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Aoki S, Yamagishi K, Maruyama K, Ikeda A, Nagao M, Noda H, Umesawa M, Hayama-Terada M, Muraki I, Okada C, Tanaka M, Kishida R, Kihara T, Takada M, Shimizu Y, Ohira T, Imano H, Sankai T, Okada T, Tanigawa T, Kitamura A, Kiyama M, Iso H. Mushroom intake and risk of incident disabling dementia: the Circulatory Risk in Communities Study (CIRCS). Br J Nutr 2024; 131:1641-1647. [PMID: 38239014 DOI: 10.1017/s000711452400014x] [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: 02/13/2024]
Abstract
It is uncertain whether dietary intake of mushrooms rich in dietary fibre and several antioxidants is associated with a lower risk of dementia. We sought to examine prospectively the association between mushroom intake and the risk of disabling dementia. We performed a prospective study involving 3750 people aged 40 to 64 years residing in three communities who participated in an annual cardiovascular risk survey from 1985 to 1999. Cases of incident disabling dementia were surveyed from 1999 to 2020. We calculated the hazard ratios (HR) and 95 % CI for incident total dementia according to mushroom intake among participants with or without a history of stroke. During a mean 16·0 years' follow-up in 3739 eligible participants, 670 people developed disabling dementia. For women, mushroom intake was inversely associated with the risk of total dementia and the association was confined to dementia without a history of stroke. The multivariable HR (95 % CI) for total dementia in women were 0·81 (0·62, 1·06) for mushroom intake of 0·1-14·9 g/d and 0·56 (0·42, 0·75) for mushroom intake above 15·0 g/d (Pfor trend = 0·003) compared with no intake. The corresponding HR (95 % CI) for dementia without a history of stroke were 0·66 (0·47, 0·93) and 0·55 (0·38, 0·79) (Pfor trend = 0·01). In men, no associations were observed between mushroom intake and the risk of disabling dementia. Among Japanese women, dietary mushroom intake was associated with a lower risk of disabling dementia.
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Affiliation(s)
- Shoko Aoki
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Doctoral Program in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
- Ibaraki Western Medical Center, Chikusei, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Ibaraki Western Medical Center, Chikusei, Japan
| | - Kotatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Japan
| | - Ai Ikeda
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Masanori Nagao
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroyuki Noda
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Dokkyo Medical University, School of Medicine, Mibu, Japan
| | | | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Chika Okada
- Department of Public Health, Kindai University, Osakasayama, Japan
| | - Mari Tanaka
- Department of Public Health, Kindai University, Osakasayama, Japan
| | - Rie Kishida
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Tomomi Kihara
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Midori Takada
- Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, Japan
| | - Yuji Shimizu
- Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hironori Imano
- Department of Public Health, Kindai University, Osakasayama, Japan
| | - Tomoko Sankai
- Department of Public Health and Nursing, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | | | | | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Jinnouchi H, Kiyama M, Kitamura A, Matsudaira K, Kakihana H, Hayama-Terada M, Muraki I, Honda E, Okada T, Yamagishi K, Imano H, Iso H. Medical and exercise consultation use for low back and knee pain among cardiovascular mass screening population: A cross-sectional study. Prev Med Rep 2024; 41:102684. [PMID: 38533393 PMCID: PMC10963857 DOI: 10.1016/j.pmedr.2024.102684] [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: 07/14/2023] [Revised: 03/12/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024] Open
Abstract
Low back and knee pain, as major symptoms and early signs of osteoarthritis, have restricted healthy life expectancy, and numerous guidelines have recommended therapeutic exercise as the first-line treatment for chronic pain. Proportions of medical and exercise consultation use for those pain have been unclear, and these may change in the future. We performed a cross-sectional study of 2,954 persons aged over 30 years in 2017 as a part of the Circulatory Risk in Communities Study. A generalized linear model with logit link and 11-year age-group moving averages were used to estimate sex- and age-specific average proportions of lifetime pain, chronic pain, and dysfunctional chronic pain of the low back and knee, and history of medical and exercise consultation use. The medical consultation use increased in the order of lifetime pain, chronic pain, and dysfunctional chronic pain, reaching 69.1 % [65.2, 72.8] in women and 74.9 % [70.3, 79.0] in men for chronic low back pain, and 70.3 % [66.1, 74.2] in women and 55.6 % [49.3, 61.7] in men for chronic knee pain. On the other hand, the exercise consultation use accounted for 36.5 % [32.6, 40.6] in women and 28.8 % [24.4, 33.5] in men for chronic low back pain, and 40.8 % [36.5, 45.2] in women and 20.6 % [16.0, 26.0] in men for chronic knee pain. This survey revealed the differences in the multilayer proportions of medical and exercise consultation use for low back and knee pain in the cardiovascular mass screening, suggesting exercise consultation was less often provided compared to medical consultation.
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Affiliation(s)
- Hiroshige Jinnouchi
- Department of Hygiene and Public Health, Nippon Medical School, 1-25-16 Nezu, Bunkyo-ku, Tokyo 113-0031, Japan
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki 305-8575, Japan
- Osaka Center for Cancer and Cardiovascular Disease Prevention, 1-6-107 Morinomiya, Joto-ku, Osaka 536-8588, Japan
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, 1-6-107 Morinomiya, Joto-ku, Osaka 536-8588, Japan
| | - Akihiko Kitamura
- Yao City Public Health Center, 1-2-5 Shimizu-cho, Yao, Osaka 581-0006, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hironobu Kakihana
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, 518 Arise, Ikawadani-cho, Nishi-ku, Kobe 651-2180 Japan
| | - Mina Hayama-Terada
- Yao City Public Health Center, 1-2-5 Shimizu-cho, Yao, Osaka 581-0006, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Eiko Honda
- Osaka Center for Cancer and Cardiovascular Disease Prevention, 1-6-107 Morinomiya, Joto-ku, Osaka 536-8588, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, 1-6-107 Morinomiya, Joto-ku, Osaka 536-8588, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki 305-8575, Japan
| | - Hironori Imano
- Osaka Center for Cancer and Cardiovascular Disease Prevention, 1-6-107 Morinomiya, Joto-ku, Osaka 536-8588, Japan
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka 589-8511, Japan
| | - Hiroyasu Iso
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki 305-8575, Japan
- Osaka Center for Cancer and Cardiovascular Disease Prevention, 1-6-107 Morinomiya, Joto-ku, Osaka 536-8588, Japan
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
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Kishida R, Yamagishi K, Ikeda A, Hayama-Terada M, Shimizu Y, Muraki I, Umesawa M, Imano H, Sankai T, Okada T, Kitamura A, Kiyama M, Iso H. Serum folate and risk of disabling dementia: a community-based nested case-control study. Nutr Neurosci 2024; 27:470-476. [PMID: 37314940 DOI: 10.1080/1028415x.2023.2218533] [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] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of this study was to examine associations between serum folate levels and risk of disabling dementia that required care under the national insurance (disabling dementia). METHODS We performed a nested case-control study in a community-based cohort, the Circulatory Risk in Communities Study, involving 13,934 Japanese individuals aged 40-84 years at the baseline period of 1984-2005. Serum folate was measured in 578 cases of incident disabling dementia, and in 1,156 controls whose age (±1 years), sex, area of residence, and baseline year were matched with the cases. The diagnosis of disabling dementia was performed by attending physicians under the National Long-Term Care Insurance System in Japan. Conditional odds ratios of disabling dementia according to quintiles of serum folate were calculated using conditional logistic regression models. RESULTS After a 20.8-year follow-up, serum folate was inversely associated with risk of disabling dementia. The respective multivariable odds ratios (95% CIs) were 0.71 (0.51-0.99), 0.76 (0.54-1.06), 0.70 (0.49-1.00), and 0.62 (0.43-0.90) for persons with the second, third, fourth, and highest quintiles of serum folate as compared with the lowest quintile (P for trend = 0.03). A similar association was observed for dementia with or without stroke. CONCLUSION In this nested case-control study with a long follow-up, low serum folate levels were associated with an increased risk of disabling dementia among Japanese individuals.
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Affiliation(s)
- Rie Kishida
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Ibaraki Western Medical Center, Chikusei, Japan
| | - Ai Ikeda
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | | | - Yuji Shimizu
- Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | | | - Hironori Imano
- Department of Public Health, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | | | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- National Center for Global Health and Medicine, Institute of Global Health Policy Research, Bureau of International Health Cooperation, Tokyo, Japan
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4
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Tezuka K, Kubota Y, Ohira T, Muraki I, Hayama-Terada M, Shimizu Y, Imano H, Shirai K, Okada T, Kiyama M, Iso H. Retirement status after the age of 60 years modifies the association between anger expression and the risk of cardiovascular disease: The Circulatory Risk in Communities Study. Geriatr Gerontol Int 2024; 24:385-389. [PMID: 38449304 DOI: 10.1111/ggi.14852] [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: 09/24/2023] [Revised: 02/01/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
AIM Anger expression is associated with an increased risk of cardiovascular disease. This positive association was confined to individuals with lower perceived social support and outdoor recreational activity. However, the effects of retirement status remain unclear. This study aimed to investigate whether retirement status after the age of 60 years modifies the association between anger expression and the risk of cardiovascular disease in the Japanese population. METHODS This longitudinal study included 499 community-dwelling retired and employed workers aged 60-79 years, who completed a cardiovascular risk survey in 1997. A Cox proportional hazards model was used to estimate the hazard ratios and 95% confidence intervals of incident cardiovascular disease (ischemic heart disease and stroke) according to anger expression in retired and employed workers after adjusting for potential cardiovascular risk factors. RESULTS A total of 37 participants experienced incident cardiovascular disease during the mean follow-up period of 14.8 years (standard deviation 5.5 years). In retired workers, anger expression was associated with an increased cardiovascular disease risk, whereas no such association was observed in employed workers. The respective hazard ratio per one-standard deviation increment of total anger expression was 1.77 (95% confidence interval 1.29-2.43) and 1.03 (95% confidence interval 0.64-1.66; P for interaction = 0.036) among retired and employed workers, respectively. CONCLUSIONS A positive association between anger expression and the risk of cardiovascular disease was confined to retired workers, suggesting that continuing work after retirement age could reduce anger expression-related cardiovascular disease risk. Geriatr Gerontol Int 2024; 24: 385-389.
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Affiliation(s)
- Kazuhide Tezuka
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Yasuhiko Kubota
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Isao Muraki
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Yuji Shimizu
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hironori Imano
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Public Health, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takeo Okada
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Masahiko Kiyama
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan
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5
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O’Keefe JH, Tintle NL, Harris WS, O’Keefe EL, Sala-Vila A, Attia J, Garg GM, Hure A, Bork CS, Schmidt EB, Venø SK, Chien KL, Chen YY(A, Egert S, Feldreich TR, Ärnlöv J, Lind L, Forouhi NG, Geleijnse JM, Pertiwi K, Imamura F, de Mello Laaksonen V, Uusitupa WM, Tuomilehto J, Laakso M, Lankinen MA, Laurin D, Carmichael PH, Lindsay J, Leander K, Laguzzi F, Swenson BR, Longstreth WT, Manson JE, Mora S, Cook NR, Marklund M, van Lent DM, Murphy R, Gudnason V, Ninomiya T, Hirakawa Y, Qian F, Sun Q, Hu F, Ardisson Korat AV, Risérus U, Lázaro I, Samieri C, Le Goff M, Helmer C, Steur M, Voortman T, Ikram MK, Tanaka T, Das JK, Ferrucci L, Bandinelli S, Tsai M, Guan W, Garg P, Verschuren WMM, Boer JMA, Biokstra A, Virtanen J, Wagner M, Westra J, Albuisson L, Yamagishi K, Siscovick DS, Lemaitre RN, Mozaffarian D. Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies. Stroke 2024; 55:50-58. [PMID: 38134264 PMCID: PMC10840378 DOI: 10.1161/strokeaha.123.044281] [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: 06/22/2023] [Accepted: 10/30/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The effect of marine omega-3 PUFAs on risk of stroke remains unclear. METHODS We investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual-level analysis using a prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome. RESULTS Among 183 291 study participants, there were 10 561 total strokes, 8220 ischemic strokes, and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76-0.91]; P<0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74-0.91]; P<0.0001). For docosahexaenoic acid, comparing Q5 with Q1, there was a 12% lower incidence of total stroke (HR, 0.88 [CI, 0.81-0.96]; P=0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78-0.95]; P=0.0001). Neither eicosapentaenoic acid nor docosahexaenoic acid was associated with a risk for hemorrhagic stroke. These associations were not modified by either baseline history of AF or prevalent CVD. CONCLUSIONS Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.
