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Iwasawa T, Aoyagi Y, Suda S, Ishiyama D, Toi K, Ohashi M, Kimura K. Prevalence and outcome of pre-onset frailty in patients with acute stroke. Top Stroke Rehabil 2024; 31:493-500. [PMID: 38108292 DOI: 10.1080/10749357.2023.2291898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Frailty in older individuals is an underappreciated condition that affects the incidence and/or prognosis of stroke. OBJECTIVES We evaluated the prevalence of pre-onset frailty in patients with acute first-onset and recurrent strokes and association between pre-onset frailty and functional disability at hospital discharge. METHODS This prospective cohort study included 210 acute stroke patients admitted to the Stroke Unit of Nippon Medical School Hospital during November 2021-June 2022. The mean participant age was 79.2 ± 7.4 years. Age, sex, pre-onset frailty, body mass index (BMI), stroke type, medical history, and National Institutes of Health Stroke Scale (NIHSS) score at admission were evaluated. Frailty was defined as a clinical frailty scale (CFS) score ≥ 5. Frailty prevalence was calculated for all patients, and scores of functional disabilities at discharge were evaluated using modified Rankin scale. RESULTS Overall frailty prevalence was 31% in all stroke patients, with 24% and 47% of first-onset and recurrent strokes, respectively. Pre-onset frailty, NIHSS score at admission, age, stroke type, previous stroke, sex, BMI, dyslipidemia, and atrial fibrillation were significantly associated with functional disability at discharge. Logistic regression analysis revealed that CFS score, NIHSS score at admission, and previous stroke were independent predictors of functional disability at discharge. CONCLUSIONS Approximately one-fourth of patients with first-onset stroke had pre-onset frailty; the rate doubled in recurrent stroke; these rates appear to be much larger than rate in healthy individuals. Pre-onset frailty, a negative independent factor affecting functional disability at discharge, is important for pre-onset frailty evaluation and rehabilitation intervention in acute stroke patients.
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Affiliation(s)
- Tatsuya Iwasawa
- Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan
- Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan
- Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Satoshi Suda
- Department of Neurology, Nippon Medical School, Tokyo, Japan
| | - Daisuke Ishiyama
- Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - Kennosuke Toi
- Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - Miho Ohashi
- Department of Rehabilitation Medicine, Nippon Medical School Hospital, Tokyo, Japan
- Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazumi Kimura
- Department of Neurology, Nippon Medical School, Tokyo, Japan
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2
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Yii F, Nguyen L, Strang N, Bernabeu MO, Tatham AJ, MacGillivray T, Dhillon B. Factors associated with pathologic myopia onset and progression: A systematic review and meta-analysis. Ophthalmic Physiol Opt 2024; 44:963-976. [PMID: 38563652 DOI: 10.1111/opo.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE To synthesise evidence across studies on factors associated with pathologic myopia (PM) onset and progression based on the META-analysis for Pathologic Myopia (META-PM) classification framework. METHODS Findings from six longitudinal studies (5-18 years) were narratively synthesised and meta-analysed, using odds ratio (OR) as the common measure of association. All studies adjusted for baseline myopia, age and sex at a minimum. The quality of evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation framework. RESULTS Five out of six studies were conducted in Asia. There was inconclusive evidence of an independent effect (or lack thereof) of ethnicity and sex on PM onset/progression. The odds of PM onset increased with greater axial length (pooled OR: 2.03; 95% CI: 1.71-2.40; p < 0.001), older age (pooled OR: 1.07; 1.05-1.09; p < 0.001) and more negative spherical equivalent refraction, SER (OR: 0.77; 0.68-0.87; p < 0.001), all of which were supported by an acceptable level of evidence. Fundus tessellation was found to independently increase the odds of PM onset in a population-based study (OR: 3.02; 2.58-3.53; p < 0.001), although this was only supported by weak evidence. There was acceptable evidence that greater axial length (pooled OR: 1.23; 1.09-1.39; p < 0.001), more negative SER (pooled OR: 0.87; 0.83-0.92; p < 0.001) and higher education level (pooled OR: 3.17; 1.36-7.35; p < 0.01) increased the odds of PM progression. Other baseline factors found to be associated with PM progression but currently supported by weak evidence included age (pooled OR: 1.01), severity of myopic maculopathy (OR: 3.61), intraocular pressure (OR: 1.62) and hypertension (OR: 0.21). CONCLUSIONS Most PM risk/prognostic factors are not supported by an adequate evidence base at present (an indication that PM remains understudied). Current factors for which an acceptable level of evidence exists (limited in number) are unmodifiable in adults and lack personalised information. More longitudinal studies focusing on uncovering modifiable factors and imaging biomarkers are warranted.
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Affiliation(s)
- Fabian Yii
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Linda Nguyen
- MRC Human Genetics Unit, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - Niall Strang
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Miguel O Bernabeu
- Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
- The Bayes Centre, The University of Edinburgh, Edinburgh, UK
| | - Andrew J Tatham
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
| | - Tom MacGillivray
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Baljean Dhillon
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
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Yamashita S, Kiyosue A, Maheux P, Mena-Madrazo J, Lesogor A, Shao Q, Tamaki Y, Nakamura H, Akahori M, Kajinami K. Efficacy, Safety, and Pharmacokinetics of Inclisiran in Japanese Patients: Results from ORION-15. J Atheroscler Thromb 2024; 31:876-903. [PMID: 38220186 DOI: 10.5551/jat.64454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
AIM To evaluate the efficacy, safety, and pharmacokinetics (PK) of inclisiran in Japanese patients with high cardiovascular risk and elevated low-density lipoprotein cholesterol (LDL-C). METHODS ORION-15 was a phase 2, double-blind, placebo-controlled randomized trial. Patients with hypercholesterolemia, including heterozygous familial hypercholesterolemia (HeFH), were randomized to inclisiran sodium 100, 200, or 300 mg, or placebo and dosed subcutaneously on Days 1, 90, and 270. The primary endpoint was the percentage change from baseline to Day 180 to demonstrate the superiority of inclisiran vs. placebo. Patients who consented to the PK substudy had additional study procedures for blood collection and safety assessment. RESULTS Overall, 312 patients (mean age, 63.6 years; male, 74.4%; baseline LDL-C, 114.0 mg/dL) were randomized. Baseline characteristics were well balanced among the groups. At Day 180, inclisiran at all doses demonstrated significant LDL-C and proprotein convertase subtilisin/kexin type 9 (PCSK9) reductions (p<0.0001 for both), which showed a dose-response relationship. The greatest reductions (LDL-C, 65.3%; PCSK9, 79.2%) were with inclisiran sodium 300 mg. At Day 180, >86% of the patients receiving inclisiran achieved the Japan Atherosclerosis Society 2017 lipid management targets compared to 8.9% for placebo. The mean (SD) plasma half-life for inclisiran was 6.8 (2.0)-7.6 (0.8) h. The incidence of adverse events with inclisiran was similar to that with placebo. CONCLUSION Inclisiran sodium 100, 200, and 300 mg demonstrated clinically meaningful and statistically significant LDL-C and PCSK9 reductions at Day 180, which were consistent over 12 months. Inclisiran was effective and well tolerated in Japanese patients with hypercholesterolemia, including HeFH.
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Affiliation(s)
| | | | | | | | | | - Qing Shao
- Novartis Pharmaceuticals Corporation
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4
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Nakamura S, Ueda E, Ohara T, Hata J, Honda T, Fujiwara K, Furuta Y, Shibata M, Hashimoto S, Nakazawa T, Nakao T, Kitazono T, Sonoda KH, Ninomiya T. Association between retinopathy and risk of dementia in a general Japanese population: the Hisayama Study. Sci Rep 2024; 14:12017. [PMID: 38797729 PMCID: PMC11128440 DOI: 10.1038/s41598-024-62688-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
We investigated the association of retinopathy with the risk of dementia in a general older Japanese population. A total of 1709 population-based residents aged 60 years or older without dementia were followed prospectively for 10 years (2007-2017). They underwent color fundus photography in 2007. Retinopathy was graded according to the Modified Airlie House Classification. Main outcome was the Incidence of dementia. A Cox proportional hazards model was used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) for the risk of dementia by the presence of retinopathy. During the follow-up period, 374 participants developed all-cause dementia. The cumulative incidence of dementia was significantly higher in those with retinopathy than those without (p < 0.05). Individuals with retinopathy had significantly higher risk of developing dementia than those without after adjustment for potential confounding factors (HR 1.64, 95% CI 1.19-2.25). Regarding the components of retinopathy, the presence of microaneurysms was significantly associated with a higher multivariable-adjusted HR for incident dementia (HR 1.94, 95% CI 1.37-2.74). Our findings suggest that, in addition to systemic risk factors, retinal microvascular signs from fundus photography provide valuable information for estimating the risk of developing dementia.
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Affiliation(s)
- Shun Nakamura
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Emi Ueda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Tomoyuki Ohara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohta Fujiwara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Sawako Hashimoto
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Taro Nakazawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Tabara Y, Shoji-Asahina A, Ogawa A, Sato Y. Additive association of blood pressure and short stature with stroke incidence in 450,000 Japanese adults: the Shizuoka study. Hypertens Res 2024:10.1038/s41440-024-01702-x. [PMID: 38755286 DOI: 10.1038/s41440-024-01702-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 04/03/2024] [Accepted: 04/07/2024] [Indexed: 05/18/2024]
Abstract
Short stature was suggested to be a risk factor for cardiovascular events. Because short stature increases central blood pressure, this study aimed to investigate a longitudinal association between short stature, blood pressure, and incidence of cardiovascular disease by the analysis of insurance-based real-world dataset. We analyzed data from 463,844 adults aged 40 or older with a mean age of 66.7 enrolled in National Health Insurance, excluding individuals who experienced a stroke or myocardial infarction, or required long-term care. Data from annual health checkups were used to obtain baseline clinical information. Comorbidities and incidences of stroke and myocardial infarction were obtained from the insurance data. During a 5.5-year follow-up period, we observed 11,027 cases of stroke. Adults of a short stature exhibited a higher incidence rate in both men (≤155 cm: 99.7, >175 cm: 24.4) and women (≤140 cm: 85.9, >160 cm: 13.7). Although those in the short stature group had higher blood pressure, and often took antihypertensive drugs, the inverse association between height and stroke incidence was independent of these factors (hazard ratio for 5 cm shorter in height; men: 1.06 [1.03-1.09], women: 1.11 [1.06-1.13]). Short stature and blood pressure showed additive association with stoke incidence (log-rank p < 0.001). No significant association was observed with myocardial infarction (men: 1.01 [0.95-1.06], women: 1.06 [0.98-1.14]). In a longitudinal analysis of a large general Japanese population, short stature was linked to an increased risk of stroke in both genders in any blood pressure range.
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Affiliation(s)
- Yasuharu Tabara
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, 420-0881, Japan.
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Aya Shoji-Asahina
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, 420-0881, Japan
| | - Aya Ogawa
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, 420-0881, Japan
| | - Yoko Sato
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka, 420-0881, Japan
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Yatsuya H, Yamagishi K, Li Y, Saito I, Kokubo Y, Muraki I, Inoue M, Tsugane S, Iso H, Sawada N. Risk and Population Attributable Fraction of Stroke Subtypes in Japan. J Epidemiol 2024; 34:211-217. [PMID: 37460296 PMCID: PMC10999523 DOI: 10.2188/jea.je20220364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/20/2023] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Associations of major risk factors for stroke with total and each type of stroke, as well as subtypes of ischemic stroke, and their population attributable fractions had not been examined comprehensively. METHODS Participants of the Japan Public Health Center-based prospective (JPHC) Study Cohort II without histories of cardiovascular disease and cancer (n = 14,797) were followed from 1993 through 2012. Associations of current smoking, hypertension, diabetes, overweight (body mass index ≥25 kg/m2), non-high-density lipoprotein cholesterol (non-HDLC) categories, low HDLC (<40 mg/dL), urine protein, and history of arrhythmia were examined in a mutually-adjusted Cox regression model that included age and sex. Population attributable fractions (PAFs) were estimated using the hazard ratios and the prevalence of risk factors among cases. RESULTS Subjects with hypertension were 1.63 to 1.84 times more likely to develop any type of stroke. Diabetes, low HDLC, current smoking, overweight, urine protein, and arrhythmia were associated with risk of overall and ischemic stroke. Hypertension and urine protein were associated with risk of intracerebral hemorrhage, while current smoking, hypertension, and low non-HDLC were associated with subarachnoid hemorrhage. Hypertension alone accounted for more than a quarter of stroke incidence, followed by current smoking and diabetes. High non-HDLC, current smoking, low HDLC, and overweight contributed mostly to large-artery occlusive stroke. Arrhythmia explained 13.2% of embolic stroke. Combined PAFs of all the modifiable risk factors for total, ischemic, and large-artery occlusive strokes were 36.7%, 44.5%, and 61.5%, respectively. CONCLUSION Although there are differences according to subtypes, hypertension could be regarded as the most crucial target for preventing strokes in Japan.
