Language：Japanese   Publisher：(一社)日本睡眠学会  

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Background: This cohort study aimed to examine the relationship between objectively measured daily ambulatory activity (AA) variables and the onset of metabolic syndrome (MetS) in middle-aged and older Japanese individuals. Methods: A total of 1,034 participants (women, 76.8%; mean age, 56.9 years) who were initially free from MetS, underwent objective assessment of daily AA using a uniaxial accelerometer at baseline. The number of steps, time accumulated in light-intensity AA (LIAA), moderate-to-vigorous intensity AA (MVAA), and total AA (LIAA + MVAA) were calculated. The diagnostic criteria outlined by the Japanese standards were employed to define the presence of MetS. To explore the association between AA variables and MetS onset, both multivariate logistic regression and a restricted cubic spline model were used while controlling for variables such as age, sex, education, alcohol habit, smoking habit, energy intake, and the number of MetS components present at baseline. Results: Over the course of the 5-year follow-up period, 116 participants (11.2%) developed MetS. In terms of the number of steps, LIAA, and total AA, the third quartile had significantly lower multivariate adjusted odds ratios for MetS onset than the first quartile. The odds ratios (95% confidence intervals) were 0.386 (0.197–0.755), 0.527 (0.285–0.975), and 0.392 (0.206–0.745), respectively. In the spline model, an L-shaped association with MetS was observed for the number of steps (p for nonlinearity = 0.066), LIAA (p for nonlinearity = 0.034), and total AA (p for nonlinearity = 0.040). Conclusions: Among the variables related to AA, the index of daily amount AA, in particular, may be linked to the onset of MetS.

DOI： 10.1038/s41366-024-01483-w

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.clnu.2024.04.017

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AIMS/INTRODUCTION: Gene-environment interactions are considered to critically influence type 2 diabetes mellitus development; however, the underlying mechanisms and specific interactions remain unclear. Given the increasing prevalence of low birthweight (LBW) influenced by the intrauterine environment, we sought to investigate genetic factors related to type 2 diabetes development in individuals with LBW. MATERIALS AND METHODS: The interaction between 20 reported type 2 diabetes susceptibility genes and the development of type 2 diabetes in LBW (<2,500 g) individuals in a population-based Japanese cohort (n = 1,021) was examined by logistic regression and stratified analyses. RESULTS: Logistic regression analyses showed that only the G/G genotype at the rs1862513 locus of the resistin gene (RETN), an established initiator of insulin resistance, was closely related to the prevalence of type 2 diabetes in individuals with LBW. Age, sex and current body mass index-adjusted stratified analyses showed a significant interaction effect of LBW and the RETN G/G genotype on fasting insulin, homeostatic model assessment 2-insulin resistance, Matsuda index and the prevalence of type 2 diabetes (all P-values for interaction <0.05). The adjusted odds ratio for type 2 diabetes in the LBW + G/G genotype group was 7.33 (95% confidence interval 2.43-22.11; P = 0.002) compared with the non-LBW + non-G/G genotype group. Similar results were obtained after excluding the influence of malnutrition due to World War II. CONCLUSIONS: Simultaneous assessment of LBW and the RETN G/G genotype can more accurately predict the risk of future type 2 diabetes than assessing each of these factors alone, and provide management strategies, including early lifestyle intervention in LBW population.

DOI： 10.1111/jdi.14163

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We aimed to investigate the association between pulse rate variability (PRV) and health-related quality of life (HRQOL) in the general population. A cross-sectional study was conducted with 5908 Japanese men and women aged 30-79 years. PRV was assessed at rest using 5-min recordings of pulse waves with a photoplethysmographic signal from a fingertip sensor, and the time and frequency domains of PRV were determined. HRQOL was assessed with the Short Form-8 (SF-8) Japanese version, and poor HRQOL was defined as an SF-8 sub-scale score < 50. A test for nonlinear trends was performed with the generalized additive model with a smoothing spline adjusted for confounders. The lowest multivariable-adjusted odds ratios for poor physical component score were found in those who had second or third quartile levels of standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive difference (RMSSD), and high-frequency (HF) power and trended slightly upward in the higher levels. PRV-derived parameters were nonlinearly associated with poor physical component scores. In conclusion, reduced PRV-derived SDNN, RMSSD and HF power were associated with poor HRQOL in the domain of physical function. Higher levels of these parameters did not necessarily translate into better HRQOL.

DOI： 10.1038/s41598-024-54748-9

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It is uncertain whether dietary intake of mushrooms rich in dietary fiber and several antioxidants is associated with a lower risk of dementia. We sought to examine prospectively the association between mushroom intake and the risk of disabling dementia. We performed a prospective study involving 3,750 people aged 40 to 64 years residing in three communities who participated in an annual cardiovascular risk survey from 1985 to 1999. Cases of incident disabling dementia were surveyed from 1999 to 2020. We calculated the hazard ratios and 95% confidence intervals for incident total dementia according to mushroom intake among participants with or without a history of stroke. During a mean 16.0 years' follow-up in 3,739 eligible participants, 670 people developed disabling dementia. For women, mushroom intake was inversely associated with the risk of total dementia and the association was confined to dementia without a history of stroke. The multivariable hazard ratios (95% confidence intervals) for total dementia in women were 0.81 (0.62-1.06) for mushroom intake of 0.1 to 14.9 g/day and 0.56 (0.42-0.75) for mushroom intake above 15.0 g/day (p for trend = 0.003) compared to no intake. The corresponding hazard ratios (95% confidence intervals) for dementia without a history of stroke were 0.66 (0.47-0.93) and 0.55 (0.38-0.79) (p for trend = 0.01). In men, no associations were observed between mushroom intake and the risk of disabling dementia. Among Japanese women, dietary mushroom intake was associated with a lower risk of disabling dementia.

DOI： 10.1017/S000711452400014X

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

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

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本動脈硬化学会  

Aims: Several studies have revealed an association between moderate-to-vigorous physical activity (MVPA) and arterial stiffness, which is a known risk factor for cardiovascular disease. However, a few studies have considered the difference in the longitudinal effect of its intensity in a large general population. Therefore, we examined the effect of MVPA intensity on longitudinal changes in arterial stiffness. Methods: We conducted a prospective cohort study involving 1,982 Japanese men and women. Arterial stiffness was measured using the cardio–ankle vascular index (CAVI) at baseline and 5-year follow-up. Physical activity was quantified using the Japan Arteriosclerosis Longitudinal Study Physical Activity Questionnaire and categorized into quartiles as MVPA levels. Linear mixed models were used to examine the differences at baseline and the rate of changes in CAVI associated with MVPA levels for over 5 years. Results: The multivariable-adjusted mean differences in CAVI at baseline were significantly lower in the third (β =－0.019 [95% confidence interval {CI} =－0.033 to −0.005]) and fourth (β=－0.018 [95% CI =－0.035 to －0.001]) quartiles of the MVPA group compared with those in the lowest quartile of MVPA, and the significant effect persisted 5 years later. Conclusions: In summary, this study provides evidence to support the existence of a threshold for beneficial levels of MVPA in the prevention of arterial stiffness. Furthermore, this study suggests that exceeding this threshold may exert similar effects on arterial stiffness. These findings suggest that an optimal level of MVPA exists for preventing arterial stiffness, and exceeding this threshold may not engender additional benefits.

DOI： 10.5551/jat.64173

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

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

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

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

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

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

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

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

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DOI： 10.1265/ehpm.23-00110

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Tight junction disruption and dysfunction are involved in the progression of blood-brain barrier (BBB) breakdown. Recent investigations have revealed BBB disruption in patients with vascular cognitive decline. Our previous studies showed that miR-501-3p negatively regulates cerebral endothelial tight junction protein-1, resulting in the disruption of the BBB, and playing an important role in the development of vascular cognitive impairment. BBB breakdown in white matter lesions is often seen in the patients with vascular mild cognitive impairment (MCI). We therefore hypothesize that most early-phase MCI patients may demonstrate elevated expression of miR-501-3p and sought to investigate whether serum exosome miR-501-3p levels could be a clinical indicator for detecting mild cognitive impairment. One hundred and seventy-eight subjects (aged 73 [68-75] years, 53% male) were recruited for this study. The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was used for detecting MCI. Serum exosome miR-501-3p expression levels were measured by qPCR methods. Patients were divided into two groups depending on whether their miR-501-3p ∆Ct values were above ("High"; n = 74) or below ("Low"; n = 104) cutoff levels determined by ROC curve. MCI was detected significantly more often in the miR-501-3p-High group (vs. -Low group, 63.5% vs. 47.1%, respectively; p < 0.05). Multivariate logistic regression analysis showed a significant association between MCI status and High miR-501-3p (odds ratio 2.662; p < 0.01), improved vs. known risk factors. In non-diabetic patients, High miR-501-3p was positively associated with MCI status (odds ratio 3.633; p < 0.01) and also positively associated with MCI status in those with atherosclerosis (odds ratio 3.219; p < 0.01). The present study demonstrates that elevated expression of blood exosomal miR-501-3p can indicate the presence of MCI in human patients. Early detection of vascular injuries may allow a reduction in progressive dementia through the management of vascular risk factors.

DOI： 10.1111/jnc.15911

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OBJECTIVES: Few studies examined the association between deterioration of masticatory ability assessed by objective marker and physical function. Therefore, we examined the association between salivary flow rate which is one of the objective and surrogate marker of masticatory ability and lower Timed Up & Go (TUG) performance which is one of major measurement of physical function among aging Japanese. METHODS: This cross-sectional study enrolled 464 Japanese aged 60-84 years old. Participants chewed tasteless and odorless gum for 5 min, calculated stimulated salivary flow rate (g/min) during all chews. The 3 m TUG was conducted, and 75th percentile value (6.8 s for men and 7.0 s for women) or higher was defined as lower TUG performance. Logistic regression analysis was used to examine the association between stimulated salivary flow rate and lower TUG performance. RESULTS: We found that the stimulated salivary flow rate tended to be negatively associated with the TUG time. We also observed significant negative association between stimulated salivary flow rate and lower TUG performance; the multivariable-adjusted OR (95% confidence interval, CIs) of lower TUG performance for the highest quartile of stimulated salivary flow rate compared with the lowest quartile was 0.34 (0.16-0.69, P for trend = 0.02). Further adjusting for BMI, the association was attenuated but remaind significant; the OR (95% CIs) in highest quartile was 0.37 (0.18-0.76, P for trend = 0.04). CONCLUSIONS: Higher stimulated salivary flow, which means well masticatory ability, was inversely associated with lower TUG performance in the aging Japanese population.

DOI： 10.1016/j.afos.2023.08.001

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Resistin is mainly expressed in human monocytes/macrophages and is associated with insulin resistance, inflammation, and atherosclerosis. Serum resistin is strongly correlated with the G-A haplotype defined by single nucleotide polymorphisms (SNPs) c.-420 C>G (SNP-420) (rs1862513) and c.-358 G>A (SNP-358) (rs3219175) in the promoter region of the human resistin gene (RETN). Smoking is also associated with insulin resistance. We investigated the association between smoking and serum resistin and the effect of the G-A haplotype on this association. Participants were recruited under the Toon Genome Study (an observational epidemiology research in the Japanese population). Of these, 1975 subjects genotyped for both SNP-420 and SNP-358 were analyzed for serum resistin by grouping them based on smoking status and G-A haplotype status. RETN mRNA, isolated from whole blood cells, was evaluated in smokers (n = 7) and age-, sex-, and BMI-matched non-smokers (n = 7) with the G-A haplotype homozygotes. Serum resistin tended to be higher in current smokers who smoked more cigarettes per day (P for trend < 0.0001). The positive association between serum resistin and smoking was strongest in the G-A haplotype homozygotes, followed by heterozygotes and non-carriers (interaction P < 0.0001). This positive association was stronger in the G-A homozygotes than the C-G homozygotes (interaction P < 0.0001). RETN mRNA was 1.40-fold higher in smokers than non-smokers with the G-A homozygotes (P = 0.022). Therefore, the positive association between serum resistin and smoking was strongest in the G-A haplotype homozygotes defined by RETN SNP-420 and SNP-358.

DOI： 10.1038/s10038-023-01176-8

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Language：English   Publisher：(一社)日本動脈硬化学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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AIM/INTRODUCTION: Resistin, which induces insulin resistance, is mainly expressed in monocytes/macrophages in humans. We reported previously that serum resistin was highest in the G-A haplotype defined by resistin single nucleotide polymorphisms (SNPs) at -420 (rs1862513) and - 358 (rs3219175). As sarcopenic obesity is associated with insulin resistance, we aimed to examine whether serum resistin and its haplotypes were associated with sarcopenic obesity at a latent stage. MATERIALS AND METHODS: We cross-sectionally analyzed 567 community-dwelling Japanese participants attending annual medical check-ups in which the sarcopenic obesity index was evaluated. The age- and gender-matched normal glucose tolerance subjects with G-A homozygotes and those with C-G homozygotes were examined via RNA-sequencing and pathway analysis (each n = 3), and RT-PCR (each n = 8). RESULTS: In multivariate logistic regression analyses, the fourth quartile (Q4) of serum resistin and G-A homozygotes were both associated with the latent sarcopenic obesity index defined by a visceral fat area of ≥ 100 cm2 and grip strength Q1 after adjustment for age and gender, with or without other confounding factors. RNA sequencing and pathway analysis showed that tumor necrosis factor (TNF) was involved in the top five pathways in the whole blood cells of G-A homozygotes compared with C-G homozygotes. RT-PCR revealed that TNF mRNA was higher in G-A homozygotes than in C-G homozygotes. CONCLUSIONS: The G-A haplotype was associated with the latent sarcopenic obesity index defined by grip strength in the Japanese cohort, could be mediated by TNF-α.

DOI： 10.1111/jdi.13998

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AIM: We aimed to examine sex-specific risk factors for hyperuricemia or gout in Japanese cohorts. METHODS: We followed up 3,188 men (mean age, 55.6 years) and 6,346 women (mean age, 54.1 years) without hyperuricemia, gout, or elevated liver enzymes at baseline from 1986 to 1990 for a median of 14.6 years. The participants were considered as having hyperuricemia or gout if their serum uric acid levels were ≥ 7.0 mg/dL or they were receiving treatment for hyperuricemia or gout during annual health checkups. The sex-specific multivariable hazard ratios (HRs) of hyperuricemia or gout incidence were calculated after adjustment for smoking and drinking status, body mass index, hypertension, diabetes, hypercholesterolemia, and hypertriglyceridemia using the Cox proportional-hazard model. RESULTS: During follow-up, 733 men and 355 women had hyperuricemia or gout. Among men, the multivariable HRs (95% confidence intervals) of hyperuricemia or gout were 1.23 (1.00-1.52) and 1.41 (1.13-1.75) for drinkers of ＜46 and ≥ 46 g ethanol/day, respectively, compared with non-drinkers; 1.00 (0.81-1.24) and 1.18 (0.93-1.50) for smokers of 1-19 and ≥ 20 cigarettes/day, respectively, compared with never smokers; and 1.41 (1.20-1.65) for hypertensive compared with non-hypertensive participants. The HRs for women were 1.02 (0.70-1.48), 1.66 (1.05-2.63), and 1.12 (0.88-1.42) for current drinkers, current smokers, and hypertensive participants, respectively. For both men and women, body mass index, diabetes, hypercholesterolemia, and hypertriglyceridemia were not associated with hyperuricemia or gout incidence. CONCLUSIONS: Hypertension and alcohol drinking are risk factors for hyperuricemia or gout among men and smoking among women.

DOI： 10.5551/jat.63907

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Age-related changes in physical function are closely associated with daily activity impairment among the elderly. Continuous maslinic acid intake may improve skeletal muscle mass; however, the concentration-dependent benefits of maslinic acid for physical functionality remain unclear. Therefore, we evaluated the bioavailability of maslinic acid and examined the effect of maslinic acid intake on skeletal muscle and quality of life in the healthy Japanese elderly. Five healthy adult men were administered test diets containing 30, 60, or 120 mg of maslinic acid. Analysis of plasma maslinic acid revealed concentration-dependent elevations in blood maslinic acid levels (p<0.01). Next, 69 healthy Japanese adult men and women were administered a placebo or 30 or 60 mg of maslinic acid continuously for 12 weeks with physical exercise in a randomized, double-blind, placebo-controlled trial. The trunk muscle mass (p<0.05) and vitality score according to the Short-Form-8 (p<0.05) were significantly higher in the 60 mg maslinic acid group than in the placebo group. Additionally, grip strength was significantly higher in the 30 (p<0.05) and 60 mg (p<0.05) groups than in the placebo group. Overall, maslinic acid intake with physical exercise improved muscle strength, muscle mass, and quality of life in a maslinic acid-intake-dependent manner.

DOI： 10.3164/jcbn.23-5

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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

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OBJECTIVE: To examine whether bean intake (including soybeans) among Japanese adults is associated with risk of disabling dementia severe enough to require care under the national insurance system. METHODS: This cohort study involved 3739 individuals aged 40 to 64 years. The participants were categorized into five groups based on their dietary bean intake estimated by a 24h dietary recall. Hazard ratios and 95% confidence intervals of disabling dementia were estimated using Cox proportional hazard models adjusted for potential confounding factors (smoking, drinking, and intakes of energy and fish). RESULTS: During the 59,681 person-year follow-up, 670 cases of disabling dementia were observed. A weak inverse association between bean intake and risk of disabling dementia was found; the multivariable hazard ratios (95% CIs) were 0.79 (0.62-1.00), 0.80 (0.63-1.01), 0.84 (0.67-1.06), and 0.78 (0.62-0.99) for the four groups with higher bean intake, respectively, compared with the lowest group (P for trend = 0.21). A significant inverse association was observed for dementia without a history of stroke; for the four groups with higher bean intake the multivariable hazard ratios were 0.81 (0.61-1.08), 0.70 (0.52-0.95), 0.71 (0.52-0.95), and 0.69 (0.51-0.92), respectively, (P for trend = 0.03). No such association was observed for dementia with history of stroke. The group with increased natto intake were inversely associated with risk of disabling dementia (P for trend = 0.003), but tofu intake was not (P for trend = 0.19). CONCLUSIONS: Bean intake was inversely associated with risk of disabling dementia in those without a history of stroke.

DOI： 10.1038/s41430-022-01188-1

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BACKGROUND: Alcohol consumption is a prevalent behavior that is bi-directionally related to the risk of type 2 diabetes. However, the effect of daily alcohol consumption on glucose levels in real-world situations in the general population has not been well elucidated. This study aimed to clarify the relationship between alcohol consumption and all-day and time-specific glucose levels among non-diabetic individuals. METHODS: We investigated 913 non-diabetic males and females, aged 40-69 years, during 2018-2020 from four communities across Japan. The daily alcohol consumption was assessed using a self-report questionnaire. All-day and time-specific average glucose levels were estimated from the interstitial glucose concentrations measured using the Flash glucose monitoring system for a median duration of 13 days. Furthermore, we investigated the association between all-day and time-specific average glucose levels and habitual daily alcohol consumption levels, using never drinkers as the reference, and performed multiple linear regression analyses after adjusting for age, community, and other diabetes risk factors for males and females separately. RESULTS: All-day average glucose levels did not vary according to alcohol consumption categories in both males and females. However, for males, the average glucose levels between 5:00 and 11:00 h and between 11:00 and 17:00 h were higher in moderate and heavy drinkers than in never drinkers, with the difference values of 4.6 and 4.7 mg/dL for moderate drinkers, and 5.7 and 6.8 mg/dL for heavy drinkers. Conversely, the average glucose levels between 17:00 and 24:00 h were lower in male moderate and heavy drinkers and female current drinkers than in never drinkers; the difference values of mean glucose levels were -5.8 for moderate drinkers, and -6.1 mg/dL for heavy drinkers in males and -2.7 mg/dL for female current drinkers. CONCLUSIONS: Alcohol consumption was associated with glucose levels in a time-dependent biphasic pattern.

DOI： 10.1265/ehpm.22-00215

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BACKGROUND: Whether dietary protein intake worsens renal function in the general population has been discussed but not yet determined. We aimed to examine the longitudinal association between dietary protein intake and risk of incident chronic kidney disease (CKD). METHODS: We conducted a 12-year follow-up study with 3,277 Japanese adults (1,150 men and 2,127 women) aged 40-74 years, initially free from CKD, who participated in cardiovascular risk surveys from two Japanese communities under the Circulatory Risk in Communities Study. The development of CKD was defined by the estimated glomerular filtration rate (eGFR) during the follow-up period. Protein intake was measured at baseline by using the brief-type self-administered diet history questionnaire. We estimated sex-, age-, community- and multivariate-adjusted hazard ratios (HR) for incident CKD were calculated using the Cox proportional hazards regression models according to quartiles of percentage of energy (%energy) from protein intake. RESULTS: During 26,422 person-years of follow-up, 300 participants developed CKD (137 men and 163 women). The sex-, age-, and community-adjusted HR (95% confidence interval, CI) for the highest (≥16.9%energy) versus lowest (≤13.4%energy) quartiles of total protein intake was 0.66 (0.48-0.90), p for trend = 0.007. The multivariable HR (95%CI) was 0.72 (0.52-0.99), p for trend = 0.016 after further adjustment for body mass index, smoking status, alcohol drinking status, diastolic blood pressure, antihypertensive medication use, diabetes mellitus, serum total cholesterol levels, cholesterol-lowering medication use, total energy intake, and baseline eGFR. The association did not vary by sex, age, and baseline eGFR. When examining animal and vegetable protein intake separately, the respective multivariable HRs (95%CIs) were 0.77 (0.56-1.08), p for trend = 0.036, and 1.24 (0.89-1.75), p for trend = 0.270. CONCLUSIONS: Higher protein intake, more specifically animal protein intake was associated with a lower risk of CKD.

DOI： 10.1265/ehpm.22-00247

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We aimed to validate a method for assessing trans-fatty acid (TFA) intake in the Japanese population using the Food Frequency Questionnaire (FFQ) developed in the 1990s from a prospective study that was based on the Japan Public Health Center-based Prospective Cohort Study. For FFQ validation, we included 565 participants (Cohort I: n=215, Cohort II: n=350) aged 40-69 years. We used a 28-day dietary record (DR) over one year and two FFQs administered before and after DR assessment. We calculated total TFA intake, TFA from industrial oils (i-TFA), and TFA from ruminants (r-TFA) considering a database of measurements obtained mainly from Japan. Spearman's rank correlation coefficients (CC) were computed for validity and reproducibility. Energy adjustments were applied using two methods considering the TFA measurement: density method for TFA% of total energy and residual method for TFA g/day. The total TFA intake (% of the total energy intake) was 0.08-0.76% (median, 0.27-0.37%) in DRs of both cohorts, and was 0.00-1.13% (median, 0.30-0.40%) in FFQs. The i-TFA accounted for approximately 50% of the total TFA intake in DRs and approximately 40% in FFQs. For total TFA(% of the total energy intake), CCs were 0.54-0.69, and weighted kappa coefficients were 0.88-0.92 for both cohorts. The de-attenuated CC was 0.46-0.62 for i-TFA (g/day) and 0.57-0.68 for r-TFA (g/day). Our study showed that the validity and reproducibility of TFA intake estimation using the FFQ were reasonable, suggesting its suitability among the Japanese population with low TFA intake.

DOI： 10.1017/S0007114522003828

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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BACKGROUND: Elevated resting heart rate (RHR) is a predictor of incident type 2 diabetes (T2D). Insulin resistance is thought to play a role in this association; however, the extent to which insulin resistance mediates this association is unclear. METHODS: 1309 Japanese individuals without diabetes were recruited during 2009-2012 and followed for 5 years, of whom 78 developed T2D, as diagnosed by the 75 g oral glucose tolerance test. Supine RHR was measured by electrocardiography. Using logistic regression analysis, we examined the association between RHR and incident T2D, and interaction with the homeostasis model assessment of insulin resistance (HOMA-IR) index. Causal mediation analysis was applied to decompose the effect of RHR on the outcome and estimate the proportion mediated by the HOMA-IR index. RESULTS: The sex- and age-adjusted cumulative incidence rate of T2D increased with increasing RHR. After adjustment for sex, age, waist circumference, current smoking status, alcohol use, habitual exercise, and cardiovascular disease medications, individuals with a RHR ≥80 bpm, compared with <60 bpm, showed an increased risk of incident T2D [odds ratio (OR), 2.89; 95 % confidence interval (CI), 1.07 to 7.80]. Multivariate adjusted OR for the total effect per 1 SD increase in RHR on incident T2D was 1.37 (95 % CI, 1.01 to 1.74) in the mediation analysis, and the proportion of the total indirect effect mediated by the HOMA-IR index was 27.5 % (95 % CI, 1.5 to 53.5). CONCLUSIONS: Approximately 30 % of the effect of RHR on incident T2D was explained by the indirect effect of insulin resistance.

