Faculty Profiles - NAKAMURA Kazutoshi

Papers - NAKAMURA Kazutoshi

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Effect of Low-Dose Calcium Supplements on Bone Loss in Perimenopausal and Postmenopausal Asian Women: A Randomized Controlled Trial Reviewed

Kazutoshi Nakamura, Toshiko Saito, Ryosaku Kobayashi, Rieko Oshiki, Kaori Kitamura, Mari Oyama, Sachiko Narisawa, Mitsue Nashimoto, Shunsuke Takahashi, Ribeka Takachi

JOURNAL OF BONE AND MINERAL RESEARCH 27 ( 11 ) 2264 - 2270 2012.11

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

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 (>= 80% compliance) revealed that spinal BMD for the 500 mg/d and 250-mg/d calcium supplement groups decreased less than the placebo group (1.6%, p = 0.010 and 1.0%, p = 0.078, respectively), and that femoral neck BMD for the 500-mg/d calcium supplement group decreased less relative to the placebo group (1.0%, p = 0.077). A low-dose calcium supplement of 500 mg/d can effectively slow lumbar spine bone loss in perimenopausal and postmenopausal women with habitually low calcium intake, but its effect on the femoral neck is less certain. Calcium supplementation dosage should thus be reassessed. (Clinical Trials Registry number: UMIN000001176). (C) 2012 American Society for Bone and Mineral Research.

DOI： 10.1002/jbmr.1676

Effect of low-dose calcium supplements on bone loss in perimenopausal and postmenopausal Asian women: a randomized controlled trial. Reviewed

Nakamura K, Saito T, Kobayashi R, Oshiki R, Kitamura K, Oyama M, Narisawa S, Nashimoto M, Takahashi S, Takachi R

J Bone Miner Res 27 ( 11 ) 2264 - 2270 2012.11

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

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 (>/=80% compliance) revealed that spinal BMD for the 500-mg/d and 250-mg/d cal

DOI： 10.1002/jbmr.1676

Change in bone mineral density and tooth loss in Japanese community-dwelling postmenopausal women: a 5-year cohort study Reviewed

Masanori Iwasaki, Kazutoshi Nakamura, Akihiro Yoshihara, Hideo Miyazaki

JOURNAL OF BONE AND MINERAL METABOLISM 30 ( 4 ) 447 - 453 2012.7

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER TOKYO

The aim of this longitudinal study was to investigate the association between the change in bone mineral density (BMD) and tooth loss in Japanese community-dwelling postmenopausal women. The subjects were 404 women. At baseline (2005) and follow-up (2010), BMDs of the lumbar spine and right femoral neck were measured using dual-energy X-ray absorptiometry (QDR4500a) and participants were classified by tertiles of the annual percentage change in BMD. The number of teeth was counted at the baseline and follow-up to calculate the number of lost teeth over 5 years. Poisson regression analysis was conducted with tertiles of the changes in BMDs of the lumbar spine and femoral neck as the main exposures to estimate their influence on the number of lost teeth. Participants in the tertile with a greater decrease in BMD at each skeletal site (lumbar spine and femoral neck, respectively) had a larger number of lost teeth, controlling for possible confounders. The adjusted relative risks (95% confidence interval) for the mean number of lost teeth in the first, second, and third tertiles were 1.00, 1.15 (0.91-1.45), and 1.38 (1.11-1.72) for the lumbar spine and 1.00, 1.17 (0.93-1.47), and 1.27 (1.01-1.59) for the femoral neck, respectively. In conclusion, a significant relationship exists between a change in BMD and the number of lost teeth during 5-year study period in Japanese community-dwelling postmenopausal women.

DOI： 10.1007/s00774-011-0337-x

The association between renal function and tooth loss in Japanese community-dwelling postmenopausal women Reviewed

Akihiro Yoshihara, Kazutoshi Nakamura, Hideo Miyazaki

GERODONTOLOGY 29 ( 2 ) E363 - E367 2012.6

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Objectives: This study examined whether low renal function is associated with the number of remaining teeth among community-dwelling elderly Japanese.
Background data: Many elderly individuals display both low renal function and tooth loss.
Materials and Methods: Subjects comprised 405 randomly selected women (55-74 years old). Serum cystatin C level was used to assess renal dysfunction. Multiple linear regression analysis was used to evaluate the relationship between number of remaining teeth and serum cystatin C level, with number of remaining teeth as the dependent variable. Six variables were selected as independent variables in the final model: serum cystatin C; age; mean clinical attachment level; serum cross-linked N-telopeptide of type I collagen level; body mass index and smoking habits.
Results: Multiple linear regression analysis revealed a significant relationship between number of remaining teeth and serum cystatin C level. The beta value for serum cystatin C level for the number of remaining teeth was -0.11 (p = 0.018).
Conclusion: This study indicates a relationship between serum cystatin C level and number of remaining teeth, suggesting that low renal function could be associated with tooth loss.