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Affiliation(s)
- James H O’Keefe
- Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO
| | | | - William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD
- University of South Dakota, Sioux Falls, SD
| | - Evan L O’Keefe
- Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO
| | - Aleix Sala-Vila
- Fatty Acid Research Institute, Sioux Falls, SD
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - John Attia
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | - G Manohar Garg
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | - Alexis Hure
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | | | - Erik Berg Schmidt
- Aalborg University Hospital, Department of Clinical Medicine, Aalborg, Denmark
| | - Stine Krogh Venø
- Aalborg University Hospital, Department of Clinical Biochemistry, Aalborg, Denmark
| | - Kuo-Liong Chien
- National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei Taiwan
| | - Yun-Yu (Amelia) Chen
- Taichung Veterans General Hospital, Department of Medical Research, Taichung, Taiwan
| | - Sarah Egert
- University of Bonn, Institute of Nutrition and Food Sciences and Nutritional Physiology, Bonn, Germany
| | | | - Johan Ärnlöv
- Karolinska Institutet, Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences & Society, Solna, Sweden
| | - Lars Lind
- Uppsala University, Department of Medical Sciences Cardiovascular Epidemiology, Uppsala, Sweden
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Johanna M Geleijnse
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, Netherlands
| | - Kamalita Pertiwi
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, Netherlands
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Vanessa de Mello Laaksonen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - W Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Tuomilehto
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markku Laakso
- University of Eastern Finland, School of Medicine, Department of Internal Medicine, Kuopio, Finland
| | - Maria Anneli Lankinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Danielle Laurin
- CHU de Québec-Université Laval and VITAM Research Centers, Centre d’Excellence sur le Vieillissement de Québec, Québec, Canada
| | - Pierre-Hugues Carmichael
- CHU de Québec-Université Laval and VITAM Research Centers, Centre d’Excellence sur le Vieillissement de Québec, Québec, Canada
| | - Joan Lindsay
- University of Ottawa, School of Epidemiology and Public Health, Ottawa, Canada
| | - Karin Leander
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden
| | - Federica Laguzzi
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden
| | - Brenton R Swenson
- University of Washington, Cardiovascular Health Research Unit, Seattle, WA
| | - William T Longstreth
- University of Washington, Departments of Neurology and Epidemiology, Seattle, WA
| | - JoAnn E Manson
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Samia Mora
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Nancy R Cook
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Matti Marklund
- The George Institute for Global Health, University of New South Wales, Newtown, NSW Australia; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland: and Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Debora Melo van Lent
- University of Texas, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, TX
| | - Rachel Murphy
- University of British Columbia, Cancer Control Research, British Columbia Cancer, School of Population and Public Health, Vancouver, Canada
| | | | - Toshihara Ninomiya
- Kyushu University, Department of Epidemiology and Public Health and Center for Cohort Studies, Fukouka, Japan
| | - Yoichiro Hirakawa
- Kyushu University, Department of Epidemiology and Public Health and Center for Cohort Studies, Fukouka, Japan
| | - Frank Qian
- Harvard Medical School, T.H. Chan School of Public Health and Beth Deaconess Medical Center, Boston, MA
| | - Qi Sun
- Harvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women’s Hospital, Boston, MA
| | - Frank Hu
- Harvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women’s Hospital, Boston, MA
| | | | - Ulf Risérus
- Uppsala University, Department of Public Health and Caring Sciences Clinical Nutrition and Metabolism Unit, Uppsala, Sweden
| | - Iolanda Lázaro
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Cecilia Samieri
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Mélanie Le Goff
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Catherine Helmer
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Marinka Steur
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - Trudy Voortman
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - M Kamran Ikram
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - Toshiko Tanaka
- National Institute of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD
| | | | - Luigi Ferrucci
- National Institute of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD
| | | | - Michael Tsai
- University of Minnesota, Department of Laboratory Medicine and Pathology, Minneapolis, MN
| | - Weihua Guan
- University of Minnesota, Division of Biostatistics, Minneapolis, MN
| | - Parveen Garg
- University of Southern California, Department of Medicine, Cardiology, Los Angeles, CA
| | - WM Monique Verschuren
- National Institute for Public Health and the Environment Bilthoven, The Netherlands, Julius Center for Health Sciences and Primary Care and Centre for Nutrition, Prevention and Health Services, Utrecht, The Netherlands
| | - Jolanda MA Boer
- National Institute for Public Health and the Environment Bilthoven, The Netherlands
| | - Anneke Biokstra
- National Institute for Public Health and the Environment Bilthoven, The Netherlands
| | - Jyrki Virtanen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Michael Wagner
- University Hospital, Depts of Neurodegenerative Diseases and Geriatric Psychiatry and German Center for Neurodegenerative Diseases, Bonn, Germany
| | | | | | - Kazumasa Yamagishi
- University of Tsukubu, Department of Public Health Medicine, Tsukuba, Japan
| | - David S Siscovick
- New York Academy of Medicine, Department of Epidemiology, New York, New York
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Teramura S, Yamagishi K, Umesawa M, Hayama-Terada M, Muraki I, Maruyama K, Tanaka M, Kishida R, Kihara T, Takada M, Ohira T, Imano H, Shimizu Y, Sankai T, Okada T, Kitamura A, Kiyama M, Iso H. Risk Factors for Hyperuricemia or Gout in Men and Women: The Circulatory Risk in Communities Study (CIRCS). J Atheroscler Thromb 2023; 30:1483-1491. [PMID: 36878531 PMCID: PMC10564651 DOI: 10.5551/jat.63907] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/12/2023] [Indexed: 03/06/2023] Open
Abstract
AIM We aimed to examine sex-specific risk factors for hyperuricemia or gout in Japanese cohorts. METHODS We followed up 3,188 men (mean age, 55.6 years) and 6,346 women (mean age, 54.1 years) without hyperuricemia, gout, or elevated liver enzymes at baseline from 1986 to 1990 for a median of 14.6 years. The participants were considered as having hyperuricemia or gout if their serum uric acid levels were ≥ 7.0 mg/dL or they were receiving treatment for hyperuricemia or gout during annual health checkups. The sex-specific multivariable hazard ratios (HRs) of hyperuricemia or gout incidence were calculated after adjustment for smoking and drinking status, body mass index, hypertension, diabetes, hypercholesterolemia, and hypertriglyceridemia using the Cox proportional-hazard model. RESULTS During follow-up, 733 men and 355 women had hyperuricemia or gout. Among men, the multivariable HRs (95% confidence intervals) of hyperuricemia or gout were 1.23 (1.00-1.52) and 1.41 (1.13-1.75) for drinkers of <46 and ≥ 46 g ethanol/day, respectively, compared with non-drinkers; 1.00 (0.81-1.24) and 1.18 (0.93-1.50) for smokers of 1-19 and ≥ 20 cigarettes/day, respectively, compared with never smokers; and 1.41 (1.20-1.65) for hypertensive compared with non-hypertensive participants. The HRs for women were 1.02 (0.70-1.48), 1.66 (1.05-2.63), and 1.12 (0.88-1.42) for current drinkers, current smokers, and hypertensive participants, respectively. For both men and women, body mass index, diabetes, hypercholesterolemia, and hypertriglyceridemia were not associated with hyperuricemia or gout incidence. CONCLUSIONS Hypertension and alcohol drinking are risk factors for hyperuricemia or gout among men and smoking among women.
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Affiliation(s)
- Saki Teramura
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Ibaraki Western Medical Center, Ibaraki, Japan
| | | | | | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Koutatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University, Ehime, Japan
| | - Mari Tanaka
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
| | - Rie Kishida
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Tomomi Kihara
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Midori Takada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University school of Medicine, Fukushima, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Tomoko Sankai
- Department of Public Health and Nursing, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Akihiko Kitamura
- Yao City Public Health Center, Yao City Office, Osaka, Japan
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Institute for Global Health Policy Research, Bureau of International Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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7
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Onuki K, Ikeda A, Muraki I, Tanaka M, Yamagishi K, Kiyama M, Okada T, Kubota Y, Imano H, Kitamura A, Sankai T, Umesawa M, Ohira T, Iso H, Tanigawa T. Nocturnal Intermittent Hypoxia and the Risk of Cardiovascular Disease among Japanese Populations: The Circulatory Risk in Communities Study (CIRCS). J Atheroscler Thromb 2023; 30:1276-1287. [PMID: 36642535 PMCID: PMC10499452 DOI: 10.5551/jat.63754] [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: 06/08/2022] [Accepted: 11/17/2022] [Indexed: 01/15/2023] Open
Abstract
AIMS Information is limited about the influence of obstructive sleep apnea (OSA) on developing cardiovascular disease (CVD) among Asian community-dwelling populations. We examined the association between nocturnal intermittent hypoxia as a surrogate marker of OSA and the risk of CVD in a Japanese community-based cohort study. METHODS We used baseline surveys from 2000 to 2008 to study the cohort data of 5,313 residents from three Japanese communities who were between the ages of 40 and 74 years and initially free from ischemic heart disease and stroke. We assessed the number of 3% oxygen desaturation index (ODI) as the indicator of nocturnal intermittent hypoxia. We divided individuals into two groups depending on 3% ODI (3% ODI ≥ 5 or 3% ODI <5). Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD according to 3% ODI. Age, sex, body mass index, alcohol, and smoking were adjusted in the multivariable models. RESULTS During 12.8 years of the median follow-up with 66,796 person-years, 185 cases with CVD (115 stroke and 70 coronary heart disease [CHD]) were recorded. The multivariable HRs (95% CIs) were 1.49 (1.09-2.03), 2.13 (1.08-4.22), and 1.93 (1.16-3.19) for the 3% ODI ≥ 5 group versus the 3% ODI <5 group of developing CVD, lacunar infarction, and CHD, respectively. CONCLUSIONS Nocturnal intermittent hypoxia may increase the risk of developing lacunar infarction and CHD among community-dwelling Japanese populations. However, we could not find a significant risk of developing total stroke or stroke subtypes such as intraparenchymal hemorrhage, subarachnoid hemorrhage, and total ischemic stroke.
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Affiliation(s)
- Keisuke Onuki
- Department of Public Health, Graduate School of Juntendo University, Tokyo, Japan
| | - Ai Ikeda
- Department of Public Health, Graduate School of Juntendo University, Tokyo, Japan
| | - Isao Muraki
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mari Tanaka
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
- Ibaraki Western Medical Center, Ibaraki, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hironori Imano
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | | | - Tomoko Sankai
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Mitsumasa Umesawa
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Hiroyasu Iso
- Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Graduate School of Juntendo University, Tokyo, Japan
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8
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Mitsutake S, Ishizaki T, Edahiro A, Kitamura A, Hirata T, Saito A. The effects of dental visits on the occurrence of acute hospitalization for systemic diseases among patients aged 75 years or older: A propensity score-matched study. Arch Gerontol Geriatr 2023; 107:104876. [PMID: 36516734 DOI: 10.1016/j.archger.2022.104876] [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: 09/22/2022] [Revised: 11/03/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Although several studies examined the association between oral status and the risk of systemic diseases, few have examined whether dental visits affect the occurrence of acute hospitalization due to systemic diseases. This study examined the effects of dental visits on preventing the occurrence of acute hospitalization due to systemic diseases in adults aged ≥ 75 years, in order to optimize the healthcare system for older adults. METHODS This propensity-score-matched retrospective cohort study was conducted using medical insurance claims data from Hokkaido, Japan. We analyzed 432,292 adult outpatients aged ≥ 75 years between September 2016 and February 2017 (baseline period). The exposure variable was visits to the dental office during the baseline period. The primary outcome variable was the occurrence of acute hospitalization due to pneumonia, urinary tract infections, cerebrovascular diseases, or coronary heart diseases between March 2017 and March 2019. RESULTS Among the 432,292 patients before propensity score matching, 149,639 (34.6%) had visited the dental office. One-to-one propensity score matching produced 149,289 matched pairs adjusted for the differences in all covariables (age, sex, copayment rate, annual health checkup, chronic diseases, and residential area). In these matched pairs, the risk ratio of the occurrence of acute hospitalization due to pneumonia, urinary tract infections, and cerebrovascular diseases was lower among patients who had visited dental office than among those who did not. CONCLUSIONS Dental visits appeared to be effective in preventing acute hospitalization due to systemic diseases, thus, dental care services would be an important component of healthcare for older adults.
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Affiliation(s)
- Seigo Mitsutake
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Tatsuro Ishizaki
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University, Nara, Japan
| | - Atsushi Saito
- Department of Peridontology, Tokyo Dental College, Tokyo, Japan
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9
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Jinnouchi H, Kitamura A, Matsudaira K, Kakihana H, Oka H, Yamagishi K, Kiyama M, Iso H. Brief self-exercise education for adults with chronic knee pain: A randomized controlled trial. Mod Rheumatol 2023; 33:408-415. [PMID: 35134993 DOI: 10.1093/mr/roac009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/01/2022] [Accepted: 01/24/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Effective brief instructions for self-management of chronic knee pain are needed. METHODS Forty-six participants with chronic knee pain were randomly allocated into two programmes: material-based education alone or brief self-exercise education (brief-See), which comprised a 100-minute instruction for self-exercise combined with compact pain education. Total function (KOOS4, 4-subscale average of knee injury and osteoarthritis outcome score), pain intensity (NRS, numeric rating scale), self-efficacy (PSEQ, pain self-efficacy questionnaire), and health-related quality of life (EQ-5D, European quality of life-5 dimensions) were evaluated at baseline and 4 and 12 weeks after the initial intervention. A generalized mixed linear model estimated average group differences in changes from baseline and 95% confidence intervals (95% CIs) using intention-to-treat principle. RESULTS Compared to material-based education alone, the brief-See provided significant additional improvements of 9.4% (95% CI: 2.3 to 16.4) on the KOOS4 and 5.4 points (0.3 to 10.4) on the PSEQ at 12 weeks but did not on the NRS and EQ-5D. Adherence and satisfaction were favourable in the brief-See without any notable adverse event. CONCLUSIONS Adding the brief-See to material-based education could be more acceptable and restore total function and self-efficacy, which could contribute to the self-management of chronic knee pain in primary care.
