124 results on '"Akihiko Kitamura"'
Search Results
2. Nocturnal Intermittent Hypoxia and the Risk of Cardiovascular Disease among Japanese Populations: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Keisuke Onuki, Ai Ikeda, Isao Muraki, Mari Tanaka, Kazumasa Yamagishi, Masahiko Kiyama, Takeo Okada, Yasuhiko Kubota, Hironori Imano, Akihiko Kitamura, Tomoko Sankai, Mitsumasa Umesawa, Tetsuya Ohira, Hiroyasu Iso, and Takeshi Tanigawa
- Subjects
Biochemistry (medical) ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
3. Risk Factors for Hyperuricemia or Gout in Men and Women: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Saki Teramura, Kazumasa Yamagishi, Mitsumasa Umesawa, Mina Hayama-Terada, Isao Muraki, Koutatsu Maruyama, Mari Tanaka, Rie Kishida, Tomomi Kihara, Midori Takada, Tetsuya Ohira, Hironori Imano, Yuji Shimizu, Tomoko Sankai, Takeo Okada, Akihiko Kitamura, Masahiko Kiyama, and Hiroyasu Iso
- Subjects
Biochemistry (medical) ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
4. Impact of Major Cardiovascular Risk Factors on the Incidence of Cardiovascular Disease among Overweight and Non-Overweight Individuals: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Hiroyasu Iso, Tomoko Sankai, Mina Hayama-Terada, Renzhe Cui, Tetsuya Ohira, Akihiko Kitamura, Hironori Imano, Takeo Okada, Masahiko Kiyama, Kazumasa Yamagishi, Mitsumasa Umesawa, Isao Muraki, Yasuhiko Kubota, and Takumi Matsumura
- Subjects
Adult ,Male ,medicine.medical_specialty ,Population ,030204 cardiovascular system & hematology ,Overweight ,Risk Assessment ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,Humans ,Medicine ,Risk factor ,education ,Aged ,education.field_of_study ,business.industry ,Incidence ,Biochemistry (medical) ,Hazard ratio ,Hemodynamics ,Middle Aged ,medicine.disease ,Blood pressure ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,030217 neurology & neurosurgery ,Kidney disease - Abstract
Aim We aimed to examine the impact of high-risk levels of cardiovascular risk factors on the incidence of cardiovascular disease (CVD) in overweight and non-overweight individuals without treatment for the risk factors. Methods A total of 8,051 individuals aged 40-74 years without a history of CVD and/or without treatment for hypertension, diabetes, hyperlipidemia, and kidney disease at baseline in 1995-2000 were followed up for a median of 14.1 years. We classified the participants into three risk categories (low-, intermediate-, and high-risk groups) on the basis of individual risk factors (blood pressure, serum glucose, low-density lipoprotein cholesterol [LDL-C], and urinary protein) according to the guidelines of Japanese clinical societies. The high-risk group (systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 100 mmHg, fasting serum glucose ≥ 130 mg/dL or non-fasting serum glucose ≥ 180 mg/dL, LDL-C ≥ 180 mg/dL, proteinuria ≥ 2+) needed to refer to physicians or start treatment immediately. Overweight was defined as a body mass index of ≥ 25 kg/m2. Results Compared with those in the non-overweight low-risk group, the hazard ratios (HRs) (95% confidence intervals, population-attributable fractions [PAFs]) of CVD in the high-risk categories of blood pressure were 2.0 (1.4-2.9, 7.0%) in the non-overweight high-risk group and 2.9 (1.9-4.3, 6.8%) in the overweight high-risk group. The corresponding HRs (95% confidence intervals, PAFs) of serum glucose were 2.0 (1.2-3.4, 2.5%) and 2.2 (1.1-4.3, 1.5%) in the non-overweight and overweight high-risk groups, respectively. Such associations were not observed for the high-risk group of LDL-C and proteinuria. Conclusions The present long-term observational study implies that targeting persons with non-treated severe hypertension and diabetes is prioritized to prevent CVD regardless of overweight status.
- Published
- 2022
5. Retinal microvascular abnormalities and risks of incident stroke and its subtypes: The Circulatory Risk in Communities Study
- Author
-
Jiaqi Li, Hironori Imano, Akihiko Kitamura, Masahiko Kiyama, Kazumasa Yamagishi, Mari Tanaka, Tetsuya Ohira, Tomoko Sankai, Mitsumasa Umesawa, Isao Muraki, Mina Hayama-Terada, Takeo Okada, Renzhe Cui, Takeshi Tanigawa, and Hiroyasu Iso
- Subjects
Adult ,Retinal Diseases ,Risk Factors ,Physiology ,Hypertension ,Internal Medicine ,Humans ,Retinal Vessels ,Blood Pressure ,Middle Aged ,Cardiology and Cardiovascular Medicine ,Retina ,Aged - Abstract
This study aimed to investigate the association between retinal microvascular abnormalities and the risk of incident stroke and its subtypes in the general Japanese population.A total of 12 965 residents aged 40-74 years without a history of stroke and/or coronary heart disease underwent retinal photography during the annual health checkups of four Japanese communities between 1990 and 1999. Retinal microvascular abnormalities, such as the presence or absence of generalized arteriolar narrowing, focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar light reflex, and retinal hemorrhages were graded using standard protocols.During a median follow-up of 20 years, 817 patients were diagnosed with incident stroke. Retinal microvascular abnormalities were positively associated with the risk of total stroke; after adjustment for age, sex, community, SBP, antihypertensive medication use, and other cardiovascular risk factors, the multivariable hazard ratio [95% confidence interval (CI)] was 1.68 (1.42-1.98), 1.67 (1.34-2.07), 1.41 (1.17-1.72), 1.54 (1.26-1.87), and 1.57 (1.19-2.07) for generalized arteriolar narrowing, focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar light reflex, and retinal hemorrhages, respectively. Similar positive associations were observed for the risk of stroke subtypes, except for subarachnoid hemorrhage, for which no association was observed. Furthermore, the positive associations were similar in participants with and without hypertension.Retinal microvascular abnormalities were positively associated with the risk of incident stroke in the general Japanese population. Routine retinal photography could provide positive clinical insights into stroke risk stratification independent of blood pressure, antihypertensive medication use, and other risk factors.
- Published
- 2022
6. Seaweed Intake and Risk of Cardiovascular Disease: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Tomoko Sankai, Koutatsu Maruyama, Masahiko Kiyama, Isao Muraki, Yuji Shimizu, Takeshi Tanigawa, Tetsuya Ohira, Hiroyasu Iso, Takeo Okada, Hironori Imano, Akihiko Kitamura, Haruka Chichibu, Kazumasa Yamagishi, Mitsumasa Umesawa, Mina Hayama-Terada, Renzhe Cui, and Rie Kishida
- Subjects
Male ,medicine.medical_specialty ,Epidemiology ,Disease ,030204 cardiovascular system & hematology ,Risk Assessment ,Eating ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Japan ,Surveys and Questionnaires ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Risk factor ,Stroke ,Proportional Hazards Models ,Flavonoids ,Cerebral infarction ,Proportional hazards model ,business.industry ,Biochemistry (medical) ,Hazard ratio ,Cerebral Infarction ,Middle Aged ,Seaweed ,medicine.disease ,Cardiovascular Diseases ,Original Article ,Female ,Cohort study ,Cardiology and Cardiovascular Medicine ,business ,Food Analysis ,030217 neurology & neurosurgery - Abstract
Aim Seaweed contains soluble dietary fibers, potassium, and flavonoids and was recently reported to be inversely associated with the risk of coronary heart disease and mortality from stroke. However, epidemiological evidence on this issue has remained scarce. Methods At the baseline survey of four Japanese communities between 1984 and 2000, we enrolled 6,169 men and women aged 40-79 years who had no history of cardiovascular disease. We assessed their seaweed intake using the data from a 24 h dietary recall survey and categorized the intake into four groups (0, 1-5.5, 5.5-15, and ≥ 15 g/day). We used sex-specific Cox proportional hazards models to examine the association between seaweed intake and risk of cardiovascular disease (stroke, stroke subtypes, and coronary heart disease). Results During the 130,248 person-year follow-up, 523 cases of cardiovascular disease occurred: 369 cases of stroke and 154 cases of coronary heart disease. Seaweed intake levels were inversely associated with the risk of total stroke and cerebral infarction among men but not among women. Adjustment for cardiovascular risk factors did not change the associations: the hazard ratios (95% confidence intervals; P for trend) for the highest versus lowest categories of seaweed intake were 0.63 (0.42-0.94; 0.01) for total stroke and 0.59 (0.36-0.97; 0.03) for cerebral infarction. No associations were observed between seaweed intake and risks of intraparenchymal hemorrhage, subarachnoid hemorrhage, or coronary heart disease among men or women. Conclusions We found an inverse association between seaweed intake and risk of total stroke, especially that from cerebral infarction, among Japanese men.
- Published
- 2021
7. Overweight and Hypertension in Relation to Chronic Musculoskeletal Pain Among Community-Dwelling Adults: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Mina Hayama-Terada, Akihiko Kitamura, Hironori Imano, Kazumasa Yamagishi, Masahiko Kiyama, Ko Matsudaira, Hironobu Kakihana, Isao Muraki, Takeo Okada, Hiroyasu Iso, Yasuhiko Kubota, and Hiroshige Jinnouchi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Medicine (General) ,hypertension ,Epidemiology ,Cross-sectional study ,back pain ,030209 endocrinology & metabolism ,Overweight ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,R5-920 ,Musculoskeletal Pain ,Internal medicine ,medicine ,Back pain ,cross-sectional study ,Humans ,030212 general & internal medicine ,Depression (differential diagnoses) ,knee pain ,business.industry ,General Medicine ,Odds ratio ,Low back pain ,humanities ,Knee pain ,Cross-Sectional Studies ,Original Article ,Female ,Public Health ,Independent Living ,medicine.symptom ,Chronic Pain ,business ,human activities - Abstract
Background: The association between overweight and chronic musculoskeletal pain may vary by anatomical site and be modified by hypertension status. This study examined the associations between overweight and low back and knee pains and their effect modification by hypertension status. Methods: We conducted a community-based cross-sectional study involving 2,845 adults (1,080 men and 1,765 women) aged 40–89 years. Chronic knee pain (CKP) and low back pain (CLBP) lasting more than 3 months were categorized into more or less severe pain. Odds ratios (ORs) and 95% confidence intervals (CIs) of the association between overweight and more or less severe CKP and CLBP were determined using logistic regression and stratified by hypertension status. Adjustment variables were age, sex, area, hypertension, smoking and drinking status, inactivity, job category, mental stress, depression, and overall CKP or CLBP. Results: Overall, 288 (10.1%) and 631 (22.2%) adults had more and less severe CKP, respectively, and 284 (10.0%) and 830 (29.2%) had more and less severe CLBP, respectively. Overweight was associated with overall CKP and more or less severe CKP, regardless of hypertension status. Overweight was not associated with overall CLBP; its association was more pronounced for more severe CLBP. The association between overweight and more severe CLBP was evident among non-hypertensives (multivariable OR 1.72; 95% CI, 1.09–2.71); however, that between overweight and less severe CLBP was not evident (multivariable OR 1.07; 95% CI, 0.73–1.56). Conclusions: As hypertension may attenuate the association between overweight and CLBP, we should consider hypertension status for proper management of CLBP among overweight individuals.
- Published
- 2021
8. Standardized gait speed ratio in elderly patients with heart failure
- Author
-
Hiroshi Wada, Hiroshi Saito, Nobuaki Hamazaki, Emi Maekawa, Masashi Yamashita, Shoji Shinkai, Tetsuya Ozawa, Kentaro Iwata, Kentaro Jujo, Yuki Ogasahara, Akihiko Kitamura, Kazuya Saito, Satoshi Seino, Hunkyung Kim, Takeshi Kitai, Kohei Nozaki, Shin-ichi Momomura, Takatoshi Kasai, Masaaki Konishi, Yuya Matsue, Kentaro Kamiya, Shuichi Obuchi, Nobuyuki Kagiyama, and Hisashi Kawai
- Subjects
Aging ,medicine.medical_specialty ,Population ,General Population Cohort ,Gait speed ,Cohort Studies ,Original Research Articles ,Internal medicine ,medicine ,Humans ,Diseases of the circulatory (Cardiovascular) system ,Original Research Article ,Mortality ,education ,Aged ,Proportional Hazards Models ,Heart Failure ,Geriatrics ,education.field_of_study ,Frailty ,business.industry ,Mortality rate ,Hazard ratio ,medicine.disease ,Confidence interval ,Walking Speed ,RC666-701 ,Heart failure ,Cohort ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Although aging is strongly associated with both heart failure and a decline in gait speed, a definition of slowness incorporating an age‐related decline has yet to be developed. We aimed to define an event‐driven cut‐off for the relative decline in gait speed against age‐adjusted reference values derived from the general population and evaluate its prognostic implications. Methods and results Standardized gait speed (SGS) was defined as the median gait speed stratified by age, sex, and height in 3777 elderly (age ≥ 65 years) individuals without a history of cardiovascular diseases (Tokyo Metropolitan Institute of Gerontology‐Longitudinal Interdisciplinary Study on Aging: general population cohort). The mortality event‐driven optimal cut‐off of the SGS ratio (actual gait speed divided by the respective SGS) was defined using FRAGILE‐HF cohort data and externally validated using Kitasato cohort data, comprising 1301 and 1247 hospitalized elderly patients with heart failure, respectively. Using FRAGILE‐HF data, the optimal SGS ratio cut‐off was determined as 0.527. In the Kitasato cohort, SGS ratio
- Published
- 2021
9. Trends for the Association between Body Mass Index and Risk of Cardiovascular Disease among the Japanese Population: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Takumi Matsumura, Tomoko Sankai, Kazumasa Yamagishi, Mari Tanaka, Yasuhiko Kubota, Mina Hayama-Terada, Yuji Shimizu, Isao Muraki, Mitsumasa Umesawa, Renzhe Cui, Hironori Imano, Tetsuya Ohira, Akihiko Kitamura, Takeo Okada, Masahiko Kiyama, and Hiroyasu Iso
- Subjects
Biochemistry (medical) ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Abstract
This study aimed to investigate whether the impact of body mass index (BMI) on the risk of cardiovascular disease (CVD) has changed among the 1960s, 1970s, 1980s, 1990s, and early 2000s in Japan.The study population consisted of residents in Japan aged 40-69 years who had no history of CVD. The baseline surveys have been conducted every year since 1963. We defined the first, second, third, fourth, and fifth cohorts as 1963-1969 (n=4,248), 1970-1979 (n=6,742), 1980-1989 (n=12,789), 1990-1999 (n=12,537), and 2000-2005 (n=9,140) respectively. The participants were followed up for a median of 15 years for each cohort to determine the incidence of CVD. We classified them into four categories (BMI <21.0, 21.0-<23.0, 23.0-<25.0, and ≥ 25.0 kg/mFrom 1963-1969 to 2000-2005, the prevalence of BMI ≥ 25.0 increased over time. Compared with BMI 23.0-<25.0, the age-, sex- and community-adjusted hazard ratios (95% confidence interval [CIs]) of CVD for BMI ≥ 25.0 were 1.10 (0.77-1.57), 0.89 (0.68-1.18), 1.03 (0.85-1.26), 1.28 (1.04-1.58), and 1.36 (1.04-1.78)in the first, second, third, fourth, and fifth cohorts, respectively. The corresponding population attributable fractions were 2.0% (nonsignificant), -2.6% (nonsignificant), 0.9% (nonsignificant), 7.6%, and 10.9%. Further adjustment for systolic blood pressure and antihypertensive medication use in the fourth and fifth cohorts attenuated the associations, which may reflect that blood pressure may mediate the BMI-CVD association.The proportion of CVD attributable to overweight/obesity has increased during the periods between 1963-1969 and 2000-2005. The significant associations between overweight/obesity and risk of CVD after the 1990s were mediated by blood pressure levels.
