Details of a Researcher - Okamura, Tomonori

Papers - Okamura, Tomonori

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Intima-media thickness of the carotid artery and the distribution of lipoprotein subclasses in men aged 40 to 49 years between whites in the United States and the Japanese in Japan for the ERA JUMP study

Sekikawa Akira, Ueshima Hirotsugu, Sutton-Tyrrell Kim, Kadowaki Takashi, El-Saed Aiman, Okamura Tomonori, Takamiya Tomoko, Ueno Yoshiki, Evans Rhobert W., Nakamura Yasuyuki, Edmundowicz Daniel, Kashiwagi Atsunori, Maegawa Hiroshi, Kuller Lewis H.

Metabolism: Clinical and Experimental 57 ( 2 ) 177 - 182 2008.02

ISSN 0026-0495

In men in the post-World War II birth cohort, that is, men aged 40 to 49 years, whites in the United States had significantly higher levels of intima-media thickness of the carotid arteries (IMT) than the Japanese in Japan (Electron-Beam Tomography and Risk Assessment Among Japanese and US Men in the Post World War II Birth Cohort [ERA JUMP] study). The difference remained after adjusting for traditional risk factors. Primary genetic effects are unlikely, given the degree to which IMT is increased in the Japanese who migrated to the United States. We investigated whether the differences in the distributions of lipoprotein subclasses explain the difference in IMT between the 2 populations. We examined population-based samples of 466 randomly selected men aged 40 to 49 years (215 whites from Allegheny County, Pennsylvania, and 241 Japanese from Kusatsu, Shiga, Japan). Lipoprotein subclasses were determined by nuclear magnetic resonance (NMR) spectroscopy. The whites had significantly higher levels of large very low-density lipoprotein particles and significantly lower levels of large high-density lipoprotein particles than the Japanese, whereas the 2 populations had similar levels of small low-density lipoprotein particles. The 2 populations had similar associations of IMT with NMR lipoproteins. Adjusting for NMR lipoproteins did not attenuate the significant difference in IMT between the 2 populations (0.671 ± 0.006 mm for the whites and 0.618 ± 0.006 mm for the Japanese, P = .01, mean ± SE). Differences in the distributions of NMR lipoproteins between the 2 populations did not explain the higher IMT in the whites. © 2008 Elsevier Inc. All rights reserved.

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Effects of the Y chromosome on cardiovascular risk factors in Japanese men

Hiura Yumiko, Fukushima Yasue, Kokubo Yoshihiro, Okamura Tomonori, Goto Yoichi, Nonogi Hiroshi, Takahashi Rie, Iwai Naoharu

Hypertension Research 31 ( 9 ) 1687 - 1694 2008

ISSN 0916-9636

Excess cardiovascular risk in men compared with women has been suggested to be partly explained by effects of the Y chromosome. However, inconsistent results have been reported on the Y chromosome's genetic influence on blood pressure and lipid levels. The purpose of the present study was to settle the question whether genetic variants of the Y chromosome influence cardiovascular risk factors using a large epidemiological cohort, the Suita study. Possible influences of the Y chromosome polymorphisms (Y chromosome Alu insertion polymorphism [YAP], M175 and SRY+465) on cardiovascular risk factors were assessed in 974 Japanese men. The frequency of the YAP(+) allele in our study sample was 0.31. The prevalence of hypertension tended to be higher in YAP(+) than in YAP(-) men, and this tendency was found to be stronger among men aged 65 years or older. Men with the YAP(+) genotype had higher levels of high density lipoprotein (HDL) cholesterol compared with those with the YAP(-) genotype, even after adjustment for age, body mass index, and daily ethanol and cigarette consumption (57.0±14.6 mg/dL vs. 54.2±14.2 mg/dL, nominal p=0.011, adjusted p=0.0062). However, these observed nominal associations disappeared after adjusting for multiple testing (Bonferroni). No association was detected between the YAP genotype and myocardial infarction. Similarly, none of the associations with M175 and SRY+465 attained significance when multiple testing was taken into account. In conclusion, Y chromosome polymorphisms (YAP, M175 and SRY+465) do not appear to be associated with cardiovascular risk factors in Japanese men. Studies using much larger sample sizes and/or additional independent samples will be required for definitive conclusions.

