Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
早期公開論文
早期公開論文の100件中1~50を表示しています
  • Wei-Jie Gong, Daniel Yee-Tak Fong, Man-Ping Wang, Tai-Hing Lam, Thomas ...
    論文ID: JE20210081
    発行日: 2021年
    [早期公開] 公開日: 2021/06/19
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background

    Breakfast is deemed the most important meal of the day. We examined the prospective associations of breakfast habits with emotional/behavioral problems in adolescents and potential effect modification.

    Methods

    115,217 Primary 6 students (US grade 6, age 11.9±0.59 years) who attended the Student Health Service of Department of Health in Hong Kong in 2004/05, 2006/07, 2008/09 were followed till Secondary 6 (US grade 12). Emotional/behavioral problems were biennially examined using Youth Self-Report since Secondary 2 (US grade 8). Lifestyles were biennially examined using standardized questionnaires since Primary 6. Prospective associations of breakfast habit with emotional/behavioral problems and potential effect modification were examined using generalized estimating equations.

    Results

    Compared with eating breakfast at home, eating breakfast away from home was significantly associated with total emotional/behavioral problems and 7 syndromes, including withdrawal, somatic complaints, anxiety/depression, thought problems, attention problems, delinquent behaviors and aggressive behaviors (adjusted odds ratios [AORs] 1.22-2.04), while skipping breakfast showed stronger associations with the above problems and social problems (AORs 1.34-2.29). Stronger associations were observed in younger students for total and attention problems (P<0.03) and in those with lower weight status for delinquent behaviors (P=0.005).

    Conclusions

    Eating breakfast away from home and especially skipping breakfast were prospectively associated with more adolescent emotional/behavioral problems. The associations weakened with increasing age for total emotional/behavioral and attention problems, and weakened with higher weight status for delinquent behaviors, highlighting the vulnerability of younger and underweight children. If the associations are causal, increasing home breakfast may reduce adolescent emotional/behavioral problems and benefit psychosocial health.

  • Kenji Matsui, Yusuke Inoue, Keiichiro Yamamoto
    論文ID: JE20210263
    発行日: 2021年
    [早期公開] 公開日: 2021/06/19
    ジャーナル オープンアクセス 早期公開
  • Nam-Hee Kim, Hawazin W. Elani, Ichiro Kawachi
    論文ID: JE20200596
    発行日: 2021年
    [早期公開] 公開日: 2021/06/12
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: In 2012, the Korean government expanded dental insurance for the elderly to promote improved access to dental care. We examined the causal effect of this policy on dental care needs, focusing on low-income older adults.

    Methods: We compared data before and after policy implementation using double difference (DD) and triple difference (DDD) analyses. We used the nationally representative data from the Korea National Health and Nutrition Examination Survey from 2010 and 2016–2018. Individuals aged ≥65 years were included in the treatment group, and individuals aged <65 years were included in the control group.

    Results: Dental insurance expansion was associated with a paradoxical increase in perceived unmet dental needs among elderly individuals (8.8 percentage points increase, 95% CI: 4.7 to 13.0). However, there were improvements in dental prosthetics outcomes (denture wearing [4.0 percentage points, 95% CI: 0.2 to 7.9] and dental implants [5.0 percentage points, 95% CI: 2.1 to 7.9]; P < 0.01). Upon analyzing low-income elderly individuals by using DDD analysis, we found that the insurance expansion led to a 21.6% lower increase in unmet dental needs among low-income adults, compared to high-income adults (95% CI: -35.0 to -8.5; P < 0.01).

    Conclusions: Dental insurance expansion in South Korea resulted in improvements in access to dental prosthetic services overall. It also led to a lower increase in unmet dental needs among low-income older adults, compared to high-income adults.

  • Koichiro Shiba, Takuya Kawahara
    論文ID: JE20210145
    発行日: 2021年
    [早期公開] 公開日: 2021/06/12
    ジャーナル オープンアクセス 早期公開
    電子付録

    Methods based on propensity score (PS) have become increasingly popular as a tool for causal inference. A better understanding of the relative advantages and disadvantages of the alternative analytic approaches can contribute to the optimal choice and use of a specific PS method over other methods. In this article, we provide an accessible overview of causal inference from observational data and two major PS-based methods (matching and inverse probability weighting), focusing on the underlying assumptions and decision-making processes. We then discuss common pitfalls and tips for applying the PS methods to empirical research and compare the conventional multivariable outcome regression and the two alternative PS-based methods (i.e., matching and inverse probability weighting) and discuss their similarities and differences. Although we note subtle differences in causal identification assumptions, we highlight that the methods are distinct primarily in terms of the statistical modeling assumptions involved and the target population for which exposure effects are being estimated for.

  • Tomoko Tsubokawa, Yugo Shobugawa, Seitaro Iguchi, Tsubasa Suzuki, Mich ...
    論文ID: JE20200154
    発行日: 2021年
    [早期公開] 公開日: 2021/06/11
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Homebound status is one of the most important risk factors associated with functional decline and long-term care in older adults. Studies show that neighborhood built environment and community social capital may be related to homebound status. This study aimed to clarify the association between homebound status for community-dwelling older adults and community environment—including social capital and neighborhood built environment—in rural and urban areas.

    Methods: We surveyed people aged 65 years and older residing in three municipalities of Niigata Prefecture, Japan, who were not certified as requiring long-term care. The dependent variable was homebound status; explanatory variables were community-level social capital and neighborhood built environment. Covariates were age, sex, household, marital status, socioeconomic status, instrumental activities of daily living, the Geriatric Depression Scale-15, self-rated health, number of diseases under care, and individual social capital. The association between community social capital or neighborhood built environment and homebound status, stratified by rural/urban areas, was investigated using multilevel logistic regression analysis.

    Results: Among older adults (n = 18,099), the homebound status prevalence rate was 6.9% in rural areas and 4.2% in urban areas. The multilevel analysis showed that, in rural areas, fewer older adults were homebound in communities with higher civic participation and with suitable parks or pavements for walking and exercising. However, no significant association was found between community social capital or neighborhood built environment and homebound status for urban older adults.

    Conclusions: Community social capital and neighborhood built environment were significantly associated with homebound status in older adults in rural areas.

  • Yuuki Tsuchihashi, Yuzo Arima, Takuri Takahashi, Kazuhiko Kanou, Yusuk ...
    論文ID: JE20200519
    発行日: 2021年
    [早期公開] 公開日: 2021/05/29
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background

    Notifications of novel coronavirus infections increased in early 2020 in Japan. We described characteristics of novel coronavirus infection cases and analyzed risk factors for severe outcomes.

    Methods

    Cases were persons with laboratory-confirmed novel coronavirus infection reported under national surveillance between January and March 2020. Clinical characteristics were described, and factors associated with severe outcomes (intensive care unit [ICU] admission, invasive ventilation/death) were analyzed using Poisson regression.

    Results

    Among the 516 cases analyzed, median age was 60 years (range: 1–97 years) and 285 (55%) were male. Common symptoms/signs were fever (375/475, 79%), cough (353/465, 76%), and pneumonia (245/387, 63%). Ten (2%) cases died. Of the 348 cases with data, 50 (14%) required invasive ventilation. Adjusted for each other, male gender and 1-year increase in age were associated with ICU admission (risk ratio (RR) 4.18; 95% confidence interval (CI), 1.69–10.32 and RR 1.05; 95%CI, 1.03–1.08, respectively) and invasive ventilation/death (RR 2.79; 95%CI, 1.49–5.21 and RR 1.06; 95%CI, 1.04–1.08). Diabetes, dyslipidemia, hyperuricemia, and lung diseases were also associated with severe outcomes. Of the 80 cases asymptomatic at hospitalization, 40 developed symptoms and five of them >70 years of age required invasive ventilation.

    Conclusions

    The early stage of the novel coronavirus epidemic in Japan disproportionately affected the elderly. Older age, male gender, and underlying conditions were associated with severe outcomes. Notably, some elderly case-patients who were asymptomatic at diagnosis and promptly hospitalized still went on to develop severe disease, indicating the importance of careful monitoring of certain populations.

  • Wei-Te Wu, Cheng-Ya Pan, Szu-Li Chang, Yi-Hau Chen, Chuan-Jong Tung, P ...
    論文ID: JE20210020
    発行日: 2021年
    [早期公開] 公開日: 2021/05/29
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: This cohort was established to evaluate whether 38-year radiation exposure (since the start of nuclear reactor operations) is related to cancer risk in residents near three near nuclear power plants (NPPs).

    Methods: This cohort study enrolled all residents who lived near (within 8 km) of any of the three NPPs in Taiwan from 1978 to 2016 (n=214,502; person-years=4,660,189). The control population (n=257,475; person-years=6,282,390) from three towns comprised all residents having lived far (more than 15 km) from all three NPPs. Radiation exposure will be assessed by computer programs GASPAR-II and LADTAP-II by following methodologies provided in the USNRC regulatory guides. We calculated the cumulative individual tissue organ equivalent dose and cumulative effective dose for each resident. This study presents the number of new cancer cases and prevalence in the residence-nearest NPP group and control group in the 38-year research observation period.

    Conclusions: TNPECS provides a valuable platform for research and opens unique possibilities for testing whether radiation exposure since the start of operations of nuclear reactors will affect health across the life course. The release of radioactive nuclear species caused by the operation of NPPs caused residents to have an effective dose between 10-7 and 10-3 mSv / year. The mean of cumulative medical radiation exposure dose between the residence-nearest NPP group and the control group is not different (7.69±18.39 mSv and 7.61±19.17 mSv, p=0.114).

