研究者詳細 - 岡村　智教

論文 - 岡村　智教

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Coronary artery calcification by computed tomography in epidemiologic research and cardiovascular disease prevention.

Sekikawa A, Curb JD, Edmundowicz D, Okamura T, Choo J, Fujiyoshi A, Masaki K, Miura K, Kuller LH, Shin C, Ueshima H

Journal of epidemiology 22 （ 3 ） 188 - 198 2012年

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0917-5040

Both American and European guidelines recommend coronary artery calcification (CAC) as a tool for screening asymptomatic individuals at intermediate risk for coronary heart disease (CHD). These recommendations are based on epidemiologic studies mostly in the United States. We review (1) the use of CAC in primary prevention of CHD in the United States, (2) epidemiologic studies of CAC in asymptomatic adults outside of the United States, and (3) international epidemiologic studies of CAC. This review will not consider clinical studies of CAC among patients or symptomatic individuals. US studies have shown that CAC is a strong independent predictor of CHD in both sexes among middle-aged and old age groups, various ethnic groups, and individuals with and without diabetes and that CAC plays an important role in reclassifying individuals from intermediate to high risk. Studies in Europe support these conclusions. The Electron-Beam Tomography, Risk Factor Assessment Among Japanese and US Men in the Post-World-War-II birth cohort (ERA JUMP) Study is the first international study to compare subclinical atherosclerosis, including CAC among Japanese, Japanese Americans, Koreans, and whites. It showed that as compared with whites, Japanese had lower levels of atherosclerosis, whereas Japanese Americans had similar or higher levels. CAC is being increasingly used as a screening tool for asymptomatic individuals in Europe and the United States. CAC is a powerful research tool, because it enables us to describe differences in atherosclerotic burden across populations. Such research could identify factors responsible for differences among populations, which may improve CHD prevention. © 2012 by the Japan Epidemiological Association.

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Guidelines for the management of familial hypercholesterolemia.

Harada-Shiba M, Arai H, Oikawa S, Ohta T, Okada T, Okamura T, Nohara A, Bujo H, Yokote K, Wakatsuki A, Ishibashi S, Yamashita S

Journal of atherosclerosis and thrombosis 19 （ 12 ） 1043 - 1060 2012年

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1340-3478

Familial hypercholesterolemia (FH) is a highly prevalent autosomal dominant hereditary disease, generally characterized by three major signs, hyper-low-density-lipoprotein (LDL) cholesterolemia, tendon/skin xanthomas and premature coronary artery disease (CAD). Because the risk of CAD is very high in these patients, they should be identified at an early stage of their lives and started on intensive treatment to control LDL-cholesterol. We here introduce a new guideline for the management of FH patients in Japan intending to achieve better control to prevent CAD. Diagnostic criteria for heterozygous FH are 2 or more of 1) LDL-cholesterol ≥180 mg/dL, 2) tendon/skin xanthoma(s), and 3) family history of FH or premature CAD within second degree relatives, for adults; and to have both 1) LDL-cholesterol ≥140 mg/dL and 2) family history of FH or premature CAD within second degree relatives, for children. For the treatment of adult heterozygous FH, intensive lipid control with statins and other drugs is necessary. Other risks of CAD, such as smoking, diabetes mellitus, hypertension etc., should also be controlled strictly. Atherosclerosis in coronary, carotid, or peripheral arteries, the aorta and aortic valve should be screened periodically. FH in children, pregnant women, and women who wish to bear a child should be referred to specialists. For homozygotes and severe heterozygotes resistant to drug therapies, LDL apheresis should be performed. The treatment cost of homozygous FH is authorized to be covered under the program of Research on Measures against Intractable Diseases by the Japanese Ministry of Health, Labour, and Welfare.

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Multicenter study to determine the diagnosis criteria of heterozygous familial hypercholesterolemia in Japan.

Harada-Shiba M, Arai H, Okamura T, Yokote K, Oikawa S, Nohara A, Okada T, Ohta T, Bujo H, Watanabe M, Wakatsuki A, Yamashita S

