Papers - Okamura, Tomonori

動脈硬化性疾患の絶対リスクの評価と脂質管理目標．

岡村 智教、杉山大典．

日本臨床 (日本臨床社)  71 ( 増刊号3 ) 29-35. 2013

Research paper (scientific journal), Joint Work

Influence of cigarette smoking on coronary artery and aortic calcium among random samples from populations of middle-aged Japanese and Korean men

Hirooka Nobutaka, Kadowaki Takashi, Sekikawa Akira, Ueshima Hirotsugu, Choo Jina, Miura Katsuyuki, Okamura Tomonori, Fujiyoshi Akira, Kadowaki Sayaka, Kadota Aya, Nakamura Yasuyuki, Maegawa Hiroshi, Kashiwagi Atsunori, Masaki Kamal, Sutton-Tyrrell Kim, Kuller Lewis H., Curb J. David, Shin Chol

Journal of Epidemiology and Community Health 67 ( 2 ) 119 - 124 2013

Research paper (scientific journal), Joint Work, Accepted,  ISSN  0143-005X

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<p>Background: Cigarette smoking is a risk factor of coronary heart disease. Vascular calcification such as coronary artery calcium (CAC) and aortic calcium (AC) is associated with coronary heart disease. The authors hypothesised that cigarette smoking is associated with coronary artery and aortic calcifications in Japanese and Koreans with high smoking prevalence. Methods: Random samples from populations of 313 Japanese and 302 Korean men aged 40e49 years were examined for calcification of the coronary artery and aorta using electron beam CT. CAC and AC were quantified using the Agatston score. The authors examined the associations of cigarette smoking with CAC and AC after adjusting for conventional risk factors and alcohol consumption. Current and past smokers were combined and categorised into two groups using median pack-years as a cut-off point in each of Japanese and Koreans. The never-smoker group was used as a reference for the multiple logistic regression analyses. Results: The ORs of CAC (score $10) for smokers with higher pack-years were 2.9 in Japanese (p&lt;0.05) and 1.3 in Koreans (non-significant) compared with neversmokers. The ORs of AC (score $100) for smokers with higher pack-years were 10.4 in Japanese (p&lt;0.05) and 3.6 in Koreans (p&lt;0.05). Conclusion Cigarette smoking with higher pack-years is significantly associated with CAC and AC in Japanese men, while cigarette smoking with higher pack-years is significantly associated with AC but not significantly with CAC in Korean men.</p>

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Absolute risk of cardiovascular disease and lipid management targets

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

Journal of Atherosclerosis and Thrombosis 20 ( 9 ) 689 - 697 2013

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

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The clustering of cardiovascular disease risk factors and their impacts on annual medical expenditure in japan

Murakami Yoshitaka, Okamura Tomonori, Nakamura Koshi, Miura Katsuyuki, Ueshima Hirotsugu

BMJ Open 3 ( 3 )  2013

Research paper (scientific journal), Joint Work, Accepted

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<p>Objective: The clustering of cardiovascular disease (CVD) risk factors is a serious threat for increasing medical expenses. The age-specific proportion and distribution of medical expenditure attributable to CVD risk factors, especially focused on the elderly, is thus indispensable for formulating public health policy given the extent of the ageing population in developed countries. Design: Cost analysis using individuals' medical expenses and their corresponding health examination measures. Setting: Shiga prefecture, Japan, from April 2000 to March 2006. Participants: 33 213 participants aged 40 years and over. Main outcome measures: Mean medical expenditure per year. Methods: Gamma regression models were applied to examine how the number of CVD risk factors affects mean medical expenditure. The four CVD risk factors analysed in this study were defined as follows: hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg), hypercholesterolaemia (serum total cholesterol ≥240 mg/dl), high blood glucose (casual blood glucose ≥200 mg/dl) and smoking (current smoker). Sex-specific and age-specific investigations were carried out on the elderly (aged 65 and over) and nonelderly (aged 40-64) populations. Results: The mean medical expenditure (per year) for the no CVD risk-factor group was only 110 000 yen at age 50 (men, 110 708 yen; women, 107 109 yen), but this expenditure was 6-7 times higher for 80-year-olds who have three or four CVD risk factors (men, 603 351 yen; women, 765 673 yen). The total overspend (excess fraction) was larger for the non-elderly (men, 15.4%; women, 11.1%) than that for the elderly (men, 0.1%; women, 5.2%) and largely driven by people with one or two CVD risk factors, except for elderly men. Conclusions: The age-specific proportion and distribution of medical expenditure attributable to CVD risk factors showed that a high-risk approach for the elderly and a population approach for the majority are both necessary to reduce total medical expenditure in Japan.</p>

