文献一覧: Hirotsugu Ueshima (著者)

61 0 0 0 OA Explanation for the Japanese Paradox: Prevention of Increase in Coronary Heart Disease and Reduction in Stroke

著者: Hirotsugu Ueshima
出版者: Japan Atherosclerosis Society
雑誌: Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
巻号頁・発行日: pp.0712140006, (Released:2007-12-17)
参考文献数: 52
被引用文献数: 192 228

Japan's age-adjusted rate for mortality from stroke increased after the Second World War until 1965 and then showed a significant decline until 1990; however, the age-adjusted rate for mortality from all heart disease and coronary heart disease (CHD) increased until 1970 and then declined slowly. A puzzling question is why the rate of mortality from CHD declined in spite of an increase in serum total cholesterol level following an increase in fat consumption.It was confirmed that CHD incidence was far lower in several Japanese populations compared to Western countries in the “ Monitoring Trends and Determinants in Cardiovascular Disease ” (MONICA) project; therefore, the lower CHD mortality in Japan stems from the lower CHD incidence. CHD risk factors based on epidemiologic cohort studies in Japan were no different from those of other industrialized countries: hypertension, hypercholesterolemia, smoking and diabetes mellitus (DM). So, how can we explain this phenomenon?There are three possible explanations. One is the decline in population blood pressure level and the prevalence of hypertension during the years 1965-1990; the second is the decline in smoking rate in men and women; the third is that the serum total cholesterol level for middle-aged and elderly populations remains 5-15 mg/dL lower than that of the US elderly counterpart, although men aged 40-49 in Japan and the US had similar serum total cholesterol levels. It was also noted that elderly people in Japan, as observed in the Seven Countries Study, had far lower serum total cholesterol levels in midlife, i.e., around 160 mg/dL in the 1960s. This was not the case for elderly in the US where a higher serum total cholesterol level was observed in midlife.In conclusion, the lower serum cholesterol level in the past of Japanese middle-aged and elderly people compared to Western counterparts helps to maintain the low CHD incidence and mortality supported by the declining trend in blood pressure level and smoking rate for both men and women.

2020-07-29 20:09:35
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6 0 0 0 OA White Blood Cell Count and Risk of All-Cause and Cardiovascular Mortality in Nationwide Sample of Japanese

著者: Koji Tamakoshi Hideaki Toyoshima Hiroshi Yatsuya Kunihiro Matsushita Tomonori Okamura Takehito Hayakawa Akira Okayama Hirotsugu Ueshima The NIPPON DATA90 Research Group
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.71, no.4, pp.479-485, 2007 (Released:2007-03-25)
参考文献数: 23
被引用文献数: 24 52

Background The association of white blood cell (WBC) count with all-cause and cardiovascular disease (CVD) mortality were examined in the National Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged (NIPPON DATA) 90. Methods and Results A total of 6,756 Japanese residents (2,773 men and 3,983 women) throughout Japan without a history of CVD were followed for 9.6 years. A Cox proportional hazards regression model was used to estimate the relative risk (RR) and 95% confidence interval (CI). We documented 576 deaths with 161 deaths from CVD. Overall, after adjusting for several confounders including age, sex, body mass index at baseline, smoking status, alcohol consumption, regular exercise, diastlic blood pressure, total cholesterol, high-density lipoprotein-cholesterol and hemoglobin A1c, a graded association between WBC count and higher risk of all-cause mortality was observed (WBC of 9,000-10,000 cells/mm3 vs WBC of 4,000-4,900: RR =1.61, 95% CI: 1.07-2.40, p for trend =0.02). Elevated WBC count was almost significantly associated with high risk of CVD mortality (WBC of 9,000-10,000 vs WBC of 4,000-4,900: RR =1.79, 95% CI: 0.97-3.71). These associations strengthened among women. Stratified by smoking status, never-smokers with WBC counts of 9,000-10,000 had a 3.2 fold elevated risk for CVD death compared with those with WBC counts of 4,000-4,900. Conclusions The WBC count may have potential as a predictor for all-cause mortality, particularly CVD mortality. (Circ J 2007; 71: 479 - 485)

2017-09-02 14:39:27
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4 0 0 0 OA Association Between Body Mass Index and All-Cause Death in Japanese Population: Pooled Individual Participant Data Analysis of 13 Cohort Studies

著者: Atsushi Hozawa Takumi Hirata Hiroshi Yatsuya Yoshitaka Murakami Shinichi Kuriyama Ichiro Tsuji Daisuke Sugiyama Atsushi Satoh Sachiko Tanaka-Mizuno Katsuyuki Miura Hirotsugu Ueshima Tomonori Okamura
出版者: Japan Epidemiological Association
雑誌: Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日: pp.JE20180124, (Released:2018-11-03)
参考文献数: 20
被引用文献数: 17

