研究者詳細 - 大西　浩文

論文 - 大西　浩文

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Effects of Parental Hypertension on Longitudinal Trends in Blood Pressure and Plasma Metabolic Profile Mixed-Effects Model Analysis

Kaneto Mitsumata, Shigeyuki Saitoh, Hirofumi Ohnishi, Hiroshi Akasaka, Tetsuji Miura

HYPERTENSION ( LIPPINCOTT WILLIAMS & WILKINS ) 60 ( 5 ) 1124 - + 2012年11月 [査読有り]

The mechanism underlying the association of parental hypertension with cardiovascular events in offspring remains unclear. In this study, the effects of parental hypertension on longitudinal trends of blood pressure and metabolic parameters were examined by mixed-effects model analysis. From 1977 to 2006, 5198 subjects participated in the Tanno-Sobetsu Study, and we selected 2607 subjects (1095 men and 1512 women) for whom data on parental history of hypertension were available. In both men and women with and without parental hypertension, systolic blood pressure and fasting blood glucose levels consistently increased from the third to eighth decades of life, whereas diastolic blood pressure and serum triglyceride levels followed biphasic (inverted U shape) time courses during that period. However, the relationships between the parameters and age were significantly shifted upward (by approximate to 5.3 mm Hg in systolic blood pressure, 2.8 mm Hg in diastolic blood pressure, 0.30 mmol/L in blood glucose, and 0.09 mmol/L in triglyceride) in the group with parental hypertension compared with those in the group without parental hypertension. Both paternal and maternal histories of hypertension were determinants of systolic blood pressure and diastolic blood pressure, and there was no significant interaction between the sides of parental history. There were no significant effects of parental hypertension on age-dependent or body mass index-dependent changes in serum low-density lipoprotein cholesterol or high-density lipoprotein cholesterol level. The present results indicate that parental hypertension has an age-independent impact on elevation of blood pressure, plasma glucose, and triglyceride levels, which may underlie the reported increase in cardiovascular events by family history of hypertension. (Hypertension. 2012;60:1124-1130.). Online Data Supplement

DOI PubMed

Burden among Family Caregivers of Patients on Chronic Hemodialysis in Northern Japan

Masakazu Washio, Hideaki Yoshida, Nobuyuki Ura, Hirofumi Ohnishi, Nobuhiko Togashi, Fumio Sakauchi, Yumiko Arai, Mitsuru Mori, Kazuaki Shimamoto

INTERNATIONAL MEDICAL JOURNAL ( JAPAN INT CULTURAL EXCHANGE FOUNDATION ) 19 ( 3 ) 221 - 223 2012年09月 [査読有り]

Purpose: To investigate factors related to burden among family caregivers of regular hemodialysis patients. Design: Cross sectional study. Subjects: 108 pairs of family caregivers and regular hemodialysis patients in Hokkaido Prefecture, Japan. Subjects and Methods: Caregivers answered a self-administered questionnaire about various factors that may affect their care-burden and also completed the Japanese version of the Zarit careburden interview (J-ZBI). They were divided into two groups according to their ZBI score. Results: Compared with lightly burdened caregivers, those heavily burdened were more likely to be spouses and to have chronic diseases under medical treatment. Patients cared for by heavily burdened caregivers were more likely to be males, have dementia, and be disabled than their counterparts. Heavily burdened caregivers spent a longer time with their charges as well as in providing for their physical care than lightly burdened caregivers. In addition, they spent more money to use social services in their caregiving than lightly burdened caregivers. Heavily burdened caregivers were more likely to rent wheelchairs, to consult a staff of a support center for the frail elderly, to consult a home doctor, to use home renovation services, to apply to the insurer for the assessment of need for care, and to make a care plan than their counterparts. Compared with lightly burdened caregivers, more of those heavily burdened wanted regular assistance for care and facilities for regular day-time respite care. Conclusion: These findings suggest that looking after patients for a long time as well as paying a lot of money seems to be an important factor related to caregiver's developing psychological feelings of heavy burden.