Relationships between family histories of stroke and of hypertension and stroke mortality

Kadota Aya, Okamura Tomonori, Hozawa Atsushi, Kadowaki Takashi, Murakami Yoshitaka, Hayakawa Takehito, Kita Yoshikuni, Okayama Akira, Nakamura Yasuyuki, Ueshima Hirotsugu

Hypertension Research 31 ( 8 ) 1525 - 1531 2008

ISSN 0916-9636

A family history of stroke seems to be related with increased risk of stroke although the relationship is not always significant. Increased risk of stroke is strongly associated with hypertension, which might be also associated with family history. However, investigations into the relationship between family history of hypertension and stroke mortality are scarce. We investigated whether a family history of stroke and that of hypertension evaluated using a simple questionnaire could predict stroke mortality in Japanese. We obtained parental histories of stroke and of hypertension from 8,037 randomly selected general Japanese without history of cardiovascular disease and followed them for 19 years. The multivariate adjusted hazard ratios (HRs) for total stroke mortality, intra-cerebral hemorrhage mortality and for cerebral infarction mortality according to family history were estimated using the Cox proportional hazards model. The prevalences of family histories of stroke and of hypertension were 20.6% and 31.1%, respectively. A family history of stroke was not related to total stroke mortality, intra-cerebral hemorrhage mortality or to cerebral infarction mortality. Meanwhile, a family history of hypertension was positively related to total stroke mortality among women aged less than 60 years and men aged 60 or more years (women: HR=3.41, 95% confidence interval [CI]: 1.49-7.81; men: HR=1.50, 95% CI: 1.00-2.24) even after adjustment for systolic blood pressure. In conclusion, a family history of stroke could not predict total stroke mortality. However, a family history of hypertension might predict an increased risk for total stroke.

Impact of metabolic syndrome components on the incidence of cardiovascular disease in a general urban Japanese population

Kokubo Yoshihiro, Okamura Tomonori, Yoshimasa Yasunao, Miyamoto Yoshihiro, Kawanishi Katsuyuki, Kotani Yasushi, Okayama Akira, Tomoike Hitonobu

Hypertension Research 31 ( 11 ) 2027 - 2035 2008

ISSN 0916-9636

Abdominal obesity is a prerequisite for some definitions of metabolic syndrome (MetS). We investigated the impact of MetS defined by two different criteria, which either did or did not require abdominal obesity as a prerequisite, on cardiovascular disease (CVD) incidence in an urban Japanese cohort study. We studied 5,332 Japanese (aged 30-79 years, without CVD at baseline), who completed a baseline survey (September 1989 to March 1994) and were followed up through December 2005. MetS was defined by the NCEP-ATPIII (modified by Asian obesity criteria) and the Japanese criteria. After 61,846 person-years of follow-up, we documented 317 CVD incidences. The MetS frequencies of the Japanese and of the modified NCEP-ATPIII criteria were 17.7% and 25.1% for men and 5.0% and 14.3% for women, respectively. The multivariate hazard ratios (HRs; 95% confidence intervals [CI]) of CVD incidence for MetS by the modified NCEP-ATPIII criteria were 1.75 (1.27-2.41) in men and 1.90 (1.31-2.77) in women, and those for MetS by the Japanese criteria were 1.34 (0.96-1.87) in men and 2.20 (1.31-3.68) in women. The multivariate HRs of CVD incidence for MetS for the Japanese and for the modified NCEP-ATPIII criteria were 2.92 (1.54-5.55) and 1.94 (0.98-3.82) in men under 60 years old, respectively. The CVD incidence risks increased according to the number of MetS components. The risks were similar among participants with the same number of MetS components, regardless of abdominal obesity. In conclusion, the number of MetS components (modified NCEP-ATPIII criteria) may be more strongly associated with CVD incidence than the abdominal obesity essential criteria (the Japanese criteria) in a general urban Japanese population.

