Uemura Y.,University of Tokyo |
Miyakawa N.,Public Health Research Foundation |
Orimo H.,Japan Osteoporosis Foundation |
Shiraki M.,Research Institute and Practice for Involutional Diseases |
And 2 more authors.
Journal of Bone and Mineral Metabolism | Year: 2015
Assessment of vertebral fracture is critically important for the diagnosis and treatment of osteoporosis. This study aimed to clarify the effectiveness of the semiquantitative (SQ) method in the assessment of vertebral fractures in Japanese clinical practice. Forty-four physicians (seven experts and 37 nonexperts) assessed the spinal radiographs of 40 patients participating in the Adequate Treatment of Osteoporosis (A-TOP) Japanese Osteoporosis Intervention Trial (JOINT)-02 at the baseline, 12 months, and 24 months using the SQ method. The proportion of diagnosed fracture cases per spine was higher in the nonexpert group than in the expert group at each time point, and was especially high in the upper thoracic spine (T4–T6). The least mean squares spinal fracture index was significantly higher in the nonexpert group than in the expert group for all time points. The kappa statistics were also higher in the expert group than in the nonexpert group for all vertebral levels at all time points. Assessment of vertebral fractures using the SQ method tended to be overestimated by nonexpert physicians compared with the experts, with poor nonexpert interobserver reliability and well-matched expert interobserver reliability. Conscious efforts to avoid overestimation and to obtain higher reliability with the SQ method should be made to achieve more precise diagnoses and treatment of osteoporosis in Japanese clinical practice. © 2014, The Japanese Society for Bone and Mineral Research and Springer Japan.
Tanaka S.,Kyoto University |
Uenishi K.,Kagawa Nutrition University |
Ishida H.,Kagawa Nutrition University |
Takami Y.,The Japan Dairy Association |
And 4 more authors.
Journal of Nutritional Science and Vitaminology | Year: 2015
Dairy foods are postulated to have beneficial effects on blood pressure, body fat, serum lipids, and the incidence of type 2 diabetes. To evaluate the effects of the consumption of milk and dairy products, we performed a randomized dietary intervention trial for 24 wk in Japanese men, aged 20 to 60 y, with 2 or more components of the metabolic syndrome (Clinical trial registration: UMIN000006353). Subjects were randomized to a control group (n598) that received dietary intervention focused on weight control supervised by registered dietitians, and a dairy-consumption group (n5102) that received both dietary intervention and regular home dairy delivery of 400 g/d for 24 wk. Co-primary endpoints included waist circumference, blood pressure, fasting blood sugar (FBS), and serum lipids. The dietary intervention decreased energy intake from 2,150 to 1,850 kcal/d in both groups (p<0.01). Mean rates of compliance with the dairy-consumption intervention were over 90%, resulting in increased calcium intake in the dairy-consumption group from 329 to 667 mg/d (p<0.01). Co-primary endpoints improved in both groups, but the degree of improvement was smaller in the dairy-consumption group (one-sided p50.99). Subgroup analyses specified in the study protocol identified weight and leisure-time physical activity (LTPA) as significant effect modifiers. Differences in changes in systolic blood pressure compared with the control group were 28.0 mmHg (95% CI, 214.0 to 21.9, interaction; p<0.01) in the normal weight group and 25.8 mmHg (211.4 to 20.2, interaction; p50.02) in the moderate-to-high LTPA group, indicating lower systolic blood pressure in the dairy-consumption group among participants in these subgroups. In conclusion, although effects on the co-primary endpoints of dairy consumption were not shown, dairy consumption lowered systolic blood pressure in the subgroups with normal weight and moderate-tohigh LTPA and lowered FBS in the subgroup with normal weight. © 2014, Center for Academic Publications Japan.
Ohta H.,International University of Health and Welfare |
Uemura Y.,University of Tokyo |
Nakamura T.,National Center for Global Health and Medicine |
Fukunaga M.,Kawasaki Medical School |
And 7 more authors.
Clinical Therapeutics | Year: 2014
Background Deteriorated quality of life (QOL) is a major problem in osteoporotic women. However, little is known regarding the determinants of QOL in patients with osteoporosis. Objective Our aim was to explore the role of vitamin D status on QOL score in osteoporosis with high fracture risk. Methods Patients were osteoporotic women aged ≥70 years and with ≥1 risk factor for incident fracture, namely prevalent osteoporotic fracture, bone mineral density (BMD) >-3.0 SD of young adult mean, or high bone turnover marker. Health-related QOL was assessed using the Japanese Osteoporosis Quality of Life Questionnaire (JOQOL). When patients were classified into quartiles by total QOL score). Serum 25-hydroxyvitamin D (25[OH]D) level was measured by immunoassay. Results A total of 1585 osteoporotic women were included in the study (age range, 70-95 years). Age, body mass index, serum 25(OH)D status (low, normal, or high), bone mineral density, number of prevalent vertebral fractures, presence of hypertension, presence of osteoarthritis, and history of falls were significantly correlated with QOL quartile. Multivariate liner regression analysis indicated that low serum 25(OH)D level (<20 ng/mL) was an independent determinant of total QOL score quartile (P = 0.0055). The conventional determinants of QOL - age (P < 0.0001), body mass index (P = 0.0060), number of prevalent vertebral fractures (P < 0.0001), presence of osteoarthritis (P = 0.0074), and history of fall (P = 0.0098) - were also independent determinants of total QOL score. Conclusions These results strongly suggest that low serum 25(OH)D level was a significant determinant of QOL in these osteoporotic women, independently of the conventional factors that reduce QOL. Maintenance of serum 25(OH)D levels >20 ng/mL may be required to maintain patients' QOL in osteoporosis. © 2014 The Authors.
