論文 - 岡村　智教

Differential association of docosahexaenoic and eicosapentaenoic acids with carotid intima-media thickness.

Sekikawa A, Kadowaki T, El-Saed A, Okamura T, Sutton-Tyrrell K, Nakamura Y, Evans RW, Mitsunami K, Edmundowicz D, Nishio Y, Nakata K, Kadota A, Otake T, Miura K, Choo J, Abbott RD, Kuller LH, Curb JD, Ueshima H, ERA JUMP Study group.

Stroke 42 （ 9 ） 2538 - 2543 2011年09月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0039-2499

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<p>Background and Purpose-Recent studies reported the differential effect of docosahexaenoic (DHA) and eicosapentaenoic acids (EPA). We examined the differential association of DHA and EPA with carotid intima-media thickness (IMT) in Japanese individuals in Japan and in U.S. white individuals and explored whether DHA or EPA contributes to the difference in IMT between the two groups. Methods-A population-based cross-sectional study in 608 Japanese and U.S. white men aged 40 to 49 was conducted to assess IMT, serum DHA, EPA, and other cardiovascular risk factors. Results-Japanese compared to U.S. whites had significantly lower IMT (mean±SD, 618±81 and 672±94 μm for Japanese and whites, respectively; P&lt;0.001) and had &gt;2-fold higher levels of DHA and EPA. DHA, but not EPA, had an inverse association with IMT in both Japanese and U.S. whites. The inverse association remained only in Japanese men after adjusting for risk and other factors. The significant difference in multivariable-adjusted IMT became nonsignificant after further adjusting for DHA (mean difference, 17 μm; 95% CI,-8 to 43; P=0.177) but not EPA. In this multivariable-adjusted model, DHA but not EPA was a significant predictor of IMT (P=-0.032 versus 0.863, respectively). Conclusions-These data suggest that DHA may have a more potent antiatherogenic effect than EPA, especially in levels observed in the Japanese, independent of risk factors. © 2011 American Heart Association. All rights reserved.</p>

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High oolong tea consumption predicts future risk of diabetes among Japanese male workers

Hayashino Y., Fukuhara S., Okamura T., Tanaka T., Ueshima H.

Diabetic Medicine 28 （ 7 ） 805 - 810 2011年07月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0742-3071

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<p>Aims Acute administration of oolong tea decreases blood glucose levels. We investigated the association between long-term oolong tea intake and subsequent risk of developing diabetes among men of working age. Methods Data were analysed from a cohort of participants in the High-risk and Population Strategy for Occupational Health Promotion Study (HIPOP-OHP), conducted in Japan from 1999 to 2004. Oolong tea intake at baseline and subsequent risk of diabetes was evaluated using a Cox proportional hazards model. Results Of 4975 male workers, a total of 201 cases of diabetes were reported over a median of 3.4years of follow-up. Mean age and BMI of all participants at baseline were 38.3years and 22.9kg/m ², respectively. Compared with those not consuming oolong tea, multivariable adjusted hazard ratios for developing diabetes were 1.00 (95%CI 0.67-1.49) for those who drank one cup of oolong tea per day and 1.64 (95%CI 1.11-2.40) for those drinking two or more cups per day. Fasting blood glucose increment per year was 0.11mmol/l (95%CI 0.09-0.12mmol/l), 0.12mmol/l (95%CI 0.09-0.15mmol/l) and 0.15mmol/l (95%CI 0.11-0.18mmol/l), respectively, for oolong tea consumption of 0, 1 and ≥2cups/day, with a significant linear trend (P&lt;0.0001). Conclusions Long-term consumption of oolong tea may be a predictive factor for new onset diabetes. Further studies are necessary to elucidate the role of oolong tea in the risk of developing diabetes. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.</p>

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A revised definition of the metabolic syndrome predicts coronary artery disease and ischemic stroke after adjusting for low density lipoprotein cholesterol in a 13-year cohort study of Japanese: the Suita study.

