Details of a Researcher - Okamura, Tomonori

Papers - Okamura, Tomonori

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Relationship between shift work and clustering of the metabolic syndrome diagnostic components

Kawabe Yuri, Nakamura Yasuyuki, Kikuchi Sayuri, Murakami Yoshitaka, Tanaka Taichiro, Takebayashi Toru, Okayama Akira, Miura Katsuyuki, Okamura Tomonori, Ueshima Hirotsugu

Journal of Atherosclerosis and Thrombosis 21 ( 7 ) 703 - 711 2014

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

Aim: To examine the relationship between the type of work and the number of metabolic syndrome diagnostic componentsS (MetS-DC), as well as the risk of MetS, with adjustment for lifestyle habits in Japanese workers. Methods: We examined the baseline data from 4,427 participants (81.4% male) aged 19 to 69 years old. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined the four MetS-DC in this study as follows: 1) high blood pressure (BP): systolic BP ≥ 130 mmHg, or diastolic BP ≥ 85 mmHg, or the use of antihypertensive drugs; 2) dyslipidemia: high-density lipoprotein-cholesterol concentration <40 mg/dl or triglyceride concentration ≥ 150 mg/dl, or on medication for dyslipidemia; 3) dysglycemia: fasting blood sugar level ≥ 110 mg/dl, or if less than eight hours after meals ≥ 140 mg/dl, or on medication for diabetes mellitus; 4) overweight: a body mass index ≥ 25 kg/m2. We defined MetS as overweight plus two or more of the MetS-DC. Results: There were 3,094 subjects in the daytime work group, 73 in the fixed nighttime work group, 1,017 in the shift work group and 243 in the day-to-night work group. The Poisson regression analysis revealed that fixed nighttime (regression coefficient [b] = -0.233, P=0.028) and shift work (b=0.098, P=0.034) independently contributed to the number of MetS-DC, compared to daytime work. The multivariate logistic analysis not including sleep hours in the model showed that shift work was positively related to MetS (odd ratio = 1.47, P<0.01). Conclusion: Shift work were significantly associated with the number of MetS-DC, and was related to risk of MetS compared to daytime work.

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Worksite wellness for the primary and secondary prevention of cardiovascular disease in Japan

Okamura Tomonori, Sugiyama Daisuke, Tanaka Taichiro, Dohi Seitaro

Progress in Cardiovascular Diseases 56 ( 5 ) 515 - 521 2014

Research paper (scientific journal), Joint Work, Accepted, ISSN 0033-0620

In the Japanese workplace, employers are required to provide annual health checkups for workers in accordance with the "Industrial Safety and Health Law," which also mandates that an occupational physician be assigned to companies employing at least 50 workers. The annual medical examination includes testing for the early detection of cardiovascular risk factors such as hypertension, dyslipidemia, diabetes, and the metabolic syndrome. This approach has successfully contributed to the extremely low incidence of coronary artery disease among Japanese workers. However, problems such as poor health and the low rate of participation in health checkups among small-scale companies still persist. Furthermore, although most wellness delivery systems in Japan employ strategies targeting high-risk individuals, instituting a strategy addressing the broader population irrespective of screening may be effective in reducing disease risk in the overall population. As a future direction, we should therefore develop practical methods for implementing a population strategy. © 2014 Elsevier Inc.

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High long-chain n-3 fatty acid intake attenuates the effect of high resting heart rate on cardiovascular mortality risk

Hisamatsu Takashi, Miura Katsuyuki, Ohkubo Takayoshi, Yamamoto Takashi, Fujiyoshi Akira, Miyagawa Naoko, Kadota Aya, Takashima Naoyuki, Okuda Nagako, Yoshita Katsushi, Kita Yoshikuni, Murakami Yoshitaka, Nakamura Yasuyuki, Okamura Tomonori, Horie Minoru, Okayama Akira, Ueshima Hirotsugu