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Low-risk profile for cardiovascular disease and mortality in Japanese

Yamamoto Takako, Nakamura Yasuyuki, Hozawa Atsushi, Okamura Tomonori, Kadowaki Takashi, Hayakawa Takehito, Murakami Yoshitaka, Kita Yoshikuni, Okayama Akira, Abbott Robert D., Ueshima Hirotsugu

Circulation Journal 72 ( 4 ) 545 - 550 2008

ISSN 1346-9843

Background: Some studies focusing on low-risk profiles for cardiovascular disease have been reported in Western countries. Yet, few reports have examined, with substantial longevity, the low-risk profile for cardiovascular disease in the Japanese population. This study examines whether having a favorable risk factor profile yields lower all-cause mortality and whether the proportion of those with a low-risk profile is larger in the Japanese population. Methods and Results: A total of 8,339 men and women aged 30-69 years without a history of cardiovascular diseases for 19 years, who had participated in the 1980 National Survey on Circulatory Disorders after being randomly selected from throughout Japan, were followed. Low risk was defined as having all of the following baseline characteristics: blood pressure (BP) <120/80 mmHg; no antihypertensive medication; serum cholesterol 160-240 mg/dl (4.14-6.22 mmol/L); no history of diabetes; and non-smoker. The long-term mortality of the low-risk group was compared with that of others using the Cox proportional hazard model. The prevalence of low risk was 9.4% of all participants. The multivariate-adjusted hazard ratios for low-risk individuals compared with others were as follows: 0.33 (95% confidence intervals (CI), 0.15-0.74) for cardiovascular disease and 0.63 (95% CI, 0.46-0.88) for all-cause mortality. The most attributable risk factor for all-cause mortality was high BP (≥120/80 mmHg). Conclusion Japanese individuals with favorable cardiovascular disease risk profiles had lower mortality from cardiovascular disease and all-causes than those without.

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The relationship between white blood cell count and risk of hypertension in populations with high prevalence of smoking

Okamura Tomonori, Watanabe Makoto

Hypertension Research 31 ( 7 ) 1279 - 1281 2008

ISSN 0916-9636

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Association of lipoprotein-associated phospholipase A2 with coronary calcification among American and Japanese men

El-Saed Aiman, Sekikawa Akira, Zaky Riad Wahid, Kadowaki Takashi, Takamiya Tomoko, Okamura Tomonori, Edmundowicz Daniel, Kita Yoshikuni, Kuller Lewis H., Ueshima Hirotsugu

Journal of Epidemiology 17 ( 6 ) 179 - 185 2007.12

ISSN 0917-5040

Background: We have previously reported that the prevalence of coronary artery calcification (CAC) was substantially lower among Japanese than American men despite a less favorable profile of many traditional risk factors in Japanese men. To determine whether lipoprotein-associated phospholipase A2 (Lp-PLA2) levels are related to the difference in the prevalence of CAC between the two populations. Methods: A total of 200 men aged 40-49 years were examined: 100 residents in Allegheny County, Pennsylvania, United States, and 100 residents in Kusatsu City, Shiga, Japan. Coronary calcium score (CCS) was evaluated by electron-beam tomography, Lp-PLA2 levels, nuclear magnetic resonance (NMR) lipoprotein subclasses, and other factors were assessed in 2001-2002. Results: Lp-PLA2 levels were higher among American than Japanese men (Mean ± standard deviation 301.7 ± 82.6 versus 275.9 ± 104.7 ng/mL, respectively, p=0.06). Among all Japanese men and those with low density lipoprotein (LDL) cholesterol ≥130 mg/dL, there was an inverse association of the prevalence of CCS>0 with the tertile groups of Lp-PLA2 levels (p=0.08 and p=0.03, respectively). American men did not have any association between CCS>0 with the tertile groups of Lp-PLA2 (p=0.62). Although Lp-PLA2 among both populations correlated positively with LDL and total cholesterol, American and Japanese men had different correlations with NMR lipoprotein subclasses. Reported high odds ratio for CCS>0 among American compared to Japanese men was not reduced after adjusting for Lp-PLA2 levels. Conclusion: Lp-PLA2 may have different mechanisms of action among American and Japanese men. Lp-PLA2 levels can not explain the observed CAC differences between the two populations. Copyright © 2007 by the Japan Epidemiological Association.