Background: We sought to investigate the optimal values of BMI for the lowest risk of all-cause death and whether the optimal BMI differs according to smoking status in large-scale pooled analysis of 13 Japanese cohorts.Methods: Data from 179,987 participants of 13 well-qualified cohort studies conducted throughout Japan were used for our analysis. A cohort-stratified Cox proportional hazard model was used. P values for interactions were calculated based on the cross product of BMI and age, sex, or smoking status.Results: In the entire study population, all-cause mortality risk was lowest when the BMI was 22.0–24.9 kg/m2. This was also the case for selected healthy participants (never smoked, baseline total cholesterol level ≥4.1 mmol/L; the first 5 years of follow-up data were excluded). No effect modification of age, sex, or smoking status was observed. Regardless of their BMI, never smokers always had a lower all-cause mortality risk than did current smokers even with an ideal BMI in terms of mortality risk.Conclusion: A BMI of 22–24.9 kg/m2 correlated with the lowest risk of mortality, regardless of whether all participants or selected healthy participants were analyzed. The fact that smoking was more strongly associated with mortality than obesity emphasizes the urgency for effective anti-smoking programs.

2019-09-16 17:42:38
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4 0 0 0 OA Cardiovascular Risk Assessment Chart by Dietary Factors in Japan ― NIPPON DATA80 ―

著者: Keiko Kondo Katsuyuki Miura Sachiko Tanaka-Mizuno Aya Kadota Hisatomi Arima Nagako Okuda Akira Fujiyoshi Naoko Miyagawa Katsushi Yoshita Tomonori Okamura Akira Okayama Hirotsugu Ueshima for the NIPPON DATA80 Research Group
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.83, no.6, pp.1254-1260, 2019-05-24 (Released:2019-05-24)
参考文献数: 47
被引用文献数: 10

Background:Many studies show that dietary factors such as vegetables, fruit, and salt are associated with cardiovascular disease (CVD) risk. However, a risk assessment chart for CVD mortality according to combinations of dietary factors has not been established.Methods and Results:Participants were 9,115 men and women aged 30–79 years enrolled in the National Nutritional Survey of Japan in 1980 with a 29-year follow-up. Dietary intake was assessed using a 3-day weighed dietary record at baseline. Cox regression models were used to estimate the hazard ratio (HR) of CVD mortality stratified by vegetables, fruit, fish, and salt consumption. HRs of CVD mortality according to combinations of dietary factors were color coded on an assessment chart. Higher intakes of vegetables, fruit, and fish, and lower salt intake were associated with lower CVD mortality risk. HRs calculated from combinations of dietary factors were displayed using 5 colors corresponding to the magnitude of the HR. People with the lowest intake of vegetables, fruit, and fish, and higher salt intake had a HR of 2.87 compared with those with the highest intake of vegetables, fruit, and fish, and lower salt intake.Conclusions:Vegetables, fruit, fish, and salt intake were independently associated with CVD mortality risk. The assessment chart generated could be used in Japan as an educational tool for CVD prevention.

2019-06-04 21:35:38
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3 0 0 0 OA Relationship between non-fasting triglycerides and cardiovascular disease mortality in a 20-year follow-up study of a Japanese general population: NIPPON DATA90

著者: Aya Hirata Tomonori Okamura Takumi Hirata Daisuke Sugiyama Takayoshi Ohkubo Nagako Okuda Yoshikuni Kita Takehito Hayakawa Aya Kadota Keiko Kondo Katsuyuki Miura Akira Okayama Hirotsugu Ueshima
出版者: Japan Epidemiological Association
雑誌: Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日: pp.JE20200399, (Released:2021-01-16)
参考文献数: 31
被引用文献数: 9

BackgroundNon-fasting triglycerides (TG) are considered a better predictor of cardiovascular disease (CVD) than fasting TG. However, the effect of non-fasting TG on fatal CVD events remains unclear. In the present study, we aimed to explore the relationship between non-fasting TG and CVD mortality in a Japanese general population.MethodsA total of 6,831 participants without a history of CVD, in which those who had a blood sampling over 8 hours or more after a meal were excluded, were followed for 18.0 years. We divided participants into seven groups according to non-fasting TG levels: ≤59 mg/dL, 60-89 mg/dL, 90-119 mg/dL, 120-149 mg/dL, 150-179 mg/dL, 180-209 mg/dL, and ≥210 mg/dL, and estimated the multivariable-adjusted hazard ratios (HRs) of each TG group for CVD mortality after adjusting for potential confounders, including high density lipoprotein cholesterol. Additionally, we performed analysis stratified by age <65 and ≥65 years.ResultsDuring the follow-up period, 433 deaths due to CVD were detected. Compared with a non-fasting TG of 150-179 mg/dL, non-fasting TG ≥210 mg/dL was significantly associated with increased risk for CVD mortality (HR=1.56, 95% CI, 1.01-2.41). Additionally, lower levels of non-fasting TG were also significantly associated with increased risk for fatal CVD. In participants aged ≥65 years, lower levels of non-fasting TG had a stronger impact on increased risk for CVD mortality, while higher levels of non-fasting TG had a stronger impact in those aged <65 years.ConclusionIn a general Japanese population, we observed a U-shaped association between non-fasting TG and fatal CVD events.

