Language：English   Publishing type：Research paper (scientific journal)   Publisher：Mary Ann Liebert Inc  

Background: Serum gamma-glutamyltransferase (g-GT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels often increase in metabolic diseases. Objective: This study was conducted to determine which liver enzymes are strongly associated with metabolic syndrome (MetS), how they interact to produce different probability estimates, and what cutoff levels should be used to guide clinical decision-making. Methods: The researchers examined the insurance-based medical checkup data of 293,610 employees ‡35 years years of age, who underwent medical checkups between April 1, 2016, and March 31, 2017. Liver enzyme levels were grouped into quartiles. The association and interaction of liver enzymes with MetS were examined using logistic regression, and receiver operating characteristic (ROC) analyses were used to determine the optimal cutoff values for each liver enzyme in detecting the prevalence of MetS. Results: High levels of g-GT and ALT were more strongly associated with MetS than AST. At various levels, the tested liver enzymes were found interactive, and associated with the likelihood of MetS prevalence. ROC analysis underscored the significance of all liver enzymes in predicting the development of MetS. The cutoff values for each liver enzyme were determined. Conclusion: This findings of this study directly support the identification of MetS risks within the population, prioritize prevention strategies, and potentially inform policy formulation.

DOI： 10.1089/met.2023.0055

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Other Link： https://www.liebertpub.com/doi/abs/10.1089/met.2023.0055

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Annals of Allergy, Asthma and Immunology  

DOI： 10.1016/j.anai.2023.10.013

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Other Link： https://www.annallergy.org/article/S1081-1206(23)01342-X/fulltext

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Journal of Diabetes Investigation  

AIMS/INTRODUCTION: Although the association between dipeptidyl peptidase-4 (DPP-4) inhibitors and bullous pemphigoid (BP) has begun to be established, some studies have suggested there are risk differences among DPP-4 inhibitors. We conducted a population-based cohort study to examine the risk differences. MATERIALS AND METHODS: Using the claims databases of the Fukuoka Prefecture Wide-Area Association of Latter-Stage Elderly Healthcare between April 1, 2013 and March 31, 2017, we conducted a retrospective cohort study to compare patients receiving one DPP-4 inhibitor with those who were prescribed another antidiabetic drug. The primary outcome was an adjusted hazard ratio (HR) of the development of bullous pemphigoid during a 3-year follow-up. The secondary outcome was the development of BP requiring systemic steroids immediately after the diagnosis. These were estimated using Cox proportional hazards regression models. RESULTS: The study comprised 33,241 patients, of which 0.26% (n = 88) developed bullous pemphigoid during follow-up. The percentages of patients with bullous pemphigoid who required immediate systemic steroid treatment was 0.11% (n = 37). We analyzed four DPP-4 inhibitors: sitagliptin, vildagliptin, alogliptin, and linagliptin. Vildagliptin and linagliptin raised the risk of BP significantly (primary outcome, vildagliptin, HR 2.411 [95% confidence interval (CI) 1.325-4.387], linagliptin, HR 2.550 [95% CI 1.266-5.136], secondary outcome, vildagliptin HR 3.616 [95% CI 1.495-8.745], linagliptin HR 3.556 [95% CI 1.262-10.024]). A statistically significant risk elevation was not observed with sitagliptin and alogliptin (primary outcome, sitagliptin, HR 0.911 [95% CI 0.508-1.635], alogliptin, HR 1.600 [95% CI 0.714-3.584], secondary outcome, sitagliptin, HR 1.192 [95% CI 0.475-2.992], alogliptin, HR 2.007 [95% CI 0.571-7.053]). CONCLUSIONS: Not all the DPP-4 inhibitors could induce bullous pemphigoid significantly. Therefore, the association warrants further investigations before generalization.

DOI： 10.1111/jdi.14004

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Other Link： https://onlinelibrary.wiley.com/doi/full/10.1111/jdi.14004

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

Metabolic syndrome (MetS) prevalence has increased globally with considerable morbidity and economic burden at both individual and national levels. Japan is the first and only country that has introduced a nationwide lifestyle guidance intervention program to manage and control MetS. We conducted a quasi-experiment approach-regression discontinuity design-to evaluate the impact of this intervention on health outcomes at the population level. We retrospectively collected data of adults aged ≥35 years who participated in health checkups in 2015. Age in 2015 was used as the assignment variable, and an age of 40 years old was the threshold because those with MetS aged ≥40 were required to receive lifestyle guidance intervention. Among 26,772 MetS adults, those who received the intervention had significant reductions in obesity measurements (bodyweight, waist circumference, and body mass index [BMI]) after 1 year of this intervention. Blood pressure was also significantly reduced in men after 1 year of undertaking the intervention. The results were similar when including demographic, socioeconomic, and behavioral covariates and using alternative functional forms to estimate the impact, or when bandwidths around intervention thresholds were changed. Our results showed that lifestyle guidance intervention for MetS has an important impact on weight loss and blood pressure reduction at the population level. This intervention could address the high burden of obesity and cardiovascular diseases in Japan and other countries with an unmet need for MetS prevention and management.

