研究者データベース

三浦 克之

  • NCD疫学研究センター 教授
Last Updated :2022/11/30

研究者情報

所属

  • NCD疫学研究センター 教授

職名

  • 教授

学位

  • 医学博士(金沢大学)

ホームページURL

J-Global ID

研究キーワード

  • 公衆衛生学   循環器疾患   予防医学   疫学   

研究分野

  • ライフサイエンス / 栄養学、健康科学
  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含まない

経歴

  • 2021年04月 - 現在  滋賀医科大学NCD疫学研究センターセンター長(併任)
  • 2009年12月 - 現在  滋賀医科大学医学部 教授(社会医学講座公衆衛生学部門)Undergraduate School of Medicine
  • 2013年04月 - 2021年03月  滋賀医科大学アジア疫学研究センターセンター長(併任)
  • 2008年02月 - 2009年11月  滋賀医科大学医学部 准教授(社会医学講座公衆衛生学部門)Undergraduate School of Medicine
  • 2002年04月 - 2008年01月  金沢医科大学医学部 助教授(健康増進予防医学)School of Medicine
  • 1996年04月 - 2002年03月  金沢医科大学医学部 講師(公衆衛生学)School of Medicine
  • 1999年07月 - 2000年08月  米国Northwestern大学医学部 客員研究員(予防医学)
  • 1993年04月 - 1996年03月  金沢医科大学医学部 助手(公衆衛生学)School of Medicine

学歴

  • 1989年04月 - 1993年03月   金沢大学大学院   医学研究科   社会医学系公衆衛生学専攻
  • 1982年04月 - 1988年03月   金沢大学   医学部   医学科

所属学協会

  • 日本衛生学会   日本循環器学会   日本循環器予防学会   米国心臓病学会・疫学部会   国際疫学会   日本高血圧学会   日本産業衛生学会   日本公衆衛生学会   日本疫学会   American Heart Association   日本栄養改善学会   

