Impairments in Activities of Daily Living in Older Japanese Men in Hawaii and Japan

Introduction. Hypertension and cigarette smoking are dominant risk factors for cardiovascular disease in Japan while in westernized countries, broader effects encompass obesity, diabetes, and hypercholesterolemia. This paper examines whether different associations also appear important in the manifestation of activities of daily living (ADL) in older Japanese men in Hawaii and Japan. Methods. Measures of ADL (feeding, toileting, dressing, bathing, and walking around the house) were assessed from 1995 to 1999 in 1,893 men in Hawaii and 543 men in Japan. Concomitant risk factors were measured from 1990 to 1993. Results. In Hawaii, diabetes increased the odds of ≥1 ADL impairment nearly 1.5-fold (P = .020). A similar association was absent in Japan. In contrast, the odds of an ADL impairment in Japan was increased more than 5-fold in the presence of stroke (P < .001). The association in Hawaii was significantly weaker (P = .007). In both cohorts, past alcohol use was associated with a greater likelihood of ADL impairment. Conclusion. In this comparison of genetically similar samples, findings suggest that different strengths in risk factor associations with cardiovascular disease in Japan and westernized countries may also include different strengths in associations with impaired ADL

Relationship between sleep duration and clustering of metabolic syndrome diagnostic components

Sayuri Katano1, Yasuyuki Nakamura1,2, Aki Nakamura1, Yoshitaka Murakami3, Taichiro Tanaka4, Toru Takebayashi5, Akira Okayama6, Katsuyuki Miura2, Tomonori Okamura7, Hirotsugu Ueshima2, for HIPOP-OHP Research Group1Cardiovascular Epidemiology, Kyoto Women&amp;#39;s University, Kyoto, Japan; 2Department of Health Science, Shiga University of Medical Science, Otsu, Japan; 3Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan; 4Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan; 5Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan; 6The First Institute of Health Service, Japan Anti-Tuberculosis Association, Tokyo, Japan; 7Department of Preventive Cardiology, National Cardiovascular Center, Suita, JapanObjective: To examine the relation between sleep duration and metabolic syndrome (MetS).Methods: We examined the baseline data from 4356 healthy workers (3556 men and 800 women) aged 19&amp;ndash;69 years. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined four components of MetS diagnostic components in this study as follows: 1) high blood pressure (BP) systolic BP [SBP] &amp;ge; 130 mmHg, or diastolic BP [DBP] &amp;ge; 85 mmHg, or on medication; 2) dyslipidemia (high-density lipoprotein-cholesterol concentration ,40 mg/dL, or triglycerides concentration &amp;ge;150 mg/dL, or on medication; 3) impaired glucose tolerance (fasting blood sugar concentration &amp;ge; 110 mg/dL, or if less than 8 hours after meals &amp;ge; 140 mg/dL), or on medication; and 4) overweight (body mass index [BMI] &amp;ge; 25 kg/m2), or obesity (BMI &amp;ge; 30 kg/m2). There were 680 participants in the group, with sleep duration &amp;lt;6 hours (15.6%).Results: Those who had 0&amp;ndash;4 MetS diagnostic components, including overweight, accounted for 2159, 1222, 674, 255, and 46 participants, respectively, in the Poisson distribution. Poisson regression analysis revealed that independent factors that contributed to the number of MetS diagnostic components were being male (regression coefficient b = 0.752, P &amp;lt; 0.001), age (b = 0.026, P &amp;lt; 0.001), IPAQ classification (b = -0.238, P = 0.034), and alcohol intake (mL/day) (b = 0.018, P &amp;lt; 0.001). Short sleep duration (&amp;lt;6 hours) was also related to the number of MetS (b = 0.162, P &amp;lt; 0.001). The results of analyses with obesity component showed a similar association.Conclusion: Short sleep duration was positively associated with the number of MetS diagnostic components independent of other lifestyle habits.Keyword: short sleep duration, MetS diagnostic components, obesit

Relationship between Dietary and Other Lifestyle Habits and Cardiometabolic Risk Factors in Men

<p>Abstract</p> <p>Background</p> <p>Prevalence of men with cardiometabolic risk factors (CMRF) is increasing in Japan. Few studies have comprehensively examined the relation between lifestyles and CMRF.</p> <p>Methods</p> <p>We examined the baseline data from 3,498 male workers ages 19 to 69 years who participated in the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study at 12 large-scale companies throughout Japan. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). Dietary intake was surveyed by a semi-quantitative Food Frequency Questionnaire. We defined four CMRF in this study as follows: 1) high blood pressure (BP): systolic BP ≥ 130 mmHg, or diastolic BP ≥ 85 mmHg, or the use of antihypertensive drugs; 2) dyslipidemia: high-density lipoprotein-cholesterol concentration < 40 mg/dl, or triglycerides concentration ≥ 150 mg/dl, or on medication for dyslipidemia; 3) impaired glucose tolerance: fasting blood sugar concentration ≥110 mg/dl; 4) obese: a body mass index ≥ 25 kg/m².</p> <p>Results</p> <p>Those who had 0 to 4 CMRF accounted for 1,597 (45.7%), 1,032 (29.5%), 587 (16.8%), 236 (6.7%), and 44 (1.3%) participants, respectively, in the Poisson distribution. Poisson regression analysis revealed that independent factors that contributed to the number of CMRF were age (b = 0.020, P < 0.01), IPAQ (b = -0.091, P < 0.01), alcohol intake (ml/day) (b = 0.001, P = 0.03), percentage of protein intake (b = 0.059, P = 0.01), and total energy intake (kcal)(b = 0.0001, P < 0.01). Furthermore, alcohol intake and its frequency had differential effects.</p> <p>Conclusions</p> <p>Alcohol intake, percent protein and total energy intake were positively associated, whereas drinking frequency and IPAQ were inversely associated, with the number of CMRF.</p

