Journal of Epidemiology

キービジュアル

Highlights

 

Volume 30, Issue 1-12 (2020)

Issue 12 (December 2020)
Issue 11 (November 2020)
Issue 10 (October 2020)
Issue 9 (September 2020)
Issue 8 (August 2020)
Issue 7 (July 2020)
Issue 6 (June 2020)
Issue 5 (May 2020)
Issue 4 (April 2020)
Issue 3 (March 2020)
Issue 2 (February 2020)
Issue 1 (January 2020)

Volume 30, Issue 12 (December 2020)

Comparison of Intentional and Unintentional Injuries Among Chinese Children and Adolescents
 
  • This work comprehensively described patterns of intentional injuries in China where little information published before.
  • Blunt injuries accounted for 59% of violent attacks. Cuts and poisoning accounted for 37% and 23% involving self-mutilation/ suicide. Falls (50%) ranked first among unintentional injuries.
  • Six additional risk factors associated with gender, region, age, time of injuries occur, occupation and injury place with intentional injuries identified.
  • Mechanism and occurrence time of intentional and unintentional injuries were different according to different age groups.
Did the Expansion of Insurance Coverage for Oral Health Reduce Self-reported Oral Health Inequalities in Korea? Results of Repeated Cross-Sectional Analysis, 2007-2015
 
  • We examine whether improved access resulted in a reduction in income-based self-reported oral health inequalities.
  • We analyzed repeated cross-sectional data from the Korea National Health and Nutrition Examination Surveys (2007–2015).
  • Average self-reported oral health status of children and adolescents improved the most over the observation period.
  • The absolute of self-reported oral health inequalities improved for most groups.
  • By contrast, the relative inequalities remained resistant to change.
Influence of the Fukushima Daiichi Nuclear Power Plant Accident on the Use of Computed Tomography in Children With Mild Head Injuries
 
  • This is the first study that the Fukushima Daiichi Nuclear Power Plant accident significantly reduced the use of CT, using individual-level data.
  • The use of CT in children with mild head injuries significantly declined after the Fukushima Daiichi Nuclear Power Plant accident.
  • Concerns about radiation exposure and radiation-induced cancer can reduce unnecessary CT.
Heated Tobacco Product Smokers in Japan Identified by a Population-Based Survey
 
  • No population-based studies on heated tobacco product (HTP) prevalence have been reported yet.
  • We conducted a national population-based survey to estimate the number of HTP smokers.
  • As of February 2018, estimated HTP use was 8.3% for men and 1.9% for women in Japan.
Longitudinal Associations of Toothbrushing With Obesity and Hyperglycemia
 
  • This study investigated the longitudinal association between toothbrushing and various metabolic abnormalities.
  • Toothbrushing habits were associated with development of obesity and hyperglycemia.
  • This study extends the findings of prior studies by specifying the association between the time of day of toothbrushing and the development of comprehensive metabolic abnormalities considering oral health condition.
Association Between Second-hand Smoke Exposure and Depressive Symptoms Among Japanese Adults: A Cross-sectional Study
 
  • We examined the association between exposure to second-hand smoke and depressive symptoms among adults from the general Japanese population.
  • Second-hand smoking was associated with a higher risk of depressive symptoms. This association was significant among a sample of non-smoking.
  • Our findings highlighted the importance of tobacco control measures to protect mental health.

Volume 30, Issue 11 (November 2020)

Explaining Within- vs Between-Population Variation in Child Anthropometry and Hemoglobin Measures in India: A Multilevel Analysis of the National Family Health Survey 2015–2016
 
  • Poor nutritional status in early childhood remains highly prevalent in low- and middle- income, including India.
  • The dominant epidemiologic approach focusing on the comparison of mean values of health outcomes and exposures between populations may be undermining efforts to improve child nutrition given that the determinants of population averages may be fundamentally different from the determinants of individual cases.
  • The observed differences in between- and within-population variability in child anthropometry and hemoglobin level, and the differing ability of a comprehensive set of proximate and distal covariates, to explain these differences necessitate more targeted policy and practice interventions.
  • Given the persistently high burden of child undernutrition in India, inferential target should be more explicitly and clearly defined while efforts to improve mean measures and underlying variability should occur in tandem, not separately.
Gender Difference in the Association Between Subjective Socioeconomic Mobility Across Life Course and Mortality at Older Ages: Results From the JAGES Longitudinal Study
 
  • This is the first study to elucidate whether there are gender differences in the association between life-course subjective socioeconomic status (SSS) mobility and mortality at older ages.
  • Downward subjective socioeconomic mobility was related to higher mortality among men, but not women.
  • Upward socioeconomic mobility was associated with lower mortality among women, but not in men.
Associations of Sedentary and Physically-Active Behaviors With Cognitive-Function Decline in Community-Dwelling Older Adults: Compositional Data Analysis From the NEIGE Study
 
