論文 - 岡村　智教

Association of blood pressure with estimates of 24-h urinary sodium and potassium excretion from repeated single-spot urine samples

Trang Thi Minh Nguyen, Miura Katsuyuki, Tanaka-Mizuno Sachiko, Tanaka Taichiro, Nakamura Yasuyuki, Fujiyoshi Akira, Kadota Aya, Tamaki Junko, Takebayashi Toru, Okamura Tomonori, Ueshima Hirotsugu

HYPERTENSION RESEARCH （Hypertension Research）  42 （ 3 ） 411 - 418 2019年03月

研究論文（学術雑誌）,  ISSN  0916-9636

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© 2018, The Japanese Society of Hypertension. While the association between 24-h urinary sodium and potassium excretion with blood pressure is well established, the relationships of these ions to spot urine measurements are unclear. Our purpose is to assess the association between blood pressure and the estimated 24-h sodium and potassium excretion from repeated single-spot urine samples. Spot urine and blood pressure were collected annually during a 5-year period from 4360 Japanese workers with ages ranging from 19 to 55 years. Estimates of 24-h sodium and potassium excretion were based on Tanaka’s formula. Overall, a single standard deviation increase in the estimated sodium excretion (36.5 mmol/day) was associated with a 1.3 mmHg higher systolic blood pressure and a 0.8 mmHg higher diastolic blood pressure (P < 0.001). A single standard deviation increase in estimated potassium excretion (8.9 mmol/day) was associated with a 1.1 mmHg lower systolic blood pressure and a 0.7 mmHg lower diastolic blood pressure (P < 0.001). As a combined measure of the excretion of both electrolytes, the estimated 24-h sodium-to-potassium ratio was positively associated with both blood pressures (P < 0.001). Associations of blood pressure with sodium and the sodium-to-potassium ratio increased with age and were stronger in men compared to women. Associations with potassium and the sodium-to-potassium ratio were stronger in individuals who were overweight. The findings provide evidence for an association between blood pressure and the estimated 24-h sodium and potassium excretion from repeated single-spot urine samples. As convenient measures of dietary intake for each electrolyte, repeated spot urine samples may be useful for assessing hypertension risk, especially in men, older individuals, and overweight individuals.

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Longitudinal Trajectories of Fasting Plasma Glucose and Risks of Cardiovascular Diseases in Middle Age to Elderly People Within the General Japanese Population: The Suita Study

Ogata Soshiro, Watanabe Makoto, Kokubo Yoshihiro, Higashiyama Aya, Nakao Yoko M., Takegami Misa, Nishimura Kunihiro, Nakai Michikazu, Kiyoshige Ed, Hosoda Kiminori, Okamura Tomonori, Miyamoto Yoshihiro

JOURNAL OF THE AMERICAN HEART ASSOCIATION （Journal of the American Heart Association）  8 （ 3 ） e010628 2019年02月

研究論文（学術雑誌）,  ISSN  2047-9980

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Background Few previous studies used information on changes in fasting plasma glucose ( FPG ) assessed at multiple points in time in relationship to cardiovascular disease ( CVD ) incidence. The present study aimed to identify subgroups of FPG trajectories with assessing CVD incidence. Methods and Results The present study was based on the Suita study, a population-based cohort study in Japan. The primary outcome was incidence of the first CVD events consisting of stroke and coronary heart diseases between 1989 and 2013. The main exposure was FPG assessed every 2 years. We used joint latent class mixed models to derive FPG trajectories over time while evaluating cumulative incidence of CVD , and categorized participants into several subgroups based on those trajectories and cumulative incidence. We observed 356 and 243 CVD events during the median follow-up of 17.2 and 20.2 years among 3120 men and 3482 women, respectively. The joint latent mixed models found 3 subgroups in men and 2 subgroups in women. Of the 3 subgroups in men, 1 subgroup had FPG levels that increased sharply (96.5-205.0 mg/dL from aged 40 to 80 years) and higher CVD cumulative incidence. Of the 2 subgroups in women, 1 subgroup had FPG levels that increased sharply (97.7-190.5 mg/dL from aged 40 to 80 years) and tended to have slightly higher CVD incidence compared with the other subgroup. Conclusion It can be important to manage CVD risk factors especially for people whose FPG trajectories sharply increased to prevent CVD .