Relationship of Hobby Activities With Mortality and Frailty Among Community-Dwelling Elderly Adults: Results of a Follow-up Study in Japan

Yasuhiro Fushiki, Hirofumi Ohnishi, Fumio Sakauchi, Asae Oura, Mitsuru Mori

JOURNAL OF EPIDEMIOLOGY ( JAPAN EPIDEMIOLOGICAL ASSOC ) 22 ( 4 ) 340 - 347 2012年07月 [査読有り]

Background: The proportion of Japanese adults aged 65 years or older is predicted to increase; thus, it is becoming more important to identify factors that influence health status among elderly adults in Japan. We conducted a follow-up study of community-dwelling elderly adults to assess the relationship of hobby activities with mortality and incident frailty. Methods: We randomly selected 3583 individuals aged 65 to 84 years from the residential registries of 7 study areas in Hokkaido, Japan in August 2007. Among them, 1955 (54.6%) returned completed questionnaires with written informed consent by mail. The baseline assessment questionnaire comprised questions on current and past involvement in hobby activities, self-perceived health status, smoking and drinking habits, and body height and weight. Questions on hobby activities were from 4 categories: solitary physical, group physical, solitary cultural, and group cultural activities. We later conducted a follow-up survey of the participants to ascertain all-cause mortality and incident frailty. A Cox proportional hazards model was used for analysis of data from September 2007 to May 2010. Results: After adjusting for potential confounders, the risk of incident frailty among respondents participating in solitary physical activities was significantly lower than in those who did not participate in such activities (hazard ratio = 0.57; 95% CI 0.33, 0.99). Furthermore, the risk of incident frailty among respondents taking part in group cultural activities was significantly lower than in those who did not participate in such activities (0.41; 0.19, 0.87). Conclusions: These findings may be important for programs that seek to promote good health among elderly adults.

DOI PubMed

Relationship between dysphagia and depressive states in patients with Parkinson's disease

Meng Han, Hirofumi Ohnishi, Michio Nonaka, Rika Yamauchi, Takayoshi Hozuki, Takashi Hayashi, Masaki Saitoh, Shin Hisahara, Tomihiro Imai, Shun Shimohama, Mitsuru Mori

Parkinson's Disease: Diagnosis, Treatment and Prognosis 201 - 208 2012年07月

Aspiration pneumonia related to dysphagia is known to be the leading cause of death in patients with Parkinson's disease (PD). We investigated the relationship between depressive states and dysphagia in patients with PD. A hundred and twenty-seven PD patients gave their informed consent and were enrolled in this study. We used the Beck Depression Inventory II (BDI-II) questionnaire to determine the participants' depressive states, and also used a questionnaire to assess participants' state of dysphagia. Participants were divided into four groups according to their BDI-II score. We compared the PD patients with Swallowing Disturbances Questionnaire (SDQ) scores of more than or equal to 11 with the SDQ scores of less than 11 regarding depressive categories. A logistic regression analysis was conducted to calculate odds ratios (ORs) and their 95% confidence intervals (95%CI) adjusting for age, sex, disease duration, wearing-off phenomenon and severity of movement disorder. OR (95%CI) of depressive categories,in which the trivial class was set as a reference group, were 3.28 (0.93-11.55), 13.44 (3.10-58.16), 30.35 (5.65-162.97) in the mild class, the moderate class and the severe class, respectively. This study suggests that there may be a strong relationship between depressive states and dysphagia in patients with PD. © 2012 Nova Science Publishers, Inc. All rights reserved.

[The Tanno and Sobetsu study].

