Faculty Profiles - YATSUYA Hiroshi

Impact of diabetes on mortality and hospitalization after dementia diagnosis: Health insurance claims data analysis Reviewed

Masaaki Matsunaga, Shinichi Tanihara, Yupeng He, Hiroshi Yatsuya, Atsuhiko Ota

Geriatrics & Gerontology International Vol. 24 ( 8 ) page： 773 - 781 2024.8

Language：English Publishing type：Research paper (scientific journal) Publisher：Wiley

Aim

Japan faces a public health challenge of dementia, further complicated by the increasing complications from diabetes within its rapidly aging population. This study assesses the impact of diabetes on mortality and hospitalization among individuals aged ≥75 years with new dementia diagnoses.

Methods

We analyzed administrative claims data in Japan from 73 324 individuals aged ≥75 years with dementia, of whom 17% had comorbid diabetes. Dementia and diabetes were identified from the International Classification of Diseases, Tenth Revision codes. We used Kaplan–Meier survival analysis, Cox proportional hazards analysis, and population attributable fractions (PAFs) to evaluate the impact on mortality and hospitalization after dementia diagnosis.

Results

One‐year mortality and 1‐year hospitalization probabilities in individuals with dementia and diabetes (10.3% and 31.7%, respectively) were higher than those without diabetes (8.3% and 25.4%, respectively). The adjusted hazard ratios for individuals with diabetes, as compared to those without, were 1.126 (95% confidence interval [CI], 1.040–1.220) for mortality and 1.191 (95% CI, 1.140–1.245) for hospitalization. The PAFs from the comorbidity of dementia and diabetes were 2.2% for mortality and 3.1% for hospitalization. Subgroup analysis showed that the PAFs were highest in men aged 75–79 years and women aged 80–84 years for mortality and in individuals aged 75–79 for hospitalization.

Conclusion

During the early postdiagnosis period, comorbid diabetes increases mortality and hospitalization risks in older adults with dementia. The variation in disease burden across age groups underscores the need for age‐specific health care strategies to manage comorbid diabetes in individuals with dementia. Geriatr Gerontol Int 2024; 24: 773–781.

DOI： 10.1111/ggi.14926

Efficacy of Immune Checkpoint Inhibitors in Postoperative Recurrence of Wild-type EGFR Non-Small Cell Lung Cancer. Reviewed

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Imamura Y, Kato T, Nomata Y, Okado S, Watanabe H, Kawasumi Y, Nakanishi K, Kadomatsu Y, Ueno H, Nakamura S, Mizuno T, Hase T, Tanaka I, Ishii M, Yatsuya H, Chen-Yoshikawa TF

Anticancer research Vol. 44 ( 8 ) page： 3451 - 3461 2024.8

Language：English Publishing type：Research paper (scientific journal) Publisher：Anticancer Research

Background/Aim: Immune checkpoint inhibitors (ICIs) have been widely used in the treatment of non-small cell lung cancer (NSCLC), but specific outcomes of ICIs treatment among patients with postoperative recurrence of NSCLC remain unclear. The objective of the study was to compare the efficacy of ICIs and chemotherapy with conventional chemotherapy only in patients with postoperative recurrence of epidermal growth factor receptor (EGFR) wild-type NSCLC. Patients and Methods: A retrospective analysis was performed on patients who underwent anatomical lung resection at the Nagoya University Hospital and were treated for postoperative recurrence of wild-type EGFR NSCLC. This study evaluated the prognosis for postoperative recurrence, including ICIs treatment and other clinicopathological factors. Results: Of the 83 patients included in the analysis, 20 patients underwent chemotherapy and 63 patients underwent chemotherapy combined with ICIs. The combination of ICIs and chemotherapy significantly prolonged survival after recurrence (median survival: 33.1 months vs. 22.0 months, p=0.01). In the ICIs group, no significant differences in survival were detected between patients with different programmed death ligand 1 (PD-L1) status (Tumor Proportion Scores: <1%, 1%-49%, ≥50%, p=0.27). Multivariate analysis revealed that postoperative distant recurrence was a significant poor prognostic factor for survival after recurrence (HR=1.85, 95% CI=1.06-3.25, p=0.03), and combining ICIs with chemotherapy significantly improved survival after recurrence (HR=0.43, 95% CI=0.24-0.78, p<0.01). Conclusion: Combination of ICIs with chemotherapy significantly prolonged survival of postoperative recurrence with wild-type EGFR NSCLC regardless of PD-L1 status.

