Papers - Okamura, Tomonori

Seasonal BMI Amplitude and Risk of Kidney Function Decline in Japanese Adults With Type 2 Diabetes (JDDM 82).

Toki R, Sakamoto M, Yuki M, Iida M, Yamazaki M, Ichikawa S, Horiuchi R, Maegawa H, Okamura T, Takebayashi T

Diabetes care  2026.04

ISSN  0149-5992

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Are changes in the urinary sodium-to-potassium ratio associated with changes in blood pressure in a healthy population with low urinary sodium-to-potassium ratios? Eight-year follow-up results from the KOBE Study.

Kawahara M, Tsukinoki R, Miyamatsu N, Kuwabara K, Kubo S, Kubota Y, Higashiyama A, Hirata A, Hirata T, Miyazaki J, Sugiyama D, Miyamoto Y, Okamura T

Hypertension research : official journal of the Japanese Society of Hypertension  2026.04

ISSN  0916-9636

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Little is known about the associations between changes in the urinary sodium-to-potassium (Na/K) ratio and blood pressure (BP) in healthy individuals. Using survey data, urinary data, and BP data from the KOBE Study, this longitudinal study aimed to assess the associations between changes in the urinary Na/K ratio and BP in a healthy Japanese population over an 8-year follow-up period. We analyzed 567 participants aged 40–74 years who did not initiate antihypertensive or cardiovascular disease treatment during follow-up. Changes in the spot urinary Na/K ratio and BP were calculated by subtracting the baseline values from the follow-up measurements, and their associations were examined using a multivariable linear regression analysis that adjusted for sex, age, body mass index, baseline Na/K ratio and BP, low-density lipoprotein, hemoglobin A1c, ethanol intake, smoking status, salt taste sensitivity, years of education, employment status, baseline survey season, and 8-year follow-up survey season. The study cohort had a mean spot urinary Na/K ratio of 2.1 at baseline. While BP increased significantly over the 8-year follow-up period, the urinary Na/K ratio remained unchanged. However, urinary Na/K ratio changes were positively associated with changes in systolic BP (β = 1.48, p = 0.001) and diastolic BP (β = 0.76, p = 0.004). In conclusion, increases in spot urinary Na/K ratios were predictive of long-term BP elevation in a healthy, normotensive population with near-optimal urinary Na/K ratios at baseline. These findings indicate that maintaining a low urinary Na/K ratio is important for BP control, even among healthy individuals. (Figure presented.)

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Cardiovascular Risk of Alcohol Consumption due to Renal Impairment: A 10-Year Prospective Study in a Community-Dwelling Japanese Population

Hirata, A; Harada, S; Iida, M; Matsumoto, M; Miyagawa, N; Toki, R; Edagawa, S; Shibuki, T; Kuwabara, K; Kohsaka, S; Izawa, Y; Sawano, M; Takizawa, T; Shoji, S; Katsumata, M; Sugiyama, D; Okamura, T; Takebayashi, T

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS  2026.03

ISSN  1340-3478

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Associations between Mobile Health Applications and Blood Pressure among Non-Patient Adults: A Systematic Review and Meta-Analysis.

Li Q, Ikeda A, Charvat H, Ohira T, Muraki I, Okamura T, Sato S, Miura M, Kamijima J, Ikeda S, Yamagishi K, Tanigawa T

American journal of hypertension  2026.02

ISSN  0895-7061

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Independent and combined associations of body mass index and visceral fat area with kidney function decline in a healthy Japanese urban population: a longitudinal study.

