Hidekatsu Takahashi

Cross-cultural validation of the Beck Depression Inventory-II in Japan.

The Beck Depression Inventory has undergone substantial revision recently as the BDI-II to correspond to DSM-IV criteria. We developed the Japanese version of the BDI-II and examined its psychometric properties. The linguistic equivalence was verified by a back-translation method. The final translation was administered to the visitors at a public health care center, and the responses of 766 adults (age = 24-82 years, women = 40%) were analyzed. Half of the participants completed the Center for Epidemiologic Studies Depression Scale (CES-D) as well. A high level of internal consistency reliability (Cronbachs alpha = 0.87) and item homogeneity was confirmed. Exploratory factor analysis showed a two-factor structure (cognitive and somatic-affective), which was almost identical to the original model demonstrated by Beck et al. (1996, Manual for the Beck Depression Inventor Psychological Corporation, San Antonio, TX, USA). The following confirmatory factor analysis also supported the two-factor structure. Adequate correlation (r = 0.69, P < 0.001) between the total score of the BDI-II and that of the CES-D was observed. A higher score for women compared to men, without significant age differences, was consistent with the results of previous reports. We conclude that the Japanese version of the BDI-II is psychometrically robust and can be used to assess depressive symptoms in Japanese people.

Increases in body mass index, even within non‐obese levels, raise the risk for Type 2 diabetes mellitus: a follow‐up study in a Japanese population

Aims  Obesity, the strongest risk factor for Type 2 diabetes mellitus, is less prevalent in Japanese than in other populations. We investigated the effects of body mass index (BMI, kg/m2) on the incidence of diabetes mellitus in a Japanese population.

Cigarette Smoking Weakens Exercise Habits in Healthy Men

To investigate the longitudinal impact of smoking cessation and relapse on the exercise habits of apparently healthy Japanese men, 750 subjects presenting for a checkup at a metropolitan health center were surveyed annually for 7 years. Exercise was dichotomously classified as none or any. Subjects were grouped in two categories: 98 smokers who ceased smoking during the second year of the study, matched with 196 continuing smokers and 196 men who had never smoked; and 52 relapsed smokers (including 2 new smokers) who did not smoke at baseline or at Year 1 but smoked from Year 2 to final follow-up, matched with 104 continuing smokers and 104 never-smokers. Based on self-reported responses to questionnaires, exercise was consistently less prevalent among smokers who did not quit than among never-smokers throughout the study. Habitual exercise in subjects who had quit smoking increased during the follow-up (any exercise: 42.9% at baseline increased to 51% at final follow-up, p for longitudinal trend = .115). Habitual exercise in matched never-smokers did not change during the study and decreased significantly among persistent smokers (p = .025). Habitual exercise in relapsed smokers decreased during the follow-up (any exercise: 50.0% at baseline declined to 32.7% at final follow-up, p = .007), but habitual exercise in matched persistent smokers and never-smokers did not change. We conclude that smoking and sedentary lifestyle coexist continuously, that smoking cessation is associated with increased habitual exercise among healthy men, and that relapse is associated with reduced habitual exercise, suggesting that cigarette smoking weakens exercise habits.

Body mass index (weight/height2) or percentage body fat by bioelectrical impedance analysis: which variable better reflects serum lipid profile?

We present population data on percentage body fat (%BF) by bioelectrical impedance analysis (BIA) in 12 287 men and 6657 women aged 30–69 y. In addition, we examined relationships among BMI, %BF and serum lipids (total-cholesterol (TC), HDL-cholesterol (HDLC), TC/HDLC ratio, LDL-cholesterol (LDLC) and triglycerides (TG)) in order to determine whether body mass index (BMI, kg/m2) or %BF by BIA better reflected lipid metabolism. Women had larger %BF than men in all age groups. On the other hand, women aged <60 y had smaller BMI than corresponding men. Regardless of age, BMI was obviously correlated with %BF (r = 0.743–0.924). As previously reported, high BMI and high %BF were strongly associated with high serum TC/HDLC ratio and TG, and low serum HDLC rather than high serum TC and LDLC. Compared with BMI, %BF by BIA was better correlated with the serum indices except for serum HDLC. These results were found in both sexes, and there was a trend in which younger subjects had stronger correlations among BMI, %BF and serum lipids. Consequently, %BF by BIA (an index of body composition) better reflects serum lipid profile than BMI.