Orimo H.,Japan Osteoporosis Foundation |
Nakamura T.,University of Occupational and Environmental Health Japan |
Hosoi T.,National Center for Geriatrics and Gerontology |
Iki M.,Kinki University |
And 10 more authors.
Archives of Osteoporosis | Year: 2012
Introduction: In 1998, the first Japanese practice guidelines on osteoporosis was published. It has been updated several times, with the most recent being the full-scale 2011 edition and its abridged edition. The present guidelines provide information for the managements of primary osteoporosis in postmenopausal women and men over 50 years old, a summary of the evidence for the treatment of secondary osteoporosis, and a summary of the evidence for the prevention of osteoporosis in younger people. Method: The present Executive Summary is primarily based on the content of the 2011 Japanese abridged edition. One of the key changes is revision of the criteria for initiation of pharmacological treatment, along with an introduction of the fracture risk factors used in FRAX®. Key figures and tables were selected from the Japanese abridged edition and a reference list was added. Result and conclusions: The essential points of the Japanese practice guidelines on osteoporosis were translated into English for the first time. It is hoped that the content of the guidelines becomes known throughout the world. © 2012 The Author(s).
Efficacy and safety of once-yearly zoledronic acid in Japanese patients with primary osteoporosis: two-year results from a randomized placebo-controlled double-blind study (ZOledroNate treatment in Efficacy to osteoporosis; ZONE study)
PubMed | Nojima Hospital, Tamana Central Hospital, Research Institute and Practice for Involutional Diseases, Asahi Kasei Corporation and 5 more.
Type: Journal Article | Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA | Year: 2016
In a 2-year randomized, placebo-controlled study of 665 Japanese patients with primary osteoporosis, once-yearly administration of zoledronic acid (5mg) reduced the risk of new morphometric vertebral fractures.The purpose of this study was to determine the efficacy and safety of once-yearly intravenous infusion of ZOL in Japanese patients with primary osteoporosis.This was a two-year multicenter, randomized, placebo-controlled, double-blind, parallel-group comparative study (ZONE Study). Subjects were 665 Japanese patients between the ages of 65 and 89years who had prevalent vertebral fracture. Subjects were randomly assigned to receive once-yearly intravenous infusion of 5mg of ZOL or placebo at baseline and 12months.The 2-year incidence of new morphometric vertebral fracture was 3.0% (10/330 subjects) in the ZOL group and 8.9% (29/327) in the placebo group (p=0.0016). The 24-month cumulative incidence of new morphometric vertebral fracture was 3.3% in the ZOL group versus 9.7% in the placebo group (log-rank test: p=0.0029; hazard ratio: 0.35; 95% confidence interval: 0.17-0.72). The cumulative incidence of any clinical fracture, clinical vertebral fracture, and non-vertebral fracture was significantly reduced in the ZOL group by 54, 70, and 45%, respectively, compared to the placebo group. At 24months, ZOL administration increased bone mineral density in the lumbar spine, femoral neck, and total hip (t test: p<0.0001). No new adverse events or osteonecrosis of the jaw were observed in this study.Once-yearly administration of ZOL 5mg to Japanese patients with primary osteoporosis reduced the risk of new morphometric vertebral fractures and was found to be safe.
PubMed | Kanagawa Academy Of Science And Technology, Public Health Research Foundation, Research Institute and Practice for Involutional Diseases, National Center for Global Health and Medicine and 2 more.
Type: | Journal: Journal of bone and mineral metabolism | Year: 2016
The frequency of hip fractures associated with aging of the population is declining in many countries. Even in Japan, where this frequency has been increasing continually, a shift to decreasing frequency has been noted in recent reports. The objective of this study was to investigate the effects of this decrease and to estimate the number of hip fracture patients and the resulting reduction in national medical care expenditures. The differences in the number of patients were estimated by multiplying the population for each sex and each age group by the fracture rates before the decrease (2007) and after the decrease (2012). Total reduced cost was calculated by multiplying the treatment cost required for hip fracture and the annual medical cost of nursing care. The estimated number of hip fracture patients decreased by approximately 4000 in the elderly female population, and the resulting reduction in medical costs was approximately US$280 million. The number of patients with hip fractures has decreased in elderly Japanese women; as a result, the medical costs for treatment and nursing care might decrease.
