著者

Megumi Hara Yuichiro Nishida Keitaro Tanaka Chisato Shimanoe Kayoko Koga Takuma Furukawa Yasuki Higaki Koichi Shinchi Hiroaki Ikezaki Masayuki Murata Kenji Takeuchi Takashi Tamura Asahi Hishida Mineko Tsukamoto Yuka Kadomatsu Keitaro Matsuo Isao Oze Haruo Mikami Miho Kusakabe Toshiro Takezaki Rie Ibusuki Sadao Suzuki Hiroko Nakagawa-Senda Daisuke Matsui Teruhide Koyama Kiyonori Kuriki Naoyuki Takashima Yasuyuki Nakamura Kokichi Arisawa Sakurako Katsuura-Kamano Kenji Wakai

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.6, pp.285-293, 2023-06-05 (Released:2023-06-05)

参考文献数

49

被引用文献数

6

---

Background: Little is known about whether insufficient moderate-to-vigorous physical activity (MVPA) and longer sedentary behavior (SB) are independently associated with estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD), whether they interact with known risk factors for CKD, and the effect of replacing sedentary time with an equivalent duration of physical activity on kidney function.Methods: We examined the cross-sectional association of MVPA and SB with eGFR and CKD in 66,603 Japanese cohort study in 14 areas from 2004 to 2013. MVPA and SB were estimated using a self-reported questionnaire, and CKD was defined as eGFR <60 mL/min/1.73 m2. Multiple linear regression analyses, logistic regression analyses, and an isotemporal substitution model were applied.Results: After adjusting for potential confounders, higher MVPA and longer SB were independently associated with higher eGFR (P for trend MVPA <0.0001) and lower eGFR (P for trend SB <0.0001), and a lower odds ratio (OR) of CKD (adjusted OR of MVPA ≥20 MET·h/day, 0.76; 95% confidence interval [CI], 0.68–0.85 compared to MVPA <5 MET·h/day) and a higher OR of CKD (adjusted OR of SB ≥16 h/day, 1.81; 95% CI, 1.52–2.15 compared to SB <7 h/day), respectively. The negative association between MVPA and CKD was stronger in men, and significant interactions between sex and MVPA were detected. Replacing 1 hour of SB with 1 hour of physical activity was associated with about 3 to 4% lower OR of CKD.Conclusion: These findings indicate that replacing SB with physical activity may benefit kidney function, especially in men, adding to the possible evidence on CKD prevention.

著者

Shizuka Sasazuki

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.26, no.12, pp.611-612, 2016-12-05 (Released:2016-12-05)

参考文献数

4

被引用文献数

9 10

著者

Atsushi Hozawa Kozo Tanno Naoki Nakaya Tomohiro Nakamura Naho Tsuchiya Takumi Hirata Akira Narita Mana Kogure Kotaro Nochioka Ryohei Sasaki Nobuyuki Takanashi Kotaro Otsuka Kiyomi Sakata Shinichi Kuriyama Masahiro Kikuya Osamu Tanabe Junichi Sugawara Kichiya Suzuki Yoichi Suzuki Eiichi N Kodama Nobuo Fuse Hideyasu Kiyomoto Hiroaki Tomita Akira Uruno Yohei Hamanaka Hirohito Metoki Mami Ishikuro Taku Obara Tomoko Kobayashi Kazuyuki Kitatani Takako Takai-Igarashi Soichi Ogishima Mamoru Satoh Hideki Ohmomo Akito Tsuboi Shinichi Egawa Tadashi Ishii Kiyoshi Ito Sadayoshi Ito Yasuyuki Taki Naoko Minegishi Naoto Ishii Masao Nagasaki Kazuhiko Igarashi Seizo Koshiba Ritsuko Shimizu Gen Tamiya Keiko Nakayama Hozumi Motohashi Jun Yasuda Atsushi Shimizu Tsuyoshi Hachiya Yuh Shiwa Teiji Tominaga Hiroshi Tanaka Kotaro Oyama Ryoichi Tanaka Hiroshi Kawame Akimune Fukushima Yasushi Ishigaki Tomoharu Tokutomi Noriko Osumi Tadao Kobayashi Fuji Nagami Hiroaki Hashizume Tomohiko Arai Yoshio Kawaguchi Shinichi Higuchi Masaki Sakaida Ryujin Endo Satoshi Nishizuka Ichiro Tsuji Jiro Hitomi Motoyuki Nakamura Kuniaki Ogasawara Nobuo Yaegashi Kengo Kinoshita Shigeo Kure Akio Sakai Seiichiro Kobayashi Kenji Sobue Makoto Sasaki Masayuki Yamamoto