  • Kenta Tanaka, Tomotaka Sobue, Ling Zha, Tetsuhisa Kitamura, Norie Sawa ...
    論文ID: JE20210057
    発行日: 2021年
    [早期公開] 公開日: 2021/05/29
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Few cohort studies have used multiple surveys of screening attendance to simultaneously evaluate the effectiveness of fecal occult blood test (FOBT) and colonoscopy.

    Methods: We analyzed data of 30,381 middle-aged Japanese adults from a population-based prospective cohort study. Information on FOBT and colonoscopy was obtained from three questionnaire surveys (every 5 years). We classified the subjects into three groups—the FOBT (15,649 subjects), screening colonoscopy (2,407 subjects), and unscreened (12,325 subjects) groups. We used the unscreened group as reference group to compare the mortality and incidence of colorectal cancer (CRC).

    Results: During the 14-year follow-up, 64, 12, and 104 CRC deaths were identified in the FOBT, screening colonoscopy, and unscreened groups, respectively. The risk of CRC death reduced with increasing the number of FOBTs (p for trend=0.02) and reduced by 44% in the subjects screened twice or thrice using FOBT (HR=0.56 95% CI, 0.33-0.94). Significant decreases were seen for the incidence of CRC, but not seen for the incidence of non-advanced CRC in the FOBT group. Concerning the screening colonoscopy, subjects screened at the start of follow-up showed a 69% reduced risk of CRC death (HR=0.31, 95% CI, 0.10–0.9996). Significant decreases were also seen for the incidence of CRC and non-advanced CRC in the subjects screened at the start of follow-up.

    Conclusion: FOBT, depending on the number of FOBTs, and colonoscopy, depending on recency, reduced the risk of death due to CRC and the incidence of CRC.

  • Han Eol Jeong, Hyesung Lee, In-Sun Oh, Kristian B. Filion, Ju-Young Sh ...
    論文ID: JE20210099
    発行日: 2021年
    [早期公開] 公開日: 2021/05/29
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Impact of immeasurable time bias (IMTB) is yet to be examined in self-controlled designs.

    Methods: We conducted case-crossover, case-time-control, and case-case-time-control analyses using Korea’s healthcare database. Two empirical examples among elderly patients were used: 1) benzodiazepines-hip fracture; 2) benzodiazepines-mortality. For cases, the date of hip fracture diagnosis or death was defined as the index date, and the inherited date of their matched cases for controls or future cases. Exposure was assessed in the 1-30 day (hazard) and 61-90 day (control) windows preceding the index date. A non-missing exposure setting included in- and outpatient prescriptions and the pseudo-outpatient setting included only the outpatients. Conditional logistic regression was done to estimate odds ratio (OR) with 95% confidence intervals (CI), where the relative difference in OR among the two settings was calculated to quantify the IMTB.

    Results: The IMTB had negligible impacts in the hip fracture example in the case-crossover (non-missing exposure setting OR 1.27, 95% CI 1.12-1.44; pseudo-outpatient setting 1.21, 1.06-1.39; magnitude 0.05), case-time-control (1.18, 0.98-1.44; 1.13, 0.92-1.38; 0.04), and case-case-time-control analyses (0.99, 0.80-1.23; 0.94, 0.75-1.18; 0.05). In the mortality example, IMTB had significant impacts in the case-crossover (1.44, 1.36-1.52; 0.72, 0.67-0.78; 1.00), case-time-control (1.38, 1.26-1.51; 0.68, 0.61-0.76; 1.03), and case-case-time-control analyses (1.27, 1.15-1.40; 0.62, 0.55-0.69; 1.05).

    Conclusions: Although IMTB had negligible impacts on the drug’s effect on acute events as these are unlikely to be accompanied with hospitalizations, it negatively biased the drug’s effect on mortality, an outcome with prodromal phases, in the three self-controlled designs.

  • Makiko Sekiyama, Shin Yamazaki, Takehiro Michikawa, Shoji F. Nakayama, ...
    論文ID: JE20200448
    発行日: 2020年
    [早期公開] 公開日: 2020/12/26
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: The Japan Environment and Children’s Study (JECS) is a nationwide birth cohort study investigating environmental effects on children’s health and development. A Sub-Cohort Study has begun, conducting extended exposure and outcome measurements by targeting a subgroup randomly selected from the JECS Main Study. We report the Sub-Cohort Study methodology and participants’ baseline profiles.

    Methods: Of 100,148 children in the JECS Main Study, children born after April 1, 2013 who met eligibility criteria ([1] all questionnaire and medical record data from children and their mothers collected from the first trimester to 6 months of age, [2] biospecimens [except umbilical cord blood] from children and their mothers collected at first to second/third trimester and delivery) were randomly selected for each Regional Centre at regular intervals. Face-to-face assessment of neuropsychiatric development, body measurement, paediatrician’s examination, blood/urine collection for clinical testing and chemical analysis, and home visits (ambient and indoor air measurement and dust collection) are conducted. Participants are followed up at 1.5 and 3 years old for home visits, and 2, 4, 6, and 8 years old for developmental/medical examination. The details of protocols after age 10 are under discussion.

    Results: Of 10,302 selected children, 5,017 participated. The profiles of the participating mothers, fathers and children did not substantially differ between the Main Study and Sub-Cohort Study.

    Conclusion: The JECS Sub-Cohort Study offers a platform for investigating associations between environmental exposure and outcomes.

  • Tetsuro Kobayashi, Hiroshi Nishiura
    論文ID: JE20200455
    発行日: 2020年
    [早期公開] 公開日: 2020/12/05
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: A measles outbreak involving 60 cases occurred in Yamagata, Japan in 2017. Using two different mathematical models for different datasets, we aimed to estimate measles transmissibility over time and explore any heterogeneous transmission patterns.

    Methods: The first model relied on the temporal distribution for date of illness onset for cases, and a generation-dependent model was applied to the data. Another model focused on the transmission network. Using the illness-onset date along with the serial interval and geographical location of exposure, we reconstructed a transmission network with 19 unknown links. We then compared the number of secondary transmissions with and without clinical symptoms or laboratory findings.

    Results: Using a generation-dependent model (assuming three generations other than the index case), the reproduction number (R) over generations 0, 1, and 2 were 25.3, 1.3, and <0.1, respectively, explicitly yielding the transmissibility over each generation. The network data enabled us to demonstrate that both the mean and the variance for the number of secondary transmissions per primary case declined over time. Comparing primary cases with and without secondary transmission, high viral shedding was the only significant determinant (P < 0.01).

    Conclusions: The R declined abruptly over subsequent generations. Use of network data revealed the distribution of the number of secondary transmissions per primary case and also allowed us to identify possible secondary transmission risk factors. High viral shedding from the throat mucosa was identified as a potential predictor of secondary transmission.

  • Yusuke Inoue, Taketoshi Okita
    論文ID: JE20210169
    発行日: 2021年
    [早期公開] 公開日: 2021/04/24
    ジャーナル オープンアクセス 早期公開
    電子付録
  • Kanami Tanigawa, Satoyo Ikehara, Meishan Cui, Yoko Kawanishi, Tadashi ...
    論文ID: JE20210031
    発行日: 2021年
    [早期公開] 公開日: 2021/05/22
    ジャーナル オープンアクセス 早期公開

    Background: Both short and long interpregnancy intervals (IPIs) have been associated with risk of preterm birth, but the evidence is limited in Asians. It is also uncertain whether the association is modified by dietary folate intake or folic acid supplementation during pregnancy. Thus, we examined associations between IPI and risk of preterm birth, and effect modification of those associations by dietary intake of folate and supplementation with folic acid on the basis of a nationwide birth cohort study.

    Methods: Among 103,062 pregnancies registered in the Japan Environment and Children’s Study, 55,203 singleton live-birth pregnancies were included in the analysis. We calculated IPI using birth date, gestational age at birth of offspring, and birth data of the latest offspring. Odds ratios (ORs) and 95% confidence intervals (CIs) of the risk of preterm birth were estimated according to IPI categories.

    Results: Both <6-month and ≥120-month IPIs were associated with an increased risk of preterm birth, compared with an 18–23-month IPI. The multivariable ORs were 1.63 (95% CI, 1.30–2.04) for <6-month and 1.41 (95% CI, 1.11–1.79) for ≥120-month IPIs. These associations were confined to women with inadequate intake of dietary folate and folic acid supplementation during pregnancy. Multivariable ORs were 1.76 (95% CI, 1.35–2.29) for <6-month IPI and 1.65 (95% CI, 1.24–2.19) for ≥120-month IPI.

    Conclusion: Both <6-month and ≥120-month IPIs were associated with an increased risk of preterm birth. These higher risks were confined to women with inadequate intake of dietary folate and folic acid supplementation during pregnancy.

  • Masako Shimoda, Kayo Kaneko, Takeshi Nakagawa, Naoko Kawano, Rei Otsuk ...
    論文ID: JE20210128
    発行日: 2021年
    [早期公開] 公開日: 2021/05/22
    ジャーナル オープンアクセス 早期公開

    Background: There is limited evidence regarding the relationship between Diabetes mellitus (DM) in middle age and mild cognitive impairment after a follow-up. Therefore, we investigated the relationship between fasting blood glucose (FBG) levels in middle age and cognitive function (assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in later life, following over 15 years of follow-up in the Aichi Workers’ Cohort Study in Japan.

