Papers - Okamura, Tomonori

Prognostic value of ST-T abnormalities and left high R waves with cardiovascular mortality in Japanese (24-Year follow-up of NIPPON DATA80)

Rumana Nahid, Turin Tanvir Chowdhury, Miura Katsuyuki, Nakamura Yasuyuki, Kita Yoshikuni, Hayakawa Takehito, Choudhury Sohel Reza, Kadota Aya, Nagasawa Shin Ya, Fujioshi Akira, Takashima Naoyuki, Okamura Tomonori, Okayama Akira, Ueshima Hirotsugu

American Journal of Cardiology 107 ( 12 ) 1718 - 1724 2011.06

Research paper (scientific journal), Joint Work, Accepted,  ISSN  0002-9149

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<p>Little is known about the prognostic value of ST-segment depression and/or T wave (ST-T abnormalities) with or without left high R waves on electrocardiogram recorded at rest for death from cardiovascular disease (CVD) in Asian populations. Japanese participants without a history of CVD and free of major electrocardiographic (ECG) abnormalities were followed for 24 years. Subjects were divided into 4 groups based on baseline ECG findings: isolated left high R waves, isolated ST-T abnormalities, ST-T abnormalities with left high R waves, and normal electrocardiogram. Cox proportional hazard model was used to estimate risk of CVD mortality in groups with ECG abnormalities compared to the normal group. Of 8,572 participants (44.4% men, mean age 49.5 years; 55.6% women, mean age 49.4 years), 1,142 had isolated left high R waves, 292 had isolated ST-T abnormalities, and 128 had ST-T abnormalities with left high R waves at baseline. Multivariable-adjusted hazard ratios of ST-T abnormalities with left high R waves for CVD mortality were 1.95 (95% confidence interval 1.25 to 3.04) in men and 2.68 (95% confidence interval 1.81 to 3.97) in women. Isolated ST-T abnormalities increased the risk for CVD death by 1.66 times (95% confidence interval 1.01 to 2.71) in men and 1.62 times (95% confidence interval 1.18 to 2.24) in women. Association of ECG abnormalities with CVD mortality was independent of age, body mass index, systolic blood pressure, serum cholesterol, blood glucose, smoking and drinking, and antihypertensive medication. In conclusion, ST-T abnormalities with or without left high R waves on electrocardiogram recorded at rest constitute an independent predictor of CVD mortality in Japanese men and women. © 2011 Elsevier Inc. All rights reserved.</p>

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Serum 1,5-anhydro-d-glucitol levels predict first-ever cardiovascular disease

Watanabe M., Kokubo Y., Higashiyama A., Ono Y., Miyamoto Y., Okamura T.

Atherosclerosis 216 ( 2 ) 477 - 483 2011.06

Research paper (scientific journal), Joint Work, Accepted,  ISSN  0021-9150

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<p>Objective: Serum 1,5-anhydro-d-glucitol (1,5-AG) is well-known to be a useful clinical marker of both short-term glycemic status and postprandial hyperglycemia. In addition, previous epidemiological studies have shown that an increased postload glucose level in an oral glucose tolerance test is a risk factor for cardiovascular diseases (CVD). However, no previous prospective study has reported the association between serum 1,5-AG levels and the risk of CVD. In this study, we examined whether serum 1,5-AG levels can predict the incidence of first-ever CVD. Methods: Our study was a population-based cohort study in an urban area of Japan. Study subjects comprised 2095 initially healthy Japanese (991 men and 1104 women, mean age: 58.5 years) with no history of coronary heart disease (CHD) or stroke. They were followed up for an average of 11.1 years, and 147 CVD events (64 CHD and 83 strokes) were observed. Results: The adjusted hazard ratios (HRs) of all CVD in men increased linearly (p= 0.004). The HR in the category with serum 1,5-AG levels of 14.0 μg/mL or less was 2.22 (95% confidence interval; 1.24-3.98) compared to the reference category (24.5 μg/mL or greater). Similar results were also shown with a sensitivity analysis in non-diabetic men. Conversely, no significant relationship between serum 1,5-AG levels and CVD risks was observed in women. Conclusions: Our results suggest that measurement of serum 1,5-AG levels is useful to detect individuals, especially men, at higher risk for CVD, regardless of the presence or absence of diabetes. © 2011 Elsevier Ireland Ltd.</p>

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Association with serum gamma-glutamyltransferase levels and alcohol consumption on stroke and coronary artery disease

Higashiyama Aya, Wakabayashi Ichiro, Ono Yuu, Watanabe Makoto, Kokubo Yoshihiro, Okayama Akira, Miyamoto Yoshihiro, Okamura Tomonori