Okamura T, Kokubo Y, Watanabe M, Higashiyama A, Ono Y, Nishimura K, Okayama A, Miyamoto Y

Atherosclerosis 217 （ 1 ） 201 - 206 2011年07月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0021-9150

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<p>Objective: Recently, several major organizations have proposed a unified definition for the metabolic syndrome (MetS), which should be evaluated in multiethnic groups. The effect of Mets on the incidence of cardiovascular disease needs to be assessed after adjusting for serum low density lipoprotein cholesterol (LDLC), a major risk factor for atherosclerotic diseases. This is especially needed to be evaluated in Asian populations with low incidence of coronary artery disease (CAD). Methods: We conducted a 13-year prospective study of 4939 Japanese living in an urban area. The MetS was defined using a unified classification that included cut-off points for waist circumference in Asians. The multivariable adjusted hazard ratios (HRs) of MetS for CAD and stroke were calculated using a Cox proportional model adjusted for other potential confounding factors with LDLC. Results and conclusion: During the follow-up period, there were 155 cases of CAD and 204 of stroke including 118 cerebral infarctions. In participants under 65 years old, the multivariable HRs of MetS for CAD were 1.21 (95% C.I., 0.64-2.28) in men and 4.44 (95% C.I., 1.73-11.4) in women; the HRs for ischemic stroke were 3.24 (95% C.I., 1.55-6.77) in men and 3.99 (95% C.I., 1.34-11.8) in women. In participants aged 65 years old and over, MetS only showed a significant association with CAD in men (HR 1.89, 95% C.I., 1.11-3.21). Serum LDLC was associated with increased risk of CAD in men irrespective of age group; however, it was not associated with CAD in women. There was no association between serum LDLC and ischemic stroke in any group stratified by sex and the age of 65. These results indicate that the new uniform MetS definition is useful for detecting high risk individuals, especially for middle-aged population. However, continuous screening for hypercholesterolemia is necessary to prevent CAD, especially in men, even in Asian countries such as Japan. © 2011 Elsevier Ireland Ltd.</p>

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Prognostic value of ST-T abnormalities and left high R waves with cardiovascular mortality in Japanese (24-year follow-up of NIPPON DATA80).

Rumana N, Turin TC, Miura K, Nakamura Y, Kita Y, Hayakawa T, Choudhury SR, Kadota A, Nagasawa SY, Fujioshi A, Takashima N, Okamura T, Okayama A, Ueshima H, NIPPON DATA80 Research Group.

The American journal of cardiology 107 （ 12 ） 1718 - 1724 2011年06月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0002-9149

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<p>Little is known about the prognostic value of ST-segment depression and/or T wave (ST-T abnormalities) with or without left high R waves on electrocardiogram recorded at rest for death from cardiovascular disease (CVD) in Asian populations. Japanese participants without a history of CVD and free of major electrocardiographic (ECG) abnormalities were followed for 24 years. Subjects were divided into 4 groups based on baseline ECG findings: isolated left high R waves, isolated ST-T abnormalities, ST-T abnormalities with left high R waves, and normal electrocardiogram. Cox proportional hazard model was used to estimate risk of CVD mortality in groups with ECG abnormalities compared to the normal group. Of 8,572 participants (44.4% men, mean age 49.5 years; 55.6% women, mean age 49.4 years), 1,142 had isolated left high R waves, 292 had isolated ST-T abnormalities, and 128 had ST-T abnormalities with left high R waves at baseline. Multivariable-adjusted hazard ratios of ST-T abnormalities with left high R waves for CVD mortality were 1.95 (95% confidence interval 1.25 to 3.04) in men and 2.68 (95% confidence interval 1.81 to 3.97) in women. Isolated ST-T abnormalities increased the risk for CVD death by 1.66 times (95% confidence interval 1.01 to 2.71) in men and 1.62 times (95% confidence interval 1.18 to 2.24) in women. Association of ECG abnormalities with CVD mortality was independent of age, body mass index, systolic blood pressure, serum cholesterol, blood glucose, smoking and drinking, and antihypertensive medication. In conclusion, ST-T abnormalities with or without left high R waves on electrocardiogram recorded at rest constitute an independent predictor of CVD mortality in Japanese men and women. © 2011 Elsevier Inc. All rights reserved.</p>