DOI： 10.21873/anticanres.17165

Lifetime Risk of Incident Coronary Heart Disease, Stroke, and Cardiovascular Disease: The Japan Public Health Center-Based Prospective Study. Reviewed

Isao Saito, Kazumasa Yamagishi, Yoshihiro Kokubo, Hiroshi Yatsuya, Isao Muraki, Hiroyasu Iso, Manami Inoue, Shoichiro Tsugane, Norie Sawada

Journal of atherosclerosis and thrombosis Vol. advpub ( 0 ) 2024.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Japan Atherosclerosis Society

AIM: The constellation of cardiovascular disease (CVD) risk factors greatly impacts the lifetime risk (LTR) of incident CVD, but the LTR has not been thoroughly evaluated in the Japanese population. METHODS: We conducted a prospective study involving a total of 25,896 individuals 40-69 years old without a history of CVD in 1995 (Cohort I) and 1993-1994 (Cohort II) in Japan. CVD risk factors (blood pressure, non-high-density lipoprotein [HDL] cholesterol levels, smoking status, and glucose concentrations) were used to stratify them by risk. The sex-specific LTR of incident coronary heart disease, stroke, atherosclerotic CVD, and total CVD were estimated for participants 45 years old in the 4 risk categories with the cumulative incidence rate, adjusting for the competing risk of death. RESULTS: We found apparent differences in the LTR of total CVD according to the risk stratification. Individuals with ≥ 2 of the risk factors of blood pressure ≥ 140/90 mmHg or treated, non-HDL cholesterol level ≥ 170 mg/dL or treated, current smoker, and diabetes had substantially higher adjusted LTRs of CVD than those in other groups, with a LTR of 26.5% (95% confidence interval, 24.0%-29.0%) for men and 15.3% (13.1%-17.5%) for women at 45 years. The LTR of incident stroke was the highest among CVDs, and the presence of hypertension and diabetes mellitus strongly influenced the LTR of total CVD. CONCLUSION: The impact of risk accumulation on LTR of CVD was greater in men, and 1 in 4 men with ≥ 2 major risk factors at 45 years of age developed CVD in their lifetime.

DOI： 10.5551/jat.64934

Association between milk consumption in middle age and frailty in later life: The Aichi Workers' cohort study Reviewed

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Young Jae Hong, Rei Otsuka, Zean Song, Chisato Fukuda, Rina Tajima, Jingyi Lin, Mizuho Hibino, Mei Kobayashi, Yupeng He, Masaaki Matsunaga, Atsuhiko Ota, Yoshihisa Nakano, Yuanying Li, Koji Tamakoshi, Hiroshi Yatsuya

Geriatrics & Gerontology International Vol. 24 ( 7 ) page： 700 - 705 2024.7

Authorship：Last author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Wiley

Aim

Several studies have shown that dairy consumption in old age is effective in preventing frailty. However, there is a lack of evidence regarding the association between milk consumption during middle age and the development of frailty in old age. Therefore, we carried out an investigation to explore the association between milk consumption during middle age and development of frailty examined after over 15 years of follow up in a long‐term cohort study in Japan.

Methods

We studied 265 participants aged 60–79 years (212 men and 53 women) in 2018, who participated in both the baseline survey in 2002 and the frailty assessment in 2018. The amount of milk consumption (g/day) at baseline was age‐ and energy‐adjusted, and classified into three categories (no, low and high consumption: 0 g/day, ≤135.86 g/day, >135.86 g/day in men and 0 g/day, ≤126.44 g/day, >126.44 g/day in women). Odds ratios (OR) and 95% confidence intervals (CI) for prefrailty/frailty after adjusting for lifestyles at baseline, stratified by sex, were estimated using logistic regression analysis.

Results

The prevalence of prefrailty/frailty in 2018 was 37.7% and 28.3% in men and women, respectively. Milk consumption categories were inversely associated with the prevalence of prefrailty/frailty in men (OR 0.34, 95% CI 0.14–0.84 in low consumption; OR 0.31, 95% CI 0.10–0.95 in high consumption; P < 0.05), but not in women (OR 0.53, 95% CI 0.11–2.65; P = 0.44).