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Erratum

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

Acta Diabetologica 44 ( 4 ) 241 2007.12

ISSN 0940-5429

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Coronary artery calcification in Japanese men in Japan and Hawaii

Abbott Robert D., Ueshima Hirotsugu, Rodriguez Beatriz L., Kadowaki Takashi, Masaki Kamal H., Willcox Bradley J., Sekikawa Akira, Kuller Lewis H., Edmundowicz Daniel, Shin Chol, Kashiwagi Atsunori, Nakamura Yasuyuki, El-Saed Aiman, Okamura Tomonori, White Roger, Curb J. David

American Journal of Epidemiology 166 ( 11 ) 1280 - 1287 2007.12

ISSN 0002-9262

Explanations for the low prevalence of atherosclerosis in Japan versus the United States are often confounded with genetic variation. To help remove such confounding, the authors compared coronary artery calcification (CAC), a marker of subclinical atherosclerosis, between Japanese men in Japan and Japanese men in Hawaii. Findings were based on risk factors and CAC measured from 2001 to 2005 in 311 men in Japan and 300 men in Hawaii. Men were aged 40-50 years and without cardiovascular disease. After age adjustment, there was a threefold excess in the odds of prevalent CAC scores of ≥10 in Hawaii versus Japan (relative odds = 3.2, 95% confidence interval: 2.1, 4.9). Whereas men in Hawaii had a generally poorer risk factor profile, men in Japan were four times more likely to smoke cigarettes (49.5% vs. 12.7%, p < 0.001). In spite of marked risk factor differences between the samples, none of the risk factors explained the low amounts of CAC in Japan. After risk factor adjustment, the relative odds of CAC scores of ≥10 in Hawaii versus Japan was 4.0 (95% confidence interval: 2.2, 7.4). Further studies are needed to identify factors that protect against atherosclerosis in Japanese men in Japan. © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved.

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Joint impact of smoking and hypertension on cardiovascular disease and all-cause mortality in Japan

Hozawa Atsushi, Okamura Tomonori, Murakami Yoshitaka, Kadowaki Takashi, Nakamura Koshi, Hayakawa Takehito, Kita Yoshikuni, Nakamura Yasuyuki, Abbott Robert D., Okayama Akira, Ueshima Hirotsugu

Hypertension Research 30 ( 12 ) 1169 - 1175 2007.12

ISSN 0916-9636

Hypertension and smoking are major risk factors for death to cardiovascular disease (CVD). These attributions for CVD mortality should be higher in the countries where obesity-related conditions are uncommon. However, the joint effect of these risk factors on CVD and all-cause mortality have not been described. We followed a representative 8,912 Japanese men and women without a history of stroke and heart disease. Participants were categorized into 4 groups as follows: a group of individuals who neither smoked nor had hypertension (HT), a group of current smokers, a group with HT, and a group of current smokers with HT. We further calculated population-attributable fractions (PAF) of CVD and all-cause mortality based on relative hazards assessed by proportional hazard regression models. After 19 years of follow-up, we observed 313 and 291 CVID and 948 and 766 all-cause deaths for men and women, respectively. The PAF of CVD mortality due to smoking or HT were 35.1 % for men and 22.1 % for women. The PAF of CVID mortality was higher in participants <60 years of age (57.4% for men and 40.7% for women) vs. those who were older (26.3% for men and 18.1% for women). Aggressive aftempts to discourage smoking and to curb HT could yield large health benefits in Japan and throughout Asia, particularly for those aged <60 years. Efforts to warn about the adverse consequence of HT and smoking during adolescence and youth could yield the greatest health benefits, since positive behaviors adopted early are more easily continued into middle adulthood and later life.

