著者

Takuhiro Moromizato Ryoto Sakaniwa Takamasa Miyauchi Ryuhei So Hiroyasu Iso Kunitoshi Iseki

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.8, pp.390-397, 2023-08-05 (Released:2023-08-05)

参考文献数

31

被引用文献数

2

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Background: Serial weight decrease can be a prognostic predictor in chronic hemodialysis (HD) patients. We investigated the impact of long-term post-HD body weight (BW) changes on all-cause mortality among HD patients.Methods: This longitudinal cohort study and post-hoc analysis evaluated participants of a previous randomized controlled trial conducted between 2006 and 2011 who were followed up until 2018. Weight change slopes were generated with repeated measurements every 6 months during the trial for patients having ≥5 BW measurements. Participants were categorized into four groups based on quartiles of weight change slopes; the median weight changes per 6 months were −1.02 kg, −0.25 kg, +0.26 kg, and +0.86 kg for first, second, third, and fourth quartile, respectively. Cox proportional hazard regression was used to evaluate differences in subsequent survival among the four groups. BW trajectories were plotted with a backward time-scale and multilevel regression analysis to visualize the difference in BW trajectories between survivors and non-survivors.Results: Among the 461 patients, 404 were evaluated, and 168 (41.6%) died within a median follow-up period of 10.2 years. The Cox proportional hazard regression adjusted for covariates and baseline BW showed that a higher rate of weight loss was associated with higher mortality. The hazard ratios were 2.02 (95% confidence interval [CI], 1.28–3.20), 1.77 (95% CI, 1.10–2.85), 1.00 (reference), and 1.11 (95% CI, 0.67–1.83) for the first, second, third (reference), and fourth quartiles, respectively. BW trajectories revealed a significant decrease in BW in non-survivors.Conclusion: Weight loss elucidated via serial BW measurements every 6 months is significantly associated with higher mortality among HD patients.

著者

Ehab S. Eshak Sachiko Baba Hiroshi Yatsuya Hiroyasu Iso Yoshihisa Hirakawa Eman M. Mahfouz Chiang Chifa Ryoto Sakaniwa Ayman S. El-khateeb

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.7, pp.360-366, 2023-07-05 (Released:2023-07-05)

参考文献数

38

被引用文献数

6

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Background: Total work-family conflicts (TWFCs) could associate with mental health, and having ikigai (a purpose of life) may mediate this association.Methods: In a cross-cultural study of 4,792 Japanese Aichi Workers’ Cohort study participants and 3,109 Egyptian civil workers, the Midlife Development in the United States (MIDUS) questionnaire measured TWFCs and the Center for Epidemiological Studies Depression (CES-D) 11-item scale measured depression. We used logistic regression models to estimate odds ratios (ORs) of having depression and a high-ikigai across levels of TWFCs (low, moderate, and high), and the PROCESS macro of Hayes to test the mediation effect.Results: The prevalence of high TWFCs, depression, and having a high ikigai were 17.9%, 39.4%, and 70.1% in Japanese women, 10.5%, 26.8%, and 70.1% in Japanese men, 23.7%, 58.2%, and 24.7% in Egyptian women, and 19.1%, 38.9%, and 36.9% in Egyptian men, respectively. Compared with participants with low TWFCs, the multivariable ORs of depression in Japanese women and men with high TWFCs were 4.11 (95% confidence interval [CI], 2.99–5.65) and 5.42 (95% CI, 4.18–7.02), and those in Egyptian women and men were 4.43 (95% CI, 3.30–5.95) and 4.79 (95% CI, 3.53–6.48), respectively. The respective ORs of having a high-ikigai were 0.46 (95% CI, 0.33–0.64) and 0.40 (95% CI, 0.31–0.52) in Japanese women and men and were 0.34 (95% CI, 0.24–0.48) and 0.28 (95% CI, 0.20–0.39) in Egyptian women and men. No interaction between TWFCs and country was observed for the associations with depression or ikigai. Ikigai mediated (up to 18%) the associations between the TWFCs and depression, especially in Egyptian civil workers.Conclusion: TWFCs were associated with depression, and having low ikigai mediated these associations in Japanese and Egyptian civil workers.

著者

Keiko Ishimura Ryoto Sakaniwa Kokoro Shirai Jun Aida Kenji Takeuchi Katsunori Kondo Hiroyasu Iso

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220221, (Released:2023-03-25)

参考文献数

35

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BackgroundThe association between the frequency of going outdoors and the risk of poor oral health has been reported in several studies; however, the findings have been inconclusive.MethodsWe conducted a three-year longitudinal study of 19,972 Japanese adults aged ≥65 years who reported no poor oral condition at baseline in 2013. The respondents rated their frequency of going outdoors in three categories (≤1, 2–3, or ≥4 times/week), and the oral conditions reported in 2016 included tooth loss, chewing difficulty, swallowing difficulty, dry mouth, and composite outcomes. The associations between the frequency of going outdoors and the risk of poor oral health were examined as relative risk ratios (RR) and 95% confidence intervals (CI) using multivariable Poisson regression, while mediation analysis was performed to investigate indirect effects.ResultsDuring the follow-up, 32.5% of participants developed poor oral health. In the mediation analysis, indirect effects were observed through low instrumental activities of daily living, depressive symptoms, little social network diversity, and underweight.Compared to going outdoors ≥4 times/week, the multivariable RR(95%CI) of composite poor oral health conditions was 1.12 (1.05–1.20) for 2–3 times/week and 1.22 (1.07–1.39) for ≤1 time/week (P-trend<0.001). Similar associations were observed for tooth loss, chewing difficulty, and swallowing difficulty; the corresponding RRs(95%CIs) were 1.07(0.97–1.19) and 1.36(1.13–1.64) (P-trend=0.002), 1.18(1.06–1.32) and 1.30(1.05–1.60) (P-trend<0.001), and 1.15(1.01–1.31) and 1.38(1.08–1.77) (P-trend=0.002), respectively.ConclusionThe frequency of going outdoors was inversely associated with the risk of poor oral health through several modifiable risk factors in the older population.