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Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium

Inker L., Grams M., Levey A., Coresh J., Cirillo M., Collins J., Gansevoort R., Gutierrez O., Hamano T., Heine G., Ishikawa S., Jee S., Kronenberg F., Landray M., Miura K., Nadkarni G., Peralta C., Rothenbacher D., Schaeffner E., Sedaghat S., Shlipak M., Zhang L., van Zuilen A., Hallan S., Kovesdy C., Woodward M., Levin A., Astor B., Appel L., Greene T., Chen T., Chalmers J., Arima H., Perkovic V., Yatsuya H., Tamakoshi K., Li Y., Hirakawa Y., Matsushita K., Grams M., Sang Y., Polkinghorne K., Chadban S., Atkins R., Djurdjev O., Liu L., Zhao M., Wang F., Wang J., Ebert N., Martus P., Tang M., Heine G., Emrich I., Seiler S., Zawada A., Nally J., Navaneethan S., Schold J., Shlipak M., Sarnak M., Katz R., Hiramoto J., Iso H., Yamagishi K., Umesawa M., Muraki I., Fukagawa M., Maruyama S., Hasegawa T., Fujii N., Wheeler D., Emberson J.

American Journal of Kidney Diseases （American Journal of Kidney Diseases）  73 （ 2 ） 206 - 217 2019年02月

研究論文（学術雑誌）,  ISSN  02726386

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© 2018 National Kidney Foundation, Inc. Rationale & Objective: Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework. Study Design: Cross-sectional individual participant-level analyses in a global consortium. Setting & Study Populations: 17 CKD and 38 general population and high-risk cohorts. Selection Criteria for Studies: Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension. Data Extraction: Data were obtained and analyzed between July 2015 and January 2018. Analytical Approach: We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses. Results: The CKD cohorts (n = 254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n = 1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59 mL/min/1.73 m 2 ), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30 mg/g). Limitations: Variations in study era, health care delivery system, typical diet, and laboratory assays. Conclusions: Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD.

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Having few remaining teeth is associated with a low nutrient intake and low serum albumin levels in middle-aged and older Japanese individuals: findings from the NIPPON DATA2010

Nakamura Mieko, Ojima Toshiyuki, Nagahata Tomomi, Kondo Imako, Ninomiya Toshiharu, Yoshita Katsushi, Arai Yusuke, Ohkubo Takayoshi, Murakami Keiko, Nishi Nobuo, Murakami Yoshitaka, Takashima Naoyuki, Okuda Nagako, Kadota Aya, Miyagawa Naoko, Kondo Keiko, Okamura Tomonori, Ueshima Hirotsugu, Okayama Akira, Miura Katsuyuki

ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE （Environmental Health and Preventive Medicine）  24 （ 1 ） 1 2019年01月

研究論文（学術雑誌）,  ISSN  1342-078X

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© 2019 The Author(s). Background: Oral health is thought to be associated with diet quality, and socioeconomic status (SES) affects both oral health and diet. The aim of this study was to investigate the association between the number of teeth and dietary intake as well as nutritional biomarker, considering the subjects' SES. Methods: We conducted a cross-sectional analysis of data from 2049 individuals aged ≥ 50 years from the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010. The number of remaining teeth was categorized into age-specific quartiles (Q1 to Q4). We assessed the adjusted means and 95% confidence intervals for dietary variables by the number of teeth using analysis of covariance. Stratified analyses by SES were also conducted. Results: The intake of grain products was 31 g higher, and those of vegetables and meat were 30 g and 8 g lower, respectively, in Q1 (fewer teeth) than in Q4 (more teeth). Carbohydrate intake was higher whereas protein, minerals (potassium, magnesium, and zinc), vitamins (vitamins A, E, B 1 , B 6 , β-carotene, and folic acid), and dietary fiber intakes were lower among individuals with fewer teeth. Adjusted mean serum albumin levels were low in Q1. The associations between the number of teeth and dietary intake were more evident in individuals with a low SES. Conclusions: Having few remaining teeth was associated with a low nutrient intake and low serum albumin levels in middle-aged and older Japanese adults, and these associations were more evident in individuals with low SES.

