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Tanaka F.,9 1 Uchimaru | Komi R.,9 1 Uchimaru | Makita S.,9 1 Uchimaru | Ishibashi Y.,Iwate Medical University | And 3 more authors.
Journal of Hypertension

Background: Recent studies indicate that, in people with diabetes or hypertension and in the general population, low-grade albuminuria (LGA) below the microalbuminuria threshold is a predictor for incidence of cardiovascular disease (CVD) and mortality. However, it remains unclear whether LGA predicts the risk of CVD incidence and death in nondiabetic and normotensive individuals. Methods: A total of 3599 individuals aged not less than 40 years from the general population who are free of CVD in nondiabetic and normotensive individuals with preserved glomerular filtration rate were followed for CVD incidence and all-cause death. LGA was defined as urinary albumin to creatinine ratio (UACR) less than 30mg/g. It was examined whether there is an association between LGA and CVD incidence or all-cause death. Results: During the average 5.9 years of follow-up, 61 individuals had first CVD events, and 85 individuals died. The hazard ratios (HRs) for CVD incidence and all-cause death after full adjustment by potential confounders increased significantly in the top tertile of LGA (UACR ≥ 9.6mg/g for men, ≥ 12.0mg/g for women) compared with the first tertile [HR=2.79, 95% confidence interval (CI), 1.41-5.52, HR=1.69, 95% CI, 1.00-2.84, respectively]. Population-attributable fractions of the top tertile of LGA for CVD incidence and all-cause death were 37.9 and 20.1%, respectively. Conclusion: In apparently healthy individuals with optimal blood pressure and no diabetes, LGA independently predicts CVD incidence and all-cause death, particularly with the large contribution to the excessive incidence of CVD. © Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved. Source

Nakamura K.,Kanazawa Medical University | Okuda N.,University of Human Arts and Sciences | Okamura T.,Keio University | Miura K.,Shiga University of Medical Science | And 5 more authors.
Alcohol and Alcoholism

Aims: This study investigated the relationship between alcohol drinking habits and the onset of high medical expenditure in a Japanese male population. Methods: The cohort comprised 94,307 male beneficiaries 40-69 years of age of the Japanese medical insurance system, who had daily alcohol drinking habits. The likelihood of incurring high medical expenditure, defined as the ≥90th percentile of the medical expenditure distribution in the study population 1 year after baseline, as well as the likelihood of undergoing hospitalization that year were compared among the participants grouped according to their alcohol consumption amount (<2, 2-3.9, 4-5.9, ≥6 drinks/day). Results: Participants who ranked in the top 10% medical expenditure group within the 1 year after baseline each incurred at least 2152 euros/year. The top 10% medical expenditure group accounted for 61.1% of the total medical expenditure in the study population. The odds ratios (95% confidence intervals) for ranking in the top 10% group during the 1-year period, compared with the <2 drinks (23 g of alcohol)/day group, were 1.08 (1.02-1.15) for 2-3.9 drinks/day, 1.11 (1.05-1.19) for 4-5.9 drinks/day, and 1.31 (1.18-1.45) for ≥6 drinks/day after adjustment for age, body mass index, and smoking and exercise habits. The adjusted odds ratios for undergoing hospitalization were 1.11 (1.04-1.19), 1.14 (1.06-1.24) and 1.39 (1.24-1.56), respectively. Conclusion: The likelihood of incurring high medical expenditure and undergoing hospitalization increased with daily alcohol consumption amount. © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved. Source

Nagai M.,Shiga University of Medical Science | Nagai M.,Fukushima Medical University | Ohkubo T.,Shiga University of Medical Science | Ohkubo T.,Teikyo University | And 18 more authors.
Journal of Atherosclerosis and Thrombosis