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Affiliation(s)
- Hiroshige Jinnouchi
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.,Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Department of Social Medicine, Public Health, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Public Health Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Akihiko Kitamura
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, The University of Tokyo, Tokyo, Japan
| | - Hironobu Kakihana
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Hyôgo, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, The University of Tokyo, Tokyo, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Masahiko Kiyama
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Department of Social Medicine, Public Health, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Public Health Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
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10
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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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11
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Imano H, Yamagishi K, Ohira T, Kitamura A, Okada T, Muraki I, Umesawa M, Sankai T, Kiyama M, Iso H. Serum High-Sensitivity Cardiac Troponin T as an Independent Predictor for Incident Coronary Heart Disease in the Japanese General Population: The Circulatory Risk in Communities Study (CIRCS). J Atheroscler Thromb 2023; 30:237-246. [PMID: 35569956 PMCID: PMC9981345 DOI: 10.5551/jat.63378] [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] [Indexed: 11/11/2022] Open
Abstract
AIMS Epidemiological evidence is extremely limited about high-sensitivity cardiac troponin T (hs-cTnT) and future coronary heart disease (CHD) events for the general population in countries with low mortality from CHD. Therefore, we investigated the association between hs-cTnT levels and the risk of incident CHD using a nested case-control study in a large Japanese cohort study. METHODS The participants were residents of four Japanese communities in the Circulatory Risk in Communities Study (CIRCS). We obtained 120 cases (81 men and 39 women, aged 38-86 years at baseline) of first incident CHD and 240 controls matched by age, sex, communities, and blood sampling term. Serum hs-cTnT levels were measured using an electrochemiluminescence immunoassay with stored sera collected between 2001 and 2011. The median period between sampling at survey and CHD incidence was 2.0 (interquartile range, 0.9-3.7) years. After adjusting for conventional risk factors, the multivariable odds ratios (ORs) of CHD were calculated using conditional logistic regression analyses. RESULTS hs-cTnT ranged from ≤ 3 (assay detection limit) to 155 ng/L. Compared with the lowest quartile of hs-cTnT, multivariable ORs (95% confidence intervals) of CHD for the second, third, and highest quartiles were 1.30 (0.57-2.95), 2.48 (1.09-5.64), and 3.01 (1.27-7.12), respectively. Similar associations were observed after adjusting for estimated glomerular filtration, or after excluding matched groups, including people with chronic kidney disease. CONCLUSION Serum hs-cTnT could predict CHD in the Japanese general population. These findings implicate a benefit from monitoring hs-cTnT to predict CHD even among populations in countries with low mortality from CHD.
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Affiliation(s)
- Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan,Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan,Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University
of Tsukuba, Ibaraki, Japan,Ibaraki Western Medical Center, Ibaraki, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | | | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University
of Tsukuba, Ibaraki, Japan,Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Tomoko Sankai
- Department of Community Health and Public Health Nursing, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan,Institute for Global Health Policy Research (iGHP), National Center for Global Health and Medicine, Tokyo, Japan
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12
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Development of a data platform for monitoring personal health records in Japan: The Sustaining Health by Integrating Next-generation Ecosystems (SHINE) Study. PLoS One 2023; 18:e0281512. [PMID: 36787325 PMCID: PMC9928020 DOI: 10.1371/journal.pone.0281512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 01/25/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The Sustaining Health by Integrating Next-generation Ecosystems (SHINE) Study was developed as a data platform that incorporates personal health records (PHRs) into health-related data at the municipal level in Japan. This platform allows analyses of the associations between PHRs and future health statuses, and supports the production of evidence for developing preventive care interventions. Herein, we introduce the SHINE Study's profile and describe its use in preliminary analyses. METHODS The SHINE Study involves the collection of participants' health measurements and their addition to various health-related data from the Longevity Improvement & Fair Evidence (LIFE) Study. With cooperation from municipal governments, measurements can be acquired from persons enrolled in government-led long-term care prevention classes and health checkups who consent to participate in the SHINE Study. For preliminary analyses, we collected salivary test measurements, lifelog measurements, and gait measurements; these were linked with the LIFE Study's database. We analyzed the correlations between these measurements and the previous year's health care expenditures. RESULTS We successfully linked PHR data of 33 participants for salivary test measurements, 44 participants for lifelog measurements, and 32 participants for gait measurements. Only mean torso speed in the gait measurements was significantly correlated with health care expenditures (r = -0.387, P = 0.029). CONCLUSION The SHINE Study was developed as a data platform to collect and link PHRs with the LIFE Study's database. The analyses undertaken with this platform are expected to contribute to the development of preventive care tools and promote health in Japan.
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13
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Yamagishi K, Maruyama K, Ikeda A, Nagao M, Noda H, Umesawa M, Hayama-Terada M, Muraki I, Okada C, Tanaka M, Kishida R, Kihara T, Ohira T, Imano H, Brunner EJ, Sankai T, Okada T, Tanigawa T, Kitamura A, Kiyama M, Iso H. Dietary fiber intake and risk of incident disabling dementia: the Circulatory Risk in Communities Study. Nutr Neurosci 2023; 26:148-155. [PMID: 35125070 DOI: 10.1080/1028415x.2022.2027592] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES It has been hypothesized that dietary fiber intake has a beneficial impact on prevention of dementia, but the epidemiological evidence is scant. We sought to examine whether dietary fiber intake is inversely associated with risk of dementia requiring care under the national insurance (disabling dementia). METHODS The study setting was the Circulatory Risk in Communities Study, involving 3739 Japanese individuals aged 40-64 years at the dietary surveys (1985-99). Dietary fiber intake was estimated using the 24-hour dietary recall method. Incident disabling dementia was followed up from 1999 through 2020. Disabling dementia was further classified into that with or without a history of stroke. Hazard ratios of disabling dementia according to quartiles of total, soluble, and insoluble fiber intake were calculated using the Cox proportional hazards model. RESULTS During a median 19.7-year follow-up, a total of 670 cases of disabling dementia developed. Dietary fiber intake was inversely associated with risk of dementia: the multivariate hazards ratios (95% confidence intervals) were 0.83 (0.67-1.04), 0.81 (0.65-1.02), and 0.74 (0.57-0.96) for individuals with the second, third, and highest quartiles of dietary fiber intake, respectively, as compared with the lowest quartile (P for trend = 0.03). The inverse association was more evident for soluble fiber intake and was confined to dementia without a history of stroke. As for fiber-containing foods, potatoes, but not vegetables or fruits, showed a similar association. CONCLUSIONS Dietary fiber intake, especially soluble fiber, was inversely associated with risk of disabling dementia in a general Japanese population.
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Affiliation(s)
- Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan.,Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Ibaraki Western Medical Center, Chikusei, Japan
| | - Koutatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Japan
| | - Ai Ikeda
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Masanori Nagao
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Hiroyuki Noda
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan.,Department of Public Health, Dokkyo Medical University, Mibu, Japan
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Yao City Public Center, Yao City Office, Yao, Japan
| | - Isao Muraki
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Chika Okada
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Mari Tanaka
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Rie Kishida
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Tomomi Kihara
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Eric J Brunner
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | | | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Imano H, Li J, Tanaka M, Yamagishi K, Muraki I, Umesawa M, Kiyama M, Kitamura A, Sato S, Iso H. Optimal Cut-off Points of Nonfasting and Fasting Triglycerides for Prediction of Ischemic Heart Disease in Japanese General Population: The Circulatory Risk in Communities Study (CIRCS). J Atheroscler Thromb 2023; 30:110-130. [PMID: 35444102 PMCID: PMC9925200 DOI: 10.5551/jat.63358] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
AIMS We investigated the optimal cut-off points of nonfasting and fasting triglycerides in Japanese individuals with lower average triglyceride levels than westerners. METHODS Residents aged 40-69 years without a history of ischemic heart disease or stroke were enrolled between 1980 and 1994 and followed. Serum triglyceride concentrations were measured from 10851 nonfasting (<8 h after meal) and 4057 fasting (≥ 8 h) samples. As a prerequisite, we confirmed the shape of a receiver operating characteristic (ROC) curves, the area under ROC curves (AUC), and the integrated time-dependent AUC. We identified optimal cut-off points for incident ischemic heart disease based on C-statistic, Youden index, and Harrell's concordance statistic. We used dichotomized concentrations of triglycerides via the univariate logistic regression and Cox proportional hazards regression models. We also calculated multivariable hazard ratios and population attributable fractions to evaluate the optimal cut-off points. RESULTS Nonfasting and fasting optimal cut-off points were 145 mg/dL and 110 mg/dL, with C-statistic of 0.594 and 0.626, Youden index of 0.187 and 0.252, and Harrell's concordance statistic of 0.590 and 0.630, respectively. The corresponding multivariable hazard ratios of ischemic heart disease were 1.43 (95%CI 1.09-1.88) and 1.69 (1.03-2.77), and the corresponding population attributable fractions were 16.1% (95%CI 3.3-27.2%) and 24.6 (-0.3-43.3). CONCLUSION The optimal cut-off points of nonfasting and fasting triglycerides in the Japanese general population were 145 mg/dL and 110 mg/dL, respectively, lower than the current cut-off points recommended in the US and Europe.
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Affiliation(s)
- Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan,Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan,Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Jiaqi Li
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mari Tanaka
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba,Ibaraki Western Medical Center, Ibaraki, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mitsumasa Umesawa
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | | | - Shinichi Sato
- Chiba Prefectural Institute of Public Health, Chiba, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan,Institute for Global Health Polycy Research (iGHP), National Center for Global Health and Medicine, Tokyo, Japan
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15
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Modifying Effect of Outdoor Recreational Activity on the Association Between Anger Expression and Cardiovascular Disease Risk: The Circulatory Risk in Communities Study. Psychosom Med 2023; 85:182-187. [PMID: 36728525 DOI: 10.1097/psy.0000000000001166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Outdoor recreational activity (ORA) has been suggested as a practical strategy for anger management to moderate the risk of cardiovascular disease (CVD). However, there is a lack of evidence pertaining to this topic. Our aim was to examine whether ORA modified the association between anger expression and the risk of CVD. METHODS A community-based cohort study was conducted among 1877 Japanese individuals aged 40 to 79 years at baseline in 1997. The anger expression was measured using the Spielberger Anger Expression Scale. Stratified into low and high ORA (0 and ≥1 of the four behaviors), a Cox proportional hazards model was used to assess the anger expression-related risk of incident CVD (ischemic heart disease and stroke). RESULTS We identified 76 incident CVDs during a median follow-up of 18.8 years. Among participants with low ORA, anger expression was associated with an increased risk of CVD, whereas no association was identified among those with high ORA. The standardized hazard ratios were 1.53 (95% confidence interval, 1.23-1.91) and 0.77 (0.51-1.15) among those with low and high ORA, respectively ( p for interaction = .004). Similar associations were observed regarding the risk of total and ischemic stroke, and ischemic CVD. CONCLUSIONS We found an elevated risk of CVD associated with anger expression among participants with low ORA but not among those with high ORA, suggesting that ORA use may mitigate the association between anger expression and CVD risk.
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16
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Kishida R, Yamagishi K, Maruyama K, Okada C, Tanaka M, Ikeda A, Hayama-Terada M, Shimizu Y, Muraki I, Umesawa M, Imano H, Brunner EJ, Sankai T, Okada T, Kitamura A, Kiyama M, Iso H. Dietary intake of beans and risk of disabling dementia: The Circulatory Risk in Communities Study (CIRCS). Eur J Clin Nutr 2023; 77:65-70. [PMID: 35953593 DOI: 10.1038/s41430-022-01188-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To examine whether bean intake (including soybeans) among Japanese adults is associated with risk of disabling dementia severe enough to require care under the national insurance system. METHODS This cohort study involved 3739 individuals aged 40 to 64 years. The participants were categorized into five groups based on their dietary bean intake estimated by a 24h dietary recall. Hazard ratios and 95% confidence intervals of disabling dementia were estimated using Cox proportional hazard models adjusted for potential confounding factors (smoking, drinking, and intakes of energy and fish). RESULTS During the 59,681 person-year follow-up, 670 cases of disabling dementia were observed. A weak inverse association between bean intake and risk of disabling dementia was found; the multivariable hazard ratios (95% CIs) were 0.79 (0.62-1.00), 0.80 (0.63-1.01), 0.84 (0.67-1.06), and 0.78 (0.62-0.99) for the four groups with higher bean intake, respectively, compared with the lowest group (P for trend = 0.21). A significant inverse association was observed for dementia without a history of stroke; for the four groups with higher bean intake the multivariable hazard ratios were 0.81 (0.61-1.08), 0.70 (0.52-0.95), 0.71 (0.52-0.95), and 0.69 (0.51-0.92), respectively, (P for trend = 0.03). No such association was observed for dementia with history of stroke. The group with increased natto intake were inversely associated with risk of disabling dementia (P for trend = 0.003), but tofu intake was not (P for trend = 0.19). CONCLUSIONS Bean intake was inversely associated with risk of disabling dementia in those without a history of stroke.