研究活動情報

論文

  • Ayako Kunimura, Katsuyuki Miura, Hiroyoshi Segawa, Sayuki Torii, Keiko Kondo, Takashi Hisamatsu, Aya Kadota, Akira Fujiyoshi, Yuichiro Yano, Yoshihisa Nakagawa, Tomonori Okamura, Hirotsugu Ueshima
    Journal of atherosclerosis and thrombosis 2022年09月 研究論文(学術雑誌) 
    AIMS: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a promising new target for reducing low-density lipoprotein cholesterol (LDL-C) and cardiovascular events in high-risk patients. However, the influence of circulating PCSK9 concentration on atherosclerotic plaque formation in the general population remains unknown. We assessed the relationship between serum PCSK9 concentration and coronary artery calcium (CAC) prevalence in the general population. METHODS: Community-dwelling Japanese men (n=622) aged 46-82 years without a history of cardiovascular disease and lipid-lowering medications were included. Serum PCSK9 concentration and CAC score were measured using the Agatston method, and the multivariable analysis was used to assess their association. CAC was defined as an Agatston score of >10. We conducted further analysis stratified by age (<60, 60-69, and ≥ 70 years). RESULTS: The average age, LDL-C, and median serum PCSK9 concentration were 68 years, 122 mg/dL, and 240 ng/mL, respectively. After multivariable adjustment for traditional cardiovascular risk factors, no significant association was observed between serum PCSK9 concentration and CAC prevalence (adjusted relative risk [aRR] 1.05, 95% confidence interval [CI] 0.97-1.13). With age stratification, serum PCSK9 concentration was significantly associated with CAC prevalence in men aged <60 years (aRR 1.38, 95% CI 1.01-1.88) but not in men aged 60-69 years (aRR 0.96, 95% CI 0.85-1.10) or ≥ 70 years (aRR 1.08, 95% CI 0.99-1.19). CONCLUSIONS: A higher serum PCSK9 concentration was associated with a higher CAC prevalence in men aged <60 years, which was independent of traditional cardiovascular risk factors.
  • Kota Kubo, Tomonori Okamura, Daisuke Sugiyama, Takashi Hisamatsu, Aya Hirata, Aya Kadota, Keiko Kondo, Takumi Hirata, Aya Higashiyama, Takehito Hayakawa, Yoshihiro Miyamoto, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
    The American journal of cardiology 2022年09月 研究論文(学術雑誌) 
    The relation between chronic kidney disease (CKD) and cardiovascular disease (CVD) in the general population is well elucidated. In patients with CKD, anemia is associated with adverse outcomes. However, the effects of CKD and anemia on CVD in the general population remains poorly explored, especially in Asian populations. This study aimed to investigate the effect of CKD and/or anemia on CVD mortality in a long-term cohort study involving Japanese community dwellers. We assessed 7,339 participants (aged ≥30 years) with no CVD history. These participants were divided into 4 categories according to their CKD (estimated glomerular filtration rate <60 or urine protein >1+ by dipstick qualitative test) and/or anemia (hemoglobin: <13 g/100 ml [men], <12 g/100 ml [women]) statuses. For each category, we calculated the hazard ratios (HRs) of CVD mortality by using the Cox proportional hazards model after adjusting for age, body mass index, hypertension, diabetes, dyslipidemia, smoking, and alcohol drinking. Within 25 years of follow-up, 637 participants died because of CVD. The HRs of CVD in patients with CKD only, anemia only, and both were 1.27, 1.59, and 2.60 (95% confidence intervals [CI] 1.06 to 1.53, 1.34 to 1.90, and 1.80 to 3.76) in men and 1.42, 1.08, and 2.00 (95% CI 1.19 to 1.69, 0.99 to 1.18, and 1.54 to 2.60) in women, respectively. In conclusion, CKD with anemia is associated with an increased risk for CVD mortality in a general population in Japan.
  • Mizuki Ohashi, Shunichiro Tsuji, Sachiko Tanaka-Mizuno, Kyoko Kasahara, Makiko Kasahara, Katsuyuki Miura, Takashi Murakami
    Scientific reports 12 1 15345 - 15345 2022年09月 研究論文(学術雑誌) 
    We aimed to evaluate the changes in maternal and neonatal complications such as threatened preterm labor (TPL) and preterm birth before and during the coronavirus disease 2019 (COVID-19) pandemic using large-scale real-world data in Japan. We obtained data from the Japan Medical Data Center claims database and evaluated differences in maternal and neonatal complications, such as the prevalence of TPL and preterm birth before the COVID-19 pandemic (in the year 2018 or 2019) and during the COVID-19 pandemic (in 2020). We included 5533, 6257, and 5956 deliveries in the years 2018, 2019, and 2020, respectively. TPL prevalence and preterm birth had significantly decreased in 2020 (41.3%, 2.6%, respectively) compared with those reported in 2018 (45.3%, 3.9%, respectively) and 2019 (44.5%, 3.8%, respectively). Neonatal outcomes such as low-birth-weight infants and retinopathy of prematurity were also improved during the pandemic. There were no clear trends in the prevalence of maternal complications such as hypertensive disorders of pregnancy; hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome; and preeclampsia. Oral ritodrine hydrochloride usage in all participants had significantly decreased during the COVID-19 pandemic. In conclusion, our results suggest that the COVID-19 pandemic has ameliorated TPL and consequently reduced the number of preterm births.
  • Sabrina Ahmed, Mithila Faruque, Mohammad Moniruzzaman, Naym Uddin Roby, Fatema Ashraf, Yuichiro Yano, Katsuyuki Miura, M S A Mansur Ahmed
    Endocrinology, diabetes & metabolism 5 5 e365  2022年09月 研究論文(学術雑誌) 
    INTRODUCTION: Diabetes mellitus itself is a known predictor of physical disability and impairment in activities of daily living (ADL); however, there are existing controversies about the factors explaining the association between diabetes and disability. Therefore, we assessed the possible determinants associated with ADL impairment among people with diabetes in Dhaka city, Bangladesh. METHODS: We conducted a cross-sectional study among 480 people with diabetes aged between 50 and 70 years, and attended a tertiary level hospital in Dhaka city. For determining the ADL impairment, we used the Katz Index Scoring (6 = no impairment; <6 = impairment). Age, sex, educational attainment, household expenditure, body mass index, the status of diabetes (controlled or uncontrolled), hypertension and medication adherence to anti-diabetic drugs were included in the statistical models, and we defined any ADL impairment (Katz score <6) as an event. Multivariable logistic regression was performed to assess the significance of relevant factors. RESULTS: The mean age of the participants was 59.0 (standard deviation [SD], 7.0) years. The majority of the participants (76.3%) had at least some sort of physical disability. In multivariable logistic regression analysis after adjusting for all covariates simultaneously, age (odds ratio [95% confidence interval]: 1.35 [1.20 to 1.75] per 1-SD increment), BMI (1.32 [1.08 to 1.21] per 1-SD increment), higher educational attainment (0.34 [0.09-0.90]), multi-morbidity (2.79 [1.48-5.25]) and uncontrolled diabetes (1.35 [1.10-1.45]) were independently associated with ADL impairment. CONCLUSIONS: Physical disability was common, and ADL impairment was associated with age, educational attainment, BMI, multi-morbidities and uncontrolled diabetes among the people with diabetes in Bangladesh.
  • Kunihiro Matsushita, Stephen Kaptoge, Steven Hj Hageman, Yingying Sang, Shoshana H Ballew, Morgan E Grams, Aditya Surapaneni, Luanluan Sun, Johan Arnlov, Milica Bozic, Hermann Brenner, Nigel J Brunskill, Alex R Chang, Rajkumar Chinnadurai, Massimo Cirillo, Adolfo Correa, Natalie Ebert, Kai Uwe Eckardt, Ron T Gansevoort, Orlando Gutierrez, Farzad Hadaegh, Jiang He, Shih Jen Hwang, Tazeen H Jafar, Simerjot K Jassal, Takamasa Kayama, Csaba P Kovesdy, Gijs W Landman, Andrew S Levey, Donald M Lloyd-Jones, Rupert W Major, Katsuyuki Miura, Paul Muntner, Girish N Nadkarni, Christoph Nowak, Takayoshi Ohkubo, Michelle J Pena, Kevan R Polkinghorne, Toshimi Sairenchi, Elke Schaeffner, Markus P Schneider, Varda Shalev, Michael G Shlipak, Marit D Solbu, Nikita Stempniewicz, James Tollitt, José M Valdivielso, Joep van der Leeuw, Angela Yee Moon Wang, Chi Pang Wen, Mark Woodward, Kazumasa Yamagishi, Hiroshi Yatsuya, Luxia Zhang, Jannick An Dorresteijn, Emanuele Di Angelantonio, Frank Lj Visseren, Lisa Pennells, Josef Coresh
    European journal of preventive cardiology 2022年08月 研究論文(学術雑誌) 
    AIMS: The 2021 ESC guideline on cardiovascular disease (CVD) prevention categorizes moderate and severe chronic kidney disease (CKD) as high and very-high CVD risk status regardless of other factors like age and does not include estimated glomerular filtration rate (eGFR) and albuminuria in its algorithms, SCORE2 and SCORE2-OP, to predict CVD risk. We developed and validated an "Add-on" to incorporate CKD measures into these algorithms, using a validated approach. METHODS: In 3,054,840 participants from 34 datasets, we developed three Add-ons (eGFR only, eGFR + urinary albumin-to-creatinine ratio [ACR] [the primary Add-on], and eGFR + dipstick proteinuria) for SCORE2 and SCORE2-OP. We validated c-statistics and net reclassification improvement (NRI), accounting for competing risk of non-CVD death, in 5,997,719 participants from 34 different datasets. RESULTS: In the target population of SCORE2 and SCORE2-OP without diabetes, the CKD Add-on (eGFR only) and CKD Add-on (eGFR + ACR) improved c-statistic by 0.006 (95%CI 0.004-0.008) and 0.016 (0.010-0.023), respectively, for SCORE2 and 0.012 (0.009-0.015) and 0.024 (0.014-0.035), respectively, for SCORE2-OP. Similar results were seen when we included individuals with diabetes and tested the CKD Add-on (eGFR + dipstick). In 57,485 European participants with CKD, SCORE2 or SCORE2-OP with a CKD Add-on showed a significant NRI (e.g., 0.100 [0.062-0.138] for SCORE2) compared to the qualitative approach in the ESC guideline. CONCLUSION: Our Add-ons with CKD measures improved CVD risk prediction beyond SCORE2 and SCORE2-OP. This approach will help clinicians and patients with CKD refine risk prediction and further personalize preventive therapies for CVD.
  • Huynh Thi Hong Tram, Sachiko Tanaka-Mizuno, Naoyuki Takashima, Kawser Khan, Hisatomi Arima, Aya Kadota, Takako Fujii, Satoshi Shitara, Akihiro Kitamura, Naomi Miyamatsu, Yoshikuni Kita, Makoto Urushitani, Yoshihisa Nakagawa, Katsuyuki Miura, Kazuhiko Nozaki
    Cerebrovascular diseases (Basel, Switzerland) 1 - 8 2022年08月 研究論文(学術雑誌) 
    BACKGROUND: The relationship between diabetes control status and long-term prognosis after stroke incidence remains unclear. This study aimed to investigate the effect of diabetes status at admission on long-term survival in patients with first-ever stroke. METHODS: A retrospective cohort study was conducted based on the Shiga Stroke and Heart Attack Registry in Japan. Patients were classified according to their diabetes status and glycated hemoglobin (HbA1c) value at hospital admission into the following: (1) free of diabetes (no history of diabetes and HbA1c <6.5%); (2) good control (history of diabetes and HbA1c <7%; free of history and 6.5% ≤HbA1c <7%); and (3) poor control (with or without a history of diabetes and HbA1c ≥7%). Multivariable Cox regression models were used to evaluate the association between diabetes status and long-term survival from stroke onset. Additionally, we also evaluated the association between diabetes status and conditional survival, beginning 29 days after stroke onset. RESULTS: A total of 6,331 first-ever stroke patients were eligible for this study. Among study patients, the mean (±SD) age was 72.85 ± 13.19 years, and the mean (±SD) follow-up year was 2.76 ± 1.66 years; additionally, 42.09% of patients were women. Among patients with all strokes, considering the free-of-diabetes group as the reference group, the adjusted hazard ratio (95% confidence interval) for mortality was 1.26 (1.10, 1.44) in the good control group and 1.22 (1.05, 1.41) in the poor control group. Among patients with ischemic stroke, the adjusted hazard ratio was 1.24 (1.06, 1.46) in good control group and 1.27 (1.08, 1.50) in poor control group. After excluding patients who died within 28 days, the adjusted hazard ratio for conditional mortality in the poor control group was 1.31 (1.12, 1.54) among all stroke patients and 1.29 (1.08, 1.54) among ischemic stroke patients. No significant associations were observed between diabetic status and long-term mortality in intracerebral hemorrhage patients. CONCLUSIONS: The findings suggest that first-ever stroke patients with diabetes exhibited a higher risk of all-cause mortality than those without diabetes, particularly in the overall stroke and ischemic stroke populations. Additionally, in stroke populations after 28 days of onset, high risk of long-term mortality was stated in stroke patients with poor HbA1c control.
  • Takashi Hisamatsu, Katsuyuki Miura, Yasuharu Tabara, Yuichi Sawayama, Takashi Kadowaki, Aya Kadota, Sayuki Torii, Keiko Kondo, Yuichiro Yano, Akira Fujiyoshi, Takashi Yamamoto, Yoshihisa Nakagawa, Minoru Horie, Takeshi Kimura, Tomonori Okamura, Hirotsugu Ueshima
    European Journal of Preventive Cardiology 2022年07月 研究論文(学術雑誌) 
    Abstract Aims The potential effect of alcohol consumption on coronary heart disease (CHD) remains unclear. We used the variant rs671 in the aldehyde dehydrogenase 2 gene (ALDH2) as an instrument to investigate the causal role of alcohol intake in subclinical and clinical CHD. Methods We conducted two Mendelian randomization studies: a cross-sectional study of coronary artery calcification (CAC) on computed tomography of 1029 healthy men (mean age, 63.8 years) and a case-control study of 421 men with CHD (acute coronary syndrome [ACS] or stable angina pectoris) who underwent coronary revascularization and 842 age-matched male controls. Results In the CAC study, medians (25%tiles, 75%tiles) of alcohol consumption by ALDH2-rs671 *2 homozygotes (n = 86 [8.4%]), *1*2 heterozygotes (n = 397 [38.5%]), and *1 homozygotes (n = 546 [53.1%]) were 0.0 (0.0, 0.0), 28.0 (0.0, 129.0), and 224.0 (84.0, 350.0) g/week, respectively. In age-adjusted Poisson regression with robust error variance, compared with *2 homozygotes, relative risks for prevalent CAC score &gt;0, ≥100, and ≥300 in *1 homozygotes were 1.29 (95% confidence interval, 1.06-1.57), 1.76 (1.05-2.96), and 1.81 (0.80-4.09), respectively. In age-adjusted ordinal logistic regression for CAC distributions, we observed higher odds among *1 homozygotes (odds ratio, 2.19 [1.39-3.46]) and even among *1*2 heterozygotes (1.77 [1.11-2.82]) compared with *2 homozygotes. In the case-control study, conditional logistic regression revealed lower prevalence of *1 homozygotes among men with CHD (odds ratio, 0.54 [0.35-0.82]), especially ACS (0.46 [0.27-0.77]), than controls. Conclusion Our findings indicate a positive association of alcohol consumption with CAC burden but an inverse association with clinical CHD, especially ACS.
  • Sabrina Ahmed, Takashi Hisamatsu, Aya Kadota, Akira Fujiyoshi, Hiroyoshi Segawa, Sayuki Torii, Naoyuki Takashima, Keiko Kondo, Yoshihisa Nakagawa, Hirotsugu Ueshima, Katsuyuki Miura
    Circulation journal : official journal of the Japanese Circulation Society 86 8 1298 - 1306 2022年07月 研究論文(学術雑誌) 
    BACKGROUND: Premature atrial contractions (PACs) are predictors of atrial fibrillation, stroke, and cardiovascular mortality. The present study aimed to assess relevant factors for PACs among a general population of Japanese men.Methods and Results:This study conducted a population-based, cross-sectional study among 517 men, aged 40-79 years, with neither apparent myocardial infarction nor atrial fibrillation. 24-h Holter electrocardiography to assess PAC frequency was used. Age, body mass index, height, low-density lipoprotein cholesterol, triglycerides, high-density lipoprotein cholesterol, mean heart rate, diabetes mellitus, hypertension, physical activity, smoking, alcohol consumption, and lipid-lowering therapy were included in multivariable negative binomial regression analyses to assess correlation for the number of PACs per hour. Almost all participants (99%) had at least 1 PAC in 1 h (median number 2.84 PACs per h). In multivariable negative binomial regression after adjusting for all covariates simultaneously, age (relative risk [95% confidence interval], 1.30 [1.08-1.57] per 1-standard deviation [SD] increment), height (1.19 [1.02-1.39] per 1-SD increment), triglycerides (0.79 [0.65-0.97] per 1-SD increment), mean heart rate (0.69 [0.59-0.80] per 1-SD increment), physical activity (0.63 [0.43-0.93]), current smoking (1.69 [1.06-2.69]), current moderate (1.97 [1.23-3.16]) and heavy (1.84 [1.12-3.01]) alcohol consumption were independently associated with PAC frequency. CONCLUSIONS: PAC frequency was independently associated with age, height, smoking, alcohol consumption, heart rate, physical activity, and triglycerides.
  • Yuichi Sawayama, Takashi Hisamatsu, Aya Kadota, Sayuki Torii, Keiko Kondo, Akira Fujiyoshi, Yosuke Higo, Akiko Harada, Yoshiyuki Watanabe, Yoshihisa Nakagawa, Katsuyuki Miura, Hirotsugu Ueshima
    Journal of hypertension 40 7 1344 - 1351 2022年07月 研究論文(学術雑誌) 
    OBJECTIVE: We aimed to investigate the effect of ambulatory blood pressure (BP) on aortic valve calcification (AVC) and coronary artery calcification (CAC), which are subclinical atherosclerotic diseases. METHODS: In this population-based, cross-sectional study, we assessed office BP, mean ambulatory BP (24-h, awake, and asleep), and variability of ambulatory BP, as determined by the coefficient of variation (awake and asleep). AVC and CAC were quantified using an Agatston score (>0) based on computed tomography scanning. We calculated relative risks (RRs) and 95% confidence intervals (CIs) with a 1-standard deviation increment in each BP index for the presence of AVC and CAC using a multivariate-adjusted Poisson regression with robust error variance. RESULTS: Of 483 participants (mean age: 66.8 years), 154 (31.9%) and 310 (64.2%) had AVC and CAC, respectively. The presence of AVC was associated with office systolic BP (SBP; RR, 1.15; 95% CI, 1.03-1.28), awake diastolic BP (DBP) variability (RR, 1.12; 95% CI, 1.01-1.25), and asleep SBP variability (RR, 1.14; 95% CI, 1.03-1.27). The presence of CAC was associated with office SBP (RR, 1.08; 95% CI, 1.01-1.15), mean 24-h SBP (RR, 1.10; 95% CI, 1.04-1.16), mean awake SBP (RR, 1.11; 95% CI, 1.04-1.17), mean asleep SBP (RR, 1.07; 95% CI, 1.01-1.13), and asleep SBP variability (RR, 1.07; 95% CI, 1.01-1.13). CONCLUSION: These findings highlight the association of ambulatory BP indices with both AVC and CAC, but with different effects on their presences.
  • Takashi Waki, Katsuyuki Miura, Sachiko Tanaka-Mizuno, Yusuke Ohya, Koichi Node, Hiroshi Itoh, Hiromi Rakugi, Jumpei Sato, Kazuo Goda, Masaru Kitsuregawa, Tomoki Ishikawa, Naohiro Mitsutake
    Hypertension Research 45 7 1123 - 1133 2022年07月 研究論文(学術雑誌)
  • Itsuko Miyazawa, Hiroshi Maegawa, Aya Kadota, Takashi Nakamura, Makoto Konishi, Shinichi Ochi, Katsuyuki Miura, Motozumi Okamoto
    Diabetology international 13 3 566 - 574 2022年07月 研究論文(学術雑誌) 
    Aim: To examine the trends in the management of patients with diabetes over an 18-year period in Japan. Participants and methods: We recorded the height, body mass, laboratory data, diabetes treatment, and screening status of diabetic complications from the data collected during the Shiga Diabetes Clinical Survey, which has been performed every 6 years since 2000. We then evaluated the management of patients with diabetes in Shiga Prefecture. The study included 17,870, 18,398, 24,243, and 26,624 participants in each of the 4 years of measurements. Results: The mean age and body mass index (BMI) of the participants gradually increased. The percentage of patients with BMI of ≥ 25 kg/m2 was higher in younger patients. Glycemic control significantly improved over 18 years (hemoglobin A1c: 7.3% ± 1.4% in 2000 to 7.1% ± 1.1% in 2018, P for trend < 0.001). The mean hemoglobin A1c levels were higher in younger patients than in elderly patients and increased from 2012 to 2018 in patients aged ≥ 65 years. The proportion of participants who underwent screening for albuminuria and diabetic retinopathy increased. The mean blood pressure and low-density lipoprotein cholesterol concentration decreased. Conclusions: Glycemic control has been maintained at an acceptable level since the previous survey. Although glycemic control has become less strict in elderly patients with diabetes, glycemic control is poorer in younger patients than in elderly patients. Obesity is an increasingly important problem, particularly in younger patients. The frequency of screening for diabetic complications and the control of blood pressure should be improved. Supplementary Information: The online version contains supplementary material available at 10.1007/s13340-022-00573-2.
  • Phap Tran Ngoc Hoang, Aya Kadota, Yano Yuichiro, Harada Akiko, Hayakawa Takehito, Okamoto Shohei, Naoko Miyagawa, Keiko Kondo, Okuda Nagako, Yoshiuni Kita, Akira Okayama, Fujita Yukihiro, Hiroshi Maegawa, Katsuyuki Miura, Tomonori Okamura, Hirotsugu Ueshima
    Journal of diabetes investigation 2022年06月 研究論文(学術雑誌) 
    AIMS: To examine the association between diabetes and prediabetes at baseline and disability, mortality over a 22-year period among middle-aged adult Japanese. METHODS: Participants consisted of 1,788 adults aged 45 to 64 years at baseline from the cohort study NIPPON DATA90. Disability, defined as having decline in ADL, was assessed by a modified Katz questionnaire at four time points. Disability and death without disability for 22-year follow-up were used as outcomes to test the association with a diagnosis of diabetes or prediabetes at baseline, using multinomial logistic regression. Adjusted odd ratios were obtained from four models that contained appropriate adjustment factors such as age, sex, smoking status, drinking status, body mass index, and cardiovascular risk factors (hypertension, hypercholesterolemia, triglycerides, low serum high-density lipoprotein) at baseline. RESULTS: In the present study, 334 (18.7%) reported at least one disability, and 350 (19.6%) were reported dead without observation of disability during follow-up. Adjusting sex and other risk factors, participants with diabetes and prediabetes had higher risk for disability (OR = 1.43, 95%CI=1.07-1.91 and OR = 1.66, 95%CI=1.10-2.50, respectively) and for mortality (OR = 1.56, 95%CI=1.16-2.08 and OR = 1.77, 95%CI=1.18-2.65, respectively) than individuals with normal glucose tolerance. CONCLUSIONS: In middle-aged Japanese, individuals with diabetes and prediabetes were more likely to be associated with disability and mortality. Our findings suggest that prediabetes and diabetes in middle-aged adults should be paid more attention and requires more intervention to prevent disability and mortality in later life.
  • 【高血圧医療のニューノーマル】新たな社会ネットワークの構築 減塩対策としての食環境整備の新たな動き
    岡見 雪子, 三浦 克之
    Progress in Medicine 42 5 485 - 491 (株)ライフ・サイエンス 2022年05月
  • Satoshi Shitara, Sachiko Tanaka-Mizuno, Naoyuki Takashima, Takako Fujii, Hisatomi Arima, Yoshikuni Kita, Atsushi Tsuji, Akihiro Kitamura, Makoto Urushitani, Katsuyuki Miura, Kazuhiko Nozaki
    Journal of stroke 24 2 292 - 295 2022年05月 研究論文(学術雑誌)
  • Keiko Kondo, Hisatomi Arima, Akira Fujiyoshi, Akira Sekikawa, Aya Kadota, Takashi Hisamatsu, Sayuki Torii, Akihiko Shiino, Katsutaro Morino, Naoko Miyagawa, Hiroyoshi Segawa, Yoshiyuki Watanabe, Hiroshi Maegawa, Kazuhiko Nozaki, Katsuyuki Miura, Hirotsugu Ueshima
    Cerebrovascular diseases (Basel, Switzerland) 1 - 7 2022年04月 研究論文(学術雑誌) 
    BACKGROUND: An association between a high intake of marine-derived n-3 polyunsaturated fatty acids (n-3 PUFAs) with a lower risk of coronary heart disease was previously reported. However, the association between n-3 PUFAs and cerebrovascular lesions remains unclear. We evaluated this association in a general-population-based sample of Japanese men. METHODS: Participants were community-dwelling men (40-79 years old) living in Kusatsu City, Shiga, Japan. Serum concentrations of n-3 PUFAs, defined as the sum of eicosapentaenoic and docosahexaenoic acids, were measured via gas-liquid chromatography between 2006 and 2008. Magnetic resonance imaging was used to assess cerebrovascular lesions (including intracerebral large-artery stenosis, lacunar infarction, and microbleeds) and white matter lesions between 2012 and 2015. Logistic regression adjusting for conventional cardiovascular risk factors was used to estimate the odds ratio of prevalent cerebrovascular lesions per 1 standard deviation higher serum concentration of n-3 PUFAs. RESULTS: Of a total of 739 men, the numbers (crude prevalence in %) of prevalent cerebral large-artery stenoses, lacunar infarctions, microbleeds, and white matter lesions were 222 (30.0), 162 (21.9), 103 (13.9), and 164 (22.2), respectively. A 1 standard deviation higher concentration of n-3 PUFAs (30.5 μmol/L) was independently associated with lower odds of cerebral large-artery stenosis (multivariable-adjusted odds ratio, 0.80; 95% confidential interval, 0.67-0.97). There were no significant associations of n-3 PUFAs with the other types of lesions. CONCLUSIONS: n-3 PUFAs may have protective effects against large-artery stenosis, but not small vessel lesions, in the brain.
  • Hiroaki Iwase, Sachiko Tanaka-Mizuno, Naoyuki Takashima, Aya Kadota, Kenji Matsui, Yasuyuki Nakamaura, Katsuyuki Miura, Hirotsugu Ueshima, Yoshikuni Kita
    BMC cardiovascular disorders 22 1 132 - 132 2022年03月 研究論文(学術雑誌) 
    BACKGROUND: High levels of participation in leisure-time and household physical activity lower the risk of cardiovascular disease (CVD), although it is unclear whether the number of activity types is related to new-onset CVD. We aimed to evaluate the effect of the amount of leisure-time physical activity and the number of types of leisure-time physical activities on the risk of CVD incidence. METHODS: From 2002 to 2003, 3,741 participants without any history of CVD participated in the Takashima Study. Data on the amount of leisure-time and household physical activity and the types of leisure-time and household physical activity were obtained from a self-administered questionnaire. Hazard ratios for CVD (acute myocardial infarction and stroke) incidence (follow-up data from 2002 to 2013), according to the participation level and number of activity types, were calculated using Cox proportional hazards models. RESULTS: The mean age of the subjects was 58.7 ± 13.1 years. During the mean follow-up period of 8.0 ± 1.1 years, 92 participants developed CVD. An inverse dose-response relationship was noted between the amount of leisure-time and household physical activity and CVD events. After adjusting for baseline characteristics, lifestyle-related diseases, and the amount of physical activity other than leisure-time and household, the risk of CVD onset was compared by dividing the participants into two groups by the level of participation; the highest activity group had an adjusted hazard ratio (95% confidence interval) of 0.40 (0.20-0.82) compared to the lowest activity group. Compared to participants who engaged in 0-1 type of activity, participants who engaged in two or more types of activities had a multivariable-adjusted hazard ratio (95% confidence interval) of 0.31 (0.12-0.79). CONCLUSION: Increasing the amount of leisure-time and household physical activity and promoting engagement in two or more types of such activities may reduce the rate of CVD incidence in the Japanese general population.
  • Mizuki Sata, Tomonori Okamura, Nobuo Nishi, Aya Kadota, Mieko Nakamura, Keiko Kondo, Yukiko Okami, Kaori Kitaoka, Toshiyuki Ojima, Katsushi Yoshita, Katsuyuki Miura
    Nutrients 14 6 2022年03月 研究論文(学術雑誌) 
    The prevalence of hypertension has been decreasing in Japan due to improved medical treatment and a decrease in dietary salt intake. However, disparities in the prevalence, treatment, and control of hypertension are expected to occur in different regions. This study aimed to investigate the trends in the prevalence, treatment, and control of hypertension at the prefectural level of life expectancy among Japanese population. We used data from the National Health and Nutrition Survey and analysed the individual survey information of individuals aged 40-69 years by dividing it into six terms, i.e., 1995-1997, 1999-2001, 2003-2005, 2007-2009, 2012, and 2016. Prefectures were classified into four groups according to their 40-year-old life expectancy in 2000. Outcome values were standardised to the population by 10-year age groups in 2010, and they were tested by two-way analysis of variance according to six terms and life expectancies. The prevalence of hypertension tended to decrease, especially among women, whereas the treatment and control tended to improve from the first to the sixth period in both men and women. The prevalence and treatment of hypertension in men with longer life expectancy tended to be lower than that in other groups, and there was no obvious difference in the control. In women, there were no obvious differences in the prevalence, treatment, or control. Reducing the prevalence of hypertension by improving lifestyle factors, such as high salt intake in each prefecture with a relatively short life expectancy, may be important to resolve the disparity in life expectancy among prefectures.
  • Naoyuki Takashima, Yasuyuki Nakamura, Naoko Miyagawa, Aya Kadota, Yoshino Saito, Kenji Matsui, Katsuyuki Miura, Hirotsugu Ueshima, Yoshikuni Kita
    Journal of atherosclerosis and thrombosis 2022年03月 研究論文(学術雑誌) 
    AIMS: High-sensitivity C-reactive protein (hsCRP) associates with atherosclerotic diseases such as stroke. However, previous results on the association between hsCRP levels and functional disability were controversial. METHODS: We analyzed 2,610 men and women who did not exhibit functional disability or death within the first 3 years of the baseline survey and those aged 65 years or older at the end of follow-up. The levels of hsCRP were assessed using latex agglutination assay at baseline survey from 2006 to 2014. Functional disability was followed up using the long-term care insurance (LTCI) program until November 1, 2019. Functional disability was defined as a new LTCI program certification. Cox proportional hazards model with competing risk analysis for death was used to evaluate the association between hsCRP levels and future functional disability. RESULTS: During a 9-year follow-up period, we observed 328 cases of functional disability and 67 deaths without prior functional disability incidence. The multivariable-adjusted hazard ratio (HR, 95% confidence interval [CI]) of functional disability in log-transferred hsCRP levels was 1.43 (1.22-1.67) in men and 0.97 (0.81-1.15) in women. When hsCRP level was analyzed as a categorical variable, low hsCRP levels (<1.0 mg/l) as the reference, the multivariable-adjusted HR (95% CI) of functional disability in high hsCRP levels (≥ 3.0 mg/l) was 2.37 (1.56-3.62). Similar results were observed when stratified by sex, but it was not significant in women. CONCLUSIONS: This study demonstrates that low-grade systemic inflammation to assess hsCRP might predict the future incidence of functional disability, especially in men.
  • 中川 夕美, 由田 克士, 荒井 裕介, 尾島 俊之, 藤吉 朗, 中川 秀昭, 奥田 奈賀子, 宮川 尚子, 門田 文, 近藤 慶子, 岡村 智教, 大久保 孝義, 西 信雄, 上島 弘嗣, 岡山 明, 三浦 克之
    日本循環器病予防学会誌 57 1 42 - 54 (一社)日本循環器病予防学会 2022年03月 
    【目的】高血圧者に対する食事指導等の介入によって野菜摂取量の増加が認められたとする報告はこれまでにもあるが、高血圧を指摘されることそれ自体や治療の継続状況と野菜摂取量の関連を検討した報告はない。そこで本研究では、高血圧の指摘や治療の継続状況が、実際の野菜摂取量に影響を与えるのか検討した。【方法】平成22年国民健康・栄養調査及びNIPPON DATA2010の20歳以上の参加者を対象とした。このうち、これまでに医療機関や健康診査で脳卒中、心筋梗塞、腎臓病または腎機能低下と指摘されたことはないが、高血圧の指摘を受けている者もしくは高血圧、糖尿病、脂質異常症のいずれの指摘も受けたことはないが、国民健康・栄養調査の血圧測定値が高血圧(収縮期血圧140mmHg以上または拡張期血圧90mmHg以上の者と定義)であった高値血圧者の男女1,004人を解析対象とした。野菜摂取量が多いこと(1日350g以上)をアウトカムとして、高血圧を指摘されることやその後の治療の継続状況(治療継続、治療中断、未治療)との関連をロジスティック回帰分析にて検討した。【結果】野菜摂取量が多いことと高血圧を指摘されることは男女とも有意な関連はなく、野菜を積極的に摂取しようと心がけることとのオッズ比が男性1.72(95%CI:1.17-2.53)、女性1.51(95%CI:1.04-2.21)と有意な正の関連が認められた。野菜摂取量が多いことと高血圧者における治療の継続状況では、野菜を積極的に摂取しようと心がけることとのオッズ比が男性1.69(95%CI:1.07-2.68)と有意な正の関連、「治療中断」の女性でオッズ比0.37(95%CI:0.15-0.90)と有意な負の関連がみられた。【結論】男女とも野菜の摂取量と高血圧の指摘自体との関連は認められなかったが、女性では治療中断と負の関連が示唆された。(著者抄録)
  • Kayo Horibe, Katsutaro Morino, Itsuko Miyazawa, Sachiko Tanaka-Mizuno, Keiko Kondo, Daisuke Sato, Natsuko Ohashi, Shogo Ida, Tsuyoshi Yanagimachi, Masahiro Yoshimura, Ryuta Itoh, Kiyoshi Murata, Katsuyuki Miura, Hisatomi Arima, Yukihiro Fujita, Satoshi Ugi, Hiroshi Maegawa
    Diabetes research and clinical practice 186 109781 - 109781 2022年02月 研究論文(学術雑誌) 
    AIM: We aimed to determine whether SGLT2 inhibitor dapagliflozin treatment affects body composition and amino acid (AA) metabolism. METHODS: Fifty-two overweight patients treated by oral antidiabetic agents were randomly assigned to dapagliflozin (Dapa) or a standard treatment (Con) and followed for 24 weeks. The primary outcome was the change in body mass (BM) between baseline and week 24. Body composition, intrahepatic triglyceride (IHTG) content, and plasma AA concentrations were examined as secondary outcomes. RESULTS: The change in BM was significantly larger in the Dapa than in the Con group, with a difference in the mean change of -1.72 kg (95%CI: -2.85, -0.59; P = 0.004) between the groups. Total fat mass was reduced by dapagliflozin treatment, but fat-free mass was maintained. IHTG content was significantly reduced in the Dapa than in the Con (P = 0.033). Changes in AAs showed small differences between the groups, but only serine concentrations were significantly reduced in the Dapa. Intra-group analysis showed that positive associations were observed between changes in branched chain AA concentrations and body composition only in the Dapa. CONCLUSIONS: Dapagliflozin treatment causes a reduction in BM mainly by reducing fat mass. AA metabolism shows subtle changes with dapagliflozin treatment.
  • Yasuyuki Nakamura, Takashi Tamura, Akira Narita, Atsushi Shimizu, Yoichi Sutoh, Naoyuki Takashima, Kenji Matsui, Naoko Miyagawa, Aya Kadota, Katsuyuki Miura, Jun Otonari, Hiroaki Ikezaki, Asahi Hishida, Mako Nagayoshi, Rieko Okada, Yoko Kubo, Keitaro Tanaka, Chisato Shimanoe, Rie Ibusuki, Daisaku Nishimoto, Isao Oze, Hidemi Ito, Etsuko Ozaki, Daisuke Matsui, Haruo Mikami, Miho Kusakabe, Sadao Suzuki, Miki Watanabe, Kokichi Arisawa, Sakurako Katsuura-Kamano, Kiyonori Kuriki, Masahiro Nakatochi, Yukihide Momozawa, Michiaki Kubo, Kenji Takeuchi, Kenji Wakai
    European journal of clinical nutrition 76 8 1103 - 1110 2022年02月 研究論文(学術雑誌) 
    BACKGROUND/OBJECTIVES: Low-carbohydrate diets (LCD) are useful for weight reduction, and 50-55% carbohydrate consumption is associated with minimal risk. Genetic differences were related to nutritional consumption, food preferences, and dietary patterns, but whether particular genetic differences in individuals influence LCD adherence is unknown. SUBJECTS/METHODS: We conducted a GWAS on adherence to LCD utilizing 14,076 participants from the Japan Multi-Institutional Collaborative Cohort study. We used a previously validated semiquantitative food frequency questionnaire to estimate food consumption. Association of the imputed variants with the LCD score by Halton et al. we used linear regression analysis adjusting for sex, age, total dietary energy consumption, and components 1 to 10 by principal component analysis. We repeated the analysis with adjustment for alcohol consumption (g/day) in addition to the above-described variables. RESULTS: Men and women combined analysis without adjustment for alcohol consumption; we found 395 variants on chromosome 12 associated with the LCD score having P values <5 × 10-8. A conditional analysis with the addition of the dosage data of rs671 on chromosome 12 as a covariate, P values for all 395 SNPs on chromosome 12 turned out to be insignificant. In the analysis with additional adjustment for alcohol consumption, we did not identify any SNPs associated with the LCD score. CONCLUSION: We found rs671 was inversely associated with adherence to LCD, but that was strongly confounded by alcohol consumption.
  • Xiao Zhang, Akira Fujiyoshi, Vasudha Ahuja, Abhishek Vishnu, Emma Barinas-Mitchell, Aya Kadota, Katsuyuki Miura, Daniel Edmundowicz, Hirotsugu Ueshima, Akira Sekikawa
    International journal of cardiology 352 158 - 164 2022年02月 研究論文(学術雑誌) 
    BACKGROUND: Equol, an isoflavone (ISF)-derived metabolite by the gut microbiome in certain individuals termed as equol-producers, might be the key anti-atherogenic component of ISFs. Our objective was to determine the association between equol-producing status and aortic atherosclerosis assessed as aortic calcification (AC). METHODS: This population-based study of 302 Japanese men aged 40-49, free of cardiovascular disease, examined serum levels of equol and ISFs, AC in the entire aorta by electron-beam computed tomography with Agatston method, and cardiovascular risk factors. We defined equol-producers as individuals with serum levels of equol ≥20 nM and prevalent AC as an AC score ≥ 10. We analyzed the association between equol-producing status and AC using Tobit and logistic regressions. We performed age-stratified analyses since age was a significant effect-modifier. RESULTS: The 60th to 90th percentile AC scores were 4 to 243 in equol-producers and 15 to 444 in non-producers, respectively. Overall, equol-producers (41% of the sample) had lower AC scores (-209, [95% confidence interval (CI): -455, 36]) and odds of AC (odds ratio (OR): 0.7 [95% CI: 0.4, 1.3]), although not statistically significant, compared to non-producers after controlling for cardiovascular risk factors. Among men aged 46-49, equol-producers had significantly lower AC scores (-428 [95% CI: -827, -29]). Furthermore, there were null associations between serum levels of ISFs and both AC score and the odds of AC. CONCLUSION: In middle-aged Japanese men, equol-producers had a non-significantly lower burden of aortic atherosclerosis than non-producers whereas ISFs had a null association. Studies with larger sample sizes in both sexes are warranted.
  • Naoyuki Takashima, Hisatomi Arima, Tanvir Chowdhury Turin, Yasuyuki Nakamura, Hideki Sugihara, Yutaka Morita, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima, Yoshikuni Kita
    Cerebrovascular diseases (Basel, Switzerland) 1 - 7 2022年01月 研究論文(学術雑誌) 
    INTRODUCTION: Since the 1960s, the stroke morality rate in Japan has declined significantly. Although several risk factors for stroke have become more evident due to increasingly Westernized lifestyle, there have been no population-based registry data on recent time trends in stroke incidence in Japan. The purpose of this study is to determine these trends in stroke incidence using a population-based registry. METHODS: Data were obtained from the Takashima Stroke Registry, which covers approximately 50,000 residents in Takashima City, Japan. The age- and sex-standardized stroke incidence rate was estimated using the direct method. Average annual relative changes of stroke incidence were estimated using Poisson regression models. RESULTS: We identified a total of 2,371 patients with first-ever stroke during the period 1990-2010. Crude incidence rates of total stroke (per 100,000 person-years) were 225 in the early period (1990-2001) and 187 in the late period (2002-2010), and the mean age at onset of stroke increased from 71.9 years in the early period to 74.8 years in the late period. Age- and sex-standardized incidence rates of stroke (per 100,000 person-years) decreased from 327 in the early part of this study period and 206 in the later period. During the 21-year period, age- and sex-standardized average annual relative reduction in stroke incidence was statistically significant (-3.7% per year). When stratified into early and late periods, the adjusted annual relative reduction in stroke incidence was observed during the early period (-2.1% per year), and there were no significant changes during the late period. CONCLUSIONS: In this population-based registry, there was a significant reduction in incidence of stroke from 1990 to 2010. Although the speed of reduction in stroke incidence appears to have slowed down after 2000, continuous public health measures are required to provide further protection against stroke.
  • Sabrina Ahmed, Takashi Hisamatsu, Aya Kadota, Akira Fujiyoshi, Hiroyoshi Segawa, Sayuki Torii, Naoyuki Takashima, Keiko Kondo, Yoshihisa Nakagawa, Hirotsugu Ueshima, Katsuyuki Miura
    The American journal of cardiology 169 51 - 56 2022年01月 研究論文(学術雑誌) 
    Increased ventricular premature complexes (VPCs) are associated with a higher risk of cardiac morbidities. However, little information is available on the risk factors of Western general populations. Therefore, we aimed to assess the frequency and associated factors of VPCs in healthy general Japanese men. We conducted a population-based cross-sectional study in 517 men, aged 40 to 79 years, using 24-hour Holter electrocardiography. Age, body mass index, height, low-density lipoprotein cholesterol, triglycerides, high-density lipoprotein cholesterol, resting heart rate, diabetes mellitus, hypertension, physical activity, smoking, alcohol consumption, lipid-lowering therapy were included in multivariable negative binomial regression to assess independent correlates for the number of VPCs per hour. We observed at least 1 VPC in 1 hour in 429 men (83%). In multivariable negative binomial regression adjusted for all covariates simultaneously, age (risk ratio [95% confidence interval] 1.91 [1.56 to 2.33] per 1-SD increment), height (1.17 [1.04 to 1.49] per 1-SD increment), resting heart rate(1.34 [1.02 to 1.77] per 1-SD increment), diabetes mellitus (2.36 [1.17 to 4.76] ), hypertension (1.90 [1.03 to 3.50]), physical activity (0.67 [0.47 to 0.97] ), current smoking (4.23 [1.86 to 9.60] ), past smoking (2.08 [1.03 to 4.19] ), current light alcohol consumption (0.16 [0.04 to 0.64] ), and lipid-lowering therapy (0.47 [0.23 to 0.96] ) were independently associated with VPCs frequency. In conclusion, VPCs frequency was independently associated with age, height, resting heart rate, diabetes mellitus, hypertension, physical activity, smoking, alcohol consumption, and lipid-lowering therapy.
  • Mizuki Ohashi, Katsuyuki Miura, Naoyuki Takashima, Aya Kadota, Yoshino Saito, Shunichiro Tsuji, Takashi Murakami, Yuka Kadomatsu, Mako Nagayoshi, Megumi Hara, Keitaro Tanaka, Takashi Tamura, Asahi Hishida, Toshiro Takezaki, Ippei Shimoshikiryo, Etsuko Ozaki, Isao Watanabe, Sadao Suzuki, Miki Watanabe, Kiyonori Kuriki, Kokichi Arisawa, Sakurako Katsuura-Kamano, Sho Yamasaki, Hiroaki Ikezaki, Isao Oze, Yuriko N Koyanagi, Haruo Mikami, Yohko Nakamura, Kenji Takeuchi, Yoshikuni Kita, Kenji Wakai
    Hypertension research : official journal of the Japanese Society of Hypertension 45 4 708 - 714 2022年01月 研究論文(学術雑誌) 
    Previous studies have reported that the number of pregnancies and childbirths affected the risk of cardiovascular diseases (CVDs). However, the influence of reproductive history on hypertension and obesity, which are important risk factors for CVDs, is still unclear. Moreover, this association may vary depending on menopausal status. We evaluated the association of reproductive history with hypertension and obesity using a large cross-sectional dataset from the Japan Multi-Institutional Collaborative Cohort Study (J-MICC Study). At the baseline survey, physical data, blood samples, and self-reported health questionnaires were collected. Participants with insufficient data were excluded, and 24,558 women from eight study regions were included in this study. Logistic regression analysis was conducted to evaluate the association of reproductive history with hypertension and obesity using multivariable-adjusted odds ratios. In premenopausal women, childbirth showed a generally protective effect on hypertension but not on obesity. In postmenopausal women, childbirth was positively associated with obesity and hypertension but not with hypertension after adjusting for BMI. In conclusion, reproductive history was associated with hypertension and obesity in a large Japanese population, and this association differed between premenopausal and postmenopausal women.
  • Takuma Furukawa, Yuichiro Nishida, Megumi Hara, Chisato Shimanoe, Kayoko Koga, Chiharu Iwasaka, Yasuki Higaki, Keitaro Tanaka, Ryoko Nakashima, Hiroaki Ikezaki, Asahi Hishida, Takashi Tamura, Yasufumi Kato, Yudai Tamada, Keitaro Matsuo, Hidemi Ito, Haruo Mikami, Miho Kusakabe, Rie Ibusuki, Keiichi Shibuya, Sadao Suzuki, Hiroko Nakagawa-Senda, Etsuko Ozaki, Daisuke Matsui, Kiyonori Kuriki, Yasuyuki Nakamura, Aya Kadota, Kokichi Arisawa, Sakurako Katsuura-Kamano, Kenji Takeuchi, Kenji Wakai
    BMJ open diabetes research & care 10 1 2022年01月 研究論文(学術雑誌) 
    INTRODUCTION: Healthy diet and physical activity (PA) are essential for preventing type 2 diabetes, particularly, a combination of diet and PA. However, reports on interaction between PA and diet, especially from large epidemiological studies, are limited. We investigated the effect of interaction between PA and macronutrient intake on hemoglobin A1c (HbA1c) levels in the general population. RESEARCH DESIGN AND METHODS: We conducted a cross-sectional study of 55 469 men and women without diabetes who participated in the baseline survey of the Japan Multi-Institutional Collaborative Cohort Study. A self-administered questionnaire ascertained PA and macronutrient intake (carbohydrate, fat, and protein). Multiple linear regression analyses were performed to adjust for confounding variables and examine the interactions. In addition, we conducted a longitudinal study during a 5-year period within a subcohort (n=6881) with accelerometer-assessed PA data. RESULTS: Overall, PA had a weak inverse association (β=-0.00033, p=0.049) and carbohydrate intake had a strong positive association (β=0.00393, p<0.001) with HbA1c. We observed a tendency of interactions between PA and carbohydrate or fat intake, but not protein intake, on HbA1c levels after adjusting for age, sex, study area, total energy intake, alcohol consumption, smoking, and medication for hypertension or hypercholesterolemia (Pinteraction=0.054, 0.006, and 0.156, respectively). The inverse associations between PA and HbA1c level were more evident in participants with high-carbohydrate (or low-fat) intake than in participants with low-carbohydrate (or high-fat) intake. Although further adjustment for body mass index slightly attenuated the above interactions (Pinteraction=0.098 for carbohydrate and 0.068 for fat), the associations between PA and HbA1c level in stratified analyses remained unchanged. Similar associations and interactions were reproduced in the longitudinal study. CONCLUSIONS: The present results suggest that the effect of PA on HbA1c levels is modified by intake of macronutrient composition.
  • Yusuke Ohya, Kazuomi Kario, Hiroshi Itoh, Akira Nishiyama, Toshihiko Ishimitsu, Atsuhiro Ichihara, Hisashi Kai, Naoki Kashihara, Tomohiro Katsuya, Katsuyuki Miura, Masashi Mukoyama, Satoko Nakamura, Koichi Node, Mitsuru Ohishi, Shigeyuki Saito, Hirotaka Shibata, Tatsuo Shimosawa, Kouichi Tamura, Kazunori Toyoda, Mohd Arifin Mohd Ali, Yook-Chin Chia, Godwin Constantine, Erwinanto Erwinanto, Sang Hyun Ihm, Hsien-Li Kao, Huynh Van Minh, S N Narasingan, Deborah Ignacia D Ona, Saulat Siddique, Apichard Sukonthasarn, Boon Wee Teo, Tsolmon Unurjargal, Ji-Guang Wang, Tzung-Dau Wang, Hiromi Raukgi
    Hypertension research : official journal of the Japanese Society of Hypertension 45 1 1 - 2 2022年01月
  • Yoshino Saito, Katsuyuki Miura, Hisatomi Arima, Takehito Hayakawa, Naoyuki Takashima, Yoshikuni Kita, Nagako Okuda, Akira Fujiyoshi, Toshiyuki Iwahori, Naoko Miyagawa, Keiko Kondo, Sayuki Torii, Aya Kadota, Takayoshi Ohkubo, Akira Okayama, Tomonori Okamura, Hirotsugu Ueshima
    PloS one 17 2 e0261716  2022年 研究論文(学術雑誌) 
    OBJECTIVE: This study aimed to investigate the incidence rates and predictors of lower limb fractures in a general Japanese population. METHODS: NIPPON DATA is a nationwide, long-term, prospective cohort study of individuals who participated in the National Cardiovascular Survey Japan and the National Nutrition Survey in 1990. Overall, 3,134 individuals (1,827 women, 1,307 men) who participated in follow-up assessments in 1995, 2000, and/or 2006 were included in the present analysis. The outcomes of this study were lower limb fractures (including proximal femur fractures). RESULTS: The mean age at baseline was 63.8 years in women and 63.1 years in men. The average body mass index (BMI) was 23.3 kg/m2 in women and 22.9 kg/m2 in men. During a mean follow-up of 12.1 years, 271 total lower limb fractures were observed. In women, older age, lower BMI, and less intake of vegetables were associated with increased risks of proximal femur fractures. With regard to the outcome of total lower limb fractures, less intake of vegetables and regular exercise were significant predictors in women. Calcium intake was not significantly associated with proximal femur or total lower limb fractures. There were no significant predictors of proximal femur or total lower limb fractures in men, except for age. CONCLUSIONS: Aging was a significant risk factor for proximal femur and total lower limb fractures in both men and women. With regard to modifiable risk factors, low BMI and low intake of vegetables were associated with increased risks of proximal femur and/or total lower limb fractures in the general population of Japanese women.
  • Tomiyo Nakamura, Yasuyuki Nakamura, Naoyuki Takashima, Aya Kadota, Katsuyuki Miura, Hirotsugu Ueshima, Yosikuni Kita
    Nutrients 14 1 2021年12月 研究論文(学術雑誌) 
    The double burden of malnutrition refers to the co-occurrence of overweight and obesity and undernutrition. Eating quickly has been linked to overweight and obesity. However, no study has examined the association between eating speed and undernutrition. This retrospective, cross-sectional study analyzed data from 3529 community-dwelling residents. Eating speed was divided into three categories: fast, medium, and slow. Undernutrition was defined as body mass index (BMI) of <18.5 kg/m2 in adults aged < 70 years (adults) and as <20 kg/m2 in adults aged ≥ 70 years (older adults), in accordance with the Global Leadership Initiative on Malnutrition criteria for Asians. Multivariable logistic regression analysis was used to examine the association between eating speed and undernutrition. Among adult men, compared with eating quickly, eating slowly was associated with elevated prevalence of undernutrition (odds ratio (OR) 9.68, 95% confidence interval (CI) 2.32-40.51, p = 0.001). Among older adult women, the prevalence of undernutrition in the slow-eating group was higher than that in the fast-eating group (OR 3.82, 95% Cl 1.51-9.69, p = 0.005). Eating slowly is independently associated with the prevalence of undernutrition among community-dwelling adult men and older adult women in Japan.
  • Yukiko Imai, Sachiko Mizuno Tanaka, Michihiro Satoh, Takumi Hirata, Yoshitaka Murakami, Katsuyuki Miura, Takashi Waki, Aya Hirata, Toshimi Sairenchi, Fujiko Irie, Mizuki Sata, Toshiharu Ninomiya, Takayoshi Ohkubo, Shizukiyo Ishikawa, Yoshihiro Miyamoto, Hirofumi Ohnishi, Shigeyuki Saitoh, Akiko Tamakoshi, Michiko Yamada, Masahiko Kiyama, Hiroyasu Iso, Kiyomi Sakata, Hideaki Nakagawa, Akira Okayama, Hirotsugu Ueshima, Tomonori Okamura
    Journal of the American Heart Association 10 23 e021753  2021年12月 研究論文(学術雑誌) 
    Background Lifetime risk is an informative estimate for driving lifestyle and behavioral changes especially for young adults. The impact of composite risk factors for cardiovascular disease on lifetime risk stratified by sex has not been investigated in the Japanese population, which has a much lower mortality of coronary heart disease compared with the Western population. We aimed to estimate lifetime risk of death from cardiovascular disease attributable to traditional risk factors. Methods and Results We analyzed pooled individual data from the Evidence for Cardiovascular Prevention from Observational Cohorts in a Japanese cohort study. A modified Kaplan-Meier approach was used to estimate the remaining lifetime risk of cardiovascular death. In total, 41 002 Japanese men and women with 537 126 person-years of follow-up were included. The lifetime risk at the index-age of 45 years for those with optimal risk factors (total cholesterol <4.65 mmol/L, systolic blood pressure <120 mm Hg, diastolic blood pressure <80 mm Hg, absence of diabetes, and absence of smoking habit) was lower compared with the highest risk profile of ≥2 risk factors (6.8% [95% CI, 0%-11.9%] versus 19.4% [16.7%-21.4%] for men and 6.9% [1.2%-11.5%] versus 15.4% [12.6%-18.1%] for women). Conclusions The magnitude and the number of risk factors were progressively associated with increased lifetime risk even in individuals in early adulthood who tend to have low short-term risk. The degree of established cardiovascular risk factors can be converted into lifetime risk. Our findings may be useful for risk communication in the early detection of future cardiovascular disease risk.
  • Hidehiro Kaneko, Yuichiro Yano, Hidetaka Itoh, Kojiro Morita, Hiroyuki Kiriyama, Tatsuya Kamon, Katsuhito Fujiu, Nobuaki Michihata, Taisuke Jo, Norifumi Takeda, Hiroyuki Morita, Akira Nishiyama, Koichi Node, George Bakris, Katsuyuki Miura, Paul Muntner, Anthony J Viera, Suzanne Oparil, Donald M Lloyd-Jones, Hideo Yasunaga, Issei Komuro
    Journal of the American Heart Association 10 22 e022479  2021年11月 研究論文(学術雑誌) 
    Background Studies of the association of hypertension with incident colorectal cancer (CRC) may have been confounded by including individuals taking antihypertensive medication, at high risk for CRC (ie, colorectal polyps and inflammatory bowel disease), or with shared risk factors (eg, obesity and diabetes). We assessed whether adults with untreated hypertension are at higher risk for incident CRC compared with those with normal blood pressure (BP), and whether any association is evident among individuals without obesity or metabolic abnormalities. Methods and Results Analyses were conducted using a nationwide health claims database collected in the JMDC Claims Database between 2005 and 2018 (n=2 220 112; mean age, 44.1±11.0 years; 58.4% men). Participants who were taking antihypertensive medications or had a history of CRC, colorectal polyps, or inflammatory bowel disease were excluded. Each participant was categorized as having normal BP (systolic BP [SBP]<120 mm Hg and diastolic BP [DBP] <80 mm Hg, n=1 164 807), elevated BP (SBP 120-129 mm Hg and DBP <80 mm Hg, n=341 273), stage 1 hypertension (SBP 130-139 mm Hg or DBP 80-89 mm Hg, n=466 298), or stage 2 hypertension (SBP ≥140 mm Hg or DBP ≥90 mm Hg, n=247 734). Over a mean follow-up of 1112±854 days, 6899 incident CRC diagnoses occurred. After multivariable adjustment, compared with normal BP, hazard ratios for incident CRC were 0.93 (95% CI, 0.85-1.01) for elevated BP, 1.07 (95% CI, 0.99-1.15) for stage 1 hypertension, and 1.17 (95% CI, 1.08-1.28) for stage 2 hypertension. The hazard ratios for incident CRC for each 10-mm Hg-higher SBP or DBP were 1.04 (95% CI, 1.02-1.06) and 1.06 (95% CI, 1.03-1.09), respectively. These associations were present among adults who did not have obesity, high waist circumference, diabetes, or dyslipidemia. Conclusions Higher SBP and DBP, and stage 2 hypertension are associated with a higher risk for incident CRC, even among those without shared risk factors for CRC. BP measurement could identify individuals at increased risk for subsequent CRC.
  • 新型コロナウイルス感染症緊急事態宣言下における国民の生活習慣の変化
    南 朗子, 門田 文, 大久保 孝義, 岡村 智教, 奥田 奈賀子, 西 信雄, 宮本 恵宏, 由田 克士, 尾島 俊之, 近藤 慶子, 早川 岳人, 上島 弘嗣, 岡山 明, 三浦 克之
    日本公衆衛生学会総会抄録集 80回 506 - 506 日本公衆衛生学会 2021年11月
  • 都道府県単位の平均寿命別にみた国民健康・栄養調査結果における生活習慣等の推移
    西 信雄, 北岡 かおり, 岡見 雪子, 近藤 慶子, 佐田 みずき, 門田 文, 中村 美詠子, 尾島 俊之, 岡村 智教, 由田 克士, 三浦 克之
    日本循環器病予防学会誌 56 3 258 - 264 (一社)日本循環器病予防学会 2021年11月 
    【目的】都道府県別の平均寿命の格差について、その要因を断面で検討した研究はいくつかあるが、経年的に平均寿命と生活習慣等との関連を検討した研究は見当たらない。本研究は、日本国民を代表する標本による国民健康・栄養調査(国民栄養調査)の約20年間のデータ推移分析により、国民の生活習慣病リスク要因の変化を生態学的研究により明らかにすることを目的とした。【方法】国民健康・栄養調査(国民栄養調査)の1995-2016年の結果について、1995-1997年(1期)、1999-2001年(2期)、2003-2005年(3期)、2007-2009年(4期)、2012年(5期)、2016年(6期)の14年分を分析対象とした。2000年の平均寿命別に都道府県を4群に分類し、body mass index(BMI)、腹囲、歩数、現在習慣的に喫煙している者の割合、現在飲酒者の割合、現在飲酒者における1日あたり平均飲酒量の推移を比較した。これらの数値または割合の比較においては、平均寿命別の4群の平均値の高低について、平均寿命をさらに延伸させると想定される場合を健康増進性が高いとした。分析対象は40歳から69歳とし、2010年の10歳階級別人口に基づき年齢調整した値について、年次推移に関する6期(腹囲と飲酒に関する調査項目については4期)と平均寿命による4群をもとに二元配置分散分析を行った。【結果】男性のBMI、腹囲、歩数、現在飲酒者における1日あたり平均飲酒量と女性の現在習慣的に喫煙している者の割合において平均寿命別の有意差がみられ、いずれも平均寿命が高い群で健康増進性が高い(または平均寿命が低い群で健康増進性が低い)数値または割合を示した。これらの調査項目については期別でも有意差がみられ、経年的な変化にもかかわらず平均寿命と関連する可能性が示された。【結論】国民健康・栄養調査の約20年間のデータをもとに都道府県単位の平均寿命別に生活習慣等の推移を生態学的研究により検討したところ、男性のBMIや腹囲等、女性の現在習慣的に喫煙している者の割合において有意差がみられた。都道府県別の平均寿命の格差を縮小するためには、特に平均寿命が比較的短い都道府県において生活習慣等を地域レベルで改善することが重点的課題であると考えられた。(著者抄録)
  • Namuun Ganbaatar, Aya Kadota, Takashi Hisamatsu, Shinichi Araki, Shinji Kume, Akira Fujiyoshi, Sayaka Kadowaki, Sayuki Torii, Keiko Kondo, Hiroyoshi Segawa, Ebtehal Salman, Itsuko Miyazawa, Takashi Yamamoto, Yoshihisa Nakagawa, Hiroshi Maegawa, Katsuyuki Miura, Hirotsugu Ueshima
    Journal of atherosclerosis and thrombosis 2021年10月 研究論文(学術雑誌) 
    AIMS: The roles of urinary albumin, eGFRcystatin (eGFRcys), and eGFRcreatinine (eGFRcre) in the progression of coronary artery calcification (CAC) remain unclear. Therefore, the present study investigated the relationship between kidney function and CAC progression. METHODS: A total of 760 Japanese men aged 40-79 years were enrolled in this population-based study. Kidney function was measured using eGFRcre, eGFRcys, and the urine albumin-to-creatinine ratio. CAC scores were calculated using the Agatston method. CAC progression was defined as an annual increase of >10 Agatston units (AU) among men with 0<CAC<100 AU at baseline, that of >10% among those with CAC ≥ 100 AU, and any progression for those with CAC=0 at baseline. The relative risk (RR) of CAC progression based on kidney function was assessed using a robust Poisson regression model. RESULTS: The mean follow-up period was 4.9 years. CAC progression was detected in 45.8% of participants. Positive associations between CAC progression and albuminuria (>30mg/g) (RR: 1.29; 1.09 to 1.53; p=0.004) and low eGFRcys (<60ml/min/1.73m2) (RR: 1.27; 1.05 to 1.53; p=0.012) remained significant after adjustments for age, the follow-up time, and computerized tomography type. Following further adjustments for hypertension, diabetes mellitus, dyslipidemia, C-reactive protein, and lifestyle factors, CAC progression was associated with albuminuria (RR: 1.20; 1.01 to 1.43; p=0.04) and low eGFRcys (RR: 1.19; 0.99 to 1.43; p=0.066), but not with eGFRcre. CONCLUSION: CAC progression was associated with albuminuria; however, its relationship with eGFRcys was weakened by adjustments for risk factors.
  • Kei Asayama, Takayoshi Ohkubo, Hiromi Rakugi, Masaaki Miyakawa, Hisao Mori, Tomohiro Katsuya, Yumi Ikehara, Shinichiro Ueda, Yusuke Ohya, Takuya Tsuchihashi, Kazuomi Kario, Katsuyuki Miura, Sadayoshi Ito, Satoshi Umemura
    Journal of hypertension 40 2 398 - 407 2021年10月 研究論文(学術雑誌) 
    OBJECTIVE: The aim was to compare short-term and long-term reproducibilities of in-office unattended blood pressure (BP), namely automated office blood pressure (AOBP), conventionally measured attended office BP, and self-measured home BP. METHODS: A multicentre, clinical study was conducted in Japan, and 287 Japanese outpatients on antihypertensive drug medication were followed-up for 1 year. RESULTS: The intensity of drug treatment was sustained consistently throughout the study period (defined daily doses, 1.62-1.68; P = 0.12). The mean SBP differences between baseline and 1 month later, as well as baseline and 1 year later, were less than 1.5 mmHg, whereas the standard deviations of the differences for home, AOBP, and attended office measurements for the 1-year interval were 7.7, 14.5, and 15.3 mmHg, respectively. The coefficients of variation were significantly smaller for home BP than for AOBP among all patients at both 1-month and 1-year intervals (P < 0.0001). In the 1-month interval, partial correlation coefficients of home BP (r, 0.73/0.88 for systolic/diastolic measures) were significantly higher than of conventional BP (r, 0.47/0.69). However, the correlations converged to the modest level regardless of BP information (r, 0.49-0.54/0.63-0.73) when the 1-year interval was assessed. Results were confirmatory when patients on the same drug regimen (n = 167) were analysed. CONCLUSION: A higher reproducibility of home BP was demonstrated compared with in-office BP, including AOBP. However, the modest correlations for the 1-year interval support the importance of regular assessment of BP, regardless of in-office or home measurements for treatment of hypertension.
  • 地域住民男性における大豆イソフラボン代謝産物エクオールと冠動脈石灰化との横断的関連 SESSA研究
    藤吉 朗, 三浦 克之, 門田 文, 有馬 久富, 関川 暁, 近藤 慶子, 門脇 紗也佳, 岡見 雪子, 鈴木 春満, 久松 隆史, 中川 義久, 東山 綾, 岡村 智教, 上島 弘嗣
    日本動脈硬化学会総会プログラム・抄録集 53回 248 - 248 (一社)日本動脈硬化学会 2021年10月
  • Takashi Hisamatsu, Takayoshi Ohkubo, Atsushi Hozawa, Akira Fujiyoshi, Sayuki Torii, Hiroyoshi Segawa, Keiko Kondo, Aya Kadota, Naoyuki Takashima, Satoshi Shitara, Hisatomi Arima, Yoshihisa Nakagawa, Yoshiyuki Watanabe, Akihiko Shiino, Kazuhiko Nozaki, Hirotsugu Ueshima, Katsuyuki Miura
    Journal of hypertension 39 10 2030 - 2039 2021年10月 研究論文(学術雑誌) 
    OBJECTIVE: Hypertension and intracranial artery stenosis (ICAS) are closely related; however, few studies have compared the strength of the relationship between strictly measured office and out-of-office blood pressure (BP) measurements. The relationship of day-by-day or short-term variability in BP to asymptomatic ICAS also remains unclear. METHODS: In apparently healthy 677 men (mean age, 70 years) from a population-based cohort, we examined the association of strictly measured office BP and 7-day home BP with ICAS on magnetic resonance angiography. We conducted 24-h ambulatory BP monitoring in 468 of the men. Variability indices included day-by-day, daytime, and night-time variability, nocturnal decline, and morning pressor surge. Any ICAS was defined as either mild (1-49%) or severe (≥50%) stenosis. RESULTS: We observed mild and severe ICAS in 153 (22.6%) and 36 (5.3%) participants, respectively. In multivariable-adjusted Poisson regression with robust error variance, higher SBP in office, home, or ambulatory BP monitoring was associated with the presence of any or severe ICAS. The associations with ICAS were comparable between office, home, and ambulatory SBP (all heterogeneity P values >0.1). Independent of mean SBP, greater nocturnal decline or morning pressor surge, but not day-by-day, daytime, or night-time variability, in SBP was associated with higher burden of any or severe ICAS. CONCLUSION: The magnitude of association of strictly measured office BP for asymptomatic ICAS was comparable with that of BP measured at home or in ambulatory BP monitoring. Circadian BP variation based on ambulatory BP monitoring was positively associated with asymptomatic ICAS burden.
  • Naoyuki Takashima, Yasuyuki Nakamura, Naoko Miyagawa, Aya Kadota, Sachiko Tanaka-Mizuno, Kenji Matsui, Katsuyuki Miura, Hirotsugu Ueshima, Yoshikuni Kita
    Gerontology 68 6 1 - 8 2021年09月 研究論文(学術雑誌) 
    BACKGROUND: Both physical and psychological factors have been associated with functional disability. However, the associations between stress-coping strategies and future functional disability remain unclear. METHODS: We analyzed 2,924 participants who did not have incidence of functional disability or death within the first 3 years of the baseline survey and were aged 65 years or more at the end of follow-up. Stress-coping strategies were assessed via a self-administered questionnaire (emotional expression, emotional support seeking, positive thought, problem-solving, and disengagement) in a baseline survey from 2006 to 2014. Levels of coping strategies were classified as low, middle, and high based of frequency. Functional disability decline was followed up using the long-term-care insurance program until November 1, 2019. Functional disability decline was defined as a new long-term-care insurance program certification. Cox proportional hazards model with competing risk analysis for death was used to evaluate associations between coping strategy levels and functional disability. RESULTS: During the follow-up period, we observed 341 cases of functional disability and 73 deaths without previous incidence of functional disability. A significant inverse association between "positive thought" and "problem-solving" and future functional disability was observed. Multivariable adjusted hazard ratios (95% confidence interval) for functional disability were 0.68 (0.51-0.92) for high levels of "positive thought" and 0.73 (0.55-0.95) for high levels of "problem-solving," compared with low levels of the coping strategies. The inverse association was stronger in men. CONCLUSIONS: Some subcomponents of stress-coping strategies might be associated with future incidence of functional disability among older adults.
  • Yiwei Liu, Aya Hirata, Tomonori Okamura, Daisuke Sugiyama, Takumi Hirata, Aya Kadota, Keiko Kondo, Takayoshi Ohkubo, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    Journal of epidemiology 2021年09月 研究論文(学術雑誌) 
    BackgroundElevated resting heart rate (RHR) is associated with an increased risk for cardiovascular disease (CVD) and all-cause mortality. However, the findings of cohort studies differed. Thus, the impact of RHR on CVD mortality might be different according to the background of the population. Therefore, we examined the relationship of RHR and CVD mortality according to serum ALB levels in a Japanese general population.MethodsIn total, 8363 individuals without a history of CVD were followed-up for 24.0 years. The participants were divided into four groups according to the quartiles of RHR (Q1-Q4), and they were further classified into the high and low ALB groups based on a median value of 44 g/L. We estimated the multivariable-adjusted hazard ratios (HRs) of CVD mortality in each RHR group based on ALB levels, and the interaction between RHR and ALB groups on CVD mortality was evaluated.ResultsWe found no significant association between RHR and CVD mortality. However, the Q4 of RHR was significantly associated with an increased risk for CVD mortality (HR: 1.27 [95% confidence interval, CI: 1.02-1.57]) in participants with a low ALB level. Meanwhile, the Q4 of RHR was significantly correlated with a decreased risk for CVD morality in those with a high ALB level (HR: 0.61 [95% CI: 0.47-0.79]) after adjusting for covariates. A significant interaction between RHR and ALB for CVD mortality was shown (p<0.001).ConclusionsThe impact of RHR on CVD mortality differed according to ALB levels in a general Japanese population.
  • Takako Fujii, Hisatomi Arima, Naoyuki Takashima, Yoshikuni Kita, Naomi Miyamatsu, Sachiko Tanaka-Mizuno, Satoshi Shitara, Makoto Urushitani, Katsuyuki Miura, Kazuhiko Nozaki
    Cerebrovascular diseases (Basel, Switzerland) 51 1 1 - 7 2021年08月 研究論文(学術雑誌) 
    INTRODUCTION: The purpose of this study was to investigate seasonal variation in stroke incidence using data from a large-scale stroke registry of general population in current Japan. METHODS: Shiga Stroke Registry (SSR) is an ongoing population-based registry of stroke that occurred in the Shiga Prefecture in central Honshu, Japan. A total 6,688 cases of first-ever stroke, with onset dates ranging from 1 January 2011 to 31 December in 2013 were included in this study. Incidence rates of first-ever stroke in each season were estimated using the person-year approach and adjusted for age and sex using the Poisson regression models. RESULTS: From 2011 to 2013, we identified a total of 6,688 stroke cases (3,570 men, 3,118 women), of which 4,480 cases had ischemic stroke (2,518 men, 1,962 women), 1,588 had intracerebral hemorrhage (857 men, 731 women) and 563 had subarachnoid hemorrhage (166 men, 397 women). Age- and sex-adjusted incidence rates of total stroke were 151 (95% confidence interval [CI] 144-160, p = <0.001 vs. summer) in spring, 130 (95% CI 122-137) in summer, 141 (95% CI 133-149, p = 0.020 vs. summer) in autumn and 170 (95% CI 161-179, p = <0.001 vs. summer) in winter. Seasonal variation was more pronounced in intracerebral hemorrhage than in ischemic stroke. CONCLUSION: In the present large-scale stroke registry of general population, incidence rates of stroke were highest in winter and lowest in summer in current Japan.
  • Tserenlkham Byambajav, Takashi Waki, Katsuyuki Miura, Sachiko Tanaka-Mizuno
    Pharmacoepidemiology and drug safety 31 2 149 - 157 2021年08月 研究論文(学術雑誌) 
    PURPOSE: We aimed to evaluate adherence and persistence to warfarin therapy among patients with antiphospholipid syndrome (APS) and investigate the association between adherence and thrombotic events in those patients. METHODS: We conducted a retrospective cohort study using the Japan Medical Data Center claims database from 2005 to 2018. Patients with APS receiving warfarin treatment were included in this study. Adherence and persistence were evaluated using the proportion of days covered (PDS) and refill gap methods, respectively. Demographic characteristics of patients were obtained. Kaplan-Meier curves with log-rank tests and Cox regression models were used to examine the association between adherence or persistence and time to thrombotic events. RESULTS: A total of 186 patients (mean age: 46.5 ± 12.4 years, females 68.8%) were included in this study. No significant differences were observed in risk factors for thrombosis and cardiovascular diseases among groups. Most patients were adherent (91.4%) and persistent (88.2%) to warfarin treatment. Adherent and persistent patients had a significantly higher rate of thrombotic event-free survival than nonadherent and nonpersistent patients (p < 0.05). Multivariable Cox regression showed that the risk of thrombotic events was higher in nonadherent patients (with a hazard ratio of 3.23 [95% confidence interval CI: 1.15-9.11]) and in nonpersistent patients (with a hazard ratio of 3.45 [95% CI: 1.35-8.82]). CONCLUSIONS: In patients with APS, nonadherence and nonpersistence to warfarin treatment was associated with a higher risk of thrombotic events, suggesting the careful monitoring of those patients.
  • Yuichiro Yano, Akira Nishiyama, Toshihiko Ishimitsu, Naoki Kashihara, Hiromi Rakugi, Kouichi Tamura, Hiroshi Itoh, Takuya Tsuchihashi, Atsushi Sakima, Hisatomi Arima, Tetsutaro Matayoshi, Yutaka Imai, Katsuyuki Miura, Takashi Hisamatsu, Kei Asayama, Takayoshi Ohkubo, Kouihci Node, Kazuomi Kario
    Journal of human hypertension 2021年08月
  • Kawser Khan, Sachiko Tanaka-Mizuno, Tanvir C Turin, Naoyuki Takashima, Aya Kadota, Hirotsugu Ueshima, Katsuyuki Miura, Yoshikuni Kita
    Circulation journal : official journal of the Japanese Circulation Society 85 12 2215 - 2221 2021年07月 研究論文(学術雑誌) 
    BACKGROUND: Using a population-based stroke registry system, we evaluated the relationship between ambient temperature parameters and stroke incidence in a Japanese population.Methods and Results:We analyzed data from the Takashima Stroke Registry, which records all stroke occurrences in Takashima City, Japan. The study period of 8,401 days was divided into quintiles of daily weather parameters, and the middle quintile was used as the reference category. Incidence rates (IR per 100,000 person-years) were calculated across the quintiles. Poisson regression analysis was used to calculate the effect of temperature parameters on stroke incidence. There were 2,405 first-ever strokes (1,294 men), including 1,625 ischemic, 545 cerebral hemorrhages, 213 subarachnoid hemorrhages, and 22 unclassified strokes. The stroke IR was higher in the middle quintile of average temperature, 357.3 (328.4-388.8), and for other parameters. After adjustment for age and sex, for all stroke, the incidence rate ratio (IRR) in the highest (Q5: IRR 0.81, 95% confidence interval (CI) 0.71-0.92) and the second-highest (Q4: IRR 0.80, 95% CI 0.71-0.91) quintile was lower than that in the middle quintile (Q3: Reference). Analogous results were observed for the minimum, maximum, and lag-days temperatures, also in the subtypes and across ≥65 years of age, also in females. CONCLUSIONS: Higher temperatures, irrespective of the parameter (average, minimum, or maximum), had a protective effect against stroke occurrence in Japan.
  • Hideki Nagata, Katsuyuki Miura, Sachiko Tanaka, Aya Kadota, Takehito Hayakawa, Keiko Kondo, Akira Fujiyoshi, Naoyuki Takashima, Yoshikuni Kita, Akira Okayama, Tomonori Okamura, Hirotsugu Ueshima
    Journal of epidemiology 2021年07月 研究論文(学術雑誌) 
    BACKGROUND: Basic and instrumental activities of daily living (BADL, IADL) are known predictors of mortality. However, the relationship between higher-level functional capacity (HLFC) and mortality and related sex differences have rarely been investigated. METHODS: A prospective population-based cohort study was conducted in 1,824 older residents (≥65 years) with independent BADL from 300 randomly selected areas in Japan from 1995, and the participants were followed up until 2010. Using the Cox proportional hazards model, the relationship between HLFC and mortality risk was investigated with adjustment for possible confounders. HLFC was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Baseline data were collected using a questionnaire or by home-visit interviews. RESULTS: During an average 12.2-year follow-up, all-cause death was observed in 836 (45.8%) participants. Impaired HLFC was significantly associated with mortality (hazard ratio [HR] 1.37; 95% confidence interval [CI], 1.13-1.65). Lower social role was significantly associated with higher mortality risk in men (HR 1.38; 95% CI, 1.13-1.68). Lower IADL and intellectual activity were significantly associated with higher mortality risk in women (HR 1.50; 95% CI, 1.15-1.95; HR 1.46; 95% CI, 1.19-1.79). The relationship between HLFC and mortality risk showed a similar tendency among cardiovascular diseases, stroke, cancer, and pneumonia. CONCLUSION: Impaired HLFC was associated with a high risk of all-cause mortality among community-dwelling older people with independent BADL. In particular, social role in men and IADL and intellectual activity in women were associated with long-term mortality risk.
  • Harumitsu Suzuki, Kendra Davis-Plourde, Alexa Beiser, Ayako Kunimura, Katsuyuki Miura, Charles DeCarli, Pauline Maillard, Gary F Mitchell, Ramachandran S Vasan, Sudha Seshadri, Akira Fujiyoshi
    Circulation. Cardiovascular imaging 14 7 e011753  2021年07月 研究論文(学術雑誌) 
    BACKGROUND: Using magnetic resonance diffusion tensor imaging, we previously showed a cross-sectional association between carotid-femoral pulse wave velocity, a measure of aortic stiffness, and subtle white matter injury in clinically asymptomatic middle-age adults. While coronary artery calcium (CAC) is a robust measure of atherosclerosis, and a predictor of stroke and dementia, whether it predicts diffusion tensor imaging-based subtle white matter injury in the brain remains unknown. METHODS: In FHS (Framingham Heart Study), an observational study, third-generation participants were assessed for CAC (2002-2005) and brain magnetic resonance imaging (2009-2014). Outcomes were diffusion tensor imaging-based measures; free water, fractional anisotropy, and peak width of mean diffusivity. After excluding the participants with neurological conditions and missing covariates, we categorized participants into 3 groups according to CAC score (0, 0 < to 100, and >100) and calculated a linear trend across the CAC groups. In secondary analyses treating CAC score as continuous, we computed slope of the outcomes per 20 to 80th percentiles higher log-transformed CAC score using linear regression. RESULTS: In a total of 1052 individuals analyzed (mean age 45.4 years, 45.4% women), 71.6%, 22.4%, and 6.0% had CAC score of 0, 0 < to 100, and >100, respectively. We observed a significant linear trend of fractional anisotropy, but not other measures, across the CAC groups after multivariable adjustment. In the secondary analyses, CAC was associated with lower fractional anisotropy in men but not in women. CONCLUSIONS: CAC may be a promising tool to predict prevalent subtle white matter injury of the brain in asymptomatic middle-aged men.
  • Thien Vu, Akira Fujiyoshi, Takashi Hisamatsu, Aya Kadota, Maryam Zaid, Hiroyoshi Segawa, Keiko Kondo, Sayuki Torii, Yoshihisa Nakagawa, Tomoaki Suzuki, Tohru Asai, Katsuyuki Miura, Hirotsugu Ueshima
    Circulation journal : official journal of the Japanese Circulation Society 85 7 1076 - 1082 2021年06月 研究論文(学術雑誌) 
    BACKGROUND: Risk factors for atherosclerotic disease including dyslipidemia have been shown to be associated with aortic valve calcification (AVC). Nuclear magnetic resonance (NMR)-measured lipoprotein particles, low-density and high-density lipoprotein particles (LDL-p, HDL-p) in particular, have emerged as novel markers of atherosclerotic disease; however, whether NMR-measured particles are associated with AVC remains to be determined. This study aimed to examine the association between NMR-based lipoprotein particle measurements and standard lipids with AVC. The primary variables of interest were LDL-p (nmol/L), HDL-p (μmol/L), LDL-cholesterol, and HDL-cholesterol (both in mg/dL).Methods and Results:A community-based random sample of Japanese men aged 40-79 years examined in 2006-2008, in Shiga, Japan was studied. Presence of AVC was defined as an Agatston score >0. Lipoprotein particles were measured using NMR spectroscopy. In the main analysis, multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for the prevalence of AVC across the higher quartiles of lipids in reference to the lowest ones were obtained. Of 874 participants analyzed, 153 men had AVC. Multivariable-adjusted ORs of prevalent AVC for the highest vs. the lowest quartile were significantly elevated for LDL-p (OR, 2.20; 95% CI: 1.23-3.93) and LDL-cholesterol (OR, 2.16; 95% CI: 1.23-3.78). In contrast, neither HDL-p nor HDL-cholesterol was associated with AVC. CONCLUSIONS: The association of prevalent AVC with NMR-based LDL-p was comparable to that with LDL-cholesterol.
  • 顕性アルブミン尿を伴わない糖尿病・非糖尿病におけるeGFR低下リスク要因の探索:滋賀動脈硬化疫学研究SESSA
    久米 真司, 宮澤 伊都子, 門田 文, 久松 隆史, 近藤 慶子, 瀬川 裕佳, 鳥居 さゆき, 荒木 信一, 前川 聡, 三浦 克之, 上島 弘嗣, SESSA研究グル-プ
    日本腎臓学会誌 63 4 478 - 478 (一社)日本腎臓学会 2021年06月
  • Takashi Hisamatsu, Takayoshi Ohkubo, Akira Fujiyoshi, Sayuki Torii, Hiroyoshi Segawa, Keiko Kondo, Aya Kadota, Naoyuki Takashima, Satoshi Shitara, Hisatomi Arima, Yoshihisa Nakagawa, Yoshiyuki Watanabe, Akihiko Shiino, Kazuhiko Nozaki, Hirotsugu Ueshima, Katsuyuki Miura
    Circulation 143 Suppl_1 2021年05月 研究論文(学術雑誌) 
    Background: Few studies have compared accurately measured office, self-measured home, and ambulatory blood pressure (BP) for asymptomatic intracranial artery stenosis (ICAS). Relationship of day-by-day or short-term variability in BP to asymptomatic ICAS remains unclear. Objectives: To examine the association of office, home (mean value and day-by-day variability), and ambulatory BP indices (24-hour/daytime/nighttime mean values, short-term variability, nocturnal decline, and morning pressor surge) with asymptomatic ICAS. Methods: Data on office and 7-day home BP and magnetic resonance angiography to assess ICAS were obtained in 677 men (mean age, 70.0 years) from a population-based cohort. Among them, 468 underwent 24-hour ambulatory BP monitoring. Mild- or severe-ICAS was defined as 1-49% or ≥50% stenosis, respectively, and any-ICAS as either mild or severe-ICAS. Results: We observed mild- and severe-ICAS in 153 (22.6%) and 36 (5.3%) participants, respectively. In multivariable Poisson regression with robust error variance, higher systolic BP at office, home, or ambulatory BP monitoring was associated with the presence of any- or severe-ICAS. The associations with ICAS were comparable between office, home, and ambulatory systolic BP (all heterogeneity Ps >0.1). Independent of mean systolic BP, greater nocturnal decline or morning pressor surge in systolic BP was associated with higher burden of any- or severe-ICAS. Conclusion: The magnitude of association of BP accurately measured at office for asymptomatic ICAS was comparable with that of BP at home or ambulatory BP monitoring. Circadian BP variation based on ambulatory BP monitoring may be considered when assessing ICAS in apparently healthy individuals.
  • Yuka Sumimoto, Masahiko Yanagita, Naomi Miyamatsu, Nagako Okuda, Nobuo Nishi, Yosikazu Nakamura, Koshi Nakamura, Naoko Miyagawa, Motohiko Miyachi, Aya Kadota, Takayoshi Ohkubo, Tomonori Okamura, Hirotsugu Ueshima, Akira Okayama, Katsuyuki Miura
    Environmental health and preventive medicine 26 1 57 - 57 2021年05月 研究論文(学術雑誌) 
    BACKGROUND: It has been pointed out that prolonged television (TV) viewing is one of the sedentary behaviors that is harmful to health; however, the association between socioeconomic status (SES) and prolonged TV viewing time has not been sufficiently investigated in Japan. METHODS: The study population are the participants of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey 2010 in Japan. They were residents in 300 randomly selected areas across Japan. This study included 2752 adults. SES was classified according to the employment status, educational attainment, living status, and equivalent household expenditure (EHE). Prolonged TV viewing time was defined as more than or equal to 4 h of TV viewing per day. Multivariable logistic regression analyses were conducted to examine the association of SES with prolonged TV viewing time. RESULTS: The mean TV viewing time was 2.92 h in all participants. Of 2752 participants, 809 (29.4%) prolonged TV viewing, and the mean TV viewing time of them was 5.61 h. The mean TV viewing time in participants without prolonged TV viewing time was 1.81 h. The mean TV viewing time was prolonged as age classes increased and significantly longer in aged ≥60 years. Prolonged TV viewing time was associated with not working for all age classes and sexes. Only among women, education attainment and living status were also associated with prolonged TV viewing time. For education attainment, the lower the received years of education, the higher odds ratios (OR) of prolonged TV viewing time. For living status, in women aged <60 years, living with others had a significantly higher OR compared to living with spouse. On the other hand, in women aged ≥60 years, living alone had a significantly higher OR. EHE did not have any significant associations with prolonged TV viewing time. CONCLUSIONS: In a general Japanese population, it should be noted that the association between SES and prolonged TV viewing time differed by age and sex. Particularly, it must draw attention to the prolonged TV viewing in elderly. The intervention in order to shorten TV viewing time needs to consider these attributes.
  • 西 信雄, 北岡 かおり, 近藤 慶子, 門田 文, 中村 美詠子, 佐田 みずき, 尾島 俊之, 岡村 智教, 由田 克士, 三浦 克之
    日本循環器病予防学会誌 56 2 173 - 173 (一社)日本循環器病予防学会 2021年05月
  • 佐田 みずき, 岡村 智教, 西 信雄, 門田 文, 中村 美詠子, 近藤 慶子, 北岡 かおり, 尾島 俊之, 由田 克士, 三浦 克之
    日本循環器病予防学会誌 56 2 174 - 174 (一社)日本循環器病予防学会 2021年05月
  • 中村 美詠子, 尾島 俊之, 西 信雄, 門田 文, 佐田 みずき, 近藤 慶子, 北岡 かおり, 岡村 智教, 由田 克士, 三浦 克之
    日本循環器病予防学会誌 56 2 174 - 174 (一社)日本循環器病予防学会 2021年05月
  • 北岡 かおり, 門田 文, 岡見 雪子, 近藤 慶子, 中村 美詠子, 尾島 俊之, 岡村 智教, 由田 克士, 西 信雄, 三浦 克之
    日本循環器病予防学会誌 56 2 174 - 174 (一社)日本循環器病予防学会 2021年05月
  • Takashi Hisamatsu, Katsuyuki Miura
    Journal of human hypertension 2021年04月 研究論文(学術雑誌) 
    Based on data from national surveys, the prevalence of hypertension rests at 40-60% in Japan, the USA, and in European countries. This suggests there has been little progress in the prevention of hypertension in even high-income countries despite their well-functioning health systems. In particular, compared with the USA and European countries, the improvement in awareness, treatment, and control of hypertension has been relatively low in Japan. For example, the rates of hypertension awareness, treatment, and control were observed, respectively, in 60-70%, 50-60%, and 20-30% of Japanese compared with 80-90%, 70-80%, and 50-60% of US citizens in the years around 2015. The lower proportions in Japan might be explained by the slower progress in lowering the accepted thresholds for diagnosis of hypertension and initiation of treatment compared with Western countries; however, the underlying reasons for the differences warrant further study. The high prevalence (>40%) of uncontrolled hypertension in even high-income countries has major implications for the prevention of cardiovascular disease. Health policy and research on early control of high blood pressure at the individual and public health levels will contribute to decreases in the prevalence of hypertension. Furthermore, proactive treatment and strict adherence to intensified antihypertensive treatment guidelines will more effectively achieve targeted blood pressure levels. In this context, it is important to continue to carefully monitor and compare trends in hypertension across countries.
  • Factors of Premature Atrial Contractions among General Japanese Men(和訳中)
    Ahmed Sabrina, Miura Katsuyuki, Hisamatsu Takashi, Kadota Aya, Fujiyoshi Akira, Segawa Hiroyoshi, Torii Sayuki, Takashima Naoyuki, Kondo Keiko, Nakagawa Yoshihisa, Ueshima Hirotsugu
    日本循環器学会学術集会抄録集 85回 OE083 - 1 2021年03月
  • Taro Suzuki, Yasuyuki Nakamura, Yukio Doi, Akira Narita, Atsushi Shimizu, Nahomi Imaeda, Chiho Goto, Kenji Matsui, Aya Kadota, Katsuyuki Miura, Masahiro Nakatochi, Keitaro Tanaka, Megumi Hara, Hiroaki Ikezaki, Masayuki Murata, Toshiro Takezaki, Daisaku Nishimoto, Keitaro Matsuo, Isao Oze, Nagato Kuriyama, Etsuko Ozaki, Haruo Mikami, Yohko Nakamura, Miki Watanabe, Sadao Suzuki, Sakurako Katsuura-Kamano, Kokichi Arisawa, Kiyonori Kuriki, Yukihide Momozawa, Michiaki Kubo, Kenji Takeuchi, Yoshikuni Kita, Kenji Wakai
    The British journal of nutrition 126 12 1 - 37 2021年02月 研究論文(学術雑誌) 
    Differences in individual eating habits may be influenced by genetic factors, in addition to cultural, social, or environmental factors. Previous studies suggested that genetic variants within sweet taste receptor genes family were associated with sweet taste perception and the intake of sweet foods. The aim of this study was to conduct a genome-wide association study (GWAS) to find genetic variations that affect confection consumption in a Japanese population. We analyzed GWAS data on sweets consumption using 14,073 participants from the Japan Multi-Institutional Collaborative Cohort study. We used a semi-quantitative food frequency questionnaire to estimate food intake that was validated previously. Association of the imputed variants with sweets consumption was performed by linear regression analysis with adjustments for age, sex, total energy intake and principal component analysis components 1 to 3. Furthermore, the analysis was repeated adjusting for alcohol intake (g/day) in addition to the above-described variables. We found 418 single nucleotide polymorphisms (SNPs) located in 12q24 that were associated with sweets consumption. SNPs with the 10 lowest P-values were located on nine genes including at the BRAP, ACAD10, and ALDH2 regions on 12q24.12-13. After adjustment for alcohol intake, no variant was associated with sweets intake with genome-wide significance. In conclusion, we found a significant number of SNPs located on 12q24 genes that were associated with sweets intake before adjustment for alcohol intake. However, all of them lost statistical significance after adjustment for alcohol intake.
  • Maryam Zaid, Akira Fujiyoshi, Takashi Hisamatsu, Aya Kadota, Sayaka Kadowaki, Atsushi Satoh, Akira Sekikawa, Emma Barinas-Mitchell, Minoru Horie, Katsuyuki Miura, Hirotsugu Ueshima
    Journal of atherosclerosis and thrombosis 29 2 282 - 295 2021年02月 研究論文(学術雑誌) 
    AIMS: The utility of carotid intima-media thickness (cIMT) as a marker for coronary heart disease is under heavy debate. This is predominantly due to the lack of a standard definition of cIMT, leading to inconsistent results. We investigated and compared the relationships of five different measures of cIMT with coronary calcium. METHODS: Japanese men aged 40-79y (n=869) from Shiga Epidemiological Study of Subclinical Atherosclerosis were examined. Mean cIMT was measured in three segments of the carotid arteries: common carotid artery (CCAmean), internal carotid artery (ICAmean) and bifurcation (Bifmean). Mean cIMT of average values (Mean cIMT) and mean cIMT of maximum values (Mean-Max cIMT) of all segments combined were assessed. Coronary calcium was assessed as coronary artery calcification (CAC). Ordinal logistic regression was used to determine the odds ratio (OR) of higher CAC per 1 standard deviation higher cIMT measure. Analyses were adjusted for cardiovascular covariates and stratified by age quartiles. RESULTS: All cIMT measures had positive associations with CAC (p<0.001): [OR, 95% Confidence Interval]: ICAmean [1.23, 1.07-1.42], CCAmean [1.27, 1.08-1.49], Bifmean [1.33, 1.15-1.53], Mean cIMT [1.42, 1.22-1.66], and Mean-Max [1.50, 1.28-1.75]. In age-stratified analyses, only Mean-Max cIMT maintained a significant relationship with CAC in every age quartile (p<0.05), while CCAmean had some of the weakest associations among age quartiles. CONCLUSIONS: Mean-Max cIMT had consistently stronger associations with coronary calcium, independent of important confounders, such as age. The most oft-used measure, CCAmean, was no longer associated with coronary calcium after age-adjustment and stratification.
  • Asahi Hishida, Masahiro Nakatochi, Takashi Tamura, Mako Nagayoshi, Rieko Okada, Yoko Kubo, Mineko Tsukamoto, Yuka Kadomatsu, Sadao Suzuki, Takeshi Nishiyama, Nagato Kuriyama, Isao Watanabe, Toshiro Takezaki, Daisaku Nishimoto, Kiyonori Kuriki, Kokichi Arisawa, Sakurako Katsuura-Kamano, Haruo Mikami, Miho Kusakabe, Isao Oze, Yuriko N Koyanagi, Yasuyuki Nakamura, Aya Kadota, Chisato Shimanoe, Keitaro Tanaka, Hiroaki Ikezaki, Masayuki Murata, Michiaki Kubo, Yukihide Momozawa, Kenji Takeuchi, Kenji Wakai
    Nagoya journal of medical science 83 1 183 - 194 2021年02月 [有り]
     研究論文(学術雑誌) 
    Prostate cancer is emerging as a significant global public health burden. The incidence and prevalence of prostate cancer has increased in Japan, as westernized lifestyles become more popular. Recent advances in genetic epidemiology, including genome-wide association studies (GWASs), have identified considerable numbers of human genetic factors associated with diseases. Several GWASs have reported significant loci associated with serum prostate-specific antigen (PSA) levels. One GWAS, which was based on classic GWAS microarray measurements, has been reported for Japanese so far. In the present study, we conducted a GWAS of serum PSA using 1000Genomes imputed GWAS data (n =1,216) from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study, to detect candidate novel genetic loci that influence serum PSA levels in Japanese. The association of SNPs/genetic variants with serum PSA as a continuous variable was tested using the linear Wald test. SNP rs10000006 in SGMS2 (sphingomyelin synthase 2) on chromosome 4 had genome-wide significance (P <5×10-8), and eight variants on three chromosomes (chromosomes 12, 14, 15) had genome-wide suggestive levels of significance (P <1×10-6). With an independent data set from the J-MICC Shizuoka Study (n = 2,447), the association of the SGMS2 SNP with blood PSA levels was not replicated. Although our GWAS failed to detect novel loci associated with serum PSA levels in the Japanese cohort, it confirmed the significant effects of previously reported genetic loci on PSA levels in Japanese. Importantly, our results confirmed the significance of KLK3 SNPs also in Japanese, implying that consideration of individual genetic information in prostate cancer diagnosis may be possible in the future.
  • Ali Haidar Syaifullah, Akihiko Shiino, Akira Fujiyoshi, Aya Kadota, Keiko Kondo, Takahiro Ito, Hiroyoshi Segawa, Mohammad Moniruzzaman, Takashi Waki, Naoko Miyagawa, Ikuo Tooyama, Hirotsugu Ueshima, Katsuyuki Miura, Hirotsugu Ueshima, Katsuyuki Miura
    Alcohol (Fayetteville, N.Y.) 90 57 - 65 2021年02月 研究論文(学術雑誌) 
    The clinical implications of alcohol consumption have been extensively examined; however, its effects on brain structures in apparently healthy community-dwellers remain unclear. Therefore, we investigated the relationship between alcohol consumption and brain gray matter volume (GMV) in community-dwelling Japanese men using voxel-based morphometry (VBM). We recruited cognitively intact Japanese men, aged 40-79 years, from a population-based cohort in Shiga, Japan. Brain magnetic resonance imaging was performed, on average, 2 years after demographic and medical information was obtained in 2010-2014. A multivariable linear regression analysis of 639 men was conducted to elucidate the relationship between the amount of alcohol consumed and GMV. VBM statistics were analyzed by threshold-free cluster enhancement with a family-wise error rate of <0.05. The results obtained demonstrated that the amount of alcohol consumed was associated with lower GMV. The VBM analysis showed lower GMV within the parahippocampal, entorhinal, cingulate, insular, temporal, and frontal cortices and cerebellum in very heavy drinkers (≥42 ethanol g/day) than in non-drinkers. Furthermore, alcohol consumption was associated with a higher white matter lesion volume. These results suggest subclinical structural changes similar to alcohol-related neurological diseases.
  • Ebtehal Salman, Aya Kadota, Takashi Hisamatsu, Hiroyoshi Segawa, Sayuki Torii, Akira Fujiyoshi, Keiko Kondo, Yoshiyuki Watanabe, Hisatomi Arima, Akihiko Shiino, Kazuhiko Nozaki, Hirotsugu Ueshima, Katsuyuki Miura, For The Sessa Research Group
    Journal of atherosclerosis and thrombosis 29 2 174 - 187 2021年01月 研究論文(学術雑誌) 
    AIM: The relationship of blood pressure (BP) indexes (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], mean arterial pressure [MAP]) to subclinical cerebrovascular diseases (SCVDs) remains unclear. This study aimed to elucidate the relationship of four BP indexes measured at two visits on SCVDs assessed by magnetic resonance imaging (MRI) in general Japanese men. METHODS: In general Japanese men aged 40-79 years (N=616), office BP indexes were measured at two visits (Visits 1 [2006-2008] and 2 [2010-2014]). MRI images obtained on the third visit (2012-2015) were examined for prevalent SCVDs: lacunar infarction, periventricular hyperintensity (PVH), deep subcortical white matter hyperintensity (DSWMH), microbleeds, and intracranial artery stenosis (ICAS). Using a multivariable logistic regression analysis, we computed and estimated the odds ratio of each prevalent SCVD for one standard deviation higher BP indexes. The same analyses were performed using home BP. RESULTS: All four office BP indexes at both visits associated with lacunar infarction. Visit 1 and 2 DBP and Visit 1 MAP associated with PVH and DSWMH, and Visit 1 SBP associated with DSWMH. All Visit 2 BP indexes appear to show stronger association with microbleeds than Visit 1 indexes, and Visit 1 and 2 SBP, PP, and MAP showed similar associations with ICAS. Additional analyses using home BP indexes revealed similar relationships; however, the significance of some relationships decreased. CONCLUSION: In general Japanese men, BP indexes were associated with most of SCVDs, and BP indexes measured at different periods associated with different SCVDs assessed by MRI.
  • Aya Hirata, Tomonori Okamura, Takumi Hirata, Daisuke Sugiyama, Takayoshi Ohkubo, Nagako Okuda, Yoshikuni Kita, Takehito Hayakawa, Aya Kadota, Keiko Kondo, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    Journal of epidemiology 2021年01月 研究論文(学術雑誌) 
    BackgroundNon-fasting triglycerides (TG) are considered a better predictor of cardiovascular disease (CVD) than fasting TG. However, the effect of non-fasting TG on fatal CVD events remains unclear. In the present study, we aimed to explore the relationship between non-fasting TG and CVD mortality in a Japanese general population.MethodsA total of 6,831 participants without a history of CVD, in which those who had a blood sampling over 8 hours or more after a meal were excluded, were followed for 18.0 years. We divided participants into seven groups according to non-fasting TG levels: ≤59 mg/dL, 60-89 mg/dL, 90-119 mg/dL, 120-149 mg/dL, 150-179 mg/dL, 180-209 mg/dL, and ≥210 mg/dL, and estimated the multivariable-adjusted hazard ratios (HRs) of each TG group for CVD mortality after adjusting for potential confounders, including high density lipoprotein cholesterol. Additionally, we performed analysis stratified by age <65 and ≥65 years.ResultsDuring the follow-up period, 433 deaths due to CVD were detected. Compared with a non-fasting TG of 150-179 mg/dL, non-fasting TG ≥210 mg/dL was significantly associated with increased risk for CVD mortality (HR=1.56, 95% CI, 1.01-2.41). Additionally, lower levels of non-fasting TG were also significantly associated with increased risk for fatal CVD. In participants aged ≥65 years, lower levels of non-fasting TG had a stronger impact on increased risk for CVD mortality, while higher levels of non-fasting TG had a stronger impact in those aged <65 years.ConclusionIn a general Japanese population, we observed a U-shaped association between non-fasting TG and fatal CVD events.
  • Mohammad Moniruzzaman, Aya Kadota, Akihiko Shiino, Akira Fujiyoshi, Takahiro Ito, Ali Haidar Syaifullah, Naoko Miyagawa, Keiko Kondo, Takashi Hisamatsu, Hiroyoshi Segawa, Ikuo Tooyama, Hirotsugu Ueshima, Katsuyuki Miura
    Journal of physical activity & health 18 2 157 - 164 2021年01月 研究論文(学術雑誌) 
    BACKGROUND: To investigate the association between step counts and brain volumes (BVs)-global and 6 a priori selected cognition-related regions of interest-in Japanese men aged 40-79 years. METHODS: The authors analyzed data from 680 cognitively intact participants of the Shiga Epidemiological Study of Subclinical Atherosclerosis-a population-based observational study. Using multivariable linear regression, the authors assessed cross-sectional associations between 7-day step counts at baseline (2006-2008) and BVs at follow-up (2012-2015) for age-stratified groups (<60 y and ≥60 y). RESULTS: In the older adults ≥60 years, step counts at baseline (per 1000 steps) were associated with total BV at follow-up (β = 1.42, P = .022) while adjusted for potential covariates. Regions of interest-based analyses yielded an association of step counts with both prefrontal cortexes (P < .05) in older adults, while the left entorhinal cortex showed marginally significant association (P = .05). No association was observed with hippocampus, parahippocampal, cingulum, and cerebellum. No association was observed in younger adults (<60 y). CONCLUSIONS: The authors found a positive association between 7-day step counts and BVs, including prefrontal cortexes, and left entorhinal cortex in apparently healthy Japanese men.
  • 日本人女性の妊娠出産歴と高血圧の関連 J-MICCベースライン分析
    大橋 瑞紀, 三浦 克之, 高嶋 直敬, 門田 文, 斎藤 祥乃, 辻 俊一郎, 村上 節, 喜多 義邦, 若井 建志
    Journal of Epidemiology 31 Suppl. 119 - 119 (一社)日本疫学会 2021年01月
  • Yasuyuki Nakamura, Akira Narita, Yoichi Sutoh, Nahomi Imaeda, Chiho Goto, Kenji Matsui, Naoyuki Takashima, Aya Kadota, Katsuyuki Miura, Masahiro Nakatochi, Takashi Tamura, Asahi Hishida, Ryoko Nakashima, Hiroaki Ikezaki, Megumi Hara, Yuichiro Nishida, Toshiro Takezaki, Rie Ibusuki, Isao Oze, Hidemi Ito, Nagato Kuriyama, Etsuko Ozaki, Haruo Mikami, Miho Kusakabe, Hiroko Nakagawa-Senda, Sadao Suzuki, Sakurako Katsuura-Kamano, Kokichi Arisawa, Kiyonori Kuriki, Yukihide Momozawa, Michiaki Kubo, Kenji Takeuchi, Yoshikuni Kita, Kenji Wakai
    Journal of nutritional science 10 e61  2021年 研究論文(学術雑誌) 
    Recent genome-wide association studies (GWAS) on the dietary habits of the Japanese population have shown that an effect rs671 allele was inversely associated with fish consumption, whereas it was directly associated with coffee consumption. Although meat is a major source of protein and fat in the diet, whether genetic factors that influence meat-eating habits in healthy populations are unknown. This study aimed to conduct a GWAS to find genetic variations that affect meat consumption in a Japanese population. We analysed GWAS data using 14 076 participants from the Japan Multi-Institutional Collaborative Cohort (J-MICC) study. We used a semi-quantitative food frequency questionnaire to estimate food intake that was validated previously. Association of the imputed variants with total meat consumption per 1000 kcal energy was performed by linear regression analysis with adjustments for age, sex, and principal component analysis components 1-10. We found that no genetic variant, including rs671, was associated with meat consumption. The previously reported single nucleotide polymorphisms that were associated with meat consumption in samples of European ancestry could not be replicated in our J-MICC data. In conclusion, significant genetic factors that affect meat consumption were not observed in a Japanese population.
  • 診察室・家庭・24時間自由行動下血圧および血圧変動と無症候性脳動脈狭窄との関連 滋賀動脈硬化疫学研究
    久松 隆史, 大久保 孝義, 藤吉 朗, 鳥居 さゆ希, 瀬川 裕佳, 近藤 慶子, 門田 文, 高嶋 直敬, 設楽 智史, 有馬 久富, 中川 義久, 渡邉 嘉之, 椎野 顯彦, 野崎 和彦, 上島 弘嗣, 三浦 克之
    Journal of Epidemiology 31 Suppl. 89 - 89 (一社)日本疫学会 2021年01月
  • Yuka Sumimoto, Masahiko Yanagita, Naomi Miyamatsu, Nagako Okuda, Nobuo Nishi, Yosikazu Nakamura, Koshi Nakamura, Naoko Miyagawa, Motohiko Miyachi, Aya Kadota, Takayoshi Ohkubo, Tomonori Okamura, Hirotsugu Ueshima, Akira Okayama, Katsuyuki Miura
    PloS one 16 7 e0254706  2021年 研究論文(学術雑誌) 
    BACKGROUND: Lower socioeconomic status (SES) may be related to inactivity lifestyle; however, the association between SES and physical inactivity has not been sufficiently investigated in Japan. METHODS: The study population is the participants of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey 2010 in Japan. They were residents in 300 randomly selected areas across Japan. This study included 2,609 adults. Physical activity was assessed by physical activity index (PAI) calculated from activity intensity and time. The lowest tertile of PAI for each 10-year age class and sex was defined as physical inactivity. Multivariable logistic regression analyses were conducted to examine the association of SES (employment status, educational attainment, living status, and equivalent household expenditure (EHE)) with physical inactivity. RESULTS: In the distribution of PAI by age classes and sex, the highest median PAI was aged 30-39 years among men (median 38.6), aged 40-49 years among women (38.0), and median PAI was decreased with increasing age. Multivariable-adjusted model shows that not working was significantly associated with physical inactivity after adjustment for age in all age groups and sexes. Not living with spouse for adult women and elderly men was significantly associated with physical inactivity compared to those who living with spouse. However, neither educational attainment nor EHE had any significant associations with physical inactivity. CONCLUSIONS: The result indicated that physical inactivity was associated with SES in a general Japanese population. SES of individuals need to be considered in order to prevent inactivity lifestyle.
  • Naoko Miyagawa, Takayoshi Ohkubo, Akira Fujiyoshi, Akihiko Shiino, Randi Chen, George Webster Ross, Bradley Willcox, Katsuyuki Miura, Hirotsugu Ueshima, Kamal Masaki
    Journal of Alzheimer's disease : JAD 81 1 403 - 412 2021年 研究論文(学術雑誌) 
    BACKGROUND: Few studies have compared factors related to cognitive function among people with similar genetic backgrounds but different lifestyles. OBJECTIVE: We aimed to identify factors related to lower cognitive scores among older Japanese men in two genetically similar cohorts exposed to different lifestyle factors. METHODS: This cross-sectional study of community-dwelling Japanese men aged 71-81 years included 2,628 men enrolled in the Kuakini Honolulu-Asia Aging Study based in Hawaii and 349 men in the Shiga Epidemiological Study of Subclinical Atherosclerosis based in Japan. We compared participant performance through Cognitive Abilities Screening Instrument (CASI) assessment in Hawaii (1991-1993) and Japan (2009-2014). Factors related to low cognitive scores (history of cardiovascular disease, cardiometabolic factors, and lifestyle factors) were identified with questionnaires and measurements. Multivariable logistic regression analysis was used to calculate the adjusted odds ratios (ORs) of a low (< 82) CASI score based on different factors. RESULTS: CASI scores were lower in Hawaii than in Japan [21.2%(n = 556) versus 12.3%(n = 43), p < 0.001], though this was not significant when adjusted for age and educational attainment (Hawaii 20.3%versus Japan 17.9%, p = 0.328). History of stroke (OR = 1.65, 95%confidence interval = 1.19-2.29) was positively associated with low cognitive scores in Hawaii. Body mass index ≥25 kg/m2 tended to be associated with low cognitive scores in Japan; there was a significant interaction between the cohorts. CONCLUSION: Cognitive scores differences between cohorts were mostly explained by differences in educational attainment. Conversely, cardiovascular diseases and cardiometabolic factors differentially impacted cognitive scores among genetically similar older men exposed to different lifestyle factors.
  • Hiromi Matsumoto-Yamauchi, Keiko Kondo, Katsuyuki Miura, Sachiko Tanaka-Mizuno, Hiroyoshi Segawa, Seiko Ohno, Naoko Miyagawa, Maryam Zaid, Yukiko Okami, Nagako Okuda, Hideaki Nakagawa, Kiyomi Sakata, Shigeyuki Saitoh, Akira Okayama, Katsushi Yoshita, Queenie Chan, Kamal Masaki, Paul Elliott, Jeremiah Stamler, Hirotsugu Ueshima
    Journal of nutritional science and vitaminology 67 1 28 - 38 2021年 研究論文(学術雑誌) 
    Several studies have reported a J-shaped relationship between alcohol consumption and coronary heart disease (CHD) risk. However, the mechanisms of this relationship remain unclear. This study aimed to evaluate the relationships of alcohol consumption with established CHD risk factors and with macro-/micro-nutrient intake among Japanese people. Participants were 1,090 Japanese men and women aged 40-59 y enrolled in the INTERLIPID study, excluding former drinkers. Based on two 7-d alcohol records, participants were classified as non-drinkers (0 g/wk), light-drinkers (<100 g/wk), moderate-drinkers (100-299 g/wk), or heavy-drinkers (≥300 g/wk). Detailed macro-/micro-nutrient intake was evaluated using four in-depth 24-h dietary recalls and adjusted for total energy intake excluding alcohol. We analyzed the associations of CHD risk factors and nutrient intake with alcohol consumption. Serum high-density lipoprotein cholesterol and blood pressure were higher and low-density lipoprotein cholesterol was lower among those with higher alcohol consumption. J-shaped relationships with alcohol consumption were observed for the proportion of current smokers, number of cigarettes smoked, and prevalence of hypertension; these risk factors were lowest among light-drinkers. Carbohydrate and total fiber intakes were lower and protein and dietary cholesterol intakes were higher among those with higher alcohol consumption. These associations were similar for men and women. Alcohol consumption was related to nutrient intake as well as established CHD risk factors. Non-drinkers were higher on some CHD risk factors than were light-drinkers. These findings may influence the J-shaped relationship between alcohol consumption and CHD risk.
  • Takashi Waki, Sachiko Tanaka-Mizuno, Naoyuki Takashima, Hajime Takechi, Takehito Hayakawa, Katsuyuki Miura, Hirotsugu Ueshima, Yoshikuni Kita, Hiroko H Dodge
    Journal of Alzheimer's disease : JAD 79 2 929 - 930 2020年12月 研究論文(学術雑誌)
  • Yukiko Okami, Hirotsugu Ueshima, Yasuyuki Nakamura, Keiko Kondo, Aya Kadota, Nagako Okuda, Takayoshi Ohkubo, Naomi Miyamatsu, Tomonori Okamura, Katsuyuki Miura, Akira Okayama
    Circulation journal : official journal of the Japanese Circulation Society 85 6 908 - 913 2020年12月 研究論文(学術雑誌) 
    BACKGROUND: This study assessed sex-specific time-associated changes in the impact of risk factors on coronary artery disease (CAD) mortality in a general population over long-term follow-up.Methods and Results:A prospective longitudinal cohort study was conducted on representative Japanese populations followed up for 29 years. Data from 8,396 participants (3,745 men, 4,651 women) were analyzed. The sex-specific multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of 4 risk factors (smoking, diabetes, serum total cholesterol [TC], and systolic blood pressure [SBP]) for CAD mortality were calculated at baseline and at 10, 15, 20, 25, and 29 years of follow-up. In men, smoking (HR 3.23; 95% CI 1.16-9.02) and a 1-SD increase in TC (HR 1.82; 95% CI 1.29-2.57) were strongly associated with a higher risk of CAD in the first 10 years, but this association decreased over time. Diabetes (HR 2.30; 95% CI 1.37-3.85) and a 1-SD increase in SBP (HR 1.23; 95% CI 1.00-1.50) were strongly correlated with a higher risk of CAD after 29 years). In women, diabetes was correlated with CAD after 20 years (HR 2.53; 95% CI 1.19-5.36) and this correlation persisted until after 29 years (HR 2.47; 95% CI 1.40-4.35). CONCLUSIONS: The duration of follow-up needed for the accurate assessment of risk factors for CAD mortality varies according to risk factor and sex.
  • Harumitsu Suzuki, Yasuyuki Nakamura, Keitaro Matsuo, Nahomi Imaeda, Chiho Goto, Akira Narita, Atsushi Shimizu, Naoyuki Takashima, Kenji Matsui, Katsuyuki Miura, Masahiro Nakatochi, Asahi Hishida, Takashi Tamura, Yuka Kadomatsu, Rieko Okada, Yuichiro Nishida, Chisato Shimanoe, Daisaku Nishimoto, Toshiro Takezaki, Isao Oze, Hidemi Ito, Hiroaki Ikezaki, Masayuki Murata, Daisuke Matsui, Etsuko Ozaki, Haruo Mikami, Yohko Nakamura, Sadao Suzuki, Miki Watanabe, Kokichi Arisawa, Hirokazu Uemura, Kiyonori Kuriki, Yukihide Momozawa, Michiaki Kubo, Yoshikuni Kita, Kenji Takeuchi, Kenji Wakai
    European journal of clinical nutrition 75 6 937 - 945 2020年12月 研究論文(学術雑誌) 
    BACKGROUND/OBJECTIVES: Individual eating habits may be influenced by genetic factors, in addition to environmental factors. Previous studies suggested that adherence to Japanese food patterns was associated with a decreased risk of all-cause and cardiovascular disease mortality. We conducted a genome-wide association study (GWAS) in a Japanese population to find genetic variations that affect adherence to a Japanese food pattern. SUBJECTS/METHODS: We analyzed GWAS data using 14,079 participants from the Japan Multi-Institutional Collaborative Cohort study. We made a Japanese food score based on six food groups. Association of the imputed variants with the Japanese food score was performed by linear regression analysis with adjustments for age, sex, total energy intake, alcohol intake (g/day), and principal components 1-10 omitting variants in the major histocompatibility region. RESULTS: We found one SNP in the 14q11.2 locus that was significantly associated with the Japanese food score with P values <5 × 10-8. Functional annotation revealed that the expression levels of two genes (BCL2L2, SLC22A17) were significantly inversely associated with this SNP. These genes are known to be related to olfaction and obesity. CONCLUSION: We found a new SNP that was associated with the Japanese food score in a Japanese population. This SNP is inversely associated with genes link to olfaction and obesity.
  • Ghadeer Aljuraiban, Queenie Chan, Rachel Gibson, Jeremiah Stamler, Martha L Daviglus, Alan R Dyer, Katsuyuki Miura, Yangfeng Wu, Hirotsugu Ueshima, Liancheng Zhao, Linda Van Horn, Paul Elliott, Linda M Oude Griep
    BMJ nutrition, prevention & health 3 2 133 - 142 2020年12月 研究論文(学術雑誌) 
    Background: Plant-based diets are associated with a lower risk of cardiovascular diseases; however, little is known how the healthiness of the diet may be associated with blood pressure (BP). We aimed to modify three plant -based diet indices: overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI) according to country-specific dietary guidelines to enable use across populations with diverse dietary patterns - and assessed their associations with BP. Design: We used cross-sectional data including 4,680 men and women ages 40-59y in Japan, China, the United Kingdom, and the United States from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). During four visits, eight BP measurements, and four 24-h dietary recalls were collected. Multivariable regression coefficients were estimated, pooled, weighted, and adjusted extensively for lifestyle/dietary confounders. Results: Modified PDI was not associated with BP. Consumption of hPDI higher by 1SD was inversely associated with systolic (-0.82 mm Hg;95% CI:-1.32,-0.49) and diastolic BP (-0.49 mm Hg; 95% CI:-0.91, -0.28). In contrast, consumption of an uPDI was directly associated with systolic (0.77 mm Hg;95% CI:0.30,1.20). Significant associations between hPDI with BP were attenuated with separate adjustment for vegetables and whole grains; associations between uPDI and BP were attenuated after adjustment for refined grains, sugar-sweetened beverages, and meat. Conclusion: An hPDI is associated with lower BP while a uPDI is adversely related to BP. Plant-based diets rich in vegetables and whole grains and limited in refined grains, sugar-sweetened beverages, and total meat may contribute to these associations. In addition to current guidelines, the nutritional quality of consumed plant foods is as important as limiting animal-based components. Trial registration number: The observational INTERMAP study was registered at www.clinicaltrials.gov as NCT00005271.
  • Mohammad Moniruzzaman, Aya Kadota, Hiroyoshi Segawa, Keiko Kondo, Sayuki Torii, Naoko Miyagawa, Akira Fujiyoshi, Takashi Hisamatsu, Yoshiyuki Watanabe, Akihiko Shiino, Kazuhiko Nozaki, Hirotsugu Ueshima, Katsuyuki Miura
    Stroke 51 12 3584 - 3591 2020年12月 研究論文(学術雑誌) 
    BACKGROUND AND PURPOSE: Cerebral small vessel disease (CSVD) is a common subclinical feature of the aging brain. Steps per day may contribute to its prevention. We herein investigated the association between step counts and CSVD in a healthy Japanese male population. METHODS: We analyzed data from 680 men who were free of stroke and participated in this observational study. Seven-day step counts were assessed at baseline (2006-2008) using a pedometer. CSVD was assessed at follow-ups (2012-2015) based on deep and subcortical white matter hyperintensities (WMHs), periventricular hyperintensities, lacunar infarcts, and cerebral microbleeds on magnetic resonance imaging. Using a logistic regression analysis, we computed the adjusted odds ratios, with 95% CIs, of prevalent CSVD according to quartiles of step counts (reference: Q1). We also investigated the association between step counts and WMH volumes using a quantile regression. RESULTS: Steps per day were significantly associated with lower odds ratios, with the lowest at Q3 (8175-10 614 steps/day), of higher (versus low or no burden) deep and subcortical WMHs (odds ratio, 0.52 [95% CI, 0.30-0.89]), periventricular hyperintensities (0.50 [95% CI, 0.29-0.86]), and lacunar infarcts (0.52 [95% CI, 0.30-0.91]) compared with Q1 (≤6060 steps/day) but not cerebral microbleeds. An inverse linear association was observed between step counts and WMH volumes. These associations were independent of age and smoking and drinking status and remained consistent when adjusted for vascular risk factors. CONCLUSIONS: We found a J-shaped relationship between step counts and prevalent CSVD in healthy Japanese men, with the lowest risk being observed among participants with ≈8000 to 10 000 steps/day. Higher steps were also associated with lower WMH volumes.
  • Kei Asayama, Yasuharu Tabara, Emi Oishi, Satoko Sakata, Takashi Hisamatsu, Kayo Godai, Mai Kabayama, Yukako Tatsumi, Jun Hata, Masahiro Kikuya, Kei Kamide, Katsuyuki Miura, Toshiharu Ninomiya, Takayoshi Ohkubo
    Hypertension research : official journal of the Japanese Society of Hypertension 43 12 1403 - 1412 2020年12月 [有り][無し]
     研究論文(学術雑誌) 
    Despite the clinical usefulness of self-measured home blood pressure (BP), reports on the characteristics of home BP have not been sufficient and have varied due to the measurement conditions in each study. We constructed a database on self-measured home BP, which included five Japanese general populations as subdivided aggregate data that were clustered and meta-analyzed according to sex, age category, and antihypertensive drug treatment at baseline (treated and untreated). The self-measured home BPs were collected after a few minutes of rest in a sitting position: (1) the morning home BP was measured within 1 h of waking, after urination, before breakfast, and before taking antihypertensive medication (if any); and (2) the evening home BP was measured just before going to bed. The pulse rate was simultaneously measured. Eligible data from 2000 onward were obtained. The morning BP was significantly higher in treated participants than in untreated people of the same age category, and the BP difference was more marked in women. Among untreated residents, home systolic/diastolic BPs measured in the morning were higher than those measured in the evening; the differences were 5.7/5.0 mmHg in women (ranges across the cohorts, 5.3-6.8/4.7-5.4 mmHg) and 7.3/7.7 mmHg in men (ranges, 6.4-8.5/7.0-8.7 mmHg). In contrast, the home pulse rate in women and men was 2.4 (range, 1.5-3.7) and 5.6 (range, 4.6-6.6) beats per minute, respectively, higher in the evening than in the morning. We demonstrated the current status of home BP and home pulse rate in relation to sex, age, and antihypertensive treatment status in the Japanese general population. The approach by which fine-clustered aggregate statistics were collected and integrated could address practical issues raised in epidemiological research settings.
  • Hiroyoshi Segawa, Keiko Kondo, Aya Kadota, Hiromi Yamauchi, Seiko Ohno, Sachiko Tanaka-Mizuno, Nagako Okuda, Naoko Miyagawa, Hisatomi Arima, Tomonori Okamura, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima, The Nippon Data Research Group
    Nutrients 12 12 2020年11月 研究論文(学術雑誌) 
    The consumption of red meat has been recommended for individuals with reduced kidney function. However, red meat intake was recently suspected to increase cardiovascular disease (CVD) risk. We evaluated the association of red meat intake with CVD mortality risk in Japanese with/without reduced kidney function. Overall, 9112 participants of a Japanese national survey in 1980, aged ≥30 years, were followed for 29 years. Red meat intake was assessed using weighed dietary record. Cox proportional hazards models were used to estimate the hazard ratio (HR) of CVD mortality according to sex-specific tertiles of red meat intake. We also performed stratified analyses with/without reduced kidney function defined as estimated glomerular filtration rate less than 60 mL/min/1.73 m2. Red meat intake was not associated with CVD mortality risk in men and women. In stratified analyses, the HR of the highest compared with the lowest tertile of red meat intake was lower only in women with reduced kidney function (0.67, 95% confidence interval 0.46-0.98). In conclusion, there were no clear associations between red meat intake and CVD mortality risk in Japanese population; however, a higher intake of red meat was associated with lower risk of future CVD mortality in women with reduced kidney function.
  • Takuya Tsuchihashi, Toshihiko Ishimitsu, Katsuyuki Ando, Miho Kusaka, Atsuhiro Ichihara, Katsuyuki Miura, Yuhei Kawano, Takafumi Ishida, Hiroo Kumagai, Atsushi Sakima, Hiroyuki Takase, Hitomi Hayabuchi, Hiroshi Itoh
    Hypertension research : official journal of the Japanese Society of Hypertension 43 11 1133 - 1134 2020年11月
  • 志摩 梓, 辰巳 友佳子, 有馬 久富, 三浦 克之, 河津 雄一郎, 森野 亜弓, 大久保 孝義, 木村 隆, 呉代 華容, 宮松 直美
    日本循環器病予防学会誌 55 3 225 - 225 (一社)日本循環器病予防学会 2020年11月
  • 栗原 綾子, 岡村 智教, 杉山 大典, 奥田 奈賀子, 大久保 孝義, 岡山 明, 宮川 尚子, 門田 文, 三浦 克之, 上島 弘嗣
    日本循環器病予防学会誌 55 3 228 - 228 (一社)日本循環器病予防学会 2020年11月
  • 北岡 かおり, 三浦 克之, 門田 文, 近藤 慶子, 岡見 雪子, 田中 佐智子, 高嶋 直敬, 中村 保幸, 喜多 義邦, 若井 建志
    日本循環器病予防学会誌 55 3 222 - 222 (一社)日本循環器病予防学会 2020年11月
  • 岡見 雪子, 中村 保幸, 三浦 克之, 宮松 直美, 岡村 智教, 近藤 慶子, 門田 文, 大久保 孝義, 岡山 明, 上島 弘嗣
    日本循環器病予防学会誌 55 3 223 - 223 (一社)日本循環器病予防学会 2020年11月
  • Yuko Takatsuji, Aya Ishiguro, Kei Asayama, Takayoshi Ohkubo, Katsuyuki Miura, Aya Kadota, Masahiko Yanagita, Akira Fujiyoshi, Hisatomi Arima, Naoko Miyagawa, Naoyuki Takashima, Yoshikuni Kita, Takehito Hayakawa, Masahiro Kikuya, Yasuyuki Nakamura, Akira Okayama, Tomonori Okamura, Hirotsugu Ueshima
    The Tohoku journal of experimental medicine 252 3 253 - 262 2020年11月 研究論文(学術雑誌) 
    Exercise habits are known as a protective factor for a variety of diseases and thus recommended worldwide; however, few studies have examined long-term effects of exercise habits on mortality. We continuously monitored death status in a nationwide population sample of 7,709 eligible persons from the National Integrated Project for Prospective Observation of Noncommunicable Disease and its Trends in the Aged in 1990 (NIPPON DATA90), for which baseline data were obtained in 1990. To investigate the long-term impact of baseline exercise habits, we calculated the relative risk of non-exercisers (participants without regular voluntary exercise habits) in reference to exercisers (those with these habits) for all-cause or cause-specific mortality using a Cox proportional hazard model, in which the following confounding factors were appropriately adjusted: sex, age, body mass index, total energy intake, smoking, drinking, and history of cardiovascular disease. During a median 20 years of follow-up, 1,747 participants died, 99 of heart failure. The risk for all-cause mortality was 12% higher in non-exercisers than in exercisers (95% confidence interval, 1%-24%), which was also observed for mortality from heart failure, as 68% higher in non-exercisers than in exercises (95% confidence interval, 3%-173%). These associations were similarly observed when the participants were divided to subgroups by sex, age, and the light, moderate, or vigorous intensity of physical activity, without any significant heterogeneities (P > 0.1). The present study has revealed significant impact of exercise habits on long-term mortality risks, supporting worldwide recommendations for improvement of exercise habits.
  • Aya Hirata, Akemi Kakino, Tomonori Okamura, Yoko Usami, Yoshiko Fujita, Aya Kadota, Akira Fujiyoshi, Takashi Hisamatsu, Keiko Kondo, Hiroyoshi Segawa, Tatsuya Sawamura, Katsuyuki Miura, Hirotsugu Ueshima
    Atherosclerosis 313 20 - 25 2020年11月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND AND AIMS: Dysfunctional high-density lipoprotein (HDL) is a risk factor for cardiovascular disease (CVD) beyond HDL concentrations. Recently, a novel method has been introduced to measure LOX-1 ligand containing apolipoprotein AI (LAA), which is an indicator of various types of modified HDL with binding capacity to LOX-1 and related to impaired anti-atherogenic functions of HDL. This study aimed to examine the relationship between LAA as a novel marker of dysfunctional HDL and coronary artery calcification (CAC). METHODS: We selected 910 community-dwelling Japanese men aged 40-79 years without a history of CVD. The odds ratios per 1SD of LAA for the presence of CAC (Agatston score >10) were estimated using logistic regression model adjusted for confounders, including HDL-C or HDL particle (HDL-P) concentration. In addition, we performed further analysis stratified by age (<65 and ≥ 65 years). RESULTS: The mean age of the participants was 63.6 years, and the median LAA was 187.0 ng/mL. The prevalent CAC was 46.2%. The multivariable adjusted odds ratio (95% confidence interval) per 1SD of LAA for CAC was 1.14 (0.96-1.36) for all participants. After stratification by age, multivariable adjusted odds ratios per 1SD of LAA were 1.34 (1.02-1.76) and 0.97 (0.77-1.23) in men aged <65 and ≥ 65 years, respectively. CONCLUSIONS: The present study showed that LAA was associated with CAC independent of HDL-C or HDL-P in middle-aged Japanese men. This finding suggests that LAA might be an early marker for CVD events. Future longitudinal studies are warranted.
  • Takashi Hisamatsu, Katsuyuki Miura, Takayoshi Ohkubo, Aya Kadota, Keiko Kondo, Yoshikuni Kita, Takehito Hayakawa, Hideyuki Kanda, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
    Journal of hypertension 38 11 2230 - 2236 2020年11月 [有り][無し]
     研究論文(学術雑誌) 
    OBJECTIVE: The prognostic implication of isolated systolic hypertension (ISH), defined as SBP at least 140 mmHg and DBP less than 90 mmHg, among young-to-middle-aged adults remains controversial. We examined the association of ISH with cardiovascular disease (CVD) risk in adults aged 30-49 years. METHODS: In a prospective cohort of representative Japanese general populations from the NIPPON DATA80 (1980-2009), we studied 4776 participants (mean age, 39.4 years; 55.4% women) without clinical CVD or antihypertensive medication. Participants were classified as follows: normal blood pressure (BP) (SBP/DBP, <120/<80 mmHg), high-normal BP (120-129/<80 mmHg), elevated BP (130-139/80-89 mmHg), ISH, isolated diastolic hypertension (IDH) (<140/≥90 mmHg), and systolic--diastolic hypertension (SDH) (≥140/≥90 mmHg). RESULTS: ISH was observed in 389 (8.1%) participants. During the 29-year follow-up, 115 participants died of CVD, 28 of coronary heart disease, and 49 of stroke. Cox proportional hazards models adjusted for demographics and CVD risk factors showed that participants with ISH had higher risk of CVD mortality than those with normal BP [hazard ratio (confidence interval), 4.10 (1.87-9.03)]. The magnitude of CVD mortality risk related to ISH was comparable with that related to IDH [3.38 (1.31-8.72)] and not as great as that related to SDH [5.41 (2.63-11.14)]. We found significant associations of ISH with coronary and stroke mortality. The association of ISH with CVD mortality was consistent across men and women and those aged 30-39 and 40-49 years. CONCLUSION: ISH among young-to-middle-aged Japanese adults was independently associated with higher risk of CVD mortality later in life.
  • Azusa Shima, Hisatomi Arima, Katsuyuki Miura, Yukako Tatsumi, Takayoshi Ohkubo, Yuichiro Kawatsu, Ayumi Morino, Takashi Kimura, Kayo Godai, Saori Azuma, Naomi Miyamatsu
    Hypertension research : official journal of the Japanese Society of Hypertension 44 3 355 - 362 2020年10月 [有り][無し]
     研究論文(学術雑誌) 
    Despite clear evidence of the benefits of lowering blood pressure among patients with hypertension, the treatment rate remains <40% worldwide. In the present trial, we aimed to investigate the effects of the early promotion of clinic visits among patients with untreated hypertension detected during annual health checkups. This was a worksite-based, parallel group, cluster-randomized trial with blinded outcome assessment. Employees of 152 Japanese supermarket stores found to have untreated hypertension (blood pressure levels ≥ 160/100 mmHg) during health checkups were assigned to an early promotion group (encouraged to visit a clinic in face-to-face interviews and provided with a referral letter to a physician as well as a leaflet) or a control group (received usual care), according to random assignment. The primary outcome was the completion of a clinic visit within 6 months. Odds ratios with 95% confidence intervals for the early promotion group versus the control group were estimated using multilevel logistic regression with random effects of clusters. A total of 273 participants (mean age 50.3 years, 55% women) from 107 stores were assigned to the early promotion group (138 from 55 stores) or control group (135 from 52 stores). During the 6-month follow-up, 47 (34.1%) participants in the early promotion group visited a clinic, as did 26 (19.3%) in the control group (odds ratio 2.33, 95% confidence interval 1.12-4.84, P = 0.024). Early promotion using a referral letter during health checkups significantly increased the number of clinic visits within 6 months completed by participants with untreated hypertension (UMIN000025411).
  • Yuanying Li, Hiroshi Yatsuya, Sachiko Tanaka, Hiroyasu Iso, Akira Okayama, Ichiro Tsuji, Kiyomi Sakata, Yoshihiro Miyamoto, Hirotsugu Ueshima, Katsuyuki Miura, Yoshitaka Murakami, Tomonori Okamura
    Journal of atherosclerosis and thrombosis 28 8 816 - 825 2020年10月 [有り][無し]
     研究論文(学術雑誌) 
    AIMS: We aimed to develop and validate risk prediction models to estimate the absolute 10-year risk of death from coronary heart disease (CHD), stroke, and cardiovascular disease (CVD). METHODS: We evaluated a total of 44,869 individuals aged 40-79 years from eight Japanese prospective cohorts to derive coefficients of risk equations using cohort-stratified Cox proportional hazard regression models. Discrimination (C-index) of the equation was examined in each cohort and summarised using random-effect meta-analyses. Calibration of the equation was assessed using Hosmer-Lemeshow chi-squared statistic. RESULTS: Within a median follow-up of 12.7 years, we observed 765 deaths due to CVD (276 CHDs and 489 strokes). After backward selection, age, sex, current smoking, systolic blood pressure (SBP), proteinuria, prevalent diabetes mellitus, the ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDLC), interaction terms of age by SBP, and age by current smoking were retained as predictors for CHD. Sex was excluded in the stroke equation. We did not consider TC/HDLC as a risk factor for the stroke and CVD equations. The pooled C-indices for CHD, stroke, and CVD were 0.83, 0.80, and 0.81, respectively, and the corresponding p-values of the Hosmer-Lemeshow tests were 0.18, 0.003, and 0.25, respectively. CONCLUSIONS: Risk equations in the present study can adequately estimate the absolute 10-year risk of death from CHD, stroke, and CVD. Future work will evaluate the system as an education and risk communication tool for primary prevention of CHD and stroke.
  • Anna Kontsevaya, Oxana Drapkina, Boris Gorniy, Anna Kalinina, Denis Komkov, Yulia Balanova, Anna Bunova, Daria Kushunina, Aleksandra Antsiferova, Azalia Myrzamatova, Evgenia Lavrenova, Eri Nomura, Maki Iwatake, Takashi Waki, Sachiko Tanaka-Mizuno, Katsuyuki Miura, Yoshihiro Miyamoto, Kazuyo Tsushita
    Circulation reports 2 11 695 - 700 2020年10月 研究論文(学術雑誌) 
    Background: The prevalence of obesity in Russia has increased sharply since the mid-1990s. Interestingly, the prevalence of obesity in Japan is lower than in many Western countries. Japan has implemented different types of weight control programs using a smart device to monitor patients remotely. New health promotion methods from Japan are now being used in Russia. The Russian-Japanese "Tackle Obesity and Metabolic Syndrome Outcome by Diet, Activities and Checking Body Weight Intervention" (RJ-TOMODACHI) study aims to evaluate a preventive intervention using Japanese health monitoring technology in reducing excess body weight, compared with standard care, in Russia. Methods and Results: The trial is a single-center, 3-armed, parallel group randomized controlled trial conducted among overweight/obese adults. It has been designed to compare the effectiveness of 2 newly developed interventions against standard care for 6 months. Participants in the low- and high-intensity intervention groups will have 3 and 6 consultations over the study period, respectively. In all, 260 adults were screened at baseline; 65 did not participate in the trial for various reasons. The remaining 195 people were randomized into 3 groups (high-intensity intervention, n=73, low-intensity, n=73; standard care group, n=49). Conclusions: The trial protocol has been designed so that the methodology can be adapted for use in Russia.
  • Kunihiro Matsushita, Simerjot K Jassal, Yingying Sang, Shoshana H Ballew, Morgan E Grams, Aditya Surapaneni, Johan Arnlov, Nisha Bansal, Milica Bozic, Hermann Brenner, Nigel J Brunskill, Alex R Chang, Rajkumar Chinnadurai, Massimo Cirillo, Adolfo Correa, Natalie Ebert, Kai-Uwe Eckardt, Ron T Gansevoort, Orlando Gutierrez, Farzad Hadaegh, Jiang He, Shih-Jen Hwang, Tazeen H Jafar, Takamasa Kayama, Csaba P Kovesdy, Gijs W Landman, Andrew S Levey, Donald M Lloyd-Jones, Rupert W Major, Katsuyuki Miura, Paul Muntner, Girish N Nadkarni, David Mj Naimark, Christoph Nowak, Takayoshi Ohkubo, Michelle J Pena, Kevan R Polkinghorne, Charumathi Sabanayagam, Toshimi Sairenchi, Markus P Schneider, Varda Shalev, Michael Shlipak, Marit D Solbu, Nikita Stempniewicz, James Tollitt, José M Valdivielso, Joep van der Leeuw, Angela Yee-Moon Wang, Chi-Pang Wen, Mark Woodward, Kazumasa Yamagishi, Hiroshi Yatsuya, Luxia Zhang, Elke Schaeffner, Josef Coresh
    EClinicalMedicine 27 100552 - 100552 2020年10月 研究論文(学術雑誌) 
    Background: Chronic kidney disease (CKD) measures (estimated glomerular filtration rate [eGFR] and albuminuria) are frequently assessed in clinical practice and improve the prediction of incident cardiovascular disease (CVD), yet most major clinical guidelines do not have a standardized approach for incorporating these measures into CVD risk prediction. "CKD Patch" is a validated method to calibrate and improve the predicted risk from established equations according to CKD measures. Methods: Utilizing data from 4,143,535 adults from 35 datasets, we developed several "CKD Patches" incorporating eGFR and albuminuria, to enhance prediction of risk of atherosclerotic CVD (ASCVD) by the Pooled Cohort Equation (PCE) and CVD mortality by Systematic COronary Risk Evaluation (SCORE). The risk enhancement by CKD Patch was determined by the deviation between individual CKD measures and the values expected from their traditional CVD risk factors and the hazard ratios for eGFR and albuminuria. We then validated this approach among 4,932,824 adults from 37 independent datasets, comparing the original PCE and SCORE equations (recalibrated in each dataset) to those with addition of CKD Patch. Findings: We confirmed the prediction improvement with the CKD Patch for CVD mortality beyond SCORE and ASCVD beyond PCE in validation datasets (Δc-statistic 0.027 [95% CI 0.018-0.036] and 0.010 [0.007-0.013] and categorical net reclassification improvement 0.080 [0.032-0.127] and 0.056 [0.044-0.067], respectively). The median (IQI) of the ratio of predicted risk for CVD mortality with CKD Patch vs. the original prediction with SCORE was 2.64 (1.89-3.40) in very high-risk CKD (e.g., eGFR 30-44 ml/min/1.73m2 with albuminuria ≥30 mg/g), 1.86 (1.48-2.44) in high-risk CKD (e.g., eGFR 45-59 ml/min/1.73m2 with albuminuria 30-299 mg/g), and 1.37 (1.14-1.69) in moderate risk CKD (e.g., eGFR 60-89 ml/min/1.73m2 with albuminuria 30-299 mg/g), indicating considerable risk underestimation in CKD with SCORE. The corresponding estimates for ASCVD with PCE were 1.55 (1.37-1.81), 1.24 (1.10-1.54), and 1.21 (0.98-1.46). Interpretation: The "CKD Patch" can be used to quantitatively enhance ASCVD and CVD mortality risk prediction equations recommended in major US and European guidelines according to CKD measures, when available. Funding: US National Kidney Foundation and the NIDDK.
  • 血圧、糖尿病、喫煙、高脂血症と心血管疾患死亡の生涯リスクの関連 EPOCH-JAPAN
    今井 由希子, 村上 義孝, 二宮 利治, 宮本 恵宏, 石川 鎮清, 坂田 清美, 磯 博康, 中川 秀昭, 大久保 孝義, 玉腰 暁子, 斎藤 重幸, 三浦 克之, 上島 弘嗣, 岡村 智教
    日本公衆衛生学会総会抄録集 79回 239 - 239 日本公衆衛生学会 2020年10月
  • Chikako Nakama, Takashi Kadowaki, Jina Choo, Aiman El-Saed, Aya Kadota, Bradley J Willcox, Akira Fujiyoshi, Chol Shin, Joseph K Leader, Katsuyuki Miura, Kamal Masaki, Hirotsugu Ueshima, Lewis H Kuller, Jessica Bon, Akira Sekikawa
    International journal of cardiology. Heart & vasculature 30 100618 - 100618 2020年10月 [有り][無し]
     研究論文(学術雑誌) 
    Introduction: Inverse associations of cardiovascular disease (CVD) and atherosclerosis with osteoporosis and bone mineral density (BMD) have been reported in post-menopausal women and elderly men. We aimed to investigate an association between vetebral bone density (VBD) and coronary artery cacification (CAC) in an international multi-ethnic cohort of middle-aged men in the EBCT and Risk Factor Assessment among Japanese and US Men in the Post-World-War-II birth cohort (ERA JUMP). Methods: ERA JUMP examined 1134 men aged 40-49 (267 white, 84 black, and 242 Japanese Americans, 308 Japanese in Japan, and 233 Koreans in South Korea) free from CVD for CAC, and VBD, biomarkers of coronary atherosclerosis and BMD, respectively, with electron-beam computed tomography, and other risk factors. CAC was quantified with the Agatston method and VBD by computing the mean Hounsfield Unit (HU) value of the T12 to L3 vertebrae. To examine multivariable-adjusted associations of CAC with VBD, we used robust linear and logistic regressions. Results: The mean VBD and median CAC were 175.4 HU (standard deviation: 36.3) and 0 (interquartile range: (0, 4.5)), respectively. The frequency of CAC was 19.0%. There was no significant interaction by race. VBD had a significant inverse association with CAC score (β = -0.207, p-value = 0.005), while a 10-unit increase in VBD was significantly associated with the frequency of CAC (odds ratio (95% confidence interval) = 0.929 (0.890-0.969)). Both associations remained significant after adjusting for covariates. Conclusions: VBD had a significant inverse association with CAC in this international multi-ethnic cohort of men aged 40-49.
  • Taro Suzuki, Yasuyuki Nakamura, Keitaro Matsuo, Isao Oze, Yukio Doi, Akira Narita, Atsushi Shimizu, Nahomi Imaeda, Chiho Goto, Kenji Matsui, Masahiro Nakatochi, Katsuyuki Miura, Naoyuki Takashima, Kiyonori Kuriki, Chisato Shimanoe, Keitaro Tanaka, Hiroaki Ikezaki, Masayuki Murata, Rie Ibusuki, Toshiro Takezaki, Yuriko Koyanagi, Hidemi Ito, Daisuke Matsui, Teruhide Koyama, Haruo Mikami, Yohko Nakamura, Sadao Suzuki, Takeshi Nishiyama, Sakurako Katsuura-Kamano, Kokichi Arisawa, Kenji Takeuchi, Takashi Tamura, Rieko Okada, Yoko Kubo, Yukihide Momozawa, Michiaki Kubo, Yoshikuni Kita, Kenji Wakai
    European journal of clinical nutrition 75 3 480 - 488 2020年09月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND/OBJECTIVE: Although benefits of fish consumption for health are well known, a significant percentage of individuals dislike eating fish. Fish consumption may be influenced by genetic factors in addition to environmental factors. We conducted a genome-wide association study (GWAS) to find genetic variations that affect fish consumption in a Japanese population. METHODS: We performed a two-stage GWAS on fish consumption using 13,739 discovery samples from the Japan Multi-Institutional Collaborative Cohort study, and 2845 replication samples from the other population. We used a semi-quantitative food frequency questionnaire to estimate food intake. Association of the imputed variants with fish consumption was analyzed by separate linear regression models per variant, with adjustments for age, sex, energy intake, principal component analysis components 1-10, and alcohol intake (g/day). We also performed conditional analysis. RESULTS: We found 27 single nucleotide polymorphisms (SNPs) located in 12q24 and 14q32.12 that were associated with fish consumption. The 19 SNPs were located at 11 genes including six lead SNPs at the BRAP, ACAD10, ALDH2, NAA25, and HECTD4 regions on 12q24.12-13, and CCDC197 region on 14q32.12. In replication samples, all five SNPs located on chromosome 12 were replicated successfully, but the one on chromosome 14 was not. Conditional analyses revealed that the five lead variants in chromosome 12 were in fact the same signal. CONCLUSION: We found that new SNPs in the 12q24 locus were related to fish intake in two Japanese populations. The associations between SNPs on chromosome 12 and fish intake were strongly confounded by drinking status.
  • Naoyuki Takashima, Hisatomi Arima, Yoshikuni Kita, Takako Fujii, Sachiko Tanaka-Mizuno, Satoshi Shitara, Akihiro Kitamura, Yoshihisa Sugimoto, Makoto Urushitani, Katsuyuki Miura, Kazuhiko Nozaki
    Journal of stroke 22 3 336 - 344 2020年09月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND AND PURPOSE: Although numerous measures for stroke exist, stroke remains one of the leading causes of death in Japan. In this study, we aimed to determine the long-term survival rate after first-ever stroke using data from a large-scale population-based stroke registry study in Japan. METHODS: Part of the Shiga Stroke and Heart Attack Registry, the Shiga Stroke Registry is an ongoing population-based registry study of stroke, which covers approximately 1.4 million residents of Shiga Prefecture in Japan. A total 1,880 patients with non-fatal first-ever stroke (among 29-day survivors after stroke onset) registered in 2011 were followed up until December 2016. Five-year cumulative survival rates were estimated using the Kaplan-Meier method, according to subtype of the index stroke. Cox proportional hazards models were used to assess predictors of subsequent all-cause death. RESULTS: During an average 4.3-year follow-up period, 677 patients died. The 5-year cumulative survival rate after non-fatal first-ever stroke was 65.9%. Heterogeneity was present in 5-year cumulative survival according to stroke subtype: lacunar infarction, 75.1%; large-artery infarction, 61.5%; cardioembolic infarction, 44.9%; intracerebral hemorrhage, 69.1%; and subarachnoid hemorrhage, 77.9%. Age, male sex, Japan Coma Scale score on admission, and modified Rankin Scale score before stroke onset were associated with increased mortality during the chronic phase of ischemic and hemorrhagic stroke. CONCLUSIONS: In this study conducted in a real-world setting of Japan, the 5-year survival rate after non-fatal first-ever stroke remained low, particularly among patients with cardioembolic infarction and large-artery infarction in the present population-based stroke registry.
  • Tai Pham, Akira Fujiyoshi, Takahashi Hisamatsu, Sayaka Kadowaki, Aya Kadota, Maryam Zaid, Ayako Kunimura, Sayuki Torii, Hiroyoshi Segawa, Keiko Kondo, Minoru Horie, Katsuyuki Miura, Hirotsugu Ueshima
    International journal of cardiology 314 89 - 94 2020年09月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND AND AIMS: To examine whether smoking habits, including smoking amount and cessation duration at baseline, are associated with atherosclerosis progression. METHODS: At baseline (2006-08, Japan), we obtained smoking status, amount of smoking and time since cessation for quitters in a community-based random sample of Japanese men initially aged 40-79 years and free of cardiovascular disease. Coronary artery calcification (CAC) and aortic artery calcification (AAC) as biomarker of atherosclerosis was quantified using Agatston's method at baseline and after 5 years of follow-up. We defined progression of CAC and AAC (yes/no) using modified criteria by Berry. RESULTS: A total of 781 participants was analyzed. Multivariable adjusted odds ratios (ORs) of CAC and AAC progression for current smokers were 1.73 (95% CI, 1.09-2.73) and 2.47 (1.38-4.44), respectively, as compared to never smokers. In dose-response analyses, we observed a graded positive relationship of smoking amount and CAC progression in current smokers (multivariable adjusted ORs: 1.23, 1.72, and 2.42 from the lowest to the highest tertile of pack-years). Among the former smokers, earlier quitters (≥10.7 years) had similar ORs of the progression of CAC and AAC to that of participants who had never smoked. CONCLUSIONS: Compared with never smokers, current smokers especially those with greater pack-years at baseline had higher risk of atherosclerosis progression in community-dwelling Japanese men. Importantly, the residual adverse effect appears to be present for at least ten years after smoking cessation. The findings highlight the importance of early avoidance or minimizing smoking exposure for the prevention of atherosclerotic disease.
  • Sayaka Kadowaki, Takashi Kadowaki, Atsushi Hozawa, Akira Fujiyoshi, Takashi Hisamatsu, Atsushi Satoh, Hisatomi Arima, Sachiko Tanaka, Sayuki Torii, Keiko Kondo, Aya Kadota, Kamal Masaki, Tomonori Okamura, Takayoshi Ohkubo, Katsuyuki Miura, Hirotsugu Ueshima
    Hypertension research : official journal of the Japanese Society of Hypertension 44 1 80 - 87 2020年08月 [有り][無し]
     研究論文(学術雑誌) 
    Conventional office blood pressure (OBP) and home blood pressure (HBP) measurements are often inconsistent. The purpose of this research was (1) to test whether strictly measured OBP values with sufficient rest time before measurement (st-OBP) is comparable to HBP at the population level and (2) to ascertain whether there are particular determinants for the difference between HBP and st-OBP at the individual level. Data from a population-based group of 1056 men aged 40-79 years were analyzed. After a five-min rest, st-OBP was measured twice. HBP was measured after a 2-min rest every morning for seven consecutive days. To determine factors related to ΔSBP (HBP minus st-OBP measurements), multiple linear regression analyses and analyses of covariance were performed. While st-OBP and HBP were comparable (136.5 vs. 137.2 mmHg) at the population level, ΔSBP varied with a standard deviation of 13.5 mmHg. Smoking was associated with a larger ΔSBP regardless of antihypertensive usage, and BMI was associated with a larger ΔSBP in participants using antihypertensive drugs. The adjusted mean ΔSBP in the highest BMI tertile category was 4.6 mmHg in participants taking antihypertensive drugs. st-OBP and HBP measurements were comparable at the population level, although the distribution of ΔSBP was considerably broad. Smokers and obese men taking antihypertensive drugs had higher HBP than st-OBP, indicating that their blood pressure levels are at risk of being underestimated. Therefore, this group would benefit from the addition of HBP measurements.
  • Takashi Hisamatsu, Hiroyoshi Segawa, Aya Kadota, Takayoshi Ohkubo, Hisatomi Arima, Katsuyuki Miura
    Hypertension research : official journal of the Japanese Society of Hypertension 2020年07月 [有り][無し]
     研究論文(学術雑誌) 
    From the national surveys of Japan over a 55-year period (1961-2016), a steady decrease was observed in systolic blood pressure (BP) levels among all age groups of men and women, but not in diastolic BP levels-particularly among men. Hypertension prevalence remains high: over 60% of men aged ≥50 years and women aged ≥60 years had hypertension in 2016. However, the control rates of hypertension have continuously improved over a 36-year period, and were ~40% in 2016. Nonetheless, the over 50% prevalence of uncontrolled hypertension is a major risk factor for future cardiovascular diseases. Of the estimated 43 million hypertensives in Japan, most (31 million, 72%) were under poor control. According to new Japanese hypertension guidelines (JSH 2019), there will be only a small increase (2.2 million, 2.1 percentage points) in adults who are recommended for antihypertensive medication compared with 2014 guidelines. However, an additional 5.3 million (22.1 percentage points) adults taking antihypertensive medication would have a BP above the target defined by JSH 2019. The number of hypertensives with poor control was targeted to decrease by 7 million-from 31 million in 2017 to 24 million in 2028-when the followings are achieved: (1) the prevalence of hypertension decreases by 5 percentage points; (2) the treatment rate of hypertension among hypertensives increases by 10 percentage points; and (3) the control rate of hypertension, defined as BP <140/90 mmHg, among individuals taking antihypertensive medication increases by 10 percentage points. Both high-risk and population strategies to manage and prevent hypertension deserve greater priority.
  • Yukiko Imai, Takumi Hirata, Shigeyuki Saitoh, Toshiharu Ninomiya, Yoshihiro Miyamoto, Hirofumi Ohnishi, Yoshitaka Murakami, Hiroyasu Iso, Sachiko Tanaka, Katsuyuki Miura, Akiko Tamakoshi, Michiko Yamada, Masahiko Kiyama, Hirotsugu Ueshima, Shizukiyo Ishikawa, Tomonori Okamura
    Hypertension research : official journal of the Japanese Society of Hypertension 43 12 1437 - 1444 2020年07月 [有り][無し]
     研究論文(学術雑誌) 
    Lifetime risk is an informative estimate to motivate people to change lifestyle behaviors, especially from a younger age, in public health education. The impact of the combination of hypertension and diabetes on the lifetime risk of cardiovascular mortality has not been investigated in Asian populations. A pooled analysis of individual data from nine cohorts was performed. A total of 57,339 Japanese men and women were eligible for the analysis. We used the modified Kaplan-Meier approach and estimated the remaining lifetime risk of cardiovascular mortality starting from the index age of 35 years. Participants were classified into four categories defined by hypertension and diabetes. The lifetime risk was increased in the order of those without either risk, those without hypertension but with diabetes, those with hypertension but without diabetes, and those with both risks. The lifetime risk of cardiovascular mortality at the 35-year index age was as follows: 7.8% in men and 6.2% in women for those without either hypertension or diabetes, 13.2% in men and 9.5% in women for those without hypertension but with diabetes, 17.2% in men and 11.7% in women for those with hypertension but without diabetes, and 19.4% in men and 15% in women for those with both risks. These findings reinforce the need for a life-course perspective in the management of hypertension and diabetes from a younger age.
  • 日本人男性における冠動脈の石灰化で判断した潜在性アテローム硬化進行と腎機能との関連 SESSA研究(The association between kidney function and subclinical atherosclerosis progression evaluated by coronary artery calcification in Japanese men: SESSA study)
    Ganbaatar Namuun, Kadota Aya, Miura Katsuyuki, Fujiyoshi Akira, Miyazawa Itsuko, Kondo Keiko, Salman Ebtehal, Segawa Hiroyoshi, Torii Sayuki, Kume Shinji, Hisamatsu Takashi, Araki Shinichi, Maegawa Hiroshi, Ueshima Hirotsugu
    日本腎臓学会誌 62 4 383 - 383 2020年07月
  • 中年期日本人男性におけるApoAI含有LOX-1リガンドの血中レベルと冠動脈石灰化との関連(Serum Levels of LOX-1 Ligand Containing ApoAI are Associated with Coronary Artery Calcification in Middle-aged Japanese Men)
    平田 あや, 垣野 明美, 岡村 智教, 門田 文, 藤吉 朗, 久松 隆史, 沢村 達也, 三浦 克之, 上島 弘嗣
    日本循環器学会学術集会抄録集 84回 OJ25 - 5 2020年07月
  • Nurun Nahar, Takeshi Kinoshita, Tomoaki Suzuki, Katsuyuki Miura, Tohru Asai
    General thoracic and cardiovascular surgery 2020年06月 [有り][無し]
     研究論文(学術雑誌) 
    OBJECTIVE: This study was designed to assess structural and dynamic changes in the mitral annulus in patients before mitral valve reconstruction for degenerative mitral regurgitation with or without chronic atrial fibrillation. METHODS: One hundred and fifty one consecutive patients undergoing mitral valve reconstruction for mitral regurgitation due to myxomatous disease between July 2013 and May 2016 were included. Of these, 117 had a sinus rhythm (SR group) and 34 had chronic AF (AF group). Patients who underwent aortic surgery and were found to have no underlying cardiac valve disease nor coronary artery disease were included as the control group (n = 20). Real-time three-dimensional trans-esophageal echocardiography (3D-TEE) was used to assess mitral annulus shape, size, and movements. RESULTS: Annular areas in the control group were the smallest of the three groups and changed considerably through the cardiac cycle. Mean anteroposterior and intercommissural diameter measurements in the SR group were significantly larger but oscillated less than in the control group. Those diameters were the largest in the AF group and oscillated very little. Dilatation of the annulus in the AF and SR groups was accompanied by flattening and marked loss of oscillation in the height-to-intercommissural-width ratio which should peak in early systole. CONCLUSIONS: In patients with degenerative mitral regurgitation undergoing mitral valve surgery, preoperative chronic atrial fibrillation is associated with more progressed annular remodeling, characterized by marked enlargement of annular area, circumference, and anteroposterior diameter.
  • Ali Tanweer Siddiquee, Aya Kadota, Akira Fujiyoshi, Naoko Miyagawa, Yoshino Saito, Harumitsu Suzuki, Keiko Kondo, Hiromi Yamauchi, Takahiro Ito, Hiroyoshi Segawa, Ikuo Tooyama, Katsuyuki Miura, Hirotsugu Ueshima
    Alcohol (Fayetteville, N.Y.) 85 145 - 152 2020年06月 [有り][無し]
     研究論文(学術雑誌) 
    Although heavy alcohol consumption has been identified as a risk factor for adverse cognitive functioning, it currently remains unclear whether moderate alcohol consumption exerts similar effects. Observational studies previously reported the potential benefits of moderate alcohol consumption on cognition, particularly in the elderly; however, these effects have not yet been demonstrated in Asian populations. The aim of the present study was to investigate the relationship between alcohol consumption levels and global and domain-specific cognitive functions in cognitively intact elderly Japanese men. Cross-sectional data from the Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA), an ongoing prospective, population-based study in Shiga, Japan, were used to examine the relationship between alcohol consumption and cognitive function. Men (n = 585) aged ≥65 years provided information on their weekly consumption of alcohol, and the data obtained were used to construct categories of never, ex- (quit before interview), very light (<14 g/day), light (14-23 g/day), moderate (>23-46 g/day), and heavy (>46 g/day) drinkers. Cognitive function was measured using the Cognitive Abilities Screening Instrument (CASI). A fractional logistic regression model adjusted for age, education, body mass index, smoking, exercise, hypertension, diabetes, and dyslipidemia showed that the CASI scores for global and domain-specific cognitive functions were not significantly different between all subgroups of current drinkers and never-drinkers. However, the CASI score of ex-drinkers (multivariable adjusted mean CASI score [SD]) was significantly lower than that of never-drinkers in the global [never vs. ex: 90.16 (2.21) vs. 88.26 (2.58)] and abstraction and judgment domain [never vs. ex: 9.48 (0.46) vs. 8.61 (0.57)]). The present results do not suggest any beneficial or adverse relationship between current alcohol consumption levels and cognitive functioning (both global and domain specific) in elderly Japanese men; however, low cognitive function among ex-drinkers warrants future investigations to identify the factors causing drinkers to quit.
  • Naoyuki Takashima, Hisatomi Arima, Yoshikuni Kita, Takako Fujii, Sachiko Tanaka-Mizuno, Satoshi Shitara, Akihiro Kitamura, Katsuyuki Miura, Kazuhiko Nozaki
    Circulation journal : official journal of the Japanese Circulation Society 84 6 943 - 948 2020年05月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Despite many effective strategies for the prevention of recurrent stroke, individuals who survive an initial stroke have been shown to be at high risk of recurrent stroke. The aim of this study was to investigate the current status of stroke recurrence after first-ever stroke using a population-based stroke registry in Japan.Methods and Results:As part of the Shiga Stroke and Heart Attack Registry, the Shiga Stroke Registry is an ongoing population-based stroke registry study that covers approximately 1.4 million residents of Shiga Prefecture, Japan. A total of 1,883 first-ever stroke survivors at 28 days was registered in 2011 and followed-up until the end of 2013. Recurrence was defined as any type of stroke after 28 days from the onset of an index event. Two-year cumulative recurrence rates were estimated using cumulative incidence function methods. Over a mean 2.1-year follow-up period, 120 patients experienced recurrent stroke and 389 patients died without recurrence. The 2-year cumulative recurrence rate was higher in patients with index ischemic stroke (6.8%) than in those with index hemorrhagic stroke (3.8%). CONCLUSIONS: Two-year cumulative recurrence rate after first-ever stroke remained high, particularly among patients with ischemic stroke, in the present population-based registry study in a real-world setting in Japan. Further intensive secondary prevention strategies are required for these high-risk individuals.
  • Michihiro Satoh, Takayoshi Ohkubo, Kei Asayama, Yoshitaka Murakami, Daisuke Sugiyama, Takashi Waki, Sachiko Tanaka-Mizuno, Michiko Yamada, Shigeyuki Saitoh, Kiyomi Sakata, Fujiko Irie, Toshimi Sairenchi, Shizukiyo Ishikawa, Masahiko Kiyama, Akira Okayama, Katsuyuki Miura, Yutaka Imai, Hirotsugu Ueshima, Tomonori Okamura
    Journal of atherosclerosis and thrombosis 28 1 6 - 24 2020年04月 [有り][無し]
     研究論文(学術雑誌) 
    AIM: Lifetime risk (LTR) indicates the absolute risk of disease during the remainder of an individual's lifetime. We aimed to assess the LTRs for coronary heart disease (CHD) mortality associated with blood pressure (BP) and total cholesterol levels in an Asian population using a meta-analysis of individual participant data because no previous studies have assessed this risk. METHODS: We analyzed data from 105,432 Japanese participants in 13 cohorts. Apart from grade 1 and 2-3 hypertension groups, we defined "normal BP" as systolic/diastolic BP <130/<80 mmHg and "high BP" as 130-139/80-89 mmHg. The sex-specific LTR was estimated while considering the competing risk of death. RESULTS: During the mean follow-up period of 15 years (1,553,735 person-years), 889 CHD deaths were recorded. The 10-year risk of CHD mortality at index age 35 years was ≤ 0.11%, but the corresponding LTR was ≥ 1.84%. The LTR of CHD at index age 35 years steeply increased with an increase in BP of participants with high total cholesterol levels [≥ 5.7 mmol/L (220 mg/dL)]. This risk was 7.73%/5.77% (95% confidence interval: 3.53%-10.28%/3.83%-7.25%) in men/women with grade 2-3 hypertension and high total cholesterol levels. In normal and high BP groups, the absolute differences in LTRs between the low and high total cholesterol groups were ≤ 0.25% in men and ≤ 0.40% in women. CONCLUSIONS: High total cholesterol levels contributed to an elevated LTR of CHD mortality in hypertensive individuals. These findings could help guide high-risk young individuals toward initiating lifestyle changes or treatments.
  • Liu Ziyi, Zaid Maryam, Hisamatsu Takashi, Tanaka Sachiko, Fujiyoshi Akira, Miyagawa Naoko, Ito Takahiro, Kadota Aya, Tooyama Ikuo, Miura Katsuyuki, Ueshima Hirotsugu, the SESSA Research Group
    Journal of Epidemiology 30 3-4 121 - 127 2020年04月 
    ●日本人男性集団において認知機能と空腹時血糖の関連を検討した。●認知機能はCASIで評価した。●糖尿病のない男性では血糖値が3.97-6.20mmol/Lの範囲で認知機能が最も高かった。●糖尿病のある男性では、血糖値が高いほど認知機能が低かった。●血糖値と認知機能との関連は糖尿病の有無により異なっていた。(著者抄録)
  • Satoshi Shoji, Shun Kohsaka, Mitsuaki Sawano, Tomonori Okamura, Aya Hirata, Daisuke Sugiyama, Takayoshi Ohkubo, Yasuyuki Nakamura, Makoto Watanabe, Aya Kadota, Hirotsugu Ueshima, Akira Okayama, Katsuyuki Miura
    Journal of atherosclerosis and thrombosis 28 1 34 - 43 2020年03月 [有り][無し]
     研究論文(学術雑誌) 
    AIMS: P-wave terminal force in lead V1 (PTFV1) is an electrocardiogram marker of increased left atrial pressure and may be a noninvasive and early detectable marker for future cardiovascular events in the general population compared to serum B-type natriuretic peptide (BNP) concentration. The clinical significance of PTFV1 in the contemporary general population is an area of unmet need. We aimed to demonstrate the correlation between PTFV1 and BNP concentrations in a contemporary representative Japanese population. METHODS: Among 2,898 adult men and women from 300 randomly selected districts throughout Japan (NIPPON DATA2010), we analyzed 2,556 participants without cardiovascular disease (stroke, myocardial infarction, and atrial fibrillation). Elevated BNP was defined as a value of ≥ 20 pg/mL based on the definition from the Japanese Circulation Society guidelines. RESULTS: In total, 125 (4.9%) participants had PTFV1. Participants with PTFV1 were older with a higher prevalence of hypertension, major electrocardiographic findings, and elevated BNP concentrations (13.5 [6.9, 22.8] versus 7.8 [4.4, 14.5] pg/mL; P<0.001). After adjustment for confounders, PTFV1 was correlated with elevated BNP (odds ratio, 1.66; 95% confidence interval, 1.05-2.62; P=0.030). This correlation was consistent among various subgroups and was particularly evident in those aged <65 years or those without a history of hypertension. CONCLUSIONS: In the contemporary general population cohort, PTFV1 was independently related to high BNP concentration. PTFV1 may be an alternative marker to BNP in identifying individuals at a higher risk of future cardiovascular events in the East Asian population.
  • Nagako Okuda, Akira Okayama, Katsuyuki Miura, Katsushi Yoshita, Naoko Miyagawa, Shigeyuki Saitoh, Hideaki Nakagawa, Kiyomi Sakata, Queenie Chan, Paul Elliott, Hirotsugu Ueshima, Jeremiah Stamler
    Nutrients 12 3 2020年03月 [有り][無し]
     研究論文(学術雑誌) 
    A lower-than-recommended potassium intake is a well-established risk factor for increased blood pressure. Although the Japanese diet is associated with higher sodium intake and lower potassium intake, few studies have examined the source foods quantitatively. Studies on dietary patterns in association with potassium intake will be useful to provide dietary advice to increase potassium intake. Twenty-four-hour (hr) dietary recall data and 24-hr urinary potassium excretion data from Japanese participants (574 men and 571 women) in the International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) were used to calculate food sources of potassium and compare food consumption patterns among quartiles of participants categorized according to 24-hr urinary potassium excretion per unit of body weight (UK/BW). The average potassium intake was 2791 mg/day per participant, and the major sources were vegetables and fruits (1262 mg/day), fish (333 mg/day), coffee and tea (206 mg/day), and milk and dairy products (200 mg/day). Participants in the higher UK/BW quartile consumed significantly more vegetables and fruits, fish, and milk and dairy products, and ate less rice and noodles. Conclusion: Advice to increase the intake of vegetables and fruits, fish, and milk may be useful to increase potassium intake in Japan.
  • Ziyi Liu, Maryam Zaid, Takashi Hisamatsu, Sachiko Tanaka, Akira Fujiyoshi, Naoko Miyagawa, Takahiro Ito, Aya Kadota, Ikuo Tooyama, Katsuyuki Miura, Hirotsugu Ueshima
    Journal of epidemiology 30 3 121 - 127 2020年03月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Cognitive dysfunction has been recognized as a diabetes-related complication. Whether hyperglycemia or elevated fasting glucose are associated with cognitive decline remains controversial. We aimed to investigate the relationship between fasting glucose levels and cognitive function in diabetic and non-diabetic individuals. METHODS: Participants were Japanese diabetic (n = 191) and non-diabetic (n = 616) men, aged 46-81 years, from 2010-2014. Blood samples were taken after a 12 h fast. The Cognitive Ability Screening Instrument (CASI), with a maximum score of 100, was used for cognitive assessment. Cognitive domains of CASI were also investigated. Fractional logit regression with covariate adjustment for potential confounders was used to model cross-sectional relationships between fasting blood glucose and CASI score. RESULTS: For diabetic individuals, CASI score was 0.38 (95% confidence interval: 0.66-0.12) lower per 1 mmol/L higher fasting glucose level. Short-term memory domain also exhibited an inverse association. For non-diabetic individuals, a reverse U-shaped relationship was observed between fasting glucose and cognitive function, identifying a threshold for highest cognitive performance of 91.8 CASI score at 3.97-6.20 mmol/L (71.5-111.6 mg/dL) fasting glucose. Language ability domain displayed a similar relationship with fasting glucose. CONCLUSIONS: Elevated fasting glucose levels in diabetic men were associated with lower cognitive function, in which short-term memory was the main associated domain. Interestingly, in non-diabetic men, we identified a threshold for the inverse relationship of elevated fasting glucose with cognitive function. Contrastingly to diabetic men, language ability was the main associated cognitive domain among non-diabetic men.
  • Naoko Sagawa, Bonny Rockette-Wagner, Koichiro Azuma, Hirotsugu Ueshima, Takashi Hisamatsu, Tomoko Takamiya, Aiman El-Saed, Katsuyuki Miura, Andrea Kriska, Akira Sekikawa
    Journal of sport and health science 9 2 170 - 178 2020年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Metabolic syndrome (MetS) is a global health problem. Physical activity (PA) is a known modifiable risk factor for MetS and individual MetS components. However, the role of PA could differ between sub-populations due to differences in the variability of PA and other MetS risk factors. To examine these differences, multi-country studies with standardized outcome measurement methods across cohorts are needed. Methods: Cross-sectional PA levels (total and domain specific) in healthy middle-aged (44-56 years) men in the Risk Factor Assessment among Japanese and U.S. Men in the Post-World War II Birth Cohort (ERA-JUMP) Study (n = 730; American: n = 417; Japanese: n = 313; from population-representative samples in Pittsburgh, Pennsylvania, USA, and Kusatsu, Shiga, Japan) were compared. The relationships between PA levels and MetS (overall and specific components) in/across the American and Japanese sub-cohorts (adjusting for age, smoking, and alcohol consumption) were also assessed using the same instruments (pedometer and validated questionnaire) to measure PA in both cohorts. Results: A total of 510 individuals provided complete data on PA (American: n = 265; Japanese: n = 245). The American cohort had significantly lower mean ± SD steps/day (7878 ± 3399 steps/day) vs. the Japanese cohort (9055 ± 3797 steps/day) (p < 0.001) but had significantly higher self-reported moderate-vigorous leisure PA (American: 15.9 (7.4-30.3) metabolic task equivalent hours per week (MET-h/week) vs. Japanese: 4.0 (0-11.3) MET-h/week, p < 0.0001). In both sub-cohorts, each 1000 steps/day increase was associated with lower odds of having MetS (American: OR = 0.90, 95%CI: 0.83-0.98; Japanese: OR = 0.87, 95%CI: 0.79-0.95) and the individual MetS component of high waist circumference (American: OR = 0.86, 95%CI: 0.79-0.94; Japanese: OR = 0.87, 95%CI: 0.80-0.95). In the American cohort only, higher self-reported leisure PA (Met-h/week) was associated with lower odds of MetS and high waist circumference (OR = 0.98, 95%CI: 0.97-0.99 for MetS and waist circumference, respectively). Conclusion: Higher total step counts/day had an important protective effect on MetS prevalence in both the Japanese and American cohorts, despite differences in PA levels and other MetS risk factors. The effect of steps/day (across all intensity levels) was much greater than domain-specific moderate-vigorous PA captured by questionnaire, suggesting the need for measurement tools that can best capture total movement when examining the effects of PA on MetS development.
  • 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
    Journal of epidemiology 31 2 119 - 124 2020年02月 [有り][無し]
     研究論文(学術雑誌) 
    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.
  • Yunqing Yang, Atsushi Hozawa, Mana Kogure, Akira Narita, Takumi Hirata, Tomohiro Nakamura, Naho Tsuchiya, Naoki Nakaya, Toshiharu Ninomiya, Nagako Okuda, Aya Kadota, Takayoshi Ohkubo, Tomonori Okamura, Hirotsugu Ueshima, Akira Okayama, Katsuyuki Miura
    Journal of epidemiology 30 2 98 - 107 2020年02月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: It has been reported that chronic inflammation may play an important role in the pathogenesis of several serious diseases and could be modulated by diet. Recently, the Dietary Inflammatory Index (DII®) was developed to assess the inflammatory potential of the overall diet. The DII has been reported as relevant to various diseases but has not been validated in Japanese. Thus, in the present study, we analyzed the relationship between DII scores and high-sensitivity C-reactive protein (hs-CRP) levels in a Japanese population. METHODS: Data of the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010 (NIPPON DATA2010), which contained 2,898 participants aged 20 years or older from the National Health and Nutrition Survey of Japan (NHNS2010), were analyzed. Nutrient intakes derived from 1-day semi-weighing dietary records were used to calculate DII scores. Energy was adjusted using the residual method. Levels of hs-CRP were evaluated using nephelometric immunoassay. Multiple linear regression analyses were performed. RESULTS: After adjusting for age, sex, smoking status, BMI, and physical activity, a significant association was observed between DII scores and log(CRP+1) (standard regression coefficient = 0.05, P < 0.01). Although it was not statistically significant, the positive association was consistently observed in almost all age-sex subgroups and the non-smoker subgroup. CONCLUSIONS: The current study confirmed that DII score was positively associated with hs-CRP in Japanese.
  • Azusa Shima, Naomi Miyamatsu, Katsuyuki Miura, Naoko Miyagawa, Nagako Okuda, Katsushi Yoshita, Aya Kadota, Harumitsu Suzuki, Keiko Kondo, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
    Hypertension research : official journal of the Japanese Society of Hypertension 43 2 132 - 139 2020年02月 [有り][無し]
     研究論文(学術雑誌) 
    In Asian countries, a major source of salt intake is from seasoning or table salt added at home. However, little is known about the adverse effects of salt intake evaluated according to household unit. We investigated the relationship between household salt intake level and mortality from all-cause and cardiovascular diseases (CVDs). Participants included 8702 individuals (56% women) who were living with someone else and who were aged 30-79 years and enrolled in the National Nutritional Survey of Japan in 1980 with a 24-year follow-up. Household nutrient intake was evaluated using a 3-day weighing record method in which all foods and beverages consumed by any of the household members were recorded. The household salt intake level was defined as the amount of salt consumed (g) per 1000 kcal of total energy intake in each household, and its average was 6.25 (2.02) g/1000 kcal. During the follow-up, there were 2360 deaths (787 CVD, 168 coronary heart disease [CHD], and 361 stroke). Cox proportional hazard ratios (HRs) for an increment of 2 g/1000 kcal in household salt intake were calculated and adjusting for sex, age, body mass index, smoking status, alcohol consumption status, self-reported work exertion level, household potassium intake, household saturated fatty acid intake, and household long-chain n-3 polyunsaturated fatty acid intake. The HRs (95% confidence intervals) were 1.07 (1.02, 1.12) for all-cause mortality, 1.11 (1.03, 1.19) for CVD, 1.25 (1.08, 1.44) for CHD, and 1.12 (1.00, 1.25) for stroke. The household salt intake level was significantly associated with long-term risk of all-cause, CVD, CHD, and stroke mortality in a representative Japanese population.
  • Rachel Gibson, Chung-Ho E Lau, Ruey Leng Loo, Timothy M D Ebbels, Elena Chekmeneva, Alan R Dyer, Katsuyuki Miura, Hirotsugu Ueshima, Liancheng Zhao, Martha L Daviglus, Jeremiah Stamler, Linda Van Horn, Paul Elliott, Elaine Holmes, Queenie Chan
    The American journal of clinical nutrition 111 2 280 - 290 2020年02月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Results from observational studies regarding associations between fish (including shellfish) intake and cardiovascular disease risk factors, including blood pressure (BP) and BMI, are inconsistent. OBJECTIVE: To investigate associations of fish consumption and associated urinary metabolites with BP and BMI in free-living populations. METHODS: We used cross-sectional data from the International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP), including 4680 men and women (40-59 y) from Japan, China, the United Kingdom, and United States. Dietary intakes were assessed by four 24-h dietary recalls and BP from 8 measurements. Urinary metabolites (2 timed 24-h urinary samples) associated with fish intake acquired from NMR spectroscopy were identified. Linear models were used to estimate BP and BMI differences across categories of intake and per 2 SD higher intake of fish and its biomarkers. RESULTS: No significant associations were observed between fish intake and BP. There was a direct association with fish intake and BMI in the Japanese population sample (P trend = 0.03; fully adjusted model). In Japan, trimethylamine-N-oxide (TMAO) and taurine, respectively, demonstrated area under the receiver operating characteristic curve (AUC) values of 0.81 and 0.78 in discriminating high against low fish intake, whereas homarine (a metabolite found in shellfish muscle) demonstrated an AUC of 0.80 for high/nonshellfish intake. Direct associations were observed between urinary TMAO and BMI for all regions except Japan (P < 0.0001) and in Western populations between TMAO and BP (diastolic blood pressure: mean difference 1.28; 95% CI: 0.55, 2.02 mmHg; P = 0.0006, systolic blood pressure: mean difference 1.67; 95% CI: 0.60, 2.73 mmHg; P = 0.002). CONCLUSIONS: Urinary TMAO showed a stronger association with fish intake in the Japanese compared with the Western population sample. Urinary TMAO was directly associated with BP in the Western but not the Japanese population sample. Associations between fish intake and its biomarkers and downstream associations with BP/BMI appear to be context specific. INTERMAP is registered at www.clinicaltrials.gov as NCT00005271.
  • Keiko Fuse, Aya Kadota, Keiko Kondo, Katsutaro Morino, Akira Fujiyoshi, Takashi Hisamatsu, Sayaka Kadowaki, Itsuko Miyazawa, Satoshi Ugi, Hiroshi Maegawa, Katsuyuki Miura, Hirotsugu Ueshima
    Diabetes research and clinical practice 160 108002 - 108002 2020年02月 [有り][無し]
     研究論文(学術雑誌) 
    AIMS: Ectopic fat accumulation is related to insulin resistance and diabetes mellitus (DM). However, the effect of fatty liver on DM in non-obese individuals has not been clarified. We investigated whether liver fat accumulation assessed by computed tomography (CT) is associated with the incidence of DM. METHODS: In a prospective population-based study, 640 Japanese men were followed up for 5 years. The liver to spleen (L/S) ratio of the CT attenuation value was used as the liver fat accumulation index. We calculated the odds ratio (OR) and 95% confidence interval (CI) for the DM incidence of per 1 standard deviation (SD) lower L/S and those of L/S < 1.0 compared with L/S ≥ 1.0, using logistic regression models. RESULTS: Both per 1 SD lower L/S and L/S < 1.0 were significantly associated with a risk for DM incidence (1 SD lower L/S: OR = 1.57, 95%CI = 1.14-2.16; L/S < 1.0: OR = 2.27, 95%CI = 1.00-5.14). The relationship between L/S and incidence of DM was consistent in the obese and non-obese groups, with thresholds of BMI 25 kg/m2, waist circumference 85 cm, or visceral adipose tissue 100 cm2. CONCLUSIONS: Liver fat accumulation assessed by CT was associated with the incidence of DM.
  • Md Maruf Haque Khan, Akira Fujiyoshi, Akihiko Shiino, Takashi Hisamatsu, Sayuki Torii, Sentaro Suzuki, Ayako Kunimura, Hiroyoshi Segawa, Aya Kadota, Takayoshi Ohkubo, Kazuhiko Nozaki, Katsuyuki Miura, Hirotsugu Ueshima
    Journal of atherosclerosis and thrombosis 27 9 995 - 1009 2020年01月 [有り][無し]
     研究論文(学術雑誌) 
    AIM: Coronary artery calcification (CAC) is an independent predictor of stroke and dementia, in which subclinical cerebrovascular diseases (SCVDs) play a vital pathogenetic role. However, few studies have described the association between CAC and SCVDs. Therefore, the aim of this study was to assess the clinical relationship between CAC and SCVDs in a healthy Japanese male population. METHODS: In this observational study, 709 men, free of stroke, were sampled from a city in Japan from 2010 to 2014. CAC was scored using the Agatston method. The following SCVDs were assessed using magnetic resonance imaging: intracranial arterial stenosis (ICAS), lacunar infarction, deep and subcortical white matter hyperintensity (DSWMH), periventricular hyperintensity (PVH), and microbleeds. The participants were categorized according to CAC scores as follows: no CAC (0), mild CAC (1-100), and moderate-to-severe CAC (>100). The adjusted odds ratios of prevalent SCVDs were computed in reference to the no-CAC group using logistic regression. RESULTS: The mean (standard deviation) age of the participants was 68 (8.4) years. Participants in the moderate-to-severe-CAC category showed significantly higher odds of prevalent lacunar infarction, DSWMH, and ICAS in age-adjusted and risk-factor-adjusted models. Microbleeds and PVH, in contrast, did not show any significant associations. The trends for CAC with lacunar infarction, DSWMH, and ICAS were also significant (all P-values for trend ≤ 0.02). CONCLUSIONS: Higher CAC scores were associated with higher odds of lacunar infarction, DSWMH, and ICAS. The presence and degree of CAC may be a useful indicator for SCVDs involving small and large vessels.
  • Mohammad Moniruzzaman, Aya Kadota, Maksudul Shadat Akash, Patrick J Pruitt, Katsuyuki Miura, Roger Albin, Hiroko H Dodge
    Alzheimer's & dementia (New York, N. Y.) 6 1 e12109  2020年 研究論文(学術雑誌) 
    Introduction: Physical activities (PA) may lead to improved cognition in mild cognitive impairment (MCI), Alzheimer's disease (AD), and dementia. The mechanisms mediating potential PA effects are unknown. Assessment of PA effects on relevant biomarkers may provide insights into mechanisms underlying potential PA effects on cognition. Methods: We systematically reviewed randomized controlled trials (RCTs) that studied PA effects on biomarkers in MCI, AD, and dementia populations. We examined whether biological mechanisms were hypothesized to explain associations among PA, biomarkers, and cognitive functions. We used the PubMed database and searched for RCTs with PA until October 31, 2019. Results: Of 653 studies examining changes in biomarkers in PA trials, 18 studies met inclusion criteria for the present review. Some studies found favorable effects of PA on neurotrophic and inflammatory biomarkers. AD pathological markers were rarely investigated, with inconclusive results. Most studies were relatively small in sample size, of limited duration, and not all studies compared the changes in biomarkers between the control and experimental groups. Discussion: There is only limited use of potentially informative biomarkers in PA trials for MCI, AD, and dementia. Most studies did not examine the role of biomarkers to study associations between PA and cognitive functions in their analyses. Several potential biomarkers remain uninvestigated. Careful use of biomarkers may clarify mechanisms underlying PA effects on cognition. Our review serves as a useful resource for developing future PA RCTs aimed at improving cognitive functions in MCI, AD, and dementias.
  • Itsuko Miyazawa, Katsuyuki Miura, Naoko Miyagawa, Keiko Kondo, Aya Kadota, Nagako Okuda, Akira Fujiyoshi, Izumi Chihara, Yosikazu Nakamura, Atsushi Hozawa, Yasuyuki Nakamura, Yoshikuni Kita, Katsushi Yoshita, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
    European journal of clinical nutrition 74 1 67 - 76 2020年01月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND/OBJECTIVES: The association between carbohydrate intake and cardiovascular disease (CVD) risk has been investigated, but whether the quality of carbohydrate is more important than its amount is not known. We examined the associations between intake of dietary fibre (DF), carbohydrate, available carbohydrate, and starch with long-term CVD mortality in a Japanese population. SUBJECTS/METHODS: We prospectively followed 8925 participants (3916 men and 5009 women) aged 30-79 years without CVD at baseline who participated in the National Nutrition Survey in Japan. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for CVD mortality by quartiles of exposure variables. RESULTS: During 24 years of follow-up, 823 CVD deaths were observed. In men, the multivariable-adjusted HR for CVD mortality was lower in the highest quartile of DF intake (HR: 0.64; 95% CI: 0.47-0.87; Ptrend = 0.007) compared with the lowest quartile. This association was not significant in women. Multivariable-adjusted HR for total stroke mortality was lower in the highest quartile of DF intake (HR: 0.61; 95% CI: 0.38-0.98; Ptrend = 0.046) compared with the lowest quartile in women. Carbohydrate, available carbohydrate, and starch intake were not associated with CVD mortality. CONCLUSIONS: Higher intake of DF was associated significantly with a lower risk of CVD mortality in men and lower risk of stroke mortality in women. Intake of carbohydrate, available carbohydrate, and starch were not associated with the risk of CVD mortality in men or women.
  • Takashi Waki, Sachiko Tanaka-Mizuno, Naoyuki Takashima, Hajime Takechi, Takehito Hayakawa, Katsuyuki Miura, Hirotsugu Ueshima, Yoshikuni Kita, Hiroko H Dodge
    Journal of Alzheimer's disease : JAD 73 3 887 - 896 2020年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: While being obese in mid-life is associated with an increased risk of dementia and cognitive decline in late-life, being obese in late-life is shown to be associated with a lower risk of these outcomes in some studies. This phenomenon is known as the "obesity paradox", but the underlying reasons and potential sex difference have not been well understood. OBJECTIVE: To investigate the association between cognition and waist circumference (WC), an alternative measure of body fat which can be measured easier than body mass index (BMI), among older adults in each generation of late-life for men and women separately. METHODS: Three hundred thirty-five participants were used in the current study who were identified by random sampling of residents aged 65-74, 75-84, and 85 + years in Takashima County, Shiga Prefecture, Japan during 2005-2006. Associations between WC and domain-specific cognitive functions measured by 12 neuropsychological tests were examined using multivariable linear regression models with covariates: age, education, and hypertension. RESULTS: Larger WC was associated with better attention/working memory among 65-74-year old women and with better learning/acquisition among 65-74-year-old men, while larger WC was associated with worse learning/acquisition, memory, attention/working memory, and language/fluency among 75-84-year old men. CONCLUSION: We found age and sex differences in the association between WC and domain-specific cognitive functions. Among older old men (age 75-84), larger WC had negative effects on various domains including memory, attention, language, and executive functions, while we did not find any negative effects of larger WC on cognition among women in any age groups.
  • Atsushi Hozawa, Takumi Hirata, Hiroshi Yatsuya, Yoshitaka Murakami, Shinichi Kuriyama, Ichiro Tsuji, Daisuke Sugiyama, Atsushi Satoh, Sachiko Tanaka-Mizuno, Katsuyuki Miura, Hirotsugu Ueshima, Tomonori Okamura
    Journal of epidemiology 29 12 457 - 463 2019年12月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: We sought to investigate the optimal values of BMI for the lowest risk of all-cause death and whether the optimal BMI differs according to smoking status in large-scale pooled analysis of 13 Japanese cohorts. METHODS: Data from 179,987 participants of 13 well-qualified cohort studies conducted throughout Japan were used for our analysis. A cohort-stratified Cox proportional hazard model was used. P values for interactions were calculated based on the cross product of BMI and age, sex, or smoking status. RESULTS: In the entire study population, all-cause mortality risk was lowest when the BMI was 22.0-24.9 kg/m2. This was also the case for selected healthy participants (never smoked, baseline total cholesterol level ≥4.1 mmol/L; the first 5 years of follow-up data were excluded). No effect modification of age, sex, or smoking status was observed. Regardless of their BMI, never smokers always had a lower all-cause mortality risk than did current smokers even with an ideal BMI in terms of mortality risk. CONCLUSION: A BMI of 22-24.9 kg/m2 correlated with the lowest risk of mortality, regardless of whether all participants or selected healthy participants were analyzed. The fact that smoking was more strongly associated with mortality than obesity emphasizes the urgency for effective anti-smoking programs.
  • Yuyan Liu, Akira Fujiyoshi, Hisatomi Arima, Aya Kadota, Sayaka Kadowaki, Takashi Hisamatsu, Itsuko Miyazawa, Keiko Kondo, Ikuo Tooyama, Katsuyuki Miura, Hirotsugu Ueshima
    Journal of atherosclerosis and thrombosis 26 12 1102 - 1114 2019年12月 [有り][無し]
     研究論文(学術雑誌) 
    AIM: Computed tomography (CT) can directly provide information on body compositions and distributions, compared to anthropometric indices. It has been shown that various obesity indices are associated with carotid intima-media thickness (IMT). However, whether CT-based obesity indices are stronger than anthropometric indices in association with atherosclerosis remains to be determined in a general population. METHODS: We cross-sectionally assessed carotid IMT using ultrasound in 944 community-dwelling Japanese men free of stroke and myocardial infarction. CT image at the L4-L5 level was obtained to compute areas of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Anthropometric measures assessed included body mass index (BMI), waist circumference, and waist-to-hip ratio. Using multivariable linear regression, slopes of IMT per 20th to 80th percentile of each index were compared. We also compared the slope of index with simultaneous adjustment for BMI in the same model. RESULTS: Areas of VAT and SAT were positively associated with IMT, but not stronger than those of anthropometric indices in point estimates. Among all obesity indices, BMI was strongest in association with IMT after adjusting for age and lifestyle factors or further adjusting for metabolic factors. In simultaneous adjustment models, BMI, but not CT-based indices, remained significant and showed the strongest association. CONCLUSIONS: In community-dwelling Japanese men, anthropometric obesity indices, BMI in particular, were more strongly associated with carotid atherosclerosis than CT-based obesity indices. The association of general obesity with carotid atherosclerosis was strong and adding CT-based obesity measure did not considerably influence in the association.
  • 東 さおり, 西村 路子, 市川 瑞希, 橋本 美弥子, 樺山 舞, 由田 克士, 永田 啓, 三浦 克之, 宮松 直美
    日本禁煙学会学術総会プログラム・抄録集 13回 48 - 48 (一社)日本禁煙学会 2019年11月
  • Kei Asayama, Takayoshi Ohkubo, Hiromi Rakugi, Masaaki Miyakawa, Hisao Mori, Tomohiro Katsuya, Yumi Ikehara, Shinichiro Ueda, Yusuke Ohya, Takuya Tsuchihashi, Kazuomi Kario, Katsuyuki Miura, Naoyuki Hasebe, Sadayoshi Ito, Satoshi Umemura
    Hypertension research : official journal of the Japanese Society of Hypertension 42 11 1726 - 1737 2019年11月 [有り][無し]
     研究論文(学術雑誌) 
    Self-measured blood pressure (BP) at home (HBP) has been commonly used in clinical practice. Although the unattended office BP (UBP), in which a patient is left alone before and during the measurement, has been investigated, the advantages of UBP over HBP or conventionally measured attended office BP obtained using automated devices (CBP) remain unclear. We performed a multicenter clinical study in Japan to compare the UBP, CBP, and HBP among 308 patients with hypertension at 3 clinics (women, 57.8%; mean age 71.8 years; under antihypertensive drug therapy, 96.4%). The patients measured HBP twice in the morning and twice in the evening for 5 days according to the Japanese Society of Hypertension guidelines. Using the Omron HEM-907 cuff-oscillometric device, the UBP and CBP were measured in line with the protocol in the Systolic blood PRessure INtervention Trial (SPRINT) and in accordance with the guidelines, respectively. Correlation coefficients were ≤0.16 for the comparison of UBP versus morning and evening HBP for the systolic measurement, whereas they were approximately 0.5 (P < 0.001) for the diastolic measurement. The difference between UBP minus HBP was small on average but varied among individuals (mean ± SD for UBP minus morning HBP: 0.9 ± 17.8/-4.5 ± 10.5 mmHg; UBP minus evening HBP: 5.7 ± 17.8/-0.1 ± 11.3 mmHg). In contrast, the measurement values of CBP and UBP were highly correlated (r ≥ 0.72), but the difference between CBP minus UBP was 10.4 ± 12.0/4.2 ± 6.5 mmHg. Based on the low correlations and wide range of differences, UBP cannot be used as an alternative to HBP.
  • Shitara S, Fujiyoshi A, Hisamatsu T, Torii S, Suzuki S, Ito T, Arima H, Shiino A, Nozaki K, Miura K, Ueshima H, SESSA Research group
    Stroke 50 10 2967 - 2969 2019年10月 [有り][無し]
     研究論文(学術雑誌) 
    Background and Purpose- Few community-based studies have reported the prevalence of intracranial artery stenosis (ICAS) assessed with magnetic resonance angiography. The aim was to determine the prevalence of ICAS using magnetic resonance angiography in a general population of Japanese men and to investigate the associations between ICAS and conventional cardiovascular risk factors. Methods- The Shiga Epidemiological Study of Subclinical Atherosclerosis randomly recruited and examined participants from Kusatsu City, Shiga, Japan, in 2006 to 2008 (baseline); 740 men returned for follow-up and underwent 1.5 T brain magnetic resonance angiography in 2012 to 2015. Participants were categorized as having no-ICAS, mild-ICAS (1 to <50%), or severe-ICAS (≥50%) in any of the arteries examined. After excluding the men with a history of stroke, 709 men were analyzed using multivariable logistic regression to assess independent associations of conventional cardiovascular risk factors with reference to the no-ICAS group. Results- The participants' mean age was 68.0 years. The age-standardized prevalences of mild and severe-ICAS were 20.7% and 4.5%, respectively (with the population of the 2010 Japanese vital statistics as the reference). Age, hypertension, diabetes mellitus, and dyslipidemia were associated with a higher prevalence of severe-ICAS after simultaneous adjustment for conventional cardiovascular risk factors. Conclusions- In a community-based sample of Japanese men, ICAS was estimated to be present in 25.2%, and related to metabolic risk factors, in addition to hypertension and age. These results support the importance of comprehensive management of conventional cardiovascular risk factors for stroke prevention.
  • 宮澤 伊都子, 大久保 孝義, 村上 陽子, 永谷 幸裕, 佐藤 滋高, 藤吉 朗, 久松 隆史, 門田 文, 門脇 紗也佳, 瀬川 裕佳, 近藤 慶子, 新田 哲久, 前川 聡, 三浦 克之, 上島 弘嗣
    肥満研究 25 Suppl. 250 - 250 (一社)日本肥満学会 2019年10月 [有り][無し]
  • 現代の我が国の一般地域住民における家庭血圧の現状 Modern Database on Ambulatory and Self-measured home blood pressure(MDAS)
    浅山 敬, 田原 康玄, 大石 絵美, 坂田 智子, 久松 隆史, 呉代 華容, 樺山 舞, 辰巳 友佳子, 秦 淳, 菊谷 昌浩, 神出 計, 三浦 克之, 二宮 利治, 大久保 孝義
    日本高血圧学会総会プログラム・抄録集 42回 293 - 293 (NPO)日本高血圧学会 2019年10月 [有り][無し]
  • 若中年成人における孤立性収縮期高血圧および孤立性拡張期高血圧の予後予測能の検討,NIPPON DATA80
    久松 隆史, 三浦 克之, 大久保 孝義, 門田 文, 近藤 慶子, 喜多 義邦, 早川 岳人, 神田 秀幸, 岡村 智教, 岡山 明, 上島 弘嗣
    日本高血圧学会総会プログラム・抄録集 42回 302 - 302 (NPO)日本高血圧学会 2019年10月 [有り][無し]
  • 未治療高血圧者への健診現場における即日の紹介状発行が外来受診率向上に及ぼす効果 クラスターランダム化比較試験
    志摩 梓, 有馬 久富, 三浦 克之, 辰巳 友佳子, 大久保 孝義, 呉代 華容, 木村 隆, 宮松 直美
    日本高血圧学会総会プログラム・抄録集 42回 386 - 386 (NPO)日本高血圧学会 2019年10月 [有り][無し]
  • A Smoking Cessation Support for Non-Japanese Patients with using STOP SMOKING Application.
    Azuma S, Nishimura M, Sugimoto Y, Sakihana N, Ichikawa M, Shimada B, Y, Kurebayashi H, Yoshita K, Hashimoto M, Kabayama M, Miura K, Nagata S, Miyamatsu N
    2019年10月 [無し][無し]
     研究論文(その他学術会議資料等)
  • Satoko Nakamura, Naoyuki Hasebe, Midori Yatabe, Takuya Kishi, Mari Ishida, Atsuhiro Ichihara, Koichi Node, Toshihiko Ishimitsu, Hiroshi Itoh, Masaaki Ito, Mitsuru Ohishi, Takayoshi Ohkubo, Hisashi Kai, Naoki Kashihara, Kazuomi Kario, Shigeyuki Saitoh, Takuya Tsuchihashi, Akira Nishiyama, Jitsuo Higaki, Katsuyuki Miura, Hiromi Rakugi, Yuhei Kawano, Kouichi Tamura, Takashi Yatabe, Yusuke Ohya, Sadayoshi Ito
    Hypertension research : official journal of the Japanese Society of Hypertension 42 10 1483 - 1484 2019年10月 [有り][無し]
  • Qi Wu, Hideki Hayashi, Daiki Hira, Keiko Sonoda, Satoshi Ueshima, Seiko Ohno, Takeru Makiyama, Tomohiro Terada, Toshiya Katsura, Katsuyuki Miura, Minoru Horie
    Journal of Arhythmia 35 5 752 - 759 2019年10月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Patients with Brugada syndrome (BrS) are known to have arrhythmic events after alcohol drinking and are recommended to avoid its excessive intake. Mechanisms underlying the alcohol-induced cardiac events are however unknown. This study aimed to test the hypothesis whether activity of alcohol-metabolizing enzymes determines fatal arrhythmic events after drinking alcohol. Methods: A total of 198 Japanese patients with BrS were enrolled in this study. These patients were classified into symptomatic (n = 90) and asymptomatic (n = 108) groups. The former was divided into an alcohol-related group (syncope after alcohol drinking, n = 16) and an alcohol-unrelated group (n = 74). Polymerase chain reaction was performed to determine genetic variants of genes encoding alcohol dehydrogenase 1B (ADH1B) and aldehyde dehydrogenase 2 (ALDH2). Results: The genotype distribution for ALDH2 was not significantly different between symptomatic and asymptomatic groups and between alcohol-related and alcohol-unrelated groups. The genotype distribution for ADH1B was not significantly different between symptomatic and asymptomatic groups, but the genotype ADH1B His/His was significantly more prevalent in the alcohol-related group than in the alcohol-unrelated group (81.3% vs 50%, P = .023). In multivariate logistic regression analysis, the genotype of ADH1B His/His was independently associated with syncope after alcohol drinking (odds ratio, 5.746; 95% confidence interval, 1.580-28.421; P = .007). Conclusions: Arrhythmic events after alcohol drinking was associated with enhanced activity of alcohol-metabolizing enzyme ADH1B in our cohort of BrS. Therefore, the lifestyle change to avoid the excessive alcohol intake deserves attention.
  • Toshiyuki Iwahori, Katsuyuki Miura, Hirotsugu Ueshima, Sachiko Tanaka-Mizuno, Queenie Chan, Hisatomi Arima, Alan R Dyer, Paul Elliott, Jeremiah Stamler
    Hypertension research : official journal of the Japanese Society of Hypertension 42 10 1590 - 1598 2019年10月 [有り][無し]
     研究論文(学術雑誌) 
    The Na/K ratio may be more strongly related to blood pressure and cardiovascular disease than sodium or potassium. The casual urine Na/K ratio can provide prompt on-site feedback, and with repeated measurements, may provide useful individual estimates of the 24-h ratio. The World Health Organization has published guidelines for sodium and potassium intake, but no generally accepted guideline prevails for the Na/K ratio. We used standardized data on 24 h and casual urinary electrolyte excretion obtained from the INTERSALT Study for 10,065 individuals aged 20-59 years from 32 countries (52 populations). Associations between the casual urinary Na/K ratio and the 24-h sodium and potassium excretion of individuals were assessed by correlation and stratification analyses. The mean 24-h sodium and potassium excretions were 156.0 mmol/24 h and 55.2 mmol/24 h, respectively; the mean 24-h urinary Na/K molar ratio was 3.24. Pearson's correlation coefficients (r) for the casual urinary Na/K ratio with 24-h sodium and potassium excretions were 0.42 and -0.34, respectively, and these were 0.57 and -0.48 for the 24-h ratio. The urinary Na/K ratio predicted a 24-h urine Na excretion of <85 mmol/day (the WHO recommended guidelines) with a sensitivity of 99.7% and 94.0%, specificity of 39.5% and 48.0%, and positive predictive value of 96.3% and 61.1% at the cutoff point of 1 in 24 h and casual urine Na/K ratios, respectively. A urinary Na/K molar ratio <1 may be a useful indicator for adherence to the WHO recommended levels of sodium and, to a lesser extent, the potassium intake across different populations; however, cutoff points for Na/K ratio may be tuned for localization.
  • Masaru Sakurai, Masao Ishizaki, Katsuyuki Miura, Motoko Nakashima, Yuko Morikawa, Teruhiko Kido, Yuchi Naruse, Kazuhiro Nogawa, Yasushi Suwazono, Koji Nogawa, Hideaki Nakagawa
    Journal of occupational health 62 1 e12088  2019年09月 [有り][無し]
     研究論文(学術雑誌) 
    OBJECTIVES: The increasing number of working elderly people has enhanced the importance of workplace health promotion activities. We investigated the association between the health status of workers approximately 60 years of age and the risk of all-cause mortality after compulsory retirement in Japan. METHODS: The 2026 participants (1299 males and 727 females) had retired from a metal-products factory at ≥60 years of age. Baseline health examinations were conducted at 60 years of age and included questions about medical history and lifestyle factors; the participants also underwent a physical examination. The participants were followed up annually by mail for an average of 7.4 years. The association between health status at age 60 years and the risk of all-cause mortality was assessed by Cox proportional hazards regression analysis. RESULTS: During the study, 71 deaths were reported. The age- and sex-adjusted hazard ratio (HR [95% confidence interval]) for all-cause mortality was higher for males (HR, 3.41 [1.73-6.69]) compared with females, participants with a low body mass index (<18.5 kg/m2 ; HR 3.84 [1.91-7.73]) compared with normal body weight, smokers (HR, 2.63 [1.51-4.58]) compared with nonsmokers, and those with three or more of four metabolic abnormalities (obesity, high blood pressure, dyslipidemia, and glucose intolerance) (HR 2.29 [1.04-5.02]) compared with no metabolic abnormalities. The associations were unaffected by adjustment for these factors. CONCLUSION: Maintenance of an appropriate body weight, smoking cessation, and elimination of metabolic syndrome are required for older workers to prevent early death after retirement.
  • Satoshi Umemura, Hisatomi Arima, Shuji Arima, Kei Asayama, Yasuaki Dohi, Yoshitaka Hirooka, Takeshi Horio, Satoshi Hoshide, Shunya Ikeda, Toshihiko Ishimitsu, Masaaki Ito, Sadayoshi Ito, Yoshio Iwashima, Hisashi Kai, Kei Kamide, Yoshihiko Kanno, Naoki Kashihara, Yuhei Kawano, Toru Kikuchi, Kazuo Kitamura, Takanari Kitazono, Katsuhiko Kohara, Masataka Kudo, Hiroo Kumagai, Kiyoshi Matsumura, Hideo Matsuura, Katsuyuki Miura, Masashi Mukoyama, Satoko Nakamura, Takayoshi Ohkubo, Yusuke Ohya, Takafumi Okura, Hiromi Rakugi, Shigeyuki Saitoh, Hirotaka Shibata, Tatsuo Shimosawa, Hiromichi Suzuki, Shori Takahashi, Kouichi Tamura, Hirofumi Tomiyama, Takuya Tsuchihashi, Shinichiro Ueda, Yoshinari Uehara, Hidenori Urata, Nobuhito Hirawa
    Hypertension research : official journal of the Japanese Society of Hypertension 42 9 1235 - 1481 2019年09月 [有り][無し]
     研究論文(学術雑誌)
  • Aya Kadota, Katsuyuki Miura, Tomonori Okamura, Akira Fujiyoshi, Takayoshi Ohkubo, Takashi Kadowaki, Naoyuki Takashima, Takashi Hisamatsu, Yasuyuki Nakamura, Fumiyoshi Kasagi, Hiroshi Maegawa, Atsunori Kashiwagi, Hirotsugu Ueshima
    Journal of atherosclerosis and thrombosis 26 8 746 - 746 2019年08月 [有り][無し]
     研究論文(学術雑誌)
  • Atsushi Satoh, Hisatomi Arima, Atsushi Hozawa, Takayoshi Ohkubo, Takashi Hisamatsu, Sayaka Kadowaki, Aya Kadota, Akira Fujiyoshi, Naoko Miyagawa, Maryam Zaid, Sayuki Torii, Tomonori Okamura, Akira Sekikawa, Katsuyuki Miura, Hirotsugu Ueshima
    Journal of hypertension 37 8 1676 - 1681 2019年08月 [有り][無し]
     研究論文(学術雑誌) 
    OBJECTIVE: We conducted a cross-sectional study to clarify whether home blood pressure (HBP) is more strongly associated with coronary artery calcification (CAC) than accurately measured office blood pressure (OBP) among the general population of Japanese men. METHODS: We analyzed the data of 919 Japanese male participants who were randomly selected from general population (mean age 64.5 years). OBP was measured twice consecutively by a trained nurse using electrical device after 5 min of complete rest alone in a sitting position in a silent room. The participants were asked to measure HBP with an electrical device once in the morning during 7 consecutive days. CAC was assessed using computed tomography. Presence of CAC was defined as Agatston score at least 10. We calculated odds ratios for the presence of CAC per one SD higher OBP and HBP adjusted for age and other cardiovascular risk factors. RESULTS: The mean systolic OBP (SD) and HBP (SD) were 136.8 (19.0) and 137.2 (18.5) mmHg, respectively, without statistical difference between the two (P = 0.595). OBP and HBP were highly correlated (r = 0.74 P < 0.001). CAC was found in 454 (49.4%) participants. Multivariable-adjusted odds ratios [95% confidence interval (CI)] for the presence of CAC were comparable between OBP (1.32, 95% CI: 1.12-1.56) and HBP (1.35, 95% CI: 1.14-1.60) (P heterogeneity = 0.813). CONCLUSION: The strength of association of accurately measured OBP with CAC was comparable with that of HBP among randomly selected male general population aged 40-79 years.
  • 冠動脈石灰化と無症候性脳血管疾患の相関性 コミュニティベース研究(The Association Between Coronary Artery Calcium and The Subclinical Cerebrovascular Disease: A Community Based Study)
    Khan Md Maruf Haque, Fujiyoshi Akira, Miura Katsuyuki, Hisamatsu Takashi, Torii Sayuki, Suzuki Sentaro, Shiino Akihiko, Nozaki Kazuhiko, Ohkubo Takayoshi, Kunimura Ayako, Ueshima Hirotsugu
    日本動脈硬化学会総会プログラム・抄録集 51回 2 - 2 2019年07月
  • レセプト情報・特定健診等情報データベースを活用した都道府県の平均寿命に関連する要因の解析:地域相関研究
    井上 英耶, 鈴木 智之, 小嶋 美穂子, 井下 英二, 三浦 克之
    日本公衆衛生雑誌 66 7 370 - 377 2019年07月 [有り][無し]
     研究論文(学術雑誌)
  • Hideka Inoue, Katsutaro Morino, Satoshi Ugi, Sachiko Tanaka-Mizuno, Keiko Fuse, Itsuko Miyazawa, Keiko Kondo, Daisuke Sato, Natsuko Ohashi, Shogo Ida, Osamu Sekine, Masahiro Yoshimura, Kiyoshi Murata, Katsuyuki Miura, Hisatomi Arima, Hiroshi Maegawa
    Journal of Diabetes Investigation 10 4 1012 - 1021 2019年07月 [有り][無し]
     研究論文(学術雑誌) 
    © 2018 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd Aims/Introduction: Sodium–glucose cotransporter 2 inhibitors reduce bodyweight (BW) by creating a negative energy balance. Previous reports have suggested that this BW reduction is mainly loss of body fat and that ~20% of the reduction is lean mass. However, the effects of sodium–glucose cotransporter 2 inhibitors on BW and body composition remain unclear. We examined these effects in Japanese patients with type 2 diabetes mellitus treated with insulin. Materials and Methods: In this open-label, randomized controlled trial, 49 overweight patients (body mass index ≥23 kg/m2) with inadequate glycemic control (hemoglobin A1c >7.0%) receiving insulin treatment were randomly assigned to receive add-on ipragliflozin or no additional treatment (control group). Patients were followed for 24 weeks. The goal for all patients was to achieve glycated hemoglobin <7.0% without hypoglycemia. The primary end-point was a change in BW from baseline to week 24. Body composition was assessed with dual-energy X-ray absorptiometry and bioelectrical impedance analysis. Results: BW change was significantly larger in the ipragliflozin group than in the control group (−2.78 vs −0.22 kg, P < 0.0001). Total fat mass was reduced evenly in the arms, lower limbs and trunk in the ipragliflozin group. Total muscle mass and bone mineral content were maintained, but muscle mass in the arms might have been affected by ipragliflozin treatment. Conclusions: Ipragliflozin treatment for 24 weeks resulted in reduced BW, mainly from fat mass loss. Muscle mass and bone mineral content were maintained. Further study is necessary to elucidate the long-term effects of ipragliflozin.
  • Nagako Okuda, Aya Kadota, Nobuo Nishi, Katsuyuki Miura, Takayoshi Ohkubo, Naoko Miyagawa, Atsushi Satoh, Yoshikuni Kita, Takehito Hayakawa, Naoyuki Takashima, Akira Fujiyoshi, Akira Okayama, Tomonori Okamura, Hirotsugu Ueshima
    Circulation journal : official journal of the Japanese Circulation Society 83 7 1506 - 1513 2019年06月 [有り][無し]
     
