Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
Review Article
  • Hirokazu Tanaka, Noriko Ihana-Sugiyama, Takehiro Sugiyama, Mitsuru Ohs ...
    2019 年 29 巻 1 号 p. 1-10
    発行日: 2019/01/05
    公開日: 2019/01/05
    [早期公開] 公開日: 2018/06/23
    ジャーナル オープンアクセス

    Background: Several epidemiological studies have determined the relationship between diabetes and the incidence and/or prevalence of recently identified comorbid conditions (cancer, periodontal disease, fracture, cognitive impairment, and depression). These relationships may vary by country or race/ethnicity. We aimed to systematically review studies in this field conducted with the Japanese population because such a review in the Japanese population has never been undertaken.

    Methods: We conducted systematic literature searches in PubMed and Ichushi-Web databases for studies published until December 2016. Studies comparing the incidence and/or prevalence of the comorbidities among the Japanese population were included. The studies were classified as integrated analyses, cohort studies, case-control studies, or cross-sectional studies.

    Results: We identified 33 studies (cancer: 17, periodontal disease: 5, fracture: 5, cognitive impairment: 4, and depression: 2). Although several cohort studies and meta-analyses had assessed the development of cancer in diabetes, there was scant epidemiological evidence for the other conditions. Indeed, only one cohort study each had been conducted for periodontal disease, fracture, and cognitive impairment, whereas other evidence was cross-sectional, some of which was induced from baseline characteristic tables of studies designed for other purposes.

    Conclusion: In Japan, there is insufficient evidence about the relationship between diabetes and the incidence/prevalence of periodontal disease, fracture, cognitive impairment, and depression. By contrast, several cohort studies and integrated analyses have been conducted for the relationship with cancer. Further studies should be undertaken to estimate the contribution of diabetes on the incidence/prevalence of comorbidities that may be specific to the Japanese population.

Original Article
  • Ling Zha, Tomotaka Sobue, Tetsuhisa Kitamura, Yuri Kitamura, Norie Saw ...
    2019 年 29 巻 1 号 p. 11-17
    発行日: 2019/01/05
    公開日: 2019/01/05
    [早期公開] 公開日: 2018/07/21
    ジャーナル オープンアクセス

    Background: To update the findings of relative risk associated with smoking for all-cause mortality and that for lung cancer by considering longitudinal changes in smoking status during follow-up.

    Methods: Data from the JPHC study of 98,747 middle-aged Japanese adults, which started in 1990–1993, were analyzed. The information on smoking status was obtained from three questionnaire surveys (baseline, the 5th year, and the 10th year after the start of follow-up). A Poisson regression model was used to investigate the impact of smoking on mortality from all causes and lung cancer using two approaches. Model 1 used information only from baseline, while model 2 used the updated smoking status from all three surveys.

    Results: During the 15-year follow-up, 10,702 all-cause deaths (including 870 lung cancer cases) were identified. We compared the results obtained from two models. The relative risks associated with former smokers versus never smokers were 1.42 (95% confidence interval [CI], 1.31–1.54) among men and 1.46 (95% CI, 1.23–1.73) among women for all-cause mortality and 2.98 (95% CI, 2.09–4.24) among men and 1.83 (95% CI, 0.92–3.64) among women for lung cancer mortality, as determined using model 2. All of these were higher than the relative risks obtained from model 1. In addition, former smokers who had quit smoking due to disease during follow-up had a higher mortality risk than continuous smokers did in this study.

    Conclusions: The relative risks of all-cause mortality and mortality due to lung cancer among former smokers be higher than previously documented based on updated smoking status data from repeated surveys.

  • Yang Yu, Wendy Cozen, Amie E. Hwang, Myles G. Cockburn, John Zadnick, ...
    2019 年 29 巻 1 号 p. 18-25
    発行日: 2019/01/05
    公開日: 2019/01/05
    [早期公開] 公開日: 2018/09/29
    ジャーナル オープンアクセス

    Background: Inherited factors and maternal behaviors are thought to play an important role in the etiology of several congenital malformations. Twin studies can offer additional evidence regarding the contribution of genetic and lifestyle factors to common birth anomalies, but few large-scale studies have been reported.

