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DOI： 10.1620/tjem.2024.J088

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PURPOSE: To investigate the association of low renal function and overweight with poor periodontal condition in community-dwelling older Japanese women. MATERIALS AND METHODS: In total, 359 older women (age range: 55-74 years) participated in this study. Two periodontal parameters - the number of teeth with a probing pocket depth (PPD) or clinical attachment level (CAL) ≥ 4 mm - were used as the dependent variables. The principal independent variables were low renal function as defined by the estimated glomerular filtration rate (eGFR) and overweight as defined by the body mass index. Poisson regression analysis was used to calculate the ratio of means (RM). RESULTS: The RMs of the number of teeth with a PPD or CAL ≥ 4 mm in an adjusted model without an interaction term were 1.21- or 1.27-fold higher among those with an eGFR < 60, while those among the participants with an eGFR < 60 in the adjusted model with interaction terms for the number of teeth with a PPD or CAL ≥ 4 mm were 1.43- or 1.36-fold higher. In addition, increments of periodontal risk with low renal function and overweight showed a slightly smaller to negative trend. CONCLUSION: The present findings suggest a connection between unfavourable periodontal health and both renal function and being overweight among older Japanese women. A weak negative interaction was also found between poor renal condition and overweight in relation to periodontal condition.

DOI： 10.3290/j.ohpd.b5573943

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Language：Japanese   Publisher：日本老年社会科学会  

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Accurate measurement of sodium intake in the diet is challenging, and epidemiological studies can be hampered by the attenuation of associations due to measurement error in sodium intake. A prediction formula for habitual 24-h urine sodium excretion and sodium-to-potassium ratio might lead to more reliable conclusions. Five 24-h urinary samples and two Food Frequency Questionnaires (FFQs) were conducted among 244 Japanese participants aged 35-80 years. We conducted multivariate linear regression analysis with urinary excretion as dependent variables and eating behaviour and food frequency as independent variables. Empirical weights of sodium excretion and sodium-to-potassium ratio were extracted. Preliminary validity was also assessed by randomly dividing the subjects into development and validation groups based on the correlation coefficient between estimates by the prediction formula and urinary excretion. Taste preference, soy sauce use at the table, frequency of pickled vegetables intake and number of bowls of miso soup were extracted as determinants of sodium excretion. Correlation coefficients between the estimates and urinary excretion for men and women were 0.42 and 0.43, respectively, for sodium and 0.49 and 0.50, respectively, for sodium-to-potassium ratio. This prediction formula may provide more accurate estimation of sodium intake and sodium-to-potassium ratio than the food composition approach.

DOI： 10.1038/s41598-024-60349-3

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s11657-024-01381-8

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OBJECTIVE: To determine the longitudinal association between chronic pain in the lower extremities and low back and the odds of recurrent falls in middle-aged and older people. DESIGN: A cohort study. SETTING: Communities in Japan. PARTICIPANTS: Participants were 7540 community-dwelling volunteers aged 40-74 years (N=7540). The baseline survey was a self-administered questionnaire conducted between 2011-2013. Predictors were presence of chronic pain in the knee, foot or ankle, and low back, with the degree of pain categorized as none, very mild/mild, moderate, or severe/very severe. Covariates in the multivariate model of chronic pain in a site were demographics, body mass index, physical activity level, disease history, and chronic pain in the other 2 sites. Logistic regression analysis was used to calculate odds ratios (ORs). INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): Recurrent falls in the year before the 5-year follow-up survey. RESULTS: Mean participant age was 60.2 years. Higher degrees of chronic pain were associated with higher odds of recurrent falls for the knee (P=.0002) with a higher OR of 1.48 (95% CI: 1.11-1.97), for the foot or ankle (P=.0001) with a higher OR of 1.97 (95% CI: 1.36-2.86), and for the low back (P=.0470) with a higher OR of 1.45 (95% CI: 1.09-1.91) in those with any degree of pain relative to those without pain. Higher degrees of chronic knee pain were associated with higher odds of recurrent falls in women (P=.0005), but not in men (P=.0813). Meanwhile, higher degrees of chronic low back pain were associated with the odds of recurrent falls in men (P=.0065), but not in women (P=.8735). CONCLUSIONS: Chronic pain in the knee, foot or ankle, and lower back was independently and dose-dependently associated with a higher risk of recurrent falls. A marked sex-dependent difference was also noted in the association.

DOI： 10.1016/j.apmr.2023.09.021

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Language：Japanese   Publisher：(一社)日本衛生学会  

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DOI： 10.3390/nu16030442

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BACKGROUND: The Japanese database of food composition was revised in 2020, during which both the number of food items and the number of food items measured for sugars, amino acids, and fatty acids were increased. We evaluated the validity of estimated intakes of sugars, amino acids and fatty acids using a long-food frequency questionnaire (FFQ) among middle-aged and elderly Japanese. METHODS: From 2012 to 2013, 240 men and women aged 40-74 years from five areas in the JPHC-NEXT protocol were asked to respond to the long-FFQ and provide a 12-day weighed food record (WFR) as reference. The long-FFQ, which included 172 food and beverage items and 11 seasonings, was compared with a 3-day WFR, completed during each distinct season, and validity was assessed using Spearman's correlation coefficients. RESULTS: Percentage differences based on the long-FFQ with the 12-day WFR in men and women varied from -83.9% to 419.6%, and from -75.8% to 623.1% for sugars, -17.5% to 2.8% and -5.8% to 19.6% for amino acids, and -58.5% to 78.8% and -43.4% to 129.3% for fatty acids, respectively. Median values of correlation coefficients for the long-FFQ in men and women were 0.52 and 0.42 for sugars, 0.38 and 0.37 for amino acids, and 0.42 and 0.42 for fatty acids, respectively. CONCLUSIONS: The long-FFQ provided reasonable validity in estimating the intakes of sugars, amino acids, and fatty acids in middle-aged and elderly Japanese. Although caution is warranted for some nutrients, these results may be used in future epidemiological studies.

DOI： 10.2188/jea.JE20230132

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BACKGROUND: Sleep is a potentially modifiable factor associated with dementia, including Alzheimer's disease, but current evidence supporting this is insufficient. OBJECTIVE: This study aimed to determine whether sleep duration and bedtime patterns are associated with the risk of dementia among middle-aged and older people. METHODS: This cohort study had an eight-year follow-up period. Participants were 13,601 community-dwelling people aged 40-74 years living in Murakami (Niigata, Japan). Data were collected using a self-administered questionnaire. Predictors were self-reported sleep duration and bedtime, and the outcome was newly-diagnosed dementia determined using the long-term care insurance database. Covariates were demographic characteristics, body mass index, smoking, alcohol consumption, total physical activity, insomnia symptoms, disease history, and either bedtime or sleep duration. Cox proportional hazard models were used to calculate hazard ratios (HRs). RESULTS: The mean age of participants at baseline was 59.2 years. Over a mean follow-up period of 8.0 years, 319 cases of dementia were observed. A long self-reported sleep duration relative to the reference sleep duration (7 hours) was associated with increased dementia risk, with the "8 hours" group (adjusted HR = 1.30, 95% CI:0.99-1.73) and "≥9 hours" group (adjusted HR = 1.46, 95% CI:1.00-2.15) having an increased risk (marginally significant) relative to the reference group. Early bedtime was associated with increased dementia risk (adjusted p for trend = 0.0010), with the "21 : 00 or earlier" group (adjusted HR = 1.61, 95% CI:1.14-2.28) having an increased risk relative to the reference ("23 : 00"). CONCLUSIONS: A long self-reported sleep duration and early bedtime are both associated with increased dementia risk in middle-aged and older people.

DOI： 10.3233/JAD-231104

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DOI： 10.1007/s00774-023-01478-z

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BACKGROUND: In recent years, an increasing number of epidemiological studies have suggested a role of polyphenols in the prevention of chronic diseases. Prospective cohort studies have typically measured polyphenol concentrations in a single blood sample and the reproducibility of plasma polyphenol measurements is largely unknown. OBJECTIVE: We evaluated the reproducibility of 35 plasma polyphenols collected at an interval of 1-year. We also examined correlations of these polyphenols with food group intakes calculated from weighed food records (WFR) and food frequency questionnaire (FFQ). METHODS: The study included 227 middle-aged participants from the JPHC-NEXT Protocol Area in Japan. We measured 35 polyphenols in plasma collected at two points 1-year apart. Food group intakes were calculated from 12-day WFR and FFQ. For the reproducibility analysis, the intraclass correlation coefficient (ICC) of 35 polyphenol concentrations were examined between the two points. Pearson's partial correlations was used to assess the correlation between polyphenols and food groups. RESULTS: Moderate- to high ICCs were observed for tea-originated polyphenols such as gallic acid, quercetin, epigallocatechin, and kaempferol - and coffee-derived polyphenols, such as caffeic acid, and ferulic acid. For the dietary analyses, moderate correlations were observed for non-alcoholic beverages intake and epigallocatechin, epicatechin, catechin, and gallic acid. For green tea, higher correlations were observed with these polyphenols. CONCLUSION: Plasma concentrations of tea and coffee-related polyphenols, except for catechin, had good reproducibility over a 1-year period. The correlations between intake of non-alcoholic beverages, particularly green tea, and tea polyphenols, indicated moderate- to high correlations.