    BACKGROUND: Several cohort studies have demonstrated an association between socioeconomic status (SES) and health outcomes in Japan. As long-term employment is common in Japan, the size of the company may be related to cardiovascular disease (CVD) mortality risk. We examined the association of employment conditions with CVD mortality risk among working-age Japanese men (30-59 years, n=2,091).Methods and Results:We used 20-year follow-up data from NIPPON DATA90, for which baseline data were obtained from the 4th National Survey on Circulatory Disorders in 1990. Participants were classified into 4 groups: 3 strata for indefinite-term employees according to company size (large company/public office, moderate-sized, or small), and the self-employed/administrator group. Multivariable-adjusted hazard ratios (HRs) were adjusted for age, lifestyle, and CVD risk factors. Smokers were more common, habitual exercise was less common, and the average systolic blood pressure was higher among indefinite-term employees of small companies compared with employees at large companies/public offices. There was no significant difference in the total CVD mortality risk between indefinite-term employees and self-employed/administrator participants. The age-adjusted HR (95% confidence interval) for total CVD using indefinite-term employees of large companies/public office as a reference was 2.53 (1.12, 5.69) for employees of small companies. CONCLUSIONS: Working as an indefinite-term employee at a small company in Japan was significantly associated with elevated risk of CVD mortality among Japanese men.
  • Masaki Sumi, Takashi Hisamatsu, Akira Fujiyoshi, Aya Kadota, Naoko Miyagawa, Keiko Kondo, Sayaka Kadowaki, Sentaro Suzuki, Sayuki Torii, Maryam Zaid, Atsushi Sato, Hisatomi Arima, Tomohiro Terada, Katsuyuki Miura, Hirotsugu Ueshima
    Journal of epidemiology 29 6 205 - 212 2019年06月 [有り][無し]
     
    BACKGROUND: Excessive alcohol intake has been shown to be associated with cardiovascular disease via metabolic pathways. However, the relationship between alcohol intake and obesity has not been fully elucidated. We aimed to examine the association of alcohol consumption with fat deposition and anthropometric measures. METHODS: From 2006-2008, we conducted a cross-sectional study in a population-based sample of Japanese men aged 40 through 79 years. Areas of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated using computed tomography imaging. Based on a questionnaire, we classified participants into five groups according to weekly alcohol consumption, excluding former drinkers: non-drinkers (0 g/week), 0.1-160.9, 161-321.9, 322-482.9, and ≥483 g/week. Multivariable linear regression was used to estimate adjusted means of obesity indices for each group. RESULTS: We analyzed 998 men (mean age and body mass index [BMI], 63.8 years and 23.6 kg/m2, respectively). Higher weekly alcohol consumption was strongly and significantly associated with higher abdominal VAT area, percentage of VAT, and VAT-to-SAT ratio (all P for trend <0.001), and also with waist circumferences and waist-to-hip ratio (P for trend = 0.042 and 0.007, respectively). These associations remained significant after further adjustment for BMI, whereas alcohol consumption had no significant association with abdominal SAT area. CONCLUSIONS: Higher alcohol consumption was associated with higher VAT area, VAT%, and VAT-to-SAT ratio, independent of confounders, including BMI, in general Japanese men. These results suggest that alcohol consumption may have a potential adverse effect on visceral fat deposition.
  • Hirokazu Uemura, Sakurako Katsuura-Kamano, Yuki Iwasaki, Kokichi Arisawa, Asahi Hishida, Rieko Okada, Takashi Tamura, Yoko Kubo, Hidemi Ito, Isao Oze, Chisato Shimanoe, Yuichiro Nishida, Yasuyuki Nakamura, Naoyuki Takashima, Sadao Suzuki, Hiroko Nakagawa-Senda, Daisaku Nishimoto, Toshiro Takezaki, Haruo Mikami, Yohko Nakamura, Norihiro Furusyo, Hiroaki Ikezaki, Etsuko Ozaki, Teruhide Koyama, Kiyonori Kuriki, Kaori Endoh, Mariko Naito, Kenji Wakai
    Endocrine 64 3 552 - 563 2019年06月 研究論文(学術雑誌) 
    PURPOSE: This study aimed to investigate independent relationships of daily non-exercise life activity and leisure-time exercise volume and intensity with the prevalence of metabolic syndrome and its traits in Japanese adults. METHODS: Data of 24,625 eligible subjects (12,709 men, 11,916 women) who participated in the baseline survey of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study were analyzed. Information about lifestyle characteristics was obtained from a questionnaire. Logistic regression analyses were performed to evaluate the independent associations of daily life activity as well as leisure-time exercise volume and intensity with the prevalence of metabolic syndrome and its traits by sex. RESULTS: Male subjects with higher daily life activity as well as with higher leisure-time exercise volume had a lower prevalence of metabolic syndrome, independently with each other. Female subjects with higher daily life activity also had a lower prevalence of metabolic syndrome. Particularly, male and female subjects with the highest daily life activity quartile showed considerably low odds ratios of 0.66 (95% CI, 0.53-0.81) and 0.64 (0.52-0.79), respectively, for low HDL-cholesterol even after the adjustment for BMI compared with the first quartile. Meanwhile, male subjects with the higher leisure-time exercise showed a quite lower prevalence of elevated triglycerides. Higher moderate-intensity exercise was more intensely associated with a lower prevalence of metabolic syndrome and some of its traits in both sexes. CONCLUSIONS: Our results suggest that higher daily life activity and higher moderate-intensity exercise may be independently associated with a lower risk of metabolic syndrome in Japanese adults.
  • Longjian Liu, Katsuyuki Miura, Aya Kadota, Akira Fujiyoshi, Edward J Gracely, Fuzhong Xue, Zuolu Liu, Naoyuki Takashima, Naoko Miyagawa, Takayoshi Ohkubo, Hisatomi Arima, Akira Okayama, Tomonori Okamura, Hirotsugu Ueshima
    Journal of diabetes and its complications 33 6 417 - 423 2019年06月 [有り][無し]
     
    AIMS: To test a hypothesis that women with diabetes mellitus (DM) versus those without DM had a significantly higher risk of heart disease (HD), stroke and all-cause mortality than their male counterparts in the U.S. as well as in Japan. METHODS: We analyzed two nationally representative datasets, one from the U.S. NHANES III cohort (n = 13,169), and the other from the Japan NIPPON DATA90 cohort (n = 7445). Hazard ratios (HRs) of DM for risk of mortality and sex-DM interaction effect on mortality were analyzed prospectively using Cox's proportional hazards regression models. RESULTS: Patients with DM had significantly higher mortality from HD, stroke and all-cause mortality in the U.S. and in Japan. However, the HRs of DM versus non-DM for HD and all-cause mortality were significantly higher in women compared to men in the U.S. (sex-DM interaction: HR = 1.59, p = 0.01, and 1.24, p = 0.045 for HD and all-cause mortality), but the sex-DM interaction effect was not statistically significant in the Japanese cohort. DISCUSSION: Patients with DM had a significantly higher risk of mortality than those without DM in the U.S. and Japan. However, women with DM versus those without DM had a higher relative risk of HD and all-cause mortality than their counterparts in men in the U.S, but this sex difference by DM status was not observed in the Japanese cohort. Whether the sex-difference effect of DM on HD and all-cause mortality is due to a difference in metabolic disorders between the two populations warrants consideration and further studies.
  • Masaaki Ito, Toshihiko Ishimitsu, Atsuhiro Ichihara, Hiroshi Itoh, Mitsuru Ohishi, Takayoshi Ohkubo, Hisashi Kai, Naoki Kashihara, Kazuomi Kario, Shigeyuki Saitoh, Takuya Tsuchihashi, Satoko Nakamura, Akira Nishiyama, Koichi Node, Naoyuki Hasebe, Jitsuo Higaki, Katsuyuki Miura, Hiromi Rakugi, Kouichi Tamura, Yuhei Kawano, Takashi Yatabe, Yusuke Ohya, Sadayoshi Ito
    Hypertension research : official journal of the Japanese Society of Hypertension 42 6 759 - 760 2019年06月 [有り][無し]
  • Harumitsu Suzuki, Aya Kadota, Nagako Okuda, Takehito Hayakawa, Nobuo Nishi, Yasuyuki Nakamura, Hisatomi Arima, Naoko Miyagawa, Atsushi Satoh, Naomi Miyamatsu, Masahiko Yanagita, Hiroshi Yatsuya, Zentaro Yamagata, Takayoshi Ohkubo, Tomonori Okamura, Hirotsugu Ueshima, Akira Okayama, Katsuyuki Miura
    Environmental health and preventive medicine 24 1 37 - 37 2019年05月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: The gender-specific characteristics of individuals at an increased risk of developing depression currently remain unclear despite a higher prevalence of depression in women than in men. This study clarified socioeconomic and lifestyle factors associated with an increased risk of subclinical depression in general Japanese men and women. METHODS: Study participants were residents not receiving psychiatric treatments in 300 sites throughout Japan in 2010 (1152 men, 1529 women). Multivariable-adjusted odds ratios (OR) and 95% confidence intervals (95%CIs) for socioeconomic factors and lifestyle factors were calculated using a logistic regression analysis. RESULTS: Risk of depressive tendencies was significantly higher in men who were single and living alone (OR, 3.27; 95% CI, 1.56-6.88) than those married. The risk was significantly lower in women who were not working and aged ≥ 60 years (OR, 0.39; 95% CI, 0.22-0.68) and higher in men who were not working and aged < 60 years (OR, 3.57; 95%CI, 1.31-9.72) compared with those who were working. Current smoking was also associated with a significantly increased risk of depressive tendencies in women (OR, 2.96; 95% CI, 1.68-5.22) but not in men. CONCLUSIONS: Socioeconomic and lifestyle factors were associated with an increased risk of depressive tendencies in general Japanese. Related factors were different by sex.
  • Akira Fujiyoshi, Katsuyuki Miura, Takayoshi Ohkubo, Naoko Miyagawa, Yoshino Saito, Itsuko Miyazawa, Akihiko Shiino, Aya Kadota, Sayaka Kadowaki, Takashi Hisamatsu, Sayuki Torii, Naoyuki Takashima, Ikuo Tooyama, Hirotsugu Ueshima
    Journal of epidemiology 30 6 244 - 252 2019年05月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: The association of proteinuria and reduced estimated glomerular filtration rate (eGFR) with cognition needs more clarification. We cross-sectionally examined whether proteinuria and reduced eGFR, even in moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. METHODS: Our cohort initially comprised 1,094 men aged 40-79 years from a random sample from Shiga, Japan in 2006-2008. Of 853 men who returned for the follow-up examination (2009-2014), we analyzed 561 who were ≥65 years, free of stroke, and completed the Cognitive Abilities Screening Instrument (CASI) at follow-up. Higher CASI score (range 0 to 100) indicates better cognition. Proteinuria was assessed by dipstick. eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration Equation. Participants were divided into three groups either by eGFR (≥60, 59-40, and <40 mL/min/1.73 m2) or by proteinuria (no, trace, and positive), considered normal, moderate, and advanced, respectively. Using linear regression, we computed mean CASI score with simultaneous adjustment for proteinuria and eGFR in addition to other potential confounders. RESULTS: Significant trends of lower cognition were observed across the groups of worse proteinuria and lower eGFR independently: multivariable-adjusted mean CASI scores were 90.1, 89.3, and 88.4 for proteinuria (Ptrend=0.029), and 90.0, 88.5, and 88.5 for eGFR (Ptrend=0.015) in mutual adjustment model. CONCLUSIONS: Proteinuria and reduced eGFR, even in their moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. The results suggest the importance of proteinuria and low eGFR for early detection and prevention of cognitive decline.
  • Keiko Kondo, Katsuyuki Miura, Sachiko Tanaka-Mizuno, Aya Kadota, Hisatomi Arima, Nagako Okuda, Akira Fujiyoshi, Naoko Miyagawa, Katsushi Yoshita, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
    Circulation journal : official journal of the Japanese Circulation Society 83 6 1254 - 1260 2019年05月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Many studies show that dietary factors such as vegetables, fruit, and salt are associated with cardiovascular disease (CVD) risk. However, a risk assessment chart for CVD mortality according to combinations of dietary factors has not been established.Methods and Results:Participants were 9,115 men and women aged 30-79 years enrolled in the National Nutritional Survey of Japan in 1980 with a 29-year follow-up. Dietary intake was assessed using a 3-day weighed dietary record at baseline. Cox regression models were used to estimate the hazard ratio (HR) of CVD mortality stratified by vegetables, fruit, fish, and salt consumption. HRs of CVD mortality according to combinations of dietary factors were color coded on an assessment chart. Higher intakes of vegetables, fruit, and fish, and lower salt intake were associated with lower CVD mortality risk. HRs calculated from combinations of dietary factors were displayed using 5 colors corresponding to the magnitude of the HR. People with the lowest intake of vegetables, fruit, and fish, and higher salt intake had a HR of 2.87 compared with those with the highest intake of vegetables, fruit, and fish, and lower salt intake. CONCLUSIONS: Vegetables, fruit, fish, and salt intake were independently associated with CVD mortality risk. The assessment chart generated could be used in Japan as an educational tool for CVD prevention.
  • Mahajan H, Choo J, Masaki K, Fujiyoshi A, Guo J, Evans R, Shangguan S, Willcox B, Barinas-Mitchell E, Kadota A, Miura K, Kuller L, Shin C, Ueshima H, Sekikawa A
    Nutrition, metabolism, and cardiovascular diseases : NMCD 29 8 837 - 846 2019年05月 [有り][無し]
  • Zhou L, Stamler J, Chan Q, Van Horn L, Daviglus ML, Dyer AR, Miura K, Okuda N, Wu Y, Ueshima H, Elliott P, Zhao L, INTERMAP Research Group
    The American journal of clinical nutrition 110 1 34 - 40 2019年05月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Several studies have reported that dietary salt intake may be an independent risk factor for overweight/obesity, but results from previous studies are controversial, reflecting study limitations such as use of a single spot urine or dietary recall to estimate daily salt intake rather than 24-h urine collections, and population samples from only a single country or center. OBJECTIVE: The aim of this study was to use data from the International Study of Macro-/Micro-nutrients and Blood Pressure (INTERMAP Study) to explore the relation between dietary salt intake estimated from 2 timed 24-h urine collections and body mass index (BMI; in kg/m2) as well as prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States. METHODS: Data were from a cross-sectional study of 4680 men and women aged 40-59 y in Japan (n = 1145), China (n = 839), the United Kingdom (n = 501), and the United States (n = 2195). General linear models were used to obtain the regression coefficients (β) of salt intake associated with BMI. Multivariable logistic regression models were used to determine the ORs and 95% CIs of overweight/obesity associated with a 1-g/d higher dietary salt intake. RESULTS: After adjustment for potential confounding factors including energy intake, salt intake 1 g/d higher was associated with BMI higher by 0.28 in Japan, 0.10 in China, 0.42 in the United Kingdom, and 0.52 in the United States, all P values < 0.001. Salt intake 1 g/d higher was associated with odds of overweight/obesity 21% higher in Japan, 4% higher in China, 29% higher in the United Kingdom, and 24% higher in the United States, all P values < 0.05. CONCLUSIONS: Salt intake is positively associated with BMI and the prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States. This association needs to be further confirmed in well-designed prospective studies with repeated dietary and BMI measurements.This trial was registered at clinicaltrials.gov as NCT00005271.
  • 12年間継続して観察しえた糖尿病診療の推移 滋賀県医師会糖尿病実態調査より
    宮澤 伊都子, 門田 文, 三浦 克之, 岡本 元純, 中村 隆志, 越智 眞一, 前川 聡, 大西 淳夫
    糖尿病 62 Suppl.1 S - 324 (一社)日本糖尿病学会 2019年04月
  • 佐藤 倫広, 大久保 孝義, 浅山 敬, 村上 義孝, 杉山 大典, 山田 美智子, 齋藤 重幸, 坂田 清美, 入江 ふじこ, 西連地 利己, 石川 鎮清, 木山 昌彦, 岡山 明, 三浦 克之, 今井 潤, 上島 弘嗣, 岡村 智教
    日本循環器病予防学会誌 54 2 118 - 118 (一社)日本循環器病予防学会 2019年04月 [有り][無し]
  • Noriaki Yamada, Yoshihiro Asano, Masashi Fujita, Satoru Yamazaki, Atsushi Inanobe, Norio Matsuura, Hatasu Kobayashi, Seiko Ohno, Yusuke Ebana, Osamu Tsukamoto, Saki Ishino, Ayako Takuwa, Hidetaka Kioka, Toru Yamashita, Norio Hashimoto, Dimitar P. Zankov, Akio Shimizu, Masanori Asakura, Hiroshi Asanuma, Hisakazu Kato, Yuya Nishida, Yohei Miyashita, Haruki Shinomiya, Nobu Naiki, Kenshi Hayashi, Takeru Makiyama, Hisakazu Ogita, Katsuyuki Miura, Hirotsugu Ueshima, Issei Komuro, Masakazu Yamagishi, Minoru Horie, Koichi Kawakami, Tetsushi Furukawa, Akio Koizumi, Yoshihisa Kurachi, Yasushi Sakata, Tetsuo Minamino, Masafumi Kitakaze, Seiji Takashima
    Circulation 139 18 2157 - 2169 2019年04月 [有り][無し]
     研究論文(学術雑誌) 
    © 2019 American Heart Association, Inc. Background: Bradyarrhythmia is a common clinical manifestation. Although the majority of cases are acquired, genetic analysis of families with bradyarrhythmia has identified a growing number of causative gene mutations. Because the only ultimate treatment for symptomatic bradyarrhythmia has been invasive surgical implantation of a pacemaker, the discovery of novel therapeutic molecular targets is necessary to improve prognosis and quality of life. Methods: We investigated a family containing 7 individuals with autosomal dominant bradyarrhythmias of sinus node dysfunction, atrial fibrillation with slow ventricular response, and atrioventricular block. To identify the causative mutation, we conducted the family-based whole exome sequencing and genome-wide linkage analysis. We characterized the mutation-related mechanisms based on the pathophysiology in vitro. After generating a transgenic animal model to confirm the human phenotypes of bradyarrhythmia, we also evaluated the efficacy of a newly identified molecular-targeted compound to upregulate heart rate in bradyarrhythmias by using the animal model. Results: We identified one heterozygous mutation, KCNJ3 c.247A>C, p.N83H, as a novel cause of hereditary bradyarrhythmias in this family. KCNJ3 encodes the inwardly rectifying potassium channel Kir3.1, which combines with Kir3.4 (encoded by KCNJ5) to form the acetylcholine-activated potassium channel (IKACh channel) with specific expression in the atrium. An additional study using a genome cohort of 2185 patients with sporadic atrial fibrillation revealed another 5 rare mutations in KCNJ3 and KCNJ5, suggesting the relevance of both genes to these arrhythmias. Cellular electrophysiological studies revealed that the KCNJ3 p.N83H mutation caused a gain of IKACh channel function by increasing the basal current, even in the absence of m2 muscarinic receptor stimulation. We generated transgenic zebrafish expressing mutant human KCNJ3 in the atrium specifically. It is interesting to note that the selective IKACh channel blocker NIP-151 repressed the increased current and improved bradyarrhythmia phenotypes in the mutant zebrafish. Conclusions: The IKACh channel is associated with the pathophysiology of bradyarrhythmia and atrial fibrillation, and the mutant IKACh channel (KCNJ3 p.N83H) can be effectively inhibited by NIP-151, a selective IKACh channel blocker. Thus, the IKACh channel might be considered to be a suitable pharmacological target for patients who have bradyarrhythmia with a gain-of-function mutation in the IKACh channel.
  • Wen X, Zhou L, Stamler J, Chan Q, Van Horn L, Daviglus ML, Dyer AR, Elliott P, Ueshima H, Miura K, Okuda N, Wu Y, Zhao L
    Journal of hypertension 37 4 814 - 819 2019年04月 [有り][無し]
     研究論文(学術雑誌) 
    OBJECTIVE: The present study aims to compare 24-h dietary recalls with 24-h urine collections for the estimation of sodium intake at both population and individual levels in China, Japan, the United Kingdom (UK), and the United States of America (USA), using data from the International Study of Macro- and Micro-nutrients and Blood Pressure (INTERMAP). METHODS: Mean differences between 24-h dietary recalls and 24-h urine collections were calculated for their agreement in estimating sodium intake at the population level; relative and absolute differences as well as misclassification of salt intake groups (salt intake <6, 6-8.9, 9-11.9, 12-14.9, and ≥15 g/day) were used to determine the agreement at the individual level. RESULTS: The mean differences (95% CI) between dietary recalls and urine collections for China, Japan, UK, and USA were -54.0 (-59.8, -48.3), 3.9 (0.6, 7.2), 2.9 (-1.8, 7.6), and -3.5 (-5.8, -1.1) mmol/day, respectively. The proportions of individual relative differences beyond ±40% were 34.3% for China, 16.9% for Japan, 24.2% for UK, and 21.3% for USA; the proportions of individual absolute differences greater than 51.3 mmol/day (3 g salt) were 58.6% for China, 32.8% for Japan, 25.4% for UK, and 31.9% for USA. The rate for misclassification of salt intake groups at individual level for China, Japan, UK, and USA were 71.4, 60.9, 58.7, and 60.0%, respectively. CONCLUSION: The 24-h dietary recalls demonstrate greater agreement with the 24-h urine collections in estimating population sodium intake for Japan, UK, and USA, compared with China. The 24-h dietary recall has poor performance in assessing individual sodium intake in these four countries.
  • Takashima N, Kita Y, Miura K, Nozaki K
    No shinkei geka. Neurological surgery 47 3 297 - 307 2019年03月 [有り][無し]
  • Trang Thi Minh Nguyen, Katsuyuki Miura, Sachiko Tanaka-Mizuno, Taichiro Tanaka, Yasuyuki Nakamura, Akira Fujiyoshi, Aya Kadota, Junko Tamaki, Toru Takebayashi, Tomonori Okamura, Hirotsugu Ueshima
    Hypertension research : official journal of the Japanese Society of Hypertension 42 3 411 - 418 2019年03月 [有り][無し]
     研究論文(学術雑誌) 
    While the association between 24-h urinary sodium and potassium excretion with blood pressure is well established, the relationships of these ions to spot urine measurements are unclear. Our purpose is to assess the association between blood pressure and the estimated 24-h sodium and potassium excretion from repeated single-spot urine samples. Spot urine and blood pressure were collected annually during a 5-year period from 4360 Japanese workers with ages ranging from 19 to 55 years. Estimates of 24-h sodium and potassium excretion were based on Tanaka's formula. Overall, a single standard deviation increase in the estimated sodium excretion (36.5 mmol/day) was associated with a 1.3 mmHg higher systolic blood pressure and a 0.8 mmHg higher diastolic blood pressure (P < 0.001). A single standard deviation increase in estimated potassium excretion (8.9 mmol/day) was associated with a 1.1 mmHg lower systolic blood pressure and a 0.7 mmHg lower diastolic blood pressure (P < 0.001). As a combined measure of the excretion of both electrolytes, the estimated 24-h sodium-to-potassium ratio was positively associated with both blood pressures (P < 0.001). Associations of blood pressure with sodium and the sodium-to-potassium ratio increased with age and were stronger in men compared to women. Associations with potassium and the sodium-to-potassium ratio were stronger in individuals who were overweight. The findings provide evidence for an association between blood pressure and the estimated 24-h sodium and potassium excretion from repeated single-spot urine samples. As convenient measures of dietary intake for each electrolyte, repeated spot urine samples may be useful for assessing hypertension risk, especially in men, older individuals, and overweight individuals.
  • Naoyuki Takashima, Hisatomi Arima, Yoshikuni Kita, Takako Fujii, Sachiko Tanaka, Satoshi Shitara, Akihiro Kitamura, Katsuyuki Miura, Kazuhiko Nozaki
    Stroke 50 Suppl_1 2019年02月 研究論文(学術雑誌) 
    Introduction: Despite many effective strategies for the secondary prevention of stroke, individuals who survived an initial stroke have been shown to be at high risk of recurrent stroke. The aim of the present analysis is to investigate the current status of stroke recurrence after first-ever stroke using data from a large-scale population-based stroke registry in Japan. Methods: Shiga Stroke Registry is an ongoing population-based registry of stroke, which covers approximately 1.4 million residents of the Shiga prefecture in central Japan (located central part of Honshu Island). There is an integrated surveillance system involving the registration of cases among a network of all acute care hospitals with neurology/neurosurgery facilities and smaller hospitals with rehabilitation facilities. A total of 2,176 first-ever stroke cases (1,398 cerebral infarction, 551 intracerebral hemorrhage, 227 others), who were registered in 2011, were followed up till December 2013. We defined recurrence as any type of stroke after 28days from the onset of index event. The 2-year cumulative recurrence rates were estimated using Kaplan-Meier method for total stroke cases and according to gender or subtypes of index stroke. The study has been approved by the Institutional Review Board of Shiga University of Medical Science. Results: During a 2-year follow up period, 57 patients experienced recurrent stroke and 646 patients died without recurrence. One-year and two-year crude cumulative recurrence rates after first-ever stroke were 1.8% and 3.4%, respectively. Two-year crude cumulative recurrence rates were similar for men and women (3.4% vs 3.5%). Two-year crude cumulative recurrence rate was higher in patients with prior cerebral infarction (4.3%) than that in those with prior intracerebral hemorrhage (2.0%). Conclusions: In the present population-based stroke registry with real-world setting in Japan, 2-year cumulative recurrence rate after first-ever stroke is still high, particularly among patients with a history of cerebral infarction. More intensive secondary prevention strategies are required for these high-risk individuals.
  • Lesley A. Inker, Morgan E. Grams, Andrew S. Levey, Josef Coresh, Massimo Cirillo, John F. Collins, Ron T. Gansevoort, Orlando M. Gutierrez, Takayuki Hamano, Gunnar H. Heine, Shizukiyo Ishikawa, Sun Ha Jee, Florian Kronenberg, Martin J. Landray, Katsuyuki Miura, Girish N. Nadkarni, Carmen A. Peralta, Dietrich Rothenbacher, Elke Schaeffner, Sanaz Sedaghat, Michael G. Shlipak, Luxia Zhang, Arjan D. van Zuilen, Stein I. Hallan, Csaba P. Kovesdy, Mark Woodward, Adeera Levin, Brad Astor, Larry Appel, Tom Greene, Teresa Chen, John Chalmers, Hisatomi Arima, Vlado Perkovic, Hiroshi Yatsuya, Koji Tamakoshi, Yuanying Li, Yoshihisa Hirakawa, Kunihiro Matsushita, Yingying Sang, Kevan Polkinghorne, Steven Chadban, Robert Atkins, Ognjenka Djurdjev, Lisheng Liu, Minghui Zhao, Fang Wang, Jinwei Wang, Natalie Ebert, Peter Martus, Mila Tang, Insa Emrich, Sarah Seiler, Adam Zawada, Joseph Nally, Sankar Navaneethan, Jesse Schold, Mark Sarnak, Ronit Katz, Jade Hiramoto, Hiroyasu Iso, Kazumasa Yamagishi, Mitsumasa Umesawa, Isao Muraki, Masafumi Fukagawa, Shoichi Maruyama, Takeshi Hasegawa, Naohiko Fujii, David Wheeler, John Emberson, John Townend, Hermann Brenner, Ben Schöttker, Kai Uwe Saum, Caroline Fox, Shih Jen Hwang, Anna Köttgen, Markus P. Schneider, Kai Uwe Eckardt, Jamie Green, H. Lester Kirchner, Alex R. Chang, Kevin Ho, Sadayoshi Ito, Mariko Miyazaki, Masaaki Nakayama, Gen Yamada, Fujiko Irie, Toshimi Sairenchi, Yuichiro Yano, Kazuhiko Kotani, Takeshi Nakamura, Heejin Kimm, Yejin Mok, Gabriel Chodick, Varda Shalev, Jack F.M. Wetzels, Peter J. Blankestijn, Jan van den Brand, Barbara Kollerits
    American Journal of Kidney Diseases 73 2 206 - 217 2019年02月 研究論文(学術雑誌) 
    © 2018 National Kidney Foundation, Inc. Rationale & Objective: Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework. Study Design: Cross-sectional individual participant-level analyses in a global consortium. Setting & Study Populations: 17 CKD and 38 general population and high-risk cohorts. Selection Criteria for Studies: Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension. Data Extraction: Data were obtained and analyzed between July 2015 and January 2018. Analytical Approach: We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses. Results: The CKD cohorts (n = 254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n = 1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59 mL/min/1.73 m2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30 mg/g). Limitations: Variations in study era, health care delivery system, typical diet, and laboratory assays. Conclusions: Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD.
  • Tsukinoki R, Okamura T, Okuda N, Kadota A, Murakami Y, Yanagita M, Miyamatsu N, Miura K, Ueshima H
    Journal of occupational health 2019年02月 [有り][無し]
  • Hisamatsu T, Liu K, Chan C, Krefman AE, Fujiyoshi A, Budoff MJ, Miura K, Lloyd-Jones DM, Ueshima H
    Circulation. Cardiovascular imaging 12 2 e008104  2019年02月 [有り][無し]
     研究論文(学術雑誌)
  • Harada A, Ueshima H, Kinoshita Y, Miura K, Ohkubo T, Asayama K, Ohashi Y, Japan Arteriosclerosis Longitudinal, Study Group
    Hypertension research : official journal of the Japanese Society of Hypertension 42 4 567 - 579 2019年02月 [有り][無し]
  • Mieko Nakamura, Toshiyuki Ojima, Tomomi Nagahata, Imako Kondo, Toshiharu Ninomiya, Katsushi Yoshita, Yusuke Arai, Takayoshi Ohkubo, Keiko Murakami, Nobuo Nishi, Yoshitaka Murakami, Naoyuki Takashima, Nagako Okuda, Aya Kadota, Naoko Miyagawa, Keiko Kondo, Tomonori Okamura, Hirotsugu Ueshima, Akira Okayama, Katsuyuki Miura
    Environmental health and preventive medicine 24 1 1 - 1 2019年01月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Oral health is thought to be associated with diet quality, and socioeconomic status (SES) affects both oral health and diet. The aim of this study was to investigate the association between the number of teeth and dietary intake as well as nutritional biomarker, considering the subjects' SES. METHODS: We conducted a cross-sectional analysis of data from 2049 individuals aged ≥ 50 years from the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010. The number of remaining teeth was categorized into age-specific quartiles (Q1 to Q4). We assessed the adjusted means and 95% confidence intervals for dietary variables by the number of teeth using analysis of covariance. Stratified analyses by SES were also conducted. RESULTS: The intake of grain products was 31 g higher, and those of vegetables and meat were 30 g and 8 g lower, respectively, in Q1 (fewer teeth) than in Q4 (more teeth). Carbohydrate intake was higher whereas protein, minerals (potassium, magnesium, and zinc), vitamins (vitamins A, E, B1, B6, β-carotene, and folic acid), and dietary fiber intakes were lower among individuals with fewer teeth. Adjusted mean serum albumin levels were low in Q1. The associations between the number of teeth and dietary intake were more evident in individuals with a low SES. CONCLUSIONS: Having few remaining teeth was associated with a low nutrient intake and low serum albumin levels in middle-aged and older Japanese adults, and these associations were more evident in individuals with low SES.
  • 久松 隆史, 藤吉 朗, 三浦 克之
    Clinical Calcium 29 2 215 - 223 (株)医薬ジャーナル社 2019年01月 
    <文献概要>潜在性動脈硬化指標の一つとして,単純CTにより定量的に評価された冠動脈石灰化がある。一次予防において,危険因子への長期曝露の結果である冠動脈石灰化所見を用いることで,有効に動脈硬化性心血管病の発症を予測し,中等度リスク保有者の管理において治療方針の決定などリスクの層別化を行い得る可能性が検討されている。また,冠動脈石灰化は動脈硬化進展マーカーとしても用いられる。一方,冠動脈石灰化測定の費用対効果や放射線被曝の問題などでは確定的な結論が得られていない。一次予防における冠動脈石灰化の有用性の確立のために,わが国を含む冠動脈石灰化に関する研究の更なる発展およびエビデンスの集積が望まれる。
  • NMR-Measured Lipoprotein Particle Distributions and Coronary Artery Calcification in US White and Japanese Men Aged 40-49 Years
    Mahajan H, Zaid M, Mackey R, Kadota A, Vishnu A, Fujiyoshi A, Ahuja V, Hisamatsu T, Evans R, Okamura T, Miura K, Kuller L, Ueshima H, Sekikawa A
    Open Heart 2019年 [有り][無し]
  • Hemant Mahajan, Maryam Zaid, Rachel Mackey, Aya Kadota, Abhishek Vishnu, Akira Fujiyoshi, Ahuja Vasudha, Takashi Hisamatsu, Rhobert Evans, Tomonori Okamura, Katsuyuki Miura, Lewis Kuller, Hirotsugu Ueshima, Akira Sekikawa
    Open heart 6 2 e001119  2019年 [有り][無し]
     研究論文(学術雑誌) 
    Objective: This cross-sectional study examined whether contrasting distributions of nuclear magnetic resonance (NMR)-measured lipoproteins contribute to differences in the prevalence of subclinical atherosclerosis measured using coronary artery calcium (CAC) between the two groups of middle-aged males: the US-residing Caucasian (US-White) and Japan-residing Japanese (Japanese). Methods: In a population-based study of 570 randomly selected asymptomatic men aged 40-49 years (270 US-White and 300 Japanese), we examined the relationship between race/ethnicity, NMR-measured lipoproteins and CAC (measured by Electron Beam CT and quantified using the Agatston method) using multivariable robust Poisson regression adjusting for traditional and novel risk factors for coronary heart disease (CHD). Results: The US-White compared with the Japanese had significantly different NMR-measured lipoprotein particle distributions. The US-White had a significantly higher prevalence of CAC≥10 (CAC-prevalence) compared with the Japanese adjusting for CHD risk factors (prevalence ratio (PR)=2.10; 95% CI=1.24 to 3.48), and this difference was partially attenuated (~18%) with further adjustment for lipoprotein levels (PR=1.73; 95% CI=1.02 to 3.08). There was no reclassification improvement with further addition of lipoproteins particle concentrations/size to a model that already included traditionally measured lipids (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), cardiovascular risk factors, and inflammatory markers (net reclassification improvement index=-2% to 3%). Conclusions: Variations in the distribution of NMR-measured lipoprotein particles partially accounted for the difference in the CAC-prevalence between middle-aged US-White and Japanese men.
  • Hideya Inoue, Tomoyuki Suzuki, Mihoko Kojima, Eiji Inoshita, Jongchan Lee, Sachiko Tanaka, Akira Fujiyoshi, Taketo Hayakawa, Katsuyuki Miura
    [Nihon koshu eisei zasshi] Japanese journal of public health 66 7 370 - 377 2019年 [有り][無し]
     研究論文(学術雑誌) 
    Objective In recent years, studies have reported a prefectural-level disparity in life expectancy. Therefore, we analyzed the related factors using the National Database (NDB), which includes data pertaining to the specific health checkup conducted for 20 million individuals. By doing so, we aimed to obtain basic data for developing future health promotion measures.Methods We used specific health checkup items from NDB Open Data for 2014, and life expectancy data from Prefecture Life Table for 2015. The specific health checkup items were adjusted by age using Japanese population data for 2015. A multiple linear regression analysis was conducted using specific health checkup items that were significantly related to average life expectancy as explanatory variables.Results In men, excessive drinking, smoking, antihypertensive drug use, systolic blood pressure, and hyperglycemia were independently and inversely related to life expectancy. In women, smoking and antihypertensive drug use emerged as significant factors.Conclusions Analysis using NDB Open Data showed that lifestyle factors such as smoking and drinking, and cardiovascular risk factors such as high blood pressure and hyperglycemia, were strongly related to life expectancy. These result suggest that it is necessary to focus on the above factors when prefectural authorities implement health promotion measures.
  • Hisamatsu T, Miura K, Fujiyoshi A, Kunimura A, Ito T, Miyazawa I, Torii S, Shiino A, Nozaki K, Kanda H, Arima H, Ohkubo T, Ueshima H
    European Journal of Neurology 26 9 1219 - 1225 2019年 [有り][無し]
     研究論文(学術雑誌)
  • Chang AR, Grams ME, Ballew SH, Bilo H, Correa A, Evans M, Gutierrez OM, Hosseinpanah F, Iseki K, Kenealy T, Klein B, Kronenberg F, Lee BJ, Li Y, Miura K, Navaneethan SD, Roderick PJ, Valdivielso JM, Visseren FLJ, Zhang L, Gansevoort RT, Hallan SI, Levey AS, Matsushita K, Shalev V, Woodward M, CKD Prognosis Consortium, CKD-PC
    BMJ (Clinical research ed.) 364 k5301  2019年01月 [有り][無し]
  • Hisamatsu T, Fujiyoshi A, Miura K
    Clinical calcium 29 2 215 - 223 2019年 [有り][無し]
  • Satoh M, Ohkubo T, Asayama K, Murakami Y, Sugiyama D, Yamada M, Saitoh S, Sakata K, Irie F, Sairenchi T, Ishikawa S, Kiyama M, Ohnishi H, Miura K, Imai Y, Ueshima H, Okamura T, EPOCH-JAPAN Research Group
    Hypertension (Dallas, Tex. : 1979) 73 1 52 - 59 2019年01月 [有り][無し]
     研究論文(学術雑誌) 
    Lifetime risk (LTR) provides an absolute risk assessment during the remainder of one’s life. Few studies have focused on the LTRs of stroke and coronary heart disease (CHD), categorized by fine blood pressure in Asian populations. We aimed to assess it using a large database of a meta-analysis with the individual participant data. The present metaanalysis included 107 737 Japanese (42.4% men; mean age, 55.1 years) from 13 cohorts. During the mean follow-up of 15.2±5.3 years (1 559 136 person-years), 1922 died from stroke and 913 from CHD. We estimated risks after adjusting for competing risk of death other than the outcome of interest. The 10-year risk of stroke and CHD deaths at index age of 35 years was ≤1.9% and ≤0.3%, respectively. The LTRs of stroke death at the index age of 35 years (men/women) were 6.1%/4.8% for optimal, 5.7%/6.3% for normal, and 6.6%/6.0% for high-normal blood pressure groups, and 9.1%/7.9% for grade 1, 14.5%/10.3% for grade 2, and 14.6%/14.3% for grade 3 hypertension groups. The LTRs of CHD death similarly elevated with an increase in blood pressure but were lower (≤7.2%) than those of stroke death. In conclusion, blood pressure was clearly associated with an elevated LTR of stroke or CHD death, although the LTR of CHD death was one-half of that of stroke death in an Asian population. These results would help young people with hypertension to adopt a healthy lifestyle or start antihypertensive therapy early.
  • Yukiko Okami, Hirotsugu Ueshima, Yasuyuki Nakamura, Keiko Kondo, Aya Kadota, Nagako Okuda, Tomonori Okamura, Katsuyuki Miura
    Circulation journal : official journal of the Japanese Circulation Society 83 1 147 - 155 2018年12月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: In recent years, individuals with high serum total cholesterol (TC) have been more likely to modify their diet by reducing their intake of dietary lipids. The aim of this study was to investigate time-related changes in the relationships between the Keys score, dietary lipids, and TC between 1980 and 2010 in representative Japanese populations. Methods and Results: We used 3 cross-sectional cohort studies conducted among Japanese representative populations in 1980, 1990, and 2010 (NIPPON DATA80/90/2010) for the analyses. We analyzed data for 10,365, 7,714, and 2,657 participants, respectively, in each dataset. The relationships between TC and the Keys score (calculated by dietary lipids, cholesterol, and energy intake)/dietary lipids were examined. In men, a 1-unit higher Keys score correlated with 0.92 mg/dL and 0.64 mg/dL TC in 1980 and 1990, respectively, but not in 2010. In women, a 1-unit higher Keys score correlated with 0.70 mg/dL and 0.74 mg/dL TC in 1980 and 1990, respectively, but with 0.33 mg/dL in 2010. In men and women, dietary cholesterol, saturated fatty acid (SFA), and trans fatty acid (TFA) levels were positively associated with TC concentrations in 1980 and 1990, but not in 2010. CONCLUSIONS: In these representative Japanese populations, a higher Keys score as well as dietary cholesterol, SFA, and TFA levels correlated with higher TC concentrations in 1980/1990, but the relationships were weaker or not observed in 2010.
  • Hiroko Nakagawa-Senda, Tsuyoshi Hachiya, Atsushi Shimizu, Satoyo Hosono, Isao Oze, Miki Watanabe, Keitaro Matsuo, Hidemi Ito, Megumi Hara, Yuichiro Nishida, Kaori Endoh, Kiyonori Kuriki, Sakurako Katsuura-Kamano, Kokichi Arisawa, Yora Nindita, Rie Ibusuki, Sadao Suzuki, Akihiro Hosono, Haruo Mikami, Yohko Nakamura, Naoyuki Takashima, Yasuyuki Nakamura, Nagato Kuriyama, Etsuko Ozaki, Norihiro Furusyo, Hiroaki Ikezaki, Masahiro Nakatochi, Tae Sasakabe, Sayo Kawai, Rieko Okada, Asahi Hishida, Mariko Naito, Kenji Wakai, Yukihide Momozawa, Michiaki Kubo, Hideo Tanaka
    Scientific Reports 8 1 1493 - 1493 2018年12月 [無し][無し]
     研究論文(学術雑誌) 
    © 2018 The Author(s). Coffee is one of the most widely consumed beverages worldwide, and its role in human health has received much attention. Although genome-wide association studies (GWASs) have investigated genetic variants associated with coffee consumption in European populations, no such study has yet been conducted in an Asian population. Here, we conducted a GWAS to identify common genetic variations that affected coffee consumption in a Japanese population of 11,261 participants recruited as a part of the Japan Multi-Institutional Collaborative Cohort (J-MICC) study. Coffee consumption was collected using a self-administered questionnaire, and converted from categories to cups/day. In the discovery stage (n = 6,312), we found 2 independent loci (12q24.12-13 and 5q33.3) that met suggestive significance (P < 1 × 10-6). In the replication stage (n = 4,949), the lead variant for the 12q24.12-13 locus (rs2074356) was significantly associated with habitual coffee consumption (P = 2.2 × 10-6), whereas the lead variant for the 5q33.3 locus (rs1957553) was not (P = 0.53). A meta-analysis of the discovery and replication populations, and the combined analysis using all subjects, revealed that rs2074356 achieved genome-wide significance (P = 2.2 × 10-16 for a meta-analysis). These findings indicate that the 12q24.12-13 locus is associated with coffee consumption among a Japanese population.
  • Koichi Node, Takuya Kishi, Atsushi Tanaka, Hiroshi Itoh, Hiromi Rakugi, Yusuke Ohya, Katsuyuki Miura, Tomonori Okamura, Toshihiko Ishimitsu, Atsuhiro Ichihara, Masaaki Ito, Mitsuru Ohishi, Takayoshi Ohkubo, Hisashi Kai, Naoki Kashihara, Kazuomi Kario, Shigeyuki Saitoh, Takuya Tsuchihashi, Satoko Nakamura, Akira Nishiyama, Naoyuki Hasebe, Jitsuo Higaki, Kouichi Tamura, Yuhei Kawano, Takashi Yatabe, Sadayoshi Ito
    Hypertension research : official journal of the Japanese Society of Hypertension 41 12 989 - 990 2018年12月 [有り][無し]
  • Okuyama Y, Uchida HA, Iwahori T, Segawa H, Kato A, Takeuchi H, Kakio Y, Umebayashi R, Kitagawa M, Sugiyama H, Miura K, Ueshima H, Wada J
    Journal of human hypertension 33 4 286 - 297 2018年11月 [有り][無し]
     研究論文(学術雑誌) 
    This study aimed to clarify the relationship between repeated measurements of casual (spot) and 24-h urinary sodium-to-potassium (Na/K) ratios in patients with chronic kidney disease (CKD). A total of 61 inpatients with CKD, 31 in stage 1-3 (eGFR [estimated glomerular filtration rate] ≥ 30 ml/min/1.73 m2) and 30 in stage 4-5 (eGFR < 30 ml/min/1.73 m2), aged 20-85 consuming a low-sodium diet (NaCl [sodium chloride] 6 g/day) were recruited. Urinary Na, K, and Na/K ratios were measured in both casual urine samples and 2-day, 24 h urine samples, and then analyzed by correlation and Bland-Altman analyses. Mean 24-h urine Na/K ratio was higher in participants in stage 4-5 (5.1) than in participants in stage 1-3 (4.1) CKD. Casual urine Na/K ratio was strongly correlated with 2-day, 24-h urine Na/K ratio by sampling 4 casual urine specimens every morning and evening in participants in stage 1-3 (r = 0.69-0.78), but not in stage 4-5 (r = 0.12-0.19). The bias for mean Na/K ratio between 2-day, 24-h urine, and the 4 casual urine sampling ranged from -0.86 to 0.16 in participants in stage 1-3, and the quality of agreement for the mean of this casual urine sampling was similar to that of sampling 8 casual urine samples for estimating 2-day, 24-h values. Methods using repeated casual urine Na/K ratios may provide a reasonable estimation of 24-h urine Na/K ratio in normotensive and hypertensive as well as individuals with stage 1-3, but not stage 4-5 CKD.
  • Kimani C, Kadota A, Miura K, Fujiyoshi A, Zaid M, Kadowaki S, Hisamatsu T, Arima H, Horie M, Ueshima H, SESSA Research Group
    Journal of atherosclerosis and thrombosis 26 5 452 - 464 2018年11月 [有り][無し]
     研究論文(学術雑誌)
  • Takashima N, Ohkubo T, Miura K, Okayama A, Okuda N, Nakagawa H, Saito S, Sakata K, Choudhury SR, Miyagawa N, Chan Q, Zhao L, Elliott P, Ueshima H, Stamler J, INTERMAP Study Group
    Journal of human hypertension 33 3 229 - 236 2018年11月 [有り][無し]
     研究論文(学術雑誌) 
    Several studies demonstrated that visit-to-visit variability of blood pressure (BP) predicted future events of total death, stroke and cardiovascular disease. Little is known about factors associated with visit-to-visit BP variability in different countries. We recruited participants aged 40-59 years from four countries (Japan, the People's Republic of China [PRC], the United Kingdom [UK] and the United States [US]). At each study visit, BP was measured twice by trained observers using random zero sphygmomanometers after five minutes resting. We defined visit-to-visit BP variability as variation independent of mean (VIM) by using average systolic BP of 1st and 2nd measurement across four study visits. Data on 4680 men and women were analyzed. Mean ± standard deviation of VIM values among participants in Japan, the PRC, the UK and the US were 5.44 ± 2.88, 6.85 ± 3.49, 5.65 ± 2.81 and 5.84 ± 3.01, respectively; VIM value in the PRC participants was significantly higher. Sensitivity analyses among participants without antihypertensive treatment or past history of cardiovascular disease yielded similar results. Higher VIM value was associated with older age, female gender, lower pulse rate and urinary sodium excretion and use of antihypertensive agents such as angiotensin converting enzyme inhibitors, beta blockers and calcium channel blockers. The difference of visit-to-visit BP variability between PRC and other countries remained significant after adjustment for possible confounding factors. In this large international study across four countries, visit-to-visit BP variability in the PRC was higher than in the other three countries. Reproducibility and mechanisms of these findings remain to be elucidated.
  • 食品摂取の多様性と尿中Na,K排泄量、血圧との関連 NIPPON DATA2010
    大塚 礼, 八谷 寛, 西 信雄, 奥田 奈賀子, 門田 文, 由田 克士, 大久保 孝義, 岡村 智教, 上島 弘嗣, 岡山 明, 三浦 克之
    日本公衆衛生学会総会抄録集 77回 322 - 322 日本公衆衛生学会 2018年10月
  • 定年等により新たに国民健康保険の被保険者になった者の特長や取扱等に関する研究
    小池 創一, 古井 祐司, 宮本 恵宏, 三浦 克之, 立石 清一郎, 津下 一代, 磯 博康, 山縣 然太朗, 岡村 智教
    日本公衆衛生学会総会抄録集 77回 212 - 212 日本公衆衛生学会 2018年10月 [有り][無し]
  • LIFETIME RISK OF STROKE AND CORONARY HEART DISEASE DEATH ACCORDING TO BLOOD PRESSURE LEVEL: EVIDENCE FOR CARDIOVASCULAR PREVENTION FROM OBSERVATIONAL COHORTS IN JAPAN
    Satoh Michihiro, Ohkubo Takayoshi, Asayama Kei, Murakami Yoshitaka, Sugiyama Daisuke, Yamada Michiko, Saitoh Shigeyuki, Sakata Kiyomi, Irie Fujiko, Sairenchi Toshimi, Ishikawa Shizukiyo, Kiyama Masahiko, Ohnishi Hirofumi, Miura Katsuyuki, Imai Yutaka, Ueshima Hirotsugu, Okamura Tomonori
    JOURNAL OF HYPERTENSION 36 E92 - E93 2018年10月 [無し][無し]
     研究論文(学術雑誌)
  • Takashi Hisamatsu, Katsuyuki Miura, Hisatomi Arima, Akira Fujiyoshi, Aya Kadota, Sayaka Kadowaki, Maryam Zaid, Naoko Miyagawa, Atsushi Satoh, Ayako Kunimura, Minoru Horie, Hirotsugu Ueshima, for the SESSA Research Group
    International Journal of Cardiology 267 177 - 182 2018年09月 [有り][無し]
     研究論文(学術雑誌) 
    Background: The mechanisms by which exercise reduces the risk of coronary heart disease remain poorly understood. Irisin, an exercise-induced polypeptide secreted from skeletal muscles, is proposed to potentially mediate beneficial effects of exercise, especially in metabolic regulation and development of atherosclerosis. We examined whether higher serum irisin levels are associated with lower prevalence and progression of coronary atherosclerosis. Methods and results: We performed a prospective, population-based study of Japanese men aged 40–79 years without known coronary heart disease. We measured baseline serum irisin levels using an enzyme-linked immunosorbent assay and quantified coronary artery calcification (CAC) from serial computed tomography scans. Of 1038 participants (mean age, 63.9 years) at baseline, 670 (64.6%) had prevalent CAC. Of 810 participants at follow-up (median, 5.1 years), 407 (50.3%) experienced CAC progression. In Poisson regression with robust error variance adjusted for age and behavioral factors, serum irisin levels were inversely associated with CAC prevalence (relative risk [RR] of 4th versus 1st quartiles [95% confidence interval], 0.88 [0.78–0.99] trend P = 0.016) and CAC progression (RR, 0.76 [0.63–0.91] trend P = 0.002). After further adjustment for cardiometabolic risk factors, the inverse association with CAC prevalence disappeared (RR, 0.95 [0.84–1.08] trend P = 0.319), but that with CAC progression persisted (RR, 0.77 [0.64–0.93] trend P = 0.003). These associations were consistent when we applied ordinal logistic regression and across subgroups by cardiometabolic risk factor status. Conclusions: Higher serum irisin levels were associated with less burden of coronary atherosclerosis. This association would be mediated through and beyond traditional cardiometabolic pathways.
  • Abhishek Vishnu, Jina Choo, Aya Kadota, Emma J.M. Barinas-Mitchell, Akira Fujiyoshi, Dorothy Leann Long, Takashi Hisamatsu, Vasudha Ahuja, Yasuyuki Nakamura, Rhobert W. Evans, Katsuyuki Miura, Kamal H. Masaki, Chol Shin, Hirotsugu Ueshima, Akira Sekikawa
    International Journal of Cardiology 266 245 - 249 2018年09月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Carotid plaque has emerged as a marker of coronary heart disease (CHD) risk. Comparison of carotid plaque burden between different race/ethnic groups may provide a relative estimate of their future CHD risk. Methods: We conducted a population-based study among apparently healthy middle-aged men aged 40–49 years (ERA JUMP study (n = 924)) and recruited 310 Whites in Pittsburgh, US, 313 Japanese in Otsu, Japan, and 301 Koreans in Ansan, South Korea. The number of carotid plaque and CHD risk factors was assessed using a standardized protocol across all centers. The burden of carotid plaque was compared between race/ethnic groups after adjustment for age and BMI, and after multivariable adjustment for other CHD risk factors using marginalized zero-inflated Poisson regression models. Cross-sectional associations of risk factors with plaque were examined. Results: Whites (22.8%) had more than four-fold higher prevalence (p < 0.01) of carotid plaque than Japanese men (4.8%) while the prevalence among Koreans was 10.6%. These differences remained significant after adjustment for age, BMI as well as other risk factors – incidence density ratio (95% confidence interval) for plaque was 0.13 (0.07, 0.24) for Japanese and 0.32 (0.18, 0.58) for Koreans as compared to Whites. Age, hypertension and diabetes were the only risk factors significantly associated with presence of carotid plaque in the overall population. Conclusion: Whites have significantly higher carotid plaque burden than men in Japan and Korea. Lower carotid plaque burden among Japanese and Koreans is independent of traditional CVD risk factors.
  • Wen X, Zhou L, Stamler J, Chan Q, Van Horn L, Daviglus ML, Dyer AR, Elliott P, Ueshima H, Miura K, Okuda N, Wu Y, Zhao L
    Journal of hypertension 2018年09月 [有り][無し]
  • Shigekazu Ukawa, Akiko Tamakoshi, Yoshitaka Murakami, Yutaka Kiyohara, Michiko Yamada, Masato Nagai, Atsushi Satoh, Katsuyuki Miura, Hirotsugu Ueshima, Tomonori Okamura, EPOCH-JAPAN Research Group
    Asian Pacific journal of cancer prevention : APJCP 19 8 2089 - 2095 2018年08月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: We employed a large-scale pooled analysis to investigate the association of liver cancer-related mortality with being overweight/obese and total cholesterol (TC) levels, since limited and inconsistent data on these associations exist in Japan. Methods: A total of 59,332 participants (23,853 men and 35,479 women) from 12 cohorts without a history of cancer who were followed for a median of 14.3 years were analyzed. A sex-specific stratified Cox proportional hazards model adjusted for age and other potential confounders was used to calculate hazard ratios (HRs) and 95% confidence intervals (CI) for liver cancer-related mortality. Results: A total of 447 participants (266 men and 181 women) died of liver cancer within the follow-up period. Individuals classified as having a high BMI (≥25.0 kg/m2) and low TC levels (<160 mg/dL) had a significantly increased risk for liver cancer-related mortality (HR 7.05, 95% CI 4.41–11.26 in men; HR 8.07, 95% CI 4.76–13.67 in women) when compared with those in the intermediate BMI (18.5–24.9 kg/m2) and TC (160–219 mg/dL) categories. These associations remained after limiting the follow-up duration to >5 years. Conclusion: Being overweight/obese, combined with low TC levels, was strongly associated with liver cancer-related mortality in the EPOCH-JAPAN.
  • Ueshima H, Kadowaki T, Hisamatsu T, Fujiyoshi A, Miura K, Ohkubo T, Sekikawa A, Kadota A, Kadowaki S, Nakamura Y, Miyagawa N, Okamura T, Kita Y, Takashima N, Kashiwagi A, Maegawa H, Horie M, Yamamoto T, Kimura T, Kita T, ACCESS, SESSA Research Groups
    Atherosclerosis 278 336 - 336 2018年08月 [有り][無し]
  • Zaid M, Miura K, Okayama A, Nakagawa H, Sakata K, Saitoh S, Okuda N, Yoshita K, Choudhury SR, Rodriguez B, Masaki K, Willcox B, Miyagawa N, Okamura T, Chan Q, Elliott P, Stamler J, Ueshima H, INTERLIPID, INTERMAP Research Groups
    Circulation journal : official journal of the Japanese Circulation Society 82 10 2557 - 2565 2018年08月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Recently, high-density lipoprotein particles (HDL-P) have been found to be more strongly inversely associated with coronary artery disease (CAD) risk than their counterpart, HDL cholesterol (HDL-C). Given that lifestyle is among the first targets in CAD prevention, we compared the associations of HDL-P and HDL-C with selected lifestyle factors. Methods and Results: We examined 789 Japanese participants of the INTERLIPID Study: men (n=386) and women (n=403) aged 40-59 years in 1996-1998. Participants treated for dyslipidemias were excluded. Lifestyle factors included alcohol intake, smoking amount, and body mass index (BMI). Multivariable linear regression was used for cross-sectional analyses of these factors with HDL-P, HDL-C, HDL-P size subclasses (small, medium and large) and mean HDL-P size. In men, higher alcohol intake was associated with higher HDL-P and higher HDL-C. The associations of alcohol, however, were strongest with HDL-P. A higher smoking amount tended to be associated with lower HDL-P and HDL-C. In contrast, BMI was not associated with HDL-P, but was strongly inversely associated with HDL-C. While alcohol intake favored larger mean HDL-P size, smoking and BMI favored a lipid profile with smaller HDL-P subclasses and overall smaller mean HDL-P size. Similar, but generally weaker results were observed in women. CONCLUSIONS: Although both HDL-P and HDL-C are parameters of HDL, they have different associations with alcohol, smoking and BMI.
  • Kurihara A, Okamura T, Sugiyama D, Higashiyama A, Watanabe M, Okuda N, Kadota A, Miyagawa N, Fujiyoshi A, Yoshita K, Ohkubo T, Okayama A, Miura K, Ueshima H, NIPPON DATA, Research Group
    Journal of atherosclerosis and thrombosis 26 2 198 - 206 2018年08月 [有り][無し]
     研究論文(学術雑誌) 
    AIM: To examine the relationship between the intake of dietary vegetable protein and CVD mortality in a 15-year follow-up study of a representative sample of the Japanese population. METHODS: A total of 7,744 participants aged 30 years or older (3,224 males and 4,520 females) who were free of CVD at baseline were included in this analysis. Vegetable protein intake (% energy) was assessed using a three-day semi-weighed dietary record at baseline. Multivariable-adjusted hazard ratios (HRs) were calculated using Cox's proportional hazards model after adjusting for confounding factors. RESULTS: The total person-years studied were 107,988 with a mean follow-up period of 13.9 years. There were 1,213 deaths during the follow-up period, among which 354 (29.2%) were due to CVD. Vegetable protein intake was associated inversely with CVD and cerebral hemorrhage mortality, with the HRs for a 1% energy increment in vegetable protein intake being 0.86 (95% CI, 0.75-0.99) and 0.58 (95% CI, 0.35-0.95), respectively. In the subgroup analysis of participants with or without hypertension, the inverse association between vegetable protein intake and CVD mortality was more evident in the nonhypertensive group, with the HRs for CVD and stroke being 0.68 (95% CI, 0.50-0.94) and 0.50 (95% CI, 0.30-0.84), respectively. CONCLUSIONS: Vegetable protein intake may prevent future CVD, particularly in nonhypertensive subjects in the Japanese population. However, further studies are necessary to examine the biological mechanisms of this effect.
  • Y. Murakami, R. Tsukinoki, K. Miura, T. Okamura, A. Kadota, A. Okayama, H. Ueshima
    Revue d'Épidémiologie et de Santé Publique 66 S329 - S330 2018年07月 研究論文(学術雑誌)
  • R. Tsukinoki, Y. Murakami, K. Miura, T. Okamura, A. Kadota, T. Hayakawa, A. Okayama, H. Ueshima
    Revue d'Épidémiologie et de Santé Publique 66 S326 - S326 2018年07月 研究論文(学術雑誌)
  • Takashima N, Arima H, Kita Y, Fujii T, Miyamatsu N, Komori M, Sugimoto Y, Nagata S, Miura K, Nozaki K
    Circulation journal : official journal of the Japanese Circulation Society 2018年07月 [有り][無し]
  • Sekikawa A, Mahajan H, Kadowaki S, Hisamatsu T, Miyagawa N, Fujiyoshi A, Kadota A, Maegawa H, Murata K, Miura K, Edmundowicz D, Ueshima H, SESSA Research Group
    European journal of clinical nutrition 73 5 783 - 792 2018年07月 [有り][無し]
     研究論文(学術雑誌)
  • Miyazawa I, Ohkubo T, Kadowaki S, Fujiyoshi A, Hisamatsu T, Kadota A, Arima H, Budoff M, Murata K, Miura K, Maegawa H, Ueshima H, SESSA Research Group
    Circulation journal : official journal of the Japanese Circulation Society 82 10 2542 - 2548 2018年07月 [有り][無し]
     研究論文(学術雑誌)
  • Shibata Y, Ojima T, Nakamura M, Kuwabara K, Miyagawa N, Saito Y, Nakamura Y, Kiyohara Y, Nakagawa H, Fujiyoshi A, Kadota A, Ohkubo T, Okamura T, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 29 4 133 - 138 2018年07月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: The trend of association between overweight and high serum total cholesterol (TC) among the elderly is unclear. In addition, there is little evidence of risk of underweight for high TC. Therefore, we examined the trend of association of overweight or underweight with high TC among Japanese elderly people using nationwide population-based data. METHODS: Data of the National Survey on Circulatory Disorders and National Health and Nutrition Survey for 1980, 1990, 2000, and 2010 were used in the analysis. High TC was defined as 220 mg/dL and above. For participants aged ≥50 years, sex-specific odds ratios (ORs) of overweight or underweight compared with normal body mass index participants for high TC were calculated using a logistic regression model adjusted for age, smoking, drinking, exercise, food, and treatment of hyperlipidemia. RESULTS: A total of 5,734, 4,673, 5,059, and 2,105 participants enrolled in these surveys in 1980, 1990, 2000, and 2010, respectively. Although overweight was positively and significantly associated with high TC in 1980, the association has gradually weakened since (ORs in 1980 and 2010 were 2.44; 95% confidence interval [CI], 1.83-3.24 and 0.92; 95% CI, 0.66-1.27 among men and 1.43; 95% CI, 1.18-1.72 and 1.08; 95% CI, 0.81-1.44 among women, respectively). While underweight was inversely and significantly associated with high TC in 1980, the association also gradually weakened among women (ORs in 1980 and 2010 were 0.28; 95% CI, 0.12-0.60 and 0.37; 95% CI, 0.10-1.28 among men and 0.39; 95% CI, 0.26-0.57 and 0.96; 95% CI, 0.58-1.57 among women, respectively). CONCLUSIONS: These findings provide evidence that high TC prevention efforts must expand the target to not only overweight but also to normal and underweight people.
  • Hisamatsu T, Miura K, Ohkubo T, Arima H, Fujiyoshi A, Satoh A, Kadota A, Zaid M, Takashima N, Ohno S, Horie M, Ueshima H, SESSA Research Group
    Journal of hypertension 36 11 2193 - 2203 2018年06月 [有り][無し]
     研究論文(学術雑誌)
  • Okami Y, Ueshima H, Nakamura Y, Okuda N, Nakagawa H, Sakata K, Saitoh S, Okayama A, Yoshita K, R Choudhury S, Chan Q, Elliott P, Stamler J, Miura K, INTERMAP, INTERLIPID Research Groups
    Journal of atherosclerosis and thrombosis 26 2 170 - 182 2018年06月 [有り][無し]
     研究論文(学術雑誌) 
    AIM: The positive relationship between dietary cholesterol and serum cholesterol has been questioned by a set of recent cohort studies. This study aimed to investigate how employment status and education years relate to the association between dietary cholesterol and serum low-density lipoprotein cholesterol (LDL-C) in a Japanese population. METHODS: A population-based, random sample, cross-sectional study (INTERLIPID) was performed. Among 1,145 Japanese individuals aged 40-59 years, 106 were excluded because of special diets, use of lipid-lowering drugs, hormone replacement, and missing data, leaving 1,039 individuals (533 men and 506 women). Dietary cholesterol was assessed from four 24-h dietary recalls, and LDL-C was measured enzymatically with an auto-analyzer. A standard questionnaire inquired about employment status and education years. RESULTS: In men, a 1 standard deviation (SD) higher dietary cholesterol was associated with 3.16 mg/dL lower serum LDL-C (P=0.009; unadjusted model). After adjustment for covariates, higher serum LDL-C was estimated per 1 SD higher intake of dietary cholesterol in nonemployed men [self-employed, homemakers, farmers, fishermen, and retired employees; β=+9.08, 95% confidence interval (CI)=+0.90-+17.27] and less educated men (β=+4.46, 95% CI=-0.97-+9.90), whereas an inverse association was observed in employed men (β=-3.02, 95% CI=-5.49--0.54) and more educated men (β=-3.66, 95% CI=-6.25--1.07). CONCLUSIONS: In men who were nonemployed and less educated, a higher intake of dietary cholesterol was associated with elevated concentrations of serum LDL-C, whereas an inverse association was observed in men who were employed and more educated.
  • Takashi Hisamatsu, Katsuyuki Miura, Akira Fujiyoshi, Aya Kadota, Naoko Miyagawa, Atsushi Satoh, Maryam Zaid, Takashi Yamamoto, Minoru Horie, Hirotsugu Ueshima, for the SESSA Research Group
    Atherosclerosis 273 145 - 152 2018年06月 [有り][無し]
     研究論文(学術雑誌) 
    Background and aims: Calcific aortic valve disease (CAVD) is the most common valve disease. Although micronutrients are known to contribute to cardiovascular disease, the relationship with CAVD remains poorly evaluated. We examined the association of serum levels of magnesium, phosphorus, and calcium with prevalence, incidence, and progression of aortic valve calcification (AVC). Methods: We conducted a prospective study in a population-based sample of Japanese men aged 40–79 years without known cardiovascular disease and chronic kidney disease at baseline, and quantified AVC from serial computed tomographic images with the Agatston method. Results: Of 938 participants at baseline (mean age, 63.7 ± 9.9 years), AVC prevalence was observed in 173 (18.4%). Of 596 participants without baseline AVC at follow-up (median duration, 5.1 years), AVC incidence was observed in 138 (23.2%). After adjustment for demographics, behaviors and cardiovascular risk factors, relative risks (95% confidence intervals) in the highest versus lowest categories of serum magnesium, phosphorus, and calcium were 0.62 (0.44–0.86), 1.45 (1.02–2.04), and 1.43 (0.95–2.15), respectively, for AVC prevalence and 0.62 (0.42–0.92), 1.93 (1.28–2.91), and 1.09 (0.77–1.55), respectively, for AVC incidence. Their linear trends of serum magnesium and phosphorus were also all statistically significant. Of 131 participants with baseline AVC, there was no association of any serum micronutrients with AVC progression. Conclusions: Serum magnesium was inversely associated, while serum phosphorus was positively associated with AVC prevalence and incidence, suggesting that these serum micronutrients may be potential candidates for risk prediction or prevention of CAVD, and warranting further studies.
  • Yasuyuki Nakamura, Tomonori Okamura, Yoshikuni Kita, Nagako Okuda, Aya Kadota, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    European Journal of Clinical Nutrition 72 6 841 - 847 2018年06月 [有り][無し]
     研究論文(学術雑誌) 
    Background/objective: Egg intake was associated with serum total cholesterol adjusted for age (aTCH) and total mortality in women, but not in men, using data from NIPPON DATA (ND) 80 which followed up for 14 years. Re-evaluation of these associations in a different cohort is needed. Subject/methods: We analyzed the associations of egg intake with aTCH and cause-specific and total mortality using the ND90 data set with a 15-year follow-up. A nutritional examination was done at the baseline in 1990 using the food-frequency method and by weighed food records. We followed 4686 female participants (ages ≥30 years), with no history of stroke or myocardial infarction (mean age 52.8 years) for 15 years. Results: The participants were divided into 5 egg intake groups (< 1/w, 1-2/w, 1/2d, 1/d, and ≥2/d). There were 203, 1462, 1594, 1387, and 40 women in each group, respectively. Egg intake was not associated with aTCH (P = 0.886). There were 183 cardiovascular disease (CVD), 210 cancer, and 599 total mortality cases during follow-up. Cox analysis, adjusted for background factors, found egg intake was directly associated with total and cancer mortality (HR in the ≥2/d vs.The 1 egg/d group: Total, 2.05 (95% CI: 1.20-3.52) cancer, 3.20 (1.51-6.76)), and that cancer mortality in the 1-2/w group was significantly less than that in the 1 egg/d group (0.68 (0.47-0.97)). Egg intake was not associated with CVD mortality. Conclusions: Egg intake was associated with cancer and total mortality. Reducing egg intake may have some definitive health benefits in women in Japan, at least.
  • Akira Fujiyoshi, Hisatomi Arima, Sachiko Tanaka-Mizuno, Takahashi Hisamatsu, Sayaka Kadowaki, Aya Kadota, Maryam Zaid, Akira Sekikawa, Takashi Yamamoto, Minoru Horie, Katsuyuki Miura, Hirotsugu Ueshima
    Journal of atherosclerosis and thrombosis 25 6 477 - 489 2018年06月 [有り][無し]
     研究論文(学術雑誌) 
    AIM: The clinical significance of coronary artery calcification (CAC) is not fully determined in general East Asian populations where background coronary heart disease (CHD) is less common than in USA/Western countries. We cross-sectionally assessed the association between CAC and estimated CHD risk as well as each major risk factor in general Japanese men. METHODS: Participants were 996 randomly selected Japanese men aged 40-79 y, free of stroke, myocardial infarction, or revascularization. We examined an independent relationship between each risk factor used in prediction models and CAC score ≥100 by logistic regression. We then divided the participants into quintiles of estimated CHD risk per prediction model to calculate odds ratio of having CAC score ≥100. Receiver operating characteristic curve and c-index were used to examine discriminative ability of prevalent CAC for each prediction model. RESULTS: Age, smoking status, and systolic blood pressure were significantly associated with CAC score ≥100 in the multivariable analysis. The odds of having CAC score ≥100 were higher for those in higher quintiles in all prediction models (p-values for trend across quintiles <0.0001 for all models). All prediction models showed fair and similar discriminative abilities to detect CAC score ≥100, with similar c-statistics (around 0.70). CONCLUSIONS: In a community-based sample of Japanese men free of CHD and stroke, CAC score ≥100 was significantly associated with higher estimated CHD risk by prediction models. This finding supports the potential utility of CAC as a biomarker for CHD in a general Japanese male population.
  • 本村柊斗, 奥田奈賀子, 栗林 徹, 中村幸志, 渡邉 至, 神出 計, 三浦克之, 板井一好, 由田克士, 岡山 明
    日本循環器病予防学会誌 53 2 103 - 112 (一社)日本循環器病予防学会 2018年05月 [無し][無し]
     研究論文(学術雑誌) 
    【背景】特定保健指導による効果検討では保健指導効果に関連する対象者要因はほとんど検討されていない。朝食欠食者に肥満者が多いと報告されており、朝食欠食は保健指導による減量効果に関連している可能性がある。【目的】155の医療保険者および特定保健指導実施機関より収集した平成23-25年度特定健康診査結果に平成23-24年度特定保健指導結果を個人ごとに突合したデータセットを用いて朝食欠食習慣の有無と保健指導効果との関連を検討した。保健指導効果の指標として翌年健診時体重の差(以下、体重差)を用いた。【方法】平成23年、24年に積極的支援に参加し翌年特定健診結果のある10,480名を用いた。内訳は朝食欠食習慣がある者が2,077名(朝食欠食あり群)、朝食欠食習慣のない者が8,403名であった[Total(T-)朝食欠食なし群]である。他の生活習慣の類似した対照を設定するため積極的支援実施前の特定健診結果を用いて朝食欠食の傾向性スコアを計算した。朝食欠食あり群の1名に対し、T-朝食欠食なし群から傾向性スコアが最も近い1名を選択する操作を繰り返し、選択された者をPropensity score matching(Pro-)朝食欠食なし群とした。【結果】現在喫煙や運動習慣がないことなどが朝食欠食習慣と関連していた。体重差の平均値は朝食欠食あり群よりもT-朝食欠食なし群で有意に大きかった(-1.16kg vs.-1.40kg、P=0.002)が、Pro-朝食欠食なし群では-1.30kgであり有意差は消失した(P=0.181)。【結論】朝食欠食あり群とT-朝食欠食なし群の間で観察された保健指導の効果の差は、傾向性スコアを用いて他の生活習慣をマッチさせたPro-朝食欠食なし群との比較では消失した。朝食欠食習慣がない者では、他の良好な生活習慣を併せもつことが、保健指導による減量効果が大きいことと関連したと考えられた。(著者抄録)
  • Sayaka Kadowaki, Katsuyuki Miura, Takashi Kadowaki, Akira Fujiyoshi, Aiman El-Saed, Kamal H. Masaki, Tomonori Okamura, Daniel Edmundowicz, Beatriz L. Rodriguez, Yasuyuki Nakamura, Emma J.M. Barinas-Mitchell, Aya Kadota, Bradley J. Willcox, Robert D. Abbott, Lewis H. Kuller, Jina Choo, Chol Shin, Hirotsugu Ueshima, Akira Sekikawa
    Metabolic Syndrome and Related Disorders 16 4 166 - 173 2018年05月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Abdominal fat distribution varies across groups with different races or environments. Whether environmental factors, apart from racial differences, affect abdominal fat distribution is unknown. Methods: We compared the abdominal fat distribution of four groups different races with similar environments (Caucasians vs. Japanese Americans), different environments with an identical race (Japanese Americans vs. Japanese), and similar races with similar environments (Japanese vs. Koreans). A population-based sample of 1212 men aged 40-49 were analyzed: 307 Caucasians and 300 Japanese Americans in the United States, 310 Japanese in Japan, and 295 Koreans in Korea. We compared the proportion of visceral adipose tissue area to total abdominal adipose tissue area (VAT%) and other factors that can affect abdominal fat distribution (smoking, alcohol use, physical activity levels, and metabolic factors). Results: VAT% was significantly higher in Japanese and Koreans than in Japanese Americans and Caucasians (50.0, 48.5, 43.2, 41.0%, respectively, P < 0.001). Even after adjustment for possible confounders, the significant VAT% difference remained in comparing groups with identical race but different environments (i.e., Japanese vs. Japanese Americans). In contrast, comparing groups with different races but similar environments (i.e., Caucasians vs. Japanese Americans), VAT% was not significantly different. Comparing groups with similar races and similar environments (i.e., Japanese vs. Koreans), VAT% did not significantly differ. Conclusions: Environmental differences, apart from racial differences, affect the difference in abdominal fat distribution across different groups in middle-aged men.
  • Aya Hirata, Daisuke Sugiyama, Makoto Watanabe, Akiko Tamakoshi, Hiroyasu Iso, Kazuhiko Kotani, Masahiko Kiyama, Michiko Yamada, Shizukiyo Ishikawa, Yoshitaka Murakami, Katsuyuki Miura, Hirotsugu Ueshima, Tomonori Okamura, Hirotsugu Ueshima, Tomonori Okamura, Yutaka Imai, Takayoshi Ohkubo, Fujiko Irie, Hiroyasu Iso, Akihiko Kitamura, Toshiharu Ninomiya, Yutaka Kiyohara, Katsuyuki Miura, Yoshitaka Murakami, Hideaki Nakagawa, Takeo Nakayama, Akira Okayama, Toshimi Sairenchi, Shigeyuki Saitoh, Kiyomi Sakata, Akiko Tamakoshi, Ichiro Tsuji, Michiko Yamada, Masahiko Kiyama, Yoshihiro Miyamoto, Shizukiyo Ishikawa, Hiroshi Yatsuya, Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH–JAPAN) Research Group
    Journal of Clinical Lipidology 12 3 674 - 684.e5 2018年05月 [有り][無し]
     研究論文(学術雑誌) 
    Background: The effect of very high or extremely high levels of high-density lipoprotein cholesterol (HDL-C) on cardiovascular disease (CVD) is not well described. Although a few recent studies have reported the adverse effects of extremely high levels of HDL-C on CVD events, these did not show a statistically significant association between extremely high levels of HDL-C and cause-specific CVD mortality. In addition, Asian populations have not been studied. Objective: We examine the impact of extremely high levels of HDL-C on cause-specific CVD mortality using pooled data of Japanese cohort studies. Methods: We performed a large-scale pooled analysis of 9 Japanese cohorts including 43,407 participants aged 40–89 years, dividing the participants into 5 groups by HDL-C levels, including extremely high levels of HDL-C ≥2.33 mmol/L (≥90 mg/dL). We estimated the adjusted hazard ratio of each HDL-C category for all-cause death and cause-specific deaths compared with HDL-C 1.04–1.55 mmol/L (40–59 mg/dL) using a cohort-stratified Cox proportional hazards model. Results: During a 12.1-year follow-up, 4995 all-cause deaths and 1280 deaths due to overall CVD were identified. Extremely high levels of HDL-C were significantly associated with increased risk of atherosclerotic CVD mortality (hazard ratio = 2.37, 95% confidence interval: 1.37–4.09 for total) and increased risk for coronary heart disease and ischemic stroke. In addition, the risk for extremely high HDL-C was more evident among current drinkers. Conclusion: We showed extremely high levels of HDL-C had an adverse effect on atherosclerotic CVD mortality in a pooled analysis of Japanese cohorts.
  • Shohei Okamoto, Tomonori Okamura, Daisuke Sugiyama, Takehito Hayakawa, Yasuyuki Nakamura, Naoko Miyagawa, Shuji Kurita, Naoyuki Takashima, Takayoshi Ohkubo, Aya Kadota, Akira Fujiyoshi, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    Geriatrics and Gerontology International 18 5 799 - 805 2018年05月 [有り][無し]
     研究論文(学術雑誌) 
    Aim: The present study aimed to clarify the association between body mass index (BMI) and the activities of daily living (ADL). Although BMI is likely to be concerned regarding the relationship with specific diseases or mortality, few studies have focused on the relationship of BMI and ADL. Methods: A total of 3353 Japanese participants of a 22-year cohort study from 1990 to 2012 aged 45–74 years at baseline were divided into four groups according to their BMI levels: ≤18.5, 18.5–21.9 (reference), 22.0–24.9 and ≥25.0 kg/m2. Outcomes were becoming dependent in ADL (including death after ADL decline) and death without observation of ADL decline as a competing risk. Sex-specific multinomial logistic regression analysis was carried out in 2017 to estimate the odds ratios (OR) after adjusting for age, smoking, alcohol drinking, hypertension, hypercholesterolemia, diabetes and serum albumin. Results: After multivariable adjustment, though the relationship between BMI and risk of ADL decline was U-shaped among women, only those with BMI ≥25.0 showed a higher risk for ADL decline (OR 1.39, 95% CI 1.01–1.92) compared with the reference. The OR for death without observation of ADL decline was significantly lower for men with BMI ≥25.0 (OR 0.70, 95% CI 0.50–0.98). Conclusions: This study suggests being overweight is a good predictor of future decline in ADL for women, whereas men with BMI 22.0–24.9 had lower risks of ADL decline. Appropriate management of weight in older women could prevent disabilities. Geriatr Gerontol Int 2018 18: 799–805.
  • CTによる肝脾CT値比と糖尿病発症リスクとの関連 滋賀動脈硬化疫学研究
    布施 恵子, 門田 文, 近藤 慶子, 藤吉 朗, 久松 隆史, 門脇 紗也佳, 宮澤 伊都子, 森野 勝太郎, 関根 理, 卯木 智, 前川 聡, 三浦 克之, 上島 弘嗣, SESSA研究グループ
    糖尿病 61 Suppl.1 S - 293 (一社)日本糖尿病学会 2018年04月
  • 赤身・加工肉摂取と心血管疾患死亡との関連は腎機能により異なるか? NIPPON DATA80
    瀬川 裕佳, 近藤 慶子, 山内 宏美, 大野 聖子, 田中 佐智子, 門田 文, 岡村 智教, 三浦 克之, 岡山 明, 上島 弘嗣, NIPPON DATA80研究グループ
    日本腎臓学会誌 60 3 353 - 353 (一社)日本腎臓学会 2018年04月
  • 日本人一般住民男性における腸内細菌と糖尿病有病との関連
    近藤 慶子, 有馬 久富, 岡見 雪子, 安藤 朗, 藤吉 朗, 門田 文, 久松 隆史, 宮澤 伊都子, 森野 勝太郎, 前川 聡, 三浦 克之, 上島 弘嗣, 滋賀動脈硬化疫学研究(SESSA)グループ
    糖尿病 61 Suppl.1 S - 157 (一社)日本糖尿病学会 2018年04月
  • Koshi Nakamura, Makoto Watanabe, Nagako Okuda, Katsushi Yoshita, Mai Kabayama, Sayuki Torii, Toru Kuribayashi, Kazuyoshi Itai, Kei Kamide, Katsuyuki Miura, Akira Okayama
    Journal of atherosclerosis and thrombosis 25 4 323 - 334 2018年04月 [有り][無し]
     研究論文(学術雑誌) 
    AIM: We investigated whether 2 types of personalized health guidance (repeated and single counseling) in the Japanese nationwide cardiovascular prevention system promoted smoking cessation among smokers. METHODS: The study included 47,745 Japanese smokers aged 40 to 74 years classified into 2 personalized health guidance schemes. After a 1-year follow-up, we compared the rates of smoking cessation between individuals who had received counseling ("supported") and those who had not received counseling ("unsupported"). Using propensity score matching analysis, we estimated the average treatment effect (ATE) of each approach on smoking cessation after balancing out the characteristics between the supported and unsupported groups. The propensity score regression model included age, medical insurance type, weight gain since the age of 20 years, exercise, eating habits, alcohol intake, quality of sleep, readiness to modify lifestyle, willingness to receive support, and body mass index. RESULTS: In the repeated counseling scheme, the age-adjusted rates of smoking cessation in the supported and unsupported groups were 8.8% and 6.3% for males, and 9.8% and 9.1% for females respectively. In the single counseling scheme, the corresponding rates were 8.4% and 7.3% for supported and unsupported males, and 11.0% and 11.7% for supported and unsupported females respectively. The ATE of repeated counseling was +2.64% (95% confidence interval: +1.51% to +3.77%) for males and +3.11% (-1.85% to +8.07%) for females. The ATE of single counseling was +0.61% (-1.17% to +2.38%) for males and -1.06% (-5.96% to +3.85%) for females. CONCLUSIONS: In the Japanese cardiovascular prevention system, repeated counseling may promote smoking cessation among male smokers.
  • Hemant Mahajan, Jina Choo, Kamal Masaki, Akira Fujiyoshi, Jingchuan Guo, Takashi Hisamatsu, Rhobert Evans, Siyi Shangguan, Bradley Willcox, Tomonori Okamura, Abhishek Vishnu, Emma Barinas-Mitchell, Vasudha Ahuja, Katsuyuki Miura, Lewis Kuller, Chol Shin, Hirotsugu Ueshima, Akira Sekikawa
    Data in Brief 17 1091 - 1098 2018年04月 [有り][無し]
     研究論文(学術雑誌) 
    Data presented in this article are supplementary data to our primary article ‘Association of Alcohol Consumption and Aortic Calcification in Healthy Men Aged 40–49 Years for the ERA JUMP Study’ [1]. In this article, we have presented supplementary tables showing the independent association of alcohol consumption with coronary artery calcification using Tobit conditional regression and ordinal logistic regression.
  • Stamler J, Chan Q, Daviglus ML, Dyer AR, Van Horn L, Garside DB, Miura K, Wu Y, Ueshima H, Zhao L, Elliott P, INTERMAP Research Group
    Hypertension (Dallas, Tex. : 1979) 71 4 631 - 637 2018年04月 [有り][無し]
     研究論文(学術雑誌) 
    Available data indicate that dietary sodium (as salt) relates directly to blood pressure (BP). Most of these findings are from studies lacking dietary data; hence, it is unclear whether this sodium-BP relationship is modulated by other dietary factors. With control for multiple nondietary factors, but not body mass index, there were direct relations to BP of 24-hour urinary sodium excretion and the urinary sodium/potassium ratio among 4680 men and women 40 to 59 years of age (17 population samples in China, Japan, United Kingdom, and United States) in the INTERMAP (International Study on Macro/Micronutrients and Blood Pressure), and among its 2195 American participants, for example, 2 SD higher 24-hour urinary sodium excretion (118.7 mmol) associated with systolic BP 3.7 mm Hg higher. These sodium-BP relations persisted with control for 13 macronutrients, 12 vitamins, 7 minerals, and 18 amino acids, for both sex, older and younger, blacks, Hispanics, whites, and socioeconomic strata. With control for body mass index, sodium-BP-but not sodium/potassium-BP-relations were attenuated. Normal weight and obese participants manifested significant positive relations to BP of urinary sodium; relations were weaker for overweight people. At lower but not higher levels of 24-hour sodium excretion, potassium intake blunted the sodium-BP relation. The adverse association of dietary sodium with BP is minimally attenuated by other dietary constituents; these findings underscore the importance of reducing salt intake for the prevention and control of prehypertension and hypertension. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT00005271.
  • Kazuyo Tsushita, Akiko S Hosler, Katsuyuki Miura, Yukiko Ito, Takashi Fukuda, Akihiko Kitamura, Kozo Tatara
    Journal of atherosclerosis and thrombosis 25 4 308 - 322 2018年04月 [有り][無し]
     研究論文(学術雑誌) 
    AIM: All health insurers in Japan are mandated to provide Specific Health Checkups and Specific Health Guidance (SHG) focusing on metabolic syndrome (MetS) in middle-aged adults, beginning in 2008; intensive HG for individuals who have abdominal obesity and two or more additional MetS risk factors, and motivational HG for individuals with one risk factor. The aim of this study is to describe medium-term changes in health indexes for intensive and motivational HG groups using the National Database. METHODS: We compared changes of risk factors and initiation of pharmacological therapy over 3 yr between participants (n=31,790) and nonparticipants (n=189,726) who were eligible for SHG in 2008. RESULTS: Body weight reduction in intensive HG was 1.98 kg (participants) vs 0.42 kg (nonparticipants) in men (p<0.01) and 2.25 vs 0.68 kg in women (p<0.01) after 1 yr. In motivational HG, the respective reduction was 1.40 vs 0.30 kg in men (p<0.01) and 1.53 vs 0.42 kg in women (p<0.01). Waist circumference reduction was also greatest among participants in intensive HG (2.34 cm in men and 2.98 cm in women). These reductions were fairly unchanged over 3 yr and accompanied greater improvements in MetS risk factors in participants. We also detected significantly smaller percentages of SHG participants who initiated pharmacological therapy compared with nonparticipants. CONCLUSION: Participants in SHG showed greater improvements in MetS profiles with proportionally smaller pharmacological treatment initiations than did nonparticipants for 3 yr. Although selection bias may be present, this study suggests SHG would be a feasible strategy to prevent MetS and its sequelae.
  • 日本人一般集団における血清N-3 polyunsaturated fatty acidと高感度C反応性蛋白の関連性(Association of Serum N-3 Polyunsaturated Fatty Acids and High-sensitivity C-reactive Protein in Japanese General Population)
    中村 翼, 門田 文, 近藤 慶子, 宮川 尚子, 関川 暁, 藤 吉朗, 久松 隆史, 三浦 克之, 上島 弘嗣
    日本循環器学会学術集会抄録集 82回 OJ24 - 7 2018年03月
  • A Genome-wide Association Study in the Diabetic Patients Finds the 13q35.43-35.46 Locus Associated with Estimated Glomerular Filtration Rate: The Japan Multi-Institutional Collaborative Cohort Study
    Yasuyuki Nakamura, Akira Narita, Tsuyoshi Hachiya, Yoichi Sutoh, Atsushi Shimizu, Seiko Ohno, Naoyuki Takashima, Harumitsu Suzuki
    Clin Diabetes 2018, 2:2 2018年02月 [有り][無し]
  • Seto-Yukimura R, Ogawa E, Hisamatsu T, Torii S, Shiino A, Nozaki K, Fujiyoshi A, Miura K, Nakano Y, Ueshima H, SESSA Research Group
    Journal of atherosclerosis and thrombosis 25 10 1009 - 1021 2018年02月 [有り][無し]
     研究論文(学術雑誌)
  • Kei Asayama, Takayoshi Ohkubo, Atsushi Satoh, Sachiko Tanaka, Aya Higashiyama, Yoshitaka Murakami, Michiko Yamada, Shigeyuki Saitoh, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima, Yoshihiro Miyamoto, Tomonori Okamura
    Journal of hypertension 36 2 410 - 418 2018年02月 [有り][無し]
     研究論文(学術雑誌) 
    OBJECTIVE: There is little evidence to support an increased risk of blood pressure (BP) elevation among elderly individuals receiving antihypertensive drug treatment. METHODS: To clarify the impact on BP level and residual cardiovascular risk in treated elderly individuals, we analysed individual participant data of 26 133 residents aged 60-89 years from seven Japanese general populations and cross-classified participants by age category, 60-74 (young-old) versus 75-89 years (old-old), and by usage of antihypertensive medication at baseline survey (1980-1995). RESULTS: During a median follow-up period of 12.7 years, 2451 cardiovascular deaths were observed. Multivariable-adjusted hazard ratios of cardiovascular mortality in treated participants compared with untreated participants were 1.30 [95% confidence intervals, 1.16-1.46) and 1.35 (95% confidence interval, 1.16-1.56) in young-old and old-old participants, respectively. Irrespective of antihypertensive medication, the risk increase of total cardiovascular and stroke mortality with elevation of BP was significant among young-old (P ≤ 0.0013), but not significant among old-old participants (P ≥ 0.061). CONCLUSION: Although impact on BP was more evident among young-old than old-old individuals, clinicians who prescribe antihypertensive medication to elderly patients should consider that such patients require further monitoring.
  • Ho N. Nguyen, Naoko Miyagawa, Katsuyuki Miura, Nagako Okuda, Katsushi Yoshita, Yusuke Arai, Hideaki Nakagawa, Kiyomi Sakata, Toshiyuki Ojima, Aya Kadota, Naoyuki Takashima, Akira Fujiyoshi, Takayoshi Ohkubo, Robert D. Abbott, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima, NIPPON DATA80 Research Group
    Clinical Nutrition 37 1 182 - 188 2018年02月 [有り][無し]
     研究論文(学術雑誌) 
    Background & aim: Although dietary soy intake is linked with health benefits, a relation with stroke has not been established. The present study examined the association between the intake of tofu, the richest source of dietary soy, with stroke mortality in a general population cohort of Japanese men and women. Methods: Data comprise 9244 Japanese enrolled in the National Nutrition Survey of Japan in 1980. Participants were free of cardiovascular disease and followed for 24 years. Dietary intake was estimated from 3-day weighed food records. Multivariable Cox regression models were used to estimate hazard ratios across levels of tofu intake. Results: During follow-up, there were 417 deaths due to stroke (88 cerebral hemorrhage [CH], 245 cerebral infarction [CI], and 84 of other subtypes). Among all men, and in women aged 65 years or more, tofu intake was unrelated to each form of stroke. For young women (< 65 years of age), a significantly lower risk of CH in the top versus bottom quartile of tofu intake was observed (Multivariable-adjusted HR = 0.26, 95% CI: 0.08–0.85). Conclusions: In this large prospective study with long follow-up of Japanese men and women, consumption of tofu was unrelated to the risk of stroke except for CH in women < 65 years of age. Whether the association in younger women is real or due to chance alone warrants further study.
  • 近藤 慶子, 森野 勝太郎, 石角 篤, 有馬 久富, 仁神 史生, 関根 理, 松本 元伸, 三浦 克之, 卯木 智, 前川 聡
    日本病態栄養学会誌 21 Suppl. S - 71 (一社)日本病態栄養学会 2018年01月
  • 退職前の健康診断結果から見た退職後死亡の予測因子の検討
    三浦克之, 櫻井 勝, 石﨑昌夫, 中川秀昭
    厚生労働省科学研究費補助金循環器疾患・糖尿病等生活習慣病対策総合研究事業:「健康診査・保健指導の有効性評価に関する研究」 平成29年度 総括・分担研究報告書(研究代表者 永井良三) - 19 - 23 2018年 [無し][無し]
  • Aryandhito Widhi Nugroho, Hisatomi Arima, Naoyuki Takashima, Takako Fujii, Satoshi Shitara, Naomi Miyamatsu, Yoshihisa Sugimoto, Satoru Nagata, Masaru Komori, Yoshikuni Kita, Katsuyuki Miura, Kazuhiko Nozaki
    Journal of Stroke and Cerebrovascular Diseases 27 10 2579 - 2586 2018年 [有り][無し]
     研究論文(学術雑誌) 
    Background and Purpose: Most available scoring system to predict outcome after acute ischemic stroke (AIS) were established in Western countries. We aimed to develop a simple prediction score of 1-month severe disability/death after onset in AIS patients ineligible for recanalization therapy based on readily and widely obtainable on-admission clinical, laboratory and radiological examinations in Asian developing countries. Methods: Using the Shiga Stroke Registry, a large population-based registry in Japan, multivariable logistic regression analysis was conducted in 1617 AIS patients ineligible for recanalization therapy to yield ß-coefficients of significant predictors of 1-month modified Rankin Scale score of 5-6, which were then multiplied by a specific constant and rounded to nearest integer to develop 0-10 points system. Model discrimination and calibration were evaluated in the original and bootstrapped population. Results: Japan Coma Scale score (J), age (A), random glucose (G), untimely onset-to-arrival time (U), atrial fibrillation (A), and preadmission dependency status according to the modified Rankin Scale score (R), were recognized as independent predictors of outcome. Each of their β-coefficients was multiplied by 1.3 creating the JAGUAR score. Its area under the curve (95% confidence interval) was .901 (.880- .922) and .901 (.900- .901) in the original and bootstrapped population, respectively. It was found to have good calibration in both study population (P = .27). Conclusions: The JAGUAR score can be an important prediction tool of severe disability/death in AIS patients ineligible for recanalization therapy that can be applied on admission with no complicated calculation and multimodal neuroimaging necessary, thus suitable for Asian developing countries.
  • Ota A, Yatsuya H, Nishi N, Okuda N, Ohkubo T, Hayakawa T, Kadota A, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S66 - S72 2018年 [有り][無し]
  • Itsuko Miyazawa, Aya Kadota, Katsuyuki Miura, Motozumi Okamoto, Takashi Nakamura, Tsuyoshi Ikai, Hiroshi Maegawa, Atsushi Ohnishi
    Endocrine Journal 65 5 527 - 536 2018年 [有り][無し]
     研究論文(学術雑誌) 
    The prevalence of obesity is increasing globally in patients with diabetes. This study aimed to examine 12-year trends of increasing obesity in Japanese patients with diabetes, and their clinical features. The study used results of the Shiga Diabetes Clinical Survey, which recorded medical performance in diabetic patients in 2000, 2006 and 2012. Data were analyzed from 14,205, 14,407 and 21,449 adult patients in these three years, respectively. Overweight and obesity prevalence and the clinical features of diabetes patients were examined, stratified by body mass index (BMI) and age. The prevalence of overweight (BMI 25–30 kg/m2) and obesity (BMI ≥30 kg/m2) were 27.0% and 5.1% in 2000, 28.9% and 7.3% in 2006 and 30.9% and 10.0% in 2012. Glycemic control, blood pressure and serum lipid profile improved over 12 years in all BMI categories. However, glycemic and triglyceride control were insufficient in obese patients aged < 65 years (hemoglobin A1c 7.5 ± 1.4%, triglyceride 197.7 ± 178.4 mg/dL in 2012). The percentage of patients who used antihypertensive and lipid-lowering drugs increased and patients with higher BMI had increased frequency of using these drugs, both in young and old age groups. Higher BMI was significantly and positively associated with albuminuria. In summary, overweight and obesity have increased in Japanese diabetic patients, particularly for younger generations. Findings suggest that obesity may lead to poorer glycemic control, blood pressure and lipid profiles. Overweight and obesity are important modifiable risk factors for diabetes, suggesting that more active weight-control interventions are warranted.
  • Widhi Nugroho A, Arima H, Miyazawa I, Fujii T, Miyamatsu N, Sugimoto Y, Nagata S, Komori M, Takashima N, Kita Y, Miura K, Nozaki K
    Journal of atherosclerosis and thrombosis 25 7 570 - 579 2018年01月 [有り][無し]
     研究論文(学術雑誌) 
    AIM: Although renal dysfunction has been identified as a novel risk factor affecting stroke prognosis, few have analyzed the association within large-scale population-based setting, using wide-range estimated glomerular filtration rate (eGFR) category. We aimed to determine the association of admission eGFR with acute stroke outcomes using data from a registry established in Shiga Prefecture, Japan. METHODS: Following exclusion of patients younger than 18 years, with missing serum creatinine data, and with onset more than 7 days prior to admission, 2,813 acute stroke patients registered in the Shiga Stroke Registry year 2011 were included in the final analysis. The Japanese Society of Nephrology equation was used to estimate GFR. Multivariable logistic regression was performed to analyze the association of eGFR with all-cause in-hospital death (modified Rankin Scale [mRS] 6), and at-discharge death/disability (mRS 2-6). Separate analyses were conducted within stroke subtypes. RESULTS: Compared to eGFR 60-89 mL/min/1.73 m2, adjusted odds ratios (ORs) and 95% confidence interval [95% CI] for in-hospital death (in the order of eGFR <45, 45-59, and ≥90 mL/min/1.73 m2) were 1.54 [1.04-2.27], 1.07 [0.72-1.58], and 1.04 [0.67-1.59]. Likewise, adjusted ORs [95% CI] for at-discharge death/disability were 1.54 [1.02-2.32], 0.97 [0.73-1.31], and 1.48 [1.06-2.05]. Similar pattern was further evident in the eGFR <45 mL/min/1.73 m2 group for both outcomes within acute ischemic stroke patients. CONCLUSIONS: Our study has ascertained that in acute stroke, particularly ischemic stroke, low eGFR was significantly associated with in-hospital death and at-discharge death/disability. Additionally, high eGFR was found to be associated with at-discharge death/disability.
  • Liu Z, Kameshima N, Nanjo T, Shiino A, Kato T, Shimizu S, Shimizu T, Tanaka S, Miura K, Tooyama I
    Journal of Alzheimer's disease : JAD 62 2 737 - 744 2018年 [有り][無し]
     研究論文(学術雑誌) 
    Cost-effective and feasible methods for early diagnosis of Alzheimer's disease (AD) are needed. We present two methods to measure AD-related biomarkers simultaneously from one nasal smear for the purpose of diagnosing AD. Japanese men and women aged 63-85 years old were recruited in 2015-2016 for this case-control study. A total of 25 AD cases and 25 controls (22 men and 28 women) participated in this research. Nasal smears were collected from the common nasal meatus, inferior concha, middle nasal meatus, and olfactory cleft, and the proteins in the samples were analyzed by two methods, which we named PGD (Pre-treatment with guanidine- n-Dodecyl-beta-D-maltoside solution) method 1 (PGD-I) and 2 (PGD-II). The PGD-I method measured total tau and amyloid-β (Aβ)42, but no differences in median levels of total tau and Aβ42 between AD cases and controls were found in any of the nasal locations. The PGD-II method measured Aβ42, total tau, and phosphorylated tau, but levels of Aβ40 in all nasal locations of both groups were near zero. Median levels of phosphorylated tau to total tau (p-tau/t-tau) ratios in the middle nasal meatus and in the olfactory cleft were significantly higher in AD cases than in controls, and could significantly predict AD. To assess diagnostic reliability, areas under the ROC curve were 0.74 (95% CL = 0.52-0.95, p = 0.030) for the middle nasal meatus and 0.72 (95% CL = 0.52-0.92, p = 0.029) for the olfactory cleft. Thus, PGD-I and PGD-II can detect AD-related biomarkers in nasal smears and PGD-II may be a useful tool for diagnosing AD.
  • Miura K, Okayama A
    Journal of epidemiology 28 Supplement_III S1  2018年 [有り][無し]
  • Nakamura T, Nakamura Y, Saitoh S, Okamura T, Yanagita M, Yoshita K, Kita Y, Murakami Y, Yokomichi H, Nishi N, Okuda N, Kadota A, Ohkubo T, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S10 - S16 2018年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Socioeconomic status (SES) imbalances in developed and developing countries may result in individuals being overweight and obese. However, few studies have investigated this issue in Japan. We herein examined the relationship between SES and being underweight, overweight or obese according to sex and age groups (20-64 or ≥65 years) in Japan. METHODS: In 2010, we established a cohort of participants in the National Health and Nutrition Survey of Japan. We divided 2,491 participants (1,081 men and 1,410 women) according to the WHO definitions of underweight, overweight or obesity and performed multinomial logistic analyses using BMI <18.5 kg/m2 (underweight), BMI 25.0-29.9 kg/m2 (overweight), and BMI ≥30.0 kg/m2 (obese) versus BMI 18.5-24.9 kg/m2 (normal) as the outcome, with SES groups as the main explanatory variables. RESULTS: In adult men, a lower education level relative to a higher education level was inversely associated with obesity after adjustments for other SESs (odds ratio [OR] 0.41; 95% confidence interval [CI], 0.18-0.96). However, in adult women, lower education level was positively associated with being overweight and obese (OR 1.67; 95% CI, 1.07-2.49 for overweight and OR 2.66; 95% CI, 1.01-7.01 for obese). In adult women, a lower household income was positively associated with being overweight and obese (obese: OR 4.84; 95% CI, 1.36-17.18 for those with a household income <2 million JPY relative to those with ≥6 million JPY). CONCLUSIONS: In adult women, a lower education level and lower household income were positively associated with being overweight or obese. In contrast, in adult men, a lower education level was inversely associated with obesity. Gender and age differences in SESs affect the prevalence of being overweight or obese.
  • Sakurai M, Nakagawa H, Kadota A, Yoshita K, Nakamura Y, Okuda N, Nishi N, Miyamoto Y, Arima H, Ohkubo T, Okamura T, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S17 - S22 2018年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: This study examined the relationships among household income, other SES indicators, and macronutrient intake in a cross-sectional study of a representative Japanese population. METHODS: In 2010, we established a cohort of participants in the National Health and Nutrition Survey (NHNS) from 300 randomly selected areas throughout Japan. A total of 2,637 participants (1,145 men and 1,492 women) were included in the study. Data from NHNS2010 and the Comprehensive Survey of Living Conditions 2010 (CSCL2010) were merged, and relationships among macronutrient intake and SES were evaluated. Additionally, socioeconomic factors associated with a risk of a higher carbohydrate/lower fat intake beyond dietary recommendations were evaluated. RESULTS: Household income was positively associated with fat intake (P = 0.001 for men and <0.001 for women) and inversely associated with carbohydrate intake (P = 0.003 for men and <0.001 for women) after adjustments for age and other SES variables. Similar relationships were observed between equivalent household expenditure (EHE) and macronutrient intake; however, these relationships were weaker than those of household income. Older age was the factor most strongly associated with a high carbohydrate/low fat intake, followed by household income, EHE, education levels, and occupation type. CONCLUSIONS: Older age was the factor most strongly associated with a high carbohydrate/low fat intake, and some aspects of SES, such as household income, EHE, education levels, and occupation type, were independently associated with an imbalanced macronutrient intake. SES may affect the health status of individuals through the intake of macronutrients.
  • Kadota A, Okuda N, Ohkubo T, Okamura T, Nishi N, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S2 - S9 2018年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: The structure and risk factors for cardiovascular diseases (CVD) in Japan may change because lifestyle, particularly nutrition, socioeconomic status, and medical care, which affect CVD, may markedly change over time. Therefore, a new prospective cohort study on a representative general Japanese population based on national surveys is required. METHODS: In November 2010, the baseline survey of the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010 (NIPPON DATA2010) was performed with the National Health and Nutrition Survey of Japan (NHNS2010) in 300 randomly selected districts throughout Japan. The survey included a questionnaire, electrocardiogram, urinalysis, and blood biomarkers added to the NHNS2010 examinations. Physical measurements, blood biomarkers, and dietary data were also obtained in NHNS2010. Socioeconomic factors were obtained by merging with the Comprehensive Survey of Living Conditions 2010 (CSLC2010) dataset. Participants are followed annually for the incidence of diabetes mellitus, CVD events (acute coronary events, heart failure, atrial fibrillation, and stroke), and cause-specific mortality. The activities of daily living are followed every 5 years. RESULTS: A total of 2,898 individuals aged 20 years or older agreed to participate in the baseline survey of NIPPON DATA2010. The participation rate was 74.6%. Of these, data from NHNS2010 was merged for 2,891 participants (1,236 men and 1,655 women). The data of 2,807 participants were also merged with CSLC2010 data. CONCLUSIONS: We established NIPPON DATA2010 as a cohort study on a representative general Japanese population that covers all of Japan.
  • Nagahata T, Nakamura M, Ojima T, Kondo I, Ninomiya T, Yoshita K, Arai Y, Ohkubo T, Murakami K, Nishi N, Murakami Y, Takashima N, Okuda N, Kadota A, Miyagawa N, Kondo K, Okamura T, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S23 - S28 2018年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: A lower socioeconomic status (SES) may be related to the intake of unhealthy food; however, this relationship has not been examined in detail. This study was undertaken to examine relationships among food group intakes and SES in a representative Japanese population. METHODS: This was a cross-sectional study using the baseline data of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey in Japan. A total of 2,898 participants were included in the baseline survey in 2010. The effects of age (<65 years and ≥65 years), equivalent household expenditure (EHE), and education attainment on food group intakes (gram per 1,000 kcal) were analyzed using a two-way analysis of variance. RESULTS: When EHE was lower, cereal intake was higher in men and women. Among men, fish, milk, and alcohol intakes were reduced with lower EHE. Among women, vegetable intake was reduced with lower EHE. In men and women, cereal intake was higher with lower education attainment. In contrast, meat intake was reduced with lower education attainment. CONCLUSIONS: Lower SES was associated with a higher cereal intake and lower vegetable, fish, meat, and milk intakes in a representative Japanese population. Socioeconomic discrepancies need to be considered in order to promote healthier dietary habits.
  • Miyagawa N, Okuda N, Nakagawa H, Takezaki T, Nishi N, Takashima N, Fujiyoshi A, Ohkubo T, Kadota A, Okamura T, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S29 - S34 2018年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Although socioeconomic status (SES) may affect food and nutrient intakes, few studies have reported on sodium (Na) and potassium (K) intakes among individuals with various SESs in Japan. We investigated associations of SES with Na and K intake levels using urinary specimens in a representative Japanese population. METHODS: This was a cross-sectional study of 2,560 men and women (the NIPPON DATA2010 cohort) who participated in the National Health and Nutrition Survey Japan in 2010. Casual urine was used to calculate estimated excretion in 24-hour urinary Na (E24hr-Na) and K (E24hr-K). The urinary sodium-to-potassium (Na/K) ratio was calculated from casual urinary electrolyte values. An analysis of covariance was performed to investigate associations of aspects of SES, including equivalent household expenditure (EHE), educational attainment, and job category, with E24hr-Na, E24hr-K, and the Na/K ratio for men and women separately. A stratified analysis was performed on educational attainment and the job category for younger (<65 years) and older (≥65 years) participants. RESULTS: In men and women, average E24hr-Na was 176.2 mmol/day and 172.3, average E24hr-K was 42.5 and 41.3, and the average Na/K ratio was 3.61 and 3.68, respectively. Lower EHE was associated with a higher Na/K ratio in women and lower E24hr-K in men and women. A shorter education was associated with a higher Na/K ratio in women and younger men, and lower E24hr-K in older men and women. CONCLUSION: Lower EHE and a shorter education were associated with a lower K intake and higher Na/K ratio estimated from casual urine specimens in Japanese men and women.
  • Goryoda S, Nishi N, Hozawa A, Yoshita K, Arai Y, Kondo K, Miyagawa N, Hayakawa T, Fujiyoshi A, Kadota A, Ohkubo T, Okamura T, Okuda N, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S35 - S39 2018年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: The relationships among socioeconomic status and lifestyle improvements have not yet been examined in a representative Japanese population. METHODS: We analyzed data from 2,647 participants (1,087 men and 1,560 women) who participated in NIPPON DATA2010. This survey inquired about lifestyle improvements and socioeconomic status. Education was categorized as low (≤9 years), middle (10-12 years), and high (≥13 years). Marital status was categorized as married, divorced, widowed, and never married/other. A multivariable logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of lifestyle improvements with the intention of preventing cardiovascular diseases for educational attainment and marital status, with adjustments for age and awareness of cardiovascular disease risk factors. RESULTS: Overall, 1,507 (56.9%) participants practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome, and the OR of lifestyle improvements was significantly higher with a high education than with a low education in men (OR 2.86; 95% CI, 1.96-4.17) and women (OR 2.36; 95% CI, 1.67-3.33). The number of participants who practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome was significantly lower in divorced than in married men (OR 0.46; 95% CI, 0.22-0.95) and women (OR 0.53; 95% CI, 0.33-0.86). CONCLUSIONS: Specific differences caused by educational attainment and marital status may exist in lifestyle improvements.
  • Nguyen M, Nishi N, Kadota A, Okuda N, Arima H, Fujiyoshi A, Nakano Y, Ohkubo T, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S40 - S45 2018年 [有り][無し]
     研究論文(学術雑誌)
  • Tsuji M, Arima H, Ohkubo T, Nakamura K, Takezaki T, Sakata K, Okuda N, Nishi N, Kadota A, Okamura T, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S46 - S52 2018年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: The relationship between socioeconomic status (SES) and knowledge of cardiovascular risk factors remains unknown in a general Japanese population. METHODS: Of 8,815 participants from 300 randomly selected areas throughout Japan, 2,467 participants who were free of cardiovascular disease and who provided information on SES in the National Health and Nutrition Survey of Japan 2010 were enrolled in this cross-sectional analysis. SES was classified according to the employment status, length of education, marital and living statuses, and equivalent household expenditure (EHE). Outcomes were ignorance of each cardiovascular risk factor (hypertension, diabetes, hypercholesterolemia, low high-density lipoprotein [HDL] cholesterol, arrhythmia, and smoking) and insufficient knowledge (number of correct answers <4 out of 6). RESULTS: A short education and low EHE were significantly associated with a greater ignorance of most cardiovascular risk factors. A short education (<10 years) was also associated with insufficient knowledge of overall cardiovascular risk factors: age- and sex-adjusted odds ratios (OR) were 1.92 (95% confidence interval [CI], 1.51-2.45) relative to participants with ≥13 years of education. Low EHE was also associated with insufficient knowledge (age- and sex-adjusted OR 1.24; 95% CI, 1.01-1.51 for the lowest quintile vs the upper 4 quintiles). These relationships remained significant, even after further adjustments for regular exercise, smoking, weekly alcohol consumption, body mass index, hypertension, diabetes mellitus, hypercholesterolemia, and low HDL cholesterol. CONCLUSION: Participants with a short education and low EHE were more likely to have less knowledge of cardiovascular risk factors.
  • Imamura H, Kogure M, Kita Y, Nakagawa H, Hozawa A, Okamura T, Murakami Y, Nishi N, Okuda N, Kadota A, Ohkubo T, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S53 - S58 2018年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: This study investigated relationships among socioeconomic factors and participation in health examinations for Japanese National Health Insurance (NHI) using a representative Japanese population. METHODS: We used the linkage database of NIPPON DATA2010 and Comprehensive Survey of Living Conditions 2010. Participants with NHI aged 40-74 years were included in the analysis. Prevalence ratios (PRs) for participation in health examinations in the past year were set as an outcome. Participant characteristics, including sex, age, socioeconomic factors (educational attainment, employment, equivalent household expenditure [EHE], house ownership, and marital status), laboratory measures, and lifestyle were included in an age-stratified modified Poisson regression analysis to examine relationships. RESULTS: The number of study participants was 812, and 564 (69.5%) participated in health examinations in the past year. Among those aged 40-64 years, there was no significant PR for socioeconomic factors. Among those aged 65-74 years, high (≥13 years) educational attainment (adjusted PR, 1.22; 95% confidence interval [CI], 1.05-1.41) and house ownership (PR 1.40; 95% CI, 1.11-1.77) were positively associated with participation, while high (4th quartile) EHE (PR 0.84; 95% CI, 0.73-0.97) was negatively associated. CONCLUSION: These results suggest that high educational attainment, house ownership, and low EHE were positive factors for participation in health examinations among those aged 65-74 years.
  • Murakami K, Ohkubo T, Nakamura M, Ninomiya T, Ojima T, Shirai K, Nagahata T, Kadota A, Okuda N, Nishi N, Okamura T, Ueshima H, Okayama A, Miura K
    Journal of epidemiology 28 Supplement_III S59 - S65 2018年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Most studies on socioeconomic inequalities in oral health have not considered the effects of behavioral and biological factors and age differences. Furthermore, the nationwide status of inequalities remains unclear in Japan. METHODS: We analyzed data from 2,089 residents aged ≥40 years throughout Japan. The lowest quartile of the number of remaining teeth for each 10-year age category was defined as poor oral health. Behavioral and biological factors included smoking status, obesity, diabetes mellitus, high-sensitivity C-reactive protein, and the use of dental devices. Multiple logistic regression analyses were conducted to examine the associations of educational attainment and equivalent household expenditure (EHE) with oral health, and stratified analyses by age category were also conducted (40-64 years and ≥65 years). RESULTS: Lower education and lower EHE were significantly associated with an increased risk of poor oral health after adjusting for age, sex, employment status, marital and living statuses, and EHE/education; the odds ratio for junior high school education compared with ≥college education was 1.84 (95% confidence interval [CI], 1.36-2.49), and the odds ratio of the lowest compared with the highest EHE quartile was 1.91 (95% CI, 1.43-2.56). Further adjustments for behavioral and biological factors attenuated but did not eliminate these associations. EHE was significantly associated with oral health among elderly adults only, with a significant interaction by age category. CONCLUSIONS: Those with a lower education and those with lower EHE had a significantly higher risk of poor oral health, even after adjustments for behavioral and biological factors.
  • Toshiyuki Iwahori, Katsuyuki Miura, Keiichi Obayashi, Takayoshi Ohkubo, Hiroshi Nakajima, Toshikazu Shiga, Hirotsugu Ueshima
    BMJ Open 8 1 e017351  2018年01月 [有り][無し]
     研究論文(学術雑誌) 
    Objectives Our aim was to assess seasonal variation in home blood pressure (BP) among free-living nationwide participants using home BP values accumulated from a web-based healthcare platform established in Japan. Settings An observational study. OMRON Healthcare Co., Ltd. has been developing web-based personal healthcare record systems in Japan since November 2010 over two million voluntary participants had joined this platform in September 2015. Nationwide home BP measurements made by oscillometric-type electronic sphygmomanometers from over 110 000 voluntary participants have been transmitted to the system from devices. Participants Seasonal variation in home BP was evaluated among 64 536 (51 335 men, 13 201 women mean age 52.9 years) free-living nationwide users for whom data were automatically and simultaneously transmitted to the system from devices. Primary outcome measures Mean monthly and weekly home BP. Results In multiple regression analysis, the relationship between BP and temperature was a significant inverse association, independent of age, gender and geological locations. Highest and lowest BP was observed in December and July, respectively. Substantial seasonal differences in the mean values of morning and evening home systolic BP between summer and winter were 6.2 mmHg and 5.5 mmHg in men, and 7.3 mmHg and 6.5 mmHg in women. Seasonal variation was a little greater in older (7.3 mmHg in men, 8.7 mmHg in women) than in younger individuals (5.8 mmHg in men, 6.5 mmHg in women). BP from February to July was approximately 1.5 mmHg lower than the value from August to December. Conclusions A web-based healthcare platform has enabled easier monitoring of population-wide BP. Tighter BP control is necessary in winter than in summer, and especially in a colder climate toward winter than toward summer. New technologies using web-based self-monitoring systems for health-related indexes are expected to initiate a new phase of cardiovascular disease prevention and public health promotion.
  • Fujiyoshi N, Arima H, Satoh A, Ojima T, Nishi N, Okuda N, Kadota A, Ohkubo T, Hozawa A, Nakaya N, Fujiyoshi A, Okamura T, Ueshima H, Okayama A, Miura K, NIPPON DATA, Research Group
    Journal of atherosclerosis and thrombosis 25 7 606 - 620 2018年01月 [有り][無し]
     研究論文(学術雑誌) 
    AIM: To investigate associations between socioeconomic status (SES) and the prevalence and treatment status of hypercholesterolemia in a general Japanese population. METHODS: In 2010, we established a cohort study of 2417 adults (age 20-91 yr) from 300 randomly selected areas across Japan who participated in the National Health and Nutrition Survey of Japan. We cross-sectionally examined an association between SES and (1) prevalence of hypercholesterolemia in 2417 participants (999 men and 1418 women) and (2) not receiving medication for hypercholesterolemia in 654 participants (215 men and 439 women). SES included employment status, marital status, length of education, and household expenditures. Hypercholesterolemia was defined as a total serum cholesterol level of ≥6.21 mmol/L (240 mg/dL) or the use of lipid-lowering medications. RESULTS: The overall prevalence of hypercholesterolemia was 21.5% in men and 31.0% in women. In men, the lowest quintile of household expenditures was associated with a higher prevalence of hypercholesterolemia (28.3%) compared with the upper 4 quintiles (19.9%) (multivariable-adjusted odds ratio 1.66; 95% confidence interval [CI] 1.16-2.38). Among participants with hypercholesterolemia, 55.4% of men and 55.1% of women were not receiving medication. Unmarried men were more likely to be untreated (75.0%) than married men (50.9%) (multivariable-adjusted odds ratio 2.53;95%CI 1.05-6.08). SES had no significant effects in women. CONCLUSION: In a general population of Japanese men, low household expenditures were associated with a higher prevalence of hypercholesterolemia, and unmarried men with hypercholesterolemia were less likely to receive medication.
  • Hemant Mahajan, Jina Choo, Kamal Masaki, Akira Fujiyoshi, Jingchuan Guo, Takashi Hisamatsu, Rhobert Evans, Siyi Shangguan, Bradley Willcox, Tomonori Okamura, Abhishek Vishnu, Emma Barinas-Mitchell, Vasudha Ahuja, Katsuyuki Miura, Lewis Kuller, Chol Shin, Hirotsugu Ueshima, Akira Sekikawa
    Atherosclerosis 268 84 - 91 2018年01月 [有り][無し]
     研究論文(学術雑誌) 
    Background and aims Several studies have reported a significant inverse association of light to moderate alcohol consumption with coronary heart disease (CHD). However, studies assessing the relationship between alcohol consumption and atherosclerosis have reported inconsistent results. The current study was conducted to determine the relationship between alcohol consumption and aortic calcification. Methods We addressed the research question using data from the population-based ERA-JUMP Study, comprising of 1006 healthy men aged 40–49 years, without clinical cardiovascular diseases, from four race/ethnicities: 301 Whites, 103 African American, 292 Japanese American, and 310 Japanese in Japan. Aortic calcification was assessed by electron-beam computed tomography and quantified using the Agatston method. Alcohol consumption was categorized into four groups: 0 (non-drinkers), ≤1 (light drinkers), > 1 to ≤3 (moderate drinkers) and > 3 drinks per day (heavy drinkers) (1 drink = 12.5 g of ethanol). Tobit conditional regression and ordinal logistic regression were used to investigate the association of alcohol consumption with aortic calcification after adjusting for cardiovascular risk factors and potential confounders. Results The study participants consisted of 25.6% nondrinkers, 35.3% light drinkers, 23.5% moderate drinkers, and 15.6% heavy drinkers. Heavy drinkers [Tobit ratio (95% CI) = 2.34 (1.10, 4.97) odds ratio (95% CI) = 1.67 (1.11, 2.52)] had significantly higher expected aortic calcification score compared to nondrinkers, after adjusting for socio-demographic and confounding variables. There was no significant interaction between alcohol consumption and race/ethnicity on aortic calcification. Conclusions Our findings suggest that heavy alcohol consumption may be an independent risk factor for atherosclerosis.
  • Toshiyuki Iwahori, Hirotsugu Ueshima, Naoto Ohgami, Hideyuki Yamashita, Naoko Miyagawa, Keiko Kondo, Sayuki Torii, Katsushi Yoshita, Toshikazu Shiga, Takayoshi Ohkubo, Hisatomi Arima, Katsuyuki Miura
    Journal of Epidemiology 28 1 41 - 47 2018年 [有り][無し]
     研究論文(学術雑誌) 
    Background: Reducing the urinary sodium-to-potassium ratio is important for reducing both blood pressure and risk of cardiovascular disease. Among free-living Japanese individuals, we carried out a randomized trial to clarify the effect of lifestyle modification for lowering urinary sodium-to-potassium ratio using a self-monitoring device. Methods: This was an open, prospective, parallel randomized, controlled trial. Ninety-two individuals were recruited from Japanese volunteers. Participants were randomly allocated into intervention and control groups. A month-long dietary intervention on self-monitoring urinary sodium-to-potassium ratio was carried out using monitors (HEU-001F, OMRON Healthcare Co., Ltd., Kyoto, Japan). All participants had brief dietary education and received a leaflet as usual care. Monitors were handed out to the intervention group, but not to the control group. The intervention group was asked to measure at least one spot urine sodium-to-potassium ratio daily, and advised to lower their sodium-to-potassium ratio toward the target of less than 1. Outcomes included changes in 24-hour urinary sodium-to-potassium ratio, sodium excretion, potassium excretion, blood pressure, and body weight in both groups. Results: Mean measurement frequency of monitoring was 2.8 times/day during the intervention. Changes in urinary sodium-to-potassium ratio were –0.55 in the intervention group and –0.06 in the control group (P = 0.088) respective sodium excretion changes were –18.5 mmol/24 hours and –8.7 mmol/24 hours (P = 0.528) and corresponding potassium excretion was 2.6 mmol/24 hours and –1.5 mmol/24 hours (P = 0.300). No significant reductions were observed in either blood pressure or body weight after the intervention. Conclusions: Providing the device to self-monitor a sodium-to-potassium ratio did not achieve the targeted reduction of the ratio in “pure self-management” settings, indicating further needs to study an effective method to enhance the synergetic effect of dietary programs and self-monitoring practice to achieve the reduction. However, we cannot deny the possibility of reducing sodium-to-potassium ratio using a self-monitoring device.
  • Sentaro Suzuki, Hisatomi Arima, Soichiro Miyazaki, Akira Fujiyoshi, Aya Kadota, Naoyuki Takashima, Takashi Hisamatsu, Sayaka Kadowaki, Maryam Zaid, Sayuki Torii, Minoru Horie, Kiyoshi Murata, Katsuyuki Miura, Hirotsugu Ueshima
    Journal of Atherosclerosis and Thrombosis 25 2 186 - 198 2018年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: There are few data regarding associations between sleep duration and subclinical atherosclerosis in Japan. The aim of this study was to evaluate associations of self-reported sleep duration with calcification in the coronary arteries (CAC) and carotid intima media thickness (IMT) in Japanese men. Methods: This was a cross-sectional survey of 1093 randomly selected men from Kusatsu City, Japan. Average sleep duration on weekdays was estimated through questionnaire CAC by computed tomography and carotid IMT by ultrasonography. Results: The prevalence of CAC was 50.0% for participants with sleep duration<5.5 h, 43.9% with 5.5 – 6.4 h, 50.0% with 6.5 –7.4 h, 49.3% with 7.5–8.4 h, and 62.5% with ≥8.5 h. In univariate analysis, participants with sleep duration ≥8.5 h had significantly higher prevalence of CAC than those with 6.5–7.4 h (p=0.043). After adjustment for age and other risk factors, however, the association was not significant (p=0.776). The average IMT was 0.85 mm for participants with sleep duration<5.5 h, 0.83 mm with 5.5–6.4 h, 0.85 mm with 6.5–7.4 h, 0.88 mm with 7.5–8.4 h, and 0.90 mm with ≥ 8.5 h. None of the differences in IMT observed in crude or multivariable-adjusted analyses was significant (all p>0.1). Conclusion: Self-reported sleep duration was not associated with increased CAC or carotid IMT in a general population of Japanese men.
  • Naoyuki Takashima, Hisatomi Arima, Yoshikuni Kita, Takako Fujii, Naomi Miyamatsu, Masaru Komori, Yoshihisa Sugimoto, Satoru Nagata, Katsuyuki Miura, Kazuhiko Nozaki
    CIRCULATION JOURNAL 81 11 1636 - + 2017年11月 [有り][無し]
     研究論文(学術雑誌) 
    Background: This study determined the current status of the incidence, management, and prognosis of stroke in Japan using a population-based stroke registry. Methods and Results: Shiga Stroke Registry is an ongoing population-based registry that covers approximately 1.4 million residents of Shiga Prefecture. Cases of acute stroke were identified using standard definitions through surveillance of both all acute-care hospitals with neurology/neurosurgery facilities and death certificates in 2011. A total of 2,956 stroke cases and 2,176 first-ever stroke cases were identified. The age-and sex-adjusted incidence rate for first-ever stroke using the 2013 European Standard Population as standard was per 100,000 person-years: 91.3 for ischemic stroke, 36.4 for intracerebral hemorrhage, and 13.7 for subarachnoid hemorrhage. It was estimated that approximately 220,000 new strokes occurred in 2011 in Japan. Among the 2,956 cases, most stroke patients underwent neuroimaging, 268 received surgical or endovascular treatment, and 2,158 had rehabilitation therapy; 78 patients received intravenous thrombolysis. A total of 1,846 stroke patients had died or were dependent at hospital discharge, and 390 died within 28 days of onset. Conclusions: Incidence rates of stroke by subtypes were clarified and the total number of new strokes in Japan was estimated. More than half of stroke patients die or become dependent after a stroke. This study re-emphasized the importance of public health measures in reducing the burden of stroke in Japan.
  • Toshiyuki Iwahori, Katsuyuki Miura, Hirotsugu Ueshima, Queenie Chan, Alan R. Dyer, Paul Elliott, Jeremiah Stamler
    INTERNATIONAL JOURNAL OF EPIDEMIOLOGY 46 5 1564 - 1572 2017年10月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Association between casual and 24-h urinary sodium-to-potassium (Na/K) ratio is well recognized, although it has not been validated in diverse demographic groups. Our aim was to assess utility across and within populations of casual urine to estimate 24-h urinary Na/K ratio using data from the INTERSALT Study. Methods: The INTERSALT Study collected cross-sectional standardized data on casual urinary sodium and potassium and also on timed 24-h urinary sodium and potassium for 10 065 individuals from 52 population samples in 32 countries (1985-87). Pearson correlation coefficients and agreement were computed for Na/K ratio of casual urine against 24-h urinary Na/K ratio both at population and individual levels. Results: Pearson correlation coefficients relating means of 24-h urine and casual urine Na/K ratio were r = 0.96 and r = 0.69 in analyses across populations and individuals, respectively. Correlations of casual urine Na/creatinine and K/creatinine ratios with 24-h urinary Na and K excretion, respectively, were lower than correlation of casual and 24-h urinary Na/K ratio in analyses across populations and individuals. The bias estimate with the Bland-Altman method, defined as the difference between Na/K ratio of 24-h urine and casual urine, was approximately 0.4 across both populations and individuals. Spread around, the mean bias was higher for individuals than populations. Conclusion: With appropriate bias correction, casual urine Na/K ratio may be a useful, low-burden alternative method to 24-h urine for estimation of population urinary Na/K ratio. It may also be applicable for assessment of the urinary Na/K ratio of individuals, with use of repeated measurements to reduce measurement error and increase precision.
  • Midori Sasaki Yatabe, Toshiyuki Iwahori, Ami Watanabe, Kozue Takano, Hironobu Sanada, Tsuyoshi Watanabe, Atsuhiro Ichihara, Robin A. Felder, Katsuyuki Miura, Hirotsugu Ueshima, Junko Kimura, Junichi Yatabe
    NUTRIENTS 9 9 2017年09月 [有り][無し]
     研究論文(学術雑誌) 
    The Na/K ratio is considered to be a useful index, the monitoring of which allows an effective Na reduction and K increase, because practical methods (self-monitoring devices and reliable individual estimates from spot urine) are available for assessing these levels in individuals. An intervention trial for lowering the Na/K ratio has demonstrated that a reduction of the Na/K ratio mainly involved Na reduction, with only a small change in K. The present study aimed to clarify the relationship between dietary Na intake and the urinary Na/K molar ratio, using standardized low- and high-salt diets, with an equal dietary K intake, to determine the corresponding Na/K ratio. Fourteen healthy young adult volunteers ingested low-salt (3 g salt per day) and high-salt (20 g salt per day) meals for seven days each. Using a portable urinary Na/K meter, participants measured their spot urine at each voiding, and 24-h urine was collected on the last day of each diet period. On the last day of the unrestricted, low-salt, and high-salt diet periods, the group averages of the 24-h urine Na/K ratio were 4.2, 1.0, and 6.9, while the group averages of the daily mean spot urine Na/K ratio were 4.2, 1.1, and 6.6, respectively. The urinary Na/K ratio tracked changes in dietary salt intake, and reached a plateau approximately three days after each change in diet. Frequent monitoring of the spot urine Na/K ratio may help individuals adhere to an appropriate dietary Na intake.
  • 日本人男性の地域在住被験者における喫煙と関連する冠動脈硬化性の高発症率および進行度 The Shiga Epidemiological Study of Subclinical Atherosclerosis(SESSA)(Smoking associates with higher incidence and progression of coronary atherosclerosis in a community-based sample of Japanese men: The Shiga Epidemiological Study of Subclinical Atherosclerosis(SESSA))
    Pham Tai, Fujiyoshi Akira, Hisamatsu Takashi, Kadota Aya, Kadowaki Sayaka, Zaid Maryam, Horie Minoru, Miura Katsuyuki, Ueshima Hirotsugu, for the SESSA Research Group
    日本アルコール・薬物医学会雑誌 52 4 239 - 239 2017年08月
  • Toshiyuki Iwahori, Hirotsugu Ueshima, Sayuki Torii, Yoshino Saito, Keiko Kondo, Sachiko Tanaka-Mizuno, Hisatomi Arima, Katsuyuki Miura
    HYPERTENSION RESEARCH 40 7 720 - 720 2017年07月 [有り][無し]
  • Toshiyuki Iwahori, Katsuyuki Miura, Hirotsugu Ueshima
    NUTRIENTS 9 7 2017年07月 [有り][無し]
     