    Methods: Participants were 253 former local government employees aged 60–79 years in 2018 who participated in a baseline survey conducted in 2002. Using baseline FBG levels and self-reported history, participants were classified into the normal, impaired fasting glucose (IFG) and, and DM groups. Total MoCA-J score ranges from 0 to 30, and cognitive impairment was defined as MoCA-J score ≤25 in this study. A general linear model was used to estimate the mean MoCA-J scores in the FBG groups, adjusted for age, sex, educational year, smoking status, alcohol consumption, physical activity, body mass index, systolic blood pressure, total cholesterol, and estimated glomerular filtration rate.

    Results: The mean MoCA-J score in the total population was 25.0, and the prevalence of MoCA-J score ≤25 was 49.0%. Multivariable-adjusted total MoCA-J scores were 25.2, 24.8, and 23.4 in the normal, IFG, and DM groups, respectively. The odds ratio of MoCA-J score ≤25 in the DM group was 3.29.

    Conclusions: FBG level in middle age was negatively associated with total MoCA-J scores assessed later in life, independent of confounding variables.

  • Takashi Oshio, Satoshi Shimizutani
    論文ID: JE20210030
    発行日: 2021年
    [早期公開] 公開日: 2021/05/15
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Encouraging older adults to continue working longer would be a realistic solution to the shrinking labor force, which is a result of the aging population. This study examined whether working longer improves the health of older adults.

    Methods: We used repeated cross-sectional data from 1,483,591 individuals aged 55–69 years collected from 11 waves of a nationwide population-based survey conducted in Japan from 1986 to 2016. We estimated pooled regression models to explain health outcomes by work status, controlling for potential endogeneity biases. Based on the estimation results, we conducted simulations to predict the health impact of policy measures that encourage older adults to participate in the labor force.

    Results: The regression analysis showed that work status had a mixed health impact. For example, work reduced the probability of poor self-rated health by 6.7 (95% confidence interval [CI]: 6.2–7.2) percentage points and increased that of psychological distress by 12.2 (95% CI: 11.3–13.1) percentage points. The simulation results showed that raising both the mandatory retirement age and eligibility age for claiming public pension benefits to 70 years would increase the employment rate by 27.8 (standard deviation [SD]: 4.2) percentage points among those aged 65–69 years, which would reduce their probability of poor self-rated health by 1.8 (SD: 0.4) percentage points and raise that of psychological distress by 4.1 (SD: 0.8) percentage points for that age group.

    Conclusions: The results suggest the need to pay attention to the health outcomes of policy measures that encourage older adults to work longer.

  • Koki Ibayashi, Yoshihisa Fujino, Masakazu Mimaki, Kenji Fujimoto, Shin ...
    論文ID: JE20200577
    発行日: 2021年
    [早期公開] 公開日: 2021/04/28
    ジャーナル オープンアクセス 早期公開

    Background: To provide a better healthcare system for patients with mitochondrial diseases, it is important to understand the basic epidemiology of these conditions, including the number of patients affected. However, little information about them has appeared in Japan to date.

    Methods: To gather data of patients with mitochondrial diseases, we estimated the number of patients with mitochondrial diseases from April 2018 to March 2019 using a national Japanese health care claims database, the NDB (National Database). Further, we calculated the prevalence of patients, and sex ratio, age class, and geographical distribution.

    Results: From April 2018 to March 2019, the number of patients with mitochondrial diseases was 3,629, and the prevalence was 2.9 per 100,000 general population (95% CI, 2.8-3). The ratio of females and males was 53 to 47, and the most frequent age class was 40-49 years old. Tokyo had the greatest number of patients with mitochondrial diseases, at 477, whereas Yamanashi had the fewest, at 13. Kagoshima had the highest prevalence of patients with mitochondrial diseases, 8.4 (95% CI, 7.1-10) per 100,000 population, whereas Yamanashi had the lowest, 1.6 (95% CI, 0.8-2.7).

    Conclusion: The number of patients with mitochondrial diseases estimated by this study, 3,269, was more than double that indicated by the Japanese government. This result may imply that about half of all patients are overlooked for reasons such as low severity of illness, suggesting that the Japanese healthcare system needs to provide additional support for these patients.

  • Keiko Murakami, Mami Ishikuro, Fumihiko Ueno, Aoi Noda, Tomomi Onuma, ...
    論文ID: JE20200609
    発行日: 2021年
    [早期公開] 公開日: 2021/04/28
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: While a wide range of predictors of postpartum smoking relapse have been suggested, population-based studies have rarely examined these factors exclusively among women who quit in early pregnancy. Furthermore, workplace secondhand smoke (SHS) exposure has never been examined.

    Methods: We analyzed data from 10,466 pregnant women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Age, education, parity, breastfeeding, postpartum depression, SHS exposure at home, and SHS exposure at work (not working, working without SHS exposure, working with SHS exposure) were evaluated as possible predictors. Multiple logistic regression analyses were conducted to examine the associations between these factors and smoking relapse by 1 year postpartum among women who quit in early pregnancy. Analyses stratified by SHS exposure at home were also conducted.

    Results: About one-fourth of early-pregnancy quitters had relapsed into smoking by 1 year postpartum. Lower education, multiparity, not breastfeeding, postpartum depression, and SHS exposure at home were associated with increased risks of smoking relapse. Working with SHS exposure was associated with an increased risk of smoking relapse; the multivariate-adjusted odds ratios (95% confidence intervals) of working without SHS exposure and working with SHS exposure compared with not working were 1.14 (0.82–1.59) and 2.18 (1.37–3.46), respectively. The significant association of workplace SHS exposure was observed only among women without SHS exposure at home.

    Conclusions: SHS exposure at work, as well as education, multiparity, breastfeeding, postpartum depression, and SHS exposure at home were associated with postpartum smoking relapse among early-pregnancy quitters.

  • Shiori Tanaka, Atsushi Goto, Kazumasa Yamagishi, Motoki Iwasaki, Taiki ...
    論文ID: JE20200618
    発行日: 2021年
    [早期公開] 公開日: 2021/04/28
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Helicobacter pylori (H. pylori) is an established causative factor of gastric cancer. Although the expansion of insurance coverage has led to an increase in the number of patients treated for H. pylori, the population impact of eradication treatment for H.pylori has been scarcely investigated. This study aimed to clarify the long-term responses of H. pylori antibody titer after eradication treatment using large scale cross-sectional data from the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT Study).

    Methods: A total of 55,282 Japanese participants aged 40 to 74 years residing in 16 areas provided blood samples between 2011 and 2016. From these, treated (n=6,276) and untreated subjects who were seropositive for H. pylori or had serological atrophy (n= 22,420) formed the study population (n=28,696). Seropositivity was defined as an anti-H. pylori IgG titer of ≥10 U/mL. Antibody level was compared among subjects according to self-reported treatment history as untreated, and treated for less than one year (<1Y), one to five years (1-5Y), and more than six years ago (6Y+).

    Results: Median serum antibody titer was 34.0 U/mL, 7.9 U/mL, 4.0 U/mL, and 2.9 U/mL for the Untreated, <1Y, 1-5Y, and 6Y+ groups, respectively. While those treated for H.pylori within the previous year had a 76.8% lower antibody titer compared to untreated subjects, approximately 41% of subjects were still seropositive.

    Conclusions: A significant reduction in H.pylori antibody titer occurs within one year after eradication treatment, but that a long period is needed to achieve complete negative conversion.

  • Ai Yamashita, Aya Isumi, Takeo Fujiwara
    論文ID: JE20200079
    発行日: 2020年
    [早期公開] 公開日: 2020/10/31
    ジャーナル オープンアクセス 早期公開

    Background: Online peer support groups are common and can be an effective tool for mothers with young children. The purpose of this review is to examine the types of support that online-based peer groups establish, as well as its health effects on mothers and their children.

    Methods: Systematic scoping review. Systematic review of existing literature was conducted using PubMed, CINAHL, Medline, Cochrane and Ichushi (Japanese language) database in December 2019.

    Results: Based on the inclusion and exclusion criteria, a total of 1,475 articles were extracted by initial search. After the review of titles, abstracts and full texts, a total of 21 articles met the inclusion criteria. The types of support mothers received were mainly informational and emotional support. Mothers also felt a sense of connection and community. Some health effects of online-based peer support group were seen in the area of mothers’ mental well-being. Minimal effects were seen in behavioral modification for child nutrition and breastfeeding.

    Conclusion: Due to the limited evidence in interventional studies, the effects of online-based peer support groups were inconclusive. Further studies with rigorous research designs would be helpful in future research.

  • Euma Ishii, Nobutoshi Nawa, Hiroki Matsui, Yasuhiro Otomo, Takeo Fujiw ...
    論文ID: JE20200211
    発行日: 2020年
    [早期公開] 公開日: 2020/12/05
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Japan’s historically low immigration rate and monolingual culture makes it a particularly interesting setting for clarifying non-national medical care. Our study objective was to examine disease patterns and outcome differences between Japanese and non-Japanese patients in a rapidly globalizing nation.

    Methods: A secondary data analysis of 325 non-Japanese and 13,370 Japanese patients requiring tertiary care or intensive-care unit or high-care unit admission to the emergency department at the Tokyo Medical and Dental University medical hospital from 2010 through 2019 was conducted. Multivariable linear and logistic regressions models were applied to examine differences in percentage of diagnosis, mortality rates, and length of stay, stratified by Glasgow Coma Scale (GCS) scores to consider the impact of language barriers. Sex and age were adjusted.