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Serum 1,5-anhydro-d-glucitol levels predict first-ever cardiovascular disease

Watanabe M., Kokubo Y., Higashiyama A., Ono Y., Miyamoto Y., Okamura T.

Atherosclerosis 216 （ 2 ） 477 - 483 2011年06月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0021-9150

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<p>Objective: Serum 1,5-anhydro-d-glucitol (1,5-AG) is well-known to be a useful clinical marker of both short-term glycemic status and postprandial hyperglycemia. In addition, previous epidemiological studies have shown that an increased postload glucose level in an oral glucose tolerance test is a risk factor for cardiovascular diseases (CVD). However, no previous prospective study has reported the association between serum 1,5-AG levels and the risk of CVD. In this study, we examined whether serum 1,5-AG levels can predict the incidence of first-ever CVD. Methods: Our study was a population-based cohort study in an urban area of Japan. Study subjects comprised 2095 initially healthy Japanese (991 men and 1104 women, mean age: 58.5 years) with no history of coronary heart disease (CHD) or stroke. They were followed up for an average of 11.1 years, and 147 CVD events (64 CHD and 83 strokes) were observed. Results: The adjusted hazard ratios (HRs) of all CVD in men increased linearly (p= 0.004). The HR in the category with serum 1,5-AG levels of 14.0 μg/mL or less was 2.22 (95% confidence interval; 1.24-3.98) compared to the reference category (24.5 μg/mL or greater). Similar results were also shown with a sensitivity analysis in non-diabetic men. Conversely, no significant relationship between serum 1,5-AG levels and CVD risks was observed in women. Conclusions: Our results suggest that measurement of serum 1,5-AG levels is useful to detect individuals, especially men, at higher risk for CVD, regardless of the presence or absence of diabetes. © 2011 Elsevier Ireland Ltd.</p>

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Association with serum gamma-glutamyltransferase levels and alcohol consumption on stroke and coronary artery disease: the Suita study.

Higashiyama A, Wakabayashi I, Ono Y, Watanabe M, Kokubo Y, Okayama A, Miyamoto Y, Okamura T

Stroke 42 （ 6 ） 1764 - 1767 2011年06月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0039-2499

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<p>Background And Purpose- Light-to-moderate alcohol consumption is associated with reduced risk for cardiovascular disease, whereas high serum γ-glutamyltransferase (GGT) level is associated with cardiovascular disease. However, whether light-to-moderate alcohol drinking is still related to reduced risk of cardiovascular disease irrespective of GGT level is uncertain. Methods- We performed a 12.5-year cohort study of 2336 men (excluding exdrinkers) who were free from cardiovascular disease. They were classified into 4 groups according to alcohol consumption: never, and current light, moderate, or heavy drinker. The multivariate-adjusted hazard ratios of alcohol consumption for incidence of coronary artery disease, total stroke, and ischemic stroke compared with those of never drinkers were assessed with stratification by GGT median (32 IU/L). Results- In participants with GGT &gt;32 IU/L, the hazard ratios of all current drinkers for total and ischemic stroke were higher than those of never drinkers. However, in all current drinkers with GGT ≤32 IU/L, the multivariate-adjusted hazard ratios for total and ischemic stroke were lower than in never drinkers. Conclusions- In men with above GGT median, alcohol drinking even with light-to-moderate consumption could be a risk factor for ischemic stroke. © 2011 American Heart Association, Inc.</p>

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Association of intima-media thickening of carotid artery with genetic polymorphisms of the regulator of G-protein signaling 2 gene in patients with hypertension and in the general population.