DOI： 10.1038/s41430-023-01349-w

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OBJECTIVE: Alcohol drinking and tobacco smoking have impacts on lifestyle-related diseases, but their association with dementia remains a debated topic. This study aimed to examine longitudinal associations between alcohol consumption, smoking, and dementia risk in middle-aged and older Japanese people. METHODS: This study used a cohort design with an 8-year follow-up. Participants were community-dwelling Japanese people (N = 13,802) aged 40-74 years. The baseline survey, including a self-administered questionnaire, was conducted in 2011-2013. Predictors were alcohol consumption and tobacco smoking. The outcome was incident dementia obtained from a long-term care insurance database. Covariates were demographics, lifestyle factors, body mass index, general health status, and history of stroke, diabetes, and depression. RESULTS: Participant mean age was 59.0 years. The 1-149, 150-299, and 300-449 g ethanol/week groups had significantly lower adjusted hazard ratios (HRs) (0.62, 0.59, and 0.47, respectively) compared with the reference group, with no significant linear association. HRs increased toward 1 when past-drinkers and those with poor health status and a disease history were excluded (0.80, 0.66, and 0.82, respectively). Higher smoking levels were dose-dependently associated with a higher HR (adjusted P for trend = 0.0105), with the ≥20 cigarettes/day group having a significantly higher adjusted HR (1.80). Heavy drinkers (≥449 g ethanol/week) with smoking habits, but not those without smoking habits, had higher dementia risk (P for interaction = 0.0046). CONCLUSION: Light-to-moderate alcohol consumption is associated with decreased dementia risk, and smoking is dose-dependently associated with increased dementia risk, with an interaction between high alcohol consumption and smoking on dementia risk.

DOI： 10.1016/j.maturitas.2023.107788

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AIM: Despite global efforts in public health campaigns concerning chronic kidney disease (CKD), awareness of the condition remains low. We evaluated CKD awareness and related factors to identify an effective way to raise awareness. METHODS: This study assessed laboratory-confirmed CKD and self-reported CKD using a population-based cohort (baseline from 2012 to 2014, age ≥40 years) in Niigata, Japan. Self-reported CKD was obtained at a 5-year follow-up survey and laboratory-confirmed CKD was diagnosed when an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or dipstick urinary protein ≥1+ was observed in at least two health check-ups during the 5-year period. CKD awareness was defined as a match between laboratory-confirmed and self-reported CKD. The association between characteristics and CKD awareness was tested by multivariable logistic regression analysis with adjustment for eGFR and other potential confounders. RESULTS: The analytic population comprised 7472 individuals (mean age, 65.6 years old, 51.2% women) and 19.4% with laboratory-confirmed CKD. The sensitivity and specificity of the survey question concerning self-reported CKD were 12.4% and 98.2%, respectively. Among the participants with laboratory-confirmed CKD, significant factors associated with CKD awareness were male sex (adjusted odds ratio [95% confidence interval], 1.81 [1.27, 2.59]), a history of urinary tract stone (1.86 [1.06, 3.26]), age (0.97 [0.95, 0.99]), and married status (0.66 [0.44, 0.99]). CONCLUSION: Our findings suggest that known lifestyle-related diseases that could cause CKD are not associated with CKD awareness independently of kidney function and that a sex-dependent approach may help to raise CKD awareness in community-dwelling Japanese adults.

DOI： 10.1111/nep.14170

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BACKGROUND: The association between body mass index (BMI) and dementia risk is heterogeneous across age groups and might be influenced by sex. OBJECTIVE: This study aimed to clarify sex differences in the association between BMI and dementia risk in community-dwelling people. METHODS: This cohort study with an 8-year follow-up targeted 13,802 participants aged 40-74 years at baseline in 2011-2013. A self-administered questionnaire requested information on body size, including height, weight, and waist circumference (the values of which were validated by direct measurement), socio-demographics, lifestyle, and disease history. BMI was calculated and categorized as < 18.5 (underweight), 18.5-20.6 (low-normal), 20.7-22.7 (mid-normal), 22.8-24.9 (high-normal), 25.0-24.9 (overweight), and≥30.0 kg/m2 (obese). Incident cases of dementia were obtained from the long-term care insurance database. A Cox proportional hazards model was used to calculate multivariable-adjusted hazard ratios (HRs). RESULTS: The mean age of participants was 59.0 years. In men, higher BMI was associated with lower dementia risk (fully-adjusted p for trend = 0.0086). In women, the association between BMI and dementia risk was U-shaped; the "underweight," "low-normal," and "overweight" groups had a significantly higher risk (fully-adjusted HR = 2.12, 2.08, and 1.78, respectively) than the reference ("high-normal" group). These findings did not change after excluding dementia cases which occurred within the first four years of the follow-up period. CONCLUSION: Overweight/obese women, but not men, had an increased risk of dementia, suggesting that sex differences in adiposity might be involved in the development of dementia.

DOI： 10.3233/JAD-230294

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BACKGROUND: Association between vitamin D levels and the occurrence of depression are not always consistent. The present cohort study aimed to determine this association in older adults, using a method for measuring vitamin D levels which is more accurate than those used in previous studies. METHODS: Participants were 3447 individuals aged 40-74 years without depressive symptoms at baseline who participated in the 5-year follow-up survey. The baseline investigation, including a self-administered questionnaire survey and blood collection, was conducted in 2011-2013. Plasma 25-hydroxyvitamin D (25[OH]D) levels were measured, and divided into overall quartiles summed up by sub-quartiles and stratified by age, sex, and season. The outcome was depressive symptoms determined by the CES-D (11-item, cut-off score of 6/7) 5 years later. Covariates were demographics, lifestyles, baseline CES-D score, and disease history. RESULTS: Mean plasma 25(OH)D levels were 58.0 nmol/L in men and 45.7 in women (P < 0.0001), and cumulative incidences of depressive symptoms were 249/1577 (15.8 %) in men and 313/1870 (16.7 %) in women (P = 0.4526). The lower 25(OH)D quartile group had higher adjusted ORs in men and women combined (P for trend = 0.0107) and women (P for trend = 0.0003), but not in men. Adjusted ORs of the lowest quartile group were significantly higher than the highest group in men and women combined (OR = 1.39, 95 % CI: 1.06-1.81) and women (OR = 1.89, 95 % CI: 1.31-2.72). LIMITATION: Depressive symptoms were self-reported. CONCLUSIONS: Low vitamin D levels were associated with a high risk of depressive symptoms, especially in women. Women are thus considered a major target for preventing vitamin D deficiency to address depression.

DOI： 10.1016/j.jad.2022.12.104

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Non-invasive and simple methods enabling easy identification of individuals at high risk of cognitive decline are needed as preventive measures against dementia. This pilot study aimed to explore protein biomarkers that can predict cognitive decline using urine, which can be collected non-invasively. Study subjects were selected from participants in a cohort study of middle-aged and older community-dwelling adults who underwent cognitive testing using the Mini-Mental State Examination and provided spot urine samples at two time points with an interval of approximately 5 years. Seven participants whose cognitive function declined 4 or more points from baseline (Group D) and 7 sex- and age-matched participants whose cognitive function remained within the normal range during the same period (Group M) were selected. Urinary proteomics using mass spectrometry was performed and discriminant models were created using orthogonal partial least squares-discriminant analysis (OPLS-DA). OPLS-DA yielded two models that significantly discriminated between the two groups at baseline and follow-up. Both models had ORM1, ORM2, and SERPINA3 in common. A further OPLS-DA model using baseline ORM1, ORM2, and SERPINA3 data showed similar predictive performance for data at follow-up as it did for baseline data (sensitivity: 0.85, specificity: 0.85), with the receiver operating characteristic curve analysis yielding an area under the curve of 0.878. This prospective study demonstrated the potential for using urine to identify biomarkers of cognitive decline.