  • We examined combined relationships of device-based activity behaviors with cognitive health among older Japanese adults.
  • The co-dependence of activity behaviors was taken into account.
  • Time spent in moderate-to-vigorous physical activity relative to the light-intensity physical activity and sedentary behavior linked cognition.
  • Relative proportions of sedentary behavior and light-intensity physical activity was not related to cognition.
  • The shift of time from any behavior toward any form of moderate-to-vigorous physical activity (bouted or sporadic) may be beneficial for cognition.
Relationships Between Reproductive History and Mortality From Cardiovascular Diseases Among Japanese Women: The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study
 
  • The number of deliveries showed a U-shaped association with risk of CVD mortality.
  • Higher maternal age at first delivery was associated with increased CVD mortality.
  • Excessive risk of CVD morality associated with maternal age at first delivery was noted in women with ≧ 3 deliveries.
Personal Characteristics Effects on Validation of Self-reported Type 2 Diabetes From a Cross-sectional Survey Among Chinese Adults
 
  • Findings of this survey among Chinese adults supported the self-reported type 2 diabetes is sufficiently valid to large-scale epidemiologic studies.
  • The results implied to have a better agreement for the participants of women, older, and having a family history of diabetes. But education and obesity status did not have effects on the agreement.
  • Using the diabetes medication or the FPG test as identified diabetes, it will provide good sensitivity, specificity, PPV, NPV and Kappa of self-reported type 2 diabetes.
  • Additional HbA1c test would decrease the sensitivity, NPV, and Kappa, but could find more potential diabetes cases if compared to only using the FPG test.
Changes in Psychological Distress during the COVID-19 Pandemic in Japan: a Longitudinal Study
 
  • This longitudinal study assessed changes in severe psychological distress (SPD).
  • The proportion of SPD increased from early to community-transmission phases in Japan.
  • Those with low income and those with respiratory diseases are at higher risk.

Volume 30, Issue 10 (October 2020)

Epidemiologic Features of Kawasaki Disease in Shanghai From 2013 Through 2017
 
  • This study was conducted in 50 hospitals in Shanghai, China, involving 4452 children with Kawasaki disease (KD).
  • The incidence of KD in Shanghai has substantially increased whereas the rate of coronary artery lesions (CAL) has substantially decreased.
  • The prevalence of coronary stenosis and thrombosis were described in detail for the first time.
  • Higher platelets, lower albumin, male sex, incomplete KD, IVIG resistance, and receiving initial IVIG ≤4 days or >10 days, were risk factors for CAL.
Student Loans and Psychological Distress: A Cross-sectional Study of Young Adults in Japan
 
  • This is a first study on the association of student loans with psychological distress in Japan.
  • Compared with graduates without student loans, ones with student loan debt of over 4 million yen had 1.44 times the possibility of having severe psychological distress.
  • On the other hand, there was no significant association among current university students.
Combined Effect of Marriage and Education on Mortality: A Cross-national Study of Older Japanese and Finnish Men and Women
 
  • Being unmarried at age 65 years or older is associated with a higher mortality risk among men but not among women in both Japan and Finland.
  • In Japan and Finland, older unmarried men with tertiary education have the highest risk for mortality.
  • Combined effect of marriage and education on mortality may vary according to the socioeconomic health inequality within countries.
Municipality-Level Checklist to Promote Parental Behaviors Related to Prevention of Unintentional Injury in Young Children: A Multilevel Analysis of National Data
 
  • Because most injuries in children under two years old occur at home, parental behaviors is an important pathway to target for injury prevention.
  • The results of studies examining the effect of policy-level injury prevention strategies in young children are inconsistent.
  • Using rigorous survey and analytical approaches, we showed that a policy-level implementation aimed at providing information to parents through a safety checklist may promote certain child safety behaviors in parents with children around 1.5 years of age.

Diabetes and Mortality From Respiratory Diseases: The Japan Collaborative Cohort Study
 
  • We found a significant association between diabetes and total respiratory diseases mortality.
  • A significant association between diabetes and mortality from respiratory infection was observed.
  • We failed to detect a significant association between diabetes and COPD mortality.
  • The association between diabetes and total respiratory diseases mortality was stronger in never smokers compared with ever smokers.
  • Prevention of respiratory diseases should be addressed among diabetic patients.
Factors Associated With Family Member’s Spanking of 3.5-year-old Children in Japan
 
  • 62.8% and 7.9% of families sometimes and always spanked their children at 3.5 years of age in Japan.
  • Children in the second cohort, born in 2010, were spanked less frequently compared with those in the first cohort, born in 2001.
  • Presence of siblings was associated with the higher likelihood of spanking but a three-generation household was a protective factor.
  • Housewives and unstable work (part-time employment, self-employment, and domestic side jobs) were associated with the higher likelihood of spanking.
  • Father’s involvement in parenting may be protective against spanking.
Public Awareness, Individual Prevention Practice, and Psychological Effect at the Beginning of the COVID-19 Outbreak in China
 
  • This is the first study to assess public awareness, individual prevention practice and psychological effects at the beginning of the COVID-19 outbreak in China.
  • A high proportion of people knew about the transmission route and incubation period of the disease and practiced the hand hygiene behavior.
  • Quite a number of people developed anxiety especially in Hubei province.

