Details of a Researcher - Okamura, Tomonori

Papers - Okamura, Tomonori

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HDL cholesterol performance using an ultracentrifugation reference measurement procedure and the designated comparison method

Nakamura Masakazu, Yokoyama Shinji, Kayamori Yuzo, Iso Hiroyasu, Kitamura Akihiko, Okamura Tomonori, Kiyama Masahiko, Noda Hiroyuki, Nishimura Kunihiro, Nakai Michikazu, Koyama Isao, Dasti Mahnaz, Vesper Hubert W., Teramoto Tamio, Miyamoto Yoshihiro

Clinica Chimica Acta 439 185 - 190 2015.01

Research paper (scientific journal), Joint Work, Accepted, ISSN 0009-8981

Background: Accurate high-density lipoprotein cholesterol (HDL-C) measurements are important for management of cardiovascular diseases. The US Centers for Disease Control and Prevention (CDC) and Cholesterol Reference Method Laboratory Network (CRMLN) perform ultracentrifugation (UC) reference measurement procedure (RMP) to value assign HDL-C. Japanese CRMLN laboratory (Osaka) concurrently runs UC procedure and the designated comparison method (DCM). Osaka performance of UC and DCM was examined and compared with CDC RMP. Methods: CDC RMP involved UC, heparin-MnCl₂ precipitation, and cholesterol analysis. CRMLN DCM for samples containing <200mg/dl triglycerides involved 50-kDa dextran sulfate-MgCl₂ precipitation and cholesterol determination. Results: HDL-C regression equations obtained with CDC (x) and Osaka (y) were y=0.992x+0.542 (R²=0.996) for Osaka UC and y=1.004x-0.181 (R²=0.998) for DCM. Pass rates within ±1mg/dl of the CDC target value were 91.9 and 92.1% for Osaka UC and DCM, respectively. Biases at 40mg/dl HDL-C were +0.22 and -0.02mg/dl for Osaka UC and DCM, respectively. Conclusions: Osaka UC and DCM were highly accurate, precise, and stable for many years, assisting manufacturers to calibrate products for clinical laboratories to accurately measure HDL-C for patients, calculate non-HDL-C, and estimate low-density lipoprotein cholesterol with the Friedewald equation.

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The reasonable reliability of a self-administered food frequency questionnaire for an urban, Japanese, middle-aged population

Maruyama Koutatsu, Kokubo Yoshihiro, Yamanaka Tamami, Watanabe Makoto, Iso Hiroyasu, Okamura Tomonori, Miyamoto Yoshihiro

Nutrition Research 35 ( 1 ) 14 - 22 2015.01

Research paper (scientific journal), Joint Work, Accepted, ISSN 0271-5317

Because few studies have developed food frequency questionnaires (FFQ) and examined their reliability for Japanese urban populations, FFQ developed for urban Japanese populations may show reasonable reliability for estimating intakes of nutrients and food groups. Therefore, the objective of this study was to examine the reliability of an FFQ developed for a prospective cohort study in a Japanese urban area. A total of 29 men and 29 women aged 47 to 78 years were selected from participants in the Suita study from February 1997 to February 1998. Seven-consecutive-day dietary records (DR) was collected in each season (28-day DR). The FFQ were administered 3 times in total in each season, except in autumn. We calculated Spearman correlation coefficients to assess the validation of the first and third FFQ compared with 28-day DR and to assess the repeatability for 3-, 6-, and 9-month intervals. Reasonable validity of each FFQ compared with 28-day DR were observed for energy intake and for 27 nutrients, and 11 food groups were selected. Median (range) Spearman rank correlation coefficients for energy-adjusted nutrient and food group intakes of the first FFQ were 0.52 (0.14-0.88) and 0.53 (0.24-0.74), and those of the third FFQ were 0.51 (0.07-0.84) and 0.57 (0.16-0.75), respectively. The repeatability of each interval was relatively good; median (range) Spearman correlation coefficients of nutrients for 3-, 6-, and 9-month intervals were 0.67 (0.40-0.85), 0.63 (0.25-0.93), and 0.62 (0.31-0.87), respectively; those for food groups were 0.58 (0.42-0.76), 0.56 (0.24-0.80), and 0.65 (0.30-0.76), respectively. In conclusion, this FFQ is useful for evaluating the associations of nutrient and food intakes with cardiovascular diseases and their risk factors in Japanese urban populations.

