Journal of Epidemiology | Japan Epidemiological Association

Journal of Epidemiology

Volume 28, Issue 8 (August 2018)

1) Socioeconomic Inequalities in Oral Health Among Unmarried and Married Women: Evidence From a Population-Based Study in Japan
● Lower education was associated with poor oral health only among unmarried women.
● Husbands’ education was not associated with oral health among married women.
● Lower income was associated with poor oral health particularly among housewives.

2) A Point System for Predicting 10-Year Risk of Developing Type 2 Diabetes Mellitus in Japanese Men: Aichi Workers’ Cohort Study
● The evidence of long-term diabetes risk prediction model is scarce among East Asian.
● We developed a point system to predict 10-year risk of diabetes among Japanese men.
● The point system present study derived might be useful to identify those at high risk.

3) Genome Database of the Latvian Population (LGDB): Design, Goals, and Primary Results
● The Genome Database of the Latvian Population is an open research platform.
● National biobank in small country is essential to epidemiological research.
● Biobank can significantly contribute to genetic testing and health care improvement.
● It is crucial for biobank to plan and foresee biosample demand in research.
● Financial support of biobank can be national funding, study or industrial research.

4) The Association Between Metabolically Healthy Obesity and the Risk of Proteinuria: The Kansai Healthcare Study
● We examined whether metabolically healthy obese phenotype related to proteinuria.
● Metabolically healthy obese phenotype did not increase the risk of proteinuria.
● Metabolically unhealthy phenotypes increased its risk regardless of obesity.

5) Association of Adiponectin With Cancer and All-Cause Mortality in a Japanese Community-Dwelling Elderly Cohort: A Case-Cohort Study
● The association between adiponectin and cancer/all-cause mortality were examined.
● The study was conducted in an elderly, community-dwelling cohort (n=697).
● We found positive but nonlinear association between cancer deaths and plasma APN.
● This nonlinear relationship implies a complex mechanism that warrants more study.

Volume 28, Issue 7 (July 2018)

1) Living Alone or With Others and Depressive Symptoms, and Effect Modification by Residential Social Cohesion Among Older Adults in Japan: The JAGES Longitudinal Study
● Older adults living alone are at risk of deteriorate mental health.
● Little longitudinal evidence on the impact of living arrangements on mental health.
● Few studies examining the modifying effect of social cohesion on this association.
● Living arrangements affected the risk of depressive symptoms among older adults.
● Gender and neighborhood social cohesion level affected the identified association.

2) Breast Cancer Incidence Trends and Projections in Northeastern Thailand
● By using regional cancer registry data in Khon Kaen, Thailand, age standardized rates (ASRs) of female breast cancer incidence increased between 1995-2012.
● Women at age 50 or above had the largest increase in incidence of breast cancer.
● Increasing trends of breast cancer incidence in Khon Kaen are lower than those in other regions in Thailand, but it is expected to rise significantly by 2030.

3) Sex Differences in Birth Weight and Physical Activity in Japanese Schoolchildren
● Lower birth weight is associated with increased chronic disease risk later in life.
● Physical activity in childhood may partly explain this association.
● We examined birth weight and physical activity in Japanese school-aged children.
● Girls with low birth weight were less likely to be physically active, but not boys.

4) Short Communication
Sleep Duration Modifies the Association of Overtime Work With Risk of Developing Type 2 Diabetes: Japan Epidemiology Collaboration on Occupational Health Study
● The effect of long work hours and sleep deprivation on diabetes risk is unknown.
● Overtime work was not materially associated with risk of diabetes.
● But overtime with insufficient sleep was associated with a higher diabetes risk.

Volume 28, Issue 6 (June 2018)

1) The Gradual Shift of Overweight, Obesity and Abdominal Obesity towards the Poor in a Multi-ethnic Developing Country: Findings from the Malaysian National Health and Morbidity Surveys
● Overweight/obesity among women are becoming concentrated among the poor.
● Obesity distributions among women in Peninsular Malaysia are pro-rich.
● Chinese women had the lowest rates and lowest increase in obesity.
● Obesity distributions among men in Peninsular Malaysia became less pro-poor.
● The distributions in Peninsular Malaysia are more pro-rich compared to East Malaysia.