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Is weak association between cigarette smoking and cardiovascular disease mortality observed in Japan explained by low total cholesterol? - NIPPON DATA80

Hozawa Atsushi, Okamura Tomonori, Kadowaki Takashi, Murakami Yoshitaka, Nakamura Koshi, Hayakawa Takehito, Kita Yoshikuni, Nakamura Yasuyuki, Okayama Akira, Ueshima Hirotsugu

International Journal of Epidemiology 36 ( 5 ) 1060 - 1067 2007.10

ISSN 0300-5771

Background: An international comparison has indicated that the association between smoking and cardiovascular disease (CVD) differs according to total cholesterol (TC) levels. However, little has been published about the relationship between smoking and CVD mortality among populations with various cholesterol levels. Methods: We calculated the adjusted relative hazard (RH) of smoking for CVD mortality among 8912 Japanese individuals without a history of stroke or heart disease, who were separated according to TC levels of ≥5.40, 4.81-5.39, 4.26-4.80 and <4.25 mmol/l into groups Q4, Q3, Q2 and Q1, respectively. The P-values for multiple interactions between TC and smoking status for CVD mortality were calculated using TC as a continuous variable, dichotomized smoking status (never vs current), and by including cross-product terms in the regression models. Results: After 19 years of follow-up, 313 men and 291 women died of CVD. The RH of CVD mortality among men who currently smoked compared with those who never smoked was increased with higher TC (RH = 2.36 in Q4) and decreased in those with lower TC (RH = 0.85 in Q1) (interaction, P = 0.01). The profiles for coronary heart disease (CHD) mortality and ischaemic CVD (composite endpoint of CHD and ischaemic stroke) in men and for ischaemic CVD mortality in women were identical. The interaction might be explained by a biological mechanism and by frailty of those who have never smoked with lower TC. Conclusions: Counteractive measures should be implemented against smoking targeted towards Japanese with elevated TC levels. © The Author 2007; all rights reserved.

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The proportion of individuals with obesity-induced hypertension among total hypertensives in a general Japanese population

Nakamura Koshi, Okamura Tomonori, Hayakawa Takehito, Hozawa Atsushi, Kadowaki Takashi, Murakami Yoshitaka, Kita Yoshikuni, Okayama Akira, Ueshima Hirotsugu

European Journal of Epidemiology 22 ( 10 ) 691 - 698 2007.10

ISSN 0393-2990

The increased prevalence of obesity in Japan may contribute to the high prevalence of hypertension in Japan. In the present study, we calculated the odds ratio for hypertension in obesity (body mass index (BMI) ≥ 25.0 kg/m²) using data from independent nationwide surveys conducted in 1980 and 1990. We estimated the percentage of hypertensives whose condition was due to obesity among total hypertensives in the general Japanese population. In the 1980 survey, 18.8% of 4,623 male participants were obese and 50.4% were hypertensive, whereas 22.6% of 5,893 female participants were obese and 41.1% were hypertensive. For both sexes, obese participants had a higher odds ratio for hypertension than non-obese participants (BMI < 25.0 kg/m²), and there was a significant dose-response relationship between BMI and the odds ratio for hypertension. Among all hypertensives, the percentage whose hypertension was due to obesity in 1980 and 1990 was 11.4% (95% confidence interval (CI): 4.7-17.7%) and 15.3% (95% CI: 6.8-23.1%) for men and 19.3% (95% CI: 12.1-25.9%) and 22.3% (95% CI: 14.6-29.3%) for women, respectively. Approximately 80-90% of individuals with obesity-induced hypertension were in the 25.0 ≤ BMI < 30.0 kg/m² category for both sexes in each year. In conclusion, we found that obesity-induced hypertension as a proportion of total hypertension increased between 1980 and 1990 for both sexes. Obesity now is playing a more important role in the high prevalence of hypertension in Japan than it was before. © 2007 Springer Science+Business Media B.V.

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Medical costs of obese Japanese

Nakamura Koshi, Okamura Tomonori, Kanda Hideyuki, Hayakawa Takehito, Okayama Akira, Ueshima Hirotsugu, Yamashita Shigeo, Tominaga Yoshinori, Katsuyama Kazuaki, Kakuno Fumihiko, Kitanishi Machiko, Tobita Yukio, Okamura Kanehiro, Hatta Kiminobu, Okada Takao, Hatanaka Michiko