    Pathogenetic studies have demonstrated that the interdependency of sodium and potassium affects blood pressure. Emerging evidences on the sodium-to-potassium ratio show benefits for a reduction in sodium and an increase in potassium compared to sodium and potassium separately. As presently there is no known review, this article examined the practical use of the sodium-to-potassium ratio in daily practice. Epidemiological studies suggest that the urinary sodium-to-potassium ratio may be a superior metric as compared to separate sodium and potassium values for determining the relation to blood pressure and cardiovascular disease risks. Higher correlations and better agreements are seen for the casual urine sodium-to-potassium ratio than for casual urine sodium or potassium alone when compared with the 24-h urine values. Repeated measurements of the casual urine provide reliable estimates of the 7-day 24-h urine value with less bias for the sodium-to-potassium ratio as compared to the common formulas used for estimating the single 24-h urine from the casual urine for sodium and potassium separately. Self-monitoring devices for the urinary sodium-to-potassium ratio measurement makes it possible to provide prompt onsite feedback. Although these devices have been evaluated with a view to support an individual approach for sodium reduction and potassium increase, there has yet to be an accepted recommended guideline for the sodium-to-potassium ratio. This review concludes with a look at the practical use of the sodium-to-potassium ratio for assistance in practical sodium reduction and potassium increase.
  • Toshiyuki Iwahori, Hirotsugu Ueshima, Sayuki Torii, Yoshino Saito, Keiko Kondo, Sachiko Tanaka-Mizuno, Hisatomi Arima, Katsuyuki Miura
    HYPERTENSION RESEARCH 40 7 658 - 664 2017年07月 [有り][無し]
     研究論文(学術雑誌) 
    High sodium-to-potassium ratios are associated with elevated blood pressure levels and an increased risk of cardiovascular diseases. We aimed to determine whether urinary sodium-to-potassium ratios fluctuate diurnally during the day to understand measured values of casual urinary sodium-to-potassium ratios. A total of 13,277 casual urine specimens were collected under free-living conditions from 122 Japanese normotensive and hypertensive individuals. Participants collected all casual urine samples in aliquot tubes, reported urine volumes and the time at each voiding for 10-22 days. Then, specimens were classified into hourly data. Diurnal patterns of urinary sodium-to-potassium ratios and urinary concentrations of sodium and potassium were evaluated. Overall mean values of hourly urinary sodium-to-potassium ratios were highest (4.1-5.0) in the early morning, lower (3.3-3.8) in the daytime and higher (4.0-4.4) toward evening hours. The mean urinary sodium and potassium concentrations were the lowest (90-110 and 24-32 mmol l(-1), respectively) during the early morning and higher (110-140 and 35-43 mmol l(-1), respectively) after mid-morning. Diurnal variability of potassium concentrations was larger than for sodium concentrations. Diurnal variations in urinary sodium-to-potassium ratios were comparable between normotensive and hypertensive individuals, between hypertensive individuals with and without antihypertensive medications, and among age and gender-specific subgroups. Overall mean hourly urinary sodium-to-potassium ratios fluctuated diurnally under free-living conditions and were higher during the morning and evening and lower during the daytime compared with 24-h urinary sodium-to-potassium ratios. Diurnal variation in urinary sodium-to-potassium ratios should be considered to understand actual daily dietary levels and avoid over-and under-estimation in clinical practice.
  • Takumi Hirata, Daisuke Sugiyama, Shin-Ya Nagasawa, Yoshitaka Murakami, Shigeyuki Saitoh, Akira Okayama, Hiroyasu Iso, Fujiko Irie, Toshimi Sairenchi, Yoshihiro Miyamoto, Michiko Yamada, Shizukiyo Ishikawa, Katsuyuki Miura, Hirotsugu Ueshima, Tomonori Okamura
    European journal of epidemiology 32 7 547 - 557 2017年07月 [有り][無し]
     研究論文(学術雑誌) 
    Low levels of serum high-density lipoprotein cholesterol (HDL-C) have been shown to be associated with increased risk of coronary heart disease (CHD). However, because this is usually observed in the context of other lipid abnormalities, it is not known whether isolated low serum HDL-C levels are an independent risk factor for CHD. We performed a large pooled analysis in Japan using data from nine cohorts with 41,206 participants aged 40-89 years who were free of cardiovascular disease at baseline. We divided participants into three groups: isolated low HDL-C, non-isolated low HDL-C, and normal HDL-C. Cohort-stratified Cox proportional hazards models were used to estimate multivariate-adjusted hazard ratios (HRs) for death due to CHD, ischemic stroke, and intracranial cerebral hemorrhage; during a 12.9-year follow-up, we observed 355, 286, and 138 deaths, respectively, in these groups. Non-isolated low HDL-C was significantly associated with increased risk of CHD compared with normal HDL-C (HR 1.37, 95 % confidence interval (CI) 1.04-1.80); however, isolated low HDL-C was not. Although isolated low HDL-C was significantly associated with decreased risk of CHD (HR 0.51, 95 % CI 0.29-0.89) in women, it was significantly associated with increased risk of intracranial cerebral hemorrhage in all participants (HR 1.62, 95 % CI 1.04-2.53) and in men (HR 2.00, 95 % CI 1.04-3.83). In conclusion, isolated low HDL-C levels are not associated with increased risk of CHD in Japan. CHD risk may, therefore, be more strongly affected by serum total cholesterol levels in this population.
  • 日本人一般男性における血中n-3系多価不飽和脂肪酸濃度と無症候性脳血管病変との関係
    近藤 慶子, 有馬 久富, 久松 隆史, 藤吉 朗, 門田 文, 関川 暁, 鳥居 さゆ希, 鈴木 仙太朗, 椎野 顯彦, 野崎 和彦, 宮川 尚子, 前川 聡, 村田 喜代史, 三浦 克之, 上島 弘嗣
    日本動脈硬化学会総会プログラム・抄録集 49回 195 - 195 (一社)日本動脈硬化学会 2017年06月
  • Keiko Kondo, Katsutaro Morino, Yoshihiko Nishio, Atsushi Ishikado, Hisatomi Arima, Keiko Nakao, Fumiyuki Nakagawa, Fumio Nikami, Osamu Sekine, Ken-ichi Nemoto, Makoto Suwa, Motonobu Matsumoto, Katsuyuki Miura, Taketoshi Makino, Satoshi Ugi, Hiroshi Maegawa
    PLOS ONE 12 6 e0179869  2017年06月 [有り][無し]
     研究論文(学術雑誌) 
    Background & Aims A fiber-rich diet has a cardioprotective effect, but the mechanism for this remains unclear. We hypothesized that a fiber-rich diet with brown rice improves endothelial function in patients with type 2 diabetes mellitus. Methods Twenty-eight patients with type 2 diabetes mellitus at a single general hospital in Japan were randomly assigned to a brown rice (n = 14) or white rice (n = 14) diet and were followed for 8 weeks. The primary outcome was changes in endothelial function determined from flow debt repayment by reactive hyperemia using strain-gauge plethysmography in the fasting state. Secondary outcomes were changes in HbA(1c), postprandial glucose excursions, and markers of oxidative stress and inflammation. The area under the curve for glucose after ingesting 250 kcal of assigned rice was compared between baseline (TO) and at the end of the intervention (T1) to estimate glucose excursions in each group. Results Improvement in endothelial function, assessed by fasting flow debt repayment (20.4% vs. -5.8%, p = 0.004), was significantly greater in the brown rice diet group than the white rice diet group, although the between-group difference in change of fiber intake was small (5.6 g/day vs. -1.2 g/day, p<0.0001). Changes in total, HDL-, and LDL-cholesterol, and urine 8-isoprostane levels did not differ between the two groups. The high-sensitivity C-reactive protein level tended to improve in the brown rice diet group compared with the white rice diet group (0.01 pg/L vs. -0.04 mu g/L, p = 0.063). The area under the curve for glucose was subtly but consistently lower in the brown rice diet group (TO: 21.4 mmol/L*h vs. 24.0 mmol/L*h, p = 0.043, Ti: 20.4 mmol/L*h vs. 23.3 mmol/L*h, p = 0.046) without changes in HbA(1c) Conclusions Intervention with a fiber-rich diet with brown rice effectively improved endothelial function, without changes in HbA(1c) levels, possibly through reducing glucose excursions.
  • Masato Nagai, Yoshitaka Murakami, Akiko Tamakoshi, Yutaka Kiyohara, Michiko Yamada, Shigekazu Ukawa, Takumi Hirata, Sachiko Tanaka, Katsuyuki Miura, Hirotsugu Ueshima, Tomonori Okamura
    Cancer causes & control : CCC 28 6 625 - 633 2017年06月 [有り][無し]
     研究論文(学術雑誌) 
    PURPOSE: The dose-response relationship between fasting blood glucose levels and risk of pancreatic cancer has been investigated, but the association between casual blood glucose levels and pancreatic cancer death has not been examined. We examined the association between casual and fasting blood glucose levels and death due to pancreatic cancer in Japanese. METHODS: We performed a pooled analysis of the individual Japanese including 46,387 participants aged 40-79 years from ten cohorts. Participants were classified into five groups: low normal, middle normal, high normal, prediabetes (casual blood glucose 140-199 mg/dl, or fasting blood glucose 110-125 mg/dl), and diabetes (casual blood glucose ≥200 mg/dl, fasting blood glucose ≥126 mg/dl, or anti-diabetic drug use). Low normal, middle normal, and high normal were defined according to tertiles of casual or fasting normal blood glucose levels. Hazard ratios (HRs) and 95% confidence intervals (CIs) for pancreatic cancer mortality were estimated stratifying casual and fasting blood glucose by cohort-stratified Cox proportional hazards regression analysis, with low normal (casual blood glucose <94 mg/dl, or fasting blood glucose <90 mg/dl) as a reference. RESULTS: Fasting blood glucose showed a dose-response relationship with pancreatic cancer mortality (p for trend = 0.005). After adjusting for covariates, HRs (95% CIs) were 2.83 (1.18-6.76) for prediabetes and 3.96 (1.56-10.08) for diabetes. However, there were no significant associations with casual blood glucose. These tendencies were observed after the exclusion of participants who were censored for the first 5 years of follow-up. CONCLUSIONS: Fasting blood glucose is a better predictor of pancreatic cancer death than casual blood glucose.
  • Nagako Okuda, Akira Okayama, Katsuyuki Miura, Katsushi Yoshita, Shigeyuki Saito, Hideaki Nakagawa, Kiyomi Sakata, Naoko Miyagawa, Queenie Chan, Paul Elliott, Hirotsugu Ueshima, Jeremiah Stamler
    EUROPEAN JOURNAL OF NUTRITION 56 3 1269 - 1280 2017年04月 [有り][無し]
     研究論文(学術雑誌) 
    Purpose It is often reported that Na intake levels are higher in Japan than in western countries. Detailed analysis of food intake and its association with Na intake are necessary for supporting further decreases in Na consumption in Japan. We investigated the association between Na and food intake by food group using data from the Japanese participants of the INTERMAP Study. Method Results from the Japanese participants of the INTERMAP Study who did not use antihypertensive medication and/or consume a reduced Na diet were used (531 men and 518 women, aged 40-59 years), obtained from four 24-h dietary recalls and two 24-h urine collections from each participant. We developed a classification system with 46 food group classifications; food consumption and Na intake from these groups were compared across quartiles of participants determined by 24-h urinary Na excretion per unit of body weight (UNa/BW). Results Average daily Na intake from Japanese high-Na foods was 2552 mg/day. Participants with a higher UNa/BW consumed a significantly greater amount of high-Na Japanese foods, such as salted fish (P= 0.001) and miso soup (P < 0.001). They also had greater amount of rice (P = 0.001). Participants with lower UNa/BW consumed a significantly greater amount of western foods, such as bread (P < 0.001) and milk and dairy products (P < 0.001). Conclusions Detailed analyses of various Japanese and western food intakes in addition to Na intake were performed. These results can be used to help draw up effective programs for the reduction in Na intake and prevention of prehypertension/hypertension in the Japanese population.
  • Aya Hirata, Tomonori Okamura, Daisuke Sugiyama, Kazuyo Kuwabara, Aya Kadota, Akira Fujiyoshi, Katsuyuki Miura, Nagako Okuda, Takayoshi Ohkubo, Akira Okayama, Hirotsugu Ueshima
    EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY 24 5 505 - 513 2017年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Studies have shown significant associations of chronic kidney disease (CKD) and diabetes mellitus (DM) with cardiovascular disease (CVD) mortality. The impact on the general population is an important public health issue. However, the population attributable fraction (PAF) of CVD because of CKD and/or DM in a general population is uncertain. Methods: We followed 7229 participants (age: >= 30 years) with no history of CVD in a Japanese community. We divided participants into four categories according to CKD and/or DM and calculated hazard ratios (HRs) of CVD mortality for each category using a Cox proportional hazards model adjusted for age, dyslipidemia, smoking and alcohol consumption. In addition, PAFs of CVD were estimated among populations with CKD and/or DM. Results: During 20-year follow-up, 488 participants died. HRs for CVD were 1.63 [ 95% confidence interval (CI): 1.16-2.30] with DM only, 1.42 (95% CI: 1.08-1.86) with CKD only and 2.37 (95% CI: 1.40-4.01) with CKD+DM. In men, the corresponding HRs for CVD were 1.88 (95% CI: 1.19-2.97), 1.71 (95% CI: 1.15-2.56) and 3.26 (95% CI: 1.69-6.30), respectively; the corresponding PAFs of CVD were 4.1%, 5.1% and 2.9%, respectively. PAFs for CVD among women were lower than those in men, 1.6% for DM only, 2.0% for CKD only and 0.7% for CKD+DM. Conclusions: PAFs of CVD mortality due to CKD and/or DM were not so high in past 20 years; however, they might increase in the future because of recent increase in prevalence of these in Japanese population.
  • Yoichiro Hirakawa, Toshiharu Ninomiya, Yutaka Kiyohara, Yoshitaka Murakami, Shigeyuki Saitoh, Hideaki Nakagawa, Akira Okayama, Akiko Tamakoshi, Kiyomi Sakata, Katsuyuki Miura, Hirotsugu Ueshima, Tomonori Okamura
    JOURNAL OF EPIDEMIOLOGY 27 3 123 - 129 2017年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Diabetes mellitus is a strong risk factor for cardiovascular disease. However, the age-specific association of diabetes with cardiovascular risk, especially in the elderly, remains unclear in non-Western populations. Methods: A pooled analysis was conducted using 8 cohort studies (mean follow-up period, 10.3 years) in Japan, combining the data from 38,854 individual participants without history of cardiovascular disease. In all, 1867 of the participants had diabetes, defined based on the 1998 World Health Organization criteria. The association between diabetes and the risk of death from cardiovascular disease, coronary heart disease (CHD), and stroke was estimated using a stratified Cox model, accounting for variability of baseline hazard functions among cohorts. Results: During the follow-up, 1376 subjects died of cardiovascular disease (including 268 of coronary heart disease and 621 of stroke). Diabetes was associated with an increased risk of cardiovascular death after multivariable adjustment (hazard ratio [HR] 1.62; 95% confidence interval [CI], 1.35-1.94). Similarly, diabetes was a risk factor for CHD (HR 2.13; 95% CI, 1.47-3.09) and stroke (HR 1.40; 95% CI, 1.05-1.85). In the age-stratified analysis of the risk of cardiovascular death, the relative effects of diabetes were consistent across age groups (p for heterogeneity =0.18), whereas the excess absolute risks of diabetes were greater in participants in their 70s and 80s than in younger subjects. Conclusions: The management of diabetes is important to reduce the risk of death from cardiovascular disease, not only in midlife but also in late life, in the Japanese population. (C) 2016 Publishing services by Elsevier B.V.
  • Atsushi Satoh, Hisatomi Arima, Takayoshi Ohkubo, Nobuo Nishi, Nagako Okuda, Ryusuke Ae, Mariko Inoue, Shuji Kurita, Keiko Murakami, Aya Kadota, Akira Fujiyoshi, Kiyomi Sakata, Tomonori Okamura, Hirotsugu Ueshima, Akira Okayama, Katsuyuki Miura
    JOURNAL OF HYPERTENSION 35 2 401 - 408 2017年02月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: To investigate associations between socioeconomic status (SES) and prevalence, awareness, treatment, and control of hypertension in Japan's general population. Methods: In 2010, we established a cohort of participants in the National Health and Nutrition Survey of Japan. The cohort included 2623 adults from 300 randomly selected areas across Japan. Using baseline data, four cross-sectional analyses were performed: association of SES with prevalent hypertension in 2623 participants; association of SES with unawareness of hypertension and with no treatment in 1282 hypertensive patients; and association of SES with uncontrolled hypertension in 720 treated hypertensive patients. SES was classified according to employment status, length of education, marital and living status, and household expenditure. Results: The overall prevalence of hypertension was 48.9%. Among hypertensive participants, the proportions of unawareness and no treatment were 33.1 and 43.8%, respectively. Target blood pressure levels were not achieved among 61.2% of treated hypertensive patients. Hypertension was more prevalent in the unmarried and living alone group than in the married group (odds ratio 1.76; 95% confidence interval 1.26-2.44), after adjustment for age, sex, BMI, smoking, alcohol consumption, habitual exercise, history of cardiovascular diseases, diabetes mellitus, hypercholesterolemia, dietary sodium, and potassium intake. SES was not clearly associated with unawareness, no treatment, nor poor control of hypertension. Conclusion: Being unmarried and living alone was associated with increased prevalence of hypertension. There was no clear association of SES with unaware, untreated, and uncontrolled hypertension.
  • Vasudha Ahuja, Kamal Masaki, Abhishek Vishnu, Lei Ye, Bradley Wilcox, Christina Wassel, Akira Fujiyoshi, Emma J. M. Barinas-Mitchell, Katsuyuki Miura, Hirotsuga Ueshima, Beatriz L. Rodriguez, Daniel Edmundowicz, Akira Sekikawa
    INTERNATIONAL JOURNAL OF CARDIOLOGY 228 672 - 676 2017年02月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Progression of coronary artery calcium(CAC) is associated with increased risk of coronary heart disease (CHD) and is reported to be greater in whites than blacks, Hispanics, and Chinese in the US. Our objective was to compare progression of CAC between Japanese Americans and whites. Methods: Population-based sample of 303 Japanese Americanmen and 310 white men aged 40-49 years, free of clinical cardiovascular disease at baseline, were examined for CAC at baseline (2004-2007) and follow-up (20082013). Progression of CAC was defined as change in coronary calcium scores (CCS) in participants with baseline CCS > 0 and incident CAC in participants with baseline CCS = 0. Multiple linear regression and relative risk regression were used to compare change in CCS scores and incident CAC between the two races, respectively. Results: Japanese American men had significantly greater annual change in CCS than white men (median [interquartile range]: 11.3Agatston units [1.4, 24.9] vs 2.5 [-0.22, 14.5]) in the unadjusted analyses. After adjusting for cardiovascular risk factors and follow-up time, change in CCS (beta +/- CI) and incidence rate ratio of CAC was similar in Japanese American men and white men:-0.12 (-0.34, 0.15) and (0.87 [95% CI: 0.20, 3.9]), respectively. Conclusions: In contrast to previously reported greater progression of CAC inwhites than other races, we found a similar progression of CAC in Japanese Americanmen as white men. Our study identifies Japanese American men as a target group for prevention of CHD. Large prospective studies are warranted to confirm these findings. (C) 2016 Published by Elsevier Ireland Ltd.
  • 糖尿病発症および75歳未満の循環器疾患死亡の予測要因の検討
    三浦克之, 櫻井 勝, 高嶋直敬, 佐藤 敦
    NIPPON DATA80およびYKKスタディ.厚生労働省科学研究費補助金循環器疾患・糖尿病等生活習慣病対策総合研究事業:「健康診査・保健指導の有効性評価に関する研究」 平成28年度 総括・分担研究報告書(研究代表者 永井良三) - 27 - 32 2017年 [無し][無し]
  • Skipping breakfast and 5-year changes in body mass index and waist circumference in Japanese men and women
    M.Sakurai, K.Yoshita, K.Nakamura, K.Miura, T.Takamura, S-Y.Nagasawa, Y.Morikawa, T.Kido, Y.Naruse, K.Nogawa, Y.Suwazono, S.Sasaki, M.Ishizaki, H.Nakagawa
    Obesity Science & Practice 3 2 162 - 170 2017年 [有り][無し]
  • 三大栄養素摂取量と社会経済学的要因の検討
    櫻井 勝, 中川秀昭, 門田 文, 由田克士, 中村保幸, 奥田奈賀子, 西 信雄, 宮本恵宏, 有馬久富, 大久保孝義, 岡村智教, 上島弘嗣, 岡山 明, 三浦克之
    NIPPON DATA2010. 厚生労働行政推進調査事業費補助金(循環器疾患・糖尿病等生活習慣病対策総合研究事業)社会的要因を含む生活習慣病リスク要因の解明を目指した国民代表集団の大規模コホート研究:NIPPON DATA80/90/2010 平成28年度総括・分担研究報告書(研究代表者 三浦克之) - 61 - 64 2017年 [無し][無し]
  • 富山職域コホート研究
    中川秀昭, 櫻井 勝, 長澤晋哉, 森河裕子, 中村幸志, 三浦克之
    厚生労働省科学研究費補助金循環器疾患等生活習慣病対策政策研究事業:「循環器疾患における集団間の健康格差の実態把握とその対策を目的とした大規模コホート共同研究」 平成28年度総括・分担研究報告書(研究代表者 岡村智教) - 119 - 123 2017年 [無し][無し]
  • 富山職域コホート研究
    中川秀昭, 櫻井 勝, 長澤晋哉, 森河裕子, 中村幸志, 三浦克之
    厚生労働省科学研究費補助金循環器疾患等生活習慣病対策政策研究事業:「循環器疾患における集団間の健康格差の実態把握とその対策を目的とした大規模コホート共同研究」 平成26-28年度 総合研究報告書(研究代表者 岡村智教) - 167 - 175 2017年 [無し][無し]
  • Nakamura K, Sakurai M, Morikawa Y, Nagasawa SY, Miura K, Ishizaki M, Kido T, Naruse Y, Nakashima M, Nogawa K, Suwazono Y, Nakagawa H
    Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association 125 1 12 - 20 2017年01月 [有り][無し]
     研究論文(学術雑誌) 
    Objectives: The present cohort study investigated the relationship between serum ferritin levels and indices of insulin resistance and beta-cell dysfunction in a normoglycemic population without iron overload disorders. Methods: The study participants included 575 normoglycemic Japanese men aged 35-57 years with serum ferritin levels of 400 mu g/L or less. Insulin resistance and beta-cell dysfunction were estimated at baseline and after 3 years by the homeostasis model assessments of insulin resistance and beta-cell function (HOMA-IR and HOMA-beta, respectively). To compare the subsequent changes in HOMA-IR and HOMA-beta over a 3-year follow-up period among 3 groups based on tertiles of baseline serum ferritin levels (4.9-87.1, 87.2-140.5, and 140.6-396.8 mu g/L), the geometric mean HOMA-IR and HOMA-beta values at year 3 were calculated for each group using analysis of covariance, incorporating the respective log-transformed parameters at baseline in addition to age, body mass index and major confounding factors. Results: The multivariate-adjusted geometric mean HOMA-IR at year 3 was significantly higher in those in the highest and middle serum ferritin tertiles (1.24 and 1.22, respectively), compared with the lowest tertile (1.07) (p = 0.009). When the total study participants were stratified by median body mass index (22.72 kg/m(2)), similar positive relationships were observed between serum ferritin levels and HOMA-IR for both obese and non-obese participants. However, the adjusted geometric mean HOMA-beta at year 3 was similar among the 3 serum ferritin groups. Conclusions: Elevated serum ferritin levels predicted a subsequent increase in HOMA-IR in normoglycemic Japanese men without iron overload disorders.
  • Takahiro Ito, Sachiko Tanaka-Mizuno, Narihito Iwashita, Ikuo Tooyama, Akihiko Shiino, Katsuyuki Miura, Sei Fukui
    JOURNAL OF PAIN RESEARCH 10 10 287 - 293 2017年 [有り][無し]
     研究論文(学術雑誌) 
    Background: Chronic pain is a common cause of reduced quality of life. Recent studies suggest that chronic pain patients have a different brain neurometabolic status to healthy people. Proton magnetic resonance spectroscopy (H-1-MRS) can determine the concentrations of metabolites in a specific region of the brain without being invasive. Patients and methods: We recruited 56 chronic pain patients and 60 healthy controls to compare brain metabolic characteristics. The concentrations of glutamic acid (Glu), myo-inositol (Ins), N-acetylaspartate (NAA), Glu + glutamine (Glx), and creatine + phosphocreatine (total creatine [tCr]) in the anterior cingulate cortex of participants were measured using (II)-I-1-MRS. We used age-and gender-adjusted general linear models and receiver-operating characteristic analyses for this investigation. Patients were also assessed using the Hospital Anxiety and Depression Scale (HADS) to reveal the existence of any mental health issues. Results: Our analysis indicates that pain patients have statistically significantly higher levels of Glu/tCr (p=0.039) and Glx/tCr (p<0.001) and lower levels of NAA/tCr than controls, although this did not reach statistical significance (p=0.052). Receiver-operating characteristic analysis performed on the combination of Glx/tCr, Ins/tCr, and NAA/tCr effectively discriminated chronic pain patients from healthy controls. Patients with higher HADS-Depression scores had increased Glx/rCr levels (p=0.015), and those with higher HADS-Anxiety scores had increased NAA/tCr levels (p=0.018). Conclusion: Chronic pain patients have a different metabolite status in the anterior cingulate cortex to controls. Within the pain patient group, HADS scores had a positive relationship with NAA/tCr and Glx/tCr levels. 1H-MRS successfully detected metabolic changes in patients' brains in a noninvasive manner, revealing its potential as a superior diagnostic tool for pain patients.
  • Tatsuya Koyama, Katsushi Yoshita, Nagako Okuda, Shigeyuki Saitoh, Kiyomi Sakata, Akira Okayama, Hideaki Nakagawa, Naoko Miyagawa, Katsuyuki Miura, Queenie Chan, Paul Elliott, Jeremiah Stamler, Hirotsugu Ueshima
    ASIA PACIFIC JOURNAL OF CLINICAL NUTRITION 26 5 837 - 848 2017年 [有り][無し]
     研究論文(学術雑誌) 
    Background and Objectives: Total fat intake is linked to the intake of other nutrients. Little data are available on the extent to which total fat affects diet quality in Japanese people. We investigated the relationship between total fat intake and other nutrient intake using INTERLIPID/INTERMAP data on Japanese people living in Japan. Methods and Study Design: The participants included 371 men and 401 women with a healthy body mass index and between the ages of 40 and 59 from 4 population samples in Japan. Nutrient intake data were based on four in-depth 24-hour dietary recalls per person. Results: Analysis of covariance adjusted for age revealed that total fat intake was positively related to intakes of calcium, thiamine, riboflavin, meat, eggs, and milks and dairy products for both sexes. Total fat intake was inversely associated with carbohydrate and cereals intake for both sexes. On average, men with total fat intake between 25.0 and 27.4% of total energy had saturated fatty acids above 7%, which is the upper limit recommended for preventing lifestyle-related diseases. Men with total fat intake less than 20% of total energy had a higher risk of not meeting the Dietary Reference Intakes for Japanese (2015) for some nutrients. Conclusions: Total fat intake was positively associated with calcium, thiamine, and riboflavin intakes and inversely associated with carbohydrate intake. Our results suggest that in 40-59-year-old men with a healthy body mass index, total fat intake between 20 and 27% of total energy may best support adequate intake of other nutrients.
  • Vasudha Ahuja, Katsuyuki Miura, Abhishek Vishnu, Akira Fujiyoshi, Rhobert Evans, Maryam Zaid, Naoko Miyagawa, Takashi Hisamatsu, Aya Kadota, Tomonori Okamura, Hirotsugu Ueshima, Akira Sekikawa
    BRITISH JOURNAL OF NUTRITION 117 2 260 - 266 2017年01月 [有り][無し]
     研究論文(学術雑誌) 
    Equol, a metabolite of the dietary isoflavone daidzein, is produced by the action of gut bacteria in some individuals who are termed as equol-producers. It is proposed to have stronger atheroprotective properties than dietary isoflavones. We examined a cross-sectional association of dietary isoflavones and equol-producer status with coronary artery calcification (CAC), a biomarker of coronary atherosclerosis, among men in Japan. A population-based sample of 272 Japanese men aged 40-49 years recruited from 2004 to 2007 was examined for serum isoflavones, serum equol, CAC and other factors. Equol-producers were classified as individuals having a serum level of equol >83 nm. The presence of CAC was defined as a coronary Ca score 10 Agatston units. The associations of dietary isoflavones and equol-producers with CAC were analysed using multiple logistic regression. The median of dietary isoflavones, equol and CAC were 5127 (interquartile range (IQR) 1941, 11700), 91 (IQR 010, 331) and 00 (IQR 00, 10) nm, respectively. Prevalence of CAC and equol-producers was 96 and 160 %, respectively. Dietary isoflavones were not significantly associated with CAC. After multivariable adjustment, the OR for the presence of CAC in equol-producers compared with equol non-producers was 010 (95 % CI 001, 090, P<004). Equol-producers had significantly lower CAC than equol non-producers, but there was no significant association between dietary isoflavones and CAC, suggesting that equol may be a key factor for atheroprotective properties of isoflavones in Japanese men. This finding must be confirmed in larger studies or clinical trials of equol that is now available as a dietary supplement.
  • Maryam Zaid, Akira Fujiyoshi, Aya Kadota, Robert D. Abbott, Katsuyuki Miura
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 24 3 227 - 239 2017年 [有り][無し]
     
