Language：English   Publishing type：Research paper (scientific journal)  

Coronary artery calcium (CAC), which is detected using computed tomography scanning, is a well-established indicator of subclinical atherosclerosis. The CAC score is independently associated with atherosclerotic cardiovascular disease (ASCVD) outcomes and provides improved predictive values for estimating the risk of ASCVD beyond traditional risk factors. Thus, CAC is considered to have important implications for reclassification as a decision aid among individuals in the preclinical phase and as the primary prevention of ASCVD. This review is focused on epidemiological evidence on CAC in asymptomatic population-based samples from Western countries and Japan. We also discuss the usability of CAC as a tool for assessing ASCVD risk and its role in the primary prevention of ASCVD. A lack of evidence for the CAC score in ASCVD risk assessment beyond traditional risk factors in populations other than those in Western countries (including Japan) warrants further investigation. Clinical trials are also necessary to demonstrate the usefulness and safety of CAC screening in the primary prevention of ASCVD.

DOI： 10.5551/jat.RV22009

PubMed

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Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一財)厚生労働統計協会  

目的 平成19年,統計法が60年ぶりに改正され,厚生労働省が実施する人口動態調査等の公的統計データの二次利用に関する規定により,死亡票に記載された死因の県間比較調査や研究が推進されることとなった。しかしながら,人口動態調査に基づく死亡率について,長期的動向の県間比較を行う際,「死因簡単分類名の心疾患(高血圧性を除く)を構成する内訳病名(ICD-10小分類相当,以下,内訳病名)」を用いることの課題点を検証した報告は見当たらない。そこでわれわれは,平成29年度環境省委託事業「放射線健康管理・健康不安対策事業(放射線の健康影響に係る研究調査事業)」「福島県内外での疾病動向の把握に関する調査研究」の一環として,死因簡単分類名の「心疾患(高血圧性を除く)」における内訳病名別死亡率の長期的動向の県間比較を行い,その課題点を検証した。方法 1995年から2015年までの人口動態調査の二次利用提供データを用いて,福島県と近隣9県(岩手,宮城,山形,茨城,栃木,群馬,埼玉,千葉,新潟)の40～79歳日本人男女を対象として,10県全体および各県別の「心疾患(高血圧性を除く)」(ICD-10:I01-I02.0,I05-I09,I20-I25,I27,I30-I52,以下,心疾患)の内訳病名割合(%)を5年ごとに算出し,上位10位までの疾患を比較した。結果 「心疾患」において,1995年では,10県全体における内訳病名上位10疾患は,1位の「急性心筋梗塞,詳細不明(I21.9)」が約半数を占め,次いで「心不全,詳細不明(I50.9)」が約1/5を占めていた。各県別の全期間における「心疾患」の内訳病名割合は,山形・福島・茨城ではほぼ変化が認められなかった。しかしながら,岩手・宮城・千葉・新潟は1995年時点で全体の数%であった「心臓性突然死<急死>と記載されたもの(I46.1)」が,2015年には全体の約15～40%に,宮城・栃木・埼玉は1995年時点で全体の数%であった「急性虚血性心疾患,詳細不明(I24.9)」が,2015年では全体の約13～35%に,群馬は1995年時点で全体の数%であった「心疾患,詳細不明(I51.9)」が,2015年では全体の約35%に,それぞれ大幅に増加していた。その逆に,それら7県では,心筋梗塞や心不全の割合は減少傾向がみられた。結論 「心疾患」の内訳病名は,急性心筋梗塞や心不全などの主要な病名の頻度が1995年以降の20年間で変化の仕方が県によって大きく異なり,判定基準が統一されていないことが明らかとなったことから,死亡率の長期的動向や県間比較には,単純に内訳病名を用いることは適切でないことが示唆された。(著者抄録)

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Authorship：Lead author   Publishing type：Research paper (scientific journal)  

