著者

Mayu Uemura Hiroshi Yatsuya Esayas Haregot Hilawe Yuanying Li Chaochen Wang Chifa Chiang Rei Otsuka Hideaki Toyoshima Koji Tamakoshi Atsuko Aoyama

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.25, no.5, pp.351-358, 2015-05-05 (Released:2015-05-05)

参考文献数

23

被引用文献数

34 49

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Background: Skipping breakfast has been suspected as a risk factor for type 2 diabetes (T2DM), but the associations are not entirely consistent across ethnicities or sexes, and the issue has not been adequately addressed in the Japanese population.Methods: We followed 4631 participants (3600 men and 1031 women) in a work-site cohort of participants aged 35–66 years in 2002 through 2011 for T2DM development. Frequency of eating breakfast was self-reported and was subsequently dichotomized to breakfast skippers, who eat breakfast 3–5 times/week or less, and to eaters. Cox proportional hazards models were used to adjust for potential confounding factors, including dietary factors, smoking and other lifestyles, body mass index (BMI), and fasting blood glucose (FBG) at baseline.Results: During 8.9 years of follow-up, 285 T2DM cases (231 men and 54 women) developed. Compared to participants who reported eating breakfast every day, maximally-adjusted hazard ratios and 95% confidence intervals (CI) of those with the frequency of almost every day and 3–5, 1–2, and 0 days/week were: 1.06 (95% CI, 0.73–1.53), 2.07 (95% CI, 1.20–3.56), 1.37 (95% CI, 0.82–2.29), and 2.12 (95% CI, 1.19–3.76), respectively. In a dichotomized analysis, breakfast skipping was positively associated with T2DM incidence (maximally-adjusted hazard ratio 1.73; 95% CI, 1.24–2.42). The positive associations were found in both men and women, current and non-current smokers, normal weight and overweight (BMI ≥25 kg/m2), and normal glycemic status and impaired fasting glycemic status (FBG 110 to <126 mg/dL) individuals at baseline (Ps for interaction all >0.05).Conclusions: The present study in middle-aged Japanese men and women suggests that skipping breakfast may increase the risk of T2DM independent of lifestyles and baseline levels of BMI and FBG.

著者

Eizaburo Tanaka Hiroshi Yatsuya Mayu Uemura Chiyoe Murata Rei Otsuka Hideaki Toyoshima Koji Tamakoshi Satoshi Sasaki Leo Kawaguchi Atsuko Aoyama

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.23, no.2, pp.132-138, 2013-03-05 (Released:2013-03-05)

参考文献数

39

被引用文献数

12 72

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Background: Diet is a modifiable factor that may affect sleep, but the associations of macronutrient intakes with insomnia are inconsistent. We investigated the associations of protein, fat, and carbohydrate intakes with insomnia symptoms.Methods: In this cross-sectional analysis of 4435 non-shift workers, macronutrient intakes were assessed by the brief-type self-administered diet history questionnaire, which requires the recall of usual intakes of 58 foods during the preceding month. Presence of insomnia symptoms, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and poor quality of sleep (PQS) were self-reported. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs adjusted for demographic, psychological, and behavioral factors, as well as medical histories.Results: Low protein intake (<16% vs ≥16% of total energy) was associated with DIS (OR 1.24, 95% CI 0.99–1.56) and PQS (OR 1.24, 95% CI 1.04–1.48), while high protein intake (≥19% vs <19% of total energy) was associated with DMS (OR 1.40, 95% CI 1.12–1.76). Low carbohydrate intake (<50% vs ≥50% of total energy) was associated with DMS (OR 1.19, 95% CI 0.97–1.45).Conclusions: Protein and carbohydrate intakes in the daily diet were associated with insomnia symptoms. The causality of these associations remains to be explained.

著者

Abubakr Ahmed Abdullah Al-shoaibi Yuanying Li Zean Song Chifa Chiang Yoshihisa Hirakawa KM Saif-Ur-Rahman Masako Shimoda Yoshihisa Nakano Masaaki Matsunaga Atsuko Aoyama Koji Tamakoshi Atsuhiko Ota Hiroshi Yatsuya

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.63519, (Released:2022-07-13)