Ohnishi H, Saitoh S, Miura T

Nihon rinsho. Japanese journal of clinical medicine 70 Suppl 3 260 - 263 2012年05月 [査読有り]

PubMed

Matsuda-DeFronzo insulin sensitivity index is a better predictor than HOMA-IR of hypertension in Japanese: the Tanno-Sobetsu study

M. Furugen, S. Saitoh, H. Ohnishi, H. Akasaka, K. Mitsumata, M. Chiba, T. Furukawa, Y. Miyazaki, K. Shimamoto, T. Miura

JOURNAL OF HUMAN HYPERTENSION ( NATURE PUBLISHING GROUP ) 26 ( 5 ) 325 - 333 2012年05月 [査読有り]

Here we examined whether the Matsuda-DeFronzo insulin sensitivity index (ISI-M) is more efficient than the homeostasis model assessment of insulin resistance (HOMA-IR) for assessing risk of hypertension. Cross-sectional and longitudinal analyses were conducted using normotensive subjects who were selected among 1399 subjects in the Tanno-Sobetsu cohort. In the cross-sectional analysis (n = 740), blood pressure (BP) level was correlated with HOMA-IR and with ISI-M, but correlation coefficients indicate a tighter correlation with ISI-M. Multiple linear regression analysis adjusted by age, sex, body mass index (BMI) and serum triglyceride level (TG) showed contribution of ISI-M and fasting plasma glucose, but not of HOMA-IR. In the longitudinal analysis (n = 607), 241 subjects (39.7%) developed hypertension during a 10-year follow-up period, and multiple logistic regression indicated that age, TG, systolic BP and ISI-M, but not HOMA-IR, were associated with development of hypertension. In subjects <60 years old, odds ratio of new-onset hypertension was higher in the low ISI-M group (ISI-M, less than the median) than in the high ISI-M group for any tertile of BMI. In conclusion, ISI-M is a better predictor of hypertension than is HOMA-IR. Non-hepatic IR may be a determinant, which is independent of TG, BP level and BMI, of the development of hypertension. Journal of Human Hypertension (2012) 26, 325-333; doi:10.1038/jhh.2011.23; published online 17 March 2011

DOI

Association between salivary alpha-amylase activity and stress-related characteristics

Yoshie Nagata, Fumio Sakauchi, Hisako Izumi, Erhua Shang, Hirofumi Ohnishi, Mitsuru Mori

Sapporo Medical journal 80 ( 1-6 ) 15 - 22 2011年12月

Introduction: Recently, salivary alpha-amylase activity has been suggested to be an index as a stress-related biomarker. In this study, we investigated possible associations between salivary alpha-amylase activity levels and lifestyle or stress-related characteristics. Methods: In total, 476 subjects voluntarily participated in the survey and their levels of salivary amylase activity were measured by a noninvasive salivary amylase monitor. Every subject filled out a self-administered questionnaire just after the measurement. Results: The results of these tests indicate the salivary alpha-amylase activity levels are significantly higher in males than those in females (P< 0.01). Furthermore, the salivary alpha-amylase activity levels were significantly higher in the subjects aged 50 years or older than those of the subjects aged younger than 50 years (P< 0.01). Scores of the behaviors of positively coping with stress as well as social support from relatives or friends against stress were inversely correlated to salivary alpha-amylase activity after being adjusted for sex and age with multiple linear regression analysis (P=0.02 and P=0.03, respectively). However, the perception of stress was not associated with changes in salivary alpha-amylase activity levels. Conclusion: Our findings may suggest that positively stress coping and emotional supports reduce the physiological response to stress, as observed by the decrease in salivary alpha-amylase activity levels.

Relationship between dysphagia and depressive states in patients with Parkinson's disease

Meng Han, Hirofumi Ohnishi, Michio Nonaka, Rika Yamauchi, Takayoshi Hozuki, Takashi Hayashi, Masaki Saitoh, Shin Hisahara, Tomihiro Imai, Shun Shimohama, Mitsuru Mori

PARKINSONISM & RELATED DISORDERS ( ELSEVIER SCI LTD ) 17 ( 6 ) 437 - 439 2011年07月 [査読有り]