European Journal of Public Health 17 ( 5 ) 424 - 429 2007.10

ISSN 1101-1262

Background: For the Japanese population, a body mass index (BMI) of 25.0-29.9 is classified as obesity and is a risk factor for cardiovascular disorders such as hypertension. Methods: A cohort study to clarify obesity costs for a Japanese population was conducted utilizing baseline BMI and medical costs over a 10-year follow-up period. The participants were 4502 community dwelling Japanese National Health Insurance (NHI) beneficiaries aged 40-69 years. According to their baseline BMI values (kg/m²), participants were classified into the following three categories: BMI < 18.5, 18.5 ≤ BMI < 25.0 and 25.0 ≤ BMI. Medical costs per person per month were compared among the three categories. Excess medical costs attributable to the 25.0 ≤ BMI category compared to the 18.5 ≤ BMI < 25.0 category were estimated. Results: Approximately 20% of the Japanese population studied had a BMI of 25.0 or over. A J-shaped relationship between BMI and personal total medical costs was observed. Personal total medical costs per month determined from the 10-year follow-up in each category were 189 Euros (BMI < 18.5), 134 Euros (18.5 ≤ BMI < 25.0) and 155 Euros (25.0 ≤ BMI). A J-shaped pattern was observed after adjusting for age, sex, smoking and drinking habits, and excluding early deceased participants. Furthermore, smoking habit did not modify the J-shaped pattern of total medical costs. The estimated excess medical costs for the 25.0 ≤ BMI category represented 3.1% of the total medical costs for the entire study population (634 105 Euros). Conclusion: The Japanese NHI beneficiaries with a BMI of 25.0 or over showed increased medical costs compared to those with a BMI of 18.5-24.9. © The Author 2007. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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Awareness and treatment of hypertension and hypercholesterolemia in Japanese workers

Tanaka Taichiro, Okamura Tomonori, Yamagata Zentaro, Takebayashi Toru, Tamura Unai, Kusaka Yukinori, Urano Sumio, Miyoshi Yuji, Okayama Akira, Ueshima Hirotsugu, Sakata Kiyomi, Tsuji Keiko, Yoshita Katsushi, Kikuchi Yuriko, Nakagawa Hideaki, Miura Katsuyuki, Yamato Hiroshi, Chiba Nagako, Yanagita Masahiko, Kodama Kazunori, Kasagi Fumiyoshi, Nishi Nobuo, Saitoh Shigeyuki, Tanaka Hideo, Nakamura Masakazu, Naito Yoshihiko, Nakamura Yasuyuki, Watanabe Makoto, Nakamura Yoshikazu, Babazono Akira, Yamagata Zentaro, Urano Sumio, Kinoshita Fujihisa, Saitoh Isao, Tanihara Shinichi, Tamaki Junko, Tochikubo Osamu, Nakayama Takeo, Fukuhara Shunichi, Fujieda Yoshiharu, Naito Mariko, Mizushima Shunsaku, Miyoshi Yuji, Tada Takayo, Kadowaki Takashi, Yoshida Toshimi, Ide Mami

Hypertension Research 30 ( 10 ) 921 - 928 2007.10

ISSN 0916-9636

The objective of this study was to clarify the awareness and treatment status of hypertension in Japanese workers, comparing with those of hypercholesterolemia. The subjects were 6,186 workers (age 19 to 69 years), who worked at 12 workplaces in Japan and who continuously participated in the High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study at the baseline (1999 or 2000) and the subsequent year (2000 or 2001). No Intervention was performed during the study period. Blood pressure and total cholesterol level were measured at baseline. Awareness and treatment status were examined by a self-administered questionnaire in the following year. Untreated subjects were defined as those were not aware of hypertension (or hypercholesterolemia) or those not taking medication and not undergoing lifestyle modification. The percentages of subjects with hypertension defined as aware were 65.7% in men and 72.7% in women, respectively. The percentages of subjects with hypercholesterolemia defined as aware were 55.7% in men and 58.6% in women, respectively. In subjects 40 years and older, the awareness rate for hypertension was significantly higher than the awareness rate for hypercholesterolemia (75.0% vs. 59.2%, p<0.001). The percentage of untreated subjects with hypertension was significantly lower than the percentage of untreated subjects with hypercholesterolemia (41.0% vs. 57.1%, p<0.001). Although Japanese workers ≥40 years old have a higher awareness of and are more often treated for hypertension than for hypercholesterolernia, there are still many unaware and untreated individuals with either disease in all age groups. It is important to increase the awareness of risk factors in individuals with positive findings for these conditions.

