Details of a Researcher - Okamura, Tomonori

Papers - Okamura, Tomonori

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Association Between Glycemic Control and Incident Stroke　- Overview From an Epidemiologic Study.

Hirata T, Okamura T

Circulation journal : official journal of the Japanese Circulation Society 82 ( 6 ) 1499 - 1500 2018.05

ISSN 1346-9843

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Overweight or underweight and the risk of decline in activities of daily living in a 22-year cohort study of a Japanese sample

Okamoto Shohei, Okamura Tomonori, Sugiyama Daisuke, Hayakawa Takehito, Nakamura Yasuyuki, Miyagawa Naoko, Kurita Shuji, Takashima Naoyuki, Ohkubo Takayoshi, Kadota Aya, Fujiyoshi Akira, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu

Geriatrics and Gerontology International (Geriatrics and Gerontology International) 18 ( 5 ) 799 - 805 2018.05

Research paper (scientific journal), ISSN 1444-1586

Aim: The present study aimed to clarify the association between body mass index (BMI) and the activities of daily living (ADL). Although BMI is likely to be concerned regarding the relationship with specific diseases or mortality, few studies have focused on the relationship of BMI and ADL. Methods: A total of 3353 Japanese participants of a 22-year cohort study from 1990 to 2012 aged 45–74 years at baseline were divided into four groups according to their BMI levels: ≤18.5, 18.5–21.9 (reference), 22.0–24.9 and ≥25.0 kg/m². Outcomes were becoming dependent in ADL (including death after ADL decline) and death without observation of ADL decline as a competing risk. Sex-specific multinomial logistic regression analysis was carried out in 2017 to estimate the odds ratios (OR) after adjusting for age, smoking, alcohol drinking, hypertension, hypercholesterolemia, diabetes and serum albumin. Results: After multivariable adjustment, though the relationship between BMI and risk of ADL decline was U-shaped among women, only those with BMI ≥25.0 showed a higher risk for ADL decline (OR 1.39, 95% CI 1.01–1.92) compared with the reference. The OR for death without observation of ADL decline was significantly lower for men with BMI ≥25.0 (OR 0.70, 95% CI 0.50–0.98). Conclusions: This study suggests being overweight is a good predictor of future decline in ADL for women, whereas men with BMI 22.0–24.9 had lower risks of ADL decline. Appropriate management of weight in older women could prevent disabilities. Geriatr Gerontol Int 2018; 18: 799–805.

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International Comparison of Abdominal Fat Distribution among Four Populations

Kadowaki Sayaka, Miura Katsuyuki, Kadowaki Takashi, Fujiyoshi Akira, El-Saed Aiman, Masaki Kamal H., Okamura Tomonori, Edmundowicz Daniel, Rodriguez Beatriz L., Nakamura Yasuyuki, Barinas-Mitchell Emma J.M., Kadota Aya, Willcox Bradley J., Abbott Robert D., Kuller Lewis H., Choo Jina, Shin Chol, Ueshima Hirotsugu, Sekikawa Akira

Metabolic Syndrome and Related Disorders 16 ( 4 ) 166 - 173 2018.05

ISSN 1540-4196

Background: Abdominal fat distribution varies across groups with different races or environments. Whether environmental factors, apart from racial differences, affect abdominal fat distribution is unknown. Methods: We compared the abdominal fat distribution of four groups; different races with similar environments (Caucasians vs. Japanese Americans), different environments with an identical race (Japanese Americans vs. Japanese), and similar races with similar environments (Japanese vs. Koreans). A population-based sample of 1212 men aged 40-49 were analyzed: 307 Caucasians and 300 Japanese Americans in the United States, 310 Japanese in Japan, and 295 Koreans in Korea. We compared the proportion of visceral adipose tissue area to total abdominal adipose tissue area (VAT%) and other factors that can affect abdominal fat distribution (smoking, alcohol use, physical activity levels, and metabolic factors). Results: VAT% was significantly higher in Japanese and Koreans than in Japanese Americans and Caucasians (50.0, 48.5, 43.2, 41.0%, respectively, P < 0.001). Even after adjustment for possible confounders, the significant VAT% difference remained in comparing groups with identical race but different environments (i.e., Japanese vs. Japanese Americans). In contrast, comparing groups with different races but similar environments (i.e., Caucasians vs. Japanese Americans), VAT% was not significantly different. Comparing groups with similar races and similar environments (i.e., Japanese vs. Koreans), VAT% did not significantly differ. Conclusions: Environmental differences, apart from racial differences, affect the difference in abdominal fat distribution across different groups in middle-aged men.

