記述言語：英語   出版者・発行元：International Archives of Occupational and Environmental Health  

Objectives: This study aimed to investigate the association between occupational stress responses indicated by fatigue and nonspecific physical complaints and the incidence of subsequent cardiovascular disease (CVD) in middle-aged Japanese workers. Methods: A cohort of 4,820 Japanese workers (3876 men and 944 women) aged 35–65 years was followed up from 2007 to March 2022 for CVD incidence. Fatigue and nonspecific physical complaints were evaluated using the 57-item Brief Job Stress Questionnaire, and each was categorized into two groups based on the presence or absence. Hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) for stress responses to CVD were estimated using a multivariable Cox proportional hazard model adjusted for age, sex, smoking status, alcohol consumption, regular exercise, sleep duration, working hours, body mass index, systolic blood pressure, total cholesterol, and histories of hypertension, hyperlipidemia, and diabetes, night shift and job type. Results: During the median follow-up of 13.7 years, 116 patients with CVD were identified. The presence of fatigue was independently associated with CVD incidence (HR: 2.28, 95% CI: 1.05–4.94). Similarly, the presence of nonspecific physical complaints was significantly associated with CVD incidence (HR: 2.54, 95% CI: 1.43–4.52). The sex-stratified analysis showed consistent results in men but not in women. Conclusions: These findings suggest that fatigue and nonspecific physical complaints may serve as early indicators of CVD risk among middle-aged Japanese male workers. Incorporating routine assessment of these stress responses into workplace health screening could facilitate targeted prevention strategies.

DOI： 10.1007/s00420-025-02189-w

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PubMed

記述言語：英語   出版者・発行元：Nagoya Journal of Medical Science  

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

DOI： 10.18999/nagjms.87.2.220

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記述言語：日本語   出版者・発行元：東海公衆衛生学会  

<p><b>目的</b>　中部地方の自治体職員を対象に，朝食欠食と5年後の抑うつ状態発症との関連を，愛知職域コホート研究のデータを用いて検討することを目的とした。</p><p><b>方法</b>　愛知職域コホート研究の2013年のベースライン調査に参加した20-54歳の対象者のうちベースライン時に抑うつがない,あるいはうつ病の治療中ではない者のうち2018年調査にも参加した2004人 (男性1452人,女性552人)を研究対象とした。抑うつ状態の評価はCenter for Epidemiologic Studies Depression Scale日本語短縮 (11項目)を使用し，8点以上を抑うつとみなした。朝食欠食は朝食摂取頻度が週6回以下と定義した。さらに，5年間の朝食欠食の変化を「非欠食 (2013年)→非欠食 (2018年)」，「欠食→非欠食」，「非欠食→欠食」，「欠食→欠食」の4パターンに分けた分析も実施した。多変量ロジスティック回帰分析を用いて，性 (男性，女性[閉経前]，女性[閉経後])，年齢，学歴，配偶者・14歳未満の子供の同居の有無，肥満 (BMI≧25 kg/m²），喫煙状況，運動頻度，アルコール摂取量，睡眠時間，ストレス，ファミリー・ワーク・コンフリクト，ワーク・ファミリー・コンフリクトを調整し，2018年の抑うつ発症のオッズ比 (OR)と95%信頼区間 (CI)を推定した。</p><p><b>結果</b>　2018年に新たに抑うつ状態となったのは261人 (13%)であった。朝食欠食と抑うつ発症には調整要因に独立した統計学的に有意な正の関連が認められた (OR: 1.39，95%CI: 1.01-1.90)。朝食欠食の変化パターン別の分析でも「非欠食→非欠食」群に比べて「欠食→欠食」群は抑うつ発症と有意な正の関連を示した (OR: 1.53，95%CI: 1.06-2.21)。</p><p><b>結論</b>　朝食欠食と抑うつ発症には調整要因に独立した正の関連が認められた。</p>