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Affiliation(s)
- Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Yuanying Li
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Isao Muraki
- Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Manami Inoue
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- International University of Health and Welfare Graduate School of Public Health, Tokyo, Japan
| | - Hiroyasu Iso
- The Institute for Global Health Policy, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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Fujiyoshi A, Kohsaka S, Hata J, Hara M, Kai H, Masuda D, Miyamatsu N, Nishio Y, Ogura M, Sata M, Sekiguchi K, Takeya Y, Tamura K, Wakatsuki A, Yoshida H, Fujioka Y, Fukazawa R, Hamada O, Higashiyama A, Kabayama M, Kanaoka K, Kawaguchi K, Kosaka S, Kunimura A, Miyazaki A, Nii M, Sawano M, Terauchi M, Yagi S, Akasaka T, Minamino T, Miura K, Node K. JCS 2023 Guideline on the Primary Prevention of Coronary Artery Disease. Circ J 2024; 88:763-842. [PMID: 38479862 DOI: 10.1253/circj.cj-23-0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Affiliation(s)
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
| | - Mitsuhiko Hara
- Department of Health and Nutrition, Wayo Women's University
| | - Hisashi Kai
- Department of Cardiology, Kurume Univeristy Medical Center
| | | | - Naomi Miyamatsu
- Department of Clinical Nursing, Shiga University of Medical Science
| | - Yoshihiko Nishio
- Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Masatsune Ogura
- Department of General Medical Science, Chiba University School of Medicine
- Department of Metabolism and Endocrinology, Eastern Chiba Medical Center
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | | | - Yasushi Takeya
- Division of Helath Science, Osaka University Gradiate School of Medicine
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
| | | | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | - Yoshio Fujioka
- Division of Clinical Nutrition, Faculty of Nutrition, Kobe Gakuin University
| | | | - Osamu Hamada
- Department of General Internal Medicine, Takatsuki General Hospital
| | | | - Mai Kabayama
- Division of Health Sciences, Osaka University Graduate School of Medicine
| | - Koshiro Kanaoka
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center
| | - Kenjiro Kawaguchi
- Division of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University
| | | | | | | | - Masaki Nii
- Department of Cardiology, Shizuoka Children's Hospital
| | - Mitsuaki Sawano
- Department of Cardiology, Keio University School of Medicine
- Yale New Haven Hospital Center for Outcomes Research and Evaluation
| | | | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Nishinomiya Watanabe Cardiovascular Cerebral Center
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Meidicine
| | - Katsuyuki Miura
- Department of Preventive Medicine, NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
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Lim MJR, Zheng H, Zhang Z, Sia CH, Tan BYQ, Hock Ong ME, Nga VDW, Yeo TT, Ho AFW. Trends in hemorrhagic stroke incidence and mortality in a National Stroke Registry of a multi-ethnic Asian population. Eur Stroke J 2024; 9:189-199. [PMID: 37776052 PMCID: PMC10916808 DOI: 10.1177/23969873231202392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/04/2023] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION High-quality epidemiological data on hemorrhagic stroke (HS) and its subtypes, intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH), remains limited in Asian ethnicities. We investigated the trends in HS incidence and 30-day mortality from 2005 to 2019 in a multi-ethnic Asian population from a national registry. PATIENTS AND METHODS Data on all stroke cases from the Singapore Stroke Registry from 2005 to 2019 were collected. Cases were defined using centrally adjudicated review of diagnosis codes. Death outcomes were obtained by linkage with the national death registry. Incidence (per 100,000 people) and 30-day mortality (per 100 people) were measured as crude and age-standardized rates. Trends were analyzed using linear regression. RESULTS We analyzed 19,017 cases of HS (83.9% ICH; 16.1% SAH). From 2005 to 2019, age-standardized incidence rates (ASIR) for HS remained stable from 34.4 to 34.5. However, age-standardized mortality rates (ASMR) decreased significantly from 29.5 to 21.4 (p < 0.001). For ICH, ASIR remained stable while ASMR decreased from 30.4 to 21.3 (p < 0.001); for SAH, ASIR increased from 2.7 to 6.0 (p = 0.006) while ASMR remained stable. In subgroup analyses, HS incidence increased significantly in persons <65 years (from 18.1 to 19.6) and Malays (from 39.5 to 49.7). DISCUSSION From 2005 to 2019, ASIR of HS remained stable while ASMR decreased. Decreasing ASMR reflects improvements in the overall management of HS, consistent with global trends. CONCLUSION Population health efforts to address modifiable risk factors for HS in specific demographic subgroups may be warranted to reduce incidence and mortality of HS.
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Affiliation(s)
| | - Huili Zheng
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Zheting Zhang
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Ching Hui Sia
- Department of Cardiology, National University Heart Centre, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Benjamin Yong-Qiang Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Neurology, National University Hospital, Singapore
| | | | | | - Tseng Tsai Yeo
- Division of Neurosurgery, National University Hospital, Singapore
| | - Andrew Fu Wah Ho
- Department of Emergency Medicine, Singapore General Hospital, Singapore
- Pre-hospital & Emergency Research Centre, Duke-National University of Singapore Medical School, Singapore
- Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore
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9
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Ohira T, Eguchi E, Hayashi F, Kinuta M, Imano H. Epidemiology of cardiovascular disease in Japan: An overview study. J Cardiol 2024; 83:191-200. [PMID: 37591340 DOI: 10.1016/j.jjcc.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/20/2023] [Accepted: 08/10/2023] [Indexed: 08/19/2023]
Abstract
Cardiovascular diseases (CVDs), such as heart disease and stroke, have a significant impact on life expectancy, healthy life expectancy, and medical costs in Japan. Each prefecture is currently promoting measures in accordance with the Japanese National Plan for Promotion of Measures Against Cerebrovascular and Cardiovascular Disease, which was established by the government. In recent years, the crude mortality rate of heart disease in Japan has been increasing year by year with the aging population. Meanwhile, the age-adjusted mortality rate has leveled off or shown a downward trend. In addition, the proportion of acute myocardial infarction has decreased, whereas the proportion of heart failure has increased. By contrast, both the crude and age-adjusted mortality rates of stroke have a declining trend. Nevertheless, considering the potential variations in death certificates issued for patients with myocardial infarction across different prefectures, it is crucial to determine the incidence of CVD in each prefecture for the accurate assessment of CVD trends. However, as for the incidence of CVD, not many prefectures have yet implemented registration programs. The age-adjusted incidence rate of acute myocardial infarction has been increasing in some areas and decreasing in others since 1990. The age-adjusted incidence rate of stroke has consistently declined since the 1960s. Nevertheless, the possible increase in the incidence rate of cerebral embolism and thrombotic cerebral infarction among patients with different stroke subtypes is a cause of concern. The impact of heart failure on the incidence of heart disease has increased. Therefore, relevant academic societies and prefectures must collaborate in registering the incidence of heart failure as well as myocardial infarction and implementing countermeasures.
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Affiliation(s)
- Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Eri Eguchi
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Fumikazu Hayashi
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Minako Kinuta
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hironori Imano
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
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10
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Hozawa A, Nakaya K, Nakaya N, Nakamura T, Kogure M, Hatanaka R, Chiba I, Kanno I, Sugawara J, Kodama E, Hamanaka Y, Kobayashi T, Uruno A, Tsuchiya N, Hirata T, Narita A, Tsuboi A, Tamahara T, Otsuki A, Goto M, Taira M, Shimizu R, Suzuki K, Obara T, Kikuya M, Metoki H, Ishikuro M, Danjoh I, Ogishima S, Nagaie S, Minegishi N, Hiratsuka M, Kumada K, Nishijima I, Nobukuni T, Yamaguchi-Kabata Y, Nagami F, Kure S, Fuse N, Kinoshita K, Izumi Y, Kuriyama S, Yamamoto M. Progress report of the Tohoku Medical Megabank Community-Based Cohort Study: Study profile of the repeated center-based survey during second period in Miyagi Prefecture. J Epidemiol 2024:JE20230241. [PMID: 38403692 DOI: 10.2188/jea.je20230241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND The purpose of this study was to report the basic profile of the Miyagi Prefecture part of a repeated center-based survey during the second period (2nd period survey) of the Tohoku Medical Megabank Community-Based Cohort Study (TMM CommCohort Study), as well as the participants' characteristics based on their participation type in the baseline survey. METHODS The 2nd period survey, conducted from June 2017 to March 2021, included participants of the TMM CommCohort Study (May 2013 to March 2016). In addition to the questionnaire, blood, urine, and physiological function tests were performed during the 2nd period survey. There were three main ways of participation in the baseline survey: Type 1, Type 1 additional, or Type 2 survey. The 2nd period survey was conducted in the same manner as the Type 2 survey, which was based on the community support center (CSC). RESULTS In Miyagi Prefecture, 29,383 (57.7%) of 50,967 participants participated in the 2nd period survey. The participation rate among individuals who had visited the CSC was approximately 80%. Although some factors differed depending on the participation type in the baseline survey, the 2nd period survey respondents in the Type 1 and Type 2 survey groups at baseline had similar traits. CONCLUSIONS The 2nd period survey of the TMM CommCohort Study provided detailed follow-up information. Following up on the health conditions of the participants will clarify the long-term effects of disasters and contribute to personalized prevention.
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Affiliation(s)
- Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Kumi Nakaya
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- Faculty of Data Science, Kyoto Women's University
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Rieko Hatanaka
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Ippei Chiba
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Ikumi Kanno
- Graduate School of Medicine, Tohoku University
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- Suzuki Memorial Hospital
| | - Eiichi Kodama
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Yohei Hamanaka
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Tomoko Kobayashi
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Naho Tsuchiya
- Tohoku Medical Megabank Organization, Tohoku University
- Yamato Home Medical Care Clinic Kurihara
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University
- Institute for Clinical and Translational Science, Nara Medical University Hospital
| | - Akira Narita
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Akito Tsuboi
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Toru Tamahara
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Akihito Otsuki
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Maki Goto
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Makiko Taira
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Ritsuko Shimizu
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Kichiya Suzuki
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Inaho Danjoh
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Satoshi Nagaie
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Naoko Minegishi
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Masahiro Hiratsuka
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Kazuki Kumada
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Ichiko Nishijima
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Takahiro Nobukuni
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Yumi Yamaguchi-Kabata
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Fuji Nagami
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Shigeo Kure
- Tohoku Medical Megabank Organization, Tohoku University
- Miyagi Children's Hospital
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Kengo Kinoshita
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- Graduate School of Information Sciences, Tohoku University
- Institute of Development., aging, and cancer, Tohoku University
| | - Yoko Izumi
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
- International Research Institute of Disaster Science, Tohoku University
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University
- Graduate School of Medicine, Tohoku University
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Shimozuru Y, Matsushima Y, Ochi M, Itoh H, Hachisuka A, Saeki S. Survey of patients with stroke in the Kitakyushu Area, Japan: a 12-year retrospective analysis of the critical pathway. J Stroke Cerebrovasc Dis 2024; 33:107525. [PMID: 38171185 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES We aimed to clarify the incidence, clinical profile, outcome, and activities of daily living of patients with stroke using the Kitakyushu clinical pathway database and to investigate the characteristics of patients with stroke in the Kitakyushu medical area in Japan. MATERIALS AND METHODS The clinical data of patients with stroke registered in the Kitakyushu database between April 1, 2009 and December 31, 2021 were retrospectively examined. The National Institutes of Health Stroke Scale was used to classify stroke severity. A descriptive analysis of basic variables, including age, stroke type, length of hospital stay, and activities of daily living, according to stroke severity was conducted. RESULTS There were 7,487 acute care hospital patients and 5,441 rehabilitation hospital patients. Compared with patients in similar cities in Japan, patients in the Kitakyushu area tended to be older at the time of stroke onset with a higher proportion of cases of hemorrhagic stroke. Length of hospital stay in both acute and rehabilitation hospitals increased with stroke severity. The Functional Independence Measure gain was highest in patients with moderate disability. CONCLUSIONS Compared with patients in similar cities in Japan, in the Kitakyushu area, patients with stroke were older and the proportion of patients with hemorrhagic stroke was higher. Stroke rehabilitation therapy is effective for patients with moderately severe stroke.
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Affiliation(s)
- Yukihiro Shimozuru
- Graduate School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
| | - Yasuyuki Matsushima
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Mitsuhiro Ochi
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Hideaki Itoh
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Akiko Hachisuka
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Satoru Saeki
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
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12
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Mizushima I, Saeki T, Kobayashi D, Sawa N, Hayashi H, Taniguchi Y, Nakata H, Yamada K, Matsui S, Yasuno T, Masutani K, Nagasawa T, Takahashi H, Ubara Y, Yanagita M, Kawano M. Improved Renal Function in Initial Treatment Improves Patient Survival, Renal Outcomes, and Glucocorticoid-Related Complications in IgG4-Related Kidney Disease in Japan. Kidney Int Rep 2024; 9:52-63. [PMID: 38312790 PMCID: PMC10831353 DOI: 10.1016/j.ekir.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/26/2023] [Accepted: 10/16/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction We aimed to clarify long-term renal prognosis, complications of malignancy, glucocorticoid (GC) toxicity, and mortality in immunoglobulin G4 (IgG4)-related kidney disease (IgG4-RKD). Methods Reviewing the medical records of 95 patients with IgG4-RKD, we investigated clinical and pathologic features at baseline, the course of renal function, complications of malignancy, GC toxicity, and mortality during follow-up (median 71 months). The standardized incidence ratio (SIR) of malignancy and standardized mortality ratio were calculated using national statistics. Factors related to outcomes were assessed by Cox regression analyses. Results At diagnosis, the median estimated glomerular infiltration rate (eGFR) was 46 ml/min per 1.73 m2. GC achieved initial improvement. Additional renal function recovery within 3-months of initial treatment occurred in patients with highly elevated serum IgG and IgG4 levels and hypocomplementemia. During follow-up, 68%, 17%, and 3% of the patients had chronic kidney disease (CKD), >30% eGFR decline, and end-stage renal disease (ESRD), respectively. Age-adjusted and sex-adjusted Cox regression analyses indicated that eGFR (hazard ratio [HR], 0.71) and extensive fibrosis (HR, 2.58) at treatment initiation had a significant impact on the time to CKD. Ten patients died, and the standardized mortality ratio was 0.94. The SIR of malignancy was 1.52. The incidence rate (IR) of severe infection was 1.80/100 person-years. Cox regression analyses showed that the best eGFR within 3 months after treatment initiation were associated with lower mortality (HR 0.67) and fewer severe infections (HR 0.63). Conclusion This study suggests that more renal function recovery through early treatment initiation may improve patient survival, renal outcomes, and some GC-related complications in IgG4-RKD.