Stroke 42 ( 6 ) 1764 - 1767 2011.06

Research paper (scientific journal), Joint Work, Accepted,  ISSN  0039-2499

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<p>Background And Purpose- Light-to-moderate alcohol consumption is associated with reduced risk for cardiovascular disease, whereas high serum γ-glutamyltransferase (GGT) level is associated with cardiovascular disease. However, whether light-to-moderate alcohol drinking is still related to reduced risk of cardiovascular disease irrespective of GGT level is uncertain. Methods- We performed a 12.5-year cohort study of 2336 men (excluding exdrinkers) who were free from cardiovascular disease. They were classified into 4 groups according to alcohol consumption: never, and current light, moderate, or heavy drinker. The multivariate-adjusted hazard ratios of alcohol consumption for incidence of coronary artery disease, total stroke, and ischemic stroke compared with those of never drinkers were assessed with stratification by GGT median (32 IU/L). Results- In participants with GGT &gt;32 IU/L, the hazard ratios of all current drinkers for total and ischemic stroke were higher than those of never drinkers. However, in all current drinkers with GGT ≤32 IU/L, the multivariate-adjusted hazard ratios for total and ischemic stroke were lower than in never drinkers. Conclusions- In men with above GGT median, alcohol drinking even with light-to-moderate consumption could be a risk factor for ischemic stroke. © 2011 American Heart Association, Inc.</p>

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Association of intima-media thickening of carotid artery with genetic polymorphisms of the regulator of G-protein signaling 2 gene in patients with hypertension and in the general population

Kamide Kei, Kokubo Yoshihiro, Yang Jin, Takiuchi Shin, Horio Takeshi, Matsumoto Sachiko, Banno Mariko, Matayoshi Tetsutaro, Yasuda Hisayo, Miwa Yoshikazu, Yoshihara Fumiki, Nakamura Satoko, Nakahama Hajime, Iwashima Yoshio, Oguro Ryousuke, Ohishi Mitsuru, Rakugi Hiromi, Okamura Tomonori, Miyata Toshiyuki, Kawano Yuhei

Hypertension Research 34 ( 6 ) 740 - 746 2011.06

Research paper (scientific journal), Joint Work, Accepted,  ISSN  0916-9636

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<p>Regulator of G-protein signaling 2 (RGS2) is a key molecule in signal pathways of vasoactive peptides, such as angiotensin II and endothelin 1, and is believed to have an important role in the pathophysiology of atherosclerosis. We have previously reported that common polymorphisms of RGS2 are associated with hypertension in Japanese. In this study, we studied whether the three previously identified common polymorphisms of RGS2 (638AG, 1026TA and 1891-1892delTC) could be implicated in carotid atherosclerosis in Japanese patients with hypertension (459 men and 382 woman) and in a Japanese general population (814 men and 956 woman). We assessed two criteria for carotid atherosclerosis: maximal intima-media thickness (M-IMT) and mean-IMT. When subjects with atherosclerotic lesions were defined as having mean-IMT1.0 mm, multivariate logistic regression analysis performed after adjusting for confounding factors showed a significant association of the three common polymorphisms, 638AG (AA versus AGGG: odds ratio (OR), 1.55; 95% confidence interval (CI), 1.105-2.185; P0.0113 only for the general population), 1026TA (TT versus TAAA: OR, 1.42; 95% CI, 1.027-1.972; P0.034 for hypertensive subjects and OR, 1.56; 95% CI, 1.129-2.151; P0.0071 for the general population), and 1891-1892delTC (II versus IDDD: OR, 1.44; 95% CI, 1.043-2.008; P0.028 for hypertensive subjects, OR, 1.32; 95% CI 1.002-1.742; P0.048 for the total general population and OR 1.59; 95% CI 1.155-2.207; P0.0047 for the general population), with carotid atherosclerosis. When atherosclerosis was defined as M-IMT 1.0 mm, the values of M-IMT were also significantly different between the three genotypes in the three common polymorphisms. Taken together, these data suggest that genetic polymorphisms in RGS2 are associated with intima-media thickening of carotid artery in humans. © 2011 The Japanese Society of Hypertension All rights reserved.</p>

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Corrigendum to 'Gamma-Glutamyltransferase and mortality risk from heart disease and stroke in Japanese men and women

Fujiyoshi Akira, Miura Katsuyuki, Hozawa Atsushi, Murakami Yoshitaka, Takashima Naoyuki, Okuda Nagako, Kadowaki Takashi, Kita Yoshikuni, Okamura Tomonori, Nakamura Yasuyuki, Hayakawa Takehito, Okayama Akira, Ueshima Hirotsugu

CVD Prevention and Control 6 ( 2 ) 63 2011.06

Research paper (scientific journal), Joint Work, Accepted,  ISSN  1875-4570

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Fasting plasma insulin is associated with metabolic syndrome in farmers but not in nomads among the Mongolian population, China.

