著者

Emiko Okada Shigekazu Ukawa Koshi Nakamura Makoto Hirata Akiko Nagai Koichi Matsuda Toshiharu Ninomiya Yutaka Kiyohara Kaori Muto Yoichiro Kamatani Zentaro Yamagata Michiaki Kubo Yusuke Nakamura BioBank Japan Cooperative Hospital Group Akiko Tamakoshi

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.27, no.Supplement_III, pp.S29-S35, 2017 (Released:2017-04-14)

参考文献数

33

被引用文献数

26

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Background: Several studies have evaluated associations between the characteristics of patients with esophageal and gastric cancer and survival, but these associations remain unclear. We described the distribution of demographic and lifestyle factors among patients with esophageal and gastric cancer in Japan, and investigated their potential effects on survival.Methods: Between 2003 and 2007, 24- to 95-year-old Japanese patients with esophageal and gastric cancer were enrolled in the BioBank Japan Project. The analysis included 365 patients with esophageal squamous cell carcinoma (ESCC) and 1574 patients with gastric cancer. Hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were estimated using medical institution-stratified Cox proportional hazards models.Results: During follow-up, 213 patients with ESCC (median follow-up, 4.4 years) and 603 patients with gastric cancer (median follow-up, 6.1 years) died. Among patients with ESCC, the mortality risk was higher in ever drinkers versus never drinkers (multivariable HR = 2.37, 95% CI: 1.24, 4.53). Among patients with gastric cancer, the mortality risk was higher in underweight patients versus patients of normal weight (multivariable HR = 1.66, 95% CI: 1.34, 2.05). Compared to patients with gastric cancer with no physical exercise habit, those who exercised ≥3 times/week had a lower mortality risk (multivariate HR = 0.75, 95% CI = 0.61, 0.93). However, lack of stage in many cases was a limitation.Conclusions: Among patients with ESCC, alcohol drinkers have a poor prognosis. Patients with gastric cancer who are underweight also have a poor prognosis, whereas patients with physical exercise habits have a good prognosis.

著者

Akiko Tamakoshi Koshi Nakamura Shigekazu Ukawa Emiko Okada Makoto Hirata Akiko Nagai Koichi Matsuda Yoichiro Kamatani Kaori Muto Yutaka Kiyohara Zentaro Yamagata Toshiharu Ninomiya Michiaki Kubo Yusuke Nakamura BioBank Japan Cooperative Hospital Group

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.27, no.Supplement_III, pp.S36-S42, 2017 (Released:2017-04-14)

参考文献数

16

被引用文献数

33

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Background: Colorectal cancer is the third most common cancer worldwide, and in Japan, it is estimated that about 10% of men and 8% of women will be diagnosed with colorectal cancer during their lifetime.Methods: We focused on 5864 participants (3699 men and 2165 women) who had colorectal cancer and were registered with BioBank Japan (BBJ) between April 2003 and March 2008. Characteristics of colon and rectal cancer patients were calculated separately. Among the enrolled patients registered in BBJ within 90 days after diagnosis, we also calculated the 5-year cumulative and relative survival rates, and estimated the effect of lifestyle factors on all-cause mortality.Results: Our participants included younger men than those in the Patient Survey and the Cancer Registry Japan. In more than 95% of cases the histological type was adenocarcinoma both in colon and rectal cancer. Rectal cancer patients tended to eat more meat and less green leafy vegetables compared with colon cancer patients. The 5-year cumulative survival rate was 73.0% (95% CI; 70.1%–75.7%) and the 5-year relative survival rate was 80.6% (77.4%–83.6%), respectively, for colon cancer. For rectal cancer, the rates were 73.3% (69.1%–77.0%) and 80.9% (76.3%–85.0%), in the same order. Lifestyle factors such as consuming less green leafy vegetables, being underweight, smoking, not consuming alcoholic beverages and being physically inactive were found to be related to poor survival.Conclusions: We described lifestyle characteristics of colorectal cancer patients in BBJ and examined the impacts on subsequent all-cause mortality.