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.1, pp.65-76, 2021-01-05 (Released:2021-01-05)

参考文献数

34

被引用文献数

54 75

---

Background: We established a community-based cohort study to assess the long-term impact of the Great East Japan Earthquake on disaster victims and gene-environment interactions on the incidence of major diseases, such as cancer and cardiovascular diseases.Methods: We asked participants to join our cohort in the health check-up settings and assessment center based settings. Inclusion criteria were aged 20 years or over and living in Miyagi or Iwate Prefecture. We obtained information on lifestyle, effect of disaster, blood, and urine information (Type 1 survey), and some detailed measurements (Type 2 survey), such as carotid echography and calcaneal ultrasound bone mineral density. All participants agreed to measure genome information and to distribute their information widely.Results: As a result, 87,865 gave their informed consent to join our study. Participation rate at health check-up site was about 70%. The participants in the Type 1 survey were more likely to have psychological distress than those in the Type 2 survey, and women were more likely to have psychological distress than men. Additionally, coastal residents were more likely to have higher degrees of psychological distress than inland residents, regardless of sex.Conclusion: This cohort comprised a large sample size and it contains information on the natural disaster, genome information, and metabolome information. This cohort also had several detailed measurements. Using this cohort enabled us to clarify the long-term effect of the disaster and also to establish personalized prevention based on genome, metabolome, and other omics information.

著者

Juan Xu Atsushi Goto Maki Konishi Masayuki Kato Tetsuya Mizoue Yasuo Terauchi Shoichiro Tsugane Norie Sawada Mitsuhiko Noda

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220329, (Released:2023-05-20)

参考文献数

45

---

Background: This study aimed to develop models to predict the 5-year incidence of T2DM in a Japanese population and validate them externally in an independent Japanese population.Methods: Data from 10,986 participants (aged 46–75 years) in the development cohort of the Japan Public Health Center-based Prospective Diabetes Study and 11,345 participants (aged 46–75 years) in the validation cohort of the Japan Epidemiology Collaboration on Occupational Health Study were used to develop and validate the risk scores in logistic regression models.Results: We considered non-invasive (sex, body mass index, family history of diabetes mellitus, and diastolic blood pressure) and invasive (glycated hemoglobin [HbA1c] and fasting plasma glucose [FPG]) predictors to predict the 5-year probability of incident diabetes. The area under the receiver operating characteristic curve was 0.643 for the non-invasive risk model, 0.786 for the invasive risk model with HbA1c but not FPG, and 0.845 for the invasive risk model with HbA1c and FPG. The optimism for the performance of all models was small by internal validation. In the internal-external cross-validation, these models tended to show similar discriminative ability across different areas. The discriminative ability of each model was confirmed using external validation datasets. The invasive risk model with only HbA1c was well-calibrated in the validation cohort.Conclusions: Our invasive risk models are expected to discriminate between high- and low-risk individuals with T2DM in a Japanese population.

著者

Mikiko Shibata Kyoko Kogawa Sato Hideo Koh Izumi Shibata Kaori Okamura Yuka Takeuchi Keiko Oue Michio Morimoto Tomoshige Hayashi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220312, (Released:2023-05-20)