Enami MS, Hirata A, Kuwabara K, Miyazaki J, Kubota Y, Nishida Y, Kubo S, Hirata T, Uchida T, Kadota A, Higashiyama A, Sugiyama D, Nishikawa T, Miyamatsu N, Miyamoto Y, Okamura T

BMC nephrology 27 ( 1 ) 96 2026.01

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Background: Obesity has been linked to progressive loss of kidney function, but the independent and combined associations of body mass index (BMI) and visceral fat accumulation remain uncertain in healthy individuals. This study aimed to clarify the longitudinal relationship between BMI, visceral fat area (VFA), and chronic kidney disease (CKD), defined as an estimated glomerular filtration rate based on serum cystatin C (eGFRcys) < 60 mL/min/1.73 m² among the Kobe Study participants targeting healthy urban residents in Japan. Methods: A total of 897 participants (267 men, 630 women) without CKD and with a mean age of 61.4 years were analyzed. VFA was measured using the impedance method, and participants were followed for a median of 8.3 years. Participants were classified into four groups based on baseline BMI (kg/m²) and VFA (cm²): G1 (VFA < 100 and BMI < 25), G2 (VFA < 100 and BMI ≥ 25), G3 (VFA ≥ 100 and BMI < 25), G4 (VFA ≥ 100 and BMI ≥ 25). Multivariable linear regression models were used to estimate adjusted mean annual changes in eGFRcys, and Cox proportional hazards models were applied to calculate hazard ratios (HRs) for incident CKD, adjusting for potential confounders (age, sex, smoking status, alcohol consumption, dyslipidemia, diabetes, hypertension and eGFRcys at baseline). Results: During follow-up, 85 participants (9.5%) developed CKD. The adjusted mean annual decline in eGFRcys was − 2.17% in G1, − 3.29% in G2, − 2.81% in G3, and − 3.81% in G4. Compared with G1, both G3 and G4 showed an elevated risks of CKD incidence (G3: HR 2.40, 95% CI 1.14–5.05; G4: HR 3.89, 95% CI 2.17–6.98), whereas the confidence interval crossed 1 for G2 (HR 0.88, 95% CI 0.12–6.47). Participants in G4 exhibited the steepest decline in kidney function and the highest CKD incidence rate (49.2 per 1,000 person-years). Conclusions: In healthy adults, the combination of elevated BMI and VFA was associated with accelerated kidney function decline. These findings underscore the importance of evaluating visceral fat in addition to BMI for early identification of individuals at increased risk of CKD and enable preventive strategies. Clinical trial number: Not applicable.

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The Japanese Society of Hypertension Guidelines for blood pressure control using digital technologies

Arima H., Itoh H., Ohkubo T., Ohya Y., Kabayama M., Kishi T., Hirawa N., Miura K., Miura S.I., Yamamoto K., Yoshimura C., Rakugi H., Asayama K., Inoue T., Ohishi M., Kusaka M., Goto K., Shimosawa T., Nishiyama A., Hoshide S., Yano Y., Kaneko K., Uesugi F., Shigyo M., Suenaga E., Masujima T., Kawachi S., Okayama A., Miyakawa M., Miyamatsu N., Nakamura K., Saito I., Murakami Y., Ishida M., Kitagawa K., Ohnishi H., Okada H., Fujioka Y., Ogawa Y., Shide K., Inoue S., Naito Y., Tsukahara T., Kakuma T., Yoshida M., Takashima N., Yagita Y., Kuwabara M., Takahashi K., Hozawa A., Eguchi H., Mogi M., Metoki H., Mukoyama M., Mizuno A., Furuhashi M., Fujiyoshi A., Higashi Y., Node K., Toyoda K., Tsuchihashi T., Tamura K., Takemi Y., Sugawara A., Shibata H., Shibata S., Koriyama H., Kario K., Katsuya T., Kai H., Ogura S., Okamura T., Uehara Y., Ichihar A., yamashita S., hosoki S., satoh A., sakamoto Y., koyoshi R., maeda T., Yamazato M., Mori F., Fujii T., Haze T., Niijima T., Sakaguchi T., Kobayashi Y., Kitajima K., Akasaki Y., Akagi Y., Sakima A., Yoshida S., Yamanokuchi T., Morito N., Fujimoto T., Hirata T., Tada K., Takami Y., Takahashi K., Segawa H.

Hypertension Research 49 ( 4 ) 1087 - 1123 2026

ISSN  09169636

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Serum total apoptosis inhibitor of macrophage, metabolomic signatures, and incident dyslipidemia: A population-based prospective study

Toki R., Harada S., Arai S., Hirata A., Iida M., Miyagawa N., Edagawa S., Ishikawa T., Hirayama A., Sugimoto M., Okamura T., Miyazaki T., Takebayashi T.