Aspiration pneumonia related to dysphagia is known to be the leading cause of death in patients with Parkinson's disease (PD). We investigated the relationship between depressive states and dysphagia in patients with PD. A hundred and twenty-seven PD patients gave their informed consent and were enrolled in this study. We used the Beck Depression Inventory (BDI) questionnaire to determine the participants' depressive states, and also used a questionnaire to assess participants' state of dysphagia. Participants were divided into four groups according to their BDI score. We compared the PD patients with Swallowing Disturbances Questionnaire (SDQ) scores of more than or equal to 11 with the SDQ scores of less than 11 regarding depressive categories. A logistic regression analysis was conducted to calculate odds ratios (ORs) and their 95% confidence intervals (95%CI) adjusting for age, sex, disease duration, wearing-off phenomenon and severity of movement disorder. OR (95%CI) of depressive categories, in which the trivial class was set as a reference group, were 3.28 (0.93-11.55), 13.44(3.10-58.16), 30.35 (5.65-162.97) in the mild class, the moderate class and the severe class, respectively. This study suggests that there may be a strong relationship between depressive states and dysphagia in patients with PD. (C) 2011 Elsevier Ltd. All rights reserved.

DOI PubMed

Comparison of the effect of abdominal obesity on new onset of type 2 diabetes in a general Japanese elderly population with that in a non-elderly population-The Tanno and Sobetsu study

Mizue Fujii, Hirofumi Ohnishi, Shigeyuki Saitho, Mitsuru Mori, Kazuaki Shimamoto

Japanese Journal of Geriatrics ( 1 ) 48 ( 1 ) 71 - 77 2011年 [査読有り]

Aim: We investigated the effect of abdominal obesity (AO) on new onset of type 2 diabetes (NODM) in a general Japanese elderly population compared with that in a non-elderly population. Methods: The subjects were 827 people aged 29-84 who underwent medical examinations in the towns of Tanno and Sobetsu in Hokkaido, first in 1994 and subsequently in either 2003 or 2004, after the exclusion of individuals with preexisting type 2 diabetes at baseline. The subjects were divided into 2 groups according to waist circumference (WC) at baseline: an AO (WC ≥85 cm for men and ≥90 cm for women) group and a non-AO group. The percentages of subjects with NODM recorded in either in 2003 or 2004 were compared between these 2 groups, and the AO odds ratio in NODM was calculated separately for elderly (≤65 years) and non-elderly (< 65 years) subjects, using multiple logistic regression analysis. Results: The percentage of non-elderly subjects with NODM was significantly higher in the AO group than in the non-AO group (16.9% vs. 5.4%, p< 0.0001), but there was no statistically significant difference in the elderly subjects. Multiple logistic regression analysis showed that there was a significant relationship between AO and NODM (AO odds ratio in NODM= 2.68, 95% confidence interval (CI): 1.05-6.90) in the non-elderly subjects, but not in the elderly subjects. Conclusion: Consideration of the different effects of AO on NODM in elderly and non-elderly people may be important for the prevention of type 2 diabetes.

DOI PubMed

Associations of metabolic factors, especially serum retinol-binding protein 4 (RBP4), with blood pressure in Japanese -the Tanno and Sobetsu study-

Mizue Chiba, Shigeyuki Saitoh, Hirofumi Ohnishi, Hiroshi Akasaka, Kaneto Mitsumata, Tetsuaki Furukawa, Kazuaki Shimamoto

ENDOCRINE JOURNAL ( JAPAN ENDOCRINE SOC ) 57 ( 9 ) 811 - 817 2010年09月 [査読有り]