- Published
- 2022
10. Relationship between Endothelial Dysfunction and Prevalence of Chronic Kidney Disease: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Ehab S. Eshak, Yuting Li, Tetsuya Ohira, Akihiko Kitamura, Jia-Yi Dong, Masahiko Kiyama, Keyang Liu, Hironori Imano, Isao Muraki, Kazumasa Yamagishi, Takeo Okada, Hiroyasu Iso, Mitsumasa Umesawa, Renzhe Cui, and Meishan Cui
- Subjects
Male ,medicine.medical_specialty ,Brachial Artery ,Population ,Renal function ,030204 cardiovascular system & hematology ,Kidney ,Cardiovascular System ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Risk Factors ,Chronic kidney disease ,Internal medicine ,medicine.artery ,Internal Medicine ,Humans ,Medicine ,Endothelial dysfunction ,Renal Insufficiency, Chronic ,Brachial artery ,Correlation of Data ,education ,education.field_of_study ,business.industry ,Biochemistry (medical) ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Vasodilation ,Cross-Sectional Studies ,Quartile ,General Japanese population ,Female ,Original Article ,Endothelium, Vascular ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Glomerular Filtration Rate ,Kidney disease - Abstract
Aims Patients with chronic kidney disease (CKD) have a higher burden of cardiovascular morbidity and mortality than the general population. Endothelial dysfunction has been suggested to play a role in both glomerular filtration rate loss and cardiovascular damage. Thus, the present study aimed to evaluate the relationship between endothelial dysfunction and the prevalence of CKD in the general Japanese population. Methods We conducted a cross-sectional study of 1042 men and women aged 30-81 years in two communities under the Circulatory Risk in Communities Study between 2013 and 2017. Endothelial function was evaluated by percent change of brachial artery flow-mediated dilation (%FMD) before and after the cuff inflation. Results Among the total 1042 participants, there were 62 cases of CKD (~6%). The multivariable odds ratios (ORs) (95% confidence intervals [CIs]) of CKD according to quartiles of %FMD were 2.02 (0.68-5.99), 3.56 (1.27-9.94), and 3.14 (1.10-8.93) for the third to lowest quartile compared with the highest %FMD quartile; p for trend=0.02. The respective multivariable ORs (95% CIs) of CKD in subjects without antihypertensive medication use (39 cases among 886 subjects) were 1.83 (0.46-7.33), 3.41 (0.92-12.61), and 4.60 (1.22-17.31); p for trend=0.01, and that for one-point decrement in %FMD was 1.16 (1.00-1.35); p for interaction with the status of antihypertensive medication use was 0.12. Conclusions Our cross-sectional study suggested the relationship between endothelial dysfunction and the higher prevalence of CKD in the general Japanese population.
- Published
- 2021
11. Serum High-Sensitivity Cardiac Troponin T as an Independent Predictor for Incident Coronary Heart Disease in the Japanese General Population: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Hironori Imano, Kazumasa Yamagishi, Tetsuya Ohira, Akihiko Kitamura, Takeo Okada, Isao Muraki, Mitsumasa Umesawa, Tomoko Sankai, Masahiko Kiyama, and Hiroyasu Iso
- Subjects
Biochemistry (medical) ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Epidemiological evidence is extremely limited about high-sensitivity cardiac troponin T (hs-cTnT) and future coronary heart disease (CHD) events for the general population in countries with low mortality from CHD. Therefore, we investigated the association between hs-cTnT levels and the risk of incident CHD using a nested case-control study in a large Japanese cohort study.The participants were residents of four Japanese communities in the Circulatory Risk in Communities Study (CIRCS). We obtained 120 cases (81 men and 39 women, aged 38-86 years at baseline) of first incident CHD and 240 controls matched by age, sex, communities, and blood sampling term. Serum hs-cTnT levels were measured using an electrochemiluminescence immunoassay with stored sera collected between 2001 and 2011. The median period between sampling at survey and CHD incidence was 2.0 (interquartile range, 0.9-3.7) years. After adjusting for conventional risk factors, the multivariable odds ratios (ORs) of CHD were calculated using conditional logistic regression analyses.hs-cTnT ranged from ≤ 3 (assay detection limit) to 155 ng/L. Compared with the lowest quartile of hs-cTnT, multivariable ORs (95% confidence intervals) of CHD for the second, third, and highest quartiles were 1.30 (0.57-2.95), 2.48 (1.09-5.64), and 3.01 (1.27-7.12), respectively. Similar associations were observed after adjusting for estimated glomerular filtration, or after excluding matched groups, including people with chronic kidney disease.Serum hs-cTnT could predict CHD in the Japanese general population. These findings implicate a benefit from monitoring hs-cTnT to predict CHD even among populations in countries with low mortality from CHD.
- Published
- 2022
12. Relationship between the urinary Na/K ratio, diet and hypertension among community-dwelling older adults
- Author
-
Noriko Yamanaka, Mitsuyo Itabashi, Yoshinori Fujiwara, Yu Nofuji, Takumi Abe, Akihiko Kitamura, Shoji Shinkai, Toru Takebayashi, and Takashi Takei
- Subjects
Physiology ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Abstract
The association between the urinary sodium (Na)/potassium (K) ratio and hypertension is well recognized. We investigated whether the urinary Na/K ratio might be associated with hypertension in community-dwelling older adults and whether the association was influenced by habitual dietary patterns. We enrolled a total of 684 older adults (mean age, 76.8 years) and conducted health examinations at Kusatsu, Japan, in 2021. The urinary Na/K ratio was found to be independently associated with systolic blood pressure (SBP) (p 0.0001), years of education (p = 0.0027), number of cohabitants (p = 0.0175), estimated glomerular filtrate rate (eGFR) (p = 0.0244), and Geriatric Depression Scale short-version (GDS15) score (p = 0.0366). In addition, an unsupervised hierarchical clustering analysis revealed a spectrum of habitual dietary patterns for higher and lower values of the urinary Na/K ratio. The decision tree indicated that the urinary Na/K ratio was associated with the history of milk consumption. A positive history of daily milk consumption predicted a mean urinary Na/K ratio of 2.8, and a negative history of daily milk consumption predicted a mean urinary Na/K ratio of 3.3. Furthermore, the frequency of fruit and vegetable consumption also predicted the urinary Na/K ratio. The relationship between the urinary Na/K ratio and hypertension was influenced by the frequency of consumption of milk, fruits, and vegetables in the subjects. This finding might be due to the influence of education and/or depression. The results suggested the importance of nutritional education in the development of hypertension.
- Published
- 2022
13. Optimal Cut-off Points of Nonfasting and Fasting Triglycerides for Prediction of Ischemic Heart Disease in Japanese General Population: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Hironori Imano, Jiaqi Li, Mari Tanaka, Kazumasa Yamagishi, Isao Muraki, Mitsumasa Umesawa, Masahiko Kiyama, Akihiko Kitamura, Shinichi Sato, and Hiroyasu Iso
- Subjects
Biochemistry (medical) ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Abstract
We investigated the optimal cut-off points of nonfasting and fasting triglycerides in Japanese individuals with lower average triglyceride levels than westerners.Residents aged 40-69 years without a history of ischemic heart disease or stroke were enrolled between 1980 and 1994 and followed. Serum triglyceride concentrations were measured from 10851 nonfasting (<8 h after meal) and 4057 fasting (≥ 8 h) samples. As a prerequisite, we confirmed the shape of a receiver operating characteristic (ROC) curves, the area under ROC curves (AUC), and the integrated time-dependent AUC. We identified optimal cut-off points for incident ischemic heart disease based on C-statistic, Youden index, and Harrell's concordance statistic. We used dichotomized concentrations of triglycerides via the univariate logistic regression and Cox proportional hazards regression models. We also calculated multivariable hazard ratios and population attributable fractions to evaluate the optimal cut-off points.Nonfasting and fasting optimal cut-off points were 145 mg/dL and 110 mg/dL, with C-statistic of 0.594 and 0.626, Youden index of 0.187 and 0.252, and Harrell's concordance statistic of 0.590 and 0.630, respectively. The corresponding multivariable hazard ratios of ischemic heart disease were 1.43 (95%CI 1.09-1.88)and 1.69 (1.03-2.77), and the corresponding population attributable fractions were 16.1% (95%CI 3.3-27.2%) and 24.6 (-0.3-43.3).The optimal cut-off points of nonfasting and fasting triglycerides in the Japanese general population were 145 mg/dL and 110 mg/dL, respectively, lower than the current cut-off points recommended in the US and Europe.
- Published
- 2022
14. Longitudinal Trends in Blood Pressure Associated With the Frequency of Laughter: The Circulatory Risk in Communities Study (CIRCS), a Longitudinal Study of the Japanese General Population
- Author
-
Hiroyasu Iso, Chika Okada, Tomoko Sankai, Satomi Ikeda, Masahiko Kiyama, Kazumasa Yamagishi, Tetsuya Ohira, Takeshi Tanigawa, Sachimi Kubo, Akihiko Kitamura, Mitsumasa Umesawa, Mizuki Sata, Ai Ikeda, and M. Hori
- Subjects
Adult ,Male ,Risk ,medicine.medical_specialty ,Longitudinal study ,Epidemiology ,media_common.quotation_subject ,Population ,Diastole ,030209 endocrinology & metabolism ,Sphygmomanometer ,Laughter ,stress ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,medicine ,Humans ,Longitudinal Studies ,030212 general & internal medicine ,cardiovascular-related biomarker ,education ,Aged ,media_common ,lcsh:R5-920 ,education.field_of_study ,business.industry ,longitudinal study ,blood pressure ,General Medicine ,Middle Aged ,Confidence interval ,Blood pressure ,Cardiovascular Diseases ,Circulatory system ,Cardiology ,laughter frequency ,Original Article ,Female ,Public Health ,lcsh:Medicine (General) ,business - Abstract
Background: The frequency of laughter has been associated with cardiovascular disease and related biomarkers, but no previous studies have examined association between laughter and changes in blood pressure levels. We sought to identify temporal relationships between frequency of laughter in daily life and systolic and diastolic blood pressure changes in participants from 2010 through 2014. Methods: Participants were 554 men and 887 women aged 40–74 years who answered self-administered questionnaire quantifying frequency of laughter at baseline. We measured participant blood pressure levels twice using automated sphygmomanometers for each year from 2010 to 2014. The associations between laughter and changes in blood pressure over time were analyzed using linear mixed-effect models. Results: There was no significant difference in blood pressure according to frequency of laughter at baseline in either sex. Men with frequency of laughter 1 to 3 per month or almost never had significantly increased systolic and diastolic blood pressure levels over the 4-year period (time-dependent difference: 0.96 mm Hg (95% confidence interval [CI], −0.2 to 1.8; P = 0.05). Changes in blood pressure associated with infrequent laughter (ie, 1 to 3 per month or almost never) were evident in men without antihypertensive medication use over 4 years (0.94 mm Hg; 95% CI, −0.2 to 2.0; P = 0.09) and men who were current drinkers at baseline (1.29 mm Hg; 95% CI, −0.1 to 2.3; P = 0.04). No significant difference was found between frequency of laughter and systolic (0.23 mm Hg; 95% CI, −1.0 to 1.5; P = 0.72) and diastolic (−0.07 mm Hg; 95% CI, −0.8 to 0.7; P = 0.86) blood pressure changes in women. Conclusions: Infrequent laughter was associated with long-term blood pressure increment among middle-aged men.
