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BACKGROUND: Higher vegetable intake is being promoted as an initiative to prevent lifestyle-related diseases. Carotenoids are yellow or red pigment components and are widely present in vegetables. Since ingested carotenoids accumulate in the skin, skin carotenoid levels are a quantitative indicator of vegetable intake. Recently, noninvasive optical sensors for assessing skin carotenoid levels were developed. We here examined the association between skin carotenoid scores measured using optical sensors and the presence of metabolic syndrome. METHODS: A total of 1618 individuals (604 men and 1014 women) aged ≥ 40 years (mean age 63.1 years) participated in the study. Skin carotenoid scores were determined using a noninvasive optical sensor based on multiple spatially resolved reflectance spectroscopy. Metabolic syndrome was defined based on the Joint Scientific Statement criteria developed by six international scientific societies. Multivariable-adjusted logistic regression models were used. RESULTS: The prevalence of metabolic syndrome was 31.3% (n = 506). A remarkably strong association was found between higher skin carotenoid scores and lower prevalence of metabolic syndrome after adjusting for confounders. The multivariable-adjusted odds ratio for the presence of metabolic syndrome in individuals with the highest quartile of skin carotenoid scores was 0.39 (95% confidence interval, 0.28-0.55) compared to those with the lowest quartile. CONCLUSIONS: Our findings suggest that higher skin carotenoid scores measured by non-invasive optimal sensors are significantly associated with a lower likelihood of having metabolic syndrome in the general Japanese population.

DOI： 10.1038/s41366-024-01575-7

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

<p><b>Background:</b> Studies on the association between preserved ratio impaired spirometry (PRISm) and dementia are limited. Indeed, PRISm has often been overlooked or ignored as an index of lung function impairment. Therefore, we investigated the association of PRISm with the risk for the development of dementia in an older Japanese population.</p><p><b>Methods:</b> A total of 1,202 community-dwelling, older Japanese participants aged ≥65 years without dementia were followed up for a median of 5.0 years. Participants were categorized by spirometry as follows: normal spirometry (FEV₁/FVC ≥0.70 and FEV₁ ≥80% predicted), PRISm (≥0.70 and <80%), airflow limitation (AFL) Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1 (<0.70 and ≥80%), and AFL GOLD 2 to 4 (<0.70 and <80%). Hazard ratios (HRs) and their 95% confidence intervals (CIs) were computed using a Cox proportional hazards model.</p><p><b>Results:</b> During the follow-up period, 122 participants developed dementia. The age- and sex-adjusted incidences of dementia in the participants with normal spirometry, PRISm, AFL GOLD 1, and AFL GOLD 2 to 4 were 20.5, 37.0, 18.4, and 28.6 per 1,000 person-years, respectively. Participants with PRISm had a higher risk of dementia (HR 2.04; 95% CI, 1.19–3.49) than those with normal spirometry after adjusting for confounders. Moreover, both reduced FEV₁% predicted values and FVC% predicted values were associated with the risk of dementia.</p><p><b>Conclusion:</b> PRISm was associated with an increased risk of dementia in a general older Japanese population.</p>

DOI： 10.2188/jea.je20230207

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

Abstract

Background

Increase in functional disability in aging societies is an international medical and public health issue. Masticatory function may be a potential risk factor for functional disability, but the role of frailty in the association has not been clarified.

Methods

Forty thousand five hundred sixty-two community-dwelling older adults aged 65 years and over who were insured by public health insurance as of April 2018 were followed up for a median of 3.0 years. Masticatory function was categorized as good, moderate, or poor based on a self-reported questionnaire. The development of functional disability was defined as a new certification of the need for long-term care. A Cox proportional hazards model was used to calculate hazard ratios (HRs) and their 95% confidence intervals (CIs).

Results

During the follow-up period, 1,397 individuals experienced functional disability. After adjusting for age, sex, comorbidities, medical history, and lifestyle behaviors, the HR for incident functional disability was significantly higher in the moderate and poor groups compared to the good group (moderate, HR 1.21 [95% CI, 1.07–1.37]; poor, HR 1.64 [95% CI, 1.03–2.62]). However, after additional adjustment for frailty-related factors—namely, underweight, regular exercise, and gait speed—the association was attenuated in both the moderate group (HR 1.06 [95% CI, 0.94–1.21]) and the poor group (HR 1.51 [95% CI, 0.94–2.41]).

Conclusions

Masticatory dysfunction was significantly associated with incident functional disability in a community-dwelling older Japanese population. Our findings suggest that masticatory dysfunction may be a surrogate of frailty rather than a direct cause of functional disability.

DOI： 10.1186/s12877-024-05131-w

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Language：English   Publisher：John Wiley & Sons Australia, Ltd  

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

Abstract

We investigated the association of retinopathy with the risk of dementia in a general older Japanese population. A total of 1709 population-based residents aged 60 years or older without dementia were followed prospectively for 10 years (2007–2017). They underwent color fundus photography in 2007. Retinopathy was graded according to the Modified Airlie House Classification. Main outcome was the Incidence of dementia. A Cox proportional hazards model was used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) for the risk of dementia by the presence of retinopathy. During the follow-up period, 374 participants developed all-cause dementia. The cumulative incidence of dementia was significantly higher in those with retinopathy than those without (p &lt; 0.05). Individuals with retinopathy had significantly higher risk of developing dementia than those without after adjustment for potential confounding factors (HR 1.64, 95% CI 1.19–2.25). Regarding the components of retinopathy, the presence of microaneurysms was significantly associated with a higher multivariable-adjusted HR for incident dementia (HR 1.94, 95% CI 1.37–2.74). Our findings suggest that, in addition to systemic risk factors, retinal microvascular signs from fundus photography provide valuable information for estimating the risk of developing dementia.

DOI： 10.1038/s41598-024-62688-7

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Language：English   Publisher：Public Health Nutrition  

Objective: Improved food availability and a growing economy in Tanzania may insufficiently decrease pre-existing nutritional deficiencies and simultaneously increase overweight within the same individual, household or population, causing a double burden of malnutrition (DBM). We investigated economic inequalities in DBM at the household level, expressed as a stunted child with a mother with overweight/obesity, and the moderating role of dietary diversity in these inequalities. Design: We used cross-sectional data from the 2015-2016 Tanzania Demographic and Health Survey. Setting: A nationally representative survey. Participants: Totally, 2867 children (aged 6-23 months) and their mothers (aged 15-49 years). The mother-child pairs were categorised into two groups based on dietary diversity score: achieving and not achieving minimum dietary diversity. Results: The prevalence of DBM was 5·6 % (s d = 0·6) and significantly varied by region (ranging from 0·6 % to 12·2 %). Significant interaction was observed between dietary diversity and household wealth index (P for interaction < 0·001). The prevalence of DBM monotonically increased with greater household wealth among mother-child pairs who did not achieve minimum dietary diversity (P for trend < 0·001; however, this association was attenuated in those who achieved minimum dietary diversity (P for trend = 0·16), particularly for the richest households (P = 0·44). Analysing household wealth index score as a continuous variable yielded similar results (OR (95 % CI): 2·10 (1·36, 3·25) for non-achievers of minimum dietary diversity, 1·38 (0·76, 2·54) for achievers). Conclusions: Greater household wealth was associated with higher odds of DBM in Tanzania; however, the negative impact of household economic status on DBM was mitigated by minimum dietary diversity.

DOI： 10.1017/S136898002400106X

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AIM: To assess the association between plasma amyloid β (Aβ) 42/40, phosphorylated tau (p-τ)181, glial fibrillary acidic protein (GFAP), or neurofilament light chain (NfL) and the risk of dementia and to determine whether these plasma biomarkers could improve the ability to predict incident dementia in a general older population. METHODS: A total of 1346 Japanese community-dwelling individuals aged ≥65 years without dementia were followed prospectively for 5.0 years. Plasma biomarkers were quantified using a Simoa HD-X analyzer. A Cox proportional hazards model was used to estimate the hazard ratios of each plasma biomarker level for the risk of dementia. RESULTS: During the follow-up, 151 participants developed dementia, of whom 108 had Alzheimer disease (AD) and 43 non-Alzheimer dementia (non-AD). Lower plasma Aβ42/40 levels and higher plasma p-τ181 levels were significantly associated with developing AD but not non-AD, whereas significant associations were observed between higher plasma levels of GFAP and NfL and risk of both AD and non-AD (all P for trend <0.05). In addition, adding these four plasma biomarkers into a model consisting of the total score of the dementia risk model significantly improved the predictive ability for incident dementia. CONCLUSION: Our findings suggest that plasma Aβ42/40 and p-τ181 are specific markers of AD, and plasma GFAP and NfL are potential biomarkers for all-cause dementia in the general Japanese older population. In addition, the measurement of these plasma biomarkers may be a useful and relatively low-invasive procedure for identifying individuals at high risk for developing dementia in clinical practice.