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Association of extremely high levels of high-density lipoprotein cholesterol with cardiovascular mortality in a pooled analysis of 9 cohort studies including 43,407 individuals: The EPOCH–JAPAN study

Hirata A., Sugiyama D., Watanabe M., Tamakoshi A., Iso H., Kotani K., Kiyama M., Yamada M., Ishikawa S., Murakami Y., Miura K., Ueshima H., Okamura T., Okamura T., Imai Y., Ohkubo T., Irie F., Iso H., Kitamura A., Ninomiya T., Kiyohara Y., Miura K., Murakami Y., Nakagawa H., Nakayama T., Okayama A., Sairenchi T., Saitoh S., Sakata K., Tamakoshi A., Tsuji I., Yamada M., Miyamoto Y., Ishikawa S., Yatsuya H.

Journal of Clinical Lipidology (Journal of Clinical Lipidology) 12 ( 3 ) 674 - 684.e5 2018.05

Research paper (scientific journal), ISSN 19332874

© 2018 National Lipid Association Background: The effect of very high or extremely high levels of high-density lipoprotein cholesterol (HDL-C) on cardiovascular disease (CVD) is not well described. Although a few recent studies have reported the adverse effects of extremely high levels of HDL-C on CVD events, these did not show a statistically significant association between extremely high levels of HDL-C and cause-specific CVD mortality. In addition, Asian populations have not been studied. Objective: We examine the impact of extremely high levels of HDL-C on cause-specific CVD mortality using pooled data of Japanese cohort studies. Methods: We performed a large-scale pooled analysis of 9 Japanese cohorts including 43,407 participants aged 40–89 years, dividing the participants into 5 groups by HDL-C levels, including extremely high levels of HDL-C ≥2.33 mmol/L (≥90 mg/dL). We estimated the adjusted hazard ratio of each HDL-C category for all-cause death and cause-specific deaths compared with HDL-C 1.04–1.55 mmol/L (40–59 mg/dL) using a cohort-stratified Cox proportional hazards model. Results: During a 12.1-year follow-up, 4995 all-cause deaths and 1280 deaths due to overall CVD were identified. Extremely high levels of HDL-C were significantly associated with increased risk of atherosclerotic CVD mortality (hazard ratio = 2.37, 95% confidence interval: 1.37–4.09 for total) and increased risk for coronary heart disease and ischemic stroke. In addition, the risk for extremely high HDL-C was more evident among current drinkers. Conclusion: We showed extremely high levels of HDL-C had an adverse effect on atherosclerotic CVD mortality in a pooled analysis of Japanese cohorts.

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International Comparison of Abdominal Fat Distribution among Four Populations: The ERA-JUMP Study

Kadowaki S., Miura K., Kadowaki T., Fujiyoshi A., El-Saed A., Masaki K., Okamura T., Edmundowicz D., Rodriguez B., Nakamura Y., Barinas-Mitchell E., Kadota A., Willcox B., Abbott R., Kuller L., Choo J., Shin C., Ueshima H., Sekikawa A.

Metabolic Syndrome and Related Disorders (Metabolic Syndrome and Related Disorders) 16 ( 4 ) 166 - 173 2018.05