参考文献数

44

---

Background: Glomerular hyperfiltration has been reported to be associated with adverse renal outcomes in general population. It is not known whether drinking pattern is associated with the risk of glomerular hyperfiltration in healthy individuals.Methods: We prospectively followed middle-aged 8,640 Japanese men with normal renal function, no proteinuria, no diabetes, and no use of antihypertensive medications at entry. Data on alcohol consumption were gathered by questionnaire. Glomerular hyperfiltration was defined as estimated glomerular filtration rate (eGFR) ≥117 mL/min/1.73 m2, which was the upper 2.5th percentile value of eGFR in the entire cohort.Results: During 46,186 person-years of follow-up, 330 men developed glomerular hyperfiltration. In a multivariate model, for men who consumed alcohol on 1–3 days per week, alcohol consumption of ≥69.1g ethanol/drinking day was significantly associated with the risk of glomerular hyperfiltration (hazard ratio (HR), 2.37 (95% CI, 1.18–4.74)) compared with non-drinkers. For those who consumed alcohol on 4–7 days per week, higher alcohol consumption per drinking day was associated with a higher risk of glomerular hyperfiltration: the HRs (95% CI) for alcohol consumption of 46.1–69.0, and ≥69.1 g ethanol/drinking day were 1.55 (1.01–2.38), and 1.78 (1.02–3.12), respectively.Conclusions: For high drinking frequency per week, more alcohol intake per drinking day was associated with an increased risk of glomerular hyperfiltration, while for low drinking frequency per week, only very high alcohol intake per drinking day was associated with an increased risk of glomerular hyperfiltration in middle-aged Japanese men.

著者

Chiemi Hotta Yuki Fujinuma Takashi Ogawa Mamiko Akita Tomoko Ogawa

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220305, (Released:2023-05-20)

参考文献数

42

被引用文献数

1

---

Background: In Japan, sentinel surveillance is used to monitor the trend of infectious gastroenteritis. Another method of pathogen surveillance, wastewater-based epidemiology, has been used recently because it can help to monitor infectious disease without relying on patient data. Here, we aimed to determine the viral trends reflected in the number of reported patients and number of gastroenteritis virus-positive samples. We focused on gastroenteritis viruses present in wastewater and investigated the usefulness of wastewater surveillance for the surveillance of infectious gastroenteritis.Methods: Real-time polymerase chain reaction was used for viral gene detection in wastewater. The number of reported patients per pediatric sentinel site and number of viral genome copies were compared for correlation potential. The number of gastroenteritis virus-positive samples reported by NESID and a status of gastroenteritis viruses detected in wastewater were also evaluated.Results: Genes of norovirus GI, norovirus GII, sapovirus, astrovirus, rotavirus group A, and rotavirus group C were detected in wastewater samples. Viruses were detected in wastewater during periods when no gastroenteritis virus-positive samples were reported to NESID.Conclusions: Norovirus GII and other gastroenteritis viruses were detected in wastewater even during periods when no gastroenteritis virus-positive samples were found. Therefore, surveillance using wastewater can complement sentinel surveillance and is an effective tool for the surveillance of infectious gastroenteritis.

著者

Sanae Matsuyama Yoshitaka Murakami Yukai Lu Toshimasa Sone Yumi Sugawara Ichiro Tsuji

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.10, pp.456-463, 2022-10-05 (Released:2022-10-05)

参考文献数

37

被引用文献数

1 2

---

Background: Although social participation has been reported to be associated with significantly lower risks of mortality and disability, to our knowledge, no study has estimated its impact on disability-free life expectancy (DFLE). Therefore, this study aimed to investigate the association between social participation and DFLE in community-dwelling older people.Methods: We analyzed 11-year follow-up data from a cohort study of 11,982 Japanese older adults (age ≥65 years) in 2006. We collected information on the number of social participations using a questionnaire. Using this information, we categorized the participants into four groups. DFLE was defined as the average number of years a person could expect to live without disability. The multistate life table method using a Markov model was employed for calculating DFLE.Results: The results revealed that DFLE according to the number of social participations was 17.8 years (95% confidence interval [CI], 17.3–18.2) for no activities, 20.9 (95% CI, 20.4–21.5) for one activity, 21.5 (95% CI, 20.9–22.0) for two activities, and 22.7 (95% CI, 22.1–23.2) for three activities in men, and 21.8 (95% CI, 21.5–22.2), 25.1 (95% CI, 24.6–25.6), 25.3 (95% CI, 24.7–25.9), and 26.7 years (95% CI, 26.1–27.4), respectively, in women. This difference in DFLE did not change after the participants were stratified for smoking, body mass index, physical activity, and depression.Conclusion: Social participation is associated with longer DFLE among Japanese older people; therefore, encouraging social participation at the population level could increase life-years lived in good health.