DOI： 10.1111/j.1741-2358.2011.00481.x

Nutritional and biochemical parameters associated with 6-year change in bone mineral density in community-dwelling Japanese women aged 69 years and older: The Muramatsu Study Reviewed

Kazutoshi Nakamura, Mari Oyama, Toshiko Saito, Rieko Oshiki, Ryosaku Kobayashi, Tomoko Nishiwaki, Mitsue Nashimoto, Yasuo Tsuchiya

NUTRITION 28 ( 4 ) 357 - 361 2012.4

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

Objective: Predictors of bone loss in elderly Asian women have been unclear. This cohort study aimed to assess lifestyle, nutritional, and biochemical predictors of bone loss in elderly Japanese women.
Methods: Subjects included 389 community-dwelling women aged 69 y and older from the Muramatsu cohort initiated in 2003; follow-up ended in 2009. We obtained data on physical characteristics, osteoporosis treatment (with bisphosphonates or selective estrogen receptor modulators), physical activity, calcium intake, serum 25-hydroxyvitamin D. undercarboxylated osteocalcin, serum albumin, and bone turnover markers as predictors. The outcome was a 6-y change in forearm BMD (Delta BMD). Osteoporosis treatment was coded as 0 for none, 1 for sometimes, and 2 for always during the follow-up period. Stepwise multiple linear regression analysis was used to identify independent predictors of Delta BMD.
Results: Mean age of the subjects was 73.3 y. Mean values of Delta BMD and Delta weight were 0.019 g/cm(2) (-5.8%) and -2.2 kg, respectively. Stepwise multiple linear regression analysis revealed baseline BMD (beta = 0.137, P < 0.0001), osteoporosis treatment beta = 0.0068, P = 0.0105), serum albumin levels (beta = 0.0122, P = 0.0319), and Delta weight (beta = 0.0015, P = 0.0009) as significant independent predictors of Delta BMD. However, none of the other nutritional or biochemical indices were found to be significant predictors of Delta BMD.
Conclusions: Our findings indicate that adequate general nutrition and appropriate osteoporosis medication, rather than specific nutritional regimens, may be effective in preventing bone loss in elderly women. (C) 2012 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.nut.2011.05.013

Association between periodontitis and systemic bone mineral density in Japanese community-dwelling postmenopausal women Reviewed

Osamu Takahashi, Akihiro Yoshihara, Kazutoshi Nakamura, Hideo Miyazaki

JOURNAL OF DENTISTRY 40 ( 4 ) 304 - 311 2012.4

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Objective: The purpose of this cross-sectional study was to evaluate the association between loss of attachment (LA) which is clinical index of periodontitis and bone mineral density (BMD) of the lumbar vertebrae and femur measured with dual energy X-ray absorptiometry (DXA) in Japanese community-dwelling postmenopausal women.
Subjects and methods: Subjects were 347 women aged 55-74. The oral cavity was divided into 6 areas according to the WHO's method for the determination of the clinical attachment level score (CALscore); the LA was measured at 6 sites using a WHO probe in 17, 16, 11, 26, 27, 37, 36, 31, 46, and 47, and the values were recorded in mm. Then, we assessed BMD of the lumbar vertebrae (L2-L4) and femur (femoral neck, proximal part) by DXA. Based on these data, analysis of covariance was used to estimate relation between periodontitis and systemic BMD status excluding effect of age. Multiple linear regression analysis was used to estimate relation between periodontitis and BMD adjusted for 17 variables.
Results: Significant differences were observed in the mean value between the mean CALscore = 0 and CALscore >= 1 groups in the Z value in lumbar vertebrate (106.9 +/- 18.7 vs. 102.3 +/- 1.0, p < 0.05, t-test). Multiple regression analysis was conducted using the mean LA as dependent variable. Lumbar vertebral BMD (regression coefficient: B = -1.039 +/- 0.379, p = 0.007), femoral neck BMD (B = -1.332 +/- 0.627, p = 0.034), and proximal femoral BMD (B = -1.329 +/- 0.536, p = 0.014) all exhibited a significant negative correlation with the mean LA.
Conclusion: A significant negative correlation was observed between periodontal disease and truncal bone BMD in this study. (C) 2012 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jdent.2012.01.005