DOI： 10.24802/tpha.2024-07

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CiNii Research

記述言語：日本語   出版者・発行元：一般社団法人 日本循環器病予防学会  

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

DOI： 10.11381/jjcdp.60.1_64

CiNii Research

記述言語：英語   出版者・発行元：一般社団法人日本衛生学会  

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

DOI： 10.1265/ehpm.25-00284

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CiNii Research

記述言語：英語   出版者・発行元：日本疫学会  

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

DOI： 10.2188/jea.je20230184

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CiNii Research

記述言語：英語   出版者・発行元：Geriatrics and Gerontology International  

Aim: Several studies have shown that dairy consumption in old age is effective in preventing frailty. However, there is a lack of evidence regarding the association between milk consumption during middle age and the development of frailty in old age. Therefore, we carried out an investigation to explore the association between milk consumption during middle age and development of frailty examined after over 15 years of follow up in a long-term cohort study in Japan. Methods: We studied 265 participants aged 60–79 years (212 men and 53 women) in 2018, who participated in both the baseline survey in 2002 and the frailty assessment in 2018. The amount of milk consumption (g/day) at baseline was age- and energy-adjusted, and classified into three categories (no, low and high consumption: 0 g/day, ≤135.86 g/day, >135.86 g/day in men and 0 g/day, ≤126.44 g/day, >126.44 g/day in women). Odds ratios (OR) and 95% confidence intervals (CI) for prefrailty/frailty after adjusting for lifestyles at baseline, stratified by sex, were estimated using logistic regression analysis. Results: The prevalence of prefrailty/frailty in 2018 was 37.7% and 28.3% in men and women, respectively. Milk consumption categories were inversely associated with the prevalence of prefrailty/frailty in men (OR 0.34, 95% CI 0.14–0.84 in low consumption; OR 0.31, 95% CI 0.10–0.95 in high consumption; P < 0.05), but not in women (OR 0.53, 95% CI 0.11–2.65; P = 0.44). Conclusions: In this study, milk intake in middle-aged men was inversely associated with the prevalence of prefrailty/frailty later in life. Geriatr Gerontol Int 2024; 24: 700–705.

DOI： 10.1111/ggi.14916

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記述言語：英語   出版者・発行元：Obesity Research and Clinical Practice  

Background: The association between obesity and cardiovascular disease (CVD) remains unclear, particularly for those with established CVD risk factors. We analyzed follow-up data from the Aichi Workers’ Cohort Study. We studied the association between the degree of obesity and risk of CVD and its subtypes specifically among individuals with hypertension, hyper-low-density lipoprotein (LDL)-cholesterolemia, or diabetes. Methods: Pooled data of 8972 adults (7076 men and 1896 women) who were recruited between 2002 and 2008 were used in the current analysis. We used multivariable Cox proportional hazard model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between the degree of obesity assessed with body mass index (BMI) and the risk of CVD and its subtypes, i.e., coronary heart disease (CHD) and stroke. Results: During a median of 12 years, there were 197 CVDs (80 CHDs and 117 strokes). BMI ≥ 27.5 compared to 21.0–22.9 kg/m² was positively and significantly associated with the risks of CVD, CHD, and total stroke. Hypertension, hyper-LDL-cholesterolemia, and diabetes mediated 15.9%, 5.8%, and 8.7% of obesity-CVD associations, respectively, and 28.3% by their combination. In the stratified analyses by the presence of risk factors, BMI ≥ 25.0 (overweight/obesity) compared to BMI < 25 kg/m² was associated with a higher risk of CVD in those with and without hypertension, but only with hyper-LDL-cholesterolemia, and without diabetes. Conclusions: Overweight/obesity was associated with the risk of CVD and its subtypes. About 30% of the risk was explained by hypertension, hyper-LDL-cholesterolemia, and diabetes, of which hypertension accounted for approximately the half of the explained risk. However, overweight/obesity increased the risk of CVD even in those without hypertension. These findings highlight the importance of controlling and preventing overweight/obesity regardless of chronic disease status.

DOI： 10.1016/j.orcp.2024.02.006

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記述言語：英語   出版者・発行元：Heliyon  

Objective: This study examined the longitudinal association of perceived stress, ikigai, and having someone one can count on in middle age with the advanced-level functional competency in older age, which is crucial for the maintenance of independent life among older adults. The issue is especially relevant in super-aged countries like contemporary Japan, where more and more older people live in a household consisting only of older people. Methods: Data were collected in 2019 from a total of 1692 retirees of the Aichi Workers’ Cohort Study participants in which baseline survey including psychological factors was conducted during their employment in 2002. Japan Science and Technology Agency Index of Competence (JST-IC) was used to measure the advanced-level functional competency. Multivariable-adjusted odds ratios (ORs) were obtained for having low JST-IC in later life by the degrees of psychological factors reported in the middle age adjusting for the presence of depressive mood in 2019. Results: Those who were not sure about ikigai (OR: 2.02, 95 % CI: 1.33 to 3.08) and who have no one to count on (OR: 2.19, 95 % CI: 1.52 to 3.16) in the middle age were significantly associated with low JST-IC after retirement. Having much stress was significantly inversely associated with a low JST-IC (OR: 0.69, 95 % CI: 0.50 to 0.97). Conclusion: Having ikigai and someone reliable, and stress during middle age might play a role in preventing impaired advanced-level functional competency. Improved ikigai and increased social interaction and support might improve functional competency. Further research might explore avenues for improving ikigai.

DOI： 10.1016/j.heliyon.2023.e21931

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記述言語：英語   出版者・発行元：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

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記述言語：英語   出版者・発行元：一般社団法人 日本動脈硬化学会  

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

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CiNii Research

記述言語：英語   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

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記述言語：英語   会議種別：口頭発表（一般）  

記述言語：英語