研究者詳細 - 杉山　大典

論文 - 杉山　大典

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Development of a digital health competency scale for public health nurses

Akatsuka E., Taguchi A., Miyagawa S., Sugiyama D.

International Journal of Medical Informatics 204 106076 2025年12月

ISSN 13865056

Objectives: This study developed and psychometrically validated a new instrument – the Digital Health Competency Scale for Public Health Nurses (hereafter, DHCP) – to assess digital health competencies among public health nurses working in administrative agencies. Methods: DHCP was developed based on a literature review and expert interviews with four public health nurses (PHNs) and three researchers. A cross-sectional national survey was conducted with 1810 PHNs from stratified, randomly selected municipalities across Japan. Exploratory factor analysis (EFA) was used to identify the initial structure of DHCP, followed by confirmatory factor analysis (CFA) to assess construct validity. Internal consistency was calculated using Cronbach's alpha and criterion-related validity was examined by correlating DHCP scores with the eHealth Literacy Scale (eHEALS). Results: In total, 521 valid responses were obtained. The EFA applied an initial version of the scale with 28 items. The analysis identified a 12-item scale with a three-factor structure (motivation for digitalization, ethical-social assessment, and technical skills). The CFA supported the three-factor structure for DHCP, demonstrating a good model fit (GFI = 0.949, AGFI = 0.922, CFI = 0.960, RMSEA = 0.067). The Cronbach's alpha for the scale was 0.869. The total DHCP score was positively correlated with eHEALS (r = 0.444, 95 % confidence interval 0.372–0.511, p < 0.001), supporting criterion-related validity. Conclusions: DHCP is a novel instrument with good psychometric properties for assessing digital health competencies among PHNs. It has the potential to support digitalization efforts within municipal public health services.

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[Current status and challenges in the utilization of information and communication technology and digitalization in public health nursing activities: A national survey of supervisory public health nurses in local governments].

Akatsuka E, Taguchi A, Yoshida C, Miyagawa S, Sugiyama D

[Nihon koshu eisei zasshi] Japanese journal of public health 2025年06月

ISSN 0546-1766

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[Effect of the combination of "weight gain of more than 10 kg since age 20" and obesity on the new onset of diabetes mellitus].

Naruse H, Kuwabara K, Hirata A, Imai Y, Sugiyama D, Funamoto M, Okamura T

[Nihon koshu eisei zasshi] Japanese journal of public health 72 （ 3 ） 199 - 207 2025年03月

ISSN 0546-1766

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「20歳から10kg以上の体重増加の有無」と肥満の有無の組み合わせが糖尿病新規発症に与える影響

成瀬華子, 桑原和代, 平田あや, 今井由希子, 杉山大典, 舟本美果, 岡村智教

日本公衆衛生雑誌（日本公衆衛生学会） 72 （ 3 ） 199 - 207 2025年03月

ISSN 0546-1766

目的「過去からの体重増加と肥満の有無の組み合わせ」と,糖尿病との関連について検討した報告は少ない。そこで,「20歳からの体重増加10kg以上」の有無と肥満の有無の組み合わせが糖尿病の新規発症に与える影響を縦断的に検証した。方法大阪府羽曳野市の国民健康保険加入者で2013年度の特定健診受診者8,704人をベースラインとして設定し,当初から糖尿病であった者,追跡不能,その他欠損値がある者を除外した5,708人を解析対象とした。厚生労働省の標準的な質問票による20歳からの体重10kg以上の増加の有無と,BMI 25kg/m^2以上か未満かを用いて,「体重増加無し・非肥満」群,「体重増加無し・肥満」群,「体重増加有り・非肥満」群,「体重増加有り・肥満」群の4群に分類し,糖尿病の新規発症リスクをCoxの比例ハザードモデルを用いて検討した。結果平均年齢は64.3±7.9歳,平均追跡年数3.14±1.13年間の糖尿病の新規発症は男性126人(6.0%),女性は133人(3.7%)であった。「体重増加無し・非肥満」群を参照群とした糖尿病新規発症ハザード比(95%信頼区間[CI])は,着目群「体重増加有り・非肥満」群:1.77(95%CI:1.26-2.49)と「体重増加有り・肥満」群:2.76(95%CI:2.05-3.72)が有意に高かった。男女別では,男性は「体重増加有り・肥満」群:2.06(95%CI:1.34-3.18)であった。一方,女性では「体重増加有り・肥満」群:3.68(95%CI:2.44-5.53)に加えて,「体重増加有り・非肥満」群:2.19(95%CI:1.35-3.55)でもハザード比が高かった。結論非肥満者にとって体重増加は糖尿病発症のリスクであることが示された。さらに女性でその傾向が強く見られ,BMI 25kg/m2未満でも,20歳から10kg以上の体重増加がある場合は,糖尿病の新規発症のリスクが高かった。これに該当する者は,特定保健指導の対象外であっても,生活習慣改善指導などの対応が必要であることが示唆された。(著者抄録)