Determination of whether the association between serum albumin and activities of daily living in frail elderly people is causal Reviewed

Kaori Kitamura, Kazutoshi Nakamura, Tomoko Nishiwaki, Kimiko Ueno, Akemi Nakazawa, Mariko Hasegawa

Environmental Health and Preventive Medicine 17 ( 2 ) 164 - 168 2012.3

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

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's correlation coefficients were calculated for serum albumin, ADL, and handgrip strength for baseline values and for their 2-year changes (Δ). 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 Δ Barthel Index (r = 0.096) or Δ handgrip strength (r = - 0.058). The Δ serum albumin correlated significantly with Δ Barthel Index (r = 0.296), but not with Δ handgrip strength (r = 0.182), baseline Barthel Index (r = - 0.044), or baseline handgrip strength (r = 0.047). Conclusions This 2-year cohort study has demonstrated that a decrease in serum albumin levels is associated with a decrease in ADL levels. A third factor may play a role in adversely affecting both serum albumin and ADL levels in frail elderly people. © The Japanese Society for Hygiene 2011.

DOI： 10.1007/s12199-011-0233-y

Determination of whether the association between serum albumin and activities of daily living in frail elderly people is causal Reviewed

Kitamura K, Nakamura K, Nishiwaki T, Ueno K, Nakazawa A, Hasegawa M

Environ Health Prev Med 17 ( 2 ) 164 - 168 2012.3

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

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'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

Social network disruption as a major factor associated with psychological distress 3 years after the 2004 Niigata-Chuetsu earthquake in Japan Reviewed

Mari Oyama, Kazutoshi Nakamura, Yuko Suda, Toshiyuki Someya

Environmental Health and Preventive Medicine 17 ( 2 ) 118 - 123 2012.3

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

Objectives The 2004 Niigata-Chuetsu earthquake of Japan caused a great deal of damage, and people living in the affected region are still struggling to reconstruct their lives. The aim of this study was to determine factors associated with psychological distress in people living in a town at the epicenter 3 years after the earthquake. Methods We conducted a cross-sectional study from June 2007 to January 2008. Participants included 225 individuals living in Kawaguchi (age ≥20 years) who reported psychological symptoms. Information on family structure, employment status, alcohol use, social network, and extent of house damage was elicited by public health nurses conducting structured interviews. Levels of psychological distress were assessed with the Kessler Psychological Distress Scale (K10), with a K10 score ≥25 defined as psychological distress. Results The mean age of participants was 66.1 ± 12.9 years. The prevalence of psychological distress varied among different employment classes, being 5/73 (6.8%) for participants with paid employment, 12/50 (24.0%) for fulltime housewives, and 11/101 (10.9%) for those who were unemployed (χ 2 = 8.42, P = 0.015). It also varied between participants who had lost contact with people in the community and those who had no change in social contact [9/20 (45.0%) vs. 19/189 (10.1%), respectively
χ 2 = 19.04, P&lt
0.001]. Multiple logistic regression analysis showed that age [odds ratio (OR) 0.95, 95% confidence interval (CI) 0.91-0.98], poor or loss of contact with people in the community (OR 6.97, 95% CI 1.85-26.2), and lack of employment (full-time housewives or unemployed individuals) (OR 6.74, 95% CI 1.62-28.0) were associated with psychological distress. Conclusions People who lose their social network are at a very high risk for post-earthquake psychological distress and require appropriate care. © The Japanese Society for Hygiene 2011.

