著者

Nobuyoshi Ozawa Kiyoshi Ito Toru Tase Daisuke Shibuya Hirohito Metoki Nobuo Yaegashi

出版者

Tohoku University Medical Press

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.243, no.4, pp.329-334, 2017 (Released:2017-12-20)

参考文献数

13

被引用文献数

13

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The Japanese national immunization programme for Human Papillomavirus (HPV) started in 2010. Vaccination rates increased up to 70% in women in the 1996-1999 birth. However, the proactive recommendation for HPV vaccine was suspended in 2013, following repeated media reports of adverse events. Vaccination rates plumped to less than 1% in women born since 2002. In this study, incidence of abnormal cytology and histology was examined in terms of HPV vaccination among 5,924 women aged 20 to 24 years in the fiscal year (FY) 2014 and 2015. The total rate of vaccination was 16.9% (1,002/5,924). In case of FY 2015, the rates of vaccination were 59.26%, 49.68%, 11.97%, 9.08%, and 4.58% in those aged 20, 21, 22, 23, and 24 years old, respectively. The rates of high-grade squamous intraepithelial lesion (HSIL) or worse were 0.20% (2/1,002) in women with HPV vaccination and 1.14% (56/4,922) in those without HPV vaccination, indicating a significant reduction of 82.46% with vaccination (P < 0.0001). The rates of cervical intraepithelial neoplasia (CIN) 1+ were 0.80% (8/1,002) in women with vaccination and 2.28% (112/4,922) in those without vaccination. The reduction rate of CIN1+ was 64.91% (P = 0.0025). The rates of CIN2+ were 0.10% (1/1,002) with vaccination and 0.69% (34/4,922) without vaccination. The reduction rate of CIN2+ was 85.51% (P = 0.0261). Our data are the first to demonstrate a significant reduction of CIN2+ cases in an Asian population. Scientific discussion is needed to restart the proactive recommendation for HPV vaccine in Japan.

著者

Nobuyoshi Ozawa Kiyoshi Ito Toru Tase Hirohito Metoki Nobuo Yaegashi

出版者

Tohoku University Medical Press

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.240, no.2, pp.147-151, 2016 (Released:2016-10-15)

参考文献数

8

被引用文献数

5 16

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Prevention of cervical cancer has been unsuccessful in Japan because of low rates of cancer screening and vaccination. The Vaccine Adverse Review Committee of the Japanese Government investigated 2,475 adverse events and reported 617 (6.9/100,000) severe cases and 176 (2.0/100,000) cases with chronic pain. The proactive recommendation for human papillomavirus (HPV) vaccination has been suspended since June 2013. In this study, we examined vaccination rate and incidence of abnormal cervical cytology in women aged 20 to 24 years attending cancer screening in Miyagi. Among the 3,272 women who underwent a health check in the fiscal year 2014 (April 2014-March 2015), 332 (10.2%) received a HPV vaccination. The HPV vaccination rates were 42.3%, 10%, 17.5%, 3.8% and 4.0% in women aged 20, 21, 22, 23 and 24 years, respectively. The rates of atypical squamous cells of undetermined significance (ASC-US) or worse were 2.41% (8/332) in women with HPV vaccination and 5.03% (148/2,940) in those without HPV vaccination, indicating a significant decrease in vaccinated women (p = 0.03). ASC-US cases were referred to HPV DNA tests. In addition, the rates of high grade squamous intraepithelial lesion (HSIL) or worse were 0.30% (1/332) in women with HPV vaccination and 0.82% (24/2,940) in those without HPV vaccination, showing the marginal decrease in women who were vaccinated (p = 0.3). Thus, this study indicates that HPV vaccination is associated with a reduction in the incidence of cervical abnormalities, suggesting a need for scientific discussion of reinstatement of proactive recommendation for HPV vaccine in Japan.

