Faculty Profiles - YATSUYA Hiroshi

Papers - YATSUYA Hiroshi

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Good death for people living with dementia: a qualitative study Reviewed

Mamun, MR; Hirakawa, Y; Saif-Ur-Rahman, KM; Hong, YJ; Song, Z; Yoshida, Y; Yatsuya, H

BMC GERIATRICS Vol. 23 ( 1 ) page： 665 2023.10

Authorship：Corresponding author Language：English Publisher：BMC Geriatrics

Background: Ensuring a good death is one of the primary objectives of palliative care and end-of-life care. There is insufficient evidence regarding what defines a good death for people living with dementia. Obtaining an understanding of what constitutes a good death could help improve dementia care. This study aimed to explore how multiple stakeholders perceive a good death for people living with dementia. Methods: This qualitative study was carried out across six prefectures in Japan. Enrollment of participants took place within dementia outpatient clinics, hospitals, daycare centers, and community centers. A total of thirty-three in-depth interviews with people living with dementia, physicians, and nurses were conducted. Six focus group discussions were performed with family caregivers and care workers. Verbatim transcripts of the interviews were prepared, and inductive content analysis was used to examine the data. Findings: Regarding the perception of a good death, the following themes were derived: (1) painless death; (2) dying in a preferred environment; (3) family’s coping with loss; (4) maintaining regular life; (5) living with respect; and (6) preparation for death. All these themes are interrelated. Participants viewed a good death as a process rather than a single event. Conclusion: This study identifies crucial components of a good death for people living with dementia. The findings could be used to improve dementia care.

DOI： 10.1186/s12877-023-04395-y

Estimated Glomerular Filtration Rate, Albuminuria, and Adverse Outcomes: An Individual-Participant Data Meta-Analysis. Reviewed International coauthorship International journal

Morgan E Grams, Josef Coresh, Kunihiro Matsushita, Shoshana H Ballew, Yingying Sang, Aditya Surapaneni, Natalia Alencar de Pinho, Amanda Anderson, Lawrence J Appel, Johan Ärnlöv, Fereidoun Azizi, Nisha Bansal, Samira Bell, Henk J G Bilo, Nigel J Brunskill, Juan J Carrero, Steve Chadban, John Chalmers, Jing Chen, Elizabeth Ciemins, Massimo Cirillo, Natalie Ebert, Marie Evans, Alejandro Ferreiro, Edouard L Fu, Masafumi Fukagawa, Jamie A Green, Orlando M Gutierrez, William G Herrington, Shih-Jen Hwang, Lesley A Inker, Kunitoshi Iseki, Tazeen Jafar, Simerjot K Jassal, Vivekanand Jha, Aya Kadota, Ronit Katz, Anna Köttgen, Tsuneo Konta, Florian Kronenberg, Brian J Lee, Jennifer Lees, Adeera Levin, Helen C Looker, Rupert Major, Cheli Melzer Cohen, Makiko Mieno, Mariko Miyazaki, Olivier Moranne, Isao Muraki, David Naimark, Dorothea Nitsch, Wonsuk Oh, Michelle Pena, Tanjala S Purnell, Charumathi Sabanayagam, Michihiro Satoh, Simon Sawhney, Elke Schaeffner, Ben Schöttker, Jenny I Shen, Michael G Shlipak, Smeeta Sinha, Benedicte Stengel, Keiichi Sumida, Marcello Tonelli, Jose M Valdivielso, Arjan D van Zuilen, Frank L J Visseren, Angela Yee-Moon Wang, Chi-Pang Wen, David C Wheeler, Hiroshi Yatsuya, Kunihiro Yamagata, Jae Won Yang, Ann Young, Haitao Zhang, Luxia Zhang, Andrew S Levey, Ron T Gansevoort