参考文献数

48

被引用文献数

4

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Aims: The associations between low-density lipoprotein cholesterol (LDL-C) and the risk of cardiovascular disease (CVD) subtypes are not well established among the Japanese population. This study used longitudinal data from the Aichi Workers' Cohort Study to explore the association between LDL-C levels and the risk of coronary heart disease (CHD) and stroke subtypes. Methods: Pooled data of 8966 adults (7093men and 1903 women) who were recruited between (2002) and (2008) were used for the current analysis. Propensity scores for the LDL-C categories were generated using multinomial logistic regression. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from the inverse probability weighted Cox proportional hazards model for LDL-C category associations with risks of CHD, stroke subtypes, and CVD. Results: During a median follow-up of 12 years, 122 strokes (57 ischemic strokes, 25 intracerebral hemorrhage, and 40 unknown subtypes) and 82 cases of CHD were observed. LDL-C 160- mg/dL compared to LDL-C 100-119 mg/dL was positively and significantly associated with the risk of CHD (HR: 4.56; 95% CI: 1.91-10.9) but not with ischemic stroke (HR: 0.99; 95% CI: 0.44-2.22). LDL-C was inversely associated with the risk of intracerebral hemorrhage (P for trend=0.009). Conclusion: In middle-aged Japanese workers, LDL-C was significantly and positively associated with CHD, but not with ischemic stroke. LDL-C was inversely significantly associated with intracerebral hemorrhage.

著者

Yoshie Hose Junko Ishihara Ayaka Kotemori Misako Nakadate Sachiko Maruya Junta Tanaka Hiroshi Yatsuya Atsuko Aoyama Chifa Chiang Tsuneo Konta Takamasa Kayama Yoshiyuki Ueno Manami Inoue Norie Sawada Shoichiro Tsugane Ribeka Takachi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.8, pp.419-427, 2023-08-05 (Released:2023-08-05)

参考文献数

25

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Background: Recent innovations in information and communication technology have made it possible to assess diet using web-based methods; however, their applicability in the general population remains unclear. Hence, we aimed to examine the applicability of a web-based 24-hour dietary recall (24HR) tool to large-scale epidemiological studies by determining the sampling rate and characteristics of randomly selected participants from a Japanese cohort study.Methods: In total, 5,013 individuals were recruited from a cohort of 21,537 individuals, and 975 agreed to participate in this study. The participants selected either self-administered web-based dietary 24HR (self-administered 24HR) or interviewer-administered telephone-based 24HR (interviewer-administered 24HR) as the method for the dietary assessment and answered questions regarding the acceptability of the system.Results: The response rate of the 975 participants was 19.4%, corresponding to approximately 4.5% of the total study sample. About half of them chose the self-administered 24HR (46.9%). The median time required for the self-administered and interviewer-administered 24HR was 25 and 27 minutes, respectively. In the self-administered 24HR, older people, regardless of sex, tended to require a longer time, and approximately 60% of the participants rated the ease of use of the system as “somewhat difficult” or “difficult.”Conclusion: Characteristics of the participants in this study were not systemically different from those of the entire study sample. Improvements in the approach to entering cooking details and the dish name selection may be necessary for better acceptability in order to be accepted as a self-administered dietary recall tool.

著者

Masako Shimoda Kayo Kaneko Takeshi Nakagawa Naoko Kawano Rei Otsuka Atsuhiko Ota Hisao Naito Masaaki Matsunaga Naohiro Ichino Hiroya Yamada Chifa Chiang Yoshihisa Hirakawa Koji Tamakoshi Atsuko Aoyama Hiroshi Yatsuya

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.2, pp.76-81, 2023-02-05 (Released:2023-02-05)

参考文献数

33

被引用文献数

2

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Background: There is limited evidence regarding the relationship between Diabetes mellitus (DM) in middle age and mild cognitive impairment after a follow-up. Therefore, we investigated the relationship between fasting blood glucose (FBG) levels in middle age and cognitive function assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in later life, following over 15 years of follow-up in the Aichi Workers’ Cohort Study in Japan.Methods: Participants were 253 former local government employees aged 60–79 years in 2018 who participated in a baseline survey conducted in 2002. Using baseline FBG levels and self-reported history, participants were classified into the normal, impaired fasting glucose (IFG) and, and DM groups. Total MoCA-J score ranges from 0 to 30, and cognitive impairment was defined as MoCA-J score ≤25 in this study. A general linear model was used to estimate the mean MoCA-J scores in the FBG groups, adjusted for age, sex, educational year, smoking status, alcohol consumption, physical activity, body mass index, systolic blood pressure, total cholesterol, and estimated glomerular filtration rate.Results: The mean MoCA-J score in the total population was 25.0, and the prevalence of MoCA-J score ≤25 was 49.0%. Multivariable-adjusted total MoCA-J scores were 25.2, 24.8, and 23.4 in the normal, IFG, and DM groups, respectively. The odds ratio of MoCA-J score ≤25 in the DM group was 3.29.Conclusion: FBG level in middle age was negatively associated with total MoCA-J scores assessed later in life, independent of confounding variables.