Kamide K, Kokubo Y, Yang J, Takiuchi S, Horio T, Matsumoto S, Banno M, Matayoshi T, Yasuda H, Miwa Y, Yoshihara F, Nakamura S, Nakahama H, Iwashima Y, Oguro R, Ohishi M, Rakugi H, Okamura T, Miyata T, Kawano Y

Hypertension research : official journal of the Japanese Society of Hypertension 34 （ 6 ） 740 - 746 2011年06月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0916-9636

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<p>Regulator of G-protein signaling 2 (RGS2) is a key molecule in signal pathways of vasoactive peptides, such as angiotensin II and endothelin 1, and is believed to have an important role in the pathophysiology of atherosclerosis. We have previously reported that common polymorphisms of RGS2 are associated with hypertension in Japanese. In this study, we studied whether the three previously identified common polymorphisms of RGS2 (638AG, 1026TA and 1891-1892delTC) could be implicated in carotid atherosclerosis in Japanese patients with hypertension (459 men and 382 woman) and in a Japanese general population (814 men and 956 woman). We assessed two criteria for carotid atherosclerosis: maximal intima-media thickness (M-IMT) and mean-IMT. When subjects with atherosclerotic lesions were defined as having mean-IMT1.0 mm, multivariate logistic regression analysis performed after adjusting for confounding factors showed a significant association of the three common polymorphisms, 638AG (AA versus AGGG: odds ratio (OR), 1.55; 95% confidence interval (CI), 1.105-2.185; P0.0113 only for the general population), 1026TA (TT versus TAAA: OR, 1.42; 95% CI, 1.027-1.972; P0.034 for hypertensive subjects and OR, 1.56; 95% CI, 1.129-2.151; P0.0071 for the general population), and 1891-1892delTC (II versus IDDD: OR, 1.44; 95% CI, 1.043-2.008; P0.028 for hypertensive subjects, OR, 1.32; 95% CI 1.002-1.742; P0.048 for the total general population and OR 1.59; 95% CI 1.155-2.207; P0.0047 for the general population), with carotid atherosclerosis. When atherosclerosis was defined as M-IMT 1.0 mm, the values of M-IMT were also significantly different between the three genotypes in the three common polymorphisms. Taken together, these data suggest that genetic polymorphisms in RGS2 are associated with intima-media thickening of carotid artery in humans. © 2011 The Japanese Society of Hypertension All rights reserved.</p>

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Corrigendum to 'Gamma-Glutamyltransferase and mortality risk from heart disease and stroke in Japanese men and women

Fujiyoshi Akira, Miura Katsuyuki, Hozawa Atsushi, Murakami Yoshitaka, Takashima Naoyuki, Okuda Nagako, Kadowaki Takashi, Kita Yoshikuni, Okamura Tomonori, Nakamura Yasuyuki, Hayakawa Takehito, Okayama Akira, Ueshima Hirotsugu

CVD Prevention and Control 6 （ 2 ） 63 2011年06月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  1875-4570

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Fasting plasma insulin is associated with metabolic syndrome in farmers but not in nomads among the Mongolian population, China.

Kanda H, Wang P, Okamura T, Wuyun G, Wu H, Su X, Hayakawa T, Amamoto K, Ueshima H

Journal of atherosclerosis and thrombosis 18 （ 4 ） 291 - 297 2011年04月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  1340-3478