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Affiliation(s)
- Rie Kishida
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan.
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.
- Ibaraki Western Medical Center, Chikusei, Japan.
| | - Koutatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Japan
| | - Chika Okada
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Mari Tanaka
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Public Health, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Ai Ikeda
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | | | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | | | - Hironori Imano
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Public Health, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Eric J Brunner
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | | | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Institute of Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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17
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Kubo S, Imano H, Muraki I, Kitamura A, Noda H, Cui R, Maruyama K, Yamagishi K, Umesawa M, Shimizu Y, Hayama-Terada M, Kiyama M, Okada T, Iso H. Total protein intake and subsequent risk of chronic kidney disease: the Circulatory Risk in Communities Study. Environ Health Prev Med 2023; 28:32. [PMID: 37211392 DOI: 10.1265/ehpm.22-00247] [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: 05/23/2023] Open
Abstract
BACKGROUND Whether dietary protein intake worsens renal function in the general population has been discussed but not yet determined. We aimed to examine the longitudinal association between dietary protein intake and risk of incident chronic kidney disease (CKD). METHODS We conducted a 12-year follow-up study with 3,277 Japanese adults (1,150 men and 2,127 women) aged 40-74 years, initially free from CKD, who participated in cardiovascular risk surveys from two Japanese communities under the Circulatory Risk in Communities Study. The development of CKD was defined by the estimated glomerular filtration rate (eGFR) during the follow-up period. Protein intake was measured at baseline by using the brief-type self-administered diet history questionnaire. We estimated sex-, age-, community- and multivariate-adjusted hazard ratios (HR) for incident CKD were calculated using the Cox proportional hazards regression models according to quartiles of percentage of energy (%energy) from protein intake. RESULTS During 26,422 person-years of follow-up, 300 participants developed CKD (137 men and 163 women). The sex-, age-, and community-adjusted HR (95% confidence interval, CI) for the highest (≥16.9%energy) versus lowest (≤13.4%energy) quartiles of total protein intake was 0.66 (0.48-0.90), p for trend = 0.007. The multivariable HR (95%CI) was 0.72 (0.52-0.99), p for trend = 0.016 after further adjustment for body mass index, smoking status, alcohol drinking status, diastolic blood pressure, antihypertensive medication use, diabetes mellitus, serum total cholesterol levels, cholesterol-lowering medication use, total energy intake, and baseline eGFR. The association did not vary by sex, age, and baseline eGFR. When examining animal and vegetable protein intake separately, the respective multivariable HRs (95%CIs) were 0.77 (0.56-1.08), p for trend = 0.036, and 1.24 (0.89-1.75), p for trend = 0.270. CONCLUSIONS Higher protein intake, more specifically animal protein intake was associated with a lower risk of CKD.
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Affiliation(s)
- Sachimi Kubo
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
- Faculty of Human Sciences, Tezukayama Gakuin University
| | - Hironori Imano
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
- Department of Public Health, Kindai University Faculty of Medicine
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Isao Muraki
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Akihiko Kitamura
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
- Yao City Public Health Center
| | - Hiroyuki Noda
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
- Cabinet Secretariat
| | - Renzhe Cui
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
- Department of Internal Medicine, Okanami General Hospital
| | - Koutatsu Maruyama
- Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University
| | - Kazumasa Yamagishi
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
| | - Mitsumasa Umesawa
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
- Dokkyo Medical University School of Medicine
| | - Yuji Shimizu
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
| | - Mina Hayama-Terada
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
- Yao City Public Health Center
| | - Masahiko Kiyama
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
| | - Takeo Okada
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
| | - Hiroyasu Iso
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Diseases Prevention
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine
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18
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Changes in cardiovascular disease risk factors during menopausal transition in Japanese women: the Circulatory Risk in Communities Study (CIRCS). Menopause 2023; 30:88-94. [PMID: 36318736 PMCID: PMC9812420 DOI: 10.1097/gme.0000000000002081] [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] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We aimed to longitudinally clarify the changes in cardiovascular disease risk factors associated with menopause in Japanese women in the 2000s. METHODS Of the 4,596 women who underwent health examinations between 2007 and 2012 in three communities of the Circulatory Risk in Communities Study, 263 women who reported going through menopause during that period were included in the study. We randomly selected 1,665 men as control subjects who participated in a health examination at least once between 2001 and 2009 and at least once between 2010 and 2018 by 1:1 pair-matching for age, community, and examination year. The health examination data from 3 to 6 years before (2001-2009) and after menopause age (2010-2018) were compared in terms of body mass index, systolic and diastolic blood pressure levels, serum total cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, triglycerides, uric acid, hemoglobin A 1c , hemoglobin, aspartate aminotransferase, alanine aminotransferase, and current smoker status. RESULTS Compared with the men, the women showed a greater increase in serum total cholesterol (+16.7 vs -3.1 mg/dL, P < 0.001), non-high-density lipoprotein cholesterol (+15.9 vs -6.3 mg/dL, P < 0.001), fasting triglycerides (+1.2 vs +1.0 mg/dL, P = 0.027), triglycerides regardless of fasting status (+1.2 vs -0.9 mg/dL, P < 0.001), uric acid (+0.5 vs +0.2 mg/dL, P = 0.008), hemoglobin (+0.9 vs -0.3 g/dL, P < 0.001), aspartate aminotransferase (+2.9 vs -2.7 IU/L, P < 0.001), and alanine aminotransferase (+2.9 vs -2.6 IU/L, P < 0.001). No differences were found in the changes in body mass index, systolic and diastolic blood pressures, and hemoglobin A 1c between the women and the matched men. CONCLUSIONS Menopause may be a crucial factor related to changes in serum total cholesterol, non-high-density lipoprotein cholesterol, triglycerides, uric acid, hemoglobin, and liver enzymes.
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19
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Ishihara M, Imano H, Muraki I, Yamagishi K, Maruyama K, Hayama-Terada M, Tanaka M, Yasuoka M, Kihara T, Kiyama M, Okada T, Takada M, Shimizu Y, Sobue T, Iso H. Relationships of habitual daily alcohol consumption with all-day and time-specific average glucose levels among non-diabetic population samples. Environ Health Prev Med 2023; 28:20. [PMID: 36927672 PMCID: PMC10025860 DOI: 10.1265/ehpm.22-00215] [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: 03/17/2023] Open
Abstract
BACKGROUND Alcohol consumption is a prevalent behavior that is bi-directionally related to the risk of type 2 diabetes. However, the effect of daily alcohol consumption on glucose levels in real-world situations in the general population has not been well elucidated. This study aimed to clarify the relationship between alcohol consumption and all-day and time-specific glucose levels among non-diabetic individuals. METHODS We investigated 913 non-diabetic males and females, aged 40-69 years, during 2018-2020 from four communities across Japan. The daily alcohol consumption was assessed using a self-report questionnaire. All-day and time-specific average glucose levels were estimated from the interstitial glucose concentrations measured using the Flash glucose monitoring system for a median duration of 13 days. Furthermore, we investigated the association between all-day and time-specific average glucose levels and habitual daily alcohol consumption levels, using never drinkers as the reference, and performed multiple linear regression analyses after adjusting for age, community, and other diabetes risk factors for males and females separately. RESULTS All-day average glucose levels did not vary according to alcohol consumption categories in both males and females. However, for males, the average glucose levels between 5:00 and 11:00 h and between 11:00 and 17:00 h were higher in moderate and heavy drinkers than in never drinkers, with the difference values of 4.6 and 4.7 mg/dL for moderate drinkers, and 5.7 and 6.8 mg/dL for heavy drinkers. Conversely, the average glucose levels between 17:00 and 24:00 h were lower in male moderate and heavy drinkers and female current drinkers than in never drinkers; the difference values of mean glucose levels were -5.8 for moderate drinkers, and -6.1 mg/dL for heavy drinkers in males and -2.7 mg/dL for female current drinkers. CONCLUSIONS Alcohol consumption was associated with glucose levels in a time-dependent biphasic pattern.
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Affiliation(s)
- Maho Ishihara
- Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Hironori Imano
- Department of Social Medicine, Osaka University Graduate School of Medicine
- Osaka Center for Cancer and Cardiovascular Disease Prevention
- Department of Public Health, Kindai University Faculty of Medicine
| | - Isao Muraki
- Department of Social Medicine, Osaka University Graduate School of Medicine
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Kazumasa Yamagishi
- Osaka Center for Cancer and Cardiovascular Disease Prevention
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
- Ibaraki Western Medical Center
| | - Koutatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
- Yao City Public Health Center
| | - Mari Tanaka
- Department of Social Medicine, Osaka University Graduate School of Medicine
- Department of Public Health, Kindai University Faculty of Medicine
| | - Mikako Yasuoka
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
- Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology
| | - Tomomi Kihara
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Midori Takada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
| | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Tomotaka Sobue
- Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Hiroyasu Iso
- Department of Social Medicine, Osaka University Graduate School of Medicine
- Osaka Center for Cancer and Cardiovascular Disease Prevention
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine
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20
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Aoki S, Yamagishi K, Kihara T, Tanaka M, Imano H, Muraki I, Shimizu Y, Hayama‐Terada M, Umesawa M, Sankai T, Okada T, Kitamura A, Kiyama M, Iso H. Risk factors for pre-heart failure or symptomatic heart failure based on NT-proBNP. ESC Heart Fail 2022; 10:90-99. [PMID: 36151844 PMCID: PMC9871651 DOI: 10.1002/ehf2.14149] [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: 02/21/2022] [Revised: 08/09/2022] [Accepted: 09/05/2022] [Indexed: 01/27/2023] Open
Abstract
AIMS Evidence on the risk factors for incident heart failure in Asia has been limited. We sought to identify the risk factors for pre-heart failure or symptomatic heart failure, based on N-terminal pro-B-type natriuretic peptide (NT-proBNP), in the Japanese general population. METHODS We performed a retrospective cohort study based on the Circulatory Risk in Communities Study involving 5335 Japanese individuals whose NT-proBNP levels were measured between 2010 and 2015. Of these, 2768 people aged between 30 and 69 years who undertook annual cardiovascular risk surveys at least once between 1990 and 2000 were retrospectively eligible to be participants in this study. We performed multivariable logistic regression analyses to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of pre-heart failure or symptomatic heart failure defined as NT-proBNP >400 pg/mL or as having a diagnosis of heart failure and taking medication for heart failure for several cardiovascular risk factors (body mass index, blood pressure, diabetes mellitus, total cholesterol, triglyceride, smoking status, drinking status). RESULTS We identified 85 cases of heart failure. The multivariable ORs (95% CIs) were 5.70 (2.70-12.0) for body mass index of 27-29.9 kg/m2 and 5.91 (2.19-16.0) for ≥30 kg/m2 compared with 21-22.9 kg/m2 ; 2.49(1.01-6.13) for systolic blood pressure of ≥160 mmHg vs. <130 mmHg; 2.87(1.23-6.68) for diastolic blood pressure of ≥100 mmHg vs. <80 mmHg; 5.16(2.14-12.4) for diabetes vs. non-diabetes; and 2.24 (0.92-5.49) for current smokers of ≥20 cigarettes/day vs. never smokers. The multivariable ORs (95% CIs) of the number of risk factors, defined as the sum of four risk factors (obesity, hypertension, diabetes, and current smoker) was 6.80 (3.69-12.5) for ≥2 risk factors vs. no risk factors. CONCLUSIONS The accumulation of these risk factors was associated with a graded higher risk of pre-heart failure or symptomatic heart failure.