2023-09-02 14:15:55
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3 0 0 0 OA Vegetable Protein Intake was Inversely Associated with Cardiovascular Mortality in A 15-Year Follow-Up Study of A General Japanese Population

著者: Ayako Kurihara Tomonori Okamura Daisuke Sugiyama Aya Higashiyama Makoto Watanabe Nagako Okuda Aya Kadota Naoko Miyagawa Akira Fujiyoshi Katsushi Yoshita Takayoshi Ohkubo Akira Okayama Katsuyuki Miura Hirotsugu Ueshima for the NIPPON DATA90 Research Group
出版者: Japan Atherosclerosis Society
雑誌: Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
巻号頁・発行日: pp.44172, (Released:2018-08-09)
参考文献数: 36
被引用文献数: 19

Aim: To examine the relationship between the intake of dietary vegetable protein and CVD mortality in a 15-year follow-up study of a representative sample of the Japanese population.Methods: A total of 7,744 participants aged 30 years or older (3,224 males and 4,520 females) who were free of CVD at baseline were included in this analysis. Vegetable protein intake (% energy) was assessed using a three-day semi-weighed dietary record at baseline. Multivariable-adjusted hazard ratios (HRs) were calculated using Cox's proportional hazards model after adjusting for confounding factors.Results: The total person-years studied were 107,988 with a mean follow-up period of 13.9 years. There were 1,213 deaths during the follow-up period, among which 354 (29.2%) were due to CVD. Vegetable protein intake was associated inversely with CVD and cerebral hemorrhage mortality, with the HRs for a 1% energy increment in vegetable protein intake being 0.86 (95% CI, 0.75–0.99) and 0.58 (95% CI, 0.35–0.95), respectively. In the subgroup analysis of participants with or without hypertension, the inverse association between vegetable protein intake and CVD mortality was more evident in the nonhypertensive group, with the HRs for CVD and stroke being 0.68 (95% CI, 0.50–0.94) and 0.50 (95% CI, 0.30–0.84), respectively.Conclusions: Vegetable protein intake may prevent future CVD, particularly in nonhypertensive subjects in the Japanese population. However, further studies are necessary to examine the biological mechanisms of this effect.

2018-08-12 16:41:07
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2 0 0 0 OA Estimation of 10-Year Risk of Death from Coronary Heart Disease, Stroke, and Cardiovascular Disease in a Pooled Analysis of Japanese Cohorts: EPOCH-JAPAN

著者: Yuanying Li Hiroshi Yatsuya Sachiko Tanaka Hiroyasu Iso Akira Okayama Ichiro Tsuji Kiyomi Sakata Yoshihiro Miyamoto Hirotsugu Ueshima Katsuyuki Miura Yoshitaka Murakami Tomonori Okamura
出版者: Japan Atherosclerosis Society
雑誌: Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
巻号頁・発行日: vol.28, no.8, pp.816-825, 2021-08-01 (Released:2021-08-01)
参考文献数: 44
被引用文献数: 2 9

Aims: We aimed to develop and validate risk prediction models to estimate the absolute 10-year risk of death from coronary heart disease (CHD), stroke, and cardiovascular disease (CVD). Methods: We evaluated a total of 44,869 individuals aged 40–79 years from eight Japanese prospective cohorts to derive coefficients of risk equations using cohort-stratified Cox proportional hazard regression models. Discrimination (C-index) of the equation was examined in each cohort and summarised using random-effect meta-analyses. Calibration of the equation was assessed using Hosmer-Lemeshow chi-squared statistic. Results: Within a median follow-up of 12.7 years, we observed 765 deaths due to CVD (276 CHDs and 489 strokes). After backward selection, age, sex, current smoking, systolic blood pressure (SBP), proteinuria, prevalent diabetes mellitus, the ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDLC), interaction terms of age by SBP, and age by current smoking were retained as predictors for CHD. Sex was excluded in the stroke equation. We did not consider TC/HDLC as a risk factor for the stroke and CVD equations. The pooled C-indices for CHD, stroke, and CVD were 0.83, 0.80, and 0.81, respectively, and the corresponding p-values of the Hosmer-Lemeshow tests were 0.18, 0.003, and 0.25, respectively. Conclusions: Risk equations in the present study can adequately estimate the absolute 10-year risk of death from CHD, stroke, and CVD. Future work will evaluate the system as an education and risk communication tool for primary prevention of CHD and stroke.