DOI： 10.1007/s12199-011-0225-y

Physical activity and 5-year changes in physical performance tests and bone mineral density in postmenopausal women: The Yokogoshi Study Reviewed

Kaori Kitamura, Kazutoshi Nakamura, Ryosaku Kobayashi, Rieko Oshiki, Toshiko Saito, Mari Oyama, Shunsuke Takahashi, Tomoko Nishiwaki, Masanori Iwasaki, Akihiro Yoshihara

MATURITAS 70 ( 1 ) 80 - 84 2011.9

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER IRELAND LTD

Objective: The effect of physical activity on musculoskeletal health in older adults is not completely understood. The aim of this study was to determine the relationship between physical activity and 5-year changes in physical performance tests and bone mineral density (BMD) in postmenopausal women.
Study design: The design was a 5-year cohort study.
Main outcome measures: Subjects were 507 women (55-74 years old) living in a rural community in Japan. Physical activity assessed included housework, farm work, and moderate leisure-time physical activity within the previous week. Measurements at baseline included handgrip strength, walking time (timed "Up & Go" test) and BMD of the femoral neck and vertebrae. Five-year changes in these measures (outcome variables) were compared among groups with different levels of physical activity by analysis of covariance.
Results: Women who did not do housework performed worse in changes in handgrip strength (difference = 2.22 kg, P = 0.0201) and worse in changes in the walking time (difference = 0.54 s, P = 0.0072) than those who did housework alone. Women who spent at least 9 h per week (median = 24) doing farm work performed better in changes in handgrip strength (difference = 0.28 kg, P= 0.0334), but worse in changes in the walking time (difference = 0.66 s, P<0.0001) than those who did not do farm work. However, leisure-time activity was not associated with changes in any outcome variable, and none of the physical activities predicted BMD changes.
Conclusions: Engaging in housework and farm work are determinants of physical function in postmenopausal women, which may help them maintain independence in daily living. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.maturitas.2011.06.014

Positive predictive values for self-reported fractures in an adult Japanese population Reviewed

Kazutoshi Nakamura, Manami Inoue, Yoshikazu Kaneko, Shoichiro Tsugane

Environmental Health and Preventive Medicine 16 ( 2 ) 129 - 132 2011.3

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

Objectives: Self-reporting provides useful information for assessing the risk factors of osteoporotic fractures in large cohort studies. However, to data, no studies in Japan have confirmed the accuracy of this approach in this context. The aim of the study reported here was to determine the positive predictive value (PPV) for the self-reporting of fractures. Methods: A total of 133 participants of the Oguni cohort in the Japan Public Health Center-based Prospective Study who reported a vertebral, upper limb, or hip fracture on the 15-year follow-up questionnaire survey were evaluated. The accuracy of fractures was confirmed by cross-referencing medical records. Results: The average age of the participants was 72.4 (standard deviation 7.9) years. The PPV for vertebral fracture in the last 15 years was 17/20 (85.0%) for women and 2/9 (22.2%) for men, for a total of 19/29 (65.5%). PPVs for upper limb and hip fractures were as low as 30/68 (44.1%) and 12/22 (54.5%), respectively. Conclusion: Female self-reporting provided PPVs suitable for symptomatic vertebral fracture over 15 years and can be used as an outcome measure in large cohort studies in Japan. © 2010 The Japanese Society for Hygiene.

DOI： 10.1007/s12199-010-0166-x

Postural sway velocity predicts osteoporotic fracture in community-dwelling elderly Japanese women: the Muramatsu Study Reviewed

Kazutoshi Nakamura, Rieko Oshiki, Ryosaku Kobayashi, Mari Oyama, Toshiko Saito, Tomoko Nishiwaki, Mitsue Nashimoto, Yasuo Tsuchiya

AGE AND AGEING 40 ( 1 ) 132 - 135 2011.1

Low Body Mass Index and Low Serum Albumin Are Predictive Factors for Short-Term Mortality in Elderly Japanese Requiring Home Care Reviewed

Kaori Kitamura, Kazutoshi Nakamura, Tomoko Nishiwaki, Kimiko Ueno, Mariko Hasegawa

TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE 221 ( 1 ) 29 - 34 2010.5

Language：English Publishing type：Research paper (scientific journal) Publisher：TOHOKU UNIV MEDICAL PRESS