DOI： 10.1016/j.jdiacomp.2022.108319

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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STUDY OBJECTIVES: Although excessive daytime sleepiness (EDS) has a crucial impact on motor vehicle crashes (MVCs), the assessment of subjective sleepiness as a screening tool for MVC has limitations. Objective daytime sleepiness may be a better predictor of MVC rather than subjective daytime sleepiness. Therefore, we aimed to examine the association of psychomotor vigilance as a surrogate marker of objective sleepiness and subjective sleepiness with MVC in a prospective cohort study of the general population. METHODS: The study participants were 903 community-dwelling Japanese followed-up five years after the baseline and ascertained history of MVC over the study period. Psychomotor vigilance was measured by psychomotor vigilance task (PVT) and categorized into quartiles by the reciprocal of the mean reaction time (mean1/RT). Subjective EDS was defined using the Japanese version of the Epworth Sleepiness Scale. Multivariable logistic regression analysis was used to examine the association between mean1/RT and MVC after stratification by subjective EDS. RESULTS: The multivariable-adjusted odds ratio (95% confidence interval) for MVC among the highest quartile group of mean1/RT was 0.31 (0.17-0.57), compared with the lowest group (P for trend<0.01). After stratification by subjective EDS, the significant association was found only among non-subjective EDS group (P for trend<0.01), and not among subjective EDS group (P for trend=0.16). CONCLUSIONS: Decreased psychomotor vigilance measured by PVT was associated with a higher risk of MVC, and the association was more evident among non-subjective EDS group. PVT may be useful to prevent sleep-related MVC in general population, particularly for individuals without subjective EDS.

DOI： 10.5664/jcsm.10328

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Fish and omega-3 fatty acid consumption is known to be beneficial for cardiometabolic health. However, the related evidence for individuals with a relatively higher intake of fish or omega-3 unsaturated fatty acids, e.g., Japanese individuals, is scarce. Therefore, this study aimed to examine the association of fish and omega-3 fatty acid intakes with the carotid intima-media thickness (C-IMT) in the Japanese population. In total, 1803 Japanese men and women aged 30-84 years without a history of myocardial infarction or angina pectoris were included in the study. The fish and omega-3 fatty acid intakes were estimated using food frequency questionnaires. The C-IMT was measured using ultrasound imaging, and the participants were classified into three groups: normal, moderate (1.1 to 1.4 mm of maximum C-IMT), and severely increased C-IMT (≥1.5 mm). Multinomial logistic regression models were used to calculate the odds ratio (OR) and 95% confidence intervals (95% CI) of the presence of moderately and severely increased C-IMT. The omega-3 fatty acid intake was shown to be associated with lower odds of severely increased C-IMT. The multivariable-adjusted OR (95%CI) was 0.55 (0.31-0.97; p for trend = 0.04). We also found a borderline significant negative association between fish intake and the presence of severely increased C-IMT. In conclusion, omega-3 fatty acid intake might protect against the development of atherosclerosis in the Japanese population.

DOI： 10.3390/nu14173644

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

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

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

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

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

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

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

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

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

DOI： 10.11236/jph.22-020

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Psychological stress is considered to be a potential contributor in the development of arterial stiffness. However, an independent association between arterial stiffness and biological markers of stress has not yet been established. We examined the independent association between salivary alpha-amylase (sAA) activity and arterial stiffness, not mediated by cardiometabolic disease associated with arterial stiffness, in a sample of healthy Japanese men and women. Participants (992 in total, 296 men and 696 women aged 30-79 years) had neither previous cardiovascular events or stroke, nor coexisting hypertension, diabetes, or dyslipidemia. Arterial stiffness was measured by the cardio-ankle vascular index (CAVI), and increased CAVI was defined as a CAVI value of 9 or higher. A saliva sample was collected in the morning and sAA was measured with a commercial assay kit. Higher sAA activity was positively associated with greater arterial stiffness particularly among women (β = 0.070; 95% CI = 0.014-0.126; p = 0.01), and not across all participants (β = 0.042; 95% CI = -0.005-0.089; p = 0.08) and in men (β = -0.005; 95% CI = -0.097-0.087; p = 0.91). The association was strongest in the group of women aged 60 years and older (β = 0.121; 95% CI = 0.018-0.224; p = 0.02). Although the association between sAA and increased CAVI (CAVI ≥ 9) was not significant in all and sex subgroups, odds ratios (OR) for CAVI ≥ 7 were significantly high in all participants (OR = 1.25; 95% CI = 1.03-1.53) and women (OR = 1.43; 95% CI = 1.12-1.82). Elevation of sAA was associated with an increase in arterial stiffness, particularly for women aged 60 years or older.

DOI： 10.1038/s41440-022-00963-8

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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

The single nucleotide polymorphisms (SNPs) rs3808607, rs2072183, rs2032582, and rs1761667 are associated with coenzyme Q10 (CoQ10) bioavailability in women after long-term CoQ10 supplementation. However, the beneficial aspects of the association between these SNPs and CoQ10 supplementation remain unknown. We investigated their relationship using the subjective quality of life score SF-36 by reanalyzing previous data from 92 study participants who were receiving ubiquinol (a reduced form of CoQ10) supplementation for 1 year. Two-way repeated-measures analysis of variance revealed a significant interaction between rs1761667 and the SF-36 scores of role physical (p = 0.016) and mental health (p = 0.017) in women. Subgrouping of participants based on the above four SNPs revealed significant interactions between these SNPs and the SF-36 scores of general health (p = 0.045), role emotional (p = 0.008), and mental health (p = 0.019) and increased serum CoQ10 levels (p = 0.008), suggesting that the benefits of CoQ10 supplementation, especially in terms of psychological parameters, are genotype-dependent in women. However, significant interactions were not observed in men. Therefore, inclusion of SNP subgrouping information in clinical trials of CoQ10 supplementation may provide conclusive evidence supporting other beneficial health effects exerted by the association between these SNPs and CoQ10 on women.

DOI： 10.3390/nu14132579

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Language：Japanese   Publisher：日本体質医学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本肥満学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Informa UK Limited  

OBJECTIVES: It has been hypothesized that dietary fiber intake has a beneficial impact on prevention of dementia, but the epidemiological evidence is scant. We sought to examine whether dietary fiber intake is inversely associated with risk of dementia requiring care under the national insurance (disabling dementia). METHODS: The study setting was the Circulatory Risk in Communities Study, involving 3739 Japanese individuals aged 40-64 years at the dietary surveys (1985-99). Dietary fiber intake was estimated using the 24-hour dietary recall method. Incident disabling dementia was followed up from 1999 through 2020. Disabling dementia was further classified into that with or without a history of stroke. Hazard ratios of disabling dementia according to quartiles of total, soluble, and insoluble fiber intake were calculated using the Cox proportional hazards model. RESULTS: During a median 19.7-year follow-up, a total of 670 cases of disabling dementia developed. Dietary fiber intake was inversely associated with risk of dementia: the multivariate hazards ratios (95% confidence intervals) were 0.83 (0.67-1.04), 0.81 (0.65-1.02), and 0.74 (0.57-0.96) for individuals with the second, third, and highest quartiles of dietary fiber intake, respectively, as compared with the lowest quartile (P for trend = 0.03). The inverse association was more evident for soluble fiber intake and was confined to dementia without a history of stroke. As for fiber-containing foods, potatoes, but not vegetables or fruits, showed a similar association. CONCLUSIONS: Dietary fiber intake, especially soluble fiber, was inversely associated with risk of disabling dementia in a general Japanese population.

DOI： 10.1080/1028415x.2022.2027592

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OBJECTIVE: In type 2 diabetes, the significant pathological change in pancreatic islets is amyloid deposits. Its major component is islet amyloid polypeptide (IAPP). The objective of this study was to evaluate the possibility that the effect of the IAPP genotype on β-cell dysfunction in type 2 diabetes is modified by variations in plasma glucose levels. METHODS: Participants from the Toon Genome Study underwent a 75 g OGTT for the diagnosis of glucose tolerance and the evaluation of insulin secretion. We examined the effect of a SNP, rs77397980, on β-cell function by analyzing an interaction (statistics) between the IAPP genotype and AUC glucose. RESULTS: The ratio of the C-allele carriers was essentially the same among subjects with normal glucose tolerance, impaired glucose tolerance and diabetes. In subjects with diabetes, along with an increase in AUC glucose, fasting insulin remained constant in the T/T homozygotes and appeared to decrease in the C-allele carriers. A homeostasis model assessment (HOMA)-IR appeared to be increased in the former and decreased in the latter. In subjects with diabetes stratified into cases with higher AUC glucose than the median, fasting insulin and HOMA-IR were lower in the C-allele carriers than in the T/T homozygotes. An interaction between the IAPP genotype and AUC glucose was indicated in the effect on HOMA-IR. CONCLUSIONS: The possibility that the association between IAPP genotype and basal insulin level is modified by variation in plasma glucose, resulting in a decreased basal insulin in type 2 diabetes, cannot be excluded. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13340-021-00523-4.

DOI： 10.1007/s13340-021-00523-4

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

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

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

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Eating disorders are serious psychiatric conditions in terms of chronicity and have the highest mortality rate among psychiatric disorders. The assessment and treatment of eating disorders are also challenging, due to patients' denial of their illness and reluctance for change. Despite a large number of previous assessment and treatment studies, new strategies to overcome these difficulties are still needed. This study casts light on four aspects; involvement of the brain's reward system, stages of change in relationship with motivation, refeeding syndrome during renourishment, and gut microbiota changes relating to chronicity. Further studies relating to these aspects are encouraged.

DOI： 10.3177/jnsv.68.S46

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

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

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

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

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

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There is limited evidence regarding the combined effects of sleep-disordered breathing (SDB) and alcohol consumption on hypertension. The aim of this study was to examine the combined effects of SDB and alcohol consumption on hypertension in Japanese male bus drivers. This cross-sectional study included 2525 Japanese male bus drivers aged 20-65 years. SDB was assessed using a single-channel airflow monitor, which measured the respiratory disturbance index (RDI) during overnight sleep at home. Alcohol consumption (g/day) was assessed by a self-administered questionnaire and calculated per unit of body weight. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg and/or use of antihypertensive medications. Multiple logistic regression analyses were performed to examine the association of the combined categories of RDI and alcohol consumption with hypertension. The multivariable-adjusted odds ratio (OR) and 95% confidence interval (95% CI) of hypertension for the alcohol consumption ≥1.0 g/day/kg and RDI ≥ 20 events/h group were 2.41 (1.45-4.00) compared with the alcohol consumption <1.0 g/day/kg and RDI < 10 events/h group. Our results suggest that Japanese male bus drivers with both SDB and excessive alcohol consumption are at higher risk of hypertension than those without SDB and excessive alcohol consumption, highlighting the importance of simultaneous management of SDB and excessive alcohol consumption to prevent the development of hypertension among bus drivers.

DOI： 10.1038/s41440-021-00674-6

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

Tocopherols, strong antioxidants, may be useful in preventing dementia, but the epidemiological evidence is insufficient. We performed a community-based follow-up study of Japanese, the Circulatory Risk in Community Study, involving 3739 people aged 40-64 years at baseline (1985-1999). Incident disabling dementia was followed up from 1999 through 2020. For subtype analysis, we classified disabling dementia into that with and that without a history of stroke. Dietary intake of tocopherols (total, α, β, γ, and δ) were estimated using 24-h recall surveys. During a median follow-up of 19.7 years, 670 cases of disabling dementia developed. Total tocopherol intake was inversely associated with risk of disabling dementia with multivariable hazard ratios (95% confidence intervals) of 0.79 (0.63-1.00) for the highest versus lowest quartiles of total tocopherol intake (P for trend = 0.05). However, the association was strengthened when further adjusted for α-linolenic acid intake (Spearman correlation with total tocopherol intake = 0.93), with multivariable hazard ratios of 0.50 (0.34-0.74) (P for trend = 0.001) but was weakened and nonsignificant when further adjusted for linoleic acid intake (Spearman correlation with total tocopherol intake = 0.92), with multivariable hazard ratios of 0.69 (0.47-1.01) (P for trend = 0.05). Similar but nonsignificant inverse associations were observed for α-, γ-, and δ-tocopherols but not for β-tocopherol. These results were similar regardless of the presence of a history of stroke. Dietary tocopherol intake was inversely associated with risk of disabling dementia, but its independent effect was uncertain owing to a high intercorrelation of α-linolenic linoleic acids with total tocopherol intake. Even with such confounding, a diet high in tocopherols may help prevent the onset of dementia.

DOI： 10.1038/s41598-021-95671-7

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Language：Japanese   Publisher：日本体質医学会  

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This study evaluated the Timed Up & Go test (TUG) among healthy Japanese individuals without walking problems to clarify the relationship of TUG performance with physical characteristics and physical activity according to sex and age groups. In total, 797 men and women (30-84 years old) in Toon City, Ehime Prefecture, were assessed from 2016 to 2017. The survey data for physical characteristics, TUG performance, and physical activity measures were used. After adjusting for age according to TUG time and categorization into sex and age groups (30-64 and 65-84 years), the relationship of TUG performance with physical characteristics and physical activities was confirmed using multiple regression analysis. In men, TUG performance was associated with work and household chores in the 30-64-year age group, whereas it was only associated with skeletal muscle mass among those older than 65 years. In women, TUG performance was associated with height and amount of exercise, regardless of age. In conclusion, TUG performance may be maintained by increasing the amount of physical activity for men through work and housework, and increasing the amount of exercise for women, which may prevent the need for long-term care in the future.

DOI： 10.3390/healthcare9080933

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

The association between the intake of non-alcoholic beverages and CVD in Asians is uncertain. The intake of non-alcoholic beverages was estimated in 77 407 participants of the Japan Public Health Centre-based cohort study aged 45-74 years. The Cox regression calculated the hazard ratios (HR) and 95 % CI for incident CVD according to sex-specific quintiles of intake of non-alcoholic beverages. A total of 4578 incident CVD (3751 strokes and 827 CHD) were diagnosed during a 13·6-year median follow-up. The risks of stroke and total CVD were lower for the highest v. lowest intake quintiles of non-alcoholic beverages in men and women: the multivariable HRs (95 % CIs) were 0·82 (0·71, 0·93, Ptrend = 0·005) and 0·86 (0·76, 0·97, Ptrend = 0·02), respectively, in men and were 0·73 (0·63, 0·86, Ptrend = 0·003) and 0·75 (0·65, 0·87, Ptrend = 0·005), respectively, in women. The reduced risk was evident for both ischaemic and haemorrhagic strokes and was mainly attributable to green tea consumption. The intake of non-alcoholic beverages from coffee and other beverages was not associated with the risk of CVD in both men and women. Also, there was no association between the intake of non-alcoholic beverages and the risk of CHD in either sex. In conclusion, the risks of stroke and total CVD were lower with a higher intake of non-alcoholic beverages in Japanese men and women.

DOI： 10.1017/S0007114521002737

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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

BACKGROUND: We conducted a randomized controlled trial to investigate the effects of consumption of yogurt fermented with Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1 in women healthcare workers. In a previous study we used these data to investigate hypothesized preventive effects against flu, however any effects on improving mental quality of life were not analyzed at that time. In the present study, we focus on that aspect. METHODS: The participants (961 women; mainly nurses, aged 20-71 years) were randomly allocated to either the yogurt group (n = 479) or the control group (n = 482). Participants in the yogurt group drank 112 mL of OLL1073R-1 yogurt for 16 weeks, while those in the control group did not consume any yogurt. All participants were prohibited from consuming other yogurt or fermented dairy products during the study period. The participants answered the Pittsburgh Sleep Quality Index (PSQI), Short Form-8 Health Survey (SF-8), and Gastrointestinal Symptom Rating Scale (GSRS) questionnaires at baseline and after 16 weeks. RESULTS: The PSQI score showed significant improvement after the intake of yogurt (p < 0.01). SF-8 results showed significant intervention effects in the General Health and Vitality scores (p = 0.02 and p = 0.01, respectively). In other subscales of SF-8, we did not observe significant effects of the yogurt. In the GSRS, daily intake of yogurt exerted a preventive effect on constipation (p = 0.03). CONCLUSIONS: Consumption of yogurt fermented with Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1 enhances subjective psychological quality of life by improving quality of sleep and gastrointestinal condition among women healthcare workers.

DOI： 10.1186/s12876-021-01793-7

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PURPOSE: With a rapidly aging society, there is increasing interest in the health of female workers in the field of care services for older adults due to increasing demands to maintain 24-h care and to support older adults without errors or accidents. Therefore, the purpose of this cross-sectional study was to examine the association between sleep-disordered breathing (SDB) and sustained attention in women caring for older adults in Japan. METHODS: The study was conducted in women aged 18-67 years old working in care service facilities for older adults in Japan. The sustained attention of participants was measured by the 10-min psychomotor vigilance task (PVT). SDB was assessed based on the respiratory disturbance index (RDI), which was measured using an ambulatory airflow monitor with a polyvinylidene fluoride (PVDF) film sensor to monitor the respiratory airflow of nasal and oral breathing. The participants wore the monitor to record the breathing status while asleep at home. The severity of SDB was categorized as follows: normal, RDI < 5 events/h; mild SDB, RDI 5-10 events/h; and moderate-to-severe SDB, RDI ≥ 10 events/h. RESULTS: Of 688 women enrolled, medians of age, body mass index (BMI), sleep duration, and prevalence of hypertension tended to be higher with increasing RDI. No significant association was found between RDI and PVT parameters. However, when we limited the analysis to women with BMI ≥ 22 kg/m2, those with moderate-to-severe SDB had significantly higher odds of having the slowest 10% reaction times compared to those without SDB (OR = 2.03; 95% CI = 1.17-3.53). The association did not decrease after adjusting to account for sleep duration, alcohol drinking habits, and history of hypertension (OR = 1.97; 95% CI = 1.10-3.52). A significant increasing trend was also found between RDI and the slowest 10% of reaction times (p for trend = 0.03). CONCLUSIONS: Our findings suggest that SDB is associated with reduced sustained attention in participants with BMI ≥ 22 kg/m2, although the number of assessments of SDB and PVT was only once per participant due to the nature of the cross-sectional study.

DOI： 10.1007/s11325-021-02389-x

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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DOI： 10.5551/jat.ED166

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

OBJECTIVE: The association between work-family conflict and insomnia has not been thoroughly studied. Therefore, we sought to examine the relationship between work-family conflict and insomnia symptoms among Japanese working women. METHODS: In a cross-sectional study, 608 women aged 18-60 years old who worked in aged care services between 2015 and 2016 were selected, and 445 of these women were ultimately included. Insomnia symptoms were measured using the Athens Insomnia Scale. Work-to-family conflict (WFC) and family-to-work conflict (FWC) were assessed through a self-administered questionnaire and were divided into four categories: low work-family conflict (low WFC and FWC), high FWC, high WFC, and high work-family conflict (high WFC and FWC). The prevalence ratio (PR) and 95% confidence interval (CI) of insomnia symptoms were calculated using a Poisson regression model after multivariable adjustment. RESULTS: The multivariable-adjusted PR (95% CI) of insomnia symptoms was 1.99 (1.34-2.93) in the high work-family conflict group compared to the low work-family conflict group. CONCLUSIONS: The results from the present study suggest that insomnia symptoms are highly prevalent among working women in aged care services with high work-family conflict.

DOI： 10.1016/j.sleep.2021.03.034

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

本研究では,トランス脂肪酸摂取量を推定するための食品成分表を作成することを目的とした。さらにこの成分表を用い,実際の摂取食品についてトランス脂肪酸量を推定し得るか,食事記録調査結果を対象に確認を行った。23文献に報告のある280食品のトランス脂肪酸量は平均値を求め,食品成分表記載の各食品の脂質を乗じ可食部100g当たりに含まれるトランス脂肪酸量を算出した。文献に報告のない食品の内,312食品は置き換え法にて対応,計592食品のトランス脂肪酸含有量を決定した。その食品成分表を用い,糖尿病境界型の男女35名が実施した食事記録から1日平均のトランス脂肪酸摂取量を算出した。本対象集団が摂取していた可食部100g当たりの脂質量が1g以上の食品延べ4,539食品の内,4,535食品(99.9%)のトランス脂肪酸量が算出し得,1日当たりの平均トランス脂肪酸摂取量は0.66g(エネルギー比率:0.33%)であった。本成分表は,置き換え法による食品数の占める割合が高いこと等の限界に留意する必要があるものの,多数の食品に対して数値を求めていることから,異なる日本人集団や食事記録以外の食事調査法での応用も可能なものと考える。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01614&link_issn=&doc_id=20210422450004&doc_link_id=%2Fda0eisho%2F2021%2F007402%2F004%2F0093-0101%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fda0eisho%2F2021%2F007402%2F004%2F0093-0101%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Nature  

The original version of this article unfortunately contained a mistake in the ESM. The original article has been corrected.

DOI： 10.1038/s41366-021-00770-0

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AIM: Seaweed contains soluble dietary fibers, potassium, and flavonoids and was recently reported to be inversely associated with the risk of coronary heart disease and mortality from stroke. However, epidemiological evidence on this issue has remained scarce. METHODS: At the baseline survey of four Japanese communities between 1984 and 2000, we enrolled 6,169 men and women aged 40-79 years who had no history of cardiovascular disease. We assessed their seaweed intake using the data from a 24 h dietary recall survey and categorized the intake into four groups (0, 1-5.5, 5.5-15, and ≥ 15 g/day). We used sex-specific Cox proportional hazards models to examine the association between seaweed intake and risk of cardiovascular disease (stroke, stroke subtypes, and coronary heart disease). RESULTS: During the 130,248 person-year follow-up, 523 cases of cardiovascular disease occurred: 369 cases of stroke and 154 cases of coronary heart disease. Seaweed intake levels were inversely associated with the risk of total stroke and cerebral infarction among men but not among women. Adjustment for cardiovascular risk factors did not change the associations: the hazard ratios (95% confidence intervals; P for trend) for the highest versus lowest categories of seaweed intake were 0.63 (0.42-0.94; 0.01) for total stroke and 0.59 (0.36-0.97; 0.03) for cerebral infarction. No associations were observed between seaweed intake and risks of intraparenchymal hemorrhage, subarachnoid hemorrhage, or coronary heart disease among men or women. CONCLUSIONS: We found an inverse association between seaweed intake and risk of total stroke, especially that from cerebral infarction, among Japanese men.

DOI： 10.5551/jat.61390

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To clarify how low BMI and weight loss were associated with risk of chronic obstructive pulmonary disease (COPD) mortality, in a large prospective cohort of the general population across Japan, the Japan Collaborative Cohort Study, conducted between 1988 and 2009. A total of 45,837 male residents were observed for a median period of 19.1 years. Self-administered questionnaires, collecting information on BMI, weight loss since the age of 20, lifestyles, history of diseases, as well as records of COPD mortality, were analysed at 2019. During follow-up, 268 participants died from COPD. The multivariate-adjusted hazard ratio (95% confidence interval) of COPD mortality associated with a 1-SD increment of body mass index (BMI) was 0.48 (0.41-0.57), while for weight change from age of 20 (+ 2.0 kg) it was 0.63 (0.59-0.68). These associations were persistently observed after stratifications with smoking status, excluding those having airway symptoms in the baseline survey, and excluding early COPD deaths within 5, 10 and 15 years. Our study suggests that BMI and weight change since the age of 20 could be markers for COPD prognosis, indicated by risk of COPD mortality.

DOI： 10.1038/s41598-020-79860-4

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BACKGROUND/OBJECTIVES: The mediating role of eating behaviors in genetic susceptibility to weight gain during mid-adult life is not fully understood. This longitudinal study aims to help us understand contributions of genetic susceptibility and appetite to weight gain. SUBJECTS/METHODS: We followed the body-mass index (BMI) trajectories of 2464 adults from 45 to 65 years of age by measuring weight and height on four occasions at 5-year intervals. Genetic risk of obesity (gene risk score: GRS) was ascertained, comprising 92 BMI-associated single-nucleotide polymorphisms and split at a median (=high and low risk). At the baseline, the Eating Inventory was used to assess appetite-related traits of 'disinhibition', indicative of opportunistic eating or overeating and 'hunger' which is susceptibility to/ability to cope with the sensation of hunger. Roles of the GRS and two appetite-related scores for BMI trajectories were examined using a mixed model adjusted for the cohort effect and sex. RESULTS: Disinhibition was associated with higher BMI (β = 2.96; 95% CI: 2.66-3.25 kg/m2), and accounted for 34% of the genetically-linked BMI difference at age 45. Hunger was also associated with higher BMI (β = 1.20; 0.82-1.59 kg/m2) during mid-life and slightly steeper weight gain, but did not attenuate the effect of disinhibition. CONCLUSIONS: Appetite disinhibition is most likely to be a defining characteristic of genetic susceptibility to obesity. High levels of appetite disinhibition, rather than hunger, may underlie genetic vulnerability to obesogenic environments in two-thirds of the population of European ancestry.