DOI： 10.3389/fneur.2023.1134976

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BACKGROUND: Falls are important causes of injury and mortality in older people, and associated medical costs can be enormous. Physical activity (PA) is a potential preventive factor for falls. However, few studies have examined the effect of different types of PA on fall prevention. This study aimed to evaluate the association between PA levels and the incidence of recurrent falls by type of PA in middle-aged and older people. METHODS: This cohort study targeted 7,561 community-dwelling individuals aged 40-74 years who did not experience recurrent falls in the year before baseline. Information on PA levels, demographics, body size, lifestyle, and fall/disease history was obtained using a self-administered questionnaire in the baseline survey. Levels of total PA, leisure-time PA, and non-leisure-time PA (occupation, commuting, and housework) were estimated using metabolic equivalent (MET) scores (MET-h/day; hours spent on a given activity per day multiplied by its MET intensity). PA levels were categorized into four groups. Falls were recorded as none, once, or twice or more (recurrent falls). The outcome of the study was the incidence of recurrent falls in the past year before a survey conducted 5 years after the baseline survey. Logistic regression analyses were performed to calculate odds ratios for recurrent falls. RESULTS: Higher total PA and non-leisure-time PA levels were associated with a higher risk of recurrent falls (P for trend = 0.0002 and 0.0001, respectively), with the highest total PA and non-leisure-time PA groups having a significantly higher adjusted OR (1.96 [95%CI:1.33-2.88] and 2.15 [95%CI:1.48-3.14], respectively) relative to the lowest group (reference). As for leisure-time PA, the medium group had a significantly lower adjusted OR (0.70 [95%CI:0.49-0.99]) relative to the reference group. By sex, the adjusted OR in the medium leisure-time PA group was significantly lower relative to the reference group in women (0.50 [95%CI: 0.29-0.85]) but not in men. CONCLUSIONS: Medium level leisure-time PA reduces the risk of recurrent falls in middle-aged and older people, whereas higher level non-leisure-time PA is associated with a higher risk of recurrent falls.

DOI： 10.1186/s11556-022-00300-5

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Reducing sodium (Na) intake is an urgent global challenge, especially in East Asia and high-income Asia-Pacific regions. However, the sources of Na and their effects on urinary Na excretion have not been fully studied. We sought to clarify these sources and their association with urinary Na excretion. We examined four 3-day weighed food records and five 24-h urinary collections from each of 253 participants in Japan, aged 35-80 years, between 2012 and 2013. We compared the levels of Na according to four categories: foods contributing to discretionary or nondiscretionary Na intake, the situation in which dishes were cooked and consumed, food groups and types of cuisine. We also conducted regression analysis in which 24-h urinary Na excretion was a dependent variable and the amounts of food intake in the four categories were independent variables. Levels of Na were the highest in discretionary intake (60.6%) and in home-prepared dishes (84.0%). Of the food groups, miso soup showed the highest percentage contribution to Na intake (13.3%) after seasonings such as soy sauce. In the regression analysis, the standardised coefficient for foods of nondiscretionary Na sources was larger than that for discretionary sources, whereas that for home-prepared dishes was consistent with the levels of Na in those foods. Pickled products, followed by fresh fish and shellfish, miso soup and rice, were associated with high urinary Na excretion. Thus, discretionary foods (such as miso soup) contribute the most to Na consumption, although nondiscretionary intake (such as pickled vegetables) may influence urinary Na excretion.

DOI： 10.1017/S0007114522002653

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OBJECTIVE: Although physical activity (PA) in late life is considered a preventive factor for dementia, effects of different types of PAs on the development of dementia in early old age are unclear. This study aimed to determine the effect of leisure-time and non-leisure-time PAs on dementia risk in middle-aged and older adults during an 8-year follow-up. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: Participants were 13,773 community-dwelling individuals aged 40-74 years who completed the baseline self-administered questionnaire survey of the Murakami cohort study in 2011-2013. METHODS: Main predictors were leisure-time and non-leisure-time (commute, occupational work, and housework) PAs as assessed by MET score (MET-hour/d). The outcome was newly developed dementia determined using a long-term care insurance database. Covariates included demographics, lifestyle, body size, disease history, and PA level. Hazard ratios (HRs) were calculated using Cox proportional hazards models. RESULTS: Mean age of participants was 59.0 (SD 9.3) years. Higher levels of leisure-time PA were associated with lower HRs (adjusted P for trend <.001), with all tertiles having significantly lower HRs (low: 0.71, 95% CI 0.51-0.99; medium: 0.59, 95% CI 0.43-0.81; high: 0.55, 95% CI 0.41-0.75) relative to the reference (zero). Higher quartiles of non-leisure-time PA were associated with lower adjusted HRs for dementia (adjusted P for trend < .001), with the second-fourth quartiles having significantly lower HRs (second: 0.73, 95% CI 0.54-0.98; third: 0.59, 95% CI 0.43-0.81; fourth: 0.55, 95% CI 0.41-0.75) relative to the lowest quartile. These associations were robust regardless of sex and age group. CONCLUSIONS AND IMPLICATIONS: Both leisure-time and non-leisure-time PAs are independently and robustly associated with a reduced risk of dementia.

DOI： 10.1016/j.jamda.2022.01.053

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Using Food Frequency Questionnaires (FFQs) to compare dietary references for screening has been in high demand. However, FFQs have been widely used for ranking individuals in a population based on their dietary intake. We determined the validity of sodium (salt equivalent) intake, potassium intake, and sodium-to-potassium (Na/K) ratio obtained using the FFQ for identifying individuals who deviated from the dietary reference intakes (DRIs) measured using multiple 24-h urinary excretion measurements or 12-day weighed food records (WFR). This study included 235 middle-aged subjects. The correlation coefficients (CCs) between the FFQ and WFR estimates were mostly moderate (0.24-0.54); the CCs between the FFQ and 24-h urinary excretion measurements were low or moderate (0.26-0.38). Values of area under the receiver-operating curve (AUC) at the point of DRIs for salt equivalent or potassium were &gt;0.7 with the WFR as the reference standard and 0.60-0.76 with the 24-h urinary excretion as the reference standard. Using both standard measures, the AUC for the Na/K ratio was &lt;0.7. The accuracy of salt equivalent and potassium intake estimation using the FFQ to determine absolute intake point was comparable to that using WFR, allowing for quantified error, but not as good as that of 24-h urinary excretion.

DOI： 10.3390/nu14132594

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Several studies have reported an association between sarcopenia and depression. Their results, however, are inconsistent, partly due to small sample sizes and lack of consideration of important confounders. The present study aimed to cross-sectionally examine this association in community-dwelling people in Japan. This study used baseline data from the Yuzawa cohort study (age ≥ 40 years), with the final analysis population comprising 2,466 participants. A self-administered questionnaire was used to elicit information related to sarcopenia, depressive symptoms, demographic characteristics, anthropometrics, disease history, and lifestyles. Sarcopenia was diagnosed using SARC-F, a validated questionnaire including components of Strength, Assistance in walking, Rising from a chair, Climbing stairs, and Falls. Depressive symptoms were assessed using the 11-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). For depressive symptoms, prevalence ratios (PRs) were calculated, and odds ratio (ORs) were obtained using simple and multiple logistic regression analyses. Mean age of participants was 61.7 years (standard deviation = 11.8), and 10.5% and 34.7% had sarcopenia and depressive symptoms, respectively. Sarcopenic individuals had a significantly higher PR (2.00), unadjusted OR (3.67), and adjusted OR (4.96) compared to non-sarcopenic individuals, with an estimated adjusted PR of 2.7. There was a significant dose-dependent association between SARC-F scores and depressive symptoms in sarcopenic individuals (adjusted P for trend = 0.0028). In conclusion, sarcopenia and depressive symptoms were robustly associated in community-dwelling, middle-aged and older people in Japan. However, the direction of this association is unclear, and a future cohort study will be needed to determine causality.