Japan has a rapidly growing elderly population requiring care. This study aimed to clarify risk factors for two-year mortality in such people. Subjects included 205 community-dwelling elderly people, who were approved for care in the 2003 Yamato Study, an epidemiologic study of individuals utilizing the long-term care service system. Demographic characteristics, Barthel index (measuring activities of daily living), grip strength, thigh muscle volume, psychological evaluation, and blood values including hemoglobin, serum albumin, and serum 25-hydroxyvitamin D levels were investigated at baseline. The average age of subjects was 83.6 (S.D., 8.0) years. Of the 205 subjects, 42 died during the follow-up period. Bivariate analysis showed that older age (p = 0.0015), lower weight (p = 0.0087), lower body mass index (BMI) (p = 0.0001), lower Barthel index (p = 0.0017), lower hemoglobin (p = 0.0180), and lower serum albumin (p = 0.0001) were associated with mortality, but that sex was not (p = 0.1248). Stepwise multiple logistic regression analysis showed that BMI < 17.1 kg/m(2) (adjusted OR = 4.0, p = 0.0007), age >= 90 years (adjusted OR = 3.3, p = 0.0033), and lower serum albumin levels (adjusted OR = 0.86, p = 0.0007) were independently associated with mortality. We conclude that low BMI and low serum albumin are strong predictors of 2-year mortality in frail elderly individuals, and that nutritional risk should appropriately be evaluated for elderly people requiring home care.

DOI： 10.1620/tjem.221.29

Long-Term Suicide Mortality Rates Decrease in Men and Increase in Women after the Niigata-Chuetsu Earthquake in Japan Reviewed

Keiko Hyodo, Kazutoshi Nakamura, Mari Oyama, Osamu Yamazaki, Izumi Nakagawa, Kazuo Ishigami, Yasuo Tsuchiya, Masaharu Yamamoto

TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE 220 ( 2 ) 149 - 155 2010.2

Language：English Publishing type：Research paper (scientific journal) Publisher：TOHOKU UNIV MEDICAL PRESS

A devastating earthquake causes psychological distress, and may increase suicide mortality thereafter, yet previous studies have made inconsistent conclusions regarding this issue. The purpose of the present study was to determine whether the 2004 Niigata-Chuetsu earthquake in Japan affected long-term mortality from suicide. We conducted a comparative study of suicide mortality rates during the 5-year period preceding and the 3-year period following the earthquake in the disaster area and a control area in Niigata Prefecture, by analyzing death certificate data from October 1, 1999, to September 30, 2007. In men, baseline suicide mortality rates (5 years preceding the earthquake) were 48.4 per 100,000 person-years in the disaster area and 46.1 in the control area, and suicide mortality rates during the 3-year period following the earthquake were 46.0 and 45.1, respectively. In women, baseline suicide mortality rates were 22.3 in the disaster area and 18.7 in the control area, and post-earthquake suicide mortality rates were 20.2 and 15.3, respectively. In consequence, the decrease in suicide mortality rate during the 3 years post-earthquake was significantly higher in the disaster area (2.5) than in the control area (1.0) (p = 0.0013) in men, whereas the decrease in suicide mortality rate was 2.1 in the disaster area and 3.0 in the control area (p = 0.1246) in women. We have concluded that the long-term mortality from suicide after the earthquake decreases in men and increases in women, suggesting that post-earthquake suicide mortality is sex-dependent. Post-earthquake suicide prevention strategies should more aggressively target women.

DOI： 10.1620/tjem.220.149

Intake of dairy products and bone ultrasound measurement in late adolescents: a nationwide crosssectional study in Japan Reviewed

Kazuhiro Uenishi, Kazutoshi Nakamura

ASIA PACIFIC JOURNAL OF CLINICAL NUTRITION 19 ( 3 ) 432 - 439 2010

Language：English Publishing type：Research paper (scientific journal) Publisher：H E C PRESS, HEALTHY EATING CLUB PTY LTD

Introduction: There is little evidence regarding the effects of dairy product intake on bone mineralization among late adolescents, especially in Asians. The aim of this study was to determine the association between dairy product intake and bone strength as measured by quantitative ultrasound (QUS) in a large Japanese population. Methods: Subjects were 38,719 high school students (14,996 males and 23,723 females) across 33 prefectures in Japan. Bone stiffness of the calcaneus was measured by QUS densitometry (AOS-100, Aloka). Subjects were given a self-administered questionnaire, which included questions on gender, age, height, weight, consumption of dairy products, and levels of physical activity. Intake of milk and yogurt were classified as none, 1-99, 100199, 200-399, and >= 400 ml/day. Results: The proportion of subjects who consumed milk 400 ml/day or more was 21% in males and 7.3% in females, while 24% of males and 41.1% of females did not consume milk. After adjusting for physical activity, weight, gender, age, and area of residence, milk intake (R(2)=2.8%, p<0.001) and yogurt intake (R(2)=0.1%, p<0.001) were independently associated with the QUS measurement. Similar associations were found in males and females when a gender-stratified analysis was conducted. Conclusion: We found a positive dose-effect relationship between milk intake and bone strength in late adolescents, to whom we recommend milk intake of 400 ml/day or more to obtain greater bone mass.