著者

Koshi Nakamura Shigekazu Ukawa Emiko Okada Makoto Hirata Akiko Nagai Zentaro Yamagata Toshiharu Ninomiya Kaori Muto Yutaka Kiyohara Koichi Matsuda Yoichiro Kamatani Michiaki Kubo Yusuke Nakamura BioBank Japan Cooperative Hospital Group Akiko Tamakoshi

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.27, no.Supplement_III, pp.S49-S57, 2017 (Released:2017-04-14)

参考文献数

20

被引用文献数

15

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Background: In Japanese males and females, lung cancer is currently the second and fourth most common type of cancer, and the first and second leading cause of cancer-related deaths, respectively.Methods: Of all Japanese male and female lung cancer patients aged ≥20 years whom the BioBank Japan Project originally enrolled between 2003 and 2008, 764 males and 415 females were registered within 90 days after their diagnosis. We described the lifestyle and clinical characteristics of these patients at study entry. Furthermore, we examined the effect of these characteristics on all-cause mortality.Results: In the lung cancer patients registered within 90 days, the frequencies of occult or stage 0, stage I, II, III and IV were 0.4%, 55.8%, 10.8%, 22.0% and 11.0% for males and 0.3%, 62.4%, 9.9%, 17.1% and 10.2% for females, respectively. The proportions of histological types in males and females were 56.3% and 82.4% for adenocarcinoma, 26.9% and 8.2% for squamous cell carcinoma, 4.5% and 1.5% for large cell carcinoma, 7.7% and 4.1% for small cell carcinoma and 4.6% and 3.8% for others, respectively. Among 1120 participants who registered within 90 days, 572 participants died during 5811 person-years of follow-up. Low body mass index, ever smoker, more advanced stage, squamous cell or small cell carcinoma and high serum carcinoembryonic antigen level at study entry were crudely associated with an increased risk of all-cause mortality after adjustment for age.Conclusions: This study showed the association of several lifestyle and clinical characteristics with all-cause mortality in lung cancer patients.

著者

Nakamura Koshi Okada Emiko Ukawa Shigekazu Hirata Makoto Nagai Akiko Yamagata Zentaro Kiyohara Yutaka Muto Kaori Kamatani Yoichiro Ninomiya Toshiharu Matsuda Koichi Kubo Michiaki Nakamura Yusuke BioBank Japan Cooperative Hospital Group Tamakoshi Akiko

出版者

Elsevier

雑誌

Journal of epidemiology (ISSN:09175040)

巻号頁・発行日

vol.27, no.3, pp.S58-S64, 2017-03

被引用文献数

24

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Background: Breast cancer is currently the most common type of cancer in Japanese females. Unlike most other types of cancer, breast cancer develops more frequently in middle-aged females than in elderly females. Methods: Of all Japanese female breast cancer patients aged ≥20 years whom the BioBank Japan Project originally enrolled between 2003 and 2008, 2034 were registered within 90 days after their diagnosis. We described the lifestyle and clinical characteristics of these patients at study entry. Furthermore, we examined the effect of these characteristics on all-cause mortality. Results: In the female patients registered within 90 days after diagnosis, the frequency of stage 0 or unclassified, stage I, II, III and IV were 11.4%, 47.9%, 37.0%, 2.9% and 0.8%, respectively. The proportion of histological types was 12.9% for non-invasive carcinoma (ductal carcinoma and lobular carcinoma), 81.0% for invasive carcinoma (papillotubular carcinoma, solid tubular carcinoma, scirrhous carcinoma and special types), 0.2% for Paget's diseases and 5.8% for others. Those positive for the estrogen and progesterone receptors accounted for 75.8% and 62.1% of all patients, respectively. Among 1860 female participants registered within 90 days, 218 participants died during 144,54 person-years of follow-up. More advanced stage, elevation of serum carcinoembryonic antigen and carbohydrate antigen 15-3 levels and absence of the estrogen receptor at study entry were crudely associated with an increased risk of all-cause mortality after adjustment for age. Conclusions: This study showed the association of several clinical characteristics with all-cause mortality in female breast cancer patients.

著者

Ukawa Shigekazu Nakamura Koshi Okada Emiko Hirata Makoto Nagai Akiko Yamagata Zentaro Muto Kaori Matsuda Koichi Ninomiya Toshiharu Kiyohara Yutaka Kamatani Yoichiro Kubo Michiaki Nakamura Yusuke BioBank Japan Cooperative Hospital Group Tamakoshi Akiko

出版者

Elsevier

雑誌

Journal of epidemiology (ISSN:09175040)

