Background: Lower mortality has been reported in light-to-moderate alcohol drinkers. We examined the association between the amount and frequency of alcohol consumption and all-cause mortality in a Japanese population. Methods: We conducted a prospective cohort study among 8934 Japanese people (3444 men and 5490 women) who completed a baseline survey between 1992 and 1995. We confirmed the date and cause of death by referring to death certificates. The Cox proportional hazards model was used to evaluate the effect of alcohol consumption on risk for all-cause mortality, after adjustment for potential confounding factors. Results: We identified 637 (397 men and 240 women) deaths during the 12.0 years of mean follow-up. Among men, as compared with non-drinkers, the relative risk was higher in ex-drinkers (hazard ratio [HR], 1.18), lower in light drinkers (HR, 0.95) and moderate drinkers (HR, 0.91), and significantly higher in heavy drinkers (HR, 1.67; 95% confidence interval, 1.10–2.55). Among women, light, moderate, and heavy drinkers were grouped into current drinkers. The relative risk was slightly higher in current drinkers (HR, 1.23), and that in ex-drinkers was near 1.0 (HR, 0.97). In stratified analysis, the harmful effects of heavy drinking were more severe among male smokers and younger men. In terms of frequency, men who drank only on special occasions had the highest mortality (HR, 1.28), regardless of alcohol intake per drinking session. Conclusions: In men, a near J-shaped association was identified between alcohol consumption and all-cause mortality. Both the amount and frequency of alcohol consumption were related to mortality.
Background: Gallstone disease (GSD) is a major public health problem that is associated with a number of risk factors. Methods: We conducted a case–control study of 407 participants comprising 207 cases with GSD and 200 controls without GSD, as confirmed by ultrasonography. The participants completed a questionnaire and underwent physical and ultrasonographic examination. The risk factors examined were age, sex, BMI, use of oral contraceptives, diabetes mellitus, cirrhosis, thalassemia, dyspepsia, family history of gallstone disease, smoking status, alcohol consumption, and dietary history. Results: BMI, fat content of dietary meat, and smoking were associated with GSD. When compared to participants with a BMI below 25, participants with a BMI of 25 or higher had a multivariate relative risk of 4.1 (95% CI, 2.5–6.7). Participants who consumed meat with moderate fat content or high fat content had respective relative risks of 2.5 and 2.9 (95% CI, 1.5–4.2 and 1.5–5.6), when compared to those who consumed meat with a low fat content. Also, the multivariate relative risk for former smokers, as compared to never smokers, was 2.4 (95% CI, 1.1–5.2). Conclusions: High BMI, consumption of high-fat meat, and smoking were associated with gallstone disease.
Background: In China, and in Shandong province, the proportionate contribution of birth defects to infant mortality has increased, and congenital heart disease (CHD) is now the most common cause of birth defects. The cause of approximately 90% of cases of congenital heart disease is multifactorial. Little is known about modifiable environmental risk factors or regional differences. We investigated putative environmental risk factors for congenital heart disease in the Shandong province of China in order to improve prevention of CHD. Methods: We conducted a hospital-based 1:2 matched case–control study of 164 patients with congenital heart diseases and 328 controls, all of whom were retrospectively interviewed. Univariate and multivariate analyses were conducted to identify environmental risk factors for CHD. Results: The environmental risk factors associated with CHD were mother’s education level (odds ratio [OR], 0.31; 95% confidence interval [CI], 0.15–0.67), neonatal asphyxia or hypoxia (OR, 3.74; 95% CI, 1.25–11.18), number of previous pregnancies (OR, 2.68; 95% CI, 1.44–4.97), maternal upper respiratory tract infection (OR, 4.12; 95% CI, 1.56–10.85), maternal infection (OR, 7.98; 95% CI, 2.14–29.72), maternal B-mode ultrasound examination (OR, 4.05; 95% CI, 1.48–11.08), and maternal mental stress (OR, 3.93; 95% CI, 1.94–7.94) during early pregnancy. No significant interactions were observed among these factors. Conclusions: Augmenting maternal mental healthcare, obtaining regular health counseling and testing during pregnancy, preventing upper respiratory tract infections, limiting medication during early pregnancy, offering health promotion and health education to women of childbearing age (especially those with less formal education), and improving obstetric procedures and techniques may lower the occurrence of congenital heart disease.