DOI： 10.1620/tjem.2022.J024

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INTRODUCTION: The urinary sodium-to-potassium ratio is an indicator of dietary sodium intake and has been associated with reduced kidney function. However, less is known about its association with albuminuria, the other key component of chronic kidney disease, in the community-dwelling adult population. We examined the association of the spot urinary sodium-to-potassium ratio with albuminuria and compared spot urinary and dietary sodium-to-potassium ratios. METHODS: We quantified the association of the urinary sodium-to-potassium ratio with albuminuria in 6,274 Japanese adults (aged 40-97 years; 50.9% women) based on spot urine samples. We performed linear and logistic regression modeling to account for potential confounders. Elevated albuminuria was defined as a spot urinary albumin-to-creatinine ratio (ACR) ≥30 mg/g. We secondarily evaluated the dietary sodium-to-potassium ratio based on a food-frequency questionnaire. RESULTS: The median spot urinary and dietary sodium-to-potassium ratios were 2.70 (interquartile interval, 1.87-3.83) and 1.50 (1.21-1.84), respectively. The median ACR was 11.0 (6.0-24.0) mg/g. In a multivariable linear regression model, the spot urinary sodium-to-potassium ratio (per increment) was significantly associated with the natural logarithm of the ACR (regression coefficient, 0.023 [95% confidence interval {95% CI}, 0.007-0.038]). This result was consistent in a multivariable logistic regression model (adjusted odds ratio, 1.08 [95% CI: 1.04-1.12]). The corresponding estimates for the dietary sodium-to-potassium ratio were 0.139 (95% CI: 0.087-0.191) and 1.28 (95% CI: 1.14-1.45), respectively. CONCLUSIONS: Both spot urinary and dietary sodium-to-potassium ratios were associated with elevated albuminuria in community-dwelling Japanese adults. Our findings further support the potential usefulness of the spot urinary sodium-to-potassium ratio as an indicator of sodium intake and suggest a link between sodium intake and kidney damage.

DOI： 10.1159/000526277

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INTRODUCTION: Secular changes in hip fracture incidence have been reported in the last few decades in Japan, but whether long-term bone mineral density (BMD) is also changing is unclear. This study aimed to determine whether BMD of Japanese women has changed over time. METHODS: Subjects were 10,649 adult women who underwent BMD measurement in a health check-up population in Niigata, Japan, between 1995 and 2013. BMD of the distal, non-dominant forearm was measured by dual-energy X-ray absorptiometry. Demographic information and BMI were also obtained. Secular trends were determined by linear regression analysis. RESULTS: BMD of subjects in their 40's decreased significantly in the age-adjusted model (P for trend=0.0162), but not in the age- and BMI-adjusted model (P for trend=0.2171). BMD of subjects in their 50's decreased marginally in the age-adjusted model (P for trend=0.0535), but not in the age- and BMI-adjusted model (P for trend=0.6601). BMDs of subjects in their 30's and 60's did not significantly change, while BMIs of subjects in their 40's-60's decreased significantly. CONCLUSIONS: A secular decrease in BMD, partly attributed to decreases in BMI, was observed in middle-aged Japanese women from 1995 to 2013. Measures to help maintain suitable BMI will be necessary to prevent a decrease in BMD among women.

DOI： 10.5387/fms.2021-10

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OBJECTIVES: A positive association between levels of blood 25-hydroxyvitamin D (25[OH]D), an index of vitamin D status, and physical balance has been reported from cross-sectional studies, but longitudinal studies are rare. The present study aimed to test the hypothesis that low serum 25(OH)D levels are longitudinally associated with impaired postural sway over a 6-year follow-up period in older women. METHODS: The present cohort consisted of 392 community-dwelling Japanese women aged ≥69 years. Baseline examinations included serum 25(OH)D and physical performance tests, including postural sway velocity. Standing postural sway was evaluated by measuring gravity-center sway velocity. Follow-up physical performance tests were conducted 6 years later. RESULTS: Mean subject age and serum 25(OH)D levels were 73.3 years (SD 3.7) and 61.0 nmol/L (SD 16.9), respectively. No significant association was found between 25(OH)D levels and changes in postural sway velocity (adjusted P for trend=0.72). Women with 25(OH)D <30 nmol/L tended to have lower Δpostural sway velocity than those with 25(OH)D ≥30 nmol/L (mean, -0.59 vs 0.37 cm/s, respectively; adjusted P=0.13). CONCLUSIONS: Vitamin D levels are not longitudinally associated with impaired postural sway in older women. Further longitudinal studies are needed to corroborate the results of this study.

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title><sec>
<title>Background</title>
Beneficial effects of napping on cognition have been suggested in cross-sectional studies. This study aimed to clarify longitudinal associations between cognitive decline and sleep characteristics, particularly daytime napping, over a 5-year period in older adults.


</sec><sec>
<title>Methods</title>
Study participants were 389 community-dwelling individuals aged ≥65 years living in Ojiya City, Niigata, Japan. Baseline and follow-up examinations were conducted in 2011–2013 and 2016–2018, respectively. Trained nurses visited and interviewed participants to collect the following information at baseline and follow-up: demographic characteristics, disease history, lifestyle habits including bedtime, sleeping hours, and daytime nap duration, and cognitive function. The assessment of cognitive function was performed using the revised Hasegawa’s dementia scale (HDS-R), with cognitive decline defined as a change in the HDS-R of ≤ − 3 over 5 years. Odds ratios (ORs) for cognitive decline were calculated using multiple logistic regression analysis.


</sec><sec>
<title>Results</title>
Mean age of participants was 74.6 years (SD 6.4), and the cumulative incidence of cognitive decline was 106/389 (27.3%). The adjusted OR for 1–29 min daytime napping was significantly lower compared to that for no napping (OR = 0.47, 95%CI: 0.23–0.96). Earlier bedtime was associated with cognitive decline (adjusted P for trend = 0.0480).


</sec><sec>
<title>Conclusion</title>
Short daytime napping (&lt; 30 min) reduces the risk of cognitive decline over 5 years for community-dwelling older people. A future study will be necessary to confirm the effect of short napping on the reduction of risk for clinically diagnosed dementia.


</sec>

DOI： 10.1186/s12877-021-02418-0

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Language：Japanese   Publisher：新潟医学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J00990&link_issn=&doc_id=20220705060001&doc_link_id=%2Fdg3nigta%2F2021%2F013510%2F001%2F0213-0219%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2021%2F013510%2F001%2F0213-0219%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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BACKGROUND: Income inequality has dramatically increased worldwide, and there is a need to re-evaluate the association between socio-economic status (SES) and depression. Relative contributions of household income and education to depression, as well as their interactions, have not been fully evaluated. This study aimed to examine the association between SES and depressive symptoms in Japanese adults, focusing on interactions between education and household income levels. METHODS: This cross-sectional study used data from baseline surveys of two cohort studies. Participants were 38,499 community-dwelling people aged 40-74 years who participated in baseline surveys of the Murakami cohort study (2011-2012) and Uonuma cohort study (2012-2015) conducted in Niigata Prefecture, Japan. Information regarding marital status, education level, household income, occupation, activities of daily living (ADL), and history of cancer, myocardial infarction, stroke, and diabetes was obtained using a self-administered questionnaire. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regression analysis was used to obtain odds ratios (ORs). Covariates included age, sex, marital status, education, household income, occupation, ADL, and disease history. RESULTS: Individuals with higher education levels had lower ORs (adjusted P for trend = 0.0007) for depressive symptoms, independently of household income level. The OR of the university-or-higher group was significantly lower than that of the junior high school group (adjusted OR = 0.79). Individuals with lower household income levels had higher ORs (adjusted P for trend< 0.0001) for depressive symptoms, independently of education level. The type of occupation was not associated with depressive symptoms. In subgroup analyses according to household income level, individuals with higher education levels had significantly lower ORs in the lowest- and lower-income groups (adjusted P for trend = 0.0275 and 0.0123, respectively), but not in higher- and highest-income groups (0.5214 and 0.0915, respectively). CONCLUSIONS: Both education and household income levels are independently associated with the prevalence of depressive symptoms, with household income levels showing a more robust association with depressive symptoms than education levels. This suggests that a high household income level may offset the risk of depressive symptoms from having a low education level.

DOI： 10.1186/s12889-021-12168-8

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OBJECTIVES: Coffee, green tea, and caffeine are potential preventive factors for dementia, but the underlying evidence is insufficient. This study aimed to examine associations between the consumption of coffee, green tea, and caffeine and dementia risk in middle-aged and older people. METHODS: This was a cohort study with an 8.0-year follow-up. Participants were community-dwelling individuals (n = 13,757) aged 40-74 years. A self-administered questionnaire survey was conducted in 2011-2013. Predictors were the consumption of coffee/green tea, from which caffeine consumption was estimated. The outcome was incident dementia obtained from the long-term care insurance database. Covariates were demographic factors, body mass index, physical activity, energy, smoking, drinking, and disease history. Adjusted hazard ratios (HRs) were calculated using Cox proportional hazards models. HRs were also calculated using a Cox model with delayed entry. RESULTS: The number of dementia cases during the study period was 309. Participants with higher coffee consumption had lower HRs (adjusted p for trend = 0.0014), with the fifth quintile (≥326 ml/day) having a significantly lower HR (0.49, 95% confidence interval [CI]: 0.30-0.79) than the first quintile (<26 ml/day, reference). Similarly, participants with higher caffeine consumption had a significantly lower HR (adjusted p for trend = 0.0004) than the reference. The Cox model with delayed entry yielded similar results. These associations were significant in men, but not in women. Moreover, participants who consumed 2-2.9 cups/day and ≥3 cups/day of coffee had lower HRs (0.69, 95% CI: 0.48-0.98 and 0.53, 95% CI: 0.31-0.89, respectively) than those who consumed 0 cup/day. The association between green tea consumption and reduced dementia risk was significant (adjusted p for trend = 0.0146) only in the 60-69 years age subgroup. CONCLUSIONS: High levels of coffee and caffeine consumption were significantly associated with a reduced dementia risk in a dose-dependent manner, especially in men. Moreover, coffee consumption of ≥3 cups/day was associated with a 50% reduction in dementia risk.