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Lifetime Risk of Stroke and Coronary Heart Disease Deaths According to Blood Pressure Level: EPOCH-JAPAN (Evidence for Cardiovascular Prevention From Observational Cohorts in Japan)

Satoh Michihiro, Ohkubo Takayoshi, Asayama Kei, Murakami Yoshitaka, Sugiyama Daisuke, Yamada Michiko, Saitoh Shigeyuki, Sakata Kiyomi, Irie Fujiko, Sairenchi Toshimi, Ishikawa Shizukiyo, Kiyama Masahiko, Ohnishi Hirofumi, Miura Katsuyuki, Imai Yutaka, Ueshima Hirotsugu, Okamura Tomonori, Iso Hiroyasu, Kitamura Akihiko, Ninomiya Toshiharu, Kiyohara Yutaka, Nakagawa Hideaki, Nakayama Takeo, Okayama Akira, Sairenchi Toshimi, Tamakoshi Akiko, Tsuji Ichiro, Miyamoto Yoshihiro, Ishikawa Shizukiyo, Yatsuya Hiroshi, Okamura Tomonori

HYPERTENSION （Hypertension）  73 （ 1 ） 52 - 59 2019年01月

研究論文（学術雑誌）,  ISSN  0194-911X

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© 2018 American Heart Association, Inc. Lifetime risk (LTR) provides an absolute risk assessment during the remainder of one's life. Few studies have focused on the LTRs of stroke and coronary heart disease (CHD), categorized by fine blood pressure in Asian populations. We aimed to assess it using a large database of a meta-analysis with the individual participant data. The present meta-analysis included 107 737 Japanese (42.4% men; mean age, 55.1 years) from 13 cohorts. During the mean follow-up of 15.2±5.3 years (1 559 136 person-years), 1922 died from stroke and 913 from CHD. We estimated risks after adjusting for competing risk of death other than the outcome of interest. The 10-year risk of stroke and CHD deaths at index age of 35 years was ≤1.9% and ≤0.3%, respectively. The LTRs of stroke death at the index age of 35 years (men/women) were 6.1%/4.8% for optimal, 5.7%/6.3% for normal, and 6.6%/6.0% for high-normal blood pressure groups, and 9.1%/7.9% for grade 1, 14.5%/10.3% for grade 2, and 14.6%/14.3% for grade 3 hypertension groups. The LTRs of CHD death similarly elevated with an increase in blood pressure but were lower (≤7.2%) than those of stroke death. In conclusion, blood pressure was clearly associated with an elevated LTR of stroke or CHD death, although the LTR of CHD death was one-half of that of stroke death in an Asian population. These results would help young people with hypertension to adopt a healthy lifestyle or start antihypertensive therapy early.

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Time-Related Changes in Relationships Between the Keys Score, Dietary Lipids, and Serum Total Cholesterol in Japan - NIPPON DATA80/90/2010-

Okami Yukiko, Ueshima Hirotsugu, Nakamura Yasuyuki, Kondo Keiko, Kadota Aya, Okuda Nagako, Okamura Tomonori, Miura Katsuyuki, Fujiyoshi Akira, Hozawa Atsushi, Kadota Aya, Kasagi Fumiyoshi, Nakagawa Hideaki, Toyoshima Hideaki, Yanagawa Hiroshi, Yoshita Katsushi, Kodama Kazunori, Ueda Kazuo, Sakata Kiyomi, Tamakoshi Koji, Okuda Nagako, Miyamatsu Naomi, Nishi Nobuo, Saitoh Shigeyuki, Tokudome Shinkan, Okubo Takayoshi, Hayakawa Takehito, Izumi Toru, Ojima Toshiyuki, Matsumura Yasuhiro, Miyamoto Yoshihiro, Kita Yoshikuni, Murakami Yoshitaka, Nakamura Yoshikazu, Kiyohara Yutaka