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The relationship between lectin-like oxidized low-density lipoprotein receptor-1 ligands containing apolipoprotein B and the cardio-ankle vascular index in healthy community inhabitants

Sugiyama Daisuke, Higashiyama Aya, Wakabayashi Ichiro, Kubota Yoshimi, Adachi Yoshiko, Hayashibe Akiko, Kawamura Kuniko, Kuwabara Kazuyo, Nishimura Kunihiro, Kadota Aya, Nishida Yoko, Hirata Takumi, Imano Hironori, Miyamatsu Naomi, Miyamoto Yoshihiro, Sawamura Tatsuya, Okamura Tomonori

Journal of Atherosclerosis and Thrombosis 22 ( 5 ) 499 - 508 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 1340-3478

Aims: Lectin-like oxidized low-density lipoprotein (LDL) receptor-1 ligands containing apolipoprotein B (LAB) and lectin-like oxidized LDL receptor-1 (LOX-1) are known as LOX-1-related modified LDL indicators. These indicators play an important role in the early phase atherosclerosis, but the relationship between these indicators and subclinical atherosclerosis, as represented by the cardioankle vascular index (CAVI), has not been assessed. We herein investigated the association of LOX-1- related modified LDL indicators and the CAVI in healthy, Japanese urban community inhabitants who were considered to be at low risk for cardiovascular disease (CVD). Methods: The participants were 515 healthy Japanese (310 men and 205 women) without a history of CVD, cancer or the use of medication for hypertension, diabetes or dyslipidaemia. To estimate the association between LOX-1-related modified LDL indicators (LAB, soluble form of LOX-1 (sLOX- 1)) and the CAVI, we performed multivariable linear regression analyses with possible confounders such as the serum LDL cholesterol level. Results: The plasma LAB showed a positive association with the CAVI in men (standardized coefficient: 0.11, p= 0.04). This relationship was not observed in women. On the other hand, no clear association was observed between the CAVI and the plasma sLOX-1 level in either sex. Conclusions: The plasma LAB levels may represent a useful marker for detecting potential atherosclerosis in healthy individuals considered to be at low risk for atherosclerosis and CVD. Further studies are needed to confirm the present findings.

Risk of Hypercholesterolemia for Cardiovascular Disease and the Population Attributable Fraction in a 24-year Japanese Cohort Study

Sugiyama Daisuke, Okamura Tomonori, Watanabe Makoto, Higashiyama Aya, Okuda Nagako, Nakamura Yasuyuki, Hozawa Atsushi, Kita Yoshikuni, Kadota Aya, Murakami Yoshitaka, Miyamatsu Naomi, Ohkubo Takayoshi, Hayakawa Takehito, Miyamoto Yoshihiro, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu

Journal of Atherosclerosis and Thrombosis 22 ( 1 ) 95 - 107 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 1340-3478

Aims: The population-attributable fraction (PAF) is an indicator of the disease burden. In Western countries, the PAF of hypercholesterolemia in cardiovascular disease (CVD) is the highest among that for traditional risk factors; however, data for Asian populations are limited. Methods: A 24-year cohort study was conducted among 9,209 randomly selected participants who were not taking statins. We estimated the hazard ratio (HR) after adjusting for covariates and PAF associated with the serum total cholesterol (TC) levels in relation to CVD mortality. Results: The TC level was found to be positively associated with an increased risk of CVD, coronary heart disease (CHD) and cardiac death (CHD plus heart failure), with an HR of 1.08 (95% confidence interval [CI]: 1.00-1.16), 1.33 (95% CI: 1.14-1.55) and 1.21 (95% CI: 1.08-1.35) for a 1-SD increment in the serum TC level, respectively. Similar positive associations between the TC level and both CHD and cardiac death were observed after classifying the patients by age and sex. Furthermore, the highest serum TC level (≥6.72 mmol/L) was positively associated with CVD death, with an HR of 1.76 (95% CI: 1.25-2.47), as well as both CHD death and cardiac death. In contrast, no significant relationships were observed between the serum TC level and stroke. Meanwhile, the PAF for CVD, CHD, and cardiac deaths due to hypercholesterolemia (serum TC level ≥5.69 mmol/L, defined by the Japan Atherosclerosis Society) was 1.7%, 10.6% and 5.6%, respectively. Conclusions: The estimated PAF of CVD death due to hypercholesterolemia is moderately high, but lower than that for other risk factors, such as hypertension.