DOI： 10.1038/s41366-020-00735-9

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CAMBRIDGE UNIV PRESS  

To examine the associations of salt perception with salt intake and blood pressure levels in general populations, we performed a cross-sectional study in two communities where salt intake level is different, Akita and Osaka in Japan. Taste perception (detection for certain taste and recognition for salt taste) was determined using a Na-impregnated test strip for 1024 Akita and 1199 Osaka adults aged 30-74 years. The proportions of detection for 0 center dot 1 % salt were 61, 62, 79, and 79 % in Akita men, Osaka men, Akita women and Osaka women, respectively. The corresponding proportions of not recognising of 1 center dot 6 % salt taste (>1 center dot 6 %) were 34, 30, 16 and 21 %. Detection threshold was higher in Akita than in Osaka for women aged 60-74 years, and recognition threshold was lower in Akita than in Osaka for women aged 30-59 and 60-74 years. The high detection (>= 0 center dot 4 %) and recognition (>1 center dot 6 %) thresholds of salt taste were associated with higher salt intake scores for Akita men aged 30-59 years, whose detection and recognition thresholds tended be positively associated with systolic and diastolic blood pressures (SBP and DBP) after adjustment for potential confounders. Among Akita elderly men, detection threshold tended to be positively associated with SBP and DBP, while among Akita middle-aged women, recognition threshold was associated with SBP. In conclusion, the high thresholds of salt perception were inversely associated with salt intake for Akita middle-aged men and with blood pressure levels for Akita middle-aged and elderly men and middle-aged women.

DOI： 10.1017/S0007114520002640

Web of Science

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Publishing type：Research paper (scientific journal)  

Aims: Patients with chronic kidney disease (CKD) have a higher burden of cardiovascular morbidity and mortality than the general population. Endothelial dysfunction has been suggested to play a role in both glomerular filtration rate loss and cardiovascular damage. Thus, the present study aimed to evaluate the relationship between endothelial dysfunction and the prevalence of CKD in the general Japanese population. Methods: We conducted a cross-sectional study of 1042 men and women aged 30-81 years in two communities under the Circulatory Risk in Communities Study between 2013 and 2017. Endothelial function was evaluated by percent change of brachial artery flow-mediated dilation (%FMD) before and after the cuff inflation. Results: Among the total 1042 participants, there were 62 cases of CKD (~6%). The multivariable odds ratios (ORs) (95% confidence intervals [CIs]) of CKD according to quartiles of %FMD were 2.02 (0.68-5.99), 3.56 (1.27-9.94), and 3.14 (1.10-8.93) for the third to lowest quartile compared with the highest %FMD quartile; p for trend=0.02. The respective multivariable ORs (95% CIs) of CKD in subjects without antihypertensive medication use (39 cases among 886 subjects) were 1.83 (0.46-7.33), 3.41 (0.92-12.61), and 4.60 (1.22-17.31); p for trend=0.01, and that for one-point decrement in %FMD was 1.16 (1.00-1.35); p for interaction with the status of antihypertensive medication use was 0.12. Conclusions: Our cross-sectional study suggested the relationship between endothelial dysfunction and the higher prevalence of CKD in the general Japanese population.

DOI： 10.5551/jat.56424

Scopus

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

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

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

Sleep disordered breathing (SDB) is a significant cause of motor vehicle crash (MVC). We conducted a prospective cohort study among 1047 Japanese community-dwellers to detect whether the presence or absence of subjective excessive daytime sleepiness (EDS) affect the association of SDB with a risk of MVC. SDB was assessed by a single airflow monitor which measured the respiratory disturbance index (RDI) during one-night, and participants were classified into the SDB group (RDI ≥ 10) and non-SDB group (RDI < 10). Subjective EDS was defined as Japanese version of Epworth Sleepiness Scale scores ≥ 11. A follow-up questionnaire five years after the baseline ascertained history of MVC over the period. Multivariable logistic regression analysis examined the association between SDB and MVC after stratification by subjective EDS. The multivariable-adjusted odds ratios (95% confidence interval) for MVC among the female SDB group were 1.66 (1.05-2.63) compared with the non-SDB group, and this association was more evident in females without subjective EDS [1.84(1.02-3.32)], but not among those with subjective EDS. There was no significant association in males. These findings indicate that SDB screening should be recommended regardless of subjective EDS to prevent SDB-related MVC among general population, particularly in females.

DOI： 10.1038/s41598-020-74132-7

PubMed

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

AIMS: Stress is known to be a potential contributor to the development of diabetes and hypertension. However, the biological mechanisms underlying the association between cardiometabolic risk markers and the biological stress response have not yet been determined. Therefore, we examined salivary alpha-amylase and heart rate variability in relation to cardiometabolic status in a sample of healthy Japanese men and women. METHODS: Participants (473 men and 1,029 women aged 30-84) underwent a 75 g oral glucose tolerance test after a 10-hr fast. The homeostasis model assessment index for insulin resistance was based on fasting and 2-hr postload glucose and insulin concentrations. Sitting blood pressure was measured twice after rest. A saliva sample was collected in the morning and salivary alpha-amylase was assayed. A 5-min heart rate variability recording was evaluated using time-domain indices of standard deviations of normal-to-normal intervals and root mean square of successive differences. Multivariate linear regression models were used to estimate associations between salivary alpha-amylase and each outcome measure. RESULTS: Salivary alpha-amylase was associated with fasting glucose (β=0.008; 95% CI=0.002, 0.014), 2-hr postload glucose (β=0.023; 95% CI=0.004, 0.041), homeostasis model assessment index for insulin resistance (β=0.032; 95%CI=0.000, 0.064), systolic (β=1.603; 95% CI=0.479, 2.726) and diastolic (β=0.906; 95% CI=0.212, 1.600) blood pressures among women. These associations remained significant after further adjustment for heart rate variability measures. CONCLUSIONS: The elevation of salivary alpha-amylase may reflect a dysfunction of the sympathetic nervous system associated with cardiometabolic abnormalities in women.

DOI： 10.5551/jat.53926

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

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

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BACKGROUND: Autonomic activity is possibly influenced by physical activity (PA). However, it remains unclear whether this association is modified by insulin resistance. METHODS: This population-based study between 2009 and 2012 included 2016 men and women aged 30-79 years. The PA was assessed using a validated questionnaire based on sleep, occupation, transportation, household characteristics, and leisure-time PA. Heart rate (HR) and heart rate variability (HRV) in the sitting position were determined from 5-minute recordings of pulse waves detected by a fingertip sensor. The HRV was calculated as frequency (standard deviation of normal-to-normal [NN] intervals [SDNN]), root mean square of successive differences (RMSSD), and percentage differences between normal NN intervals >50 milliseconds [pNN50]) and time domains. Insulin resistance was evaluated using the homeostasis model assessment index (HOMA-IR). RESULTS: HR, RMSSD, and pNN50 were related to the total and moderate/vigorous PA tertiles in models that included HOMA-IR. The partial regression coefficient of total PA per 1-SD increase was .05 (P = .019) for log-transformed RMSSD and 1.86 (P = .001) for pNN50. No interactive associations were observed between PA and HOMA-IR. CONCLUSIONS: Low total PA was associated with increased HR and low levels of RMSSD and pNN50, reflecting parasympathetic modulation that was not modified by insulin resistance.

DOI： 10.1123/jpah.2020-0110

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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

BACKGROUND: Studies on the association between asthma and anxiety in Asian children are limited. Therefore, we aimed to evaluate the association between asthma and anxiety among Japanese elementary school students. METHODS: A cross-sectional study of the association between asthma and anxiety in primary school children in Matsuyama City was conducted in 2014. The questionnaires included inquiries on asthma, anxiety, and other demographic variables. After excluding missing values, 17 752 (51.5% male) children were included in the analysis. The presence of asthma (yes/no) was answered by guardians. A score of four or more on the emotional symptom subscale of the strengths and difficulties questionnaire was considered as having anxiety. A Rohrer index score of 145 or more was considered as overweight. We estimated the prevalence ratio (PR) of having anxiety in relation to the presence of asthma based on the Poisson regression model. RESULTS: The multivariate PR (95% confidence interval) of having anxiety in asthmatic boys compared with non-asthmatic boys was 1.56 (1.21-1.99). The association was more evident in older than younger boys, where PR = 1.32 (0.93-1.88) for younger versus 1.87(1.32-2.64) for older boys (P for interaction = .08); and in non-overweight boys than overweight, where PR = 1.64 (1.27-2.13) and 0.94 (0.41-2.19) (P for interaction = .22), respectively. Similar associations were not found for girls. CONCLUSION: Asthma was significantly associated with anxiety in boys, particularly in older boys.

DOI： 10.1002/ppul.24986

PubMed

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Language：Japanese   Publisher：(一社)日本老年医学会  

目的:飲酒と認知症に関する海外の研究のメタ分析では,飲酒量が少量の場合には発症リスクが低く,大量の場合には高い結果が示されている.しかし,アルコール代謝や飲酒文化が異なるわが国のエビデンスは限定的である.そこで本研究では,平均飲酒量と認知症前段階の軽度認知障害(Mild Cognitive Impairment,以下MCIと略)との関連について検討した.方法:2014〜2017年に愛媛県東温市の地域住民に実施した疫学研究「東温スタディ」に参加した60〜84歳の男性421名,女性700名を本研究の対象とした.質問調査によって飲酒頻度,酒の種類別飲酒量を把握し,1日あたりの平均飲酒量を推定した.またJapanese version of Montreal Cognitive Assessmentを実施し,26点未満をMCIと定義した.男女別に現在飲まない群に対する平均飲酒量について男性3群,女性2群に分け各群のMCIの多変量調整オッズ比(95%信頼区間)をロジスティック回帰モデルにて算出した.さらに,ビール,日本酒,焼酎(原液),ワインについては,日本酒1合相当あたりの多変量調整オッズ比(95%信頼区間)を算出した.結果:男性212名(50.4%),女性220名(31.4%)がMCIに判定された.男性では,現在飲まない群に比べて,1日平均2合以上の群のMCIの多変量調整オッズ比(95%信頼区間)は1.78(0.93〜3.40,傾向性p=0.045)であったが,女性では有意な関連は認められなかった(「1合以上」群の多変量調整オッズ比:95%信頼区間=0.96:0.39〜2.38,傾向性p=0.92).この関連は,高血圧者において明確に認められた.また酒の種類別の解析では,男性において焼酎(原液)については多変量調整オッズ比(95%信頼区間)が1.57(1.18〜2.07)と有意に高かった.結論:男性において平均飲酒量が多いほどMCIのリスクが高い可能性が示された.この関連は高血圧者においてより明確であった.(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01214&link_issn=&doc_id=20200910170011&doc_link_id=10.3143%2Fgeriatrics.57.300&url=https%3A%2F%2Fdoi.org%2F10.3143%2Fgeriatrics.57.300&type=Crossref&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00002_2.gif

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

AIMS/INTRODUCTION: Low birthweight is reportedly associated with type 2 diabetes mellitus; however, this association has not been confirmed in the Japanese population, and whether high birthweight is associated with type 2 diabetes mellitus is controversial. We aimed to investigate the association between birthweight and type 2 diabetes mellitus among a general Japanese population. MATERIALS AND METHODS: Overall 1,135 middle- to old-aged Japanese men and women were enrolled in the Toon Health Study. A 75-g oral glucose tolerance test was used to diagnose type 2 diabetes mellitus, and a questionnaire survey about birthweight was administered. The association between birthweight and the prevalence of type 2 diabetes mellitus in later life of the participants was examined using multivariable logistic regression analysis. Stratified analysis by current body mass index was also carried out. RESULTS: The mean age was 56.5 ± 12.2 years. Type 2 diabetes mellitus was observed in 9.3% of the participants in this study. Compared with the reference group (2,500-3,999 g), the adjusted odds ratio of the low-birthweight group (<2,500 g) for type 2 diabetes mellitus was 2.46 (95% confidence interval 1.48-4.10). The association between the high-birthweight group (≥4000 g) and type 2 diabetes mellitus was not significant after including family history of diabetes in the multivariable model. The odds ratio of the low-birthweight group for type 2 diabetes mellitus was higher in the overweight/obese group than in the non-overweight group. CONCLUSIONS: Low birthweight was associated with an increased risk of type 2 diabetes mellitus in a Japanese population, especially in overweight/obese individuals.

DOI： 10.1111/jdi.13274

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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

BACKGROUND: The proportion of non-regularly employed persons has increased in Japan, but few studies have examined the relationship between employment status and lung cancer screening (LCS) participation. METHODS: Authors analyzed data from the 2010 Comprehensive Survey of Living Conditions in Japan. The anonymous responses of 28,951 people aged 40-69 years old were analyzed. Authors defined nine employment status categories: unemployed, regularly employed in a large-, middle-, and small-scale company, non-regularly employed in a large-, middle-, and small-scale company, self-employed, and other. LCS participation in the past year was surveyed through a self-reported questionnaire. Sex-specific prevalence ratios (PRs) and 95% confidence intervals (CIs) for LCS participation for all employment status categories, using the regularly employed in a middle-scale company category as the reference, were calculated using multivariable Poisson regression analysis, after adjusting for potentially confounding factors. RESULTS: Multivariable-adjusted PRs (95% CI) for LCS participation for the regularly employed in a large-scale company were 1.33 (1.25-1.41) in men and 1.53 (1.38-1.71) in women. Multivariable-adjusted PRs (95% CI) for LCS participation for the non-regularly employed in a middle- and small-scale company compared with the regularly employed in a middle-scale company were 0.81 (0.72-0.92) and 0.62 (0.50-0.76) in men, and 0.89 (0.80-0.99) and 0.80 (0.71-0.91) in women, respectively. CONCLUSION: Regularly employed in a large-scale company had significantly higher LCS participation, and non-regularly employed in a middle- or small-scale company showed significantly lower LCS participation than those who were regularly employed in a middle-scale company.

DOI： 10.1007/s10147-019-01594-9

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

The role of serum uric acid as a predictor of stroke among the general Japanese population remains controversial. We conducted a prospective cohort study of 5235 men and 8185 women aged 40-79 years at baseline between 1985 and 1994 in four Japanese communities, who were initially free from stroke, coronary heart disease, and medication for hyperuricemia or gout. Cox proportional hazards models were used to estimate sex-specific hazard ratios of stroke and its types in relation to serum uric acid level. During a median follow-up of 23.1 years, we recorded 1018 (488 men and 530 women) incident strokes, including 222 (99 and 123) intraparenchymal hemorrhages, 113 (33 and 80) subarachnoid hemorrhages and 667 (347 and 320) ischemic strokes. After adjustment for age, community and known cardiovascular risk factors, the multivariable hazard ratios (95% CIs) in the highest vs. lowest quintile of serum uric acid were 1.45 (1.07-1.96) for total stroke, 1.20 (0.65-2.20) for intraparenchymal hemorrhage, 1.46 (0.69-3.09) for subarachnoid hemorrhage and 1.61 (1.07-2.41) for ischemic stroke in women. The corresponding multivariable hazard ratios (95% CIs) in men were 1.02 (0.74-1.35), 0.83 (0.40-1.72), 1.19 (0.38-3.75) and 1.00 (0.70-1.41). Furthermore, those positive associations with risks of total and ischemic strokes in women were more evident in nonusers of antihypertensive medication than the users. In conclusion, elevated serum uric acid level is an independent predictor of total stroke in women but not in men. The positive association in women was mostly attributable to ischemic stroke and was more pronounced among nonusers of antihypertensive medication.

DOI： 10.1038/s41440-019-0385-5

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

AIMS: In this study, the effects of licorice flavonoid oil (LFO) supplementation on mobility functions were evaluated in middle-aged and older women who underwent daily physical exercise. METHODS: The 73 women aged 59-85 years (71.2 ± 5.2 years) were randomly assigned to the LFO group (n = 37) or the placebo group (n = 36). For 16 weeks, the LFO group consumed a daily capsule containing 300 mg of LFO, while the placebo group consumed a placebo capsule. All participants were instructed to complete a strength training program during the 16 weeks and to increase their daily step count by 1000. 10-m walking speed (with/no obstruction), one-leg standing time with eyes open, handgrip strength, isometric knee extension strength, and body composition were evaluated at baseline and every eight weeks. RESULTS: In the 10-m walking speeds (with/no obstruction), LFO supplementation did not show significant improvements. One-leg standing time was significantly prolonged with LFO intake (LFO: baseline 73.9 s vs 16 weeks 93.5, placebo: baseline 82.8 vs 16 weeks 87.1, p = 0.03). In addition, a significant decrease in BMI and body fat percentage with LFO was found (p = 0.01, p = 0.03, respectively). DISCUSSION: Since a lower BMI corresponds to a lighter physical load on the lower limb, in addition, since LFO might improve skeletal muscle function by antioxidant activity, participants could stand longer and body balance control was improved. CONCLUSION: LFO supplementation improved body balance control and may contribute to fall prevention in healthy middle-aged and older women having daily physical exercise. TRIAL REGISTRATION: UMIN Clinical Trial Registry No. 000029712.

DOI： 10.1007/s40520-020-01513-3

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Publishing type：Research paper (scientific journal)  

Objective: It has been suggested that urbanization, which has been expanding rapidly for the past several decades, increases the risk of cardiovascular disease (CVD) associated with psychological factors such as anger, but the evidence is limited. We examined the hypothesis that urbanicity modifies the association of anger expression with the risk of CVD. Methods: A prospective study was conducted in 5936 residents of urban and rural communities aged 40 to 79 years who had completed an annual health checkup including a questionnaire on anger expression between 1995 and 1998. Associations of anger expression with the risk of CVDs were examined using Cox proportional hazards models, after adjusting for classical cardiovascular risk factors. Results: During a median follow-up of 16.6 years, we identified 312 incident CVDs. The means (SDs) of anger expression were 24.7 (5.8) among urban residents and 24.6 (5.7) among rural participants (p = .87). Among urban residents, anger expression was positively associated with the risk of total CVD: the multivariable hazard ratio (95% confidence interval) was 1.27 (1.05–1.54). In contrast, no association was found among rural residents: the corresponding ratio (interval) was 0.96 (0.85–1.09), with a significant interaction between urban and rural residency with anger expression for incident CVD (p = .047). Similar associations were observed with the risk of CVD subtypes, including ischemic stroke and ischemic CVD. Conclusions: We found a positive association between anger expression and the risk of CVD among urban residents but not rural residents, suggesting that urbanicity enhances the anger-CVD association.

DOI： 10.1097/PSY.0000000000000775

Scopus

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

BACKGROUND: We aimed to evaluate the association between hyperactivity/anxiety and obesity among elementary school students in Matsuyama City, Japan. METHODS: We conducted a cross-sectional study of all 46 elementary school students (24, 296 students) in Matsuyama City. The questionnaire included question items from the Strengths and Difficulties Questionnaire (SDQ), as well as questions about height and weight. The students were classified into two groups according to Rohrer index. After separating the data by gender, we examined the association between (1) obesity and hyperactivity, (2) obesity and anxiety, and (3) obesity and combination of hyperactivity and anxiety, by estimating relative risk using Poisson regression model. We also conducted stratified analyses to examine the effect modification by age groups and unbalance of diet on those associations. Moreover, we calculated relative excess risk due to the interaction (RERI) to examine whether there was an additive interaction between hyperactivity and anxiety. RESULTS: Sixteen thousand forty-eight students were included in the present analysis. The prevalence ratio (PR) of being obese in girls who had both hyperactivity and anxiety was higher compared to girls without those symptoms (PR = 1.80; 95% CI 1.04-3.13). There was no significant difference in the prevalence ratio for obesity in boys, whether they were hyperactive, anxious, or neither. RERI was 0.00 for boys and 0.18 for girls. CONCLUSION: We found a significant association between obesity and co-existence of hyperactivity and anxiety among elementary school girls. Our findings strengthen the need to further explore the association between childhood obesity, hyperactivity, and anxiety.

DOI： 10.1007/s12529-019-09827-x

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

BACKGROUND: Many overworked employees need tools to improve their depressive mood or sleep disorder. In Finland, a new device of bright light therapy was developed. OBJECTIVE: Our objective was to evaluate the effect of bright light treatment via ear canals on improving the depressive mood and sleep disorder. METHODS: We conducted a randomized, controlled, crossover designed, open-label trial. We examined 27 participants aged 23-52 years, assigned to either Early treatment or Later treatment groups. The Early treatment group used the device on weekdays for the first 4 weeks, followed by a 4-week observation period. The Later treatment group had an observation period for the first 4 weeks, followed by device treatment for the subsequent 4 weeks. Every Friday, the participants were asked to answer questionnaires: A Self-rating Depression Scale (SDS), an Athens Insomnia Scale (AIS), and a Profile of Mood States (POMS) Brief Form. RESULTS: While no significant effect was found on the SDS following treatment (p = 0.16), the AIS showed a significant improvement (p = 0.004), and the scores for the Depression (D) and Vigor (V) of POMs decreased significantly (p = 0.045, p = 0.006, respectively). CONCLUSIONS: Bright light treatment via ear canals may improve sleep quality and depressive mood.

DOI： 10.3233/WOR-203282

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

AIM: The effects of alcohol consumption on Mild Cognitive Impairment (MCI) among the Japanese population had not been fully examined. Therefore, the objective of this study was to examine the association between alcohol consumption and MCI among the Japanese elderly population. METHODS: In total, 421 men and 700 women aged 60-84 years participated in this cross-sectional study. Alcohol consumption was estimated according to frequency and amount of major alcoholic beverages (i.e., beer, Japanese sake, shochu, and wine) consumed by each individual using a self-administered questionnaire. MCI was assessed using the Japanese version of the Montreal Cognitive Assessment. Multivariable odds ratio (OR) and 95% confidence intervals (CIs) of MCI according to alcohol consumption were calculated using logistic models. We further analyzed the associations of the major alcoholic beverages with MCI. RESULTS: The prevalence of MCI was 50.4% among the male participants and 31.4% among the females. A positive association between alcohol consumption and MCI was observed in men, but not in women. The multivariable OR (95% CI) of MCI for ≥ 2 go (46 g ethanol) /day vs. non-drinkers was 1.78 (0.93-3.40, p for trend = 0.045) in men and for ≥ 1 go (23 g ethanol) /day was 0.96 (0.39-2.38, p for trend = 0.92) in women, respectively. We also observed an association between shochu consumption and MCI in men, whereby the multivariable OR (95% CI) of MCI for each 1 go increment was 1.57 (1.18-2.07). CONCLUSION: Our findings suggest that alcohol consumption in moderation may contribute to the prevention of MCI development in men.

DOI： 10.3143/geriatrics.57.300

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

Probiotics have been expected to enhance human immune function. The aim of this study was to evaluate the effects of dietary intake of yogurt fermented with Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1 (OLL1073R-1) on the prevention of influenza during winter and on the activation of immunological markers among women healthcare workers. 961 women aged 20-71 years were randomly assigned to either the yogurt group (n = 479) or the control group (n = 482). Participants in the yogurt group consumed a 112 mL yogurt drink fermented with OLL1073R-1 every day for 16 weeks, whereas those in the control group consumed no yogurt during this period. All participants were instructed not to consume any other kinds of yogurt or fermented dairy products throughout this trial. The cumulative incidence rate of influenza was measured, and immunological markers were examined at the baseline and after 16 weeks. No significant difference in the incidence rate of influenza was found between the two groups (cumulative incidence rates of flu: yogurt 7.5% and control 7.7%). Natural killer (NK) cell activity did not show a significant intervention effect (p = 0.11), whereas the intervention effect on serum interferon gamma (IFN-γ) production was significant (p = 0.03). Other immunological markers did not show significant intervention effects. Consumption of OLL1073R-1 yogurt did not show a significant preventive effect against influenza or a significant enhancement in NK cell activity. However, intake of this yogurt showed an increase in IFN-γ production.