CIRCULATION JOURNAL （Circulation Journal）  83 （ 1 ） 147 - + 2019年01月

研究論文（学術雑誌）,  ISSN  1346-9843

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© 2019, Japanese Circulation Society. All rights reserved. Background: In recent years, individuals with high serum total cholesterol (TC) have been more likely to modify their diet by reducing their intake of dietary lipids. The aim of this study was to investigate time-related changes in the relationships between the Keys score, dietary lipids, and TC between 1980 and 2010 in representative Japanese populations. Methods and Results: We used 3 cross-sectional cohort studies conducted among Japanese representative populations in 1980, 1990, and 2010 (NIPPON DATA80/90/2010) for the analyses. We analyzed data for 10,365, 7,714, and 2,657 participants, respectively, in each dataset. The relationships between TC and the Keys score (calculated by dietary lipids, cholesterol, and energy intake)/ dietary lipids were examined. In men, a 1-unit higher Keys score correlated with 0.92 mg/dL and 0.64 mg/dL TC in 1980 and 1990, respectively, but not in 2010. In women, a 1-unit higher Keys score correlated with 0.70 mg/dL and 0.74 mg/dL TC in 1980 and 1990, respectively, but with 0.33 mg/dL in 2010. In men and women, dietary cholesterol, saturated fatty acid (SFA), and trans fatty acid (TFA) levels were positively associated with TC concentrations in 1980 and 1990, but not in 2010. Conclusions: In these representative Japanese populations, a higher Keys score as well as dietary cholesterol, SFA, and TFA levels correlated with higher TC concentrations in 1980/1990, but the relationships were weaker or not observed in 2010.

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Vegetable protein intake was inversely associated with cardiovascular mortality in a 15-year follow-up study of the general Japanese population

Kurihara A., Okamura T., Sugiyama D., Higashiyama A., Watanabe M., Okuda N., Kadota A., Miyagawa N., Fujiyoshi A., Yoshita K., Ohkubo T., Okayama A., Miura K., Ueshima H.

Journal of Atherosclerosis and Thrombosis （Journal of Atherosclerosis and Thrombosis）  26 （ 2 ） 198 - 206 2019年

研究論文（学術雑誌）,  ISSN  13403478

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© 2019 Japan Atherosclerosis Society. Aim: To examine the relationship between the intake of dietary vegetable protein and CVD mortality in a 15-year follow-up study of a representative sample of the Japanese population. Methods: A total of 7,744 participants aged 30 years or older (3,224 males and 4,520 females) who were free of CVD at baseline were included in this analysis. Vegetable protein intake (% energy) was assessed using a threeday semi-weighed dietary record at baseline. Multivariable-adjusted hazard ratios (HRs) were calculated using Cox’s proportional hazards model after adjusting for confounding factors. Results: The total person-years studied were 107,988 with a mean follow-up period of 13.9 years. There were 1,213 deaths during the follow-up period, among which 354 (29.2%) were due to CVD. Vegetable protein intake was associated inversely with CVD and cerebral hemorrhage mortality, with the HRs for a 1% energy increment in vegetable protein intake being 0.86 (95% CI, 0.75-0.99) and 0.58 (95% CI, 0.35-0.95), respectively. In the subgroup analysis of participants with or without hypertension, the inverse association between vegetable protein intake and CVD mortality was more evident in the nonhypertensive group, with the HRs for CVD and stroke being 0.68 (95% CI, 0.50- 0.94) and 0.50 (95% CI, 0.30-0.84), respectively. Conclusions: Vegetable protein intake may prevent future CVD, particularly in nonhypertensive subjects in the Japanese population. However, further studies are necessary to examine the biological mechanisms of this effect.