巻号頁・発行日

vol.27, no.3, pp.S65-S70, 2017-03

被引用文献数

7

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Background: Prostate cancer is the sixth leading cause of cancer-related deaths in Japan. We aimed to elucidate the clinical and histopathological characteristics of patients with prostate cancer in the BioBank Japan (BBJ) project. Methods: Four thousand, seven hundred and ninety-three patients diagnosed with prostate cancer in the BBJ project were included. Clinical and histopathological data, including causes of death, were analyzed. Relative survival (RS) rates of prostate cancer were calculated. Results: Four thousand, one hundred and seventy-one prostate cancer patients with available histological data had adenocarcinoma. The mean age of the patients was 72.5 years. The proportion of patients who were non-smokers, non-drinkers, had a normal body mass index, did not exercise, had a normal prostate-specific antigen level, and had a family history of prostate cancer were 30.7%, 28.0%, 66.6%, 58.1%, 67.6%, and 6.5%, respectively. The proportion of patients with Stage II, III, and IV disease were 24.4%, 7.3%, and 4.4%, respectively. After limiting to patients with a time from the initial diagnosis of prostate cancer to entry into the study cohort of ≤90 days (n = 869), the 5- and 10-year RS rates were 96.3% and 100.5%, respectively, although we were unable to consider management strategies due to a plenty of data missing. Conclusions: We provide an overview of patients with prostate cancer in the BBJ project. Our findings, coupled with those from various high throughput “omics” technologies, will contribute to the implementation of prevention interventions and medical management of prostate cancer patients.

著者

Jun Hata Akiko Nagai Makoto Hirata Yoichiro Kamatani Akiko Tamakoshi Zentaro Yamagata Kaori Muto Koichi Matsuda Michiaki Kubo Yusuke Nakamura Biobank Japan Cooperative Hospital Group Yutaka Kiyohara Toshiharu Ninomiya

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.27, no.Supplement_III, pp.S71-S76, 2017 (Released:2017-04-14)

参考文献数

33

被引用文献数

9

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Background: Cardiovascular disease (CVD) is a leading cause of death in Japan. The present study aimed to develop new risk prediction models for long-term risks of all-cause and cardiovascular death in patients with chronic phase CVD.Methods: Among the subjects registered in the BioBank Japan database, 15,058 patients aged ≥40 years with chronic ischemic CVD (ischemic stroke or myocardial infarction) were divided randomly into a derivation cohort (n = 10,039) and validation cohort (n = 5019). These subjects were followed up for 8.55 years in median. Risk prediction models for all-cause and cardiovascular death were developed using the derivation cohort by Cox proportional hazards regression. Their prediction performances for 5-year risk of mortality were evaluated in the validation cohort.Results: During the follow-up, all-cause and cardiovascular death events were observed in 2962 and 962 patients from the derivation cohort and 1536 and 481 from the validation cohort, respectively. Risk prediction models for all-cause and cardiovascular death were developed from the derivation cohort using ten traditional cardiovascular risk factors, namely, age, sex, CVD subtype, hypertension, diabetes, total cholesterol, body mass index, current smoking, current drinking, and physical activity. These models demonstrated modest discrimination (c-statistics, 0.703 for all-cause death; 0.685 for cardiovascular death) and good calibration (Hosmer-Lemeshow χ2-test, P = 0.17 and 0.15, respectively) in the validation cohort.Conclusions: We developed and validated risk prediction models of all-cause and cardiovascular death for patients with chronic ischemic CVD. These models would be useful for estimating the long-term risk of mortality in chronic phase CVD.

著者

Hiroshi Yokomichi Hokuto Noda Akiko Nagai Makoto Hirata Akiko Tamakoshi Yoichiro Kamatani Yutaka Kiyohara Koichi Matsuda Kaori Muto Toshiharu Ninomiya Michiaki Kubo Yusuke Nakamura BioBank Japan Cooperative Hospital Group Zentaro Yamagata

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.27, no.Supplement_III, pp.S77-S83, 2017 (Released:2017-04-14)

参考文献数

32

被引用文献数

3

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Background: Controlling serum cholesterol is critical to prevent cardiovascular disease in patients with dyslipidaemia. Guidelines emphasise the need to select treatment for dyslipidaemia based on specific patient profiles; however, there is little information about the serum cholesterol levels of patients in each profile in Japan. Therefore, we aimed to describe the serum cholesterol levels and prevalence of uncontrolled cases in Japanese patients with dyslipidaemia.Methods: We included data for patients with dyslipidaemia between 2003 and 2007 from the BioBank Japan Project (66 hospitals). Then, we reported their serum cholesterol levels by age, body mass index, glycaemic control (glycated haemoglobin A1c), blood pressure, smoking, drinking, comorbidity and medication profiles.Results: We included 22,189 male and 21,545 female patients. The mean serum low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG) and non-HDL-C levels in males were 117.4 mg/dL, 51.0 mg/dL, 187.6 mg/dL and 153.6 mg/dL, respectively; the corresponding levels in females were 129.5 mg/dL, 60.5 mg/dL, 144.9 mg/dL and 157.9 mg/dL, respectively. In both males and females, the LDL-C levels were the highest in the following profiles: age 19–44 years, body mass index 18.5–22 kg/m2, glycated haemoglobin A1c <6.0%, never smoker, chronic respiratory disease as a comorbidity and no medication use.Conclusions: These data provide details of serum cholesterol levels by risk-factor profile in patients with dyslipidaemia and could add evidence of treatment decisions.

