Faculty Profiles - YATSUYA Hiroshi

Papers - YATSUYA Hiroshi

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Long-term variability and change trend of systolic blood pressure and risk of type 2 diabetes mellitus in middle-aged Japanese individuals: findings of the Aichi Workers’ Cohort Study Reviewed International coauthorship International journal

Zean Song, Yupeng He, Chifa Chiang, Abubakr A. A. Al-shoaibi, K. M. Saif-Ur-Rahman, Md Razib Mamun, Atsuko Aoyama, Yoshihisa Hirakawa, Masaaki Matsunaga, Atsuhiko Ota, Koji Tamakoshi, Yuanying Li, Hiroshi Yatsuya

Hypertension Research Vol. 45 ( 11 ) page： 1772 - 1780 2022.11

Authorship：Last author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

DOI： 10.1038/s41440-022-00993-2

Other Link： https://www.nature.com/articles/s41440-022-00993-2

Increased serum anti-CYP2E1 IgG autoantibody levels may be involved in the pathogenesis of occupational trichloroethylene hypersensitivity syndrome: a case-control study. Reviewed International journal Open Access

Tamie Nakajima, Hailan Wang, Yuan Yuan, Yuki Ito, Hisao Naito, Yoshiyuki Kawamoto, Kozue Takeda, Kiyoshi Sakai, Na Zhao, Hongling Li, Xinxiang Qiu, Lihua Xia, Jiabin Chen, Qifeng Wu, Laiyu Li, Hanlin Huang, Yukie Yanagiba, Hiroshi Yatsuya, Michihiro Kamijima

Archives of toxicology Vol. 96 ( 10 ) page： 2785 - 2797 2022.10

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

Occupational exposure to trichloroethylene (TCE) causes a systemic skin disorder with hepatitis known as TCE hypersensitivity syndrome (TCE-HS). Human Leukocyte Antigen (HLA)-B*13:01 is its susceptibility factor; however, the immunological pathogenesis of TCE-HS remains unknown. We herein examined the hypothesis that autoantibodies to CYP2E1 are primarily involved in TCE-HS. A case-control study of 80 TCE-HS patients, 186 TCE-tolerant controls (TCE-TC), and 71 TCE-nonexposed controls (TCE-nonEC) was conducted to measure their serum anti-CYP2E1 antibody (IgG) levels. The effects of TCE exposure indices, such as 8-h time-weighted-average (TWA) airborne concentrations, urinary metabolite concentrations, and TCE usage duration; sex; smoking and drinking habits; and alanine aminotransferase (ALT) levels on the antibody levels were also analyzed in the two control groups. There were significant differences in anti-CYP2E1 antibody levels among the three groups: TCE-TC > TCE-HS patients > TCE-nonEC. Antibody levels were not different between HLA-B*13:01 carriers and noncarriers in TCE-HS patients and TCE-TC. The serum CYP2E1 measurement suggested increased immunocomplex levels only in patients with TCE-HS. Multiple regression analysis for the two control groups showed that the antibody levels were significantly higher by the TCE exposure. Women had higher antibody levels than men; however, smoking, drinking, and ALT levels did not affect the anti-CYP2E1 antibody levels. Anti-CYP2E1 antibodies were elevated at concentrations lower than the TWA concentration of 2.5 ppm for TCE exposure. Since HLA-B*13:01 polymorphism was not involved in the autoantibody levels, the possible mechanism underlying the pathogenesis of TCE-HS is that TCE exposure induces anti-CYP2E1 autoantibody production, and HLA-B*13:01 is involved in the development of TCE-HS.

DOI： 10.1007/s00204-022-03326-x

Association between irregular daily routine and risk of incident stroke and coronary heart disease in a large Japanese population. Reviewed International journal Open Access

Takahiro Yoshizaki, Junko Ishihara, Ayaka Kotemori, Yoshihiro Kokubo, Isao Saito, Hiroshi Yatsuya, Kazumasa Yamagishi, Norie Sawada, Motoki Iwasaki, Hiroyasu Iso, Shoichiro Tsugane