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A novel cell-free, non-fluorescent method to measure lox-1-binding activity corresponding to the functional activity of hdl

Kakino A., Usami Y., Horiuchi S., Fujita Y., Kotani K., Chen C., Okamura T., Sawamura T.

Journal of Atherosclerosis and Thrombosis （Journal of Atherosclerosis and Thrombosis）  26 （ 11 ） 947 - 958 2019年

研究論文（学術雑誌）,  ISSN  13403478

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©2019 Japan Atherosclerosis Society. Aims: A functional abnormality in high-density lipoprotein (HDL) particles rather than a quantitative abnormality in HDL cholesterol levels has been suggested to promote atherosclerosis. The modification of HDL may underlie functional changes to HDL such as gaining the ability to bind and activate the lectin-like oxidized low-density lipoprotein (LDL) receptor-1 (LOX-1). We aimed to develop a novel method for measuring modified HDL on the basis of its binding to LOX-1. Methods: We designed a LOX-1 binding–based enzyme-linked immunosorbent assay (ELISA) with recombinant LOX-1 and anti-apoAI antibody. A lipid-free standard was devised by making a chimeric fusion protein containing anti-LOX-1 antibody and human apoAI fragment. We used this system to detect modified HDL, designated as LOX-1 ligand containing apoAI (LAA). Results: With our ELISA system, we detected HDL modified by copper oxidation, hypochlorous acid, 4-hydroxynonenal, and potassium cyanate, but not native HDL. Upon oxidation, HDL showed increased LOX-1 binding activity and decreased cholesterol efflux and paraoxonase-1 activities. In the ELISA, the chimeric fusion protein standard showed minimal variation in reference binding curves in contrast to copper-oxidized HDL preparations, suggesting better quality control of the chimeric fusion protein as the standard for measuring modified HDL activity. LAA was detectable in the plasma of healthy individuals and of mice fed a high-fat diet. Conclusion: We have developed a novel ELISA by using recombinant LOX-1 and anti-apoAI antibody to measure the activity of modified HDL in plasma.

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Household Salt Intake Level is Associated With All-Cause, Cardiovascular and Stroke Mortality: A 24-Year Follow-Up of Nippon Data80

Shima Azusa, Miyamatsu Naomi, Miura Katsuyuki, Miyagawa Naoko, Okuda Nagako, Nishi Nobuo, Yoshita Katsushi, Kadota Aya, Suzuki Harumitsu, Kondo Keiko, Okamura Tomonori, Okayama Akira, Ueshima Hirotsugu

CIRCULATION 139 2019年

研究論文（学術雑誌）,  ISSN  0009-7322

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Differences Between Coronary Artery Calcification and Aortic Artery Calcification in Relation to Cardiovascular Disease Risk Factors in Japanese Men

Kimani Cecilia, Kadota Aya, Miura Katsuyuki, Fujiyoshi Akira, Zaid Maryam, Kadowaki Sayaka, Hisamatsu Takashi, Arima Hisatomi, Horie Minoru, Ueshima Hirotsugu, Yamamoto Takashi, Maegawa Hiroshi, Murata Kiyoshi, Nozaki Kazuhiko, Shiino Akihiko, Toyama Ikuo, Tsuru Teruhiko, Ogita Hisakazu, Takashima Naoyuki, Kadowaki Takashi, Miyamatsu Naomi, Miyagawa Naoko, Torii Sayuki, Hayashi Hideki, Nakano Yasutaka, Ogawa Emiko, Miyazawa Itsuko, Shimizu Akio, Abbott Robert D., Kondo Keiko, Suzuki Sentaro, Ito Takahiro, Andoh Akira, Kunimura Ayako, Nishio Yoshihiko, Mitsunami Kenichi, Kita Toru, Kimura Takeshi, Tabara Yasuharu, Nakamura Yasuyuki, Okamura Tomonori, Sekikawa Akira, Barinas-Mitchell Emma J. M., Ohkubo Takayoshi, Kita Yoshikuni, Murakami Yoshitaka, Hozawa Atsushi, Okuda Nagako, Higashiyama Aya, Ohno Seiko, Nagasawa Shinya, Yamazo Masahiro, Saito Yoshino, Edmundowicz Daniel, Satoh Atsushi, Azuma Koichiro, Yanagita Masahiko, Sawamura Tatsuya, Igase Michiya