Conclusions

In this study, milk intake in middle‐aged men was inversely associated with the prevalence of prefrailty/frailty later in life. Geriatr Gerontol Int 2024; 24: 700–705.

DOI： 10.1111/ggi.14916

Relationship between size of pharyngeal and palatine tonsils and apnea–hypopnea index in pediatric obstructive sleep apnea Reviewed

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定年退職期の就労継続と脳灰白質容積の10年間の変化

大塚礼, 西田裕紀子, 丹下智香子, 八谷寛, 久保田彩, 安藤富士子, 下方浩史, 加藤隆司, 中村昭範, 荒井秀典

日本老年医学会雑誌 Vol. 61 ( Suppl. ) page： 141 - 141 2024.5

20歳から老年期にかけての体重変動はフレイル発症関連要因である愛知職域コホート研究

洪英在, 大塚礼, 宋澤安, 福田知里, 小林芽生, 松永眞章, 太田充彦, 李媛英, 玉腰浩司, 八谷寛

日本老年医学会雑誌 Vol. 61 ( Suppl. ) page： 133 - 133 2024.5

Kaneko Masamichi, Hirata Masatoshi, Kimura Ayami, Inada Hiroya, Shikano Kazuki, Ito Satoshi, Okano Takayuki, Yatsuya Hiroshi, Nakata Seiichi

Fujita Medical Journal Vol. 10 ( 2 ) page： 60 - 63 2024.5

Language：English Publisher：Fujita Medical Society

Objective: To determine whether the combination of the pharyngeal tonsil grade and palatine tonsil grade results in differences in the apnea–hypopnea index (AHI) and to determine whether each parameter separately (pharyngeal tonsil grade and palatine tonsil grade) results in differences in severe obstructive sleep apnea (OSA).Methods: This cross-sectional study involved 107 children (mean age, 7.2 years; range, 4–12 years) suspected of having OSA because of snoring or sleep-related complaints. The patients underwent polysomnography, and their palatine and pharyngeal tonsils were graded.Results: In examining whether the palatine tonsils and pharyngeal tonsils could be risk factors for severe OSA, the adjusted odds ratios were 4.42 for palatine tonsil grade 4 versus 1–3 and 10.40 for pharyngeal tonsil grade 4 versus 1–3; both were highly statistically significant. We also found that the AHI when both the pharyngeal and palatine tonsils were grade 4 was higher than the AHI expected for the pharyngeal and palatine tonsils alone.Conclusions: The combination of grade 4 pharyngeal tonsils and grade 4 palatine tonsils resulted in an AHI much higher than the AHI of other combinations (pharyngeal tonsils grades 1–3 and 4, palatine tonsils grades 1–3 and 4). We believe that grade 4 pharyngeal tonsils and grade 4 palatine tonsils have a great influence on severe OSA and that grade 4 pharyngeal tonsils increase the AHI.

DOI： 10.20407/fmj.2023-011

Factors influencing interprofessional collaboration in long-term care from a multidisciplinary perspective: a case study approach. Reviewed

日本人中年男性における長期的な収縮期血圧変動とうつ状態発症との関連

小林芽生, 李媛英, 宋澤安, 洪英在, 日比野瑞歩, 田島里菜, 太田充彦, 大塚礼, 玉腰浩司, 八谷寛

日本循環器病予防学会誌 Vol. 59 ( 2 ) page： 127 - 127 2024.4

Yoshida Y, Hirakawa Y, Hong YJ, Mamun MR, Shimizu H, Nakano Y, Yatsuya H

Home health care services quarterly page： 1 - 20 2024.3

Authorship：Last author Language：English Publisher：Home Health Care Services Quarterly

Systematic assessments of interprofessional collaboration barriers and enablers in long-term care settings are critical for delivering person-centered healthcare. However, research on factors influencing interprofessional collaboration in long-term care settings is limited. For this study, 65 healthcare professionals across multiple facilities experienced in long-term care in Japan participated in online focus group discussions and individual interviews to discuss cases. The qualitative data were analyzed using qualitative content analysis. Seven themes emerged: coordination, the need for care manager training, hierarchy among healthcare professionals, specialization but not the mind-set of overspecialization, casual conversations, electronic group communication tools, and excessive fear of personal information protection. These findings highlight the need to develop coordinator roles and for interprofessional education on the proper approach to personal information protection laws. Furthermore, daily casual conversations, the use of online platforms, and the prevention of patients being left behind due to overspecialization are required.