2) Yellow tongue coating is associated with diabetes mellitus among Japanese non-smoking men and women: The Toon Health Study
● Yellow tongue coating is a clinical sign of diabetes in traditional medicine.
● Yellow tongue coating was associated with the prevalence of diabetes mellitus.
● Yellow tongue coating tended to be associated with the prevalence of prediabetes.

3) Weight Status, Physical Activity, and Depression in Korean Older Adults
● Obesity and inactivity carry the increased risk of cardiovascular diseases.
● The risk of inactive individuals for depression is independent of weight status.
● Association between obesity and depression is affected by modifiable risk factors.

4) An 18-year follow-up survey of dioxin levels in human milk in Japan
● Dioxin levels in human milk tended to decline over time from 1998 to 2015.
● Data from the last 5 years indicated a plateau at minimal levels.
● An increasing trend was found in the mean age of participants in the last 5 years.
● Significantly higher dioxin levels were found in samples from older participants.
● Human exposure to dioxins may be approaching a minimum in recent years in Japan.

5) Comprehensive assessment of risk factors of cause-specific infant deaths in Japan
● Both biological and social risk factors increase risk of infant death by injuries.
● Both factors also increase risk of infant death by internal (medical) causes.
● For effective prevention, an approach covering families with either risk is needed.

Volume 28, Issue 5 (May 2018)

1) Review Article
A Literature Review of Mathematical Models of Hepatitis B Virus Transmission Applied to Immunization Strategies From 1994 to 2015
● Transmission dynamics models simulating hepatitis B prevalence have shortcomings.
● Common models have some disadvantages in accurate data acquisition.
● Age-structure models should be fully considered.
● Age- and time-dependent forces of HBV infection should be fully considered.

2) Importance of Achieving a “Fit” Cardiorespiratory Fitness Level for Several Years on the Incidence of Type 2 Diabetes Mellitus: A Japanese Cohort Study
● Achieving Japanese guideline fitness level is related with a lower risk of diabetes.
● Achieving the fitness level is better than having temporarily higher levels.
● The recommended fitness levels appear to be reasonable for prevention of diabetes.

3) Impact of the Great East Japan Earthquake on Body Mass Index, Weight, and Height of Infants and Toddlers: An Infant Survey
● The Great East Japan Earthquake may have affected the growth of young children.
● We compared the change in growth indices between affected and unaffected children.
● Results revealed an increase in BMI towards 42 months in the children in Fukushima.
● Analysis indicates growth disturbances in a subset of children in Fukushima.
● Pediatricians should carefully follow these children with future risk of obesity.

4) Body-Mass Index and Pancreatic Cancer Incidence: A Pooled Analysis of Nine Population-Based Cohort Studies With More Than 340,000 Japanese Subjects
● We conducted a pooled analysis of BMI and pancreatic cancer with >340,000 subjects.
● We found possible association of BMI and pancreatic cancer in an Asian population.
● Obesity was associated with a higher risk of pancreatic cancer among men.
● J-shaped association of BMI at age 20 with pancreatic cancer was observed among men.

5) Epicardial Fat Thickness and Bone Mineral Content: The Healthy Twin Study in Korea
● General adiposity has an osteotropic effect.
● Our findings do not support epicardial fat’s beneficial effects on bone health.
● The observed association between EFT and BMC might suggest a genetic correlation.

6) Patterns and Levels of Sedentary Behavior and Physical Activity in a General Japanese Population: The Hisayama Study
● Japanese adults spent much of their day being sedentary (7–8 hours/day).
● Over one-third of the sedentary time was accumulated in prolonged bouts ≥30 min.
● Japanese adults engaged in very low levels of sustained bouts of physical activity.
● The majority (65.2%) of the population did not meet physical activity guidelines.
● Interventions for sedentary and physical activity are needed at the population level.

7) Long-term Impact of Cardiorespiratory Fitness on Type 2 Diabetes Incidence: A Cohort Study of Japanese Men
● Japanese male workers (n=7,804) were followed for a maximum of 23 years.
● Fitness level influenced diabetes incidence over 20 years.
● This relation did not weaken regardless of the length of follow-up period.