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 26 （ 5 ） 452 - 464 2019年

研究論文（学術雑誌）,  ISSN  1340-3478

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Cardiovascular risk assessment chart by dietary factors in Japan: NIPPON DATA80

Kondo K., Miura K., Tanaka-Mizuno S., Kadota A., Arima H., Okuda N., Fujiyoshi A., Miyagawa N., Yoshita K., Okamura T., Okayama A., Ueshima H.

Circulation Journal （Circulation Journal）  83 （ 6 ） 1254 - 1260 2019年

研究論文（学術雑誌）,  ISSN  13469843

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© 2019, Japanese Circulation Society. All rights reserved. Background: Many studies show that dietary factors such as vegetables, fruit, and salt are associated with cardiovascular disease (CVD) risk. However, a risk assessment chart for CVD mortality according to combinations of dietary factors has not been established. Methods and Results: Participants were 9,115 men and women aged 30–79 years enrolled in the National Nutritional Survey of Japan in 1980 with a 29-year follow-up. Dietary intake was assessed using a 3-day weighed dietary record at baseline. Cox regression models were used to estimate the hazard ratio (HR) of CVD mortality stratified by vegetables, fruit, fish, and salt consumption. HRs of CVD mortality according to combinations of dietary factors were color coded on an assessment chart. Higher intakes of vegetables, fruit, and fish, and lower salt intake were associated with lower CVD mortality risk. HRs calculated from combinations of dietary factors were displayed using 5 colors corresponding to the magnitude of the HR. People with the lowest intake of vegetables, fruit, and fish, and higher salt intake had a HR of 2.87 compared with those with the highest intake of vegetables, fruit, and fish, and lower salt intake. Conclusions: Vegetables, fruit, fish, and salt intake were independently associated with CVD mortality risk. The assessment chart generated could be used in Japan as an educational tool for CVD prevention.

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Association of work situation with cardiovascular disease mortality risk among working-age Japanese men: A 20-year follow-up of NIPPON DATA90

Okuda N., Kadota A., Nishi N., Miura K., Ohkubo T., Miyagawa N., Satoh A., Kita Y., Hayakawa T., Takashima N., Fujiyoshi A., Okayama A., Okamura T., Ueshima H.

Circulation Journal （Circulation Journal）  83 （ 7 ） 1506 - 1513 2019年

研究論文（学術雑誌）,  ISSN  13469843

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© 2019, Japanese Circulation Society. All rights reserved. Background: Several cohort studies have demonstrated an association between socioeconomic status (SES) and health outcomes in Japan. As long-term employment is common in Japan, the size of the company may be related to cardiovascular disease (CVD) mortality risk. We examined the association of employment conditions with CVD mortality risk among working-age Japanese men (30–59 years, n=2,091). Methods and Results: We used 20-year follow-up data from NIPPON DATA90, for which baseline data were obtained from the 4th National Survey on Circulatory Disorders in 1990. Participants were classified into 4 groups: 3 strata for indefinite-term employees according to company size (large company/public office, moderate-sized, or small), and the self-employed/administrator group. Multivariable-adjusted hazard ratios (HRs) were adjusted for age, lifestyle, and CVD risk factors. Smokers were more common, habitual exercise was less common, and the average systolic blood pressure was higher among indefinite-term employees of small companies compared with employees at large companies/public offices. There was no significant difference in the total CVD mortality risk between indefinite-term employees and self-employed/administrator participants. The age-adjusted HR (95% confidence interval) for total CVD using indefinite-term employees of large companies/public office as a reference was 2.53 (1.12, 5.69) for employees of small companies. Conclusions: Working as an indefinite-term employee at a small company in Japan was significantly associated with elevated risk of CVD mortality among Japanese men.

