Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
30 巻 , 2 号
選択された号の論文の7件中1~7を表示しています
Original Article
  • Toshiki Fukasawa, Nanae Tanemura, Shinya Kimura, Hisashi Urushihara
    2020 年 30 巻 2 号 p. 57-66
    発行日: 2020/02/05
    公開日: 2020/02/05
    [早期公開] 公開日: 2019/03/02
    ジャーナル オープンアクセス
    電子付録

    Background: The Japanese Ministry of Health, Labour and Welfare introduced Specific Health Checkups (SHC) to identify individuals at risk of metabolic syndrome (MS). This study aimed to describe the SHC database developed by the Japan Medical Data Center Co., Ltd. (JMDC) as a means of exploring lifestyle behaviors and lifestyle diseases among working generations.

    Methods: We conducted a retrospective, cross-sectional study of employees and their families using the JMDC-SHC database to describe the prevalence of lifestyle behaviors (smoking, exercise, dietary habits, drinking habits, and sleeping) and lifestyle diseases (MS, hypertension, dyslipidemia, and diabetes mellitus). Results were compared with data from the 2015 National Health and Nutrition Survey (NHNS) in Japan as a benchmark.

    Results: All 646,869 enrollees in the JMDC-SHC database were included, of whom 66.5% were men. Age ranged from 40–74 years. Compared with the results of the NHNS, the JMDC-SHC subjects were younger and had fewer MS components and a lower prevalence of diabetes and hypertension. Subjects in their 40s were most likely to have unhealthy lifestyle behaviors in all age groups (eg, smoking: 41.0% in men and 10.2% in women). The SHC group had more favorable behaviors overall, but underweight was more prevalent in the SHC females.

    Conclusions: The JMDC-SHC population showed different lifestyle and lifestyle disease profiles to the NHNS population, probably due to its different age, gender, and employment distributions. Development of healthcare policies and plans for working generations would benefit from the selection of an age- and employment-appropriate database.

  • Atsushi Miyawaki, Yasuki Kobayashi, Ichiro Kawachi
    2020 年 30 巻 2 号 p. 67-73
    発行日: 2020/02/05
    公開日: 2020/02/05
    [早期公開] 公開日: 2019/01/19
    ジャーナル オープンアクセス
    電子付録

    Background: The association of sensory loss with mortality remains unclear. We aimed to explore the associations of hearing loss (HL), visual loss (VL), and dual sensory loss (DSL) with survival.

    Methods: Data came from the Komo-Ise study cohort in Gunma Prefecture, Japan, where the community-dwelling residents aged 40–69 years were followed up from 1993 to 2010. We analyzed 9,522 individuals who answered the follow-up questionnaires in 2000 (average age 64 [range, 47 to 77] years in 2000). The primary exposures were “HL only,” “VL only,” or “DSL”, with “no HL/VL” as the reference. These sensory loss statuses were assessed by asking the difficulty in hearing conversation or reading newspaper even with aids in the follow-up questionnaires in 2000. All-cause and cause-specific mortality were ascertained from linkage to death certificate data. Cox proportional hazards models adjusting for confounders, including demographic factors, socioeconomic status, and health status, were used. Potential mediators (depression, walking disability, and social participation) were additionally adjusted for.

    Results: There were 1,105 deaths over the 10-year follow-up. After adjustment for the potential confounders, HL and DSL were associated with increased all-cause mortality (hazard ratios of 1.74 [95% CI, 1.18–2.57] and 1.63 [95% CI, 1.09–2.42], respectively). Potential mediators explained a modest portion of the association. As for cause-specific mortality, HL was associated with increased cancer mortality, while VL and DSL were associated with increased cardiovascular disease mortality.

    Conclusions: Self-reported HL and DSL may be risk factors of mortality among middle-aged or elderly Japanese populations.

  • Hitomi Okubo, Tetsuji Yokoyama
    2020 年 30 巻 2 号 p. 74-83
    発行日: 2020/02/05
    公開日: 2020/02/05
    [早期公開] 公開日: 2019/03/02
    ジャーナル オープンアクセス
    電子付録

    Background: The National Nutrition Survey on Preschool Children, Japan (NNSPC) provides fundamental information for policy making for child nutrition. However, the response rate and background characteristics of subjects are unclear. Here, we examined response rate and sociodemographic factors related with response to the survey and evaluated the magnitude of bias due to selective response in the survey estimates of the NNSPC.

    Methods: This study was based on two national surveys conducted in 2015: the NNSPC and the Comprehensive Survey of Living Conditions (CSLC). Because potential survey participants of the NNSPC were children aged <6 years and their households that answered the CSLC, we examined response rates and respondent characteristics by linking the data of the NNSPC and CSLC. Multiple logistic regression analysis was used to identify sociodemographic factors associated with response. Potential bias caused by non-response in the survey estimates was examined after considering missingness through multiple imputation.

    Results: Among the 5,343 children who participated in the CSLC, 3,426 children responded to the NNSPC (response rate = 64.1%). Variables associated with response were living in a smaller city, a large number of children, three-generation family structure, older maternal age, and a non-working mother. The prevalence of overweight was underestimated by 20%, but the bias for almost all variables examined was small.

