研究者詳細 - 岡村　智教

論文 - 岡村　智教

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Risk of stroke and heart failure attributable to atrial fibrillation in middle-aged and elderly people: Results from a five-year prospective cohort study of Japanese community dwellers.

Ohsawa M, Okamura T, Tanno K, Ogasawara K, Itai K, Yonekura Y, Konishi K, Omama S, Miyamatsu N, Turin TC, Morino Y, Itoh T, Onoda T, Sakata K, Ishibashi Y, Makita S, Nakamura M, Tanaka F, Kuribayashi T, Ohta M, Okayama A

Journal of epidemiology 27 （ 8 ） 360 - 367 2017年08月

研究論文（学術雑誌）, ISSN 0917-5040

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Risk of stroke and heart failure attributable to atrial fibrillation in middle-aged and elderly people: Results from a five-year prospective cohort study of Japanese community dwellers.

Journal of epidemiology 27 （ 8 ） 360 - 367 2017年08月

研究論文（学術雑誌）, ISSN 0917-5040

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Causal effect of plasminogen activator inhibitor type 1 on coronary heart disease

Song Ci, Burgess Stephen, Eicher John D., O'Donnell Christopher J., Johnson Andrew D., Huang Jie, Sabater-Lleal Maria, Asselbergs Folkert W., Tregouet David, Shin So Youn, Ding Jingzhong, Baumert Jens, Oudot-Mellakh Tiphaine, Folkersen Lasse, Smith Nicholas L., Williams Scott M., Ikram Mohammad A., Kleber Marcus E., Becker Diane M., Truong Vinh, Mychaleckyj Josyf C., Tang Weihong, Yang Qiong, Sennblad Bengt, Moore Jason H., Williams Frances M.K., Dehghan Abbas, Silbernagel Günther, Schrijvers Elisabeth M.C., Smith Shelly, Karakas Mahir, Tofler Geoffrey H., Silveira Angela, Navis Gerjan J., Lohman Kurt, Chen Ming Huei, Peters Annette, Goel Anuj, Hopewell Jemma C., Chambers John C., Saleheen Danish, Lundmark Per, Psaty Bruce M., Strawbridge Rona J., Boehm Bernhard O., Carter Angela M., Meisinger Christa, Peden John F., Bis Joshua C., Okamura Tomonori

Journal of the American Heart Association 6 （ 6 ） 2017年06月

ISSN 2047-9980

Background--Plasminogen activator inhibitor type 1 (PAI-1) plays an essential role in the fibrinolysis system and thrombosis. Population studies have reported that blood PAI-1 levels are associated with increased risk of coronary heart disease (CHD). However, it is unclear whether the association reflects a causal influence of PAI-1 on CHD risk. Methods and Results--To evaluate the association between PAI-1 and CHD, we applied a 3-step strategy. First, we investigated the observational association between PAI-1 and CHD incidence using a systematic review based on a literature search for PAI-1 and CHD studies. Second, we explored the causal association between PAI-1 and CHD using a Mendelian randomization approach using summary statistics from large genome-wide association studies. Finally, we explored the causal effect of PAI-1 on cardiovascular risk factors including metabolic and subclinical atherosclerosis measures. In the systematic meta-analysis, the highest quantile of blood PAI-1 level was associated with higher CHD risk comparing with the lowest quantile (odds ratio=2.17; 95% CI: 1.53, 3.07) in an age- and sex-adjusted model. The effect size was reduced in studies using a multivariable-adjusted model (odds ratio=1.46; 95% CI: 1.13, 1.88). The Mendelian randomization analyses suggested a causal effect of increased PAI-1 level on CHD risk (odds ratio=1.22 per unit increase of log-transformed PAI-1; 95% CI: 1.01, 1.47). In addition, we also detected a causal effect of PAI-1 on elevating blood glucose and high-density lipoprotein cholesterol. Conclusions--Our study indicates a causal effect of elevated PAI-1 level on CHD risk, which may be mediated by glucose dysfunction.

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Birthweight and cardiovascular risk factors in a Japanese general population.