    Atherosclerosis begins in early life and has a long latent period prior to onset of clinical disease. Measures of subclinical atherosclerosis, therefore, may have important implications for research and clinical practice of atherosclerotic cardiovascular disease (ASCVD). In this review, we focus on coronary artery calcium (CAC) and carotid artery intima-media thickness (cIMT) and plaque as many population-based studies have investigated these measures due to their non-invasive features and ease of administration. To date, a vast majority of studies have been conducted in the US and European countries, in which both CAC and cIMT/plaque have been shown to be associated with future risk of ASCVD, independent of conventional risk factors. Furthermore, these measures improve risk prediction when added to a global risk prediction model, such as the Framingham risk score. However, no clinical trial has assessed whether screening with CAC or cIMT/plaque will lead to improved clinical outcomes and healthcare costs. Interestingly, similar levels of CAC or cIMT/plaque among various regions and ethnic groups may in fact be associated with significantly different levels of absolute risk of ASCVD. Therefore, it remains to be determined whether measures of subclinical atherosclerosis improve risk prediction in non-US/European populations. Although CAC and cIMT/plaque are promising surrogates of ASCVD in research, we conclude that their use in clinical practice, especially as screening tools for primary prevention in asymptomatic adults, is premature due to many vagaries that remain to be clarified.
  • Jingchuan Guo, Akira Fujiyoshi, Bradley Willcox, Jina Choo, Abhishek Vishnu, Takashi Hisamatsu, Vasudha Ahuja, Naoyuki Takashima, Emma Barinas-Mitchell, Aya Kadota, Rhobert W. Evans, Katsuyuki Miura, Daniel Edmundowicz, Kamal Masaki, Chol Shin, Lewis H. Kuller, Hirotsugu Ueshima, Akira Sekikawa
    HYPERTENSION 69 1 102 - 108 2017年01月 [有り][無し]
     研究論文(学術雑誌) 
    Arterial stiffness is established as an independent predictor of cardiovascular morbidity and mortality. The objective was to prospectively evaluate association of aortic calcification burden with progression of arterial stiffness in population-based samples of healthy middle-aged men from ERA JUMP cohort (Electron-Beam Computed Tomography and Risk Factor Assessment in Japanese and US Men in the Post-World War II Birth Cohort). Men (n=635) aged 40 to 49 years (207 white American, 45 black American, 142 Japanese American, and 241 Japanese in Japan) were examined at baseline and 4 to 7 years later. Aortic calcification was evaluated from level of aortic arch to iliac bifurcation. Arterial stiffness progression was measured as annual change in brachial-ankle pulse wave velocity. Multivariable-adjusted general linear models were applied to investigate associations of longitudinal change in aortic calcification with arterial stiffness progression in participants overall, as well as in subgroups without or with prevalent aortic calcification at baseline. Annual change in aortic calcification was positively and significantly associated with arterial stiffness progression. In participants with annual changes in aortic calcium score of 0, 1 to 10, 11 to 100, and >100, the adjusted means (SD) for the annual change in brachial-ankle pulse wave velocity were 3.8 (2.2), 7.2 (2.2), 12.2 (1.8), and 15.6 (2.6) cm/s, respectively (P for trend <0.01) adjusted for baseline aortic calcification, arterial stiffness, and standard cardiovascular risk factors. Arterial stiffness was associated with the incidence of aortic calcification over the follow-up period among participants without aortic calcification (n=297) and with an increase in aortic calcification among participants with prevalent aortic calcification at baseline (n=388). Our findings suggest aortic calcification may be causally linked to arterial stiffness.
  • Jingchuan Guo, Akira Fujiyoshi, Kamal Masaki, Abhisek Vishnu, Aya Kadota, Emma J. M. Barinas-Mitchell, Takashi Hisamatsu, Vasudha Ahuja, Naoyuki Takashima, Rhobert W. Evans, Bradley J. Willcox, Katsuyuki Miura, Beatriz Rodriguez, Hirotsugu Ueshima, Lewis H. Kuller, Akira Sekikawa
    JOURNAL OF HYPERTENSION 35 1 111 - 117 2017年01月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: A few studies have examined the longitudinal association of blood pressure (BP) with arterial stiffness progression, and the results were inconsistent. The objective of this study was to investigate the roles of initial BP and its longitudinal change on the progression of arterial stiffness measured using brachial-ankle pulse wave velocity (baPWV). Method: Study participants (n = 656) were from population-based samples of healthy men aged 40-49 years at baseline (213 White Americans, 47 AfricanAmericans, 152 Japanese Americans and 244 Japanese in Japan). BP measures, baPWV and other factors were examined at baseline and 4-7 years later. General linear regression was applied for statistical analyses. Result: Annual change in SBP (standardized coefficient: 0.33, P<0.001), but not its baseline level (standardized coefficient: 0.03, P = 0.495), had a positive significant association with the progression of baPWV after adjusting for a wide range of standard cardiovascular risk factors. Similarly, annual changes in DBP (standardized coefficient: 0.35, P<0.001), pulse pressure (standardized coefficient: 0.15, P = 0.001) and mean arterial pressure (standardized coefficient: 0.37, P<0.001) were positively associated with the progression of baPWV. None of the baseline measures were related to the progression of baPWV. Conclusion: Our findings imply that, regardless of initial BP, effective monitoring and controlling of BP is important to slow down arterial wall stiffening and hence reduce cardiovascular risk.
  • Akira Fujiyoshi, Katsuyuki Miura, Sayaka Kadowaki, Koichiro Azuma, Sachiko Tanaka, Takashi Hisamatsu, Hisatomi Arima, Aya Kadota, Naoko Miyagawa, Naoyuki Takashima, Takayoshi Ohkubo, Yoshino Saitoh, Sayuki Torii, Itsuko Miyazawa, Hiroshi Maegawa, Kiyoshi Murata, Hirotsugu Ueshima
    Preventive medicine reports 4 225 - 32 2016年12月 [有り][無し]
     研究論文(学術雑誌) 
    Studies from Western countries suggest that smokers tend to display greater abdominal obesity than non-smokers, despite showing lower weight. Whether this holds true in a leaner population requires clarification. Using indices of abdominal obesity including visceral adipose tissue, we examined whether lifetime cigarette smoking is associated with unfavorable fat distribution among Japanese men. From 2006 to 2008, we conducted a cross-sectional investigation of a community-based sample of Japanese men at 40-64 years old, free of cardiovascular diseases and cancer. Areas of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated using computed tomography. We divided participants into four groups: never-smokers; and tertiles of pack-years of smoking among ever-smokers. Using multivariable linear regression, we calculated adjusted means of obesity indices (VAT, SAT, VAT-SAT ratio [VSR], and waist-hip ratio [WHR]) for each group, and mean differences between consecutive groups. We analyzed 513 men (median age, 58.2 years; current smokers, 40.1%). Two-thirds showed body mass index (BMI) < 25 kg/m(2) (median, 23.5 kg/m(2)). Overall, greater lifetime smoking group was associated with greater WHR and VSR. On average, one higher smoking group was associated with 0.005 higher WHR (95% CI, 0.001-0.008; P = 0.005) and 0.041 greater VSR (95% CI, 0.009-0.073; P = 0.012) after adjustment for potential confounders, including BMI. In this sample of relatively lean Japanese men, greater lifetime smoking was associated with a metabolically more adverse fat distribution. Although smoking is commonly associated with lower BMI, minimizing the amount of lifetime smoking should be advocated.
  • Yasuharu Tabara, Hirotsugu Ueshima, Naoyuki Takashima, Takashi Hisamatsu, Akira Fujiyoshi, Maryam Zaid, Masaki Sumi, Katsuhiko Kohara, Tetsuro Miki, Katsuyuki Miura
    ATHEROSCLEROSIS 254 242 - 248 2016年11月 [有り][無し]
     研究論文(学術雑誌) 
    Background and aims: While alcohol consumption is known to increase plasma high-density lipoprotein (HDL) cholesterol levels, its relationship with low-density lipoprotein (LDL) cholesterol levels is unclear. Aldehyde dehydrogenase 2 (ALDH2) is a rate-controlling enzyme in alcohol metabolism, but a large number of Japanese people have the inactive allele. Here, we conducted a Mendelian randomization analysis using the ALDH2 genotype to clarify a causal role of alcohol on circulating cholesterol levels and lipoprotein particle numbers. Methods: This study was conducted in three independent general Japanese populations (men, n = 2289; women, n = 1940; mean age 63.3 +/- 11.2 years). Alcohol consumption was assessed using a questionnaire. Lipoprotein particle numbers were determined by nuclear magnetic resonance spectroscopy. Results: Alcohol consumption increased linearly in proportion to the number of subjects carrying the enzymatically active *1 allele in men (p < 0.001). The *1 allele was also positively associated with HDL cholesterol level (adjusted mean +/- standard error, *1*1: 60 +/- 0.5, *1*2: 56 +/- 0.6, *2*2: 55 +/- 1.3 mg/dl, p < 0.001) and inversely associated with LDL cholesterol level (116 +/- 0.9, 124 +/- 1.1, 130 +/- 2.6 mg/dl, p < 0.001). The *1 allele was also positively associated with HDL particle numbers (per-allele: 2.60 +/- 0.32 mmol/l, p < 0.001) and inversely associated with LDL particle numbers (-67.8 +/- 19.6 nmol/l, p = 0.001). Additional Mendelian randomization analysis failed to clarify the involvement of cholesteryl ester transfer protein in alcohol-related changes in lipoprotein cholesterol levels. No significant association was observed in women, presumably due to their small amount of alcohol intake. Conclusions: Alcohol consumption has a causal role in not only increasing HDL cholesterol levels but also decreasing LDL cholesterol levels and particle numbers. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Maryam Zaid, Katsuyuki Miura, Akira Fujiyoshi, Robert D. Abbott, Takashi Hisamatsu, Aya Kadota, Hisatomi Arima, Sayaka Kadowaki, Sayuki Torii, Naoko Miyagawa, Sentaro Suzuki, Naoyuki Takashima, Takayoshi Ohkubo, Akira Sekikawa, Hiroshi Maegawa, Minoru Horie, Yasuyuki Nakamura, Tomonori Okamura, Hirotsugu Ueshima
    JOURNAL OF CLINICAL LIPIDOLOGY 10 5 1195 - 1202 2016年10月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Low-density lipoprotein particle (LDL-P) has recently been found to be a stronger predictor of cardiovascular disease (CVD) than LDL-cholesterol (LDL-C). OBJECTIVES: Whether LDL-P is associated with subclinical atherosclerosis, independent of LDLC, as well as other lipid measures has not been fully examined. We aimed to analyze LDL-P associations with measures of subclinical atherosclerosis. METHODS: We examined 870 Japanese men randomly selected from Kusatsu City, Shiga, Japan, aged 40-79 years from 2006-2008, free of clinical CVD and not using lipid-lowering medication. Cross-sectional associations of lipid measures with carotid intima-media thickness (cIMT) and coronary artery calcification (CAC; >0 Agatston score) were examined. RESULTS: LDL-P was significantly positively associated with cIMT and maintained this association after adjustments for LDL-C and other lipid measures. Although these lipid measures were positively associated with cIMT, model adjustment for LDL-P removed any significant relationships. Higher LDL-P was associated with a significantly higher odds ratio of CAC and further adjustment for LDL-C did not affect this relationship. In contrast, the LDL-C association with CAC was no longer significant after adjustment for LDL-P. Other lipid measures attenuated associations of LDL-P with CAC. Likewise, associations of these measures with CAC were attenuated when model adjustments for LDL-P were made. CONCLUSIONS: In a community-based sample of Japanese men, free of clinical CVD, LDL-P was a robust marker for subclinical atherosclerosis, independent of LDL-C and other lipid measures. Associations of LDL-C and other lipid measures with either cIMT or CAC were generally not independent of LDL-P. (C) 2016 National Lipid Association. All rights reserved.
  • Takahiro Ito, Hisatomi Arima, Akira Fujiyoshi, Katsuyuki Miura, Naoyuki Takashima, Takayoshi Ohkubo, Aya Kadota, Takehito Hayakawa, Yoshikuni Kita, Naoko Miyagawa, Akira Okayama, Tomonori Okamura, Hirotugu Ueshima
    INTERNATIONAL JOURNAL OF CARDIOLOGY 220 262 - 267 2016年10月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Non-high-density lipoprotein (HDL) cholesterol level, generally less affected by fasting status or serum triglyceride levels, may be useful for predicting future cardiovascular events in daily clinical practice. This study aimed to investigate the role of non-HDL cholesterol in the development of fatal coronary events and stroke in the general Japanese population. Methods and results: From the NIPPON DATA 90 prospective cohort study, 8383 participants were followed up for 20 years since 1990. After exclusion of 666 cases without lipid or covariates data, 561 cases who were 75 years old or older, 274 cases with history of cardiovascular disease, and 181 cases with lipid-lowering treatment, 6701 participants were included in this analysis. Non-HDL cholesterol was defined as total cholesterol minus HDL cholesterol. Outcomes were death from coronary heart disease and stroke. During the period, 69 participants died from coronary heart disease and 112 from stroke. Compared with participants with non-HDL cholesterol level b3.9 mmol/L, age- and sex-adjusted hazard ratios for mortality by coronary heart disease in those with non-HDL cholesterol levels of 3.9-4.3 mmol/L, 4.4-4.8 mmol/L and >= 4.9 mmol/L were 1.27 (95% confidence interval [CI] 0.65-2.49), 1.81 (95% CI 0.92-3.55) and 2.40 (95% CI 1.30-4.43), respectively (P trend = 0.010). This association remained significant even after adjusting for other cardiovascular risk factors (P trend = 0.010). There was no clear association between non-HDL cholesterol levels and mortality by stroke (P trend= 0.052). Conclusions: Among the general Japanese population, non-HDL cholesterol levels were clearly associated with future mortality by coronary heart disease, but not by stroke. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Takashi Hisamatsu, Katsuyuki Miura, Hisatomi Arima, Aya Kadota, Sayaka Kadowaki, Sayuki Torii, Sentaro Suzuki, Naoko Miyagawa, Atsushi Sato, Masahiro Yamazoe, Akira Fujiyoshi, Takayoshi Ohkubo, Takashi Yamamoto, Kiyoshi Murata, Robert D. Abbott, Akira Sekikawa, Minoru Horie, Hirotsugu Ueshima
    JOURNAL OF THE AMERICAN HEART ASSOCIATION 5 9 2016年09月 [有り][無し]
     研究論文(学術雑誌) 
    Background-Smoking is an overwhelming, but preventable, risk factor for cardiovascular diseases (CVD), although smoking prevalence remains high in developed and developing countries in East Asia. Methods and Results-In a population-based sample of 1019 Japanese men aged 40 to 79 years, without CVD, we examined cross-sectional associations of smoking status, cumulative pack-years, daily consumption, and time since cessation, with subclinical atherosclerosis at 4 anatomically distinct vascular beds, including coronary artery calcification, carotid intima-media thickness (CIMT) and plaque, aortic artery calcification (AoAC), and ankle-brachial index. Current, former, and never smoking were present in 32.3%, 50.0%, and 17.7%, respectively. Compared to never smokers, current smokers had significantly higher risks of subclinical atherosclerosis in all 4 circulations (eg, odds ratios for coronary artery calcification >0, 1.79 [95% CIs, 1.16-2.79]; CIMT >1.0 mm, 1.88 [1.02-3.47]; AoAC >0, 4.29 [2.30-7.97]; and ankle-brachial index <1.1, 1.78 [1.16-2.74]) and former smokers did in carotid and aortic circulations (CIMT >1.0 mm, 1.94 [1.13-3.34]; and AoAC >0, 2.55 [1.45-4.49]). Dose-response relationships of pack-years and daily consumption, particularly with CIMT, carotid plaque, AoAC, and ankle-brachial index, were observed among both current and former smokers, and even a small amount of pack-years or daily consumption among current smokers was associated with coronary artery calcification and AoAC, whereas time since cessation among former smokers was linearly associated with lower burdens of all atherosclerotic indices. Conclusions-Cigarette smoking was strongly associated with subclinical atherosclerosis in multiple vascular beds in Japanese men, and these associations attenuated with time since cessation.
  • Mitsuaki Sawano, Shun Kohsaka, Tomonori Okamura, Taku Inohara, Daisuke Sugiyama, Makoto Watanabe, Yasuyuki Nakamura, Aya Higashiyama, Aya Kadota, Nagako Okud, Yoshitaka Murakami, Takayoshi Ohkubo, Akira Fujiyoshi, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    ATHEROSCLEROSIS 252 116 - 121 2016年09月 [有り][無し]
     研究論文(学術雑誌) 
    Background and aims: The European Society of Cardiology developed prediction models (SCORE) for lowand high-risk populations in the European countries. However, whether or not these models are valid in different ethnicities is unknown. We aimed to evaluate the performance of the low-risk SCORE model in the general Japanese population. Methods: Healthy middle-aged Japanese participating in the NIPPON DATA80 cohort had been observed. The predicted 10-year cardiovascular death risk was calculated using the low-risk SCORE model for the overall population as well as for each gender individually. The model performance of the low-risk SCORE model was evaluated with the Harrel's c-statistics for discrimination and the Gronnesby and Borgan goodness-of-fit test for calibration. Results: A total of 4842 participants aged 40-64 years old and 47,606 person-years were evaluated in our study. 203 (4.19%) died within the ten-years of follow-up and 44 (0.91%) CV deaths were observed. The low-risk SCORE model in the overall population had reasonable discrimination (c statistics 0.72, 95% CI 0.71-0.73) but poor calibration (R-2, 0.67, Chi-square value 6.15, p = 0.01). Discrimination was reasonable in both men (c statistics 0.71, 95% CI 0.69e0.73) and women (c statistics 0.71, 95% CI 0.70-0.73). However, calibration was poor in men (R-2, 0.22, Chi-square value 0.749, p = 0.38) compared to women (R-2, 0.96, Chi-square value 1.39, p = 0.24). Conclusions: Although the low-risk SCORE model performs reasonably well in women, the SCORE models generally overestimated the risk of cardiovascular death risk in the Japanese general population. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Linda M. Oude Griep, Paraskevi Seferidi, Jeremiah Stamler, Linda Van Horn, Queenie Chan, Ioanna Tzoulaki, Lyn M. Steffen, Katsuyuki Miura, Hirotsugu Ueshima, Nagako Okuda, Liancheng Zhao, Sabita S. Soedamah-Muthu, Paul Elliott
    JOURNAL OF HYPERTENSION 34 9 1721 - 1729 2016年09月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Epidemiologic evidence suggests that relationships of red meat consumption with risk of cardiovascular diseases depends on whether or not the meat is processed, including addition of preservatives, but evidence is limited for blood pressure (BP). Objective: To examine cross-sectional associations with BP of unprocessed and processed red meat and poultry consumption, total and by type, using data from the international study on MAcro/micronutrients and blood Pressure. Design: international study on MAcro/micronutrients and blood Pressure included 4680 men and women ages 4059 years from 17 population samples in Japan, China, the United Kingdom, and the United States. During four visits, eight BP measurements, four multipass 24-h dietary recalls, and two timed 24-h urine samples were collected. Results: Average daily total unprocessed/processed meat consumption (g/1000 kcal) was 20/5 in East Asian and 38/21 in Western participants. Unprocessed meat intakes comprised red meat for 75% in East Asian and 50% in Western participants. In Westerners, multiple linear regression analyses showed SBP/DBP differences for total unprocessed red meat consumption higher by 25 g/1000 kcal R0.74/R0.57mmHg (P = 0.03/0.01) and for unprocessed poultry of R0.79/R0.16mmHg (P = 0.02/0.50). Unprocessed red meat was not related to BP in East Asian participants. In Westerners, SBP/DBP differences for processed red meat higher by 12.5 g/1000 kcal were R1.20/R0.24mmHg (P< 0.01/0.24), due to consumption of cold cuts and sausages (R1.59/R0.32mmHg, P< 0.001/0.27). Conclusion: These findings are consistent with recommendations to limit meat intake (processed and unprocessed) to maintain and improve cardiovascular health.
  • Mana Kogure, Naho Tsuchiya, Atsushi Hozawa, Naoki Nakaya, Tomohiro Nakamura, Naomi Miyamatsu, Hideo Tanaka, Ichiro Wakabayashi, Aya Higashiyama, Nagako Okuda, Naoyuki Takashima, Akira Fujiyoshi, Aya Kadota, Takayoshi Ohkubo, Tomonori Okamura, Hirotsugu Ueshima, Akira Okayama, Katsuyuki Miura
    HYPERTENSION RESEARCH 39 9 670 - 679 2016年09月 [有り][無し]
     研究論文(学術雑誌) 
    The influence of alcohol intake on hypertension may vary depending on the flushing response, but this relationship has not been confirmed. The relationship between alcohol intake and hypertension was examined according to the flushing response in a representative sample of the Japanese population. Participants in the National Health and Nutrition Survey in 2010 were asked to participate in the baseline survey of NIPPON DATA2010. Here, we investigated the relationship between alcohol intake and hypertension according to the flushing response. Statistical analyses were performed in a cross-sectional manner using multiple logistic regression models after adjusting for age, body mass index, smoking status, present illness of diabetes mellitus and present illness of dyslipidemia. Of the 1139 men and 1263 women, 659 and 463, respectively, had hypertension. Among the men, alcohol intake was positively associated with hypertension, regardless of the flushing response (P for linear trend both <0.05). This positive relationship was observed for both users and non-users of antihypertensive drugs. No interaction with the flushing response was observed (P for interaction=0.360). In women, although the direction differed between flushers and non-flushers, the association between alcohol intake and hypertension was not significant, regardless of flushing response. In conclusion, In Japanese men, alcohol intake was positively associated with hypertension in a manner that was not influenced by the flushing response.
  • Hiroshi Yamamoto, Kazuhisa Maeda, Hisatomi Arima, Hiromichi Sonoda, Tomoharu Shimizu, Eiji Mekata, Sachiko Kaida, Tsuyoshi Yamaguchi, Satoshi Murata, Katsuyuki Miura, Makoto Kadowaki, Masaji Tani
    Annals of surgical oncology 23 Suppl 4 540 - 545 2016年08月 研究論文(学術雑誌) 
    BACKGROUND: Adiponectin (ADN) is a key molecule associated with obesity and metabolic syndrome, and functions as an immunomodulator. We have shown that the ADN ratio (i.e., postoperative ADN/preoperative ADN) can predict infection after gastrectomy in patients with gastric cancer . In the present study, we evaluated whether the ADN ratio could reliably predict the incidence of postoperative infection in patients undergoing colorectal cancer surgery. METHODS: We retrospectively analyzed 131 consecutive patients who underwent colorectal cancer surgery and measured their preoperative and postoperative ADN values. The outcome was postoperative infection, including surgical site and remote infections. The association between the ADN ratio and postoperative infection was assessed using logistic regression models. For the ADN ratio and other significant predictors, we conducted receiver operating characteristics (ROC) analyses. RESULTS: Forty-nine patients (37.4 %) experienced postoperative infections. Logistic regression analysis indicated that the ADN ratio was most significantly associated with postoperative infection [odds ratio per one standard deviation (1 SD) decrease 0.36; 95 % confidence interval 0.18-0.71] even after adjustment for diabetes, type of surgery, blood loss, C-reactive protein level, and preoperative ADN level. History of type 2 diabetes mellitus also significantly predicted postoperative infection (odds ratio per 1 SD increase 2.93; 95 % confidence interval 1.03-8.38). When predicting postoperative infection, the area under the ROC curve for the ADN ratio (0.707) was comparable to that for blood loss (0.698; p = 0.975). CONCLUSIONS: ADN ratio is a clinically useful predictor of postoperative infection in patients undergoing colorectal cancer.
  • T. H. Hisamatsu, K. M. Miura, H. A. Arima, S. K. Kadowaki, S. T. Torii, S. S. Suzuki, N. M. Miyagawa, A. K. Kadota, A. F. Fujiyoshi, T. O. Ohkubo, H. U. Ueshima
    EUROPEAN HEART JOURNAL 37 9 223 - 223 2016年08月 [有り][無し]
  • Masahiro Yamazoe, Takashi Hisamatsu, Katsuyuki Miura, Sayaka Kadowaki, Maryam Zaid, Aya Kadota, Sayuki Torii, Itsuko Miyazawa, Akira Fujiyoshi, Hisatomi Arima, Akira Sekikawa, Hiroshi Maegawa, Minoru Horie, Hirotsugu Ueshima
    ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY 36 8 1703 - 1708 2016年08月 [有り][無し]
     研究論文(学術雑誌) 
    Objective The association between insulin resistance (IR) and coronary artery calcification (CAC) has been uncertain after adjustment for metabolic syndrome components. We aimed to evaluate whether IR is associated with CAC prevalence or progression independently of metabolic syndrome components. Approach and Results We conducted a population-based study in a random sample of Japanese men aged 40 to 79 years and determined IR using the homeostasis model assessment of insulin resistance (HOMA-IR). The associations of HOMA-IR and other diabetic parameters per 1-SD increase with CAC prevalence and progression were evaluated using multivariable logistic regression. Of 1006 total participants at baseline (mean age, 6410 years), CAC prevalence was observed in 646 (64.2%), and of 789 participants at follow-up (mean duration, 4.9 +/- 1.3 years), CAC progression was observed in 365 (46.3%). After adjustment for covariates including metabolic syndrome components, higher HOMA-IR was independently associated with CAC prevalence (adjusted odds ratio 1.34, 95% confidence interval 1.10-1.63; P=0.003) and progression (odds ratio 1.32, 95% confidence interval 1.09-1.60; P=0.004). In participants without diabetes mellitus, positive associations were similarly observed (prevalence: odds ratio 1.29, 95% confidence interval 1.04-1.60; P=0.022; and progression: odds ratio 1.25, 95% confidence interval 1.01-1.55; P=0.042), whereas glucose and hemoglobin A1c were not associated with CAC prevalence and progression. Conclusions Higher IR was associated with CAC prevalence and progression independently of metabolic syndrome components in Japanese men and also in those without diabetes mellitus. Among diabetic measures, IR and fasting insulin, but not glucose and hemoglobin A1c, predicted CAC progression in men without diabetes mellitus.
  • 糖尿病患者における肥満合併率の推移と肥満別臨床的特徴-滋賀県医師会糖尿病実態調査より
    宮澤 伊都子, 門田 文, 岡本 元純, 三浦 克之, 前川 聡, 大西 淳夫, 滋賀県医師会糖尿病実態調査委員会
    日本肥満症治療学会学術集会プログラム・抄録集 34回 115 - 115 日本肥満症治療学会 2016年07月
  • 久松 隆史, 三浦 克之
    血圧 23 7 460 - 465 (株)先端医学社 2016年07月 
    高血圧は、冠動脈疾患を含む心血管病の代表的な危険因子であり、日常診療で最もよく遭遇する疾患である。人口の急速な高齢化や生活習慣の欧米化の進展に伴い、都市部を中心とした冠動脈疾患発症率の増加および、とくに男性における高血圧有病率の上昇が今後懸念され、またアジア人では冠動脈疾患に対する高血圧の寄与度は大きいことから、わが国における冠動脈疾患予防に関して、高血圧対策が重要であると再認識する必要がある。至適血圧を超えて血圧が高くなるほど冠動脈疾患の死亡・発症リスクは高くなり、わが国における冠動脈疾患死亡の50%以上が至適血圧を超える血圧高値に起因するものと推定される。ポピュレーションアプローチを用いて国民全体の収縮期血圧平均値を4mmHg低下させることにより、冠動脈疾患死亡数が年間約5千人減少すると推計される。(著者抄録)
  • Takehiro Michikawa, Tomonori Okamura, Hiroshi Nitta, Yuji Nishiwaki, Toru Takebayashi, Kayo Ueda, Aya Kadota, Akira Fujiyoshi, Takayoshi Ohkubo, Hirotsugu Ueshima, Akira Okayama, Katsuyuki Miura
    ENVIRONMENTAL POLLUTION 213 460 - 467 2016年06月 [有り][無し]
     研究論文(学術雑誌) 
    A suggestive mechanism behind the association between particulate matter and cardiovascular disease is inflammatory response. Earlier population-based studies investigating the association between particulate matter and inflammatory biological markers, in particular C-reactive protein (CRP), showed inconsistent results. In addition, evidence from the Asian population, in which CRP levels are typically lower than those observed in Western populations, was sparse. We examined the cross-sectional association between short- and long-term exposure to particulate matter and inflammatory markers, including high-sensitivity CRP (hs-CRP) and white blood cell (WBC) count, in a representative population of Japanese community dwellers (NIPPON DATA2010). We analysed data from 2360 participants (1002 men and 1358 women), aged 20 years or older, who resided in 300 randomly selected districts (222 public health centre areas) throughout Japan. We used background concentrations of suspended particulate matter (SPM, defined as particles with a 100% cut-off level at 10 gm aerodynamic diameter) and co-pollutants within the public health centre area. A logistic regression model was applied to estimate odds ratios (ORs) of elevated hs-CRP (>0.3 mg/dl) or WBC (> 9000/mu l). Since smoking is an important confounding factor, we firstly included this in the models, and additionally conducted the analyses after excluding current smokers. The one-month average concentration of SPM was positively associated with hs-CRP (OR per 10 mu g/m(3) increase in SPM = 1.42, 95% confidence interval = 1.00-2.04), and high exposure to SPM on the day of blood draw was associated with increased WBC count, after excluding current smokers (OR = 1.13, 1.01-1.28). Similar association patterns were observed for ozone. In conclusion, exposure to particulate matter was associated with inflammatory markers in the general Japanese population. Systemic inflammation may play a role in the link between particulate matter and cardiovascular disease. (C) 2016 Elsevier Ltd. All rights reserved.
  • Yasuyuki Nakamura, Hirotsugu Ueshima, Nagako Okuda, Katsuyuki Miura, Yoshikuni Kita, Naoko Miyagawa, Katsushi Yoshita, Hideaki Nakagawa, Kiyomi Sakata, Shigeyuki Saitoh, Tomonori Okamura, Akira Okayama, Sohel R. Choudhry, Beatriz Rodriguez, Kamal H. Masaki, Queenie Chan, Paul Elliott, Jeremiah Stamler
    EUROPEAN JOURNAL OF NUTRITION 55 4 1515 - 1524 2016年06月 [有り][無し]
     研究論文(学術雑誌) 
    Purpose Low-carbohydrate diets (LCD) are a popular dietary strategy for weight reduction. The effects of LCD on long-term outcome vary depending on type of LCD, possibly due to the fact that effects on cardiometabolic risk factors may vary with different types of LCD. Accordingly, we studied these relations. Methods We assessed serum concentrations of high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), high-sensitivity C-reactive protein (CRP), total cholesterol, glycated hemoglobin, and uric acid, and nutrient intakes by standardized methods in men and women ages 40-59 years from four population samples of Japanese in Japan (553 men and 544 women, combined). For people consuming usual, animal-based, and plant-based LCDs, we calculated LCD scores, based on relative level of fat, protein, and carbohydrate, by modifying the methods of Halton et al. Instead of calculating scores based on animal or vegetable fat, we used saturated fatty acids (SFA) or monounsaturated fatty acids (MUFA) + polyunsaturated fatty acids (PUFA). Results In multivariate regression analyses with adjustment for site, age, sex, BMI, smoking, alcohol intake, physical activity, and years of education, all three LCD scores were significantly positively related to HDLc (all P < 0.001), but not to LDLc. The plant-based LCD score was significantly inversely related to log CRP (coefficient = -0.010, P = 0.018). Conclusions All three LCD scores were significantly positively related to HDLc. The plant-based LCD score was significantly inversely related to CRP. Carbohydrate intake below 50 % of total energy with higher intakes of vegetable protein and MUFA + PUFA, and lower intakes of SFA may be favorable for reducing cardiometabolic risk factors.
  • 樺山 舞, 神出 計, 樋口 温子, 栗林 徹, 奥田 奈賀子, 中村 幸志, 渡邉 至, 鳥居 さゆ希, 由田 克士, 三浦 克之, 岡山 明
    日本循環器病予防学会誌 51 2 139 - 139 (一社)日本循環器病予防学会 2016年05月 [有り][無し]
  • 樋口 温子, 樺山 舞, 神出 計, 奥田 奈賀子, 中村 幸志, 渡邉 至, 鳥居 さゆ希, 栗林 徹, 由田 克士, 三浦 克之, 岡山 明
    日本循環器病予防学会誌 51 2 140 - 140 (一社)日本循環器病予防学会 2016年05月 [有り][無し]
  • T. Iwahori, H. Ueshima, S. Torii, Y. Saito, A. Fujiyoshi, T. Ohkubo, K. Miura
    Journal of Human Hypertension 30 5 328 - 334 2016年05月 [有り][無し]
     研究論文(学術雑誌) 
    This study was done to clarify the optimal number and type of casual urine specimens required to estimate urinary sodium/potassium (Na/K) ratio in individuals with high blood pressure. A total of 74 individuals with high blood pressure, 43 treated and 31 untreated, were recruited from the Japanese general population. Urinary sodium, potassium and Na/K ratio were measured in both casual urine samples and 7-day 24-h urine samples and then analyzed by correlation and Bland-Altman analyses. Mean Na/K ratio from random casual urine samples on four or more days strongly correlated with the Na/K ratio of 7-day 24-h urine (r=0.80-0.87), which was similar to the correlation between 1 and 2-day 24-h urine and 7-day 24-h urine (r=0.75-0.89). The agreement quality for Na/K ratio of seven random casual urine for estimating the Na/K ratio of 7-day 24-h urine was good (bias: -0.26, limits of agreements: -1.53-1.01), and it was similar to that of 2-day 24-h urine for estimating 7-day 24-h values (bias: 0.07, limits of agreement: -1.03 to 1.18). Stratified analyses comparing individuals using antihypertensive medication and individuals not using antihypertensive medication showed similar results. Correlations of the means of casual urine sodium or potassium concentrations with 7-day 24-h sodium or potassium excretions were relatively weaker than those for Na/K ratio. The mean Na/K ratio of 4-7 random casual urine specimens on different days provides a good substitute for 1-2-day 24-h urinary Na/K ratio for individuals with high blood pressure.
  • Masaru Sakurai, Koshi Nakamura, Katsuyuki Miura, Toshinari Takamura, Katsushi Yoshita, Shin-ya Nagasawa, Yuko Morikawa, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Motoko Nakashima, Kazuhiro Nogawa, Yasushi Suwazono, Satoshi Sasaki, Hideaki Nakagawa
    JOURNAL OF DIABETES INVESTIGATION 7 3 343 - 351 2016年05月 [有り][無し]
     研究論文(学術雑誌) 
    Aims/Introduction: The present cohort study assessed the risk among Japanese men for developing type 2 diabetes, based on the percentage of energy intake from carbohydrates and degree of obesity. Participants and Methods: The participants were 2,006 male factory employees, and the macronutrient intake of each patient was measured using a self-administered diet history questionnaire. The incidence of diabetes was determined in annual blood examinations over a 10-year period. Results: During the study, 232 participants developed diabetes. The crude incidence rates (/1,000 person-years) for different levels of carbohydrate intake as a percentage of calories consumed (<50.0, 50.0-57.4, 57.5-65.0, >65.0% of energy intake) were 16.5, 14.4, 12.7 and 17.6. Overall, carbohydrate intake was not associated with the risk of diabetes. However, there was significant interaction between carbohydrate intake and degree of obesity on the incidence of diabetes (P for interaction = 0.024). Higher carbohydrate intake was associated with elevated risk for diabetes among participants with a body mass index >= 25.0 kg/m(2) (P for trend = 0.034). For obese participants, the multivariate-adjusted hazard ratio for those with carbohydrate intakes >65% energy was 2.01 (95% confidence interval 1.08-3.71), which was significantly higher than that of participants with carbohydrate intakes 50.0-57.4% energy. Conclusions: Higher carbohydrate intake was associated with higher risk of diabetes in obese participants, but not in non-obese participants. Obese participants with carbohydrate intakes >65% energy should reduce their intakes to levels within the desirable carbohydrate energy proportion for Japanese (50-65% energy) to prevent development of type 2 diabetes.
  • Masako Tanaka, Masayuki Shiota, Takafumi Nakao, Ryo Uemura, Satoshi Nishi, Yasuyuki Ohkawa, Masaki Matsumoto, Maki Yamaguchi, Mayuko Osada-Oka, Azusa Inagaki, Katsuyuki Takahashi, Keiichi I. Nakayama, Min Gi, Yasukatsu Izumi, Katsuyuki Miura, Hiroshi Iwao
    JOURNAL OF PROTEOMICS 136 214 - 221 2016年05月 [有り][無し]
     研究論文(学術雑誌) 
    Heat shock protein 72 (HSP72) is an intracellular molecular chaperone that is overexpressed in tumor cells, and has also been detected in extracellular regions such as the blood. HSP72 forms complexes with peptides and proteins that are released from tumors. Accordingly, certain HSP72-binding proteins/peptides present in the blood of cancer patients may be derived from tumor cells. In this study, to effectively identify low-abundance proteins/peptides in the blood as tumor markers, we established a method for isolating HSP72-binding proteins/peptides from serum. Nine HSP72-specific monoclonal antibodies were conjugated to N-hydroxysulfosuccinimide-activated Sepharose beads (NHq) and used to isolate HSP72 complexes from serum samples. Precipitated proteins were then identified by LC-MS/MS analysis. Notably, this approach enabled the isolation of low-abundance proteins from serum without albumin removal. Moreover, by subjecting the serum samples of ten patients with multiple myeloma (MM) to NHq analysis, we identified 299 proteins present in MM HSP72 complexes, including 65 intracellular proteins. Among the intracellular proteins detected, 21 were present in all serum samples tested, while 11 were detected in both the conditioned media from cultured multiple myeloma cells and serum from MM patients. These results suggest that the NHq method can be applied to discover candidate tumor markers. (C) 2016 Elsevier B.V. All rights reserved.
  • 眼底検査、尿中アルブミン測定実施の現況と今後の課題 滋賀県医師会糖尿病実態調査より
    宮澤 伊都子, 門田 文, 岡本 元純, 三浦 克之, 前川 聡, 大西 淳夫
    糖尿病 59 Suppl.1 S - 472 (一社)日本糖尿病学会 2016年04月
  • Tatsuya Koyama, Katsushi Yoshita, Masaru Sakurai, Katsuyuki Miura, Yuchi Naruse, Nagako Okuda, Akira Okayama, Jeremiah Stamler, Hirotsugu Ueshima, Hideaki Nakagawa
    JOURNAL OF NUTRITIONAL SCIENCE AND VITAMINOLOGY 62 2 101 - 107 2016年04月 [有り][無し]
     研究論文(学術雑誌) 
    A Japanese-style diet consists of meals that include grain (shushoku), fish and meat (shusai), and vegetable dishes (fukusai). Little is known about the association of such meals (designated well-balanced meals hereafter) with nutrient intake. We therefore examined the frequency of well-balanced meals required to prevent nutrient deficiency. Participants were Japanese people, ages 40 to 59 y, from Toyama, recruited for INTERMAP, in an international population-based study. Each person provided 4 in-depth 24-h dietary recalls (149 men, 150 women). The prevalence of risk ratios of not meeting the Dietary Reference Intakes for Japanese (2015) was calculated. Well-balanced diets were assessed by the Japanese Food Guide Spinning Top. We counted the frequencies of meals in which participants consumed 1.0 or more servings of all 3 dishes categories. We divided the frequency of consumption of well-balanced meals into the following 4 groups: <1.00 time/d, 1.00-1.49 times/d, 1.50-1.74 times/d, and >= 1.75 times/d. Compared with participants in the highest frequency group for well-balanced meals, those who consumed well-balanced meals less than once a day had a higher risk of not meeting the adequate intake for potassium and the recommended dietary allowance for vitamin A. Those who consumed well-balanced meals on average less than 1.50 times per day had a higher risk of not meeting the recommended dietary allowance for calcium and vitamin C. Our results suggest that individuals should on average consume well-balanced meals more than 1.5 times per day to prevent calcium and vitamin C deficiencies.
  • 日本人男性における心臓周囲脂肪量の縦断的変化の予測因子とは 滋賀動脈硬化疫学研究(SESSA)(Which Factors Predict Longitudinal Change of Pericardial Fat Volume in Japanese Men? The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA))
    Miyazawa Itsuko, Ohkubo Takayoshi, Kadowaki Sayaka, Fujiyoshi Akira, Hisamatsu Takashi, Kadota Aya, Arima Hisatomi, Miura Katsuyuki, Maegawa Hiroshi, Ueshima Hirotsugu
    Circulation Journal 80 Suppl.I 823 - 823 2016年03月
  • 一般集団においてinsulin抵抗性はメタボリックシンドロームよりも冠動脈石灰化の有病率および進行に関連する(Relationship of Insulin Resistance to Prevalence and Progression of Coronary Artery Calcification beyond Metabolic Syndrome in a General Population)
    Yamazoe Masahiro, Hisamatsu Takashi, Miura Katsuyuki, Kadowaki Sayaka, Zaid Maryam, Fujiyoshi Akira, Kadowaki Takashi, Abbott Robert, Arima Hisatomi, Sekikawa Akira, Maegawa Hiroshi, Horie Minoru, Ueshima Hirotsugu
    Circulation Journal 80 Suppl.I 2036 - 2036 2016年03月
  • Hirotsugu Ueshima, Takashi Kadowaki, Takashi Hisamatsu, Akira Fujiyoshi, Katsuyuki Miura, Takayoshi Ohkubo, Akira Sekikawa, Aya Kadota, Sayaka Kadowaki, Yasuyuki Nakamura, Naoko Miyagawa, Tomonori Okamura, Yoshikuni Kita, Naoyuki Takashima, Atsunori Kashiwagi, Hiroshi Maegawa, Minoru Horie, Takashi Yamamoto, Takeshi Kimura, Toru Kita
    ATHEROSCLEROSIS 246 141 - 147 2016年03月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme predominantly bound to low-density lipoprotein (LDL). Lp-PLA2 is recognized as playing a key role in inflammatory processes and the development of atherosclerosis. This study aimed to investigate whether Lp-PLA2 is related to subclinical atherosclerosis, independently from traditional risk factors, in a general Japanese population by analyses of both the observational study and Mendelian randomization using V279F polymorphism. Methods and results: We cross-sectionally examined community-based sample of 929 Japanese men aged 40-79 years, without statin treatment, who were randomly selected from the resident registration. Multiple regression analyses of Lp-PLA2 activity and concentration were undertaken separately for men aged 40-49 years and 50-79 years, to clarify interactions of age and Lp-PLA2. Lp-PLA2 activity for men aged 50-79 years was significantly and positively related to intima-media thickness (IMT) (P = 0.013) and plaque index (P = 0.008) independent of traditional risk factors including small LDL particles, but not to coronary artery calcification (CAC) score. Associations with Lp-PLA2 concentration were qualitatively similar to those of activity. Corresponding relationships were not observed in men aged 40e49 years. Mendelian randomization analyses based on V279F genotype did not show any significant associations with subclinical atherosclerosis, although the homozygote and heterozygote of V279F showed low LpPLA2 activity and concentration. Conclusions: Lp-PLA2 activity in Japanese men aged 50-79 years was associated significantly and positively with IMT and plaque in the carotid artery but Mendelian randomization did not support that LpPLA2 is a causative factor for subclinical atherosclerosis. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
  • Tomonori Okamura, Katsuyuki Miura, Tatsuya Sawamura, Aya Kadota, Takashi Hisamatsu, Akira Fujiyoshi, Naomi Miyamatsu, Naoyuki Takashima, Naoko Miyagawa, Takashi Kadowaki, Takayoshi Ohkubo, Yoshitaka Murakami, Yasuyuki Nakamura, Hirotsugu Ueshima
    JOURNAL OF CLINICAL LIPIDOLOGY 10 1 172 - 180 2016年02月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: The serum level of LOX-1 ligand containing ApoB (LAB) may reflect atherogenicity better than usual lipid parameters; however, the relationship between LAB and carotid intima-media thickness (IMT) was not clear even in Asian populations. METHODS: A total of 992 community-dwelling Japanese men, aged 40 to 79 years, were enrolled in the present study. Serum LAB levels were measured by enzyme-linked immunosorbent assays (ELISAs) with recombinant LOX-1 and monoclonal anti-apolipoprotein B antibody. RESULTS: Serum LAB levels (median [interquartile range], mu g cs/L) were 5341 mu g cs/L (4093-7125). The mean average IMT of the common carotid artery was highest in the fourth LAB quartile (842 mu m) compared with the first quartile (797 mu m) after adjustment for age, high-density lipoprotein cholesterol, triglyceride, body mass index, hypertension, diabetes, high sensitivity C-reactive protein, smoking, and alcohol drinking. However, this statistically significant difference was lost after further adjustment for total cholesterol (TC). After stratification using the combination of median LAB and hypercholesterolemia (serum TC >= 6.21 mmol/L and/or lipid-lowering medication), the adjusted mean average IMT (standard error) in the high LAB/hypercholesterolemia group was 886 mu m (12.7), 856 mu m (16.7) in the low LAB/hypercholesterolemia group, and 833 mu m (8.4) in the low LAB/normal cholesterol group (P = .004). After further adjustment for TC, mean average IMT in the high LAB group was significantly higher than that measured in the low LAB group in hypercholesterolemic participants not taking lipid-lowering medication. CONCLUSION: Serum LAB was associated with an increased carotid IMT in Japanese men, especially those with hypercholesterolemia. (C) 2016 National Lipid Association. All rights reserved.
  • Wanqing Wen, Norihiro Kato, Joo-Yeon Hwang, Xingyi Guo, Yasuharu Tabara, Huaixing Li, Rajkumar Dorajoo, Xiaobo Yang, Fuu-Jen Tsai, Shengxu Li, Ying Wu, Tangchun Wu, Soriul Kim, Xiuqing Guo, Jun Liang, Dmitry Shungin, Linda S. Adair, Koichi Akiyama, Matthew Allison, Qiuyin Cai, Li-Ching Chang, Chien-Hsiun Chen, Yuan-Tsong Chen, Yoon Shin Cho, Bo Youl Choi, Yutang Gao, Min Jin Go, Dongfeng Gu, Bok-Ghee Han, Meian He, James E. Hixson, Yanling Hu, Tao Huang, Masato Isono, Keum Ji Jung, Daehee Kang, Young Jin Kim, Yoshikuni Kita, Juyoung Lee, Nanette R. Lee, Jeannette Lee, Yiqin Wang, Jian-Jun Liu, Jirong Long, Sanghoon Moon, Yasuyuki Nakamura, Masahiro Nakatochi, Keizo Ohnaka, Dabeeru Rao, Jiajun Shi, Jae Woong Sull, Aihua Tan, Hirotsugu Ueshima, Chen Wu, Yong-Bing Xiang, Ken Yamamoto, Jie Yao, Xingwang Ye, Mitsuhiro Yokota, Xiaomin Zhang, Yan Zheng, Lu Qi, Jerome I. Rotter, Sun Ha Jee, Dongxin Lin, Karen L. Mohlke, Jiang He, Zengnan Mo, Jer-Yuarn Wu, E. Shyong Tai, Xu Lin, Tetsuro Miki, Bong-Jo Kim, Fumihiko Takeuchi, Wei Zheng, Xiao-Ou Shu
    SCIENTIFIC REPORTS 6 2016年01月 [有り][無し]
     研究論文(学術雑誌) 
    Sixty genetic loci associated with abdominal obesity, measured by waist circumference (WC) and waist-hip ratio (WHR), have been previously identified, primarily from studies conducted in Europeanancestry populations. We conducted a meta-analysis of associations of abdominal obesity with approximately 2.5 million single nucleotide polymorphisms (SNPs) among 53,052 (for WC) and 48,312 (for WHR) individuals of Asian descent, and replicated 33 selected SNPs among 3,762 to 17,110 additional individuals. We identified four novel loci near the EFEMP1, ADAMTSL3, CNPY2, and GNAS genes that were associated with WC after adjustment for body mass index (BMI); two loci near the NID2 and HLA-DRB5 genes associated with WHR after adjustment for BMI, and three loci near the CEP120, TSC22D2, and SLC22A2 genes associated with WC without adjustment for BMI. Functional enrichment analyses revealed enrichment of corticotropin-releasing hormone signaling, GNRH signaling, and/or CDK5 signaling pathways for those newly-identified loci. Our study provides additional insight on genetic contribution to abdominal obesity.
  • A. El-Saed, K. Masaki, T. Okamura, R. W. Evans, Y. Nakamura, B. J. Willcox, S. Lee, H. Maegawa, T. B. Seto, J. Choo, A. Fujiyoshi, K. Miura, L. H. Kuller, H. Ueshima, A. Sekikawa
    JOURNAL OF NUTRITION HEALTH & AGING 20 1 16 - 21 2016年01月 [有り][無し]
     研究論文(学術雑誌) 
    Background: C-reactive protein (CRP) and many fatty acids (FAs) have been linked to cardiovascular disease. Associations of serum CRP with FAs in different populations have not been established. Methods: Participants were 926 men aged 40-49 (2002-2006) from a population-based sample; 310 Whites from Pennsylvania, U.S., 313 Japanese from Shiga, Japan, and 303 Japanese Americans from Hawaii, U.S. Serum CRP (mg/L) was measured using immunosorbent assay while serum FAs (%) were measured using capillary-gas-liquid chromatography. Results: Whites had CRP (mg/L) levels higher than Japanese with Japanese Americans in-between (age-adjusted geometric mean "GM" 0.96, 0.38, 0.66, respectively). Whites had also higher levels of total n-6 FAs (%) and trans fatty acids (TFAs) but lower levels of marine-derived n-3 FAs compared to Japanese (41.78 vs. 35.05, 1.04 vs. 0.58, & 3.85 vs. 9.29, respectively). Japanese Americans had FAs levels in-between the other two populations. Whites had significant inverse trends between CRP and tertiles of total n-6 FAs (GM 1.20, 0.91 & 0.80; p=0.002) and marine-derived n-3 FAs (GM 1.22, 1.00 & 0.72; p<0.001) but a significant positive trend with TFAs (GM 0.80, 0.95 & 1.15; p=0.007). Japanese had a significant inverse trend between CRP and only total n-6 FAs (GM 0.50, 0.35 & 0.31; p<0.001). Japanese Americans had CRP associations with n-3 FAs, n-6 FAs, and TFAs similar to but weaker than Whites. Conclusions: With the exception of consistent inverse association of CRP with total n-6 FAs, there are considerable variations across the three populations in the associations of CRP with different FAs.
  • 富山職域コホート研究
    中川秀昭, 櫻井 勝, 長澤晋哉, 森河裕子, 中村幸志, 三浦克之
    厚生労働省科学研究費補助金循環器疾患等生活習慣病対策政策研究事業:「循環器疾患における集団間の健康格差の実態把握とその対策を目的とした大規模コホート共同研究 平成27年度総括・分担研究報告書(研究代表者 岡村智教) 107 - 111 2016年 [無し][無し]
  • Mitsuaki Sawano, Shun Kohsaka, Tomonori Okamura, Taku Inohara, Daisuke Sugiyama, Yasuyuki Shiraishi, Makoto Watanabe, Yasuyuki Nakamura, Aya Higashiyama, Aya Kadota, Nagako Okuda, Yoshitaka Murakami, Takayoshi Ohkubo, Akira Fujiyoshi, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    PloS one 11 6 e0157563  2016年 [有り][無し]
     研究論文(学術雑誌) 
    AIMS: The long-term prognostic effect of non-specific 12-lead electrocardiogram findings is unknown. We aimed to evaluate the cumulative prognostic impact of axial, structural, and repolarization categorical abnormalities on cardiovascular death, independent from traditional risk scoring systems such as the Framingham risk score and the NIPPON DATA80 risk chart. METHODS AND RESULTS: A total of 16,816 healthy men and women from two prospective, longitudinal cohort studies were evaluated. 3,794 (22.6%) individuals died during a median follow-up of 15 years (range, 2.0-24 years). Hazard ratios for cardiovascular death, all-cause death, coronary death and stroke death were calculated for the cumulative and independent axial, structural, and repolarization categorical abnormalities adjusted for the Framingham risk score and the NIPPON DATA80 risk chart. Individuals with two or more abnormal categories had a higher risk of cardiovascular death after adjustment for Framingham risk score (men: HR 4.27, 95%CI 3.35-5.45; women: HR 4.83, 95%CI 3.76-6.22) and NIPPON DATA80 risk chart (men: HR 2.39, 95%CI 1.87-3.07; women: HR 2.04, 95%CI 1.58-2.64). CONCLUSION: Cumulative findings of axial, structural, and repolarization abnormalities are significant predictors of long-term cardiovascular death in asymptomatic, healthy individuals independent of traditional risk stratification systems.
  • Wen Zhang, Hiroyasu Iso, Yoshitaka Murakami, Katsuyuki Miura, Masato Nagai, Daisuke Sugiyama, Hirotsugu Ueshima, Tomonori Okamura
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 23 12 1365 - 1366 2016年 [有り][無し]
  • Birru RL, Ahuja V, Vishnu A, Evans RW, Miyamoto Y, Miura K, Usui T, Sekikawa A
    Journal of nutritional science 5 e30  2016年 [有り][無し]
     研究論文(学術雑誌) 
    Recent studies suggest that the ability to produce equol, a metabolite of the soya isoflavone daidzein, is beneficial to coronary health. Equol, generated by bacterial action on isoflavones in the human gut, is biologically more potent than dietary sources of isoflavones. Not all humans are equol producers. We investigated whether equol-producing status is favourably associated with risk factors for CHD following an intervention by dietary soya isoflavones. We systematically reviewed randomised controlled trials (RCT) that evaluated the effect of soya isoflavones on risk factors for CHD and that reported equol-producing status. We searched PubMed, EMBASE, Ovid Medline and the Cochrane Central Register for Controlled Trials published up to April 2015 and hand-searched bibliographies to identify the RCT. Characteristics of participants and outcomes measurements were extracted and qualitatively analysed. From a total of 1671 studies, we identified forty-two articles that satisfied our search criteria. The effects of equol on risk factors for CHD were mainly based on secondary analyses in these studies, thus with inadequate statistical power. Although fourteen out of the forty-two studies found that equol production after a soya isoflavone intervention significantly improved a range of risk factors including cholesterol and other lipids, inflammation and blood pressure variables, these results need further verification by sufficiently powered studies. The other twenty-eight studies primarily reported null results. RCT of equol, which has recently become available as a dietary supplement, on CHD and its risk factors are awaited.
  • Akira Okayama, Nagako Okuda, Katsuyuki Miura, Tomonori Okamura, Takehito Hayakawa, Hiroshi Akasaka, Hirofumi Ohnishi, Shigeyuki Saitoh, Yusuke Arai, Yutaka Kiyohara, Naoyuki Takashima, Katsushi Yoshita, Akira Fujiyoshi, Maryam Zaid, Takayoshi Ohkubo, Hirotsugu Ueshima
    BMJ OPEN 6 7 e011632  2016年 [有り][無し]
     研究論文(学術雑誌) 
    Objectives: To evaluate the impact of dietary sodium and potassium (Na-K) ratio on mortality from total and subtypes of stroke, cardiovascular disease (CVD) and all causes, using 24-year follow-up data of a representative sample of the Japanese population. Setting: Prospective cohort study. Participants: In the 1980 National Cardiovascular Survey, participants were followed for 24 years (NIPPON DATA80, National Integrated Project for Prospective Observation of Non-communicable Disease And its Trends in the Aged). Men and women aged 30-79 years without hypertensive treatment, history of stroke or acute myocardial infarction (n=8283) were divided into quintiles according to dietary Na-K ratio assessed by a 3-day weighing dietary record at baseline. Age-adjusted and multivariable-adjusted HRs were calculated using the Mantel-Haenszel method and Cox proportional hazards model. Primary outcome measures: Mortality from total and subtypes of stroke, CVD and all causes. Results: A total of 1938 deaths from all causes were observed over 176 926 person-years. Na-K ratio was significantly and non-linearly related to mortality from all stroke (p=0.002), CVD (p=0.005) and total mortality (p=0.001). For stroke subtypes, mortality from haemorrhagic stroke was positively related to Na-K ratio (p=0.024). Similar relationships were observed for men and women. The observed relationships remained significant after adjustment for other risk factors. Quadratic non-linear multivariable-adjusted HRs (95% CI) in the highest quintile versus the lowest quintile of Na-K ratio were 1.42 (1.07 to 1.90) for ischaemic stroke, 1.57 (1.05 to 2.34) for haemorrhagic stroke, 1.43 (1.17 to 1.76) for all stroke, 1.39 (1.20 to 1.61) for CVD and 1.16 (1.06 to 1.27) for all-cause mortality. Conclusions: Dietary Na-K ratio assessed by a 3-day weighing dietary record was a significant risk factor for mortality from haemorrhagic stroke, all stroke, CVD and all causes among a Japanese population.
  • Aya Hirata, The NIPPON DATA90 Research Group, Tomonori Okamura, Daisuke Sugiyama, Kazuyo Kuwabara, Aya Kadota, Akira Fujiyoshi, Katsuyuki Miura, Nagako Okuda, Takayoshi Ohkubo, Akira Okayama, Hirotsugu Ueshima, Shigeyuki Saitoh, Kiyomi Sakata, Atsushi Hozawa, Takehito Hayakawa, Yoshikazu Nakamura, Nobuo Nishi, Fumiyoshi Kasagi, Yoshitaka Murakami, Toru Izumi, Yasuhiro Matsumura, Toshiyuki Ojima, Koji Tamakoshi, Hideaki Nakagawa, Yoshikuni Kita, Naomi Miyamatsu, Katsushi Yoshita, Yoshihiro Miyamoto, Kazunori Kodama, Yutaka Kiyohara
    Journal of Atherosclerosis and Thrombosis 23 7 800 - 809 2016年 [有り][無し]
     研究論文(学術雑誌) 
    Aims: There is no community-based cohort study to examine the effect of very high level of highdensity lipoprotein cholesterol (HDL-C) on coronary heart disease (CHD) and other cause-specific mortality. Therefore, we investigated the relationship between HDL-C including very high level and cause-specific mortality in a 20-year cohort study of the representative sample of Japanese. Methods: We followed 7,019 individuals from the Japanese general population (2,946 men and 4,073 women). We defined HDL-C levels as follow: low (HDL-C < 1.04 mmol/L), reference (1.04-1.55 mmol/L), high (1.56- 2.06 mmol/L), very high (≥2.07 mmol/L). The multivariate adjusted hazard ratio (HR) for all-cause or cause-specific mortality was calculated using a Cox proportional hazards model adjusted for other traditional risk factors. Results: During follow-up, we observed 1,598 deaths. No significant association was observed between HDL-C and all-cause mortality. Serum HDL-C also showed no association with stroke. In contrast, the risk for CHD among high HDL-C was lower than reference, HRs were 0.51 [95% confidence interval (CI): 0.21-1.23] in men, 0.33 (95% CI: 0.11-0.95) in women, and 0.41 (95% CI: 0.21 -0.81) when men and women were combined. However, very high HDL-C did not show significant association with CHD and other cause-specific mortality. Conclusions: HDL-C was not associated with all-cause and stroke mortality. In contrast, high serum HDL-C levels, at least up to 2.06 mmol/L, were protective against CHD, although further high levels were not. However, sample size of cause-specific death in very high HDL-C group was not enough even in this 20-year follow-up of 7,019 Japanese larger cohort studies should be warranted.
  • Li Y, Iso H, Cui R, Murakami Y, Yatsuya H, Miura K, Nagasawa SY, Ueshima H, Okamura T, EPOCH-JAPAN Research Group
    Journal of atherosclerosis and thrombosis 23 7 792 - 799 2016年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: Whether the association between serum γ-glutamyltransferase (γ-GTP) levels and total cardiovascular disease (CVD) mortality is independent of alcohol drinking in East Asian populations is not well known. We conducted a pooled analysis of Japanese men and women that enabled an analysis restricted to never-drinkers. Methods: A total of 15,987 men and 25,053 women aged 40-79 years, pooled from seven cohort studies throughout Japan, were followed-up to examine sex-specific relationship between serum γ -GTP levels and total CVD mortality. Cox regression model was used that was adjusted for age, smoking status, body mass index, and systolic blood pressure and serum triglyceride, total cholesterol, aspartate aminotransferase, and alanine aminotransferase levels. Results: During an average follow-up of 8.7 years, we documented 361 and 340 deaths from total CVD, 146 and 168 from stroke, and 101 and 53 from coronary heart disease (CHD) for men and women, respectively. Among the never-drinkers, hazard ratios (HRs) for mortality for one standard deviation of log-γ-GTP for men were 1.89 (1.00-3.58) for stroke, 1.04 (0.57-1.90) for CHD, and 1.43 (1.04-1.96) for total CVD. For women, HRs were 1.28 (1.06-1.54), 1.81 (1.34-2.44), and 1.30 (1.14-1.49), respectively. Conclusion: γ-GTP may be a risk factor for total CVD mortality independent of alcohol drinking status in Japanese men and women.
  • Wen Zhang, Hiroyasu Iso, Yoshitaka Murakami, Katsuyuki Miura, Masato Nagai, Daisuke Sugiyama, Hirotsugu Ueshima, Tomonori Okamura
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 23 6 692 - 703 2016年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: To investigate the relationship between serum uric acid levels and cardiovascular disease in Asians. Methods: We examined the above relationship using the data of Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN Study). The data of 36,313 subjects (15,628 men and 20,685 women aged 35-89 years without histories of stroke, coronary heart disease, or cancer at baseline) were used for the analyses. Sex-specific hazard ratios (HRs) of mortality from cardiovascular disease were estimated according to the quintiles of serum uric acid using Cox hazard models stratified by cohorts. Results: During 441,771 person-years of follow-up, we documented 1,288 cardiovascular deaths. A J-or U-shaped relationship between serum uric acid level and cardiovascular disease mortality was observed. Compared with the lowest quintile of serum uric acid levels, the highest quintile was associated with an increased cardiovascular disease mortality in men [HR: 1.28; 95% confidence interval (CI): 1.01-1.63] and women (HR: 1.51; 95% CI: 1.14-1.99). However, there was no significant association with mortality from stroke, coronary heart disease or heart failure in both men and women. Conclusion: This large pooled analysis in Japan suggested a J-or U-shaped relationship between serum uric acid levels and cardiovascular mortality. The highest quintile of serum uric acid levels was associated with increased cardiovascular disease mortality in both Japanese men and women.
  • Michikazu Nakai, Yoshihiro Miyamoto, Aya Higashiyama, Yoshitaka Murakami, Kunihiro Nishimura, Hiroshi Yatsuya, Shigeyuki Saitoh, Kiyomi Sakata, Hiroyasu Iso, Katsuyuki Miura, Hirotsugu Ueshima, Tomonori Okamura
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 23 2 176 - 195 2016年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: In Japan Atherosclerosis Society guidelines for the prevention of atherosclerotic cardiovascular diseases 2012 (JAS2012), NIPPON DATA80 risk assessment chart (ND80RAC) was adopted to estimate the 10-year probability of coronary artery disease (CAD) mortality. However, there was no comparison between the estimated mortality calculated by ND80RAC and actual mortality in external populations. Accordingly, we used the large pooled database of cohorts in Japan, EPOCH-JAPAN, as an external population. Methods: The participants of EPOCH-JAPAN without a history of cardiovascular disease (15,091 men and 18,589 women aged 40-74 years) were analyzed based on sex. The probability of a 10-year risk of CAD/stroke mortality was estimated by ND80RAC. The participants were divided into both decile of their estimated mortality and three categories according to JAS2012. The calibration between the mean estimated mortality and the actual mortality was performed by the Hosmer and Lemeshow (H-L) test. Results: In both sexes, the estimated CAD mortality was higher than the actual mortality, particularly in higher deciles of estimated mortality, and the estimated stroke mortality was almost concordant with the actual mortality in low/moderate deciles of estimated mortality. As for the categories according to JAS2012, the estimated CAD mortality was higher than the actual mortality in both sexes; actual mortality in Category III was lower than that in Category II in women. However, it increased in the ascending order of category when we excluded the presence of diabetes from Category III. Conclusions: The estimated CAD mortality by ND80RAC tended to be higher than the actual mortality in the population in which the baseline survey was more recently performed.
  • Masato Nagai, Takayoshi Ohkubo, Katsuyuki Miura, Akira Fujiyoshi, Nagako Okuda, Takehito Hayakawa, Katsushi Yoshita, Yusuke Arai, Hideaki Nakagawa, Koshi Nakamura, Naoko Miyagawa, Naoyuki Takashima, Aya Kadota, Yoshitaka Murakami, Yasuyuki Nakamura, Robert D. Abbott, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 23 3 339 - 354 2016年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: In animals, dietary energy restriction is reported to increase longevity, whereas in humans, all cohort studies from Western countries have not shown an association between the low energy intake and longevity. We examined the association between total energy intake and longevity in Japan where dietary pattern is different from that in the West. Methods: A total of 7,704 Japanese aged 30-69 years were followed from 1980 to 2009. Participants were divided into the quintiles of total energy (kcal/day) based on data collected from the National Nutrition Survey. Hazard ratios and 95% confidence intervals (CIs) were derived through the use of Cox proportional hazards models to compare the risk of death across and between the quintiles. Results: There was a significant association between increased energy intake and all-cause mortality risk in only men (P for linear trend 0.008). In cause-specific analysis, compared with the lowest quintile, there was rise in coronary heart disease (CHD) mortality among men (HR; 2.63, 95% CI; 0.95-7.28, P for linear trend 0.016) and women (HR; 2.91, 95% CI; 1.02-8.29, P for linear trend 0.032) and cancer mortality among men (HR; 1.50, 95% CI; 0.999-2.24, P for linear trend 0.038) in the top quintile. Conclusion: We observed significant associations of high energy intake with all-cause and cancer mortality among men and with CHD mortality among men and women. Further studies are needed to confirm the benefits of caloric restriction.
  • Yuri Kawabe, Yasuyuki Nakamura, Sayuri Kikuchi, Yoshimi Suzukamo, Yoshitaka Murakami, Taichiro Tanaka, Toru Takebayashi, Akira Okayama, Katsuyuki Miura, Tomonori Okamura, Shunichi Fukuhara, Hirotsugu Ueshima
    QUALITY OF LIFE RESEARCH 24 12 2927 - 2932 2015年12月 [有り][無し]
     研究論文(学術雑誌) 
    To examine the relation of work type with health-related quality of life (HRQoL) in healthy workers. We cross-sectionally examined 4427 (3605 men and 822 women) healthy workers in Japan, aged 19-69 years. We assessed HRQoL based on scores for five scales of the SF-36. Multiple regression was applied to examine the relation of work type (nighttime, shift, day to night, and daytime) with the five HRQoL norm-based scores, lower scores of which indicate poorer health status, adjusted for confounding factors, including sleeping duration. Shiftwork was inversely related to role physical [regression estimate (beta) = -2.12, 95 % confidence intervals (CI) -2.94, -1.30, P < 0.001], general health (beta = -1.37, 95 % CI -2.01, -0.72, P < 0.001), role emotional (beta = -1.24, 95% CI -1.98, -0.50, P < 0.001), and mental health (beta = -1.31, 95% CI -2.01, -0.63, P < 0.001) independent of confounding factors, but not to vitality. Day-to-nighttime work was inversely related to all the five HRQoL subscales (Ps 0.012 to < 0.001). Shiftwork was significantly inversely related to four out of the five HRQoL, except for vitality, and day-to-nighttime work was significantly inversely related to all five HRQoL, independent of demographic and lifestyle factors.
  • Nagai Masato, Ohkubo Takayoshi, Murakami Yoshitaka, Takashima Naoyuki, Kadota Aya, Miyagawa Naoko, Saito Yoshino, Nishi Nobuo, Okuda Nagako, Kiyohara Yutaka, Nakagawa Hideaki, Nakamura Yoshikazu, Fujiyoshi Akira, Abbott Robert D, Okamura Tomonori, Okayama Akira, Ueshima Hirotsugu, Miura Katsuyuki
    Hypertension Research 38 11 798  2015年11月 [無し][無し]
  • Masato Nagai, Takayoshi Ohkubo, Yoshitaka Murakami, Naoyuki Takashima, Aya Kadota, Naoko Miyagawa, Yoshino Saito, Nobuo Nishi, Nagako Okuda, Yutaka Kiyohara, Hideaki Nakagawa, Yoshikazu Nakamura, Akira Fujiyoshi, Robert D. Abbott, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima, Katsuyuki Miura
    HYPERTENSION RESEARCH 38 11 790 - 795 2015年11月 [有り][無し]
     研究論文(学術雑誌) 
    The prevalence of overweight (body mass index (BMI)= 25.0-29.9 kgm(-2)) and obesity (>= 30.0 kgm(-2)) has been increasing over the last several decades in Japan. We examined trends of the impact of overweight and obesity on hypertension (systolic/diastolic blood pressure. 140/90mmHg or antihypertensive drugs use) using four national surveys in Japan, from which the participants were randomly sampled from the entire population. Study participants aged 30-79 years were selected for each survey (10 370 in 1980, 8005 in 1990, 5327 in 2000 and 2547 in 2010). The results showed that the impact of overweight and obesity on hypertension had increased significantly (P=0.040 and 0.006 in men and women, respectively). From 1980 to 2010, the multivariable-adjusted odds ratios for hypertension, comparing overweight and obesity with normal weight (BMI = 18.5-24.9 kgm(-2)), went from 1.94 (95% confidence intervals: 1.64, 2.28) to 2.82 (2.07, 3.83) in men, and from 2.37 (2.05, 2.73) to 3.48 (2.57, 4.72) in women. Most of the association was observed in overweight participants, as only 3% of the Japanese were obese. In addition to the relationship between excessive BMI and other adverse health conditions, the rise in the association with hypertension increases the urgency in addressing weight control. We need to address the overweight and obesity epidemic.
  • Koshi Nakamura, Hideaki Nakagawa, Yoshitaka Murakami, Akihiko Kitamura, Masahiko Kiyama, Kiyomi Sakata, Ichiro Tsuji, Katsuyuki Miura, Hirotsugu Ueshima, Tomonori Okamura
    KIDNEY INTERNATIONAL 88 5 1144 - 1152 2015年11月 [有り][無し]
     研究論文(学術雑誌) 
    Little is known about the magnitude and nature of the combined effect of chronic kidney disease (CKD) and smoking on cardiovascular diseases. We studied this in a Japanese population using a pooled analysis of 15,468 men and 19,154 women aged 40-89 years enrolled in 8 cohort studies. The risk of mortality from all-causes and cardiovascular disease was compared in 6 gender-specific categories of baseline CKD status (non-CKD or CKD) and smoking habits (lifelong never smoked, former smokers, or currently smoking). CKD was defined as a decreased level of estimated glomerular filtration rate (under 60 ml/min per 1.73 m(2)) and/or dipstick proteinuria. Hazard ratios were estimated for each category, relative to never smokers without CKD. During the follow-up period (mean 14.8 years), there were 6771 deaths, 1975 of which were due to cardiovascular diseases. In both men and women, current or former smokers with CKD had the first or second highest crude mortality rates from all-cause and cardiovascular diseases among the 6 categories. After adjustment for age and other major cardiovascular risk factors, the hazard ratios in male and female current smokers with CKD were 2.26 (95% confidence interval, 1.95-2.63) and 1.78 (1.36 - 2.32) for all-causes, and 2.66 (2.04-3.47) and 1.71 (1.10 - 2.67) for cardiovascular diseases, respectively. Thus, coexistence of CKD and smoking may markedly increase the risk of all-cause and cardiovascular mortality.
  • Masato Nagai, Takayoshi Ohkubo, Yoshitaka Murakami, Naoyuki Takashima, Aya Kadota, Naoko Miyagawa, Yoshino Saito, Nobuo Nishi, Nagako Okuda, Yutaka Kiyohara, Hideaki Nakagawa, Yoshikazu Nakamura, Akira Fujiyoshi, Robert D. Abbott, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima, Katsuyuki Miura
    HYPERTENSION RESEARCH 38 11 798 - 798 2015年11月 [有り][無し]
  • 自由行動下の日本人における尿Na/K比の日内変動
    岩堀 敏之, 上島 弘嗣, 鳥居 さゆ希, 斎藤 祥乃, 近藤 慶子, 宮川 尚子, 有馬 久富, 三浦 克之
    日本高血圧学会総会プログラム・抄録集 38回 360 - 360 (NPO)日本高血圧学会 2015年10月
  • Akira Sekikawa, Yoshihiro Miyamoto, Katsuyuki Miura, Kunihiro Nishimura, Bradley J. Willcox, Kamal H. Masaki, Beatriz Rodriguez, Russell P. Tracy, Tomonori Okamura, Lewis H. Kuller
    INTERNATIONAL JOURNAL OF EPIDEMIOLOGY 44 5 1614 - 1624 2015年10月 [有り][無し]
     研究論文(学術雑誌) 
    Background: The Seven Countries Study in the 1960s showed very low mortality from coronary heart disease (CHD) in Japan, which was attributed to very low levels of total cholesterol. Studies of migrant Japanese to the USA in the 1970s documented increase in CHD rates, thus CHD mortality in Japan was expected to increase as their lifestyle became Westernized, yet CHD mortality has continued to decline since 1970. This study describes trends in CHD mortality and its risk factors since 1980 in Japan, contrasting those in other selected developed countries. Methods: We selected Australia, Canada, France, Japan, Spain, Sweden, the UK and the USA. CHD mortality between 1980 and 2007 was obtained from WHO Statistical Information System. National data on traditional risk factors during the same period were obtained from literature and national surveys. Results: Age-adjusted CHD mortality continuously declined between 1980 and 2007 in all these countries. The decline was accompanied by a constant fall in total cholesterol except Japan where total cholesterol continuously rose. In the birth cohort of individuals currently aged 50-69 years, levels of total cholesterol have been higher in Japan than in the USA, yet CHD mortality in Japan remained the lowest: > 67% lower in men and > 75% lower in women compared with the USA. The direction and magnitude of changes in other risk factors were generally similar between Japan and the other countries. Conclusions: Decline in CHD mortality despite a continuous rise in total cholesterol is unique. The observation may suggest some protective factors unique to Japanese.
  • 宮澤 伊都子, 門田 文, 岡本 元純, 三浦 克之, 前川 聡, 大西 淳夫, 滋賀県医師会糖尿病実態調査委員会
    肥満研究 21 Suppl. 148 - 148 (一社)日本肥満学会 2015年09月
  • Abhishek Vishnu, Jina Choo, Bradley Wilcox, Takashi Hisamatsu, Emma J. M. Barinas-Mitchell, Akira Fujiyoshi, Rachel H. Mackey, Aya Kadota, Vasudha Ahuja, Takashi Kadowaki, Daniel Edmundowicz, Katsuyuki Miura, Beatriz L. Rodriguez, Lewis H. Kuller, Chol Shin, Kamal Masaki, Hirotsugu Ueshima, Akira Sekikawa
    INTERNATIONAL JOURNAL OF CARDIOLOGY 189 67 - 72 2015年06月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Brachial-ankle pulse wave velocity (baPWV) is a simple and reproducible measure of arterial stiffness and is extensively used to assess cardiovascular disease (CVD) risk in eastern Asia. We examined whether baPWV is associated with coronary atherosclerosis in an international study of healthy middle-aged men. Methods: A population-based sample of 1131men aged 40-49 years was recruited - 257 Whites and 75 Blacks in Pittsburgh, US, 228 Japanese-Americans in Honolulu, US, 292 Japanese in Otsu, Japan, and 279 Koreans in Ansan, Korea. baPWV was measured with an automated waveform analyzer (VP2000, Omron) and atherosclerosis was examined as coronary artery calcification (CAC) by computed-tomography (GE-Imatron EBT scanner). Association of the presence of CAC (defined as >= 10 Agatston unit) was examined with continuous measure as well as with increasing quartiles of baPWV. Results: As compared to the lowest quartile of baPWV, the multivariable-adjusted odds ratio (95% Confidence Interval [CI]) for the presence of CAC in the combined sample was 1.70 (0.98, 2.94) for 2nd quartile, 1.88 (1.08, 3.28) for 3rd quartile, and 2.16 (1.19, 3.94) for 4th quartile (p-trend = 0.01). The odds for CAC increased by 19% per 100 cm/s increase (p < 0.01), or by 36% per standard-deviation increase (p < 0.01) in baPWV. Similar effect-sizes were observed in individual races, and were significant among Whites, Blacks and Koreans. Conclusion: baPWV is cross-sectionally associated with CAC among healthy middle-aged men. The association was significant in Whites and Blacks in the US, and among Koreans. Longitudinal studies are needed to determine its CVD predictive ability. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
  • Maryam Zaid, Akira Fujiyoshi, Katsuyuki Miura, Robert D. Abbott, Tomonori Okamura, Naoyuki Takashima, Sayuki Torii, Yoshino Saito, Takashi Hisamatsu, Naoko Miyagawa, Takayoshi Ohkubo, Aya Kadota, Akira Sekikawa, Hiroshi Maegawa, Yasuyuki Nakamura, Kenichi Mitsunami, Hirotsugu Ueshima
    ATHEROSCLEROSIS 239 2 444 - 450 2015年04月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: The association of high-density lipoprotein particle (HDL-P) with atherosclerosis may be stronger than that of HDL-cholesterol (HDL-C) and independent of conventional cardiovascular risk factors. Whether associations persist in populations at low risk of coronary heart disease (CHD) remains unclear. This study examines the associations of HDL-P and HDL-C with carotid intima-media thickness (cIMT) and plaque counts among Japanese men, who characteristically have higher HDL-C levels and a lower CHD burden than those in men of Western populations. Methods: We cross-sectionally examined a community-based sample of 870 Japanese men aged 40-79 years, free of known clinical cardiovascular disease (CVD) and not on lipid-lowering medication. Participants were randomly selected among Japanese living in Kusatsu City in Shiga, Japan. Results: Both HDL-P and HDL-C were inversely and independently associated with cIMT in models adjusted for conventional CHD risk factors, including low-density lipoprotein cholesterol (LDL-C) and diabetes. HDL-P maintained an association with cIMT after further adjustment for HDL-C (P < 0.01), whereas the association of HDL-C with cIMT was noticeably absent after inclusion of HDL-P in the model. In plaque counts of the carotid arteries, HDL-P was significantly associated with a reduction in plaque count, whereas HDL-C was not. Conclusion: HDL-P, in comparison to HDL-C, is more strongly associated with measures of carotid atherosclerosis in a cross-sectional study of Japanese men. Findings demonstrate that, HDL-P is a strong correlate of subclinical atherosclerosis even in a population at low risk for CHD. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
  • N. Okuda, K. Miura, A. Okayama, T. Okamura, R. D. Abbott, N. Nishi, A. Fujiyoshi, Y. Kita, Y. Nakamura, N. Miyagawa, T. Hayakawa, T. Ohkubo, Y. Kiyohara, H. Ueshima
    EUROPEAN JOURNAL OF CLINICAL NUTRITION 69 4 482 - 488 2015年04月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND/OBJECTIVES: There have been few studies on the association of fruit and vegetable (FV) intake with cardiovascular disease (CVD) risk in Asian populations where both dietary habits and disease structure are different from western countries. No study in Asia has found its significant association with stroke. We examined associations of FV intake with mortality risk from total CVD, stroke and coronary heart diseases (CHDs) in a representative Japanese sample. METHODS: A total of 9112 participants aged from 24-year follow-up data in the NIPPON DATA80, of which baseline data were obtained in the National Nutrition Survey Japan in 1980, were studied. Dietary data were obtained from 3-day weighing dietary records. Participants were divided into sex-specific quartiles of energy adjusted intake of FV. Multivariate-adjusted hazard ratios (HRs) were calculated between strata of the total of FV intake, fruit intake and vegetable intake. The adjustment included age, sex, smoking, drinking habit and energy adjusted intakes of sodium and some other food groups. RESULTS: Participants with higher FV intake were older, ate more fish, milk and dairy products and soybeans and legumes and ate less meat. Multivariate-adjusted HR (95% confidence interval; P; P for trend) for the highest versus the lowest quartile of the total of FV intake was 0.74 (0.61-0.91; 0.004; 0.003) for total CVD, 0.80 (0.59-1.09; 0.105; 0.036) for stroke and 0.57 (0.37-0.87; 0.010; 0.109) for CHD. CONCLUSIONS: The results showed that higher total intake of FVs was significantly associated with reduced risk of CVD mortality in Japan.
  • 日本人男性におけるhigh-density lipoprotein粒子濃度と頸動脈の無症候性アテローム性動脈硬化症との関連性(The Association of High-density Lipoprotein Particle Concentration with Subclinical Atherosclerosis of the Carotid Arteries in Japanese Men)
    Zaid Maryam, Fujiyoshi Akira, Miura Katsuyuki, Abbott Robert D., Okamura Tomonori, Takashima Naoyuki, Torii Sayuki, Saito Yoshino, Hisamatsu Takashi, Miyagawa Naoko, Ohkubo Takayoshi, Kadota Aya, Sekikawa Akira, Maegawa Hiroshi, Nakamura Yasuyuki, Mitsunami Kenichi, Ueshima Hirotsugu
    Circulation Journal 79 Suppl.I 634 - 634 2015年03月
  • 一般日本人集団における主要および軽微なECG異常の無症候性アテローム硬化との関連性 SESSA(Association of Major and Minor ECG Abnormalities with Subclinical Atherosclerosis in a General Japanese Population: SESSA)
    Hisamatsu Takashi, Miura Katsuyuki, Fujiyoshi Akira, Kadowaki Sayaka, Zaid Maryam, Torii Sayuki, Kadota Aya, Nakamura Yasuyuki, Horie Minoru, Ueshima Hirotsugu
    Circulation Journal 79 Suppl.I 2059 - 2059 2015年03月
  • Koshi Nakamura, Nagako Okuda, Tomonori Okamura, Katsuyuki Miura, Kunihiro Nishimura, Seiji Yasumura, Kiyomi Sakata, Hideki Hidaka, Akira Okayama
    ALCOHOL AND ALCOHOLISM 50 2 236 - 243 2015年03月 [有り][無し]
     研究論文(学術雑誌) 
    Aims: This study investigated the relationship between alcohol drinking habits and the onset of high medical expenditure in a Japanese male population. Methods: The cohort comprised 94,307 male beneficiaries 40-69 years of age of the Japanese medical insurance system, who had daily alcohol drinking habits. The likelihood of incurring high medical expenditure, defined as the a parts per thousand yen90th percentile of the medical expenditure distribution in the study population 1 year after baseline, as well as the likelihood of undergoing hospitalization that year were compared among the participants grouped according to their alcohol consumption amount (< 2, 2-3.9, 4-5.9, a parts per thousand yen6 drinks/day). Results: Participants who ranked in the top 10% medical expenditure group within the 1 year after baseline each incurred at least 2152 euros/year. The top 10% medical expenditure group accounted for 61.1% of the total medical expenditure in the study population. The odds ratios (95% confidence intervals) for ranking in the top 10% group during the 1-year period, compared with the < 2 drinks (23 g of alcohol)/day group, were 1.08 (1.02-1.15) for 2-3.9 drinks/day, 1.11 (1.05-1.19) for 4-5.9 drinks/day, and 1.31 (1.18-1.45) for a parts per thousand yen6 drinks/day after adjustment for age, body mass index, and smoking and exercise habits. The adjusted odds ratios for undergoing hospitalization were 1.11 (1.04-1.19), 1.14 (1.06-1.24) and 1.39 (1.24-1.56), respectively. Conclusion: The likelihood of incurring high medical expenditure and undergoing hospitalization increased with daily alcohol consumption amount.
  • S. R. El Khoudary, C. Shin, K. Masaki, K. Miura, M. Budoff, D. Edmundowicz, S. Kadowaki, E. Barinas-Mitchell, A. El-Saed, A. Fujiyoshi, R. W. Evans, T. Hisamatsu, T. Ohkubo, B. J. Willcox, L. H. Kuller, H. Ueshima, A. Sekikawa
    INTERNATIONAL JOURNAL OF OBESITY 39 3 488 - 494 2015年03月 [無し][無し]
     研究論文(学術雑誌) 
    BACKGROUND/OBJECTIVES: Higher volumes of ectopic cardiovascular fat (ECF) are associated with greater risk of coronary heart disease (CHD). Identifying factors that are associated with ECF volumes may lead to new preventive efforts to reduce risk of CHD. Significant racial/ethnic differences exist for overall and central adiposity measures, which are known to be associated with ECF volumes. Whether racial/ethnic differences also exist for ECF volumes and their associations with these adiposity measures remain unclear. SUBJECTS/METHODS: Body mass index (BMI), computerized tomography-measured ECF volumes (epicardial, pericardial and their summation) and visceral adipose tissue (VAT) were examined in a community-based sample of 1199 middle-aged men (24.2% Caucasians, 7.0% African-Americans, 23.6% Japanese-Americans, 22.0% Japanese, 23.2% Koreans). RESULTS: Significant racial/ethnic differences existed in ECF volumes and their relationships with BMI and VAT. ECF volumes were the highest among Japanese-Americans and the lowest among African-Americans. The associations of BMI and VAT with ECF differed by racial/ethnic groups. Compared with Caucasians, for each 1-unit increase in BMI, African-Americans had lower, whereas Koreans had higher increases in ECF volumes (P-values < 0.05 for both). Meanwhile, compared with Caucasians, for each 1-unit increase in log-transformed VAT, African-Americans, Japanese-Americans and Japanese had similar increases, whereas Koreans had a lower increase in ECF volumes (P-value < 0.05). CONCLUSIONS: Racial/ethnic groups differed in their propensity to accumulate ECF at increasing level of overall and central adiposity. Future studies should evaluate whether reducing central adiposity or overall weight will decrease ECF volumes more in certain racial/ethnic groups. Evaluating these questions might help in designing race-specific prevention strategy of CHD risk associated with higher ECF.
  • Michihiro Satoh, Takayoshi Ohkubo, Kei Asayama, Yoshitaka Murakami, Masaru Sakurai, Hideaki Nakagawa, Hiroyasu Iso, Akira Okayama, Katsuyuki Miura, Yutaka Imai, Hirotsugu Ueshima, Tomonori Okamura
    HYPERTENSION 65 3 517 - 524 2015年03月 [有り][無し]
     研究論文(学術雑誌) 
    No large-scale, longitudinal studies have examined the combined effects of blood pressure (BP) and total cholesterol levels on long-term risks for subtypes of cardiovascular death in an Asian population. To investigate these relationships, a meta-analysis of individual participant data, which included 73 916 Japanese subjects (age, 57.7 years; men, 41.1%) from 11 cohorts, was conducted. During a mean follow-up of 15.0 years, deaths from coronary heart disease, ischemic stroke, and intraparenchymal hemorrhage occurred in 770, 724, and 345 cases, respectively. Cohort-stratified Cox proportional hazard models were used. After stratifying the participants by 4 systolic BP x4 total cholesterol categories, the group with systolic BP >= 160 mm Hg with total cholesterol >= 5.7 mmol/L had the greatest risk for coronary heart disease death (adjusted hazard ratio, 4.39; P<0.0001 versus group with systolic BP <120 mm Hg and total cholesterol <4.7 mmol/L). The adjusted hazard ratios of systolic BP (per 20 mm Hg) increased with increases in total cholesterol categories (hazard ratio, 1.52; P<0.0001 in group with total cholesterol >= 5.7 mmol/L). Similarly, the adjusted hazard ratios of total cholesterol increased with increases in systolic BP categories (P for interaction <= 0.04). Systolic BP was positively associated with ischemic stroke and intraparenchymal hemorrhage death, and total cholesterol was inversely associated with intraparenchymal hemorrhage, but no significant interactions between BP and total cholesterol were observed for stroke. High BP and high total cholesterol can synergistically increase the risk for coronary heart disease death but not for stroke in the Asian population.
  • Miura K
    Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine 104 2 203 - 210 2015年02月 [有り][無し]
  • Johan Sundstrom, Hisatomi Arima, Rod Jackson, Fiona Turnbull, Kazem Rahimi, John Chalmers, Mark Woodward, Bruce Neal
    ANNALS OF INTERNAL MEDICINE 162 3 184 - U74 2015年02月 [無し][無し]
     研究論文(学術雑誌) 
    Background: Effects of blood pressure reduction in persons with grade 1 hypertension are unclear. Purpose: To investigate whether pharmacologic blood pressure reduction prevents cardiovascular events and deaths in persons with grade 1 hypertension. Data Sources: Trials included in the BPLTTC (Blood Pressure Lowering Treatment Trialists' Collaboration) and trials identified from a previous review and electronic database searches. Study Selection: Patients without cardiovascular disease with blood pressures in the grade 1 hypertension range (140 to 159/90 to 99 mm Hg) who were randomly assigned to an active (antihypertensive drug or more intensive regimen) or control (placebo or less intensive regimen) blood pressure-lowering regimen. Data Extraction: Individual-patient data from BPLTTC trials and aggregate data from other trials were extracted. Risk of bias was assessed for all trials. Data Synthesis: Individual-patient data involved 10 comparisons from trials where most patients had diabetes, and aggregate data involved 3 comparisons from trials of patients without diabetes. The average blood pressure reduction was about 3.6/2.4 mm Hg. Over 5 years, odds ratios were 0.86 (95% CI, 0.74 to 1.01) for total cardiovascular events, 0.72 (CI, 0.55 to 0.94) for strokes, 0.91 (CI, 0.74 to 1.12) for coronary events, 0.80 (CI, 0.57 to 1.12) for heart failure, 0.75 (CI, 0.57 to 0.98) for cardiovascular deaths, and 0.78 (CI, 0.67 to 0.92) for total deaths. Results were similar in secondary analyses. Withdrawal from treatment due to adverse effects was more common in the active groups. Limitation: Blood pressure reductions and numbers of events were small. Conclusion: Blood pressure-lowering therapy is likely to prevent stroke and death in patients with uncomplicated grade 1 hypertension.
  • Ahuja V, Kadowaki T, Evans RW, Kadota A, Okamura T, El Khoudary SR, Fujiyoshi A, Barinas-Mitchell EJ, Hisamatsu T, Vishnu A, Miura K, Maegawa H, El-Saed A, Kashiwagi A, Kuller LH, Ueshima H, Sekikawa A, for the ERA JUMP, Study Group
    Diabetologia 58 2 265 - 271 2015年02月 [有り][無し]
     研究論文(学術雑誌) 
    At the same level of BMI, white people have less visceral adipose tissue (VAT) and are less susceptible to developing type 2 diabetes than Japanese people. No previous population-based studies have compared insulin resistance and insulin secretion between these two races in a standardised manner that accounts for VAT. We compared HOMA-IR, HOMA of beta cell function (HOMA-beta%) and disposition index (DI) in US white men and Japanese men in Japan. We conducted a population-based, cross-sectional study, comprising 298 white men and 294 Japanese men aged 40-49 years without diabetes. Insulin, glucose, VAT and other measurements were performed at the University of Pittsburgh. We used ANCOVA to compare geometric means of HOMA-IR, HOMA-beta% and DI, adjusting for VAT and other covariates. White men had higher HOMA-IR, HOMA-beta% and DI than Japanese men, and the difference remained significant (p < 0.01) after adjusting for VAT (geometric mean [95% CI]): 3.1 (2.9, 3.2) vs 2.5 (2.4, 2.6), 130.8 (124.6, 137.3) vs 86.7 (82.5, 91.0), and 42.4 (41.0, 44.0) vs 34.8 (33.6, 36.0), respectively. Moreover, HOMA-IR, HOMA-beta% and DI were significantly higher in white men even after further adjustment for BMI, impaired fasting glucose and other risk factors. The higher VAT-adjusted DI in white men than Japanese men may partly explain lower susceptibility of white people than Japanese people to developing type 2 diabetes. The results, however, should be interpreted with caution because the assessment of insulin indices was made using fasting samples and adjustment was not made for baseline glucose tolerance. Further studies using formal methods to evaluate insulin indices are warranted.
  • Daisuke Sugiyama, Tomonori Okamura, Makoto Watanabe, Aya Higashiyama, Nagako Okuda, Yasuyuki Nakamura, Atsushi Hozawa, Yoshikuni Kita, Aya Kadota, Yoshitaka Murakami, Naomi Miyamatsu, Takayoshi Ohkubo, Takehito Hayakawa, Yoshihiro Miyamoto, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 22 1 95 - 107 2015年 [有り][無し]
     研究論文(学術雑誌) 
    Aims: The population-attributable fraction (PAF) is an indicator of the disease burden. In Western countries, the PAF of hypercholesterolemia in cardiovascular disease (CVD) is the highest among that for traditional risk factors; however, data for Asian populations are limited. Methods: A 24-year cohort study was conducted among 9,209 randomly selected participants who were not taking statins. We estimated the hazard ratio (HR) after adjusting for covariates and PAF associated with the serum total cholesterol (TC) levels in relation to CVD mortality. Results: The TC level was found to be positively associated with an increased risk of CVD, coronary heart disease (CHD) and cardiac death (CHD plus heart failure), with an HR of 1.08 (95% confidence interval [CI]: 1.00-1.16), 1.33 (95% CI: 1.14-1.55) and 1.21 (95% CI: 1.08-1.35) for a 1-SD increment in the serum TC level, respectively. Similar positive associations between the TC level and both CHD and cardiac death were observed after classifying the patients by age and sex. Furthermore, the highest serum TC level (>= 6.72 mmol/L) was positively associated with CVD death, with an HR of 1.76 (95% CI: 1.25-2.47), as well as both CHD death and cardiac death. In contrast, no significant relationships were observed between the serum TC level and stroke. Meanwhile, the PAF for CVD, CHD, and cardiac deaths due to hypercholesterolemia (serum TC level >= 5.69 mmol/L, defined by the Japan Atherosclerosis Society) was 1.7%, 10.6% and 5.6%, respectively. Conclusions: The estimated PAF of CVD death due to hypercholesterolemia is moderately high, but lower than that for other risk factors, such as hypertension.
  • Shin-ya Nagasawa, Takayoshi Ohkubo, Kamal Masaki, Emma Barinas-Mitchell, Katsuyuki Miura, Todd B. Seto, Aiman El-Saed, Takashi Kadowaki, Bradley J. Willcox, Daniel Edmundowicz, Aya Kadota, Rhobert W. Evans, Sayaka Kadowaki, Akira Fujiyoshi, Takashi Hisamatsu, Marianne H. Bertolet, Tomonori Okamura, Yasuyuki Nakamura, Lewis H. Kuller, Hirotsugu Ueshima, Akira Sekikawa
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 22 6 590 - 598 2015年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: To examine whether the inflammatory markers C-reactive protein (CRP) and fibrinogen are associated with biomarkers of atherosclerosis [carotid intima-media thickness (IMT) and coronary artery calcification (CAC)] in the general male population, including Asians. Methods: Population-based samples of 310 Japanese, 293 Japanese-American and 297 white men 40-49 years of age without clinical cardiovascular disease underwent measurement of IMT, CAC and the CRP and fibrinogen levels as well as other conventional risk factors using standardized methods. Statistical associations between the variables were evaluated using multiple linear or logistic regression models. Results: The Japanese group had significantly lower levels of inflammatory markers and subclinical atherosclerosis than the Japanese-American and white groups (P-values all < 0.001). The mean level of CRP was 0.66 vs. 1.11 and 1.47 mg/L, while that of fibrinogen was 255.0 vs. 313.0 and 291.5 mg/dl, respectively. In addition, the mean carotid IMT was 0.61 vs. 0.73 and 0.68 mm, while the mean prevalence of CAC was 11.6% vs. 32.1% and 26.3%, respectively. Body mass index (BMI) showed significant positive associations with both the CRP and fibrinogen levels. Although CRP showed a significant positive association with IMT in the Japanese men, this association became non-significant following adjustment for traditional risk factors or BMI. In all three populations, CRP was not found to be significantly associated with the prevalence of CAC. Similarly, fibrinogen did not exhibit a significant association with either IMT or the prevalence of CAC. Conclusions: The associations between inflammatory markers and subclinical atherosclerosis may merely reflect the strong associations between BMI and the levels of inflammatory markers and incidence of subclinical atherosclerosis in both Eastern and Western populations.
  • Misawa A, Yoshita K, Fukumura T, Tanaka T, Tamaki J, Takebayashi T, Kusaka Y, Nakagawa H, Yamato H, Okayama A, Miura K, Okamura T, Ueshima H, HIPOP-OHP Research Group
    Sangyo eiseigaku zasshi = Journal of occupational health 57 3 97 - 107 Japan Society for Occupational Health 2015年 [有り][無し]
     
