Eri Eguchi

Healthy lifestyle behaviours and cardiovascular mortality among Japanese men and women: the Japan collaborative cohort study

AIMS To examine the combined impacts of healthy lifestyle behaviours on cardiovascular disease (CVD) in Asians. METHODS AND RESULTS A total of 18 747 men and 24 263 women aged 40-79 without a history of stroke or coronary heart disease (CHD) at baseline in 1988-90 were followed up until 2006. Participants scored one point for each following lifestyle behaviour: consumption of fruits ≥1 intake per day, fish ≥1 intake per day, milk almost every day, exercise ≥5 h per week and/or walking ≥1 h per day, body mass index (BMI) of 21-25 kg/m(2), alcohol intake <46.0 g per day, non-smoking, and sleep duration of 5.5-7.5 h per day. During 16.5 years of follow-up, there were 1907 deaths from total CVDs including 849 strokes and 402 CHDs. For both genders, persons with the highest scores had the lowest CVD mortality. The multivariable hazard ratios (95% confidence interval, population-attributable fraction) for the highest (7-8) vs. lowest (0-2) score categories were 0.35 (0.25-0.49, 52.3%) in men, and 0.24 (0.16-0.36, 44.6%) in women. Similar associations were found for stroke: 0.36 (0.22-0.58, 45.0%) in men and 0.28 (0.15-0.53, 43.4%) in women, and for CHD: 0.19 (0.08-0.50, 76.2%) and 0.20 (0.09-0.47, 34.5%), respectively. CONCLUSION Mortality from stroke, CHD, and CVD in the highest healthy lifestyle score category was one-third in men and one-fourth in women of those in the lowest scores, suggesting that a large fraction of CVD could be prevented through lifestyle modification.

Sleep-related intermittent hypoxemia and glucose intolerance: a community-based study.

BACKGROUND Intermittent hypoxemia is a fundamental pathophysiological consequence of sleep-disordered breathing and may alter glucose metabolism. To characterize the association between sleep-related intermittent hypoxemia and glucose metabolism, overnight pulse-oximetry and an oral glucose tolerance test were completed in a cohort of middle-aged and older Japanese adults. METHODS The study sample consisted of 1836 community-dwelling Japanese (age, 30-79 years; women, 65.5%; mean body mass index, 23.1 kg/m(2)). The oxygen desaturation index (ODI) was quantified during sleep using a ≥3% oxygen desaturation threshold and categorized as normal (<5.0 events/h), mild (5.0-15.0 events/h), and moderate to severe (≥15.0 events/h). The independent associations between the ODI and the prevalence of impaired fasting glucose, impaired glucose tolerance, diabetes, and two metrics of insulin resistance [homeostasis model assessment index for insulin resistance (HOMA-IR) and Matsuda index] were examined. RESULTS Compared with subjects with an ODI < 5 events/h, the adjusted odds ratio for prevalent impaired fasting glucose, glucose intolerance, and diabetes for subjects with an ODI ≥15.0 events/h were 1.27 (95% confidence interval, 0.72-2.23), 1.69 (1.03-2.76), and 1.28 (0.59-2.79), respectively. Both HOMA-IR and Matsuda index were significantly associated with the severity of sleep-related intermittent hypoxemia as assessed by the ODI (P for trend = 0.03 and 0.007, respectively). CONCLUSION Among middle-aged and older Japanese adults, sleep-related intermittent hypoxemia is associated with glucose intolerance and insulin resistance, and may contribute to the development of type 2 diabetes mellitus.

Heart Rate Variability, Insulin Resistance, and Insulin Sensitivity in Japanese Adults: The Toon Health Study

Background Although impaired cardiac autonomic function is associated with an increased risk of type 2 diabetes in Caucasians, evidence in Asian populations with a lower body mass index is limited. Methods Between 2009–2012, the Toon Health Study recruited 1899 individuals aged 30–79 years who were not taking medication for diabetes. A 75-g oral glucose tolerance test was used to diagnose type 2 diabetes, and fasting and 2-h-postload glucose and insulin concentrations were measured. We assessed the homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutt’s insulin sensitivity index (ISI). Pulse was recorded for 5 min, and time-domain heart rate variability (HRV) indices were calculated: the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive difference (RMSSD). Power spectral analysis provided frequency domain measures of HRV: high frequency (HF) power, low frequency (LF) power, and the LF:HF ratio. Results Multivariate-adjusted logistic regression models showed decreased SDNN, RMSSD, and HF, and increased LF:HF ratio were associated significantly with increased HOMA-IR and decreased ISI. When stratified by overweight status, the association of RMSSD, HF, and LF:HF ratio with decreased ISI was also apparent in non-overweight individuals. The interaction between LF:HF ratio and decreased ISI in overweight individuals was significant, with the odds ratio for decreased ISI in the highest quartile of LF:HF ratio in non-overweight individuals being 2.09 (95% confidence interval, 1.41–3.10). Conclusions Reduced HRV was associated with insulin resistance and lower insulin sensitivity. Decreased ISI was linked with parasympathetic dysfunction, primarily in non-overweight individuals.