著者

Naho Morisaki Taku Obara Aurelie Piedvache Sumitaka Kobayashi Chihiro Miyashita Tomoko Nishimura Mami Ishikuro Fumihiro Sata Reiko Horikawa Chisato Mori Hirohito Metoki Kenji J Tsuchiya Shinichi Kuriyama Reiko Kishi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220076, (Released:2022-08-06)

参考文献数

35

被引用文献数

7

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Background: Recent literature suggest the effect of maternal smoking on risk of hypertensive disorders in pregnancy (HDP) and preeclampsia may differ by ethnicity, however studies on Asians are limited.Methods: We investigated the association between maternal smoking and HDP and preeclampsia, by using a common analysis protocol to analyze the association in six birth cohorts participating in a Japanese consortium of birth cohorts (JBiCC). Results were compared with published results from cohorts not included in this consortium, and where possible produced a meta-analysis including these studies.Results: Meta-analysis of four cohort studies including 28,219 participants produced an odds ratio (OR) of 1.24 (95% confidence interval (CI) 0.88-1.87) for effect of smoking beyond early pregnancy compared to women who did not smoke during pregnancy. These results combined with those from the Japan Environment and Children’s Study (JECS) yielded an OR of 1.19 (95%CI 1.00-1.43, p=0.056). Meta-analysis results for categories of smoking volume were insignificant, but when combined with JECS yielded an OR of 0.86 (95%CI 0.65-1.12) for smoking 1-4 cigarettes, 1.25 (95%CI 0.98-1.60) for smoking 5-9 cigarettes, and 1.27 (95%CI 1.04-1.54) for smoking 10 or more cigarettes per day. All effects were insignificant for preeclampsia.Conclusion: Our results suggest the protective effect of smoking longer, smoking more on HDP and preeclampsia repeatedly observed among Europeans and North Americans likely do not hold for the Japanese.

著者

Shinichi Kuriyama Nobuo Yaegashi Fuji Nagami Tomohiko Arai Yoshio Kawaguchi Noriko Osumi Masaki Sakaida Yoichi Suzuki Keiko Nakayama Hiroaki Hashizume Gen Tamiya Hiroshi Kawame Kichiya Suzuki Atsushi Hozawa Naoki Nakaya Masahiro Kikuya Hirohito Metoki Ichiro Tsuji Nobuo Fuse Hideyasu Kiyomoto Junichi Sugawara Akito Tsuboi Shinichi Egawa Kiyoshi Ito Koichi Chida Tadashi Ishii Hiroaki Tomita Yasuyuki Taki Naoko Minegishi Naoto Ishii Jun Yasuda Kazuhiko Igarashi Ritsuko Shimizu Masao Nagasaki Seizo Koshiba Kengo Kinoshita Soichi Ogishima Takako Takai-Igarashi Teiji Tominaga Osamu Tanabe Noriaki Ohuchi Toru Shimosegawa Shigeo Kure Hiroshi Tanaka Sadayoshi Ito Jiro Hitomi Kozo Tanno Motoyuki Nakamura Kuniaki Ogasawara Seiichiro Kobayashi Kiyomi Sakata Mamoru Satoh Atsushi Shimizu Makoto Sasaki Ryujin Endo Kenji Sobue the Tohoku Medical Megabank Project Study Group Masayuki Yamamoto

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20150268, (Released:2016-07-02)

参考文献数

64

被引用文献数

1 227

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The Great East Japan Earthquake (GEJE) and resulting tsunami of March 11, 2011 gave rise to devastating damage on the Pacific coast of the Tohoku region. The Tohoku Medical Megabank Project (TMM), which is being conducted by Tohoku University Tohoku Medical Megabank Organization (ToMMo) and Iwate Medical University Iwate Tohoku Medical Megabank Organization (IMM), has been launched to realize creative reconstruction and to solve medical problems in the aftermath of this disaster. We started two prospective cohort studies in Miyagi and Iwate Prefectures: a population-based adult cohort study, the TMM Community-Based Cohort Study (TMM CommCohort Study), which will recruit 80 000 participants, and a birth and three-generation cohort study, the TMM Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study), which will recruit 70 000 participants, including fetuses and their parents, siblings, grandparents, and extended family members. The TMM CommCohort Study will recruit participants from 2013 to 2016 and follow them for at least 5 years. The TMM BirThree Cohort Study will recruit participants from 2013 to 2017 and follow them for at least 4 years. For children, the ToMMo Child Health Study, which adopted a cross-sectional design, was also started in November 2012 in Miyagi Prefecture. An integrated biobank will be constructed based on the two prospective cohort studies, and ToMMo and IMM will investigate the chronic medical impacts of the GEJE. The integrated biobank of TMM consists of health and clinical information, biospecimens, and genome and omics data. The biobank aims to establish a firm basis for personalized healthcare and medicine, mainly for diseases aggravated by the GEJE in the two prefectures. Biospecimens and related information in the biobank will be distributed to the research community. TMM itself will also undertake genomic and omics research. The aims of the genomic studies are: 1) to construct an integrated biobank; 2) to return genomic research results to the participants of the cohort studies, which will lead to the implementation of personalized healthcare and medicine in the affected areas in the near future; and 3) to contribute the development of personalized healthcare and medicine worldwide. Through the activities of TMM, we will clarify how to approach prolonged healthcare problems in areas damaged by large-scale disasters and how useful genomic information is for disease prevention.