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Affiliation(s)
- Ichiro Mizushima
- Department of Rheumatology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Takako Saeki
- Department of Internal Medicine, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Daisuke Kobayashi
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Naoki Sawa
- Department of Nephrology Center, Toranomon Hospital, Kawasaki, Japan
| | - Hiroki Hayashi
- Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yoshinori Taniguchi
- Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi University, Nankoku-shi, Japan
| | - Hirosuke Nakata
- Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto City, Japan
| | - Kazunori Yamada
- Department of Hematology and Immunology, Kanazawa Medical University, Kahoku-gun, Japan
| | - Shoko Matsui
- Health Administration Center, University of Toyama, Toyama City, Japan
| | - Tetsuhiko Yasuno
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Jonan-Ku, Japan
| | - Kosuke Masutani
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Jonan-Ku, Japan
| | - Tasuku Nagasawa
- Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Hospital, Sendai, Japan
| | - Hiroki Takahashi
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yoshifumi Ubara
- Department of Nephrology Center, Toranomon Hospital, Kawasaki, Japan
| | - Motoko Yanagita
- Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto City, Japan
| | - Mitsuhiro Kawano
- Department of Rheumatology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
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Shokri Varniab Z, Saeedi Moghaddam S, Pourabhari Langroudi A, Shati M, Koolaji S, Ghanbari A, Mehdipour P, Barakati SH, Moghadam M, Shobeiri P, Esfahani Z, Sharifnejad Tehrani Y, Salahi S, Bagheri H, Mortazavi SS. The levels and trends of metabolic risk factors in the elderly population at the national and sub-national scale in Iran from 1990 to 2016. J Diabetes Metab Disord 2023; 22:1645-1655. [PMID: 37975131 PMCID: PMC10638250 DOI: 10.1007/s40200-023-01297-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/03/2023] [Indexed: 11/19/2023]
Abstract
Purpose Describing the trends of metabolic risk factors (MRFs) in the elderly population. Methods We used modeled data from previous comprehensive systematic reviews for MRFs among adults aged ≥ 60 years. Two stages of age-specific Spatio-temporal modeling and Gaussian process regression were used to estimate the mean of MRFs. We used crosswalk modeling to estimate the prevalence of elevated and raised Total cholesterol (TC), overweight/obesity and obesity, hypertension, and diabetes. Estimates were analyzed based on combinations of sex, age, year, and province from 1990 to 2016. Results Comparing prevalence estimates from 2016 with those of 1990, in the elderly population, the age-standardized prevalence of overweight/obesity, obesity, diabetes, and hypertension increased, conversely, the prevalence of hypercholesteremia decreased. The prevalence of hypertension increased about 141.5% and 129.9% in men and women respectively. The age-standardized prevalence of diabetes increased about 109.5% in females, and 116.0% in males. Prevalence of elevated TC at the national level decreased to 67.4% (64.1-70.4) in women and to 51.1% (47.5-54.8) in men. These findings were almost shown across provinces. In general, the northern and western provinces had the highest prevalence of overweight/obesity in women in 2016. Conclusion The rising prevalence of most MRFs, as well as the greater prevalence and mean of all MRFs in women, necessitate effective public health policies to reduce the burden of non-communicable diseases and run preventive programs. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01297-z.
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Affiliation(s)
- Zahra Shokri Varniab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashkan Pourabhari Langroudi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Shati
- Mental Health Research Center, Department of Epidemiology, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Sogol Koolaji
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghanbari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parinaz Mehdipour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Manije Moghadam
- Department of Older Adult Health, Health Deputy, Ministry of Health and Medical Education of Iran, Tehran, Iran
| | - Parnian Shobeiri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Esfahani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yeganeh Sharifnejad Tehrani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarvenaz Salahi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanie Bagheri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyede Salehe Mortazavi
- Geriatric Mental Health Research Center, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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Onishi Y, Shirabe S, Eguchi K, Nishijima K, Sato T, Seino H. Use of diabetes medications in adults with T2D and CVD in Japan: secondary analysis of the CAPTURE study. Diabetol Int 2023; 14:363-371. [PMID: 37781463 PMCID: PMC10533472 DOI: 10.1007/s13340-023-00638-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/09/2023] [Indexed: 10/03/2023]
Abstract
Introduction The CAPTURE study estimated the global prevalence of established cardiovascular disease (CVD) and characterized the usage of glucose-lowering agents (GLAs) in adults with type 2 diabetes (T2D) across 13 countries. The purpose of this secondary analysis of data from the Japanese sites within CAPTURE (NCT03786406, NCT03811288) was to provide data about medication usage stratified by CVD status among Japanese participants with T2D. Materials and methods Data on GLA usage (including those with proven cardiovascular [CV] benefits) in Japanese participants with T2D managed in clinics or hospitals were collected and stratified by CVD subgroups. Results There were 800 Japanese participants in the CAPTURE study (n = 502 [no CVD group], n = 298 [CVD group], n = 268 [atherosclerotic CVD subgroup]). Oral antidiabetic agents and insulin were used by 88.5% and 23.4%, respectively, of participants overall. Among participants with established CVD, dipeptidyl peptidase-4 inhibitors (65.1%) were most frequently used, followed by biguanides (50.7%) and insulins (26.2%). The pattern was similar among participants with atherosclerotic CVD. A lower proportion of participants in the CVD group used glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is) with proven CV benefits versus the no CVD group (GLP-1 RAs: 7.0% vs. 8.6%; SGLT-2is: 13.4% vs. 19.1%). Conclusion This analysis of the CAPTURE study provided a comprehensive overview of prescription patterns for the treatment of T2D in Japan. Use of GLAs with proven CV benefit was low, even in participants with established CVD, which was comparable to the findings from the global cohort. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-023-00638-w.
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Affiliation(s)
- Yukiko Onishi
- The Institute of Medical Science, Asahi Life Foundation, 2-2-6 Nihonbashibakurocho, Chuo-ku, Tokyo, 103-0002 Japan
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15
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Kawanaka M, Nishino K, Kawada M, Ishii K, Tanikawa T, Katsumata R, Urata N, Nakamura J, Suehiro M, Haruma K, Kawamoto H. Lean nonalcoholic fatty liver disease: Age-dependent differences in pathology, prognosis, and liver-related events. Hepatol Res 2023; 53:829-843. [PMID: 37118869 DOI: 10.1111/hepr.13911] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/14/2023] [Accepted: 04/20/2023] [Indexed: 04/30/2023]
Abstract
AIM This study aimed to evaluate the age-specific characteristics, prognosis, and complications of patients with lean nonalcoholic fatty liver disease (NAFLD). METHODS Background factors (age, sex, diabetes, dyslipidemia, hypertension, and PNPLA3 gene polymorphism), blood test results, liver histology findings, muscle mass, and grip strength were investigated in 782 patients with NAFLD who underwent liver biopsy. Prognosis and complications were compared among 549 patients with nonlean or lean NAFLD who were followed up for 6.5 years. Additionally, background factors, blood test results, liver histology findings, prognosis, and complications were compared according to age (≥60 years vs. <60 years) in patients with lean NAFLD. RESULTS Lean NAFLD patients showed lower aspartate aminotransferase, alanine aminotransferase, homeostasis model assessment-insulin resistance, high-sensitivity C-reactive protein, ferritin, and leptin but higher adiponectin and hemoglobin A1c (HbA1c) levels than patients with nonlean NAFLD. Furthermore, lean NAFLD patients showed less liver fibrosis, inflammation, steatosis, and ballooning. Among lean NAFLD patients, those aged 60 years and older were more frequently female, showed higher rates of hypertension, diabetes, and dyslipidemia, had higher HbA1c and type IV collagen 7S levels, lower platelet count, higher liver fibrosis and inflammation grades, and lower muscle mass and grip strength. Lean NAFLD was associated with a worse prognosis in patients aged 60 years and over than in those younger than 60 years of age and with a higher incidence of liver-related disease, cerebrocardiovascular events, and nonliver cancer. CONCLUSIONS Age is an important consideration in patients with lean NAFLD. Compared with nonlean NAFLD, lean NAFLD was associated with a worse prognosis and higher risk of complications in patients aged 60 years and older.
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Affiliation(s)
- Miwa Kawanaka
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
| | - Ken Nishino
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
| | - Mayuko Kawada
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
| | - Katsunori Ishii
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
| | - Tomohiro Tanikawa
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
| | - Ryo Katsumata
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
| | - Noriyo Urata
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
| | - Jun Nakamura
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
| | - Mitsuhiko Suehiro
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
| | - Ken Haruma
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
| | - Hirofumi Kawamoto
- Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Kurashiki, Japan
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Katano H, Nishikawa Y, Uchida M, Yamanaka T, Hayashi Y, Yamada S, Tanikawa M, Yamada K, Mase M. Secular trends and features of thalamic hemorrhages compared with other hypertensive intracerebral hemorrhages: an 18-year single-center retrospective assessment. Front Neurol 2023; 14:1205091. [PMID: 37649871 PMCID: PMC10464616 DOI: 10.3389/fneur.2023.1205091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Trends regarding the locations of hypertensive cerebral hemorrhages are unclear. To clarify hypertensive hemorrhage trends, we investigated intracerebral hemorrhages (ICHs) over an 18-year period, focusing on thalamic hemorrhages compared with other sites of hemorrhages. Methods We reviewed the cases of patients hospitalized for hypertensive ICH in 2004-2021 at our hospital; 1,320 eligible patients were registered with a primary ICH/intraventricular hemorrhage. After exclusion criteria were applied, we retrospectively analyzed 1,026 hypertensive ICH cases. Results The proportions of thalamic and subcortical hemorrhages increased over the 18-year period, whereas putaminal hemorrhage decreased. Multivariate logistic regression analyses revealed that for thalamic hemorrhage, ≥200 mmHg systolic blood pressure (p = 0.031), bleeding <15 mL (p = 0.001), and higher modified Rankin scale (mRS) score ≥ 4 at discharge (p = 0.006) were significant variables in the late period (2013-2021) versus the early period (2004-2012), whereas for putaminal hemorrhage, significant factors in the late period were triglyceride <150 mg/dL (p = 0.006) and mRS score ≥ 4 at discharge (p = 0.002). Among the features of the thalamic hemorrhages in the late period revealed by our group comparison with the putaminal and subcortical hemorrhages, the total and subcortical microbleeds were more notable in the thalamic hemorrhages than in the other two types of hemorrhage, whereas cerebellar microbleeds were more prominent when compared only with subcortical hemorrhages. Discussion Our findings revealed an increasing trend for thalamic hypertensive hemorrhage and a decreasing trend for putaminal hemorrhage. The thalamic hemorrhage increase was observed in both young and older patients, regardless of gender. The main features of thalamic hemorrhage in the late period versus the early period were decrease in larger hemorrhage (≥15 mL) and an increase in cases with higher systolic blood pressure (at least partially involved a small number of untreated hypertensive patients who developed major bleeding). The total and subcortical microbleeds were more notable in the thalamic hemorrhages of the late period than in the putaminal and subcortical hemorrhages. These results may contribute to a better understanding of the recent trends of hypertensive ICHs and may help guide their appropriate treatments for this condition.
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Affiliation(s)
- Hiroyuki Katano
- Department of Neurosurgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
- Department of Medical Informatics and Integrative Medicine, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Yusuke Nishikawa
- Department of Neurosurgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Mitsuru Uchida
- Department of Neurosurgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Tomoyasu Yamanaka
- Department of Neurosurgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Yuki Hayashi
- Department of Neurosurgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Shigeki Yamada
- Department of Neurosurgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Motoki Tanikawa
- Department of Neurosurgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Kazuo Yamada
- Nagoya City Rehabilitation Center Hospital, Nagoya, Japan
| | - Mitsuhito Mase
- Department of Neurosurgery, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
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Sasaki O, Nishioka T, Inoue Y, Isshiki A, Sasaki H. Predictors of In-Hospital Death in Patients With Acute Myocardial Infarction. Cureus 2023; 15:e43392. [PMID: 37701010 PMCID: PMC10495238 DOI: 10.7759/cureus.43392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2023] [Indexed: 09/14/2023] Open
Abstract
OBJECTIVE Factors such as age, vital signs, renal function, Killip class, cardiac arrest, elevated cardiac biomarker levels, and ST deviation predict survival in patients with acute myocardial infarction (AMI). However, the existing risk assessment tools lack comprehensive consideration of catheter-related factors, and short-term prognostic predictors are unknown. This study aimed to clarify in-hospital prognostic predictors in hospitalized patients with AMI. METHODS Five hundred and thirty-six patients who underwent percutaneous coronary intervention (PCI) for AMI were divided into non-survivor (n = 36) and survivor (n = 500) groups. Coronary risk factors, laboratory findings, angiographic findings, and clinical courses were compared between the two groups. Multiple logistic regression was used to analyze in-hospital death in pre- and post-PCI phases. RESULTS In the pre-PCI phase, multiple logistic regression analysis revealed several predictors of in-hospital death, including systolic blood pressure [odds ratio (OR) = 0.985, p = 0.023)], Killip class ≥2 (OR = 14.051, p <0.001), and chronic kidney disease (OR = 4.859, p = 0.040). In the post-PCI phase, multiple logistic regression analysis revealed additional predictors of in-hospital death, including Killip class ≥2 (OR = 5.982, p = 0.039), presence of lesions in the left main trunk (OR = 51.381, p = 0.044), utilization of intra-aortic balloon pumps and percutaneous cardiopulmonary support (OR = 6.141, p = 0.016), and presence of multi-vessel disease (OR = 6.323, p = 0.022). CONCLUSION Predictors of in-hospital death in AMI extend beyond conventional risk factors to include culprit lesions, mechanical support, and multi-vessel disease that manifest post-PCI.