飲酒習慣・インスリン抵抗性とFatty liver indexとの関連　神戸研究

平田匠, 平田あや, 桑原和代, 久保田芳美, 西田陽子, 宮嵜潤二, 久保佐智美, 東山綾, 杉山大典, 西川智文, 宮松直美, 宮本恵宏, 岡村智教

日本循環器病予防学会誌（(一社)日本循環器病予防学会） 60 （ 1 ） 56 - 63 2025年02月

ISSN 1346-6267

【目的】脂肪肝は内臓脂肪蓄積の肝臓における表現型とされており、過量飲酒は脂肪肝のリスク因子であることが知られている。Fatty liver index(FLI)は脂肪肝の予測能に優れ、特定健診の測定項目のみで算出可能であるため健診での活用が期待される。本研究では、地域住民における飲酒習慣およびインスリン抵抗性の指標であるHOMA-IRとFLI高値との関連について検討した。【方法】循環器疾患の既往がなく生活習慣病の治療を受けていない40～74歳の男女を対象とした神戸研究のベースライン調査参加者1,078名のデータを用いた横断研究である。飲酒習慣は現在飲酒の有無と1日飲酒量に基づき、男性を4群(なし、1合未満/日、1-2合/日、2合以上/日)、女性を3群(なし、1合未満/日、1合以上/日)に分類し、脂肪肝の存在が疑われるFLI30以上をFLI高値と定義した。飲酒習慣・HOMA-IRとFLI高値との関連は多変量ロジスティック回帰分析により検討し、オッズ比と95%信頼区間を算出した。【結果】全解析対象者1,078名(男性323名、女性755名、平均年齢58.9歳)のうち、FLI高値を認める者は172名(16.0%)であった。飲酒習慣とFLIとの関連において、男性では1-2合/日および≧2合/日の群でFLI高値と有意な正の関連を認め、女性では1合以上/日の群でFLI高値と有意な正の関連を認めた。また、HOMA-IRは男女ともにFLI高値と有意な正の関連を認めた。非肥満者に限定した解析でも同様の結果となった。【結論】非肥満者を中心とした地域住民において、1合以上/日の現在飲酒は男女ともFLI高値と有意な正の関連を認めた。非肥満者であっても日常的な飲酒量が多い者では脂肪肝に伴うインスリン抵抗性の増大が循環器疾患の発症につながる可能性があるため、減酒を推奨することが望ましい。また、FLIは非肥満者でもインスリン抵抗性を反映していることが示唆された。(著者抄録)

保健師活動におけるICT活用の促進要因・阻害要因　文献レビュー

赤塚永貴, 佐野葵, 和田涼花, 宮川祥子, 杉山大典, 田口敦子

日本臨床知識学会誌（日本臨床知識学会） 5 66 - 68 2024年12月

保健師活動におけるICT(Information and Communication Technology)活用の推進へ向け、本邦の地方自治体における保健師活動へのICT活用の促進要因と阻害要因を整理することを目的に、医学中央雑誌Web版を用いて、情報通信技術に関する国および地方公共団体の責務について定めた法律である高度情報通信ネットワーク社会形成基本法が制定された2000年から2023年3月の文献を対象に検索を行い、得られた9件を分析した。その結果、保健師活動におけるICT活用の促進要因として、保健師個人の要因では「業務の効率化」「住民の健康管理・健康増進」が、保健師が所属する組織の要因では「目的が明確化できていること」「必要性が認識されていること」「ICT専門職を含めた連携体制」に加え「国や制度によるデジタル推進の流れ」が挙げられた。ここから、保健師活動におけるICT活用の推進へ向け、組織内での合意形成とともに、事務職やICT専門職等との連携・協力体制構築の必要性が示された。ICT活用の阻害要因では、保健師個人の要因である「ICTへの無関心さ」「苦手意識」「ネガティブな認識」「ICTの活用状況やスキルの差」などが、保健師が所属する組織の要因として「職場のICT環境の不十分さ」「予算・マンパワーの課題」などが挙げられていたほか、電子記録システム自体の整備や標準化も課題として挙げられていた。

Posttraumatic negative cognitions in nurses affected by the Great East Japan Earthquake: A longitudinal study two years after the nuclear power plant accident

Sato Y., Nozue K., Sugiyama D.