    目的:従業員食堂を中心とした長期間の食環境介入が野菜類の摂取量に及ぼす効果を検討する.対象と方法:対象は福井県現業系事業所の従業員約1,200人(19–61歳)である.野菜摂取量を増加させるため,日本型の3要素(主食・主菜・副菜(野菜))を組み合わせた食事の摂取を推進した.適切な食物選択を導くための食環境整備として,従業員食堂の全ての献立表示を3色で示した(3要素順に,黄色・赤色・緑色).食事の代金清算時に,3要素を組み合わせて食事を選択するよう栄養教育を実施した(適切選択者).同時に適切選択者の割合も評価した.介入前後に,半定量食物摂取頻度調査法に準じた質問紙調査を実施した.野菜類の摂取頻度と摂取目安量を質問し,1人1日当たりの推定摂取量の平均値を求めた.結果:適切選択者は,介入1年後63.5%から,介入2年後82.1%(p<0.001),介入3年後80.0%(p<0.001)へと有意に増加した.介入3年後では,朝食時(p<0.001),昼食時(p<0.001),夕食時(p=0.011)の野菜,野菜ジュース(p=0.030)の推定摂取量は,有意に増加した.漬物は有意に減少した(p=0.009).これにより野菜類摂取量は,男性では167.3 gから184.6 g,女性では157.9 gから187.7 gに増加したと推定された.考察:従業員食堂を中心とした長期間の食環境介入によって(3年間),野菜の推定摂取量の増加,漬物の推定摂取量の減少が認められ,野菜類の摂取量に望ましい効果が示された.
  • Takehiro Yamaguchi, Takanori Yamazaki, Yasuhiro Nakamura, Masayuki Shiota, Kenei Shimada, Katsuyuki Miura, Hiroshi Iwao, Minoru Yoshiyama, Yasukatsu Izumi
    Journal of Pharmacological Sciences 127 4 474 - 480 2015年 [有り][無し]
     研究論文(学術雑誌) 
    Percutaneous treatment with carbon dioxide (CO2) mist, CO2 gas dissolved in water, contributes to improved cardiac function after myocardial infarction (MI). In this study, we investigated the effects of repeated pretreatment with CO2 mist on cardiac dysfunction after MI. The CO2 mist was generated by a dry mist production unit. The whole body of rats below the axilla was wrapped in a polyethylene bag, which was sealed and filled with the CO2 mist in the draft cabinet for 30 min daily for 7 days. MI was induced by ligation of the coronary artery in untreated (UT), CO2 gas-pretreated (CG), and CO2 mistpretreated (CM) rats. The infarct size and the increase in oxidative stress due to MI were significantly smaller in the CM rats than in the UT rats. Furthermore, the expression of inflammation-related genes, such as monocyte chemoattractant protein-1, and fibrosis-related genes, such as transforming growth factor-β1, was significantly suppressed in the CM rats. The CM rats had a better left ventricular ejection fraction than the UT rats 7 days after MI. These parameters in the CG rats were the same as in the UT group. Thus, CO2 mist preparative treatment may be potentially useful for the reduction of MI.
  • Sayuki Torii, Hisatomi Arima, Takayoshi Ohkubo, Akira Fujiyoshi, Aya Kadota, Naoyuki Takashima, Sayaka Kadowaki, Takashi Hisamatsu, Yoshino Saito, Naoko Miyagawa, Maryam Zaid, Yoshitaka Murakami, Robert D. Abbott, Minoru Horie, Katsuyuki Miura, Hirotsugu Ueshima
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 22 12 1266 - 1277 2015年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: Pulse wave velocity (PWV) is a simple and valid clinical method for assessing arterial stiffness. Coronary artery calcification (CAC) is an intermediate stage in the process leading to overt cardiovascular disease (CVD) and an established determinant of coronary artery disease. This study aimed to examine the association between PWV and CAC in a population-based sample of Japanese men. Methods: This is a cross-sectional study of 986 randomly selected men aged 40-79 years from Shiga, Japan. CVD-free participants were examined from 2006 to 2008. Brachial-ankle PWV (baPWV) was measured using an automatic waveform analyzer. CAC was assessed using computed tomography. Agatston scores >= 10 were defined as the presence of CAC. Results: Prevalence of CAC progressively increased with rising levels of baPWV: 20.6%, 41.7%, 56.3%, and 66.7% across baPWV quartiles < 1378, 1378-1563, 1564-1849, and > 1849 cm/s (P < 0.001 for trend). Associations remained significant after adjusting for age and other factors, including body mass index, systolic blood pressure, pulse rate, total and high-density lipoprotein cholesterol, hemoglobin A1c, drinking, smoking and exercise status, and the use of medication to treat hypertension, dyslipidemia and diabetes (P = 0.042 for trend). The optimal cutoff level of baPWV to detect CAC was 1612 cm/s using receiver operating characteristic curve analysis. Conclusions: Arterial stiffness as defined by an elevated baPWV is associated with an increased prevalence of CAC in a general population-based setting among Japanese men.
  • Takashi Hisamatsu, NIPPON DATA80 Research Group, Katsuyuki Miura, Akira Fujiyoshi, Tomonori Okamura, Takayoshi Ohkubo, Shin-Ya Nagasawa, Minoru Horie, Akira Okayama, Hirotsugu Ueshima, Shigeyuki Saitoh, Kiyomi Sakata, Atsushi Hozawa, Takehito Hayakawa, Yosikazu Nakamura, Yasuhiro Matsumura, Nobuo Nishi, Nagako Okuda, Fumiyoshi Kasagi, Toru Izumi, Toshiyuki Ojima, Koji Tamakoshi, Hideaki Nakagawa, Yoshitaka Murakami, Yoshikuni Kita, Naomi Miyamatsu, Yasuyuki Nakamura, Katsushi Yoshita, Aya Kadota, Yoshihiro Miyamoto, Kazunori Kodama, Yutaka Kiyohara
    International Journal of Cardiology 184 1 291 - 293 2015年 [有り][無し]
     研究論文(学術雑誌)
  • Taku Inohara, Shun Kohsaka, Tomonori Okamura, Makoto Watanabe, Yasuyuki Nakamura, Aya Higashiyama, Aya Kadota, Nagako Okuda, Yoshitaka Murakami, Takayoshi Ohkubo, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY 21 12 1501 - 1508 2014年12月 [有り][無し]
     研究論文(学術雑誌) 
    Aims Various cohort studies have shown a close association between long-term cardiovascular disease (CVD) outcomes and individual electrocardiographic (ECG) abnormalities such as axial, structural, and repolarization changes. The combined effect of these ECG abnormalities, each assumed to be benign, has not been thoroughly investigated. Methods and Results Community-dwelling Japanese residents from the National Integrated Project for Perspective Observation of Non-Communicable Disease and its Trends in the Aged, 1980-2004 and 1990-2005 (NIPPON DATA80 and 90), were included in this study. Baseline ECG findings were classified using the Minnesota Code and categorized into axial (left axis deviation, clockwise rotation), structural (left ventricular hypertrophy, atrial enlargement), and repolarization (minor and major ST-T changes) abnormalities. The hazard ratios of the cumulative impacts of ECG findings on long-term CVD death were estimated by stratified Cox proportional hazard models, including adjustments for cohort strata. In all, 16,816 participants were evaluated. The average age was 51.213.5 years; 42.7% participants were male. The duration of follow up was 300,924 person-years (mean 17.9 +/- 5.8 years); there were 1218 CVD deaths during that time. Overall, 4203 participants (25.0%) had one or more categorical ECG abnormalities: 3648 (21.7%) had a single abnormality, and 555 (3.3%) had two or more. The risk of CVD mortality increased as the number of abnormalities accumulated (single abnormality HR 1.29, 95% CI 1.13-1.48; 2 abnormalities HR 2.10, 95% CI 1.73-2.53). Conclusions Individual ECG abnormalities had an additive effect in predicting CVD outcome risk in our large-scale cohort study.
  • Nagako Okuda, Jeremiah Stamler, Ian J. Brown, Hirotsugu Ueshima, Katsuyuki Miura, Akira Okayama, Shigeyuki Saitoh, Hideaki Nakagawa, Kiyomi Sakata, Katsushi Yoshita, Liancheng Zhao, Paul Elliott
    JOURNAL OF HYPERTENSION 32 12 2385 - 2392 2014年12月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: Habitual high-salt intake raises blood pressure and risk of cardiovascular diseases. To prevent/control these risks, reduced salt diet (RSD) is recommended in many countries and some people report practicing it; however, little is known about actual achievement. This population-based study assessed level of 24-h dietary sodium intake of participants reporting RSD and others. Method: Participants were 4680 men and women ages 40-59 years randomly selected from 17 populations in People's Republic of China (PRC), Japan, UK and USA, for an observational study on diet and blood pressure (INTERMAP). Daily sodium intake was determined by two timed 24-h urine collections. Antihypertensive treatment status and RSD were ascertained by questionnaire. Results: Participants reporting RSD were few; 3.1% (Japan), 1.3% (PRC), 2.5% (UK), 7.2% (USA); 15.1, 7.9, 16.7 and 16.8% of people with treated hypertension. For those reporting RSD, 24-h urinary sodium excretion was significantly, but only modestly lower than for others, by 17.9 mmol/day (Japan), 56.7 (PRC) and 14.7 (USA), but higher by 10.5 in UK. Sodium intakes for participants reporting RSD remained higher than recommended; 181.0 mmol/day (Japan), 171.5 (PRC), 155.2 (UK) and 148.9 (USA). For these people, as for others, main sources of salt were processed foods in Japan, UK and USA; in PRC, salt added in preparation at home. Conclusion: Enhanced sustained efforts are needed to raise general awareness of the harmful effects of salt on health and the benefits of salt reduction. Population approaches are needed to reduce salt content of processed foods and restaurant meals.
  • Koshi Nakamura, Masaru Sakurai, Katsuyuki Miura, Yuko Morikawa, Shin-Ya Nagasawa, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Motoko Nakashima, Kazuhiro Nogawa, Yasushi Suwazono, Hideaki Nakagawa
    JOURNAL OF SLEEP RESEARCH 23 6 717 - 727 2014年12月 [有り][無し]
     研究論文(学術雑誌) 
    We investigated the relation between overall sleep status based on the modified Pittsburgh Sleep Quality Index (PSQI) global score and subsequent changes in serum high-sensitivity C-reactive protein (hsCRP) in a population of Japanese factory workers, who were predominantly female. A total of 991 Japanese with inflammation classified as low cardiovascular risk (baseline hsCRP<1.0mgL(-1)) were grouped according to the presence or absence of unfavourable sleep, defined as a modified PSQI global score>5.5 points. The subsequent changes in hsCRP after 3years were then compared in the two groups. Analysis of covariance incorporating log-transformed baseline hsCRP, age, sex, lifestyle and physical and biochemical profiles was used to compare the geometric means of hsCRP at year 3 in each sleep status group. A logistic regression model incorporating the same variables was used to calculate the odds ratios for development of inflammation with a medium-to-high cardiovascular risk (hsCRP at year 31.0mgL(-1)) comparing the presence or absence of unfavourable sleep habits. The multivariate-adjusted geometric mean of hsCRP at year 3 was significantly higher in subjects with unfavourable sleep habits compared with those with a normal pattern (0.275 versus 0.242mgL(-1)). The multivariate-adjusted odds ratio for developing increased and potentially pathogenic levels of inflammation due to unfavourable sleep was 2.08 (95% confidence interval=1.29-3.35). There was a significant linear trend for the development of increased inflammation across the modified PSQI global scores (P=0.04). Unfavourable sleep is associated with activation of low-grade systemic inflammation.
  • Takehiro Yamaguchi, Takanori Yamazaki, Hiroaki Kawaguchi, Masashi Tawa, Yasuhiro Nakamura, Masayuki Shiota, Mayuko Osada-Oka, Akihide Tanimoto, Tomio Okamura, Katsuyuki Miura, Hiroshi Iwao, Minoru Yoshiyama, Yasukatsu Izumi
    JOURNAL OF PHARMACOLOGICAL SCIENCES 126 2 168 - 171 2014年10月 [有り][無し]
     研究論文(学術雑誌) 
    Metabolic syndrome (MetS) induces serious complications; therefore, we developed a noninvasive MetS model using an extremely small minipig, the Microminipig. For 8 weeks, Microminipigs were administrated a high-fat and high-cholesterol diet (HFCD) for atherosclerosis and N-G-nitro-L-arginine methyl ester (L-NAME) for inhibiting nitric oxide synthase. HFCD significantly increased serum low-density lipoprotein levels, L-NAME increased blood pressure and cardiac hypertrophy, and HFCD-induced aortal arteriosclerosis was accelerated by L-NAME administration. Endothelium-dependent relaxation of the coronary artery was remarkably decreased by L-NAME administration. This model may be useful for elucidating the mechanisms of MetS and developing new therapeutic medicines for its treatment.
  • Koshi Nakamura, Masaru Sakurai, Katsuyuki Miura, Yuko Morikawa, Shin-ya Nagasawa, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Motoko Nakashima, Kazuhiro Nogawa, Yasushi Suwazono, Hideaki Nakagawa
    DIABETES RESEARCH AND CLINICAL PRACTICE 106 1 154 - 160 2014年10月 [有り][無し]
     研究論文(学術雑誌) 
    Aims: To examine the relation of insulin resistant status determined by homeostasis model assessment of insulin resistance (HOMA-IR) with the risk of incident hyperuricemia. Methods: The study participants included 2071 Japanese men without hyperuricemia and diabetes, aged 35-54 years. The participants had undergone annual heath examinations for 6 years to compare incident hyperuricemia (serum uric acid >416.4 mu mol/L (7.0 mg/dL) and/or taking medication for hyperuricemia) in four groups based on quartiles of baseline HOMA-IR. Results: During follow-up there were 331 incident cases of hyperuricemia. The hazard ratios for hyperuricemia, compared with HOMA-IR <= 0.66, were 1.42 (95% confidence interval 1.02-1.98) for HOMA-IR 0.67-0.98, 1.20 (0.86-1.68) for HOMA-IR 0.99-1.49 and 1.44 (1.04-1.98) for HOMA-IR >= 1.50 after adjustment for baseline serum uric acid, creatinine, hypercholesterolemia and hypertension status, age, alcohol intake, and smoking and exercise habits. The hazard ratio associated with an increase of one standard deviation in lnHOMA-IR (1.85 as one geometric standard deviation of HOMA-IR) was 1.14 (1.03-1.28) (p for trend = 0.02). Conclusions: Increased HOMA-IR independently predicted the subsequent development of hyperuricemia. Insulin resistance itself or compensatory hyperinsulinemia may contribute to the development of hyperuricemia. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
  • Takashi Hisamatsu, Akira Fujiyoshi, Katsuyuki Miura, Takayoshi Ohkubo, Aya Kadota, Sayaka Kadowaki, Takashi Kadowaki, Takashi Yamamoto, Naoko Miyagawa, Maryam Zaid, Sayuki Torii, Naoyuki Takashima, Yoshitaka Murakami, Tomonori Okamura, Minoru Horie, Hirotsugu Ueshima
    ATHEROSCLEROSIS 236 2 237 - 243 2014年10月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: The utility of lipoprotein particle profiles measured by nuclear magnetic resonance (NMR) spectroscopy beyond standard serum lipids remains inconclusive. Furthermore, few studies have compared NMR measurements with standard lipids in association with coronary artery calcification (CAC) in Japanese, where the coronary atherosclerotic burden is low. We examined whether NMR-based lipoprotein particle profiles are associated with CAC, and compared them with standard lipid and lipid ratios in the Japanese general population. Methods and Results: We conducted a cross-sectional study in 851 men aged 40-79 years without cardiovascular diseases and lipid-lowering therapies. Adjusted odds ratios (ORs) (95% confidence intervals) for the top versus the bottom quartile of NMR-measured particle concentrations were 2.01 (1.24-3.23) for low-density lipoprotein (LDL-P), 1.04 (0.62-1.75) for high-density lipoprotein (HDL-P), 1.82 (1.13-2.95) for very-low-density lipoprotein (VLDL-P), and 1.92 (1.18-3.17) for LDL-P/HDL-P ratio. Similarly adjusted ORs of NMR-measured particle sizes were 0.59 (0.36-0.97) for LDL-P, 0.66 (0.40-1.10) for HDL-P, and 0.67 (0.40-1.12) for VLDL-P. The corresponding ORs were 1.82 (1.14-2.90) for total cholesterol (TC), 2.06 (1.28-3.30) for low-density lipoprotein cholesterol (LDL-C), 0.56 (0.34-0.91) for high-density lipoprotein cholesterol (HDL-C), 2.02 (1.24-3.29) for triglycerides, 2.08 (1.29-3.36) for non-high-density lipoprotein cholesterol (non-HDL-C), 2.27 (1.37-3.78) for TC/HDL-C ratio, and 1.73 (1.06-2.85) for LDL-C/HDL-C ratio. After mutual adjustment for total LDL-P concentration and TC/HDL-C ratio or non-HDL-C, LDL-P was no longer associated, whereas TC/HDL-C ratio remained significantly associated with CAC. Conclusions: In community-based Japanese men, the overall association of CAC with NMR-measured lipoprotein indices is comparable, but not superior, to that with standard lipids. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
  • Nahid Rumana, Yoshikuni Kita, Tanvir Chowdhury Turin, Yasuyuki Nakamura, Naoyuki Takashima, Masaharu Ichikawa, Hideki Sugihara, Yutaka Morita, Kunihiko Hirose, Kenzou Kawakami, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
    INTERNATIONAL JOURNAL OF STROKE 9 69 - 75 2014年10月 [有り][無し]
     研究論文(学術雑誌) 
    Background Few comprehensive stroke and acute myocardial infarction registries of long duration exist in Japan to illustrate trends in acute case-fatality of stroke and acute myocardial infarction with greater precision. We examined 17-year case-fatality rates of stroke and acute myocardial infarction using an entire community-monitoring registration system to investigate trends in these rates over time in a Japanese population. Methods Data were obtained from the Takashima Stroke and AMI Registry covering a stable population of approximately 55 000 residents of Takashima County in central Japan. We divided the total observation period of 17 years into four periods, 1989-1992, 1993-1996, 1997-2000, and 2001-2005. We calculated gender, age-specific and age-adjusted acute case-fatality rates (%) of stroke and acute myocardial infarction across these four periods. Results During the study period of 1989-2005, there were 341 fatal cases within 28 days of onset among 2239 first-ever stroke events and 163 fatal cases among 433 first-ever acute myocardial infarction events. The age-adjusted acute case-fatality rate of stroke was 14.9% in men and 15.7% in women. The age-adjusted acute case-fatality rate of acute myocardial infarction was 34.3% in men and 43.3% in women. The age-adjusted acute case-fatality rates of stroke and acute myocardial infarction showed insignificant differences across the four time periods. The average annual change in the acute case-fatality rate of stroke (-0.2%; 95% CI: -2.4-2.1) and acute myocardial infarction (2.7%; 95% CI: -0.7-6.1) did not change significantly across the study years. Conclusions The acute case-fatality rates of stroke and acute myocardial infarction have remained stable from 1989 to 2005 in a rural and semi-urban Japanese population.
  • Yasuyuki Nakamura, Nagako Okuda, Tomonori Okamura, Aya Kadota, Naoko Miyagawa, Takehito Hayakawa, Yoshikuni Kita, Akira Fujiyoshi, Masato Nagai, Naoyuki Takashima, Takayoshi Ohkubo, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    BRITISH JOURNAL OF NUTRITION 112 6 916 - 924 2014年09月 [無し][無し]
     研究論文(学術雑誌) 
    Long-term safety of consuming low-carbohydrate diets (LCD) in Asian populations, whose carbohydrate intake is relatively high, is not known. In the present study, the association of LCD with CVD and total mortality was assessed using data obtained in the NIPPON DATA80 (National Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged 1980) during 29 years of follow-up. At baseline in 1980, data were collected from study participants aged >= 30 years from randomly selected areas in Japan. LCD scores were calculated based on the percentage of energy as carbohydrate, fat and protein, estimated by 3 d weighed food records. A total of 9200 participants (56% women, mean age 51 years) were followed up. During the follow-up, 1171 CVD deaths (52% in women) and 3443 total deaths (48% in women) occurred. The multivariable-adjusted hazard ratio (HR) for CVD mortality using the Cox model comparing the highest v. lowest deciles of LCD score was 0 60 (95% CI 0 38, 0 94; P-trend = 0 021) for women and 0 78 (95% CI 0 58, 1 05; P-trend = 0 079) for women and men combined; the HR for total mortality was 0 74 (95% CI 0 57, 0 95; P-trend = 0 029) for women and 0 87 (95% CI 0 74, 1 02; P-trend = 0 090) for women and men combined. None of the associations was statistically significant in men. No differential effects of animal-based and plant-fish-based LCD were observed. In conclusions, moderate diets lower in carbohydrate and higher in protein and fat are significantly inversely associated with CVD and total mortality in women.
  • Akira Fujiyoshi, Katsuyuki Miura, Takayoshi Ohkubo, Takashi Kadowaki, Sayaka Kadowaki, Maryam Zaid, Takashi Hisamatsu, Akira Sekikawa, Matthew J. Budoff, Kiang Liu, Hirotsugu Ueshima
    AMERICAN JOURNAL OF EPIDEMIOLOGY 180 6 590 - 598 2014年09月 [有り][無し]
     研究論文(学術雑誌) 
    The incidence of coronary heart disease in the United States has declined, and prevalences of several coronary disease risk factors have become comparable to those in Japan. Therefore, the burden of coronary atherosclerosis may be closer among younger persons in the 2 countries. We aimed to compare prevalences of coronary atherosclerosis, measured with coronary artery calcium scores, between men in the 2 countries by age group (45-54, 55-64, or 65-74 years). We used community-based samples of Caucasian men in the United States (2000-2002; n = 1,067) and Japanese men in Japan (2006-2008; n = 832) aged 45-74 years, stratifying them into groups with 0, 1, 2, or >= 3 of the following risk factors: current smoking, overweight, diabetes, dyslipidemia, and hypertension. We calculated adjusted odds ratios of US Caucasian men's having Agatston scores of >= 10, >= 100, and >= 400 with reference to Japanese men. Overall, the odds of Caucasian men having each Agatston cutoff point were greater. The ethnic difference, however, became smaller in younger age groups. For example, adjusted odds ratios for Caucasian men's having an Agatston score of >= 100 were 2.05, 2.43, and 3.86 among those aged 45-54, 55-64, and 65-74 years, respectively. Caucasian men in the United States had a higher burden of coronary atherosclerosis than Japanese men, but the ethnic difference was smaller in younger age groups.
  • Takashi Hisamatsu, Katsuyuki Miura, Takayoshi Ohkubo, Takashi Yamamoto, Akira Fujiyoshi, Naoko Miyagawa, Aya Kadota, Naoyuki Takashima, Nagako Okuda, Katsushi Yoshita, Yoshikuni Kita, Yoshitaka Murakami, Yasuyuki Nakamura, Tomonori Okamura, Minoru Horie, Akira Okayama, Hirotsugu Ueshima
    JOURNAL OF CARDIOLOGY 64 3-4 218 - 224 2014年09月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Increased resting heart rate (RHR) independently predicts cardiovascular mortality. Meanwhile, long-chain n-3 fatty acids (LCn3FAs) have a cardioprotective effect. Our aim was to evaluate whether higher LCn3FAs intake attenuates the elevated risk of cardiovascular mortality associated with increased RHR. Methods: We conducted a population-based 24-year prospective cohort study of Japanese, whose LCn3FAs intake is relatively high. Study participants included 8807 individuals aged 30-95 years from randomly selected areas across Japan without cardiovascular diseases and anti-hypertensive drugs at baseline. The primary endpoint was cardiovascular mortality, and the secondary endpoints were cardiac and stroke mortality during 24 years of follow-up. Individual dietary LCn3FAs intake was estimated from household-based 3-day weighed food records. RHR was obtained from 3 consecutive R-wave intervals on 12-lead electrocardiography. Cox models were used to estimate the multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) adjusting for possible confounders. Results: During the follow-up period, 617 cardiovascular deaths were observed. The median daily intake of LCn3FAs was 0.37% kcal (0.86 g/day). The interaction between dietary LCn3FAs intake and RHR in the risk of cardiovascular mortality was statistically significant (p = 0.033). The risk of cardiovascular mortality was significantly higher in the low-intake group (<0.37% kcal) with an RHR >85 beats/min (bpm) [hazard ratio (HR), 1.67; 95% confidence interval (CI), 1.15-2.43], but not in the high-intake group (>= 0.37% kcal) with an RHR >85 bpm (HR, 0.92; 95% CI, 0.61-1.38), compared with those in the high-intake group with an RHR <70 bpm. Similar results were observed with stroke mortality, but not with cardiac mortality. Conclusions: The risk of cardiovascular mortality associated with increased RHR is elevated in participants with low dietary LCn3FAs intake, but not in participants with high dietary LCn3FAs intake in a representative Japanese general population. These results suggest that high dietary LCn3FAs intake may prevent cardiovascular mortality associated with increased RHR. (C) 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
  • Satoko Yoneyama, Masaru Sakurai, Koshi Nakamura, Yuko Morikawa, Katsuyuki Miura, Motoko Nakashima, Katsushi Yoshita, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Kazuhiro Nogawa, Yasushi Suwazono, Satoshi Sasaki, Hideaki Nakagawa
    PLOS ONE 9 8 e105198  2014年08月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Previous studies have shown that a diet with a high-glycemic index is associated with good sleep quality. Therefore, we investigated the association of sleep quality with the intake of 3 common starchy foods with different glycemic indexes-rice, bread, and noodles-as well as the dietary glycemic index in a Japanese population. Methods: The participants were 1,848 men and women between 20 and 60 years of age. Rice, bread, and noodle consumption was evaluated using a self-administered diet history questionnaire. Sleep quality was evaluated by using the Japanese version of the Pittsburgh Sleep Quality Index, and a global score >5.5 was considered to indicate poor sleep. Results: Multivariate-adjusted odds ratios (95% confidence intervals) for poor sleep across the quintiles of rice consumption were 1.00 (reference), 0.68 (0.49-0.93), 0.61 (0.43-0.85), 0.59 (0.42-0.85), and 0.54 (0.37-0.81) (p for trend = 0.015); those for the quintiles of noodle consumption were 1.00 (reference), 1.25 (0.90-1.74), 1.05 (0.75-1.47), 1.31 (0.94-1.82), and 1.82 (1.31-2.51) (p for trend = 0.002). Bread intake was not associated with sleep quality. A higher dietary glycemic index was significantly associated with a lower risk of poor sleep (p for trend = 0.020). Conclusion: A high dietary glycemic index and high rice consumption are significantly associated with good sleep in Japanese men and women, whereas bread intake is not associated with sleep quality and noodle consumption is associated with poor sleep. The different associations of these starchy foods with sleep quality might be attributable to the different glycemic index of each food.
  • Toshiyuki Iwahori, Hirotsugu Ueshima, Naoko Miyagawa, Naoto Ohgami, Hideyuki Yamashita, Takayoshi Ohkubo, Yoshitaka Murakami, Toshikazu Shiga, Katsuyuki Miura
    HYPERTENSION RESEARCH 37 8 765 - 771 2014年08月 [有り][無し]
     研究論文(学術雑誌) 
    The objective of this study was to determine the optimal number and type of casual (spot) urine specimens required to estimate an individual's urinary sodium/potassium (Na/K) ratio. A total of 48 participants, 25 men and 23 women, aged between 25 and 59 years, was recruited from healthy volunteers. The Na/K ratio in each casual urine and 7-day 24-h urine sample was measured. Correlation analysis and the quality of agreement by the Bland and Altman method between casual urine and 24-h urine were analyzed. The mean Na/K ratio of 7-day 24-h urine was 4.3. The mean Na/K ratio of six random specimens of daytime (collected between 09 and 17 hours) casual urine correlated most strongly with the Na/K ratio of 7-day 24-h urine (r=0.87). The bias for the mean Na/K ratio between 7-day 24-h urine and daytime casual urine was almost negligible (0.03), and the quality of agreement for the mean of the six random, daytime casual urine specimens on different days was similar to that of the 2-day 24-h urine samples for estimating 7-day 24-h values. Our findings show that the mean Na/K ratio of six random daytime casual urine specimens on different days was a good substitute for the 2-day 24-h urine Na/K ratio.
  • Nakamura K, Okamura T, Miura K, Okayama A
    World J Cardiol 6 7 531 - 538 2014年07月 [有り][無し]
     研究論文(学術雑誌) 
    Hypertension is a major determinant of health and is likely to have an effect on medical economics. The economic burden due to hypertension may be attributable not only to antihypertensive medication but also to the very expensive procedures required for cases of cardiovascular disease that occur more frequently in hypertensive compared with normotensive individuals. The objective of this article was to review articles published on prospective cohort studies that measured medical expenditure attributable to hypertension in community-dwelling populations in Japan. Many medical services in these populations are provided under the medical insurance system that requires the enrolment of all Japanese residents. Personal medical expenditure attributable to hypertension increases with worsening severity of the condition. Medical expenditure was increased further in cases of hypertensive patients who have another concomitant cardiovascular risk factor. In particular, hypertension, especially moderate-to-severe untreated hypertension, increases the risk of long-term hospitalization resulting in considerably higher medical expenditure, compared with non-hospitalized cases. Therefore, assuming that the use of antihypertensive medication is essential for hypertensive patients to prevent serious vascular diseases, a cost-effective high-risk strategy needs to be considered to reduce both ill-health and the economic burden due to hypertension. However, from a population perspective, medical expenditure attributable to hypertension comes mainly from pre-to-mild hypertension. Therefore, there is also a need to consider a population strategy that aims to shift the entire population to lower levels of blood pressure.
  • NIPPON DATA80の絶対リスクスコアの外的妥当性の検証
    中井 陸運, 宮本 恵宏, 西村 邦宏, 村上 義孝, 東山 綾, 斉藤 重幸, 坂田 清美, 磯 博康, 三浦 克之, 上島 弘嗣, 岡村 智教
    日本動脈硬化学会総会プログラム・抄録集 46回 289 - 289 (一社)日本動脈硬化学会 2014年06月
  • M. Sakurai, K. Nakamura, K. Miura, T. Takamura, K. Yoshita, S. Y. Nagasawa, Y. Morikawa, M. Ishizaki, T. Kido, Y. Naruse, Y. Suwazono, S. Sasaki, H. Nakagawa
    EUROPEAN JOURNAL OF NUTRITION 53 4 1137 - 1138 2014年06月 [無し][無し]
     研究論文(学術雑誌)
  • Q Chan, J Stamler, I J Brown, M L Daviglus, L Van Horn, A R Dyer, L M Oude Griep, K Miura, H Ueshima, L Zhao, J K Nicholson, E Holmes, P Elliott
    Journal of Human Hypertension 28 6 353 - 359 2014年06月 [有り][無し]
     研究論文(学術雑誌) 
    Inverse associations have been reported of overall vegetable intake to blood pressure (BP) whether such relations prevail for both raw and cooked vegetables has not been examined. Here we report cross-sectional associations of vegetable intakes with BP for 2195 Americans ages 40-59 in the International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) using four standardized multi-pass 24-h dietary recalls and eight BP measurements. Relations to BP of raw and cooked vegetables consumption, and main individual constituents were assessed by multiple linear regression. Intakes of both total raw and total cooked vegetables considered separately were inversely related to BP in multivariate-adjusted models. Estimated average systolic BP differences associated with two s.d. differences in raw vegetable intake (68 g per 1000 kcal) and cooked vegetable intake (92 g per 1000 kcal) were -1.9 mm Hg (95% confidence interval (CI): -3.1, -0.8 P=0.001) and -1.3 mm Hg (95% CI: -2.5, -0.2 P=0.03) without body mass index (BMI) in the full model -1.3 mm Hg (95% CI: -2.4, -0.2 P=0.02) and -0.9 mm Hg (95% CI: -2.0, 0.2 P=0.1) with additional adjustment for BMI. Among commonly consumed individual raw vegetables, tomatoes, carrots, and scallions related significantly inversely to BP. Among commonly eaten cooked vegetables, tomatoes, peas, celery, and scallions related significantly inversely to BP. © 2014 Macmillan Publishers Limited All rights reserved.
  • Kei Asayama, Michihiro Satoh, Yoshitaka Murakami, Takayoshi Ohkubo, Sin-ya Nagasawa, Ichiro Tsuji, Takeo Nakayama, Akira Okayama, Katsuyuki Miura, Yutaka Imai, Hirotsugu Ueshima, Tomonori Okamura
    HYPERTENSION 63 6 1189 - 1197 2014年06月 [有り][無し]
     研究論文(学術雑誌) 
    To evaluate the cardiovascular mortality risk in association with blood pressure level among people with and without antihypertensive treatment, we performed the participant-level meta-analysis that included 39 705 Japanese from 6 cohorts (58.4% women; mean age, 60.1 years; 20.4% treated). Multivariable-adjusted Cox models were used to analyze the risk of cardiovascular mortality and its subtypes among 6 blood pressure levels according to recent guidelines, optimal to Grade 3 hypertension, and the usage of antihypertensive medication at baseline. During median 10.0 years of follow-up, there were 2032 cardiovascular deaths (5.1 per 1000 person-years), of which 410 deaths were coronary heart disease, 371 were heart failure, and 903 deaths were stroke. Treated participants had significantly higher risk for cardiovascular mortality (hazard ratios, 1.50; 95% confidence intervals, 1.36-1.66), coronary heart disease (hazard ratios, 1.53; confidence intervals, 1.23-1.90), heart failure (hazard ratios, 1.39; confidence intervals, 1.09-1.76), and stroke (hazard ratios, 1.48; confidence intervals, 1.28-1.72) compared with untreated people. Among untreated participants, the risks increased linearly with an increment of blood pressure category (P0.011). The risk increments per blood pressure category were higher in young participants (<60 years; 22% to 79%) than those in old people (60 years; 7% to 15%) with significant interaction for total cardiovascular, heart failure, and stroke mortality (P0.026). Among treated participants, the significant linear association was also observed for cardiovascular mortality (P=0.0003), whereas no stepwise increase in stroke death was observed (P=0.19). The risks of cardiovascular mortality were approximate to 1.5-fold high in participants under antihypertensive medication. More attention should be paid to the residual cardiovascular risks in treated patients.
  • N. Takashima, T. C. Turin, K. Matsui, N. Rumana, Y. Nakamura, A. Kadota, Y. Saito, H. Sugihara, Y. Morita, M. Ichikawa, K. Hirose, K. Kawakani, N. Hamajima, K. Miura, H. Ueshima, Y. Kita
    JOURNAL OF HUMAN HYPERTENSION 28 5 323 - 327 2014年05月 [無し][無し]
     研究論文(学術雑誌) 
    Brachial-ankle pulse wave velocity (baPWV) is a non-invasive measure of arterial stiffness obtained using an automated system. Although baPWVs have been widely used as a non-invasive marker for evaluation of arterial stiffness, evidence for the prognostic value of baPWV in the general population is scarce. In this study, we assessed the association between baPWV and future cardiovascular disease (CVD) incidence in a Japanese population. From 2002 to 2009, baPWV was measured in a total of 4164 men and women without a history of CVD, and they were followed up until the end of 2009 with a median follow-up period of 6.5 years. Hazard ratios (HRs) for CVD incidence according to baPWV levels were calculated using a Cox proportional hazards model adjusted for potential confounding factors, including seated or supine blood pressure (BP). During the follow-up period, we observed 40 incident cases of CVD. In multivariable-adjusted model, baPWV as a continuous variable was not significantly associated with future CVD risk after adjustment for supine BP. However, compared with lower baPWV category (<18 ms(-1)), higher baPWV (>= 18.0 ms(-1)) was significantly associated with an increased CVD risk (HR: 2.70, 95% confidence interval: 1.18-6.19). Higher baPWV (>= 18.0 ms(-1)) would be an independent predictor of future CVD event in the general Japanese population.
  • Kazuaki Shimamoto, Katsuyuki Ando, Toshiro Fujita, Naoyuki Hasebe, Jitsuo Higaki, Masatsugu Horiuchi, Yutaka Imai, Tsutomu Imaizumi, Toshihiko Ishimitsu, Masaaki Ito, Sadayoshi Ito, Hiroshi Itoh, Hiroshi Iwao, Hisashi Kai, Kazuomi Kario, Naoki Kashihara, Yuhei Kawano, Shokei Kim-Mitsuyama, Genjiro Kimura, Katsuhiko Kohara, Issei Komuro, Hiroo Kumagai, Hideo Matsuura, Katsuyuki Miura, Ryuichi Morishita, Mitsuhide Naruse, Koichi Node, Yusuke Ohya, Hiromi Rakugi, Ikuo Saito, Shigeyuki Saitoh, Kazuyuki Shimada, Tatsuo Shimosawa, Hiromichi Suzuki, Kouichi Tamura, Norio Tanahashi, Takuya Tsuchihashi, Makoto Uchiyama, Shinichiro Ueda, Satoshi Umemura
    Hypertension research : official journal of the Japanese Society of Hypertension 37 4 253 - 390 2014年04月 [有り][無し]
  • Akira Sekikawa, Katsuyuki Miura, Sunghee Lee, Akira Fujiyoshi, Daniel Edmundowicz, Takashi Kadowaki, Rhobert W. Evans, Sayaka Kadowaki, Kim Sutton-Tyrrell, Tomonori Okamura, Marnie Bertolet, Kamal H. Masaki, Yasuyuki Nakamura, Emma J. M. Barinas-Mitchell, Bradley J. Willcox, Aya Kadota, Todd B. Seto, Hiroshi Maegawa, Lewis H. Kuller, Hirotsugu Ueshima
    HEART 100 7 569 - 573 2014年04月 [有り][無し]
     研究論文(学術雑誌) 
    Objective To determine whether serum concentrations of long chain n-3 polyunsaturated fatty acids (LCn3PUFAs) contribute to the difference in the incidence rate of coronary artery calcification (CAC) between Japanese men in Japan and white men in the USA. Methods In a population based, prospective cohort study, 214 Japanese men and 152 white men aged 40-49years at baseline (2002-2006) with coronary calcium score (CCS)=0 were re-examined for CAC in 2007-2010. Among these, 175 Japanese men and 113 white men participated in the follow-up exam. Incident cases were defined as participants with CCS10 at follow-up. A relative risk regression analysis was used to model the incidence rate ratio between the Japanese and white men. The incidence rate ratio was first adjusted for potential confounders at baseline and then further adjusted for serum LCn3PUFAs at baseline. Results Mean (SD) serum percentage of LCn3PUFA was >100% higher in Japanese men than in white men (9.08 (2.49) vs 3.84 (1.79), respectively, p<0.01). Japanese men had a significantly lower incidence rate of CAC compared to white men (0.9 vs 2.9/100 person-years, respectively, p<0.01). The incidence rate ratio of CAC taking follow-up time into account between Japanese and white men was 0.321 (95% CI 0.150 to 0.690; p<0.01). After adjusting for age, systolic blood pressure, low density lipoprotein cholesterol, diabetes, and other potential confounders, the ratio remained significant (0.262, 95% CI 0.094 to 0.731; p=0.01). After further adjusting for LCn3PUFAs, however, the ratio was attenuated and became non-significant (0.376, 95% CI 0.090 to 1.572; p=0.18). Conclusions LCn3PUFAs significantly contributed to the difference in the incidence of CAC between Japanese and white men.
  • J波症候群と関連する電気的障害 日本人集団における早期再分極 日本における循環器疾患基礎調査(NIPPON DATA)からの新たな知見(J-wave Syndrome and Related Electrical Disorders Early Repolarization in Japanese General Population: New Findings from the National Surveys of Circulatory Disorders of Japan (NIPPON DATA))
    Hisamatsu Takashi, Miura Katsuyuki, Ohkubo Takayoshi, Okamura Tomonori, Okayama Akira, Ueshima Hirotsugu
    Circulation Journal 78 Suppl.I 115 - 115 2014年03月
  • Yuan Lu, Kaveh Hajifathalian, Majid Ezzati, Mark Woodward, Eric B. Rimm, Goodarz Danaei
    LANCET 383 9921 970 - 983 2014年03月 [無し][無し]
     研究論文(学術雑誌) 
    Background Body-mass index (BMI) and diabetes have increased worldwide, whereas global average blood pressure and cholesterol have decreased or remained unchanged in the past three decades. We quantified how much of the effects of BMI on coronary heart disease and stroke are mediated through blood pressure, cholesterol, and glucose, and how much is independent of these factors. Methods We pooled data from 97 prospective cohort studies that collectively enrolled 1.8 million participants between 1948 and 2005, and that included 57 161 coronary heart disease and 31 093 stroke events. For each cohort we excluded participants who were younger than 18 years, had a BMI of lower than 20 kg/m(2), or who had a history of coronary heart disease or stroke. We estimated the hazard ratio (HR) of BMI on coronary heart disease and stroke with and without adjustment for all possible combinations of blood pressure, cholesterol, and glucose. We pooled HRs with a random-effects model and calculated the attenuation of excess risk after adjustment for mediators. Findings The HR for each 5 kg/m(2) higher BMI was 1.27 (95% CI 1.23-1.31) for coronary heart disease and 1.18 (1.14-1.22) for stroke after adjustment for confounders. Additional adjustment for the three metabolic risk factors reduced the HRs to 1.15 (1.12-1.18) for coronary heart disease and 1.04 (1.01-1.08) for stroke, suggesting that 46% (95% CI 42-50) of the excess risk of BMI for coronary heart disease and 76% (65-91) for stroke is mediated by these factors. Blood pressure was the most important mediator, accounting for 31% (28-35) of the excess risk for coronary heart disease and 65% (56-75) for stroke. The percentage excess risks mediated by these three mediators did not differ significantly between Asian and western cohorts (North America, western Europe, Australia, and New Zealand). Both overweight (BMI >= 25 to < 30 kg/m(2)) and obesity (BMI >= 30 kg/m(2)) were associated with a significantly increased risk of coronary heart disease and stroke, compared with normal weight (BMI >= 20 to < 25 kg/m(2)), with 50% (44-58) of the excess risk of overweight and 44% (41-48) of the excess risk of obesity for coronary heart disease mediated by the selected three mediators. The percentages for stroke were 98% (69-155) for overweight and 69% (64-77) for obesity. Interpretation Interventions that reduce high blood pressure, cholesterol, and glucose might address about half of excess risk of coronary heart disease and three-quarters of excess risk of stroke associated with high BMI. Maintenance of optimum bodyweight is needed for the full benefits.
  • Yayoi Yoshimura, Yoshitaka Murakami, Makoto Saitoh, Toshihiro Yokoi, Tomohiro Aoki, Katsuyuki Miura, Hirotsugu Ueshima, Kazuhiko Nozaki
    JOURNAL OF STROKE & CEREBROVASCULAR DISEASES 23 2 343 - 348 2014年02月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Recent reports have showed that some statins have protective effects in experimental cerebral aneurysm models. We conducted a case-control study to investigate an association between statin use and the rupture risk of cerebral aneurysm in Japanese population. Methods: This was a multihospital case-control study; cases and controls were collected from 15 hospitals in Japan. Cases consisted of patients with aneurysmal subarachnoid hemorrhage hospitalized from April 2009 to March 2011. Controls were selected from patients who had newly diagnosed unruptured saccular aneurysms from April 2006 to March 2011. The primary exposure of interest was statin use. Multivariable logistic regression was used to assess the relationship between stain use and the rupture risk of cerebral aneurysm. Results: A total of 117 cases and 304 controls were included in the analyses. Statin was used in 9.4% of cases and 26.0% of controls. Controls had a significantly higher rate of use of statin. The use of any statin was associated with cerebral aneurysm rupture after adjustment of potential confounders (adjusted odds ratio: .30, 95% confidence interval: .14-.66). The association was similar in each stratum of total cholesterol level. Conclusions: This observation from a hospital-based case-control study in Japan suggested that there is inverse relationship between use of statins and cerebral aneurysm rupture. Future clinical studies are needed.
  • A. Vishnu, J. Choo, K. H. Masaki, R. H. Mackey, E. Barinas-Mitchell, C. Shin, B. J. Willcox, A. El-Saed, T. B. Seto, A. Fujiyoshi, K. Miura, S. Lee, K. Sutton-Tyrrell, L. H. Kuller, H. Ueshima, A. Sekikawa
    JOURNAL OF HUMAN HYPERTENSION 28 2 111 - 117 2014年02月 [無し][無し]
     研究論文(学術雑誌) 
    We examined the association between serum lipoprotein subclasses and the three measures of arterial stiffness, that is, (i) carotidfemoral pulse wave velocity (cfPWV), which is a gold standard measure of central arterial stiffness, (ii) brachial-ankle PWV (baPWV), which is emerging as a combined measure of central and peripheral arterial stiffness and (iii) femoral-ankle PWV (faPWV), which is a measure of peripheral arterial stiffness. Among a population-based sample of 701 apparently healthy Caucasian, Japanese American and Korean men aged 40-49 years, concentrations of lipoprotein particles were assessed by nuclear magnetic resonance (NMR) spectroscopy, and the PWV was assessed with an automated waveform analyzer (VP2000, Omron, Japan). Multiple linear regressions were performed to analyse the association between each NMR lipoprotein subclasses and PWV measures, after adjusting for cardiovascular risk factors and other confounders. A cutoff of P<0.01 was used for determining significance. All PWV measures had significant correlations with total and small low-density lipoprotein particle number (LDL-P) (all P<0.0001) but not LDL cholesterol (LDL-C) (all P>0.1), independent of race and age. In multivariate regression analysis, no NMR lipoprotein subclass was significantly associated with cfPWV (all P>0.01). However, most NMR lipoprotein subclasses had significant associations with both baPWV and faPWV (P<0.01). In this study of healthy middle-aged men, as compared with cfPWV, both baPWV and faPWV had stronger associations with particle numbers of lipoprotein subclasses. Our results may suggest that both baPWV and faPWV are related to arterial stiffness and atherosclerosis, whereas cfPWV may represent arterial stiffness alone.
  • Naoko Miyagawa, Katsuyuki Miura, Nagako Okuda, Takashi Kadowaki, Naoyuki Takashima, Shin-ya Nagasawa, Yasuyuki Nakamura, Yasuhiro Matsumura, Atsushi Hozawa, Akira Fujiyoshi, Takashi Hisamatsu, Katsushi Yoshita, Akira Sekikawa, Takayoshi Ohkubo, Robert D. Abbott, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
    ATHEROSCLEROSIS 232 2 384 - 389 2014年02月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Dietary intake of long-chain n-3 PUFA (LCn3FA) among Japanese is generally higher than that in Western populations. However, little is known whether an inverse association of LCn3FA with cardiovascular disease (CVD) risk exists in a population with higher LCn3FA intake. Objective: To investigate the association between LCn3FA intake and the long-term risk of CVDs in a Japanese general population. Methods: We followed-up a total of 9190 individuals (56.2% women, mean age 50.0 years) randomly selected from 300 areas across Japan and free from CVDs at baseline. Dietary LCn3FA intake was estimated using household weighed food records. Cox models were used to calculate multivariate-adjusted hazard ratios (HR) and confidence intervals (CI) according to sex specific quartiles of LCn3FA intake. Results: During 24-year follow-up (192,897 person-years), 879 cardiovascular deaths were observed. The median daily intake of LCn3FA was 0.37% kcal (0.86 g/day). Adjusted HR for CVD mortality was lower in the highest quartile of LCn3FA intake (HR 0.80; 95% CI 0.66-0.96) compared with the lowest quartile, and the trend was statistically significant (P = 0.038). The similar but statistically non-significant trends were observed for coronary heart disease death and stroke death. In analyses by age groups, the inverse associations of LCn3FA intake with the risk of total CVD death and stroke death were significant in younger individuals (30-59 years at baseline). Conclusion: LCn3FA intake was inversely and independently associated the long-term risk of total CVD mortality in a representative sample of Japanese with high LCn3FA intake. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
  • M. Sakurai, K. Nakamura, K. Miura, T. Takamura, K. Yoshita, S. Y. Nagasawa, Y. Morikawa, M. Ishizaki, T. Kido, Y. Naruse, Y. Suwazono, S. Sasaki, H. Nakagawa
    EUROPEAN JOURNAL OF NUTRITION 53 1 251 - 258 2014年02月 [無し][無し]
     研究論文(学術雑誌) 
    This cohort study investigated the association between sugar-sweetened beverage (SSB) and diet soda consumption and the incidence of type 2 diabetes in Japanese men. The participants were 2,037 employees of a factory in Japan. We measured consumption of SSB and diet soda using a self-administered diet history questionnaire. The incidence of diabetes was determined in annual medical examinations over a 7-year period. Hazard ratios (HRs) with 95 % confidence intervals (CIs) for diabetes were estimated after adjusting for age, body mass index, family history, and dietary and other lifestyle factors. During the study, 170 participants developed diabetes. The crude incidence rates (/1,000 person-years) across participants who were rare/never SSB consumers, < 1 serving/week, a parts per thousand yen1 serving/week and < 1 serving/day, and a parts per thousand yen1 serving/day were 15.5, 12.7, 14.9, and 17.4, respectively. The multivariate-adjusted HR compared to rare/never SSB consumers was 1.35 (95 % CI 0.80-2.27) for participants who consumed a parts per thousand yen1 serving/day SSB. Diet soda consumption was significantly associated with the incident risk of diabetes (P for trend = 0.013), and multivariate-adjusted HRs compared to rare/never diet soda consumers were 1.05 (0.62-1.78) and 1.70 (1.13-2.55), respectively, for participants who consumed < 1 serving/week and a parts per thousand yen1 serving/week. Consumption of diet soda was significantly associated with an increased risk for diabetes in Japanese men. Diet soda is not always effective at preventing type 2 diabetes even though it is a zero-calorie drink.
  • Longjian Liu, Katsuyuki Miura, Akira Fujiyoshi, Aya Kadota, Naoko Miyagawa, Yasuyuki Nakamura, Takayoshi Ohkubo, Akira Okayama, Tomonori Okamura, Hirotsugu Ueshima
    AMERICAN JOURNAL OF CARDIOLOGY 113 1 84 - 89 2014年01月 [有り][無し]
     研究論文(学術雑誌) 
    The United States has a higher prevalence of metabolic syndrome (MS) and cardiovascular disease (CVD) mortality than Japan, but it is unknown how much of the difference in MS accounts for the mortality difference. The aim of this study was to examine the impact of MS on the excess CVD mortality in the United States compared with that in Japan. Data from the United States Third National Health and Nutrition Examination Survey (NHANES 111; n = 12,561) and the Japanese National Integrated Project for Prospective Observation of Noncommunicable Disease and Its Trends in Aged (NIPPON DATA; n = 7,453) were analyzed. MS was defined as of 5 risk factors (obesity, high blood pressure, decreased high-density lipoprotein cholesterol, elevated glycosylated hemoglobin, and elevated triglycerides). The results show that after a median of 13.8 years of follow-up in the United States, 1,683 patients died from CVD (11.75 per 1,000 person-years), and after a median of 15 years of follow-up in Japan, 369 patients died from CVD (3.56 per 1,000 person-years). The age-adjusted prevalence of MS was 26.7% in the United States and 19.3% in Japan. Of 5 MS factors, obesity, high blood pressure, elevated triglycerides, and glycosylated hemoglobin in the United States, and high blood pressure and elevated glycosylated hemoglobin in Japan were significant risk factors for CVD mortality. Estimates of 13.3% and 44% of the excess CVD mortality for the United States could be explained by the higher prevalence of MS and MS plus baseline CVD history than in Japan. In conclusion, the present study is the first to quantitatively demonstrate that MS and MS plus baseline CVD history may significantly contribute to the explanation of excess CVD mortality in the United States compared with Japan. (C) 2014 Elsevier Inc. All rights reserved.
  • Miyagawa N, Murakami Y, Okayama A, Kakuno F, Miura K
    [Nihon koshu eisei zasshi] Japanese journal of public health 61 7 333 - 341 2014年 [有り][無し]
  • 宮川 尚子, 門田 文, 清水 めぐみ, 山澤 幸子, 宇野 裕子, 大黒 清夏, 今堀 初美, 山下 亜希代, 櫻井 真汐, 駒井 文昭, 吉田 和司, 門脇 崇, 上島 弘嗣, 三浦 克之, 岡村 智教
    厚生の指標 61 4 28 - 34 厚生労働統計協会 2014年 [無し][無し]
     研究論文(学術雑誌)
  • 宮川 尚子, 村上 義孝, 岡山 明, 角野 文彦, 三浦 克之
    日本公衆衛生雑誌 61 7 333 - 341 2014年 [無し][無し]
     研究論文(学術雑誌)
  • Toshinaga Maeda, Keisuke Takeuchi, Pang Xiaoling, Dimitar P. Zankov, Naoyuki Takashima, Akira Fujiyoshi, Takashi Kadowaki, Katsuyuki Miura, Hirotsugu Ueshima, Hisakazu Ogita
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 21 8 839 - 853 2014年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: Mutations in lipoprotein-associated phospholipase A2 (Lp-PLA2) are related to atherosclerosis. However, the molecular effects of Lp-PLA2 on atherosclerosis have not been fully investigated. Therefore, this study attempted to elucidate this issue. Methods: Monocytes were isolated from randomly selected healthy male volunteers according to each Lp-PLA2 genotype (wild-type Lp-PLA2 [Lp-PLA2 (V/V)], the heterozygous V279F mutation [Lp-PLA2 (V/F)] and the homozygous V279F mutation [Lp-PLA2 (F/F)]) and differentiated into macrophages. The level of apoptosis in the macrophages following incubation without serum was measured using the annexin V/propidium iodide double staining method, and the underlying mechanisms were further examined using a culture cell line. Results: The average plasma Lp-PLA2 concentration [Lp-PLA2 (V/V): 129.4 ng/mL, Lp-PLA2 (V/F): 70.7 ng/mL, Lp-PLA2 (F/F): 0.4 ng/mL] and activity [Lp-PLA2 (V/V): 164.3 nmol/min/mL, Lp-PLA2 (V/F): 100.9 nmol/min/mL, Lp-PLA2 (F/F): 11.6 nmol/min/mL] were significantly different between each genotype, although the basic clinical characteristics were similar. The percentage of apoptotic cells was significantly higher among the Lp-PLA2 (F/F) macrophages compared with that observed in the Lp-PLA2 (V/V) macrophages. This induction of apoptosis was independent of the actions of acetylated low-density lipoproteins. In addition, the transfection of the expression plasmid of V279F mutant Lp-PLA2 into Cos-7 cells or monocyte/macrophage-like U937 cells promoted apoptosis. The knockdown of Lp-PLA2 also increased the number of apoptotic cells. Among the cells expressing mutant Lp-PLA2, the caspase-7 activity was increased, while the activated Akt level was decreased. Conclusions: The V279F mutation of Lp-PLA2 positively regulates the induction of apoptosis in macrophages and Cos-7 cells. An increase in the caspase-7 activity and a reduction in the activated Akt level are likely to be involved in this phenomenon.
  • Yuri Kawabe, Yasuyuki Nakamura, Sayuri Kikuchi, Yoshitaka Murakami, Taichiro Tanaka, Toru Takebayashi, Akira Okayama, Katsuyuki Miura, Tomonori Okamura, Hirotsugu Ueshima
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 21 7 703 - 711 2014年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: To examine the relationship between the type of work and the number of metabolic syndrome diagnostic components (MetS-DC), as well as the risk of MetS, with adjustment for lifestyle habits in Japanese workers. Methods: We examined the baseline data from 4,427 participants (81.4% male) aged 19 to 69 years old. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined the four MetS-DC in this study as follows: 1) high blood pressure (BP): systolic BP >= 130 mmHg, or diastolic BP >= 85 mmHg, or the use of antihypertensive drugs; 2) dyslipidemia: high-density lipoprotein-cholesterol concentration < 40 mg/dl or triglyceride concentration >= 150 mg/dl, or on medication for dyslipidemia; 3) dysglycemia: fasting blood sugar level >= 110 mg/dl, or if less than eight hours after meals >= 140 mg/dl, or on medication for diabetes mellitus; 4) overweight: a body mass index >= 25 kg/m(2). We defined MetS as overweight plus two or more of the MetS-DC. Results: There were 3,094 subjects in the daytime work group, 73 in the fixed nighttime work group, 1,017 in the shift work group and 243 in the day-to-night work group. The Poisson regression analysis revealed that fixed nighttime (regression coefficient [b] = -0.233, P=0.028) and shift work (b=0.098, P=0.034) independently contributed to the number of MetS-DC, compared to daytime work. The multivariate logistic analysis not including sleep hours in the model showed that shift work was positively related to MetS (odd ratio = 1.47, P<0.01). Conclusion: Shift work were significantly associated with the number of MetS-DC, and was related to risk of MetS compared to daytime work.
  • A Cross-Cultural Analysis of Physician Management of Obesity. Comparing the US, France, Israel and Japan: Little Interest and Little Success.
    Richard J Schuster, Colleen O’Brien Cherry, Shira Zelbar-Sagi, Hanny Yeshua, Andre Matalon, Olivier Steichen, Didier Duhot, Akira Fujiyoshi, Katsuyuki Miura
    Primary Health Care:Open Access 4 3 - - - 2014年 [無し][無し]
     研究論文(学術雑誌)
  • Jina Choo, Chol Shin, Emma Barinas-Mitchell, Kamal Masaki, Bradley J. Willcox, Todd B. Seto, Hirotsugu Ueshima, Sunghee Lee, Katsuyuki Miura, Lakshmi Venkitachalam, Rachel H. Mackey, Rhobert W. Evans, Lewis H. Kuller, Kim Sutton-Tyrrell, Akira Sekikawa
    BMC CARDIOVASCULAR DISORDERS 14 - ---in press  2014年01月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Both carotid-femoral (cf) pulse wave velocity (PWV) and brachial-ankle (ba) PWV employ arterial sites that are not consistent with the path of blood flow. Few previous studies have reported the differential characteristics between cfPWV and baPWV by simultaneously comparing these with measures of pure central (aorta) and peripheral (leg) arterial stiffness, i.e., heart-femoral (hf) PWV and femoral-ankle (fa) PWV in healthy populations. We aimed to identify the degree to which these commonly used measures of cfPWV and baPWV correlate with hfPWV and faPWV, respectively, and to evaluate whether both cfPWV and baPWV are consistent with either hfPWV or faPWV in their associations with cardiovascular (CV) risk factors. Methods: A population-based sample of healthy 784 men aged 40-49 (202 white Americans, 68 African Americans, 202 Japanese-Americans, and 282 Koreans) was examined in this cross-sectional study. Four regional PWVs were simultaneously measured by an automated tonometry/plethysmography system. Results: cf PWV correlated strongly with hfPWV (r = .81, P < .001), but weakly with faPWV (r = .12, P = .001). baPWV correlated moderately with both hfPWV (r = .47, P < .001) and faPWV (r = .62, P < .001). After stepwise regression analyses with adjustments for race, cf PWV shared common significant correlates with both hfPWV and faPWV: systolic blood pressure (BP) and body mass index (BMI). However, BMI was positively associated with hfPWV and cfPWV, and negatively associated with faPWV. baPWV shared common significant correlates with hf PWV: age and systolic BP. baPWV also shared the following correlates with faPWV: systolic BP, triglycerides, and current smoking. Conclusions: Among healthy men aged 40 - 49, cf PWV correlated strongly with central PWV, and baPWV correlated with both central and peripheral PWVs. Of the CV risk factors, systolic BP was uniformly associated with all the regional PWVs. In the associations with factors other than systolic BP, cf PWV was consistent with central PWV, while baPWV was consistent with both central and peripheral PWVs.
  • Masaru Sakurai, Koshi Nakamura, Katsuyuki Miura, Katsushi Yoshita, Toshinari Takamura, Shin-ya Nagasawa, Yuko Morikawa, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Motoko Nakashima, Kazuhiro Nogawa, Yasushi Suwazono, Hideaki Nakagawa
    INTERNAL MEDICINE 53 7 669 - 674 2014年 [有り][無し]
     研究論文(学術雑誌) 
    Objective This cross-sectional study investigated the associations between the serum thyroid-stimulating hormone (TSH) concentration and indices of obesity in middle-aged Japanese men and women. Methods The participants were 2,037 employees (1,044 men and 993 women; age, 36-55 yr) of a metal products factory in Japan. Clinical examinations were conducted in 2009. We obtained a medical history and anthropometric measurements (body weight, body mass index [BMI] and waist circumference) and measured the serum TSH concentrations. The anthropometric indices were compared across serum TSH quartiles. The associations were evaluated separately according to the smoking status in men. Results The mean body weight (kg), BMI (kg/m(2)) and waist circumference (cm) were 69.2, 23.7 and 83.2 in men and 55.3, 22.3 and 74.3 in women, respectively. Men with a higher TSH concentration had higher body weight and BMI values (p for trend=0.016 and 0.019, respectively), and these significant associations were observed even after adjusting for age, smoking status and other potential confounders. The TSH level was not associated with waist circumference. We found a significant interaction between the TSH level and the smoking status on body weight (p for interaction=0.013) and a significant association between the TSH level and body weight in nonsmokers, but not in current smokers. No significant associations were observed between the TSH level and the anthropometric indices in women. Conclusion Significant positive associations between the serum TSH concentration, body weight and BMI were detected in men only, and an interaction with the smoking status was observed for this association.
  • Katsuyuki Takahashi, Masako Tanaka, Azusa Inagaki, Hideki Wanibuchi, Yasukatsu Izumi, Katsuyuki Miura, Katsuya Nagayama, Masayuki Shiota, Hiroshi Iwao
    INTERNATIONAL JOURNAL OF ONCOLOGY 43 6 1985 - 1991 2013年12月 [有り][無し]
     研究論文(学術雑誌) 
    Triple-negative breast cancers (TNBCs) are defined as tumors that lack expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2. Clinically, TNBC patients are treated with cytotoxic drugs including 5-fluorouracil (5-FU). However, TNBCs develop resistance to such drugs after a series of treatments. To elucidate the mechanisms of drug resistance, establishment of drug-resistant cancer cell lines should be one of the most useful model systems. However, 5-FU-resistant TNBC cell lines have not been previously reported. In this study, we established a 5-FU-resistant cell line, MDA-MB-231/5-FU, from the human TNBC cell line MDA-MB-231, by repeated exposure to stepwise increases in the concentration of 5-FU. The IC50 value of 5-FU for MDA-MB-231/5-FU was 5.5-fold that for the parental cells. The MDA-MB-231/5-FU cell line acquired resistance to not only 5-FU, but also vinorelbine, paclitaxel and gemcitabine. Additionally, we performed iTRAQ-based quantitative proteomics in MDA-MB-231/5-FU cells and the parental cells in order to characterize MDA-MB-231/5-FU. The proteins upregulated in the newly established cells were mainly classified into the categories of DNA recombination', cell cycle', complex assembly', cytoskeleton organization', transport' and negative regulation of cell death'. These proteins may be related to mechanisms of drug resistance in TNBCs. Our established MDA-MB-231/5-FU cell line should be a useful tool for identifying new mechanisms of drug resistance and new drug targets in TNBCs.
  • Katsuyuki Miura, Katsuyuki Ando, Takuya Tsuchihashi, Katsushi Yoshita, Yoshihiko Watanabe, Hiroo Kawarazaki, Hideo Matsuura, Miho Kusaka, Hisashi Kai, Minoru Kawamura, Yuhei Kawano
    HYPERTENSION RESEARCH 36 12 1020 - 1025 2013年12月 [有り][無し]
     
    In this section of the Report of the Salt Reduction Committee of the Japanese Society of Hypertension, the target level of dietary salt reduction and its scientific evidence, present status of salt consumption in Japan, salt-reducing measures/guidance methods in individuals and population strategies to reduce salt intake are introduced. In the Dietary Reference Intake for the general population in Japan (2010 version), the target levels of salt restriction in men and women were established as less than 9.0 per day and 7.5 g per day, respectively. The Japanese Society of Hypertension Guidelines for the Management of Hypertension 2009 recommended the target level of dietary salt restriction in patients with hypertension as less than 6 g per day. However, the National Health and Nutrition Survey of Japan in 2010 reported that the mean salt intake in adults was 10.6 g per day (men: 11.4 g per day and women: 9.8 g per day). To effectively decrease salt intake in Japan, it is necessary to reduce the consumption of high-salt foods (especially traditional foods) and replace high-salt seasonings (soy sauce and so on) with low-salt alternatives. Health-care professionals must effectively perform salt-reduction guidance for hypertensive patients in hospitals/administrative organizations. To promote population strategies for salt reduction in the whole society of Japan, social strategies, such as administrative policies, companies' cooperation and educational staff's cooperation, are necessary.
  • Katsuyuki Ando, Hiroo Kawarazaki, Katsuyuki Miura, Hideo Matsuura, Yoshihiko Watanabe, Katsushi Yoshita, Minoru Kawamura, Miho Kusaka, Hisashi Kai, Takuya Tsuchihashi, Yuhei Kawano
    Hypertension Research 36 12 1009 - 1019 2013年12月 [有り][無し]
     
    Dietary salt consumption is closely associated with the level of blood pressure (BP) stricter salt reduction more markedly decreased BP. Obesity/metabolic syndrome, Dietary Approach to Stop Hypertension (DASH) diet, exercise and mental stress influence the BP-elevating effect of high-salt diet. Observational and intervention studies suggested that salt restriction improved the risk of cardiovascular diseases. However, the effects may differ among the types of the hypertensive complications salt reduction may decrease the risk of stroke more than that of ischemic heart disease. Small-scale studies demonstrated that excess salt increased the risk of the left ventricular hypertrophy, heart failure, the urinary protein/albumin levels and end-stage renal failure. These diverse beneficial effects of salt reduction are probably because low-salt diet is an effective strategy to decrease BP and body fluid volume but is less effective to ameliorate the other cardiovascular risk factors. A mean salt intake in Japan is markedly high. Considering the present condition, salt reduction is essential for the prevention and treatment of hypertension and for the prevention of cardiovascular diseases. © 2013 The Japanese Society of Hypertension All rights reserved.
  • Takuya Tsuchihashi, Hisashi Kai, Miho Kusaka, Minoru Kawamura, Hideo Matsuura, Katsuyuki Miura, Katsuyuki Ando, Satomi Maruyama, Hitomi Hayabuchi, Yoko Takagi, Norie Nakahigashi, Toshiko Sato, Yuhei Kawano
    HYPERTENSION RESEARCH 36 12 1026 - 1031 2013年12月 [有り][無し]
     