JAMA Vol. 330 ( 13 ) page： 1266 - 1277 2023.10

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

IMPORTANCE: Chronic kidney disease (low estimated glomerular filtration rate [eGFR] or albuminuria) affects approximately 14% of adults in the US. OBJECTIVE: To evaluate associations of lower eGFR based on creatinine alone, lower eGFR based on creatinine combined with cystatin C, and more severe albuminuria with adverse kidney outcomes, cardiovascular outcomes, and other health outcomes. DESIGN, SETTING, AND PARTICIPANTS: Individual-participant data meta-analysis of 27 503 140 individuals from 114 global cohorts (eGFR based on creatinine alone) and 720 736 individuals from 20 cohorts (eGFR based on creatinine and cystatin C) and 9 067 753 individuals from 114 cohorts (albuminuria) from 1980 to 2021. EXPOSURES: The Chronic Kidney Disease Epidemiology Collaboration 2021 equations for eGFR based on creatinine alone and eGFR based on creatinine and cystatin C; and albuminuria estimated as urine albumin to creatinine ratio (UACR). MAIN OUTCOMES AND MEASURES: The risk of kidney failure requiring replacement therapy, all-cause mortality, cardiovascular mortality, acute kidney injury, any hospitalization, coronary heart disease, stroke, heart failure, atrial fibrillation, and peripheral artery disease. The analyses were performed within each cohort and summarized with random-effects meta-analyses. RESULTS: Within the population using eGFR based on creatinine alone (mean age, 54 years [SD, 17 years]; 51% were women; mean follow-up time, 4.8 years [SD, 3.3 years]), the mean eGFR was 90 mL/min/1.73 m2 (SD, 22 mL/min/1.73 m2) and the median UACR was 11 mg/g (IQR, 8-16 mg/g). Within the population using eGFR based on creatinine and cystatin C (mean age, 59 years [SD, 12 years]; 53% were women; mean follow-up time, 10.8 years [SD, 4.1 years]), the mean eGFR was 88 mL/min/1.73 m2 (SD, 22 mL/min/1.73 m2) and the median UACR was 9 mg/g (IQR, 6-18 mg/g). Lower eGFR (whether based on creatinine alone or based on creatinine and cystatin C) and higher UACR were each significantly associated with higher risk for each of the 10 adverse outcomes, including those in the mildest categories of chronic kidney disease. For example, among people with a UACR less than 10 mg/g, an eGFR of 45 to 59 mL/min/1.73 m2 based on creatinine alone was associated with significantly higher hospitalization rates compared with an eGFR of 90 to 104 mL/min/1.73 m2 (adjusted hazard ratio, 1.3 [95% CI, 1.2-1.3]; 161 vs 79 events per 1000 person-years; excess absolute risk, 22 events per 1000 person-years [95% CI, 19-25 events per 1000 person-years]). CONCLUSIONS AND RELEVANCE: In this retrospective analysis of 114 cohorts, lower eGFR based on creatinine alone, lower eGFR based on creatinine and cystatin C, and more severe UACR were each associated with increased rates of 10 adverse outcomes, including adverse kidney outcomes, cardiovascular diseases, and hospitalizations.

DOI： 10.1001/jama.2023.17002

孤食は、世帯構成や孤独感とは独立した抑うつ関連因子である愛知職域コホート研究

洪英在, 大塚礼, 平川仁尚, 太田充彦, 玉腰浩司, 八谷寛

日本公衆衛生学会総会抄録集 Vol. 82回 page： 286 - 286 2023.10

Applicability of a web-based 24-hour dietary recall tool for Japanese populations in large-scale epidemiological studies. Reviewed

Yoshie Hose, Junko Ishihara, Ayaka Kotemori, Misako Nakadate, Sachiko Maruya, Junta Tanaka, Hiroshi Yatsuya, Atsuko Aoyama, Chifa Chiang, Tsuneo Konta, Takamasa Kayama, Yoshiyuki Ueno, Manami Inoue, Norie Sawada, Shoichiro Tsugane, Ribeka Takachi

Journal of epidemiology Vol. 33 ( 8 ) page： 419 - 427 2023.8

Language：English Publishing type：Research paper (scientific journal) Publisher：Japan Epidemiological Association

BACKGROUND: Recent innovations in information and communication technology have made it possible to assess diet using web-based methods; however, their applicability in the general population remains unclear. Hence, we aimed to examine the applicability of a web-based 24-hour dietary recall (24HR) tool to large-scale epidemiological studies by determining the sampling rate and characteristics of randomly selected participants (partially entire population) from a Japanese cohort study. METHODS: In total, 5,013 individuals were recruited from a cohort of 21,537 individuals, and 975 agreed to participate in this study. The participants selected either self-administered web-based dietary 24HR (self-administered 24HR) or interviewer-administered telephone-based 24HR (interviewer-administered 24HR) as the method for the dietary assessment and answered questions regarding the acceptability of the system. RESULTS: The response rate of the 975 participants was 19.4%, and approximately 4.5% of the total study population. About half of them chose the self-administered 24HR (46.9%). The median time required for the self-administered and interviewer-administered 24HR was 25 and 27 minutes, respectively. In the self-administered 24HR, older people, regardless of sex, tended to require a longer time, and approximately 60% of the participants rated the ease of use of the system as "somewhat difficult" or "difficult." CONCLUSIONS: Characteristics of the participants in this study were not systemically different from those of the entire study population. Improvements in approach for the entering cooking details and the dish name selection may be necessary for better acceptability in order to be accepted as a self-administered 24HR.