Volume 28, Issue 4 (April 2018)

1) Special Article
Japanese Legacy Cohorts: The Life Span Study Atomic Bomb Survivor Cohort and Survivors’ Offspring
● The Life Span Study is a unique and large-scale cohort study of the lifetime health outcomes of the atomic bomb survivors.
● The Life Span Stud has confirmed increased risks of malignancies and investigated other late health effects due to atomic bomb radiatio.n
● Survivors exposed to radiation in their mothers’ womb experienced late health effects similar to those of survivors exposed at young ages.
● No increased risks of cancer or noncancer outcomes have been observed to date among the cohort of children conceived after their parents’ exposures to radiation.
● The results of these cohort studies have been used by the Japanese government for the health administration and welfare of the survivors and their children.
● Life Span Study results are the most reliable source of quantifiable risk estimates for radiation exposure and are used around the world.

2) Review Article
Tobacco Control Measures to Reduce Socioeconomic Inequality in Smoking: The Necessity, Time-Course Perspective, and Future Implications
● Impact of tobacco control measures on smoking inequality has been investigated.
● A previous review found that tobacco taxation reduced smoking inequality by income.
● To reduce smoking inequality, the inverse equity hypothesis may be a key hypothesis.
● All measures may reduce smoking inequality, if they are continued long-term.
● Tackling socioeconomic inequality in smoking may be a key public health target.

3) Prevalence of Dizziness and Associated Factors in South Korea: A Cross-Sectional Survey From 2010 to 2012
● The 1-year prevalence of dizziness in the general population was 20.10%.
● Dizziness was more prevalent in women and in older-age participants.
● Dizziness was related with serum TG level and limited physical performance.
● Dizziness was related with smoking, alcohol, depression, and perception of stress.
● Interventions for dizziness should be approached in a multifactorial manner.

4) Modification of the Associations of Alcohol Intake With Serum Low-Density Lipoprotein Cholesterol and Triglycerides by ALDH2 and ADH1B Polymorphisms in Japanese Men
● We investigated the association between alcohol intake and serum lipid profile.
● We examined effect modifications caused by ADH1B and ALDH2 polymorphisms.
● Furthermore, we also examined if the findings for ALDH2 could be replicated.
● Serum LDL cholesterol decreased with increasing alcohol intake.
● ALDH2 modified the association between alcohol intake and serum LDL cholesterol.

5) Nutrient-Derived Dietary Patterns and Their Association With Metabolic Syndrome in a Japanese Population
● Reduced rank regression was used to extract dietary patterns.
● The first dietary pattern was related to lower prevalence of metabolic syndrome.
● Dietary pattern 1 was inversely related to blood pressure and blood glucose level.

6) Prevalence and Risk Factors of Internet Addiction Among Employed Adults in Japan
● Around 5% of employed adults are at risk for developing addiction to the Internet.
● Use of Internet for game playing is related to at-risk internet addiction.
● Employed adults need to be instructed to use the Internet properly.

7) Coffee Consumption and Lung Cancer Risk: The Japan Public Health Center-Based Prospective Study
● Coffee consumption was not associated with lung cancer risk in our study.
● Elevated risk for small cell carcinoma was observed in multivariate models.
● Increased lung cancer risk among heavy smokers suggests residual confounding.
● Further evidence is needed on lung cancer subtypes and detailed tobacco exposure.

8) Short Communication
Increased Incidence of Visual Field Abnormalities as Determined by Frequency Doubling Technology Perimetry in High Computer Users Among Japanese Workers: A Retrospective Cohort Study
● This is the first study to investigate workers using a periodical perimetric test.
● The incidence of perimetric abnormalities was increased among high computer users.
● This association was particularly seen among workers with refractive errors.

Volume 28, Supplement 3 (March 2018)

1) The National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010 (NIPPON DATA2010): Objectives, Design, and Population Characteristics
● A nationwide prospective cohort study for cardiovascular diseases was established.
● The study assessed physical measurements, lifestyle, diet, and socioeconomic factors.
● Outcome measures were the incidence of heart disease, stroke, and diabetes mellitus. Activities of daily life (ADL) and instrumental ADL were also surveyed as outcomes.

2) Relationship Between Socioeconomic Status and the Prevalence of Underweight, Overweight or Obesity in a General Japanese Population: NIPPON DATA2010
● In adult women, a low education level was related to being overweight or obese.
● In adult women, a low household income was related to being overweight or obese.
● In adult men, a lower education level was inversely associated with obesity.
● Gender and age differences in SESs affect the prevalence of obesity.