Scientific reports Vol. 12 ( 1 ) page： 15750 - 15750 2022.9

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

Circadian misalignments have been linked to adverse cardiometabolic outcomes. However, the association between irregular daily routine and the risk of cardiovascular disease (CVD) remains unknown. We examined this association in a prospective study in Japan. The study included 78,115 Japanese participants aged 45-74 years. The self-reported daily routine was evaluated using the question, 'Is your daily routine or activity schedule regular?' The response (yes/no) was obtained as a binary variable. Cox proportional hazard regression analysis was used to estimate the hazard ratios and 95% confidence intervals for the association between an irregular daily routine and CVD incidence risk. Among the participants, 23.7% reported an irregular daily routine. During the mean follow-up period of 13.3 years, we observed 4641 CVD events. An irregular daily routine was significantly associated with increased risks of CVD and total stroke in women, but not in men. This positive association between an irregular daily routine and the risk of CVD was weak in the high vegetable and fruit consuming population. An irregular daily routine is positively associated with the risk of incident CVD, especially in women. These associations may be weak in populations that consume a diet rich in vegetables and fruits.

DOI： 10.1038/s41598-022-20019-8

Diabetes management in people living with dementia in Japan: a qualitative exploration Reviewed International journal

KM, SUR; HIRANO, Y; HIRAKAWA, Y; YATSUYA, H

PSYCHOGERIATRICS Vol. 22 ( 5 ) page： 728 - 735 2022.9

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

Background: Dementia and diabetes are highly prevalent among the older society in Japan. People living with dementia (PLWD) often face hurdles in managing diabetes. This study explored the perspectives of healthcare providers in Japan regarding diabetes management in PLWD. Methods: We conducted a qualitative study using in-depth interviews as a data collection method. A total of 15 physicians and nurses were interviewed. A qualitative content analysis of the codes was performed to generate the themes. Results: The major themes focused on the management of medications/therapeutic regimen, difficulties of continuing health care, emotional aspects of PLWD for adherence to lifestyle modification, and varying direction and degree of family support for diabetes care. Conclusion: PLWD in Japan face challenges in medication management, food restriction, and lifestyle modification. Policies to engage home visit care workers in medication management, consideration of the emotional aspect of PLWD, and utilisation of social support might help in the proper management of diabetes in PLWD.

DOI： 10.1111/psyg.12876

Web of Science

Scopus

PubMed

Secondhand smoke and the risk of incident cardiovascular disease among never-smoking women. Reviewed International journal Open Access

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

Preventive medicine Vol. 162 page： 107145 - 107145 2022.9

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

The prospective association between secondhand smoke (SHS) and the risk of incident cardiovascular disease (CVD) remains unclear. This study was the first to examine the association between SHS and risks of ischemic heart disease (IHD), stroke, and total CVD in a large cohort in Asia. The study followed 24,232 never-smoking women aged 40-59 from around Japan (Akita, Iwate, Nagano, Niigata, Ibaraki, Kochi, Nagasaki, and Okinawa prefectures). Their husbands were classified into never, former, and current smokers. After adjustment for age, body mass index, alcohol consumption, histories of hypertension and diabetes mellitus, medication use for hyperlipidemia, menopausal status, and public health center areas, the hazard ratios (HRs) of CVD according to husbands' smoking status were estimated by Cox proportional hazards models. During the 440,360 person-years follow-up, 846 women had total CVDs (103 IHDs, 744 strokes). The proportional hazard assumption was not assured during the total follow-up from 1990 to 2012, but so was then the follow-up of < and ≥ 10 person-years were examined separately. The multivariable HRs (95% confidence intervals) associated with husbands' current versus non-current smoking was 2.02 (1.19-3.45) for IHD, 1.18 (0.98-1.42) for stroke, and 1.25 (1.05-1.49) for total CVD in the follow-up of ≥10 person-years. The SHS from husbands may raise the risk of IHD among middle-aged never-smoking women.

DOI： 10.1016/j.ypmed.2022.107145

Web of Science

PubMed

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母体特性と妊娠中期血清n3系多価不飽和脂肪酸濃度の関連

金子佳世, 伊藤由起, 加藤沙耶香, 榎原毅, 八谷寛, 上島通浩

日本公衆衛生学会総会抄録集 Vol. 81回 page： 207 - 207 2022.9

A comparative study of the work-family conflicts prevalence, their sociodemographic, family, and work attributes, and their relation to the self-reported health status in Japanese and Egyptian civil workers Reviewed International coauthorship International journal Open Access

Omnyh Kamal Abd El Latief, Ehab Salah Eshak, Eman Mohamed Mahfouz, Hiroyasu Iso, Hiroshi Yatsuya, Eman Mohamed Sameh, Eman Ramadan Ghazawy, Sachiko Baba, Shimaa Anwer Emam, Ayman Soliman El-khateeb, Ebtesam Esmail Hassan

BMC Public Health Vol. 22 ( 1 ) page： 1490 2022.8

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Background

Cross-cultural studies studying work-family conflicts (W_F_Cs) are scarce. We compared the prevalence of W_F_Cs, factors correlated with them, and their association with self-rated health between Japan and Egypt.