DOI： 10.1039/c9fo02128k

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

BACKGROUND AND OBJECTIVE: Coffee is a major caffeine-containing food source that can be used for treatment of apnea in prematurity. However, few studies have examined the association between coffee consumption and sleep-disordered breathing (SDB). We investigated whether coffee consumption is associated with the oxygen desaturation index (ODI) as a marker of SDB among middle-aged Japanese male workers. METHODS: The subjects were 1126 male local government workers aged 22-59 who participated in SDB screening in 2011-2012. Daily coffee consumption was assessed by a self-administered questionnaire. We measured 3% oxygen desaturation (3%ODI) during a night's sleep using a pulse oximeter. A general linear model was used to calculate the multivariate-adjusted means of 3%ODI per quartile of coffee consumption. We further analyzed the data after stratifying by overweight and current smoking status. RESULTS: A inverse association between coffee consumption and 3%ODI was found. The multivariate-adjusted mean of 3%ODI for the lowest and highest coffee consumption groups were 11.9 times/h and 10.6 times/h (p for trend = 0.06), respectively; 14.6 and 11.5 times/h (p for trend = 0.01) in overweight participants; and 12.7 and 11.0 times/h (p for trend = 0.06) in non-smokers. No associations were found in non-overweight and smoking workers. CONCLUSIONS: Our results suggest that higher coffee consumption was associated with lower 3% ODI as a marker of SDB in overweight and non-smoking workers.

DOI： 10.1007/s11325-019-01815-5

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Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

<title>Abstract</title>
<sec>
<title>Background</title>
Commercial drivers suffering from excessive daytime sleepiness (EDS) have been identified as a major cause of road traffic accidents. Alcohol usage directly affects sleep, adversely affecting next-day alertness and performance.


</sec>
<sec>
<title>Aims</title>
To examine the relationship between alcohol consumption and EDS among commercial truck drivers in Japan and the implications of this on public health.


</sec>
<sec>
<title>Methods</title>
All participants in this cross-sectional study were commercial motor vehicle drivers from Tokyo and Niigata Prefecture. Participants completed a self-administered questionnaire with details of their age, body mass index, alcohol consumption, Epworth Sleepiness Scale (ESS) score and tobacco usage. Participants’ oxygen desaturation index was determined by a pulse oximetry device that participants took home.


</sec>
<sec>
<title>Results</title>
A total of 1422 males registered with the Japan Trucking Association and aged 20–69 years participated. The multivariate-adjusted odds ratio (OR) of EDS among participants aged &lt;43 years was 0.81 (95% confidence interval (CI) 0.47–1.40) for light drinkers, 0.93 (95% CI 0.51–1.70) for moderate drinkers and 0.61 (95% CI 0.21–1.79) for heavy drinkers, compared to non-drinkers. The multivariate-adjusted OR among participants aged ≥43 years was 1.42 (95% CI 0.59–3.45) for light drinkers, 1.53 (95% CI 0.63–3.75) for moderate drinkers and 3.37 (95% CI 1.14–9.96) for heavy drinkers (P for interaction = 0.05).


</sec>
<sec>
<title>Conclusion</title>
We found that the association between ESS and alcohol intake was more evident among those aged ≥43 years, who reported higher levels of EDS with increased alcohol consumption.


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DOI： 10.1093/occmed/kqz091

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Other Link： http://academic.oup.com/occmed/article-pdf/69/6/406/30092510/kqz091.pdf

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AIM: The prevalence and clinical impact of snoring in the independent older adult population is unknown. To address this, we carried out this cross-sectional epidemiological study of community-dwelling independent older adults. METHODS: The study data were collected by the Japan Gerontological Evaluation Study 2013, a postal survey distributed to a large cohort of independent community-dwelling older adults (aged ≥65 years) in 2013, across 30 municipalities of 14 prefectures. We used data for 24 837 participants (13 135 women, mean age 73.5 years, and 11 702 men, mean age 73.3 years). The association of snoring with airway symptoms and history of hypertension, diabetes and heart disease were investigated using Poisson regression models. RESULTS: The prevalence ratio (95% confidence intervals) for wheezing according to snoring frequency in men was 1.87 (1.45-2.43) among those who snored on 1-6 nights a week, and 2.95 (2.15-4.05) among those who snored every night. Similar relationships were observed for women. Expectoration, another airway symptom, was also associated with snoring frequency. Furthermore, snoring frequency was associated with a higher prevalence of hypertension, diabetes and heart disease. Both diabetes and heart disease were associated with snoring frequency in women independent of body mass index, but the association was only observed in men with a normal or lower body mass index. CONCLUSIONS: Snoring is a highly prevalent and pathogenic symptom in adults aged ≥65 years. Geriatr Gerontol Int 2019; 19: 1165-1171.

DOI： 10.1111/ggi.13763

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

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

BACKGROUND: Marital status is one of the socio-economic factors associated with health. Several studies have indicated a significant association between marital status and insomnia. The increases in the percentages of unmarried people in Japan are expected to produce a significant impact on insomnia. The purpose of this study was to examine the association between marital status and insomnia. METHODS: The participants were 35 288 people aged 30-59 years selected from the 2010 comprehensive survey of living conditions. We categorized marital status into five groups: single, married couples living with other family members, married couples living without other family members, widowed and divorced. Insomnia-related symptoms (IRS) were based on the participants who chose the answer, 'I couldn't sleep'. Sex-specific multivariable odds ratios (ORs) and 95% confidence intervals (CI) of IRS according to marital status were calculated using the logistic regression model, which was adjusted for potential confounding factors. RESULTS: The proportions of people with IRS were 2.5% in men and 2.8% in women. The multivariable ORs (95% CI) were 1.15 (0.89-1.49) for single, 1.69 (1.11-2.58) for divorced and 1.01 (0.73-1.39) for married couples living without other family members in men, and 1.56 (1.20-2.03) for single, 2.43 (1.83-3.22) for divorced and 1.31 (1.01-1.71) for married couples living without other family members in women. CONCLUSIONS: We found divorced men and single, divorced and married women living without other family members had higher IRS than those who were married couples living with other family members in Japanese. This association was more evident in unemployed men.

DOI： 10.1093/eurpub/ckz119

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BACKGROUND: Short sleep duration (SSD) is reported to be highly associated with socio-economic status. There are few studies on the relationship between employment status and SSD in Japan. METHOD: The authors used the 2006 Survey on Time Use and Leisure Activities conducted by the Ministry of Internal Affairs and Communications Japan, which provides representative samples of Japanese people. The anonymous data of 120,783 people aged 30-59 years were analyzed. Authors defined five categories of employment status: "unemployed," "regularly employed," "non-regularly employed," "self-employed," and "other." Authors also defined a sleep duration shorter than 5 h per night as SSD. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of SSD using regular employment as the reference group were calculated using the logistic regression model, adjusting for potential confounding factors, i.e., age, marital status, education level, communication device use, and the amount of time spent on various daily activities. RESULTS: The prevalence of SSD was 2.8% (1639/58,308) in men and 3.2% (1976/62,475) in women. The multivariable-adjusted OR (95% CI) of SSD for the self-employed was 0.78 (0.65-0.92) in men and 1.78 (1.43-2.21) in women after adjustment for potential confounding factors, i.e., age, marital status, education level, and communication device use. Further adjustment for the time spent on daily activities revealed that the OR (95% CI) of SSD for the self-employed was 0.78 (0.65-0.92) in men and 1.89 (1.52-2.36) in women. CONCLUSION: Self-employed women had a higher prevalence of SSD. By contrast, self-employed men had a lower prevalence of SSD.

DOI： 10.1007/s12529-019-09807-1

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OBJECTIVE: To investigate the effect of non-surgical periodontal therapy on insulin resistance and sensitivity among individuals with borderline diabetes not receiving medications. METHODS: A crossover, randomized controlled trial was conducted among participants with borderline diabetes diagnosed by a 75-g oral glucose tolerance test. Participants were randomly assigned to either an early or later intervention group. The early intervention group underwent non-surgical periodontal therapy of scaling and root planing during the first 6 months, followed by a 6-month non-intervention period. The order was reversed in the later intervention group. Primary outcomes included: fasting or post-load serum glucose and insulin, body mass index (BMI), HOMA-IR, HOMA-β, and Matsuda Index. RESULTS: Seventy-four participants were randomized, and 71 participants completed the trial. There were no significant differences between groups in glucose and insulin concentrations during the intervention and non-intervention periods. When analyzed within groups by median-split of bleeding on probing (BOP) levels before intervention, the lower BOP group showed improved changes in BMI, HOMA-IR, HOMA-β, and Matsuda Index (P < 0.05). Further, we observed a positive correlation between baseline BOP and change in BMI (P = 0.06). Change in BMI was positively correlated with changes in HbA1c, HOMA-IR, and HOMA-β (P < 0.05), and inversely correlated with change in Matsuda Index (P = 0.001). CONCLUSIONS: Periodontal therapy had no significant effect on markers related to insulin and glucose metabolism among individuals with borderline diabetes. However, participants with a lower BOP (%) showed significant improvements in BMI, fasting serum insulin, HOMA-IR, HOMA-β and Matsuda Index. CLINICAL SIGNIFICANCE: Among individuals diagnosed with borderline diabetes, those who had <37% of a lower BOP (%) showed potential improvements in BMI, fasting serum insulin, HOMA-IR, HOMA-β and Matsuda Index following non-surgical periodontal therapy.

DOI： 10.1016/j.jdent.2019.04.005

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

DOI： 10.3164/jcbn.17-56

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

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Publishing type：Research paper (scientific journal)   Publisher：National Institute of Industrial Health  

DOI： 10.2486/indhealth.2018-0031

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Language：Japanese  

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

AIMS: The frequency of breakfast intake has been reported to be inversely associated with the risk of cardiovascular events; however, it is uncertain what the impact of the energy and nutrient intakes from breakfast are. We assessed the association between these intakes from breakfast and the risk of stroke prospectively. METHODS: In a baseline survey of four Japanese communities between 1981 and 1990, we enrolled 3 248 residents (1 662 men and 1 586 women) aged 40-59 years who were free from stroke and heart disease and who responded to the 24-hour dietary recall survey. We assessed the dietary intake at breakfast, lunch, dinner, and other times separately. RESULTS: During the median 25-year follow-up, 230 individuals (147 men and 83 women) developed stroke. After adjustment for age, community, other dietary intakes, and lifestyle and physiological factors, the multivariable-adjusted hazard ratios (95% confidence intervals) of intracerebral hemorrhage for the highest versus lowest quartiles of energy intake from breakfast were 0.38 (0.15-0.99) in men and 1.36 (0.36-5.10) in women. For the major nutrients, a higher saturated or monounsaturated fat intake at breakfast was associated with a reduced risk of intracerebral hemorrhage in men, and remained statistically significant after further adjustment for intake of other major nutrients from breakfast. CONCLUSIONS: A higher intake of energy from breakfast, primarily saturated or monounsaturated fat, was associated with a reduced risk of intracerebral hemorrhage in Japanese men.

DOI： 10.5551/jat.44438

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

The desastrous traffic accidents to date have provided the relevance for promotion of harmonization of work with treatment and prevention of sleep disordered breathing (SDB) in transport sectors. SDB is highly prevalent in commercial motor vehicle (CMV) drivers and is one cause of cognitive impairment and consequent traffic accidents, potentially costing billions and leading to many deaths. Various screening, diagnostic, and therapeutic approaches, some well established, are explored in this paper. Although drivers with SDB need to be appropriately diagnosed and treated, some are reluctant to continue their treatment or never submit to screening because of a lack of information. Thus, CMV drivers need to be well informed and screened, in addition to being encouraged to continue the treatment. The harmonization of work with treatment and prevention aids these objectives, providing benefits not only for individual health but also for transport companies, and further being an essential step towards uptake of "health and productivity management" in the transport sectors.

DOI： 10.2486/indhealth.2018-0083

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We examined the effect of television viewing and walking on the risk of type 2 diabetes among an Asian population. A total of 25,240 participants (9786 men and 15,454 women) aged 40-79 years, with no history of diabetes, stroke, coronary heart disease, or cancer at the baseline (1988-1990) and who have completed the 5-year follow-up questionnaire were included. During the 5-year follow-up, 778 new cases of type 2 diabetes were reported (397 men and 381 women). Television viewing time was positively associated with risk of type 2 diabetes (p for trend = 0.01). The multivariable OR (95% CI) for ≥5 h/day versus <2 h/day television viewing was 1.51 (1.03-2.19) in women and 1.06 (0.71-1.59) in men (p for interaction = 0.82). Walking time was inversely associated with type 2 diabetes risk in a fully adjusted model (p for trend = 0.02). The multivariable OR for type 2 diabetes of ≥1 h/day walking time was 0.87 (0.71-1.06) compared with 0.5 h/day walking time. The inverse association was found in men (p for trend = 0.02), but not in women (p for trend = 0.38) (p for interaction = 0.36). The multivariable OR for type 2 diabetes of <5 h/day television viewing and ≥1 h/day walking times was 0.72 (0.55-0.94) in fully adjusted model compared with ≥5 h/day television viewing and <1 h/day walking times. Limiting television viewing time and increasing walking time may reduce risk of type 2 diabetes among Japanese.

DOI： 10.1016/j.ypmed.2018.11.006

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Sleep-disordered breathing (SDB) is linked with brachial blood pressure. Although central systolic blood pressure (cSBP) is a better predictor of cardiovascular diseases than is brachial blood pressure, the association between SDB and cSBP is not fully understood. This cross-sectional study included 1484 participants without cardiovascular diseases who were enrolled in the Toon Health Study between 2009 and 2012. The respiratory disturbance index (RDI) was estimated with a one-night sleep test using an airflow monitor. Participants were grouped into three categories according to RDI level: mild (<10 events/h), moderate (10 to <20 events/h), and severe (≥20 events/h). The cSBP was measured using a noninvasive automated tonometer. Multivariable-adjusted cSBP means for the mild, moderate, and severe RDI categories were, respectively, 116.0, 118.0, and 120.7 mm Hg (p for trend = 0.02) for men and 111.8, 113.7, and 111.7 mm Hg (p for trend = 0.59) for women. The association for men was no longer significant after adjusting for BMI. When stratified by BMI (<22 or ≥22 kg/m2), the RDI was associated with cSBP among men with BMI ≥ 22 kg/m2, and this association was of borderline significance. Augmentation index, pulse pressure amplification, and brachial blood pressure were not significantly associated with the RDI. Higher RDI values were associated with increased multivariable-adjusted cSBP means among men. This association was more evident among those with BMI ≥ 22 kg/m2. In conclusion, we found that the RDI was associated with cSBP among men, and this association was independent of confounding variables among individuals above the ideal weight.

DOI： 10.1038/s41440-019-0219-5

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To date, there are few studies in Asian populations on the association between snoring (a major clinical symptom of sleep apnea) and hypertension. This study aims to examine whether snoring frequency is associated with blood pressure and hypertension in the general Japanese population, after adjustment for major confounding factors. A cross-sectional study of 2021 middle-aged Japanese men and women enrolled in the Toon Health Study between 2009-2012 was conducted. Snoring frequency was assessed using a self-reported questionnaire, and was classified into four categories: never, ≤2 times/week, ≥3 times/week, and unknown. Multivariable regression coefficients for each snoring category were calculated for systolic and diastolic blood pressure, and their odds ratios (ORs) and 95% confidence intervals (95% CIs) for hypertension were calculated after adjusting for major confounding factors. The same analyses were also conducted after stratification by several major confounding factors. Multivariable-adjusted means of systolic and diastolic blood pressure among individuals who snored ≥3 times/week were 4.57 mmHg and 2.58 mmHg higher, respectively, than in individuals who never snored (p < 0.05). The multivariable-adjusted OR (95% CI) for hypertension in the group that snored ≥3 times/week was 1.79 (1.29-2.48), compared with the group that never snored. We also found a significant positive association between snoring frequency and hypertension not only in normal and overweight individuals, but also in lean individuals (body mass index ≤22.8 kg/m2). Higher snoring frequency was associated with higher blood pressure and hypertension among both lean and non-lean Japanese.

DOI： 10.1038/s41371-018-0148-9

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

Objective: Previous studies have suggested that young sports players may suffer from sleep disordered breathing (SDB). It was hypothesised that SDB in heavy-class judo players was far more prevalent than expected and that it could reduce judo performance, which could be improved by appropriate therapies. To address this, the present study estimated the percentage of heavy-class judo players with SDB and investigated the effect of SDB treatment on judo performance. Methods: We enrolled 19 young judo players from a university judo team with body weight >100 kg and/or body mass index >30 kg/m2. Both excessive daytime sleepiness (EDS) and respiratory disturbance index (RDI) were evaluated using the Epworth Sleepiness Scale (ESS) and an overnight type 3 sleep monitor. Results: The percentages of young heavyweight-class judo players with EDS (ESS ≥11) and those with SDB (RDI ≥5) were both 63%, which was unexpectedly high for the age class. Seven of the participants underwent continuous positive airway pressure therapy, which improved both RDI and ESS scores (p<0.05 for each) and subsequently the sleep quality and judo performance of the participants. Conclusions: Our study indicates that young judo players might silently suffer from SDB, leading to poorer judo performance and to future cardiovascular diseases. Clinicians should be aware of the possible presence of SDB in young sports players and consider the application of diagnostic and therapeutic remedies.

DOI： 10.1136/bmjsem-2018-000418

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BACKGROUND AND OBJECTIVES: The aim of this study was to examine the reproducibility of a self-administered food frequency questionnaire (FFQ) originally developed for the Japan Public Health Center-Based Prospective Study (JPHC study) and modified for use in the Next Generation (JPHC-NEXT) study. METHODS AND STUDY DESIGN: Participants included 98 men and 142 women aged 40-74 years from the five areas included in the JPHCNEXT protocol. In November 2012, participants were recruited and asked to complete the first nutrition survey. The second nutrition survey was completed after 1 year. RESULTS: We estimated daily energy as well as 53 nutrient and 29 food group intakes using the FFQ. To assess reproducibility, we calculated Spearman correlation coefficients between both FFQs, which showed mostly intermediate-to-high values. Median (range) correlation coefficients and quartile distribution in the same and adjacent categories for energy-adjusted nutrient intakes were 0.55 (0.42-0.84) and 84.7% (76.5%-98.0%) in men and 0.54 (0.35-0.80) and 84.5% (76.1%-94.4%) in women. The respective values for energy-adjusted food group intakes in men and women were also mostly intermediate to high: 0.54 (0.39-0.79) and 83.7% (75.5%-90.8%) in men and 0.57 (0.40-0.83) and 84.5% (77.5%-93.7%) in women. CONCLUSIONS: The FFQ developed for the JPHC-NEXT study has reasonable reproducibility. Because this FFQ has also been validated in a previous study, it can be considered a useful dietary assessment tool to examine associations between dietary consumption and lifestyle-related diseases.

DOI： 10.6133/apjcn.201906_28(2).0019

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Language：English   Publisher：公益社団法人 日本栄養・食糧学会  

&lt;p&gt;High-amylose rice elicits a reduced postprandial glucose response, as well as a lower glycemic index, in comparison with low-amylose white rice. The Ehime Research Institute of Agriculture has been growing the high-amylose rice variety &quot;Hoshinishiki&quot; because its yield and taste may be rated more highly than other high-amylose rice varieties grown in a similar climate. The objective of this study was to assess the glycemic index of &quot;Hoshinishiki&quot;. The protocol employed conformed to that of the Japanese Association for Glycemic Index Studies. The subjects were eight healthy men aged 21‐48 years. The glycemic index of &quot;Hoshinishiki&quot; was calculated from the incremental area under the curve (IAUC) of the blood glucose level two hours after consumption of standard white rice (twice) and &quot;Hoshinishiki&quot; (once). The mean IAUC was 4872.5 min・mg/dL and 4015.31 min・mg/dL for standard white rice and &quot;Hoshinishiki&quot;, respectively. The glycemic index of &quot;Hoshinishiki&quot; based on these values was 86.2. In conclusion, the glycemic index for the high-amylose rice variety &quot;Hoshinishiki&quot; grown in Ehime prefecture is 86.2, compared with that of standard white rice.&lt;/p&gt;

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OBJECTIVES: The aim of this study was to examine the prevalence of sleep-disordered breathing (SDB) in women working in the field of aged care in Japan. METHODS: A cross-sectional study was conducted for female employees aged 18-60 years in aged care facilities in Japan. The analyzed set consisted of 712 participants with complete data. SDB was determined by respiratory disturbance index (RDI), measured using an ambulatory airflow monitor with a polyvinylidene fluoride film sensor to detect nasal and oral airflow overnight at home. Based on the findings of previous studies, RDI 10 was considered equivalent to apnea-hypopnea index (AHI) 15. RESULTS: The prevalence of moderate-to-severe SDB (RDI ≥ 10) was 22.8%. The mean age was 38.1 years, and mean sleeping time of participants was 6.1 h. The median body mass index (BMI) was 22.0. Women with moderate-to-severe SDB (RDI ≥ 10) had a higher age, neck circumference, neck-height ratio, BMI, systolic blood pressure, and increased prevalence of hypertension, short sleepers (amount of sleep on the SDB testing day < 6 h), and habitual snorers, compared to women with no or mild SDB (RDI < 10). CONCLUSIONS: Our study found that women working in the aged care services in Japan were heavily burdened by SDB even though they were relatively young and slim. To prevent CVD from developing in the future, programs through which workplaces can help their employees improve their lifestyle, and early diagnosis and treatment of SDB are highly recommended.

DOI： 10.1007/s00420-018-1381-9

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BACKGROUND: High dietary non-enzymatic antioxidant capacity (NEAC) has been inversely related to the incidence of degenerative diseases. However, few studies have investigated the validity and reproducibility of dietary NEAC estimated from a food frequency questionnaire (FFQ). We assessed the validity and reproducibility of FFQ-based dietary NEAC against a dietary record (DR). METHODS: Participants were 244 men and 253 women who completed a 28-day DR and FFQs. NEAC for each food item was estimated according to available databases of antioxidant capacity, as measured by ferric reducing-antioxidant power (FRAP), oxygen radical absorbance capacity (ORAC), and total radical-trapping antioxidant parameter (TRAP). Using Spearman's rank correlation coefficients (CCs), we assessed the validity for dietary NEACs from a 28-day DR and a FFQ, and the reproducibility for them from two FFQs administered at a 1-year interval. Additionally, joint classification and the Bland-Altman method were applied to assess agreement between the two methods. RESULTS: Regarding validation, deattenuated CCs for the energy-adjusted overall dietary NEACs between FFQ and DR for FRAP, ORAC, and TRAP were 0.52, 0.54, and 0.52, respectively, for all subjects. Extreme miscategorization rates by joint classification analysis were 2% for FRAP and ORAC and 1% for TRAP. Regarding reproducibility, CCs between the energy-adjusted dietary NEACs from two FFQs were 0.64 for FRAP and 0.65 for ORAC and TRAP. CONCLUSION: The validity and reproducibility of dietary NEAC of total food from the FFQ were moderate. Estimations of dietary NEAC using FFQ would be useful in studying disease relationships by categorizing habitual dietary NEAC.

DOI： 10.2188/jea.JE20170063

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

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

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

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INTRODUCTION: The association between nocturnal enuresis (NE) and sleep disordered breathing (SDB) has been repeatedly reported, but has primarily been focused on clinical cohorts. The purpose of this study, was to assess whether SDB-related symptoms such as snoring and unrefreshing sleep in the morning are associated with NE in a large-scale community school-based survey. METHODS: A cross-sectional assessment using a standard questionnaire was conducted on nearly 20 000 primary school children (5-12 years old) in Matsuyama, Japan. Associations between NE and the frequencies of snoring and unrefreshing sleep were evaluated using multivariate logistic and regression analyses. RESULTS: Multivariate adjusted odds ratios (95% confidence intervals) for enuresis were 1.21 (1.04 to 1.40) and 1.36 (1.07 to 1.73) in boys who snored 1 or 2 nights per week and ≥3 nights per week, respectively (P for trend <0.0001). Those for enuresis were 1.67 (1.41 to 1.99) and 1.96 (1.63 to 2.36) in boys who showed unrefreshing sleep 1 or 2 nights per week and ≥3 nights per week, respectively (P for trend <0.0001). Significant associations between NE and snoring frequency emerged among children who did not report unrefreshing sleep (P-trend for boys and girls were <0.0001 and <0.01, respectively), while significant associations between NE and frequency of unrefreshing sleep were detected among children who snored ≥1 nights per week (P for trend >0.1). CONCLUSIONS: The pathogenic mechanisms linking snoring and unrefreshing sleep to increased risk of NE are unknown. However, snoring, a surrogate reporter of SDB, is associated with increased urine production, while unrefreshing sleep may result from disrupted sleep facilitating increased sleep pressure and elevated arousal thresholds. Thus, both SDB and unrefreshing sleep are potential independent risk factors of NE in school age children.