著者

Michihiro Satoh Takahisa Murakami Kei Asayama Takuo Hirose Masahiro Kikuya Ryusuke Inoue Megumi Tsubota-Utsugi Keiko Murakami Ayako Matsuda Azusa Hara Taku Obara Ryo Kawasaki Kyoko Nomura Hirohito Metoki Koichi Node Yutaka Imai Takayoshi Ohkubo

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-1227, (Released:2018-06-09)

参考文献数

30

被引用文献数

6

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Background:N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point.Methods and Results:We followed 1,198 participants (33.4% men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95% CI) in the NT-proBNP 30.0–54.9-pg/mL, 55.0–124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94–3.94), 1.77 (0.85–3.66), and 1.99 (0.86–4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95% CI: 1.03–19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened.Conclusions:NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.

著者

Masako Miyashita Masahiro Kikuya Chizuru Yamanaka Mami Ishikuro Taku Obara Yuki Sato Hirohito Metoki Naoki Nakaya Fuji Nagami Hiroaki Tomita Hideyasu Kiyomoto Junichi Sugawara Atsushi Hozawa Nobuo Fuse Yoichi Suzuki Ichiro Tsuji Shigeo Kure Nobuo Yaegashi Masayuki Yamamoto Shinichi Kuriyama

出版者

東北ジャーナル刊行会

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.237, no.4, pp.297-305, 2015 (Released:2015-12-02)

参考文献数

32

被引用文献数

1 21

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After the Great East Japan Earthquake of 2011, there has been a concern about health problems among children. Therefore, we investigated the prevalence of wheeze and eczema symptoms and associated factors among children in areas primarily affected by the disaster. From 2012 to 2014, we distributed the parent-administered questionnaire to 25,198 children in all 233 public schools in the 13 municipalities of Miyagi Prefecture in northeast Japan. A total of 7,155 responses (mean age 10.5 ± 2.2 years) were received (response rate: 28.4%). The prevalence of allergic symptoms according to the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire in 2nd, 4th, 6th, and 8th graders was 12.4%, 9.9%, 9.3%, and 5.6% for wheeze, and 20.1%, 18.0%, 14.0%, and 12.4% for eczema. In multivariate logistic analysis, younger age, history of hospitalization, and difficulties in children’s daily lives as assessed by the Strengths and Difficulties Questionnaire (SDQ), were significantly and consistently associated with both allergic symptoms (both P < 0.05). Living in a coastal municipality was also associated with eczema symptoms (P = 0.0278). The prevalence of eczema symptoms in the 2nd (20.1%) and 8th (12.4%) grades was significantly higher than previously reported in Japan. Living in a coastal municipality was independently associated with eczema symptoms, and psychometric properties were also closely linked to allergic symptoms. These findings are clinically important for understanding the risks of allergic disorders after natural disasters.

著者

Shingo Nakayama Michihiro Satoh Hirohito Metoki Takahisa Murakami Kei Asayama Azusa Hara Takuo Hirose Ryusuke Inoue Megumi Tsubota-Utsugi Masahiro Kikuya Takefumi Mori Atsushi Hozawa Koichi Node Yutaka Imai Takayoshi Ohkubo

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.1, pp.24-32, 2020-01-10 (Released:2020-01-10)