Methods

Among 4862 Japanese and 3111 Egyptian civil workers recruited by a convenience sample in 2018/2019 and reported self-rated health status, we assessed the W_F_Cs by the Midlife Development in the US (MIDUS) and attributed them to sociodemographic, family, and work variables. We also evaluated the W_F_Cs’ gender- and country-specific associations with self-rated health by logistic regression analyses.

Results

W_F_Cs were more prevalent in Egyptian than in Japanese women (23.7% vs. 18.2%) and men (19.1% vs. 10.5%), while poor self-rated health was more prevalent in Japanese than Egyptians (19.3% and 17.3% vs. 16.9% and 5.5%). Longer working hours, shift work, and overtime work were positively associated with stronger work-to-family conflict (WFC). Whereas being single was inversely associated with stronger family-to-work conflict (FWC). Living with children, fathers, or alone in Japan while education in Egypt was associated with these conflicts. The OR (95% CI) for poor self-reported health among those with the strong, in reference to weak total W_F_Cs, was 4.28 (2.91–6.30) and 6.01 (4.50–8.01) in Japanese women and men and was 2.46 (1.75–3.47) and 3.11 (1.67–5.80) in Egyptian women and men.

Conclusions

Japanese and Egyptian civil workers have different prevalence and correlated factors of W_F_Cs and self-rated health. W_F_Cs were associated in a dose–response pattern with poor-self-rated health of civil workers in both countries.

DOI： 10.1186/s12889-022-13924-0

Other Link： https://link.springer.com/article/10.1186/s12889-022-13924-0/fulltext.html

Impact of the COVID-19 pandemic on national and prefectural health and nutrition examination surveys: A report by the Monitoring Report Committee of the Japanese Society of Public Health Reviewed Open Access

KUBO Akiko, KUNO Kazue, MARUYAMA Koutatsu, TSUKINOKI Rumi, NODA Hiroyuki, EGAWA Ken'ichi, SHIBUYA Izumi, SEI Masako, CHIHARA Mieko, NISHINA Kazue, YATSUYA Hiroshi

Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH) Vol. 69 ( 8 ) page： 586 - 594 2022.8

Dietary Patterns Derived from Reduced Rank Regression Are Associated with the 5-Year Occurrence of Metabolic Syndrome: Aichi Workers’ Cohort Study Reviewed International journal Open Access

Yuanying Li, Hiroshi Yatsuya, Chaochen Wang, Mayu Uemura, Masaaki Matsunaga, Yupeng He, Maythet Khine, Atsuhiko Ota

Nutrients Vol. 14 ( 15 ) page： 3019 - 3019 2022.8

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

The aim of the present study was to derive dietary patterns to explain variation in a set of nutrient intakes or in the measurements of waist circumference (WC) and fasting blood glucose (FBG) using reduced rank regression (RRR) and to prospectively investigate these patterns in relation to the risk of developing metabolic syndrome (MetS) and its components during the follow-up. The study participants were comprised of 2944 government employees aged 30–59 years without MetS. RRR was applied with 38 food groups as predictors and with two sets of response variables. The first set included intake of putatively beneficial nutrients, and the first factor retained was named the Healthy Dietary Pattern (HDP). The second one included baseline WC and FBG, and the first factor was named the Unhealthy Dietary Pattern (UHDP). Multivariable Cox proportional hazard model was used to estimate hazard ratio and 95% confidence intervals with adjustments for age, sex, total energy consumption and other potential confounders. During the 5-year median follow-up, we ascertained 374 cases of MetS. The HDP score was inversely associated with the incidence of MetS (p-trend = 0.009) and hypertension (p-trend = 0.002) and marginally significantly associated with elevated triglyceride and decreased high-density lipoprotein cholesterol (p-trend = 0.08). The UHDP score was linearly positively associated with the incidence of MetS and all its components (all p-trend < 0.05). Both the HDP and UHDP predicted the development of MetS and its components.