DOI： 10.1111/pcn.13661

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Publisher：Scientific Reports  

In recent years, the association between neuroinflammatory markers and dementia, especially Alzheimer’s disease (AD), has attracted much attention. However, the evidence for the relationship between serum-hs-CRP and dementia including AD are inconsistent. Therefore, the relationships of serum high-sensitivity CRP (hs-CRP) with dementia including AD and with regions of interest of brain MRI were investigated. A total of 11,957 community residents aged 65 years or older were recruited in eight sites in Japan (JPSC-AD Study). After applying exclusion criteria, 10,085 participants who underwent blood tests and health-related examinations were analyzed. Then, serum hs-CRP levels were classified according to clinical cutoff values, and odds ratios for the presence of all-cause dementia and its subtypes were calculated for each serum hs-CRP level. In addition, the association between serum hs-CRP and brain volume regions of interest was also examined using analysis of covariance with data from 8614 individuals in the same cohort who underwent brain MRI. After multivariable adjustment, the odds ratios (ORs) for all-cause dementia were 1.04 (95% confidence interval [CI] 0.76–1.43), 1.68 (95%CI 1.08–2.61), and 1.51 (95%CI 1.08–2.11) for 1.0–1.9 mg/L, 2.0–2.9 mg/L, and ≥ 3.0 mg/L, respectively, compared to < 1.0 mg/L, and those for AD were 0.72 (95%CI 0.48–1.08), 1.76 (95%CI 1.08–2.89), and 1.61 (95%CI 1.11–2.35), for 1.0–1.9 mg/L, 2.0–2.9 mg/L, and ≥ 3.0 mg/L, respectively, compared to < 1.0 mg/L. Multivariable-adjusted ORs for all-cause dementia and for AD prevalence increased significantly with increasing serum hs-CRP levels (p for trend < 0.001 and p = 0.001, respectively). In addition, the multivariable-adjusted temporal cortex volume/estimated total intracranial volume ratio decreased significantly with increasing serum hs-CRP levels (< 1.0 mg/L 4.28%, 1.0–1.9 mg/L 4.27%, 2.0–2.9 mg/L 4.29%, ≥ 3.0 mg/L 4.21%; p for trend = 0.004). This study’s results suggest that elevated serum hs-CRP levels are associated with greater risk of presence of dementia, especially AD, and of temporal cortex atrophy in a community-dwelling Japanese older population.

DOI： 10.1038/s41598-024-57922-1

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DOI： 10.1136/bmjph-2023-000186

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DOI： 10.1111/jdi.14096

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Language：English   Publisher：(一社)日本疫学会  

＜Highlight＞●本研究は、血清リポ多糖結合蛋白(LBP)値とメタボリックシンドローム(MetS)発症との関連を検討した最初の前向きコホート研究である。●血清LBP値の上昇に伴いメタボリックシンドロームおよびその構成要素の発症リスクは上昇した。●媒介解析において、HOMA-IRと血清高感度CRPは血清LBPとMetS発症との関連に、部分的に介在していた。●血清LBP値とメタボリックシンドロームの発症リスクの関連はインスリン抵抗性と慢性炎症を介した機序が示唆された。(著者抄録)

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

<p><b>Background:</b> The association between chronic lipopolysaccharide exposure and the development of metabolic syndrome (MetS) is unclear. In this study we examined the association between serum lipopolysaccharide-binding protein (LBP) levels, an indicator of lipopolysaccharide exposure, and the development of MetS in a general Japanese population.</p><p><b>Methods:</b> 1,869 community-dwelling Japanese individuals aged ≥40 years without MetS at baseline examination in 2002–2003 were followed up by repeated examination in 2007–2008. MetS was defined according to the Japanese criteria. Serum LBP levels were classified into quartiles (quartiles 1–4: 2.20–9.56, 9.57–10.78, 10.79–12.18, and 12.19–24.34 µg/mL, respectively). Odds ratios (ORs) for developing MetS were calculated using a logistic regression model.</p><p><b>Results:</b> At the follow-up survey, 159 participants had developed MetS. Higher serum LBP levels were associated with greater risk of developing MetS after multivariable adjustment for age, sex, smoking, drinking, and exercise habits (OR [95% confidence interval] for quartiles 1–4: 1.00 [reference], 2.92 [1.59–5.37], 3.48 [1.91–6.35], and 3.86 [2.12–7.03], respectively; <i>P</i> for trend <0.001). After additional adjustment for homeostasis model assessment of insulin resistance, this association was attenuated but remained significant (<i>P</i> for trend = 0.007). On the other hand, no significant association was observed after additional adjustment for serum high-sensitivity C-reactive protein (<i>P</i> for trend = 0.07).</p><p><b>Conclusion:</b> In the general Japanese population, our findings suggest that higher serum LBP levels are associated with elevated risk of developing MetS. Low-grade endotoxemia could play a role in the development of MetS through systemic chronic inflammation and insulin resistance.</p>

DOI： 10.2188/jea.je20220232

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Society for Clinical Epidemiology  

<p><b>BACKGROUND</b></p><p>The Fukuoka-City Information Platform for Community-based Integrated Care is an advanced big data platform that aggregates information on the health and medical services of Fukuoka citizens. Fukuoka City is engaged in a joint project with Kyushu University to promote policy making through a large-scale real-world data analysis. This paper describes the framework for this cooperative effort and the features of the analytical platform.</p><p><b>METHODS</b></p><p>Fukuoka City is the fifth most populous ordinance-designated city in Japan, with an estimated population of approximately 1.6 million. Under an agreement with Fukuoka City, Kyushu University was granted access to a portion of the city’s anonymized healthcare database as secondary-use information. The database contains information on resident registration, health insurance claims, specific health checkups and health checkups for the older adults, specific health guidance, long-term care insurance data, and cancer screenings collected after fiscal year 2012. Each of these constituent datasets can be interlinked using anonymized hashed key variables, allowing individuals to be followed across databases and over time.</p><p><b>CONCLUSIONS</b></p><p>The platform allows longitudinal investigation of the complex association between various aspects of healthcare, such as medical procedures, examinations, interviews, medical costs, long-term care certifications, and care costs. The platform can provide valuable public-health information because it is relatively large for a single database, and because it allows analysis of data across multiple domains and tracing of individuals over time.</p>

DOI： 10.37737/ace.24002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.xops.2023.100350

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

Background

Studies have shown that decreased gait speed is associated with impaired cognitive function. However, whether this association is equivalent across ages or genders in the older population remains unclear. Thus, we examined the association between mild cognitive impairment (MCI) and gait speed emphasising the influence of age and gender.

Methods

Overall, 8233 Japanese participants aged ≥65 years were enrolled in this cross‐sectional study between 2016 and 2018. After stratification by gender and age group, the participants' gait speeds were divided into quintiles, and the difference in MCI prevalence at each gait speed quintile was calculated. Logistic regression analyses were performed to assess the odds of MCI for each quintile and to assess the influence of age and gender.

Results

Males had a consistently higher prevalence of MCI than females. The odds of MCI were increased as gait speed decreased. Logistic regression analyses revealed that in the multivariable‐adjusted model 2, the odds ratios (95% confidence interval; CI) for MCI were 2.02 (1.47–2.76) for females and 1.75 (1.29–2.38) for males in the slowest gait speed quintiles compared to the fastest quintile. In the stratified analyses, only males showed an age‐dependent increase in the associations between gait speed and MCI, while females exhibited comparable associations across age groups.

Conclusions

Reduced gait speed was associated with increased odds of MCI, and this association may vary according to gender and age. Therefore, gait speed could serve as a valuable screening tool for MCI, with gender‐ and age‐dependent clinical implications.

DOI： 10.1111/psyg.13013

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Language：English   Publisher：John Wiley & Sons Australia, Ltd  

日本人高齢者における軽度認知障害(MCI)と歩行速度の関連について検討した。2016～2018年にJPSC-ADに参加した65歳以上の日本人8233人(男性3540人、女性4693人、平均72.8±6.0歳)を対象とした。性別及び年齢グループにより層別化した後、参加者の歩行速度を5グループに分けた。その結果、歩行速度の低下はMCIのオッズ上昇と関連し、性別及び年齢により変化していた。また、歩行速度はMCIのスクリーニングツールとして有用であることが示された。

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DOI： 10.5551/jat.ER61960

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DOI： 10.1101/2023.10.10.23296857

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Language：English   Publisher：Neurology  

Background and ObjectivesEpidemiologic evidence has shown that social isolation, a low frequency of social contact with others, is associated with the risk of dementia and late-life depressive symptoms. Therefore, we hypothesized that low frequency of social contact may be involved in brain atrophy, and depressive symptoms may play some role in this relationship. We aimed to evaluate the association between low frequency of social contact and the volumes of various brain regions and to assess the extent to which depressive symptoms mediate these relationships from a large population-based multisite cohort study.MethodsDementia-free community-dwelling Japanese aged 65 years or older underwent brain MRI scans and a comprehensive health examination. Frequency of contact with noncohabiting relatives and friends was determined by asking a single question with 4 categories: everyday, several times a week, several times a month, and seldom. Total and regional brain volumes, intracranial volume (ICV), and white matter lesion volume were estimated using FreeSurfer software. The associations between frequency of social contact and brain volumes per ICV were examined using analyses of covariance. Mediation analyses were conducted to calculate the proportion of the associations explained by depressive symptoms.ResultsWe included 8,896 participants. The multivariable-adjusted mean of the total brain volume in the group with the lowest frequency of social contact was significantly lower compared with that in the group with the highest frequency of social contact (67.3% vs 67.8%), with a significant increasing trend across the groups (p value for trend <0.001). The white matter lesion volume increased significantly with lower frequency of social contact (0.30% in the lowest frequency group vs 0.26% in the highest frequency group, p value for trend <0.001). Lower frequency of social contact was associated with smaller volumes in the temporal lobe, occipital lobe, cingulum, hippocampus, and amygdala (all q values of false discovery rate correction <0.05). The relationships seemed to be partly mediated by depressive symptoms, which accounted for 15%-29% of the observed associations.DiscussionLower frequency of social contact was associated with decreased total and cognitive function-related regional brain volumes. In addition, depressive symptoms partially explained the association in community-dwelling older people without dementia in Japan.