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<p>The World Health Organization (WHO) includes insulin resistance among its criteria for diagnosing metabolic syndrome (MetS); however, previous epidemiologic studies have limited their research to settled populations only. This study aims to clarify the relationship between plasma insulin and metabolic factors on a broader scale by studying data obtained from nomadic and settled Mongolian populations. A cross-sectional epidemiologic study of 200 nomads and 256 farmers was performed in Inner Mongolia, Republic of China. Plasma insulin levels and other metabolic factors, such as blood pressure, serum lipids and obesity, were measured. Participants were classified into 3 categories according to their plasma insulin levels. Cut-off values grouped into tertiles of fasting insulin for all participants were 6.73 nmol/L and 10.33 nmol/L. The mean number of metabolic risk factors, waist circumference, fasting plasma glucose and triglyceride were higher, and the mean HDL cholesterol was lower in the higher fasting insulin tertile among farmers after adjusting for age, gender, smoking, alcohol drinking and total cholesterol. However, no MetS factors were statistically related with fasting insulin tertile levels among nomads. In nomads, hyperinsulinemia may not be an indicator of MetS due to their specific life-style.</p>

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Relationship of moderate metabolic risk factor clustering to cardiovascular disease mortality in non-lean Japanese: a 15-year follow-up of NIPPON DATA90.

Kadota A, Miura K, Okamura T, Hozawa A, Murakami Y, Fujiyoshi A, Takashima N, Hayakawa T, Kita Y, Okayama A, Nakamura Y, Ueshima H, NIPPON DATA90 Research Group.

Atherosclerosis 215 （ 1 ） 209 - 213 2011年03月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0021-9150

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<p>Objective: The individual components of metabolic syndrome are defined as levels ranging from moderate to high level as to require medication. We investigated the impact of moderate metabolic risk factor clustering on cardiovascular disease (CVD) mortality. Methods: We followed up 6758 non-lean Japanese in randomly selected areas from all over the country who had no history of CVD for 15 years. The multivariate-adjusted hazards ratio (HR) and 95% confidence interval (CI) for CVD mortality according to the number of moderate metabolic risk factors (BMI≥25kg/m², 130/85mmHg≤systolic/diastolic BP&lt;140/90mmHg, 140mg/dl≤casual blood glucose&lt;200mg/dl, triglycerides≥150mg/dl and/or HDL cholesterol&lt;40mg/dl [men], 50mg/dl [women]) were estimated using the Cox proportional hazards model. The population-attributable risk fraction of moderate metabolic risk factor clustering was also estimated. Results: During the follow-up, 282 participants died of CVD. CVD mortality tended to increase with the number of moderate metabolic risk factors. However, they were not statistically significant. The multivariate-adjusted HRs were 1.82 (95%CI: 0.89-3.73) for having any moderate metabolic risk factors and 2.87 (95%CI: 1.46-5.64) for having any medication-required metabolic risk factors, compared with participants without any moderate metabolic risk factors. The population-attributable risk fractions were 7.3% and 52.4% for any moderate and medication-required metabolic risk factors, respectively. Conclusions: We did not find the statistically significant increase of CVD mortality for moderate metabolic risk factor clustering. Its attribution was relatively small in this Japanese population. More efforts would be required to detect and control medication-required risk factors. © 2010 Elsevier Ireland Ltd.</p>

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Population attributable numbers and fractions of deaths due to smoking: a pooled analysis of 180,000 Japanese.

Murakami Y, Miura K, Okamura T, Ueshima H, EPOCH-JAPAN Research Group.

Preventive medicine 52 （ 1 ） 60 - 65 2011年01月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0091-7435

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<p>Objective: Age- and sex-specific population attributable fraction (PAF) and premature deaths attributable to smoking were estimated from a pooled analysis of cohort studies in Japan. Methods: A pooled analysis of individual participant data from 13 well-qualified cohort studies throughout Japan (a total of 183,251 Japanese aged 40-89, 69,502 men and 113,749 women; the baseline years between 1987 and 1995 with average 10 years of follow-up) was performed. Poison regression model was used to estimate age- and sex-specific hazard ratios, and their PAFs of all-cause deaths and number of annual premature deaths attributable to smoking were estimated. Results: Overall PAF attributable to smoking was 24.6% in men and 6.0% in women. The estimated number of annual premature deaths due to smoking was 121,854 (men: 109,998; women: 11,856) in Japan. The age-specific PAF was largest in men aged 60-69 (47.7%) and in women aged 50-59 (12.2%). In the older group aged 70-79 and 80-89, PAF was 15.4% and 8.0% in men and 3.5% and 1.5% in women, respectively. Conclusions: Age-specific PAFs attributable to smoking in Japanese men are much larger than that reported from other Asian countries. © 2010 Elsevier Inc.</p>

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Impairments in activities of daily living in older Japanese men in hawaii and Japan.

