研究者詳細 - 八谷　寛

論文 - 八谷　寛

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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 査読有り国際共著国際誌

Song, ZA; He, YP; Chiang, CF; Al-Shoaibi, AAA; Saif-Ur-Rahman, KM; Mamun, MR; Aoyama, A; Hirakawa, Y; Matsunaga, M; Ota, A; Tamakoshi, K; Li, YY; Yatsuya, H

HYPERTENSION RESEARCH 45 巻 ( 11 ) 頁： 1772 - 1780 2022年11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：Hypertension Research

Studies have reported that short-term blood pressure (BP) variability (BPV) is associated with type 2 diabetes mellitus (T2DM) incidence, but the association with long-term BPV remains unclear. The present study investigated the associations of long-term BPV as well as the time trend of BP changes over time with the incidence of T2DM. This study followed a cohort of 3017 Japanese individuals (2446 male, 571 female) aged 36–65 years from 2007 through March 31, 2019. The root-mean-square error (RMSE) and the slope of systolic BP (SBP) change regressed on year were calculated individually using SBP values obtained from 2003 to baseline (2007). A multivariable Cox proportional hazard model was applied to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for tertiles of SBP RMSE and continuous SBP slopes adjusted for age, sex, smoking status, regular exercise, sodium intake, family history of diabetes, sleep disorder, body mass index (BMI), SBP, and fasting blood glucose (FBG) at baseline, and BMI slope from 2003 to 2007. The highest RMSE tertile compared to the lowest was associated with a significantly higher incidence of T2DM after adjusting for covariates (HR: 1.79, 95% CI: 1.15, 2.78). The slope was also significantly associated with T2DM incidence until baseline SBP and FBG were adjusted (HR: 1.03, 95% CI: 0.99, 1.07). In conclusion, long-term SBP variability was significantly associated with an increased incidence of T2DM independent of baseline age, sex, BMI, SBP, FBG, lifestyle factors and BMI slope from 2003 until baseline.

DOI： 10.1038/s41440-022-00993-2

その他リンク： 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 査読有り国際誌 Open Access

Nakajima, T; Wang, HL; Yuan, Y; Ito, Y; Naito, H; Kawamoto, Y; Takeda, K; Sakai, K; Zhao, N; Li, HL; Qiu, XX; Xia, LH; Chen, JB; Wu, QF; Li, LY; Huang, HL; Yanagiba, Y; Yatsuya, H; Kamijima, M

ARCHIVES OF TOXICOLOGY 96 巻 ( 10 ) 頁： 2785 - 2797 2022年10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 Toxicology

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 査読有り国際誌 Open Access

Yoshizaki, T; Ishihara, J; Kotemori, A; Kokubo, Y; Saito, I; Yatsuya, H; Yamagishi, K; Sawada, N; Iwasaki, M; Iso, H; Tsugane, S

SCIENTIFIC REPORTS 12 巻 ( 1 ) 頁： 15750 - 15750 2022年9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：Scientific Reports

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 査読有り国際誌

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

PSYCHOGERIATRICS 22 巻 ( 5 ) 頁： 728 - 735 2022年9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：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 査読有り国際誌 Open Access

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

PREVENTIVE MEDICINE 162 巻頁： 107145 - 107145 2022年9月

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 81回巻頁： 207 - 207 2022年9月

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 査読有り国際共著国際誌 Open Access

Abd El Latief, OK; Eshak, ES; Mahfouz, EM; Iso, H; Yatsuya, H; Sameh, EM; Ghazawy, ER; Baba, S; Emam, SA; El-khateeb, AS; Hassan, EE

BMC PUBLIC HEALTH 22 巻 ( 1 ) 頁： 1490 2022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：BMC Public Health

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

その他リンク： 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]. 査読有り Open Access

Kubo A, Kuno K, Maruyama K, Tsukinoki R, Noda H, Egawa K, Shibuya I, Sei M, Chihara M, Nishina K, Yatsuya H

[Nihon koshu eisei zasshi] Japanese journal of public health 69 巻 ( 8 ) 頁： 586 - 594 2022年8月

担当区分：最終著者記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：日本公衆衛生学会

目的　新型コロナウイルス感染症の蔓延により2020年度および2021年度の国民健康・栄養調査が中止され，都道府県の調査も中止または延期が予想されたため，日本公衆衛生学会公衆衛生モニタリング・レポート委員会生活習慣病・公衆栄養グループでは都道府県民健康・栄養調査の実施状況を調査し，公衆衛生施策立案のために必要なデータ収集の現状と課題を検討した。方法　47都道府県の調査担当者を対象に，郵送もしくは電子媒体による自記式質問紙調査を実施した。結果　47都道府県（回収率100％）から回答が得られた。健康・栄養調査を実施しているのは44自治体（93.6％）であった。新型コロナウイルス感染症の影響から2020年度調査予定の18自治体のうち「予定通りの内容で実施した」は2（11.1％）「中止した」は16（88.9％）であった。2021年度調査予定の31自治体のうち「予定通りの内容で実施した」は4（12.9％）「内容を一部変更して実施した」は5（16.1％）「中止した」は22（71.0％）であった。今後の調査方法について，身体状況調査実施の32自治体のうち「変更する予定はない」は6（18.8％）「未定」は18（56.3％）であった。栄養摂取状況調査実施の40自治体のうち「変更する予定はない」は12（30.0％）「未定」は19（47.5％）であった。2か年とも調査を中止した13自治体の各種計画評価は「各種計画期間を延長する」8（61.5％）「その他」7（53.8％）であった。2か年に調査を中止または延期した38自治体のうち，各種計画評価に関する問題点は「調査法の変更に伴う経年評価が不可能になる」「コロナ禍でのライフスタイル変化の影響が想定される」「評価に影響はないが評価期間が短縮となる」「国民健康・栄養調査中止により全国比較が不可能である」等があげられた。結論　都道府県健康増進計画等の評価のため，ほとんどの自治体が都道府県民健康・栄養調査を実施していた。また，全国比較ができるよう国民健康・栄養調査と同じ方式で実施する自治体が多かった。新型コロナウイルス感染症の影響により，国民健康・栄養調査と同様に調査を中止する都道府県が多く，今後の調査も未定と回答する自治体が多かった。