著者

Hiroshi Yokomichi Akiko Nagai Makoto Hirata Yutaka Kiyohara Kaori Muto Toshiharu Ninomiya Koichi Matsuda Yoichiro Kamatani Akiko Tamakoshi Michiaki Kubo Yusuke Nakamura BioBank Japan Cooperative Hospital Group Zentaro Yamagata

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.27, no.Supplement_III, pp.S92-S97, 2017 (Released:2017-04-14)

参考文献数

28

被引用文献数

12

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Background: Evidence of characteristics of Japanese patients with diabetes from a large-scale population is necessary. Few studies have compared glycaemic controls, complications and comorbidities between type 1 and 2 diabetic patients. This paper focuses on illustrating a clinical picture of Japanese diabetic patients and comparing glycaemic control and prognoses between type 1 and 2 diabetes using multi-institutional data.Methods: The BioBank Japan Project enrolled adult type 1 and 2 diabetic patients between fiscal years 2003 and 2007. We have presented characteristics, controls of serum glucose, cholesterol and blood pressure, prevalence of complications and comorbidities and survival curves. We have also shown glycaemic controls according to various individual profiles of diabetic patients.Results: A total of 558 type 1 diabetic patients and 30,834 type 2 diabetic patients participated in this study. The mean glycated haemoglobin A1c was higher in type 1 diabetes than in type 2 diabetes. In the type 1 diabetic patients, the glycated haemoglobin A1c had no consistent trend according to age and body mass index. The Kaplan–Meier estimates represented a longer survival time from baseline with type 1 diabetes than with type 2 diabetes. Compared with type 1 diabetic patients, type 2 diabetic patients had double the prevalence of macrovascular complications.Conclusions: This work has revealed detailed plasma glucose levels of type 1 and 2 diabetic patients according to age, body mass index, blood pressure, serum cholesterol levels and smoking and drinking habits. Our data have also shown that the prognosis is worse for type 2 diabetes than for type 1 diabetes in Japan.

著者

Hiroshi Yokomichi Akiko Nagai Makoto Hirata Yutaka Kiyohara Kaori Muto Toshiharu Ninomiya Koichi Matsuda Yoichiro Kamatani Akiko Tamakoshi Michiaki Kubo Yusuke Nakamura BioBank Japan Cooperative Hospital Group Zentaro Yamagata

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.27, no.Supplement_III, pp.S98-S106, 2017 (Released:2017-04-14)

参考文献数

39

被引用文献数

17

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Background: The number of patients with diabetes is increasing worldwide. Macrovascular disease, chronic kidney disease, chronic respiratory disease, cancer and smoking frequently accompany type 2 diabetes. Few data are available related to mortality of Asians with diabetes associated with these serious comorbidities. The present study aimed to quantify the excess mortality risks of type 2 diabetic patients with comorbidities.Methods: We analysed the available records of 30,834 Japanese patients with type 2 diabetes from the BioBank Japan Project between 2003 and 2007. Men and women were followed up for median 8.03 and 8.30 years, respectively. We applied Cox proportional hazard model and Kaplan–Meier estimates for survival curves to evaluate mortality in diabetic patients with or without macrovascular disease, chronic respiratory disease, chronic kidney disease, cancer and smoking.Results: Adjusted hazard ratios (HRs) for mortality were 1.39 (95% CI, 1.09–1.78) for male sex, 2.01 (95% CI, 1.78–2.26) per 10-year increment of age. Adjusted HRs of primary interest were 1.77 (95% CI, 1.42–2.22), macrovascular disease; 1.58 (95% CI, 1.08–2.31), chronic respiratory disease; 2.03 (95% CI, 1.67–2.47), chronic kidney disease; 1.16 (95% CI, 0.86–1.56), cancer; and 1.74 (95% CI, 1.30–2.31), current smoking.Conclusions: Diabetic patients with a past or current history of chronic kidney, macrovascular or respiratory diseases or smoking habit have exhibited the highest risk of mortality. Data were limited to those of survivors of comorbidities but we propose the need to improve comorbidities and terminate cigarette smoking for better prognosis in patients with diabetes.