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Association between serum long-chain n-3 and n-6 polyunsaturated fatty acid profiles and glomerular filtration rate assessed by serum creatinine and cystatin C levels in Japanese community-dwellers

Higashiyama Aya, Kubota Yoshimi, Marumo Mikio, Konishi Masami, Yamashita Yoshiko, Nishimura Kunihiro, Fukuda Yoshihiro, Okamura Tomonori, Wakabayashi Ichiro

Journal of Epidemiology 25 ( 4 ) 303 - 311 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 0917-5040

Background: Plasma concentration of n-3 polyunsaturated fatty acids (PUFAs) has been reported to be associated with renal function in Western populations. However, few studies have investigated the association between serum long-chain n-3 and n-6 PUFA profiles and renal function in a Japanese population with high marine-derived longchain n-3 PUFA intake. Methods: A cross-sectional study was performed in 549 Japanese rural community-dwellers aged 40 to 64 years. In adjusted analysis of covariance, we assessed the relationship between estimated glomerular filtration rate (eGFR) and tertiles of serum long-chain n-3 and n-6 PUFA profiles ([eicosapentaenoic acid {EPA} + docosahexaenoic acid {DHA}]:arachidonic acid [AA]). GFR was estimated by Japanese specific equations using serum creatinine and cystatin C (eGFR<inf>cre</inf> and eGFR<inf>cys</inf>). Using multivariate-adjusted linear regression models, we also assessed the relationships between eGFRs and several n-3 and n-6 PUFAs, which have been suggested to be associated with renal function. Results: In all participants, higher dietary fish intake as assessed by a semi-quantitative questionnaire was associated with higher serum value of (EPA+DHA):AA. Participants in the higher (EPA+DHA):AA tertiles had nonsignificantly higher eGFR<inf>cre</inf> and significantly higher eGFR<inf>cys</inf> (P = 0.016). In addition, eGFR<inf>cys</inf> in T2+T3 of (EPA+DHA):AA was significantly higher than that in T1 (adjusted mean eGFR<inf>cys</inf>, T1: 87 ml/min/1.73m2, T2+T3: 91 ml/min/1.73m2; P < 0.01). Among the PUFAs, only (EPA+DHA) was significantly associated with eGFR<inf>cys</inf>. Conclusions: Serum (EPA+DHA):AA, which reflects an individual's fish intake, might be associated with eGFR<inf>cys</inf> in Japanese community-dwellers.

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The relationship between Asian dust events and out-of-hospital cardiac arrests in Japan

Nakamura Takahiro, Hashizume Masahiro, Ueda Kayo, Kubo Tatsuhiko, Shimizu Atsushi, Okamura Tomonori, Nishiwaki Yuji

Journal of Epidemiology 25 ( 4 ) 289 - 296 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 0917-5040

Background: Asian dust events are caused by dust storms that originate in the deserts of China and Mongolia and drift across East Asia. We hypothesized that the dust events would increase incidence of out-of-hospital cardiac arrests by triggering acute events or exacerbating chronic diseases. Methods: We analyzed the Utstein-Style data collected in 2005 to 2008 from seven prefectures covering almost the entire length of Japan to investigate the effect of Asian dust events on out-of-hospital cardiac arrests. Asian dust events were defined by the measurement of light detection and ranging. A time-stratified case-crossover analysis was performed. The strength of the association between Asian dust events and out-of-hospital cardiac arrests was shown by odds ratios and 95% confidence intervals in two conditional logistic models. A pooled estimate was obtained from area-specific results by random-effect meta-analysis. Results: The total number of cases of out-of-hospital cardiac arrest was 59 273, of which 35 460 were in men and 23 813 were in women. The total number of event days during the study period was smallest in Miyagi and Niigata and largest in Shimane and Nagasaki. There was no significant relationship between Asian dust events and out-ofhospital cardiac arrests by area in either of the models. In the pooled analysis, the highest odds ratios were observed at lag day 1 in both model 1 (OR 1.07; 95% CI, 0.97-1.19) and model 2 (OR 1.08; 95% CI, 0.97-1.20). However, these results were not statistically significant. Conclusions: We found no evidence of an association between Asian dust events and out-of-hospital cardiac arrests.

