著者
Naoki Nago Shizukiyo Ishikawa Tadao Goto Kazunori Kayaba
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.1012070204-1012070204, (Released:2010-12-11)
参考文献数
17
被引用文献数
28 66

Background: We investigated the relationship between low cholesterol and mortality and examined whether that relationship differs with respect to cause of death.Methods: A community-based prospective cohort study was conducted in 12 rural areas in Japan. The study subjects were 12 334 healthy adults aged 40 to 69 years who underwent a mass screening examination. Serum total cholesterol was measured by an enzymatic method. The outcome was total mortality, by sex and cause of death. Information regarding cause of death was obtained from death certificates, and the average follow-up period was 11.9 years.Results: As compared with a moderate cholesterol level (4.14–5.17 mmol/L), the age-adjusted hazard ratio (HR) of low cholesterol (<4.14 mmol/L) for mortality was 1.49 (95% confidence interval [CI]: 1.23–1.79) in men and 1.50 (1.10–2.04) in women. High cholesterol (≥6.21 mmol/L) was not a risk factor. This association was unchanged in analyses that excluded deaths due to liver disease, which yielded age-adjusted HRs of 1.38 (95% CI, 1.13–1.67) in men and 1.49 (1.09–2.04) in women. The multivariate-adjusted HRs and 95% CIs of the lowest cholesterol group for hemorrhagic stroke, heart failure (excluding myocardial infarction), and cancer mortality significantly higher than those of the moderate cholesterol group, for each cause of death.Conclusions: Low cholesterol was related to high mortality even after excluding deaths due to liver disease from the analysis. High cholesterol was not a risk factor for mortality.
著者
Naoki Nago Shizukiyo Ishikawa Tadao Goto Kazunori Kayaba
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.21, no.1, pp.67-74, 2011-01-05 (Released:2011-01-05)
参考文献数
17
被引用文献数
66 66 23

Background: We investigated the relationship between low cholesterol and mortality and examined whether that relationship differs with respect to cause of death.Methods: A community-based prospective cohort study was conducted in 12 rural areas in Japan. The study subjects were 12 334 healthy adults aged 40 to 69 years who underwent a mass screening examination. Serum total cholesterol was measured by an enzymatic method. The outcome was total mortality, by sex and cause of death. Information regarding cause of death was obtained from death certificates, and the average follow-up period was 11.9 years.Results: As compared with a moderate cholesterol level (4.14–5.17 mmol/L), the age-adjusted hazard ratio (HR) of low cholesterol (<4.14 mmol/L) for mortality was 1.49 (95% confidence interval [CI]: 1.23–1.79) in men and 1.50 (1.10–2.04) in women. High cholesterol (≥6.21 mmol/L) was not a risk factor. This association was unchanged in analyses that excluded deaths due to liver disease, which yielded age-adjusted HRs of 1.38 (95% CI, 1.13–1.67) in men and 1.49 (1.09–2.04) in women. The multivariate-adjusted HRs and 95% CIs of the lowest cholesterol group for hemorrhagic stroke, heart failure (excluding myocardial infarction), and cancer mortality significantly higher than those of the moderate cholesterol group, for each cause of death.Conclusions: Low cholesterol was related to high mortality even after excluding deaths due to liver disease from the analysis. High cholesterol was not a risk factor for mortality.
著者
Toshihide Izumida Yosikazu Nakamura Yumika Hino Shizukiyo Ishikawa
出版者
Japan Atherosclerosis Society
雑誌
Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
巻号頁・発行日
pp.49528, (Released:2019-08-29)
参考文献数
38
被引用文献数
24