DOI： 10.1111/jgs.17407

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AIM: Although menstrual/reproductive factors are known to be associated with physical disability, little is known about these associations in relation to activities of daily living (ADL). This study aimed to clarify associations between menstrual/reproductive factors and ADL limitations in peri- and postmenopausal women. STUDY DESIGN: A nested case-control study of the Japan Public Health Center-based Prospective (JPHC) Study. METHODS: The main outcome measure was self-reported ADL levels in the 10-year follow-up questionnaire survey of the JPHC Study conducted between 2000 and 2004 (N = 36 460). Women who "live inside almost independently, but go out with assistance" or had a lower level of activity were considered to have ADL limitations ("cases"), and all others served as controls. Candidate menstrual/reproductive predictors were as follows: menarcheal age, menopausal status, menopausal age, regularity of menses, menstrual cycle, number of pregnancies, age at first pregnancy, number of deliveries, age at first delivery, and breast feeding. Multiple logistic regression analyses were conducted, and odds ratios adjusted for age and past lifestyle were calculated. RESULTS: Mean ages of cases (N = 592) and controls (N = 38 656) were 68.3 (SD = 7.6) and 61.1 (SD = 7.7) years, respectively. With respect to menopausal age, groups aged <45 and ≥55 years had significantly higher adjusted ORs (1.44, 95% CI: 1.09-1.90 and 1.55, 95%CI: 1.09-2.18, respectively) than the reference group (50-54 years). Multiparous women had significantly lower ORs than nulliparous women. CONCLUSION: Our findings suggest that menopausal age and parity may predict future ADL limitations in women.

DOI： 10.1111/jog.14959

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press  

DOI： 10.1093/gerona/glaa240

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DOI： 10.1111/ger.12523

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Public Library of Science  

DOI： 10.1371/journal.pone.0256481

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BACKGROUND/OBJECTIVES: Isothiocyanate (ITC) is formed via the hydrolysis of glucosinolates by myrosinase, found in cruciferous vegetables. Although myrosinase is inactivated by the cooking process, no studies have incorporated the effect of cooking into the estimation of dietary ITC intake or evaluated the validity. We evaluated the validity of dietary ITC intake estimated from a food frequency questionnaire (FFQ), and urinary ITC levels using 24 h urine samples or a WFR (weighed food record), and evaluated the reproducibility of dietary ITC in two FFQs administered at an interval of 1-year. SUBJECTS/METHODS: The JPHC-NEXT Protocol Area included a total of 255 middle-aged participants across Japan. We calculated dietary ITC intake from WFR and two FFQs by assuming that cooked cruciferous vegetables contain zero ITC. Urinary ITC excretion was measured at two points during summer and winter. The validity and reproducibility of dietary ITC intake estimated by FFQ were assessed using Spearman's correlation coefficients. RESULTS: Although we observed a moderate correlation between dietary ITC intake derived from a 12-day WFR and urinary ITC excretion, notwithstanding the cooking process, the correlation between dietary ITC intake estimated by FFQ and mean urinary ITC excretion was low. However, the correlation was improved when we compared urinary ITC excretion and a 3-day WFR or FFQ collected during winter. Our FFQ showed good reproducibility. CONCLUSION: Although seasonality is a critical factor, dietary ITC intake estimated using an FFQ showed moderate validity and reproducibility and can be used in future epidemiological studies.

DOI： 10.1038/s41430-021-00970-x

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AIMS: A prior meta-analysis found that obesity (body mass index [BMI] ≥ 30 kg/m2 ) was associated with a high fall risk, while being overweight (BMI≥25, <30 kg/m2 ) was associated with the lowest fall risk. However, whether these associations hold true for East Asians is unknown. This study aimed to assess the association between BMI and incidence of recurrent falls in Japanese aged 40-74 years. METHODS: This 5-year follow-up cohort study involved 7538 community-dwelling individuals who did not experience recurrent falls in the year before the baseline study. Information on demographics, body size, lifestyle, and disease history was obtained using a self-administered questionnaire. BMI was categorized as <18.5 (underweight), 18.5-20.6 (low-normal), 20.7-22.7 (mid-normal, reference), 22.8-24.9 (high-normal), and ≥ 25.0 kg/m2 (overweight). The outcome was recurrent falls reported, and fall history in the previous year was recorded as none, once, or twice or more (recurrent falls). RESULTS: Mean BMI was 23.5 kg/m2 (SD 2.9) for men and 22.7 kg/m2 (SD 3.2) for women. The adjusted odds ratio (OR) for recurrent falls in the BMI ≥25 group was significantly higher (1.41, 95%CI: 1.02-1.93) than that in the reference group. The adjusted OR in the BMI ≥25 group was significantly higher than that in the reference group for the age ≥ 60 subgroup (1.62, 95%CI: 1.09-2.40), but not for the age < 60 subgroup (OR = 1.04, 95%CI: 0.60-1.80). CONCLUSIONS: Being overweight may be a risk factor for recurrent falls in community-dwelling older Japanese. Further studies are needed to determine the underlying mechanism. Geriatr Gerontol Int 2021; 21: 498-505.

DOI： 10.1111/ggi.14167

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<title>Abstract</title>Physical activity is associated with subjective well-being. In rural communities, however, physical activity may be affected by environmental factors (e.g., nature and socioecological factors). We examined the association of two physical activities in rural life (farming activity and snow removal) with subjective well-being in terms of happiness and <italic>ikigai</italic> (a Japanese word meaning purpose in life). In this cross-sectional study, we analysed data collected from community-dwelling adults aged ≥ 40 years in the 2012–2014 survey of the Uonuma cohort study, Niigata, Japan. Happiness (<italic>n</italic> = 31,848) and <italic>ikigai</italic> (<italic>n</italic> = 31,785) were evaluated with respect to farming activity from May through November and snow removal from December through April by using an ordinal logistic regression model with adjustments for potential confounders. The analyses were conducted in 2019. Among the participants who reported some farming or snow-removal time, median farming and snow-removal time (minutes per day) was 90.0 and 64.3 for men and 85.7 and 51.4 for women, respectively. Ordinal logistic regression analysis showed that longer time farming was associated with greater happiness and <italic>ikigai</italic> in men (adjusted odds ratio for first vs. fourth quartile: happiness = 1.17, 95% confidence interval [CI] = 1.01, 1.35; <italic>ikigai</italic> = 1.29, 95% CI = 1.10, 1.50), and also in women (adjusted odds ratio for first vs. fourth quartile: happiness = 1.17, 95% CI = 1.001, 1.36; <italic>ikigai</italic> = 1.42, 95% CI = 1.20, 1.67). More snow-removal time was inversely associated with happiness and with <italic>ikigai</italic> in women only (adjusted odds ratio for first vs. fourth quartile: happiness = 0.75, 95% CI = 0.67, 0.85; <italic>ikigai</italic> = 0.78, 95% CI = 0.69, 0.88). Our findings showed that physical activity in rural life was associated with happiness and with <italic>ikigai</italic>, and gender differences were observed in their associations with more snow-removal time. These results may be useful in helping to identify people in rural communities who are vulnerable in terms of psychological well-being.

DOI： 10.1057/s41599-021-00723-y

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Other Link： http://www.nature.com/articles/s41599-021-00723-y

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An easily accessible and non-invasive biomarker for the early detection of Alzheimer's disease (AD) is needed. Evidence suggests that metabolic dysfunction underlies the pathophysiology of AD. While urine is a non-invasively collectable biofluid and a good source for metabolomics analysis, it is not yet widely used for this purpose. This small-scale pilot study aimed to examine whether the metabolic profile of urine from AD patients reflects the metabolic dysfunction reported to underlie AD pathology, and to identify metabolites that could distinguish AD patients from cognitively healthy controls. Spot urine of 18 AD patients (AD group) and 18 age- and sex-matched, cognitively normal controls (control group) were analyzed by mass spectrometry (MS). Capillary electrophoresis time-of-flight MS and liquid chromatography-Fourier transform MS were used to cover a larger range of molecules with ionic as well as lipid characteristics. A total of 304 ionic molecules and 81 lipid compounds of 12 lipid classes were identified. Of these, 26 molecules showed significantly different relative concentrations between the AD and control groups (Wilcoxon's rank-sum test). Moreover, orthogonal partial least-squares discriminant analysis revealed significant discrimination between the two groups. Pathway searches using the KEGG database, and pathway enrichment and topology analysis using Metaboanalyst software, suggested alterations in molecules relevant to pathways of glycerolipid and glycerophospholipid metabolism, thermogenesis, and caffeine metabolism in AD patients. Further studies of urinary metabolites will contribute to the early detection of AD and understanding of its pathogenesis.