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Fatty acid intakes and coronary heart disease mortality in Japan

Nakamura Yasuyuki, Kiyohara Yutaka, Okuda Nagako, Okamura Tomonori, Higashiyama Aya, Watanabe Makoto, Kadota Aya, Nagasawa Shin ya, Miyagawa Naoko, Ohkubo Takayoshi, Kita Yoshikuni, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu

Current Nutrition and Food Science 9 ( 1 ) 26 - 32 2013

Research paper (scientific journal), Joint Work, Accepted,  ISSN  1573-4013

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<p>Associations between dietary fatty acid intakes and risk of coronary heart disease (CHD) are not entirely consistent in prospective studies in the U.S. and Europe. Such studies in Japan are rare. The objective of this study was to examine the association between dietary total, saturated (SFA), and polyunsaturated (PUFA) fatty acids, cholesterol intake and CHD mortality using the dataset of NIPPON DATA90. At the baseline in 1990, we performed blood biochemical measurements and a nutritional survey on participants from 300 randomly selected districts. After exclusion of participants with a history of CHD and/or stroke at the baseline, we followed 7,819 community residents (3,254 men and 4,565 women, age ≥ 30) for 15 years. We estimated individual nutrient intakes among family members by weighed food records in three consecutive representative days. During the follow-up, there were 42 CHD deaths in men and 30 in women. Mean daily SFA and PUFA % calorie intakes were 5.90±1.36%, and 5.59±1.30%, respectively in men, and 6.48±1.53%, and 6.08±1.14% in women. A Cox analysis adjusted for age, vegetable and fruit intakes, and other confounders in women found that SFA intake was significantly associated with CHD mortality (hazards ratio per one quintile increment=1.34, 95% confidence intervals: 1.02-1.74, P=0.03), while no such association was noted in men. No associations were found between other fat intakes and CHD mortality in men or women. In conclusion, SFA intake was positively associated with CHD mortality independent of confounders in women, but not in men. © 2013 Bentham Science Publishers.</p>

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Consumption of dairy products and death from cardiovascular disease in the Japanese General Population

Kondo Imako, Ojima Toshiyuki, Nakamura Mieko, Hayasaka Shinya, Hozawa Atsushi, Saitoh Shigeyuki, Ohnishi Hirofumi, Akasaka Hiroshi, Hayakawa Takehito, Murakami Yoshitaka, Okuda Nagako, Miura Katsuyuki, Okayama Akira, Ueshima Hirotsugu, Okamura Tomonori, Sakata Kiyomi, Nakamura Yosikazu, Matsumura Yasuhiro, Nishi Nobuo, Kasagi Fumiyoshi, Izumi Toru, Tamakoshi Koji, Nakagawa Hideaki, Ohkubo Takayoshi, Kita Yoshikuni, Nakamura Yasuyuki, Yoshita Katsushi, Kadota Aya, Kodama Kazunori, Kiyohara Yutaka

Journal of Epidemiology 23 ( 1 ) 47 - 54 2013

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

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<p>Background: Recent Western studies show an inverse association between milk and dairy product intake and cardiovascular disease (CVD). We studied the association between consumption of milk and dairy products and CVD death in Japan. Methods: Men and women aged 30 years or older were followed for 24 years. All had participated in a national nutrition survey in 300 health districts throughout Japan in 1980. The Cox proportional hazards model was used to assess mortality risk according to tertiles of milk and dairy product intake, with the high consumption group as reference. Hazard ratios (HRs) per 100-g/day increase in consumption were also estimated. Results: During the 24-year follow-up period, there were 893 CVD deaths, 174 deaths from coronary heart disease (CHD), and 417 stroke deaths among 9243 participants. For women, the HRs for death from CVD, CHD, and stroke in the low consumption group were 1.27 (95% CI: 0.99-1.58; P for trend = 0.045), 1.67 (0.99-2.80; P = 0.02), and 1.34 (0.94-1.90; P = 0.08), respectively, after adjustment for age, body mass index, smoking status, alcohol drinking habits, history of diabetes, use of antihypertensives, work category, and total energy intake. With each 100-g/day increase in consumption of milk and dairy products, HRs tended to decrease for deaths from CVD (HR, 0.86; 95% CI, 0.74-0.99), CHD (0.73; 0.52-1.03), and stroke (0.81; 0.65-1.01) in women. No significant association was observed in men. Conclusions: Consumption of milk and dairy products was inversely associated with CVD death among women in Japan. © 2012 by the Japan Epidemiological Association.</p>

