Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
30 巻 , 5 号
選択された号の論文の6件中1~6を表示しています
Original Article
  • Kunihito Nishikawa, Masayuki Yamamoto
    2020 年 30 巻 5 号 p. 201-207
    発行日: 2020/05/05
    公開日: 2020/05/05
    [早期公開] 公開日: 2019/04/13
    ジャーナル オープンアクセス

    Background: The combined associations of body mass index (BMI) levels and metabolic dysfunction with medical and dental care utilizations is unclear.

    Methods: A 4-year follow-up study was performed in 16,386 Japanese male employees (mean age 48.2 [standard deviation, 11.0] years) without a history of cardiovascular disease (CVD), cancer, or renal failure. They were classified into eight phenotypes based on four BMI levels (underweight, <18.5; normal weight, 18.5–24.9; overweight, 25.0–29.9; and obese, ≥30.0 kg/m2) and the presence or absence of ≥2 of 4 metabolic abnormalities: high blood pressure, high triglycerides, low high-density-lipoprotein cholesterol, and high blood sugar. Based on their health insurance claims data, we compared medical and dental care days and costs among the eight different BMI/metabolic phenotypes during 2010–2013.

    Results: The combinations of BMI levels and metabolic status were significantly associated with the adjusted mean and median medical outpatient days and costs and the median dental outpatient days and costs. The obese/unhealthy subjects had the highest medical outpatient days and costs, and the underweight/unhealthy subjects had the highest dental outpatient days and costs. The underweight/unhealthy subjects also had the highest medical inpatient days and hospitalization rates of CVD, and had higher medical costs compared with the obese/healthy subjects. The differences in median medical costs between healthy and unhealthy phenotypes were larger year by year across all BMI levels.

    Conclusions: Identification of obesity phenotypes using both BMI levels (including the underweight level) and metabolic status may more precisely predict healthcare days and costs compared with either BMI or metabolic status alone.

  • Bingqing Liu, Lulu Song, Lina Zhang, Lulin Wang, Mingyang Wu, Shunqing ...
    2020 年 30 巻 5 号 p. 208-212
    発行日: 2020/05/05
    公開日: 2020/05/05
    [早期公開] 公開日: 2019/04/20
    ジャーナル オープンアクセス

    Background: Pregnancy leads to substantial maternal metabolic and lifestyle alterations. However, it is still unclear whether repeated exposure to these changes will influence the development of gestational diabetes mellitus (GDM). In the present study, we aimed to investigate the association between the number of pregnancies and GDM among Chinese women.

    Methods: A total of 7,008 subjects from the Healthy Baby Cohort study were included in this study. The number of pregnancies was classified into three categories: 1, 2, or ≥3 pregnancies. GDM was diagnosed using International Association of Diabetes and Pregnancy Study Groups criteria. Multivariate logistic regression models were used.

    Results: In the fully adjusted model, women with ≥3 pregnancies had a 1.27-fold (95% confidence interval [CI], 1.05–1.54) higher risk of GDM. Among women ≥30 years old, 2 and ≥3 pregnancies were associated with a higher risk of GDM (odds ratio [OR] 1.32; 95% CI, 1.01–1.73 and OR 1.54; 95% CI, 1.17–2.01, respectively). Among women with a pre-pregnancy BMI <24 kg/m2, ≥3 pregnancies were associated with a 1.35-fold (95% CI, 1.09–1.67) higher risk of GDM.

    Conclusions: Our findings suggested that higher numbers of pregnancies is an independent risk factor of GDM. The association between number of pregnancies and GDM was more prominent among women who were ≥30 years old or with a pre-pregnancy BMI <24 kg/m2.

  • Yuko Goto, Keiko Wada, Takahiro Uji, Sachi Koda, Fumi Mizuta, Michiyo ...
    2020 年 30 巻 5 号 p. 213-218
    発行日: 2020/05/05
    公開日: 2020/05/05
    [早期公開] 公開日: 2019/04/20
    ジャーナル オープンアクセス

    Background: The association between the number of teeth and mortality among community-dwelling people has been examined in many epidemiological studies. However, few Japanese studies have included cancer mortality as an endpoint. We prospectively investigated the association between number of remaining teeth and all-cause and cancer mortality in a Japanese community.

    Methods: This study included participants in the Takayama Study who were aged 35–70 years old at baseline in 1992. Information on the number of remaining teeth was obtained from 11,273 participants via questionnaire at the second survey in 2002. The response rate was 66.9%. Deaths and their causes were ascertained during 11.8 years of follow-up.

