著者
Shiho Amagasa Noritoshi Fukushima Hiroyuki Kikuchi Koichiro Oka Sebastien Chastin Catrine Tudor-Locke Neville Owen Shigeru Inoue
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20200080, (Released:2020-06-13)
参考文献数
39
被引用文献数
19

Background: Daily step count is the most simple measure of physical activity. However, little is known about how daily step count related to time spent in different intensities of physical activity (PA) and sedentary behavior (SB).Methods: These cross-sectional data were derived from 450 older Japanese adults (56.7% men, mean age 74.3 years) who were randomly selected from three communities and responded a survey. Daily step count and time spent in moderate-to-vigorous PA (MVPA), light-intensity PA (LPA), and SB were measured using a validated wearable technology (HJA-350IT). Associations of daily step count with time spent in measured behaviors were examined by linear regression models using isometric log-ratio transformations of time-use composition, adjusting for gender, age and residential area.Results: Participants averaged 5,412 (SD: 2,878) steps/d and accumulated MVPA, LPA, and SB corresponding to 4.0, 34.8, and 61.2% of daily waking time, respectively. Daily step count significantly increased with increase in time spent in MVPA relative to other behaviors (i.e. LPA and SB) and in the ratio of LPA to SB after allowing for MVPA. After stratification, daily step count was significantly related to the ratio of LPA to SB in those taking <5,000 steps/d, but not in those taking 5,000-7,499 and ≥7,500 steps/d.Conclusions: Higher daily step count can be an indicator of not only larger relative contribution of time spent in MVPA, but also higher ratio between LPA and SB, particularly among those who are the least physically active.
著者
Xiuting Mo Ruoyan Gai Tobe Yoshimitsu Takahashi Naoko Arata Tippawan Liabsuetrakul Takeo Nakayama Rintaro Mori
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20190338, (Released:2020-05-23)
参考文献数
55
被引用文献数
14

Background: This study aims to find evidence of the cost-effectiveness of gestational diabetes mellitus (GDM) screening and assess the quality of current economic evaluations which have shown different conclusions with a variation in screening methods, data sources, outcome indicators, and implementation in diverse organizational contexts.Search Strategy: Embase, Medline, Web of Science, HTA, and NHSEED databases were searched till June 2019.Selection Criteria: Studies on economic evaluation reporting both cost and health outcomes of GDM screening programs in English language.Data Collection and Analysis: The quality of the studies was assessed using Drummond’s checklist. The general characteristics, main assumptions, and results of the economic evaluations were summarized.Main Results: Our search yielded ten eligible economic evaluations with different screening strategies comparison in different settings and perspectives. The selected papers scored 81% (68%–97%) on the items in Drummond’s checklist on average. In general, a screening program is cost-effective (C-E) or even dominant over no screening. The 1-step screening, with more cases detected, is more likely to be C-E than the 2-step screening. Universal screening is more likely to be C-E than screening targeting the high-risk population. Parameters affecting cost-effectiveness include: diagnosis criteria, epidemiological characteristics of the population, efficacy of screening and treatment, and costs.Conclusions: Most studies found GDM screening to be cost-effective, though uncertainties remain due to many factors. The quality assessment identified weaknesses in the economic evaluations in terms of integrating existing data, measuring costs and consequences, analyzing perspectives, and adjusting for uncertainties.
著者
Takashi OSHIO
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20200071, (Released:2020-05-23)
参考文献数
32
被引用文献数
1

Background: The “retired husband syndrome” refers to the negative impact of the husband’s retirement on the wife’s health. This study provided new insights by examining whether and to what extent the wife’s social participation, interactions with her husband, and job status prior to her husband’s retirement affected the evolution of her mental health after her husband’s retirement.Methods: We collected data from a 12-wave nationwide panel survey conducted from 2005 to 2016, starting with individuals aged 50–59 years. Focusing on 3,794 female respondents whose husbands retired during the survey period, we applied random-effects linear regression models to investigate the evolution of their mental health as measured by the Kessler 6 (K6) score (range: 0–24; M: 3.41 SD: 4.11) during the five years after their husbands’ retirement.Results: On average, the wife’s K6 score rose by 0.18 (95% confidence interval [CI]: 0.08–0.28), 0.18 (95% CI: 0.03–0.34), and 0.19 (95% CI: –0.02–0.43) in the first three years, respectively, after the husband’s retirement, before declining toward the baseline level. However, the wife’s active social participation, intense interactions with her husband, and absence of paid employment before her husband’s retirement prevented her mental health from deteriorating.Conclusion: The results suggest the limited relevance of the “retired husband syndrome” among middle-aged Japanese couples. The effects of a husband’s retirement on the wife’s mental health depended heavily on her prior behavior.
著者
Izumi Mishiro Norie Sawada Motoki Iwasaki Kayo Ohashi Shoichiro Tsugane
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.26, no.10, pp.522-529, 2016-10-05 (Released:2016-10-05)
参考文献数
14
被引用文献数
1 1