DOI： 10.1212/WNL.0000000000207602

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BACKGROUND: To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up. METHODS: In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA. RESULTS: On average, a significant decrease in MVPA over 2 years was observed only in women (P < .001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years. CONCLUSIONS: Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women.

DOI： 10.1123/jpah.2022-0411

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BACKGROUND: The associations of sedentary time and patterns with functional disability among older adults remain unclear, and few studies have accounted for the co-dependency of sedentary behavior and physical activities when modeling sedentary behavior with risk of functional disability. We aimed to examine the associations between sedentary time and patterns and risk of incident functional disability, and assess whether replacing sedentary time with light physical activity (LPA) or moderate-to-vigorous intensity physical activity (MVPA) is associated with reduced risk of functional disability in community-dwelling older adults. METHODS: A total of 1,687 Japanese adults aged ≥ 65 years without functional disability at baseline were prospectively followed-up for 9 years (2011-2020). Functional disability was ascertained using the national database of Japan's Long-term Care Insurance System. Sedentary time and patterns, LPA, and MVPA were measured using a tri-axial accelerometer secured to participants' waists. RESULTS: During follow-up, 466 participants developed functional disability. Compared with the lowest quartile of total sedentary time, the multivariable-adjusted hazard ratios (95% confidence intervals) of functional disability for the second, third, and top quartiles were 1.21 (0.91‒1.62), 1.45 (1.10‒1.92), and 1.40 (1.05‒1.88) (p for trend = 0.01). After further adjusting for MVPA, total sedentary time was no longer significantly associated with the risk of functional disability (p for trend = 0.41). Replacing 10 min/day of sedentary time with the same amount of MVPA (but not LPA) was significantly associated with a 12% reduced risk of functional disability (hazard ratio [95% confidence interval]: 0.88 [0.84‒0.92]). No significant association was observed between sedentary bout length and functional disability. CONCLUSION: Higher levels of total sedentary time were associated with an increased risk of incident functional disability. However, this association was not independent of MVPA. Replacing sedentary time with MVPA, but not LPA, was associated with reduced risk of functional disability in older adults.

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BACKGROUND AND OBJECTIVES: Epidemiological evidence has shown that social isolation, a low frequency of social contact with others, is associated with the risk of dementia and late-life depressive symptoms. Therefore, we hypothesized that low frequency of social contact may be involved in brain atrophy, and depressive symptoms may play some role in this relationship. We aimed to evaluate the association between low frequency of social contact and the volumes of various brain regions and to assess the extent to which depressive symptoms mediate these relationships from a large population-based multisite cohort study. METHODS: Dementia-free community-dwelling Japanese aged ≥65 years underwent brain MRI scans and a comprehensive health examination. Frequency of contact with non-cohabiting relatives and friends was determined by asking a single question with four categories: everyday, several times a week, several times a month, and seldom. Total and regional brain volumes, intracranial volume (ICV) and white matter lesions volume were estimated using FreeSurfer software. The associations between frequency of social contact and brain volumes per ICV were examined using analyses of covariance. Mediation analyses were conducted to calculate the proportion of the associations explained by depressive symptoms. RESULTS: We included 8,896 participants. The multivariable-adjusted mean of the total brain volume in the group with the lowest frequency of social contact was significantly lower compared to that in the group with the highest frequency (67.3% vs 67.8%), with a significant increasing trend across the groups (p value for trend <0.001). The white matter lesions volume increased significantly with lower frequency of social contact (0.30% in the lowest frequency vs 0.26% in the highest frequency group, p value for trend <0.001). Lower frequency of social contact was associated with smaller volumes in the temporal lobe, occipital lobe, cingulum, hippocampus, and amygdala (all q value of FDR correction <0.05). The relationships appeared to be partly mediated by depressive symptoms, which accounted for 15% to 29% of the observed associations. DISCUSSION: Lower frequency of social contact was associated with decreased total and cognitive function-related regional brain volumes. In addition, depressive symptoms partially explained the association in community-dwelling older people without dementia in Japan.

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Publisher：Physics Letters, Section B: Nuclear, Elementary Particle and High-Energy Physics  

This letter documents a search for flavour-changing neutral currents (FCNCs), which are strongly suppressed in the Standard Model, in events with a photon and a top quark with the ATLAS detector. The analysis uses data collected in pp collisions at s=13 TeV during Run 2 of the LHC, corresponding to an integrated luminosity of 139 fb−1. Both FCNC top-quark production and decay are considered. The final state consists of a charged lepton, missing transverse momentum, a b-tagged jet, one high-momentum photon and possibly additional jets. A multiclass deep neural network is used to classify events either as signal in one of the two categories, FCNC production or decay, or as background. No significant excess of events over the background prediction is observed and 95% CL upper limits are placed on the strength of left- and right-handed FCNC interactions. The 95% CL bounds on the branching fractions for the FCNC top-quark decays, estimated (expected) from both top-quark production and decay, are B(t→uγ)<0.85(0.88−0.25+0.37)×10−5 and B(t→cγ)<4.2(3.40−0.95+1.35)×10−5 for a left-handed tqγ coupling, and B(t→uγ)<1.2(1.20−0.33+0.50)×10−5 and B(t→cγ)<4.5(3.70−1.03+1.47)×10−5 for a right-handed coupling.

DOI： 10.1016/j.physletb.2022.137379

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Language：Japanese   Publisher：Japanese Association of Exercise Epidemiology  

DOI： 10.24804/ree.2155

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DOI： 10.1210/clinem/dgad011

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Atherosclerosis Society  

<p> <b>Aim:</b> Circulating omega-3 and omega-6 polyunsaturated fatty acids may to contribute to cardiovascular health at the population level. Over a decade, we investigated changes in the serum eicosapentaenoic acid (EPA) to arachidonic acid (AA) ratio, and in serum concentrations of the individual fatty acids, in a Japanese community.</p><p> <b>Methods:</b> Community surveys took place in 2002–2003 and 2012–2013 in a rural area of Japan. The community surveys included 3,194 and 3,220 community dwellers aged ≥ 40 years who did not take EPA medication in 2002–2003 and 2012–2013, respectively. Fatty acid fractionations in serum were measured using a gas chromatography method. Changes in the serum EPA/AA ratio over time were examined using linear mixed models.</p><p><b>Results:</b> Overall, the average serum EPA/AA ratio decreased over the 10 years. A decreasing trend in the serum EPA/AA ratio occurred in all age groups except participants aged ≥ 80 years, with larger decreases in the younger age groups. A similar decline in serum EPA/AA ratio occurred in participants with and those without lipid-lowering therapy. Serum EPA concentrations were slightly increased in the whole population but remained stable or even decreased in participants aged 40–69. In contrast, the average serum AA concentrations increased in all age groups.</p><p><b>Conclusion:</b> In a Japanese community, the serum EPA/AA ratio decreased over 10 years at the population level, especially in middle-aged participants.</p>

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AIM: To investigate the association of white matter lesions volume (WMLV) levels with dementia risk and the association between dementia risk and the combined measures of WMLV and either total brain atrophy or dementia-related gray matter atrophy in a general older population. METHODS: One thousand one hundred fifty-eight Japanese dementia-free community-residents aged ≥65 years who underwent brain magnetic resonance imaging were followed for 5.0 years. WMLV were segmented using the Lesion Segmentation Toolbox. Total brain volume (TBV) and regional gray matter volume were estimated by voxel-based morphometry. The WMLV-to-intracranial brain volume ratio (WMLV/ICV) was calculated, and its association with dementia risk was estimated using Cox proportional hazard models. Total brain atrophy, defined as the TBV-to-ICV ratio (TBV/ICV), and dementia-related regional brain atrophy defined based on our previous report were calculated. The association between dementia risk and the combined measures of WMLV/ICV and either total brain atrophy or the number of atrophied regions was also tested. RESULTS: During the follow-up, 113 participants developed dementia. The risks of dementia increased significantly with higher WMLV/ICV levels. In addition, dementia risk increased additively both in participants with higher WMLV/ICV levels and lower TBV/ICV levels and in those with higher WMLV/ICV levels and a higher number of dementia-related brain regional atrophy. CONCLUSION: The risk of dementia increased significantly with higher WMLV/ICV levels. An additive increment in dementia risk was observed with higher WMLV/ICV levels and lower TBV/ICV levels or a higher number of dementia-related brain regional atrophy, suggesting the importance of prevention or control of cardiovascular risk factors.