DOI： 10.1002/ppul.24156

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INTRODUCTION: The association between nocturnal enuresis (NE) and sleep disordered breathing (SDB) has been repeatedly reported, but has primarily been focused on clinical cohorts. The purpose of this study, was to assess whether SDB-related symptoms such as snoring and unrefreshing sleep in the morning are associated with NE in a large-scale community school-based survey. METHODS: A cross-sectional assessment using a standard questionnaire was conducted on nearly 20 000 primary school children (5-12 years old) in Matsuyama, Japan. Associations between NE and the frequencies of snoring and unrefreshing sleep were evaluated using multivariate logistic and regression analyses. RESULTS: Multivariate adjusted odds ratios (95% confidence intervals) for enuresis were 1.21 (1.04 to 1.40) and 1.36 (1.07 to 1.73) in boys who snored 1 or 2 nights per week and ≥3 nights per week, respectively (P for trend <0.0001). Those for enuresis were 1.67 (1.41 to 1.99) and 1.96 (1.63 to 2.36) in boys who showed unrefreshing sleep 1 or 2 nights per week and ≥3 nights per week, respectively (P for trend <0.0001). Significant associations between NE and snoring frequency emerged among children who did not report unrefreshing sleep (P-trend for boys and girls were <0.0001 and <0.01, respectively), while significant associations between NE and frequency of unrefreshing sleep were detected among children who snored ≥1 nights per week (P for trend >0.1). CONCLUSIONS: The pathogenic mechanisms linking snoring and unrefreshing sleep to increased risk of NE are unknown. However, snoring, a surrogate reporter of SDB, is associated with increased urine production, while unrefreshing sleep may result from disrupted sleep facilitating increased sleep pressure and elevated arousal thresholds. Thus, both SDB and unrefreshing sleep are potential independent risk factors of NE in school age children.

DOI： 10.1002/ppul.24156

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BACKGROUND: Limited evidence is available on the association of insulin-like growth factors (IGFs) and risk of heart failure in population-based samples. We investigated whether serum IGFs concentrations can predict mortality from heart failure. METHODS: We conducted a nested case-control study of 39,242 subjects aged 40-79 years who participated in the JACC study, a large Japanese prospective cohort study; participants provided serum samples and were followed up for 9 years. In heart failure cases and age-, sex-, community-, and year of blood withdrawal-matched controls, we measured serum concentrations of IGF-I, IGF-II, and IGF binding protein 3 (IGFBP3) and transforming growth factor (TGF-β1). RESULTS: During the follow-up, there were 88 heart failure deaths (44 men and 44 women). Each increment of 1 standard deviation [SD] of IGF-II (120.0 ng/mL in women and 143.7 ng/mL in men) was associated with a 47% reduced risk of mortality from heart failure; multivariable odds ratio was 0.53 (95% confidence interval [CI], 0.30-0.94, P-trend = 0.03). The multivariable odds ratio in the highest quartile of IGFBP3 serum concentrations (≥3.29 µg/mL in women and ≥3.31 µg/mL in men) compared with the lowest (<2.11 µg/mL in women and <2.56 µg/mL in men) was 0.24 (95% CI, 0.05-1.11; P-trend = 0.12). No association was found between serum concentrations of IGF-I or TGF-β1 and risk of heart failure. CONCLUSIONS: Higher serum concentrations of IGF-II were associated with lower mortality from heart failure, which might suggest a possible role of IGF-II in the occurrence or prognosis of heart failure.

DOI： 10.2188/jea.JE20170123

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OBJECTIVE: To examine the association of water intake with risk of mortality from CVD. DESIGN: Prospective cohort study.Setting/SubjectsA total of 22 939 men and 35 362 women aged 40-79 years enrolled in the Japan Collaborative Cohort (JACC) Study with available data regarding water intake from foods and beverages. The underlying causes of death were determined based on the International Classification of Diseases. RESULTS: During the median 19·1 years of follow-up, 1637 men and 1707 women died from CVD. There was an inverse trend between high water intake and risk of CVD in both sexes. Compared with participants in the lowest quintile of water intake, the multivariable-adjusted hazard ratios (95 % CI) for mortality from total CVD in the highest quintile of water intake were 0·88 (0·72, 1·07; P for trend=0·03) in men and 0·79 (0·66, 0·95; P for trend=0·10) in women. Those for CHD were 0·81 (0·54, 1·21; P for trend=0·06) in men and 0·60 (0·39, 0·93; P for trend=0·20) in women. Reduced risk of mortality from ischaemic stroke was also observed among women in the highest water intake quintile: 0·70 (0·47, 0·99; P for trend=0·19). There was no association between water intake and mortality from haemorrhagic stroke in either sex. CONCLUSIONS: Higher intake of fluids from foods and beverages was associated with reduced risk of cardiovascular mortality in both sexes and reduced risk of ischaemic stroke in women in Japan.

DOI： 10.1017/S1368980018001386

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Inc.  

Several studies have related cardiovascular disease (CVD) to serum concentrations of copper and zinc but not to their dietary intakes. We thought to examine the association between dietary intakes of copper and zinc with risk of mortality from CVD in a prospective study encompassing 58,646 healthy Japanese men and women aged 40-79 years. The intakes of copper and zinc were determined by a validated self-administered food frequency questionnaire, and their associations with risk of mortality from CVD were evaluated by Cox proportional hazard modelling. During 965, 970 person-years of follow-up between 1989-2009, we documented 3,388 CVD deaths [1,514 from stroke, 702 from coronary heart disease (CHD) and 1,172 from other CVD]. Copper intake was not associated with CHD mortality
however, the multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) for mortality from stroke, other CVD and total CVD in the highest versus the lowest quintiles of copper intake among men were 1.78 (1.16-2.77
P-trend=0.007), 1.61 (1.01-2.81
P-trend =0.03) and 1.63 (1.21-2.33
P-trend=0.001), respectively, and those among women were 1.49 (1.00-2.19
P-trend=0.04), 1.59 (1.09-2.55
P-trend =0.02) and 1.36 (1.06-1.69
P-trend=0.01), respectively. Higher intakes of zinc was inversely associated with mortality from CHD in men
0.68 (0.58-1.03
P-trend=0.05) but not women
1.13 (0.71- 1.49
P-trend=0.61). No associations were observed with other mortality endpoints. In conclusion, dietary copper intake was positively associated with mortality from CVD in both genders
whereas, higher dietary zinc intake was inversely associated with mortality from CHD in men but not women.

DOI： 10.1016/j.jnutbio.2018.02.008

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BACKGROUND: Yellow tongue coating is one of the clinical signs for diabetes mellitus according to traditional East Asian medicine. Few reports have been available on the association between yellow tongue coating and the prevalence of type 2 diabetes in the general population. We examined that association among population samples of non-smoking men and women. METHODS: The study subjects were Japanese non-smoking men (n = 315) and women (n = 654) aged 30-79 years who resided in Toon city and participated in the Toon Health Study from July 2011 through November 2014. Tongue coating was assessed by a nationally licensed acupuncturist and classified into three categories of white (normal), light yellow, and yellow. We performed an oral glucose tolerance test to confirm the presence of diabetes mellitus and prediabetes. The associations between yellow tongue coating and the prevalence of diabetes mellitus and prediabetes were examined using multivariable logistic regression analyses, adjusting for age, sex, body mass index, drinking status, and physical activity. RESULTS: The multivariable odds ratios of diabetes mellitus were 1.39 (95% confidence interval [CI], 0.72-2.67) for light yellow tongue coating and 2.23 (95% CI, 1.16-4.30) for yellow tongue coating compared with white tongue coating. The respective multivariable odds ratios of prediabetes were 1.13 (95% CI, 0.80-1.61) and 1.43 (95% CI, 0.96-2.12). CONCLUSIONS: Yellow tongue coating was associated with higher prevalence of diabetes mellitus and tended to be associated with that of prediabetes among Japanese non-smoking men and women.

DOI： 10.2188/jea.JE20160169

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BACKGROUND: Although blood pressure (BP) is regulated by the autonomic nervous system, it is not fully understood how autonomic activity affects BP at home in the general population. METHODS: Subjects were enrolled from 2009 to 2012 and included 1,888 men and women aged 30-79 years. We measured casual BP in the morning during health checkups and asked participants to monitor BP at home twice in the morning and evening for 1 week. The mean of the two measurements of mean arterial pressure (MAP) was calculated. Five-minute recordings of the pulse wave from a fingertip sensor were used to determine the following indices of heart rate variability (HRV): standard deviation of normal-to-normal RR intervals (SDNN), root mean square of successive differences in RR intervals (RMSSD), high frequency (HF) power, low frequency (LF) power, and LF/HF. RESULTS: Sex- and age-adjusted means of casual MAP, and morning and evening MAP at home were significantly different among quartiles of SDNN, RMSSD, and HF. When further adjusted for smoking, alcohol drinking, medication for hypertension, diabetes, sleeping hours, snoring, and mental health status, the associations were somewhat attenuated. Inverse relationships were found between the means of morning home MAP, and RMSSD (P = 0.02) and HF (P = 0.051) after adjustment for confounders. The association between MAP and RMSSD, or MAP and HF was evident in individuals <65 years old. CONCLUSION: Low HF and RMSSD, which reflect impaired parasympathetic nervous system activity, were associated with increased home MAP in the morning rather than in the evening.

DOI： 10.1093/ajh/hpy100

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Churchill Livingstone  

Background &amp
aims: Abnormal homeostasis of iron, copper and zinc has been included in the pathogenesis of type 2 diabetes mellitus (T2DM). However, the evidence of associations between dietary intakes of these elements and T2DM is limited. We thought to examine the association between dietary intakes of iron, copper and zinc with risk of T2DM in Japanese population. Methods: A prospective study encompassing 16,160 healthy Japanese men and women aged 40–65 years in whom the associations between dietary intakes of iron, copper and zinc, determined by a validated self-administered food frequency questionnaire, with risk of 5-year cumulative incidence of validated physician-diagnosed T2DM, were evaluated by logistic regression model. Results: We ascertained 396 self-reported new cases of diabetes within 5-year period. Dietary intakes of iron (total and nonheme but not heme iron) and copper were positively associated with risk of T2DM
the multivariable OR in the highest versus lowest quartiles of intakes were 1.32 (1.04, 1.70
P-trend = 0.03) and 1.55 (1.13, 2.02
P-trend = 0.003), respectively. These associations were more evident in the high risk group
older, overweight, smokers and those with family history of diabetes. The dietary intake of zinc was inversely associated with risk of T2DM
the multivariable OR was 0.64 (0.54, 1.00
P-trend = 0.003), and such association was evident among younger subjects (age 40–55 years) only. Conclusions: Dietary intakes of iron and copper were associated with a higher risk, while dietary intake of zinc was associated with a reduced risk of T2DM in Japanese population.

DOI： 10.1016/j.clnu.2017.02.010

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Background: Ubiquinol is widely used as an ant i aging supplement. In this study, we evaluated the effects of long term ubiquinol intake on improving or maintaining the qu a lity of life (QOL) of community residents. Methods: 124 adult (aged 22 86) residents 36 male, 88 female) participated in this trial . Each consumed 100 120 mg of ubiquinol per day for 6 months (n=22) or 12 months (n=102). We measured serum ubiquinol level s and QOL score s by SF 36 at baseline and after ubiquinol intake . Results: In female participants , the SF 36 scores of role physical ( RP), vitality ( VT), social functioning ( SF), mental health ( MH), and mental c omponent summary ( increased significantly. On the other hand , significant score changes were not shown in male participants . A fter s trati f ying baseline serum ubiquinol levels by tertiles, we found a significant improvement of mental QOL scores in the low and middle ubiquinol level groups of female participants , but not in the highest tertile. Conclusions: This trial indicate s that ubiq u inol supplement ation has effects on female participant s psychological QOL , especially for those whose baseline serum ubiquinol level s a re in the l ow to middle range.

DOI： 10.31989/ffhd.v8i4.411

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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AIMS/INTRODUCTION: No reports have been published on the association between dietary intake habits and nocturia in the diabetes population. We therefore evaluated this issue among Japanese patients with diabetes mellitus. MATERIALS AND METHODS: Study participants in the present study were 785 Japanese patients with type 2 diabetes mellitus. Self-administered questionnaires were used to assess each type of dietary intake habit. Vegetable intake habit was assessed by the following question: "Do you have vegetables or seaweed every day?" We used the following two outcomes: (i) nocturia: ≥2 voids per night; and (ii) severe nocturia: ≥3 voids per night. Adjustment was made for age, sex, body mass index, glycated hemoglobin, hypertension, dyslipidemia, smoking, drinking, exercise habit, stroke, ischemic artery disease, diabetic nephropathy, diabetic neuropathy and diabetic retinopathy. RESULTS: The prevalence of nocturia, severe nocturia, and vegetable intake habit was 39.9%, 14.4% and 67.3%, respectively. After adjusting for confounding factors, vegetable intake habit was independently inversely associated with nocturia and severe nocturia: the adjusted odds ratios were 0.67 (95% confidence interval [CI] 0.48-0.94) and 0.46 (95% CI 0.30-0.71), respectively. Among male patients, vegetable intake habit was independently inversely associated with severe nocturia, but not nocturia: the adjusted OR was 0.51 (95% CI 0.29-0.88). Among female patients, vegetable intake habit was independently inversely associated with nocturia and severe nocturia: the adjusted ORs were 0.44 (95% CI 0.24-0.79) and 0.34 (95% CI 0.15-0.78), respectively. CONCLUSIONS: We found an inverse association between vegetable intake habit and nocturia in Japanese patients with type 2 diabetes mellitus.

DOI： 10.1111/jdi.12709

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OBJECTIVES: No studies have investigated the association between nocturia and depressive symptoms in patients with type 2 diabetes mellitus. Because nocturia and depressive symptoms are common in patients with type 2 diabetes, we examined this association in Japanese patients with type 2 diabetes. METHODS: We studied 762 Japanese patients with type 2 diabetes. A self-administered questionnaire was used to collect information about the variables under study. The subjects were divided into 3 groups according to their nocturnal micturition: 1) no nocturia; 2) mild nocturia (1 void per night) and 3) moderate to severe nocturia (2 or more voids per night). Depressive symptoms were defined as being present when a subject had a Self-Rating Depression Scale score higher than 49. RESULTS: The prevalence values of mild nocturia, moderate to severe nocturia and depressive symptoms were 39.5%, 41.9% and 16.8%, respectively. Both mild nocturia and moderate to severe nocturia were independently positively associated with depressive symptoms in all patients; the adjusted ORs were 1.96 (95% CI 1.06 to 3.77) and 2.58 (95% CI 1.38 to 5.04). In female patients, both mild nocturia and moderate to severe nocturia were independently associated with depressive symptoms; the adjusted ORs were 5.26 (95% CI 1.73 to 20.61) and 6.91 (95% CI 2.15 to 28.54), respectively. In male patients, neither mild nocturia nor moderate to severe nocturia was significantly related to depressive symptoms. CONCLUSIONS: In Japanese female patients with type 2 diabetes, nocturia may be positively associated with depressive symptoms.

DOI： 10.1016/j.jcjd.2017.03.002

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/jre.12537

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Blackwell Publishing Ltd  

Objective: Resistin is secreted by monocytes/macrophages and is associated with insulin resistance, inflammation and cardiovascular diseases. In the Japanese cohort, serum resistin is tightly associated with a single-nucleotide polymorphism (SNP) at -420 (rs1862513) in the promoter region of the human resistin gene. However, interactions between SNP-420 and environmental factors remain to be elucidated. The aim of this study was to investigate the association between serum resistin levels and nutrient intake, and the effect of SNP-420 on this association. Design, Participants and Measurements: The Toon Genome Study is a cohort study of Japanese community-dwelling subjects. A total of 1981 participants were cross-sectionally analysed. Each nutrient intake was assessed using the semiquantitative food frequency questionnaire and categorized into the quartiles (Q1-Q4). Serum resistin was measured by ELISA. Results: Serum resistin tended to be inversely associated with fish intake and positively associated with meat intake after adjustment for age, sex, BMI and energy intake. Serum resistin was inversely associated with n-3 polyunsaturated fatty acids (PUFA) intake after adjustment for age, sex, BMI and energy intake (Q1 12.5, Q2 12.5, Q3 12.2, Q4 11.5 ng/mL
P for trend =.007). This inverse association was strongest in the G/G genotype of SNP-420, followed by C/G and C/C (G/G, Q1 18.9, Q2 19.5, Q3 18.4, Q4 14.5 ng/mL, P =.001
C/G, 14.4, 13.3, 13.1, 12.9, P =.015
C/C, 9.5, 9.5, 9.2, 8.8, P =.020
P for interaction =.004). Conclusions: The inverse association between serum resistin and n-3 PUFA intake was strongest in SNP-420 G/G genotype in the Japanese cohort.

DOI： 10.1111/cen.13500

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AIMS/INTRODUCTION: To date, there is no evidence regarding the association between physical activity (PA) and erectile dysfunction (ED) among Japanese patients with type 2 diabetes mellitus. We investigated this issue among Japanese patients with type 2 diabetes mellitus. MATERIALS AND METHODS: Study participants were 460 male Japanese patients with type 2 diabetes mellitus. The definitions of exercise habit, walking habit and fast walking were based on a self-administered questionnaire regarding PA behavior. Participants were classified into one of four PA levels based on the number of 'Yes' answers to the three questions in the questionnaire: (i) lowest; (ii) lower; (iii) moderate; and (iv) higher. Severe ED and moderate-to-severe ED were based on Sexual Health Inventory for Men score <8 and <12, respectively. RESULTS: The prevalence of moderate-to-severe ED, severe ED, exercise habit, walking habit, and fast walking was 64.6, 51.1, 36.3, 41.3 and 37.6%, respectively. Walking habit was independently inversely associated with moderate-to-severe ED and severe ED. Exercise habit was independently inversely associated with severe ED, but not moderate-to-severe ED. Higher PA was independently inversely associated with moderate-to-severe ED and severe ED (adjusted odds ratio 0.42, 95% confidence interval 0.21-0.85; and adjusted odds ratio 0.38, 95% CI: 0.19-0.73, respectively). There was a statistically significant inverse exposure-response relationship between the PA level and moderate-to-severe ED and severe ED (P for trend = 0.02 and 0.005), respectively. CONCLUSIONS: PA might be inversely associated with ED in Japanese patients with type 2 diabetes mellitus.

DOI： 10.1111/jdi.12660

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Publishing type：Research paper (scientific journal)   Publisher：The Jutendo Medical Journal  

DOI： 10.14789/jmj.2018.64.jmj17-oa10

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Background: Ubiquinol is widely used as an anti-Agingsupplement. In this study, we evaluatedthe effects of long-Term ubiquinol intake on improving or maintaining the quality of life(QOL) of community residents. Methods: 124 adult(aged 22-86) residents(36 male, 88 female) participated in this trial. Each consumed 100-120 mg of ubiquinol per day for 6 months (n=22) or 12 months (n=102). We measured serum ubiquinol levelsandQOL scoresby SF-36 at baseline and after ubiquinolintake. Results:Infemaleparticipants, the SF-36 scores of role physical(RP), vitality(VT), social functioning(SF), mental health(MH), and mental component summary(MCS)increased significantly. On the other hand, significant score changes were not shownin maleparticipants. Afterstratifyingbaseline serum ubiquinol levels by tertiles,we found a significant improvement of mental QOL scores in the lowandmiddleubiquinol level groupsof female participants, but not in the highest tertile. Conclusions: This trial indicatesthatubiquinol supplementationhas effects on femaleparticipants psychological QOL, especially for those whose baseline serum ubiquinol levelsare in the low to middle range.

DOI： 10.31989/ffhd.v7i12.349

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

AimNocturia is common among patients with type2 diabetes mellitus, but limited evidence regarding the association between body mass index (BMI) and nocturia exists among such patients. The aim of the present study, therefore, was to evaluate the association between BMI and nocturia among Japanese patients with type2 diabetes mellitus.
MethodsStudy participants were 809 Japanese patients with type2 diabetes mellitus. Study participants were considered to have nocturia if they answered two or more to the question: How many times do you typically wake up to urinate from sleeping at night until waking in the morning? We used the following two outcomes: (i) moderate nocturia was defined as 2 voids per night; and (ii) severe nocturia was defined as 3 voids per night. Participants were categorized into four groups according to their BMI: (i) BMI &lt;18.5; (ii) 18.5BMI&lt;25; (iii) 25BMI&lt;30; and (iv) BMI 30. Multiple logistical regression analysis for nocturia in relation to BMI was used, with the category of 18.5BMI&lt;25 as the reference.
ResultsObesity (BMI 30) was independently positively associated with severe nocturia among elderly patients (age 65years) with type2 diabetes mellitus, but not among young and middle-aged patients: the adjusted OR was 2.96 (95% CI 1.10-7.83). BMI was not associated with moderate nocturia in all patients.
ConclusionsIn Japanese elderly patients with type2 diabetes mellitus, obesity was independently positively associated with severe nocturia. Geriatr Gerontol Int 2017; 17: 2460-2465.

DOI： 10.1111/ggi.13103

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

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPANESE CIRCULATION SOC  

Background: Insulin resistance is strongly associated with metabolic syndrome (MetS), but it is not known how this association is influenced by the autonomic nervous system, which controls insulin secretion.
Methods and Results: The subjects were 2,016 individuals aged 30-79 years enrolled between 2009 and 2012. MetS was determined using the harmonized MetS definition, which includes waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol, and fasting glucose. The homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutt's insulin sensitivity index (ISI) were calculated based on fasting and 2 h-post-load glucose and insulin concentrations in a 75-g oral glucose tolerance test. The 5-min heart rate variability (HRV) was evaluated using time-domain indices of standard deviations of NN intervals (SDNN) and root mean square of successive differences (RMSSD). Power spectral analysis yielded frequency-domain measures for HRV: high-frequency (HF) power, low-frequency (LF) power and LF/HF. Multivariable adjusted logistic models showed that the highest quartiles for SDNN, RMSSD, LF, and HF vs. the lowest quartiles had a significant association with MetS. RMSSD, HF, and LF/HF remained significantly associated with MetS after adjustment for HOMA-IR (or ISI). Additive interactions between the levels of high LF/HF and high HOMA-IR (or low ISI) were significantly positive.
Conclusions: Sympathovagal imbalance as evidenced by low HF and high LF/HF modified the association of insulin resistance or low insulin sensitivity with MetS.

DOI： 10.1253/circj.CJ-17-0192

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

Scalloped tongue is considered as a possible clinical finding of obstructive sleep apnoea (OSA). There are few evidence of the association between scalloped tongue and OSA. To examine the association between scalloped tongue and nocturnal intermittent hypoxia (NIH), a surrogate marker of OSA, among a general Japanese population. Study participants were 398 men and 732 women aged 30-79years who participated in the Toon Health Study from 2011 to 2014. Scalloped tongue was classified into three categories: none, mild and moderate-to-severe. Moderate-to-severe NIH was defined as the 3% oxygen desaturation index of 15 events/h during sleep for one night with pulse oximetry. The multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for moderate-to-severe NIH were calculated according to scalloped tongue categories using a logistic regression model. There were 69 (6&lt;bold&gt;&lt;/bold&gt;1%) moderate-to-severe NIH cases in this population. The multivariable-adjusted ORs (95% CIs) of moderate-to-severe NIH were 1&lt;bold&gt;&lt;/bold&gt;59 (0&lt;bold&gt;&lt;/bold&gt;85-2&lt;bold&gt;&lt;/bold&gt;95) for mild and 2&lt;bold&gt;&lt;/bold&gt;39 (1&lt;bold&gt;&lt;/bold&gt;10-5&lt;bold&gt;&lt;/bold&gt;17) for the moderate-to-severe scalloped tongue group compared with the group without scalloped tongues. When stratified by overweight status (BMI &lt;25 or 25kg m(-2)), the respective ORs (95% CIs) were 2&lt;bold&gt;&lt;/bold&gt;83 (1&lt;bold&gt;&lt;/bold&gt;06-7&lt;bold&gt;&lt;/bold&gt;55) and 4&lt;bold&gt;&lt;/bold&gt;74 (1&lt;bold&gt;&lt;/bold&gt;28-17&lt;bold&gt;&lt;/bold&gt;49) among overweight individuals, and 0&lt;bold&gt;&lt;/bold&gt;94 (0&lt;bold&gt;&lt;/bold&gt;40-2&lt;bold&gt;&lt;/bold&gt;70) and 1&lt;bold&gt;&lt;/bold&gt;52 (0&lt;bold&gt;&lt;/bold&gt;57-4&lt;bold&gt;&lt;/bold&gt;05) among non-overweight individuals. Scalloped tongue was associated with higher prevalence of moderate-to-severe NIH among the general Japanese population and this association was more evident in overweight individuals.