DOI： 10.2188/jea.JE20220071

Impact of Cardiovascular Disease on the Death Certificate Diagnosis of Heart Failure, Ischemic Heart Disease, and Cerebrovascular Disease - The Japan Public Health Center-Based Prospective Study. Reviewed

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

Circulation journal : official journal of the Japanese Circulation Society Vol. 87 ( 9 ) page： 1196 - + 2023.8

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Circulation Society

BACKGROUND: There is considerable interest in the trending discrepancy between ischemic heart disease (IHD) and heart failure (HF) in vital statistics. Clinically, acute myocardial infarction (AMI) and stroke are closely associated with HF, but their contribution to HF as the underlying cause of death (UCD) is unclear.Methods and Results: In 1990 and 1992-1993, we enrolled a total of 140,420 residents of Japanese nationality (aged 40-69 years) from 11 public health center areas. We prospectively examined the occurrence of cardiovascular disease (CVD), including AMI, sudden cardiac death within 1 h (SCD), and stroke, and analyzed the 14,375 participants without a history of CVD at baseline who died during the 20-year follow-up. A time-dependent Cox proportional hazards model was used to estimate hazard ratios and the population attributable fraction (PAF) of AMI, AMI+SCD, stroke, and CVD for deaths due to HF, IHD, and cerebrovascular disease as the UCD, adjusted for individuals' lifestyles and comorbid conditions. The PAF of AMI for HF deaths was 2.4% (95% confidence interval [CI] 1.7-2.9%), which increased to 12.0% (95% CI 11.6-12.2%) for AMI+SCD. The PAF of CVD-attributed HF deaths was estimated to be 17.6% (95% CI 15.9-18.9%). CONCLUSIONS: HF as the UCD was partly explained by CVD. The data imply that most HF deaths reported in vital statistics may be associated with underlying causes other than CVD.

DOI： 10.1253/circj.CJ-22-0805

Associations between changes in social contact pattern and the mental health status of Chinese adults: cross-sectional findings Reviewed International coauthorship

Zhang, JY; Zhou, S; Wang, Q; Hou, FF; Han, X; Shen, GD; Chiang, CF; Yatsuya, H; Zhang, Y

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 85 ( 3 ) page： 476 - 489 2023.8

Language：English Publisher：Nagoya Journal of Medical Science

The study aims to examine the associations between social contact pattern changes and mental health status, including depression, anxiety, and loneliness, among Chinese adults in the context of coronavirus disease 2019 (COVID-19). Data on social contact patterns before and after the outbreak of COVID-19 were obtained from 3511 participants. Mental health (ie, depression, anxiety, and loneliness) was assessed by the 9-item Patient Health Questionnaire, Dark Future Scale, and the 9-scale Three-Item Loneliness Scale, respectively. Poisson regression analyses revealed that the participants who had increased in-person communication were more likely to have mental disorders [depression: prevalence ratio (PR)=1.13, 95% confidence interval (CI): 1.02, 1.26; anxiety: PR=1.15, 95% CI: 1.01, 1.30]. The current study concluded that the in-person communication increase before and after the outbreak of COVID-19 was associated with mental disorders among Chinese adults.

DOI： 10.18999/nagjms.85.3.476

Risk and population attributable fraction of stroke subtypes in Japan. Reviewed

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

Journal of epidemiology Vol. 34 ( 5 ) page： 211 - 217 2023.7

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Japan Epidemiological Association

BACKGROUND: Associations of major risk factors for stroke with total and each type of stroke as well as subtypes of ischemic stroke and their population attributable fractions had not been examined comprehensively. METHODS: Participants of the Japan Public Health Center-based prospective (JPHC) Study Cohort II without histories of cardiovascular disease and cancer (n=14,797) were followed from 1993 through 2012. Associations of current smoking, hypertension, diabetes, overweight (body mass index ≥ 25 kg/m2), non-high-density lipoprotein cholesterol (non-HDLC) categories, low HDLC (< 40 mg/dL), urine protein, and history of arrhythmia were examined in a mutually-adjusted Cox regression model that included age and sex. Population attributable fraction (PAF) was estimated using the hazard ratios and the prevalence of risk factors among cases. RESULTS: Subjects with hypertension were 1.63 to 1.84 times more likely to develop any type of stroke. Diabetes, low HDLC, current smoking, overweight, urine protein, and arrhythmia were associated with risk of overall and ischemic stroke. Hypertension and urine protein were associated with risk of intracerebral hemorrhage while current smoking, hypertension, and low non-HDLC were associated with subarachnoid hemorrhage. Hypertension alone accounted for more than a quarter of stroke incidence, followed by current smoking and diabetes. High non-HDLC, current smoking, low HDLC, and overweight contributed mostly to large-artery occlusive stroke. Arrhythmia explained 13.2% of embolic stroke. Combined PAFs of all the modifiable risk factors for total, ischemic and large-artery occlusive strokes were 36.7 and 44.5% and 61.5%, respectively. CONCLUSION: Although there are differences according to the subtypes, hypertension could be regarded as the most crucial target for preventing strokes in Japan.