参考文献数

41

被引用文献数

6

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Background:N-terminal pro-B-type natriuretic peptide (NT-proBNP) is known to increase in heart failure patients. Given that no reports have described the association between NT-proBNP and chronic kidney disease (CKD) incidence in Asian populations, we investigated this association in the Japanese population.Methods and Results:We followed up 867 participants without CKD from the general population of Ohasama, Japan. We defined CKD as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2and/or proteinuria. In accordance with previous studies, the participants were classified into 4 groups according to NT-proBNP level (<30.0, 30.0–54.9, 55.0–124.9, and ≥125.0 pg/mL). The Cox model was applied to assess adjusted hazard ratios (HR) for CKD incidence after full adjustment including baseline eGFR. Participant mean age was 59.1 years, and 587 (67.7%) were women. During the mean follow-up period of 9.7 years, 177 participants developed CKD. When the group with NT-proBNP <30.0 pg/mL was used as the reference, adjusted HR for CKD incidence in the 30.0–54.9, 55.0–124.9, and ≥125.0 pg/mL groups were 1.34 (95% CI: 0.90–2.01), 1.25 (95% CI: 0.81–1.92), and 1.83 (95% CI: 1.05–3.18), respectively.Conclusions:NT-proBNP can be significantly predictive for CKD incidence in Asian populations.

著者

Atsushi Hozawa Kozo Tanno Naoki Nakaya Tomohiro Nakamura Naho Tsuchiya Takumi Hirata Akira Narita Mana Kogure Kotaro Nochioka Ryohei Sasaki Nobuyuki Takanashi Kotaro Otsuka Kiyomi Sakata Shinichi Kuriyama Masahiro Kikuya Osamu Tanabe Junichi Sugawara Kichiya Suzuki Yoichi Suzuki Eiichi N Kodama Nobuo Fuse Hideyasu Kiyomoto Hiroaki Tomita Akira Uruno Yohei Hamanaka Hirohito Metoki Mami Ishikuro Taku Obara Tomoko Kobayashi Kazuyuki Kitatani Takako Takai-Igarashi Soichi Ogishima Mamoru Satoh Hideki Ohmomo Akito Tsuboi Shinichi Egawa Tadashi Ishii Kiyoshi Ito Sadayoshi Ito Yasuyuki Taki Naoko Minegishi Naoto Ishii Masao Nagasaki Kazuhiko Igarashi Seizo Koshiba Ritsuko Shimizu Gen Tamiya Keiko Nakayama Hozumi Motohashi Jun Yasuda Atsushi Shimizu Tsuyoshi Hachiya Yuh Shiwa Teiji Tominaga Hiroshi Tanaka Kotaro Oyama Ryoichi Tanaka Hiroshi Kawame Akimune Fukushima Yasushi Ishigaki Tomoharu Tokutomi Noriko Osumi Tadao Kobayashi Fuji Nagami Hiroaki Hashizume Tomohiko Arai Yoshio Kawaguchi Shinichi Higuchi Masaki Sakaida Ryujin Endo Satoshi Nishizuka Ichiro Tsuji Jiro Hitomi Motoyuki Nakamura Kuniaki Ogasawara Nobuo Yaegashi Kengo Kinoshita Shigeo Kure Akio Sakai Seiichiro Kobayashi Kenji Sobue Makoto Sasaki Masayuki Yamamoto

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.1, pp.65-76, 2021-01-05 (Released:2021-01-05)

参考文献数

34

被引用文献数

54 66

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Background: We established a community-based cohort study to assess the long-term impact of the Great East Japan Earthquake on disaster victims and gene-environment interactions on the incidence of major diseases, such as cancer and cardiovascular diseases.Methods: We asked participants to join our cohort in the health check-up settings and assessment center based settings. Inclusion criteria were aged 20 years or over and living in Miyagi or Iwate Prefecture. We obtained information on lifestyle, effect of disaster, blood, and urine information (Type 1 survey), and some detailed measurements (Type 2 survey), such as carotid echography and calcaneal ultrasound bone mineral density. All participants agreed to measure genome information and to distribute their information widely.Results: As a result, 87,865 gave their informed consent to join our study. Participation rate at health check-up site was about 70%. The participants in the Type 1 survey were more likely to have psychological distress than those in the Type 2 survey, and women were more likely to have psychological distress than men. Additionally, coastal residents were more likely to have higher degrees of psychological distress than inland residents, regardless of sex.Conclusion: This cohort comprised a large sample size and it contains information on the natural disaster, genome information, and metabolome information. This cohort also had several detailed measurements. Using this cohort enabled us to clarify the long-term effect of the disaster and also to establish personalized prevention based on genome, metabolome, and other omics information.

