Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
Volume 27, Issue 5
Displaying 1-7 of 7 articles from this issue
Original Articles
  • Kohei Ogawa, Seung-Chik Jwa, Minatsu Kobayashi, Naho Morisaki, Haruhik ...
    2017 Volume 27 Issue 5 Pages 201-208
    Published: 2017
    Released on J-STAGE: May 11, 2017
    Supplementary material

    Background: No previous study has shown the validity of a food frequency questionnaire (FFQ) in early pregnancy with consideration of nausea and vomiting during pregnancy (NVP). The aim of this study was to evaluate the validity of a FFQ in early pregnancy for Japanese pregnant women.

    Method: We included 188 women before 15 weeks of gestation and compared estimated nutrient intake and food group intake based on a modified FFQ with that based on 3-day dietary records (DRs). Spearman's rank correlation coefficients, adjusting energy intake and attenuating within-person error, were calculated. Subgroup analysis for those with and without NVP was conducted. We also examined the degree of appropriate classification across categories between FFQ and DRs through division of consumption of nutrients and food groups into quintiles.

    Results: Crude Spearman's correlation coefficients of nutrients ranged from 0.098 (sodium) to 0.401 (vitamin C), and all of the 36 nutrients were statistically significant. In 27 food groups, correlation coefficients ranged from −0.015 (alcohol) to 0.572 (yogurt), and 81% were statistically significant. In subgroup analysis, correlation coefficients in 89% of nutrients and 70% of food groups in women with NVP and 97% of nutrients and 74% of food groups in women without NVP were statistically significant. On average, 63.7% of nutrients and 60.4% of food groups were classified into same or adjacent quintiles according to the FFQ and DRs.

    Conclusions: The FFQ is a useful instrument, regardless of NVP, for assessing the diet of women in early pregnancy in Japan.

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  • Yasuo Haruyama, Takako Yamazaki, Motoki Endo, Rika Kato, Masanori Naga ...
    2017 Volume 27 Issue 5 Pages 209-214
    Published: 2017
    Released on J-STAGE: May 11, 2017

    Background: We sought to clarify the association between the personal utilization of general health checkups (GHCs) and medical expenditures (MEs) in a middle-aged Japanese population.

    Methods: A retrospective cohort study was conducted. Subjects were 33,417 residents (15,819 males and 17,598 females) aged 48 years or older in 2010 who were invited to undergo GHCs every year. Official records on GHCs from 2002 to 2007 and MEs from 2008 to 2010 were provided by Soka City, Saitama Prefecture, Japan. The utilization of GHCs was divided into zero times (non-utilizers), 1–3 times (low-frequency utilizers), and 4–6 times (high-frequency utilizers). Tweedie distributions in the generalized linear model were used to analyze the association between MEs and the subgroups of GHC utilization after adjustment for age and sex.

    Results: Of the 33,417 subjects, 20,578 (61.6%) were non-utilizers, 5,777 (17.3%) were low-frequency utilizers, and 7,062 (21.1%) were high-frequency utilizers, based on the attendance to GHCs from 2002 to 2007. Compared with the non-utilizers, the high-frequency utilizers showed significantly higher outpatient MEs (JPY394,700 vs. JPY373,100). The low- and high-frequency utilizers showed significantly lower inpatient MEs (JPY224,000 and JPY181,500 vs. JPY309,300) and total MEs (JPY610,600 and JPY580,700 vs. JPY689,600) than the non-utilizers based on the pooled data from 2008 to 2010.

    Conclusions: This study suggests that the outpatient MEs rise when annual GHCs are increasingly attended (not including the GHC cost), but inpatient and total MEs are lower. To reduce MEs, increasing the rates of attendance at GHCs by the general public may be important.

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  • Young Ae Cho, Jeongseon Kim
    2017 Volume 27 Issue 5 Pages 215-220
    Published: 2017
    Released on J-STAGE: May 11, 2017
    Supplementary material

    Background: Previous studies have suggested that IL4, IL13, and IL4R are associated with serum IgE levels and allergies, and common variants of these genes may alter cancer risk. To clarify these associations, we conducted a meta-analysis to investigate the associations of IL4, IL13, and IL4R polymorphisms with gastrointestinal cancer risk.