Journal of Clinical Lipidology 20 ( 4 ) 806 - 816 2026

ISSN  19332874

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BACKGROUND The role of the apoptosis inhibitor of macrophages (AIM) in human lipid metabolism remains unclear. OBJECTIVE This study aimed to investigate the cross-sectional associations between serum AIM and plasma metabolites and to determine if baseline AIM concentrations predict incident dyslipidemia. METHODS This study used a community-based cohort of 3139 participants for cross-sectional metabolomic analysis. Among them, 1292 participants without dyslipidemia at baseline were followed prospectively for up to 8.5 years. Cox proportional hazards models were used to estimate hazard ratios for incident high low-density lipoprotein cholesterol and metabolic dyslipidemia (high triglycerides and/or low high-density lipoprotein cholesterol [HDL-C]) across AIM tertiles. RESULTS Cross-sectionally, higher AIM concentrations were associated with elevated acylcarnitines and tricarboxylic acid cycle intermediates. Longitudinally, higher baseline AIM was associated with an increased risk of developing metabolic dyslipidemia in women (highest vs lowest tertile hazard ratio, 1.84) and showed a similar but smaller nonsignificant trend in men. The risk for high low-density lipoprotein cholesterol was significantly increased in women but not in men. These associations remained robust after multivariable adjustment. CONCLUSION Elevated baseline AIM concentrations were prospectively associated with the development of metabolic dyslipidemia in women, with a similar but nonsignificant trend in men, and with high LDL-C in women. The related metabolomic profile suggests enhanced lipolysis and altered lipid metabolism. Therefore, AIM may serve as a biomarker for future dyslipidemia, particularly for triglyceride and HDL-C dysregulation.

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[Development of quality management checklists for medical facilities conducting workplace cancer screening programs].

Okada Y, Saika K, Tatemichi M, Okamura T, Saitoh E

Sangyo eiseigaku zasshi = Journal of occupational health 68 ( 2 ) 65 - 77 2025.12

ISSN  1341-0725

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Longitudinal study of plasma metabolites during menopause and their associations with later onset of metabolic syndrome.

Miyake A, Iida M, Harada S, Sugiyama D, Matsumoto M, Miyagawa N, Toki R, Edagawa S, Hirata A, Kuwabara K, Okamura T, Sato A, Amano K, Hirayama A, Sugimoto M, Soga T, Tomita M, Arakawa K, Kisu I, Yamagami W, Takebayashi T

The Journal of clinical endocrinology and metabolism  2025.12

ISSN  0021-972X

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Current Status of Cardiovascular Disease in Japan: Prevention Strategies, Future Challenges, and Fundamental Lessons

Okamura T., Hirata A.

Journal of the American College of Cardiology 86 ( 22 ) 2106 - 2108 2025.12

ISSN  07351097

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Association of repeated high serum osmolarity with cognitive function in older Japanese adults in a KOBE study subanalysis

Nishikawa T., Miyamatsu N., Higashiyama A., Kubota Y., Nishida Y., Hirata T., Hirata A., Miyazaki J., Tatsumi Y., Sugiyama D., Kuwabara K., Kubo S., Miyamoto Y., Okamura T.

