研究者詳細 - 八谷　寛

論文 - 八谷　寛

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A comparison of modifiable risk factors for dementia among South Asian migrants and non-migrants aged 50 or older in Tasmania, Australia 査読有り国際共著 Open Access

Hamrah, MS; Alty, J; Goldberg, LR; Doherty, K; Kitsos, A; Bindoff, A; Roccati, E; Yatsuya, H; Vickers, JC

BMC PUBLIC HEALTH 25 巻 ( 1 ) 頁： 2362 2025年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC Public Health

Background: South Asian migrants are one of the fastest-growing populations in Australia, particularly in the southern island state of Tasmania. However, there is limited research evaluating their modifiable dementia risk factors. This study aimed to fill this gap by comparing risk factors in South Asian migrants to non-migrant Australians in Tasmania. Methods: A cross-sectional study was conducted with 136 South Asian migrants and 2743 non-migrant Australians aged 50 or older residing in Tasmania. Participants completed a survey questionnaire. Logistic regression models were used to assess differences in the odds of reporting modifiable dementia risk factors between the two cohorts as they responded to a survey. Results: South Asian migrants had higher odds of reporting hypertension (OR, 5.5; 95% CI, 3.5 to 8.4; p < 0.001), hypercholesterolaemia (OR, 4.4; 95% CI, 2.3 to 6.4; p < 0.001), cognitive inactivity (OR, 16.9; 95% CI, 10.4 to 28.9; p < 0.001), diabetes (OR, 5.2; 95% CI, 3.5 to 7.6; p < 0.001), smoking (OR, 3.6; 95% CI, 1.7 to 7.1; p < 0.001) and nonadherence to a Mediterranean-type diet (OR, 7.4; 95% CI, 3.5 to 18.9; p < 0.001), compared to non-migrant Australians. However, South Asian migrants had lower odds of reporting alcohol consumption (OR, 0.25; 95% CI, 0.14 to 0.43; p < 0.001). Conclusions: The risk profiles were different between South Asian migrants and non-migrant Australians, highlighting the need for targeted interventions addressing group-specific risk factors. However, the use of convenience sampling for the South Asian migrant group may limit the representativeness of the findings and affect their generalizability. However, the use of convenience sampling and the relatively small sample size of the South Asian migrant group may limit the representativeness and generalizability of the findings. Additionally, the South Asian migrant group may represent a more socioeconomically disadvantaged population compared to the non-migrant sample, which may be relatively healthier and more financially advantaged than the general Tasmanian population. The study highlights the need for targeted, culturally appropriate interventions to address these risks. Further research is needed to comprehensively assess the prevalence and determinants of modifiable dementia risk factors among South Asian migrants.

DOI： 10.1186/s12889-025-23426-4

Risk factors for intracerebral hemorrhage by five specific bleeding sites: Japan Public Health Center-based Prospective Study 査読有り Open Access

Ariyada, K; Yamagishi, K; Kihara, T; Muraki, I; Imano, H; Kokubo, Y; Saito, I; Yatsuya, H; Iso, H; Tsugane, S; Sawada, N

EUROPEAN STROKE JOURNAL 10 巻 ( 2 ) 頁： 600 - 609 2025年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：European Stroke Journal

Background: Evaluating the risk factors for intracerebral hemorrhage is indispensable for primary prevention. However, the pathogenesis varies depending on the bleeding site, and few prospective studies have explored risk factors in detail for each site. Participants and methods: The Japan Public Health Center-based Prospective Study is a prospective study comprising a population-based sample of Japanese adults in 1990 (Cohort I) and in 1993 (Cohort II). A total of 34,137 participants (11,907 men and 22,230 women) were enrolled in this study and followed up until 2009 for Cohort I and until 2012 for Cohort II. The association between risk factors (age, sex, blood pressure, serum cholesterol, triglycerides, blood glucose, body mass index, smoking, and drinking status) and intracerebral hemorrhage by its bleeding site (lobes, putamen, thalamus, cerebellum, and brainstem) was assessed using Cox proportional hazards analysis. Results: During a median 20-year follow-up, 571 intracerebral hemorrhage events occurred. Hypertension was associated with an increased risk of total intracerebral hemorrhage, but not lobar hemorrhage. The multivariable hazard ratio (95% confidence intervals) was 2.09 (1.75–2.50) for total intracerebral hemorrhage. In contrast, a low serum total cholesterol level was associated only with lobar hemorrhage (1.73 (1.01–2.96)). Heavy drinking was associated with the risk of total and putamen hemorrhage, and obesity was associated with the risk of putamen hemorrhage. Discussion and conclusion: The present study identified different risk factors depending on the bleeding site of intracerebral hemorrhage.