- Published
- 2021
15. Moderate Levels of N-Terminal Pro-B-Type Natriuretic Peptide is Associated with Increased Risks of Total and Ischemic Strokes among Japanese: The Circulatory Risk in Communities Study
- Author
-
Yuji Shimizu, Hironori Imano, Tomoko Sankai, Kazumasa Yamagishi, Yasuhiko Kubota, Tetsuya Ohira, Akihiko Kitamura, Takeo Okada, Kenji Ebihara, Mitsumasa Umesawa, Hiroyasu Iso, Isao Muraki, Mina Hayama-Terada, Renzhe Cui, and Masahiko Kiyama
- Subjects
medicine.medical_specialty ,Lacunar stroke ,Proportional hazards model ,business.industry ,medicine.drug_class ,Biochemistry (medical) ,Hazard ratio ,Atrial fibrillation ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Heart failure ,Internal medicine ,Internal Medicine ,Natriuretic peptide ,Cardiology ,Medicine ,cardiovascular diseases ,Risk factor ,Cardiology and Cardiovascular Medicine ,business ,Stroke ,hormones, hormone substitutes, and hormone antagonists ,030217 neurology & neurosurgery - Abstract
Aim N-terminal pro-B-type natriuretic peptide (NT-proBNP), frequently used as a biochemical marker for detecting and monitoring heart failure, is also a risk marker for development of coronary heart disease and total stroke. However, studies that explore subtypes of ischemic stroke with regard to NT-proBNP are scarce. Here, we examined NT-proBNP and its impact upon subtypes of ischemic stroke (lacunar stroke, large-artery occlusive stroke and embolic stroke) among Japanese. Methods We measured NT-proBNP and categorized 4,393 participants of the Circulatory Risk in Communities Study into four groups (<55, 55-124, 125-399, and ≥ 400 pg/ml). We used a multivariable Cox proportional hazards model to examine association with risks of stroke and subtypes. Results During 4.7 years of follow-up, we identified 50 strokes, including 35 ischemic (15 lacunar, 6 largeartery occlusive, 10 embolic strokes) and 14 hemorrhagic strokes. NT-proBNP was associated with stroke risk: the multivariable hazard ratio of total strokes was 7.29 (2.82-18.9) for the highest and 2.78 (1.25-6.16) for the second highest NT-proBNP groups compared with the lowest group. The respective hazard ratios for the highest NT-proBNP group were 9.37 (3.14-28.0) for ischemic stroke and 6.81 (1.11-41.7) for lacunar stroke. Further adjustment for atrial fibrillation did not attenuate these associations. The associations were similarly observed for large-artery occlusive and embolic strokes. Conclusion We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners.
- Published
- 2020
16. Serum uric acid and risk of stroke and its types: the Circulatory Risk in Communities Study (CIRCS)
- Author
-
Hiroyasu Iso, Jiaqi Li, Takeshi Tanigawa, Takeo Okada, Tetsuya Ohira, Mitsumasa Umesawa, Akihiko Kitamura, Hironori Imano, Kazumasa Yamagishi, Masahiko Kiyama, Isao Muraki, Tomoko Sankai, Circs Investigators, Mina Hayama-Terada, and Renzhe Cui
- Subjects
medicine.medical_specialty ,Physiology ,Proportional hazards model ,business.industry ,Hazard ratio ,030204 cardiovascular system & hematology ,medicine.disease ,Gout ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,Internal medicine ,Internal Medicine ,medicine ,Uric acid ,030212 general & internal medicine ,Hyperuricemia ,Cardiology and Cardiovascular Medicine ,Prospective cohort study ,business ,Stroke ,Intraparenchymal hemorrhage - Abstract
The role of serum uric acid as a predictor of stroke among the general Japanese population remains controversial. We conducted a prospective cohort study of 5235 men and 8185 women aged 40-79 years at baseline between 1985 and 1994 in four Japanese communities, who were initially free from stroke, coronary heart disease, and medication for hyperuricemia or gout. Cox proportional hazards models were used to estimate sex-specific hazard ratios of stroke and its types in relation to serum uric acid level. During a median follow-up of 23.1 years, we recorded 1018 (488 men and 530 women) incident strokes, including 222 (99 and 123) intraparenchymal hemorrhages, 113 (33 and 80) subarachnoid hemorrhages and 667 (347 and 320) ischemic strokes. After adjustment for age, community and known cardiovascular risk factors, the multivariable hazard ratios (95% CIs) in the highest vs. lowest quintile of serum uric acid were 1.45 (1.07-1.96) for total stroke, 1.20 (0.65-2.20) for intraparenchymal hemorrhage, 1.46 (0.69-3.09) for subarachnoid hemorrhage and 1.61 (1.07-2.41) for ischemic stroke in women. The corresponding multivariable hazard ratios (95% CIs) in men were 1.02 (0.74-1.35), 0.83 (0.40-1.72), 1.19 (0.38-3.75) and 1.00 (0.70-1.41). Furthermore, those positive associations with risks of total and ischemic strokes in women were more evident in nonusers of antihypertensive medication than the users. In conclusion, elevated serum uric acid level is an independent predictor of total stroke in women but not in men. The positive association in women was mostly attributable to ischemic stroke and was more pronounced among nonusers of antihypertensive medication.
- Published
- 2020
17. The relationship between blood pressure and cognitive function
- Author
-
Shuichi Awata, Kazumasa Harada, Akihiko Kitamura, Yoshinori Fujiwara, Joji Ishikawa, Atsushi Araki, Yutaka Watanabe, Kenji Toyoshima, Ayumi Toba, Satoshi Seino, Shoji Shinkai, Yoshiaki Tamura, and Hiroki Inagaki
- Subjects
medicine.medical_specialty ,behavioral disciplines and activities ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Outpatient clinic ,Diseases of the circulatory (Cardiovascular) system ,Stroke ,Mini–Mental State Examination ,medicine.diagnostic_test ,business.industry ,Cognition ,medicine.disease ,Blood pressure ,Cognitive impairment ,RC666-701 ,Cardiology ,Smoking status ,Dementia ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,human activities ,Research Paper - Abstract
Background: Although an elevated systolic blood pressure (SBP) is associated with cognitive dysfunction, BP may decrease with advanced cognitive dysfunction; therefore, we attempted to identify the turning point in the relationship between cognitive function and SBP in elderly subjects. Methods: In pooled datasets of general populations and outpatient clinics (age>65 years), in which the risk of frailty or cognitive dysfunction was assessed (N = 4076), the relationship between SBP and the Mini Mental State Examination (MMSE) score was examined. Results: Mean age was 72.5 ± 6.2 years (male 45.1%), and SBP was 133.0 ± 19.5 mmHg. In an analysis of locally weighted scatter plot smoothing, the relationship between SBP and MMSE scores changed at an MMSE score of 24 points. In subjects with preserved cognitive function (MMSE ≥24 points), MMSE scores decreased with increases in SBP (B = −0.047 per 10 mmHg increase, P = 0.002) after adjustments for age, sex, body mass index, alcohol habit, smoking status, diabetes, a history of stroke, and the geriatric nutritional index; however, in subjects with reduced cognitive function (MMSE
- Published
- 2021
18. Dietary Intake of Energy and Nutrients from Breakfast and Risk of Stroke in The Japanese Population: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Chika Okada, Hiroyasu Iso, Hironori Imano, Kazumasa Yamagishi, Isao Muraki, Yuji Shimizu, Takeo Okada, Koutatsu Maruyama, Masahiko Kiyama, Mitsumasa Umesawa, Mina Hayama-Terada, Renzhe Cui, Akihiko Kitamura, and Tomoko Sankai
- Subjects
Adult ,Male ,Community-Based Participatory Research ,Heart disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Nutrient ,Risk Factors ,Environmental health ,Internal Medicine ,medicine ,Humans ,Prospective Studies ,Prospective study ,Prospective cohort study ,Stroke ,Breakfast ,Intracerebral hemorrhage ,Energy ,business.industry ,digestive, oral, and skin physiology ,Biochemistry (medical) ,Hazard ratio ,Nutrients ,Middle Aged ,Nutrition Surveys ,Prognosis ,medicine.disease ,Confidence interval ,Diet ,Quartile ,Population Surveillance ,Female ,Original Article ,Macronutrients ,Energy Intake ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Aims: The frequency of breakfast intake has been reported to be inversely associated with the risk of cardiovascular events; however, it is uncertain what the impact of the energy and nutrient intakes from breakfast are. We assessed the association between these intakes from breakfast and the risk of stroke prospectively. Methods: In a baseline survey of four Japanese communities between 1981 and 1990, we enrolled 3 248 residents (1 662 men and 1 586 women) aged 40–59 years who were free from stroke and heart disease and who responded to the 24-hour dietary recall survey. We assessed the dietary intake at breakfast, lunch, dinner, and other times separately. Results: During the median 25-year follow-up, 230 individuals (147 men and 83 women) developed stroke. After adjustment for age, community, other dietary intakes, and lifestyle and physiological factors, the multivariable-adjusted hazard ratios (95% confidence intervals) of intracerebral hemorrhage for the highest versus lowest quartiles of energy intake from breakfast were 0.38 (0.15–0.99) in men and 1.36 (0.36–5.10) in women. For the major nutrients, a higher saturated or monounsaturated fat intake at breakfast was associated with a reduced risk of intracerebral hemorrhage in men, and remained statistically significant after further adjustment for intake of other major nutrients from breakfast. Conclusions: A higher intake of energy from breakfast, primarily saturated or monounsaturated fat, was associated with a reduced risk of intracerebral hemorrhage in Japanese men.
- Published
- 2019
19. Albumin and Hemoglobin Trajectories and Incident Disabling Dementia in Community-Dwelling Older Japanese
- Author
-
Yuri Yokoyama, Akihiko Kitamura, Yu Taniguchi, Sho Kaito, Tomoko Ikeuchi, Shoji Shinkai, Isao Yokota, Satoshi Seino, Yutaka Matsuyama, Tomohiro Shinozaki, Yoshinori Fujiwara, and Hiroshi Murayama
- Subjects
Male ,medicine.medical_specialty ,Databases, Factual ,Cognitive Neuroscience ,Serum albumin ,Risk Assessment ,Hemoglobins ,03 medical and health sciences ,0302 clinical medicine ,Asian People ,Japan ,Internal medicine ,medicine ,Humans ,Dementia ,Disabled Persons ,Prospective Studies ,Prospective cohort study ,Geriatric Assessment ,Serum Albumin ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,030214 geriatrics ,biology ,business.industry ,Hazard ratio ,Confounding ,Repeated measures design ,medicine.disease ,Confidence interval ,Psychiatry and Mental health ,biology.protein ,Female ,Independent Living ,Hemoglobin ,Geriatrics and Gerontology ,business ,Biomarkers ,030217 neurology & neurosurgery - Abstract
Background: Serum albumin and hemoglobin levels are independently associated with subsequent cognitive deterioration in older adults. This prospective study used repeated measures analysis to identify aging trajectories in serum albumin and hemoglobin levels and investigated if these trajectories were associated with incident disabling dementia among community-dwelling older Japanese. Methods: A total of 2,005 adults aged 65–90 years participated in annual geriatric health assessments during the period from June 2002 through July 2017; the total number of observations was 9,330. A review of a municipal database of the Japanese public long-term care insurance system identified 1,999 of 2,005 adults without dementia at baseline, 278 (13.9%) of whom developed disabling dementia during the follow-up period (June 2002 through December 2017). Results: We identified three trajectory patterns (high, moderate, and low) for serum albumin and hemoglobin levels for the age period 65 through 90 years. After controlling for potential confounders, participants with moderate and low trajectories for serum albumin level had hazard ratios of 1.27 (95% confidence interval 0.94–1.72) and 2.07 (1.37–3.11), respectively, for the development of incident disabling dementia, with the high trajectory group as reference. The respective hazard ratios for hemoglobin level were 1.31 (0.93–1.85) and 1.58 (1.04–2.40), respectively. Conclusion: Dementia risk was higher for individuals with low trajectories for serum albumin and hemoglobin levels. This finding highlights the importance of interventions that improve nutritional status and control relevant diseases in middle-aged and older adults with low serum albumin and hemoglobin levels.
- Published
- 2019
20. Serum Fatty Acid and Risk of Coronary Artery Disease ― Circulatory Risk in Communities Study (CIRCS) ―
- Author
-
Tetsuya Ohira, Akihiko Kitamura, Tomoko Sankai, Takeo Okada, Renzhe Cui, Mitsumasa Umesawa, Hironori Imano, Kazumasa Yamagishi, Isao Muraki, Takeshi Tanigawa, Masahiko Kiyama, Shinichi Sato, Choy-Lye Chei, and Hiroyasu Iso
- Subjects
Adult ,Male ,medicine.medical_specialty ,Linoleic acid ,Protective factor ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Gastroenterology ,Palmitic acid ,Coronary artery disease ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Japan ,Risk Factors ,Internal medicine ,medicine ,Humans ,Palmitoleic acid ,030212 general & internal medicine ,Prospective cohort study ,Aged ,Aged, 80 and over ,chemistry.chemical_classification ,business.industry ,Incidence ,Incidence (epidemiology) ,Fatty Acids ,Fatty acid ,General Medicine ,Middle Aged ,medicine.disease ,chemistry ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Few prospective studies have explored the association between fatty acids (FA) and risk of CAD. Understanding of the role of each individual serum FA as a coronary risk or protective factor is still limited. The aim was to investigate which serum FA are associated with the incidence of CAD in Japanese subjects. Methods and Results: A prospective nested case-control study of 40-85-year-old Japanese subjects was undertaken using frozen serum samples collected from 12,840 participants who participated in cardiovascular risk surveys from 1984 to 1998 for 1 community and 1989-1997 for 2 other communities. Three control subjects per case were matched by sex, age, community, year of serum storage and fasting status. By 2005 we had identified 152 incident cases of CAD. Mean n-3-polyunsaturated and saturated FA did not differ between cases and controls, while mean n-6-polyunsaturated FA was higher in controls compared with cases. The multivariable OR of CAD for the highest vs. lowest quartiles of miristic acid (14:0), palmitic acid (16:0), palmitoleic acid (16:1), and linoleic acid (18:2) were 2.8 (95% CI: 1.5-5.2), 2.7 (95% CI: 1.4-5.5), 3.2 (95% CI: 1.7-6.1) and 0.4 (95% CI: 0.2-0.7), respectively. Conclusions High serum miristic acid, palmitic acid and palmitoleic acid have an adverse effect, and high serum linoleic acid had a protective effect, on the risk of CAD.