DOI： 10.1111/joor.12526

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

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BACKGROUND & AIMS: The associations between dietary magnesium intake and stroke and coronary heart disease (CHD) incidences are inconsistent and not established in Asian. We aimed to determine the association between dietary magnesium intake and the risk of stroke and CHD in a Japanese population. SUBJECTS/METHODS: We studied 85,293 Japanese subjects by questionnaire at baseline (age 45-74 years, without cardiovascular disease or cancer in 1995 and 1998 for Cohorts I and II, respectively). The participants were followed until the end of 2009 and 2010 in Cohorts I and II, respectively. Dietary magnesium intake was estimated from a self-administered 138-item food-frequency questionnaire. RESULTS: After 1,305,738 person-years of follow-up, 4110 strokes and 1283 cases of CHD were documented. The multivariable-adjusted hazard ratios (HRs, 95% confidence intervals, 95%CIs) of CHD for the fourth and fifth quintiles of dietary magnesium intake were 0.70 (0.50-0.99) and 0.66 (0.44-0.97) in men (P for trend = 0.036), respectively, and third quintile of dietary magnesium intake was 0.61 (0.39-0.96) in women (P for trend = 0.241), compared with the lowest quintile in men and women. We observed no decreased risks of incident stroke in men or women with higher dietary magnesium intakes. CONCLUSIONS: Higher dietary magnesium intake was associated with a reduced risk of CHD in Japanese men.

DOI： 10.1016/j.clnu.2017.08.006

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Background: Ubiquinol is widely used as an anti-aging supplement. In this study, we evaluated the effects of long-term ubiquinol intake on improving or maintaining the quality of life (QOL) of community residents. Methods: 124 adult (aged 22-86) residents (36 male, 88 female) participated in this trial. Each consumed 100-120 mg of ubiquinol per day for 6 months (n=22) or 12 months (n=102). We measured serum ubiquinol levels and QOL scores by SF-36 at baseline and after ubiquinol intake. Results: In female participants, the SF-36 scores of role physical (RP), vitality (VT), social functioning (SF), mental health (MH), and mental component summary (MCS) increased significantly. On the other hand, significant score changes were not shown in male participants. After stratifying baseline serum ubiquinol levels by tertiles, we found a significant improvement of mental QOL scores in the low and middle ubiquinol level groups of female participants, but not in the highest tertile. Conclusions: This trial indicates that ubiquinol supplementation has effects on female participants’ psychological QOL, especially for those whose baseline serum ubiquinol levels are in the low to middle range.

DOI： 10.31989/ffhd.v7i7.335

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

AimsNo evidence exists regarding the association between smoking status and nocturia among patients with type 2 diabetes mellitus. We evaluated this association among Japanese patients with type 2 diabetes mellitus by post-hoc analysis.
MethodsStudy subjects were 817 Japanese patients with type 2 diabetes mellitus. Study subjects were considered to have nocturia if they answered once or more to the question: Within one week, how many times do you typically wake up to urinate from sleeping at night until waking in the morning? We used the following three outcomes: (1) nocturia was 1 voids per night; (2) moderate nocturia was 2 voids per night; and (3) severe nocturia was 3 voids per night. Adjustments were made for age, sex, body mass index, hypertension, dyslipidemia, stroke, glycated hemoglobin, current drinking, use of anti-hypertensive agent, use of insulin, use of oral anti-hyperglycemic agent, and diabetic retinopathy.
ResultsThe prevalence values of one void per night, two voids per night, and three or more voids per night were 39.5%, 27.1%, and 14.8%, respectively. Current smoking was independently inversely associated with severe nocturia compared with never or former smoking; the adjusted PR was 0.47 (95%CI: 0.25-0.89). Among the 443 patients who had ever smoked, compared with former smoking, current smoking was independently inversely related to severe nocturia; the adjusted PR was 0.44 (95%CI: 0.24-0.82).
ConclusionsIn Japanese patients with type 2 diabetes mellitus, current smoking may be independently inversely associated with severe nocturia.

DOI： 10.1002/nau.23102

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Background: The Japanese database of food amino acid composition was revised in 2010 after a 24-year interval. To examine the impact of the 2010 revision compared with that of the 1986 revision, we evaluated the validity and reliability of amino acid intakes assessed using a food frequency questionnaire (FFQ).
Methods: A FFQ including 138 food items was compared with 7-day dietary records, completed during each distinct season, to assess validity and administered twice at approximately a 1-year interval, to assess reliability. We calculated amino acid intakes using a database that compensated for missing food items via the substitution method. Subjects were a subsample of two cohorts of the Japan Public Health Center-based prospective study. A total of 102 men and 113 women in Cohort I and 174 men and 176 women in Cohort II provided complete dietary records and the FFQ, of whom 101 men and 108 women of Cohort I and 143 men and 146 women of Cohort II completed the FFQ twice.
Results: In the comparison of the FFQ with dietary records, the medians (ranges) of energy-adjusted correlation coefficients for validity were 0.35 (0.25-0.43) among men and 0.29 (0.19-0.40) among women in Cohort I, and 0.37 (0.21-0.52) and 0.38 (0.24-0.59), respectively, in Cohort II. Values for reliability were 0.47 (0.42-0.52) among men and 0.43 (0.38-0.50) among women in Cohort I, and 0.59 (0.52-0.70) and 0.54 (0.45-0.61), respectively, in Cohort II.
Conclusions: The FFQ used in our prospective cohort study is a suitable tool for estimating amino acid intakes. (C) 2016 The Authors. Publishing services by Elsevier B. V. on behalf of The Japan Epidemiological Association.

DOI： 10.1016/j.je.2016.06.003

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Background and aims: Limited evidence has been available on the relationship between apoptosis and cardiovascular disease in population-based samples. We examined whether blood soluble Fas (sFas) are associated with mortality from cardiovascular diseases.
Methods: In a nested case-control study under a large prospective cohort, the Japan Collaborative Cohort (JACC) Study, where a total of 39,242 subjects, 40-79 years of age, provided serum samples and were followed up for 9 years, we measured sFas levels among cases and controls, matched for sex, age, area of residence and year of serum storage. Conditional logistic regression models were used to calculate odds ratio (95% CI) of mortality from stroke and stroke types, according to quartiles and 1-SD increment of sFas levels.
Results: During the follow-up (1988-1997), we identified 233 (121 in men and 112 in women) deaths from total stroke, comprising 49 (18 and 31) subarachnoid hemorrhages, 55 (27 and 28) intra-parenchymal hemorrhages, 71 (44 and 27) ischemic strokes, and 97 (53 and 44) coronary heart diseases. After adjustment for cardiovascular risk factors, the multivariable odds ratio (95% CI) of subarachnoid hemorrhage associated with a 1-SD increment of sFas (1.3 ng/ml in both men and women) was 4.04 (1.07-15.3; p = 0.04). No association was found between blood sFas levels and risk of intraparenchymal hemorrhage, ischemic stroke or coronary heart disease.
Conclusions: Higher blood sFas levels were associated with higher mortality from subarachnoid hemorrhage, suggesting a potential role of apoptosis factors in the development or prognosis of subarachnoid hemorrhage.(C) 2017 Published by Elsevier Ireland Ltd.

DOI： 10.1016/j.atherosclerosis.2017.03.020

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Associated Professional Sleep Societies,LLC  

Study Objectives: Poor or short sleep and the presence of snoring indicative of sleep-disordered breathing (SDB) have been associated with behavioral problems in school-aged children. We examined the relationship between SDB, sleep duration, obesity risk, and behavioral characteristics in Japanese elementary school students using a large-scale survey. Methods: We conducted a cross-sectional study of children enrolled in all 46 public primary schools in Matsuyama city, Japan. The children's parents or guardians completed a questionnaire that covered sleep habits, presence of SDB risk, and behavioral characteristics. Results: In total, 24 296 responses were received (90% response rate). After excluding incomplete responses, we analyzed complete datasets for 17 769 children. Mean sleep duration decreased with age, as did the prevalence of pediatric SDB. We found an increased risk for the presence of SDB and short sleep among overweight/obese children. With SDB or short sleep, we observed significantly increased odds of restless behaviors, fidgety behaviors, and poor concentration in school. Conclusions: Shorter sleep duration was associated with increased risk of obesity, and in turn, obesity increased SDB risk. Both short sleep duration and SDB risk were significantly associated with behavioral problems in school.

DOI： 10.1093/sleep/zsw082

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS INC  

Study Objectives: Poor or short sleep and the presence of snoring indicative of sleep-disordered breathing (SDB) have been associated with behavioral problems in school-aged children. We examined the relationship between SDB, sleep duration, obesity risk, and behavioral characteristics in Japanese elementary school students using a large-scale survey.
Methods: We conducted a cross-sectional study of children enrolled in all 46 public primary schools in Matsuyama city, Japan. The children's parents or guardians completed a questionnaire that covered sleep habits, presence of SDB risk, and behavioral characteristics.
Results: In total, 24 296 responses were received (90% response rate). After excluding incomplete responses, we analyzed complete datasets for 17 769 children. Mean sleep duration decreased with age, as did the prevalence of pediatric SDB. We found an increased risk for the presence of SDB and short sleep among overweight/ obese children. With SDB or short sleep, we observed significantly increased odds of restless behaviors, fidgety behaviors, and poor concentration in school.
Conclusions: Shorter sleep duration was associated with increased risk of obesity, and in turn, obesity increased SDB risk. Both short sleep duration and SDB risk were significantly associated with behavioral problems in school.

DOI： 10.1093/sleep/zsw082

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

In several studies of patients with type 2 diabetes mellitus, a positive association between depressive symptoms and erectile dysfunction (ED) has been reported. No evidence exists, however, regarding the association between depressive symptoms and ED among Japanese patients with type 2 diabetes mellitus. Thus, we examined this issue among Japanese patients with type 2 diabetes mellitus. Study subjects were 469 male Japanese patients with type 2 diabetes mellitus, aged 19 years or over. ED, moderate to severe ED and severe ED were defined as present when a subject had a Sexual Health inventory for Men score &lt;22, &lt; 12 and &lt; 8, respectively. Depressive symptoms were defined as present when a subject had a Self-Rating Depression Scale (SDS) score &gt;49. Adjustment was made for age, body mass index, waist, duration of type 2 diabetes, current smoking, current drinking, hypertension, dyslipidemia, coronary artery disease, stroke, glycated hemoglobin and diabetic neuropathy. The prevalence values of depressive symptoms, moderate to severe ED and severe ED were 15.1%, 64.2% and 51.0%, respectively. Depressive symptoms were independently positively associated with moderate to severe ED and severe ED (adjusted odds ratios were 2.23 (95% confidence interval (CI): 1.17-4.43) and 1.86 (95% CI: 1.04-3.41), respectively). In Japanese patients with type 2 diabetes mellitus, depressive symptoms may be associated with ED.

DOI： 10.1038/ijir.2016.45

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Aims: No evidence exists regarding the association between sitting time and erectile dysfunction (ED) among patients with type 2 diabetes mellitus. The aim of this study was to evaluate the association between self-reported sitting time and ED among patients with type 2 diabetes mellitus.
Methods: Study subjects were 430 male Japanese patients with type 2 diabetes mellitus (mean age, 60.5 years). A self-administered questionnaire was used to collect information on the variables under study. The study subjects were asked about time spent sitting during typical 24-hour periods over the past 12 months. Subjects were divided into four groups according to seit-reported sitting time: 1) &lt;5 hours, 2) 5-7 hours, 3) 7-9 hours, and 4) &gt;= 9 hours. ED was defined as present when a subject had a Sexual Health Inventory for Men score &lt;8. Adjustment was made for age, body mass index, duration of type 2 diabetes, current smoking, current drinking, hypertension, coronary artery disease, stroke, glycated hemoglobin, walking habit, and diabetic neuropathy.
Results: The prevalence values of moderate to severe ED and severe ED were 36.1% and 49.8%. At least 9 hours sitting was independently positively associated with severe ED but not moderate to severe ED; the adjusted OR was 1.84 (95% CI: 1.06-333). In the multivariate model, there was a statistically significant inverse exposure-response relationship between the self-reported sitting time and severe ED (p for trend = 0.029).
Conclusions: Self-reported sitting time may be positively associated with ED in Japanese patients with type 2 diabetes mellitus. (C) 2017 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.jdiacomp.2016.10.011

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Only limited epidemiological evidence exists regarding the relationship between diabetic neuropathy and erectile dysfunction (ED) among Japanese patients with type 2 diabetes mellitus. To investigate the relationship between diabetic neuropathy and ED among Japanese patients with type 2 diabetes mellitus, a multicenter cross-sectional study was conducted in 287 male Japanese patients with type 2 diabetes Mellitus, age (19-65 years). Diabetic neuropathy was diagnosed if the patients showed two or more of the following three characteristics: neuropathic symptoms, decreased or disappeared Achilles tendon reflex and/or abnormal vibration perception. ED, moderate to severe ED, and severe ED were defined as present when a subject had a Sexual Health Inventory for Men score &lt; 22, &lt; 12 and &lt; 8, respectively. The prevalenee values of diabetic neuropathy and severe ED were 47.0 and 39.0%, respectively. Diabetic neuropathy was independently positively associated with severe ED, but not ED and moderate ED: the adjusted odds ratio was 1.90 (95% confidence interval: 1.08-3.38). No relationships were found between diabetic retinopathy or diabetic nephropathy and ED. Diabetic neuropathy is positively associated with severe erectile dysfunction among Japanese type 2 diabetes mellitus patients aged &lt; 65 years.

DOI： 10.1038/ijir.2016.40

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

Background: Sleep disordered breathing (SDB) is associated with decreased psychomotor vigilance (hereafter "vigilance") in clinical settings, but this association has yet to be confirmed in the general population. The aim of this study is to determine the associations between SDB and vigilance in a large sample of community-based participants.
Methods: The study sample consisted of 1508 community-dwelling Japanese persons (age: 30e79 years, women: 62.7%, mean body mass index [BMI]: 23.1 kg/m2). Vigilance was measured by the psychomotor vigilance task (PVT), and SDB was measured by overnight pulse oximetry. We investigated odds ratios for "high mean reaction time (RT)" and "high number of lapses," which we defined as the 75th percentile of each value, across categories of oximetry values (three percent oxygen desaturation index [ODI], 4% ODI, average oxygen saturation, minimum oxygen saturation).
Results: Multivariable-adjusted odds ratios of high mean RT and high number of lapses in severe SDB (3% ODI 30.0 events/h) were 3.0 (95% confidence interval: 1.0-8.9; P for trend = 0.03) and 3.3 (95% confidence interval: 1.2-9.2, P for trend 0.03), respectively, compared to participants without SDB. Similar associations were observed between PVT metrics and four percent ODI. No significant associations between average oxygen saturation and PVT metrics were observed. Minimum oxygen saturationwas significantly associated with the trend of high number of lapses (P for trend = 0.007), but not with high mean RT.
Conclusions: The present study provides evidence that the intermittent hypoxia in SDB is significantly associated with the deterioration of PVT outcome metrics. (C) 2016 Elsevier B. V. All rights reserved.

DOI： 10.1016/j.sleep.2016.08.024

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN SOC INTERNAL MEDICINE  

Objective Macrovascular diseases and urgency incontinence are common among Japanese patients with type 2 diabetes mellitus. However, little evidence exists regarding the association between stroke and urgency incontinence among patients with type 2 diabetes mellitus. We examined the associations between macrovascular complications and urgency incontinence among Japanese patients with type 2 diabetes mellitus.
Methods The study subjects were 818 Japanese patients with type 2 diabetes mellitus. Urgency incontinence was defined as present when a subject answered "once a week or more" to the question: "Within one week, how often do you leak urine because you cannot defer the sudden desire to urinate?" We adjusted our analyses for sex, age, body mass index, duration of type 2 diabetes, current smoking, current drinking, hypertension, dyslipidemia, glycated hemoglobin, diabetic nephropathy, diabetic retinopathy, and diabetic peripheral neuropathy.
Results The prevalence of urgency incontinence was 9.2%. Stroke was independently positively associated with urgency incontinence, with an adjusted odds ratio of 2.34 (95% confidence interval: 1.03-4.95). The associations between ischemic heart disease or peripheral artery disease and the prevalence of urgency incontinence were not significant.
Conclusion In Japanese patients with type 2 diabetes mellitus, stroke, but not ischemic heart diseases or peripheral artery disease, was independently positively associated with urgency incontinence.

DOI： 10.2169/internalmedicine.56.8063

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Language：Japanese   Publisher：公益財団法人 パブリックヘルスリサーチセンター  

&lt;p&gt;The purpose of this study was to examine whether perceived stress and Sense of Coherence (SOC) were associated with Mibyou (presymptomatic disease) from Oriental medicine among community-dwelling Japanese. Participants were 651 men and 1,183women aged 30 to 79 years who participated in the Toon Health Study, which was conducted in Toon city, Ehime prefecture, from 2011 to 2015. Mibyou was assessed using the Oriental Medicine Health Questionnaire 57 (OHQ57); a total score of ≥ 29 points on the OHQ57 indicated presence of Mibyou. Perceived stress was assessed using a self-administered questionnaire. SOC was assessed using a 13-item Japanese version of the SOC scale. Gender and age group-specific analyses were performed using logistic regression model. The prevalence of Mibyou was positively associated with the perceived stress (&lt;i&gt;p&lt;/i&gt; &lt; .01), and negatively associated with SOC (trend &lt;i&gt;p&lt;/i&gt; &lt; .01) among men and women. Age-adjusted odds ratio (95% confidence intervals) of Mibyou for participants with perceived stress and low-median score of SOC was 8.35 (5.20-13.41) for men and 9.25 (6.39-13.41) for women, compared with those without perceived stress and with high SOC. Our findings suggested that the measure for Mibyou was important especially for people with perceived stress and low SOC.&lt;/p&gt;

DOI： 10.5058/stresskagakukenkyu.2017004

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

AimsDiabetes was significantly positively associated with urgency incontinence in several epidemiological studies. We examine the association between diabetic neuropathy, which we defined based on neuropathic symptoms, the absence of the Achilles reflex, and/or abnormal vibration perception, and urgency incontinence among Japanese patients with type 2 diabetes mellitus.
MethodsStudy subjects were 742 Japanese patients with type 2 diabetes mellitus, aged 19-70 years, who had undergone blood tests at our institutions. A self-administered questionnaire was used to collect information on the variables under study. Urgency incontinence was defined as present when a subject answered once a week or more to the question: Within one week, how often do you leak urine because you cannot defer the sudden desire to urinate ?. Diabetic neuropathy was diagnosed if the patients showed two or more of the following three characteristics: neuropathic symptoms, the absence of the Achilles reflex, and/or abnormal vibration perception. Adjustment was made for sex, age, body mass index, duration of type 2 diabetes mellitus, current smoking, hypertension, dyslipidemia, glycated hemoglobin, stroke, coronary artery disease, insulin therapy, diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy.
ResultsThe prevalence of urgency incontinence was 8.6%. Diabetic neuropathy was independently positively associated with urgency incontinence: the adjusted OR was 2.20 (95%CI: 1.16-4.36). Associations between diabetic retinopathy or nephropathy and the prevalence of urgency incontinence were not significant.
ConclusionsIn Japanese patients with type 2 diabetes mellitus, only diabetic neuropathy was independently positively associated with urgency incontinence. Neurourol. Urodynam. 35:1024-1027, 2016. (c) 2015 Wiley Periodicals, Inc.

DOI： 10.1002/nau.22875

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Background: Ubiquinol is widely used as an ant i aging supplement. In this study, we evaluated the effects of long term ubiquinol intake on improving or maintaining the qu a lity of life (QOL) of community residents. Methods: 124 adult (aged 22 86) residents 36 male, 88 female) participated in this trial . Each consumed 100 120 mg of ubiquinol per day for 6 months (n=22) or 12 months (n=102). We measured serum ubiquinol level s and QOL score s by SF 36 at baseline and after ubiquinol intake . Results: In female participants , the SF 36 scores of role physical ( RP), vitality ( VT), social functioning ( SF), mental health ( MH), and mental c omponent summary ( increased significantly. On the other hand , significant score changes were not shown in male participants . A fter s trati f ying baseline serum ubiquinol levels by tertiles, we found a significant improvement of mental QOL scores in the low and middle ubiquinol level groups of female participants , but not in the highest tertile. Conclusions: This trial indicate s that ubiq u inol supplement ation has effects on female participant s psychological QOL , especially for those whose baseline serum ubiquinol level s a re in the l ow to middle range.

DOI： 10.31989/ffhd.v6i11.281

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

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

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

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

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

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

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

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Aims/Introduction: Several epidemiological studies have reported a positive association between nocturia and erectile dysfunction (ED). Yet only limited evidence exists regarding the association between nocturia and ED among patients with type 2 diabetes mellitus, although nocturia and ED are common among type 2 diabetes mellitus patients.
Material and Methods: Study participants were 332 male Japanese patients with type 2 diabetes mellitus, aged 19-70 years, who had undergone blood tests at our institutions. A self-administered questionnaire was used to collect information on the variables under study. Adjustment was made for age, body mass index, hypertension, stroke, ischemic heart disease, glycated hemoglobin and diabetic neuropathy. ED, moderate to severe ED and severe ED were defined as present when a participant had a Sexual Health Inventory for Men score &lt;22, &lt;12 and &lt;8, respectively. Study participants were considered to have nocturia if they answered 'once or more' to the question: 'Within 1 week, how many times do you typically wake up to urinate from sleeping at night until waking in the morning?'
Results: The prevalence of nocturia was 79.8%. Nocturia was independently positively associated with ED and moderate to severe ED: the adjusted odds ratios were 7.86 (95% confidence interval 2.11-33.56) and 2.17 (95% confidence interval 1.16-4.12), respectively. The positive association between nocturia and severe ED fell just short of significance.
Conclusions: In Japanese men with type 2 diabetes mellitus, nocturia might be associated with ED and moderate to severe ED.

DOI： 10.1111/jdi.12503

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Diabetes mellitus and heavy alcohol consumption are both associated with vascular disease, a category that includes erectile dysfunction (ED). However, the association between alcohol consumption and ED among patients with type 2 diabetes mellitus remains unclear. The aim of the present multicenter crosssectional study was to investigate the relationship between drinking frequency, weekly alcohol consumption, daily alcohol consumption, and ED among Japanese patients with type 2 diabetes mellitus. Study subjects were 340 male Japanese patients with type 2 diabetes mellitus, aged 19-70 years, who had undergone blood tests at our institutions. A self-administered questionnaire was used to collect information on the variables under study.
ED was defined as present when a subject had a Sexual Health Inventory for Men score &lt;8. Adjustment was made for age, body mass index, duration of type 2 diabetes mellitus, current smoking, hypertension, dyslipidemia, glycated hemoglobin, stroke, coronary artery disease, diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. The prevalence of ED was 43.2% (147/340). The frequency of alcohol consumption and weekly alcohol consumption were independently inversely associated with ED (p for trend p = 0.001 and 0.004, respectively). The relationship between daily alcohol consumption and ED was an inverted J-shaped curve: alcohol consumption of less than 60 g, but not 60 g or more, per day was independently related to a lower prevalence of ED (p for quadratic trend = 0.003). In Japanese men with type 2 diabetes mellitus, an inverted J-shaped relationship between daily alcohol consumption and ED was observed, while frequency of alcohol consumption and weekly alcohol consumption were significantly inversely associated with ED. (C) 2016 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.alcohol.2016.07.006

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

OBJECTIVE To evaluate the association between microvascular complications and nocturia among Japanese patients with type 2 diabetes mellitus.
METHODS Study subjects were 731 Japanese patients with type 2 diabetes mellitus. A self-administered questionnaire was used to collect information on the variables under study. Study subjects were considered to have nocturia if they answered "once or more" to the question: "How many times do you typically wake up to urinate from sleeping at night until waking in the morning?" Diabetic neuropathy was diagnosed if the patients showed two or more of the following three characteristics: neuropathic symptoms, the absence of the Achilles reflex, or abnormal vibration perception. Diabetic nephropathy was defined as positive when the estimated glomerular filtration rate was &lt; 30 mL/min/1.73 m(2) and/or the urine albumin-to-creatinine ratio was &gt;= 34 mg/mmol creatinine. Several ophthalmology specialists were responsible for evaluating diabetic retinopathy. Adjustment was made for sex, age, body mass index, duration of diabetes mellitus, current smoking, current drinking, hypertension, stroke, ischemic heart disease, and glycated hemoglobin.
RESULTS The prevalence of nocturia was 80.4%. Diabetic retinopathy was independently positively associated with nocturia (adjusted odds ratio 2.39 [95% confidence interval: 1.08-6.11]). In contrast, diabetic nephropathy or diabetic neuropathy was not associated with nocturia.
CONCLUSION In Japanese patients with type 2 diabetes mellitus, only diabetic retinopathy was independently positively associated with nocturia. (C) 2016 Elsevier Inc.