    Results: Non-Japanese patients had more anaphylaxis, burns, and infectious disease, but less cardiovascular diagnoses prior to adjustment. After adjustment, there were significantly more anaphylaxis (adjusted odds ratio [aOR] 2.7; 95% confidence interval [CI], 1.7–4.4) and infectious disease diagnoses (aOR 2.2; 95% CI, 1.3–3.7), and marginally more burn diagnoses (aOR 2.3; 95% CI, 0.96–5.3) than Japanese patients. Regardless of GCS scores, there were no significant differences between non-Japanese and Japanese patient length of stay for anaphylaxis, burn, and infectious disease after covariate adjustment.

    Conclusion: There were more non-Japanese patients diagnosed with anaphylaxis, burns, and infectious disease, but no notable patient care differences for length of stay. Further prevention efforts are needed against anaphylaxis, burns, and infectious disease for non-Japanese tourists or residents.

  • Yukai Lu, Yumi Sugawara, Sanae Matsuyama, Ichiro Tsuji
    論文ID: JE20200260
    発行日: 2020年
    [早期公開] 公開日: 2020/12/26
    ジャーナル オープンアクセス 早期公開

    Background: Both weight loss and cognitive impairment are common in late-life, but it remains unknown whether weight change is associated with risk of incident dementia among elderly Japanese. Our study aimed to investigate the association between long-term weight change since midlife and risk of incident disabling dementia using a community-based cohort study of elderly Japanese.

    Methods: In 2006, we conducted a cohort study of 6,672 disability-free Japanese adults aged ≥65 years. In both 1994 and 2006, the participants reported their weight using a self-reported questionnaire. Based on weight obtained at these two time points, participants were classified into: stable weight (−1.4 to +1.4 kg), weight gain (≥+1.5 kg), and weight loss of −2.4 to −1.5 kg, −3.4 to −2.5 kg, −4.4 to −3.5 kg, −5.4 to −4.5 kg, and ≥−5.5 kg. Incident disabling dementia was retrieved from the public Long-term Care Insurance database. Participants were followed-up for 5.7 years (between April 2007 and November 2012). Cox proportional hazards model was used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident disabling dementia.

    Results: During 32,865 person-years of follow-up, 564 participants were ascertained as having incident disabling dementia. Compared with stable weight, the multivariable-adjusted HRs were 0.97 (95% CI, 0.70–1.34) for weight loss of −2.4 to −1.5 kg, 0.98 (95% CI, 0.70–1.38) for −3.4 to −2.5 kg, 1.28 (95% CI, 0.91–1.81) for −4.4 to −3.5 kg, 1.27 (95% CI, 0.92–1.77) for −5.4 to −4.5 kg, and 1.64 (95% CI, 1.29–2.09) for ≥−5.5 kg.

    Conclusion: Our study suggested that a ≥−3.5 kg weight loss over 12 years might be associated with higher risk of incident disabling dementia among elderly Japanese.

  • Keiji Muramatsu, Hanaka Imamura, Kei Tokutsu, Kenji Fujimoto, Kiyohide ...
    論文ID: JE20200309
    発行日: 2020年
    [早期公開] 公開日: 2020/11/28
    ジャーナル オープンアクセス 早期公開

    Background: Food allergies are common among children, and food-induced anaphylaxis (FIA) is a serious disease with a risk of death; however, there is yet to be a large-scale epidemiological study on causative foods in Japan. The purpose of this study was to identify foods that cause FIA in Japan.

    Methods: We identified 9,079 patients from the Japanese Diagnosis Procedure Combination Database who were admitted for treatment for FIA from April 1, 2014 through March 31, 2017. We extracted data on patient sex, age, use of epinephrine injections on the first day, prescription for epinephrine self-injection on the day of discharge, length of stay, readmission, and causative foods.

    Results: The most common causative food was eggs, followed by wheat, milk, peanuts, and buckwheat. The most common causative food in each age group was eggs among 0–3-year-olds, milk among 4–6-year-olds, peanuts among 7–19-year-olds, and wheat among those aged 20 years and older. Epinephrine was used at admission among about 40%, 50%, and over 60% of cases in which the causative food was eggs; wheat, milk and peanuts; and buckwheat, respectively. The proportion of cases with a prescription for epinephrine self-injection at discharge was highest among those in which the causative food was wheat, followed by peanuts, buckwheat, milk, and eggs.

    Conclusions: FIA due to peanuts has become as common in Japan as it is in the West. These results suggest the importance of taking measures to prevent peanut allergies because children cannot make adequate decisions regarding food.

  • Beladenta Amalia, Marcela Fu, Ariadna Feliu, Olena Tigova, Ranti Fayok ...
    論文ID: JE20200332
    発行日: 2020年
    [早期公開] 公開日: 2020/12/19
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: The objective of this study is to describe the legislation regulating the use of electronic cigarettes (e-cigarettes) in various places in European countries.

    Methods: A survey among experts from all countries of the World Health Organization (WHO) European Region was conducted in 2018. We collected and described data on legislation regulating e-cigarette use indoors and outdoors in public and private places, the level of difficulties in adopting the legislation, and the public support and compliance. Factors associated with the legislation adoption were identified with Poisson and linear regression analyses.

    Results: Out of 48 countries, 58.3% had legislation on e-cigarette use at the national level. Education facilities were the most regulated place (58.3% of countries), while private areas (eg, homes, cars) were the least regulated ones (39.6%). A third of countries regulated e-cigarette use indoors. Difficulty and support in adopting the national legislation and its compliance were all at a moderate level. Countries’ smoking prevalence and income levels were linked to legislation adoption.

    Conclusions: Although most WHO European Region countries had introduced e-cigarette use legislation at the national level, only a few of the legislation protect bystanders in indoor settings.

  • Wei-Shan Chin, Shih-Cheng Liao, Shin-Chun Pan, Yue-Liang Leon Guo
    論文ID: JE20200374
    発行日: 2020年
    [早期公開] 公開日: 2020/10/10
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: The long-term effects of occupational injury (OI) on psychiatric diseases are unclear. This study assessed and compared the effects of OI, no injury (control), and non-OI (NOI) on the development of psychiatric diseases.

    Methods: We used Taiwan’s National Health Insurance Research Database to investigate the incidence of psychiatric disorders in OI, NOI, and control groups. The subjects were aged 20–50 years, actively employed in 2000, and did not have history of injury or psychiatric disorders. All subjects were followed from 2000 and were classified into OI, NOI, and control groups according to occurrence of target injury later on. Individuals in each group were matched by age, sex, insurance premium before the index date, and year of the index date. Psychiatric disease-free days were compared among the groups using survival analysis and Cox regression.

    Results: We included a total of 12,528 patients for final analysis, with 4,176 in each group. Compared with the control group, the OI group had an increased occurrence of trauma and stress-related disorder, depressive disorders, anxiety disorders, and alcohol and other substance dependence. These increases were similar to those in the NOI group. Elevated cumulative incidence rate of any psychiatric disorders was observed among those with OI or NOI up to 10 years after injury.

    Conclusion: We confirmed that OI and NOI induced psychiatric disorders. These findings highlight the need for workers’ compensation mechanisms to consider long-term psychological care among injured workers.

  • Masao Ichikawa, Haruhiko Inada, Ai Hori, Takahiro Tabuchi
    論文ID: JE20210151
    発行日: 2021年
    [早期公開] 公開日: 2021/04/10
    ジャーナル オープンアクセス 早期公開
  • Kohei Ogawa, Naho Morisaki, Aurelie Piedvache, Chie Nagata, Haruhiko S ...
    論文ID: JE20200302
    発行日: 2021年
    [早期公開] 公開日: 2021/04/13
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Although prevalence of low birth weight has increased in the last 3 decades in Japan, no studies in Japanese women have investigated whether birth weight is associated with the risk of pregnancy complications, such as pregnancy-induced hypertension (PIH) and gestational diabetes mellitus (GDM).

    Methods: We used data from the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT), a population-based cohort study in Japan that launched in 2011. In the main analysis, we included 46,365 women who had been pregnant at least once, for whom information on birth weight and events during their pregnancy was obtained using a self-administered questionnaire. Women were divided into five categories according to their birth weight, and the relationship between birth weight and risk of PIH and GDM was examined using multilevel logistic regression analyses with place of residence as a random effect.

    Results: Compared to women born with birth weight of 3,000–3,999 grams, the risk of PIH was significantly higher among women born <1,500 grams (adjusted odd ratio [aOR] 1.60; 95% confidence interval [CI], 1.17–2.21), 1,500–2,499 grams (aOR 1.16; 95% CI, 1.03–1.30), and 2,500–2,999 grams (aOR 1.13; 95% CI, 1.04–1.22). The risk of GDM was significantly higher among women born 1,500–2,499 grams (aOR 1.20; 95% CI, 1.02–1.42), albeit non-significant association among women in other birthweight categories.

    Conclusions: We observed an increased risk of PIH among women born with lower birth weight albeit non-significant increased risk of GDM among Japanese women.

  • Moemi Shimamura, Yusuke Matsuyama, Ayako Morita, Takeo Fujiwara
    論文ID: JE20200366
    発行日: 2021年
    [早期公開] 公開日: 2021/04/10
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Procrastination is associated with stress and unhealthy behaviors. The oral condition reflects the long-term history of an individual’s stress exposure and oral health behaviors; however, empirical studies on the association of procrastination in childhood with remaining teeth in older age are limited. We investigated the association of procrastination in childhood with the number of remaining teeth among community-dwelling older Japanese adults.