- Published
- 2018
21. Leukocyte Count and Risks of Stroke and Coronary Heart Disease: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Hironori Imano, Kazumasa Yamagishi, Tetsuya Ohira, Hiroyasu Iso, Tomoko Sankai, Akihiko Kitamura, Takeshi Tanigawa, Isao Muraki, Mina Hayama-Terada, Renzhe Cui, Jiaqi Li, Takeo Okada, Masahiko Kiyama, Mitsumasa Umesawa, and Mari Tanaka
- Subjects
Adult ,medicine.medical_specialty ,Infarction ,Coronary Disease ,Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Leukocyte Count ,0302 clinical medicine ,Japan ,Risk Factors ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Stroke ,Aged ,business.industry ,Incidence ,Biochemistry (medical) ,Hazard ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Quartile ,Cardiovascular Diseases ,Circulatory system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Aim This study aimed to investigate the associations of leukocyte count with the risks of stroke and coronary heart disease among the general Japanese population. Methods A total of 5,242 residents aged 40-69 years living in two Japanese communities underwent leukocyte count measurements between 1991 and 2000, and the data were updated using 5- or 10-year follow-ups or both. Participants who had histories of stroke, coronary heart disease, or high values of leukocyte count (>130×102 cells/mm3) were excluded. Hazard ratios with 95% confidence intervals (CIs) were calculated according to quartiles of cumulative average leukocyte count. Results During follow-up of 21 years, 327 stroke and 130 coronary heart disease cases were determined. After adjustments for age, sex, community, and updated cardiovascular risk factors, the multivariable hazard ratio (95% CI) for the highest versus lowest quartile of leukocyte count was 1.50 (1.08-2.08) for ischemic stroke, 1.59 (1.00-2.51) for lacunar infarction, 1.42 (0.90-2.26) for non-lacunar infarction, 2.17 (1.33-3.55) for coronary heart disease, and 1.40 (1.11-1.76) for total cardiovascular disease. In smoking status-stratified analyses, the corresponding multivariable hazard ratio (95% CI) was 2.45 (1.11-5.38) for ischemic stroke, 2.73 (1.37-5.44) for coronary heart disease in current smokers, 2.42 (1.07-5.46), 1.55 (0.58-4.15) in former smokers, and 1.17 (0.75-1.82), 1.78 (0.83-3.82) in never smokers. Conclusion Leukocyte count was positively associated with the risks of ischemic stroke and coronary heart disease among the general Japanese population, especially in current smokers.
- Published
- 2021
22. Tau‐induced brain atrophy and neuroinflammation accelerated by low‐protein diet and decelerated by selected essential amino acids in a murine model of tauopathies
- Author
-
Muneki Isokawa, Yuhei Takado, Akihiko Kitamura, Maiko Ono, Takuya Urushihata, Jun Maeda, Masako Tsukamoto-Yasui, Keiichiro Minatohara, Hideaki Sato, Mai Nishimura, Naruhiko Sahara, Sakiko Toyoda, Noriko Kawasaki, Sachise Karakawa, Ichio Aoki, Manami Takahashi, Mayuka Kanda, Katsuya Suzuki, Kenji Nagao, Satoko Ueno, Makoto Higuchi, Akira Mitsui, and Hiroyuki Takuwa
- Subjects
chemistry.chemical_classification ,medicine.medical_specialty ,Epidemiology ,Chemistry ,Health Policy ,medicine.medical_treatment ,medicine.disease ,Amino acid ,Psychiatry and Mental health ,Cellular and Molecular Neuroscience ,Atrophy ,Endocrinology ,Developmental Neuroscience ,Low-protein diet ,Murine model ,Internal medicine ,medicine ,Neurology (clinical) ,Geriatrics and Gerontology ,Neuroinflammation - Published
- 2020
23. Plasma‐free amino acid (PFAA) profile is a potential blood‐based biomarker for detection of mild cognitive impairment (MCI)
- Author
-
Kenji Nagao, Takayoshi Tokutake, Fumiyoshi Morikawa, Takeshi Ikeuchi, Naoko Arashida, Eiji Kaneko, Shuta Toru, Akihiko Kitamura, Yasuko Kuroha, Yuki Yano, Wataru Sato, Nobuhiko Miyazawa, Minoru Yamakado, Hitomi Kitamura, Chika Nishimura, Mayuka Kanda, and Kensaku Kasuga
- Subjects
medicine.medical_specialty ,Epidemiology ,Blood based biomarkers ,business.industry ,Health Policy ,medicine.disease ,Free amino ,Psychiatry and Mental health ,Cellular and Molecular Neuroscience ,Endocrinology ,Developmental Neuroscience ,Internal medicine ,medicine ,Neurology (clinical) ,Geriatrics and Gerontology ,Mild cognitive impairment (MCI) ,business - Published
- 2020
24. Associations of Carotid Intima‐Media Thickness and Plaque Heterogeneity With the Risks of Stroke Subtypes and Coronary Artery Disease in the Japanese General Population: The Circulatory Risk in Communities Study
- Author
-
Tomoko Sankai, Yasuhiko Kubota, Akihiko Kitamura, Masahiko Kiyama, Mina Hayama-Terada, Renzhe Cui, Takeo Okada, Yuji Shimizu, Isao Muraki, Mitsumasa Umesawa, Saeko Shimoda, Hironori Imano, Kazumasa Yamagishi, and Hiroyasu Iso
- Subjects
Adult ,Male ,medicine.medical_specialty ,Epidemiology ,Population ,Coronary Artery Disease ,carotid intima‐media thickness ,Carotid Intima-Media Thickness ,plaque ,Coronary artery disease ,Japan ,Risk Factors ,Cardiovascular Disease ,Internal medicine ,medicine ,Humans ,Carotid Stenosis ,Prospective Studies ,cardiovascular diseases ,education ,Stroke ,lacunar infarct ,Original Research ,Aged ,Ischemic Stroke ,Proportional Hazards Models ,education.field_of_study ,business.industry ,Middle Aged ,medicine.disease ,stroke ,Hemorrhagic Stroke ,Intima-media thickness ,Circulatory system ,cardiovascular system ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Evidence on the associations of carotid intima‐media thickness and carotid plaque characteristics with stroke subtypes and coronary artery disease risks in Asians is limited. This study investigated these associations in the Japanese general population. Methods and Results Maximum intima‐media thicknesses of both the common carotid artery and internal carotid artery and carotid plaque characteristics were evaluated in 2943 Japanese subjects aged 40 to 75 years without history of cardiovascular disease. Subjects were followed up for a median of 15.1 years. Using a multivariate Cox proportional hazard model, we found that hazard ratios (HRs) and 95% CIs for the highest (≥1.07 mm) versus lowest (≤0.77 mm) quartiles of maximum intima‐media thicknesses of the common carotid artery were 1.97 (1.26–3.06) for total stroke, 1.52 (0.67–3.41) for hemorrhagic stroke, 2.45 (1.41–4.27) for ischemic stroke, 3.60 (1.64–7.91) for lacunar infarction, 1.53 (0.69–3.41) for nonlacunar cerebral infarction, 2.68 (1.24–5.76) for coronary artery disease, and 2.11 (1.44–3.12) for cardiovascular disease (similar results were found for maximum intima‐media thicknesses of the internal carotid artery). HRs(95% CIs) for heterogeneous plaque versus no plaque were 1.58 (1.09–2.30) for total stroke, 1.25 (0.58–2.70) for hemorrhagic stroke, 1.74 (1.13–2.67) for ischemic stroke, 1.84 (1.03–3.19) for lacunar infarction, 1.58 (0.80–3.11) for nonlacunar cerebral infarction, 2.11 (1.20–3.70) for coronary artery disease, and 1.71 (1.25–2.35) for cardiovascular disease. Conclusions Maximum intima‐media thicknesses of the common carotid artery, maximum intima‐media thicknesses of the internal carotid artery, and heterogeneous plaque were associated with the risks of stroke, lacunar infarction, coronary artery disease, and cardiovascular disease in Asians.
- Published
- 2020
25. Serum High-Sensitivity C-Reactive Protein Levels and the Risk of Atrial Fibrillation in Japanese Population: the Circulatory Risk in Communities Study
- Author
-
Takeshi Tanigawa, Tomoko Sankai, Hironori Imano, Kazumasa Yamagishi, Mari Tanaka, Yasuhiko Kubota, Shinichi Sato, Takeo Okada, Mitsumasa Umesawa, Isao Muraki, Yuji Shimizu, Masahiko Kiyama, Mina Hayama-Terada, Renzhe Cui, Tetsuya Ohira, Akihiko Kitamura, and Hiroyasu Iso
- Subjects
Male ,medicine.medical_specialty ,Population ,030204 cardiovascular system & hematology ,Overweight ,Risk Assessment ,C-reactive protein ,03 medical and health sciences ,Electrocardiography ,0302 clinical medicine ,Japan ,Internal medicine ,Internal Medicine ,Medicine ,Humans ,Prospective Studies ,Risk factor ,education ,Prospective cohort study ,Aged ,Proportional Hazards Models ,education.field_of_study ,business.industry ,Biochemistry (medical) ,Hazard ratio ,Smoking ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Confidence interval ,Heart Disease Risk Factors ,Hypertension ,Female ,Original Article ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Cohort study ,030217 neurology & neurosurgery - Abstract
Aim This study aimed to investigate the association between the serum high-sensitivity C-reactive protein (hs-CRP) levels and incident atrial fibrillation risk in the general Japanese population, who have lower hs-CRP levels than the Western population, and assess whether the association is modified by sex, overweight, hypertension, and smoking status. Methods We conducted a prospective study in 6517 Japanese men and women aged 40-79 years without atrial fibrillation at baseline and enrolled in the Circulatory Risk in Communities Study (2002-2008). The hs-CRP levels were measured using the latex particle-enhanced immunonephelometric assay. Atrial fibrillation was identified using standard 12-lead electrocardiograms and information on physician-diagnosed atrial fibrillation history from the follow-up surveys. We used a Cox proportional hazard regression stratified by community. Results During a median follow-up of 11 years, 127 new cases of atrial fibrillation (74 and 53 cases among men and women, respectively) were found. Compared to the lowest quintile of hs-CRP levels, the multivariable hazard ratios (95% confidence intervals) were 2.54 (1.17-5.50), 2.28 (1.06-4.93), 2.92 (1.37-6.23), and 2.77 (1.30-5.91) for the second, third, fourth, and fifth (highest) quintiles, respectively. There was no significant effect modification by sex, overweight, hypertension, and smoking status (P for interaction >0.05). Conclusions Elevated hs-CRP levels were significantly associated with increased risk of atrial fibrillation in the Japanese population. The association of hs-CRP levels with incident atrial fibrillation did not vary according to sex, overweight, hypertension status, or smoking status.
- Published
- 2020
26. Protein Deficiency-Induced Behavioral Abnormalities and Neurotransmitter Loss in Aged Mice Are Ameliorated by Essential Amino Acids
- Author
-
Sachise Karakawa, Muneki Isokawa, Masako Tsukamoto-Yasui, Satoko Ueno, Katsuya Suzuki, Hideaki Sato, Mayuka Kanda, Makoto Higuchi, Akihiko Kitamura, Keiko Matsunaga, Mai Nishimura, Yuhei Takado, Noriko Kawasaki, and Kenji Nagao
- Subjects
0301 basic medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Endocrinology, Diabetes and Metabolism ,lcsh:TX341-641 ,elevated plus maze test ,030209 endocrinology & metabolism ,Phenylalanine ,protein deficiency ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Low-protein diet ,low protein diet ,Valine ,Internal medicine ,medicine ,Neurotransmitter ,cognitive function ,Essential amino acid ,Nutrition ,chemistry.chemical_classification ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Glutamate receptor ,Brief Research Report ,essential amino acids ,Amino acid ,Endocrinology ,passive avoidance test ,chemistry ,Leucine ,business ,lcsh:Nutrition. Foods and food supply ,aged mouse ,neurotransmitter ,Food Science - Abstract
Nutritional epidemiology shows that insufficient protein intake is related to senile dementia. The levels of protein intake in aged people are positively associated with memory function, and elderly people with high protein intake have a low risk of mild cognitive impairment. Although the beneficial roles of protein nutrition in maintaining brain function in aged people are well demonstrated, little is known about the mechanism by which dietary intake of protein affects memory and brain conditions. We fed aged mice a low protein diet (LPD) for 2 months, which caused behavioral abnormalities, and examined the nutritional effect of essential amino acid administration under LPD conditions. The passive avoidance test revealed that LPD mice demonstrated learning and memory impairment. Similarly, the LPD mice showed agitation and hyperactive behavior in the elevated plus maze test. Moreover, LPD mice exhibited decreased concentrations of gamma-aminobutyric acid (GABA), glutamate, glycine, dopamine, norepinephrine, serotonin and aspartate in the brain. Interestingly, oral administration of seven essential amino acids (EAAs; valine, leucine, isoleucine, lysine, phenylalanine, histidine, and tryptophan) to LPD mice, which can be a source of neurotransmitters, reversed those behavioral changes. The oral administration of EAAs restored the brain concentration of glutamate, which is involved in learning and memory ability and may be associated with the observed behavioral changes. Although the details of the link between decreased amino acid and neurotransmitter concentrations and behavioral abnormalities must be examined in future studies, these findings suggest the importance of dietary protein and essential amino acids for maintaining brain function.