Magnifying Endoscopy with Blue Laser Imaging Improves the Microstructure Visualization in Early Gastric Cancer: Comparison of Magnifying Endoscopy with Narrow-Band Imaging

Backgrounds. Magnifying endoscopy with blue laser imaging (ME-BLI) for diagnosis of early gastric cancer (EGC) is as effective as magnifying endoscopy with narrow-band imaging (ME-NBI). However, there are different EGCs in microstructure visualization between ME-BLI and ME-NBI. This study aimed to clarify the pathological features of the EGCs, in which microstructure visualization was different between ME-NBI and ME-BLI. Methods. EGCs were classified into groups A (irregular microsurface pattern (MSP) in ME-BLI and absent MSP in ME-NBI), B (irregular MSP in two modalities), or C (absent MSP in two modalities), according to the vessel plus surface classification. We compared the pathological features of EGCs between the three groups. Results. 17, four, and five lesions could be evaluated in detail in groups A, B and C, respectively. Well-differentiated adenocarcinomas with shallow crypts were more frequent in group A than in group B (58.8 and 0%, resp.). The mean crypt depth of group A was significantly shallower than that of group B (56 ± 20, 265 ± 64 μm, resp., P=0.0002). Conclusions. ME-BLI could better visualize the microstructures of the EGCs with shallow crypts compared with ME-NBI. Therefore, ME-BLI could enable a more accurate diagnosis of EGC with shallow crypts

シンガタ コロナ ウイルス カンセンショウ カクダイカ ニ オケル コウレイシャ ノ シャカイ カツドウ ノ ジッタイ ツウショガタ サービス ノ リヨウシャ ヲ タイショウ ニ シタ シツテキ ケンキュウカラ

【緒言】本研究の目的は、新型コロナウイルス感染症拡大下における高齢者の社会活動の実態を明らかにすることである。【対象と方法】対象者は京都市の通所型サービスを利用する75 歳以上の後期高齢者12 名である。外出自粛の影響によって変化した社会活動について問い、その特徴を質的帰納的に分析した。【結果】困難な社会活動には「家族との関わり」、「知人との対面交流」、「ボランティア活動」の3 つのカテゴリーがあった。しかし、その一方で、取り組めた社会活動には「家族のための活動」、「継続的な知人との交流」、「限定的なボランティア活動」の3 つのカテゴリーがあり、工夫を凝らして取り組みを続けた、あるいは新しく始めた経験が伺えた。また、社会活動を実施できた要因としては「興味関心の有無」、「過去の経験の有無」、「人的環境の有無」、「物的環境の有無」の4 つのカテゴリーが抽出された。【結語】パンデミックの際、高齢者の社会活動の維持および促進のために、高齢者自身の内的要因（興味関心、過去の経験）の把握と、高齢者を取り巻く外的要因（人的環境、物的環境）を調整する重要性が示唆された。Introduction: Social activity is considered to be an important factor in the prevention of care for the elderly. The purpose of this study is to clarify the actual situation of social activities in COVID-19 through qualitative research focusing on the narratives of the elderly. Subjects and Methods: The subjects were 12 elderly people over 75 years old who use a day-care Center in Kyoto City. The subjects were selected from those whose cognitive and physical functions were maintained and who were using day-care services for the purpose of care prevention. Semi-structured interviews were used to qualitatively and inductively analyze the characteristics of social activities in terms of activities that became difficult to carry out and activities that were able to be undertaken due to the effects of the COVID-19 voluntary restraint from going out. Result: From the narratives on social activities in COVID-19, there were three categories of experiences that were difficult: family relations, face-to-face interactions with acquaintances, and volunteer activities. On the other hand, there were three categories of experiences that were implemented: activities for family members, ongoing interaction with acquaintances, and limited volunteer activities, indicating that they continued their efforts with ingenuity or started new ones. There were four categories of factors that enabled the implementation of social activities were identified: interest, past experience, human environment, and physical environment. Conclusion: Due to the prolonged period of voluntary restraint from going out, various changes were observed in the social activities of the elderly. In order to maintain and promote social activities, it is important to focus on understanding the internal factors of the elderly, such as their interests and past experiences, and intervening in the external factors, such as the human and physical environments surrounding them.論文Research Articl

