研究者詳細 - 宮川　尚子

論文 - 宮川　尚子

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Relationship between calcium intake and impaired activities of daily living in a japanese population: Nippon data90

Kogure M., Tsuchiya N., Narita A., Hirata T., Nakaya N., Nakamura T., Hozawa A., Hayakawa T., Okuda N., Miyagawa N., Kadota A., Ohkubo T., Murakami Y., Sakata K., Miura K., Okayama A., Okamura T., Ueshima H.

Journal of Epidemiology （Journal of Epidemiology） 31 （ 1 ） 119 - 124 2021年

研究論文（学術雑誌）, 共著, 査読有り, ISSN 09175040

Background: Major reasons for long-term care insurance certification in Japan are stroke, dementia, and fracture. These diseases are reported to be associated with calcium intake. This study examined the association between calcium intake and impaired activities of daily living (ADL) using the data from NIPPON DATA90, consisting of representative sample of the Japanese population. Methods: A population-based nested case-control study was performed. A baseline survey was conducted in 1990, followed by ADL surveys of individuals ≥65 years old in 2000. Individuals with impaired ADL and selected age-and sex-matched controls were then identified. We obtained 132 pairs. Calcium intake was energy-adjusted using the residual method. The association between calcium intake and impaired ADL was examined using conditional logistic regression models. To assess the accuracy of the estimates, we conducted bootstrap analyses. Results: The adjusted odds ratios (ORs) for impaired ADL compared with the group with a calcium intake of <476 mg/day were 0.72 (95% confidence interval [CI], 0.37–1.40) for the 476–606 mg/day group and 0.44 (95% CI, 0.21–0.94) for the ≥607 mg/ day group in 2000 (P for linear trend = 0.03). After the bootstrap analyses, the inverse relationship unchanged (median OR per 100-mg rise in calcium intake, 0.87 [1,000 resamplings]; 95% CI, 0.76–0.97). Conclusions: After bootstrap analyses, calcium intake was inversely associated with impaired ADL 10 years after the baseline survey.

Relationships of alcohol consumption with coronary risk factors and macro-and micro-nutrient intake in Japanese people: The interlipid study

Matsumoto-Yamauchi H., Kondo K., Miura K., Tanaka-Mizuno S., Segawa H., Ohno S., Miyagawa N., Zaid M., Okami Y., Okuda N., Nakagawa H., Sakata K., Saitoh S., Okayama A., Yoshita K., Chan Q., Masaki K., Elliott P., Stamler J., Ueshima H.

Journal of Nutritional Science and Vitaminology （Journal of Nutritional Science and Vitaminology） 67 （ 1 ） 28 - 38 2021年

研究論文（学術雑誌）, 共著, ISSN 03014800

Several studies have reported a J-shaped relationship between alcohol consumption and coronary heart disease (CHD) risk. However, the mechanisms of this relationship remain unclear. This study aimed to evaluate the relationships of alcohol consumption with established CHD risk factors and with macro-/micro-nutrient intake among Japanese people. Participants were 1,090 Japanese men and women aged 40–59 y enrolled in the INTERLIPID study, excluding former drinkers. Based on two 7-d alcohol records, participants were classified as non-drinkers (0 g/wk), light-drinkers (<100 g/wk), moder-ate-drinkers (100–299 g/wk), or heavy-drinkers (≥300 g/wk). Detailed macro-/micro-nu-trient intake was evaluated using four in-depth 24-h dietary recalls and adjusted for total energy intake excluding alcohol. We analyzed the associations of CHD risk factors and nutrient intake with alcohol consumption. Serum high-density lipoprotein cholesterol and blood pressure were higher and low-density lipoprotein cholesterol was lower among those with higher alcohol consumption. J-shaped relationships with alcohol consumption were observed for the proportion of current smokers, number of cigarettes smoked, and prevalence of hypertension; these risk factors were lowest among light-drinkers. Carbohydrate and total fiber intakes were lower and protein and dietary cholesterol intakes were higher among those with higher alcohol consumption. These associations were similar for men and women. Alcohol consumption was related to nutrient intake as well as established CHD risk factors. Non-drinkers were higher on some CHD risk factors than were light-drinkers. These findings may influence the J-shaped relationship between alcohol consumption and CHD risk.