著者

BITO Seiji FUKUHARA Shunichi SHAPIRO Martin F HASHIMOTO Hideki KUROKAWA Kiyoshi

出版者

日本疫学会

雑誌

Journal of epidemiology (ISSN:09175040)

巻号頁・発行日

vol.11, no.4, pp.160-169, 2001-07

参考文献数

34

被引用文献数

2

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While universal insurance coverage should eliminate or substantially reduce financial and certain structural barriers to medical care, inequity in utilization of care may continue to exist. We conducted a questionnaire survey of a national random sample of 4500 Japanese age16 or over in October, 1995. Separate analyses were conducted to predict the physician visit rates for the entire respondents (N=3395) and for those with chronic conditions (N=777). Forty-three percent of the total subjects reported an ambulatory physician visit within the past three months. About 17% of subjects with one chronic condition and 14% of those with two or more chronic conditions did not have any physician visits within recent three months. The regression model demonstrated that having a home doctor, as well as comorbidity and perceived health status, is significantly associated with outpatient visit both among all subjects (p< 0.0001) and among those with chronic conditions (p< 0.01). The Japanese health system still has unevenness in outpatient resource utilization. This mainly pertains to whether they have their own regular physician. The failure of some persons with chronic diseases to be seen requires further investigation. J Epidemiol, 2001 ; 11 : 160-169

著者

Xing-Gang Zhuo Shaw Watanabe

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.9, no.4, pp.275-284, 1999 (Released:2007-11-30)

参考文献数

28

被引用文献数

12 31

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Dietary factors were analyzed for the regional difference of GI tract cancer mortality rates in China. Sixty-five rural counties were selected among a total of 2, 392 counties to represent a range of rates for seven most prevalent cancers. The dietary data in the selected 65 counties were obtained by three-day dietary record of households in 1983. The four digestive cancer mortality rates (annual cases per 100, 000 standardized truncated rates for ages 35-64) and per capita food consumption were analyzed by the principal components factor analysis. Esophageal cancer associated with poor area, dietary pattern rich in starchy tubers, and salt, lack of consumption of meat, eggs, vegetables and rice. Stomach cancer seemed to be less associated with diet in this study because of its small model Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy, suggesting some other carcinogenic factors would play more important role in the development of this cancer in China. The colon and rectal cancer showed close relation to diet; rich in sea vegetables, eggs, soy sauce, meat and fish, while lack in consumption of milk and dairy products. Rapeseed oil was more important risk factor for colon cancer than that of rectum. Rice, processed starch and sugar were closely associated with colon cancer, supporting the insulin/colon cancer hypothesis. J Epidemiol, 1999 ; 9 : 275-284.

著者

Chushi Kuroiwa Phengta Vongphrachanh Phoxay Xayyavong Kongmany Southalack Masahiro Hashizume Satoshi Nakamura

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.11, no.6, pp.255-262, 2001 (Released:2007-11-30)

参考文献数

22

被引用文献数

5 5

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Following the Pan American Health Organization (PAHO) recommendation on measles elimination, the Western Pacific Region of WHO (WPR) is emphasizing accelerated measles control programme especially since the achievement of polio eradication in WPR in 2000. This includes upgraded surveillance and mass measles vaccination campaign for children aged 9 months to 4 years. However, there are limited scientific evidences supporting the feasibility of this programme in Laos. To examine measles elimination feasibility in the country, we conducted measles outbreak investigation using immunoglobulin M (IgM). From March 1999 to March 2000, we conducted 7 outbreak investigations. At the outbreak sites, we examined clinical manifestations of cases and collected individual data. About five blood samples were drawn from each outbreak, and lgM antibodies to measles were tested. Of 7 investigated outbreaks, 5 were confirmed as measles, one was chickenpox, and one occurred in the inaccessible area due to flooding. In a village of high land Lao, blood drawn was refused. Of 185 cases, 64 (34.6%) cases were immunized, and 110 (59.5%) were unimunized. The estimated vaccine efficacy is 67.9%. The number of measles cases among school-aged children was 74 (40.0%), which represented 2.5% of the total population in investigated villages. Our findings showed various difficulties of the surveillance and the limited outcomes of mass measles vaccination campaign under the accelerated measles control programme by WPR. Efforts to improve cold chain as well as increasing routine immunization coverage must be the priority of measles control. J Epidemiol, 2001 ; 11 : 255-262

著者

Ryoma Michishita Takuro Matsuda Shotaro Kawakami Akira Kiyonaga Hiroaki Tanaka Natsumi Morito Yasuki Higaki

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.26, no.7, pp.378-385, 2016-07-05 (Released:2016-07-05)