    Methods: We included data from twins (20,803 pairs) from the population-based California Twin Program. We compared concordance in monozygotic (MZ) to dizygotic (DZ) twins for the following birth anomalies: clubfoot, oral cleft, spina bifida, muscular dystrophy, deafness, cerebral palsy, strabismus, and congenital heart defects. Each birth anomaly was also examined for the associations with birth characteristics (birthweight and birth order) and parental exposures (age, smoking, and parental education).

    Results: The overall prevalence of any selected birth anomaly in California twins was 38 per 1,000 persons, with a slightly decreasing trend from 1957–1982. For pairwise concordance in 6,752 MZ and 7,326 like-sex DZ twin pairs, high MZ:DZ concordance ratios were observed for clubfoot (CR 5.91; P = 0.043) and strabismus (CR 2.52; P = 0.001). Among the total 20,803 pairs, parental smoking was significantly associated with risk of spina bifida (OR 3.48; 95% CI, 1.48–8.18) and strabismus (OR 1.61; 95% CI, 1.28–2.03). A significant quadratic trend of increasing risk for clubfoot, spina bifida, and strabismus was found when examining whether father smoked, mother smoked, or both parents smoked relative to non-smoking parents (P = 0.029, 0.026, and 0.0005, respectively).

    Conclusions: Our results provide evidence for a multifactorial etiology underlying selected birth anomalies. Further research is needed to understand the biological mechanisms.

  • Mizuki Saito, Yoshihiro Shimazaki, Toshiya Nonoyama, Yasushi Tadokoro
    2019 年 29 巻 1 号 p. 26-32
    発行日: 2019/01/05
    公開日: 2019/01/05
    [早期公開] 公開日: 2018/06/16
    ジャーナル オープンアクセス

    Background: Many studies have reported that oral health status is associated with various systemic health issues. This study examined the correlations among oral health, lifestyle factors, and metabolic syndrome (MetS) in aged participants.

    Methods: We analyzed cross-sectional oral and medical health checkup data from 2,379 participants aged 75 and 80 years. MetS was diagnosed according to the Harmonization criteria, with the exception of the criterion for central obesity, and body mass index was used instead of waist circumference. Logistic regression analyses were performed to evaluate the correlation between oral health status and lifestyle factors and MetS in both sexes and by sex.

    Results: In both sexes, the odds ratio (OR) for MetS was 1.54 (95% confidence interval [CI], 1.10–2.17) among those who had 0–9 teeth compared with those with 20–28 teeth. MetS was significantly more likely for those eating quickly than those eating slowly (OR 2.06; 95% CI, 1.35–3.16). Participants using secondary oral hygiene products every day had a significantly lower OR (0.71; 95% CI, 0.55–0.92) for MetS than did those who did not. Participants with 0–9 teeth who ate quickly had a significantly higher OR (2.48; 95% CI, 1.06–5.78) for MetS compared with those with 20–28 teeth who ate slowly.

    Conclusion: These results suggest that maintaining teeth, eating slowly, and using secondary oral hygiene products every day are associated with a lower likelihood of MetS in the aged population.

Short Communication
  • Yasutake Tomata, Kumiko Tanno, Shu Zhang, Michiko Sakai, Kaori Kobayas ...
    2019 年 29 巻 1 号 p. 33-37
    発行日: 2019/01/05
    公開日: 2019/01/05
    [早期公開] 公開日: 2018/06/09
    ジャーナル オープンアクセス

    Background: Although lower household economic status is known to be a risk factor for obesity among school-age children, such an association among toddlers remains unclear. The present study investigated the association between household economic status and obesity in toddlers.

    Design: We conducted a cross-sectional study of children aged 4 years attending daycare centers in Japan. Information on subjective household economic status [“affluent”, “neither”, “less affluent”, or “non-affluent”] was collected via questionnaire from the children’s guardians in 2015. Based on measured values of height and weight, obesity was defined using the International Obesity Task Force cut-offs of overweight (BMI ≥17.47 for boys and ≥17.19 for girls). We used the logistic regression model to investigate the association between household economic status and obesity.

    Results: Among 1,848 respondents, the prevalence of obesity was 6.8%. Non-affluent household economic status was associated with a significantly higher probability of obesity in toddlers; the multivariate adjusted odds ratio for “non-affluent” households was 2.31 (95% confidence interval, 1.23–4.33) compared with “affluent” households.

    Conclusion: Perception of non-affluent economic status by the guardian was associated with a higher probability of toddler obesity. This result suggests that non-affluent household economic status is associated with obesity in toddlers.

Letter to the Editor