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Affiliation(s)
- Shoko Aoki
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development CenterUniversity of TsukubaTsukubaJapan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development CenterUniversity of TsukubaTsukubaJapan,Osaka Center for Cancer and Cardiovascular Disease PreventionOsakaJapan,Ibaraki Western Medical CenterChikuseiJapan
| | - Tomomi Kihara
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development CenterUniversity of TsukubaTsukubaJapan
| | - Mari Tanaka
- Public Health, Department of Social MedicineOsaka University Graduate School of MedicineSuitaJapan,Department of Public HealthKindai UniversityOsakasayamaJapan
| | - Hironori Imano
- Osaka Center for Cancer and Cardiovascular Disease PreventionOsakaJapan,Public Health, Department of Social MedicineOsaka University Graduate School of MedicineSuitaJapan,Department of Public HealthKindai UniversityOsakasayamaJapan
| | - Isao Muraki
- Public Health, Department of Social MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease PreventionOsakaJapan
| | - Mina Hayama‐Terada
- Osaka Center for Cancer and Cardiovascular Disease PreventionOsakaJapan,Yao City Public Health CenterYaoJapan
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development CenterUniversity of TsukubaTsukubaJapan,School of MedicineDokkyo Medical UniversityMibuJapan
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease PreventionOsakaJapan
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease PreventionOsakaJapan,Yao City Public Health CenterYaoJapan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease PreventionOsakaJapan
| | - Hiroyasu Iso
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development CenterUniversity of TsukubaTsukubaJapan,Public Health, Department of Social MedicineOsaka University Graduate School of MedicineSuitaJapan,Institute for Global Health Policy Research Center, Bureau of International Health CooperationNational Center for Global Health and MedicineTokyoJapan
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21
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Matsumura T, Sankai T, Yamagishi K, Tanaka M, Kubota Y, Hayama-Terada M, Shimizu Y, Muraki I, Umesawa M, Cui R, Imano H, Ohira T, Kitamura A, Okada T, Kiyama M, Iso H. Trends for the Association between Body Mass Index and Risk of Cardiovascular Disease among the Japanese Population: The Circulatory Risk in Communities Study (CIRCS). J Atheroscler Thromb 2022; 30:335-347. [PMID: 35896353 PMCID: PMC10067340 DOI: 10.5551/jat.63415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
AIM This study aimed to investigate whether the impact of body mass index (BMI) on the risk of cardiovascular disease (CVD) has changed among the 1960s, 1970s, 1980s, 1990s, and early 2000s in Japan. METHODS The study population consisted of residents in Japan aged 40-69 years who had no history of CVD. The baseline surveys have been conducted every year since 1963. We defined the first, second, third, fourth, and fifth cohorts as 1963-1969 (n=4,248), 1970-1979 (n=6,742), 1980-1989 (n=12,789), 1990-1999 (n=12,537), and 2000-2005 (n=9,140) respectively. The participants were followed up for a median of 15 years for each cohort to determine the incidence of CVD. We classified them into four categories (BMI <21.0, 21.0-<23.0, 23.0-<25.0, and ≥ 25.0 kg/m 2). RESULTS From 1963-1969 to 2000-2005, the prevalence of BMI ≥ 25.0 increased over time. Compared with BMI 23.0-<25.0, the age-, sex- and community-adjusted hazard ratios (95% confidence interval [CIs]) of CVD for BMI ≥ 25.0 were 1.10 (0.77-1.57), 0.89 (0.68-1.18), 1.03 (0.85-1.26), 1.28 (1.04-1.58), and 1.36 (1.04-1.78)in the first, second, third, fourth, and fifth cohorts, respectively. The corresponding population attributable fractions were 2.0% (nonsignificant), -2.6% (nonsignificant), 0.9% (nonsignificant), 7.6%, and 10.9%. Further adjustment for systolic blood pressure and antihypertensive medication use in the fourth and fifth cohorts attenuated the associations, which may reflect that blood pressure may mediate the BMI-CVD association. CONCLUSION The proportion of CVD attributable to overweight/obesity has increased during the periods between 1963-1969 and 2000-2005. The significant associations between overweight/obesity and risk of CVD after the 1990s were mediated by blood pressure levels.
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Affiliation(s)
- Takumi Matsumura
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Ibaraki Western Medical Center
| | - Mari Tanaka
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Yao City Public Health Center
| | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,School of Medicine, Dokkyo Medical University
| | - Renzhe Cui
- Department of Internal Medicine, Okanami General Hospital
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Osaka Center for Cancer and Cardiovascular Disease Prevention.,Department of Public Health, Kindai University Faculty of Medicine
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine
| | | | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
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22
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Fukuda H, Ishiguro C, Ono R, Kiyohara K. The Longevity Improvement & Fair Evidence (LIFE) Study: Overview of the Study Design and Baseline Participant Profile. J Epidemiol 2022. [PMID: 35753792 PMCID: PMC10319523 DOI: 10.2188/jea.je20210513] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The Longevity Improvement & Fair Evidence (LIFE) Study, which was launched in 2019, is a multi-region community-based database project that aims to generate evidence toward extending healthy life expectancy and reducing health disparities in Japan. Herein, we describe the LIFE Study's design and baseline participant profile. METHODS Municipalities participating in the LIFE Study provide data from government-administered health insurance enrollees and public assistance recipients. These participants cover all disease types and age groups. Centered on healthcare claims data, the project also collects long-term care claims data, health checkup data, vaccination records, residence-related information, and income-related information. The different data types are converted into a common data model containing five modules (health care, long-term care, health checkup, socioeconomic status, and health services). We calculated the descriptive statistics of participants at baseline in 2018. RESULTS The LIFE Study currently stores data from 1,420,437 residents of 18 municipalities. The health care module contains 1,280,756 participants (mean age: 65.2 years), the long-term care module contains 189,069 participants (mean age: 84.3 years), and the health checkup module contains 274,375 participants (mean age: 69.0 years). Although coverage and follow-up rates were lower among younger persons, the health care module includes 74,151 children (0-19 years), 273,157 working-age adults (20-59 years), and 933,448 older persons (≥60 years). CONCLUSION The LIFE Study provides data from over 1 million participants and can facilitate a wide variety of life-course research and cohort studies. This project is expected to be a useful platform for generating real-world evidence from Japan.
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Affiliation(s)
- Haruhisa Fukuda
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences.,Center for Cohort Studies, Kyushu University Graduate School of Medical Sciences
| | - Chieko Ishiguro
- Section of Clinical Epidemiology, Department of Data Science, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences
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23
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Retinal microvascular abnormalities and risks of incident stroke and its subtypes: The Circulatory Risk in Communities Study. J Hypertens 2022; 40:732-740. [PMID: 35081584 DOI: 10.1097/hjh.0000000000003071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study aimed to investigate the association between retinal microvascular abnormalities and the risk of incident stroke and its subtypes in the general Japanese population. METHODS A total of 12 965 residents aged 40-74 years without a history of stroke and/or coronary heart disease underwent retinal photography during the annual health checkups of four Japanese communities between 1990 and 1999. Retinal microvascular abnormalities, such as the presence or absence of generalized arteriolar narrowing, focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar light reflex, and retinal hemorrhages were graded using standard protocols. RESULTS During a median follow-up of 20 years, 817 patients were diagnosed with incident stroke. Retinal microvascular abnormalities were positively associated with the risk of total stroke; after adjustment for age, sex, community, SBP, antihypertensive medication use, and other cardiovascular risk factors, the multivariable hazard ratio [95% confidence interval (CI)] was 1.68 (1.42-1.98), 1.67 (1.34-2.07), 1.41 (1.17-1.72), 1.54 (1.26-1.87), and 1.57 (1.19-2.07) for generalized arteriolar narrowing, focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar light reflex, and retinal hemorrhages, respectively. Similar positive associations were observed for the risk of stroke subtypes, except for subarachnoid hemorrhage, for which no association was observed. Furthermore, the positive associations were similar in participants with and without hypertension. CONCLUSION Retinal microvascular abnormalities were positively associated with the risk of incident stroke in the general Japanese population. Routine retinal photography could provide positive clinical insights into stroke risk stratification independent of blood pressure, antihypertensive medication use, and other risk factors.
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24
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Sun W, Yamagishi K, Iso H. Current Status of Low-Density Lipoprotein Cholesterol and Cardiovascular Diseases in Japan. J Atheroscler Thromb 2022; 30:432-433. [PMID: 36261367 PMCID: PMC10164601 DOI: 10.5551/jat.ed217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Wanlu Sun
- Department of Public Health Medicine, Faculty of Medicine and Health Services Research and Development Center, University of Tsukuba
| | | | - Hiroyasu Iso
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine
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25
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Chichibu H, Yamagishi K, Kishida R, Maruyama K, Hayama-Terada M, Shimizu Y, Muraki I, Umesawa M, Cui R, Imano H, Ohira T, Tanigawa T, Sankai T, Okada T, Kitamura A, Kiyama M, Iso H. Seaweed Intake and Risk of Cardiovascular Disease: The Circulatory Risk in Communities Study (CIRCS). J Atheroscler Thromb 2021; 28:1298-1306. [PMID: 33597328 PMCID: PMC8629711 DOI: 10.5551/jat.61390] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/14/2020] [Indexed: 11/11/2022] Open
Abstract
AIM Seaweed contains soluble dietary fibers, potassium, and flavonoids and was recently reported to be inversely associated with the risk of coronary heart disease and mortality from stroke. However, epidemiological evidence on this issue has remained scarce. METHODS At the baseline survey of four Japanese communities between 1984 and 2000, we enrolled 6,169 men and women aged 40-79 years who had no history of cardiovascular disease. We assessed their seaweed intake using the data from a 24 h dietary recall survey and categorized the intake into four groups (0, 1-5.5, 5.5-15, and ≥ 15 g/day). We used sex-specific Cox proportional hazards models to examine the association between seaweed intake and risk of cardiovascular disease (stroke, stroke subtypes, and coronary heart disease). RESULTS During the 130,248 person-year follow-up, 523 cases of cardiovascular disease occurred: 369 cases of stroke and 154 cases of coronary heart disease. Seaweed intake levels were inversely associated with the risk of total stroke and cerebral infarction among men but not among women. Adjustment for cardiovascular risk factors did not change the associations: the hazard ratios (95% confidence intervals; P for trend) for the highest versus lowest categories of seaweed intake were 0.63 (0.42-0.94; 0.01) for total stroke and 0.59 (0.36-0.97; 0.03) for cerebral infarction. No associations were observed between seaweed intake and risks of intraparenchymal hemorrhage, subarachnoid hemorrhage, or coronary heart disease among men or women. CONCLUSIONS We found an inverse association between seaweed intake and risk of total stroke, especially that from cerebral infarction, among Japanese men.
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Affiliation(s)
- Haruka Chichibu
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
- Ibaraki Western Medical Center, Ibaraki, Japan
| | - Rie Kishida
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Koutatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University, Ehime, Japan
| | | | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mitsumasa Umesawa
- Department of Public Health, Dokkyo Medical University, Tochigi, Japan
| | - Renzhe Cui
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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26
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Aoki S, Yamagishi K, Maruyama K, Kishida R, Ikeda A, Umesawa M, Renzhe C, Kubota Y, Hayama-Terada M, Shimizu Y, Muraki I, Imano H, Sankai T, Okada T, Kitamura A, Kiyama M, Iso H. Dietary intake of tocopherols and risk of incident disabling dementia. Sci Rep 2021; 11:16429. [PMID: 34385499 PMCID: PMC8361201 DOI: 10.1038/s41598-021-95671-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 07/27/2021] [Indexed: 11/09/2022] Open
Abstract
Tocopherols, strong antioxidants, may be useful in preventing dementia, but the epidemiological evidence is insufficient. We performed a community-based follow-up study of Japanese, the Circulatory Risk in Community Study, involving 3739 people aged 40-64 years at baseline (1985-1999). Incident disabling dementia was followed up from 1999 through 2020. For subtype analysis, we classified disabling dementia into that with and that without a history of stroke. Dietary intake of tocopherols (total, α, β, γ, and δ) were estimated using 24-h recall surveys. During a median follow-up of 19.7 years, 670 cases of disabling dementia developed. Total tocopherol intake was inversely associated with risk of disabling dementia with multivariable hazard ratios (95% confidence intervals) of 0.79 (0.63-1.00) for the highest versus lowest quartiles of total tocopherol intake (P for trend = 0.05). However, the association was strengthened when further adjusted for α-linolenic acid intake (Spearman correlation with total tocopherol intake = 0.93), with multivariable hazard ratios of 0.50 (0.34-0.74) (P for trend = 0.001) but was weakened and nonsignificant when further adjusted for linoleic acid intake (Spearman correlation with total tocopherol intake = 0.92), with multivariable hazard ratios of 0.69 (0.47-1.01) (P for trend = 0.05). Similar but nonsignificant inverse associations were observed for α-, γ-, and δ-tocopherols but not for β-tocopherol. These results were similar regardless of the presence of a history of stroke. Dietary tocopherol intake was inversely associated with risk of disabling dementia, but its independent effect was uncertain owing to a high intercorrelation of α-linolenic linoleic acids with total tocopherol intake. Even with such confounding, a diet high in tocopherols may help prevent the onset of dementia.