Excess secretion of various adipocyte-derived molecules has been linked with insulin resistance, obesity, diabetes, inflammation, atherosclerosis, and cardiovascular disease. Retinol-binding protein 4 (RBP4), one of the new adipocytokine, is recently reported to provide a link between insulin resistance and features of metabolic factors. Hypertension is one of the most influential risk factors among cardiovascular disease. We examined the relationship between systolic blood pressure (BP) levels and metabolic factors including homeostasis model assessment of insulin resistance (HOMA-R), high sensitivity C-reactive protein (hs-CRP), adiponectin, and RBP4. The subjects were 153 men aged 59 +/- 14 years and 224 women aged 57 +/- 14 years who had undergone medical check-ups in rural communities in 2007. Systolic BP was positively correlated with HOMA-R, hs-CRP and RBP4 but not with adiponectin in women. There was a positive significant relationship between serum RBP4 levels and blood pressure in women, but such a relationship was not found in men. Serum RBP4 levels were not correlated with HOMA-R in either men or women. Serum RBP4 levels negatively were correlated with estimated glomerular filtration rate (eGFR) in women but not in men. Multiple regression analysis revealed that serum RBP4 levels significantly were related to systolic BP independently of age, sex, body mass index (BMI), total cholesterol levels and eGFR. Our study showed that increased levels of RBP4 as well as HOMA-R and hs-CRP in women were significantly associated with increased levels of systolic BP.

DOI CiNii

Total energy intake and intake of three major nutrients by body mass index in Japan: NIPPON DATA80 and NIPPON DATA90

Katsushi Yoshita, Yusuke Arai, Miho Nozue, Kumi Komatsu, Hirohumi Ohnishi, Shigeyuki Saitoh, Katsuyuki Miura

Journal of Epidemiology 20 ( 3 ) S515 - S523 2010年 [査読有り]

Background: This paper investigated the relationship between body mass index (BMI) and total energy intake as well as intake of three major nutrients in representative Japanese populations enrolled in the National Nutrition Surveys of Japan in 1980 and 1990. Methods: A total of 10 422 participants (4585 men and 5837 women) and 8342 participants (3488 men and 4854 women) aged 30 or older from 300 randomly selected districts participated in the National Survey of Circulatory Disorders and the National Nutrition Survey in Japan in 1980 and 1990, respectively. The nutrition surveys were performed with weighing record method for three consecutive days to each household. Individually estimated total energy intake and intakes of three major nutrients (carbohydrate, protein, and fat) were compared by the categories of BMI and by 10-year age groups. Results: In men, total energy intake (kcal/day), intakes of three major nutrients (g/day) and energy intake ratio from protein and fat (%) increased as BMI increased in each age group, whereas energy intake ratio from carbohydrate (%) decreased. In women, total energy intake, intakes of three major nutrients, and energy intake ratio from protein increased as BMI increased. Energy intake ratio from carbohydrate and fat decreased as BMI increased in women in 1990. When participants were categorized into quartiles according to total energy intake in each sex group, BMI increased as total energy intake increased in men in both 1980 and 1990. Conclusions: A positive relationship was observed between body mass index and total energy intake in Japanese men. The relationship was weaker in Japanese women. © 2010 by the Japan Epidemiological Association.

DOI PubMed

過体重の健常者における心房内電気力学的遅延と左心房機能の変化 2次元Speckle Tracking画像の検討(Alterations in Intra-atrial Electromechanical Delay and Left Atrial Function in Healthy Overweight Subjects: A Study of Two-dimensional Speckle Tracking Imaging)

Muranaka Atsuko, Yuda Satoshi, Funayama Maki, Yamamoto Hitomi, Kohzu Hidemichi, Doi Takahiro, Kaneko Naofumi, Akasaka Hiroshi, Ohnishi Hirofumi, Shimoshige Shinya, Hashimoto Akiyoshi, Saitoh Shigeyuki, Nakata Tomoaki, Tsuchihashi Kazufumi, Watanabe Naoki, Shimamoto Kazuaki

Circulation Journal ( (一社)日本循環器学会 ) 73 ( Suppl.I ) 702 - 702 2009年03月

Traditional Japanese diet and prostate cancer

Mitsuru Mori, Naoya Masumori, Fumimasa Fukuta, Yoshie Nagata, Tomoko Sonoda, Fumio Sakauchi, Hirofumi Ohnishi, Masanori Nojima, Taiji Tsukamoto

MOLECULAR NUTRITION & FOOD RESEARCH ( WILEY-V C H VERLAG GMBH ) 53 ( 2 ) 191 - 200 2009年02月 [査読有り]