DOI： 10.1111/pcn.13533

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Language：English   Publisher：(一社)日本動脈硬化学会  

日本の集団ベース研究である久山町研究のデータを用いて、集団レベルでの血清エイコサペンタエン酸(EPA)/アラキドン酸(AA)比、血清EPA濃度、血清AA濃度の10年間の変化を評価した。2002～2003年と2012～2013年に久山町研究に参加した40歳以上でEPA薬を服用していない地域住民(2002～2003年は3194名、2012～2013年は3220名)のデータを解析した。血清EPA/AA比は10年間で低下し、2002年と2012年の幾何平均値はそれぞれ0.40、0.32であった。血清EPA濃度は軽度に上昇し、2002年と2012年の幾何平均値はそれぞれ59.0μg/mL、65.1μg/mLであった。血清AA濃度は大きく上昇し、2002年と2012年の幾何平均値はそれぞれ147.6μg/mL、199.9μg/mLであった。年齢群別の解析では、血清EPA/AA比は80歳以上を除いて有意に低下し、若年群ほど低下が大きかった。血清EPA濃度は50～59歳で有意に低下し、70歳以上で有意に上昇した。血清AA濃度はすべての年齢群で有意に上昇した。

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

高齢者集団における白質病変容積(WMLV)及び脳萎縮と認知症リスクの関係について検討した。福岡県久山町の認知症がない65歳以上の住民のうち、脳MRIを実施した1158人(男性512人、女性646人、平均73.6±6.2歳)を対象とした。WMLVをLesion Segmentation Toolboxを用いてセグメント化し、全脳容積(TBV)と局所灰白質容積をvoxel-based morphometryを用いて推定した。頭蓋内脳容積(ICV)に対するWMLVの比(WMLV/ICV)を計算し、WMLV/ICVと認知症リスクの関連をCox比例ハザードモデルにより推定した。ICVに対するTBVの比(TBV/ICV)で定義された全脳萎縮と、著者等の過去の報告で定義された認知症関連の脳局所萎縮を算出した。5年間の経過観察期間中に113人が認知症を発症した。認知症リスクはWMLV/ICVとともに有意に増加した。WMLV/ICVが大きくTBV/ICVが小さい住民と、WMLV/ICVが大きく認知症関連の脳局所萎縮の数が多い住民では認知症リスクが相加的に増加することが観察された。

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

DOI： 10.1002/ejp.2076

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ejp.2076

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

RATIONALE & OBJECTIVE: Chronic kidney disease, defined by albuminuria and/or reduced estimated glomerular filtration rate (eGFR), has been reported to be associated with brain atrophy and/or higher white matter lesion volume (WMLV), but there are few large-scale population-based studies assessing this issue. This study aimed to examine the associations between the urinary albumin-creatinine ratio (UACR) and eGFR levels and brain atrophy and WMLV in a large-scale community-dwelling older population of Japanese. STUDY DESIGN: Population-based cross-sectional study. SETTING & PARTICIPANTS: A total of 8,630 dementia-free community-dwelling Japanese aged greater than or equal to 65 years underwent brain magnetic resonance imaging scanning and screening examination of health status in 2016-2018. EXPOSURES: UACR and eGFR levels. OUTCOMES: The total brain volume (TBV)-to-intracranial volume (ICV) ratio (TBV/ICV), the regional brain volume-to-TBV ratio, and the WMLV-to-ICV ratio (WMLV/ICV). ANALYTICAL APPROACH: The associations of UACR and eGFR levels with the TBV/ICV, the regional brain volume-to-TBV ratio, and the WMLV/ICV were assessed by using an analysis of covariance. RESULTS: Higher UACR levels were significantly associated with lower TBV/ICV and higher geometric mean values of the WMLV/ICV (P for trend = 0.009 and <0.001, respectively). Lower eGFR levels were significantly associated with lower TBV/ICV, but not clearly associated with WMLV/ICV. In addition, higher UACR levels, but not lower eGFR, were significantly associated with lower temporal cortex volume-to-TBV ratio and lower hippocampal volume-to-TBV ratio. LIMITATIONS: Cross-sectional study, misclassification of UACR or eGFR levels, generalizability to other ethnicities and younger populations, and residual confounding factors. CONCLUSIONS: The present study demonstrated that higher UACR was associated with brain atrophy, especially in the temporal cortex and hippocampus, and with increased WMLV. These findings suggest that chronic kidney disease is involved in the progression of morphologic brain changes associated with cognitive impairment.

DOI： 10.1016/j.xkme.2022.100593

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BACKGROUND: To investigate the association of gait speed with regional brain volumes and the risk of incident dementia. METHODS: A total of 1112 dementia-free Japanese residents aged ≥65 years who underwent brain magnetic resonance imaging were followed for 5.0 years (median). The participants were classified into the age- and sex-specific quartile levels of maximum gait speed. Regional gray matter volumes (GMV) and white matter hyperintensities volumes (WMHV) were measured by applying voxel-based morphometry methods. The cross-sectional association of maximum gait speed with regional GMV was examined using an analysis of covariance. We also estimated the association between maximum gait speed level and the risk of developing dementia using a Cox proportional hazards model. Mediation analyses were conducted to determine the contribution of regional brain volumes to the association between maximum gait speed and dementia. RESULTS: Lower maximum gait speed was significantly associated with lower GMV of the total brain, frontal lobe, temporal lobe, cingulate gyrus, insula, hippocampus, amygdala, basal ganglia, thalamus, and cerebellum, and increased WMHV at baseline. During the follow-up, 108 participants developed dementia. The incidence rate of all dementias increased significantly with decreasing maximum gait speed after adjusting for potential confounders (P for trend = 0.03). The mediating effects of the GMV of the hippocampus, GMV of the insula, and WMHV were significant. CONCLUSIONS: Lower maximum gait speed was significantly associated with an increased risk of dementia. Reduced GMV of the hippocampus or insula, and an increase in WMHV was likely to be involved in this association.

DOI： 10.1016/j.archger.2022.104883

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Language：Japanese   Publisher：The Japanese Society of Physical Fitness and Sports Medicine  

DOI： 10.7600/jspfsm.72.126

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Language：Japanese   Publisher：The Japanese Society of Physical Fitness and Sports Medicine  

DOI： 10.7600/jspfsm.72.84

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Language：Japanese   Publisher：Japanese Association of Exercise Epidemiology  

DOI： 10.24804/ree.2140

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Language：Japanese   Publisher：Japanese Association of Exercise Epidemiology  

<p><b>Objective</b>: To quantify the associations between muscle-strengthening activities and risk of noncommunicable diseases and mortality in adults independent of aerobic activities.</p><p><b>Design</b>: Systematic review and meta-analysis of prospective cohort studies.</p><p><b>Data sources</b>: MEDLINE and Embase were searched from inception to June 2021, and the reference lists of all related articles were reviewed.</p><p><b>Eligibility criteria for selecting studies</b>: Prospective cohort studies that examined the association between muscle-strengthening activities and health outcomes in adults aged ≥ 18 years without severe health conditions.</p><p><b>Results</b>: Sixteen studies met the eligibility criteria. Muscle-strengthening activities were associated with a 10−17% lower risk of all-cause mortality, cardiovascular disease, total cancer, diabetes, and lung cancer. No association was found between muscle-strengthening activities and the risk of some site-specific cancers (colon, kidney, bladder, and pancreatic cancers). J-shaped associations with the maximum risk reduction (approximately 10−20%) at approximately 30−60 min/week of muscle-strengthening activities were found for all-cause mortality, CVD, and total cancer, whereas an L-shaped association showing a large risk reduction at up to 60 min/week of muscle-strengthening activities was observed for diabetes. Combined muscle-strengthening and aerobic activities (vs. none) were associated with a lower risk of all-cause, CVD, and total cancer mortality.</p><p><b>Conclusion</b>: Muscle-strengthening activities were inversely associated with the risk of all-cause mortality and major non-communicable diseases including CVD, total cancer, diabetes, and lung cancer; however, the influence of a higher volume of muscle-strengthening activities on all-cause mortality, CVD, and total cancer is unclear when considering the observed J-shaped associations.</p><p><b>Systematic review registration</b>: PROSPERO CRD42020219808</p>

DOI： 10.24804/ree.2203

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Language：Japanese   Publisher：Japanese Association of Exercise Epidemiology  

DOI： 10.24804/ree.2153

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Language：Japanese   Publisher：日本運動疫学会  

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Language：Japanese   Publisher：日本運動疫学会  

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Language：Japanese   Publisher：日本運動疫学会  

目的:成人において,有酸素性の身体活動の影響を考慮して,筋力向上活動と非感染性疾患および死亡リスクの関連を定量化すること。デザイン:コホート研究のシステマティックレビューおよびメタ解析 データソース:2021年6月までの文献をMEDLINEおよびEmbaseで検索し,さらに文献のハンドサーチを行った。研究の適格基準:深刻な健康問題がない18歳以上の成人を対象に,筋力向上活動と健康アウトカムの関連を検討したコホート研究とした。結果:16件の研究が適格基準を満たした。筋力向上活動の実施により,総死亡,心血管疾患(cardiovascular diseases:CVD),全がん,糖尿病,肺がんのリスクは10～17%低い値を示した。筋力向上活動とほかの部位別がん(結腸がん,腎臓がん,膀胱がん,膵臓がん)に関連はなかった。総死亡,CVD,全がんに関してはJ字の関連が認められ,週約30～60分の時点で最も大きいリスクの減少(約10～20%)が得られた。一方,糖尿病についてはL字の関連が認められ,週60分まで大きなリスク減少が得られた。筋力向上活動と有酸素性の身体活動を組み合わせて実施すると,どちらも実施なしと比較して,総死亡,CVD死亡,全がん死亡のリスクは低い値を示した。結論:筋力向ヒ活動は総死亡および主要な非感染性疾患(CVD,全がん,糖尿病,肺がん)のリスクと負の関連を示した。しかしながら,総死亡,CVD,全がんにおいてJ字の関連が認められたことを考慮すると,筋力向上活動をより多く実施することの影響については明確ではない。(著者抄録)

Language：Japanese   Publisher：(NPO)日本心療内科学会  

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Background Several longitudinal studies have reported that higher visit-to-visit blood pressure variability is associated with greater risk for developing chronic kidney disease. However, no population-based studies have investigated the association between day-to-day home blood pressure variability and incident chronic kidney disease. Methods and Results A total of 2342 Japanese community-dwelling residents aged ≥40 years without chronic kidney disease at baseline were followed up by annual health examinations for 10 years. Home blood pressure was measured 3 times every morning for 28 days. Day-to-day coefficients of variation of home systolic blood pressure levels were categorized into quintiles. Chronic kidney disease was defined as an estimated glomerular filtration rate <60 mL/min per 1.73 m2 or the presence of proteinuria. The hazard ratios for developing chronic kidney disease were estimated with a Cox proportional hazards model. During the follow-up period, 772 participants developed chronic kidney disease. Increased coefficients of variation of home systolic blood pressure were associated significantly with higher risk of chronic kidney disease after adjusting for confounders (P for trend <0.001): Individuals in the highest quintile of coefficients of variation had a 1.50-fold (95% CI, 1.17-1.94) greater risk of developing chronic kidney disease than those in the lowest quintile. The combination of higher coefficients of variation and higher mean value of home systolic blood pressure was associated with the multivariable-adjusted risk of developing chronic kidney disease. Conclusions These findings suggest that increased day-to-day blood pressure variability is a significant risk factor for developing chronic kidney disease in a general Japanese population.