3) Macronutrient Intake and Socioeconomic Status: NIPPON DATA2010
● Household income was inversely associated with carbohydrate intake.
● Household income was positively associated with fat intake.
● The risk of a high carbohydrate/low fat intake was associated with an older age.
● Both lower household income and lower household expenditure were associated with the risk of a high carbohydrate/low fat diet.

4) Relationships among Food Group Intakes, Household Expenditure, and Education Attainment in a General Japanese Population: NIPPON DATA2010
● Lower expenditure was associated with a higher cereal intake in both sexes.
● Lower expenditure was associated with a lower milk intake in men.
● Lower expenditure was associated with a lower vegetable intake in women.
● Lower education was associated with a higher cereal intake in both sexes.
● Lower education was associated with a lower meat intake in both sexes.

5) Socioeconomic Status Associated With Urinary Sodium and Potassium Excretion in Japan: NIPPON DATA2010
● We investigated associations between SES factors and Na and K intakes in Japan.
● Participants in the National Health and Nutrition Survey in Japan were enrolled.
● Amount of sodium and potassium intake were assessed by casual urine Na/K ratio and estimation of excretion in 24-hour urinary Na and K using casual urine.
● SES factors included economic status, educational attainment, and job category.
● Lower SES was associated with a lower K intake and higher Na/K ratio.

6) Differences in Lifestyle Improvements With the Intention to Prevent Cardiovascular Diseases by Socioeconomic Status in a Representative Japanese Population: NIPPON DATA2010
● A high or middle education level was associated with lifestyle improvements.
● Lifestyle improvements were less common among divorced men and women.
● Participants with CVD risk factors practiced lifestyle improvements.
● These associations were independent of other factors.

7) Passive Smoking at Home by Socioeconomic Factors in a Japanese Population: NIPPON DATA2010
● Relationships among socioeconomic factors and passive smoking at home were evaluated.
● Employed status and lower education were associated with passive smoking at home.
● Smoke-free policies should target socioeconomically disadvantaged groups.

8) Socioeconomic Status and Knowledge of Cardiovascular Risk Factors: NIPPON DATA2010
● Relationship between SES and knowledge on CV risk factors was analyzed in NIPPON DATA2010.
● A short education was related to insufficient knowledge on CV risk factors.
● A low equivalent household expenditure was also related to insufficient knowledge.

9) Factors Related to Participation in Health Examinations for Japanese National Health Insurance: NIPPON DATA2010
● Socioeconomic factors are relevant for participation in health examinations.
● Relationships were observed in those aged 65-74 years.
● Participation rates were high for “high educational attainment” and house owners.
● Participation rates were low for “high equivalent household expenditure.”

10) Socioeconomic Inequalities in Oral Health among Middle-Aged and Elderly Japanese: NIPPON DATA2010
● Lower educational attainment was associated with poor oral health in Japan.
● Lower equivalent expenditure was associated with poor oral health in Japan.
● Behavioral and biological factors do not fully explain oral health inequalities.
● An association with expenditure was found among elderly, not middle-aged adults.

11) Relationships among Socioeconomic Factors and Self-rated Health in Japanese Adults: NIPPON DATA2010
● High educational attainment was associated with fine SRH in Japanese adults.
● The relationship between martial and living statuses and SRH was inconsistent.
● Working status was not associated with SRH after age adjustments.
● Strong relationships exist among household income, expenditure, and SRH in women.

Volume 28, Issue 3 (March 2018)

Alcohol Consumption and Risk of Type 2 Diabetes in East Asian Populations: Do Healthy Patterns of Consumption Exist?
● Binge drinking was associated with a greater likelihood of having newly diagnosed type 2 diabetes in adult Koreans, even in those with low average daily consumption.
● Regular consumption of moderate amounts of alcohol consumption was associated with a lower prevalence of type 2 diabetes in women, but not in men. This sex difference is consistent with results from previous studies.
● The adverse health consequences of alcohol consumption on cancer and other health outcomes have led to lowering the recommended upper level of alcohol consumption in several western countries. In East Asian populations, high alcohol consumption may be of even greater public health concern because a large proportion of the population is genetically predisposed to slower metabolism of alcohol and its carcinogenic metabolite acetaldehyde.
● The high prevalence of binge drinking and likelihood of adverse health effects of this behavior suggest that public health policies addressing binge drinking are warranted.
1) Community Social Capital, Built Environment, and Income-Based Inequality in Depressive Symptoms Among Older People in Japan: An Ecological Study From the JAGES Project
● Better community social capital was associated with small depression disparity in men.
● %unemployment and income gap were positively associated with depression inequality.
● Those factors potentially reducing health disparities should be studied further.