DOI： 10.3389/fneur.2021.719159

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DOI： 10.1186/s12937-020-00534-y

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Other Link： http://link.springer.com/article/10.1186/s12937-020-00534-y/fulltext.html

Language：Japanese   Publisher：(公財)木村看護教育振興財団  

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Publishing type：Research paper (scientific journal)   Publisher：S. Karger AG  

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Biomarkers of Alzheimer’s disease (AD) that can easily be measured in routine health checkups are desirable. Urine is a source of biomarkers that can be collected easily and noninvasively. We previously reported on the comprehensive profile of the urinary proteome of AD patients and identified proteins estimated to be significantly increased or decreased in AD patients by a label-free quantification method. The present study aimed to validate urinary levels of proteins that significantly differed between AD and control samples from our proteomics study (i.e., apolipoprotein C3 [ApoC3], insulin-like growth factor-binding protein 3 [Igfbp3], and apolipoprotein D [ApoD]). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Enzyme-linked immunosorbent assays (ELISAs) were performed using urine samples from the same patient and control groups analyzed in the previous proteomics study (18 AD and 18 controls, set 1) and urine samples from an independent group of AD patients and controls (13 AD, 5 mild cognitive impairment [MCI], and 32 controls) from the National Center for Geriatrics and Gerontology Biobank (set 2). &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; In set 1, the crude urinary levels of ApoD, Igfbp3, and creatinine-adjusted ApoD were significantly higher in the AD group relative to the control group (&lt;i&gt;p&lt;/i&gt; = 0.003, &lt;i&gt;p&lt;/i&gt; = 0.002, and &lt;i&gt;p&lt;/i&gt; = 0.019, respectively), consistent with our previous proteomics results. In set 2, however, the crude urinary levels of Igfbp3 were significantly lower in the AD+MCI group than in the control group (&lt;i&gt;p&lt;/i&gt; = 0.028), and the levels of ApoD and ApoC3 did not differ significantly compared to the control group. Combined analysis of all samples revealed creatinine-adjusted ApoC3 levels to be significantly higher in the AD+MCI group (&lt;i&gt;p&lt;/i&gt; = 0.015) and the AD-only group (&lt;i&gt;p&lt;/i&gt; = 0.011) relative to the control group. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; ApoC3 may be a potential biomarker for AD, as validated by ELISA. Further analysis of ApoC3 as a urinary biomarker for AD is warranted.

DOI： 10.1159/000509561

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Little is known about predictors of decline in vitamin D status (vitamin D decline) over time. We aimed to determine demographic and lifestyle variables associated with vitamin D decline by sufficiently controlling for seasonal effects of vitamin D uptake in a middle-aged to elderly population. Using a longitudinal study design within the larger framework of the Murakami Cohort Study, we examined 1044 individuals aged between 40 and 74 years, who provided blood samples at baseline and at 5-year follow-up, the latter of which were taken on a date near the baseline examination (±14 d). Blood 25-hydroxyvitamin D (25(OH)D) concentrations were determined with the Liaison® 25OH Vitamin D Total Assay. A self-administered questionnaire collected demographic, body size and lifestyle information. Vitamin D decline was defined as the lowest tertile of 5-year changes in blood 25(OH)D (Δ25(OH)D) concentration (<6·7 nmol/l). Proportions of those with vitamin D decline were 182/438 (41·6 %) in men and 166/606 (27·4 %) in women (P < 0·0001). In men, risk of vitamin D decline was significantly lower in those with an outdoor occupation (P = 0·0099) and those with the highest quartile of metabolic equivalent score (OR 0·34; 95 % CI 0·14, 0·83), and higher in those with 'university or higher' levels of education (OR 2·92; 95 % CI 1·04, 8·19). In women, risk of vitamin D decline tended to be lower with higher levels of vitamin D intake (Pfor trend = 0·0651) and green tea consumption (Pfor trend = 0·0025). Predictors of vitamin D decline differ by sex, suggesting that a sex-dependent intervention may help to maintain long-term vitamin D levels.

DOI： 10.1017/S0007114520001580

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Although dietary calcium, vitamin D, and vitamin K are nutritional factors associated with osteoporosis, little is known about their effects on incident osteoporotic fractures in East Asian populations. This study aimed to determine whether intakes of these nutrients predict incident osteoporotic fractures. We adopted a cohort-study design with a 5-year follow-up. Subjects were 12,794 community-dwelling individuals (6,301 men and 6,493 women) aged 40-74 years. Dietary intakes of calcium, vitamin D, and vitamin K were assessed with a validated food frequency questionnaire. Covariates were demographic and lifestyle factors. All incident cases of major osteoporotic limb fractures, including those of the distal forearm, neck of humerus, neck or trochanter of femur, and lumbar or thoracic spine were collected. Hazard ratios (HRs) for energy-adjusted calcium, vitamin D, and vitamin K were calculated with the residual method. Mean age was 58.8 years (SD=9.3). Lower energy-adjusted intakes of calcium and vitamin K in women were associated with higher adjusted HRs of total fractures (P for trend=0.005 and 0.08, respectively). When vertebral fracture was the outcome, P for trend values for calcium and vitamin K were 0.03 and 0.006, respectively, and HRs of the lowest and highest (reference) intake groups were 2.03 (95%CI:1.08-3.82) and 2.26 (95%CI:1.19-4.26), respectively. In men, there were null associations between incident fractures and each of the three nutrient intakes. Lower intakes of dietary calcium and vitamin K were independent, lifestyle-related risk factors for osteoporotic fracture in women but not men. These associations were robust for vertebral fractures, but not for limb fractures.

DOI： 10.1017/S0007114520001567

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Epidemiological Association  

BACKGROUND: Evidence for primary prevention of chronic kidney disease (CKD) is insufficient. The population-based prospective Uonuma CKD cohort study aims to explore associations of lifestyle and other risk factors with CKD. We report here the study design and baseline profiles. METHODS: All 67,322 residents aged ≥40 years in Minamiuonuma City, Uonuma City, and Yuzawa Town, Niigata Prefecture, Japan and 11,406 participants who attended local health-check examinations were targeted for baseline questionnaire and biochemical sampling, respectively. Information was gathered from 43,217 (64.2%) questionnaires and 8,052 (70.6%) biochemical samples; 6,945 participants consented to both questionnaire and biochemical sampling at baseline, conducted between fiscal years 2012 and 2015. Participants provided information regarding sociodemographic, lifestyle, and self-reported outcomes. Urine albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) were measured. The primary outcome is CKD based on self-report and biochemical/clinical diagnosis. RESULTS: Mean age of questionnaire respondents was 63.3 (standard deviation [SD], 12.5) years for men and 64.3 (SD, 13.3) years for women. Among participants who submitted urine samples, median ACR was 10.0 (interquartile range [IQR], 5.0-24.0) mg/g for men and 13.0 (IQR, 7.7-27.0) mg/g for women, and median eGFR was 73.6 mL/min/1.73 m2 (IQR, 63.5-84.5) for men and 73.5 mL/min/1.73 m2 (IQR, 64.4-83.5) for women. ACR 30 mg/g or more was found in 1,741 participants (21.7%) and eGFR <60 mL/min/1.73 m2 in 1,361 participants (16.9%). CONCLUSION: The Uonuma CKD cohort study was established to investigate the impact of lifestyle on CKD development and to provide data for preventing the onset and progression of CKD.