DOI： 10.1177/23969873241290680

その他リンク： https://journals.sagepub.com/doi/full-xml/10.1177/23969873241290680

Utility of long-term systolic blood pressure variability for predicting the development of type 2 diabetes mellitus 査読有り

Song, Z; Li, YY; Hong, YJ; Chiang, CF; Matsunaga, M; He, YP; Ota, A; Tamakoshi, K; Yatsuya, H

NAGOYA JOURNAL OF MEDICAL SCIENCE 87 巻 ( 2 ) 頁： 220 - 236 2025年5月

担当区分：最終著者,　責任著者記述言語：英語出版者・発行元：Nagoya Journal of Medical Science

Better identification of individuals at high risk for type 2 diabetes mellitus (T2DM) requires risk-prediction models incorporating novel predictors. Accordingly, this study aimed to evaluate the merits of including long-term systolic blood pressure variability (SBPV) in predicting T2DM incidence in a Japanese cohort of 3017 participants (2446 men, 571 women; age, 36–65 years) in 2007, who were followed up until March 2019. Consecutive SBP values, recorded between 2003 and 2007, were regressed annually for each participant. The slope and root-mean-square error of the regression line were calculated for each individual to represent SBPV. The significance of SBPV was examined by adding it to a multivariate Cox model incorporating age, sex, smoking status, regular exercise, family history of diabetes, body mass index, blood levels of triglycerides, high-density lipoprotein cholesterol, and fasting blood glucose. The c-index, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to compare the performance of the prediction models without (Model 1) and with (Model 2) SBPV. During the 9.8-year follow-up period, 135 participants developed T2DM. Although a statistically significant difference in c-index between Model 1 (0.785) and Model 2 (0.786) was not found, the NRI (8.312% [p < 0.001]) and IDI (0.700% [p = 0.012]) demonstrated that the performance of Model 2 improved compared with Model 1. In conclusion, results suggested that long-term SBPV slightly improved predictive utility for T2DM when added to a conventional prediction model. The study was registered at University Hospital Medical Information Network Clinical Trial registry (UMIN000052544, https://www.umin.ac.jp/).

DOI： 10.18999/nagjms.87.2.220

Association between eveningness and depressive symptoms in daytime workers: A cross-sectional analysis of the Aichi Workers' Cohort Study. 査読有り Open Access

Ishihara K, Kitajima T, Ota A, Yatsuya H, Iwata N

Fujita medical journal 11 巻 ( 2 ) 頁： 64 - 69 2025年5月

記述言語：英語出版者・発行元：Fujita Medical Journal

Objectives: Eveningness (evening preference in chronotype) has been reported to be associated with a number of psychiatric problems. We examined a cross-sectional association between eveningness and depressive symptoms in daytime workers. Methods: The subjects were 4410 civil servants (71.7% male, aged 18–69 years [mean, 43.5 years]) with no history of depressive disorder who did not perform shift work, and for whom there were no missing data. The association between eveningness, determined using the reduced Morningness–Eveningness Questionnaire, and depressive symptoms, determined using the shorter form of the Central Epidemiological Studies Depression scale, was assessed with logistic regression analysis adjusted for potential confounding factors (gender, income, living alone, breakfast intake, coffee consumption, drinking habits, exercise, smoking, working hours, sleep duration, and difficulty falling asleep). Results: Of the subjects, 529 (12.0%) had eveningness, and 1408 (31.9%) reported depressive symptoms. Depressive symptoms were reported more frequently by those with eveningness than by those with other chronotypes (57.3% vs 28.5%). The association between eveningness and depression (gender-and age-adjusted odds ratio, 3.27; 95% confidence interval, 2.71–3.95) was significant after adjustment for the other confounding factors (odds ratio, 2.40; 95% confidence interval, 1.96–2.95). Conclusions: Our results suggest that eveningness is associated with depressive symptoms among day workers and that this association is independent of potential confounding factors. Further longitudinal studies are needed to examine the causal relationship.