Long-chain n-3 polyunsaturated fatty acids intake and cardiovascular disease mortality risk in Japanese: a 24-year follow-up of NIPPON DATA80

Background:Dietary intake of long-chain n-3 PUFA (LCn3FA) among Japanese is generally higher than that in Western populations. However, little is known whether an inverse association of LCn3FA with cardiovascular disease (CVD) risk exists in a population with higher LCn3FA intake.Objective:To investigate the association between LCn3FA intake and the long-term risk of CVDs in a Japanese general population.Methods:We followed-up a total of 9190 individuals (56.2% women, mean age 50.0 years) randomly selected from 300 areas across Japan and free from CVDs at baseline. Dietary LCn3FA intake was estimated using household weighed food records. Cox models were used to calculate multivariate-adjusted hazard ratios (HR) and confidence intervals (CI) according to sex specific quartiles of LCn3FA intake.Results:During 24-year follow-up (192,897 person-years), 879 cardiovascular deaths were observed. The median daily intake of LCn3FA was 0.37% kcal (0.86 g/day). Adjusted HR for CVD mortality was lower in the highest quartile of LCn3FA intake (HR 0.80; 95% CI 0.66-0.96) compared with the lowest quartile, and the trend was statistically significant (P = 0.038). The similar but statistically non-significant trends were observed for coronary heart disease death and stroke death. In analyses by age groups, the inverse associations of LCn3FA intake with the risk of total CVD death and stroke death were significant in younger individuals (30-59 years at baseline).Conclusion:LCn3FA intake was inversely and independently associated the long-term risk of total CVD mortality in a representative sample of Japanese with high LCn3FA intake

Functional assessment of coronary artery flow using adenosine stress dual-energy CT: a preliminary study

We attempted to assess coronary artery flow using adenosine-stress and dual-energy mode with dual-source CT (DE-CT). Data of 18 patients with suspected coronary arteries disease who had undergone cardiac DE-CT were retrospectively analyzed. The patients were divided into two groups: 10 patients who performed adenosine stress CT, and 8 patients who performed rest CT as controls. We reconstructed an iodine map and composite images at 120 kV (120 kV images) using raw data with scan parameters of 100 and 140 kV. We measured mean attenuation in the coronary artery proximal to the distal portion on both the iodine map and 120 kV images. Coronary enhancement ratio (CER) was calculated by dividing mean attenuation in the coronary artery by attenuation in the aortic root, and was used as an estimate of coronary enhancement. Coronary stenosis was identified as a reduction in diameter of >50% on CT angiogram, and myocardial ischemia was diagnosed by adenosine-stress myocardial perfusion scintigraphy. The iodine map showed that CER was significantly lower for ischemic territories (0.76 ± 0.06) or stenosed coronary arteries (0.77 ± 0.06) than for non-ischemic territories (0.95 ± 0.21, P = 0.02) or non-stenosed coronary arteries (1.07 ± 0.33, P < 0.001). The 120 kV images showed no difference in CER between these two groups. Use of CER on the iodine map separated ischemic territories from non-ischemic territories with a sensitivity of 86% and a specificity of 75%. Our quantification is the first non-invasive analytical technique for assessment of coronary artery flow using cardiac CT. CER on the iodine map is a candidate method for demonstration of alteration in coronary artery flow under adenosine stress, which is related to the physiological significance of coronary artery disease

Population Attributable Fraction of Smoking and Metabolic Syndrome on Cardiovascular Disease Mortality in Japan: a 15-Year Follow Up of NIPPON DATA90

<p>Abstract</p> <p>Background</p> <p>Smoking and metabolic syndrome are known to be related to cardiovascular diseases (CVD) risk. In Asian countries, prevalence of obesity has increased and smoking rate in men is still high. We investigated the attribution of the combination of smoking and metabolic syndrome (or obesity) to excess CVD deaths in Japan.</p> <p>Methods</p> <p>A cohort of nationwide representative Japanese samples, a total of 6650 men and women aged 30-70 at baseline without history of CVD was followed for 15 years. Multivariate-adjusted hazard ratio for CVD death according to the combination of smoking status and metabolic syndrome (or obesity) was calculated using Cox proportional hazard model. Population attributable fraction (PAF) of CVD deaths was calculated using the hazard ratios.</p> <p>Results</p> <p>During the follow-up period, 87 men and 61 women died due to CVD. The PAF component of CVD deaths in non-obese smokers was 36.8% in men and 11.3% in women, which were higher than those in obese smokers (9.1% in men and 5.2% in women). The PAF component of CVD deaths in smokers without metabolic syndrome was 40.9% in men and 11.9% in women, which were also higher than those in smokers with metabolic syndrome (7.1% in men and 3.9% in women).</p> <p>Conclusion</p> <p>Our results indicated that a large proportion of excess CVD deaths was observed in smokers without metabolic syndrome or obesity, especially in men. These findings suggest that intervention targeting on smokers, irrespective of the presence of metabolic syndrome, is still important for the prevention of CVD in Asian countries.</p