    Methods: In total, 1616 community-dwelling senior residents of Wakuya City (Miyagi Prefecture, Japan) who were enrolled in the National Health Plan & the Medical Care System for the Elderly completed a self-administered questionnaire on the number of teeth. Procrastination was measured using a single binary question about timing of holiday homework completion in childhood. The number of remaining teeth was assessed via a questionnaire with response options of ≥20, 10–19, 1–9, and 0 teeth. Ordered logistic regression models with potential confounders (sex, age, maternal education, childhood socioeconomic status (SES), childhood maltreatment, conscientiousness trait) and mediators (adulthood SES, smoking history, alcohol use history) were estimated.

    Results: Forty-six percent of participants reported a higher tendency to procrastinate in childhood. The proportions of participants with ≥20, 10–19, 1–9, and 0 teeth were 39.6, 22.7, 24.0, and 13.7%, respectively. After adjusting for all covariates, a higher tendency to procrastinate in childhood was significantly associated with having fewer remaining teeth (odds ratio = 1.28; 95% confidence interval = 1.05–1.57).

    Conclusion: A higher tendency to procrastinate in childhood was associated with having fewer remaining teeth in later life.

  • Takahisa Ohta, Junzo Nagashima, Wataru Fukuda, Hiroyuki Sasai, Naokata ...
    論文ID: JE20200581
    発行日: 2021年
    [早期公開] 公開日: 2021/04/10
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background

    Knee extensor muscle strength and cardiorespiratory fitness (CRF) are major components of physical fitness. Because the interactive association of knee extensor muscle strength and CRF with bone health remains unclear, we aimed to investigate such association in Japanese adults.

    Methods

    Altogether, 8,829 Japanese adults (3,731 men and 5,098 women) aged ≥45 years completed the maximum voluntary knee extension test, submaximal exercise test, medical examination, and a questionnaire on lifestyle habits. Using an osteo-sono assessment index, low bone stiffness tendency was defined as 80% under the young-adults mean. Multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated after confounder adjustment.

    Results

    Overall, 542 men (14.5%) and 978 women (19.2%) had low bone stiffness tendency. We observed an inverse association between muscle strength and low bone stiffness tendency after adjustment for CRF in both sexes (p for linear trend < 0.001). Compared with the lowest CRF, the multivariable ORs (95% CI) for low bone stiffness tendency in the highest CRF were 0.47 (0.36, 0.62) for men and 1.05 (0.82, 1.35) for post-menopausal women (p < 0.001 and p = 0.704, respectively). No interactive association between muscle strength and CRF for low bone stiffness tendency existed in both sexes and irrespective of menopausal status.

    Conclusion

    Knee extensor muscle strength and CRF were associated additively, not synergistically, with bone health. Maintaining high levels of both physical fitness components may improve musculoskeletal health in the cohort. The relationship between physical fitness and bone status should be longitudinally investigated in the future.

  • Mari Yamashita, Satoshi Seino, Yu Nofuji, Yasuhiro Sugawara, Yosuke Os ...
    論文ID: JE20200599
    発行日: 2021年
    [早期公開] 公開日: 2021/04/10
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: To clarify the association between psychosocial problems and frailty in the areas affected by the Great East Japan Earthquake, and to develop strategies for preventive long-term care in the community, we launched the Kesennuma Study in 2019. This report describes the study design and the participants’ profiles at baseline.

    Methods: The prospective study comprised 9,754 people (4,548 men, 5,206 women) randomly selected from community-dwelling independent adults aged 65 to 84 who were living in Kesennuma City, Miyagi. The baseline survey was conducted in October 2019. It included information on general health, socio-economic status, frailty, lifestyle, psychological factors (e.g. personality, depressive moods), and social factors (e.g. social isolation, social capital). A follow-up questionnaire survey is planned. Mortality, incident disability, and long-term care insurance certifications will also be collected.

    Results: A total of 8,150 questionnaires were returned (83.6% response rate), and 7,845 were included in the analysis (80.4%, mean age [SD] 73.6 [5.5] years; 44.7% male). About 23.5% were considered frail. Regarding psychological and social functions, 42.7% had depressive moods, 29.1% were socially isolated, and only 37.0% participated in social activities at least once a month. However, 82.5% trusted their neighbours.

    Conclusions: While local ties were strong, low social activity and poor mental health were revealed as issues in the affected area. Focusing on the association between psychological and social factors and frailty, we aim to delay the need for long-term care for as long as possible, through exercise, nutrition, social participation, and improvement of mental health.

  • Chih-Ching Liu, Chien-Hui Liu, Yu Sun, Huey-Jane Lee, Li-Yu Tang, Ming ...
    論文ID: JE20200602
    発行日: 2021年
    [早期公開] 公開日: 2021/04/10
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Screening or diagnosis for the elderly with dementia in rural regions might be delayed and underestimated due to limited utilization of healthcare resources. This study aimed to evaluate the disparities of prevalence and risk factors of mild cognitive impairment (MCI) and dementia between urban and rural residence.

    Methods: In this nationwide door-to-door survey, 10,432 participants aged 65 years and more were selected by computerized random sampling from all administrative districts in Taiwan and were assessed by an in-person interview. We calculated the prevalence of MCI and dementia with their risk factors examined by multivariable logistic regression.

    Results: The prevalence of dementia in rural, suburban, and urban areas among the elderly was 8.69% (95% CI, 8.68-8.69), 6.63% (95% CI, 6.62-6.63), and 4.46% (95% CI, 4.46-4.47), respectively. A similar rural-suburban-urban gradient relationship on the dementia prevalence was observed in any age and sex group. The rural/urban ratio was higher in women than in men for both MCI and dementia. Urbanization remained to be an independent factor for both MCI and dementia after adjustment for age, gender, education, lifestyle, and health status. The beneficial effects of exercise on dementia were more evident in rural areas than in urban ones.

    Conclusions: Significantly higher prevalence of MCI and dementia were found in rural areas than in urban ones, especially for women. The odds of risk factors for MCI and dementia varied between urbanization statuses. Focus on the rural-urban inequality and the modification of associated factors specifically for different urbanization levels are needed.

  • Megumi Tsubota-Utsugi, Yuki Yonekura, Ruriko Suzuki, Ryohei Sasaki, Ko ...
    論文ID: JE20200617
    発行日: 2021年
    [早期公開] 公開日: 2021/04/10
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: People with poor health or mental conditions are generally unwilling to participate in the health examinations, and no studies have directly examined the relationship of psychological distress among disaster survivors with participation status to date. The present study thus examined psychosocial differences according to the respondent status in a 5-year follow-up survey among participants in the prospective health surveys on survivors of the Great East Japan Earthquake and Tsunami Disaster study in Iwate prefecture, Japan.

    Methods: We analyzed data from 10203 Japanese survivors aged ≥18 years (mean age, 65.6 years; 38.0% men) and who underwent health examinations at baseline in 2011. Participants were classified into responders and nonresponders according to their 2015 health examination participation status. Psychological distress was evaluated using the Kessler 6 scale and categorized as none, mild, and severe. Multinominal logistic regression was used to examine the risk of psychological distress in relation to participation status.

    Results: In the 2015 survey, 6334 of 6492 responders and 1686 of 3356 nonresponders were analyzed. The most common reasons for nonparticipation in the survey were participated in other health examinations, examined at a hospital, and did not have time to participate. Nonresponse in males was associated only with mild psychological stress, whereas nonresponse in females was associated with mild and severe psychological distress.

    Conclusions: Nonresponders in the follow-up survey had a higher risk of psychological distress than responders. Continuous monitoring of the health of nonresponders and responders may help to prevent future health deterioration.

  • Hiroyuki Ohbe, Yusuke Sasabuchi, Ryosuke Kumazawa, Hiroki Matsui, Hide ...
    論文ID: JE20210016
    発行日: 2021年
    [早期公開] 公開日: 2021/04/10
    ジャーナル オープンアクセス 早期公開

    Background: Detailed data on intensive care unit (ICU) occupancy in Japan are lacking. Using a nationwide inpatient database in Japan, we aimed to assess ICU bed occupancy to guide critical care utilization planning.

    Methods: We identified all ICU patients admitted from January 1, 2015 to December 31, 2018 to ICU-equipped hospitals participating in the Japanese Diagnosis Procedure Combination inpatient database. We assessed the trends in daily occupancy by counting the total number of occupied ICU beds on a given day divided by the total number of licensed ICU beds in the participating hospitals. We also assessed ICU occupancy for patients with mechanical ventilation, patients with extracorporeal membrane oxygenation, and patients without life-supportive therapies.

    Results: Over the 4 study years, 1,379,618 ICU patients were admitted to 495 hospitals equipped with 5,341 ICU beds, accounting for 75% of all ICU beds in Japan. Mean ICU occupancy on any given day was 60%, with a range of 45.0% to 72.5%. Mean ICU occupancy did not change over the 4 years. Mean ICU occupancy was about 9% higher on weekdays than on weekends and about 5% higher in the coldest season than in the warmest season. For patients with mechanical ventilation, patients with extracorporeal membrane oxygenation, and patients without life-supportive therapies, mean ICU occupancy was 24%, 0.5%, and 30%, respectively.