著者

Sanyu Ge Ling Zha Tomotaka Sobue Tetsuhisa Kitamura Junko Ishihara Motoki Iwasaki Manami Inoue Taiki Yamaji Shoichiro Tsugane Norie Sawada

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220235, (Released:2023-05-06)

参考文献数

41

被引用文献数

1

---

Background: Many epidemiological studies have investigated dietary intake of antioxidant vitamins in relation to prostate cancer risk in Western countries, but the results are inconsistent. However, few studies have reported this relationship in Asian countries.Methods: We investigated the association between intake of vitamins, including lycopene, α-carotene, β-carotene, vitamin C, vitamin E, with prostate cancer risk in the Japan Public Health Center-based Prospective (JPHC) study. 40,720 men without history of cancer finished the food frequency questionnaire (FFQ) and were included in the study. Hazard ratios (HRs) and 95% confidence intervals (CIs) of prostate cancer risk were calculated according to the quintiles of energy-adjusted intake of vitamins using Cox models.Results: After an average of 15.2 years (617,599 person-years in total) of follow-up, 1,386 cases of prostate cancer were identified, including 944 localized cases and 340 advanced cases. No associations were observed in consumption of antioxidant vitamins, including α-carotene, β-carotene, vitamin C, and vitamin E, and prostate cancer risk. Although higher lycopene intake was associated with increased risk of prostate cancer (HR for the highest versus the lowest, 1.24; 95% CI, 1.04–1.47; P for trend=0.01), there was a null association of lycopene intake with risk of prostate cancer detected by subjective symptoms (HR, 1.12; 95% CI, 0.79–1.58; P for trend=0.11).Conclusions: Our study suggested no association between antioxidant intake of vitamins and prostate cancer risk.

著者

Fumiko Kagiura Ryota Matsuyama Dai Watanabe Yuuki Tsuchihashi Kazuhiko Kanou Takuri Takahashi Yusuke Matsui Masayuki Kakehashi Tomimasa Sunagawa Takuma Shirasaka

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.5, pp.256-261, 2023-05-05 (Released:2023-05-05)

参考文献数

29

被引用文献数

1

---

Background: The CD4 cell count of patients during diagnosis and distribution of CD4 cell counts in the patient population are important to understand infection-diagnosis interval and incidence rate of human immunodeficiency virus (HIV) infection, respectively. However, this information has not been published in Japan. This study aimed to describe the change in CD4 cell count trends and clarify the change in patients’ characteristics in association with the CD4 cell count information.Methods: A descriptive study was conducted to analyze the medical records of patients with HIV who visited one of the largest acquired immunodeficiency syndrome (AIDS) core hospitals in western Japan. The basic characteristics, CD4 cell counts, viral loads, and diagnosis-treatment intervals between the first (2003–2010) and second (2011–2017) halves of the study duration were compared.Results: The distribution of CD4 cell counts significantly changed between 2003–2010 and 2011–2017 (χ2 = 20.42, P < 0.001). The proportion of CD4 cell count <200 cells/mm3 increased (38.8% in 2003 to 45.9% in 2017), whereas CD4 cell count ≥500 cells/mm3 decreased (19.4% in 2003 to 12.2% in 2017). Moreover, the distributions of age groups, history of HIV screening test, patient outcomes, HIV viral load, and diagnosis-treatment interval also significantly changed (χ2 = 25.55, P < 0.001; χ2 = 8.37, P = 0.015; χ2 = 6.07, P = 0.014; χ2 = 13.36, P = 0.020; χ2 = 173.76, P < 0.001, respectively).Conclusion: This study demonstrated the fundamental trends of the HIV epidemic in Osaka, Japan between 2003–2010 and 2011–2017 and indicated that the incidence rate of HIV was decreasing in Japan.