DOI： 10.2188/jea.JE20220364

Work and Family Conflicts, Depression, and "Ikigai": A Mediation Analysis in a Cross-Cultural Study Between Japanese and Egyptian Civil Workers. Reviewed International coauthorship

Ehab S Eshak, Sachiko Baba, Hiroshi Yatsuya, Hiroyasu Iso, Yoshihisa Hirakawa, Eman M Mahfouz, Chiang Chifa, Ryoto Sakaniwa, Ayman S El-Khateeb

Journal of epidemiology Vol. 33 ( 7 ) page： 360 - 366 2023.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Japan Epidemiological Association

BACKGROUND: Work-family conflicts (total-WFCs) could associate with mental health, and having ikigai (a purpose of life) may mediate this association. METHODS: In a cross-cultural study of 4792 Japanese Aichi Workers' Cohort study participants and 3109 Egyptian civil workers, the Midlife Development in the United States (MIDUS) questionnaire measured total-WFCs and Center for Epidemiological Studies Depression (CES-D) 11-item scale measured depression. Logistic regression models estimated odds ratios (ORs) of having depression and a high-ikigai across levels of total-WFCs (low, moderate, and high), and the PROCESS macro of Hayes tested the mediation effect. RESULTS: The prevalence of high total-WFCs, depression, and having a high-ikigai were 17.9%, 39.4%, and 70.1% in Japanese women, 10.5%, 26.8%, and 70.1% in Japanese men, 23.7%, 58.2%, and 24.7% in Egyptian women, and 19.1%, 38.9%, and 36.9% in Egyptian men. Compared with participants with low total-WFCs, the multivariable ORs (95% CIs) of depression in Japanese women and men with high total-WFCs were 4.11 (2.99-5.65) and 5.42 (4.18-7.02), and those in Egyptian women and men were 4.43 (3.30-5.95) and 4.79 (3.53-6.48). The respective ORs of having a high-ikigai were 0.46 (0.33-0.64) and 0.40 (0.31-0.52) in Japanese women and men and were 0.34 (0.24-0.48) and 0.28 (0.20-0.39) in Egyptian women and men. No interaction between total-WFCs and country was observed for the associations with depression or ikigai. Ikigai has mediated (up to 18%) the associations between the total-WFCs and depression, especially in Egyptian civil workers. CONCLUSIONS: Total-WFCs were associated with depression, and having low-ikigai mediated these associations in Japanese and Egyptian civil workers.

DOI： 10.2188/jea.JE20210338

Impact of combined resection of the internal iliac artery on loss of volume of the gluteus muscles after pelvic exenteration Reviewed

Murata, Y; Uehara, K; Ogura, A; Ishigaki, S; Aiba, T; Mizuno, T; Kokuryo, T; Yokoyama, Y; Yatsuya, H; Ebata, T

SURGERY TODAY Vol. 53 ( 7 ) page： 791 - 799 2023.7

Language：English Publisher：Surgery Today

Purpose: To clarify the influence of additional internal iliac artery (IIA) resection on the loss of the gluteus muscle volume after pelvic exenteration (PE). Methods: The subjects of this retrospective analysis were 78 patients who underwent PE with or without IIA resection (n = 44 and n = 34, respectively) between 2006 and 2018. The areas of gluteal muscles (GMs) and psoas muscles (PSMs) were calculated using CT images before and 6 months after PE, and the difference was compared. Results: The volumes of the GMs and PSMs were significantly reduced after PE (P < 0.001 and P = 0.005, respectively). In the IIA resection group, the GMs were significantly reduced after surgery, but the PSMs were not. The maximum GM (Gmax) was the most atrophied among the GMs. Multivariable analysis revealed that complete IIA resection was an independent promotor of the loss of volume of the Gmax (P = 0.044). In 18 patients with unilateral IIA resection, the downsizing rate of the Gmax was significantly greater on the resected side than on the non-resected side (P = 0.008). Conclusions: The GMs and PSMs were significantly smaller after PE. Complete IIA resection reduced the Gmax area remarkably. Preservation of the superior gluteus artery is likely to help maintain Gmax size, suggesting a potential preventative measure against secondary sarcopenia.