Scientific Reports 15 ( 1 ) 36784 2025.12

ISSN  2045-2322

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The relationship between serum osmolarity and cognitive function has not been fully characterized. This study aimed to examine the cross-sectional association between repeated high serum osmolarity and cognitive performance among elderly community residents. We performed a subanalysis of the Kobe Orthopedic and Biomedical Epidemiological Study, including residents aged ≥ 75 years who completed the Japanese Montreal Cognitive Assessment (MoCA-J) in 2016–2017 (n = 127), 2018–2019 (n = 71), and 2020 (n = 16). Serum osmolarity was obtained from the data in the 2012–2013 survey and in the 2016–2017 survey. MoCA-J scores were dichotomized at ≤ 22 versus > 22. Multivariate logistic regression adjusted for demographic, lifestyle including daily non-alcohol drink intake, seasonal, and clinical covariates to assess associations between osmolarity status and cognitive group. Among 214 participants (mean age 76.2 ± 1.3 years; 56% female), high osmolarity (≥ 300 mOsm/L) in 2012–2013 was associated with MoCA-J ≤ 22 (OR 2.67, 95% CI 1.29–5.53, p = 0.008). A similar association emerged for 2016–2017 measurements (OR 6.12, 95% CI 1.46–25.61, p = 0.013). Participants with high serum osmolarity at both time points showed a stronger cross-sectional association with lower MoCA-J scores (OR 17.64, 95% CI = 1.8–184.83, p = 0.017). No significant association was observed between daily non-alcoholic drink (NAD) intake and either MoCA-J scores or serum osmotic pressure. Repeated high serum osmolarity was cross-sectionally associated with lower cognitive performance in Japanese community-dwelling older adults. While NAD intake showed no significant association, further research is needed to explore the potential role of serum osmolarity in cognitive health. These findings warrant confirmation in larger prospective studies.

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The JSH Morning Hypertension Eradication Program Project

Kario, K; Nishiyama, A; Shibata, S; Mogi, M; Arima, H; Kishi, T; Ishida, M; Furuhashi, M; Ichihara, A; Katsuya, T; Miura, K; Miura, SI; Ohishi, M; Shibata, H; Shimosawa, T; Sugawara, A; Tamura, K; Toyoda, K; Yamamoto, K; Hoshide, S; Nakagawa, N; Tomita, H; Tanaka, A; Hozawa, A; Hatta, T; Nomura, A; Kabayama, M; Rakugi, H; Ohya, Y; Node, K; Kai, HSS; Arakawa, K; Kawarazaki, W; Okamura, T; Takemi, Y; Kaneko, H; Shinohara, K; Hirawa, N; Sakima, A; Ohkubo, T; Asayama, K; Tomitani, N

HYPERTENSION RESEARCH 48 ( 11 ) 2771 - 2780 2025.11

ISSN  0916-9636

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[Comparison of estimated salt and potassium intake and urinary sodium-to-potassium ratio based on casual urine: A 10-year follow-up of NIPPON DATA2010].

Kitaoka K, Kadota A, Yoshita K, Okami Y, Kondo K, Harada A, Okuda N, Ohkubo T, Okamura T, Miura K

[Nihon koshu eisei zasshi] Japanese journal of public health 73 ( 2 ) 139 - 146 2025.10

ISSN  0546-1766

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Low-Density-Lipoprotein Cholesterol Control and Treatment Status 1 Year after the Initial Health Checkup in Individuals with Referral-Level LDL Cholesterol.

Aoki H, Kitaoka K, Suzuki Y, Kaneko H, Okada A, Takeda N, Morita H, Hiroi Y, Node K, Furui Y, Okamura T, Miura K, Yasunaga H, Takeda N

Journal of atherosclerosis and thrombosis 33 ( 2 ) 204 - 215 2025.09

ISSN  1340-3478

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Aims: Despite strong recommendations for medical consultation, the treatment status and low-density lipoprotein cholesterol (LDL-C) levels at 1-year follow-up of individuals with referral-level LDL-C identified in health checkups remain unclear. We evaluated the treatment status and 1-year LDL-C control among individuals identified in health checkups as requiring early medical consultation due to LDL-C levels of ≥ 180 mg/dL. Methods: We conducted a nationwide cohort study including health checkup data for individuals aged 20–74 years. We identified 102,049 individuals (median age: 48 years; male: 66.8%) with uncontrolled LDL-C (≥ 180 mg/dL) at baseline, who had no prior lipid-lowering therapy. Poisson regression with robust error variance was used to assess factors associated with uncontrolled LDL-C at 1 year. Results: Among individuals with LDL-C ≥ 180 mg/dL at baseline, 56,147 (55.0%) visited a medical institution within 3 months of the checkup, and 13,124 (12.9%) were prescribed lipid-lowering medications at 1 year. At 1 year follow-up, 49,260 (48.3%) still had LDL-C ≥ 180 mg/dL. Factors associated with persistent LDL-C ≥ 180 mg/dL at 1 year included obesity (RR: 1.07, [95% CI: 1.06–1.09]), 10 mg/dL increase in LDL-C at baseline (1.11 [1.10–1.11]), smoking (1.05 [1.04–1.07]), alcohol consumption (0.95 [0.94–0.97]), poor sleep quality (1.02 [1.01–1.03]), and skipping breakfast ≥ 3 times per week (1.07 [1.05–1.08]). Conclusions: Despite being classified as requiring early medical intervention, only half of individuals with LDL-C ≥ 180 mg/dL visited a physician within 3 months, and nearly half continued to have uncontrolled LDL-C at 1 year. Strategies to facilitate timely medical visits and appropriate lipid management in health checkup-identified cases are warranted.