自然災害後の栄養問題と改善の取り組みに関連する要因のレビュー

宮川尚子, 笠岡 (坪山) 宜代, 原田萌香, 西信雄

栄養学雑誌（特定非営利活動法人日本栄養改善学会） 78 （ Supplement ） S111 - S120 2020年12月

ISSN 00215147

【目的】このレビューの目的は，避難所での食事と栄養問題の改善方法と，日本における自然災害後の健康と栄養を改善するためのさまざまな取り組みを明らかにすることである。【方法】世界の避難所における栄養問題の改善方法を明らかにするため，PubMedおよびJ-STAGEにて，「災害」および「避難所ORキャンプ」AND「栄養OR食品OR食事」をキーワードとして文献検索した。活動報告，レビュー，方法のない記事，英語と日本語以外の言語で書かれた論文は，本レビューから除外した。また，日本の政府，専門機関，学術研究機関による自然災害後の健康と栄養改善の取り組みに関する情報を整理した。【結果】条件に合致した7編の論文から，自然災害後の避難所における栄養問題の改善に関連する4つの主要な要素，1）避難所のサイズと設備，2）避難所での食事の提供方法と内容，3）専門家との共同作業，4）避難所間の協力，が抽出された。また，東日本大震災以降に日本で開始された自然災害後の健康・栄養問題改善のための取り組みとして，国の研究機関への災害栄養に特化した部署の設置，災害食の備蓄の推奨や認証制度，人材の開発育成，災害時の栄養基準などがあった。【結論】本レビューにより，緊急時の避難所における栄養問題の改善に関連する要因と日本における自然災害に伴う栄養と健康の問題を軽減するための様々な取り組みを明らかにした。

Association of red meat intake with the risk of cardiovascular mortality in general japanese stratified by kidney function: Nippon data80

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

Nutrients （Nutrients） 12 （ 12 ） 1 - 10 2020年12月

研究論文（学術雑誌）, 共著

The consumption of red meat has been recommended for individuals with reduced kidney function. However, red meat intake was recently suspected to increase cardiovascular disease (CVD) risk. We evaluated the association of red meat intake with CVD mortality risk in Japanese with/without reduced kidney function. Overall, 9112 participants of a Japanese national survey in 1980, aged ≥30 years, were followed for 29 years. Red meat intake was assessed using weighed dietary record. Cox proportional hazards models were used to estimate the hazard ratio (HR) of CVD mortality according to sex-specific tertiles of red meat intake. We also performed stratified analyses with/without reduced kidney function defined as estimated glomerular filtration rate less than 60 mL/min/1.73 m2. Red meat intake was not associated with CVD mortality risk in men and women. In stratified analyses, the HR of the highest compared with the lowest tertile of red meat intake was lower only in women with reduced kidney function (0.67, 95% confidence interval 0.46–0.98). In conclusion, there were no clear associations between red meat intake and CVD mortality risk in Japanese population; however, a higher intake of red meat was associated with lower risk of future CVD mortality in women with reduced kidney function.

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Alcohol consumption and cognitive function in elderly Japanese men

Siddiquee A.T., Kadota A., Fujiyoshi A., Miyagawa N., Saito Y., Suzuki H., Kondo K., Yamauchi H., Ito T., Segawa H., Tooyama I., Miura K., Ueshima H.

Alcohol （Alcohol） 85 145 - 152 2020年06月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 07418329

Although heavy alcohol consumption has been identified as a risk factor for adverse cognitive functioning, it currently remains unclear whether moderate alcohol consumption exerts similar effects. Observational studies previously reported the potential benefits of moderate alcohol consumption on cognition, particularly in the elderly; however, these effects have not yet been demonstrated in Asian populations. The aim of the present study was to investigate the relationship between alcohol consumption levels and global and domain-specific cognitive functions in cognitively intact elderly Japanese men. Cross-sectional data from the Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA), an ongoing prospective, population-based study in Shiga, Japan, were used to examine the relationship between alcohol consumption and cognitive function. Men (n = 585) aged ≥65 years provided information on their weekly consumption of alcohol, and the data obtained were used to construct categories of never, ex- (quit before interview), very light (<14 g/day), light (14–23 g/day), moderate (>23–46 g/day), and heavy (>46 g/day) drinkers. Cognitive function was measured using the Cognitive Abilities Screening Instrument (CASI). A fractional logistic regression model adjusted for age, education, body mass index, smoking, exercise, hypertension, diabetes, and dyslipidemia showed that the CASI scores for global and domain-specific cognitive functions were not significantly different between all subgroups of current drinkers and never-drinkers. However, the CASI score of ex-drinkers (multivariable adjusted mean CASI score [SD]) was significantly lower than that of never-drinkers in the global [never vs. ex: 90.16 (2.21) vs. 88.26 (2.58)] and abstraction and judgment domain [never vs. ex: 9.48 (0.46) vs. 8.61 (0.57)]). The present results do not suggest any beneficial or adverse relationship between current alcohol consumption levels and cognitive functioning (both global and domain specific) in elderly Japanese men; however, low cognitive function among ex-drinkers warrants future investigations to identify the factors causing drinkers to quit.

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Food sources of dietary potassium in the adult Japanese population: The international study of macro-/micronutrients and blood pressure (INTERMAP)

Okuda N., Okayama A., Miura K., Yoshita K., Miyagawa N., Saitoh S., Nakagawa H., Sakata K., Chan Q., Elliott P., Ueshima H., Stamler J.