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Affiliation(s)
- Shoko Aoki
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8575, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8575, Japan. .,Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan. .,Ibaraki Western Medical Center, Chikusei, Japan.
| | - Koutatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Japan
| | - Rie Kishida
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8575, Japan
| | - Ai Ikeda
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8575, Japan.,Department of Public Health, Dokkyo Medical University, Mibu, Japan
| | - Cui Renzhe
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Yao City Public Health Center, Yao, Japan
| | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tennodai 1-1-1, Tsukuba, 305-8575, Japan.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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27
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Tezuka K, Kubota Y, Ohira T, Muraki I, Hayama-Terada M, Shimizu Y, Imano H, Okada T, Kiyama M, Iso H. Impact of Perceived Social Support on the Association Between Anger Expression and the Risk of Stroke: The Circulatory Risk in Communities Study (CIRCS). J Epidemiol 2021; 33:159-164. [PMID: 34176854 PMCID: PMC9939924 DOI: 10.2188/jea.je20200607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Anger has been suggested as a risk factor for stroke. Perceived social support (PSS) may relieve anger, thus reducing the risk of stroke; however, evidence supporting this is limited. We aimed to examine whether PSS modifies the risk of stroke associated with anger expression. METHODS A cohort study was conducted among 1,806 community residents aged 40-74 years who received a cardiovascular risk survey including anger expression in 1997. A Cox proportional hazards model was applied to the participants with low and high PSS to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the risks of total stroke and its subtypes based on total anger expression after adjusting for known stroke risk factors. RESULTS The median follow-up duration was 18.8 years, with 51 incident strokes. Among the participants with low PSS, anger expression had a positive association with the total stroke risk: The multivariable HR per SD increment of total anger expression was 1.43 (95% CI, 1.13-1.82). In contrast, no association was identified among those with high PSS. The corresponding HR was 0.83 (95% CI, 0.49-1.40), with a significant interaction between low and high PSS (p = 0.037). Similar associations regarding the risk of ischemic stroke were found. CONCLUSIONS We found an increased risk of stroke associated with anger expression among the participants with low PSS, but not among those with high PSS. Our results suggest that PSS might mitigate the risk of stroke associated with anger.
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Affiliation(s)
- Kazuhide Tezuka
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Yasuhiko Kubota
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Isao Muraki
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Mina Hayama-Terada
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention.,Yao Public Health Center, Yao City Office
| | - Yuji Shimizu
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Hironori Imano
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Takeo Okada
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Masahiko Kiyama
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Hiroyasu Iso
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
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28
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Li Y, Cui R, Liu K, Eshak ES, Cui M, Dong J, Imano H, Muraki I, Kiyama M, Kitamura A, Okada T, Yamagishi K, Umesawa M, Ohira T, Iso H. Relationship between Endothelial Dysfunction and Prevalence of Chronic Kidney Disease: The Circulatory Risk in Communities Study (CIRCS). J Atheroscler Thromb 2021; 28:622-629. [PMID: 32879150 PMCID: PMC8219532 DOI: 10.5551/jat.56424] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/29/2020] [Indexed: 12/17/2022] Open
Abstract
AIMS Patients with chronic kidney disease (CKD) have a higher burden of cardiovascular morbidity and mortality than the general population. Endothelial dysfunction has been suggested to play a role in both glomerular filtration rate loss and cardiovascular damage. Thus, the present study aimed to evaluate the relationship between endothelial dysfunction and the prevalence of CKD in the general Japanese population. METHODS We conducted a cross-sectional study of 1042 men and women aged 30-81 years in two communities under the Circulatory Risk in Communities Study between 2013 and 2017. Endothelial function was evaluated by percent change of brachial artery flow-mediated dilation (%FMD) before and after the cuff inflation. RESULTS Among the total 1042 participants, there were 62 cases of CKD (~6%). The multivariable odds ratios (ORs) (95% confidence intervals [CIs]) of CKD according to quartiles of %FMD were 2.02 (0.68-5.99), 3.56 (1.27-9.94), and 3.14 (1.10-8.93) for the third to lowest quartile compared with the highest %FMD quartile; p for trend=0.02. The respective multivariable ORs (95% CIs) of CKD in subjects without antihypertensive medication use (39 cases among 886 subjects) were 1.83 (0.46-7.33), 3.41 (0.92-12.61), and 4.60 (1.22-17.31); p for trend=0.01, and that for one-point decrement in %FMD was 1.16 (1.00-1.35); p for interaction with the status of antihypertensive medication use was 0.12. CONCLUSIONS Our cross-sectional study suggested the relationship between endothelial dysfunction and the higher prevalence of CKD in the general Japanese population.
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29
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Li J, Imano H, Yamagishi K, Cui R, Muraki I, Umesawa M, Hayama-Terada M, Ohira T, Kiyama M, Okada T, Sankai T, Tanigawa T, Kitamura A, Iso H. Serum Albumin and Risks of Stroke and Its Subtypes - The Circulatory Risk in Communities Study (CIRCS). Circ J 2021; 85:385-392. [PMID: 33191391 DOI: 10.1253/circj.cj-20-0384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few studies have investigated the association between serum albumin levels and the risk of stroke subtypes among the general Japanese population.Methods and Results:In this study, 5,071 men and 7,969 women aged 40-74 years, initially free from stroke, coronary artery disease, and kidney and hepatic failure, and residing in 4 Japanese communities completed a baseline risk factor survey between 1985 and 1994. During the 24-year follow-up, 528 men and 553 women experienced stroke. In the entire study cohort, multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) of total stroke, ischemic stroke, and intracerebral hemorrhage for the lowest vs. highest quartiles of serum albumin were 1.45 (1.18-1.77), 1.52 (1.17-1.97), and 1.57 (1.04-2.37), respectively. In men, multivariable HRs (95% CIs) for total stroke, ischemic stroke, and intracerebral hemorrhage in the lowest vs. highest serum albumin quartile were 1.44 (1.07-1.92), 1.48 (1.03-2.11) and 1.71 (0.92-3.18), respectively, whereas in women they were 1.50 (1.13-1.99), 1.63 (1.11-2.39), and 1.56 (0.89-2.74), respectively. Similar inverse associations were observed for each of the ischemic stroke subtypes, but not for subarachnoid hemorrhage. CONCLUSIONS Low serum albumin levels were associated with an increased risk of total stroke, ischemic stroke, ischemic stroke subtypes, and intracerebral hemorrhage.
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Affiliation(s)
- Jiaqi Li
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Kazumasa Yamagishi
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba.,Ibaraki Western Medical Center
| | - Renzhe Cui
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba.,Department of Public Health, Dokkyo Medical University School of Medicine
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Yao City Public Health Center
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Tomoko Sankai
- Department of Community Health, Faculty of Medicine, University of Tsukuba
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University School of Medicine
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba
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30
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Li J, Imano H, Yamagishi K, Tanaka M, Cui R, Muraki I, Umesawa M, Hayama-Terada M, Ohira T, Kiyama M, Okada T, Sankai T, Tanigawa T, Kitamura A, Iso H. Leukocyte Count and Risks of Stroke and Coronary Heart Disease: The Circulatory Risk in Communities Study (CIRCS). J Atheroscler Thromb 2021; 29:527-535. [PMID: 33746157 PMCID: PMC9090484 DOI: 10.5551/jat.60889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim:
This study aimed to investigate the associations of leukocyte count with the risks of stroke and coronary heart disease among the general Japanese population.
Methods:
A total of 5,242 residents aged 40–69 years living in two Japanese communities underwent leukocyte count measurements between 1991 and 2000, and the data were updated using 5- or 10-year follow-ups or both. Participants who had histories of stroke, coronary heart disease, or high values of leukocyte count (>130×10
2
cells/mm
3
) were excluded. Hazard ratios with 95% confidence intervals (CIs) were calculated according to quartiles of cumulative average leukocyte count.
Results:
During follow-up of 21 years, 327 stroke and 130 coronary heart disease cases were determined. After adjustments for age, sex, community, and updated cardiovascular risk factors, the multivariable hazard ratio (95% CI) for the highest versus lowest quartile of leukocyte count was 1.50 (1.08–2.08) for ischemic stroke, 1.59 (1.00–2.51) for lacunar infarction, 1.42 (0.90–2.26) for non-lacunar infarction, 2.17 (1.33–3.55) for coronary heart disease, and 1.40 (1.11–1.76) for total cardiovascular disease. In smoking status-stratified analyses, the corresponding multivariable hazard ratio (95% CI) was 2.45 (1.11–5.38) for ischemic stroke, 2.73 (1.37–5.44) for coronary heart disease in current smokers, 2.42 (1.07–5.46), 1.55 (0.58–4.15) in former smokers, and 1.17 (0.75–1.82), 1.78 (0.83–3.82) in never smokers.
Conclusion:
Leukocyte count was positively associated with the risks of ischemic stroke and coronary heart disease among the general Japanese population, especially in current smokers.
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Affiliation(s)
- Jiaqi Li
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Hironori Imano
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Ibaraki Western Medical Center
| | - Mari Tanaka
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Renzhe Cui
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Isao Muraki
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Department of Public Health, Dokkyo Medical University, School of Medicine
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Diseases Prevention.,Yao City Public Health Center, Yao City Office
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Diseases Prevention
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Diseases Prevention
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba
| | - Takeshi Tanigawa
- Department of Public Health, Graduate School of Medicine, Juntendo University
| | | | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
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Matsumura T, Sankai T, Yamagishi K, Kubota Y, Hayama-Terada M, Muraki I, Umesawa M, Cui R, Imano H, Ohira T, Kitamura A, Okada T, Kiyama M, Iso H. Impact of Major Cardiovascular Risk Factors on the Incidence of Cardiovascular Disease among Overweight and Non-Overweight Individuals: The Circulatory Risk in Communities Study (CIRCS). J Atheroscler Thromb 2021; 29:422-437. [PMID: 33731540 PMCID: PMC8894112 DOI: 10.5551/jat.60103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim:
We aimed to examine the impact of high-risk levels of cardiovascular risk factors on the incidence of cardiovascular disease (CVD) in overweight and non-overweight individuals without treatment for the risk factors.
Methods:
A total of 8,051 individuals aged 40–74 years without a history of CVD and/or without treatment for hypertension, diabetes, hyperlipidemia, and kidney disease at baseline in 1995–2000 were followed up for a median of 14.1 years. We classified the participants into three risk categories (low-, intermediate-, and high-risk groups) on the basis of individual risk factors (blood pressure, serum glucose, low-density lipoprotein cholesterol [LDL-C], and urinary protein) according to the guidelines of Japanese clinical societies. The high-risk group (systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 100 mmHg, fasting serum glucose ≥ 130 mg/dL or non-fasting serum glucose ≥ 180 mg/dL, LDL-C ≥ 180 mg/dL, proteinuria ≥ 2+) needed to refer to physicians or start treatment immediately. Overweight was defined as a body mass index of ≥ 25 kg/m
2
.
Results:
Compared with those in the non-overweight low-risk group, the hazard ratios (HRs) (95% confidence intervals, population-attributable fractions [PAFs]) of CVD in the high-risk categories of blood pressure were 2.0 (1.4–2.9, 7.0%) in the non-overweight high-risk group and 2.9 (1.9–4.3, 6.8%) in the overweight high-risk group. The corresponding HRs (95% confidence intervals, PAFs) of serum glucose were 2.0 (1.2–3.4, 2.5%) and 2.2 (1.1–4.3, 1.5%) in the non-overweight and overweight high-risk groups, respectively. Such associations were not observed for the high-risk group of LDL-C and proteinuria.
Conclusions:
The present long-term observational study implies that targeting persons with non-treated severe hypertension and diabetes is prioritized to prevent CVD regardless of overweight status.
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Affiliation(s)
- Takumi Matsumura
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Ibaraki Western Medical Center
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Yao City Public Health Center
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,School of Medicine, Dokkyo University
| | - Renzhe Cui
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Tetsuya Ohira
- Department of Epidemiology, School of Medicine, Fukushima Medical University
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
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32
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Salt taste perception and blood pressure levels in population-based samples: the Circulatory Risk in Communities Study (CIRCS). Br J Nutr 2021; 125:203-211. [PMID: 32814612 DOI: 10.1017/s0007114520002640] [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: 11/07/2022]
Abstract
To examine the associations of salt perception with salt intake and blood pressure levels in general populations, we performed a cross-sectional study in two communities where salt intake level is different, Akita and Osaka in Japan. Taste perception (detection for certain taste and recognition for salt taste) was determined using a Na-impregnated test strip for 1024 Akita and 1199 Osaka adults aged 30-74 years. The proportions of detection for 0·1 % salt were 61, 62, 79, and 79 % in Akita men, Osaka men, Akita women and Osaka women, respectively. The corresponding proportions of not recognising of 1·6 % salt taste (>1·6 %) were 34, 30, 16 and 21 %. Detection threshold was higher in Akita than in Osaka for women aged 60-74 years, and recognition threshold was lower in Akita than in Osaka for women aged 30-59 and 60-74 years. The high detection (≥0·4 %) and recognition (>1·6 %) thresholds of salt taste were associated with higher salt intake scores for Akita men aged 30-59 years, whose detection and recognition thresholds tended be positively associated with systolic and diastolic blood pressures (SBP and DBP) after adjustment for potential confounders. Among Akita elderly men, detection threshold tended to be positively associated with SBP and DBP, while among Akita middle-aged women, recognition threshold was associated with SBP. In conclusion, the high thresholds of salt perception were inversely associated with salt intake for Akita middle-aged men and with blood pressure levels for Akita middle-aged and elderly men and middle-aged women.