DOI： 10.20407/fmj.2024-021

Mortality after partner's cancer diagnosis or death: A population-based prospective cohort study in Japan 査読有り Open Access

Makiuchi, T; Kakizaki, M; Sobue, T; Kitamura, T; Yatsuya, H; Yamaji, T; Iwasaki, M; Inoue, M; Tsugane, S; Sawada, N

JOURNAL OF EPIDEMIOLOGY 35 巻 ( 3 ) 頁： 118 - 128 2025年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Epidemiology

Background: The health statuses of closely connected individuals are interdependent. Little is known about mortality risk associated with partner’s cancer diagnosis and cause-specific mortality risk associated with partner’s death. Methods: Relative risks for all-cause and cause-specific mortality following a partner’s cancer diagnosis or death compared to the period when the partner is cancer-free and alive were investigated in the population-based prospective cohort study that enrolled 140,420 people at the age between 40–69 years in 1990–1994. Results: 55,050 participants (27,665 men and 27,385 women) who were identified as married couples were followed-up for 1,073,746.1 (518,368.5 in men and 555,377.6 in women) person-years, during which 9,816 deaths were observed (7,217 in men and 2,599 in women). After a partner’s cancer diagnosis, the mortality rate ratio (MRR) of all-cause mortality was not increased among both men and women, while an increase of externally-caused MRR was observed. The suicide MRR significantly increased among men (MRR 2.90; 95% confidence interval, 1.70–4.93), and it persisted for more than 5 years. After a partner’s death, the MRRs of all-cause, cardiovascular disease (CVD), respiratory disease (RD), and externally-caused mortality significantly increased only among men. Stratified analysis by smoking status among men showed significantly increased MRRs of CVD and RD mortality among former/current smokers, but not among never-smokers. Conclusion: Partner’s cancer diagnosis did not increase all-cause mortality risk, but increased externally-caused mortality risk, especially suicide among men. The impact of partner’s death on mortality risk differed by the mortality causes and sex, and smoking affected some of cause-specific mortality risk.

DOI： 10.2188/jea.JE20240114

勤労者における朝食欠食と抑うつ発症の関連：愛知職域コホート研究査読有り Open Access

日比野瑞歩, 李媛英, 宋澤安, 髙田碧, 洪英在, 福田知里, 王爽, 桶川龍世, 西尾七海, 服部優奈, 太田充彦, 玉腰浩司, 八谷寛

東海公衆衛生雑誌 12 巻 ( 2 ) 頁： 135 - 142 2025年3月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：東海公衆衛生学会

<p><b>目的</b>　中部地方の自治体職員を対象に，朝食欠食と5年後の抑うつ状態発症との関連を，愛知職域コホート研究のデータを用いて検討することを目的とした。</p><p><b>方法</b>　愛知職域コホート研究の2013年のベースライン調査に参加した20-54歳の対象者のうちベースライン時に抑うつがない,あるいはうつ病の治療中ではない者のうち2018年調査にも参加した2004人 (男性1452人,女性552人)を研究対象とした。抑うつ状態の評価はCenter for Epidemiologic Studies Depression Scale日本語短縮 (11項目)を使用し，8点以上を抑うつとみなした。朝食欠食は朝食摂取頻度が週6回以下と定義した。さらに，5年間の朝食欠食の変化を「非欠食 (2013年)→非欠食 (2018年)」，「欠食→非欠食」，「非欠食→欠食」，「欠食→欠食」の4パターンに分けた分析も実施した。多変量ロジスティック回帰分析を用いて，性 (男性，女性[閉経前]，女性[閉経後])，年齢，学歴，配偶者・14歳未満の子供の同居の有無，肥満 (BMI≧25 kg/m<sup>2</sup>），喫煙状況，運動頻度，アルコール摂取量，睡眠時間，ストレス，ファミリー・ワーク・コンフリクト，ワーク・ファミリー・コンフリクトを調整し，2018年の抑うつ発症のオッズ比 (OR)と95%信頼区間 (CI)を推定した。</p><p><b>結果</b>　2018年に新たに抑うつ状態となったのは261人 (13%)であった。朝食欠食と抑うつ発症には調整要因に独立した統計学的に有意な正の関連が認められた (OR: 1.39，95%CI: 1.01-1.90)。朝食欠食の変化パターン別の分析でも「非欠食→非欠食」群に比べて「欠食→欠食」群は抑うつ発症と有意な正の関連を示した (OR: 1.53，95%CI: 1.06-2.21)。</p><p><b>結論</b>　朝食欠食と抑うつ発症には調整要因に独立した正の関連が認められた。</p>

