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Charvat H, Goto A, Goto M, Inoue M, Heianza Y, Arase Y, Sone H, Nakagami T, Song X, Qiao Q, Tuomilehto J, Tsugane S, Noda M, Inoue M. Impact of population aging on trends in diabetes prevalence: A meta-regression analysis of 160,000 Japanese adults. J Diabetes Investig 2015; 6:533-42. [PMID: 26417410 PMCID: PMC4578492 DOI: 10.1111/jdi.12333] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 01/06/2015] [Accepted: 01/16/2015] [Indexed: 12/20/2022] Open
Abstract
AIMS/INTRODUCTION To provide age- and sex-specific trends, age-standardized trends, and projections of diabetes prevalence through the year 2030 in the Japanese adult population. MATERIALS AND METHODS In the present meta-regression analysis, we included 161,087 adults from six studies and nine national health surveys carried out between 1988 and 2011 in Japan. We assessed the prevalence of diabetes using a recorded history of diabetes or, for the population of individuals without known diabetes, either a glycated hemoglobin level of ≥6.5% (48 mmol/mol) or the 1999 World Health Organization criteria (i.e., a fasting plasma glucose level of ≥126 mg/dL and/or 2-h glucose level of ≥200 mg/dL in the 75-g oral glucose tolerance test). RESULTS For both sexes, prevalence appeared to remain unchanged over the years in all age categories except for men aged 70 years or older, in whom a significant increase in prevalence with time was observed. Age-standardized diabetes prevalence estimates based on the Japanese population of the corresponding year showed marked increasing trends: diabetes prevalence was 6.1% among women (95% confidence interval [CI] 5.5-6.7), 9.9% (95% CI 9.2-10.6) among men, and 7.9% (95% CI 7.5-8.4) among the total population in 2010, and was expected to rise by 2030 to 6.7% (95% CI 5.2-9.2), 13.1% (95% CI 10.9-16.7) and 9.8% (95% CI 8.5-12.0), respectively. In contrast, the age-standardized diabetes prevalence using a fixed population appeared to remain unchanged. CONCLUSIONS This large-scale meta-regression analysis shows that a substantial increase in diabetes prevalence is expected in Japan during the next few decades, mainly as a result of the aging of the adult population.
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Affiliation(s)
- Hadrien Charvat
- Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer CenterTokyo, Japan
| | - Atsushi Goto
- Department of Diabetes Research, National Center for Global Health and MedicineTokyo, Japan
| | - Maki Goto
- Department of Diabetes Research, National Center for Global Health and MedicineTokyo, Japan
| | - Machiko Inoue
- General Medical Education Center, Teikyo UniversityTokyo, Japan
| | - Yoriko Heianza
- Department of Internal Medicine, Faculty of Medicine, Niigata UniversityNiigata, Japan
| | - Yasuji Arase
- Health Management Center, Toranomon HospitalTokyo, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Faculty of Medicine, Niigata UniversityNiigata, Japan
| | - Tomoko Nakagami
- Diabetes Center, Tokyo Women's Medical UniversityTokyo, Japan
| | - Xin Song
- Department of Public Health, University of HelsinkiHelsinki, Finland
- Department of Chronic Disease Prevention, National Institute for Health and WelfareHelsinki, Finland
| | - Qing Qiao
- Department of Public Health, University of HelsinkiHelsinki, Finland
- Department of Chronic Disease Prevention, National Institute for Health and WelfareHelsinki, Finland
- R&D AstraZeneca ABMölndal, Sweden
| | - Jaakko Tuomilehto
- Department of Chronic Disease Prevention, National Institute for Health and WelfareHelsinki, Finland
- Center for Vascular Prevention, Danube University KremsKrems, Austria
- King Abdulaziz UniversityJeddah, Saudi Arabia
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer CenterTokyo, Japan
| | - Mitsuhiko Noda
- Department of Diabetes Research, National Center for Global Health and MedicineTokyo, Japan
| | - Manami Inoue
- AXA Department of Health and Human Security, Graduate School of Medicine, The University of TokyoTokyo, Japan
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Nakamura Y, Saitoh S, Takagi S, Ohnishi H, Chiba Y, Kato N, Akasaka H, Miura T, Tsuchihashi K, Shimamoto K. Impact of Abnormal Glucose Tolerance, Hypertension and Other Risk Factors on Coronary Artery Disease. Circ J 2007; 71:20-5. [PMID: 17186973 DOI: 10.1253/circj.71.20] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The degree to which abnormal glucose tolerance contributes to the development of coronary artery disease (CAD) has not been clarified in Japanese. The relationship between abnormal glucose tolerance and severity of coronary artery stenosis, as well as the contributions of hypertension, diabetes and other risk factors for CAD to recurrence of the disease, were investigated in the present study. METHODS AND RESULTS The subjects were 474 consecutive patients (mean age: 63.8+/-11.3 years) with suspected CAD who were admitted to Sapporo Medical University Hospital during April 1, 1997 to March 31, 2004. The coronary index and stenosis score were higher in subjects with diabetes mellitus (DM) and in subjects with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) than in subjects with normal glucose tolerance (NGT). Ischemic episodes recurred during the observation period (mean 2.5 years) in 61 of 341 patients diagnosed as having CAD. In the follow-up subjects, systolic blood pressure (SBP) was significantly higher in the recurrence group than in the non-recurrence group, and SBP was a significant variable in logistic regression analysis after adjustment for age, gender, hemoglobin A1c, total cholesterol, body mass index, smoking history, family history and stenosis score. The relative risk of recurrence became 1.7-fold higher with a rise in SBP of 10 mmHg (95% confidence interval: 1.252-2.250). Analysis of the relationship between glucose tolerance and recurrence showed that the rate of recurrence was higher in patients with IFG+IGT+DM than in those with NGT. CONCLUSIONS CAD progresses not only in patients with DM but also in those with IGT. The rate of recurrence of ischemic episodes increases in individuals with IGT or DM, and suggesting that hypertension is a risk factor for recurrence of ischemic episodes. Management of glucose tolerance and blood pressure is therefore important for prevention of CAD in Japanese.
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Affiliation(s)
- Yosuke Nakamura
- Second Department of Internal Medicine, Sapporo Medical University, Japan.
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