Nutrients （Nutrients） 12 （ 3 ） 2020年03月

研究論文（学術雑誌）, 共著, 査読有り

A lower-than-recommended potassium intake is a well-established risk factor for increased blood pressure. Although the Japanese diet is associated with higher sodium intake and lower potassium intake, few studies have examined the source foods quantitatively. Studies on dietary patterns in association with potassium intake will be useful to provide dietary advice to increase potassium intake. Twenty-four-hour (hr) dietary recall data and 24-hr urinary potassium excretion data from Japanese participants (574 men and 571 women) in the International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) were used to calculate food sources of potassium and compare food consumption patterns among quartiles of participants categorized according to 24-hr urinary potassium excretion per unit of body weight (UK/BW). The average potassium intake was 2791 mg/day per participant, and the major sources were vegetables and fruits (1262 mg/day), fish (333 mg/day), coffee and tea (206 mg/day), and milk and dairy products (200 mg/day). Participants in the higher UK/BW quartile consumed significantly more vegetables and fruits, fish, and milk and dairy products, and ate less rice and noodles. Conclusion: Advice to increase the intake of vegetables and fruits, fish, and milk may be useful to increase potassium intake in Japan.

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Relationship of household salt intake level with long-term all-cause and cardiovascular disease mortality in Japan: NIPPON DATA80

Shima A., Miyamatsu N., Miura K., Miyagawa N., Okuda N., Yoshita K., Kadota A., Suzuki H., Kondo K., Okamura T., Okayama A., Ueshima H., Saitoh S., Sakata K., Hozawa A., Hayakawa T., Nakamura Y., Nishi N., Ohkubo T., Kasagi F., Murakami Y., Izumi T., Matsumura Y., Ojima T., Tamakoshi K., Nakagawa H., Kita Y., Fujiyoshi A., Nakamura Y., Miyamoto Y., Kodama K., Kiyohara Y.

Hypertension Research （Hypertension Research） 43 （ 2 ） 132 - 139 2020年02月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 09169636

In Asian countries, a major source of salt intake is from seasoning or table salt added at home. However, little is known about the adverse effects of salt intake evaluated according to household unit. We investigated the relationship between household salt intake level and mortality from all-cause and cardiovascular diseases (CVDs). Participants included 8702 individuals (56% women) who were living with someone else and who were aged 30–79 years and enrolled in the National Nutritional Survey of Japan in 1980 with a 24-year follow-up. Household nutrient intake was evaluated using a 3-day weighing record method in which all foods and beverages consumed by any of the household members were recorded. The household salt intake level was defined as the amount of salt consumed (g) per 1000 kcal of total energy intake in each household, and its average was 6.25 (2.02) g/1000 kcal. During the follow-up, there were 2360 deaths (787 CVD, 168 coronary heart disease [CHD], and 361 stroke). Cox proportional hazard ratios (HRs) for an increment of 2 g/1000 kcal in household salt intake were calculated and adjusting for sex, age, body mass index, smoking status, alcohol consumption status, self-reported work exertion level, household potassium intake, household saturated fatty acid intake, and household long-chain n-3 polyunsaturated fatty acid intake. The HRs (95% confidence intervals) were 1.07 (1.02, 1.12) for all-cause mortality, 1.11 (1.03, 1.19) for CVD, 1.25 (1.08, 1.44) for CHD, and 1.12 (1.00, 1.25) for stroke. The household salt intake level was significantly associated with long-term risk of all-cause, CVD, CHD, and stroke mortality in a representative Japanese population.

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Relationship between carbohydrate and dietary fibre intake and the risk of cardiovascular disease mortality in Japanese: 24-year follow-up of NIPPON DATA80

Miyazawa I., Miura K., Miyagawa N., Kondo K., Kadota A., Okuda N., Fujiyoshi A., Chihara I., Nakamura Y., Hozawa A., Nakamura Y., Kita Y., Yoshita K., Okamura T., Okayama A., Ueshima H.

European Journal of Clinical Nutrition （European Journal of Clinical Nutrition） 74 （ 1 ） 67 - 76 2020年01月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 09543007

Background/Objectives: The association between carbohydrate intake and cardiovascular disease (CVD) risk has been investigated, but whether the quality of carbohydrate is more important than its amount is not known. We examined the associations between intake of dietary fibre (DF), carbohydrate, available carbohydrate, and starch with long-term CVD mortality in a Japanese population. Subjects/Methods: We prospectively followed 8925 participants (3916 men and 5009 women) aged 30–79 years without CVD at baseline who participated in the National Nutrition Survey in Japan. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for CVD mortality by quartiles of exposure variables. Results: During 24 years of follow-up, 823 CVD deaths were observed. In men, the multivariable-adjusted HR for CVD mortality was lower in the highest quartile of DF intake (HR: 0.64; 95% CI: 0.47–0.87; Ptrend = 0.007) compared with the lowest quartile. This association was not significant in women. Multivariable-adjusted HR for total stroke mortality was lower in the highest quartile of DF intake (HR: 0.61; 95% CI: 0.38–0.98; Ptrend = 0.046) compared with the lowest quartile in women. Carbohydrate, available carbohydrate, and starch intake were not associated with CVD mortality. Conclusions: Higher intake of DF was associated significantly with a lower risk of CVD mortality in men and lower risk of stroke mortality in women. Intake of carbohydrate, available carbohydrate, and starch were not associated with the risk of CVD mortality in men or women.

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Elevated fasting blood glucose levels are associated with lower cognitive function, with a threshold in non-diabetic individuals: A population-based study

Liu Z., Zaid M., Hisamatsu T., Tanaka S., Fujiyoshi A., Miyagawa N., Ito T., Kadota A., Tooyama I., Miura K., Ueshima H.