J-GLOBAL

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Ambient temperature and blood pressure (BP) are closely related; however, few studies have examined the association of out-of-office BP with indoor or outdoor temperature. The effect of the difference between indoor and outdoor temperatures on BP also remains unknown. Therefore, this study aimed to investigate the association of indoor and outdoor temperatures and their difference with home BP. We studied healthy 352 participants (mean age, 49.8 years; 46.0% women) from a population-based cohort using 2-year data on temperature and self-measured home BP. We measured home BP and indoor temperature at the same time in the morning and evening every day. Outdoor temperature during the same period was based on national data. We observed 82,900 home BP measurements in the morning and 66,420 in the evening. In the mixed-effects model adjusted for age, sex, and possible confounders, indoor temperature was inversely associated with systolic and diastolic BP in the morning and evening. A 1 °C increase in indoor temperature reduced systolic and diastolic BP by 0.37 and 0.22 mmHg, respectively, in the morning and by 0.45 and 0.30 mmHg, respectively, in the evening (all P-values<0.001). The magnitude of associations was stronger for indoor than outdoor temperature. Similarly, a 1 °C increase in indoor temperature above outdoor temperature decreased systolic and diastolic BP by 0.33 and 0.12 mmHg, respectively, in the morning and by 0.45 and 0.26 mmHg, respectively, in the evening independent of outdoor temperature (all P-values <0.001). In conclusion, controlling indoor temperature is important to stabilize home BP levels.

DOI： 10.1038/s41440-022-01059-z

PubMed

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)  

There has been an increase in lifestyle-related diseases in Fukushima Prefecture since the Great East Japan Earthquake. However, the overall long-term trends of lifestyle-related diseases in the Fukushima Prefecture according to the evacuation and other area are not reported. Therefore, we examined the long-term trends in the prevalence of metabolic syndrome before and after the Great East Japan Earthquake in Fukushima Prefecture according to these areas using a national database. The target population was approximately 330,000-440,000 per year; Fukushima Prefecture residents aged 40-74 years who underwent specific health check-ups during 2008-2017 participated in the study. Fukushima was divided into mountainous, central, coastal and evacuation areas. Using the Poisson regression model, the prevalence of metabolic syndrome in each fiscal year was determined by gender and age group for each location and compared before and after the disaster as well as between areas. Prevalence increased significantly throughout the observation period, particularly in the evacuation area. Age- and gender-adjusted prevalence rates significantly increased from 16.2% in 2010 to 19.5% in 2012 (prevalence ratios = 1.21) and 20.4% in 2017 in the evacuation area. Among other areas, coastal areas showed the highest increase with 17.9% (2017), followed by central areas with 16.5% (2017) and mountainous areas with 18.3% (2016). These increases were particularly high among men and the elderly. The prevalence of metabolic syndrome increased rapidly after the disaster, especially in evacuation area, and continued for subsequent 6-7 year. Long-term monitoring and measures to prevent lifestyle-related diseases are needed after major disasters, especially in evacuation areas, among men and the elderly.

DOI： 10.3390/ijerph19159492

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

Early diagnosis and treatment are necessary to prevent lifestyle-related diseases among high-risk individuals. This study aimed to examine the impact of counselor characteristics on clinic visits among individuals at high risk for lifestyle-related diseases. A total of 8975 patients aged 40 to 74 years with lifestyle-related comorbidities, who underwent an annual health checkup and received health counseling, were included in this study. Data intervention timing, mode of counseling, number of counseling sessions, and explanation methods were collected. We assessed the impact of counselor characteristics, including profession (public health nurse, clinical nurse, and nutritionist), age, and years of counseling experience, on counseling outcomes. The probability ratios (95% confidence intervals) of clinic visits were 1.22 (1.11–1.35) for public health nurses and 1.04 (0.90–1.20) for nurses compared with nutritionists. After adjustment for participant and counselor characteristics and initial timing, mode, and number of counseling sessions, the corresponding probability ratios (95% confidence intervals) were 1.16 (1.05–1.29) and 1.12 (0.95–1.31), respectively. Counselor age and years of experience did not influence clinic visits of the target population. Public health nurses were more effective in increasing clinic visits among the target population owing to their profession-specific knowledge, skills, and experience.