- Published
- 2020
- Full Text
- View/download PDF
27. Association of pharmacological treatments for hypertension, diabetes, and dyslipidemia with health checkup participation and identification of disease control factors among older adults in Tokyo, Japan
- Author
-
Akihiko Kitamura, Tatsuro Ishizaki, Seigo Mitsutake, Sayuri Shimizu, Chie Teramoto, Hideki Ito, Takuya Yamaoka, and Rumiko Tsuchiya-Ito
- Subjects
BP, blood pressure ,medicine.medical_specialty ,DBP, diastolic blood pressure ,lcsh:Medicine ,030209 endocrinology & metabolism ,Health Informatics ,HDL-C, high-density lipoprotein cholesterol ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Diabetes mellitus ,Health care ,medicine ,Diabetes Mellitus ,030212 general & internal medicine ,Multinomial logistic regression ,Aged ,TC, triglycerides ,business.industry ,SBP, systolic blood pressure ,Healthcare ,lcsh:R ,Public Health, Environmental and Occupational Health ,Retrospective cohort study ,Regular Article ,Odds ratio ,medicine.disease ,Disease control ,Health services ,Blood pressure ,Dyslipidemia ,Hypertension ,Administrative claims ,LDL-C, low-density lipoprotein cholesterol ,business - Abstract
Highlights • We examined links between medical claims and health check-up data for older adults. • Patients receiving pharmacotherapies were more likely to participate in health checkups. • Patients with intensive disease control were more likely to be aged ≥ 90 years. • Linking these databases can improve evaluations of diseases control in older adults., The Japanese government encourages older adults to participate in annual health checkups designed to detect lifestyle diseases such as hypertension, diabetes, and dyslipidemia. However, individuals who are already being treated for these diseases are unlikely to benefit from health checkup participation. This retrospective cohort study of older adults evaluated the associations of pharmacological treatments for these diseases with health checkup participation and identified the disease control factors among patients receiving treatments. Using medical claims data and health checkup data between September 2013 and August 2014 from 820,215 older adults aged ≥ 75 years residing in Tokyo, Japan, we examined the associations between pharmacological treatments and health checkup participation using binary logistic regression analysis. Next, patients receiving pharmacological treatments were categorized into intensive, moderate, or limited disease control based on their blood pressure, hemoglobin A1c levels, and lipid levels; multinomial logistic regression analyses were used to identify the disease control factors. The results showed that patients receiving pharmacological treatments were more likely (odds ratio: 1.374; P
- Published
- 2020
28. Joint impact of muscle mass and waist circumference on type 2 diabetes in Japanese middle-aged adults: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Hiroshige Jinnouchi, Hiroyasu Iso, Mikako Yasuoka, Tetsuya Ohira, Takeo Okada, Akihiko Kitamura, Mitsumasa Umesawa, Circs Investigators, Masahiko Kiyama, Isao Muraki, Mina Hayama-Terada, Yasuhiko Kubota, Hironori Imano, and Kazumasa Yamagishi
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,China ,Sarcopenia ,Waist ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Mole ,medicine ,Humans ,Obesity ,Muscle, Skeletal ,Abdominal obesity ,Aged ,Glycated Hemoglobin ,business.industry ,Odds ratio ,Middle Aged ,medicine.disease ,Prognosis ,Endocrinology ,Quartile ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Female ,Hemoglobin ,medicine.symptom ,Waist Circumference ,business ,Biomarkers ,Follow-Up Studies - Abstract
Although evidence about skeletal muscle mass loss and type 2 diabetes risk has accumulated, little information is available on the combined effect of skeletal muscle mass and abdominal obesity on type 2 diabetes. We examined whether skeletal muscle mass and abdominal obesity were synergistically associated with the prevalence of type 2 diabetes.Skeletal muscle mass and waist circumference (WC) were measured in 1515 Japanese aged 40 to 69 years. Relative muscle mass was calculated as percentage of total skeletal muscle mass in body weight (SMM%). Type 2 diabetes was identified as fasting serum glucose ≥7.0 mmol/L (126 mg/dL), nonfasting serum glucose ≥11.1 mmol/L (200 mg/dL), glycosylated hemoglobin ≥ 6.5%, and/or diabetes medication use.The multivariable-adjusted odds ratio (OR) of prevalent diabetes from the lowest to the third quartile of SMM% compared to the highest quartile gradually increased in both sexes. The association between a high WC and prevalent diabetes was similar. The multivariable-adjusted OR (95% confidence intervals) for the prevalence of type 2 diabetes in the low skeletal muscle mass/high WC group was 3.19 (1.78-5.71) for men and 4.46 (2.09-9.51) for women compared with the high skeletal muscle mass/low WC group. The relative excess risk due to interaction was 2.2 (0.5-3.9) in men and 2.8 (0.2-5.3) in women for an excess burden of type 2 diabetes for low skeletal muscle mass and high WC.Low skeletal muscle mass and abdominal obesity were synergistically associated with presence of type 2 diabetes.背景: 虽然关于骨骼肌肉质量的下降与2型糖尿病风险的证据已有研究, 但关于骨骼肌质量和腹型肥胖对2型糖尿病的联合作用的信息很少。我们研究了骨骼肌质量和腹型肥胖是否与2型糖尿病的患病率协同相关。 方法: 测量1515名40-69岁日本人的骨骼肌质量和腰围。相对肌量以总骨骼肌质量占体重的百分比(SMM%)计算。2型糖尿病被定义为空腹血糖≥7.0 mmol/L(126 mg/dL), 非空腹血糖≥11.1mmol/L(200mg/dL), 糖化血红蛋白≥6 5%, 且或正在使用糖尿病药物。 结果: 相对肌量最低的四分之一与最高四分之一相比, 男性及女性糖尿病患病率的多变量调整优势比(OR)都有所升高。较高腰围和糖尿病发病率之间的联系也是相似的。与高骨骼肌质量/低腰围组相比, 低骨骼肌质量/高腰围组的2型糖尿病患病率多变量调整OR值于男性为3.19(1.78~5.71), 女性为4.46(2.09~9.51)。低骨骼肌质量与高腰围之间的交互作用导致了额外的糖尿病相对风险, 男性为2.2(0.5-3.9), 女性为2.8(0.2-5.3)。 结论: 低骨骼肌质量和腹型肥胖与2型糖尿病发病存在协同关系。.
- Published
- 2019
29. Nonfasting Glucose and Incident Stroke and Its Types ― The Circulatory Risk in Communities Study (CIRCS) ―
- Author
-
Takeo Okada, Mitsumasa Umesawa, Isao Muraki, Tetsuya Ohira, Akihiko Kitamura, Takeshi Tanigawa, Tomoko Sankai, Hironori Imano, Kazumasa Yamagishi, Masahiko Kiyama, Mina Hayama-Terada, Renzhe Cui, and Hiroyasu Iso
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Population ,Lacunar infarction ,030204 cardiovascular system & hematology ,Prediabetic State ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Diabetes Mellitus ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,education ,Stroke ,Aged ,Proportional Hazards Models ,education.field_of_study ,business.industry ,Hazard ratio ,General Medicine ,Middle Aged ,Postprandial Period ,medicine.disease ,Confidence interval ,Postprandial ,Stroke, Lacunar ,Ischemic stroke ,Circulatory system ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background:The effect of postprandial glucose on the risk of cardiovascular disease has been emphasized, but it is controversial whether nonfasting glucose is related to incident stroke and its types. Methods and Results:We investigated the associations of nonfasting glucose with incident stroke and its types among 7,198 participants aged 40–74 years from the Circulatory Risk in Communities Study, enrolled in 1995–2000. We estimated multivariable hazard ratios (HR) using Cox proportional hazard models. Over a median follow-up of 14.1 years, 291 cases of total stroke (ischemic strokes: 191 including 109 lacunar infarctions) were identified. Nonfasting glucose concentration was associated with greater risk of incident total stroke, ischemic stroke and lacunar infarction when modeled categorically (for prediabetic type: 7.8–11.0 mmol/L vs. normal type
- Published
- 2018
30. Association between markers of arterial stiffness and atrial fibrillation in the Circulatory Risk in Communities Study (CIRCS)
- Author
-
Ehab S. Eshak, Isao Muraki, Yuanying Li, Mina Hayama-Terada, Renzhe Cui, Tetsuya Ohira, Circs Investigators, Akihiko Kitamura, Hironori Imano, Kazumasa Yamagishi, Masahiko Kiyama, Takeshi Tanigawa, Takeo Okada, Mitsumasa Umesawa, and Hiroyasu Iso
- Subjects
Adult ,Male ,medicine.medical_specialty ,Manometry ,Population ,030204 cardiovascular system & hematology ,Electrocardiography ,03 medical and health sciences ,Vascular Stiffness ,0302 clinical medicine ,Asian People ,Japan ,Heart Rate ,Risk Factors ,Internal medicine ,Atrial Fibrillation ,Epidemiology ,Odds Ratio ,Prevalence ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,education ,Aged ,education.field_of_study ,business.industry ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Confidence interval ,Pulse pressure ,Cross-Sectional Studies ,Logistic Models ,Multivariate Analysis ,Circulatory system ,cardiovascular system ,Aortic pressure ,Cardiology ,Arterial stiffness ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background and aims Limited evidence is available on the association between markers of arterial stiffness and the prevalence of atrial fibrillation among Asian populations. Therefore, we examined those associations in the Japanese population. Methods We conducted a cross-sectional population-based study of 4264 men and women aged 40–79 years. The augmentation index (AI), a marker of arterial stiffness, was calculated as the ratio of central pulse pressure/brachial pulse pressure, where the AI and central aortic pressure were measured by an automated tonometer: the HEM-9000AI device (Omron Healthcare co., Kyoto, Japan). Atrial fibrillation was estimated by the Minnesota codes using resting electrocardiograph (ECG). Results The prevalence of atrial fibrillation and total arrhythmia were higher with larger AI values. These associations did not change after adjustment for known cardiovascular risk factors. The multivariable odd ratios (95% confidence intervals) in the highest versus lowest tertiles of AI were 3.4 (1.4–8.6, p for trend = 0.008) for atrial fibrillation and 1.8 (1.2–2.7, p for trend = 0.004) for total arrhythmia. There was no association of central or brachial pulse pressure levels with the prevalence of atrial fibrillation or total arrhythmia. Conclusions AI values, but not brachial or central pulse pressures, were positively associated with the prevalence of atrial fibrillation and total arrhythmia, independent of cardiovascular risk factors.
- Published
- 2017
31. Comprehensive risk management for the prevention of cerebro- cardiovascular diseases in Japan
- Author
-
Tetsuya Shoji, Masayasu Matsumoto, Akihiko Kitamura, Hidenori Arai, Ryouichi Nagatomi, Tamio Teramoto, Tsuyoshi Kimura, Mami Iida, Shigeru Inoue, Hiromi Rakugi, Masayuki Yokode, Hirohito Sone, Shigeru Mizyzaki, Hiroyasu Iso, Shizuya Yamashita, Jun Sasaki, and Hiroki Shiomi
- Subjects
Risk Management ,medicine.medical_specialty ,Thesaurus (information retrieval) ,Pediatrics ,Physiology ,business.industry ,Alternative medicine ,030204 cardiovascular system & hematology ,Cerebrovascular Disorders ,Peripheral Arterial Disease ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Cardiovascular Diseases ,Family medicine ,Internal Medicine ,medicine ,Humans ,Cardiology and Cardiovascular Medicine ,business ,Algorithms ,030217 neurology & neurosurgery ,Risk management - Abstract
Comprehensive risk management for the prevention of cerebro- cardiovascular diseases in Japan
- Published
- 2017
32. Impact of Hypertension and Subclinical Organ Damage on the Incidence of Cardiovascular Disease Among Japanese Residents at the Population and Individual Levels : The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Tomoko Sankai, Hironori Imano, Kazumasa Yamagishi, Tetsuya Ohira, Mitsumasa Umesawa, Akihiko Kitamura, Isao Saito, Hiroyasu Iso, Masahiko Kiyama, Renzhe Cui, and Isao Muraki
- Subjects
Adult ,Male ,medicine.medical_specialty ,Population ,030204 cardiovascular system & hematology ,Coronary artery disease ,03 medical and health sciences ,Electrocardiography ,0302 clinical medicine ,Asian People ,Japan ,Risk Factors ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,cardiovascular diseases ,education ,Stroke ,Subclinical infection ,Aged ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Incidence ,Hazard ratio ,Cholesterol, HDL ,Smoking ,General Medicine ,Middle Aged ,medicine.disease ,Relative risk ,Attributable risk ,Hypertension ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background In Japan, a community-based screening program for cardiovascular disease (CVD) has been effective in preventing stroke and coronary artery disease (CAD). The present study aimed to clarify which risk factors assessed at the screening examinations affect the incidence of CVD and the magnitude of the association after the late 1990 s.Methods and Results:We conducted a 12.5-year prospective study of 10,612 Japanese residents aged 40-74 years between 1995 and 2000, initially free of CVD and who underwent the screening examinations. During the follow-up, 364 cases of stroke and 137 cases of CAD were identified. The population attributable fraction of stroke was the largest for hypertension (HT; 46%), while the relative risk of stroke was the highest for atrial fibrillation (multivariable hazard ratio, 4.9; 95% confidence interval, 2.9-8.3). The population attributable fraction of CAD was relatively large for HT, current smoking, and high non-high-density lipoprotein cholesterol (20-29%). A dose-response relationship was found between the incidence of these cardiovascular events and the number of comorbid hypertensive subclinical organ damage markers: funduscopic changes, ST-T changes on ECG at rest, proteinuria and low estimated glomerular filtration rate. Conclusions HT and hypertensive subclinical organ damage are significantly associated with incident stroke and CAD at the population level, suggesting that management of HT and assessment of subclinical organ damage in hypertensive subjects at a screening program are still beneficial for community-based CVD prevention.
- Published
- 2017
33. Serum α-linolenic and other ω-3 fatty acids, and risk of disabling dementia: Community-based nested case–control study
- Author
-
Takeo Okada, Masahiko Kiyama, Mitsumasa Umesawa, Renzhe Cui, Tetsuya Ohira, Ai Ikeda, Hiroyasu Iso, Takeshi Tanigawa, Akihiko Kitamura, Choy-Lye Chei, Hiroyuki Noda, Isao Muraki, Hironori Imano, Kazumasa Yamagishi, and Tomoko Sankai
- Subjects
0301 basic medicine ,chemistry.chemical_classification ,medicine.medical_specialty ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Odds ratio ,Critical Care and Intensive Care Medicine ,Prevention of dementia ,medicine.disease ,Surgery ,03 medical and health sciences ,chemistry ,Docosahexaenoic acid ,Internal medicine ,Nested case-control study ,Cohort ,Epidemiology ,medicine ,Dementia ,business ,Polyunsaturated fatty acid - Abstract
Summary Background & aims It has been hypothesized that ω-3 polyunsaturated fatty acids have anti-atherosclerotic and neuronal protective functions and may benefit prevention of dementia, but the epidemiological evidence, especially for α-linolenic acid, is quite limited. The aim of this study was to examine whether serum ω-3 polyunsaturated fatty acids are associated with risk of dementia. Methods We performed an intracohort case–control study nested in a community-based cohort, the Circulatory Risk in Communities Study, involving 7586 Japanese individuals aged 40–74 years at the baseline period of 1984–1994. Omega-3 polyunsaturated fatty acid constituents (α-linolenic, eicosapentaenoic, and docosahexaenoic acids) in serum total lipid were measured in 315 cases of incident disabling dementia in the above-mentioned cohort between 1999 and 2004, and in 630 controls whose age, sex, area, and baseline year were matched with the cases. Results As we had postulated, serum α-linolenic acid was inversely associated with risk of disabling dementia: the multivariate odds ratios (95% confidence intervals) were 0.57 (0.39–0.85), 0.51 (0.34–0.76), and 0.61 (0.41–0.90) for persons with the second, third, and highest quartiles of serum α-linolenic acid, respectively, as compared with the lowest quartile ( P for trend = 0.01). Associations of other ω-3 fatty acids with disabling dementia were not statistically significant. Conclusions Serum α-linolenic acid was inversely associated with risk of disabling dementia. Although the causality needs to be confirmed by randomized control trials, we identified serum α-linolenic acid as a biomarker that predicts future dementia.