Journal of Cardiology 64 ( 3 ) 218 - 224 2014

Research paper (scientific journal), Joint Work, Accepted, ISSN 0914-5087

Background: Increased resting heart rate (RHR) independently predicts cardiovascular mortality. Meanwhile, long-chain n-3 fatty acids (LCn3FAs) have a cardioprotective effect. Our aim was to evaluate whether higher LCn3FAs intake attenuates the elevated risk of cardiovascular mortality associated with increased RHR. Methods: We conducted a population-based 24-year prospective cohort study of Japanese, whose LCn3FAs intake is relatively high. Study participants included 8807 individuals aged 30-95 years from randomly selected areas across Japan without cardiovascular diseases and anti-hypertensive drugs at baseline. The primary endpoint was cardiovascular mortality, and the secondary endpoints were cardiac and stroke mortality during 24 years of follow-up. Individual dietary LCn3FAs intake was estimated from household-based 3-day weighed food records. RHR was obtained from 3 consecutive R-wave intervals on 12-lead electrocardiography. Cox models were used to estimate the multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) adjusting for possible confounders. Results: During the follow-up period, 617 cardiovascular deaths were observed. The median daily intake of LCn3FAs was 0.37% kcal (0.86. g/day). The interaction between dietary LCn3FAs intake and RHR in the risk of cardiovascular mortality was statistically significant (p= 0.033). The risk of cardiovascular mortality was significantly higher in the low-intake group (<0.37%. kcal) with an RHR >85. beats/min (bpm) [hazard ratio (HR), 1.67; 95% confidence interval (CI), 1.15-2.43], but not in the high-intake group (≥0.37%. kcal) with an RHR >85. bpm (HR, 0.92; 95% CI, 0.61-1.38), compared with those in the high-intake group with an RHR <70. bpm. Similar results were observed with stroke mortality, but not with cardiac mortality. Conclusions: The risk of cardiovascular mortality associated with increased RHR is elevated in participants with low dietary LCn3FAs intake, but not in participants with high dietary LCn3FAs intake in a representative Japanese general population. These results suggest that high dietary LCn3FAs intake may prevent cardiovascular mortality associated with increased RHR.

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Women

Journal of Atherosclerosis and Thrombosis 21 ( 4 ) 291 - 295 2014

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

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Chronic kidney disease

Journal of Atherosclerosis and Thrombosis 21 ( 3 ) 173 - 174 2014

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

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Cerebrovascular diseases

Journal of Atherosclerosis and Thrombosis 21 ( 3 ) 175 - 179 2014

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

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The elderly

Journal of Atherosclerosis and Thrombosis 21 ( 3 ) 180 - 185 2014

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

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Cardiovascular risk with and without antihypertensive drug treatment in the japanese general population

Asayama Kei, Satoh Michihiro, Murakami Yoshitaka, Ohkubo Takayoshi, Nagasawa Sin Ya, Tsuji Ichiro, Nakayama Takeo, Okayama Akira, Miura Katsuyuki, Imai Yutaka, Ueshima Hirotsugu, Okamura Tomonori