DOI： 10.2188/jea.je20180220

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BACKGROUND: Specific components of physical activity, such as vigorous exercise and heavy occupational work, are known to increase the risk of chronic low back pain (CLBP) and chronic knee pain (CKP), but impacts of other components are less known. This study aimed to assess the relationship between total physical activity and risk of CLBP and CKP from a public health perspective. METHODS: Participants were 7,565 individuals, aged 40-74 years, who did not have CLBP or CKP, and who participated in the 5-year follow-up survey. A self-administered questionnaire was used to obtain information on demographics, body size and lifestyle (including physical activity) in the baseline survey in 2011-2013, and on CLBP and CKP using Short Form 36 (SF-36) in the follow-up survey. Sitting, standing, walking and strenuous work for occupational activity were assessed for total physical activity, and walking slowly, walking quickly, light to moderate exercise and strenuous exercise were assessed for leisure-time physical activity using metabolic equivalent hours/day (METs score). RESULTS: Mean age of participants was 60.1 years (SD, 8.8). Participants with higher METs scores had a significantly higher risk of CKP (p for trend = 0.0089, OR of 4th quartile = 1.29, 95% CI: 1.04-1.59 vs. 1st quartile), but not CLBP. An intermediate leisure-time METs score was associated with a lower risk of CLBP (OR = 0.75, 95%CI: 0.61-0.92 vs. 0 METs-group). CONCLUSIONS: A high level of total physical activity may increase the risk of CKP, whereas an intermediate level of leisure-time physical activity may decrease the risk of CLBP, in middle-aged and elderly individuals. SIGNIFICANCE: Evidence on the longitudinal association between total physical activity and CLBP and CKP in middle-aged and elderly people is lacking. We conducted a cohort study to assess this association, and found that high levels of total physical activity increased risk of CKP, and intermediate levels of leisure-time physical activity decreased risk of CLBP. This suggests that the effect of physical activity on chronic pain differed by pain site.

DOI： 10.1002/ejp.1535

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BACKGROUND: A large earthquake can cause extreme stress and may adversely affect cognitive function in humans. We aimed to examine a possible association between psychological distress and incident dementia after the 2004 Niigata-Chuetsu earthquake in Japan. METHODS: This is a retrospective cohort study followed participants for 10-12 years. Subjects were 6,012 residents in 2005, 5,424 in 2006, and 5,687 in 2007 (age ≥40 years) living in Ojiya city who participated in the annual health check examinations after the 2004 Niigata-Chuetsu earthquake. Psychological distress was assessed using the Kessler Psychological Distress Scale (K10), and individuals with a K10 score ≥10 were considered to have psychological distress. Incident dementia cases were identified from a long-term care insurance database of the local government during the follow-up period. We evaluated hazard ratios (HRs) of psychological distress for incident dementia in each year, unadjusted and adjusted for covariates, including sex, age, occupation, BMI, and property damage of residential area. RESULTS: The average age of the subjects was 64.6 years in 2005, 64.6 in 2006, and 65.2 in 2007. Adjusted HRs were significantly higher (HR = 1.20-1.66) in the psychological distress group than in the reference group in each year. In particular, adjusted HR was high (HR = 2.89) in those with psychological distress in all three years (2005-2007). CONCLUSION: Psychological distress, especially persistent distress, is a risk factor for incident dementia in victims of large disasters.

DOI： 10.1016/j.jad.2019.08.041

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

BACKGROUND: Acid-base imbalance might promote the progression of chronic kidney disease (CKD), but whether nutrient-derived dietary acid load increases the risk of albuminuria or even high normoalbuminuria is unclear. METHODS: A Japanese cohort comprising 3250 men and 3434 women aged 40-97 years with urine albumin-to-creatinine ratio (ACR) < 33.9 mg/mmol or estimated glomerular filtration rate ≥ 15 ml/min/1.73 m2 were assessed. We performed a cross-sectional evaluation of the association between net endogenous acid production (NEAP), estimated as dietary protein to potassium content ratio, and the presence of high normoalbuminuria (ACR: 1.13-3.38 mg/mmol) or microalbuminuria. RESULTS: Median NEAP was 43.4 (interquartile range (IQR): 34.2-53.4) mEq/day in men and 35.0 (IQR: 27.7-43.6) mEq/day in women. Median ACR was 1.11 (IQR: 0.57-2.49) mg/mmol in men and 1.47 (IQR: 0.82-2.83) mg/mmol in women. In multivariate analysis, the adjusted odds ratio of the highest versus lowest NEAP quartile for microalbuminuria was 1.47 (95% confidence interval (CI): 1.08-1.99) in men and 1.54 (95% CI: 1.11-2.14) in women. For high normoalbuminuria or microalbuminuria, the adjusted odds ratio was 1.28 (95% CI: 1.02-1.59) in men and 1.39 (95% CI: 1.11-1.74) in women. From nutrient composition analysis, subjects with the highest potassium intake, but not protein intake, had lower adjusted odds ratios for the presence of microalbuminuria than those in the lowest quartile for potassium intake. CONCLUSIONS: Higher NEAP was associated with albuminuria and its association might negatively relate to potassium intake in an adult Japanese population.

DOI： 10.1186/s12882-019-1352-8

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Other Link： http://link.springer.com/article/10.1186/s12882-019-1352-8/fulltext.html

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OBJECTIVES: Modifiable risk factors for knee osteoarthritis (OA) have not been studied in detail. This study aimed to determine lifestyle-related modifiable factors of symptomatic knee osteoarthritis in an East Asian population. STUDY DESIGN: This 5-year cohort study involved 11,091 individuals (age range 40-72 years) living in the Murakami region of Niigata, Japan, who did not have a history of knee OA. At baseline, information on sociodemographic characteristics, body size, lifestyle, and living condition was obtained using a self-administered questionnaire. MAIN OUTCOME MEASURES: Incident symptomatic knee OA observed at hospitals and orthopaedic clinics in the five years to 2016. Clinical grades of knee OA were based on the Kellgren-Lawrence scale. P for trend was assessed to examine linear associations between predictors and the outcome in multiple logistic regression analysis. RESULTS: The mean age of participants was 58.1 (SD 9.3) years. The number of cases of grade 2 or more incident knee OA was 429. In men, older age (P for trend < 0.0001), higher BMI (P for trend < 0.0001), higher METs score (P for trend = 0.0150), less smoking (P for trend = 0.0249), and lower green tea consumption (P for trend = 0.0437) were associated with incident knee OA. In women, older age (P for trend < 0.0001), higher BMI (P for trend < 0.0001), and alcohol consumption (P = 0.0153) were associated with incident knee OA. CONCLUSIONS: Several lifestyle-related factors were found to be associated with incident knee OA and exhibited sex-dependent differences. In particular, higher consumption of green tea was associated with a lower incidence of knee OA in men.

DOI： 10.1016/j.maturitas.2019.06.013

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DOI： 10.1007/s00774-019-01040-w

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DOI： 10.1007/s11657-019-0575-4

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DOI： 10.1159/000496100

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BACKGROUND AND OBJECTIVES: The aim of this study was to examine the reproducibility of a self-administered food frequency questionnaire (FFQ) originally developed for the Japan Public Health Center-Based Prospective Study (JPHC study) and modified for use in the Next Generation (JPHC-NEXT) study. METHODS AND STUDY DESIGN: Participants included 98 men and 142 women aged 40-74 years from the five areas included in the JPHCNEXT protocol. In November 2012, participants were recruited and asked to complete the first nutrition survey. The second nutrition survey was completed after 1 year. RESULTS: We estimated daily energy as well as 53 nutrient and 29 food group intakes using the FFQ. To assess reproducibility, we calculated Spearman correlation coefficients between both FFQs, which showed mostly intermediate-to-high values. Median (range) correlation coefficients and quartile distribution in the same and adjacent categories for energy-adjusted nutrient intakes were 0.55 (0.42-0.84) and 84.7% (76.5%-98.0%) in men and 0.54 (0.35-0.80) and 84.5% (76.1%-94.4%) in women. The respective values for energy-adjusted food group intakes in men and women were also mostly intermediate to high: 0.54 (0.39-0.79) and 83.7% (75.5%-90.8%) in men and 0.57 (0.40-0.83) and 84.5% (77.5%-93.7%) in women. CONCLUSIONS: The FFQ developed for the JPHC-NEXT study has reasonable reproducibility. Because this FFQ has also been validated in a previous study, it can be considered a useful dietary assessment tool to examine associations between dietary consumption and lifestyle-related diseases.

DOI： 10.6133/apjcn.201906_28(2).0019

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DOI： 10.1007/s00198-018-4665-8

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BioMed Central Ltd.  