    Salt-reduction guidance to hypertensive patients should be performed by evaluating salt intake of the individuals. However, each method to assess salt intake has both merits and limitations. Therefore, evaluation methods must be selected in accordance with the subject and facility's environment. In special facilities for hypertension treatment, measurement of sodium (Na) excretion with 24-h pooled urine or a survey on dietary contents by dietitians is recommended. In medical facilities in general, measurement of the levels of Na and creatinine (Cr) using second urine samples after waking-up or spot urine samples is recommended. The reliability of this method improves by using formulae including a formula to estimate 24-h Cr excretion. A method to estimate salt intake based on the Na excretion per gram Cr using the Na/Cr ratio in spot urine is simple, but not reliable. The method to estimate the daily excretion of salt from nighttime urine using an electronic salt sensor installed with a formula is recommended to hypertensive patients. Although its reliability is not high, patients themselves can measure this parameter simply at home and thus useful for monitoring salt intake and may intensify consciousness regarding salt reduction. Using these methods, salt intake (excretion) should be evaluated, and salt-reduction guidance targeting <6 g (Na: 100 mmol) per day should be conducted in the management of hypertension.
  • Marie A. Berger, Chol Shin, Kristi L. Storti, J. David Curb, Andrea M. Kriska, Vincent C. Arena, Jina Choo, Hirotsuga Ueshima, Tomonori Okamura, Katsuyuki Miura, Todd B. Seto, Kamal Masaki, Aiman El-Saed, Akira Sekikawa
    JOURNAL OF EPIDEMIOLOGY 23 6 411 - 417 2013年11月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Physical activity (PA) is complex and a difficult behavior to assess as there is no ideal assessment tool(s) that can capture all contexts of PA. Therefore, it is important to understand how different assessment tools rank individuals. We examined the extent to which self-report and direct assessment PA tools yielded the same ranking of PA levels. Methods: PA levels were measured by the Modifiable Activity Questionnaire (MAQ) and pedometer at baseline among 855 white (W), African-American (AA), Japanese-American (JA), and Korean (K) men (mean age 45.3 years) in 3 geographic locations in the ERA JUMP study. Results: Korean men were more active than W, AA, and JA men, according to both the MAQ and pedometer (MAQ total PA [mean +/- SD]: 41.6 +/- 17.8, 20.9 +/- 9.9, 20.0 +/- 9.1, and 29.4 +/- 10.3 metabolic equivalent [MET] hours/week, respectively; pedometer: 9584.4 +/- 449.4, 8363.8 +/- 368.6, 8930.3 +/- 285.6, 8335.7 +/- 368.6 steps/day, respectively). Higher levels of total PA in Korean men, as shown by MAQ, were due to higher occupational PA. Spearman correlations between PA levels reported on the MAQ and pedometer indicated positive associations ranging from rho = 0.29 to 0.42 for total activity, rho = 0.13 to 0.35 for leisure activity, and rho = 0.10 to 0.26 for occupational activity. Conclusions: The 2 assessment methods correlated and were complementary rather than interchangeable. The MAQ revealed why Korean men were more active. In some subpopulations it may be necessary to assess PA domains other than leisure and to use more than 1 assessment tool to obtain a more representative picture of PA levels.
  • Masaru Sakurai, Shigeyuki Saitoh, Katsuyuki Miura, Hideaki Nakagawa, Hirofumi Ohnishi, Hiroshi Akasaka, Aya Kadota, Yoshikuni Kita, Takehito Hayakawa, Takayoshi Ohkubo, Akira Okayama, Tomonori Okamura, Hirotsugu Ueshima
    DIABETES CARE 36 11 3759 - 3765 2013年11月 [有り][無し]
     研究論文(学術雑誌) 
    OBJECTIVEAssociations between HbA(1c) and cardiovascular diseases (CVD) have been reported mainly in Western countries. It is not clear whether HbA(1c) measurements are useful for assessing CVD mortality risk in East Asian populations.RESEARCH DESIGN AND METHODSThe risk for cardiovascular death was evaluated in a large cohort of participants selected randomly from the overall Japanese population. A total of 7,120 participants (2,962 men and 4,158 women; mean age 52.3 years) free of previous CVD were followed for 15 years. Adjusted hazard ratios (HRs) and 95% CIs among categories of HbA(1c) (<5.0%, 5.0-5.4%, 5.5-5.9%, 6.0-6.4%, and 6.5%) for participants without treatment for diabetes and HRs for participants with diabetes were calculated using a Cox proportional hazards model.RESULTSDuring the study, there were 1,104 deaths, including 304 from CVD, 61 from coronary heart disease, and 127 from stroke (78 from cerebral infarction, 25 from cerebral hemorrhage, and 24 from unclassified stroke). Relations to HbA(1c) with all-cause mortality and CVD death were graded and continuous, and multivariate-adjusted HRs for CVD death in participants with HbA(1c) 6.0-6.4% and 6.5% were 2.18 (95% CI 1.22-3.87) and 2.75 (1.43-5.28), respectively, compared with participants with HbA(1c) <5.0%. Similar associations were observed between HbA(1c) and death from coronary heart disease and death from cerebral infarction.CONCLUSIONSHigh HbA(1c) levels were associated with increased risk for all-cause mortality and death from CVD, coronary heart disease, and cerebral infarction in general East Asian populations, as in Western populations.
  • Akira Sekikawa, Chol Shin, Kamal H. Masaki, Emma J. M. Barinas-Mitchell, Nobutaka Hirooka, Bradley J. Willcox, Jina Choo, Jessica White, Rhobert W. Evans, Akira Fujiyoshi, Tomonori Okamura, Katsuyuki Miura, Matthew F. Muldoon, Hirotsugu Ueshima, Lewis H. Kuller, Kim Sutton-Tyrrell
    AMERICAN JOURNAL OF HYPERTENSION 26 11 1321 - 1327 2013年11月 [有り][無し]
     研究論文(学術雑誌) 
    Few previous studies have reported the association of aortic stiffness with marine n-3 fatty acids (Fas) in the general population. The aim of this study was to determine the combined and independent associations of 2 major marine n-3 FAs, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), with aortic stiffness evaluated using carotidfemoral pulse wave velocity (cfPWV) in Korean, white, and Japanese American men. A population-based sample of 851 middle-aged men (299 Koreans, 266 whites, and 286 Japanese Americans) was examined for cfPWV during 20022006. Serum FAs, including EPA and DHA, were measured as a percentage of total FAs using gas chromatography. Multiple regression analysis was used to examine the association of EPA and DHA with cfPWV after adjusting for blood pressure and other confounders. Mean EPA and DHA levels were 1.9 (SD 1.0) and 4.8 (SD 1.4) for Koreans, 0.8 (SD 0.6) and 2.4 (SD 1.2) for whites, and 1.0 (SD 1.0) and 3.2 (SD 1.4) for Japanese Americans. Both EPA and DHA were significantly higher in Koreans than in the other 2 groups (P < 0.01). Multiple regression analyses in Koreans showed that cfPWV had a significant inverse association with total marine n-3 FAs and with EPA alone after adjusting for blood pressure and other potential confounders. In contrast, there was no significant association of cfPWV with DHA. Whites and Japanese Americans did not show any significant associations of cfPWV with total marine n-3 FAs, EPA, or DHA. High levels of EPA observed in Koreans have an inverse association with aortic stiffness.
  • Kiyomi Harada, Ayako Saruwatari, Kaori Kitaoka, Wataru Aoi, Sayori Wada, Takayoshi Ohkubo, Katsuyuki Miura, Yoshiyuki Watanabe, Takashi Kusunoki, Akane Higashi
    The Tohoku journal of experimental medicine 231 2 85 - 91 2013年10月 [有り][無し]
     研究論文(学術雑誌) 
    In Japan, the rate of low birth weight infants has increased, due to an increase in the number of women who smoke or are lean. A recent study showed that low birth weight was associated with a high adult waist-to-height ratio in adult Japanese women, but little data is available concerning children. In this cross-sectional study with 568 subjects (276 boys and 292 girls), we examined the association between birth weight and waist-to-height ratio in 7- or 8-year-old Japanese children, all born at full term. The mothers of the subjects responded to a questionnaire about the weight of the children at birth, and physical data were collected from the results of measurements conducted at each school. We divided the subjects into two groups by the median of the birth weight (3,000 g) by sex to elucidate the effects of birth weight on the waist-to-height ratio. There were 119 boys and 164 girls and 157 boys and 128 girls in the < 3,000 g and ≥ 3,000 g birth weight groups, respectively. The Mann-Whitney U test was used to compare the physical conditions in the two birth weight categories. Height was significantly lower in the birth weight < 3,000 g group among both the boys (P < 0.001) and girls (P < 0.001). The waist-to-height ratio was significantly higher in the < 3,000 g group in girls (P = 0.004), but not in the boys. Our results suggest that intrauterine environmental insults might have an effect on children, depending on sex.
  • Takanori Yamazaki, Yasuhiro Nakamura, Masayuki Shiota, Mayuko Osada-Oka, Hiroyuki Fujiki, Akihisa Hanatani, Kenei Shimada, Katsuyuki Miura, Minoru Yoshiyama, Hiroshi Iwao, Yasukatsu Izumi
    JOURNAL OF PHARMACOLOGICAL SCIENCES 123 1 58 - 66 2013年09月 [有り][無し]
     研究論文(学術雑誌) 
    Tolvaptan, a non-peptide V-2-receptor antagonist, is a newly developed diuretic agent. Recently, we reported that tolvaptan has diuretic as well as anti-inflammatory and anti-fibrotic actions in chronic heart failure. In this study, we investigated whether tolvaptan has a cardioprotective effect in acute heart failure after myocardial infarction (MI). After MI induction, rats were randomized into 6 groups as follows: vehicle group, group treated with 15 mg.kg(-1).day(-1) furosemide, 2 groups treated with 3 or 10 mg.kg(-1).day(-1) tolvaptan, and 2 groups treated with 15 mg.kg(-1).day(-1) furosemide combined with 3 or 10 mg.kg(-1).day(-1) tolvaptan. Each agent was administered for 2 weeks, and blood pressure levels and infarct sizes were similar in all MI groups. Lower left ventricular end-systolic volumes and greater improvement of left ventricular ejection fraction were observed in the tolvaptan-treated groups compared with the vehicle group. In contrast, furosemide alone did not improve them. Sirius red staining revealed that tolvaptan significantly repressed MI-induced interstitial fibrosis in the left ventricle. MI-induced mRNA expressions related to cardiac load, inflammation, and fibrosis were significantly attenuated in the combination group. The combination treatment also repressed MI-induced mineralocorticoid receptor expression. Tolvaptan, or combination of furosemide and tolvaptan, may improve cardiac function in acute MI.
  • Yasuyuki Nakamura, Hirotsugu Ueshima, Nagako Okuda, Yoshitaka Murakami, Katsuyuki Miura, Yoshikuni Kita, Tomonori Okamura, Akira Okayama, Tanvir C. Turin, Sohel R. Choudhry, Beatriz Rodriguez, J. David Curb, Jeremiah Stamler
    EUROPEAN JOURNAL OF NUTRITION 52 6 1641 - 1648 2013年09月 [無し][無し]
     研究論文(学術雑誌) 
    It has been hypothesized that leptin-induced appetite suppression is impaired in obese individuals, but little human evidence is available documenting this. We investigated relations between serum leptin and total energy intake using INTERLIPID/INTERMAP data on Japanese-Americans in Hawaii and Japanese in Japan. Serum leptin and nutrient intakes were examined by standardized methods in men and women aged 40-59 years from two population samples, one Japanese-American in Hawaii (88 men, 94 women), the other Japanese in central Japan (123 men, 111 women). Multiple linear regression analyses stratified by BMI category (< 25 kg/m(2), 25-29.9 kg/m(2), and a parts per thousand yen30 kg/m(2)) with adjustment for possible confounders were used to examine the relation between log-leptin and total dietary energy intake. In multivariate regression analyses, in those with BMI < 25 kg/m(2) and in those with BMI between 25 and 29.9 kg/m(2), log-leptin was not significantly related to total dietary energy intake; in those with BMI a parts per thousand yen 30 kg/m(2), it was significantly inversely related to total dietary energy intake (P = 0.029), independent of body weight and physical activity. Physical activity score was significantly positively related to total dietary energy intake only in participants with BMI < 25 kg/m(2) (P < 0.001). Leptin was significantly inversely associated with dietary energy intake in obese persons, but not in overweight and normal-weight persons.
  • Akira Fujiyoshi, Akira Sekikawa, Chol Shin, Kamal Masaki, J. David Curb, Takayoshi Ohkubo, Katsuyuki Miura, Takashi Kadowaki, Sayaka Kadowaki, Aya Kadota, Daniel Edmundowicz, Amber Shah, Rhobert W. Evans, Marianne Bertolet, Jina Choo, Bradley J. Willcox, Tomonori Okamura, Hiroshi Maegawa, Kiyoshi Murata, Lewis H. Kuller, Hirotsugu Ueshima
    European Heart Journal Cardiovascular Imaging 14 9 921 - 927 2013年09月 [有り][無し]
     研究論文(学術雑誌) 
    AimsConflicting evidence exists regarding whether obesity is independently associated with coronary artery calcium (CAC), a measure of coronary atherosclerosis. We examined an independent association of obesity with prevalent CAC among samples of multi-ethnic groups whose background populations have varying levels of obesity and coronary heart disease (CHD).Methods and resultsWe analysed a population-based sample of 1212 men, aged 40-49 years free of clinical cardiovascular disease recruited in 2002-06 310 Japanese in Japan (JJ), 294 Koreans in South Korea (KN), 300 Japanese Americans (JA), and 308 Whites in the USA (UW). We defined prevalent CAC as an Agatston score of ≥10. Prevalent CAC was calculated by tertile of the body mass index (BMI) in each ethnic group and was plotted against the corresponding median of tertile BMI. Additionally, logistic regression was conducted to examine whether an association of the BMI was independent of conventional risk factors. The median BMI and crude prevalence of CAC for JJ, KN, JA, and UW were 23.4, 24.4, 27.4, and 27.1 (kg/m2) 12, 11, 32, and 26 (%), respectively. Despite the absolute difference in levels of BMI and CAC across groups, higher BMI was generally associated with higher prevalent CAC in each group. After adjusting for age, smoking, alcohol, hypertension, lipids, and diabetes mellitus, the BMI was positively and independently associated with prevalent CAC in JJ, KN, UW, but not in JA.ConclusionIn this multi-ethnic study, obesity was independently associated with subclinical stage of coronary atherosclerosis among men aged 40-49 years regardless of the BMI level. © 2013 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013.
  • Aiman El-Saed, J. David Curb, Takashi Kadowaki, Tomonori Okamura, Kim Sutton-Tyrrell, Kamal Masaki, Todd B. Seto, Tomoko Takamiya, Jina Choo, Daniel Edmundowicz, Rhobert W. Evans, Akira Fujiyoshi, Yasuyuki Nakamura, Katsuyuki Miura, Chol Shin, Lewis H. Kuller, Hirotsugu Ueshima, Akira Sekikawa
    International Journal of Cardiology 167 1 134 - 139 2013年07月 [有り][無し]
     研究論文(学術雑誌) 
    Background: The prevalence of coronary artery calcification (CAC) in Japanese men is lower than in white and Japanese-American men. It is unclear if aortic calcification (AC) strongly linked to smoking is also lower in Japanese men who have many times higher smoking prevalence compared to US men. Methods: We conducted a population-based study of 903 randomly-selected men aged 40-49 years: 310 Japanese men in Kusatsu, Japan, 301 white men in Allegheny County, US, and 292 Japanese men in Hawaii, US (2002-2006). The presence of AC was assessed by electron-beam tomography. AC was defined as Agatston aortic calcium scores (AoCaS) > 0 and ≥ 100. Results: Japanese (35.8%) had significantly less AoCaS > 0 compared to both white (68.8%, p < 0.001) and Japanese-American (62.3%, p < 0.001) but similar AoCaS ≥ 100 (19.4%, 18.3%, 22.6%, respectively, p = 0.392). The pack-years of smoking, which was highest in Japanese, was the most important single associate of AC in all populations. Additionally age, low-density-lipoprotein cholesterol (LDL-C), and triglycerides in Japanese body-mass index (BMI) in white and BMI, LDL-C, hypertension, diabetes, and lipid medications in Japanese-American were independent associates of AC. The risk of AC using either cut points adjusted for pack-years of smoking and additional risk factors was lower in Japanese compared to both white and Japanese-American. AC and CAC had moderately positive and significant correlations in Japanese (r = 0.26), white (r = 0.39), and Japanese-American (r = 0.45). Conclusions: The prevalence of AC defined both > 0 and ≥ 100 was significantly lower in Japanese than in white and Japanese-American men after adjusting for cigarette smoking and additional risk factors. © 2011 Elsevier Ireland Ltd.
  • Yasuyuki Nakamura, Tomonori Okamura, Taku Inohara, Shun Kohsaka, Makoto Watanabe, Aya Higashiyama, Aya Kadota, Nagako Okuda, Takayoshi Ohkubo, Shin-Ya Nagasawa, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    Journal of Electrocardiology 46 4 360 - 365 2013年07月 [有り][無し]
     研究論文(学術雑誌) 
    Aims Left bundle branch block (LBBB) is generally considered to be associated with a poorer prognosis in comparison with normal controls. However, there are some studies that showed no difference in prognosis of LBBB in comparison with normal controls. Methods and Results We studied prognostic values of BBBs on cardiovascular disease (CVD) and total mortality using the NIPPON DATA80 database with a 24-year follow-up. At the baseline in 1980, data were collected on study participants, ages 30 years and over, from randomly selected areas in Japan. We followed 9,090 participants (44% men, mean age 51). During the 24 year follow-up, there were 886 CVD, and 2,597 total mortality cases. Among participants, 0.2% of them were in LBBB, 1.3% in RBBB, 4.3% in other ventricular conduction defect (VCD) groups. The multivariate-adjusted hazard ratio (HR) using the Cox model including biochemical and other ECG variables revealed that LBBB was significantly positively associated with CVD (HR = 2.71, 95% confidence intervals [CI]: 1.35-5.45, P = 0.005), and total (HR = 2.07, 95%CI: 1.26-3.39, P = 0.004) mortality in men and women combined compared to participants without VCD. RBBB and other VCDs did not carry any significant risk for CVD or total mortality. Conclusions We found significant positive associations of LBBB with CVD and total mortality independent of confounding factors including other ECG changes. © 2013 Elsevier Inc.
  • Masaharu Nagata, Toshiharu Ninomiya, Yutaka Kiyohara, Yoshitaka Murakami, Fujiko Irie, Toshimi Sairenchi, Katsuyuki Miura, Tomonori Okamura, Hirotsugu Ueshima
    American Journal of Epidemiology 178 1 1 - 11 2013年07月 [有り][無し]
     研究論文(学術雑誌) 
    There are limited studies addressing whether proteinuria and estimated glomerular filtration rate (eGFR) are independently associated with cardiovascular disease in Asia. Using data from 7 prospective cohorts recruited between 1980 and 1994 in Japan, we assessed the influence of proteinuria (≥1+ on dipstick) and reduced eGFR on the risk of cardiovascular disease mortality in 39,405 participants (40-89 years) without kidney failure. During a 10.1-year follow-up, 1,927 subjects died from cardiovascular disease. Proteinuria was associated with a 1.75-fold (95% confidence interval (CI): 1.44, 2.11) increased risk of cardiovascular disease mortality after adjustment for potential confounding factors. Additionally, the multivariate-adjusted hazard ratio of cardiovascular disease mortality increased linearly with lower eGFR levels (Ptrend < 0.001): Subjects with eGFR of < 45 mL/minute/1.73 m2 had a 2.22-fold (95% CI: 1.60, 3.07) greater risk of cardiovascular disease mortality than those with eGFR of ≥90 mL/minute/1.73 m2. Subjects with both proteinuria and eGFR of < 45 mL/minute/1.73 m2 had a 4.05-fold (95% CI: 2.55, 6.43) higher risk of cardiovascular disease mortality compared with those with neither of these risk factors. There was no evidence of interaction in the relationship between proteinuria and lower eGFR (Pinteraction = 0.77). The present results suggest that proteinuria and lower eGFR are independent risk factors for cardiovascular disease mortality in the Japanese population. © The Author 2013. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.
  • Tomonori Okamura, Akira Sekikawa, Tatsuya Sawamura, Takashi Kadowaki, Emma Barinas-Mitchell, Rachel H. Mackey, Aya Kadota, Rhobert W. Evans, Daniel Edmundowicz, Aya Higashiyama, Yasuyuki Nakamura, Robert D. Abbott, Katsuyuki Miura, Akira Fujiyoshi, Yoshiko Fujita, Yoshitaka Murakami, Naomi Miyamatsu, Akemi Kakino, Hiroshi Maegawa, Kiyoshi Murata, Minoru Horie, Kenichi Mitsunami, Atsunori Kashiwagi, Lewis H. Kuller, Hirotsugu Ueshima
    ATHEROSCLEROSIS 229 1 240 - 245 2013年07月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: The serum level of LOX-1 ligand containing ApoB (LAB) may reflect atherogenicity better than LDL cholesterol (LDLC), total LDL particles and usual measurement of oxidized LDL. The association between LAB and intima-media thickness (IMT) of carotid artery was investigated by ultrasound in US and Japan men. Methods: Participants were 297 US Caucasian and 310 Japanese men, aged 40-49 years without past history of cardiovascular disease. Serum LAB levels were measured by ELISAs with recombinant LOX-1 and monoclonal anti-apolipoprotein B antibody. Results: Serum LAB levels [median (interquartile range), mu g/L] were 1321 (936, 1730) in US Caucasians and 940 (688, 1259) in Japanese. For Caucasian men, average IMT was higher in higher LAB quartile, which was 0.653, 0.667, 0.688, and 0.702 mm, respectively (p for trend = 0.02). Linear regression analysis showed serum LAB was significantly associated with IMT after adjustment for LDLC or total LDL particles in addition to other traditional or novel risk factors for atherosclerosis such as C-reactive protein. However, there was no significant relationship between LAB and IMT in Japanese men. Conclusion: Serum LAB, a new candidate biomarker for residual risk, was associated with an increased carotid IMT in US Caucasian men independently of various risk factors; however, ethnic difference should be clarified in the future. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
  • Takashi Hisamatsu, Katsuyuki Miura, Takayoshi Ohkubo, Takashi Yamamoto, Akira Fujiyoshi, Naoko Miyagawa, Aya Kadota, Naoyuki Takashima, Nagako Okuda, Yasuhiro Matsumura, Katsushi Yoshita, Yoshikuni Kita, Yoshitaka Murakami, Yasuyuki Nakamura, Tomonori Okamura, Minoru Horie, Akira Okayama, Hirotsugu Ueshima
    HEART 99 14 1024 - 1029 2013年07月 [有り][無し]
     研究論文(学術雑誌) 
    Objective Higher marine-derived n-3 fatty acids (MDn3FAs) intake reduces the risk of sudden cardiac death via antiarrhythmic effects. The article evaluates whether MDn3FAs intake attenuates the increased risk of cardiac death associated with J-point elevation (JPE), characterised by an elevation of QRS-ST junction (J-point) >= 0.1 mV on electrocardiography. Design A prospective population-based cohort study. Setting The National Survey on Circulatory Disorders and the National Nutrition Survey of Japan. Participants A total of 4348 community-dwelling men (mean age 49.3 years), without cardiovascular diseases at baseline, from randomly selected areas across Japan. Main outcome measures Cardiac death (200 men) during the 24-year follow-up. Results Dietary MDn3FAs intake was assessed using a dietary method to estimate individual intake of household-based weighed food records for 3 days. Cox models were used to calculate HRs and 95% CIs adjusted for possible confounding factors. JPE was present in 340 participants (7.8%). The median daily intake of MDn3FAs was 0.35% kcal (0.92 g/day). The risk of cardiac death was significantly higher in participants with JPE than in those without JPE in the low intake group (<0.35% kcal; adjusted HR 3.51; 95% CI 1.84 to 6.73; p<0.001), but not in the high intake group (>= 0.35% kcal; adjusted HR 1.09; 95% CI 0.56 to 2.16; p=0.795). The interaction between dietary MDn3FAs intake and JPE on the risk of cardiac death was statistically significant (p=0.006). Conclusions The increased risk of cardiac death associated with JPE may be attenuated by higher dietary MDn3FAs intake.
  • Jeremiah Stamler, Ian J. Brown, Martha L. Daviglus, Queenie Chan, Katsuyuki Miura, Nagako Okuda, Hirotsugu Ueshima, Liancheng Zhao, Paul Elliott
    AMERICAN JOURNAL OF CLINICAL NUTRITION 98 1 136 - 145 2013年07月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Available data have indicated independent direct relations of dietary animal protein and meat to the blood pressure (BP) of individuals. Objective: In this study, we aimed to assess whether BP is associated with the intake of dietary amino acids higher relatively in animal than in vegetable protein (alanine, arginine, aspartic acid, glycine, histidine, lysine, methionine, and threonine). Design: The study was a cross-sectional epidemiologic study that involved 4680 persons aged 40-59 y from 17 random population samples in the People's Republic of China, Japan, the United Kingdom, and the United States. BP was measured 8 times at 4 visits; dietary data (83 nutrients and 18 amino acids) were from four 24-h dietary recalls and two 24-h urine collections. Results: Dietary glycine and alanine (the percentage of total protein intake) were considered singly related directly to BP; with these 2 amino acids together in regression models (from model 1, which was controlled for age, sex, and sample, to model 5, which was controlled for 16 possible confounders), glycine, but not alanine, was significantly related to BP. Estimated average BP differences associated with a 2-SD higher glycine intake (0.71 g/24 h) were 2.0-3.0-mm Hg systolic BP (z = 2.97-4.32) stronger in Western than in East Asian participants. In Westerners, meat was the main dietary source of glycine but not in East Asians (Chinese: grains/flour and rice/noodles; Japanese: fish/shellfish and rice/noodles). Conclusion: Dietary glycine may have an independent adverse effect on BP, which possibly contributes to direct relations of animal protein and meat to BP.
  • Takashi Hisamatsu, Takayoshi Ohkubo, Katsuyuki Miura, Minoru Horie, Hirotsugu Ueshima
    CIRCULATION JOURNAL 77 6 1643 - 1643 2013年06月 [有り][無し]
  • Katsuyuki Miura, Jeremiah Stamler, Ian J. Brown, Hirotsugu Ueshima, Hideaki Nakagawa, Masaru Sakurai, Queenie Chan, Lawrence J. Appel, Akira Okayama, Nagako Okuda, J. David Curb, Beatriz L. Rodriguez, Claire Robertson, Liancheng Zhao, Paul Elliott
    Journal of Hypertension 31 6 1144 - 1150 2013年06月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: In short-term feeding trials, replacement of other macronutrients with monounsaturated fatty acid reduces blood pressure. However, observational studies have not clearly demonstrated a relationship between monounsaturated fatty acid intake and blood pressure. We report associations of monounsaturated fatty acid intake of individuals with blood pressure in a cross-sectional study. Methods: The International Study of Macro/Micronutrients and Blood Pressure is a cross-sectional epidemiologic study of 4680 men and women ages 40-59 years from 17 population samples in China, Japan, UK and USA. Nutrient intake data were based on four in-depth multipass 24-h dietary recalls/person and two-timed 24-h urine collections/person. Blood pressure was measured eight times at four visits. Results: Mean monounsaturated fatty acid intake ranged from 8.1%kcal (China) to 12.2%kcal (USA). With sequential models to control for possible confounders (dietary, other), linear regression analyses showed significant inverse relationship of total monounsaturated fatty acid intake with DBP for all participants for 2238 'nonintervened' individuals, the relationship was stronger. Estimated DBP differences with 2-SD higher monounsaturated fatty acids (5.35%kcal) were-0.82 mmHg (P < 0.05) for all participants and-1.70 mmHg (P < 0.01) for nonintervened individuals. Inverse associations of dietary total oleic acid (main monounsaturated) with blood pressure in nonintervened individuals were not significant, but those of oleic acid from vegetable sources were stronger and significant (P < 0.05). Conclusion: Dietary monounsaturated fatty acid intake, especially oleic acid from vegetable sources, may contribute to prevention and control of adverse blood pressure levels in general populations. © 2013 Lippincott Williams & Wilkins.
  • Ian J. Brown, Alan R. Dyer, Queenie Chan, Mary E. Cogswell, Hirotsugu Ueshima, Jeremiah Stamler, Paul Elliott
    AMERICAN JOURNAL OF EPIDEMIOLOGY 177 11 1180 - 1192 2013年06月 [無し][無し]
     研究論文(学術雑誌) 
    High intakes of dietary sodium are associated with elevated blood pressure levels and an increased risk of cardiovascular disease. National and international guidelines recommend reduced sodium intake in the general population, which necessitates population-wide surveillance. We assessed the utility of casual (spot) urine specimens in estimating 24-hour urinary sodium excretion as a marker of sodium intake in the International Cooperative Study on Salt, Other Factors, and Blood Pressure. There were 5,693 participants recruited in 19841987 at the ages of 2059 years from 29 North American and European samples. Participants were randomly assigned to test or validation data sets. Equations derived from casual urinary sodium concentration and other variables in the test data were applied to the validation data set. Correlations between observed and estimated 24-hour sodium excretion were 0.50 for individual men and 0.51 for individual women; the values were 0.79 and 0.71, respectively, for population samples. Bias in mean values (observed minus estimated) was small; for men and women, the values were 1.6 mmol per 24 hours and 2.3 mmol per 24 hours, respectively, at the individual level and 1.8 mmol per 24 hours and 2.2 mmol per 24 hours, respectively, at the population level. Proportions of individuals with urinary 24-hour sodium excretion above the recommended levels were slightly overestimated by the models. Casual urine specimens may be a useful, low-burden, low-cost alternative to 24-hour urine collections for estimation of population sodium intakes; ongoing calibration with study-specific 24-hour urinary collections is recommended to increase validity.
  • Koshi Nakamura, Katsuyuki Miura, Hideaki Nakagawa, Tomonori Okamura, Nagako Okuda, Kunihiro Nishimura, Seiji Yasumura, Kiyomi Sakata, Hideki Hidaka, Akira Okayama
    JOURNAL OF HYPERTENSION 31 5 1032 - 1042 2013年05月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: This study investigated the effect of hypertension on hospitalization risk and medical expenditure according to treatment status in a Japanese population. Methods: A total of 314 622 beneficiaries of the medical insurance system in Japan, aged 40-69 years, without a history of cardiovascular, cerebrovascular, or end-stage renal disease were classified into seven blood pressure categories. These categories were used to compare the risk of undergoing hospitalization in the 1 year after the baseline survey and to examine the percentage of inpatient medical expenditure attributable to overall hypertension relative to total medical expenditure in the study population. Results: During the follow-up period, 6.6% of men and 5.1% of women were hospitalized. In men and women aged 40-54 years, cases of hypertension, especially grade 3 untreated hypertension, led to more frequent hospitalization, compared with optimal blood pressure. Individuals who were hospitalized, especially long-term, incurred considerably higher medical expenditure compared with those who were not hospitalized, regardless of their hypertension status. In women aged 55-69 years, there was little variation in hospitalization risk across blood pressure categories. The inpatient medical expenditure attributable to overall hypertension represented 7.2 and 6.9% of the total medical expenditure for men aged 40-54 and 55-69 years, whereas it represented 2.8 and 3.8% for women, respectively. Conclusion: Although cases of hypertension were an economic burden especially in men, grade 3 untreated hypertension was more likely to incur extremely high medical expenditure as a result of hospitalization, compared with other cases.
  • Linda M. Oude Griep, Jeremiah Stamler, Queenie Chan, Linda Van Horn, Lyn M. Steffen, Katsuyuki Miura, Hirotsugu Ueshima, Nagako Okuda, Liancheng Zhao, Martha L. Daviglus, Paul Elliott
    AMERICAN JOURNAL OF CLINICAL NUTRITION 97 5 1083 - 1091 2013年05月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Epidemiologic evidence suggests that fruit consumption may lower the risk of cardiovascular diseases through blood pressure (BP) lowering effects; little is known on the independent effect of raw fruit and fruit juice on BP. Objective: The objective was to quantify associations of raw fruit and fruit juice consumption with BP by using cross-sectional data from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) of 4680 men and women aged 40-59 y from Japan, China, the United Kingdom, and the United States. Design: During 4 visits, 8 BP, four 24-h dietary recalls, and two 24-h urine samples were collected. Country-specific multivariate-controlled linear regression coefficients, including adjustment for urinary sodium excretion, were estimated and pooled, weighted by inverse of their variance. Results: The average total raw fruit consumption varied from a mean +/- SD of 52 65 g/1000 kcal in the United States to 68 +/- 70 g/1000 kcal in China. Individual raw fruit intake was not associated with BP in pooled analyses for all countries or in participants from Western countries, although a positive association with diastolic BP was observed in East Asian participants (per 50 g/1000 kcal; 0.37 mm Hg; 95% CI: 0.02, 0.71). Positive relationships with diastolic BP were found for citrus fruit intake in Western consumers (per 25 g/1000 kcal; 0.47 mm Hg; 95% CI: 0.12, 0.81) and for apple intake in East Asian consumers (0.40 mm Hg; 95% CI: 0.03, 0.78). Among East Asian banana consumers, banana intake was inversely associated with diastolic BP (-1.01 mm Hg; 95% CI: -1.88, -0.02). Fruit juice intake, which was negligible in Asia, was not related to BP in Western countries. Conclusion: Consistent associations were not found between raw fruit and fruit juice consumption of individuals and BP. This observational study was registered at www.clinicaltrials.gov as NCT00005271. Am J Clin Nutr 2013;97:1083-91.
  • Koichiro Azuma, J. David Curb, Takashi Kadowaki, Daniel Edmundowicz, Sayaka Kadowaki, Kamal H. Masaki, Aiman El-Saed, Yoshihiko Nishio, Todd B. Seto, Tomonori Okamura, Cemal Cetinel, Aya Kadota, Kim Sutton-Tyrrell, Katsuyuki Miura, Rhobert W. Evans, Tomoko Takamiya, Hiroshi Maegawa, Iva Miljkovic, Lewis H. Kuller, Hirotsugu Ueshima, David E. Kelley, Akira Sekikawa
    OBESITY RESEARCH & CLINICAL PRACTICE 7 3 E198 - E205 2013年05月 [有り][無し]
     研究論文(学術雑誌) 
    Background: We recently reported that Japanese had higher liver fat at a lower level of BMI compared with non-Hispanic whites (NHW). Objective: We hypothesize that ethnic difference in fat storage capacity contributes to this ethnic difference in liver fat. Design: To examine this, we assessed liver fat among 244 Japanese-American aged 40-49, using regional computed-tomography images, along with metabolic variables. Results: Despite the similar BMI between Japanese-Americans and NHW men, Japanese-Americans had more liver fat (liver to spleen attenuation ratio: 1.03 +/- 0.22 for Japanese-Americans, and 1.07 +/- 0.15 for NHW men; p < 0.05) and tended to have a greater disposition for fatty liver with an increase in BMI than NHW, indicating a clear difference between the two groups. In addition, liver fat is less in Japanese-Americans compared with Japanese men (1.03 +/- 0.22 vs. 1.01 +/- 0.16; p < 0.05), despite of a much higher BMI. These ethnic differences support the hypothesis that higher fat storage capacity indeed seems to be associated with less liver fat. In all the groups, liver fat content strongly correlated with triglycerides, homeostasis model assessment-insulin resistance, and C-reactive protein (CRP). Nevertheless, these metabolic variables were worse in Japanese-Americans, despite of less liver fat, compared with Japanese. Moreover, CRP levels were least among Japanese with highest liver fat, and highest among NHW men with least liver fat, despite of a strong positive association between CRP and fatty liver within each population. Conclusions: Fat content in the liver is intermediate for Japanese-Americans compared with Japanese and NHW men, which supports the hypothesis of less fat storage capacity among Japanese, closely linked to ethnic difference in predisposition to fatty liver. (C) 2011 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.
  • Masaru Sakurai, Koshi Nakamura, Katsuyuki Miura, Toshinari Takamura, Katsushi Yoshita, Satoshi Sasaki, Shin-Ya Nagasawa, Yuko Morikawa, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Yasushi Suwazono, Hideaki Nakagawa
    Journal of Diabetes Investigation 4 3 261 - 268 2013年05月 [有り][無し]
     研究論文(学術雑誌) 
    Aims/Introduction: This cohort study of middle-aged Japanese participants investigated the relationship between family history of diabetes, the incident risk of type 2 diabetes and the interaction of these variables with other factors. Materials and Methods: Study participants were 3,517 employees (2,037 men and 1,480 women) of a metal products factory in Japan. Baseline health examinations included questions about medical history, physical examination, anthropometric measurements, questions about lifestyle factors, such as smoking, alcohol consumption and habitual exercise, and a self-administered diet history questionnaire. Family history of diabetes was defined as having at least one-first-degree relative with diabetes. The incidence of diabetes was determined in annual medical examinations over a 7-year period. Hazard ratios (HRs) for type 2 diabetes were estimated by Cox proportional hazards analysis. Results: Of the 3,517 participants, 630 (18%) had a family history of diabetes mellitus. During the study, 228 participants developed diabetes. The age and sex-adjusted HR for type 2 diabetes in participants with a family history of diabetes was 1.82 (95% confidence interval 1.36-2.43) as compared with those without a family history of diabetes. HRs did not change after adjustment for body mass index and lifestyle factors. We found no interactions with body mass index, insulin resistance, pancreatic β-cell function or lifestyle factors. Conclusions: Family history of diabetes was associated with the incident risk of diabetes, and these associations were independent of other risk factors, such as obesity, insulin resistance, and lifestyle factors in Japanese men and women. © 2013 Asian Association for the Study of Diabetes and Wiley Publishing Asia Pty Ltd.
  • 一般日本人集団において非HDLコレステロールは冠動脈石灰化と強く関連する SESSA(Non-HDL Cholesterol is Strongly Associated with Coronary Artery Calcification in a General Japanese Population: SESSA)
    Hisamatsu Takashi, Miura Katsuyuki, Ohkubo Takayoshi, Fujiyoshi Akira, Kadota Aya, Kadowaki Sayaka, Yamamoto Takashi, Miyagawa Naoko, Torii Sayuki, Saitoh Yoshino, Takashima Naoyuki, Murakami Yoshitaka, Okamura Tomonori, Horie Minoru, Ueshima Hirotsugu
    Circulation Journal 77 Suppl.I 123 - 123 2013年03月
  • 長鎖n-3系脂肪酸の食事による高摂取は心血管疾患死亡リスクに関係する安静時心拍数増加の影響を軽減させる(Higher Dietary Long-chain n-3 Fatty Acids Attenuated the Effect of Higher Resting Heart Rate on the Risk of Cardiovascular Mortality)
    Hisamatsu Takashi, Miura Katsuyuki, Ohkubo Takayoshi, Yamamoto Takashi, Miyagawa Naoko, Fujiyoshi Akira, Kadota Aya, Takashima Naoyuki, Okuda Nagako, Murakami Yoshitaka, Okamura Tomonori, Horie Minoru, Okayama Akira, Ueshima Hirotsugu
    Circulation Journal 77 Suppl.I 259 - 260 2013年03月
  • Hiroshi Yamamoto, Kazuhisa Maeda, Yoshitaka Uji, Hiroshi Tsuchihashi, Tsuyoshi Mori, Tomoharu Shimizu, Yoshihiro Endo, Aya Kadota, Katsuyuki Miura, Yusuke Koga, Toshinori Ito, Tohru Tani
    PLOS ONE 8 3 e56129  2013年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background and Purpose: Infections are important causes of postoperative morbidity after gastric surgery; currently, no factors have been identified that can predict postoperative infection. Adiponectin (ADN) mediates energy metabolism and functions as an immunomodulator. Perioperative ADN levels and perioperative immune functioning could be mutually related. Here we evaluated a potential biological marker to reliably predict the incidence of postoperative infections to prevent such comorbidities. Methods: We analyzed 150 consecutive patients who underwent elective gastric cancer surgery at the Shiga University of Medical Science Hospital (Shiga, Japan) from 1997 to 2009; of these, most surgeries (n = 100) were performed 2008 onwards. The patient characteristics and surgery-related factors between two groups (with and without infection) were compared by the paired t-test and chi(2) test, including preoperative ADN levels, postoperative day 1 ADN levels, and ADN ratio (postoperative ADN levels/preoperative ADN levels) as baseline factors. Logistic regression analysis was performed to access the independent association between ADN ratio and postoperative infection. Finally, receiver operating curves (ROCs) were constructed to examine its clinical utility. Results: Sixty patients (40%) experienced postoperative infections. The baseline values of age, American Society of Anesthesiologists physical status, total operating time, blood loss, surgical procedure, C-reactive protein (CRP) levels, preoperative ADN levels, and ADN ratio were significantly different between groups. Logistic regression analysis using these factors indicated that type 2 diabetes mellitus (T2DM) and ADN ratio were significantly independent variables (*p<0.05, ** p<0.01, respectively). ROC analysis revealed that the useful cutoff values (sensitivity/specificity) for preoperative ADN levels, ADN ratio, blood loss, operating time, and CRP levels were 8.81(0.567/0.568), 0.76 (0.767/0.761), 405 g (0.717/0.693), 342 min (0.617/0.614), and 8.94 mg/dl (0.583/0.591), respectively. Conclusion: T2DM and ADN ratio were independent predictors of postoperative infection and ADN ratio was the most useful predictor for postoperative infection.
  • Naoko Miyagawa, Katsuyuki Miura, Nagako Okuda, Takashi Kadowaki, Naoyuki Takashima, Shin-ya Nagasawa, Yasuyuki Nakamura, Yasuhiro Matsumura, Atsushi Hozawa, Akira Fujiyoshi, Takashi Hisamatsu, Katsushi Yoshita, Takayoshi Ohkubo, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
    STROKE 44 2 2013年02月 [有り][無し]
  • Miura K, Ueshima H
    Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine 102 2 282 - 288 2013年02月 [有り][無し]
  • Nobutaka Hirooka, Takashi Kadowaki, Akira Sekikawa, Hirotsugu Ueshima, Jina Choo, Katsuyuki Miura, Tomonori Okamura, Akira Fujiyoshi, Sayaka Kadowaki, Aya Kadota, Yasuyuki Nakamura, Hiroshi Maegawa, Atsunori Kashiwagi, Kamal Masaki, Kim Sutton-Tyrrell, Lewis H. Kuller, J. David Curb, Chol Shin
    JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH 67 2 119 - 124 2013年02月 [有り][無し]
     研究論文(学術雑誌) 
    Background Cigarette smoking is a risk factor of coronary heart disease. Vascular calcification such as coronary artery calcium (CAC) and aortic calcium (AC) is associated with coronary heart disease. The authors hypothesised that cigarette smoking is associated with coronary artery and aortic calcifications in Japanese and Koreans with high smoking prevalence. Methods Random samples from populations of 313 Japanese and 302 Korean men aged 40-49 years were examined for calcification of the coronary artery and aorta using electron beam CT. CAC and AC were quantified using the Agatston score. The authors examined the associations of cigarette smoking with CAC and AC after adjusting for conventional risk factors and alcohol consumption. Current and past smokers were combined and categorised into two groups using median pack-years as a cut-off point in each of Japanese and Koreans. The never-smoker group was used as a reference for the multiple logistic regression analyses. Results The ORs of CAC (score >= 10) for smokers with higher pack-years were 2.9 in Japanese (p<0.05) and 1.3 in Koreans (non-significant) compared with never-smokers. The ORs of AC (score >= 100) for smokers with higher pack-years were 10.4 in Japanese (p<0.05) and 3.6 in Koreans (p<0.05). Conclusion Cigarette smoking with higher pack-years is significantly associated with CAC and AC in Japanese men, while cigarette smoking with higher pack-years is significantly associated with AC but not significantly with CAC in Korean men.
  • Koshi Nakamura, Masaru Sakurai, Katsuyuki Miura, Yuko Morikawa, Shin-Ya Nagasawa, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Yasushi Suwazono, Hideaki Nakagawa
    PLoS ONE 8 1 --- in press  2013年01月 [有り][無し]
     研究論文(学術雑誌) 
    Given the lack of economic studies evaluating the outcomes of smoking cessation programs from the viewpoint of program sponsors, we conducted a case study to provide relevant information for worksites. The present study was carried out between 2006 and 2008 at a manufacturing factory in the Toyama Prefecture of Japan and included subjects who voluntarily entered a smoking cessation program. The program included face-to-face counselling followed by weekly contact to provide encouragement over six months using e-mail or inter-office mail. Nicotine patches were available if required. All 151 participants stopped smoking immediately. Over the 24-month study period, self-report showed 49.7% abstained continuously from smoking. The rate of 24-month consecutive abstinence was higher in participants with lower Fagerström Test scores for Nicotine Dependence at baseline than in those with higher scores (63.6% for 0-2 points vs. 46.5% for 3-6 points vs. 43.8% for 7-10 points chi-square test p = 0.19). A logistic regression model showed a significant linear trend for the association between the score and abstinence status after adjustment for possible confounding factors (p = 0.03). The crude incremental cost for one individual to successfully quit smoking due to the support program was \46,379 (i.e., \100 = $1.28, £0.83, or €1.03 at foreign exchange rates). The corresponding costs for the three categories of the Fagerström Test score for Nicotine Dependence were \31,953, \47,450 and \64,956, respectively. When a sensitivity analysis was conducted based on the 95% confidence interval of the success rate, the variance in the corresponding costs was \25,514-45,034 for 0-2 points, \38,344-61,824 for 3-6 points, and \45,698-108,260 for 7-10 points. The degree of nicotine dependence may therefore be an important determinant of the cost-effectiveness of smoking cessation programs. © 2013 Nakamura et al.
  • Takashi Hisamatsu, Takayoshi Ohkubo, Katsuyuki Miura, Takashi Yamamoto, Akira Fujiyoshi, Naoko Miyagawa, Aya Kadota, Naoyuki Takashima, Shin-ya Nagasawa, Yoshikuni Kita, Yoshitaka Murakami, Akira Okayama, Minoru Horie, Tomonori Okamura, Hirotsugu Ueshima
    Circulation Journal 77 5 1260 - 1266 2013年 [有り][無し]
     研究論文(学術雑誌) 
    Background: An early repolarization pattern, characterized by an elevation of the QRS-ST junction (J-point) on 12-lead electrocardiography (ECG) is associated with cardiac and sudden death. However, little is known about the prognostic significance of J-point elevation for various disease-specific cardiovascular outcomes, including coronary artery disease (CAD). Methods and Results: To investigate the association between the presence of J-point elevation ≥0.1 mV and various disease-specific cardiovascular outcomes, we conducted a 15-year prospective study in a representative general Japanese population of 7,630 individuals (41% men, mean age 52.4 years) who participated in the National Survey of Circulatory Disorders. Cox models were used to estimate the hazard ratios (HRs) adjusted for possible confounding factors. J-point elevation was present in 264 individuals (3.5%) and was associated with an increased risk of cardiac death (adjusted HR, 2.54 95% confidence interval [CI] 1.40-4.58 P=0.002) and death from CAD (adjusted HR, 4.66 95% CI 2.30-9.46 P< 0.001). In a subgroup analysis by age, the association between J-point elevation and cardiovascular outcomes was more remarkable in middle-aged (< 60 years) than in older individuals (≥60 years) (all P for interaction < 0.05). Conclusions: J-point elevation on standard 12-lead ECG was an independent predictor of cardiac death and death from CAD in a representative sample of the general Japanese population, particularly among the middle-aged.
  • Aya Kadota, Katsuyuki Miura, Tomonori Okamura, Akira Fujiyoshi, Takayoshi Ohkubo, Takashi Kadowaki, Naoyuki Takashima, Takashi Hisamatsu, Yasuyuki Nakamura, Fumiyoshi Kasagi, Hiroshi Maegawa, Atsunori Kashiwagi, Hirotsugu Ueshima
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 20 10 755 - 766 2013年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: To examine whether subclinical atherosclerosis of the carotid arteries is concordant with the categories in the 2012 atherosclerosis prevention guidelines proposed by the Japan Atherosclerosis Society (JAS guidelines 2012), which adopted the estimated 10-year absolute risk of coronary artery disease (CAD) death in the NIPPON DATA80 Risk Assessment Chart. Methods: Between 2006 and 2008, 868 Japanese men 40 to 74 years of age without a history of cardiovascular disease were randomly selected from Kusatsu City, Japan. The intima media thickness (IMT) and plaque number from the common to internal carotid arteries were investigated using ultrasonography. The absolute risk of CAD death was estimated based on the individual risk factor data, and the mean IMT and plaque number in Categories I, II and III of the guidelines were examined. Results: The estimated 10-year absolute risk of CAD was directly related to the IMT (mean IMT (mean +/- SD) (mm) for a 10-year absolute risk of >= 2.0% and >= 5.0%: 0.88 +/- 0.18 and 0.95 +/- 0.19, respectively) and the plaque number. These results are compatible with the categories described by the guidelines (mean IMT (mean +/- SD) (mm) for Categories I, II, and III: 0.70 +/- 0.11, 0.81 +/- 0.16 and 0.88 +/- 0.18, respectively; mean plaque number: 0.9, 2.1 and 3, respectively). These findings were similar for Category. participants with or without DM and CKD. Conclusions: Subclinical atherosclerosis of the carotid arteries is concordant with the 10-year absolute risk of CAD and the categories in the JAS guidelines 2012.
  • Katsuyuki Miura, Masato Nagai, Takayoshi Ohkubo
    Circulation journal : official journal of the Japanese Circulation Society 77 9 2226 - 31 2013年 [有り][無し]
     研究論文(学術雑誌) 
    Analyses of data from national surveys of the Japanese population have shown a clear decreasing tendency in mean systolic blood pressure (BP) level over the past 50 years in all age groups of men and women; however, mean diastolic BP level clearly did not decrease in men. Hypertension prevalence is high among older people and may increase in the future, especially in men aged ≥50 years. The treatment and control rates of hypertension are not sufficiently high, although they have been continuously improving. Recent epidemiological studies also showed that the burden of cardiovascular diseases and total mortality because of the adverse BP level of the nation is still the highest among other preventable risk factors. To overcome this epidemic, the first priority should be primary prevention of a lifetime increase in BP through lifestyle improvement. Lowering the distribution of BP in the whole population and maintaining BP at optimal levels contributes to the achievement of this goal.
  • Yasuyuki Nakamura, Hirotsugu Ueshima, Nagako Okuda, Katsuyuki Miura, Yoshikuni Kita, Tomonori Okamura, Akira Okayama, Sohel R. Choudhury, Beatriz Rodriguez, Kamal H. Masaki, Jeremiah Stamler
    International Journal of Vascular Medicine 2013 - 1 - 7 2013年 [有り][無し]
     研究論文(学術雑誌) 
    Objective. Despite considerable study, the relevance of leptin and adiponectin for atherosclerosis development is still unsettled. We investigated relations of serum leptin and adiponectin to serum C-reactive protein (CRP), using the INTERLIPID dataset on Japanese emigrants living in Hawaii and Japanese in Japan.Design and Methods. Serum leptin, adiponectin, and CRP were measured by standardized methods in men and women of ages 40 to 59 years from two population samples, one Japanese-American in Hawaii (83 men, 89 women) and the other Japanese in central Japan (111 men, 104 women). Participants with CRP >10 mg/L were excluded.Results. Sex-specific multiple linear regression analyses, with log-transformed leptin and adiponectin (log-leptin, log-adipo), site (Hawaii = 1, Japan = 0), SBP, HbA1c, smoking (cigarettes/day), and physical activity index score of the Framingham Offspring Study as covariates, showed that log-leptin directly related and log-adipo inversely related to log-CRP for both sexes (Ps < 0.05 to <0.01). Addition to the model of BMI and interaction terms (BMI × log-leptin, BMI × log-adipo, SITE × log-leptin, SITE × log-adipo) resulted in disappearance of statistical significance except for direct relation of log-leptin to log-CRP in men (P=0.006).Conclusions. Leptin directly related to CRP independent of BMI and other confounding factors in men but not in women.
  • Nobutaka Hirooka, Chol Shin, Kamal H. Masaki, Daniel Edmundowicz, Jina Choo, Emma J.M. Barinas-Mitchell, Bradley J. Willcox, Kim Sutton-Tyrrell, Aiman El-Saed, Iva Miljkovic-Gacic, Takayoshi Ohkubo, Katsuyuki Miura, Hirotsugu Ueshima, Lewis H. Kuller, Akira Sekikawa
    Global Heart 8 3 273 - 280 2013年 [有り][無し]
     研究論文(学術雑誌) 
    Background Both indices of obesity and lipoprotein subfractions contribute to coronary heart disease risk. However, associations between indices of obesity and lipoprotein subfractions remain undetermined across different ethnic groups. Objective This study aims to examine the associations of indices of obesity in Japanese Americans, African Americans, and Koreans with lipoprotein subfractions. Methods A population-based sample of 230 Japanese American, 91 African American, and 291 Korean men ages 40 to 49 was examined for indices of obesity - that is, visceral and subcutaneous adipose tissue (VAT and SAT, respectively) waist circumference and body mass index - and for lipoprotein subfractions by nuclear magnetic resonance spectroscopy. Multiple regression analyses were performed in each of the 3 ethnic groups to examine the associations of each index of obesity with lipoprotein. Conclusions VAT had significant positive associations with total and small low-density lipoprotein (LDL) and a significant negative association with large high-density lipoprotein (HDL) in all 3 ethnicities (p < 0.01). SAT, waist circumference, and body mass index had significant positive associations with total and small LDL in only Japanese Americans and Koreans, whereas these indices had significant inverse associations with large HDL in all ethnic groups (p < 0.01). Compared with SAT, VAT had larger R2 values in the associations with total and small LDL and large HDL in all 3 ethnic groups. VAT is significantly associated with total and small LDL and large HDL in all 3 ethnic groups. The associations of SAT, waist circumference, and body mass index with lipoprotein subfractions are weaker than the associations of VAT in all 3 ethnic groups. © 2013 Published by Elsevier Ltd.
  • 国民代表集団における慢性腎臓病有病率の推定:NIPPON DATA2010
    門田 文, 永井 雅人, 大久保 孝義, 松下 邦洋, 村上 義孝, 高嶋 直敬, 宮川 尚子, 奥田 奈賀子, 西 信雄, 岡村 智教, 上島 弘嗣, 岡山 明, 三浦 克之
    第36回日本高血圧学会総会 抄録集(2013.10.24-26 大阪) - - - - - 2013年 [無し][無し]
     研究論文(学術雑誌)
  • Circ J. 77 6 1643 - 1643 2013年 [無し][無し]
     研究論文(学術雑誌)
  • Am J Cardiol. - - ---in press  2013年 [無し][無し]
     研究論文(学術雑誌)
  • J Atheroscler Thromb 20 10 755 - 766 2013年 [無し][無し]
     研究論文(学術雑誌) 
    Carotid Intima-Media Thickness and Plaque in Apparently Healthy Japanese Individuals with an Estimated 10-Year Absolute Risk of CAD Death According to the Japan Atherosclerosis Society (JAS) Guidelines 2012: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA).
  • 高血圧予防のための食生活-疫学研究からの知見-
    日本医師会雑誌 141 11 RS267-RS268  2013年 [無し][無し]
     研究論文(学術雑誌)
  • 高血圧セミナー 最近の高血圧じ実地診療上不可欠の課題とその対策 実地診療に役立つ高血圧の疫学
    Medical Practice 30 3 409 - 413 2013年 [無し][無し]
     研究論文(学術雑誌)
  • Yoshitaka Murakami, Tomonori Okamura, Koshi Nakamura, Katsuyuki Miura, Hirotsugu Ueshima
    BMJ OPEN 3 3 ---in press  2013年 [有り][無し]
     研究論文(学術雑誌) 
    Objective: The clustering of cardiovascular disease (CVD) risk factors is a serious threat for increasing medical expenses. The age-specific proportion and distribution of medical expenditure attributable to CVD risk factors, especially focused on the elderly, is thus indispensable for formulating public health policy given the extent of the ageing population in developed countries. Design: Cost analysis using individuals' medical expenses and their corresponding health examination measures. Setting: Shiga prefecture, Japan, from April 2000 to March 2006. Participants: 33 213 participants aged 40 years and over. Main outcome measures: Mean medical expenditure per year. Methods: Gamma regression models were applied to examine how the number of CVD risk factors affects mean medical expenditure. The four CVD risk factors analysed in this study were defined as follows: hypertension (systolic blood pressure >= 140 mm Hg or diastolic blood pressure >= 90 mm Hg), hypercholesterolaemia (serum total cholesterol >= 240 mg/dl), high blood glucose (casual blood glucose >= 200 mg/dl) and smoking (current smoker). Sex-specific and age-specific investigations were carried out on the elderly (aged 65 and over) and non-elderly (aged 40-64) populations. Results: The mean medical expenditure (per year) for the no CVD risk-factor group was only 110 000 yen at age 50 (men, 110 708 yen; women, 107 109 yen), but this expenditure was 6-7 times higher for 80-year-olds who have three or four CVD risk factors (men, 603 351 yen; women, 765 673 yen). The total overspend (excess fraction) was larger for the non-elderly (men, 15.4%; women, 11.1%) than that for the elderly (men, 0.1%; women, 5.2%) and largely driven by people with one or two CVD risk factors, except for elderly men. Conclusions: The age-specific proportion and distribution of medical expenditure attributable to CVD risk factors showed that a high-risk approach for the elderly and a population approach for the majority are both necessary to reduce total medical expenditure in Japan.
  • Circ J. 77 6 1643 - 1643 2013年 [無し][無し]
     研究論文(学術雑誌)
  • Imako Kondo, Toshiyuki Ojima, Mieko Nakamura, Shinya Hayasaka, Atsushi Hozawa, Shigeyuki Saitoh, Hirofumi Ohnishi, Hiroshi Akasaka, Takehito Hayakawa, Yoshitaka Murakami, Nagako Okuda, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    Journal of epidemiology 23 1 47 - 54 2013年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Recent Western studies show an inverse association between milk and dairy product intake and cardiovascular disease (CVD). We studied the association between consumption of milk and dairy products and CVD death in Japan. METHODS: Men and women aged 30 years or older were followed for 24 years. All had participated in a national nutrition survey in 300 health districts throughout Japan in 1980. The Cox proportional hazards model was used to assess mortality risk according to tertiles of milk and dairy product intake, with the high consumption group as reference. Hazard ratios (HRs) per 100-g/day increase in consumption were also estimated. RESULTS: During the 24-year follow-up period, there were 893 CVD deaths, 174 deaths from coronary heart disease (CHD), and 417 stroke deaths among 9243 participants. For women, the HRs for death from CVD, CHD, and stroke in the low consumption group were 1.27 (95% CI: 0.99-1.58; P for trend = 0.045), 1.67 (0.99-2.80; P = 0.02), and 1.34 (0.94-1.90; P = 0.08), respectively, after adjustment for age, body mass index, smoking status, alcohol drinking habits, history of diabetes, use of antihypertensives, work category, and total energy intake. With each 100-g/day increase in consumption of milk and dairy products, HRs tended to decrease for deaths from CVD (HR, 0.86; 95% CI, 0.74-0.99), CHD (0.73; 0.52-1.03), and stroke (0.81; 0.65-1.01) in women. No significant association was observed in men. CONCLUSIONS: Consumption of milk and dairy products was inversely associated with CVD death among women in Japan.
  • Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Yasuyuki Nakamura, Naoyuki Takashima, Masaharu Ichikawa, Hideki Sugihara, Yutaka Morita, Kunihiko Hirose, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
    EUROPEAN NEUROLOGY 69 6 354 - 359 2013年 [有り][無し]
     研究論文(学術雑誌) 
    Characterization of the time of stroke onset has been plagued by the problem of determining the time of the onset of events that are detected when the patient awakens. Our aim was to evaluate the characteristics, risk factors and acute fatality associated with wake-up stroke. Data was obtained from Takashima Stroke Registry covering approximately 55,000 residents in central Japan. During the period 1988-2003, information about the situation at stroke onset was available for 897 cerebral infarction (CI) and 335 intracerebral hemorrhage (ICH) events. Differences in characteristics and outcome between stroke during sleep and stroke while awake were explored. Among CI and ICH cases, 9.7 and 11.9% suffered from stroke during sleep, respectively. Hypertension and experiencing a severe event were associated with stroke during sleep among CI. Smoking and experiencing a severe event were associated with stroke during sleep and a drinking history reduced the chance of stroke during sleep among ICH. Acute fatality risks did not differ between stroke during sleep and stroke while awake among both CI and ICH cases. About 1 in 10 stroke patients had an onset of stroke during sleep. Hypertensive, smoker and clinically more severely affected patients had a higher prevalence of stroke during sleep. There were no differences between the 2 groups with respect to acute-case fatality. Copyright (C) 2013 S. Karger AG, Basel
  • Taku Inohara, Shun Kohsaka, Tomonori Okamura, Makoto Watanabe, Yasuyuki Nakamura, Aya Higashiyama, Aya Kadota, Nagako Okuda, Takayoshi Ohkubo, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
    PloS one 8 11 e80853  2013年 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Atrial premature complexes (APC) are among the most frequently encountered electrocardiographic abnormalities. However, their prognostic value among healthy individuals is unclear. This study aimed to clarify the role of APC in predicting cardiovascular events in a large Japanese community cohort using long-term follow-up data. METHODS: National Integrated Project for Prospective Observation of Non-communicable Disease And its Trends in the Aged, 1990-2005, (NIPPON DATA 90) was a large cohort study of cardiovascular disease (CVD) in Japan. A total of 7692 otherwise healthy participants with no history of myocardial infarction, stroke, atrial fibrillation, or atrial flutter were enrolled (men, 41.5%; mean age, 52.5 ± 13.7 years). RESULTS: A total of 64 (0.8%) participants had at least one beat of APC on screening 12-lead electrocardiogram. During the follow-up of 14.0 ± 2.9 years (total, 107,474 patient-years), 338 deaths occurred due to CVD. The association between APC and CVD outcome was assessed using Cox proportional hazard models. Cox regression analysis revealed that the presence of APC was an independent predictor for CVD deaths (HR: 2.03, 95% CI: 1.12-3.66, P = 0.019). The association of APC on CVD death was more evident in participants with hypertension (P-value for interaction, 0.03). CONCLUSIONS: APC recorded during the screening electrocardiogram are significantly associated with an increased risk of CVD deaths in a Japanese community-dwelling population and are a strong prognostic factor for hypertensive participants.
  • Hyeon Chang Kim, Sun Min Oh, Wen-Harn Pan, Hirotsugu Ueshima, Dongfeng Gu, Shao-Yuan Chuang, Akira Fujiyoshi, Ying Li, Liancheng Zhao, Il Suh
    NEUROEPIDEMIOLOGY 41 2 131 - 138 2013年 [無し][無し]
     研究論文(学術雑誌) 
    Background: Intracerebral hemorrhage (ICH) and chronic liver disease are relatively common in East Asian countries. However, the relationship between the two diseases is unclear. Thus, we investigated the association between serum alanine aminotransferase (ALT) levels and ICH risk in East Asian populations. Methods: The East Asian Network for Stroke Prevention enrolled 279,982 participants with ALT measurements from four cohort studies in Korea, Taiwan, Japan and mainland China. Among them, 1,324 ICH events and 493 ICH deaths were observed. Cox's proportional hazard regression analysis was performed in each cohort to estimate the hazard ratio (HR) after adjusting for age, blood pressure, diabetes, total cholesterol, smoking and alcohol intake. Combined HRs were then estimated using pooled analyses with fixed-effects models. Results: The multivariate-adjusted pooled HRs (with 95% confidence interval, CI) for ICH incidence per 10 IU/I increments of ALT were 1.04 (1.03-1.04) in men and 1.01 (0.98-1.04) in women. Corresponding HRs for ICH mortality were 1.04(1.02-1.05) in men and 1.04 (1.00-1.08) in women. The pooled HRs for ICH incidence in participants with ALT levels greater than or equal to 50 IU/I compared to those with levels less than 20 IU/I were 1.74(1.41-2.16) in men and 1.60 (1.06-2.40) in women. The corresponding HRs for ICH mortality were 1.72 (1.21-2.44) in men and 1.63(0.79-3.36) in women. Conclusions:An elevated ALT level was independently and significantly associated with an increased risk of ICH in East Asian men, but the association was less prominent in women. (C) 2013 S. Karger AG, Basel
  • Aya Kadota, Katsuyuki Miura, Tomonori Okamura, Akira Fujiyoshi, Takayoshi Ohkubo, Takashi Kadowaki, Naoyuki Takashima, Takashi Hisamatsu, Yasuyuki Nakamura, Fumiyoshi Kasagi, Hiroshi Maegawa, Atsunori Kashiwagi, Hirotsugu Ueshima
    J Atheroscler Thromb 20 10 755 - 766 2013年 [無し][無し]
     研究論文(学術雑誌) 
    Carotid Intima-Media Thickness and Plaque in Apparently Healthy Japanese Individuals with an Estimated 10-Year Absolute Risk of CAD Death According to the Japan Atherosclerosis Society (JAS) Guidelines 2012: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA).
  • Richard J. Schuster, M. D. Ye Zhu, Oluseye Ogunmoroti, Nancy Terwoord, Sylvia Ellison, Akira Fujiyoshi, Hirotsugu Ueshima, Katsuyuki Miura
    Quality in Primary Care 21 1 51 - 60 2013年 [無し][無し]
     研究論文(学術雑誌) 
    Background There is a 42% lower cardiovascular disease (CVD) death rate in Japan compared with the USA. Do physicians report differences in practice management of CVD risk factors in the two countries that might contribute to this difference? Aims CVD risk factor management reported by Japanese versus US primary care physicians was studied. Methods We undertook a descriptive study. An internet-based survey was conducted with physicians from each country. A convenience sample from the Shiga Prefecture in Japan and the state of Ohio in the USA resulted in 48 Japanese and 53 US physicians completing the survey. Results The survey group may not be representative of a larger sample. The survey demonstrated that 98% of responding Japanese physicians spend < 10 minutes performing a patient visit, while 76% of US physicians spend 10 to 20 minutes (P < 0.0001) managing CVD risk factors. Eighty-seven percent of Japanese physicians (vs. 32% of US physicians) see patients in within three months for follow-up (P < 0.0001). Sixty-one percent of Japanese physicians allocate < 30% of visit time to patient education, whereas 60% of US physicians spend > 30% of visit time on patient education (P< 0.0001). Prescriptions are renewed very frequently by Japanese physicians (83% renewing less than monthly) compared with 75% of US physicians who renew medications every one to six months (P < 0.0001). Only 20% of Japanese physicians use practice guidelines routinely compared with 50% of US physicians (P = 0.0413). US physicians report disparities in care more frequently (P < 0.0001 ). Forty-three percent of Japanese (vs. 10% of US) physicians believe that they have relative freedom to practise medicine (P< 0.0001). Conclusion Many factors undoubtedly affect CVD in different countries. The dominant ones include social determinants of health, genetics, public health and overall culture (which in turn determine diet, exercise and other factors). Yet the medical care system is an expensive component of society and its role in managing CVD risk factors deserves study. This descriptive report poses questions that require a more definitive study either with a more representative sample or direct observation of physician practices. US physicians responding to the survey reported greater administrative efforts, frustration and disparities in their practice, yet they followed practice guidelines more carefully. Japanese physicians responding reported focusing on quick, frequent visits that may have been more medication oriented, expecting more patient responsibility in self-care, which may have resulted in better chronic disease management. There may be differences in CVD risk factor management by primary care physicians in Japan versus the USA. © 2013 Radcliffe Publishing.
  • Christina M. Shay, Jeremiah Stamler, Alan R. Dyer, Ian J. Brown, Queenie Chan, Paul Elliott, Liancheng Zhao, Nagako Okuda, Katsuyuki Miura, Martha L. Daviglus, Linda Van Horn
    EUROPEAN JOURNAL OF NUTRITION 51 8 917 - 926 2012年12月 [有り][無し]
     研究論文(学術雑誌) 
    Individuals with favorable levels of readily measured cardiovascular disease (CVD) risk factors (low risk, LR) experience low long-term rates of CVD mortality and greater longevity. The purpose of the current study was to compare nutrient/food intakes of LR participants with participants not LR in the INTERMAP study. Men and women (40-59 years) from 17 population samples in four countries (China, Japan, UK, US) provided four 24-h dietary recalls and two timed 24-h urine collections. LR was defined as meeting all of the following CVD risk criteria: systolic/diastolic blood pressure (BP) a parts per thousand currency sign120/a parts per thousand currency sign80 mmHg; no drug treatment for high BP, hyperlipidemia, or CVD; non-smoking; BMI < 25.0 kg/m(2) (US, UK) or < 23.0 kg/m(2) (China, Japan); alcohol consumption < 26.0 g/day (men)/< 13.0 g/day (women); and no history of diabetes or CVD. Multivariate logistic regression was used to examine associations of nutrient/food intakes with LR. LR individuals reported higher intake of vegetable protein, fiber, magnesium, non-heme iron, potassium; lower energy intake; lower intake of cholesterol, saturated fatty acids, animal protein; and lower 24-h urinary sodium compared with individuals not LR. With regard to foods, LR individuals reported higher intake of fruits, vegetables, grains, pasta/rice, fish; lower intakes of meats, processed meats, high-fat dairy, and sugar-sweetened beverages than individuals not LR. Lower energy intake and differential intake of multiple specific nutrients and foods are characteristic of individuals at low risk for developing CVD. Identification of dietary habits associated with LR is important for further development of public health efforts aimed at reduction/prevention of CVD.
  • K. Nakamura, M. Sakurai, K. Miura, Y. Morikawa, S. Nagasawa, M. Ishizaki, T. Kido, Y. Naruse, Y. Suwazono, H. Nakagawa
    HORMONE AND METABOLIC RESEARCH 44 13 966 - 974 2012年12月 [無し][無し]
     研究論文(学術雑誌) 
    We conducted a longitudinal study to investigate whether increased serum gamma-glutamyltransferase independently predicts subsequent development of hyperuricemia. The study participants included 3 310 Japanese men without hyperuricemia, aged 20-54 years. The participants had annual heath examinations for 6 years to assess incident hyperuricemia (defined as serum uric acid >416.4 mu mol/l and/or taking medication for hyperuricemia). The risk of incident hyperuricemia was compared in participants grouped according to their baseline serum gamma-glutamyltransferase level. During follow-up, there were 529 incident cases of hyperuricemia. A positive, dose-response relationship was observed between serum gamma-glutamyltransferase and the risk of incident hyperuricemia. The hazard ratios (95 % confidence intervals) for hyperuricemia, compared with a serum gamma-glutamyltransferase level <= 19 U/l, were 1.32 (1.05-1.67) for 20-39 U/l, 1.28 (0.90-1.83) for 40-59 U/l, 1.56 (0.98-2.47) for 60-79 U/l, and 1.57 (1.02-2.41) for >= 80 U/l after adjustment for baseline serum uric acid, creatinine, total cholesterol, and glycated hemoglobin levels, ln(serum alanine aminotransferase), age, systolic blood pressure, medications for hypertension, hypercholesterolemia, and diabetes, body mass index, and smoking and exercise habits. A similar positive relationship was observed regardless of the presence or absence of alcohol drinking, obesity, metabolic disorders (any combination of hypertension, hypercholesterolemia and/or diabetes), or clinically high serum aminotransferases, without evidence of a significant interaction between increased serum gamma-glutamyltransferase and risk factors for incident hyperuricemia. These findings indicate that increased serum gamma-glutamyltransferase is an independent predictor of subsequent development of hyperuricemia.
  • Naoyuki Takashima, Takayoshi Ohkubo, Katsuyuki Miura, Tomonori Okamura, Yoshitaka Murakami, Akira Fujiyoshi, Shin-ya Nagasawa, Aya Kadota, Yoshikuni Kita, Naoko Miyagawa, Takashi Hisamatsu, Takehito Hayakawa, Akira Okayama, Hirotsugu Ueshima
    JOURNAL OF HYPERTENSION 30 12 2299 - 2306 2012年12月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: In Western populations, blood pressure (BP) measured at baseline has been reported to predict long-term (over 20 years) risk of mortality from cardiovascular diseases (CVDs). However, corresponding evidence is scarce in Asia where stroke is dominant. We investigated the association between baseline BP and 24-year mortality risk due to CVD, in a representative Japanese general population. Methods: We followed up a nationwide sample of 8592 Japanese, aged 30 years or above without a history of CVD and antihypertensive medication at baseline, for 24 years. Hazard ratios for CVD mortality in BP categories defined according to JCN7 criteria were estimated using Cox model adjusted for potential confounding factors with normal BP treated as the reference category. Results: We observed 689 CVD deaths. Hazard ratios for CVD mortality were progressively and significantly increased from the category of prehypertension. Population-attributable fraction (PAF) demonstrated that 43 and 48% of CVD and stroke deaths were explained by non-normal BP at baseline. Hazard ratios and PAF were remarkably higher in younger participants (aged 30-59 years) than those in the elderly (aged 60 years or above). Particularly, in younger men, 81% of CVD deaths were explained by non-normal BP. In sensitivity analysis, participants with antihypertensive medication showed the highest hazard ratio for CVD morality compared with the other categories. Conclusions: BP levels above normal at baseline retained significant relative and absolute risks of CVD and stroke mortality during 24 years. Long-lasting burden of non-normal BP particularly in younger individuals suggests the importance of primary prevention of high BP from younger generation.
  • Samar R. El Khoudary, Emma Barinas-Mitchell, Jessica White, Kim Sutton-Tyrrell, Lewis H. Kuller, J. David Curb, Chol Shin, Hirotsugu Ueshima, Kamal Masaki, Rhobert W. Evans, Katsuyuki Miura, Daniel Edmundowicz, Akira Sekikawa
    ATHEROSCLEROSIS 225 2 475 - 480 2012年12月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: Limited data are available about risk factors for the progression of aortic stiffness in healthy population. We examined several risk factors as possible independent predictors of aortic stiffness progression among a population-based sample of US men. Methods: A total of 240 men (40-49 years) free of CVD at baseline from the Pittsburgh site of the ERA JUMP study were evaluated. Aortic stiffness was measured as carotid-femoral pulse wave velocity at baseline and after 4.6 +/- 0.2 (mean +/- SD) years of follow-up. Progression of aortic stiffness was evaluated as relative annual change in carotid-femoral pulse wave velocity (% change/year). Using linear regression, both baseline potential risk factors and their annual changes were evaluated as possible risk factors for aortic stiffness progression. Baseline age, follow-up time, race, heart rate, and medications use were forced in all models. Results: During follow-up, relative to baseline level, aortic stiffness increased 0.3% +/- 5.3% per year. In final models, the independent predictors of degree of aortic stiffness progression were lower levels of adiponectin (P = 0.03), higher levels of systolic blood pressure (P = 0.03), greater annual change in systolic blood pressure (P = 0.04), and alcohol consumption >= 2 times/week (P = 0.02). Adiponectin levels within the third (9.8 mu g/Ml <= adiponectin < 13.0 mu g/mL) and the fourth (adiponectin >= 13.0 mu g/mL) quartiles were associated with an improvement in relative annual aortic stiffness progression (P = 0.02, P = 0.01, respectively) compared to levels within the first quartile (adiponectin <= 7.0 mu g/mL). Conclusion: Among apparently healthy men, lower levels of baseline adiponectin could be a novel marker for greater risk of aortic stiffness progression. Longitudinal research is required to evaluate whether adiponectin change over time would have similar association with aortic stiffness progression. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
  • Masaru Sakurai, Koshi Nakamura, Katsuyuki Miura, Toshinari Takamura, Katsushi Yoshita, Shin-ya Nagasawa, Yuko Morikawa, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Yasushi Suwazono, Satoshi Sasaki, Hideaki Nakagaw
    METABOLISM-CLINICAL AND EXPERIMENTAL 61 11 1566 - 1571 2012年11月 [有り][無し]
     研究論文(学術雑誌) 
    Objective. This cohort study investigated the association between eating speed and the incidence of type 2 diabetes in middle-aged Japanese men. Materials/Methods. Participants were 2,050 male employees of a metal products factory in Japan. We measured self-reported categorical eating speed. The incidence of diabetes was determined in annual medical examinations over a 7-year period. The association between eating speed and the incidence of diabetes adjusted for multiple variables (age, family history of diabetes, smoking, alcohol drinking, habitual exercise, and presence of hypertension and hyperlipidemia) was evaluated using Cox proportional hazards models. Results. The prevalence of obesity (BMI >= 25 kg/m(2)) across the categories of eating speed (slow, medium, and fast) was 14.6, 23.3, and 34.8%, respectively, and a faster eating speed was associated with a higher prevalence of obesity. During the study, 177 participants developed diabetes. Crude incidence rates (/1,000 person-years) across the three categories of eating speed were 9.9, 15.6, and 17.3, respectively. Multivariate-adjusted hazard ratios (95% CI) across the categories were 1.00 (reference), 1.68 (0.93-3.02), and 1.97 (1.10-3.55), respectively, and eating speed was associated with the risk of diabetes (p for trend=0.030). After further adjustment for BMI, a significant association was not observed. Conclusions. Eating speed was associated with the incidence of diabetes. Since these associations were not significant after adjusting for BMI, eating speed may act via its effect on body weight. Eating speed is a controllable risk factor, and eating slowly could be an acceptable lifestyle intervention for the prevention of diabetes mellitus. (C) 2012 Elsevier Inc. All rights reserved.
  • Kiyomi Harada, Sayuki Torii, Ayako Saruwatari, Yurika Tanaka, Kaori Kitaoka, Junpei Takaaki, Wataru Aoi, Sayori Wada, Takayoshi Ohkubo, Katsuyuki Miura, Yoshiyuki Watanabe, Akane Higashi
    The Tohoku journal of experimental medicine 228 3 205 - 14 2012年11月 [有り][無し]
     研究論文(学術雑誌) 
    Low birth weight has been associated with cardiovascular diseases. The waist-to-height ratio is a good indicator of risks for these diseases. The objective of this study was to examine the associations between birth weight and adult waist-to-height ratio in a Japanese population. A cross-sectional study, comprised of 851 subjects (401 men and 450 women) aged 35-62 years who were born at full term, was conducted at a medical checkup. The subjects responded to a questionnaire about weight at birth, and data on physical characteristics were collected from the results of the medical checkup. The subjects were stratified with sex and a Body Mass Index of 25 kg/m(2) to elucidate the effects of birth weight on adult waist-to-height ratio. Analysis of covariance was used to compare the physical condition among the 4 birth weight categories. After adjusting for age, alcohol consumption, smoking status and exercise, the height was significantly lower in the birth weight < 2,500 g category among men (P < 0.001) and women (P < 0.001), while the waist-to-height ratio was significantly higher in the birth weight < 2,500 g category, compared with the > 3,500 g category in the non-obese women (P = 0.004), but not in the obese women. In conclusion, low birth weight was independently associated with a low adult height among men and women and with a high adult waist-to-height ratio among non-obese women. Our results suggest that intrauterine environmental insults might lead to accumulation of visceral fat among non-obese women.
  • Ioanna Tzoulaki, Chirag J. Patel, Tomonori Okamura, Queenie Chan, Ian J. Brown, Katsuyuki Miura, Hirotsugu Ueshima, Liancheng Zhao, Linda Van Horn, Martha L. Daviglus, Jeremiah Stamler, Atul J. Butte, John P. A. Ioannidis, Paul Elliott
    CIRCULATION 126 21 2456 - 2464 2012年11月 [有り][無し]
     研究論文(学術雑誌) 
    Background-A nutrient-wide approach may be useful to comprehensively test and validate associations between nutrients (derived from foods and supplements) and blood pressure (BP) in an unbiased manner. Methods and Results-Data from 4680 participants aged 40 to 59 years in the cross-sectional International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) were stratified randomly into training and testing sets. US National Health and Nutrition Examination Survey (NHANES) four cross-sectional cohorts (1999-2000, 2001-2002, 2003-2004, 2005-2006) were used for external validation. We performed multiple linear regression analyses associating each of 82 nutrients and 3 urine electrolytes with systolic and diastolic BP in the INTERMAP training set. Significant findings were validated in the INTERMAP testing set and further in the NHANES cohorts (false discovery rate <5% in training, P<0.05 for internal and external validation). Among the validated nutrients, alcohol and urinary sodium-to-potassium ratio were directly associated with systolic BP, and dietary phosphorus, magnesium, iron, thiamin, folacin, and riboflavin were inversely associated with systolic BP. In addition, dietary folacin and riboflavin were inversely associated with diastolic BP. The absolute effect sizes in the validation data (NHANES) ranged from 0.97 mmHg lower systolic BP (phosphorus) to 0.39 mmHg lower systolic BP (thiamin) per 1-SD difference in nutrient variable. Inclusion of nutrient intake from supplements in addition to foods gave similar results for some nutrients, though it attenuated the associations of folacin, thiamin, and riboflavin intake with BP. Conclusions-We identified significant inverse associations between B vitamins and BP, relationships hitherto poorly investigated. Our analyses represent a systematic unbiased approach to the evaluation and validation of nutrient-BP associations. (Circulation. 2012; 126: 2456-2464.)
  • K. Nakamura, M. Sakurai, K. Miura, Y. Morikawa, K. Yoshita, M. Ishizaki, T. Kido, Y. Naruse, Y. Suwazono, H. Nakagawa
    NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES 22 11 989 - 996 2012年11月 [無し][無し]
     研究論文(学術雑誌) 
    Background and aims: Since there is little information derived from prospective studies on the amount of alcohol drinking required to induce hyperuricaemia, we attempted to address this issue in a Japanese population. Methods and results: A total of 3310 Japanese men aged 20-54 years that were free of hyperuricaemia were classified according to their alcohol intake per week at baseline. Incident hyperuricaemia, defined as >7.0 mg/dl and/or taking medication for hyperuricaemia, was assessed through annual heath examinations for 6 years after the baseline examination. During follow-up, 529 incident cases of hyperuricaemia occurred. There was a positive, dose-response relationship between alcohol intake and the risk of incident hyperuricaemia. The hazard ratio (95% confidence interval) for hyperuricaemia in drinkers compared with nondrinkers was 1.10 (0.85-1.42) for <10.0 drinks/week, 1.40 (1.07-1.84) for 10.0-19.9 drinks/week, 1.64 (1.23-2.21) for 20.0-29.9 drinks/week and 1.98 (1.40-2.80) for >= 30.0 drinks/week (one drink contained 11.5 g of ethanol) after adjusting for age, baseline serum uric acid, body mass index, smoking habits, exercise habits, serum creatinine, blood pressure, serum cholesterol and blood glucose. The fraction of hyperuricaemia in the population attributable to alcohol intake was 21.6%. A clear dose-response pattern was observed for both beer and sake, when the consumption of these two beverages was analysed separately. Conclusion: Habitual alcohol intake significantly contributed to the development of hyperuricaemia in Japanese men, regardless of type of alcoholic beverage consumed. Therefore, it is essential to reduce excessive alcohol intake to prevent and manage hyperuricaemia. (C) 2011 Elsevier B. V. All rights reserved.
  • Nagasawa SY, Okamura T, Iso H, Tamakoshi A, Yamada M, Watanabe M, Murakami Y, Miura K, Ueshima H, Evidence for Cardiovascular Prevention from Observational Cohorts in Japan, EPOCH-JAPAN) Research Group
    Journal of the American Heart Association 1 5 e001974  2012年10月 [有り][無し]
  • Koshi Nakamura, Masaru Sakurai, Yuko Morikawa, Katsuyuki Miura, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Yasushi Suwazono, Hideaki Nakagawa
    AMERICAN JOURNAL OF HYPERTENSION 25 9 979 - 985 2012年09月 [有り][無し]
     研究論文(学術雑誌) 
    BACKGROUND Epidemiological studies have observed conflicting patterns as to whether overtime work increases blood pressure (BP), probably as a consequence of methodological issues. METHODS We conducted a prospective cohort study to investigate the relationship between overtime work hours and 1-year changes in BP in 1,235 normotensive Japanese male workers who carried out a variety of jobs in a manufacturing factory. Casual BP measurements were repeated at annual health examinations in 2004-2005, using an automatic manometer. An analysis of covariance that incorporated potential confounding factors including baseline age, body mass index (BMI), and lifestyle factors was used to calculate and compare the means of the 1-year change in systolic (SBP) and diastolic BP (DBP). The participants were grouped according to their average monthly overtime work hours obtained from timecard data between April and September 2004. RESULTS The multivariate-adjusted mean for 1-year change in DBP in 611 male assembly-line workers was 1.5 mm Hg (95% confidence interval (CI) 0.8-2.2) for <40.0 h/month, 2.3 mm Hg (95% CI 1.3-3.2) for 40.0-79.9 h/month, and 5.3 mm Hg (95% CI 2.7-7.9) for >= 80.0 h/month (P for heterogeneity = 0.02). A broadly similar pattern was observed for SBP. In contrast, there was no significant difference in means 1-year change for both SBP and DBP in 315 clerks and 309 engineers/special technicians, grouped according to overtime work hours. CONCLUSIONS Extensive overtime work was associated with increased BP in normotensive male assembly-line workers, but not in clerks and engineers/special technicians.
  • Tanvir Chowdhury Turin, Yoshitaka Murakami, Katsuyuki Miura, Nahid Rumana, Yoshikuni Kita, Takehito Hayakawa, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
    HYPERTENSION RESEARCH 35 9 954 - 958 2012年09月 [有り][無し]
     研究論文(学術雑誌) 
    Life expectancy (LE) is a measure that describes the health status of a population. The few published studies that have examined the impact of hypertension on LE were predominantly performed in Western populations. The effect of hypertension on LE has not been reported in an Asian population. Thus, we examined the impact of hypertension on LE in the Japanese population, which has the highest LE worldwide. The abridged life table method was applied to calculate the LEs of both normotensive and hypertensive men and women aged 40-85 years. Hypertensive participants were categorized as having either stage 1 or stage 2 hypertension. Age-specific mortality rates across different groups were estimated using the person-year method based on the follow-up data from a representative Japanese population in a national survey (NIPPON DATA80). The proportion of hypertensive patients in the baseline survey was 50.5% for men and 41.4% for women. The LE of 40-year-old men and women was 41.7 years and 48.7 years, respectively, in normotensive participants and 39.5 and 45.8 years, respectively, in hypertensive participants. The LE difference between normotensive and hypertensive participants was 2.2 years for men and 2.9 years for women. LE decreased with increasing stages of hypertension. Similar patterns of LE, with respect to blood pressure (BP) status, were observed in all index ages and for both genders. At the population level, hypertension leads to decreased LE and affects both genders similarly. Our findings highlight the importance of preventing high BP and the consequences of hypertension in Japanese population. Hypertension Research (2012) 35, 954-958; doi:10.1038/hr.2012.86; published online 5 July 2012
  • Akira Fujiyoshi, Takayoshi Ohkubo, Katsuyuki Miura, Yoshitaka Murakami, Shin-ya Nagasawa, Tomonori Okamura, Hirotsugu Ueshima
    HYPERTENSION RESEARCH 35 9 947 - 953 2012年09月 [有り][無し]
     研究論文(学術雑誌) 
    Blood pressure (BP) categories defined by systolic BP (SBP) and diastolic BP (DBP) are commonly used. However, the BP category-specific risk of cardiovascular disease (CVD) has not been thoroughly investigated in different age groups. The aim of this study was to assess long-term CVD risk and its impact according to BP categories and age group. Pooling individual data from 10 cohorts, we studied 67 309 Japanese individuals (40-89 years old) who were free of CVD at baseline: we categorized them as belonging to three age groups: 'middle-aged' (40-64 years), 'elderly' (65-74 years) and 'very elderly' (75-89 years). BP was classified according to the 2009 Japanese Society of Hypertension Guidelines. Cox models were used to estimate adjusted hazard ratios for CVD deaths. We observed 1944 CVD deaths over a mean follow-up of 10.2 years. In all age groups, the overall relationship between BP category and CVD risk was positive, with a greater strength observed for younger age groups. We observed a trend of increased risk from SBP/DBP >= 130/85 mm Hg in the very elderly, and a significant increase from SBP/DBP >= 120/80 mm Hg in the other age groups. The population attributable fractions (PAFs) of CVD death in reference to the SBP/DBP < 120/80 mm Hg category ranged from 23.4% in the very elderly to 60.3% in the middle-aged. We found an overall graded increase in CVD risk with higher BP category in the very elderly. The PAFs suggest that keeping BP levels low is an important strategy for primary CVD prevention, even in an elderly population. Hypertension Research (2012) 35, 947-953; doi:10.1038/hr.2012.87; published online 28 June 2012
  • Sayuri Katano, Yasuyuki Nakamura, Aki Nakamura, Yoshimi Suzukamo, Yoshitaka Murakami, Taichiro Tanaka, Akira Okayama, Katsuyuki Miura, Tomonori Okamura, Shunichi Fukuhara, Hirotsugu Ueshima
    QUALITY OF LIFE RESEARCH 21 7 1165 - 1170 2012年09月 [有り][無し]
     研究論文(学術雑誌) 
    Purpose To examine the association of the number of metabolic syndrome diagnostic components (MetS-DC) with health-related quality of life (HR-QOL). Methods We examined the baseline data from 4,480 healthy workers in Japan (3,668 men and 812 women) aged 19-69 years. We assessed HR-QOL based on scores for five scales of the SF-36. We defined four components for MetS in this study as follows: (1) high blood pressure (BP); (2) dyslipidemia; (3) impaired glucose tolerance; and (4) overweight: a body mass index >= 25 kg/m(2). Logistic regression analysis adjusted for lifestyle factors was used to examine the association of the number of MetS-DC with the HR-QOL sub-scales. Results Those who had 0-4 MetS-DC accounted for 2,287, 1,135, 722, 282, and 54 participants. The number of MetS-DC inversely contributed significantly to General Health (norm-based scoring >50) (odd ratios [OR] 0.59-0.82, P < 0.05) and positively associated with Mental Health (OR 1.37, P < 0.05). Conclusion When adjusted for lifestyle factors, the number of MetS-DC was inversely associated with General Health and positively with Mental Health in men and women.
  • Akira Sekikawa, Laufey Steingrimsdottir, Hirotsugu Ueshima, Chol Shin, J. David Curb, Rhobert W. Evans, Alda M. Hauksdottir, Aya Kadota, Jina Choo, Kamal Masaki, Bolli Thorsson, Lenore J. Launer, Melisa E. Garcia, Hiroshi Maegawa, Bradley J. Willcox, Gudny Eiriksdottir, Akira Fujiyoshi, Katsuyuki Miura, Tamara B. Harris, Lewis H. Kuller, Vilmundur Gudnason
    PROSTAGLANDINS LEUKOTRIENES AND ESSENTIAL FATTY ACIDS 87 1 11 - 16 2012年07月 [有り][無し]
     研究論文(学術雑誌) 
    In the 1990s Iceland and Japan were known as countries with high fish consumption whereas coronary heart disease (CHD) mortality in Iceland was high and that in Japan was low among developed countries. We described recent data fish consumption and CHD mortality from publicly available data. We also measured CHD risk factors and serum levels of marine-derived n-3 and other fatty acids from population-based samples of 1324 men in Iceland, Japan, South Korea, and the US. CHD mortality in men in Iceland was almost 3 times as high as that in Japan and South Korea. Generally, a profile of CHD risk factors in Icelanders compared to Japanese was more favorable. Serum marine-derived n-3 fatty acids in Iceland were significantly lower than in Japan and South Korea but significantly higher than in the US. (C) 2012 Elsevier Ltd. All rights reserved.
  • Akira Sekikawa, Chol Shin, J. David Curb, Emma Barinas-Mitchell, Kamal Masaki, Aiman El-Saed, Todd B. Seto, Rachel H. Mackey, Jina Choo, Akira Fujiyoshi, Katsuyuki Miura, Daniel Edmundowicz, Lewis H. Kuller, Hirotsugu Ueshima, Kim Sutton-Tyrrell
    ATHEROSCLEROSIS 222 2 473 - 477 2012年06月 [有り][無し]
     研究論文(学術雑誌) 
    Objectives: Aortic stiffness, a hallmark of vascular aging, is an independent risk factor of cardiovascular disease and all-cause mortality. The association of aortic stiffness with aortic calcification in middle-aged general population remains unknown although studies in patients with end-stage renal disease or elderly subjects suggest that aortic calcification is an important determinant of aortic stiffness. The goal of this study was to examine the association of aortic calcification and stiffness in multi-ethnic population-based samples of relatively young men. Methods: We examined the association in 906 men aged 40-49 (81 Black Americans, 276 Japanese Americans, 258 White Americans and 291 Koreans). Aortic stiffness was measured as carotid-femoral pulse wave velocity (cfPWV) using an automated waveform analyzer. Aortic calcification from aortic arch to iliac bifurcation was evaluated using electron-beam computed tomography. Results: Aortic calcium score was calculated and was categorized into four groups: zero (n = 303), 1-100 (n = 411), 101-300 (n = 110), and 401+ (n = 82). Aortic calcification category had a significant positive association with cfPWV after adjusting for age, race, and mean arterial pressure (mean (standard error) of cfPWV (cm/s) from the lowest to highest categories: 836 (10), 850 (9), 877 (17) and 941 (19), P for trend <0.001). The significant positive association remained after further adjusting for other cardiovascular risk factors. The significant positive association was also observed in each race group. Conclusions: The results suggest that aortic calcification can be one mechanism for aortic stiffness and that the association of aortic calcification with stiffness starts as early as the 40s. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
  • Tanvir Chowdhury Turin, Yoshitaka Murakami, Katsuyuki Miura, Nahid Rumana, Aya Kadota, Takayoshi Ohkubo, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
    DIABETES RESEARCH AND CLINICAL PRACTICE 96 2 E18 - E22 2012年05月 [有り][無し]
     研究論文(学術雑誌) 
    Life expectancy (LE) among the Japanese population with or without diabetes mellitus was estimated. LE in 40-year old men and women was 41.1 and 47.5 years in those without diabetes and 32.3 and 40.9 years in those with diabetes. The LE of 40-year old men and women with diabetes was 8.8 and 6.6 years shorter than in those without diabetes. Diabetes mellitus leads to a decrease in LE. The presence of impaired glucose tolerance also affected LE inversely. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
  • Akira Sekikawa, J. David Curb, Daniel Edmundowicz, Tomonori Okamura, Jina Choo, Akira Fujiyoshi, Kamal Masaki, Katsuyuki Miura, Lewis H. Kuller, Chol Shin, Hirotsugu Ueshima
    JOURNAL OF EPIDEMIOLOGY 22 3 188 - 198 2012年05月 [有り][無し]
     研究論文(学術雑誌) 
    Both American and European guidelines recommend coronary artery calcification (CAC) as a tool for screening asymptomatic individuals at intermediate risk for coronary heart disease (CHD). These recommendations are based on epidemiologic studies mostly in the United States. We review (I) the use of CAC in primary prevention of CHD in the United States, (2) epidemiologic studies of CAC in asymptomatic adults outside of the United States, and (3) international epidemiologic studies of CAC. This review will not consider clinical studies of CAC among patients or symptomatic individuals. US studies have shown that CAC is a strong independent predictor of CHD in both sexes among middle-aged and old age groups, various ethnic groups, and individuals with and without diabetes and that CAC plays an important role in reclassifying individuals from intermediate to high risk. Studies in Europe support these conclusions. The Electron-Beam Tomography, Risk Factor Assessment Among Japanese and US Men in the Post-World-War-II birth cohort (ERA JUMP) Study is the first international study to compare subclinical atherosclerosis, including CAC among Japanese, Japanese Americans, Koreans, and whites. It showed that as compared with whites, Japanese had lower levels of atherosclerosis, whereas Japanese Americans had similar or higher levels. CAC is being increasingly used as a screening tool for asymptomatic individuals in Europe and the United States. CAC is a powerful research tool, because it enables us to describe differences in atherosclerotic burden across populations. Such research could identify factors responsible for differences among populations, which may improve CHD prevention.
  • 喫煙と循環器疾患(冠動脈疾患、脳卒中)死亡-他の循環器疾患危険因子の合併を考慮して-.
    中川秀昭, 中村幸志, 櫻井 勝, 村上義孝, 入江ふじこ, 藤 吉朗, 三浦克之, 岡村智教, 上島弘嗣
    厚生労働科学研究費補助金(循環器疾患等生活習慣病対策総合研究事業)研究報告書 36-41 2012年03月 [無し][無し]
     学位論文(その他)
  • Yasuyuki Nakamura, Tomonori Okamura, Aya Higashiyama, Makoto Watanabe, Aya Kadota, Takayoshi Ohkubo, Katsuyuki Miura, Fumiyoshi Kasagi, Kazunori Kodama, Akira Okayama, Hirotsugu Ueshima
    CIRCULATION 125 10 1226 - 1233 2012年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background-Although clockwise rotation and counterclockwise rotation are distinct findings of the ECG, their prognostic significance is rarely studied. Methods and Results-We studied prognostic values of clockwise and counterclockwise rotation on total, cardiovascular disease (CVD), and subtype mortality using the National Integrated Project for Prospective Observation of Noncommunicable Disease and Its Trends in the Aged, 1980-2004 (NIPPON DATA80) database with a 24-year follow-up. At baseline in 1980, data were collected on study participants aged >= 30 years from randomly selected areas in Japan. We followed 9067 participants (44% men; mean age, 51 years). During the 24-year follow-up, mortality was as follows: 2581 total, 887 CVD, 179 coronary heart disease, 173 heart failure, and 411 stroke. The multivariate-adjusted hazard ratio (HR) with the use of the Cox model including biochemical and other ECG variables revealed that clockwise rotation was significantly positively associated with heart failure in men and women combined (HR=1.79; 95% confidence interval [CI], 1.13-2.83; P=0.013), CVD in men and in men and women combined (HR=1.49; 95% CI, 1.12-1.98; P=0.007 in men; HR=1.28; 95% CI, 1.02-1.59; P=0.030 in combined), and total mortality in men and in men and women combined (HR=1.19; 95% CI, 1.00-1.49; P=0.0496 in men; HR=1.15; 95% CI, 1.00-1.32; P=0.045 in combined). Counterclockwise rotation was significantly inversely associated stroke in men and women combined (HR=0.77; 95% CI, 0.62-0.96; P=0.017), CVD in men and in men and women combined (HR=0.74; 95% CI, 0.59-0.94; P=0.011 in men; HR=0.81; 95% CI, 0.70-0.94; P=0.006 in combined), and total mortality in women (HR=0.87; 95% CI, 0.77-0.98; P=0.023). Conclusions-We found a significant positive association of clockwise rotation and a significant inverse association of counterclockwise rotation with CVD mortality in men and in men and women combined, independent of confounding factors including other ECG changes. (Circulation. 2012;125:1226-1233.)
  • Keiichi Samukawa, Yasukatsu Izumi, Masayuki Shiota, Takafumi Nakao, Mayuko Osada-Oka, Katsuyuki Miura, Hiroshi Iwao
    JOURNAL OF PHARMACOLOGICAL SCIENCES 118 3 391 - 400 2012年03月 [有り][無し]
     研究論文(学術雑誌) 
    Pruritus is a severe symptom that is difficult to treat in atopic dermatitis patients. Red ginseng (RG), a natural medicine, has various biological activities such as anti-inflammatory effects. In this study, we examined the efficacy of RG extract (RGE) and its mechanism on experimental atopic dermatitis in mice. The effects of RGE on vascular permeability and itching were first evaluated. Histamine-induced permeability and itching were significantly inhibited by embrocation with RGE as well as diphenhydramine, an antihistamine drug. Next, we assessed the therapeutic effect of topical RGE in a mouse model of atopic dermatitis. Dermatitis was induced by repeated application of 2,4-dinitrofluorobenzene (DNFB) acetone solution to the mouse ear. The effects of tacrolimus (a calcineurin blocker), dexamethasone (a corticosteroid), and RGE on dermatitis and associated scratching behavior were compared. Repeated DNFB application caused frequent scratching behaviors and ear swelling. Topical treatment with tacrolimus, dexamethasone, and RGE for 8 days before the final challenge with DNFB significantly inhibited ear swelling. Tacrolimus and RGE significantly inhibited scratching behavior, whereas dexamethasone failed to do so. DNFB-induced nerve growth factor expression and nerve fiber extension were significantly attenuated by tacrolimus and RGE, but not by dexamethasone. RGE may have the potential for treatment of atopic dermatitis.
  • L. J. Hassen, H. Ueshima, J. D. Curb, J. Choo, S. Lee, K. Masaki, T. Kadowaki, C. Shin, R. W. Evans, T. B. Seto, A. Fujiyoshi, B. J. Willcox, K. Sutton-Tyrrell, A. Kadota, A. El-Saed, K. Miura, L. H. Kuller, A. Sekikawa
    EUROPEAN JOURNAL OF CLINICAL NUTRITION 66 3 329 - 335 2012年03月 [無し][無し]
     研究論文(学術雑誌) 
    Background/Objectives: Numerous studies reported beneficial effects of marine n-3 fatty acids (n-3 FAs) on cardiovascular disease (CVD) and its risk factors. However, the association of marine n-3 FAs with plasma fibrinogen, a risk factor for CVD, remains uncertain. Subjects/Methods: In a population-based, cross-sectional study of 795 men aged 40-49 without CVD (262 whites in Allegheny County, Pennsylvania, USA, 302 Japanese in Kusatsu, Japan and 229 Japanese Americans in Honolulu, Hawaii, USA), we examined the association of marine n-3 FAs with plasma fibrinogen. Serum FAs were measured by capillary gas-liquid chromatography. Marine n-3 FAs were defined as the sum of docosahexaenoic, eicosapentaenoic and docosapentaenoic acids. Plasma fibrinogen was measured by an automated clot-rate assay. Multiple linear regression analyses were performed to assess the association. Results: White, Japanese and Japanese-American men had mean marine n-3 FAs levels of 3.47%, 8.78% and 4.46%, respectively. Japanese men had a significant inverse association of marine n-3 FAs with fibrinogen (standardized regression coefficient of -0.11, P=0.049), after adjusting for age, body-mass index and current smoking. The significant inverse association remained after further adjusting for diabetes, C-reactive protein, triglycerides and other variables. White or Japanese-American men did not show a significant association. Conclusions: We observed the significant inverse association of marine n-3 FAs with fibrinogen in Japanese, but not in whites or Japanese Americans. The observation suggests that marine n-3 FAs at very high levels, as seen in the Japanese, may decrease plasma fibrinogen levels. European Journal of Clinical Nutrition (2012) 66, 329-335; doi: 10.1038/ejcn.2011.155; published online 7 September 2011
  • T. C. Turin, Y. Kita, N. Rumana, Y. Nakamura, N. Takashima, M. Ichikawa, H. Sugihara, Y. Morita, K. Hirose, A. Okayama, K. Miura, H. Ueshima
    ACTA NEUROLOGICA SCANDINAVICA 125 3 206 - 212 2012年03月 [無し][無し]
     研究論文(学術雑誌) 
    Background - Circadian periodicity in the onset of stroke has been reported. However, it is unclear whether this variation affects the acute stroke case fatality. Time of the day variation in stroke case fatality was examined using population-based stroke registration data. Methods -Stroke event data were acquired from the Takashima Stroke Registry, which covers a stable population of approximate to 55,000 in Takashima County in central Japan. During the period of 1990-2003, there were 1080 (549 men and 531 women) cases with classifiable stroke onset time. Stroke incidence was categorized as occurring at night (midnight6 a. m.), morning (6 a. m.-noon), afternoon (noon-6 p. m.), and evening (6 p. m.-midnight). The 28-day case fatality rates and 95% confidence intervals (95% CI) were calculated by gender, age, and stroke subtype across the time blocks. After adjusting for gender, age at onset, and stroke severity at onset, the hazard ratios for fatal strokes in evening, night, and morning were calculated, with afternoon serving as the reference. Results -For all strokes, the 28-day case fatality rate was 23.3% (95% CI: 19.4-27.6) for morning onset, 16.9% (95% CI: 13.121.6) for afternoon onset, 18.3% (95% CI: 13.6-24.1) for evening onset, and 21.0% (95% CI: 15.0-28.5) for the night onset stroke. The case fatality for strokes during the morning was higher than the case fatality for strokes during afternoon. This fatality risk excess for morning strokes persisted even after adjusting for age, gender, and stroke severity on onset in multivariate analysis. Conclusion -In the examination of circadian variation of stroke case fatality, 28-day case fatality rate tended to be higher for the morning strokes.
  • Sunghee Lee, J. David Curb, Takashi Kadowaki, Rhobert W. Evans, Katsuyuki Miura, Tomoko Takamiya, Chol Shin, Aiman El-Saed, Jina Choo, Akira Fujiyoshi, Teruo Otake, Sayaka Kadowaki, Todd Seto, Kamal Masaki, Daniel Edmundowicz, Hirotsugu Ueshima, Lewis H. Kuller, Akira Sekikawa
    BRITISH JOURNAL OF NUTRITION 107 4 567 - 572 2012年02月 [有り][無し]
     研究論文(学術雑誌) 
    Epidemiological studies suggested that n-6 fatty acids, especially linoleic acid (LA), have beneficial effects on CHD, whereas some in vitro studies have suggested that n-6 fatty acids, specifically arachidonic acid (AA), may have harmful effects. We examined the association of serum n-6 fatty acids with plasminogen activator inhibitor-1 (PAI-1). A population-based cross-sectional study recruited 926 randomly selected men aged 40-49 years without CVD during 2002-2006 (310 Caucasian, 313 Japanese and 303 Japanese-American men). Plasma PAI-1 was analysed in free form, both active and latent. Serum fatty acids were measured with gas-capillary liquid chromatography. To examine the association between total n-6 fatty acids (including LA and AA) and PAI-1, multivariate regression models were used. After adjusting for confounders, total n-6 fatty acids, LA and AA, were inversely and significantly associated with PAI-1 levels. These associations were consistent across three populations. Among 915 middle-aged men, serum n-6 fatty acids had significant inverse associations with PAI-1.
  • Masaru Sakurai, Tsuguhito Ota, Katsuyuki Miura, Hideaki Nakagawa, Shuichi Kaneko, Toshinari Takamura
    Handbook of Anthropometry: Physical Measures of Human Form in Health and Disease 1973 - 1988 2012年01月 [有り][無し]
     論文集(書籍)内論文 
    The prevalence of overweight and obesity in Japan is much lower than in Western countries: about 30% for Japanese men and 20% for Japanese women. Despite this low rate of obesity, the prevalence of metabolic abnormalities related to cardiovascular risk factors such as hypertension, dyslipidaemia, and diabetes is not lower in Japan than in Western countries. Visceral fat accumulation is also closely associated with metabolic abnormalities in the Japanese. Among the anthropometric variables, waist circumference is an indirect measure of abdominal fat accumulation. The waist circumference cutoff points for the Japanese have been proposed as 90 cm for women and 85 cm for men, which correspond to a 100-cm 2 area of visceral fat at the umbilical level on computed tomography imaging. However, subcutaneous fat strongly influences waist circumference in relatively lean Japanese women, and waist circumference does not effectively predict the existence of metabolic syndrome. In relatively lean Japanese women, BMI rather than waist circumference is reported to be more strongly associated with metabolic syndrome and may be more appropriate as an index for total and abdominal fat accumulation. Normal weight is associated with increased cardiovascular risk factors in Japanese. The difference in the association between obesity and metabolic abnormalities in Asian and Western countries may be due to genetic factors, different lifestyles, or sensitivity to metabolic disorders of obesity. Japanese have more total body fat and visceral fat than Caucasian men with the same degree of obesity, and the difference in body fat distribution also contributes to these differences. Furthermore, there is a J-shaped relationship between waist circumference and subsequent risk for type 2 diabetes in relatively lean Japanese lower pancreatic B-cell function may also increase the diabetes risk in very lean Japanese. Recently, nonalcoholic fatty liver disease has been reported to be closely associated with metabolic syndrome in Western and Asian populations. Not only fat accumulation in the visceral area, but fat accumulation in the liver may also contribute to the development of metabolic syndrome. Therefore, when we consider the association between obesity indices, such as waist circumference and BMI, and metabolic syndrome, we should consider the gender/ethnic differences of these associations, insulin deficiency, and fatty liver-associated insulin resistance.
  • Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Yasuyuki Nakamura, Kayo Ueda, Naoyuki Takashima, Hideki Sugihara, Yutaka Morita, Masaharu Ichikawa, Kunihiko Hirose, Hiroshi Nitta, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
    CEREBROVASCULAR DISEASES 34 2 130 - 139 2012年 [有り][無し]
     研究論文(学術雑誌) 
    Background: Apart from the conventional risk factors, cerebro-cardiovascular disease (CVD) are also reported to be associated with air pollution, thus lowering the level of exposure might contribute in prevention activities to reduce the associated adverse outcomes. Though few studies conducted in Japan have reported on the CVD mortality but none have explored the effect of air pollutant exposure on the acute case-fatality of CVD. We investigated the effects of air pollution exposure on acute case-fatality of stroke and acute myocardial infarction (AMI) in a setting where pollutant levels are rather low. Methods: We leveraged the data from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County located in central Japan. The study period of 6,210 days (16 years, leap years also taken into account) were divided into quartiles of daily average pollutant concentration; suspended particulate matter (SPM), sulfur dioxide (SO2), nitrogen dioxide (NO2), and photochemical oxidants (Ox). The stroke and AMI events were categorized to corresponding quartiles based on the pollution levels of the onset day. To study the effects of air pollutants, we estimated the fatality rate ratio across quartiles of the pollutants where the lowest quartile served as the reference. Results: There were 307 (men: 153 and women: 154) fatal stroke cases within 28 days of onset among the 2,038 first ever stroke during 1988-2004. In the same period, there were 142 (men: 94 and women: 54) fatal AMI cases within 28 days of onset among the 429 first ever AMI events. The mean of the measured pollutant levels were as follows: SPM 26.9 mu g/m(3), SO2 3.9 ppb, NO2 16.0 ppb, and Ox 28.4 ppb. Among the pollutants, higher levels of NO2 showed increased fatality risk. In multi-pollutant model, the highest quartile of NO2 was associated with 60% higher stroke case-fatality risk in comparison to lowest quartile of NO2. In the fully adjusted model the fatality-rate ratio was 1.65 (95% CI 1.06-2.57). This association was more prominent among stroke subtype of cerebral infarction. Other pollutant levels did not show any association with stroke or AMI case-fatality. Conclusion: We observed association between NO2 levels, an index of traffic related air pollution, with the acute case-fatality of stroke, especially cerebral infarction in our study population. Further studies are needed in different regions to determine the association between ambient air pollutants and acute cardiovascular fatalities. Copyright (c) 2012 S. Karger AG, Basel
  • Okamura T, Nakamura K, Hayakawa T, Kanda H, Miura K, Okayama A, Ueshima H
    Nihon eiseigaku zasshi. Japanese journal of hygiene 67 1 38 - 43 2012年01月 [有り][無し]
     研究論文(学術雑誌) 
    A 10-year follow-up cohort study of 4,535 National Health Insurance beneficiaries aged 40 to 69 years in Shiga was performed as part of a research project conducted by the Health Promotion Research Committee of the Shiga National Health Insurance Organizations in 2002. The relationship between cardiovascular risk factors and medical expenditures during the 10-year study period has been examined in this cohort. For example, there was a positively graded correlation between blood pressure and individual total medical expenditures per month. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensives were also higher than those in normotensives. However, from the viewpoint of the entire population, the excess medical expenditures attributable to hypertension within the total medical expenditures were higher for mild-to-moderate hypertensives than for severe hypertensives. On the other hand, although individual medical expenditures per month were 1.7-fold higher for participants with 2 or 3 risk factors and obesity, which was broadly equivalent to metabolic syndrome, than for those without these factors, the excess medical expenditures determined by risk clustering within the total medical expenditures were higher in normal-weight people than in obese people because of the higher prevalence of normal weight. These findings suggest that high-risk individuals are a good target of a high-risk approach, such as intensive health guidance, from the viewpoint of medical expenditures. However, another approach for the majority with a low-to-moderate cardiovascular risk should be considered, because they account for a greater proportion of the excess medical expenditures. Another way to solve this problem may be a population approach with an effective method of providing information to citizens.
  • Y. Nakamura, H. Ueshima, N. Okuda, K. Miura, Y. Kita, T. Okamura, T. C. Turin, A. Okayama, B. Rodriguez, J. D. Curb, J. Stamler
    NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES 22 1 14 - 22 2012年01月 [無し][無し]
     研究論文(学術雑誌) 
    Background and Aims: Previously, we found significantly higher serum leptin in Japanese-Americans in Hawaii than Japanese in Japan. We investigated whether differences in dietary and other lifestyle factors explain higher serum leptin concentrations in Japanese living a Western lifestyle in Hawaii compared with Japanese in Japan. Methods and Results: Serum leptin and nutrient intakes were examined by standardized methods in men and women ages 40-59 years from two population samples, one Japanese-American in Hawaii (88 men, 94 women), the other Japanese in central Japan (123 men, 111 women). Multiple linear regression models were used to assess role of dietary and other lifestyle traits in accounting for serum leptin difference between Hawaii and Japan. Mean leptin was significantly higher in Hawaii than Japan (7.2 +/- 6.8 vs 3.7 +/- 2.3 ng/ml in men, P < 0.0001; 12.8 +/- 6.6 vs 8.5 +/- 5.0 in women < 0.0001). In men, higher BMI in Hawaii explained over 90% of the difference in serum leptin; in women, only 47%. In multiple linear regression analyses in women, further adjustment for physical activity and dietary factors - alcohol, dietary fiber, iron - produced a further reduction in the coefficient for the difference, total reduction 70.7%; P-value for the Hawaii-Japan difference became 0.126. Conclusion: The significantly higher mean leptin concentration in Hawaii than Japan may be attributable largely to differences in BMI. Differences in nutrient intake in the two samples were associated with only modest relationship to the leptin difference. (C) 2010 Elsevier B. V. All rights reserved.
  • Prognostic Values of Clockwise and Counter-Clockwise Rotation for Cardiovascular Mortality in Japanese (24 Year Follow-up of NIPPON DATA80)
    CIRCULATION 125 10 1226 - 1233 2012年 [無し][無し]
     研究論文(学術雑誌)
  • Y. Nakamura, H. Ueshima, N. Okuda, K. Miura, Y. Kita, T. Okamura, T. C. Turin, A. Okayama, B. Rodriguez, J. D. Curb, J. Stamler
    NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES 22 1 14 - 22 2012年01月 [無し][無し]
     研究論文(学術雑誌) 
    Background and Aims: Previously, we found significantly higher serum leptin in Japanese-Americans in Hawaii than Japanese in Japan. We investigated whether differences in dietary and other lifestyle factors explain higher serum leptin concentrations in Japanese living a Western lifestyle in Hawaii compared with Japanese in Japan. Methods and Results: Serum leptin and nutrient intakes were examined by standardized methods in men and women ages 40-59 years from two population samples, one Japanese-American in Hawaii (88 men, 94 women), the other Japanese in central Japan (123 men, 111 women). Multiple linear regression models were used to assess role of dietary and other lifestyle traits in accounting for serum leptin difference between Hawaii and Japan. Mean leptin was significantly higher in Hawaii than Japan (7.2 +/- 6.8 vs 3.7 +/- 2.3 ng/ml in men, P < 0.0001; 12.8 +/- 6.6 vs 8.5 +/- 5.0 in women < 0.0001). In men, higher BMI in Hawaii explained over 90% of the difference in serum leptin; in women, only 47%. In multiple linear regression analyses in women, further adjustment for physical activity and dietary factors - alcohol, dietary fiber, iron - produced a further reduction in the coefficient for the difference, total reduction 70.7%; P-value for the Hawaii-Japan difference became 0.126. Conclusion: The significantly higher mean leptin concentration in Hawaii than Japan may be attributable largely to differences in BMI. Differences in nutrient intake in the two samples were associated with only modest relationship to the leptin difference. (C) 2010 Elsevier B. V. All rights reserved.