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Association between body mass index and all-cause death in japanese population: Pooled individual participant data analysis of 13 cohort studies

Hozawa A., Hirata T., Yatsuya H., Murakami Y., Kuriyama S., Tsuji I., Sugiyama D., Satoh A., Tanaka-Mizuno S., Miura K., Ueshima H., Okamura T.

Journal of Epidemiology （Journal of Epidemiology）  29 （ 12 ） 457 - 463 2019年

研究論文（学術雑誌）,  ISSN  09175040

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© 2018 Atsushi Hozawa et al. Background: We sought to investigate the optimal values of BMI for the lowest risk of all-cause death and whether the optimal BMI differs according to smoking status in large-scale pooled analysis of 13 Japanese cohorts. Methods: Data from 179,987 participants of 13 well-qualified cohort studies conducted throughout Japan were used for our analysis. A cohort-stratified Cox proportional hazard model was used. P values for interactions were calculated based on the cross product of BMI and age, sex, or smoking status. Results: In the entire study population, all-cause mortality risk was lowest when the BMI was 22.0–24.9 kg=m2. This was also the case for selected healthy participants (never smoked, baseline total cholesterol level ≥4.1 mmol=L; the first 5 years of follow-up data were excluded). No effect modification of age, sex, or smoking status was observed. Regardless of their BMI, never smokers always had a lower all-cause mortality risk than did current smokers even with an ideal BMI in terms of mortality risk. Conclusion: A BMI of 22–24.9 kg=m2 correlated with the lowest risk of mortality, regardless of whether all participants or selected healthy participants were analyzed. The fact that smoking was more strongly associated with mortality than obesity emphasizes the urgency for effective anti-smoking programs.

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Anthropometric Obesity Indices were Stronger than CT-Based Indices in Associations with Carotid Intima-Media Thickness in Japanese Men

Liu Yuyan, Fujiyoshi Akira, Arima Hisatomi, Kadota Aya, Kadowaki Sayaka, Hisamatsu Takashi, Miyazawa Itsuko, Kondo Keiko, Tooyama Ikuo, Miura Katsuyuki, Ueshima Hirotsugu, Horie Minoru, Nakano Yasutaka, Yamamoto Takashi, Ogawa Emiko, Maegawa Hiroshi, Murata Kiyoshi, Mitsunami Kenichi, Nozaki Kazuhiko, Shiino Akihiko, Araki Isao, Tsuru Teruhiko, Toyama Ikuo, Ogita Hisakazu, Kurita Souichi, Maeda Toshinaga, Miyamatsu Naomi, Kita Toru, Kimura Takeshi, Nishio Yoshihiko, Nakamura Yasuyuki, Okamura Tomonori, Sekikawa Akira, Barinas-Mitchell Emma J. M., Edmundowicz Daniel, Ohkubo Takayoshi, Hozawa Atsushi, Okuda Nagako, Higashiyama Aya, Nagasawa Shinya, Kita Yoshikuni, Murakami Yoshitaka, Takashima Naoyuki, Kadowaki Takashi, Abbott Robert D., Ohno Seiko, Zaid Maryam, Miyagawa Naoko, Torii Sayuki, Saito Yoshino, Suzuki Sentaro, Ito Takahiro

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 26 （ 12 ） 1102 - 1114 2019年

研究論文（学術雑誌）,  ISSN  1340-3478

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Carotid Intima-Media Thickness and Plaque in Apparently Healthy Japanese Individuals with an Estimated 10-Year Absolute Risk of CAD Death According to the Japan Atherosclerosis Society (JAS) Guidelines 2012: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA) (vol 20, pg 755, 2013)