Hypertension 63 ( 6 ) 1189 - 1197 2014

Research paper (scientific journal), Joint Work, Accepted, ISSN 0194-911X

To evaluate the cardiovascular mortality risk in association with blood pressure level among people with and without antihypertensive treatment, we performed the participant-level meta-analysis that included 39 705 Japanese from 6 cohorts (58.4% women; mean age, 60.1 years; 20.4% treated). Multivariable-adjusted Cox models were used to analyze the risk of cardiovascular mortality and its subtypes among 6 blood pressure levels according to recent guidelines, optimal to Grade 3 hypertension, and the usage of antihypertensive medication at baseline. During median 10.0 years of follow-up, there were 2032 cardiovascular deaths (5.1 per 1000 person-years), of which 410 deaths were coronary heart disease, 371 were heart failure, and 903 deaths were stroke. Treated participants had significantly higher risk for cardiovascular mortality (hazard ratios, 1.50; 95% confidence intervals, 1.36-1.66), coronary heart disease (hazard ratios, 1.53; confidence intervals, 1.23-1.90), heart failure (hazard ratios, 1.39; confidence intervals, 1.09-1.76), and stroke (hazard ratios, 1.48; confidence intervals, 1.28-1.72) compared with untreated people. Among untreated participants, the risks increased linearly with an increment of blood pressure category (P≤0.011). The risk increments per blood pressure category were higher in young participants (<60 years; 22% to 79%) than those in old people (≥60 years; 7% to 15%) with significant interaction for total cardiovascular, heart failure, and stroke mortality (P≤0.026). Among treated participants, the significant linear association was also observed for cardiovascular mortality (P=0.0003), whereas no stepwise increase in stroke death was observed (P=0.19). The risks of cardiovascular mortality were ≈1.5-fold high in participants under antihypertensive medication. More attention should be paid to the residual cardiovascular risks in treated patients. © 2014 American Heart Association, Inc.

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Predicting coronary heart disease using risk factor categories for a Japanese urban population, and comparison with the Framingham risk score

Nishimura Kunihiro, Okamura Tomonori, Watanabe Makoto, Nakai Michikazu, Takegami Misa, Higashiyama Aya, Kokubo Yoshihiro, Okayama Akira, Miyamoto Yoshihiro

Journal of Atherosclerosis and Thrombosis 21 ( 8 ) 784 - 798 2014

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

Aim: The Framingham risk score (FRS) is one of the standard tools used to predict the incidence of coronary heart disease (CHD). No previous study has investigated its efficacy for a Japanese population cohort. The purpose of this study was to develop new coronary prediction algorithms for the Japanese population in the manner of the FRS, and to compare them with the original FRS.Methods: Our coronary prediction algorithms for Japanese were based on a large population-based cohort study (Suita study). The study population comprised 5,521 healthy Japanese. They were followed-up for 11.8 years on average, and 213 cases of CHD were observed. Multiple Cox proportional hazard model by stepwise selection was used to construct the prediction model.Results: Our coronary prediction algorithms for Japanese patients were based on a large population-based cohort study (the Suita study). A multiple Cox proportional hazard model by stepwise selection was used to construct the prediction model. The C-statistics showed that the new model had better accuracy than the original and recalibrated Framingham scores. The net reclassification improvement (NRI) by the Suita score with the inclusion of CKD was 41.2% (P＜0.001) compared with the original FRS. The recalibration of the FRS slightly improved the efficiency of the prediction, but it was still worse than the Suita score with the CKD model. The calibration analysis suggested that the original FRS and the recalibrated FRS overestimated the risk of CHD in the Japanese population. The Suita score with CKD more accurately predicted the risk of CHD.Conclusion: The FRS and recalibrated FRS overestimated the 10-year risk of CHD for the Japanese population. A predictive score including CKD as a coronary risk factor for the Japanese population was more accurate for predicting CHD than the original Framingham risk scores in terms of the C-statics and NRI.

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Diagnosis of atherosclerosis

Journal of Atherosclerosis and Thrombosis 21 ( 4 ) 296 - 298 2014

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

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Comparison of HOMA-IR, HOMA-β% and disposition index between US white men and Japanese men in Japan

Ahuja Vasudha, Kadowaki Takashi, Evans Rhobert W., Kadota Aya, Okamura Tomonori, El Khoudary Samar R., Fujiyoshi Akira, Barinas-Mitchell Emma J M, Hisamatsu Takashi, Vishnu Abhishek, Miura Katsuyuki, Maegawa Hiroshi, El-Saed Aiman, Kashiwagi Atsunori, Kuller Lewis H., Ueshima Hirotsugu, Sekikawa Akira