  • Yoshitaka Murakami, Rachel R. Huxley, Tai-Hing Lam, Rumi Tsukinoki, Xianghua Fang, Hyeon Chang Kim, Mark Woodward
    PREVENTIVE MEDICINE 54 1 38 - 41 2012年01月 [無し][無し]
     研究論文(学術雑誌) 
    Objective. To examine the effects of diabetes on coronary heart disease, ischemic and hemorrhagic stroke and cardiovascular disease according to category of body mass index. Methods. Data on 161.161 men and women from 31 cohorts (baseline years, 1966-99: mean follow-up, 2-24 years) from the Asia Pacific Cohort Studies Collaboration were analyzed using Cox regression, stratified by sex and study and adjusted for age, systolic blood pressure and smoking. Diabetes was self-reported in all but one study. Body mass index was divided into five categories according to the World Health Organization Asian criteria. Results. The hazard ratio (diabetes v. not) for cardiovascular disease was 1.83 (95% confidence interval, 1.66-2.01). Across body mass index categories, this hazard ratio did not change significantly (p=0.19). Similar lack of difference across body mass index groups was found for coronary heart disease (p=0.33), ischemic stroke (p=0.97) and hemorrhagic stroke (p=0.98). Conclusions. Body mass index does not modify the effect of diabetes on major cardiovascular outcomes. (C) 2011 Elsevier Inc. All rights reserved.
  • 前期高齢者におけるBMI別医療費と医療費高値群の特性
    日本公衛誌 59 7 466 - 473 2012年 [無し][無し]
     研究論文(学術雑誌)
  • 宮川 尚子, 三浦 克之
    Progress in Medicine 32 5 1009 - 1014 ライフ・サイエンス 2012年 [無し][無し]
     研究論文(学術雑誌)
  • Masaru Sakurai, Koshi Nakamura, Katsuyuki Miura, Toshinari Takamura, Katsushi Yoshita, Yuko Morikawa, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Yasushi Suwazono, Shuichi Kaneko, Satoshi Sasaki, Hideaki Nakagawa
    METABOLISM-CLINICAL AND EXPERIMENTAL 61 1 47 - 55 2012年01月 [有り][無し]
     研究論文(学術雑誌) 
    This cohort study investigated the association between dietary glycemic index (GI), glycemic load (GL), and the incidence of type 2 diabetes mellitus in middle-aged Japanese men, and the effect of insulin resistance and pancreatic B-cell function on the association. Participants were 1995 male employees of a metal products factory in Japan. Dietary GI and GL were assessed using a self-administered diet history questionnaire. The incidence of diabetes was detected in annual medical examinations over a 6-year period. The association between GI, GL, and the incidence of diabetes was evaluated using Cox proportional hazards models. During the study, 133 participants developed diabetes. Age- and body mass index-adjusted hazard ratios across the GI quintiles were 1.00 (reference), 1.62, 1.50, 1.68, and 1.80; and those of GL were 1.00 (reference), 1.07, 1.48, 0.95, and 0.98. The hazard ratio for the highest GI quintile was significantly greater than that for the lowest quintile. The influence of GI was more pronounced in the lowest insulin resistance subgroups. GI and pancreatic B-cell function were independently associated with the incidence of type 2 diabetes mellitus; participants with low B-cell function and the highest tertile of GI had the highest risk of diabetes. Dietary GI is associated with the incidence of diabetes in middle-aged Japanese men. GI and B-cell function were independently associated with incidence of diabetes. (C) 2012 Elsevier Inc. All rights reserved.
  • Prognostic Values of Clockwise and Counter-Clockwise Rotation for Cardiovascular Mortality in Japanese (24 Year Follow-up of NIPPON DATA80)
    CIRCULATION 125 10 1226 - 1233 2012年 [無し][無し]
     研究論文(学術雑誌)
  • Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Yasuyuki Nakamura, Kayo Ueda, Naoyuki Takashima, Hideki Sugihara, Yutaka Morita, Masaharu Ichikawa, Kunihiko Hirose, Hiroshi Nitta, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
    NEUROEPIDEMIOLOGY 38 2 84 - 92 2012年 [有り][無し]
     研究論文(学術雑誌) 
    Background: Exposure to high levels of air pollution can increase the risk of cardiovascular events. However, there is no clear information in Japan on the effect of pollution on the incidence of stroke and acute myocardial infarction (AMI). Therefore, we investigated the effects of air pollution on the incidence of stroke and AMI in a setting where pollutant levels are rather low. Methods: Data were obtained from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County in central Japan. We applied a time-stratified, bidirectional, case-crossover design to estimate the effects of air pollutants, which included suspended particulate matter (SPM), sulfur dioxide (SO2), nitrogen dioxide (NO2) and photochemical oxidants (Ox). We used the distributed lag model to estimate the effect of pollutant exposure 0-3 days before the day of event onset and controlled for meteorological covariates in all of the models. Results:There were 2,038 first-ever strokes (1,083 men, 955 women) and 429 first-ever AMI cases (281 men, 148 women) during 1988-2004. The mean pollutant levels were as follows: SPM 26.9 mu g/m(3); SO2 3.9 ppb; NO2 16.0 ppb, and Ox 28.4 ppb. In single-pollutant and two-pollutant models, SO2 was associated with the risk of cerebral hemorrhage. Other stroke subtypes and AMI were not associated with air pollutant levels. Conclusions: We observed an association between SO2 and hemorrhagic stroke; however, we found inconclusive evidence for a short-term effect of air pollution on the incidence of other stroke types and AMI. Copyright (C) 2012 S. Karger AG, Basel
  • Kayo Ueda, Shin-ya Nagasawa, Hiroshi Nitta, Katsuyuki Miura, Hirotsugu Ueshima
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 19 3 246 - 254 2012年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: It remains uncertain whether chronic exposure to particulate air pollution is associated with increased mortality in Japan because Japan has a different distribution pattern of cardiovascular disease and its risk factors compared to Western countries. We investigated the association between long-term exposure to particulate matter (PM) and cardiovascular mortality risk using a representative Japanese cohort. Methods: A total of 7,250 participants aged 30 years and older from 232 districts throughout Japan were followed from 1980 to 2004. We linked the averaged annual concentrations of PM from 1985 to 2004 to each cohort participant who resided in the district at the time of the baseline survey. Study participants were divided into quintiles of average PM concentration. We applied the Cox proportional hazard model adjusting for sex, age, body mass index, blood pressure, total cholesterol, blood glucose, smoking categories, drinking categories, and the municipality population size. Results: During follow-up, there were 1,716 deaths from all causes; 571 from cardiovascular disease, 116 from coronary heart disease, and 250 from stroke. Hazard ratios were not different among the quintiles and those for trend per 10 mu g/m(3) increase in annual PM concentration were 0.98 (95% confidence interval, 0.92-1.04) for all-cause mortality and 0.90 (95% confidence interval, 0.81-1.00) for cardiovascular mortality. Conclusion: Long-term exposure to PM was not associated with increased cardiovascular mortality risk in this population-based cohort in Japan.
  • Koshi Nakamura, Hideaki Nakagawa, Masaru Sakurai, Yoshitaka Murakami, Fujiko Irie, Akira Fujiyoshi, Tomonori Okamura, Katsuyuki Miura, Hirotsugu Ueshima
    CEREBROVASCULAR DISEASES 33 5 480 - 491 2012年 [有り][無し]
     研究論文(学術雑誌) 
    Background: In spite of the importance of a multifactorial approach to preventing cardiovascular disease in smokers, most information on the combined adverse effects of smoking and hypertension or high serum cholesterol on cardiovascular disease has been derived from Western populations, and coronary heart disease was often used as the only endpoint. Therefore, the present large-scale pooled analysis attempted to provide reliable information on the adverse effects of the coexistence of smoking and hypertension or high serum cholesterol on the risk of mortality from coronary heart disease and stroke in both, individuals and the entire population in Japan. Methods: A total of 27,385 male and 39,207 female participants aged 40-89 years were enrolled from 10 well-qualified Japanese cohort studies with a mean follow-up of 10.1 years. Hazard ratios and their corresponding 95% confidence intervals in smokers who had hypertension or high serum cholesterol were estimated for men and women separately using a Cox proportional hazards regression model that included age, body mass index, cohort and either serum total cholesterol or systolic blood pressure as covariates. Fractions of deaths attributable to the coexistence of these risk factors were also calculated. Results: The multivariate-adjusted hazard ratios in male and female current smokers with hypertension, compared with those with neither factor were 2.57 (95% confidence intervals, 1.51-4.38) and 6.14 (3.49-10.79) for coronary heart disease, and 3.28 (1.89-5.71) and 1.61 (0.81-3.18) for cerebral infarction, respectively. The fractions of deaths attributable to the coexistence of current smoking and hypertension in men and women were 24.6 and 9.6% for coronary heart disease and 28.1 and 2.0% for cerebral infarction, respectively. Smokers with high serum cholesterol were broadly comparable to hypertensive smokers only with respect to coronary mortality risk; the hazard ratios, compared with those with neither factor were 4.19 (2.33-7.53) for men and 3.90 (1.57-9.67) for women. The fraction of coronary deaths attributable to the coexistence of current smoking and high serum cholesterol was 6.3% in men and 2.2% in women. There was no interaction between smoking habit and blood pressure or serum total cholesterol for these two subtypes in both men and women. Conclusions: Particular attention should be given to smokers who have concomitant hypertension or high serum cholesterol for preventing deaths due to cardiovascular disease. From a public health perspective in Japan, priority should be given to hypertensive smokers, since this group makes a large contribution to the burden of both coronary and cerebral infarction deaths. Copyright (C) 2012 S. Karger AG, Basel
  • Turin TC, Kita Y, Rumana N, Nakamura Y, Ueda K, Takashima N, Sugihara H, Morita Y, Ichikawa M, Hirose K, Nitta H, Okayama A, Miura K, Ueshima H
    Am J Clin Nutr 96 3 483 - 491 2012年 [有り][無し]
     研究論文(学術雑誌)
  • Sayuri Katano, Yasuyuki Nakamura, Nagako Okuda, Yoshitaka Murakami, Nagako Chiba, Katsushi Yoshita, Taichiro Tanaka, Junko Tamaki, Toru Takebayashi, Akira Okayama, Katsuyuki Miura, Tomonori Okamura, Hirotsugu Ueshima
    DIABETOLOGY & METABOLIC SYNDROME 3 1 30  2011年11月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Prevalence of men with cardiometabolic risk factors (CMRF) is increasing in Japan. Few studies have comprehensively examined the relation between lifestyles and CMRF. Methods: We examined the baseline data from 3,498 male workers ages 19 to 69 years who participated in the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study at 12 large-scale companies throughout Japan. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). Dietary intake was surveyed by a semi-quantitative Food Frequency Questionnaire. We defined four CMRF in this study as follows: 1) high blood pressure (BP): systolic BP >= 130 mmHg, or diastolic BP >= 85 mmHg, or the use of antihypertensive drugs; 2) dyslipidemia: high-density lipoprotein-cholesterol concentration < 40 mg/dl, or triglycerides concentration >= 150 mg/dl, or on medication for dyslipidemia; 3) impaired glucose tolerance: fasting blood sugar concentration >= 110 mg/dl; 4) obese: a body mass index >= 25 kg/m(2). Results: Those who had 0 to 4 CMRF accounted for 1,597 (45.7%), 1,032 (29.5%), 587 (16.8%), 236 (6.7%), and 44 (1.3%) participants, respectively, in the Poisson distribution. Poisson regression analysis revealed that independent factors that contributed to the number of CMRF were age (b = 0.020, P < 0.01), IPAQ (b = -0.091, P < 0.01), alcohol intake (ml/day) (b = 0.001, P = 0.03), percentage of protein intake (b = 0.059, P = 0.01), and total energy intake (kcal)(b = 0.0001, P < 0.01). Furthermore, alcohol intake and its frequency had differential effects. Conclusions: Alcohol intake, percent protein and total energy intake were positively associated, whereas drinking frequency and IPAQ were inversely associated, with the number of CMRF.
  • Sayuri Katano, Yasuyuki Nakamura, Aki Nakamura, Yoshitaka Murakami, Taichiro Tanaka, Toru Takebayashi, Akira Okayama, Katsuyuki Miura, Tomonori Okamura, Hirotsugu Ueshima
    JOURNAL OF DIABETES INVESTIGATION 2 5 366 - 372 2011年10月 [有り][無し]
     研究論文(学術雑誌) 
    Aims/Introduction: To examine the cross-sectional relationship between sleep duration and impaired glucose tolerance (IGT), including diabetes mellitus (DM), we analyzed a large-scale healthy workers database in Japan. Materials and Methods: We examined the baseline database of 4143 participants (3415 men and 728 women) aged 19-69 years. Sleep duration of participants was categorized into four groups: <6, 6 to <7, 7 to <8 and >= 8 h. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined IGT including DM (IGT/DM) in the present study according to previous studies as follows: fasting blood sugar level >= 110 mg/dL, or if <8 h after meals >= 140 mg/dL, or on medication for diabetes mellitus, or those diagnosed as having DM. Logistic regression was applied to estimate the odds ratio (OR) to examine the relationship between IGT/DM, sleep duration and other related factors. Results: The number of participants with IGT/DM was 402 (9.7%). The factors that significantly associated with IGT/DM were age (OR 1.08, 95% confidence interval [CI] 1.07-1.10, P < 0.001), high blood pressure (OR 1.94, CI 1.52-2.47, P < 0.001), and <6 h of sleep duration in comparison with 6 to <7 h sleep (OR 2.32, CI 1.18-4.55, P = 0.015). The associations of difficulty in sleep initiation, IPAQ classification, current smoking and alcohol intake with IGT/DM were not statistically significant. Conclusions: Our results showed that shorter sleep duration (<6 h of sleep duration per night) was associated with a risk of IGT/DM independent of other lifestyle habits and metabolic risk factors. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00114.x, 2011)
  • Yuko Hamazaki, Yuko Morikawa, Koshi Nakamura, Masaru Sakurai, Katsuyuki Miura, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Yasushi Suwazono, Hideaki Nakagawa
    SCANDINAVIAN JOURNAL OF WORK ENVIRONMENT & HEALTH 37 5 411 - 417 2011年09月 [有り][無し]
     研究論文(学術雑誌) 
    Objectives Although previous epidemiological studies have investigated the relationship between sleep duration and various cardiovascular events, the results have been inconsistent. Accordingly, we conducted a follow-up survey to investigate the relationship between sleep duration and cardiovascular events among male workers, accounting for occupational factors that might confound the true relationship. Methods A total of 2282 male employees aged 35-54 years based in a factory in Japan were followed for 14 years. The risk of cardiovascular events was compared among 4 groups stratified based on sleep duration at baseline (<6, 6-6.9, 7-7.9, and >= 8 hours). Cardiovascular events included stroke, coronary events and sudden cardiac death. The hazard ratios for events were calculated using a Cox proportional hazards model, with the 7-7.9-hour group serving as a reference. The model was adjusted for potential confounders including traditional cardiovascular risk factors and working characteristics. Results During 14 years of follow-up, 64 cardiovascular events were recorded including 30 strokes, 27 coronary events and 7 sudden cardiac deaths. After adjustment for possible confounders, the hazard ratios for cardiovascular and coronary events in the <6-hour group were 3.49 [95% confidence interval (95% CI) 1.30-9.40] and 4.95 (95% CI 1.31-18.73), respectively. There was no significant increment in the risk of stroke for any sleep duration groups. Conclusion Short sleep duration (<6 hours) was a significant risk factor for coronary events in a Japanese male working population.
  • Akira Sekikawa, Takashi Kadowaki, Aiman El-Saed, Tomonori Okamura, Kim Sutton-Tyrrell, Yasuyuki Nakamura, Rhobert W. Evans, Ken-ichi Mitsunami, Daniel Edmundowicz, Yoshihiko Nishio, Katsumi Nakata, Aya Kadota, Teruo Otake, Katsuyuki Miura, Jina Choo, Robert D. Abbott, Lewis H. Kuller, J. David Curb, Hirotsugu Ueshima
    STROKE 42 9 2538 - U263 2011年09月 [有り][無し]
     研究論文(学術雑誌) 
    Background and Purpose-Recent studies reported the differential effect of docosahexaenoic (DHA) and eicosapentaenoic acids (EPA). We examined the differential association of DHA and EPA with carotid intima-media thickness (IMT) in Japanese individuals in Japan and in U. S. white individuals and explored whether DHA or EPA contributes to the difference in IMT between the two groups. Methods-A population-based cross-sectional study in 608 Japanese and U. S. white men aged 40 to 49 was conducted to assess IMT, serum DHA, EPA, and other cardiovascular risk factors. Results-Japanese compared to U. S. whites had significantly lower IMT (mean +/- SD, 618 +/- 81 and 672 +/- 94 mu m for Japanese and whites, respectively; P<0.001) and had >2-fold higher levels of DHA and EPA. DHA, but not EPA, had an inverse association with IMT in both Japanese and U. S. whites. The inverse association remained only in Japanese men after adjusting for risk and other factors. The significant difference in multivariable-adjusted IMT became nonsignificant after further adjusting for DHA (mean difference, 17 mu m; 95% CI, -8 to 43; P=0.177) but not EPA. In this multivariable-adjusted model, DHA but not EPA was a significant predictor of IMT (P=-0.032 versus 0.863, respectively). Conclusions-These data suggest that DHA may have a more potent antiatherogenic effect than EPA, especially in levels observed in the Japanese, independent of risk factors. (Stroke. 2011;42:2538-2543.)
  • Akira Fujiyoshi, Takashi Kadowaki, Sayaka Kadowaki, Akira Sekikawa, Takayoshi Ohkubo, Katsuyuki Miura, Daniel Edmundowicz, Matthew J. Budoff, Kiyoshi Murata, Kiang Liu, Hirotsugu Ueshima
    INTERNATIONAL JOURNAL OF CARDIOLOGY 149 2 244 - 245 2011年06月 [有り][無し]
     研究論文(学術雑誌)
  • Nahid Rumana, Tanvir Chowdhury Turin, Katsuyuki Miura, Yasuyuki Nakamura, Yoshikuni Kita, Takehito Hayakawa, Sohel Reza Choudhury, Aya Kadota, Shin-Ya Nagasawa, Akira Fujioshi, Naoyuki Takashima, Tomonori Okamura, Akira Okayama, Hirotsugu Ueshima
    AMERICAN JOURNAL OF CARDIOLOGY 107 12 1718 - 1724 2011年06月 [有り][無し]
     研究論文(学術雑誌) 
    Little is known about the prognostic value of ST-segment depression and/or T wave (ST-T abnormalities) with or without left high R waves on electrocardiogram recorded at rest for death from cardiovascular disease (CVD) in Asian populations. Japanese participants without a history of CVD and free of major electrocardiographic (ECG) abnormalities were followed for 24 years. Subjects were divided into 4 groups based on baseline ECG findings: isolated left high R waves, isolated ST-T abnormalities, ST-T abnormalities with left high R waves, and normal electrocardiogram. Cox proportional hazard model was used to estimate risk of CVD mortality in groups with ECG abnormalities compared to the normal group. Of 8,572 participants (44.4% men, mean age 49.5 years; 55.6% women, mean age 49.4 years), 1,142 had isolated left high R waves, 292 had isolated ST-T abnormalities, and 128 had ST-T abnormalities with left high R waves at baseline. Multivariable-adjusted hazard ratios of ST-T abnormalities with left high R waves for CVD mortality were 1.95 (95% confidence interval 1.25 to 3.04) in men and 2.68 (95% confidence interval 1.81 to 3.97) in women. Isolated ST-T abnormalities increased the risk for CVD death by 1.66 times (95% confidence interval 1.01 to 2.71) in men and 1.62 times (95% confidence interval 1.18 to 2.24) in women. Association of ECG abnormalities with CVD mortality was independent of age, body mass index, systolic blood pressure, serum cholesterol, blood glucose, smoking and drinking, and antihypertensive medication. In conclusion, ST-T abnormalities with or without left high R waves on electrocardiogram recorded at rest constitute an independent predictor of CVD mortality in Japanese men and women. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:1718-1724)
  • Kenji Wakai, Nobuyuki Hamajima, Rieko Okada, Mariko Naito, Emi Morita, Asahi Hishida, Sayo Kawai, Kazuko Nishio, Guang Yin, Yatami Asai, Keitaro Matsuo, Satoyo Hosono, Hidemi Ito, Miki Watanabe, Takakazu Kawase, Takeshi Suzuki, Kazuo Tajima, Keitaro Tanaka, Yasuki Higaki, Megumi Hara, Takeshi Imaizumi, Naoto Taguchi, Kazuyo Nakamura, Hinako Nanri, Tatsuhiko Sakamoto, Mikako Horita, Koichi Shinchi, Yoshikuni Kita, Tanvir Chowdhury Turin, Nahid Rumana, Kenji Matsui, Katsuyuki Miura, Hirotsugu Ueshima, Naoyuki Takashima, Yasuyuki Nakamura, Sadao Suzuki, Ryosuke Ando, Akihiro Hosono, Nahomi Imaeda, Kiyoshi Shibata, Chiho Goto, Nami Hattori, Mitsuru Fukatsu, Tamaki Yamada, Shinkan Tokudome, Toshiro Takezaki, Hideshi Niimura, Kazuyo Hirasada, Akihiko Nakamura, Masaya Tatebo, Shin Ogawa, Noriko Tsunematsu, Shirabe Chiba, Haruo Mikami, Suminori Kono, Keizo Ohnaka, Ryoichi Takayanagi, Yoshiyuki Watanabe, Etsuko Ozaki, Masako Shigeta, Nagato Kuriyama, Aya Yoshikawa, Daisuke Matsui, Isao Watanabe, Kaoru Inoue, Kotaro Ozasa, Satoko Mitani, Kokichi Arisawa, Hirokazu Uemura, Mineyoshi Hiyoshi, Hidenobu Takami, Miwa Yamaguchi, Mariko Nakamoto, Hideo Takeda, Michiaki Kubo, Hideo Tanaka
    JOURNAL OF EPIDEMIOLOGY 21 3 223 - 235 2011年05月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Most diseases are thought to arise from interactions between environmental factors and the host genotype. To detect gene-environment interactions in the development of lifestyle-related diseases, and especially cancer, the Japan Multi-institutional Collaborative Cohort (J-MICC) Study was launched in 2005. Methods: We initiated a cross-sectional study to examine associations of genotypes with lifestyle and clinical factors, as assessed by questionnaires and medical examinations. The 4519 subjects were selected from among participants in the J-MICC Study in 10 areas throughout Japan. In total, 108 polymorphisms were chosen and genotyped using the Invader assay. Results: The study group comprised 2124 men and 2395 women with a mean age of 55.8 +/- 8.9 years (range, 35-69 years) at baseline. Among the 108 polymorphisms examined, 4 were not polymorphic in our study population. Among the remaining 104 polymorphisms, most variations were common (minor allele frequency >= 0.05 for 96 polymorphisms). The allele frequencies in this population were comparable with those in the HapMap-JPT data set for 45 Japanese from Tokyo. Only 5 of 88 polymorphisms showed allele-frequency differences greater than 0.1. Of the 108 polymorphisms, 32 showed a highly significant difference in minor allele frequency among the study areas (P < 0.001). Conclusions: This comprehensive data collection on lifestyle and clinical factors will be useful for elucidating gene environment interactions. In addition, it is likely to be an informative reference tool, as free access to genotype data for a large Japanese population is not readily available.
  • 2010年国民健康栄養調査対象者の追跡開始(NIPPON DATA 2010)とNIPPON DATA80/90の追跡継続に関する研究
    三浦克之, 上島弘嗣, 和泉 徹, 大久保孝義, 岡村智教, 岡山 明, 奥田奈賀子, 尾島俊之, 笠置文善, 門田 文, 喜多義邦, 清原 裕, 斉藤重幸, 坂田清美, 中川秀昭, 中村保幸, 中村好一, 西 信雄, 早川岳人, 寶澤 篤, 松村康弘, 由田克士
    厚生労働科学研究費補助金(指定研究)循環器疾患・糖尿病等生活習慣病対策総合研究事業「2010年国民健康栄養調査対象者の追跡開始(NIPPON DATA2010)とNIPPON DATA80/90の追跡継続に関する研究」平成22年度総括・分担研究報告書 42012 2011年03月 [無し][無し]
     学位論文(その他)
  • 大規模コホート共同研究による生活習慣病発症予防データベース構築とその高度利用に関する研究
    上島弘嗣, 磯 博康, 今井 潤, 岡村智教, 岡山 明, 清原 裕, 斉藤重幸, 坂田清美, 玉腰暁子, 辻 一郎, 中川秀昭, 中山健夫, 三浦克之, 村上義孝, 山田美智子
    厚生労働科学研究費補助金・循環器疾患等生活習慣病対策総合研究事業「大規模コホート共同研究による生活習慣業発症予防データベース構築とその高度利用に関する研究」平成20-22年度総合報告書 42077 2011年03月 [無し][無し]
     学位論文(その他)
  • 富山県職域コホートの概要と成果
    中川秀昭, 櫻井 勝, 中村幸志, 森河裕子, 三浦克之
    厚生労働科学研究費補助金・循環器疾患等生活習慣病対策総合研究事業「大規模コホート共同研究による生活習慣業発症予防データベース構築とその高度利用に関する研究」平成20-22年度総合報告書 111-116 2011年03月 [無し][無し]
     学位論文(その他)
  • 平成22年国民健康・栄養調査 実施自治体への協力依頼
    三浦克之, 門田 文, 大久保孝義, 岡村智教, 岡山 明, 和泉 徹, 尾島俊之, 笠置文善, 喜多義邦, 清原 裕, 斉藤重幸, 坂田清美, 中川秀昭, 中村保幸, 中村好一, 早川岳人, 寶澤 篤, 松村康弘, 由田克士
    厚生労働科学研究費補助金(指定研究)循環器疾患・糖尿病等生活習慣病対策総合研究事業「2010年国民健康栄養調査対象者の追跡開始(NIPPON DATA2010)とNIPPON DATA80/90の追跡継続に関する研究」平成22年度総括・分担研究報告書 19-30 2011年03月 [無し][無し]
     学位論文(その他)
  • Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Yasuyuki Nakamura, Naoyuki Takashima, Hideki Sugihara, Yutaka Morita, Kenji Matsui, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
    EMERGENCY MEDICINE JOURNAL 28 3 239 - 241 2011年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background Prompt initiation of treatment is the cornerstone in the management of patients with acute myocardial infarction (AMI). The time lags for AMI hospitalisations were examined to identify the factors influencing the interval. Methods Time lag information was available for 273 men and 148 women from the Takashima AMI Registry during 1988-2006. Multivariate regression analyses were performed to evaluate the factors influencing early and late admission. Results The median time to hospitalisation was 2 h (mean 6.1, SD 18.7). Within 2 h of onset, 59.8% patients arrived and 20.6% arrived during the 2-6 h interval. A substantial number of patients (19.6%) arrived after 6 h and onwards. A time lag of > 2 h in hospital admission was significantly influenced by history of hypertension, angina, presence of syncope as an initial symptom and time of AMI onset. A time lag of > 6 h shared similar characteristics except for presence of history of angina. Conclusions About one-fifth of patients with AMI have prolonged time lag in the study population. Future research intervention and health promotion activities should focus on achieving a reduction in presentation delays.
  • Aya Kadota, Katsuyuki Miura, Tomonori Okamura, Atsushi Hozawa, Yoshitaka Murakami, Akira Fujiyoshi, Naoyuki Takashima, Takehito Hayakawa, Yoshikuni Kita, Akira Okayama, Yasuyuki Nakamura, Hirotsugu Ueshima
    ATHEROSCLEROSIS 215 1 209 - 213 2011年03月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: The individual components of metabolic syndrome are defined as levels ranging from moderate to high level as to require medication. We investigated the impact of moderate metabolic risk factor clustering on cardiovascular disease (CVD) mortality. Methods: We followed up 6758 non-lean Japanese in randomly selected areas from all over the country who had no history of CVD for 15 years. The multivariate-adjusted hazards ratio (HR) and 95% confidence interval (CI) for CVD mortality according to the number of moderate metabolic risk factors (BMI >= 25 kg/m(2), 130/85mmHg <= systolic/diastolic BP < 140/90mmHg, 140 mg/dl <= casual blood glucose < 200 mg/dl, triglycerides > 150 mg/dl and/or HDL cholesterol < 40 mg/dl [men], 50 mg/dl [women]) were estimated using the Cox proportional hazards model. The population-attributable risk fraction of moderate metabolic risk factor clustering was also estimated. Results: During the follow-up, 282 participants died of CVD. CVD mortality tended to increase with the number of moderate metabolic risk factors. However, they were not statistically significant. The multivariate-adjusted HRs were 1.82 (95% CI: 0.89-3.73) for having any moderate metabolic risk factors and 2.87 (95% CI: 1.46-5.64) for having any medication-required metabolic risk factors, compared with participants without any moderate metabolic risk factors. The population-attributable risk fractions were 7.3% and 52.4% for any moderate and medication-required metabolic risk factors, respectively. Conclusions: We did not find the statistically significant increase of CVD mortality for moderate metabolic risk factor clustering. Its attribution was relatively small in this Japanese population. More efforts would be required to detect and control medication-required risk factors. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
  • Motoko Nakashima, Yuko Morikawa, Masaru Sakurai, Koshi Nakamura, Katsuyuki Miura, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Yasushi Suwazono, Hideaki Nakagawa
    JOURNAL OF SLEEP RESEARCH 20 1 110 - 116 2011年03月 [有り][無し]
     研究論文(学術雑誌) 
    P>The purpose of this study is to examine the association between long work hours and sleep disturbance among white-collar workers. We evaluated 1510 male white-collar full-time employees, between the ages of 18 and 59 years, using a comprehensive sleep quality questionnaire, the Pittsburgh Sleep Quality Index (PSQI). All subjects worked in a light metal products factory in Japan. The mean number of monthly overtime work hours was determined using data from the previous 6 months from timecard records. Subjects were divided into five groups based on quintiles of the mean number of monthly overtime work hours: < 26 h month-1; >= 26 but < 40; >= 40 but < 50; >= 50 but < 63; and > 63. Leisure time physical activity, drinking habits just before sleep, presence of family/partner and health status were used as confounding factors in the multiple regression model. The prevalence of short sleep hours, impairment of sleep efficiency and daytime dysfunction among seven components of PSQI increased, in a dose-response relationship, with overtime work hours. The prevalence of high global score (> 5.5 points) was highest in workers with overtime hours >= 50 h week-1. The odds ratios after adjustment for confounding factors for high global score using less than 26 h as a reference group were 1.67 for workers with >= 50 h and < 63 h, and 1.87 for workers with 63 h and more. To conclude, the present results suggest that long work hours correlate with reduced sleep quality in a dose-response manner.
  • Katsuyuki Miura
    EPMA Journal 2 1 59 - 64 2011年03月 [有り][無し]
     研究論文(学術雑誌) 
    Japan is one of the countries with the longest longevity in the world, and it was accomplished by a drastic decline in stroke mortality from 1960's. The decline in stroke mortality would be largely explained by a population-wide decreasing trend in blood pressure (BP) level, because higher BP has been the strongest risk factor of stroke about 20% of total deaths can be explained by higher BP above optimal in Japan. Decreasing trend in BP occurred both in men and women in all age-groups, which cannot be fully explained by the widespread use of anti-hypertensive agents. The most probable reason for the population-wide BP decline in Japan would be a large decline in dietary salt intake after 1950's. However, other factors including obesity, high alcohol intake, and unfavorable dietary habits could increase BP level of Japanese again. © 2011 European Association for Predictive, Preventive and Personalised Medicine.
  • J. David Curb, Hirotsugu Ueshima, Beatriz L. Rodriguez, QiMei He, Tanya A. Koropatnick, Hideaki Nakagawa, Kiyomi Sakata, Shigeyuki Saitoh, Akira Okayama
    JOURNAL OF CLINICAL LIPIDOLOGY 5 1 30 - 36 2011年02月 [無し][無し]
     研究論文(学術雑誌) 
    BACKGROUND: Current data suggest that low density lipoprotein (LDL) and high density lipoprotein (HDL) subclass concentrations relate directly to the risk of coronary heart disease (CHD). Earlier Studies indicated that Japanese in Japan had lower rates of CHD than Japanese Americans in Hawaii. Rates of CHD appear to continue to be lower in Japan despite increasing cholesterol levels in Japan and decreasing CHD rates in the United States. OBJECTIVE: To provide insight into CHD rate differences. METHODS: Nuclear Magnetic Resonance (NMR) measurements of lipoprotein subclasses were used to assess lipoprotein particle concentration and size in samples from these two genetically similar populations in Japan and Hawaii. RESULTS: Japanese Americans had significantly higher age- and risk factor- adjusted concentrations of lipoprotein particles implicated in atherogenesis, including large very low density lipoprotein (VLDL; P < 0.001), small LDL (P < 0.001), and small HDL (women, P < 0.001; men, P < 0.01), and significantly lower concentrations of large LDL (P < 0.001) and the putative cardio-protective large HDL (P < 0.05) than Japanese in Japan. Average age- and risk factor- adjusted LDL and HDL particle sizes were also significantly (P < 0.001) smaller in Japanese Americans. Adjustment for body mass index markedly reduced the differences in some lipoprotein measures, including total LDL and large HDL particle concentrations for both genders, total VLDL particle concentration for women, and large VLDL concentration and average HDL particle size for men. CONCLUSIONS: Differences in lipoprotein subclass distributions and lifestyle factors such as body weight may contribute to differences in CHD incidence for Japanese in Japan and Japanese Americans. (C) 2011 National Lipid Association. All rights reserved.
  • Masaru Sakurai, Jeremiah Stamler, Katsuyuki Miura, Ian J. Brown, Hideaki Nakagawa, Paul Elliott, Hirotsugu Ueshima, Queenie Chan, Ioanna Tzoulaki, Alan R. Dyer, Akira Okayama, Liancheng Zhao
    JOURNAL OF HYPERTENSION 29 2 222 - 228 2011年02月 [無し][無し]
     研究論文(学術雑誌) 
    Objective A direct relationship of dietary cholesterol to blood pressure of men has been reported in a few observational studies from the USA. It is not clear whether this association prevails consistently, for example, in populations with varied dietary habits, across ethnic groups, and sexes. Cross-sectional data from the International Study of Macro/Micro-nutrients and Blood Pressure (INTERMAP) were used to assess relations of dietary cholesterol intake to blood pressure in men and women from four countries. Methods Data include 83 nutrients from four multipass 24-h dietary recalls and two-timed 24-h urine collections; eight blood pressure readings, and questionnaire data, for 4680 participants ages 40-59 years from 17 population samples in Japan, People's Republic of China, UK, and USA. Results With sequential models to control for multiple possible confounders (dietary, other), linear regression analyses showed that dietary cholesterol was directly related to SBP for all participants and for nonhypertensive individuals, but not to DBP. With adjustment for 12 variables, estimated SBP differences with 2SD for higher cholesterol intake (131.0 mg/1000 kcal) were 0.9mmHg(P<0.05) for all participants and 1.1mmHg (P<0.01) for nonhypertensive individuals, findings attenuated with addition of height and weight to the model. Conclusion INTERMAP found a low-order, positive relationship of dietary cholesterol intake to SBP with control for multiple possible confounders. Reduction of dietary cholesterol intake may contribute to prevention and control of adverse blood pressure levels in general populations. J Hypertens 29: 222-228 (c) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
  • Kadota A, Miura K, Ueshima H
    Nihon rinsho. Japanese journal of clinical medicine 69 Suppl 1 35 - 39 2011年01月 [有り][無し]
  • A cross-sectional association of visceral adipose tissue with coronary artery calcification among White, Japanese-American, Japanese, and Korean (the ERA JUMP Study)
    AHA(atolanta) - - ---  2011年 [無し][無し]
  • The Association of Visceral Adipose Tissue, Subcutaneous Adipose Tissue, BMI, and Waist Circumference with Lipoprotein Profile in Middle-Aged Japanese American, African American, and Korean Men
    AHA(atolanta) - - ---  2011年 [無し][無し]
  • Yoshitaka Murakami, Katsuyuki Miura, Tomonori Okamura, Hirotsugu Ueshima
    Preventive Medicine 52 1 60 - 65 2011年01月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: Age- and sex-specific population attributable fraction (PAF) and premature deaths attributable to smoking were estimated from a pooled analysis of cohort studies in Japan. Methods: A pooled analysis of individual participant data from 13 well-qualified cohort studies throughout Japan (a total of 183,251 Japanese aged 40-89, 69,502 men and 113,749 women the baseline years between 1987 and 1995 with average 10 years of follow-up) was performed. Poison regression model was used to estimate age- and sex-specific hazard ratios, and their PAFs of all-cause deaths and number of annual premature deaths attributable to smoking were estimated. Results: Overall PAF attributable to smoking was 24.6% in men and 6.0% in women. The estimated number of annual premature deaths due to smoking was 121,854 (men: 109,998 women: 11,856) in Japan. The age-specific PAF was largest in men aged 60-69 (47.7%) and in women aged 50-59 (12.2%). In the older group aged 70-79 and 80-89, PAF was 15.4% and 8.0% in men and 3.5% and 1.5% in women, respectively. Conclusions: Age-specific PAFs attributable to smoking in Japanese men are much larger than that reported from other Asian countries. © 2010 Elsevier Inc.
  • Katano S, Nakamura Y, Nakamura A, Murakami Y, Tanaka T, Takebayashi T, Okayama A, Miura K, Okamura T, Ueshima H, HIPOP-OHP Research Group
    Diabetes Metab Syndr Obes 4 119 - 125 2011年 [有り][無し]
     研究論文(学術雑誌)
  • Robert D. Abbott, Aya Kadota, Katsuyuki Miura, Takehito Hayakawa, Takashi Kadowaki, Tomonori Okamura, Akira Okayama, Kamal H. Masaki, Hirotsugu Ueshima
    Journal of Aging Research 2011 1 - 8 2011年 [有り][無し]
     研究論文(学術雑誌) 
    Introduction. Hypertension and cigarette smoking are dominant risk factors for cardiovascular disease in Japan while in westernized countries, broader effects encompass obesity, diabetes, and hypercholesterolemia. This paper examines whether different associations also appear important in the manifestation of activities of daily living (ADL) in older Japanese men in Hawaii and Japan.Methods. Measures of ADL (feeding, toileting, dressing, bathing, and walking around the house) were assessed from 1995 to 1999 in 1,893 men in Hawaii and 543 men in Japan. Concomitant risk factors were measured from 1990 to 1993.Results. In Hawaii, diabetes increased the odds of ≥1 ADL impairment nearly 1.5-fold (P=.020). A similar association was absent in Japan. In contrast, the odds of an ADL impairment in Japan was increased more than 5-fold in the presence of stroke (P<.001). The association in Hawaii was significantly weaker (P=.007). In both cohorts, past alcohol use was associated with a greater likelihood of ADL impairment.Conclusion. In this comparison of genetically similar samples, findings suggest that different strengths in risk factor associations with cardiovascular disease in Japan and westernized countries may also include different strengths in associations with impaired ADL.
  • Yasushi Suwazono, Kazuhiro Nogawa, Mirei Uetani, Katsuyuki Miura, Kiyomi Sakata, Akira Okayama, Hirotsugu Ueshima, Jeremiah Stamler, Hideaki Nakagawa
    JOURNAL OF APPLIED TOXICOLOGY 31 1 89 - 93 2011年01月 [無し][無し]
     研究論文(学術雑誌) 
    We used an updated hybrid approach to estimate the benchmark doses and their 95% lower confidence limits (BMDL) for cadmium-induced renal effects in humans. Participants were 828 inhabitants (410 men, 418 women), aged 40-59 years who lived in three areas without any known environmental cadmium pollution. We measured urinary cadmium (U-Cd) as a marker of exposure, and urinary protein, beta 2-microglobulin (beta 2-MG) and N-acetyl-beta-D-glucosaminidase (NAG) as markers of renal effects. For urinary protein, the BMDL ranged from 0.9 to 1.1 mu g g(-1) creatinine (cre) and approximately 1.6 mu g per 24 h in men, and from 1.9 to 3.4 mu g g(-1) cre and 2.0 mu g per 24 h in women. For the renal tubular markers beta 2-MG and NAG, the BMDL for U-Cd ranged from 0.6 to 1.2 mu g g(-1) cre and from 0.8 to 1.7 mu g per 24 h in men, and from 0.6 to 2.3 mu g g(-1) cre and from 0.6 to 2.1 mu g per 24 h in women. The lowest BMDL for urinary cadmium (0.6 mu g g-1 cre) was somewhat lower than average urinary cadmium in Japanese older population. These results suggest the importance of measures to decrease cadmium exposure in the general population of Japan. Copyright (C) 2010 John Wiley & Sons, Ltd.
  • Yuichi Machida, Koichiro Kitamoto, Yasukatsu Izumi, Masayuki Shiota, Junji Uchida, Yukimi Kira, Tatsuya Nakatani, Katsuyuki Miura
    JOURNAL OF PHARMACOLOGICAL SCIENCES 114 4 464 - 473 2010年12月 [有り][無し]
     研究論文(学術雑誌) 
    The role of renal dendritic cells (DCs) in renal fibrosis is unknown The present study was conducted to examine the relative role of renal DCs and macrophages in the development of renal fibrosis in murine obstructive nephropathy CD11c-diphtheria toxin receptor (DTR) transgenic mice and CD11b-DTR transgenic mice were subjected to unilateral ureteral obstruction To conditionally and selectively deplete DCs or macrophages, DT was given to these mice and kidneys were harvested on day 5 Ureteral obstruction elicited renal fibrosis characterized by tubulointerstitial collagen III deposition and accumulation of alpha-smooth muscle actin positive cells Flow cytometric analysis revealed a marked increase in cell counts of F4/80(+) macrophages, F4/80(+) DCs, as well as neutrophils and T cells in the obstructed kidney DT administration to CD11c-DTR mice led to selective depletion of renal CD11c(+) DCs, but did not affect renal fibrosis In contrast, administration of DT to CD11b-DTR mice resulted in ablation of all monocyte lineages including macrophages and DCs and attenuated renal fibrosis Our results do not support the role of renal DCs, but confirm the importance of monocyte lineage cells other than DCs in the development of the early phase of renal fibrosis following ureteral obstruction in mice
  • Katsumi Nakata, Jina Choo, Michael J. S. Hopson, Hirotsugu Ueshima, J. David Curb, Chol Shin, Rhobert W. Evans, Takashi Kadowaki, Teruo Otake, Aya Kadota, Syaka Kadowaki, Katsuyuki Miura, Aiman El-Saed, Daniel Edmundowicz, Kim Sutton-Tyrrell, Lewis H. Kuller, Akira Sekikawa
    METABOLISM-CLINICAL AND EXPERIMENTAL 59 12 1742 - 1751 2010年12月 [有り][無し]
     研究論文(学術雑誌) 
    Both sagittal abdominal diameter (SAD) and waist circumference (WC) highly correlate with visceral adipose tissue (VAT) being linked to an atherogenic lipoprotein profile. However, it is uncertain whether SAD is a better correlate of atherogenic lipoprotein subfractions than WC. We examined relative associations of SAD vs WC with lipoprotein subfractions for US white and Japanese men, concurrently examining the associations of VAT vs subcutaneous adipose tissue with lipoprotein subfractions. A population-based sample of 260 white and 282 Japanese men aged 40 to 49 years was examined for VAT and subcutaneous adipose tissue by computed tomography; SAD and WC by a portable sliding-beam caliper and a measuring tape, respectively; and lipoprotein subfractions by nuclear magnetic resonance spectroscopy. Both SAD and WC were significantly and positively associated with large very low-density lipoprotein and total and small low-density lipoprotein particle concentrations, and inversely associated with large high-density lipoprotein particle concentration for both white and Japanese men. In body mass index-adjusted regression models, the significant associations of SAD remained for both white and Japanese men, whereas those of WC became nonsignificant for white men. When SAD and WC were simultaneously included into the body mass index-adjusted models, the associations of SAD remained significant and statistically stronger than those of WC for both white and Japanese men. Furthermore, the pattern of the associations of SAD with those lipoprotein subfractions was comparable to that of the associations of VAT. Sagittal abdominal diameter was comparable to VAT and stronger than WC in the associations with atherogenic lipoprotein subfractions for middle-aged, nondiabetic, white and Japanese men. (C) 2010 Elsevier Inc. All rights reserved.
  • K. Nakamura, M. Sakurai, K. Miura, Y. Morikawa, M. Ishizaki, K. Yoshita, T. Kido, Y. Naruse, H. Nakagawa
    DIABETOLOGIA 53 9 1894 - 1902 2010年09月 [無し][無し]
     研究論文(学術雑誌) 
    Aims/hypothesis Little is known about the relationship between the HOMA of insulin resistance (HOMA-IR) and the risk of cardiovascular events in Asian populations, which have lower levels of HOMA-IR than Western populations. Accordingly, we determined the predictive value of HOMA-IR for cardiovascular risk in a Japanese population that was apparently free of diabetes, addressing whether insulin resistance itself increases cardiovascular risk independently of other relevant metabolic disorders. Methods We followed 2,548 non-diabetic men aged 35 to 59 years for 11 years. The hazard ratios for the incidence of cardiovascular events due to increased HOMA-IR were estimated using a Cox proportional hazards model that was adjusted for potential confounding factors. Results The multivariate-adjusted hazard ratio for cardiovascular events compared with the first quartile of HOMAIR (<= 0.66) was 1.07 (95% CI 0.44-2.64) for the second (HOMA-IR 0.67-1.01), 1.36 (0.56-3.28) for the third (HOMA-IR 1.02-1.51) and 2.50 (1.02-6.10) for the fourth quartile (HOMA-IR >= 1.52). The hazard ratio associated with a one SD (0.61) increment in log-transformed HOMA-IR was 1.51 (1.13-2.02). A similar positive relationship was observed for coronary events and stroke. In addition, the relationship between HOMA-IR and cardiovascular risk was broadly similar in participants with and without hypertension, dyslipidaemia (elevated triacylglycerol and/or reduced HDL-cholesterol), abdominal obesity and current smoking. Conclusions/interpretation Increased HOMA-IR predicted subsequent cardiovascular events in non-diabetic Japanese men. The association was independent of traditional cardiovascular risk factors and other relevant metabolic disorders.
  • Hiroshi Yatsuya, Hideaki Toyoshima, Kazumasa Yamagishi, Koji Tamakoshi, Masataka Taguri, Akiko Harada, Yasuo Ohashi, Yoshikuni Kita, Yoshihiko Naito, Michiko Yamada, Naohito Tanabe, Hiroyasu Iso, Hirotsugu Ueshima
    CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES 3 5 498 - 2 2010年09月 [無し][無し]
     研究論文(学術雑誌) 
    Background-The association of overweight/obesity with the incidence of cardiovascular diseases, especially stroke, has not been comprehensively examined in relatively lean populations in which stroke is more prevalent than coronary heart disease. Methods and Results-Pooled individual data from 16 Japanese cohorts comprising 45 235 participants ages 40 to 89 years without previous history of cardiovascular disease were studied. During follow-up, 1113 incident strokes and 190 myocardial infarctions were identified. At baseline, mean ages of men and women were 55.4 and 56.5 years and mean body mass indices (BMI) were 23.0 and 23.4 kg/m(2), respectively. Compared with those with BMI <21.0, incidence rates of cerebral infarction in subjects with BMI >= 27.5 were significantly elevated in both men (hazard ratio, 1.81; 95% confidence interval [CI], 1.28 to 2.56) and women (hazard ratio, 1.65; 95% CI, 1.23 to 2.21), adjusted for age, smoking, and drinking habit. Incidence of cerebral hemorrhage was also associated positively with BMI in both men (hazard ratio, 2.51; 95% CI, 1.21 to 5.20) and women (hazard ratio, 1.98; 95% CI, 1.12 to 3.52). Adjustment for systolic blood pressure, a mediating factor, significantly attenuated most BMI association with stroke in both sexes. For myocardial infarction, the hazard ratio was 3.16 (95% CI, 1.66 to 6.01) for BMI 27.5 or greater versus less than 21.0 only in men, which appeared partly mediated by total cholesterol and SBP. Conclusions-Overweight/obesity was associated with an increased risk of cerebral infarction and hemorrhage in men and women and myocardial infarction in men. Weight control may have the potential to prevent both stroke and myocardial infarction in Japan. (Circ Cardiovasc Qual Outcomes. 2010;3:498-505.)
  • Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Naoyuki Takashima, Aya Kadota, Kenji Matsui, Hideki Sugihara, Yutaka Morita, Yasuyuki Nakamura, Katsuyuki Miura, Hirotsugu Ueshima
    HYPERTENSION RESEARCH 33 9 922 - 925 2010年09月 [有り][無し]
     研究論文(学術雑誌) 
    Brachial-ankle pulse wave velocity (baPWV) is a relatively new non-invasive measure of arterial stiffness obtained using an automated system. We assessed the relationship between baPWV and 6.5-year overall mortality from the Takashima cohort study. The baPWV was measured in 2642 participants at baseline. When participants were divided into tertiles, all-cause mortality increased significantly as baPWV increased (P<0.001). Participants in the highest baPWV tertile showed an increased risk of all-cause mortality evidenced by a multivariable adjusted hazard ratio of 6.8 (95% confidence interval: 1.4-32.8) as compared with the lowest tertile. The present study demonstrated that increased baPWV is an independent predictor of all-cause mortality in the Japanese population. Hypertension Research (2010) 33, 922-925; doi: 10.1038/hr.2010.103; published online 17 June 2010
  • K. Nakamura, M. Sakurai, K. Miura, Y. Morikawa, M. Ishizaki, K. Yoshita, T. Kido, Y. Naruse, H. Nakagawa
    DIABETOLOGIA 53 9 1894 - 1902 2010年09月 [無し][無し]
     研究論文(学術雑誌) 
    Aims/hypothesis Little is known about the relationship between the HOMA of insulin resistance (HOMA-IR) and the risk of cardiovascular events in Asian populations, which have lower levels of HOMA-IR than Western populations. Accordingly, we determined the predictive value of HOMA-IR for cardiovascular risk in a Japanese population that was apparently free of diabetes, addressing whether insulin resistance itself increases cardiovascular risk independently of other relevant metabolic disorders. Methods We followed 2,548 non-diabetic men aged 35 to 59 years for 11 years. The hazard ratios for the incidence of cardiovascular events due to increased HOMA-IR were estimated using a Cox proportional hazards model that was adjusted for potential confounding factors. Results The multivariate-adjusted hazard ratio for cardiovascular events compared with the first quartile of HOMAIR (<= 0.66) was 1.07 (95% CI 0.44-2.64) for the second (HOMA-IR 0.67-1.01), 1.36 (0.56-3.28) for the third (HOMA-IR 1.02-1.51) and 2.50 (1.02-6.10) for the fourth quartile (HOMA-IR >= 1.52). The hazard ratio associated with a one SD (0.61) increment in log-transformed HOMA-IR was 1.51 (1.13-2.02). A similar positive relationship was observed for coronary events and stroke. In addition, the relationship between HOMA-IR and cardiovascular risk was broadly similar in participants with and without hypertension, dyslipidaemia (elevated triacylglycerol and/or reduced HDL-cholesterol), abdominal obesity and current smoking. Conclusions/interpretation Increased HOMA-IR predicted subsequent cardiovascular events in non-diabetic Japanese men. The association was independent of traditional cardiovascular risk factors and other relevant metabolic disorders.
  • Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Yasuyuki Nakamura, Naoyuki Takashima, Masaharu Ichikawa, Hideki Sugihara, Yutaka Morita, Kunihiko Hirose, Akira Okayama, Katsuyuki Miura, Hirotsugu Ueshima
    STROKE 41 9 1871 - 1876 2010年09月 [有り][無し]
     研究論文(学術雑誌) 
    Background and Purpose-Population-based information on the epidemiology of ischemic stroke (IS) subtypes is scant. In this study, we characterized IS subtypes in terms of incidence, time trend, and risk factor profiles in a community-based population. Methods-We obtained data from the Takashima Stroke Registry on approximately 55 000 residents of Takashima County in central Japan and calculated age-adjusted stroke incidence rates for different IS subtypes. We determined the incidence time trend by calculating the average annual change across years and also compared risk factors between subtypes. Results-There were 1389 first-ever ischemic strokes registered during 1988 to 2004. Lacunar infarction was the most frequent etiology (54.1%) followed by cardioembolic infarction (22.9%). Age-adjusted incidence rates for different IS subtypes were lacunar, 77.1; cardioembolic, 31.5; and nonlacunar, 29.7/10(5) person-years. The average annual change was not significant for the IS subtypes except for nonlacunar infarction, which showed a decreasing trend. Risk factor analysis showed that patients with lacunar infarctions were younger and less likely to have a history of transient ischemic attack or a drinking habit than patients with nonlacunar infarctions. Conclusion-Lacunar infarct was the most common IS subtype in our population. We found no significant change in the incidence of subtypes during the study, except a decrease in nonlacunar infarction. (Stroke. 2010; 41:1871-1876.)
  • Naoyuki Takashima, Katsuyuki Miura, Atsushi Hozawa, Tomonori Okamura, Takehito Hayakawa, Nagako Okuda, Takashi Kadowaki, Yoshitaka Murakami, Yoshikuni Kita, Yasuyuki Nakamura, Akira Okayama, Hirotsugu Ueshima
    NICOTINE & TOBACCO RESEARCH 12 9 944 - 949 2010年09月 [有り][無し]
     研究論文(学術雑誌) 
    Few studies have reported the relationship between smoking in middle age and long-term risk of impaired activities of daily living (ADL). We analyzed 2,276 men and women aged 47-59 years at the baseline survey of NIPPON DATA80 in 1980. At the follow-up survey in 1999, ADL was surveyed among 1890 survivors. Multivariate-adjusted odds ratio (AOR) and 95% CI of impaired ADL or of composite outcome of either death or impaired ADL according to baseline smoking status were calculated by multiple logistic regression analyses. In 1999, 386 participants were dead, and 75 participants had impaired ADL. Compared with nonsmokers, AOR (95% CI) of impaired ADL was significantly higher in current smokers at baseline (odds ratio [OR] 2.11 [1.09-4.06]). Compared with nonsmokers, AOR of impaired ADL was higher as the number of cigarettes increased (OR 2.04 [1.02-4.06] for < 20 cigarettes/day and OR 2.35 [0.94-5.88] for > 20 cigarettes/day; p for trend = .04). AOR of composite outcome for current smoking was 1.83 (1.37-2.41). Smoking in middle age would increase future risks of impaired ADL. Smoking cessation may be important to prevent future impairment of ADL as well as death.
  • Yasuyuki Nakamura, Tanvir C. Turin, Nahid Rumana, Katsuyuki Miura, Yoshikuni Kita, Naoyuki Takashima, Akira Fujiyoshi, Takehito Hayakawa, Tomonori Okamura, Hirotsugu Ueshima
    CVD Prevention and Control 5 3 97 - 103 2010年09月 [無し][無し]
     研究論文(学術雑誌) 
    Background: Although prevention of heart failure (HF) is an urgent public health need with national and global implications, population-based studies are rare. Methods and results: We studied risk factors for HF and coronary heart disease (CHD) mortality using the NIPPON DATA80 database with a 24-year follow-up. At the baseline in 1980, data were collected on study participants aged 30 years and over from randomly selected areas in Japan. We followed 9300 participants (44% men, mean age 51). Over the 24-year follow-up, there were 189 deaths from HF (82 men and 107 women) and 188 (91 men and 97 women) from CHD. Cox analyses revealed common and specific risk factors for both mortalities. Common risk factors were: systolic blood pressure for male HF (hazard ratio: 1.28 per 1SD, P = 0.02) and for CHD in both (men: 1.20, P = 0.01 women: 1.27, P = 0.003), smoking for male CHD (1.31, P = 0.004) and for female HF (1.39, P = 0.01), blood sugar for HF and CHD in men (HF: 1.21 per 1SD, P = 0.009 CHD: 1.29, P < 0.0001) T wave abnormality in male HF (2.33, P = 0.003) and female CHD (1.84, P = 0.001). Specific risk factors were: serum creatinine for HF in both (men: 1.14 per 1SD, P < 0.0001, women: 1.09, P = 0.01) total cholesterol for CHD in men (1.38 per 1SD, P = 0.001), history of valvular heart disease (6.48, P = 0.002) or stroke (2.41, P = 0.048) in male HF, and history of angina in female CHD (3.59, P = 0.003). Conclusion: Common and specific measures need to be undertaken to prevent HF and CHD mortality. © 2010 Published by Elsevier Ltd. on behalf of World Heart Federation.
  • Hiroshi Yatsuya, Hideaki Toyoshima, Kazumasa Yamagishi, Koji Tamakoshi, Masataka Taguri, Akiko Harada, Yasuo Ohashi, Yoshikuni Kita, Yoshihiko Naito, Michiko Yamada, Naohito Tanabe, Hiroyasu Iso, Hirotsugu Ueshima
    CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES 3 5 498 - 2 2010年09月 [無し][無し]
     研究論文(学術雑誌) 
    Background-The association of overweight/obesity with the incidence of cardiovascular diseases, especially stroke, has not been comprehensively examined in relatively lean populations in which stroke is more prevalent than coronary heart disease. Methods and Results-Pooled individual data from 16 Japanese cohorts comprising 45 235 participants ages 40 to 89 years without previous history of cardiovascular disease were studied. During follow-up, 1113 incident strokes and 190 myocardial infarctions were identified. At baseline, mean ages of men and women were 55.4 and 56.5 years and mean body mass indices (BMI) were 23.0 and 23.4 kg/m(2), respectively. Compared with those with BMI <21.0, incidence rates of cerebral infarction in subjects with BMI >= 27.5 were significantly elevated in both men (hazard ratio, 1.81; 95% confidence interval [CI], 1.28 to 2.56) and women (hazard ratio, 1.65; 95% CI, 1.23 to 2.21), adjusted for age, smoking, and drinking habit. Incidence of cerebral hemorrhage was also associated positively with BMI in both men (hazard ratio, 2.51; 95% CI, 1.21 to 5.20) and women (hazard ratio, 1.98; 95% CI, 1.12 to 3.52). Adjustment for systolic blood pressure, a mediating factor, significantly attenuated most BMI association with stroke in both sexes. For myocardial infarction, the hazard ratio was 3.16 (95% CI, 1.66 to 6.01) for BMI 27.5 or greater versus less than 21.0 only in men, which appeared partly mediated by total cholesterol and SBP. Conclusions-Overweight/obesity was associated with an increased risk of cerebral infarction and hemorrhage in men and women and myocardial infarction in men. Weight control may have the potential to prevent both stroke and myocardial infarction in Japan. (Circ Cardiovasc Qual Outcomes. 2010;3:498-505.)
  • Ryoko W. Azuma, Takashi Kadowaki, Aiman El-Saed, Hirotsugu Ueshima, Kim Sutton-Tyrrell, Yasuyuki Nakamura, Daniel Edmundowicz, Yoshiki Ueno, Rhobert W. Evans, Aya Kadota, Lewis H. Kuller, Kiyoshi Murata, Tomoko Takamiya, Sayaka Kadowaki, J. David Curb, Akira Sekikawa
    ACTA CARDIOLOGICA 65 4 449 - 456 2010年08月 [無し][無し]
     研究論文(学術雑誌) 
    Objective - D-dimer and von Willebrand factor (vWF) are associated with atherosclerosis. We recently reported that in a post-World War II birth cohort, Japanese men in Japan had lower levels of atherosclerosis than white men in the United States (US). We examined whether the differences in D-dimer and vWF levels are associated with differences in atherosclerosis between the two populations. Methods and results - Population-based samples of 99 Japanese and 100 white American men aged 40-49 years were examined for coronary artery calcification (CAC), carotid intima-media thickness (IMT), D-dimer, vVVF, and other factors using a standardized protocol. When compared to white American men, Japanese had similar levels of D-dimer (0.22 +/- 0.28 vs. 0.19 +/- 0.24 mu g/L, respectively, P = 0.39) but significantly higher levels of vWF (124.1 +/- 36.6 vs. 91.3 +/- 48.8%, respectively, P < 0.01). Japanese as compared to white American men had significantly lower prevalence of CAC (13.1 vs. 28.0%, P < 0.01, respectively) and significantly lower IMT (0.61 +/- 0.07 vs. 0.66 +/- 0.08 mm, P < 0.01, respectively). Japanese men had a significant positive association of D-dimer with the prevalence of CAC and a negative association of vVVF with IMT, whereas white American men did not have any significant associations. Conclusions - In men aged 40-49 years, Japanese as compared to white Americans had similar levels of D-dimer and higher levels of vVVF although Japanese had a significantly lower prevalence of CAC and IMT. These haemostatic factors are unlikely to explain the difference in atherosclerosis in these populations.
  • Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Nayouki Takashima, Masaharu Ichikawa, Hideki Sugihara, Yutaka Morita, Kunihiko Hirose, Katsuyuki Miura, Akira Okayama, Yasuyuki Nakamura, Hirotsugu Ueshima
    JOURNAL OF CLINICAL NEUROSCIENCE 17 7 869 - 873 2010年07月 [有り][無し]
     研究論文(学術雑誌) 
    We explored the circaseptan variation in 28-day case-fatalities for patients with subarachnoid hemorrhage (SAH) across days of the week. Data were obtained from the Takashima Stroke Registry, which covers approximately 50,000 residents of central Japan There were 169 first-ever SAH cases registered during the period 1988-2003 (68 in males. 101 in females) We divided the SAH cases into two groups according to the day on which the SAH occurred "weekend" and "weekday" The 28-day case-fatality rate and 95% confidence interval (CI) were calculated Multiple logistic regression analysis was used to calculate the adjusted odds ratio (95% CI) for weekday fatalities by entering all relevant patient-level variables into the model The 28-day case-fatality late for SAH was higher on weekdays (51.7%) than on weekends (32.6%; odds ratio 2.19; 95% CI 1.10-4.49) The differences in fatality rate persisted after adjustment for age, sex, severity, family history of stroke and patient history of hypertension, diabetes mellitus, dyslipidemia, drinking and smoking We observed a ciicaseptan variation in fatalities from SAH, with higher fatality rates during weekdays in our study population (C) 2009 Elsevier Ltd All rights reserved
  • Nagako Okuda, Katsuyuki Miura, Katsushi Yoshita, Yasuhiro Matsumura, Akira Okayama, Yasuyuki Nakamura, Tomonori Okamura, Shigeyuki Saitoh, Kiyomi Sakata, Toshiyuki Ojima, Tanvir Chowdhury Turin, Hirotsugu Ueshima
    JOURNAL OF EPIDEMIOLOGY 20 4 346 - 346 2010年07月 [有り][無し]
     研究論文(学術雑誌)
  • Naohito Tanabe, Hiroyasu Iso, Katsutoshi Okada, Yasuyuki Nakamura, Akiko Harada, Yasuo Ohashi, Takashi Ando, Hirotsugu Ueshima
    CIRCULATION JOURNAL 74 7 1346 - 1356 2010年07月 [無し][無し]
     研究論文(学術雑誌) 
    Background: Few Japanese studies have compared serum non-high-density lipoprotein (non-HDL) cholesterol with serum total cholesterol as factors for predicting risk of cardiovascular events. Currently, few tools accurately estimate the probability of developing cardiovascular events for the Japanese general population. Methods and Results: A total of 22,430 Japanese men and women (aged 40-89 years) without a history of cardiovascular events from 10 community-based cohorts were followed. In an average 7.6-year follow up, 104 individuals experienced acute myocardial infarction (AMI) and 339 experienced stroke. Compared to serum total cholesterol, serum non-HDL cholesterol was more strongly associated with risk of AMI in a dose-response manner (multivariable adjusted incidence rate ratio per 1 SD increment [95% confidence interval]=1.49 [1.24-1.79] and 1.62 [1.35-1.95], respectively). Scoring systems were constructed based on multivariable Poisson regression models for predicting a 5-year probability of developing AMI; the non-HDL cholesterol model was found to have a better predictive ability (area under the receiver operating curve [AUC]=0.825) than the total cholesterol model (AUC=0.815). Neither total nor non-HDL serum cholesterol levels were associated with any stroke subtype. Conclusions: The risk of AMI can be more reliably predicted by serum non-HDL cholesterol than serum total cholesterol. The scoring systems are useful tools to predict risk of AMI. Neither total nor non-HDL serum cholesterol can predict stroke risk in the Japanese general population. (Circ J 2010; 74: 1346-1356)
  • Akira Sekikawa, Takashi Kadowaki, J. David Curb, Rhobert W. Evans, Hiroshi Maegawa, Robert D. Abbott, Kim Sutton-Tyrrell, Tomonori Okamura, Chol Shin, Daniel Edmundowicz, Aya Kadota, Jina Choo, Aiman El-Saed, Hirotsugu Ueshima, Lewis H. Kuller
    JOURNAL OF INTERFERON AND CYTOKINE RESEARCH 30 7 541 - 548 2010年07月 [無し][無し]
     研究論文(学術雑誌) 
    This study examines the differences in circulating levels of cytokines among Japanese in Japan (JJ), Japanese Americans (JA), and whites and their associations with obesity and marine n-3 fatty acids (FA) in a cross-sectional population-based study of 297 men aged 40-49 (100 JJ, 99 whites, and 98 JA). Experimental studies show that cytokines are associated with obesity positively and marine n-3 FA inversely. Serum interleukin-1 alpha (IL-1 alpha), IL-1 receptor agonist (IL-1ra), IL-4, IL-8, IL-10, inducible protein-10 (IP-10), tumor necrosis factor-alpha (TNF-alpha), monocyte chemoattractant protein-1 (MCP-1), and marine n-3 FA were determined. Body mass index (BMI), waist circumference, and computed tomography-measured visceral and subcutaneous adipose tissues were determined. The JJ had significantly lower levels of IL-1 alpha, IL-4, IL-8, MCP-1, and TNF-alpha than whites and JA. Whites and JA had similar levels of IL-1 alpha, IL-4, and IL-8 whereas whites had significantly higher levels of MCP-1 and TNF-alpha than JA. The JJ were least obese (BMI (kg/m(2)), mean +/- standard deviation) 23.6 +/- 2.8, 27.9 +/- 4.6, and 27.9 +/- 4.5 for JJ, whites, and JA, respectively. The JJ had marine n-3 FA about 100% higher than whites and JA (serum marine n-3 FA (%), median (interquartile range) 8.79 (7.41, 11.16), 3.47 (2.63, 4.83), and 4.44 (3.33, 6.01) for JJ, whites, and JA, respectively). Generally cytokines had weak and nonsignificant associations with indices of obesity and nonsignificant associations with marine n-3 FA. BMI had significant inverse associations with IL-1 alpha, IL-4, and IL-8 in JA (P < 0.05). Marine n-3 FA had marginally significant inverse associations with IL-8 in JJ (P = 0.055) and TNF-alpha in whites (P = 0.076). The JJ had lower levels of many cytokines than whites and JA. Generally cytokines had weak and nonsignificant associations with indices of obesity and marine n-3 FA. Further investigation is needed to determine why JJ had lower circulating levels of cytokines.
  • Rie Oka, Junji Kobayashi, Akihiro Inazu, Kunimasa Yagi, Susumu Miyamoto, Masaru Sakurai, Koshi Nakamura, Katsuyuki Miura, Hideaki Nakagawa, Masakazu Yamagishi
    METABOLISM-CLINICAL AND EXPERIMENTAL 59 5 748 - 754 2010年05月 [有り][無し]
     研究論文(学術雑誌) 
    We investigated the relative impacts of visceral adiposity and insulin resistance on the metabolic risk profile in middle-aged Japanese men. A cross-sectional study was conducted in 636 nondiabetic Japanese men with a mean age of 51.6 years. Visceral adipose tissue (AT) was assessed using computed tomography, and insulin resistance was determined by the homeostasis model assessment of insulin resistance (HOMA-IR). Metabolic risk factors were diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome criteria: (1) hypertriglyceridemia, (2) low high-density lipoprotein cholesterol, (3) hypertension, (4) impaired fasting glucose, and (5) impaired glucose tolerance. Visceral AT and HOMA-IR were significantly and positively correlated with each other (r = 0.41, P < .001). Using the 75th percentile value as a cut point, those with isolated large visceral AT showed significantly greater odds ratios for each of the 5 risk factors measured except impaired fasting glucose, whereas those with isolated high HOMA-IR showed significantly greater odds ratios for each of the 5 risk factors except hypertriglyceridemia and impaired glucose tolerance, compared with the control group. The combined group (increased visceral AT and HOMA-IR) had the highest odds ratios for all studied risk factors. On logistic regression analysis using visceral AT and HOMA-IR as continuous independent variables, they were each independently associated with most of the metabolic risk factors and their clustering. In conclusion, neither visceral AT nor HOMA-IR stands out as the sole driving force of the risk profile; each makes a significant contribution to metabolic abnormalities in Japanese men. (C) 2010 Elsevier Inc. All rights reserved.
  • Kadota A, Miura K, Ueshima H
    Nihon rinsho. Japanese journal of clinical medicine 68 5 847 - 852 2010年05月 [有り][無し]
  • Jina Choo, Hirotsugu Ueshima, J. David Curb, Chol Shin, Rhobert W. Evans, Aiman El-Saed, Takashi Kadowaki, Tomonori Okamura, Katsumi Nakata, Teruo Otake, Katsuyuki Miura, Robert D. Abbott, Kim Sutton-Tyrrell, Daniel Edmundowicz, Lewis H. Kuller, Akira Sekikawa
    AMERICAN JOURNAL OF CLINICAL NUTRITION 91 5 1195 - 1203 2010年05月 [有り][無し]
     研究論文(学術雑誌) 
    Background: The associations of serum omega-6 (n-6) fatty acids with lipoprotein subclasses at the population level are uncertain. Objective: We aimed to examine associations between major n-6 fatty acids [ie, linoleic acid (LA, 18:2n-6) and arachidonic acid (AA, 20:4n-6)] and the lipoprotein subclasses VLDL, LDL, and HDL. Design: We conducted a cross-sectional study in 1098 participants using population-based data from US white, Japanese American, Japanese, and Korean men aged 40-49 y. Serum fatty acids were analyzed by capillary gas-liquid chromatography. Lipoprotein subclasses were measured by nuclear magnetic resonance spectroscopy. Multiple linear regression models as a function of each fatty acid were used after adjustment for age, population, body mass index, pack-years of smoking, alcohol consumption, diabetes, hypertension, and omega-3 (n-3) and trans fatty acids. Results: Serum LA was inversely associated with large VLDL (beta = -0.62, P < 0.001), total LDL (beta = -22.08, P < 0.001), and small LDL (beta = -31.89, P < 0.001) particle concentrations and VLDL size (beta = -0.72, P < 0.001). Serum LA was positively associated with large HDL particle concentration (beta = 0.21, P < 0.001) and HDL size (beta = 0.03, P < 0.001). The patterns of association of AA with large VLDL and large HDL particle concentrations were comparable with those of LA. Conclusions: At the population level, higher serum concentrations of LA were significantly associated with lower concentrations of total LDL particles. Higher serum concentrations of LA and AA were significantly associated with a lower concentration of large VLDL particles and a higher concentration of large HDL particles. These associations were consistent across the population groups. This trial was registered at clinicaltrials.gov as NCT00069797. Am J Clin Nutr 2010; 91: 1195-203.
  • Cheryl A. M. Anderson, Lawrence J. Appel, Nagako Okuda, Ian J. Brown, Queenie Chan, Liancheng Zhao, Hirotsugu Ueshima, Hugo Kesteloot, Katsuyuki Miura, J. David Curb, Katsushi Yoshita, Paul Elliott, Monica E. Yamamoto, Jeremiah Stamler
    JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 110 5 736 - 745 2010年05月 [有り][無し]
     研究論文(学術雑誌) 
    Public health campaigns in several countries encourage population-wide reduced sodium (salt) intake, but excessive intake remains a major problem. Excessive sodium intake is independently related to adverse blood pressure and is a key factor in the epidemic of prehypertension/hypertension. Identification of food sources of sodium in modern diets is critical to effective reduction of sodium intake worldwide. We used data from the INTERMAP Study to define major food sources of sodium in diverse East Asian and Western population samples. INTERMAP is an international, cross-sectional, epidemiologic study of 4, 680 individuals ages 40 to 59 years from Japan (four samples), People's Republic of China (three rural samples), the United Kingdom (two samples), and the United States (eight samples); four in-depth, multipass 24-hour dietary recalls/person were used to identify foods accounting for most dietary sodium intake. In the People's Republic of China sample, most (76%) dietary sodium was from salt added in home cooking, about 50% less in southern than northern samples. In Japan, most (63%) dietary sodium came from soy sauce (20%), commercially processed fish/seafood (15%), salted soups (15%), and preserved vegetables (13%). Processed foods, including breads/cereals/grains, contributed heavily to sodium intake in the United Kingdom (95%) and the United States (for methodological reasons, underestimated at 71%). To prevent and control prehypertension/hypertension and improve health, efforts to remove excess sodium from diets in rural China should focus on reducing salt in home cooking. To avoid excess sodium intake in Japan, the United Kingdom, and the United States, salt must be reduced in commercially processed foods. J Am Diet Assoc. 2010;110:736-745.
  • Qian Li, Yuko Morikawa, Masaru Sakurai, Koshi Nakamura, Katsuyuki Miura, Masao Ishizaki, Teruhiko Kido, Yuchi Naruse, Yasushi Suwazono, Hideaki Nakagawa
    INDUSTRIAL HEALTH 48 3 324 - 330 2010年05月 [有り][無し]
     研究論文(学術雑誌) 
    We investigated whether occupational class affects the incidence of cardiovascular events in Japanese factory workers. We prospectively evaluated 1,794 male workers aged 40-59, including 632 non-manual and 1,162 manual workers, employed in a metal products factory in Japan. The hazard ratios of stroke, myocardial infarction (MI) and cardiovascular events (combined stroke, MI and sudden cardiac death) for manual workers were compared with non-manual workers as estimated by the Cox proportional hazards regression model. Among the 1,794 workers, there were 60 cardiovascular events (32 cases of stroke, 23 cases of MI and 5 cases of sudden cardiac death) with an incidence rate of 3.14 per 1,000 person-years for cardiovascular events; 1.68 for stroke and 1.20 for MI. Blood pressure and HbAlc significantly increased the risk of stroke. Body mass index and total cholesterol significantly increased the risk of MI. However, occupational class was determined not to be a risk factor for cardiovascular events. The hazard ratios of stroke, MI and cardiovascular events for manual workers compared with non-manual workers were 0.97 (95%CI, 0.45-2.08), 0.73 (95%CI, 0.30-1.79) and 0.92 (95%CI, 0.53-1.61), respectively. Our study did not reveal significant occupational class inequalities in the rate of cardiovascular events. These findings are not in accordance with studies from other industrialized countries.
  • Hirotsugu Ueshima, Katsuyuki Miura, Nagako Okuda
    JOURNAL OF EPIDEMIOLOGY 20 S587 - S596 2010年03月 [有り][無し]
     研究論文(学術雑誌)
  • Nagako Okuda, Katsuyuki Miura, Katsushi Yoshita, Yasuhiro Matsumura, Akira Okayama, Yasuyuki Nakamura, Tomonori Okamura, Shigeyuki Saitoh, Kiyomi Sakata, Toshiyuki Ojima, Tanvir Chowdhury Turin, Hirotsugu Ueshima
    JOURNAL OF EPIDEMIOLOGY 20 S506 - S514 2010年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background: Diet is one of the most important lifestyle factors that a affect healthy life expectancy through onset of various lifestyle-related diseases. Large-scale cohort studies with sufficient baseline nutritional information are scarce. NIPPON DATA80/90 is cohort study of representative Japanese population, and the cohorts also participated in the National Nutrition Survey in japan (NNSI) at the baseline. The corresponding datasets could be combined. Methods: Individual records of NIPPON DATA and NNSJ were compared and integrated. Intakes of nutrients and food groups for individual participants were calculated by distributing intakes in the each household in NNSJ, considering age and sex of the individuals. The results from an international cooperative epidemiological study (INTERMAP) were utilized to estimate intakes of 75 nutrients for NNSJ80 and 70 nutrients for NNSJ90. Nutrient intakes calculated utilizing INTERMAP data were compared with those in the NNSJ datasets. Results: NIPPON DATA80/90 datasets were enhanced with detailed baseline nutrient intake data (the numbers of participants combined were 10422 and 8342 for NIPPON DATA80 and 90, respectively). The mean nutrient intakes calculated through utilizing INTEMRAP data and those calculated from the NNSJ datasets were similar, and the calculated values were strongly correlated with those calculated from NNSJ datasets (Pearson's correlation coefficients greater than 0.8 [P < 0.001]). Detailed nutrient intakes (eg, cholesterol, fatty acids, amino acids, and dietary fiber) were complemented. Conclusions: The nutrient intakes calculated from NNSJ datasets for the participants of NIPPON DATA are appropriate as the baseline nutrient intake data. The enhanced cohort datasets are suitable for investigations of baseline dietary habits and the consequent health status.
  • Masayuki Shiota, Hiromi Kusakabe, Yasukatsu Izumi, Yuko Hikita, Takafumi Nakao, Yoshihiko Funae, Katsuyuki Miura, Hiroshi Iwao
    ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY 30 3 491 - U279 2010年03月 [有り][無し]
     研究論文(学術雑誌) 
    Objective-Heat shock protein 70s (Hsp70s) are molecular chaperones that protect cells from damage in response to various stress stimuli. However, the functions and mechanisms in endothelial cells (ECs) have not been examined. Herein, we investigate the role of Hsp70s, including heat shock cognate protein 70 (Hsc70), which is constitutively expressed in nonstressed cells (ie, ECs). Methods and Results-The Hsp70 inhibitor, KNK437, significantly decreased vascular endothelial growth factor (VEGF)-induced cell migration and tube formation in vitro. KNK437 inhibited the phosphorylation of VEGF-induced Akt and endothelial nitric oxide synthase (eNOS) in human umbilical vein endothelial cells. In a mouse hind limb model of vascular insufficiency, intramuscular inhibition of Hsp70s attenuated collateral and capillary vessel formation. Silencing the Hsc70 gene by short interfering RNA abolished VEGF-induced Akt phosphorylation and VEGF-stimulated human umbilical vein endothelial cell migration and tube formation. As the molecular mechanisms, Hsc70 knockdown reduced the expression of phosphatidylinositol 3-kinase. Conclusion-Collectively, Hsc70 plays a significant role in ECs via the phosphatidylinositol 3-kinase/Akt pathway. Hsc70 may provide the basis for the development of new therapeutic strategies for angiogenesis. (Arterioscler Thromb Vasc Biol. 2010;30:491-497.)
  • Katsushi Yoshita, Yusuke Arai, Miho Nozue, Kumi Komatsu, Hirohumi Ohnishi, Shigeyuki Saitoh, Katsuyuki Miura
    JOURNAL OF EPIDEMIOLOGY 20 S515 - S523 2010年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background: This paper investigated the relationship between body mass index (BMI) and total energy intake as well as intake of three major nutrients in representative Japanese populations enrolled in the National Nutrition Surveys of Japan in 1980 and 1990. Methods: A total of 10 422 participants (4585 men and 5837 women) and 8342 participants (3488 men and 4854 women) aged 30 or older from 300 randomly selected districts participated in the National Survey of Circulatory Disorders and the National Nutrition Survey in Japan in 1980 and 1990, respectively. The nutrition surveys were performed with weighing record method for three consecutive days to each household. Individually estimated total energy intake and intakes of three major nutrients (carbohydrate, protein, and fat) were compared by the categories of BMI and by 10-year age groups. Results: In men, total energy intake (kcal/day), intakes of three major nutrients (g/day) and energy intake ratio from protein and fat (%) increased as BMI increased in each age group, whereas energy intake ratio from carbohydrate (%) decreased. In women, total energy intake, intakes of three major nutrients, and energy intake ratio from protein increased as BMI increased. Energy intake ratio from carbohydrate and fat decreased as BMI increased in women in 1990. When participants were categorized into quartiles according to total energy intake in each sex group. BMI increased as total energy intake increased in men in both 1980 and 1990. Conclusions: A positive relationship was observed between body mass index and total energy intake in Japanese men. The relationship was weaker in Japanese women.
  • Yasuyuki Nakamura, Nagako Okuda, Tanvir Chowdhury Turin, Akira Fujiyoshi, Tomonori Okamura, Takehito Hayakawa, Yasuhiro Matsumura, Katsuyuki Miura, Hirotsugu Ueshima
    JOURNAL OF EPIDEMIOLOGY 20 Suppl S582 - S586 2010年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background: The National Nutritional Survey in Japan (NNSJ) was initiated in 1946. Using the majority of the participants for NNSJ, the National Survey on Circulatory Disorders has been conducted every 10 year since 1960. We performed a comparative study of the NNSJ80 estimated individual-based nutritional data by comparing those with NIPPON DATA80 food frequency questionnaires (FFQ) data. Methods: A total of 10 546 community residents from 300 randomly selected districts participated in the both surveys in 1980. At baseline, history, physical, and blood biochemical measurement and a nutritional survey by FFQ were performed individually. From household-based NNSJ80 data, we estimated nutrient intakes of each household member by dividing household intake data proportionally using average intakes by sex and age groups calculated for NNSJ95. We re-categorized NNSJ80 estimated data to correspond to NIPPON DATA80 FFQ categories. Data were analyzed in men and women separately. Results: Cross tables showed fairly good agreement of the two categories. The majorities of participants situated on the diagonally aligned cells or the next to them. Weighted kappa ranged from 0.152 to 0.241. Spearman's rank correlation coefficients between the two categories ranged from 0.224 to 0.338, and those between NNSJ80 continuous data and NIPPON DATA80 categorical data ranged from 0.237 to 0.354. All these values have P < 0.001. Conclusions: These results may indicate that the present nutritional estimation method is applicable to, further studies.
  • Tanvir Chowdhury Turin, Nagako Okuda, Katsuyuki Miura, Yasuyuki Nakamura, Nahid Rumana, Hirotsugu Ueshima
    JOURNAL OF EPIDEMIOLOGY 20 Suppl S567 - S575 2010年03月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: The purpose of this study was to investigate the dietary potassium intake and associated other dietary factors among a representative sample cohort of Japanese population. Methods: We obtained data from NIPPON DATA80 and 90 that were conducted with the National Nutrition Surveys in 1980 and in 1990. Then we estimated nutrient and food intakes of individuals in the National Nutrition Survey of 1980 and that of 1990, which were adjusted on the basis of data of the National Nutrition Survey of 1995. We analyzed data for 10 422 participants (4585 men and 5837 women) in NIPPON DATA80 and 8342 participants (3488 men and 4854 women) in NIPPON DATA90 having dietary potassium intake information. Results: In NIPPON DATA80 and 90 it was observed that there was a significant relationship between the dietary potassium intake and age for both men and women. Higher potassium intake was associated with higher age, intake of protein, iron, calcium, sodium, vitamins, and fiber. Regarding food groups, lower amount of dietary cereals, rice, flour, fats and oils were associated with higher dietary potassium for both men and women. On the other hand, higher intake of nuts, potatoes, soy beans, fruits, vegetables, mushrooms, sea algae, fish and shellfish were associated with higher dietary potassium. Conclusions: We obtained the mean dietary potassium intake and its association with other dietary nutrient intake in Japanese adults as the baseline data in NIPPON DATA80 and in NIPPON DATA90.
  • Tanvir Chowdhury Turin, Nagako Okuda, Katsuyuki Miura, Yasuyuki Nakamura, Nahid Rumana, Aya Kadota, Koji Tamakoshi, Hirotsugu Ueshima
    JOURNAL OF EPIDEMIOLOGY 20 Suppl 3 S557 - S566 2010年03月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: The purpose of this study was to investigate the dietary iron intake and associated other dietary factors and clinical characteristics among a representative sample cohort of Japanese population. Methods: We obtained data from NIPPON DATA80 and 90 that were conducted with the National Nutrition Surveys in 1980 and in 1990. Then we estimated nutrient and food intakes of individuals in the National Nutrition Survey of 1980 and that of 1990, which were adjusted on the basis of data of the National Nutrition Survey of 1995. Finally, we analyzed data for the 10 422 participants (4585 men and 5837 women) in NIPPON DATA80 and 8342 participants (3488 men and 4854 women) in NIPPON DATA90 having dietary iron intake information. Results: In NIPPON DATA80 and 90, there was a significant relationship between the dietary iron intake and age for both men and women. Dietary protein intake was associated with iron intake where as dietary fat intake did not show any association. Regarding the minerals, significant relationships were observed between the different minerals and dietary iron intake. Apart from the food group of milk and dairy products, there were significant differences in other food groups according to quintiles of iron intakes for men and women. Conclusions: We described the mean dietary iron intake and its relation with other dietary factors and clinical characteristics in Japanese adults as the baseline data in NIPPON DATA80 and in NIPPON DATA90.
  • Yasuyuki Nakamura, Nagako Okuda, Tanvir Chowdhury Turin, Akira Fujiyoshi, Tomonori Okamura, Takehito Hayakawa, Katsushi Yoshita, Katsuyuki Miura, Hirotsugu Ueshima
    JOURNAL OF EPIDEMIOLOGY 20 Suppl 3 S544 - S548 2010年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background: The National Nutritional Survey in Japan (NNSJ) was initiated in 1946. Using the majority of the participants for NNSJ, the National Survey on Circulatory Disorders (NSCD) has been conducted every 10 year since 1960. We compared fatty acids intakes obtained from NNSJ and serum lipid profiles from NSCD conducted in 1990. Methods: A total of 8344 community residents (4856 women and 3488 men, age? 30) from 300 randomly selected districts participated in the both surveys in 1990. At baseline, history, physical, and blood biochemical measurement and a nutritional survey were performed. We estimated nutrient intakes of each household member by dividing household intake data proportionally using average intakes by sex and age groups calculated for NNSJ95. Results: Total fat, saturated fatty acids (SEA), poly-unsaturated fatty acwere ids (PUFA), dietary cholesterol, and Keys dietary lipid factor (KEYS) inversely associated with age in both men and women (all Ps < 0.001). In women, age and body mass index (BMI) adjusted serum total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), and low-density lipoprotein cholesterol (LDLc) were positively associated with SFA, total fat intakes (%kcal), and with KEYS (P < 0.001). In men, age-BMI adjusted HDLc was not associated with SFA, total fat intakes, and with KEYS factors unlike in women. Other associations were similar to those in women. Conclusions: The total fatty acids, SFA intakes, and KEYS lipid factor obtained from NNSJ were significantly associated with serum total and LDL cholesterol from the National Survey on Circulatory Disorders conducted in 1990.
  • Katsuyuki Miura, Nagako Okuda, Tanvir Chowdhury Turin, Naoyuki Takashima, Hideaki Nakagawa, Koshi Nakamura, Katsushi Yoshita, Akira Okayama, Hirotsugu Ueshima
    JOURNAL OF EPIDEMIOLOGY 20 Suppl 3 S524 - S530 2010年03月 [有り][無し]
     研究論文(学術雑誌) 
    Background: The relationship between dietary salt intake and blood pressure (BP) has been rarely investigated in a large population of Japanese. The characteristics of nutrients intake and foods intake in Japanese people with high salt intake have also not investigated well. Methods: Data of 10 422 participants (4585 men and 5837 women) aged 30 or older who participated in both the National Survey on Circulatory Disorders and National Nutrition Survey in Japan conducted in 1980 were used. The nutrition surveys were performed with weighing record method for three consecutive days to each household. BP and intakes of nutrients and foods were compared by the quintiles of estimated individual salt intake per day. Analyses of covariance were used to calculate multivariate-adjusted mean BP values by the quintiles. Results: Participants with higher salt intake showed higher intakes of soy beans/legume, fruit, other vegetables, and fish/shellfish. Intakes of protein, potassium, calcium, iron, magnesium, and fiber were higher in higher quintiles of salt intake. In men, adjusted systolic BPs were higher in the higher salt intake quintiles; there was 4.3 mm Hg difference in multivariate-adjusted systolic BP between the lowest quintile (mean salt intake 8.7 g/day) and the highest quintile (mean salt intake 23.5 g/day) (P < 0.001). In women, adjusted mean systolic BPs were not statistically different among the quintile of salt intake. Conclusions: A positive relationship of dietary salt intake to BP was observed, especially in men, in this large-scale representative Japanese population.
  • Tanvir Chowdhury Turin, Nahid Rumana, Yoshikuni Kita, Yasuyuki Nakamura, Katsuyuki Miura, Hirotsugu Ueshima
    JOURNAL OF CARDIOLOGY 55 2 283 - 284 2010年03月 [有り][無し]
     研究論文(学術雑誌)
  • Population attributable fraction of smoking and metabolic syndrome on cardiovascular disease mortality in Japan: a 15-year follow up of NIPPON DATA90
    N.Takashima, K.Miura, A.Hozawa, A.Kadota, T.Okamura, Y.Nakamura, T.Hayakawa, N.Okuda, A.Fujiyoshi, SY.Nagasawa, T.Kadowaki, Y.Murakami, Y.Kita, A.Okayama, H.Ueshima, H.Nakagawa, NIPPON DATA, Research Group, Collaborator
    BMC public health 0.629166667 2010年01月 [無し][無し]
     研究論文(国際会議プロシーディングス)
  • Rie Oka, Katsuyuki Miura, Masaru Sakurai, Koshi Nakamura, Kunimasa Yagi, Susumu Miyamoto, Tadashi Moriuchi, Hiroshi Mabuchi, Junji Koizumi, Hideki Nomura, Yoshiyu Takeda, Akihiro Inazu, Atsushi Nohara, Masa-aki Kawashiri, Shinya Nagasawa, Junji Kobayashi, Masakazu Yamagishi
    OBESITY 18 1 153 - 160 2010年01月 [有り][無し]
     研究論文(学術雑誌) 
    Regional fat distribution rather than overall fat volume has been considered to be important to understanding the link between obesity and metabolic disorders. We aimed to evaluate the independent associations of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) with metabolic risk factors in apparently healthy middle-aged Japanese. Participants were 1,119 men and 854 women aged 38-60 years who were not taking medications for diabetes, hypertension, or dyslipidemia. VAT and SAT were measured by use of computed tomography (CT) scanning. VAT and SAT were significantly and positively correlated with each other in men (r = 0.531, P < 0.001) and women (r = 0.589, P < 0.001). In multiple regression analyses, either measure of abdominal adiposity (VAT or SAT) was positively associated with blood pressure, fasting plasma glucose, and log triglyceride (P < 0.001) and inversely with high-density lipoprotein (HDL)-cholesterol (P < 0.001). When VAT and SAT were simultaneously included in the model, the association of VAT with triglycerides was maintained (P < 0.001) but that of SAT was lost. The same was true for HDL-cholesterol in women. For fasting plasma glucose, the association with VAT was strong (P < 0.001) and the borderline association with SAT was maintained (P = 0.060 in men and P = 0.020 in women). Both VAT and SAT were independently associated with blood pressure (P < 0.001). Further adjustment for anthropometric indices resulted in the independent association only with VAT for all risk factors. In conclusion, impacts of VAT and SAT differed among risk factors. VAT showed dominant impacts on triglyceride concentrations in both genders and on HDL-cholesterol in women, while SAT also had an independent association with blood pressure.
  • Wataru Hirokawa, Koshi Nakamura, Masaru Sakurai, Yuko Morikawa, Katsuyuki Miura, Masao Ishizaki, Katsushi Yoshita, Teruhiko Kido, Yuchi Naruse, Hideaki Nakagawa
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 17 9 934 - 943 2010年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: We investigated the individual and population impacts of mild abnormalities associated with metabolic syndrome (blood pressure, lipids and glucose) and abdominal obesity, for which lifestyle modification is initially applicable, on cardiovascular disease risk. Methods: Using a cohort study of 2,685 Japanese men aged 35 to 59 years with an 11-year follow-up period, we calculated the relative risks for cardiovascular diseases due to mild metabolic abnormalities that included at least one of the following three conditions: 1) systolic blood pressure 130-139 mmHg and/or diastolic blood pressure 85-89 mmHg; 2) triglycerides 150-299 mg/dL and/or high-density lipoprotein cholesterol 35-39 mg/dL; and 3) fasting plasma glucose 110-125 mg/dL and/or abdominal obesity. Participants with a mild metabolic abnormality were compared to participants with no metabolic abnormality or abdominal obesity. The population attributable fraction of these abnormalities for cardiovascular diseases was also estimated. Results: At baseline, 9.8% and 21.8% of the total population had a mild metabolic abnormality with or without abdominal obesity, respectively, while 7.5% had isolated abdominal obesity without any metabolic abnormality. A mild metabolic abnormality with or without abdominal obesity and isolated abdominal obesity increased the risk of cardiovascular disease by 2.68-fold, 1.49-fold, and 2.36-fold, respectively. Approximately 20% of cardiovascular diseases in the total population were attributable to either mild metabolic abnormalities or isolated abdominal obesity. Conclusion: The importance of lifestyle modification should be acknowledged, especially in cases of mild metabolic abnormality and/or abdominal obesity, which may contribute to approximately 20% of the population burden for cardiovascular diseases.
  • 日本人の脳卒中、心筋梗塞、腎臓病に対するリスク因子の寄与度の違い:わが国の疫学研究から。
    Mebio 27 10 30 - 44 2010年 [無し][無し]
  • NIPPON DATAにおける糖尿病と心血管病
    日本臨床 68 5 847 - 851 2010年 [無し][無し]
  • Akira Fujiyoshi, Katsuyuki Miura, Atsushi Hozawa, Yoshitaka Murakami, Naoyuki Takashima, Nagako Okuda, Takashi Kadowaki, Yoshikuni Kita, Tomonori Okamura, Yasuyuki Nakamura, Takehito Hayakawa, Akira Okayama, Hirotsugu Ueshima
    CVD Prevention and Control 5 1 27 - 34 2010年01月 [無し][無し]
     研究論文(学術雑誌) 
    Background: Studies have shown that baseline serum γ- glutamyltransferase (GGT) is independently associated with cardiovascular disease (CVD) risk in men and women. However, less is known whether GGT is similarly associated with both stroke and heart disease (HD) risk in Asia. We examined an association between serum GGT and deaths from stroke and HD in Japanese men and women. Methods: From 1990 to 2005, we followed 7488 adults (3089 men) randomly selected from 300 districts throughout Japan, aged 30-95 with no history of coronary disease nor stroke at baseline. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) according to sex-specific GGT strata. Results: During the study period, observed deaths from HD and stroke were 165 (83 men), and 135 (66 men), respectively. After adjustment for confounding factors, HRs of HD death for 25th, 50th, 75th, and 90th GGT percentiles in reference to the lowest GGT stratum were 1.61, 2.28, 2.48, and 4.59 in women (P for trend = 0.001), and 0.90, 0.74, 1.42, and 1.56 in men (P for trend = 0.250). The corresponding HRs of total stroke death were 1.52, 0.95, 1.22, and 1.34 in women (P for trend = 0.785), and 0.75, 0.91, 1.26, and 1.02 in men (P for trend = 0.642). Results were similar when analysis was limited to never-drinkers. Conclusion: This cohort study of representative Japanese men and women suggested that baseline GGT independently predicts future HD mortality risk, especially in women, but not stroke mortality risk in Asian. © 2010 World Heart Federation. Published by Elsevier Ltd. All rights reserved.
  • Naohito Tanabe, Hiroyasu Iso, Katsutoshi Okada, Yasuyuki Nakamura, Akiko Harada, Yasuo Ohashi, Takashi Ando, Hirotsugu Ueshima, The Japan Arteriosclerosis Longitudinal, Study Group
    Circ J 74 7 1346 - 1356 2010年 [無し][無し]
     研究論文(学術雑誌)
  • Unai Tamura, Taichiro Tanaka, Tomonori Okamura, Takashi Kadowaki, Hiroshi Yamato, Hideo Tanaka, Masakazu Nakamura, Akira Okayama, Hirotsugu Ueshima, Zentaro Yamagata
    Journal of Atherosclerosis and Thrombosis 17 1 12 - 20 2010年 [無し][無し]
     研究論文(学術雑誌) 
    Aim: It is well established that people gain weight after smoking cessation however, changes in cardiovascular risk factors and the estimated risk of coronary heart disease following smoking cessation have yet to be fully clarified. Methods: The participants were 1,995 Japanese male workers at 11 workplaces who participated continuously in the High-risk and Population Strategy for Occupational Health Promotion (HIPOPOHP) study. Participants with a smoking habit had cardiovascular risk factors measured at baseline and over a 4-yr period. Their estimated incidence risk of coronary heart disease was calculated by a formula based on a previous cohort study. Results: Successful abstainers who had stopped smoking for at least 6 months at the end of the follow-up period had weight gains of approximately 2 kg. These subjects had significant worsening of the following factors compared to continuing smokers: systolic and diastolic blood pressure, total cholesterol, triglyceride and fasting blood sugar levels. In contrast, HDL-cholesterol levels improved significantly. When the overall instantaneous incidence risk of coronary heart disease prior to smoking cessation was assumed to be 1.00, the estimated risk was 0.76 (95%CI: 0.68-0.85) in successful abstainers due mainly to smoking cessation, despite weight gain. Conclusion: Although smoking cessation leads to weight gain, the estimated risk of coronary heart disease was decreased markedly by smoking cessation.
  • Takehito Hayakawa, Tomonori Okamura, Akira Okayama, Hideyuki Kanda, Makoto Watanabe, Yoshikuni Kita, Katsuyuki Miura, Hirotsugu Ueshima
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 17 1 64 - 72 2010年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: To clarify the relationship between the accumulation of cardiovascular risk factors and the 5-year decline in instrumental activity of daily living (IADL) among a cohort representative of the Japanese population aged 65 years and over. Methods: An IADL survey was performed by public health centers throughout Japan. Study subjects were elderly men and women living in districts under the jurisdiction of collaborating health centers. Subjects were invited to participate in the IADL survey assessed by the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence twice in 1995 and in 2000; 1222 participants were eligible for the analysis. The relationship between the number of cardiovascular risk factors, such as hypertension, hypercholesterolemia, hypertriglycemia, low serum high-density lipoprotein cholesterol, diabetes, obesity and smoking, at baseline and the 5-year difference in IADL scores was examined by linear regression analysis and logistic regression analysis. Results: Decrease in IADL scores was larger in those with cardiovascular risk factors than in those without. The multivariable odds ratio (OR) for decreased IADL after adding one CVD risk factor was 1.16 (95% confidence interval (CI), 1.04-1.29) after adjusting for age, sex, alcohol consumption and TMIG score at baseline. Among participants who were regarded as physically independent with respect to basic ADL in the baseline survey, the odds ratio was also similar and significant. Conclusion: Preventive interventions directed against cardiovascular risk factors, especially against their accumulation, may contribute to maintaining IADL in the Japanese elderly.
  • Sayuri Katano, Yasuyuki Nakamura, Aki Nakamura, Yoshitaka Murakami, Taichiro Tanaka, Hideaki Nakagawa, Toru Takebayashi, Hiroshi Yamato, Akira Okayama, Katsuyuki Miura, Tomonori Okamura, Hirotsugu Ueshima
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 17 6 644 - 650 2010年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: To examine the relation between lifestyle and the number of metabolic syndrome (MetS) diagnostic components in a general population, and to find a means of preventing the development of MetS components. Methods: We examined baseline data from 3,365 participants (2,714 men and 651 women) aged 19 to 69 years who underwent a physical examination, lifestyle survey, and blood chemical examination. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined four components for MetS in this study as follows: 1) high BP: systolic BP >= 130 mmHg or diastolic BP >= 85 mmHg, or the use of antihypertensive drugs; 2) dyslipidemia: high-density lipoprotein-cholesterol concentration <40 mg/dL, triglycerides concentration >= 150 mg/dL, or on medication for dyslipidemia; 3) Impaired glucose tolerance: fasting blood sugar level >= 110 mg/d, or if less than 8 hours after meals >= 140 mg/dL), or on medication for diabetes mellitus; 4) obesity: body mass index >= 25 kg/m(2). Results: Those who had 0 to 4 MetS diagnostic components accounted for 1,726, 949, 484, 190, and 16 participants, respectively, in the Poisson distribution. Poisson regression analysis revealed that independent factors contributing to the number of MetS diagnostic components were being male (regression coefficient b = 0.600, p<0.01), age (b = 0.027, p<0.01), IPAQ class (b = -0.272, p = 0.03), and alcohol consumption (b = 0.020, p = 0.01). The contribution of current smoking was not statistically significant (b = -0.067, p = 0.76). Conclusion: Moderate physical activity was inversely associated with the number of MetS diagnostic components, whereas smoking was not associated.
  • Zhao Guo, Katsuyuki Miura, Tanvir Chowdhury Turin, Atsushi Hozawa, Nagako Okuda, Tomonori Okamura, Shigeyuki Saitoh, Kiyomi Sakata, Hideaki Nakagawa, Akira Okayama, Katsushi Yoshita, Takashi Kadowaki, Sohel R. Choudhury, Yasuyuki Nakamura, Beatriz L. Rodriguez, J. David Curb, Paul Elliott, Jeremiah Stamler, Hirotsugu Ueshima
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 17 8 777 - 784 2010年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: There have been few studies on the relationships of the dietary polyunsaturated to saturated fatty acid ratio (P/S) to cardiovascular risk factors and metabolic syndrome. We hypothesized that there would be favorable relationships. Methods: Metabolic cardiovascular risk factors from dietary nutrient intake were investigated in 1,004 men and women aged 40-59 years from 4 population samples of Japanese. Multiple linear regression analysis was used to examine the relationship of the dietary P/S ratio to the following risk factors: hemoglobin A1c, blood pressure, serum triglycerides, LDL and total cholesterol, and HDL-cholesterol. Adjusted odds ratio of having metabolic syndrome was also calculated. Results: The dietary P/S ratio was significantly and inversely related to serum total and LDL cholesterol with control for possible confounding variables. We did not find any significant relationship between the P/S ratio and single metabolic risk factors or the prevalence of metabolic syndrome. Conclusions: Managing the P/S ratio is important to control serum LDL-cholesterol; however, increasing the P/S ratio may not improve metabolic risk factors. Other countermeasures, such as weight control, greater physical activity, and smoking cessation should be recommended to prevent and control metabolic syndrome.
  • Atsushi Hozawa, Tomonori Okamura, Taichiro Tanaka, Katsuyuki Miura, Yuriko Kikuchi, Takashi Kadowaki, Katsushi Yoshita, Toru Takebayashi, Junko Tamaki, Junko Minai, Takayo Tada, Nagako Chiba, Akira Okayama, Hirotsugu Ueshima
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 17 2 195 - 202 2010年 [有り][無し]
     研究論文(学術雑誌) 
    Aim: Gamma-glutamyltransferase (GGT) is known to correlate well with alcohol consumption; however, the relation between GGT and diabetes and that between alcohol consumption and diabetes mellitus (DM) is inconsistent. Thus, several questions, such as whether light to moderate drinkers can be considered as low risk for diabetes incidence irrespective of their GGT level, is unresolved. In this study, we investigated the relation of GGT or alcohol drinking with DM incidence considering the body mass index (BMI) in healthy Japanese workers. Methods: We followed 3095 men who did not have DM at baseline for 4 years. Incident diabetes was defined as a fasting (non-fasting) plasma glucose level of >= 7.0 (11.1) mmol/L, or treatment of diabetes. Multiple adjusted hazard ratios (HR) were calculated using Cox proportional models. Results: Participants with higher GGT (GGT >= 27 IU/L) showed an increased risk of diabetes incidence even when their BMI level was low. Although a U-shaped relation between alcohol drinking and incident diabetes was observed, the risk to light to moderate drinkers (alcohol < 23 g/day) was not low if they were either overweight (BMI >= 25 kg/m(2)) or had higher GGT (HR=2.60, p=0.08) or both overweight and higher GGT (HR=3.16, p=0.07) compared with never drinkers without higher GGT and overweight. Conclusions: Higher GGT was associated with a higher incidence of DM irrespective of drinking status or obesity. Although a U-shaped relation between alcohol drinking and incident diabetes was observed, the risk to light to moderate drinkers was not low if they were either overweight or had higher GGT.
  • Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Naoyuki Takashima, Masaharu Ichikawa, Hideki Sugihara, Yutaka Morita, Kunihiko Hirose, Yoshitaka Murakami, Katsuyuki Miura, Akira Okayama, Yasuyuki Nakamura, Robert D. Abbott, Hirotsugu Ueshima
    NEUROEPIDEMIOLOGY 34 1 25 - 33 2010年 [有り][無し]
     研究論文(学術雑誌) 
    Background: We examined the circadian periodicity of hemorrhagic stroke onset to identify any existing specific pattern and its relationship with conventional stroke risk factors using 14-year stroke registration data. Methods: Data were obtained from the Takashima Stroke Registry, which covers a stable population of approx. 55,000 in Takashima County in central Japan. Out of 499 registered first-ever hemorrhagic stroke events during 1990-2003, there were 429 (186 men, 243 women) events with classifiable onset time. Hemorrhagic stroke incidence was categorized as occurring at night (midnight to 6 a.m.), morning (6 a.m. to noon), afternoon (noon to 6 p.m.) or evening (6 p.m. to midnight). The OR (with 95% CI) of having a stroke in the morning, afternoon or evening were calculated, with night serving as reference. Results: There was significant diurnal variation in hemorrhagic stroke incidence (p < 0.001). The proportion of hemorrhagic strokes was highest in the morning (36.1%, 95% CI: 31.7-40.8) and lowest in the night (11.9%, 95% CI: 9.1-15.3). An excess stroke incidence in the morning was observed in both genders, in subjects <65 years and >= 65 years, and in both intracerebral hemorrhage and subarachnoid hemorrhage. A second surge was also observed during the later part of the day. The higher daytime risk persisted after adjusting for age, gender, and risk factors. Conclusion: In the examination of circadian variation of hemorrhagic stroke onset, a 2-peak temporal distribution was observed, which was independent of conventional risk factors. Copyright (C) 2009 S. Karger AG, Basel
  • Naoyuki Takashima, Katsuyuki Miura, Atsushi Hozawa, Aya Kadota, Tomonori Okamura, Yasuyuki Nakamura, Takehito Hayakawa, Nagako Okuda, Akira Fujiyoshi, Shin-Ya Nagasawa, Takashi Kadowaki, Yoshitaka Murakami, Yoshikuni Kita, Akira Okayama, Hirotsugu Ueshima
    BMC Public Health 10 10 306 - 306 2010年 [有り][無し]
     研究論文(学術雑誌) 
    Background. Smoking and metabolic syndrome are known to be related to cardiovascular diseases (CVD) risk. In Asian countries, prevalence of obesity has increased and smoking rate in men is still high. We investigated the attribution of the combination of smoking and metabolic syndrome (or obesity) to excess CVD deaths in Japan. Methods. A cohort of nationwide representative Japanese samples, a total of 6650 men and women aged 30-70 at baseline without history of CVD was followed for 15 years. Multivariate-adjusted hazard ratio for CVD death according to the combination of smoking status and metabolic syndrome (or obesity) was calculated using Cox proportional hazard model. Population attributable fraction (PAF) of CVD deaths was calculated using the hazard ratios. Results. During the follow-up period, 87 men and 61 women died due to CVD. The PAF component of CVD deaths in non-obese smokers was 36.8% in men and 11.3% in women, which were higher than those in obese smokers (9.1% in men and 5.2% in women). The PAF component of CVD deaths in smokers without metabolic syndrome was 40.9% in men and 11.9% in women, which were also higher than those in smokers with metabolic syndrome (7.1% in men and 3.9% in women). Conclusion. Our results indicated that a large proportion of excess CVD deaths was observed in smokers without metabolic syndrome or obesity, especially in men. These findings suggest that intervention targeting on smokers, irrespective of the presence of metabolic syndrome, is still important for the prevention of CVD in Asian countries. © 2010 Takashima et al licensee BioMed Central Ltd.
  • Yoshiko Kawai, Tomohiko Satoh, Daisuke Hibi, Yukihiro Ohno, Yuka Kohda, Katsuyuki Miura, Munekazu Gemba
    JOURNAL OF PHARMACOLOGICAL SCIENCES 111 4 433 - 439 2009年12月 [有り][無し]
     研究論文(学術雑誌) 
    Cisplatin causes chronic interstitial disease with fibrosis, but the development mechanism of interstitial fibrosis is not yet understood. We examined the effect of an antioxidant, N,N'-diphenyl-1,4-phenylenediamine (DPPD), on development of interstitial fibrosis induced by cisplatin. Cisplatin increased blood Urea nitrogen (BUN), plasma creatinine, and elicited glucosuria and enzymuria at 3 days after administration, but these changes were restored to the normal level after 14 days. Type III collagen increased from 7 days after administration of cisplatin and the expansion of the interstitial fibrosis area became evident at 14 days. Sustained renal fibrosis worsened renal function again at 56 days. Administration of DPPD, which was started at 3 days after cisplatin treatment, significantly inhibited the increase in renal type III collagen contents and the expansion of the interstitial fibrosis area Without affecting enzymuria and increased BUN. These results indicate that anti-fibrotic action of DPPD is not secondary due to the inhibition of acute renal injury but is rather a direct effect oil renal fibrogenesis. DPPD did not prevent the infiltration of macrophages by cisplatin, suggesting that anti-fibrotic action of DPPD was not mediated by the inhibition of inflammatory cellular Influx. It is Suggested that reactive oxygen species are involved in cisplatin-induced renal interstitial fibrosis.
  • Yasuyuki Nakamura, Hirotsugu Ueshima, Aya Kadota, Atsushi Hozawa, Tomonori Okamura, Sayaka Kadowaki, Takashi Kadowaki, Takehito Hayakawa, Yoshikuni Kita, Robert D. Abbott, Akira Okayama
    ALCOHOL 43 8 635 - 641 2009年12月 [無し][無し]
     研究論文(学術雑誌) 
    Although moderate alcohol intake in diabetic Caucasians is associated with a reduction in coronary heart disease mortality, no study in Japanese with diabetes has examined the association between alcohol intake and mortality outcomes. We analyzed the relationship between alcohol intake and all-cause and cause-specific mortality using the database from NIPPON DATA80. At the baseline in 1980, data on history, lifestyle, and physical examinations were collected on study participants aged 30 years and older from randomly selected areas in Japan. After excluding participants with comorbidities, we followed 4,018 male participants (3,614 nondiabetics, 195 with impaired glucose tolerance and 209 diabetic) for 19 years. During the 19 years of follow-up, there were 990 deaths; 328 were from cardiovascular disease and 157 from all-heart diseases. With the never-drinking category serving as a reference, the Cox multivariate-adjusted hazard ratios for non-daily and daily drinkers for cardiovascular mortality were 0.43 (95% confidence intervals: 0.19-0.95) and 0.45 (0.25-0.80), respectively, and 0.33 (0.12-0.91) and 0.31 (0.15-0.67) for all-heart disease mortality in the combined impaired glucose tolerance and diabetic Japanese men. Alcohol drinking in men with glucose intolerance was associated with a significant reduction in cardiovascular and all-heart disease mortality as seen in the general population in Japan. (C) 2009 Elsevier Inc. All rights reserved.
  • Yasuyuki Nakamura, Hirotsugu Ueshima, Nagako Okuda, Yoshitaka Murakami, Katsuyuki Miura, Yoshikuni Kita, Tomonori Okamura, Tanvir C. Turin, Beatriz Rodriguez, J. David Curb, Jeremiah Stamler
    HYPERTENSION 54 6 1416 - 1422 2009年12月 [有り][無し]
     研究論文(学術雑誌) 
    Data from animal studies clearly indicate an association between leptin and hypertension; results of human studies are less concordant. We investigated the role of leptin in obesity-related higher blood pressure (BP) in Japanese Americans living in Hawaii and Japanese in Japan. Serum leptin and BP were examined by standardized methods in men and women ages 40 to 59 years from 2 population samples, one Japanese American in Hawaii ( 88 men and 94 women) and the other Japanese in central Japan (123 men and 111 women). Multiple linear regression models were used to assess role of leptin in obesity-related higher BP. Across quartiles of leptin, there were significantly higher mean body mass index levels, systolic BP, and diastolic BP for both sexes and sites (P<0.01 to 0.02). In multivariate regression analyses using all of the data combined, relations of body mass index and leptin to systolic BP and diastolic BP remained significant with the interaction term (body mass indexXlog-leptin) in the models ( P<0.01 to <0.05). These findings are consistent with the inference that leptin may be an independent mediator for obesity-related elevations in BP. ( Hypertension. 2009; 54: 1416-1422.)
  • Koichiro Kitamoto, Yuichi Machida, Junji Uchida, Yasukatsu Izumi, Masayuki Shiota, Takafumi Nakao, Hiroshi Iwao, Tokihito Yukimura, Tatsuya Nakatani, Katsuyuki Miura
    JOURNAL OF PHARMACOLOGICAL SCIENCES 111 3 285 - 292 2009年11月 [有り][無し]
     研究論文(学術雑誌) 
    Although liposome-encapsulated clodronate has been used as a means to deplete macrophages from certain tissues, target leukocyte subtypes within the kidney are not clearly known under normal and pathologic conditions. The present study was therefore conducted to examine the effects of liposome clodronate on renal infiltrating cell type following unilateral ureteral obstruction (UUO) and tried to correlate these changes to the mechanisms of early development of renal fibrosis. Renal infiltrating leukocyte subtypes and Counts were determined by using multicolor flow cytometric analysis of cell suspensions from obstructed kidneys. UUO for 5 days elicited renal tubular apoptosis and renal fibrosis and showed 4-fold increase in renal leukocytes including monocytes/macrophages, dendritic cells, and T-cells. Repeated administration of liposome clodronate selectively depleted F4/80(+) monocytes/macrophages and F4/80(+) dendritic cells but not F4/80(-) dendritic cells or other cell types in both obstructed and non-obstructed kidneys. Tubular apoptosis and renal fibrosis were also significantly attenuated by liposome clodronate. Increased gene expression of TNF-alpha and TGF-beta observed in obstructed kidneys were markedly attenuated by depletion of renal mononuclear phagocytes. These findings suggest that F4/80(+) monocytes/macrophages and/or F4/80(+) dendritic cells play a pivotal role in the development of obstruction-induced tubular apoptosis and renal fibrosis, possibly through TNF-alpha and TGF-beta dependent mechanisms.
  • Rie Oka, Junji Kobayashi, Katsuyuki Miura, Shinya Nagasawa, Tadashi Moriuchi, Senshu Hifumi, Susumu Miyamoto, Masa-aki Kawashiri, Atsushi Nohara, Akihiro Inazu, Yoshiyu Takeda, Hiroshi Mabuchi, Kunimasa Yagi, Masakazu Yamagishi
    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 16 5 633 - 640 2009年10月 [有り][無し]
     研究論文(学術雑誌) 
    Aim: Postprandial hypertriglyceridemia is recognized as an independent risk factor for cardiovascular disease. The aim of this study was to identify differences between fasting and postprandial TG levels, focusing on the influence of waist circumference. Methods: Subjects included 1,505 men and 798 women aged 38-65 years who were not taking medications for diabetes or dyslipidemia. Fasting TG levels were measured after an overnight fast, and postprandial TG levels were measured 2 hours after a standardized rice-based lunch (total 740 kcal, 20 g fat, 30 g protein, and 110 g carbohydrates) in the afternoon on the same day. Results: Fasting and postprandial TG levels were highly correlated in both men (r=0.86, p<0.001) and women (r=0.84, p<0.001). Waist circumference was positively correlated with fasting TG (r=0.38 in men and r=0.36 in women) and postprandial TG (r=0.42 in men and r=0.45 in women), respectively. On multiple regression analyses, the association of waist circumference with postprandial TG was still significant (standardized beta=0.10 in men and standardized beta=0.15 in women, p<0.001) after the inclusion of HbA1c, age, high-density-lipoprotein (HDL)-cholesterol alcohol consumption, and fasting TG in the regression model. Conclusion: Postprandial TG has a better relation with waist circumference than fasting TG.
  • Tanvir Chowdhury Turin, Yoshikuni Kita, Nahid Rumana, Naoyuki Takashima, Masaharu Ichikawa, Hideki Sugihara, Yutaka Morita, Katsuyuki Miura, Akira Okayama, Yasuyuki Nakamura, Hirotsugu Ueshima
    Neuroepidemiology 33 3 240 - 246 2009年10月 [無し][無し]
     研究論文(学術雑誌) 
    Objective: Successful acute stroke intervention depends on early hospitalization. The time interval between stroke onset to hospitalization was examined to identify the factors influencing the interval and also to determine whether treatment time window expansion will translate into more treatment. Methods: Data was obtained from Takashima Stroke Registry covering approximately 55,000 residents in Japan. During 1988-2002, the interval between stroke onset and hospitalization was available for 1,446 registered patients (men 761, women 685). Multivariate regression analyses were performed to evaluate the factors influencing early and late admission. Results: The proportions of the patients who arrived within 3 h of onset were 61.4%. Only 8.7% of the patients arrived during a 3- to 6-hour interval. A substantial proportion (29.9%) of patients arrived after 6 h. Early stroke hospitalization was significantly associated with the severity of the stroke event and time of stroke onset. Conclusion: Clinically more severe stroke patients were hospitalized earlier and nocturnal strokes had delayed admission. Even expanding the therapeutic time window from ≤3 to ≤6 h, there are possibilities that a substantial proportion of patients would not benefit from acute intervention. Future research should focus not only on developing therapies for expanding the treatment time window, but also place emphasis on reducing the interval between onset and hospitalization. Copyright © 2009 S. Karger AG.
  • Rie Naganuma, Masaru Sakurai, Katsuyuki Miura, Katsushi Yoshita, Yuko Morikawa, Teruhiko Kido, Hirotsugu Ueshima, Hideaki Nakagawa, Jeremiah Stamler
    ATHEROSCLEROSIS 206 1 282 - 286 2009年09月 [有り][無し]
     研究論文(学術雑誌) 
    Objective: This study investigated the relationship between changes in lipoprotein particle size and body weight change over a 9-year period in Japanese adult men and women. Methods: Among 299 INTERMAP Toyama Study participants aged 40-59 in 1997,260 were followed up in 2006 (129 men and 131 women). Their body w