Journal of Epidemiology （Journal of Epidemiology） 30 （ 3 ） 121 - 127 2020年

研究論文（学術雑誌）, 共著, 査読有り, ISSN 09175040

Background: Cognitive dysfunction has been recognized as a diabetes-related complication. Whether hyperglycemia or elevated fasting glucose are associated with cognitive decline remains controversial. We aimed to investigate the relationship between fasting glucose levels and cognitive function in diabetic and non-diabetic individuals. Methods: Participants were Japanese diabetic (n = 191) and non-diabetic (n = 616) men, aged 46–81 years, from 2010–2014. Blood samples were taken after a 12 h fast. The Cognitive Ability Screening Instrument (CASI), with a maximum score of 100, was used for cognitive assessment. Cognitive domains of CASI were also investigated. Fractional logit regression with covariate adjustment for potential confounders was used to model cross-sectional relationships between fasting blood glucose and CASI score. Results: For diabetic individuals, CASI score was 0.38 (95% confidence interval: 0.66–0.12) lower per 1 mmol/L higher fasting glucose level. Short-term memory domain also exhibited an inverse association. For non-diabetic individuals, a reverse Ushaped relationship was observed between fasting glucose and cognitive function, identifying a threshold for highest cognitive performance of 91.8 CASI score at 3.97–6.20 mmol/L (71.5–111.6 mg/dL) fasting glucose. Language ability domain displayed a similar relationship with fasting glucose. Conclusions: Elevated fasting glucose levels in diabetic men were associated with lower cognitive function, in which short-term memory was the main associated domain. Interestingly, in non-diabetic men, we identified a threshold for the inverse relationship of elevated fasting glucose with cognitive function. Contrastingly to diabetic men, language ability was the main associated cognitive domain among non-diabetic men.

Exercise habits are associated with improved long-term mortality risks in the nationwide general japanese population: A 20-year follow-up of the Nippon data90 study

Takatsuji Y., Ishiguro A., Asayama K., Ohkubo T., Miura K., Kadota A., Yanagita M., Fujiyoshi A., Arima H., Miyagawa N., Takashima N., Kita Y., Hayakawa T., Kikuya M., Nakamura Y., Okayama A., Okamura T., Ueshima H.

Tohoku Journal of Experimental Medicine （Tohoku Journal of Experimental Medicine） 252 （ 3 ） 253 - 262 2020年

研究論文（学術雑誌）, 共著, ISSN 00408727

Exercise habits are known as a protective factor for a variety of diseases and thus recommended worldwide; however, few studies have examined long-term effects of exercise habits on mortality. We continuously monitored death status in a nationwide population sample of 7,709 eligible persons from the National Integrated Project for Prospective Observation of Noncommunicable Disease and its Trends in the Aged in 1990 (NIPPON DATA90), for which baseline data were obtained in 1990. To investigate the longterm impact of baseline exercise habits, we calculated the relative risk of non-exercisers (participants without regular voluntary exercise habits) in reference to exercisers (those with these habits) for all-cause or cause-specific mortality using a Cox proportional hazard model, in which the following confounding factors were appropriately adjusted: Sex, age, body mass index, total energy intake, smoking, drinking, and history of cardiovascular disease. During a median 20 years of follow-up, 1,747 participants died, 99 of heart failure. The risk for all-cause mortality was 12% higher in non-exercisers than in exercisers (95% confidence interval, 1%-24%), which was also observed for mortality from heart failure, as 68% higher in non-exercisers than in exercises (95% confidence interval, 3%-173%). These associations were similarly observed when the participants were divided to subgroups by sex, age, and the light, moderate, or vigorous intensity of physical activity, without any significant heterogeneities (P > 0.1). The present study has revealed significant impact of exercise habits on long-term mortality risks, supporting worldwide recommendations for improvement of exercise habits.

Proteinuria and reduced estimated glomerular filtration rate are independently associated with lower cognitive abilities in apparently healthy community-dwelling elderly men in Japan: A cross-sectional study

Fujiyoshi A., Miura K., Ohkubo T., Miyagawa N., Saito Y., Miyazawa I., Shiino A., Kadota A., Kadowaki S., Hisamatsu T., Torii S., Takashima N., Tooyama I., Ueshima H.