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γ-Glutamyltransferase predicts cardiovascular death among Japanese women

Hozawa Atsushi, Okamura Tomonori, Kadowaki Takashi, Murakami Yoshitaka, Nakamura Koshi, Hayakawa Takehito, Kita Yoshikuni, Nakamura Yasuyuki, Okayama Akira, Ueshima Hirotsugu

Atherosclerosis 194 ( 2 ) 498 - 504 2007.10

ISSN 0021-9150

The clinical importance of γ-glutamyltransferase (GGT) has recently been debated. Although some studies have suggested that the relationship between GGT and cardiovascular disease (CVD) mortality is independent of alcohol consumption, to our knowledge no studies have reported the relationship between GGT and CVD mortality in never-drinker subgroups. Since Japanese women are known to have a lower prevalence of alcohol consumption, we examined whether GGT predicts CVD mortality in never-drinkers. We followed 2724 Japanese men and 4122 Japanese women without prior CVD or liver dysfunction for 9.6 years and observed 83 and 82 CVD deaths, respectively. Current alcohol drinkers comprised 59% of men and 7% of women. Among women, the multiple adjusted hazard ratio (HR) for CVD mortality compared with the reference group (GGT: 1-12 U/L) was 2.88 (95% confidence interval (CI), 1.14-7.28) for the elevated group (GGT ≥ 50 U/L). This positive relationship was unchanged in the never-drinkers subgroup (HR for log-transformed continuous GGT, 1.62 (95% CI, 1.11-2.37)). No significant relationships were observed in men. GGT displays a strong positive association with CVD mortality among Japanese women, for whom the prevalence of ever-drinkers is very low. Exploring the significance and biological mechanisms of GGT might provide useful insights into CVD prevention. © 2006 Elsevier Ireland Ltd. All rights reserved.

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Response to letter by Walsh et al [14]

Hozawa Atsushi, Okamura Tomonori, Ueshima Hirotsugu

Stroke 38 ( 9 ) 2007.09

ISSN 0039-2499

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Normal fasting plasma glucose levels and type 2 diabetes

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

Acta Diabetologica 44 ( 3 ) 164 - 166 2007.09

ISSN 0940-5429

The objective of this study is to ascertain if higher normal fasting glucose levels are also an independent risk of developing diabetes in an Asian population, and we thus analysed data from a cohort of healthy Japanese workers. We used data from the non-randomised trial on health promotion intervention, High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) Study. Diabetes cases and those who had fasting blood glucose levels equal to or greater than 100 mg/dl at baseline were excluded, and the Cox proportional-hazards model was used for the analysis. During the four-year follow-up of 2212 participants, we found 37 diabetes cases. In the multivariable model, people with blood glucose levels in the 4th quartile had a higher risk of diabetes than those in the bottom quartile; the multivariable-adjusted odds ratio was 2.52. The risk of diabetes abruptly rose in persons with blood glucose levels higher than 94 mg/dl (fourth quartile). A significant linear trend was not observed in the 1st to 3rd quartiles (p=0.726). In conclusion, higher fasting glucose level was associated with the risk of diabetes, and we found a threshold in the association between fasting blood glucose levels and risk of diabetes in an Asian population. © 2007 Springer-Verlag.

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Fish consumption and early atherosclerosis in middle-aged men

Nakamura Yasuyuki, Ueno Yoshiki, Tamaki Shinji, Kadowaki Takashi, Okamura Tomonori, Kita Yoshikuni, Miyamatsu Naomi, Sekikawa Akira, Takamiya Tomoko, El-Saed Aiman, Sutton-Tyrrell Kim, Ueshima Hirotsugu