Kanda Hideyuki, Wang Peiyu, Okamura Tomonori, Wuyun GaoWa, Wu HePing, Su Xiulan, Hayakawa Takehito, Amamoto Kenji, Ueshima Hirotsugu

Journal of Atherosclerosis and Thrombosis 18 ( 4 ) 291 - 297 2011.04

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

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<p>The World Health Organization (WHO) includes insulin resistance among its criteria for diagnosing metabolic syndrome (MetS); however, previous epidemiologic studies have limited their research to settled populations only. This study aims to clarify the relationship between plasma insulin and metabolic factors on a broader scale by studying data obtained from nomadic and settled Mongolian populations. A cross-sectional epidemiologic study of 200 nomads and 256 farmers was performed in Inner Mongolia, Republic of China. Plasma insulin levels and other metabolic factors, such as blood pressure, serum lipids and obesity, were measured. Participants were classified into 3 categories according to their plasma insulin levels. Cut-off values grouped into tertiles of fasting insulin for all participants were 6.73 nmol/L and 10.33 nmol/L. The mean number of metabolic risk factors, waist circumference, fasting plasma glucose and triglyceride were higher, and the mean HDL cholesterol was lower in the higher fasting insulin tertile among farmers after adjusting for age, gender, smoking, alcohol drinking and total cholesterol. However, no MetS factors were statistically related with fasting insulin tertile levels among nomads. In nomads, hyperinsulinemia may not be an indicator of MetS due to their specific life-style.</p>

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Relationship of moderate metabolic risk factor clustering to cardiovascular disease mortality in non-lean Japanese

Kadota Aya, Miura Katsuyuki, Okamura Tomonori, Hozawa Atsushi, Murakami Yoshitaka, Fujiyoshi Akira, Takashima Naoyuki, Hayakawa Takehito, Kita Yoshikuni, Okayama Akira, Nakamura Yasuyuki, Ueshima Hirotsugu

Atherosclerosis 215 ( 1 ) 209 - 213 2011.03

Research paper (scientific journal), Joint Work, Accepted,  ISSN  0021-9150

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<p>Objective: The individual components of metabolic syndrome are defined as levels ranging from moderate to high level as to require medication. We investigated the impact of moderate metabolic risk factor clustering on cardiovascular disease (CVD) mortality. Methods: We followed up 6758 non-lean Japanese in randomly selected areas from all over the country who had no history of CVD for 15 years. The multivariate-adjusted hazards ratio (HR) and 95% confidence interval (CI) for CVD mortality according to the number of moderate metabolic risk factors (BMI≥25kg/m², 130/85mmHg≤systolic/diastolic BP&lt;140/90mmHg, 140mg/dl≤casual blood glucose&lt;200mg/dl, triglycerides≥150mg/dl and/or HDL cholesterol&lt;40mg/dl [men], 50mg/dl [women]) were estimated using the Cox proportional hazards model. The population-attributable risk fraction of moderate metabolic risk factor clustering was also estimated. Results: During the follow-up, 282 participants died of CVD. CVD mortality tended to increase with the number of moderate metabolic risk factors. However, they were not statistically significant. The multivariate-adjusted HRs were 1.82 (95%CI: 0.89-3.73) for having any moderate metabolic risk factors and 2.87 (95%CI: 1.46-5.64) for having any medication-required metabolic risk factors, compared with participants without any moderate metabolic risk factors. The population-attributable risk fractions were 7.3% and 52.4% for any moderate and medication-required metabolic risk factors, respectively. Conclusions: We did not find the statistically significant increase of CVD mortality for moderate metabolic risk factor clustering. Its attribution was relatively small in this Japanese population. More efforts would be required to detect and control medication-required risk factors. © 2010 Elsevier Ireland Ltd.</p>

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Population attributable numbers and fractions of deaths due to smoking

Murakami Yoshitaka, Miura Katsuyuki, Okamura Tomonori, Ueshima Hirotsugu

Preventive Medicine 52 ( 1 ) 60 - 65 2011.01

Research paper (scientific journal), Joint Work, Accepted,  ISSN  0091-7435

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<p>Objective: Age- and sex-specific population attributable fraction (PAF) and premature deaths attributable to smoking were estimated from a pooled analysis of cohort studies in Japan. Methods: A pooled analysis of individual participant data from 13 well-qualified cohort studies throughout Japan (a total of 183,251 Japanese aged 40-89, 69,502 men and 113,749 women; the baseline years between 1987 and 1995 with average 10 years of follow-up) was performed. Poison regression model was used to estimate age- and sex-specific hazard ratios, and their PAFs of all-cause deaths and number of annual premature deaths attributable to smoking were estimated. Results: Overall PAF attributable to smoking was 24.6% in men and 6.0% in women. The estimated number of annual premature deaths due to smoking was 121,854 (men: 109,998; women: 11,856) in Japan. The age-specific PAF was largest in men aged 60-69 (47.7%) and in women aged 50-59 (12.2%). In the older group aged 70-79 and 80-89, PAF was 15.4% and 8.0% in men and 3.5% and 1.5% in women, respectively. Conclusions: Age-specific PAFs attributable to smoking in Japanese men are much larger than that reported from other Asian countries. © 2010 Elsevier Inc.</p>