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HOMA-IR values are associated with glycemic control in Japanese subjects without diabetes or obesity

Hirata Takumi, Higashiyama Aya, Kubota Yoshimi, Nishimura Kunihiro, Sugiyama Daisuke, Kadota Aya, Nishida Yoko, Imano Hironori, Nishikawa Tomofumi, Miyamatsu Naomi, Miyamoto Yoshihiro, Okamura Tomonori

Journal of Epidemiology 25 ( 6 ) 407 - 414 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 0917-5040

Background: Several studies have reported that insulin resistance was a major risk factor for the onset of type 2 diabetes mellitus in individuals without diabetes or obesity. We aimed to clarify the association between insulin resistance and glycemic control in Japanese subjects without diabetes or obesity. Methods: We conducted a community-based cross-sectional study including 1083 healthy subjects (323 men and 760 women) in an urban area. We performed multivariate regression analyses to estimate the association between the homeostasis model assessment of insulin resistance (HOMA-IR) values and markers of glycemic control, including glycated haemoglobin (HbA1c), 1,5-anhydroglucitol (1,5-AG), and fasting plasma glucose (FPG) levels, after adjustment for potential confounders. Results: Compared with the lowest tertile of HOMA-IR values, the highest tertile was significantly associated with HbA1c and FPG levels after adjustment for potential confounders, both in men (HbA1c: β = 1.83, P = 0.001; FPG: β = 0.49, P < 0.001) and women (HbA1c: β = 0.82, P = 0.008; FPG: β = 0.39, P < 0.001). The highest tertile of HOMA-IR values was inversely associated with 1,5-AG levels compared with the lowest tertile (β = -18.42, P = 0.009) only in men. Conclusions: HOMA-IR values were associated with markers of glycemic control in Japanese subjects without diabetes or obesity. Insulin resistance may influence glycemic control even in a lean, non-diabetic Asian population.

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Nationwide distribution of cardiovascular practice in Japan - Results of Japanese circulation society 2010 annual survey

Tomoike Hitonobu, Yokoyama Hiroyuki, Sumita Yoko, Hanai Sotaro, Kada Akiko, Okamura Tomonori, Yoshikawa Junichi, Doi Yoshinori, Hori Masatsugu, Tei Chuwa

Circulation Journal 79 ( 5 ) 1058 - 1067 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 1346-9843

Background: The geographic distribution of cardiovascular (CV) health-care services has not been assessed systematically. Methods and Results: Data of the Japanese Circulation Society (JCS) annual survey were provided to the JCS working group with the permission of the JCS Scientific Committee. The status of CV practice in 2010 was then assessed in 47 prefectures retrospectively, along with national census and gross domestic product (GDP) data. The surveyed indices included resources (hospitals, beds and cardiologists), burden (number of inpatients), and outcome (CV mortality and autopsy) in each prefecture, which correlated well with respective populations or GDP. Inequality of geographic distribution was evident for pediatrics among the 47 prefectures, according to Lorenz curve, Gini coefficient or the maximum/minimum ratio for each index. According to the Gini coefficients, only the number of inpatients (medical or acute myocardial infarction) and beds for the total number of general hospitals or the hospitals surveyed in the present JCS study were lower than expected with regard to GDP. Conclusions: Geographic disparity of CV resources or burden was larger in pediatrics than in CV medicine or surgery. Improvement of equality in CV practice with regard to appropriateness and quality are the coming challenges for the JCS.