DOI： 10.24802/tpha.2024-07

都市部職域コホートにおける危険因子の集積と心血管疾患発症リスクとの関連及びその集団寄与危険割合査読有り

田島里菜, 宋澤安, 洪英在, 福田知里, 史旭良, 吉田裕子, 清水宏子, 村上美晴, 小林芽生, 中野嘉久, 松永眞章, 太田充彦, 玉腰浩司, 八谷寛

日本循環器病予防学会誌 60 巻 ( 1 ) 頁： 64 - 73 2025年2月

記述言語：日本語出版者・発行元：一般社団法人日本循環器病予防学会

<p>【目的】心血管疾患 (冠動脈疾患及び脳卒中) の発症予防のために、我が国では腹部肥満の存在を必須とするメタボリックシンドロームに着目した特定健診・特定保健指導が実施されている。しかし、非肥満者であっても危険因子の存在や集積が心血管疾患発症リスクとなり、日本人ではその割合が大きいことから、非肥満者で危険因子を有する者への保健指導実施の必要性が指摘されている。肥満の有無による危険因子集積数と心血管疾患発症との関連については、地方住民を対象とした研究が多く、都市部職域勤労者を対象とした研究は少ない。そこで本研究は都市部の自治体職員を対象とする愛知職域コホート研究において、危険因子とその集積数による心血管疾患発症リスク及び集団寄与危険割合 (PAF) を肥満の有無別に推定することを目的とした。</p><p>【方法】2002～08年をベースラインとする愛知職域コホート研究対象者の内、心血管疾患・がん既往のある者、血圧・血糖・脂質・肥満度・蛋白尿・喫煙に欠損のある者、追跡期間1年未満の者を除外した7,179人を対象とした。高血圧 (収縮期血圧≧140 mmHgかつ／又は拡張期血圧≧90 mmHg、又は高血圧治療者)、糖尿病 (空腹時血糖≧126 mg/dL又はHbA1c≧6.5％、又は糖尿病治療者)、高LDLコレステロール血症 (LDLコレステロール≧140 mg/dL又は脂質異常症治療者)、腎臓病 (尿蛋白±以上、又は腎臓病治療者)、現喫煙の5つの危険因子の保有数 (0、1、2、≧3) により4群に分け、心血管疾患発症との関連について多変量調整Cox比例ハザードモデルによるハザード比 (HR) と人口寄与危険度割合 (PAF) を推定した。</p><p>【結果】追跡期間中の心血管疾患発症者数は99名 (非肥満群66名、肥満群33名) であった。非肥満者で危険因子を有さない群と比較し、非肥満者で危険因子1個の群 (HR: 2.43, 95％CI: 1.14-5.21)、2個の群 (HR: 3.96, 95％CI: 1.79-8.74)、3個以上の群 (HR: 4.75, 95％CI: 1.73-13.0)、肥満者で危険因子1個の群 (HR: 4.31, 95％CI: 1.85-10.00)、2個の群 (HR: 3.75, 95％CI: 1.47-9.57)、3個以上の群 (HR: 7.53, 95％CI: 2.86-19.8) における心血管疾患発症リスクは有意に高かった。PAFは、非肥満者で危険因子1個の群、2個の群、3個以上の群でそれぞれ16.7％、16.6％、5.6％、肥満者の危険因子1個の群、2個の群、3個以上の群でそれぞれ10.9％、6.7％、7.0％でいずれも有意であった。</p><p>【結論】肥満の有無によらず危険因子が集積するほど心血管疾患発症リスクは高くなった。危険因子2個以上の集積によるPAFの合計は非肥満群で22.2％、肥満群で13.7％であった。</p>

DOI： 10.11381/jjcdp.60.1_64

Sex-specific association of comorbid heart failure on mortality after Alzheimer's disease diagnosis in older adults aged 75 years and above: A health insurance claims data analysis in Japan 査読有り Open Access

Matsunaga, M; Tanihara, S; He, YP; Yatsuya, H; Ota, A

JOURNAL OF ALZHEIMERS DISEASE 103 巻 ( 3 ) 頁： 749 - 757 2025年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Alzheimer S Disease