DOI： 10.11236/jph.22-020

Open Access

PubMed

CiNii Research

Dietary Patterns Derived from Reduced Rank Regression Are Associated with the 5-Year Occurrence of Metabolic Syndrome: Aichi Workers' Cohort Study 査読有り国際誌 Open Access

Li, YY; Yatsuya, H; Wang, CC; Uemura, M; Matsunaga, M; He, YP; Khine, M; Ota, A

NUTRIENTS 14 巻 ( 15 ) 頁： 3019 - 3019 2022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：Nutrients

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 査読有り国際誌 Open Access

Watanabe, T; Iwami, K; Kishida, Y; Nagatani, T; Yatsuya, H; Miyachi, S

CURRENT ONCOLOGY 29 巻 ( 8 ) 頁： 5370 - 5382 2022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：Current Oncology

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 査読有り国際誌 Open Access

Maeda, T; Nishi, T; Harada, M; Tanno, K; Nishiya, N; Asayama, K; Okuda, N; Sugiyama, D; Yatsuya, H; Okayama, A; Arima, H

MEDICINE 101 巻 ( 29 ) 頁： e29458 2022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：Medicine United States

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 査読有り国際誌 Open Access

Kaneko, K; Ito, Y; Ebara, T; Kato, S; Matsuki, T; Tamada, H; Sato, H; Saitoh, S; Sugiura-Ogasawara, M; Yatsuya, H; Kamijima, M

FRONTIERS IN ENDOCRINOLOGY 13 巻頁： 939366 - 939366 2022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：Frontiers in Endocrinology

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 査読有り国際誌 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 22 巻 ( 1 ) 頁： 329 2022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 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

新型コロナウイルス感染拡大が日本の医療・介護・福祉の現場にもたらした初期段階の影響に関する質的研究査読有り Open Access

平野有希子, 平川仁尚, 江啓発, 八谷寛

東海公衆衛生雑誌 10 巻 ( 1 ) 頁： 85 - 94 2022年7月

担当区分：最終著者記述言語：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

目的　新型コロナウイルス (SARS-COV-2) の感染拡大初期に医療・介護・福祉の現場で起きた課題の構造を整理することは, 今後直面する可能性がある新たな新興感染症への対策策定の第一歩として有用と考えられる。本研究では, 2020年4～5月頃の新型コロナウイルス感染拡大の初期段階における地域の医療・介護・福祉の現場の課題とその構造を実務者の言説の質的分析を通して明らかにすることを目的とした。方法　医療・介護・福祉従事者27名を対象に2020年4月から5月にオンラインインタビュー調査を実施した。インタビューガイドを用いた半構造化インタビューとし, 自由回答形式で行った。録画したインタビュー内容から逐語録を作成し, テキストデータを質的内容分析により分析した。結果　質的内容分析の結果, 126種類の意味単位が抽出された。グループ化により, (1) 不足する情報・十分でない情報共有に対する不安や不満, (2) 業務ならびに社会からの差別に対する心身の疲労, (3) 孤独と貧困に対する対応, (4) 感染予防対策における困難さ, の4テーマが抽出された。結論　本研究の結果から, 新興感染症拡大初期の現場で, 医療資材の不足だけでなく信頼性が高い情報の不足が特に深刻であった。また, 初期に限定した課題ではないが, 医療者の心身の疲労軽減, 孤独や貧困に対する生活支援も重要であった。

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査読有り 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 10 巻 ( 1 ) 頁： 180 - 186 2022年7月

担当区分：最終著者記述言語：日本語出版者・発行元：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査読有り 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 10 巻 ( 1 ) 頁： 166 - 179 2022年7月

担当区分：最終著者,　責任著者記述言語：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

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 査読有り 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 126 巻 ( 10 ) 頁： 1481 - 1489 2022年6月

記述言語：英語出版者・発行元：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 査読有り

Ohara, N; Uehara, K; Ogura, A; Sando, M; Aiba, T; Murata, Y; Mizuno, T; Toshio, K; Yokoyama, Y; Ishigaki, S; Li, YY; Yatsuya, H; Ebata, T

SURGERY TODAY 52 巻 ( 6 ) 頁： 953 - 963 2022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：Surgery Today

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 査読有り国際共著国際誌 Open Access

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

CAMPBELL SYSTEMATIC REVIEWS 18 巻 ( 2 ) 頁： e1229 2022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：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 査読有り Open Access

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

BMC HEALTH SERVICES RESEARCH 22 巻 ( 1 ) 頁： 409 2022年3月

記述言語：英語出版者・発行元：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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論文 - 八谷　寛