    Conclusion: Only one-fourth of ICU beds were occupied by mechanically ventilated patients, suggesting that the critical care system in Japan has substantial surge capacity under normal temporal variation to care for critically ill patients.

  • Ping Li, Mingjia Yang, Dong Hang, Yongyue Wei, Hongling Di, Hongbing S ...
    論文ID: JE20200497
    発行日: 2021年
    [早期公開] 公開日: 2021/04/03
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Chronic kidney disease (CKD) is an important contributor to morbidity and mortality from noncommunicable diseases. We aimed to examine the longitudinal trajectories in risk factors, estimate their impact on CKD burden in China from 1991 to 2011, and project trends in the next 20 years.

    Methods: We used data from a cohort of the China Health and Nutrition Survey and applied the comparative risk assessment method to estimate the number of CKD events attributable to all non-optimal levels of each risk factors.

    Results: In 2011, current smoking was the leading individual attributable factor for CKD burden in China responsible for 7.9 (95% CI, 7.5-8.3) million CKD cases with a population-attributable fraction of 8.7% (95% CI, 6.0-11.6), while the rates of smoking have reduced and may have mitigated the increase in CKD. High triglyceride (TG) and high systolic blood pressure (SBP) were the leading metabolic risk factors responsible for 6.8 (95% CI, 6.4-7.1) million and 5.8 (95% CI, 5.5-6.1) million CKD-attributable cases, respectively. Additionally, the number of CKD cases associated with high body mass index (BMI), high diastolic blood pressure (DBP), high plasma glucose, and low high-density lipoprotein cholesterol (HDL-C) was 5.4 (95% CI, 5.1-5.6), 3.9 (95% CI, 3.7-4.1), 3.0 (95% CI, 2.8-3.1) and 2.6 (95% CI, 2.5-2.8) million, respectively.

    Conclusions: Current smoking, high TG, and high SBP were the top three risk factors that contributed to CKD burden in China. Increased BMI, DBP, plasma glucose, and decreased HDL-C were also associated with the increase in CKD burden.

  • Mayu Yasuda Uemura, Tetsuya Ohira, Seiji Yasumura, Akira Sakai, Atsush ...
    論文ID: JE20200597
    発行日: 2021年
    [早期公開] 公開日: 2021/04/03
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: The proportion of overweight individuals living in the evacuation zone of Fukushima increased after the Great East Japan Earthquake. However, the change in the prevalence of abdominal obesity has not been reported. Lifestyle habits and changes in these habits after the disaster might have affected the onset of abdominal obesity; however, the association between the two is unclear.

    Methods: This study evaluated 19,673 Japanese participants of the Fukushima Health Management Survey. We used data from general health check-ups conducted in 13 municipalities between 2008 and 2010. Follow-up examinations were performed from June 2011 to March 2013. Changes in the proportion of individuals with abdominal obesity before and after the disaster were compared. Then, lifestyle habits affecting these changes were assessed.

    Results: We found that 34.2% and 36.6% of participants (P < 0.001), both evacuees (37.0% and 42.1% (P < 0.001)) and non-evacuees (32.8% and 34.0% (P < 0.001)), had abdominal obesity before and after the disaster, respectively. Abdominal obesity was positively associated with smoking cessation, snacking after dinner and non-breakfast skipping after the disaster and alcohol drinking before and after the disaster (all P < 0.05). Smoking cessation was positively associated with abdominal obesity in both evacuees and non-evacuees and in both men and women (all P < 0.01).

    Conclusions: The prevalence of abdominal obesity increased among residents in the area affected by nuclear disaster. It might be associated with not only lifestyle habits before the disaster but also changes in these habits after the disaster, especially smoking cessation.

  • Sanae Matsuyama, Yoshitaka Murakami, Yukai Lu, Toshimasa Sone, Yumi Su ...
    論文ID: JE20200574
    発行日: 2021年
    [早期公開] 公開日: 2021/03/27
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Although social participation has been reported to be associated with significantly lower risks of mortality and disability, to our knowledge, no study has estimated its impact on disability-free life expectancy (DFLE). Therefore, this study aimed to investigate the association between social participation and DFLE in community-dwelling older people.

    Methods: We analyzed 11-year follow-up data from a cohort study of 11,982 Japanese older adults (age ≥65 years) in 2006. We collected information on the number of social participation using a questionnaire. Using this information, we categorized the participants into four groups. DFLE was defined as the average number of years a person could expect to live without disability. The multistate life table method using Markov model was employed for calculating DFLE.

    Results: The results revealed that DFLE (95% confidence interval) according to the number of social participation was 17.8 years (17.3–18.2) for no activities, 20.9 (20.4–21.5) for one activity, 21.5 (20.9–22.0) for two activities, and 22.7 (22.1–23.2) for three activities in men, and 21.8 (21.5–22.2), 25.1 (24.6–25.6), 25.3 (24.7–25.9), and 26.7 years (26.1–27.4), respectively, in women. This difference in DFLE did not change after the participants were stratified for smoking, body mass index, physical activity, and depression.

    Conclusions: Social participation is associated with longer DFLE among Japanese older people; therefore, encouraging social participation at the population level could increase life-years lived in good health.

  • Daisuke Nishioka, Chisato Tamaki, Noriko Furuita, Hirokazu Nakagawa, E ...
    論文ID: JE20210005
    発行日: 2021年
    [早期公開] 公開日: 2021/03/27
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: The Free/Low-Cost Medical Care Program (FLCMC) can subsidize the payment (exempt/lower) in designated institutions in Japan. Given that poverty is a multidimensional concept including social isolation, the FLCMC applicants may need social support over and above financial aid to improve their quality of life. However, there was no data to discuss what services should be provided and to whom. Hence, we aimed to describe the changes in health-related quality of life scores among users of the FLCMC, with respect to their socioeconomic backgrounds.

    Methods: This cohort study included patients who newly used FLCMC from July 2018 to April 2019. We used patients’ social work records, obtained at baseline, and self-report questionnaires on the Medical Outcomes Study 8 Items Short Form Health Survey (SF-8), measured both at baseline and six-month-after the application. We used the change in physical and mental health component summary score (PCS-8 and MCS-8) as outcome variables.

    Results: Multiple linear regression analyses, adjusting for age, sex, healthcare institute, and baseline PCS-8 and MCS-8, showed that lower income was associated with an increase in PCS-8 (coef. -0.09; 95% CI, -0.15 to, -0.03) and MCS-8 (coef. -0.04; 95% CI, -0.11, to 0.03). Living alone (versus. living with someone) was potentially associated with a decrease in both PCS-8 (coef. -1.58; 95% CI, -7.26 to 4.09) and MCS-8 (coef. -3.62; 95% CI, -9.19 to 1.95).

    Conclusions: Among patients using FLCMC, those who live alone may need additional support. Further study testing the generalizability of the findings is required.

  • Chao Wang, Heng Jiang, Yi Zhu, Yingying Guo, Yong Gan, Qingfeng Tian, ...
    論文ID: JE20200502
    発行日: 2021年
    [早期公開] 公開日: 2021/03/20
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Increasing number of studies has suggested the time to first cigarette after waking (TTFC) have significant positive effect on respiratory diseases. However, few of them are focused on Chinese population. This study aims to estimate the impact of TTFC on the prevalence of chronic respiratory diseases (CRD) in Chinese elderly and explore the association in different sub-populations.

    Methods: Cross-sectional data of demographic characteristics, living environment, smoking-related variables, and CRD were drawn from the Chinese Longitudinal Healthy Longevity Survey in 2018. Multivariate stepwise logistic regression analyses were conducted to examine the association of the TTFC with the prevalence of CRD.

    Results: This study includes 13208 subjects aged 52 years and older, with a mean age of 85.3 years. Of them, 3779 participants are ex- or current smokers (44.9% had the TTFC ≤30 minutes, 55.1% >30 minutes) and 1503 have suffered from CRD. Compared with non-smokers, participants with TTFC ≤30 minutes seemed to have higher prevalence of CRD (OR 1.97; 95% CI, 1.65-2.35) than those with TTFC >30 minutes (OR 1.70; 95% CI, 1.44-2.00), although the difference was statistically insignificant (Pinteraction=0.12). Compared with TTFC >30 minutes, TTFC ≤30 minutes could drive a higher prevalence of CRD among female participants, those aged 90 years and older, urban residents, and those ex-smokers (Pinteraction<0.05).

    Conclusions: Shorter TTFC relates to higher prevalences of CRD in Chinese older females, those aged 90 years and older, urban residents, and ex-smokers. Delaying TTFC might particially reduce its detrimental impact on respiratory disease in these specific subpopulations.

  • Takashi Fujiwara, Yohei Maeda
    論文ID: JE20210002
    発行日: 2021年
    [早期公開] 公開日: 2021/03/20
    ジャーナル オープンアクセス 早期公開

    Mumps deafness is a serious complication of mumps and its risk factors have not been evaluated. Takagi et al. suggested that adolescents and adults have an 8.4 times higher incidence of mumps deafness than children. However, they did not validate the outcome definition of mumps and mumps deafness, and the age-related difference they observed is not the true difference in the incidence of mumps deafness.