Katsuragi S, Okamura T, Kokubo Y, Ikeda T, Miyamoto Y

The journal of obstetrics and gynaecology research 43 （ 6 ） 1001 - 1007 2017年06月

研究論文（学術雑誌）, ISSN 1341-8076

Aim: This study was conducted to examine whether babies born small develop cardiovascular problems in later life. Methods: Data were examined retrospectively for 1241 city dwellers (men 521, women 720) aged 40–69 years who received a medical examination at a single institution. Blood tests, physical measurements, and a questionnaire survey regarding birth weight (small, medium, large), medication history and lifestyle (alcohol consumption, smoking, exercise) was administered. We selected 28 persons (12 men and 16 women) from and studied the rate of conformity between the participants’ memory (small, medium, large) and the actual birth weight recorded in their maternal and child health handbook (< 2500, 2500–3500, > 3500 g). Results: Participants’ recall of their birth weight correlated well with the weight recorded in the maternal notebook (r = 0.73; P < 0.025). Low-density lipoprotein (P < 0.05), and total cholesterol (P < 0.01) levels in men, and systolic (P < 0.05) and diastolic (P < 0.05) blood pressure in women were significantly inversely related to birth weight when controlling for age, body mass index, medication, and lifestyle. The percentage of women born small, medium, and large taking antidiabetic agents was 17.8%, 2.9% and 0% (P < 0.05), respectively. Conclusion: A low birth weight was associated with high low-density lipoprotein and total cholesterol levels in men, and hypertension and diabetes mellitus in women aged 40–69.

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Left ventricular hypertrophy by electrocardiogram as a predictor of success in home blood pressure control: HOMED-BP study.

Tanabe A, Asayama K, Hanazawa T, Watabe D, Nomura K, Okamura T, Ohkubo T, Imai Y

Hypertension research : official journal of the Japanese Society of Hypertension 40 （ 5 ） 504 - 510 2017年05月

研究論文（学術雑誌）, ISSN 0916-9636

Few studies have focused on the effect of organ damage on achievement of long-term home blood pressure (BP) control. Based on the nationwide home BP-based trial data, we aimed to investigate the factors associated with home BP control, in particular, left ventricular hypertrophy (LVH) using the electrocardiogram in patients who started antihypertensive drug treatment. According to the trial protocol, we defined BP as controlled when systolic home BP reached specified targets (125-134 mm Hg in usual control (UC), n=1261; <125 mm Hg in tight control (TC), n=1288). At baseline, before drug treatment started, the mean Sokolow-Lyon voltage was 2.57±0.87 mV, and the mean Cornell product was 1573±705 mm·ms. The numbers of patients who achieved the target BP level in the UC and TC groups were 892 (70.7%) and 576 (44.7%), respectively. In both the UC and TC groups, systolic home BP at baseline was significantly lower in patients who achieved target levels than in those who did not achieve target levels (P<0.0001). Sokolow-Lyon voltage was significantly lower in patients who achieved target levels than in those who did not (P≤0.0055). The Cornell product levels in each group were similar (P≥0.12), although significantly different between patients who did or did not achieve the target level when the UC and TC groups were combined for analysis (P=0.031). Sokolow-Lyon voltage was significantly associated with achievement of home BP control in the multivariable-adjusted model (odds ratio, 1.13; 95% confidence intervals, 1.02-1.26; P=0.015), but Cornell product was not (P=0.13). These results indicate the difficulty of sufficient antihypertensive treatment when untreated patients had target organ damage, that is, LVH diagnosed by Sokolow-Lyon voltage.

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Fasting but not casual blood glucose is associated with pancreatic cancer mortality in Japanese: EPOCH-JAPAN.

Nagai M, Murakami Y, Tamakoshi A, Kiyohara Y, Yamada M, Ukawa S, Hirata T, Tanaka S, Miura K, Ueshima H, Okamura T, Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN) Research Group.