著者

Mako Nagayoshi Kenji Takeuchi Yudai Tamada Yasufumi Kato Yoko Kubo Rieko Okada Takashi Tamura Asahi Hishida Jun Otonari Hiroaki Ikezaki Yuichiro Nishida Chisato Shimanoe Yuriko N. Koyanagi Keitaro Matsuo Haruo Mikami Miho Kusakabe Daisaku Nishimoto Keiichi Shibuya Sadao Suzuki Takeshi Nishiyama Etsuko Ozaki Isao Watanabe Kiyonori Kuriki Naoyuki Takashima Aya Kadota Kokichi Arisawa Sakurako Katsuura-Kamano Kenji Wakai

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.5, pp.236-245, 2023-05-05 (Released:2023-05-05)

参考文献数

50

被引用文献数

2

---

Background: Stress coping strategies are related to health outcomes. However, there is no clear evidence for sex differences between stress-coping strategies and mortality. We investigated the relationship between all-cause mortality and stress-coping strategies, focusing on sex differences among Japanese adults.Methods: A total of 79,580 individuals aged 35–69 years participated in the Japan Multi-Institutional Collaborative Cohort Study between 2004 and 2014 and were followed up for mortality. The frequency of use of the five coping strategies was assessed using a questionnaire. Sex-specific, multivariable-adjusted hazard ratios (HRs) for using each coping strategy (“sometimes,” and “often/very often” use versus “very few” use) were computed for all-cause mortality. Furthermore, relationships were analyzed in specific follow-up periods when the proportion assumption was violated.Results: During the follow-up (median: 8.5 years), 1,861 mortalities were recorded. In women, three coping strategies were related to lower total mortality. The HRs for “sometimes” were 0.81 (95% confidence interval [CI], 0.67–0.97) for emotional expression, 0.79 (95% CI, 0.66–0.95) for emotional support-seeking, and 0.80 (95% CI, 0.66–0.98) for disengagement. Men who “sometimes” used emotional expression and sometimes or often used problem-solving and positive reappraisal had a 15–41% lower HRs for all-cause mortality. However, those relationships were dependent on the follow-up period. There was evidence that sex modified the relationships between emotional support-seeking and all-cause mortality (P for interaction = 0.03).Conclusion: In a large Japanese sample, selected coping strategies were associated with all-cause mortality. The relationship of emotional support-seeking was different between men and women.

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.

著者

Sachiko Baba Satoyo Ikehara Ehab S. Eshak Kimiko Ueda Tadashi Kimura Hiroyasu Iso

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.5, pp.209-216, 2023-05-05 (Released:2023-05-05)

参考文献数

48

被引用文献数

8

---

Background: Postpartum depression (PPD) has been associated with adverse health outcomes, including maternal suicide. Mode of delivery has been suggested to be a risk factor for PPD, but no large cohort study has examined the association between mode of delivery and PPD. We aimed to examine the association between mode of delivery and risks of PPD at 1 and 6 months after childbirth.Methods: In a nationwide study of 89,954 mothers with a live singleton birth, we examined the association between mode of delivery and risks of PPD. PPD was evaluated using the Edinburgh Postnatal Depression Scale (≥13) at 1 and 6 months after childbirth. Odds ratios (ORs) with 95% confidence intervals (CIs) of PPD were calculated using multivariable logistic regression analyses after adjustment of antenatal physical, socioeconomic, and mental factors.Results: Among 89,954 women, 3.7% and 2.8% had PPD at 1 and 6 months after childbirth, respectively. Compared with unassisted vaginal delivery, cesarean section (CS) was marginally associated with PPD at 1 month but not at 6 months; adjusted ORs were 1.10 (95% CI, 1.00–1.21) and 1.01 (95% CI, 0.90–1.13), respectively. The association with PPD at 1 month was evident in women with antenatal psychological distress (adjusted OR 1.15; 95% CI, 1.03–1.28). The observed associations were attenuated after adjusting for infant feeding method.Conclusion: Women who had antenatal psychological distress and underwent CS delivery may be regarded as a target for monitoring PPD.