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Treatment B) drug therapy

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

Journal of Atherosclerosis and Thrombosis 20 ( 12 ) 850 - 860 2013

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

Small dense low-density lipoproteins cholesterol can predict incident cardiovascular disease in an urban Japanese cohort

Arai Hidenori, Kokubo Yoshihiro, Watanabe Makoto, Sawamura Tatsuya, Ito Yasuki, Minagawa Asako, Okamura Tomonori, Miyamato Yoshihiro

Journal of Atherosclerosis and Thrombosis 20 ( 2 ) 195 - 203 2013

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

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<p>Aim: Several lines of evidence indicate that small dense low-density lipoproteins (sd-LDL) are more atherogenic than large buoyant LDL; however, few prospective studies have addressed the role of sd-LDL in cardiovascular disease (CVD). We therefore examined the association between sd-LDL cholesterol (sd-LDL-C) and CVD in a Japanese cohort. Methods: An 11.7-year prospective study was performed using a general population aged 30-79 without a history of cardiovascular disease. Direct LDL-C and sd-LDL-C were measured in samples from 2034 participants (968 men and 1066 women). Results: During the follow-up period, there were 116 incident cases of CVD. The multivariableadjusted hazard ratios (HRs) of sd-LDL-C for CVD were calculated using a proportional hazards regression model after adjusting for age, hypertension, diabetes, use of lipid-lowering drugs, body mass index, and current smoking and alcohol drinking, and found that increasing quartiles of sd-LDL-C were associated with increased risk of CVD. We also determined that age and sex-adjusted HRs per 10 mg/dL of sd-LDL-C and HRs for CVD, stroke, cerebral infarction, and coronary artery disease were 1.21 (95% CI: 1.12-1.31), 1.17 (95% CI: 1.05-1.30), 1.15 (95% CI: 1.00-1.33), and 1.29 (95% CI: 1.14-1.45), respectively. Conclusions: It was demonstrated that sd-LDL-C was significantly associated with CVD in a Japanese population, providing evidence of sd-LDL-C as an important biomarker to predict CVD.</p>

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Relation of serum leptin and adiponectin level to serum C-reactive protein

Nakamura Yasuyuki, Ueshima Hirotsugu, Okuda Nagako, Miura Katsuyuki, Kita Yoshikuni, Okamura Tomonori, Okayama Akira, Choudhury Sohel R., Rodriguez Beatriz, Masaki Kamal H., Stamler Jeremiah

International Journal of Vascular Medicine 2013   601364 2013

Research paper (scientific journal), Joint Work, Accepted,  ISSN  2090-2824

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<p>Objective. Despite considerable study, the relevance of leptin and adiponectin for atherosclerosis development is still unsettled. We investigated relations of serum leptin and adiponectin to serum C-reactive protein (CRP), using the INTERLIPID dataset on Japanese emigrants living in Hawaii and Japanese in Japan. Design and Methods. Serum leptin, adiponectin, and CRP were measured by standardized methods in men and women of ages 40 to 59 years from two population samples, one Japanese-American in Hawaii (83 men, 89 women) and the other Japanese in central Japan (111 men, 104 women). Participants with CRP &gt;10 mg/L were excluded. Results. Sex-specific multiple linear regression analyses, with log-transformed leptin and adiponectin (log-leptin, log-adipo), site (Hawaii = 1, Japan = 0), SBP, HbA1c, smoking (cigarettes/day), and physical activity index score of the Framingham Offspring Study as covariates, showed that log-leptin directly related and log-adipo inversely related to log-CRP for both sexes (P s &lt; 0.05 to &lt;0.01). Addition to the model of BMI and interaction terms (BMI × log-leptin, BMI × log-adipo, SITE × log-leptin, SITE × log-adipo) resulted in disappearance of statistical significance except for direct relation of log-leptin to log-CRP in men (P = 0.006). Conclusions. Leptin directly related to CRP independent of BMI and other confounding factors in men but not in women. © 2013 Yasuyuki Nakamura et al.</p>