Diabetologia 58 ( 2 ) 265 - 271 2014

Research paper (scientific journal), Joint Work, Accepted, ISSN 0012-186X

Aims/hypothesis: At the same level of BMI, white people have less visceral adipose tissue (VAT) and are less susceptible to developing type 2 diabetes than Japanese people. No previous population-based studies have compared insulin resistance and insulin secretion between these two races in a standardised manner that accounts for VAT. We compared HOMA-IR, HOMA of beta cell function (HOMA-β%) and disposition index (DI) in US white men and Japanese men in Japan.Methods: We conducted a population-based, cross-sectional study, comprising 298 white men and 294 Japanese men aged 40–49 years without diabetes. Insulin, glucose, VAT and other measurements were performed at the University of Pittsburgh. We used ANCOVA to compare geometric means of HOMA-IR, HOMA-β% and DI, adjusting for VAT and other covariates.Results: White men had higher HOMA-IR, HOMA-β% and DI than Japanese men, and the difference remained significant (p < 0.01) after adjusting for VAT (geometric mean [95% CI]): 3.1 (2.9, 3.2) vs 2.5 (2.4, 2.6), 130.8 (124.6, 137.3) vs 86.7 (82.5, 91.0), and 42.4 (41.0, 44.0) vs 34.8 (33.6, 36.0), respectively. Moreover, HOMA-IR, HOMA-β% and DI were significantly higher in white men even after further adjustment for BMI, impaired fasting glucose and other risk factors.Conclusions/interpretation: The higher VAT-adjusted DI in white men than Japanese men may partly explain lower susceptibility of white people than Japanese people to developing type 2 diabetes. The results, however, should be interpreted with caution because the assessment of insulin indices was made using fasting samples and adjustment was not made for baseline glucose tolerance. Further studies using formal methods to evaluate insulin indices are warranted.

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Statements

Journal of Atherosclerosis and Thrombosis 21 ( 4 ) 299 - 303 2014

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

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Long chain n-3 polyunsaturated fatty acids and incidence rate of coronary artery calcification in Japanese men in Japan and white men in the USA

Sekikawa Akira, Miura Katsuyuki, Lee Sunghee, Fujiyoshi Akira, Edmundowicz Daniel, Kadowaki Takashi, Evans Rhobert W., Kadowaki Sayaka, Sutton-Tyrrell Kim, Okamura Tomonori, Bertolet Marnie, Masaki Kamal H., Nakamura Yasuyuki, Barinas-Mitchell Emma J M, Willcox Bradley J., Kadota Aya, Seto Todd B., Maegawa Hiroshi, Kuller Lewis H., Ueshima Hirotsugu

Heart 100 ( 7 ) 569 - 573 2014

Research paper (scientific journal), Joint Work, Accepted, ISSN 1355-6037

Objective: To determine whether serum concentrations of long chain n-3 polyunsaturated fatty acids (LCn3PUFAs) contribute to the difference in the incidence rate of coronary artery calcification (CAC) between Japanese men in Japan and white men in the USA. Methods: In a population based, prospective cohort study, 214 Japanese men and 152 white men aged 40.49 years at baseline (2002.2006) with coronary calcium score (CCS)=0 were re-examined for CAC in 2007.2010. Among these, 175 Japanese men and 113 white men participated in the follow-up exam. Incident cases were defined as participants with CCS≥10 at follow-up. A relative risk regression analysis was used to model the incidence rate ratio between the Japanese and white men. The incidence rate ratio was first adjusted for potential confounders at baseline and then further adjusted for serum LCn3PUFAs at baseline. Results: Mean (SD) serum percentage of LCn3PUFA was >100% higher in Japanese men than in white men (9.08 (2.49) vs 3.84 (1.79), respectively, p<0.01). Japanese men had a significantly lower incidence rate of CAC compared to white men (0.9 vs 2.9/100 personyears, respectively, p<0.01). The incidence rate ratio of CAC taking follow-up time into account between Japanese and white men was 0.321 (95% CI 0.150 to 0.690; p<0.01). After adjusting for age, systolic blood pressure, low density lipoprotein cholesterol, diabetes, and other potential confounders, the ratio remained significant (0.262, 95% CI 0.094 to 0.731; p=0.01). After further adjusting for LCn3PUFAs, however, the ratio was attenuated and became non-significant (0.376, 95% CI 0.090 to 1.572; p=0.18). Conclusions: LCn3PUFAs significantly contributed to the difference in the incidence of CAC between Japanese and white men.