The traditional Japanese diet has been suggested by some researchers to be associated with a decreased risk of prostate cancer (PCa). In this paper, we assumed the following three characteristics of the traditional Japanese diet high in soybean products, high in fish, and low in red meat. Isoflavones, polyunsaturated long chain (n - 3) fatty acids, and saturated fatty acids were thought to be micronutrients in biological etiology relevant to soybean products, fish, and red meat, respectively. Analytical epidemiological studies oil the risk of PCa were identified using the MEDLINE database from 1998 to 2007. Some published studies showed a negative association of soybean products and isoflavones to PCa risk, an inverse association for fish or polyunsaturated long chain (n - 3) fatty acids such as eicosapentaenic acid (EPA) and docosahexacnoic acid (DHA) with PCa risk, and a positive association of red meat or saturated fatty acids with PCa risk, respectively. In conclusion, although it is possible that the traditional Japanese diet may reduce the risk of PCa through a combination of characteristics such as being high in soybean products, high in fish, and low in red meat, further well-designed epidemiological studies such as nested case-control studies with nutritional analyses of blood samples are needed to confirm this association.

DOI

A Promoter Polymorphism of Lamin A/C Gene is an Independent Genetic Predisposition to Arterial Stiffness in a Japanese General Population (The Tanno and Sobetsu Study)

Hiroshi Akasaka, Tomohiro Katsuya, Shigeyuki Saitoh, Ken Sugimoto, Hirofumi Ohnishi, Ada Congrains, Miyuki Ohnishi, Mitsuru Ohishi, Hiromi Rakugi, Toshio Ogihara, Kazuaki Shimamoto

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS ( JAPAN ATHEROSCLEROSIS SOC ) 16 ( 4 ) 404 - 409 2009年 [査読有り]

Aim: We examined the hypothesis that there is a positive, independent association between polymorphisms of lamin A/C gene (LMNA) and arterial stiffness in Japanese. Methods: The subjects were 261 men (mean age, 64.4 +/- 0.7 years) selected from inhabitants of the towns of Tanno and Sobetsu in a rural area of Japan who underwent medical check-ups. We conducted clinical examinations, including measurement of bilateral brachial-ankle pulse wave velocity (baPWV) as a marker of arterial Stiffness, and genetic analysis. Subjects with atrial fibrillation, subjects with ankle-brachial index < 0.9, and subjects taking any medication were excluded. We selected two single nucleotide polymorphisms (SNPs) as markers of LMNA, 1908C/T in exon 10 and -1030C/T in the promoter region, which we have recently identified. All genotypes were clearly determined by the TaqMan PCR method. Results: Genotype frequencies of the two polymorphisms satisfied the Hardy-Weinberg equilibrium. The baPWV of -1030C/T polymorphism was significantly greater in subjects with CC genotype than in subjects with CT + TT genotype (1,652 +/- 22.1 cm/s vs. 1,552 +/- 43.0 cm/s, p = 0.039); however, no significant difference was found for 1908C/T polymorphism. The baPWV was found to be significantly associated with age, body height, systolic blood pressure, and smoking habit; therefore, we next performed multiple regression analysis including these parameters, and found an independent, significant association between baPWV and -1030C/T polymorphism. Conclusion: Promoter -1030C/T polymorphism of LMNA is a possible genetic predisposition to arterial stiffness in the Japanese population.