参考文献数

36

被引用文献数

1 31

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Background: This cross-sectional study evaluated the association between unhealthy lifestyle behaviors and the prevalence of chronic kidney disease (CKD) in middle-aged and older men.Methods: The subjects included 445 men without a history of cardiovascular disease, stroke, or dialysis treatment, who were not taking medications. Unhealthy lifestyle behaviors were evaluated using a standardized self-administered questionnaire and were defined as follows: 1) lack of habitual moderate exercise, 2) lack of daily physical activity, 3) slow walking speed, 4) fast eating speed, 5) late-night dinner, 6) bedtime snacking, and 7) skipping breakfast. The participants were divided into four categories, which were classified into quartile distributions based on the number of unhealthy lifestyle behaviors (0–1, 2, 3, and ≥4 unhealthy behaviors).Results: According to a multivariate analysis, the odds ratio (OR) for CKD (defined as estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 and/or proteinuria) was found to be significantly higher in the ≥4 group than in the 0–1 group (OR 4.67; 95% confidence interval [CI], 1.51–14.40). Moreover, subjects’ lack of habitual moderate exercise (OR 3.06; 95% CI, 1.13–8.32) and presence of late-night dinner (OR 2.84; 95% CI, 1.40–5.75) and bedtime snacking behaviors (OR 2.87; 95% CI, 1.27–6.45) were found to be significantly associated with the prevalence of CKD.Conclusions: These results suggest that an accumulation of unhealthy lifestyle behaviors, especially those related to lack of habitual moderate exercise and presence of late-night dinner and bedtime snacking may be associated with the prevalence of CKD.

著者

Toshiaki Kawachi Keiko Wada Kozue Nakamura Michiko Tsuji Takashi Tamura Kie Konishi Chisato Nagata

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.26, no.3, pp.123-130, 2016-03-05 (Released:2016-03-05)

参考文献数

39

被引用文献数

2 19

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Background: Few studies have assessed the associations between sleep duration and stroke subtypes. We examined whether sleep duration is associated with mortality from total stroke, ischemic stroke, and hemorrhagic stroke in a population-based cohort of Japanese men and women.Methods: Subjects included 12 875 men and 15 021 women aged 35 years or older in 1992, who were followed until 2008. The outcome variable was stroke death (ischemic stroke, hemorrhagic stroke, and total stroke).Results: During follow-up, 611 stroke deaths (354 from ischemic stroke, 217 from hemorrhagic stroke, and 40 from undetermined stroke) were identified. Compared with 7 h of sleep, ≥9 h of sleep was significantly associated with an increased risk of total stroke and ischemic stroke mortality after controlling for covariates. Hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.51 (95% CI, 1.16–1.97) and 1.65 (95% CI, 1.16–2.35) for total stroke mortality and ischemic stroke mortality, respectively. Short sleep duration (≤6 h of sleep) was associated with a decreased risk of mortality from total stroke (HR 0.77; 95% CI, 0.59–1.01), although this association was of borderline significance (P = 0.06). The trends for total stroke and ischemic stroke mortality were also significant (P < 0.0001 and P = 0.0002, respectively). There was a significant risk reduction of hemorrhagic stroke mortality for ≤6 h of sleep as compared with 7 h of sleep (HR 0.64; 95% CI, 0.42–0.98; P for trend = 0.08). The risk reduction was pronounced for men (HR 0.31; 95% CI, 0.16–0.64).Conclusions: Data suggest that longer sleep duration is associated with increased mortality from total and ischemic stroke. Short sleep duration may be associated with a decreased risk of mortality from hemorrhagic stroke in men.

著者

Ryota Sakurai Hisashi Kawai Hideyo Yoshida Taro Fukaya Hiroyuki Suzuki Hunkyung Kim Hirohiko Hirano Kazushige Ihara Shuichi Obuchi Yoshinori Fujiwara

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20150017, (Released:2016-02-20)

参考文献数

28

被引用文献数

20

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Background: The health benefits of bicycling in older adults with mobility limitation (ML) are unclear. We investigated ML and functional capacity of older cyclists by evaluating their instrumental activities of daily living (IADL), intellectual activity, and social function.Methods: On the basis of interviews, 614 community-dwelling older adults (after excluding 63 participants who never cycled) were classified as cyclists with ML, cyclists without ML, non-cyclists with ML (who ceased bicycling due to physical difficulties), or non-cyclists without ML (who ceased bicycling for other reasons). A cyclist was defined as a person who cycled at least a few times per month, and ML was defined as difficulty walking 1 km or climbing stairs without using a handrail. Functional capacity and physical ability were evaluated by standardized tests.Results: Regular cycling was documented in 399 participants, and 74 of them (18.5%) had ML; among non-cyclists, 49 had ML, and 166 did not. Logistic regression analysis for evaluating the relationship between bicycling and functional capacity revealed that non-cyclists with ML were more likely to have reduced IADL and social function compared to cyclists with ML. However, logistic regression analysis also revealed that the risk of bicycle-related falls was significantly associated with ML among older cyclists.Conclusions: The ability and opportunity to bicycle may prevent reduced IADL and social function in older adults with ML, although older adults with ML have a higher risk of falls during bicycling. It is important to develop a safe environment for bicycling for older adults.