Volume 30, Issue 9 (September 2020)

Commentary
Professional Commitment to Ethical Discussions Needed From Epidemiologists in the COVID-19 Pandemic
 
  • COVID-19 pandemic has risen various ethical challenges in public health.
  • We performed a database search of PubMed to identify articles with the constraints of “COVID-19”and “ethics.”
  • Among 424 articles identified, only one article was found to be published in an epidemiological journal.
  • We argue the epidemiologists should commit more to ethical discussions directly concerning epidemiology.
Special Article
Understanding Marginal Structural Models for Time-Varying Exposures: Pitfalls and Tips
 
  • Marginal structural models (MSMs) should be distinguished from inverse probability weighting.
  • MSM shows prespecified assumptions on causal estimands, while an exposure probability model is an imposed restriction on observed distribution.
  • As MSM and exposure probability model are used for different purposes, misspecification of these models would lead to biases in different ways.
  • Model specifications of MSMs and exposure probability models raise different challenges in real data analysis.
  • G-formula, which shares identifiability assumptions with inverse probability weighting, can be used to fit MSMs only when the models are saturated.
Psychosocial Work Environment Explains the Association of Job Dissatisfaction With Long-term Sickness Absence: A One-Year Prospect Study of Japanese Employees
 
  • We examined a prospective association of job dissatisfaction with long-term sickness absence obtained from personnel records using survival analysis.
  • Job dissatisfaction was associated with an increased risk of long-term sickness absence, which could be explained by psychosocial work environment.
  • Improving psychosocial work environment may be effective for the prevention of long-term sickness absence.
Cross-Sectional Association Between Employment Status and Self-Rated Health Among Middle-Aged Japanese Women: The Influence of Socioeconomic Conditions and Work-Life Conflict
 
  • Few studies examining the health effects of employment status among women have taken social and economic conditions as well as work–family conflict into consideration.
  • Among middle-aged Japanese women, non-regular employees and self-employee workers were less likely than regular employees to rate their health as poor.
  • Decreased likelihood of poor self-rated health among non-regular employees compared with regular employees could be explained by reduced work–family conflict.
Prevalence and Correlates of Physical Activity Among Children and Adolescents: A Cross-Sectional Population-Based Study of a Rural City in Japan
 
  • The current study is the first report about physical activity levels among children and adolescents in Japanese community setting.
  • Only 20.1% of the Japanese children and adolescents met WHO recommended physical activity levels.
  • Physical activity were associated with grade, gender, PA preference and population density.
Lingering Impact of Starting Working Life During a Recession: Health Outcomes of Survivors of the “Employment Ice Age” (1993–2004) in Japan
 
  • Health outcomes of the employment ice age (1993–2004) in Japan were examined.
  • Severe economic conditions at labor market entry had a lingering impact on health.
  • The impact was direct rather than mediated by socio-demographic/economic factors.
  • Reforms toward more flexible labor markets are needed to enhance public health.
Statistical Data
Meta-regression Analysis of Sex- and Birth Year-Specific Prevalence of HBsAg and Anti-HCV Among Un-diagnosed Japanese: Data From the First-time Blood Donors, Periodical Health Checkup, and the Comprehensive Health Checkup With Lifestyle Education (Ningen Dock)
 
  • We estimated the pooled prevalence of HBsAg and anti-HCV based on three large-scaled cohort.
  • Birth year-specific pooled prevalence of HBsAg peaked at 1941 – 1950 birth cohort.
  • That of anti-HCV showed the decreasing trend by birth year.
  • The result of this study can be used reference data of various countermeasure for hepatitis eradication.

Volume 30, Issue 8 (August 2020)

Relative Validity of Starch and Sugar Intake in Japanese Adults as Estimated With Comprehensive and Brief Self-Administered Diet History Questionnaires
 
  • DHQ and BDHQ reasonably ranked for energy-adjusted intakes of starch and sugars in Japanese adults.
  • Spearman correlations of the first DHQ were acceptable for all variables (0.31-0.67), except for maltose and trehalose in women.
  • The correlations of the first BDHQ were also acceptable (0.32-0.64), except for maltose and galactose.
  • Similar results were observed for the mean of four DHQs and BDHQs.
  • Neither questionnaires satisfactory estimated intakes at the group and individual levels.
Association Between Routine Nephropathy Monitoring and Subsequent Change in Estimated Glomerular Filtration Rate in Patients With Diabetes Mellitus: A Japanese Non-Elderly Cohort Study
 