2) Association of Alcohol Drinking Patterns With Presence of Impaired Fasting Glucose and Diabetes Mellitus Among South Korean Adults
● The pattern of alcohol consumption is associated with the presence of IFG and DM.
● Frequency of high-risk drinking is associated with higher risk of IFG/ DM in men.
● Frequency of high-risk drinking is associated with higher risk of IFG in women.
● Frequent non-high-risk drinking is associated with higher risk of DM in men.
● Frequent non-high-risk drinking is associated with lower risk of DM in women.

3) Prevalence and Risk of Birth Defects Observed in a Prospective Cohort Study: The Hokkaido Study on Environment and Children’s Health
● We reported the prevalence of birth defects after 12 weeks of gestation.
● Prevalence of all birth defects was 18.9/1000 births.
● Of all birth defect, 9.4% was delivered between 12 and 21 weeks of gestation.
● Of nervous system malformation patients, 39% were delivered <22 weeks of gestation.

4) Social Inequalities in Secondhand Smoke Among Japanese Non-smokers: A Cross-Sectional Study
● Social gradients in secondhand smoke (SHS) among Japanese non-smokers were found.
● Knowledge of tobacco seemed to reduce SHS at home but not at the workplace/school.
● Proportionate universalism approach is needed to reduce social inequalities in SHS.

5) Impact of Alcohol Intake and Drinking Patterns on Mortality From All Causes and Major Causes of Death in a Japanese Population
● We examined the association of alcohol consumption with mortality risk.
● J-shaped associations were found between alcohol intake and total mortality.
● Mortality risk linearly increases in current drinkers as they drink more.
● Liver holidays was associated with a lower risk of cancer/cerebrovascular mortality.
● Necessity of drinking in moderation coupled with liver holidays are highlighted.

6) Validity and Reliability of Japanese-Language Self-reported Measures for Assessing Adults Domain-Specific Sedentary Time
● We assessed validity and reliability of domain-specific sedentary behavior scale.
● This scale shows acceptable validity and reliability.
● It can estimate what purpose Japanese adults spend their sedentary time.

7) Motivating Mothers to Recommend Their 20-Year-Old Daughters Receive Cervical Cancer Screening: A Randomized Study
● Cervical cancer screening in Japan is dangerously low among women most at risk.
● Effects of interventions with 20-year-old girls not yet screened were studied.
● A modified screening invitation targeting the mother best increased participation.

Volume 28, Issue 2 (February 2018)

1) Review Article
Critical Points for Interpreting Patients’ Survival Rate Using Cancer Registries: A Literature Review

● Several factors should be considered for interpreting survival rate.
● The quality of registry data should be assessed.
● Estimating method should be chosen after assessing magnitude of the biases.
● Age-adjustment is needed to compare survival among different groups.
● Multiple tumors should be included in survival estimates.

2) Epidemiology of Out-of-Hospital Cardiac Arrest Due to Suffocation Focusing on Suffocation Due to Japanese Rice Cake: A Population-Based Observational Study From the Utstein Osaka Project
● About 10% of OHCAs due to suffocation were caused by rice cake in Japan
● OHCAs due to rice cake mainly occurred during the first 3 days of the New Year
● Earlier recognition of choking and quicker calls to the EMS improved outcomes

3) Improvement in 5-Year Relative Survival in Cancer of the Corpus Uteri From 1993–2000 to 2001–2006 in Japan
● The survival in cancer of the corpus uteri improved in the early 2000s in Japan.
● Short-term survival improved in other specified adenocarcinoma and carcinosarcoma.
● The spread of concomitant therapy with taxane and platinum might have contributed.