2021-08-11 08:29:21
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2 0 0 0 OA Association Between Body Mass Index and All-Cause Death in Japanese Population: Pooled Individual Participant Data Analysis of 13 Cohort Studies

著者: Atsushi Hozawa Takumi Hirata Hiroshi Yatsuya Yoshitaka Murakami Shinichi Kuriyama Ichiro Tsuji Daisuke Sugiyama Atsushi Satoh Sachiko Tanaka-Mizuno Katsuyuki Miura Hirotsugu Ueshima Tomonori Okamura
出版者: Japan Epidemiological Association
雑誌: Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日: vol.29, no.12, pp.457-463, 2019-12-05 (Released:2019-12-05)
参考文献数: 20
被引用文献数: 7 17

2021-04-04 19:47:59
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2 0 0 0 OA Relationship Between Socioeconomic Status and the Prevalence of Underweight, Overweight or Obesity in a General Japanese Population: NIPPON DATA2010

著者: Tomiyo Nakamura Yasuyuki Nakamura Shigeyuki Saitoh Tomonori Okamura Masahiko Yanagita Katsushi Yoshita Yoshikuni Kita Yoshitaka Murakami Hiroshi Yokomichi Nobuo Nishi Nagako Okuda Aya Kadota Takayoshi Ohkubo Hirotsugu Ueshima Akira Okayama Katsuyuki Miura
出版者: Japan Epidemiological Association
雑誌: Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日: vol.28, no.Supplement_III, pp.S10-S16, 2018-03-05 (Released:2018-03-05)
参考文献数: 20
被引用文献数: 23

Background: Socioeconomic status (SES) imbalances in developed and developing countries may result in individuals being overweight and obese. However, few studies have investigated this issue in Japan. We herein examined the relationship between SES and being underweight, overweight or obese according to sex and age groups (20–64 or ≥65 years) in Japan.Methods: In 2010, we established a cohort of participants in the National Health and Nutrition Survey of Japan. We divided 2,491 participants (1,081 men and 1,410 women) according to the WHO definitions of underweight, overweight or obesity and performed multinomial logistic analyses using BMI <18.5 kg/m2 (underweight), BMI 25.0–29.9 kg/m2 (overweight), and BMI ≥30.0 kg/m2 (obese) versus BMI 18.5–24.9 kg/m2 (normal) as the outcome, with SES groups as the main explanatory variables.Results: In adult men, a lower education level relative to a higher education level was inversely associated with obesity after adjustments for other SESs (odds ratio [OR] 0.41; 95% confidence interval [CI], 0.18–0.96). However, in adult women, lower education level was positively associated with being overweight and obese (OR 1.67; 95% CI, 1.07–2.49 for overweight and OR 2.66; 95% CI, 1.01–7.01 for obese). In adult women, a lower household income was positively associated with being overweight and obese (obese: OR 4.84; 95% CI, 1.36–17.18 for those with a household income <2 million JPY relative to those with ≥6 million JPY).Conclusions: In adult women, a lower education level and lower household income were positively associated with being overweight or obese. In contrast, in adult men, a lower education level was inversely associated with obesity. Gender and age differences in SESs affect the prevalence of being overweight or obese.

2018-12-19 15:34:43
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1 0 0 0 OA Association of Pro-Inflammatory Diet with Long-Term Risk of All-Cause and Cardiovascular Disease Mortality: NIPPON DATA80

著者: Gantsetseg Ganbaatar Yukiko Okami Aya Kadota Namuun Ganbaatar Yuichiro Yano Keiko Kondo Akiko Harada Nagako Okuda Katsushi Yoshita Tomonori Okamura Akira Okayama Hirotsugu Ueshima Katsuyuki Miura for the NIPPON DATA80 Research Group
出版者: Japan Atherosclerosis Society
雑誌: Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
巻号頁・発行日: pp.64330, (Released:2023-10-06)
参考文献数: 53
被引用文献数: 2

Aim: A pro-inflammatory diet may increase the risk of cardiovascular disease (CVD) and all-cause mortality. However, this remains inconclusive as there is yet no study using a dietary record method that has been conducted in a large general population. Furthermore, an underestimation of the pro-inflammatory diet may exist due to the unmeasured effect of salt intake. Thus, in this study, we aimed to examine how pro-inflammatory diet is associated with the long-term risk of all-cause and CVD mortality in a representative Japanese population. Methods: A national nutrition survey was conducted throughout Japan in 1980. After considering the exclusion criteria, 9284 individuals (56% women aged 30-92 years) were included in this study. In total, 20 dietary parameters derived from 3-day weighed dietary records were used to calculate the dietary inflammatory index (DII). The causes of death were monitored until 2009. The Cox proportional hazards model was used to determine multivariable-adjusted hazard ratios (HRs). Stratified analysis according to salt intake level was also performed. Results: Compared with the lowest quartile of DII, multivariable-adjusted HRs (95% confidence intervals) in the highest quartile were 1.28 (1.15, 1.41), 1.35 (1.14, 1.60), 1.48 (1.15, 1.92), 1.62 (1.11, 2.38), and 1.34 (1.03, 1.75) for all-cause mortality, CVD mortality, atherosclerotic CVD mortality, coronary heart disease mortality, and stroke mortality, respectively. Stratified analysis revealed stronger associations among individuals with higher salt intake. Conclusions: As per our findings, a pro-inflammatory diet was determined to be positively associated with the long-term risk of all-cause and CVD mortality in a representative Japanese population. Thus, considering both salt intake and pro-inflammatory diet is deemed crucial for a comprehensive assessment of CVD risk.