Background: Recent studies have revealed a close relationship between obesity and polymorphism in the inflammation gene. However, the association between interleukin-1beta (IL-1β) and obesity remains controversial. We therefore investigated the association between IL-1B C-31T polymorphism and obesity in Japanese. Methods: The participants were 802 inhabitants (281 men and 521 women) of Japan, aged 39 to 88 years, who attended a health examination in 2003. Body height, weight, waist and hip circumferences, and body fat percentage were measured. The IL-1B C-31T polymorphism was genotyped by polymerase chain reaction with confronting 2-pair primers. The association between IL-1B C-31T genotypes and various indices of obesity was then investigated. The confounding factor-adjusted odds ratios (OR) and 95% confidence intervals (CI) for obesity were calculated for each IL-1B C-31T genotype by using unconditional logistic regression analysis. Results: Among male carriers of the CT and TT genotypes, the ORs for high body fat percentage were 2.58 (95% CI, 1.17–6.34) and 2.81 (1.17–7.33), respectively, as compared to carriers of the CC genotype (P for trend = 0.037). Among women, carriers of the TT genotype had significantly higher ORs for high BMI (OR, 2.13; 95% CI, 1.25–3.67) and large waist circumference (2.49; 1.37–4.66), as compared to women with the CC genotype (P for trend = 0.005 and 0.004, respectively). Conclusions: The IL-1B C-31T polymorphism is associated with obesity in Japanese. Men and women with the TT genotype of IL-1B C-31T had a higher risk for obesity than those with the CC genotype.
Background: We previously reported that a number of factors related to maternal lifestyle during early pregnancy, including smoking, are associated with childhood obesity at 5 years of age. In the present study, we investigated whether the association with maternal smoking persisted to the age of 9–10 years. Methods: The study population comprised children born between April 1, 1991 and March 31, 1999, and their mothers. The dependent variables—childhood overweight and obesity at 5 and 9–10 years of age—were defined according to internationally acknowledged cut-off values. Maternal smoking during early pregnancy was used as the independent variable. Results: Mothers who completed a specifically designed questionnaire gave birth to a total of 1644 infants during the study period. Anthropometric data were collected from 1302 of these children during medical checkups at 9–10 years of age (follow-up rate: 79.2%). Maternal smoking during early pregnancy was associated with obesity in 9- to 10-year-old children (adjusted odds ratio, 1.91; 95% confidence interval, 1.03–3.53). However, the point estimates at the age of 9–10 years were considerably lower than those at the age of 5 years. Conclusions: Our results suggest that fetal environment, including exposure to maternal smoking, continues to be associated with childhood obesity at the age of 9–10 years.
Background: We examined the association between short-term exposure to outdoor air pollution and nighttime primary care visits due to asthma attack. We also investigated the modifying effects of age on this association. Methods: A case–crossover study was conducted at a primary care clinic in metropolitan Tokyo. The subjects were 308 children aged 0–14 years and 95 adolescents and adults aged 15–64 years. All subjects made visits to the clinic for an asthma attack at between 7 PM and 12 AM. Data on hourly concentrations of particulate matter with a 50% cut-off aerodynamic diameter ≤2.5 µm (PM2.5), ozone, and nitrogen dioxide (NO2) were obtained. A conditional logistic regression model was used to estimate odds ratios (ORs) of primary care visits per unit increment of each air pollutant. Results: Among children, the ORs in warmer months per 10 ppb increment of the 24-hour mean concentration of ozone were 1.16 (95% confidential interval [CI], 1.00–1.33) adjusted for temperature, and 1.29 (95% CI, 1.08–1.55) adjusted for PM2.5, NO2, and temperature. With respect to modification of the association by age, the ORs for 24-hour mean concentration of ozone—after adjustment for PM2.5, NO2 and temperature in warmer months—in children aged 0–1 years, 2–5 years, and 6–14 years were 1.06 (95% CI, 0.63–1.78), 1.37 (95% CI, 1.05–1.71), and 1.25 (95% CI, 0.87–1.82), respectively. There was no association between ozone and primary care visits among adults. Conclusions: An association was found between ozone and nighttime primary care visits for asthma attack in warmer months; the association was greater among preschool children.
Background: We compared the birth weight of newborns born to foreign-born mothers (FBMs) and Taiwan-born mothers (TBMs), using data from the 2005–2006 Taiwan Birth Registry of singleton live births. Methods: The Wilcox–Russell method, data restriction, and multiple linear regression were used to analyze the data. The rates of low birth weight (<2500 g) with 95% confidence intervals were computed for TBMs, and for each of the nationalities of FBMs. Results: The mean birth weight of newborns of FBMs was 3157 g, which was higher than that of newborns of TBMs (3109 g). On analysis using the Wilcox–Russell method, both the rate and residual proportion of low-birth-weight (LBW) births were lower among newborns of FBMs (4.1% and 1.1%, respectively) than among newborns of TBMs (5.9% and 1.7%, respectively). After adjusting for sex, mode of delivery, maternal age, smoking status, predisposing maternal risk factors, and condition during pregnancy, the newborns of FBMs weighed 72.9 g (95% CI, 68.8 g to 77.0 g) more than the newborns of TBMs. When data were restricted to mothers without any adverse conditions and adjusted for maternal age, the differences in birth weight between the 2 groups remained unchanged. The rates of LBW deliveries among FBMs in Taiwan were significantly lower than those in their respective countries of origin. Conclusions: In Taiwan, newborns of FBMs had a higher birth weight than those of TBMs, even after accounting for potential confounding factors, and had lower rates of LBW deliveries than did mothers in their respective countries of origin.