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Changes in waist circumference and the incidence of type 2 diabetes in community-dwelling men and women

Tatsumi Yukako, Watanabe Makoto, Nakai Michikazu, Kokubo Yoshihiro, Higashiyama Aya, Nishimura Kunihiro, Kobayashi Takashi, Takegami Misa, Nakao Yoko M., Watanabe Takuya, Okayama Akira, Okamura Tomonori, Miyamoto Yoshihiro

Journal of Epidemiology 25 ( 7 ) 489 - 495 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 0917-5040

Backgrounds: The association between weight gain and the incidence of type 2 diabetes is well known. The aim of our study was to investigate the relationship between change in waist circumference (WC) and type 2 diabetes incidence. Methods: The participants in the Suita Study, a population-based cohort study in an urban area of Japan, underwent a baseline survey between 1989 and 1994 (Exam 1) and were examined at follow-up every 2 years. We performed a 9.3-year cohort study of 946 men and 1327 women with no history of diabetes who underwent Exam 1 and Exam 2 (between 1997 and 1999). Participants were stratified by sex and median WC at Exam 1, and, in each stratum, participants were further classified into three categories by tertile of WC change per year between Exam 1 and Exam 2. Hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes incidence were calculated by Cox proportional hazard models. The endpoints were first diagnosis of type 2 diabetes or March 2011. Results: During follow-up, 287 participants developed type 2 diabetes. In both sexes with median WC or higher, participants in the highest tertile of WC change had a significantly higher risk of developing type 2 diabetes. Multivariable adjusted HRs were 1.84 (95% CI, 1.10-3.08) in men and 2.30 (95% CI, 1.31-4.04) in women. No significant association was observed among participants with WC below median. Conclusions: Preventing WC gain is important in preventing type 2 diabetes in the Japanese population, especially among individuals with a relatively high WC.

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Alcohol consumption, hospitalization and medical expenditure

Nakamura Koshi, Okuda Nagako, Okamura Tomonori, Miura Katsuyuki, Nishimura Kunihiro, Yasumura Seiji, Sakata Kiyomi, Hidaka Hideki, Okayama Akira

Alcohol and Alcoholism 50 ( 2 ) 236 - 243 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 0735-0414

Aims: This study investigated the relationship between alcohol drinking habits and the onset of high medical expenditure in a Japanese male population. Methods: The cohort comprised 94,307 male beneficiaries 40-69 years of age of the Japanese medical insurance system, who had daily alcohol drinking habits. The likelihood of incurring high medical expenditure, defined as the ≥90th percentile of the medical expenditure distribution in the study population 1 year after baseline, as well as the likelihood of undergoing hospitalization that year were compared among the participants grouped according to their alcohol consumption amount (<2, 2-3.9, 4-5.9, ≥6 drinks/day). Results: Participants who ranked in the top 10% medical expenditure group within the 1 year after baseline each incurred at least 2152 euros/year. The top 10% medical expenditure group accounted for 61.1% of the total medical expenditure in the study population. The odds ratios (95% confidence intervals) for ranking in the top 10% group during the 1-year period, compared with the <2 drinks (23 g of alcohol)/day group, were 1.08 (1.02-1.15) for 2-3.9 drinks/day, 1.11 (1.05-1.19) for 4-5.9 drinks/day, and 1.31 (1.18-1.45) for ≥6 drinks/day after adjustment for age, body mass index, and smoking and exercise habits. The adjusted odds ratios for undergoing hospitalization were 1.11 (1.04-1.19), 1.14 (1.06-1.24) and 1.39 (1.24-1.56), respectively. Conclusion: The likelihood of incurring high medical expenditure and undergoing hospitalization increased with daily alcohol consumption amount.

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Relative and absolute risks of all-cause and cause-specific deaths attributable to atrial fibrillation in middle-aged and elderly community dwellers

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

International Journal of Cardiology 184 ( 1 ) 692 - 698 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 0167-5273