Research paper (scientific journal), ISSN 15404196

© 2018, Mary Ann Liebert, Inc. Background: Abdominal fat distribution varies across groups with different races or environments. Whether environmental factors, apart from racial differences, affect abdominal fat distribution is unknown. Methods: We compared the abdominal fat distribution of four groups; different races with similar environments (Caucasians vs. Japanese Americans), different environments with an identical race (Japanese Americans vs. Japanese), and similar races with similar environments (Japanese vs. Koreans). A population-based sample of 1212 men aged 40-49 were analyzed: 307 Caucasians and 300 Japanese Americans in the United States, 310 Japanese in Japan, and 295 Koreans in Korea. We compared the proportion of visceral adipose tissue area to total abdominal adipose tissue area (VAT%) and other factors that can affect abdominal fat distribution (smoking, alcohol use, physical activity levels, and metabolic factors). Results: VAT% was significantly higher in Japanese and Koreans than in Japanese Americans and Caucasians (50.0, 48.5, 43.2, 41.0%, respectively, P < 0.001). Even after adjustment for possible confounders, the significant VAT% difference remained in comparing groups with identical race but different environments (i.e., Japanese vs. Japanese Americans). In contrast, comparing groups with different races but similar environments (i.e., Caucasians vs. Japanese Americans), VAT% was not significantly different. Comparing groups with similar races and similar environments (i.e., Japanese vs. Koreans), VAT% did not significantly differ. Conclusions: Environmental differences, apart from racial differences, affect the difference in abdominal fat distribution across different groups in middle-aged men.

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Data on alcohol consumption and coronary artery calcification among asymptomatic middle-aged men for the ERA-JUMP study

Mahajan Hemant, Choo Jina, Masaki Kamal, Fujiyoshi Akira, Guo Jingchuan, Hisamatsu Takashi, Evans Rhobert, Shangguan Siyi, Willcox Bradley, Okamura Tomonori, Vishnu Abhishek, Barinas-Mitchell Emma, Ahuja Vasudha, Miura Katsuyuki, Kuller Lewis, Shin Chol, Ueshima Hirotsugu, Sekikawa Akira

Data in Brief (Data in Brief) 17 1091 - 1098 2018.04

Research paper (scientific journal), ISSN 2352-3409

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Heterogeneity of Absolute/Relative Measures of Cardiovascular Mortality Among Cohorts in an Individual Participant Data Meta-Analysis: An EPOCH-JAPAN Study

Murakami Yoshitaka, Okamura Tomonori, Miura Katsuyuki, Ueshima Hirotsugu

CIRCULATION 137 2018.03

Research paper (scientific journal), ISSN 0009-7322

Trajectories of Stroke Risk Factors Before Stroke Onset With a 24-year Follow-up of Japanese People Living in an Urban Area: The Suita Study

Ogata Soshiro, Nakamura Fumiaki, Nishimura Kunihiro, Watanabe Makoto, Kokubo Yoshihiro, Higashiyama Aya, Takegami Misa, Nakao Yoko M., Nakai Michikazu, Okamura Tomonori, Miyamoto Yoshihiro

CIRCULATION 137 2018.03

Research paper (scientific journal), ISSN 0009-7322

Left Atrial Dilatation Predicts The Incidence Of Persistent Atrial Fibrillation In Japanese General Population; The Suita Study

Higashiyama Aya, Watanabe Makoto, Kokubo Yoshihiro, Okamura Tomonori, Okayama Akira, Miyamoto Yoshihiro

CIRCULATION 137 2018.03

Research paper (scientific journal), ISSN 0009-7322

Cardiovascular risk and blood pressure lowering treatment among elderly individuals

Asayama Kei, Ohkubo Takayoshi, Satoh Atsushi, Tanaka Sachiko, Higashiyama Aya, Murakami Yoshitaka, Yamada Michiko, Saitoh Shigeyuki, Okayama Akira, Miura Katsuyuki, Ueshima Hirotsugu, Miyamoto Yoshihiro, Okamura Tomonori

Journal of Hypertension 36 ( 2 ) 410 - 418 2018.02

ISSN 0263-6352

Objective: There is little evidence to support an increased risk of blood pressure (BP) elevation among elderly individuals receiving antihypertensive drug treatment. Methods: To clarify the impact on BP level and residual cardiovascular risk in treated elderly individuals, we analysed individual participant data of 26 133 residents aged 60-89 years from seven Japanese general populations and cross-classified participants by age category, 60-74 (young-old) versus 75-89 years (old-old), and by usage of antihypertensive medication at baseline survey (1980-1995). Results: During a median follow-up period of 12.7 years, 2451 cardiovascular deaths were observed. Multivariable-Adjusted hazard ratios of cardiovascular mortality in treated participants compared with untreated participants were 1.30 [95% confidence intervals, 1.16-1.46) and 1.35 (95% confidence interval, 1.16-1.56) in young-old and old-old participants, respectively. Irrespective of antihypertensive medication, the risk increase of total cardiovascular and stroke mortality with elevation of BP was significant among young-old (P ≤ 0.0013), but not significant among old-old participants (P ≥ 0.061). Conclusion: Although impact on BP was more evident among young-old than old-old individuals, clinicians who prescribe antihypertensive medication to elderly patients should consider that such patients require further monitoring.