Cancer causes & control : CCC 28 （ 6 ） 1 - 9 2017年03月

研究論文（学術雑誌）, ISSN 0957-5243

Purpose: The dose–response relationship between fasting blood glucose levels and risk of pancreatic cancer has been investigated, but the association between casual blood glucose levels and pancreatic cancer death has not been examined. We examined the association between casual and fasting blood glucose levels and death due to pancreatic cancer in Japanese. Methods: We performed a pooled analysis of the individual Japanese including 46,387 participants aged 40–79 years from ten cohorts. Participants were classified into five groups: low normal, middle normal, high normal, prediabetes (casual blood glucose 140–199 mg/dl, or fasting blood glucose 110–125 mg/dl), and diabetes (casual blood glucose ≥200 mg/dl, fasting blood glucose ≥126 mg/dl, or anti-diabetic drug use). Low normal, middle normal, and high normal were defined according to tertiles of casual or fasting normal blood glucose levels. Hazard ratios (HRs) and 95% confidence intervals (CIs) for pancreatic cancer mortality were estimated stratifying casual and fasting blood glucose by cohort-stratified Cox proportional hazards regression analysis, with low normal (casual blood glucose <94 mg/dl, or fasting blood glucose <90 mg/dl) as a reference. Results: Fasting blood glucose showed a dose–response relationship with pancreatic cancer mortality (p for trend = 0.005). After adjusting for covariates, HRs (95% CIs) were 2.83 (1.18–6.76) for prediabetes and 3.96 (1.56–10.08) for diabetes. However, there were no significant associations with casual blood glucose. These tendencies were observed after the exclusion of participants who were censored for the first 5 years of follow-up. Conclusions: Fasting blood glucose is a better predictor of pancreatic cancer death than casual blood glucose.

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Impacts of chronic kidney disease and diabetes on cardiovascular mortality in a general Japanese population: A 20-year follow-up of the NIPPON DATA90 study.

Hirata A, Okamura T, Sugiyama D, Kuwabara K, Kadota A, Fujiyoshi A, Miura K, Okuda N, Ohkubo T, Okayama A, Ueshima H, NIPPON DATA90 and 2010 Research Group.

European journal of preventive cardiology 24 （ 5 ） 505 - 513 2017年03月

研究論文（学術雑誌）, ISSN 2047-4873

Background Studies have shown significant associations of chronic kidney disease (CKD) and diabetes mellitus (DM) with cardiovascular disease (CVD) mortality. The impact on the general population is an important public health issue. However, the population attributable fraction (PAF) of CVD because of CKD and/or DM in a general population is uncertain. Methods We followed 7229 participants (age: ≥30 years) with no history of CVD in a Japanese community. We divided participants into four categories according to CKD and/or DM and calculated hazard ratios (HRs) of CVD mortality for each category using a Cox proportional hazards model adjusted for age, dyslipidemia, smoking and alcohol consumption. In addition, PAFs of CVD were estimated among populations with CKD and/or DM. Results During 20-year follow-up, 488 participants died. HRs for CVD were 1.63 [95% confidence interval (CI): 1.16-2.30] with DM only, 1.42 (95% CI: 1.08-1.86) with CKD only and 2.37 (95% CI: 1.40-4.01) with CKD + DM. In men, the corresponding HRs for CVD were 1.88 (95% CI: 1.19-2.97), 1.71 (95% CI: 1.15-2.56) and 3.26 (95% CI: 1.69-6.30), respectively; the corresponding PAFs of CVD were 4.1%, 5.1% and 2.9%, respectively. PAFs for CVD among women were lower than those in men, 1.6% for DM only, 2.0% for CKD only and 0.7% for CKD + DM. Conclusions PAFs of CVD mortality due to CKD and/or DM were not so high in past 20 years; however, they might increase in the future because of recent increase in prevalence of these in Japanese population.

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Increased childhood BMI is associated with young adult serum uric acid levels: a linkage study from Japan.

Kuwahara E, Murakami Y, Okamura T, Komatsu H, Nakazawa A, Ushiku H, Maejima F, Nishigaki Y, Nishiwaki Y

Pediatric research 81 （ 2 ） 293 - 298 2017年02月

研究論文（学術雑誌）, ISSN 0031-3998

Background:Growth pattern in early life is one of the most important factors affecting the pathogenesis of metabolic-associated diseases. The associations between serum uric acid (SUA) and hypertension, kidney disease, and coronary heart disease have been recognized. We investigated the association between increased BMI during childhood and adult SUA levels in Japan.Methods:We included 298 children with health examination data between 1981 and 2002 who had also undergone physical examinations after reaching early adulthood (approximately 27 y old). Subjects were divided into sex-specific tertiles based on the difference in their BMI (DBMI) over a 6-y period (6-12 y of age). The association between the three DBMI groups and SUA in adults was analyzed.Results:The predicted average SUA level in adults from the high DBMI group was 5.32 mg/dl after adjustment for related factors in a combined sex analysis. This was significantly higher than among the low DBMI group.Conclusion:Excessive BMI increases during childhood led to young adult SUA elevation even after adjusting for several factors. Lifestyle in early life may be a strong predictor of future uric acid metabolism and the resulting disease risk.