DOI： 10.1161/JAHA.122.027173

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Language：English   Publisher：John Wiley & Sons Australia, Ltd  

通勤手段の違いが糖尿病発症リスクに及ぼす影響について検討した。対象は福岡県久山町の住民検診を受診した40～79歳の住民1208名で、通勤手段に徒歩か自転車を含む活動的通勤者が189名、自動車や公共交通機関のみの非活動的通勤者が653名、非通勤者が366名であった。追跡期間中央値14年で191名が糖尿病を発症した。Cox比例ハザードモデルによる解析の結果、活動的通勤者は非活動的通勤者に比べて糖尿病発症リスクが有意に低かった(調整HR 0.54、95%CI 0.31～0.92、p=0.02)。通勤形態別にみた糖尿病発症のHR(95%CI)は、非活動的通勤者を基準として、自転車のみが0.46(0.22～0.98、p=0.04)、徒歩のみが0.14(0.02～1.02、p=0.053)であった。徒歩と非活動的通勤手段の併用は、糖尿病発症リスクの低下と関連しなかった(HR 1.69、95%CI 0.77～3.71)。

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We examined the association of serum s-adenosylmethionine (SAM), s-adenosylhomocysteine (SAH) (methionine metabolites), and their ratio on the risk of dementia and death in a community-dwelling population of older Japanese individuals. 1371 residents of Hisayama, Japan, aged 65 years or older and without dementia, were followed for a median of 10.2 years (2007-2017). We divided serum SAM, SAH, and SAM/SAH ratio into quartiles. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) of serum SAM, SAH, and SAM/SAH ratio levels on the risk of a composite outcome of all-cause dementia or death, and each outcome. During the follow-up, 635 participants developed all-cause dementia and/or died, of which 379 participants developed dementia and 394 deaths occurred. The multivariable-adjusted HRs of the composite outcome decreased significantly with increasing serum SAM levels (P for trend = 0.01), while they increased significantly with higher serum SAH levels (P for trend = 0.03). Higher serum SAM/SAH ratio levels were significantly associated with a lower risk of the composite outcome (P for trend = 0.002), as well as with lower risk of each outcome. Our findings suggest that the balance of methionine metabolites may closely associate with the risk of dementia and death.

DOI： 10.1038/s41598-022-16242-y

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PURPOSE: To assess the association of inner retinal thickness with prevalent dementia and regional brain atrophy in a general older population of Japanese. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 1078 residents aged 65 years or older who participated in an eye examination, a comprehensive survey of dementia, and brain magnetic resonance imaging scanning in 2017. METHODS: The thicknesses of the inner retinal layers, namely, the ganglion cell-inner plexiform layer (GC-IPL) and retinal nerve fiber layer (RNFL)-were measured by swept-source OCT (SS-OCT). The association of these retinal thicknesses with the risk of the presence of dementia was estimated using restricted cubic splines and logistic regression models. Regional brain volumes were estimated separately by applying 2 different methods: voxel-based morphometry (VBM) and analysis by FreeSurfer software. The associations of GC-IPL and RNFL thickness with each brain regional volume were analyzed using multiple regression analysis. MAIN OUTCOME MEASURE: Prevalent dementia and regional brain atrophy. RESULTS: Among the study participants, 61 participants (5.7%) were diagnosed with dementia. The likelihood of the presence of dementia significantly increased with lower GC-IPL thickness after adjusting for potential confounders (odds ratio, 1.62 [95% confidence interval, 1.30-2.01] per 1 standard deviation decrement in the GC-IPL thickness), but no significant association was observed with RNFL thickness. In the VBM analyses with the multivariable adjustment, lower GC-IPL thickness was significantly associated with lower volume of known brain regions related to cognitive functions (i.e., the hippocampus, amygdala, entorhinal area, and parahippocampal gyrus) and visual functions (i.e., the cuneus, lingual gyrus, and thalamus). Meanwhile, the volume of the thalamus significantly decreased with lower RNFL thickness, but none of the brain regions related to cognitive function exhibited a volume change in association with RNFL thickness. The sensitivity analysis using FreeSurfer analysis also showed that lower GC-IPL thickness was significantly associated with lower regional brain volume/intracranial volume of the hippocampus, amygdala, cuneus, lingual gyrus, and thalamus. CONCLUSIONS: Our findings suggest that the measurement of GC-IPL thickness by SS-OCT, which is a noninvasive, convenient, and reproducible method, might be useful for identifying high-risk individuals with dementia.

DOI： 10.1016/j.xops.2022.100157

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AIMS/INTRODUCTION: We aimed to investigate the association of active commuting (cycling or walking to work), as well as the association of the individual commuting modes, with the risk of diabetes in a prospective cohort of community-dwelling adults in Japan. MATERIAL AND METHODS: A total of 1,270 residents aged 40-79 years were followed up for a median of 14 years. Active commuting was defined as either cycling or walking to work. A Cox proportional hazards model was used to examine the association of active commuting with the risk of diabetes. Associations for different forms of active commuting (cycling, walking and mixed modes of cycling or walking with non-active components) were also examined. RESULTS: During the follow-up period, 191 participants developed diabetes. Active commuting was associated with a lower risk of diabetes than non-active commuting after adjustment for potential confounders (hazard ratio [HR] 0.54, 95% confidence interval [CI] 0.31-0.92). With regard to the commuting modes, the risk of diabetes was significantly lower in individuals who commuted by cycling alone (HR 0.46, 95% CI 0.22-0.98), and tended to be lower in individuals who commuted by walking alone (HR 0.14, 95% CI 0.02-1.02) compared with that in individuals with non-active commuting. Meanwhile, no significant associations were observed for the mixed mode of walking and non-active commuting (HR 1.69, 95% CI 0.77-3.71). CONCLUSIONS: Active commuting, particularly that consisting exclusively of cycling or walking, was associated with a reduced risk of diabetes. Our findings support a public health policy that promotes the choice of active commuting for the prevention of diabetes.

DOI： 10.1111/jdi.13844

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INTRODUCTION: Human immunodeficiency virus (HIV) prevention interventions focused at reducing risky sexual behaviours are an important strategy for preventing HIV infection among youth (15-24 years) who continue to be vulnerable to the disease. This systematic review aims to synthesise current global evidence on the effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth in the last decade. METHODS AND ANALYSIS: MEDLINE/PubMed, EMBASE, PsychINFO, ProQuest Central, CINAHL and Web of Science databases, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform and reference lists of included studies and systematic reviews on effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth will be searched for articles published from August 2011 to August 2021. Eligible studies will be longitudinal studies including randomised controlled trials and quasi-experimental studies that examined the effectiveness of HIV prevention interventions among youth populations (15-24 years) with risky sexual behaviour as a primary or secondary outcome. Study selection and quality assessment will be undertaken independently by three reviewers and disagreements will be resolved through consensus. Data analysis will be undertaken using RevMan software V.5.3.3. A random effects meta-analysis will be conducted to report heterogeneous data where statistical pooling is achievable. We will use I2 statistics to test for heterogeneity. Where appropriate, a funnel plot will be generated to assess publication bias. Where statistical pooling is unachievable, the findings will be reported in a narrative form, together with tables and figures to assist in data presentation if required. Reporting of the systematic review will be informed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. ETHICS AND DISSEMINATION: Ethical approval is not required. Findings of the systematic review will be published in a peer-reviewed journal. The findings will be of interest to researchers, healthcare practitioners and policymakers. PROSPERO REGISTRATION NUMBER: CRD42021271774.

DOI： 10.1136/bmjopen-2021-056929

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RATIONALE: Several Western studies have reported that participants with preserved ratio impaired spirometry (PRISm) have higher risks of airflow limitation (AFL) and death. However, evidence in East Asian populations is limited. OBJECTIVES: To investigate the relation between PRISm and the risks of death and incident AFL in a Japanese population. METHODS: A total of 3,032 community-dwelling Japanese participants aged ≥40 years were followed up for a median of 5.3 years by annual spirometry examinations. Participants were classified into lung function categories at baseline as follows: normal spirometry (forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ≥0.70 and FEV1 ≥80% predicted), PRISm (≥0.70 and <80%), AFL Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1 (<0.70 and ≥80%), and AFL GOLD 2-4 (<0.70 and <80%). Hazard ratios (HRs) and their 95% confidence intervals (CIs) were computed using a Cox proportional hazard model. MEASUREMENTS AND MAIN RESULTS: During the follow-up period, 131 participants died, 22 of whom died from cardiovascular disease, and 218 participants developed AFL. When examining the prognosis of each baseline pulmonary function category, participants with PRISm had higher risks of all-cause death (HR 2.20 [95%CI: 1.35 to 3.59]) and cardiovascular death (HR 4.07 [1.07 to 15.42]) than those with normal spirometry after adjusting for confounders. Moreover, the multivariable-adjusted risk of incident AFL was greater in participants with PRISm than in those with normal spirometry (HR 2.48 [1.83 to 3.36]). CONCLUSIONS: PRISm was associated with higher risks of all-cause and cardiovascular death and a greater risk of the development of AFL in a Japanese community. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).