Journal of atherosclerosis and thrombosis 19 （ 11 ） 1019 - 1026 2012年

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1340-3478

Aim: Heterozygous patients of familial hypercholesterolemia (FH) are known to have a high risk of coronary artery disease (CAD). Early diagnosis and prompt treatment are necessary to prevent their CAD. In this study we tried to amend the Japanese diagnostic criteria of FH for general practitioners by examining each component of the current criteria. Methods: A multicenter study was performed, which included 1356 dyslipidemic patients at 6 centers. Pretreatment demographic information including LDL-cholesterol (LDL-C), Achilles tendon thickness (ATT), family history of FH and premature CAD and the result of genetic analysis were analyzed. Results: Of 1356 patients, 419 were diagnosed with FH by criteria in 1988, which were used as a golden standard. We tried to define FH according to 3 conventional major items, i.e., 1) LDL-C, 2) ATT and/or cutaneous nodular xanthomas (CX), 3) family history of FH and/or family history of premature CAD. We then determined the cutoff of LDL-C using the new criteria. When we used 180 mg/dL as the cutoff of LDL-C, 94.3% of FH patients and 0.85% of non-FH satisfied 2 or more criteria. When we used 190 mg/dL, 92.1% of FH and 0.85% of non-FH satisfied 2 or more criteria; therefore, we chose 180 mg/dL for the cutoff of LDL-C in the new criteria and proposed that the diagnosis of definite FH can be made if 2 or more criteria are satisfied. Conclusions: We examined each component for the diagnosis of heterozygous FH in a multicenter study in Japan.

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Does high-sensitivity C-reactive protein or low-density lipoprotein cholesterol show a stronger relationship with the cardio-ankle vascular index in healthy community dwellers?: the KOBE study.

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

Journal of atherosclerosis and thrombosis 19 （ 11 ） 1027 - 1034 2012年

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1340-3478

Aim: High-sensitivity C-reactive protein (hs-CRP) identifies individuals at risk for cardiovascular disease (CVD) without an increased level of low-density lipoprotein cholesterol (LDL-C). The present study was performed to compare hs-CRP and LDL-C in association with the cardio-ankle vascular index (CAVI) in Japanese community dwellers considered to be at low risk for atherosclerosis from their level of traditional CVD risk factors. Methods: A community-based study involving 386 healthy Japanese (261 men and 125 women) without a history of CVD and medications for hypertension, diabetes, and dyslipidemia was performed. Multiple adjustments were performed with linear regression models to estimate the association between CAVI and hs-CRP or LDL-C levels. The participants were divided into four groups on the basis of whether they were above or below the median hs-CRP and LDL-C values, and CAVI was compared among the four groups by analysis of covariance after adjusting for confounders. Results: In multiple linear regression models, hs-CRP showed a significant positive association with CAVI; however, no clear association was observed between CAVI and LDL-C. These results were similar in the analyses among the participants with LDL-C <140 mg/dL or hs-CRP <1.0 mg/L. CAVI was higher in the groups with high hs-CRP than in those with low hs-CRP, irrespective of LDL-C; however, CAVI was highest in the group with high LDL-C and high hs-CRP. Conclusions: The present study suggests that hs-CRP could be a better risk factor assessor for atherosclerosis than LDL-C in individuals considered to be at low risk for atherosclerosis assessed by their traditional CVD risk factors.

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Blood cholesterol level and risk of stroke in community-based or worksite cohort studies: a review of Japanese cohort studies in the past 20 years.

Tanaka T, Okamura T

The Keio journal of medicine 61 （ 3 ） 79 - 88 2012年

研究論文（学術雑誌）, ISSN 0022-9717

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Blood cholesterol level and risk of stroke in community-based or worksite cohort studies: a review of Japanese cohort studies in the past 20 years.

Tanaka T, Okamura T

The Keio journal of medicine 61 （ 3 ） 79 - 88 2012年

研究論文（学術雑誌）, ISSN 0022-9717

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Association of short sleep duration with impaired glucose tolerance or diabetes mellitus.

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

Journal of diabetes investigation 2 （ 5 ） 366 - 372 2011年10月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 2040-1116

Aims/Introduction: To examine the cross-sectional relationship between sleep duration and impaired glucose tolerance (IGT), including diabetes mellitus (DM), we analyzed a large-scale healthy workers database in Japan. Materials and Methods: We examined the baseline database of 4143 participants (3415 men and 728 women) aged 19-69years. Sleep duration of participants was categorized into four groups: <6, 6 to <7, 7 to <8 and ≥8h. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined IGT including DM (IGT/DM) in the present study according to previous studies as follows: fasting blood sugar level ≥110mg/dL, or if <8h after meals ≥140mg/dL, or on medication for diabetes mellitus, or those diagnosed as having DM. Logistic regression was applied to estimate the odds ratio (OR) to examine the relationship between IGT/DM, sleep duration and other related factors. Results: The number of participants with IGT/DM was 402 (9.7%). The factors that significantly associated with IGT/DM were age (OR 1.08, 95% confidence interval [CI] 1.07-1.10, P<0.001), high blood pressure (OR 1.94, CI 1.52-2.47, P<0.001), and <6h of sleep duration in comparison with 6 to <7h sleep (OR 2.32, CI 1.18-4.55, P=0.015). The associations of difficulty in sleep initiation, IPAQ classification, current smoking and alcohol intake with IGT/DM were not statistically significant. Conclusions: Our results showed that shorter sleep duration (<6h of sleep duration per night) was associated with a risk of IGT/DM independent of other lifestyle habits and metabolic risk factors. © 2011 Asian Association for the Study of Diabetes and Blackwell Publishing Asia Pty Ltd.