2023-10-13 23:05:36
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1 0 0 0 OA Smoking is associated with impaired long-term quality of life in elderly people: a 22-year cohort study in NIPPON-DATA 90.

著者: Yiwei Liu Tomonori Okamura Aya Hirata Yasunori Sato Takehito Hayakawa Aya Kadota Keiko Kondo Takayoshi Ohkubo Katsuyuki Miura Akira Okayama Hirotsugu Ueshima
出版者: Japan Epidemiological Association
雑誌: Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日: pp.JE20220226, (Released:2023-09-23)
参考文献数: 17
被引用文献数: 1

Background: Whether smoking is associated with worse quality of life (QoL) or not is relatively controversial. Current study is to investigate relationship between smoking and subjective QoL in a long cohort study.Methods: NIPPON DATA 90 project collected 8383 community residents in 300 randomly selected areas as baseline data in 1990, and 4 follow-up QOL surveys and mortality statistics were performed. We conducted multinomial logistic regression analysis to compare past smoker and current smoker to never smoker, of which impaired QOL and mortality as outcomes.Results: In 4 follow-ups, QOL data was collected from 2035, 2252, 2522 and 3280 participants, in 1995, 2000, 2005, 2012, respectively. In 1995 follow-up, current smoking at baseline was not associated with worse QOL. In 2000 and 2005 follow-up, smoking is significantly associated with worse QOL, OR = 2.11[95%CI: 1.33, 3.36, P<0.01], OR = 2.29[95%CI:1.38, 3.80, P < 0.001], respectively. In 2012 follow-up, smoking is not associated with QOL. Sensitivity analysis didn’t change the result significantly.Conclusions: In this study we found that baseline smoking is associated worse QOL in long-follow-up.

2023-09-26 15:01:03
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1 0 0 0 OA Impact of Resting Heart Rate on Cardiovascular Mortality According to Serum Albumin Levels in a 24-year Follow-up Study on a General Japanese Population: NIPPON DATA80

著者: Yiwei Liu Aya Hirata Tomonori Okamura Daisuke Sugiyama Takumi Hirata Aya Kadota Keiko Kondo Takayoshi Ohkubo Katsuyuki Miura Akira Okayama Hirotsugu Ueshima
出版者: Japan Epidemiological Association
雑誌: Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日: vol.33, no.5, pp.227-235, 2023-05-05 (Released:2023-05-05)
参考文献数: 42

Background: Elevated resting heart rate (RHR) is associated with an increased risk of cardiovascular disease (CVD) and all-cause mortality. However, the findings of cohort studies differed. Thus, the impact of RHR on CVD mortality might be different according to the background of the population. Therefore, we examined the relationship of RHR and CVD mortality according to serum albumin (ALB) levels in a Japanese general population.Methods: In total, 8,363 individuals without a history of CVD were followed for 24.0 years. The participants were divided into four groups according to the quartiles of RHR (Q1–Q4), and they were further classified into the high and low ALB groups based on a median value of 44 g/L. We estimated the multivariable-adjusted hazard ratios (HRs) of CVD mortality in each RHR group based on ALB levels, and the interaction between RHR and ALB groups on CVD mortality was evaluated.Results: We found no significant association between RHR and CVD mortality. However, the Q4 of RHR was significantly associated with an increased risk for CVD mortality (HR 1.27; 95% confidence interval [CI], 1.02–1.57) in participants with a low ALB level. Meanwhile, the Q4 of RHR was significantly correlated with a decreased risk for CVD morality in those with a high ALB level (HR 0.61; 95% CI, 0.47–0.79) after adjusting for covariates. A significant interaction between RHR and ALB for CVD mortality was shown (P < 0.001).Conclusion: The impact of RHR on CVD mortality differed according to ALB levels in a general Japanese population.

2023-05-10 12:32:02
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1 0 0 0 OA Relationship of Higher-level Functional Capacity With Long-term Mortality in Japanese Older People: NIPPON DATA90

著者: Hideki Nagata Katsuyuki Miura Sachiko Tanaka Aya Kadota Takehito Hayakawa Keiko Kondo Akira Fujiyoshi Naoyuki Takashima Yoshikuni Kita Akira Okayama Tomonori Okamura Hirotsugu Ueshima
出版者: Japan Epidemiological Association
雑誌: Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日: vol.33, no.3, pp.136-141, 2023-03-05 (Released:2023-03-05)
参考文献数: 25
被引用文献数: 6