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Affiliation(s)
- Osamu Sasaki
- Cardiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN
- Internal Medicine, Mombetsu General Hospital, Mombetsu, JPN
| | - Toshihiko Nishioka
- Cardiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN
| | - Yoshiro Inoue
- Cardiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN
| | - Ami Isshiki
- Cardiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN
| | - Hideki Sasaki
- Cardiovascular Surgery, Nagoya City University East Medical Center, Nagoya, JPN
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18
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Hiramatsu Y, Ide H, Furui Y. Differences in the components of metabolic syndrome by age and sex: a cross-sectional and longitudinal analysis of a cohort of middle-aged and older Japanese adults. BMC Geriatr 2023; 23:438. [PMID: 37460963 PMCID: PMC10353138 DOI: 10.1186/s12877-023-04145-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 07/02/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The prevalence of metabolic syndrome (MetS) in Japan, a super-aged society, is increasing and poses a major public health issue. Several studies have reported sex differences in the association between age and MetS prevalence. This study aimed to examine the association between age and the prevalence of MetS based on multiple screening criteria and MetS components by sex. METHODS We used 6 years of individual-level longitudinal follow-up data (June 2012 to November 2018; checkup year: 2012-2017) of middle-aged and older adults aged 40-75 years in Japan (N = 161,735). The Joint Interim Statement criteria, International Diabetes Federation criteria, and another set of criteria excluding central obesity were used as the screening criteria for MetS. The prevalence of MetS and MetS components was cross-sectionally analyzed according to sex and age. A longitudinal association analysis of age, MetS, and MetS components by sex was performed using a multilevel logistic model, adjusted for lifestyle- and regional-related factors. RESULTS Sex differences were observed in the prevalence and association of MetS and MetS components. In all age groups, the prevalence of central obesity was higher among women, and the prevalence of high blood pressure and fasting glucose was higher among men (P < 0.001). The prevalence of high triglyceride and low high-density lipoprotein cholesterol was higher among women aged > 60 years (P < 0.05). Based on the criteria of the Joint Interim Statement and International Diabetes Federation, the prevalence of MetS was higher among women than in men aged > 55 years (P < 0.001). Men had a higher prevalence of MetS without central obesity than women in all age groups (P < 0.001). The odds ratio for MetS and MetS components with aging was greater among women than in men. CONCLUSIONS Medical management should be based on the prevalence of MetS and its components according to sex and age. In particular, the high prevalence of MetS without central obesity in middle-aged and older Japanese men suggests that the adoption of the Joint Interim Statement criteria, which do not precondition central obesity, should be considered.
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Affiliation(s)
- Yuji Hiramatsu
- Healthcare Data Science Research Unit, Institute for Future Initiatives, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
- MCVP Division, AXA Life Insurance Co., Ltd, Tokyo, Japan.
| | - Hiroo Ide
- Healthcare Data Science Research Unit, Institute for Future Initiatives, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Yuji Furui
- Healthcare Data Science Research Unit, Institute for Future Initiatives, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
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19
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Higashioka M, Hirakawa Y, Hata J, Honda T, Sakata S, Shibata M, Kitazono T, Osawa H, Ninomiya T. Serum Mac-2 Binding Protein Glycosylation Isomer Concentrations Are Associated With Incidence of Type 2 Diabetes. J Clin Endocrinol Metab 2023; 108:e425-e433. [PMID: 36638007 PMCID: PMC10271221 DOI: 10.1210/clinem/dgad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 12/29/2022] [Accepted: 01/06/2023] [Indexed: 01/14/2023]
Abstract
CONTEXT Serum Mac-2 binding protein glycosylation isomer (M2BPGi) concentrations are known to be an indicator of chronic liver injury and fibrosis. OBJECTIVE This study aimed to investigate the association between serum M2BPGi concentrations and the development of type 2 diabetes in a Japanese community. METHODS A total of 2143 community-dwelling Japanese individuals aged 40-79 years without diabetes at baseline were followed up for 7 years. Serum M2BPGi concentrations were divided into quintiles: Q1, ≤0.37 cutoff index (COI); Q2, 0.38-0.49 COI; Q3, 0.50-0.62 COI; Q4, 0.62-0.80 COI; and Q5, ≥0.81 COI. Cox proportional hazards models were used to estimate hazard ratios and 95% CIs for the development of type 2 diabetes. RESULTS During the follow-up period, 219 individuals developed type 2 diabetes. The age- and sex-adjusted cumulative incidence of type 2 diabetes significantly increased with elevating serum M2BPGi levels (P for trend < .01). This association remained significant after adjustment for potential confounders (P for trend = .04). This significant association attenuated to a nonsignificant level after additionally adjusting for serum high-sensitivity C-reactive protein or homeostasis model assessment of insulin resistance. CONCLUSION The present study demonstrated that higher serum M2BPGi concentrations were significantly associated with higher risk of diabetes in a Japanese community. Moreover, inflammation and insulin resistance were suggested to contribute to the excess risk of diabetes in individuals with higher serum M2BPGi levels. These findings shed light on the importance of inflammation and insulin resistance when considering the pathogenesis of diabetes.
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Affiliation(s)
- Mayu Higashioka
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
- Department of Diabetes and Molecular Genetics, Graduate School of Medicine, Ehime University, Ehime 791-0204, Japan
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
| | - Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
| | - Haruhiko Osawa
- Department of Diabetes and Molecular Genetics, Graduate School of Medicine, Ehime University, Ehime 791-0204, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
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20
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Iwase M, Ohkuma T, Fujii H, Oku Y, Higashi T, Oshiro A, Ide H, Nakamura U, Kitazono T. Incidence and risks of coronary heart disease and heart failure in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry. Diabetes Res Clin Pract 2023:110732. [PMID: 37245724 DOI: 10.1016/j.diabres.2023.110732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023]
Abstract
AIMS We prospectively investigated the incidence of coronary heart disease (CHD) and heart failure (HF), risk factors and prognosis in Japanese patients with type 2 diabetes. METHODS A total of 4,874 outpatients with type 2 diabetes (mean age 65 years, male 57%, previous CHD 14%) were registered at multicenter diabetes clinics of a prefecture in 2008-2010 and followed for the development of CHD and HF requiring hospitalization for a median of 5.3 years (follow-up rate 98%). Risk factors were evaluated using multivariable adjusted Cox proportional models. RESULTS The incidence rates per 1,000 person-years were 12.3 for CHD (silent myocardial ischemia 5.8, angina pectoris 4.3, myocardial infarction 2.1) and 3.1 for hospitalized HF, respectively. New-onset CHD was significantly associated with higher serum adiponectin [the highest quartile vs. the lowest quartile HR 1.6 (95%CI 1.0-2.6)]. HF was significantly associated with higher serum adiponectin [the highest quartile vs. the lowest quartile HR 2.4 (95%CI 1.1-5.2)], and lower serum creatinine/cystatin C ratio, a surrogate marker for sarcopenia [lowest quartile vs. the highest quartile HR 4.6 (95%CI 1.9-11.1)]. CONCLUSIONS The incidence of heart disease was low and circulating adiponectin and sarcopenia may predict the development of heart disease in Japanese patients with type 2 diabetes.
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Affiliation(s)
- Masanori Iwase
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Diabetes Center and Clinical Research Center, Hakujyuji Hospital, Fukuoka, Japan.
| | - Toshiaki Ohkuma
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroki Fujii
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yutaro Oku
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taiki Higashi
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ayaka Oshiro
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hitoshi Ide
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Diabetes Center and Clinical Research Center, Hakujyuji Hospital, Fukuoka, Japan
| | - Udai Nakamura
- Diabetes Center, Steel Memorial Yawata Hospital, Kitakyushu, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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21
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Masuda D. Triglyceride Level and Cardiovascular Risk Reduction Using Pemafibrate Compared with Fibrates. J Atheroscler Thromb 2023; 30:429-431. [PMID: 36216574 PMCID: PMC10164602 DOI: 10.5551/jat.ed216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Affiliation(s)
- Daisaku Masuda
- Rinku General Medical Center, Rinku Innovation Center for Wellness Care and Activities (RICWA), Health Care Center, Department of Cardiology
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22
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Seino H, Onishi Y, Eguchi K, Nishijima K, Sato T, Shirabe S. Cardiovascular disease prevalence in adults with type 2 diabetes in Japan: results from the Japanese centers in the CAPTURE study. Diabetol Int 2023; 14:172-182. [PMID: 37090129 PMCID: PMC10113416 DOI: 10.1007/s13340-022-00612-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 12/06/2022] [Indexed: 01/15/2023]
Abstract
Introduction CAPTURE was a cross-sectional, non-interventional study (NCT03786406, NCT03811288) investigating the prevalence and characteristics of cardiovascular disease (CVD) in adults with type 2 diabetes (T2D) across 13 countries worldwide. Here we present the findings for Japan. Materials and methods Data were collected from adults aged ≥ 20 years (aged ≥ 18 years in countries outside Japan) with T2D who were managed in clinics or hospitals in 2019. Standardized methodology was used for all countries. The prevalence of CVD and its subtypes was estimated, weighted by care setting (clinics versus hospitals). Results Among participants from Japan (total: 800; clinics: 440; hospitals: 360), mean (standard deviation) age was 65.6 (11.2) years and glycated hemoglobin 7.2% (0.9). Sixty-seven percent of participants were male, 57.8% had diabetes duration > 10 years, 49.8% had body mass index ≥ 25 kg/m2 and 63.1% had hypertension. The weighted prevalences (95% confidence interval [CI]) of CVD and atherosclerotic CVD were 37.3% (34.2;40.3) and 33.5% (30.6;36.4), respectively. The prevalence (95% CI) of the most common subtypes of CVD was: carotid artery disease 20.5% (18.2;22.8), coronary heart disease 11.9% (9.7;14.1) and cerebrovascular disease 10.4% (8.3;12.5). Conclusions These contemporary data from the CAPTURE study on CVD prevalence in adults with T2D in Japan show that approximately one in three adults with T2D had established CVD, which is comparable to the prevalence in the global study cohort. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-022-00612-y.
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Affiliation(s)
- Hiroaki Seino
- Seino Internal Medicine Clinic, 6-192-2 Kaisei, Koriyama, Fukushima 963-8851 Japan
| | - Yukiko Onishi
- The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
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23
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Iwasa K, Onoda K, Takamura M, Takayoshi H, Mitaki S, Yamaguchi S, Nagai A. Development of a stroke risk score with MRI asymptomatic brain lesions attributes to evaluate prognostic vascular events. J Neurol Sci 2023; 448:120642. [PMID: 37030186 DOI: 10.1016/j.jns.2023.120642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/24/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND The use of a combination of stroke predictors, such as clinical factors and asymptomatic lesions on brain magnetic resonance imaging (MRI), may improve the accuracy of stroke risk prediction. Therefore, we attempted to develop a stroke risk score for healthy individuals. METHODS We investigated the presence of cerebral stroke in 2365 healthy individuals who underwent brain dock screening at the Health Science Center in Shimane. We examined the factors that contributed to stroke and attempted to determine the risk of stroke by comparing background factors and MRI findings. RESULTS The following items were found to be significant risk factors for stroke: age (≥60 years), hypertension, subclinical cerebral infarction, deep white matter lesion, and microbleeds. Each item was scored with 1 point, and the hazard ratios for the risk of developing stroke based on the group with 0 points were 17.2 (95% confidence interval [CI] 2.31-128) for 3 points, 18.1 (95% CI 2.03-162) for 4 points, and 102 (95% CI 12.6-836) for 5 points. CONCLUSIONS A precise stroke prediction score biomarker can be obtained by combining MRI findings and clinical factors.
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Affiliation(s)
- Kenichi Iwasa
- Department of Neurology, Faculty of Medicine, Shimane University, Japan.
| | - Keiichi Onoda
- Department of Psychology, Faculty of Psychology, Otemon Gakuin University, Japan
| | - Masahiro Takamura
- Department of Neurology, Faculty of Medicine, Shimane University, Japan
| | | | - Shingo Mitaki
- Department of Neurology, Faculty of Medicine, Shimane University, Japan
| | - Shuhei Yamaguchi
- Department of Neurology, Shimane Prefectural Central Hospital, Japan
| | - Atsushi Nagai
- Department of Neurology, Faculty of Medicine, Shimane University, Japan
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24
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Yamagishi K, Sankai T, Muraki I, Umesawa M, Cui R, Imano H, Kihara T, Noda H, Ikeda A, Ohira T, Tanigawa T, Kitamura A, Sato S, Kiyama M, Iso H. Trends in stroke, cardiovascular disease, and medical expenditure under a community-based long-term stroke prevention program. J Hypertens 2023; 41:429-436. [PMID: 36728733 PMCID: PMC10035654 DOI: 10.1097/hjh.0000000000003351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Evidence on the effects of preventive measures for noncommunicable disease is urgently needed for low-income and middle-income countries suffering from stroke epidemics along with population aging. OBJECTIVES We sought to examine the impact of a community-based stroke prevention program on incidences of stroke and ischemic heart disease, mortality from cardiovascular disease, and medical expenditure. METHODS Trends in the incidences of stroke and ischemic heart disease were documented in a Japanese rural community, Kyowa, from 1981 through 2015. Trends in mortality from cardiovascular disease and in medical expenditures were compared between Kyowa and its surrounding municipalities from 1981 through 2004. RESULTS In Kyowa, the age-and-sex-adjusted incidences of stroke and of ischemic heart disease decreased by half (from 4.1 to 1.9 and from 1.5 to 0.7 per year/1000 persons, respectively) over the past 35 years. A similar decreasing trend was observed for the age-and-sex-adjusted mortality from cardiovascular disease, and this decreasing trend occurred earlier than that in the surrounding municipalities. The medical expenditures for cardiovascular disease became lower in Kyowa than in the surrounding municipalities over time. CONCLUSION Our study's findings suggest that a community-based stroke prevention program augmented the decline in the incidences of stroke and ischemic heart disease, mortality from cardiovascular disease, and attenuated the increase in medical expenditures for cardiovascular disease.