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Significant inverse association of equol-producer status with coronary artery calcification but not dietary isoflavones in healthy Japanese men.

Ahuja V, Miura K, Vishnu A, Fujiyoshi A, Evans R, Zaid M, Miyagawa N, Hisamatsu T, Kadota A, Okamura T, Ueshima H, Sekikawa A

The British journal of nutrition 117 （ 2 ） 260 - 266 2017年01月

研究論文（学術雑誌）, ISSN 0007-1145

Equol, a metabolite of the dietary isoflavone daidzein, is produced by the action of gut bacteria in some individuals who are termed as equol-producers. It is proposed to have stronger atheroprotective properties than dietary isoflavones. We examined a cross-sectional association of dietary isoflavones and equol-producer status with coronary artery calcification (CAC), a biomarker of coronary atherosclerosis, among men in Japan. A population-based sample of 272 Japanese men aged 40-49 years recruited from 2004 to 2007 was examined for serum isoflavones, serum equol, CAC and other factors. Equol-producers were classified as individuals having a serum level of equol >83 nm. The presence of CAC was defined as a coronary Ca score ≥10 Agatston units. The associations of dietary isoflavones and equol-producers with CAC were analysed using multiple logistic regression. The median of dietary isoflavones, equol and CAC were 512·7 (interquartile range (IQR) 194·1, 1170·0), 9·1 (IQR 0·10, 33·1) and 0·0 (IQR 0·0, 1·0) nm, respectively. Prevalence of CAC and equol-producers was 9·6 and 16·0 %, respectively. Dietary isoflavones were not significantly associated with CAC. After multivariable adjustment, the OR for the presence of CAC in equol-producers compared with equol non-producers was 0·10 (95 % CI 0·01, 0·90, P<0·04). Equol-producers had significantly lower CAC than equol non-producers, but there was no significant association between dietary isoflavones and CAC, suggesting that equol may be a key factor for atheroprotective properties of isoflavones in Japanese men. This finding must be confirmed in larger studies or clinical trials of equol that is now available as a dietary supplement.

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Is Childhood Exposure to Parental Smoking a Risk Factor for Future Cardiovascular Disease?

Michikawa T, Okamura T

Journal of atherosclerosis and thrombosis 24 （ 12 ） 1204 - 1205 2017年01月

研究論文（学術雑誌）, ISSN 1340-3478

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Risk for metabolic diseases in normal weight individuals with visceral fat accumulation: a cross-sectional study in Japan.

Tatsumi Y, Nakao YM, Masuda I, Higashiyama A, Takegami M, Nishimura K, Watanabe M, Ohkubo T, Okamura T, Miyamoto Y

BMJ open 7 （ 1 ） e013831 2017年01月

研究論文（学術雑誌）, ISSN 2044-6055

Objective To investigate the association between visceral fat area (VFA) and metabolic syndrome (Mets) among normal weight Japanese. Design A cross-sectional study. Setting The health check-up centre of the Takeda Hospital group in Kyoto, Japan. Methods This study involved 1674 men and 1448 women aged 30-74years who underwent medical check-ups in 2012 in the health check-up centre. They were stratified by Body Mass Index (BMI cut-off for obesity is set at 23.0kg/m² for Asians): normal weight 18.5-22.9kg/m² or higher weight ≥23.0kg/m². The age-adjusted ORs of the 2nd to 4th groups of sex-specific VFA quartiles compared with the 1st quartile for a Mets component clustering were estimated. The clustering was having two or more of the following factors: High blood pressure, high fasting blood glucose (FBG), low high-density lipoprotein cholesterol (HDL-C) and high triglycerides. Statistical analyses were conducted in 2016. Results Participants in the 2nd to 4th VFA quartiles had significantly higher clustering risks; ORs were 3.4 (1.5 to 8.0), 6.3 (2.8 to 14.2) and 9.3 (4.2 to 20.7) for normal weight participants, and 1.7 (1.2 to 2.6), 2.6 (1.8 to 3.9) and 6.0 (4.1 to 8.8) for higher weight participants, respectively. The ORs of the 4th VFA quartile for Mets components were significantly higher; ORs for normal weight participants were 2.1 (1.5 to 3.0) (high blood pressure), 2.4 (1.4 to 4.2) (high FBG), 5.2 (2.1 to 12.9) (low HDL-C) and 12.0 (5.7 to 25.3) (high triglycerides), and higher weight participants were 3.9 (2.8 to 5.5), 4.1 (2.8 to 6.2), 3.9 (2.2 to 6.9) and 5.0 (3.4 to 7.4), respectively. Conclusions Among participants with normal weight, as well as those of higher weight, dose-dependent responses were observed between VFA and risk for Mets components and the clustering among Japanese adults. VFA may be useful information for interventions to improve metabolic risk factors in people with normal weight.