Background: The relative and absolute risks of outcomes other than all-cause death (ACD) attributable to atrial fibrillation (AF) stratified age have not been sufficiently investigated. Methods: A prospective study of 23,634 community dwellers aged 40 years or older without organic cardiovascular disease (AF = 335, non-AF = 23,299) was conducted. Multivariate-adjusted rates, rate ratios (RRs) and excess deaths (EDs) for ACD, cardiovascular death (CVD) and non-cardiovascular death (non-CVD), and sexand age-adjusted RR and ED in middle-aged (40 to 69) and elderly (70 years or older) for ACD, CVD, non-CVD, sudden cardiac death (SCD), stroke-related death (Str-D), neoplasm-related death (NPD), and infectionrelated death (IFD) attributable to AF were estimated using Poisson regression. Results: Multivariate-adjusted analysis revealed that AF significantly increased the risk of ACD (RR [95% confidence interval]:1.70 [1.23-2.95]) and CVD (3.86 [2.38-6.27]), but not non-CVD. Age-stratified analysis revealed that AF increased the risk of Str-D in middle-aged (14.5 [4.77-44.3]) and elderly individuals (4.92 [1.91-12.7]), SCD in elderly individuals (3.21 [1.37-7.51]), and might increase the risk of IFD in elderly individuals (2.02 [0.80-4.65], p = 0.098). The RR of CVD was higher in middle-aged versus elderly individuals (RRs, 6.19 vs. 3.57) but the absolute risk difference was larger in elderly individuals (EDs: 7.6 vs. 3.0 per 1000 person-years). Conclusions: Larger absolute risk differences for ACD and CVD attributable to AF among elderly people indicate that the absolute burden of AF is higher in elderly versus middle-aged people despite the relatively small RR.

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Long-term outcomes associated with prolonged PR interval in the general Japanese population

Hisamatsu Takashi, Miura Katsuyuki, Fujiyoshi Akira, Okamura Tomonori, Ohkubo Takayoshi, Nagasawa Shin Ya, Horie Minoru, Okayama Akira, Ueshima Hirotsugu, Saitoh Shigeyuki, Sakata Kiyomi, Hozawa Atsushi, Hayakawa Takehito, Nakamura Yosikazu, Matsumura Yasuhiro, Nishi Nobuo, Okuda Nagako, Kasagi Fumiyoshi, Izumi Toru, Ojima Toshiyuki, Tamakoshi Koji, Nakagawa Hideaki, Murakami Yoshitaka, Kita Yoshikuni, Miyamatsu Naomi, Nakamura Yasuyuki, Yoshita Katsushi, Kadota Aya, Miyamoto Yoshihiro, Kodama Kazunori, Kiyohara Yutaka

International Journal of Cardiology 184 ( 1 ) 291 - 293 2015

Research paper (scientific journal), ISSN 0167-5273

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Effects of a long-term intervention in a work cafeteria on employee vegetable intake

Misawa Akemi, Yoshita Katsushi, Fukumura Tomoe, Tanaka Taichiro, Tamaki Junko, Takebayashi Toru, Kusaka Yukinori, Nakagawa Hideaki, Yamato Hiroshi, Okayama Akira, Miura Katsuyuki, Okamura Tomonori, Ueshima Hirotsugu

Sangyō eiseigaku zasshi = Journal of occupational health 57 ( 3 ) 97 - 107 2015

Research paper (scientific journal), ISSN 1341-0725

OBJECTIVES: We examined the effects on employee vegetable intake of a long-term intervention in an employee work cafeteria.METHODS: The subjects were approximately 1,200 employees (aged 19-61 years) of an industrial company in Fukui prefecture. We promoted the intake of typical Japanese style meals that combined three elements (staple foods, main dishes and vegetable dishes) to increase vegetables intake. We displayed all items on the menus of the employee cafeteria using three colors (yellow, red and green to denote three elements) to indicate healthy food choices for the maintenance of a healthy food environment. We advised employees to choose meals containing the three elements at the time of payment, for nutritional education (appropriate portion choice: APC). We evaluated the ratio of APC at the same time. To calculate the mean daily intake per person, we carried out a questionnaire survey similar to the "semi-quantitative food frequency questionnaire" and asked about the frequency and approximate intake of vegetables.RESULTS: The APC was 63.5% after one year of intervention, significantly increased to 82.1% after two years (p <0.001), and was 80.0% after three years of intervention (p <0.001). Vegetable intake at breakfast (p <0.001), lunch (p <0.001) and dinner (p = 0.011), and from vegetable juice (p = 0.030) significantly increased after three years of intervention. The consumption of pickles significantly decreased after three years of intervention (p = 0.009). It was estimated that the vegetable intake of men increased from 167.3 to 184.6 g, and that of women from 157.9 to 187.7 g.CONCLUSIONS: Employee estimated vegetable intake was significantly increased and that of pickles was significantly decreased by a long-term intervention (three years) in the employee work cafeteria.