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Affiliation(s)
- Kazumasa Yamagishi
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba
- Ibaraki Western Medical Center, Chikusei
| | - Tomoko Sankai
- Department of Public Health and Nursing, Institute of Medicine, University of Tsukuba, Tsukuba
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba
- Department of Public Health, Dokkyo Medical University School of Medicine, Mibu
| | - Renzhe Cui
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka
- Department of Public Health, Kindai University Faculty of Medicine, Osakasayama
| | - Tomomi Kihara
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba
| | - Hiroyuki Noda
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita
| | - Ai Ikeda
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo
| | - Tetsuya Ohira
- Department of Epidemiology School of Medicine, Fukushima Medical University School of Medicine, Fukushima
| | - Takeshi Tanigawa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka
- Yao City Public Health Center, Yao
| | | | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, Osaka
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita
- Institute for Global Health Policy Research (iGHP), Bureau of International Health Cooperation, National Center for Global and Health and Medicine, Tokyo, Japan
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25
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Furuya C, Hashimoto Y, Morishita S, Inano T, Ochiai T, Shirane S, Edahiro Y, Araki M, Ando M, Komatsu N. Reevaluation of cardiovascular risk factors for thrombotic events in 580 Japanese patients with essential thrombocythemia. J Thromb Thrombolysis 2023; 55:263-272. [PMID: 36484956 DOI: 10.1007/s11239-022-02751-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 12/13/2022]
Abstract
Risk-adapted therapy is recommended to prevent thrombosis in essential thrombocythemia (ET) patients. An advanced age, a history of thrombosis, and the presence of the JAK2V617F mutation are well-defined risk factors for thrombosis in ET; however, the impact of cardiovascular risk (CVR) factors on thrombosis in ET remains elusive. Therefore, we herein investigated the impact of CVR factors on thrombosis in 580 ET patients who met the 2017 World Health Organization Classification diagnostic criteria. A univariate analysis identified hypertriglyceridemia and multiple CVR factors as strong risk factors for thrombosis (hazard ratio [HR] 3.530, 95% confidence interval [CI] 1.630-7.643, P = 0.001 and HR 3.368, 95% CI 1.284-8.833, P = 0.014, respectively) and hyper-LDL cholesterolemia as a potential risk factor (HR 2.191, 95% CI 0.966-4.971, P = 0.061). A multivariate analysis revealed that hypertriglyceridemia was an independent risk factor for thrombosis (HR 3.364, 95% CI 1.541-7.346, P = 0.002). Furthermore, poor thrombosis-free survival was observed in patients with a serum triglyceride level ≥ 1.2 mmol/L (HR = 2.592, P = 0.026 vs. < 1.2 mmol/L) or two or more CVR factors (P = 0.011 vs. no CVR factors and P = 0.005 vs. one CVR factor). These results revealed the impact of CVR factors on thrombosis in ET. Since CVR factors are manageable, lifestyle interventions, such as the control of serum triglyceride levels, may effectively prevent thrombosis in ET patients.
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Affiliation(s)
- Chiho Furuya
- Department of Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yoshinori Hashimoto
- Department of Hematology, Tottori Prefectural Central Hospital, 730 Ezu, Tottori City, Tottori, 680-0901, Japan.,Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Soji Morishita
- Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tadaaki Inano
- Department of Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tomonori Ochiai
- Department of Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Shuichi Shirane
- Department of Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yoko Edahiro
- Department of Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Marito Araki
- Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Miki Ando
- Department of Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. .,Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. .,Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. .,PharmaEssentia Japan KK, 1-3-13 Motoakasaka, Minato-ku, Tokyo, 107-0051, Japan.
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Impact of hypertension and diabetes on the onset of chronic kidney disease in a general Japanese population. Hypertens Res 2023; 46:311-320. [PMID: 36171326 DOI: 10.1038/s41440-022-01041-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/19/2022] [Accepted: 08/25/2022] [Indexed: 02/07/2023]
Abstract
Hypertension (HT) and diabetes mellitus (DM) are both major risk factors for chronic kidney disease (CKD); however, few studies have examined the impacts of the combination of HT and DM on CKD development in general populations. We aimed to explore whether HT or DM contributes more to CKD development in a Japanese community. A total of 5823 individuals without a history of CKD who underwent specific health checkups in fiscal year 2013 were monitored until the end of March 2018. Participants were categorized as having neither HT nor DM (none group), either HT or DM, and both (HT + DM). We calculated the hazard ratios (HRs) for developing CKD in each category using Cox proportional hazards models after adjusting for age, dyslipidemia, smoking, and alcohol drinking and with the none group as the reference. We also estimated the population attributable fraction (PAF) for CKD development in populations with either HT or DM or both. During a mean follow-up of 3.0 years, 759 individuals developed CKD, with HRs of 1.56 with a 95% confidence interval (CI) [1.33, 1.83], 1.22 with a 95% CI [0.86, 1.75], and 2.83 with a 95% CI [2.22, 3.63] for the HT only, DM only and HT + DM categories, respectively. Sex-specific analysis showed similar findings. The PAFs for CKD (14.1% and 17.2% for men and women, respectively) were the highest among participants with HT only. We concluded that in this Japanese community, HT contributed more than DM to CKD development; hence, managing hypertension is important to prevent CKD as well as diabetes.
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Two Distinct Groups Are Shown to Be at Risk of Diabetes by Means of a Cluster Analysis of Four Variables. J Clin Med 2023; 12:jcm12030810. [PMID: 36769457 PMCID: PMC9918294 DOI: 10.3390/jcm12030810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/05/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Recent attempts to classify adult-onset diabetes using only six diabetes-related variables (GAD antibody, age at diagnosis, BMI, HbA1c, and homeostatic model assessment 2 estimates of b-cell function and insulin resistance (HOMA2-B and HOMA2-IR)) showed that diabetes can be classified into five clusters, of which four correspond to type 2 diabetes (T2DM). Here, we classified nondiabetic individuals to identify risk clusters for incident T2DM to facilitate the refinement of prevention strategies. Of the 1167 participants in the population-based Iwaki Health Promotion Project in 2014 (baseline), 868 nondiabetic individuals who attended at least once during 2015-2019 were included in a prospective study. A hierarchical cluster analysis was performed using four variables (BMI, HbA1c, and HOMA2 indices). Of the four clusters identified, cluster 1 (n = 103), labeled as "obese insulin resistant with sufficient compensatory insulin secretion", and cluster 2 (n = 136), labeled as "low insulin secretion", were found to be at risk of diabetes during the 5-year follow-up period: the multiple factor-adjusted HRs for clusters 1 and 2 were 14.7 and 53.1, respectively. Further, individuals in clusters 1and 2 could be accurately identified: the area under the ROC curves for clusters 1and 2 were 0.997 and 0.983, respectively. The risk of diabetes could be better assessed on the basis of the cluster that an individual belongs to.
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Zheng W, Wang X, Xue X, Li W, Fan L, Zhang S, Li C, Wang Z, Xie M, Xin P, Jiang G. Characteristics of hypertension in the last 16 years in high prevalence region of China and the attribute ratios for cardiovascular mortality. BMC Public Health 2023; 23:114. [PMID: 36647044 PMCID: PMC9841650 DOI: 10.1186/s12889-022-14974-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Tianjin is one of the cities with the highest prevalence of hypertension in China and one of the first regions to develop community management of hypertension. Our aim was to analyze the characteristics of hypertension in the last 16 years, and estimate the population attributable fraction for cardiovascular mortality in Tianjin, China. METHODS We compared the epidemiological characteristics of hypertension between 2002 and 2018 by analyzing data from the National Nutrition and Chronic Disease Risk Factor Survey. Subsequently, we obtained the cause-specific mortality in the same year from the Tianjin All Cause of Death Registration System (CDRS), and the population attributable fraction was used to estimate the annual cardiovascular disease (CVD) deaths caused by hypertension. RESULTS In 2002 and 2018, the crude prevalence, awareness, treatment rate in diagnosed, control rate in treated, and overall control rate of hypertension were 36.6% and 39.8%, 36.0% and 51.9%, 76.0% and 90.1%, 17.4% and 38.3%, 4.8% and 17.9%, respectively (P < 0.05). The mean SBP for males between the ages of 25 and 50 was significantly higher in 2018 than in 2002. The number of CVD deaths attributed to hypertension was 13.8 thousand in 2002 (account for 59.1% of total CVD deaths), and increased to 21.7 thousand in 2018 (account for 58.8% of total CVD deaths). The population attributable fraction have increased in the age groups of 25-44 and 75 and above, and decreased in the age group of 45-74 from 2002 to 2018. CONCLUSIONS Compare to 2002, the proportion of CVD deaths attributed to hypertension remains high, particularly among younger and older people, despite a very significant increase in treatment and control rates for hypertension in 2018.
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Affiliation(s)
- Wenlong Zheng
- grid.464467.3NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011 China
| | - Xiaohe Wang
- grid.464467.3NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011 China
| | - Xiaodan Xue
- grid.464467.3NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011 China
| | - Wei Li
- grid.464467.3NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011 China
| | - Lili Fan
- grid.464467.3NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011 China
| | - Shuang Zhang
- grid.464467.3NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011 China
| | - Changkun Li
- grid.464467.3NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011 China
| | - Zhuo Wang
- grid.464467.3NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011 China
| | - Meiqiu Xie
- grid.464467.3NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011 China
| | - Peng Xin
- grid.464467.3NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011 China
| | - Guohong Jiang
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, 300011, China. .,School of Public Health, Tianjin Medical University, Tianjin, China.
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Kondo Y, Yatsuya H, Ota A, Matsumoto S, Ueda A, Watanabe H, Toyoshima H. The Association Between Adult Height and Stroke Incidence in Japanese Men and Women: A Population-based Case-Control Study. J Epidemiol 2023; 33:23-30. [PMID: 34176853 PMCID: PMC9727208 DOI: 10.2188/jea.je20200531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND No studies have examined the associations between adult height and ischemic stroke subtypes. METHODS We conducted a population-based case-control study that included 2,451 thrombotic and 687 embolic stroke cases, as well as 1,623 intracerebral and 768 subarachnoid hemorrhage cases without history of stroke aged 40-79 years, and the same number of sex- and age-matched controls. Cases and controls were grouped according to the quintile cut-off values of height in controls, and the third quintile, which was approximately the average height group, was used as the reference group. Height divided by one standard deviation of height in controls was also examined as a continuous variable. The analyses were carried out separately for participants aged 40-59 years and 60-79 years. RESULTS In both younger and older men, height was linearly inversely associated with total and thrombotic strokes, and the shortest quintile compared to the reference group was associated with increased risks of these strokes. Although height was linearly inversely associated with embolic stroke and intracerebral hemorrhage in younger men, the shortest quintile did not show increased risks of these strokes. Height did not seem to be associated with total stroke and any stroke subtypes in younger women. In contrast, the tallest quintile was significantly associated with increased risks of total stroke and intracerebral hemorrhage, and height tended to be positively associated with these strokes in older women. CONCLUSION We reported the associations between adult height and ischemic stroke subtypes for the first time, which differed according to sex and age group.
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Affiliation(s)
- Yoshinobu Kondo
- Bureau of Health and Medical Care, Aichi Prefectural Government, Aichi, Japan,Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Aichi, Japan,Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan
| | - Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan
| | - Shoji Matsumoto
- Department of Comprehensive Strokology, Fujita Health University School of Medicine, Aichi, Japan
| | - Akihiro Ueda
- Department of Neurology and Neuroscience, Fujita Health University School of Medicine, Aichi, Japan
| | - Hirohisa Watanabe
- Department of Neurology and Neuroscience, Fujita Health University School of Medicine, Aichi, Japan
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30
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Yoshida S, Tanaka S, Okada M, Ohki T, Yamagishi K, Okuno Y. Development and validation of ischemic heart disease and stroke prognostic models using large-scale real-world data from Japan. Environ Health Prev Med 2023; 28:16. [PMID: 36792224 PMCID: PMC9989775 DOI: 10.1265/ehpm.22-00106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Previous cardiovascular risk prediction models in Japan have utilized prospective cohort studies with concise data. As the health information including health check-up records and administrative claims becomes digitalized and publicly available, application of large datasets based on such real-world data can achieve prediction accuracy and support social implementation of cardiovascular disease risk prediction models in preventive and clinical practice. In this study, classical regression and machine learning methods were explored to develop ischemic heart disease (IHD) and stroke prognostic models using real-world data. METHODS IQVIA Japan Claims Database was searched to include 691,160 individuals (predominantly corporate employees and their families working in secondary and tertiary industries) with at least one annual health check-up record during the identification period (April 2013-December 2018). The primary outcome of the study was the first recorded IHD or stroke event. Predictors were annual health check-up records at the index year-month, comprising demographic characteristics, laboratory tests, and questionnaire features. Four prediction models (Cox, Elnet-Cox, XGBoost, and Ensemble) were assessed in the present study to develop a cardiovascular disease risk prediction model for Japan. RESULTS The analysis cohort consisted of 572,971 invididuals. All prediction models showed similarly good performance. The Harrell's C-index was close to 0.9 for all IHD models, and above 0.7 for stroke models. In IHD models, age, sex, high-density lipoprotein, low-density lipoprotein, cholesterol, and systolic blood pressure had higher importance, while in stroke models systolic blood pressure and age had higher importance. CONCLUSION Our study analyzed classical regression and machine learning algorithms to develop cardiovascular disease risk prediction models for IHD and stroke in Japan that can be applied to practical use in a large population with predictive accuracy.
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Affiliation(s)
- Shigeto Yoshida
- Data Science and Advanced Analytics, IQVIA Solutions Japan K.K
| | - Shu Tanaka
- Real-World Evidence Solutions, IQVIA Solutions Japan K.K
| | - Masafumi Okada
- Real-World Evidence Solutions, IQVIA Solutions Japan K.K
| | - Takuya Ohki
- Real-World Evidence Solutions, IQVIA Solutions Japan K.K
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
| | - Yasushi Okuno
- Medical Sciences Innovation Hub Program, RIKEN.,Graduate School of Medicine, Kyoto University
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The Relationship between Serum Adiponectin, Urinary Albumin/Creatinine Ratio and Type 2 Diabetes: A Population-Based Cross-Sectional Study. J Clin Med 2022; 11:jcm11237232. [PMID: 36498806 PMCID: PMC9738010 DOI: 10.3390/jcm11237232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
The relationship between serum adiponectin concentration (S-Adipo) and various diseases, such as type 2 diabetes (T2D) is conflicting. We hypothesized that the extent of kidney damage in patients with T2D may be responsible for this inconsistency and, thus, examined association between S-Adipo and T2D after consideration for the extent of kidney damage present. Of the 1816 participants in the population-based Iwaki study of Japanese people, 1751 participants with a complete dataset were included. Multivariate logistic regression analyses revealed that low S-Adipo was independently associated with T2D (<0.001), as was high urinary albumin to creatinine ratio (uACR) (<0.001). Principal components analysis showed that the relative value of S-Adipo to uACR (adiponectin relative excess) was significantly associated with T2D (odds ratio: 0.49, p < 0.001). Receiver operating curve analyses revealed that an index of adiponectin relative excess the ratio of S-Adipo to uACR was superior to S-Adipo per se as a marker of T2D (area under the curve: 0.746 vs. 0.579, p < 0.001). This finding indicates that the relationship between S-Adipo and T2D should be evaluated according to the extent of kidney damage present and may warrant similar analyses of the relationships between S-Adipo and other medicalconditions, such as cardiovascular disease.