DOI： 10.1164/rccm.202110-2302OC

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BACKGROUND: Little is known about the influence of serum level of soluble triggering receptor expressed on myeloid cells 2 (sTREM2), which is a soluble type of an innate immune receptor expressed on the microglia, on the association of the daily sleep duration with the risk of dementia. METHODS: A total of 1230 Japanese community-residents aged 60 and older without dementia were followed prospectively for 10 years (2002-2012). Serum sTREM2 levels were divided into two groups using the median value (334.8 pg/ml). Self-reported daily sleep duration was grouped into three categories of <5.0, 5.0-7.9, and ≥8.0 h. A Cox proportional hazards model was used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) of daily sleep duration on the risk of dementia according to serum sTREM2 levels. RESULTS: During the follow-up, 262 subjects developed dementia. In subjects with low serum sTREM2 levels, subjects with ≥8.0 h of daily sleep had a significantly greater risk of dementia (multivariable-adjusted HR 2.05 [95% CI 1.32-3.19]) than those with 5.0-7.9 h of daily sleep, but those with <5.0 h did not. In contrast, the risk of dementia increased significantly in subjects with both <5.0 (1.95 [1.03-3.68]) and ≥8.0 h of daily sleep (1.48 [1.06-2.07]) in the subjects with high serum sTREM2 levels. CONCLUSIONS: The influence of daily sleep duration on risk of dementia differed according to serum sTREM2 levels in the older Japanese population. Short daily sleep may be associated with greater risk of dementia only in subjects with a high serum sTREM2 level.

DOI： 10.1111/jgs.17634

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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ABSTRACT: Chronic low back pain (CLBP) is the leading cause of years lived with disability. Recently, it has been reported that CLBP is associated with alterations in the central nervous system. The present study aimed to investigate the association between CLBP and regional brain atrophy in an older Japanese population. A total of 1106 community-dwelling participants aged ≥65 years underwent brain magnetic resonance imaging scans and a health examination in 2017 to 2018. We used the FreeSurfer software for the analysis of brain magnetic resonance imaging. Chronic pain was defined as subjective pain for ≥3 months. Participants were divided into 3 groups according to the presence or absence of chronic pain and the body part that mainly suffered from pain: a "no chronic pain (NCP)" group (n = 541), "CLBP" group (n = 189), and "chronic pain in body parts other than the lower back (OCP)" group (n = 376). The brain volumes of the ventrolateral and dorsolateral prefrontal cortex, the posterior cingulate gyrus, and the amygdala were significantly lower in the CLBP group than in the NCP group after adjustment for sociodemographic, physical, and lifestyle factors and depressive symptoms. In addition, the left superior frontal gyrus was identified as a significant cluster by the Query, Design, Estimate, Contrast interface. There were no significant differences in the brain volumes of pain-related regions between the NCP and the OCP groups. The present study suggests that CLBP is associated with lower brain volumes of pain-related regions in a general older population of Japanese.

DOI： 10.1097/j.pain.0000000000002612

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BACKGROUND: Several prospective Western studies have reported an inverse association of vegetable and fruit intake with dementia risk. However, there is limited epidemiologic evidence in Asians. This study investigated the association of intakes of vegetables, fruits, and their nutrients on the risk of incident dementia and its subtypes in a Japanese community. METHODS: A total of 1071 participants (452 men and 619 women) aged ≥60 years without dementia at baseline were prospectively followed up for 24 years. Intakes of vegetables, fruits, and nutrients were evaluated using a 70-item semiquantitative food frequency questionnaire at baseline and were categorized into quartiles separately by gender. The outcome measure was the development of dementia and its subtypes-namely, Alzheimer's disease (AD) and vascular dementia (VaD). The risk estimates of incident dementia were computed using a Cox proportional hazards model. RESULTS: During the long-term follow-up period, 464 subjects developed dementia, of whom 286 had AD and 144 had VaD. Higher vegetable intake was associated gradually with lower risk of developing dementia and AD (both P-trend < 0.05), but not VaD, after adjusting for confounders. Subjects allocated the highest quartile of vegetable intake had 27 and 31% lower risk of dementia and AD, respectively, than those with the lowest quartile. The risk of dementia decreased significantly with higher intakes of vitamin A, riboflavin, vitamin C, magnesium, calcium, and potassium (all P-trend < 0.05). Subjects with higher total dietary fiber intake tended to be at decreased risk for total dementia (P-trend = 0.07). Meanwhile, there were no significant associations between fruit intake and the risk of dementia and its subtypes. CONCLUSION: Higher intakes of vegetables and their constituent nutrients were associated with a lower risk of dementia in Japanese older adults. A diet rich in vegetables may be beneficial in reducing the dementia risk in Asians.

DOI： 10.1186/s12877-022-02939-2

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Language：English   Publisher：(一社)日本動脈硬化学会  

心血管疾患の既往がない成人被験者2454名(男性1026名、女性1428名、平均58.2±11.1歳)を対象に、Cox比例ハザードモデルを用いてアテローム動脈硬化性心血管疾患(ASCVD)発症のリスク予測モデルを開発し、妥当性を検証した。対象は久山町研究に参加した40歳から84歳までの一般住民で、ASCVDは冠状動脈性心疾患またはアテローム血栓性脳梗塞と定義した。平均追跡期間は24年で、ASCVDは270名で初発した。発生率は1000人あたり5.8人年であった。リスク予測モデルの予測因子として年齢、性別、収縮期血圧、糖尿病、血中HDLコレステロール、LDLコレステロール、蛋白尿、喫煙習慣、定期的な運動を選択した。上記の変数を組み込んで10年後のASCVD発症予測モデルを構築し、簡便なリスクスコアを作成した。C統計量により妥当性を評価したところ、ASCVD発症リスク予測モデル(0.786)と簡便なリスクスコア(0.789)のいずれも優れた識別能を呈した。またGreenwood-Nam-D' Agostino検定で良好なキャリブレーションが確認された(それぞれP=0.29とP=0.52)。

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

This study aimed to investigate the cross-sectional associations of objectively-measured sedentary time and patterns with cognitive function in Japanese older adults. A total of 1681 non-demented community-dwelling older adults (aged 73 ± 6, 62.1% women) were included. Total sedentary time, prolonged sedentary time (accumulated in ≥30 min bouts) and mean sedentary bout length were assessed using a tri-axial accelerometer. Global and domain-specific cognitive functions were measured using the Montreal Cognitive Assessment. The average of total sedentary time and prolonged sedentary time were 462 ± 125 and 186 ± 111 min/day, respectively. Greater prolonged sedentary time, but not total sedentary time, was significantly associated with poorer performance in the orientation domain even after controlling for moderate-to-vigorous physical activity (p for trend = 0.002). A significant inverse association was also observed between mean sedentary bout length and the orientation domain (p for trend = 0.009). No significant associations were observed for global cognitive function or other cognitive domains. Sedentary time accumulated in prolonged bouts, but not total sedentary time, was inversely associated with orientation ability among older adults. Our results encourage further researches to confirm the role of prolonged sedentary time in changes to cognitive domains over time among older adults.

DOI： 10.3390/ijerph19041999

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DOI： 10.1136/bjsports-2021-105061

Language：English   Publisher：(一社)日本動脈硬化学会  

体重変化が、モデルから予測される心血管疾患(CVD)の包括的リスクと個々の心血管リスクの変化に及ぼす影響について検討した。久山町研究の縦断データを用いて、2002年と2007年の健康診断に参加した40～74歳の地域住民2140名を対象に解析を行った。BMI 25kg/m2以上を肥満とし、2002年と2007年のBMIにより、「安定肥満」(両年とも肥満)、「肥満から非肥満」、「非肥満から肥満」、「安定非肥満」(両年とも肥満)に分類した。CVDの推定累積リスクおよびCVDリスク因子の2002年から2007年にかけての変化を群間比較した。2140名を解析対象とした。CVDの推定リスクは、2007年にかけて全ての群で増加した。CVDの推定リスクの増加は、「肥満から非肥満」群で最も小さく、「非肥満から肥満」群で最も大きかった。「肥満から非肥満」群は「安定肥満」群よりもウエスト周囲長、血圧、空腹時血糖値、血清HDLコレステロール値、血清トリグリセリド値、肝酵素の望ましい変化量が大きかった。全変数について、「非肥満から肥満」群と「安定非肥満」群では逆の傾向が認められた。以上から、肥満者での減量および非肥満者での過剰な体重増加の回避と、CVD包括的リスクおよび個々のCVDリスク要因に望ましい関連が認められた。

Language：Japanese   Publisher：(一社)日本総合健診医学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：The Japanese Society of Physical Fitness and Sports Medicine  

DOI： 10.7600/jspfsm.71.18

CiNii Research

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Language：Japanese   Publisher：The Japanese Society of Physical Fitness and Sports Medicine  

DOI： 10.7600/jspfsm.71.40

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Language：Japanese   Publisher：The Japanese Society of Physical Fitness and Sports Medicine  

DOI： 10.7600/jspfsm.71.43

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Language：Japanese   Publisher：The Japanese Society of Physical Fitness and Sports Medicine  