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Associations of socioeconomic status with prevalence, awareness, treatment, and control of hypertension in a general Japanese population: NIPPON DATA2010.

Satoh A, Arima H, Ohkubo T, Nishi N, Okuda N, Ae R, Inoue M, Kurita S, Murakami K, Kadota A, Fujiyoshi A, Sakata K, Okamura T, Ueshima H, Okayama A, Miura K, NIPPON DATA2010 Research Group.

Journal of hypertension 35 （ 2 ） 401 - 408 2017年

研究論文（学術雑誌）, ISSN 0263-6352

Objective: To investigate associations between socioeconomic status (SES) and prevalence, awareness, treatment, and control of hypertension in Japan's general population. Methods: In 2010, we established a cohort of participants in the National Health and Nutrition Survey of Japan. The cohort included 2623 adults from 300 randomly selected areas across Japan. Using baseline data, four crosssectional analyses were performed: association of SES with prevalent hypertension in 2623 participants; association of SES with unawareness of hypertension and with no treatment in 1282 hypertensive patients; and association of SES with uncontrolled hypertension in 720 treated hypertensive patients. SES was classified according to employment status, length of education, marital and living status, and household expenditure. Results: The overall prevalence of hypertension was 48.9%. Among hypertensive participants, the proportions of unawareness and no treatment were 33.1 and 43.8%, respectively. Target blood pressure levels were not achieved among 61.2% of treated hypertensive patients. Hypertension was more prevalent in the unmarried and living alone group than in the married group (odds ratio 1.76; 95% confidence interval 1.26-2.44), after adjustment for age, sex, BMI, smoking, alcohol consumption, habitual exercise, history of cardiovascular diseases, diabetes mellitus, hypercholesterolemia, dietary sodium, and potassium intake. SES was not clearly associated with unawareness, no treatment, nor poor control of hypertension. Conclusion: Being unmarried and living alone was associated with increased prevalence of hypertension. There was no clear association of SES with unaware, untreated, and uncontrolled hypertension.

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Age-specific impact of diabetes mellitus on the risk of cardiovascular mortality: An overview from the evidence for Cardiovascular Prevention from Observational Cohorts in the Japan Research Group (EPOCH-JAPAN).

Hirakawa Y, Ninomiya T, Kiyohara Y, Murakami Y, Saitoh S, Nakagawa H, Okayama A, Tamakoshi A, Sakata K, Miura K, Ueshima H, Okamura T, Evidence for Cardiovascular Prevention From Observational Cohorts in Japan Research Group (EPOCH-JAPAN).

Journal of epidemiology 27 （ 3 ） 123 - 129 2017年

研究論文（学術雑誌）, ISSN 0917-5040

Background: Diabetes mellitus is a strong risk factor for cardiovascular disease. However, the age-specific association of diabetes with cardiovascular risk, especially in the elderly, remains unclear in non-Western populations. Methods: A pooled analysis was conducted using 8 cohort studies (mean follow-up period, 10.3 years) in Japan, combining the data from 38,854 individual participants without history of cardiovascular disease. In all, 1867 of the participants had diabetes, defined based on the 1998 World Health Organization criteria. The association between diabetes and the risk of death from cardiovascular disease, coronary heart disease (CHD), and stroke was estimated using a stratified Cox model, accounting for variability of baseline hazard functions among cohorts. Results: During the follow-up, 1376 subjects died of cardiovascular disease (including 268 of coronary heart disease and 621 of stroke). Diabetes was associated with an increased risk of cardiovascular death after multivariable adjustment (hazard ratio [HR] 1.62; 95% confidence interval [CI], 1.35-1.94). Similarly, diabetes was a risk factor for CHD (HR 2.13; 95% CI, 1.47-3.09) and stroke (HR 1.40; 95% CI, 1.05-1.85). In the age-stratified analysis of the risk of cardiovascular death, the relative effects of diabetes were consistent across age groups (p for heterogeneity = 0.18), whereas the excess absolute risks of diabetes were greater in participants in their 70s and 80s than in younger subjects. Conclusions: The management of diabetes is important to reduce the risk of death from cardiovascular disease, not only in midlife but also in late life, in the Japanese population.