Background: Basic and instrumental activities of daily living (BADL and IADL, respectively) are known predictors of mortality. However, the relationship between higher-level functional capacity (HLFC) and mortality and related sex differences have rarely been investigated.Methods: A prospective population-based cohort study was conducted in 1,824 older residents (≥65 years) with independent BADL from 300 randomly selected areas in Japan from 1995, and the participants were followed up until 2010. Using the Cox proportional hazards model, the relationship between HLFC and mortality risk was investigated, with adjustment for possible confounders. HLFC was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Baseline data were collected using a questionnaire or by home-visit interviews.Results: During an average 12.2-year follow-up, all-cause death was observed in 836 (45.8%) participants. Impaired HLFC was significantly associated with mortality (hazard ratio [HR] 1.37; 95% confidence interval [CI], 1.13–1.65). Lower social role was significantly associated with higher mortality risk in men (HR 1.38; 95% CI, 1.13–1.68). Lower IADL and intellectual activity were significantly associated with higher mortality risk in women (HR 1.50; 95% CI, 1.15–1.95 and HR 1.46; 95% CI, 1.19–1.79, respectively). The relationship between HLFC and mortality risk showed a similar tendency among cardiovascular diseases, stroke, cancer, and pneumonia.Conclusion: Impaired HLFC was associated with a high risk of all-cause mortality among community-dwelling older people with independent BADL. In particular, social role in men and IADL and intellectual activity in women were associated with long-term mortality risk.

2023-03-22 12:00:38
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1 0 0 0 OA Relationship Between Non-fasting Triglycerides and Cardiovascular Disease Mortality in a 20-year Follow-up Study of a Japanese General Population: NIPPON DATA90

著者: Aya Hirata Tomonori Okamura Takumi Hirata Daisuke Sugiyama Takayoshi Ohkubo Nagako Okuda Yoshikuni Kita Takehito Hayakawa Aya Kadota Keiko Kondo Katsuyuki Miura Akira Okayama Hirotsugu Ueshima
出版者: Japan Epidemiological Association
雑誌: Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日: vol.32, no.7, pp.303-313, 2022-07-05 (Released:2022-07-05)
参考文献数: 31
被引用文献数: 5 9

Background: Non-fasting triglycerides (TG) are considered a better predictor of cardiovascular disease (CVD) than fasting TG. However, the effect of non-fasting TG on fatal CVD events remains unclear. In the present study, we aimed to explore the relationship between non-fasting TG and CVD mortality in a Japanese general population.Methods: A total of 6,831 participants without a history of CVD, in which those who had a blood sampling over 8 hours or more after a meal were excluded, were followed for 18.0 years. We divided participants into seven groups according to non-fasting TG levels: ≤59 mg/dL, 60–89 mg/dL, 90–119 mg/dL, 120–149 mg/dL, 150–179 mg/dL, 180–209 mg/dL, and ≥210 mg/dL, and estimated the multivariable-adjusted hazard ratios (HRs) of each TG group for CVD mortality after adjusting for potential confounders, including high density lipoprotein cholesterol. Additionally, we performed analysis stratified by age <65 and ≥65 years.Results: During the follow-up period, 433 deaths due to CVD were detected. Compared with a non-fasting TG of 150–179 mg/dL, non-fasting TG ≥210 mg/dL was significantly associated with increased risk for CVD mortality (HR 1.56: 95% CI, 1.01–2.41). Additionally, lower levels of non-fasting TG were also significantly associated with increased risk for fatal CVD. In participants aged ≥65 years, lower levels of non-fasting TG had a stronger impact on increased risk for CVD mortality, while higher levels of non-fasting TG had a stronger impact in those aged <65 years.Conclusion: In a general Japanese population, we observed a U-shaped association between non-fasting TG and fatal CVD events.

2022-12-27 14:00:04
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1 0 0 0 OA Relationship between Serum Irisin Levels and MRI-Measured Cerebral Small Vessel Disease in Japanese Men

著者: Mohammad Moniruzzaman Aya Kadota Takashi Hisamatsu Hiroyoshi Segawa Keiko Kondo Sayuki Torii Naoko Miyagawa Akira Fujiyoshi Yuichiro Yano Yoshiyuki Watanabe Akihiko Shiino Kazuhiko Nozaki Hirotsugu Ueshima Katsuyuki Miura on behalf of the SESSA Research Group
出版者: Japan Atherosclerosis Society
雑誌: Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
巻号頁・発行日: pp.63824, (Released:2022-11-15)
参考文献数: 42
被引用文献数: 1

Aim: Irisin, an exercise-induced myokine, is a potential neurotrophic factor; however, its relationship with cerebral small vessel disease (CSVD) remains unknown. Therefore, we investigated whether serum irisin levels are associated with CSVD in healthy Japanese men. Methods: We analyzed data from 720 men free of stroke and participated in this observational study. Serum irisin levels were measured by enzyme-linked immunosorbent assay. CSVD was assessed on deep and subcortical white matter hyperintensities (DSWMHs), periventricular hyperintensities (PVHs), lacunar infarcts (LIs), and cerebral microbleeds (CMBs) on brain magnetic resonance imaging. We calculated the total CSVD score (ranges 0–4) to express the total CSVD burden. We computed the adjusted odds ratios (ORs), with 95% confidence intervals (CIs), of the total CSVD score and individual CSVD features using logistic regression models according to the quartiles of irisin (reference: Q1). Results: Serum irisin levels were associated with lower ORs of higher (vs. zero or lower score) total CSVD score, with the lowest risk (OR, 0.63; 95% CI, 0.41–0.97) being observed in Q3 compared to Q1 after adjustment of potential covariates. Similar results were obtained for younger adults (<65 years). Among individual CSVD features, irisin was associated with a reduced risk of LIs in the total sample and PVHs, LIs, and CMBs in younger adults. No relationship was observed in older adults (≥ 65 years). Conclusions: Serum irisin levels were associated with less burden of total CSVD in healthy Japanese men. Serum irisin levels were also related with a reduced risk of PVHs, LIs, and CMBs, but not DSWMHs.