Background: Research on the influence of heart failure on mortality after Alzheimer's disease diagnosis is limited. Objective: To evaluate the association between comorbid heart failure and mortality following Alzheimer's disease diagnosis, particularly considering sex differences. Methods: We analyzed administrative claims data from Japan, involving 32,363 individuals (11,064 men and 21,299 women) aged 75 or older newly diagnosed with Alzheimer's disease, with 7% having comorbid heart failure. Cox proportional hazard models and population attributable fractions (PAFs) were used to evaluate the association between comorbid heart failure and mortality within one year following Alzheimer's disease diagnosis. Results: Individuals with Alzheimer's disease and heart failure had a multivariate-adjusted hazard ratio of 1.51 (95% confidence interval [CI], 1.32–1.73) for mortality during the one-year follow-up period compared to those with Alzheimer's disease and without heart failure. Subgroup analysis by sex revealed a higher mortality hazard ratio in women of 1.63 (95% CI, 1.36–1.95) than that in men of 1.39 (95% CI, 1.13–1.71). Further age and sex subgroup analysis indicated that women across all age brackets—75–79, 80–84, and ≥ 85 years—had higher mortality hazard ratios. The PAF for heart failure increased with age in both sexes, with women having higher PAFs than men, and the sex difference in PAF being most pronounced in the 75–79 age category (men: 1.4%, women: 4.0%). Conclusions: Hazard ratios and PAFs for mortality associated with comorbid heart failure in newly diagnosed Alzheimer's disease are higher in women than in men, which persists across all age subgroups.

DOI： 10.1177/13872877241305813

その他リンク： https://journals.sagepub.com/doi/full-xml/10.1177/13872877241305813

Exploring the development of safety culture among physicians with text mining of patient safety reports: a retrospective study 査読有り Open Access

Koike, D; Ito, M; Horiguchi, A; Yatsuya, H; Ota, A

INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE 37 巻 ( 1 ) 頁： mzae108 2025年1月

記述言語：英語出版者・発行元：International Journal for Quality in Health Care

Background: Safety culture development is essential for patient safety in healthcare institution. Perceptions of patient safety and cultural changes are reflected in patient safety reports; however, they were rarely investigated. The aim of this study was to investigate the perception of physicians and to explore the development of safety culture using quantitative content analysis for patient safety reports. Methods: A retrospective analysis of free descriptions of harmful patient safety reports submitted by physicians was performed. Natural language processing and text analysis were conducted using the "KH Coder."A co-occurrence analysis was performed in each period to identify and analyze the safety concepts. The study period was grouped into three for comparison. Results: The patient safety reports from physicians were collected between April 2004 and March 2020. Of these, 3351 reports were harmful: 839 reports were included in period 1, 1016 reports in period 2, and 1496 reports in period 3. Natural language processing identified 316 307 words in the free descriptions of 3351 reports. We identified seven concepts from the cluster in co-occurrence analysis as follows: "explanation of adverse event to patients and families,""central venous catheter,""intraoperative procedure and injury,""minimally invasive surgery,""life-Threatening events,""blood loss,"and "medical emergency team and critical care."These seven concepts showed significant differences among the three periods, except for "blood loss."The "explanation of adverse event to patients and families"decreased in proportion from 11.3% to 8.8% (P <. 05). The "central venous catheter"decreased from 17.3% to 11.3% (P <. 01). Meanwhile, "minimally invasive surgeries"and "intraoperative procedures"increased from 3.9% to 12.9% (P <. 01) and from 10.8% to 14.6% (P <. 05), respectively. Focusing on patients' events, "life-Threatening events"decreased from 13.0% to 8.1% (P <. 01); however, "medical emergency teams and critical care"increased from 3.3% to 10.6% (P <. 01). Conclusion: Free description in patient safety reports is useful for evaluating the safety culture. Co-occurrence analysis revealed multiple concepts of physicians' perceptions. Quantitative content analysis revealed changes in perceptions and attitudes, and a disclosure policy of adverse events and the priority of patient care appeared with the development of safety culture.

DOI： 10.1093/intqhc/mzae108

Associations of maternal urinary nitrophenol concentrations with adverse birth outcomes and neurodevelopment delay at 4 years of age: The Japan environment and children's study 査読有り

Kaneko, K; Ito, Y; Ebara, T; Yatsuya, H; Sugiura-Ogasawara, M; Saitoh, S; Sekiyama, M; Isobe, T; Kamijima, M

ENVIRONMENTAL RESEARCH 264 巻 ( Pt 1 ) 頁： 120290 - 120290 2025年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Environmental Research