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Effectiveness of recommendations in promoting the use of Mobile health applications in health guidance: a randomized controlled trial.

Onoue T, Nishida K, Nakata Y, Hayashi F, Marutani M, Sakane N, Moriguchi J, Muto S, Kato K, Masuda I, Okamura T, Matsuzaki K, Kawamura T, Tsushita K

Journal of occupational health 67 ( 1 )  2025.07

ISSN  1341-9145

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Objectives: Use of commercially available mobile health (mHealth) applications in supporting lifestyle improvements has become popular in recent years. However, the effectiveness of advice promoting the use of such applications based on individual behavioral goals in a health guidance setting remains unclear. This study explored how guiding participants of the Specific Health Guidance (SHG) program, a Japanese public health initiative to prevent cardiovascular disease, to use commercially available mHealth applications impacted their application usage, lifestyle habits, and cardiovascular risk factors. Methods: In this multicenter, randomized, open-label, parallel-group comparison study, 156 individuals with a history of SHG participation and who were engaged in the Motivational Health Guidance program (a type of SHG) in 2021 were assigned to intervention (n = 76) or control (n = 80) groups. Whereas both groups received standard guidance, the intervention group also received recommendations for mHealth applications based on their individual behavioral goals. The participants' application usage, behavioral changes, and body weight were assessed after 3 months, with health checkup data evaluated after 1 year. Results: The proportion of mHealth application users after 3 months was significantly higher in the intervention group (68.4%) than in the control group (40.0%). The intervention group also reported a significantly greater weekly frequency of mHealth application usage. Moreover, the intervention group reported a significantly decreased change in triglyceride levels after 1 year compared with the control group. Conclusions: Recommending commercially available mHealth applications in a health guidance setting significantly increased the number of mHealth application users and their frequency of use.

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Association of Social Participation with Cardiovascular Risk Factors: A Systematic Review.

Miura M, Ikeda A, Sato S, Muraki I, Okamura T, Ohira T, Miyazaki J, Ishihara M, Okamoto K, Kamijima J, Li Q, Ikeda S, Yamagishi K, Tanigawa T

Journal of atherosclerosis and thrombosis 32 ( 8 ) 897 - 910 2025.05

ISSN  1340-3478

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Aim: Although social participation, defined as involvement in social activities, may be beneficial for cardiovascular health, evidence about the association remains limited. This systematic review summarized the relationship between social participation and cardiovascular risk factors. Methods: Original articles of longitudinal observational studies published in English before January 1, 2024, were searched via PubMed, Scopus, and Cochrane Library. Two investigators selected eligible literature for four health outcomes: hypertension, diabetes, dyslipidemia, and obesity. Results: Eight articles (including duplicates) covering cohort studies were included. The results indicated that social participation is associated with lower hypertension risk, but gender differences may exist in the association between social participation and hypertension. Two articles from a Japanese cohort study were found on diabetes, both of which reported significant preventive association with social participation. The only study on dyslipidemia showed a higher hyperlipidemia risk among women, but not men, with social participation. Two studies on the risk of obesity showed inconsistent results, with one reporting the association between social participation and maintenance of smaller waist circumference only among men, while the other found no association with body mass index. Conclusions: There is some evidence of the association between social participation and better cardiovascular health outcomes. However, evidence on gender differences and validation of the methodology for measuring social participation was still lacking.