DOI： 10.1016/j.socscimed.2022.115468

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Other Link： https://doi.org/10.1016/j.socscimed.2022.115468

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Population Health Management  

This study aimed to determine whether there are disparities in the utilization of home-based care services according to income level among people aged 75 years or older in Japan. The research team used administrative claims data from April 2014 to March 2018 for people aged 75 years or older in Fukuoka Prefecture. Subjects were categorized according to income level using medical insurance claim data. Associations between income level and usage days of inpatient care, outpatient care, home medical care, and usage number of home-based long-term care (LTC) services were evaluated. Furthermore, medical and LTC costs were evaluated and adjusted for gender, age, and level of LTC needs. The team used generalized linear models (GLMs) to estimate medical and LTC services utilization, as well as the potential influence of gender, age, care needs level, and death as risk factors. The study analyzed 31,322 subjects, among whom 17,288 were in low-, 12,755 were in middle-, and 1399 were in high-income groups. The results of GLMs showed the number of home medical care days was 59.45, 62.24, and 69.66 days for users from low-, middle-, and high-income groups, respectively. Correspondingly, the number of home-based LTC services used was 668.84, 709.59, and 833.14 times. This study suggests that older adults with lower incomes had relatively low utilizations of home-based care services and high utilizations of nonhome-based LTC services. Policymakers should implement policies focused on people who need care to tackle socioeconomic inequalities in home-based care.

DOI： 10.1089/pop.2022.0110

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

DOI： 10.1136/bmjopen-2021-049157

Other Link： https://bmjopen.bmj.com/content/11/11/e049157.long

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Pharmacoepidemiology and Drug Safety  

本研究では、禁煙治療薬であるバレニクリンの費用対効果について、実際の医療費を元に評価を行った。3,657名の禁煙者をバレニクリン使用群と薬剤治療を行っていない群に分け、増分費用効果比（ICER）を治療必要数（NNT）を算出して計算した。その結果、バレニクリンを使用していたのは対象者の8.8％であり、1人当たりの実際の治療費は平均で52,177円であることがわかった。また、ICERの結果から、最も費用対効果が優れている属性は、男性、年齢が40歳未満、低所得、製造業者であることがわかった。このことから、禁煙支援対策において、焦点を当てるべき属性が示唆された。

DOI： 10.1002/pds.5359

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Other Link： https://doi.org/10.1002/pds.5359

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Population Health Management  

This study aimed to comprehensively evaluate whether income affects long-term health outcomes for older patients who underwent percutaneous coronary intervention (PCI) provided by a universal health coverage system. Data were from the Latter Stage Elderly Healthcare Insurance database in Fukuoka Prefecture, Japan. A total of 5625 individuals aged ≥65 years who underwent PCI in 2014-2016 were included. Cox proportional hazards models were used to assess the association between income status and the incidence of health outcomes. With a median follow-up of 1095 days, 554 acute myocardial infarction (AMI) cases, 1075 stroke cases, 1690 repeat revascularization cases, and 1094 deaths were observed. Risk of all-cause mortality decreased significantly with increasing income level in both unadjusted and adjusted Cox regression models. Patients in the low-income level had a significantly higher rate of AMI (log-rank P = 0.003), stroke (log-rank P = 0.039), and all-cause mortality (log-rank P = 0.001) compared with patients in the high-income level. Observed rates for repeat revascularization also were high in the first year after PCI. In the Japanese universal health setting, low-income patients had a comparatively higher mortality risk after PCI. Poor long-term outcomes might be attributed to patients' baseline characteristics rather than treatment processes.