DOI： 10.1007/s00595-022-02635-z

Predictive Value of Long-Term Systolic Blood Pressure Variability for the Development of Type 2 Diabetes Mellitus Reviewed

Yatsuya, H; Song, ZA; Hong, YJ; Mamun, R; Yoshida, Y; Akter, T; Nuamah, G; Tajima, R; Lin, JY; Al-Shoaibi, A; Chiang, C; Nakano, Y; Li, YY; Matsunaga, M; Ota, A; Tamakoshi, K

CIRCULATION Vol. 147 2023.2

Relationship between fasting blood glucose levels in middle age and cognitive function in later life: The Aichi Workers’ Cohort Study Reviewed

Masako Shimoda, Kayo Kaneko, Takeshi Nakagawa, Naoko Kawano, Rei Otsuka, Atsuhiko Ota, Hisao Naito, Masaaki Matsunaga, Naohiro Ichino, Hiroya Yamada, Chifa Chiang, Yoshihisa Hirakawa, Koji Tamakoshi, Atsuko Aoyama, Hiroshi Yatsuya

Journal of Epidemiology Vol. 33 ( 2 ) page： 76 - 81 2023.2

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

<p><b>Background:</b> There is limited evidence regarding the relationship between Diabetes mellitus (DM) in middle age and mild cognitive impairment after a follow-up. Therefore, we investigated the relationship between fasting blood glucose (FBG) levels in middle age and cognitive function assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in later life, following over 15 years of follow-up in the Aichi Workers’ Cohort Study in Japan.</p><p><b>Methods:</b> Participants were 253 former local government employees aged 60–79 years in 2018 who participated in a baseline survey conducted in 2002. Using baseline FBG levels and self-reported history, participants were classified into the normal, impaired fasting glucose (IFG) and, and DM groups. Total MoCA-J score ranges from 0 to 30, and cognitive impairment was defined as MoCA-J score ≤25 in this study. A general linear model was used to estimate the mean MoCA-J scores in the FBG groups, adjusted for age, sex, educational year, smoking status, alcohol consumption, physical activity, body mass index, systolic blood pressure, total cholesterol, and estimated glomerular filtration rate.</p><p><b>Results:</b> The mean MoCA-J score in the total population was 25.0, and the prevalence of MoCA-J score ≤25 was 49.0%. Multivariable-adjusted total MoCA-J scores were 25.2, 24.8, and 23.4 in the normal, IFG, and DM groups, respectively. The odds ratio of MoCA-J score ≤25 in the DM group was 3.29.</p><p><b>Conclusion:</b> FBG level in middle age was negatively associated with total MoCA-J scores assessed later in life, independent of confounding variables.</p>

DOI： 10.2188/jea.JE20210128

Corrigendum to "Secondhand smoke and the risk of incident cardiovascular disease among never-smoking women" [Preventive Medicine 162 (2022) 107145]. Reviewed International journal

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

Preventive medicine Vol. 167 page： 107396 - 107396 2023.2

The Association between Adult Height and Stroke Incidence in Japanese Men and Women: A Population- Based Case- Control Study Reviewed

Yoshinobu Kondo, Hiroshi Yatsuya, Atsuhiko Ota, Shoji Matsumoto, Akihiro Ueda, Hirohisa Watanabe, Hideaki Toyoshima

Journal of Epidemiology Vol. 33 ( 1 ) page： 23 - 30 2023.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Japan Epidemiological Association

BACKGROUND: No studies have examined the associations between adult height and ischemic stroke subtypes. METHODS: We conducted a population-based case-control study that included 2,451 thrombotic and 687 embolic stroke cases, as well as 1,623 intracerebral and 768 subarachnoid hemorrhage cases without history of stroke aged 40-79 years, and the same number of sex- and age-matched controls. Cases and controls were grouped according to the quintile cut-off values of height in controls, and the third quintile, which was approximately the average height group, was used as the reference group. Height was also examined as a continuous variable as divided by one standard deviation of height in controls. The analyses were carried out separately for participants aged 40-59 years and 60-79 years. RESULTS: In both younger and older men, continuous height was linearly inversely associated with total and thrombotic strokes, and the shortest quintile compared to the reference was associated with increased risks of these strokes. Although height was linearly inversely associated with embolic stroke and intracerebral hemorrhage in younger men, the shortest quintile did not show increased risks of these strokes. Height did not seem to be associated with total stroke and any stroke subtypes in younger women. In contrast, the tallest quintile was significantly associated with increased risks of total stroke and intracerebral hemorrhage, and height tended to be positively associated with these strokes in older women. CONCLUSIONS: We reported the associations between adult height and ischemic stroke subtypes for the first time, which differed according to sex and age-group.