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Serum Total Cholesterol and Fatal Subarachnoid Hemorrhage in 120,000 Japanese: A Pooled Analysis of Data from 12 Cohorts.

Satoh A, Arima H, Tanaka-Mizuno S, Fujiyoshi A, Kadota A, Miura K, Ueshima H, Okamura T, Murakami Y, EPOCH JAPAN Research Group

Journal of atherosclerosis and thrombosis 32 ( 11 ) 1425 - 1433 2025.05

ISSN  1340-3478

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Aim: The aim of this study was to clarify the association between serum total cholesterol and fatal subarachnoid hemorrhage in Japanese men and women. Methods: The study involved a pooled analysis of individual data from 12 well-qualified cohort studies conducted in Japan. The participants were classified according to their serum total cholesterol levels: ＜4.14 mmol/L (＜160 mg/dL), 4.14–4.64 mmol/L (160–180 mg/dL), 4.65–5.16 mmol/L (180–199 mg/dL), 5.17–5.68 mmol/L (200–219 mg/dL), 5.69–6.20 mmol/L (220–239 mg/dL), and ≥ 6.21 mmol/L (≥ 240 mg/dL). The outcome of the analysis was death from subarachnoid hemorrhage. Results: A total of 120,973 participants (70,947 women and 50,026 men) aged 18–96 years at baseline underwent follow-up for a median of 12.7 years, and 261 participants died from subarachnoid hemorrhage during this period. In women, both low (＜5.69 mmol/L [＜220 mg/dL]) and high (≥ 6.21 mmol/L [≥ 240 mg/ dL]) serum total cholesterol levels were significantly associated with a higher risk of fatal subarachnoid hemorrhage compared with the reference group (5.69–6.20 mmol/L [220–239 mg/dL]). These associations remained significant after adjustment for confounding factors. In contrast, no associations were observed in men. Conclusion: Both low and high serum total cholesterol levels were associated with a higher risk of fatal subarachnoid hemorrhage in 70,947 female participants from 12 cohort studies throughout Japan.

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Cross-Sectional Association between Sedentary Behavior and Physical Inactivity with Cardiometabolic Risk Factors among Japanese: The NIPPON DATA2010.

Ohashi M, Miyagawa N, Yanagita M, Okuda N, Fujiyoshi A, Ohkubo T, Kadota A, Okami Y, Kondo K, Harada A, Okamura T, Ueshima H, Okayama A, Miura K, NIPPON DATA2010 Research Group

Journal of atherosclerosis and thrombosis 32 ( 10 ) 1328 - 1346 2025.05

ISSN  1340-3478

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Aim: Sedentary behavior and physical inactivity increase the risk of cardiometabolic diseases. It is important to evaluate physical activity in daily life and understand the influence of these factors on cardiometabolic diseases in the Japanese population, which tends to have a prolonged sitting time. We examined the association between sedentary behavior and physical inactivity, characterized by extended television (TV) viewing and low step counts, which are easily monitored and modifiable, and cardiometabolic risk factors in the Japanese population. Methods: This cross-sectional study included 2,531 Japanese adults (1,087 men and 1,444 women) 20–91 years old, randomly selected throughout Japan. TV viewing was assessed using a self-reported questionnaire, and step counts were measured using pedometers. Cardiometabolic risk factors were determined using physical examinations or blood samples. The association between sedentary behavior and physical inactivity with each risk factor was examined using a cross-sectional analysis with multivariate-adjusted logistic regression models. Results: In both sexes, longer TV viewing positively correlated with low high-density lipoprotein (HDL) cholesterol and high triglycerides (TG). In women, TV viewing time is associated with obesity and increased abdominal circumference (AC). Conversely, in men, lower step counts were positively associated with obesity and increased AC, low HDL cholesterol, and high TG levels. Conclusions: The association between prolonged TV viewing and cardiometabolic risk factors was more pronounced in women than in men, whereas the influence of lower step counts was stronger in men than in women. These findings contribute to the improvement of cardiovascular health by monitoring and managing individual screen times and step counts in daily life.