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Executive summary of the japan atherosclerosis society (JAS) guidelines for the diagnosis and prevention of atherosclerotic cardiovascular diseases in Japan-2012 version

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

Journal of Atherosclerosis and Thrombosis 20 ( 6 ) 517 - 523 2013

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

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Effect of age on the association between waist-to-height ratio and incidence of cardiovascular disease

Tatsumi Yukako, Watanabe Makoto, Kokubo Yoshihiro, Nishimura Kunihiro, Higashiyama Aya, Okamura Tomonori, Okayama Akira, Miyamoto Yoshihiro

Journal of Epidemiology 23 ( 5 ) 351 - 359 2013

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

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<p>Background: Waist-to-height ratio (WHtR) has been shown to be a useful screening tool for metabolic syndrome and cardiovascular disease (CVD). We investigated the association of WHtR with CVD incidence by age group. Methods: We conducted a 13.0-year cohort study of Japanese adults (2600 men and 2888 women) with no history of CVD. WHtR was calculated as waist circumference (cm) (WC) divided by height (cm). We stratified participants by sex and age group (30-49, 50-69, ≥70 years). Using the Cox proportional hazards model, we calculated hazard ratios (HRs) and 95% CIs for CVD in relation to WHtR quartile for participants aged 50 to 69 years and 70 years or older. Results: Men aged 50 to 69 years in the highest quartile had significantly increased risks of CVD and coronary heart disease as compared with the lowest quartile; the HRs (95% CI) were 1.82 (1.13-2.92) and 2.42 (1.15-5.12), respectively. Women aged 50 to 69 years in the highest quartile had a significantly increased risk of stroke (HR, 2.43; 95% CI, 1.01-5.85). No significant results were observed in men or women aged 70 years or older. The likelihood ratio test showed that the predictive value of WHtR was greater than that of WC among men aged 50 to 69 years. Conclusions: The association between WHtR and CVD risk differed among age groups. WHtR was useful in identifying middle-aged Japanese at higher risk of CVD and was a better predictor than WC of CVD, especially in men. © 2013 Yukako Tatsumi et al.</p>

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Association between J-point elevation and death from coronary artery disease

Hisamatsu Takashi, Ohkubo Takayoshi, Miura Katsuyuki, Yamamoto Takashi, Fujiyoshi Akira, Miyagawa Naoko, Kadota Aya, Takashima Naoyuki, Nagasawa Shin ya, Kita Yoshikuni, Murakami Yoshitaka, Okayama Akira, Horie Minoru, Okamura Tomonori, Ueshima Hirotsugu

Circulation Journal 77 ( 5 ) 1260 - 1266 2013

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

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<p>Background: An early repolarization pattern, characterized by an elevation of the QRS-ST junction (J-point) on 12-lead electrocardiography (ECG) is associated with cardiac and sudden death. However, little is known about the prognostic significance of J-point elevation for various disease-specific cardiovascular outcomes, including coronary artery disease (CAD). Methods and Results: To investigate the association between the presence of J-point elevation ≥0.1 mV and various disease-specific cardiovascular outcomes, we conducted a 15-year prospective study in a representative general Japanese population of 7,630 individuals (41% men, mean age 52.4 years) who participated in the National Survey of Circulatory Disorders. Cox models were used to estimate the hazard ratios (HRs) adjusted for possible confounding factors. J-point elevation was present in 264 individuals (3.5%) and was associated with an increased risk of cardiac death (adjusted HR, 2.54; 95% confidence interval [CI] 1.40-4.58; P=0.002) and death from CAD (adjusted HR, 4.66; 95% CI 2.30-9.46; P&lt;0.001). In a subgroup analysis by age, the association between J-point elevation and cardiovascular outcomes was more remarkable in middle-aged (&lt;60 years) than in older individuals (≥60 years) (all P for interaction &lt;0.05). Conclusions: J-point elevation on standard 12-lead ECG was an independent predictor of cardiac death and death from CAD in a representative sample of the general Japanese population, particularly among the middle-aged.</p>

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Treatment A) lifestyle modification