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Cardiovascular risk and blood pressure lowering treatment among elderly individuals: Evidence for Cardiovascular Prevention from Observational Cohorts in Japan

Asayama K., Ohkubo T., Satoh A., Tanaka S., Higashiyama A., Murakami Y., Yamada M., Saitoh S., Okayama A., Miura K., Ueshima H., Miyamoto Y., Okamura T.

Journal of Hypertension (Journal of Hypertension) 36 ( 2 ) 410 - 418 2018.02

Research paper (scientific journal), ISSN 02636352

© 2018 Wolters Kluwer Health, Inc. All rights reserved. Objective: There is little evidence to support an increased risk of blood pressure (BP) elevation among elderly individuals receiving antihypertensive drug treatment. Methods: To clarify the impact on BP level and residual cardiovascular risk in treated elderly individuals, we analysed individual participant data of 26 133 residents aged 60-89 years from seven Japanese general populations and cross-classified participants by age category, 60-74 (young-old) versus 75-89 years (old-old), and by usage of antihypertensive medication at baseline survey (1980-1995). Results: During a median follow-up period of 12.7 years, 2451 cardiovascular deaths were observed. Multivariable-Adjusted hazard ratios of cardiovascular mortality in treated participants compared with untreated participants were 1.30 [95% confidence intervals, 1.16-1.46) and 1.35 (95% confidence interval, 1.16-1.56) in young-old and old-old participants, respectively. Irrespective of antihypertensive medication, the risk increase of total cardiovascular and stroke mortality with elevation of BP was significant among young-old (P ≤ 0.0013), but not significant among old-old participants (P ≥ 0.061). Conclusion: Although impact on BP was more evident among young-old than old-old individuals, clinicians who prescribe antihypertensive medication to elderly patients should consider that such patients require further monitoring.

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Association of extremely high levels of high-density lipoprotein cholesterol with cardiovascular mortality in a pooled analysis of 9 cohort studies including 43,407 individuals

Hirata Aya, Sugiyama Daisuke, Watanabe Makoto, Tamakoshi Akiko, Iso Hiroyasu, Kotani Kazuhiko, Kiyama Masahiko, Yamada Michiko, Ishikawa Shizukiyo, Murakami Yoshitaka, Miura Katsuyuki, Ueshima Hirotsugu, Okamura Tomonori

Journal of Clinical Lipidology 2018.01

ISSN 1933-2874

Background: The effect of very high or extremely high levels of high-density lipoprotein cholesterol (HDL-C) on cardiovascular disease (CVD) is not well described. Although a few recent studies have reported the adverse effects of extremely high levels of HDL-C on CVD events, these did not show a statistically significant association between extremely high levels of HDL-C and cause-specific CVD mortality. In addition, Asian populations have not been studied. Objective: We examine the impact of extremely high levels of HDL-C on cause-specific CVD mortality using pooled data of Japanese cohort studies. Methods: We performed a large-scale pooled analysis of 9 Japanese cohorts including 43,407 participants aged 40-89 years, dividing the participants into 5 groups by HDL-C levels, including extremely high levels of HDL-C ≥2.33 mmol/L (≥90 mg/dL). We estimated the adjusted hazard ratio of each HDL-C category for all-cause death and cause-specific deaths compared with HDL-C 1.04-1.55 mmol/L (40-59 mg/dL) using a cohort-stratified Cox proportional hazards model. Results: During a 12.1-year follow-up, 4995 all-cause deaths and 1280 deaths due to overall CVD were identified. Extremely high levels of HDL-C were significantly associated with increased risk of atherosclerotic CVD mortality (hazard ratio = 2.37, 95% confidence interval: 1.37-4.09 for total) and increased risk for coronary heart disease and ischemic stroke. In addition, the risk for extremely high HDL-C was more evident among current drinkers. Conclusion: We showed extremely high levels of HDL-C had an adverse effect on atherosclerotic CVD mortality in a pooled analysis of Japanese cohorts.