著者

Mami Ishikuro Taku Obara Keiko Murakami Fumihiko Ueno Aoi Noda Masahiro Kikuya Junichi Sugawara Hirohito Metoki Shinichi Kuriyama

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.3, pp.127-135, 2023-03-05 (Released:2023-03-05)

参考文献数

31

被引用文献数

5

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Background: The present study analyzed the relation of disaster exposure prior to pregnancy with maternal characteristics and obstetric outcomes.Methods: The participants were 13,148 pregnant women recruited from 2013 to 2017. The women were classified into three groups by the severity of housing damage caused by the Great East Japan Earthquake of 2011: group A, house was not destroyed/did not live in the disaster area; group B, half/part of the house was destroyed; and group C, house was totally/mostly destroyed. Maternal characteristics, hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), and gestational weeks were obtained using questionnaires and medical records. Multiple logistic regression analyses were performed to investigate the relation between disaster exposure and maternal characteristics, HDP, and GDM. A structural equation model was applied to investigate the relation of disaster exposure with HDP and gestational weeks.Results: The homes of about 11% of the women were totally/mostly destroyed. For groups B and C compared with those in group A, the adjusted ORs for HDP were 1.04 and 1.26 (P for trend = 0.01), and for GDM were 0.89 and 1.14 (P for trend = 0.9), respectively. Pre-pregnancy body mass index (BMI) mediated 23.2% of the relation between disaster exposure and HDP. Disaster exposure was associated with gestational weeks.Conclusion: Disaster exposure at least 2.5 years before pregnancy was found to be associated with maternal characteristics and the prevalence of HDP. Pre-pregnancy BMI mediated the relation between disaster exposure and the prevalence of HDP, and gestational weeks were reduced through HDP.

著者

Junichi Sugawara Mami Ishikuro Taku Obara Tomomi Onuma Keiko Murakami Masahiro Kikuya Fumihiko Ueno Aoi Noda Satoshi Mizuno Tomoko Kobayashi Yohei Hamanaka Kichiya Suzuki Eiichi Kodama Naho Tsuchiya Akira Uruno Yoichi Suzuki Osamu Tanabe Hideyasu Kiyomoto Akito Tsuboi Atsushi Shimizu Seizo Koshiba Naoko Minegishi Soichi Ogishima Gen Tamiya Hirohito Metoki Atsushi Hozawa Nobuo Fuse Kengo Kinoshita Shigeo Kure Nobuo Yaegashi Shinichi Kuriyama Masayuki Yamamoto

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.2, pp.69-79, 2022-02-05 (Released:2022-02-05)

参考文献数

33

被引用文献数

3 10

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Background: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study was launched in 2013 to evaluate the complex interactions of genetic and environmental factors in multifactorial diseases. The present study describes the maternal baseline profile and perinatal data of participating mothers and infants.Methods: Expectant mothers living in Miyagi Prefecture were recruited from obstetric facilities or affiliated centers between 2013 and 2017. Three sets of self-administered questionnaires were collected, and the medical records were reviewed to obtain precise information about each antenatal visit and each delivery. Biospecimens, including blood, urine, umbilical cord blood, and breast milk, were collected for the study biobank. The baseline maternal sociodemographic characteristics, results of screening tests, and obstetric outcomes were analyzed according to the maternal age group.Results: A total of 23,406 pregnancies involving 23,730 fetuses resulted in 23,143 live births. Younger maternal participants had a tendency toward a higher incidence of threatened abortion and threatened premature labor, while older age groups exhibited a significantly higher rate of low lying placenta, placenta previa, gestational diabetes, and hypertensive disorders of pregnancy.Conclusions: The present study clearly shows the distribution of maternal baseline characteristics and the range of perinatal outcomes according to maternal age group. This cohort study can provide strategic information for creating breakthroughs in the pathophysiology of perinatal, developmental, and noncommunicable diseases by collaborative data visiting or sharing.

著者

Kazushi Watanabe Keiichi Matsubara Osamu Nakamoto Junko Ushijima Akihide Ohkuchi Keiko Koide Shintaro Makino Kazuya Mimura Mamoru Morikawa Katsuhiko Naruse Kanji Tanaka Tomoyoshi Nohira Hirohito Metoki Ikuno Kawabata Satoru Takeda Hiroyuki Seki Kenjiro Takagi Mineo Yamasaki Atsuhiro Ichihara Tadashi Kimura Shigeru Saito

出版者

Japan Society for the Study of Hypertension in Pregnancy

雑誌

Hypertension Research in Pregnancy (ISSN:21875987)

巻号頁・発行日

vol.6, no.2, pp.33-37, 2018-11-30 (Released:2019-03-28)

参考文献数

5

被引用文献数

57