DOI： 10.3390/nu14153019

Combined Exoscopic and Endoscopic Two-Step Keyhole Approach for Intracranial Meningiomas Reviewed International journal Open Access

Tadashi Watanabe, Kenichiro Iwami, Yugo Kishida, Tetsuya Nagatani, Hiroshi Yatsuya, Shigeru Miyachi

Current Oncology Vol. 29 ( 8 ) page： 5370 - 5382 2022.8

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

The advantages of neuroendoscopic surgery are the wide viewing angle and the freedom of an axis of view with minimal surgical trauma. With the advent of the exoscope, which has similar advantages to endoscopy, such as a small body and ergonomically superior heads-up surgery, it has become possible to add a field of view that is similar to that of microsurgery to endoscopic surgery. By taking advantage of the features of these scopes, we report the usefulness of the minimally invasive combined exoscopic and endoscopic two-step keyhole approach (EEKA) for various types of meningiomas. We reviewed data from 34 consecutive cases of EEKA for various types of intracranial meningiomas compared with that of conventional microsurgery. All of the tumors were resected as planned without severe complications. Significantly better outcome data were obtained in terms of the blood loss and the surgical time in the EEKA group, in addition to the craniotomy size. The well-illuminated fine vision in the deep corners by the endoscope enabled radical resection of the tumors with minimum burden on the patients. This technique has the potential for minimally invasive surgery in intracranial meningioma patients, including the older population.

DOI： 10.3390/curroncol29080426

Influence of the COVID-19 pandemic on regular clinic visits and medication prescriptions among people with diabetes: Retrospective cohort analysis of health care claims. Reviewed International journal Open Access

Toshiki Maeda, Takumi Nishi, Masataka Harada, Kozo Tanno, Naoyuki Nishiya, Kei Asayama, Nagako Okuda, Daisuke Sugiyama, Hiroshi Yatsuya, Akira Okayama, Hisatomi Arima

Medicine Vol. 101 ( 29 ) page： e29458 2022.7

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

The aim of this study was to investigate the effect of the COVID-19 pandemic on regular clinic visits among people with diabetes and to elucidate the factors related to visit patterns among these patients during the pandemic. This was a longitudinal study using anonymized insurance claims data from the Joint Health Insurance Society in Tokyo from October 2017 to September 2020. First, we identified patients with diabetes who were fully enrolled in the health plan from fiscal year 2017 until September 2020 and who were regularly receiving glucose-lowering medications (every 1-3 months) from October 2017 to September 2018. We divided follow-up into the pre-pandemic period (October 2018 to March 2020) and the pandemic period (April 2020 to September 2020). A multilevel logistic regression model was used to determine the risks of delayed clinic visits/medication prescriptions (i.e., >3 months after a previous visit/prescription) during the pandemic period. We identified 1118 study participants. The number of delayed clinic visits/medication prescriptions during the pre-pandemic and pandemic periods was 188/3354 (5.6%) and 125/1118 (11.2%), respectively. There was a significant increase in delayed clinic visits during the pandemic (adjusted odds ratio 3.68 (95% confidence interval 2.24 to 6.04, P < .001), even after controlling for confounding factors. We also found a significant interaction between sex and delayed visits; women had significantly fewer clinic visits during the COVID-19 pandemic than men. We clarified the relationship of the COVID-19 pandemic with delays in regular clinic visits and medication prescriptions among people with diabetes. The response to the COVID-19 pandemic differed between men and women.

DOI： 10.1097/MD.0000000000029458

High Maternal Total Cholesterol Is Associated With No-Catch-up Growth in Full-Term SGA Infants: The Japan Environment and Children's Study. Reviewed International journal Open Access

Kayo Kaneko, Yuki Ito, Takeshi Ebara, Sayaka Kato, Taro Matsuki, Hazuki Tamada, Hirotaka Sato, Shinji Saitoh, Mayumi Sugiura-Ogasawara, Hiroshi Yatsuya, Michihiro Kamijima