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Genome-wide association study of plasma amino acids and Mendelian randomization for cardiometabolic traits.

Toki R, Fushiki S, Kojima S, Sutoh Y, Otsuka-Yamasaki Y, Harada S, Iida M, Hirata A, Miyagawa N, Matsumoto M, Edagawa S, Miyake A, Kuwabara K, Hirayama A, Sugimoto M, Sato A, Amano K, Soga T, Tomita M, Arakawa K, Kinoshita K, Sakurai-Yageta M, Tamiya G, Ohmomo H, Shimizu A, Okamura T, Takebayashi T

Scientific reports 15 ( 1 ) 14569 2025.04

ISSN  2045-2322

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Plasma amino acids (AAs) have emerged as promising biomarkers for metabolic disorders, yet their causality remains unclear. We aimed to investigate the genetic determinants of AA levels in a cohort of 10,333 individuals and their causal effects on cardiometabolic traits using Mendelian randomization (MR). Plasma levels of 20 AAs were quantified using capillary electrophoresis mass spectrometry. Genome-wide association studies were conducted using BOLT-LMM and heritability estimation via LDSC analysis. Causal effects of AAs on 11 cardiometabolic traits were examined using two-sample MR analyses. We identified 85 locus-metabolite associations across 43 genes for 18 AAs, including 44 novel loci linked to metabolic genes. Heritability for AAs was estimated at 16%. MR analysis demonstrated cystine to positively associate with systolic blood pressure (SBP) (β = 0.056, SE = 0.010), while serine indicated protective effects on SBP (β = − 0.040, SE = 0.011), diastolic BP (β = − 0.044, SE = 0.010), and coronary artery disease (odds ratio 0.888, SE = 0.028). We identified potentially novel genetic loci associated with AA levels and demonstrated robust causal associations between several AAs and cardiometabolic traits. These findings reinforce the importance of AAs as potential biomarkers and therapeutic targets in cardiometabolic health.

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A Randomized Clinical Trial of ICT-based Interventions for Sodium and Potassium Regulation in Healthy Adults.

Yano Y, Kitaoka K, Ohkubo T, Okamura T, Kanegae H, Yoshita K, Tsukinoki R, Okami Y, Node K, Rakugi H, Itoh H, Miura K

American journal of hypertension 38 ( 8 ) 588 - 594 2025.04

ISSN  0895-7061

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BACKGROUND: There is limited knowledge regarding effective strategies, including information and communication technology (ICT)-based interventions, to reduce sodium intake and increase potassium intake in healthy individuals. METHODS: We conducted a 3-month randomized controlled trial involving healthy adult employees with spot urine sodium-to-potassium ratios (spot UNa/UK) ≥4.0 or estimated 24-hour salt intake ≥10g. Estimated 24-hour UNa and UK were calculated using the Tanaka formula. Participants were assigned to one of four groups: (i) online education, where participants monitored their spot UNa/UK and received feedback from dieticians (n = 84); (ii) messaging, with similar self-monitoring and dietician messages (n = 84); (iii) self-learning, provided with an educational leaflet (n = 87); and (iv) a control group (n = 87). The primary outcome was the change in spot UNa/UK ratios, and secondary outcomes included changes in estimated 24-hour UNa and UK. The trial protocol specified a hierarchical order for testing the interventions, anticipating the highest efficacy in the online education group. RESULTS: After the intervention, the online education group showed a decrease in spot UNa/UK ratios (mean -0.9 (95% CI: -1.8 to 0.0), P = 0.052) compared to the control group. The increase in estimated 24-hour UK excretion was larger in online education compared to the control group (mean + 2.5 mmol/day (95% CI: -0.3 to 5.3), P = 0.085). The difference in estimated 24-hour UNa excretion between the online education and control groups was -4.3 mmol/day (95% CI: -15.5 to 6.9, P = 0.45). CONCLUSIONS: Combining self-monitoring of sodium and potassium intake with ICT-based interventions, including online nutritional education, was associated with a modest reduction in the estimated ratios of sodium and potassium intake in healthy individuals.

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