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Metabolic syndrome.

Journal of Atherosclerosis and Thrombosis 21 ( 1 ) 1 - 5 2014

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

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Diabetes mellitus

Journal of Atherosclerosis and Thrombosis 21 ( 2 ) 93 - 98 2014

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

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Familial hypercholesterolemia

Teramoto Tamio, Sasaki Jun, Ishibashi Shun, Birou Sadatoshi, Daida Hiroyuki, Dohi Seitaro, Egusa Genshi, Hiro Takafumi, Hirobe Kazuhiko, Iida Mami, Kihara Shinji, Kinoshita Makoto, Maruyama Chizuko, Ohta Takao, Okamura Tomonori, Yamashita Shizuya, Yokode Masayuki, Yokote Koutaro, Harada-Shiba Mariko, Arai Hidenori, Bujo Hideaki, Nohara Atsushi, Ohta Takao, Oikawa Shinichi, Okada Tomoo, Wakatsuki Akihiko

Journal of Atherosclerosis and Thrombosis 21 ( 1 ) 6 - 10 2014

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

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Other types of primary Hyperlipoproteinemia (Hyperlipidemia)

Journal of Atherosclerosis and Thrombosis 21 ( 2 ) 82 - 85 2014

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

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Coronary Artery Disease

Journal of Atherosclerosis and Thrombosis 21 ( 2 ) 86 - 92 2014

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

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High risks of all-cause and cardiovascular deaths in apparently healthy middle-aged people with preserved glomerular filtration rate and albuminuria

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

International Journal of Cardiology 170 ( 2 ) 167 - 172 2013.12

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

Background The reason why coexistence of preserved estimated glomerular filtration rate (eGFR) and albuminuria contributes to a high risk of death and which cause of death increases all-cause mortality have not been elucidated. Methods A total of 16,759 participants aged 40 to 69 years with normal or mildly reduced eGFR (45-119 ml/min/1.73 m²) were enrolled and divided into six groups (group 1, eGFR: 90-119 without albuminuria; group 2, eGFR: 90-119 with albuminuria; group 3, eGFR: 60-89 without albuminuria (reference); group 4, eGFR: 60-89 with albuminuria; group 5, eGFR: 45-59 without albuminuria; group 6, eGFR: 45-59 with albuminuria) based on GFR estimated by using the CKD-EPI study equation modified by a Japanese coefficient and albuminuria (urine albumin-creatinine ratio ≥ 30 mg/g). Outcomes included all-cause death (ACD), cardiovascular death (CVD) and neoplasm-related death (NPD). Multivariable-adjusted mortality rate ratios (RR) and their 95% confidence intervals (CIs) in the groups were estimated by Poisson's regression analysis. Results The highest risk of ACD (RR (95% CIs): 3.95 (2.08-7.52)), CVD (7.15 (2.25-22.7)) and NPB (3.25 (1.26-8.38)) was observed in group 2. Subjects in group 2 were relatively young and had the highest levels of body mass index, blood pressure and HbA_1c and the highest prevalence of diabetes and metabolic syndrome. Conclusion Coexistence of preserved eGFR and albuminuria increases risks for ACD, CVD and NPD. Relatively young metabolic persons having both preserved eGFR and albuminuria should be considered as a very high-risk population. © 2013 Elsevier Ireland Ltd.

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The economic and medical costs of alcohol consumption in Japan.

Kanda H, Okamura T

The West Indian medical journal 62 ( 9 ) 785 - 6 2013.12

ISSN 0043-3144

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