Aims: Small dense low-density lipoprotein cholesterol (sdLDL-C) and remnant-like particle cholesterol (RLP-C) are the novel atherosclerotic risk factors and might be strongly associated with inflammation. The basic evidence supports that sdLDL and RLP have some different mechanisms inducing an inflammatory response. Many studies have focused on the mechanism of inflammation of sdLDL-C or RLP-C per se, with limited data on the association between sdLDL-C and RLP-C in the real-world, population-based setting. Thus, the aim of this study was to investigate the association between sdLDL-C and RLP-C with inflammation. Methods: We examined the baseline cross-sectional data of participants from the Jichi Medical School-II Cohort Study. In total, 5,305 participants (2,439 men and 2,866 women) were included in this study. Results: Of all quartiles of sdLDL-C, the fourth had the highest high-sensitivity C-reactive protein (hs-CRP) level. Once adjusted for age, sex, smoking status, homeostasis model assessment of insulin resistance, antidyslipidemic and antihyperglycemic medication use, and RLP-C, sdLDL-C was significantly and positively associated with hs-CRP (geometric mean, 95% confidence interval (CI), 0.36 mg/L (0.34–0.38 mg/L), 0.37 mg/L (0.35–0.39 mg/L), 0.40 mg/L (0.37–0.42 mg/L) versus 0.44 mg/L (0.42–0.47 mg/L), P<0.001 for trend). After stratifying the participants into four sdLDL-C×four RLP-C categories, the group in the fourth sdLDL-C quartile and the forth RLP-C quartile had the highest hs-CRP level (geometric mean, 95% CI, 0.52 mg/L, 0.48–0.57 mg/L, interaction P=0.75). Conclusions: SdLDL-C and RLP-C had different associations with inflammation. Our results support sdLDL-C as the potential novel factor of cardiovascular disease, independently of RLP-C.
著者
Tsuyako Sakamaki Motohiko Hara Kazunori Kayaba Kazuhiko Kotani Shizukiyo Ishikawa
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20150092, (Released:2015-10-10)
参考文献数
23
被引用文献数
5

Background: Previous studies on the association between coffee consumption and subarachnoid hemorrhage (SAH) have provided inconsistent results. We examine the risk of SAH from coffee consumption in a Japanese population.Methods: Our analyses were based on the Jichi Medical School Cohort Study, a large-scale population-based prospective cohort study. A total of 9941 participants (3868 men and 6073 women; mean age 55 years) with no history of cardiovascular disease or carcinoma were examined. Participants were asked to choose one of five options to indicate their daily coffee consumption: none, less than 1 cup a day, 1–2 cups a day, 3–4 cups a day, or 5 or more cups a day. The incidence of SAH was assessed independently by a diagnostic committee. Cox proportional hazards models were used to calculate hazard ratios (HRs) and their 95% confidence intervals (CI) after adjustment for age and sex (HR1) and for additional potential confounders (HR2).Results: During 10.7 years of follow-up, SAH occurred in 47 participants. When compared with the participants who consumed less than 1 cup of coffee a day, the HR of SAH was significantly higher in the group who consumed 5 or more cups a day in both models (HR1 4.49; 95% CI, 1.44–14.00; HR2 3.79; 95% CI, 1.19–12.05).Conclusions: The present community-based cohort study showed that heavy coffee consumption was associated with an increased incidence of SAH after adjusting for age, sex, and multiple potential cardiovascular confounders.
著者
Shizukiyo Ishikawa Kazunori Kayaba Tadao Gotoh Naoki Nago Yosikazu Nakamura Akizumi Tsutsumi Eiji Kajii
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.18, no.4, pp.144-150, 2008 (Released:2008-08-07)
参考文献数
37
被引用文献数
38 56

Background: Previous reports indicated that the incidence rate of stroke was higher in Japan than in Western countries, but the converse was true in the case of myocardial infarction (MI). However, few population-based studies on the incidence rates of stroke and MI have been conducted in Japan.Methods: The Jichi Medical School (JMS) Cohort Study is a multicenter population-based cohort study that was conducted in 12 districts in Japan. Baseline data were collected between April 1992 and July 1995. We examined samples from 4,869 men and 7,519 women, whose mean ages were 55.2 and 55.3 years, respectively. The incidence of stroke, stroke subtypes, and MI were monitored.Results: The mean follow-up duration was 10.7 years. A total of 229 strokes and 64 MIs occurred in men, and 221 strokes and 28 MIs occurred in women. The age-adjusted incidence rates (per 100,000 person-years) of stroke were 332 and 221 and those of MI were 84 and 31 in men and women, respectively. In the case of both sexes, the incidence rates of stroke and MI were the highest in the group of subjects aged > 70 years.Conclusion: We reported current data on the incidence rates of stroke and MI in Japan. The incidence rate of stroke remains high, considerably higher than that of MI, in both men and women. The incidence rates of both stroke and MI were higher in men than in women.
著者
Masatoshi Matsumoto Shizukiyo Ishikawa Kazunori Kayaba Tadao Gotoh Naoki Nago Akizumi Tsutsumi Eiji Kajii the Jichi Medical School (JMS) Cohort Study Group
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.19, no.2, pp.94-100, 2009-03-05 (Released:2009-03-19)
参考文献数
30
被引用文献数
8 16