Background: Some recent molecular epidemiology studies of the effects of genetic and environmental factors on human health have required the enrollment of more than 100 000 participants and the involvement of regional study offices across the country. Although regional study office investigators play a critical role in these studies, including the acquisition of funds, this role is rarely discussed.Methods: We first differentiated the functions of the regional and central study offices. We then investigated the minimum number of items required and approximate cost of a molecular epidemiology study enrolling 7400 participants from a model region with a population of 100 000 for a 4-year baseline survey using a standard protocol developed based on the protocol of Japan Public Health Center-based Prospective Study for the Next Generation.Results: The functions of the regional study office were identified, and individual expenses were itemized. The total cost of the 4-year baseline survey was 153 million yen, excluding consumption tax. Accounting difficulties in conducting the survey were clarified.Conclusions: We investigated a standardized example of the tasks and total actual costs of a regional study office. Our approach is easy to utilize and will help improve the management of regional study offices in future molecular epidemiology studies.
著者
Sachiko Baba Ehab S. Eshak Kokoro Shirai Takeo Fujiwara Yui Yamaoka Hiroyasu Iso
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20190160, (Released:2019-11-02)
参考文献数
37
被引用文献数
8

Background: Spanking can cause adverse psychological development and biological functional changes in children. However, spanking is widely used by parents in Japan. This study explored the risk factors for family member’s spanking of 3.5-year-old children using nationwide population data in Japan.Methods: Surveys were administered to family members in Japan who had a child in 2001 (first cohort) or in 2010 (second cohort), and the data when their child was 0.5, 1.5, and 3.5 years old were used. We used multivariate binary and ordinal logistic regression analyses to examine the associations between risk factors and spanking children at 3.5 years of age, which was subcategorized into frequencies of never, sometimes, and always spanking, presented with odds ratios (ORs) and 95% confidence intervals (CIs).Results: Among 70,450 families, 62.8% and 7.9% sometimes and always spanked their children, respectively. Children in the second cohort were spanked less frequently compared with those in the first cohort, and fathers who responded to the questionnaire spanked children less frequently than mothers who responded. Identified associated factors for spanking were male child, presence of siblings of the child, not living in a two-parent household, not living in a three-generation household, younger parents, parents with lower education, no outside work or unstable work, and lower family income.Conclusions: We found a high prevalence of spanking and its associated factors. Approaching those with lower socioeconomic factors and promoting fathers’ involvement in parenting may be important public health strategies for reducing and preventing spanking.
著者
Kaori Sakurada Tsuneo Konta Masafumi Watanabe Kenichi Ishizawa Yoshiyuki Ueno Hidetoshi Yamashita Takamasa Kayama
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.30, no.4, pp.188-193, 2020-04-05 (Released:2020-04-05)
参考文献数
23
被引用文献数
30