DOI： 10.3390/ijerph19116375

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Epidemiological Association  

DOI： 10.2188/jea.je20200598

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: It is uncertain whether health counselling after community-based health checkups for high-risk individuals of lifestyle-related disease enhances their referral to physicians. METHODS: We performed a clustered randomized controlled trial of untreated high-risk individuals aged 40 to 74 years who were screened from the annual health checkup in 2014 and 2015 under the national health insurance in 43 municipalities around Japan, assigning 21 intervention and 22 usual care municipalities. The high-risk conditions were severe forms of hypertension, diabetes, dyslipidemia (for men), and proteinuria. For the intervention group, the theory-based health counselling was performed to enhance referrals to physicians, while each municipality performed its own standard counselling for the usual care group. Data on clinical visits and risk factors were collected systematically and anonymously from the databases of health insurance qualification, health insurance claims, and annual health checkups. Hypotheses are that the cumulative proportion of seeing physicians (clinical visits) is higher in the intervention than the usual care groups, and that those in the intervention group have lower cumulative incidence of composite outcomes associated with lifestyle-related diseases. RESULTS: The numbers of subjects for the analyses were 8,977 in the intervention group and 6,733 in the usual care group. Among them, 6,758 had hypertension, 2,147 had diabetes, 2,861 had dyslipidemia, and 1,221 had proteinuria in the intervention group, with corresponding numbers of 4,833, 1,517, 2,262, and 845, respectively, in the usual care group. There were no material differences in mean levels and proportions of major cardiovascular risk factors between the two groups. CONCLUSIONS: We expect to provide scientific evidence on the effectiveness of health counselling.

DOI： 10.2188/jea.JE20180194

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

There is limited evidence examining the association between B vitamin supplementation and improved endothelial function via lowering plasma homocysteine levels. This study investigated whether low-dose B vitamin supplementation improves endothelial dysfunction in Japanese adults with one or more components of metabolic syndrome. A randomized, controlled, crossover trial, without a washout period or blinding of subjects, was conducted from May-September, 2010. The subjects were 127 Japanese men and women aged 40-65 years who had at least one component of metabolic syndrome without medication. Participants took a supplement drink for two months but were divided into early intervention or later intervention groups. The flow-mediated dilatation, plasma homocysteine level, serum B-vitamins, and vitamin C levels were measured. A significant increase in serum B vitamins and vitamin C levels, and a reduction in plasma homocysteine levels were observed. The mean serum homocysteine level pre- and post-intervention was 9.8 and 8.2 µmol/L in the early intervention group and 10.8 and 7.4 µmol/L in the later intervention group (p<0.01). However, no significant changes in flow-mediated dilatation was found. Low-dose multivitamin supplementation including B vitamins is associated with a significant reduction in plasma homocysteine levels among patients with one or more components of metabolic syndrome. This study was registered at the University Hospital Medical Information Network (UMIN) centre, and has the identifier UMIN000004436.

DOI： 10.3164/jcbn.17-56

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: Studies have shown that elevated high-sensitivity C-reactive protein (hs-CRP) predicts stroke, which is a risk factor for dementia. It remains, however, unclear whether hs-CRP increases risk of dementia. METHODS: A prospective nested case-control study of Japanese 40-69 years of age was conducted using frozen serum samples collected from approximately 7531men and women who participated in cardiovascular risk surveys from 1984 to 1994 in one community and 1989-1995 in another community under the Circulatory Risk in Communities Study (CIRCS). Two control subjects per case were matched by sex, age, community, and year of serum storage. The hs-CRP was measured using a latex particle-enhanced immunonephelometric assay. RESULTS: Between 1999 and 2013, we identified 275 disabling dementia cases (96 cases with history of stroke and 179 without it). There was a positive association between hs-CRP levels and risk of dementia with history of stroke. No significant association was observed between hs-CRP levels and risk of dementia without history of stroke. After adjustment for hypertension, diabetes and other confounding variables, the positive association remained statistically significant. The multivariable odds ratios associated with 1-SD increment of log hs-CRP were 1.02 (0.87-1.20) for total dementia, 1.35 (1.02-1.79) for dementia with history of stroke, and 0.89 (0.72-1.10) for dementia without history of stroke. CONCLUSION: Elevated hs-CRP levels were associated with increased risk of disabling dementia in individuals with history of stroke but not in those without it.

DOI： 10.1016/j.atherosclerosis.2014.07.036

PubMed

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Language：Japanese   Publisher：(株)医学書院  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J00447&link_issn=&doc_id=20140501090006&doc_link_id=10.11477%2Fmf.1401103008&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1401103008&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：日本公衆衛生学会  

