著者
Hiroshi Yatsuya Hiroyasu Iso Yuanying Li Kazumasa Yamagishi Yoshihiro Kokubo Isao Saito Norie Sawada Manami Inoue Shoichiro Tsugane
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-16-0081, (Released:2016-04-15)
参考文献数
41
被引用文献数
4 15

Background:Global risk assessment for the prevention of atherosclerotic cardiovascular diseases helps guide the intensity of behavioral and pharmacological interventions.Methods and Results:The Japan Public Health Center-based prospective (JPHC) Study Cohort II (age range: 40–69 years at baseline in 1993–1994, n=15,672) was used to derive the risk equations for coronary artery disease (CAD) and ischemic stroke incidence via hazard regression. The model discrimination was evaluated by the area under the receiver-operating curve (AUC), and model goodness-of-fit by the Grønnesby-Borgan chi-squared statistic. During a mean of 16.4 years of follow up, 192 incident CAD cases and 552 ischemic stroke cases occurred. Variables selected for the CAD equation were age, sex, current smoking, systolic blood pressure, antihypertensive medication use, diabetes, and high-density lipoprotein cholesterol (HDLC) and non-HDLC. The same variables, except non-HDLC, were selected for the ischemic stroke equation. The equations discriminated incidence reasonably well (AUC: 0.81 for CAD, 0.78 for ischemic stroke). The AUC of the equation applied externally to Cohort I (n=11,598) was also good: 0.77 and 0.76 for CAD and ischemic stroke, respectively. Risk calculator application and color charts to visualize estimated risk according to the combinations of risk factors were prepared.Conclusions:Risk equations were developed to estimate the 10-year probability of CAD and ischemic stroke in Japanese people, using variables that are routinely obtained.
著者
Mayu Uemura Hiroshi Yatsuya Esayas Haregot Hilawe Yuanying Li Chaochen Wang Chifa Chiang Rei Otsuka Hideaki Toyoshima Koji Tamakoshi Atsuko Aoyama
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.25, no.5, pp.351-358, 2015-05-05 (Released:2015-05-05)
参考文献数
23
被引用文献数
18 19

Background: Skipping breakfast has been suspected as a risk factor for type 2 diabetes (T2DM), but the associations are not entirely consistent across ethnicities or sexes, and the issue has not been adequately addressed in the Japanese population.Methods: We followed 4631 participants (3600 men and 1031 women) in a work-site cohort of participants aged 35–66 years in 2002 through 2011 for T2DM development. Frequency of eating breakfast was self-reported and was subsequently dichotomized to breakfast skippers, who eat breakfast 3–5 times/week or less, and to eaters. Cox proportional hazards models were used to adjust for potential confounding factors, including dietary factors, smoking and other lifestyles, body mass index (BMI), and fasting blood glucose (FBG) at baseline.Results: During 8.9 years of follow-up, 285 T2DM cases (231 men and 54 women) developed. Compared to participants who reported eating breakfast every day, maximally-adjusted hazard ratios and 95% confidence intervals (CI) of those with the frequency of almost every day and 3–5, 1–2, and 0 days/week were: 1.06 (95% CI, 0.73–1.53), 2.07 (95% CI, 1.20–3.56), 1.37 (95% CI, 0.82–2.29), and 2.12 (95% CI, 1.19–3.76), respectively. In a dichotomized analysis, breakfast skipping was positively associated with T2DM incidence (maximally-adjusted hazard ratio 1.73; 95% CI, 1.24–2.42). The positive associations were found in both men and women, current and non-current smokers, normal weight and overweight (BMI ≥25 kg/m2), and normal glycemic status and impaired fasting glycemic status (FBG 110 to <126 mg/dL) individuals at baseline (Ps for interaction all >0.05).Conclusions: The present study in middle-aged Japanese men and women suggests that skipping breakfast may increase the risk of T2DM independent of lifestyles and baseline levels of BMI and FBG.
著者
Hiroshi Yatsuya Yuanying Li Yoshihisa Hirakawa Atsuhiko Ota Masaaki Matsunaga Hilawe Esayas Haregot Chifa Chiang Yan Zhang Koji Tamakoshi Hideaki Toyoshima Atsuko Aoyama
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20170048, (Released:2018-03-17)
参考文献数
36

Background: Relatively little evidence exists for type 2 diabetes mellitus (T2DM) prediction models from long-term follow-up studies in East Asians. This study aims to develop a point-based prediction model for 10-year risk of developing T2DM in middle-aged Japanese men.Methods: We followed 3,540 male participants of Aichi Workers’ Cohort Study, who were aged 35–64 years and were free of diabetes in 2002, until March 31, 2015. Baseline age, body mass index (BMI), smoking status, alcohol consumption, regular exercise, medication for dyslipidemia, diabetes family history, and blood levels of triglycerides (TG), high density lipoprotein cholesterol (HDLC) and fasting blood glucose (FBG) were examined using Cox proportional hazard model. Variables significantly associated with T2DM in univariable models were simultaneously entered in a multivariable model for determination of the final model using backward variable selection. Performance of an existing T2DM model when applied to the current dataset was compared to that obtained in the present study’s model.Results: During the median follow-up of 12.2 years, 342 incident T2DM cases were documented. The prediction system using points assigned to age, BMI, smoking status, diabetes family history, and TG and FBG showed reasonable discrimination (c-index: 0.77) and goodness-of-fit (Hosmer-Lemeshow test, P = 0.22). The present model outperformed the previous one in the present subjects.Conclusion: The point system, once validated in the other populations, could be applied to middle-aged Japanese male workers to identify those at high risk of developing T2DM. In addition, further investigation is also required to examine whether the use of this system will reduce incidence.