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血漿ホモシステイン高値、関連ビタミン群と動脈硬化性疾患の関連

久保田芳美、吉野佳織、岡村智教

総合臨床（永井書店） 60 （ 10 ） 2047-2052 2011年10月

研究論文（学術雑誌）, 共著

[Smoking is an important risk factor for cardiovascular disease in Japan].

Okamura T, Morimoto A

Nihon rinsho. Japanese journal of clinical medicine 69 Suppl 7 599 - 603 2011年09月

研究論文（学術雑誌）, 共著, ISSN 0047-1852

Differential association of docosahexaenoic and eicosapentaenoic acids with carotid intima-media thickness.

Sekikawa A, Kadowaki T, El-Saed A, Okamura T, Sutton-Tyrrell K, Nakamura Y, Evans RW, Mitsunami K, Edmundowicz D, Nishio Y, Nakata K, Kadota A, Otake T, Miura K, Choo J, Abbott RD, Kuller LH, Curb JD, Ueshima H, ERA JUMP Study group.

Stroke 42 （ 9 ） 2538 - 2543 2011年09月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0039-2499

Background and Purpose-Recent studies reported the differential effect of docosahexaenoic (DHA) and eicosapentaenoic acids (EPA). We examined the differential association of DHA and EPA with carotid intima-media thickness (IMT) in Japanese individuals in Japan and in U.S. white individuals and explored whether DHA or EPA contributes to the difference in IMT between the two groups. Methods-A population-based cross-sectional study in 608 Japanese and U.S. white men aged 40 to 49 was conducted to assess IMT, serum DHA, EPA, and other cardiovascular risk factors. Results-Japanese compared to U.S. whites had significantly lower IMT (mean±SD, 618±81 and 672±94 μm for Japanese and whites, respectively; P<0.001) and had >2-fold higher levels of DHA and EPA. DHA, but not EPA, had an inverse association with IMT in both Japanese and U.S. whites. The inverse association remained only in Japanese men after adjusting for risk and other factors. The significant difference in multivariable-adjusted IMT became nonsignificant after further adjusting for DHA (mean difference, 17 μm; 95% CI,-8 to 43; P=0.177) but not EPA. In this multivariable-adjusted model, DHA but not EPA was a significant predictor of IMT (P=-0.032 versus 0.863, respectively). Conclusions-These data suggest that DHA may have a more potent antiatherogenic effect than EPA, especially in levels observed in the Japanese, independent of risk factors. © 2011 American Heart Association. All rights reserved.

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High oolong tea consumption predicts future risk of diabetes among Japanese male workers

Hayashino Y., Fukuhara S., Okamura T., Tanaka T., Ueshima H.

Diabetic Medicine 28 （ 7 ） 805 - 810 2011年07月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0742-3071

Aims Acute administration of oolong tea decreases blood glucose levels. We investigated the association between long-term oolong tea intake and subsequent risk of developing diabetes among men of working age. Methods Data were analysed from a cohort of participants in the High-risk and Population Strategy for Occupational Health Promotion Study (HIPOP-OHP), conducted in Japan from 1999 to 2004. Oolong tea intake at baseline and subsequent risk of diabetes was evaluated using a Cox proportional hazards model. Results Of 4975 male workers, a total of 201 cases of diabetes were reported over a median of 3.4years of follow-up. Mean age and BMI of all participants at baseline were 38.3years and 22.9kg/m ², respectively. Compared with those not consuming oolong tea, multivariable adjusted hazard ratios for developing diabetes were 1.00 (95%CI 0.67-1.49) for those who drank one cup of oolong tea per day and 1.64 (95%CI 1.11-2.40) for those drinking two or more cups per day. Fasting blood glucose increment per year was 0.11mmol/l (95%CI 0.09-0.12mmol/l), 0.12mmol/l (95%CI 0.09-0.15mmol/l) and 0.15mmol/l (95%CI 0.11-0.18mmol/l), respectively, for oolong tea consumption of 0, 1 and ≥2cups/day, with a significant linear trend (P<0.0001). Conclusions Long-term consumption of oolong tea may be a predictive factor for new onset diabetes. Further studies are necessary to elucidate the role of oolong tea in the risk of developing diabetes. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

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A revised definition of the metabolic syndrome predicts coronary artery disease and ischemic stroke after adjusting for low density lipoprotein cholesterol in a 13-year cohort study of Japanese: the Suita study.