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Risk of stroke and heart failure attributable to atrial fibrillation in middle-aged and elderly people

Ohsawa Masaki, Okamura Tomonori, Tanno Kozo, Ogasawara Kuniaki, Itai Kazuyoshi, Yonekura Yuki, Konishi Kazuki, Omama Shinichi, Miyamatsu Naomi, Turin Tanvir Chowdhury, Morino Yoshihiro, Itoh Tomonori, Onoda Toshiyuki, Sakata Kiyomi, Ishibashi Yasuhiro, Makita Shinji, Nakamura Motoyuki, Tanaka Fumitaka, Kuribayashi Toru, Ohta Mutsuko, Okayama Akira

Journal of Epidemiology 27 （ 8 ） 360 - 367 2017年

ISSN 0917-5040

Background: The relative and absolute risks of stroke and heart failure attributable to atrial fibrillation (AF) have not been sufficiently examined. Methods: A prospective study of 23,731 community-dwelling Japanese individuals was conducted. Participantswere divided into two groups based on the presence or absence of prevalent AF (n = 338 and n = 23,393, respectively). Excess events (EE) due to AF and relative risks (RRs) determined using the non-AF group as the reference for incident stroke and heart failurewere estimated using Poisson regression stratified by age groups (middle-aged: 40-69 years old; elderly: 70 years of age or older) after adjustment for sex and age. Results: There were 611 cases of stroke and 98 cases of heart failure during the observation period (131,088 person-years). AF contributed to a higher risk of stroke both in middle-aged individuals (EE 10.4 per 1000 person-years;RR4.88;95%confidenceinterval [CI],2.88-8.29) andelderlyindividuals (EE18.3per1000 personyears; RR 3.05; 95% CI, 2.05-4.54). AFalso contributed to a higher risk of heart failure in middle-aged individuals (EE 3.7 per 1000 person-years; RR 8.18; 95% CI, 2.41-27.8) and elderly individuals (EE 15.4 per 1000 personyears; RR 7.82; 95% CI, 4.11-14.9). Results obtained from multivariate-adjusted analysis were similar (stroke: EE 8.9 per 1000 person-years; RR 4.40; 95% CI, 2.57-7.55 inmiddle-aged and EE 17.4 per 1000 person-years; RR 2.97; 95% CI, 1.99-4.43 in elderly individuals; heart failure: EE 3.1 per 1000 person-years; RR 7.22; 95% CI, 2.06-25.3 in middle-aged and EE 14.1 per 1000 person-years; RR 7.41; 95% CI, 3.86-14.2 in elderly individuals). Conclusions: AF increased the risk of stroke by the same magnitude as that reported previously in Western countries. AF increased the RR of heart failure more than that in Western populations.

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Association between lifestyle factors assessed by standard question items of specific health checkup and the incidence of metabolic syndrome and hypertension in community dwellers: A five-year cohort study of National Health Insurance beneficiaries in Habikino City.

Tsutatani H, Funamoto M, Sugiyama D, Kuwabara K, Miyamatsu N, Watanabe K, Okamura T

[Nihon koshu eisei zasshi] Japanese journal of public health 64 （ 5 ） 258 - 269 2017年

研究論文（学術雑誌）, ISSN 0546-1766

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Relationship between health promotion volunteer experience and medical costs: Hoken-hodouin activities in Suzaka, Nagano.