Background: Positive and negative psychological factors are associated with mortality and cardiovascular disease. This study prospectively investigated associations of daily frequency of laughter with mortality and cardiovascular disease in a community-based population.Methods: This study included 17,152 subjects ≥40 years old who participated in an annual health check in Yamagata Prefecture. Self-reported daily frequency of laughter was grouped into three categories (≥1/week; ≥1/month but <1/week; <1/month). Associations of daily frequency of laughter with increase in all-cause mortality and cardiovascular disease incidence were determined using Cox proportional hazards modeling.Results: During follow-up (median, 5.4 years), 257 subjects died and 138 subjects experienced cardiovascular events. Kaplan-Meier analysis revealed that all-cause mortality and cardiovascular disease incidence were significantly higher among subjects with a low frequency of laughter (log-rank P < 0.01). Cox proportional hazard model analysis adjusted for age, gender, hypertension, smoking, and alcohol drinking status showed that risk of all-cause mortality was significantly higher in subjects who laughed <1/month than in subjects who laughed ≥1/week (hazard ratio [HR] 1.95; 95% confidence interval [CI], 1.16–3.09). Similarly, risk of cardiovascular events was higher in subjects who laughed ≥1/month but <1/week than in subjects who laughed ≥1/week (HR 1.62; 95% CI, 1.07–2.40).Conclusion: Daily frequency of laughter represents an independent risk factor for all-cause mortality and cardiovascular disease in a Japanese general population.
著者
Jing Sun Zhaoying Li Yan Li Dongfeng Zhang
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20200003, (Released:2020-04-11)
参考文献数
62
被引用文献数
9

Background: Epidemiological evidence on the relationships between different categories of vegetables and fruits and depressive symptoms is very limited and inconsistent, especially with no evidence from the general population. This study aimed to estimate their relationships among a large general population.Methods: The cross-sectional design was based on the National Health and Nutrition Examination Survey (2007–2014) and included 16925 adults. Dietary information was attained from two nonconsecutive 24-h dietary recalls. Patient Health Questionnaire was applied for measuring depressive symptoms. The associations between vegetables and fruits intakes and depressive symptoms were appraised utilizing logistic regression and restricted cubic spline.Results: Compared with the lowest category, the most adjusted odds ratios (95% confidence intervals, CI) of depressive symptoms for the highest category of tomatoes and tomato mixtures were 0.81 (95% CI, 0.66-0.99), and 0.64 (95% CI, 0.48-0.85) for dark-green, 0.67 (95% CI, 0.53-0.84) for other vegetables, 0.48 (95% CI, 0.29-0.79) for berries, 0.67 (95% CI, 0.55-0.82) for total vegetables, and 0.70 (95% CI, 0.57-0.86) for total fruits, and for the medium categories of bananas and dried fruits were 0.62 (95% CI, 0.41-0.95) and 0.39 (95% CI, 0.19-0.81), respectively. After sensitivity analysis by further excluding subjects with co-morbid health conditions, these findings remained significant, except for bananas. An L-shaped relationship was observed between depressive symptoms and total vegetables, while the association was linear with total fruits.Conclusions: Intakes of tomatoes and tomato mixtures, dark-green, other vegetables, berries, dried fruits, total vegetables, and total fruits were inversely related to depressive symptoms among adults.
著者
Ryosuke Fujii Hiroya Yamada Eiji Munetsuna Mirai Yamazaki Koji Ohashi Hiroaki Ishikawa Keisuke Maeda Chiharu Hagiwara Yoshitaka Ando Shuji Hashimoto Nobuyuki Hamajima Koji Suzuki
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.30, no.4, pp.177-182, 2020-04-05 (Released:2020-04-05)
参考文献数
63
被引用文献数
13

Background: MicroRNAs (miRNAs) play crucial roles in the development of various diseases, including chronic kidney disease (CKD). Although previous studies in clinically severe patients have investigated associations between CKD and miRNAs, with particular attention on renal fibrosis, relationships in a general population have yet to be established. The aim of this study was to examine the relationship between expression level of circulating miRNAs and CKD in a middle-aged Japanese population.Methods: A final total of 513 individuals (216 men and 297 women) who participated in the health check-up program in 2012 were included in our analysis. Quantitative real-time polymerase chain reaction was used to determine expression levels of 22 miRNAs. Estimated glomerular filtration rate (eGFR) was calculated based on serum creatinine level, sex, and age. Participants with eGFR <60 mL/min/1.73 m2 were defined as having CKD.Results: Three different miRNAs (miR-17, miR-21, and miR-150) showed significant correlations with eGFR after Bonferroni correction and were selected for further analyses. Expression levels of miR-17, miR-21, and miR-150 miRNAs were positively associated with eGFR after adjusting for potential confounders (P = 0.004, 0.002, and 0.004, respectively). Logistic regression analyses showed significantly lower odds ratios for CKD (eGFR <60 mL/min/1.73 m2) in the highest tertile of all three miRNAs (miR-17, miR-21, and miR-150) compared with the lowest tertile (P = 0.003, 0.01, and 0.02, respectively).Conclusions: We found that three circulating miRNAs were significantly associated with CKD in a general Japanese population, which suggested that these miRNAs may be biomarkers for CKD among general adults.
著者
Hideto Suzuki Wakako Hikiji Takanobu Tanifuji Nobuyuki Abe Tatsushige Fukunaga
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.25, no.2, pp.126-132, 2015-02-05 (Released:2015-02-05)
参考文献数
21
被引用文献数
19 41