  • Only 6.0% of individuals with diabetes in Japan monitored for nephropathy.
  • The effect of nephropathy monitoring on renal function was assessed.
  • Nephropathy monitoring was not associated with preserved renal function.
The Risk of Functional Limitations After Driving Cessation Among Older Japanese Adults: The JAGES Cohort Study
 
  • Driving cessation was associated with an increased risk of functional limitations.
  • The risk might be alleviated among older adults who maintained independent mobility.
  • They should be assisted with driving safely or securing alternative transportation.
Intake of Coffee Associated With Decreased Depressive Symptoms Among Elderly Japanese Women: A Multi-Center Cross-Sectional Study
 
  • Higher coffee intake was associated with a lower prevalence of depressive symptoms.
  • Caffeine intake was marginally associated with depressive symptoms, but the association was not statistically significant.
  • This cross-sectional study was conducted on 1,992 Japanese women aged 65–94 years.
  • A validated dietary questionnaire and the adjustment for known and putative risk factors for depressive symptoms were used.
  • We investigated using total caffeine intake estimated from BDHQ with foods, coffee and green tea, since there are several sources of caffeine in foods.
Gestational Weight Gain Charts by Gestational Age and Body Mass Index for Chinese Women: A Population-Based Follow-up Study
 
  • Models of weight gain for gestational age were developed from data of 132,835 Chinese women.
  • Z-score charts were developed for underweight, normal weight, overweight, and obese categories based on height and weight in the first trimester.
  • These charts would be useful for precise control of weight gain during pregnancy.
Temporal Trends and Geographic Disparity in Hypertension Care in China
 
  • This study is the first to investigate temporal trends in the geographic variations in diagnosis, treatment and control of hypertension in China.
  • To explore the association between geographic correlates and hypertension care, random effects models were performed, using a nationally longitudinal dataset.
  • This study provided an overview of the progress of China towards effective coverage of hypertension management following health system reform.
  • A nationally strong primary care system and provincially characterized working plans are all needed to achieve the goal of standard hypertension management.
Early SNS-Based Monitoring System for the COVID-19 Outbreak in Japan: A Population-Level Observational Study
 
  • A chatbot-based healthcare system named COOPERA (COvid-19: Operation for Personalized Empowerment to Render smart prevention And care seeking) was developed in Japan.
  • COOPERA is the first system to monitor epidemiological trends of COVID-19, which provides insights to assist political decisionmaking to tackle the epidemic.
  • No symptoms were reported by 96.93% of participants, but we found a significant 0–3 day gap between the date of onset of self-reported fever and the date of report of polymerase chain reaction test results (confirmed COVID-19), suggesting that the fever reported in COOPERA partially captures the shape of COVID-19 and may be a useful tool to estimate the scale of the COVID-19 epidemic in real time.

Volume 30, Issue 7 (July 2020)

Cohort Profile of the NEIGE Study in Tokamachi City, Japan
 
  • The NEIGE (The Neuron to Environmental Impact across Generation) study has been launched to elucidate social determinants of health in rural older adults in Tokamachi city, Japan. A total of 527 older Japanese adults participated in the study with an average age of 73.5 ± 5.6 years, and 47.3% were male.
  • Baseline characteristics were not significantly different between mountain and downtown except that educational attainment was longer in downtown residents than in mountain residents.
  • Muscle mass and grip strength were markedly higher among mountain residents, as well as physical activity.
  • Walking speed and balance were better among downtown residents than among mountain residents.
Prospective Study on the Association Between Adherence to Healthy Lifestyles and Depressive Symptoms Among Japanese Employees: The Furukawa Nutrition and Health Study
 
  • We prospectively investigated the association between combined healthy lifestyles and depressive symptoms in a Japanese working population.
  • Adherence to multiple healthy lifestyle factors was significantly associated with a lower risk of depressive symptom.
  • Sleep duration, alcohol intake, BMI, leisure-time physical activity, and smoking status were the important contributors of the association between the Healthy Lifestyle Index and depressive symptoms.
Description of Maternal Smoking Status Before and After Pregnancy: A Longitudinal, Community-Based Cohort Study
 
  • A few studies examined individual smoking statuses before and after pregnancy.
  • The longitudinal maternal smoking rates during these periods were described.
  • About 60% of mothers who smoked before and after delivery failed smoking cessation.
  • Younger mothers were significantly likely to relapse smoking after delivery.
Factors Influencing the Proportion of Non-examinees in the Fukushima Health Management Survey for Childhood and Adolescent Thyroid Cancer: Results From the Baseline Survey
 
  • The baseline survey of thyroid ultrasound examination was conducted in 2011-2013 in Fukushima Prefecture.
  • Factors influencing the proportion of non-examinees for the survey was assessed.
  • The proportion of non-examinees was lower among girls than among boys.
  • There were more non-examinees among populations that moved after the nuclear power plant accident.
Short Communication
Alcohol Drinking and Bladder Cancer Risk From a Pooled Analysis of Ten Cohort Studies in Japan
 
  • This pooled analysis included the data of ten population-based prospective cohort studies in Japan.
  • No evidence of significant association between alcohol drinking and bladder cancer incidence was observed for both sexes.
  • The present null result may emphasize on future studies with information on the polymorphisms of alcohol-metabolizing enzymes in East Asians.