Background: Risk charts that depict the absolute risk of myocardial infarction (MI) for each combination of risk factors in individuals are convenient and beneficial tools for primary prevention of ischemic heart disease. Although risk charts have been developed using data from North American and European cardiovascular cohort studies, there is no such chart derived from cardiovascular incidence data obtained from the Japanese population.Methods and Results: We calculated and constructed risk charts that estimate the 10-year absolute risk of MI by using data from the Jichi Medical School (JMS) Cohort Study—a prospective cohort study which followed 12 490 participants in 12 Japanese rural communities for an average of 10.9 years. We identified 92 cases of a clinically-certified MI event. Color-coded risk charts were created by calculating the absolute risk associated with the following conventional cardiovascular risk factors: age, sex, smoking status, diabetes status, systolic blood pressure, and serum total cholesterol.Conclusions: In health education and clinical practice, particularly in rural communities, these charts should prove useful in understanding the risks of MI, without the need for cumbersome calculations. In addition, they can be expected to provide benefits by improving existing risk factors in individuals.
著者
Shizukiyo Ishikawa Masatoshi Matsumoto Kazunori Kayaba Tadao Gotoh Naoki Nago Akizumi Tsutsumi Eiji Kajii the Jichi Medical School (JMS) Cohort Study Group
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.19, no.2, pp.101-106, 2009-03-05 (Released:2009-03-19)
参考文献数
36
被引用文献数
7 18

Background: Risk charts are used to estimate the risk of cardiovascular diseases; however, most have been developed in Western countries. In Japan, currently available risk charts are based on mortality data. Using data on cardiovascular disease incidence from the JMS Cohort Study, we developed charts that illustrated the risk of stroke.Methods and Results: The JMS Cohort Study is a community-based cohort study of cardiovascular disease. Baseline data were obtained between 1992 and 1995. In the present analysis, the participants were 12 276 subjects without a history of stroke; the follow-up period was 10.7 years. Color-coded risk charts were created by using Cox’s proportional hazards models to calculate 10-year absolute risks associated with sex, age, smoking status, diabetes status, and systolic blood pressure. The risks of stroke and cerebral infarction rose as age and systolic blood pressure increased. Although the risk of cerebral hemorrhage were generally lower than that of cerebral infarction, the patterns of association with risk factors were similar.Conclusion: These risk charts should prove useful for clinicians and other health professionals who are required to estimate an individual’s risk for stroke.
著者
Toshihide Izumida Yosikazu Nakamura Yukihiro Sato Shizukiyo Ishikawa
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.32, no.3, pp.145-150, 2022-03-05 (Released:2022-03-05)
参考文献数
40
被引用文献数
1 4

Background: Sleeping pills are widely used for sleep disorders and insomnia. This population-based study aimed to evaluate the association between the use of sleeping pills and metabolic syndrome (MetS) and metabolic components in an apparently healthy Japanese cohort.Methods: We examined baseline cross-sectional data from the JMS-II Cohort Study. The criteria for MetS and its components were based on The National Cholesterol Education Program Adult Treatment Panel III. Sleep habits including the sleep duration of the subjects and the frequency of sleeping pill use were obtained using The Pittsburgh Sleep Quality Index questionnaire. For different sleep durations, the association between sleeping pill use and MetS was assessed. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated using multiple logistic regression models to quantify this association.Results: Our study included 6,153 individuals (mean age, 63.8 [standard deviation 11.2] years), and 3,348 (54.4%) among them were women. The association between sleep duration and MetS was an inverted J-shaped curve among sleeping pill users and a J-shaped curve among non-users. After adjustment for various confounders, less than 6 h of sleep among sleeping pill users was associated with increased rates of MetS (<6 h, OR 3.08; 95% CI, 1.29–7.34]). The frequency of sleeping pill use in individuals with short sleep duration showed a positive association with the prevalence of MetS and its components.Conclusions: Sleeping pill users with a short sleep duration had a 3-fold higher chance of having MetS than non-users with a short sleep duration.
著者
Fumitaka Sato Yosikazu Nakamura Kazunori Kayaba Shizukiyo Ishikawa
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.32, no.3, pp.125-130, 2022-03-05 (Released:2022-03-05)
参考文献数
29
被引用文献数
2