Frontiers in endocrinology Vol. 13 page： 939366 - 939366 2022.7

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

Objectives: Infants born small for gestational age (SGA) with no catch-up growth (No-CU) are at high risk of intellectual and developmental disabilities. However, factors leading to No-CU among SGA infants are unclear. This study aimed to examine the association between maternal total cholesterol (TC) in mid-pregnancy and No-CU at 3 years among full-term SGA infants. Study Design: The Japan Environment and Children's Study (JECS) is a nationwide prospective birth cohort study. We extracted a total of 2,222 mothers and full-term SGA infants (length and/or weight <-2 standard deviation [SD]) without congenital abnormalities from the original JECS cohort comprising a total of 104,062 fetal records. According to the distribution of maternal TC in the entire cohort, participants were classified into nine groups per each fifth percentile with the 20th-79th percentiles (204-260 mg/dl) as the reference group. No-CU was defined by a Z-score of height at 3 years <-2 SD according to the growth standard charts for Japanese children. Multivariable-adjusted logistic regression models were carried out using multiple imputations. Additionally, a multiple-adjusted restricted cubic spline model was performed in the complete dataset. Results: A total of 362 (16.3%) children were No-CU at 3 years. After adjusting for the Z-score of birth weight, age of mother, smoking status, weight gain during pregnancy, breastfeeding and meal frequency at 2 years, and parents' heights, the odds ratio (95% confidence intervals) of No-CU was 2.95 (1.28-6.80) for children whose maternal TC levels were in the highest category (≥294 mg/dl), compared to the reference group. A multiple-adjusted restricted cubic spline model showed a non-linear trend of the significant association between high maternal TC and No-CU (p for linear trend = 0.05, p for quadratic trend <0.05). Conclusion: High maternal TC at mid-pregnancy was associated with No-CU among SGA infants. Such infants should be carefully followed up to introduce appropriate growth hormonal treatment. The findings may support previous animal experimental studies which indicated that maternal high-fat diet exposure induces impairment of growth and skeletal muscle development in the offspring. Future studies are required to elucidate the detailed mechanism.

DOI： 10.3389/fendo.2022.939366

Endoscopic sphincterotomy and endoscopic biliary stenting do not affect the sensitivity of transpapillary forceps biopsy for the diagnosis of bile duct adenocarcinoma Reviewed International journal Open Access

Aoki, T; Ohno, E; Ishikawa, T; Mizutani, Y; Iida, T; Yamao, K; Yamamura, T; Furukawa, K; Nakamura, M; Honda, T; Ishigami, M; Yatsuya, H; Kawashima, H

BMC GASTROENTEROLOGY Vol. 22 ( 1 ) page： 329 2022.7

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

Background: The pathological evaluation of tissues with cholangitis is considered difficult, which can often occur after endoscopic sphincterotomy (EST) and endoscopic biliary stenting (EBS). This study aimed to evaluate the influence of a history of EST and EBS on the sensitivity of transpapillary forceps bile duct biopsy (TB) for bile duct adenocarcinoma. Methods: This retrospective study included consecutive cases of bile duct adenocarcinoma in which TB was performed before July 2020 until the number exceeded that required to support statistical and noninferiority analyses of the sensitivity of TB between patients with and without each variable. The incidence of postprocedural adverse events related to each factor was also investigated. Results: Overall, 280 samples were required in each group, and 437 subjects (792 samples) were included. The sensitivity of TB was 63.6% for the subjects and 59.6% for the biopsy samples. For the biopsy samples, the sensitivity did not differ significantly between samples from patients with and without a history of EST (59.1% vs. 58.9%, P = 0.952) and EBS (62.1% vs. 55.4%, P = 0.065). The sensitivity was significantly higher for samples from patients with jaundice (67.9% vs. 57.0%, P = 0.008). There were significantly fewer procedure-related adverse events in patients with a history of EST (10.8% vs. 19.0%, P = 0.017) and EBS (12.0% vs. 21.7%, P = 0.005). Conclusions: A history of EST or EBS did not influence sensitivity of TB but significantly decreased the incidence of adverse events. To safely and reliably perform TB to diagnose bile duct adenocarcinoma, planning, including for EST and EBS, is necessary.

DOI： 10.1186/s12876-022-02402-x

Early impact of the spread of the novel coronavirus infection on medical, long-term care and welfare sites in Japan: A qualitative study Reviewed Open Access

Tokai Journal of Public Health Vol. 10 ( 1 ) page： 85 - 94 2022.7

Authorship：Last author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Tokai Public Health Association

ObjectivesThis study aimed to describe the structure of problems that occurred in the field of medical, long-term care and welfare under the unprecedented situation of the early stage of the spread of novel coronavirus.MethodsWe conducted the online interview from April to May in 2020, targeting 27 workers on medical, long-term care, and welfare sites. The semi-structured interview using an interview guide was conducted in a free-answer format. A verbatim record was created from the recorded interview content, and the text data was analyzed by qualitative content analysis.ResultsWe extracted 126 types of the meaning unit and the following four themes. (1) anxiety and dissatisfaction with information deficiency and insufficient information sharing, (2) stress of medical workers due to the double burden of overwork and discrimination from society, (3) the measures against loneliness and poverty, and (4) difficulty in infection prevention measures.ConclusionUnder the unprecedented situation in the early stage of novel coronavirus infection, shortages of highly reliable information as well as of medical materials were particularly serious. Preventive measures against stress for medical staff and the livelihood support for loneliness and poverty were found to be important.