Volume 30, Issue 6 (June 2020)

Help-Seeking Behavior and Psychological Distress by Age in a Nationally Representative Sample of Japanese Employees
 
  • We examined the association between the presence/absence of help-seeking behavior and psychological distress among private and public employees by age group using a nationally representative sample of the Japanese population.
  • Data from the 2016 Comprehensive Survey of Living Conditions, a nationwide cross-sectional survey, were analyzed.
  • Among 78,284 private and public employees aged 20 to 59 years not using any mental health services for mental disorders, 9% and 6% reported severe psychological distress in those aged 20-39 and 40-59, respectively.
  • The proportion of participants without help-seeking behavior was significantly higher among older participants compared to younger participants.
  • After adjusting for sociodemographic and job/life-related variables, participants without help-seeking behavior were more likely to have severe psychological distress regardless of age group, and this trend appeared to be slightly stronger among those aged 20-39.
Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study
 
  • Association of proteinuria and low eGFR with cognition warrants further clarification.
  • Multivariable adjusted cognitive score was computed by proteinuria and eGFR status.
  • Proteinuria and low eGFR were independently associated with lower cognition.
  • Coexistence of these conditions showed the lowest cognitive score.
  • Proteinuria or low eGFR even in moderate stage may lead to low cognition.
Relationship Between Parental Lifestyle and Dietary Habits of Children: A Cross-Sectional Study
 
  • We examined the relationship between parental lifestyle factors and children’s dietary habits.
  • There were two types of dietary habits associated with lifestyle factors among parent and children.
  • Undesirable parental lifestyle factors were associated with lack of parental dietary attitude and children eating breakfast alone.
The Value of a Cystatin C-based Estimated Glomerular Filtration Rate for Cardiovascular Assessment in a General Japanese Population: Results From the Iwate Tohoku Medical Megabank Project
 
  • The present study investigated the comparison between the cystatin C-based estimated glomerular filtration rate (GFRcys) and creatinine-based GFR (GFRcr) to determine whether these measurements are associated with elevated cardiovascular disease (CVD) risk in a general Japanese population (n = 29,375).
  • Multiple variable analyses after adjusting for baseline characteristics showed that GFRcys was associated CV biomarkers of high-sensitive cardiac troponin T (hs-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP).
  • The area under the receiver operating characteristic curve for identifying individuals with a high Suita score was higher for the GFRcys than it was for the GFRcr.
  • The GFRcys provided reclassification improvement for detection of participants with estimated high CVD risk compared with the GFRcr.
  • In conclusions, the GFRcys is more closely associated with CV biomarkers and high Suita scores than the GFRcr, and it provides additional value in the detection of individuals with high CV risk.
Statistical Data
Characteristics of Sports-Related Emergency Transport: A Population-Based Descriptive Study in Osaka City
 
  • In Osaka City, characteristics of cases that required sports-related emergency transport widely varied by the type of sports.
  • The 10 sports with the highest number of cases were baseball, soccer, futsal, basketball, rugby, softball, long-distance running, volleyball, tennis, and judo.
  • The leading diagnosis of injury was fracture/bone contusion and that of illness was heatstroke/dehydration.
  • Half of sudden cardiac arrests occurred during long-distance running.

Volume 30, Issue 5 (May 2020)

Combined Associations of Body Mass Index and Metabolic Health Status on Medical and Dental Care Days and Costs in Japanese Male Employees: A 4-Year Follow-Up Study
 
  • The combinations of BMI levels and metabolic health status were associated with the adjusted mean and median medical outpatient days and costs.
  • The BMI levels and metabolic health combinations were associated with the median dental outpatient days and costs. 
  • The highest costs were shown in the obesity/unhealthy phenotype for medical and underweight/unhealthy phenotype for dental.
  • The underweight/unhealthy subjects had higher medical inpatient days and costs than obesity/healthy subjects.
  • Obesity phenotypes identified by both BMI levels and metabolic status may more precisely predict healthcare costs compared with either factor alone. 
Higher Numbers of Pregnancies Associated With an Increased Prevalence of Gestational Diabetes Mellitus: Results From the Healthy Baby Cohort Study
 