Low calcium intake is associated with increased bone resorption in postmenopausal Japanese women: Yokogoshi Study Reviewed

Kazutoshi Nakamura, Toshiko Saito, Akihiro Yoshihara, Miki Ishikawa, Yasuo Tsuchiya, Rieko Oshiki, Ryosaku Kobayashi, Keiko Maruyama, Keiko Hyodo, Mitsue Nashimoto, Naoko Tsugawa, Toshio Okano, Mari Oyama, Masaharu Yamamoto

PUBLIC HEALTH NUTRITION 12 ( 12 ) 2366 - 2370 2009.12

Language：English Publishing type：Research paper (scientific journal) Publisher：CAMBRIDGE UNIV PRESS

Objective: Low Ca intake is common among Japanese women, but its effect Oil bone metabolism has not been fully elucidated. The aim Of the present study was to determine the relationship between Ca intake and serum markers of bone turnover ill postmenopausal Japanese women.
Design: A cross-sectional study.
Setting: A community setting.
Subjects: Subjects were 595 home-dwelling postmenopausal Japanese women. Ca intake was assessed by a validated FFQ, Serum type I collagen cross-linked N-telopeptides (NTX) and osteocalcin Were measured as markers of bone turnover. The relationships between demographic characteristics, lifestyles, serum Ca, vitamin D and intact serum parathyroid hormone and bone turnover were also assessed.
Results: The average age of the subjects was 64.5 (SD 5.8) years and the mean Ca intake was 527 (SD 160) mg/d. Ca intake was significantly associated with serum NTX (P=0.0104); but not with serum osteocalcin. Mean serum NTX concentration in the lowest quartile of Ca intake (<417 mg/d) was significantly higher than in the fourth, referent quartile. Among these Japanese postmenopausal women, very low Ca intake (less than similar to 400 mg/d) was associated with increased bone resorption but not one formation.
Conclusions: Increased bone resorption may be one mechanism by which this Ca-depleted population normalizes bone metabolism and prevents osteoporosis.

DOI： 10.1017/S1368980009005084

Incidence and risk factors associated with hip fracture in institutionalised elderly people in Japan Reviewed

Kazutoshi Nakamura, Shunsuke Takahashi, Mari Oyama, Mitsue Nashimoto, Toshiko Saito, Yasuo Tsuchiya, Yoshiaki Yoshizawa, Masaharu Yamamoto

AGE AND AGEING 38 ( 4 ) 478 - 482 2009.7

Microscopic hematuria is associated with low bone mineral density in aged women and men Reviewed

Kazutoshi Nakamura, Junichiro James Kazama, Yoshifumi Tanaka, Keiko Makabe, Mari Oyama, Yasuo Tsuchiya, Masaharu Yamamoto

JOURNAL OF BONE AND MINERAL METABOLISM 27 ( 2 ) 251 - 254 2009.3

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER TOKYO

Little is known concerning renal or urological risk factors for osteoporosis. The aim of this study was to explore an association between urinalysis and bone mineral density (BMD) in 4,835 Japanese adults. Participants were 4,835 individuals (female 3,683; male 1,152) aged 50 years and over who received a health check-up between January 1995 and March 2006 in Japan. BMD of the distal radius and ulna of the non-dominant forearm was measured by the dual-energy X-ray absorptiometry (DXA) method using a DTX-200 Dexacare osteometer (Osteometer MediTech A/S, Rodovre, Denmark). Urine variables were protein, and red blood cells (RBCs) and white blood cells (WBCs) in urine sediment (categorized as < 1, 1-4, 5-9, or a parts per thousand yen10 cells per high-power microscopic field). Average age was 58.9 years (SD 5.6) in women, and 60.5 years (SD 6.2) in men. Simple linear regression analysis showed that urinary RBCs were associated with BMD in women (beta = -5.88 x 10(-3), R (2) = 0.004, p < 0.0001) and men (beta = -1.34 x 10(-2), R (2) = 0.013, p = 0.0001). These associations held when possible confounders were adjusted (beta = -2.05 x 10(-3), R (2) = 0.001, p = 0.0338 for women and beta = -5.67 x 10(-3), R (2) = 0.006, p = 0.0163 for men). Microscopic hematuria is associated with forearm BMD in women and men aged 50 years and over. Further studies should be conducted to determine the mechanisms underlying this association.