Background: Several studies have described an association between hemoglobin concentration and stroke; however, the influence of hemoglobin on stroke incidence has not been fully revealed. Our objective was to elucidate the association between hemoglobin concentration and stroke incidence in Japanese community residents.Methods: In the present study, we collected the data of 12,490 subjects who were enrolled between April 1992 and July 1995 in the Jichi Medical School (JMS) Cohort Study. We excluded the subjects with a history of stroke. Hemoglobin concentrations were grouped in quartiles, and quartile 2 (Q2) was used as the reference category. A Cox proportional-hazards model was used to examine hazard ratios (HRs) and the stroke incidence rates with 95% confidence intervals (CIs).Results: During 10.8 years of follow-up, 409 participants (212 men and 197 women) experienced a new stroke, including 97 intracerebral hemorrhages, 259 cerebral infarctions, and 52 subarachnoid hemorrhages (SAH). In sex-specific hemoglobin quartiles, the multivariate-adjusted HR was statistically significantly higher in Q1 than in Q2, and a relationship similar to a J shape was observed between all strokes (HR in Q2 vs Q1, 1.36; 95% CI, 1.02–1.83; Q3, 1.20; 95% CI, 0.87–1.64; and Q4, 1.16; 95% CI, 0.84–1.60). Furthermore, the analysis of stroke subtypes showed a statistically significantly higher multivariate-adjusted HR in Q1 than in Q2 for SAH (HR 2.61; 95% CI, 1.08–6.27).Conclusions: A low hemoglobin concentration was associated with an increased risk of stroke, which was strongly influenced by the incidence of SAH.
著者
Tsuyako Sakamaki Motohiko Hara Kazunori Kayaba Kazuhiko Kotani Shizukiyo Ishikawa
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.26, no.2, pp.71-75, 2016-02-05 (Released:2016-02-05)
参考文献数
23
被引用文献数
5

Background: Previous studies on the association between coffee consumption and subarachnoid hemorrhage (SAH) have provided inconsistent results. We examine the risk of SAH from coffee consumption in a Japanese population.Methods: Our analyses were based on the Jichi Medical School Cohort Study, a large-scale population-based prospective cohort study. A total of 9941 participants (3868 men and 6073 women; mean age 55 years) with no history of cardiovascular disease or carcinoma were examined. Participants were asked to choose one of five options to indicate their daily coffee consumption: none, less than 1 cup a day, 1–2 cups a day, 3–4 cups a day, or 5 or more cups a day. The incidence of SAH was assessed independently by a diagnostic committee. Cox proportional hazards models were used to calculate hazard ratios (HRs) and their 95% confidence intervals (CI) after adjustment for age and sex (HR1) and for additional potential confounders (HR2).Results: During 10.7 years of follow-up, SAH occurred in 47 participants. When compared with the participants who consumed less than 1 cup of coffee a day, the HR of SAH was significantly higher in the group who consumed 5 or more cups a day in both models (HR1 4.49; 95% CI, 1.44–14.00; HR2 3.79; 95% CI, 1.19–12.05).Conclusions: The present community-based cohort study showed that heavy coffee consumption was associated with an increased incidence of SAH after adjusting for age, sex, and multiple potential cardiovascular confounders.
著者
Kazuhiro Murata Shizukiyo Ishikawa Takashi Sugioka
出版者
日本プライマリ・ケア連合学会
雑誌
General Medicine (ISSN:13460072)
巻号頁・発行日
vol.14, no.1, pp.32-39, 2013 (Released:2013-07-05)
参考文献数
11
被引用文献数
2

Objective: With the recent aging trend in the Japanese population, dysphagia appears to be increasing. However, few epidemiologic surveys have been conducted to determine the prevalence of dysphagia in local inhabitants. Ohkuma et al. prepared a highly reliable questionnaire using a simple test and safe examination method. We investigated the presence/absence of symptoms of dysphagia in local inhabitants, evaluated their association with subjective symptoms, and examined whether the inhabitants were following a particular diet, which is the most important factor in management of dysphagia.Methods: A cross-sectional study involving 743 inhabitants (age: over 20) of an isolated island was performed. Each subject was asked basic questions (awareness about the presence/absence of dysphagia and dietary habits), and the data was analyzed by chi-square test. Based on their responses, dysphagia incidence was determined and rated on a 3-category scale (severe, mild, and no dysphagia).Results: Responses were recollected from 368 subjects (response rate, 49.5%). The percentage of subjects aware of dysphagia in the severe, mild, and no dysphagia groups was 13.8%, 3.2%, and 0%, respectively and the percentage of subjects who changed their dietary habits was 17.2%, 2.6%, and 0%. These percentages were significantly higher in the severe group than in the mild and no dysphagia groups, though the value was less than 20% in the 3 groups.Conclusion: Most subjects in the present study were unaware of dysphagia, suggesting that patients with dysphagia tend to be unaware of the key symptoms of dysphagia.
著者
Kazuhiko Kotani Yoshitaka Sekine Shizukiyo Ishikawa Imoh Z. Ikpot Kazuhiro Suzuki Alan T. Remaley
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20130006, (Released:2013-08-27)
参考文献数
35
被引用文献数
10 36