    Methods: We used 27 eligible case–control studies describing the associations of six polymorphisms of IL4, IL13, and IL4R with gastrointestinal cancer risk to calculate summary odds ratios (ORs) and 95% confidence intervals (CIs) using five different genetic models. The Q-statistic and I2 statistic were calculated to examine heterogeneity.

    Results: The IL4 rs2070874 T allele seems to be associated with an increased risk of gastrointestinal cancer (OR 1.11; 95% CI, 1.00–1.24 for T allele vs. C allele). This association was significant in studies conducted outside of Asia (OR 1.28; 95% CI, 1.03–1.58 for T allele vs. C allele) and in studies investigating the association with gastric cancer (OR 1.17; 95% CI, 1.03–1.34 for T allele vs. C allele). However, the IL4R rs1801275 heterozygote seems to be associated with a reduced risk of gastrointestinal cancer (OR 0.79; 95% CI, 0.65–0.96 for AG vs. AA). Other polymorphisms did not show any significant associations with gastrointestinal cancer risk in any of the genetic models and subgroup analyses.

    Conclusions: Our results suggest that certain polymorphisms of IL4 and IL4R may affect susceptibility to gastrointestinal cancer. However, further studies are required to confirm these findings.

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  • Masashige Saito, Naoki Kondo, Jun Aida, Ichiro Kawachi, Shihoko Koyama ...
    2017 Volume 27 Issue 5 Pages 221-227
    Published: 2017
    Released on J-STAGE: May 11, 2017
    Supplementary material

    Background: We developed and validated an instrument to measure community-level social capital based on data derived from older community dwellers in Japan.

    Methods: We used cross-sectional data from the Japan Gerontological Evaluation Study, a nationwide survey involving 123,760 functionally independent older people nested within 702 communities (i.e., school districts). We conducted exploratory and confirmatory factor analyses on survey items to determine the items in a multi-dimensional scale to measure community social capital. Internal consistency was checked with Cronbach's alpha. Convergent construct validity was assessed via correlating the scale with health outcomes.

    Results: From 53 candidate variables, 11 community-level variables were extracted: participation in volunteer groups, sports groups, hobby activities, study or cultural groups, and activities for teaching specific skills; trust, norms of reciprocity, and attachment to one's community; received emotional support; provided emotional support; and received instrumental support. Using factor analysis, these variables were determined to belong to three sub-scales: civic participation (eigenvalue = 3.317, α = 0.797), social cohesion (eigenvalue = 2.633, α = 0.853), and reciprocity (eigenvalue = 1.424, α = 0.732). Confirmatory factor analysis indicated the goodness of fit of this model. Multilevel Poisson regression analysis revealed that civic participation score was robustly associated with individual subjective health (Self-Rated Health: prevalence ratio [PR] 0.96; 95% confidence interval [CI], 0.94–0.98; Geriatric Depression Scale [GDS]: PR 0.95; 95% CI, 0.93–0.97). Reciprocity score was also associated with individual GDS (PR 0.98; 95% CI, 0.96–1.00). Social cohesion score was not consistently associated with individual health indicators.

    Conclusions: Our scale for measuring social capital at the community level might be useful for future studies of older community dwellers.

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  • Ji Li, Hong Lai, Shaoguang Chen, Hong Zhu, Shenghan Lai
    2017 Volume 27 Issue 5 Pages 228-234
    Published: 2017
    Released on J-STAGE: May 11, 2017
    Supplementary material

    Background: As an endocrine disruptor, bisphenol A (BPA) exposure has been implicated as a potential risk factor in childhood obesity, which is defined using percentiles of body mass index for age. We aimed to examine the associations between BPA exposure, reflected by urinary BPA concentration, and body composition in American children.

    Methods: Data of 1860 children aged 8–19 years who participated in the 2003–2006 National Health and Nutrition Examination Survey (NHANES) were analyzed in this study. Urinary BPA concentration (ng/mL) was used to indicate BPA status in the body. Body composition was measured by dual-energy X-ray absorptiometry (DXA). Multivariate linear regression models were fitted using survey procedures to investigate the associations between urinary BPA level and body composition separately for boys and girls.