DOI： 10.1016/j.urology.2016.03.017

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Background: Ubiquinol is widely used as an ant i aging supplement. In this study, we evaluated the effects of long term ubiquinol intake on improving or maintaining the qu a lity of life (QOL) of community residents. Methods: 124 adult (aged 22 86) residents 36 male, 88 female) participated in this trial . Each consumed 100 120 mg of ubiquinol per day for 6 months (n=22) or 12 months (n=102). We measured serum ubiquinol level s and QOL score s by SF 36 at baseline and after ubiquinol intake . Results: In female participants , the SF 36 scores of role physical ( RP), vitality ( VT), social functioning ( SF), mental health ( MH), and mental c omponent summary ( increased significantly. On the other hand , significant score changes were not shown in male participants . A fter s trati f ying baseline serum ubiquinol levels by tertiles, we found a significant improvement of mental QOL scores in the low and middle ubiquinol level groups of female participants , but not in the highest tertile. Conclusions: This trial indicate s that ubiq u inol supplement ation has effects on female participant s psychological QOL , especially for those whose baseline serum ubiquinol level s a re in the l ow to middle range.

DOI： 10.31989/ffhd.v6i5.248

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Background: Ubiquinol is widely used as an anti-Agingsupplement. In this study, we evaluatedthe effects of long-Term ubiquinol intake on improving or maintaining the quality of life(QOL) of community residents. Methods: 124 adult(aged 22-86) residents(36 male, 88 female) participated in this trial. Each consumed 100-120 mg of ubiquinol per day for 6 months (n=22) or 12 months (n=102). We measured serum ubiquinol levelsandQOL scoresby SF-36 at baseline and after ubiquinolintake. Results:Infemaleparticipants, the SF-36 scores of role physical(RP), vitality(VT), social functioning(SF), mental health(MH), and mental component summary(MCS)increased significantly. On the other hand, significant score changes were not shownin maleparticipants. Afterstratifyingbaseline serum ubiquinol levels by tertiles,we found a significant improvement of mental QOL scores in the lowandmiddleubiquinol level groupsof female participants, but not in the highest tertile. Conclusions: This trial indicatesthatubiquinol supplementationhas effects on femaleparticipants psychological QOL, especially for those whose baseline serum ubiquinol levelsare in the low to middle range.

DOI： 10.31989/ffhd.v6i4.240

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Language：Japanese   Publisher：和洋女子大学  

【目的】補酵素Q10（CoQ10）は、エネルギー産生や抗酸化能に関わる生命活動に必須の分子である。CoQ10は体内で生合成されるため、栄養学上は非必須栄養素に分類されている。目安となる摂取量は決められておらず、また食習慣と血中CoQ10値の関連を調査した報告もない。本研究では愛媛県上島町の住民を対象として、食習慣が血中CoQ10値に影響を与えているか、横断的調査による検討を行った。【方法】愛媛県上島町の住民189名（男性67名：年齢58.8±14.3歳、女性122名：年齢60.1±13.9歳）を対象とし、身体状況、血液・生化学的検査、栄養素摂取調査および生活習慣調査を実施した。【結果】血中CoQ10値は個人差が大きかった。食事からのCoQ10摂取量は、男女ともに60歳以上の方が多い傾向にあった。CoQ10を多く含む魚類および豆類の摂取量は、男女ともに60歳以上の方が有意に多かった。血中CoQ10値とCoQ10摂取量との間には明瞭な関連がみられなかった。【考察】血中CoQ10値は個人差が大きく、本横断的研究では食事による影響を見出すことはできなかった。一方、生合成経路が途中まで共通である血中総コレステロール値が、血中CoQ10値の高いグループでは低いグループよりも高かったことから、血中CoQ10値の個人差の一部は、生合成能力と関連がある可能性が示された。食習慣の影響を調べるには、横断研究における研究デザインの最適化やCoQ10摂取量を変化させるような食事介入調査を行うことが必要であると推測された。

DOI： 10.18909/00001386

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Background: Ubiquinol is widely used as an anti-aging supplement. In this study, we evaluated the effects of long-term ubiquinol intake on improving or maintaining the quality of life (QOL) of community residents. Methods: 124 adult (aged 22-86) residents (36 male, 88 female) participated in this trial. Each consumed 100-120 mg of ubiquinol per day for 6 months (n=22) or 12 months (n=102). We measured serum ubiquinol levels and QOL scores by SF-36 at baseline and after ubiquinol intake. Results: In female participants, the SF-36 scores of role physical (RP), vitality (VT), social functioning (SF), mental health (MH), and mental component summary (MCS) increased significantly. On the other hand, significant score changes were not shown in male participants. After stratifying baseline serum ubiquinol levels by tertiles, we found a significant improvement of mental QOL scores in the low and middle ubiquinol level groups of female participants, but not in the highest tertile. Conclusions: This trial indicates that ubiquinol supplementation has effects on female participants’ psychological QOL, especially for those whose baseline serum ubiquinol levels are in the low to middle range.

DOI： 10.31989/ffhd.v6i2.228

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Objective: Lower heart rate variability (HRV) is associated with the inflammation that is linked with the progression of atherosclerosis. We examined this association, taking insulin sensitivity into consideration, as it is related to both HRV and inflammation.
Methods: Subjects were 1728 individuals ages 30-79 years who did not smoke between 2009 and 2012. C-reactive protein (CRP) concentrations and white blood cell (WBC) counts were assessed as markers of inflammation. The homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutt's insulin sensitivity index (ISI) were calculated based on fasting and 2h-post-load glucose and insulin concentrations in a 75-g oral glucose tolerance test. Pulse was recorded for 5 min, and time-domain HRV indices of standard deviation of NN intervals (SDNN) and root mean square of successive differences (RMSSD) were calculated. Power spectral analysis provided frequency domain measures of HRV: high frequency (HF) power, low frequency (LF) power and LF/HF.
Results: Sex and age-adjusted logistic models presented quartiles of SDNN, RMSSD, LF, and HF significantly associated with the highest quartile of CRP or WBC. After adjustment for body mass index and ISI, the associations were attenuated for WBC; however, even after further adjustment for several variables, SDNN, RMSSD, LF, and HF remained significantly associated with elevated CRP concentrations. When results were stratified by weight, the associations appeared more evident among non-overweight individuals.
Conclusion: Lowered HRV, primarily due to parasympathetic dysfunction, was associated with elevated inflammation, independent of weight, insulin sensitivity, and other related factors. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.atherosclerosis.2015.10.112

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：FUNCTIONAL FOOD CENTER INC  

Background: Ubiquinol is widely used as an anti-aging supplement. In this study, we evaluated the effects of long-term ubiquinol intake on improving or maintaining the quality of life (QOL) of community residents.Methods: 124 adult (aged 22-86) residents (36 male, 88 female) participated in this trial. Each consumed 100-120 mg of ubiquinol per day for 6 months (n=22) or 12 months (n=102). We measured serum ubiquinol levels and QOL scores by SF-36 at baseline and after ubiquinol intake.Results: In female participants, the SF-36 scores of role physical (RP), vitality (VT), social functioning (SF), mental health (M11), and mental component summary (MCS) increased significantly. On the other hand, significant score changes were not shown in male participants. After stratifying baseline serum ubiquinol levels by tertiles, we found a significant improvement of mental QOL scores in the low and middle ubiquinol level groups of female participants, but not in the highest tertile.Conclusions: This trial indicates that ubiquinol supplementation has effects on female participants' psychological QOL, especially for those whose baseline serum ubiquinol levels are in the low to middle range.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Atherosclerosis Society  

Aim: It is important to explore predictive markers other than conventional cardiovascular risk factors for early detection and treatment of chronic kidney disease (CKD), a major risk factor for end-stage renal failure. We hypothesized that serum albumin and high-sensitivity C-reactive protein (hs-CRP) to be independent markers, and examined their associations with the risk of CKD. Methods: We examined the associations of serum albumin and hs-CRP levels with the risk of incident CKD, in 2535 Japanese adults aged 40-69 years without CKD at baseline during a median 9.0-year follow-up after adjustment for known cardiovascular risk factors. Results: During the follow-up period, 367 cases of CKD developed. In multivariable analyses adjusted for known risk factors, the CKD hazard ratios (95% confidence intervals) for the highest versus lowest quartiles of serum albumin levels were 0.69 (0.40-1.17) for men and 0.42 (0.28-0.64) for women. Corresponding values for hs-CRP were 0.95 (0.54-1.67) for men and 1.85 (1.25 -2.75) for women. The association of combined serum albumin and hs-CRP with the risk of CKD was examined for women. The hazard ratio was 1.72 (1.17-2.54) for low versus higher albumin levels at lower hs-CRP levels, but such an association was not observed at high hs-CRP level. The hazard ratio was 1.96 (1.44- 2.66) for high versus lower hs-CRP levels at higher serum albumin levels, but such association was not observed at low serum albumin level. Conclusion: Both low serum albumin and high hs-CRP levels were predictive of CKD for women.

DOI： 10.5551/jat.33530

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

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN EPIDEMIOLOGICAL ASSOC  

Background: Although impaired cardiac autonomic function is associated with an increased risk of type 2 diabetes in Caucasians, evidence in Asian populations with a lower body mass index is limited.
Methods: Between 2009-2012, the Toon Health Study recruited 1899 individuals aged 30-79 years who were not taking medication for diabetes. A 75-g oral glucose tolerance test was used to diagnose type 2 diabetes, and fasting and 2-h-postload glucose and insulin concentrations were measured. We assessed the homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutt's insulin sensitivity index (ISI). Pulse was recorded for 5 min, and time-domain heart rate variability (HRV) indices were calculated: the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive difference (RMSSD). Power spectral analysis provided frequency domain measures of HRV: high frequency (HF) power, low frequency (LF) power, and the LF: HF ratio.
Results: Multivariate-adjusted logistic regression models showed decreased SDNN, RMSSD, and HF, and increased LF: HF ratio were associated significantly with increased HOMA-IR and decreased ISI. When stratified by overweight status, the association of RMSSD, HF, and LF: HF ratio with decreased ISI was also apparent in nonoverweight individuals. The interaction between LF: HF ratio and decreased ISI in overweight individuals was significant, with the odds ratio for decreased ISI in the highest quartile of LF: HF ratio in non-overweight individuals being 2.09 (95% confidence interval, 1.41-3.10).
Conclusions: Reduced HRV was associated with insulin resistance and lower insulin sensitivity. Decreased ISI was linked with parasympathetic dysfunction, primarily in non-overweight individuals.

DOI： 10.2188/jea.JE20140254

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Objective: Although green and yellow vegetables have beneficial effects against type 2 diabetes, the relationship of their nutritive content with insulin resistance is poorly understood. The aim of this study was to examine the associations of serum beta-carotene and retinol concentrations with glucose and insulin concentrations.
Methods: We recruited 951 Japanese men and women ages 30 to 79 y who were not undergoing treatment for diabetes and measured their serum beta-carotene and retinal concentrations. A 75-g oral glucose tolerance test was performed and the homeostasis model assessment for insulin resistance (HOMA-IR) and the Matsuda Index were calculated as measures of insulin resistance. Several confounding factors were adjusted for with multivariable logistic models.
Results: Multivariable-adjusted odds ratios of the highest quartile of serum beta-carotene compared with the lowest quartile for HOMA-IR &gt;1.6 and Matsuda Index &lt;4.9 were 0.56 (95% confidence interval, 0.34-0.94) and 0.62 (0.37-1.02), respectively. When stratified by sex and overweight status, these associations were observed for women and non-overweight individuals. Serum retinol concentration was not associated with either index. Furthermore, according to the nutritional survey, serum beta-carotene concentration was associated with green and yellow vegetable intake (P = 0.01).
Conclusion: Our findings suggest that higher serum beta-carotene levels, associated with higher intake of green and yellow vegetables, confer beneficial effects against insulin resistance. (C) 2015 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.nut.2015.02.015

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

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

ObjectiveThis study examined the associations of masticatory ability evaluated by chewing-gum-stimulated salivary flow rate with anthropometric indices among a general Japanese population.
MethodsIn total, 921 Japanese men and women aged 30-79 years participated in this cross-sectional study. Saliva production was stimulated by 5 min of gum chewing, then collected; salivary flow rate was calculated as g/min. Overweight, abdominal obesity in terms of waist circumference (WC), and waist-hip ratio (WHR), and elevated skinfold thickness statuses were determined.
ResultsThe multivariable odds ratio and 95% confidence intervals of overweight, abdominal obesity (WC, WHR), and elevated skinfold thickness status for highest vs. lowest quartile of salivary flow rate were 0.59 (0.37-0.95, P for trend=0.02), 0.65 (0.43-0.98, P=0.03), 0.54 (0.35-0.83, P&lt;0.01), and 0.61 (0.39-0.96, P&lt;0.01), respectively. The linear trends of multivariable-adjusted means of BMI, WC, WHR, and skinfold thickness according to quartiles of salivary flow rate did not vary after stratification by overweight status.
ConclusionsHigher stimulated salivary flow rate, a surrogate marker for mastication ability, was associated with lower prevalence of overweight, abdominal obesity (whether WC- or WHR-defined), and elevated skinfold thickness among the general Japanese population.

DOI： 10.1002/oby.21071

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

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

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

【背景】わが国では、朝食欠食率はこの30年間で増加し続けてきた。先行研究によると、朝食欠食は循環器疾患やその危険因子との関連がみられているがわが国においてそのエビデンスは少ない。そこで本研究では、朝食欠食と循環器疾患危険因子との関係について横断的分析を行った。【方法】秋田県、大阪府にて実施しているCirculatory Risk in Communities Study(CIRCS)における2003〜2006年度の循環器健診を受診した30〜69歳の男性1,283名、女性2,531名を対象とした。循環器疾患危険因子として、body mass index(BMI)、血圧値、HbA1c、総コレステロール値、LDL-コレステロール値、HDL-コレステロール値、Non HDL-コレステロール値を分析に用いた。また、過去1ヵ月間の朝食欠食は、保健師による問診により把握した。共分散分析により朝食欠食の有無別に各循環器疾患危険因子について、年齢、喫煙、飲酒、早食い、おなかいっぱい食べる、運動習慣、総エネルギー、総食物繊維、ナトリウム、カリウム、カルシウム摂取量、服薬治療(高血圧、糖尿病、脂質異常症)、調査地域、閉経の有無を交絡因子として調整した多変量調整平均値を算出し比較した。【結果】男性1,283名中178名(13.9%)、女性2,531名中229名(9.0%)が朝食欠食であった。女性の朝食欠食者は非欠食者と比べて、総コレステロール値(欠食vs非欠食:221.8 vs 215.4mg/dL、p=0.01)、LDL-コレステロール値(それぞれ134.5 vs 127.5mg/dL、p&lt;0.01)、HDL-コレステロール値(69.7 vs 69.0mg/dL、p=0.54)、Non HDL-コレステロール値(152.1 vs 46.4mg/dL、p=0.02)とHDL-コレステロール値以外で高値を示した。男性でも同様の傾向がみられたが、有意差はみられなかった。また、他の危険因子については、朝食欠食有無によって差はみられなかった。さらに、秋田県、大阪府に分けて層別した分析結果においても同様の傾向がみられた。【考察】日本人女性において朝食欠食は脂質異常と関連することが示された。(著者抄録)

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Language：Japanese   Publisher：四国公衆衛生学会  

【目的】メタボリックシンドロームは循環器疾患を発症させる大きな原因の1つであり、予防が必要とされる。愛媛県愛南町では、メタボリックシンドロームの有病率が高いが、これまでに生活習慣やメタボリックシンドロームについての縦断的な検討を実施していない。そこで本研究では、生活習慣とメタボリックシンドロームの構成項目について、個人の経年的な変化を比較すること、及び、生活習慣とメタボリックシンドロームの出現との関連を縦断的に検討することを目的とした。【方法】2008〜2009年と2012年にS協会で特定健診を受診した40〜72歳の男女1,463人を対象とし、生活習慣及び、メタボリックシンドロームとその構成項目について、2008-2009年のベースライン時と2012年の値を対応のあるt検定およびマクネマー検定により比較した。また、各生活習慣の無いものに比較してあるもののメタボリックシンドローム出現の年齢調整及び多変量調整オッズ比を算出した。メタボリックシンドロームの基準は、必須項目の腹部肥満「男性85cm以上、女性90cm以上の腹囲」に加えて、選択項目の脂質異常「中性脂肪150mg/dl以上またはHDLコレステロール40mg/dl未満」、血圧高値「収縮期血圧130mmHg以上または拡張期血圧85mmHg以上」、高血糖「HbA1c(NGSP値)6.0%以上」の3つの内、2つ以上該当した場合とした。また、血圧高値・脂質異常・高血糖には、それぞれの服薬者も含めた。【結果】ベースライン時と2012年の比較では、生活習慣では現在喫煙、飲酒習慣、朝食を抜く者の割合が有意に減少し、検診成績では収縮期血圧と拡張期血圧の平均値がともに有意に低下していた。一方で、高血糖者、脂質異常者の割合は有意に増加した。平均3.84年度の追跡調査において、109人の新規のメタボリックシンドロームが出現した。メタボリックシンドロームの出現要因を検討した結果、喫煙習慣がある者はない者に比べてメタボリックシンドローム出現のオッズ比が高く多変量調整オッズ比(95%信頼区間)は3.54(1.91-6.56)であった。就寝前2時間の夕食が週に3回以上であることもリスクを高める傾向があった。【結論】生活習慣では、喫煙者、飲酒習慣者、朝食を抜く者の割合、に改善が見られ、愛南町における生活習慣改善の対策には一定の効果があると考えられた。一方で、高血糖者、脂質異常者に増加が見られた。さらに、愛南町におけるメタボリックシンドロームに関連する要因として、喫煙、及び夜遅くの夕食が考えられ、引き続き対策が必要であると考えられる。(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PERGAMON-ELSEVIER SCIENCE LTD  

Because few studies have developed food frequency questionnaires (FFQ) and examined their reliability for Japanese urban populations, FFQ developed for urban Japanese populations may show reasonable reliability for estimating intakes of nutrients and food groups. Therefore, the objective of this study was to examine the reliability of an FFQ developed for a prospective cohort study in a Japanese urban area. A total of 29 men and 29 women aged 47 to 78 years were selected from participants in the Suita study from February 1997 to February 1998. Seven-consecutive-day dietary records (DR) was collected in each season (28-day DR). The FFQ were administered 3 times in total in each season, except in autumn. We calculated Spearman correlation coefficients to assess the validation of the first and third FFQ compared with 28-day DR and to assess the repeatability for 3-, 6-, and 9-month intervals. Reasonable validity of each FFQ compared with 28-day DR were observed for energy intake and for 27 nutrients, and 11 food groups were selected. Median (range) Spearman rank correlation coefficients for energy-adjusted nutrient and food group intakes of the first FFQ were 0.52 (0.14-0.88) and 0.53 (0.24-0.74), and those of the third FFQ were 0.51 (0.07-0.84) and 0.57 (0.16-0.75), respectively. The repeatability of each interval was relatively good; median (range) Spearman correlation coefficients of nutrients for 3-, 6-, and 9-month intervals were 0.67 (0.40-0.85), 0.63 (0.25-0.93), and 0.62 (0.31-0.87), respectively; those for food groups were 0.58 (0.42-0.76), 0.56 (0.24-0.80), and 0.65 (0.30-0.76), respectively. In conclusion, this FFQ is useful for evaluating the associations of nutrient and food intakes with cardiovascular diseases and their risk factors in Japanese urban populations. (C) 2015 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.nutres.2014.10.012

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Language：English   Publisher：Libertas Academica Ltd.  

Elevated C-reactive protein (CRP) levels are associated with an increased risk of cardiovascular disease (CVD) in Caucasians
however, evidence is lacking for East Asians, who have low CRP levels. PubMed and Google Scholar searches were conducted (1966 through September 2014), and eight prospective studies in East Asian countries (China, Hong Kong, Japan, Korea, Macao, Mongolia, and Taiwan) that documented risk ratios of elevated CRP for CVD were included for meta-analysis with random-effects models. The overall association between CRP levels and stroke was significant in six studies (risk ratio = 1.40 [95% confidence interval {CI}, 1.10–1.77], P = 0.008). The association with ischemic stroke was more evident in subgroup analyses. For coronary heart disease (CHD) and CVD, the risk ratio was 1.75 (95% CI, 0.96–3.19, P = 0.07) and 1.76 (95% CI, 1.29–2.40, P, 0.001), respectively. Although East Asians have low CRP levels, this meta-analysis shows that elevated CRP levels were significantly associated with an increased risk of stroke, primarily ischemic stroke.

DOI： 10.4137/CMC.S17066

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

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN ENDOCRINE SOC  

Subclinical hypothyroidism (SCH) has been associated with type 2 diabetes mellitus. However, it is unknown whether common complications of type 2 diabetes, such as diabetic nephropathy, are also present with SCH. Here, we investigated the association between SCH and diabetic nephropathy among Japanese patients with type 2 diabetes mellitus. In this multicenter cross-sectional study, we recruited 414 such patients who had no previous history of thyroid disease. Serum thyroid hormone levels and the urinary albumin:creatinine ratio were measured. SCH was defined as an elevated thyroid-stimulating hormone (TSH) level (&gt;4.0 mIU/L), and diabetic nephropathy was defined as urinary albumin/creatinine ratio &gt;= 300 mg/g. The prevalence of SCH was 8.7% (n = 36) among patients with type 2 diabetes mellitus. The SCH group had a higher prevalence of dyslipidemia (p = 0.008) and diabetic nephropathy (p = 0.014) than the euthyroid group. Multivariate analysis identified significant positive associations between diabetic nephropathy and SCH (odds ratio [OR], 3.51; 95% confidence interval [CI], 1.10-10.0; p = 0.034), hypertension (OR, 4.56; 95% CI, 1.69-14.7; p = 0.001), and smoking (OR, 3.02; 95% CI, 1.14-7.91;p = 0.026). SCH may be independently associated with diabetic nephropathy in Japanese patients with type 2 diabetes mellitus.

DOI： 10.1507/endocrj.EJ14-0206

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

Background: Intermittent hypoxemia is a fundamental pathophysiological consequence of sleep-disordered breathing and may alter glucose metabolism. To characterize the association between sleep-related intermittent hypoxemia and glucose metabolism, overnight pulse-oximetry and an oral glucose tolerance test were completed in a cohort of middle-aged and older Japanese adults.
Methods: The study sample consisted of 1836 community-dwelling Japanese (age, 30-79 years; women, 65.5%; mean body mass index, 23.1 kg/m(2)). The oxygen desaturation index (ODI) was quantified during sleep using a &gt;= 3% oxygen desaturation threshold and categorized as normal (&lt; 5.0 events/h), mild (5.015.0 events/h), and moderate to severe (&gt;= 15.0 events/h). The independent associations between the ODI and the prevalence of impaired fasting glucose, impaired glucose tolerance, diabetes, and two metrics of insulin resistance [homeostasis model assessment index for insulin resistance (HOMA-IR) and Matsuda index] were examined.
Results: Compared with subjects with an ODI &lt; 5 events/h, the adjusted odds ratio for prevalent impaired fasting glucose, glucose intolerance, and diabetes for subjects with an ODI &gt;= 15.0 events/h were 1.27 (95% confidence interval, 0.72-2.23), 1.69 (1.03-2.76), and 1.28 (0.59-2.79), respectively. Both HOMA-IR and Matsuda index were significantly associated with the severity of sleep-related intermittent hypoxemia as assessed by the ODI (P for trend &gt;= 0.03 and 0.007, respectively).
Conclusion: Among middle-aged and older Japanese adults, sleep-related intermittent hypoxemia is associated with glucose intolerance and insulin resistance, and may contribute to the development of type 2 diabetes mellitus. (C) 2014 Elsevier B. V. All rights reserved.

DOI： 10.1016/j.sleep.2014.05.027

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

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

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

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

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

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

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Heart rate variability (HRV) is associated with blood pressure levels; however, very few studies have correlated HRV to lifestyle in the general population. We investigated 1418 men and 2040 women aged 40-74 years and measured the HRV indices in the time and frequency domains using a 5-min R-R interval recording. Multiple linear regression analyses were used to estimate the association between HRV and blood pressure levels after adjustment for major confounders. HRV indices were not associated with systolic blood pressure levels in men, whereas in women, one-s.d. (1-s.d.) increment of s.d. of normal R-R intervals (SDNN) was associated with a 1.21-mm Hg decrease in systolic blood pressure after adjusting for several confounders (P&lt;0.05). In addition, a 1-s.d. increment of SDNN corresponded with 1.00 and 1.10 mm Hg reductions in diastolic blood pressure in men and women, respectively (P&lt;0.05). When stratified by the use or nonuse of antihypertensive medication, these inverse associations were more evident in the nonuser group. Furthermore, among men not using antihypertensive medication, reduced HRV was associated with increased systolic blood pressure levels in nondrinkers. The data suggest that HRV reflects diastolic blood pressure better than systolic blood pressure levels for both sexes and that alcohol intake strongly affects systolic blood pressure levels in men, which may have weakened the association with HRV.