Journal of Epidemiology （Journal of Epidemiology） 30 （ 6 ） 244 - 252 2020年

研究論文（学術雑誌）, 共著, 査読有り, ISSN 09175040

Background: The association of proteinuria and reduced estimated glomerular filtration rate (eGFR) with cognition needs more clarification. We cross-sectionally examined whether proteinuria and reduced eGFR, even in moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. Methods: Our cohort initially comprised 1,094 men aged 40–79 years from a random sample from Shiga, Japan in 2006–2008. Of 853 men who returned for the follow-up examination (2009–2014), we analyzed 561 who were ≥65 years, free of stroke, and completed the Cognitive Abilities Screening Instrument (CASI) at follow-up (higher CASI scores [range 0 to 100] indicate better cognition). Proteinuria was assessed via dipstick. eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration Equation. Participants were divided into three groups either by eGFR (≥60, 59–40, and <40 mL= min=1.73 m2) or by proteinuria (no, trace, and positive), considered normal, moderate, and advanced, respectively. Using linear regression, we computed mean CASI score, with simultaneous adjustment for proteinuria and eGFR in addition to other potential confounders. Results: Significant trends of lower cognition were observed across the groups of worse proteinuria and lower eGFR independently: multivariable-adjusted mean CASI scores were 90.1, 89.3, and 88.4 for proteinuria (Ptrend = 0.029), and 90.0, 88.5, and 88.5 for eGFR (Ptrend = 0.015) in mutual-adjustment model. Conclusions: Proteinuria and reduced eGFR, even in their moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. The results suggest the importance of proteinuria and low eGFR for early detection and prevention of cognitive decline.

Relationship between Step Counts and Cerebral Small Vessel Disease in Japanese Men

Moniruzzaman M., Kadota A., Segawa H., Kondo K., Torii S., Miyagawa N., Fujiyoshi A., Hisamatsu T., Watanabe Y., Shiino A., Nozaki K., Ueshima H., Miura K.

Stroke （Stroke） 51 （ 12 ） 3584 - 3591 2020年

研究論文（学術雑誌）, 共著, ISSN 00392499

Background and Purpose: Cerebral small vessel disease (CSVD) is a common subclinical feature of the aging brain. Steps per day may contribute to its prevention. We herein investigated the association between step counts and CSVD in a healthy Japanese male population. Methods: We analyzed data from 680 men who were free of stroke and participated in this observational study. Seven-day step counts were assessed at baseline (2006-2008) using a pedometer. CSVD was assessed at follow-ups (2012-2015) based on deep and subcortical white matter hyperintensities (WMHs), periventricular hyperintensities, lacunar infarcts, and cerebral microbleeds on magnetic resonance imaging. Using a logistic regression analysis, we computed the adjusted odds ratios, with 95% CIs, of prevalent CSVD according to quartiles of step counts (reference: Q1). We also investigated the association between step counts and WMH volumes using a quantile regression. Results: Steps per day were significantly associated with lower odds ratios, with the lowest at Q3 (8175-10 614 steps/day), of higher (versus low or no burden) deep and subcortical WMHs (odds ratio, 0.52 [95% CI, 0.30-0.89]), periventricular hyperintensities (0.50 [95% CI, 0.29-0.86]), and lacunar infarcts (0.52 [95% CI, 0.30-0.91]) compared with Q1 (≤6060 steps/day) but not cerebral microbleeds. An inverse linear association was observed between step counts and WMH volumes. These associations were independent of age and smoking and drinking status and remained consistent when adjusted for vascular risk factors. Conclusions: We found a J-shaped relationship between step counts and prevalent CSVD in healthy Japanese men, with the lowest risk being observed among participants with ≈8000 to 10 000 steps/day. Higher steps were also associated with lower WMH volumes.

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飲酒日におけるエネルギー及び栄養素等摂取量の特徴　NIPPON DATA2010

岩橋明子, 由田克士, 荒井裕介, 尾島俊之, 藤吉朗, 中川秀昭, 奥田奈賀子, 宮川尚子, 門田文, 岡村智教, 大久保孝義, 西信雄, 上島弘嗣, 岡山明, 三浦克之, NIPPON DATA2010研究グループ

日本循環器病予防学会誌（(一社)日本循環器病予防学会） 54 （ 3 ） 178 - 188 2019年12月

研究論文（学術雑誌）, 共著, ISSN 1346-6267

【目的】過度の飲酒はアルコールそのものが与える健康障害や循環器疾患の発症リスクのみならず、食事にも大きく影響する。しかし、国を代表する集団において飲酒量が栄養素等摂取量に与えている影響を詳細に検討した報告は限られている。そこで、飲酒日における栄養素等摂取量の特徴について検討した。【方法】平成22年国民健康・栄養調査にあわせて20歳以上の男女を対象に実施されたNIPPON DATA2010に参加した、生活習慣病の関連疾患での服薬がなく、栄養摂取状況調査の項目に欠損がない男性729名を解析対象とした。調査日1日の飲酒量に基づき、生活習慣病のリスクを高める量(純アルコール40g以上)の飲酒者をO群(111名)、適量飲酒者(同5g以上40g未満)をM群(187名)、非飲酒者(同5g未満)をN群(431名)とし、各群の栄養素及び食品群別の摂取量について比較検討した。【結果】血圧、HDL及びLDLコレステロール、AST、γ-GTPは、飲酒量により有意な差が認められた。総エネルギー摂取量及びアルコールエネルギー比率は、O群、M群、N群の順に有意に高かったのに対し、炭水化物エネルギー比率及び脂肪エネルギー比率は、O群、M群、N群の順に有意に低かった。また、たんぱく質エネルギー比率は、O群がM群及びN群と比較して有意に低かった。アルコール由来のエネルギーを除外して算出した場合、たんぱく質エネルギー比率は、O群及びM群がN群と比較して有意に高かった。脂肪エネルギー比率は、M群がN群と比較して有意に高かった。炭水化物エネルギー比率はO群及びM群がN群と比較して有意に低かった。たんぱく質、脂質、カリウム、マグネシウム、リン、ビタミンB2、ナイアシン、葉酸、パントテン酸、ビタミンB12、飽和脂肪酸及びコレステロールについて、飲酒量により摂取量に有意な差が認められた。穀類、豆類、野菜類、果実類、菓子類及び嗜好飲料類について、飲酒量により摂取量に有意な差が認められた。【結論】多量飲酒日にはアルコールの摂取により総エネルギー摂取量が高値を示したが、それとは逆に主として穀類から由来する炭水化物の摂取量は低値を示した。循環器疾患をはじめとした生活習慣病予防において、過度の飲酒を控えることは、アルコールそのものによる影響だけでなく、食事によるエネルギー産生栄養素バランスを整える上でも重要であることが示唆された。(著者抄録)