DOI： 10.24802/tpha.2022-02

Open Access

CiNii Research

健診で血圧高値を指摘された高血圧症患者の疾患と治療に対する認識と態度 Reviewed Open Access

洪英在, 平川仁尚, 犬飼麻里子, 水野晴子, 江啓発, 八谷寛

東海公衆衛生雑誌 Vol. 10 ( 1 ) page： 180 - 186 2022.7

Authorship：Last author Language：Japanese Publisher：東海公衆衛生学会

目的　適切に血圧がコントロールされている人を増やすためには, コントロール不良の高血圧症患者に焦点を当て, その要因を明らかにする必要がある。高血圧症は無症候性であることが多いため, 患者本人の疾患や治療に関する認識への働きかけを行うことが重要であるが, そうした研究は少ない。本研究は, 健診でII度以上の血圧高値を指摘された高血圧患者 (すなわち, 良好なコントロール状態にあるとは判断されない高血圧症患者) の疾患と治療に対する認識や態度を探索することを目的とした。方法　対象者は, 愛知県岩倉市が2019年度, 2020年度, 2021年度に実施した特定健診受診者の中から, 一度でも収縮期血圧160mmHg以上または拡張期血圧100mmHg以上であった300名に対して研究参加を呼び掛け, 同意が得られた13名とした。データ収集は1回約30分間の1対1の半構造化面接により行われた。データ分析は, 質的内容分析により行われた。結果　対象者の性別は女性5名, 平均年齢は69.2歳 (60-74歳) であった。2名がBMI 25kg/m2以上の肥満であったがBMI 35kg/m2以上の高度肥満は存在しなかった。13名ともに高血圧症での医療機関通院歴を有し, 8名がかかりつけ医から降圧剤を処方されていた。質的分析の結果, 高血圧に対するイメージ, 治療に関する認識, ピアから受ける影響, 患者からみたかかりつけ医の診療姿勢, 実際に行動変容することの難しさ, の5テーマが抽出された。対象者の中には, 高血圧症に対して重大性を認識していないか, 生活習慣改善に向けて行動を起こすメリットを感じていないようであった。また, 降圧剤について, 必要性を感じず, 副作用を危惧していた。こうした認識は, ピア, つまり同じ疾患を持つ家族・同僚や, かかりつけ医の診療姿勢から影響を受けていた。結論　コントロールが良好でない可能性がある高血圧症患者の疾患と治療に対する認識と態度として, 行動変容の準備性の低さ, 治療内容に関する否定的な認識, ピアからの影響の大きさ, かかりつけ医の診療姿勢への転嫁的態度が存在する可能性があると考えられた。

DOI： 10.24802/tpha.2022-13

Open Access

CiNii Research

特定健診およびレセプトデータを用いた愛知県岩倉市における心血管疾患発症リスクおよび人口寄与危険割合に関するコホート研究 Reviewed Open Access

江啓発, 藤社紗梨, 水野晴子, 平川仁尚, 八谷寛

東海公衆衛生雑誌 Vol. 10 ( 1 ) page： 166 - 179 2022.7

Authorship：Last author,　Corresponding author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：東海公衆衛生学会