Kadota Aya, Miura Katsuyuki, Okamura Tomonori, Fujiyoshi Akira, Ohkubo Takayoshi, Kadowaki Takashi, Takashima Naoyuki, Hisamatsu Takashi, Nakamura Yasuyuki, Kasagi Fumiyoshi, Maegawa Hiroshi, Kashiwagi Atsunori, Ueshima Hirotsugu

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 26 （ 8 ） 746 - 746 2019年

研究論文（学術雑誌）,  ISSN  1340-3478

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Employment and health after retirement in Japanese men

Okamoto Shohei, Okamura Tomonori, Komamura Kohei

BULLETIN OF THE WORLD HEALTH ORGANIZATION （Bulletin of the World Health Organization）  96 （ 12 ） 826 - 833 2018年12月

研究論文（学術雑誌）,  ISSN  0042-9686

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© 2018, World Health Organization. All rights reserved. Objective To estimate the average treatment effect of working past the current retirement age on the health of Japanese men. Methods We used publicly available data from the National Survey of Japanese Elderly, extracting a sample of 1288 men who were 60 years or older. Survey respondents were followed-up for at most 15 years for the onset of four health outcomes: death, cognitive decline, stroke and diabetes. By using the propensity score method, we adjusted for the healthy worker effect by incorporating economic, sociodemographic and health data in the form of independent variables. By calculating the differences in times to a health outcome between those in employment and those not employed, we estimated the average treatment effects on health of being in paid work past retirement age. Findings Compared with those not employed, those in employment lived 1.91 years longer (95% confidence interval, CI: 0.70 to 3.11), had an additional 2.22 years (95% CI: 0.27 to 4.17) before experiencing cognitive decline, and had a longer period before the onset of diabetes and stroke of 6.05 years (95% CI: 4.44 to 7.65) and 3.35 years (95% CI: 1.42 to 5.28), respectively. We also observed differences between employees and the self-employed: the self-employed had longer life expectancies than employees. In terms of years to onset of diabetes or stroke, however, we only observed significant benefits to health of being an employee but not self-employed. Conclusion Our study found that being in employment past the current age of retirement had a positive impact on health.

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Response to the letter entitled "Extremely high levels of high-density lipoprotein cholesterol and increased risk of cardiovascular mortality"

Hirata Aya, Okamura Tomonori

JOURNAL OF CLINICAL LIPIDOLOGY 12 （ 6 ） 1551 - 1551 2018年12月

研究論文（学術雑誌）,  ISSN  1933-2874

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The Japanese Society of Hypertension-Digest of plan for the future.

Node K, Kishi T, Tanaka A, Itoh H, Rakugi H, Ohya Y, Miura K, Okamura T, Ishimitsu T, Ichihara A, Ito M, Ohishi M, Ohkubo T, Kai H, Kashihara N, Kario K, Saitoh S, Tsuchihashi T, Nakamura S, Nishiyama A, Hasebe N, Higaki J, Tamura K, Kawano Y, Yatabe T, Ito S, JSH Future Plan Working Group and Executive Board Members

Hypertension research : official journal of the Japanese Society of Hypertension 41 （ 12 ） 989 - 990 2018年12月

ISSN  0916-9636

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Cardiometabolic index as a useful discriminator for the risk of increased arterial stiffness.

Wakabayashi I, Marumo M, Kubota Y, Higashiyama A, Miyamoto Y, Okamura T

Clinica chimica acta; international journal of clinical chemistry 486   42 - 43 2018年11月

ISSN  0009-8981

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Difference in water intake between persons with a history of cerebral infarction and healthy persons

Nishikawa T., Miyamatsu N., Higashiyama A., Hojo M., Nishida Y., Fukuda S., Ichiura K., Kubo S., Ueba T., Okamura T.

EUROPEAN JOURNAL OF PUBLIC HEALTH 28   326 - 326 2018年11月

研究論文（学術雑誌）,  ISSN  1101-1262