DOI： 10.7600/jspfsm.71.44

CiNii Research

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

DOI： 10.1136/jnnp-2021-326611

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DOI： 10.1038/s41440-021-00673-7

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

DOI： 10.1186/s12877-021-02415-3

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

DOI： 10.1007/s00125-021-05459-7

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

DOI： 10.2188/jea.JE20190289

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

DOI： 10.1111/jdi.13377

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

DOI： 10.1186/s12199-021-00970-0

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

DOI： 10.1016/j.ekir.2021.01.006

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

DOI： 10.1093/jn/nxaa382

Language：Others  

〔目的〕福岡女学院看護大学教員と保健統計学を担当する外部講師とでプロジェクトチームを結成し、統計学的思考をもった看護職の育成を目指して新ICT（Information and Communication Technology）教材を作成した。本報告では、新ICT 教材開発のプロセスを明示し、今後の課題について考察する。
〔方法〕2018年12月～2019年8月、「教材開発前の授業評価」「教材を掲載する為のミッションタウンの整備」「授業内容と教材の検討」「教材活用後の授業評価」を経て、新ICT 教材を作成した。
〔結果〕ミッションタウン住人の架空の健康診断結果（Excel）を示す新ICT 教材（MT 健診結果教材）を作成し、保健統計学のコンピューターを用いた演習で使用した。新ICT 教材の有効性を確認するうえで、2018 年度と2019 年度の保健統計学の科目履修生を対象として質問紙調査を実施した結果、2019 年度は2018年度と比較して、学習への動機づけ及び授業評価に関する得点が高いことが明らかになった。
〔考察〕新ICT 教材により、2019 年度の科目履修生は、授業で提示された事例や状況設定が容易に理解できるようになっており、このことが保健統計学の興味・関心、理解度の向上につながったと考える。看護実践・研究に活用できる統計学的思考力の育成に向けては、上級学年で開講される卒業研究等の統合科目や保健師教育の科目も視野に、系統的な学習プログラムを検討することが今後の課題である。
identifier:http://repository.fukujo.ac.jp/dspace/handle/11470/943

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

DOI： 10.1111/jdi.13550

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

DOI： 10.1253/circj.CJ-20-0794

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Atherosclerosis Society  

<p><b>Aim:</b> We investigated the influence of weight change on concurrent changes in predicted cardiovascular disease (CVD) risk and individual CVD risk factors over time. </p><p><b>Methods:</b> A total of 2,140 community-dwellers aged 40–74 years participated in both 2002 and 2007 health examinations. Obesity was defined as body mass index ≥ 25 kg/m². Weight trajectories were classified as: “stable obese” (obese at both examinations), “obese to nonobese” (obese in 2002 but nonobese in 2007), “nonobese to obese” (nonobese in 2002 but obese in 2007), or “stable nonobese” (nonobese at both examinations). We compared changes in the model-predicted risk for CVD and individual CVD risk factors across weight-change categories. </p><p><b>Results:</b> The predicted risk for CVD increased during 5 years in all groups; the increment in the predicted risk for CVD was smallest in the obese to nonobese participants and steepest in the nonobese to obese subjects. Compared with the stable obese participants, the obese to nonobese participants had greater favorable changes in waist circumferences, blood pressure, fasting plasma glucose, serum high-density lipoprotein cholesterol, serum triglycerides, and liver enzymes. For all these parameters, opposite trends were observed when comparing the nonobese to obese participants with the stable nonobese group. </p><p><b>Conclusions:</b> We demonstrated the favorable association of losing weight in obese people and avoiding excessive weight gain in nonobese people with global risk of future CVD and individual CVD risk factors in a real-world setting. The findings could improve behavioral lifestyle interventions that provide information on the health consequences of weight change at health checkups. </p>

DOI： 10.5551/jat.59394

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

DOI： 10.5551/jat.55350

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Atherosclerosis Society  

<p><b>Aim:</b>To develop and validate a new risk prediction model for predicting the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) in Japanese adults. </p><p><b>Methods:</b> A total of 2,454 participants aged 40–84 years without a history of cardiovascular disease (CVD) were prospectively followed up for 24 years. An incident ASCVD event was defined as the first occurrence of coronary heart disease or atherothrombotic brain infarction. A Cox proportional hazards regression model was used to construct the prediction model. In addition, a simplified scoring system was translated from the developed prediction model. The model performance was evaluated using Harrell’s C statistics, a calibration plot with the Greenwood-Nam-D’Agostino test, and a bootstrap validation procedure. </p><p><b>Results:</b> During a median of a 24-year follow-up, 270 participants experienced the first ASCVD event. The predictors of the ASCVD events in the multivariable Cox model included age, sex, systolic blood pressure, diabetes, serum high-density lipoprotein cholesterol, serum low-density lipoprotein cholesterol, proteinuria, smoking habits, and regular exercise. The developed models exhibited good discrimination with negligible evidence of overfitting (Harrell’s C statistics: 0.786 for the multivariable model and 0.789 for the simplified score) and good calibrations (the Greenwood-Nam-D’Agostino test: <i>P</i>=0.29 for the multivariable model, 0.52 for the simplified score). </p><p><b>Conclusion:</b> We constructed a risk prediction model for the development of ASCVD in Japanese adults. This prediction model exhibits great potential as a tool for predicting the risk of ASCVD in clinical practice by enabling the identification of specific risk factors for ASCVD in individual patients. </p>

DOI： 10.5551/jat.61960

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DOI： 10.1111/pcn.13204

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

DOI： 10.1093/gerona/glaa231

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

DOI： 10.1016/j.ijcard.2020.06.018

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DOI： 10.1016/j.atherosclerosis.2020.08.016

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

DOI： 10.3390/nu12103160

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

BACKGROUND: It is unknown whether moderate-to-vigorous physical activity (MVPA) in bouts of <10 minutes protects against disability risks or if only 10 minutes bouts of MVPA is critical. Additionally, it is unclear whether light physical activity (LPA) or its accumulation patterns is associated with functional disability. METHODS: A total of 1,678 adults aged ≥65 years and without functional disability at baseline were followed up for 6 years. Functional disability was identified using the database of Japan's Long-term Care Insurance System. Physical activity was measured using a tri-axial accelerometer secured to the waist. RESULTS: Functional disability was identified in 274 participants (16.3%). When examined as quartiles, higher levels of all MVPA measures were dose-dependently associated with lower risk of functional disability. Associations of MVPA in ≥10 and <10 minutes bouts remained significant in a mutually adjusted model. Neither total LPA nor LPA in bout of ≥10 minutes, but LPA in bouts of <10 minutes was associated with functional disability. Analyses using restricted cubic spline functions showed that associations of all MVPA measures and LPA in bouts of <10 minutes with functional disability were linear (p for nonlinear >.05). The hazard ratios (HRs; 95% confidence interval [CI]) for functional disability per 10 minutes increment of total MVPA and LPA in bout of <10 minutes were 0.86 (0.81-0.92) and 0.96 (0.93-0.99), respectively. CONCLUSIONS: Higher MVPA, regardless accumulation patterns, or LPA in bouts of <10 minutes was associated with lower risk of functional disability in a linear dose-response manner in older adults.

DOI： 10.1093/gerona/glaa046

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

DOI： 10.1212/WNL.0000000000009917

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

DOI： 10.1136/bmjdrc-2019-001156

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

DOI： 10.1038/s41440-019-0390-8

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

DOI： 10.1136/jnnp-2019-322366

Language：English  

AIMS/INTRODUCTION: To investigate the association of alternative glycemic measures - namely, serum glycated albumin (GA), hemoglobin A1c (HbA1c ) and the GA : HbA1c ratio - with global brain and hippocampal atrophy in a general elderly Japanese population. MATERIALS AND METHODS: A total of 1,278 Japanese individuals aged ≥65 years in a community participated in brain magnetic resonance imaging scanning and screening examination of health status in 2012. We measured total brain volume (TBV), hippocampal volume (HV) and intracranial volume (ICV) using the data from the magnetic resonance imaging examination. The association of each glycemic measure with the ratios of TBV : ICV (an indicator of global brain atrophy) and HV : ICV (an indicator of hippocampal atrophy) was examined by analysis of covariance. RESULTS: The mean values of the TBV : ICV and HV : ICV ratios decreased significantly with elevating serum GA levels and GA : HbA1c ratio levels (all P for trend < 0.05), but not with higher HbA1c levels, after adjusting for age, sex, low education, systolic blood pressure, antihypertensive medication, diabetes mellitus, serum total cholesterol, electrocardiogram abnormalities, body mass index, smoking habits, alcohol drinking habits and regular exercise. These significant associations were still observed in the sensitivity analysis after excluding individuals with mild cognitive impairment and dementia. In addition, increased serum GA levels and the GA : HbA1c ratio levels, but not HbA1c , were closely associated with lower mean values of the TBV : ICV and HV : ICV ratios, irrespective of the presence or absence of diabetes mellitus. CONCLUSIONS: The present study suggests that higher serum GA and higher GA : HbA1c ratio are significantly associated with global brain and hippocampal atrophy.

DOI： 10.1111/jdi.13220

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

DOI： 10.1007/s12603-019-1242-6

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Small Dense Low-Density Lipoprotein Cholesterol and the Risk of Coronary Heart Disease in a Japanese Community.

DOI： 10.5551/jat.51961

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Serum Lipopolysaccharide-Binding Protein Levels and the Incidence of Cardiovascular Disease in a General Japanese Population: The Hisayama Study.

DOI： 10.1161/JAHA.119.013628

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

DOI： 10.1161/JAHA.119.013628

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Serum elaidic acid concentration and risk of dementia: The Hisayama study.