DOI： 10.1186/s12199-018-0715-2

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DOI： 10.1007/s00774-018-0934-z

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Background: The interaction of periodontopathic bacteria with host immune system induces the production of inflammatory mediators which leads to alveolar bone loss (ABL), the essential feature of periodontitis. Concurrently, periodontal diseases cause the elevation of blood cytokine levels, the alteration of gut microbiota and the dissemination of enterobacteria to the liver. Owing to these mechanisms, periodontal disease might be a risk for liver dysfunction. Several epidemiological studies have reported associations between periodontal diseases and liver dysfunction, although the association between ABL and liver dysfunction has not been investigated. This cross-sectional study determined if elevated serum liver enzyme levels were associated with ABL in Japanese adults. Material and Methods: Japanese adults living on Sado Island who visited Sado General Hospital were invited to participate in the study. Participants over 40 years of age who underwent dental panoramic radiography and blood tests were included. Drinking and smoking habits were self-administered. After excluding patients with edentulous jaw, diagnosed liver diseases, and those on dialysis, data from 44 men and 66 women with a mean age of 73 years were analyzed. The average percentage of ABL for each participant was calculated for mesial and distal sites of all remaining teeth. The levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) were determined. Univariate analyses were performed to select covariates to be put in multivariate analyses. The association between elevated serum liver enzyme levels and the highest quartile of ABL were assessed by multiple logistic regression analysis. Results: After adjusting for covariates, no significant association was found between elevated serum AST, ALT, or GGT levels as dependent variables and the highest quartile of ABL as an explanatory variable. Conclusions: There was no significant association between the elevation of serum liver enzyme levels and ABL in Japanese adults. Key words:Liver enzymes, dental panoramic radiography, alveolar bone loss, Japanese adults.

DOI： 10.4317/jced.54555

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DOI： 10.1038/s41430-017-0053-2

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DOI： 10.2147/JPR.S184746

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DOI： 10.1111/ggi.129.7

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DOI： 10.1371/journal.pone.0185960

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DOI： 10.1016/j.je.2016.08.021

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DOI： 10.1016/j.je.2016.08.008

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DOI： 10.1007/s12199-016-0572-9

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DOI： 10.1007/s12199-016-0542-2

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DOI： 10.2188/jea.JE20150064

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DOI： 10.1620/tjem.239.95

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Language：Japanese   Publisher：(一社)日本自殺予防学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：S. Karger AG  

DOI： 10.1159/000442585

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：S. Karger AG  

DOI： 10.1159/000447963

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DOI： 10.1111/obr.12309

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DOI： 10.1093/pubmed/fdu052

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BACKGROUND: It has been hypothesized that β-3 adrenergic receptor and peroxisome proliferator-activated receptor gamma (PPARγ) might have gene-environmental and gene-gene interactions in periodontal disease. The purpose of this study is to elucidate the interaction between β-3 adrenergic receptor and PPARγ gene polymorphism with periodontal disease. METHODS: Three hundred thirty-two postmenopausal females were enrolled, and their serum high-sensitivity C-reactive protein (hsCRP) and hemoglobin A1c (HbA1c) were examined. β-3 adrenergic receptor and PPARγ genotypes were then determined. An oral examination was performed. The number of remaining teeth was counted, and the probing depth (PD) and clinical attachment level (CAL) were measured. Prevalence-rate ratios (PRRs) were calculated by multiple Poisson regression analyses to evaluate the relationship among periodontal disease markers, such as the number of sites with CAL 4 to 5 or ≥6 mm or PD 4 to 5 or ≥6 mm, and β-3 adrenergic receptor polymorphisms, PPARγ polymorphisms, and the interaction term adjusted by age, hsCRP, and HbA1c, after converting the number of remaining teeth (n) to an offset variable. RESULTS: In the participants with body mass index (BMI) ≥25, PRRs of β-3 adrenergic receptor genotype (Trp/Arg and Arg/Arg) for periodontal disease markers were 0.13 to 0.70 (P <0.0001 to 0.74), those of PPARγ genotype (Pro/Pro) were 0.66 to 3.14 (P = 0.01 to 0.68), and those of the interaction term for the two genotypes were 1.69 to 12.61 (P <0.0001 to 0.33). However, in the participants with BMI <25, a constant tendency was not observed. CONCLUSION: The results confirmed a positive relationship between the interaction term for β-3 adrenergic receptor genotype and PPARγ genotype and various periodontal markers in obese elderly females.

DOI： 10.1902/jop.2015.140472

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DOI： 10.1016/j.bone.2014.12.064

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DOI： 10.1007/s00198-014-2770-x

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DOI： 10.2188/jea.JE20130097

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DOI： 10.1007/s11657-013-0153-0

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DOI： 10.1902/jop.2013.120613

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DOI： 10.1007/s12199-013-0351-9

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：ライフサイエンス出版(株)  

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DOI： 10.2188/jea.JE20110153

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DOI： 10.1002/jbmr.1676

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Current standard-dose calcium supplements (eg, 1000 mg/d) may increase the risk for cardiovascular events. Effectiveness of lower-dose supplements in preventing bone loss should thus be considered. This study aimed to assess whether calcium supplements of 500 or 250 mg/d effectively prevent bone loss in perimenopausal and postmenopausal Japanese women. We recruited 450 Japanese women between 50 and 75 years of age. They were randomly assigned to receive 500 mg of calcium (as calcium carbonate), 250 mg of calcium, or placebo daily. Medical examinations conducted three times over a 2-year follow-up period assessed bone mineral density (BMD) of the lumbar spine and femoral neck. One-factor repeated measures ANOVA was used for statistical tests. Subgroup analyses were also conducted. Average total daily calcium intake at baseline for the 418 subjects who underwent follow-up examinations was 493 mg/d. Intention-to-treat analysis showed less dramatic decreases in spinal BMD for the 500-mg/d calcium supplement group compared to the placebo group (1.2% difference over 2 years, p = 0.027). Per-protocol analysis (&gt;/=80% compliance) revealed that spinal BMD for the 500-mg/d and 250-mg/d cal

DOI： 10.1002/jbmr.1676

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00774-011-0337-x

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DOI： 10.1111/j.1741-2358.2011.00481.x

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DOI： 10.1016/j.nut.2011.05.013

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DOI： 10.1016/j.jdent.2012.01.005

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DOI： 10.1007/s12199-011-0233-y

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OBJECTIVES: Serum albumin and activities of daily living (ADL) are associated with each other, but whether the association is causal is not known. The purpose of this study was to determine whether a causal association exists between serum albumin and ADL levels. METHODS: The subjects were 116 frail elderly individuals (34 men and 82 women; mean age 83.0 years). Demographic characteristics, serum albumin, ADL, and handgrip strength were measured at a baseline examination and at a follow-up examination 2 years later. Levels of ADL were assessed with the Barthel Index. Pearson&#039;s correlation coefficients were calculated for serum albumin, ADL, and handgrip strength for baseline values and for their 2-year changes (Delta). RESULTS: At baseline, the mean serum albumin concentration was 4.0 g/dL and the total score of the Barthel Index (baseline Barthel Index) was 71.1. The baseline serum albumin level correlated significantly with the baseline Barthel Index (r = 0.287) and baseline handgrip strength (r = 0.315), but not with Delta Barthel Index (r = 0.096) or Delta handgrip strength (r = - 0.058). The Delta serum albumin correlated significantly with Delta Barthel Index (r = 0.296),

DOI： 10.1007/s12199-011-0233-y

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s12199-011-0225-y

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DOI： 10.1016/j.maturitas.2011.06.014

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DOI： 10.1007/s12199-010-0166-x

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DOI： 10.1093/ageing/afq148

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DOI： 10.1620/tjem.221.29

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DOI： 10.1620/tjem.220.149

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DOI： 10.1017/S1368980009005084

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DOI： 10.1093/ageing/afp052

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DOI： 10.1007/s00774-008-0027-5

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DOI： 10.1017/S0007114508993533

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DOI： 10.3177/jnsv.54.25

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DOI： 10.1016/j.bone.2007.09.056

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DOI： 10.1007/s00774-007-0755-y

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DOI： 10.1007/s00774-006-0699-7

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Language：English   Publishing type：Research paper (bulletin of university, research institution)  

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Other Link： http://hdl.handle.net/10191/19584

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DOI： 10.1007/s00774-005-0637-0

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DOI： 10.1265/ehpm.11.155

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DOI： 10.1265/ehpm.11.271

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DOI： 10.1007/s00774-005-0633-4

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DOI： 10.1093/ajcn/82.5.1127

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DOI： 10.1620/tjem.206.319

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DOI： 10.1620/tjem.205.231

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DOI： 10.1007/s00774-004-0543-x

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DOI： 10.1016/j.nut.2003.12.004

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DOI： 10.1016/S0899-9007(03)00181-3

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DOI： 10.1016/S0045-6535(03)00110-3

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DOI： 10.1016/S0899-9007(02)00751-7

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DOI： 10.1016/S0899-9007(01)00662-1

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DOI： 10.1002/1098-108X(200009)28:2<173::AID-EAT6>3.0.CO;2-I

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DOI： 10.1007/s001980070056

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Language：Japanese   Publisher：新潟県医師会  

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DOI： 10.2188/jea.18.37

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DOI： 10.1016/S0899-9007(99)00208-7

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