Background: Sudden bath-related deaths occur frequently in Japan, particularly among elderly people. However, the precise mechanism of bath-related death remains uncertain, and effective prevention strategies have not been established.Methods: Cases of bath-related deaths (n = 3289) were selected from all cases handled by the Tokyo Medical Examiner’s Office from 2009 to 2011 (N = 41 336). The ages and occurrence dates were examined, and major autopsy findings, including toxicological analysis, were evaluated for the autopsied cases (n = 550).Results: Most cases occurred in individuals older than 60 years of age during winter. Analysis of autopsy findings revealed water inhalation signs in many cases (n = 435, 79.1%). Circulatory system diseases constituted more than half of the pathological findings regarding factors that may have contributed significantly to death (n = 300, 54.5%), and cardiac lesions were the most common pathological finding (n = 250, 45.5%). However, approximately one-third of the cases exhibited no remarkable pathological findings (n = 198, 36.0%). A quarter of all cases involved blood ethanol levels that exceeded 0.5 mg/mL (n = 140).Conclusions: The results suggested that drowning plays an important role in the final process of bath-related death. Circulatory system diseases may be the primary underlying pathology; however, there were variations in the medical histories and pathologies of cases of bath-related death. From a preventive perspective, family members should pay attention to elderly people with circulatory system diseases during bathing, particularly in winter. Additionally, the notion that ill or inebriated individuals should not take baths should be reinforced.
著者
Mana Kogure Naho Tsuchiya Akira Narita Takumi Hirata Naoki Nakaya Tomohiro Nakamura Atsushi Hozawa Takehito Hayakawa Nagako Okuda Naoko Miyagawa Aya Kadota Takayoshi Ohkubo Yoshitaka Murakami Kiyomi Sakata Katsuyuki Miura Akira Okayama Tomonori Okamura Hirotsugu Ueshima
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20190234, (Released:2020-02-08)
参考文献数
20
被引用文献数
4

Background: Major reasons for long-term care insurance certification in Japan are stroke, dementia and fracture. These diseases are reported to be associated with calcium intake. This study examined the association between calcium intake and impaired activities of daily living (ADL) using the data from NIPPON DATA90, consisting of representative sample of the Japanese population.Methods: A population-based nested case control study was performed. A baseline survey was conducted in 1990, followed by ADL surveys of individuals ≥65 years old in 2000. Individuals with impaired ADL and selected age- and sex-matched controls were then identified. We obtained 132 pairs. Calcium intake was energy-adjusted using the residual method. The association between calcium intake and impaired ADL was examined using conditional logistic regression models. To assess the accuracy of the estimates, we conducted bootstrap analyses.Results: The adjusted odds ratios (ORs) for impaired ADL compared with the group with a calcium intake of <476 mg/day were 0.72 (95% confidence interval, 95% CI: 0.37-1.40) for the 476-606 mg/day group and 0.44 (0.21-0.94) for the ≥607 mg/day group in 2000 (P for linear trend = 0.03). After the bootstrap analyses, the inverse relationship unchanged (median OR per 100-mg rise in calcium intake: 0.87 [1,000 resamplings], 95% CI: 0.76-0.97).Conclusions: After bootstrap analyses, calcium intake was inversely associated with impaired ADL, 10 years after the baseline survey.
著者
Xing-Bing Pan Hui-Jun Wang Bing Zhang Ying-Li Liu Su-Fen Qi Qing-Bao Tian
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.30, no.3, pp.128-135, 2020-03-05 (Released:2020-03-05)
参考文献数
32
被引用文献数
8