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OBJECTIVE: There is little evidence concerning risk factors for sudden cardiac death (SCD) among Asians. PATIENTS AND METHODS: A prospective, nested, case-control study of Japanese patients aged between 30 and 84 years was undertaken using data collected from 26 870 participants in cardiovascular risk surveys conducted in four communities between 1975 and 2005. The incidence of SCD was ascertained by systematic surveillance, with 239 cases of SCD identified over this period. For each case of SCD, three control patients were selected, matched by age, sex, examination year, follow-up time, and community. RESULTS: Hypertension, diabetes mellitus, smoking, major ST-T abnormalities, left high amplitude R waves, and increased heart rate (≥77 beat/min) were all independently associated with a 1.5-3.2-fold increase in SCD risk, whereas no associations were observed for body mass index and hypercholesterolemia. The population-attributable fraction [95% confidence interval (CI)] was 23.0% (2.9-39.0) for hypertension, 15.3% (3.8-25.5) for current smoking, 14.5% (8.0-20.5) for major ST-T abnormalities, and 8.1% (2.2-13.7) for diabetes mellitus. The number of SCD risk factors (hypertension, diabetes, smoking, and ECG abnormalities) was positively associated with increased SCD risk. The odds ratio for increased SCD risk with three or more risk factors versus zero risk factors was 5.76 (95% CI 3.20-10.39). CONCLUSIONS: Among the Japanese population, hypertension, smoking, major ST-T abnormalities, left high amplitude R waves, and diabetes mellitus were associated with an increased incidence of SCD, whereas there were no associations of body mass index or hypercholesterolemia with SCD incidence.

DOI： 10.1097/HJH.0b013e328352ac16

PubMed

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: There is little evidence whether sudden cardiac death (SCD) is increasing in Asia, although the incidence of coronary heart disease among urban middle-aged Japanese men has increased recently. We examined trends in the incidence of SCD and its risk factors in the Circulatory Risk in Communities Study. DESIGN AND SETTING: This was a population-based longitudinal study. Surveillance of men and women for SCD incidence and risk factors was conducted from 1981 to 2005. SUBJECTS: The surveyed population was all men and women aged 30-84 years who lived in three rural communities and one urban community in Japan. MAIN OUTCOME MEASURES: Trends in SCD incidence and its risk factors. RESULTS: Age-adjusted and sex-adjusted incidence of SCD decreased from 1981-1985 to 1991-1995, and plateaued thereafter. The annual incidence per 100 000 person-years was 76.0 in 1981-1985, 57.9 in 1986-1990, 39.3 in 1991-1995, 31.6 in 1996-2000 and 36.8 in 2001-2005. The prevalence of hypertension decreased from 1981-1985 to 1991-1995, and plateaued thereafter for men and women. The age-adjusted prevalence of current smoking for men decreased while that of diabetes mellitus increased for both sexes from 1981-1985 to 2001-2005. CONCLUSIONS: The incidence of SCD decreased from 1981 to 1995 but was unchanged from 1996 to 2005. Continuous surveillance is necessary to clarify future trends in SCD in Japan because of an increasing incidence of diabetes mellitus.

DOI： 10.1136/bmjopen-2011-000573

PubMed

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本病態栄養学会  

栄養管理の現場では、血液生化学検査や身体計測が栄養評価指標として広く用いられているが、身体活動量が栄養評価指標として有用か否かについては、一定の見解が得られていない。本研究では、栄養障害に陥っていた5例の入院患者を対象として、加速度センサー(active tracer AC-200R)を用いて身体活動量を自発的体動の加速度として測定し、栄養評価指標としての有用性について検討した。加速度センサーによる体動の加速度測定は3日間とし、それぞれの症例に対して1週間毎に2回または3回行った。栄養指標である血清総たんぱくや血清コリンエステラーゼ、がんや抗がん剤による組織の傷害・炎症と関連する血清アルブミンやC反応性蛋白(CRP)の濃度が、累積加速度の上昇および下降に追随する変動を示したことから、加速度センサーを用いて評価した身体活動量は栄養評価の一指標になることが示唆された。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J03578&link_issn=&doc_id=20100728590006&doc_link_id=%2Fcw3eiyou%2F2010%2F001302%2F006%2F0163-0170%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcw3eiyou%2F2010%2F001302%2F006%2F0163-0170%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

J-GLOBAL

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：Japanese  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)   Publisher：(一社)日本循環器病予防学会  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)   Publisher：(一社)日本循環器病予防学会  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)   Publisher：日本公衆衛生学会  

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Language：Japanese   Publishing type：Research paper, summary (national, other academic conference)   Publisher：(一社)日本肥満学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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J-GLOBAL

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(一社)日本循環器病予防学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(一社)日本病態栄養学会  

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Language：Japanese   Publisher：(一社)日本循環器病予防学会  

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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Event date： 2018.7.28

Language：Japanese   Presentation type：Oral presentation (general)  

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