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Impairments in activities of daily living in older Japanese Men in Hawaii and Japan

Abbott Robert D., Kadota Aya, Miura Katsuyuki, Hayakawa Takehito, Kadowaki Takashi, Okamura Tomonori, Okayama Akira, Masaki Kamal H., Ueshima Hirotsugu

Journal of Aging Research 2011   324592 2011

Research paper (scientific journal), Joint Work, Accepted,  ISSN  2090-2204

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<p>Introduction. Hypertension and cigarette smoking are dominant risk factors for cardiovascular disease in Japan while in westernized countries, broader effects encompass obesity, diabetes, and hypercholesterolemia. This paper examines whether different associations also appear important in the manifestation of activities of daily living (ADL) in older Japanese men in Hawaii and Japan. Methods. Measures of ADL (feeding, toileting, dressing, bathing, and walking around the house) were assessed from 1995 to 1999 in 1,893 men in Hawaii and 543 men in Japan. Concomitant risk factors were measured from 1990 to 1993. Results. In Hawaii, diabetes increased the odds of ≥1 ADL impairment nearly 1.5-fold (P=.020). A similar association was absent in Japan. In contrast, the odds of an ADL impairment in Japan was increased more than 5-fold in the presence of stroke (P&lt;.001). The association in Hawaii was significantly weaker (P=.007). In both cohorts, past alcohol use was associated with a greater likelihood of ADL impairment. Conclusion. In this comparison of genetically similar samples, findings suggest that different strengths in risk factor associations with cardiovascular disease in Japan and westernized countries may also include different strengths in associations with impaired ADL. © 2011 Robert D. Abbott et al.</p>

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Relationship between sleep duration and clustering of metabolic syndrome diagnostic components.

Katano S, Nakamura Y, Nakamura A, Murakami Y, Tanaka T, Takebayashi T, Okayama A, Miura K, Okamura T, Ueshima H; HIPOP-OHP Research Group.

Diabetes Metab Syndr Obes 4   119-125 - 25 2011

Research paper (scientific journal), Joint Work, Accepted

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NIPPON DATA80-リスク評価チャートの評価-.

渡邉 至、岡村 智教

The Lipid (メディカルレビュー社)  22 ( 1 ) 14-19 2011

Research paper (scientific journal), Joint Work

禁煙専門医の立場から-リスクとしての喫煙、治療としての禁煙-.

岡村 智教

治療 (南山堂)  93 ( 4 ) 608-611 2011

Research paper (scientific journal), Single Work

粥状動脈硬化症の発症における脂質異常症の関与-疫学的側面から．

岡村 智教

レジデント (医学出版)  4 ( 8 ) 6-16 2011

Research paper (scientific journal), Single Work

脳卒中予防のイノベーション-早期発見・早期受診・早期介入.

宮本恵宏、中山博文、岡村 智教、豊田一則

Medicina (医学書院)  48 ( 7 ) 1254-1266 2011

Research paper (scientific journal), Joint Work

脂質異常症と動脈硬化の疫学的エビデンスは？

田中太一郎、岡村 智教

Heart View (メディカルビュー社)  15 ( 9 ) 915-920 2011

Research paper (scientific journal), Joint Work

虚血性心疾患の最近の疫学的動向からみた実地診療のすすめかた.

田中太一郎、岡村 智教

Medical Practice (文光堂)  28 ( 9 ) 1506-1512 2011

Research paper (scientific journal), Joint Work

動脈硬化性疾患の絶対リスクの評価.

岡村 智教、杉山大典

日本医師会雑誌 140 ( 6 ) 1208-1212 2011

Research paper (scientific journal), Joint Work

ホモシステインの動脈硬化リスクについてのpros and cons.

岡村 智教、久保田芳美、吉野佳織

循環器内科 (科学評論社)  70 ( 2 ) 202-209 2011

Research paper (scientific journal), Joint Work

心血管病の危険因子としての喫煙

岡村 智教、森本明子

日本臨床 (日本臨床社)  69 ( 増刊号7. 冠動脈疾患動脈（上巻） ) 599-603 2011

Research paper (scientific journal), Joint Work

Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk.

Okamura T in The International Consortium for Blood Pressure Genome-Wide Association Studies

Nature 478   103-109 2011

Research paper (scientific journal), Joint Work, Accepted