  • Akira Takagi, Satoko Ohfuji, Takashi Nakano, Hideaki Kumihashi, Munehi ...
    論文ID: JE20210098
    発行日: 2021年
    [早期公開] 公開日: 2021/03/20
    ジャーナル オープンアクセス 早期公開
  • Akiho Sugita, Ling Ling, Taishi Tsuji, Katsunori Kondo, Ichiro Kawachi
    論文ID: JE20190337
    発行日: 2020年
    [早期公開] 公開日: 2020/09/19
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Active engagement in intellectually enriching activities reportedly lowers the risk of cognitive decline; however, few studies have examined this association, including engagement in traditional cultural activities. This study aimed to elucidate the types of cultural engagement associated with lower risk of cognitive impairment.

    Methods: We examined the association between cultural engagement and cognitive impairment using Cox proportional hazards models in a cohort of 44,985 participants (20,772 males and 24,213 females) aged 65 years or older of the Japan Gerontological Evaluation Study from 2010 to 2016. Intellectual activities (eg, reading books, magazines, and/or newspapers), creative activities (eg, crafts and painting), and traditional cultural activities (eg, poetry composition [haiku], calligraphy, and tea ceremony/flower arrangement) were included among cultural engagement activities.

    Results: Over a follow-up period of 6 years, incident cognitive disability was observed in 4,198 respondents (9.3%). After adjusting for potential confounders, such as depression and social support, intellectual activities were protectively associated with the risk of cognitive impairment (hazard ratio [HR] for those who read and stated that reading was their hobby, 0.75; 95% confidence interval [CI] 0.66–0.85 and HR for those who read but did not consider reading a hobby, 0.72; 95% CI, 0.65–0.80). Engagement in creative activities was also significantly correlated with lower risk of cognitive impairment (crafts: HR 0.71; 95% CI, 0.62–0.81 and painting: HR 0.80; 95% CI, 0.66–0.96). The association between traditional cultural activities and the risk of cognitive impairment was not statistically significant.

    Conclusions: Engagement in intellectual and creative activities may be associated with reduced risk of dementia.

  • Keiko Murakami, Mami Ishikuro, Fumihiko Ueno, Aoi Noda, Tomomi Onuma, ...
    論文ID: JE20200313
    発行日: 2020年
    [早期公開] 公開日: 2020/09/19
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Secondhand smoke (SHS) from partners is a major source of exposure for non-smoking women. However, epidemiological studies have rarely examined social factors associated with continued and indoor smoking among pregnant women’s partners.

    Methods: We analyzed data on 6,091 partners of non-smoking pregnant women in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Partners’ age, education, income, workplace SHS exposure (almost never or sometimes, almost every day), and pregnant women’s smoking history (never, quit before pregnancy awareness, quit after pregnancy awareness) were used as social factors. Multiple logistic regression analyses were conducted to examine the associations of social factors with partners’ continued smoking and indoor smoking.

    Results: Among 2,432 smoking partners, 2,237 continued to smoke after pregnancy awareness. Workplace SHS exposure was associated with increased risk of partners’ continued smoking: the odds ratio of workplace SHS exposure almost every day compared with almost never or sometimes was 2.08 (95% confidence interval, 1.52–2.83). Women’s quitting smoking after—but not before—pregnancy awareness was associated with decreased risk of partners’ continued smoking: the odds ratio of women’s quitting after pregnancy awareness compared with never smoking was 0.57 (95% confidence interval, 0.40–0.80). About one-third of partners who continued to smoke did so indoors. Older age, lower education, workplace SHS exposure, and women’s quitting smoking after pregnancy awareness were associated with increased risk of partners’ indoor smoking.

    Conclusions: Workplace SHS exposure and pregnant women’s smoking history were associated with continued smoking and indoor smoking among partners of non-smoking pregnant women.

  • Fumitaka Sato, Yosikazu Nakamura, Kazunori Kayaba, Shizukiyo Ishikawa
    論文ID: JE20200346
    発行日: 2020年
    [早期公開] 公開日: 2020/11/07
    ジャーナル オープンアクセス 早期公開

    Background: Several studies have described an association between hemoglobin concentration and stroke; however, the influence of hemoglobin on stroke incidence has not been fully revealed. Our objective was to elucidate the association between hemoglobin concentration and stroke incidence in Japanese community residents.

    Methods: In the present study, we collected the data of 12,490 subjects who were enrolled between April 1992 and July 1995 in the Jichi Medical School (JMS) Cohort Study. We excluded the subjects with a history of stroke. Hemoglobin concentrations were grouped in quartiles, and quartile 2 (Q2) was used as the reference category. A Cox proportional-hazards model was used to examine hazard ratios (HRs) and the stroke incidence rates with 95% confidence intervals (CIs).

    Results: During 10.8 years of follow-up, 409 participants (212 men and 197 women) experienced a new stroke, including 97 intracerebral hemorrhages, 259 cerebral infarctions, and 52 subarachnoid hemorrhages (SAH). In sex-specific hemoglobin quartiles, the multivariate-adjusted HR was statistically significantly higher in Q1 than in Q2, and a relationship similar to a J shape was observed between all strokes (HR in Q2 vs Q1, 1.36; 95% CI, 1.02–1.83; Q3, 1.20; 95% CI, 0.87–1.64; and Q4, 1.16; 95% CI, 0.84–1.60). Furthermore, the analysis of stroke subtypes showed a statistically significantly higher multivariate-adjusted HR in Q1 than in Q2 for SAH (HR 2.61; 95% CI, 1.08–6.27).

    Conclusions: A low hemoglobin concentration was associated with an increased risk of stroke, which was strongly influenced by the incidence of SAH.

  • Toshihide Izumida, Yosikazu Nakamura, Yukihiro Sato, Shizukiyo Ishikaw ...
    論文ID: JE20200361
    発行日: 2020年
    [早期公開] 公開日: 2020/11/07
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Sleeping pills are widely used for sleep disorders and insomnia. This population-based study aimed to evaluate the association between the use of sleeping pills and metabolic syndrome (MetS) and metabolic components in an apparently healthy Japanese cohort.

    Methods: We examined baseline cross-sectional data from the JMS-II Cohort Study. The criteria for MetS and its components were based on The National Cholesterol Education Program Adult Treatment Panel III. Sleep habits including the sleep duration of the subjects and the frequency of sleeping pill use were obtained using The Pittsburgh Sleep Quality Index questionnaire. For different sleep durations, the association between sleeping pill use and MetS was assessed. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated using multiple logistic regression models to quantify this association.

    Results: Our study included 6,153 individuals (mean age, 63.8 [standard deviation 11.2] years), and 3,348 (54.4%) among them were women. The association between sleep duration and MetS was an inverted J-shaped curve among sleeping pill users and a J-shaped curve among non-users. After adjustment for various confounders, less than 6 h of sleep among sleeping pill users was associated with increased rates of MetS (<6 h, OR 3.08; 95% CI, 1.29–7.34]). The frequency of sleeping pill use in individuals with short sleep duration showed a positive association with the prevalence of MetS and its components.

    Conclusions: Sleeping pill users with a short sleep duration had a 3-fold higher chance of having MetS than non-users with a short sleep duration.

  • Masaki Machida, Tomoko Takamiya, Shiho Amagasa, Hiroshi Murayama, Take ...
    論文ID: JE20200534
    発行日: 2021年
    [早期公開] 公開日: 2021/03/13
    ジャーナル オープンアクセス 早期公開

    Background: The hippocampus is a brain structure important for memory and cognitive function. Physical activity may help prevent hippocampal atrophy. However, few studies have measured sedentary behavior (SB) and intensity-specific physical activity using an accelerometer. This study aimed to examine the cross-sectional associations of objectively-determined SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) measured by an accelerometer with hippocampal volume among community-dwelling older adults using compositional data analysis (CoDa) approach.

    Methods: This cross-sectional study was part of the Neuron to Environmental Impact across Generations (NEIGE) study. A randomly recruited sample of 485 Japanese older adults (47% male; aged 65-84 years) wore tri-axial accelerometers (Omron Healthcare) for seven consecutive days in 2017. Hippocampal volume was measured with magnetic resonance imaging and the left and right hippocampal volumes were automatically segmented using FreeSurfer software. Associations of sedentary and physically active behaviors with hippocampal volume were examined with compositional linear regression analysis based on isometric log-ratio transformations of time use adjusted for potential confounding factors.

    Results: The relative proportion of time spent in MVPA, compared to the other two activities, was significantly positively associated with right hippocampal volume (β: 57.1, p-value = 0.027).

    However, no association existed between higher proportions of MVPA and left hippocampal volume, or between proportions of SB or LPA with either left or right hippocampal volumes.

    Conclusions: The proportion of time spent in MVPA, relative to the other two activities, was significantly positively associated with right hippocampal volume. MVPA may be beneficial for maintaining hippocampal volume.

  • Chihiro Nishiura, Yosuke Inoue, Ikuko Kashino, Akiko Nanri, Motoki End ...
    論文ID: JE20200541
    発行日: 2021年
    [早期公開] 公開日: 2021/03/13
    ジャーナル オープンアクセス 早期公開

    Background: While it is essential to understand how long is sufficient for return-to-work when designing paid sick-leave systems, little attempt has been done to collect cause-specific information on when and how many of sickness absentees returned to work, became unemployed, or passed away.

    Methods: We studied the first sick-leave episode of ≥30 consecutive days in those ≤55 years of age during 2012–2013 among 11 Japanese private companies (n = 1209), which were followed until 2017. Overall and disease-specific cumulative incidences of return-to-work, resignations, and deaths were estimated using competing risk analysis.