4) Trend of Prevalence of Atrial Fibrillation and use of Oral Anticoagulation Therapy in Patients With Atrial Fibrillation in South Korea (2002–2013)
● The prevalence of AF in South Korea increased during 2002–2013.
● The prevalence of AF increased in men aged ≥30 years and in women aged ≥60 years.
● It might be attributable to both the aging society and change of AF comorbidities.
● The rate of warfarin therapy remains low.

5) Work Sustainability Among Male Cancer Survivors After Returning to Work
● Work continuance rates among cancer survivors were 80.1% one year after RTW, 48.5% five years after RTW, among cancer survivors.
● There was a steep decrease in work continuance rates during the first year after RTW, among cancer survivors.
● The work continuance rates after RTW varied significantly by cancer type.

6) Short Communication
Intensity of Leisure-Time Exercise and Risk of Depressive Symptoms Among Japanese Workers: A Cohort Study
● We examined the association of physical activity intensity with risk of depression.
● Vigorous but not moderate exercise showed a lower risk of depressive symptoms.
● Vigorous-intensity exercise may help reduce risk of depressive symptoms.

7) Study Profile
Baseline Profile of Participants in the Japan Environment and Children’s Study (JECS)
● The Japan Environment and Children’s Study is a nationwide birth cohort study.
● We recruited approximately 100,000 mother-child pairs, and fathers (if accessible).
● The baseline profiles of mothers, children, and fathers were summarized.
● We consider this cohort can be regarded as national representative population.

Volume 28, Issue 1 (January 2018)

1) Review Article
Quantitative Relationship Between Cumulative Risk Alleles Based on Genome-Wide Association Studies and Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis
This meta-analysis assessed the genetic risk of type 2 diabetes mellitus (T2DM).
● The estimated odds ratio (OR) for T2DM morbidity for +1 risk allele (RA) was 1.16.
● The estimated OR for incident T2DM for +1 RA was 1.10.
● This value was found to be modest, corresponding to 0.58 kg/m2 of body mass index.

2) Adipokines are Associated With Hypertension in Metabolically Healthy Obese (MHO) Children and Adolescents: A Prospective Population-Based Cohort Study
● Leptin/adiponectin ratio might be a discriminator between MHO and MUO phenotypes.
● Abnormal adipokines increased hypertension risk in MHO children and adolescents.
● Be cautious with the term “metabolically healthy” in future research.

3) Patterns of Ultraviolet Radiation Exposure and Skin Cancer Risk: the E3N-SunExp Study
● Melanoma, BCC, and SCC are associated with different UV exposure profiles in women.
● Melanoma risk was strongly associated with number of sunburns before 25 years.
● BCC risk was more strongly associated with recreational UV exposures.
● SCC risk was mostly associated with total and residential UV exposures.

4) Gastroduodenal Ulcers and ABO Blood Group: the Japan Nurses’ Health Study (JNHS)
● Older women with blood type O have an increased susceptibility to GDU.
● GDU incidence was associated with blood type O and H. pylori infection.
● JNHS participants report their blood type with a high degree of accuracy.

5) Effectiveness of a Self-monitoring Device for Urinary Sodium-to-Potassium Ratio on Dietary Improvement in Free-Living Adults: a Randomized Controlled Trial
● A new device is available for self-monitoring urinary Na/K ratio.
● Our trial comparted urinary Na/K ratio between users of the device and non-users.
● Those who used the device were likely to have larger reduction in urinary Na/K ratio.
● With an education for improving dietary habit, there may be a much larger reduction.

6) Association Between Passive Smoking and the Risk of Cervical Intraepithelial Neoplasia 1 in Korean Women
● Among nonsmokers, passive smoking increased CIN1 risk.
● CIN1 risk increases with longer time exposed to passive smoking.
● Interaction between passive smoking and HPV infection on CIN1 risk was absent.

7) Efficacy of Antimicrobial Catheters for Prevention of Catheter-Associated Urinary Tract Infection in Acute Cerebral Infarction
● Antimicrobial catheter use rate was 43% in Acute Cerebral Infarction patients.
● Using antimicrobial catheter was not associated with Urinary Tract Infections (UTIs).
● Antimicrobial catheter reduced UTIs in diabetics who were treated with insulin.