Aim: In animals, dietary energy restriction is reported to increase longevity, whereas in humans, all cohort studies from Western countries have not shown an association between the low energy intake and longevity. We examined the association between total energy intake and longevity in Japan where dietary pattern is different from that in the West. Methods: A total of 7,704 Japanese aged 30–69 years were followed from 1980 to 2009. Participants were divided into the quintiles of total energy (kcal/day. based on data collected from the National Nutrition Survey. Hazard ratios and 95% confidence intervals (CIs. were derived through the use of Cox proportional hazards models to compare the risk of death across and between the quintiles. Results: There was a significant association between increased energy intake and all-cause mortality risk in only men (P for linear trend=0.008). In cause-specific analysis, compared with the lowest quintile, there was rise in coronary heart disease (CHD. mortality among men (HR; 2.63, 95%CI; 0.95–7.28, P for linear trend 0.016. and women (HR; 2.91, 95%CI; 1.02–8.29, P for linear trend 0.032. and cancer mortality among men (HR; 1.50, 95%CI; 0.999–2.24, P for linear trend 0.038. in the top quintile. Conclusion: We observed significant associations of high energy intake with all-cause and cancer mortality among men and with CHD mortality among men and women. Further studies are needed to confirm the benefits of caloric restriction. © 2016, Japan Atherosclerosis Society. All rights reserved. Source

Okuda N.,University of Human Arts and Sciences | Miura K.,Shiga University of Medical Science | Okayama A.,Research Institute of Strategy for Prevention | Okamura T.,Keio University | And 10 more authors.
European Journal of Clinical Nutrition

Background/Objectives:There have been few studies on the association of fruit and vegetable (FV) intake with cardiovascular disease (CVD) risk in Asian populations where both dietary habits and disease structure are different from western countries. No study in Asia has found its significant association with stroke. We examined associations of FV intake with mortality risk from total CVD, stroke and coronary heart diseases (CHDs) in a representative Japanese sample.Methods:A total of 9112 participants aged from 24-year follow-up data in the NIPPON DATA80, of which baseline data were obtained in the National Nutrition Survey Japan in 1980, were studied. Dietary data were obtained from 3-day weighing dietary records. Participants were divided into sex-specific quartiles of energy adjusted intake of FV. Multivariate-adjusted hazard ratios (HRs) were calculated between strata of the total of FV intake, fruit intake and vegetable intake. The adjustment included age, sex, smoking, drinking habit and energy adjusted intakes of sodium and some other food groups.Results:Participants with higher FV intake were older, ate more fish, milk and dairy products and soybeans and legumes and ate less meat. Multivariate-adjusted HR (95% confidence interval; P; P for trend) for the highest versus the lowest quartile of the total of FV intake was 0.74 (0.61-0.91; 0.004; 0.003) for total CVD, 0.80 (0.59-1.09; 0.105; 0.036) for stroke and 0.57 (0.37-0.87; 0.010; 0.109) for CHD.Conclusions:The results showed that higher total intake of FVs was significantly associated with reduced risk of CVD mortality in Japan. © 2015 Macmillan Publishers Limited. Source

Michikawa T.,Japan National Institute of Environmental Studies | Michikawa T.,Keio University | Okamura T.,Keio University | Nitta H.,Japan National Institute of Environmental Studies | And 10 more authors.
Environmental Pollution

A suggestive mechanism behind the association between particulate matter and cardiovascular disease is inflammatory response. Earlier population-based studies investigating the association between particulate matter and inflammatory biological markers, in particular C-reactive protein (CRP), showed inconsistent results. In addition, evidence from the Asian population, in which CRP levels are typically lower than those observed in Western populations, was sparse. We examined the cross-sectional association between short- and long-term exposure to particulate matter and inflammatory markers, including high-sensitivity CRP (hs-CRP) and white blood cell (WBC) count, in a representative population of Japanese community dwellers (NIPPON DATA2010). We analysed data from 2360 participants (1002 men and 1358 women), aged 20 years or older, who resided in 300 randomly selected districts (222 public health centre areas) throughout Japan. We used background concentrations of suspended particulate matter (SPM, defined as particles with a 100% cut-off level at 10 μm aerodynamic diameter) and co-pollutants within the public health centre area. A logistic regression model was applied to estimate odds ratios (ORs) of elevated hs-CRP (> 0.3 mg/dl) or WBC (> 9000/μl). Since smoking is an important confounding factor, we firstly included this in the models, and additionally conducted the analyses after excluding current smokers. The one-month average concentration of SPM was positively associated with hs-CRP (OR per 10 μg/m3 increase in SPM = 1.42, 95% confidence interval = 1.00-2.04), and high exposure to SPM on the day of blood draw was associated with increased WBC count, after excluding current smokers (OR = 1.13, 1.01-1.28). Similar association patterns were observed for ozone. In conclusion, exposure to particulate matter was associated with inflammatory markers in the general Japanese population. Systemic inflammation may play a role in the link between particulate matter and cardiovascular disease. © 2016 Elsevier Ltd. Source

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