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

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
Keiko Murakami Mami Ishikuro Fumihiko Ueno Aoi Noda Tomomi Onuma Taku Obara Shinichi Kuriyama
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.33, no.1, pp.8-14, 2023-01-05 (Released:2023-01-05)
参考文献数
38
被引用文献数
2 2

Background: While a wide range of predictors of postpartum smoking relapse have been suggested, population-based studies have rarely examined these factors exclusively among women who quit in early pregnancy. Furthermore, workplace secondhand smoke (SHS) exposure has never been examined.Methods: We analyzed data from 10,466 pregnant women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Age, education, parity, breastfeeding, postpartum depression, SHS exposure at home, and SHS exposure at work (not working, working without SHS exposure, working with SHS exposure) were evaluated as possible predictors. Multiple logistic regression analyses were conducted to examine the associations between these factors and smoking relapse by 1 year postpartum among women who quit in early pregnancy. Analyses stratified by SHS exposure at home were also conducted.Results: About one-fourth of early-pregnancy quitters had relapsed into smoking by 1 year postpartum. Lower education, multiparity, not breastfeeding, postpartum depression, and SHS exposure at home were associated with increased risks of smoking relapse. Working with SHS exposure was associated with an increased risk of smoking relapse; the multivariate-adjusted odds ratios of working without SHS exposure and working with SHS exposure compared with not working were 1.14 (95% confidence interval [CI], 0.82–1.59) and 2.18 (95% CI, 1.37–3.46), respectively. The significant association of workplace SHS exposure was observed only among women without SHS exposure at home.Conclusion: SHS exposure at work, as well as education, multiparity, breastfeeding, postpartum depression, and SHS exposure at home were associated with postpartum smoking relapse among early-pregnancy quitters.
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

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 11

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.