Prostate cancer is a common disease in modern, developed societies and has a high incidence and mortality. High-density lipoprotein cholesterol (HDL-C) has recently received much attention as a possible risk marker of prostate cancer development and prognosis. In the present article, we summarized findings from epidemiologic studies of the association between HDL-C and prostate cancer. Low HDL-C level was found to be a risk and prognostic factor of prostate cancer in several epidemiologic studies, although the overall linkage between HDL and prostate cancer has not been definitively established. The mechanisms for this association remain uncertain; however, limited data from experimental studies imply a possible role of HDL in the pathophysiology of prostate cancer. More epidemiologic research, in combination with experimental studies, is needed in this field.
著者
Yasunori Niwa Shizukiyo Ishikawa Tadao Gotoh Kazunori Kayaba Yosikazu Nakamura Eiji Kajii
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.17, no.6, pp.203-209, 2007 (Released:2007-12-19)
参考文献数
28
被引用文献数
10 11 14

BACKGROUND: Metabolic syndrome is known to increase morbidity and mortality of cardiovascular disease. The National Cholesterol Education Program Adult Treatment Expert Panel III in 2001 (revised in 2005) and the Japanese definition of metabolic syndrome were launched in 2005. No study regarding the association between metabolic syndrome by Japanese definition and mortality has been performed. The aim of this study was to clarify the prevalence of metabolic syndrome and its effects to mortality in a population-based cohort study.METHODS: A total of 2176 subjects who satisfied the necessary criteria for metabolic syndrome were examined between 1992 and 1995 as a part of Jichi Medical School Cohort Study by Japanese definition. Cox's proportional hazard models were used to analyze the association of metabolic syndrome with mortality.RESULTS: The prevalence of metabolic syndrome was 9.0% in males and 1.7% in females. There were 17 deaths (14 males), including 6 cardiovascular deaths (5 males), during a 12.5-year follow-up period among metabolic syndrome subjects. After adjusting for age, smoking status, and alcohol drinking status, the hazard ratio (95% confidence interval) for all-cause mortality was 1.13 (0.64-1.98) in males and 1.31 (0.41-4.18) in females, and HR for cardiovascular mortality was 1.84 (0.68-4.96) in males, and 1.31 (0.17-9.96) in females.CONCLUSION: No statistical significant relationship between metabolic syndrome by Japanese definition and all-cause mortality was observed in a population-based cohort study.J Epidemiol 2007; 17: 203-209.
著者
Atsuko Sadakane Tadao Gotoh Shizukiyo Ishikawa Yosikazu Nakamura Kazunori Kayaba
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.19, no.3, pp.107-115, 2009-05-05 (Released:2009-05-05)
参考文献数
35
被引用文献数
19 21

Background: Lower mortality has been reported in light-to-moderate alcohol drinkers. We examined the association between the amount and frequency of alcohol consumption and all-cause mortality in a Japanese population.Methods: We conducted a prospective cohort study among 8934 Japanese people (3444 men and 5490 women) who completed a baseline survey between 1992 and 1995. We confirmed the date and cause of death by referring to death certificates. The Cox proportional hazards model was used to evaluate the effect of alcohol consumption on risk for all-cause mortality, after adjustment for potential confounding factors.Results: We identified 637 (397 men and 240 women) deaths during the 12.0 years of mean follow-up. Among men, as compared with non-drinkers, the relative risk was higher in ex-drinkers (hazard ratio [HR], 1.18), lower in light drinkers (HR, 0.95) and moderate drinkers (HR, 0.91), and significantly higher in heavy drinkers (HR, 1.67; 95% confidence interval, 1.10–2.55). Among women, light, moderate, and heavy drinkers were grouped into current drinkers. The relative risk was slightly higher in current drinkers (HR, 1.23), and that in ex-drinkers was near 1.0 (HR, 0.97). In stratified analysis, the harmful effects of heavy drinking were more severe among male smokers and younger men. In terms of frequency, men who drank only on special occasions had the highest mortality (HR, 1.28), regardless of alcohol intake per drinking session.Conclusions: In men, a near J-shaped association was identified between alcohol consumption and all-cause mortality. Both the amount and frequency of alcohol consumption were related to mortality.