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32
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Takashima N. Importance of Continuous Monitoring of Stroke Recurrence in the General Population. J Atheroscler Thromb 2022; 29:1699-1700. [PMID: 35598984 PMCID: PMC9881472 DOI: 10.5551/jat.ed202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Naoyuki Takashima
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
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Nakanishi Y, Furuta Y, Hata J, Yubi T, Oishi E, Sakata S, Hirakawa Y, Wakisaka Y, Ago T, Kitazono T, Ninomiya T. Long-Term Trends in The 5-Year Risk of Recurrent Stroke over A Half Century in A Japanese Community: The Hisayama Study. J Atheroscler Thromb 2022; 29:1759-1773. [PMID: 35185108 PMCID: PMC9881531 DOI: 10.5551/jat.63344] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
AIM Secular trends in the risk of recurrent stroke have been reported in several epidemiological studies worldwide, but this issue has not been investigated in general Japanese populations. We examined the trends in the 5-year risk of recurrent stroke over a half century using community-based prospective data in Japan. METHODS We established 4 cohort studies in 1961, 1974, 1988, and 2002. To examine the risk of recurrent stroke, participants who developed stroke during a 10-year follow-up period in each cohort were followed-up for 5 years from the date of first onset. A total of 154 (first sub-cohort: 1961-1971), 144 (second sub-cohort: 1974-1984), 172 (third sub-cohort: 1988-1998), and 146 (fourth sub-cohort: 2002-2012) participants from each cohort were enrolled in the present study. The 5-year cumulative risk of recurrent stroke was compared among the sub-cohorts using the Kaplan-Meier method and the age- and sex-adjusted Cox proportional hazards model. RESULTS The risks of recurrent stroke after any stroke and ischemic stroke decreased significantly from the first to the third sub-cohort, but they did not clearly change from the third to the fourth sub-cohort. The risk of recurrent stroke after hemorrhagic stroke decreased mainly from the first to the second sub-cohort and there was no apparent decrease from the second to the fourth sub-cohort. These trends were substantially unchanged after adjusting for age and sex. CONCLUSIONS In the Japanese community, the risk of recurrent stroke decreased mainly from the 1960s to 1990s, but there was no apparent decrease in recent years.
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Affiliation(s)
- Yasuyuki Nakanishi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Division of Medical Engineering and Healthy Longevity, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Yubi
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Department of Cerebrovascular Disease and Neurology, Hakujyuji Hospital, Fukuoka, Japan
| | - Emi Oishi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinobu Wakisaka
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tetsuro Ago
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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34
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Akasaki Y, Tabira T, Maruta M, Makizako H, Miyata M, Han G, Ikeda Y, Nakamura A, Shimokihara S, Hidaka Y, Kamasaki T, Kubozono T, Ohishi M. Social Frailty and Meaningful Activities among Community-Dwelling Older Adults with Heart Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15167. [PMID: 36429885 PMCID: PMC9690307 DOI: 10.3390/ijerph192215167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Patients with heart disease are more likely to experience social frailty due to physical inactivity, which may affect meaningful activities such as hobbies. This study aimed to investigate (1) the association between heart disease and social frailty in community-dwelling older adults and (2) the characteristics of meaningful activities in community-dwelling older adults with heart disease. Data from 630 older adults who participated in a community-based health survey were obtained, including clinical history, meaningful activities, social frailty and psychosomatic functions. Participants were divided into two groups: those with heart disease (n = 79) and those without (n = 551), and comparisons were made. Social frailty was observed in 23.7% of participants with heart disease, and logistic regression revealed significant associations with heart disease and social frailty after adjusting for potential covariates (OR, 1.97; 95% CI, 1.06 3.67; p = 0.032). Participants with heart disease did not differ significantly in terms of satisfaction or performance; their frequency of engagement in meaningful activities was significantly lower than without heart disease (p = 0.041). These results suggest that heart disease and social frailty are associated in community-dwelling older adults, and that this demographic is inclined to engage in meaningful activities less frequently.
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Affiliation(s)
- Yoshihiko Akasaki
- Department of Rehabilitation, Tarumizu Central Hospital, 1-140 Kinko-cho, Tarumizu 891-2124, Japan
| | - Takayuki Tabira
- Graduate School of Health Sciences, Kagoshima University Faculty of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Michio Maruta
- Department of Occupational Therapy, Nagasaki University Graduate School of Biomedical Sciences Health Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan
| | - Hyuma Makizako
- Graduate School of Health Sciences, Kagoshima University Faculty of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Masaaki Miyata
- Graduate School of Health Sciences, Kagoshima University Faculty of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Gwanghee Han
- Department of Occupational Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, 137-1 Enokizu, Fukuoka 831-8501, Japan
| | - Yuriko Ikeda
- Graduate School of Health Sciences, Kagoshima University Faculty of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Atsushi Nakamura
- National Institute for Minamata Disease, Ministry of the Environment, 4058-18 Hama, Kumamoto 867-0008, Japan
| | - Suguru Shimokihara
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Yuma Hidaka
- Department of Rehabilitation, Medical Corporation, Sanshukai, Okatsu Hospital, 3-95 Masagohonmachi, Kagoshima 890-0067, Japan
| | - Taishiro Kamasaki
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Takuro Kubozono
- Department of Cardiovascular Medicine Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
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35
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Liu K, Yu Y, Yuan Y, Xu X, Lei W, Niu R, Shen M, Zhou L, Peng R, Wang Q, Yang H, Guo H, Ge Y, Liu G, He M, Wu T, Zhang X. Elevated Levels of Serum Alkaline Phosphatase are Associated with Increased Risk of Cardiovascular Disease: A Prospective Cohort Study. J Atheroscler Thromb 2022:63646. [PMID: 36261365 DOI: 10.5551/jat.63646] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
AIM We aimed to investigate the associations of serum alkaline phosphatase (ALP) levels with incident cardiovascular disease (CVD), coronary heart disease (CHD), and stroke, as well as their subtypes, among men and women in a prospective cohort study. METHODS A total of 11,408 men and 14,981 women were included to evaluate the associations between ALP levels and incident CVD. Participants were divided into four groups according to the quartiles of serum ALP levels in men and women separately. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS During an average follow-up of 7.3 years, 7,015 incident CVDs (5,561 CHDs and 1,454 strokes) were documented. After adjustments for age, body mass index, smoking status, drinking status, diabetes, hyperlipidemia, hypertension, physical activity, aspirin usage, anticoagulants usage, menopausal status (women only), family history of CVD, estimated glomerular filtration rate, white blood cell counts, and admission batch and comparing the lowest quartile of ALP, the adjusted HRs (95% CIs) of participants in the highest quartile were 1.22 (1.11-1.34) for CVD, 1.14 (1.02-1.28) for CHD, 1.43 (1.18-1.73) for stroke, 1.31 (1.09-1.57) for acute coronary syndrome (ACS), 1.37 (1.11-1.70) for ischemic stroke, and 1.75 (1.10-2.79) for hemorrhagic stroke in men and 1.12 (1.01-1.23) for CVD, 1.10 (0.99-1.23) for CHD, 1.18 (0.92-1.51) for stroke, 1.23 (1.03-1.47) for ACS, 1.10 (0.83-1.45) for ischemic stroke, and 1.54 (0.90-2.65) for hemorrhagic stroke in women. The ALP-CVD associations remained significant even within the normal ranges of ALP levels (40-150 U/L). Moreover, linear dose-response relationships were found between ALP levels and incident CVD. CONCLUSIONS Higher ALP levels, even within the normal range, were significantly associated with increased risks of CVD, in a dose-dependent manner. These findings suggested that regular monitoring of ALP levels may help in improving the early identification of the population at higher CVD risk.
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Affiliation(s)
- Kang Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
- School of Public Health, Guangzhou Medical University
| | - Yanqiu Yu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Yu Yuan
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Xuedan Xu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Wenhui Lei
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Rundong Niu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Miaoyan Shen
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Lue Zhou
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Rong Peng
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Qiuhong Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Handong Yang
- Department of Cardiovascular Diseases, Sinopharm Dongfeng General Hospital, Hubei University of Medicine
| | - Huan Guo
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Yang Ge
- School of Public Health, Shanghai Jiaotong University School of Medicine
| | - Gang Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Meian He
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College
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Sasaki T, Sakata S, Oishi E, Furuta Y, Honda T, Hata J, Tsuboi N, Kitazono T, Yokoo T, Ninomiya T. Day-to-Day Blood Pressure Variability and Risk of Incident Chronic Kidney Disease in a General Japanese Population. J Am Heart Assoc 2022; 11:e027173. [PMID: 36172942 DOI: 10.1161/jaha.122.027173] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Several longitudinal studies have reported that higher visit-to-visit blood pressure variability is associated with greater risk for developing chronic kidney disease. However, no population-based studies have investigated the association between day-to-day home blood pressure variability and incident chronic kidney disease. Methods and Results A total of 2342 Japanese community-dwelling residents aged ≥40 years without chronic kidney disease at baseline were followed up by annual health examinations for 10 years. Home blood pressure was measured 3 times every morning for 28 days. Day-to-day coefficients of variation of home systolic blood pressure levels were categorized into quintiles. Chronic kidney disease was defined as an estimated glomerular filtration rate <60 mL/min per 1.73 m2 or the presence of proteinuria. The hazard ratios for developing chronic kidney disease were estimated with a Cox proportional hazards model. During the follow-up period, 772 participants developed chronic kidney disease. Increased coefficients of variation of home systolic blood pressure were associated significantly with higher risk of chronic kidney disease after adjusting for confounders (P for trend <0.001): Individuals in the highest quintile of coefficients of variation had a 1.50-fold (95% CI, 1.17-1.94) greater risk of developing chronic kidney disease than those in the lowest quintile. The combination of higher coefficients of variation and higher mean value of home systolic blood pressure was associated with the multivariable-adjusted risk of developing chronic kidney disease. Conclusions These findings suggest that increased day-to-day blood pressure variability is a significant risk factor for developing chronic kidney disease in a general Japanese population.
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Affiliation(s)
- Takaya Sasaki
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences Kyushu University Fukuoka Japan.,Division of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences Kyushu University Fukuoka Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan.,Center for Cohort Studies, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Emi Oishi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences Kyushu University Fukuoka Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences Kyushu University Fukuoka Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences Kyushu University Fukuoka Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan.,Center for Cohort Studies, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Nobuo Tsuboi
- Division of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan.,Center for Cohort Studies, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences Kyushu University Fukuoka Japan.,Center for Cohort Studies, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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EEG Correlation Coefficient Change with Motor Task Activation Can Be a Predictor of Functional Recovery after Hemiparetic Stroke. Neurol Int 2022; 14:738-747. [PMID: 36135997 PMCID: PMC9503013 DOI: 10.3390/neurolint14030062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Recently, it was reported that the extent of cortico-cortical functional connections can be estimated by the correlation coefficient based on electroencephalography (EEG) monitoring. We aimed to investigate whether the EEG correlation coefficient change with motor task activation can predict the functional outcomes of hemiparetic stroke patients. METHODS Sixteen post-stroke hemiparetic patients admitted to our rehabilitation ward were studied. On admission, EEG recording to calculate the correlation coefficient was performed at rest and during motor task activation. For the analysis of the EEG data, the program software FOCUS (NIHON KOHDEN, Japan) was used. The motor function of paretic limbs was evaluated with the Fugl-Meyer Assessment (FMA) on admission and 4 weeks after admission. RESULTS Significant increases in the correlation coefficient with motor task activation were noted in C3-F3 or C4-F4, C3-F7 or C4-F8, and F3-F7 or F4-F8 of the lesional hemisphere. Among them, the rate of the correlation coefficient change in F3-F7 or F4-F8 in the lesional hemisphere was significantly correlated with the rate of the upper-limb FMA score change. CONCLUSION The extent of the EEG correlation coefficient change with motor task activation in F3-F7 or F4-F8 of the lesional hemisphere may help predict the motor functional outcomes of hemiparetic upper limbs after stroke.
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Suzuki K, Tsujiguchi H, Hara A, Nakamura H, Kotani K, Noda M, Yamakage H, Satoh‐Asahara N, Takamura T. Cystatin C-based eGFR predicts cardiovascular disease in patients with overweight/obesity and hyperglycemia. Obes Sci Pract 2022; 9:4-14. [PMID: 36789028 PMCID: PMC9913198 DOI: 10.1002/osp4.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/10/2022] [Accepted: 07/04/2022] [Indexed: 11/06/2022] Open
Abstract
Background Although many clinical parameters have been identified as predictors for cardiovascular disease (CVD) development in the general population, the accurate predictor for CVD in patients with obesity is still unknown. Objective The study aimed to explore an additional risk factor and predictor for CVD in patients with overweight/obesity considering the interaction of obesity-related pathophysiology. Methods The Japan Obesity and Metabolic Syndrome study, a multicenter prospective study, enrolled 787 outpatients, of which 318 eligible patients were analyzed. Patients with fasting plasma glucose (FPG) levels ≥6.11 and < 6.11 mmol/L were considered to have high FPG (HFPG) and normal FPG (NFPG), respectively. Thirty-six patients who developed CVD during the 5 years follow-up were assigned to the CVD group. Results Cox's proportional hazards model revealed no significant association between CVD and cystatin C-based estimated glomerular filtration rate (eGFRcys) or creatinine-based eGFR (eGFRcr) in the NFPG group. In the HFPG group, lower eGFRcys, but not eGFRcr, was significantly associated with CVD development. A generalized linear mixed model demonstrated greater reduction in eGFRcys levels over time with HFPG than with NFPG. Although the CVD group showed gradual reduction in eGFRcys levels, the non-CVD group-matched using propensity scores-did not show a decline in eGFRcys levels. Conclusions Lower eGFRcys levels may be more accurate than eGFRcr in predicting CVD development in patients with overweight/obesity and hyperglycemia. Furthermore, eGFRcys reduction over time is associated with CVD development. Clinical Trial Registry Number UMIN000000559.