Okamura T, Kokubo Y, Watanabe M, Higashiyama A, Ono Y, Nishimura K, Okayama A, Miyamoto Y

Atherosclerosis 217 （ 1 ） 201 - 206 2011年07月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0021-9150

Objective: Recently, several major organizations have proposed a unified definition for the metabolic syndrome (MetS), which should be evaluated in multiethnic groups. The effect of Mets on the incidence of cardiovascular disease needs to be assessed after adjusting for serum low density lipoprotein cholesterol (LDLC), a major risk factor for atherosclerotic diseases. This is especially needed to be evaluated in Asian populations with low incidence of coronary artery disease (CAD). Methods: We conducted a 13-year prospective study of 4939 Japanese living in an urban area. The MetS was defined using a unified classification that included cut-off points for waist circumference in Asians. The multivariable adjusted hazard ratios (HRs) of MetS for CAD and stroke were calculated using a Cox proportional model adjusted for other potential confounding factors with LDLC. Results and conclusion: During the follow-up period, there were 155 cases of CAD and 204 of stroke including 118 cerebral infarctions. In participants under 65 years old, the multivariable HRs of MetS for CAD were 1.21 (95% C.I., 0.64-2.28) in men and 4.44 (95% C.I., 1.73-11.4) in women; the HRs for ischemic stroke were 3.24 (95% C.I., 1.55-6.77) in men and 3.99 (95% C.I., 1.34-11.8) in women. In participants aged 65 years old and over, MetS only showed a significant association with CAD in men (HR 1.89, 95% C.I., 1.11-3.21). Serum LDLC was associated with increased risk of CAD in men irrespective of age group; however, it was not associated with CAD in women. There was no association between serum LDLC and ischemic stroke in any group stratified by sex and the age of 65. These results indicate that the new uniform MetS definition is useful for detecting high risk individuals, especially for middle-aged population. However, continuous screening for hypercholesterolemia is necessary to prevent CAD, especially in men, even in Asian countries such as Japan. © 2011 Elsevier Ireland Ltd.

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

Rumana N, Turin TC, Miura K, Nakamura Y, Kita Y, Hayakawa T, Choudhury SR, Kadota A, Nagasawa SY, Fujioshi A, Takashima N, Okamura T, Okayama A, Ueshima H, NIPPON DATA80 Research Group.

The American journal of cardiology 107 （ 12 ） 1718 - 1724 2011年06月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0002-9149

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.

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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年06月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0021-9150

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.

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Association with serum gamma-glutamyltransferase levels and alcohol consumption on stroke and coronary artery disease: the Suita study.

Higashiyama A, Wakabayashi I, Ono Y, Watanabe M, Kokubo Y, Okayama A, Miyamoto Y, Okamura T

Stroke 42 （ 6 ） 1764 - 1767 2011年06月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0039-2499

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 >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.

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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 K, Kokubo Y, Yang J, Takiuchi S, Horio T, Matsumoto S, Banno M, Matayoshi T, Yasuda H, Miwa Y, Yoshihara F, Nakamura S, Nakahama H, Iwashima Y, Oguro R, Ohishi M, Rakugi H, Okamura T, Miyata T, Kawano Y

Hypertension research : official journal of the Japanese Society of Hypertension 34 （ 6 ） 740 - 746 2011年06月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0916-9636

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.

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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年06月

研究論文（学術雑誌）, 共著, 査読有り, 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 H, Wang P, Okamura T, Wuyun G, Wu H, Su X, Hayakawa T, Amamoto K, Ueshima H

Journal of atherosclerosis and thrombosis 18 （ 4 ） 291 - 297 2011年04月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 1340-3478

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.

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Relationship of moderate metabolic risk factor clustering to cardiovascular disease mortality in non-lean Japanese: a 15-year follow-up of NIPPON DATA90.

Kadota A, Miura K, Okamura T, Hozawa A, Murakami Y, Fujiyoshi A, Takashima N, Hayakawa T, Kita Y, Okayama A, Nakamura Y, Ueshima H, NIPPON DATA90 Research Group.

Atherosclerosis 215 （ 1 ） 209 - 213 2011年03月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0021-9150

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<140/90mmHg, 140mg/dl≤casual blood glucose<200mg/dl, triglycerides≥150mg/dl and/or HDL cholesterol<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.

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Population attributable numbers and fractions of deaths due to smoking: a pooled analysis of 180,000 Japanese.

Murakami Y, Miura K, Okamura T, Ueshima H, EPOCH-JAPAN Research Group.

Preventive medicine 52 （ 1 ） 60 - 65 2011年01月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0091-7435

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.

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岡村 智教

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岡村　智教

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