  • This is the first study to investigate the association between number of pregnancy and gestational diabetes mellitus.
  • In an analysis of 7008 pregnant women in China in 2012–2014, ≥ 3 pregnancies was associated with a higher risk of gestational diabetes after adjustment for potential confounders, the associations between number of pregnancy and gestational diabetes were more evident in women who were ≥ 30 year old or with pre-pregnancy BMI < 24 Kg/m2.
  • Our study suggested that number of pregnancy should be taken into consideration when assessing gestational diabetes risk, especially among women who were ≥ 30 year old or with pre-pregnancy BMI < 24 Kg/m2.
Number of Teeth and All-Cause and Cancer Mortality in a Japanese Community: The Takayama Study
 
  • The association between number of remaining teeth and mortality was examined in a community cohort in Japan.
  • A lower number of remaining teeth was associated with increased risk of all-cause and lung cancer mortality.
  • The association between number of remaining teeth and lung cancer mortality was not attenuated among never-smokers.
Incidence of Metabolic Syndrome in Young Japanese Adults in a 6-Year Cohort Study: The Uguisudani Preventive Health Large-Scale Cohort Study (UPHLS)
 
  • In 20s and 30s Japanese, the incidences of metabolic syndrome (MS) per 1,000 person-years with the Japanese criteria were 2.2, 5.5 in the female groups and 26.3, 40.5 in the male groups.
  • Compared with the 40s group, the hazard ratios of MS in the young adults account for about 20 to 50% for females and 50 to 70% for males.
  • Smoking, eating speed, physical activity, and alcohol intake are likely to be risks in young adults. These findings suggest that early lifestyle intervention for MS is necessary in young adults.
Association Between Okinawan Vegetables Consumption and Risk of Type 2 Diabetes in Japanese Communities: The JPHC Study
 
  • Some Okinawan vegetables have been reported to potentially have anti-diabetic activity.
  • We aimed to determine the association between consumption of Okinawan vegetables and risk of type 2 diabetes through a large-scale, population-based, prospective study in Okinawa Prefecture.
  • The consumption of Okinawan vegetables was not associated with the risk of type 2 diabetes.

Volume 30, Issue 4 (April 2020)

Special Article
Causal Diagrams: Pitfalls and Tips
 
  • Causal diagrams have been often used among epidemiologists as a tool to describe what is already known about the relevant causal structure.
  • Causal directed acyclic graphs have proven to be a useful tool to clarify our causal thinking if appropriately used.
  • There are many pitfalls to avoid when using causal directed acyclic graphs.
  • Causal diagrams provide an incomparable help at the stages of study design, data collection and analysis, interpretation of study findings, etc.
  • The value of causal diagrams as a pedagogical tool cannot be overlooked in the causal inference literature.
Serum Gamma-Glutamyltransferase, Daily Alcohol Consumption, and the Risk of Chronic Kidney Disease: The Kansai Healthcare Study
 
  • We prospectively examined whether serum gamma-glutamyltransferase (GGT) related to proteinuria or low estimated glomerular filtration rate (eGFR).
  • Elevated serum GGT was independently associated with the risk of proteinuria.
  • In joint analysis, non-drinkers with the highest tertile of serum GGT had the highest risk of persistent proteinuria.
  • There was no association between serum GGT and low eGFR.
Study Design and Baseline Profiles of Participants in the Uonuma CKD Cohort Study in Niigata, Japan
 
  • The Uonuma CKD cohort study aims to investigate the prevention of the onset and progression of CKD.
  • This study is one of the largest population-based prospective cohort studies on CKD.
  • This study will provide evidence that should be useful for decreasing the individual and social burden of CKD.
Associations of Circulating MicroRNAs (miR-17, miR-21, and miR-150) and Chronic Kidney Disease in a Japanese Population
 
  • We examined the relationship between expression level of circulating miRNAs and CKD in a middle-aged Japanese population.
  • Expression levels of miR-17, miR-21, and miR-150 were positively associated with eGFR.
  • We found significant lower odds ratios for CKD in the highest tertile of three miRNAs compared with the lowest tertile.
Echocardiographic Parameters and the Risk of Incident Atrial Fibrillation: The Suita Study
 
  • Association between echocardiographic parameters and the incidence of atrial fibrillation (AF) was investigated in the Suita study.
  • Left atrial diameter (LAD) was associated with increased risk for AF after adjustment for the risk factors of the AF risk score.
  • Among the examined continuous echocardiographic parameters of cardiac structure and function, 1-SD-increase of LAD showed the highest HR for AF.
  • The present study is the first population-based cohort study to show the risk of LAD enlargement for AF incidence in the Asian general population.
  • LAD might be useful for identifying individuals with a high risk of AF in health check-ups of the general population.
Associations of Frequency of Laughter With Risk of All-Cause Mortality and Cardiovascular Disease Incidence in a General Population: Findings From the Yamagata Study
 