Background: The prevalence of overweight is increasing dramatically worldwide. The aim of our study was to investigate the association of plain water intake (PWI) with the risk of new-onset overweight risk among Chinese adults.Methods: A total of 3,200 adults aged 18–65 who were free of overweight at baseline were enrolled from China Health and Nutrition Survey (CHNS) cohort study in 2006–2011. The risk of new-onset overweight with different amounts of PWI per day was analyzed in this 5-year cohort. A multiple logistic regression model was used to assess the association of PWI and the risk of new-onset overweight and adjust for potential confounders. Moreover, dose-response models were developed to estimate the linear relationship.Results: During 5 years of follow-up, 1,018 incident cases were identified. Our analysis indicated an inverse association of more than 4 cups of PWI per day and the risk of new-onset overweight among normal weight individuals. Compared with participants who drank 2 to 3 cups PWI, the adjusted odds ratios (OR) of overweight were 0.741 (95% confidence interval [CI], 0.599–0.916) in participants who drank 4 to 5 cups PWI, and 0.547 (95% CI, 0.435–0.687) in participants who drank more than 6 cups PWI. The dose-response analysis showed that every cup of PWI was associated with a 6.5% and 8.4% decrease in the risk of new-onset overweight among men and women, respectively. The interactions of PWI and covariates on the risk of overweight were not found.Conclusion: Drinking more than 4 cups (≈1 liter) per day of plain water is associated with decrease in the risk of new-onset overweight among normal-weight individuals.
著者
Fuyu Miyake Chimed-Ochir Odgerel Yuko Mine Tatsuhiko Kubo Toshiharu Ikaga Yoshihisa Fujino
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20190312, (Released:2020-03-07)
参考文献数
29
被引用文献数
3

Background: Customarily, bedrooms in Japan are left unheated. Although several studies have reported that the use of a heating system has positive outcomes on respiratory infection and asthma, the preventive effect of heating systems against infectious diseases in children is not well known.Methods: We conducted a cohort study using two questionnaire surveys, one before the winter season in November, 2018 and the second after winter in March, 2019.Participants were 155 children who did not use a heating system in the bedroom and 156 children who did.Results: Having a heated bedroom with a heating system was associated with decreased odds for the frequency of cold (≥3 times) (adjust odds ratio (AOR): 0.35, 95% confidence interval (CI): 0.19-0.65), duration of fever (≥3 days) (AOR: 0.38, 95% CI: 0.22- 0.66), duration of medicine for a cold (≥3 days) (AOR: 0.91, 95% CI: 0.87-0.95), hospital visit due to cold (≥3 days) (AOR: 0.54, 95% CI: 0.31-0.94), absence from school or nursery (≥3 days) (AOR: 0.43, 95% CI: 0.27-0.70), influenza infection (AOR: 0.43, 95% CI: 0.26-0.71) and gastroenteritis (AOR: 0.39, 95% CI: 0.21-0.72). Influenza vaccination reduced the odds of influenza infection (AOR: 0.36, 95% CI: 0.22-0.59) and absence from school or nursery (≥3days<=) (AOR: 0.62, 95% CI: 0.39-0.99).Conclusion: This study implies that the heating of bedrooms may have a preventive effect against infections among children. Broader dissemination of this knowledge in Japan will require cultural change through public health awareness.
著者
Tetsuhisa Kitamura Kosuke Kiyohara Tasuku Matsuyama Toshihiro Hatakeyama Tomonari Shimamoto Junichi Izawa Chika Nishiyama Taku Iwami
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20150100, (Released:2015-12-05)
参考文献数
30
被引用文献数
4 10