    Conclusions: Response to the survey varied by sociodemographic characteristics. Some biases, mostly small, were seen in survey estimates of the 2015 NNSPC. Further insight into the effect of selective response is important to assess associations between variables more precisely.

  • Takamasa Komiyama, Takashi Ohi, Yasutake Tomata, Fumiya Tanji, Ichiro ...
    2020 年 30 巻 2 号 p. 84-90
    発行日: 2020/02/05
    公開日: 2020/02/05
    [早期公開] 公開日: 2019/01/26
    ジャーナル オープンアクセス
    電子付録

    Background: A growing number of epidemiology studies have shown that poor oral health is associated with an increased incidence of functional disability. However, there are few studies in which the confounding bias is adjusted appropriately. In this study, we examined whether dental status is associated with functional disability in elderly Japanese using a 13-year prospective cohort study after elimination of confounding factors with propensity score matching.

    Methods: Participants were community-dwelling Japanese aged 70 years or older who lived in the Tsurugaya district of Sendai (n = 838). The number of remaining teeth (over 20 teeth vs 0–19 teeth) was defined as the exposure variable. The outcome was the incidence of functional disability, defined as the first certification of long-term care insurance (LTCI) in Japan. The variables that were used to determine propensity score matching were age, sex, body mass index (BMI), medical history (stroke, hypertension, myocardial infarction, cancer, and diabetes), smoking, alcohol consumption, educational attainment, depression symptoms, cognitive impairment, physical function, social support, and marital status.

    Results: As a result of the propensity score matching, 574 participants were selected. Participants with 0–19 teeth were more likely to develop functional disability than those with 20 or more teeth (hazard ratio 1.33; 95% confidence interval, 1.01–1.75).

    Conclusions: In this prospective cohort study targeting community-dwelling older adults in Japan, having less than 20 teeth was confirmed to be an independent risk factor for functional disability even after conducting propensity score matching. This study supports previous publications showing that oral health is associated with functional disability.

  • Yui Yamaoka, Takeo Fujiwara, Yoshihisa Fujino, Shinya Matsuda, Kiyohid ...
    2020 年 30 巻 2 号 p. 91-97
    発行日: 2020/02/05
    公開日: 2020/02/05
    [早期公開] 公開日: 2019/02/02
    ジャーナル オープンアクセス

    Background: Abusive head trauma (AHT) is the leading cause of fatal maltreatment among young children. The incidence of AHT in Japan, however, remains unknown. This study examined the incidence and distribution of age in months among young children under 12 months of age hospitalized with intracranial injury in Japan.

    Methods: We conducted a multicenter cross-sectional study of children under 36 months old admitted with intracranial injury to hospitals that employed the Diagnostic Procedure Combination (DPC) payment system between 2010 and 2013. Presumptive and possible AHT were defined using the combination of ICD-10 codes modified from the coding system recommended by the United States Centers for Disease Control and Prevention.

    Results: The average incidence was 7.2 (95% confidence interval [CI], 7.18–7.26) for presumptive and 41.7 (95% CI, 41.7–41.8) for possible AHT per 100,000 children less than 12 months old from 2010 to 2013. The distributions of age in months for both presumptive AHT and possible AHT had peaks at around 2 and 8 months.

    Conclusions: This is the first study to report the incidence of hospitalized children with presumptive and possible AHT using population-based data. Further datasets are needed to evaluate the incidence and specific preventive strategies to prevent AHT in infants during the months of highest risk.

  • Yunqing Yang, Atsushi Hozawa, Mana Kogure, Akira Narita, Takumi Hirata ...
    2020 年 30 巻 2 号 p. 98-107
    発行日: 2020/02/05
    公開日: 2020/02/05
    [早期公開] 公開日: 2019/02/09
    ジャーナル オープンアクセス
    電子付録

    Background: It has been reported that chronic inflammation may play an important role in the pathogenesis of several serious diseases and could be modulated by diet. Recently, the Dietary Inflammatory Index (DII®) was developed to assess the inflammatory potential of the overall diet. The DII has been reported as relevant to various diseases but has not been validated in Japanese. Thus, in the present study, we analyzed the relationship between DII scores and high-sensitivity C-reactive protein (hs-CRP) levels in a Japanese population.

    Methods: Data of the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010 (NIPPON DATA2010), which contained 2,898 participants aged 20 years or older from the National Health and Nutrition Survey of Japan (NHNS2010), were analyzed. Nutrient intakes derived from 1-day semi-weighing dietary records were used to calculate DII scores. Energy was adjusted using the residual method. Levels of hs-CRP were evaluated using nephelometric immunoassay. Multiple linear regression analyses were performed.

    Results: After adjusting for age, sex, smoking status, BMI, and physical activity, a significant association was observed between DII scores and log(CRP+1) (standard regression coefficient = 0.05, P < 0.01). Although it was not statistically significant, the positive association was consistently observed in almost all age-sex subgroups and the non-smoker subgroup.

    Conclusions: The current study confirmed that DII score was positively associated with hs-CRP in Japanese.

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