Maternal urinary nitrophenol concentrations are reportedly associated with preterm birth and foetal/offspring development delay, but the evidence is still inconclusive. We investigated the association between maternal urinary concentrations of 4-nitrophenol (4NP) and 3-methyl-4-nitrophenol (3M4NP) and adverse birth outcomes, as well as offspring neurodevelopment delay, defined using the Ages and Stages Questionnaires at 4 years of age, stratified by offspring sex. A total of 3650 non-hypertensive mothers with singleton births were enrolled from the Japan Environment and Children's Study. High 4NP (≥0.41 μg/L) and 3M4NP (≥0.29 μg/L) were defined as ≥ lowest concentration minimum reporting level. Four groups were created using these dichotomized 4NP and 3M4NP concentrations: ‘both low’, ‘either high/low’, and ‘both high’. Multivariable logistic regression models were used to estimate the adjusted odds ratios (aOR) and population attributable fraction (PAF). For 4NP and 3M4NP, 68.4% and 19.0% of participants had ’high’ urinary concentrations, respectively. Compared to ‘both low’, the overall analysis showed no significant associations between ‘both high’ and any of the outcomes. However, the stratified analysis showed that the aOR (95% confidence interval [CI]) and PAF (95% CI) for ‘both high’ regarding preterm birth (<37 weeks' gestation) were 2.7 (1.3, 5.7) and 16.3% (2.5%, 28.1%), respectively, in male offspring. Among female offspring, the aOR and PAF for the ‘both high’ regarding small-for-gestational-age (SGA)—defined as weight-for-gestational age <10 percentile based on the Japanese neonatal anthropometric charts—were 1.7 (1.0, 2.8) and 10.6% (−0.2%, 20.2%), respectively. Urinary 4NP and 3M4NP concentrations showed no association with low birth weight (<2500 g) and neurodevelopment delay. In conclusion, offspring sex-specific associations of maternal urinary nitrophenols with preterm birth and SGA were observed. Even slight elevations in their levels may explain a certain proportion of preterm birth and SGA. The exposure source, expressed by urinary nitrophenols, should be identified.

DOI： 10.1016/j.envres.2024.120290

Lifetime Risk of Incident Coronary Heart Disease, Stroke, and Cardiovascular Disease: The Japan Public Health Center-Based Prospective Study 査読有り Open Access

Saito, I; Yamagishi, K; Kokubo, Y; Yatsuya, H; Muraki, I; Iso, H; Inoue, M; Tsugane, S; Sawada, N

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 32 巻 ( 1 ) 頁： 48 - 57 2025年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Atherosclerosis and Thrombosis

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 fasting blood glucose level and difficulty with chewing: the Aichi Workers' Cohort Study Open Access

Hamrah, MH; Song, Z; Hong, Y; Akter, T; Nuamah, HG; Gondo, N; Matsunaga, M; Ota, A; Takada, M; Otsuka, R; Tamakoshi, K; Yatsuya, H

ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE 30 巻 ( 0 ) 頁： 95 - 95 2025年

記述言語：英語出版者・発行元：Environmental Health and Preventive Medicine

Background: Difficulty in chewing has been shown to be associated with increased mortality, geriatric syndromes, and poor activities of daily living, indicating the need for intervention. Chewing difficulties are related to tooth loss, periodontitis, dry mouth, and a number of oral health conditions. Diabetes mellitus (DM) is one of the major causes of global burden of diseases, and has been associated with poor oral health. Prospective association between oral health status and the development of diabetes has also been reported. However, relationship between glycemic control and self-reported chewing difficulty remains less explored in working-age populations. The objective of this study is to cross-sectionally explore the association between fasting blood glucose (FBG) and self-reported chewing difficulty in adults working in a Japanese worksite. Methods: Participants from the Aichi Workers’ Cohort Study who responded to the 2018 survey were included. Participants were categorized into five FBG groups (<100, 100–109, 110–125, 126–159, and ²160 mg/dl). Multivariable odds ratios (ORs) and 95% confidence intervals (CIs) for chewing difficulty were estimated using logistic regression adjusted for age, sex, body mass index, smoking and alcohol consumption status, number of teeth, presence of periodontal disease and the number of anti-diabetic medication classes. Results: A total of 164 participants (4.2%) reported difficulty with chewing, the prevalence of which tended to increase with increasing FBG level. FBG ²160 mg/dl was significantly and strongly associated with difficulty with chewing in the final multivariable model (multivariable OR 3.84 [95% CI 1.13–13.0]). Conclusions: A relationship between higher FBG levels and difficulty with chewing was observed, independent of potential confounding factors. However, prospective or interventional studies are needed to determine causality.