The association of home and accurately measured office blood pressure with coronary artery calcification among general Japanese men

Satoh A., Arima H., Hozawa A., Ohkubo T., Hisamatsu T., Kadowaki S., Kadota A., Fujiyoshi A., Miyagawa N., Zaid M., Torii S., Okamura T., Sekikawa A., Miura K., Ueshima H.

Journal of Hypertension （Journal of Hypertension） 37 （ 8 ） 1676 - 1681 2019年08月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 02636352

Objective:We conducted a cross-sectional study to clarify whether home blood pressure (HBP) is more strongly associated with coronary artery calcification (CAC) than accurately measured office blood pressure (OBP) among the general population of Japanese men.Methods:We analyzed the data of 919 Japanese male participants who were randomly selected from general population (mean age 64.5 years). OBP was measured twice consecutively by a trained nurse using electrical device after 5 min of complete rest alone in a sitting position in a silent room. The participants were asked to measure HBP with an electrical device once in the morning during 7 consecutive days. CAC was assessed using computed tomography. Presence of CAC was defined as Agatston score at least 10. We calculated odds ratios for the presence of CAC per one SD higher OBP and HBP adjusted for age and other cardiovascular risk factors.Results:The mean systolic OBP (SD) and HBP (SD) were 136.8 (19.0) and 137.2 (18.5) mmHg, respectively, without statistical difference between the two (P = 0.595). OBP and HBP were highly correlated (r = 0.74 P < 0.001). CAC was found in 454 (49.4%) participants. Multivariable-adjusted odds ratios [95% confidence interval (CI)] for the presence of CAC were comparable between OBP (1.32, 95% CI: 1.12-1.56) and HBP (1.35, 95% CI: 1.14-1.60) (P heterogeneity = 0.813).Conclusion:The strength of association of accurately measured OBP with CAC was comparable with that of HBP among randomly selected male general population aged 40-79 years.

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The impact of sex on risk of cardiovascular disease and all-cause mortality in adults with or without diabetes mellitus: A comparison between the U.S. and Japan

Liu L., Miura K., Kadota A., Fujiyoshi A., Gracely E.J., Xue F., Liu Z., Takashima N., Miyagawa N., Ohkubo T., Arima H., Okayama A., Okamura T., Ueshima H.

Journal of Diabetes and its Complications （Journal of Diabetes and its Complications） 33 （ 6 ） 417 - 423 2019年06月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 10568727

Aims: To test a hypothesis that women with diabetes mellitus (DM)versus those without DM had a significantly higher risk of heart disease (HD), stroke and all-cause mortality than their male counterparts in the U.S. as well as in Japan. Methods: We analyzed two nationally representative datasets, one from the U.S. NHANES III cohort (n = 13,169), and the other from the Japan NIPPON DATA90 cohort (n = 7445). Hazard ratios (HRs)of DM for risk of mortality and sex-DM interaction effect on mortality were analyzed prospectively using Cox's proportional hazards regression models. Results: Patients with DM had significantly higher mortality from HD, stroke and all-cause mortality in the U.S. and in Japan. However, the HRs of DM versus non-DM for HD and all-cause mortality were significantly higher in women compared to men in the U.S. (sex-DM interaction: HR = 1.59, p = 0.01, and 1.24, p = 0.045 for HD and all-cause mortality), but the sex-DM interaction effect was not statistically significant in the Japanese cohort. Discussion: Patients with DM had a significantly higher risk of mortality than those without DM in the U.S. and Japan. However, women with DM versus those without DM had a higher relative risk of HD and all-cause mortality than their counterparts in men in the U.S, but this sex difference by DM status was not observed in the Japanese cohort. Whether the sex-difference effect of DM on HD and all-cause mortality is due to a difference in metabolic disorders between the two populations warrants consideration and further studies.