- Published
- 2017
34. Retinal Vascular Changes and Prospective Risk of Disabling Dementia: the Circulatory Risk in Communities Study (CIRCS)
- Author
-
Masahiko Kiyama, Mina Hayama-Terada, Renzhe Cui, Hiroshige Jinnouchi, Ryo Kawasaki, Tomoko Sankai, Tetsuya Ohira, Akihiko Kitamura, Isao Muraki, Hiroyasu Iso, Hironori Imano, Kazumasa Yamagishi, Takeo Okada, and Mitsumasa Umesawa
- Subjects
Adult ,Male ,medicine.medical_specialty ,Population ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Retinal Diseases ,Risk Factors ,Internal medicine ,mental disorders ,Internal Medicine ,Medicine ,Dementia ,Humans ,Longitudinal Studies ,skin and connective tissue diseases ,education ,Retinopathy ,Stroke ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Biochemistry (medical) ,Case-control study ,Odds ratio ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,Case-Control Studies ,Cardiology ,Cohort studies ,Original Article ,Nested case-control studies ,Female ,sense organs ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Cohort study ,Retinal vascular changes ,Follow-Up Studies - Abstract
Aim: To investigate the association of retinal vascular changes with a risk of dementia in longitudinal population-based study., Methods: We performed a nested case-control study of 3,718 persons, aged 40–89 years, enrolled between 1983 and 2004. Retinal vascular changes were observed in 351 cases with disabling dementia (average period before the onset, 11.2 years) and in 702 controls matched for sex, age, and baseline year. Incidence of disabling dementia was defined as individuals who received cares for disabilities including dementia-related symptoms and/or behavioral disturbance. Conditional logistic regression analysis was used to calculate odds ratio (OR) and multivariable adjusted OR (Models 1 and 2) for incidence of dis- abling dementia according to each retinal vascular change. Regarding confounding variables, Model 1 included overweight status, hypertension, hyperglycemia, dyslipidemia, and smoking status, whereas Model 2 also included incidence of stroke prior to disabling dementia for further analysis., Results: The proportion of cases (controls) with retinal vascular changes was 23.1 (15.7)% for general-ized arteriolar narrowing, 7.7 (7.5)% for focal arter iolar narrowing, 15.7 (11.8)% for arteriovenous nick-ing, 10.5 (9.3)% for increased arteriolar wall reflex, and 11.4 (9.8)% for any other retinopathy. General-ized arteriolar narrowing was associated with an in creased risk of disabling dementia: crude OR, 1.66 (95% confidence interval, 1.19 –2.31); Model 1: OR, 1.58 (1.12–2.23); Model 2: OR, 1.48 (1.04–2.10). The number of retinal abnormalities was associated in a dose–response manner with the risk., Conclusion: Generalized arteriolar narrowing and total number of retinal abnormalities may be use-ful markers for identifying persons at higher risks of disabling dementia.
- Published
- 2017
35. Fifty-year Time Trends in Blood Pressures, Body Mass Index and their Relations in a Japanese Community: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Tetsuya Ohira, Akihiko Kitamura, Hironori Imano, Isao Saito, Takeo Okada, Kazumasa Yamagishi, Tomoko Sankai, Mitsumasa Umesawa, Masahiko Kiyama, Hiroyasu Iso, M. Hori, Isao Muraki, Renzhe Cui, and Takeshi Tanigawa
- Subjects
Gerontology ,Adult ,Male ,Diastole ,Blood Pressure ,Disease ,030204 cardiovascular system & hematology ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal Medicine ,medicine ,Prevalence ,Humans ,030212 general & internal medicine ,Obesity ,Aged ,Time trends ,business.industry ,Biochemistry (medical) ,Age Factors ,Long-term trends ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Cardiovascular Diseases ,Circulatory system ,Hypertension ,Mixed effects ,Disease prevention ,Original Article ,Female ,Public Health ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Demography - Abstract
Aim Data for long-term trends in blood pressures, body mass index (BMI), and their relations are needed to set future intervention priorities for prevention of cardiovascular disease. The objective of this study was to investigate these trends revealed by repeated cross-sectional surveys conducted from 1963 to 2013 in a Japanese community. Methods Men and women aged 40-79 years who participated in annual cardiovascular checkups were enrolled, and the number of participants ranged between 1,776 and 2,366 with consistently high participation rates for both sexes aged 60-69 years. Sex- and age-specific mean systolic and diastolic blood pressures were calculated using mixed effects modeling for repeated measurement, and the prevalence of hypertension with and without obesity (BMI ≥ 25 kg/m2) were also calculated. Results Sex- and age-specific mean systolic and diastolic blood pressures declined irrespective of antihypertensive medication use in both men and women from 1963-1966 to 2009-2013, while mean BMI increased among men of all ages and women of ages 60-69 and 70-79 years. For both sexes aged 60-69 years, the prevalence of hypertension with obesity increased, but the prevalence of hypertension without obesity was still higher that with obesity. Conclusions Despite the transition to increased BMI levels, targeting non to obese hypertension remains important in addition to targeting obese hypertension for cardiovascular disease prevention.
- Published
- 2017
36. Changes in ischaemic ECG abnormalities and subsequent risk of cardiovascular disease
- Author
-
Hiroyasu Iso, Tomoko Sankai, Takeshi Sawai, Yuji Shimizu, Tetsuya Ohira, Isao Muraki, Akihiko Kitamura, Hironori Imano, Mina Hayama-Terada, Renzhe Cui, Kazumasa Yamagishi, Takeo Okada, Masahiko Kiyama, and Mitsumasa Umesawa
- Subjects
ST depression ,medicine.medical_specialty ,business.industry ,Disease ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Increased risk ,Internal medicine ,Abnormal T-wave ,Cohort ,Cardiology ,Medicine ,030212 general & internal medicine ,Abnormality ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Prospective cohort study ,Stroke ,Original Research - Abstract
Objective The prognostic importance of changes in ischaemic ECG abnormalities over time (especially ST-T abnormalities) among Asians has not been fully investigated. We examined the associations between changes in ischaemic abnormalities upon serial ECG (improvement, persistence, deterioration) and cardiovascular disease (CVD) risk. Methods A prospective study cohort was conducted with 9374 men and women aged 40–69 years in four communities. Participants had multiple ECGs at study entry and during the next 10 years, and were followed up for a median period of 23.0 years. Total CVD (stroke and coronary heart disease) was ascertained under systematic surveillance. ECG abnormalities were defined by the Minnesota Code, ST depression (Code4), abnormal T wave (Code5) and categorised into nine groups (no–no, no–minor, no–major, minor–no, minor–minor, minor–major, major–no, major–minor, major–major) by comparison with the point of entrance and maximum change. Results We documented 1196 CVD events. Compared with no–no abnormality, no–minor, minor–major and major–major in Code4, HRs (95% CI) adjusted for cardiovascular risk factors were 1.19 (1.00–1.42), 1.57 (1.15–2.12) and 1.87 (1.42–2.47). Similar results were observed in Code5. Conclusions Changes in ischaemic ECG abnormalities from none to minor, and minor to major, as well as persistent major abnormalities, were associated with an increased risk of CVD.
- Published
- 2017
37. Cardiovascular reactivity to acute stress associated with sickness absence among Japanese men and women: A prospective study
- Author
-
Tetsuya Ohira, Hironori Imano, Akihiko Kitamura, Mitsugu Kajiura, Hiroyasu Iso, Masahiko Kiyama, Takeo Okada, and Kumi Hirokawa
- Subjects
Adult ,Male ,medicine.medical_specialty ,Japanese workers ,Blood Pressure ,Logistic regression ,050105 experimental psychology ,lcsh:RC321-571 ,03 medical and health sciences ,Behavioral Neuroscience ,0302 clinical medicine ,Japan ,Heart Rate ,Internal medicine ,Medicine ,Heart rate variability ,Humans ,0501 psychology and cognitive sciences ,Prospective Studies ,Prospective cohort study ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Original Research ,Sickness absence ,business.industry ,05 social sciences ,heart rate variability ,mental problems ,Odds ratio ,Middle Aged ,sickness absence ,Mental health ,Confidence interval ,Blood pressure ,Female ,Sick Leave ,business ,030217 neurology & neurosurgery ,Stress, Psychological ,autonomic reactivity to stress ,prospective study - Abstract
Objective We aimed to investigate associations between cardiovascular reactivity to acute stress and sickness absence among Japanese male and female workers, in a prospective study. Methods Among healthy employed Japanese workers who underwent mental health checks between 2006 and 2009, data of 111 participants were analyzed. Changes in blood pressure, pulse rate, peripheral blood flow (PBF), and heart rate variability (HRV) (high frequency [HF] and low frequency [LF]) were calculated using differences between the two tasks, mirror drawing stress [MDS] and a maze task, and the postperiod value. Sickness absence through March 2010 was followed up by mail survey (average follow‐up 2.3 years). Logistic regression analysis was used, adjusting for lifestyle factors. Results Among 12 participants who took sickness absences, eight were owing to mental problems. Changes in the LF during the MDS and maze tasks and LF‐to‐HF ratio during the MDS task were positively associated with all sickness absences (odds ratio [OR], 95% confidence interval [CI]: 2.09, 1.03–4.22; 2.04, 1.09–3.82; and 3.10, 1.46–6.58, respectively). Changes in PBF during the MDS task were also associated with increased risk of sickness absence (OR, 95% CI: 2.53, 1.10–5.81). Conclusion Cardiovascular reactivity to acute stress should be considered at workers' health checks., Changes in the LF during the MDS and maze tasks and LF‐to‐HF ratio during the MDS task were positively associated with all sickness absences. Changes in PBF during the MDS task were also associated with increased risk of sickness absence.
- Published
- 2019
38. Low Protein Diet Induces Memory Loss and Anxiety Like Behavior via Decreases of Neurotransmitters in Aged Male Mice (P14-028-19)
- Author
-
Masako Tsukamoto-Yasui, Akihiko Kitamura, Keiko Matsunaga, Hideaki Sato, and Satoko Ueno
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,Chemistry ,medicine.medical_treatment ,Glutamate receptor ,Medicine (miscellaneous) ,Amnesia ,Neuroscience, Cognitive Function and Chronobiology ,Norepinephrine ,medicine.anatomical_structure ,Endocrinology ,Low-protein diet ,Cerebral cortex ,Dopamine ,Internal medicine ,medicine ,Anxiety ,Serotonin ,medicine.symptom ,Food Science ,medicine.drug - Abstract
OBJECTIVES: Increase of elderly people, dementia and cognitive decline has been already one of the social problems all over the world. There are a lot of risk factors including dietary composition. Several studies have reported the importance of protein for maintaining brain functions in the elderly, but the details are not well understood. To clarify the relationship between protein intake and brain function in the elderly, we evaluated the effect of low protein diet on cognitive function and psychiatric symptoms in aged mice. METHODS: Male mice at 60 weeks of age were fed a control diet (NPD; casein 20%) or a low protein diet (LPD; casein 5%). To evaluate neurobehavioral abnormality, we performed the elevated plus maze task (Day 64) and Passive avoidance task (conditioning: Day 66, evaluation: Day 67). Cerebral cortex tissues and plasma were measured for free amino acid concentration by LC-MSMS method, and monoamine concentration in cerebral cortex was measured by HPLC method. RESULTS: In the Passive avoidance task, LPD group decreased the time to keep staying in the light box and the rate of individuals entering the dark box during the test period. In the elevated plus maze task, LPD group significantly increased in the number of entry and staying times in open arm. In addition, total travel distance was significantly increased. Moreover, LPD decreased the concentration of not only amino acid in plasma and cerebral cortex but also neurotransmitter such as Glutamate, GABA, Aspartate, Glycine, Dopamine, Norepinephrine, Serotonin. CONCLUSIONS: We found that long-term intake of low-protein diet occurred memory loss and anxiety like behavior in elderly mice. Intracerebral neurotransmitters are mainly synthesized from amino acids, which is transferred from blood, within the brain. Therefore, behavioral change observed in LPD group might be induced by the decrease of neurotransmitters in the brain. FUNDING SOURCES: Ajinomoto Co., Inc.
