Changes in Cardiovascular Risk Factors over a 24-Year Follow-Up Period : A Japanese Pediatric Cohort Study

This study examined changes in body mass index (BMI), fasting blood sugar (FBS), total cholesterol (TC) and HDL-cholesterol (HDL-C) levels over a 24-year follow-up period in a pediatric cohort. An appropriate starting age for intervention to prevent cardiovascular diseases is still unclear. The subjects were 655 children, aged 10-12. A follow-up survey was conducted when the subjects reached ages 13-15, 16-18, and 35-45, respectively, and height, weight, and blood tests including FBS, TC and HDL-C were examined. Forty (6%) of these subjects participated. BMI at ages 35-45 were significantly higher than those at ages 10-12 (p < 0.0001), 13-15 (p < 0.001), and 16-18 (p < 0.001). TC levels at ages 35-45 were significantly higher than at ages 10-12 (p < 0.0001), 13-15 (p < 0.0001), and 16-18 (p < 0.0001). BMI at the end of the follow-up (ages 35-45) had a significant correlation with BMI at ages 13-15 (R = 0.38, p = 0.041) and 16-18 (R = 0.41, p = 0.049). TC and HDL-C values at the end of the follow-up had a significant correlation with those at ages 10-12 (R = 0.55, p = 0.0004; R = 0.55, p = 0.016), 13-15 (R = 0.35, p = 0.045; R = 0.42, p = 0.015), and 16-18 (R = 0.47, p = 0.019; R = 0.44, p = 0.028). These results may suggest that intervention for children in Japan with cardiovascular risk factors should be initiated in the early years of life

Rate of myringotomy for acute otitis media per 1,000 population-years in age groups, according to year.

<p>Public funding for PCV7 was introduced in January 2011.</p

Statistical analysis of significance between fiscal years using Ryan’s multiple comparisons for the number of myringotomies performed before and after introduction of the free heptavalent pneumococcal conjugate vaccine.

<p>^# nominal level of significance.</p><p>Statistical analysis of significance between fiscal years using Ryan’s multiple comparisons for the number of myringotomies performed before and after introduction of the free heptavalent pneumococcal conjugate vaccine.</p

Comparison of clinical practice guidelines for the diagnosis and management of AOM in children in Japan in 2006, with revisions published in 2009 [11] and 2013 [12].

<p>The main difference between the first and second guidelines is the recommendation for duration of antimicrobial use. All guidelines recommend myringotomy for all AOM with severe otoscopic findings. The first and second guidelines recommend second myringotomy for all treatment-resistant AOM, and the third recommends myringotomy on a case-by case basis. Indications for myringotomy are the same in the first and second editions.</p><p>Comparison of clinical practice guidelines for the diagnosis and management of AOM in children in Japan in 2006, with revisions published in 2009 [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0137546#pone.0137546.ref011" target="_blank">11</a>] and 2013 [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0137546#pone.0137546.ref012" target="_blank">12</a>].</p

Seasonal changes in rate of myringotomy for acute otitis media per 1,000 population according to year.

<p>Public funding for PCV7 was introduced in January 2011.</p