Background: Outcomes after out-of-hospital cardiac arrests (OHCAs) might be worse during academic meetings because many medical professionals attend them.Methods: This nationwide population-based observation of all consecutively enrolled Japanese adult OHCA patients with resuscitation attempts from 2005 to 2012. The primary outcome was 1-month survival with a neurologically favorable outcome. Calendar days at three national meetings (Japanese Society of Intensive Care Medicine, Japanese Association for Acute Medicine, and Japanese Circulation Society) were obtained for each year during the study period, because medical professionals who belong to these academic societies play an important role in treating OHCA patients after hospital admission, and we identified two groups: the exposure group included OHCAs that occurred on meeting days, and the control group included OHCAs that occurred on the same days of the week 1 week before and after meetings. Multiple logistic regression analysis was used to adjust for confounding variables.Results: A total of 20 143 OHCAs that occurred during meeting days and 38 860 OHCAs that occurred during non-meeting days were eligible for our analyses. The proportion of patients with favorable neurologic outcomes after whole arrests did not differ during meeting and non-meeting days (1.6% [324/20 143] vs 1.5% [596/38 855]; adjusted odds ratio 1.02; 95% confidence interval, 0.88–1.19). Regarding bystander-witnessed ventricular fibrillation arrests of cardiac origin, the proportion of patients with favorable neurologic outcomes also did not differ between the groups.Conclusions: In this population, there were no significant differences in outcomes after OHCAs that occurred during national meetings of professional organizations related to OHCA care and those that occurred during non-meeting days.
著者
Isabelle Savoye Catherine M Olsen David C Whiteman Anne Bijon Lucien Wald Laureen Dartois Françoise Clavel-Chapelon Marie-Christine Boutron-Ruault Marina Kvaskoff
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.28, no.1, pp.27-33, 2018-01-05 (Released:2018-01-05)
参考文献数
52
被引用文献数
1 86

Background: While ultraviolet (UV) radiation exposure is a recognized risk factor for skin cancer, associations are complex and few studies have allowed a direct comparison of exposure profiles associated with cutaneous melanoma, basal-cell carcinoma (BCC), and squamous-cell carcinoma (SCC) within a single population.Methods: We examined associations between UV exposures and skin cancer risk in a nested case-control study within E3N, a prospective cohort of 98,995 French women born in 1925–1950. In 2008, a lifetime UV exposure questionnaire was sent to all reported skin cancer cases and three controls per case, which were matched on age, county of birth, and education. Analyses were performed using conditional logistic regression and included 366 melanoma cases, 1,027 BCC cases, 165 SCC cases, and 3,647 controls.Results: A history of severe sunburns <25 years was associated with increased risks of all skin cancers (melanoma: OR 2.7; BCC: OR 1.7; SCC: OR 2.0 for ≥6 sunburns vs. none), while sunburns ≥25 years were associated with BCC and SCC only. While high-sun protection factor sunscreen use before age 25 was associated with lower BCC risk (Ptrend = 0.02), use since age 25 and reapplication of sunscreen were associated with higher risks of all three types of skin cancer. There were positive linear associations between total UV score and risks of BCC (Ptrend = 0.01) and SCC (Ptrend = 0.09), but not melanoma. While recreational UV score was strongly associated with BCC, total and residential UV scores were more strongly associated with SCC.Conclusions: Melanoma, BCC, and SCC are associated with different sun exposure profiles in women.
著者
Atsushi Miyawaki Yasuki Kobayashi Ichiro Kawachi
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.30, no.2, pp.67-73, 2020-02-05 (Released:2020-02-05)
参考文献数
49
被引用文献数
12

Background: The association of sensory loss with mortality remains unclear. We aimed to explore the associations of hearing loss (HL), visual loss (VL), and dual sensory loss (DSL) with survival.Methods: Data came from the Komo-Ise study cohort in Gunma Prefecture, Japan, where the community-dwelling residents aged 40–69 years were followed up from 1993 to 2010. We analyzed 9,522 individuals who answered the follow-up questionnaires in 2000 (average age 64 [range, 47 to 77] years in 2000). The primary exposures were “HL only,” “VL only,” or “DSL”, with “no HL/VL” as the reference. These sensory loss statuses were assessed by asking the difficulty in hearing conversation or reading newspaper even with aids in the follow-up questionnaires in 2000. All-cause and cause-specific mortality were ascertained from linkage to death certificate data. Cox proportional hazards models adjusting for confounders, including demographic factors, socioeconomic status, and health status, were used. Potential mediators (depression, walking disability, and social participation) were additionally adjusted for.Results: There were 1,105 deaths over the 10-year follow-up. After adjustment for the potential confounders, HL and DSL were associated with increased all-cause mortality (hazard ratios of 1.74 [95% CI, 1.18–2.57] and 1.63 [95% CI, 1.09–2.42], respectively). Potential mediators explained a modest portion of the association. As for cause-specific mortality, HL was associated with increased cancer mortality, while VL and DSL were associated with increased cardiovascular disease mortality.Conclusions: Self-reported HL and DSL may be risk factors of mortality among middle-aged or elderly Japanese populations.
著者
Yukari Taniyama Takahiro Tabuchi Yuko Ohno Toshitaka Morishima Sumiyo Okawa Shihoko Koyama Isao Miyashiro
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20190242, (Released:2020-01-11)
参考文献数
30
被引用文献数
6