    Results: After adjusting for demographic and lifestyle covariates, higher quartiled and log-transformed urinary BPA levels were significantly associated with elevated lean body mass index (LBMI) z-scores in boys (p < 0.05), and significantly associated with elevated fat mass index (FMI) z-scores in girls (p < 0.05). Lower urinary BPA concentration was associated with lower percentage of trunk fat in girls (compared to 1st quartile, 2nd-quartile: β = 2.85, 95% CI, 0.92–4.78; 3rd-quartile: β = 2.57, 95% CI, 0.28–4.85; 4th-quartile: β = 2.79, 95% CI, 0.44–5.14; all p < 0.05). Such patterns were not observed in boys.

    Conclusions: Higher BPA levels may be associated with elevated LBM in boys, but not in girls, while higher BPA levels may be associated with elevated FM in girls, but not in boys.

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  • Wen-Hsuan Hou, Chung-Yi Li, Hsin-Hui Chang, Yu Sun, Chiang-Chin Tsai
    2017 Volume 27 Issue 5 Pages 235-241
    Published: 2017
    Released on J-STAGE: May 11, 2017

    Background: To prospectively investigate the incidence and relative risks of multiple sclerosis (MS) in patients with type 2 diabetes (T2DM).

    Materials and methods: Patients with T2DM (n = 614,623) and age- and sex-matched controls (n = 614,021) were followed from 2000 to 2008 to identify cases of newly diagnosed MS (ICD-9-CM: 340). The person-year approach with Poisson assumption was used to evaluate the incidence density. We estimated the covariate-adjusted hazard ratio (HR) of MS incidence in relation to T2DM diabetes using a multiple Cox proportional hazard regression model.

    Results: Over 9 years of follow-up, 175 T2DM patients were newly diagnosed with MS, and 114 matched controls had the same first-ever diagnosis, representing a covariate-adjusted HR of 1.44 (95% confidence interval [CI], 1.08–1.94). The sex-specific adjusted HR for both men and women with T2DM was also elevated at 1.34 (95% CI, 0.81–2.23) and 1.51 (95% CI, 1.05–2.19), respectively. Women aged ≤50 years had the greatest risk of MS (HR 2.16; 95% CI, 1.02–4.59).

    Conclusion: This study demonstrated a moderate but significant association of T2DM with MS incidence, and the association was not confounded by socio-demographic characteristics or certain MS-related comorbidities.

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Short Communication
  • Chika Okada, Hiroyasu Iso, Junko Ishihara, Koutatsu Maruyama, Norie Sa ...
    2017 Volume 27 Issue 5 Pages 242-247
    Published: 2017
    Released on J-STAGE: May 11, 2017

    Background: The Japanese database of food amino acid composition was revised in 2010 after a 24-year interval. To examine the impact of the 2010 revision compared with that of the 1986 revision, we evaluated the validity and reliability of amino acid intakes assessed using a food frequency questionnaire (FFQ).

    Methods: A FFQ including 138 food items was compared with 7-day dietary records, completed during each distinct season, to assess validity and administered twice at approximately a 1-year interval, to assess reliability. We calculated amino acid intakes using a database that compensated for missing food items via the substitution method. Subjects were a subsample of two cohorts of the Japan Public Health Center-based prospective study. A total of 102 men and 113 women in Cohort I and 174 men and 176 women in Cohort II provided complete dietary records and the FFQ, of whom 101 men and 108 women of Cohort I and 143 men and 146 women of Cohort II completed the FFQ twice.

    Results: In the comparison of the FFQ with dietary records, the medians (ranges) of energy-adjusted correlation coefficients for validity were 0.35 (0.25–0.43) among men and 0.29 (0.19–0.40) among women in Cohort I, and 0.37 (0.21–0.52) and 0.38 (0.24–0.59), respectively, in Cohort II. Values for reliability were 0.47 (0.42–0.52) among men and 0.43 (0.38–0.50) among women in Cohort I, and 0.59 (0.52–0.70) and 0.54 (0.45–0.61), respectively, in Cohort II.

    Conclusions: The FFQ used in our prospective cohort study is a suitable tool for estimating amino acid intakes.

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