著者

Jaesung Choi JooYong Park Ji-Eun Kim Jong-koo Lee Daehee Kang Miyoung Lee Ick-Joong Chung Ji-Yeob Choi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.11, pp.557-565, 2021-11-05 (Released:2021-11-05)

参考文献数

51

被引用文献数

2

---

Background: There is a lack of evidence of the complicated pathways of underlying determinants in the phases of physical activity. The purpose of this study was to evaluate simultaneously a set of potential determinants on the initiation and maintenance phases of leisure-time physical activity (LTPA).Methods: The longitudinal data of 54,359 Korean adults aged 40–69 years from the Health Examinees study were used. The median follow-up duration was 4.2 years. The self-reported durations per week of LTPA was repeatedly assessed. Based on previous longitudinal studies, the potential determinants were selected, and hypothetical models were constructed that consider the complex associations between the determinants. The standardized coefficients for direct and indirect effects were estimated using path analysis to differentiate contributions of mediation from the total effects.Results: In the total population, age, education, chronic diseases, smoking, depression symptoms, and self-rated health were significantly associated with both initiation and maintenance phases. Income (B = 0.025) and social supports (B = 0.019) were associated only with the initiation phase. Waist-to-hip ratio (B = −0.042) and stress (B = −0.035) were associated only with the maintenance phase. After stratifying by sex, the significant effects of education, chronic diseases, and smoking were found only in men. The initiation phase-specific effects of income and social supports and the maintenance phase-specific effects of stress were found only in women. It was estimated that indirect effects contributed approximately 15% of the total effect.Conclusion: The findings suggested that there were initiation- or maintenance-specific determinants of leisure-time physical activity according to sex.

著者

Takaki Kobayashi Yukako Tani Shiho Kino Takeo Fujiwara Katsunori Kondo Ichiro Kawachi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.6, pp.245-253, 2022-06-05 (Released:2022-06-05)

参考文献数

53

被引用文献数

2 6

---

Background: Engagement in leisure activities among older people is associated with a lower risk of mortality. However, no studies have been conducted focusing on the difference of associations with mortality risk among multiple types of leisure activities.Methods: We examined prospectively the association of engagement in leisure activities with all-cause mortality in a cohort of older Japanese adults. The Japan Gerontological Evaluation Study included 48,216 participants aged 65 years or older. During a mean follow-up period of 5.6 years, we observed 5,575 deaths (11.6%). We investigated the total number of leisure activities, as well as combinations of 25 different leisure activities with Cox proportional hazards models, adjusting for potential confounding factors.Results: We found a linear relationship between the total number of leisure activities and mortality hazard (adjusted hazard ratio, 0.93; 95% CI, 0.92–0.95). Furthermore, engagement in leisure activities involving physical activity, as well as group-based interactions, showed the strongest associations with lowered mortality. By contrast, engagement in cultural leisure activities and solitary leisure activities were not associated with all-cause mortality.Conclusion: Although we cannot rule out residual confounding, our findings suggest that encouraging engagement in physically-active group-based leisure activities may promote longevity in older adults.

著者

Aki Kuwauchi Satomi Yoshida Chikashi Takeda Yugo Yamashita Takeshi Kimura Masato Takeuchi Koji Kawakami

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220360, (Released:2023-04-22)

参考文献数

27

---

BackgroundAcute pulmonary embolism (PE) is a life-threatening in-hospital complication. Recently, several studies have reported the clinical characteristics of PE among Japanese patients using the diagnostic procedure combination (DPC)/per diem payment system database. However, the validity of PE identification algorithms for Japanese administrative data is not yet clear. The purpose of this study was to evaluate the validity of using DPC data to identify acute PE inpatients.MethodsThe reference standard was symptomatic/asymptomatic PE patients included in the COntemporary ManageMent AND outcomes in patients with Venous ThromboEmbolism (COMMAND VTE) registry, which is a cohort study of acute symptomatic venous thromboembolism (VTE) patients in Japan. The validation cohort included all patients discharged from the 6 hospitals included in both the registry and DPC database. The identification algorithms comprised diagnosis, anticoagulation therapy, thrombolysis therapy, and inferior vena cava filter placement. Each algorithm’s sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were estimated.ResultsA total of 43.4% of the validation cohort was female, with a mean age of 67.3 years. The diagnosis-based algorithm showed a sensitivity of 90.2% (222/246, 95% CI; 85.8–93.6), a specificity of 99.8% (228,485/229,027, 95% CI; 99.7–99.8), a PPV of 29.1% (222/764, 95% CI; 25.9–32.4) and an NPV of 99.9% (228,485/229,509, 95% CI; 99.9–99.9) for identifying symptomatic/asymptomatic PE. Additionally, 94.6% (159/168, 95% CI; 90.1–97.5) of symptomatic PE patients were identified by the diagnosis-based algorithm.ConclusionsThe diagnosis-based algorithm may be a relatively sensitive method for identifying acute PE inpatients in the Japanese DPC database.