Background: The impact of hospital surgical volume on long-term mortality has not been well assessed in Japan, especially for esophageal, biliary tract, and pancreatic cancer, although these three cancers need a high-level of medical technical skill. The purpose of this study was to examine associations between hospital surgical volume and 3-year mortality for these severe prognosis cancer patients.Methods: Patients who received curative surgery for esophageal, biliary tract, and pancreatic cancers were analyzed using Osaka Cancer Registry data from 2006-2013. Hospital surgical volume was categorized into tertiles (high/middle/low) according to the average annual number of curative surgeries per hospital for each cancer. Three-year survivals were calculated using the Kaplan-Meier method. Hazard ratios (HRs) of 3-year mortality were calculated using Cox proportional hazard models, adjusting for patient characteristics.Results: Three-year survival was higher with increased hospital surgical volume for all three cancers, but the relative importance of volume varied across sites. After adjustment for all confounding factors, HRs (95% Confidence interval [CI]) in middle- and low-volume hospitals were 1.34 (95% CI, 1.14-1.58) and 1.57 (95% CI, 1.33-1.86) for esophageal cancer; 1.39 (95% CI, 1.15-1.67) and 1.57 (95% CI, 1.30-1.89) for biliary tract cancer; 1.38 (95% CI, 1.16-1.63) and 1.90 (1.60-2.25) for pancreatic cancer, respectively. In particular localized pancreatic cancer, the impact of hospital surgical volume on 3-year mortality was strong (HRs: 2.66 [95% CI, 1.61-4.38]).Conclusion: We suggest that patients who require curative surgery for esophageal, biliary tract, and pancreatic cancer may benefit from referral to high-volume hospitals.
著者
Yuan-Qing Fu Ju-Sheng Zheng Bo Yang Duo Li
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20140120, (Released:2015-03-14)
参考文献数
52
被引用文献数
15 33

Epidemiological studies have suggested inconsistent associations between omega-3 polyunsaturated fatty acids (n-3 PUFAs) and prostate cancer (PCa) risk. We performed a dose-response meta-analysis of prospective observational studies investigating both dietary intake and circulating n-3 PUFAs and PCa risk. PubMed and EMBASE prior to February 2014 were searched, and 16 publications were eligible. Blood concentration of docosahexaenoic acid, but not alpha-linolenic acid or eicosapentaenoic acid, showed marginal positive association with PCa risk (relative risk for 1% increase in blood docosahexaenoic acid concentration: 1.02; 95% confidence interval, 1.00–1.05; I2 = 26%; P = 0.05 for linear trend), while dietary docosahexaenoic acid intake showed a non-linear positive association with PCa risk (P < 0.01). Dietary alpha-linolenic acid was inversely associated with PCa risk (relative risk for 0.5 g/day increase in alpha-linolenic acid intake: 0.99; 95% confidence interval, 0.98–1.00; I2 = 0%; P = 0.04 for linear trend), which was dominated by a single study. Subgroup analyses indicated that blood eicosapentaenoic acid concentration and blood docosahexaenoic acid concentration were positively associated with aggressive PCa risk and nonaggressive PCa risk, respectively. Among studies with nested case-control study designs, a 0.2% increase in blood docosapentaenoic acid concentration was associated with a 3% reduced risk of PCa (relative risk 0.97; 95% confidence interval, 0.94–1.00; I2 = 44%; P = 0.05 for linear trend). In conclusion, different individual n-3 PUFA exposures may exhibit different or even opposite associations with PCa risk, and more prospective studies, especially those examining dietary n-3 PUFAs and PCa risk stratified by severity of cancer, are needed to confirm the results.