目的　特定健診とレセプトの分析に基づき保健事業の効果や効率を高めていくこと (データヘルス計画) が保険者には求められているが、課題設定や被保険者への情報提供に資する実態把握には特定健診受診率や有所見者割合、高額医療費者数等の横断的な検討が中心である。そこで本研究は、愛知県岩倉市国民健康保険 (国保) 加入者の特定健診とその後の経年的なレセプト情報を突合したコホート研究データを用い、心血管疾患発症リスクおよび人口寄与危険割合の推定を試みた。方法　岩倉市国保加入者のうち、2013年から2018年までの5年間に特定健診を1回以上受診した者を対象とし、最初の受診年をベースラインとした。ベースライン以前に心血管疾患の既往歴のある者および問診データに欠損値の多い者を除外した6,496名 (男性2,722名、女性3,774名) を解析対象とした。レセプト情報を用いて追跡期間中の心血管疾患の発症を把握し、特定健診結果から把握した危険因子と全心血管疾患、心筋梗塞、脳卒中の関連を性・年齢および危険因子を相互に調整したCox比例ハザードモデルで検討した。また、多変量調整ハザード比(HR)と発症者における危険因子の割合から人口寄与危険割合を推定した。結果　解析対象者のベースライン時平均年齢は62.5歳であった。追跡期間中の全心血管疾患、心筋梗塞、脳卒中の発症者数はそれぞれ149名、58名、91名であった。女性に比し男性 (HR : 2.0、95%信頼区間 (CI) : 1.4-2.8)、非現喫煙者に比し現喫煙者 (HR : 1.7、95% CI : 1.1-2.5) は心血管疾患発症リスクが約2倍高かった。非高血圧に比しI度およびII度以上高血圧の心血管疾患発症のハザード比はそれぞれ1.7 (95% CI : 1.1-2.4)、2.3 (95% CI : 1.5-3.5) であった。また、糖尿病 (HR : 2.3、95% CI : 1.4-3.9)、メタボリックシンドローム該当者 (HR : 1.6、95% CI : 1.1-2.3) ともに約2倍の心血管疾患発症リスクと関連した。心血管疾患の人口寄与危険割合は高血圧 (I度以上) で27.2%と最も高く、次いで喫煙11.3% メタボリックシンドローム10.5%、糖尿病10.2%であった。結論　高血圧、喫煙、糖尿病、メタボリックシンドロームは性、年齢、その他の危険因子に独立して心血管疾患発症リスク上昇と有意に関連した。心血管疾患の人口寄与危険割合は高血圧で最も高かった。

DOI： 10.24802/tpha.2022-12

Open Access

CiNii Research

Association between C-reactive protein and risk of overall and 18 site-specific cancers in a Japanese case-cohort Reviewed Open Access

Suzuki S., Katagiri R., Yamaji T., Sawada N., Imatoh T., Ihira H., Inoue M., Tsugane S., Iwasaki M., Miyamoto Y., Abe S.K., Tanaka S., Moriya T., Minamizono T., Shirai Y., Kuniyoshi H., Yoshimi T., Sonoda H., Tagami T., Ando T., Kimura T., Kokubo Y., Yamagishi K., Mizoue T., Nakamura K., Takachi R., Ishihara J., Iso H., Kitamura T., Saito I., Yasuda N., Mimura M., Sakata K., Noda M., Goto A., Yatsuya H.

British Journal of Cancer Vol. 126 ( 10 ) page： 1481 - 1489 2022.6

Language：English Publisher：British Journal of Cancer

Background: Evidence of the association between chronic low-grade inflammation, as reflected by C-reactive protein (CRP) measurements, and cancer risk is equivocal. Specifically, few studies have examined this in uncommon cancers and Asian populations. Methods: We utilised a case-cohort design consisting of multi-types of cancer (N = 3608), and a random subcohort (N = 4432) in a Japanese large population-based study, with a median follow-up time of 15.6 years, and measured baseline plasma CRP using high sensitivity assay. The hazard ratios (HRs) were estimated using weighted Cox proportional hazards methods. Results: The multivariable-adjusted HR (95% confidence interval) for the top quartile of CRP was 1.28 (1.11‒1.48) (P<inf>trend</inf> < 0.001) for overall cancer compared to the bottom quartile of CRP. Among site-specific cancers, higher CRP levels were associated with an increased risk of colorectal, lung, breast, biliary tract, and kidney cancer, and leukaemia. These positive associations remained among participants after >3 years’ follow-up. Furthermore, subgroup analyses for overall cancer robustly showed a positive association with CRP levels, regardless of sex and obesity. Conclusion: Our consistent findings suggested that chronic low-grade inflammation measured by CRP is associated with the risk of cancer.