  • This cohort study included 17,152 subjects aged greater than or equal to 40 years who participated in an annual health check-up in Yamagata, Japan.
  • Self-reported daily frequency of laughter was grouped into 3 categories (greater than or equal to 1/week; greater than or equal to 1/month but <1/week; and <1/month).
  • Low frequency of laughter was associated with higher all-cause mortality and cardiovascular disease incidence.
  • This association was significant even after adjustment for possible confounders.
Study Profile
Japan Trial in High-Risk Individuals to Enhance Their Referral to Physicians (J-HARP)—A Nurse-Led, Community-Based Prevention Program of Lifestyle-Related Disease
 
  • We performed a clustered randomized controlled trial of untreated high-risk individuals aged 40 to 74 years in 43 municipalities around Japan.
  • The intervention group received the theory-based health counselling to accelerate referrals to physicians.
  • A major hypothesis is that high-risk individuals in the intervention group see a physician more than those in the usual care group.
  • We obtained enough number of participants and information to test the effectiveness of health counselling.

Volume 30, Issue 3 (March 2020)

Special Article
Japanese Legacy Cohorts: Six-Prefecture Cohort Study (Hirayama Cohort Study)
 
  • Late Dr. Takeshi Hirayama and his collaborators conducted a large-scale cohort study in six prefectures in Japan (Miyagi, Aichi, Osaka, Hyogo, Okayama, Kagoshima), which is called the Six-Prefectures Cohort Study or Hirayama Cohort Study.
  • Its baseline survey covered male and female residents aged 40 and over based on the National Census in 1965, of whom 264,118 people (equivalent to 94.8% of the total population) were followed for 17 years until the end of 1982.
  • One of the most important findings obtained from Hirayama Cohort Study was the association between second-hand smoke exposure and lung cancer mortality, which triggered the worldwide spread of smoking ban in indoor public places and workplaces.
  • This special article presented a succinct summary of the main findings obtained from the study, paying respect to the foresight and the leadership of late Dr. Takeshi Hirayama, and his outstanding contributions to improving national and global public health.
Relationship Between Severe Respiratory Depression and Codeine-Containing Antitussives in Children: A Nested Case-Control Study
 
  • Occurrence of respiratory depression was very rare.
  • The association of codeine with respiratory depression was insignificant.
  • Our findings have important clinical and health policy implications.
Elevated Fasting Blood Glucose Levels Are Associated With Lower Cognitive Function, With a Threshold in Non-Diabetic Individuals: A Population-Based Study
 
  • Investigated relationships between cognition and fasting blood glucose.
  • Cognitive ability screening instrument (CASI) was used to assess cognition.
  • 3.97-6.20mmol/L glucose associated with highest cognition in men without diabetes.
  • Higher glucose was associated with lower cognition in men with diabetes.
  • Distinct relationships between glucose and cognition by diabetes status were found.
Plain Water Intake and Association With the Risk of Overweight in the Chinese Adult Population: China Health and Nutrition Survey 2006–2011
 
  • An inverse dose-response relationship existed between plain water intake and new-onset overweight risk.
  • More than 4 cups (≈1 liter) plain water intake per day was associated with the reduction of overweight risk.
  • The association of plain water intake and overweight risk was independent of socioeconomic and lifestyle factors.
The Association Between Education and Smoking Prevalence, Independent of Occupation: A Nationally Representative Survey in Japan
 
  • Independent of occupation, lower education level was significantly related to current smoking among the Japanese general population.
  • Educational disparities in smoking were larger among the younger generation than among older people, especially among women aged 20–39 years.
  • Regarding occupation, after adjustment of education and other covariates, significantly higher smoking prevalence in manual workers than in upper non-manual workers was found only in men aged 20–64 years.
  • Among women aged 65 or older, manual workers were less likely to be current smokers than upper non-manual workers, while among women aged 20–64 years, occupation was not associated with smoking.
  • The current study suggests that we should pay attention to social inequality in smoking as well as national smoking prevalence.
Socio-Economic Disparities in Early Childhood Education Enrollment: Japanese Population-Based Study
 
  • Although studies from other developed countries have shown that the benefits of center-based childcare may be most pronounced among socioeconomically disadvantaged families, such families are less likely to use it.
  • Socio-economic disadvantage (e.g., low income and mother’s low education) were associated with the non-use of center-based childcare.
  • Child’s health and developmental problems (e.g., preterm birth) were also associated with the non-use of center-based childcare.