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Affiliation(s)
- Keita Suzuki
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan,Department of Hygiene and Public HealthFaculty of MedicineInstitute of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaIshikawaJapan
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public HealthFaculty of MedicineInstitute of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaIshikawaJapan
| | - Akinori Hara
- Department of Hygiene and Public HealthFaculty of MedicineInstitute of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaIshikawaJapan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public HealthFaculty of MedicineInstitute of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaIshikawaJapan
| | - Kazuhiko Kotani
- Division of Community and Family MedicineJichi Medical UniversityShimotsukeTochigiJapan
| | - Mitsuhiko Noda
- Department of Diabetes, Metabolism and EndocrinologyIchikawa HospitalInternational University of Health and WelfareIchikawaChibaJapan
| | - Hajime Yamakage
- Department of Endocrinology, Metabolism and Hypertension ResearchClinical Research InstituteNational Hospital OrganizationKyoto Medical CenterKyotoJapan
| | - Noriko Satoh‐Asahara
- Department of Endocrinology, Metabolism and Hypertension ResearchClinical Research InstituteNational Hospital OrganizationKyoto Medical CenterKyotoJapan,Department of Metabolic Syndrome and Nutritional ScienceResearch Institute of Environmental MedicineNagoya UniversityNagoyaAichiJapan
| | - Toshinari Takamura
- Department of Endocrinology and MetabolismKanazawa University Graduate School of Medical SciencesKanazawaIshikawaJapan
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Honda T, Chen S, Hata J, Shibata M, Furuta Y, Oishi E, Sakata S, Kitazono T, Ninomiya T. Changes in the Eicosapentaenoic Acid to Arachidonic Acid Ratio in Serum over 10 Years in a Japanese Community: The Hisayama Study. J Atheroscler Thromb 2022. [PMID: 36089395 DOI: 10.5551/jat.63727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Circulating omega-3 and omega-6 polyunsaturated fatty acids may to contribute to cardiovascular health at the population level. Over a decade, we investigated changes in the serum eicosapentaenoic acid (EPA) to arachidonic acid (AA) ratio, and in serum concentrations of the individual fatty acids, in a Japanese community. METHODS Community surveys took place in 2002-2003 and 2012-2013 in a rural area of Japan. The community surveys included 3,194 and 3,220 community dwellers aged ≥ 40 years who did not take EPA medication in 2002-2003 and 2012-2013, respectively. Fatty acid fractionations in serum were measured using a gas chromatography method. Changes in the serum EPA/AA ratio over time were examined using linear mixed models. RESULTS Overall, the average serum EPA/AA ratio decreased over the 10 years. A decreasing trend in the serum EPA/AA ratio occurred in all age groups except participants aged ≥ 80 years, with larger decreases in the younger age groups. A similar decline in serum EPA/AA ratio occurred in participants with and those without lipid-lowering therapy. Serum EPA concentrations were slightly increased in the whole population but remained stable or even decreased in participants aged 40-69. In contrast, the average serum AA concentrations increased in all age groups. CONCLUSION In a Japanese community, the serum EPA/AA ratio decreased over 10 years at the population level, especially in middle-aged participants.
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Affiliation(s)
- Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
| | - Sanmei Chen
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Global Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.,Division of Medical Engineering and Healthy Longevity, Graduate School of Medical Sciences, Kyushu University
| | - Emi Oishi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Takanari Kitazono
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
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Association of serum s-adenosylmethionine, s-adenosylhomocysteine, and their ratio with the risk of dementia and death in a community. Sci Rep 2022; 12:12427. [PMID: 35859106 PMCID: PMC9300687 DOI: 10.1038/s41598-022-16242-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/06/2022] [Indexed: 11/09/2022] Open
Abstract
We examined the association of serum s-adenosylmethionine (SAM), s-adenosylhomocysteine (SAH) (methionine metabolites), and their ratio on the risk of dementia and death in a community-dwelling population of older Japanese individuals. 1371 residents of Hisayama, Japan, aged 65 years or older and without dementia, were followed for a median of 10.2 years (2007–2017). We divided serum SAM, SAH, and SAM/SAH ratio into quartiles. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) of serum SAM, SAH, and SAM/SAH ratio levels on the risk of a composite outcome of all-cause dementia or death, and each outcome. During the follow-up, 635 participants developed all-cause dementia and/or died, of which 379 participants developed dementia and 394 deaths occurred. The multivariable-adjusted HRs of the composite outcome decreased significantly with increasing serum SAM levels (P for trend = 0.01), while they increased significantly with higher serum SAH levels (P for trend = 0.03). Higher serum SAM/SAH ratio levels were significantly associated with a lower risk of the composite outcome (P for trend = 0.002), as well as with lower risk of each outcome. Our findings suggest that the balance of methionine metabolites may closely associate with the risk of dementia and death.
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Ueda E, Hirabayashi N, Ohara T, Hata J, Honda T, Fujiwara K, Furuta Y, Shibata M, Hashimoto S, Nakamura S, Nakazawa T, Nakao T, Kitazono T, Ninomiya T, Sonoda KH. Association of Inner Retinal Thickness with Prevalent Dementia and Brain Atrophy in a General Older Population. OPHTHALMOLOGY SCIENCE 2022; 2:100157. [PMID: 36249677 PMCID: PMC9559916 DOI: 10.1016/j.xops.2022.100157] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 10/27/2022]
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Yoshimura H, Tanaka T, Fukuma K, Matsubara S, Motoyama R, Mizobuchi M, Matsuki T, Manabe Y, Suzuki J, Kobayashi K, Shimotake A, Nishimura K, Onozuka D, Kawamoto M, Koga M, Toyoda K, Murayama S, Matsumoto R, Takahashi R, Ikeda A, Ihara M. Impact of Seizure Recurrence on 1-Year Functional Outcome and Mortality in Patients With Poststroke Epilepsy. Neurology 2022; 99:e376-e384. [PMID: 35508394 DOI: 10.1212/wnl.0000000000200609] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The functional outcome and mortality of post-stroke epilepsy (PSE) patients have not been assessed in a prospective study. Previous reports have suggested that PSE patients may suffer from prolonged functional deterioration following a seizure. In the current study, we prospectively investigated the functional outcome and mortality of PSE patients and analyzed the impact of seizure recurrence on the outcomes. METHODS This is part of the Prognosis of Post-Stroke Epilepsy (PROPOSE) study, a multicenter, prospective observational cohort study, where 392 PSE patients (at least one unprovoked seizure more than 7 days after the onset of the last symptomatic stroke) were followed for at least 1 year at eight hospitals in Japan. The current study included only PSE patients with a first-ever seizure and assessed their functional decline and mortality at 1 year. Functional decline was defined as an increase in modified Rankin Scale (mRS) score at 1 year compared to baseline, excluding death. The associations between seizure recurrence and the outcomes were analyzed statistically. RESULTS A total of 211 patients (median age of 75 years; median mRS score of 3) were identified. At 1 year, 50 patients (23.7%) experienced seizure recurrence. Regarding outcomes, 25 patients (11.8%) demonstrated functional decline, and 20 (9.5%) had died. Most patients died of pneumonia or cardiac disease (seven patients each), and no known causes of death were directly related to recurrent seizures. Seizure recurrence was significantly associated with functional decline (odds ratio 2.96 [95% CI 1.25-7.03], P=0.01), even after adjusting for potential confounders (adjusted odds ratio 3.26 [95% CI 1.27-8.36], P=0.01), but not with mortality (odds ratio 0.79 [95% CI 0.18-2.61], P=0.79). Moreover, there was a significant trend where patients with more recurrent seizures were more likely to have functional decline (8.7%, 20.6%, and 28.6% in none, 1, and 2 or more recurrent seizures, respectively; P=0.006). DISCUSSION One-year functional outcome and mortality of PSE patients were poor. Seizure recurrence was significantly associated with functional outcome, but not with mortality. Further studies are needed to ascertain whether early and adequate anti-seizure treatment can prevent the functional deterioration of PSE patients.
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Affiliation(s)
- Hajime Yoshimura
- Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tomotaka Tanaka
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazuki Fukuma
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Soichiro Matsubara
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Rie Motoyama
- Department of Neurology and Brain Bank for Aging Research, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Masahiro Mizobuchi
- Department of Neurology, Nakamura Memorial Hospital, Sapporo, Japan.,Minami-ichijyo Neurology Clinic, Sapporo, Japan
| | | | - Yasuhiro Manabe
- Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Junichiro Suzuki
- Department of Neurology, Toyota Memorial Hospital, Toyota, Japan
| | - Katsuya Kobayashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihiro Shimotake
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Daisuke Onozuka
- Department of Medical Informatics and Clinical Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Michi Kawamoto
- Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Shigeo Murayama
- Department of Neurology and Brain Bank for Aging Research, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.,Brain Bank for Neurodevelopmental, Neurological and Psychiatric Disorders, Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan
| | - Riki Matsumoto
- Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
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Ghelani KP, Chen LY, Norby FL, Soliman EZ, Koton S, Alonso A. Thirty-Year Trends in the Incidence of Atrial Fibrillation: The ARIC Study. J Am Heart Assoc 2022; 11:e023583. [PMID: 35414195 PMCID: PMC9238452 DOI: 10.1161/jaha.121.023583] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 03/14/2022] [Indexed: 11/16/2022]
Abstract
Background Long-term data to study recent trends in the incidence of atrial fibrillation (AF), overall and among sex and race groups, are scarce. We evaluated the 30-year trends in the incidence of AF in the ARIC (Atherosclerosis Risk in Communities) study cohort and explored race and sex differences in these trends. Methods and Results We included 15 343 men and women aged 45 to 64 years in 1987 to 1989 without AF from 4 US communities in the ARIC cohort. Incident AF was identified based on study ECGs, hospital discharge codes, and death certificates through 2017. We calculated age and period-specific incidence rates (IRs) of AF. We used Poisson regression to calculate IR ratios of AF over time adjusting for age, sex, and race. A total of 3241 AF cases were identified during a mean (SD) follow-up of 22 years (8.4 years) (599 in Black participants, 2642 in White participants, 1582 in women, and 1659 in men). Overall, the IR of AF in the ARIC cohort was 9.6 per 1000 person-years (6.9 in Black participants, 10.5 in White participants, 8.1 in women, and 11.6 in men). Age-specific IR by time period did not show significant changes over time. In a model adjusted for sex, race, and age group, the rate of AF did not change significantly from 1987 to 1991 compared with 2012 to 2017 (IR ratio, 1.10 [95% CI, 0.88-1.36] comparing 2012-2017 with 1987-1991). Similarly, no evidence of changes over time in AF rates were identified in men and women or White and Black participants separately. Conclusions Even though IRs of AF increase as age increases, our analysis provided evidence suggesting that the overall IRs of AF have not changed over time in a multicenter cohort of Black and White individuals in the United States from 1987 to 2017.
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Affiliation(s)
- Kunali P. Ghelani
- Department of EpidemiologyRollins School of Public HealthEmory UniversityAtlantaGA
| | - Lin Yee Chen
- Cardiovascular DivisionDepartment of MedicineUniversity of Minnesota Medical SchoolMinneapolisMN
| | - Faye L. Norby
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai‐Health SystemLos AngelesCA
| | - Elsayed Z. Soliman
- Department of EpidemiologyDivision of Public Health SciencesWake Forest University School of MedicineWinston‐SalemNC
| | - Silvia Koton
- Stanley Steyer School of Health ProfessionsSackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
- Department of EpidemiologyJohns Hopkins University School of Public HealthBaltimoreMD
| | - Alvaro Alonso
- Department of EpidemiologyRollins School of Public HealthEmory UniversityAtlantaGA
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Ma J, Furuta M, Uchida K, Takeshita T, Kageyama S, Asakawa M, Takeuchi K, Suma S, Sakata S, Hata J, Sohn W, Ninomiya T, Yamashita Y. Yogurt product intake and reduction of tooth loss risk in a Japanese community. J Clin Periodontol 2022; 49:345-352. [PMID: 35066918 PMCID: PMC9305141 DOI: 10.1111/jcpe.13593] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/09/2021] [Accepted: 01/13/2022] [Indexed: 12/01/2022]
Abstract
Aim To evaluate the longitudinal association between yogurt product intake and oral health in a population‐based study. Materials and Methods This study included 1967 Japanese residents aged 40–79 years who underwent dental examinations in 2012. Among them, 1469 participants were followed up in 2017 for the incidence of tooth loss, which was defined as two or more teeth lost over 5 years. The intake of yogurt products, defined as yogurt and lactic acid beverages, was estimated using a semi‐quantitative food frequency questionnaire. The composition of the salivary microbiota was evaluated. Results The Poisson regression model showed that a higher intake of yogurt products was negatively associated with the incidence of tooth loss (p for trend = .020), adjusted for potential confounding factors. Mediation analysis confirmed that periodontal condition partly mediated the effect of yogurt product intake on tooth loss, while dental caries experience did not. Additionally, we confirmed the association of a high intake of yogurt products with a low percentage of the salivary microbiota pattern, which was associated with poor oral health. Conclusion These findings suggest that the intake of yogurt products is associated with a lower risk of tooth loss resulting from periodontal disease, probably via modulation of the oral microbiome composition.