Archives of Psychiatric Nursing 53 51 - 61 2024年12月

ISSN 08839417

This study elucidated mental health changes in 39 nurses in Fukushima Prefecture one to two years after the Great East Japan Earthquake. Posttraumatic stress disorder symptoms improved, but posttraumatic negative cognitions worsened significantly. Factors including stress during the disaster, nursing-related stressors, and lack of disaster nursing experience contributed to negative cognitions. However, higher resilience and social support were associated with fewer negative cognitions. The complexity and uniqueness of radiation disasters may have influenced the nurses' negative thoughts. To address these issues, hospital administrators should reduce occupational stress, provide flexibility in work choices during disasters, and offer organizational support for nurses.

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Evaluation of Medication Adherence Among Prevalent Users in Hypertension, Dyslipidemia, and Diabetes Using Health Insurance Claims: A Population-Based Cohort Study in Japan

Matsumoto M., Harada S., Ikuta H., Iida M., Kato S., Sata M., Shibuki T., Ishibashi Y., Miyagawa N., Hisamatsu M., Hirata A., Kuwabara K., Takeuchi A., Sugiyama D., Suzuki S., Nakamura T., Okamura T., Takebayashi T.

Pharmacoepidemiology and Drug Safety 33 （ 8 ） e5855 2024年08月

ISSN 10538569

Purpose: Hypertension (HT), dyslipidemia (DL), and diabetes mellitus (DM) are major risk factors for cardiovascular diseases. Despite the wide availability of medications to reduce this risk, poor adherence to medications remains an issue. The aim of this study is to evaluate medication adherence of prevalent users in these disease medications (HT, DL, DM) using claims data. Factors associated with non-adherence were also examined. Methods: Of 7538 participants of the Tsuruoka Metabolomics Cohort Study, 3693 (HT: 2702, DL: 2112, DM: 661) were identified as prevalent users of these disease medications. Information on lifestyle was collected through a questionnaire. Adherence was assessed by a proportion of days covered (PDC) and participants with PDC ≥0.8 were defined as adherent. Predictors of non-adherence were determined by performing multivariable logistic regression. Results: Medication adherence differed by treatment status. Among those without comorbidities, those with HT-only showed the highest adherence (90.2%), followed by those with DM-only (81.2%) and those with DL-only (80.8%). Factors associated with non-adherence in each medication group were skipping breakfast and poor understanding of medications among those with HT medications, females, having comorbidities, having a history of heart disease, and drinking habit among those with DL medications, and good sleep quality and skipping breakfast among those with DM medications. Conclusion: While participants showed high medication adherence, differences were observed across medication groups. The identified predictors of non-adherence could help target those in need of adherence support.

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Risk and protective factors for early dropout from telephone monitoring for individuals with drug convictions in community mental health centers in Japan

Tsutsumi S., Takano A., Usami T., Kumakura Y., Kanazawa Y., Takebayashi T., Sugiyama D., Matsumoto T.

Journal of Substance Use and Addiction Treatment 162 209347 2024年07月

ISSN 29498767

Introduction: Individuals involved with the criminal justice system face challenges in receiving and maintaining substance use disorder (SUD) treatment and support. Although telephone monitoring (TM) could reduce these barriers, data on TM for community-dwelling individuals involved with the criminal justice system and research on individuals who drop out of TM are scarce. We examined the factors associated with dropping out early from the Voice Bridges Project, which provides TM for individuals on probation for drug-related convictions through community mental health centers in Japan. Methods: Participants (n = 546) were individuals aged ≥20 years with methamphetamine-related convictions who were on probation. Univariate analyses examine the associations between one-year follow-up status and baseline variables, and multivariate Cox proportional hazards regression analyses identify the risk and protective factors associated with dropping out. Stratified analyses report results based on sex and halfway-house residency. Results: The one-year dropout rate was 43.6 % (n = 238). Multivariate analysis identified two risk factors for dropping out—halfway-house residency and suicide attempts in the past year, and two protective factors—higher education and the current use of SUD services. Sex-stratified analyses showed that halfway-house residency was a risk factor for both men and women. Attempted suicide was a risk factor for women. Conversely, higher education and current use of SUD services were protective factors for men. Conclusions: Our results identify unique risk factors for women, such as a recent history of suicide attempts, and distinctive protective factors for men, including higher education and current use of SUD services, emphasizing the importance of sex-specific approaches. Furthermore, the study reveals that irrespective of sex, vulnerable individuals, such as halfway-house residents, are at a higher risk of dropping out from TM.