DOI： 10.2188/jea.JE20200531

Including Measures of Chronic Kidney Disease to Improve Cardiovascular Risk Prediction by SCORE2 and SCORE2-OP. Reviewed International coauthorship International journal

Kunihiro Matsushita, Stephen Kaptoge, Steven Hj Hageman, Yingying Sang, Shoshana H Ballew, Morgan E Grams, Aditya Surapaneni, Luanluan Sun, Johan Arnlov, Milica Bozic, Hermann Brenner, Nigel J Brunskill, Alex R Chang, Rajkumar Chinnadurai, Massimo Cirillo, Adolfo Correa, Natalie Ebert, Kai Uwe Eckardt, Ron T Gansevoort, Orlando Gutierrez, Farzad Hadaegh, Jiang He, Shih Jen Hwang, Tazeen H Jafar, Simerjot K Jassal, Takamasa Kayama, Csaba P Kovesdy, Gijs W Landman, Andrew S Levey, Donald M Lloyd-Jones, Rupert W Major, Katsuyuki Miura, Paul Muntner, Girish N Nadkarni, Christoph Nowak, Takayoshi Ohkubo, Michelle J Pena, Kevan R Polkinghorne, Toshimi Sairenchi, Elke Schaeffner, Markus P Schneider, Varda Shalev, Michael G Shlipak, Marit D Solbu, Nikita Stempniewicz, James Tollitt, José M Valdivielso, Joep van der Leeuw, Angela Yee Moon Wang, Chi Pang Wen, Mark Woodward, Kazumasa Yamagishi, Hiroshi Yatsuya, Luxia Zhang, Jannick An Dorresteijn, Emanuele Di Angelantonio, Frank Lj Visseren, Lisa Pennells, Josef Coresh

European journal of preventive cardiology Vol. 30 ( 1 ) page： 8 - 16 2023.1

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

AIMS: The 2021 ESC guideline on cardiovascular disease (CVD) prevention categorizes moderate and severe chronic kidney disease (CKD) as high and very-high CVD risk status regardless of other factors like age and does not include estimated glomerular filtration rate (eGFR) and albuminuria in its algorithms, SCORE2 and SCORE2-OP, to predict CVD risk. We developed and validated an "Add-on" to incorporate CKD measures into these algorithms, using a validated approach. METHODS: In 3,054,840 participants from 34 datasets, we developed three Add-ons (eGFR only, eGFR + urinary albumin-to-creatinine ratio [ACR] [the primary Add-on], and eGFR + dipstick proteinuria) for SCORE2 and SCORE2-OP. We validated c-statistics and net reclassification improvement (NRI), accounting for competing risk of non-CVD death, in 5,997,719 participants from 34 different datasets. RESULTS: In the target population of SCORE2 and SCORE2-OP without diabetes, the CKD Add-on (eGFR only) and CKD Add-on (eGFR + ACR) improved c-statistic by 0.006 (95%CI 0.004-0.008) and 0.016 (0.010-0.023), respectively, for SCORE2 and 0.012 (0.009-0.015) and 0.024 (0.014-0.035), respectively, for SCORE2-OP. Similar results were seen when we included individuals with diabetes and tested the CKD Add-on (eGFR + dipstick). In 57,485 European participants with CKD, SCORE2 or SCORE2-OP with a CKD Add-on showed a significant NRI (e.g., 0.100 [0.062-0.138] for SCORE2) compared to the qualitative approach in the ESC guideline. CONCLUSION: Our Add-ons with CKD measures improved CVD risk prediction beyond SCORE2 and SCORE2-OP. This approach will help clinicians and patients with CKD refine risk prediction and further personalize preventive therapies for CVD.