DOI： 10.1265/ehpm.25-00284

Association between predicted level of water turnover deficit and all-cause and cause-specific mortalities among Japanese adults: The Japan Collaborative Cohort Study 査読有り国際誌 Open Access

Watanabe, D; Muraki, I; Yatsuya, H; Tamakoshi, A

AMERICAN JOURNAL OF CLINICAL NUTRITION 120 巻 ( 6 ) 頁： 1399 - 1408 2024年12月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：American Journal of Clinical Nutrition

Background: Although water is essential for maintaining health and life, the association between water turnover as an indicator of daily water requirement and water deficit and mortality is unclear. Objectives: We aimed to investigate this association in Japanese adults. Methods: A total of 63,488 (36,739 females and 26,749 males) Japanese aged 40–79 y in the Japan Collaborative Cohort Study in 1988–1990 were followed up their mortality through 2009. Water turnover was calculated considering lifestyle and environmental factors using an equation previously developed by the International Doubly Labeled Water Database Group. Participants were classified into sex-specific quintiles based on their water turnover. Water deficit levels were calculated from water turnover and dietary water consumption, which were estimated using a validated questionnaire. Results: The mean daily water turnovers were 2950 and 3466 mL in females and males, respectively. During 19.4 years of median follow-up (1,039,914 person-years), 12,551 deaths were recorded. After adjusting for lifestyle and medical history, the bottom quintile was associated with higher hazard ratios (HRs) of mortality from all causes (females—HR: 1.26; 95% CI: 1.12, 1.41; males—HR: 1.18; 95% CI: 1.07, 1.29) and cardiovascular disease (CVD). In spline analyses, the water turnover range with the lowest HR for all-cause mortality was 3000–3300 mL/d in females and the water turnover at which the HR for all-cause mortality plateaued was ∼3500–3700 mL/d in males. Water deficiency levels were associated with all-cause and CVD-related mortality in both sexes. Conclusions: The association between water turnover and deficit and all-cause and CVD-related mortalities (especially coronary artery disease and ischemic stroke) in adults is L-shaped. These findings may be useful for setting the target values of water requirement, and differences between dietary requirements and actual intake may bridge the knowledge gap in water–mortality associations.

DOI： 10.1016/j.ajcnut.2024.09.021

RISK FACTORS FOR INTRACEREBRAL HEMORRHAGE BY BLEEDING SITE

Ariyada, K; Yamagishi, K; Kihara, T; Muraki, I; Imano, H; Kokubo, Y; Saito, I; Yatsuya, H; Inoue, M; Tsugane, S; Iso, H; Sawada, N

ATHEROSCLEROSIS 399 巻 2024年12月

Chronotype and leisure-time physical activity among civil servants in Japan: a cross-sectional analysis of the Aichi workers' cohort study 査読有り Open Access

Okegawa, R; He, YP; Matsunaga, M; Khine, MT; Li, YY; Kitajima, T; Yatsuya, H; Ota, A

ARCHIVES OF PUBLIC HEALTH 82 巻 ( 1 ) 頁： 205 2024年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Archives of Public Health

Background: The association between chronotype and leisure-time physical activity (LTPA) remains unclear. We investigated the difference in regular LTPA and for a sufficient duration between those with evening-type (ET) and morning-type chronotypes (MT). Methods: We conducted a cross-sectional analysis using the data of the Aichi Workers’ Cohort Study. It included 3,221 men (mean [standard deviation] age: 45.0 [11.6] years) and 1,294 women (39.8 [11.2] years). Chronotypes were determined with the reduced version of the Morningness-Eveningness Questionnaire. We calculated the metabolic equivalents (METs) consumed per week based on the four types of LTPA: strolling, brisk walking, light- and moderate-intensity PA, and vigorous-intensity PA. Regular LTPA and for a sufficient duration was defined as doing once or more per week and for 30 min or longer per session, respectively. Logistic regression analysis was conducted separately by sex to calculate odds ratios of ET for regular LTPA and for a sufficient duration, adjusted for age and other factors, for each type of LTPA. Results: ET men consumed fewer total METs per week than MT men (p <.001), although this pattern is not found in women. Compared to MT men, ET men were less likely to be engaged in regular LTPA in all types of LTPA (prevalence and adjusted odds ratio [95% confidence interval]: strolling: 39.1% vs. 28.7%, 0.685 [0.524–0.895]; brisk walking: 23.9% vs. 14.4%, 0.639 [0.454–0.899]; light- and moderate-intensity PA: 15.4% vs. 8.4%, 0.613 [0.404–0.929]; vigorous-intensity PA: 21.4% vs. 16.8%, 0.715 [0.518–0.989]). They were less likely to spend a sufficient duration in brisk walking (25.9% vs. 16.5%, 0.635 [0.461–0.875]), light- and moderate-intensity PA (37.1% vs. 26.8%, 0.684 [0.521–0.899]), and vigorous-intensity PA (35.3% vs. 35.8%, 0.741 [0.568–0.968]). Compared with MT women, ET women were less likely to be engaged in strolling (30.5% vs. 22.2%, 0.629 [0.398–0.995]), and less likely to spend a sufficient duration in light- and moderate-intensity PA (27.3% vs. 15.3%, 0.561 [0.335–0.937]). Conclusions: ET was inversely associated with LTPA in men and partly in women.