Abbott RD, Kadota A, Miura K, Hayakawa T, Kadowaki T, Okamura T, Okayama A, Masaki KH, Ueshima H

Journal of aging research 2011   324592 2011年

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  2090-2204

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<p>Introduction. Hypertension and cigarette smoking are dominant risk factors for cardiovascular disease in Japan while in westernized countries, broader effects encompass obesity, diabetes, and hypercholesterolemia. This paper examines whether different associations also appear important in the manifestation of activities of daily living (ADL) in older Japanese men in Hawaii and Japan. Methods. Measures of ADL (feeding, toileting, dressing, bathing, and walking around the house) were assessed from 1995 to 1999 in 1,893 men in Hawaii and 543 men in Japan. Concomitant risk factors were measured from 1990 to 1993. Results. In Hawaii, diabetes increased the odds of ≥1 ADL impairment nearly 1.5-fold (P=.020). A similar association was absent in Japan. In contrast, the odds of an ADL impairment in Japan was increased more than 5-fold in the presence of stroke (P&lt;.001). The association in Hawaii was significantly weaker (P=.007). In both cohorts, past alcohol use was associated with a greater likelihood of ADL impairment. Conclusion. In this comparison of genetically similar samples, findings suggest that different strengths in risk factor associations with cardiovascular disease in Japan and westernized countries may also include different strengths in associations with impaired ADL. © 2011 Robert D. Abbott et al.</p>

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Relationship between sleep duration and clustering of metabolic syndrome diagnostic components.

Katano S, Nakamura Y, Nakamura A, Murakami Y, Tanaka T, Takebayashi T, Okayama A, Miura K, Okamura T, Ueshima H, HIPOP-OHP Research Group.

Diabetes, metabolic syndrome and obesity : targets and therapy 4   119-125 - 25 2011年

研究論文（学術雑誌）, 共著, 査読有り

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NIPPON DATA80-リスク評価チャートの評価-.

渡邉 至、岡村 智教

The Lipid （メディカルレビュー社）  22 （ 1 ） 14-19 2011年

研究論文（学術雑誌）, 共著

禁煙専門医の立場から-リスクとしての喫煙、治療としての禁煙-.

岡村 智教

治療 （南山堂）  93 （ 4 ） 608-611 2011年

研究論文（学術雑誌）, 単著

粥状動脈硬化症の発症における脂質異常症の関与-疫学的側面から．

岡村 智教

レジデント （医学出版）  4 （ 8 ） 6-16 2011年

研究論文（学術雑誌）, 単著

脳卒中予防のイノベーション-早期発見・早期受診・早期介入.

宮本恵宏、中山博文、岡村 智教、豊田一則

Medicina （医学書院）  48 （ 7 ） 1254-1266 2011年

研究論文（学術雑誌）, 共著

脂質異常症と動脈硬化の疫学的エビデンスは？

田中太一郎、岡村 智教

Heart View （メディカルビュー社）  15 （ 9 ） 915-920 2011年

研究論文（学術雑誌）, 共著

虚血性心疾患の最近の疫学的動向からみた実地診療のすすめかた.

田中太一郎、岡村 智教

Medical Practice （文光堂）  28 （ 9 ） 1506-1512 2011年

研究論文（学術雑誌）, 共著

動脈硬化性疾患の絶対リスクの評価.

岡村 智教、杉山大典

日本医師会雑誌 140 （ 6 ） 1208-1212 2011年

研究論文（学術雑誌）, 共著