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

Journal of Atherosclerosis and Thrombosis 20 ( 12 ) 835 - 849 2013

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

Other high-risk conditions

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

Journal of Atherosclerosis and Thrombosis 20 ( 11 ) 785 - 789 2013

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

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Comprehensive risk management for the prevention of cardiovascular disease

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

Journal of Atherosclerosis and Thrombosis 20 ( 7 ) 603 - 615 2013

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

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Carotid intima-media thickness and plaque in apparently healthy Japanese individuals with an estimated 10-year absolute risk of CAD death according to the Japan atherosclerosis society (JAS) guidelines 2012

Kadota Aya, Miura Katsuyuki, Okamura Tomonori, Fujiyoshi Akira, Ohkubo Takayoshi, Kadowaki Takashi, Takashima Naoyuki, Hisamatsu Takashi, Nakamura Yasuyuki, Kasagi Fumiyoshi, Maegawa Hiroshi, Kashiwagi Atsunori, Ueshima Hirotsugu

Journal of Atherosclerosis and Thrombosis 20 ( 10 ) 755 - 766 2013

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

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<p>Aim: To examine whether subclinical atherosclerosis of the carotid arteries is concordant with the categories in the 2012 atherosclerosis prevention guidelines proposed by the Japan Atherosclerosis Society (JAS guidelines 2012), which adopted the estimated 10-year absolute risk of coronary artery disease (CAD) death in the NIPPON DATA80 Risk Assessment Chart. Methods: Between 2006 and 2008, 868 Japanese men 40 to 74 years of age without a history of cardiovascular disease were randomly selected from Kusatsu City, Japan. The intima media thickness (IMT) and plaque number from the common to internal carotid arteries were investigated using ultrasonography. The absolute risk of CAD death was estimated based on the individual risk factor data, and the mean IMT and plaque number in Categories I, II and III of the guidelines were examined. Results: The estimated 10-year absolute risk of CAD was directly related to the IMT (mean IMT (mean±SD) (mm) for a 10-year absolute risk of ≥2.0% and ≥5.0%: 0.88±0.18 and 0.95±0.19, respectively) and the plaque number. These results are compatible with the categories described by the guidelines (mean IMT (mean±SD) (mm) for Categories I, II, and III: 0.70±0.11, 0.81±0.16 and 0.88±0.18, respectively; mean plaque number: 0.9, 2.1 and 3, respectively). These findings were similar for Category III participants with or without DM and CKD. Conclusions: Subclinical atherosclerosis of the carotid arteries is concordant with the 10-year absolute risk of CAD and the categories in the JAS guidelines 2012.</p>

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Cardiovascular disease risk factors other than dyslipidemia executive summary of the Japan atherosclerosis society (JAS) guidelines for the diagnosis and prevention of atherosclerotic cardiovascular diseases in Japan - 2012 version

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

Journal of Atherosclerosis and Thrombosis 20 ( 10 ) 733 - 742 2013

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

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Diagnostic criteria for dyslipidemia

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

Journal of Atherosclerosis and Thrombosis 20 ( 8 ) 655 - 660 2013

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

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Influence of cigarette smoking on coronary artery and aortic calcium among random samples from populations of middle-aged Japanese and Korean men.

Hirooka N, Kadowaki T, Sekikawa A, Ueshima H, Choo J, Miura K, Okamura T, Fujiyoshi A, Kadowaki S, Kadota A, Nakamura Y, Maegawa H, Kashiwagi A, Masaki K, Sutton-Tyrrell K, Kuller LH, Curb JD, Shin C.

J Epidemiol Community Health 67 ( 2 ) 119-24, 2013. 2013

Research paper (scientific journal), Joint Work, Accepted

Comparison of predictability of future cardiovascular events between chronic kidney disease (CKD) stage based on CKD epidemiology collaboration equation and that based on modification of diet in renal disease equation in the Japanese general population--Iwate KENCO Study.

Ohsawa M, Tanno K, Itai K, Turin TC, Okamura T, Ogawa A, Ogasawara K, Fujioka T, Onoda T, Yoshida Y, Omama S, Ishibashi Y, Nakamura M, Makita S, Tanaka F, Kuribayashi T, Koyama T, Sakata K, Okayama A

Circulation journal : official journal of the Japanese Circulation Society 77 ( 5 ) 1315 - 25 2013

Research paper (scientific journal),  ISSN  1346-9843

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