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Association between glycemic control and incident stroke ― Overview from an epidemiologic study

Hirata Takumi, Okamura Tomonori

Circulation Journal 82 ( 6 ) 1499 - 1500 2018.01

ISSN 1346-9843

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Association between impairment of salty taste recognition and masked hypertension based on home blood pressure in Japanese residents

Kubota Yoshimi, Higashiyama Aya, Sugiyama Daisuke, Nishida Yoko, Kubo Sachimi, Hirata Takumi, Kadota Aya, Miyamatsu Naomi, Wakabayashi Ichiro, Miyamoto Yoshihiro, Okamura Tomonori

Hypertension Research 2018.01

ISSN 0916-9636

Excessive salt intake is an established risk factor for hypertension. We conducted a cross-sectional study to examine the association between salty taste recognition and estimated salt intake and masked hypertension in a healthy Japanese normotensive population. The participants were 892 apparently healthy community residents (246 men and 646 women) aged between 40 and 74 years with blood pressure below 140/90 mm Hg. Salty taste recognition was assessed using a salt-impregnated taste strip. Daily salt intake was calculated as estimated 24 h urinary sodium excretion using spot urine tests. Each participant performed home blood pressure measurements for a minimum of 5 days per week. The participants were classified into three groups according to their salty taste recognition threshold evaluated by the salt concentrations of the taste strips (0.6%, 0.8%, and ≥ 1.0%). In women, the multivariate odds ratio (95% confidence interval) for masked hypertension (≥ 135/85 mm Hg) was 2.98 (1.16–7.64) in the ≥ 1.0% group compared with that in the 0.6% group. In men, the proportion of masked hypertension in the ≥ 1.0% group did not differ from that in the 0.6% group, and no correlation was identified between estimated daily salt intake and the salty taste recognition threshold. In conclusion, impairment of salty taste recognition was associated with masked hypertension in women even with normal blood pressure in the clinical setting.

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Association of alcohol consumption and aortic calcification in healthy men aged 40–49 years for the ERA JUMP Study

Atherosclerosis (Atherosclerosis) 268 84 - 91 2018.01

Research paper (scientific journal), ISSN 0021-9150

Background and aims Several studies have reported a significant inverse association of light to moderate alcohol consumption with coronary heart disease (CHD). However, studies assessing the relationship between alcohol consumption and atherosclerosis have reported inconsistent results. The current study was conducted to determine the relationship between alcohol consumption and aortic calcification. Methods We addressed the research question using data from the population-based ERA-JUMP Study, comprising of 1006 healthy men aged 40–49 years, without clinical cardiovascular diseases, from four race/ethnicities: 301 Whites, 103 African American, 292 Japanese American, and 310 Japanese in Japan. Aortic calcification was assessed by electron-beam computed tomography and quantified using the Agatston method. Alcohol consumption was categorized into four groups: 0 (non-drinkers), ≤1 (light drinkers), >1 to ≤3 (moderate drinkers) and >3 drinks per day (heavy drinkers) (1 drink = 12.5 g of ethanol). Tobit conditional regression and ordinal logistic regression were used to investigate the association of alcohol consumption with aortic calcification after adjusting for cardiovascular risk factors and potential confounders. Results The study participants consisted of 25.6% nondrinkers, 35.3% light drinkers, 23.5% moderate drinkers, and 15.6% heavy drinkers. Heavy drinkers [Tobit ratio (95% CI) = 2.34 (1.10, 4.97); odds ratio (95% CI) = 1.67 (1.11, 2.52)] had significantly higher expected aortic calcification score compared to nondrinkers, after adjusting for socio-demographic and confounding variables. There was no significant interaction between alcohol consumption and race/ethnicity on aortic calcification. Conclusions Our findings suggest that heavy alcohol consumption may be an independent risk factor for atherosclerosis.