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Reliability of Time-Series Plasma Metabolome Data over 6 Years in a Large-Scale Cohort Study

Miyake A., Harada S., Sugiyama D., Matsumoto M., Hirata A., Miyagawa N., Toki R., Edagawa S., Kuwabara K., Okamura T., Sato A., Amano K., Hirayama A., Sugimoto M., Soga T., Tomita M., Arakawa K., Takebayashi T., Iida M.

Metabolites 14 （ 1 ） 2024年01月

ISSN 2218-1989

Studies examining long-term longitudinal metabolomic data and their reliability in large-scale populations are limited. Therefore, we aimed to evaluate the reliability of repeated measurements of plasma metabolites in a prospective cohort setting and to explore intra-individual concentration changes at three time points over a 6-year period. The study participants included 2999 individuals (1317 men and 1682 women) from the Tsuruoka Metabolomics Cohort Study, who participated in all three surveys—at baseline, 3 years, and 6 years. In each survey, 94 plasma metabolites were quantified for each individual and quality control (QC) sample. The coefficients of variation of QC, intraclass correlation coefficients, and change rates of QC were calculated for each metabolite, and their reliability was classified into three categories: excellent, fair to good, and poor. Seventy-six percent (71/94) of metabolites were classified as fair to good or better. Of the 39 metabolites grouped as excellent, 29 (74%) in men and 26 (67%) in women showed significant intra-individual changes over 6 years. Overall, our study demonstrated a high degree of reliability for repeated metabolome measurements. Many highly reliable metabolites showed significant changes over the 6-year period, suggesting that repeated longitudinal metabolome measurements are useful for epidemiological studies.

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薬物犯罪の更生保護施設利用者における健康格差

堤史織, 宇佐美貴士, 高野歩, 熊倉陽介, 金澤由佳, 武林亨, 杉山大典, 松本俊彦

日本アルコール・薬物医学会雑誌（(一社)日本アルコール・アディクション医学会） 59 （ 3 ） 53 - 66 2024年

ISSN 1341-8963

目的:本研究は,更生保護施設を利用する薬物事犯者の特徴を明らかにし,健康格差との関連を調査すること目的とする.方法:本研究は,保護観察中の薬物犯罪者を対象にした地域コホート調査,Voice Bridges Project(VBP)のデータを用いて,VBP協力地域の23の保護観察所からリクルートされた20歳以上で主に覚醒剤を使用する677人の保護観察中の個人を分析した.調査開始時点における,更生保護施設利用者と非利用者を分類し,人口統計,健康,犯罪関連の特徴を比較した.更生保護施設利用者の健康格差を探るために,生活の質(QOL),健康満足度,薬物使用症の治療・支援プログラムの利用の3つのアウトカムとし,多変量分析を行った.結果:更生保護施設利用者は,非利用者と比較して,女性,高齢,離死別による単身者,教育水準が低い傾向にあった.再犯率が高く,身体的・精神的健康状態が悪い傾向にあった.社会保障制度や薬物使用症の治療・支援プログラムの利用は低かった.多変量分析では,更生保護施設利用とQOL,健康満足度,治療・支援のアクセスとの間に統計的に有意な負の関連があり,健康格差との関係が示された.結論:薬物事犯者の中で更生保護施設を利用する者は,非利用者と比べて,健康格差がある集団であることが明らかにされた.施設を利用する薬物事犯者に対して,健康格差を是正するための特別な措置と支援を提供するサポートシステムの検討が必要である.(著者抄録)

A population-based urinary and plasma metabolomics study of environmental exposure to cadmium

Ishibashi Y., Harada S., Eitaki Y., Kurihara A., Kato S., Kuwabara K., Iida M., Hirata A., Sata M., Matsumoto M., Shibuki T., Okamura T., Sugiyama D., Sato A., Amano K., Hirayama A., Sugimoto M., Soga T., Tomita M., Takebayashi T.