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Anger Expression and the Risk of Cardiovascular Disease Among Urban and Rural Japanese Residents: The Circulatory Risk in Communities Study. Psychosom Med 2021; 82:215-223. [PMID: 31860529 DOI: 10.1097/psy.0000000000000775] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE It has been suggested that urbanization, which has been expanding rapidly for the past several decades, increases the risk of cardiovascular disease (CVD) associated with psychological factors such as anger, but the evidence is limited. We examined the hypothesis that urbanicity modifies the association of anger expression with the risk of CVD. METHODS A prospective study was conducted in 5936 residents of urban and rural communities aged 40 to 79 years who had completed an annual health checkup including a questionnaire on anger expression between 1995 and 1998. Associations of anger expression with the risk of CVDs were examined using Cox proportional hazards models, after adjusting for classical cardiovascular risk factors. RESULTS During a median follow-up of 16.6 years, we identified 312 incident CVDs. The means (SDs) of anger expression were 24.7 (5.8) among urban residents and 24.6 (5.7) among rural participants (p = .87). Among urban residents, anger expression was positively associated with the risk of total CVD: the multivariable hazard ratio (95% confidence interval) was 1.27 (1.05-1.54). In contrast, no association was found among rural residents: the corresponding ratio (interval) was 0.96 (0.85-1.09), with a significant interaction between urban and rural residency with anger expression for incident CVD (p = .047). Similar associations were observed with the risk of CVD subtypes, including ischemic stroke and ischemic CVD. CONCLUSIONS We found a positive association between anger expression and the risk of CVD among urban residents but not rural residents, suggesting that urbanicity enhances the anger-CVD association.
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Shimoda S, Kitamura A, Imano H, Cui R, Muraki I, Yamagishi K, Umesawa M, Sankai T, Hayama-Terada M, Kubota Y, Shimizu Y, Okada T, Kiyama M, Iso H. Associations of Carotid Intima-Media Thickness and Plaque Heterogeneity With the Risks of Stroke Subtypes and Coronary Artery Disease in the Japanese General Population: The Circulatory Risk in Communities Study. J Am Heart Assoc 2020; 9:e017020. [PMID: 32990124 PMCID: PMC7792402 DOI: 10.1161/jaha.120.017020] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Evidence on the associations of carotid intima-media thickness and carotid plaque characteristics with stroke subtypes and coronary artery disease risks in Asians is limited. This study investigated these associations in the Japanese general population. Methods and Results Maximum intima-media thicknesses of both the common carotid artery and internal carotid artery and carotid plaque characteristics were evaluated in 2943 Japanese subjects aged 40 to 75 years without history of cardiovascular disease. Subjects were followed up for a median of 15.1 years. Using a multivariate Cox proportional hazard model, we found that hazard ratios (HRs) and 95% CIs for the highest (≥1.07 mm) versus lowest (≤0.77 mm) quartiles of maximum intima-media thicknesses of the common carotid artery were 1.97 (1.26-3.06) for total stroke, 1.52 (0.67-3.41) for hemorrhagic stroke, 2.45 (1.41-4.27) for ischemic stroke, 3.60 (1.64-7.91) for lacunar infarction, 1.53 (0.69-3.41) for nonlacunar cerebral infarction, 2.68 (1.24-5.76) for coronary artery disease, and 2.11 (1.44-3.12) for cardiovascular disease (similar results were found for maximum intima-media thicknesses of the internal carotid artery). HRs(95% CIs) for heterogeneous plaque versus no plaque were 1.58 (1.09-2.30) for total stroke, 1.25 (0.58-2.70) for hemorrhagic stroke, 1.74 (1.13-2.67) for ischemic stroke, 1.84 (1.03-3.19) for lacunar infarction, 1.58 (0.80-3.11) for nonlacunar cerebral infarction, 2.11 (1.20-3.70) for coronary artery disease, and 1.71 (1.25-2.35) for cardiovascular disease. Conclusions Maximum intima-media thicknesses of the common carotid artery, maximum intima-media thicknesses of the internal carotid artery, and heterogeneous plaque were associated with the risks of stroke, lacunar infarction, coronary artery disease, and cardiovascular disease in Asians.
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Affiliation(s)
- Saeko Shimoda
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan
| | - Akihiko Kitamura
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan.,Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan.,Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan.,Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Renzhe Cui
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan
| | - Kazumasa Yamagishi
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center University of Tsukuba Ibaraki Japan.,Ibaraki Western Medical Center Ibaraki Japan
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center University of Tsukuba Ibaraki Japan.,Department of Public Health Dokkyo Medical University Tochigi Japan
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan.,Yao Public Health Center, Yao City Office Osaka Japan
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan
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35
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Jinnouchi H, Matsudaira K, Kitamura A, Kakihana H, Oka H, Hayama-Terada M, Yamagishi K, Kiyama M, Iso H. Effects of brief self-exercise education on the management of chronic low back pain: A community-based, randomized, parallel-group pragmatic trial. Mod Rheumatol 2020; 31:890-898. [PMID: 32930621 DOI: 10.1080/14397595.2020.1823603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE This study aimed to develop and assess additional effects of brief self-exercise education (brief-See) for individuals with chronic low back pain (CLBP). The brief-See comprised 100-minute consultation, individualized self-exercise program, and direct short teaching. METHODS We conducted a 6-month, community-based, randomized, parallel-group trial in a community setting, and allocated into a brief-See or material-based education alone. Pain intensity (NRS, numeric rating scale), functional limitation (RDQ, Roland-Morris disability questionnaire), self-efficacy (PSEQ, pain self-efficacy questionnaire), and quality of life (EQ-5D, European quality of life-5 dimensions) were evaluated at 4, 12, and 24 weeks after the initial consultation. RESULTS The brief-See did not show additional improvement over material-based education on the NRS, but it did on the RDQ, PSEQ, and EQ-5D; the estimated mean group differences in changes from the baseline were -2.1 (-3.5 to -0.7, p = .005) on the RDQ, 6.9 (1.7-12.1, p = .010) on the PSEQ, and 0.07 (0.02-0.12, p = .004) on the EQ-5D. CONCLUSION The 100 minutes' education program could be more acceptable, and restores functional limitation, self-efficacy, and quality of life in addition to the effects of material-based education. This has the potential to contribute to the management of CLBP in a community.
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Affiliation(s)
- Hiroshige Jinnouchi
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.,Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Department of Public Health Medicine and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, The University of Tokyo, Tokyo, Japan
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hironobu Kakihana
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Hygiene and Public Health, Osaka Medical College, Osaka, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, The University of Tokyo, Tokyo, Japan
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Yao City Public Health Center, Osaka, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Department of Public Health Medicine and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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Yasuoka M, Muraki I, Imano H, Jinnouchi H, Kubota Y, Hayama-Terada M, Umesawa M, Yamagishi K, Ohira T, Kitamura A, Okada T, Kiyama M, Iso H. Joint impact of muscle mass and waist circumference on type 2 diabetes in Japanese middle-aged adults: The Circulatory Risk in Communities Study (CIRCS). J Diabetes 2020; 12:677-685. [PMID: 32372543 DOI: 10.1111/1753-0407.13049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Although evidence about skeletal muscle mass loss and type 2 diabetes risk has accumulated, little information is available on the combined effect of skeletal muscle mass and abdominal obesity on type 2 diabetes. We examined whether skeletal muscle mass and abdominal obesity were synergistically associated with the prevalence of type 2 diabetes. METHODS Skeletal muscle mass and waist circumference (WC) were measured in 1515 Japanese aged 40 to 69 years. Relative muscle mass was calculated as percentage of total skeletal muscle mass in body weight (SMM%). Type 2 diabetes was identified as fasting serum glucose ≥7.0 mmol/L (126 mg/dL), nonfasting serum glucose ≥11.1 mmol/L (200 mg/dL), glycosylated hemoglobin ≥ 6.5%, and/or diabetes medication use. RESULTS The multivariable-adjusted odds ratio (OR) of prevalent diabetes from the lowest to the third quartile of SMM% compared to the highest quartile gradually increased in both sexes. The association between a high WC and prevalent diabetes was similar. The multivariable-adjusted OR (95% confidence intervals) for the prevalence of type 2 diabetes in the low skeletal muscle mass/high WC group was 3.19 (1.78-5.71) for men and 4.46 (2.09-9.51) for women compared with the high skeletal muscle mass/low WC group. The relative excess risk due to interaction was 2.2 (0.5-3.9) in men and 2.8 (0.2-5.3) in women for an excess burden of type 2 diabetes for low skeletal muscle mass and high WC. CONCLUSIONS Low skeletal muscle mass and abdominal obesity were synergistically associated with presence of type 2 diabetes.
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Affiliation(s)
- Mikako Yasuoka
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroshige Jinnouchi
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
- Public Health Center of Yao City, Yao, Japan
| | - Mitsumasa Umesawa
- School of Medicine, Dokkyo University, Mibu, Japan
- Department of Public Health Medicine, Faculty of Medicine, and Health Service Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Service Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Public Health Medicine, Faculty of Medicine, and Health Service Research and Development Center, University of Tsukuba, Tsukuba, Japan
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Ebihara K, Yamagishi K, Umesawa M, Muraki I, Cui R, Imano H, Kubota Y, Hayama-Terada M, Shimizu Y, Ohira T, Sankai T, Okada T, Kitamura A, Kiyama M, Iso H. Moderate Levels of N-Terminal Pro-B-Type Natriuretic Peptide is Associated with Increased Risks of Total and Ischemic Strokes among Japanese: The Circulatory Risk in Communities Study. J Atheroscler Thromb 2020; 27:751-760. [PMID: 31932552 PMCID: PMC7458784 DOI: 10.5551/jat.52241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM N-terminal pro-B-type natriuretic peptide (NT-proBNP), frequently used as a biochemical marker for detecting and monitoring heart failure, is also a risk marker for development of coronary heart disease and total stroke. However, studies that explore subtypes of ischemic stroke with regard to NT-proBNP are scarce. Here, we examined NT-proBNP and its impact upon subtypes of ischemic stroke (lacunar stroke, large-artery occlusive stroke and embolic stroke) among Japanese. METHODS We measured NT-proBNP and categorized 4,393 participants of the Circulatory Risk in Communities Study into four groups (<55, 55-124, 125-399, and ≥ 400 pg/ml). We used a multivariable Cox proportional hazards model to examine association with risks of stroke and subtypes. RESULTS During 4.7 years of follow-up, we identified 50 strokes, including 35 ischemic (15 lacunar, 6 largeartery occlusive, 10 embolic strokes) and 14 hemorrhagic strokes. NT-proBNP was associated with stroke risk: the multivariable hazard ratio of total strokes was 7.29 (2.82-18.9) for the highest and 2.78 (1.25-6.16) for the second highest NT-proBNP groups compared with the lowest group. The respective hazard ratios for the highest NT-proBNP group were 9.37 (3.14-28.0) for ischemic stroke and 6.81 (1.11-41.7) for lacunar stroke. Further adjustment for atrial fibrillation did not attenuate these associations. The associations were similarly observed for large-artery occlusive and embolic strokes. CONCLUSION We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners.
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Affiliation(s)
- Kenji Ebihara
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Osaka Center for Cancer and Cardiovascular Disease Prevention.,Ibaraki Western Medical Center
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Osaka Center for Cancer and Cardiovascular Disease Prevention.,Department of Public Health, Dokkyo Medical University School of Medicine
| | - Isao Muraki
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Renzhe Cui
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Hironori Imano
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Yao Public Health Center, Yao City Office
| | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Hiroyasu Iso
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
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38
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Tanaka M, Imano H, Kubota Y, Yamagishi K, Umesawa M, Muraki I, Cui R, Hayama-Terada M, Shimizu Y, Okada T, Ohira T, Sankai T, Tanigawa T, Sato S, Kitamura A, Kiyama M, Iso H. Serum High-Sensitivity C-Reactive Protein Levels and the Risk of Atrial Fibrillation in Japanese Population: the Circulatory Risk in Communities Study. J Atheroscler Thromb 2020; 28:194-202. [PMID: 32522907 PMCID: PMC7957035 DOI: 10.5551/jat.54064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIM This study aimed to investigate the association between the serum high-sensitivity C-reactive protein (hs-CRP) levels and incident atrial fibrillation risk in the general Japanese population, who have lower hs-CRP levels than the Western population, and assess whether the association is modified by sex, overweight, hypertension, and smoking status. METHODS We conducted a prospective study in 6517 Japanese men and women aged 40-79 years without atrial fibrillation at baseline and enrolled in the Circulatory Risk in Communities Study (2002-2008). The hs-CRP levels were measured using the latex particle-enhanced immunonephelometric assay. Atrial fibrillation was identified using standard 12-lead electrocardiograms and information on physician-diagnosed atrial fibrillation history from the follow-up surveys. We used a Cox proportional hazard regression stratified by community. RESULTS During a median follow-up of 11 years, 127 new cases of atrial fibrillation (74 and 53 cases among men and women, respectively) were found. Compared to the lowest quintile of hs-CRP levels, the multivariable hazard ratios (95% confidence intervals) were 2.54 (1.17-5.50), 2.28 (1.06-4.93), 2.92 (1.37-6.23), and 2.77 (1.30-5.91) for the second, third, fourth, and fifth (highest) quintiles, respectively. There was no significant effect modification by sex, overweight, hypertension, and smoking status (P for interaction >0.05). CONCLUSIONS Elevated hs-CRP levels were significantly associated with increased risk of atrial fibrillation in the Japanese population. The association of hs-CRP levels with incident atrial fibrillation did not vary according to sex, overweight, hypertension status, or smoking status.