著者

Hirokazu Tanaka Sayo Tanaka Kayo Togawa Kota Katanoda

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220302, (Released:2023-02-11)

参考文献数

13

被引用文献数

7

---

Background: The 2015 Japan Standard Population (JSP) was established in response to changes in the age structure. However, the effects of major updates, especially the recategorization of older age groups, for interpreting various health metrics have not been clarified.Methods: Population data were collected and estimated for older age categories (85–89, 90–94, and ≥95 years). Data on the number of deaths were also collected from the Vital Statistics. We recalculated the all-cause and leading cause-specific age-standardized mortality rate (ASMR) using the 2015 JSP by the direct standardization method for data from 1950 to 2020. We compared ASMRs calculated using the 2015 JSP with those calculated using the 1985 JSP. Pearson’s correlation coefficients were used to evaluate the consistency of mortality trends between the 2015 and 1985 JSPs.Results: The absolute all-cause ASMRs calculated using the 2015 JSP were 2.22–3.00 times higher than those calculated using the 1985 JSP. The ASMR ratios increased gradually over time. While trends in all-cause and cause-specific ASMRs calculated using the 2015 JSP and 1985 JSP were generally highly correlated (Pearson’s correlation coefficient [r] = 0.993 for all-cause), correlations were relatively low for malignant neoplasms (r = 0.720 for men and r = 0.581 for women) and pneumonia/bronchitis (r = 0.543 for men and r = 0.559 for women) due to non-monotonous trends over time and fluctuations in earlier time periods.Conclusion: The effect of introducing the new JSP for interpreting trends in all-cause mortality was considered minimal. However, caution is needed when interpreting trends in some cause-specific mortality rates.

著者

Daichi Watanuki Akiko Tamakoshi Takashi Kimura Toshiaki Asakura Masayuki Saijo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220359, (Released:2023-04-08)

参考文献数

26

---

Background: For therapeutic efficacy, molnupiravir and nirmatrelvir-ritonavir must be started to treat patients within 5 days of disease onset to treat patients with COVID-19. However, some patients spend more than 5 days from disease onset before reporting to the Public Health Office. This study aimed to clarify the characteristics of patients with reporting delay.Methods: This study included data from 12,399 patients with COVID-19 who reported to the Public Health Office from March 3rd, 2021 to June 30th, 2021. Patients were stratified into “linked” (n=7,814) and “unlinked” (n=4,585) cases depending on whether they were linked to other patients. A long reporting delay was defined as the difference between the onset and reporting dates of 5 days or more. Univariate and multivariate analyses were performed using log-binomial regression to identify factors related to long reporting delay, and prevalence ratios with corresponding 95% confidence intervals were calculated.Results: The proportion of long reporting delay was 24.4% (1904/7814) and 29.3% (1344/4585) in linked and unlinked cases, respectively. Risks of long reporting delay among linked cases were living alone and onset on the day with a higher 7-day daily average confirmed cases or onset on weekends; whereas, risks for unlinked cases were age over 65 years, without occupation and living alone.Conclusion: Our results suggest the necessity to establish a Public Health Office system that is less susceptible to the rapid increase in the number of patients, promotes educational activities for people with fewer social connections, and improves access to health care.

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

---

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.