Environmental Health and Preventive Medicine 29 22 2024年

ISSN 1342078X

Background: The application of metabolomics-based profiles in environmental epidemiological studies is a promising approach to refine the process of health risk assessment. We aimed to identify potential metabolomics-based profiles in urine and plasma for the detection of relatively low-level cadmium (Cd) exposure in large population-based studies. Method: We analyzed 123 urinary metabolites and 94 plasma metabolites detected in fasting urine and plasma samples collected from 1,412 men and 2,022 women involved in the Tsuruoka Metabolomics Cohort Study. Regression analysis was performed for urinary N-acetyl-beta-D-glucosaminidase (NAG), plasma, and urinary metabolites as dependent variables, and urinary Cd (U-Cd, quartile) as an independent variable. The multivariable regression model included age, gender, systolic blood pressure, smoking, rice intake, BMI, glycated hemoglobin, low-density lipoprotein cholesterol, alcohol consumption, physical activity, educational history, dietary energy intake, urinary Na/K ratio, and uric acid. Pathway-network analysis was carried out to visualize the metabolite networks linked to Cd exposure. Result: Urinary NAG was positively associated with U-Cd, but not at lower concentrations (Q2). Among urinary metabolites in the total population, 45 metabolites showed associations with U-Cd in the unadjusted and adjusted models after adjusting for the multiplicity of comparison with FDR. There were 12 urinary metabolites which showed consistent associations between Cd exposure from Q2 to Q4. Among plasma metabolites, six cations and one anion were positively associated with U-Cd, whereas alanine, creatinine, and isoleucine were negatively associated with U-Cd. Our results were robust by statistical adjustment of various confounders. Pathway-network analysis revealed metabolites and upstream regulator changes associated with mitochondria (ACACB, UCP2, and metabolites related to the TCA cycle). Conclusion: These results suggested that U-Cd was associated with metabolites related to upstream mitochondrial dysfunction in a dose-dependent manner. Our data will help develop environmental Cd exposure profiles for human populations.

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Association of Nonalcoholic Fatty Liver Disease with Arterial Stiffness and its Metabolomic Profiling in Japanese Community-Dwellers

Hirata A., Harada S., Iida M., Kurihara A., Fukai K., Kuwabara K., Kato S., Matsumoto M., Sata M., Miyagawa N., Toki R., Edagawa S., Sugiyama D., Sato A., Hirayama A., Sugimoto M., Soga T., Tomita M., Okamura T., Takebayashi T.

Journal of Atherosclerosis and Thrombosis 31 （ 7 ） 1031 - 1047 2024年

ISSN 13403478

Aims: Nonalcoholic fatty liver disease (NAFLD) is known to be associated with atherosclerosis. This study focused on upstream changes in the process by which NAFLD leads to atherosclerosis. The study aimed to confirm the association between NAFLD and the cardio-ankle vascular index (CAVI), an indicator of subclinical atherosclerosis, and explore metabolites involved in both by assessing 94 plasma polar metabolites.Methods: A total of 928 Japanese community-dwellers (306 men and 622 women) were included in this study. The association between NAFLD and CAVI was examined using a multivariable regression model adjusted for confounders. Metabolites commonly associated with NAFLD and CAVI were investigated using linear mixed-effects models in which batch numbers of metabolite measurements were used as a random-effects variable, and false discovery rate-adjusted p-values were calculated. To determine the extent to which these metabolites mediated the association between NAFLD and CAVI, mediation analysis was conducted.Results: NAFLD was positively associated with CAVI (coefficients [95% Confidence intervals (CI)]=0.23 [0.09–0.37]; p=0.001). A total of 10 metabolites were involved in NAFLD and CAVI, namely, branched-chain amino acids (BCAAs; valine, leucine, and isoleucine), aromatic amino acids (AAAs; tyrosine and tryptophan), alanine, proline, glutamic acid, glycerophosphorylcholine, and 4-methyl-2-oxopentanoate. Mediation analysis showed that BCAAs mediated more than 20% of the total effect in the association between NAFLD and CAVI.Conclusions: NAFLD was associated with a marker of atherosclerosis, and several metabolites related to insulin resistance, including BCAAs and AAAs, could be involved in the process by which NAFLD leads to atherosclerosis.