    Results: A total of 1,098 deaths (435 cancer-related and 235 cardiovascular-related) were identified during the follow-up period. After adjusting for covariates, participants with 0 to 9 teeth were at moderate but significantly increased risk of all-cause mortality (hazard ratio [HR] 1.19; 95% confidence interval [CI], 1.03–1.39) and cancer mortality (HR 1.31; 95% CI, 1.03–1.67) compared to those with 20 or more teeth. With regard to cancer site, a significant association was observed for lung cancer (HR for 0–9 teeth vs. 20 or more teeth, 1.75; 95% CI, 1.08–2.83). This association was somewhat strengthened among never-smokers (HR 3.56; 95% CI, 1.02–12.45).

    Conclusions: We observed that a lower number of remaining teeth was significantly associated with increased risk from all-cause and lung cancer mortality. Further studies on the number of teeth and lung and other types of cancer are needed.

  • Yasuo Haruyama, Ayako Nakagawa, Kumiko Kato, Masayo Motoi, Toshimi Sai ...
    2020 年 30 巻 5 号 p. 219-226
    発行日: 2020/05/05
    公開日: 2020/05/05
    [早期公開] 公開日: 2019/05/11
    ジャーナル オープンアクセス

    Introduction: To clarify the incidences of metabolic syndrome (MS) and risks in young Japanese adults by gender.

    Methods: A total of 58,901 adults who had undergone annual health check-ups in 2010 without a diagnosis of MS or missing data were divided into three age groups (20s through 40s) by gender. Participants were followed up for 6 years for new-onset MS according to Japanese criteria. The incidences of MS and risks were analyzed using the Cox proportional hazards model to adjust for confounding factors.

    Results: The incidences of MS per 1,000 person-years were 2.2, 5.5, and 10.2 for women aged in their 20s, 30s, and 40s, respectively, and 26.3, 40.5, and 57.4 in the respective men groups. Compared with the group aged in their 40s, the hazard ratios of new MS were 0.19 (95% confidence interval [CI], 0.13–0.29) for women in their 20s and 0.50 (95% CI, 0.41–0.61) for women in their 30s, and 0.46 (95% CI, 0.42–0.50) and 0.70 (95% CI, 0.66–0.73) for men in their 20s and 30s, respectively, after adjustment for lifestyle factors. For women, MS was associated with smoking in their 20s and 30s, and eating speed in their 30s, and for men, was associated with physical activity, eating speed, alcohol intake in their 20s and 30s, and smoking in their 30s.

    Conclusion: Our findings suggest that the incidences of MS in the 20s and 30s are lower, but account for about 20–50% of women with MS and 50–70% of men with MS in their 40s. However, the data are not negligible and early lifestyle intervention for MS is necessary in young adults.

  • Junpei Yamamoto, Junko Ishihara, Ayaka Kotemori, Takahiro Yoshizaki, A ...
    2020 年 30 巻 5 号 p. 227-235
    発行日: 2020/05/05
    公開日: 2020/05/05
    [早期公開] 公開日: 2019/05/11
    ジャーナル オープンアクセス
    電子付録

    Background: Some Okinawan vegetables have been reported to have anti-diabetic activity; however, no prospective cohort study has clarified whether consumption of Okinawan vegetables is associated with a risk of type 2 diabetes. This study aimed to determine the association between consumption of Okinawan vegetables and risk of type 2 diabetes through a large-scale, population-based, prospective study in Japan.

    Methods: We examined 10,732 participants (4,714 men and 6,018 women) aged 45–74 years who resided in Okinawa. Participants were asked to answer a 147-item food frequency questionnaire. We calculated the overall amount of Okinawan vegetables consumed and the amount of seven specific kinds of Okinawan vegetables consumed. The odds ratios (ORs) for self-reported type 2 diabetes during 5 years of follow-up were estimated via multivariate logistic regression analysis.

    Results: During the 5-year period, 216 new cases (123 men and 93 women) of type 2 diabetes were reported. Comparing the highest tertile to the lowest tertile of intake, the overall amount of Okinawan vegetables consumed was not associated with risk of type 2 diabetes in men (OR 1.22; 95% confidence interval [CI], 0.74–2.01, P-trend = 0.53) or in women (OR 0.96; 95% CI, 0.57–1.62, P-trend = 0.89). The consumption of seven specific kinds of Okinawan vegetables was also not associated with the risk of type 2 diabetes.

    Conclusions: The consumption of total Okinawan vegetables was not associated with the risk of type 2 diabetes.

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