C-Reactive Protein and Cardiovascular Disease in East Asians: A Systematic Review

Elevated C-reactive protein (CRP) levels are associated with an increased risk of cardiovascular disease (CVD) in Caucasians; however, evidence is lacking for East Asians, who have low CRP levels. PubMed and Google Scholar searches were conducted (1966 through September 2014), and eight prospective studies in East Asian countries (China, Hong Kong, Japan, Korea, Macao, Mongolia, and Taiwan) that documented risk ratios of elevated CRP for CVD were included for meta-analysis with random-effects models. The overall association between CRP levels and stroke was significant in six studies (risk ratio = 1.40 [95% confidence interval {CI}, 1.10-1.77], P = 0.008). The association with ischemic stroke was more evident in subgroup analyses. For coronary heart disease (CHD) and CVD, the risk ratio was 1.75 (95% CI, 0.96-3.19, P = 0.07) and 1.76 (95% CI, 1.29-2.40, P < 0.001), respectively. Although East Asians have low CRP levels, this meta-analysis shows that elevated CRP levels were significantly associated with an increased risk of stroke, primarily ischemic stroke.

Parental History and Lifestyle Behaviors in Relation to Mortality From Stroke Among Japanese Men and Women: The Japan Collaborative Cohort Study

Background We assessed the impact of parental history of stroke on stroke mortality, as well as the effect modification between lifestyle and stroke mortality, among Japanese. Methods In this community-based, prospective cohort study, 22 763 men and 30 928 women aged 40 to 79 years with no history of cardiovascular disease or cancer at baseline (1988–1990) were followed through 2008. We examined the association between parental history of stroke and stroke mortality and estimated the impact of the combination of lifestyle and parental history on stroke mortality in offspring. Results During a mean follow-up period of 15.9 years, there were 1502 stroke deaths. In both sexes, participants with a parental history of stroke had a higher risk of stroke mortality as compared with those without such a history. The respective multivariable hazard ratio (95% CI) and population attributable fraction were 1.28 (1.10–1.49) and 5.4% in men, 1.22 (1.04–1.43) and 4.3% in women, and 1.25 (1.12–1.40) and 4.8% in all participants, for offspring with a maternal and/or paternal history of stroke. There was an inverse association between healthy-lifestyle score and stroke mortality, irrespective of parental history of stroke. The overall multivariable hazard ratio for the highest (6–8) versus the lowest (0–3) score categories was 0.56 (95% CI, 0.43–0.72) for participants with a maternal and/or paternal history of stroke and 0.44 (0.36–0.53) for those without such a history. Conclusions Parental history of stroke was associated with stroke mortality in offspring. The inverse association between healthy lifestyle behaviors and stroke mortality, regardless of parental history, suggests that lifestyle modification is beneficial, even among individuals with a parental history of stroke.

The Effects of Aroma Foot Massage on Blood Pressure and Anxiety in Japanese Community-Dwelling Men and Women : A Crossover Randomized Controlled Trial

Objectives The aim of this study was to investigate the effects of aroma foot massage on blood pressure, anxiety, and health-related quality of life (QOL) in Japanese community-dwelling men and women using a crossover randomized controlled trial. Methods Fifty-seven eligible participants (5 men and 52 women) aged 27 to 72 were randomly divided into 2 intervention groups (group A: n = 29; group B: n = 28) to participate in aroma foot massages 12 times during the 4-week intervention period. Systolic and diastolic blood pressure (SBP and DBP, respectively), heart rate, state anxiety, and health-related QOL were measured at the baseline, 4-week follow-up, and 8-week follow-up. The effects of the aroma foot massage intervention on these factors and the proportion of participants with anxiety were analyzed using a linear mixed-effect model for a crossover design adjusted for participant and period effects. Furthermore, the relationship between the changes in SBP and state anxiety among participants with relieved anxiety was assessed using a linear regression model. Results Aroma foot massage significantly decreased the mean SBP (p = 0.02), DBP (p = 0.006), and state anxiety (p = 0.003) as well as the proportion of participants with anxiety (p = 0.003). Although it was not statistically significant (p = 0.088), aroma foot massage also increased the score of mental health-related QOL. The change in SBP had a significant and positive correlation with the change in state anxiety (p = 0.01) among participants with relieved anxiety. Conclusion The self-administered aroma foot massage intervention significantly decreased the mean SBP and DBP as well as the state anxiety score, and tended to increase the mental health-related QOL scores. The results suggest that aroma foot massage may be an easy and effective way to improve mental health and blood pressure. Trial Registration University Hospital Medical Information Network 000014260