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Affiliation(s)
- Jiale Ma
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kazuhiro Uchida
- Department of Health Promotion, School of Health and Nutrition Science, Nakamura-Gakuin University, Fukuoka, Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shinya Kageyama
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Mikari Asakawa
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Shino Suma
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Woosung Sohn
- Discipline of Population Oral Health, University of Sydney School of Dentistry, Faculty of Medicine and Health, Sydney, Australia
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Hiramatsu Y, Ide H, Tsuchiya A, Furui Y. Examining proximity to death and health care expenditure by disease: a Bayesian-based descriptive statistical analysis from the National Health Insurance database in Japan. HEALTH ECONOMICS REVIEW 2022; 12:6. [PMID: 35006373 PMCID: PMC8750752 DOI: 10.1186/s13561-021-00353-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Japan is one of the Organization for Economic Co-operation and Development (OECD) countries where population aging and increasing health care expenditures (HCE) are urgent issues. Recent studies have identified factors other than age, such as proximity to death and morbidity, as contributing factors to the increase in medical costs. It is important to assess HCE by disease and analyze their factors to estimate and improve future HCE. METHODS We extracted individual records spanning approximately 2 years prior to the death of persons aged 65 to 95 years from the National Health Insurance data in Japan, and used a Bayesian approach to decompose monthly HCE into five disease groups (circulatory, chronic kidney disease, neoplasms, respiratory, and others). The relationship between the proximity to death and the average HCE in each disease group was stratified by sex and age and analyzed using a descriptive statistical method similar to the two-part model. RESULTS The average HCE increased rapidly as death approached in most disease groups, but the increase-pattern differed greatly among disease groups, sex, and age groups. The effect of proximity to death on average HCE was small for chronic diseases, but large for lethal diseases. When stratified by age and sex, younger and male decedents tended to have higher average HCE, but the extent of this varied by disease group. The two-year cumulative average HCE for neoplasms in the 65-75 years age group was about six times larger than those in the 85-95 years age group. CONCLUSIONS In Japan, it was suggested that disease, proximity to death, age, and sex may contribute to HCE. However, these factors interact in a complex manner, and it is important to analyze HCE by disease. In addition, preventing or delaying the severity of diseases with high medical burdens in younger people may be effective in reducing future terminal care costs. These findings have important implications for future projections and improvements of HCE.
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Affiliation(s)
- Yuji Hiramatsu
- Institute for Future Initiatives, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
- MCVP Division, AXA Life Insurance Co., Ltd, Tokyo, Japan.
| | - Hiroo Ide
- Institute for Future Initiatives, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Atsuko Tsuchiya
- Health and Welfare Department, Shizuoka Prefectural Government, Shizuoka, Japan
| | - Yuji Furui
- Institute for Future Initiatives, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Umeya R, Yoshida Y, Ono K. Impact of retinal vein occlusion on cardiovascular events in elderly Japanese patients. Medicine (Baltimore) 2021; 100:e28424. [PMID: 34967379 PMCID: PMC8718221 DOI: 10.1097/md.0000000000028424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 12/06/2021] [Indexed: 01/05/2023] Open
Abstract
To assess the relationship between retinal vein occlusion (RVO) and the incidence of cardiovascular (CV) events.This was a single-institution, retrospective cohort study. We enrolled 57 patients diagnosed with RVO between January 2012 and December 2019, and 125 non-RVO patients who had undergone cataract surgery by a single surgeon between January and April 2012. We compared the relative risk and incidence rate ratio of CV events between the 2 groups. In addition, survival analysis was performed to calculate the hazard ratio (HR) using the Cox proportional hazards model. RVO, age, sex, blood pressure, body mass index, presence of diabetes, blood sample data, and smoking were considered confounders.The mean observation period (± standard deviation) for the RVO and non-RVO groups was 2.68 ± 2.04 and 2.81 ± 2.70 years, respectively. Seven CV events were observed in the RVO group and 2 in the non-RVO group. Relative risk and incidence rate ratio were 7.68 (95% confidence interval [CI]: 1.65-35.8) and 8.07 (95% CI: 1.54-79.6), respectively. Multivariate analysis revealed that the RVO group had a high HR for CV events (HR: 16.13 [95% CI: 2.29-113.74]) and older age (HR: 1.26 [95% CI: 1.06-1.49]).RVO can predict future CV events, especially in the elderly population. Fundus observations should be shared between ophthalmologists and internists to prevent future CV events.
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Affiliation(s)
- Reiko Umeya
- Department of Ophthalmology, Juntendo Tokyo-Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuto Yoshida
- Department of Ophthalmology, Juntendo Tokyo-Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan
| | - Koichi Ono
- Department of Ophthalmology, Juntendo Tokyo-Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan
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Fukai K, Furuya Y, Nakazawa S, Kojimahara N, Hoshi K, Toyota A, Tatemichi M. A case control study of occupation and cardiovascular disease risk in Japanese men and women. Sci Rep 2021; 11:23983. [PMID: 34907236 PMCID: PMC8671491 DOI: 10.1038/s41598-021-03410-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/30/2021] [Indexed: 01/08/2023] Open
Abstract
We aimed to investigate the risks of cardiovascular diseases associated with specific occupations, using a nation-wide, multicentre, hospital-based registry data from the Inpatient Clinico-Occupational Survey. The analysis included 539,110 controls (non-circulatory disease) and 23,792 cases (cerebral infarction, intracerebral/subarachnoid hemorrhage, acute myocardial infarction) aged ≥ 20 years who were initially hospitalized during 2005–2015. The participants’ occupational and clinical histories were collected by interviewers and medical doctors. Occupations were coded into 81 categories according to the Japanese standard occupation classification. Multivariable logistic regression analysis adjusted for age, admission year and hospital, smoking, alcohol consumption, hypertension, and shift-work was conducted by sex using general clerical workers as the reference. Increased risks of cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, and acute myocardial infarction, were observed in 15, 20, 25, and 1 occupation(s) in men, and 9, 2, 2, and 10 occupations in women. Motor vehicle drivers, food and drink preparatory workers, fishery workers, cargo workers, civil engineer workers, and other manual workers in men and other manual workers in women faced increased risks of all three stroke subtypes. Our findings demonstrate associations between specific occupations and the risk of cardiovascular disease incidence and suggest that the risk may vary by occupation.
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Affiliation(s)
- Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Yuko Furuya
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Shoko Nakazawa
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Noriko Kojimahara
- Department of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Keika Hoshi
- Center for Public Health Informatics, National Institute of Public Health, Wako, Japan.,Department of Hygiene, School of Medicine, Kitasato University, Sagamihara, Japan
| | - Akihiro Toyota
- Chugoku Rosai Hospital Research Center for the Promotion of Health and Employment Support, Japan Organization of Occupational Health and Safety, Hiroshima, Japan
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan.
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Pathologic Diabetic Nephropathy in Autopsied Diabetic Cases With Normoalbuminuria From a Japanese Community-Based Study. Kidney Int Rep 2021; 6:3035-3044. [PMID: 34901572 PMCID: PMC8640559 DOI: 10.1016/j.ekir.2021.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/24/2021] [Accepted: 09/13/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Albuminuria is a clinical hallmark of diabetic nephropathy (DN). Nevertheless, it is controversial whether pathologic DN lesions exist in individuals with diabetes with normoalbuminuria. We investigated the association between albuminuria levels and the frequency of DN lesions in autopsied diabetic cases from a Japanese community. Methods A total of 106 autopsied cases with diabetes mellitus (mean age = 76 years, 43.4% male) who died within 6 years after their last health examination were included in the study. Urinary albumin-creatinine ratio (UACR) levels were divided into the following 3 groups: <30.0, 30.0 to 299.9, and ≥300.0 mg/g. The kidney specimens were evaluated with light microscopy. Glomerular DN lesions were categorized into class 0 to I, IIa, IIb, and III glomerular DN lesions according to the criteria of the Renal Pathology Society. A Cochran-Armitage test was used to evaluate the association between the UACR levels and the presence of class IIa or higher glomerular DN lesions. Results The frequency of class IIa or higher glomerular DN lesions was 63.2% (IIa, 36.8%; IIb, 3.8%; and III, 22.6%) among overall cases. The frequencies increased significantly with higher UACR levels (P for trend = 0.02). The frequency of class IIa or higher glomerular DN lesions was 51.2%, even in individuals with UACR < 30 mg/g. Conclusion This study revealed a positive association of the UACR levels with the presence of class IIa or higher glomerular DN lesions, which were also frequently found even in the normal range of UACR levels, among autopsied diabetic cases from a Japanese community.
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Toyoda K, Yoshimura S, Nakai M, Koga M, Sasahara Y, Sonoda K, Kamiyama K, Yazawa Y, Kawada S, Sasaki M, Terasaki T, Miwa K, Koge J, Ishigami A, Wada S, Iwanaga Y, Miyamoto Y, Minematsu K, Kobayashi S. Twenty-Year Change in Severity and Outcome of Ischemic and Hemorrhagic Strokes. JAMA Neurol 2021; 79:61-69. [PMID: 34870689 PMCID: PMC8649912 DOI: 10.1001/jamaneurol.2021.4346] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Question Did the initial neurological severity and functional outcomes of patients with stroke change throughout a 20-year period? Findings In this hospital-based, multicenter, prospective registry involving 183 080 patients with acute stroke, initial neurological severity showed a decrease over time in all stroke types. Functional outcome at hospital discharge improved in patients with ischemic stroke but no longer showed improvement after adjustment by reperfusion therapy and others; it did not clearly improve in patients with hemorrhagic stroke. Meaning Twenty-year changes in functional outcomes after ischemic and hemorrhagic strokes showed different trends presumably partly owing to differences in the development of acute therapeutic strategies. Importance Whether recent changes in demographic characteristics and therapeutic technologies have altered stroke outcomes remains unknown. Objective To determine secular changes in initial neurological severity and short-term functional outcomes of patients with acute stroke by sex using a large population. Design, Setting, and Participants This nationwide, hospital-based, multicenter, prospective registry cohort study used the Japan Stroke Data Bank and included patients who developed acute stroke from January 2000 through December 2019. Patients with stroke, including ischemic and hemorrhagic strokes, who registered within 7 days after symptom onset were studied. Modified Rankin Scale scores were assessed at hospital discharge for all patients. Exposure Time. Main Outcomes and Measures Initial severity was assessed by the National Institutes of Health Stroke Scale for ischemic stroke and intracerebral hemorrhage and by the World Federation of Neurological Surgeons grading for subarachnoid hemorrhage. Outcomes were judged as favorable if the modified Rankin Scale score was 0 to 2 and unfavorable if 5 to 6. Results Of 183 080 patients, 135 266 (53 800 women [39.8%]; median [IQR] age, 74 [66-82] years) developed ischemic stroke, 36 014 (15 365 women [42.7%]; median [IQR] age, 70 [59-79] years) developed intracerebral hemorrhage, and 11 800 (7924 women [67.2%]; median [IQR] age, 64 [53-75] years) developed subarachnoid hemorrhage. In all 3 stroke types, median ages at onset increased, and the National Institutes of Health Stroke Scale and World Federation of Neurological Surgeons scores decreased throughout the 20-year period on multivariable analysis. In ischemic stroke, the proportion of favorable outcomes showed an increase over time after age adjustment (odds ratio [OR], 1.020; 95% CI, 1.015-1.024 for women vs OR, 1.015; 95% CI, 1.011-1.018 for men) but then stagnated, or even decreased in men, on multivariate adjustment including reperfusion therapy (OR, 0.997; 95% CI, 0.991-1.003 for women vs OR, 0.990; 95% CI, 0.985-0.994 for men). Unfavorable outcomes and in-hospital deaths decreased in both sexes. In intracerebral hemorrhage, favorable outcomes decreased in both sexes, and unfavorable outcomes and deaths decreased only in women. In subarachnoid hemorrhage, the proportion of favorable outcomes was unchanged, and that of unfavorable outcomes and deaths decreased in both sexes. Conclusions and Relevance In this study, functional outcomes improved in patients with ischemic stroke during the past 20 years in both sexes presumably partly owing to the development of acute reperfusion therapy. The outcomes of patients with hemorrhagic stroke did not clearly improve in the same period.
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Affiliation(s)
- Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Sohei Yoshimura
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Michikazu Nakai
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yusuke Sasahara
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazutaka Sonoda
- Department of Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Kenji Kamiyama
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan
| | - Yukako Yazawa
- Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan
| | - Sanami Kawada
- Stroke Center, Okayama Kyokuto Hospital, Okayama, Japan
| | - Masahiro Sasaki
- Department of Stroke Science, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan
| | - Tadashi Terasaki
- Department of Neurology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
| | - Kaori Miwa
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Junpei Koge
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Akiko Ishigami
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Shinichi Wada
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshitaka Iwanaga
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshihiro Miyamoto
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
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The association between the Moyamoya disease susceptible gene RNF213 variant and incident cardiovascular disease in a general population: the Nagahama study. J Hypertens 2021; 39:2521-2526. [PMID: 34738993 DOI: 10.1097/hjh.0000000000002964] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE An association between the Moyamoya disease susceptible gene ring finger protein 213 (RNF213) variant and ischemic stroke and coronary artery disease has been suggested in case-control studies. We aimed to investigate the possible association between the RNF213 variant and the incidence of cardiovascular disease in a general population. METHODS The study participants consisted of 9153 Japanese community residents without history of cardiovascular disease. The clinical parameters employed in this analysis were observed at baseline between 2008 and 2010. The RNF213 p.R4859K variant was determined by TaqMan probe assay and then confirmed by Sanger sequencing. RESULTS During 8.52 years follow-up period, we observed 214 incident cases of cardiovascular diseases (99 total stroke cases, 119 major adverse cardiac event cases, including 4 cases of both). The incidence rate was higher for the variant allele carriers (120 cases; incidence rate, 71.0 per 10 000 person-years) than for the homozygotes of the wild-type allele (26.9), and the group differences achieved statistical significance (P = 0.009). Although the RNF213 variant was also associated with systolic blood pressure (dominant model: coefficient of 8.19 mmHg; P < 0.001), the Cox regression analysis adjusted for major covariates including systolic blood pressure identified the RNF213 variant as an independent determinant for cardiovascular disease (hazard ratio of 3.41, P = 0.002) and major adverse cardiac event (hazard ratio of 3.80, P = 0.010) but not with total stroke (P = 0.102). CONCLUSION The Moyamoya disease susceptible RNF213 variant was associated with blood pressure and the incidence of cardiovascular disease in a Japanese general population.
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