著者

Akira Sakai Tetsuya Ohira Mitsuaki Hosoya Akira Ohtsuru Hiroaki Satoh Yukihiko Kawasaki Hitoshi Suzuki Atsushi Takahashi Gen Kobashi Kotaro Ozasa Seiji Yasumura Shunichi Yamashita Kenji Kamiya Masafumi Abe

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.25, no.1, pp.80-87, 2015-01-05 (Released:2015-01-05)

参考文献数

8

被引用文献数

3 14 2

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Background: Lymphocytes are susceptible to damage from radiation, and the white blood cell (WBC) count, including counts of neutrophils and lymphocytes, is a useful method of dosimetry. According to the basic survey of the Fukushima Health Management Survey (FHMS), among 13 localities where evacuation was recommended, Iitate and Namie had more individuals with external radiation exposure of more than 5 mSv than the other evacuation areas. We analyzed whether or not WBC, neutrophil, and lymphocyte counts decreased after the disaster.Methods: The subjects of this study were 45 278 men and women aged 20 to 99 years (18 953 men and 26 325 women; mean age 56 years) in the evacuation zone who participated in the Comprehensive Health Check (CHC) from June 2011 to the end of March 2012.Results: Significant differences were detected in the mean values of WBC, neutrophil, and lymphocyte counts, and for the proportion of individuals under the minimum standard for WBC and neutrophil counts, among the 13 localities. However, the distribution of individuals at each 200-cell/µL increment in lymphocyte count were similar in these areas, and the WBC, neutrophil, and lymphocyte counts did not decrease in Iitate or Namie specifically.Conclusions: No marked effects of radiation exposure on the distribution of WBC counts, including neutrophil and lymphocyte counts were detected within one year after the disaster in the evacuation zone.

著者

Chadwick John Green Palina de Dauwe Terry Boyle Seyed Mehdi Tabatabaei Lin Fritschi Jane Shirley Heyworth

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.24, no.2, pp.146-153, 2014-03-05 (Released:2014-03-05)

参考文献数

55

被引用文献数

7 32

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Background: Data regarding the effects of tea, coffee, and milk on the risk of colorectal cancer are inconsistent. We investigated associations of tea, coffee, and milk consumption with colorectal cancer risk and attempted to determine if these exposures were differentially associated with the risks of proximal colon, distal colon, and rectal cancers.Methods: Data from 854 incident cases and 948 controls were analyzed in a case-control study of colorectal cancer in Western Australia during 2005–07. Multivariable logistic regression was used to analyze the associations of black tea (with and without milk), green tea, herbal tea, hot coffee, iced coffee, and milk with colorectal cancer.Results: Consumption of 1 or more cups of herbal tea per week was associated with a significantly decreased risk of distal colon cancer (adjusted odds ratio, 0.37; 95% CI, 0.16–0.82; PTrend = 0.044), and consumption of 1 or more cups of iced coffee per week was associated with increased risk of rectal cancer (adjusted odds ratio, 1.52; 95% CI, 0.91–2.54; PTrend = 0.004). Neither herbal tea nor iced coffee was associated with the risk of proximal colon cancer. Hot coffee was associated with a possible increased risk of distal colon cancer. Black tea (with or without milk), green tea, decaffeinated coffee, and milk were not significantly associated with colorectal cancer risk.Conclusions: Consumption of herbal tea was associated with reduced risk of distal colon cancer, and consumption of iced coffee was associated with increased rectal cancer risk.

著者

Mahbubur Rahman Satoshi Morita Tsuguya Fukui Junichi Sakamoto

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.15, no.2, pp.38-40, 2005 (Released:2005-05-10)