DOI： 10.1186/s13690-024-01440-z

その他リンク： https://link.springer.com/article/10.1186/s13690-024-01440-z/fulltext.html

Factors influencing interprofessional collaboration in long-term care from a multidisciplinary perspective: a case study approach 査読有り

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

HOME HEALTH CARE SERVICES QUARTERLY 43 巻 ( 4 ) 頁： 239 - 258 2024年10月

記述言語：英語出版者・発行元：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

高齢男性の疲労感は独立した非就労関連因子である愛知職域コホート研究

洪英在, 大塚礼, 高田碧, 李媛英, 宋澤安, 松永眞章, He Yupeng, 太田充彦, 玉腰浩司, 八谷寛

日本公衆衛生学会総会抄録集 83回巻頁： 277 - 277 2024年10月

Global, regional, and national burden of stroke and its risk factors, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021 Open Access

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LANCET NEUROLOGY 23 巻 ( 10 ) 頁： 973 - 1003 2024年10月

掲載種別：研究論文（学術雑誌）出版者・発行元：Lancet Neurology

Background: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6–7·8] deaths; 10·7% [9·8–11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8–171·6] DALYs; 5·6% [5·0–6·1] of all DALYs). In 2021, there were 93·8 million (89·0–99·3) prevalent and 11·9 million (10·7–13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4–67·7), intracerebral haemorrhage constituted 28·8% (28·3–28·8), and subarachnoid haemorrhage constituted 5·8% (5·7–6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4–117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7–38·1]), diet high in sugar-sweetened beverages (23·4% [12·7–35·7]), low physical activity (11·3% [1·8–34·9]), high systolic blood pressure (6·7% [2·5–11·6]), lead exposure (6·5% [4·5–11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5–10·5]). Interpretation: Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. Funding: Bill & Melinda Gates Foundation.

DOI： 10.1016/S1474-4422(24)00369-7

Nonrestorative Sleep and Type 2 Diabetes Incidence: the Aichi Workers' Cohort Study 査読有り Open Access

Lin, JY; Song, Z; Li, YY; Chiang, CF; Hirakawa, Y; Nakano, Y; Hong, YJ; Matsunaga, M; Ota, A; Tamakoshi, K; Yatsuya, H

JOURNAL OF EPIDEMIOLOGY 34 巻 ( 9 ) 頁： 428 - 433 2024年9月

担当区分：最終著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Epidemiology

Background: The term “nonrestorative sleep (NRS)” refers to an unrefreshed feeling at wake-up and is a domain of poor sleep quality. Previous research has demonstrated that NRS is linked to a number of diseases and adverse health outcomes, but less is known regarding the link between NRS and diabetes, particularly in Japanese. Methods: We studied 3,665 middle-aged male participants of the Aichi Workers’ Cohort Study who were followed-up from 2002 through 2019. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of incident type 2 diabetes mellitus (T2DM) in relation to NRS adjusted for potential confounding variables. Results: During a median follow-up of 14.6 years, 421 type 2 diabetes cases were identified. Participants with NRS had a higher crude incidence rate of T2DM (11.2/1,000 person-years), compared to participants without NRS (9.3/1,000 person-years). In the fully adjusted model, individuals who reported having NRS had a significantly higher risk of developing T2DM (HR1.36; 95% CI, 1.10–1.67). The association was observed only in participants under 50 years old (HR 1.82; 95% CI, 1.36–2.43), not in the older (50 years or older) participants (P for interaction = 0.025). In contrast, stratified analyses by the presence of shift work, obesity, or sleep duration showed similar associations in all the strata. Conclusion: NRS was associated with higher risk of T2DM in middle-aged Japanese male workers independent of a variety of lifestyle factors and other sleep problems.

DOI： 10.2188/jea.JE20230184

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

Matsunaga, M; Tanihara, S; He, YP; Yatsuya, H; Ota, A

GERIATRICS & GERONTOLOGY INTERNATIONAL 24 巻 ( 8 ) 頁： 773 - 781 2024年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Geriatrics and Gerontology International

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

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