Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
29 巻 , 6 号
Original Article
  • Masaki Sumi, Takashi Hisamatsu, Akira Fujiyoshi, Aya Kadota, Naoko Miy ...
    2019 年 29 巻 6 号 p. 205-212
    発行日: 2019/06/05
    公開日: 2019/06/05
    [早期公開] 公開日: 2018/05/31
    ジャーナル オープンアクセス

    Background: Excessive alcohol intake has been shown to be associated with cardiovascular disease via metabolic pathways. However, the relationship between alcohol intake and obesity has not been fully elucidated. We aimed to examine the association of alcohol consumption with fat deposition and anthropometric measures.

    Methods: From 2006–2008, we conducted a cross-sectional study in a population-based sample of Japanese men aged 40 through 79 years. Areas of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated using computed tomography imaging. Based on a questionnaire, we classified participants into five groups according to weekly alcohol consumption, excluding former drinkers: non-drinkers (0 g/week), 0.1–160.9, 161–321.9, 322–482.9, and ≥483 g/week. Multivariable linear regression was used to estimate adjusted means of obesity indices for each group.

    Results: We analyzed 998 men (mean age and body mass index [BMI], 63.8 years and 23.6 kg/m2, respectively). Higher weekly alcohol consumption was strongly and significantly associated with higher abdominal VAT area, percentage of VAT, and VAT-to-SAT ratio (all P for trend <0.001), and also with waist circumferences and waist-to-hip ratio (P for trend = 0.042 and 0.007, respectively). These associations remained significant after further adjustment for BMI, whereas alcohol consumption had no significant association with abdominal SAT area.

    Conclusions: Higher alcohol consumption was associated with higher VAT area, VAT%, and VAT-to-SAT ratio, independent of confounders, including BMI, in general Japanese men. These results suggest that alcohol consumption may have a potential adverse effect on visceral fat deposition.

  • Ryoma Michishita, Takuro Matsuda, Shotaro Kawakami, Satoshi Tanaka, Ak ...
    2019 年 29 巻 6 号 p. 213-219
    発行日: 2019/06/05
    公開日: 2019/06/05
    [早期公開] 公開日: 2018/10/20
    ジャーナル オープンアクセス

    Background: This study investigated the relationship between long-term body weight gain after maturity and the incidence of chronic kidney disease (CKD).

    Methods: The participants were 303 men without a history of cardiovascular and cerebrovascular diseases, kidney dysfunction, or dialysis treatment. Their body weight gain after maturity was examined using a standardized self-administered questionnaire. The participants were divided into two groups based on the presence/absence of a body weight gain of ≥10 kg since 20 years of age.

    Results: After a 6-year follow-up, the cumulative incidence of CKD was significantly higher in participants with a body weight gain of ≥10 kg than in participants without body weight a body weight gain of ≥10 kg since 20 years of age (log-rank test: P = 0.041). After adjusting for the age, body mass index, estimated glomerular filtration rate levels, smoking and drinking habits, and the presence of hypertension, dyslipidemia, and hyperglycemia at baseline, the normal body weight participants with a body weight gain of ≥10 kg since 20 years of age was significantly related to the incidence of CKD (hazard ratio 2.47; 95% confidence of interval, 1.02–6.01, P = 0.045).

    Conclusions: These results suggest that long-term body weight gain after maturity in normal body weight participants may be associated with the incidence of CKD, independent of current body weight.

  • Masaaki Yamada, Michikazu Sekine, Takashi Tatsuse
    2019 年 29 巻 6 号 p. 220-226
    発行日: 2019/06/05
    公開日: 2019/06/05
    [早期公開] 公開日: 2018/08/25
    ジャーナル オープンアクセス

    Background: Childhood constipation is prevalent and negatively affects quality of life. Although psychological stress and family environment have been identified as risk factors, few epidemiological studies have examined this issue. We aimed to clarify associations of psychological stress and family environment with childhood constipation in a large-scale epidemiological study.

    Methods: In total, 7,998 children aged 9–10 years from the Toyama Birth Cohort Study completed questionnaires. Constipation was defined as bowel movements “less frequently than once every 2 days”. Children’s lifestyles, including food frequency, psychological stress, family environment, frequency of irritability, unwillingness to attend school, and frequency of interaction with their parents, were analyzed via multivariate logistic regression analysis. Parental employment status and presence at dinner were also examined.

    Results: In total, 312 children (3.9%) experienced constipation. Girls were more likely to experience constipation than boys (5.1% vs 2.8%). In addition, constipation was significantly associated with girl (odds ratio [OR] 1.97; 95% confidence interval [CI], 1.55–2.51), physical inactivity (OR 1.41; 95% CI, 1.01–1.95), overweight (OR 0.58; 95% CI, 0.40–0.85), infrequent fruit (OR 1.94; 95% CI, 1.42–2.66) and vegetable (OR 1.46; 95% CI, 1.03–2.05) consumption, frequent irritability (OR 1.76; 95% CI, 1.24–2.50), unwillingness to attend school (OR 1.66; 95% CI, 1.13–2.43), and infrequent interaction with parents (OR 1.48; 95% CI, 1.06–2.07). Children whose parents were absent at dinner were more likely to experience constipation compared to those whose parents were present at dinner; however, this differences were not statistically significant.