DOI PubMed

Increased Serum Apolipoprotein B48 Concentration in Patients with Metabolic Syndrome

Makoto Kinoshita, Hirofumi Ohnishi, Tomomi Maeda, Nakayuki Yoshimura, Yoko Takeoka, Daijiro Yasuda, Jun Kusano, Yamato Mashimo, Shigeyuki Saito, Kazuaki Shimamoto, Tamio Teramoto

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS ( JAPAN ATHEROSCLEROSIS SOC ) 16 ( 4 ) 517 - 522 2009年 [査読有り]

Aim: Postprandial hyperlipidemia is characterized by an increase of chylomicron remnants (CM-R), and is a risk factor for atherosclerosis. Apolipoprotein (apo) B48 exists exclusively in chylomicroms and CM-R, and fasting plasma levels of apo B48 may reflect high postprandial levels of chylomicrons and/or CM-R. We hypothesized that fasting apo B48 levels may be increased in metabolic syndrome. Methods: We investigated 1,349 inhabitants (528 men and 821 women aged 62.4 +/- 12.8 y; mean +/- S.D.) of two towns in rural Hokkaido, who underwent health checks in 2005. Results: The fasting apo B48 level was significantly higher in males than females (geometric mean 1.92; 95% CI 1.80-2.04 mu g/mL, vs. 1.69; 95% CI 1.61-1.76 mu g/mL; p<0.001). Ln (apo B48) showed a significant positive correlation with total cholesterol and In (triglycerides), and a negative correlation with HDL-cholesterol. The correlation between In (apo 1348) and In (triglycerides) was strong. Apo B48 was significantly higher in men and women with than without metabolic syndrome. Regression analysis revealed that In (apo B48) was significantly associated with age, BMI total cholesterol, HDL cholesterol, LDL cholesterol, and In (triglyceride). Conclusion: Fasting apo B48 levels are raised in individuals with metabolic syndrome.

DOI PubMed

Confounding in evaluating the effectiveness of influenza vaccine

Mitsuru Mori, Asae Oura, Hirofumi Ohnishi, Masakazu Washio

VACCINE ( ELSEVIER SCI LTD ) 26 ( 50 ) 6459 - 6461 2008年11月 [査読有り]

Confounding is a kind of bias which occurs in a research. Confounding is less frequent in randomized controlled trials (RCT) for evaluation of influenza vaccines. However, there are obstacles or difficulties in conducting RCT for evaluation of influenza vaccines, particularly, in the elderly people. Therefore a retro, spective or prospective cohort study has been primarily performed to evaluate effectiveness of influenza vaccine in elderly people. Confounding by indication or other confounding exist in most observational Studies. Accordingly, at the stage of designing or analyzing a study, confounding should be controlled with a restriction, matching, stratified or multivariate analysis technique. (C) 2008 Elsevier Ltd. All rights reserved.

DOI PubMed

パーキンソン病患者のADLとQOLに対する抑うつの影響

韓萌, 大西浩文, 森満, 林貴士, 久原真, 野中道夫, 今井富裕, 下濱俊

北海道公衆衛生学雑誌 ( 北海道公衆衛生学会 ) 22 ( 1特別付録 ) 65 - 65 2008年11月

未治療高血圧患者における心形態および心機能の評価組織ドプラ法による検討端野・壮瞥町研究

舟山真希, 湯田聡, 村中敦子, 山本均美, 金子尚史, 土井崇裕, 神津英至, 赤坂憲, 大西浩文, 下重晋也, 橋本暁佳, 斉藤重幸, 土橋和文, 渡辺直樹, 島本和明

日本高血圧学会総会プログラム・抄録集 ( (NPO)日本高血圧学会 ) 31回 200 - 200 2008年10月

Differences in Insulin Action and Secretion, Plasma Lipids and Blood Pressure Levels between Impaired Fasting Glucose and Impaired Glucose Tolerance in Japanese Subjects

Yoshinori Miyazaki, Hiroshi Akasaka, Hirofumi Ohnishi, Shigeyuki Saitoh, Ralph A. DeFronzo, Kazuaki Shimamoto

HYPERTENSION RESEARCH ( JAPANESE SOC HYPERTENSION CENT ACADEMIC SOC, PUBL OFFICE ) 31 ( 7 ) 1357 - 1363 2008年07月 [査読有り]