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Metabolomics Profiles Alterations in Cigarette Smokers and Heated Tobacco Product Users

Harada S., Ohmomo H., Matsumoto M., Sata M., Iida M., Hirata A., Miyagawa N., Kuwabara K., Kato S., Toki R., Edagawa S., Sugiyama D., Sato A., Hirayama A., Sugimoto M., Soga T., Tomita M., Shimizu A., Okamura T., Takebayashi T.

Journal of Epidemiology 34 （ 9 ） 403 - 410 2024年

ISSN 09175040

Background: Heated tobacco products (HTPs) have gained global popularity, but their health risks remain unclear. Therefore, the current study aimed to identify plasma metabolites associated with smoking and HTP use in a large Japanese population to improve health risk assessment. Methods: Metabolomics data from 9,922 baseline participants of the Tsuruoka Metabolomics Cohort Study (TMCS) were analyzed to determine the association between smoking habits and plasma metabolites. Moreover, alterations in smoking-related metabolites among HTP users were examined based on data obtained from 3,334 participants involved from April 2018 to June 2019 in a follow-up survey. Results: Our study revealed that cigarette smokers had metabolomics profiles distinct from never smokers, with 22 polar metabolites identified as candidate biomarkers for smoking. These biomarker profiles of HTP users were closer to those of cigarette smokers than those of never smokers. The concentration of glutamate was higher in cigarette smokers, and biomarkers involved in glutamate metabolism were also associated with cigarette smoking and HTP use. Network pathway analysis showed that smoking was associated with the glutamate pathway, which could lead to endothelial dysfunction and atherosclerosis of the vessels. Conclusion: Our study showed that the glutamate pathway is affected by habitual smoking. These changes in the glutamate pathway may partly explain the mechanism by which cigarette smoking causes cardiovascular disease. HTP use was also associated with glutamate metabolism, indicating that HTP use may contribute to the development of cardiovascular disease through mechanisms similar to those in cigarette use.

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Seasonal variation in vascular dehydration risk: insights from the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) study

Nishikawa T., Miyamatsu N., Higashiyama A., Kubota Y., Nishida Y., Hirata T., Hirata A., Miyazaki J., Sugiyama D., Kuwabara K., Kubo S., Miyamoto Y., Okamura T.

Environmental Health and Preventive Medicine 29 62 2024年

ISSN 1342078X

Background: Dehydration, a risk factor for ischemic cerebrovascular diseases, is common in summer; however, the incidence of ischemic diseases is not necessarily higher in summer. Therefore, this study aimed to clarify the relationships between serum osmolarity, hematocrit, daily non-alcohol drink (NAD) intake and factors such as season and age as risk factors for dehydration. Method: Participants (703 women and 306 men) in the follow-up survey, in 2012 and 2013, of the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) Study, consisting of healthy individuals living in Kobe, Japan, were categorized into two groups based on the examination month: the warmer and colder seasons. Multivariate analyses were conducted to examine disparities in serum osmolarity, hematocrit, and NAD intake between these two groups. Results: The colder season was found to be negatively correlated with serum osmolarity and NAD intake, but positively correlated with hematocrit, even after adjusting for relevant factors. Age was independently associated with serum osmolarity, but not with hematocrit and NAD intake. Conclusions: This study suggests that intra-vascular volume depletion is more likely in the colder season despite lower serum osmolarity compared to the warmer season. Age-related increases in serum osmolarity without a corresponding rise in water intake may contribute to this. These findings support the importance of addressing dehydration in the colder season, particularly in older adults.

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Study Profile of the Tsuruoka Metabolomics Cohort Study (TMCS)

Harada S., Iida M., Miyagawa N., Hirata A., Kuwabara K., Matsumoto M., Okamura T., Edagawa S., Kawada Y., Miyake A., Toki R., Akiyama M., Kawai A., Sugiyama D., Sato Y., Takemura R., Fukai K., Ishibashi Y., Kato S., Kurihara A., Sata M., Shibuki T., Takeuchi A., Kohsaka S., Sawano M., Shoji S., Izawa Y., Katsumata M., Oki K., Takahashi S., Takizawa T., Maruya H., Nishiwaki Y., Kawasaki R., Hirayama A., Ishikawa T., Saito R., Sato A., Soga T., Sugimoto M., Tomita M., Komaki S., Ohmomo H., Ono K., Otsuka-Yamasaki Y., Shimizu A., Sutoh Y., Hozawa A., Kinoshita K., Koshiba S., Kumada K., Ogishima S., Sakurai-Yageta M., Tamiya G., Takebayashi T.