著者

Makoto Takeyama Sen Yachi Yuji Nishimoto Ichizo Tsujino Junichi Nakamura Naoto Yamamoto Hiroko Nakata Satoshi Ikeda Michihisa Umetsu Shizu Aikawa Hiroya Hayashi Hirono Satokawa Yoshinori Okuno Eriko Iwata Yoshito Ogihara Nobutaka Ikeda Akane Kondo Takehisa Iwai Norikazu Yamada Tomohiro Ogawa Takao Kobayashi Makoto Mo Yugo Yamashita

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.3, pp.150-157, 2023-03-05 (Released:2023-03-05)

参考文献数

53

被引用文献数

1

---

Background: Reports of mortality-associated risk factors in patients with the novel coronavirus disease 2019 (COVID-19) are limited.Methods: We evaluated the clinical features that were associated with mortality among patients who died during hospitalization (n = 158) and those who were alive at discharge (n = 2,736) from the large-scale, multicenter, retrospective, observational cohort CLOT-COVID study, which enrolled consecutively hospitalized COVID-19 patients from 16 centers in Japan from April to September 2021. Data from 2,894 hospitalized COVID-19 participants of the CLOT-COVID study were analyzed in this study.Results: Patients who died were older (71.1 years vs 51.6 years, P < 0.001), had higher median D-dimer values on admission (1.7 µg/mL vs 0.8 µg/mL, P < 0.001), and had more comorbidities. On admission, the patients who died had more severe COVID-19 than did those who survived (mild: 16% vs 63%, moderate: 47% vs 31%, and severe: 37% vs 6.2%, P < 0.001). In patients who died, the incidence of thrombosis and major bleeding during hospitalization was significantly higher than that in those who survived (thrombosis: 8.2% vs 1.5%, P < 0.001; major bleeding: 12.7% vs 1.4%, P < 0.001). Multivariable logistic regression analysis revealed that age >70 years, high D-dimer values on admission, heart disease, active cancer, higher COVID-19 severity on admission, and development of major bleeding during hospitalization were independently associated with a higher mortality risk.Conclusion: This large-scale observational study in Japan identified several independent risk factors for mortality in hospitalized patients with COVID-19 that could facilitate appropriate risk stratification of patients with COVID-19.

著者

Panpan He Huan Li Zhuxian Zhang Yuanyuan Zhang Tengfei Lin Yun Song Lishun Liu Min Liang Jing Nie Binyan Wang Yong Huo Fan Fan Hou Xiping Xu Xianhui Qin

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.3, pp.142-149, 2023-03-05 (Released:2023-03-05)

参考文献数

35

---

Background: The association between changes in estimated glomerular filtration rate (eGFR) over time and the risk of stroke remains inconclusive. We aimed to evaluate the relation of eGFR change during the China Stroke Primary Prevention Trial (CSPPT) with the risk of first stroke during the subsequent post-trial follow-up.Methods: A total of 11,742 hypertensive participants with two eGFR measurements (median measure interval, 4.4; interquartile range, 4.2–4.6 years) and without a history of stroke from the CSPPT were included in this analysis.Results: Over a median post-trial follow-up of 4.4 years, 729 first strokes were identified, of which 635 were ischemic, 88 were hemorrhagic, and 6 were uncertain types of strokes. Compared with those with 1 to <2% per year increase in eGFR (with the lowest stroke risk), those with an increase in eGFR of ≥4% per year had significantly increased risks of first stroke (adjusted hazard ratio [HR] 1.96; 95% confidence interval [CI], 1.10–3.50) and first ischemic stroke (adjusted HR 2.14; 95% CI, 1.17–3.90). Similarly, those with a decline in eGFR of ≥5% per year also had significantly increased first stroke (adjusted HR 2.13; 95% CI, 1.37–3.31) and first ischemic stroke (adjusted HR 1.89; 95% CI, 1.19–3.02) risk. However, there was no significant association between eGFR change and first hemorrhagic stroke. A similar result was found when the change in eGFR was quantified as an absolute annual change.Conclusion: In Chinese hypertensive patients, both the decline and increase of eGFR levels were independently associated with the risks of first stroke or first ischemic stroke.