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Associations between Inflammatory Markers and Subclinical Atherosclerosis in Middle-aged White, Japanese-American and Japanese Men: The ERA-JUMP Study.

Nagasawa SY, Ohkubo T, Masaki K, Barinas-Mitchell E, Miura K, Seto T, El-Saed A, Kadowaki T, Willcox BJ, Edmundowicz D, Kadota A, Evans RW, Kadowaki S, Fujiyoshi A, Hisamatsu T, Bertolet MH, Okamura T, Nakamura Y, Kuller LH, Ueshima H, Sekikawa A, ERA-JUNP Study Group.

Journal of atherosclerosis and thrombosis 22 ( 6 ) 590 - 8 2015

Research paper (scientific journal), ISSN 1340-3478

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Associations between Inflammatory Markers and Subclinical Atherosclerosis in Middle-aged White, Japanese-American and Japanese Men: The ERA-JUMP Study.

Journal of atherosclerosis and thrombosis 22 ( 6 ) 590 - 8 2015

Research paper (scientific journal), ISSN 1340-3478

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The Relationship between Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Ligands Containing Apolipoprotein B and the Cardio-Ankle Vascular Index in Healthy Community Inhabitants: The KOBE Study.

Sugiyama D, Higashiyama A, Wakabayashi I, Kubota Y, Adachi Y, Hayashibe A, Kawamura K, Kuwabara K, Nishimura K, Kadota A, Nishida Y, Hirata T, Imano H, Miyamatsu N, Miyamoto Y, Sawamura T, Okamura T

Journal of atherosclerosis and thrombosis 22 ( 5 ) 499 - 508 2015

Research paper (scientific journal), ISSN 1340-3478

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Sugiyama D, Higashiyama A, Wakabayashi I, Kubota Y, Adachi Y, Hayashibe A, Kawamura K, Kuwabara K, Nishimura K, Kadota A, Nishida Y, Hirata T, Imano H, Miyamatsu N, Miyamoto Y, Sawamura T, Okamura T

Journal of atherosclerosis and thrombosis 22 ( 5 ) 499 - 508 2015

Research paper (scientific journal), ISSN 1340-3478

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Cumulative impact of axial, structural, and repolarization ECG findings on long-term cardiovascular mortality among healthy individuals in Japan

Inohara Taku, Kohsaka Shun, Okamura Tomonori, Watanabe Makoto, Nakamura Yasuyuki, Higashiyama Aya, Kadota Aya, Okuda Nagako, Murakami Yoshitaka, Ohkubo Takayoshi, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu

European Journal of Preventive Cardiology 21 ( 12 ) 1501 - 1508 2014.12

Research paper (scientific journal), Joint Work, Accepted, ISSN 2047-4873

Methods and Results: Community-dwelling Japanese residents from the National Integrated Project for Perspective Observation of Non-Communicable Disease and its Trends in the Aged, 1980-2004 and 1990-2005 (NIPPON DATA80 and 90), were included in this study. Baseline ECG findings were classified using the Minnesota Code and categorized into axial (left axis deviation, clockwise rotation), structural (left ventricular hypertrophy, atrial enlargement), and repolarization (minor and major ST-T changes) abnormalities. The hazard ratios of the cumulative impacts of ECG findings on long-term CVD death were estimated by stratified Cox proportional hazard models, including adjustments for cohort strata. In all, 16,816 participants were evaluated. The average age was 51.2 ±13.5 years; 42.7% participants were male. The duration of follow up was 300,924 person-years (mean 17.9±5.8 years); there were 1218 CVD deaths during that time. Overall, 4203 participants (25.0%) had one or more categorical ECG abnormalities: 3648 (21.7%) had a single abnormality, and 555 (3.3%) had two or more. The risk of CVD mortality increased as the number of abnormalities accumulated (single abnormality HR 1.29, 95% CI 1.13-1.48; ≥2 abnormalities HR 2.10, 95% CI 1.73-2.53).Conclusions: Individual ECG abnormalities had an additive effect in predicting CVD outcome risk in our large-scale cohort study.Aims: Various cohort studies have shown a close association between long-term cardiovascular disease (CVD) outcomes and individual electrocardiographic (ECG) abnormalities such as axial, structural, and repolarization changes. The combined effect of these ECG abnormalities, each assumed to be benign, has not been thoroughly investigated.