Associations of serum β-carotene and retinol concentrations with insulin resistance: The Toon Health Study

OBJECTIVE Although green and yellow vegetables have beneficial effects against type 2 diabetes, the relationship of their nutritive content with insulin resistance is poorly understood. The aim of this study was to examine the associations of serum β-carotene and retinol concentrations with glucose and insulin concentrations. METHODS We recruited 951 Japanese men and women ages 30 to 79 y who were not undergoing treatment for diabetes and measured their serum β-carotene and retinol concentrations. A 75-g oral glucose tolerance test was performed and the homeostasis model assessment for insulin resistance (HOMA-IR) and the Matsuda Index were calculated as measures of insulin resistance. Several confounding factors were adjusted for with multivariable logistic models. RESULTS Multivariable-adjusted odds ratios of the highest quartile of serum β-carotene compared with the lowest quartile for HOMA-IR >1.6 and Matsuda Index <4.9 were 0.56 (95% confidence interval, 0.34-0.94) and 0.62 (0.37-1.02), respectively. When stratified by sex and overweight status, these associations were observed for women and non-overweight individuals. Serum retinol concentration was not associated with either index. Furthermore, according to the nutritional survey, serum β-carotene concentration was associated with green and yellow vegetable intake (P = 0.01). CONCLUSION Our findings suggest that higher serum β-carotene levels, associated with higher intake of green and yellow vegetables, confer beneficial effects against insulin resistance.

PM2.5-induced airway inflammation and hyperresponsiveness in NC/Nga mice

The allergic inflammatory effects of particulate matter (PM) 2.5, collected with the cyclone system in Yokohama city in Japan, were investigated in NC/Nga mice, which are hypersensitive to mite allergens. PM2.5 with alum was injected intraperitoneally for sensitization. Five days later, 200 μg of PM2.5 in 25 μL of saline was administered to mice intranasally five times for further sensitization. On the 11th day, PM2.5 was administered as a challenge. On the 12th day, mice were examined for airway hyperresponsiveness (AHR), the bronchoalveolar lavage fluid (BALF) cell count, mRNA expression of Th1, Th2 cytokines, and metallothioneins in lung tissue, and histopathology. PM2.5 increased AHR, total cell numbers including eosinophils in BALF, and mRNA levels of IL‐5, IL‐22, eotaxin, eotaxin 2, and metallothionein 3. In PM2.5‐induced lungs, inflammation was observed around the bronchus. These results demonstrate that PM2.5 alone, collected with the cyclone system in Yokohama city in Japan, induces asthma‐like airway inflammation.

Impact of heart rate variability on C-reactive protein concentrations in Japanese adult nonsmokers: The Toon Health Study

OBJECTIVE Lower heart rate variability (HRV) is associated with the inflammation that is linked with the progression of atherosclerosis. We examined this association, taking insulin sensitivity into consideration, as it is related to both HRV and inflammation. METHODS Subjects were 1728 individuals ages 30-79 years who did not smoke between 2009 and 2012. C-reactive protein (CRP) concentrations and white blood cell (WBC) counts were assessed as markers of inflammation. The homeostasis model assessment index for insulin resistance (HOMA-IR) and Gutts insulin sensitivity index (ISI) were calculated based on fasting and 2h-post-load glucose and insulin concentrations in a 75-g oral glucose tolerance test. Pulse was recorded for 5 min, and time-domain HRV indices of standard deviation of NN intervals (SDNN) and root mean square of successive differences (RMSSD) were calculated. Power spectral analysis provided frequency domain measures of HRV: high frequency (HF) power, low frequency (LF) power and LF/HF. RESULTS Sex and age-adjusted logistic models presented quartiles of SDNN, RMSSD, LF, and HF significantly associated with the highest quartile of CRP or WBC. After adjustment for body mass index and ISI, the associations were attenuated for WBC; however, even after further adjustment for several variables, SDNN, RMSSD, LF, and HF remained significantly associated with elevated CRP concentrations. When results were stratified by weight, the associations appeared more evident among non-overweight individuals. CONCLUSION Lowered HRV, primarily due to parasympathetic dysfunction, was associated with elevated inflammation, independent of weight, insulin sensitivity, and other related factors.

The impact of masticatory ability as evaluated by salivary flow rates on obesity in japanese: The Toon health study

This study examined the associations of masticatory ability evaluated by chewing‐gum‐stimulated salivary flow rate with anthropometric indices among a general Japanese population.