Journal of Epidemiology 34 （ 8 ） 393 - 401 2024年

ISSN 09175040

The Tsuruoka Metabolomics Cohort Study (TMCS) is an ongoing population-based cohort study being conducted in the rural area of Yamagata Prefecture, Japan. This study aimed to enhance the precision prevention of multi-factorial, complex diseases, including non-communicable and aging-associated diseases, by improving risk stratification and prediction measures. At baseline, 11,002 participants aged 35–74 years were recruited in Tsuruoka City, Yamagata Prefecture, Japan, between 2012 and 2015, with an ongoing follow-up survey. Participants underwent various measurements, examinations, tests, and questionnaires on their health, lifestyle, and social factors. This study uses an integrative approach with deep molecular profiling to identify potential biomarkers linked to phenotypes that underpin disease pathophysiology and provide better mechanistic insights into social health determinants. The TMCS incorporates multi-omics data, including genetic and metabolomic analyses of 10,933 participants, and comprehensive data collection ranging from physical, psychological, behavioral, and social to biological data. The metabolome is used as a phenotypic probe because it is sensitive to changes in physiological and external conditions. The TMCS focuses on collecting outcomes for cardiovascular disease, cancer incidence and mortality, disability and functional decline due to aging and disease sequelae, and the variation in health status within the body represented by omics analysis that lies between exposure and disease. It contains several sub-studies on aging, heated tobacco products, and women’s health. This study is notable for its robust design, high participation rate (89%), and long-term repeated surveys. Moreover, it contributes to precision prevention in Japan and East Asia as a well-established multi-omics platform.

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The association between sleep parameters and sarcopenia in Japanese community-dwelling older adults

Shibuki T., Iida M., Harada S., Kato S., Kuwabara K., Hirata A., Sata M., Matsumoto M., Osawa Y., Okamura T., Sugiyama D., Takebayashi T.

Archives of Gerontology and Geriatrics （Archives of Gerontology and Geriatrics） 109 104948 2023年06月

ISSN 01674943

Purpose: This study aimed to examine the association between sleep duration and quality and sarcopenia, assessed by factors such as low muscle mass (LMM), low muscle strength (LMS), and low physical performance (LPP) among older community-dwellers in Japan. Methods: In this cross-sectional study, a total of 2,069 (men, 902; women, 1,167) participants aged 65 to 80 years were included. Sarcopenia and each low physical function were defined using the definitions of the Asian Working Groups of Sarcopenia 2019. Sleep duration was stratified into three categories: short sleep (<6 h), normal sleep (6-8 h), and long sleep (>8 h). Sleep quality was classified into two groups based on 8-item Athens Insomnia Scale score: insomnia (≥6), and non-insomnia (<6). We analyzed the association between sleep parameters and sarcopenia, including low physical functions, by logistic regression analysis. Results: Compared to normal sleepers, long sleepers had a positive association with sarcopenia (odds ratio [OR] 2.11, 95% confidence interval [CI] 1.25-3.58). In particular, long sleep was strongly associated with LMS (OR 1.77, 95%CI 1.07-2.94) and LPP (OR 1.90, 95%CI 1.25-2.88). On the other hand, poor sleep quality was not associated with sarcopenia in long sleepers, but in normal sleepers. Conclusions: Long sleep was associated with sarcopenia, including LMS and LPP. However, in long sleepers, insomnia was not associated with sarcopenia or any of its components.

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[Determinants of salt taste threshold among urban residents: the KOBE study].

Wakako M, Sata M, Kubota Y, Nishida Y, Kubo S, Higashiyama A, Hirata T, Kadota A, Hirata A, Miyazaki J, Kawahara M, Kuwabara K, Sugiyama D, Miyamatsu N, Miyamoto Y, Okamura T

[Nihon koshu eisei zasshi] Japanese journal of public health 70 （ 5 ） 300 - 310 2023年05月

ISSN 0546-1766

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Tsuji M., Fukahori H., Sugiyama D., Doorenbos A., Nasu K., Mashida Y., Ogawara H.