Metabolism: Clinical and Experimental 56 ( 8 ) 1060 - 1064 2007.08

ISSN 0026-0495

To investigate the association between fish consumption and early atherosclerosis, we analyzed the relationship between fish consumption and average intima-media thickness (AveIMT) by carotid ultrasound in middle-aged Japanese men. Participants were 250 randomly selected, community-based Japanese men aged 40 to 49 years without a prior history of cardiovascular disease. AveIMT was calculated from the mean of 1-cm lengths of both the right and the left carotid arteries at 8 locations. A lifestyle survey was carried out using a self-administered questionnaire including the frequency of fish intake. There were 147 men in the fewer than 4 times per week fish consumption group and 103men in the 4 or more times per week group. The mean AveIMT was significantly higher in the low fish consumption group than in the high fish consumption group (0.623 ± 0.068 vs 0.605 ± 0.065 mm, P = .03). After adjustment for age, waist circumference, pack-years of smoking, alcohol consumption, diabetes, and lipid-lowering medications, the significant difference in the AveIMT between the 2 groups remained. However, after further adjustment for low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and C-reactive protein in the model, the significant difference disappeared. Fish consumption may be protective against early atherosclerosis in middle-aged men, probably through its beneficial effects on inflammation. © 2007 Elsevier Inc. All rights reserved.

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The proportion of individuals with alcohol-induced hypertension among total hypertensives in a general japanese population

Nakamura Koshi, Okamura Tomonori, Hayakawa Takehito, Hozawa Atsushi, Kadowaki Takashi, Murakami Yoshitaka, Kita Yoshikuni, Okayama Akira, Ueshima Hirotsugu, Iimura Osamu, Omae Teruo, Ueda Kazuo, Yanagawa Hiroshi, Horibe Hiroshi, Kodama Kazunori, Kasagi Fumiyoshi, Tanihara Shinichi, Saito Shigeyuki, Sakata Kiyomi, Nakamura Yosikazu, Kakuno Fumihiko, Takeuchi Toshihiro, Hasebe Mitsuru, Kusano Fumitsugu, Kawamoto Takahisa, Minowa Masumi, Iida Minoru, Hashimoto Tsutomu, Tanaka Shigemichi, Terao Atsushi, Kawaminami Katsuhiko, Sawai Koryo, Shibata Shigeo

Hypertension Research 30 ( 8 ) 663 - 668 2007.08

ISSN 0916-9636

Japanese men consume more alcoholic beverages than men in many other developed countries. The high consumption rate of alcoholic beverages among Japanese men may contribute to the high prevalence of hypertension in Japan. In the present study, we calculated the odds ratio for hypertension in alcohol drinkers based on recent criteria using data from a nationwide survey conducted in Japan in 1990, and estimated, among total hypertensives in a general Japanese population, the percentage of hypertensives whose condition was due to alcohol consumption. Of 3,454 male participants, 64.8% were drinkers (1 gou/day, 28.9%; 2 gou/day, 20.1%; 3 gou/day or more, 8.7%; ex-drinkers, 7.0%) and 49.8% were hypertensive, whereas 7.6% of 4,808 female participants were drinkers (1 gou/day, 5.2%; 2 gou/day or more, 1.3%; ex-drinkers, 1.1%) and 43.1% were hypertensive (1 gou=23.0 g of alcohol). In both sexes, drinkers had a higher odds ratio for hypertension than never drinkers, and there was a significant dose-response relationship between the amount of alcohol consumed and the odds ratio for hypertension. Among all hypertensives, the percentage whose hypertension was due to alcohol consumption was 34.5% (95% confidence interval, 10.9%,51.9%) for men and 2.6% (0.8%,5.8%) for women. The corresponding proportion based on daily alcohol intake was 12.7% for 1 gou/day, 11.1 % for 2 gou/day, 5.8% for 3 gou/day or more, and 4.8% for ex-drinkers in men, and 1.8% for 1 gou/ day, 0.7% for 2 gou/day or more, and -0.1% for ex-drinkers in women. In conclusion, we found that a large percentage of the hypertensives in a general Japanese male population had alcohol-induced hypertension.

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Reduced HDL-cholesterol levels associated with smoking

Okamura Tomonori, Higashiyama Aya, Miyamatsu Naomi

Nippon rinsho. Japanese journal of clinical medicine 65 Suppl 7 663 - 666 2007.07

ISSN 0047-1852

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