, these associations were independent of covariates such as age, blood pressure, blood lipids glucose levels and abdominal fat accumulation, handgrip strength and lifestyle, including sleeping, drinking, exercise and smoking habits. Poor flexibility may reflect subclinical atherosclerosis in middle-aged men.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019370","type":"journal-article","created":{"date-parts":[[2018,1,6]],"date-time":"2018-01-06T01:56:16Z","timestamp":1515203776000},"page":"e019370","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Association of body flexibility and carotid atherosclerosis in Japanese middle-aged men: a cross-sectional study"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1169-5448","authenticated-orcid":false,"given":"Masataka","family":"Suwa","sequence":"first","affiliation":[{"name":"Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayuki","family":"Imoto","sequence":"additional","affiliation":[{"name":"Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Kida","sequence":"additional","affiliation":[{"name":"Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Yokochi","sequence":"additional","affiliation":[{"name":"Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan"},{"name":"Midtown Clinic Meieki, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsunori","family":"Iwase","sequence":"additional","affiliation":[{"name":"Toyota Memorial Hospital, Toyota, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Kozawa","sequence":"additional","affiliation":[{"name":"Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,5]]},"reference":[{"key":"2025121604202075000_8.1.e019370.1","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.permed.2012.01.006","article-title":"Carotid intima-media thickness (cIMT) and plaque from risk assessment and clinical use to genetic discoveries","volume":"1","author":"Bartels","year":"2012","journal-title":"Perspectives in Medicine"},{"key":"2025121604202075000_8.1.e019370.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.628875"},{"key":"2025121604202075000_8.1.e019370.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1012592"},{"key":"2025121604202075000_8.1.e019370.4","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000303969.63165.34"},{"key":"2025121604202075000_8.1.e019370.5","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/j.1600-0404.2009.01210.x","article-title":"Ultrasonographic measurements of subclinical carotid atherosclerosis in prediction of ischemic stroke","volume":"120","author":"Mathiesen","year":"2009","journal-title":"Acta Neurol Scand"},{"key":"2025121604202075000_8.1.e019370.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2006.00068.x"},{"key":"2025121604202075000_8.1.e019370.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62000-6"},{"key":"2025121604202075000_8.1.e019370.8","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000461"},{"key":"2025121604202075000_8.1.e019370.9","unstructured":"American College of Sports Medicine. Section 2, Exercise testing. 4, Health-related physical fitness testing and interpretation. In: Pescatello LS , Arena R , Riebe D , Thompson PD , et al . eds. ACSM\u2019s guidelines for exercise testing and prescription. 9th edn. Philadelphia (PA): Lippincott Williams & Wilkins, 2014:60\u2013113."},{"key":"2025121604202075000_8.1.e019370.10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0113646","article-title":"Sex differences in flexibility-arterial stiffness relationship and its application for diagnosis of arterial stiffening: a cross-sectional observational study","volume":"9","author":"Nishiwaki","year":"2014","journal-title":"PLoS One"},{"key":"2025121604202075000_8.1.e019370.11","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00061.2009"},{"key":"2025121604202075000_8.1.e019370.12","doi-asserted-by":"crossref","first-page":"901","DOI":"10.5551\/jat.28035","article-title":"The association between the cardio-ankle vascular index and other parameters of vascular structure and function in caucasian adults: MARK study","volume":"22","author":"Gomez-Sanchez","year":"2015","journal-title":"J Atheroscler Thromb"},{"key":"2025121604202075000_8.1.e019370.13","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s13047-017-0196-3","article-title":"Age-related reduction and independent predictors of toe flexor strength in middle-aged men","volume":"10","author":"Suwa","year":"2017","journal-title":"J Foot Ankle Res"},{"key":"2025121604202075000_8.1.e019370.14","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/s10396-009-0238-y","article-title":"terminology and diagnostic criteria committee, Japan society of ultrasonics in medicine. standard method for ultrasound evaluation of carotid artery lesions","volume":"36","author":"Anon","year":"2009","journal-title":"J Med Ultrason"},{"key":"2025121604202075000_8.1.e019370.15","doi-asserted-by":"crossref","first-page":"82","DOI":"10.3109\/07853890.2010.526138","article-title":"Absolute value of visceral fat area measured on computed tomography scans and obesity-related cardiovascular risk factors in large-scale Japanese general population (the VACATION-J study)","volume":"44","author":"Hiuge-Shimizu","year":"2012","journal-title":"Ann Med"},{"key":"2025121604202075000_8.1.e019370.16","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.2.454"},{"key":"2025121604202075000_8.1.e019370.17","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1253\/circj.72.598","article-title":"Cardio-ankle vascular index is a candidate predictor of coronary atherosclerosis","volume":"72","author":"Nakamura","year":"2008","journal-title":"Circ J"},{"key":"2025121604202075000_8.1.e019370.18","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-10-0910"},{"key":"2025121604202075000_8.1.e019370.19","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2005.036053"},{"key":"2025121604202075000_8.1.e019370.20","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1186\/s40064-015-1337-4","article-title":"Four weeks of regular static stretching reduces arterial stiffness in middle-aged men","volume":"4","author":"Nishiwaki","year":"2015","journal-title":"Springerplus"},{"key":"2025121604202075000_8.1.e019370.21","doi-asserted-by":"publisher","DOI":"10.1097\/HJR.0b013e3282f02fe2"},{"key":"2025121604202075000_8.1.e019370.22","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.ctim.2015.06.002","article-title":"Effect of yoga on arterial stiffness in elderly subjects with increased pulse pressure: a randomized controlled study","volume":"23","author":"Patil","year":"2015","journal-title":"Complement Ther Med"},{"key":"2025121604202075000_8.1.e019370.23","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.612010"},{"key":"2025121604202075000_8.1.e019370.24","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-006-0075-z"},{"key":"2025121604202075000_8.1.e019370.25","unstructured":"American College of Sports Medicine. Section 1, Health appraisal and risk assessment. 1, Benefits and risks associated with physical activity. In: Pescatello LS , Arena R , Riebe D , Thompson PD , et al . eds. ACSM\u2019s guidelines for exercise testing and prescription. 9th edn. Philadelphia (PA): Lippincott Williams & Wilkins, 2014:2\u201318."},{"key":"2025121604202075000_8.1.e019370.26","doi-asserted-by":"publisher","DOI":"10.5551\/jat.6924"},{"key":"2025121604202075000_8.1.e019370.27","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-134-1-200101020-00008"},{"key":"2025121604202075000_8.1.e019370.28","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-198910000-00001"},{"key":"2025121604202075000_8.1.e019370.29","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.71.3.490"},{"key":"2025121604202075000_8.1.e019370.30","first-page":"77","volume-title":"McDonald\u2019s blood flow in arteries theoretic, experimental, and clinical principles","volume":"142","author":"Nichols","year":"1990"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-019370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:20:30Z","timestamp":1765887630000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-019370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,1,5]]},"published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1136\/bmjopen-2017-019370"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-019370","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1]]}}}