著者

Masako Shimoda Kayo Kaneko Takeshi Nakagawa Naoko Kawano Rei Otsuka Atsuhiko Ota Hisao Naito Masaaki Matsunaga Naohiro Ichino Hiroya Yamada Chifa Chiang Yoshihisa Hirakawa Koji Tamakoshi Atsuko Aoyama Hiroshi Yatsuya

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20210128, (Released:2021-05-22)

参考文献数

33

被引用文献数

2

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Background: There is limited evidence regarding the relationship between Diabetes mellitus (DM) in middle age and mild cognitive impairment after a follow-up. Therefore, we investigated the relationship between fasting blood glucose (FBG) levels in middle age and cognitive function (assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in later life, following over 15 years of follow-up in the Aichi Workers’ Cohort Study in Japan.Methods: Participants were 253 former local government employees aged 60–79 years in 2018 who participated in a baseline survey conducted in 2002. Using baseline FBG levels and self-reported history, participants were classified into the normal, impaired fasting glucose (IFG) and, and DM groups. Total MoCA-J score ranges from 0 to 30, and cognitive impairment was defined as MoCA-J score ≤25 in this study. A general linear model was used to estimate the mean MoCA-J scores in the FBG groups, adjusted for age, sex, educational year, smoking status, alcohol consumption, physical activity, body mass index, systolic blood pressure, total cholesterol, and estimated glomerular filtration rate.Results: The mean MoCA-J score in the total population was 25.0, and the prevalence of MoCA-J score ≤25 was 49.0%. Multivariable-adjusted total MoCA-J scores were 25.2, 24.8, and 23.4 in the normal, IFG, and DM groups, respectively. The odds ratio of MoCA-J score ≤25 in the DM group was 3.29.Conclusions: FBG level in middle age was negatively associated with total MoCA-J scores assessed later in life, independent of confounding variables.

著者

Hiroshi Yatsuya Yuanying Li Yoshihisa Hirakawa Atsuhiko Ota Masaaki Matsunaga Hilawe Esayas Haregot Chifa Chiang Yan Zhang Koji Tamakoshi Hideaki Toyoshima Atsuko Aoyama

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20170048, (Released:2018-03-17)

参考文献数

36

被引用文献数

12

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Background: Relatively little evidence exists for type 2 diabetes mellitus (T2DM) prediction models from long-term follow-up studies in East Asians. This study aims to develop a point-based prediction model for 10-year risk of developing T2DM in middle-aged Japanese men.Methods: We followed 3,540 male participants of Aichi Workers’ Cohort Study, who were aged 35–64 years and were free of diabetes in 2002, until March 31, 2015. Baseline age, body mass index (BMI), smoking status, alcohol consumption, regular exercise, medication for dyslipidemia, diabetes family history, and blood levels of triglycerides (TG), high density lipoprotein cholesterol (HDLC) and fasting blood glucose (FBG) were examined using Cox proportional hazard model. Variables significantly associated with T2DM in univariable models were simultaneously entered in a multivariable model for determination of the final model using backward variable selection. Performance of an existing T2DM model when applied to the current dataset was compared to that obtained in the present study’s model.Results: During the median follow-up of 12.2 years, 342 incident T2DM cases were documented. The prediction system using points assigned to age, BMI, smoking status, diabetes family history, and TG and FBG showed reasonable discrimination (c-index: 0.77) and goodness-of-fit (Hosmer-Lemeshow test, P = 0.22). The present model outperformed the previous one in the present subjects.Conclusion: The point system, once validated in the other populations, could be applied to middle-aged Japanese male workers to identify those at high risk of developing T2DM. In addition, further investigation is also required to examine whether the use of this system will reduce incidence.

著者

Yoshihisa Hirakawa Chifa Chiang Atsuko Aoyama

出版者

(社)日本農村医学会

雑誌

Journal of Rural Medicine (ISSN:1880487X)

巻号頁・発行日

vol.12, no.1, pp.28-32, 2017 (Released:2017-05-24)

参考文献数

21

被引用文献数

14

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Introduction: High-quality, community-based dementia care requires a comprehensive, holistic approach. This study aimed to identify the barriers to achieving efficient cooperation and coordination among medical professionals, care managers, and medical social workers, and to improve the management model of community-based, integrated dementia care.Methods: We collected qualitative data through three focus group discussions at JA Konan Kosei Hospital. Thirteen participants (four directors of nursing service departments, three chief nurses, four medical social workers, and two care managers) were recruited for the discussions. The data were analyzed using an inductive, multi-step approach referred to as the qualitative content analysis.Results: Nine themes arose as follows: little attention given to patient wishes, lack of time and space to provide high-quality care, disturbing hospital environment, poor compensation for staff members, refusing to visit outpatient clinics, declined admission, daily life support by family members and caregivers, dementia care team, and community bonding.Conclusion: The participants wanted to launch a dementia care team in their hospital to improve the care environment and the quality of dementia-specific care. The study also suggested that advance care planning could be systematically implemented in clinical practice as a way to honor the decisions made by dementia patients.