DOI： 10.1080/01621424.2024.2331452

Prediction model of the risk for lateral local recurrence in locally advanced rectal cancer without enlarged lateral lymph nodes: Lessons from a Japanese multicenter pooled analysis of 812 patients Reviewed

新型コロナウイルス流行期の超過死亡と関連要因に関する主張への懸念 Reviewed

鈴木貞夫, 尾島俊之, 永田知里, 八谷寛, 若井建志

東海公衆衛生雑誌 Vol. 11 ( 2 ) page： 143 - 144 2024.3

Associations of overweight and obesity with the risk of cardiovascular disease according to metabolic risk factors among middle-aged Japanese workers: The Aichi Workers’ cohort study Reviewed International coauthorship

Abubakr Ahmed Abdullah Al-shoaibi, Yuanying Li, Zean Song, Young Jae Hong, Chifa Chiang, Yoshihisa Nakano, Yoshihisa Hirakawa, Masaaki Matsunaga, Atsuhiko Ota, Koji Tamakoshi, Hiroshi Yatsuya

Obesity Research & Clinical Practice Vol. 18 ( 2 ) page： 101 - 108 2024.3

Ogura, A; Shiomi, A; Yamamoto, S; Komori, K; Hamamoto, H; Manabe, S; Miyakita, H; Okuda, J; Yatsuya, H; Uehara, K

ANNALS OF GASTROENTEROLOGICAL SURGERY Vol. 8 ( 2 ) page： 284 - 292 2024.3

Language：English Publisher：Annals of Gastroenterological Surgery

Aim: Although the oncological impact of lateral lymph node dissection on enlarged lateral lymph nodes has been gradually accepted over the last decade, that on lateral lymph nodes without swelling remains doubtful. This study aimed to develop a prediction model for the future risk of lateral local recurrence and to clarify the value of adding lateral lymph node dissection in locally advanced rectal cancer without enlarged lateral lymph nodes. Methods: This retrospective, multi-institutional study recruited 812 patients with cStage II/III low rectal cancer without enlarged lateral lymph nodes <7 mm. Total lateral local recurrence was a hypothetical value of future risk of lateral local recurrence when lateral lymph node dissection was never performed. Results: Overall, total lateral local recurrences were observed in 67 patients (8.3%). In the multivariate analyses, the strongest risk factor for total local recurrences was no preoperative chemoradiotherapy (odds ratio [OR][95%Cl]: 33.2 [4.56–241.7], P < 0.001), followed by tumor distance ≤40 mm (OR [95%Cl]: 2.71 [1.51–4.86], P < 0.001) and lateral lymph node 5–7 mm (OR[95%Cl]: 2.38 [1.26–4.48], P = 0.007). In patients with lateral lymph nodes of 5–7 mm, the total lateral recurrence rate was 4.8% after preoperative chemoradiotherapy. Lateral lymph node dissection could reduce from a total lateral local recurrence of 21.6% to an actual lateral local recurrence of 8.0% in patients without preoperative treatment. Conclusion: We introduce a novel prediction model of future risk of lateral local recurrences, which has the potential to enable us to indicate lateral lymph node dissection selectively according to the patients' risks.

DOI： 10.1002/ags3.12742

Web of Science

Prevalence, severity, and risk factors of cancer-related fatigue among working cancer survivors: a systematic review and meta-analysis Reviewed

Masaaki Matsunaga, Yupeng He, May Thet Khine, Xuliang Shi, Ryusei Okegawa, Yuanying Li, Hiroshi Yatsuya, Atsuhiko Ota

Journal of Cancer Survivorship 2024.2

The effect of age on the relationship between body mass index and risks of incident stroke subtypes: The JPHC study. Reviewed International journal

Hanson Gabriel Nuamah, Yuanying Li, Hiroshi Yatsuya, Kazumasa Yamagishi, Isao Saito, Yoshihiro Kokubo, Isao Muraki, Hiroyasu Iso, Manami Inoue, Shoichiro Tsugane, Norie Sawada