DOI： 10.1038/hr.2014.73

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Language：Japanese   Publisher：徳島大学  

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OBJECTIVE: Despite the fact that the total energy intake of Japanese people has decreased, the percentage of obese people has increased. This suggests that the timing of meals is related to obesity. The purpose of the study was to investigate the relationship between the timing of meals and obesity, based on analyses of physical measurements, serum biochemical markers, nutrient intake, and lifestyle factors in the context of Chrononutrition. PARTICIPANTS AND METHODS: We analyzed data derived from 766 residents of Toon City (286 males and 480 females) aged 30 to 79 years who underwent detailed medical examinations between 2011 and 2013. These medical examinations included. (1) physical measurements (waist circumference, blood pressure, etc.); (2) serum biochemical markers (total cholesterol, etc.); (3) a detailed questionnaire concerning lifestyle factors such as family structure and daily habits (22 issues), exercise and eating habits (28 issues), alcohol intake and smoking habits; (4) a food frequency questionnaire based on food groups (FFQg); and (5) a questionnaire concerning the times at which meals and snacks are consumed. RESULTS: The values for body mass index (BMI) and waist circumference were higher for participants who ate dinner less than three hours before bedtime (<3-h group) than those who ate more than three hours before bedtime (>3-h group). The Chi-square test showed that there was a significant difference in eating habits, e.g., eating snacks, eating snacks at night, having dinner after 8 p.m., and having dinner after 9 p.m., between the <3-h group and the >3-h group. Multiple linear regression analysis showed that skipping breakfast significantly influenced both waist circumference (β = 5.271) and BMI (β = 1.440) and that eating dinner <3-h before going to bed only influenced BMI (β = 0.581). CONCLUSION: Skipping breakfast had a greater influence on both waist circumference and BMI than eating dinner <3-h before going to bed.

DOI： 10.2185/jrm.2887

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN ATHEROSCLEROSIS SOC  

Aim: Nocturnal intermittent hypoxia (NIH), a primary marker of obstructive sleep apnea, has increasingly been linked with cardiovascular morbidity and mortality. The purpose of this study was to investigate the association between NIH and arterial stiffness as measured according to the cardio-ankle vascular index (CAVI) based on cardiovascular risk factors in a Japanese community-dwelling population.
Methods: We conducted a cross-sectional study in Toon city among 684 men and 1,241 women 30-79 years of age. The severity of NIH was defined as mild or moderate-to-severe according to five or 15 events/hour on the 3% oxygen desaturation index (ODI), respectively. Increased arterial stiffness was diagnosed according to a CAVI of &gt;= 9.
Results: The number of subjects with no, mild and moderate-to-severe NIH was 1,348 (70%), 451 (23%) and 126 (7%), respectively. Increased arterial stiffness was detected in 21.9% of the participants. The multivariable-adjusted odds ratio (95% CI) of severe NIH related to an increased CAVI in comparison with a 3% ODI of &lt; 5 was 1.36 (0.82-2.23). The stratified logistic regression analysis showed that the multivariable-adjusted OR of severe NIH for an increased CAVI was remarkably increased in the individuals with a BMI of &gt;= 25 (OR = 2.53, 1.08-5.96; p = 0.03). An interaction test showed a trend for an overweight status to be a modifier of the association between OSA and increased arterial stiffness (p = 0.05).
Conclusions: NIH has a tendency to promote increased arterial stiffness as measured according to the CAVI, especially in overweight subjects.

DOI： 10.5551/jat.24505

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Language：English   Publishing type：Part of collection (book)   Publisher：Elsevier Inc.  

Cardiovascular diseases, including coronary heart disease and stroke, are major and increasing causes of mortality throughout the world. Aging is a major determinant of cardiovascular diseases because it promotes oxidative stress and atherosclerosis. Oxidative stress, a potential factor in the promotion of cardiovascular diseases, is the result of an imbalance between the biologic reactions of reactive oxygen species and the factors that promote recovery from damage by reactive oxygen species
this imbalance may play a key role in promoting cardiovascular diseases. Antioxidant vitamins have potential preventive effects against cardiovascular diseases. Vitamins A, C, and E are well known antioxidant vitamins and are also well studied in relation to primary and secondary prevention against cardiovascular diseases. Whereas reports on many cohorts have supported a primary preventative effect of antioxidant vitamins on cardiovascular diseases, the evidence from clinical trials has been controversial. Some studies have implied that antioxidant vitamins may act as pro-oxidants and subsequently promote atherosclerosis. Several factors mask the association between antioxidant vitamins and cardiovascular diseases
therefore, more studies are needed to clarify this association. © 2014 Elsevier Inc. All rights reserved.

DOI： 10.1016/B978-0-12-405933-7.00021-4

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Background and Aims: Little evidence showed the association between dietary patterns and cardiovascular disease among Japanese. The objective of this study was to examine whether dietary patterns are associated with cardiovascular disease among middle-aged Japanese. Methods and Results: At baseline (1988-1990), 26,598 men and 37,439 women aged 40-79 years enrolled in the Japan Collaborative Cohort (JACC) Study. During the follow-up through 2003, 578 men and 499 women died from stroke, and 272 men and 207 women died from coronary heart disease. We identified three major dietary patterns, 'vegetable', 'animal food' and 'dairy product', by factor analysis for both sexes. The multivariable hazard ratio (HR) and 95% confidence intervals of mortality from total cardiovascular disease in the highest versus lowest quintiles of the vegetable pattern were 0.93 (0.78-1.13), p for trend. = 0.73 for men and 0.82 (0.67-1.00), p for trend. = 0.04 for women. The respective HRs of mortality from stroke in the highest versus lowest quintiles of the dairy product pattern were 0.65 (0.49-0.86), p for trend. = 0.01 for men and 0.70 (0.51-0.97), p for trend. = 0.02 for women, and those of total cardiovascular disease were 0.89 (0.74-1.08), p for trend. = 0.23 for men and 0.76 (0.61-0.94), p for trend. = 0.01 for women. The animal food pattern was not associated with mortality from stroke, coronary heart disease or total cardiovascular disease for either sex. Conclusion: We found that 'vegetable' and 'dairy product' patterns were associated with lower morality from cardiovascular disease, while the 'animal food' pattern was not associated with mortality from cardiovascular disease among Japanese. © 2011 Elsevier B.V.

DOI： 10.1016/j.numecd.2011.10.007

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Dietary behavior can worsen or prevent hypertension. However, data on the association between dietary behavior and the risk of hypertension in Asians are limited. The aim of this study was to determine these associations in Japanese male workers. We conducted a prospective study of 30-71-year-old Japanese male workers in Osaka, Japan, between 2001 and 2011. The study subjects were 3486 normotensive males who were assessed for an average of 4.6 years using an annual survey. We defined hypertension by a systolic blood pressure of &gt;= 140 mm mg, a diastolic blood pressure of &gt;= 90 mm Hg and/or the use of antihypertensive medications. Dietary behavior questionnaires were included in the annual surveys. For each question on dietary behavior, we calculated the odds ratios (ORs) for the risk of hypertension using logistic regression models. We used subjects who consistently gave affirmative answers in the baseline and end-point surveys as a reference. The number of new cases of hypertension was 846 among 3486 subjects. Compared with subjects who eat meat frequently, subjects who did not eat meat frequently showed a higher risk of hypertension (OR = 1.26, 95% confidence interval (CI): 1.00-1.59). Subjects who did not consume dairy products every day showed a higher risk of hypertension (OR 1.39, 95% CI: 1.13-1.71) compared with those who did. Meat and dairy product intake was associated with the prevention of hypertension among Japanese male workers. Hypertension Research (2013) 36, 374-380; doi: 10.1038/hr.2012.205; published online 10 January 2013

DOI： 10.1038/hr.2012.205

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Objective: Limited evidence has been available on the relationships of cellular growth factors with cardiovascular disease in population-based samples.
Methods: We conducted a nested case-control study under a large prospective cohort study (JACC study) where a total of 39,242 subjects aged 40-79 years provided serum sample. We measured cellular growth factors [insulin-like growth factors I, II and binding protein-3 (IGF-I, IGF-II and IGFBP-3) and transforming growth factor (TGF-beta 1)] among cases and controls, matched for sex, age, area of residence and year of serum storage.
Results and conclusions: During the follow-up for 9 years, there were 233 deaths from total stroke (49 subarachnoid hemorrhages, 55 intraparenchymal hemorrhages, 71 ischemic strokes), and 97 deaths from coronary heart disease. The multivariable odds ratio (95%CI) of intraparenchymal hemorrhage associated with a 1-SD increment of IGF-I (men: 4 8 ng/ml, women: 61 ng/ml) was 0.31 (0.14-0.71). That of ischemic stroke associated with a 1-SD increment of TGF-beta 1 (men: 8.0 ng/ml, women: 10.9 ng/ml) was 0.58 (0.34-0.98). Serum IGF-II and IGFBP-3 were not associated with mortality from any outcomes. In conclusion, IGF-I was inversely associated with mortality from intraparenchymal hemorrhage while TGF-beta 1 was so with ischemic stroke, suggesting potential roles of cellular proliferation in the development or prognosis of stroke. (c) 2012 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.atherosclerosis.2012.05.026

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Language：Japanese   Publisher：日本栄養改善学会  

DOI： 10.5264/eiyogakuzashi.68.378

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Objective: To examine the reproducibility of 24-hour dietary recall for estimating dietary vitamin intakes by middle-aged Japanese men and women. Methods and Results: The subjects were 132 men and 130 women aged 40-69 years, selected from participants in cardiovascular risk surveys conducted in 4 communities. The reproducibility of the 24-hour dietary recall was tested by comparing nutrient and food intake for two recalls conducted on the same season 1 year apart, designated as recalls 1 and 2. Differences in mean values between two recalls were tested using analysis of variance, and Spearman rank correlation coefficients for the two recalls were calculated for nutrient and food intakes. Mean values of energy and vitamins for both sexes were generally similar for the two recalls. The reproducibility of recall by men was high for vitamin B2, folate, pantothenic acid, and vitamin C and by women for vitamin B2, moderate by men for vitamins A, E, K, B1, B6 and niacin, and by women for vitamins A, E, K, B1, B6 and niacin, folate, pantothenic acid and vitamin C, and low by both men and women for vitamins D and B12. T. The reproducibility during 1985-1999 was generally lower than that of 1973-1984, but that for folate, pantothenic acid and vitamin C remained to be moderate in 1984-1999. Conclusions: Although the reproducibility of 24-hour dietary recall varies among vitamins, moderate and sustained reproducibility was observed for folate, vitamin C and pantothenic acid.

DOI： 10.1007/s12603-010-0048-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN ATHEROSCLEROSIS SOC  

Background: It remains unclear how much coronary risk factors contribute to the prediction of myocardial infarction among Japanese populations.
Methods and results: A nested case-control study of Japanese male workers aged 35 to 65 years was conducted between 1997 and 2000 in the Morbidity of Myocardial Infarction Multicenter Study in Japan (3M Study). Two hundred four myocardial infarctions were identified and two controls per case were selected by matching for age. We calculated odds ratios using a conditional logistic regression model, and constructed risk predictive models for the risk of myocardial infarction using coronary risk factors. The multivariable odds ratios (95 percent confidence intervals) of myocardial infarction were 2.02 (1.29-3.16) for high blood pressure, 2.33 (1.51-3.59) for high LDL-cholesterol, 4.16 (2.36-7.33) for low HDL-cholesterol, 1.49 (0.94-2.35) for high triglycerides, 1.46 (0.89-2.39) for high glucose, and 2.95 (1.90-4.59) for current smoking. A large reduction of the predictive value for myocardial infarction was shown after exclusion of high LDL-cholesterol (reduction of predictive value was -3.4%), further exclusion of low HDL-cholesterol (-7.1%), and further exclusion of current smoking (-16.4%).
Conclusions: High LDL-cholesterol and low HDL-cholesterol as well as current smoking had high predictive values for myocardial infarction among Japanese middle-aged male workers.

DOI： 10.5551/jat.3277

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN ATHEROSCLEROSIS SOC  

Aim: To examine whether fasting blood lipid profiles are associated with the risk of myocardial infarction among Japanese men.
Methods: We conducted a nested case-control study in the Morbidity of Myocardial Infarction Multicenter Study in Japan (3M Study). For each case of myocardial infarction entered in the 3M Study between 1997 and 2000, we randomly selected two controls, matched for age ( 3 years), from among the participants in risk factor surveys with no history of myocardial infarction. A total of 723 male employees (241 cases and 482 controls) aged 35 to 65 years were enrolled in the present study.
Results: The subjects had significantly higher mean fasting LDL-cholesterol and triglyceride, and lower mean HDL-cholesterol than controls. The multivariable conditional odds ratio (95% confidence interval) for myocardial infarction after adjustment for known cardiovascular risk factors was 3.87 (1.27-11.7, p for trend &lt; 0.001) for total cholesterol [&gt;= 6.71 vs &lt;4.65 mmol/L], 3.28 (1.12-9.60, p for trend = 0.001) for LDL-cholesterol [&gt;= 4.64 vs &lt;2.59 mmol/L], 0.17 (0.07-0.43, p for trend = 0.001) for HDL-cholesterol [&gt;= 1.55 vs &lt;1.03 mmol/L] and 3.03 (1.37-6-70, P for trend = 0.01) for triglycerides [&gt;= 2.26 vs &lt; 1.13 mmol/L].
Conclusion: High total and LDL-cholesterol, low HDL-cholesterol and high triglycerides levels were independently associated with an increased risk of myocardial infarction among middle-aged Japanese male workers.

DOI： 10.5551/jat.547

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASIAN PACIFIC ORGANIZATION CANCER PREVENTION  

No observational study has examined whether cancer-related biomarkers are associated with diet in Japanese. We therefore assessed sex-specific food and nutrient intakes according to serum IGF-I, IGF-II, IGFBP-3, TGF-beta 1, total SOD activity and sFas levels, under a cross-sectional study of 10,350 control subjects who answered the food frequency questionnaire in the first-wave nested case-control study within the Japan Collaborative Cohort Study. For both men and women, IGF-I levels were associated with higher intakes of milk, fruits, green tea, calcium and vitamin C. IGF-II levels were associated with higher intakes of milk, yogurt, fruits and miso soup, and lower intakes of rice, coffee and carbohydrate. IGFBP-3 levels were associated with higher intakes of milk, yogurt, fruits and vitamin C, and lower intakes of rice, energy, protein, carbohydrate, sodium and polyunsaturated fatty acids. TGF-beta 1 levels were associated with lower intakes of coffee intakes, and higher intakes of miso soup and sodium. Total SOD activity levels were associated with lower intakes of most nutrients other than energy, carbohydrate, iron, copper, manganese, retinol equivalents, vitamin A, B2, B12, niacin, folic acid, vitamin C and fish fat. sFas levels were associated with higher intakes of manganese and folic acids. The results of the present study should help to account for findings on those biomarkers regarding risks of cancer and other lifestyle-related diseases in terms of dietary confounding as causality.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CAMBRIDGE UNIV PRESS  

Objective: To investigate long-term trends in dietary intakes of vitamins A, C and E in Japanese adults.
Design: Time series by community-based nutrition Survey.
Setting: Two rural communities (Ikawa and Kyowa) between 1974 and 2001 in Japan.
Subjects: A total of 3713 men and 3726 women aged 40-69 years.
Methods: Dietary intake data were collected by the 24 h dietary recall.
Results: In Ikawa, mean intake of vitamin A (beta-carotene and retinol) increased by 13-40%; vitamins C and E increased by approximately 23-33% among men and women front 1974-1977 to 1998-2000. In Kyowa, mean intake of vitamin A, primarily retinol, increased by 13-21% among men and women, vitamin C from fruits decreased by 16% among men; and vitamin E increased by 29% among women from 1982-1986 to 1998-2001. Mean intake of vitamin E in the latest Survey period was lower than the Adequate Intake among men and women in both communities. Generally, there were increased intakes of beta-carotene and vitamin C from green/yellow and other vegetables; increased retinol intake from fish/shellfish, eggs, milk/dairy products and fats/oils; and increased vitamin E intake from green/yellow and other vegetables, fish/shellfish, eggs, milk/dairy products and fats/oils.
Conclusions: Mean intakes of the antioxidant vitamins A, C and E increased among middle-aged Japanese men and women between the 1970s and the 1990s except for decreased vitamin C among Kyowa men. The lower mean intake of vitamin E than the Adequate intake should be considered a potential public health issue for the prevention of CVD.

DOI： 10.1017/S1368980008003960

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CAMBRIDGE UNIV PRESS  

To examine the association of plant-based food intakes with CVD and total mortality among Japanese. In the Japan Collaborative Cohort Study for Evaluation of Cancer Risk, 25 206 men and 34 279 women aged 40-79 years, whose fruit, vegetable and bean intakes were assessed by questionnaire at baseline in 1988-90, were followed for 13 years. Deaths from total stroke, stroke subtypes, CHD and total CVD, according to the International Classification for Diseases 10th Revision, were registered. During 756054 person-years of follow-up, there were 559 deaths from total stroke, 258 from CHD, 1207 from total CVD and 4514 from total mortality for men, and for women, 494, 194, 1036 and 3092, respectively. Fruit intake was inversely associated with mortality from total stroke (the multivariable hazard ratio (HR (95% CI)) in the highest v. lowest quartiles = 0.67 (0.55, 0.81)), total CVD (HR = 0.75 (0.66, 0.85)) and total mortality (HR = 0.86 (0.80, 0.92)). Vegetable intake was inversely associated with total CVD (HR = 0.88 (0.78, 0.99)). Bean intake was inversely associated with other CVD (HR = 0.79 (0.64, 0.98)), total CVD (HR = 0.84 (0.74, 0.95)) and total mortality (HR = 0.90 (0.84, 0.96)). Further adjustment for other plant-based foods did not alter the association of fruit intake with mortality from total stroke, total CVD and total mortality, but attenuated the associations of vegetables and beans with mortality risk. In conclusion, intakes of plant-based foods, particularly fruit intake, were associated with reduced mortality from CVD and all causes among Japanese men and women.

DOI： 10.1017/S0007114508143586

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JOURNAL CLINICAL BIOCHEMISTRY & NUTRITION  

Our objective was to examine whether habitual green tea consumption is associated with blood glucose levels and other biomarkers of glucose metabolism. We conducted a cross-sectional study of 35 male volunteers, 23-63 years old and residing in Shizuoka Prefecture in Japan. Biochemical data were measured and we conducted a questionnaire survey on health, lifestyle, and nutrition, as well as frequency of consumption and concentrations (1%, 2%, and 3%) of green tea. Men who consumed a 3% concentration of green tea showed lower mean values of fasting blood glucose and fructosamine than those who consumed a 1% concentration. Fasting blood glucose levels were found to be significantly associated with green tea concentration (beta = -0.14, p = 0.03). However, green tea consumption frequency showed no significant differences in mean levels of blood glucose, fructosamine and hemoglobin A(1c). In conclusion, our findings suggest that the consumption of green tea at a high concentration has the potential to reduce blood glucose levels.

DOI： 10.3164/jcbn.08-13

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：TAYLOR & FRANCIS LTD  

The objective of the present study was to examine reproducibility for mineral intakes estimated by single 24-h dietary recall for middle-aged Japanese men and women. We conducted repeated cross-sectional study between 1973 and 1999. The subjects were 262 Japanese people (132 men and 130 women) aged 40-69 years. The median Spearman correlation coefficients (range) for mineral intakes were 0.43 (0.31-0.55) for men and 0.39 (0.32-0.50) for women. The correlation coefficients stratified by the survey periods 1973-1984 and 1985-1999 were 0.42 (0.31-0.53) for men and 0.44 (0.34-0.53) for women during the earlier period, and 0.43 (0.22-0.62) for men and 0.29 (0.21-0.65) for women during the later period. In conclusion, the reproducibility of single 24-h dietary recall was fairly good for estimating mineral intakes by middle-aged Japanese men and women, although the reproducibility for some minerals tended to decline from the mid-1980s.

DOI： 10.1080/09637480802199683

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Objective: To examine whether eating until full or eating quickly or combinations of these eating behaviours are associated with being overweight. Design and participants: Cross sectional survey. Setting: Two communities in Japan. Participants: 3287 adults (1122 men, 2165 women) aged 30-69 who participated in surveys on cardiovascular risk from 2003 to 2006. Main outcome measures: Body mass index (overweight ≥25.0) and the dietary habits of eating until full (lifestyle questionnaire) and speed of eating (validated brief self administered questionnaire). Results: 571 (50.9%) men and 1265 (58.4%) women self reported eating until full, and 523 (45.6%) men and 785 (36.3%) women self reported eating quickly. For both sexes the highest age adjusted mean values for height, weight, body mass index, and total energy intake were in the eating until full and eating quickly group compared with the not eating until full and not eating quickly group. The multivariable adjusted odds ratio of being overweight for eating until full was 2.00 (95% confidence interval 1.53 to 2.62) for men and 1.92 (1.53 to 2.40) for women and for eating quickly was 1.84 (1.42 to 2.38) for men and 2.09 (1.69 to 2.59) for women. The multivariable odds ratio of being overweight with both eating behaviours compared with neither was 3.13 (2.20 to 4.45) for men and 3.21 (2.41 to 4.29) for women. Conclusion: Eating until full and eating quickly are associated with being overweight in Japanese men and women, and these eating behaviours combined may have a substantial impact on being overweight.

DOI： 10.1136/bmj.a2002

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

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DOI： 10.1136/bmj.a2002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：B M J PUBLISHING GROUP  

Objective To examine whether eating until full or eating quickly or combinations of these eating behaviours are associated with being overweight.
Design and participants Cross sectional survey.
Setting Two communities in Japan.
Participants 3287 adults (1122 men, 2165 women) aged 30- 69 who participated in surveys on cardiovascular risk from 2003 to 2006.
Main outcome measures Body mass index (overweight &gt;= 25.0) and the dietary habits of eating until full ( lifestyle questionnaire) and speed of eating ( validated brief self administered questionnaire).
Results 571 ( 50.9%) men and 1265 ( 58.4%) women self reported eating until full, and 523 ( 45.6%) men and 785 ( 36.3%) women self reported eating quickly. For both sexes the highest age adjusted mean values for height, weight, body mass index, and total energy intake were in the eating until full and eating quickly group compared with the not eating until full and not eating quickly group. The multivariable adjusted odds ratio of being overweight for eating until full was 2.00 ( 95% confidence interval 1.53 to 2.62) for men and 1.92 ( 1.53 to 2.40) for women and for eating quickly was 1.84 ( 1.42 to 2.38) for men and 2.09 ( 1.69 to 2.59) for women. The multivariable odds ratio of being overweight with both eating behaviours compared with neither was 3.13 ( 2.20 to 4.45) for men and 3.21 ( 2.41 to 4.29) for women.
Conclusion Eating until full and eating quickly are associated with being overweight in Japanese men and women, and these eating behaviours combined may have a substantial impact on being overweight.

DOI： 10.1136/bmj.a2002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Objective: We examined whether green tea-extract powder supplementation improves glucose abnormality.
Methods: The study was conducted for volunteers who resided in eastern communities of Shizuoka Prefecture and who had fasting blood glucose levels of &gt;= 6.1mmol/l or nonfasting blood glucose levels of &gt;= 7.8mmol/l in a recent health check-up. Sixty subjects aged 32-73 years ( 49 males and 11 females) participated in the trial. The Early intervention group consumed a packet of green tea-extract powder containing 544mg polyphenols (456 mg catechins) daily for the first 2 months and then entered the 2-month nonintervention period. The Later intervention group was observed for the first 2 months and then consumed green tea-extract powder as described above for the subsequent 2 months. Using the two-period crossover design, we analyzed the changes in fasting hemoglobin A1c level and other biomarkers in blood samples collected at baseline, 2 months and 4 months.
Results: A significant reduction in hemoglobin A1c level and a borderline significant reduction in diastolic blood pressure were associated with the intervention. The intervention caused no significant changes in weight, body mass index, body fat, systolic blood pressure, fasting serum glucose level, homeostasis model assessment index, serum lipid level or hypersensitive C-reactive protein.
Conclusion: Daily supplementary intake of green tea-extract powder lowered the hemoglobin A1c level in individuals with borderline diabetes.

DOI： 10.1038/sj.ejcn.1602806

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

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：English   Publisher：SPRINGER  

The original article has been corrected

DOI： 10.1007/s12529-020-09852-1

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

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

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Language：Japanese  

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

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：AMER DIABETES ASSOC  

DOI： 10.2337/db18-1720-P

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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