- Published
- 2019
39. Trajectories of kidney function and associated factors among community-dwelling older Japanese: a 16-year longitudinal study
- Author
-
Akihiko Kitamura, Yu Taniguchi, Yoshinori Fujiwara, Shoji Shinkai, Hiroshi Fukuda, Yuri Yokoyama, Toshio Naito, Hidenori Amano, Hirohide Yokokawa, Sho Kaito, and Satoshi Seino
- Subjects
Nephrology ,Male ,Longitudinal study ,medicine.medical_specialty ,Aging ,Heart disease ,Physiology ,030232 urology & nephrology ,Renal function ,030204 cardiovascular system & hematology ,Kidney ,03 medical and health sciences ,0302 clinical medicine ,Asian People ,Reference Values ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Longitudinal Studies ,Stage (cooking) ,Prospective cohort study ,Aged ,Aged, 80 and over ,business.industry ,Trajectory group ,medicine.disease ,Female ,business ,Demography ,Kidney disease ,Glomerular Filtration Rate - Abstract
No study has reported trajectories of kidney function in later life. This long-term prospective study attempted to classify trajectories of estimated glomerular filtration rate (eGFR) and identify factors associated with these trajectories. We collected data from annual geriatric health checkups conducted during 2002–2017 in Kusatsu Town, Gunma Prefecture, Japan. The participants were 1990 adults aged 65–90 years (mean [SD] age, 71.0 [5.7] years; 57.0% women), and the total number of observations was 9291. Data were analyzed with a group-based semiparametric mixture model and age-adjusted univariable cumulative logit models. Trajectory of kidney function, as determined by eGFR, was classified as low, middle, and high (4.8%, 38.9%, and 56.3% of men, respectively, and 5.2%, 31.5%, and 63.3% of women). Among men and women in the low trajectory group, chronic kidney disease (CKD) stage worsened from stage G3a (51.8 ml/min/1.73 m2 in men and 53.6 in women) at age 65 years to stage G4 (28.0 ml/min/1.73 m2 in men and 28.5 in women) by age 85 years. A history of hypertension (men and women) and heart disease (men) were more likely in the low trajectory group than in the middle and high trajectory groups. About 5% of community-dwelling older adults had an eGFR
- Published
- 2019
40. Association of Time-Dependent Diastolic Blood Pressure Trajectory and Risk for the Ischemic Type of Cardiovascular Disease in Hypertensive Patients
- Author
-
Tetsuya Ohira, Akihiko Kitamura, Hironori Imano, Tomoko Sankai, Kazumasa Yamagishi, Takeo Okada, Mitsumasa Umesawa, Ryoto Sakaniwa, Isao Muraki, Circs Investigators, Masahiko Kiyama, Hiroyasu Iso, Mina Hayama-Terada, and Renzhe Cui
- Subjects
medicine.medical_specialty ,business.industry ,Hazard ratio ,Ethics committee ,Disease ,medicine.disease ,Confidence interval ,Blood pressure ,Internal medicine ,Cohort ,Cardiology ,Medicine ,Trajectory analysis ,cardiovascular diseases ,Myocardial infarction ,business - Abstract
Background: The effect of lowering diastolic blood pressure (DBP) on the risk for ischemic cardiovascular disease (CVD) is usually only assessed with a single timepoint at baseline. This has led to a lack of explanation for the U- or J-shaped association between DBP and the risk for ischemic CVD among hypertensive patients. Methods: We studied a cohort of 7074 hypertensive patients (42.9% men) aged 35-79 years (mean age=56.5 years) at baseline in 1980-1989, with annually repeated blood pressure measurements. Time-dependent DBP trajectories were assessed by group-based trajectory analysis, adjusted by sex, age, and antihypertensive medication use. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) of ischemic CVD, composed of ischemic stroke and myocardial infarction, according to DBP trajectories were estimated by competing risk analysis. For references, we examined the same approaches mentioned above were used for systolic blood pressure. Findings: For 24.1 years, there were 799 incident cases of ischemic CVD. Eight DBP trajectories were identified. We found a U-shaped association between DBP trajectories and a risk for ischemic CVD. The HRs (95%CI) of ischemic CVD with reference to a moderately-stable trajectory were 2.0 (1.8-2.2) for a very-low-stable, 1.4 (1.3-1.6) for low-decreasing, 1.6 (1.3-1.5) for low-stable, 1.4 (1.3-1.5) for moderately-decreasing, 1.5 (1.4-1.7) for high-decreasing, 1.2 (1.1-1.4) for high-stable, and 1.4 (1.2-1.62) for very-high-stable. This U-shaped association was more pronounced in antihypertensive medication users than in non-users. No such association was observed for SBP trajectories. Interpretation: We found a U-shaped association between DBP trajectory and ischemic CVD in hypertensive patients in a time-dependent analysis, which cannot be detected by single timepoint analysis. Changes in DBP among hypertensive patients should be carefully documented for preventing ischemic CVD. Funding Statement: Ministry of Health, Labor and Welfare of Japan. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study was approved by the ethics committees of Osaka University and Osaka Center for Cancer and Cardiovascular Disease Prevention, and was performed in accordance with the Declaration of Helsinki.
- Published
- 2019
41. Prevalence of frailty, cognitive impairment, and sarcopenia in outpatients with cardiometabolic disease in a frailty clinic
- Author
-
Yoshinori Fujiwara, Akihiko Kitamura, Kazumasa Harada, Akiko Kanemaru, Masamitsu Sugie, Ko Furuta, Atsushi Araki, Jun Tanaka, Yuko Chiba, Yoshiaki Tamura, Shoji Shinkai, Sho Kaito, Satoshi Seino, Hirohiko Hirano, Takashi Nishimura, Ai Iizuka, Hideki Ito, Nobuo Kanazawa, Keigo Shimoji, Masashi Tanaka, Joji Ishikawa, and Shunei Kyo
- Subjects
Male ,Sarcopenia ,medicine.medical_specialty ,Frail Elderly ,Population ,Modified CHS criteria ,Comorbidity ,lcsh:Geriatrics ,Ambulatory Care Facilities ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Risk Factors ,030502 gerontology ,Internal medicine ,Outpatients ,Diabetes Mellitus ,Prevalence ,medicine ,Humans ,Outpatient clinic ,Dementia ,Prospective Studies ,030212 general & internal medicine ,Cognitive decline ,education ,Geriatric Assessment ,Aged ,Aged, 80 and over ,education.field_of_study ,Frailty ,business.industry ,Incidence ,Incidence (epidemiology) ,Frailty clinic ,Montreal Cognitive Assessment ,medicine.disease ,Cardiometabolic diseases ,lcsh:RC952-954.6 ,Cognitive impairment ,Cardiovascular Diseases ,Female ,Geriatrics and Gerontology ,Cognition Disorders ,0305 other medical science ,business ,Dyslipidemia ,Research Article - Abstract
Background Although frailty and cognitive impairment are critical risk factors for disability and mortality in the general population of older inhabitants, the prevalence and incidence of these factors in individuals treated in the specialty outpatient clinics are unknown. Methods We recently established a frailty clinic for comprehensive assessments of conditions such as frailty, sarcopenia, and cognition, and planned 3-year prospective observational study to identify the risk factors for progression of these aging-related statuses. To date, we recruited 323 patients who revealed symptoms suggestive of frailty mainly from a specialty outpatient clinic of cardiology and diabetes. Frailty status was diagnosed by the modified Cardiovascular Health Study (mCHS) criteria and some other scales. Cognitive function was assessed by Mini-Mental State Examination (MMSE), Japanese version of the Montreal Cognitive Assessment (MoCA-J), and some other modalities. Sarcopenia was defined by the criteria of the Asian Working Group for Sarcopenia (AWGS). In this report, we outlined our frailty clinic and analyzed the background characteristics of the subjects. Results Most patients reported hypertension (78%), diabetes mellitus (57%), or dyslipidemia (63%), and cardiovascular disease and probable heart failure also had a higher prevalence. The prevalence of frailty diagnosed according to the mCHS criteria, cognitive impairment defined by MMSE (≤27) and MoCA-J (≤25), and of AWGS-defined sarcopenia were 24, 41, and 84, and 31%, respectively. The prevalence of frailty and cognitive impairment increased with aging, whereas the increase in sarcopenia prevalence plateaued after the age of 80 years. No significant differences were observed in the prevalence of frailty, cognitive impairment, and sarcopenia between the groups with and without diabetes mellitus, hypertension, or dyslipidemia with a few exceptions, presumably due to the high-risk subjects who had multiple cardiovascular comorbidities. A majority of the frail and sarcopenic patients revealed cognitive impairment, whereas the frequency of suspected dementia among these patients were both approximately 20%. Conclusions We found a high prevalence of frailty, cognitive impairment, and sarcopenia in patients with cardiometabolic disease in our frailty clinic. Comprehensive assessment of the high-risk patients could be useful to identify the risk factors for progression of frailty and cognitive decline.
- Published
- 2018
42. Dehydroepiandrosterone-sulfate is associated with cardiovascular reactivity to stress in women
- Author
-
Kumi Hirokawa, Hiroyasu Iso, Hironori Imano, Mitsugu Kajiura, Masahiko Kiyama, Takeo Okada, Mako Nagayoshi, Tetsuya Ohira, and Akihiko Kitamura
- Subjects
Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Dehydroepiandrosterone ,Blood Pressure ,050105 experimental psychology ,Cardiovascular Physiological Phenomena ,03 medical and health sciences ,chemistry.chemical_compound ,Sex Factors ,0302 clinical medicine ,Endocrinology ,Dehydroepiandrosterone sulfate ,Japan ,Heart Rate ,Stress, Physiological ,Internal medicine ,Heart rate ,medicine ,Humans ,Heart rate variability ,0501 psychology and cognitive sciences ,Reactivity (psychology) ,Life Style ,Biological Psychiatry ,Dehydroepiandrosterone Sulfate ,Endocrine and Autonomic Systems ,Smoking ,05 social sciences ,Confounding ,Age Factors ,Middle Aged ,medicine.disease ,Menopause ,Psychiatry and Mental health ,Blood pressure ,chemistry ,Cardiovascular Diseases ,Hypertension ,Female ,Psychology ,Blood Flow Velocity ,030217 neurology & neurosurgery - Abstract
Cardiovascular stress reactivity is a predictor of atherosclerosis and cardiac events. Dehydroepiandrosterone (DHEA) protects against cardiovascular diseases, but results among previous studies have been inconsistent. We investigated the association between dehydroepiandrosterone-sulfate (DHEA-s) and cardiovascular stress reactivity in Japanese women and men. Among 979 healthy Japanese subjects (641 women and 338 men), serum levels of DHEA-s, systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate, heart rate variability, and peripheral blood flow were measured under rest and two types of task. Mean differences in measured variables during tasks and a post-task period were calculated as changes in stress reactivity. Variables of stress reactivity were adjusted for multiple potential confounding factors. In women, DHEA-s levels showed positive associations with changes in SBP and DBP (standardized beta=0.12, p=0.020; 0.17, 0.002, respectively). Stratification by menopausal status and other lifestyle factors (e.g., smoking status, alcohol consumption) were conducted. Significant positive associations remained in pre-menopausal (standardized beta=0.13, p=0.037; 0.18, 0.005), non-smoking (0.12, 0.010; 0.18
- Published
- 2016
43. Diabetes Trend and Impact on Risk of Cardiovascular Disease in Middle-Aged Japanese People – The CIRCS Study –
- Author
-
Isao Muraki, Hironori Imano, Kazumasa Yamagishi, Mina Hayama-Terada, Renzhe Cui, Shinichi Sato, Tomoko Sankai, Takeo Okada, Mitsumasa Umesawa, Hiroyasu Iso, Tetsuya Ohira, Masahiko Kiyama, and Akihiko Kitamura
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cardiovascular risk factors ,Population ,Disease ,030204 cardiovascular system & hematology ,Diabetes Complications ,03 medical and health sciences ,0302 clinical medicine ,Asian People ,Japan ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Epidemiology ,medicine ,Humans ,030212 general & internal medicine ,Risk factor ,education ,Aged ,education.field_of_study ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Clinical trial ,Cardiovascular Diseases ,Attributable risk ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background The aim of this study was to examine whether the burden of diabetes on cardiovascular disease (CVD) in Japan has increased in recent years.Methods and Results:Three cohorts were established, consisting of Japanese residents aged 40-69 years, in 1992-1995 (n=8,744), 1996-1999 (n=7,996), and 2000-2003 (n=7,273). All participants had follow-up for a median of 10 years. Diabetes was defined according to the following criteria: (1) fasting serum glucose ≥7.0 mmol/L; (2) non-fasting serum glucose ≥11.1 mmol/L; or (3) anti-diabetic treatment at baseline. During follow-up, the number of CVD incidents was 277 in the first, 214 in the second, and 190 in the third cohorts. The prevalence of diabetes increased slightly over time. Adjusting for traditional cardiovascular risk factors, multivariable HR (95% CI) for diabetes as a cardiovascular risk factor were 1.40 (0.91-2.14) in the first, 1.93 (1.25-3.00) in the second, and 2.59 (1.77-3.81) in the third cohorts. The population attributable fraction of CVD due to diabetes was 2.8%, 5.6%, and 12.4%, respectively. Conclusions This is the first study in middle-aged Japanese people to clarify an increased burden of CVD due to diabetes since the early 1990 s. Further efforts are needed to prevent and control diabetes through lifestyle modification and treatment. (Circ J 2016; 80: 2343-2348).
- Published
- 2016
44. Serum creatinine levels and risk of incident type 2 diabetes mellitus or dysglycemia in middle-aged Japanese men: a retrospective cohort study
- Author
-
Akihiko Kitamura, Hiroyasu Iso, Hironori Imano, Isao Muraki, Masahiko Kiyama, Yuji Shimizu, Mamoru Takeuchi, Mina Hayama-Terada, and Takeo Okada
- Subjects
Research design ,medicine.medical_specialty ,Diabetes risk ,endocrine system diseases ,type 2 diabetes mellitus ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,serum creatinine ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,dysglycemia ,Internal medicine ,medicine ,Risk factor ,Epidemiology/Health Services Research ,Creatinine ,business.industry ,Type 2 Diabetes Mellitus ,nutritional and metabolic diseases ,Retrospective cohort study ,Male workers ,chemistry ,risk factor ,business ,Body mass index - Abstract
ObjectiveTo assess the association between low serum creatinine levels and an increased risk of type 2 diabetes mellitus and dysglycemia.Research design and methodsWe conducted a retrospective cohort study of 3313 Japanese male workers aged 30–55 years, who underwent annual health check-ups during 2001–2008 and showed no type 2 diabetes mellitus, and underwent follow-up examinations until March 2013. Dysglycemia was defined as a fasting plasma glucose concentration of≥110 mg/dL (6.1 mmol/L), or a non-fasting plasma glucose concentration of≥140 mg/dL (7.8 mmol/L). A Cox proportional model was used to calculate HRs and 95% CIs for developing type 2 diabetes mellitus or dysglycemia.ResultsDuring the median 6.7-year follow-up, there were 207 cases of incident type 2 diabetes mellitus and 596 cases of incident dysglycemia, including 115 cases of type 2 diabetes mellitus among the subjects with normal glucose concentrations at baseline. After adjustment for age, body mass index and known diabetes risk factors, the multivariable HR of type 2 diabetes mellitus for the lowest category of serum creatinine (ConclusionsLow serum creatinine levels were associated with an increased risk of type 2 diabetes mellitus and dysglycemia.