DOI： 10.1038/s41416-022-01715-8

Scopus

Stoma creation is associated with a low incidence of midline incisional hernia after colorectal surgery: the "fighting over the fascia" theory concerning the incision and stoma hole. Reviewed

Noriaki Ohara, Kay Uehara, Atsushi Ogura, Masanori Sando, Toshisada Aiba, Yuki Murata, Takashi Mizuno, Kokuryo Toshio, Yukihiro Yokoyama, Satoko Ishigaki, Yuanying Li, Hiroshi Yatsuya, Tomoki Ebata

Surgery today Vol. 52 ( 6 ) page： 953 - 963 2022.6

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

PURPOSE: Parastomal hernia (PH) develops more frequently than incisional hernia (IH) after colorectal surgery with stoma. This study evaluated our hypothesis that inward traction of the fascia when closing a midline incision widens the stoma hole and increases the incidence of PH. METHODS: A total of 795 patients who underwent colorectal resection between 2006 and 2016 were retrospectively analyzed. The risk classification was constructed from IH risk factors extracted from the non-stoma group. Then, the classification was extrapolated to the stoma group for predicting midline IH and PH. RESULTS: The incidence of IH was 5.3% in the stoma group and 12.5% in the non-stoma group (p = 0.005). PH developed in 19.6% of 97 patients with permanent stoma. The risk classification was able to predict PH without a significant difference but was well balanced in patients with permanent stoma; however, it failed to predict IH in the stoma group. CONCLUSION: The risk classification constructed from the non-stoma group was useful for predicting not midline IH but PH, suggesting that the stoma site was the most vulnerable for herniation. The "fighting over the fascia" theory between the midline incision and stoma hole may explain the causal relationship between the midline IH and PH.

DOI： 10.1007/s00595-021-02434-y

Prioritization and sequential exclusion of articles in systematic reviews Reviewed International coauthorship International journal Open Access

Saif-Ur-Rahman, KM; Hasan, M; Hossain, S; Anwar, I; Hirakawa, Y; Yatsuya, H

CAMPBELL SYSTEMATIC REVIEWS Vol. 18 ( 2 ) page： e1229 2022.6

Language：English Publishing type：Research paper (scientific journal) Publisher：Campbell Systematic Reviews

It is difficult to match the causes of exclusion among two independent review authors after screening the title and abstract or full texts in systematic reviews. We have proposed the prioritization and sequential exclusion approach to reduce the subjectivity in reporting reasons for exclusion. This approach might reduce the burden of mismatched numbers while describing the cause of exclusion.

DOI： 10.1002/cl2.1229

Implementation strategies for the patient safety reporting system using Consolidated Framework for Implementation Research: a retrospective mixed-method analysis Reviewed Open Access

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

BMC HEALTH SERVICES RESEARCH Vol. 22 ( 1 ) page： 409 2022.3

Language：English Publisher：BMC Health Services Research

Background: Healthcare-related adverse events occur because of complex healthcare systems. The patient safety reporting system is a core component of patient safety initiatives in hospitals. However, hospital management often encounters a cultural barrier with its implementation and struggles to overcome the same. Implementation science would be useful for analysing implementation strategies. This study determines the effects of the implemented strategy on an increase in the number of patient safety reports and the determinants of successful implementation, using the implementation framework. Methods: Mixed method analysis was performed in Fujita Health University Hospital (FHUH), a large volume hospital in Japan. We identified strategies to implement the patient safety reporting system by scrutinising internal documents using the Consolidated Framework for Implementation Research (CFIR). The electronic reporting systems developed in 2004 in the FHUH and the number of reports were analysed using the staff data and hospital volumes. Results: Reports (n = 110,058) issued between April 2004 and March 2020 were analysed. The number of reports increased from 2004 to 2008 and from 2013 to 2019, reaching 14,037 reports per year. Between 2009 and 2012, the FHUH experienced a stagnation period where the number of reports were not increasing. From the qualitative materials, we identified 74 strategies which contributed to the implementation of the patient safety reporting system. Among these, the domain of ‘intervention characteristics’ in the CFIR contained 12 strategies, ‘outer settings’ contained 20, ‘inner settings’ contained 21, ‘characteristics of individuals’ contained 8, and ‘process’ contained 13. There were two concentrated periods of the implemented strategies, the number was 17 in 2007 and 10 in 2016. These concentrated periods preceded a remarkable increase in the number of patient safety reports. Conclusions: A safety culture had been fostered in FHUH in the study period. A relationship between number of strategies and development of a reporting culture was observed. The intensity of adequate strategies was needed for implementation of patient safety reporting system. Therefore, the implementation framework is useful for analysing patient safety initiatives for safety culture.

DOI： 10.1186/s12913-022-07822-9

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