We examined insulin action/secretion and cardiovascular disease risk factors in Japanese subjects with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) who were not taking any medications known to affect glucose tolerance, blood pressure (1313) or plasma lipids (PLs). A total of 1,399 subjects received measurements of anthropometry, BP, PLs, and plasma glucose/insulin concentrations during 75 g-oral glucose tolerance test (OGTT). According to 2003 American Diabetes Association criteria, subjects were classified as having normal fasting glucose (NFG)/normal glucose tolerance (NGT) (n=1,173), IFG (n=128), IGT (n=55), and IFG/IGT (n=43). Insulin action was calculated using the HOMA-R (index of hepatic insulin resistance) and Matsuda index (reflects whole body insulin sensitivity). The ratio of the incremental area under the curve of insulin to that of glucose during OGTT (Delta AUC(PI)/Delta AUC(PG)) was used as an index of beta-cell function. HOMA-R was higher in IFG (2.3 +/- 0.1) and IFG/IGT (2.5 +/- 0.2) than in NFG/NGT (1.8 +/- 0.03). The Matsuda index was lower in IFG (6.5 +/- 0.3), IGT (5.4 +/- 0.4) and IFG/IGT (5.1 +/- 0.5) than in NFG/NGT (9.6 +/- 0.2).,Delta AUC(PI)/Delta AUC(PG) was lower in IGT (0.6 +/- 0.05) and IFG/IGT (0.5 0.05) than in IFG (1.4 +/- 0.12) or NFG/NGT (1.2 +/- 0.03). Mean BP was higher in IGT (100 +/- 1.7 mmHg) than in NFG/NGT (91 +/- 0.3) or IFG (95 +/- 1.1). The plasma triglyceride level was higher in IGT (155 +/- 14 mg/dL) and IGTAFG (173 12) than in IFG (132 +/- 7) or NFG/NGT (122 +/- 2). In conclusion, 1) whole body insulin sensitivity is decreased in IFG and IGT, with a greater reduction in IGT, 2) hepatic insulin resistance and preserved beta-cell function are characteristics of IFG, and 3) higher BP and triglyceride levels are observed in IGT. IGT is more closely associated with risk factors for cardiovascular disease than is IFG. (Hypertens Res 2008; 31: 1357-1363)

DOI PubMed

Incidence of Hypertension in Individuals with Abdominal Obesity in a Rural Japanese Population: The Tanno and Sobetsu Study

Hirofumi Ohnishi, Shigeyuki Saitoh, Hiroshi Akasaka, Kaneto Mitsumata, Mizue Chiba, Makoto Furugen, Tetsuaki Furukawa, Mitsuru Mori, Kazuaki Shimamoto

HYPERTENSION RESEARCH ( JAPANESE SOC HYPERTENSION CENT ACADEMIC SOC, PUBL OFFICE ) 31 ( 7 ) 1385 - 1390 2008年07月 [査読有り]

Although abdominal obesity (AO) assessed by waist circumference (WC) is an important component of the metabolic syndrome (MetS), the usefulness of AO as a predictor of hypertension (HT) is not known. In this study, we investigated the incidence of HT in residents of two rural communities in Japan. The subjects were 187 men and 209 women selected from 712 residents who had undergone medical examinations in the towns of Tanno and Sobetsu, Hokkaido, in 1994 and 2002. Participants with HT in 1994 were excluded. Participants with AO were determined according to the WC criteria in the Japanese definition of MetS ( 85 cm for men, >= 90 cm for women). The participants were divided into two groups: a non-AO group and an AO group. We compared the incidence of HT between the two groups and found a significantly higher incidence in the AO group. The results of logistic regression analysis showed that the relative risk of developing HT in individuals with AO was 2.33 (p=0.017; 95% confidence interval [CI], 1.17-4.63) and that the risk per 1-cm increase in WC from 1994 to 2002 was 1.06 (p=0.003; 95% Cl, 1.02-1.10), both adjusted for several confounding factors. The results of this study suggest that, to prevent HT in Japanese, it is important to manage abdominal obesity and to monitor WC in individuals with or without abdominal obesity. (Hypertens Res 2008; 31: 1385-1390)

DOI PubMed

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