DOI： 10.1093/eurjpc/zwac176

MEASURES OF LONG-TERM SYSTOLIC BLOOD PRESSURE VARIABILITY AND THEIR ASSOCIATIONS WITH THE RISK OF INCIDENT TYPE 2 DIABETES MELLITUS

Song, ZA; He, YP; Chiang, CF; Alshoaibi, AAA; Rahman, KMSU; Mamun, MR; Aoyama, A; Hirakawa, Y; Matsunaga, M; Ota, A; Tamakoshi, K; Li, YY; Yatsuya, H

JOURNAL OF HYPERTENSION Vol. 41 page： E134 - E134 2023.1

Association of Low-Density Lipoprotein Cholesterol with Risk of Coronary Heart Disease and Stroke among Middle-Aged Japanese Workers: An Analysis using Inverse Probability Weighting. Reviewed International coauthorship

Abubakr Ahmed Abdullah Al-Shoaibi, Yuanying Li, Zean Song, Chifa Chiang, Yoshihisa Hirakawa, K M Saif-Ur-Rahman, Masako Shimoda, Yoshihisa Nakano, Masaaki Matsunaga, Atsuko Aoyama, Koji Tamakoshi, Atsuhiko Ota, Hiroshi Yatsuya

Journal of atherosclerosis and thrombosis Vol. 30 ( 5 ) page： 455 - 466 2023

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

AIMS: The associations between low-density lipoprotein cholesterol (LDL-C) and the risk of cardiovascular disease (CVD) subtypes are not well established among the Japanese population. This study used longitudinal data from the Aichi Workers' Cohort Study to explore the association between LDL-C levels and the risk of coronary heart disease (CHD) and stroke subtypes. METHODS: Pooled data of 8966 adults (7093men and 1903 women) who were recruited between (2002) and (2008) were used for the current analysis. Propensity scores for the LDL-C categories were generated using multinomial logistic regression. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from the inverse probability weighted Cox proportional hazards model for LDL-C category associations with risks of CHD, stroke subtypes, and CVD. RESULTS: During a median follow-up of 12 years, 122 strokes (57 ischemic strokes, 25 intracerebral hemorrhage, and 40 unknown subtypes) and 82 cases of CHD were observed. LDL-C 160- mg/dL compared to LDL-C 100-119 mg/dL was positively and significantly associated with the risk of CHD (HR: 4.56; 95% CI: 1.91-10.9) but not with ischemic stroke (HR: 0.99; 95% CI: 0.44-2.22). LDL-C was inversely associated with the risk of intracerebral hemorrhage (P for trend=0.009). CONCLUSION: In middle-aged Japanese workers, LDL-C was significantly and positively associated with CHD, but not with ischemic stroke. LDL-C was inversely significantly associated with intracerebral hemorrhage.

DOI： 10.5551/jat.63519

Increasing Role of Overweight/Obesity as the Determinant of Hypertension and the Consequent Cardiovascular Diseases in Japan

Yatsuya Hiroshi

Journal of Atherosclerosis and Thrombosis Vol. 30 ( 4 ) page： 323 - 325 2023

Sociodemographic and behavioral factors related to obesity among adults in the Republic of Palau based on the WHO STEPwise approach to NCD risk factor surveillance 2011-2013: A cross-sectional study. Reviewed International coauthorship

Miyuki Hasegawa, Kaori Honjo, Chifa Chiang, Takashi Mita, Berry Moon Watson, Edolem Ikerdeu, Sherilynn Madraisau, Hiroshi Yatsuya, Atsuko Aoyama, Hiroyasu Iso

Environmental health and preventive medicine Vol. 28 ( 0 ) page： 39 - 39 2023

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Society for Hygiene

BACKGROUND: Pacific islanders face drastic increase of obesity-related noncommunicable disease (NCD) due to lifestyle shifts of unhealthy diets and physical inactivity. To date, however, obesity related factors have not been well elucidated in Republic of Palau. This study aimed to investigate sociodemographic and behavioral factors related to obesity using the national level data in Palau. METHODS: This is a cross-sectional, population-based study analyzing random sampling data of 2133 adults aged 25-64 years (of 20 thousand national population) from the WHO STEPwise approach to NCD risk factor surveillance (STEPS) implemented between 2011 and 2013. Sociodemographic and behavioral factors were obtained by the STEPS standardized questionnaire for NCD risk factors plus the question on betel nut chewing because of its common behavior in Micronesian countries. Logistic regression analysis was performed to estimate multivariable odds ratio (OR) of general obesity (body mass index ≥30.0 kg/m2) and central obesity (waist circumference ≥90 cm in men and ≥80 cm in women). RESULTS: Means of body mass index, prevalence of general obesity and central obesity were higher in women (29.9 kg/m2, 45.5% and 85.4%) than in men (29.3 kg/m2, 40.4% and 67.6%). After adjusted by other potential factors, native Palauan (OR 4.4, 95% CI, 2.7-7.0 for men and 3.6, 2.3-5.6 for women), betel nut chewing (1.5, 1.1-2.1 for men and 1.6, 1.2-2.3 for women), men who work at government office (1.6, 1.2-2.1), women with higher household income (1.4, 1.0-1.8) were positively associated with general obesity, while frequent vegetable intake were inversely associated with it among women (0.71, 0.54-0.93). Similar associations were observed between the aforementioned factors and central obesity. CONCLUSIONS: Native Palauan, people with betel nut chewing behavior, government employment and higher income appeared to be associated with obesity, while frequent vegetable consumption were inversely associated with obesity. Further interventions for prevention and control of obesity are necessary through the enhancing public relation activities to understand harmful health effects on betel nuts chewing and recommending domestic production of vegetables.