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Affiliation(s)
- Mari Tanaka
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Kazumasa Yamagishi
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Ibaraki Western Medical Center
| | - Mitsumasa Umesawa
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Dokkyo Medical University School of Medicine
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Renzhe Cui
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Yao Public Health Center, Yao City Office
| | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Tetsuya Ohira
- Department of Epidemiology, School of Medicine, Fukushima Medical University
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine
| | | | - Akihiko Kitamura
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Osaka Center for Cancer and Cardiovascular Disease Prevention.,Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Osaka Center for Cancer and Cardiovascular Disease Prevention.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Department of Public Health, Juntendo University Graduate School of Medicine
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Nagao M, Kobashi G, Umesawa M, Cui R, Yamagishi K, Imano H, Okada T, Kiyama M, Kitamura A, Sairenchi T, Haruyama Y, Ohira T, Iso H. Urinary 8-Hydroxy-2'-Deoxyguanosine Levels and Cardiovascular Disease Incidence in Japan. J Atheroscler Thromb 2020; 27:1086-1096. [PMID: 32161250 PMCID: PMC7585906 DOI: 10.5551/jat.51664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: The association between urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG), an oxidative stress marker, and the incidence of cardiovascular disease (CVD) has not been confirmed because no previous studies evaluated 24-hour 8-OHdG excretion levels in the general population. We aimed to confirm the association between 24-hour urinary 8-OHdG levels and CVD risk among Japanese men and women. Methods: A nested case-control study was performed based on a 24-hour urine collection in a community-based cohort study performed from 1996 to 2005. Seventy-six cases (55 men and 21 women) who experienced their first CVD incidence during the follow-up period (median: 5.9 years) were recruited. The controls were frequency-matched 1:2, with each case for sex, age, area of residence, and baseline year. The 8-OHdG level was measured by enzyme-linked immunosorbent assay. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression models adjusted for body mass index, ethanol intake, smoking status, and estimated glomerular filtration rate. Results: The geometric mean and geometric standard deviation (SD) of 8-OHdG levels (nmol/day) for cases and controls were 35.5 (1.55) and 35.5 (1.54) for men and 32.1 (1.35) and 25.0 (1.39) for women, respectively. The multivariable OR (95% CI) of CVD incidence according to the 1-SD increment of the log-transformed 8-OHdG level was 2.08 (0.99–4.37) for women. The multivariable ORs (95% CIs) for the 1st (lowest) and 4th versus 2nd quartile according to 8-OHdG for men were 3.29 (1.02–10.61) and 2.77 (0.96–7.96), respectively. Conclusion: A high 8-OHdG level tended to be associated with CVD incidence among women.
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Affiliation(s)
- Masanori Nagao
- Department of Public Health, School of Medicine, Dokkyo Medical University.,Office of Epidemiology, Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Epidemiology, School of Medicine, Fukushima Medical University
| | - Gen Kobashi
- Department of Public Health, School of Medicine, Dokkyo Medical University
| | - Mitsumasa Umesawa
- Department of Public Health, School of Medicine, Dokkyo Medical University
| | - Renzhe Cui
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.,Ibaraki Western Medical Center
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Diseases Prevention
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Diseases Prevention
| | | | - Toshimi Sairenchi
- Department of Public Health, School of Medicine, Dokkyo Medical University
| | - Yasuo Haruyama
- Department of Public Health, School of Medicine, Dokkyo Medical University
| | - Tetsuya Ohira
- Office of Epidemiology, Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Epidemiology, School of Medicine, Fukushima Medical University
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
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Ikeda S, Ikeda A, Yamagishi K, Hori M, Kubo S, Sata M, Okada C, Umesawa M, Sankai T, Kitamura A, Kiyama M, Ohira T, Tanigawa T, Iso H. Longitudinal Trends in Blood Pressure Associated With the Frequency of Laughter: The Circulatory Risk in Communities Study (CIRCS), a Longitudinal Study of the Japanese General Population. J Epidemiol 2020; 31:125-131. [PMID: 32092749 PMCID: PMC7813767 DOI: 10.2188/jea.je20190140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The frequency of laughter has been associated with cardiovascular disease and related biomarkers, but no previous studies have examined association between laughter and changes in blood pressure levels. We sought to identify temporal relationships between frequency of laughter in daily life and systolic and diastolic blood pressure changes in participants from 2010 through 2014. Methods Participants were 554 men and 887 women aged 40–74 years who answered self-administered questionnaire quantifying frequency of laughter at baseline. We measured participant blood pressure levels twice using automated sphygmomanometers for each year from 2010 to 2014. The associations between laughter and changes in blood pressure over time were analyzed using linear mixed-effect models. Results There was no significant difference in blood pressure according to frequency of laughter at baseline in either sex. Men with frequency of laughter 1 to 3 per month or almost never had significantly increased systolic and diastolic blood pressure levels over the 4-year period (time-dependent difference: 0.96 mm Hg (95% confidence interval [CI], −0.2 to 1.8; P = 0.05). Changes in blood pressure associated with infrequent laughter (ie, 1 to 3 per month or almost never) were evident in men without antihypertensive medication use over 4 years (0.94 mm Hg; 95% CI, −0.2 to 2.0; P = 0.09) and men who were current drinkers at baseline (1.29 mm Hg; 95% CI, −0.1 to 2.3; P = 0.04). No significant difference was found between frequency of laughter and systolic (0.23 mm Hg; 95% CI, −1.0 to 1.5; P = 0.72) and diastolic (−0.07 mm Hg; 95% CI, −0.8 to 0.7; P = 0.86) blood pressure changes in women. Conclusions Infrequent laughter was associated with long-term blood pressure increment among middle-aged men.
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Affiliation(s)
- Satomi Ikeda
- Department of Public Health, Juntendo University Graduate School of Medicine
| | - Ai Ikeda
- Department of Public Health, Juntendo University Graduate School of Medicine
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research Center, University of Tsukuba.,Osaka Center for Cancer and Cardiovascular Diseases Prevention
| | - Miyuki Hori
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Sachimi Kubo
- Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation at Kobe
| | - Mizuki Sata
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research Center, University of Tsukuba.,Osaka Center for Cancer and Cardiovascular Diseases Prevention.,Department of Preventive Medicine and Public Health, Keio University School of Medicine
| | - Chika Okada
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research Center, University of Tsukuba.,Department of Public Health, Dokkyo Medical University, School of Medicine.,Osaka Center for Cancer and Cardiovascular Diseases Prevention
| | - Tomoko Sankai
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research Center, University of Tsukuba
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Geriatric Hospital
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Diseases Prevention
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine
| | - Hiroyasu Iso
- Department of Public Health, Juntendo University Graduate School of Medicine.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research Center, University of Tsukuba.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
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41
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Adachi H, Enomoto M, Fukami A, Nakamura S, Nohara Y, Kono S, Sakaue A, Hamamura H, Toyomasu K, Yamamoto M, Umeki Y, Fukumoto Y. Trends in nutritional intake and coronary risk factors over 60 years among Japanese men in Tanushimaru. Heart Vessels 2020; 35:901-908. [DOI: 10.1007/s00380-020-01561-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/17/2020] [Indexed: 12/24/2022]
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42
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Li J, Muraki I, Imano H, Cui R, Yamagishi K, Umesawa M, Hayama-Terada M, Ohira T, Kiyama M, Okada T, Sankai T, Tanigawa T, Kitamura A, Iso H. Serum uric acid and risk of stroke and its types: the Circulatory Risk in Communities Study (CIRCS). Hypertens Res 2020; 43:313-321. [DOI: 10.1038/s41440-019-0385-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 08/11/2019] [Accepted: 08/14/2019] [Indexed: 02/07/2023]
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43
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Kakihana H, Jinnouchi H, Kitamura A, Matsudaira K, Kiyama M, Hayama-Terada M, Muraki I, Kubota Y, Yamagishi K, Okada T, Imano H, Iso H. Overweight and Hypertension in Relation to Chronic Musculoskeletal Pain Among Community-Dwelling Adults: The Circulatory Risk in Communities Study (CIRCS). J Epidemiol 2020; 31:566-572. [PMID: 32801279 PMCID: PMC8502830 DOI: 10.2188/jea.je20200135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The association between overweight and chronic musculoskeletal pain may vary by anatomical site and be modified by hypertension status. This study examined the associations between overweight and low back and knee pains and their effect modification by hypertension status. Methods We conducted a community-based cross-sectional study involving 2,845 adults (1,080 men and 1,765 women) aged 40–89 years. Chronic knee pain (CKP) and low back pain (CLBP) lasting more than 3 months were categorized into more or less severe pain. Odds ratios (ORs) and 95% confidence intervals (CIs) of the association between overweight and more or less severe CKP and CLBP were determined using logistic regression and stratified by hypertension status. Adjustment variables were age, sex, area, hypertension, smoking and drinking status, inactivity, job category, mental stress, depression, and overall CKP or CLBP. Results Overall, 288 (10.1%) and 631 (22.2%) adults had more and less severe CKP, respectively, and 284 (10.0%) and 830 (29.2%) had more and less severe CLBP, respectively. Overweight was associated with overall CKP and more or less severe CKP, regardless of hypertension status. Overweight was not associated with overall CLBP; its association was more pronounced for more severe CLBP. The association between overweight and more severe CLBP was evident among non-hypertensives (multivariable OR 1.72; 95% CI, 1.09–2.71); however, that between overweight and less severe CLBP was not evident (multivariable OR 1.07; 95% CI, 0.73–1.56). Conclusions As hypertension may attenuate the association between overweight and CLBP, we should consider hypertension status for proper management of CLBP among overweight individuals.
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Affiliation(s)
- Hironobu Kakihana
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Hiroshige Jinnouchi
- Department of Hygiene and Public Health, Nippon Medical School
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, the University of Tokyo
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
- Yao City Public Health Center
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
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44
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Jinnouchi H, Matsudaira K, Kitamura A, Kakihana H, Oka H, Hayama-Terada M, Muraki I, Honda E, Imano H, Yamagishi K, Ohira T, Okada T, Kiyama M, Iso H. Effects of Low-Dose Therapist-Led Self-Exercise Education on the Management of Chronic Low Back Pain: Protocol for a Community-Based, Randomized, 6-Month Parallel-Group Study. Spine Surg Relat Res 2019; 3:377-384. [PMID: 31768459 PMCID: PMC6834468 DOI: 10.22603/ssrr.2019-0005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 03/21/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction Chronic low back pain (CLBP), defined as low back pain persisting for at least 3 months, leads to limitations in the activities of daily living and decreased quality of life. Individualized self-exercise education could be a preferable treatment option, especially in community-dwelling people with CLBP. Previous studies, however, did not directly compare the effects of therapist-led self-exercise education and material-only education, and there are only a few studies investigating the effects of low-dose (comprising a few sessions) self-exercise education on CLBP. We present a protocol of community-based, randomized study to evaluate the effects of low-dose (comprising a few sessions), therapist-led self-exercise education on CLBP. Methods Forty-eight participants with CLBP (men and women, aged 40-74 years) will be allocated to therapeutic self-exercise education programs, either a therapist-led group (2-week therapist's consultation and material use) or material-only group (material use only), in a randomized controlled trial. Pain intensity (NRS, numeric rating scale), pain disability (RDQ, Roland-Morris disability questionnaire), pain self-efficacy (PSEQ, pain self-efficacy questionnaire), and quality of life score (EQ-5D, European quality of life-5 dimensions) will be measured at baseline and at 4, 12, and 24 weeks. We will apply a repeated-measures design with mixed-effect models to estimate group differences from the baseline. Ethics/Trial registration number: The protocol was approved by the Ethics Committees of the Osaka Center for Cancer and Cardiovascular Disease Prevention and Osaka University. The trial registration number is registered on the University Hospital Medical Information Network (UMIN000024537).
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Affiliation(s)
- Hiroshige Jinnouchi
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.,Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, the University of Tokyo, Tokyo, Japan
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hironobu Kakihana
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Hygiene and Public Health, Osaka Medical College, Osaka, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, the University of Tokyo, Tokyo, Japan
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Yao City Public Health Center, Osaka, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eiko Honda
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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