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Low-carbohydrate diets and cardiovascular and total mortality in Japanese

Nakamura Yasuyuki, Okuda Nagako, Okamura Tomonori, Kadota Aya, Miyagawa Naoko, Hayakawa Takehito, Kita Yoshikuni, Fujiyoshi Akira, Nagai Masato, Takashima Naoyuki, Ohkubo Takayoshi, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu

British Journal of Nutrition 112 ( 6 ) 916 - 924 2014.09

Research paper (scientific journal), Joint Work, Accepted, ISSN 0007-1145

Long-term safety of consuming low-carbohydrate diets (LCD) in Asian populations, whose carbohydrate intake is relatively high, is not known. In the present study, the association of LCD with CVD and total mortality was assessed using data obtained in the NIPPON DATA80 (National Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged 1980) during 29 years of follow-up. At baseline in 1980, data were collected from study participants aged ≥30 years from randomly selected areas in Japan. LCD scores were calculated based on the percentage of energy as carbohydrate, fat and protein, estimated by 3d weighed food records. A total of 9200 participants (56% women, mean age 51 years) were followed up. During the follow-up, 1171 CVD deaths (52% in women) and 3443 total deaths (48% in women) occurred. The multivariable-adjusted hazard ratio (HR) for CVD mortality using the Cox model comparing the highest v. lowest deciles of LCD score was 0·60 (95% CI 0·38, 0·94; P_trend=0·021) for women and 0·78 (95% CI 0·58, 1·05; P_trend=0·079) for women and men combined; the HR for total mortality was 0·74 (95% CI 0·57, 0·95; P_trend=0·029) for women and 0·87 (95% CI 0·74, 1·02; P_trend=0·090) for women and men combined. None of the associations was statistically significant in men. No differential effects of animal-based and plant-fish-based LCD were observed. In conclusions, moderate diets lower in carbohydrate and higher in protein and fat are significantly inversely associated with CVD and total mortality in women.

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Blood pressure, low-density lipoprotein cholesterol, and incidences of coronary artery disease and ischemic stroke in Japanese

Tsukinoki Rumi, Okamura Tomonori, Watanabe Makoto, Kokubo Yoshihiro, Nishimura Kunihiro, Takegami Misa, Murakami Yoshitaka, Okayama Akira, Miyamoto Yoshihiro

American Journal of Hypertension 27 ( 11 ) 1362 - 1369 2014.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 0895-7061

BACKGROUND Blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) are risk factors for coronary artery disease (CAD) and ischemic stroke. However, the hazards of their coexistence are not fully understood in Asian populations. We investigated whether the relationship between BP and cardiovascular disease (CVD) outcomes are modified by LDL-C level in a Japanese population.METHODS Individuals aged 30-79 years (n = 5,151) were classified into 6 groups according to LDL-C levels (<140 and ≥140mg/dL or lipid medication) and BP levels (optimal BP, prehypertension, and hypertension; reference: low LDL-C and optimal BP). Hazard ratios (HRs) were calculated after adjusting for age, high-density lipoprotein cholesterol, diabetes, smoking status, and alcohol consumption. The effect modification of LDL-C on BP-CVD association was assessed using likelihood ratio tests.RESULTS There were 264 CAD and 215 ischemic stroke events during 13 years of follow-up. With low LDL-C, the HRs of prehypertension and hypertension for CAD were 2.01 and 4.71, respectively. Similar trends of HRs were observed with high LDL-C (optimal BP = 2.09, prehypertension = 3.45, hypertension = 5.94). However, the HRs for ischemic stroke did not differ between normal and high LDL-C levels at the same BP level. The apparent effect modification of LDL-C was not observed in the BP-CVD association in either CAD (P = 0.48) or ischemic stroke (P = 0.39).CONCLUSIONS The HRs for CAD in prehypertensive and hypertensive groups were higher than those in the optimal BP group at the same LDL-C levels in a Japanese population; however, there was no statistical effect modification of LDL-C on the BP-CAD association.

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