DOI： 10.1212/WNL.0000000000008464

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DOI： 10.1161/JAHA.118.011652

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The ratios of serum eicosapentaenoic acid to arachidonic acid and docosahexaenoic acid to arachidonic acid were inversely associated with serum resistin levels: the Hisayama Study.

DOI： 10.1111/jdi.13129

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

DOI： d10.1093/aje/kwz116.

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Serum Ethylamine Levels as an Indicator of l-Theanine Consumption and the Risk of Type 2 Diabetes in a General Japanese Population: The Hisayama Study.

DOI： 10.2337/dc18-2655

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Dairy consumption and risk of functional disability in an elderly Japanese population: the Hisayama Study.

DOI： 10.1093/ajcn/nqz040

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DOI： 10.1093/aje/kwz116

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DOI： 10.1123/jpah.2017-0701

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DOI： 10.1002/ana.25385

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Serum Soluble Triggering Receptor Expressed on Myeloid Cells 2 as a Biomarker for Incident Dementia: The Hisayama Study.

DOI： 10.1002/ana.25385

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

DOI： 10.1111/jdi.13129

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

DOI： 10.1093/ajcn/nqz040.

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DOI： 10.2188/jea.JE20180137

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Development and validation of modified risk prediction models for cardiovascular disease and its subtypes: The Hisayama Study.

DOI： 10.1016/j.atherosclerosis.2018.10.014

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A potential novel pathological implication of serum soluble triggering receptor expressed on myeloid cell 2 in insulin resistance in a general Japanese population: The Hisayama study.

DOI： 10.1016/j.diabres.2018.10.007

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Objectively measured sedentary time and diabetes mellitus in a general Japanese population: The Hisayama Study.

DOI： 10.1111/jdi.12968

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

DOI： 10.1111/jgs.15446

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Association Between Daily Sleep Duration and Risk of Dementia and Mortality in a Japanese Community.

DOI： 10.1111/jgs.15446

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

DOI： 10.1111/jdi.12968

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

DOI： 10.1016/j.diabres.2018.10.007

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DOI： doi: 10.1111/jgs.15446

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DOI： doi: 10.2188/jea.JE20170012.

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Patterns and Levels of Sedentary Behavior and Physical Activity in a General Japanese Population: The Hisayama Study.

DOI： 10.2188/jea.JE20170012

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DOI： doi: 10.1007/s12603-017-0924-1.

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DOI： doi: 10.1186/s12889-016-3570-3

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DOI： 10.1186/s12889-016-3570-3

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DOI： doi: 10.1111/ggi.12546.

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DOI： 10.1111/ggi.12546

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DOI： doi: 10.1123/jpah.2015-0090

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DOI： 10.1123/jpah.2015-0090

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DOI： doi: 10.11236/jph.63.12_727

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DOI： doi: 10.1155/2016/8737654.

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Combination of the clock drawing test with frailty phenotype for the prediction of incident disability in two-year follow-up among nondemented community-dwelling older adults

DOI： 10.1016/j.jalz.2015.06.1634

Language：English  

Associations of Light Physical Activity and Sedentary Time with IADL Disability in Community-dwelling Older Adults

DOI： 10.1249/01.mss.0000478849.57611.42

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DOI： doi: 10.1186/s12877-015-0037-9.

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

DOI： 10.1186/s12877-015-0037-9

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DOI： doi: 10.1186/1471-2458-14-1307.

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DOI： 10.1186/1471-2458-14-1307

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Language：Japanese  

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

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Publishing type：Research paper (scientific journal)  

DOI： doi: 10.1159/000339753.

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Venue：大阪   Country：Japan  

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Venue：福岡   Country：Japan  

【背景】近年、欧米の疫学研究より、長時間の座位行動は心血管病や死亡の危険因子であることが報告されているが、糖尿病とも密接な関連があることが指摘されている。しかし、わが国の地域住民において座位行動と糖尿病との関連を検討した報告はない。さらに、先行研究では座位行動の指標としてテレビ視聴時間が用いられているが、日中の座位時間と糖尿病の関連は明らかでない。
【目的】福岡県久山町の地域住民を対象とした疫学調査（久山町研究）の成績を用いて、座位時間と糖尿病有病率の関係を横断的に検討した。
【方法】2009年の久山町循環器健診を受診した40歳以上の住民2,247人のうち、座位行動および空腹時血糖値を測定できなかった者を除いた1,657人を対象とした。座位行動は1.5メッツ以下の活動と定義し、加速度計(Active style Pro HJA-350IT, オムロンヘルスケア社)を用いて活動時間を測定した。健診受診後から約一週間を測定期間とし、一日の装着時間（就寝・入浴・水泳中を除く）が600分以上の日を有効日とし、4日以上の有効日がある者のみを解析に用いた。一日の平均座位時間レベルに基づき対象者を6時間未満、6時間以上8時間未満、8時間以上10時間未満、10時間以上の4群に分けた。糖尿病は空腹時血糖値126mg/dL以上または75g糖負荷後2時間値200mg/dL以上、糖尿病治療薬の使用ありと定義した。ロジスティック回帰分析を用いて座位時間レベル別に糖尿病のオッズ比(95%信頼区間）を算出し、調整因子は性、年齢、高血圧、中性脂肪、HDLコレステロール、BMI、糖尿病家族歴、飲酒習慣、喫煙習慣、エネルギー摂取量、中高強度活動(3メッツ以上の総活動量)、加速度計装着時間を用いた。
【成績】解析対象者のうち、糖尿病を有する者は237人（14.3％）であった。糖尿病有病率（性年齢調整後）は、座位時間レベルの上昇に伴い、14.8、12.7、18.5、33.3％と有意に上昇した。糖尿病を有するオッズ比 (多変量調整後)は、座位時間6時間未満の群に比べ10時間以上の群で2.37 (95%信頼区間1.16-4.84)と有意に高く、座位時間6時間以上8時間未満ならびに8時間以上10時間未満の群でも、それぞれ1.16 (0.76-1.76)、1.53 (0.93-2.52)と上昇する傾向にあった。座位時間1時間上昇ごとの糖尿病を有するオッズ比（多変量調整）は1.14 (1.03-1.27）であった。性、年齢階級 (40～64歳、65歳以上）、肥満 (BMI25 kg/m2以上)および糖尿病家族歴の有無で層別しても、群間に有意な相互作用を認めなかった (全ての交互作用p値＞0.1)。
【結論】わが国の地域住民において、座位時間が長くなるに伴い糖尿病を有するリスクが上昇した。

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【背景】近年、欧米の疫学研究より、長時間の座位行動は糖尿病や耐糖能異常の発症とも密接な関連があることが指摘されている。インスリン抵抗性は、糖尿病の重要な発症要因として知られているが、地域住民において座位行動とインスリン抵抗性の関係はまだ明らかでない。
【目的】福岡県久山町の地域住民を対象とした疫学調査（久山町研究）の横断研究の成績を用いて、非糖尿病者における座位時間とHOMA-IR値の関係を検討した。
【方法】2012年の久山町生活習慣病予防健診を受診した40-79歳の住民2,900人のうち、糖尿病者509人、座位時間の測定または空腹時採血が実施できなかった者908人を除いた1,483人を対象とした。75g経口糖負荷試験を用いて、耐糖能レベル（日本糖尿病学会の基準）を正常耐糖能、境界型に分類した。活動時間を加速度計(Active style Pro HJA-350IT, オムロンヘルスケア社)により測定し、1.5メッツ以下の活動時間を座位時間と定義した。健診受診後から約一週間を測定期間とし、一日の装着時間（就寝・入浴・水泳中を除く）が10時間以上の日を有効日とし、4日以上の有効日がある者のみを解析に用いた。一日の平均座位時間により対象者を6時間未満、6時間以上8時間未満、8時間以上10時間未満、10時間以上の4群に分類した。HOMA-IRは[空腹時インスリン(μU/mL)×空腹時血糖値(mg/dL)]/405の式を用いて算出した。HOMA-IR値は分布が歪んでいたため、対数変換値を解析に用いた。耐糖能レベル、座位時間レベル別にみた多変量調整後のHOMA-IRの幾何平均値 (95%信頼区間）の算出には、共分散分析を行った。調整因子として性、年齢、加速度計装着時間、糖尿病家族歴、BMI、飲酒習慣、喫煙習慣、中高強度活動を用いた。
【成績】解析対象者のうち、正常耐糖能、境界型はそれぞれ988人（66.6％）、495人（33.4％）であった。正常耐糖能者において、座位時間レベルの上昇に伴い、HOMA-IRの幾何平均値(性・年齢・装着時間調整後)は1.00 (0.94-1.07)、1.12 (1.06-1.18)、1.20 (1.12-1.28)、1.26 (1.11-1.44)と有意に上昇した(傾向性p <0.01)。多変量調整後もその関係は変らなかった。同様に、境界型者においても、各座位時間レベルのHOMA-IRの幾何平均値(性・年齢・装着時間調整後)は、1.47 (1.35-1.61)、1.66 (1.55-1.77)、1.63 (1.50-1.77)、1.67 (1.43-1.95)であり、多変量調整後も有意な正の関連が認められた(傾向性p=0.04)。

【結論】わが国の地域在住非糖尿病者において、座位時間が長くなるに伴いインスリン抵抗性は有意に上昇した。BMIを含む多変量調整後も同様の関係を認めたことから、この関係には、肥満や生活習慣病の合併以外の要因（食習慣、基礎代謝低下など）が関与していることが示唆された。

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