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Association of alcohol consumption with fat deposition in a community-based sample of Japanese men: The Shiga epidemiological study of subclinical atherosclerosis (SESSA)

Sumi M., Hisamatsu T., Fujiyoshi A., Kadota A., Miyagawa N., Kondo K., Kadowaki S., Suzuki S., Torii S., Zaid M., Sato A., Arima H., Terada T., Miura K., Ueshima H., Horie M., Nakano Y., Yamamoto T., Hayashi H., Ogawa E., Maegawa H., Miyazawa I., Murata K., Mitsunami K., Nozaki K., Tooyama I., Shiino A., Tsuru T., Ogita H., Shimizu A., Miyamatsu N., Kita T., Kimura T., Nishio Y., Nakamura Y., Okamura T., Sekikawa A., Barinas-Mitchell E.J., Edmundowicz D., Ohkubo T., Hozawa A., Miyagi S., Murakami Y., Okuda N., Kita Y., Higashiyama A., Nagasawa S., Azuma K., Yanagita M., Abbott R.D., Ohno S., Takashima N., Kadowaki T., Saito Y., Ito T., Satoh A., Yamazoe M.

Journal of Epidemiology （Journal of Epidemiology） 29 （ 6 ） 205 - 212 2019年06月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 09175040

Background: Excessive alcohol intake has been shown to be associated with cardiovascular disease via metabolic pathways. However, the relationship between alcohol intake and obesity has not been fully elucidated. We aimed to examine the association of alcohol consumption with fat deposition and anthropometric measures. Methods: From 2006–2008, we conducted a cross-sectional study in a population-based sample of Japanese men aged 40 through 79 years. Areas of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated using computed tomography imaging. Based on a questionnaire, we classified participants into five groups according to weekly alcohol consumption, excluding former drinkers: Non-drinkers (0 g=week), 0.1–160.9, 161–321.9, 322–482.9, and ≥483 g=week. Multivariable linear regression was used to estimate adjusted means of obesity indices for each group. Results: We analyzed 998 men (mean age and body mass index [BMI], 63.8 years and 23.6 kg=m2, respectively). Higher weekly alcohol consumption was strongly and significantly associated with higher abdominal VAT area, percentage of VAT, and VATto- SAT ratio (all P for trend <0.001), and also with waist circumferences and waist-to-hip ratio (P for trend = 0.042 and 0.007, respectively). These associations remained significant after further adjustment for BMI, whereas alcohol consumption had no significant association with abdominal SAT area. Conclusions: Higher alcohol consumption was associated with higher VAT area, VAT%, and VAT-to-SAT ratio, independent of confounders, including BMI, in general Japanese men. These results suggest that alcohol consumption may have a potential adverse effect on visceral fat deposition.

Socioeconomic and lifestyle factors associated with depressive tendencies in general Japanese men and women: NIPPON DATA2010

Suzuki H., Kadota A., Okuda N., Hayakawa T., Nishi N., Nakamura Y., Arima H., Miyagawa N., Satoh A., Miyamatsu N., Yanagita M., Yatsuya H., Yamagata Z., Ohkubo T., Okamura T., Ueshima H., Okayama A., Miura K.

Environmental Health and Preventive Medicine （Environmental Health and Preventive Medicine） 24 （ 1 ） 37 - 37 2019年05月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1342078X

Background: The gender-specific characteristics of individuals at an increased risk of developing depression currently remain unclear despite a higher prevalence of depression in women than in men. This study clarified socioeconomic and lifestyle factors associated with an increased risk of subclinical depression in general Japanese men and women. Methods: Study participants were residents not receiving psychiatric treatments in 300 sites throughout Japan in 2010 (1152 men, 1529 women). Multivariable-adjusted odds ratios (OR) and 95% confidence intervals (95%CIs) for socioeconomic factors and lifestyle factors were calculated using a logistic regression analysis. Results: Risk of depressive tendencies was significantly higher in men who were single and living alone (OR, 3.27; 95% CI, 1.56-6.88) than those married. The risk was significantly lower in women who were not working and aged ≥ 60 years (OR, 0.39; 95% CI, 0.22-0.68) and higher in men who were not working and aged < 60 years (OR, 3.57; 95%CI, 1.31-9.72) compared with those who were working. Current smoking was also associated with a significantly increased risk of depressive tendencies in women (OR, 2.96; 95% CI, 1.68-5.22) but not in men. Conclusions: Socioeconomic and lifestyle factors were associated with an increased risk of depressive tendencies in general Japanese. Related factors were different by sex.

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Association of blood levels of marine omega-3 fatty acids with coronary calcification and calcium density in Japanese men

Sekikawa A., Mahajan H., Kadowaki S., Hisamatsu T., Miyagawa N., Fujiyoshi A., Kadota A., Maegawa H., Murata K., Miura K., Edmundowicz D., Ueshima H.