    Results: During the 3.5-year period (follow-up rate: 99.9%), 1014 returned to work, 167 became unemployed, and 27 died. Overall, return-to-work occurred within 1 year in 74.9% of all absentees and in 89.3% of those who successfully returned to work. Resignation occurred within 1 year in 8.7% of all absentees and in 62.9% of all subjects who resigned. According to ICD-10 chapters, the cumulative incidence of return-to-work ranged from 82.1% for mental disorders (F00-F99) to 95.3% for circulatory diseases (I00-I99). The cumulative incidence of return-to-work due to mental disorders ranged from 66.7% in schizophrenia (F20) to 95.8% in bipolar affective disorders (F31). Death was rarely observed except for cases of neoplasms (C00-D48), of which the cumulative incidence of death reached 14.2% by 1.5 years.

    Conclusions: Return-to-work and resignations occurred commonly within 1 year of sick leave among long-term sickness absentees in the Japanese private companies. Our findings may assist occupational physicians and employers in developing effective social protection schemes.

  • Rand Jarroch, Behnam Tajik, Tomi-Pekka Tuomainen, Jussi Kauhanen
    論文ID: JE20200595
    発行日: 2021年
    [早期公開] 公開日: 2021/03/13
    ジャーナル オープンアクセス 早期公開

    Background

    Little is known about the role of economic recessions in the risk of cancer. Therefore, we evaluated the impact of the severe economic recession in Finland between 1991-1994 on the incidence of all cancers and cancer subtypes among middle-age and older population.

    Methods

    From the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), a population-based sample of 1620 women and men aged 53-73 years were examined between 1998-2001. The cancer-free participants completed a questionnaire on the possible impact of the 1990s recession in Finland on their lives. Incident cases of cancer were obtained through record linkage with the Finnish Cancer Registry. Cox proportional hazards regression was used to estimate hazard ratios (HR) of incident cancer events after adjusting for possible confounders.

    Results

    A total of 1096 cancer-free participants had experienced socioeconomic hardships due to the recession at the baseline. During 20 years of follow-up, 473 participants developed cancer. After adjustment for age, baseline socioeconomic position and lifestyle factors, the risk of all cancers was 32% higher among men who experienced socioeconomic hardships compared to those who did not (HR 1.32, 95%CI, 0.99-1.75, p=0.05). Prostate-genital cancer was 71% higher among men with hardships (n=103, HR=1.71, 95%CI, 1.06-2.74, p=0.02). No association was observed between socioeconomic hardships and subsequent risk of total or any subtype of cancer among women.

    Conclusions:

    The 1990s economic recession was associated with increased risk of all cancers, especially prostate-genital cancer among Finnish middle-age and older men, but no association with cancer was observed in women.

  • Chung-Yi Li, Chia-Lun Kuo, Ya-Hui Chang, Chin-Li Lu, Santi Martini, We ...
    論文ID: JE20200518
    発行日: 2021年
    [早期公開] 公開日: 2021/03/06
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: To investigate associations between exposure to various trajectories of severe hypoglycemic events and risk of dementia in patients with type 2 diabetes.

    Methods: In 2002–2003, 677618 patients in Taiwan were newly diagnosed as having type 2 diabetes. Among them, 35720 (5.3%) experienced severe hypoglycemic events during the 3-year baseline period following diagnosis. All patients were followed from the first day after baseline period to the date of dementia diagnosis, death, or the end of 2011. A group-based trajectory model was used to classify individuals with severe hypoglycemic events during the baseline period. Cox proportional hazard models with the competing risk method were used to relate dementia risk to various severe hypoglycemia trajectories.

    Results: After a median follow-up 6.70 and 6.10 years for patients with and without severe hypoglycemia at baseline, respectively, 1952 (5.5%) individuals with severe hypoglycemia and 23492 (3.7%) without developed dementia during follow-up, for incidence rates of 109.80 and 61.88 per 10000 person-years, respectively. Four groups of severe hypoglycemia trajectory were identified with a proportion of 18.06%, 33.19%, 43.25%, and 5.50%, respectively for Groups 1 to 4. Groups 3 (early manifestation but with later decrease) and 4 (early and sustained manifestation) were associated with a significantly increased risk of dementia diagnosis, with a covariate-adjusted subdistribution hazard ratio of 1.22 (95% confidence interval, 1.14–1.31) and 1.25 (95% confidence interval, 1.02–1.54), respectively.

    Conclusions: Our analysis highlighted that early manifestation of severe hypoglycemic events may contribute more than does late manifestation to the risk of dementia among individuals newly diagnosed as having type 2 diabetes.

  • Hiromi Miyata, Kokoro Shirai, Isao Muraki, Hiroyasu Iso, Akiko Tamakos ...
    論文ID: JE20200145
    発行日: 2020年
    [早期公開] 公開日: 2020/09/19
    ジャーナル オープンアクセス 早期公開

    Background: The impact of weight change, physical activity, and sedentary behavior on endometrial cancer risk among the Asian population is uncertain. We investigated the association of those factors with endometrial cancer risk among Japanese women with a low body mass index level.

    Methods: We performed a large-scale nationwide cohort study consisting of 33,801 female participants aged 40–79 years. The Cox proportional hazards model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident endometrial cancer.

    Results: The mean body mass index of participants was 22.8 kg/m2. During a median follow-up of 14.8 years, 79 participants developed endometrial cancer. After adjustment for potential confounding factors, body mass index over 23.0 kg/m2 was linearly associated with the risk of endometrial cancer. The HR per 5 kg/m2 increase was 1.80 (95% CI, 1.28–2.54). Weight increment ≥+5 kg since age 20 was associated with an increased risk of endometrial cancer compared to a weight change of −5 to <+5 kg (multivariable HR 1.96; 95% CI, 1.12–3.40). Compared with females who were mainly sitting at the worksite, those who were mainly standing and moving were at lower risk; the multivariable HRs were 0.79 (95% CI, 0.39–1.59) and 0.46 (95% CI, 0.22–0.97), respectively (P for trend = 0.042). Hours of physical exercise, daily walking, and TV viewing were not associated with endometrial cancer risk.

    Conclusions: Overweight and weight gain were positively associated with the risk of endometrial cancer, while worksite physical activity was inversely associated with the risk.

  • Naoko Hatakeyama, Masamitsu Kamada, Naoki Kondo
    論文ID: JE20200170
    発行日: 2020年
    [早期公開] 公開日: 2020/10/03
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: Sedentary behaviors are prevalent among children and can have a detrimental effect on their health. Little is known about the influence of parental time on children’s sedentary behavior. This study examined the association between parental working hours and children’s sedentary time.

    Methods: Cross-sectional data were drawn from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) in 2010 and 2011. Participants were 886 children aged 7–18 years and their parents. The primary outcome was self-reported sedentary time after school that comprised screen time and non-screen time. The main explanatory variable was parental working hours. We used multiple regression analysis adjusting for sociodemographic factors.

    Results: Children’s mean sedentary time was 222 (standard deviation [SD], 123) min/day; 144 (SD, 108) min/day screen time and 78 (SD, 65) min/day non-screen time. Children whose mothers worked ≥20 hours/week had 28 (95% CI, 9 to 48) min/day longer sedentary time than children of homemakers (240 min/day vs 214 min/day). The longer maternal working hours, the longer sedentary time (P for trend <0.01). In contrast, children whose fathers worked ≥48 hours/week had 82 (95% CI, −156 to −7) min/day shorter sedentary time than children of non-working fathers (179 min/day vs 264 min/day). When limited to children whose fathers worked, there was no statistically significant association between children’s sedentary time and paternal working hours.

    Conclusions: Children with mothers who work long hours or fathers not working tend to sit more. Supplementing the shortages in resources for childcare may be necessary among those families.

  • Shuo Wang, Guohong Zhang, Jing Wang, Zhiqiang Ye, Huikun Liu, Lingyao ...
    論文ID: JE20200238
    発行日: 2020年
    [早期公開] 公開日: 2020/10/03
    ジャーナル オープンアクセス 早期公開
    電子付録

    Background: To investigate the causal link between early-life exposures and long-term health consequences, we established the Tianjin Birth Cohort (TJBC), a large-scale prospective cohort in northern China.

    Methods: TJBC aims to enroll 10,000 families with follow-ups from pregnancy until children’s six year-old. Pregnant women and their spouses were recruited through a three-tier antenatal healthcare system at early pregnancy, with follow-ups at mid-pregnancy, late pregnancy, delivery, 42 days after delivery, 6 months after delivery, and each year until 6 years old. Antenatal/neonatal examination, biological samples and questionnaires were collected.

    Results: From August 2017 to January 2019, a total of 3,924 pregnant women have already been enrolled, and 1,697 women have given birth. We observed the prevalence of gestational diabetes mellitus as 18.1%, anemia as 20.4%, and thyroid hypofunction as 2.0%. In singleton live births, 5.6% were preterm birth (PTB), 3.7% were low birth weight, and 7.3% were macrosomia. Based on current data, we also identified maternal/paternal factors which increased the risk of PTB, including paternal age (OR 1.07; 95% CI, 1.01–1.14 for each year increase), vaginal bleeding during pregnancy (OR 2.82; 95% CI, 1.54–5.17) and maternal early-pregnancy BMI (OR 1.08; 95% CI, 1.01–1.15 for each kg/m2 increase).

    Conclusion: TJBC has the strength of collecting comprehensive maternal, paternal, and childhood information. With a diverse range of biological samples, we are also engaging with emerging new technologies for multi-omics research. The study would provide new insight into the causal link between macro/micro-environmental exposures of early life and short/long-term health consequences.

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