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association Vol. 33 ( 2 ) page： 107486 - 107486 2024.2

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: The associations between body mass index (BMI) and stroke subtypes, particularly intracerebral hemorrhage, have not been consistent. Such inconsistencies may be due to differences in the age at which BMI was obtained. We examined the possible age modifications in the association between BMI and stroke risk. MATERIALS AND METHODS: We followed 88,754 participants, aged 40-69 years at baseline (1990-1994), of the Japan Public Health Center-based prospective (JPHC) study for stroke incidence. BMI was obtained using self-reported body weight and height, which were categorized using the following cut-off points: 18.5, 21, 23, 25, 27.5, and 30 kg/m2. Time-dependent Cox proportional hazards models that updated BMI and covariates using 5- and 10-year questionnaire responses were used to estimate hazard ratios and 95 % confidence intervals. The analyses were stratified by age group (40-59 and ≥60 years) and the age of the individuals was updated. RESULTS: During the median follow-up period of 19 years, we documented 4,690 strokes, including 2,781 ischemic strokes and 1,358 intracerebral hemorrhages. After adjusting for sex, age, smoking, alcohol consumption, leisure-time physical activity, history of hypertension, dyslipidemia, and diabetes mellitus, we observed a positive linear association between BMI and ischemic stroke (linear trend, p < 0.001) in both age groups (interaction p>0.05). In contrast, a curvilinear association between BMI and intracerebral hemorrhage was observed in both the middle (curvilinear trend, p=0.017) and the older group (curvilinear trend, p=0.098) (interaction p>0.05). CONCLUSION: BMI and stroke associations did not vary significantly with age, although the association may differ according to subtype.

DOI： 10.1016/j.jstrokecerebrovasdis.2023.107486

肥満疫学研究の最前線高齢期の身体指標の加齢変化と要介護予防

大塚礼, 八谷寛

肥満研究 Vol. 29 ( 合同学術集会抄録集 ) page： 131 - 131 2023.11

The electrophysiological index can effectively predict subsequent coronary artery aneurysm in children with Kawasaki disease Reviewed International journal

Suzuki Daijiro, Suzuki Takanori, Fujino Masayuki, Asai Yumiko, Kojima Arisa, Uchida Hidetoshi, Saito Kazuyoshi, Kusuki Hirofumi, Li Yuanying, Yatsuya Hiroshi, Sadanaga Tsuneaki, Hata Tadayoshi, Yoshikawa Tetsushi

Fujita Medical Journal Vol. 9 ( 4 ) page： 275 - 281 2023.11

Language：English Publishing type：Research paper (scientific journal) Publisher：Fujita Medical Society

Objectives: The Gunma score is used to predict the severity of Kawasaki disease (KD), including coronary artery aneurysm (CAA) as a cardiac complication, in Japan. Additionally, the characteristic ratio of ventricular repolarization (T-peak to T-end interval to QT interval [Tp-e/QT]) on a surface electrocardiogram reflects myocardial inflammation. This study aimed to determine whether the Tp-e/QT can be used to predict CAA in children with KD.Methods: We analyzed chest surface electrocardiograms of 112 children with KD before receiving intravenous immunoglobulin therapy using available software (QTD; Fukuda Denshi, Tokyo, Japan).Results: The Tp-e/QT (lead V5) was positively correlated with the Gunma score (r=0.352, p<0.001). The Tp-e/QT was larger in patients with CAA (residual CAA at 1 month after onset) than in those without CAA (0.314±0.026 versus 0.253±0.044, p=0.003). A receiver operating characteristic curve analysis was performed to assess whether the Gunma score and Tp-e/QT could predict subsequent CAA. The area under the curve of the Gunma score was 0.719 with the cutoff set at 5 points. The area under the curve of the Tp-e/QT was 0.892 with a cutoff value of 0.299. The fit of the prediction models to the observed probability was tested by the Hosmer–Lemeshow test with calibration plots using Locally weighted scatterplot smoothing (LOESS) fit. The Gunma score (p=0.95) and Tp-e/QT (p=0.95) showed a good fit.Conclusions: The Tp-e/QT is a useful biomarker in predicting coronary aneurysm complications in KD.

DOI： 10.20407/fmj.2023-001