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Corrigendum to “Lipoprotein-associated phospholipase A2 is related to risk of subclinical atherosclerosis but is not supported by Mendelian randomization analysis in a general Japanese population.” [Atherosclerosis 246 (March 2016) 141–147]

Ueshima Hirotsugu, Kadowaki Takashi, Hisamatsu Takashi, Fujiyoshi Akira, Miura Katsuyuki, Ohkubo Takayoshi, Sekikawa Akira, Kadota Aya, Kadowaki Sayaka, Nakamura Yasuyuki, Miyagawa Naoko, Okamura Tomonori, Kita Yoshikuni, Takashima Naoyuki, Kashiwagi Atsunori, Maegawa Hiroshi, Horie Minoru, Yamamoto Takashi, Kimura Takeshi, Kita Toru

Atherosclerosis 2018.01

ISSN 0021-9150

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Differences in Lifestyle Improvements With the Intention to Prevent Cardiovascular Diseases by Socioeconomic Status in a Representative Japanese Population

Goryoda Sayuri, Nishi Nobuo, Hozawa Atsushi, Yoshita Katsushi, Arai Yusuke, Kondo Keiko, Miyagawa Naoko, Hayakawa Takehito, Fujiyoshi Akira, Kadota Aya, Ohkubo Takayoshi, Okamura Tomonori, Okuda Nagako, Ueshima Hirotsugu, Okayama Akira, Miura Katsuyuki

Journal of Epidemiology 28 S35 - S39 2018.01

ISSN 0917-5040

BACKGROUND: The relationships among socioeconomic status and lifestyle improvements have not yet been examined in a representative Japanese population.METHODS: We analyzed data from 2,647 participants (1,087 men and 1,560 women) who participated in NIPPON DATA2010. This survey inquired about lifestyle improvements and socioeconomic status. Education was categorized as low (≤9 years), middle (10-12 years), and high (≥13 years). Marital status was categorized as married, divorced, widowed, and never married/other. A multivariable logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of lifestyle improvements with the intention of preventing cardiovascular diseases for educational attainment and marital status, with adjustments for age and awareness of cardiovascular disease risk factors.RESULTS: Overall, 1,507 (56.9%) participants practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome, and the OR of lifestyle improvements was significantly higher with a high education than with a low education in men (OR 2.86; 95% CI, 1.96-4.17) and women (OR 2.36; 95% CI, 1.67-3.33). The number of participants who practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome was significantly lower in divorced than in married men (OR 0.46; 95% CI, 0.22-0.95) and women (OR 0.53; 95% CI, 0.33-0.86).CONCLUSIONS: Specific differences caused by educational attainment and marital status may exist in lifestyle improvements.

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Factors Related to Participation in Health Examinations for Japanese National Health Insurance

Imamura Haruhiko, Kogure Mana, Kita Yoshikuni, Nakagawa Hideaki, Hozawa Atsushi, Okamura Tomonori, Murakami Yoshitaka, Nishi Nobuo, Okuda Nagako, Kadota Aya, Ohkubo Takayoshi, Ueshima Hirotsugu, Okayama Akira, Miura Katsuyuki

Journal of Epidemiology 28 S53 - S58 2018.01

ISSN 0917-5040

BACKGROUND: This study investigated relationships among socioeconomic factors and participation in health examinations for Japanese National Health Insurance (NHI) using a representative Japanese population.METHODS: We used the linkage database of NIPPON DATA2010 and Comprehensive Survey of Living Conditions 2010. Participants with NHI aged 40-74 years were included in the analysis. Prevalence ratios (PRs) for participation in health examinations in the past year were set as an outcome. Participant characteristics, including sex, age, socioeconomic factors (educational attainment, employment, equivalent household expenditure [EHE], house ownership, and marital status), laboratory measures, and lifestyle were included in an age-stratified modified Poisson regression analysis to examine relationships.RESULTS: The number of study participants was 812, and 564 (69.5%) participated in health examinations in the past year. Among those aged 40-64 years, there was no significant PR for socioeconomic factors. Among those aged 65-74 years, high (≥13 years) educational attainment (adjusted PR, 1.22; 95% confidence interval [CI], 1.05-1.41) and house ownership (PR 1.40; 95% CI, 1.11-1.77) were positively associated with participation, while high (4th quartile) EHE (PR 0.84; 95% CI, 0.73-0.97) was negatively associated.CONCLUSION: These results suggest that high educational attainment, house ownership, and low EHE were positive factors for participation in health examinations among those aged 65-74 years.