Kidney Stone Formation is Positively Associated with Conventional Risk Factors for Coronary Heart Disease in Japanese Men

PURPOSE We investigated the association between kidney stones and coronary heart disease risk factors in Japanese men. MATERIALS AND METHODS This cross-sectional study included 13,418 Japanese men 30 to 69 years old who voluntarily underwent medical examination between April 1995 and March 2001. Participants were divided into controls, and past and current kidney stone formers based on ultrasound results and medical history. We evaluated conventional risk factors of coronary heart disease, including overweight/obesity, hypertension, diabetes mellitus, gout/hyperuricemia, dyslipidemia and chronic kidney disease. Associations between coronary heart disease risk factors and kidney stones were investigated. RESULTS Of the 13,418 participants 404 current kidney stone formers (3.0%) had kidney stones on ultrasound and 1,231 past kidney stone formers (9.2%) had a history of kidney stones but no kidney stones on medical examination. Body mass index, systolic and diastolic blood pressure, and serum uric acid were significantly higher in past and current kidney stone formers than in controls. Logistic regression analysis indicated that the multivariate adjusted OR for overweight/obesity, hypertension, gout/hyperuricemia and chronic kidney disease significantly increased in the order corresponding to controls, and past and current kidney stone formers. CONCLUSIONS Kidney stone formers, even past stone formers, are likely to have accumulated risk factors for coronary heart disease. They could be preferentially targeted for coronary heart disease prevention.

Dose–Response Relationships Between Drinking and Serum Tests in Japanese Men Aged 40–59 Years

Alcohol intake per Japanese adult has been increasing year by year. To show biological effects of drinking, the dose-response relationships between alcohol use and serum indices were analyzed in 5919 Japanese men aged 40-59 years. The subjects were classified into nine groups: a nondrinking (ND, n = 1827) group and eight drinking (1D-8D) groups, by self-reported drinking habit. The 1D (the lightest drinking, n = 699), 5D (n = 942), and 8D (the heaviest drinking, n = 46) groups consumed alcohol less than 30 g per week, 25-30 g alcohol per day, and 100 g alcohol per day or more, respectively. Ten serum indices, total cholesterol, HDL cholesterol, triglyceride, total/HDL cholesterol ratio, LDL cholesterol, gamma-glutamyl transpeptidase, aspartate aminotransferase, alanine aminotransferase, glucose, and uric acid, were used. The dose-response analysis was statistically controlled for age, body mass index, smoking, and habitual exercise, and showed that drinking, even a small amount of alcohol, always had both beneficial and adverse effects on humans. However, alcohol less than 30 g per day may be tolerable for middle-aged Japanese men, because it improved serum lipids profile but did not induce apparent liver cell damage, hyperglycemia, or hyperuricemia.

A Chronological Decrease in Type A Behavior Patterns among Japanese Male Workers in 1995-1999

A Chronological Decrease in Type A Behavior Patterns among Japanese Male Workers in 1995–1999: Masayo Kojima, et al. Department of Health Promotion and Preventive Medicine, Nagoya City University Graduate School of Medical Sciences—We examined the chronological change in Type A behavior pattern (TABP) among Japanese male workers for 5 yr. A brief questionnaire to measure TABP was administered to 21,711 male workers who underwent health check‐ups at least once during the period from 1995 to 1999 and were born in 1936–1965. The mean TABP scores decreased year by year linearly. Then the repeated measurement analysis of variance was performed with the data of 5,689 subjects who completed the questionnaire successively through the study period. Both year and the age effects were highly significant (p<0.001, respectively), whereas the time trends were comparable by baseline age. In conclusion, TABP among Japanese male workers decreased in all generations during the period from 1995 to 1999.