Volume 30, Issue 2 (February 2020)

Utility of a Specific Health Checkup Database Containing Lifestyle Behaviors and Lifestyle Diseases for Employee Health Insurance in Japan
 
  • Lifestyle and associated diseases were examined by the Specific Health Checkup (SHC).
  • Results were compared with data from the National Health and Nutrition Survey.
  • SHC subjects were younger, had better lifestyle behaviors.
  • SHC subjects had lower prevalence of metabolic syndrome, diabetes and hypertension.
  • Developing health policies would benefit from selection of an appropriate database.
 Self-Reported Hearing/Visual Loss and Mortality in Middle-Aged and Older Adults: Findings From the Komo-Ise Cohort, Japan
 
  • Hearing loss and dual sensory loss might be risk factors of mortality over ten years.
  • Hearing loss was primarily associated with cancer mortality.
  • Depression, walking disability, and social participation modestly mediated the association.
Sociodemographic Factors Influenced Response to the 2015 National Nutrition Survey on Preschool Children: Results From Linkage With the Comprehensive Survey of Living Conditions
 
  • Overall response rate to the 2015 National Nutrition Survey on Preschool Children (NNSPC) was 64.1%.
  • Response rates varied according to sociodemographic factors such as residential area, family structure, economic status, and maternal characteristics.
  • Some bias, mostly small, was seen in survey estimates of the 2015 NNSPC.
Dental Status is Associated With Incident Functional Disability in Community-Dwelling Older Japanese: A Prospective Cohort Study Using Propensity Score Matching
 
  • 13-year prospective cohort study in 574 elderly Japanese to determine the relationship between dental status and functional disability.
  • Reduction of confounding factors in the study population with propensity score matching.
  • Participants with 0-19 teeth have a higher risk to develop functional disability than those with 20 or more teeth.
Incidence and Age Distribution of Hospitalized Presumptive and Possible Abusive Head Trauma of Children Under 12 Months Old in Japan
 
  • Capturing incidence of abusive head trauma (AHT) is important for evaluating intervention effectiveness.
  • No studies reported the incidence of AHT in Japan.
  • This study revealed similar incidence of possible AHT to other countries.
  • The month-age distribution uniquely showed two peaks for around 2 and 8 months old.
  • Further research is needed to prevent AHT among children in early and late infancy.
Dietary Inflammatory Index Positively Associated With High-Sensitivity C-Reactive Protein Level in Japanese From NIPPON DATA2010
 
  • The significant associations were observed between DII scores and CRP in almost all age-sex Japanese groups.
  • The DII is applicable to the Japanese population.
  • DII score cannot be used to compare the inflammatory potential of diets of different countries directly without using the same food parameters.

Volume 30, Issue 1 (January 2020)

Decline in Handgrip Strength From Midlife to Late-Life is Associated With Dementia in a Japanese Community: The Hisayama Study
 
  • Greater decline in handgrip strength over 15 years from midlife to late-life was associated with higher risks of total dementia and Alzheimer's disease.
  • Maintaining muscle strength into late-life is important for preventing dementia.
Trends in Serum Lipid Levels of a 10- and 13-Year-Old Population in Fukuroi City, Japan (2007–2017)
 
  • We investigated trends in serum lipids from 2007 to 2017 in a population of 10- and 13-year-old children in Fukuroi City, Japan.
  • No remarkable changes in the prevalence of adverse LDL-C and HDL-C levels were observed regardless age or sex, while the prevalence of high non-HDL-C increased in boys.
  • Serum LDL-C and HDL-C levels slightly increased in boys and girls aged 10 years, and HDL-C levels slightly increased in girls aged 13 years.
Serum Pepsinogen Values in Japanese Junior High School Students With Reference to Helicobacter Pylori Infection
 
  • Accurate infection diagnosis was pursued with both serum and urine tests.
  • In the analyses, 171 H. pylori non-infected and 8 infected students were included.
  • Infected students showed higher pepsinogen I and II and lower I to II ratio.
  • The distributions of serum pepsinogen differed clearly from that in adults.
  • In non-infected students, males showed higher pepsinogen values than females.
Association of Vegetable, Fruit, and Okinawan Vegetable Consumption With Incident Stroke and Coronary Heart Disease
 
  • We aimed to elucidate associations of total Okinawan vegetable consumption as well as total fruit and vegetable consumption with risk of incident stroke and coronary heart disease among participants who lived in Okinawa Prefecture.
  • Total and specific Okinawan vegetable consumption were not statistically significantly associated with risk of stroke and coronary heart disease.
  • Consumption of total vegetable and fruit in Japanese residents of Okinawa was also not associated with risk of incident stroke and coronary heart disease.
Study Profile
The Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT): Study Design and Participants
 
  • Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT) was launched in 2011 to identify risk factors for lifestyle-related disease, elucidate factors which extend healthy life expectancy, and contribute toward personalized healthcare.
  • Between 2011 and 2016, a baseline survey was conducted at 16 municipalities in 7 prefectures across the country.
  • We have established a population-based cohort of 115,385 persons (Response rate 44.1%), among whom 55,278 (47.9% of participants) have provided blood and urine samples.
 
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