European Journal of Clinical Nutrition （European Journal of Clinical Nutrition） 73 （ 5 ） 783 - 792 2019年05月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 09543007

Background/objectives:: Clinical trials of eicosapentaenoic acid (EPA) among high-risk groups in Japan in which consumption of mairne-omega-3 fatty acids (OM3) is much higher than other countries showed slower progression of coronary atherosclerosis. We aimed to determine the cross-sectional associations of coronary artery calcification (CAC) and calcium density with OM3, EPA, and docosahexaenoic acid (DHA), two principal OM3, in the general population in Japan. Subjects/methods:: The Shiga Epidemiological Study of Subclinical Atherosclerosis examined a population-based sample of 1074 men aged 40–79 in 2006–08 for computed tomography-measured CAC score (CCS), a well-established biomarker of coronary atherosclerosis, CAC density score (CDS), a potential marker of plaque stabilization, serum levels of OM3, and risk factors. Results:: Prevalence of CCS > 0, ≥ 100, and ≥ 300 was 65.8%, 25.9%, and 12.9%, respectively; the mean (SD) OM3, EPA, and DHA were 10.1% (3.2), 3.2% (1.7), and 5.9% (1.6), respectively. Odds ratios (95% CI, p-value) of CCS 0, 100, and 300 in ordinal logistic regression associated with 1 SD increase of OM3, EPA, and DHA were 0.91 (0.81–1.03, p = 0.12), 0.99 (0.88–1.11, p = 0.87) and 0.84 (0.74–0.94, p = < 0.01), respectively. The inverse association of DHA with CCS remained significant in multivariate-adjusted model: odds ratio of 0.87 (0.77–0.99, p = 0.03). Blood levels of OM3, EPA, or DHA did not have any significant associations with CDS. Conclusions:: DHA but not EPA had a significant inverse association with coronary atherosclerosis in the general population with high levels of OM3. Future trials are warranted comparing the effect of high-dose DHA and EPA on atherosclerosis and cardiovascular outcomes.

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Associations of nutrient patterns with the prevalence of metabolic syndrome: Results from the baseline data of the Japan multi-institutional collaborative cohort study

Iwasaki Y., Arisawa K., Katsuura-Kamano S., Uemura H., Tsukamoto M., Kadomatsu Y., Okada R., Hishida A., Tanaka K., Hara M., Takezaki T., Shimatani K., Ozaki E., Koyama T., Suzuki S., Nakagawa-Senda H., Kuriki K., Miyagawa N., Kadota A., Ikezaki H., Furusyo N., Oze I., Ito H., Mikami H., Nakamura Y., Wakai K.

Nutrients （Nutrients） 11 （ 5 ） 990 - 990 2019年05月

研究論文（学術雑誌）, 共著, 査読有り

The association between nutrient patterns and metabolic syndrome (MetS) has not been examined in a Japanese population. A cross-sectional study was performed on 30,108 participants (aged 35-69 years) in the baseline survey of the Japan Multi-Institutional Collaborative Cohort Study. Dietary intake was assessed using a 46-item food frequency questionnaire. MetS was diagnosed according to the Joint Interim Statement Criteria of 2009, using body mass index instead of waist circumference. Factor analysis was applied to energy-adjusted intake of 21 nutrients, and three nutrient patterns were extracted: Factor 1 (fiber, potassium and vitamins pattern); Factor 2 (fats and fat-soluble vitamins pattern); and Factor 3 (saturated fatty acids, calcium and vitamin B2 pattern). In multiple logistic regression analysis adjusted for sex, age, and other potential confounders, Factor 1 scores were associated with a significantly reduced odds ratio (OR) of MetS and all five components. Factor 2 scores were associated with significantly increased prevalence of MetS, obesity, and high blood pressure. Factor 3 scores were significantly associated with lower OR of MetS, high blood pressure, high serum triglycerides and low HDL cholesterol levels. Analysis of nutrient patterns may be useful to assess the overall quality of diet and its association with MetS.

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Factors associated with intra-individual visit-to-visit variability of blood pressure in four countries: the INTERMAP study

Takashima N., Ohkubo T., Miura K., Okayama A., Okuda N., Nakagawa H., Saito S., Sakata K., Choudhury S.R., Miyagawa N., Chan Q., Zhao L., Elliott P., Ueshima H., Stamler J.

Journal of Human Hypertension （Journal of Human Hypertension） 33 （ 3 ） 229 - 236 2019年03月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 09509240

Several studies demonstrated that visit-to-visit variability of blood pressure (BP) predicted future events of total death, stroke and cardiovascular disease. Little is known about factors associated with visit-to-visit BP variability in different countries. We recruited participants aged 40–59 years from four countries (Japan, the People’s Republic of China [PRC], the United Kingdom [UK] and the United States [US]). At each study visit, BP was measured twice by trained observers using random zero sphygmomanometers after five minutes resting. We defined visit-to-visit BP variability as variation independent of mean (VIM) by using average systolic BP of 1st and 2nd measurement across four study visits. Data on 4680 men and women were analyzed. Mean ± standard deviation of VIM values among participants in Japan, the PRC, the UK and the US were 5.44 ± 2.88, 6.85 ± 3.49, 5.65 ± 2.81 and 5.84 ± 3.01, respectively; VIM value in the PRC participants was significantly higher. Sensitivity analyses among participants without antihypertensive treatment or past history of cardiovascular disease yielded similar results. Higher VIM value was associated with older age, female gender, lower pulse rate and urinary sodium excretion and use of antihypertensive agents such as angiotensin converting enzyme inhibitors, beta blockers and calcium channel blockers. The difference of visit-to-visit BP variability between PRC and other countries remained significant after adjustment for possible confounding factors. In this large international study across four countries, visit-to-visit BP variability in the PRC was higher than in the other three countries. Reproducibility and mechanisms of these findings remain to be elucidated.

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