DOI： 10.1007/s00774-008-0027-5

Calcium intake and the 10-year incidence of self-reported vertebral fractures in women and men: The Japan Public Health Centre-based Prospective Study Reviewed

Kazutoshi Nakamura, Norie Kurahashi, Junko Ishihara, Manami Inoue, Shoichiro Tsugane

BRITISH JOURNAL OF NUTRITION 101 ( 2 ) 285 - 294 2009.1

Language：English Publishing type：Research paper (scientific journal) Publisher：CAMBRIDGE UNIV PRESS

The purpose of this study was to evaluate the effect of low Ca intake on the 10-year incidence of vertebral fractures in cohorts I and 11 of the Japan Public Health Centre-based Prospective Study. The baseline studies were conducted in 1990-1994, with the follow-up studies conducted after 10 years. We analysed 33 970 subjects aged 40-59 years in cohort I and 41664 subjects aged 40-69 years in cohort II. At baseline, the intake of Ca was assessed as a predictor, using validated FFQ. A meta-analysis was performed to estimate a summary relative risk (RR) for the two cohort studies. The 10-year cumulative incidences of self-reported vertebral fractures were 0.38% for cohort I and 0.56% for cohort II. In women, lower Ca intake was associated with a higher incidence of vertebral fractures (P for trend=0.001), with the lowest quartile of Ca intake having a significantly higher incidence (0.89/1000 persons per year or RR 2.10 (95% CI 1.25, 3.55)) than that (0.42/1000 persons per year) of the highest. In addition, the RR calculated using energy-adjusted Ca intake (by the residual method) as an outcome was 1.92 (95% Cl 1.28, 2.88). However, no such association was observed in men. An increase of Ca intake should be considered as a preventive strategy for vertebral fractures in peri-and post-menopausal women with a low Ca intake.

DOI： 10.1017/S0007114508993533

Development of a simple food frequency questionnaire to estimate intakes of calcium and other nutrients for the prevention and management of osteoporosis Reviewed

Kazuhiro Uenishi, Hiromi Ishida, Kazutoshi Nakamura

JOURNAL OF NUTRITIONAL SCIENCE AND VITAMINOLOGY 54 ( 1 ) 25 - 29 2008.2

Language：English Publishing type：Research paper (scientific journal) Publisher：CENTER ACADEMIC PUBL JAPAN

There have been no simple methods to estimate dietary nutrient intakes for the prevention and management of osteoporosis. The aim of this study was to develop and validate a new, simple food frequency questionnaire (FFQ) for dietary intake of calcium and other nutrients relevant to the bone health of adult Japanese women. We developed a 28-item FFQ. To validate this, 208 and 72 adult women aged between 18 and 69 y were recruited for testing reliability and reproducibility, respectively. In the 208 women, moderate-to-high Spearman's correlation coefficients between our FFQ and the conventional diet record method were found in intakes of calcium (r=0.668), sodium chloride (NaCl) (r=0.475), vitamin A (r=0.501), vitamin D (r=0.413), vitamin K (r=0.649), and energy (r=0.471). In the 72 women, coefficients of variance of the four repeated measurements of intakes throughout a year were 14.1% for calcium, 7.3% for NaCl, 21.2% for vitamin A, 13.6% for vitamin D, 36.8% for vitamin K, and 9.6% for energy In conclusion, the FFQ we developed is a useful tool to evaluate the intake of dietary calcium of adult Japanese women.. Although it can also measure intakes or dietary vitamin A, vitamin D, vitamin K, NaCl, and energy, further improvement is needed to measure intakes of these nutrients and energy.

DOI： 10.3177/jnsv.54.25

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