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Fatty liver index predicts incident diabetes in a Japanese general population with and without impaired fasting glucose

Hirata Aya, Sugiyama Daisuke, Kuwabara Kazuyo, Hirata Takumi, Tsutatani Hiromi, Funamoto Mika, Watanabe Kouiti, Miyamatsu Naomi, Okamura Tomonori

Hepatology Research (Hepatology Research) 48 ( 9 ) 708 - 716 2018.01

Research paper (scientific journal), ISSN 1386-6346

Aim: Fatty liver is associated with the development of diabetes. However, to our knowledge, no study has examined the relationship between the fatty liver index (FLI), calculated scores of hepatic steatosis, and the development of diabetes among individuals without impaired fasting glucose (IFG). We aimed to examine whether FLI predicts the development of diabetes in individuals with and without IFG in a Japanese general population. Methods: We selected 1498 men and 2941 women who participated in Specific Health Checkups in Japan. We divided all participants into six groups according to tertiles of FLI (low, moderate, and high) and the presence or absence of IFG, by sex. We calculated hazard ratios for incident diabetes for each group using a Cox proportional hazard model, adjusting for potential confounders. Results: During a mean follow-up period of 3.0 years, 176 cases of diabetes in men and 320 cases in women were identified. Compared with the low FLI group without IFG, the high FLI group without IFG was significantly associated with incident diabetes in both men (hazard ratio, 1.90; 95% confidence interval, 1.08-3.36) and women (hazard ratio, 1.72; 95% confidence interval, 1.18-2.51). All IFG groups were significantly associated with incident diabetes regardless of FLI levels. Conclusions: Our results showed that FLI is associated with the development of diabetes regardless of sex and the presence or absence of IFG, and that it may be a useful predictor of future risk of incident diabetes even in individuals without IFG.

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Guidelines for diagnosis and treatment of familial hypercholesterolemia 2017

Harada-Shiba Mariko, Arai Hidenori, Ishigaki Yasushi, Ishibashi Shun, Okamura Tomonori, Ogura Masatsune, Dobashi Kazushige, Nohara Atsushi, Bujo Hideaki, Miyauchi Katsumi, Yamashita Shizuya, Yokote Koutaro

Journal of Atherosclerosis and Thrombosis 25 ( 8 ) 751 - 770 2018.01

ISSN 1340-3478

Statement 1. Familial hypercholesterolemia (FH) is an autosomal hereditary disease with the 3 major clinical features of hyper-LDL-cholesterolemia, premature coronary artery disease and tendon and skin xanthomas. As there is a considerably high risk of coronary artery disease (CAD), in addition to early diagnosis and intensive treatment, family screening (cascade screening) is required (Recommendation level A) 2. For a diagnosis of FH, at least 2 of the following criteria should be satisfied: ① LDL-C ≥180 mg/dL, ② Tendon/skin xanthomas, ③ History of FH or premature CAD within 2nd degree blood relatives (Recommendation level A) 3. Intensive lipid-lowering therapy is necessary for the treatment of FH. First-line drug should be statins. (Rec-ommendation level A, Evidence level 3) 4. Screening for CAD as well as asymptomatic atherosclerosis should be conducted periodically in FH patients. (Recommendation level A) 5. For homozygous FH, consider LDL apheresis and treatment with PCSK9 inhibitors or MTP inhibitors. (Rec-ommendation level A) 6. For severe forms of heterozygous FH who have resistant to drug therapy, consider PCSK9 inhibitors and LDL apheresis. (Recommendation level A) 7. Refer FH homozygotes as well as heterozygotes who are resistant to drug therapy, who are children or are pregnant or have the desire to bear children to a specialist. (Recommendation level A).

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