2022-11-19 17:02:42
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1 0 0 0 OA Exercise Habits Are Associated with Improved Long-Term Mortality Risks in the Nationwide General Japanese Population: A 20-Year Follow-Up of the NIPPON DATA90 Study

著者: Yuko Takatsuji Aya Ishiguro Kei Asayama Takayoshi Ohkubo Katsuyuki Miura Aya Kadota Masahiko Yanagita Akira Fujiyoshi Hisatomi Arima Naoko Miyagawa Naoyuki Takashima Yoshikuni Kita Takehito Hayakawa Masahiro Kikuya Yasuyuki Nakamura Akira Okayama Tomonori Okamura Hirotsugu Ueshima NIPPON DATA90 Research Group
出版者: Tohoku University Medical Press
雑誌: The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日: vol.252, no.3, pp.253-262, 2020 (Released:2020-11-07)
参考文献数: 24
被引用文献数: 2 5

Exercise habits are known as a protective factor for a variety of diseases and thus recommended worldwide; however, few studies have examined long-term effects of exercise habits on mortality. We continuously monitored death status in a nationwide population sample of 7,709 eligible persons from the National Integrated Project for Prospective Observation of Noncommunicable Disease and its Trends in the Aged in 1990 (NIPPON DATA90), for which baseline data were obtained in 1990. To investigate the long-term impact of baseline exercise habits, we calculated the relative risk of non-exercisers (participants without regular voluntary exercise habits) in reference to exercisers (those with these habits) for all-cause or cause-specific mortality using a Cox proportional hazard model, in which the following confounding factors were appropriately adjusted: sex, age, body mass index, total energy intake, smoking, drinking, and history of cardiovascular disease. During a median 20 years of follow-up, 1,747 participants died, 99 of heart failure. The risk for all-cause mortality was 12% higher in non-exercisers than in exercisers (95% confidence interval, 1%-24%), which was also observed for mortality from heart failure, as 68% higher in non-exercisers than in exercises (95% confidence interval, 3%-173%). These associations were similarly observed when the participants were divided to subgroups by sex, age, and the light, moderate, or vigorous intensity of physical activity, without any significant heterogeneities (P > 0.1). The present study has revealed significant impact of exercise habits on long-term mortality risks, supporting worldwide recommendations for improvement of exercise habits.

2022-09-10 02:02:21
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1 0 0 0 OA Estimation of 10-Year Risk of Death from Coronary Heart Disease, Stroke, and Cardiovascular Disease in a Pooled Analysis of Japanese Cohorts: EPOCH-JAPAN

著者: Yuanying Li Hiroshi Yatsuya Sachiko Tanaka Hiroyasu Iso Akira Okayama Ichiro Tsuji Kiyomi Sakata Yoshihiro Miyamoto Hirotsugu Ueshima Katsuyuki Miura Yoshitaka Murakami Tomonori Okamura EPOCH-JAPAN Research Group
出版者: Japan Atherosclerosis Society
雑誌: Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
巻号頁・発行日: pp.58958, (Released:2020-10-10)
参考文献数: 44
被引用文献数: 9

2020-10-17 01:04:42
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1 0 0 0 OA Relationship between calcium intake and impaired activities of daily living in a Japanese population: NIPPON DATA90

著者: Mana Kogure Naho Tsuchiya Akira Narita Takumi Hirata Naoki Nakaya Tomohiro Nakamura Atsushi Hozawa Takehito Hayakawa Nagako Okuda Naoko Miyagawa Aya Kadota Takayoshi Ohkubo Yoshitaka Murakami Kiyomi Sakata Katsuyuki Miura Akira Okayama Tomonori Okamura Hirotsugu Ueshima
出版者: Japan Epidemiological Association
雑誌: Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日: pp.JE20190234, (Released:2020-02-08)
参考文献数: 20
被引用文献数: 4