DOI： 10.1089/pop.2021.0070

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Other Link： https://doi.org/10.1089/pop.2021.0070

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

DOI： 10.1097/01.JMQ.0000735484.44163.ce

Other Link： https://doi.org/10.1097/01.JMQ.0000735484.44163.ce

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

DOI： 10.1371/journal.pone.0252196

Other Link： https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0252196

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

DOI： 10.1186/s12939-021-01415-4

Other Link： https://doi.org/10.1186/s12939-021-01415-4

Language：English   Publishing type：Research paper (scientific journal)   Publisher：International Journal of Health Policy and Management  

Background: The cost-sharing impact on hospital service utilization of different services is a critical issue that has not been well addressed worldwide. This study aimed to investigate the cost-sharing effects based on income status on hospital service utilization of different services among elderly people in Japan and provide a comprehensive examination and discussion for the reasonability of a cost-sharing system. Methods: The data were extracted from the Latter-Stage Elderly Healthcare Insurance database in the fiscal year 2016. A total of 610 182 insured people aged ≥75 years old, with 155 773 hospitalization patients, were identified. Hospitalization rate, length of stay (LOS), and total hospitalization cost were used to test the statistical significance among patients categorized by income levels. Generalized linear models for total hospitalization cost were constructed based on bed types to further assess different hospital service utilization. Results: For medical chronic care and psychiatric beds, which both required long-term care treatment, much higher hospitalization rates were observed in the patients with low-and middle-income levels than patients with high-income level. The LOS and total hospitalization cost of the patients with low-and middle-income levels were significantly higher than the patients with high-income level treated in medical chronic care and psychiatric beds. For psychiatric beds, the total hospitalization cost for patients with low-income level was significantly higher than that for patients with high-income level. Conclusion: The cost-sharing policy in Japan, especially the cap for out-of-pocket needs further determination. The importance of community-based care services needs to be emphasized, and the collaboration between hospitals and community-based care facilities should be enhanced.

DOI： 10.34172/ijhpm.2020.190

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Other Link： https://doi.org/10.34172/ijhpm.2020.190

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

DOI： 10.1089/pop.2019.0141

Other Link： https://doi.org/10.1089/pop.2019.0141

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

DOI： 10.1097/MD.0000000000019871

Other Link： https://doi.org/10.1097/MD.0000000000019871

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1089/pop.2019.0021

Other Link： https://doi.org/10.1089/pop.2019.0021

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

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

DOI： 10.1016/j.jgo.2018.09.004

Other Link： https://doi.org/10.1016/j.jgo.2018.09.004

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.11303/jsha.54.205

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

レセプトデータを使用した虚血性心疾患における保険者別入院受療行動と二次医療圏の設定に関する研究

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

Event date： 2019.11

Language：Japanese  

Venue：東京   Country：Japan  

Event date： 2019.11

Language：Japanese  

Venue：新潟市   Country：Japan  

Event date： 2019.10

Language：Japanese  

Venue：高知市   Country：Japan  

Event date： 2019.3

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2018.10

Language：Japanese  

Venue：郡山市   Country：Japan  

Event date： 2018.10

Language：Japanese  

Country：Japan  

Event date： 2018.3 - 2018.8

Language：Japanese  

Venue：福岡市   Country：Japan  

Event date： 2018.3

Language：Japanese  

Venue：福岡市   Country：Japan  

Event date： 2018.3

Language：Japanese  

Venue：京都市   Country：Japan  

Event date： 2018.3

Language：Japanese  

Country：Japan  

Event date： 2017.11

Language：Japanese  

Country：Japan  

Event date： 2017.10

Language：Japanese  

Country：Japan  

Event date： 2017.9

Language：Japanese  

Country：Japan  

Event date： 2017.3

Language：Japanese  

Country：Japan  

Event date： 2017.3

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Event date： 2017.3

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Country：Japan  

Event date： 2017.3

Language：Japanese  

Country：Japan  

Event date： 2017.2

Language：Japanese  

Country：Japan  

Event date： 2017.2

Language：Japanese  

Country：Japan  

Event date： 2016.10

Language：Japanese  

Country：Japan  

Event date： 2016.10

Language：Japanese  

Country：Japan  

Event date： 2016.10

Language：Japanese  

Country：Japan  

Event date： 2016.10

Language：Japanese  

Country：Japan  

Event date： 2016.10

Language：Japanese  

Country：Japan  

Event date： 2016.9

Language：Japanese  

Country：Japan  

Language：Japanese  

Country：Japan  

後期高齢者における睡眠薬の重複処方実態と決定因子の探索

Language：Japanese  

Country：Japan  

Language：Japanese  

Country：Japan  

Language：Others   Presentation type：Oral presentation (general)  

Venue：茨城県つくば市   Country：Japan  

Type：Peer review 

Number of peer-reviewed articles in foreign language journals：5

Type：Peer review 

Number of peer-reviewed articles in foreign language journals：1

Type：Academic society, research group, etc. 

Type：Peer review 

Number of peer-reviewed articles in foreign language journals：1

Number of peer-reviewed articles in Japanese journals：3

Type：Peer review 

Number of peer-reviewed articles in Japanese journals：1

Type：Peer review 

Number of peer-reviewed articles in Japanese journals：1

Type：Peer review 

Number of peer-reviewed articles in Japanese journals：2