Imamura H, Murakami Y, Okamura T, Nishiwaki Y

[Nihon koshu eisei zasshi] Japanese journal of public health 64 （ 1 ） 25 - 35 2017年

研究論文（学術雑誌）, ISSN 0546-1766

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Tsutatani H, Funamoto M, Sugiyama D, Kuwabara K, Miyamatsu N, Watanabe K, Okamura T

[Nihon koshu eisei zasshi] Japanese journal of public health 64 （ 5 ） 258 - 269 2017年

研究論文（学術雑誌）, ISSN 0546-1766

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Relationship between health promotion volunteer experience and medical costs: Hoken-hodouin activities in Suzaka, Nagano.

Imamura H, Murakami Y, Okamura T, Nishiwaki Y

[Nihon koshu eisei zasshi] Japanese journal of public health 64 （ 1 ） 25 - 35 2017年

研究論文（学術雑誌）, ISSN 0546-1766

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Diabetes and lifetime risk of coronary heart disease.

Turin TC, Okamura T, Rumana N, Afzal AR, Watanabe M, Higashiyama A, Nakao YM, Nakai M, Takegami M, Nishimura K, Kokubo Y, Okayama A, Miyamoto Y

Primary care diabetes 11 （ 5 ） 461 - 466 2016年12月

研究論文（学術雑誌）, ISSN 1751-9918

Introduction: Epidemiological estimate lifetime risk (LTR) is a measure that expresses the probability of disease in the remaining lifetime for individuals of a specific index age. These estimates can be useful for general audience targeted knowledge translation activities against diabetes. There are only a few reports on lifetime of impact of diabetes on coronary heart disease (CHD) events. Methods: The Suita Study, a cohort study of cardiovascular diseases (CVD), was established in 1989. We included all participants who were CVD free at baseline. Age (in years) was used as the time scale. Age-specific incidence rates were calculated with person-year method within ten-year bands. We estimated the sex and index-age specific LTR of first-ever CHD with taking the competing risk of death into account. Results: We followed 5559 participants without CHD history during 1989-2007 for 71,745.4 person-years. At age 40 years the competing risk of death adjusted LTR for all CHD were 16.61% for men without diabetes and 21.06% for men with diabetes. Therefore the LTD for CHD was higher by 4.45% for men with diabetes compared to men without. The competing risk adjusted LTR of CHD at 40 years of aged women was 9.18% for without diabetes and 14.21% for with diabetes. This increased LTR of CHD for diabetic patients were observed among both men and women across all index ages. Conclusion: In this urban community based population we observed that diabetes has significant effect on the residual LTR of CHD among both men and women of middle age. This easy understandable knowledge can be used as important indexes to assist public health education and planning.

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Diabetes and lifetime risk of stroke and subtypes in an urban middle-aged population.

Turin TC, Okamura T, Rumana N, Afzal AR, Watanabe M, Higashiyama A, Nakao YM, Nakai M, Takegami M, Nishimura K, Kokubo Y, Okayama A, Miyamoto Y

Journal of diabetes and its complications 31 （ 5 ） 831 - 835 2016年11月

研究論文（学術雑誌）, ISSN 1056-8727

Aims: Lifetime risk (LTR) is defined as the cumulative probability of developing a disease in one's remaining lifetime from a given index age. The impact of diabetes on the LTR of stroke events in Asians, where stroke incidence is higher than for Westerners, has not been estimated yet. These estimates can be useful for diabetes knowledge translation activities. Methods: All participants who were stroke-free at baseline in the Suita Study, a cohort study of cardiovascular diseases in Japan, were included in the study sample. Age, in years, was used as the time-scale. Age-specific incidence rates were calculated using the person-years method within five-year bands. We estimated the sex- and index-age-specific LTR of first-ever stroke accounting for the competing risk of death. Results: In this cohort study, we followed 5515 participants from 1989 to 2007 for 71,374.23 person-years. At age 40, the LTRs, adjusted for competing risk of death, for all strokes were 15.98% for men without diabetes and 26.64% for men with diabetes. The LTR for stroke was 10.66% higher for men with diabetes than men without diabetes. For women of same index age, the LTR of stroke was 17.29% and 30.72% with diabetes and without diabetes, respectively. The difference in LTR between persons with diabetes and without diabetes was 13.43%. This increased LTR of strokes for persons with diabetes was observed among both men and women across all index ages. Similar results were observed for cerebral infarction stroke subtype. Conclusions: In this urban community-based population we observed that diabetes has a significant effect on the residual LTR of stroke for both men and women of middle age. This knowledge can be used to inform public health education and planning.

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