Background: Major reasons for long-term care insurance certification in Japan are stroke, dementia and fracture. These diseases are reported to be associated with calcium intake. This study examined the association between calcium intake and impaired activities of daily living (ADL) using the data from NIPPON DATA90, consisting of representative sample of the Japanese population.Methods: A population-based nested case control study was performed. A baseline survey was conducted in 1990, followed by ADL surveys of individuals ≥65 years old in 2000. Individuals with impaired ADL and selected age- and sex-matched controls were then identified. We obtained 132 pairs. Calcium intake was energy-adjusted using the residual method. The association between calcium intake and impaired ADL was examined using conditional logistic regression models. To assess the accuracy of the estimates, we conducted bootstrap analyses.Results: The adjusted odds ratios (ORs) for impaired ADL compared with the group with a calcium intake of <476 mg/day were 0.72 (95% confidence interval, 95% CI: 0.37-1.40) for the 476-606 mg/day group and 0.44 (0.21-0.94) for the ≥607 mg/day group in 2000 (P for linear trend = 0.03). After the bootstrap analyses, the inverse relationship unchanged (median OR per 100-mg rise in calcium intake: 0.87 [1,000 resamplings], 95% CI: 0.76-0.97).Conclusions: After bootstrap analyses, calcium intake was inversely associated with impaired ADL, 10 years after the baseline survey.

2020-03-30 01:54:28
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1 0 0 0 OA Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated with Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study

著者: Akira Fujiyoshi Katsuyuki Miura Takayoshi Ohkubo Naoko Miyagawa Yoshino Saito Itsuko Miyazawa Akihiko Shiino Aya Kadota Sayaka Kadowaki Takashi Hisamatsu Sayuki Torii Naoyuki Takashima Ikuo Tooyama Hirotsugu Ueshima
出版者: Japan Epidemiological Association
雑誌: Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日: pp.JE20180258, (Released:2019-05-25)
参考文献数: 46
被引用文献数: 10

Background: The association of proteinuria and reduced estimated glomerular filtration rate (eGFR) with cognition needs more clarification. We cross-sectionally examined whether proteinuria and reduced eGFR, even in moderate stages, were independently associated with lower cognition in a community-based sample of elderly men.Methods: Our cohort initially comprised 1,094 men aged 40-79 years from a random sample from Shiga, Japan in 2006-2008. Of 853 men who returned for the follow-up examination (2009-2014), we analyzed 561 who were ≥65 years, free of stroke, and completed the Cognitive Abilities Screening Instrument (CASI) at follow-up. Higher CASI score (range 0 to 100) indicates better cognition. Proteinuria was assessed by dipstick. eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration Equation. Participants were divided into three groups either by eGFR (≥60, 59-40, and <40 mL/min/1.73 m2) or by proteinuria (no, trace, and positive), considered normal, moderate, and advanced, respectively. Using linear regression, we computed mean CASI score with simultaneous adjustment for proteinuria and eGFR in addition to other potential confounders.Results: Significant trends of lower cognition were observed across the groups of worse proteinuria and lower eGFR independently: multivariable-adjusted mean CASI scores were 90.1, 89.3, and 88.4 for proteinuria (Ptrend=0.029), and 90.0, 88.5, and 88.5 for eGFR (Ptrend=0.015) in mutual adjustment model.Conclusions: Proteinuria and reduced eGFR, even in their moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. The results suggest the importance of proteinuria and low eGFR for early detection and prevention of cognitive decline.

2019-07-02 12:23:27
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1 0 0 0 OA Association of Work Situation With Cardiovascular Disease Mortality Risk Among Working-Age Japanese Men ― A 20-Year Follow-up of NIPPON DATA90 ―

著者: Nagako Okuda Aya Kadota Nobuo Nishi Katsuyuki Miura Takayoshi Ohkubo Naoko Miyagawa Atsushi Satoh Yoshikuni Kita Takehito Hayakawa Naoyuki Takashima Akira Fujiyoshi Akira Okayama Tomonori Okamura Hirotsugu Ueshima for the NIPPON DATA90 Research Group
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.83, no.7, pp.1506-1513, 2019-06-25 (Released:2019-06-25)
参考文献数: 32
被引用文献数: 7

Background:Several cohort studies have demonstrated an association between socioeconomic status (SES) and health outcomes in Japan. As long-term employment is common in Japan, the size of the company may be related to cardiovascular disease (CVD) mortality risk. We examined the association of employment conditions with CVD mortality risk among working-age Japanese men (30–59 years, n=2,091).Methods and Results:We used 20-year follow-up data from NIPPON DATA90, for which baseline data were obtained from the 4th National Survey on Circulatory Disorders in 1990. Participants were classified into 4 groups: 3 strata for indefinite-term employees according to company size (large company/public office, moderate-sized, or small), and the self-employed/administrator group. Multivariable-adjusted hazard ratios (HRs) were adjusted for age, lifestyle, and CVD risk factors. Smokers were more common, habitual exercise was less common, and the average systolic blood pressure was higher among indefinite-term employees of small companies compared with employees at large companies/public offices. There was no significant difference in the total CVD mortality risk between indefinite-term employees and self-employed/administrator participants. The age-adjusted HR (95% confidence interval) for total CVD using indefinite-term employees of large companies/public office as a reference was 2.53 (1.12, 5.69) for employees of small companies.Conclusions:Working as an indefinite-term employee at a small company in Japan was significantly associated with elevated risk of CVD mortality among Japanese men.

2019-07-01 17:52:55
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