PLoS ONE （PLoS ONE） 18 （ 5 May ） e0283332 2023年05月

Globally, residents of long-term care facilities (LTCFs) often experience adverse events (AEs) and corresponding lawsuits that result in suffering among the residents, their families, and the facilities. Hence, we conducted a study to clarify the factors related to the facilities’ liabilities for damages for the AEs that occur at LTCFs in Japan. We analyzed 1,495 AE reports from LTCFs in one Japanese city. A binomial logistic regression analysis was conducted to identify factors associated with liability for damages. The independent variables were classified as: residents, organizations, and social factors. In total, 14% of AEs resulted in the facility being liable for damages. The predictors of liability for damages were as follows: for the resident factors, the increased need for care had an adjusted odds ratio (AOR) of 2.00 and care levels of 2–3; and AOR of 2.48 and care levels of 4–5. The types of injuries, such as bruises, wounds, and fractures, had AORs of 3.16, 2.62, and 2.50, respectively. Regarding the organization factors, the AE time, such as noon or evening, had an AOR of 1.85. If the AE occurred indoors, the AOR was 2.78, and if it occurred during staff care, the AOR was 2.11. For any follow-ups requiring consultation with a doctor, the AOR was 4.70, and for hospitalization, the AOR was 1.76. Regarding the type of LTCF providing medical care in addition to residential care, the AOR was 4.39. Regarding the social factors, the reports filed before 2017 had an AOR of 0.58. The results of the organization factors suggest that liability tends to arise in situations where the residents and their family expect high quality care. Therefore, it is imperative to strengthen organizational factors in such situations to avoid AEs and the resulting liability for damages.

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都市部住民における塩味味覚閾値の規定要因に関する検討　神戸研究

若子みな美, 佐田みずき, 久保田芳美, 西田陽子, 久保佐智美, 東山綾, 平田匠, 門田文, 平田あや, 宮嵜潤二, 川原瑞希, 桑原和代, 杉山大典, 宮松直美, 宮本恵宏, 岡村智教

日本公衆衛生雑誌（日本公衆衛生学会） 70 （ 5 ） 300 - 310 2023年05月

ISSN 0546-1766

目的塩味味覚閾値の高値は高血圧との関連が指摘されているが,その規定要因は明らかではない。都市部地域住民集団で塩味味覚閾値の規定要因を明らかにするとともに,複数の規定要因が同時に存在した場合の塩味味覚閾値との関連を明らかにすることを目的とした。方法がんや循環器疾患の既往歴がなく,高血圧,糖尿病,脂質異常症の治療中ではない40～74歳の健康な都市部住民を対象としたコホート研究である神戸研究のベースライン調査参加者1,117人のうち,塩味味覚閾値検査を実施し,尿検査から推定一日食塩摂取量の結果が把握できる1,116人を対象者とした。塩味味覚閾値調査はソルセイブを用いて塩味味覚閾値0.6%を正常群,0.8%以上を高値群と定義した。塩味味覚閾値高値を目的変数,問診票から得られた生活状況,家族状況,教育歴,喫煙状況,飲酒状況,塩干物摂取状況,ストレス指標,推定一日食塩摂取量を説明変数として,二項ロジスティック回帰モデルにて検討した。さらに,説明変数を塩味味覚閾値に影響を与える要因,目的変数を塩味味覚閾値(正常/高値)として強制投入法を用いた多変量解析にて二項ロジスティック回帰分析を実施した。この分析では,推定一日食塩摂取量との多重共線性を考慮して,尿中ナトカリ比を除いて実施した。結果平均年齢は男性60.9±9.0歳,女性58.0±8.7歳であった。塩味味覚閾値の正常群は80.9%(903人)(男性73.6%(251人),女性84.1%(652人)),高値群は19.1%(213人)(男性26.3%(90人),女性15.9%(123人))であった。多変量解析の結果,全対象者において現在喫煙習慣がある群は喫煙習慣が無い群と比較し,塩味味覚閾値高値となるオッズ比(95%信頼区間)が2.51(1.33-4.74)と有意な関連が認められた。また,推定一日食塩摂取量上位25%群では下位75%群と比較してオッズ比(95%信頼区間)が1.45(1.03-2.03)と塩味味覚閾値高値との有意な関連を認めた。男女別の解析では,男女ともに現在喫煙習慣と塩味味覚閾値高値との関連を認め,推定一日食塩摂取量は男性のみ関連を認めた。結論健康な都市住民において,喫煙習慣と推定一日食塩摂取量の多さが塩味味覚閾値高値と関連していた。(著者抄録)

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