参考文献数

4

被引用文献数

4 5

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BACKGROUND: Physicians' perception and attitudes towards a research topic and trial management could influence their participation in a randomized controlled trial. The objectives of this study were to determine the reasons for physicians' participation in and attitudes towards the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial.METHODS: CASE-J's main objective is to compare the effectiveness of an angiotensin II receptor antagonist (candesartan cilexetil) with that of a calcium channel blocker (amlodipine besilate) in terms of the incidence of cardiovascular events among high-risk hypertensive patients. We conducted a questionnaire survey among the physicians (n=512) participating in that trial to determine the reasons behind their participation and to elicit their reactions to the trial management.RESULTS: Eighty-eight percent of the 512 participating physicians responded to our survey. The main reasons for participation were clear objectives of the trial (85.1%), a simple protocol (61.1%), interest in finding out the inhibiting effects of the drugs on cardiac events (80.2%), and a well-organized support system (59.8%). As for negative factors, case registration and follow-up were considered cumbersome by 28.6% and 10.8%, respectively while 44.2% stated that support by the clinical research coordinators provided by the trial management authority was necessary for case screening, recruitment process, patient registration, and follow-up. Multivariate logistic regression analysis showed that participants who did not use a computer very regularly (odds ratio = 1.9, 95% confidence interval = 1.1-3.6) were more likely to consider the case registration and follow-up procedures as a cumbersome.CONCLUSION: The information generated by this study could be useful in designing future randomized controlled trials in Japan and abroad.J Epidemiol2005;15:38-40.

著者

Shizuka Sasazuki Manami Inoue Ichiro Tsuji Yumi Sugawara Akiko Tamakoshi Keitaro Matsuo Kenji Wakai Chisato Nagata Keitaro Tanaka Tetsuya Mizoue Shoichiro Tsugane

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.21, no.6, pp.417-430, 2011-11-05 (Released:2011-11-05)

参考文献数

50

被引用文献数

26 91 16

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Background: We pooled data from 7 ongoing cohorts in Japan involving 353 422 adults (162 092 men and 191 330 women) to quantify the effect of body mass index (BMI) on total and cause-specific (cancer, heart disease, and cerebrovascular disease) mortality and identify optimal BMI ranges for middle-aged and elderly Japanese.Methods: During a mean follow-up of 12.5 years, 41 260 deaths occurred. The Cox proportional hazards model was used to estimate hazard ratios (HRs) for each BMI category, after controlling for age, area of residence, smoking, drinking, history of hypertension, diabetes, and physical activity in each study. A random-effects model was used to obtain summary measures.Results: A reverse-J pattern was seen for all-cause and cancer mortality (elevated risk only for high BMI in women) and a U- or J-shaped association was seen for heart disease and cerebrovascular disease mortality. For total mortality, as compared with a BMI of 23 to 25, the HR was 1.78 for 14 to 19, 1.27 for 19 to 21, 1.11 for 21 to 23, and 1.36 for 30 to 40 in men, and 1.61 for 14 to 19, 1.17 for 19 to 21, 1.08 for 27 to 30, and 1.37 for 30 to 40 in women. High BMI (≥27) accounted for 0.9% and 1.5% of total mortality in men and women, respectively.Conclusions: The lowest risk of total mortality and mortality from major causes of disease was observed for a BMI of 21 to 27 kg/m2 in middle-aged and elderly Japanese.

著者

Shigeru Inoue Yumiko Ohya Yuko Odagiri Tomoko Takamiya Masamitsu Kamada Shinpei Okada Kohichiro Oka Yoshinori Kitabatake Tomoki Nakaya James F Sallis Teruichi Shimomitsu

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.21, no.6, pp.481-490, 2011-11-05 (Released:2011-11-05)

参考文献数

34

被引用文献数

79 111

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Background: Recent research has revealed the importance of neighborhood environment as a determinant of physical activity. However, evidence among elderly adults is limited. This study examined the association between perceived neighborhood environment and walking for specific purposes among Japanese elderly adults.Methods: This population-based, cross-sectional study enrolled 1921 participants (age: 65–74 years, men: 51.9%). Neighborhood environment (International Physical Activity Questionnaire Environmental Module) and walking for specific purposes (ie, transportation or recreation) were assessed by self-report. Multilevel logistic regression analyses with individuals at level 1 and neighborhoods at level 2 were conducted to examine the association between environment and walking, after adjustment for potential confounders.Results: Access to exercise facilities, social environment, and aesthetics were associated with total neighborhood walking. Odds ratios (95% CI) were 1.23 (1.00–1.51), 1.39 (1.14–1.71), and 1.48 (1.21–1.81), respectively. Regarding walking for specific purposes, social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Environmental correlates differed by specific types of walking and by sex. Transportation walking significantly correlated with a greater variety of environmental attributes. Sex differences were observed, especially for transportation walking. Bicycle lanes, crime safety, traffic safety, aesthetics, and household motor vehicles were significant correlates among men, while access to shops, access to exercise facilities, and social environment were important among women.Conclusions: Specific environment–walking associations differed by walking purpose and sex among elderly adults. Social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Improving these environmental features might be effective in promoting physical activity among elderly Japanese.