DOI： 10.1265/ehpm.22-00309

Renal Dysfunction after Rectal Cancer Surgery: A Long-term Observational Study Reviewed

Sando Masanori, Uehara Kay, Li Yuanying, Ogura Atsushi, Murata Yuki, Mizuno Takashi, Yatsuya Hiroshi, Ebata Tomoki

Journal of the Anus, Rectum and Colon Vol. 7 ( 3 ) page： 176 - 185 2023

Language：English Publisher：The Japan Society of Coloproctology

<p><b>Objectives: </b>Despite the high incidence of urinary dysfunction (UD) after rectal surgery, it remains questionable whether UD causes future chronic kidney disease (CKD). This study aimed to clarify the long-term trends in renal function and risk factors for future CKD after rectal resection.</p><p><b>Methods: </b>For comparison, patients who underwent rectal resection (n = 129) and colectomy (n = 127) between 2006 and 2017 were identified. The estimated glomerular filtration rate (eGFR) ratio was calculated as the ratio to the baseline. "eGFR ratio < 0.75 at 3-year" was adopted as a surrogate indicator of future CKD.</p><p><b>Results: </b>eGFR ratio significantly decreased in the rectal cohort compared with the colon cohort at 1.5 years (0.9 vs. 0.95, <i>p</i> = 0.008) and at 3 years (0.85 vs. 0.94, <i>p</i> < 0.001). Although the preoperative prevalence of CKD was lower in the rectal than the colon cohort (13.9% vs. 23.6%, <i>p</i> = 0.055), it was similar at 3 years (29.5% vs. 30.7%). In multivariate analysis, females, and cT4 were independent risk factors for future CKD, but UD itself was not.</p><p><b>Conclusions: </b>Postoperative eGFR significantly decreased after rectal cancer surgery compared to colectomy. The prevalence of CKD more than doubled at 3 years after rectal resection. The female sex and cT4 tumor, instead of the UD, were independent risk factors for future CKD.</p>

DOI： 10.23922/jarc.2022-059

Psychological Distress During the Coronavirus Disease 2019 Pandemic and Associated Factors Among Undergraduate Students in Japan Reviewed

Sato, Y; Yatsuya, H; Saijo, Y; Yoshioka, E; Tabuchi, T

DISASTER MEDICINE AND PUBLIC HEALTH PREPAREDNESS Vol. 17 ( 12 ) page： e294 2022.12

Language：English Publisher：Disaster Medicine and Public Health Preparedness

Objective: This cross-sectional study aimed to examine factors potentially associated with psychological distress among undergraduate students during the coronavirus disease 2019 pandemic in Japan. Methods: We analyzed data of 958 undergraduates (median age 20 y; 56.8% women) from a Web-based, self-administered questionnaire survey conducted from August to September 2020. Prevalence ratios (PRs) for psychological distress defined as 5 points or over of the Kessler Psychological Distress Scale (K6) were calculated by Poisson regression models. Results: The proportion of psychological distress was 40.0%. In the mutually-adjusted model, the following were significantly associated with psychological distress: decreases in household income to 50-99% of the prepandemic amount compared with no change (PR = 1.48), newly experiencing unpaid wages compared with no experience (PR = 1.44), insufficient money to buy necessities compared with no shortage (PR = 1.45), receiving a student loan or scholarship compared with none (PR = 1.27), and communication 1 to 3 times a month compared with at least once a week (PR = 1.22). In contrast, school closure during the pandemic compared with no closure was inversely associated with psychological distress (PR = 0.78). Conclusions: Among undergraduate students in Japan, economic difficulties significantly predicted psychological distress.

DOI： 10.1017/dmp.2022.245

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