    Conclusion: Psychological stress and infrequent interaction with parents were as strongly associated with childhood constipation as conventional risk factors. Psychological stress and family environment should be more prioritized in caring childhood constipation.

  • Takafumi Abe, Tsuyoshi Hamano, Keiichi Onoda, Miwako Takeda, Kenta Oku ...
    2019 年 29 巻 6 号 p. 227-232
    発行日: 2019/06/05
    公開日: 2019/06/05
    [早期公開] 公開日: 2018/08/25
    ジャーナル オープンアクセス

    Background: Previous studies have reported an additive effect of moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) on depressive symptoms. However, no studies have been conducted in rural community settings. This cross-sectional study investigated whether the additive effect of MVPA and ST was associated with depressive symptoms in rural Japanese adults.

    Methods: We identified 2,814 participants from health examinations conducted in Shimane, rural Japan, in 2012 and analyzed data from 1,958 participants. We assessed depressive symptoms using the Zung Self-Rating Depression Scale and measured the total time spent on MVPA and ST using a Japanese short version of the International Physical Activity Questionnaire. Poisson regression analysis examined the prevalence ratios (PR) of depressive symptoms in nine category combinations of MVPA level (no, insufficient, or sufficient MVPA) and ST level (high, moderate, or low ST).

    Results: A total of 117 (6.0%) participants had depressive symptoms. Compared with the reference category (no MVPA/high ST), multivariate analysis showed that the likelihood of depressive symptoms was significantly lower in the sufficient MVPA/low ST category (PR 0.23; 95% confidence intervals [CI], 0.08–0.66), insufficient MVPA/low ST category (PR 0.37; 95% CI, 0.16–0.86), and insufficient MVPA/moderate ST category (PR 0.39; 95% CI, 0.17–0.90).

    Conclusion: Analysis of the additive effect of MVPA and ST showed that the combinational category of sufficient MVPA and low ST had the lowest prevalence of depressive symptoms in rural Japanese adults. Moderate ST and low ST showed significantly lower likelihoods of depressive symptoms, regardless of insufficient MVPA.

  • Shigekazu Ukawa, Wenjing Zhao, Hiroshi Yatsuya, Kazumasa Yamagishi, Na ...
    2019 年 29 巻 6 号 p. 233-237
    発行日: 2019/06/05
    公開日: 2019/06/05
    [早期公開] 公開日: 2018/09/22
    ジャーナル オープンアクセス

    Background: The association between daily walking and pneumonia mortality, stratified by the presence of disease conditions, such as myocardial infarction (MI) or stroke, was investigated.

    Methods: The study participants were 22,280 Japanese individuals (9,067 men and 13,213 women) aged 65–79 years. Inverse propensity weighted competing risk model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for pneumonia mortality.

    Results: After a median of 11.9 years of follow-up, 1,203 participants died of pneumonia. Participants who did not have a history of MI or stroke and who walked for 1 hour/day or more were less likely to die from pneumonia (HR 0.90; 95% CI, 0.82–0.98) than those walked for 0.5 hours/day. A similar inverse association of pneumonia and walking (0.5 hours/day) was observed among participants with a history of MI (HR 0.66; 95% CI, 0.48–0.90). Among the participants with a history of stroke, those who walked for 0.6–0.9 hours/day were less likely to die because of pneumonia (HR 0.65; 95% CI, 0.43–0.98).

    Conclusions: Regular walking for ≥1 hour/day may reduce the risk of pneumonia mortality in elderly individuals with or without cardiovascular disease history.

Short Communication
  • Mai Utada, Shuji Yonehara, Kotaro Ozasa
    2019 年 29 巻 6 号 p. 238-240
    発行日: 2019/06/05
    公開日: 2019/06/05
    [早期公開] 公開日: 2018/09/15
    ジャーナル オープンアクセス

    Background: Histological classification of lung cancer is essential for investigations of carcinogenesis and treatment selection. We examined the temporal changes of lung cancer histological subtypes.

    Methods: Lung cancer cases diagnosed in the Life Span Study cohort between 1958 and 1999 were collected from tumor registries (TR), mainly consisting of population-based cancer registries. A total of 1,025 cases were histologically reviewed according to the World Health Organization 2004 Classification by a panel of pathologists (PP). Sensitivity and specificity of diagnoses in TR were calculated, assuming that the diagnosis by PP was the gold standard.

    Results: Sensitivity and specificity were 0.91 and 0.92 for adenocarcinoma (AD), respectively, and 0.92 and 0.94, respectively, for squamous cell carcinoma (SQ). They were similar for AD and SQ throughout the observation period. For small cell carcinoma (SM), sensitivity was low until about 1980 (0.47 in 1958–1969, and 0.61 in 1970–1979) and then became higher thereafter (0.98 in 1980–1989, and 0.95 in 1990–1999), whereas specificity was high during the whole period (range 0.99 to 1.00). Among 45 cases that were not reported as SM in TR but diagnosed as SM by PP, 16 cases were recorded as undifferentiated carcinoma in TR.

    Conclusion: Diagnosis of AD and SQ of lung cancer were generally consistent between TR records and PP review, but SMs tended to be coded as other histological types until the 1970s.