- Published
- 2017
45. Serum coenzyme Q10 and risk of disabling dementia: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Akihiko Kitamura, Yuri Moriyama, Mitsumasa Umesawa, Masanori Nagao, Kazumasa Yamagishi, Takashi Asada, Hiroyasu Iso, Renzhe Cui, Ai Ikeda, Yorihiro Yamamoto, Choy-Lye Chei, and Hiroyuki Noda
- Subjects
Male ,medicine.medical_specialty ,Ubiquinone ,Antioxidants ,chemistry.chemical_compound ,Japan ,Risk Factors ,Internal medicine ,Epidemiology ,medicine ,Humans ,Dementia ,Aged ,Neurons ,Coenzyme Q10 ,business.industry ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Mitochondria ,Quartile ,chemistry ,Cohort ,Circulatory system ,Physical therapy ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
Objective : To examine whether coenzyme Q10, a potent antioxidant, is associated with risk of dementia, which has not yet been elucidated. Approach and results : We performed a case–control study nested in a community-based cohort of approximately 6000 Japanese aged 40–69 years at baseline (1984–1994). Serum coenzyme Q10 was measured in 65 incident cases of disabling dementia with dementia-related behavioral disturbance or cognitive impairment incident between 1999 and 2004, and in 130 age-, sex- and baseline year-matched controls. Serum coenzyme Q10 was inversely associated with dementia: the multivariate odds ratios (95% confidence intervals) were 0.68 (0.26–1.78), 0.92 (0.33–2.56), and 0.23 (0.06–0.86) for individuals with the second, third, and highest quartiles of coenzyme Q10, respectively, as compared with the lowest quartile ( P for trend = 0.05). A similar association was found for the coenzyme Q10/total cholesterol ratio: the respective ORs were 0.67 (0.25–1.78), 0.73 (0.28–1.92), and 0.21 (0.05–0.90) ( P for trend = 0.04). Conclusions : Serum coenzyme Q10 levels were inversely associated with risk of disabling dementia.
- Published
- 2014
46. Menopausal Status in Relation to Cardiovascular Stress Reactivity in Healthy Japanese Participants
- Author
-
Kumi Hirokawa, Hiroyasu Iso, Tetsuya Ohira, Akihiko Kitamura, Mitsugu Kajiura, Takeo Okada, Mako Nagayoshi, and Masahiko Kiyama
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Blood Pressure ,Young Adult ,Japan ,Heart Rate ,Internal medicine ,Heart rate ,medicine ,Humans ,Heart rate variability ,Young adult ,Reactivity (psychology) ,Applied Psychology ,Aged ,Aged, 80 and over ,business.industry ,Confounding ,Middle Aged ,Laser Doppler velocimetry ,Postmenopause ,Psychiatry and Mental health ,Blood pressure ,Regional Blood Flow ,Cardiology ,Female ,business ,Perfusion ,Stress, Psychological - Abstract
OBJECTIVE To investigate the hypothesis that postmenopausal women demonstrate greater cardiovascular stress reactivity during mental stress tasks than do both premenopausal women and men. METHODS The study included 979 Japanese participants (338 men and 641 women [238 postmenopausal]) aged 16 to 82 years. Blood pressure, heart rate, heart rate variability, and peripheral blood flow were measured at rest and during a mirror drawing stress task and a maze task. Differences between measured variables during tasks and at rest were calculated and considered to represent reactivity to stress. Analyses were adjusted for age and other potential confounding factors. RESULTS After adjusting for multiple factors, significant group effects were found for systolic blood pressure (SBP), diastolic blood pressure, heart rate, low-frequency (LF), LF/high-frequency, and peripheral blood flow (effect size: partial η = 0.015, 0.011, 0.013, 0.013, 0.008, and 0.009, respectively). Postmenopausal women were more reactive than men to stress for SBP (15.4 ± 0.8 versus 11.7 ± 0.6 mm Hg), diastolic blood pressure (10.4 ± 0.6 versus 8.0 ± 0.5 mm Hg), heart rate (2.7 ± 0.5 versus 0.7 ± 0.4 beats/min), LF (23.0 ± 5.2 versus 3.2 ± 3.8 ms/Hz), and peripheral blood flow (-39.0 ± 3.8 versus -25.9 ± 2.8 Laser Doppler Perfusion Units) and more reactive than premenopausal women (p < .050) for SBP (15.4 ± 0.8 versus. 12.4 ± 0.5 mm Hg) and LF/high-frequency (1.7 ± 0.1 versus 1.3 ± 0.1). CONCLUSIONS Postmenopausal Japanese women evidenced greater cardiovascular stress reactivity during mental stress tasks than did Japanese men or premenopausal women. Cardiovascular hyperreactivity could play a role in the higher risks of cardiovascular diseases in postmenopausal women.
- Published
- 2014
47. C-reactive protein levels and risk of disabling dementia with and without stroke in Japanese: The Circulatory Risk in Communities Study (CIRCS)
- Author
-
Hironori Imano, Choy-Lye Chei, Kazumasa Yamagishi, Masahiko Kiyama, Minako Maruyama, Ai Ikeda, Takashi Asada, Akihiko Kitamura, Hiroyuki Noda, Hiroyasu Iso, and Renzhe Cui
- Subjects
Adult ,Male ,medicine.medical_specialty ,Alcohol Drinking ,Hypercholesterolemia ,Comorbidity ,Japan ,Internal medicine ,mental disorders ,Diabetes Mellitus ,medicine ,Humans ,Dementia ,Prospective Studies ,Risk factor ,Prospective cohort study ,Stroke ,Aged ,Aged, 80 and over ,business.industry ,Smoking ,Confounding ,Case-control study ,Confounding Factors, Epidemiologic ,Odds ratio ,Middle Aged ,medicine.disease ,Health Surveys ,C-Reactive Protein ,Case-Control Studies ,Hypertension ,Physical therapy ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
Objective Studies have shown that elevated high-sensitivity C-reactive protein (hs-CRP) predicts stroke, which is a risk factor for dementia. It remains, however, unclear whether hs-CRP increases risk of dementia. Methods A prospective nested case–control study of Japanese 40–69 years of age was conducted using frozen serum samples collected from approximately 7531men and women who participated in cardiovascular risk surveys from 1984 to 1994 in one community and 1989–1995 in another community under the Circulatory Risk in Communities Study (CIRCS). Two control subjects per case were matched by sex, age, community, and year of serum storage. The hs-CRP was measured using a latex particle-enhanced immunonephelometric assay. Results Between 1999 and 2013, we identified 275 disabling dementia cases (96 cases with history of stroke and 179 without it). There was a positive association between hs-CRP levels and risk of dementia with history of stroke. No significant association was observed between hs-CRP levels and risk of dementia without history of stroke. After adjustment for hypertension, diabetes and other confounding variables, the positive association remained statistically significant. The multivariable odds ratios associated with 1-SD increment of log hs-CRP were 1.02 (0.87–1.20) for total dementia, 1.35 (1.02–1.79) for dementia with history of stroke, and 0.89 (0.72–1.10) for dementia without history of stroke. Conclusion Elevated hs-CRP levels were associated with increased risk of disabling dementia in individuals with history of stroke but not in those without it.
- Published
- 2014
48. The Sense of Taste in the Upper Gastrointestinal Tract
- Author
-
Akihiko Kitamura, Tomokazu Tsurugizawa, Hisayuki Uneyama, and Akira Uematsu
- Subjects
Pharmacology ,Taste ,medicine.medical_specialty ,Biology ,Taste Buds ,Vagus nerve ,Gastrointestinal Hormones ,Gastrointestinal Tract ,Oxyntomodulin ,chemistry.chemical_compound ,Endocrinology ,chemistry ,Taste receptor ,Internal medicine ,Peptide YY ,Drug Discovery ,medicine ,Animals ,Humans ,Transduction (physiology) ,Homeostasis ,Signal Transduction ,Hormone - Abstract
Digestion and the absorption of food and nutrients have been considered the only functions of the gastrointestinal (GI) tract. However, recent studies suggest that taste cells in the oral cavity and taste-like cells in the GI tract share many common characteristics (taste receptors and transduction signaling). Over the last two decades, it has been revealed that the GI tract is a chemosensory organ that transfers nutrient information via GI hormone secretion (glucagon-like peptide-1, Peptide YY, oxyntomodulin, glucose-dependent insulinotropic polypeptide and others) and the activation of abdominal vagus afferents. In addition, the information relayed via the abdominal vagus nerve plays an important role in autonomic reflexes. This information, both humoral and neural, contributes to the maintenance of homeostasis (digestion, absorption, metabolism and food intake) in the body. In this review, we provide a brief overview of the following: GI chemosensory molecules, their distribution, the effect of nutrients on GI hormone secretion and the activation of vagus afferent nerves. We also focus on the possibility of clinical applications that control abdominal vagus activity.
- Published
- 2014
49. Adult Height and Body Mass Index in Relation to Risk of Total Stroke and its Subtypes: The Circulatory Risk in Communities Study
- Author
-
Circs Investigators, Tetsuya Ohira, Akihiko Kitamura, Takashi Shimamoto, Takeo Okada, Yuji Shimizu, Hiroyasu Iso, Hironori Imano, Kazumasa Yamagishi, Masahiko Kiyama, Takeshi Tanigawa, and Yoshinori Ishikawa
- Subjects
Adult ,Male ,medicine.medical_specialty ,Endpoint Determination ,Hemorrhagic strokes ,Risk Assessment ,Body Mass Index ,Stratified analysis ,Sex Factors ,Japan ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prospective cohort study ,Stroke ,Aged ,Surrogate endpoint ,business.industry ,Rehabilitation ,Middle Aged ,medicine.disease ,Body Height ,Adult height ,Epidemiologic Studies ,Circulatory system ,Physical therapy ,Female ,Surgery ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Follow-Up Studies - Abstract
Several studies have reported that height and risk of stroke are inversely associated based on the hypothesis that height is a marker of childhood physical condition. However, a limited number of studies have taken account of the effect of current physical condition on the relationship between height and risk of stroke.We conducted a prospective cohort study of 12,222 40- to 69-year-old Japanese patients under systematic surveillance for stroke incidence. Because body mass index (BMI) is regarded as a surrogate marker of current physical condition for cardiovascular risk, we performed a stratified analysis of this risk based on BMI.During the median 17-year follow-up, there were 565 incident strokes (326 ischemic and 186 hemorrhagic strokes) showing an inverse association between height and risk of stroke independent of classical cardiovascular risk factors. Compared with the lowest height group (159 cm for men and148 cm for women) as reference, the multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the highest height group (166 cm for men and154 cm for women) were 0.70 (95% CI 0.49-1.00; P = .043) for men and 0.44 (95% CI 0.27-0.70; P.001) for women. When the analysis was restricted to those with BMI23 kg/m(2), the associations were stronger for both hemorrhagic and ischemic stroke.Height was found to be inversely associated with risk of stroke for middle-aged Japanese men and women, especially with lower BMIs. Our findings suggest that childhood social and physical conditions may contribute to the development of stroke in adulthood because height is a surrogate marker of these conditions.
- Published
- 2014
50. Common carotid intima-media thickness measurements do not improve cardiovascular risk prediction in individuals with elevated blood pressure: the USE-IMT collaboration
- Author
-
Christine Robertson, Matthias W. Lorenz, Christopher M. Rembold, Karlijn A. Groenewegen, Suzanne Holewijn, Matthias Sitzer, Tatjana Rundek, Annie Britton, Giel Nijpels, Kazuo Kitagawa, Ellisiv B. Mathiesen, Shuhei Okazaki, Jacqueline de Graaf, Gunnar Engström, M. Arfan Ikram, Ai Ikeda, Akihiko Kitamura, Oscar H. Franco, Jacqueline F. Price, Todd J. Anderson, Maria Rosvall, Daniel H. O'Leary, Albert Hofman, Michiel L. Bots, Jukka T. Salonen, Maryam Kavousi, Joseph F. Polak, Eva Lonn, Diederick E. Grobbee, Jacqueline M. Dekker, Bo Hedblad, Greg Evans, Hester M. den Ruijter, Coen D.A. Stehouwer, Sanne A.E. Peters, Epidemiology and Data Science, General practice, EMGO - Lifestyle, overweight and diabetes, Epidemiology, Pulmonary Medicine, Radiology & Nuclear Medicine, Interne Geneeskunde, MUMC+: MA Interne Geneeskunde (3), and RS: CARIM - R3 - Vascular biology
- Subjects
Adult ,Male ,medicine.medical_specialty ,Carotid Artery, Common ,carotid intima-media thickness ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,primary prevention ,Blood Pressure ,Risk Assessment ,Article ,Cohort Studies ,Meta-Analysis as Topic ,Risk Factors ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Myocardial infarction ,cardiovascular diseases ,Stroke ,Antihypertensive Agents ,Aged ,risk ,Framingham Risk Score ,business.industry ,Absolute risk reduction ,Middle Aged ,medicine.disease ,Confidence interval ,Blood pressure ,Intima-media thickness ,Cardiovascular Diseases ,Hypertension ,Cardiology ,cardiovascular system ,Female ,prognosis ,atherosclerosis ,Risk assessment ,business - Abstract
Item does not contain fulltext Carotid intima-media thickness (CIMT) is a marker of cardiovascular risk. It is unclear whether measurement of mean common CIMT improves 10-year risk prediction of first-time myocardial infarction or stroke in individuals with elevated blood pressure. We performed an analysis among individuals with elevated blood pressure (i.e., a systolic blood pressure >/=140 mm Hg and a diastolic blood pressure >/= 90 mm Hg) in USE-IMT, a large ongoing individual participant data meta-analysis. We refitted the risk factors of the Framingham Risk Score on asymptomatic individuals (baseline model) and expanded this model with mean common CIMT (CIMT model) measurements. From both models, 10-year risks to develop a myocardial infarction or stroke were estimated. In individuals with elevated blood pressure, we compared discrimination and calibration of the 2 models and calculated the net reclassification improvement (NRI). We included 17 254 individuals with elevated blood pressure from 16 studies. During a median follow-up of 9.9 years, 2014 first-time myocardial infarctions or strokes occurred. The C-statistics of the baseline and CIMT models were similar (0.73). NRI with the addition of mean common CIMT was small and not significant (1.4%; 95% confidence intervals, -1.1 to 3.7). In those at intermediate risk (n=5008, 10-year absolute risk of 10% to 20%), the NRI was 5.6% (95% confidence intervals, 1.6-10.4). There is no added value of measurement of mean common CIMT in individuals with elevated blood pressure for improving cardiovascular risk prediction. For those at intermediate risk, the addition of mean common CIMT to an existing cardiovascular risk score is small but statistically significant.
- Published
- 2014
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.