PubMed | Public Health Research Foundation, Research Institute and Practice for Involutional Diseases, University of Tokyo, National Center for Global Health and Medicine and 2 more.
Type: Comparative Study | Journal: Journal of bone and mineral metabolism | Year: 2015
Assessment of vertebral fracture is critically important for the diagnosis and treatment of osteoporosis. This study aimed to clarify the effectiveness of the semiquantitative (SQ) method in the assessment of vertebral fractures in Japanese clinical practice. Forty-four physicians (seven experts and 37 nonexperts) assessed the spinal radiographs of 40 patients participating in the Adequate Treatment of Osteoporosis (A-TOP) Japanese Osteoporosis Intervention Trial (JOINT)-02 at the baseline, 12 months, and 24 months using the SQ method. The proportion of diagnosed fracture cases per spine was higher in the nonexpert group than in the expert group at each time point, and was especially high in the upper thoracic spine (T4-T6). The least mean squares spinal fracture index was significantly higher in the nonexpert group than in the expert group for all time points. The kappa statistics were also higher in the expert group than in the nonexpert group for all vertebral levels at all time points. Assessment of vertebral fractures using the SQ method tended to be overestimated by nonexpert physicians compared with the experts, with poor nonexpert interobserver reliability and well-matched expert interobserver reliability. Conscious efforts to avoid overestimation and to obtain higher reliability with the SQ method should be made to achieve more precise diagnoses and treatment of osteoporosis in Japanese clinical practice.
Yamauchi H.,Japan Osteoporosis Foundation |
Fukunaga M.,Kawasaki Medical School |
Nishikawa A.,Japan Osteoporosis Foundation |
Orimo H.,Japan Osteoporosis Foundation |
Orimo H.,Health Science University
Journal of Bone and Mineral Metabolism | Year: 2010
Many types of bone densitometry equipment are available in Japan, but the numbers of such machines and the numbers of institutions that offer bone densitometry have not been clarified. We analyzed the data from annual surveys conducted by the Japan Osteoporosis Foundation from 1996 to 2006, and we obtained the following results on the use of densitometry equipment: (1) In 1996 there were 6,687 units of bone densitometry equipment in 6,483 institutions in Japan; in 2006 there were 16,371 units in 15,020 institutions. (2) In 2006, of the types of institutions with bone densitometry equipment, the number of clinics was the highest, followed in order by general hospitals, other types of institutions, screening institutions and university hospitals. Rates of increase in the installation of equipment in clinics and other types of institutions were high during the 11-year period from 1996. (3) From 1996 to 2006 the region of interest most frequently used for bone densitometry was the radius. However, during the 11-year period, the proportion of radial densitometry equipment in all institutions with bone densitometry equipment decreased, whereas the proportion of calcaneal densitometry equipment increased. (4) The number of dual-energy X-ray absorptiometry (DXA) units was the highest from 1996 to 2006. However, the proportion of DXA machines in all institutions with bone densitometry equipment decreased over the 11-year period, whereas the proportion of quantitative ultrasound (QUS) machines increased. (5) In 2006, bone densitometry equipment was available in 118 institutions per million Japanese people. Central DXA (spine/hip) equipment was available in 15 per million, radial DXA equipment in 63 per million, and calcaneal QUS equipment in 44 per million. (6) In 2006, among those places with bone densitometry equipment, 46% of university hospitals, 14% of general hospitals, 12% of screening institutions, 5% of clinics, and 6% of other types of institutions possessed more than one type of densitometry equipment. (7) In 2006, central DXA (spine/hip) was frequently available in university hospitals, radial densitometry equipment in general hospitals and clinics, and calcaneal densitometry equipment in screening institutions and other types of institutions. © 2009 The Japanese Society for Bone and Mineral Research and Springer.
Yamauchi H.,Japan Osteoporosis Foundation
Nihon rinsho. Japanese journal of clinical medicine | Year: 2011
Medical screening system for osteoporosis is important method for detection of osteopenia or osteoporosis in the community. The medical screening for osteoporosis was done for female subjects at age 40, 45, 50, 55, 60, 65, 70 year-old people according to the Health Promotion Act in Japan. The number of females received the screening was 287,782 in 2008, and the number corresponded to 4.7% of the estimated numbers of subjects for the screening in the population. Sixty six percentages of institutions measured bone mass and/or bone mineral density with the purpose other than that proposed by Health Promotion Act at 2009. Calcaneus bone mass was measured in 81% of institutions by quantitative ultrasound(QUS). Because QUS is inexpensive, involves no radiation exposure, and is easily portable, this method should be suitable for medical screening for osteoporosis and its prevalent use in Japan supports this assumption.
Orimo H.,Japan Osteoporosis Foundation
Clinical calcium | Year: 2011
The outline of Japanese Guideline for the prevention and treatment of Osteoporosis (up dated 2011) was introduced. Descriptions were made on the identification of risk factors for fracture, prevention of osteoporosis, criteria for initiating pharmacotherapy to prevent fracture. Grading of recommendation for medication based on evidence, introduction of bone turnover markers in the treatment and secondary osteoporosis.